Monday, April 28, 2008
New Data Shows that Deep Brain Stimulation Useful for Severe, Treatment Resistant Depression and OCD
The idea that deep brain stimulation could become a useful treatment for a variety of drug resistant psychiatric disorders is not new to us or to our readers. To review, you can just take a look at many flashbacks at the end of this post. Now the news is that at the upcoming annual scientific meeting of the American Association of Neurological Surgeons (AANS), the data to be presented by Ali Rezai, M.D., a neurosurgeon at the Cleveland Clinic, will again point to usefulness of deep brain stimulation (DBS) for severe, treatment resistant depression and obsessive compulsive disorder (OCD).
From the statement by Medtronic:
The data represent the largest and longest clinical experience to date with DBS for psychiatric disorders and was collected through the collaborative research efforts of several leading institutions. All of the studies being presented used the Medtronic DBS system to stimulate a target within the brain called the ventral anterior limb of the internal capsule/ventral striatum (VC/VS), which is a central node in the neural circuits that regulate mood and anxiety.“The data we are presenting on 43 patients is the result of more than 10 years of work across multiple institutions worldwide. These data represent the largest number and the longest evaluation of patients with psychiatric disorders who have undergone DBS implants, including some with long-term follow up,” said Dr. Rezai, who represented an international working group of physicians studying DBS therapy for treatment resistant OCD and depression. “While OCD and depression treatment with DBS require additional clinical evaluation research, our early open-label experience to date is encouraging and indicates that DBS may help severely disabled and suffering patients who have exhausted other treatment options.”
Flashbacks: St. Jude Begins Trial of Deep Brain Stimulation for Depression ; Deep Brain Stimulation Shows Promise in Treatment of Obsessive Compulsive Disorder; Deep Brain Stimulation Therapy for MCS; Deep Brain Stimulation Awakens Patient; St. Jude Receives Patent for Anti Depression Neurostimulation Method; Brain Implant Relieves Depression
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Tuesday, April 22, 2008
St. Jude Receives Patent for Anti Depression Neurostimulation Method
St. Jude Medical has received a patent from the US Patent and Trademark Office for their deep brain stimulation technology that focuses on Brodmann Area 25 to treat severe, refractory depression.
Brodmann Area 25 is a structure within the subcollosal gyrus region of the brain. It is the focus of the St. Jude Medical BROADEN(TM) (Brodmann Area 25 DEep brain Neuromodulation) study, which is evaluating whether deep brain stimulation (DBS) therapy can help people who suffer from major depressive disorder, a severe form of depression. This study is being conducted under a U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE), which was announced in February 2008."This patent is a cornerstone in developing our approach to deep brain stimulation for depression, which is the leading cause of disability in the U.S. among illnesses," said Chris Chavez, president of St. Jude Medical's ANS Division. "The BROADEN study provides hope for a meaningful new therapy to the millions of patients still seeking treatment for their severe depression."
On April 4, St. Jude Medical enrolled the first patient, a woman from Chicago, in the BROADEN study. The patient will be implanted with the Libra(R) Deep Brain Stimulation System, an investigational device, at Alexian Brothers Behavioral Health Hospital in Chicago.
Full patent: Method of treating depression, mood disorders and anxiety disorders using neuromodulation...
Press release: St. Jude Medical Awarded U.S. Patent for Neurostimulation Therapy for Depression
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Tuesday, April 8, 2008
Video Case Studies from NIAAA: Helping Patients Who Drink Too Much
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH), has just introduced an online course designed to better equip clinicians in diagnosis and treatment of patients with severe alcoholism. Those that complete the Helping Patients Who Drink Too Much course can obtain a whopping 1.5 hours of CME credits available through Medscape.
"The video scenarios demonstrate evidence-based techniques for assessing and managing at-risk drinking and alcohol use disorders," says NIAAA Director Ting-Kai Li, M.D. "We want to make these techniques widely available to clinicians so that more people with alcohol use problems will get the help they need." Called Video Case Studies: Helping Patients Who Drink Too Much, the program is available through the NIAAA website at www.niaaa.nih.gov/guide.
