Glossolalia, or speaking in tongues, has fascinated thinkers ever since the “tongues of angels” descended upon early believers as a gift from the Holy Ghost in the New Testament of the Bible. This unusual mental state, characterized by utterances that sometimes sound like an untranslated psalm from Mars, typically occurs during instances of religious excitation, and is primarily associated with Pentecostal religious practices. It has commonly been considered a form of ecstatic trance accompanied by verbal utterances not found in any language.

Tongue speakers typically claim that the outbursts are non-voluntary, but others can sometimes produce instances of glossolalia on demand. Glossolalia has typically been considered a psychopathology, although little has been known about what occurs in the brain during this behavior. Plato asserted that these occurrences were caused by divine inspiration. He suggested that God took possession of the mind while man was sleeping or possessed, and during such a state, God inspired man with utterances that he can neither understand nor interpret.

Research performed in the 1980s at Denison University by the late anthropologist Felicitas Goodman led to a theory that glossolalia was a trance state caused by rhythmic discharges from the reticular formation, an area of the brain stem that plays a role in sleep and dreams. Goodman believed that this represented an alternative neural pathway for language, but more recent research has cast light on activity in other areas of the brain.

In 2006, Andrew Newberg and associates conducted the first functional neuroimaging study of cerebral changes during the act of glossolalia. In the study, published in Psychiatry Research: Neuroimaging, Newberg and other researchers at the University of Pennsylvania managed to run single photon emission computed tomography (SPECT) scans to measure regional cerebral blood flow in the brains of five people during episodes of active glossolalia. (As controls, the investigators took scans of people singing gospel songs.)  Despite the prevailing notion in the biomedical community of glossolalia as psychopathology, the researchers discovered that “the limited number of reported studies have suggested that people who speak in tongues show no differences in personality traits from other population groups.” Indeed, an earlier study in Britain of glossolalia among the clergy found that those who sometimes spoke in tongues showed more emotional stability and less depression than a control group.

In an earlier neuroimaging study of meditation states, Newberg and coworkers had observed increased activity in the frontal lobes, a finding consistent with scans of other attention-focusing activities.  But in the case of glossolalia, Newberg, the director for the Center for Spirituality and the Mind at the University of Pennsylvania School of Medicine, discovered that activity the frontal lobes decreased, including activity in the brain’s primary language processing centers: “Our finding of decreased activity in the frontal lobes during the practice of speaking in tongues is fascinating because these subjects truly believe that the spirit of God is moving through them and controlling them to speak. Our brain imaging research shows us that these subjects are not in control of the usual language centers during this activity, which is consistent with their description of a lack of intentional control while speaking in tongues.”

Another area of activity during glossolalia is the left superior parietal lobe (SPL), a region behind the frontal lobes that plays an important role in processing sensory input. In the meditation scans, during which subjects describe a loss of the sense of self, there was a significant decreases in SPL activity. However, glossolalia patients showed no such decreases, a finding consistent with their assertion that they experience no loss of individual boundaries, or submerging of the sense of self, while speaking in tongues.

The study also found increased activity in the limbic system, the seat of emotional responses, but the researchers declined to speculate on “altered emotional activity during glossolalia.”

One of the curious aspects of the study, as pointed out on the Neurocritic Blog, is that the subjects were capable of entering the state of glossolalia more or less on cue. This finding seems to call into question the “spontaneous utterance” aspect of glossolalia.

Spiritual or religious aspects notwithstanding, the study strongly points to the act of speaking in tongues as a verifiable language phenomenon that invites further study.

References

Francis, L. (2003). Personality and Glossolalia: A Study Among Male Evangelical Clergy Pastoral Psychology, 51 (5), 391-396 DOI: 10.1023/A:1023618715407

Goodman, Felicitas D. (1969). Phonetic Analysis of Glossolalia in Four Cultural Settings. Journal for the Scientific Study of Religion, 8 (2), 227-239.

NEWBERG, A., WINTERING, N., MORGAN, D., & WALDMAN, M. (2006). The measurement of regional cerebral blood flow during glossolalia: A preliminary SPECT study Psychiatry Research: Neuroimaging, 148 (1), 67-71 DOI: 10.1016/j.pscychresns.2006.07.001

Richardson, James T. (1973). Psychological Interpretations of Glossolalia: A Reexamination of Research. Journal for the Scientific Study of Religion, 12 (2), 199-207.

Published by BioMed Central, JMCR “is a peer-reviewed open access journal that will consider any original case report that expands the field of general medical knowledge.” To submit a case report for publication, please review the JMCR submission checklist.

Introduction

We describe the case of a 79-year-old Caucasian woman with a transient basilar occlusion monitored by transcranial Doppler, with subsequent recanalization and clinical shrinking deficit. [The basilar artery is one of many cerebral vessels that supply the brain, however, unlike the others, it is singular and supplies the brainstem]. This is the first case of transient basilar occlusive disease diagnosed and monitored by transcranial Doppler. This case is important and needs to be reported because transient basilar occlusion may be easily diagnosed if transcranial Doppler is performed.

Case Presentation

A 79-year-old woman affected by chronic atrial fibrillation and not treated with oral anticoagulants, cardioverted to sinus rhythm during a gastric endoscopy. She then showed a sudden-onset loss of consciousness, horizontal and vertical gaze palsy [unable to move eyes up-down or sideways], tetraparesis [paralysis of all four extremities] and bilateral miosis [constriction of the pupil] and coma. Two hours later, the symptoms resolved quickly, leaving no residual neurologic deficits. Transcranial Doppler examination showed a dampened flow in the basilar artery in the emergency examination and a restored flow when the symptoms resolved.

Conclusion

This is the first case of transient basilar occlusive disease diagnosed and monitored by transcranial Doppler. We believe that transcranial Doppler should be performed in all cases of unexplained acute loss of consciousness, in particular, if associated with signs of brainstem dysfunctions.

My Comments

I’ll take this opportunity to describe an invaluable utility in neurology — transcranial Doppler (TCD). This real-time ultrasonic examination measures blood flow through intra-cranial vessels using a probe over the patient’s head. It is inexpensive, quick, and, most importantly, noninvasive. It has been used used in the following clinical applications:

• Sickle Cell Disease — assessing stroke risk
• Intracranial Vasospasm — especially in subarachnoid hemorrhage
• Arterial Stenosis and Occlusion — including testing for recanalization post-treatment
• Monitoring for Sources of Emboli and Heart Shunts during Procedures — detecting microemboli
• Brain Death (Cerebral Circulatory Arrest) — often an adjunct modality
• Testing for Cerebrovascular Autoregulation — testing patients prior to carotid endarterectomy surgery
• Testing for Flow Changes with Cognitive Tasks — akin to MRI and fMRI

In our present case, the patient’s constellation of symptoms (sudden-onset loss of consciousness, horizontal and vertical gaze palsy, tetraparesis and bilateral miosis and coma) is highly indicative of a brainstem lesion most likely of vascular origin. The reticular activating system, a neural network in the brainstem that controls arousal, was presumably affected causing loss of consciousness. The gaze palsy may be explained by involvement of the midbrain and pons. If the cortico-spinal tracts were affected, then tetraparesis is possible. Lastly, a lesion involving hypothalamospinal fibers can triggering bilateral miosis (as in Horner’s syndrome). It is the basilar artery that supplies these territories and its occlusion is associated with the famed locked in syndrome.

In considering acute basilar artery occlusion, cerebral angiography is the gold standard diagnostic test where a neuroradiologist enters the femoral artery with a catheter and reverses his/her way up the brain to illustrate its circulation. However, since the patient’s symptoms resolved and angiography is not without risk including stroke, TCD was performed and revealed “dampened flow” suggestive of recanalization in the case of intracranial artery occlusion. In other words, the presumed embolus that once occluded the basilar artery underwent breakdown (fibrinolysis) and blood flow was re-established. Given that the neurological symptoms completely resolved in less than 24 hours from onset, we would label this event as a transient ischemic attack (TIA).

Diagnosis: Brainstem TIA most likely due to basilar artery embolism diagnosed by TCD

This case illustrates one of the great utilities of TCD — looking at the posterior-circulation of the brain (vertebral-basilar arteries) in acute events for diagnostic purposes. However, the latest application of TCD lies in treating disease, particularly stroke. The TCD ultrasound waves have shown to improve the delivery and penetration of rtPA (the FDA approved clot busting therapy for stroke) inside the clot. This utility, called sonothrombolysis, coupled with special catheters are being studied for acute strokes and look promising.

