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When Your Loved One has Aphasia

The AHA! Team — Mon, 28 Jul 2025 05:28:22 +0000

Meredith Nye, CCC-SLP, MS, via Duke Health – Speech pathologists can help relatives and friends work with a loved one who has aphasia and find ways to communicate effectively. Aphasia is a language disorder that can affect comprehension and communication. Although it is most often caused by a stroke, aphasia can also result from traumatic brain injury, brain tumors, or progressive neurological disorders such as primary progressive aphasia (PPA). These conditions damage the language centers of the brain, leading to difficulties with speaking, understanding, reading, and/or writing. Learning to communicate with someone who has aphasia can positively impact that person’s social interactions, relationships, medical decision-making, and overall wellbeing. “We work with patients and their care partners to provide customized treatment plans focusing on life participation and maximizing communication success,” says Meredith Nye, CCC-SLP, MS, a Duke speech-language pathologist. “Aphasia doesn’t impact a person’s hearing or thinking skills like memory. Rather,” she says, “people with aphasia may use the wrong word, like ‘mother’ instead of ‘daughter’ or ‘yes’ instead of ‘no.’ Or they may make up words, unintentionally repeat themselves, or only be able to say a few words or sounds when they are trying to communicate. Or they may have a hard time understanding what you’re saying.” How to Communicate with Someone with Aphasia Speech pathologists can help relatives and friends work with a loved one who has aphasia and find ways to communicate effectively. Nye recommends keeping these tips in mind: Focus Their Attention If possible, move your conversation to a quiet, well-lit room where there are no distractions. Turn off background disturbances like the radio or television. It’s best to limit conversation to one or two people at the most. Use All Forms of Nonverbal Communication Rather than rely on words, use a wave to say “goodbye” or “hello.” Thumbs up can be used to say “good job” or “yes.” Your facial expressions can show anger, sadness, or elation. Exchange written or drawn messages. Have Patience Sometimes it takes longer for a person with aphasia to communicate. Count to 10 slowly before providing help or choices. Many times it takes that much time or longer for them to get their message out. Confirm Your Understanding After an exchange with your loved one, make sure you understand by verbally repeating or by writing a synopsis of the message’s key points. If they wanted coffee, write “coffee” and draw a picture. Use intonation in your voice when you ask, “You want coffee?” and point to the picture. Have them answer yes or no. Use Technology Computers, smart devices, and other forms of technology can help people with aphasia return to hobbies, read, and converse with others. Icons and emojis can enhance email and social media conversations. Encourage your loved one to listen to audiobooks in addition to reading the print versions. Speech pathologists can also recommend programs that enable your loved one to use word-prediction or speech-to-text capabilities. Get Help Speech pathologists can help people make progress even years after they are originally diagnosed with aphasia, says Nye. “We can help them focus on their strengths and find ways to better engage with family and their community. We can offer tools to help them socialize and have a better quality of life through communication.” Find Aphasia Support Groups There are many groups and resources in the community to support people with aphasia and their families. Nye says a speech-language pathologist is your best resource for identifying groups in your area. To read the original article click here.

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Breakthrough UC San Diego Brain Recording Device Receives FDA Approval for a Clinical Trial

