Author: Medical News Today

With an aging population susceptible to stroke, Parkinson’s disease and other neurological conditions, and military personnel returning from Iraq and Afghanistan with serious limb injuries, the need for strategies that treat complex neurological impairments has never been greater.

One tack being pursued by neuroscientists and engineers is the development of “smart” neural prostheses. These devices are intended to restore function, through electrical stimulation, to damaged motor neural circuits – the long, slender fibers that conduct neurochemical messages between nerve cells in the brain and spinal cord.

It is the rapid-fire transmission of messages between nerve cells that prompts the body’s movements, leading the hand to whisk away a fly, the leg to stretch, the head to turn. And it is disruption of these messages that leads to impairment, including paralysis, staggered gaits and other forms of motor dysfunction.

Simple forms of neural prostheses — some external, some implantable — have been developed over the last four decades to treat loss of hearing, bladder control and respiration. And recent advances have led to the development of some “smart” neural prostheses, which engage higher levels of brain function.

However, significant challenges remain in developing ever-more precise implanted neural interfaces that operate at the cellular level and that will provide even greater precision and fidelity in restoring function.

Harnessing the brain’s “plasticity”

To truly harness the capacity of neural prostheses to treat complex damage of the nervous system, the devices must be designed to exploit the brain’s “plasticity,” or capacity for change, says Michael Merzenich, PhD, UCSF Francis A. Sooy Professor of Otolaryngology and a member of the Keck Center for Integrative Neuroscience at UCSF.

Merzenich’s pioneering studies over three decades have revealed the capacity of the brain to rewire itself in response to new conditions, even during adulthood and aging. And in developing the first neural prosthesis – the cochlear implant, in the early 1980s — and software programs for language and learning disabilities in the mid 1990s – he has demonstrated that the brain has the capacity to actively engage in a remediation, or retraining, process.

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Author: Medical News Today

It has been known for decades that heart attacks and strokes occur most frequently in the early-morning hours. Now, researchers at the University of Pennsylvania School of Medicine have provided the first evidence for the role of our body’s internal molecular clock in controlling blood pressure and a mechanism by which this occurs. Published online next week in the Proceedings of the National Academy of Sciences, this report points to the novel possibility of modifying blood pressure and the early-morning risk of heart attack.

The upswing in heart attacks tracks with rising blood pressure, which undergoes a 24-hour, or circadian, rhythm. This rise in blood pressure is amplified in patients with high blood pressure. However, scientists have debated as to whether this event signifies a role for the molecular clock, or merely reflects the relationship of clock time to stresses in our environment – such as awakening, hurried dressing, and the rush to work.

“This study provides evidence that integrates both explanations for the variation in blood pressure with clock time and, by inference, the daily variation in heart attack and stroke,” explains first author and postdoctoral fellow Annie M. Curtis, PhD.

The molecular clock is a complex set of genes located in a discrete brain area that tightly regulate circadian rhythms in behavior, temperature, and metabolism. Researchers now appreciate that this “master clock” also interacts with clocks in almost all types of tissues.

Using mice in which the function of major clock genes have been disrupted, the investigators found distinct and complimentary effects on blood pressure and its circadian variation. What’s more, genes relevant to the production and breakdown of catecholamines – the hormones that equip mammals for “fight and flight” behavior were under the control of the clock.

Catecholamines – norepinephrine and epinephrine – undergo a daily variation, but also rise in response to stress. The investigators wondered if they might provide a link between the two explanations for the early morning rise in heart attacks.

Using a mouse model in which catecholamines and blood pressure were made to surge, the researchers found that the rise in both blood pressure and catecholamines depended on the time of the stress. The greatest response occurred at a time that would correspond to the early morning hours in humans.

However, the greater surprise was yet to come, say the investigators. Deletion of a core clock gene completely abolished both the catecholamine and blood pressure response to stress, irrespective of when the stress was applied during the daily clock cycle. This effect was specific to the catecholamines, as the stress response of another hormone – a steroid – was unaltered.