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Thursday, April 3, 2008
Virtual Reality to Fight Real Paranoia
Did the girl standing by the automatic doors just look at you? Does she think you're strange looking? Is something wrong with your hair? Perhaps you're paranoid and are just thinking too much of the situation? Well then, scientists at King's College London just designed a virtual reality simulation of a subway car to both assess and help treat social anxiety disorders.
From the BBC:
During the four-minute ride the volunteers walked around a carriage filled with "virtual" passengers who behaved like real people.The "avatars" - computer-generated characters - breathed, looked around, and sometimes met the gaze of the participants.
A pre-assessment showed that those who were anxious, worried, pessimistic, or had low self-esteem, were most likely to feel paranoid.
Researchers also said the number of people demonstrating paranoid feelings was higher than expected.
One participant who experienced paranoid thoughts told the scientists: "There's something dodgy about one guy. Like he was about to do something - assault someone, plant a bomb, say something not nice to me, be aggressive."
Of course the system needs to be tested against the old adage: "Just because you aren't paranoid, doesn't mean they aren't out to get you".
More with video at the BBC...
Press release: Virtual tube ride 'paranoia hope'
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Tuesday, March 25, 2008
Using Mirrors to Treat Phantom Limb Pain
Returning Iraq veteran amputees using an odd neural pathway to trick the brain to treat phantom limb pain...
Dr. Jack Tsao, a Navy neurologist with the Uniform Services University, was looking for ways to help soldiers like Paupore. He remembered reading in graduate school a paper by Dr. V.S. Ramachandran that talked about an unusual treatment for amputees suffering "phantom limb pain," using a simple $20 mirror.The mirror tricks the brain into "seeing" the amputated leg, overriding mismatched nerve signals.
Here's how it works: The patient sits on a flat surface with his or her remaining leg straight out and then puts a 6-foot mirror lengthwise facing the limb. The patient moves the leg, flexing it, and watches the movement in the mirror. The reflection creates the illusion of two legs moving together.
They say necessity is the mother of invention. While improvements in armor technology have kept more soldiers alive than ever before, many of those saved are coming home as amputees. We've explicitly asked the question before, and the number of posts we've done on the subject serves as evidence: for better or worse, the Iraq and Afghanistan wars are driving major advancements in medical research and technology.
More from CNN...
Photo Credit: michiyoemi
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Home Bi-Polar Test Kits Cause Mixed Emotions
All too often we come across some new diagnostic methodology that researchers claim could be commercialized in just a few years. Typically these claims are the reason researchers stick to research and leave the commercialization to others (it's never as simple as they claim). However, out of San Diego we have the story of Dr. John Kelsoe, who's applying his genetic research on the genetic predictors of bipolar disorder to sell an at-home test kit for $399.
Not surprisingly, such a quick run to the marked has brought some dissenting opinions...
"People are always rushing to the market on the basis of one or two studies," said Dr. Muin Khoury, director of the National Office of Public Health Genomics at the Centers for Disease Control and Prevention. "We have very little evidence that telling people their genetic information is going to make any difference."
Kelsoe acknowledges the weaknesses of his product, but sees it more as a means to start a discussion between a patient and their doctor.
But [Kelsoe] said his test is a vital starting point toward moving away from the notoriously tricky practice of diagnosing bipolar disorder based purely on a person's behavior."The goal of this is to try and help doctors make an accurate diagnosis more quickly so the patient can be treated appropriately," Kelsoe said. "Anything is going to help, even if it just helps a little bit."
More from the LA Times and (of course) the product page from Psynomics, Kelsoe's company.
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Wednesday, March 19, 2008
The Blogging Madness
Dr Block, a psychiatrist, seems to believe that the editors of this blog, along with a good number of its readers, are suffering from a mental disorder. He contends that obsessive internet surfers suffer from similar symptoms that drug addicts do.
The following is a carefully crafted assault on all of us, published in the latest Am J Psychiatry. Good thing we have the internet to read this on:
Internet addiction appears to be a common disorder that merits inclusion in DSM-V. Conceptually, the diagnosis is a compulsive-impulsive spectrum disorder that involves online and/or offline computer usage and consists of at least three subtypes: excessive gaming, sexual preoccupations, and e-mail/text messaging. All of the variants share the following four components: 1) excessive use, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when the computer is inaccessible, 3) tolerance, including the need for better computer equipment, more software, or more hours of use, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue.