The AHA! Team — Fri, 02 Aug 2024 08:21:00 +0000

University of California San Diego via Newswise – The Federal Drug Administration approved a clinical trial to test the effectiveness of an electronic grid that records brain activity during surgery, developed by engineers at the University of California San Diego. The device with nanoscale sensors records electrical signals directly from the surface of the human brain in record-breaking detail. The grid’s breakthrough resolution could provide better guidance for planning and performing surgeries to remove brain tumors and treat drug-resistant epilepsy. The grid’s higher resolution for recording brain signals could improve neurosurgeons’ ability to minimize damage to healthy brain tissue. During epilepsy surgery, the novel grid could improve the ability to precisely identify the regions of the brain where epileptic seizures originate for safe and effective treatment. The new brain sensor array, known as platinum nanorod grid (PtNRGrid) features a densely packed grid of a record-breaking 1,024 embedded electrocorticography (ECoG) sensors. The device rests on the surface of the brain and is approximately 6 microns thin–smaller than one tenth of the human hair–and flexible. As a result, it can both adhere and conform to the surface of the brain, bending as the brain moves while providing high-quality, high-resolution recordings of brain activity. In contrast, the ECoG grids most commonly used in surgeries today typically have between 16 and 64 sensors. These grids are rigid, stiffer and more than 0.5 mm in thickness and do not conform to the curved surface of the brain. The PtNRGrid was invented by Shadi Dayeh, a Professor in the Department of Electrical and Computer Engineering at the University of California San Diego and members of his team. Over the years, the team developed the PtNRGrid technology in collaboration with neurosurgeons and medical researchers from UC San Diego, Massachusetts General Hospital (MGH) and Oregon Health & Science University (OHSU). “This accomplishment ushers in a new era of clinical neuroscience and neuromonitoring,” Dayeh said. “We are very excited to receive the FDA approval to apply our groundbreaking PtNRGrid in a clinical setting. It is a credit to the hard work of my team members who worked tirelessly to meet the quality criteria mandated by the FDA. I am also grateful to my clinical partners, the support of the NIH, and to the campus leadership that fostered an impactful ecosystem across engineering and medicine to transform the future of healthcare.” The FDA approved an investigational device exemption (IDE) for a “pivotal study [titled] “Systematic Evaluation of Platinum Nanorod Grids (PtNRGrids) for Intraoperative Mapping and Neurophysiological Monitoring (IONM) During Brain Surgeries.” Specifically, the clinical trial is designed to demonstrate the effectiveness of the PtNRGrid device to map both normal and pathological brain activity. During the trial, UC San Diego engineers will partner with clinician-scientists: Drs. Sharona Ben-Haim and Eric Halgren at UC San Diego, Dr. Sydney Cash at MGH, and Dr. Ahmed Raslan at OHSU. In a first phase, surgeons will implant the PtNRGrid in 20 patients, then measure and compare the grid’s performance with the present state-of-the-art. The PtNRGrid will be deployed in surgeries to remove brain tumors and to remove tissue that causes epileptic seizures. Record-breaking density Dayeh’s team has pioneered human brain and spinal cord mapping with thousands of channels since 2019, and has reported early safety and efficacy results in a series of articles published in Science Translational Medicine in 2022 in human subjects. PtNRGrid is the only device with thousands of channels to demonstrate in peer-reviewed publications that it can map motor and language brain activity, as well as epileptic discharges, by producing panoramic videos of brain waves over 10 square centimeters of the brain’s cortex while maintaining resolution at a microscopic level. Currently, Dayeh’s research group holds the world record of recording brain activity from a single cortical grid with 2,048 channels on the surface of the human brain published in Science Translational Medicine in 2022. The device was used in the operating room of Dr. Ahmed Raslan of the OHSU. Since then, the team has increased the number of recording channels to 4,096 and continues to work on increasing the number of channels in the grid to monitor brain activity in even higher resolution. Pending success of this staged trial, the team will transition to the next crucial step of making the PtNRGrid available for commercial use at scale. Demonstrating that ECoG grids with sensors in the thousands of channels record brain activity with high fidelity also opens new opportunities in neuroscience for uncovering a deeper understanding of how the human brain functions. Basic science advances, in turn, could lead to improved treatments grounded in enhanced understanding of brain function. “Our goal is to provide a new atlas for understanding and treating neurological disorders, working with a network of highly experienced clinical collaborators at UC San Diego, MGH, and OHSU,” Dayeh said. Dayeh’s work toward the FDA approval is supported by an NIH BRAIN® Initiative award # UG3NS123723. To read the original article click here.

