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By Hallie Levine Every 40 seconds, someone in the United States has a stroke, and about three-quarters occur in people ages 65 and older. “As people age, their arteries have a tendency to become less flexible,” and clogged arteries are more likely, says Doris Chan, an interventional cardiologist at NYU Langone Health. This hikes the risk of an ischemic stroke — the most common type — when a blood vessel to the brain becomes blocked by a blood clot. But about 80 percent of all strokes are preventable, according to the Centers for Disease Control and Prevention. And the lifestyle steps you take can be especially powerful in fending off stroke. Here’s what you can do to reduce your risk. 1. Watch these issues. Keeping certain conditions at bay or managing them properly can cut the likelihood of a stroke. Take high blood pressure, which some research suggests is responsible for almost half of strokes. A heart-healthy eating plan may help control it. Also, try to limit sodium to less than 1,500 milligrams a day, maintain a healthy weight and exercise regularly, says Sahil Khera, an interventional cardiologist at the Mount Sinai Hospital in New York. If your blood pressure is high even with the above measures, ask your doctor what levels you should strive for and whether meds are appropriate. Staying out of the hypertensive range can be challenging with age because of the higher potential for medication side effects. While blood pressure below 120/80 can reduce cardiovascular risk, that target should be adjusted if side effects such as dizziness occur, says Hardik Amin, an associate professor of neurology at the Yale School of Medicine in New Haven, Conn. Another important condition to watch for is atrial fibrillation (AFib), an irregular and often rapid heartbeat, which affects at least 10 percent of people over age 80, according to a 2022 study in the Journal of the American College of Cardiology. People with AFib are about five times as likely to have a stroke.

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 4: Development of the Brain
Link ID: 28974 - Posted: 10.28.2023

By Pam Belluck At Ann Johnson’s wedding reception 20 years ago, her gift for speech was vividly evident. In an ebullient 15-minute toast, she joked that she had run down the aisle, wondered if the ceremony program should have said “flutist” or “flautist” and acknowledged that she was “hogging the mic.” Just two years later, Mrs. Johnson — then a 30-year-old teacher, volleyball coach and mother of an infant — had a cataclysmic stroke that paralyzed her and left her unable to talk. On Wednesday, scientists reported a remarkable advance toward helping her, and other patients, speak again. In a milestone of neuroscience and artificial intelligence, implanted electrodes decoded Mrs. Johnson’s brain signals as she silently tried to say sentences. Technology converted her brain signals into written and vocalized language, and enabled an avatar on a computer screen to speak the words and display smiles, pursed lips and other expressions. The research, published in the journal Nature, demonstrates the first time spoken words and facial expressions have been directly synthesized from brain signals, experts say. Mrs. Johnson chose the avatar, a face resembling hers, and researchers used her wedding toast to develop the avatar’s voice. “We’re just trying to restore who people are,” said the team’s leader, Dr. Edward Chang, the chairman of neurological surgery at the University of California, San Francisco. “It let me feel like I was a whole person again,” Mrs. Johnson, now 48, wrote to me. The goal is to help people who cannot speak because of strokes or conditions like cerebral palsy and amyotrophic lateral sclerosis. To work, Mrs. Johnson’s implant must be connected by cable from her head to a computer, but her team and others are developing wireless versions. Eventually, researchers hope, people who have lost speech may converse in real time through computerized pictures of themselves that convey tone, inflection and emotions like joy and anger. “What’s quite exciting is that just from the surface of the brain, the investigators were able to get out pretty good information about these different features of communication,” said Dr. Parag Patil, a neurosurgeon and biomedical engineer at the University of Michigan, who was asked by Nature to review the study before publication. © 2023 The New York Times Company

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 2: Functional Neuroanatomy: The Cells and Structure of the Nervous System
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Link ID: 28882 - Posted: 08.24.2023

