Monthly Archives: April 2012

Whatever Happened to Brodmann Area 27?

Brodmann Area 27, by was_a_bee, adapted from Brodmann (1909), Public Domain

The brain is a complex structure and but can be organised according to several principles. One approach is to characterise the brain regions according to the microscopic properties of these regions.  More specifically the neurons are organised differently between regions. Some regions may contain unique types of neurons. This approach to understanding the organisation of the brain was proposed by the German Neuropathologist Korbinian Brodmann and resulted in the eponymously named Brodmann Area. There are 52 areas in all and I have covered other Brodmann Areas elsewhere. One area which was a little different from previous areas was Brodmann Area 27.  I undertook a search on Medline using the terms “BA27″ and “Brodmann Area 27″. At the time of writing these searches returned 16 and 42 results respectively. The only relevant studies were this one making references to cytoarchitectural properties of BA27 (as well as other areas) and this post-mortem study in which the researchers found increases in [3H] Nicotine binding in BA27 in smokers.

According to the Sylvius Neuroanatomical Reference, BA27 includes areas CA1-CA4 of the Hippocampus and according to RadLex, BA27 is synonymous with the Presubicular Area. Using these terms in Medline would produce a large set of results numbering in the hundreds of thousands. However the point is not that the search terminology is wrong but rather that BA27 has been abandoned in the research literature in favour of these other terms.

Appendix

Neuroanatomy Resources

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Antidepressant Trials and a Psychiatry Summer School for Medical Students. News Round-Up: April 2012 4th Edition

Kok and colleagues have conducted a meta-analysis of 51 randomised controlled trials of antidepressant treatment of depression in older adults and concluded that the evidence supports a beneficial effect of antidepressants in response and remission rates. The researchers were unable to distinguish between Tricyclic Antidepressants, Selective Serotonin Reuptake Inhibitors and other antidepressants in remission or response rates. However to conclude that the antidepressants were more effective than placebo in remission rates they pooled the data from all three groups of antidepressants.

In a moderately sized 12-week double-blind placebo controlled trial, Richard and colleagues investigated the treatment of Depression in Parkinson’s Disease. Using the Hamilton Anxiety and Depression Scale they found a mean reduction of 6.2 points in the Paroxetine group (p=0.0007) and 4.2 points in the Venlafaxine XR group (p=0.02)

Rihmer and colleagues have published a paper in the European Journal of Neuropsychopharmacology arguing that the placebo response has been overestimated in some trials and propose an alternative method for calculating antidepressant and placebo response rates.

Although case studies are not as useful as larger trials investigating questions they can often form the basis for hypothesis which can be subsequently investigated with appropriate methodology. In this case report, the researchers identify the progression of cortical changes in a man with Posterior Cortical Atrophy. They identified progression from the Inferior Temporal and Posterior Parietal Cortices to the Occipital Cortex followed by other regions.

In this study, the researchers found that subjective memory impairment was a common complaint in older adults but few people sought medical attention for this.

The Royal College of Psychiatrists has produced this video about the Institute of Psychiatry summer school for medical students to learn more about Psychiatry.

There is an interesting write-up of a new report by the Royal Society on how the world can flourish with 7 billion people and the necessary sociocultural changes that will facilitate this.

Appendix

2008-2011 News Round-Up

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

YouTubing the Brain’s Awareness Centre: The Anterior Cingulate Cortex – Brodmann Areas 24 and 25

Hagmann et al,  (2008), Extract from Figure 1 from Mapping the Structural Core of Human Cerebral Cortex, PLoS Biol 6(7): e159, Creative Commons 2.5 License

The brain is a complex structure and but can be organised according to several principles. One approach is to characterise the brain regions according to the microscopic properties of these regions.  More specifically the neurons are organised differently between regions. Some regions may contain unique types of neurons. This approach to understanding the organisation of the brain was proposed by the German Neuropathologist Korbinian Brodmann and resulted in the eponymously named Brodmann Area. There are 52 areas in all and I have covered other Brodmann Areas elsewhere (see Appendix). Searching YouTube for relevant videos on the different Brodmann Areas has turned up occasional videos of interest (see Appendix). I undertook a search for Brodmann Areas 24 and 25 which returned a few results which had previously been retrieved when searching for other Brodmann Areas. These were more generic videos about the Brodmann Areas.

