Friday, May 31, 2019

What is the best thing to do if diagnosed with dementia?


Sort out plans for your future i.e. lasting power of attorney

·         See you’re GP and if you haven’t been referred to a memory clinic then ensure that you are as they can help support you and those close to you. They can also try to identify what type of dementia and make sure it’s not another illness mimicking dementia
·         At the memory clinic you may be considered for medications - take expert advice as there are side effects and these may cancel out the benefits
·         Smoking cessation and good treatment of BP and other health issues
·         Financial: How do you wish your finances to be managed when unable to make decisions for yourself
·         Health: How do you wish to be cared for when you are unable to make decisions for yourself? Talk about resuscitation and care at the end of life if this is something that you wish to do.
·         Make a will with a solicitor
·         See everyone important to you
·         Get on with life and do as much to add value and pleasure to every day
·         If it suits move into accommodation that you like and is well supported where you will be able to stay - an apartment is better than a large rambling house       

Reference: Declan O'Kane,

Thursday, May 30, 2019

What is the scariest thing for Neuro surgeon?


Many actually …
·         Uncontrollable bleeding from the brain
·         Uncontrollable brain bulge
·         Wound infection after surgery
·         Fluctuating BP post blood clot evacuation from brain
·         Engaging in a difficult conversation with a mob of patient relatives at 2 in the morning after the patient got drunk and sustained a motor vehicle accident.
·         Explaining a patient relative that their kin may not ever come back from coma and they need to decide on pulling the plug.
·         Convincing a patient or kin to consider surgery in emergency situations as any delay might be life threatening.
·         Convincing an anaesthetist that the patient needs to be taken for surgery at earliest even without all the investigations as time cannot be lost moving the patient around the hospitals to get them done.
·         Etc…
However if you ask me to pick one, I would pick the bleeding part though. Nothing is scarier than seeing the brain bleed beyond control.


Reference: Kesha Megharaj

Wednesday, May 29, 2019

What happens when the frontal lobes of the brain are overactive and a person has to much inhibition? What kind of mental disorders does this cause?


The idea that mental functions are localized in a specific region of the brain is false for higher functions. The highest hierarchical controls are provided by extensive networks across the entire brain.
There is also no pathological hyperactivity of these networks, except in the case of epileptic seizures. Let's talk about hyper connectivity of the control networks, which involves them in most mental matters.

This hyper connectivity does not correspond to an inhibition. The control exerted in particular by the prefrontal regions is an evaluation and not an inhibition. Inhibition comes from the conflict between contradictory mental representations, which is sterile precisely because of the lack of evaluation. Most inhibitions come from poorly managed emotions and impulses, not from excessive control by consciousness. What is prohibited consciously is not an inhibition. The reasons are understood. To feel inhibited in one's desires is not to have appropriated the assessments made by one's own self-consciousness.
 Reference: Jean-Pierre Legros

Tuesday, May 28, 2019

What are proven facts about Parkinson's disease and stem cell treatment?


There are a lot of myths towards Parkinson’s disease but here are some clearly stated facts.
1. Parkinson's disease is not just an ''old person's disease. “Parkinson’s disease isn't just marked by tremors and other outward symptoms Diagnosing Parkinson's disease isn't simple.
Treatment should be tailored to your symptoms and your preferences. Exercises & healthy lifestyle can help you take better control of your life Stress can make the condition worse; telling people about the condition can ease it. Depression may affect more than half of all patients, and anxiety affects about 40 percent
2. Treatment is available to take care of most of the symptoms of Parkinson’s disease
3. Some treatment options such as Deep Brain Stimulation has shown significant results in patients
 Reference: Avik Sharma

Monday, May 27, 2019

How many layers of neurons are in the cortex of the human brain?


Officially there are 6 layers in the cortex, but this layering is somewhat arbitrary, and layer “1” contains almost no neurons.
Here is an idealized cross-section of the cortex showing the layering:

 In the visual cortex, layer 4 is subdivided into 4A, 4B, and 4C; and layer 4C is further subdivided into 4Cα and 4Cβ.
In truth, there are 20 or more distinct neuron types organized into a complex multi-layer circuit that repeats across the surface of the cortex. It is the horizontally repeating pattern of the circuit in all directions that creates the layered appearance under a microscope. But what is important is the circuit structure and not the layers per se.
Unfortunately the circuit has not yet been fully reverse-engineered or decoded. Hopefully that will happen in our lifetime.

