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How Playing Music Affects The Developing Brain

A cellist at the Conservatory Lab Charter School in Boston plays during a recital rehearsal. Research has found music instruction has beneficial effects on young brains. (Jesse Costa/WBUR)

A bassist at the Conservatory Lab Charter School in Boston plays during a recital rehearsal. Research has found music instruction has beneficial effects on young brains. (Jesse Costa/WBUR)

Remember “Mozart Makes You Smarter”?

A 1993 study of college students showed them performing better on spatial reasoning tests after listening to a Mozart sonata. That led to claims that listening to Mozart temporarily increases IQs — and to a raft of products purporting to provide all sorts of benefits to the brain.

In 1998, Zell Miller, then the governor of Georgia, even proposed providing every newborn in his state with a CD of classical music.

But subsequent research has cast doubt on the claims.

Ani Patel, an associate professor of psychology at Tufts University and the author of “Music, Language, and the Brain,” says that while listening to music can be relaxing and contemplative, the idea that simply plugging in your iPod is going to make you more intelligent doesn’t quite hold up to scientific scrutiny.

“On the other hand,” Patel says, “there’s now a growing body of work that suggests that actually learning to play a musical instrument does have impacts on other abilities.” These include speech perception, the ability to understand emotions in the voice and the ability to handle multiple tasks simultaneously.

Patel says this is a relatively new field of scientific study.

“The whole field of music neuroscience really began to take off around 2000,” he says. “These studies where we take people, often children, and give them training in music and then measure how their cognition changes and how their brain changes both in terms of its processing [and] its structure, are very few and still just emerging.”

Patel says that music neuroscience, which draws on cognitive science, music education and neuroscience, can help answer basic questions about the workings of the human brain.
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If You Find A Tick: Why I Resorted To Mooching Pills To Fight Lyme Disease

A March 2002 file photo of a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. (Victoria Arocho/AP)

A March 2002 file photo of a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. (Victoria Arocho/AP)

I’ve never done anything like this before. I’m a good little medical doobie. I’m wary of pills, take them only with prescriptions, and follow the instructions to the letter. But last month, I “borrowed” a friend’s extra 200 milligrams of doxycycline — the onetime antibiotic dose shown to help prevent Lyme disease soon after a prolonged tick bite.

What brought me to that desperate point? A doctor declined to prescribe the pills, even though this is prime Lyme disease season and the patient, my family member, fulfilled every one of mainstream medicine’s requirements for the single dose aimed at preventing Lyme. To wit:

• The tick was a fully engorged deer tick that had been attached for more than 36 hours.

• We sought treatment within three days of removing it.

• The tick came from a Lyme-endemic area.

• And the patient had no medical reason to avoid antibiotics.

The antibiotics I “borrowed” from a generous friend (Carey Goldberg/WBUR)

The antibiotics I “borrowed” from a generous friend (Carey Goldberg/WBUR)

But still. The doctor argued that the chances of contracting Lyme from the tick were very small, perhaps 1 in 50, and that overuse of antibiotics contributes to the growing problem of drug-resistant bacteria. This is what he would do for his own family member, he said: skip the doxycycline, wait to see if Lyme develops, and treat it with a full 10-day course of antibiotics if it does.

I was frustrated and frankly a bit appalled. WBUR ran a series on Lyme disease in 2012, and I knew that controversy raged around many aspects of the disease, particularly the use of long-term antibiotics to treat long-term symptoms. But I was just trying to follow the widely accepted guidelines written by the Infectious Disease Society of America, to be found in reputable medical venues like UpToDate. And I knew from that same series that Lyme is rife in New England, and so are personal stories of health and lives ruined or seriously harmed.

Still, maybe I was overreacting? I’ve since sought a reality check from three experts, including the lead author of the guidelines. And here’s what I come away with: No, I was not unreasonable in seeking the preventive doxycycline. Arguably, though I hate to admit it, the doctor was not being totally unreasonable in declining it. The guidelines say a doctor “may” prescribe the antibiotic; it’s not a “must.”

