Author Archives: Carey Goldberg

Sugar On The Brain Circuit: Mice Seeking Sweets May Hold Key To Compulsive Overeating

You know the feeling: you’re tired, cranky, low or just have a serious, relentless desire for something sweet. Part of your brain cries out, “No, don’t do it, this will end badly.” But another (louder) part wants what it wants and won’t let up until that pint of Cherry Garcia, or red velvet cupcake or Caramel Macchiato is in plain sight. It’s an itch that must be scratched.

Now, brain scientists at MIT say they’ve identified a specific neural circuit in mice that can increase that compulsive overeating of sweets, but doesn’t interfere with normal eating patterns necessary for survival. More specifically, turning on this set of neurons drove mice to seek the reward of a sugary drink even in the face of punishment (a shock to the foot); and compelled them to eat voraciously even when full.  When the researchers shut down this pathway, however, the compulsive sucrose-seeking decreased.

Why does this matter? The new research, published in the journal Cell, may ultimately provide a target for the treatment of compulsive overeating and sugar addiction in humans, without undermining the clearly critical drive of eating to live, the scientists say.

“Imagine if I told you that in the future, we could change the way our neural circuits communicate in a way that I did not want to binge on sweets, but still allowed me to eat healthy foods when I’m hungry?” says Kay Tye, the study’s senior author and an assistant professor in the Department of Brain & Cognitive Sciences at MIT. “Obviously there is a ton of work that needs to be done to make this vision a reality, but our study suggests that it is possible.”

A Binge-Free Future?

As obesity rates have spiked in recent decades, experts say that overeating in general and consuming too much sugar in particular are major threats to human health.

But Tye says “the real underlying problems are the cravings that lead to compulsive eating, and the behavior of compulsive overeating itself.”

To tease out what might be driving that compulsion, Tye looked to a particular set of neurons in the mouse brain.

She and her colleagues showed that when mice perform reward-seeking actions enough that they become habits, that activates neurons connecting two key areas: a brain region called the lateral hypothalamus (an area important for hunger, feeding and homeostasis) and the ventral tegmental area (a brain region important for motivation and reward).

“If we want to understand how the brain gives rise to these feelings, thoughts and actions, we need to know more than what they are saying, we need to know who they are talking to,” Tye said. The team used so-called “optogenetic projection-defined phototagging” [essentially using laser light to activate or silence neurons] to see “which neurons…were saying what…and who they were talking to…”

These neural communications are quite distinct, Tye said; for instance, it’s important to distinguish between two types of reward-seeking behavior: binge-eating and drug addiction: “You don’t need cocaine to survive, you need food to survive,” she said.

The “Wanting” Neurons

Tye says that one of the biggest challenges with treating the obesity that comes from compulsive overeating disorders is that “most treatments are just a band-aid — treating the symptoms instead of the core problems.  Gastric bypass for example, is something that just makes it harder to eat, it doesn’t always change a person’s habits and eventually many people relapse and regain the weight.” Again, she theorizes that it’s the craving embedded in the brain that drives the compulsive behavior. She says there may be a distinctive set of  “wanting neurons” as opposed to “liking neurons.” Continue reading

Study: Higher Cognitive Risk For NFL Vets Who Start Football Under Age 12

New England Patriots helmets are seen in the team locker room at Gillette Stadium last year. (Michael Dwyer/AP)

New England Patriots helmets are seen in the team locker room at Gillette Stadium last year. (Michael Dwyer/AP)

This post originally appeared on Boston University’s Research News Website as “Football: Child’s Play, Adult Peril?”

By Barbara Moran

As the 100 million viewers tuning in to this Sunday’s Super Bowl can attest, Americans adore football. And for many, the love affair begins in childhood: Pop Warner Tiny-Mites start as young as age 5, and many adults retain warm memories and friendships from their youth football days.

But a new study from BU School of Medicine researchers points to a possible increased risk of cognitive impairment from playing youth football. The National Institutes of Health–funded study, published online in the Jan. 28 edition of the journal Neurology, finds that former National Football League players who participated in tackle football before the age of 12 are more likely to have memory and thinking problems as adults.

The study contradicts conventional wisdom that children’s more plastic brains might recover from injury better than those of adults, and suggests that they may actually be more vulnerable to repeated head impacts, especially if injuries occur during a critical period of growth and development.

