Chapter 5. The Sensorimotor System

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Sarah Jane Tribble In response to outrage from patients and lawmakers, Marathon Pharmaceuticals has delayed the launch of an $89,000 drug for Duchenne muscular dystrophy. The company had announced the annual list price for Emflaza, which is a steroid, after the Food and Drug Administration approved the drug Thursday. Emflaza is approved as an orphan drug, which means it is intended to treat a rare disease. Duchenne is an inherited disorder that causes muscles to become weak. There is no cure for the condition, which mainly affects boys, but some drugs, including Emflaza, are used to lessen symptoms. For years, many American patients have imported deflazacort, the generic version of Emflaza, for about $1,200 a year. But because the medicine wasn't approved in the U.S., the cost of the medicine wasn't typically covered by insurers. That contrast in price between became a flash point Monday as Sen. Bernie Sanders, I-Vt., and Rep. Elijah Cummings, D-Md., sent a letter to Marathon on Monday morning demanding answers about the $89,000 price for a drug that isn't new. It has been used routinely by Duchenne patients in the U.S. since at least 2005. "We believe Marathon is abusing our nation's 'orphan drug' program, which grants companies seven years of market exclusivity to encourage research into new treatments for rare diseases — not to provide companies like Marathon with lucrative market exclusivity rights for drugs that have been available for decades," Sanders and Cummings wrote. Marathon said FDA approval would help more patients get the drug. © 2017 npr

Keyword: Movement Disorders
Link ID: 23234 - Posted: 02.15.2017

By Amitha Kalaichandran, When pain researcher Diane Gromala recounts how she started in the field of virtual reality, she seems reflective. She had been researching virtual reality for pain since the early 1990s, but her shift to focusing on how virtual reality could be used for chronic pain management began in 1999, when her own chronic pain became worse. Prior to that, her focus was on VR as entertainment. Gromala, 56, was diagnosed with chronic pain in 1984, but the left-sided pain that extended from her lower stomach to her left leg worsened over the next 15 years. "Taking care of my chronic pain became a full-time job. So at some point I had to make a choice — either stop working or charge full force ahead by making it a motivation for my research. You can guess what I chose," she said. Diane Gromala Pain researcher Diane Gromala found that taking care of her own chronic pain became 'a full-time job.' (Pain studies lab at Simon Fraser University) Now she's finding that immersive VR technology may offer another option for chronic pain, which affects at least one in five Canadians, according to a 2011 University of Alberta study. "We know that there is some evidence supporting immersive VR for acute pain, so it's reasonable to look into how it could help patients that suffer from chronic pain." Gromala has a PhD in human computer interaction and holds the Canada Research Chair in Computational Technologies for Transforming Pain. She also directs the pain studies lab and the Chronic Pain Research Institute at Simon Fraser University in Burnaby, B.C. ©2017 CBC/Radio-Canada.

Keyword: Pain & Touch; Vision
Link ID: 23232 - Posted: 02.15.2017

By GINA KOLATA Dr. James Weinstein, a back pain specialist and chief executive of Dartmouth-Hitchcock Health System, has some advice for most people with lower back pain: Take two aspirin and don’t call me in the morning. On Monday, the American College of Physicians published updated guidelines that say much the same. In making the new recommendations for the treatment of most people with lower back pain, the group is bucking what many doctors do and changing its previous guidelines, which called for medication as first-line therapy. Dr. Nitin Damle, president of the group’s board of regents and a practicing internist, said pills, even over-the-counter pain relievers and anti-inflammatories, should not be the first choice. “We need to look at therapies that are nonpharmacological first,” he said. “That is a change.” The recommendations come as the United States is struggling with an epidemic of opioid addiction that often begins with a simple prescription for ailments like back pain. In recent years, a number of states have enacted measures aimed at curbing prescription painkillers. The problem has also led many doctors around the country to reassess prescribing practices. The group did not address surgery. Its focus was on noninvasive treatment.The new guidelines said that doctors should avoid prescribing opioid painkillers for relief of back pain and suggested that before patients try anti-inflammatories or muscle relaxants, they should try alternative therapies like exercise, acupuncture, massage therapy or yoga. Doctors should reassure their patients that they will get better no matter what treatment they try, the group said. The guidelines also said that steroid injections were not helpful, and neither was acetaminophen, like Tylenol, although other over-the-counter pain relievers like aspirin, naproxen or ibuprofen could provide some relief. © 2017 The New York Times Company

