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Callous Unemotional Traits Related to Brain Structure in Boys
By Jason von Stietz, MA
December 28, 2017
Photo Credit: Neuroscience News

 

Researcher at the University of Basel have discovered a structure in the brains of boys, that when larger, is related to callous-unemotional traits. Utilizing magnetic resonance imaging, researchers found that the anterior insula, a structure in the brain related to emotion and empathy, is larger in boys. However, this relationship was not found in girls. The study was discussed in a recent article in Neuroscience News: 

 

Callous-unemotional traits have been linked to deficits in development of the conscience and of empathy. Children and adolescents react less to negative stimuli; they often prefer risky activities and show less caution or fear. In recent years, researchers and doctors have given these personality traits increased attention, since they have been associated with the development of more serious and persistent antisocial behavior.

 

However, until now, most research in this area has focused on studying callous-unemotional traits in populations with a psychiatric diagnosis, especially conduct disorder. This meant that it was unclear whether associations between callous-unemotional traits and brain structure were only present in clinical populations with increased aggression, or whether the antisocial behavior and aggression explained the brain differences.

 

Using magnetic resonance imaging, the researchers were able to take a closer look at the brain development of typically-developing teenagers to find out whether callous-unemotional traits are linked to differences in brain structure. The researchers were particularly interested to find out if the relationship between callous-unemotional traits and brain structure differs between boys and girls.

 

Only boys show differences in brain structure

 

The findings show that in typically-developing boys, the volume of the anterior insula – a brain region implicated in recognizing emotions in others and empathy – is larger in those with higher levels of callous-unemotional traits. This variation in brain structure was only seen in boys, but not in girls with the same personality traits.

 

“Our findings demonstrate that callous-unemotional traits are related to differences in brain structure in typically-developing boys without a clinical diagnosis,” explains lead author Nora Maria Raschle from the University and the Psychiatric Hospital of the University of Basel in Switzerland. “In a next step, we want to find out what kind of trigger leads some of these children to develop mental health problems later in life while others never develop problems.”

 

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Brain Implant Boosts Short-Term and Working Memory
By Jason von Stietz, MA
November 30, 2017

Researchers from University of Southern California have used a brain implant to help the brain’s of study participants function more effectively. Electrodes were implanted into the brain’s of participants. Once the pattern of activity associated with optimal memory performance was determined, the electrode was used to stimulate the brain reinforcing the optimal pattern. Findings indicated the short-term memory was improved by 15% and working memory was improved by 25%. The study was discussed in a recent article in Futurism:  

 

 

With everyone from Elon Musk to MIT to the U.S. Department of Defense researching brain implants, it seems only a matter of time before such devices are ready to help humans extend their natural capabilities. Now, a professor from the University of Southern California (USC) has demonstrated the use of a brain implant to improve the human memory, and the device could have major implications for the treatment of one of the U.S.’s deadliest diseases.

 

Dong Song is a research associate professor of biomedical engineering at USC, and he recently presented his findings on a “memory prosthesis” during a meeting of the Society for Neuroscience in Washington D.C. According to a New Scientist report, the device is the first to effectively improve the human memory.

 

To test his device, Song’s team enlisted the help of 20 volunteers who were having brain electrodes implanted for the treatment of epilepsy.

 

Once implanted in the volunteers, Song’s device could collect data on their brain activity during tests designed to stimulate either short-term memory or working memory. The researchers then determined the pattern associated with optimal memory performance and used the device’s electrodes to stimulate the brain following that pattern during later tests.

 

Based on their research, such stimulation improved short-term memory by roughly 15 percent and working memory by about 25 percent. When the researchers stimulated the brain randomly, performance worsened.

 

As Song told New Scientist, “We are writing the neural code to enhance memory function. This has never been done before.”

 

A GROWING PROBLEM

 

While a better memory could be useful for students cramming for tests or those of us with trouble remembering names, it could be absolutely life-changing for people affected by dementia and Alzheimer’s.

 

As Bill Gates noted when announcing plans to invest $100 million of his own money into dementia and Alzheimer’s research, the disease is a multi-level problem that’s positioned to get even worse.

