Banging toward depression

Eddy donc by Éole Wind

by Luka Laden

From mysterious condition to hot-button medical issue, concussions have moved into the forefront of the conversation when sports and athletes are involved. Now that more and more young people are choosing to play football, basketball, and soccer, embracing the status of being a dedicated athlete, more and more young people are also at risk of sustaining a blow to the head and suffering from subsequent brain trauma, more commonly known as a concussion. While some of the symptoms usually associated with concussions, like dizziness, blurry vision, and nausea are well-known, the long-term impact of head trauma is the topic of many new studies, which attempt to clear up the true significance of brain trauma for young athletes. We know that migraines, ranging from mild and infrequent to severe and persistent, can result from head injuries, for obvious reasons, but are there more serious problems when a concussion is sustained?Compared to other injuries, such as a torn ankle ligament or sprained wrist, concussions are very unique in that the symptoms, as well as the duration of these symptoms, are so unpredictable and wide-ranging. Full recovery may take a few days, but it may also take several months. Some athletes never fully recover. We already know what’s common, but how bad can things get? Unfortunately, the indications aren’t very promising.

Several studies have shown that people who have sustained one or more concussions may experience greater difficulties involving emotion. Three studies in particular, documented by Jennie Ponsford, Rosemarie Scolaro Moser, and Robert J. Ferguson (among others), tracked symptom reports submitted by large groups of patients suffering from post-concussion syndrome (PCS), as well as reports of expected PCS symptoms submitted by non-injured participants in contact sports, who made up the control group. The specific focus of these studies was the emotional toll of brain injuries, as the injured subjects reported on their altered feelings and tendencies following their concussions. In fact, most of the injured subjects reported that they had noticed a negative effect on their respective personalities and emotional traits because of brain trauma, ranging from moodiness and irritability to sadness and a lack of enthusiasm. The symptom reports showed a common pessimism among the injured subjects, in terms of their changed emotional states of mind. As a result of these reports, emotional symptoms of irritability, moodiness, and depression were linked to head trauma among athletes (Moser, 2007). The subjects in these studies demonstrated that there appears to be a tangible connection between brain injuries and symptoms that resemble depression and emotional instability. If indeed true, these findings are far more worrisome than a minor headache or a little bit of lightheadedness. When sustaining a concussion, being at risk for some form of depression down the road must be an important consideration for an athlete deciding when and whether to return to the playing field or court. It has been found that, only three months after the injury, a concussed athlete tends to suffer from concurrent anxiety, depression, and posttraumatic stress, all of which may lead to prolonged depression (Ponsford, 2012). In the short run, concussions can carry severe emotional consequences and the threat of a snowballing downward spiral of persistent depression is rather ominous and scary. Even worse, the greater problem with concussions revolves around the fact that symptoms may linger for years, which means that PCS can result in heightened, sustained emotional distress that lasts for a decade, or maybe even longer (Ferguson, 1999). Emotional imbalance and instability may not go away after three months, for instance, which opens up the possibility of lifelong depression and connected emotional problems that never seem to subside. As these studies show us, it’s clearly not an understatement to say that sustaining a concussion can wreak havoc in the long run.

Concussions: Banging away at your brain

by Topher Toffoli

Rock Dennis tackles Taylor Wardlow by John McStravick

Injuries are becoming more prevalent in high contact sports as players move towards being bigger, stronger, and faster. In ice hockey as many as 66% of hockey players have experience a head injury known as a concussion, which is a mild to severe trauma to the brain caused by the soft brain tissue hitting the hard skull.  Injuries can cause serious long-term damage to the parts of the brain responsible for memory, judgment, social conduct, reflexes, speech, balance and co-ordination.  These parts, which are located in the frontal and parietal lobes, are hit against the brain and damaged by bleeding and bruising from contact with the hard cranium. Researchers at Albert Einstein college of Medicine used diffusion tensor imaging to find that damage from concussion can cause loss in higher level thinking from planning evens to personality change. They also found that 30% of people sustaining these injuries had long terms affects associated to memory and personality.