Keyword: Pain & Touch
Link ID: 23231 - Posted: 02.15.2017

By Abigail Zuger, M.D. It was in 2011 that the Centers for Disease Control first drew public attention to the ongoing nationwide opioid crisis. Much earnest commentary has explored the roots of this new killer epidemic since then, focusing on the broad highway between heroin and pain pills, and the online pharmacies, pill mills, and bad-apple doctors who fueled the two-way traffic and enabled catastrophe. Forgive me for rolling my eyes. Anyone with a prescription pad and a shred of common sense saw this whole thing coming down the pike decades ago, a speeding 18-wheeler, tires squealing, no brakes. Furthermore, it has long been clear that while the bad medical apples certainly did their share of damage, there is not a health policy guru or medical school dean in the country whose sins of omission and commission are not also partly responsible. Call it an epidemic of unconscious collusion or, as Dr. Anna Lembke bluntly states, a nation’s doctors “trapped in a system gone mad.” In less than 200 pages, this may be the most important medical book of the decade for finally getting the story of the opioid epidemic exactly right. As far as I am concerned, “Drug Dealer, M.D.,” in less than 200 unassuming, readable, and carefully referenced pages, may be the most important medical book of the decade for finally getting the story of this epidemic exactly right. And it’s not the medical bad apples Lembke is talking about in her title — it’s every doctor in the country. Copyright 2017 Undark

Keyword: Drug Abuse; Pain & Touch
Link ID: 23218 - Posted: 02.13.2017

Sarah Boseley Health editor Low back and neck pain is an increasingly widespread and expensive condition worldwide, costing the US alone $88bn a year – the third highest bill for any health condition – despite evidence most treatments do not work. Millions of people worldwide suffer from low back and neck pain, most of it unexplained, although some professionals think it may be worsened by sitting at desks all day, carrying bags and general bad posture. Episodes of acute pain are very common, but experts say that medical investigations only make things worse and the best cure is often to take painkillers, exercise gently and wait for the pain to pass. The rising bill for treatment in the US has been uncovered in a new study by the Institute of Health Metrics and Evaluation (IHME) at the University of Washington, which looked at public and private spending on all diseases in 2013. Diabetes was in first place on $101.4bn and heart disease was second with $88.1bn. But neck and lower back pain treatment costs were close behind, at $87.6bn. The team split cancer into 29 separate conditions, which meant that none of them made the top 20, although combined the costs of treatment came to $115bn. The most remarkable thing, said Joseph Dieleman, lead author of the paper published in the Journal of the American Medical Association, was the increase in treatment costs for lower back and neck pain, running at 6.5% a year against 3.5% overall. “In absolute terms, there was an increase from $30bn in 1996 to $88bn in 2013,” he told the Guardian. © 2017 Guardian News and Media Limited

Keyword: Pain & Touch
Link ID: 23214 - Posted: 02.11.2017

Katherine Bourzac Kristopher Boesen, who broke his neck in a car accident, regained the ability to move his arms and hands after his spinal cord was injected with stem cells. Two years after having a stroke at 31, Sonia Olea Coontz remained partially paralysed on her right side. She could barely move her arm, had slurred speech and needed a wheelchair to get around. In 2013, Coontz enrolled in a small clinical trial. The day after a doctor injected stem cells around the site of her stroke, she was able to lift her arm up over her head and speak clearly. Now she no longer uses a wheelchair and, at 36, is pregnant with her first child. Coontz is one of stem-cell therapy's “miracle patients”, says Gary Steinberg, chair of neurosurgery at Stanford School of Medicine in California, and Coontz's doctor. Conventional wisdom said that her response was impossible: the neural circuits damaged by the stroke were dead. Most neuroscientists believed that the window for functional recovery extends to only six months after the injury. Stem-cell therapies have shown great promise in the repair of brain and spinal injuries in animals. But animal models often behave differently from humans — nervous-system injuries in rats, for example, heal more readily than they do in people. Clinical trial results have been mixed. Interesting signals from small trials have faded away in larger ones. There are plenty of unknowns: which stem cells are the right ones to use, what the cells are doing when they work and how soon after an injury they can be used. © 2016 Macmillan Publishers Limited,