Issues for DSM-V: Internet Addiction Am J Psychiatry 165:306-307, March 2008
More at the Ottawa Citizen...
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Friday, March 14, 2008
Exmocare Emotion Detection Technology: Capitalizing on How R U
The end is near big time. This is official. If it takes a monitor to assess someone's current emotional status, then we are in big trouble. But that is precisely what Exmocare, Inc., a NY, NY company, wants to capitalize on. Just past Wednesday, in the presence of our somber editorial staff, Frost & Sullivan has awarded Exmocare, Inc. with 2008 North American Emotion Monitoring Technology Innovation of the Year Award, 
for "developing the ExmoCare physiology and emotion monitoring platform that aids in understanding the physiological state of a person through monitoring the expression of emotion patterns. The platforms developed by the company Exmocare, Inc. are unique in that they are the first of their kind to become a first-stop solution for vital sign monitoring , emotional monitoring, and online reporting." And now the company is all set to release a new smaller, smarter, Bluetooth enabled, and more powerful emotions analyzer/vital signs recorder, dubbed BT2.
The BT1 has been used since 2006 for research missions by NASA, evaluation by research universities and clinics, and has been recognized for its unique capabilities by Frost and Sullivan. The BT2 builds on the critical success of the BT1, will be produced in larger quantities for evaluation by chronic and elder care service plan providers spanning 190 countries. Unlike any other biosensor device on the planet, the BT2 measures and transmits all basic vital signs needed via Bluetooth to alert care providers 24/7. With its sleeker appearance, smallerform factor and onboard display, the BT2 will enable Exmocare to demonstrate its online diagnosis and electronic medical record storage services globally. The BT2 will be debuted at an industry award ceremony honoring the BT1 on March 14 in San Francisco, where its final specifications will be revealed to the general public...
Amazing features of Exmocare's BT2 monitoring device:
99 Percent accurate vital signs, even when the wearer is moving
Heart rate and heart rate variability in the Exmocare watch using infrared signals to determine blood volume pulse without chest straps, electrodes or two-handed contact
Simultaneously measures skin temperature, skin moisture and relative movement
Able to detect human emotional and behavioral states, including side effects to drugs
Connects to online diagnosis and electronic medical records software via Bluetooth wireless
Press release: Exmocare Taps into $200 Billion Industry - Maker of Award-winning 24/7 Bluetooth Vital Signs Wristwatch...
Product page: The Exmocare BT2...
Technology page: De-mystifying the technology of emotion...
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Tuesday, February 19, 2008
Positive Results Reported for Deep TMS H System For Depression
Israel's Globes newspaper is reporting that Brainsway Ltd., a company trying to commercialize transcranial magnetic stimulation (TMS) device, is reporting positive outcomes in the first efficacy test on a group of 64 patients with depression. The company believes that these results will allow Brainsway to file for an application for CE Mark from the European Union, and then proceed with similar application with the FDA. We have covered the company's technology about a year ago in this post.
The company thinks that its technology, based on innovative coils, allows deeper brain TMS penetration needed for depression:
Standard TMS coils are limited to activation of only cortical brain regions, up to a depth of about 1.5 cm. Hence when treating depression with a standard TMS system, the limbic system, which is related to mood regulation and is generally deeper than 1.5 cm, is only indirectly affected, through secondary processes involving cortical structures, which are directly activated by TMS and then affect the deeper limbic system structures.
The unique technology of Brainsway Deep TMS System enables direct non-invasive activation of deep brain structures.
Deep TMS is a breakthrough in the search for a non-invasive approach for treating common brain disorders. Deep TMS uses a unique, patented coil design to produce directed electromagnetic fields that can induce excitation or inhibition of neurons deep inside the brain. The treatment is non-invasive, with no significant side effects, no systemic effect (in contrast to drugs), and no need of hospitalization or anesthesia.
Flashbacks: Deep TMS Technology by Brainsway ; Medgadget's transcranial magnetic stimulation archive...
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Friday, February 8, 2008
St. Jude Begins Trial of Deep Brain Stimulation for Depression
St. Jude Medical just received an Investigational Device Exemption (IDE) from the FDA that will allow the company to proceed with an extensive clinical trial of deep brain stimulation for the treatment of depression in patients that have failed other available forms of therapy.
