Monday, August 31, 2009

Business World: R&D Spending

A report from BusinessWeek from 27 August 2009:

Drug, Biotech Research Spending Hangs Tough
Overall U.S. corporate R&D spending is down 4% since the end of 2007, but some companies have chosen to buck the trend
By Emily Thornton and Frederick Jespersen

[snip]

Corporate America's research spending shrank 4% overall, or $1.9 billion, from the fourth quarter of 2007 through the second quarter of this year, according to data compiled by Capital IQ on 961 U.S. companies. But many health-care companies have boosted their research outlays.

BusinessWeek sought out 25 companies that most aggressively increased their research budgets during the first six months of 2009. Thirteen members of the group, which collectively boosted its spending by $2 billion, were pharmaceutical and biotech companies. Only eight were high-tech outfits, such as Apple (AAPL) and Microsoft (MSFT).

[snip]

Read the full article

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Sunday, August 30, 2009

Clinical Trials: Pradaxa (dabigatran etexilate) and Stroke Prevention

From today's Guardian:

Major drug trial highlights a new approach in stroke prevention
The success of Pradaxa in a 44-country trial indicates a possible end to the use of the rat poison warfarin as a primary treatment to prevent stroke
Press Association
guardian.co.uk
Sunday 30 August 2009 23.27 BST

Read the full article

Boehringer Ingelheim's (BI) corporate website information about their clinical trial programmes: click here

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Saturday, August 29, 2009

Clinical Trials: Social Networking for Recruitment and Feedback

Pharmafocus reported earlier in the week about a plan by Pfizer to roll out some social networking options for patients considering clinical-trial participation:

Pfizer to develop online community to find new trials patients
Monday , August 24, 2009
Read the report.

The report indicates that Pfizer has teamed with Private Access in this product.

I know I have been involved in co-hosting online communities for Alzheimer's disease and in oncology and such online communities can be very exciting for patients, caregivers, and scientists.

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Friday, August 28, 2009

U.S. Hospital Websites

Tara Calishain and her diverse service specialty called Research Buzz provides a link to a new Google Custom Search Engine specific to hospital websites in the U.S., 2800 of them at current count.

For specifics, please see her website/blog entry: click here

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Memory and Quantum Entanglement

From The Guardian's ScienceBlog, 27 August 2009:

Is quantum mechanics messing with your memory?
For all we know we may live in a world in which windows un-break and cold cups of coffee spontaneously heat up, we just don't remember. The explanation is quantum entanglement.

Read the piece here

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Thursday, August 27, 2009

Upcoming Event: Alzheimer Disease (Las Vegas, 29-30 Oct 2009)

2nd Conference on Clinical Trials on Alzheimer’s Disease (CTAD)

From the conference website:

"Dear Colleague,

"It is a great pleasure for us to invite you to attend the 2nd conference Clinical Trials on Alzheimer’s Disease (CTAD), which will take place in Las Vegas on October 29-30, 2009.

"This conference is co-organized by the Montpellier and Toulouse European Alzheimer’s Disease Consortium (EADC) Centers and the Cleveland Clinic : Lou Ruvo Center for Brain Health.

"The aims of the meeting are to bring together the current leaders in clinical trials in Alzheimer’s Disease to discuss new results, drugs in development, and future methodological issues (disease modifying, outcomes, biomarkers, health economics)."


Full details available at the conference website: http://www.ctad.fr/01-presentation/presentation.asp

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Upcoming Event: Minneapolis, 13 Nov 2009

Center for Bioethics Fall Seminar Series
Time: 12:15 to 1:30 pm
Location: 1-451 Moos Tower, University of Minnesota campus (unless noted otherwise)
Minneapolis, MN
ITV to University of Minnesota, Duluth, Room 160 Life Science

November 13

“Family Stories: Decision Making in Advanced Dementia”
Presented by
Barbara Elliott, PhD
Professor, Department of Family Medicine, Medical School, Duluth; Director,
Clinical Research, Department of Family Medicine; Adjunct Professor,
Department of Behavioral Sciences, University of Minnesota, Duluth

Seminars are free and open to the public. Refreshments will be provided.
For more information email visit www.bioethics.umn.edu

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Upcoming Event: Newcastle University, 07 September 2009

An upcoming presentation at the Newcastle University Institute of Neuroscience:

IoN Seminar: The evolution of brain systems for vocal learning

Erich Jarvis (Duke University)
Venue: Room 218, Henry Wellcome Building
Date: 7th September 2009
Time: 13:00 - 14:00

The title "The evolution of brain systems for vocal learning" is a provisional title, to be confirmed.

Host: Tom Smulders

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Medical Students and Empathy

Hojat, Mohammadreza; Vergare, Michael J.; Maxwell, Kaye; Brainard, George; Herrine, Steven K.; Isenberg, Gerald A.; Veloski, Jon; Gonnella, Joseph S. The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School Academic Medicine, September 2009 - Volume 84 - Issue 9 - pp 1182-1191.
doi: 10.1097/ACM.0b013e3181b17e55

The full text of this research paper is available at: Click here

This issue of Academic Medicine includes additional commentary and research papers on the topic of empathy, available as courtesy full-text downloads.

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Ataxia

From The Guardian:

First person: My condition means people always assume I'm drunk
Jayne Wallace
The Guardian
Thursday 27 August 2009

Read the article

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Wednesday, August 26, 2009

Obit: Sen. Edward M. Kennedy





The New York Times: Edward Kennedy, Senate Stalwart, Dies

The Independent: Legacy of the only Kennedy brother to grow old

The White House: Statement by the President

The Office of the Vice President: Statement by the Vice President (includes YouTube link.)

