Dana Foundation Blog

The political brain

Brain imaging stories seem to be everywhere these days, with catchy headlines associating some particular human behavior with some new colored blob seen on a brain scan. The news is often exciting, with important implications for our health and well-being. But designing meaningful imaging studies and interpreting their results is much more complicated than we often assume.

With a presidential election on the horizon, it seems inevitable that brain imaging should, for better or worse, want to look at the political brain. “This is Your Brain on Politics” was the headline for a recent New York Times op-ed article discussing a neuroimaging study of swing voters looking at photos of potential presidential candidates and discussing implications for the upcoming primaries. Not so fast, said Wired blogger Brandon Keim in the rather scathing “This is Your Brain on Hillary.”

I’ll leave it to the scientists to sort out what’s actually going on in our brains as we prepare to vote. But what if those brains are damaged or diseased? A Cerebrum article from 2004 is unfortunately still timely. In “Fading Minds and Hanging Chads: Alzheimer’s Disease and the Right to Vote,” neurologist David Drachman, M.D., highlights the more than 4 million Americans who are affected by cognitive failure from Alzheimer’s disease or other causes of dementia, many of whom continue to vote. Drachman writes that complicated voting machines and guidance by nursing home staff or election volunteers introduce the possibility of bias, and state laws provide little guidance. What should be realistic guidelines for people who can no longer exercise their right to suffrage with acceptable competence?

Even if such guidelines are unlikely to emerge in time for 2008, the conversation is an important one.

--Cynthia A. Read

A new dose of hope for MS

I just read about some new research suggesting that a quick simple eye scan of the retina might prove to be an inexpensive and effective way to gauge and track the progression of multiple sclerosis. It may even eventually provide the opportunity to diagnose the disease before serious symptoms, such as difficulty walking or temporary blindness, indicate the presence of more severe brain damage.

I’ve been down the long road to diagnosing MS with a close family member, as well as with several friends, so I know this is good news indeed. Although the outlook has improved enormously in the last decade, it can still take years, multiple debilitating episodes of the disease, and a series of brain scans, spinal taps, and tests of nerve function before the diagnosis is clear. And that’s a loss because treatments—although still no cure—exist. “Treatments for MS cannot reverse the damage but they can arrest it, so the earlier we get someone on medication the quicker we can stop the disease from causing more harm,” says Peter Calabresi, M.D., the lead author of the study.

Because I live with someone with relapsing-remitting MS, which comes and goes with a roller coaster of changing physical and cognitive effects, I’m all too familiar with the disease’s toll. But along with knowing how hard neuroscientists are working to understand MS, I find hope in the experiences of people such as Richard Cohen, author of the Cerebrum article “Shadowboxing with Multiple Sclerosis.” He concludes his moving article by saying “Young people dealing with MS for the first time and struggling with the bad news must pay attention to their psychological well-being and begin that process immediately. There will be plenty of time to go for another MRI; it’s time to begin adjusting. This disease takes a lifetime to get used to, and there is more to your head than disintegrating myelin. My advice is simple. Run with MS, not from it. We move with grace when the wind is at our backs.”

--Cynthia A. Read

The Misfiring Brain

Because the seizure that Chief Justice John G. Roberts, Jr., recently experienced was his second, most medical experts agree that he meets the criteria for epilepsy. Not a diagnosis anyone would wish, but I see two positive outcomes.

First, this will increase public awareness of an often misunderstood and feared condition. Second, treatment of epilepsy has come a long way since the Ancient Greeks, who believed a person got epilepsy by offending the moon goddess Selene; one purported cure was eating mistletoe that was picked without a sickle or blade during the time the moon is smallest in the sky.

In the Cerebrum article “Neither Gods Nor Demons But Misfiring Brains,” past president of the American Epilepsy Society Robert J. Gumnit, M.D., explains that seizure disorders are so diverse in their nature, causes, and treatment that even thinking of epilepsy as a single disease is a kind of myth. This confusion prevents many people with seizure disorders from getting the effective new treatments based on brain research. He wrote that “Early and effective treatment is essential, as are efforts to avoid situations that can produce the brain damage that causes seizures in the first place.” I’m confident Chief Justice Roberts is on the path to such treatment.