 

Age is the greatest risk factor for Alzheimer’s, according to the Alzheimer’s Association, with the vast majority of sufferers over the age of 65. With advances in medicine and healthcare continuously increasing how long we live, that segment of the population is growing dramatically, and by 2030, 20 percent of U.S. citizens are expected to be older than 65.

 

This increase in the number of potential dementia sufferers can be costly in both a financial and emotional sense. In 2016, the total cost of healthcare and long-term care for those suffering from dementia and Alzheimer’s disease was an estimated $236 billion, and according to the Alzheimer’s Association, the more severe a person’s cognitive impairment, the higher the rates of depression in their familial caregivers.

 

Of course, further testing is required before Song’s device could be approved as a treatment for dementia or Alzheimer’s, but if it is able to help those patients regain even part of their lost memory function, the impact would be felt not only by the patients themselves, but their families and even the economy at large.

 

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Neural Signatures of Suicidal Thoughts Detected by fMRI
By Jason von Stietz, MA
November 26, 2017
Credit: Carnegie Mellon University

 

Can suicidal thoughts be detected by a machine? Researchers from Carnegie Mellon University among other institutions investigated the use of fMRI brain scans and machine-learning, the ability of a machine to learn without it being explicitly programmed, in the detection of neural signals related to suicidal thoughts. The researchers were able to identify individuals who had attempted suicide with 94% accuracy. The study was discussed in a recent article in MedicalXpress:   

 

Suicidal risk is notoriously difficult to assess and predict, and suicide is the second-leading cause of death among young adults in the United States. Published in Nature Human Behaviour, the study offers a new approach to assessing psychiatric disorders.

 

"Our latest work is unique insofar as it identifies concept alterations that are associated with suicidal ideation and behavior, using machine-learning algorithms to assess the neural representation of specific concepts related to suicide. This gives us a window into the brain and mind, shedding light on how suicidal individuals think about suicide and emotion related concepts. What is central to this new study is that we can tell whether someone is considering suicide by the way that they are thinking about the death-related topics," said Just, the D.O. Hebb University Professor of Psychology in CMU's Dietrich College of Humanities and Social Sciences.

 

For the study, Just and Brent, who holds an endowed chair in suicide studies and is a professor of psychiatry, pediatrics, epidemiology and clinical and translational science at Pitt, presented a list of 10 death-related words, 10 words relating to positive concepts (e.g. carefree) and 10 words related to negative ideas (e.g. trouble) to two groups of 17 people with known suicidal tendencies and 17 neurotypical individuals.

 

They applied the machine-learning algorithm to six word-concepts that best discriminated between the two groups as the participants thought about each one while in the brain scanner. These were death, cruelty, trouble, carefree, good and praise. Based on the brain representations of these six concepts, their program was able to identify with 91 percent accuracy whether a participant was from the control or suicidal group.

 

Then, focusing on the suicidal ideators, they used a similar approach to see if the algorithm could identify participants who had made a previous suicide attempt from those who only thought about it. The program was able to accurately distinguish the nine who had attempted to take their lives with 94 percent accuracy.

 

"Further testing of this approach in a larger sample will determine its generality and its ability to predict future suicidal behavior, and could give clinicians in the future a way to identify, monitor and perhaps intervene with the altered and often distorted thinking that so often characterizes seriously suicidal individuals," said Brent.

 

To further understand what caused the suicidal and non-suicidal participants to have different brain activation patterns for specific thoughts, Just and Brent used an archive of neural signatures for emotions (particularly sadness, shame, anger and pride) to measure the amount of each emotion that was evoked in a participant's brain by each of the six discriminating concepts. The machine-learning program was able to accurately predict which group the participant belonged to with 85 percent accuracy based on the differences in the emotion signatures of the concepts.

 

"The benefit of this latter approach, sometimes called explainable artificial intelligence, is more revealing of what discriminates the two groups, namely the types of emotions that the discriminating words evoke," Just said. "People with suicidal thoughts experience different emotions when they think about some of the test concepts. For example, the concept of 'death' evoked more shame and more sadness in the group that thought about suicide. This extra bit of understanding may suggest an avenue to treatment that attempts to change the emotional response to certain concepts."

