Monday, November 24, 2014

Brain's dementia weak spot identified

from bbc




Conceptual computer artwork depicting neurology. From left to right: MRI brain scans, 3D dsi white matter brain scan, brain, Alzheimer's brain versus normal brain, MRI brain scan

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The brain has a weak spot for Alzheimer's disease and schizophrenia, according to UK scientists who have pinpointed the region using scans.
The brain area involved develops late in adolescence and degenerates early during ageing.
At the moment, it is difficult for doctors to predict which people might develop either condition.
The findings, in the journal PNAS, hint at a potential way to diagnose those at risk earlier, experts say.
Although they caution that "much more research is needed into how to bring these exciting discoveries into the clinic".

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Early doctors called schizophrenia 'premature dementia' but until now we had no clear evidence that the same parts of the brain might be associated with two such different diseases”
Prof Hugh Perry of the MRC
Weak spot
The Medical Research Council team who carried out the study did MRI brain scans on 484 healthy volunteers aged between eight and 85 years.
They looked at how the brain naturally changes as people age.
The images revealed a common pattern - the parts of the brain that were the last to develop were also the first to show signs of age-related decline.
These brain regions - a network of nerve cells or grey matter - co-ordinate "high order" information coming from the different senses, such as sight and sound.
When the researchers looked at scans of patients with Alzheimer's disease and scans of patients with schizophrenia they found the same brain regions were affected.
The findings fit with what other experts have suspected - that although distinct, Alzheimer's and schizophrenia are linked.
Prof Hugh Perry of the MRC said: "Early doctors called schizophrenia 'premature dementia' but until now we had no clear evidence that the same parts of the brain might be associated with two such different diseases. This large-scale and detailed study provides an important, and previously missing, link between development, ageing and disease processes in the brain.
"It raises important issues about possible genetic and environmental factors that may occur in early life and then have lifelong consequences. The more we can find out about these very difficult disorders, the closer we will come to helping sufferers and their families."
Dr Michael Bloomfield of University College London said: "Schizophrenia can be potentially devastating but at the moment it's very difficult to predict with certainty who is going to have a good prognosis and who might have a poor one.
"This study brings us a step closer to being able to make this prediction, so patients could in the future receive better targeted treatments."
Armed with this new knowledge, it may also be possible to understand how to prevent the brain changes before they occur, he said

Friday, November 21, 2014

Stanford anesthesiologist explores consciousness – and unconsciousness

from stanford.edu


Stanford anesthesiologist explores consciousness – and unconsciousness


Stanford anesthesiologist explores consciousness - and unconsciousness
face-275015_1280Anesthesiologist Divya Chander, MD, PhD, is one of a leading group of neuroscientists and anesthesiologists who are using high-tech monitoring equipment in the operating room to explore the nature of consciousness – which isn’t quite as simple as on or off, asleep or awake.
Stanford Medicine magazine profiled Chander’s work last summer, but I came across it when the title of one of Chander’s recently published papers grabbed my eye: “Electroencephalographic Variation During End Maintenance and Emergence from Surgical Anesthesia.” Okay, that might not pique your curiosity, but when I spotted the words, “for the first time” in the abstract I was hooked. I read on to learn that Chander and her team attach electrodes to the foreheads of patients during surgery, measuring the brain’s electrical signals.
After a bit of scrambling you might expect when trying to get in touch with someone who spends her days in the operating room, I managed to reach Chander on the phone. Our conversation strayed far from the bounds of her paper:
In this work, what did you do for the first time?
It’s not that no one has ever used an EEG during anesthesia. During the middle of the 20th century, several anesthesiologists attempted to record brain activity under increasing levels of anesthesia, just as many neuroscientists were using the EEG to characterize the stages of sleep. The process of recording EEG was really cumbersome back then, unlike today when you can stick a frontal set of leads on a patient’s forehead in the OR in a matter of seconds. Certain general stages of anesthesia were identified, but a formalized staging nomenclature, based on the relative contribution of dominant slow-wave oscillations in the EEG, had never been defined. Non-REM (slow-wave) and REM (rapid eye movement sleep) were staged in this way by sleep neurobiologists, but not anesthesiologists. In our study, we built upon the sleep stage classification system, to define maintenance patterns of general anesthesia. The formalized nomenclature helps us examine the stages of unconsciousness under anesthesia and communicate with other anesthesiologists.
What did you find?
We recorded the frontal EEGs (from the forehead) of 100 patients undergoing routine orthopedic surgeries. We discovered four primary electrical patterns that patients exhibit when they’re unconscious, and also as they’re waking up from anesthesia. The unconscious patterns show variety – not all patients’ brains look the same under anesthesia, despite similar drug exposure, meaning there are ‘neural phenotypes,’ or patterns of neuronal activity. The emergence patterns from anesthesia (pathways people’s brains take to reestablish conscious awareness after the anesthetic is turned off) bear some similarity to those pathways traversed when people are awakening from sleep.
When wakening from anesthesia, some people spend a relatively long time in non slow-wave anesthesia, which is similar to REM, the stage of sleep where dreams occur that usually precedes awakening. Others go straight from deep anesthesia, what we call slow-wave anesthesia (because of its dominant EEG patterns) to awakening. Interestingly, these patients were more likely to experience post-surgical pain, a situation akin to awakening from a deep sleep and experiencing confusion or discomfort; some childhood parasomnias like sleep terrors are characterized by moving abruptly from slow wave sleep to waking.
We began to see some tantalizing suggestions certain patterns of wake-ups from anesthesia might be more preferable. Could paying attention to these emergence trajectories prevent some problematic complications, like post-operative cognitive dysfunction? Could we ‘engineer’ or optimize anesthetic delivery to favor certain types of maintenance and emergence patterns? Can we monitor these patterns in a way that makes delivering anesthesia safer? Recognizing the variety of maintenance and emergence patterns under anesthesia also opens an entirely new possibility in the field of personalized medicine – imagine tailoring anesthetics to a person’s genome? I am trying to develop an initiative that addresses this in collaboration with Stanford’s new GenePool Biobank program.