“Sports offer huge benefits to kids, as far as work ethic, leadership and fitness, and we think kids should participate,” says study lead author Julie Stamm (MED’15), a PhD candidate in anatomy and neurobiology. “But there’s increasing evidence that children respond differently to head trauma than adults. Kids who are hitting their heads over and over during this important time of brain development may have consequences later in life.”

“This is one study, with limitations,” adds study senior author Robert Stern, a MED professor of neurology, neurosurgery and anatomy and neurobiology and director of the Alzheimer’s Disease Center’s Clinical Core. “But the findings support the idea that it may not make sense to allow children—at a time when their brain is rapidly developing—to be exposed to repetitive hits to the head. If larger studies confirm this one, we may need to consider safety changes in youth sports.”

In the study, researchers reexamined data from BU’s ongoing DETECT (Diagnosing and Evaluating Traumatic Encephalopathy Using Clinical Tests) study, which aims to develop methods of diagnosing chronic traumatic encephalopathy (CTE) during life. CTE is a neurodegenerative disease often found in professional football players, boxers and other athletes who have a history of repetitive brain trauma. It can currently be diagnosed only by autopsy.

For this latest study, scientists examined test scores of 42 former NFL players, with an average age of 52, all of whom had experienced memory and thinking problems for at least six months. Continue reading

Addiction Expert Discusses Statewide Surge In Heroin Overdoses

An educational pamphlet and samples of naloxone, a drug used to counter the effects of opiate overdose, are displayed at a fire station in Taunton. (Elise Amendola/AP)

An educational pamphlet and samples of naloxone, a drug used to counter the effects of opiate overdose, are displayed at a fire station in Taunton. (Elise Amendola/AP)

State Police are trying to understand a surge of heroin and opiod overdoses. Authorities tell the Boston Globe that 114 people died of suspected opioid overdoses last month across the state — double the number in November.

That number also doesn’t include the state’s three biggest cities: Boston, Worcester and Springfield.

Dr. Daniel Alford, who oversees the clinical addiction research and education unit at Boston Medical Center, joins Morning Edition to discuss this statewide rise in suspected heroin deaths.

To hear the full interview, click on the audio player above.

Interview Highlights:

On why the heroin is so deadly:

DA: “I think we’re learning a lot from our patients who are seeking addiction treatment. They certainly have talked about a difference in appearance of the heroin that they’re seeing — there seem to be more crystals. It’s being cut with something, and whether it’s fentanyl or, some people have talked about methamphetamine, it seems that it’s being cut with things that are potentially very lethal.”

“I saw a patient just the other day who talked about the heroin now causing them to pass out within minutes of taking it, so they’re very nervous about using dealers that they’ve never dealt with before. And it’s really an opportunity to start talking to patients about overdose risk and making sure they have Narcan available and that they are not using alone.”

On whether restrictions on prescriptions are causing people to turn to heroin:

DA: “As you make one drug less available there is a tendency to start using other drugs, and heroin is certainly readily available, cheap and quite pure.”

On how doctors aim to scale back on issuing pain prescriptions:

DA: “As we start to decrease the amount of prescribing that’s being done, we clearly don’t want to decrease access to these medications to those who benefit from them because of their chronic pain, but clearly we need to be more careful and safer and there is a lot of educational programs that are ongoing to train prescribers how to prescribe these more safely.”

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Surgeon’s Death Spurs Painful Debate On Docs As ‘Face Of Health Care System’

Flowers are left outside the Brigham in honor of the slain Dr. Michael Davidson. (Robin Lubbock/WBUR)

Flowers are left outside the Brigham last week in honor of the slain Dr. Michael Davidson. (Robin Lubbock/WBUR)

Shocked and saddened by last week’s shooting at Brigham and Women’s Hospital, Dr. Miranda Fielding wrote a blog post that appeared on KevinMD, a popular site that gets 5 million clicks a month: “The Legacy of Dr. Michael Davidson.”

KevinMD, as founder Dr. Kevin Pho puts it, aims “to share the stories of the many who intersect with our health care system, but are rarely heard from,” including practicing physicians. He adds: “The public often doesn’t know what it’s like to work in our health system. KevinMD.com gives them an unfiltered view of our world.”

Dr. Michael Davidson (Courtesy of Brigham and Women’s Hospital)

Dr. Michael Davidson (Courtesy of Brigham and Women’s Hospital)

In the case of Dr. Fielding’s post, that unfiltered view reveals not only deep pain at a distinguished colleague’s death but also a far broader discomfort with serving, as one commenter puts it, as “the face of the health care system” — a system that sometimes harms patients, medically or financially.