 

Just and Brent are hopeful that the findings from this basic cognitive neuroscience research can be used to save lives.

 

"The most immediate need is to apply these findings to a much larger sample and then use it to predict future suicide attempts," said Brent.

 

Just and his CMU colleague Tom Mitchell first pioneered this application of machine learning to brain imaging that identifies concepts from their brain activation signatures. Since then, the research has been extended to identify emotions and multi-concept thoughts from their neural signatures and also to uncover how complex scientific concepts are coded as they are being learned.

 

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Chronic Alcohol Consumption Kills Brain Stem Cells
By Jason von Stietz, MA
November 19, 2017

 

Chronic alcohol abuse gone untreated can lead to severe brain damage. Researchers at The University of Texas Medical Branch at Galveston recently investigated the impact of alcohol consumption on stem cells in the brains of mice. Findings indicated that chronic alcohol consumption killed brain stem cells, reduced the production of new nerve cells, and affected females significantly worse than males. The study was discussed in a recent article in MedicalXpress: 

 

Because the brain stems cells create new nerve cells and are important to maintaining normal cognitive function, this study possibly opens a door to combating chronic alcoholism.

 

The researchers also found that brain stem cells in key brain regions of adult mice respond differently to alcohol exposure, and they show for the first time that these changes are different for females and males. The findings are available in Stem Cell Reports.

 

Chronic alcohol abuse can cause severe brain damage and neurodegeneration. Scientists once believed that the number of nerve cells in the adult brain was fixed early in life and the best way to treat alcohol-induced brain damage was to protect the remaining nerve cells.

 

"The discovery that the adult brain produces stem cells that create new nerve cells provides a new way of approaching the problem of alcohol-related changes in the brain," said Dr. Ping Wu, UTMB professor in the department of neuroscience and cell biology. "However, before the new approaches can be developed, we need to understand how alcohol impacts the brain stem cells at different stages in their growth, in different brain regions and in the brains of both males and females."

 

In the study, Wu and her colleagues used a cutting-edge technique that allows them to tag brain stem cells and observe how they migrate and develop into specialized nerve cells over time to study the impact of long-term alcohol consumption on them.

 

Wu said that chronic alcohol drinking killed most brain stem cells and reduced the production and development of new nerve cells.

 

The researchers found that the effects of repeated alcohol consumption differed across brain regions. The brain region most susceptible to the effects of alcohol was one of two brain regions where new brain cells are created in adults.

 

They also noted that female mice showed more severe deficits than males. The females displayed more severe intoxication behaviors and more greatly reduced the pool of stem cells in the subventricular zone.

 

Using this model, scientists expect to learn more about how alcohol interacts with brain stem cells, which will ultimately lead to a clearer understanding of how best to treat and cure alcoholism.

 

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Should Schizophrenia Be Reconceptualized?
By Jason von Stietz, MA
October 26, 2017
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People commonly view schizophrenia as a chronic and hopeless brain disease. However, researchers and clinicians are beginning to believe that this is not the case. Rather, some believe that what we now know as schizophrenia is the most severe end of the spectrum or of psychosis. They believe that what we call schizophrenia is actually many different diseases and disorders that we currently lump together. Sciencr discussed this new conceptualization in a recent article: 

 

Today, having a diagnosis of schizophrenia is associated with a life-expectancy reduction of nearly two decades. By some criteria, only one in seven people recover. Despite heralded advances in treatments, staggeringly, the proportion of people who recover hasn’t increased over time. Something is profoundly wrong.

 

Part of the problem turns out to be the concept of schizophrenia itself.

 

Arguments that schizophrenia is a distinct disease have been “fatally undermined”. Just as we now have the concept of autism spectrum disorder, psychosis (typically characterised by distressing hallucinations, delusions, and confused thoughts) is also argued to exist along a continuum and in degrees. Schizophrenia is the severe end of a spectrum or continuum of experiences.

