May 2003

Crossroads Institute and Clinic continue to grow. We have successfully opened a facility in Austin, Texas where Dr. Curtis Cripe conducts monthly evaluations for those who find it more convenient to go to Austin.

Having just returned from a second trip to the Russian Academy of Science Human Brain Development Center, Dr. Cripe has added the latest in protocols and equipment for fine-tuning brain mapping and evoked potentials. This additional analysis technique allows new depth and insight into the cortical interactions of brain processing. This will help Dr. Cripe pin-point to within 1/10th of a millimeter the organization or disorganization of the cortex by highlighting both anatomical structures as well as speed of transfer and delay of the synaptic junctures.

Meanwhile, Dr. Martha Grout has been named the current President of the Arizona Chapter of the American Academy of Medical Acupuncture. Additionally, she has recently been appointed by Governor Janet Napolitano to the Arizona Acupuncture Board of Examiners.

The end of April Dr. Grout gave a poster presentation at the Annual Symposium of the American Academy of Medical Acupuncture in Baltimore.

Dr. Grout will act as preceptor, teaching acupuncture to Physician at Arizona State University, May 17-18, sponsored by UCLA.

Dr. Curtis Cripe and Dr. Martha Grout have been invited by the American Holistic and Integrative Medical Association to lecture on " A New Paradigm for the Treatment of ADD/ADHD".

Everyone is somewhere on the Neurodevelopmental Spectrum. Where are you on it .... where do you want to be?

Accelerated neurodevelopment allows us the ability to
maximize and use our intellectual, physical, and emotional strengths simultaneously, no matter where we begin on the spectrum.
When accelerating brain power, daily tasks such as working, studying, and sports become easier to do and manage. The brain is functioning at optimal levels and is able to make quick attentional shifts on demand.
This is the state of mind that peak performers call "the zone" and is accessible at will.

Bone Marrow Generates New Neurons in Human Brains A new study strongly suggests that some cells from bone marrow can enter the human brain and generate new neurons and other types of brain cells. If researchers can find a way to control these cells and direct them to damaged areas of the brain, this finding may lead to new treatments for stroke, Parkinson's disease, and other neurological disorders. "This study shows that some kind of cell in bone marrow, most likely a stem cell, has the capacity to enter the brain and form neurons," says Eva Mezey, M.D., Ph.D., from the National Institute of Neurological Disorders and Stroke (NINDS), who led the study. Earlier work by Dr. Mezey and others has shown that bone marrow cells can enter the mouse brain and produce new neurons. However, the new study is the first to show that this phenomenon can occur in the human brain. The study was supported in part by the NINDS and appears in the January 20, 2003, online early edition of the Proceedings of the National Academy of Sciences.1 The NINDS is a component of the National Institutes of Health, which is part of the U.S. Department of Health and Human Services. In the study, Dr. Mezey and colleagues examined brain tissue taken at autopsy from four female patients - two adults and two children - who had received bone marrow transplants from male donors. The bone marrow transplants had been performed to treat leukemia and other non-neurological diseases, and the patients survived from 1 to 9 months after their transplants. The investigators searched the autopsied brain tissue for male cells, which contain a Y chromosome. The Y chromosomes in these cells served as a useful way of distinguishing donor-derived cells from those of the female transplant recipients. The researchers found cells with Y chromosomes in brain tissue from all four of the patients. Most of the bone marrow-derived cells in the brain tissue were glia (support cells) and other non-neuronal cells. However, a small number of neurons from each brain also contained Y chromosomes, showing that those cells had developed from the transplanted male bone marrow. Most of these neurons were found in the cerebral cortex - the outer layer of the brain, which is responsible for conscious thought - and in the hippocampus, a region that helps with memory and other functions. The Y chromosome-positive cells within each patient's brain appeared in clusters, rather than being randomly dispersed throughout the brain tissue. The clusters sometimes contained both neuronal and non-neuronal cells. This suggests that a single bone marrow-derived stem cell may migrate into an "area of need" within the brain and then change, or differentiate, into several other kinds of cells, Dr. Mezey says. The clusters also might result from a large number of marrow cells that are "called" to specific parts of the brain. Previous studies have suggested that stem cells can respond to signals from within the brain that guide them to damaged regions. The brain sections with the largest number of marrow-derived neurons came from the youngest of the four patients, who had her transplant at 9 months of age. That patient also survived for 9 months after the transplant - much longer than the other patients in this study. The researchers do not know if the number of marrow-derived neurons in this patient was due to her young age or to the length of time she survived after receiving the transplant. The brains of young people usually undergo more changes than those of older people, and this might have encouraged the development of new neurons, Dr. Mezey notes. However, it is also possible that new cells enter the brain at a steady rate over time, regardless of a person's age. It is possible that irradiation or other treatments that the four patients received might have increased the ability of marrow cells to enter the brain. However, other studies have suggested that bone marrow cells circulating in the blood enter the brain even in healthy subjects who have never received a bone marrow transplant, and there is no reason to think that a transplant is necessary for stem cells to enter the nervous system, Dr. Mezey says. The numbers of marrow-derived neurons identified in the human brain tissue were very low - much lower than the numbers identified in a previous mouse study, says Dr. Mezey. However, the numbers might be greater in patients who survive for longer periods after transplant, she suggests. Bone marrow contains at least two kinds of stem cells: hematopoietic stem cells, which usually differentiate into blood cells, and mesenchymal stem cells, which can differentiate into many kinds of cells in the body. The researchers do not yet know which type of cell differentiates into the neurons and other marrow-derived cells they identified in the brain. Recent studies have shown that instead of developing into new cell types, adult stem cells sometimes fuse with mature cells from existing tissues that have already undergone differentiation. The resulting cells carry four sex chromosomes (X and Y chromosomes) instead of the usual two. While Dr. Mezey and her colleagues cannot exclude the possibility that fusion accounts for their results, they looked at several hundred donor-derived cells from one of the patients and did not see doubled sex chromosomes in any of the cells they examined. Previous studies have found some cells with Y chromosomes in adult women who had not received any transplants. Researchers believe these Y cells may have come from a past pregnancy with a male fetus. However, two of the subjects in this study were children, and the male cells in those individuals could not have come from a pregnancy, says Dr. Mezey. Scientists must now determine what growth factors or other signals prompt the bone marrow cells to enter the brain and develop into neurons. This may lead to new ways of treating Parkinson’s disease or other disorders where neurons lost to disease are not normally replaced. Researchers might also be able to discover factors that can increase the number of cells entering the brain or prompt the cells to find useful targets. "These studies are very much the beginning, but scientists should start to look down this road and find out if and how we can go further," says Dr. Mezey. She cautions that it is too early to know if this finding will lead to useful treatments for neurological disorders. She and her colleagues are now planning to study brain tissue from people who survived for longer periods after receiving a bone marrow transplant in order to see if the number of marrow-derived neurons increases with time. They also plan to study mice to determine which cells in the bone marrow develop into neurons. Two Brain Systems Tell Us To Breathe Until now, scientists believed that a single area in the brain generated breathing rhythm, enabling breathing to speed up or slow down to adapt to the body’s activity and position. But UCLA neurobiologists have discovered that two systems in the brain interact to generate breathing rhythm — a finding that may translate into better treatment for sleep apnea and sudden infant death syndrome. The journal Neuron reported the findings in its March issue. “We originally thought that only one brain center was responsible for generating breathing rhythm,” said Dr. Nicholas Mellen, UCLA assistant researcher in neurobiology and principal investigator of the study. “But our research indicates that two cellular networks closely collaborate to control breathing. This brings us an important step closer to understanding how breathing control is organized in the brain.” “Breathing is a good model for understanding brain function in general,” said Dr. Jack Feldman, UCLA professor of neurobiology and senior author. “Once we learn how the brain commands humans to breathe, we will gain valuable insight into how the brain produces other meaningful behaviors.” The UCLA finding could enhance prevention, diagnosis and treatment for sleep apnea and sudden infant death syndrome, as well as speed the development of drugs for neurological disorders that can interfere with breathing, such as stroke, multiple sclerosis and Parkinson’s disease, he added. Previously, UCLA neurobiologists located a brain region they identified as the key command post for generating breathing and dubbed it the preBotzinger Complex. When they exposed the preBötzinger Complex nerve cells in a rat’s brain to a narcotic, the animal’s breathing slowed dramatically. This led the UCLA team to conclude that the preBotzinger Complex served as the brain’s headquarters for breathing rhythm. “Overdoses of narcotics kill people because they slow your breathing until it stops entirely,” Feldman said. “The cells in the preBotzinger Complex replicated this phenomenon.” Release URL, if available: The URL must point to the specific release, not a general page of releases or your organization's main homepage.Researchers Hiroshi Onimaru and Ikuo Homma of Showa University in Tokyo, however, had described a second set of brain cells that did not respond to narcotics. They called them “pre?I” cells, for pre-inspiratory, because they are active before inhalation. The UCLA researchers decided to test the effect of a low amount of narcotics on a rat’s breathing. They first tested the drug on a slice of brainstem that did not contain pre-I neurons and then exposed the drug to a block of brainstem that did contain pre-I neurons. When the pre-I neurons were present, the animal’s breathing slowed continuously. When the cells were absent, however, Mellen and Feldman witnessed a surprising event. Instead of slowing down gradually, the rat’s breathing pattern slowed by skipping entire breaths. This suggested that two distinct systems in the brain interact to generate breathing rhythm. “Exposing the pre-I cells to narcotics still reduced the rat’s intake of oxygen, but it did so by skipping beats rather than slowing the rhythm,” Mellen said. In addition to responding to narcotics differently, the two cellular networks varied in other ways, too. The UCLA team discovered that sensory feedback from the lungs affected the preBotzinger Complex brain cells, but not the pre-I cells. The scientists hypothesize that this is the brain’s way of striking a balance between stability and sensitivity. “Humans breathe no matter what. Yet breathing is an instinctual process,” Feldman said. “We do it 24/7 from the second we’re born. The process must adapt and be sensitive to all sensory input, yet be extraordinarily stable and reliable.” For example, the act of sitting requires 250 millileters of oxygen per minute to support resting human metabolism. The minute a person stands up and begins to walk, breathing must immediately accelerate to take in 1,000 millileters of oxygen per minute to support the activity. “Our findings suggest that the pre-I cell system controls stability, while the preBotzinger network responds to sensory feedback,” Mellen said. “This division of labor allows breathing to quickly adapt to sensory and other input, yet rapidly return to its normal rhythm.” “Humans and other mammals are the only vertebrate species to possess a diaphragm. This muscle played a key role in our ascending the evolutionary ladder by letting us take in more oxygen to feed our bigger brains,” Feldman said. “We think that the preBotzinger Complex also may have evolved to control the diaphragm.” The UCLA data suggests that the preBotzinger Complex is dominant under normal circumstances, but the pre-I cell network also can give rise to the breathing rhythm. Because the two cell networks function in such an integrated manner, scientists cannot readily tease their roles apart. Only the systems’ different sensitivity to narcotics revealed their interaction. The UCLA team will next try to unravel how the two cellular networks communicate in the brain to produce breathing. The National Institute of Heart, Lung and Blood funded the research. UCLA researchers Wiktor Janczewski and Christopher Bocchiaro were co-authors on the study. Brain Imaging Study Sheds Light On Inner Workings Of Human Intelligence Washington University In St. Louis St. Louis, Mo., Feb. 13, 2003 -- Human intelligence is like a mental juggling act in which the smartest performers use specific brain regions to resist distraction and keep attention focused on critical pieces of information, according to a new brain imaging study from Washington University in St. Louis. "Some people seem to perform better than others in novel, mentally-demanding situations, but why?" asks Jeremy R. Gray, Ph.D., co-author of the study to be posted Feb. 18 in an advance online issue of the journal Nature Neuroscience. "Presumably, people are using their brains differently, but how? “ Curious about the specific cognitive and neural mechanisms that underlie individual differences in intelligence, Gray and colleagues devised a study to explore the inner workings of one important aspect of human intelligence. The study sought to better understand the process through which the mind reasons and solves novel problems, an ability known among psychologists as “fluid intelligence.” “The results may help researchers to understand the neural basis of individual differences in cognitive ability,” according to an embargoed news release issued this week by Nature Neuroscience. Describing the study as “impressive” in part because of its relatively large number of participants, the journal suggests the findings “will help to constrain theories of the neural mechanisms underlying differences in general intelligence.” The scientific team included Gray, a research scientist in psychology, and Todd S. Braver, Ph.D., an assistant professor in psychology, both in Arts & Sciences at Washington University; and Christopher F. Chabris, Ph.D., a research associate at Harvard University. Using functional magnetic resonance imaging (fMRI), the researchers measured subtle changes in brain activity as study participants performed a challenging mental task -- one perhaps analogous to trying to drive to a new destination and attempting to keep the directions in mind while maintaining a conversation with passengers in the car. Participants in the study were asked to do what might seem like a mental juggling act. They had to keep a list of three words or faces actively in mind. Every few seconds, they had to add another word or face to this list, and drop the oldest item from the list. But before they forgot the old item completely, they had to indicate whether the new item they were adding exactly matched the oldest item they were dropping. Their brain activity was monitored as they did so. Critically, the experimenters would occasionally throw participants a curve ball: showing them a new item that did not match the oldest item, but did match one nearby in the on-going sequence. Participants found these 'lure' items to be especially distracting. A key finding of the study was that participants with higher fluid intelligence were better able to respond correctly despite the interference from the 'lure' items and they appeared to do so by engaging several key brain regions more strongly, including the prefrontal and parietal cortex. "Our study depended on the fact that people vary in their intelligence level," Braver said. "We used that variation to identify which brain regions are more critical for fluid intelligence." Several previous studies have examined how the brain responds to questions that appear on intelligence tests. However, the previous studies did not examine how people differ, nor what aspects of the test questions were most sensitive to such differences. The findings in this Nature Neuroscience report draw on a cognitive theory of fluid intelligence proposed by Randall Engle, Ph.D., Professor of Psychology at Georgia Institute of Technology, and his colleagues. In this theory, the ability to resist or overcome interference like that on the 'lure' trials is important. “Imagine trying to keep a new phone number in mind just long enough to dial it,” suggests Gray. “Now imaging trying to do this while people around you are having a very interesting conversation. Paying attention to the conversation would interfere with remembering the phone number. People with higher fluid intelligence should have an easier time resisting being distracted by the conversation and keeping attention focused on the phone number.” The Washington University study included 48 participants, all healthy, right-handed, native English speakers between the ages of 18 and 37, about half men and half women. Each participant was administered a standard test of fluid intelligence, known as Raven's Advanced Progressive Matrices. Each participant was then asked to perform the word and face "mental juggling" tasks while lying inside an fMRI scanner. Each task tested a kind of short-term memory known as "working memory." To get a sense of how the task works, ask a friend to read the following words to you at a rate of about one word every 2.5 seconds: dog, cat, chair, table, cat, door, chair, dog. For each word that you hear, make a mental note of whether it is the same word as you heard three words previously. That is, compare the fourth word you hear to the first, the fifth word to the second, and so on. (For the first three words, there is nothing to compare them to, so just remember them for later.) The participants in the study had to do a similar task, except that it involved viewing a series of either unrelated words or unfamiliar faces on a computer screen, one word or face every few seconds. Participants had to press a button to indicate whether or not the word or face on the screen matched one shown exactly three previously. The task is challenging, but the researchers included some especially tricky "lure" items that were even more difficult. These were words or faces that had been shown two, four, or five previously in the sequence, but not three previously. For example, the second time the word "chair" appears in the list above is a lure. The lure items are easily confusable for an item seen three previously. The mere fact that the word or face was seen recently is salient and hard to ignore. This creates interference of the type that, according to Engle and colleagues, should engage fluid intelligence. On the task, people with higher fluid intelligence were generally more accurate than those with lower fluid intelligence. Fluid intelligence appeared to be most critical for performance on lure trials. The critical nature of lure trials also was reflected in brain activation differences between individuals of high and low fluid intelligence. In several brain areas including prefrontal and parietal cortex, people with higher fluid intelligence had stronger neural activity than people with lower fluid intelligence. That is, doing the task led to widespread activity across the brain, but the strength of this activity was related to fluid intelligence only on the lure trials. So, what is it exactly that the participants with higher fluid intelligence were doing differently on the lure trials? Their performance suggests they were keeping the distracting information at bay, and they appeared to do so by activating regions in prefrontal and parietal cortex, as well as a number of auxiliary regions. While the study offers new insight into fluid intelligence, the researchers emphasize that how well people perform in a given situation depends on the complex interaction of many abilities. For example, this study does not address every aspect of fluid intelligence, nor does it account for other forms of intelligence, such as crystallized intelligence, which involves specific skills and expertise. Motivation and emotion are also important. Other work suggests that fluid intelligence may not be fixed, but can be increased. "I find this study exciting in part because it opens a door to doing many further studies that capitalize on differences in psychological functions among individuals," added Braver. "Individuals differ in cognitive abilities and in many other ways as well, such as personality. We can use this same type of approach to understand how these psychological differences are reflected in brain function." Psychology Professor Maps Choice-making In The Brain MANHATTAN, KAN. -- The next time you are frustrated by someone who says, "I'm of two minds about this," at least you will know why. The latest research conducted by Kip Smith, an assistant professor of psychology at Kansas State University, may be able to explain why people often can't make up their minds. Smith's current study focuses on which parts of the brain are used in the decision-making process. "We're of at least two minds," Smith said. "This research shows the brain is not a single entity. There is not a single executive decision-making mechanism there." Smith's research has resulted in neuroimages of the parts of the brain used in different types of choices. Smith said there are two systems for making decisions in the brain: deliberative and emotional. Deliberative systems, also referred to as calculation areas, utilize parts of the brain related to mathematics and rational decisions. Emotional systems utilize older, more primal parts of the brain. According to Smith, individual behavior is affected by attitudes about payoffs, such as gains and losses, in addition to beliefs about outcomes, such as risk and ambiguity. During the experiments, the brain activity of participants was measured by positron emission tomography. The research demonstrates the relationship between brain activity and observed choices. Smith's results allowed him to create images of the parts of the brain used for risk, ambiguity, gains and losses with decision making in the experiment. Smith said some of the results were surprising. "We thought that risky losses would be processed by the part of the brain that responds to fear, but they were dealt with in a fairly rational manner," he said. Also, the deliberative areas of the brain did not show high usage with decisions relating to risky gains. "It could be that the emotional areas overwhelm the calculation areas. The results are correlational, because it's not a completely controlled experiment." Smith's results were published in the June 2002 issue of Management Science in the article "Neuronal Substrates for Choice under Ambiguity, Risk, Gains and Losses." The paper was co-authored by John Dickhaut, University of Minnesota; Kevin McCabe, George Mason University; and Jose V. Pardo, Veterans Affairs Medical Center and the University of Minnesota. A second paper, "The Impact of the Certainty Context on the Process of Choice," is forthcoming in the Proceedings of the National Academy of Sciences. Dickhaut, McCabe and Pardo, as well as Aldo Rustichini, University of Minnesota, and Jennifer C. Nagode, Veterans Affairs Medical Center and the University of Minnesota, co-authored the second paper.