Keyword: Regeneration; Stem Cells
Link ID: 23210 - Posted: 02.10.2017

Swedish researchers say a simple blood test is effective at differentiating symptoms of Parkinson's disease from similar disorders, but it isn't ready for clinical use. In its early stages, neurologists say Parkinson's is difficult to distinguish from rarer disorders, called atypical parkinsonian disorders. They have overlapping symptoms that tend to worsen more quickly and are more likely to lead to death. Researchers are on the hunt for biomarkers to help diagnosis these disorders. One potential biomarker, a nerve protein that can be detected when nerve cells die, is found in higher concentrations in spinal fluid collected by lumbar puncture. Now medical scientists have also found the protein in less invasive blood tests. For the study published in Wednesday's online issue of the journal Neurology, Dr. Oskar Hansson of Sweden's Lund University and his team examined 504 people in three groups. Two of the groups, in England and Sweden, included healthy people and those who had been living with one of the disorders for an average of four to six years. The third group of 109 patients had the diseases for three years or less. "The results of the present study strongly indicate that NfL when measured in blood can be used to distinguish between patients with Parkinson's disease and patients with progressive supranuclear palsy multiple system atrophy and corticobasal degeneration with high diagnostic accuracy," the study's authors said. ©2017 CBC/Radio-Canada.

Keyword: Parkinsons
Link ID: 23206 - Posted: 02.09.2017

By Anil Ananthaswamy Next time a nurse sticks a needle into your arm, don’t look away: it’ll be less painful. A new study shows that we feel less pain when we are looking at our body – and that this effect works with virtual reality too. In 2009, Patrick Haggard and Matthew Longo of University College London showed that looking at your own body has an analgesic effect. The researchers shone infrared laser light on the skin of volunteers. Those who were looking at their body rather than at a neutral object said that they felt less pain. Scalp electrodes revealed that this analgesic effect was linked to weaker activity in parts of the brain’s cortex that process pain – although why this happens is unclear. Since then, two different teams have tested the effect using the rubber hand illusion – in which a rubber hand is placed next to a person’s real hand, which is hidden from view. Stroking both the real and rubber hands with paint brushes convinces them that the rubber hand is their own. Extending this illusion, the teams wanted to know: can looking at a rubber hand that feels like one’s own alleviate pain in your real hand? The studies were contradictory: one study showed an analgesic effect, but the other did not. Maria Sanchez-Vives at the University of Barcelona, Spain, and her colleagues argue that differences in the position of the rubber hand and real hand may have led to the differing results. To test the effect of the rubber hand’s position, her team used virtual reality to induce the illusion. Instead of seeing a real rubber hand, participants were shown one via a VR headset instead. © Copyright Reed Business Information Ltd.

Keyword: Pain & Touch
Link ID: 23198 - Posted: 02.08.2017

Rae Ellen Bichell By the time Kay Schwister got her diagnosis last summer, she couldn't talk anymore. But she could still scowl, and scowl she did. After weeks of decline and no clue what was causing it, doctors had told Schwister — a 53-year-old vocational rehab counselor and mother of two from Chicago — that she had an incurable disease called Creutzfeldt-Jakob disease, or CJD. The disease was shrinking Kay's brain, and riddling it with holes. She would likely only live a few more weeks, the doctors said. It was a diagnosis that no one could ever want. But the fact that Schwister was able to get a firm diagnosis while still alive is a relatively new development that represents a step forward in understanding a group of devastating neurological disorders. And, some biochemists say, it could lead to better ways of diagnosing brain diseases that are much more common, including Parkinson's and Alzheimer's. For Kay Schwister it all started in the spring of 2016, when she started getting headaches and feeling dizzy all the time. Aging, she told herself, just didn't feel very good. Over the next few weeks, she got steadily worse. "She got to the point where she was so nauseous and so dizzy that she stopped driving and actually stopped working," says her husband, Tim Schwister. By the time Kay entered the emergency room last June her speech had changed. She was enunciating things in a strange way, and finishing each sentence on a really high note. Doctors drew blood and spinal fluid and tested it for things like multiple sclerosis and mercury poisoning. Those tests came back negative. Soon, Kay couldn't talk or walk. © 2017 npr