 

Jim van Os, a professor of psychiatry at Maastricht University, has argued that we cannot shift to this new way of thinking without changing our language. As such, he proposes the term schizophrenia “should be abolished”. In its place, he suggests the concept of a psychosis spectrum disorder.

 

Another problem is that schizophrenia is portrayed as a “hopeless chronic brain disease”. As a result, some people given this diagnosis, and some parents, have been told cancer would have been preferable, as it would be easier to cure. Yet this view of schizophrenia is only possible by excluding people who do have positive outcomes. For example, some who recover are effectively told that “it mustn’t have been schizophrenia after all”.

 

Schizophrenia, when understood as a discrete, hopeless and deteriorating brain disease, argues van Os, “does not exist”.

 

BREAKING DOWN BREAKDOWNS

 

Schizophrenia may instead turn out to be many different things. The eminent psychiatrist Sir Robin Murray describes how:

 

I expect to see the end of the concept of schizophrenia soon … the syndrome is already beginning to breakdown, for example, into those cases caused by copy number [genetic] variations, drug abuse, social adversity, etc. Presumably this process will accelerate, and the term schizophrenia will be confined to history, like “dropsy”.

 

Research is now exploring the different ways people may end up with many of the experiences deemed characteristic of schizophrenia: hallucinations, delusions, disorganised thinking and behaviour, apathy and flat emotion.

 

Indeed, one past error has been to mistake a path for the path or, more commonly, to mistake a back road for a motorway. For example, based on their work on the parasite Toxoplasma gondii, which is transmitted to humans via cats, researchers E. Fuller Torrey and Robert Yolken have argued that “the most important etiological agent [cause of schizophrenia] may turn out to be a contagious cat”. It will not.

 

Evidence does suggest that exposure to Toxoplasma gondii when young can increase the odds of someone being diagnosed with schizophrenia. However, the size of this effect involves less than a twofold increase in the odds of someone being diagnosed with schizophrenia. This is, at best, comparable to other risk factors, and probably much lower.

 

For example, suffering childhood adversity, using cannabis, and having childhood viral infections of the central nervous system, all increase the odds of someone being diagnosed with a psychotic disorder (such as schizophrenia) by around two to threefold. More nuanced analyses reveal much higher numbers.

 

Compared with non-cannabis users, the daily use of high-potency, skunk-like cannabis is associated with a fivefold increase in the odds of someone developing psychosis. Compared with someone who has not suffered trauma, those who have suffered five different types of trauma (including sexual and physical abuse) see their odds of developing psychosis increase more than fiftyfold.

 

Other routes to “schizophrenia” are also being identified. Around 1% of cases appear to stem from the deletion of a small stretch of DNA on chromosome 22, referred to as 22q11.2 deletion syndrome. It is also possible that a low single digit percentage of people with a schizophrenia diagnosis may have their experiences grounded in inflammation of the brain caused by autoimmune disorders, such as anti-NMDA receptor encephalitis, although this remains controversial.

 

All the factors above could lead to similar experiences, which we in our infancy have put into a bucket called schizophrenia. One person’s experiences may result from a brain disorder with a strong genetic basis, potentially driven by an exaggeration of the normal process of pruning connections between brain cells that happens during adolescence. Another person’s experiences may be due to a complex post-traumatic reaction. Such internal and external factors could also work in combination.

 

Either way, it turns out that the two extreme camps in the schizophrenia wars – those who view it as a genetically-based neurodevelopmental disorder and those who view it as a response to psychosocial factors, such as adversity – both had parts of the puzzle. The idea that schizophrenia was a single thing, reached by a single route, contributed to this conflict.

 

IMPLICATIONS FOR TREATMENT

 

Many medical conditions, such as diabetes and hypertension, can be reached by multiple routes that nevertheless impact the same biological pathways and respond to the same treatment. Schizophrenia could be like this. Indeed, it has been argued that the many different causes of schizophrenia discussed above may all have a common final effect: increased levels of dopamine.

