Brain Injury Help

Omega-3 fatty acids are just good for you. They are found naturally in fish or can be taken as dietary supplements. New research out of Columbia University showed that omega-3 fatty acids reduced brain damage in a neonatal mouse model of stroke. The study was published in PLOS ONE.

Omega-3 fatty acids are shown to reduce brain damage after stroke in neonatal mice. (Flickr / Creative Commons / Health Gauge)

10-day-old mice had a hypoxic-ischemic brain injury caused by a decrease in blood flow and oxygen to the brain as occurs with stroke. Researchers treated these animals with a fat emulsion of either DHA or EPA omega-3 fatty acids. Then they evaluated neurological function 24 hours and eight to nine weeks after the injury was incurred.

DHA and EPA omega-3 fatty acids typically come from cold water fish. The researchers showed that these fatty acids protect cells and organs in many ways after oxygen deprivation, decreasing inflammation and cell death.

After 24 hours, mice who had been treated with DHA but not EPA showed a reduction in brain injury; hence the name of the study: “DHA but Not EPA Emulsions Preserve Neurological and Mitochondrial Function after Brain Hypoxia-Ischemia in Neonatal Mice.” After several weeks, the DHA group showed improved brain function in several areas as compared to the EPA and control groups.

They also found that the brain mitochondria had higher levels of DHA. The mitochondria are energy-producing structures that can be injured by free radicals when oxygen returns to the brain. This is called reperfusion injury, and it commonly leads to brain damage after the oxygen and nutrient deprivation to the brain after a stroke.

“Our findings suggest that injecting the omega-3 fatty acid DHA after a stroke-like event has the ability to protect brain mitochondria against the damaging effects of free radicals,” said senior co-author, Vadim S. Ten, MD, PhD, associate professor of pediatrics at Columbia University Medical Center in an article.

The interruption of blood flow and oxygen supply to the brain during or shortly after birth is a leading cause of brain damage in newborns, which can have lasting neurological effects. Many of the pathways involved in this process is similar to an adult stroke.

As for the future, clinical trials need to be conducted to discover whether or not administering lipid emulsions containing DHA in babies or adults have the same positive impact it did in mice. If these trials are successful, it could lead to a novel treatment for stroke in babies, children, and adults.

Alzheimer’s disease can be a tough go. So one researcher is looking at how we can improve the quality of life for these people using a brain chip. Even the smallest of improvements in memory can help a person living with Alzheimer’s maintain their dignity and, hopefully, independence. Alzheimer’s is of particular interest because it affects one in nine people over the age of 65.

A team of researchers are engineering a brain chip to help people with Alzheimer’s disease remember. These are the hands of someone with the disease. (Flickr / Creative Commons / *Ann Gordon)

Dr. Theodore Berger, a professor of biomedical engineering at the University of Southern California and director of USC’s Center of Neural Engineering, has engineered a brain chip that can mimic the brain signals fired off in the hippocampus, where the brain translates memories from short to long term memory. He has already had some success testing the chip in rats and monkeys.

The doctor has spent his career trying to figure out how neurons store memories to help people with dementia, Alzheimer’s, and traumatic brain injury.

Over the past twenty years, he’s been trying to develop brain prostheses that mimic the processing that occurs in the hippocampus.

The Defense Advanced Research Projects Agency has a particular interest in the brain chip that could help wounded soldiers heal from traumatic brain injuries and has funded the studies in rats and monkeys.

One technology entrepreneur, Bryan Johnson, who sold his payments company Braintree to PayPal for $800 million in 2013, has invested in the company Kernel that is building the brain chip to help people who deal with Alzheimer’s, strokes, and concussions.

Johnson had a particular interest in artificial intelligence, so he put a team together of the best neuroscientists, led by Dr. Berger.

After success in animal models, Berger is getting ready to test his brain chip on human patients. For ten months, they have been building a prototype of the brain chip and are going to now start testing it in epilepsy patients in hospitals.

Johnson told the Washington Post that he wants to make the product widely affordable, but that will come with challenges in the beginning of the process. Many inventions start out for a select few and then branch out to serve everybody.

The biggest challenge is making the device portable. Right now, the epilepsy patients they are testing on have to have temporary electrodes placed on their brains.

The other challenge is to perfect the algorithm so that it will always predict what the unique code is in each human brain that emits electrical signals and consistently, successfully stores memories.

Eight million people live in New York City. Of those people, one million are over the age of 60. Over the next 20 years, the number will increase by 50 percent, the biggest shift in history, making the age friendly initiative ever more important.

More than 100 intersections in NYC were redesigned to try to make them more age friendly. (Flickr / Creative Commons / mgstanton)

We talked to Ruth Finkelstein, professor of health policy and management at the Columbia University Aging Center and the former director of the Age Friendly New York City Initiative.

“The process was to talk to thousands and thousands of New Yorkers about their daily lives,” Finkelstein said.

While doing that, they talked about what facilitates what people are doing and what challenges that. They focused on the eight domains put forth by the World Health Organization: the built environment, transport, housing, social participation, respect and social inclusion, civic participation and employment, communication, and community support and health services.

What’s wonderful about New York City for older people, and really everyone, is its public transportation system and the cultural liveliness of each of the bureaus. What’s challenging is affordability and housing.

The New York Academy of Medicine worked in conjunction with the government and other institutions to try to enact change. One of the problems was crossing the street, so more than 100 intersections were redesigned. “There’s demonstrable lowering of pedestrian fatalities,” Finkelstein said.

