Brain-scanning life's memories yields new insights

Is Memory as Experienced in the Lab Quantifiably Correlated with Autobiographical Memory? These reseachers are attempting to understand the relationship between Lab Memory (performance on cognitive tests, for example) and 3D Autobiographical Memory (our own experiential memory of the world/environment). The findings suggest that a relativistic relationship may exist, suggesting that measured Lab Memory may be an analog for Autobiographical memory.

Neuroscientists at Duke University have figured out how to study with rigorous experimental control how the brain recalls autobiographical memories -- the memories of a person's past experiences. Their new "photo paradigm" involves having subjects take photographs that they later recall in the laboratory while their brains are being scanned.

The researchers said their study revealed that the brain uses much of the same machinery for both autobiographical memory and the type of memory elicited in previous laboratory studies. However, the new technique also disclosed significant brain function differences between laboratory memory and autobiographical memory.

The researchers published their findings in the September 2004 issue of the Journal of Cognitive Neuroscience. First author on the paper was Roberto Cabeza of the Center for Cognitive Neuroscience and the Department of Psychological and Brain Science at Duke. Other co-authors were Steven Prince, Sander Daselaar, Daniel Greenberg, Matthew Budde, Florin Dolcos, Kevin LaBar and David Rubin. The research was sponsored by the National Institutes of Health.

According to Cabeza, in the past there have been significant experimental inconsistencies between controlled laboratory studies of memory and studies of autobiographical memory. These studies seemed to indicate that the brain may function differently in the two processes. In typical controlled studies, subjects are asked to remember items they have previously seen in the laboratory, such as words presented on a computer screen. There have been several studies in which subjects are asked to recall autobiographical memories. However, the problem has been that such studies have not been designed to rigorously control what those past experiences have been.

"Rather than believing that autobiographical memory is a different form of memory than laboratory memory, we think that the differences reflected how the memory was measured," said Cabeza. "So, we started by analyzing the similarities and differences between laboratory conditions and the real-world conditions in which we encode memories.

"For example, the events in our everyday lives are encoded in a vivid three-D world and involve perceptual and sensory information not common in the laboratory," Cabeza said. "Laboratory studies are typically done in a perceptually poor environment, and the laboratory memories aren't as relevant to the subject. The events that we remember from our lives are those that involve us as an actor or interested observer."

To study autobiographical memory rigorously, the researchers decided to create such memories in subjects and then study their recall in the laboratory under controlled conditions. To make such memories, they dispatched volunteer subjects around the Duke campus with cameras, instructing them to take pictures of campus scenes. The subjects were also instructed to remember the taking of each picture as an individual event, noting the physical conditions and their psychological state, such as their mood and associations with the subject of the images.

Back in the laboratory, the subjects were shown a selection of campus photos they had not taken. Finally, they were shown a mix of their photos with those they had not taken while their brains were being scanned using functional magnetic resonance imaging (fMRI). They were asked to press a key to indicate whether they were seeing a photo they had taken, a photo seen in the laboratory or a new photo. In the widely used fMRI brain-scanning method, harmless magnetic fields and radio signals produce brain images that reveal blood flow to each part of the brain. Such blood flow reflects brain activity.

"In autobiographical memory studies, it is very difficult to control the accuracy of memories and the various factors that affect encoding," said Cabeza. "This technique enabled us very good control of when and how the memories were formed and how they are recalled."

The researchers found that recalling the autobiographical memories activated many of the same brain areas as laboratory memories -- the medial temporal lobe and the prefrontal cortex. "Thus, our study does support the basic validity and generalizability of laboratory memory studies," said Cabeza.

However, in addition, autobiographical memory recall activated brain areas associated with "self-referential processing" -- that is, processing information about one's self. Autobiographical memories also activated brain regions associated with retrieval of visual and spatial information, and the memories more intensely activated the region associated with recollection.

"Greater activation of self-referential areas makes sense because people are more involved in their own autobiographical memories," said Cabeza. "And greater activation of the visual and spatial areas fits well with evidence that we remember events that happen in the real world with more vivid sensory recall. Finally, greater activation of recollection areas in the hippocampus makes sense because memory of events involves more intense recollection."

According to Cabeza, their new technique and findings not only add to understanding of the nature of memory processing. The new method may be useful to investigate memory deficits in normal aging and memory disorders such as Alzheimer's disease.

"An advantage of this paradigm in studying memory disorders is that it allows for very good control over memory-encoding conditions," said Cabeza. "Otherwise, it's extremely difficult to compare autobiographical memory in different populations. They may differ in terms of their memory function, lifestyles, socioeconomic status and many other variables."

Insights from such studies could aid development of new therapy approaches, he said. For example, research has revealed that the elderly or people with memory disorders can perform daily tasks better if they are given coaching that involves them in experiencing tasks, rather than just tutoring them.

"Some people have argued that many of the deficits we see in elderly in the laboratory are less pronounced in real life, because in real life there is a lot of environmental support that we typically don't provide under laboratory conditions," said Cabeza.


Study Recommends Bright Tableware and Foods

It seems that brightly colored dishes help people with Alzheimer's to eat a greater amount of food than they otherwise might. Lack of regular eating and weight loss among patients are one of the challenges that institutions and caregivers face.

Brightly colored cups and plates seem to help people with advanced Alzheimer's disease consume food and beverages, says a Boston University study in a recent issue of Clinical Nutrition.

Boldly colored tableware helped Alzheimer's' patients overcome a diminished sensitivity to visual contrast and increased the amount they ate and drank by 25 percent or more.

These findings suggest this approach may be a way to improve nutrition among people with advanced Alzheimer's disease.

About 40 percent of people with severe Alzheimer's suffer health-damaging weight loss. Depression, an inability to focus on more than one food at a time, and an inability to eat independently are among the reasons cited for this weight loss.

The University of Boston team wondered if this weight loss may be caused by visual problems that made it difficult for patients with severe Alzheimer's to distinguish a plate from a table, food from a plate, or liquid from its container.

They found that food intake increased 24.6 percent and liquid intake increased 83.7 percent when the patients were switched from white to bright red tableware.

And food intake increased 25.1 percent and liquid intake increased 29.8 percent when the patients were switched from white to bright blue tableware.


