Pinpointing Problems In The Brain

Neurologists Use New Brain Scanning Device To Better Control Seizures

March 1, 2007 — Doctors are now using a new kind of brain scan called
magnetoencephalography (MEG), which measures brain activity in real time. In
some cases, MEG can pinpoint the source of an epileptic seizure much more
accurately than the traditional method of electroencephalography (EEG). Using a
combination of MEG and MRI, neurosurgeons have a detailed brain map that allows
them to remove just the damaged tissue while preserving healthy cells.
Dawn Helton has tried just about everything available to stop her seizures so she can get back to living her life. "I
mostly, um, just lose my hearing and my speech ... confusion. Then, of course, I'm really tired and stuff," she
says.

Epilepsy is a frustrating and often debilitating condition. Medication may control seizures in about 75 percent of
cases, but neurologists say surgery is the only potential cure.

A Geodesic Sensor Net was supposed to help doctors pinpoint where Helton's seizures happen, but it didn't work.
Now there's new hope when all else fails. A powerful new brain scanning tool could make all the difference.
Magnetoencephalography, or MEG, works by measuring the magnetic field created by brain activity ... And it does
that in real time.

"Unlike other, other imaging tools that sample it several or tens or hundreds times, this imaging technology can
take thousands of samples every second," Anto Bagic, M.D., a neurologist at the Center for Advanced Brain
Magnetic Source Imaging at UPMC in Pittsburgh, tells DBIS.

That means in some cases MEG can pinpoint the source of an epileptic seizure much more accurately than the
traditional method of electroencephalography (EEG). Using a combination of MEG and MRI, neurosurgeons have
a detailed brain map guiding them during surgery to remove just the damaged tissue, while preserving healthy
cells.

Researchers say in the future, the MEG brain scanner may aid in the diagnosis and study of other disorders like
dementia, migraines, Parkinson's disease, depression and traumatic brain injuries, in addition to epilepsy -- a
breakthrough that could lead to helping patients like Helton.

"I think it's fabulous," Helton says. "I think if anybody can come up with even anything more, more advanced, it's
even greater! Stop these seizures. Or slow 'em down, or something."

BACKGROUND: At the university of Pittsburgh Medical Center, a scanning device which measures the brain's
magnetic field in real time is allowing clinicians to more accurately pinpoint those areas of the brain causing
epileptic seizures.

The scanner also can aid in the diagnosis and study of disorders such as Parkinson's disease, multiple sclerosis,
dementia, and schizophrenia. Currently, researchers are using the device to determine the location of seizures in
epileptic patients and identify the functional centers of the brain responsible for language, vision, motor and
sensory information.

HOW IT WORKS: Real-time brain mapping and monitoring is considered to be one of the most exciting areas of
neuroscience today. Magnetoencephalography (MEG) measures the magnetic fields produced by electrical
activity in the brain via extremely sensitive superconducting sensors. Any electrical current will produce a
magnetic field, and MEG measures the field generated by the brain's electrical currents. Traditionally, brain
activity has been measured using electroencephalography (EEG), in which the electrical signals are recorded
from electrodes placed on the scalp.

BENEFITS: With MEG, clinicians can now map nerve cell activity in the brain non-invasively to see the brain in
action, rather than analyzing a series of still images. The system simultaneously produces 306 separate
recordings of magnetic activity and determines where it originates and which parts of the brain undertake various
tasks. An MEG scan can also determine how the brain functions both normally and in cases of illness. The
graphical representations produced by the system can be sent directly into a navigational system used by
neurosurgeons in the operating room to help guide them to the area of the brain that should be taken out, while at
the same time marking vital centers and abnormalities -- thereby improving surgical outcomes.

ABOUT EPILEPSY: Epilepsy is a disorder of the central nervous system, specifically affecting the brain. A
network of nerve cells (called neurons) runs through the body like telephone wires, delivering "messages," via
chemical messengers known as neurotransmitters, from the brain. Epilepsy disrupts this vast communications
network. The brain's electrical rhythms tend to become imbalanced by sudden surges, leading to seizures.
Around 2.7 million Americans have been treated for epilepsy in the past five years: 8 out of every 1,000 people.
And up to 5 percent of the world's population may have a single seizure at some point in their lives.
The American Association of Physicists in Medicine contributed to the information contained in the video portion
of this report.