Oregon Health & Science University Researchers Discover New Brain Region Involved In Alcoholism 3-26-2003 PORTLAND, Ore. – Researchers at Oregon Health & Science University (OHSU) have discovered a new region of the brain involved in chronic alcohol consumption. This research may be used to develop new or improved drugs and therapies aimed at combating alcoholism. The finding also presents a more complete picture of the brain's important role in alcohol abuse. The research, which is printed in the March 25 edition of the Journal of Neuroscience, centers on a peptide called urocortin. The peptide is connected to alcohol craving. Scientists at OHSU and collaborators at Indiana University tracked urocortin to a group of brain cells located in the midbrain. The group of cells is called the Edinger-Westphal (EW) nucleus. "This research is the first to tie this region of the brain to alcohol abuse," said Andrey Ryabinin, Ph.D., an assistant professor of behavioral neuroscience in the OHSU School of Medicine and senior author of the paper. "It is also the first time urocortin levels have been tied to alcohol consumption." To conduct this research, Ryabinin and his colleagues studied mice bred to crave alcohol compared with normal mice that will drink alcohol served with a sugar solution. Researchers found that levels of urocortin in the brain corresponded with each animal's desire to drink alcohol. Animals with high urocortin levels consumed large quantities of alcohol. Conversely, animals with low urocortin levels craved less alcohol. The scientists also tracked communications between cells containing urocortin and a region of the forebrain involved in regulating alcohol consumption and brain reward mechanisms. "While there is much more research to be done, we think that either this small group of neurons or the peptide urocortin may be good targets for drugs or therapies for treating those with alcohol addiction in the future," explained Ryabinin. "For instance, it is worth testing whether reducing urocortin levels may reduce alcohol craving." The National Institute on Alcohol Abuse and Alcoholism, a component of the National Institutes of Health, funded this research. Oregon Health & Science University Researchers Discover Brain Cell Mechanism Possibly Linked To Mental Retardation PORTLAND, Ore. – Researchers at Oregon Health & Science University (OHSU) have discovered a key cellular mechanism in the brain possibly involved in mental retardation. The research may be used to develop new drugs or therapies to combat the condition. The research, which was conducted in mice, also may provide scientists with an animal model for mental retardation that will be of use in future studies aimed at understanding and treating the human condition. The research, which is printed in the Feb. 18 edition of the journal Proceedings of the National Academy of Sciences, centers on a key protein called WAVE-1 that is found throughout the brain. Researchers at OHSU produced mice lacking the WAVE-1 protein. Following observation, these animals were found to have balance, motor, learning and memory deficits. These symptoms correlate with one form of mental retardation found in humans. "WAVE-1 is a very important protein involved in brain cell communication," said researcher John Scott, Ph.D., an associate investigator of the Howard Hughes Medical Institute and a senior scientist in the OHSU Vollum Institute. "The protein acts like a scaffolding that supports the lines of communication between different parts of the cell." Scott and other OHSU researchers believe the absence of the WAVE-1 protein causes a partial breakdown of the brain cell communication system, which results in reduced learning ability and other effects associated with mental retardation. While there are thought to be literally hundreds of causes for mental retardation, it's believed the breakdown of important cellular communication systems is involved in many, if not all, forms. One major conclusion of the research is that mental retardation involves many more areas of the brain than first expected. "The protein is found in a variety of regions of the brain, including the hippocampus and the cerebellum," explained Jacob Raber, Ph.D., an assistant professor of behavioral neuroscience and neurology in the OHSU School of Medicine. "Through studying mouse models, we hope to further understand and describe the roles of various brain regions in the important functions impaired by mental retardation." The Raber lab's involvement in the project is a unique partnership between behavioral neuroscience and biochemistry experts. "The Raber lab is literally across the hall from our lab," explained Scott. "The close proximity resulted in numerous conversations between the two labs and, finally, collaboration on this project." Scott Soderling, Ph.D., a lead researcher on this project, also noted an unexpected trait found in mice lacking the WAVE-1 protein – reduced anxiety. Future studies conducted between the Scott and Raber labs will try to determine whether this trait is also found in humans with the corresponding form of mental retardation. Computer Automation Software Speeds Brain Research; Tool Sheds Light On Which Specific Brain Cells Are Active And When TROY, N.Y. -- The mind works in mysterious ways, and one Rensselaer researcher and his colleagues have created a computer automation tool to help solve those mysteries, speed understanding of how the brain develops, delve more deeply into brain function at the cellular level, and make more reliable conclusions. Rensselaer engineering professor Badri Roysam has developed a technology called Quantitative cat-FISH that analyzes 3-D, microscopic images of the brains of rats after the animals have run through mazes. By logging important cognitive cellular information -- such as activity, cell shape, size, and location -- in a simple spreadsheet for analysis, the software is helping researchers identify which cells are active and when. In the past, researchers have only been able to pinpoint which general regions of the brain are active. Researchers used to perform some of the time-consuming cell counting and transcription work that Quantitative cat-FISH does by hand. Roysam's system now allows scientists to process more data and tissue faster and without subjective error. It also enables researchers to make more reliable conclusions. "Quantitative cat-FISH" stands for Quantitative Cellular Compartment Analysis of Temporal Activity -- Fluorescence In-Situ Hybridization. It was developed by Roysam along with Jim Turner, director of the Wadsworth's Nanobiotechnology Program, and a team of scientists led by Carol Barnes, research scientist and professor of psychology and neurology at the University of Arizona. "This is a powerful tool for large-scale and quantitative testing of biological hypotheses, especially when combined with related technologies developed at Rensselaer," says Roysam. "It can be used in many other areas of cell and molecular research." The technology is currently being used to test hypotheses on the behavior of neurons grown over engineered surfaces, the development of tumor blood vessels, and the effects of polychlorinated biphenyls (PCBs) on river life forms. Barnes says the software has proven to be a helpful tool in her team's studies of whether cognitive tasks trigger specific gene reactions. "We have made great progress over the last couple of years, and we couldn't have done it without RPI's image analysis technology," says Barnes.

