Chapter 15. Brain Asymmetry, Spatial Cognition, and Language
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By Smitha Mundasad Health reporter There has been a worrying rise in the number of working-age men and women having strokes, a charity has warned. In England in 2014 there were 6,221 hospital admissions for men aged 40-54 - a rise of 1,961 on 14 years earlier, a Stroke Association study shows. Experts said unhealthy lifestyles were partly to blame for the rise, though the growing population and changes to hospital practice also played a part. Overall the rate of strokes is going down in the UK, however. Researchers say based on their findings strokes should not be considered as a disease of the old. Strokes are caused by blood clots or bleeds to the brain and can lead to long-lasting disability. The majority occur in people aged over 65, and though rates are decreasing in this group, this report suggests growing numbers of younger people are at risk. Experts analysed national hospital admission data spanning 2000 to 2014. Trends for people in their 40s and early 50s appeared to be getting worse. In women aged 40-54, there were an extra 1,075 strokes recorded in 2014, compared with 2000. Experts said growing obesity levels, sedentary lives and unhealthy diets - which raise the risks of dangerous blood clots - all played a part. And they argued strokes among this age group had long-lasting personal and financial impacts on individuals and their families, as well as on the economy. Recovering patients can find it difficult to return to work and should have more support from employers, the report suggests. Jon Barrick, of the Stroke Association, said: "These figures show stroke can no longer be seen as a disease of older people. "There is an alarming increase in the numbers of people having a stroke in working age. © 2015 BBC.
Link ID: 20912 - Posted: 05.12.2015
by Jessica Hamzelou GOO, bah, waahhhh! Crying is an obvious sign something is up with your little darling but beyond that, their feelings are tricky to interpret – except at playtime. Trying to decipher the meaning behind the various cries, squeaks and babbles a baby utters will have consumed many a parent. Some researchers reckon babies are simply practising to learn to speak, while others think these noises have some underlying meaning. "Babies probably aren't aware of wanting to tell us something," says Jitka Lindová, an evolutionary psychologist at Charles University in Prague, Czech Republic. Instead, she says, infants are conveying their emotions. But can adults pick up on what those emotions are? Lindová and her colleagues put 333 adults to the test. First they made 20-second recordings of five- to 10-month-old babies while they were experiencing a range of emotions. For example, noises that meant a baby was experiencing pain were recorded while they received their standard vaccinations. The team also collected recordings when infants were hungry, separated from a parent, reunited, just fed, and while they were playing. The volunteers had to listen to a selection of the recordings then guess which situation each related to. The adults could almost always tell whether a baby was distressed in some way. This makes sense – a baby's survival may depend on an adult being able to tell whether a baby is unwell, in pain or in danger. © Copyright Reed Business Information Ltd.
By HOWARD MEGDAL Ali Krieger has a lot on her plate this year. As a defender for the United States women’s national team, she is weeks away from the start of her second World Cup. And as one of the most prominent members of the National Women’s Soccer League, she is helping build an audience for her team and the fledgling league. On April 10, though, those roles were jeopardized when Krieger, playing for the Washington Spirit in an N.W.S.L. game at Houston, sustained a concussion after rising for a header. “Right when it happened, I had no idea why I was lying on the ground and why people were standing over me,” Krieger said by telephone last week. “And people were talking to me — I couldn’t really open my eyes at first. I was like, ‘Is this a dream?’ ” Krieger said that she lost consciousness before hitting the ground and that when she woke up, even as she lay on the grass, she quickly tried to diagnose the injury. Krieger said she believed the concussion was minor — certainly less serious than one she sustained in 2013 that took her a couple of months to recover from. But injuries like hers and the ones sustained by several other players in high-profile cases have troubled concussion activists. They say that despite clear progress in the recognition and treatment of head injuries in soccer, it is often up to the injured athlete or that athlete’s coach to determine when an injury requires removal from play. In the worst cases, the time remaining in a match and the score play a role in the decision. The ESPN analyst Taylor Twellman, a former striker whose playing career was ended by head injuries, has been a vocal advocate on television and social media for better treatment of head injuries. But given the pressure to succeed at the game’s top levels, he said in an email, “I’m scared of what I still hear in 2015.” © 2015 The New York Times Company
Keyword: Brain Injury/Concussion
Link ID: 20876 - Posted: 05.04.2015
// by Jennifer Viegas Male species of a West African monkey communicate using at least these six main sounds: boom-boom, krak, krak-oo, hok, hok-oo and wak-oo. Key to the communication by the male Campbell's monkey is the suffix "oo," according to a new study, which is published in the latest issue of the Proceedings of the Royal Society B. By adding that sound to the end of their calls, the male monkeys have created a surprisingly rich "vocabulary" that males and females of their own kind, as well as a related species of monkey, understand. The study confirms prior suspected translations of the calls. For example, "krak" means leopard, while "krak-oo" refers to other non-leopard threats, such as falling branches. "Boom-boom-krak-oo" can roughly translate to, "Watch out for that falling tree branch." "Several aspects of communication in Campbell's monkeys allow us to draw parallels with human language," lead author Camille Coye, a researcher at the University of St. Andrews, told Discovery News. For the study, she and her team broadcast actual and artificially modified male Campbell's monkey calls to 42 male and female members of a related species: Diana monkeys. The latter's vocal responses showed that they understood the calls and replied in predicted ways. They freaked out after hearing "krak," for example, and remained on alert as they do after seeing a leopard. © 2015 Discovery Communications, LLC.