In the end, I think, the crux of the question may lie in how you see the doctor’s role: Is it to lay out the risks and benefits and then let the patient choose? Or to impose his or her own best medical judgment on the patient? (You can guess where I come down on that one.) Also, “better safe than sorry” tends to rule when it comes to my loved ones. But what if the risk is small and the benefit uncertain? Continue reading

How Addiction Can Affect Brain Connections

As much of the country grapples with problems resulting from opioid addiction, some Massachusetts scientists say they’re getting a better understanding of the profound role the brain plays in addiction.

Their work is among a growing body of research showing that addiction is a complex brain disease that affects people differently. But the research also raises hopes about potential treatments.

Among the findings of some University of Massachusetts Medical School scientists is that addiction appears to permanently affect the connections between areas of the brain to almost “hard-wire” the brain to support the addiction.

They’re also exploring the neural roots of addiction and seeking novel treatments — including perhaps the age-old practice of meditation.

Meditation As Part Of Addiction Treatment

After spending 40 minutes lying on the floor with his eyes closed, being led through a meditation exercise, one of the students in a recent mindfulness class said something that many of the other students appeared to be thinking.

“I’m irritated,” he said, as several of the 30 other students murmured in agreement. Some giggled.

“I can’t really sit this long with my eyes closed without falling asleep,” he added. “I think this is overall positive. Maybe I just have a long way to go.”

Mindfulness has been touted as a way to boost quality-of-life issues, and the students in the class were there for various reasons: some to learn to relax, others to cope with health issues, and — at least one student — to support her recovery from alcoholism.
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How Childhood Neglect Harms The Brain

Like any new mother, the woman we’ll call Braille was full of hope and excitement the day she welcomed her son into her life seven years ago. “Peter” was 7 years old at the time of his adoption. He’d been living in foster care after being taken from his biological mother.

According to Braille, Peter and his siblings endured years of neglect and abuse living with their biological mother and her violent boyfriend. “It was physical, emotional and continual,” she says.

Peter, now 14, and his adoptive parents are very close now, but the years since the adoption have been challenging. His father recalls Peter’s unpredictable anger, and the times Peter would punch him, out of the blue. His mother says her son could be very sweet and affectionate one minute, but then “he would just fall apart and start banging his head against the wall or start screaming.”

Experts have long known that neglect and abuse in early life increase the risk of psychological problems, such as depression and anxiety, but now neuroscientists are explaining why. They’re showing how early maltreatment wreaks havoc on the developing brain.

Study Of Orphans Finds Smaller Brains

Dr. Charles Nelson, a Boston Children’s Hospital neuroscientist, studies how children’s early experiences shape the developing brain. Abuse and neglect, he says, can cause significant damage to the circuitry of the brain.

“Let’s say there are 1,000 neurons supposed to wire in a certain way, maybe only half wire that way and the other half wire in an incorrect way,” Nelson explains. “By altering the wiring diagram, you are altering behavior and altering psychological states.”

But what prevents the brain from wiring the right way, and how do early experiences get biologically embedded in the brain?
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‘I’m Not Stupid, Just Dyslexic’ — And How Brain Science Can Help

Sixth-grader Josh Thibeau has been struggling to read for as long as he can remember. He has yet to complete a single Harry Potter book, his personal goal.

Growing up with dyslexia: Josh Thibeau, 12, imagines his brain as an ever-changing maze with turns he must learn to navigate. Here he is with his mother, Janet. (George Hicks/WBUR)

Growing up with dyslexia: Josh Thibeau, 12, thinks of his brain as an ever-changing maze with turns he must learn to navigate. Here he is with his mom, Janet. (George Hicks/WBUR)

When he was in first grade, Josh’s parents enrolled him in a research study at Boston Children’s Hospital investigating the genetics of dyslexia. Since then, Josh has completed regular MRI scans of his brain. Initially, it seemed daunting.