Note: This story and accompanying video were originally produced for the American Institute of Physics
seriesDiscoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law.
All rights reserved.
New, Non-Invasive Surgical Procedure To Eliminate Epileptic Seizures
ScienceDaily (June 5, 2002) — The Indiana University School of Medicine is one of
six institutions in the nation participating in the National Institutes of Health clinical
trial of a new, non-invasive surgical procedure to eliminate epileptic seizures due to
intractable epilepsy.
"This is the first clinical trial in the United States of this promising treatment for epilepsy," says Paul DesRosiers,
M.D., assistant professor of radiation oncology and the principal investigator of the IU School of Medicine trial. "As
many as 10 patients will be treated at IU in this trial which is designed to determine the most effective radiation
dose for eliminating the seizure focus in the brain."

Currently, the only approved treatments involve medication or invasive surgery. This new radiosurgery protocol
uses the Gamma Knife to focus 201 beams of gamma radiation on the precise location of the brain responsible
for the seizures.
When the beams converge, the targeted area of the brain receives a full-treatment dose of radiation. Gamma
Knife radiosurgery spares healthy areas of the brain from high-dose exposure to gamma radiation.

Patients over the age of 18 with a specific form of temporal lobe epilepsy, who would otherwise be candidates for
the traditional surgery, are eligible to participate in this clinical trial. It is estimated that up to 1 percent of the U.S.
population has epilepsy and that 20 percent of those patients have the type of epilepsy that may benefit from
surgery. The surgery, for patients with seizures stemming from one temporal lobe of the brain, is up to 95 percent
effective.

"The IU Comprehensive Epilepsy Program is the only one in Indiana dealing with these extreme cases," says
Vincenta Salanova, M.D., associate professor of neurology and co-director of the program. "More than 500
patients have been evaluated in the clinic and, of those, 300 have qualified for surgery. As many as 90 percent of
these patients became seizure free or had rare seizures, with significant improvement in their quality of life.
Preliminary data indicate that the Gamma Knife radiosurgery also may be effective for select patients and will
offer them another treatment option."

Gamma Knife radiosurgery eliminates many of the risks inherent with traditional surgery because it is non-
invasive. The radiation is diffused through a 300-pound collimator helmet, which resembles a large version of the
kitchen colander. The patient's head is placed inside the helmet and held fast at four points to the skull. Each of
the "drain holes" is actually an aperture that creates beams of varying strength and diameter allowing precise
delineation of the area to be treated. When the individual beams converge, that area receives the full treatment
dose of gamma radiation. Treatment time is much less than that of traditional surgery and the recovery period
usually involves only one over-night hospital stay. Faculty members from the IU Departments of Neurology,
Neurosurgery, Neuroradiology and Radiation Oncology are involved in the clinical trial.

Treatments will be done in the Indiana Lions Gamma Knife Center at the Indiana Cancer Pavilion. The center is
directed by Robert Timmerman, M.D., assistant professor of radiation oncology, and Thomas Witt, M.D.,
associate professor of neurosurgery.

IU School of Medicine was the first in the state to use Gamma Knife radiosurgery technology. The first patient in
Indiana was treated in September 1997 and since then more than 500 patients with benign and malignant brain
tumors, vascular malformations or facial pain, such as trigeminal neuralgia, have been treated with this
sophisticated technology.
Recent advances in neuroradiology have made it possible to more precisely evaluate the function of different
regions of the brain leading to advanced treatments such as radiosurgery for epilepsy.
For more information on the IU Gamma Knife program, see http://www.iupui.edu/~neurosur/GammaKnife.html or
http://www.clarian.org/clinical/gammaknife/index.jhtml?print=true
Email or share this story:

Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Indiana
University.

