Neuroscience News from the UR Community

Chances are if you're a senior managing your health, you've already had a conversation with your doctor about stroke risk. While many patients know the warning signs of stroke -- slurred speech, weakness on one side of the body, coordination problems, double vision, and headaches -- health care providers often fail to educate patients about their risk for silent or mini-strokes, which can cause progressive, permanent damage and lead to dementia.

A new study published in the Journal of Neuroscience, examined the effects of these so-called mini-strokes. They frequently are not diagnosed or detected by a doctor because a patient does not immediately present with stroke signs. Mini-strokes may lead to permanent neurological damage and increase risk for full blown stroke.

Maiken Nedergaard, MD, lead author of the study and professor of neurosurgery at the University of Rochester Medical Center, says at least half of individuals over the age of 60 will experience one mini-stroke in their lifetime. She calls the prevalence of mini-strokes "an epidemic."

One of the key indicators of the quality of care provided by hospitals to acute stroke victims is the percentage of patients who die within a 30-day period. A new study shows that the decisions made by patients and their families to stop care may account for as many as 40 percent of these stroke-related deaths, calling into question whether it is a valid measure of a hospital’s skill in providing stroke care.

The study, which appears today in the journal Neurology, focuses on a quality measure proposed by the federal Centers for Medicaid and Medicare Services called the 30-day risk adjusted stroke mortality. While the measure is being developed as a part of federal health care reform, it is already commonly employed as an indicator of a hospital’s quality of care on websites that evaluate hospital performance.

"It is clear that a significant component of the overall mortality score as currently constructed does not tell the whole story and is predicated on the preference of patients and their families," said University of Rochester Medical Center (URMC) neurologist Adam Kelly, M.D., lead author of the study.

A previously unrecognized system that drains waste from the brain at a rapid clip has been discovered by neuroscientists at the University of Rochester Medical Center. The findings were published online August 15 in Science Translational Medicine.

The highly organized system acts like a series of pipes that piggyback on the brain's blood vessels, sort of a shadow plumbing system that seems to serve much the same function in the brain as the lymph system does in the rest of the body -- to drain away waste products.

"Waste clearance is of central importance to every organ, and there have been long-standing questions about how the brain gets rid of its waste," said Maiken Nedergaard, M.D., D.M.Sc., senior author of the paper and co-director of the University's Center for Translational Neuromedicine. "This work shows that the brain is cleansing itself in a more organized way and on a much larger scale than has been realized previously.

"We're hopeful that these findings have implications for many conditions that involve the brain, such as traumatic brain injury, Alzheimer's disease, stroke, and Parkinson's disease," she added.

A new study shows that the compound Coenzyme Q10 (CoQ) reduces oxidative damage, a key finding that hints at its potential to slow the progression of Huntington disease. The discovery, which appears in the inaugural issue of the Journal of Huntington’s Disease, also points to a new biomarker that could be used to screen experimental treatments for this and other neurological disorders.

"This study supports the hypothesis that CoQ exerts antioxidant effects in patients with Huntington’s disease and therefore is a treatment that warrants further study," says University of Rochester Medical Center neurologist Kevin M. Biglan, M.D., M.P.H., lead author of the study. "As importantly, it has provided us with a new method to evaluate the efficacy of potential new treatments."

Huntington’s disease is a genetic, progressive neurodegenerative disorder that impacts movement, behavior, cognition, and generally results in death within 20 years of the disease’s onset. While the precise causes and mechanism of the disease are not completely understood, scientists believe that one of the important triggers of the disease is a genetic "stutter" which produces abnormal protein deposits in brain cells. It is believed that these deposits – through a chain of molecular events – inhibit the cell’s ability to meet its energy demands resulting in oxidative stress and, ultimately, cellular death.

Not too simple and not too complicated: Babies focus their attention on situations that are just right, according to a new study published in the journal PLoS ONE.

Researchers from the University of Rochester coined this type of engagement the "Goldilocks effect." They proposed babies take in information that is not too predictable, but not too complicated by focusing on sights, sounds and movements.

The study showed that infants are active seekers of information rather than passive recipients, and they, therefore, adjust how they attend to visual information by avoiding overly simple and overly complex events in their world, said Richard Aslin, professor of brain and cognitive sciences at the University of Rochester Medical Center and co-author of the study. They seek information that is of intermediate complexity, presumably because that is the best way to learn from the environment.

The Finger Lakes Geriatric Education Center (FLGEC) at the University of Rochester Medical Center was awarded grant funds to enhance training and education for professionals who assess and care for people with Alzheimer's Disease.

FLGEC earned a Supplemental Funding Grant for Education from the Health Resources and Services Administration. Funding consists of approximately $135,000 over two years, made possible through the federal National Alzheimer's Project Act. The award will help FLGEC develop additional training that incorporates new materials and information developed under the National Plan to Address Alzheimer's Disease, including guidelines for care and new screening and assessment tools.