Alternative Medicine a Plus for Brain Injuries It is estimated that over 5 million people in the US currently live with disabilities resulting from traumatic brain injury. Although it was thought many of these patients used CAM therapies to aid their recovery, the prevalence and patterns of CAM use among such patients had not been previously studied. Drs Asma Rafeeq and Sharon McDowell interviewed 130 people with traumatic brain injury who were treated at the University of Michigan's trauma burn centre. Subjects were asked if they had used any alternative therapies to help them with symptoms resulting from their injury. The findings, presented this week (March 29-April 5, 2003) at the American Academy of Neurology's annual meeting in Honolulu, Hawaii, showed that more than half of the patients said they had used at least one CAM therapy, and more than a third said they had used at least two therapies. "It really underlines the high level of frustration that traumatic brain injury patients feel about the chronicity of their problems and the few proven therapies available to them," Dr McDowell commented. The most commonly used therapies were massage therapy, meditation, herbal medicine and chiropractic care. Massage therapy and chiropractic care were used by the brain injury patients to treat their pain, while meditation was used for affective disorders and herbal medicine was taken for cognitive deficits. The study found that 81 per cent of patients believed CAM was effective, despite the fact there has been little medical assessment of its safety and effectiveness in treating traumatic brain injuries. Around 40 per cent had not informed their doctors about those treatments. Dr McDowell said, "A lot of patients are embarrassed to tell their doctors, while others don't even realise that the vitamin supplements and other substances they are using can be as active as drugs, which can affect their medical treatment." Source: 55th Annual Meeting of American Academy of Neurology Knocking Noggins The Journal of Neuroscience A hit to the head during a sporting event may be worse than you think. New studies scrutinized the issue on a scientific level and found that they can create changes in mental function. Images courtesy of Marvin Bergsneider, MD, University of California Medical Center, Los Angeles. The research is explaining the biological implications of blows to the head and may lead to new ways to diagnose and treat them.     The teams line up. The center snaps the ball. Safety blitz. Helmets clash. Many players receive a blow or jolt to the head in contact sports such as football, ice hockey, boxing and lacrosse. These hits typically are not hard enough to actually crack the head open but they can cause the brain to ricochet around in the skull - like a yolk in an eggshell. One or more of a number of effects, such as a brief loss of consciousness, lightheadedness and dizziness, may follow. Often the diagnosis is a head injury, termed concussion. Traditionally, much of the general public has believed that the clanking of heads and concussions are just part of the game and no big deal. Now increasing evidence is suggesting otherwise. Most recently, studies reveal specific insights into how the hits can have serious, sometimes lasting, effects on brain function. The new research is leading to: More precise ways to rate the severity of head injuries and provide an accurate diagnosis. Methods that track the brain’s recovery to ensure that it’s healed before play is resumed. Many of the new studies detail problems with memory and attention. In one study researchers gave a series of written and verbal tests to college football players before their season started. Those who experienced a concussion during play were retested. The athletes’ performance in the areas of verbal learning, memory and speed of information processing was noticeably worse for up to five to seven days after the blow. Another study examined amateur soccer players who previously experienced concussions or just generally hit the soccer ball with their head as part of the match. Their performance on tests of memory and planning was poor compared with scores of runners and swimmers. Furthermore, the research indicated that those with the most concussions did the worst. This suggests that blows, even supposedly minor ones, to the head in sports, may lead to lasting, cumulative damage in the brain. New studies that measure brain activity confirm these findings. For example, researchers found that athletes who suffered several concussions had weaker activity in brain regions that play a role in certain memory functions. They also had problems conducting memory tasks. Another recent study tested amateur ice hockey players who had one or more concussions at least six months prior to the examination. The researchers measured the electrical activity in the brain that corresponds with their ability to process attention and memory. Players with three or more concussions had significantly different electrical activity and reported more cognitive troubles, such as memory loss, than players with no concussions. In addition, tests indicated that the brain function of players with three or more concussions was worse than players with just one concussion, which again suggests that the damage of concussions may accumulate. Another study that measured electrical activity in the brains of college athletes with concussions also found that the hits were tied to attention deficits. Specifically, the players had changes in their electrical activity and performed poorly on an attention task. In addition, they found that the athletes who didn’t have major outward symptoms after they were hit, such as being knocked out, also had problems. This suggests that injuries thought to be mild from observational clues actually may be quite serious. Other recent research that looked at general brain injuries also supports this idea (see image). The scientists found that a person’s level of consciousness following an injury did not reflect underlying brain problems. Several research groups have started to incorporate these scientific findings into strategies that may better evaluate the severity of a head injury and help confirm that the brain is recovered before a player is allowed to return to the game. The techniques also may benefit those who receive blows to the head from other situations, such as a car accident or fall. ---------------------------------------------------------------------THE IMAGES ABOVE ARE FROM A STUDY WHERE RESEARCHERS EXAMINED THE BRAIN METABOLISM OF PATIENTS WHO HIT THEIR HEADS DURING AN ACCIDENT, SUCH AS A FALL. MEASURING THE BRAIN'S METABOLIC ACTIVITY OR THE AMOUNT OF SUGAR IT USES PROVIDES CLUES ON ITS FUNCTION. RED INDICATES HIGH BRAIN METABOLISM, WHICH IS A SIGN OF HIGH BRAIN ACTIVITY, WHILE BLUE INDICATES LOW BRAIN METABOLISM OR LOW ACTIVITY. THE PATIENTS, WHO WERE CONSCIOUS AND THOUGHT TO HAVE ONLY MILD INJURIES, ACTUALLY HAD VERY LOW BRAIN METABOLISM. IN FACT, THE METABOLISM WAS AS POOR AS SOME COMA PATIENTS WITH SEVERE HEAD INJURIES. THIS SUGGESTS THAT EVEN IF A BLOW TO THE HEAD REVEALS NO MAJOR OUTSIDE SIGNS OF TROUBLE, THERE STILL MAY BE SOME PROBLEMS INSIDE THE BRAIN. Copyright © 2003 Society for Neuroscience University Of Pittsburgh Researchers Study Mild Concussions In High School Athletes PITTSBURGH, Jan. 30 – High school athletes who sustained even mild concussions showed significant decline in memory processing and other symptoms within one week post-injury, in a study conducted by researchers at the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program. The study, published in the February Journal of Neurosurgery, is the first to evaluate recovery from mild concussion in high school athletes and the first to show that even mild concussions can have significant effects, suggesting the need for more cautious return-to-play guidelines. "Our findings underscore the need for more careful on-the-field evaluation of even seemingly mild concussions," said principal investigator Mark Lovell, Ph.D., who is a neuropsychologist and director of the UPMC Sports Medicine Concussion Program. "Furthermore, our study results may lead to a suggestion that any high school athlete with a suspected concussion of any severity be kept out of that particular game and not return to play until further neurocognitive testing can be done," he said. Current return-to-play guidelines commonly used nationwide stipulate that a mildly concussed athlete whose on-the-field symptoms disappear within 15 minutes may be allowed to return to play in that particular game. "We also believe that our study results suggest an urgency for more research into the effects of concussion in high school athletes, as well as the access to formal neurocognitive testing at the high school level," added Dr. Lovell. "There are 1.25 million high school athletes playing contact sports, which represents the population with the highest participation in contact sports and the highest risk for sports-related concussion. An estimated 63,000 concussions occur in this group each year. Yet, our study is the first in which the recovery process in this age group has been investigated using formal testing," he added. "Mild concussion is the most frequently occurring type of concussion. Because on-the-field symptoms disappear within a few minutes and the athlete reports he or she is fine and appears to the sports medicine team to be fine, mild concussions often are unrecognized, overlooked or considered a trivial injury, and often the athlete is allowed to return to play," said Michael Collins, Ph.D., study investigator and neuropsychologist who is assistant director of the UPMC program. "We are concerned about returning a concussed athlete to play too soon before the brain has had time to heal because previous research has shown that once an athlete sustains an initial concussion, he is more susceptible to further, more serious damage," added Dr. Collins, who also was principal investigator for a recent UPMC study, proving that the effects of multiple concussions in high school athletes can be cumulative. Concussion occurs when the brain is violently rocked back and forth inside of the skull due to a blow to the head or upper body, much like an egg yolk inside of an eggshell. Concussion is a trauma-induced alteration of mental status that may or may not result in loss of consciousness. Other symptoms may include disorientation, confusion, dizziness, amnesia and uncoordinated hand-eye movements. "Most athletes who sustain an initial concussion can recover completely as long as they are not returned to contact sports too soon. However, the concern is that concussion symptoms are not always straightforward and not always reported by the athlete. On-the-field evaluation of the injury's effects and knowing when it is safe to return the athlete to play can be difficult to objectively measure," according to study investigator Joseph Maroon, M.D., professor of neurological surgery at UPMC. "No area of sports medicine involves more clinical uncertainty and controversy than the management of concussion," concurred Dr. Lovell. The UPMC team studied the recovery of 64 male and female high school athletes throughout the country who sustained concussions during the 2000-2001 school year. The athletes who sustained mild concussions were those whose symptoms disappeared within 15 minutes of injury. They were evaluated on the field by a certified athletic trainer or team physician, who documented the injury details. The athletes were then evaluated at 36 hours post-injury, four days post-injury and seven days post-injury. Athletes with mild concussions demonstrated significant declines in memory processes that were still evident at four and seven days post-injury. Other self-reported symptoms – including headaches, dizziness and nausea – resolved by day four. The mild concussion group was further divided into two sub-groups according to the duration of their on-the-field symptoms. One sub-group represented athletes whose on-the-field symptoms disappeared within five minutes, and were considered less severely injured. The other sub-group included athletes whose symptoms lasted between 5 minutes and 15 minutes, and were considered more severely injured. The study found that the duration of on-the-field symptoms served as a prognostic indicator of post-injury symptom duration. The group whose on-the-field symptoms lasted longer than 5 minutes had longer lasting post-injury symptoms and was five times more likely to demonstrate a major drop in memory performance at 36 hours post-injury. All of the study participants were evaluated with ImPACT© (Immediate Post-Concussion Assessment and Cognitive Testing), a 20-minute computerized assessment tool that includes tests of neurocognitive function including attention, memory, reaction time and information processing speed. All of the study participants had undergone pre-season baseline testing with ImPACT so that post-injury data could be compared to baseline data. ImPACT, developed by Drs. Lovell, Collins and Maroon and colleagues at Henry Ford Health System in Detroit, has been used for several years by the National Football League, the National Hockey League, Major League Baseball and numerous other professional and collegiate athletic teams and organizations. Approximately 250 high schools across the country also use ImPACT. Other investigators in this study are: Grant Iverson, Ph.D., University of British Columbia; Melvin Field, M.D., department of neurological surgery, UPMC; Robert Cantu, M.D., Emerson Hospital, Concord, Mass.; Kenneth Podell, Ph.D., Henry Ford Health System; John W. Powell, Ph.D., A.T.C., and Mark Belza, M.D., Michigan State University; and Freddie Fu, M.D., department of orthopaedic surgery, UPMC. The UPMC Sports Medicine Concussion Program focuses on diagnosis and management of sports-related concussions in athletes of all levels. The program's internationally known team of clinicians and researchers are leaders in studying the neurocognitive effects of sports-related concussions and developing better methods of post-concussion evaluation to determine when it is safe for an athlete to return to sports. Copyright © 1995-2002 ScienceDaily Magazine