Suzana Herculano-Houzel Neuroscientists have long assumed that neurons are greedy, hungry units that demand more energy when they become more active, and the circulatory system complies by providing as much blood as they require to fuel their activity. Indeed, as neuronal activity increases in response to a task, blood flow to that part of the brain increases even more than its rate of energy use, leading to a surplus. This increase is the basis of common functional imaging technology that generates colored maps of brain activity. Scientists used to interpret this apparent mismatch in blood flow and energy demand as evidence that there is no shortage of blood supply to the brain. The idea of a nonlimited supply was based on the observation that only about 40% of the oxygen delivered to each part of the brain is used – and this percentage actually drops as parts of the brain become more active. It seemed to make evolutionary sense: The brain would have evolved this faster-than-needed increase in blood flow as a safety feature that guarantees sufficient oxygen delivery at all times. Functional magnetic resonance imaging is one of several ways to measure the brain. But does blood distribution in the brain actually support a demand-based system? As a neuroscientist myself, I had previously examined a number of other assumptions about the most basic facts about brains and found that they didn’t pan out. To name a few: Human brains don’t have 100 billion neurons, though they do have the most cortical neurons of any species; the degree of folding of the cerebral cortex does not indicate how many neurons are present; and it’s not larger animals that live longer, but those with more neurons in their cortex. I believe that figuring out what determines blood supply to the brain is essential to understanding how brains work in health and disease. It’s like how cities need to figure out whether the current electrical grid will be enough to support a future population increase. Brains, like cities, only work if they have enough energy supplied. © 2010–2023, The Conversation US, Inc.

Related chapters from BN: Chapter 2: Functional Neuroanatomy: The Cells and Structure of the Nervous System; Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals; Chapter 15: Language and Lateralization
Link ID: 28726 - Posted: 04.01.2023

By Eva Holland Kris Walterson doesn’t remember exactly how he got to the bathroom, very early on a Friday morning — only that once he got himself there, his feet would no longer obey him. He crouched down and tried to lift them up with his hands before sliding to the floor. He didn’t feel panicked about the problem, or even nervous really. But when he tried to get up, he kept falling down again: slamming his back against the bathtub, making a racket of cabinet doors. It didn’t make sense to him then, why his legs wouldn’t lock into place underneath him. He had a pair of fuzzy socks on, and he tried pulling them off, thinking that bare feet might get better traction on the bathroom floor. That didn’t work, either. When his mother came from her bedroom to investigate the noise, he tried to tell her that he couldn’t stand, that he needed her help. But he couldn’t seem to make her understand, and instead of hauling him up she called 911. After he was loaded into an ambulance at his home in Calgary, Alberta, a paramedic warned him that he would soon hear the sirens, and he did. The sound is one of the last things he remembers from that morning. Walterson, who was 60, was experiencing a severe ischemic stroke — the type of stroke caused by a blockage, usually a blood clot, in a blood vessel of the brain. The ischemic variety represents roughly 85 percent of all strokes. The other type, hemorrhagic stroke, is a yin to the ischemic yang: While a blockage prevents blood flow to portions of the brain, starving it of oxygen, a hemorrhage means blood is unleashed, flowing when and where it shouldn’t. In both cases, too much blood or too little, a result is the rapid death of the affected brain cells. When Walterson arrived at Foothills Medical Center, a large hospital in Calgary, he was rushed to the imaging department, where CT scans confirmed the existence and location of the clot. It was an M1 occlusion, meaning a blockage in the first and largest branch of his middle cerebral artery. © 2023 The New York Times Company

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 2: Functional Neuroanatomy: The Cells and Structure of the Nervous System
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Link ID: 28688 - Posted: 03.04.2023