“When we first started, I’m like, ‘Oh no, you’re sending me to like some strange, like, science lab where I’m going to be injected with needles and it’s going to hurt,’ I’m like, ‘I’m never going to see my family again,’ ” says Josh, who lives in West Newbury, Mass.

Josh and his three biological siblings all have dyslexia to varying degrees. Pretty much every day he confronts the reality that his brain works differently than his peers’. He’s even shared scans of his brain with classmates to try to show those differences. Some kids still don’t get it.

“There was a student that said, ‘Are you stupid?’ Because my brain was working in a different way,” Josh says. “And I’m just like, ‘No, I am not stupid…I’m just dyslexic.’ ”

The Pre-Reading Brain 

On average, one or two kids in every U.S. classroom has dyslexia, a brain-based learning disability that often runs in families and makes reading difficult, sometimes painfully so.

Compared to other neurodevelopmental disorders like ADHD or autism, research into dyslexia has advanced further, experts say. That’s partly because dyslexia presents itself around a specific behavior: reading — which, as they say, is fundamental.

Now, new research shows it’s possible to pick up some of the signs of dyslexia in the brain even before kids learn to read. And this earlier identification may start to substantially influence how parents, educators and clinicians tackle the disorder.

Until recently (and sometimes even today) kids who struggled to read were thought to lack motivation or smarts. Now it’s clear that’s not true: Dyslexia stems from physiological differences in the brain circuitry. Those differences can make it harder, and less efficient, for children to process the tiny components of language, called phonemes.

And it’s much more complicated than just flipping your “b’s and “d’s.” To read, children need to learn to map the sounds of spoken language — the “KUH”, the “AH”, the “TUH” — to their corresponding letters. And then they must grasp how those letter symbols, the “C” “A” and “T”, create words with meaning. Kids with dyslexia have far more trouble mastering these steps automatically.

For these children, the path toward reading is often marked by struggle, anxiety and feelings of inadequacy. In general, a diagnosis of dyslexia usually means that a child has experienced multiple failures at school.

But collaborations currently underway between neuroscientists at MIT and Children’s Hospital may mark a fundamental shift in addressing dyslexia, and might someday eliminate the anguish of repeated failure. In preliminary findings, researchers report that brain measures taken in kindergartners — even before the kids can read — can “significantly” improve predictions of how well, or poorly, the children can master reading later on.

Implicated in dyslexia: The arcuate fasciculus is an arch-shaped bundle of fibers that connects the frontal language areas of the brain to the areas in the temporal lobe that are important for language (left). Researchers found that kindergarten children with strong pre-reading scores have a bigger, more robust and well-organized arcuate fasciculus (bottom right) while children with very low scores have a small and not particularly well-organized arcuate fasciculus (top right). (Zeynep Saygin/MIT)

Implicated in dyslexia: The arcuate fasciculus is an arch-shaped bundle of fibers that connects the frontal language areas of the brain to the areas in the temporal lobe that are important for language (left). Researchers found that kindergarten children with strong pre-reading scores have a bigger, more robust and well-organized arcuate fasciculus (bottom right) while children with very low scores have a small and not particularly well-organized arcuate fasciculus (top right). (Zeynep Saygin/MIT)

Pinpointing The White Matter Culprit

Using cutting-edge MRI technology, the researchers are able to pinpoint a specific neural pathway, a white matter tract in the brain’s left hemisphere that appears to be related to dyslexia: It’s called the arcuate fasciculus.

“Maybe the most surprising aspect of the research so far is how clear a signal we see in the brains of children who are likely to go on to be poor readers.”
– MIT neuroscientist John Gabrieli

“It’s an arch-shaped bundle of fibers that connects the frontal language areas of the brain to the areas in the temporal lobe that are important for language,” Elizabeth Norton, a neuroscientist at MIT’s McGovern Institute of Brain Research, explains.

In her lab, Norton shows me brain images from the NIH-funded kindergartner study, called READ (for Researching Early Attributes of Dyslexia).