Did the type of drug given to patients affect what you saw?
All of these patients were on the same drug – a commonly used volatile (or gas) anesthetic called sevoflurane. That brings up something very interesting: The anesthetic drugs we use, even when chemically or structurally related (e.g. sevoflurane and isoflurane), may bind to similar receptors but in different neural network distributions. Some of our other anesthetics, like ketamine, work at different receptors entirely. Yet somehow, through some combination of these drugs, we are still able to make people unconscious, we are able to remove their degree of connectedness to the external world to the point they can tolerate really noxious stimuli, like cutting into them with a scalpel, without awareness of what is happening to them.
The Holy Grail for me would be to find a way to dynamically characterize EEG states in way that is drug-independent. This would allow anesthesiologists to potentially gauge depth of unconsciousness without worrying about how some drugs differentially affect different EEG frequencies.
Why doesn’t everyone use EEGsWhat do they tell you?
All that we’re doing is measuring cortical cells at the very surface of the brain and their electrical activity, which indirectly reflects what happens much, much deeper in the brain. The really cool thing is it’s actually telling us something about the neural networks that serve to maintain or transition between different levels of consciousness.
Unfortunately, interpreting a raw EEG can take a bit of training. Anesthesiologists already have to process so much data to keep their patients alive and safe. Every second, they monitor the patient’s heart rate, blood pressure, oxygen saturation, carbon dioxide, temperature and many other variables.
Some companies have developed frontal (forehead) EEG leads that are analyzed through algorithims, that collapse the complexity of the EEG into a single number. Unfortunately, calculating those numbers has a time delay of up to 1.5 minutes – useless for making clinical decisions, and too slow for preventing things like a patient gaining awareness during an operation or unintentionally waking up. I’m working with other researchers to find algorithms that work more dynamically to improve processing time, down to five seconds – within the reaction time of a clinical decision maker. One-and-a-half minutes is too slow.
Do you consider yourself conscious when you’re dreaming?
Yes, I think so.
If I looked at the activity in your brain during REM sleep, it would look very similar to your awake brain. But when you’re dreaming, you’re paralyzed. You can’t tell me what’s going on, and you can’t respond to the external world.
So do you have to respond to the external world in a way that I can measure it to be conscious? What if you are in a ‘coma,’ but can respond to requests to visualize things? Are you conscious? What if you can’t move to communicate with me, as in locked-in syndrome? Does that make you unconscious? There are many states we define as lacking conscious awareness in which the brain may still be active in a way that reflects conscious processing. We have to come up with new ways to conceptualize and measure consciousness.
You’re also an instructor here. What do you hope to pass on to your students?
Anesthesia is just so satisfying, so exciting. We’re peering into this privileged, special place to understand what it means to be conscious or unconscious.
Anesthesia is a real art. You want to keep the patient just deep enough, but not so deep that you delay emergence, or they don’t wake up as they were before. The central nervous system is the primary target of our anesthetics; I want the students to understand that monitoring the brain is vitally important to bringing patients safely through anesthetics. Once upon a time we didn’t have pulse oximeters and capnography; now we couldn’t imagine doing anesthesia without these monitors.
Previously: Exploring the conscious (and unconscious) brain in everyday lifeAdvances in anesthesia make it possible for patients to remain awake and watch TV during surgery and Animal study shows sleeping brain behaves as if it’s remembering
Image by DrSJS
- See more at: http://scopeblog.stanford.edu/2014/11/19/stanford-anesthesiologist-explores-what-it-means-to-be-conscious-or-unconscious/#sthash.vevENI8R.dpuf