By Darren Incorvaia Sitting in an exam room, surrounded by doctors and scientists, Heather Rendulic opened her left hand for the first time since suffering a series of strokes nine years earlier when she was in her early 20s. “It was an amazing feeling for me to be able to do that again,” Rendulic says. “It’s not something I ever thought was possible.” But immediately after a surgically implanted device sent electrical pulses into her spinal cord, Rendulic could not only open her hand but also showed other marked improvements in arm mobility, researchers report February 20 in Nature Medicine. “We all started crying,” Marco Capogrosso, a neuroscientist at the University of Pittsburgh, said in a February 15 news conference. “We didn’t really expect this could work as fast as that.” The approach is similar to that recently used for patients paralyzed by spinal cord injuries (SN: 08/03/22). It represents a promising new technique for restoring voluntary movement to those left with upper-body paralysis following strokes, the team says. A stroke occurs when blood supply to parts of the brain is cut off, often causing short-term or long-term issues with movement, speech and vision. Stroke is a leading, and often underappreciated, cause of paralysis; in the United States alone, 5 million people are living with some form of motor deficit due to stroke. While physical therapy can provide some improvements, no treatment exists to help these patients regain full control of their limbs — and their lives. Strokes cause paralysis because the connection between the brain and the spinal cord is damaged; the brain tries to tell the spinal cord to move certain muscles, but the message is muddled. © Society for Science & the Public 2000–2023.

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 11: Motor Control and Plasticity
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 5: The Sensorimotor System
Link ID: 28678 - Posted: 02.22.2023

By Paula Span On a recent afternoon in Bastrop, Texas, Janet Splawn was walking her dog, Petunia, a Pomeranian-Chihuahua mix. She said something to her grandson, who lives with her and had accompanied her on the stroll. But he couldn’t follow; her speech had suddenly become incoherent. “It was garbled, like mush,” Ms. Splawn recalled a few days later from a hospital in Austin. “But I got mad at him for not understanding. It was kind of an eerie feeling.” People don’t take chances when 87-year-olds develop alarming symptoms. Her grandson drove her to the nearest hospital emergency room, which then transferred her to a larger hospital for a neurology consultation. The diagnosis: a transient ischemic attack, or T.I.A. For decades, patients have been relieved to hear that phrase. The sudden onset of symptoms like weakness or numbness (often on one side), loss of vision (often in one eye) and trouble with language (speaking, understanding or both) — if resolved in a few minutes — is considered “transient.” Whew. But in a recent editorial in JAMA, two neurologists called for doctors and patients to abandon the term transient ischemic attack. It’s too reassuring, they argued, and too likely to lead someone with passing symptoms to wait until the next morning to call a doctor or let a week go by before arranging an appointment. That’s dangerous. Better, they said, to call a T.I.A. what it is: a stroke. More specifically, a minor ischemic stroke. (Almost 90 percent of strokes, which afflict 795,000 Americans a year, are ischemic, meaning they result from a clot that reduces blood flow to the brain.) Until recently, T.I.A.s “were played down,” said Dr. J. Donald Easton, a neurologist recently retired from the University of California, San Francisco, and an author of the editorial. “The person thinks, ‘Oh, it’s over. It goes away, so all is well.’ But all is not well. There’s trouble to come, and it’s coming soon.” The advent of brain imaging — first CT scans in the late 1970s, then the more precise M.R.I.s in the 1990s — has shown that many T.I.A.s, sometimes called ministrokes, cause visible and permanent brain damage. © 2022 The New York Times Company