“These results integrate for the first time the two leading explanations for the diurnal variation in blood pressure and reveal an unexpected role for a clock gene in regulating the stress response” says senior author Garret A. FitzGerald, MD, Director of the Institute for Translational Medicine and Therapeutics at Penn FitzGerald. “They raise the novel possibility of modifying blood pressure and consequently the early-morning risk of heart attack and stroke by using drugs to ‘reset’ the molecular clock.” Since blood pressure response (via rising catecholamines) to stress in the early morning is tied to one’s internal clock, tamping down the clock using drugs could be a treatment for people with high blood pressure, whose upswing in pressure is amplified in the morning anyway.

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Author: Jennifer Viegas

In fact, a single human brain cell, or neuron, may be able to produce as many cells as exist in the brains of 50 million people. The study is the first to show that ordinary human neurons can lead to such great numbers of replacement cells, as well as morph into different cell types.

“This is a completely new source of human brain cells that can potentially be used to fight Parkinson’s disease, Alzheimer’s disease, stroke and a host of other brain disorders,” said Dennis Steindler, lead author of the study, which is published in the current issue of the journal Development.

Steindler, who is the executive director of the University of Florida’s McKnight Brain Institute, added, “We could conceivably grow cells that would come to the rescue of the part of the brain that needed them, but not to build an entire brain or a complete structure. It would probably only take months to get enough material for a human transplant operation.”

He explained to Discovery News that he and his team worked with mature human brain cells taken from epilepsy patients undergoing surgical treatment to ease their symptoms. The cells were extracted from tissue in the brain’s gray matter, which is not known for harboring stem cells.

The scientists then gave the cells a “bath” of growing agents, in a step somewhat like adding growth hormone to plant cuttings.

Transplanted into mouse brains, the treated cells seemed to take cues from their environment, producing new neurons that matched the surrounding parts of the brain.

The researchers think the chemical bath might have coaxed preexisting neural progenitors, which are stem-like cells, to emerge from the gray matter sample and multiply like rabbits.

Author: Kerri Waldowski for Advance Magazine

The July 29, 2002 edition of ADVANCE Magazine featured the Aphasia Hope Foundation as its cover story! The article focuses on both the history of the Foundation, as well as the on-going endeavors of Aphasia Hope. ADVANCE placed strong emphasis on interactive website offered by AHF!

ADVANCE Magazine for Speech-Language Pathologists & Audiologists is a weekly publication reporting on up-to-the-minute developments, the latest technology, and current trends in audiology and speech-language pathology. Issues covered range from commonsense tips and strategies for every practice setting and patient population to ground-breaking developments in treatment and technology. Special features include in-depth articles, business news, research findings, a new technology section in each issue, campus coverage, a monthly column on aging, book reviews, convention coverage, facility profiles, and an extensive listing of continuing education opportunities.

You can read the cover story on Aphasia Hope Foundation by Clicking here

This searchable database contains listings of more than 7,000 programs that employ audiologists and speech-language pathologists who hold the Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association (ASHA). Click on ASHA

This is a great tool for those with Aphasia. Make Your Photos Talk with These Voice Recorders. With these new voice recorders, your pictures no longer need to be silent.

Photos Talk!

Author: Jennifer Carnig- staff writer for Alameda Times-Star

AUTHOR Luanna Blagrove wrote 17 books on business, but can’t tell you the titles of any of them. She can’t even tell you her own name.

But don’t let that fool you. At 65, the Berkeley grandmother is still quite coherent — her killer smile, easy laugh and alert brown eyes make that clear. She still goes to church every Sunday and she still plays the piano. She just can’t sing the words to the songs anymore.

Blagrove has aphasia, a disorder you’ve probably never heard of even though more than 1 million Americans suffer from it — more than the number of patients in the United States with multiple sclerosis, muscular dystrophy or Parkinson’s disease.

But because aphasia — pronounced uh-FAY-zhuh — is a communication impairment, Blagrove and others like her can’t tell you about it, even though their levels of intelligence are still intact.

Caused by brain damage — most often from a stroke — aphasia is the name for the brain’s inability to comprehend, read or write. Patients can still speak, but they can no longer access the area of the brain where language is stored. When they want to say something, they don’t know the words anymore.

In Blagrove’s case, a stroke five years ago stopped her from talking to her three children, reading the newspaper and writing letters.

But it hasn’t stopped her from living.