However entering the term ‘Anterior Cingulate Cortex’ produced more results and these were specific to the search question.

Professor Mayberg talks about biomarkers for assessing treatment response in depression including activity in the Anterior Cingulate Cortex

Professor Ramachandaran talks about the Anterior Cingulate Cortex in relation to the qualia of consciousness in this video

Professor Kaszniak discusses metamemory in this University of Arizona lecture

Dr Phillipe Goldin gives a talk on the Neuroscience of emotions in this Google Talks video

SuperAkihabara takes us through the Anterior Cingulate Cortex and has experience in this area from his research.

In this video he talks about working memory

The Anterior Cingulate Cortex is one of the areas that is activated when subjects listen to Chopin’s Etude in E Major Op 10 No 3 with the results displayed in this video

Haseeb2 talks about a study he’s read about in Scientific American. Although he points out to the Cingulate Cortex in the video he corrects this in the comments section (similar to the picture above where the Anterior Cingulate Cortex is shown to the left of the Posterior Cingulate). Haseeb2 talks about some of the activity correlates of the Anterior Cingulate Cortex including emotions and pain (also relevant to the Insular Cortex which has close recipricocity with the Anterior Cingulate Cortex).

Haseeb2 talks about the Anterior Cingulate Cortex in more detail in this video

Two neuroscience graduates explains their theory that the Cingulate Cortex does everything. Although slightly tongue-in-cheek in parts they’ve spotted a trend in the research publications (which seems to be matched by a healthy interest on YouTube!).

These researchers talk about the design of their study (which involves neuroimaging) to investigate decision making by managers in organisations and the factors that lead to flexibility and improved performance.

This video below is not for the squeamish but illustrates the anatomy in a surgical resection of a glioma in the Right Anterior Cingulate gyrus

The functional connectivity network of the Cingulate Cortex are displayed in this video based on the results of a study by Yeo and colleagues

The Brain Parts Song by Aaron Wolf

Appendix

Neuroanatomy Resources

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Doing Science 4.0. Deconstructing Web 2.0. The End of The Software Cycle

Science 4.0 is a movement resulting from the formation and use of the World Wide Web. Scientists are using the World Wide Web to collaborate and do science in new ways with significant implications. The term Science 4.0 is a special case of the World Wide Web and is influenced by Web 2.0. Therefore it is helpful to understand what the Web 2.0 is in order to better understand Science 4.0. The term Web 2.0 was first used at the O’Reilly Media conference and implies a development in the use of the Web. This has been covered in an earlier article in the series (see Appendix).  The Web 2.0 had several characteristics according to this definition and one of these is the end of the software cycle. In the original definition this was characterised by

1. A  move towards continuous improvement rather than intermittent software releases. Google is given as an example. For instance with the Google search engine new pages are continuously indexed by web crawlers.

2. The involvement of the user community to improve the software’s usability.

Science 2.0 is distinct from the generic application of the Web 2.0 definition regarding the software cycle.

1. Firstly with reference to software, this must fit in with the process of science whether this be the acquisition of data or the analysis of results. This contrasts with the Web 2.0 definition which is much broader in remit

2. Web 2.0 software developments have been led by successful commercial organisations with lots of resources, Google being an obvious example. For Science 4.0 initiatives to be successful they would need

a. Commercial success to acquire the resources or obtain those resources from elsewhere – government or NGO’s.

b. To have more limited resources and more limited expectations

c. To circumvent the resources issues by using technical solutions which involve strategies such as automated development

Nevertheless both improvement and user development are characteristics of the Open Source software movement.  Examples in medicine include OpenMRS (see Appendix) – an open source medical database and Docear – open-source reference management software. These examples of Science 4.0 still need resources for hosting but the communities are able to rely on the Web 2.0 architecture supplied by successful companies. For example, the Docear community is able to access this introductory video via YouTube

The communities are further supported by more generic Web 2.0 applications such as Twitter, Google+ and WordPress blogs. There are lessons to be learnt from the success of leading Web 2.0 exponents and such lessons can usefully be applied to develop Science 4.0.