By Sid Perkins Imagine having a different accent from someone else simply because your house was farther up the same hill. For at least one species of songbird, that appears to be the case. Researchers have found that the mating songs of male mountain chickadees (Poecile gambeli, shown) differ in their duration, loudness, and the frequency ranges of individual chirps, depending in part on the elevation of their habitat in the Sierra Nevada mountains of the western United States. The songs also differed from those at similar elevations on a nearby peak. Young males of this species learn their breeding songs by listening to adult males during their first year of life, the researchers note. And because these birds don’t migrate as the seasons change, and young birds don’t settle far from where they grew up, it’s likely that the differences persist in each local group—the ornithological equivalent of having Southern drawls and Boston accents. Females may use the differences in dialect to distinguish local males from outsiders that may not be as well adapted to the neighborhood they’re trying to invade, the team reports today in Royal Society Open Science. © 2015 American Association for the Advancement of Science
By Linda Carroll Women may have a harder time recovering from concussion, a new study suggests. Taiwanese researchers found women were more likely than men to continue to have memory deficits nearly three months after a mild traumatic brain injury, or mTBI, according to the study published in the journal Radiology. The findings provide "evidence that women may have greater risk for developing working memory impairment after mTBI and may have longer recovery time," said study coauthor Dr. Chi-Jen Chen, a professor at Taipei Medical University Shuang-Ho Hospital. "According to our preliminary results, more aggressive management should be initiated once mTBI is diagnosed in women, including close monitoring of symptoms, more aggressive pharmacological treatments, rehabilitation, as well as longer follow-up." Chen had noticed that almost twice as many women as men were showing up in her clinic after concussions. She wondered if there might be some kind of physical difference making concussions more severe in women. To determine whether there was a real effect, she and her colleagues rounded up 30 concussed patients and 30 non-brain-injured volunteers. Each group had equal numbers of men and women. The concussed patients were scanned shortly after doing a memory test with functional MRI twice: one month after their injury and again six weeks later. The volunteers were scanned once. All the study participants took neuropsychological tests designed to measure attention span, impulsivity, and deficits in working memory.