Although this problem is very serious since the diagnoses of a “Concussion” have become so main stream players are unaware of the consequences and thus return to play too soon. 40% of younger players and 30% of adult players could not recognize symptoms and believed that they could return to play after two days with mild headaches. Researchers have found that by being diagnosed as having a concussion instead of re-wording it as brain trauma can have drastic effects on the perception of the injury to the patients. Patients diagnosed with a concussion rather than brain trauma were more than twice as likely to return to school and athletics before doctors orders allowed them too. The simple familiarity of the word concussion is putting people at risk. This is due to the mere exposure effect, meaning that the more you are exposed to a stimulus, in this case a word, the more positively you will perceive that stimulus. Since people have heard and can associate concussions with others they know they do not take it as seriously as when the more specific term of brain trauma is used.

Also athletes wishing to return to sports in our win-driven sports world are willing, in their ignorance, to put there bodies in harms way for the “win at all cost” mentality. New rules in safety such as helmets and rules prohibiting fighting are steps that are being taken in hockey to prevent further injuries however players and parents must be educated so that they know, fully, the risk they are putting themselves in.

References

St. Michael’s Hospital (2009, June 1). Minor League Hockey Players Unable To Identify Concussion Symptoms, Study Says. ScienceDaily. Retrieved March 5, 2010, from http://www.sciencedaily.com­/releases/2009/05/090527121051.htm

McMaster University (2010, January 18). Concussions not taken seriously enough, researcher finds. ScienceDaily. Retrieved March 5, 2010, from http://www.sciencedaily.com­/releases/2010/01/100118001721.htm

Albert Einstein College of Medicine (2009, August 25). Strong Link Found Between Concussions And Brain Tissue Injury. ScienceDaily. Retrieved March 5, 2010, from http://www.sciencedaily.com­/releases/2009/08/090824115905.htm

Alzheimer’s, sleep and copper

by Robert Rooney and Jesse Greenberg*

Alzheimer's disease brain (note the enlarged ventricles, or holes in the middle)

Named after German physician Alois Alzheimer, Alzheimer’s disease is a terminal brain disorder that gets progressively worse over time.  Alzheimer’s deteriorates and destroys brain cells, causing detrimental effects to memory, behavior and one’s thought process.  A main characteristic of Alzheimer’s is the extensive development of “plaques and tangles.”  Plaques are deposits of the protein beta-amyloid that accumulate in the spaces between nerve cells.  Tangles are deposits of the protein tau that accumulate inside of nerve cells.  Although most people develop some plaques and tangles over time, those diagnosed with Alzheimer’s tend to have a much larger build up of these proteins.  The plaques and tangles are thought to impede interaction between nerve cells and interrupt cell activities necessary for survival.

Scientists are still not sure what exactly causes Alzheimer’s, but current research and evidence point to a few key risk factors.  These factors include, but are not limited to, aging, heart disease, head injury, and genetic history.  While lack of sleep is not considered a risk factor, recent studies suggest it may play a role.

One study performed by members of the Department of Neurology at Washington University, St. Louis showed that plaque levels increased significantly in mice when they were deprived of sleep.  They also found a correlation between beta-amyloid levels and sleeplessness.  The research team also studied a group of male volunteers and found similar correlations.  They found increased levels of beta-amyloid during the time while the men were awake, with the highest peak level around the evening, but the protein levels decreased when the men slept.  Due to the similarities between the results of the mice and the men, the researchers concluded that optimization of sleep time could potentially reduce aggregation of the beta-amyloid protein and slow the progression of AD.

Meanwhile, copper has also been getting a lot of attention from Alzheimer’s researchers.  Over the past decade, the role of copper in Alzheimer’s disease has also been extensively explored, yet two conclusions are being drawn which only serve to cloud our understanding.  The continuing exploration of the interesting relationship between copper and Alzheimer’s disease will hopefully yield an important breakthrough in the near future.

What Broca didn’t know

By Laura Bowles

Pierre Paul Broca from Wickipedia Commons

For most people, language is taken for granted.  When they have a thought, they just speak their minds.  Little do they know that a specific area in the brain, called Broca’s area, plays a major part in speech production and language expression.