 

If so, the debate about breaking schizophrenia down by factors that lead to it would be somewhat academic, as it would not guide treatment. However, there is emerging evidence that different routes to experiences currently deemed indicative of schizophrenia may need different treatments.

 

Preliminary evidence suggests that people with a history of childhood trauma who are diagnosed with schizophrenia are less likely to be helped by antipsychotic drugs. However, more research into this is needed and, of course, anyone taking antipsychotics should not stop taking them without medical advice. It has also been suggested that if some cases of schizophrenia are actually a form of autoimmune encephalitis, then the most effective treatment could be immunotherapy (such as corticosteroids) and plasma exchange (washing of the blood).

 

Yet the emerging picture here is unclear. Some new interventions, such as the family-therapy based Open Dialogue approach, show promise for a wide range of people with schizophrenia diagnoses. Both general interventions and specific ones, tailored to someone’s personal route to the experiences associated with schizophrenia, may be needed. This makes it critical to test for and ask people about all potentially relevant causes. This includes childhood abuse, which is still not being routinely asked about and identified.

 

The potential for different treatments to work for different people further explains the schizophrenia wars. The psychiatrist, patient or family who see dramatic beneficial effects of antipsychotic drugs naturally evangelically advocate for this approach. The psychiatrist, patient or family who see drugs not working, but alternative approaches appearing to help, laud these. Each group sees the other as denying an approach that they have experienced to work. Such passionate advocacy is to be applauded, up to the point where people are denied an approach that may work for them.

 

WHAT COMES NEXT?

 

None of this is to say the concept of schizophrenia has no use. Many psychiatrists still see it as a useful clinical syndrome that helps define a group of people with clear health needs. Here it is viewed as defining a biology that is not yet understood but which shares a common and substantial genetic basis across many patients.

 

Some people who receive a diagnosis of schizophrenia will find it helpful. It can help them access treatment. It can enhance support from family and friends. It can give a name to the problems they have. It can indicate they are experiencing an illness and not a personal failing. Of course, many do not find this diagnosis helpful. We need to retain the benefits and discard the negatives of the term schizophrenia, as we move into a post-schizophrenia era.

 

What this will look like is unclear. Japan recently renamed schizophrenia as “integration disorder”. We have seen the idea of a new “psychosis spectrum disorder”. However, historically, the classification of diseases in psychiatry has been argued to be the outcome of a struggle in which “the most famous and articulate professor won”. The future must be based on evidence and a conversation which includes the perspectives of people who suffer – and cope well with – these experiences.

 

Whatever emerges from the ashes of schizophrenia, it must provide better ways to help those struggling with very real experiences.

 

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Bilateral Communication Increases in Older Adult Brain
By Jason von Stietz, M.A.
September 29, 2017

 

As the human brain ages, how does it manage to continue doing what we need it to do? A recent study found that the brain of an older adult compensates by increasing bilateral communication during a task. The study was discussed in a recent article in MedicalXpress: 

 

The aged brain tends to show more bilateral communication than the young brain. While this finding has been observed many times, it has not been clear whether this phenomena is helpful or harmful and no study has directly manipulated this effect, until now.

 

"This study provides an explicit test of some controversial ideas about how the brain reorganizes as we age," said lead author Simon Davis, PhD. "These results suggest that the aging brain maintains healthy cognitive function by increasing bilateral communication."

 

Simon Davis and colleagues used a brain stimulation technique known as transcranial magnetic stimulation (TMS) to modulate brain activity of healthy older adults while they performed a memory task. When researchers applied TMS at a frequency that depressed activity in one memory region in the left hemisphere, communication increased with the same region in the right hemisphere, suggesting the right hemisphere was compensating to help with the task.

 

In contrast, when the same prefrontal site was excited, communication was increased only in the local network of regions in the left hemisphere. This suggested that communication between the hemispheres is a deliberate process that occurs on an "as needed" basis.

 

Furthermore, when the authors examined the white matter pathways between these bilateral regions, participants with stronger white matter fibers connecting left and right hemispheres demonstrated greater bilateral communication, strong evidence that structural neuroplasticity keeps the brain working efficiently in later life.