Drs. Mayberg and Lozano conducted the first study of deep brain stimulation (DBS) for depression in Toronto, Canada, in 2003 and published their findings in Neuron in March 2005. As reported in this journal article, imaging studies led them to an area of the brain thought to be involved in depression called Brodmann Area 25. This area appears to become overactive when people are profoundly sad and depressed.St. Jude Medical owns the intellectual property rights and has various patents pending for the use of neurostimulation at Brodmann Area 25. The Libra(R) Deep Brain Stimulation System, which is being evaluated in this study, is designed to deliver mild electrical pulses from a device implanted near the collarbone and connected to small electrical leads placed at specific targets in the brain.
To be eligible for the study, participants must:-- Currently be diagnosed with major depressive disorder
-- Be between 21 and 70 years old, with onset of first episode
before age 45-- Have tried at least four treatments in their current episode,
such as different medications, various combinations of
medications or electroconvulsive therapy-- Have been depressed for at least one year.
Press release: St. Jude Medical Announces Clinical Study of Deep Brain Stimulation for Depression
Study page: BROADEN™ Clinical Study
Flashbacks: Brain Implant Relieves Depression; Deep Brain Stimulation Shows Promise in Treatment of Obsessive Compulsive Disorder
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Thursday, November 29, 2007
"Curb Your Enthusiasm" As Clinical Tool
The New Yorker has a short article on psychiatrists showing television sitcoms to schizophrenic patients, and then discussing with them the awkward social situations that are often displayed. There is some evidence that patients can more easily relate to situations they see on television. David Roberts, a second-year clinical-psychology student at the University of North Carolina at Chapel Hill, was fishing for the finest source of social ineptness available on television, and discovered Larry David's Curb Your Enthusiasm, a show highly admired around here.
From the article:
So Roberts began showing TV clips during therapy sessions. Soon he had narrowed his selections down to one show: television's purest expression of social dysfunction, "Curb Your Enthusiasm." Roberts considers Larry David to be the perfect proxy for a schizophrenic person. "On his way into his dentist's office, he holds the door open for a woman, and, as a result, she's seen first," he said. "He stews, he fumes, he explodes. He's breaking the social rules that folks with schizophrenia often break." He went on, "Or the one where Ted Danson and Mary Steenburgen invite Larry and his wife to a concert: the night arrives, they don't call, Larry assumes they don't like him, then it turns out he got the date wrong. It's a classic example of a major social cognitive error-jumping to conclusions-that schizophrenic patients are prone to." As the patients watched David flub situation after situation, they laughed, and they willingly discussed with Roberts how they might behave in the same circumstances. "That bald man made a mountain out of a molehill!" one woman called out during a session...Larry David, reached on the telephone in California, said that he hadn't realized how deeply the awkwardness on his show would affect people. "It just deals with how you're supposed to behave," he said. "A lot of the time, it's just me expressing myself freely. I knew that my own mental health was problematic, but should I be worried? I mean, I blow up, too! Is this something undiagnosed? Do I need to see a clinical psychologist?"
More in The New Yorker...
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Monday, November 5, 2007
PatchPump™: PCA in a Button
SteadyMed Ltd. is an Israeli startup developing the PatchPump™, a subcutaneous medication delivery button, that the company describes as "light and inexpensive patch-sized miniature infusion pump." What's more is that the device promises to be able to inject both basal rates and user-initiated boluses of meds.
The company says that its PatchPump™ works using a "novel solid-state battery cell which gradually expands in a stable manner under electronic control."
A couple of nuggets about the technology and capabilities of device as provided by the company:
The ECell™ merges the two major components of disposable pumps -- the power source and the motor -- into one simple miniature part, enabling the fabrication of very flat and simple devices.The key advantages of the technology are as follows:
Rock-steady drug-delivery using non-gassing mechanism
Self-powered as battery cell expands as it is depleted
Unaffected by changes in temperature or pressure
Very low cost
Lightweight
No MEMS or other exotic manufacturing technologies required
The expanding battery cell will be produced on a battery production line
SteadyMed's product range enables:
Delivery of basal and bolus combinations as required
A range of drug volumes: 5cc, 3cc, 2cc, 1cc, 0.5cc
Typical operation time 48 hours to 7 days
Penetration methods include SubQ, IV and microneedles
Integration of soft cannula insertion mechanism into the device
No MEMS or other exotic manufacturing technologies required
Varying levels of sophistication of electronic controller, from simple and disposable to re-usable and sophisticated
Videos: How the Patch Works; How the Battery Works
Product page: PatchPump ...