By KEN BELSON A federal district court judge on Wednesday gave her final approval to the settlement of a lawsuit brought by more than 5,000 former players who accused the N.F.L. of hiding from them the dangers of concussions, a major step toward ending one of the most contentious legal battles in league history. The settlement provides payments of up to $5 million to players who have one of a handful of severe neurological disorders, medical monitoring for all players to determine if they qualify for a payment and $10 million for education about concussions. The landmark deal, which many players criticized, was originally reached in August 2013, but Judge Anita B. Brody twice asked the two sides to revise their agreement, first to uncap the total amount of damages that could be paid for the conditions covered, and then to remove the limit on how much could be spent on medical monitoring. As part of the deal, the N.F.L. insisted that all retired players — not just the 5,000 or so who sued the league — be covered by the settlement as a way to fend off lawsuits in the future. But about 200 players, including Junior Seau, who committed suicide and was later found to have a degenerative brain disease, opted out of the settlement to preserve their right to continue fighting the league. Critics of the settlement said that even after the revisions, the number and variety of diseases covered by the deal were too small and that many players would receive only a small fraction of the multimillion-dollar payouts promised by the league after their age and years in the N.F.L. were considered. Critics also contended that the settlement needed to acknowledge more classes of plaintiffs, not only those with diagnosable diseases and those without them. © 2015 The New York Times Company
Keyword: Brain Injury/Concussion
Link ID: 20837 - Posted: 04.23.2015
by Clare Wilson I WAS prepared for the blood but the most shocking thing about watching brain surgery was seeing the surgical drapes being stapled to the patient's face. But surgeon Peter Hutchinson dismisses my concern that the tiny holes might bother the patient when she wakes up: "That's nothing compared with the massive hole we're about to make in her head." I am at Addenbrooke's Hospital in Cambridge, UK, to learn about craniectomy, a procedure that involves removing a large part of someone's skull, to relieve the pressure inside. There are no official tallies but it's thought that several hundred surgeries take place in the UK every year on people with head injuries or who have had a stroke. Once the brain is given room to swell, the pressure drops and the scalp is sewn back into place. The skull fragment can be stored in a freezer or kept sterile inside the patient's abdomen for weeks or months before it is reattached. The operation I'm witnessing is part of a randomised trial to compare the effectiveness of craniectomy with that of drugs alone to bring the pressure down. It will involve 400 people with head injuries, half of whom will get the surgery. This is needed as craniectomy has a long and chequered history. Human remains suggest it was done with stone tools in Peru a thousand years ago, a practise known as trepanning, perhaps for similar reasons as today. As a modern surgical procedure, though, it has fallen in and out of favour over the last few decades. Whether you would be sent for surgery today depends on how safe your surgeon thinks it is. © Copyright Reed Business Information Ltd.
Keyword: Brain Injury/Concussion
Link ID: 20836 - Posted: 04.23.2015
|By Rebecca Harrington It's best to treat the good with the bad, new medical insights into brain attacks suggest. Doctors are beginning to think the side of the brain opposite to a clot in stroke patients is just as important a target for treatment as the damaged tissue when it comes to a faster recovery. Only in the past few years have researchers discovered that the uninjured side of the brain becomes more active after a stroke to help its fallen neighbor. In some instances, it pumps out proteins that induce damaged neurons to begin repairs and others that trigger new blood vessels to form. It can even extend its own neurons across hemispheres to restore function. Current stroke treatments largely target the damaged tissue. “I think everyone thought, ‘The other side of the brain is working pretty well,’” says Stanford University neurologist Gary Steinberg. “‘Why don't we leave that alone?’” In light of the growing evidence that the healthy hemisphere provides aid naturally, however, doctors are now investigating how to boost its healing actions. One such drug, shepherded by Adviye Ergul of Georgia Regents University and Susan Fagan of the University of Georgia, activates receptors on uninjured tissue that trigger pathways to reduce harmful inflammation and support the growth of neurons and blood vessels on the side of the brain with the clot. The drug increases repair rates in rats that have experienced stroke—results described recently in the Journal of Hypertension—and Ergul and Fagan say the therapy could become available to humans in the next five years. © 2015 Scientific American
Link ID: 20835 - Posted: 04.23.2015
By Virginia Morell Baby common marmosets, small primates found in the forests of northeastern Brazil, must learn to take turns when calling, just as human infants learn not to interrupt. Even though the marmosets (Callithrix jacchus) don’t have language, they do exchange calls. And the discovery that a young marmoset (as in the photo above) learns to wait for another marmoset to finish its call before uttering its own sound may help us better understand the origins of human language, say scientists online today in the Proceedings of the Royal Society B. No primate, other than humans, is a vocal learner, with the ability to hear a sound and imitate it—a talent considered essential to speech. But the marmoset researchers say that primates still exchange calls in a manner reminiscent of having a conversation because they wait for another to finish calling before vocalizing—and that this ability is often overlooked in discussions about the evolution of language. If this skill is learned, it would be even more similar to that of humans, because human babies learn to do this while babbling with their mothers. In a lab, the researchers recorded the calls of a marmoset youngster from age 4 months to 12 months and those of its mother or father while they were separated by a dark curtain. In adult exchanges, a marmoset makes a high-pitched contact call (listen to a recording here), and its fellow responds within 10 seconds. The study showed that the youngster’s responses varied depending on who was calling to them. They were less likely to interrupt their mothers, but not their dads—and both mothers and fathers would give the kids the “silent treatment” if they were interrupted. Thus, the youngster learns the first rule of polite conversation: Don’t interrupt! © 2015 American Association for the Advancement of Science.