Indiana University (2002, June 5). New, Non-Invasive Surgical Procedure To Eliminate Epileptic
Seizures. ScienceDaily. Retrieved September 7, 2010, from
http://www.sciencedaily.com/releases/2002/06/020605073153.htm
Note: If no author is given, the source is cited instead.
Mini-Maze for Quivering Hearts
Cardiothoracic Surgeons Develop New Treatment for Fibrillation

May 1, 2005 — Researchers have developed a method to quiet atrial fibrillations

without having to perform open-heart surgery. In a technique called Mini-Maze,
doctors insert a bi-polar-radio-frequency clamp on the heart by creating tiny
incisions in the ribs. Energy flows through the clamp forming scar tissue that blocks
the erratic electrical pulses.

Atrial fibrillation is a disorder that causes the heart's two small upper chambers to quiver at 300- to 600-times-a-
minute. This rapid heartbeat leaves patients short of breath, dizzy, fatigued and of course, frightened. Now, a
breakthrough steadies the heart and gives patients some much-needed relief.
Two-point-five-million Americans have atrial fibrillation, a condition that leaves them with an erratic, racing heart.

"It gives the patients the feeling of impending doom. They think, 'Is this what a heart attack feels like?' when they
first have it," says Dr. Randall Wolf, a cardiothoracic surgeon at University of Cincinnati.

It's not a heart attack, but it can lead to a stroke. Many patients steer clear from invasive open heart surgery to fix
it. Now, Dr. Wolf has developed an easier way to quiet the problem.

Through small incisions between the ribs, doctors insert a bi-polar-radio-frequency clamp on the heart. Energy
flows through the clamp forming scar tissue that blocks the erratic electrical pulses in a heartbeat.

Dr. Wolf says, "We're at the point here, based on the patients we've reviewed here at the University of Cincinnati,
that we are curing atrial fibrillation with a minimally invasive approach."

He is now training doctors across the country to do the new Mini-Maze procedure. Dr. Cliff Van Meter says the
procedure is a breakthrough.

"It's much like a maze that has no way out. The heart can now beat regularly because this abnormal focus of
electrical activity is isolated," says Dr. Van Meter, a cardiac and thoracic surgeon at Ochsner Clinic in New
Orleans. He also says it's changed the way he talks to his patients. "Now we can say to them, 'We can assure you
that we've reduced your risk of having a stroke.'"

That was all George Rabe needed to hear from his doctor. "As far as I'm concerned, he saved my life ... not living
wise, but being part of life." His Mini-Maze procedure went off without a hitch, and he'll soon be skydiving again.
Research so far shows the procedure fixes the heart in more than 80 percent of patients. Surgeons across the
country are currently being trained to do this procedure.

The original maze procedure required many incisions, sewing the upper chambers of the heart (right and left
atrial), and a long operation.
The heart pumps by generating electrical impulses to contract the heart muscles in a precisely coordinated
manner, and keep the heartbeat regular.

Normally, the heartbeat starts in the right atrium, when a special group of cells (the "pacemaker" of the heart)
sends an electrical signal causing the muscles to contract. These signals travel through connecting fibers to all
parts of the ventricles, and must follow the exact route in order for the heart to pump properly.

An arrhythmia occurs when the heart beats too fast, too slow, or irregularly. This keeps the heart from pumping
blood properly.

Every cell in the heart muscle tissue is capable of starting electrical impulses. That's why we all experience an
occasional premature, rapid or irregular heartbeat. These are called palpitations, and are usually a benign
condition. But irregularities that happen often indicate arrhythmia, which occurs when another part of the heart
takes over as "pacemaker," disrupting the usual route.

There are many types of arrhythmia, identified by where they occur in the heart (in the atria or ventricles), and by
what happens to the heart's rhythm when they occur.
One example is atrial fibrillation, an irregular heartbeat that interferes with the heart's ability to pump blood.
Abnormal electrical signals cause the atria, or upper chambers of the heart, to contract erratically. Blood then
pools in the atria and forms clots.

These can travel to the brain and cause a stroke. The most serious arrhythmia is ventricular fibrillation, where the
lower chambers quiver and the heart can't pump any blood. This results in collapse and sudden death -- if there
isn't immediate medical attention.