--Cynthia Read

When Malaria Goes to the Brain

Malaria is a preventable, treatable disease, but it’s far from under control in Africa, where it kills a child every 30 seconds. Until I began working with the author of an upcoming Cerebrum article on cerebral malaria, I wasn’t aware that much of that toll is the result of malaria infiltrating the brain. There it can cause, in the short run, high fever, seizures, even coma, and, if you’re lucky enough to survive, lifelong neurological damage such as blindness, epilepsy and cognitive impairment.

Terrie Taylor, D.O., a Michigan State University researcher based in Malawi who was interviewed for the Cerebrum article, calls cerebral malaria a wily foe. But, with increased attention and funding, research on malaria is flourishing in some unexpected areas, including understanding the interaction of the brain and the immune system.

You’ll have to wait until May to read more about what Taylor and other researchers are discovering. But today, April 25, is Africa Malaria Day 2007, this year’s focus of the Roll Back Malaria Partnership, organized by the World Health Organization, UNICEF, and the World Bank. From the Malaria Day Web site, I learned that, in addition to more predictable activities such as a congressional briefing, “American Idol” will feature performances by famous artists along with education about malaria. So, quite literally, “stay tuned.”

-- Cynthia A. Read

Wandering corridors, wandering minds

I spent endless hours wandering the corridors of nursing homes the past ten years of my parents’ lives—an experience all too familiar to many baby boomers. And I couldn’t help wondering where I myself might end up, sooner or later. A place with compassionate, knowledgeable staff is most important, of course, but even the best have a hard time compensating for the effects on residents of a sterile, gloomy or confusing institutional environment.

So it’s good to know that not only are architects and designers taking a fresh look at facilities for the aging but they’re beginning to seek the input of brain scientists. A recent interdisciplinary workshop convened by the Academy of Neuroscience for Architecture set out questions for neuroscientists that might help in designing for people with Alzheimer’s disease. You can read more about their discussions in the new Cerebrum article, “Building for the Shattered Mind” by Kayt Sukel and Russell Epstein, Ph.D. I hope the benefits of this new research will come in time for many of us.

-- Cynthia A. Read

I spent endless hours wandering the corridors of nursing homes the past ten years of my parents’ lives—an experience all too familiar to many baby boomers. And I couldn’t help wondering where I myself might end up, sooner or later. A place with compassionate, knowledgeable staff is most important, of course, but even the best have a hard time compensating for the effects on residents of a sterile, gloomy or confusing institutional environment.

So it’s good to know that not only are architects and designers taking a fresh look at facilities for the aging but they’re beginning to seek the input of brain scientists. A recent interdisciplinary workshop convened by the Academy of Neuroscience for Architecture set out questions for neuroscientists that might help in designing for people with Alzheimer’s disease. You can read more about their discussions in the new Cerebrum article, “Building for the Shattered Mind” by Kayt Sukel and Russell Epstein, Ph.D. I hope the benefits of this new research will come in time for many of us.

-- Cynthia A. Read

Transforming drug development

The weekend decision by pharmaceutical giant Pfizer to halt its almost billion dollar development of torcetrapib, which was to be the new blockbuster drug for heart disease, has been front page news this week. Fortune columnist John Simons noted the “incredibly high failure rate” for new drugs and commented that “the very means of generating new products is broken.” But a way out, especially for drugs for brain diseases (and that means everything from Alzheimer’s to autism to stroke), may come through smart use of neuroimaging techniques, according to November’s new Cerebrum article by Paul M. Matthews, M.D., D. Phil. I was amazed by the many ways he thinks brain imaging techniques such as PET and fMRI can be transformative, from cutting the number of patients in which potential drugs need to be tested to understanding the pesky placebo effect.