“We see that in children who in kindergarten already have strong pre-reading scores, their arcuate fasciculus is both bigger and more well organized,” she says. On the other hand: “A child with a score of zero has a very small and not particularly organized arcuate fasciculus.”

She says we’re not quite ready to simply take a picture of your child’s brain and say “Aha, this kid is going to have dyslexia,” but we’re getting closer to that point. Continue reading

Unlocking The Brain: Are We Entering A Golden Age Of Neuroscience?

"We still haven’t unlocked the mystery of the three pounds of matter between our ears. That knowledge could be -- will be -- transformative,” President Obama said in announcing the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative on April 2, 2013, at the White House. (Charles Dharapak/AP)

“We still haven’t unlocked the mystery of the three pounds of matter between our ears. That knowledge could be — will be — transformative,” President Obama said in announcing the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative on April 2, 2013, at the White House. (Charles Dharapak/AP)

President John F. Kennedy set the nation’s sights on the moon. Fifty years later, President Obama announced his signature science project: neuroscience, the study of the brain.

“As humans,” he said last April, “we can identify galaxies light years away, we can study particles smaller than an atom, but we still haven’t unlocked the mystery of the three pounds of matter between our ears.”

The president committed an initial $100 million to BRAIN, an acronym for Brain Research through Advancing Neurotechnologies, to fund the development of better tools for studying how the brain works. “That knowledge could be — will be — transformative,” he said.

Over the next two months, WBUR will present a weekly series about brain science advances — many happening in Boston, a major hub for neuroscience research. Today, the overview.

If you click the “Play” arrow above, you’ll hear the hissy, Morse-Code-on-steroids sound of neurons firing, sending signals to each other.

So is this what a thought of yours would sound like, if it were played through an audio monitor like this? No. What you’re hearing is far, far simpler. These neurons belong to a crab; they make up a simple circuit of about 30 neurons that control how it chews and digests food. Their steady, rhythmic cycle is more like what your neurons do to control your breathing.

“Imagine now,” says Brandeis University neuroscientist Eve Marder, “an orchestra with billions of neurons firing in different patterns depending on what you were seeing, what you were hearing, what you were thinking and what you were feeling, so those rhythms would be changing in a tremendous symphony. If you could hear all of the neurons in your brain, it would be very hard to hear patterns, because there would be so many instruments, if you will, playing at the same time. It might sound like a cacophony.”

Making sense of that cacophonous complexity, she says, will be a lot harder than JFK’s moon shot.

“Unlike putting [a] man on the moon, where you knew exactly where the goal was and the problem was largely an engineering problem,” she says, “understanding the brain is a series of engineering problems and a series of intellectually creative, imaginative understandings, and it’s going to require the coordination of creativity across every scientific discipline that we know.”

But even if we give it everything we’ve got, can the human brain ever understand itself?

That’s the monumental gamble of Obama’s BRAIN initiative — and other major neuroscience efforts now getting under way around the world. They’re not trying to solve philosophical questions. They’re responding to the growing realization that brain disorders — from autism to mental illness to dementia — are a worldwide scourge, affecting at least a billion people.

“The global cost from brain disorders is about $2.5 trillion, and will go up more than double over the next two decades,” says Tom Insel, director of the National Institute of Mental Health. “So policymakers look at these numbers and say, ‘Oh my God, we have got to begin investing to make sure we don’t incur those kinds of costs.’ ”

Neuroscientists have been studying the brain for more than a century, and better treatments for brain diseases have been desperately needed for a lot longer than that. What’s different now is that for the first time, researchers say, we’re beginning to get a handle on the workings of the brain’s billions of neurons and trillions of connections. We’re starting to understand how groups of neurons interact, in smaller circuits or bigger networks — and that scale, out of reach even just a few years ago, is what we need if we ever hope to understand how we have a thought, or a memory, or a mental illness.