Another challenge to walking around the city, being independent, and meeting people was that New York City had taken out its benches in order to try to reduce homelessness. They were able to put in thousands of benches where people wanted them.

“The libraries adopted age friendly with a vengeance,” Finkelstein said. The city’s three library systems have all developed comprehensive programs to serve older patrons. These efforts ranged from computer programs to an arts workshop series for older adults.

“The pools were a big triumph,” she said. The city’s pools are great, but they are crowded. The parks commission set aside time in the morning where half of the pool was specifically for people aged 55 and older.

Businesses also got involved. People were saying that they wanted to continue to work. So businesses made an effort to hire older adults as part of an initiative called Age Smart Employer NYC.

“Age friendly cities are whatever you make them,” Finkelstein said. “I’d like to see each community innovating responsibly to their problems. I don’t like the idea that places think this is what is successful in one place so this is what we should do. I like when people are creative.”

For more information about the efforts that NYC has enacted, see this helpful infographic.

Patients with severe aortic stenosis (narrowing of the aortic valve) undergoing transcatheter aortic valve implantation (TAVI) benefited from using a cerebral protection device. The minimally invasive procedure repairs the old valve without removing the damaged valve. The cerebral protection device captures debris dislodged during the procedure and reduced the number and volume of brain lesions that resulted from the procedure.

This new information appeared in an August 9th issue of Journal of the American Medical Association (JAMA). The procedure wedges a replacement valve into the aortic valve’s place. Though the clinical outcomes of the procedure have improved significantly, the risk of stroke still remains a concern. Ischemic lesions are found in eighty percent of patients who undergo TAVI. Protection devices have been used, but their efficacy is unclear.

Researchers found 100 patients with severe aortic stenosis to undergo TAVI, one group with a cerebral protection device and one group without one. MRIs were performed at entry into the study, two days after the procedure, and seven days after.

After two days, researchers found the number of new lesions were less in the group with the cerebral protection device. The volume of new lesions were also less in the group with the cerebral protection device.

Adverse events during the study included one patient who died before the 30-day follow up. Life-threatening hemorrhages occurred in one patient in the control group and one in the experimental group. Major vascular complications occurred in five patients in the filter group and six in the control group. One patient in the filter group and five in the control group had acute kidney injury. Three patients in the filter group had a thoracotomy (a surgical incision into the chest wall.)

Larger studies are needed to assess the efficacy of a cerebral protection device in patients undergoing TAVI in order to devise more complete coverage of the brain to prevent new lesions.

Several of the study’s authors disclosed financial ties to pharmaceutical companies and medical device companies, including Claret Medical and Medtronic, who funded the study.

In the OnPoint podcast, “Designing Communities for an Aging America,” it was said that the elderly have to “keep their brain moving.” This can be accomplished through crosswords and Sudoku. But also just as important is keeping your body moving. This can range from walking to doing yoga. Exercise is important to keep the body fit and the brain engaged.

Yoga instructor Sharay Thomas says that yoga can help elderly people with balance, posture, and flexibility. (Photo by Cenkeshia Johnson)

Practicing yoga decreases stress, which is beneficial to overall health. It increases nerve stimulation that benefits the brain. When you line up your breathing with your body movements, you regulate your heartbeat, so you see a lot of other kinds of health benefits.

Vinyasa yoga instructor Sharay Thomas said that one of the most important benefits is balance. “People of a certain age start to lose their balance,” she said. “Yoga brings back balance to elderly people by using the left and right brain.”

Another benefit is that yoga tightens up your core and improves posture, Thomas said. At a certain age, people might start to slouch. Yoga helps lengthen the spine.

In addition, yoga improves flexibility, Thomas said. It helps with being able to reach your toes and reach behind your back, the natural mobility we are all supposed to have. Yoga keeps you pretty limber, she said.

For older people who are prone to falling, Thomas recommends adopting yoga practice. “Yoga gives you that balance and that strength to move as an individual as long as possible.”

Leading a yogic lifestyle can increase longevity. Regular exercise can help to maintain muscle strength and tone and bone density, joint flexibility, improve posture, balance, and maintain mobility. Combined with controlled breathing, regular practice can maintain respiratory and circulatory health. Reduced calorie intake can also increase longevity.

In addition, yoga has been shown to decrease depression and anxiety and generally maintaining mental health. If a vegetarian diet is adopted, it is shown to lengthen life spans and decrease risks of heart disease and cancer.

The Eight Limbs of Yoga include universal morality, personal observances, body postures, breathing exercises, control of the senses, concentration and cultivating inner perceptual awareness, devotion, and union with the Divine.

Even though the body isn’t as strong as it used to be in elderly, they can still benefit substantially from a yogic lifestyle. The benefits of yoga can vary across different age groups.

As a society, we need to start changing our attitudes about the elderly. Although there is a often a period of demise, we need to stop thinking about the elderly as frail and weak.

Yogic breathing can rapidly bring the mind to the present moment and reduce stress. Yoga can impact longevity in similar ways that meditation does.

In one study, researchers compared those who meditate to those who don’t. After the three month intervention, people who meditated had 30 percent more activity of the enzyme telomerase. Telomeres are located on the ends of chromosomes to prevent them from unraveling. Each time the cell reproduces, the telomeres become shorter. This is recognized as a cause of aging. Telomerase can help lessen aging.

In the On Point podcast, “Designing Communities for an Aging America,” one key theme was communication. Ruth Finkelstein,  professor of health policy and management at the Columbia University Aging Center and former director of the Age-Friendly New York City Initiative, emphasized this point when she spoke. This message about communication was spurred by one caller’s plea.