By Sandra G. Boodman A Braced by her partner, Suzanne Tobin shuffled back to her car parked in the cavernous garage at Johns Hopkins Hospital late on the evening of Oct. 22, 2013, distraught about what might happen next. Tobin, then 60, had been driven by her partner, James Rapp, from their Germantown home to the Hopkins ER in hopes that doctors there could determine what was causing her relentless deterioration. Three months earlier, Tobin had held a full-time job as a copy editor at AARP in the District. She spent an hour before work striding around the Mall for exercise. Now she could no longer walk unassisted, her speech was nearly unintelligible and her left hand was so weak she could no longer hold a book. Doctors in suburban Maryland had diagnosed a stroke — or possibly a series of strokes — but were unable to explain why Tobin kept getting worse by the week. Her neurologist counseled patience and offered to prescribe antidepressants, drugs that Tobin had told him she had taken for years. An occupational therapist she’d been seeing had expressed alarm; stroke patients tended to plateau or even improve over time, not to experience a steady downward spiral. “You need to get a new neurologist,” she advised Tobin. Tobin and Rapp decided their best bet was to head to Hopkins in Baltimore. But after 12 hours and a battery of tests, including a CT, MRI and other scans, emergency physicians sent Tobin home. They found no new stroke — an earlier MRI that Rapp had brought along appeared to show an old one — nor any other problem that would require immediate hospitalization. They advised her to follow up with her regular doctors.
Fred Powledge I think I knew what was happening even before my head bounced off the hard kitchen counter on its way to the even harder stone floor. I was rapidly losing my connection with reality. My wife, Tabitha, later estimated that I was out for 10 minutes. When I emerged from unconsciousness I heard the sirens on the street in front of the house. It seemed as if half of Tucson's fire department was streaming through the front door. I was scared. At my age, which is old, you laugh at any childlike faith in your immortality. In this case, what brought on the unconsciousness was apparently a quick turn of my head while reaching for an onion to peel for the night's dinner, followed by the knockout blow from hitting the floor. I was scared. At my age, which is old, you laugh at any childlike faith in your immortality. An enormous hook and ladder and an ambulance were drawn up in front of the house, sirens winding down. The commotion was embarrassing, but it was comforting to know that my wife was in the next room, had called for help, and that 911 had responded to her call as it was supposed to. The emergency room doctor said I had a concussion — a blow to the head that our new and improved language calls a MTBI. This scared me as much as the ambulance ride itself, since it stands for "Mild Traumatic Brain Injury." © 2015 NPR
Keyword: Brain Injury/Concussion
Link ID: 20795 - Posted: 04.14.2015
By KEN BELSON The developers of a new drug aimed at diagnosing chronic traumatic encephalopathy, a degenerative brain disease linked to repeated head trauma, are under scrutiny by the Food and Drug Administration. In February, the F.D.A.’s Office of Prescription Drug Promotion sent a letter to two researchers at U.C.L.A. warning them that they had improperly marketed their drug on the Internet and had made overstated claims about the drug’s potential efficacy. The researchers at U.C.L.A. have been developing a biomarker called FDDNP, which aims to identify tau protein deposits in the brain (a signature of C.T.E.) when patients are given a PET scan. To date, researchers have been able to detect C.T.E. only in brain tissue obtained posthumously. The demand for a technique that can diagnose the disease in living patients is potentially large, given growing concerns about the impact of head trauma in athletes, soldiers and others. In its letter, the F.D.A. warned that the researchers, who are partners with the company Taumark, were not allowed to market the drug and make claims about its safety or effectiveness. “Thus, these claims and presentations suggest in a promotional context that FDDNP, an investigational new drug, is safe or effective for such uses, when F.D.A. has not approved FDDNP for any use,” the letter said. The Los Angeles Times first reported the details of the F.D.A.’s letter to the researchers, Dr. Gary Small and Dr. Jorge Barrio. The researchers were told to adjust the language on Taumark’s website, which is now disabled. © 2015 The New York Times Company