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The Cognitive Side Effects of Radiation Treatment

AHA Publisher — Fri, 01 Jul 2022 07:00:52 +0000

Benedette Cuffari, M.Sc. via News-Medical – Although radiation treatment is one of the primary methods to treat both brain tumors and brain metastases, it can be associated with several adverse effects that can be difficult to diagnose and manage. Introduction Many different types of cancer will often be treated with therapeutic ionizing irradiation. When used to treat benign and malignant conditions in the brain, cranial radiation therapy (CRT) is often used for both curative and palliative purposes. Regardless of where the radiation treatment is localized, nervous system injury can occur through several mechanisms. For example, irradiation treatment that damages blood vessels that supply the brain or endocrine organs with oxygen can cause secondary neurological effects. Similarly, CRT can directly damage normal neurological structures adjacent to the benign or malignant tissue of interest. Several factors can determine the damage caused by radiation treatment to the nervous system. These include the total radiation dose and dose per fraction delivered to the nervous system, the total volume of the nervous system that was irradiated, if any, the amount of time that has passed since the radiation was completed, and whether the patient has any comorbidities that might increase the intensity of radiation side effects, such as diabetes or hypertension. Acute and Early Delayed Damage Several different types of radiation can be used in the clinical setting, including photons, electrons, protons, and other particle-based radiation. Typically, CRT will be delivered in either X-rays or gamma rays, both photons, through external sources like teletherapy or directly into the tissue of interest through implanted or injectable radioisotopes. Primary neurologic damage that is caused by radiation can be classified according to the time between after the radiation treatment was administered and when the patient began to experience symptoms related to this damage. Acute neurologic damage after radiation, which typically arises within minutes to days after the radiation treatment, is often associated with a rise in intracranial pressure, likely due to acute vasogenic edema. These patients can experience a wide range of symptoms, including nausea, headache, vomiting, somnolence, fever, and worsening neurologic symptoms. However, acute encephalopathy due to radiation treatment will rarely cause cerebral herniation or death. Comparatively, early delayed neurologic damage after CRT, which typically takes several weeks to months for symptoms to develop, is often due to demyelination of surrounding structures. Some possible symptoms of this type of neurologic damage can include headache, lethargy, and worsening of lateralizing signs. Late Delayed Damage The third type of neurologic damage that can occur following CRT is referred to as late delayed damage, which may not cause symptoms to appear for several months or even years after the radiation treatment. Late delayed neurologic damage to the brain can include radiation necrosis (RN), stroke-like migraine attacks after radiation therapy (SMART syndrome), and cerebral atrophy. RN is estimated to occur between 5% and 25% of CRT patients; however, the true incidence of this condition has not been fully established. Several possible mechanisms have been proposed to be responsible for RN. These include disruption to the blood-brain barrier that increases brain permeability, or the CRT directly damages glial cells. Some common symptoms that patients with RN may experience include headaches, nausea, cognitive impairment, seizures, or focal deficits related to the location of their irradiated tumor. SMART syndrome is considered a rare complication of CRT that can occur between one and ten years after treatment. Some characteristic symptoms of SMART syndrome include migraine-like headaches associated with transient neurologic signs that may or may not be accompanied by seizures. Cerebral atrophy typically only arises after whole-brain irradiation, rather than more localized CRT treatments like gamma-knife. Although patients with cerebral atrophy may not report any symptoms at all, others may experience memory loss that can be severe in some cases. References Kaley, T. J., & Deangelis, L. M. (2021). Chapter 28 – Neurologic Complications of Chemotherapy and Radiation Therapy. In: Aminoff’s Neurology and General Medicine; 521-537. https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780128193068000289. Tanguturi, S. K., & Alexander, B. M. (2018). Neurologic Complications of Radiation Therapy. Neurologic Clinics 36(3); 599-625. doi:10.1016/j.ncl.2018.04.012. Vellayappan, B., Tan, C. L., Yong, C., et al. (2018). Diagnosis and Management of Radiation Necrosis in Patients With Brain Metastases. Frontiers in Oncology 8(395). doi:10.3389/fonc.2018.00395. To read the original article click here.

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Asthma May Reduce Risk of Brain Tumors — But How?