An elderly woman called in and said that she has vision problems; she is going blind. She needs help with things like reading her mail and going to the bank. She seeks help from her husband, but he is getting older himself. She expressed frustration in not knowing where her community’s resources for older people were. “I can’t look things up in the phone directory,” she said.

This is why Finkelstein emphasized communication. Messages could be advertised on the radio or as public service announcements, which is good for people with vision problems. She also recommended reaching out to a local representative or a senior center for a referral.

“We have a continuum of functioning for all ages,” she said. “One of the things we have to be thinking about is communication.”

Kathryn Lawler, director of the Aging and Health Resources Division and director of the Area Agency on Aging in Atlanta, recommended calling Eldercare Locator at 800-677-1116 or visiting eldercare.gov.

Getting older does not signify weakness. We just may need accommodations that we didn’t need when we were younger, host Sacha Pfeiffer points out.

Finkelstein again chimed in about the importance neighborhoods. As we get older, our networks shrink for various reasons. Going to the store is an important social outlet. This also applies going to get a cup of coffee and the newspaper. She has identified some of the characteristics of age friendly businesses like having a human being answer the phone.

Iowa City won the award for the most age friendly city for the small metros, and Madison, WI won for large metros. The key characteristics of these cities are that health, transportation, and housing are advanced. There are pros and cons to each city. New York City is expensive, but it has good public transportation. Los Angeles doesn’t really have public transit to get to doctors or schools.

It is important to create these networks. Maybe there is something an older person does very well like music. They could share this with a younger generation in a library program. No matter what, communication about these programs and initiatives is chiefly important.

The On Point podcast with guest Sacha Pfeiffer was called “Designing Communities for an Aging America,” touching on age friendly communities. The report focused on how communities can do a better job making communities age friendly and what communities are doing that is good for an aging population.

One caller from Milwaukee, WI said that she is having trouble with her vision and is gradually going blind. She expressed her concern on the podcast that she needs more help than she has right now. She needs someone to read her mail to her twice a week. She needs somebody to go to the bank for her. The concern in her voice was palpable.

Kathryn Lawler, director of the Aging and Health Resources Division and director of the Area Agency on Aging in Atlanta, gave out a phone number that could be helpful to many older people. The number was 800-677-1116. The website is eldercare.gov. It is called the Elder Care Locator. The purpose of the nationwide service is that it “connects older Americans and their caregivers with information on senior services.” There are likely more services and opportunities in your community than you know about. There were many organizations designed to help older people in the Milwaukee community.

Pfeiffer touched on an important point that we have to stop thinking old means frail. We may need accommodations we didn’t need when we were younger, but we’re not weak.

Another kind of program that is especially interesting is one that is going on at a library in Massachusetts. Older people can check in as an expert. Then local schools will go to the library and check out “a living book.” It might be a historical event that they have lived through or an area of work they have done their whole lives. Ruth Finkelstein, who helped design the New York City age friendly initiative, thought the idea was great and said she would adopt it in her community.

Another idea is to open the mall early before the stores open for walking. Elderly residents can come and walk, especially when it’s cold or raining. It gives seniors a friendly environment and a social outlet. It is important that the elderly don’t feel socially isolated.

Local colleges can also provide free classes for senior citizens, who can pass down their knowledge to younger citizens. It is an intergenerational interaction, like the foster care program that involves seniors in the care of foster children. Local pools can also set up senior citizen swimming hours, where they can be around people in their same age group and don’t have to feel self-conscious about how they look.

These are all great ideas that go beyond simply putting in more benches and longer crosswalk signals.

Different communities across the country are trying to make their cities more age friendly. This might include making longer crosswalks or putting in more benches. (Flickr / Creative Commons / __MV__)

In the On Point podcast, “Designing Communities for an Aging America,” the issues of creating and maintaining age-friendly communities were discussed.

Sacha Pfeiffer, the guest host, started out by saying that most U.S. cities were not designed for an aging community.

The number of people in the over 65 age group will double by 2050, Pfeiffer said. The problems range from crosswalks being too short to not having enough benches to rest at a busstop.

Paul Irving, chairman of the Center for the Future of Aging at the Milken Institute, said that there are 10,000 baby boomers turning 65 every day. The fastest growing cohort of people is older people.

“It almost feels like global warming, like it’s happening slowly,” he said.

He said that we can either ignore the problems or call for fundamental change. “We can shift and realize this is a permanent state of affairs,” he said. It’s not just about baby boomers, he added. It’s about Millennials, Generation X, and Generation Y as well. The people in these groups will live longer.

The city in which I attended college, Evanston, is starting to push forward an age friendly initiative. They have created a task force and an action plan that was approved by city council in June 2016. The plan included many facets, such as transportation, communication, and housing. Evanston is part of the World Health Organization’s “Age Friendly Cities” initiative “to educate, encourage, promote, and recognize improvements that will make Evanston more user-friendly not only for senior residents but for residents of all ages.”

Ruth Finkelstein, professor of health policy and management at the Columbia University Aging Center, emphasized the importance of walking in the community. “The number one people get around is to walk,” she said. “We undervalue that.”

Walking is good physically, cognitively, and socially, she added. We need to take a look at the city’s sidewalks. The first job is to put in sidewalks where there are none. The second job is to maintain the sidewalk, so we don’t have to walk with our heads down trying to avoid falling. This applies to all age groups, not just senior citizens. Anyone can fall on a sidewalk.

