Epilepsy affects more than 65 million people worldwide. One-third of these patients have seizures that are not controlled by medications. In addition, one-third have brain lesions, the hallmark of the disease, which cannot be located by conventional imaging methods. Researchers at the Perelman School of Medicine at the University of Pennsylvania have piloted a new method using advanced non-invasive neuroimaging to recognize the neurotransmitter glutamate, thought to be the culprit in the most common form of medication-resistant epilepsy.
Glutamate is an amino acid which transmits signals from neuron to neuron, telling them when to fire. Glutamate normally docks with the neuron, gives it the signal to fire and is swiftly cleared. In patients with epilepsy, stroke and possibly ALS, the glutamate is not cleared, leaving the neuron overwhelmed with messages and in a toxic state of prolonged excitation.
In localization-related epilepsy, the most common form of medication-resistant epilepsy, seizures are generated in a focused section of the brain; in 65 percent of patients, this occurs in the temporal lobe. Removal of the seizure-generating region of the temporal lobe, guided by preoperative MRI, can offer a cure. However, a third of these patients have no identified abnormality on conventional imaging studies and, therefore, more limited surgical options.
‘Identification of the brain region generating seizures in location-related epilepsy is associated with significantly increased chance of seizure freedom after surgery,’ said the new study’s lead author, Kathryn Davis, MD, MSTR, an assistant professor of Neurology at Penn. ‘The aim of the study was to investigate whether a novel imaging method, developed at Penn, could use glutamate to localize and identify the epileptic lesions and map epileptic networks in these most challenging patients.’
‘We theorized that if we could develop a technique which allows us to track the path of and make non-invasive measurements of glutamate in the brain, we would be able to better identify the brain lesions and epileptic foci that current methods miss,’ said senior author Ravinder Reddy, PhD, a professor of Radiology and director of Penn’s Center for Magnetic Resonance and Optical Imaging.
Reddy’s lab developed the glutamate chemical exchange saturation transfer (GluCEST) imaging method, a very high resolution magnetic resonance imaging contrast method not available before now, to measure how much glutamate was in different regions of the brain including the hippocampi, two structures within the left and right temporal lobes responsible for short- and long-term memory and spatial navigation and the most frequent seizure onset region in adult epilepsy patients.
The study tested four patients with medication-resistant epilepsy and 11 controls. In all four patients, concentrations of glutamate were found to be higher in one of the hippocampi, and confirmatory methods (electroencephalography and magnetic resonance spectra) verified independently that the hippocampus with the elevated glutamate was located in the same hemisphere as the epileptic focus/lesion. Consistent lateralization to one side was not seen in the control group.

Penn Medicinehttp://tinyurl.com/jrbr5se

Researchers at the University of Waterloo have developed a revolutionary system for monitoring vital signs that could lead to improved detection and prevention of some cardiovascular issues, as well as greater independence for older adults.

Using patent-pending technology called Coded Hemodynamic Imaging, the device is the first portable system that monitors a patient’s blood flow at multiple arterial points simultaneously and without direct contact with the skin. It is ideal for assessing patients with painful burns, highly contagious diseases, or infants in neonatal intensive care whose tiny fingers make traditional monitoring difficult.

‘Traditional systems in wide use now take one blood pulse reading at one spot on the body. This device acts like many virtual sensors that measure blood flow behaviour on various parts of the body. The device relays measurements from all of these pulse points to a computer for continuous monitoring,’ said Robert Amelard, a PhD candidate in systems design engineering at Waterloo and recipient of the prestigious Alexander Graham Bell Canada Graduate Scholarship from the Natural Sciences and Engineering Research Council of Canada. ‘By way of comparison, think of measuring the traffic flow across an entire city rather than through one intersection.’