Keyword: Prions
Link ID: 23191 - Posted: 02.06.2017

Sara Constantino Certain multisensory conditions can alter the experience of bodily ownership. For instance, in the rubber hand illusion, simultaneous visual and haptic inputs lead to the adoption of sensations applied to an artificial limb as one's own. Understanding body ownership, and its malleability, has implications for the development of prosthetics. In a recent paper, Kelly Collins and colleagues at the University of Washington and Karolinska Institute elicited the illusion of ownership of an artificial hand in two epilepsy patients with embedded electrodes through the direct electrical stimulation of the hand area in somatosensory cortex (SI) applied in synchrony with visible touches to a rubber hand. When stimulation was asynchronous or administered to a different SI area, feelings of ownership were no longer induced, stressing the importance of temporal and spatial congruence. They also found that the details of the visual signal (for example, type of touch) affected the sensation. This method extends previous studies by eliciting ownership without stimulation of the peripheral nervous system, which is damaged in patients with spinal cord or nerve lesions. Human–technology mixtures have a long history, with the first known prosthesis, a wooden toe, dating as far back as 950 bc. Today, recent materials, electronics and neuroscience advances are enabling the development of prosthetic limbs that both look and feel real. © 2017 Macmillan Publishers Limited,

Keyword: Pain & Touch
Link ID: 23168 - Posted: 01.31.2017

By Roni Caryn Rabin Neuromas of the foot, a painful condition caused by an inflamed nerve in the ball of the foot, can be effectively treated at home with daily massage and stretches and over-the-counter painkillers, said Dr. Jacqueline Sutera, a doctor of podiatric medicine and surgery. “Of all the patients with neuromas I see in the office, I would say that ultimately only two of 10 might need surgery,” said Dr. Sutera, who practices in New York City and New Jersey. Neuromas of the foot, also known as Morton's neuromas, typically cause sharp, stabbing pain in the second, third and fourth toes. The goal of massaging and stretching is to open up the space between the bones — the metatarsals — in the ball of the foot and increase circulation, which can help reduce the pain and inflammation. Focus on the ball of the foot, not the toes, since the pain in the toes is referred pain from the ball of the foot. Dr. Sutera recommends placing the thumbs at the top of the foot and the other fingers on the bottom of the foot — or vice versa — and pressing and massaging the bones of the ball of the foot, “creating pressure on both sides, top and bottom.” Follow massages with stretches, using your hands to “grab your forefoot and pull it apart so you’re stretching the spaces between the metatarsals in the ball of the foot.” Massages and stretches are most effective at the end of the day, she said, ideally after a hot shower, bath or other heat application. After the massage and stretching, the area should be iced. © 2017 The New York Times Company

Keyword: Pain & Touch
Link ID: 23161 - Posted: 01.28.2017

By GRETCHEN REYNOLDS When people get up and move, even a little, they tend to be happier than when they are still, according to an interesting new study that used cellphone data to track activities and moods. In general, the researchers found, people who move are more content than people who sit. There already is considerable evidence that physical activity is linked to psychological health. Epidemiological studies have found, for example, that people who exercise or otherwise are active typically are less prone to depression and anxiety than sedentary people. But many of these studies focused only on negative moods. They often also relied on people recalling how they had felt and how much they had moved or sat in the previous week or month, with little objective data to support these recollections. For the new study, which was published this month in PLoS One, researchers at the University of Cambridge in England decided to try a different approach. They would look, they decided, at correlations between movement and happiness, that most positive of emotions. In addition, they would look at what people reported about their activity and compare it with objective measures of movement. To accomplish these goals, they first developed a special app for Android phones. Available free on the Google app store and ultimately downloaded by more than 10,000 men and women, it was advertised as helping people to understand how lifestyle choices, such as physical activity, might affect people’s moods. (The app, which is no longer available for download, opened with a permission form explaining to people that the data they entered would be used for academic research.) The app randomly sent requests to people throughout the day, asking them to enter an estimation of their current mood by answering questions and also using grids in which they would place a dot showing whether they felt more stressed or relaxed, depressed or excited, and so on. © 2017 The New York Times Company

