New Treatment for ‘Sleeping Beauty’ Syndrome?

Most of us have experienced it: that dull, dragging semi-conscious state of deadened awareness and desperate urge to nap that comes from sleep deprivation. For people with primary hypersomnia, however, this is the way they go through life, constantly feeling only half-awake but never able to get enough good sleep to arise truly refreshed. Also known as “Sleeping Beauty Syndrome,” the condition leaves those with the worst cases languishing in bed in what seems like the opposite of a fairy tale, without a prince’s kiss to cure them.

But a new study, published in Science Translational Medicine, suggests both a possible cause and a potential treatment for the condition, which may ultimately lead to treatments for other sleep disorders. The origin of primary hypersomnia, which has some genetic components is still unknown, as is the number of people who are affected by it.

One particularly striking form of the disease, Kleine-Levin syndrome, produces such tiredness and sleep-drunkenness that people are unable to attend school or work. In males, it can include hypersexual behavior, compulsive masturbation, a desire for promiscuous sex or making inappropriate sexual advances, all while in a sleepy, semi-conscious state.

In the latest study, researchers led by David Rye of Emory University in Atlanta studied 10 men and 22 women seeking treatment for primary hypersomnia. In the patients’ spinal fluid, the scientists discovered a previously uncharacterized chemical that stimulates the GABA-A receptor. This receptor is best known as the site where sleep-inducing drugs like Valium and Xanax have their effects, since activating GABA-A receptors can result in drowsiness.

The finding suggested a possible treatment. A drug, known as flumanezil can treat Valium and Xanax overdoses or to reverse the effects of related compounds used in anesthesia. Could it block or reverse the effects of the unknown agent that was activating GABA-A receptors in primary hypersomnia?

The authors conducted a brief placebo controlled trial with seven patients—including one with Kleine-Levin symptoms — to find out. Indeed, injections of flumanezil improved the participants’ ability to pay attention and remain alert. One participant has now taken the drug daily for four years. “Although her nightly sleep duration remained at 9 to 10 hours, she nearly always awakened refreshed without an alarm and daytime sleepiness was markedly reduced,” the researchers write.

What makes us intelligent?

… and does Google and Wikipedia make it better or worse? Studies show that other people and tools influence our brain power as much as our own minds.

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Research shows that people don’t tend to rely on their memories for things they can easily access. Things like the world in front of our eyes, for example, can be changed quite radically without people noticing. Experiments have shown that buildings can somehow disappear from pictures we’re looking at, or the people we’re talking to can be switched with someone else, and often we won’t notice – a phenomenon called “change blindness”. This isn’t as an example of human stupidity – far from it, in fact – this is an example of mental efficiency. The mind relies on the world as a better record than memory, and usually that’s a good assumption.

As a result, philosophers have suggested that the mind is designed to spread itself out over the environment. So much so that, they suggest, the thinking is really happening in the environment as much as it is happening in our brains. The philosopher Andy Clark called humans “natural born cyborgs”, beings with minds that naturally incorporate new tools, ideas and abilities. From Clark’s perspective, the route to a solution is not the issue – having the right tools really does mean you know the answers, just as much as already knowing the answer.

Hippocampal Pyramidal Neurons Comprise Two Distinct Cell Types that Are Countermodulated by Metabotropic Receptors

Relating the function of neuronal cell types to information processing and behavior is a central goal of neuroscience. In the hippocampus, pyramidal cells in CA1 and the subiculum process sensory and motor cues to form a cognitive map encoding spatial, contextual, and emotional information, which they transmit throughout the brain. Do these cells constitute a single class or are there multiple cell types with specialized functions? Using unbiased cluster analysis, we show that there are two morphologically and electrophysiologically distinct principal cell types that carry hippocampal output. We show further that these two cell types are inversely modulated by the synergistic action of glutamate and acetylcholine acting on metabotropic receptors that are central to hippocampal function. Combined with prior connectivity studies, our results support a model of hippocampal processing in which the two pyramidal cell types are predominantly segregated into two parallel pathways that process distinct modalities of information.

Capturing living cells in micro pyramids

A field full of pyramids, but on a micro scale. Each of the pyramids hides a living cell. Thanks to 3D micro- and nano scale fabrication, promising new applications can be found. One of them is applying the micro pyramids for cell research: thanks to the open ‘walls’ of the pyramids, the cells interact. Scientists of the research institutes MESA+ and MIRA of the University of Twente in The Netherlands present this new technology and first applications in Small journal of the beginning of December.

Most of the cell studies take place in 2D: this is not a natural situation, because cells organize themselves in another way than in the human body. If you give the cells room to move in three dimensions, the natural situation is approached in a better way while capturing them in an array. This is possible in the ‘open pyramids’ fabricated in the NanoLab of the MESA+ Institute for Nanotechnology of the University of Twente.

Tiny corner remains filled

The cleanroom technology applied for this, has been discovered by coincidence and is now called ‘corner lithography’. If you join a number of flat silicon surface in a sharp corner, it is possible to deposit another material on them. After having removed the material, however, a small amount of material remains in the corner. This tiny tip can be used for an Atomic Force Microscope, or, in this case, for forming a micro pyramid.