 Reference: Paul King

Saturday, May 25, 2019

What is the best treatment for dementia? Is it curable?

Dementia is a set of symptoms, not a specific disorder per se. There are many disorders that can cause dementia symptoms, and quite a few of those are treatable or even curable. You need to consult with a qualified doctor to diagnose the disorder causing your symptoms, and identify the appropriate treatments.

If, however, you are asking about Alzheimer’s, which is the most common cause of a neurodegenerative, progressive dementia … no, no treatment has been shown to cure Alzheimer’s or even slow down its progression. There are some treatments that can, in some patients, improve certain aspects of cognitive function even while the brain continues to deteriorate. There are also treatments for certain symptoms associated with Alzheimer’s — for example, the so-called “behavioural and psychological symptoms of dementia (BPSD)” — that may, hopefully, improve quality of life for the patients and/or their caregivers.
If you see articles or blogs about treatments that cure Alzheimer’s, somebody is severely misinformed … or a scam artist.
Reference: Sunny Smith

Friday, May 24, 2019

Neurologically, how different is a happy brain from a sad brain?


Happiness and sadness are emotions, which are states. Although there may be structural differences in a person who is depressed (more prone to be in a “sad state”) versus a brain who has a more balanced tendency to exist in a state (a euthymic person), only functional neuroimaging can be used to study differences in brains between a “happy” and a “sad state. This is challenging, as happiness and sadness are emotions that are subjective, and inducing emotions in the setting of an MRI or PET is also difficult. Furthermore fMRI and PET scans measure metabolic changes in brain regions, meaning that they only demonstrate changes in the time frame of seconds to minutes after a state is induced. Now to the neuroscience of emotion.
Attempts to localize happiness or sadness to activity in certain brain regions has been more or less futile. This is because emotions involve complex circuitry, and many overlapping regions are activated in emotional processing. Furthermore, the method of emotional induction can cause differing regional changes. For example, if the method of inducing happiness is having a person reminisce about a happy time, temporal or hippocampal regions may be more involved, while viewing emotionally charged stimuli may involve visual cortices to a larger extent.
One ALE meta-analysis observed increased activity in the superior temporal gyrus in happiness (versus neutral emotional stimuli) and increased medial frontal gyrus activity in sadness. Another meta-analysis observed no difference between happiness and sadness, and found them both to activate the ACC and areas of the prefrontal cortex. This is likely because they are both involved in emotional processing. Another Meta analysis reported increased activity of the subcallosal cingulate cortex in sadness, versus increased activity in the basal ganglia in happiness. Other studies have utilized different emotional models compared to the traditional classification of “happiness” and “sadness”, instead comparing things like general emotional valence, or approach emotions vs retreat emotions. Complex multiaxis models of emotions have been used, and classification of emotional systems have also been used, which puts into perspective the complexity of affective neuroscience.
From a pharmacological point, euphoria, which is in a sense pure happiness, can be induced by opioids or high doses of psychostimulants. Reward can also be mediated by physical stimulation of the NAcc. Following this logic, the euphoria of cocaine has been associated with decreased BOLD of the NAcc (possibly representing a metabolic change associated with opioid release, not inactivation). If we view sadness through the lens of depression, which would be a longer term more intense version of normal everyday sadness, then sadness involves increased activity of the anterior cingulate cortex, with decreased activity of the striatum and dorsolateral prefrontal cortex. However, these differences may just represent emotional biases that lead to depression, and therefore is not a great guide to what a non-pathologically sad brain looks like.
So in summary, it is difficult to determine or localize sadness or happiness, given current methodological limitations, as well as the possible poor classifications of “happiness” and “sadness”. However, from Phan et al, the knowledge of the association between the NAcc (a region of the striatum) and reward, and the studies of depression, it can be inferred that sadness involves increaed activity in the anterior cingulate, and happiness involves increased activity of the striatum. Chemically, the reward elicited by drugs correlates not with dopamine release, but with the opioid release in the NAcc elicited by said drug. So chemically, happiness would be represented by increased NAcc opioid release, and sadness by the opposite. So in short
·         Happiness=Striatum-increased activity, NAcc-increased endogenous opioid release
·         Sadness=Anterior Cingulate Cortex-increased activity, NAcc-decreased endogenous opioid release

Reference: Alexander Saytsev

Thursday, May 23, 2019

What are some of the most unusual brains?