And if you’ve wondered why the current process is so cumbersome, Matthews has provided a little online tutorial, “The Long Sometimes Bumpy Road of Drug Development.” The story begins long before the first step in the New York Times timeline of the torcetrapib disaster, invention of a potential drug, and after being Matthews’ editor for this article, I understand much better why. (photo image courtesy of Photo Researchers, Inc.)

-- Cynthia A. Read

The weekend decision by pharmaceutical giant Pfizer to halt its almost billion dollar development of torcetrapib, which was to be the new blockbuster drug for heart disease, has been front page news this week. Fortune columnist John Simons noted the “incredibly high failure rate” for new drugs and commented that “the very means of generating new products is broken.” But a way out, especially for drugs for brain diseases (and that means everything from Alzheimer’s to autism to stroke), may come through smart use of neuroimaging techniques, according to November’s new Cerebrum article by Paul M. Matthews, M.D., D. Phil. I was amazed by the many ways he thinks brain imaging techniques such as PET and fMRI can be transformative, from cutting the number of patients in which potential drugs need to be tested to understanding the pesky placebo effect.

And if you’ve wondered why the current process is so cumbersome, Matthews has provided a little online tutorial, “The Long Sometimes Bumpy Road of Drug Development.” The story begins long before the first step in the New York Times timeline of the torcetrapib disaster, invention of a potential drug, and after being Matthews’ editor for this article, I understand much better why. (photo image courtesy of Photo Researchers, Inc.)

-- Cynthia A. Read

Neuroethics Society Launched

In Cerebrum’s June article, “Knowing Sin: Making Sure Good Science Doesn’t Go Bad,” bioethicist Henry T. Greely, J.D., of Stanford University, wrote, “The potential benefits from neuroscience are breathtaking, but so are some of the potential harms.” He described a recent meeting of neuroscientists, scholars, and clinicians who discussed the social, legal, ethical, and policy implications of advances in brain research. The discussion appears to have led quickly to concrete action, as this month formation of a new Neuroethics Society was announced.

The Society hopes to draw new people into neuroethics as well as support critical interaction and discussion through events, a newsletter, and dissemination of neuroethics research through partnerships with The American Journal of Bioethics and The Journal of Cognitive Neuroscience. I was interested to learn that several Neuroethics Society leaders, including Hank Greely, have been contributors to Cerebrum and to the Dana Foundation Series on Neuroethics. Moreover, the president of the new society is Steven E. Hyman, M.D., provost of Harvard University, a professor of neurobiology at Harvard Medical School., and also a Dana Foundation director.

Greely concluded his Cerebrum article by saying he believed it was not too late for neuroethics to help “maximize the benefits and minimize the harms of the revolution in brain science.” I think the new Neuroethics Society is an important step toward that goal.

-- Cynthia A. Read

In Cerebrum’s June article, “Knowing Sin: Making Sure Good Science Doesn’t Go Bad,” bioethicist Henry T. Greely, J.D., of Stanford University, wrote, “The potential benefits from neuroscience are breathtaking, but so are some of the potential harms.” He described a recent meeting of neuroscientists, scholars, and clinicians who discussed the social, legal, ethical, and policy implications of advances in brain research. The discussion appears to have led quickly to concrete action, as this month formation of a new Neuroethics Society was announced.

The Society hopes to draw new people into neuroethics as well as support critical interaction and discussion through events, a newsletter, and dissemination of neuroethics research through partnerships with The American Journal of Bioethics and The Journal of Cognitive Neuroscience. I was interested to learn that several Neuroethics Society leaders, including Hank Greely, have been contributors to Cerebrum and to the Dana Foundation Series on Neuroethics. Moreover, the president of the new society is Steven E. Hyman, M.D., provost of Harvard University, a professor of neurobiology at Harvard Medical School., and also a Dana Foundation director.

Greely concluded his Cerebrum article by saying he believed it was not too late for neuroethics to help “maximize the benefits and minimize the harms of the revolution in brain science.” I think the new Neuroethics Society is an important step toward that goal.

-- Cynthia A. Read