Published in Health & Medicine
Scientists are beginning to findout why people with Parkinson's disease often feel socially awkward.Parkinson's patients find it harder to recognize expressions of emotionin other people's faces and voices, report two studies published by theAmerican Psychological Association. One of the studies raises questionsabout how deep brain stimulation, the best available treatment forpatients who no longer respond to medication, more strongly affects therecognition of fear and sadness. A neurodegenerative disorder,Parkinson's causes tremors, stiffness and balance problems, as well asfairly frequent depression and dementia.
In the March issue ofNeuropsychology, Heather Gray, PhD, and Linda Tickle-Degnen, PhD, reportthat people with Parkinson's disease, compared with matched controls,often have difficulty discerning how others are feeling.
Theirmeta-analysis of 34 different studies using data from 1,295 participantsshows a robust link between Parkinson's and specific deficits inrecognizing emotions, especially negative emotions, across differenttypes of stimuli and tasks.
The meta-analysis, conducted at HarvardMedical School and Tufts University, found that patients typically hadsome degree of problem identifying emotion from faces and voices.
Furtherclarification is provided in a second study that showed that deep-brainstimulation, compared with medication, caused a consistently largedeficit in the recognition of fear and sadness two key facialexpressions that, when understood, aid survival. That study is publishedin the January issue of Neuropsychology.
Researchers led by JuliePron, PhD, at the Centre Hospitalier Universitaire de Rennes in France,compared the ability of people with Parkinson's in three differentgroups to recognize facial emotions: 24 advanced patients implanted withdeep-brain stimulators after they didn't respond or were sensitive tooral levodopa (the usual drug for the disease); 20 advanced patientsgiven apomorphine hydrochloride by injection or infusion pump while theywaited an implant; and 30 healthy controls.
Researchers tested allparticipants using standard photographs of facial expression before andthree months after they were treated. Before implantation of thestimulators, all participants read facial expressions equally well.
Patientsin the surgical group were implanted with stimulators, electricaldevices that prod the brain's subthalamic nucleus, a small, lens-shapedstructure, to normalize the nerve signals that control movement. Thisnucleus is part of the basal ganglia system, which is thought tointegrate movement, cognition and emotion.
Three months aftertreatment, only the patients with stimulators not the drug-treatedpatients or the healthy controls were significantly worse atrecognizing fear and sadness. Patients with stimulators confused thoseexpressions with others, such as surprise, or even no emotion. Medicatedpatients and healthy controls were either accurate about fear andsadness or occasionally mistook them for other negative emotions, suchas disgust.
"Having Parkinson's predisposes an individual to errorsin emotion recognition," said Gray. "The research in France, along withprevious studies, indicates that deep-brain stimulation produces an evenmore severe deficit."
Why would treating a movement disorder affectthe perception of emotions? Implants affect a part of the brain thatreaches across functions, so the authors suggested that the sameelectrical stimulation that calms over-excited motor activity may alsosomehow inhibit emotional processing.
Although the impact ofParkinson's and deep-brain stimulation varies by patient, it's importantto understand. "The first step is to educate patients and their closeassociates about the potential for emotion recognition difficulties, sothey can learn to manage some of the social consequences, such asmisunderstanding and frustration," said Gray and Tickle-Degnen. The nextstep might be training in emotion recognition, which they said hasshown promise.
According to the National Institutes of Health,deep-brain stimulation is used to treat a variety of disablingneurological symptoms, including Parkinson's and essential tremor, acommon neurological movement disorder.
At present, the procedure isused only for patients whose symptoms cannot be adequately controlledwith medications. According to Pron, about 15 percent of Parkinson'sdisease patients are thought capable of benefiting from the surgery.

University of Ottawa to be home of institute
By Jennifer Green, TheOttawa Citizen