(Photo: The White House)

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The Placebo Problem and Clinical Trials



The September 2009 issue of Wired has a nifty little article on the impact of placebo effects on pharmaceutical clinical trials and pharma company decision making: "Real. Fake. Both Can Cure Depression." by Steve Silberman.

===
Addendum on 28th August: As you will see from the comments, this piece is available on Wired magazine's website. You can access it here
===

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Alzheimer Disease: Famous Faces Testing and fMRI

Neuropsychologist Stephen Rao is in the news, with a recent publication in the journal Neurology looking at fMRI of individuals who had frisk factors for Alzheimer's disease and normal contols as they identify famous faces.

Here is a report from Time magazine's website:

What Britney Spears Can Reveal About Alzheimer's
By ALICE PARK
Wednesday, Aug. 26, 2009

Read article

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Drug Development in Neurodegenerative Diseases

Available at BMC Neurology

Proceedings of the 2009 Drug Discovery for Neurodegeneration Conference
Proceedings from Drug Discovery for Neurodegeneration Conference
Washington, DC, USA. 2–3 February 2009
Edited by Diana W Shineman and Howard M Fillit

BMC Neurology
Contents of Volume 9 Suppl 1

Click here for open access to contents of this issue

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Monday, August 24, 2009

Galanin and Multiple Sclerosis

From The Guardian:

'Dramatic' breakthrough in MS research
Scientists find a substance called galanin is resistant to a multiple sclerosis-like disease in both mice and human brain tissue
The Guardian
24 August 2009

Read the article

About a research finding from a neuroscience team at the University of Bristol.

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Glia

An article written by Carl Zimmer for the September issue of Discover magazine:

read the article

The Dark Matter of the Human Brain
Meet the forgotten 90 percent of your brain: glial cells, which outnumber your neurons ten to one. And no one really knows what they do.

===

Neuropsychology and neuroscience students" One of Carl's books, Soul Made Flesh, is an excellent story about Thomas Willis and his times. Must-read history about neuropsychology, alongside that of the later times of Broca, Wernicke, and Hughlings Jackson.

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Telemedicine in the US and Home Health Care: Cleveland Clinic

Cleveland Clinic considering telemedicine services for ICUs, home health care
MedCity News
August 20, 2009
by Chris Seper

Read the article

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Friday, August 21, 2009

FDA: Lundbeck's Sabril (Vigabatrin) and Infantile Spasms

From a press release by the FDA:

Sabril Approved by FDA to Treat Spasms in Infants and Epileptic Seizures

Sabril (vigabatrin) Oral Solution has been approved by the U.S. Food and Drug Administration to treat infantile spasms in children ages 1 month to 2 years. Sabril is the first drug in the United States approved to treat the disorder, characterized by a severe type of seizure that usually appears in the first year of life, typically between ages 4 months and 8 months. The disorder can be debilitating because of the frequency of difficult-to-control daily seizures.

Sabril (vigabatrin) Tablets have been approved for adult use in combination with other medications to treat complex partial seizures that have not responded adequately to previous drug therapies.

“Seizures can cause impaired nervous system function and reduced quality of life,” said Russell Katz, M.D., director of the Division of Neurology Products at the FDA’s Center for Drug Evaluation and Research. “Infantile spasms in children this young are very serious and this approval provides these patients and their parents a treatment option.”

Read the full press release

===

Lundbeck's corporate press release

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Tuesday, August 18, 2009

Business World: Novartis, Multiple Sclerosis, FTY720, & Betaseron

From The Wall Street Journal's Health Blog:

AUGUST 17, 2009, 11:12 AM ET
Novartis’s Big Plans for Multiple Sclerosis
By Jeanne Whalen

[snippet]

The FDA gave Novartis the green light today to start selling a copy of Betaseron, the multiple sclerosis drug long sold by Bayer.

Why would Novartis want to sell somebody else’s years-old drug? Largely to gain experience in the MS marketplace as Novartis plots a future launch of the MS drug FTY720.

“It’s a way to build a strong commercial organization and a strong medical organization ahead of FTY,” Novartis pharmaceuticals chief Joe Jimemez told the Health Blog recently.

[snippet]

Read the full blog entry

==========

Note: Here is a reference to FTY720:

Horga A, & Montalban X. (2008). FTY720 (fingolimod) for relapsing multiple sclerosis. Expert Rev Neurother., 8(5) 699-714.

Clinical Neuroinmunology Unit, Multiple Sclerosis Center of Catalonia (CEM-Cat), Vall d'Hebron University Hospital, Barcelona, Spain.

FTY720 (fingolimod) is a structural analogue of sphingosine, an endogenous lysophospholipid, which targets sphingosine-1-phosphate receptors after biotransformation to FTY720-phosphate. The immunomodulatory properties of this agent are mainly related to its ability to entrap lymphocytes in secondary lymphoid organs, reducing their availability for cell-mediated immune responses. Emerging evidence suggests that FTY720 also exerts direct actions on glial and precursor cells of the CNS which may be relevant for the process of tissue repair after injury. The therapeutic effects of the drug observed in animal models of human multiple sclerosis have provided the experimental basis for its clinical application. A recent Phase II study has demonstrated that oral FTY720 is effective in reducing disease activity in relapsing multiple sclerosis with a favorable adverse-effect profile. These results are awaiting confirmation in the three ongoing Phase III clinical trials evaluating FTY720 for relapsing-remitting multiple sclerosis.

PMID: 18457527 [PubMed - indexed for MEDLINE

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Monday, August 17, 2009

The CNS and Stress

From The New York Times:

Brain Is a Co-Conspirator in a Vicious Stress Loop
By NATALIE ANGIER
Published: August 18, 2009

"Chronic stress changes the brain, but relaxation can change it back."