Saturday, November 15, 2014

Can Money Buy You Happiness?

from wsj



It’s True to Some Extent. But Chances Are You’re not Getting the Most Bang for Your Buck.


New research is suggesting that happiness is determined not by how much money one earns, but rather, how one spends it. University of British Columbia associate professor Elizabeth Dunn explains why. Photo: Getty.

It’s an age-old question: Can money buy happiness?

Over the past few years, new research has given us a much deeper understanding of the relationship between what we earn and how we feel. Economists have been scrutinizing the links between income and happiness across nations, and psychologists have probed individuals to find out what really makes us tick when it comes to cash.
The results, at first glance, may seem a bit obvious: Yes, people with higher incomes are, broadly speaking, happier than those who struggle to get by.
But dig a little deeper into the findings, and they get a lot more surprising—and a lot more useful.
In short, this latest research suggests, wealth alone doesn’t provide any guarantee of a good life. What matters a lot more than a big income is howpeople spend it. For instance, giving money away makes people a lot happier than lavishing it on themselves. And when they do spend money on themselves, people are a lot happier when they use it for experiences like travel than for material goods.
With that in mind, here’s what the latest research says about how people can make smarter use of their dollars and maximize their happiness.
Experiences Are Worth More Than You Think
Ryan Howell was bothered by a conundrum. Numerous studies conducted over the past 10 years have shown that life experiences give us more lasting pleasure than material things, and yet people still often deny themselves experiences and prioritize buying material goods.
So, Prof. Howell, associate professor of psychology at San Francisco State University, decided to look at what’s going on. In a study published earlier this year, he found that people think material purchases offer better value for the money because experiences are fleeting, and material goods last longer. So, although they’ll occasionally splurge on a big vacation or concert tickets, when they’re in more money-conscious mode, they stick to material goods.
But in fact, Prof. Howell found that when people looked back at their purchases, they realized that experiences actually provided better value.
“What we find is that there’s this huge misforecast,” he says. “People think that experiences are only going to provide temporary happiness, but they actually provide both more happiness and more lasting value.” And yet we still keep on buying material things, he says, because they’re tangible and we think we can keep on using them.
Cornell University psychology professor Thomas Gilovich has reached similar conclusions. “People often make a rational calculation: I have a limited amount of money, and I can either go there, or I can have this,” he says. “If I go there, it’ll be great, but it’ll be done in no time. If I buy this thing, at least I’ll always have it. That is factually true, but not psychologically true. We adapt to our material goods.”
ENLARGE
It’s this process of “hedonic adaptation” that makes it so hard to buy happiness through material purchases. The new dress or the fancy car provides a brief thrill, but we soon come to take it for granted.
Experiences, on the other hand, tend to meet more of our underlying psychological needs, says Prof. Gilovich. They’re often shared with other people, giving us a greater sense of connection, and they form a bigger part of our sense of identity. If you’ve climbed in the Himalayas, that’s something you’ll always remember and talk about, long after all your favorite gadgets have gone to the landfill.
And, crucially, we tend not to compare our experiences with other people so much. “Keeping up with the Joneses is much more prominent for material things than for experiential things,” he says. “Imagine you’ve just bought a new computer that you really like, and I show up and say I’ve paid the same amount for one with a brighter monitor and faster processor. How much would that bug you?”
ENLARGE
DAN TAGUE
In experiments he’s run, it bugs people a lot. But when people are told to imagine they’ve gone on vacation to New Zealand, and someone else has had a slightly better vacation, “it bothers people somewhat, but you still have your own experiences and your own memories, and so it tends to trouble you less.”
In a recent paper called “Waiting for Merlot,” Prof. Gilovich and colleagues showed that we also get more pleasure out of anticipating experiences than anticipating the acquisition of material things. People waiting for an event were generally excited, whereas waiting for material things “seemed to have an impatient quality.”
Don’t Adapt to What You Buy