Case Reference

Nicoletti, G., Albano, G., Sanguigni, S., Tardi, S., Malferrari, G., Del Sette, M., Bruno, F., & Nicolai, A. (2010). Transient basilar artery occlusion monitored by transcranial color Doppler presenting with a spectacular shrinking deficit: a case report Journal of Medical Case Reports, 4 (1) DOI: 10.1186/1752-1947-4-13

Additional References

Kassab, M., Majid, A., Farooq, M., Azhary, H., Hershey, L., Bednarczyk, E., Graybeal, D., & Johnson, M. (2007). Transcranial Doppler: An Introduction for Primary Care Physicians The Journal of the American Board of Family Medicine, 20 (1), 65-71 DOI: 10.3122/jabfm.2007.01.060128

Rubiera M, & Alexandrov AV (2010). Sonothrombolysis in the management of acute ischemic stroke. American journal of cardiovascular drugs : drugs, devices, and other interventions, 10 (1), 5-10 PMID: 20104930

Recently, the United Kingdom’s General Medical Council (GMC) determined that several elements of the original publication “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children,” authored by Dr. Andrew Wakefield, are incorrect. Specifically, the GMC found evidence that the authors did not receive the necessary ethical approval for the investigation and they misrepresented the children’s diseases. The GMC issued a startling reprimand that asserted Dr. Wakefield and colleagues showed a “callous disregard” for children and acted “dishonestly” when conducting the research. It turns out that Dr. Wakefield was being paid by a group of parents who believed their children had been harmed by the MMR vaccine. Dr. Wakefield insists that he was motivated by a genuine concern for the welfare of the children.

The original research involved 12 children ranging in age from 3 to 10 years. Eleven of them were boys. Parents of 8 of the children linked the MMR vaccine to the onset of behavioral symptoms associated with autism, psychosis, or encephalitis. The authors concluded that the exposure to the MMR vaccine could not be ruled out as a cause for developmental regression in previously normal children. In 2004, The Lancet issued a partial retraction of the research, but argued they were right to publish the research to promote new ideas and new ways of thinking. In doing so, they sparked a decade of intense controversy and a decline in vaccination rates around the developed world. Now, The Lancet goes further and fully retracts the paper from its published record. Hindsight has led them to rethink their original motives.

No one yet knows exactly what causes autism, or any of the related spectrum of disorders. There is strong evidence for a genetic link, but environmental exposure to toxins cannot be ruled out. New reports of exposure to known mutagens and environmental risk factors before conception appear to be related to an increased risk for autism. A new hypothesis claims that living in urban areas, at higher altitudes, or with high levels of precipitation may decrease sun exposure, increase risk for Vitamin D deficiency, and, therefore, increase the risk for autism. Until large-scale, ethically-compliant, scientifically-sound research in confirmed, the causes and implications of autism will never be known. Until then, everyone should take heed not to believe everything they read – even in prestigious medical journals.

References

Herbert MR (2010). Contributions of the environment and environmentally vulnerable physiology to autism spectrum disorders. Current opinion in neurology PMID: 20087183

Kinney, D., Barch, D., Chayka, B., Napoleon, S., & Munir, K. (2010). Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorder? Medical Hypotheses, 74 (1), 102-106 DOI: 10.1016/j.mehy.2009.07.052

WAKEFIELD, A., MURCH, S., ANTHONY, A., LINNELL, J., CASSON, D., MALIK, M., BERELOWITZ, M., DHILLON, A., THOMSON, M., & HARVEY, P. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children The Lancet, 351 (9103), 637-641 DOI: 10.1016/S0140-6736(97)11096-0

Retraction – Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet.

WAKEFIELD, A., MURCH, S., ANTHONY, A., LINNELL, J., CASSON, D., MALIK, M., BERELOWITZ, M., DHILLON, A., THOMSON, M., & HARVEY, P. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children The Lancet, 351 (9103), 637-641 DOI: 10.1016/S0140-6736(97)11096-0

For decades, there has been an increased interest in and awareness of the need for physicians and the medical community to work more closely with journalists and the mass media to guarantee the accurate and appropriate dissemination of health information. Training programs for both physicians and journalists now include innovative curriculum to promote collaboration and build a mutual respect between the professions that, in the end, promotes public health and safety. Publishing or broadcasting clear, consistent and contemporary health and medical information to the general public is a shared responsibility of physicians and journalists. But, what happens when the physician and the journalist is the same person?

The advents of 24-hour news, numerous magazines and blogs galore have opened the flood gates for professionals who want to share their knowledge with the public. And gain a little fame in the process. The world does need health care professionals with better-than-average communication skills to share the latest research or medical news in layman’s terms. But, the world does not need physicians who have more experience holding a microphone than a scalpel. Case after case of physician-journalists helping Haitian victims were broadcast on television over the last few weeks, making the physician the story rather than the Haitians in need of help. One would hope that the physicians were simply overcome by their desire to help, and forgot that there were cameras rolling. But, a cynical eye would notice that every network seemed to “one-up” the others with broadcasts of “our doctor did this” and “our medical correspondent did that.” If the physicians really wanted to help the devastated population, they could easily travel to Haiti with a volunteer medical staff, rather than with a producer and a camera crew.  Plus, if viewers wanted to see surgery performed on television, they could watch any of a number of reality series that depict medical procedures.

The sensationalizing of the story is hardly the only downside to this type of reporting. What happens if there are complications from the treatment provided by the physician-journalists? What about patient privacy? What happens when every reporter decides to jump into the story? What happens to the just-the-facts reporting that the public needs?

The public increasingly turns to the media for health information, and inaccurate or inappropriate medical reporting damages public welfare, as well as perception and opinion about the health care community. All reporters — trained journalists and physicians-turned-correspondents alike — have the responsibility to remain objective and report facts of stories, be it medical information or news of death and destruction in crisis-stricken areas.

References

Anthony, S., Lozano-Calderon, S., & Ring, D. (2007). Stigmatization of Repetitive Hand Use in Newspaper Reports of Hand Illness HAND, 3 (1), 30-33 DOI: 10.1007/s11552-007-9052-4

Campbell, N., Heath, J., Bouknight, J., Rudd, K., & Pender, J. (2009). Speaking Out For Mental Health: Collaboration of Future Journalists and Psychiatrists Academic Psychiatry, 33 (2), 166-168 DOI: 10.1176/appi.ap.33.2.166

Catherine, N., Ko, J., & Barr, R. (2008). Getting the Word Out: Advice on Crying and Colic in Popular Parenting Magazines Journal of Developmental & Behavioral Pediatrics, 29 (6), 508-511 DOI: 10.1097/DBP.0b013e31818d0c0c

Strasser T, Gallagher J. The ethics of health communication. World Health Forum. 1994;15(2):175-177.

The study presents the results of the largest-scale clinical trial conducted with Ginkgo biloba, assessing more than 3000 adults aged 72 to 96 years. (The investigators have used the same population to investigate other aspects of Gingko treatment, with results published in several journals.) The current study focuses on the prevention of cognitive decline in older adults. The participants received a twice-daily dose of 120 mg of Ginkgo biloba or placebo. Over the 6-year follow-up period, the rate of decline of cognitive function, as assessed by standard cognitive and psychoneurological function exams, was calculated. Overall, there was no difference in the rate of cognitive decline between participants receiving Ginkgo biloba or placebo. These results did not change when modifying factors, such as age, sex, race, education, genetic variations, or baseline cognitive impairment, were considered.

This hardly seems like newsworthy information, given the plethora of studies that say the same thing. To date, there are no large-scale, definitive studies demonstrating that Ginkgo biloba has much of an effect on anything.  Most studies that do report benefits of Ginkgo biloba therapy are not comprehensive and obtained limited data regarding cognitive function. The results lend themselves to statistical misinterpretation and inappropriate extrapolation of the data.

Still, Ginkgo biloba sales are in the hundreds of millions of dollars worldwide every year. It is commonly used in European medicine to improve memory and treat neuronal disorders and improve brain metabolism. In the United States, it enjoys widespread use as a botanical dietary supplement. The current study should leave consumers asking, “Why?” Once again, Ginkgo biloba is verifiably ineffective for preventing a decline in cognitive function. Plus, as with many unregulated over-the-counter supplements, Ginkgo biloba places patients at increased risk for possible side effects and drug interactions.

Growing old gracefully and successfully is of paramount importance with an ever-older population. It is natural to strive for maintaining, and even enhancing, cognitive reserves. But, there is no evidence that proves Ginkgo biloba will help to achieve those goals. Clinicians and patients are better served by identifying and treating known conditions that may reduce brain capacity and cognitive function, including vascular risk factors, diabetes, and sleep disorders, and promote activities and lifestyles that build cognitive reserve.

… And we don’t want to have to tell you again!