Blagrove found support from the Aphasia Center of California, an Oakland-based nonprofit that provides therapy and companionship to those who have lost some or all of their ability to speak and comprehend their native language.

“Aphasia is like being dropped in Bulgaria — you’re still intelligent, you just can’t communicate because you don’t know the language,” explains Dr. Roberta Elman, the president of the center and a speech-language pathologist.

Elman opened the center seven years ago after discovering that group treatment produces major results in reducing aphasia’s effects. Now, under the leadership of Elman and two other speech therapists, nine groups of eight to 12 people meet regularly to work on their communication skills. The center also runs a book club — with the help of books on tape and accompanying large print books — and offers classes on surfing the Internet, fitness and art.

“Aphasia is very isolating,” Elman says, explaining that insurance rarely covers speech therapy in cases of aphasia. “So what tends to happen is that the patient gets discharged and goes home and sits in front of the TV set since they can’t communicate with their friends and family anymore. They’re virtually shut off from the outside world.”

But not for aphasia patients from any of the Bay Area’s nine counties. Here they can attend low-cost group therapy sessions that help them improve their communication skills while having a lot of fun.

The support group atmosphere allows those with aphasia the chance to speak up without fear of embarrassment, and make friends and laugh as they gain self-confidence. At a recent Tuesday afternoon meeting, participants were cracking each other up as they discussed current events, the quality of ribs at a local barbecue restaurant, prostate health and summer vacations.

The laughs came easy and quick as the group communicated what they’ve been up to lately.

Blagrove, who has a severe form of aphasia, answers Elman’s questions about the last church service she attended using a card bearing the numbers one through 10, a rating system with 10 being the best.

Elman asks how the sermon was. Blagrove points to a six.

“It’s usually a nine,” Elman says. “What happened?”

Blagrove closes her eyes and pretends to sleep.

“You fell asleep?” an astonished Elman asks. Blagrove shrugs her shoulders and reveals a sheepish smile. The group howls with laughter.

Philip Tien, a 49-year-old San Francisco resident who had a stroke four years ago, can say some words and phrases but forgets others. To describe where he’s been the past three weeks, he uses a map to point to New York City and Los Angeles. He loved New York’s Metropolitan Museum of Art, but can’t remember the name and says “statues” instead.

And how was it?

“Marvelous! Man, this is just marvelous!” he says, laughing, demonstrating how impressed he was with the art museum’s massive sculpture collection.

Alameda resident Jimmy Santanna, 60, who had a stroke five years ago, asks Tien if he saw the Statue of Liberty by saying “statue France,” and holding his arm in the sky as if he held a torch.

“Marvelous!” Tien answers again, laughing even more.

Oakland resident David Rose, 41, had a stroke three years ago that left him virtually unable to speak. He has since married, and his wife, Kathryn, is expecting the couple’s first child. He shows the group an abstract red and green pastel drawing he made of his pregnant wife in one of the Aphasia Center’s art classes.

To explain what the picture is, he says “baby” and puts his hand on his heart and closes his eyes, with a smile that only an expectant father can wear.

“A boy or a girl?” asks Bill Wong, a 41-year-old stroke survivor from Oakland.

Rose makes a muscle to show that he’s expecting a son. He then writes “October” to show when the boy is due.

Elman, or “Bob” as the group calls her — “They can’t say Roberta,” she explains with a smile — leads the banter for the next 11/2 hours, the group in hysterics at least half the time.

“The goal is to help them take back their lives and their independence,” Elman says. “It’s important to have a place where you can come where you know people will understand you. For some of them, this might be the only place where that happens. And that’s an invaluable service. Because it reminds them their lives didn’t end with the stroke. … There’s still a lot of life left to be lived.”

First Written by Alameda Times-Star; by Jennifer Carnig

For more information on aphasia or on the Aphasia Center of California, call (510) 336-0112 or visit www.aphasiacenter.org.

Author: Medical News Today

Results from the most comprehensive study to compare two imaging techniques for the emergency diagnosis of suspected acute stroke show that magnetic resonance imaging (MRI) can provide a more sensitive diagnosis than computed tomography (CT) for acute ischemic stroke. The difference between MRI and CT was attributable to MRI’s superiority for detection of acute ischemic stroke – the most common form of stroke, caused by a blood clot. The study was conducted by physicians at the National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH). Findings appear in the January 27, 2007 edition of The Lancet .