On the road in Boston

Today we will be in Boston discussing the Bio-IT convergence with a well known publisher. Excuse the brevity of the post, we are composing this on a samsung i500 powered by the Palm os. Congrats to my colleagues whose paper was accepted for the Neuroscience Society Annual Conference in San Diego.


Women Walk to Improve Cognitive Test Scores

women walking near the surf, Santa Cruz, CA - 2004

Physically active older women scored better on cognitive tests than those who were less active.

While we recently reported that men who walk a lot have a reduced risk of dementia, we didn't go into detail on the health impact for women. It's becoming clear that women also experience substantial benefits. Researchers at the Harvard School of Public Health surveyed nearly 20,000 women aged over 70 about their levels of physical activity. This was part of the famous long-running Nurses Health Study that has already provided so much information about healthy lifestyles.

The women took part in tests on cognitive ability, covering verbal fluency, memory and attention. Those in the highest activity category also had the highest cognitive scorings. More specifically, those who walked at an easy pace for at least 1.5 hours a week had better scores than those who walked for less than 40 minutes. The most active women had the lowest rate of cognitive decline. The researchers say the women who were active had the cognitive ability that would be expected of those about three years younger. And walking - not just more vigorous activity - was sufficient for achieving these gains.


Guest Opinion: Agony of Alzheimer's is lonely road to travel

Sometimes well-crafted words can express with poignancy and elegance all that is intimated in our travails with fate.

Tucson Citizen

I wasn't there when Nana died. The year before, the nursing home doctors told me the visits were hurting me more than they were helping her.

The first few years, I would bring my children and she would visit with them. Only my oldest remembers her. Over the next seven years, when she didn't know herself or me, it became too much.

My 10- and 11-year-old sons were altar boys at her funeral. For years, my prayers had been for her gentle death. When she could still talk, all she would say was how she wanted to go and be with my grandfather, who died 20 years earlier. "Let me go to Jerry."

Cousin Marcie and her husband, Pat, were with my Uncle Jack when pneumonia finally let him move on. Sometime during lunch, he just stopped breathing. We had prayed for that death, too - prayed that the man who had been moved from the assisted-living floor to midlevel and then the acute section would pass away surrounded by the pictures of family and the Alaskan treasures he loved.

At 87, he was gone to join his beloved wife, parents, friends. Marcie called a few minutes later, and her voice was calm.

We know about Alzheimer's in our family. We have watched people we love die by stages until only shells are left. We know that Alzheimer's someday may be something we, too, will face.

Genetic predisposition is only one of its precursors. I added to my odds when I had a brain injury 16 years ago and often wonder when I can't remember things if it's the accident's residual results or more cells dying.

I tend to write about things that are foremost in my thoughts. Since President Reagan died and Nancy laid her head on his casket, it is hard to forget. I hope he knew her love, that it is why he looked at her one last time. With Alzheimer's, they know so little at the end.

More than anything recently, I've noticed a change in the daily sounds. I no longer can set my watch by hearing my neighbor Bill's car pull in the driveway at 7:15.

For the five years we have lived here, his routine never changed. He left at 6:45 a.m. to drive to the nursing home to spend the day with his Gertrude. Bill is 87, slight, with bright blue eyes, dressed neatly in plaid cotton shirts and freshly combed white hair. He loves Arizona. They retired here after living in Chicago, where winds from Lake Michigan always kept him cold.

It was the year before we moved in that he had to make the final decision, when he could no longer take care of Gertrude because the disease had left her unlike the girl he had loved since she was 12.

Yet every day, he would leave early and be there to feed her, dress her, put her in the wheelchair and push her through the nursing home. Then he encountered no words, no recognition, nothing but the memory of the girl he had met in 1932 when they were barely out of childhood.

Last year, my husband had to go for a week's surgical rehabilitation at the same nursing home. Bill would wheel Gertrude into Art's room, talking to her as if she really knew who she was meeting.

One afternoon, I met them in the hall and saw the remnants of the beauty that had been so striking. Her skin was like silk as I held her hands and talked to her. Her skin was like Nana's.

She, too, passed away, with Bill by her side as always. But now his car is in the carport all day, and I worry about him. What now? There were no long lines waiting to salute this passing, no services and only two lines in the paper.

I had never felt akin with Nancy Reagan. But when I watched her put her head on her husband's casket, when I saw her grip her once-estranged daughter's hand, I felt related.

We are a growing number, this grieving family that Alzheimer's has forged. We mourn presidents, grandparents, beloved uncles, a neighbor gone before I could even know her.

Someday maybe my family, too, will join, and their eyes will have that same haunted look seen in Nancy Reagan's. Even now we know each other when we meet, when that shadow passes across our faces at the word "remember." Us. Them. Someday they may meld.

Patricia Simons is a local poet and writer and winner of the Arizona Poetry Society's annual competitions in 1999 to 2002


Walk to Protect Your Memory

Walking - the most natural and oldest exercise on Earth, has been found to avert dementia in a study conducted in Hawaii. Why is this? Many scientists believe the tendency of walking to improve circulation throughout the body and also the transport of oxygen to critical areas such as the cells of the brain promote longevity and may also assist in clearing away the accumulation of harmful compunds.

Combining exercise, a healty diet, and regular monitoring should give you maximum protection.

Take a walk. It may help protect your brain as well as your heart.

Two large studies, one focusing on women and the other on men, found that elderly people who walk are more likely to maintain cognitive function.

And the more they walk, the better, according to the studies in today's Journal of the American Medical Association.

The study of women looked at more than 16,000 participants, ages 70 to 81, in the Nurses' Health Study. It found those who regularly reported engaging in physical activity, even walking a mere 1 1/2 hours a week, had a higher level of cognitive function and less cognitive decline after 10 years.

The study of 2,257 Japanese-American men in Hawaii found that those who walked less than a quarter of a mile per day were nearly twice as likely to develop dementia and Alzheimer's disease, compared with men who walked more than two miles a day.

