Top 5 Dana Stories of 2018? From the Archives

bilingual_cerebrumsept12

From the 2012 Cerebrum essay, “The Cognitive Benefits of Being Bilingual.” Photo: Getty Images

At www.dana.org, we have a deep archive of great stories about the brain and the people who study it, and thanks to the internet, none of it is further than a quick search away. When I checked the list of top stories from last year, I was pleased to see that you-all seem to like to read long stories—nearly all the top-read stories are in the longest format we post. But I was surprised that many of the stories are “classic” (i.e. way more than a few years old). This year we’ll be trying to figure out how to make our more-current stories on the same topics just as popular, but for now here are a few suggestions.

Here are the stories folks found most popular on www.dana.org last year.

1. Wounds That Time Won’t Heal: The Neurobiology of Child Abuse (Cerebrum, 2000)

Developmental neuropsychiatrist Martin H. Teicher describes how scientists are discovering startling connections between abuse of all kinds and both permanent debilitating changes in the brain and psychiatric problems ranging from panic attacks to post-traumatic stress. In these surprising physical consequences of psychological trauma, Teicher sees not only a wake-up call for our society but hope for new treatments. Continue reading

Neuroethics Seminar Series: Seeing Consciousness

shutterstock_221470261How is new technology helping us gain a better understanding of consciousness in patients with severe brain damage? If a patient is unable to communicate or even blink, does that mean he or she is completely unaware? At what point should the intentions stated in a living will be determined by the patient’s family or surrogate?

These questions were among the issues discussed at Harvard Medical School’s most recent neuroethics seminar, titled “Seeing Consciousness: The Promise and Perils of Brain Imaging in Disorders of Consciousness.” The school’s  Center for Bioethics invited Joseph Giacino, Ph.D., director of Rehabilitation Neuropsychology at Spaulding Rehabilitation Hospital; Joseph Fins, M.D., chief of the Division of Medical Ethics at Weill Cornell Medical College; and James Bernat, M.D., Louis and Ruth Frank Professor of Neuroscience at The Dartmouth Institute to share the stage and give a brief talk for its Neuroethics Seminar Series.

Continue reading

Report on Progress: Disorders of Consciousness

The first Report on Progress this year comes from Thomas I. Cochrane, M.D., MBA Neurology, Brigham & Women’s Hospital, and Michael A. Williams, M.D., FAAN, The Sandra and Malcolm Berman Brain and Spine Institute LifeBridge Health. The doctors take the readers through two possible stages of consciousness after injury, using a case study approach.

“Approximately five minutes after a terrible car accident that ejected Matt Trenton from his car, first responders found him face down and not breathing. They placed an endotracheal (breathing) tube in his trachea (windpipe) and transported him to the hospital, where he was admitted to the ICU. He received treatments, such as medications to elevate blood pressure, ventilator support of breathing, and IV fluids for hydration, all of which are necessary to support the brain and the body so that the brain can recover from injury.

Continue reading

New Report on Progress

In the April Report on Progress “Waking Up from Coma: New Treatments, New Hope,” Dana Alliance member Clifford B. Saper, M.D., Ph.D., explains current research on comas and what happens to the brain in this state.

After a couple of weeks in coma due to damage to the arousal system, the remaining structures in the brainstem and the forebrain reorganize their activity, and the patient recovers apparent wake-sleep cycles, with eye opening and faster EEG waves during the day. However, if the cerebral cortex itself has been damaged, for example by severe traumatic brain injury or a period of not getting enough oxygen, then the patient will go through “empty” wake-sleep cycles, where the eye opening is not accompanied by signs of cognition (responding to events in the environment).  After a month in such a state, the patient is said to be in a “persistent vegetative state.

Dr. Saper focuses on patients that show clear, although minimal sign of cognitive, recovery because they have a greater potential for more substantial recovery.

You can find a list of all the Reports on Progress here: http://dana.org/news/reportonprogress/

– Blayne Jeffries

Study shows brain activity in patients considered “vegetative,” but with caveats

Imaging research suggesting that some patients thought to be
in vegetative states are actually at least partially conscious has made
headlines the past couple days. Such work is fascinating but comes with many
caveats, as Nicholas Schiff and Joseph Fins, two experts who are quoted in some
coverage, wrote
Dec. 4
in a guest post on this blog, about a similar finding.

In the new study, which appears in the New England Journal of Medicine,
European researchers found that five patients out of 54 showed patterns of
brain activity in response to commands or questions from doctors.

Earlier
work
had shown that one patient expressed brain activity in motor regions
when told to think of hitting a tennis ball and activity in spatial regions
when told to think about being in her house. Now the researchers report taking
that remarkable finding a step further: They told a man to associate thoughts
of tennis with “yes” and thoughts of being in his house with “no.” Then they
asked him a series of yes-or-no questions and looked at images of his brain activity
to see if he answered correctly—which, they say, he did.

Articles by the New York Times,
the Washington
Post
and the Associated
Press
do a good job of pointing out some of the limitations of the
research. For example, all the patients studied had suffered traumatic brain
injury. There is no evidence that the finding would translate to different
kinds of patients, such as Terri Schiavo, who had long-term damage following a
severe lack of oxygen to the brain.

To the Times and
the Post, Fins also relays a
significant ethical concern about what being able to “communicate” with a
patient in a vegetative state might imply. Fins asks: What if the yes/no
question presented to the patient were not “Have you ever been to the U.S.,”
but rather, “Do you want to die?”

“We know they’re responding, but they may not understand the
question,” Fins tells the Times. “Their
answer might be ‘Yes, but’—and we haven’t given them the opportunity to say the
‘but.’ ”

Colin Blakemore, a professor of neuroscience at the
universities of Oxford and Warwick, goes a step further, using this new study
as a springboard to discuss,
in London’s Telegraph, just what
brain imaging can (and cannot) reveal, and what the implications are for
individual privacy. (Blakemore is also a member of the executive committee of
the Dana Alliance for Brain
Initiatives
.)

Clearly, neuroscientists and neuroethicists have plenty of
work ahead of them as they assess and build upon these stirring findings. Stay
tuned to the Dana Foundation, too—we are
working on assigning a Cerebrum article about the
misdiagnosis of minimally conscious states, which we plan to publish later this
year.

—Dan Gordon

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