 

"Good roads make for efficient travel, and the brain is no different. By taking advantage of available pathways, aging brains may find an alternate route to complete the neural computations necessary for functioning," said Davis.

 

These results suggest that greater bilaterality in the prefrontal cortex might be the result of the aging brain adapting to the damage endured over the lifespan, in an effort to maintain normal function. Future brain-stimulation techniques could target this bilateral effect in effort to promote communication between the hemispheres and, hopefully, engender healthy cognition throughout the lifespan.

 

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Expressive Writing "Cools" The Worried Brain
By Jason von Stietz, M.A.
September 22, 2017
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It is often recommended that people write about their feelings. However, does writing calm a worried brain? Researchers at Michigan State University found that expressive writing frees cognitive resources and improves performance on a cognitive task. The study was discussed in a recent article in MedicalXpress: 

 

The research, funded by the National Science Foundation and National Institutes of Health, provides the first neural evidence for the benefits of expressive writing, said lead author Hans Schroder, an MSU doctoral student in psychology and a clinical intern at Harvard Medical School's McLean Hospital.

 

"Worrying takes up cognitive resources; it's kind of like people who struggle with worry are constantly multitasking – they are doing one task and trying to monitor and suppress their worries at the same time," Schroder said. "Our findings show that if you get these worries out of your head through expressive writing, those cognitive resources are freed up to work toward the task you're completing and you become more efficient."

 

Schroder conducted the study at Michigan State with Jason Moser, associate professor of psychology and director of MSU's Clinical Psychophysiology Lab, and Tim Moran, a Spartan graduate who's now a research scientist at Emory University. The findings are published online in the journal Psychophysiology.

 

For the study, college students identified as chronically anxious through a validated screening measure completed a computer-based "flanker task" that measured their response accuracy and reaction times. Before the task, about half of the participants wrote about their deepest thoughts and feelings about the upcoming task for eight minutes; the other half, in the control condition, wrote about what they did the day before.

 

While the two groups performed at about the same level for speed and accuracy, the expressive-writing group performed the flanker task more efficiently, meaning they used fewer brain resources, measured with electroencephalography, or EEG, in the process.

 

Moser uses a car analogy to describe the effect. "Here, worried college students who wrote about their worries were able to offload these worries and run more like a brand new Prius," he said, "whereas the worried students who didn't offload their worries ran more like a '74 Impala – guzzling more brain gas to achieve the same outcomes on the task."

 

While much previous research has shown that expressive writing can help individuals process past traumas or stressful events, the current study suggests the same technique can help people – especially worriers – prepare for stressful tasks in the future.

 

"Expressive writing makes the mind work less hard on upcoming stressful tasks, which is what worriers often get "burned out" over, their worried minds working harder and hotter," Moser said. "This technique takes the edge off their brains so they can perform the task with a 'cooler head.'"

 

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Dancing Improves Brain Health in Older Adults
By Jason von Stietz, M.A.
September 14, 2017
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Most people have heard that exercise is good for the brain? However, what are the benefits of dancing? A recent study found that a dance program involving teaching older adults a new dance move each session led to not only increases in hippocampal volume but also improvements in maintaining postural control/balance. The study was discussed in a recent article in Medical Express: 

 

"Exercise has the beneficial effect of slowing down or even counteracting age-related decline in mental and physical capacity," says Dr Kathrin Rehfeld, lead author of the study, based at the German center for Neurodegenerative Diseases, Magdeburg, Germany. "In this study, we show that two different types of physical exercise (dancing and endurance training) both increase the area of the brain that declines with age. In comparison, it was only dancing that lead to noticeable behavioral changes in terms of improved balance."

 

Elderly volunteers, with an average age of 68, were recruited to the study and assigned either an eighteen-month weekly course of learning dance routines, or endurance and flexibility training. Both groups showed an increase in the hippocampus region of the brain. This is important because this area can be prone to age-related decline and is affected by diseases like Alzheimer's. It also plays a key role in memory and learning, as well as keeping one's balance.