One of the key themes of the age friendly initiatives is that it is not just important for senior citizens. It is to make the cities friendly for people of all ages. In Evanston, they created surveys for their residents to suggest ways to make Evanston “a place to grow up and grow old.” The consequences of an age friendly initiative in a given city will have far-reaching consequences for all generations.

Former professional wrestlers are suing the WWE. (Flickr / Creative Commons / Kenya Allmond)

World Wrestling Entertainment (WWE) is being sued by more than 50 former wrestlers. The reason they are suing is because they say that the WWE intentionally hired them as independent contractors, not as employees. They say this was a cop out to avoid liability for injuries sustained on the job.

The suit is a class action case alleging that wrestlers sustained “long term neurological injuries.” It also alleges the WWE “routinely failed to care” for them “in any medically competent and meaningful” way. They also alleged that the WWE “fraudulently misrepresented and concealed” those very injuries.

A class action settlement between the U.S. National Football League (NFL) and thousands of former players could result in total payments of $1 billion due to players suffering brain injuries.

The National Hockey League (NHL) also is being sued in a class action lawsuit by more than two dozen former NHL players regarding traumatic brain injuries.

In the NFL, concussion are not always reported. Some players go right back to playing without even being tested for concussion protocols.

Professional rugby players may also look to sue as well as other sports where helmets are required. About 1,200 people suffer head injuries while playing rugby each year.

Repeated head injury like those sustained in wrestling and football can cause a neurological disease called chronic traumatic encephalopathy (CTE). CTE occurs when the tau protein jams up the brain’s circuitry. It is a progressive degenerative disease. Many people believe that CTE can only be diagnosed postmortem in an autopsy. However, the medical community should push themselves to try to make diagnosis in vivo.

One study characterized CTE while the patient is still alive using brain scans. They looked at American football players with suspected CTE and compared it to controls and those with Alzheimer’s disease. The brain scans in retired players showed the presence of brain patterns in line with images of concussion where the white matter tracts of the brainstem see early axonal damage and cumulative axonal injuries along subcortical, limbic, and cortical brain circuitries supporting mood, emotions, and behavior. The patterns were distinct from scans of patients with Alzheimer’s and is consistent with tau distribution found in autopsy of a brain with confirmed CTE.

Monday we wrote a blog about a study that linked the chemical Bisphenol A (BPA) found in plastic water bottles to ADHD in boys. We talked to lead author of the study, Shruti Tewar, clinical assistant professor at the Stead Family Department of Pediatrics at University of Iowa Children’s Hospital, to clarify a few things.

Bisphenol A can be found in some baby bottles. Manufacturers do make bottles free of Bisphenol A for concerned parents. (Flickr / Creative Commons / brokinhrt2)

The data came from the National Health and Nutrition Examination Survey (NHANES) taken in the 2003 to 2004 cycle, Tewar said. The urine was collected at the time of the NHANES visit. The urine was analyzed then, including looking for BPA. The parents or guardians of the children were contacted within two weeks of the urine collection for a phone diagnostic interview to determine if the child had ADHD. The children were ages 8 to 15 during the time of study data collection.

Multivariate regression analysis was used to determine the connection between ADHD (yes or no) and BPA in the urine, Tewar said. The analysis accounted for several other factors that could have an influence towards an ADHD diagnosis. These confounding factors included age, sex, income, and lead levels.

Questions about synthetic estrogens began in the 1960s. Seven women were diagnosed with a rare cancer. They tried to determine the cause. They determined it was diethylstilbestrol (DES), a synthetic estrogen given to pregnant women to prevent miscarriages. The FDA said to stop giving DES to pregnant women because of it’s cancer causing properties in the early 70s.

This work spurred work looking into another endocrine disruptor: BPA. Animal studies were first. Oral BPA exposure was also found in a study of rats to be linked to mammary cancer. Scientists started to talk about the growing body of evidence pointing to the chemical causing cancer in animals. A 2012 study linked BPA to human breast cancer cell growth.

In addition, the chemical has been linked to changes in the hippocampus, the brain’s memory center, and the prefrontal cortex, which may have clinical applications that resemble Alzheimer’s disease, according to a study. The toxin is known to have estrogenic properties.

A study from China found a link between the chemical and brain cancer. People with higher levels of BPA in their urine were 1.6 times more likely to have a type of brain tumor called meningioma. The link was observed even accounting for other factors that may cause meningioma. This analysis is similar to that of the ADHD and BPA study. They followed 247 brain cancer patients and 258 with no history of cancer who were getting exams. Then urine samples were collected. Surveys were used to determine the other factors such as gender, age, and hormone therapy.

A New York Times article referenced a study that found a link between the toxin and high blood pressure. This was a one-time exposure that showed immediate health effects. Participants drank soy milk from a can. Their BPA levels in their urine raised significantly along with their blood pressure in the following hours. On days when they drank the soy milk from glass bottles, which don’t contain BPA, their BPA levels and blood pressure did not rise. The study suggests that people who drink from several cans or plastic bottles per day could be more likely to have hypertension.

BPA presents many risks to your health. If you are concerned about BPA exposure, try to eat fresh foods not in containers and avoid drinking from plastic bottles or cans. It’s better to opt for glass bottles.

A causal link between BPA and cancer in humans has not yet been confirmed. “Definitive proof of the role of BPA in human cancer induction is likely to remain limited, not least by ethical limits to human experiments,” the World Health Organization wrote in a 2014 report. To expose a human to BPA on purpose is unethical, so the ability to prove the causal link is limited.

