Electrical Brain Stimulation May Strengthen Memory, Study Says

WEDNESDAY, Feb. 8 (HealthDay News) -- Deep brain stimulation, a technique used to treat Parkinson's disease and certain psychiatric disorders, appears to provide some memory-enhancing benefits, researchers report.

Using electrical impulses to stimulate a part of the brain critical for memory function significantly improved patients' navigational ability, reflecting improved spatial memory, the small study from the University of California, Los Angeles (UCLA) suggests.

Although the results are still preliminary, the method may potentially hold promise for boosting memory in patients with early Alzheimer's disease, the researchers said.

"The thing to bear in mind is that it's a first, important step," said Suzanne Haber, a brain researcher and professor of pharmacology and physiology at University of Rochester Medical Center in New York, who wasn't involved in the study. "I think it was exciting that they were really able to show that stimulating that area was important for a certain kind of learning. It raises more questions, and many more experiments that can be done."

Seven patients awaiting possible surgery for the seizure disorder epilepsy had electrodes implanted in their brains to pinpoint the origin of their convulsions. The researchers followed them and found they were better able to recognize landmarks and to navigate routes more quickly in a video game featuring a taxi cab, virtual passengers and a cyber city. Patients played the role of cab drivers who picked up passengers and delivered them to one of six requested shops in the city.

Stimulation of the entorhinal cortex -- a region considered crucial to transforming daily experience into lasting memories -- produced the improvement, the researchers said.

The study is published Feb. 9 in the New England Journal of Medicine.

During the video game task, participants learned their way around a virtual town with and without five-second periods of deep brain stimulation, and were tested for their ability to reach predetermined landmarks. Six patients showed a 64 percent reduction in "excess path length" -- the ideal path between destinations, which indicated better performance -- for locations that had been learned during periods of deep brain stimulation.

For five patients, navigation to each of the three stores learned during stimulation was faster and shorter than navigation to the three stores learned without stimulation, indicating a consistent effect, the study said. Stimulating the hippocampus -- a brain region next to the entorhinal cortex which helps form and store memories -- produced no effect during this experiment, however.

"Critically, it was the stimulation at the gateway into the hippocampus, and not the hippocampus itself, that proved effective," senior study author Dr. Itzhak Fried, a professor of neurosurgery at the David Geffen School of Medicine at UCLA, said in a university news release.

"Our preliminary results provide evidence supporting a possible mechanism for enhancing memory, particularly as people age or suffer from early dementia. At the same time, we studied a small sample of patients, so our results should be interpreted with caution," Fried added.

Currently, deep brain stimulation is used to control the tremors associated with Parkinson's, symptoms of obsessive-compulsive disorder and some other psychiatric conditions, including depression.

Haber noted that the brain damage that occurs with epilepsy, which can produce memory problems, is different than that resulting from Alzheimer's disease, in which the formation of amyloid plaques and neurofibrillary tangles are believed to contribute to nerve cell deterioration. So it's difficult to generalize this study's results to other diseases that affect memory, she said, and the research didn't show if effects of temporary deep brain stimulation last beyond the study period.

"In these types of studies you think of things like this," Haber said, "but how real it is, is something we're going to have to see. I think just trying to work out that there is some similarity in very simple learning [processes in the brain] is important."

SOURCES: Suzanne Haber, Ph.D., professor, pharmacology and physiology, University of Rochester Medical Center, Rochester, N.Y.; Feb. 9, 2012, New England Journal of Medicine

 

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Playing Sports May Help Keep Kids from Smoking

But the risk of taking up the habit rises if teammates smoke, study finds(*this news item will not be available after 05/08/2012) Wednesday, February 8, 2012

WEDNESDAY, Feb. 8 (HealthDay News) -- Middle-school kids who participate in lots of sports are less likely to start smoking than other kids, new research finds.

Yet, students with teammates who smoke are more likely to smoke, too. This apparent influence of peers is more pronounced among girls.

"This result suggests that peers on athletic teams influence the smoking behavior of others even though there might be a protective effect overall of increased participation in athletics on smoking," study leader Kayo Fujimoto, who conducted the research while at the University of Southern California, said in a journal news release.