(hat tip: ISRAEL21c)
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Tuesday, August 28, 2007
Virtual Reality for PTSD
The US military is using virtual reality to treat soldiers that suffer from post traumatic stress disorder. The idea is to virtually recreate battlefield situations and let soldiers think about, and deal with, their memories, rather than suppressing them.
So-called exposure therapy, in which patients are asked to confront memories of a trauma by imagining and recounting it in painstaking detail, has long been a first-line psychological treatment for post-traumatic stress disorder. But the bells and whistles of virtual reality may make exposure therapy more effective, said Michael Kramer, a clinical psychologist at the Veterans Administration hospital in Manhattan who is overseeing the introduction of Virtual Iraq there."One of the hallmarks of P.T.S.D. is avoidance," Dr. Kramer said. "Patients spend an awful lot of time and energy trying not to think about it or talk about it. But behaviorally, avoidance is what keeps the trauma alive.
"With virtual reality, we can put them back in the moment. And we can do it in a gradual, controlled way."
Virtual Iraq features two scenarios. In one, patients navigate the streets of a generic Iraqi city, walking past buildings, cars, civilians and markets. With the touch of a therapist's keypad, a little boy might appear on a street corner and wave, apparently in friendship, or a man might stumble down the middle of the street calling for help, a sight that provokes anxiety in some veterans who have come to fear ruses.
In the other scene, veterans ride in a Humvee. Other vehicles might slow down in front of them, and strangers might open fire. Enemy combatants might appear under bridges. Objects dotting the roadside might explode as the Humvee passes.
The patient cannot shoot back at the insurgents and also cannot die or be wounded in the simulation.
More at the New York Times...
Virtual Iraq project page at University of Southern California...
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Friday, August 24, 2007
Virtual Reality for Virtual Unreality
Two scientific teams, from University College London and the Swiss Federal Institute of Technology in Lausanne, managed to recreate the feeling of stepping out of one's body using a virtual reality system.
In Switzerland, Dr. Olaf Blanke, a neuroscientist at the École Polytechnique FÉdÉrale in Lausanne, asked people to don virtual-reality goggles while standing in an empty room. A camera projected an image of each person taken from the back and displayed that image as if it were six feet in front of the subject, who thus saw an illusory image of himself.Then Dr. Blanke stroked each person's back for one minute with a stick while simultaneously projecting the image of the stick onto the illusory body.
When the strokes were synchronous, people reported the sensation of being momentarily within the illusory body. When the strokes were not synchronous, the illusion did not occur.
In another variation, Dr. Blanke projected a "rubber body" - a cheap mannequin bought on eBay and dressed in the same clothes as the subject - into the virtual-reality goggles. With synchronous strokes of the stick, people's sense of self drifted into the mannequin.A separate set of experiments was carried out by Henrik Ehrsson, an assistant professor of neuroscience at the Karolinska Institute in Stockholm.
Last year, when Dr. Ehrsson was "a bored medical student at University College London," he wondered, he said, "what would happen if you 'took' your eyes and moved them to a different part of a room."
"Would you see yourself where your eyes were placed?" he said. "Or from where your body was placed?"
To find out, he asked people to sit in a chair and wear goggles connected to two video cameras placed six feet behind them. The left camera projected to the left eye, the right camera to the right eye. As a result, people saw their own backs from the perspective of a virtual person sitting behind them.
Using two sticks, Dr. Ehrsson stroked each person's chest for two minutes with one stick while moving the second stick just under the camera lenses, as if it were touching the virtual body.
Again, when the stroking was synchronous, people reported the sense of being outside their own bodies, in this case looking at themselves from a distance where their "eyes" were situated.
Then Dr. Ehrsson grabbed a hammer. While people were experiencing the illusion, he pretended to smash the virtual body by waving the hammer just below the cameras. Immediately, the subjects registered a threat response as measured by sensors on their skin. They sweated, and their pulses raced. They also reacted emotionally, as if they were watching themselves get hurt.