Age-related Changes In The Brain's White Matter Affect Cognitive Function In Old Age American Psychological Association 03-24-2003 WASHINGTON -- Age-related changes in the brain -- the appearance, starting around age 60, of "white-matter lesions" among the brain's message-carrying axons -- significantly affect cognitive function in old age. White-matter lesions are small bright patches that show up on magnetic resonance imaging (MRI) of the brain. What's more, hypertension may account for some of this cognitive impact. A full report on these relationships appears in the March issue of Psychology and Aging, which is published by the American Psychological Association (APA). Psychologists want to find the factors that contribute to individual differences in cognitive functioning among the elderly, because, says lead researcher Ian Deary, Ph.D., "People who retain their cognitive function in old age tend to have higher quality of life and live longer." However, researchers have been stymied by the lack of data on the childhood cognitive performance of elderly individuals. Without that data, it is hard to tell whether individual differences are due to aging or existed all along. Luckily, Deary, from the University of Edinburgh, and his colleagues at the University of Aberdeen, discovered that on June 1, 1932, Scotland gave its 11-year-olds a validated cognitive test. With its results, the authors gained a measure of early-life cognitive ability for people who were in their late 70s at the time of the study. Deary and his co-authors used local health registers to track down healthy living men and women who took the Scottish Mental Survey of 1932. Of the 427 possible matches, they contacted 327 people chosen at random; 83 of those people took part in a brain imaging study. Testing took place in 1999, when most participants were 78 years old. Participants took four different cognitive tests, examining nonverbal reasoning, memory and learning, processing speed, and executive function. They also underwent magnetic resonance imaging (MRI) of their brains to allow researchers to assess the extent of white-matter lesions, which are like little scars in the brain. The amount of brain white-matter abnormalities made a significant contribution to general cognitive ability differences in old age, independent of prior ability. In other words, if "Mary" tested better than "Billy" at age 11, they didn't necessarily test the same way at age 78. An elderly Mary might still have tested better, but the gap could have widened, narrowed or reversed --- and the differences in their white-matter lesions would matter more than differences in their earlier ability. In old age, the amount of white-matter lesions contributed 14.4 percent of the variance in cognitive scores; early IQ scores contributed 13.7 percent of the variance. What's more, these two predictors of cognitive performance in old age were independent; they didn't consistently affect scores in the same way. That is, after taking into account people's mental ability in youth, these researchers establish a factor that contributes significantly to people's cognitive function in healthy old age. Although white-matter lesions are viewed as a normal part of aging, and are found in people with no dementia or other neurocognitive disorders, they are linked with other health problems. In this study, hypertension accounted for a small but significant amount of variance both in white-matter lesion scores and in general cognitive scores in old age. This finding builds on other recent evidence that white-matter abnormalities may be related to circulatory problems (including hypertension, diabetes, heart disease and cardiovascular risk factors). Given the role played by white-matter abnormalities in cognitive performance, "Avoiding risk factors for [them] or preventing their accumulation may ameliorate age-related cognitive decrements," say the authors. "The understanding of the functional neurobiology of brain aging will be enhanced by the discovery of interactions among etiological factors." In a side note, Deary and his colleagues observe that, "the search for the causes of intelligence differences in youth is relevant to research on aging because much variance from youth persists into old age." Copyright © 1995-2002 ScienceDaily Magazine   Vitamins offer Alzheimer's treatment A study at Georgetown University in Washington DC suggests that high doses of vitamins may help slow the progress of Alzheimer's disease. Researchers say the high doses reduce levels of the amino acid homocysteine in people with the disease. Previous research has found a link between homocysteine and Alzheimer's. The Georgetown team is now leading a multi-centre trial to try to find whether three common vitamins - folic acid, B12 and B6 - will work in this way. (HealthScout 27/03/03)