References

Canis, M., Olzowy, B., Welz, C., Suckfüll, M., & Stelter, K. (2009). Simvastatin and Ginkgo biloba in the treatment of subacute tinnitus: a retrospective study of 94 patients American Journal of Otolaryngology DOI: 10.1016/j.amjoto.2009.09.004

Daffner KR. Promoting Successful Cognitive Aging: A Comprehensive Review. J Alzheimers Dis. Dec 14 2009.

Kaschel, R. (2009). Ginkgo biloba: specificity of neuropsychological improvement-a selective review in search of differential effects Human Psychopharmacology: Clinical and Experimental, 24 (5), 345-370 DOI: 10.1002/hup.1037

Leistner, E., & Drewke, C. (2010). Ginkgo biloba and Ginkgotoxin. Journal of Natural Products, 73 (1), 86-92 DOI: 10.1021/np9005019

Snitz, B., O’Meara, E., Carlson, M., Arnold, A., Ives, D., Rapp, S., Saxton, J., Lopez, O., Dunn, L., Sink, K., DeKosky, S., & , . (2009). Ginkgo biloba for Preventing Cognitive Decline in Older Adults: A Randomized Trial JAMA: The Journal of the American Medical Association, 302 (24), 2663-2670 DOI: 10.1001/jama.2009.1913

Many studies have shown similar associations between adult IQ and mortality, but the Swedish study is one of only a handful to link intelligence and cognitive performance at a young age — 10 years in this study — to decreased mortality in adulthood. Many similar studies have been inconclusive to date; the brain continues to develop and change in emotional and cognitive ability and performance until approximately 20 years of age, making early IQ tests somewhat difficult to interpret. However, the newest study published in the BMJ followed more than 1500 children for 65 years and found a significant association between high intelligence at age 10 and education attainment and decreased risk of all-cause mortality. Interestingly, this association was strongest in males, and high IQ was associated with decreased mortality, even after adjusting for education attainment and paternal education — 2 other indicators of mortality. Women, however, did not experience the same association. Women with an above average IQ actually had a higher risk of mortality, after adjusting for other factors, but only after age 60.

Noting the gender differences in the findings, the authors speculate that mortality cannot simply be explained by IQ, but involves the social and physical environment as well. Most other studies investigating a link between IQ and mortality have offered similar remarks. From a very early age, even before birth, parental education, socioeconomic status, and lifestyle choices influence the cognitive ability of children. For example, mothers with more education are more likely to breastfeed their children, and breast milk correlates significantly with total brain volume and high IQ scores.  Education and nutrition during the preschool years are also associated with increased IQ. Similarly, children with parents who were more involved in their education and social choices have a decreased risk of mortality in adulthood. To the same point, children with disengaged and uninvolved parents are more likely to engage in risky behavior and delinquency, which accounts for some of the association between increased risk of mortality and lower IQ.

Still, it is impossible to say that scoring well on an IQ test has a direct link to mortality risk. While high IQ is associated with decreased risk factors for early mortality and unhealthy lifestyle choices, including smoking, heavy alcohol consumption, and overweight and obesity, the association is weakened after adjusting for socioeconomic status. Still, increased physical fitness is linked to high IQ, and improving fitness leads to increased cognitive performance. Adults with high IQ are also less likely to experience depression, and have a significantly reduced risk of many diseases and health conditions. Further, as adults, those with lower IQ are more likely to die from injuries such as poisonings, fire, falls, drowning, and road injuries than those with higher IQ. Quite possibly, childhood IQ is not a cause, per se, of mortality, but a marker for social status and class later in life, which is an indicator of risk of death and illness. The socioeconomic inequalities in access to healthcare may explain a portion of the increased mortality among lower IQ adults.

Or, the association between high intelligence and decreased mortality could be real and causative. Is it another case of survival of the fittest? Is nature getting rid of those who swim in the shallow end of the proverbial gene pool? Probably not. While high IQ at an early age may be an indication of a strong, fit body to begin with, cognitive skills should be fostered and nourishing childhood environments should be promoted to encourage healthy behaviors and choices later in life.

References

Aberg, M., Pedersen, N., Toren, K., Svartengren, M., Backstrand, B., Johnsson, T., Cooper-Kuhn, C., Aberg, N., Nilsson, M., & Kuhn, H. (2009). Cardiovascular fitness is associated with cognition in young adulthood Proceedings of the National Academy of Sciences, 106 (49), 20906-20911 DOI: 10.1073/pnas.0905307106

Batty, G., Deary, I., & Macintyre, S. (2007). Childhood IQ in relation to risk factors for premature mortality in middle-aged persons: the Aberdeen Children of the 1950s study Journal of Epidemiology & Community Health, 61 (3), 241-247 DOI: 10.1136/jech.2006.048215

Batty, G., Gale, C., Tynelius, P., Deary, I., & Rasmussen, F. (2008). IQ in Early Adulthood, Socioeconomic Position, and Unintentional Injury Mortality by Middle Age: A Cohort Study of More Than 1 Million Swedish Men American Journal of Epidemiology, 169 (5), 606-615 DOI: 10.1093/aje/kwn381

Batty, G., Shipley, M., Mortensen, L., Boyle, S., Barefoot, J., Gronbaek, M., Gale, C., & Deary, I. (2008). IQ in late adolescence/early adulthood, risk factors in middle age and later all-cause mortality in men: the Vietnam Experience Study Journal of Epidemiology & Community Health, 62 (6), 522-531 DOI: 10.1136/jech.2007.064881

Batty, G., Wennerstad, K., Smith, G., Gunnell, D., Deary, I., Tynelius, P., & Rasmussen, F. (2009). IQ in Early Adulthood and Mortality By Middle Age Epidemiology, 20 (1), 100-109 DOI: 10.1097/EDE.0b013e31818ba076

Der, G., Batty, G., & Deary, I. (2009). The association between IQ in adolescence and a range of health outcomes at 40 in the 1979 US National Longitudinal Study of Youth Intelligence, 37 (6), 573-580 DOI: 10.1016/j.intell.2008.12.002

Hart, C. (2003). Childhood IQ, Social Class, Deprivation, and Their Relationships with Mortality and Morbidity Risk in Later Life: Prospective Observational Study Linking the Scottish Mental Survey 1932 and the Midspan Studies Psychosomatic Medicine, 65 (5), 877-883 DOI: 10.1097/01.PSY.0000088584.82822.86

Isaacs EB, Fischl BR, Quinn BT, Chong WK, Gadian DG, Lucas A. Impact of breast milk on IQ, brain size and white matter development. Pediatr Res. Dec 22 2009.

Gordon, A. (2008). Breastfeeding, Breast-Milk Feeding, Breast Feeding, and IQ: Unknown and Known Knowns Archives of General Psychiatry, 65 (12), 1457-1458 DOI: 10.1001/archpsyc.65.12.1457

Lager, A., Bremberg, S., & Vagero, D. (2009). The association of early IQ and education with mortality: 65 year longitudinal study in Malmo, Sweden BMJ, 339 (dec11 1) DOI: 10.1136/bmj.b5282

No issue has been more affected by the explosion of information than health. A 2009 study reported that 61 percent of all Americans currently look online for health information, a figure up from 25 percent in the year 2000. More and more patients are going to their doctors having already researched their symptoms on the Internet, and already convinced of their own diagnosis. What is more, doctors are also increasingly turning to the Internet, with nearly half of doctors reporting using the notoriously inaccurate Wikipedia as a source of medical information. Interestingly, despite their enthusiasm for Wikipedia as a source of information, around only 10% of the physicians surveyed actually created new posts or editing existing entries, which is surprising when you consider that these are the very people best qualified for the task.

So, just how reliable is all this information? A study from The Annals of Pharmacotherapy compared drug information from Wikipedia with the Medscape Drug Reference (MDR), the largest online drug reference designed for practicing physicians and reviewed by pharmacists. Researchers found that Wikipedia was able to answer less than half the drug information questions answered by MDR (40.0% vs. 82.5%), Wikipedia was rated 0% for information on dosing, compared with 90% for MDR, and answers on Wikipedia were 76.0% complete, compared with 95.5% complete on MDR. Errors of omission were also much higher on Wikipedia (48 in total) than MDR (just 14).

As well as the danger of inaccurate information on Wikipedia, there is some evidence that pharmaceutical companies have intentionally tried to delete or modify Wikipedia entries that have mentioned adverse effects associated with their drugs.

The irony is, that as the amount of information available grows, and people try to find ways to pick the reliable sources from the rest, it is the ‘old fashioned’ media that may ultimately provide the path through this minefield. As people are burnt by unreliable information from unknown, or discredited, sources, they may begin to go back to the names they know and trust. The traditional newspapers and broadcasting networks may yet benefit from the this age of information, particularly in the critical area of healthcare.