Participants in the experiments conducted by Dr. Blanke and Dr. Ehrsson reported having felt a sense of drifting out of their bodies, but not a strong sense of floating or rotating as is common in full-blown out-of-body experiences, the researchers said.
More at the New York Times...
Press release: Out-of-body experiences at UCL ...
Nature has a video...
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Tuesday, August 21, 2007
"Sleights of Mind" at NYT
The New York Times has a fascinating article about the mind's perception of reality, and how magicians and visual artists exploit these characteristics to make us see things we do not.
It was Sunday night on the Las Vegas Strip, where earlier this summer the Association for the Scientific Study of Consciousness was holding its annual meeting at the Imperial Palace Hotel. The organization's last gathering had been in the staid environs of Oxford, but Las Vegas - the city of illusions, where the Statue of Liberty stares past Camelot at the Sphinx - turned out to be the perfect locale. After two days of presentations by scientists and philosophers speculating on how the mind construes, and misconstrues, reality, we were hearing from the pros: James (The Amazing) Randi, Johnny Thompson (The Great Tomsoni), Mac King and Teller - magicians who had intuitively mastered some of the lessons being learned in the laboratory about the limits of cognition and attention."This wasn't just a group of world-class performers," said Susana Martinez-Conde, a scientist at the Barrow Neurological Institute in Phoenix who studies optical illusions and what they say about the brain. "They were hand-picked because of their specific interest in the cognitive principles underlying the magic."
Read on at the NYT...
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Tuesday, August 14, 2007
Aquanauts to the Rescue!
National Space Biomedical Research Institute is sending a team of 'aquanauts' to Aquarius, "the world's only underwater research habitat", 60 feet below the surface around Key Largo, Florida, in order to investigate the efficacy of stress, fatique, and other psychological tests when performed by isolated individuals and teams, like those who go to space.
"The crew takes a three-minute test that measures vigilance, attention and psychomotor speed. We've learned from laboratory experiments that the test is sensitive to fatigue and other factors that impact a person's ability to pay attention to a task and respond quickly," Dinges said [David F. Dinges, Ph.D., team leader of the National Space Biomedical Research Institute's Neurobehavioral and Psychosocial Factors Team -ed]. "The test is taken at least four times a day - on waking, before and after simulated moon walks, dives and habitat experiments, and before bed."The Psychomotor Vigilance Test, or PVT, was developed through Dinges' work with NSBRI, NASA, the Department of Defense and the National Institutes of Health. The user watches for a signal and responds when it appears, allowing the measurement of reaction times.
The crew also wears a wristwatch-sized device, called an Actiwatch®, that measures the sleep and wake cycle. The aquanauts provide saliva at various times each day including when they awake, before and after performing experiments and simulated moon walks, and before going to bed.
"With the saliva samples, we measure cortisol, a hormone that provides information on their stress levels," Dinges said. "Cortisol is normally high in the morning; it's a means of getting you going each day. If we see elevated cortisol after performing a high-level task, it would indicate some type of stress occurred during the activity."
The crew fills out brief questionnaires about how hard they are working, so researchers can get a sense of their physical and mental workload. Another questionnaire focuses on mood and interpersonal interactions between the crew as well as with mission control personnel.
More from NSBRI...
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Tuesday, June 12, 2007
Bedside Test Accurately Predicts 6 Year Risk of Dementia
The Mini Mental Status Exam (MMSE) and the Saint Louis University Mental Status Examination (SLUMS) are excellent screening tools for patients with a likely diagnosis of dementia. However, doctors have been unable to accurately identify those patients who are at risk of cognitive decline in the near future. Apparently, that has just changed thanks to researchers at the San Francisco VA Medical Center who have developed a simple bed side test with an amazing 88% accuracy.
The test, developed in the study by the researchers, is a 14-point index combining medical history, cognitive testing, and physical examination. It requires no special equipment and can be given in a clinical setting such as a doctor's office or at a patient's bedside.The new index is the "bedside" version of a longer, more technically comprehensive "best" test, also developed during the study, that is 88 percent accurate.
These are the first tools to accurately predict dementia, according to lead author Deborah E. Barnes, PhD, a mental health researcher at SFVAMC. Barnes described the tests in a presentation at the 2007 International Conference on Prevention of Dementia, in Washington, DC, sponsored by the Alzheimer's Association.