In her post, Miranda Fielding — the pen name of a California-based radiation oncologist who blogs at The Crab Diaries — recalls from her own professional past a gentle colleague who was viciously beaten by a former patient, and writes:

When we graduate from medical school, we take the Hippocratic Oath, which in the modern version not only exhorts us to heal the sick, but to exhibit warmth, sympathy, and understanding. Let our patients and their families extend those same traits to us as we complete our daily rounds. Let our clinics and hospitals be places of healing, and not of killing. Please let us do our jobs.

I only wish that I had the answers to the groundswell of anger, frustration and resentment voiced in the comments on my blog.
– Dr. Miranda Fielding

Her post has been shared on Facebook more than 40,000 times, and sparked more than 150 comments. The post, Dr. Pho emailed, “clearly touched a nerve with my audience and highlights the sacrifice that health professionals make every day.”

But the response to the post highlights more systemic issues as well. Among the comments, the most popular, by a writer identified only as “guest,” refers in part to the report that the alleged Brigham shooter had complained in the past about a medical bill for the heart attack that killed his father:

What we as a profession appear to be (willfully) unaware of is that we doctors are the face of the healthcare system. To the extent that we do not speak up, protest and advocate for our patients when they are taken advantage of by hospitals and insurers, we provide a face for patients to blame. Anyone who doesn’t think that corporate executives and hospital administrators take full advantage of the opportunity to hide behind us as they maximize profits at the expense of our patients, is a fool.

We may think that because we go through our days bathed in an aura of self-righteous goodness (Look how we’re the smartest person in the room! How hard we work! How little sleep we get! How many of our child’s soccer games we’ve missed in order to care for our patients! How we do all this without even mentioning it to our patients, because that’s how good we are!), that that is how our patients see us as well.

But they don’t. They see the fancy cars in the parking lot, the children going to elite prep schools, the expensive hobbies like equestrianism, the hospital system charging $8,000 for a 15 minute emergency room visit that ended in death, the collection agency coming after a grieving family. And they blame us for not doing more.

Responded another commenter:

This is a horrible tragedy for all involved — him, his family, friends, colleagues and his other patients. And for other docs out there who are now more afraid. My heart aches for the victim of this violence and for all of us.

But you’re right. This did not happen in a vacuum. Continue reading

How 3D-Printing Helped A Little Girl With A Rare Facial Defect

Check out this excellent story about a little girl named Violet born with a rare defect, a Tessier facial cleft, that left a fissure in her skull, and how 3D-printing is helping doctors take on these kinds of complicated surgeries. The piece is in today’s The New York Times and written by health reporter and CommonHealth contributor Karen Weintraub, who offers a little background:

Violet Pietrok was born nearly two years ago without a nose. Her eyes were set so far apart that her mom compared her vision to a bird of prey’s. There was a gap in the skull behind her forehead.

There was no question she would need drastic surgery to lead a normal life. But few surgeons have seen patients with problems as complex as Violet’s. Her parents, Alicia Taylor and Matt Pietrok, who live near Salem, Oregon, brought her to Boston Children’s Hospital, to Dr. John Meara, who had operated before on kids with Tessier facial clefts.

As part of Children’s Pediatric Simulator Program, Meara was able to get several 3D printed models made of Violet’s skull. By handling and slicing up the models, he got a better sense of what had gone wrong and how best to fix it.

Such 3D-printing is becoming more commonplace in complex surgeries, allowing doctors views and knowledge they can’t get on their screens.

Continue reading

Frostbite, Hypothermia And Other Fun Facts To Remember On Blizzard Day

It’s going to be a long, long day. If you’re like us, you’ve already cooked some kind of elaborate breakfast, chosen the morning movie lineup, and set up the “Let’s Dance” Wii. And it’s not even 8 a.m.

When you’re ready to venture outside and “play,” remember it’s freezing, with ferocious winds. No doubt you’re familiar with this kind of extreme weather, but there are a few health tips worth repeating. Here’s the Boston Public Health Commission with a cute video reminder:

Listen: How Health Care Facilities Are Preparing For The Blizzard

Most of us will be hunkered down at home over the next 24 hours, as a blizzard bears down on the state. But police, firefighters, hospital staff and workers at hundreds of nursing homes will be working. Listen above to a report from WBUR’s Martha Bebinger about how hospitals and senior care facilities are preparing to ride out the storm.