The men were 71 to 93 years old. Wire story from The Arizona Republic


New MRI Machine Reveals Better Glimpse into the Brain

Scientists are getting closer to the goal of predictive diagnostic evaluation using MRI scans, expecially with the announcement made today by the University of Illinois at Chicago. The only issue with such powerful scans is the possibility of residual radiation and cumulative effects of radiation exposure, which may pose some concern, but probably not for most people. Used in conjunction with other kinds of non-invasive monitoring such as MemCheck the possibility to economically screen millions of people now exists.

Source: Helen Pilcher, news@Nature.com

An unusually powerful magnetic resonance imaging (MRI) machine was unveiled today that should reveal not just the anatomy but also the metabolism of the human brain, say scientists at the University of Illinois at Chicago.

If it lives up to its promise, the machine should help researchers to probe how the brain thinks, learns, fights disease and responds to experimental therapies. But it will involve exposing patients to stronger magnetic fields than ever before.

MRI uses a combination of magnetism, radio waves and computing power to peer inside the body. Patients lie inside a large circular magnet. When turned on, the magnetic field causes the nuclei of certain atoms, including hydrogen, to line up. A pulse of radio waves is then sent through the magnetic field. The aligned nuclei absorb this radiation and emit it again, producing a signal that reveals the structure of the molecules in which the atoms sit.

Most MRI machines use magnets with field strengths of around 3 tesla (equivalent to around 30 fridge magnets). This allows researchers to image water molecules and create pictures of anatomical structures within the body.

At 9.4 tesla, the new machine's magnetic field is more than three times as strong. This will enable scientists to capture signals not just from molecules containing hydrogen, but also from the body's metabolic building blocks: sodium, phosphorus, carbon, nitrogen and oxygen atoms. This should allow them to watch metabolism in action.

Early warnings

Such detailed images should help doctors to spot the subtle changes in brain chemistry that precede disease, allowing them to offer treatments earlier.

It will also allow scientists to study how drugs are metabolised inside the brain, and map the molecular changes that accompany learning, says MRI researcher Penny Gowland from the University of Nottingham.

This cross-section of a kiwi was one of the first test images obtained by the new 9.4-tesla MRI machine.

© University of Illinois at Chicago

The researchers must now apply for approval to use their machine on patients. In the United States, the maximum approved magnetic field strength for an MRI scanner is 8 tesla.

Gowland thinks that the machine, which exposes patients to strong magnetic fields for around 20 minutes at a time, should be safe.

For some years after MRI was first used on patients in the 1970s, researchers worried that the magnetic fields involved were exerting unusual forces on the body's blood supply, possibly leading to cardiovascular problems. But human subjects have been exposed to magnetic fields of up to 8 tesla without any noticeable adverse effects, says Gowland.

However, Anthony Swerdlow, an epidemiologist and chair of the National Radiological Protection Board's Advisory Group on Non-Ionising Radiation, thinks more safety research is needed.

"We've no reason to think that there are any adverse health effects," he says. But he adds that there haven't been any long-term studies following up those exposed to high-strength magnetic fields. Carrying out such studies would help to allay any fears, he says.


Driving and Alzheimer's Disease

The major story we will be reporting on issued over the weekend by the University of Iowa - it seems that early stage Alzheimer's has a major impact on the operation of motor vehicles. The recommendation by the authors of the study was regular memory check-ups. People with mild Alzheimer’s disease make more mistakes on a driving test than older people with no cognitive problems, according to a study published in the September 14 issue of Neurology, the scientific journal of the American Academy of Neurology.

The study involved an on-road driving test with 32 people with mild Alzheimer’s disease and 136 people with no neurological disorders. The people with Alzheimer’s disease were still driving, although some had reduced their driving due to restrictions imposed by themselves or their families.

The 45-minute test included “on-task” time when the drivers were given verbal instructions to follow a route, as well as time when the drivers were not “on task,” or were not asked to remember and follow instructions.

The people with Alzheimer’s were more likely to make driving errors during the route-following task than those without Alzheimer’s. For example, more than 70 percent of the people with Alzheimer’s made at least one wrong turn while following the route, while about 20 percent of those without Alzheimer’s made at least one wrong turn. And nearly 70 percent of those with Alzheimer’s made two or more safety errors, such as erratic steering or going onto the shoulder, while following the route, compared to about 20 percent of those without Alzheimer’s.

Performing the task accentuated the safety gap between the two groups compared to when drivers were not asked to follow specific instructions.

“There was no difference in the basic control of the vehicle for the people with Alzheimer’s,” said study author and neurologist Matthew Rizzo, MD, of the University of Iowa in Iowa City. “This leads us to believe that the mental demands of following verbal instructions and navigating a new route can compete with drivers’ cognitive resources and potentially impair their driving abilities.”

People with Alzheimer’s who were familiar with the area of town where the test was conducted did not get lost during the test, although those with Alzheimer’s who were unfamiliar with the area were likely to get lost during the test.

“Drivers with early Alzheimer’s may have trouble learning new routes but continue to navigate accurately on familiar routes,” Rizzo said. “This suggests that drivers’ license policies could be considered that would allow driving only in familiar neighborhoods for people with mild dementia.”

Rizzo also noted that some of the people with Alzheimer’s did not make any errors or get lost, and drove safely. “This suggests that some people with mild Alzheimer’s remain fit drivers and should be allowed to continue to drive,” he said.

The study concluded that the driving ability of people with mild cognitive impairment should be assessed with driving tests that include tasks that check their memory and attention skills.

Neurologist David Drachman, MD, of the University of Massachusetts Medical School in Worcester, who wrote a commentary about the study, agreed that on-road evaluation is the best way to test driving competence. He said, “If the driver with mild Alzheimer’s is safe today, I recommend that a family member ride with him or her at least once a month, and if the observer feels endangered, the driver should no longer operate a vehicle.”

Ergun Uc, MD, Steven Anderson, PhD, Qian Shi, MS, and Jeff Dawson, ScD, also of the University of Iowa, strongly contributed to this study.

The study was supported by grants from the National Institute on Aging.

The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, autism and multiple sclerosis.

For more information about the American Academy of Neurology, visit its web site at http://www.aan.com.


Rare Deficit Maps Thinking Circuitry

Scientists tracking the rare Williams Syndrome appear to have developed an insight into how cognitive degeneracies form....

Using brain imaging, neuroscientists at the NIH's National Institute of Mental Health (NIMH) have pinpointed the site of a defect in a brain circuit associated with a specific thinking deficit.