Ottawa will soon get a $100-million researchcentre to focus on illnesses of the mind and brain, which are fastbecoming the developed world's most pressing disorders.
TheUniversity of Ottawa Brain-Mind Research Institute is still in the finalstages of approval but "the president has given the green light, (and)the partners have signed on," says Dr. Jacques Bradwejn, theuniversity's dean of medicine.
U of O's faculties of medicine,science, health science, and education will join forces with Saint PaulUniversity's faculty of human sciences, The Ottawa Hospital, CHEO, theRoyal Ottawa Mental Health Centre, the Montfort, and Bruyre ContinuingCare.
The range of expertise means that researchers can look at wholepopulations or one individual, study a newborn or a great grandmother.
"Wehave already done some consolidations," Bradwejn said. "Somelaboratories have moved over to the complex at the faculty of medicine."
Heestimates hundreds of professionals will eventually come together in aflexible "hub and spoke" model centred at the university's Smyth Roadmedical campus, with satellites at other campuses and hospitals.
"Youwill have a neurologist next to a psychologist ... a chaplain ... anethicist," Bradwejn said. "We will have better care. The knowledge willbe more interdisciplinary: The neurologists will speak more with thepsychiatrists, who will speak more with the family doctors."
Thegroup will focus on the problem instead of the discipline, meaning oneresearcher might look at the cause of Parkinson's disease, adegenerative brain illness, while another examines the incidence ofdepression among Parkinson's patients and another looks at how itaffects family dynamics.
"When people get sick, they don't get sickin compartments," Bradwejn said. "When the brain gets sick, it gets sickin more of a global fashion."
On a more practical level, thiscollaboration does away with unproductive competition that just dividesup research dollars and fundraising efforts among the variousfacilities.
The centre is focusing on neurological issues becausethey are gaining urgency as people in the developed world live longer.These elderly populations are susceptible to disorders such as dementia,Parkinson's and ALS (or Lou Gehrig's disease), all of which demandconsiderable care. It means a greater burden on families, communities,and ultimately, on governments.
"Cancer is a burden, cardiovasculardisease is a burden, but it doesn't impact our society and productionand families as brain related illnesses," Bradwejn said.
Dr. JosephMartin, former dean of Harvard's medical school, agreed with theuniversity's philosophy: "It will only become more and more of anissue," he said.
Martin, a neurologist born in Alberta, establishedHarvard's collaborative NeuroDiscovery Centre in 2001. He said Wednesdayhe was able to get highly competitive scientists to co-operate byoffering them state-of-the-art facilities they could not have affordedto duplicate on their own. The key was to distribute them so nobody felta single organization was monopolizing them.
About four months ago,University of Ottawa president Allan Rock asked Martin to look overBradwejn's plans. The crucial element of strategic distribution seems tobe in place, Martin said.
"I told president Rock that the work theyhad done was really very convincing, that this was a good direction togo. Of course, it would depend on resources. ..."
Bradwejn said acapital campaign should begin after the project's official announcementin a month or so. He is aiming for about $100 million to cover the costof a new building and, of course, the research.
Impossible in thisclimate? Bradwejn says everyone was skeptical about his last bigproject, the new Royal Ottawa Mental Health Centre on Carling Avenue,initiated when he was chief of psychiatry there. That cost $132 millionand has been operating for three years.

By Ryan Acosta, Staff Writer

Current Research and Progress

Due to its extensive funding and programs, the NIA has yielded considerable contribution to the understanding of aging. For instance, recent studies overseen by the NIA have allowed researchers to better understand metabolism of beta-amyloid, the main protein in the brain that causes Alzheimers disease, and formulate means to possibly stop synthesis of the said Alzheimer-linked protein.

Development in Alzheimers disease research in the NIA is yielding more and more positive results. This is really helpful considering the fact that little is known about this serious disease. Most recently, NIA researchers have suggested that risk for developing Alzheimers may be predicted through determining levels of a protein associated with Alzheimers disease.

In another NIA-funded research, scientists have determined certain gene mutations that may cause Parkinsons disease. This is really a promising development that can aid in fighting such a debilitating disease like Parkinsons.

With its large corps of highly skilled researchers, the NIA may possibly produce more significant results regarding aging-related diseases.

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Wehave all heard of stem cells. These are the magical starter cellsthat have the capacity to grow into any type of differentiated cell ofthe adult body. If given optimal growth conditions and with some amountof external hormonal supplementation, theoretically one can induce thesemulti-potent cells to grow into say liver cells, or brain cells forthat matter. The discovery of this unique potential of these cells ledto the probability of using them for therapy. What If these stem cellscould be harvested and grown externally in a medium and thentransplanted into patients having a chronic dysfunction of cells ororgans systems? This would indeed be a much-needed breakthrough in thefield of therapeutics. Thus was born the idea of Stem Cell Therapy. Theprocess of injecting stem cells into a person or organism to repairspecific tissues or to grow organs is known as Stem Cell Therapy.

Overthe years Stem cell research has progressed significantly and thelatest news in this field stands testimony to the hard work andrelentless research of scientists working in this field. The ReNeuronGroup on the second of February, 2010, announced that the UK GeneTherapy Advisory Committee (GTAC) has given a full and final FavorableOpinion to ReNeurons proposed first-in-man clinical trial with itsReN001 stem cell therapy for stroke.  The GTAC is the national researchethics committee for gene therapy and stem cell therapy clinical trialsin the UK. The ReNeuron Company is a Guildford (UK) based stem cellresearch company. This approval represents the final stage in a longprocess the company has been going to through to gain approval to testits expanded neural stem cell line on patients suffering from Ischemicstroke. In the official website, the company makes the followingdeclaration:  We have received regulatory and conditional ethicalapprovals to commence a ground-breaking Phase I clinical trial in the UKwith our lead ReN001 stem cell therapy for disabled stroke patients. Weare developing stem cell therapies for a number of other conditions,including peripheral arterial disease and diseases of the retina.