References

Clauson, K., Polen, H., Boulos, M., & Dzenowagis, J. (2008). Scope, Completeness, and Accuracy of Drug Information in Wikipedia Annals of Pharmacotherapy, 42 (12), 1814-1821 DOI: 10.1345/aph.1L474

Manhattan Research Study. Taking the Pulse. 2009.

Remember, we review the latest blogs related to drugs — medicinal, recreational, interactional, personal, professional, or any other aspect. If you were left out in this round, just leave a comment with your blog entry. You can check out the archives for every edition of this carnival.

For future editions, please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

Providentia writes Going To Pot:

Despite a lengthy history dating back thousands of years, hashish and other cannabis compounds were only introduced to France by veterans of Napoleon’s Egygtian campaign at the turn of the 19th century (it became so popular with the French soldiers serving in Egypt that Napoleon issued an order banning its use). Several medical doctors who had been part of the French campaign were sufficiently intrigued by hashish to send samples back to their colleagues in France for further research.

The Conscious Life writes NSAIDs: What You Need to Know Before Taking Them:

In 1971, Sir John Vane found how aspirin actually works, and took home a Nobel Prize in Physiology or Medicine for this discovery. The English pharmacologist postulated that aspirin acts by suppressing the production of prostaglandins, the messengers responsible for the inflammatory response.

JeremyJones.org writes Hyperbaric Oxygen Therapy (HBOT) with Dr Harch in New Orleans:

So we packed up and travelled to New Orleans where we met with Dr Harch and David began his treatments at 1.5 ATA at 100% oxygen in a hard chamber. We went through two treatments a day, five days a week, for four weeks. David did not show any signs of improvement at first, in fact we found him to be a bit more lethargic than usual. However, on the weekends by Sunday he was more energetic than he had been before the treatments began. After the 25th treatment, it became clear that David’s range of motion was increasing considerably and he had the ability to lift his head.

Clinical Depression writes Medical marijuana is an effective treatment for depression: True or False?:

The antidepressant and intoxicating effects of cannabis are due to its chemical similarity to natural substances in the brain known as “endo-cannabinoids,” which are released under conditions of high stress or pain, said Gobbi. They interact with the brain through structures called cannabinoid CB1 receptors. The study demonstrated that these receptors have a direct effect on the cells producing serotonin, which is a neurotransmitter that regulates the mood, she said.

Scientists have found several factors that maybe responsible for adaptive physical and psychological stress responses in individuals in the face of adversity. These adaptive responses are associated with the degree of behavioral control we have over stress. Resilience to stress is mediated by the changes that alter the functioning of the neural circuits that regulate reward, fear, emotion reactivity and social behavior.

The ability to face one’s fears might be facilitated by stress inoculation (exposure to tolerable levels of stress) during development. This early exposure to manageable stressors might be responsible for adaptations that down regulate negative emotions. Resilient individuals are better at down regulating negative emotions, a process known as ‘cognitive reappraisal’, with a resulting reduction in emotional responses. This is mediated through mechanisms that involve memory suppression, memory consolidation and cognitive control of emotion.

During development, a range of factors can offer potentially protective effects from stress. Research has shown that social competence and openness to social support promote resilience in children and adults. Mutual cooperation can activate the brain reward circuits. The capacity of adaptive systems to resist or recover from marked disturbances is more when they are healthy. Rodent studies have demonstrated that a positive, or more enriched, environment during development makes animals less vulnerable to drug abuse and to stress later in life. In particular, studies have shown that proximity to the primary caregiver is an important modulator of a child’s sense of safety when facing trauma. A close relationship with a caring adult and the capacity for self regulation promote resilience. A sense of purpose and an internal framework of beliefs about right and wrong are characteristics of resilient individuals.

Also, positive emotions might contribute to healthier cognitive responses. Moreover, physical exercise, which can be viewed as a form of active coping, has positive effects on mood, attenuates stress responses and is thought to promote neurogenesis.

So can people be trained to become more resilient? Scientists feel certain forms of psychotherapy to enhance optimism, reappraisal of traumatic events in a more positive light, preserving a person’s sense of purpose in the face of trauma can help maximize resilience. Ongoing research of healthy individuals who have recovered from traumatic experiences may further deepen our understanding of this process.

References

Feder, A., Nestler, E., & Charney, D. (2009). Psychobiology and molecular genetics of resilience Nature Reviews Neuroscience, 10 (6), 446-457 DOI: 10.1038/nrn2649

Approximately 13% of physician visits every year are for medically unexplained symptoms, and up to 25% of patients report such symptoms during physician visits. Often, patients report persistent physical symptoms, but no somatic origin can be found. Physicians may try to explore the psychological basis of the symptoms, but this is a frustrating and futile prospect that uses valuable time and resources with no satisfactory result for the patient.

Many hypochondriacal patients are taking their concerns to the Internet and making “Google” a diagnostic procedure. Researchers at Microsoft recently examined how people search for medical information on the Internet, and reported on its potential implications. The researchers reviewed logs of 515 individual’s health-related Web search experiences. Not surprisingly, one principal finding was that search engines have the potential to escalate medical concerns. The authors assert that the escalation is related to the amount of medical content viewed by searchers, the existence of escalatory terminology in the Web pages, and the searcher’s predisposition to escalate his or her anxiety versus seeking more sensible explanations for physical symptoms.

The Microsoft researchers also found that post-session anxiety lingers after escalations of medical concerns, often to an extent that interrupts other Web-related activities. The information obtained from the Web also influences people’s decisions about visiting a physician, diagnosing or treating ailments, or engaging in proactive health activities. One worrisome finding of the Microsoft study concluded that some users of search engines interpreted the ranking of the Web search results as the likelihood of the illness. The Web can ultimately be a dangerous place for people to seek advice, with no guidance on deciphering fact from fiction, and everything in between.

Not all who seek Web-based information will be misled, but the potential for the wrong information falling into the wrong hands is considerable. Patients should heed a “let the searcher beware” and always obtain sounds medical advice from a trained health care professional. Physicians, however, should be attentive to the needs of patients and maintain open lines of communication when considering all of a patient’s symptoms.

References

Kappen, T., & van Dulmen, S. (2008). General practitioners’ responses to the initial presentation of medically unexplained symptoms: a quantitative analysis BioPsychoSocial Medicine, 2 (1) DOI: 10.1186/1751-0759-2-22

Wick JY, Zanni GR. Hypochondria: the worried well. Consult Pharm. Mar 2008;23(3):192-194, 196-198, 207-198.

Peters, S., Rogers, A., Salmon, P., Gask, L., Dowrick, C., Towey, M., Clifford, R., & Morriss, R. (2008). What Do Patients Choose to Tell Their Doctors? Qualitative Analysis of Potential Barriers to Reattributing Medically Unexplained Symptoms Journal of General Internal Medicine, 24 (4), 443-449 DOI: 10.1007/s11606-008-0872-x

Salmon, P., Ring, A., Humphris, G., Davies, J., & Dowrick, C. (2009). Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want? Journal of General Internal Medicine, 24 (4), 450-456 DOI: 10.1007/s11606-008-0898-0

White RW, Horvitz E. Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search. Redmond, WA: Microsoft Research; November 2008.

We would like to hear from program participants and organizers, especially on the less-known or fewer-attended conferences. As major conferences draw near (e.g., AAN, AES), we will offer reminders, customized coverage, and interactive commentary from participants, presenters, and speakers.

Note to medical residents: Here is your opportunity to use your residency allotment/stipend for conference travel. Remember to plan early to arrange for call schedules and rotation requirements. Also, should you have an interesting case or a research project with any findings, your abstract submissions will undoubtedly be accepted in conference proceedings and/or poster-presentations at most venues.

List of 2010 Neurology, Neurosurgery, and Neuroscience Conferences (chronological):

Dates: January 08, 2010 – January 10, 2010
Conference: American Society for Peripheral Nerve (ASPN) 2010 Annual Meeting
Sponsor(s): American Society of Plastic Surgeons, American Association for Hand Surgery, American Society for Peripheral Nerve, American Society for Reconstructive Microsurgery
Venue/Location: Boca Raton Resort and Spa, Boca Raton, Florida, USA
Registration Fees: $375-$845 (ASPN conference only).

Dates: January 10, 2010 – January 15, 2010
Conference: Alzheimer’s Disease Beyond Abeta (A4)
Sponsor(s): Schering-Plough Research Institute, Takeda Pharmaceutical Company Limited
Venue/Location: Copper Mountain Resort, Copper Mountain, Colorado, USA
Registration Fees: $440-$765.