However, the findings in animals are very telling. We have to extrapolate those findings to humans, said Dr. Ana Soto, a biologist at Tufts. “If we take the results in animal models together, I think we have enough evidence to conclude that BPA increases the risk for breast and prostate cancer in humans,” she said.

By Jennifer Ball

Researchers at Washington University updated the map with almost 100 new regions.

We wrote a blog yesterday about the researchers that discovered about 100 new areas of the brain. They created a brain map, updating one that was more than a century old. They detailed about 180 parts of the brain per hemisphere.

Matthew F. Glasser is a neuroscientist at Washington University School of Medicine and lead author of this research. We spoke to him about the new research. Here’s what he had to say.

Q: What is the purpose of this research?

A: Our goal was to make a better map of the brain’s cerebral cortex, the 1.6mm-4mm thick sheet that covers the outer surface of the brain that makes it look wrinkly.  The cerebral cortex is where human higher cognitive functions like language or tool use are based.  

This map can replace what is still the field standard, a map of just under 50 areas made in 1909 by Brodmann.  There are four unique aspects of this study relative to other cortical maps that come before it.  

1) We used hundreds of precisely aligned subjects to have a sharp, group average maps for the parcellation.  

2) We used multiple measures of cortical organization, including architecture, function, connectivity, and topographic maps (e.g. maps of visual space or the body surface).  

3) We carefully compared our areas to those in the neuroanatomical literature, finding 83 areas that had previously been identified and 97 new areas.  

4) We used a machine learning algorithm to learn the fingerprints of each of the cortical areas, that is their pattern of architecture, function, connectivity, and topographic maps.  This algorithm was able to identify these areas in individual subjects that were not a part of the original parcellation or the training set.

Q: What do you hope to accomplish with it?

A: We hope to help other brain imaging investigators know which brain areas their functional activations are in.  This will help them to compare with their colleagues studies and know whether they are finding the same brain areas, neighboring brain areas, or farther away ones.  

Q: What are the real-world applications of this study?

A: One clinical application of the study is that neurosurgeons could use this map and the algorithm to identify brain areas in individual patients.  That way they could avoid areas important for movement or speech production or understanding.

It is clear that this research is new and interesting and can help people in the neuroscience field know different areas of the brain. However, this is just the first round of data. The next version of the brain map may be improved as more scientists become involved and the researchers get more data.

Water bottles can contain a potentially toxic substance called BPA. It has been linked to ADHD in boys. (Flickr / Creative Commons / Liz West)

One does not need to live next to a toxic waste dump to be exposed to toxins. Toxins can be found in everyday materials. Bisphenol A (BPA) is found in certain plastics used to make baby bottles, water bottles, and food storage containers. It acts as a hormone, which has called some people to question its safety in consumer products. The European Union and Canada have banned use of BPA in baby bottles.

In the United States, research is showing that BPA may be risky in relation to ADHD in male children. The researchers used 2003-2004 survey data from National Health and Nutrition Examination Survey that showed ADHD could be linked to BPA. Animal studies have showed that BPA may be linked to sex-specific ADHD risk. The most current research, published in June 2016, is in keeping with these findings.

The study showed that of the 460 participants, 8-15 years of age, 7.1 percent met the criteria for ADHD. Children who had above average BPA levels were more likely to have ADHD at 11.2 percent, compared to 2.9 percent for children below the median. That is a pretty striking comparison.

The adjusted odds ratio in BPA concentrations above versus below the median was 5.68. The odds were higher in boys than in girls. The adjusted odds ratio was 10.9 in boys versus 2.8 in girls. These are pretty striking numbers too. However, the meaning is unclear since the sex interaction term was not significant.

BPA is a chemical found in common plastics like those in the water bottle I am drinking right now. One prevention technique is to buy BPA free products. The chemical can seep into food or beverage products that the container holds. Also, if you are concerned about BPA, reduce your use of canned goods. BPA is contained in the resin. Use glass, porcelain, or stainless steel containers instead of plastic.

The Food and Drug Administration says that the amount of BPA in products right now are low enough to be safe. Still, however, France wants to add BPA to the list of substances of very high concern. If this is study is telling us anything, it may be that France is on the right track.

Another study in 2013 showed that boys exposed to BPA levels in children or in the fetus were more likely to experience anxiety, depression, aggression, and hyperactivity at age seven.

The brain map used scans from an MRI. (Flickr / Creative Commons / Liz West)

Researchers have revealed a new brain map that delineated 180 areas per hemisphere. Each area was separated by cortical architecture, function, connectivity, and topography. This research has detailed about 100 previously unknown regions, according to the New York Times.

The data was gathered using multi-modal magnetic resonance imaging from the Human Connectome Project. Although the answers won’t be automatic or easy, this brain map is a huge step towards progress in neuroscience.

Researchers can use it to study how the brain changes in diseases like schizophrenia and Alzheimer’s. The principal investigator Dr. David C. Van Essen hopes to study the development of young brains and how brains change in diseases like Alzheimer’s, he told the New York Times.

In the 1860s, Pierre Paul Broca found an area of the brain that was devoted to language, called Broca’s area. He examined the brains of two patients who had trouble speaking. They had damage to the same area of the brain.

In the late 1800s, German researchers, including German neurologist Korbinian Brodmann,  indicated other regions of the brain’s outer layer of neural tissue. In 1907, a researcher published a list of 52 distinct brain regions. This has been the standard, Dr. Matthew F. Glasser, lead author, told the New York Times.