“This is an exciting time to be a neuroscientist. I’m not sure there’s ever been a more exciting time,” Larry Swanson, president of the Society for Neuroscience, told an audience last fall at the society’s annual conference of about 30,000 scientists. Continue reading

Interactive Map: Comparing Childbirth At Mass. Hospitals

Compare the Massachusetts hospitals that perform deliveries in the interactive map below. The map contains five childbirth quality measures that WBUR selected after polling both experts and expectant moms. For more about the measures and how we chose them, see our companion story.

And if you think there are more important things to consider when choosing a hospital, please tell us in this survey.

Measures:
  • C-section Rate:
  • VBAC Rate:
  • Early Elective Delivery Rate:
  • Episiotomy Rate:
  • Exclusively Breast Feeding:

Measures:
  • VBAC Rate:
  • C-section Rate:
  • Early Elective Delivery Rate:
  • Episiotomy Rate:
  • Exclusively Breast Feeding:
Bold: Currently selected procedure

What is this? This is the rate at which women have a vaginal delivery after having had at least one C-section. Higher rates are better.

Why does it matter? A VBAC has the benefits of a vaginal delivery: a quicker recovery and less pain, fewer days in the hospital and a lower chance of infection. A VBAC also means one fewer scar on the woman's uterus.

What factors might affect the numbers? Most experts say women can consider labor and a vaginal delivery after one C-section. But because a VBAC could risk tearing a prior C-section scar, some hospitals and doctors might resist this out of concern for the mother’s health or their own liability. As with C-sections, there are cultural differences among hospitals but no firm proof that these explain the variations in rates.

What is this? The baby is delivered through incisions in the mother's abdomen and uterus. Lower rates are better.

Why does it matter? A C-section increases the mother's pain, recovery time and risk for infection. It may complicate future pregnancies. There is a small risk the scar could rupture or that the placement of the placenta will cause severe bleeding. C-section babies are slightly more likely to have breathing problems and be at risk for a few common chronic conditions than babies delivered vaginally.

What factors might affect the numbers?

  • These are rates for a mother’s first Cesarean section. Experts say preventing a first C-section will protect a mom against ruptures and severe bleeding that may occur with a second or third C-section.
  • Large hospitals, including teaching hospitals, often have higher C-section rates. They say it’s because they handle more premature and other high-risk deliveries.
  • There is no definitive reason for the big differences between hospitals. A mother’s age, patient choice or fear of malpractice lawsuits may help explain high rates overall, but have little effect on the gaps between hospitals. Researchers are looking at cultural differences among hospitals, time pressures and the impact of fetal health monitors on C-section rates.

What is this? Sometimes pregnant women or their doctors schedule an early delivery for convenience or to make sure the doctor who has been seeing the mom will handle her delivery. Lower rates are better.

Why does it matter? Many medical societies, child advocacy organizations and employer groups say hospitals should not schedule deliveries before 39 weeks to avoid complications, and because babies need the last two weeks for brain, lung, and other vital organ development.

What factors might affect the numbers? Most hospitals are trying to eliminate this practice and many have. Most hospitals above 0 are in the single digits. Hospitals say this reflects their goal of reducing, if not ending, early elective deliveries.

What is this? A cut made to enlarge the vaginal opening during birth. Lower rates are better.

Why does it matter? Most experts recommend natural tearing when needed. An intentional cut may prolong a mother's recovery and lead to urinary incontinence and muscle problems in the anus.

What factors might affect the numbers? Doctors may perform an episiotomy to speed a delivery if a baby is in distress. Some doctors say that younger obstetricians generally don’t perform episiotomies or that it’s more acceptable at some hospitals than others.

What is this? The percentage of babies fed nothing but breast milk from birth to hospital discharge, among mothers who say they want to breast-feed. Higher rates are better.

Why does it matter? Breast-feeding helps protect babies against allergies, Sudden Infant Death Syndrome and some illnesses. It may protect the mother against some forms of cancer and postpartum depression.