Read the full article

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Identification of Possible or Probable Memory Impairment

Settling in in my coffeehouse for a reading of an interesting new publication by Dr. Brian Brooks and his colleagues on the topic of "Minimizing Misdiagnosis: Psychometric Criteria for Possible or Probable Memory Impairment." The authors seek to develop new psychometric criteria for identification of memory problems in older individuals. This has both clinical and research implications; my primary interest at this time is the accuracy of such identification for including or excluding individuals in clinical trials that test potential drug treatments for Alzheimer's and related dementias.

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Medical Data Mining Issues

From The New York Times:

And You Thought a Prescription Was Private
By MILT FREUDENHEIM
Published: August 9, 2009

"Prescriptions and the information on them are bought and sold in a murky marketplace, often without the patients’ knowledge or permission."

Read the article

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Sunday, August 16, 2009

Brainstrust in the U.K.

From the Brainstrust.org.uk website: link here

Lizzie Hudson to appear on the 4th plinth for brainstrust!

"Fantastic news just in that Lizzie Hudson from Ipswich has won the chance to appear on the 4th plinth in Trafalgar Square for an hour. Better still, she's devoting her time on the plinth to braintrust and our battle against brain cancer.

Lizzie's appearance is part of sculptor Anthony Gormley's 'One & Other' project, wherein he is asking the people of the UK to occupy the empty Fourth Plinth in Trafalgar Square in London, a space normally reserved for statues of Kings and Generals. Gormley's idea is that successful applicants then become an image of themselves, and a representation of the whole of humanity.

Every hour, 24 hours a day, for 100 days without a break, a different person will make the Plinth their own, including lucky Lizzie!

Lizzie, 26, states "I wanted to do something useful with my time, and so have decided to raise money for this much deserving charity". And she'll certainly be putting her time on the plinth to good use! She's hoping make the longest paper chain she can, racing to make it reach the ground before her hour is up.

So, if you're in London, why not come along and meet us, and Lizzie! We'll be at Trafalgar square cheering Lizzie on from 5pm on the 16th August. If you can't make it, you'll be able to watch a video, streaming live, of Lizzie on the plinth at oneandother.co.uk

You can show your support for Lizzie and her feat of derring-do (we're scared if heights!) by clicking here and visiting her JustGiving page.

Go Lizzie!"

===

Note: If you type in the website's URL make sure you add that "s" there, elsewise you get directed elsewheres.

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Saturday, August 15, 2009

Parkinson's Disease Awareness in the U.K.


From the website of the Parkinson's Disease Society:

PDS fundraiser to stand on the Fourth Plinth in London

Tim Andrews, from Milford in Surrey, is taking part in the Antony Gormley project 'One & Other' on Saturday 15 August 2009, taking his place on the Fourth Plinth in Trafalgar Square, London from 6pm to 7pm.

Tim is taking part in the project as part of a new found determination to live life to the full since he was diagnosed with Parkinson's disease in 2005, at the age of 54.

Despite being afraid of heights, Tim intends to stand on the Fourth Plinth for the full hour.

Tim will play tracks from the new album, The Liberty of Norton Folgate by one of his favourite bands, Madness, who have given their permission for it to be played. Tim has chosen the album because the lyrics recount various stories about the city of his birth, London, which he adores.

Tim hopes that many will come along, show their support and perhaps dance with him. Tim says:

"Being diagnosed with Parkinson's has enabled me to view life and death from a completely different perspective and I feel liberated as a consequence. Standing on the Fourth Plinth represents this feeling.

"If I can raise awareness of Parkinson's at the same time, that's even better."

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Friday, August 14, 2009

FDA: Saphris (Asenapine) Approval, Schizophrenia and Bipolar

From the FDA:

FDA Approves Saphris to Treat Schizophrenia and Bipolar Disorder

The U.S. Food and Drug Administration has approved Saphris tablets (asenapine) to treat adults with schizophrenia, a chronic, severe and disabling brain disorder, and to treat bipolar I disorder in adults, a serious psychiatric disorder that causes shifts in a person's mood, energy, and ability to function.

“Mental illnesses like schizophrenia and bipolar disorder can be devastating to patients and families, requiring lifelong treatment and therapy,” said Thomas Laughren, M.D., director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research. “Effective medicines can help people with mental illness live more independent lives.”

Read the full FDA press release

S-P corporate press release

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Thursday, August 13, 2009

Chiari Malformation Awareness in the U.K.




On Saturday, the 15th, from 1100 to 1200 hrs, plinther Laura Hickman of the One&Other art project in Trafalgar Square will be promoting Chiari Malformation awareness.

The Chiari Center Foundation

Chiari Malformation information page here and here

[credits: Photo courtesy Laura Hickman}

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Imitation and Social Bonding

From a National Institutes of Health (NIH) press release:

Imitation Promotes Social Bonding in Primates
Capuchin Monkeys Predisposed Toward Individuals Who Imitate Them


Imitation, the old saying goes, is the sincerest form of flattery. It also appears to be an ancient interpersonal mechanism that promotes social bonding and, presumably, sets the stage for relative strangers to coalesce into groups of friends, according to a study by a team of scientists at the National Institutes of Health and two Italian research institutions.

The study authors found that capuchin monkeys preferred the company of researchers who imitated them to that of researchers who did not imitate them. The monkeys not only spent more time with their imitators, but also preferred to engage in a simple task with them even when provided with the option of performing the same task with a non-imitator.