The current research started three years ago at Washington University in St. Louis when researchers set out to gather information from 1200 volunteers with strong, cutting-edge scanners. They trained a computer with 210 brains to recognize different areas of the brain and how they are connected. When the computer generated distinct areas, they tested it on 210 other brains.

The brain map required little information, so it can be done in just over an hour of scanning. However, maps done in different ways can produce different results, which means that some people may not have complete faith in each map. The map in this research showed 83 familiar areas of the brain, such as Broca’s area. There were 97 new areas of the brain that were discovered or forgotten.

What I mean by forgotten is that in the 1950s scientists discovered an area of the brain with little myelin compared with other areas. The research was lost in the literature. With the current research, they discovered that area again, which becomes distinctly active while listening to stories. So, it is part of the complex language network of the brain.

The researchers also discovered the dorsolateral prefrontal cortex is comprised of many smaller areas. This part of the brain is active in thought, like decision-making and deception. It is possible that each smaller region is responsible for one of these smaller tasks.

The New York Times article ended with Dr. Van Essen looking forward. “We shouldn’t expect miracles or easy answers,” he said. “But we’re positioned to accelerate progress.”

Any research into brain mapping must be done in the light of the fact that the human brain does not have dedicated areas to do most modern information processing, including reading, typing and complex speech and memory tasks. The human brain is built on an evolutionary framework that is a million years old. Only 1/50th of that time has there been a written language. Only for the last 100 years have the majority of people been able to read. Only for the last 20 have average people been typing on computers. Neural networks are far more similar from part to part than traditional brain mappers ever thought.

We continue to believe that a given thought, memory or process can be done in places far distant to where researchers have traditionally believed they are done. This is the nature of neural plasticity and the greatest hope for a lifetime of recovery from even very severe brain damage.

Attorney Gordon Johnson

Drowning is deadly. Near drowning can result in brain damage for the simple fact that your brain is deprived of oxygen. Bodies of two men were found Monday in Lake Michigan in Sheboygan, WI. The men were swept into the lake by a giant wave over the weekend.

Two men drowned in Lake Michigan this weekend. One young man survived. (Flickr / Creative Commons / Stephanie Onderchanin)

One man was found still alive Sunday, but the other two were not so lucky. Drowning is one of the leading causes of unintentional death in the United States, according to the Centers for Disease Control and Prevention. On average, there were about 3,536 drownings that were deadly, unintentional, and non-boating related from 2005 to 2014. That amounts to about 10 deaths per day.

Drowning can cause brain dysfunction that includes memory loss, learning disabilities, and permanent vegetative state. The one survivor was able to talk to the media. He posted on Facebook after the incident that the Coast Guard pulled him from the water just as he “was losing hope.”

The story goes that the men saw a fisherman at the end of the dock and thought they could make it. The winds were up to 30 miles per hour in the area, according to the Weather Channel. The winds caused the churning wave to pull the boys into the lake.

The 911 call came just before 4:00 p.m. on Sunday, according to Fox 6 Now. One of the friends who was not swept in ran to the emergency box to call for help. 22-year-old Dylan Abeyta-Dedecker was found just after 4:00 p.m., but the other bodies were not recovered until Monday by a dive team.

The two fishermen at the end of the pier were also swept into the water. But, due to the number of rescue boats there at the time, they were recovered fairly quickly. The two had minor injuries, but they refused transport to the hospital.

The first victim, 21-year-old Kurt Ahonen, was located at about 4:45 p.m. Monday. The first diver was sent in Sunday evening, but the search was suspended due to hazardous conditions. The second victim, 22-year-old Adam Laluzerne, was located and removed from the water at about 7:00 p.m.

The survivor, Abeyta-Dedecker, said that he was swallowing water while trying to stay afloat for 30 minutes until a Coast Guard boat rescued him.

“I could barely swim to try and reach it. I was basically on my last string of hope,” Abeyta-Dedecker said. “I’m very heartbroken. It’s just terrible.”

He was taken to the hospital after he was rescued. He is now recovering at home and thinking about his friends who died that day.

Some people say that there should be signs warning people not to go out to the pier if there are big waves. Some people think people should be prohibited from going out to the pier if there are boat advisories in effect, like there was Sunday. Authorities wanted people to stay away from the coast of Lake Michigan Sunday. The Coast Guard responded to 10 calls Sunday within two hours about people being swept in by the waves and winds.  

Never leave a child unattended in a car. Always “look before you lock.” (Flickr / Creative Commons / Jay Gooby)

So far this year, there have been 16 children who have died in a hot car in the United States, according to San Jose State University. In 2015, there were 24 hot car fatalities. Forgotten baby syndrome, or forgetting that one’s child is in the car, is the number one cause of hot car deaths in children.

A tragic case in 2011 involved a one-year-old girl called “Ray Ray” who died after being forgotten in a hot car. It was 94 degrees the day that little Ray Ray died. Her father had forgotten to drop her off at daycare, subsequently leaving her in a hot car. That year, there were 33 cases of hot car fatalities in children.

The number one age group of children who were victims of vehicular heat stroke since 1998 was under one years old. This group was followed by one year olds and two year olds, decreasing as children get older. Extra care should be taken with younger children because they cannot indicate as easily that they are still in the car in cases of forgotten baby syndrome.

Dr. David Diamond of the University of South Florida studies forgotten baby syndrome. There are good, attentive, loving parents who lose awareness that their child is in the car, Dr. Diamond said. In the case of Ray Ray’s death, her mom does not blame her husband for forgetting her child in the car. It could’ve happened to her, too, she said.