Dates: January 16, 2010 – January 19, 2010
Conference: The Surgical Management of Spinal Disorders
Sponsor(s): BroadWater
Venue/Location: The Pines Lodge, Beaver Creek, Colorado, USA
Registration Fees: $645-$945.

Dates: January 21, 2010 – January 22, 2010
Conference: Advances in Chronic Pain Management
Sponsor(s): British Journal of Hospital Medicine
Venue/Location: Institute of Physics, London, England, United Kingdom
Registration Fees: £345-£862.50.

Dates: January 22, 2010 – January 24, 2010
Conference: 3rd European Neurological Conference on Clinical Practices: Neurovascular and Neurodegenerative Diseases
Sponsor(s): Romanian Society of Neurology
Venue/Location: JW Marriot Grand Hotel, Bucharest, Romania
Registration Fees: €100-€650 (free for neurology residents).

Dates: January 24, 2010 – January 29, 2010
Conference: Neuronal Control of Appetite, Metabolism and Weight
Sponsor(s): Takeda Pharmaceutical Company Limited
Venue/Location: Keystone Resort, Keystone, Colorado, USA
Registration Fees: $440-$765.

Dates: January 28, 2010 – January 29, 2010
Conference: 5th Annual NeuroICU of the Future Symposium
Sponsor(s): UCLA Neurosurgery
Venue/Location: UCLA Neuroscience Research Building Auditorium, Los Angeles, California, USA
Registration Fees: $175-$500.

Dates: January 31, 2010 – February 04, 2010
Conference: 5th Mayo Clinic International Spine Symposium
Sponsor(s): Mayo School of Continuous Professional Development
Venue/Location: Mauna Lani Bay Hotel, Big Island, Kohala Coast, Hawaii, USA
Registration Fees: $895-$1295.

Dates: February 01, 2010 – February 02, 2010
Conference: 4th Drug Discovery for Neurodegeneration Conference
Sponsor(s): Alzheimer’s Drug Discovery Foundation
Venue/Location: Houstonian Hotel, Houston, Texas, USA
Registration Fees: $200-$650 (free for the media).

Dates: February 10, 2010 – February 12, 2010
Conference: 43rd Annual Recent Advances in Neurology
Sponsor(s): University of California, San Francisco School of Medicine
Venue/Location: Ritz Carlton Hotel, San Francisco, California, USA
Registration Fees: $300-$495.

Dates: February 15, 2010 – February 16, 2010
Conference: 6th Annual Update Symposium on Clinical Neurology and Neurophysiology
Sponsor(s): The Adams Super Center for Brain Studies Tel Aviv University, Joseph Sagol Neuroscience Center at the Chaim Sheba Medical Center, Tel Hashomer
Venue/Location: Metropolitan Hotel, Tel Aviv, Israel
Registration Fees: $550-$650.

Dates: February 16, 2010 – February 19, 2010
Conference: 6th Interventional/Neurointerventional Conference
Sponsor(s): Dotter Interventional Institute, Oregon Health & Science University
Venue/Location: Park City Marriott Hotel, Park City, Utah, USA
Registration Fees: $250-$650

Dates: February 18, 2010 – February 19, 2010
Conference: Dementias 2010: 12th National Dementias Conference
Sponsor(s): British Journal of Hospital Medicine
Venue/Location: Institute of Engineering and Technology, Savoy Place London, London, England, United Kingdom
Registration Fees: £450-£763.75.

Dates: February 18, 2010 – February 20, 2010
Conference: Neurology Update and Stroke Intensive 2010 [PDF]
Sponsor(s): University of Miami Miller School of Medicine
Venue/Location: The Alexander All-Suite Oceanfront Beach Hotel, Miami Beach, Florida, USA
Registration Fees: $315-$650.

Dates: February 22, 2010 – February 26, 2010
Conference: 48th Annual Dr. Kenneth M. Earle Memorial Neuropathology Review
Sponsor(s): Armed Forces Institute of Pathology
Venue/Location: Bethesda North Marriott Hotel & Conference Center, Bethesda, Maryland, USA
Registration Fees: $350-$1175.

Dates: February 26, 2010 – February 28, 2010
Conference: 3rd International Congress on Gait and Mental Function
Sponsor(s): Kenes
Venue/Location: Omni Shoreham Hotel, Washington, District of Columbia, USA
Registration Fees: $330-$700.

Dates: February 28, 2010 – March 04, 2010
Conference: International Congress XXIII on Endovascular Interventions
Sponsor(s): International Congress Foundation
Venue/Location: The Phoenician Resort, Scottsdale, Arizona, USA
Registration Fees: $550-$1250.

Dates: March 04, 2010 – March 06, 2010
Conference: 2nd East Mediterranean Epilepsy Congress
Sponsor(s): International Bureau for Epilepsy, International League Against Epilepsy
Venue/Location: Dubai, United Arab Emirates
Registration Fees: €100-€460.

Dates: March 05, 2010 – March 07, 2010
Conference: Neuroimaging and Head & Neck Radiology Update at Mount Tremblant
Sponsor(s): University of Ottawa’s Office of Continuing Medical Education
Venue/Location: Mount Tremblant, Quebec City, Canada
Registration Fees: $125-800 (CDN).

Dates: March 17, 2010 – March 20, 2010
Conference: 1st International Congress on Epilepsy, Brain & Mind
Sponsor(s):
Venue/Location: Prague, Czech Republic
Registration Fees: €100-€330 (free for invited speakers and student discount available).

Dates: March 19, 2010 – March 21, 2010
Conference: 3rd Vienna Symposium on Surgery of Peripheral Nerves
Sponsor(s): Vienna Medical Academy of Postgraduate Education & Research
Venue/Location: General Hospital Lecture Halls, Vienna, Austria
Registration Fees: €250-€400.

Dates: March 20, 2010 – March 21, 2010
Conference: 2nd Chongqing International Clinical Neuroscience Forum & International NeuroDrug Conference
Sponsor(s): Neurological Society of Chinese Medical Association, Neurosurgical Society of Chinese Medical Association, Neurology and Neurosurgery Department of Daping Hospital, The Third Military Medical University of China
Venue/Location: Chongqing, China
Registration Fees: $500.

Dates: March 21, 2010 – March 25, 2010
Conference: 6th World Congress for Neurorehabilitation
Sponsor(s): World Federation for NeuroRehabilitation
Venue/Location: Hofburg, Vienna, Austria
Registration Fees: €170-€530.

Dates: March 22, 2010 – March 26, 2010
Conference: 20th Annual Rotman Research Institute Conference – The Frontal Lobes
Sponsor(s): Baycrest
Venue/Location: Toronto, Ontario, Canada
Registration Fees: $300-$1050 (CDN).

Dates: March 24, 2010 – March 27, 2010
Conference: 11th International Geneva/Springfield Symposium on Advances in Alzheimer Therapy
Sponsor(s): Southern Illinois University, School of Medicine, University of Geneva, Medical School Dept. of Rehabilitation and Geriatrics
Venue/Location: Geneva, Switzerland
Registration Fees: $180-$980.

Dates: March 25, 2010 – March 27, 2010
Conference: European Association of Neurosurgical Societies (EANS) Annual Meeting 2010)
Sponsor(s): Kenes
Venue/Location: Groningen, Netherlands
Registration Fees: €250-€480.

Dates: March 25, 2010 – March 26, 2010
Conference: Olfaction and Issues 2010
Sponsor(s): Takayama
Venue/Location: Paris, France
Registration Fees: €395-€895.

Dates: March 25, 2010 – March 28, 2010
Conference: Advances in Pediatric Neuropsychology: From Toddlers Through School-Aged Children
Sponsor(s): UC San Diego School of Medicine
Venue/Location: Hilton San Diego Resort, San Diego, California, USA
Registration Fees: $195-$445.

Dates: April 10, 2010 – April 17, 2010
Conference: 62nd Annual Meeting of the American Academy of Neurology (AAN) 2010
Sponsor(s): American Academy of Neurology
Venue/Location: Metro Toronto Convention Centre, Toronto, Ontario, Canada
Registration Fees: $70-$645 (free for students).

Dates: April 11, 2010 – April 15, 2010
Conference: Towards Defining the Pathophysiology of Autistic Behavior (Z4)
Sponsor(s): Keystone Symposia
Venue/Location: Snowbird Resort, Snowbird, Utah, USA
Registration Fees: $390-$715.

Dates: April 11, 2010 – April 15, 2010
Conference: Synapses: Formation, Function and Misfunction (Z3)
Sponsor(s): Keystone Symposia
Venue/Location: Snowbird Resort, Snowbird, Utah, USA
Registration Fees: $390-$715.