Read the full press release

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C-SPAN-3 Airing Alzheimer's Disease Session of Senate Subcommittee (from earlier in year)

C-SPAN-3 is currently airing an earlier session by the subcommittee on aging on the topic of Alzheimer's Disease. All C-SPAN channels can be streamed online.

Information about the program can be found here.

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Neuropsychology/Neuro New Books

I have a fun task to complete later today: Recommend to a client five new neuroscience books that have been published in 2009 to be purchased to "freshen up" their company library shelves.

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NeuroYouTube

The blog Brain Ethics posted a blog entry last month with links to several YouTube videos of historical figures in neuroscience and psychology: Read Brain Ethics post here

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Neuropsychology Abstract of the Day: Multiple Sclerosis, Fatigue, and Cognition

Morrow S, Weinstock-Guttman B, Munschauer F, Hojnacki D, & Benedict R. (2009). Subjective fatigue is not associated with cognitive impairment in multiple sclerosis: cross-sectional and longitudinal analysis. Multiple Sclerosis, 15(8),:998-1005.

School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA.

Background Studies in multiple sclerosis (MS) report conflicting conclusions regarding fatigue and cognition, which may partly be due to the use of small sample sizes and frequent reliance on a cross-sectional approach. Objective The ability to distinguish between these two disabling symptoms is necessary in order to properly assess and treat MS patients. Methods In a retrospective analysis, we assessed the correlation between fatigue and neuropsychological (NP) testing using a cross-sectional (n = 465) and longitudinal approach (n = 69). Cognition was measured using a comprehensive battery called the Minimal Assessment of Cognitive Function in MS (MACFIMS), and fatigue was measured with the Fatigue Severity Scale (FSS). FSS scores were categorized as normal (< /=4.0), borderline fatigue (4 < FSS < 5.0), and fatigued ( >/=5.0). Repeat assessments (n = 69) were categorized as improved or worsened by a change in FSS of either 0.5 or 1.0. Results MS patients had significantly higher FSS scores than normal controls (P < 0.001). No correlation was found between FSS and NP scores in either cross-sectional or longitudinal analyses. Fatigue was moderately correlated with depression, assessed using the Beck Depression Inventory Fast Screen (BDIFS) (r = 0.44, P < 0.001). Longitudinally, there was a medium correlation between change in FSS and BDIFS (r = 0.34, P = 0.001), but no significant differences on NP scores using either definition of change. Conclusion We conclude that self-reported fatigue, while correlated with self-reported depression, is not significantly related to cognitive capacity in MS.

PMID: 19667024 [PubMed - in process]

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Wednesday, August 12, 2009

Missing Meningitis in a Flaky/Dodgy Swine Flu System: Another Case

Yet another case from the UK:

Woman dies of meningitis after swine flu diagnosis
• Woman prescribed Tamiflu and paracetamol dies in hospital
• Son urges doctors to heed symptoms of other illnesses


Karen McVeigh
guardian.co.uk
Wednesday 12 August 2009 17.02 BST

A man whose mother died of meningitis days after being misdiagnosed with swine flu has called on doctors to pay more heed to other illnesses when treating patients.

Jasvir Kaur Gill, 48, a mother of three from Leicester, began suffering from a sore throat and vomiting during the evening of Saturday 1 August.

She was told to take Tamiflu after a telephone diagnosis, but 12 hours later she suffered a heart attack and was taken to hospital.

She died without regaining consciousness, four days later.

An inquest, which opened today, heard how her death was caused by meningococcal septicaemia, or blood poisoning caused by meningitis.

After the hearing, her son Sukhvinder Gill, 25, said: "We said to the doctors in the hospital, everything these days seems to be about swine flu.

"You've got a sore throat, they tell you to take Tamiflu; you've got a headache, they tell you to take Tamiflu.

"Everyone seems to be swine flu, swine flu, swine flu. What she had were also symptoms of meningitis, but they didn't think of that."

Gill, an estate agent, said the family were "just trying to get by" but were full of questions over his mother's death.

He said he hoped her funeral on Friday would allow the family to start moving on.

"I don't feel angry yet. At the moment I just miss my mum. The cause of death is not a problem, it's just wondering if it could have been caught earlier.

"The doctor said it might not have made a difference, but we don't know that. If she had 12 more hours, they could have put antibiotics in her, which might have helped."

At the inquest, Gill told Leicester city coroner, Catherine Mason, that his mother started complaining of a sore throat but then vomited repeatedly throughout the night and at 5am, prompting her husband to call NHS Direct.

Gill said that, following conversations with both his father and mother, they were told to pick up some Tamiflu.

Read the full article

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Neuropsychology Abstract of the Day: Cognitive Rehab in Ugandan Childhood Malaria Survivors

Bangirana P, Giordani B, John CC, Page C, Opoka RO, & Boivin MJ (2009). Immediate Neuropsychological and Behavioral Benefits of Computerized Cognitive Rehabilitation in Ugandan Pediatric Cerebral Malaria Survivors. Journal of Development and Behavioral Pediatrics. Aug 7.