However, they were disappointed that they were never educated about forgetting their child in a hot car. They took parenting classes and learned about a myriad of topics, but did not learn about this issue. This is why Ray Ray’s mom started her own organization to raise awareness about child vehicular heatstroke, Ray Ray’s Pledge.

In September 2015, Texas passed “Ray Ray’s Law,” which mandates hospitals to educate parents about leaving their children in hot cars. One of the tips to preventing forgotten baby syndrome is to keep an object or a note in the car when one’s child is also in the car. This way one is reminded of their child’s presence. Hospitals will hand out a keychain to remind parents they have their child in the car in Texas under Ray Ray’s Law. They will also hand out pamphlets.

In addition to keeping an object in the front seat, the daycares should also have a system where they notify parents that their children did not arrive on time. There is also a smartphone app called “Mom I Am Here.” The app has an alarm system to remind the person of the child’s presence in the car. It has emergency contacts to contact in the event of an emergency. Ray Ray’s mom uses the app with her three-year-old twin girls now, and encourages other parents to utilize smartphone alarm systems.

Parents can do everything in their power to keep their children safe, but still can forget their child in a car. The brain’s habit memory system takes over rather than the prospective memory system, which involves planned and intentional action. Something in Ray Ray’s dad’s brain thought that he wasn’t dropping his child off at daycare that day. That’s how easy it can happen. This is why Ray Ray’s mom encourages people to take preventive action like using smartphone alarms.

Even without dying from vehicular heat stroke, there can be brain damage and disability. It takes just ten minutes for a car temperature to go up 20 degrees Fahrenheit. On an 80 degree day, it takes ten minutes for the car to rise to deadly temperatures. It also only takes a 57 degree day to cause heat strokes. On a 60 degree day, car temperatures can still raise to 110 degrees.

Kids and Cars recommends implementing a “look before you lock” system. Always check the backseat for a child before locking the car doors. It is important to remember that cracking a window is not sufficient. Children should never be left in the car alone. Also it is good practice to keep car doors locked at all times. While 54 percent of hot car deaths are forgotten children, 29 percent were playing in the car unattended. and 17 percent were left in the car intentionally.  

We postulated last month in the aftermath of Muhammad Ali’s death that repeated head trauma could have played a role in Ali’s Parkinson’s disease. In a recent study published in July 2016 in JAMA Neurology, researchers found a link between Parkinson’s disease and head trauma. This study looked at the long-term effects of having a brain injury.

Pictured here is Muhammad Ali. He had Parkinson’s disease. (Flickr / Creative Commons / National Constitution Center)

The research was led by Dr. Paul Crane from the University of Washington. “We were very interested in the long term impacts of traumatic brain injury” Dr. Crane said in our interview with him.

The purpose of the study was to see if traumatic brain injury with loss of consciousness contributed to the development of neurodegenerative diseases like Parkinson’s, Alzheimer’s, and dementia. 7,130 participants were involved in the study. These subjects were pooled from three prospective cohorts of people. 865 reported traumatic brain injury with loss of consciousness. The researchers also did not look at people who were already demented, so they studied it as it happened. One of the cohorts was a sample of older nuns and priests from Chicago.

They categorized the people with head trauma into those who had loss of consciousness for less than one hour and those who lost consciousness greater than or equal to one hour.

This study did find an association between head trauma with loss of consciousness and Parkinson’s disease. The people with head injuries had a 3.5 greater chance of developing Parkinson’s disease. The chance of developing Parkinson’s disease doubled when dealing with longer periods of unconsciousness.

The researchers also found the presence of Lewy bodies associated with head trauma. These are aggregated bodies of proteins found with nerve cells with Parkinson’s disease. This showed, Dr. Crane said, that the brain can deal with brain injury in a healthy way for many years, but Lewy bodies will start to develop later in life.

No association was found between head trauma with loss of consciousness and dementia or Alzheimer’s disease. Other studies however have made such links.

This suggested that the way in which the brain is affected by Parkinson’s differs from that of Alzheimer’s and dementia. This study used a much larger sample size than the one in 1995 that saw a tenfold increase in Alzheimer’s with head injury. They also studied people where the disease was already prevalent, so the earlier could have been seeing cases of early onset Alzheimer’s, which is rare. This recent study did not include people under the age of 65.

The kind of neurological disorders analyzed in this study are different than the repeated mild head trauma in football that causes chronic traumatic encephalopathy (CTE). But, Dr. Crane says that head trauma with loss of consciousness could be related to CTE as well.

The research focused on an older population, and Dr. Crane says it is relatively representative of the general population. The subjects were not selected for any risk factors of head injury.

Dr. Crane was very passionate about the power of his data set. The number of participants was massive, he said. He hopes to pursue future studies with this data.

It should be recognized by people that even one traumatic brain injury with loss of consciousness can have long-term negative effects. It is important to prevent traumatic brain injury as much as possible, as a goal. This might include wearing a helmet while biking or not participating in distracted driving or contact sports.

“The biggest issue is in terms of prevention,” Dr. Crane says. “One hopes for a world where the research questions become less relevant because we are doing such a good job protecting people’s heads.”

Mosquitos transmit the Zika virus. This virus has been linked to the birth defect microcephaly, which affects the brain. (Flickr / Creative Commons / Tom)

In a study in the New England Journal of Medicine, Zika virus has been linked to microcephaly, a condition where infants are born with abnormally small heads often due to abnormal brain development.