AHA Publisher — Mon, 13 Dec 2021 08:00:44 +0000

Washington University in St. Louis via Newswise – There’s not much good that can be said about asthma, a breathing disease in which the airways become narrowed and inflamed. But there’s this: People with asthma seem to be less likely to develop brain tumors than others. And now, researchers at Washington University School of Medicine in St. Louis believe they have discovered why. It comes down to the behavior of T cells, a type of immune cell. When a person — or a mouse — develops asthma, their T cells become activated. In a new mouse study, researchers discovered that asthma causes the T cells to behave in a way that induces lung inflammation but prevents the growth of brain tumors. What’s bad news for the airways may be good news for the brain. The findings, available online in Nature Communications, suggest that reprogramming T cells in brain tumor patients to act more like T cells in asthma patients could be a new approach to treating brain tumors. “Of course, we’re not going to start inducing asthma in anyone; asthma can be a lethal disease,” said senior author David H. Gutmann, MD, PhD, the Donald O. Schnuck Family Professor of Neurology. “But what if we could trick the T cells into thinking they’re asthma T cells when they enter the brain, so they no longer support brain tumor formation and growth? These findings open the door to new kinds of therapies targeting T cells and their interactions with cells in the brain.” The idea that people with inflammatory diseases, such as asthma or eczema, are less prone to developing brain tumors was first proposed more than 15 years ago, based on epidemiologic observations. But there was no obvious reason why the two very different kinds of diseases would be linked, and some scientists questioned whether the association was real. Gutmann is an expert on neurofibromatosis (NF), a set of complex genetic disorders that cause tumors to grow on nerves in the brain and throughout the body. Children with NF type 1 (NF1) can develop a kind of brain tumor known as an optic pathway glioma. These tumors grow within the optic nerves, which carries messages between the eyes and the brain. Gutmann, director of the Washington University NF Center, noted an inverse association between asthma and brain tumors among his patients more than five years ago but didn’t know what to make of it. It wasn’t until more recent studies from his lab began to reveal the crucial role that immune cells play in the development of optic pathway gliomas that he began to wonder whether immune cells could account for the association between asthma and brain tumors. Jit Chatterjee, PhD, a postdoctoral researcher and the paper’s first author, took on the challenge of investigating the association. Working with co-author Michael J. Holtzman, MD, the Selma and Herman Seldin Professor of Medicine and director of the Division of Pulmonary & Critical Care Medicine, Chatterjee studied mice genetically modified to carry a mutation in their NF1 genes and form optic pathway gliomas by 3 months of age. Chatterjee exposed groups of mice to irritants that induce asthma at age 4 weeks to 6 weeks, and treated a control group with saltwater for comparison. Then, he checked for optic pathway gliomas at 3 months and 6 months of age. The mice with asthma did not form these brain tumors. Further experiments revealed that inducing asthma in tumor-prone mice changes the behavior of their T cells. After the mice developed asthma, their T cells began secreting a protein called decorin that is well-known to asthma researchers. In the airways, decorin is a problem. It acts on the tissues that line the airways and exacerbates asthma symptoms. But in the brain, Chatterjee and Gutmann discovered, decorin is beneficial. There, the protein acts on immune cells known as microglia and blocks their activation by interfering with the NFkappaB activation pathway. Activated microglia promote the growth and development of brain tumors. Treatment with either decorin or caffeic acid phenethyl ester (CAPE), a compound that inhibits the NFkappaB activation pathway, protected mice with NF1 mutations from developing optic pathway gliomas. The findings suggest that blocking microglial activation may be a potentially useful therapeutic approach for brain tumors. “The most exciting part of this is that it shows that there is a normal communication between T cells in the body and the cells in the brain that support optic pathway glioma formation and growth,” said Gutmann, who is also a professor of genetics, of neurosurgery and of pediatrics. “The next step for us is to see whether this is also true for other kinds of brain tumors. We’re also investigating the role of eczema and early-childhood infections, because they both involve T cells. As we understand this communication between T cells and the cells that promote brain tumors better, we’ll start finding more opportunities to develop clever therapeutics to intervene in the process.” To read the original article click here.

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Do Cell Phones Cause Brain Tumors?