Appendix

Doing Science 4.0. Deconstructing Web 2.0. The Importance of Data

Doing Science 4.0. Harnessing Collective Intelligence by Curating the Blogosphere

Doing Science 4.0. Deconstructing Web 2.0. Harnessing Collective Intelligence

Doing Science 4.0. Deconstructing the Web 2.0. The Web as Platform.

Doing Science 4.0. Part 1. What is Science 2.0?

Doing Science 4.0. Web 2.0

Open MRS

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Pay It Forward Day – April 26th 2012

April 26th 2012 is ‘Pay It Forward Day‘. The international ‘Pay It Forward Day’ initiative was started by Blake Beattie in response to the book of the same name by Catherine Ryan Hyde. The Pay It Forward foundation is hoping to inspire over 3 million acts of kindness on ‘Pay It Forward Day’. In 2011, participants from 35 countries took part. The Foundation provides ideas for how people can get involved here.

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Depression Awareness Week TM

An Eternity’s Gate, Vincent Van Gogh, Public Domain, The Yorck Project

This year ‘Depression Awareness Week TM‘ lasts from 22nd-28th April. People around the world are raising awareness of depression this week. The Depression Alliance is a UK based charity that is raising awareness of depression. On their website there is an interview with journalist Mark Rice-Oxley about his experience with depression. Here are some of the online responses to Depression Awareness Week TM

The NHS National Electronic Library for Medicines has an extremely helpful link to a special edition of Thinking Ahead with lots of depression related resources

Edubuzz.org has a page outlining details of Depression Awareness Week TM

David Keen writes about Depression in this article

The Staying Health at Work website  has a page about Depression Awareness Week TM

The British Psychological Society has an article about Depression Awareness Week TM here

Steps 2 Change has produced a leaflet which they are distributing to raise awareness

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

The Effects of Time on ‘Drawing’ Time: A Longitudinal Study of the Clock Drawing Test

Wall Clock, by Ikescs, Creative Commons 3.0 Unported License

There is a 2011 paper in the Journal of Dementia and Geriatric Cognitive Disorders Extra by Paganini-Hill and Clark. The researchers were interested in how people perform on a clock-drawing test as they get older. They looked at a cohort in the Leisure World Cohort Study. This cohort consisted of 4842 people with a mean age of 80 years who were asked to draw a clock in a test that was mailed to them. 1521 people completed the test in 1992 and 1998 and the researchers looked at the results in this subgroup. The researchers were interested in several questions. One of these questions was whether performance on this test deteriorated with age. The people that didn’t complete the test were more likely to have comorbid medical illnesses, to be taking medication and to do less exercise. Thus on a number of measures the group completing the test appeared to have better physical health although even this simple statement may be too broad a generalisation. I won’t go into the details of the test and the scoring methods but will just focus on the results. The researchers were interested in the percentage of participants that were able to correctly perform the clock drawing test.

Essentially they found that for each 5 year increment in age from <75 to >90 there was a corresponding decrease in the percentage of people who correctly drew the clock. Scores on the test lay along a continuum, but correct drawing implied full marks on the test. However what I found interesting was that when scores were compared 6 years later for the same person, scores improved, sometimes worsened or remained stable on average. What this might mean is that people had become used to the test although one test every 6 years seems infrequent*. Another possibility is that there are differences among the participants within these 5 year bandings. There was another interesting feature of the test which was the completion of a mailed test. Therefore it was entirely possible that participants were taking as long as necessary to complete the test and time (no pun intended) was not a constraint.

On one hand therefore there was a deterioration in performance when comparing progressive 5 year bandings of subjects. However there was actually an improvement in the second testing for the same subjects in the 3 youngest age bandings which did not hold for the two oldest bandings. These are interesting results which may tell us about learning on cognitive tests. These results though were subtle. There were also interesting results for people with dementia compared to controls.

* if there was learning it seemed to occur for the younger age-groups and the effect was lost in the two oldest age groups.

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.