Auditory Processing Disorders and Dyslexic Children Deborah W. Moncrieff Ph.D.   More children with learning and reading disabilities are being referred to audiologists for hearing and auditory processing evaluations. In the past, children with these problems were evaluated by educational specialists, speech-language pathologists, neurologists, psychologists and psychiatrists. These children were often found to have various difficulties, including problems with visual-spatial organization, receptive and expressive language, phonology, attention, and in some cases, auditory processing disorders. Most tests were administered across the table from the child, in regular classrooms, with the acoustic material delivered by a cassette recorder or by the clinician, at a conversational level. While these methods indicated a number of children had auditory processing difficulties, it was apparent that more stringent, controlled procedures, such as those typically used by audiologists, might yield better results. Today, there is an increasing demand on the audiologist to provide useful clinical batteries for diagnosing auditory processing disorders (APDs) in children using standard audiologic test conditions. I nterestingly, children are rarely referred to the audiologist based on auditory processing issues in isolation. Typically, referred children have other problems, such as learning, speech, language, attention and/or reading difficulties. It is likely that most children with APDs have comorbid conditions and therefore, the audiologist needs to ideally provide a targeted diagnostic battery that will ultimately distinguish auditory processing difficulties from other disorders. Today, audiologists struggle to deal with these issues, while few of our diagnostic tools provide the sensitivity and specificity required to accurately diagnose a specific auditory processing deficit. A good example is children with dyslexia. Many parents and professionals are confused about dyslexia and often express frustration because symptoms which characterize dyslexia appear to be indistinguishable from auditory processing disorders. Some try to distinguish auditory processing problems and dyslexia based on the commonly held notion that dyslexia is primarily characterized by the visual reversal of letters during reading. Despite many efforts to more accurately define dyslexia, there are still a number of conflicting opinions and multiple sources of misinformation that make it difficult for parents and teachers to fully understand the nature of dyslexia. Dyslexia is defined by the International Dyslexia Association (2000) as a 'language-based disability in which a person has trouble understanding words, sentences or paragraphs; both oral and written language are affected.' An earlier definition, formulated by a dyslexia research committee with the National Institutes of Health added that the disorder was 'characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing abilities' that are 'often unexpected in relation to age and other cognitive and academic abilities' (Shaywitz, Fletcher & Shaywitz, 1994). Both of these definitions describe children with disabilities in the processing and acquisition of language, despite normal intelligence, normal hearing, normal vision, no known neurological impairments or deficits, and appropriate educational opportunities. Neither definition addresses the etiology of the disability. However, a pioneer in reading disabilities (Orton, 1937) suggested that perceptual impairments either in the auditory or visual domain, or both, were at the root of developmental reading disorders. Orton recognized that the impairment was not related to absolute acuity in visual or auditory domain, but rather in the processing of information through the visual or auditory system. This is consistent with the profile of the dyslexic child with normal hearing, who has limited abilities regarding processing auditory information when the nature of the acoustic stimuli is more complex than a pure tone. While much is known about normal processing of visual and auditory information, new advances in technology have helped us understand that our knowledge is inadequate. In the auditory domain, we have a general base of information regarding the processing of simple types of stimuli such as pure tones and clicks. This has helped us understand peripheral mechanisms and to some extent, central mechanisms involved in auditory processing, especially within the lower brainstem. Nonetheless, information regarding how the brain processes complex acoustic stimuli and speech, is not yet sufficiently understood for the audiologist to diagnose a specific auditory perceptual deficit when auditory processing breaks down in the brainstem and other central locations. The deficit could occur at many points along the ascending auditory system or it could be the result of failure of auditory information to integrate with information arriving through other sensory modalities. Arousal, attention, cognition and other factors interact with auditory input and those factors must ideally be 'filtered out', to allow the auditory component of the deficit to be isolated and differentiated from other non-auditory deficits. A number of audiologic tests demonstrated sensitivity to central auditory nervous system disorders. Most were developed in medical settings where they were used to demonstrate functional deficits in patients with known lesions within the auditory system. Conversely, the assumption was often made that persons without known lesions demonstrating the same type of functional deficit, was possibly evidence of a disorder within the central auditory system. Most tests focused on known lesions in the temporal lobes of the cortex or the lower brainstem, leaving a large part of the central auditory nervous system poorly understood. When dyslexic children are referred to audiologists for evaluation of auditory processing disorders, the audiologist will likely use a battery of tests utilizing simple auditory stimuli such as tones, clicks, and noise bursts, and complex stimuli such as speech. However, audiologists should be aware of a number of important considerations relating to the evaluation of dyslexic children for APDs. A complete medical history to address non-auditory factors which may contribute to APDs such as complications at birth or early development, frequent bouts of otitis media, any type of neurological disorder or head injuries, is mandatory. Prior to the first meeting, parents and teachers should be given checklists to help describe the child's auditory abilities and deficits. Copies of all previous evaluations, especially those done by speech-language pathologists, neuropsychologists, reading specialists and other persons who have assessed the child's disorder should be made available to the audiologist. Typical complaints include poor listening skills, easy distractibility, inability to learn or sound out new words in reading, inattentiveness, and difficulty following auditory directions. Based on the symptoms outlined and documented above, the audiologist should initiate a battery of tests designed to assess the specific auditory deficits described. It would be helpful to know how the diagnosis of dyslexia was made and whether the child is characterized as a phonologic or deep dyslexic or a comprehension or surface dyslexic. The phonologic dyslexic is more likely to have problems with non-words or unfamiliar words and the diagnosis is usually based on poor performance on standardized tests of phonology and normal performance on standardized tests of reading comprehension. The comprehension dyslexic is more likely to have problems with irregular words that don't fit customary categories and the diagnosis is usually based on normal performance on standardized tests of phonology and poor performance on standardized tests of reading comprehension. There is considerable debate about whether the deficits observed in dyslexic individuals are primarily language-based or whether they stem from a more fundamental auditory perceptual problem. The auditory system is crucial for the development of language. However, there is enormous evidence that hearing impaired children have significant delays and disorders of language development, secondary to peripheral hearing loss. It seems reasonable, therefore, to expect that for at least some of the children with phonologic dyslexia there may be a disorder within the auditory system that has disrupted normal acquisition of language. Unlike hearing impaired children, the disruption is not occurring at the periphery, but perhaps at some point within the ascending auditory system, the cortical level, through intrahemispheric, interhemispheric or association connections, or there may be an abnormality of function that results in the child's inability to process linguistic input. There is evidence to suggest that dyslexic children have abnormalities within some of the auditory structures necessary for language development, including symmetry differences of the planum temporale (Hynd, et al. 1990; Kushch, et al. 1993; Larsen, et al. 1990; Leonard, et al. 1993), abnormal portions of the corpus callosum (Duara, et al. 1991; Hynd, et al. 1995), and duplicated Heschl's gyrus in the right hemisphere (Leonard, et al. 1998; Musiek & Reeves 1990; Penhune, et al. 1996). All of these (above) occur at the cortical level and can be assessed through the behavioral dichotic listening tests which were developed on patients with known lesions of the temporal lobe. There is also evidence of cellular differences in subcortical regions of the auditory system in dyslexic individuals, primarily within the medial geniculate body (Galaburda & Livingstone, 1993). The thalamo-cortical area is far more difficult to assess through a standard APD battery. The medial geniculate is thought to process the temporal characteristics of speech in a frequency-specific manner and is essential for the transmission of speech discrimination information to the primary auditory cortex. With behavioral tests, it is not possible to isolate the medial geniculate from the cortex by looking at functional deficits. What is needed is a better battery of electrophysiologic measures that can evaluate different portions of the ascending auditory system in response to a variety of complex stimuli. Through an analysis of evoked potential characteristics, the audiologist could potentially assess which acoustic features are processed normally and which are not, and at what anatomic location the breakdown appears to occur. Until this idealized battery of electrophysiologic measures is developed, the audiologist should consider which currently available measures provide the most precise diagnosis of an auditory processing disorder in a dyslexic child. Areas most likely to show performance deficits include temporal sequencing of information (as assessed by pitch pattern and duration pattern tests), auditory figure ground problems (as assessed by speech in noise tests) and interaural asymmetry in competition (as assessed by dichotic listening tests). Other deficits may appear in some dyslexic children, but in the majority of dyslexic children, these are the primary areas where weaknesses will likely be found. It is possible that results will eventually demonstrate that children with different types of dyslexia are more likely to show specific patterns on auditory processing tests. However, at this time, no such sub-typing of dyslexia and APDs has been extensively documented. For now, the audiologist can focus primarily on these three areas of auditory processing skills and develop a database of results found in children with dyslexia and other prevalent comorbid conditions. When records from a large number of patients can be compiled and analyzed, it may be possible to note patterns of results that occur specifically in this population. The development of a battery of auditory processing tests, together with standardized administration and scoring, are essential if the audiologist is to accurately reflect children's performance across a wide variety of clinical settings. Efforts are under way at the University of Florida to review the auditory processing measures currently available and to provide the audiologist with standards to better diagnose these deficits in children. These standards, together with the development of electrophysiologic measures to assess auditory functions not currently assessed, will significantly enhance the audiologist's role in auditory processing evaluations in dyslexic children and in all other patients with an auditory processing disorder. REFERENCES: Duara, R., Kushch, A., Gross-Gleen, K. Barker, W. W., Jallad, B., Pascal, S., Loewenstein, D. A., Sheldon, J., Rabin, M. Levin, B., Lubs, H. (1991). Neuroanatomic differences between dyslexic and normal readers on magnetic resonance imaging scans. Archives of Neurology, 48, 410-416. Galaburda, A. & Livingston, M. (1993). Evidence for a magnocellular defect in developmental dyslexia. Annals of the New York Academy of Sciences: Temporal information processing in the nervous system, 682, 70-82. Hynd, G. W., Hall, J., Novey, E. S., Eliopulos, D., Black, K., Gonzales, J. J., Edmonds, J. E., Riccio, C., Cohen, M. (1995). Dyslexia and corpus callosum morphology, Archives of Neurology, 52:32-38. Hynd, G. W., Semrud-Clikemand, M., Lorys, A. R., Novey, E. S., & Eliopulos, D. (1990). Brain morphology in developmental dyslexia and attention deficity-hyperactivity disorder (ADHD): Morphometric analysis of MRI. Archives of Neurology, 47, 919-926. International Dyslexia Association. (2000). ABCs of dyslexia: Facts about dyslexia. www.interdys.org/abcsofdyslexia/page4.asp Kushch, A., Gross-Glenn, K., Jallad, B., Lubs, H., Rabin, M., Feldman, E., & Duara, R. (1993). Temporal lobe surface area measurements on MRI in normal and dyslexic readers. Neuropsychologia, 31, 811-821. Larsen, J. P., Hoien, T., Lundberg, I., & Odegaard, H. (1990). MRI evaluation of the size and symmetry of the planum temporale in adolescents with developmental dyslexia. Brain Lanugage, 39, 289-301. Leonard, C. M., Eckert, M. A., Lombardino, L. J., Oakland, T., Kranzler, J., Mkohr, C. M., King, W. M., & Kreeman, A. (2001). Anatomical risk factors for phonological dyslexia. Cerebral Cortex, 11, 148-157. Leonard, C. M., Puranik, C., Kuldau, J. M., & Lombardino, L. J. (1998). Normal variation in the frequency and location of human auditory cortex landmarks: Heschl's gyrus: Where is it? Cerebral Cortex, 8, 397-406. Leonard, C. M., Voeller, K. K., Lombardino, L. J., Morris, M. K., Hynd, G. W., Alexander, A. W., Andersen, H. G. Garofalakis, M., Honeyman, J. C., Mao, J., Agee, F. & Staab, E. V. (1993). Anomalous cerebral structure in dyslexia revealed with magnetic resonance imaging. Archives of Neurology, 50(5), 461-469 Musiek, F. E., & Reeves, A. G. (1990). Asymmetries of the auditory areas of the cerebrum. Journal of the American Academy of Audiology, 1, 240-245. Orton, S. T. (1937). Reading, writing and speech problems in children. New York: Norton. Penhune, V. B., Zatorre, R. J., MacDonald, J. D., & Evens, A. C. (1996). Interhemispheric anatomical differences in human primary auditory cortex; probabilistic mapping and volume measurement from magnetic resonance scans. Cerebral Cortex, 6, 661-672. Shaywitz, B. A., Fletcher, J. M., & Shaywitz, S. (1994). A conceptual framework for learning disabilities and attention-deficit/hyperactivity disorder. Canadian Journal of Special Education, 9(3-4), 1-32.   Eye Movements Indicate Initial Attempts To Process What Humans Hear DENVER — By mapping eye movements in fractions of a second, a Brown researcher has found humans attempt to make sense of what they are hearing through visual cues long before they have heard an entire idea. The finding offers insight into how the mind uses vision to rapidly process information. Julie Sedivy, assistant professor of cognitive and linguistic sciences, will present her research during the annual meeting of the American Association for the Advancement of Science (AAAS) in Denver. Sedivy will participate in a panel discussion, “The Eyes Have It: Eye Movements and the Spoken Language,” Feb. 17, 2003, at 8:30 a.m. Sedivy is interested in the process by which humans assign meaning to words and phrases. Psycholinguists know that as humans process language they make many split-second decisions about the words they are hearing. But questions remain about how humans cope with uncertainty at every stage of that moment-by-moment decision process. In a series of studies involving approximately 150 people, participants sat either in front of a computer screen that displayed an image of objects or in front a work surface set with objects and received verbal instructions concerning the objects. Researchers used a headband-mounted camera to map the participants’ eye movements every thirtieth of a second. Given a scene of a table set with a drinking glass and pitcher, the participants heard instructions such as “pick up the tall glass.” Researchers found that participants frequently looked first at a pitcher in the display, indicating attempts to interpret “tall” early, and prior to hearing the entire noun “glass.” “On the basis of one or two sounds, we saw the participants’ eye movements begin to shift,” said Sedivy. “As soon as they identified a word, they began to map it.” However, when a short glass was added to the scene so that there were three objects – a pitcher, tall glass, and short glass – participants were more likely to look at the taller of the drinking glasses when they heard “tall” because size was the distinguishing factor between the two glasses. The finding suggests that humans consult a whole domain of information, including visual cues and expectations about rational communicative behavior, in resolving the uncertainty involved in processing a sentence, according to Sedivy. There appears to be a set of mutual expectations between conversational partners, for example, that redundant information is typically avoided. In the example with the pitcher and two drinking glasses, “tall” would be redundant in referring to the pitcher, because there is only one pitcher, while there are two glasses, Sedivy said. If that type of complex and subtle information were not available, the immediate moment-by-moment mapping of sounds to meaning would only serve to introduce a great deal of uncertainty to language processing, according to Sedivy. For example, if mapping to an object begins upon hearing “tall” rather than waiting until the following word “glass,” given a scene in which there are two tall objects, the chance of an initial mapping guess being correct is only fifty percent. Not subject to the conscious control by humans, the automatic eye movements are so subtle they are unnoticed by study participants, who may feel simply that their eyes are taking in the whole scene all at once when, in fact, the eyes are darting rapidly from one very specific location to another. “This is a surprising relationship between highly intelligent processes of language understanding and low-level automatic processes such as eye movements,” Sedivy said. “As humans, we have to deal with multiple levels of information simultaneously, and those different levels of information must be incorporated into the study of linguistics.” Sedivy conducted the research with Daniel Grodner, a postdoctoral fellow in cognitive and linguistic sciences; Anjula Joshi, research technician; and current and former undergraduate assistants including Charles Joseph, Estelle Reyes, Gitana Chunyo and Rachel Sussman. The work was funded by grants from the National Science Foundation and the National Institutes of Health.

