Ray McIntyre – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Wed, 30 May 2018 15:00:03 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.6 New Study Suggests Efficacy of Statins in Cognitive Decline http://brainblogger.com/2005/11/24/news-releases-new-study-suggests-efficacy-of-statins-in-cognitive-decline/ http://brainblogger.com/2005/11/24/news-releases-new-study-suggests-efficacy-of-statins-in-cognitive-decline/#respond Thu, 24 Nov 2005 22:46:00 +0000 http://blog.gnif.org/?p=441 Neuroscience_Neurology.jpgA new study has found evidence that suggests use of statins, commonly used in the regulation of cholesterol levels, may be associated with a reduction in cognitive decline in the elderly.

Researchers in the Cardiovascular Health Study Collaborative Research Group monitored the cognitive abilities of 3,334 people over the age of 65 without dementia for an average of seven years and found that regular statin use was associated with a rate of cognitive decline less than half of that of untreated patients.

These new results published in medical journal Neurology follow on from other positive results concerning Alzheimer’s disease and statin drugs which were released recently. In the first study, statins were found to slow the progression of Alzheimer’s disease in a new three-year study of 342 patients.

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Polypharmacy: What Cost in Morbidity and Mortality? http://brainblogger.com/2005/08/12/opinion-polypharmacy-what-cost-in-morbidity-and-mortality/ http://brainblogger.com/2005/08/12/opinion-polypharmacy-what-cost-in-morbidity-and-mortality/#respond Fri, 12 Aug 2005 19:47:00 +0000 http://blog.gnif.org/?p=408 Opinion2.jpgA paper by Dr. Charles Sullivan, presented by the author at the 2003 New England Forensic Sciences Conference at Colby College: It is common practice in Medicine to put patients on combinations of drugs. The vast majority of these combinations of drugs (especially where 3 or more drugs are involved) have never been studied at all, let alone in double-blind trials ( with the exception of Oncology/AIDS treatment, where the toxicity of the drugs demands study); yet it is frequent practice to prescribe these multiple-drug combinations.

It is well accepted in pharmacology that it is scientifically impossible to accurately predict the side effects or clinical effects of a combination of drugs without studying that particular combination of drugs in test subjects. Knowledge of the pharmacologic profiles of the individual drugs in question does not in any way assure accurate prediction of the side effects of combinations of those drugs, especially when they have different mechanisms of action, which is very common because polypharmacy is most often prescribed to patients with “multiple illnesses”. More than 100,000 patients in this country die from identified adverse drug reactions (perhaps the 4th to 6th leading cause of death in the U.S.)[1] The number who die as a consequence of polypharmacy is, to my knowledge, unknown.

The argument that the prescribing of drugs is the “Art” of Medicine is not valid in defending polypharmacy, because drugs are developed (indications, dose and administration, etc.) and approved through a “scientific” process (double-blind, placebo-controlled studies). The fact that the medicines are often prescribed for “different conditions” is irrelevant (especially to the patient’s physiology). The idea that ” we are doing the best we can “, a frequent defense of Polypharmacy, does not in any way uphold a scientific argument in favor of it. (We are, indeed, trying the best we can, with tools which do not improve at the rate we would wish!) The fact that “there is a limit to how much research can be done” in no way makes the research unnecessary in order to predict the side effects of specific combinations of drugs.

It has been said in the past that less than 30% of medical practice was backed by controlled studies.[2,3] Has this changed? How do we know? Are we looking closely enough at our way of practicing Medicine? Can the use of unstudied polypharmacy really be considered evidence-based, “scientific” Medicine? Can the Pathology community help initiate meaningful debate regarding this subject at a level that will produce more widespread awareness?

Charles Sullivan, D.O.

Science progresses, funeral by funeral.” – Max Planck

1. Incidence of Adverse Drug Reactions in Hospitalized Patients. JAMA. 1998;279:1200-1205

2. Office of Technology Assessment: Assessing the efficacy and safety of medical technologies. U.S. Government Printing Office, Washington, 1978

3. Smith R: Where is the wisdom? The poverty of medical evidence. BMJ 1991;303:798

4. “…only about 15% of medical interventions are supported by solid scientific evidence; in other words, eighty-five percent are not.” Smith, R (editor of British Medical Journal). The ethics of ignorance. Journal of Medical Ethics. 1992;18:117

Additional References

Daubert v. Merrel Dow Pharmaceuticals 509 U.S. 579 (1993), 509, 579.