Researchers cited an investigation in French Polynesia. French Polynesia is an overseas collectivity of France, comprising 118 dispersed islands in the South Pacific. The risk of microcephaly due to Zika virus infection was .95 percent, which was based on eight microcephaly cases in a population of about 270,000 people with an estimated rate of Zika infection of 66 percent.

Currently in Brazil, thousands of cases have been identified of infants with suspected microcephaly due to Zika virus. Researchers analyzed data from Bahia, a state in Brazil.

From the study in French Polynesia and a study in Yap Island, located in the western Pacific Ocean, it is evident that the number of reported Zika cases are only a fraction of the actual number of Zika cases that occur.

Therefore, when doing the study in Brazil, the researchers couldn’t rely on the available data. So, they assumed a 10 to 80 percent infection of Zika virus rate. This number was based on estimates from Yap Island, which was 73 percent, French Polynesia, which was 66 to 86 percent, and reports from surveys not attributed to a specific outbreak, which sat around 6 to 40 percent.

The researchers apportioned the risk of 10 to 80 percent across 2015 with the highest point in May 2015. They also assumed all pregnant women were equally susceptible to infection, no one person at more risk than another. In addition, they estimated the number of actual microcephaly cases compared to reported microcephaly cases, with the highest number in December 2015. Finally, they assessed the association between risk of infection with microcephaly cases reported in the Brazilian Live Births Information System between July 2015 and February 2016.

Researchers had to consider different risk rates, from 10 to 80 percent, possible overreporting, and an uncertain baseline rate, two to 12 cases per 10,000 births. Considering these factors, researchers found a significant association between the risk of microcephaly and the risk of infection in the first trimester of pregnancy. Researchers came up with a range of estimated risk due to infection in the first trimester of pregnancy 0.88 percent to 13.2 percent.

The lower end of the range was similar to the study in French Polynesia, which was .95 percent risk of microcephaly due to infection of Zika.

There are limitations with estimates of microcephaly due to Zika infection. There is limited available data. The data in Bahia, Brazil is still being collected. Carefully designed surveys could help with the estimates.

Managing editor of The New England Journal of Medicine also conducted an interview with Dr. Eric Rubin, a professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health and an associate editor at the Journal, on the state of the Zika virus and directions for research and prevention.

A growing number of recommendations say that women avoid pregnancy and practice safe sex in areas where the mosquito-borne Zika virus is present, which is 60 countries or territories. Eleven countries or territories have reported cases of microcephaly. Microcephaly is not the only risk associated with Zika virus, too. Not only the brain, but the eye and the spinal cord could also be affected.

As for the summer Olympics in Brazil, there is no consensus among health professionals as to whether or not they should be cancelled. A group of medical professionals do want the games to be cancelled. Many also think it’s an individual choice to go or not, but it is not risk free. So, people must take precautions. Since it’s a mosquito borne illness, avoiding mosquito bites is critical. Dr. Rubin predicted that insecticides sales will rise. It is also documented that the infection can be sexually transmitted, so safe sex is recommended.

Microcephaly is often a mild infection. The most severe manifestations, like microcephaly, weren’t recognized until there was a big outbreak in Yap Island, and then, it was only recognized after the fact. It is still unclear what manifestations will show up as the affected children grow older.

Severe brain injury survivors sometimes have complications that come with their hospital stay. For example, someone may acquire a catheter-associated urinary tract infection (UTI). One study looked at how to prevent catheter-associated UTI. The study was titled, “A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care.” It was authored by S. Saint et. al. and published in the New England Journal of Medicine.

A study was conducted on prevention of catheter-associated UTI in a given patient. The research involved collecting data on the use of indwelling catheters. (New England Journal of Medicine Quick Take Video)

These cases of catheter associated UTI were acquired in the hospital. The use of catheters are common in hospitals, and the condition of catheter-associated UTI is preventable.

This condition is problematic for patients. Dealing with a brain injury is problematic enough, a UTI would just add to the problems. Insurance considers them hospital-acquired conditions, and imposes penalties on hospitals with higher than average catheter-associated UTIs. These are just two reasons why prevention of this condition is important to teach.

The study included a multifaceted approach intervention. It took place in 926 intensive care units (ICUs) and non-ICUs from 603 hospitals in 32 states, Washington D.C., and Puerto Rico. The researchers collected data on indwelling urinary catheters. They also assessed the necessity of such catheters on a daily basis. In addition, they encouraged the staff to avoid the use of indwelling urinary catheters and use other techniques to collect urine such as condom catheter and intermittent straight catheterization. Finally, they emphasized the importance of aseptic technique in the use of indwelling catheters. The research also included reports on catheter-associated UTIs and knowledge gaps in this area.  

After 14 months, catheter-associated UTIs per 1,000 urinary catheter days decreased by 14 percent. In non-ICU environments, indwelling catheter use decreased six percent, and catheter-associated UTIs per 1000 catheter days decreased 32 percent, from 2.28 to 1.54. When focusing on just ICUs specifically, there was no significant change in use of indwelling catheters or catheter-associated UTIs.

In the ICU, it may be more necessary to closely monitor patients’ urine, a reason for indwelling catheters. This could be why the numbers were not significantly changed despite a multifaceted intervention. What this study did do, was lay out a blueprint for a large scale approach to hospital-acquired UTI prevention.

In conclusion, the multifaceted intervention successfully reduced the number of catheter-associated UTIs in hospitals, with best results in the non-ICU.