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 28275 - Posted: 04.09.2022

Rina Torchinsky Over the weekend, the model Hailey Bieber told her Instagram followers that she experienced stroke-like symptoms while at breakfast with her husband Thursday morning. Doctors found a small clot in her brain, she said, which caused "a small lack of oxygen." Bieber said on Instagram that her body passed the clot on its own, and she recovered within a few hours. Though Bieber recovered in her case, blood clots in the brain can lead to ischemic strokes, which make up a majority of all strokes. And among young people, stroke rates are on the rise. Here's what you need to know. Ischemic strokes happen when blood flow is blocked through an artery that delivers blood to the brain. These strokes account for the vast majority of all strokes, according to the Centers for Disease Control and Prevention. Transient ischemic attacks, which are sometimes called "mini-strokes," are different than ischemic strokes because these strokes block blood flow from the brain for a short period of time only — often, as short as five minutes. Like ischemic strokes, these strokes are also often caused by blood clots. Although these are short-lived, transient ischemic attacks warn of future strokes and are medical emergencies. More than a third of people who experience these do not receive treatment and have a major stroke within a year, according to the CDC. A hemorrhagic stroke is another type of stroke, which occurs when an artery in the brain leaks blood or ruptures. The leaked blood puts pressure on brain cells and damages them. High blood pressure and aneurysms can cause these strokes, the CDC says. Over the past 30 years, stroke incidence among adults 49 and younger has continued to increase in Southern states and the Midwest, the American Heart Association said in February. Rates have declined for those older than 75. © 2022 npr

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 28240 - Posted: 03.16.2022

By Erin Blakemore Anger — such as road rage and the simmering displeasure of the ongoing pandemic — is the watchword for 2021. But be careful — those big emotions could trigger a stroke. FAQ: What to know about the omicron variant of the coronavirus Researchers in a global study devoted to figuring out stroke triggers found that about 1 in 11 stroke patients experience anger or emotional upset in the hour before their stroke symptoms begin. The study, published in the European Heart Journal, looked at data from 13,462 patients in 32 countries who had strokes. The patients completed extensive questionnaires during the first three days after they were hospitalized, answering questions about their medical history and what they had been doing and feeling before their stroke. Just over 8 percent of the patients surveyed said they had experienced anger or emotional upset within a day of symptom onset, which served as the control period. Just over 9 percent said they had been angry or upset within an hour of the first symptoms of their stroke, which was the test period. The risk of a stroke was higher in the test period when compared with the control period, the researchers said. “Our research found that anger or emotional upset was linked to an approximately 30% increase in risk of stroke during one hour after an episode — with a greater increase if the patient did not have a history of depression,” Andrew Smyth, a professor of clinical epidemiology at NUI Galway in Ireland who co-led the study, said in a statement. Lower education upped the odds of having a stroke linked with anger or emotional upset, as well.

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 11: Emotions, Aggression, and Stress
Link ID: 28109 - Posted: 12.15.2021

Andrew Gregory Health editor Drinking coffee or tea may be linked with a lower risk of stroke and dementia, according to the largest study of its kind. Strokes cause 10% of deaths globally, while dementia is one of the world’s biggest health challenges – 130 million are expected to be living with it by 2050. In the research, 365,000 people aged between 50 and 74 were followed for more than a decade. At the start the participants, who were involved in the UK Biobank study, self-reported how much coffee and tea they drank. Over the research period, 5,079 of them developed dementia and 10,053 went on to have at least one stroke. Researchers found that people who drank two to three cups of coffee or three to five cups of tea a day, or a combination of four to six cups of coffee and tea, had the lowest risk of stroke or dementia. Those who drank two to three cups of coffee and two to three cups of tea daily had a 32% lower risk of stroke. These people had a 28% lower risk of dementia compared with those who did not drink tea or coffee. The research, by Yuan Zhang and colleagues from Tianjin Medical University, China, suggests drinking coffee alone or in combination with tea is also linked with lower risk of post-stroke dementia. Writing in the journal Plos Medicine, the authors said: “Our findings suggested that moderate consumption of coffee and tea separately or in combination were associated with lower risk of stroke and dementia.” © 2021 Guardian News & Media Limited

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 13: Memory and Learning
Link ID: 28082 - Posted: 11.20.2021