OBJECTIVE:: Our earlier studies on Ugandan children surviving cerebral malaria showed cognitive deficits mainly in attention and memory. We now present the first study in sub-Saharan Africa to investigate the feasibility and potential benefits of computerized cognitive rehabilitation training on neuropsychological and behavioral functioning of children surviving cerebral malaria. METHODS:: A randomized trial in which 65 children admitted 45 months earlier with cerebral malaria were recruited at Mulago Hospital, Kampala, Uganda. For 8 weeks, 32 of the children received weekly training sessions using Captain's Log cognitive training software and the other 33 were assigned to a nontreatment condition. Pre- and postintervention assessments were completed using CogState, a computerized neuropsychological battery, measuring visuomotor processing speed, working memory, learning, attention and psychomotor speed and the Child Behavior Checklist measuring internalizing problems, externalizing problems, and total problems. RESULTS:: Preintervention scores were similar between both groups. Treatment effects were observed on visuospatial processing speed [group effect (standard error) 0.14 (0.03); p < .001], on a working memory and learning task [0.08 (0.02); p < .001], psychomotor speed [0.14 (0.07); p = .04], and on internalizing problems [-3.80 (1.56); p = .02] after controlling for age, sex, school grade, quality of the home environment, and weight for age z scores. Similar treatment effects were observed when no adjustments for the above covariates were made. CONCLUSIONS:: Computerized cognitive training long after the cerebral malaria episode has immediate benefit on some neuropsychological and behavioral functions in African children. The long-term benefit of this intervention needs to be investigated.

PMID: 19668094 [PubMed - as supplied by publisher]

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Eunice Kennedy Shriver: NIH Statement

From a National Institutes of Health (NIH) press release:

Statement of Duane Alexander, M.D., Director
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health
On the Contributions of Eunice Kennedy Shriver
in Advancing Research in Child Health, Human Development, and Intellectual Disability


The entire world owes a debt to Eunice Kennedy Shriver for her foresight in calling for an institute at the National Institutes of Health to study the myriad aspects of human development, both as it unfolds without problems and when medical and environmental factors prevent it from doing so.

In 1961, Mrs. Shriver persuaded her brother, then-President Kennedy, to include in his first health message to Congress the proposal for an NIH institute focusing on child health and human development research. After the bill that would establish the new institute was introduced, Mrs. Shriver testified in support of that bill and worked to persuade members of Congress to approve it. The institute that now bears her name, by act of Congress, is a tribute to her vision and commitment.

Research that the Eunice Kennedy Shriver National Institute of Child Health and Human Development has sponsored has led to the near-elimination in the developed world of once common causes of intellectual disability. For example, as recently as the 1980s, Haemophilus influenzae Type B (Hib) meningitis was the leading cause of acquired mental retardation in the United States. A vaccine against the disease, developed in the NICHD's laboratories, has been so effective that today the disease is nearly eliminated. Children with the metabolic disorder phenylketonuria, or PKU, develop severe intellectual disability soon after birth. In the 1960s, a blood test for PKU was developed and children with the disorder were identified at birth. NICHD research documented that a diet low in the amino acid phenylanine spared them from brain damage and allowed normal functioning. Another newborn blood test developed through NICHD research for a disorder caused by failure to produce sufficient amounts of thyroid hormone allowed diagnosis and treatment before any brain damage could occur. Other NICHD research documented the benefits and feasibility of mainstreaming children and adults with intellectual and physical disabilities into schools and communities, a practice that is now routine.

She was also instrumental in creating in 1961 what eventually became the President's Committee for People with Intellectual Disabilities (ACF/HHS), and served on that Committee from 1966-1968 and from 1977-1980.

We owe these and numerous other advances in health, especially for those with disabilities, to Mrs. Shriver's determined efforts. She will be greatly missed.

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute's Web site at http://www.nichd.nih.gov/.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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FDA: Datscan: A Radiopharmaceutical and Parkinson Disease

Following up on a posting earlier this week:


From a General Electrics press release

11 August 2009
FDA ADVISORY COMMITTEE RECOMMENDS DaTSCAN™ (Ioflupane I 123 Injection)

PRINCETON, NJ--GE Healthcare announced today that the Peripheral and Central Nervous System Drugs advisory committee of the U.S. Food and Drug Administration (FDA) has voted to recommend DaTSCAN (Ioflupane I 123 Injection) to the FDA. The panel determined DaTSCAN has a favorable risk to benefit profile, voting 11 to two with one abstention.

The proposed indication for DaTSCAN is for the visualization of the dopamine transporter (DaT) distribution within the striata by single photon emission computed tomography (SPECT) imaging in patients presenting with symptoms or signs suggestive of dopaminergic neurodegeneration.

In May 2009, the FDA accepted the New Drug Application and granted DaTSCAN priority review, a designation identified for areas of unmet medical need. If approved, DaTSCAN will be the first radiopharmaceutical agent available to detect DaT distribution within the brain.

“We are pleased that the committee has recognized the potential benefit of DaTSCAN,” said Don Black, MD, head of R&D for GE Healthcare Medical Diagnostics. “Making DaTSCAN available in the U.S. would be an important milestone for GE Healthcare and improved patient care.”

The Prescription Drug User Fee Act (PDUFA) date for DaTSCAN is September 9, 2009.

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Sports Safety and Traumatic Brain Injury: S100 Batting Helmet

Batting Helmet is Safer, but Players Hate the Look
By DAVID WALDSTEIN
The New York Times
Published: August 13, 2009

"Some major league players don’t want to sacrifice comfort and style for the added protection of Rawlings’ new helmet."

Read article

[Note: The helmet is called the Rawlings S100 and the company's website has promotional material about it's features.}

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Tuesday, August 11, 2009

In The Wide World: Two Kennedy Centers

The Eunice Kennedy Shriver National Institute of Child Health and Human Development
Bethesda, MD
http://www.nichd.nih.gov/


The Rose F. Kennedy University Center for Excellence in Developmental Disabilities
Bronx, NY
http://www.aecom.yu.edu/cerc/kennedy.htm

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Obit: Eunice Kennedy Shriver

Eunice Kennedy Shriver, 88; member of Kennedy clan, founder of Special Olympics
By Bryan Marquard
Boston Globe Staff / August 11, 2009

"Eunice Kennedy Shriver, who planted the seeds for the Special Olympics when she launched Camp Shriver on the lawn of her Maryland home, and then with force of will and the clout of her family name spread her vision of lifting the developmentally disabled "into the sunlight of useful living," died this morning at Cape Cod Hospital in Hyannis."