Note: This story and accompanying video were originally produced for the American Institute of Physics
seriesDiscoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law.
All rights reserved.
Detecting Prostate Cancer Earlier
Cancer Biologists Develop More Accurate Blood Test for Prostate
Cancer

September 1, 2005 — A new blood test is more reliable at finding prostate cancer in its early
stages by detecting a protein marker in blood plasma. Doctors say the new test, now in clinical
trials, will have an accuracy of 95 percent, better than the commonly used PSA, which signals
abnormal prostate conditions rather than cancer.

Most men over age 50 are familiar with PSA testing, used to detect prostate cancer. But the test can sometimes
miss cancer cases. Now a new test can find cancer earlier.
When James Foster discovered he had prostate cancer, his life barely missed a beat. Now a prostate cancer
survivor, Foster says, "I don't think I was shocked. I truly was almost preparing for it." But finding out he had the
disease wasn't easy or quick. Like many men his age, he experienced the problem of having elevated PSA test
results that could mean any number of things.

Robert Getzenberg, a cancer biologist at Johns Hopkins School of Medicine in Baltimore, says, "A blood test of
PSA is not really an accurate marker of prostate cancer, but really a marker of abnormal prostate conditions."

Cancer biologists now have a new blood test, currently in clinical trials, that's more reliable and accurate at finding
the disease in its earliest stages. The new test identifies a protein marker in blood plasma, called early prostate
cancer antigen -- or EPCA. When the marker appears in a blood test, it indicates a high probability of cancer, not
just that something is wrong. Doctors say it's the best indicator yet of prostate cancer.
"If you have the EPCA marker in your blood, you almost certainly, higher than 95-percent chance, have prostate
cancer," Getzenberg says -- promising new number that might help reduce the amount of prostate biopsies, a
painful, invasive procedure to confirm cancer, and focus on men who are truly at risk.

BACKGROUND: In the first clinical study of a new blood protein associated with prostate cancer, researchers
have found that the marker EPCA, or early prostate cancer antigen, can successfully detect prostate cancer in its
earliest stages. The current technique for detecting prostate cancer prostate-specific antigen (PSA) testing, can
sometimes indicate cancer when none is there. Prostate cancer is the most common type affecting American
men, with about 232,090 new cases diagnosed in 2005.

WHAT IS THE PROSTATE: The prostate is a walnut-sized gland, located between the bladder and the penis and
in front of the rectum. Its primary function is the production of seminal fluid, the milky substance that nourishes
sperm.

WHAT IS PSA TESTING: PSA testing is one step in early identification of prostate tumors, combined with digital
rectal examination. But PSA testing can miss some cancers, or produce a false positive (indicate a cancer that
doesn't exist). Furthermore, a prostate biopsy is a very painful and unpleasant procedure, with 12 separate tissue
extractions followed by a month of pain. The biopsy usually needs to be repeated each year after the first positive
PSA result, even if the initial biopsy comes out negative. Of the 1.8 million biopsies performed annually, only 15
percent come out negative. Reducing the number of biopsies requires for an accurate diagnosis would bring
welcome relief to many patients.

NEW BLOOD TEST: Researchers at Johns Hopkins measured the ECPA levels in 46 patients, including those
with prostate cancer, bladder, colon and kidney cancer, spinal cord injury, and noncancerous prostate
inflammation, as well as 16 healthy individuals. They found that EPCA levels were high in 11 of the 12 prostate
cancer patients and low in all the healthy individuals. They estimate an accurate diagnosis rate of 94 percent.
When coupled with standard PSA screening, the new blood test could help reduce the number of unnecessary
biopsies and undetected prostate tumors. The ECPA test very specific to prostate cancer; it doesn't indicate other
types of cancer or benign prostate conditions.

WHEN AVAILABLE: Larger clinical trials will be starting soon, and it is believed that the blood test will be
generally available to medical practitioners in 2006.
Note: This story and accompanying video were originally produced for the American Institute of Physics
seriesDiscoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law.
All rights reserved.
Saving Legs - Saving Lives
Vascular Surgeons Use Vibrating Catheter To Rid Arteries Of Pad-
causing Plaque

April 1, 2008 — Vascular surgeons can address peripheral artery disease by

dissolving blood-blocking plaque concentrations with a vibrating catheter. Inserting
the catheter into the blocked artery allows it to be maneuvered to the location of the
clot, where it breaks down the plaque into small pieces that travel safely away,
opening up passages large enough to allow blood to pass through freely, or to
create space for a stent when required.