Dates: April 15, 2010 – April 16, 2010
Conference: 7th Dutch Society of Neuroradiology International Conference Course
Sponsor(s): University Medical Center Groningen
Venue/Location: University Medical Center Groningen, Groningen, Netherlands
Registration Fees: €130-€470.

Dates: April 20, 2010 – April 23, 2010
Conference: International Forum on Quality and Safety in Health Care
Sponsor(s): BMJ Publishing Group Ltd.
Venue/Location: Nice, France
Registration Fees: £382-£1396

Dates: April 23, 2010 – April 25, 2010
Conference: International Congress on Neurology and Rehabilitation (ICNR) 2010
Sponsor(s): Maharashtra Association of Neurology, World Federation for NeuroRehabilitation
Venue/Location: Hotel Holiday Inn, Goa, India
Registration Fees: 3,000-12,000 (INR).

Dates: May 01, 2010 – May 06, 2010
Conference: 78th AANS Annual Meeting
Sponsor(s): American Association of Neurological Surgeons
Venue/Location: Philadelphia Marriott, Philadelphia, Pennsylvania, USA
Registration Fees: $150-$750 ($100 for students and neurosurgery resident members).

Dates: May 02, 2010 – May 07, 2010
Conference: 11th International Child Neurology Congress (ICNC) 2010
Sponsor(s): Egyptian Society of Child Neuropsychiatry
Venue/Location: Grand Hyatt Hotel, Cairo, Egypt
Registration Fees: €380-€650.

Dates: May 05, 2010 – May 08, 2010
Conference: The American Academy of Neurological and Orthopaedic Surgeons 34th Annual Scientific Meeting & Workshops
Sponsor(s): American Academy of Neurological and Orthopaedic Surgeons
Venue/Location: The Brown Palace, Denver, Colorado, USA
Registration Fees: ?

Dates: May 11, 2010 – May 14, 2010
Conference: Association of British Neurologists (ABN) Annual Meeting
Sponsor(s): Association of British Neurologists
Venue/Location: Bournemouth International Centre, Bournemouth, England, United Kingdom
Registration Fees: £100-£300.

Dates: May 12, 2010 – May 15, 2010
Conference: 12th Congress of the European Federation of Autonomic Societies (EFAS)
Sponsor(s): European Federation of Autonomic Societies
Venue/Location: Giardini Naxos, Taormina, Italy
Registration Fees: €235-€525.

Dates: May 15, 2010 – May 20, 2010
Conference: 48th American Society of Neuroradiology (ASNR 2010) Annual Meeting
Sponsor(s): American Society of Neuroradiology
Venue/Location: Hynes Convention Center, Boston, Massachusetts, USA
Registration Fees: $185-$1600.

Dates: May 19, 2010 – May 22, 2010
Conference: 3rd International Epilepsy Colloquium: Surgery of Extratemporal Lobe Epilepsy [PDF]
Sponsor(s): Case Western Reserve University
Venue/Location: Renaissance Cleveland Hotel, Cleveland, Ohio, USA
Registration Fees: ?

Dates: May 25, 2010 – May 28, 2010
Conference: 19th European Stroke Conference (ESC)
Sponsor(s): European Stroke Organisation
Venue/Location: Barcelona, Spain
Registration Fees: €300-€700 (free for students).

Dates: May 26, 2010 – May 29, 2010
Conference: 12th Congress of the Pan Arab Union of Neurological Societies
Sponsor(s): Syrian Society of Neurosciences
Venue/Location: Damascus, Syrian Arab Republic
Registration Fees: €100-€250.

Dates: May 27, 2010 – May 30, 2010
Conference: 3rd International Congress on Neuropathic Pain (NeuPSIG 2010)
Sponsor(s): Kenes
Venue/Location: Athens, Greece
Registration Fees: €150-€495.

Dates: May 27, 2010 – May 28, 2010
Conference: Alzheimer’s Disease: Update on Research, Treatment, and Care
Sponsor(s): Shiley-Marcos Alzheimer’s Disease Research Center, UCSD
Venue/Location: Omni San Diego Hotel, San Diego, California, Guyane
Registration Fees: $299-$425 (discount for UCSD affiliates).

Dates: May 31, 2010 – June 01, 2010
Conference: 2nd International Conference – Advances in Clinical Neuroimmunology
Sponsor(s): Biuro Organizacji Konferencji i Zjazdów
Venue/Location: Gdansk, Poland
Registration Fees: €200-€300.

Dates: June 05, 2010 – June 09, 2010
Conference: Sleep 2010
Sponsor(s): Associated Professional Sleep Societies
Venue/Location: San Antonio, Texas, USA
Registration Fees: ?

Dates: June 08, 2010 – June 11, 2010
Conference: Canadian Neurological Sciences Federation 45th Annual Congress
Sponsor(s): Canadian Neurological Sciences Federation
Venue/Location: Quebec City, Canada
Registration Fees: ?

Dates: June 13, 2010 – June 17, 2010
Conference: 14th International Congress of Parkinson’s Disease and Movement Disorders
Sponsor(s): The Movement Disorder Society
Venue/Location: Sheraton Buenos Aires Hotel and Convention Center, Buenos Aires, Argentina
Registration Fees: $300-$850.

Dates: June 14, 2010 – June 17, 2010
Conference: The 2nd Joint Symposium of the International and National Neurotrauma Societies 2010
Sponsor(s): National Neurotrauma Society, Virginia Commonwealth University School of Medicine
Venue/Location: Paris Las Vegas Hotel, Las Vegas, Neveda, USA
Registration Fees: $225-$700.

Dates: June 19, 2010 – June 23, 2010
Conference: 20th Meeting of the European Neurological Society
Sponsor(s): European Neurological Society
Venue/Location: Berlin, Germany
Registration Fees: ?

Dates: June 20, 2010 – June 23, 2010
Conference: ISPNO 2010 – 14th International Symposium on Pediatric Neuro-Oncology
Sponsor(s): Vienna Medical Academy
Venue/Location: Vienna, Austria
Registration Fees: €240-€595.

Dates: June 25, 2010 – June 26, 2010
Conference: Aging and Sleep 2010
Sponsor(s): International Association of Sleep Research in Gerontology
Venue/Location: Lyon, France
Registration Fees: €150-€290.

Dates: June 25, 2010 – June 28, 2010
Conference: NeuroTalk 2010 – From Nervous Functions to Treatment
Sponsor(s): BIT Life Sciences
Venue/Location: Singapore Expo Convention and Exhibition Center, Singapore.
Registration Fees: $549-$1,799.

Dates: June 27, 2010 – July 01, 2010
Conference: 9th European Congress on Epileptology
Sponsor(s): International Bureau for Epilepsy, International League Against Epilepsy
Venue/Location: Rhodes, Greece
Registration Fees: €150-€720.

Dates: July 03, 2010 – July 07, 2010
Conference: 7th Federation of European Neurological Societies (FENS) Forum of European Neuroscience
Sponsor(s): European Federation of Neurological Societies
Venue/Location: Amsterdam, Netherlands
Registration Fees: €100-€475.

Dates: July 10, 2010 – July 15, 2010
Conference: 7th International Congress on Neuroendocrinology
Sponsor(s): International Neuroendocrine Federation
Venue/Location: Rouen, France
Registration Fees: €250-€500 (free for select students).

Dates: July 10, 2010 – July 15, 2010
Conference: 10th Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD)
Sponsor(s): Alzheimer’s Association
Venue/Location: Honolulu, Hawaii, USA
Registration Fees: ?

Dates: July 30, 2010 – July 31, 2010
Conference: 4th Annual Brain Endoscopy Course
Sponsor(s): University at Buffalo Neurosurgery, State University of New York
Venue/Location: Lecture & Practical Lab, Buffalo, New York, USA
Registration Fees: $500 (free for residents and fellows).

Dates: August 04, 2010 – August 07, 2010
Conference: American Society of Electroneurodiagnostic Technologists (ASET) 2010 Annual Conference
Sponsor(s): American Society of Electroneurodiagnostic Technologists
Venue/Location: Kentucky International Convention Center, Louisville, Kentucky, USA
Registration Fees: $285-$600.

Dates: August 25, 2010 – August 27, 2010
Conference: 12th European Congress on Epilepsy and Society
Sponsor(s): International Bureau for Epilepsy, International League Against Epilepsy
Venue/Location: Porto, Portugal
Registration Fees: ?

Dates: August 28, 2010 – September 01, 2010
Conference: 23rd Congress of The European College of Neuropsychopharmacology (ECNP)
Sponsor(s): The European College of Neuropsychopharmacology
Venue/Location: Amsterdam, Netherlands
Registration Fees: €60-€950 (waived for poster presenters).