By Ariana Eunjung Cha Autism has always been a tricky disorder to diagnose. There’s no such thing as a blood test, cheek swap or other accepted biological marker so specialists must depend on parent and teacher reports, observations and play assessments. Figuring out a child's trajectory once he or she is diagnosed is just as challenging. The spectrum is wide and some are destined to be on the mild end and be very talkative, sometimes almost indistinguishable from those without the disorder in some settings, while others will suffer from a more severe form and have trouble being able to speak basic words. Now scientists believe that they have a way to distinguish between those paths, at least in terms of language ability, in the toddler years using brain imaging. In an article published Thursday in the journal Neuron, scientists at the University of California-San Diego have found that children with autism spectrum disorder, or ASD, with good language outcomes have strikingly distinct patterns of brain activation as compared to those with poor language outcomes and typically developing toddlers. "Why some toddlers with ASD get better and develop good language and others do not has been a mystery that is of the utmost importance to solve," Eric Courchesne, one of the study’s authors and co-director of the University of California-San Diego's Autism Center, said in a statement. The images of the children in the study -- MRIs of the brain -- were taken at 12 to 29 months while their language was assessed one to two years later at 30 to 48 months.
Jordan Gaines Lewis Hodor hodor hodor. Hodor hodor? Hodor. Hodor-hodor. Hodor! Oh, um, excuse me. Did you catch what I said? Fans of the hit HBO show Game of Thrones, the fifth season of which premieres this Sunday, know what I’m referencing, anyway. Hodor is the brawny, simple-minded stableboy of the Stark family in Winterfell. His defining characteristic, of course, is that he only speaks a single word: “Hodor.” But those who read the A Song of Ice and Fire book series by George R R Martin may know something that the TV fans don’t: his name isn’t actually Hodor. According to his great-grandmother Old Nan, his real name is Walder. “No one knew where ‘Hodor’ had come from,” she says, “but when he started saying it, they started calling him by it. It was the only word he had.” Whether he intended it or not, Martin created a character who is a textbook example of someone with a neurological condition called expressive aphasia. In 1861, French physician Paul Broca was introduced to a man named Louis-Victor Leborgne. While his comprehension and mental functioning remained relatively normal, Leborgne progressively lost the ability to produce meaningful speech over a period of 20 years. Like Hodor, the man was nicknamed Tan because he only spoke a single word: “Tan.”
Link ID: 20773 - Posted: 04.10.2015
Tom Bawden Scientists have deciphered the secrets of gibbon “speech” – discovering that the apes are sophisticated communicators employing a range of more than 450 different calls to talk to their companions. The research is so significant that it could provide clues on the evolution of human speech and also suggests that other animal species could speak a more precise language than has been previously thought, according to lead author Dr Esther Clarke of Durham University. Her study found that gibbons produce different categories of “hoo” calls – relatively quiet sounds that are distinct from their more melodic “song” calls. These categories of call allow the animals to distinguish when their fellow gibbons are foraging for food, alerting them to distant noises or warning others about the presence of predators. In addition, Dr Clarke found that each category of “hoo” call can be broken down further, allowing gibbons to be even more specific in their communication. A warning about lurking raptor birds, for example, sounds different to one about pythons or clouded leopards – being pitched at a particularly low frequency to ensure it is too deep for the birds of prey to hear. The warning call denoting the presence of tigers and leopards is the same because they belong to the same class of big cats, the research found. © independent.co.uk
By KEN BELSON One of the limitations of studying chronic traumatic encephalopathy, or C.T.E., the degenerative brain disease linked to repeated head trauma, has been that researchers have been able to detect it only in tissue obtained posthumously. A study published Monday by Proceedings of the National Academy of Sciences, though, suggests that researchers trying to develop a test that will detect the disease in living patients have taken a small step forward. The study, conducted at U.C.L.A., included 14 retired N.F.L. players who suffered from mood swings, depression and cognitive problems associated with C.T.E. The players were given PET, or positron emission tomography, scans that revealed tau protein deposits in their brains, a signature of C.T.E. Although the results were not conclusive, the distribution of tau in their brains was consistent with those found in the autopsies of players who had C.T.E. The 14 players were compared with 24 patients with Alzheimer’s disease and 28 patients in a control group with no significant cognitive problems. The scans showed that the tau deposits in the 14 players were “distinctly different” from those in the patients with Alzheimer’s disease. “There seems to be an emerging new pattern we haven’t seen in any known forms of dementia, and it is definitely not normal,” said Dr. Julian Bailes, a coauthor of the study and the chairman of neurosurgery at NorthShore Neurological Institute in Evanston, Ill. © 2015 The New York Times Company