Goodstein, D. 2000. How Science Works. In U.S. Federal Judiciar Reference Manual on Evidence, pp. 66-72.

Horrobin, D.F. 1990. The philosophical basis of peer review and the suppression of innovation. J. Am. Med. Assoc. 263:1438-1441.

Horrobin, D.F. 1996. Peer review of grant applications: A harbinger for mediocrity in clinical research? Lancet 348:1293-1295.

Horrobin, D.F. 1981-1982. Peer review: Is the good the enemy of the best? J. Res. Commun. Stud. 3:327-334.

Horrobin, D.F. 2000. Innovation in the pharmaceutical industry. J. R. Soc. Med. 93:341-345.

Rothwell, P.M. and Martyn, C.N. 2000. Reproducibility of peer review in clinical neuroscience: Is agreement between reviewers any greater than would be expected by chance alone? Brain 123:1964-1969.

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Neurobiology, Genetics, and the Environment http://brainblogger.com/2005/06/16/opinion-neurobiology-genetics-and-the-environment/ http://brainblogger.com/2005/06/16/opinion-neurobiology-genetics-and-the-environment/#respond Thu, 16 Jun 2005 22:13:00 +0000 http://blog.gnif.org/?p=379 BioPsychoSocial_Health2.jpgComplimenting pre-existing behavior deficit research, this on-going literature review will shed light on much needed awareness for the general public and scientific-religious realms on our planet.

Behavior Conduct/Communication Deficits are:

  • acute;
  • prone to be chronic familiar genetic predisposition deficits;
  • derived from atmospheric ions;
  • which suggest a process of evolution by natural selection; and
  • to improve upon the survival of the human species.

Attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), learning disabilities (LD), communication disorders (CD), bipolar disorder (BP), autism, and the others alike are pandemic epidemiologic issues that have been around since the time of Adam and Eve.

The goal of this review is to refine the pre-existing behavior (communication) disorders/diseases in a fashion more appropriate for our age. In doing so, we must travel back in history, through countless sacred text to find the origins of the epidemic that has plagued humankind for millennia. The plausibility has been in the forefront of time staring at us, waiting for someone to discover why we are as we have always been: a species divided.

Ethical issues appear to be multifaceted conundrums that have caused mass genocides throughout history. When in fact, the issues can be summarized into one simplistic question: What will increase the welfare of humanity as a whole unit?

Given that each of us has a certain amount of limited acquired knowledge, along with personal choice, allows each of us to have a limited amount of power over our environment. This power affects our behavior, which in turn impacts the environment. In turn, impacts the future of our genetic structure. Since our knowledge is limited we have a tendency to do more harm with good intentions than with no intentions at all. Most often, what we think we’re doing for the welfare of our fellow human being, is actually being done for our own personal gain. We inflict our ideologies on one another because this is our way of behavior. This is our way of communicating ideas. This is the our way of progress on this planet.

So, what will increase the welfare of humanity as a whole unit with the least amount of human suffering? The answer is not only the way in which we view our environment. After all, we are not separate from it, we are a part of it. The answer is taken for granted and consumed by us every day — air.

Written by Richard W. Sharp, Jr., PhD

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Diary of an Epileptic: From 8 to 18 http://brainblogger.com/2005/04/23/special-features-diary-of-an-epileptic-8-thru-18/ http://brainblogger.com/2005/04/23/special-features-diary-of-an-epileptic-8-thru-18/#respond Sat, 23 Apr 2005 15:18:00 +0000 http://blog.gnif.org/?p=313 Living_Brain_Disorder2.jpgAnonymous: Eight years old, fearless and freckled, more interested in baseball caps and bugs than dolls and dresses, my life was very good. Recess was spent knee deep in gravel playing soccer, football or baseball with the boys. Going out for a long pass was all in a day’s work.

But this day was different. Like most ambitious kid on playgrounds, sometimes the athletic feat you have in your mind ends up in a scraped up wreck on the black top. What I didn’t realize was a couple of band-aids wasn’t going to fix what happed to me on the asphalt that day.