Infants May Offer Clues To Language Development DENVER - You may not know it, but you took a course in linguistics as a baby. By listening to the talk around them, infants pick up sound patterns that help them understand the speech they hear, according to new research from the University of Wisconsin-Madison. But this research also shows that some patterns are easier to identify, suggesting that the development of human language may have been shaped by what infants could learn. These results were presented here today, Monday, Feb. 17, at the annual meeting of the American Association for the Advancement of Science. In a series of forthcoming papers, psychologist Jenny Saffran, who directs the Infant Learning Laboratory at UW-Madison, suggests how infants quickly acquire language, specifically their ability to find word boundaries - where words begin and end - from a steady stream of speech. "We've known for a long time that babies acquire language rapidly," she says, "but what we haven't known is how they do it." In all her studies, Saffran introduces her infant listeners to an artificial, or nonsense, language. Examples of words include "giku," "tuka" and "bugo." By using these made-up words, which the tiny listeners have never heard before, Saffran can isolate particular elements found in natural languages such as English. For just a couple of minutes, the infants hear dozens of two-syllable words strung together in a stream of monotone speech, unbroken by any pauses (for example, gikutukabugo...). The words are presented in a particular order that reveals a sound pattern. If babies recognize the pattern, says Saffran, they will use it to quickly identify word boundaries in what they hear next. To test this, Saffran introduces her listeners to a new string of nonsense words in which only some of them fit the pattern heard earlier. Saffran records how long the infants listen to the parts that conform to the pattern and the parts that don't. A significant difference in times, she explains, means the infants did pick up the pattern. As her recent studies show, infants do learn sound patterns, which then help them learn words and, ultimately, grammar. Their ability to do this, however, depends on age. By exposing infants who are 6-and-a-half and 9 months old to a string of made-up words in a certain order, Saffran learned that the two age groups use different strategies to determine where words end and begin. While the younger listeners identified word boundaries by relying on the likelihood that certain sounds occur together, the older listeners paid attention to what speech sounds were emphasized, or stressed. Because 90 percent of two-syllable words in English follow the same stress pattern, says Saffran, infants can use the pattern to determine the word boundaries. "At different points in development, babies orient towards some cues and not others," says Saffran. Why? "More linguistic experience." Before infants can recognize that stressed and unstressed syllables are reliable indicators of word boundaries, explains Saffran, they must first know a few words - lessons they learn earlier by learning which sounds are likely to occur together. Findings from this study will be published in an upcoming issue of the journal Developmental Psychology. Once infants go from syllables to words, they then can recognize simple grammars, according to Saffran's second study now in press at the journal Infancy. At age one year - just three months after babies begin using stress cues - infants can recognize patterns in word orderings. After listening to a continuous string of words in a particular order, the infants were able to identify permissible word orderings. Just as noted in the other study, Saffran says that only after prior learning can infants acquire additional language abilities: "Until they learn words, the grammar is invisible." While these two studies looked at babies' ability to acquire sound patterns common in natural languages, a recent third study by the Wisconsin psychologist investigated infants' ability to acquire patterns not often heard in everyday speech. The question Saffran wanted to answer, she says, was, "'Does language work in a way that best fits the brain?'" In other words: Are certain sound patterns more common than others because they make it easier for infants to learn language? This study is in press at Developmental Psychology. Unlike the other studies, which exposed infants to generalizations in language patterns, such as the grouping of sounds, this study tested an infant's ability to recognize something more specific - that syllables begin with some sounds, such as /p/, /d/ and /k/, but not others, such as /b/, /t/ and /g/. This pattern, says Saffran, is uncommon in phonological systems, which tend to place restrictions on types of sound segments, not individual ones. As Saffran found when she measured how long the infants listened to words that did and didn't conform to the rare pattern, there was no significant difference in the listening times. This finding, she says, suggests that babies had difficulty acquiring the pattern. The infants' difficulty in identifying the unusual sound pattern in this third study, she says, is likely to be the result of removing information helpful to young listeners as they acquire language. "There are certain types of patterns that they're better at picking up," adds Saffran. "Perhaps human languages have these patterns to make language more learnable. " Asking questions about what an infant can't learn, she says, can be just as interesting and informative as asking ones about what they can learn. In addition to providing knowledge about language deficits in some children, the answers could offer clues to how human language first developed and how it has evolved. MRI analysis of an inherited speech and language disorder: structural brain abnormalities. Watkins KE, Vargha-Khadem F, Ashburner J, Passingham RE, Connelly A, Friston KJ, Frackowiak RS, Mishkin M, Gadian DG. Developmental Cognitive Neuroscience Unit, Institute of Child Health, University College London Medical School, London, UK. Analyses of brain structure in genetic speech and language disorders provide an opportunity to identify neurobiological phenotypes and further elucidate the neural bases of language and its development. Here we report such investigations in a large family, known as the KE family, half the members of which are affected by a severe disorder of speech and language, which is transmitted as an autosomal-dominant monogenic trait. The structural brain abnormalities associated with this disorder were investigated using two morphometric methods of MRI analysis. A voxel-based morphometric method was used to compare the amounts of grey matter in the brains of three groups of subjects: the affected members of the KE family, the unaffected members and a group of age-matched controls. This method revealed a number of mainly motor- and speech-related brain regions in which the affected family members had significantly different amounts of grey matter compared with the unaffected and control groups, who did not differ from each other. Several of these regions were abnormal bilaterally, including the caudate nucleus, which was of particular interest because this structure was also found to show functional abnormality in a related PET study. We performed a more detailed volumetric analysis of this structure. The results confirmed that the volume of this nucleus was reduced bilaterally in the affected family members compared with both the unaffected members and the group of age-matched controls. This reduction in volume was most evident in the superior portion of the nucleus. The volume of the caudate nucleus was significantly correlated with the performance of affected family members on a test of oral praxis, a test of non-word repetition and the coding subtest of the Wechsler Intelligence Scale. These results thus provide further evidence of a relationship between the abnormal development of this nucleus and the impairments in oromotor control and articulation reported in the KE family.