Broca’s area was first discovered by Pierre Paul Broca in 1861.  Broca encountered a man called “Tan” staying in a hospital in France.  “Tan” had lost the use of most of his speech, and could only speak one syllable: “tan.”  While he retained much of his intelligence, but could only express himself by moving his left hand after becoming paralyzed.  After his death, it was found that he had lesioning in his left frontal lobe, implying that this area is instrumental in speech and language processes.

Broca’s findings were later supported and expanded upon.  However, the nature of how Broca’s area functions remained a mystery.  A study conducted at the University of California, San Deigo, led by Dr. Ned Sahin, provided some potential and surprising answers.  By placing electrodes into the brains of patients, the Sahin and fellow researchers utilized a procedure known as ICE, or Intra-Cranial Electrophysiology.  The procedure was only used on patients undergoing neurosurgery for epilepsy.  The patients also had a history of having language and cognitive skills that can be classified as above average.  Sahin et al. were able to see how the brain processes grammar and produces words.  The subjects were required to change phrases from the present to past tense and nouns from the singular to plural form.  The results of the ICE indicated that different parts of Broca’s area handle different aspects of language, and that the production of speech is layered.  Certain pieces of Broca’s area overlap with others, and the timing of how they compute information is essential to the expression of language.  Ultimately, the researchers at UCSD found that Broca’s area is crucial in the calculation of grammar, pronunciation, and word identity;  furthering the theory that Broca’s area does not just deal with one function of language.

These findings have fueled even more curiosity about the true function of Broca’s area and its role in language and speech production.  So next time you are about to speak your mind, first appreciate how Broca’s area is helping you do something so complex.

References:

Sahin, Ned et al. (2009, October 15).  New Light on Nature of Broca’s Area: Rare Procedure Documents How Human Brain Computes Language. Science Daily. Retrieved October 15, 2009, from http://www.sciencedaily.com/releases/2009/10/091015141500.htm

Broca, Pierre Paul. (1861). Loss of Speech, Chronic Softening and Partial Destruction of the Anterior Left Lobe of the Brain. (Christopher D. Green Trans.).Bulletin de la Société Anthropologique, 2, 235-238.  Retrieved October 15, 2009.

Sahin, N. T. et al. (2009). Sequential processing of lexical, grammatical, and phonological information within broca’s area. Science, 326(5951), Retrieved December 2, 2009, from http://www.sciencemag.org/cgi/content/full/sci;326/5951/445?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=broca&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

Healing the brain through music

By  Jennifer Beckerman

Photo by foreversouls

Over the years, researchers have studied the various effects of music on human health, intelligence, and well-being, but more recently, researchers came to fascinating conclusions regarding music’s medicinal qualities.  Music’s various positive benefits reach diverse groups of people: adolescents involved with music perform better in school , music increases exercise endurance by up to 15%, music lowers stress levels, anxiety, and depression in pregnant women, and may be an inexpensive and enjoyable way to facilitate recovery in stroke patients -imagine that!

In order to fully comprehend music’s influence on stroke recovery, we must consider the mechanics.  A stroke occurs when blood supply to part of the brain is blocked, which prevents the admittance of oxygen and glucose.  Without oxygen, brain cells die.  This blockage results most commonly from the blockage of a small artery within the brain itself, but there are several other mechanisms for a stroke as well.  Some factors that lead to strokes and artery blockage include: high blood pressure, high cholesterol, diabetes, and smoking.    Strokes are unexpected and dangerous incidences that remain the third leading cause of death in the United States behind heart disease and cancer. A Harvard Imaging technique reveals increased brain activity when people play or listen to music because more blood and oxygen flow to the brain, healing brain damage.