Read full article

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Monday, August 10, 2009

FDA: Datscan: A Radiopharmaceutical and Parkinson Disease

The Wall Street Journal's HealthBlog discusses this radiopharmaceutical and the FDA meeting to be held tomorrow about it [read post here]

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Neuropsychology Abstract of the Day: Developmental Deprivation and the Cerebellum

Bauer PM, Hanson JL, Pierson RK, Davidson RJ, & Pollak SD. (2009). Cerebellar Volume and Cognitive Functioning in Children Who Experienced Early Deprivation. Biological Psychiatry. 2009 Aug 4. [Epub ahead of print]

University of Wisconsin-Madison, Madison, Wisconsin.

BACKGROUND: The cerebellum is a brain region recognized primarily in the coordination of movement and related accessory motor functions. In addition, emerging evidence implicates the cerebellum in cognitive processes and suggests that this brain region might be subject to experience-dependent changes in structure. Therefore, the aim of this study was to evaluate the role of early environmental deprivation in the maturation of the cerebellum and aspects of cognitive development. METHODS: Structural magnetic resonance imaging volumes of 12 cerebellar sub-regions from 31 previously neglected and 30 typically developing children were compared with subjects' corresponding neuropsychological test scores. RESULTS: Neglected children had smaller volume of the superior-posterior cerebellar lobes. Moreover, superior-posterior lobe volume was found to mediate neuropsychological test performance differences between groups, with larger volumes yielding better outcomes on tests of memory and planning. CONCLUSIONS: These data support the importance of experience-dependent changes in cerebellar structure and highlight the role of the cerebellum in higher cognitive functions.

PMID: 19660739 [PubMed - as supplied by publisher

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Capgras Syndrome and Traumatic Brain Injury

An interesting feature article from the front page of yesterday's New York Times:

After Injury, Fighting to Regain a Sense of Self
By BENEDICT CAREY
The New York Times
Published: August 9, 2009

"Scientists are investigating delusions caused by brain trauma for clues to one of the most confounding problems in brain science: identity."

Read the full article

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Friday, August 07, 2009

Missing Possible Meningitis in a Flaky/Dodgy Swine Flu System

From The Guardian:

Girl, two, dies after swine flu misdiagnosis
Child with possible meningitis was 'failed by system' say parents
Jo Adetunji
guardian.co.uk
Saturday 8 August 2009 01.08 BST

[snippet]

The parents of a two-year-old girl thought to have died from meningitis after they were told she was suffering from swine flu said yesterday that she had been "failed by the system".

Georgia Keeling, from Norwich, died after being rushed to hospital on Tuesday. Her parents, Paul Sewell, 21, and Tasha Keeling, 22, said they contacted health services, including NHS Direct, the swine flu helpline and the emergency services, five times after their daughter first developed a temperature on Saturday.

The couple said that by Tuesday she had also developed a rash, bruising and had been sick, but their concerns that she might have meningitis were ignored.

They said that on two occasions they were told Georgia did not need to be admitted to hospital and after one 999 call, a paramedic arrived with Tamiflu and paracetamol. It was only after another 999 call an hour later, when her eyes had glazed over, that she was taken to hospital. Georgia suffered a heart attack and attempts to resuscitate her failed.

Speaking to a local paper, Sewell said: "I don't feel like the paramedics did their job properly. She wasn't given a chance, they had diagnosed her before even looking at her and came out ready to give her Tamiflu. She was failed by the system big time. I just want to know how come they didn't take her into hospital straight away."

[snippet]

The child's death comes just a few weeks after a warning from The Meningitis Trust against mistaking the symptoms of meningitis for swine flu. Several, including fever, muscle pain and headaches, are common to both conditions and several health charities have expressed concern that doctors and health professionals could miss them.

Read the full article

Read The Meningitis Trust press release (20 July 2009)

And, with this is mind also today, read this headline from The Mail: "Swine flu hotline run by 16-year-olds: NHS pays GCSE pupils to give advice and hand out drugs" Read article

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Attention and Concentration

Dr. Ed Vogel of the University of Oregon on Distraction and The Brain, a short YouTube video:

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Neuropsychology Abstract of the Day: Cricket Learning and Memory

A very interesting paper about classical conditioning. Enjoy. If you are a student, you might also see this referred to as Pavlovian conditioning ...


Makoto Mizunami, Sae Unoki, Yasuhiro Mori, Daisuke Hirashima, Ai Hatano, & Yukihisa Matsumoto. (2009). Roles of octopaminergic and dopaminergic neurons in appetitive and aversive memory recall in an insect. BMC Biology, 7:46 [doi:10.1186/1741-7007-7-46]

Published: 4 August 2009
Abstract, with link to full BioMedCentral paper

Abstract (provisional)

Background
In insect classical conditioning, octopamine (the invertebrate counterpart of noradrenaline) or dopamine has been suggested to mediate reinforcing properties of appetitive or aversive unconditioned stimulus, respectively. However, the roles of octopaminergic and dopaminergic neurons in memory recall have remained unclear.