Dates: September 11, 2010 – September 15, 2010
Conference: XVIIth International Congress of Neuropathology
Sponsor(s): Austrian Society of Neuropathology
Venue/Location: Salzburg Congress, Salzburg, Austria
Registration Fees: ?

Dates: September 12, 2010 – September 16, 2010
Conference: 14th International Conference on Intracranial Pressure and Brain Monitoring
Sponsor(s): European Federation of Neurological Societies
Venue/Location: Tübingen, Germany
Registration Fees: €250-€450.

Dates: September 14, 2010 – September 18, 2010
Conference: 20th Congress of the European Sleep Research Society
Sponsor(s): European Sleep Research Society
Venue/Location: Lisbon, Portugal
Registration Fees: €200-€550.

Dates: September 25, 2010 – September 28, 2010
Conference: 14th Congress of the European Federation of Neurological Societies (EFNS 2010)
Sponsor(s): European Federation of Neurological Societies
Venue/Location: Geneva, Switzerland
Registration Fees: €295-€635.

Dates: September 28, 2010 – October 01, 2010
Conference: 2nd World Parkinson Congress
Sponsor(s): World Parkinson Coalition
Venue/Location: Glasgow, Scotland, United Kingdom
Registration Fees: £125-£500.

Dates: October 01, 2010 – October 04, 2010
Conference: 6th international Symposium on Neuroprotection and Neurorepair
Sponsor(s): Fraunhofer
Venue/Location: Yachthafenresidenz Hohe Düne, Rostock, Germany
Registration Fees: ?

Dates: October 04, 2010 – October 09, 2010
Conference: XIX Symposium Neuroradiologicum – The World Congress of Neuroradiology
Sponsor(s): University of Bologna
Venue/Location: Bologna, Italy
Registration Fees: ?

Dates: October 13, 2010 – October 16, 2010
Conference: ECTRIMS/RIMS 2010: 26th Congress of the European Committee for Treatment and Research in Multiple Sclerosis and the 15th Conference of Rehabilitation in Multiple Sclerosis
Sponsor(s): European Committee for Treatment and Research in Multiple Sclerosis
Venue/Location: Copenhagen, Denmark
Registration Fees: ?

Dates: October 13, 2010 – October 16, 2010
Conference: 7th World Stroke Congress, organized by the World Stroke Organization (WSO)
Sponsor(s): Kenes
Venue/Location: Seoul, Republic of Korea
Registration Fees: $50-$875.

Dates: October 26, 2010 – October 30, 2010
Conference: 10th International Congress of Neuroimmunology
Sponsor(s): International Society of NeuroImmunology
Venue/Location: Palau de Congressos de Barcelona, Barcelona, Spain
Registration Fees: ?

Dates: October 28, 2010 – November 02, 2010
Conference: 29th International Congress of Clinical Neurophysiology
Sponsor(s): International Federation of Clinical Neurophysiology
Venue/Location: Portopia Hotel, Kobe, Japan
Registration Fees: JPY 20,000-75,000.

Dates: October 28, 2010 – October 31, 2010
Conference: The 4th World Congress on Controversies in Neurology (CONy)
Sponsor(s): ComtecMed
Venue/Location: Barcelona, Spain
Registration Fees: €385-€590.

Dates: October 28, 2010 – October 31, 2010
Conference: European Headache and Migraine Trust International Congress (EHMTIC 2010)
Sponsor(s): Kenes
Venue/Location: Nice, France
Registration Fees: €225-€650.

Dates: October 28, 2010 – October 31, 2010
Conference: 14th World Society of Pain Clinicians Congress (WSPC 2010)
Sponsor(s): Kenes
Venue/Location: Beijing, China
Registration Fees: ?

Dates: October 31, 2010 – November 04, 2010
Conference: 38th Annual Meeting of the International Society for Pediatric Neurosurgery
Sponsor(s): International Society for Pediatric Neurosurgery
Venue/Location: Jeju, Republic of Korea
Registration Fees: ?

Dates: November 09, 2010 – November 12, 2010
Conference: 7th Interdisciplinary World Congress on Low Back & Pelvic Pain
Sponsor(s): University of California at San Diego
Venue/Location: Hyatt Regency Century Plaza, Los Angeles, California, USA
Registration Fees: ?

Dates: November 13, 2010 – November 17, 2010
Conference: Neuroscience 2010
Sponsor(s): Society for Neuroscience
Venue/Location: San Diego, California, USA
Registration Fees: ?

Dates: December 03, 2010 – December 07, 2010
Conference: 64th Annual Meeting of the American Epilepsy Society
Sponsor(s): American Epilepsy Society
Venue/Location: San Antonio, Texas, USA
Registration Fees: ?

Dates: December 09, 2010 – December 12, 2010
Conference: The 7th International Congress on Mental Dysfunctions & Other Non-Motor features in Parkinson’s Disease (MDPD 2010)
Sponsor(s): Kenes
Venue/Location: Barcelona, Spain
Registration Fees: €300-€680.

Dates: December 16, 2010 – December 19, 2010
Conference: 59th Annual Conference of Neurological Society of India (Neurocon) and Congress of Neurological Surgeons (CNS)
Sponsor(s): Neurological Society of India
Venue/Location: Birla Science and Technology Centre, Jaipur, India
Registration Fees: ?

The authors of the NEJM study forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year old, assuming that current trends in obesity and smoking continue. In most of the scenarios examined, the negative effects of overweight and obesity outweighed the positive effects of a decline in the rates of smoking. The average 18-year old today would gain 0.31 years of life expectancy owing to the decline in smoking; at the same time, he will lose more than 1 year owing to the rise in overweight and obesity. Overall, the authors concluded that the average 18-year old today would lose 0.71 years of life, or 0.91 quality-adjusted years, by the year 2020. If all adults in the United States became nonsmokers of healthy weight by 2020, the life expectancy of the average 18-year old would increase by almost 4 years, or more than 5 quality-adjusted years.

The increase in overweight and obesity has increased dramatically in the last 30 years, but the prevalence differs among gender, race, and age cohorts. The prevalence of obesity is approximately 35% among white men, black men, and white women, but is 55% among black women. The mean age of obese men and women is also rising, to 49 years among white and 44 years among blacks. The population of the United States is gaining years and pounds, and the disability and health care burden associated with an aging obese population are significant.

Everyone knows smoking kills; nonsmokers live up to 10 years longer than smokers. However, smoking does not cause the disability that comes with overweight and obesity. While obesity does not lead to quite the same decrease in life expectancy — 6 to 7 years on average, the quality of the life is significantly decreased compared to people of healthy weight. Overweight and obese people will spend 3 to 5 years of their life with significant disability owing to obesity-related conditions and have reduced functioning in their activities of daily living.

Still, one study concluded that unhealthy living is unhealthy living, regardless of whether that living is related to smoking or obesity. People who make unhealthy lifestyle choices will have a lower life expectancy than healthy-living cohorts, even if they eliminate smoking and obesity. Other vices, as well as unmodifiable factors like race, gender, and age, contribute to life expectancy and quality of life.

Both smoking and obesity are unhealthy lifestyle choices and are risk factors for a large burden of disease. By the year 2020, smoking is expected to decline by 21%, but 45% of the population will be obese. Targeted medical and public health interventions to control the obesity epidemic are needed to reclaim the gains made in healthy living through smoking cessation and prevention programs.

References

Lubetkin, E., & Jia, H. (2009). Health-Related Quality of Life, Quality-Adjusted Life Years, and Quality-Adjusted Life Expectancy in New York City from 1995 to 2006 Journal of Urban Health, 86 (4), 551-561 DOI: 10.1007/s11524-009-9344-9

Stewart, S., Cutler, D., & Rosen, A. (2009). Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy New England Journal of Medicine, 361 (23), 2252-2260 DOI: 10.1056/NEJMsa0900459

Reuser, M., Bonneux, L., & Willekens, F. (2009). Smoking Kills, Obesity Disables: A Multistate Approach of the US Health and Retirement Survey Obesity, 17 (4), 783-789 DOI: 10.1038/oby.2008.640

Wang, Y., Colditz, G., & Kuntz, K. (2007). Forecasting the Obesity Epidemic in the Aging U.S. Population** Obesity, 15 (11), 2855-2865 DOI: 10.1038/oby.2007.339

van Baal, P., Hoogenveen, R., de Wit, G., & Boshuizen, H. (2006). Estimating health-adjusted life expectancy conditional on risk factors: results for smoking and obesity Population Health Metrics, 4 (1) DOI: 10.1186/1478-7954-4-14

Income inequality is measured by the Gini coefficient, a measure of income disparity within a population. The Gini coefficient ranges between 0 and 1, with 0 signifying complete income equality (everyone receives the same income) and 1 signifying complete inequality (one individual receives all the income). Most European countries have a Gini coefficient of approximately 0.3, while the United States has a Gini coefficient close to 0.4. The Gini coefficient of the entire world has been estimated at approximately 0.6.