Keyword: Depression; Obesity
Link ID: 23147 - Posted: 01.26.2017

By Bob Grant More and more Americans are using cannabis both for medicinal and recreational purposes, but scientists still know little about the drug’s effects on human physiology, according to a National Academies report released this month (January 12). Part of this knowledge gap owes to the fact that cannabis is classified as a Schedule I drug under the US Controlled Substances Act. In the eyes of the federal government, marijuana is a dangerous substance—on par with heroin—that “has no currently accepted medical use in treatment in the United States.” But researchers in Canada are not far ahead of their US counterparts, even though cannabis has since 2001 been functionally legal for medicinal use at the federal level there. See “National Academies Detail the State of Weed Science” “I wish I could say that [legalizing medical marijuana] had led to more research” in Canada, said Mark Ware, a McGill University pain management physician who has researched the safety and efficacy of cannabinoids for the past 18 years. “I think there’s certainly a willingness to be able to document real world use of cannabis under a legal framework.” Ware, who served as a reviewer on the National Academies report, added that while there are several public registries that track the legal use of cannabis among Canadians, experimental evidence on the effects of that use are lacking. “The clinical trials, I think for most people that’s an expensive undertaking,” he said. “There are still questions around who owns the intellectual property, who’s going to sponsor the trials. . . . Those remain barriers even in a legal framework as to the cost of that kind of research and the drug development piece of it.” © 1986-2017 The Scientist

Keyword: Drug Abuse; Pain & Touch
Link ID: 23145 - Posted: 01.25.2017

By JANE E. BRODY Susan Sills, a Brooklyn artist who until recently made life-size cutouts on plywood using a power saw, long suspected she might be at risk for developing Parkinson’s disease. Both her mother and grandfather had this neurological movement disorder, and she knew that it sometimes runs in families. So she was not surprised when at age 72 she first noticed hand tremors and a neurologist confirmed that she had the disease. But to watch her in action three years later, it would be hard for a layperson to tell. She stands straight, walks briskly, speaks in clarion tones and maintains a schedule that could tire someone half her age. Having wisely put the power saw aside, Ms. Sills now makes intricately designed art jewelry. She is also a docent at the Brooklyn Museum, participates in a cooperative art gallery and assists her husband’s business by entertaining customers. Ms. Sills attributes her energy and well-being partly to the medication she takes but primarily to the hours she spends working out with a physical therapist and personal trainer, who have helped her develop an exercise regimen that, while not a cure, can alleviate Parkinson’s symptoms and slow progression of the disease. “The exercises opened me up,” said Ms. Sills, allowing such symptoms as small steps, slow movements and tiny, cramped handwriting to subside. “The earlier people begin exercising after a Parkinson’s diagnosis, and the higher the intensity of exercise they achieve, the better they are,” Marilyn Moffat, a physical therapist on the faculty of New York University, said. “Many different activities have been shown to be beneficial, including cycling, boxing, dancing and walking forward and backward on a treadmill. If someone doesn’t like one activity, there are others that can have equally good results.” © 2017 The New York Times Company

Keyword: Parkinsons
Link ID: 23132 - Posted: 01.23.2017

By Catherine Offord In the early 20th century, Danish biologist Johannes Schmidt solved a puzzle that had confounded European fisherman for generations. Freshwater eels—popular for centuries on menus across northern Europe—were abundant in rivers and creeks, but only as adults, never as babies. So where were they coming from? In 1922, after nearly two decades of research, Schmidt published the answer: the Sargasso Sea, the center of a massive, swirling gyre in the North Atlantic Ocean. Now regarded as some of the world’s most impressive animal migrators, European eels (Anguilla anguilla) journey westward across the Atlantic to spawning sites in the Sargasso; their eggs hatch into larvae that are carried back across the ocean by the Gulf Stream, arriving two or three years later to repopulate European waterways. For decades, researchers have assumed that adults made the journey in one short and rapid migration, leaving European coastlines in autumn and arriving in the Sargasso Sea, ready to spawn, the following spring. But this assumption rests on surprisingly little evidence, says behavioral ecologist David Righton of the UK Centre for Environment, Fisheries, and Aquaculture Science. “Since Johannes Schmidt identified this spawning area in the Sargasso Sea, people have been wondering about that great journey and trying to figure out how to follow the eels,” says Righton, whose work on epic marine migrations includes appropriately titled projects such as CODYSSEY and EELIAD. “But the technology hasn’t been available. . . . They just slip away into the darkness, really, in autumn, and no one knows what happens to them.” © 1986-2017 The Scientist