Catching cells

In cooperation with UT’s MIRA Institute for Biomedical Technology and Technical Medicine, the nanoscientists have explored the possibilities of applying the pyramids as ‘cages’ for cells. First experiments with polystyrene balls worked out well. The next experiments involved capturing chondrocytes, cells forming cartilage. Moved by capillary fluid flow, these cells automatically ‘fall’ into the pyramid through a hole at the bottom. Soon after they settle in their 3D cage, cells begin to interact with cells in adjacent pyramids. Changes in the phenotype of the cell can now be studied in a better way than in the usual 2D situation. It is therefore a promising tool to be used in for example tissue regeneration research.

The Dutch scientists expect to develop extensions tot this technology: the edges of the pyramid can be made hollow and function as fluid channels. Between the pyramids, it is also possible to create nanofluidic channels, for example used to feed the cells.

The man whose brain ignores one half of his world

Alan Burgess doesn’t need a rhyme to remember the 5th of November. He’ll never forget the day he had his stroke. It left him with a syndrome known as hemispatial neglect and a strange new perspective.

I asked him how he explains this to other people. “I say it’s two different worlds,” says Burgess. “My old world finished on 5 November 2007 and the new world started the same day.”

His stroke damaged the parietal lobe on the right side of his brain, the part that deals with the higher processing of attention. The damage causes him to ignore people, sounds, and objects on his left.

"Hemispatial neglect typically occurs after a stroke," says Dr Paresh Malhotra, senior lecturer in neurology at Imperial College London. "It is not blindness in one eye, and it’s not damage to the primary sensory cortex, it’s a process of ignoring, for want of a better word, one side of space."

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(Image credit: zeably.com)

Scientists report a potential new treatment to prevent strokes

Scientists may have discovered a new way to prevent strokes in high risk patients, according to research from the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW).

Work by a new research group, led by Professor Donald Singer, Professor of Therapeutics at Warwick Medical School and Professor Chris Imray from UHCW, has now been published in US journal Stroke.

The group is using ultrasound scanning to look at patients with carotid artery disease, one of the major causes of stroke. Clots can form on diseased carotid arteries in the neck. Small parts of these clots can released to form microemboli, which can travel to block key brain arteries and lead to weakness, disturbed speech, loss of vision and other serious stroke syndromes. Standard anti-platelet drugs such as aspirin may not prevent the formation of harmful microemboli.

The scanning process can be used to find patients at very high risk of stroke because microemboli have formed despite prior anti-platelet drugs. Using scanning, the team has found that tirofiban, another anti-platelet drug designed to inhibit the formation of blood clots, can suppress microemboli where previous treatment such as aspirin has been ineffective. In their study, tirofiban was more effective than other ‘rescue’ treatment.

Professor Singer said: “These findings show that the choice of rescue medicine is very important when carotid patients develop microemboli despite previous treatment with powerful anti-platelet drugs such as aspirin. We now need to go on to further studies of anti-microemboli rescue treatments, to aim for the right balance between protection and risk for our patients.”

Professor Imray said: “These findings show the importance of ultrasound testing for micro-emboli in carotid disease patients. These biomarkers of high stroke risk cannot be predicted just from assessing the severity of risk factors such as smoking history, cholesterol and blood pressure.”

Why older people struggle to read fine print

Psychologists from the University of Leicester have carried out unique eye tests to examine reading styles in young and old people – and discovered for the first time that the way we read words changes as we grow older.

The team from the School of Psychology used an innovative method of digitally manipulating text combined with precise measures of readers’ eye movements. This provides novel insights into how young and older adults use different visual cues during reading.

Their results have been published in the journal Psychology and Aging.

The researchers conducted experiments that used very precise measures of readers’ eye movements to assess how well they read lines of text that had been digitally manipulated to enhance the salience of different visual information. For instance, sometimes the text was blurred and other times the features of the individual letters were sharply defined.

The results showed that whereas young adults (18-30 years) found it easiest to read lines of text when the fine visual detail was present, this was more difficult for older adults (65+years), who found it easier to read more blurred text. These findings support the view that older adults use a different reading strategy from younger adults and that they rely more than young adults on holistic cues to the identities of words, such as word shape.

The research makes an important contribution to understanding why older people have difficulty in reading. The findings will promote further work to more fully understand this difficulty and already points to ways in which it can be combatted.

Smart specs may replace guide dogs

Smart specs for the blind that could take the place of white canes and guide dogs may be available in two years, researchers have said.

The hi-tech glasses are designed to prevent “legally blind” individuals with a small degree of residual vision from bumping into objects.

They use tiny stereo cameras in the frames to project simplified images onto the lenses which become brighter the closer an object is.

From January next year the glasses will be tested in a series of trials involving 160 people with severely impaired sight in Oxford and London. Developer Dr Stephen Hicks, from Oxford University, said he hoped a finished model will be commercially available in around two years.

The cost is expected to be around £600 - slightly more than a smart phone. In comparison, a guide dog costs up to £30,000 to train.

Dr Hicks said the spectacles were designed as a navigational aid, not to restore lost vision.

"The glasses work using a pair of cameras that determine the distance of objects and we simply translate that into a light display," he said. "This is not restoring sight, but we can improve spatial awareness."

Around 300,000 people in the UK are registered as legally blind. Of these, 90% possess some residual vision allowing them to detect blurry shapes and differences between light and dark.

"The aim is to increase the independence of the hundreds of thousands of people who are visually impaired in the UK," said Dr Hicks.

The research was funded through the National Institute for Health Research Invention for Innovation (i4i) programme.