Continuous data collection at different parts of the body provides a more complete picture of what

New research demonstrates that the six-step hand-hygiene technique recommended by the World Health Organization is superior to a three-step method suggested by the U.S. Centers for Disease Control and Prevention (CDC) in reducing bacteria on healthcare workers

Mindray has officially released its new premium Resona 7 ultrasound system recently. The system will be showcased for the first time at Medica 2015 in Dusseldorf, Germany, from November 16-19. Release in the North American market is scheduled for early 2016.

Resona 7 is powered by the revolutionary ZONE Sonography

As humans evolved over many thousands of years, our bodies developed a system to help us when we start running and suddenly need more oxygen. Now, using that innate reflex as inspiration, UCLA researchers have developed a non-invasive way to treat potentially harmful breathing problems in babies who were born prematurely.

The technique uses a simple device that tricks babies’ brains into thinking they are running, which prompts them to breathe.

Each year, about 150,000 babies are born after only 23 to 34 weeks of gestation, which puts them at risk for apnoea of prematurity, a condition in which breathing stops, often for several seconds, accompanied by severe falls in oxygenation.

The condition occurs because – in infants whose systems not yet fully formed – the respiratory system ignores or cannot use the body’s signals to breathe. Compounding the danger, premature newborns’ lungs are not fully developed, and therefore do not have much oxygen in reserve. When breathing stops in these periods of apnoea, the level of oxygen in the body goes down, and the heart rate can drop. That combination can damage the lungs and eyes, injure the nerves to the heart, affect the hormonal system (which can lead to diabetes later in life), or injure the brain (which can result in behavioural problems later in life).

Hospitals use a range of approaches to minimize the duration of premature babies’ breathing pauses – placing them on their stomach, forcing air into the lungs with a facemask and giving caffeine to stimulate the brain – but none is perfect and each carries other risks.

According to Dr. Ronald Harper, a distinguished professor of neurobiology at the David Geffen School of Medicine at UCLA, even newborns have the innate mechanism that triggers increased breathing.

‘When our feet hit the ground running, we flex muscles and joints that have nerve fibres leading to the brain which signal that the body is running,’ he said. ‘This message is coupled with another set of fibres to parts of the brain that regulate breathing and sends a signal that those parts need to increase breathing. Fortunately, that coupling exists even in extremely young infants.’

The idea to use an external breathing device to treat apnoea of prematurity arose over a cup of coffee between Harper and Dr. Kalpashri Kesavan, a neonatologist at Mattel Children’s Hospital UCLA, when the conversation turned to how a baby’s breathing could be supported if the brain was told the baby was running or walking.

Harper’s lab, which focuses on brain mechanisms that drive breathing during sleep, had already developed a device that he had intended to test for treating people with breathing problems. The device is a pager-sized box with wires that connect to small disks which are placed on the skin over the joints of the feet and hands. (Placing them on the hands is another nod to how the human body evolved: Early humans ran on all fours, so nerves in the hands are still involved in signalling the brain that the body is running.) Once the battery-powered machine is turned on, the disks gently vibrate, which triggers nerve fibres to alert the brain that the limb is moving.

‘We thought that if this reflex were going to work for any kind of sleep disorder with breathing problems, then premature infants would be the No. 1 target, because breathing stoppages are so common and have the potential to do so much injury,’ Kesavan said. ‘It’s almost like it was naturally made for them.’

The researchers tested the device on 15 premature infants who were born after 23 to 34 weeks of gestation, and who were experiencing breathing pauses and low oxygen. The disks were placed on one hand and one foot, and the device was turned on for six hours at a time, followed by six hours off, for a total of 24 hours.

The scientists compared the babies’ vital signs during the periods when the device was on with the times when it was off. They found that when it was on, the number of incidents when babies’ oxygen levels were low was reduced by 33 percent and the number of breathing pauses was 40 percent lower than when it was off. The device also reduced low-heart-rate episodes by 65 percent, which is especially significant because slow heart rate can impair the flow of blood to vital tissues.

UCLA Health Sciences www.newswise.com/articles/inspired-by-evolution-a-simple-treatment-for-a-common-breathing-problem-among-premature-infants