FLGEC is led by Jurgis Karuza, Ph.D., is program director, and Thomas Caprio, M.D., M.P.H., Project Co-Director.

Ernest J. Del Monte, 87, real estate and hotel developer, philanthropist and University of Rochester Life Trustee, died Saturday, April 21, 2012. His generosity to the University of Rochester leaves a legacy of innovation and collaboration to help eradicate brain diseases.

Mr. Del Monte, of Pittsford, was a visionary in business and industry. With a $10 million gift to the University in 2009, he and his wife, Thelma, helped establish the E.J. Del Monte Neuromedicine Institute to expand the study and treatment of Alzheimer's disease, stroke, spinal cord and brain injuries, and brain cancers at the University of Rochester Medical Center.

The gift was the catalyst for the establishment of the Del Monte Neuromedicine Institute, which serves as an umbrella for several vibrant research centers and growing clinical care programs throughout the Medical Center and River Campus. It has also reinvigorated the scientists and physicians who treat patients with neurological conditions.

Ernie was a force of nature who touched so many of our lives at the University. I am proud to have spent time with him and his late wife, Thelma, and continue to be deeply moved by his commitment to the Del Monte Neuromedicine Institute. When I last spoke with him, he was still planning deals, always imaginative, always determined, right up to the end, said Joel Seligman, president of the University of Rochester.

Stephen McAleavey, Associate Professor in Biomedical Engineering and Daniel Mruzek, Assistant Professor of the Department of Behavioral Pediatrics have recently submitted an Autism project for sponsorship on a new platform called Innovocracy. The University of Rochester recently signed up as an Innovocracy Launch Partner and the Autism project has already raised 172% of its funding goal from individual donors within the first few days. The Innovocracy platform allows the aggregation of small donations to help propel innovative research in the support of proof-of-concept projects. Supporters include everyone from alumni, friends and family to the general public interested in autism research. This collaboration was initiated through an undergraduate Senior Design project, and subsequently received CTSI pilot funds for further development and early clinical evaluation.

A type of cell plentiful in the brain, long considered mainly the stuff that holds the brain together and oft-overlooked by scientists more interested in flashier cells known as neurons, wields more power in the brain than has been realized, according to new research published today in Science Signaling.

Neuroscientists at the University of Rochester Medical Center report that astrocytes are crucial for creating the proper environment for our brains to work. The team found that the cells play a key role in reducing or stopping the electrical signals that are considered brain activity, playing an active role in determining when cells called neurons fire and when they don't.

That is a big step forward from what scientists have long considered the role of astrocytes -- to nurture neurons and keep them healthy.

"Astrocytes have long been called housekeeping cells -- tending to neurons, nurturing them, and cleaning up after them," said Maiken Nedergaard, M.D., D.M.Sc., professor of Neurosurgery and leader of the study. "It turns out that they can influence the actions of neurons in ways that have not been realized."

The difficulties that many women describe as memory problems when menopause approaches are real, according to a study published today in the journal Menopause, the journal of the North American Menopause Society.

The findings won't come as a surprise to the millions of women who have had bouts of forgetfulness or who describe struggles with "brain fog" in their late 40s and 50s. But the results of the study, by scientists at the University of Rochester Medical Center and the University of Illinois at Chicago who gave women a rigorous battery of cognitive tests, validate their experiences and provide some clues to what is happening in the brain as women hit menopause.

"The most important thing to realize is that there really are some cognitive changes that occur during this phase in a woman's life," said Miriam Weber, Ph.D., the neuropsychologist at the University of Rochester Medical Center who led the study. "If a woman approaching menopause feels she is having memory problems, no one should brush it off or attribute it to a jam-packed schedule. She can find comfort in knowing that there are new research findings that support her experience. She can view her experience as normal."

Benjamin Miller, Ph.D., and Itender Singh, Ph.D.

Researchers have taken another crack at a promising approach to stopping Alzheimer's disease that encountered a major hurdle last year. In research published this week in the Journal of Clinical Investigation, scientists have developed a compound that targets a molecular actor known as RAGE, which plays a central role in mucking up the brain tissue of people with the disease.

Scientists at the University of Rochester Medical Center and the University of Southern California synthesized a compound that stops RAGE in mice - reversing amyloid deposits, restoring healthy blood flow in the brain, squelching inflammation, and making old, sick mice smarter. But the scientists caution that the work has a long way to go before it's considered as a possible treatment in people.

In the latest work, Zlokovic and colleagues screened thousands of compounds for anti-RAGE activity and identified three that seemed promising. Then the team turned to chemists Benjamin Miller, Ph.D., and graduate student Nathan Ross. The pair analyzed the compounds' molecular structures, then used that knowledge to create dozens of candidates likely to have activity against RAGE.