Their study demonstrates how a rare genetic disorder, Williams Syndrome, can offer clues as to how genetic flaws may translate into cognitive symptoms in more common and complex major mental disorders. Andreas Meyer-Lindenberg, M.D., Karen Berman, M.D., and colleagues, traced the thinking deficit to a circuit at the back of the brain that processes locations of objects in the visual field. The researchers report on their Magnetic Resonance Imaging (MRI) study in the September 2, 2004 Neuron.

The study focused on the inability to visualize an object as a set of parts and then construct a replica, as in assembling a puzzle — a key cognitive deficit experienced by people with Williams Syndrome. In addition to this visuospatial construction deficit, people with Williams Syndrome also tend to be overly friendly and anxious and often have mental retardation and learning disabilities. Compared to most mental disorders, which are thought to involve complex interactions between multiple genes and environmental triggers, the genetic basis of Williams Syndrome is remarkably well understood. People with the disorder lack about 21 genes in a particular part of chromosome 7.

"Williams Syndrome yields a unique opportunity to study how genes influence our ability to construct our social and spatial worlds," said NIMH Director Thomas Insel, M.D. "By studying people with this disorder, we can discover how genetic mutations change not only molecular and cellular processes, but lead to differences in the brain circuitry for complex aspects of cognition."
>>Read More at InfoZine


Medicare Will Pay for Alzheimer's Scan

As you can read below, MediCare will soon start to pay for expensive PET scans for inidividuals with memory loss in certain cases. The cost is very high, and there is a risk of excess radiation exposure, suggesting that individuals pursue other means of getting a check up before turning to MRI or PET.

Doubts About Technology Lead Agency to Cover Only Some Patients

By Rick Weiss and David Brown
Washington Post Staff Writers
Friday, September 17, 2004; Page A02

Medicare will start paying for specialized brain scans in some patients to help determine if they have Alzheimer's disease, the federal agency that runs the reimbursement program announced yesterday.

The decision caps a four-year struggle by makers of the technology -- known as positron emission tomography, or PET -- to gain approval from the Centers for Medicare and Medicaid Services for PET's use in patients suspected of having Alzheimer's disease.

But in the absence of convincing evidence that PET scans can, by themselves, tell whether a person has Alzheimer's, the agency settled on a much narrower application. It will reimburse for the brain scans only for patients whose Alzheimer's symptoms are not typical and who doctors believe may instead have one of several rare brain diseases known collectively as "fronto-temporal dementia

>>Read More (registration required at WashingtonPost.com


The Long Goodbye

Alzheimer's can have a dramatic and personal impact on lives and families. While it is hard to comprehend the scope of life-change, even for those of us who are close to its toll on a daily basis, it's clear that people helping each other and family strength and support are essential. Daily assistance for caregivers - giving of time is perhaps even more important than a financial commitment. If the primary caregiver can have a few hours for friends, favorite activities, or a hobby through your helping intervention, we urge you to take that step

Article below from The New York Times by Jane Gross

After his retirement as a New York City carpenter four years ago, and before he faded into the incoherent fog of Alzheimer's disease, Christopher Dillon and his two grown sons renovated a bathroom in the basement of the family's Queens home.

It would be the last multigeneration home-improvement project for the Dillons. But the tiny room with its stall shower would soon become center stage in a family's determined effort to care for a failing loved one at home.

Giving Mr. Dillon, 66, a shower is unbearable for his wife, Kitty, 63, despite her long experience working in a nursing home. She has only to lay out towels, washcloth and soap and Mr. Dillon becomes agitated, sometimes shoving her or pulling her hair, she said.

So the task falls to her strapping boys, Chris, 36, a sanitation worker, and David, 34, a police officer. The National Guard, Mrs. Dillon calls them, riding to her rescue each evening with stores of patience and good cheer that she, as the primary caregiver, feels seeping away.

"It's overwhelming, worse every day," Mrs. Dillon said recently, wincing from stomach pain and steadily losing weight. "I don't have any life. Whatever happened to the golden years? Both of us have been robbed of everything we worked for."

The Dillons' ordeal is familiar to families of the 4.5 million American men and women with Alzheimer's disease, which progressively destroys the cerebral cortex and thus the ability to think, communicate and comprehend. The number of afflicted will more than triple to 14 million by midcentury, according to health care experts and demographers. For their caregivers, life is a round-the-clock vigil, an act of stoic devotion that most families embrace as the antithesis of a nursing home.

"It's a myth that Americans dump their relative in long-term care," said Dr. Peter V. Rabins, a professor of psychiatry at Johns Hopkins University and co-author of "The 36-Hour Day," a groundbreaking guidebook first published in 1981, when Alzheimer's was not yet a household word. "When you look at the numbers, that is simply not the case."

Experts like Dr. Rabins agree that a substantial majority of Alzheimer's patients are cared for at home by family members; estimates range from two-thirds to 95 percent. This growing army of caregivers props up the nation's health care system with free labor, worth, economists and researchers say, more than $100 billion a year, or more than twice the cost of nursing home and paid home care combined.

But these largely invisible caregivers, who buttress the nation's health care system, pay a terrible price. The architecture of the family is turned upside down, turning children into parents and parents into children. Emotional bonds and financial resources are strained, even in the most resilient households. Caregivers get sick from the stress.

A Test of Human Spirit

Alzheimer's disease is "a cataclysm" that "tests the human spirit" of caregivers like no other, wrote Sherwin B. Nuland, a physician and author of the best-selling 1994 book "How We Die," which describes without euphemism the most common causes of death.

With the baby-boom generation aging and life expectancy continuing to increase, Alzheimer's disease has become a ticking time bomb. The fastest-growing segment of the population is 85 and older. In Mr. Dillon's age group, 65 to 74, 3 percent have Alzheimer's; in the 85-and-over group, it is a staggering 47 percent, according to the National Institutes of Health.

But policy makers have ignored the inevitable, Dr. Rabins said. "As a society we're paying no attention," he said. "What you see is the coming together of a medical and social crisis that family caregivers alone cannot solve."