Weeks later I started to blank out. I was in the room but removed, distant. Something odd was happening to me as I would wander about but didn’t have any real control over myself. It was scary and embarrassing. It wasn’t long before my parents noticed my problems and rushed me to the doctor. Several needles, pokes, tests, procedures, and a lot of nervous looks later I was diagnosed with epilepsy.

I am uncertain if it was my tough tomboy persona or innocence, but after receiving the news I was fine and the week seemed OK. That was until my pediatrician strongly advised my mom not to tell anyone about the epilepsy. It was then that the gravity of the stigma of epilepsy settled upon my parents and a scared eight-year-old little girl.

Dr. Honeywell was a great doctor. He had curly red hair, a big red mustache, and he was always happy. He was funny, nice, warm stethoscope and mom said he was really good. I had never seen him so serious. He advised not tell the teachers, write it on any of her school administrative paperwork, or tell people outside the immediate family. He did not need to spell why.

My seizures became the family secret. We told no one. It was relatively easy because they were controlled by medication and if I had trouble it was always in the middle of the night. It was ALMOST like they didn’t exist.

Then disaster struck! A couple of months later I was invited to my first slumber party. Like any little girl I was thrilled and excited about the party. Then the realization of my condition hit me and suddenly I wanted to throw up. What if I all my friends saw me having a seizure?

This was the beginning of many difficult decisions between participation and exclusion. Should I sequester myself for fear of discrimination from others or should I take the risk and surround myself with a gaggle of fuzzy slippered, pajama clad, giggling girls? I went and slept with one eye open all night long.

My greatest challenges were maintaining secrecy and managing worry. I agonized over the thought of forgetting my medication or having a “problem” in public. Every day at 11:35 a.m. sharp mom parked under the flagpole outside my red brick elementary school. While all the other children were eating lunch, I snuck out to meet mom for a cup of juice and my medicine. For years we went undetected. She was there like clockwork and so was I.

In fifth grade my parents started to trust me to take my own medication and I started to carry a purse to school. Soon it became my sole responsibility to remember to bring and take my anti-seizure meds. The fear forgetting my meds was overwhelming and it was only compounded by the fact I had to find clandestine locations to take my pills. I swallowed my pills in bathroom stalls, empty rooms, or outside and often without any liquid.

Our secret became “my” secret. Eventually it got to the point where my family never saw me taking medication. They never asked how I was doing and I never brought it up.

Mostly life was normal, and I lived a normal life. The meds worked allowing me be a cheerleader, sing in choir, swim and play tennis competitively. I had friends and boys that liked me. Junior high school life was good.

But growing up with epilepsy was like running through an obstacle course. Except this obstacle course was also a maze complete with dead-ends. Months would go by without a seizure. I dared to think my meds transformed me into an ordinary pre-teen living a normal life. Then it would come, a humiliating seizure, as if to taunt me or let me not forget what lurks just below my skin.

I will always remember my sister’s expression as I came out of a nocturnal seizure. I was disoriented and I could tell it was one of my longer and rougher seizures. She must have been only 15 years old and she was scared, heart wrenched and helpless. She felt such deep sorrow for me. I hated being pitied.

My “problem” is when I had them, happened at night waking me from sound sleeps. Trying to get to sleep every night took tremendous effort. I slept in my own room and often the fear of being by myself would overcome me. My two older sister’s rooms were near by. I often snuck into their beds after they were asleep. But sometimes I found a door closed and preferred sleeping in the hall. There were no bad memories of in the hall.

On those nights that I had “trouble” often no one came. While only a wall separated our bedrooms my sisters said they didn’t hear anything. To this day I still wonder if they felt too helpless to come. I would recover quickly and take care of myself. Eventually I would go downstairs and crawl into my parent’s bed.

When I hit adolescence my seizures changed as my body changed. The seizures began to appear during the day. This of course was devastating. My family and I approached this bump with courage, faith and as over comers.

My neurologist changed my medication. Unlike my former medication this medication left me feeling uneasy and edgy. My seizures were MOSTLY controlled by medication. The uncertainly was unnerving.

Life went on and I had no other choice but to accept my fate. I had good days and bad days. Often an aura (the precursor to a seizure), or a seizure itself was easier to cope with than living with the fear of having “trouble.”

What if my friends discovered I was epileptic? Would they look, point and whisper when I walked into a room? It would change my friendships, relationships and social status. Or so I believed.