Results
We studied the roles of octopaminergic and dopaminergic neurons in appetitive and aversive memory recall in olfactory and visual conditioning in crickets. We found that pharmacological blockade of octopamine and dopamine receptors impaired aversive memory recall and appetitive memory recall, respectively, thereby suggesting that activation of octopaminergic and dopaminergic neurons and the resulting release of octopamine and dopamine are needed for appetitive and aversive memory recall, respectively. On the basis of this finding, we propose a new model in which it is assumed that two types of synaptic connections are formed by conditioning and are activated during memory recall, one type being connections from neurons representing conditioned stimulus to neurons inducing conditioned response and the other being connections from neurons representing conditioned stimulus to octopaminergic or dopaminergic neurons representing appetitive or aversive unconditioned stimulus, respectively. The former is called 'stimulus-response connection' and the latter is called 'stimulus-stimulus connection' by theorists studying classical conditioning in higher vertebrates. Our model predicts that pharmacological blockade of octopamine or dopamine receptors during the first stage of second-order conditioning does not impair second-order conditioning, because it impairs the formation of the stimulus-response connection but not the stimulus-stimulus connection. The results of our study with a cross-modal second-order conditioning were in full accordance with this prediction.

Conclusion
We suggest that insect classical conditioning involves the formation of two kinds of memory traces, which match to stimulus-stimulus connection and stimulus-response connection. This is the first study to suggest that classical conditioning in insects involves, as does classical conditioning in higher vertebrates, the formation of stimulus-stimulus connection and its activation for memory recall, which are often called cognitive processes.

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In the Wide World: BASIC in Manchester, UK

BASIC: Brain and Spinal Injury Centre
visit website

With a shout out to Andy_G, who is on the plinth in Trafalgar Square right now wearing a BASIC shirt and is a part of the One & Other art event.

From the website:

"BASIC is a specialist resource for people and their families in crisis followinga traumatic brain injury or neurological diagnosis. This includes people recovering from severe head injury, brain haemorrhage, brain tumour and otherbrain-related conditions such as stroke and brain cancer."

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Thursday, August 06, 2009

BBC Radio 4 Looks at DSM Decision-Making Transparency

BBC Radio 4
Rewriting the Psychiatrists' Bible
Matthew Hill
04 August 2009

Listen to the report (40 mins.) about the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA) as decisions are being reached about its forthcoming revision. Visit the show's webpage

Online availability ends on the 11th of August.

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Tuesday, August 04, 2009

Obit: Dr. Mark Rosenzweig

Mark Rosenzweig, pioneer in brain plasticity, learning and hearing, has died at 86
UCBerkeley News
By Yasmin Anwar, Media Relations | 03 August 2009
Read the full report

BERKELEY — Mark R. Rosenzweig, a professor emeritus of psychology at the University of California, Berkeley, whose early studies paved the way for today's recognition of the brain's ability to grow and repair itself, died July 20 at his home in Berkeley from kidney failure. He was 86.

A prolific researcher, writer and French-speaking internationalist, Rosenzweig collaborated with some of the greatest minds in neuropsychology at Harvard University, UC Berkeley and the Louis Pasteur University in Strasbourg, France.

At UC Berkeley, Rosenzweig collaborated with biochemist Ed Bennett, psychologist David Krech and neuroanatomist Marian Diamond on studies that provided early evidence of brain plasticity - the now-well established notion that neural pathways change throughout our lives as we grow and learn. In addition, his earlier research into auditory perception also laid the groundwork for modern, noninvasive hearing tests.

"Rosenzweig's investigations were rigorous, groundbreaking and continue to be cited in all current accounts of brain development and plasticity, though they were conducted half a century ago," said Stephen Hinshaw, chair of UC Berkeley's Department of Psychology. "If anyone deserves the term 'pioneer,' he does."

Through extensive studies of laboratory rats at UC Berkeley in the 1950s and '60s, Rosenzweig and his colleagues were able to show that "environmental therapy" can stimulate brain growth at a cellular level not only in children, but also in adults. For example, he found that rats living in an "enriched environment" with stimulating interactive tasks performed better at learning activities than those in passive, impoverished conditions.

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Neuropsychology Abstract of the Day: Alzheimer's, MCI, & CSF Markers

Mattsson N, Zetterberg H, Hansson O, Andreasen N, Parnetti L, Jonsson M, Herukka SK, van der Flier WM, Blankenstein MA, Ewers M, Rich K, Kaiser E, Verbeek M, Tsolaki M, Mulugeta E, Rosén E, Aarsland D, Visser PJ, Schröder J, Marcusson J, de Leon M, Hampel H, Scheltens P, Pirttilä T, Wallin A, Jönhagen ME, Minthon L, Winblad B, & Blennow K. (2009). CSF biomarkers and incipient Alzheimer disease in patients with mild cognitive impairment. JAMA, 302(4), 385-393.

Institute of Neuroscience and Physiology, Department of Neurochemistry and Psychiatry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.