Each family has a different capacity for caring for an Alzheimer's patient, experts say, depending on its size, financial resources, location, competing obligations, social and religious support and approach to conflict resolution. According to criteria established by hospital groups for caregivers, the Dillons would score A-plus on all counts. Still, there are moments when the house seems to vibrate with silent tension.

> Read More (Registration Required at nytimes.com)


Doctors say you cannot escape the impact of Alzheimer's...

It affects nearly half of our elderly 85 years and older.

Currently, clinical trials are ongoing as researchers look for a way to slow the progression of the disease.

A hormone used to treat prostate cancer in men, who also had Alzheimer's disease, is now the focus of a nationwide study.

Researchers found Alzheimer's did not progress among the men who took leuprolide acetate.

Dr. Alan Seigal says,"And so the question is does this hormone specifically given to men with Alzheimer's disease have some unknown clinical input in improving their underlying dementia, slowing the rate of progression."

"Tell me, what's been going on? Are you doing all right? Are you feeling good?"


Congress Demonstrates support for Alzheimer's and Memory Loss Testing

It's time for a pat on the back for our readership and members. It's not often that the wishes of a community are reflected by our political leaders in such a direct way. Your thoughts, voices,and wishes have been heard by the Congress of the United States on the topic of memory screening. Congratulations. Simply by becoming a member you have helped advance the cause. Our position at Cognitive Labs is to support screening over time, with our easy to use tools, and to provide a more accurate and easy way for professionals to offer assistance. Awareness and early intervention are our best chances of staving off early memory loss and Alzheimer's. Thanks to you, we have become the largest community concerned with memory loss on the Internet. If we continue to work together, who knows what we can achieve.

Alzheimer's Foundation Applauds House Passage of Memory Screening Proposal

NEW YORK, Sept. 10 /PRNewswire/ -- The Alzheimer's Foundation of America (AFA) today applauded passage by the U.S. House of Representatives of a proposal advanced by AFA to promote memory screenings as a tool that drives early diagnosis and treatment of Alzheimer's disease and related illnesses, and encourages successful aging.

The provision was attached to H.R. 5006 that appropriates funding for fiscal 2005 for the departments of Labor, Education, and Health and Human Services, and related agencies. The House passed the bill yesterday by an overwhelming bipartisan vote of 388-to-13; it will now be sent to the Senate for consideration.

The report accompanying the spending bill calls for an analysis by the Secretary of Health and Human Services by March 2005 of "the effectiveness and accuracy of existing screening tools to detect early stage memory impairment." The Secretary is also charged with developing "recommendations to expand access to screening in the public and private sectors."

In applauding the legislative action, Eric J. Hall, AFA's chief executive officer, said: "This is a critical first step in AFA's efforts to secure federal support for a national public-private memory screening initiative. We all need to stand together for care as this devastating disease continues to affect more Americans."

According to Dr. Richard Powers, an AFA board member and chief of the Bureau of Geriatric Psychiatry, Alabama Department of Mental Health, "This cost-effective, safe and simple intervention can direct individuals to appropriate care that can improve quality of life, and provide a vehicle for the distribution of cognitive wellness information to millions of Americans."

Currently, an estimated five million Americans suffer from Alzheimer's disease. The number is expected to rise to 16 million by mid-century.

AFA's latest advocacy builds on an initiative that began last November when it declared National Memory Screening Day to encourage those concerned about memory problems to take advantage of free, local screenings across the country. This annual event will be held again this year on November 16, along with other AFA-sponsored activities during National Alzheimer's Disease Awareness Month. For more information, visit http://www.nationalmemoryscreening.org.

In the past year, AFA has taken its message to Capitol Hill on several occasions to rally support behind the promotion of early detection. The initiative coincides with AFA's overall mission to ensure optimal care to those with Alzheimer's disease and related illnesses, and their families.

AFA, a nonprofit organization, unites grassroots agencies from coast-to- coast that provide hands-on dementia care. Its services include a toll-free hotline -- 866-AFA-8484, counseling, educational materials, a caregiver magazine, and referrals to local resources. For more information, call 866- AFA-8484 or visit http://www.alzfdn.org.


Technological Tools

There is increasing use of computer (and in our case, internet and computer) based tools to detect, monitor, and track human cognition.

If you have tried our service, and now we are to the point where almost a million of you have, of one variety or another, you know that we offer easy to use testing and tracking which provides a snapshot of your cognitive speed. To get the full benefit, you need to get MemCheck. Now, many scientists are starting to believe that decline in brain speed over time is a critical observation - it is a flag like increasing blood pressure is a flag for circulatory problems. There have been at least 100 stories on alcoholism and cognitive impairment or Alzheimer's in the past few days. We were among the first to report it directly from the scientists.

A few days ago in the Age (Australia) there was a lengthy treatment of the computerized assessment phenomenon, in fact, that's where the photo above was initially published. One of our first thoughts on this subject occurred in 1999 with a decision to move to a Java architecture in the early prototype of our current architecture, though not yet an n-tier application (jargon alert: definition) as has become predominant in the supply chain field. We now are at an n-tier application but it is surprising how revolutionary and easy this is. The main benefit in what we are doing, so you can get an understanding as general readers is to create an analytical repository of ranges of performance; the more data we collect, the more insight we have into understanding memory and cognitive changes over time, the better we understand cognition and interaction with pharmaceuticals (or any substance, for that matter). In the clinical trials field companies such as PHT are conducting clinical evaluations on substances, sometimes globally using handheld computers and PDAa such as Psion and networks such sa AT&T wireless; further, specific occupations can be tested such as the work of Jerome Yesavage at Stanford on former military pilots; or perhaps in the future on astronauts in training.

I liken it to the early stages of supply chain visibility "alerts" or tracking. One of the firsts in that field was Red Pepper software and their response agents, which came out of NASA Ames. Simultaneously, the technology emerged to 'track' shipments using bar codes and electronic scanners, first internally (call to track your shipment) than externally (on the Internet). Many people thought that was a bad idea. I know, I remember arguing for hours about it. Luckily I got to work with a very smart guy who came out of the US Naval Academy, had worked for IBM for many years, and was the first to use OCR technology in the freight industry (hint: not FedEX or UPS) before coming to UPS. Here we are roughly ten years later with a field that is just as wide open. The big idea in the supply chain area was to integrate real time detail status info a responsive system. That's why our concept had a rather poor fit with i2 Technologies which was derived from predictive modeling, a better fit conceptually with Red Pepper Software, which was in the process of being acquired by PeopleSoft. We ran our idea by Charles Phillips at Morgan Stanley at an analyst meeting in NY, and PeopleSoft, which picked it up and ran with it. The lesson is that a responsive tracking system for the cognitive processes is what is called for, accessible from anywhere.