By LAWRENCE K. ALTMAN, M.D WASHINGTON — Even before Ronald Reagan became the oldest elected president, his mental state was a political issue. His adversaries often suggested his penchant for contradictory statements, forgetting names and seeming absent-mindedness could be linked to dementia. In 1980, Mr. Reagan told me that he would resign the presidency if White House doctors found him mentally unfit. Years later, those doctors and key aides told me they had not detected any changes in his mental abilities while in office. Now a clever new analysis has found that during his two terms in office, subtle changes in Mr. Reagan’s speaking patterns linked to the onset of dementia were apparent years before doctors diagnosed his Alzheimer’s disease in 1994. The findings, published in The Journal of Alzheimer’s Disease by researchers at Arizona State University, do not prove that Mr. Reagan exhibited signs of dementia that would have adversely affected his judgment and ability to make decisions in office. But the research does suggest that alterations in speech one day might be used to predict development of Alzheimer’s and other neurological conditions years before symptoms are clinically perceptible. Detection of dementia at the earliest stages has become a high priority. Many experts now believe that yet-to-be-developed treatments are likely to be effective at preventing or slowing progression of dementia only if it is found before it significantly damages the brain. The “highly innovative” methods used by the researchers may eventually help “to further clarify the extent to which spoken-word changes are associated with normal aging or predictive of subsequent progression to the clinical stages of Alzheimer’s disease,” said Dr. Eric Reiman, the director of the Banner Alzheimer’s Institute in Phoenix, who was not involved in the new study. © 2015 The New York Times Company
By Nicholas Bakalar Air pollution — even for just one day — significantly increases the risk of stroke, a large review of studies has found. Researchers pooled data from 103 studies involving 6.2 million stroke hospitalizations and deaths in 28 countries. The analysis, published online in BMJ, found that all types of pollution except ozone were associated with increased risk for stroke, and the higher the level of pollution, the more strokes there were. Daily increases in pollution from nitrogen dioxide, sulfur dioxide, carbon monoxide and particulate matter were associated with corresponding increases in strokes and hospital admissions. The strongest associations were apparent on the day of exposure, but increases in particulate matter had longer-lasting effects. The exact reason for the effect is unclear, but studies have shown that air pollution can constrict blood vessels, increase blood pressure and increase the risk for blood clots. Other research has tied air pollution to a higher risk of heart attacks, stroke and other ills. The lead author, Dr. Anoop Shah, a lecturer in cardiology at the University of Edinburgh, said that there was little an individual can do when air pollution spikes. “If you’re elderly, or have co-morbid conditions, you should stay inside,” he said. But policies leading to cleaner air would have the greatest impact, he said. “It’s a question of getting cities and countries to change.” © 2015 The New York Times Company
Alice Park We start to talk before we can read, so hearing words, and getting familiar with their sounds, is obviously a critical part of learning a language. But in order to read, and especially in order to read quickly, our brains have to “see” words as well. At least that’s what Maximilian Riesenhuber, a neuroscientist at Georgetown University Medical Center, and his colleagues found in an intriguing brain-mapping study published in the Journal of Neuroscience. The scientists recruited a small group of college students to learn a set of 150 nonsense words, and they imaged their brains before and after the training. Before they learned the words, their brains registered them as a jumble of symbols. But after they were trained to give them a meaning, the words looked more like familiar words they used every day, like car, cat or apple. The difference in way the brain treated the words involved “seeing” them rather than sounding them out. The closest analogy would be for adults learning a foreign language based on a completely different alphabet system. Students would have to first learn the new alphabet, assigning sounds to each symbol, and in order to read, they would have to sound out each letter to put words together. In a person’s native language, such reading occurs in an entirely different way.
Link ID: 20719 - Posted: 03.25.2015