Jon Hamilton People who have had a stroke appear to regain more hand and arm function if intensive rehabilitation starts two to three months after the injury to their brain. A study of 72 stroke patients suggests this is a "critical period," when the brain has the greatest capacity to rewire, a team reports in this week's journal PNAS. The finding challenges the current practice of beginning rehabilitation as soon as possible after a stroke and suggests intensive rehabilitation should go on longer than most insurance coverage allows, says Elissa Newport, a co-author of the study and director of the Center for Brain Plasticity and Recovery at Georgetown University Medical Center. Newport was speaking in place of the study's lead author, Dr. Alexander Dromerick, who died after the study was accepted but before it was published. If the results are confirmed with other larger studies, "the clinical protocol for the timing of stroke rehabilitation would be changed," says Li-Ru Zhao, a professor of neurosurgery at Upstate Medical University in Syracuse, N.Y., who was not involved in the research. The study involved patients treated at Medstar National Rehabilitation Hospital in Washington, D.C., most in their 50s and 60s. One of the study participants was Anthony McEachern, who was 45 when he had a stroke in 2017. Just a few hours earlier, McEachern had been imitating Michael Jackson dance moves with his kids. But at home that night he found himself unable stand up. © 2021 npr

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 13: Memory and Learning
Link ID: 28002 - Posted: 09.22.2021

Robin McKie, Science Editor Anne Abbott is a scientist on a mission. She believes large numbers of debilitating strokes can be prevented without surgical interventions. Lifestyle changes and medication alone can make massive improvements to people at risk from the thickening of their arteries. It is not an attitude that has endeared her to the medical establishment, however. For years, it has attempted to block her work while instead pressing for increasing use of carotid surgery and stents, she told the Observer last week. “I was told not to publish my research findings,” said Abbott, associate professor of neuroscience at Monash University in Melbourne. “I was shocked. Then it became hard to submit grant applications to continue my research. People would say ‘yes’ to my proposals, then at the last minute, they would back out. If you can’t put a grant in, it could be the end of your research career.” But now Abbott’s efforts have received global recognition – thanks to the judges of the John Maddox prize. Named after the former editor of Nature, and organised by the journal and the charity Sense About Science, the international awards are given to researchers who stand up for sound science. Past winners have included scientists who have been persecuted for speaking out about the dangers of rainforest destruction, the bleaching of coral reefs and the misuse of vitamin C supplements as “treatments” for cancer. This year, US health chief Anthony Fauci and his South African counterpart Salim Abdool Karim were jointly awarded the main John Maddox prize for “communicating the complex science of Covid-19 in the midst of international uncertainty and anxiety”. However, the judges also gave an early career award to Abbott for her perseverance in challenging traditional surgical and stenting procedures as the main way to treat patients at risk of strokes. (A stent is a tiny tube that can be placed into an artery or vein.) © 2020 Guardian News & Media Limited

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 27634 - Posted: 12.22.2020

By Jennifer Couzin-Frankel Athena Akrami’s neuroscience lab reopened last month without her. Life for the 38-year-old is a pale shadow of what it was before 17 March, the day she first experienced symptoms of the novel coronavirus. At University College London (UCL), Akrami’s students probe how the brain organizes memories to support learning, but at home, she struggles to think clearly and battles joint and muscle pain. “I used to go to the gym three times a week,” Akrami says. Now, “My physical activity is bed to couch, maybe couch to kitchen.” Her early symptoms were textbook for COVID-19: a fever and cough, followed by shortness of breath, chest pain, and extreme fatigue. For weeks, she struggled to heal at home. But rather than ebb with time, Akrami’s symptoms waxed and waned without ever going away. She’s had just 3 weeks since March when her body temperature was normal. “Everybody talks about a binary situation, you either get it mild and recover quickly, or you get really sick and wind up in the ICU,” says Akrami, who falls into neither category. Thousands echo her story in online COVID-19 support groups. Outpatient clinics for survivors are springing up, and some are already overburdened. Akrami has been waiting more than 4 weeks to be seen at one of them, despite a referral from her general practitioner. The list of lingering maladies from COVID-19 is longer and more varied than most doctors could have imagined. Ongoing problems include fatigue, a racing heartbeat, shortness of breath, achy joints, foggy thinking, a persistent loss of sense of smell, and damage to the heart, lungs, kidneys, and brain. © 2020 American Association for the Advancement of Science.