Making memories fail

by Annie Black

Photo by eioua

We have all had experiences that we wish would just disappear from our memory. As it turns out, if a memory is detrimental to our mental health, our brain has the capacity to suppress it in order to minimize the anxiety it causes us. However, a recent study led by Dr. Nivedita Agarwal, a radiologist at the University of Udine in Italy, has found that the part of the brain responsible for suppressing memory is less functional in patients with stress- or anxiety-related psychiatric disorders than in patients without these disorders. As a result, these unpleasant memories that would have been suppressed continue to cause anxiety and inhibit the patient’s ability to function normally. Dr. Agarwal and his associates performed a study involving 39 subjects with stress-related disorders including major depression, generalized anxiety disorder, panic attack disorders, and personality disorders along with 21 healthy subjects that served as the control group. The subjects were given a list of neutral word pairs then, while being monitored by a functional MRI, were given a word and asked to recall or suppress its associated word. Agarwal noticed that when asked to suppress the memory, the patients with stress-related disorders had greater activity in the hippocampus, which points to limited activation of the prefrontal cortex, which is supposed to suppress and retrieve memories from the hippocampus.

If patients with stress-related disorders cannot suppress unpleasant memories on their own, perhaps they can be treated with something that will do it for them. Dr. Todd Sacktor and his colleagues Reut Shema and Yadin Dudai have published a study of a memory-sustaining enzyme called PKMzeta and its effects on rats. In this study, Sacktor conditioned one group of rats to associate a certain space with getting shocked and conditioned another group to avoid the taste of saccharin by pairing it with lithium. After both groups were successfully conditioned, he injected the rats with a PKMzeta-blocking drug and found that the conditioning was entirely forgotten. If this drug can be given to patients with stress-related disorders in order to block the memories that their brains have failed to suppress, perhaps their anxiety will be diminished or even eliminated.

References

Radiological Society of North America (2008). Stress-related Disorders Affect Brain’s     Processing Of Memory. Science Daily. Retrieved December 10, 2008 from     http://www.sciencedaily.com/releases/2008/12/081203084310.htm

National Institute of Mental Health (2007). Memory-sustaining Enzyme May Help Treat PTSD, Cognitive Decline. Retrieved December 10, 2008 from http://www.nimh.nih.gov/science-news/2007/memory-sustaining-enzyme-may-    help-treat-ptsd-cognitive-decline.shtml

The nose knows

By Nick Trotta

If you are in the terrifying position on having an epileptic seizure and after the whole ordeal your doctor asks you whether you wiped your nose and, if so, which nostril, how would you respond? As was explained in this article in Science Daily, strangely enough, it would not be uncommon. In temporal seizures, seizures affecting the temporal region of the brain, it is very important for a physician to know what side of the brain it is taking place in order to treat it.

Lets review shall we? Epilepsy is a condition where there are storms of electrical activity in the brain usually resulting in a seizure in severe cases. These storms are not, necessarily, localized either. Often they can spread out of their region of origin, in which case surgery may be required.

Anyway, back to the weird stuff. In this article, Christoph Baumgartner MD designed an experiment where researchers had to watch 440 (Yikes!) taped seizures to find that 97 percent of those that wiped their nose afterwards wiped the nostril of the side with the seizure.

Weird things these researchers notice, nothing can be taken for granted when trying to find hints of how to find warnings or hints to help patients.

Reference

American Academy Of Neurology (1998, October 20). Simple Gesture — Nose Wiping — Identifies Origin Of Epileptic Seizure. ScienceDaily. Retrieved March 13, 2008, from http://www.sciencedaily.com­ /releases/1998/10/981020073706.htm

Alternatives for cerebral palsy patients

by Alex Crocker

Would you rather ride in a wheelchair or ride a horse? Speak with a voice synthesizer, or make music? For many children with cerebral palsy, alternative therapies such as therapeutic riding and music therapy are providing alternatives to traditional medicine. Because cerebral palsy is caused by brain damage to the motor cortex before or shortly after birth, therapies that begin early in life can take advantage of the plasticity of the young brain to remap damaged areas and restore full mobility.

In Exeter, UK, Erzsebet Gordon teaches a therapeutic music class in which young cerebral palsy patients “use rhythm to strengthen their muscles.” Research shows that targeted exercises can enhance connections between neurons in the brain, which can lead to improved muscular control (Holloway, 2003). Patients undergoing music therapy are encouraged to complete the exercises needed for remapping in ways that are safer and more enjoyable than traditional therapies like drugs and surgery.