Keyword: Animal Migration
Link ID: 23116 - Posted: 01.18.2017

Charles Q. Choi Prions, the infectious agents best known for causing degenerative brain disorders such as ‘mad cow’ disease, may have been spotted in bacteria. A section of a protein in Clostridium botulinum, the microbe that causes botulism, can behave like a prion when it is inserted into yeast and Escherichia coli bacteria, researchers report in the 13 January issue of Science1. Prions are formed by proteins that can fold in a number of structurally distinct ways. A prion version of a protein can perpetuate itself in an infectious manner by converting normal forms of that protein into the prion version. Scientists first discovered prions in the 1980s as the agents behind fatal brain disorders known as transmissible spongiform encephalopathies. Since then, researchers have found the misfolded proteins in mammals, insects, worms, plants and fungi2, and learned that not all prions harm their hosts. But until now, prions were only seen in the cells of eukaryotic organisms, a group that includes animals, plants and fungi. In the latest study, researchers analysed roughly 60,000 bacterial genomes using software trained to recognize prion-forming proteins in yeast. They focused on a section of the bacterial protein Rho. In many bacteria, such as C. botulinum and E. coli, Rho is a global regulator of gene expression, meaning that it can control the activity of many genes. © 2017 Macmillan Publishers Limited,

Keyword: Prions
Link ID: 23104 - Posted: 01.14.2017

Bruce Bower Marijuana’s medical promise deserves closer, better-funded scientific scrutiny, a new state-of-the-science report concludes. The report, released January 12 by the National Academies of Sciences, Engineering and Medicine in Washington, D.C., calls for expanding research on potential medical applications of cannabis and its products, including marijuana and chemical components called cannabinoids. Big gaps in knowledge remain about health effects of cannabis use, for good or ill. Efforts to study these effects are hampered by federal classification of cannabis as a Schedule 1 drug, meaning it has no accepted medical use and a high potential for abuse. Schedule 1 status makes it difficult for researchers to access cannabis. The new report recommends reclassifying the substance to make it easier to study. Recommendations from the 16-member committee that authored the report come at a time of heightened acceptance of marijuana and related substances. Cannabis is a legal medical treatment in 28 states and the District of Columbia. Recreational pot use is legal in eight of those states and the District. “The legalization and commercialization of cannabis has allowed marketing to get ahead of science,” says Raul Gonzalez, a psychologist at Florida International University in Miami who reviewed the report before publication. While the report highlights possible medical benefits, Gonzalez notes that it also underscores negative consequences of regular cannabis use. These include certain respiratory and psychological problems. |© Society for Science & the Public 2000 - 2017.

Keyword: Pain & Touch; Drug Abuse
Link ID: 23098 - Posted: 01.13.2017

Parkinson’s disease, a chronic, progressive movement disorder characterized by tremors and stiffness, is not considered a fatal disease in and of itself, though it may reduce life expectancy by a modest amount. It is often said that people die “with” Parkinson’s rather than “of” the disease. “People who are healthy when diagnosed will generally live about as long as other people in their age cohort,” said James Beck, the vice president for scientific affairs at the Parkinson’s Disease Foundation, which is involved in research, education and advocacy. “It is not a death sentence.” Since Parkinson’s generally affects people later in life — patients are typically given a diagnosis in their 60s — patients often die of unrelated age-related diseases like cancer, heart disease or stroke. But the most common cause of death in those with Parkinson’s is pneumonia, because the disease impairs patients’ ability to swallow, putting them at risk for inhaling or aspirating food or liquids into their lungs, leading to aspiration pneumonia. Since Parkinson’s also impairs mobility and balance, those with the disease are also at high risk for falls and accidents, which can trigger a cascade of medical problems, including being bedridden and developing pneumonia, Dr. Beck said. In its advanced stages, the disease can make walking and talking difficult and cause other problems not related to movement, including cognitive impairment. Patients often cannot care for themselves and need assistance carrying out simple activities of daily living. One long-term study followed a group of 142 Parkinson’s patients after they were given their diagnosis; their mean age at diagnosis was around 70. The researchers found that 23 percent were generally doing well 10 years later, meaning they could maintain their balance and did not have dementia. But over half of the patients in the original group had died, with the most common cause related to Parkinson’s being pneumonia. © 2017 The New York Times Company