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5 Reasons You Should Worry Way More About Flu Than Ebola

(CDC)

(CDC)

By Veronica Thomas
Guest Contributor

A deadly virus is sweeping America, putting nearly 10,000 people in the hospital so far. No, it’s not Ebola. We’re talking about the common seasonal flu that shows up every fall and lingers on until spring.

Every year, 5 to 20 percent of Americans get the flu and, depending on the strain, anywhere from 4,000 to 49,000 people die from the virus or its complications, like pneumonia. And this season’s flu virus is shaping up to be pretty nasty — so nasty that the CDC declared a national flu epidemic at the end of December.

As a graduate student at the Harvard School of Public Health, I’m baffled by this: A couple months ago, I couldn’t step on a subway car or flip through Facebook without being bombarded by panicked comments about Ebola spreading to the U.S. But when it comes to the real and immediate threat of the flu: radio silence.

“Ebola is exotic. It has a very high mortality rate that people are very much aware of. It seems like you can be exposed to it without your control,” says Dr. Alfred DeMaria, medical director for the Bureau of Infectious Disease at the Massachusetts Department of Public Health. “All of those [factors] contribute to a higher perception of risk than the flu.”

In reality, far, far more people die from flu-related complications than from Ebola, but it’s a very small proportion of the millions who get sick each year. That’s one reason we should be more concerned about the flu than Ebola, Dr. DeMaria says. Here’s why else:

1) The flu is next door, not across the Atlantic.

Ebola has tragically claimed over 8,600 lives in West Africa, largely because many countries don’t have the capacity to contain the outbreak or treat infected patients. And though the news cycles have moved on, Ebola hasn’t. As the virus continues to spread, Ebola remains a real threat for some West African countries.

But for ordinary Americans: “The risk of getting Ebola is somewhere in the order of magnitude of getting personally hit by a meteorite,” Dr. DeMaria says. Just four people have been treated for Ebola in the U.S., and only one has died. No new cases have been reported since October. Continue reading

AG Healey Weighs In Against Partners Acquisition Of South Shore Hospital

Attorney General Maura Healey, at WBUR (Robin Lubbock/WBUR)

Attorney General Maura Healey, at WBUR (Robin Lubbock/WBUR)

Updated 7:15 p.m.

BOSTON — On her first Monday morning as Massachusetts attorney general, Maura Healey stepped into a fight that may well continue through her first term. Healey said, in short, that Partners HealthCare should not be allowed to acquire South Shore Hospital and that she would sue to block the acquisition.

Her predecessor, Martha Coakley, had the option of suing Partners, but chose instead to negotiate concessions. In a deal filed in court by Coakley, Partners would be able to add at least three more hospitals — South Shore and two owned by Hallmark Health — but would have to keep price increases in line with inflation for six and half years and cap the size of its physician group for five years.

Healey raised several concerns about the agreement in a brief filed in court Monday. She suggests that the physician cap is too lax and that the terms of the deal are too short. When the deal expires, “Partners may wield market leverage that is greater than its current, already significant market leverage,” Healey said.

Healey said she wants proof that Partners has figured out how to use its size to save money.

Continue reading

Hundreds Mourn Surgeon Fatally Shot At Boston’s Brigham And Women’s Hospital

A woman wears a button honoring Michael Davidson at his funeral service Friday. (Jesse Costa/WBUR)

A woman wears a button honoring Michael Davidson at his funeral service Friday. (Jesse Costa/WBUR)

The cardiac surgeon killed inside Brigham and Women’s Hospital in Boston this week was laid to rest on Friday.

More than a thousand people gathered at Temple Beth Elohim in Wellesley Friday to pay their respects to Dr. Michael Davidson, who was fatally shot by a patient’s son on Tuesday.

Some wore buttons with Davidson’s initials, MJD, in a heart. Six buses brought people from Brigham and Women’s, and when Rabbi Joel Sisenwine asked all the doctors and caregivers to rise, at least half the room stood.

Several colleagues and friends of Davidson’s spoke, as did Davidson’s father, Robert, a well-known cardiologist at Cedars-Sinai Medical Center in Los Angeles. He spoke of the hopeful flight he and his wife took to Boston Tuesday after they received news that their son had been shot — hopeful because Davidson’s parents thought when they boarded the plane that he would live.

Continue reading

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