Shape shifting cell protein helps us remember and forget

Researchers at MIT's Picower Center for Learning and Memory, USA, are one step closer to understanding how brain synapses make chameleon-like changes in their structure and composition depending on the input they receive.

Yasunori Hayashi, assistant professor of brain and cognitive sciences, seeks to understand how brain cells accomplish this remarkable plasticity. His work on the shape-shifting cell protein called actin will appear in Nature Neuroscience online on Sep. 5. This knowledge may one day make it possible to enhance learning and memory by manipulating neurons at a molecular level.

In the fraction of a second it takes one brain cell to communicate with another, a lot happens. Chemical neurotransmitters are released from the signaling side of the synapse and bind to the receiving side, which triggers certain proteins to be assembled or disassembled. Long-term changes in the structure of brain cells create long-term memories and lifetime learning, while other changes destroy unneeded connections to eliminate unneeded information.

A cellular protein called actin is responsible for helping synapses keep their shape. Hayashi and colleagues speculate that actin works with other mechanisms to help synapses assemble proteins on the postsynaptic, receiving end of a transmission.

Actin itself is transformed from ball-like globular to stringy filament forms (G-actin and F-actin), which do radically different things during key brain processes. How actin behaves and what it does is not well understood because no one has been able to see this conversion in synapses in living neurons.

Using a method called fluorescent resonance energy transfer (FRET) in combination with a state-of-art microscopic technique called two-photon laser scanning microscopy, Hayashi was able for the first time to observe the change in equilibrium between G-actin and F-actin. By attaching a protein derived from jellyfish, he modified actin so that G-actin glows blue and F-actin in yellow. Change in color from blue to yellow means a conversion from G-actin to F-actin. "Without FRET, we couldn't see this kind of change," Hayashi said.

Hayashi's laboratory zapped the fibers of a pre-synaptic cell in the rat hippocampus, the brain region associated with formation of new memory, with intense electrical stimulation. This initiates biochemical processes creating a physical change that can last for hours or even days in the post-synaptic receiving cell, either potentiation or depotentiation. These two key brain processes are long-term potentiation (LTP) and long-term depression (LTD), which many believe are the basis for learning and memory. LTP causes long-lasting changes by helping build new connections among brain cells and LTD helps destroy unneeded connections. The low-frequency stimulation created a reaction like LTD, while the intense electrical stimulation mimicked LTP.

Hayashi and colleagues Ken-Ichi Okamoto, postdoctoral associate in the Picower Center for Learning and Memory, and Takeharu Nagai and Atsushi Miyawaki of the RIKEN Brain Sciences Institute in Japan, found that LTP induction induces F-actin, which in turn enlarges synaptic spines and increases their ability to transmit information. In contrast, LTD induction shifts the equilibrium toward G-actin, resulting in a loss of actin the post-synaptic cell, the one receiving the message from the pre-synaptic cell.

"If we could manipulate actin equilibrium, we may some day be able to manipulate synaptic plasticity, affording significant control over the learning power of the brain," Hayashi said.

This work is supported by RIKEN and the Ellison Medical Foundation.


Fertile Time for Memory Research

There is increasing activity in the field of memory and cognition which we will be bringing to you over several posts in the next few days. First, Dr. Stephen Ferris of the Silberstein Center for Aging at NYU and Dr. Gerald Hausman of pharmaceutical company Axonyx will report on the progress of the drug phenserine which is believed to show promise in the modification of the rate of adoption of Alzheimer's Disease. Let us certainly hope that this is the case.

Meanwhile, our news blog here http://blog.cognitivelabs.com has been gaining national attention and momentum in addition to reporting the latest news and research. From our coverage of Governor Schwarzenegger of California, to Japan, the U.K. and Australia, the multiple perspectives help advance the agenda for all.

Our goal is to put the information and tools in the hands of the people that need them, that's why, I think, this news site has become so popular...exceeding the circulation of a large newspaper. We have been starting to post the number of new users signing up every day, our rolling 30 day average, which is in the thousands and growing, to our total membership, which is almost a million. If we can go the direction of Skype or Altnet (Hello Kevin) that would be something. And I really think the prepaid memory card at Starbucks (Hello Howard) would work, since caffeine improves cognitive processes. Stay tuned. Best


Games Do Impact The Brain and Body

Some Japanese theorists (Rayuta Kawashima is one of them) have advanced the notion that games stimulating the frontal lobe of the brain may not build cognitive skills, since they tend to rely on primitive emotional response (fight or flight) where those of a more puzzle and pattern recognition orientation will. The BBC is covering new research from Europe...soon, we will launch our game of the month service for our membership with games selected by both computer scientists and neuropsychologists to achieve the goal of cognitive enhancement. The game of the month club will start with our 'proven effective'game modules deployed with tens of thousands of hours of use, but brought together and accessible from the member dashboard (accessible with a subscription)

By Jo Twist
BBC News Online science and technology staff

What does this kind of game do to your brain? Scientists are attempting to inject some real science into video games development to accurately measure the effects games have on minds and bodies.
University of Hull researchers said the games industry needs a scientific boost instead of just anecdotal evidence.

Scientific testing of physiological and psychological responses, or "mood profiling", could help developers robustly plan which games will be hits.

The research is being presented at a games conference in London.

"We think there is very little in the way of good science being done," Dr Jeremy Thornton, lead researcher on the project told BBC News Online.

The video games industry is an expensive one, and is the fastest-growing entertainment media sector, according to analysts.

Hit and miss

Sophisticated, graphics-intensive titles - characteristic of multiplayer online games such as first-person-shooters Unreal Tournament and Halo - can cost millions and that is set to rise.

Getting the right recipe for success for developers who want to make games that stimulate players, and investors who want a return, can be hit and miss.