 

While previous research has shown that physical exercise can combat age-related brain decline, it is not known if one type of exercise can be better than another. To assess this, the exercise routines given to the volunteers differed. The traditional fitness training program conducted mainly repetitive exercises, such as cycling or Nordic walking, but the dance group were challenged with something new each week.

 

Dr Rehfeld explains, "We tried to provide our seniors in the dance group with constantly changing dance routines of different genres (Jazz, Square, Latin-American and Line Dance). Steps, arm-patterns, formations, speed and rhythms were changed every second week to keep them in a constant learning process. The most challenging aspect for them was to recall the routines under the pressure of time and without any cues from the instructor."

 

These extra challenges are thought to account for the noticeable difference in balance displayed by those participants in dancing group. Dr Rehfeld and her colleagues are building on this research to trial new fitness programs that have the potential of maximizing anti-aging effects on the brain.

 

"Right now, we are evaluating a new system called "Jymmin" (jamming and gymnastic). This is a sensor-based system which generates sounds (melodies, rhythm) based on physical activity. We know that dementia patients react strongly when listening to music. We want to combine the promising aspects of physical activity and active music making in a feasibility study with dementia patients."

 

Dr Rehfeld concludes with advice that could get us up out of our seats and dancing to our favorite beat.

 

"I believe that everybody would like to live an independent and healthy life, for as long as possible. Physical activity is one of the lifestyle factors that can contribute to this, counteracting several risk factors and slowing down age-related decline. I think dancing is a powerful tool to set new challenges for body and mind, especially in older age."

 

This study falls into a broader collection of research investigating the cognitive and neural effects of physical and cognitive activity across the lifespan.

 

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Robotic Exoskeleton Improves Walking Ability in Children With Cerebral Palsy
By Jason von Stietz, M.A.
August 27, 2017
Credit: Northern Arizona University

 

Children with cerebral palsy, a neurological and movement disorder, often limits mobility and independent life functioning in children. Researchers at Northern Arizona University and the National Institutes of Health examined the use of a robotic exoskeleton to improve waling ability in children with cerebral palsy. The study was discussed in a recent article in Medical Xpress: 

 

 

According to the Centers for Disease Control and Prevention, cerebral palsy (CP)—caused by neurological damage before, during or after birth—is the most common movement disorder in children, limiting mobility and independence throughout their lives. An estimated 500,000 children in the U.S. have CP.
 

Although nearly 60 percent of children with the disorder can walk independently, many have crouch gait, a pathological walking pattern characterized by excessive knee bending, which can cause an abnormally high level of stress on the knee. Crouch gait can lead to knee pain and progressive loss of function and is often treated through invasive orthopedic surgery.

 

Assistant professor of mechanical engineering Zach Lerner, who joined Northern Arizona University's Center for Bioengineering Innovation in 2017, recently published a study in the journal Science Translational Medicine investigating whether wearing a robotic exoskeleton—a leg brace powered by small motors—could alleviate crouch gait in children with cerebral palsy.

 

"We evaluated a novel exoskeleton for the treatment of crouch gait, one of the most debilitating pathologies in CP," Lerner said. "In our exploratory, multi-week trial, we fitted seven participants between the ages of five and 19 with robotic exoskeletons designed to increase their ability to extend their knees at specific phases in the walking cycle."

 

After being fitted with the assistive devices, the children participated in several practice sessions. At the end of the trial, six of the seven participants exhibited improvements in walking posture equivalent to outcomes reported from invasive orthopedic surgery. The researchers also demonstrated that improvements in crouch increased over the course of the exploratory trial, which was conducted at the National Institutes of Health Clinical Center in Bethesda, Maryland.

 

"Together, these results provide evidence supporting the use of wearable exoskeletons as a treatment strategy to improve walking in children with CP," Lerner said.

 

The exoskeleton was safe and well-tolerated, and all the children were able to walk independently with the device. Rather than guiding the lower limbs, the exoskeleton dynamically changed their posture by introducing bursts of knee extension assistance during discrete portions of the walking cycle, which resulted in maintained or increased knee extensor muscle activity during exoskeleton use.