Metal Ions May Play Big Role In How We Sense Smells University Of Illinois At Urbana-Champaign CHAMPAIGN, Ill. -- Of the five basic senses, the sense of smell is the least understood. Now, scientists at the University of Illinois at Urbana-Champaign have sniffed out potential clues to how olfactory receptors in the nose detect odors. Those clues may also explain why dietary zinc deficiencies lead to a loss of smell. Olfactory receptors are proteins that bridge through the cell membrane. Professor Kenneth S. Suslick and co-workers have found that the structure of the protein changes dramatically when a zinc or copper ion binds to it. They propose that the olfactory response to an odorant involves this change in structure that pushes and pulls part of the olfactory receptor protein into and out of the cell in a "shuttlecock" motion. This back-and-forth motion passes information through the cell membrane. The researchers will report their findings in the Proceedings of the National Academy of Sciences. A paper on the subject is to appear in the PNAS Online Early Edition the week of Feb. 24. The average human nose can detect nearly 10,000 distinct scents, a feat that requires about 1,000 olfactory genes, or roughly 3 percent of the human genome. "It seems surprising that such a large percentage of our genome is dedicated to the olfactory system," said Suslick, a William H. and Janet Lycan Professor of Chemistry at Illinois. "Being visually oriented and olfactorily impaired, we tend to overlook our sense of smell. But other mammals, like dogs and rats, live or die by their sense of smell." Knowing that molecules that bind strongly to metal ions usually smell strongly (and often badly), Suslick and his colleagues -- chemistry professor Zaida A. Luthey-Schulten and doctoral student Jiangyun Wang -- investigated the possibility that olfactory receptors are metalloproteins (proteins that contain a metal ion as part of their structure). Inorganic chemists have long suspected that the olfactory system involved metal ions. Only recently, however, have the genes responsible for smell been identified. "When we searched the genome data, we found an identical site in more than 75 percent of the olfactory receptors that looks like it can bind to metal ions very strongly," Suslick said. The structure of these receptors is thought to be a protein that weaves in and out of the cell membrane seven times. Between the fourth and fifth helices, the scientists found an uncommonly long loop that they suspected contained the binding site for a metal ion. To test their theory, the researchers created synthetic peptide analogs of the potential binding site in the receptor protein. As predicted, metal ions -- particularly zinc and copper -- were bound very strongly. The researchers then used computer models to study the behavior of olfactory receptors upon odorant binding. "Computer simulations initially put this big loop outside the cell membrane because the loop is negatively charged," Suslick said. "When a positively charged metal ion binds to the site, however, the loopÕs charge is neutralized, so the computer places the loop in the membrane." When the long loop containing the metal ion slides into the cell membrane, a portion of the receptor protein's fourth helix is pushed outside the membrane, Suslick said. When an odorant binds to the metal ion, the loop is ejected from the membrane, and the fourth helix is dragged back in, triggering a sequence of events leading to nerve cell activity. Then, when the odorant leaves the metal ion, the process can start over. This back and forth movement of the protein, which the researchers refer to as a shuttlecock motion, may be a new mechanism for passing information through cell membranes. "Another piece to this puzzle is that one of the first symptoms of dietary zinc deficiency is loss of the sense of smell," Suslick said. "That, too, is keeping with this idea that the olfactory receptors are metalloproteins." The National Institutes of Health funded the work.     Odors Summon Emotion And Influence Behavior, New Study Says Brown University SARASOTA, Fla. -- College students frustrated by playing a rigged computer game in a scented room later exhibited that frustration when they inhaled the same smell, according to a new study by a Brown University psychologist. The study provides further evidence for a growing body of research that indicates emotions can become conditioned to odors and subsequently influence behavior, according to Rachel S. Herz, assistant professor of psychology at Brown, who will present her research at the annual meeting of the Association for Chemoreception Sciences at 8 a.m. Sunday, April 13, 2003, in Sarasota, Fla. Sixty-three female undergraduates at Brown University participated in the two-pronged study, which used novel scents developed in a laboratory so that the students would not have any previous emotional connections to them. Any potential subjects who noted that a scent "reminded" them of another smell did not take part. In the first portion of the study, half of the participants were asked to play a computer game that, unbeknownst to them, was designed so that they could not win. During that time, the students were exposed to a novel odor. Then they were given a 20-minute break. Following the break, the students were taken to a different room and given a set of word tests. Participants took the tests in one of three rooms: a room containing the same scent as the room in which they played the computer game; a room with a different, novel scent; or a room without scent. Participants who performed the word tests in a room with the scent from the computer game room spent significantly less time working on the problems than participants in the other rooms, said Herz. (Researchers used the time spent on the problems, not the test scores, as a measure of frustration because they anticipated correctly that scores would be similar based on the intellectual ability of the students.) Overall, those participants who took the tests in the room with the computer-game room scent demonstrated less persistence – spending less time on each of the problems they could not solve – than the people who had taken the word tests in the rooms with a different odor or no odor at all. "Compromised by the emotion of frustration that was induced by the odor, they showed an unwillingness to work on a challenging task," said Herz. The second portion of the study confirmed the ability to create a connection between an emotion and scent. Instead of a frustrating computer game, the other half of the participants watched a neutral video in the scented room. Those later given word tests in a room with the same scent did not register any difference in performance compared to groups taking the tests in rooms with a different scent or no scent. Herz led the research with assistance from Corrente Schankler, a student, and Sophia Beland, a staff member, in the Brown University Department of Psychology, with supplies donated by AromaSys Inc. Females were studied because previous research has suggested that there may be stronger effects of emotional conditioning in women.     Smell, Emotion Processor In Brain May Be Altered In Depressed Patients Center For The Advancement Of Health A portion of the brain that helps us respond to odors and process emotions may be malfunctioning in severely depressed individuals, say researchers who measured the brain activity of individuals presented with smells like roses and rotten butter. Because odors and emotions are processed in similar brain structures, study of the olfactory system may increase our understanding of the physiological underpinnings of depression, according to the study. Previous studies have attempted to pinpoint exactly what processes in depressed individuals' brains lead to their tendency to remember negative memories over positive ones, and to have a sense of hopelessness regarding the future. Some studies have measured brain responses to emotionally charged images or words, but these methods involve a certain amount of decoding, as individuals can respond to such images differently. "The presentation of odors as emotional stimuli, by contrast, is powerfully direct, and odors seem to be powerful emotional stimuli," says study author Bettina M. Pause, Ph.D., of the Department of Psychology at Christian-Albrechts-University of Kiel in Germany. Pause and colleagues investigated how 25 depressed study participants compared with a same-sized healthy group in how their senses of smell and sight responded to emotional stimuli. They also re-examined 15 of the depressed patients after their recovery to see if their responses had changed. In addition to exposing participants to emotionally charged sights and smells, such as a compelling slide demonstration, the fragrance of roses and the fetid odor of rotten butter, the researchers also showed participants emotionally neutral color slides. Via electrodes placed on 32 scalp locations, Pause and colleagues monitored the electrical activity of the participants' brains during these exposures. The brains of the depressed patients were less responsive to the smells and the visual stimuli than the healthy participants, the researchers found. However, while the patients showed changes in the way they processed visual cues relatively late in the perceptual process (cognitive level), they showed early deviations in registering scents (sensory level). This electrical pattern changed once their depression lifted -- the 15 patients who were re-examined after their depression was successfully treated no longer exhibited any differences from the healthy participants. The study results are published in the March issue of the journal Psychophysiology. The researchers noted that while the depressed patients were less responsive to smells, their ability to identify smells had not suffered. This finding is in line with previous studies suggesting that while depressed individuals have no problem identifying odors, depression appears to muffle their sense of smell. Pause and colleagues suspect that the depressed patients' reduced brain responses to odors relates to deviations in two intimately connected brain areas, called the orbitofrontal cortex and the amygdala, which play significant roles in processing emotional information and are also connected with sense of smell. Meanwhile, their reduced responsiveness to visual emotional stimuli occurs via another brain area, called the dorsal prefrontal cortex. "Studies on the role of the orbitofrontal cortex and the amygdala in emotion strikingly parallel the studies on these brain structures in olfaction," Pause says. The amygdala may help "encode" odors and emotions, while the orbitofrontal cortex helps develop strategies for how to respond to such stimuli, according to the study. The researchers target a dysfunctional state of the main olfactory bulb, a pea-sized structure located below the orbitofrontal cortex that receives sensory input, as potentially playing a pivotal role in depressed patients' reduced sense of smell, and well as "their intensified experience of sadness and fear," according to the study. This study was supported by the German Research Foundation.

Traditional Chinese Medicine Offers Remedy for SARS BEIJING - It was crisis time at the traditional Chinese medicine shop. The city was gripped by fear of SARS and the Yong An Tang Pharmacy had run out of wu gen, imperiling the health and mental well being of hundreds of customers. "I'll call and order more immediately," the harried deputy manager told his two exhausted pharmacists before hustling downstairs to his telephone from the musty odors of the second-floor lab. "We were here until 2 a.m. last night," one of the white-jacketed pharmacists confided Thursday as she used a hand scale to measure out tiny mounds of black, brown and tan roots and herbs for a recipe to prevent SARS. This order of several dozen portions for a local business would be the last batch of the morning because now there was no more wu gen, a yellow wild grass from China's northwest. Concern about severe acute respiratory syndrome, which has much of Asia in a high state of anxiety, mounted slowly in Beijing because the government has underplayed the threat posed by the flu-like, sometimes-deadly disease. But then came Wednesday's newspapers, with helpful articles by several doctors of Chinese medicine. Eight dried herbs, they said, boiled for 25 minutes into a sipping broth and taken twice daily, would prevent the onslaught of atypical pneumonia by regulating the body's energy balance, or qi, which the Chinese view as the key to good health. Two major Beijing newspapers published the same remedy, while some local pharmacies began recommending their own house blends, and the rush was on. At Tong Ren Tang, the biggest and most famous Chinese medicine pharmacy, located on an old pedestrian walkway south of Tiananmen Square, a three-hour line snaked through corridors to the pick-up counter. Pharmacists had to limit sales to batches of 10 to serve everyone. "We've never had a crowd like this before, but we've never had to deal with atypical pneumonia before," said one of several overworked security guards. Around the world, SARS has afflicted more than 2,700 people, resulting in at least 110 deaths. The epidemic started in southern China in November and spread through Hong Kong. Officially, Beijing has reported 22 cases and 4 fatalities, but worry has increased here in the past week as the Chinese government has begun to address the threat. The Chinese media have been eager for confirmation that traditional medicine works to prevent or cure SARS, and they asked experts at several news conferences for their views. The American doctor from the World Health Organization demurred, but Zhong Nanshan, director of the Guangdong Respiratory Research Institute, was encouraging. While there is no cure for SARS, Zong said Chinese medicine could prevent or ward off the disease. "In the beginning, SARS develops flu-like symptoms," Zhong explained. "Traditional Chinese medicine works to alleviate heat and rid the body of toxins. This treatment should be able to shorten the time of illness." The outbreak of SARS has reasserted the role of both traditional medicine and other folk remedies in Chinese culture. While most urban Chinese rely on Western medicine, they also are likely to be at least familiar with the basic principles of yin and yang - the cold vs. hot properties of the universe that need to be kept in equilibrium according to Chinese medical theory. That is why many Chinese, for example, will not drink a glass of cold water in winter. They sip plain hot water, ever mindful of the body's need to remain in temperature balance. Chinese medicine relies on herbs, roots, grasses and animal powders - each with its own yin or yang properties - to counterbalance health problems, which also come in yin or yang. The Chinese medicinal mantra is "treat yin for yang, yang for yin." So it would be natural to use dried scorpions to treat a stroke victim. Scorpions are yin; a stroke is yang. In Guangdong province during the height of the SARS outbreak in February, the price of vinegar shot up to $12 a bottle from 60 cents as housewives kept pots of vinegar boiling on the kitchen stove in an effort to kill SARS germs. They also drank soup bowls of ban lan gen, a southern Chinese root. The Beijing Evening News laughed at both the vinegar and root soup stories, saying those remedies would not help. "But if you burn sandalwood and Tibetan incense," the newspaper said, "it will have more effect." The paper also recommended keeping rooms well ventilated, being careful with pets and disinfecting elevators. But it failed to mention the first admonition of Western doctors: washing hands frequently. In the line at Tong Ren Tang, most of the customers were middle-aged or older, but a 30-year-old man named Qin, the manager of an electrical machine company, was chatting on his cell phone while waiting to buy an allotment for his employees. "People are worried, so the Beijing Evening News provided a therapy," he said. "I don't know for sure if it will have any effect, but most of the ingredients are meant to alleviate heat, so that should help."   Acupuncture may rival Hormone Replacement Therapy Researchers at the University of Pittsburgh School of Nursing, in the US, are to study the effectiveness of acupuncture in reducing the severity of menopausal symptoms in women with breast cancer. Hormone replacement therapy (HRT) has for some time been the primary treatment for menopausal symptoms but studies indicate that it increases the risk of uterine cancer, and in the case of oestrogen combined with progestin, of breast cancer. Some healthcare workers believe alternative treatments may be a safer way to treat symptoms of menopause. (HealthScout 27/03/03)   Alternative Therapies Gain Respect From Institutions Imagine someone, back in the '70s, predicting that major medical institutions in this country would devote time and money to investigate treatments from non-Western cultures. "I would have said, 'Not in my lifetime,' '' said Dr. David Eisenberg. But now the National Institutes of Health are devoting $100 million a year to research complementary and alternative therapies. And these therapies are gaining popularity among the public. When it comes to out-of-pocket costs -- not counting the portion insurance picks up -- people are spending as much on complementary and alternative treatments as they are on their regular doctors. A study in 1997 showed that people in this country spent between $27 billion and $34 billion on those therapies, compared to about $29 billion on physicians' services, according to Eisenberg, associate professor of medicine at Harvard Medical School. He was in Albuquerque earlier this month to speak at a symposium on integrative medicine sponsored by the University of New Mexico School of Medicine. About half of those expenditures went for massage and chiropractic treatments, he said, while herbal remedies and relaxation techniques also got a good chunk. People most often pursued complementary therapies to deal with neck and back pain, anxiety, depression and headaches, he added. Many doctors still pooh-pooh alternative remedies. "In the absence of mechanistic, scientific explanations, these things will not be accepted," Eisenberg said. Often, physicians dismiss as a placebo effect any improvement their patients see from these therapies. "The placebo has been maligned and misunderstood. What was once a dirty little word is now at the center," he said. New studies have shown how changes in the mind can trigger a whole cascade of measurable effects in the body, he said. Some Albuquerque physicians at the symposium told how they are integrating these different therapies into their own practices. Dr. Jeffrey Sollins said he worked as an emergency-room physician for 10 years before starting Bridges in Medicine. In that practice, a patient will be evaluated by a team that could include anyone from a Western medical specialist to a yoga teacher. Doctors of Oriental medicine might share their suggestions with a Reiki practitioner. Each patient gets a 28-page integrative medicine questionnaire, and the team -- with the patient as the center -- sits at a table and works out a treatment plan, he said. A patient with chronic sinusitis, for example, got acupuncture and other treatments from a doctor of Oriental medicine, nasal sprays from an allergist, body manipulation from a chiropractor, meditation and healing touch and nutritional recommendations. Sollins added that he looks for practitioners with extensive training, often favoring cross-credentialing, such as a registered nurse who has studied Reiki. He warned against medical professionals who try to learn a complementary therapy in a weekend seminar. "The idea that they can become 'weekend warriors,' I think, is dangerous," he said. Dr. Stephen Weiss said he was in a similar group practice, but turned to solo practice recently. He sees eight to 10 patients a day on only three days a week -- by choice, he said. His therapies might include elements of homeopathy, herbs, nutritional supplements, Ayurvedic treatments, counseling, diet and lifestyle changes, and Western drugs, if necessary. "What brings me the greatest joy," Weiss said, "is incorporating spirituality into my work ... praying with them, telling them to meditate." He doesn't abandon Western treatments, he said, noting that he would insist a cancer patient, for example, have a full work-up from an oncologist. But, noting that many deaths are caused by medical errors and drug reactions, Weiss said he thinks it's important to explore less toxic therapies.