One of the main reasons why having more stuff doesn’t always make us happy is that we adapt to it. “Human beings are remarkably good at getting used to changes in their lives, especially positive changes,” says Sonja Lyubomirsky, psychology professor at the University of California, Riverside. “If you have a rise in income, it gives you a boost, but then your aspirations rise too. Maybe you buy a bigger home in a new neighborhood, and so your neighbors are richer, and you start wanting even more. You’ve stepped on the hedonic treadmill. Trying to prevent that or slow it down is really a challenge.”
ENLARGE
One approach that can work, she says, is consciously trying to foster appreciation and gratitude for what you have. The process of adaptation, after all, comes from taking what you have for granted, so you can slow it down by reminding yourself of why you value what you have.
It could be as simple as setting aside time every day to follow the traditional advice of “counting your blessings.” Or you might want to keep a daily journal or express your gratitude to other people. The key is to find a way to remain conscious of everything you own and avoid simply adapting to having it around.
Because you’re working against your natural inclination, Prof. Lyubomirsky acknowledges that feelings of gratitude and appreciation can be very difficult to sustain. If your journal or daily list becomes just a stale routine, it will no longer have much effect. You might have to keep switching techniques.
Increasing variety, novelty or surprise can also help you to enjoy your possessions more. “When things become unchanging, that’s when you adapt to them,” Prof. Lyubomirsky says.
If you keep a painting hanging in the same spot on the same wall, for example, you’ll stop noticing it after a while. But swap it with a painting from another room, and you’ll see each of them with fresh eyes, and appreciate them more. Try sharing your possessions with other people, too, and opening yourself up to new experiences, she says.
ENLARGE
This could even mean depriving yourself of your possessions for a while, perhaps by lending them or sharing them with someone else. Elizabeth Dunn, associate professor of psychology at the University of British Columbia and co-author of the book “Happy Money,” recently conducted an experiment where she sent people home with a big bag of chocolate, telling some of them to eat as much of it as they could and others that they were forbidden to eat it. A third group could choose how much to eat.
The result? The people who had been forbidden from eating chocolate were able to enjoy their next chocolate bar much more than those who’d either eaten a lot or consumed their normal amount. “Giving something up temporarily can actually help to preserve our capacity to enjoy it,” Prof. Dunn says.
Try Giving It Away
The paradox of money is that although earning more of it tends to enhance our well-being, we become happier by giving it away than by spending it on ourselves.
That’s the finding from a series of studies by Prof. Dunn. She began by handing out cash to students on campus and telling some to spend it on themselves and others to spend it on someone else. Those who spent money on other people were happier than those who treated themselves.
Prof. Dunn has since repeated the experiment in other countries across the world, and has extended it to look at whether people were still happy when giving away their own money rather than free money handed to them by a professor. She found that in countries as diverse as Canada, South Africa and Uganda, giving away money consistently made people happier. This was even true when people were giving away their own money, and even when they themselves were relatively poor.
She also worked with economists to analyze survey data from 100 countries in the Gallup World Poll, and found that people who donated money to charity were happier, in poor and rich countries alike.
“The fact that we were able to observe the same effect that we’d seen in Canada in places like South Africa and Uganda was probably the biggest surprise of my career,” she says. “A lot of us think we’ll give to charity one day, when we’re richer, but actually we see the benefits of giving even among people who are struggling to meet their own basic needs.”
What moves the needle in terms of happiness is not so much the dollar amount you give, Prof. Dunn says, but the perceived impact of your donation. If you can see your money making a difference in other people’s lives, it will make you happy even if the amount you gave was quite small.
Be Sure to Buy Time, Too
It’s also important to consider how what you’re buying will affect how you spend your time. That big house in the suburbs may seem like a good idea, but a 2004 study by Alois Stutzer and Bruno Frey of the University of Zurich found that people with longer commutes reported lower overall life satisfaction, all other things being equal. They calculated that you would need a 40% raise to offset the added misery of a one-hour commute.
ENLARGE
DAN TAGUE
“Use money to buy yourself better time,” says Prof. Dunn. “Don’t buy a slightly fancier car so that you have heated seats during your two-hour commute. Buy a place close to work, so that you can use that final hour of daylight to kick a ball around in the park with your kids.”