TheRe N001 neural Stem cell line has been developed from the brain cellsof a fetus (fetal stem cells, which can grow into any one of roughly 210types of cells in our body) aborted in the year 2003. The fetal stageis the stage attained by an embryo after about 8 weeks of conception inthe womb. The company will be able to cultivate all the cells it needsfrom a single piece of tissue and no more fetal cells will now need tobe harvested. These cell lines will now be used to cure patientssuffering from stroke, in the very first clinical trial of this sort toever be undertaken in the field of Stem Cell Therapy in the world.Earlier trials of similar nature have been successful in rodents. Strokeis the third leading cause of death and the single largest cause ofadult disability in the world.  Every year, about 5 million peopleworldwide are disabled by strokes, according to the World HealthOrganization in Geneva.

ReNeuronwon U.K. government approval in January to test its ReN001 stem-cellline after three failures get permission from U.S. regulators.Preliminary

analysis of the study next yearwill determine whether Guildford, England-based ReNeuron can continuedeveloping the treatment and may also determine the viability of thecompany, whose market value is 19.9 million pounds ($32 million). ¹

Thecompany has modified these cells by adding a gene called c-myc to theneural cells. This enables scientists to control the growth of thesecells by supplementing the external growth medium with the drug,tamoxifen. What is this c-myc gene? The c-myc gene belongs to the familyof retrovirus-associated DNA sequences (myc) originally isolated froman avian myelocytomatosis virus. The proto-oncogene myc (c-myc) codesfor a nuclear protein, which is involved in nucleic acid metabolism andfurther, in mediating the cellular response to growth factors.Truncation of the first exon, which appears to regulate c-mycexpression, is crucial for tumorigenicity. The human c-myc gene islocated at 8q24 on the long arm of chromosome 8. ²

TheSouthern General Hospital in Glasgow, Scotland, will be one of theplaces where the first of 12 men awaiting the clinical trial willundergo treatment to transplant from 2 million to 20 million neuralcells for the purpose of cure from stroke. While there are definitelyrisks that the company may fail these trials, the approval is a hugestep forward in terms of development of this technology. Currently,ReNeuron will enroll only men in ReN001 stem cell line trial because thedrug needed to activate or inactivate the c-myc gene which could poserisks for certain women. However, women patients could be added to thetrial protocol later on after certain data are confirmed.

Aword of caution though, The facts are it certainly may fail, saidMichael D. West, who founded Geron Corp., the first company to use humanembryonic stem cells after they were discovered in 1996, and now ischief executive officer of BioTime Inc., a biotechnology company inAlameda, California. The risks of this and other cell-based therapiesare currently unknown.

Whenthe trials begin, Keith Muir, a neurologist at the University ofGlasgow, will recruit patients, a process Muir said will take at leasttwo months. No more than one patient can be treated in a month, he said.Complications such as bleeding or injury to the brain are Muirsbiggest concern, he said. Introducing foreign cells into a patientsbody also could lead to immune rejection or swelling. Muir said thoserisks didnt appear in rodents or in Parkinsons disease patients whohave undergone fetal brain tissue transplants. Weve had a longdiscussion with people who are experts in immunology and transplantrejection and it seems highly improbable that theres going to be anyclinically important reaction, Muir said. Another potential risk iscancer. Stem cells may work because they are capable of multiplying,much as cancer cells do. The key to their use is controlling theirgrowth, a process that researchers dont understand completely.

MichaelHunt, Chief Executive Officer of ReNeuron, said: This regulatoryapproval marks the first step in the process of testing the safety andpotency of our lead ReN001 stroke therapy at a clinical level. It is themost important milestone in ReNeurons history thus far and alsorepresents a significant development in the wider field as regards thetranslation of exciting stem cell science into clinical stage therapies.In many ways, ReNeuron has set the regulatory pathway in the UK forcell therapy trials of this type, and we are delighted to have beengiven the opportunity to move ReN001 into its clinical phase on hometerritory in the UK.

IfReNeuron succeeds in the trial, bigger drug makers may show interest. Inthe past year, Pfizer Inc., based in New York, said it would invest$100 million in the field over five years and GlaxoSmithKline Plc, basedin London, said it would fund $25 million of research at the HarvardStem Cell Institute in Cambridge, Massachusetts.

Well,the company has spent 3 years in trying to get approval for thispromising trial, and has cut down on its research on retinitispigmentosa, Parkinsons Disease and Diabetes to save money for thetrials. It has undergone a downsizing of staff from 45 to 15 and cut Rand D spending by 29 % since last year.

Itwill be interesting to see where this landmark trial leads us and ofcourse the success of such a brave effort is to be fervently wished for.All the very best to the Scientists as well as the 12 men who willundergo this treatment for the first time in History! !