“These NIH research findings on acute stroke imaging are directly applicable to real-world clinical practice,” said NIH Director Elias A. Zerhouni, M.D. “The patients involved in this study were the typical cross-section of suspected stroke patients that come into emergency rooms on a daily basis.”

Furthermore, the study has good news for patients, according to Walter J. Koroshetz, M.D., NINDS Deputy Director. “This study shows that approximately 25 percent of stroke patients who come to the hospital within three hours of onset, the time frame for approved clot-busting therapy, have no detectable signs of damage. In other words, brain injury may be completely avoided in some stroke victims by quick re-opening of the blocked blood vessel,” said Dr. Koroshetz.

The researchers conducted the study to determine whether MRI was superior to CT for emergency diagnosis of acute ischemic and hemorrhagic stroke (caused by bleeding into the brain). Standard CT uses X-rays which are passed through the body at different angles and processed by a computer as cross-sectional images, or slices of the internal structure of the body or organ. Standard MRI uses computer-generated radio waves and a powerful magnet to produce detailed slices or three-dimensional images of body structures and nerves. A contrast dye may be used in both imaging techniques to enhance visibility of certain areas or tissues.

Study results show immediate non-contrast MRI is about five times more sensitive than and twice as accurate as immediate non-contrast CT for diagnosing ischemic stroke. Non-contrast CT and MRI were equally effective in the diagnosis of acute intracranial hemorrhage. Non-contrast CT has been the standard in emergency stroke treatment, primarily to exclude hemorrhagic stroke, which cannot be treated with clot-busting therapies.

“Many patients who come to hospitals with a suspected stroke ultimately have a different diagnosis. Most possible stroke victims are first evaluated by non-specialists, who may be reluctant to treat a patient for stroke without greater confidence in the accuracy of the diagnosis. Our results show that MRI is twice as accurate in distinguishing stroke from non-stroke,” said Steven Warach, M.D., Ph.D., director of the NINDS Stroke Diagnostics and Therapeutic Section and senior investigator of the study. “Based on these results, MRI should become the preferred imaging technique for diagnosing patients with acute stroke.”

The study included 356 consecutive patients with suspected stroke arriving at the NIH Stroke Center at Suburban Hospital in Bethesda, MD, a primary stroke center that is designed to stabilize and treat acute stroke patients. Stroke specialists conducted emergency clinical assessments with all patients, including the NIH Stroke Scale which is used to measure stroke severity. MRI was done prior to CT in 304 patients. Scans were initiated within two hours of each other, with a median difference of 34 minutes. Patients were excluded from the analysis if either CT or MRI was not done. The images were sorted randomly and independently by two neuroradiologists and two stroke neurologists.

Results of the study show standard MRI is superior to standard CT in detecting acute stroke and particularly acute ischemic stroke. The four readers were unanimous in their agreement on the presence or absence of acute stroke in 80 percent of patients using MRI compared to 58 percent using non-contrast CT. No significant difference using the two technologies was seen in the diagnosis of acute intracranial hemorrhage, which is consistent with previous findings.

“Although MRI is remarkably accurate in detecting early stroke damage, it can’t substitute for a doctor’s clinical judgment in making a stroke diagnosis and deciding upon treatment,” said Dr. Koroshetz. “Future studies are needed to determine whether advanced contrast enhanced CT techniques can afford the same level of clinical information more quickly and with less expense,” he added.

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The Internet Stroke Center exists to advance understanding of stroke research and clinical care. Their goal is to provide current, professional, un-biased information about stroke. The information on this site is obtained from published accounts, meeting presentations, internet searches, and direct correspondence.

To view their site, click on Stroke Center and search for “aphasia”.

The crisis creates an immediate need for the family to understand how to take care of the stroke patient. After years of nursing experience and teaching nurses’ assistants, Helen Underwood has compiled a practical manual for families and caregivers. Noting the causes and symptoms of a stroke and the methods for assisting the patient, Ms. Underwood then discusses care facilities, reviews medical terminology, and includes illustrations to help caregiver and patient communicate.

To Order: www.alibris.com.