Another way to buy yourself time, Prof. Dunn says, is by outsourcing tasks you dislike. Whereas hiring personal assistants used to be the preserve of the wealthy, it’s now easier and more affordable to hire freelancers and virtual assistants online to help you with either regular administration or just individual tasks.
She’s currently doing research on how people actually spend the time they save by outsourcing tasks and whether it makes them happier. The preliminary findings, she says, are that most people do become happier by buying time for themselves, but only if they use the time in the right way.
“Our hypothesis is that people will be much more likely to derive an emotional benefit if they think of it as ‘windfall time’ and use it to do something good, rather than just taking it for granted,” she says.
But while buying time is a good idea, putting a dollar value on your time may not be. In another piece of research in progress, Prof. Dunn is finding that when people think of their time as money, it makes them less likely to spend even small amounts of time on things that are not financially compensated. “Seeing time as money may have a number of destructive consequences,” she says.
Money Only Brings Happiness Up to a Point
When looking at all of these research results, there’s an important caveat to bear in mind. Those in the field divide happiness into two components, and you need to have both parts working together to be truly happy. But only one of those components keeps improving the more you earn. The other tops out after a certain point.
The first measure of happiness is “evaluative.” Prof. Lyubomirsky defines it as “a sense that your life is good—you’re satisfied with your life, you’re progressing towards your life goals.” That’s the measure used by economists Justin Wolfers and Betsey Stevenson, who have conducted extensive research comparing economic data and happiness surveys across the world. “We found very clear evidence that in just about every country around the world, rich people are happier than poor people,” says Prof. Wolfers. “And people in rich countries are happier than people in poor countries.”
The other component of happiness—“affective”—looks at how often you experience positive emotions like joy, affection and tranquility, as opposed to negative ones, explains Prof. Lyubomirsky. “You could be satisfied with your life overall but you may not actually be happy at the time,” she says. “Of course, happy people experience negative emotions, just not as often. So you have to have both components.”
Daniel Kahneman and Angus Deaton of Princeton University found that when they looked at affective measures, happiness did not rise after a household reached an annual income of approximately $75,000. (They did, however, find a consistent rise in overall life satisfaction, matching the results of Profs. Wolfers and Stevenson.)
The bottom line: When you don’t have much money, a little extra can go a long way, because you have more essential needs to fulfill. As you accumulate more wealth, however, it becomes more difficult to keep “buying” more happiness.
Don’t Get in Over Your Head
Finally, although much of the research in this field is on spending money rather than saving it, the researchers agree that spending more than you can afford is a route to misery. Taking care of your basic needs and achieving a level of financial security is important.
Prof. Gilovich says that although his research shows that life experiences give more happiness than material goods, people should of course buy the essentials first. His findings hold true across a broad range of income levels and demographic groups, but not for people with very low incomes. “Those people don’t really have discretionary income; it pretty much all has to go on necessities,” he says.
Some studies, meanwhile, have shown that debt has a detrimental effect on happiness, while savings and financial security tend to boost it. A survey of British households found that those with higher levels of debt reported lower happiness, and a separate piece of research on married couples showed that those in more debt had more marital conflict.
“Savings are good for happiness; debt is bad for happiness. But debt is more potently bad than savings are good,” Prof. Dunn says. “From a happiness perspective, it’s more important to get rid of debt than to build savings.”
So before you go out and spend all your money on a dream vacation, make sure you’ve taken care of the basics, paid off your debts, and have enough money to shield yourself from the worst of life’s troubles.
“Financial advisers are actually right,” Prof. Howell says. “The first thing you should be doing with your money is building up a safety net. If you go into debt to buy these great life experiences, the stress you’ll feel when the credit-card bill comes in will probably wipe out the good that you got from the experience.”
Mr. Blackman is a writer in Crete. He can be reached atreports@wsj.com.