The BMJ analysis systematically examined 9 cohort and 19 cross-sectional studies involving a total of more than 61 million subjects to describe the association between the Gini coefficient and mortality and self-reported health status. Overall, the investigators concluded that people living in regions with high income inequality (a higher Gini coefficient) had an increased risk of premature death, independent of their individual socioeconomic status, age, or gender. The increase mortality risk amounted to 8% per 0.05 increase in the Gini coefficient. There were stronger associations between income inequality and poor health in samples with a higher Gini coefficient, studies conducted after 1990, and studies with a follow-up duration of more than 7 years.

This study also seems to confirm a theoretical “threshold effect” above which the disparities in health outcomes are seen. By the authors’ estimation, the Gini must be above 0.3 before the adverse health effects are apparent. If the associations and estimations are true, the authors calculate that 1.5 million deaths could be avoided in 30 developed countries if the Gini coefficients were leveled to 0.3 or below. However, very little data is available on income inequality or health outcomes in developing nations, which would likely adjust the findings.

Income inequality is believed to damage health outcomes in two ways. First, an unequal society usually involves a considerable portion of the population that is living in poverty, and many studies have determined that poverty is bad for overall health outcomes. The greater the income inequality, the more impoverished citizens, and the more who are in poor health. The second, less easily defined, explanation is that income inequality is also detrimental to the more affluent members of society, since these citizens experience psychosocial stress from the inequality and loss of social cohesion. The public health burdens of the second situation are obviously broader, but much less quantifiable, and more controversial.

It is nearly impossible to confirm a causal relationship between income inequality and health outcomes. And no one supports the redistribution of income just to improve health outcomes. Simply improving health education and increasing access to health care of the socially and economically disadvantaged — two issues that could use improvement no matter which end of the Gini spectrum a country falls — could level the proverbial playing field. But, many policy makers support, at the very least, acknowledging the link between macroeconomic conditions and individual health outcomes when drafting economic and health care policy or legislation for local and international communities.

References

Kondo, N., Sembajwe, G., Kawachi, I., van Dam, R., Subramanian, S., & Yamagata, Z. (2009). Income inequality, mortality, and self rated health: meta-analysis of multilevel studies BMJ, 339 (nov10 2) DOI: 10.1136/bmj.b4471

SUBRAMANIAN, S., & KAWACHI, I. (2006). Whose health is affected by income inequality? A multilevel interaction analysis of contemporaneous and lagged effects of state income inequality on individual self-rated health in the United States Health & Place, 12 (2), 141-156 DOI: 10.1016/j.healthplace.2004.11.001

LYNCH, J., SMITH, G., HARPER, S., HILLEMEIER, M., ROSS, N., KAPLAN, G., & WOLFSON, M. (2004). Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review The Milbank Quarterly, 82 (1), 5-99 DOI: 10.1111/j.0887-378X.2004.00302.x

Ichida, Y., Kondo, K., Hirai, H., Hanibuchi, T., Yoshikawa, G., & Murata, C. (2009). Social capital, income inequality and self-rated health in Chita peninsula, Japan: a multilevel analysis of older people in 25 communities Social Science & Medicine, 69 (4), 489-499 DOI: 10.1016/j.socscimed.2009.05.006

We at Brain Blogger have seen our readership and feed subscriptions triple from the preceding year, and we are grateful to our loyal readers. But, let’s not forget our contributors. We have been fortunate to have regular contributions from Mr. Dirk Hanson, noted book author and science writer (Marijuana Withdrawal Syndrome); Dr. Jennifer Gibson, clinical pharmacist and medical writer/editor (Autism – No Need For A Cure?); Dr. Sajid Surve, physiatrist and osteopath (Are Humans Hard-Wired to Torture?); and the more than 50 other contributors.

2010 will be a year of change and expansion for Brain Blogger. We are completely redesigning our site from the ground up for both style and functionality. Headed by Rolam Shahin Designs, it is projected to be finished by the end of this month. We will offer the same great articles that have been piquing your interests for quite some time now, however, I will take a more prominent role in covering the breadth of neuro-, psych-, and health-related topics.

Here is just a preview of what is to come in the new year:

• Interviews with notable names and rising stars in science and medicine.
• Strong twitter coverage that will keep you abreast on the latest news/findings in neurology, psychiatry, and general health.
• Neurology anecdotes, secrets, and pearls that will both entertain and tickle your mind.
• Sneak peek at future article titles that are schedule to go live at Brain Blogger.
• Regular announcements, updates, and reviews of the major neuro/psych/health conferences where participants will be encouraged to contribute.
• Monthly articles on the most enlightening neurological case from the Journal of Medical Case Reports.
• Latest research findings and author commentaries under our new partnership with BioMed Central’s International Archives of Medicine.

We have taken in many suggestions throughout the past months and we will try to implement them in our redesign and writings. Should you have any suggestions on how to improve our site/articles, please feel free to comment.

I would like to end my first post of the year with one of my favorite maxims:

Any man who reads too much and uses his own brain too little falls into lazy habits of thinking.

— Albert Einstein

So, rev up your brain and put it to good use for 2010…

Happy New Year!

Sincerely,
SHAHEEN E LAKHAN
Editor and Co-Founder, Brain Blogger

Faking it

There is a significant and growing international business in the manufacture and sale of counterfeit medicines. The World Health Organization (WHO) estimates that up to 20% of all medicines in some areas of the world are fake. Customs data from the European Union shows that 34 million counterfeit pills, valued at €89m, were seized between October and December 2008. The European Medicines Agency (EMEA) is warning that criminal gangs are currently busy trying to cash in on the H1N1 flu pandemic by selling fake or low-quality antiviral medicines and vaccines.

Counterfeit medicines, which can be either branded or generic, appear in a variety of guises. Some contain no active ingredients while others, according to industry sources, are laced with sugar, unrelated medicines or even rat poison. While the dangers of taking a medication containing traces of poison are obvious, counterfeit drugs that contain no active ingredients can be equally damaging if they deprive a patient of an essential treatment.

Many of the counterfeit drugs in circulation are purchased online, and patients should always be wary of obtaining medications in this way. However, fake drugs can also reach patients through apparently reputable pharmacies in cases when the supply chain is not 100% secure.

Pharmaceutical companies, regulators, law enforcement authorities, and healthcare professionals have joined forces to try to combat the threat of counterfeit medicines. The Partnership for Safe Medicines is a US-based group of organizations and individuals dedicated to protecting consumers from counterfeit or contraband medicines. The European Alliance for Access to Safe Medicines (EAASM) was founded in 2007 with the objective of fighting against counterfeit medicines and promoting patient safety around Europe.

Technology also has an important part to play in tackling the problem of counterfeit drugs. The US Food and Drug Administration (FDA) is developing an electronic pedigree (ePedigree) system, scheduled for launch in 2011, to track the movement of prescription drugs throughout the entire supply chain. This technology is intended to prevent the diversion or counterfeiting of drugs by allowing wholesalers and pharmacists to determine the identity of individual products. Other technological solutions include the use of radio frequency identification to track and identify pharmaceutical products by through individual serial numbers, while techniques such as Raman spectroscopy and Energy Dispersive X-Ray Diffraction (EDXRD) can be used to uncover counterfeit drugs while still inside their packaging.

It seems that the scale of the problem is starting to be appreciated by patients. In recent research carried out by ICM, on behalf of patient safety communications company, Aegate, 61 per cent of those surveyed in Europe were aware that prescription medicines could be faked and 79 per cent of consumers reported that they feared counterfeit medicine more than any other fake product. However, even with the combined efforts of industry, patients and regulatory authorities, we may have to learn to exercise a little more caution over the medications that we routinely receive.

References

WHO Counterfeit Medicines Factsheet, July 2009. http://www.who.int/medicines/services/counterfeit/CfeitsFactSheetJuly09.pdf

Rankin J. Fake medicines…genuine solutions? Europeanvoice.com, November 2009. http://www.who.int/medicines/services/counterfeit/CfeitsFactSheetJuly09.pdf

Medicines top counterfeit concern list in Europe – consumers call for tougher safety measures. Press release, November 2009. http://www.aegate.com/aegate-news/medicines-top-counterfeit-concern-list-in-europe-consumers-call-for-tougher-safety-measures.html