I was 17 and as life would have it I fell in love. His name was Jake and he was my best friend. I was crazy for him. We would stay up late and talk for hours (at least that’s what I told my parents). Sometimes we would fall asleep together. Like a slap to the face it dawned on me that if we kept doing this I was likely to have trouble in front of him.

It was strange. I would have been mortified if I had a seizure in front of him but I also wanted to tell him everything. I was in love and love has no secrets. I had to tell him sooner or later.

We were parked in his beat up grey civic and I knew it was now or never. I was terrified. He could tell something was up by my pasty white face and deer in the headlights eyes. Acting like a typical teenage guy he tried to brush off a serious conversation with some juicy gossip about the pom-poms.

I interrupted him, I have to tell you something. I have epilepsy. The problem is from an injury on the left side of my brain from a playground fall when I was eight. I am ok. I take medication. I wanted to tell you because I don’t have trouble that often, but when I do it at night and I wanted you to know, but I won’t have trouble. OK? Huge breath!

He stared back at me eyes wide open. Then a small, painful eternity passed, probably 3 seconds. Slowly he began telling me a story about when he was a little boy. He incurred a head injury and experienced grand mal seizures for a few years until he finally grew out of them. Now, that was unexpected!

All of a sudden my big secret didn’t seem so dark. That night I wasn’t all alone. He still loved me.

This article deals with epilepsy, a neurological disorder marked by electrical disruptions in normal brain conductance that produce body movements, false sensations, and emotions collectively termed seizures. For further information on the disorder pathology, interventions, and lines of research please visit The Epilepsy Project website at epilepsy.com. The article was collected by driveCommerce.

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Deep Brain Stimulation: An Introduction http://brainblogger.com/2005/04/12/articles-deep-brain-stimulation/ http://brainblogger.com/2005/04/12/articles-deep-brain-stimulation/#comments Tue, 12 Apr 2005 11:02:00 +0000 http://blog.gnif.org/?p=294 Neuroscience and Neurology CategoryImagine that your head and neck twitch uncontrollably, or seize up painfully, or that your left arm starts shaking for no reason. Dystonia refers to a group of complex muscle disorders that involve involuntary twisting, repetitive movements that cause abnormal, sometimes painful positions.

Or imagine that your hand shakes so badly that you can’t write your name or pour a liquid without spilling it everywhere. Essential tremor is the rhythmic shaking of a body part, usually a hand or arm, especially when the person tries to do something like hold a pen or cup. People with Parkinson’s disease also have tremors, as well as muscle stiffness and slowness of movement.

A new treatment

What do all these neuromuscular disorders have in common? Typically, people with these conditions are treated with medications, which may or may not give them relief. But a new therapy, called deep brain stimulation (DBS), is demonstrating in research studies that it may provide an excellent way of controlling dystonia and tremors.

A hidden electrical system

Deep brain stimulation involves putting the tip of a hair-thin wire down inside the brain in a special area that controls movement. The wire then runs up through a small hole in the skull and under the scalp down to a little device implanted under the collarbone. The device, called a neurostimulator, sends tiny electrical impulses down the wire into the brain. The person can turn the DBS on when needed, and turn it off during sleep (when tremors are less).

DBS and Parkinson’s

The picture for Parkinson’s disease is very encouraging. In 1997, the U.S. Food and Drug Administration (FDA) approved DBS for the treatment of tremor in Parkinson’s disease using a single implanted electrode. In January 2002 the FDA approved DBS using two implanted electrodes (bilateral, meaning one on each side of the brain).

Over 2,000 people with Parkinson’s disease in the U.S. have had DBS systems implanted. For most people, DBS has relieved many symptoms and improved their ability to walk and do the activities of daily life. Researchers believe that as many as 15% of people with Parkinson’s could benefit from DBS each year. So far, the risks seem acceptable; a study in 2000 reported that long-term use of DBS does not cause damage to the brain around the electrode.

DBS and dystonia

About 100 people around the world with dystonia have had a DBS system implanted. German researchers reported in February 2002 that bilateral DBS relieved head twitching in five patients with cervical dystonia (spasmodic torticollis). This is similar to research results in previous years.