The testing process the industry has in place at the moment is "broken", said Dr Thornton. What he proposes is more or less testing the blood, sweat and tears of gamers and seeing what it says about the games.

Playing a game puts you into an altered state. It's like a runner's high, where sports athletes are aware they are doing well. They not sure what they are doing, but they know they are functioning at their peak

Dr Jeremy Thornton
"The current way of developing games is through a portfolio where a publisher will have proposals for games and maybe two will get to market," he explained.

"It is very unlikely that any of those will reach the top 10 and those are the ones that generate millions."

Many games are dropped by developers before they have a chance to make it onto the market.

Although they are designed to generate emotion in a player, according to Dr Thornton, there is no evidence of how this happens on which to rely.

"Often, they rely on in-house industry wisdom and so it needs the application of some science."

Dr Thornton, a practicing GP, said medical techniques such as pain management can translate well to games.

"The question is," he said, "can you detail out from successful games what it does to humans, profile it and make sure future games can generate that response."

Mood and spit

Microsoft's UK research arm, Microsoft Research Cambridge (MSRC), is part funding the three-year project, and has recently set up its own Interactive Systems group to specifically work on this area.

But past research on gaming and its impacts has focused on violence and children, said Dr Thornton.

Pioneering work by Dr Paul Lynch from the University of Oklahoma in 1999 measured hormonal levels in game players, and Microsoft's Bill Fulton lead the software firm's push to test games.

Dr Thornton's research with Dr Jon Purdy involves measuring mood with psychological questionnaires, and using computer software, they can monitor alertness and cognitive function.

"We are also measuring heart rate to look at how games activate human bodies and analysing spit for hormones", said Dr Thornton.

Early signs suggest players can enter an "altered state of consciousness"
"We are hoping to be able to compare that with sportsmen and women playing physical games."

Although the work is in its pilot stages in which the testing methods are being formalised, the team have had some interesting early results.

Some of them may seem obvious to hardcore gamers, but very little evidence of this sort has been formally collected before.

"Playing a game does not make you happy if you lose. A game does alert and activate you though," said Dr Thornton.

"In cognitive function tests with the small test group, it was found that with 100% of subjects the speed of completion went up."

But people who are conscious of rules feel guilty when they finish a game because they see it as too much fun, he added.

The stress hormone, cortisol, also shot up in the group of 16 men, doubling that of an average person. In a control group where they sat passively watching a video of a game, they fell.

Based on this, the researchers have hypothesised so far that the psycho-physiological impacts are similar to physical sports.

"It is much like playing football or rugby. If you lose, you feel rubbish but still elated."

Using a skull cap with 12 sensor nodes on it, they also monitored theta brain wave patterns, usually associated with "an altered state".

"Playing a game puts you into an altered state. It's like a runner's high, where sports athletes are aware they are doing well.

"They not sure what they are doing, but they know they are functioning at their peak."

So far, 600 people have been questioned about video game imagery, 20 have taken part in the personality study on mood, and 16 have been involved with the ECG study.

The vision is to provide the techniques and tools to do this on a larger scale, internationally, and across gender, age and culture.

In order to scale-up the tests globally, the researchers are developing ways of delivering questionnaires and record ECGs, in real-time, over the net.

Thousands of games developers and analysts have converged in London for two major trade shows and conferences to discuss future challenges for the industry.

The research is being presented at the Game Developers' Conference Europe.


The apoE4 gene increases risk for Alzheimer's among even infrequent drinkers

The apoE4 gene, one of the genetic markers for Alzheimer's, makes dementia and Alzheimer's four times more likely when combined with even infrequent drinking in midlife; ratchet the use of alcohol to 'moderate' or a drink per day and the risks increase even more. Our readers with the apoE4 would do well to avoid alcohol altogether.

Gene May Boost Dementia Risk in Drinkers

The apoE4 gene is already considered a risk factor for Alzheimer's, researchers say.

THURSDAY, Sept. 2 (HealthDayNews) -- Drinking alcohol even infrequently may increase your risk of dementia if you're one of the estimated 20 percent of people with a gene that has been linked to Alzheimer's disease, a new study suggests.

The gene, called apolipoprotein e4 (apoE4) allele, appears to alter alcohol's effect on the brain. The gene is also a known risk factor for Alzheimer's, say the Swedish researchers behind the study.

"We found that drinking alcohol at middle age is related to cognitive function and impairment in late life," said Dr. Miia Kivipelto, a researcher at the Aging Research Center at the Karolinska Institute in Stockholm.


Kivipelto's team collected data on 1,018 men and women 65 to 79 years of age. They had had their physical and mental health monitored for about 23 years. Their alcohol consumption was recorded and their apolipoprotein E genotype determined.

"Persons who had the apoE4 and drank infrequently had a four times higher risk of developing dementia compared with people who never drank," Kivipelto said. Frequent drinkers with the apoE4 gene had seven times the risk compared with people who never drank, she added.

Frequent drinking was defined as drinking several times a month. Infrequent drinking was drinking less than once a month, according to the report in the Sept. 4 issue of the British Medical Journal.

"The apoE4 genotype is quite common," Kivipelto said. "Something like 20 to 25 percent of people have this genotype."

For people who did not have the apoE4 gene, drinking did not have a significant effect of developing dementia, Kivipelto noted.

"We did find that infrequent drinkers who did not have the apoE4 allele did have a lower risk of developing dementia compared with those who never drank," Kivipelto said. This has been shown in other studies, she noted. However, this may be due to other factors besides alcohol, Kivipelto said.

"Based on our findings, I would not encourage people to drink more alcohol in the belief that they are medicating themselves against dementia," Kivipelto said.

Dr. Kenneth J. Mukamal, an assistant professor of medicine at Harvard Medical School, said, "The apoE4 findings are particularly interesting, as they dovetail nicely with findings in an older U.S. population.

"It suggests that apoE4 has two important roles in the development of dementia. First, the apoE4 allele is a very strong risk factor by itself. Second, it amplifies the hazards of heavier alcohol consumption on risk of dementia," he added.

The study's findings don't mean that people with the apoE4 gene should not drink alcohol -- or that everyone should get tested for the gene, Mukamal said. "However, those with a family history of Alzheimer's disease should be particularly careful to avoid even moderately heavy intake, perhaps from as early as middle age," he said.