Millions of Americans may be at risk for heart attack or stroke and not even know it. A pain in your leg may be a
sign of something much more serious -- even fatal. Ivanhoe explains a new way to fight peripheral arterial disease
(PAD).

Marjo Madden thought her age was catching up with her! "I couldn't walk any more than 50 feet without sitting
down," Madden recalls.
But it wasn't age. It was PAD that was slowing her down. "I had a very bad burning sensation in the calves of my
legs," Madden says.

Just as the blood flow in a heart attack patient is cut off by plaque, in PAD, blood flow throughout the body can be
cut off. PAD is treated now with a balloon or stent, but for some patients the plaque is too hard, or there's too
much of it. Until now, these patients would face invasive surgery … or worse.

"They have to have something done," Imran Mohiuddin, M.D., a vascular surgeon at Methodist DeBakey Heart
Center in Houston, told Ivanhoe. "Otherwise, they're at risk of losing that limb. So this is sort of -- we call it limb
salvage."

The FDA has just approved a vibrating catheter that gives doctors another tool to help patients who are running
out of options. "The catheter works like a miniature jack hammer inside the blood vessel, and it comes up against
an inclusion and then it starts vibrating," Dr. Mohiuddin explains. "Through its vibrations, it's able to slowly burrow
a hole."

Sensors detect tissue, so even though the vibrating catheter is strong enough to break through plaster, it won't go
through tissue. "It breaks up the particles into very, very microscopic particles, as small as a red blood cell," Dr.
Mohiuddin explains.
Once the catheter is through, doctors will use angioplasty or a stent to keep the artery open. "Often times, we
would have to just abandon that case and actually perform a bypass operation," Dr. Mohiuddin says.

Recovery time is just a day and for patients like Madden, this could be one way to help stop the pain and get
moving again! "However much the Lord has given me, I'm going to use it to the fullest," Madden says.
The vibrating catheter was just approved by the FDA for use in the legs. The next step is to get it approved for
other arteries. Doctors in Europe are already using this procedure successfully in the heart.

ABOUT PAD: Peripheral artery disease is a condition that affects about 10 million people in the U.S. It often
leads to severe blockage in the arteries, particularly in the lower leg. Such blockages reduce blood flow to the
legs and feet, increasing the risk of infection, leg ulcers, gangrene and amputation. Those with PAD are also more
at risk for other cardiovascular diseases, including heart attack and stroke.

ABOUT STROKES: The brain is made up of living cells that require a constant supply of nutrient- and oxygen-
rich blood. Blockage or rupture of the blood vessels supply parts of the brain cause most strokes. A stroke occurs
when brain tissue is deprived of blood and brain cells die from the lack of oxygen. Depending on which area of the
brain is affected, a stroke can cause vision problems, speech problems, disability, even death.
Traditionally, treatment for stroke-causing diseases involves blood-thinning drugs to prevent clots, but for patients
with severe blockage, this may not be sufficient. Some temporary blockages only last minutes or hours, leading to
mini-strokes. Mini-strokes are a sign of a serious problem and can lead to a permanent stroke if left untreated.

WHAT CAUSES HEART ATTACKS? Heart attack is the leading cause of death in North and South America and
in Europe. It is usually the result of prolonged hardening and narrowing of the arteries that direct blood into the
heart. When blood vessels are healthy, oxygen-rich blood flows easily to all the muscles and organs of the body.
But if they become clogged by the buildup of fatty deposits on vessel walls, blood can be cut off, killing heart
muscle cells. This is called coronary heart disease, and it can lead to heart attacks or strokes.