Researchers questioned 1,260 sixth through eighth graders about their smoking behavior. The children were middle class, lived in urban areas and ethnically diverse.

The study, appearing Feb. 8 in Child Development, found that the more sports the kids played, the less likely they were to smoke.

The authors suggested their findings could be used to improve anti-smoking programs targeting children.

"Current guidelines recommend the use of peer leaders selected within the class to implement such programs," said Fujimoto. "The findings of this study suggest that peer-led interactive programs should be expanded to include sports teams as well."

SOURCE: Society for Research in Child Development, news release, Feb. 1, 2012

Copyright (c) 2012 HealthDay. All rights reserved.More Health News on:Exercise for Children Recent Health News

 

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Fear of Lawsuits Influences Care from Most Orthopedic Surgeons

More than 95 percent said they ordered unnecessary tests, referrals and hospitalizations to protect themselves

THURSDAY, Feb. 9 (HealthDay News) -- A shocking new national survey suggests that nearly all orthopedic surgeons may order unnecessary tests, referrals or hospitalizations to avoid being sued, to the tune of $2 billion a year.

The report is the first of its kind to demonstrate that "defensive medicine" -- practiced to help exonerate doctors from malpractice accusations but adding no benefits to patient care -- is common among orthopedic surgeons across the United States, the study authors said.

"All across America, orthopedic surgeons are moving away from a standard of care and doing things out of fear of lawsuits," said study co-author Dr. Manish Sethi, an assistant professor of orthopedic surgery at Vanderbilt University Medical Center in Nashville. "This is a major issue that costs a lot of money, and no one's done anything about it."

The research is scheduled to be presented Thursday at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting, in San Francisco.

Of the 2,000 orthopedic surgeons chosen randomly from the AAOS registry to participate in the web-based survey, 61 percent responded. Of those 1,214 surgeons, 96 percent reported they had practiced defensive medicine by ordering scans, laboratory tests, specialist referrals or hospital admissions mainly to avoid possible malpractice claims. On average, 24 percent of all ordered tests were for defensive reasons.

Using the American Medical Association's billing codes as a reference point for costs, researchers determined that orthopedic surgeons spent nearly $8,500 per month -- nearly a quarter of their total practice costs -- on defensive medicine, adding up to an average of nearly $102,000 per doctor each year. Given the 20,400 practicing orthopedic surgeons in the United States, this amounts to $173 million per month and $2 billion annually nationwide, the study said.

Typical scenarios resulting in unnecessary costs include patients with minor injuries who ask for MRIs after their doctors lay out a course of action that doesn't require such a high-level diagnostic tool, physicians said. Depending on the region of the country, MRIs cost $1,000 or more per scan, Sethi said.

"It's so ingrained in how we practice now," said Dr. Douglas Lundy, an orthopedic surgeon in Atlanta and chair of the AAOS medical liability committee. "There's so much faith in technology that not using it almost makes you look like you're not doing all you can do. Also, the overall attitude of our culture is that we get everything we want pretty much when we want it."

Researchers also found that between 70 percent and 84 percent of orthopedic surgeons who responded also practice "negative defensive medicine" by avoiding high-risk patients or procedures to limit liability. Other examples of defensive medicine include closing a practice to become a consultant, no longer seeing patients in the emergency room and not operating on patients with diabetes or heart problems.

Fixing the problem would require "massive medical liability reform at a federal level," Lundy said, while Sethi suggested the implementation of clinical practice guidelines that would lay out treatment steps for different conditions and exonerate doctors from liability if patients develop problems outside the scope of those guidelines.

"I'm optimistic," Sethi said. "I think physicians as a whole need to begin the steer the future of our country. I think we have to make this an issue and cut costs anywhere we can."

SOURCES: Manish K. Sethi, M.D., assistant professor, orthopedic surgery, Vanderbilt University Medical Center, Nashville, Tenn.; Douglas Lundy, M.D., orthopedic surgeon, Atlanta and chair, American Academy of Orthopaedic Surgeons' medical liability committee; Feb. 9, 2012, presentation, American Academy of Orthopaedic Surgeons annual meeting, San Francisco

 

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