AHA Publisher — Wed, 28 Apr 2021 07:00:34 +0000

Michael Greger M.D. FACLM via Nutrition Facts – What does the world’s leading authority on carcinogens have to say about mobile phones? Do cell phones cause cancer? That’s a question billions of people would like to have answered and one I address in my video Cell Phone Brain Tumor Risk?. That’s why we have the World Health Organization’s International Agency for Research on Cancer (IARC), the recognized authority on determining what is and is not carcinogenic. There are five categories: Group 1 carcinogens are agents that we know with the highest level of certainty do cause cancer in human beings, Group 2A probably cause cancer, Group 2B possibly cause cancer, we’re not sure about agents categorized as Group 3, and Group 4 agents probably don’t cause cancer. In May 2011, 30 scientists from 14 countries met at the IARC to assess the carcinogenicity of the radiation emitted from cell phones and concluded that, given the limited amount of available evidence, cell phones are “‘possibly carcinogenic to humans’ (Group 2B).” So they’re not classified as a Group 1 carcinogen that’s known definitively to be cancer-causing, like plutonium, or processed meat, or as probable carcinogen, like DDT, Monsanto’s Roundup pesticide, or some regular meat, but they are classified as a possible carcinogen, ranked similarly as preserved vegetables like kimchi. Now, this classification was made more than five years ago. Evidence continues to mount, and the latest two 2017 systematic reviews found a 33 percent increase in odds of brain tumors with long-term use and showed 46 percent higher odds for tumors on the phone side of your head—and the reviews included the industry-funded studies that have been accused of being biased and flawed, and underestimating the risk, as opposed to independent studies free from “financial conditioning.” How’s that for a euphemism? Given this, some scientists are pushing to have the IARC reclassify cell phones as probable carcinogens or even bump them all the way up into Group 1, at least for brain cancer and acoustic neuroma, a type of inner ear tumor. But the IARC classification for cell phones currently remains at possible carcinogen. What does that mean? What do we do with that information? Well, given the uncertainty, we could follow “the precautionary principle” and use simple personal measures to reduce our exposure, like not putting the phone directly up to our head all the time. Indeed, the “main concern about cell phones is that they are usually held close to the head,” which is considered particularly important for children. There’s no evidence of finger cancer, though, so you can keep texting away. Other potential personal recommendations include waiting a moment before putting your cell phone to your ear, if you don’t have a headset, because “when the cell phone establishes a connection, the emission is high.” And don’t fall for those anti-radiation gizmos, those “so-called protection covers,” as they may make things worse by forcing the phone to boost the signal. Not all agree, however, with this precautionary approach. Employees at two cell phone industry trade organizations emphasize “there are many aspects of human activity that are not ‘totally without adverse health effects,’—for example, transport (including aviation) and hot showers,” so they suggest we should just accept the risk as being worth it. Wait. Hot showers? As in we might scald ourselves or something? In any case, they further suggest that we shouldn’t put forth any recommendations because “such judgment should be made by parents on a personal basis for their own children,” and, if we do put out guidelines or something, people might get nervous and we all know “anxiety itself can have deleterious health consequences.” So, basically, the cell phone industry cares so much about your health that it doesn’t want you worrying your pretty little head. Nevertheless, all of this is openly discussed in the risk analysis literature. “From a public health perspective, it might be reasonable to provide cell phone users with voluntary precautionary recommendations for their cell phone handling in order to enable them to make informed decisions”—but what if the public can’t handle the truth? We don’t want to freak people out. There’s still “scientific uncertainty” and we don’t want to “foster inappropriate fears.” For example, brain cancer is rare to begin with. You only have about a 1 in 15,000 chance a year of getting a brain tumor, so even if cell phones double your risk, that would only take you up to a 1 in 7,500 chance. You may be more likely to get killed by a cell phone in the hands of a distracted driver than by cancer. So, whether health authorities want to inform the general public about precautionary possibilities really remains more of a political decision. To read the original article click here. For more articles from Dr. Greger click here.

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Can Cell Phone Radiation Damage Your DNA?