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27399 - Posted: 08.03.2020

Ian Sample Science editor Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned. Neurologists are on Wednesday publishing details of more than 40 UK Covid-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom. The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication. A dozen patients had inflammation of the central nervous system, 10 had brain disease with delirium or psychosis, eight had strokes and a further eight had peripheral nerve problems, mostly diagnosed as Guillain-Barré syndrome, an immune reaction that attacks the nerves and causes paralysis. It is fatal in 5% of cases. “We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust. “What we’ve seen with some of these Adem patients, and in other patients, is you can have severe neurology, you can be quite sick, but actually have trivial lung disease,” he added. “Biologically, Adem has some similarities with multiple sclerosis, but it is more severe and usually happens as a one-off. Some patients are left with long-term disability, others can make a good recovery.” © 2020 Guardian News & Media Limited

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 11: Motor Control and Plasticity
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 5: The Sensorimotor System
Link ID: 27354 - Posted: 07.08.2020

By Linda Searing Every 40 seconds, on average, someone in the United States has a stroke — amounting to 795,000 people a year, according to the Centers for Disease Control and Prevention. Most strokes, 80 percent or more, occur when blood flow to the brain is blocked by a clot. Known as an ischemic stroke, it results in brain cells not getting needed oxygen and nutrients, which causes the cells to start dying within minutes. The other main type of stroke, hemorrhagic stroke, occurs when a blood vessel in the brain leaks or bursts, with the flood of blood putting pressure on and damaging the brain cells. This type of stroke may be caused by high blood pressure (which over time can weaken blood vessel walls) or an aneurysm (a bulge in a blood vessel that bursts). Both types of stroke can cause lasting brain damage, disability or death, and some 140,000 Americans die each year from a stroke. The likelihood of brain damage and disability increases the longer a stroke goes untreated, making it critical to call 911 and get emergency stroke treatment started as soon as possible. Signs of a stroke usually come on suddenly and may include numbness or weakness in the face, arm or leg, trouble speaking, blurred or double vision, dizziness or stumbling when trying to walk or a very severe headache. A condition similar to a stroke, known as a transient ischemic attack, occurs when the blood supply to the brain is blocked for a short time (hence its nickname, “mini-stroke”). Though damage to the brain from a TIA is not permanent, it does make the chances of a full-blown stroke more likely. Because of this, the American Stroke Association refers to a TIA as a “warning stroke.” © 1996-2020 The Washington Post

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 27347 - Posted: 07.08.2020

By Laura Sanders COVID-19 cases described by U.K. doctors offer a sharper view of the illness’s possible effects on the brain. Strokes, confusion and psychosis were found among a group of 125 people hospitalized with infections of SARS-CoV-2, the coronavirus behind the pandemic. The results, described June 25 in Lancet Psychiatry, come from a group of severely sick people, so they can’t answer how common these types of neurological symptoms may be in a more general population. Still, these details bring scientists closer to better understanding COVID-19. Brain-related symptoms of COVID-19 patients can slip through the cracks. “These relatively rare but incredibly severe complications get missed, like needles in a haystack,” says Benedict Michael, a neurologist at the University of Liverpool in England. So he and his colleagues designed a survey to uncover these symptoms. Sign up for e-mail updates on the latest coronavirus news and research In April, neurologists, stroke physicians, psychiatrists and other doctors across the United Kingdom entered COVID-19 patient details to a centralized database as part of the survey. Targeting these scientific specialties meant that the patients included were likely to have brain-related symptoms. Of the 125 patients described fully, 77 experienced an interruption of blood flow in the brain, most often caused by a blood clot in the brain. Blood clots are a well-known and pernicious COVID-19 complication (SN: 6/23/20), and strokes have been seen in younger people with COVID-19. About a third of the 125 patients had a shift in mental state, including confusion, personality change or depression. Eighteen of 37 patients with altered mental states were younger than 60. So far, it’s unclear exactly how SARS-CoV-2 causes these symptoms. © Society for Science & the Public 2000–2020.