The Brain of Phineas Gage.
In case you're not familiar with Gage, he has one of the most shocking incidents I've ever read about it when it comes to brains. His story goes like this:
In 1848, Gage was a foreman of crew cutting a railroad. He used an iron to pack explosive powder into a hole, but as he turned his back the powder suddenly exploded, propelling the tamping iron through his head. The tamping iron was 48 inches long, 1.25 inches in diameter, and weighed about 14 pounds. It went through his left cheek, then his brain, and exited the other way. When his crew went to check on him he suddenly got up, without seeming to realize there was a hole through his head. According to the doctor who treated him, Martyn Harlow, you could see into his head. Literally. He was treated, and returned home 10 weeks later. He claimed he never lost consciousness throughout the entire event.
However, the iron had brought unforeseen results. His personality completely changed. He was suddenly capricious, lacked money sense, and became "fitful and irreverent, indulging at times in the grossest profanity."
So yeah. My opinion of the weirdest brain. Wasn't born like this, but an incredible event culminated in one of the most incredible brains.

Phineas Gage and the Iron that went through his head.

 Reference: Bryce Cai

Wednesday, May 22, 2019

What are some tips for visiting someone with Alzheimer’s?

1.       Never treat them or speak to them like children!!
2.   You go into their room and enter “their world,” don’t force them into reality! If it’s spring, and you’re swinging at the park - be there. Don’t do the ridiculous and remind them that they’re in a nursing home and need to “snap out of it.”
3.   Always ask if they’re thirsty or hungry. If they say yes, let us know, we’ll get them a snack.
4.    Talk to them as you did before they got sick. Catch up. They may not understand at that moment, but I’ll often hear them chatting about their “granddaughters having a sleepover, and they’d have loved to see it…” hours after you’ve left.
5.  If you have the ability, print out 3–4 photos that they might remember. Make them photos in their early middle ages (35–45)ish. A car, a foursome of them and their two best friends, their church!!!
6.   Never purchase them anything of value. Their bedroom is their bedroom, the room next door may very well be “their” dining room, so they take things from room to room. Everyone shares, nobody minds because nothing is valuable.
7.   Adding to the above … if mom/dad’s jewelry is significantly important to them, buy replicas that cost little. As we age, (most often) our fingers grow thinner. Rings fall off and go right down drains in the shower while soapy and wet. If their wedding rings are an heirloom you want to keep - exchange them! Please do this! I’ve seen jewelry go down drains…after begging a daughter to replace them a dozen times! We are always accused of stealing them. This actually happened to my grandmother in 1975, but her ring size was a 2! She was an itty bitty thing. I was promised those diamonds when I turned 16, they were lost when I was 10 and I lost her when I was 11. My step-mom didn’t like her much (because she always reminded her of his kind my mom was to her and her child(ten). In any case, my step mom, in spite, gave away everything! All of her needlework, crocheted afghans… should be -50 to -70 windchill tomorrow morning!! Could break the coldest day ever recorded in my city - I’d love to snuggle under several of those afghans tomorrow with a cup or two of cocoa. Sorry! I digress. Just sayin’ these things DO happen! And moms with dementia have NEVER noticed!! And those without dementia and going to a nursing home because they want that - have chosen to be safe than sorry! You might think the ring is snug, but 1 illness can change all of that. They’d much rather have their jewels given to those they’d be willed to now.
8.    If you buy them ANY clothing - please put their name on the tags! We’ve talked often about overworked and underpaid…sometimes, we end up with stacks of clothes in bags with names, but we never find the time to label each piece. Their kids get hopping mad when they see their roommate in their mom’s sweater. Ugh!! Please! For the Love of us, do this simple favor.
9.   If your loved one has a depression issue because no one visits which we KNOW is untrue, but they don’t believe us… but a blank book - everyone who comes and goes can leave a note of sweetness with a date. This can be helpful if we nip it in the bud.
10. Should you see something “odd,” please inform us immediately!! Someone could be changing clothes in the kitchen, getting into the shower in a closet, someone is throwing things in their room, emptying of closets is big (“going home from the hospital today,” is quite common - just let us know.