 

"Our results suggest powered knee exoskeletons should be investigated as an alternative to or in conjunction with existing treatments for crouch gait, including orthopedic surgery, muscle injections and physical therapy," Lerner said.

 

Lerner leads NAU's Biomechatronics Lab, where his goal is to improve mobility and function in individuals with neuromuscular and musculoskeletal disabilities through innovations in mechanical and biomedical engineering. Building on the encouraging results of this study, his team is working toward conducting longer-term exoskeleton interventions to take place at home and in the community.

 

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Fear-Memories Can Be Erased, Study Finds
By Jason von Stietz, M.A.
August 25, 2017
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At times, fear is healthy and necessary. For example, an individual hiking in the woods should feel fear and avoid approaching a bear or other wild animals. However, often times individuals develop unhealthy or unhelpful fears such as a phobia of dogs, even if they are domesticated and friendly. Researchers at University of California, Riverside investigatesd the use of a method of selectively erasing fear-memories by weakening the connections of the neurons involved in the formation of those memories. The study was discussed in a recent article in Medical Xpress: 

 

To survive in a dynamic environment, animals develop fear responses to dangerous situations. But not all fear memories, such as those in PTSD, are beneficial to our survival. For example, while an extremely fearful response to the sight of a helicopter is not a useful one for a war veteran, a quick reaction to the sound of a gunshot is still desirable. For survivors of car accidents, it would not be beneficial for them to relive the trauma each time they sit in a car.

 

In their lab experiments, Jun-Hyeong Cho, M.D., Ph.D., an assistant professor of molecular, cell, and systems biology, and Woong Bin Kim, his postdoctoral researcher, found that fear memory can be manipulated in such a way that some beneficial memories are retained while others, detrimental to our daily life, are suppressed.

 

The research, done using a mouse model and published today in Neuron, offers insights into how PTSD and specific phobias may be better treated.

 

"In the brain, neurons communicate with each other through synaptic connections, in which signals from one neuron are transmitted to another neuron by means of neurotransmitters," said Cho, who led the research. "We demonstrated that the formation of fear memory associated with a specific auditory cue involves selective strengthening in synaptic connections which convey the auditory signals to the amygdala, a brain area essential for fear learning and memory. We also demonstrated that selective weakening of the connections erased fear memory for the auditory cue."

 

In the lab, Cho and Kim exposed mice to two sounds: a high-pitch tone and a low-pitch tone. Neither tone produced a fear response in the mice. Next, they paired only the high-pitched tone with a mild footshock administered to the mice. Following this, Cho and Kim again exposed the mice to the two tones. To the high-pitch tone (with no accompanying footshock), the mice responded by ceasing all movement, called freezing behavior. The mice showed no such response to the low-pitch sound (with no accompanying footshock). The researchers found that such behavioral training strengthened synaptic connections that relay the high-pitch tone signals to the amygdala.

 

The researchers then used a method called optogenetics to weaken the synaptic connection with light, which erased the fear memory for the high-pitch tone.

 

"In the brain, neurons receiving the high- and low-pitch tone signals are intermingled," said Cho, a member of the Center for Glial-Neuronal Interactions in the UC Riverside School of Medicine. "We were able, however, to experimentally stimulate just those neurons that responded to the high-pitch sound. Using low-frequency stimulations with light, we were able to erase the fear memory by artificially weakening the connections conveying the signals of the sensory cue—a high-pitch tone in our experiments - that are associated with the aversive event, namely, the footshock."

 

Cho explained that for adaptive fear responses to be developed, the brain must discriminate between different sensory cues and associate only relevant stimuli with aversive events.

 

"This study expands our understanding of how adaptive fear memory for a relevant stimulus is encoded in the brain," he said. "It is also applicable to developing a novel intervention to selectively suppress pathological fear while preserving adaptive fear in PTSD."

 

The researchers note that their method can be adapted for other research, such as "reward learning" where stimulus is paired with reward. They plan next to study the mechanisms involved in reward learning which has implications in treating addictive behaviors.

 

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