DBS and essential tremor

Given the successes in using DBS to treat the tremors in Parkinson’s disease, researchers have turned to applying DBS to essential tremor. A U.S. study in 1999 evaluated DBS of 38 people with essential head tremor. All of the people had less tremors after the DBS system was implanted. And a Swedish study in January 2002 of 27 people with essential tremor found all had improved ability to do daily activities.

The future for DBS

Researchers are interested in expanding testing of DBS for other disorders. Studies have found DBS can relieve chronic nerve-related pain. In one study, a man given DBS for pain after a stroke also had some improvement in the arm weakened by the stroke. Possible areas of study for DBS are in seizure disorders, multiple sclerosis, paralysis, obsessive-compulsive disorders, and depression. Although the possibilities are exciting, it will no doubt be many years before DBS would be used to treat these additional conditions.

References

Haberler, C., Alesch, F., Mazal, P.R., Pilz, P., Jellinger, K., Pinter, M.M., Hainfellner, J.A., & Budka, H. (2000). No tissue damage by chronic deep brain stimulation in Parkinson’s disease. Ann Neurol, 48(3), 372-376.

Kitagawa, M., Murata, J., Kikuchi, S., Sawamura, Y., Saito, H., Sasaki, H., & Tashiro, K. (2000). Deep brain stimulation of subthalamic area for severe proximal tremor. Neurology, 55(1), 114-116.

Kumar, R., Dagher, A., Hutchinson, W.D., Lang, A.E., & Lozano, A.M. (1999). Globus pallidus deep brain stimulation for generalized dystonia: clinical and PET investigation. Neurology, 53(4), 871-874.

Mishra, R. “Brain waves of the future, now.” The Boston Globe, February 7, 2002.

Phillips, N.I., & Bhakta, B.B. (2000). Effect of deep brain stimulation on limb paresis after stroke. Lancet, 356(9225), 222-223.

Taira, T., Kawamura, H., & Takakura, K. (1998). Posterior occipital approach in deep brain stimulation for both pain and involuntary movement. A case report. Stereotact Funct Neurosurg, 70(1), 52-56.

Tasker, R.R., & Vilela Filho, O. (1995). Deep brain stimulation for neuropathic pain. Stereotact Funct Neurosurg, 65(1-4), 122-124.

Written by Mary Kugler

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Welcome to the GNIF Brain Blogger! http://brainblogger.com/2005/01/05/welcome-to-the-gnif-brain-blogger/ http://brainblogger.com/2005/01/05/welcome-to-the-gnif-brain-blogger/#comments Wed, 05 Jan 2005 23:20:00 +0000 http://blog.gnif.org/?p=3 System_Messages2.jpgThe official purpose of this blog is to:

“…review the latest interesting news in neuroscience, psychiatry, and neurology; on brain disorder related stigmatization and discrimination; and it will occasionally integrate GNIF news, PR, and events. It will serve as a focal point for attracting new minds into the science of the brain and the biopsychosocial model.”

In a sense, then, this blog should serve as both an entry point into the ‘popular’ face of Neuroscience, Psychiatry and Neurology, sciences which tend to be shrouded in misunderstanding or incomprehension and a resource for professionals involved in the fields.

This blog and its writers will attempt to strike a balance between making Neuroscience more accessible to folk and being informative to members of the profession.

To begin with (and please skip this if you already understand them) what exactly do we mean by Neuroscience, Neurology and Psychiatry?

According to the Merriam-Webster Medical Dictionary, Neuroscience is:

“… a branch (as neurophysiology) of the life sciences that deals with the anatomy, physiology, biochemistry, or molecular biology of nerves and nervous tissue and especially their relation to behavior and learning.”

While Neurology is:

“… the scientific study of the nervous system especially in respect to its structure, functions, and abnormalities.”

and Psychiatry is:

“… a branch of medicine that deals with the science and practice of treating mental, emotional, or behavioral disorders especially as originating in endogenous causes or resulting from faulty interpersonal relationships”

Please check the Brain Blogger on a regular basis; we will be getting things moving quickly now. I have recently been appointed as the project coordinator and writers are coming on-stream. Furthermore, if you see an area which needs improvement or where we are ‘missing the boat,’ do not hesitate to contact the me and pass your comments along.

Sincerely,
Ray McIntyre
[Former] Brain Blogger Project Coordinator

Shaheen Lakhan
GNIF Executive Director

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