CONTEXT: Small single-center studies have shown that cerebrospinal fluid (CSF) biomarkers may be useful to identify incipient Alzheimer disease (AD) in patients with mild cognitive impairment (MCI), but large-scale multicenter studies have not been conducted. OBJECTIVE: To determine the diagnostic accuracy of CSF beta-amyloid(1-42) (Abeta42), total tau protein (T-tau), and tau phosphorylated at position threonine 181 (P-tau) for predicting incipient AD in patients with MCI. DESIGN, SETTING, AND PARTICIPANTS: The study had 2 parts: a cross-sectional study involving patients with AD and controls to identify cut points, followed by a prospective cohort study involving patients with MCI, conducted 1990-2007. A total of 750 individuals with MCI, 529 with AD, and 304 controls were recruited by 12 centers in Europe and the United States. Individuals with MCI were followed up for at least 2 years or until symptoms had progressed to clinical dementia. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative likelihood ratios (LRs) of CSF Abeta42, T-tau, and P-tau for identifying incipient AD. RESULTS: During follow-up, 271 participants with MCI were diagnosed with AD and 59 with other dementias. The Abeta42 assay in particular had considerable intersite variability. Patients who developed AD had lower median Abeta42 (356; range, 96-1075 ng/L) and higher P-tau (81; range, 15-183 ng/L) and T-tau (582; range, 83-2174 ng/L) levels than MCI patients who did not develop AD during follow-up (579; range, 121-1420 ng/L for Abeta42; 53; range, 15-163 ng/L for P-tau; and 294; range, 31-2483 ng/L for T-tau, P < .001). The area under the receiver operating characteristic curve was 0.78 (95% confidence interval [CI], 0.75-0.82) for Abeta42, 0.76 (95% CI, 0.72-0.80) for P-tau, and 0.79 (95% CI, 0.76-0.83) for T-tau. Cut-offs with sensitivity set to 85% were defined in the AD and control groups and tested in the MCI group, where the combination of Abeta42/P-tau ratio and T-tau identified incipient AD with a sensitivity of 83% (95% CI, 78%-88%), specificity 72% (95% CI, 68%-76%), positive LR, 3.0 (95% CI, 2.5-3.4), and negative LR, 0.24 (95% CI, 0.21-0.28). The positive predictive value was 62% and the negative predictive value was 88%. CONCLUSIONS: This multicenter study found that CSF Abeta42, T-tau, and P-tau identify incipient AD with good accuracy, but less accurately than reported from single-center studies. Intersite assay variability highlights a need for standardization of analytical techniques and clinical procedures.

PMID: 19622817 [PubMed - indexed for MEDLINE]

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Monday, August 03, 2009

Robot Suit HAL (Hybrid Assistive Limb) Back in the News

The assistive-limb robot is back in the news this week:

Japanese 'robot suit' to help disabled
The Telegraph (UK)
By Claudine Beaumont, Technology Editor
Published: 3:48PM BST 03 Aug 2009

Read the full article

===

Corporate website: Cyberdyne

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ICD-10 Implementation

Lisa Eramo has written a piece for HealthLeaders Media about ICD-10 implementation issues and timelines. The article is available online: Providers May Need Four Years to Implement ICD-10.

[snippet]

"Industry experts have repeatedly said that ICD-10 implementation must begin immediately in order for hospitals, health plans, and vendors to meet the October 1, 2013 compliance deadline. But now there is detailed evidence to prove it."

[snippet]

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Neuropsychology Abstract of the Day: Donepezil, MCI, and AD

Lu PH, Edland SD, Teng E, Tingus K, Petersen RC, Cummings JL & Alzheimer's Disease Cooperative Study Group. (2009)
Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72(24):, 2115-2121.

Departments of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

OBJECTIVE: To determine whether the presence of depression predicts higher rate of progression to Alzheimer disease (AD) in patients with amnestic mild cognitive impairment (aMCI) and whether donepezil treatment beneficially affect this relationship. METHODS: The study sample was composed of 756 participants with aMCI from the 3-year, double-blind, placebo-controlled Alzheimer's Disease Cooperative Study drug trial of donepezil and vitamin E. Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and participants were followed either to the end of study or to the primary endpoint of progression to probable or possible AD. RESULTS: Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03). The sample was stratified into depressed (BDI score > or =10; n = 208) and nondepressed (BDI <10; n = 548) groups. Kaplan-Meier analysis showed that among the depressed subjects, the proportion progressing to AD was lower for the donepezil group than the combined vitamin E and placebo groups at 1.7 years (p = 0.023), at 2.2 years (p = 0.025), and remained marginally lower at 2.7 years (p = 0.070). The survival curves among the three treatment groups did not differ within the nondepressed participants. CONCLUSIONS: Results suggest that depression is predictive of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD) and treatment with donepezil delayed progression to AD among depressed subjects with aMCI. Donepezil appears to modulate the increased risk of AD conferred by the presence of depressive symptoms.

PMID: 19528519 [PubMed - indexed for MEDLINE]

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In The Wide World: Scotland Neuroscience

Edinburgh Neuroscience:

"The mission of Edinburgh Neuroscience is to integrate basic and clinical research in order to drive the fundamental genetic, cellular, organ, systems and computational neuroscience underpinning pathogenesis into mechanistic understanding, future diagnostics and therapeutics of important diseases of the nervous system. We serve the interests of all members of the neuroscience community, encompassing and supported by the Research Centres and Institutes of the University of Edinburgh and its affiliates. Edinburgh Neuroscience is hosted by the College of Medicine and Veterinary Medicine at The University of Edinburgh and currently consists of approximately 470 staff, 160 PhD students and 40 MSc students, working in 137 research laboratories." - from the website

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Welcome to Philadelphia Neuroscience Boot Campers!

I was pointed to this event in my own town by a post at The Law and Neuroscience Blog: Read their post here.

Apparently the Boot Camp is an introduction to the neurosciences for non-neuroscientists, held at the University of Pennsylvania. What an excellent thing!

Enjoy the event and enjoy our fair city!

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Saturday, August 01, 2009

A Little Neuropsych History: Paul Satz, Ph.D.

Here is a webpage from the University of Florida (click here) that will be of interest to neuropsychologists, if only because it includes some cool photographs (as a profession, neuropsychology seems to be on the slim side when it comes to available photographs of persons and places). Enjoy graduate school and early-career pictures and stories of some fine neuropsychologists!

And, as an added treat, some additional photographs (click here) of a fine neuropsychologist and his friends and colleagues, posted online by one of them.

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