11. Safety safety safety!!! Think before doing, and ask before changing something. That one change could cause fits that take us a week to undo.
12. Don’t redecorate without approval. Bedspreads can’t be slick, maintenance has to check anything with a plug or battery before use. Even a fan. Again, safety safety!
13.  If there’s a sign in book at the door, SIGN IN! This isn’t kept nor recorded anywhere - nor is it ever even looked at again. BUT, should their be an emergency in the facility - THIS is how we’ll know you’re here! The Fire/Police Depts will be looking for you as well as all residents = don’t forget to sign OUT, so we are not wasting time. If you do forget, please call us and let us know you’ve left the bldg. :)
14.  Bring them a box of their favorite candy, cookies - DONT go overboard! Most places don’t have much storage, AND tell us there there, so we remember to give them a few cookies every few days…
15.  Turn on their favorite tv show, and do tell us they’ve watched “Jeopardy” every M-F since 1968… we will turn it on for them regularly. If you’re a friend, it may be a show his/her kids were unaware of. If he/she has been a Chicago Cub fan since childhood - let us KNOW! We’ll turn on the games, especially if you hang a Cub calendar (those little fold up cards that fit in every wallet from every gas station :) The more we know, the easier it is for us to make any issue calmer… or just the girls having coffee in the morning. STORY: One of my residents came to sit with me, with 3 others every morning at 5am to drink coffee - I’d do my paperwork while they chatted. I butted in now n then, so they knew I was part of the group… all 4 drank black coffee. One morning, I’d forgotten my travel mug with a lid, so my coffee was exposed. One noticed that my coffee was light brown. She said with glee, “I haven’t had that “good” coffee in years!” She went on to tell us, as a treat, she’d sprinkle a few Cheerios on top, I added cream n sugar to a new cup and brought her an individual sized serving box of Cheerios, opened…she put in about 10, and thoroughly enjoyed that cup of coffee!!! I phoned her son when the real workday began, and I asked him. I should have waited until after work. He burst into tears over the phone cuz his mom remembered something!! A fond childhood memory - him and his brother were tossing Cheerios into the air to see if the other could catch it in their mouth (like kids do…) she pretended not to notice the few that landed in her coffee. The sons thought they’d be stopped from their game. She just crunched a Cheerio, said, “mmm, pretty tasty!” Everyone laughed, and she continued to add them to her coffee after that. Well, “when they had Cheerios and not Corn Flakes,” he said… “the Corn Flakes turned to mush too quickly.” He never forgot that I was able to draw such an odd memory from his mom, and he mentioned it every time I saw him since. He sent accolades to my boss, my bosses boss, the owner of the company (he owns about 200 nursing homes). I got a raise and a promotion (not really, just a nicer title, but extra $ is always grand - all because I forgot my travel mug which I used to keep from spilling and to use a straw - keeps the lipstick in place ;-) THE END.
16. I digress. Forgive me. Little miracles like that story made my job so enjoyable, knowing there’d be 25 emergencies that had to have attention…those little moments of recognition made us all dance through the day.

          Reference: Robin Rae

Tuesday, May 21, 2019

How do jellyfish respond to stimuli in their environment if they don’t have a brain and central nervous system?


Even though jellyfish lack a central nervous system (CNS), that doesn’t mean they completely lack neural tissue.
Jellyfish, and many other cnidarians, have what is known as a neural net. Imagine instead of a centralized brain, the “brain” of the jellyfish is spread throughout its entire body. Even in an animal as “simple” as a jellyfish, there are different types neurons with various specializations.
Jellyfish are able to come in contact with something in their environment, and use their sensory receptors to “feel” the physical contact, and use their motor neurons to move, just like many other animals.
In fact, scientists who actually study jellyfish have demonstrated that the jellyfish’s nervous system is more than just a neural net, and there are certain ganglia diffused throughout the entire body where information can be processed.
 Reference: Kathryn Elle

Monday, May 20, 2019

How is pain treated in Parkinson’s disease?