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 27330 - Posted: 06.27.2020

Jon Hamilton A neurologist who encased his healthy right arm in a pink fiberglass cast for two weeks has shown how quickly the brain can change after an injury or illness. Daily scans of Dr. Nico Dosenbach's brain showed that circuits controlling his immobilized arm disconnected from the body's motor system within 48 hours. But during the same period, his brain began to produce new signals seemingly meant to keep those circuits intact and ready to reconnect quickly with the unused limb. Dosenbach, an assistant professor at Washington University School of Medicine in St. Louis, repeated the experiment on two colleagues (their casts were purple and blue) and got the same result. In all three people, the disconnected brain circuits quickly reconnected after the cast was removed. The study, published online in the journal Neuron, shows that "within a few days, we can rearrange some of the most fundamental, most basic functional relationships of the brain," Dosenbach says. It suggests it is possible to reverse brain changes caused by disuse of a limb after a stroke or brain injury. The results of the study appear to support the use of something called constraint-induced movement therapy, or CIMT, which helps people – usually children — regain the use of a disabled arm or hand by constraining the other, healthy limb with a sling, splint or cast. Previous studies of CIMT have produced mixed results, in part because they focused on brain changes associated with increased use of a disabled arm, Dosenbach says. "We looked at the effect of actually not using an arm because we thought that was a much more powerful intervention," he says. © 2020 npr

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 11: Motor Control and Plasticity
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 5: The Sensorimotor System
Link ID: 27311 - Posted: 06.19.2020

In a nationwide study, NIH funded researchers found that the presence of abnormal bundles of brittle blood vessels in the brain or spinal cord, called cavernous angiomas (CA), are linked to the composition of a person’s gut bacteria. Also known as cerebral cavernous malformations, these lesions which contain slow moving or stagnant blood, can often cause hemorrhagic strokes, seizures, or headaches. Current treatment involves surgical removal of lesions when it is safe to do so. Previous studies in mice and a small number of patients suggested a link between CA and gut bacteria. This study is the first to examine the role the gut microbiome may play in a larger population of CA patients. Led by scientists at the University of Chicago, the researchers used advanced genomic analysis techniques to compare stool samples from 122 people who had at least one CA as seen on brain scans, with those from age- and sex-matched, control non-CA participants, including samples collected through the American Gut Project(link is external). Initially, they found that on average the CA patients had more gram-negative bacteria whereas the controls had more gram-positive bacteria, and that the relative abundance of three gut bacterial species distinguished CA patients from controls regardless of a person’s sex, geographic location, or genetic predisposition to the disease. Moreover, gut bacteria from the CA patients appeared to produce more lipopolysaccharide molecules which have been shown to drive CA formation in mice. According to the authors, these results provided the first demonstration in humans of a “permissive microbiome” associated with the formation of neurovascular lesions in the brain.

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27280 - Posted: 06.04.2020

Kerry Grens Several hospitals in the US have observed strokes in a number of patients being treating for coronavirus, leading to concern that the infection may be causing devastating blockages in the brain. For at least two facilities, these events account for a spike in stroke cases among middle-aged patients. “Our report shows a seven-fold increase in incidence of sudden stroke in young patients during the past two weeks,” Thomas Oxley, a neurosurgeon at Mount Sinai Health System in New York who describes five of his patients in an upcoming paper in the New England Journal of Medicine, tells CNN. “Most of these patients have no past medical history and were at home with either mild symptoms (or in two cases, no symptoms) of Covid.” Although the numbers of stroke incidents among coronavirus patients remains low, The Washington Post notes that three medical centers in the US will be publishing reports on dozens of COVID-19 patients who experienced strokes. And these appear to be the most serious kind of stroke, called a large vessel occlusion, which might account for the surge in the number of people who have died at home during the pandemic, but this cannot be confirmed. Thomas Jefferson University Hospitals and NYU Langone Health found that 40 percent of the 12 people treated for large vessel blockage who also tested positive for SARS-CoV-2 were under age 50, according to the Post. “We are used to thinking of 60 as a young patient when it comes to large vessel occlusions,” Eytan Raz of NYU Langone tells the newspaper. “We have never seen so many in their 50s, 40s and late 30s.” © 1986–2020 The Scientist.