Keyword: Parkinsons
Link ID: 23094 - Posted: 01.13.2017

Rachel Ehrenberg A protein that sounds the alarm when the body encounters something painful also helps put out the fire. Called Nav1.7, the protein sits on pain-sensing nerves and has long been known for sending a red alert to the brain when the body has a brush with pain. Now, experiments in rodent cells reveal another role for Nav1.7: Its activity triggers the production of pain-relieving molecules. The study, published online January 10 in Science Signaling, suggests a new approach to pain management that takes advantage of this protein’s dual role. “This is very interesting research,” says neuroscientist Munmun Chattopadhyay of Texas Tech University Health Sciences Center El Paso. The findings suggest that when opiates are given for certain kinds of pain relief, also targeting Nav1.7 might lessen the need for those pain relievers, Chattopadhyay says. That could reduce opiate use and their associated side effects. The new research also solves a puzzle that has frustrated researchers and pharmaceutical companies alike. People with rare mutations in the gene for making Nav1.7 feel no pain at all. That discovery, made more than a decade ago, suggested that Nav1.7 was an ideal target for controlling pain. If a drug could block Nav1.7 activity, some kinds of pain might be eradicated (SN: 6/30/12, p 22). Yet drugs designed to do just that didn’t wipe out people’s pain. “It seemed so obvious and simple,” says study leader Tim Hucho, a neuroscientist at the University Hospital Cologne in Germany. “But it was not so simple.” |© Society for Science & the Public 2000 - 2017

Keyword: Pain & Touch
Link ID: 23090 - Posted: 01.12.2017

Valerie Piro The alarm goes off at 4:30 a.m. Groggy, I turn on the lamp on my night stand and try to sit up. I put my right hand on the wall next to my bed to steady myself, and push my left into the bed. Right away, my abs and back seize up and my legs spasm and kick out straight, forcing me back down onto the bed. Clearly my body thinks it is too early to get up, but I don’t have time to argue with it. I have to get physical therapy out of the way so I can be on time for my medieval history class. After I sit up, I place my hands under my right knee and clasp them together as I bring my knee up and closer to my chest. I reach out to my right foot and cross its heel over my left thigh so that I can plant my heel on the bed. I hug my right leg against my torso and chest and feel a stretch in my lower back and butt. I repeat this on my other side and then proceed to stretch each ankle. Paralysis requires maintenance. I then hop toward the foot of my bed, where my commode chair sits. I set both feet on the footrests as best I can, grab the armrest on the far side of the chair with my left hand, and, using my right hand to drive down into my bed, lift myself onto the commode wheelchair, and wheel to the bathroom. I emerge at 5:35 a.m. I transfer now into a wheelchair whose dimensions are friendly toward my Functional Electrical Stimulation (F.E.S.) cycle — something like a gym exercise bike, without the seat. I pull some milk out of the mini-fridge and pour it over a bowl of cereal. I eat while checking and answering email. At 6:30 it’s time to start cycling. I put two small rectangular electrodes on my left shin muscles, and then two on my right, connect them to the cycle, then strap in my legs and feet. Then two more electrodes then two more, and so on, until most of my lower body is tapped and wired. After I turn on the tablet that’s attached to the cycle, I choose from one of several preset programs to start my workout. Within a couple of minutes, electrical shocks are pulsing into my legs, causing them to contract into pedaling. Imagine pedaling a bicycle uphill for an hour; this is my workout. © 2017 The New York Times Company

Keyword: Movement Disorders
Link ID: 23081 - Posted: 01.11.2017