Parkinson’s patients tend to experience stiffness in muscles and joints which lead to difficulty in walking and maintaining a balanced posture. Since the muscles tend to get rigid, it causes pain. Also, they find it difficult to complete their daily tasks and require help. This is because the hand movement becomes slow and it causes pain while using it actively. In such cases, physical therapy, occupational therapy and yoga can help a great deal.

Physical Therapy
According to a study by North-western University and Rehabilitation Institute of Chicago, 2.5 hours of exercise a week may help PD patients improve their mobility impairment and enhance their quality of life. Exercising reduces the slowness movement (Bradykinesia), pain and weakness from the body.
Occupational Therapy
Exercises pertaining to arm and hand therapy, handwriting aids, manual or electric wheelchair, grooming and dressing aids can help PD patients loosen up their muscles and reduce the severity of pain. Also, this therapy helps in assisting PD fighters to complete their daily task.
Yoga and Meditation
The benefits of yoga and meditation are known to many around the world. It helps in reducing stress and anxiety levels. To treat pain in Parkinson’s, asanas like Downward-facing Dog (Adho Mukha Svanasana) can help in reducing back pain as it helps in stretching and calming the muscles. One can also try Pranayama and Hatha Yoga as these yoga techniques help in making the joints and muscles flexible.
Reference: Manoj Agarwala

Saturday, May 18, 2019

What are the best treatments for Multiple Sclerosis?



Multiple Sclerosis (MS) is a disabling disease in which brain and spinal cord (central nervous system) are potentially damaged.
Basically, the immune system attacks the protective sheath that covers nerve fibres and develops communication problems between your brain and the rest of the body.
Eventually, this causes physical, mental and sometimes, psychiatric problems that are concluded as the signs and symptoms of MS. Though, it also depends on the amount of nerve damage. Hence, the person loses the ability to walk independently.
Other symptoms are as follows:
1.       Weakness in one or more limbs
2.      Painful eye movement, partial or complete loss of vision - Vision problems
3.      Fatigue
4.      Dizziness
5.      Chronic pain
6.      Problems with speech or swallowing
Treatment
There is no particular cure for MS. The treatment mainly focuses on speedy recovery from attacks, slowing down the progression of MS and trying to lessen the impact of MS symptoms. In some cases, MS is quite mild that treatment isn’t possible.
Multiple Treatments
1.       Corticosteroids such as oral prednisone and intravenous methylprednisolone, are prescribed to relief the inflamed areas of the body and reduces swelling, itching, redness and other allergic diseases. Though one could suffer insomnia, fluctuation in blood pressure, and mood swings.
2.      Plasma exchange (plasmapheresis) in this procedure, the liquid part of the blood is removed and separated from your blood cells. These blood cells are then mixed with a protein solution, albumin and put back in the body. This treatment could make a positive impact if you are a sufferer just a few days back.
Ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy for primary-progressive MS. This antibiotic slowdowns the worsening condition of the patient, though doesn’t cure fully.
Other Treatments
1.       Physical Therapy: In this procedure, a physical therapist helps the patient in stretching exercises that should be done on daily basis. It aids in managing leg numbness or weakness.
2.      Muscle Relaxtants: As you may experience stiffness in your legs. In this case, you may be prescribed to have baclofen (Lioresal) and tizanidine (Zanaflex).
3.      Other Medications: You are also prescribed medicines that may reduce fatigue to some extent, for depression, pain, bowel control problems or sexual dysfunction, associated with MS.
Change in Life-style
Like every other disease, you must follow a good lifestyle in MS as well.
1.       You are advised to get proper rest.
2.      Regular exercise helps improve your strength, coordination, muscle tone. Swimming could be a good option as well.
3.      Its symptoms could make you short-tempered. You should avoid exposure to sun, heat and use cooling devices such as cooling scarves, etc.
4.      Follow a regular balanced diet low in saturated fats and high in omega-3 fatty acids.
Reference: Komal Khera