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 27217 - Posted: 04.29.2020

Nathan Denette/The Canadian Press While the new coronavirus is known to cause respiratory illness, some scientists suggest it can also potentially lead to brain and nerve damage in certain patients. Beyond the typical symptoms of COVID-19, including fever, cough and difficulty breathing, doctors around the world have reported cases of infected patients with an array of neurological problems, including stroke, seizures, anosmia, or a loss of smell, and encephalopathy, a broad term used to describe brain damage or dysfunction. Since these reports have so far been limited to anecdotal case studies, it is still too early to know whether the virus is to blame for these neurological symptoms, said clinical epidemiologist Jose Tellez-Zenteno, a professor of neurology at the University of Saskatchewan. Nevertheless, he said, it’s important for the public and health care providers to know this is a possibility. “The virus can go to the brain potentially,” Dr. Tellez-Zenteno said. “And not only for neurologists, but for [front-line] doctors …, they have to be aware that neurological complications can happen and be ready to diagnose and ready to treat, if there is some treatment for them.” He noted that in one study of 214 hospitalized COVID-19 patients in Wuhan, China, researchers reported more than 35 per cent had neurological complications, including decreased levels of consciousness, stroke and muscle damage. These were more likely to occur among the hospitalized patients who were severely ill with COVID-19. Dr. Tellez-Zenteno emphasized that the vast majority of individuals who catch COVID-19 have mild or no symptoms. © Copyright 2020 The Globe and Mail Inc.

Related chapters from BN: Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 15: Language and Lateralization
Link ID: 27175 - Posted: 04.07.2020

By Sarah Witman Nicole Dodds first noticed her son, Rowan, was having trouble using the right side of his body when he was about 6 months old. Babies typically use both hands to pick up toys and lift their chest off the floor at that age, but Rowan was mostly using his left arm and hand, keeping his right hand balled in a fist. That started a string of doctor visits. Around Rowan’s first birthday, doctors did an MRI and diagnosed his one-sided weakness as hemiplegia, probably caused by a stroke he sustained in utero. This surprised Dodds, since as far as she knew she’d had a totally normal pregnancy and birth Perinatal stroke — when an infant loses blood supply to the brain in late pregnancy, during birth or in the first month of life — is one of the most common causes of hemiplegia in infants, affecting anywhere from 1 in 2,500 to 1 in 4,000 live births in the United States every year. Like adult stroke, perinatal stroke is usually caused by a blood clot that jams brain arteries, or else by bleeding in or around the infant’s brain. Babies with heart disease, clotting disorders such as hemophilia, and bacterial infection among other factors have a higher risk of perinatal stroke, but the exact cause is often unknown. As in the case with Rowan, there are often no outward signs for up to a year that something is amiss, resulting in delayed or inconclusive diagnosis. It’s nearly impossible to detect a stroke in utero, or even in the first few weeks after birth, since the symptoms can seem within the norm for infants: favoring one side, extreme sleepiness, mild seizures that seem like shivering or sudden stiffening. More obvious behaviors such as trouble walking and talking don’t usually become apparent until the child turns 2, and are associated with other childhood problems.

Related chapters from BN: Chapter 7: Life-Span Development of the Brain and Behavior; Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 15: Language and Lateralization
Link ID: 27069 - Posted: 02.25.2020