As measured by the "bedside" index, the risk factors for developing dementia are an age of 70 or older, poor scores on two simple cognitive tests, slow physical functioning on everyday tasks such as buttoning a shirt or walking 15 feet, a history of coronary artery bypass surgery, a body mass index of less than 18, and current non-consumption of alcohol.
To develop the tests, the study authors tracked a broad range of physical, mental, demographic and other variables for six years among 3,375 participants in the Cardiovascular Health Cognition Study, a national prospective study sponsored by the National Heart, Lung, and Blood Institute (NHLBI).
UCSF press release: Simple test predicts six-year risk of dementia
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Monday, June 4, 2007
Digital Strait Jacket Helps Diagnose Mental Disorders
In the old days, straight jackets were only used to restrain psych patients, but thanks to researchers at the University of California, they may now be used to identify unique behavior patterns for more accurate diagnosis.
Researchers at the University of California, San Diego (UCSD), are using a novel device to study the behavior of patients with mental illnesses, such as bipolar disorder and schizophrenia. The device, called a behavioral-pattern monitor, combines a computerized vest, worn by the patient, and a video camera, embedded in the ceiling. Monitoring the patient with this technology could enable researchers to more accurately diagnose disorders and test the effectiveness of treatments."When patients with bipolar disorder and schizophrenia are very symptomatic and psychotic, they often look very similar, and this makes it hard to discern one population from the other," says William Perry, a professor of psychiatry at UCSD and the lead investigator in the study, whose preliminary results reveal very distinct patterns of activity among patients within these two patient groups. The study uses the behavioral-pattern monitor and is being funded by the National Institute of Mental Health. "By analyzing these unique signature patterns, we hope to learn about the brain functioning in psychotic individuals in ways that current observation methods cannot."
Researchers at UCSD will be tracking and evaluating the movement patterns of patients wearing a computerized vest, called the LifeShirt, developed by Vivometrics, a company based in Ventura, CA. Part of the behavioral-pattern monitor, the vest is embedded with sensors that measure the physiological responses of patients as they explore a novel environment, in this case a room containing different objects but no chairs. The vest is also equipped with an accelerometer that measures the G forces applied to it. The accelerometer is of particular importance to the UCSD researchers because it enables them to measure how these patients are interacting with their environment--are they walking, moving quickly, standing still, or fidgeting?--and it creates a signature of their activity.
Perry says that if the appropriate behavioral signatures can be distinguished, the system could be used by drug companies to test the effectiveness of some medications. But the UCSD system is challenging because it makes the assumption that body movements are in perfect synchrony with the brain. This is sometimes true, but not always, says Tamminga.
Perry's ultimate goal: "We want someone to come into a room and spend 15 minutes, and based on the analysis, we can say the probability of this person having an attentional disorder or schizophrenia is quite high."
With the inherent difficulty of accurately diagnosing psychiatric disorders, we gladly welcome any device that may improve this process.
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Wednesday, May 30, 2007
Transforming the Psychiatrist's Office
MIT Tech Review has an interesting article on where everyone's favorite specialty is headed in the future. The article features technologies that are well known around here: Neurostar System by Neuronetics, a transcranial magnetic stimulation device, and Aspect Medical Systems' BIS Monitor, that is undergoing a clinical trial to determine the device's efficacy in detecting antidepressant response.
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» Experience Schizophrenia with Virtual Hallucinating Goggles (May 22, 2007)
» 'Virtual Iraq' to Study, Treat Post-Traumatic Stress Disorder (May 17, 2007)
» Depressed? Try Surfing the Internet (April 12, 2007)
» Call a Name for Autistic Child's Sake (April 5, 2007)
» Technology Used to Measure Empathy (March 19, 2007)
» Virtual Reality Game Links Depression to Hippocampus (March 5, 2007)
» LINKX Links Play and Language for Autistic Children (February 27, 2007)
» New Video Games Aim at Improving Mental Health (February 8, 2007)
» Deep TMS Technology by Brainsway (January 5, 2007)
» The Sun Will Come Out... NOW. (January 5, 2007)
» Virtual Reality Helps Young Burn Patients (January 4, 2007)
» Primetime Basic Instincts: Milgram Experiment on TV (Janu