More information

The American Association for Clinical Chemistry can tell you about apolipoprotein E genotyping (www.labtestsonline.org ).


The Power of Positive Thinking

Governor Schwarzenegger laid out a bold vision for the future of America last night at the Republican convention, important for the nation, important for Silicon Valley. The governor stopped in our little town recently on a fundraiser for President Bush. We hope he picks up the standard on the war against Alzheimer's Disease with the powerful vigor he demonstrated, the power to act, not just talk. Mr. Schwarzenegger's wife, Maria Shriver has comforted thousands with her book helping families understand the changes wrought by the disease, if you haven't read it, you should. Meanwhile, another day is passing and we have again passed the century mark in terms of new members. Thanks again for your support.

New York -- Gov. Arnold Schwarzenegger, completing his transformation from muscular curiosity to political powerhouse, told a national television audience Tuesday that "America is back'' - and delivered a rousing, crowd- pleasing endorsement of George W. Bush that downplayed his differences with the president.

"Ladies and gentlemen, America is back. Back from the attack on our homeland, back from the attack on our economy, back from the attack on our way of life,'' Schwarzenegger -- in a play on his signature "Terminator" movie line -- told the nearly 5,000 delegates to the Republican National Convention. "We're back because of the perseverance, character and leadership of the 43rd president of the United States, George W. Bush.''

In a finely tuned address, thick with applause lines, Schwarzenegger electrified the crowd with the story of his immigrant journey to America and his arm-pumping tale of "why I'm even more proud to be an American, why I'm proud to be a Republican and why I believe this country is in good hands.''

While Schwarzenegger's more moderate views on issues such as legalized abortion, gay rights and gun control don't mesh with those of Bush -- or the generally conservative convention delegates -- the governor argued that was no problem for his party.

"That's what's great about this country,'' the Austrian-born immigrant said. "Here we can respectfully disagree and still be patriotic, still be American and still be good Republicans.''

But Schwarzenegger's story wasn't really about Bush's re-election or even about politics. Instead, he focused on his adopted country, a land of hope, opportunity and dreams for a boy growing up during the Soviet occupation of Austria. America is still "the lamp lighting the world,'' he said, for new immigrants, as it was for him.

Schwarzenegger's career as a champion bodybuilder and Hollywood superstar has been characterized by a sense of showmanship and raucous fun that didn't disappear when he was elected governor last October, not even when he talked on the national stage.

"To those critics who are so pessimistic about our country, I say: Don't be economic girlie men,'' the finger-wagging governor said, breaking up the crowd with a line that brought him grief when he used it during California's budget battle earlier this summer.

That showmanship carried over to the California delegation, where members donned Terminator-style wraparound sunglasses, bobblehead lapel pins and "I'm with Arnold" T-shirts.

While Schwarzenegger's speech might have been the marquee event on the second night of the GOP convention, he shared the prime-time stage with first lady Laura Bush, who delivered a low-key and highly personal endorsement of her husband.

George Bush today is "still the same person I met at a backyard barbecue in Midland, Texas, and married three months later,'' she said. "He'll always tell you what he really thinks. You can count on him, especially in a crisis. His friends don't change -- and neither do his values.

Laura Bush painted an intimate picture of a president who has agonized over his decisions , sitting quietly through family dinners, walking alone on the White House lawn and crying with families who have lost loved ones.

"I was there when my husband had to decide,'' she said. "Once again, as in our parents' generation, America had to make the tough choices, the hard decisions, and lead the world toward greater security and freedom.''

Although the president typically doesn't show up at the convention hall until it's time to give his acceptance speech, Bush sidestepped that tradition Tuesday, introducing his wife in a live video feed from Pennsylvania, where he is campaigning.

"I have the best and easiest job of this convention,'' said the president, looking proud and relaxed in an open-collar shirt. "I am a lucky man to have Laura at my side.''

It was Schwarzenegger, though, who brought the Madison Square Garden crowd to its feet with a speech that showcased the charisma and political savvy that has propelled him from movie action hero to GOP superstar in little more than a year. With a billboard-sized American flag waving behind him on the video monitor, he was confident and comfortable as only a veteran actor can be. He controlled the crowd from his self-deprecating opening joke, waiting patiently for the applause he knew would come and gesturing straight into the camera to make his points.

But Schwarzenegger -- a pro-choice, pro-gay rights Republican married to a prominent member of the Kennedy family -- also was a critical part of the GOP effort to attract independent, swing and disaffected Democratic voters who may help sway the Nov. 2 election.

"To think that a once-scrawny boy from Austria could grow up to become governor of the state of California and stand here in Madison Square Garden and speak on behalf of the president of the United States -- that is an immigrant's dream,'' Schwarzenegger, 57, said as his wife, Maria Shriver, and four children watched. "It is the American dream.''

The Republican message of free enterprise, a strong military and a smaller government should provide the same lure to immigrants that it did when he arrived in the United States in 1968, penniless and unable to speak English, Schwarzenegger said.

"To my fellow immigrants listening here tonight, I want you to know how welcome you are in this party,'' the governor said. "We Republicans admire your ambition. We encourage your dreams. We believe in your future.''

The speech earned rave reviews from the California delegation.

"He nailed it,'' said former Gov. Pete Wilson. "It was a very personal and passionate speech ... and it had the appeal that it did because of the candor.''

A beaming Gerald Parsky, a Southern California financier who leads Bush's state campaign, pronounced the speech "phenomenal. ... I've always been proud to be a Republican. But tonight, I'm especially proud to be a Californian.''

Democrats said Schwarzenegger's speech -- and his whole New York visit -- was a carefully crafted, Hollywood-style attempt to paper over Schwarzenegger's many differences with the president and his own party.

"It's another example of the Republicans masquerading around, trying to hide the truth,'' said David Chai, a Democratic Party spokesman.

Earlier in the day, the governor went to Fire Station 54 in midtown Manhattan, which lost many of its firefighters in the terrorist attack on the World Trade Center. Surrounded by about a dozen firefighters, the governor led a moment of silence for those killed in the Sept. 11 attacks.

"I'm not the real hero," he told the firefighters. "You're the real heroes. It takes balls to do what you do."

Service Update

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