UCLA Neuroscientists Reveal The Symphony Of Memory Formation; Advanced Imaging Shows Crescendo, Diminuendo Of Brain Circuitry University Of California - Los Angeles Using newly developed imaging techniques, UCLA neuroscientists for the first time have "unfolded" the brain's sea-horse-shaped hippocampus to reveal how dynamic activity within the brain structure's complex architecture orchestrates memory formation. Details appear in the Jan. 24 edition of the peer-reviewed journal Science. The researchers used extremely high-resolution functional magnetic resonance imaging (fMRI) and software developed at UCLA's Ahmanson-Lovelace Brain Mapping Center to study blood flow within the hippocampus as 10 human volunteers learned to associate names with faces. The study identified areas within the hippocampus -- the cornu ammonis and the dentate gyrus -- as highly active only during encoding of the face-name pairs. This activity decreased as associations were learned. The subiculum, another area of the hippocampus, was active primarily during the retrieval of the face-name associations. Activity in the subiculum also decreased as retrieval became more practiced. Previous studies have demonstrated the importance of the hippocampus in forming memories. However, no studies until now have directly examined how activity patterns within specific substructures change during learning. "Our findings demonstrate that memory formation is a dynamic process, with subdivisions within the hippocampus making distinct but changing contributions as learning takes place," said lead author Michael M. Zeineh, a Brain Mapping Center researcher and student in the David Geffen School of Medicine's Medical Scientist Training Program. "Brain activity increases as information is introduced, then diminishes as the new information becomes better learned. "As knowledge about the brain's complex circuitry grows, neuroscientists will be better able to understand and address a host of debilitating neurological disorders, from Alzheimer's disease to epilepsy to damage caused by head injuries," Zeineh said. The brain's hippocampus is located on the floor of each lateral ventricle. The debilitating effects of damage to the hippocampus were highlighted in the 2001 feature film "Memento," which told the story of a man who struggles to track his wife's killer despite a head injury that destroys his ability to form short-term memories. The UCLA study used fMRI to scan the brains of volunteers as they viewed information using goggles with a TV display. Researchers first introduced pairs of names and faces in sequence and instructed volunteers to learn which face corresponded to which name. In order to distract the subject to prevent rote rehearsal, researchers then asked the volunteers to focus on a crosshair on the screen and report any change. Finally, the researchers showed the volunteers the earlier faces at random, asking them to recall the name associated with each. The process was repeated five times over eight minutes. Researchers used the scans to evaluate blood-oxygen level dependent signals. When the brain becomes active, blood flow increases. The magnetic properties of hemoglobin, a protein in red blood cells that carries oxygen to body tissues, vary depending on the level of oxygenation. These differences can be detected by fMRI. Other UCLA researchers on the team were Stephen A. Engel of the Department of Psychology; Paul M. Thompson of the Laboratory of Neuroimaging and Department of Neurology; and Susan Y. Bookheimer of the Ahmanson-Lovelace Brain Mapping Center and Department of Psychiatry and Biobehavioral Sciences, Division of Brain Mapping. ### Funding for the study was provided the National Institute of Mental Health, the National Institutes of Health, the UCLA Interdepartmental Neuroscience Program, the UCLA Medical Scientist Training Program, the Brain Mapping Medical Research Organization, the Brain Mapping Support Foundation, the Pierson-Lovelace Foundation, the Tamkin Foundation, the Jennifer Jones-Simon Foundation, the Capital Group Companies Charitable Foundation, the Robson Family, the Northstar Fund and the National Center for Research Resources. The Ahmanson-Lovelace Brain Mapping Center at UCLA seeks to improve understanding of the brain in health and disease, through the comprehensive and quantitative study of its structure and function. Spinal stretch for good memory NEW STRAITS TIMES-MANAGEMENT TIMES Florence Thomas ASIA WorldSources, Inc. COPYRIGHT 2003 BY WORLDSOURCES, INC., THERE are various spinal stretches and twists in the practice of yoga. The Concentration Posture (or the Memory Pose) is one of the best tension-relieving postures to perfect. This also helps for light relaxation. The effects of the pose are immediate. Localised tensions like a sinus headache or even migraine headaches are relieved by this posture. Anyone suffering from car sickness, air sickness or any form of motion disorientation will find this posture helps overcome these maladies. Vertigo caused by inner ear imbalance and many inner ear disorders are also positively controlled with this posture. Yogis teach that this spinal stretch acts as a prevention against the growth of spinal cord tumours and also tumours in the brain. The spinal cord is drawn to its most tense position while in this posture. The cerebrospinal fluids cushioning the spinal cord and the brain are relieved of excess pressure, bringing about a beneficial, healthy relaxation. The spine is in a complete arch, with the nose drawn in between the knees. While in this posture, the breathing becomes very shallow-it should almost stop. You should now think about what you want to remember and repeat it over and over. This is indeed a very helpful posture for students studying for exams. You will find you are able to remember information easily. To begin the posture, sit on your heels as in Figures 1A and 1B. Grab hold of your ankles or your feet, whichever the length of your arms allow. Now bend forward at your waist until the head touches the floor in front of the knees. Relax with the elbows to the floor as in Figure 2. Remain sitting on your heels and breathe in a shallow manner for about 30 seconds to a minute. When you are ready to sit up, take a long, deep complete breath, raising the body to an upright position.

Alternative Approach : There Are Many Ways You Can Benefit from Eating Omega-3 Fats In past articles, I have mentioned the many health benefits of fish oil and specifically omega-3 fats. This is not breaking news, since the potential health benefits of omega-3 fats have been discussed for several decades. The first recommendations I ever read were from Andrew Weil, MD, in his writings about the advantages of the Mediterranean diet. But even before that, I was introduced to omega-3 fats by my mother. She got me hooked on a British snack of sardines on toast. Sardines are rich in omega-3 fats. I found the treat to be delicious and often took it to school for lunch. My friends, however, thought it was a very strange sandwich and as hard as I tried, I could not convince them to try it. The benefits of omega-3 fats were discovered by accident. It was found that people who had a diet rich in omega-3 fats, primarily from north Atlantic fish, had a much lower incidence of heart disease and stroke. In contrast, the average American diet only has small amounts of omega-3 fats. It could even be said that our diet, rich in fried foods and red meat, is a good example of what not to eat, since it actually promotes heart disease and stroke. A recent article in the Journal of the American Medical Association discussed the relationship between stroke and fish oil consumption. The authors asked study participants about their consumption of fish. Years later, they looked at the rate of stroke in the group. The results were very significant. Those who ate fish, even one serving per week, had a much lower incidence of stroke than those who did not eat fish. The benefit of eating fish was similar to taking one aspirin per day - without the risks associated with chronic aspirin use. There are two types of stroke. One involves blood clots that block the flow of blood to the brain, called ischemic stroke. It is by far the most common type of stroke and was significantly reduced with fish consumption. The other type of stroke involves the breaking of blood vessels and bleeding into the brain - a hemorrhagic stroke. It is much less common. Fish oil had no benefit in preventing this type of stroke, but neither does aspirin.