Similarly, therapeutic riding helps cerebral palsy patients regain sensory and motor skills, especially those used for walking. In a study published in the Pediatric Physical Therapy Journal, in which the mobility of 10 children with cerebral palsy was determined before and after 10 weeks of treatment, it was determined that therapeutic riding “has a positive effect on functional movement in children with cerebral palsy.”

According to Pia Tillberg, this improvement can be explained by the rhythmic motions of the horse at the walk and trot, which correspond to the “repeated movement [of the] human walking motion.” By stimulating the motor areas that control the muscles used for walking, therapeutic riding encourages neuron growth, in a sense “teaching” the brain—and thus the body—how to walk. Repetitive-movement based treatments like music therapy and therapeutic riding can help many patients build the strength and control that their muscles need for normal functioning.
While there is no “cure” for cerebral palsy, alternative therapies like music and therapeutic riding are providing hope for patients with cerebral palsy and other brain injuries.

Reference

Holloway, M. (2003). The Mutable Brain. Scientific American, 289 (3), 78-86.

Body Image and Eating Disorders

by Lynne Ciccaglione

For most first year college students, the issue of what and how much to eat is constantly presented throughout any given day. The adjustment to college life, classes, being away from home, (and the wonderful options of food at campus dining) all play key factors in the development of eating disorders such as binge-eating, anorexia, and bulimia. However, the research of Silja Vocks among many others reveals that the root of eating disorders results from an altered and grossly distorted body image.
According to the article Through a Glass, Darkly in Scientific American about .5 to 3.7 percent of women in the United States will develop anorexia nervosa and 1.1 to 4.2 percent develop bulimia nervosa. If these percents are applied to the Vassar class of 2011 that means that 2-15 women have or will face anorexia and 5-18 women have or will face bulimia. Another startling fact is that 5.6% of these women with anorexia will die within 10 years of their diagnosis. Again if applied to the freshman class here at Vassar that means that at least one person will lose their life to an eating disorder. Now you all know why research regarding body image and its relationship with eating disorders is so important in today’s society.

GIs coping with TBIs

by Danielle Unger

Like the gangrene epidemic of WWI and the influenza outbreak of WWII, the Iraqi war is beginning to show signs of its own military plague- traumatic brain injuries (TBIs). A TBI is defined broadly as a head injury where a sudden trauma is to blame. The majority of TBIs in young people are due to transportation accidents or violent activities. It is possible to sustain a mild, medium, or severe TBI, and the symptoms of a TBI are virtually limitless. However, some include headaches, dizziness, trouble sleeping, depression, irritability, and confusion. The staggering variety of symptoms, which are easily confused with symptoms of other disorders, make diagnosing a TBI very difficult. On top of this confusion, there are many types of TBI’s such as, concussions (the most common type), depressed skull fractures, penetrating skull fractures, and cerebral hematomas, all with their own laundry list of signs and symptoms.

TBI’s don’t just confuse doctors with their conflicting and common symptoms, they also manage to evade detection in most CAT scans.

“It’s the so-called invisible injury…. a complicated injury to the most complicated part of the body,” said Dr. Alisa Gean , a neurosurgeon at the University of California, San Francisco (quoted here).
In the context of the Iraq war, where soldiers see approximately one explosion per month, the failure of usual detection methods for TBI’s is worrisome. Soldiers with unnoticed TBI’s frequently get sent back into battle much earlier than they should, lowering their chances of ever recovering. For those lucky enough to receive treatment for their TBI, treatments vary. Because the scope of TBI’s are so wide, more often than not, doctors are forced to nothing more than treat preexisting symptoms. TBI patients often work with a therapist who leads them in certain exercises that are designed to help them retain important life skills like following directions while distracted and completely many complex tasks simultaneously.

One thing is for sure, the difficult effects of TBIs are aggravated by combat situations. For example, while being trained to be alert at all times might be beneficial to a healthy soldier, one who suffers from a TBI might become paranoid or confused because this fight or flight reflex is stimulated at all times. The high occurrence of TBIs is also a burden to the entire military system, and the general public who must pay for the treatment of TBI patients at places like Vanderbilt University’s brain injury rehab program

Sources:
1. Washington post article
2. CDC fact page
3. National Organization of Neurological Disorders and Stroke fact sheet