AHA Publisher — Fri, 23 Apr 2021 07:00:41 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Do mobile phones cause brain tumors? Whenever a trillion-dollar industry is involved—whether it’s Big Food, Big Tobacco, Big Pharma, or Big Telecom—there’s so much money that the science can get manipulated. When it comes to the potential human health effects of cell phone use, certainly, you might endup with a crick in your neck if you text excessively or even break your neck or the neck of someone you may hit if you text while driving. On the other hand, think of the countless lives that have been saved on the road, because people are now able to so quickly phone in emergencies. But what about cancer? Since the turn of the century, there have been studies suggesting up to double the risk of brain tumors with long-term cell phone use on the side of your head you use to talk. That’s important, because the radiation only really penetrates up to a couple of inches into your brain. At 0:48 in my video Does Cell Phone Radiation Cause Cancer?, I show views from the back of the head and the top of the head, and you can see why you might develop cancer on one side of the head over the other. Since it’s such a local effect, you can see why there are recommendations for using the speakerphone function or a hands-free headset, which can reduce brain exposure by a factor of 100 or more—and this includes Bluetooth headsets. This may be particularly important in children, who have thinner skulls. Cell phone radiation isn’t like nuclear radiation, though. It doesn’t damage DNA directly, like gamma rays from an atomic bomb. Yes, but it does appear to be able to damage DNA indirectlyby generating free radicals. Out of 100 studies that looked at this, 93 confirmed these oxidative effects of the kind of low-intensity radiofrequency radiation that comes out of cell phones. Okay, but does that oxidative stress translate out into DNA damage? Most studies found it did, detecting signs of genotoxicity, which is damage to our genes, DNA, or chromosomes. A lot of those studies were done in petri dishes or in lab animals, though. I’m less interested in whether Mickey or Minnie is at risk than I am concerned about brain tumors in people. Yes, some population studies found increased cancer risk, but other studies did not. Could the source of funding for those studies have anything to do with the different findings? Some of the studies were funded by cell phone companies. Researchers “hypothesized that studies would be less likely to show an effect of the exposure if funded by the telecommunications industry, which has a vested interest in portraying the use of mobile phones as safe.” So, they ran the numbers and—surprise, surprise—“found that the studies funded exclusively by industry were indeed substantially less likely to report statistically significant effects…” Indeed, most of the independently funded studies showed an effect while most of the industry-funded studies did not. In fact, industry-funded studies had about ten times fewer odds of finding an adverse effect from cell phone use. That’s even worse than the drug industry! Studies sponsored by Big Pharma about their own products only had about four times the odds of favoring the drug compared to independent researchers. Big Tobacco still reigns supreme when it comes to Big Bias, though. Why do research articles on the health effects of second-hand smoke reach different conclusions? Well, it turns out that studies funded by the tobacco industry itself had a whopping 88 times the odds of concluding it was not harmful. So about ten times more for telecom puts it more towards the drug industry end of the bias spectrum. There are conflicts of interest on both sides of the debate, though. If it’s not financial conflict, then it may be intellectual, as it can be human nature to show bias towards evidence that supports your personal position. As such, you’ll see flimsy science published, like a study I show at 3:55 in my video that appears to find a “disturbing” and “very linear relationship” between the states with the most brain tumors and the states with the most cell phone subscriptions. Okay, but one could think of lots of reasons why states like New York and Texas might have more brain tumors andmore cells phones than the Dakotas, and those reasons have nothing to do with cell phone radiation. Sometimes, you might even see outright fraud with allegations that the academic researchers who authored two of those genotoxicity papers and the very review I mentioned earlier were involved in scientific misconduct—allegations they deny, pointing out that their lead accuser turned out to be a lawyer working for the telecom industry. Whenever there’s a trillion-dollar industry involved, whether it’s the food industry, tobacco industry, drug industry, or telecom industry, there’s so much money involved that the science can get manipulated. Take the nuclear energy industry for example. There were decades of “a high-level, institutional…cover up” about the health consequences of Chernobyl. The official estimates of resulting health problems were a hundred or even a thousand times lower than estimates from independent researchers. Did only 4,000 people eventually die from it or nearly a million? It depends on who you ask and who happens to be funding whomever you’re asking. That’s why, when it comes to cancer, all eyes turn to the International Agency for Research on Cancer, the IARC, which is the official World Health Organization body that independently and objectively tries to determine what is and is not carcinogenic. You can find out what the IARC concluded about cell phones in my video Cell Phone Brain Tumor Risk?. To read the original article click here. For more articles from Dr. Greger click here.

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