Note: This story and accompanying video were originally produced for the American Institute of Physics
seriesDiscoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law.
All rights reserved.
Stroke Stopper
Interventional Neuroradiologists Treat Brain Strokes with New Kind of
Stent
April 1, 2006 — A new "wingspan" stent helps restore blood flow for patients with
intracranial atherosclerotic disease, or ICAD. Surgeons insert the stent up the leg
arteries, guide it to the brain, then let its wire mesh expand, propping open a
clogged blood vessel. The new stent, designed for the fragile, curvy arteries in the
brain, replaces stiffer stents used in heart and neck vessels.
When a stroke hits, it hits the brain hard -- many times causing paralysis, speech problems, or even death. Now,
doctors have a new weapon against this deadly brain attacker.
John Dietz is happy to be back on his feet after a surprise stroke left him almost speechless. "I have trouble
getting the words out. I know the words in my brain, but I can't get them out."
The artery in John's brain that caused the stroke was almost completely blocked. Now, to save his life a new tiny,
flexible stent to open clogged arteries and prevent another stroke from happening is in his brain.

Traditional stiff stents are used to treat blockages in the heart and neck. The new wingspan stent, however, is
designed for the fragile, curvy arteries in the brain.
Abraham Obuchowski, an interventional neuroradiologist at the University of Maryland Medical Center in
Baltimore, says, "The stent is more flexible so it can make the turns to get up into the brain."

Neuroradiologists guide the wire-mesh stent with a catheter up the artery in the leg leading to the brain. Then a
protective covering is removed and the self-expanding stent props open the clogged artery. "You can actually take
it and squeeze it and crush it, and it will pop back into position. So that's what's unique about this stent," Dr.
Obuchowski says.
John is hopeful this unique device will help him have a stroke-free future.
The new wingspan stent system is designed for patients with intracranial atherosclerotic disease, or ICAD. Until
now, the only treatment option for these patients was medication therapy like aspirin or using a heart stent in the
brain.

BACKGROUND: A new medical device can open clogged arteries in the brain, helping prevent strokes. Called
the Wingspan Stent System, it is specifically designed to treat blockages caused by intracranial athlerosclerotic
disease, a condition that causes strokes. While it won't address risk factors such as high blood pressure or high
cholesterol, the device will significantly decrease a patient's risk of stroke.

WHAT ARE STENTS? A stent is essentially a small piece of metal "scaffolding" that pushes arterial plaque to the
side and provides a framework to keep the blood vessel open so that the blood can flow freely through it. Stents
have been used for many years to clear blockages in the arteries of the heart and neck. But arteries in the brain
are fragile, with many more curves, so it is much harder to get the stent to the blockage site. Steel stents can
injure those vessels. The Wingspan stent is made of an alloy of nickel and titanium, which puts less pressure on
the blood vessel when it expands.

HOW IT WORKS: Neuroradiologists insert a catheter into an artery in the upper leg. Using digital X-rays for
image guidance, they then navigate the catheter through the blood vessels to the site of the blockage in the brain.
They then slowly inflate an angioplasty balloon to push away the plaque and put the stent in place to hold the
vessel open.

ABOUT STROKES: The brain is made up of living cells that require a constant supply of nutrient- and oxygen-
rich blood. Blockage or rupture of the blood vessels supply parts of the brain cause most strokes. A stroke occurs
when brain tissue is deprived of blood and brain cells die from the lack of oxygen. Depending on which area of the
brain is affected, a stroke can cause vision problems, speech problems, disability, even death. Traditionally,
treatment for stroke-causing diseases involves blood-thinning drugs to prevent clots, but for patients with severe
blockage, this may not be sufficient. Some temporary blockages only last minutes or hours, leading to mini-
strokes. Mini-strokes are a sign of a serious problem and can lead to a permanent stroke if left untreated.

ABOUT BLOOD FLOW: The heart pumps blood through the arteries, capillaries and veins to provide oxygen and
nutrients to every cell of the body, and also carries away waste products from those cells. The liquid portion of the
blood is called plasma. It distributes various nutrients and chemicals throughout the body, diffusing into the
tissues and cells. In general, they diffuse from areas of high concentration to areas of low concentration. Waste
flows in the opposite direction and are removed in the kidneys or the lungs. Blood pressure pushes fluid out of
blood vessels. This is balanced by something called oncotic pressure, which keeps fluid inside the blood vessels
so that the body maintains a constant volume of blood.
Note: This story and accompanying video were originally produced for the American Institute of Physics seriesDiscoveries
and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law. All rights reserved.