Thriving DRG cells

The carnage evident in disasters like car wrecks or wartime battles is oftentimes mirrored within the bodies of the people involved. A severe wound can leave blood vessels and nerves severed, bones broken, and cellular wreckage strewn throughout the body – a debris field within the body itself.

It's scenes like this that neurosurgeon Jason Huang, M.D., confronts every day. Severe damage to nerves is one of the most challenging wounds to treat for Huang and colleagues. It's a type of wound suffered by people who are the victims of gunshots or stabbings, by those who have been involved in car accidents – or by soldiers injured on the battlefield, like those whom Huang treated in Iraq.

Now, back in his university laboratory, Huang and his team have taken a step forward toward the goal of repairing nerves in such patients more effectively. In a paper published in the journal PLoS One, Huang and colleagues at the University of Rochester Medical Center report that a surprising set of cells may hold potential for nerve transplants.

The human brain is bombarded with a cacophony of information from the eyes, ears, nose, mouth and skin. Now a team of scientists at the University of Rochester, Washington University in St. Louis, and Baylor College of Medicine has unraveled how the brain manages to process those complex, rapidly changing, and often conflicting sensory signals to make sense of our world.

The study, published online Nov. 20 in Nature Neuroscience, represents the first direct evidence of how the brain combines multiple sources of sensory information to form as accurate a perception as possible of its environment, the researchers report.

The discovery may eventually lead to new therapies for people with Alzheimer's disease and other disorders that impair a person's sense of self-motion, says study coauthor Greg DeAngelis, professor and chair of Brain and Cognitive Sciences at the University of Rochester. This deeper understanding of how brain circuits combine different sensory cues could also help scientists and engineers to design more sophisticated artificial nervous systems such as those used in robots, he adds.

The brains of autistic children have far more neurons in the prefrontal cortex than the brains of kids without autism, finds a new study that could advance research into the disorder. For the first time, we have the potential to understand why autism gets started, said study author Eric Courchesne, a professor of neurosciences at the University of California, San Diego School of Medicine and director of the Autism Center of Excellence.

The prefrontal cortex is key to complex thoughts and behaviors, including language, social behavior and decision-making. The dorsolateral prefrontal cortex is closely linked with executive function, including planning, reasoning and very high level cognition, said Lizabeth Romanski, an associate professor of Neurobiology & Anatomy at the University of Rochester Medical Center, who was not involved with the research. The medial prefrontal cortex is thought to be important to social and other behavior and emotions.

A physician who specializes in treating patients with Parkinson's disease and related disorders will speak about the condition and take questions from patients, family members and caregivers in a free public talk next week.

Michelle Burack, M.D., Ph.D., a neurologist at the University of Rochester Medical Center, will speak from 9:30 to 11 a.m. Thursday, Oct. 20, at Lifetime Care, 3111 S. Winton Road. The discussion is aimed especially at patients who have recently been diagnosed with Parkinson's, along with family members, though all are welcome.

The talk is part of a series of public discussions Burack has initiated across New York State, as part of educational outreach efforts through the Parkinson Support Group of Upstate New York. The talks are a way for Burack, who is part of a medical team that treats hundreds of patients with the disease, to educate people about Parkinson's and at the same time learn more about the disease, enabling her to treat patients more effectively. Three talks per year in the Rochester area are planned.

Areas in red indicate mouse brain cells coated with myelin, a crucial substance lacking in patients with M.S.

A diverse group of scientists -- experts in cardiology, neurology, immunology, microbiology and chemistry -- are teaming up to study drugs that show promise in the treatment of dementia for the treatment of an equally debilitating disease -- heart failure. In this case, the connection between the head and the heart lies in a particular enzyme that they believe plays a role in the development of both conditions.

The team, headed by Burns C. Blaxall, Ph.D., Harris A. "Handy" Gelbard, M.D., Ph.D., and Stephen Dewhurst, Ph.D., recently won the largest grant awarded to date by the University's Clinical and Translational Science Institute (CTSI) -- $250,000 over two years. The grant, part of the CTSI's newly initiated Incubator Program, is larger than most awarded by the Medical Center.

Thomas Pearson, M.D., Ph.D., who heads the CTSI and helped develop the new program, says tremendous weight was given to forming new teams that had never worked together before, and for these teams to study things they had never addressed before. The Blaxall/Gelbard/Dewhurst team fit the bill on both counts.

As it turns out, keeping pace in ever-more-electronic world is no small feat for the aging brain. That's because our mental circuitry – the most frequently used neuron pathways, like well-traveled roads – tends to crystallize into a series of expressways over time. But that doesn't mean paving new paths (by, say, learning in middle age) is a lost cause – it just demands special learning techniques and a little more patience.

That's heartening news for adults who are headed back to school, shifting careers in later life, or simply want to be lifelong learners, says neuropsychologist Dr. Mark Mapstone. In the clip below, he sheds more light on our amazing (and aging) brains.