What factors might affect the numbers? Hospitals can help mothers with breast-feeding, but they can’t control whether they succeed. Larger hospitals -- those that perform 1,100 births or more per year -- are beginning to report this measure to a national accrediting group and appear to be making a greater effort to collect this information than some smaller hospitals.

 

Where did we get the numbers? These rates (table 31) were collected by the state Department of Public Health for 2010, the most recent year available.

Where did we get the numbers? These rates (table 31) were collected by the state Department of Public Health for 2010, the most recent year available.

Where did we get the numbers? Our numbers are from The Leapfrog Group, which monitors healthcare quality and safety through voluntary hospital surveys. Leapfrog shared its latest numbers from 1-31-14.

Where did we get the numbers? Our numbers are from The Leapfrog Group, which collects the information through voluntary hospital surveys. Leapfrog shared its latest numbers from 1-31-14.

Where did we get the numbers? WBUR collected this information directly from hospitals across Massachusetts. In January, The Joint Commission, a national hospital accreditation group, will begin collecting this information from hospitals that perform 1,100 or more births a year.


Correction: An earlier version of this interactive included an incorrect early elective delivery rate for Holyoke Medical Center. Its correct EED rate is 0 percent. We regret the error.

Editor’s note: Thanks to Jessica Martin at The Boston Foundation for her early assistance with vetting data and project design.

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First Treatment Found For Rapid-Aging Disease In Children

progeria

Researchers have found the first treatment for progeria, a rare “rapid aging” disease in children. (Courtesy of the Progeria Research Foundation)

I first heard of progeria in “When Bad Things Happen To Good People,” by Harold Kushner. The author, a Natick rabbi, lost his 14-year-old son to the disease, a rare genetic defect that causes accelerated aging and effectively turns children into little old people, afflicted by strokes and heart attacks. They die young, of old age.

So my first reaction to today’s big news about the first promising treatment for progeria was: “Now at least the bad things that happen to some good people may not be quite so bad.”

A paper just published in the Proceedings of The National Academy of Sciences reports on a clinical trial for the first known treatment for progeria, and the findings are highly promising. The drug used, Lonafarnib, originally aimed at fighting cancer, appeared to help with weight, bone structure, and most importantly, artery health in 28 children with progeria.

That the drug appeared not only to slow but to reverse some aspects of damage to the children’s blood vessels “is a tremendous breakthrough, because cardiovascular disease is the ultimate cause of death in children with progeria,” said Dr. Leslie Gordon in the press release. She is the lead author of the study, medical director for the Progeria Research Foundation, and the mother of a child with progeria. (She’s also affiliated with Boston Children’s Hospital, Harvard, Brown and Hasbro Children’s Hospital.)

I challenged her on “breakthrough” — I tend to be so cautious with that word that I’m downright allergic to it. Her justification:

“This is a 100% fatal pediatric disease and we had no idea whether it could be influenced in any way by any drug treatment.’

“I do think it can be called a breakthrough, and the reason is that prior to this study finding, we had no idea whether we could offer anything for progeria at all. This is a 100% fatal pediatric disease and we had no idea whether it could be influenced in any way by any drug treatment.

So to me, the breakthrough here is that we have findings that show that progeria can be altered. Not only in the rate of weight gain but that the vasculature can be influenced and the bone can be influenced. That’s a real breakthrough that gives us tremendous hope that by finding more treatments and more ways to get at the disease process in progeria — with the protein called progerin — that we can actually have an impact on the disease.”

The clinical trial was only 2-1/2 years long, she noted, so it is not yet known whether the drug’s benefits will translate into longer lives. But “the breakthrough element is really, ‘Oh my gosh, for the first time, we know the disease can be influenced.’”

I also spoke today with Dr. Mark Kieran, senior author of the progeria study and director of pediatric medical neuro-oncology at Boston Children’s Hospital and Dana Farber Cancer Institute. Our conversation, lightly edited:

So it sounds like this is one of those times when science works just as it’s supposed to: Researchers found the gene, figured out what it did, and then corrected it, at least partially?? Continue reading