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Written by: Caroline Kim September 7, 2024 In today’s piece on neurodegenerative disorders, we’ll discuss Multiple System Atrophy. The NIH defines this disease as “a progressive neurodegenerative disorder characterized by a combination of symptoms that affect both the central nervous system… and the autonomic nervous system”. Multiple System Atrophy is a branch of a family of atypical parkinson's disorder and results in the deterioration of nerve cells in both the brain and spinal cords (National Institute of Health). According to the NIH, MSA is sporadic and rare considering it affects approximately 15,000 to 50,000 Americans.  Symptoms of this condition resemble those of Parkinson’s disease, but progresses more rapidly. These symptoms of MSA include stiffness of muscles, tremors, clumsiness, bradykinesia, lightheadedness, and bladder control problems (Mayo Clinic Staff). There are two main categories of MSA (Multiple System Atrophy): Parkinson’s type MSA and Cerebellar type MSA. Parkinson’s MSA is associated with coordination problems and autonomic nervous system dysfunction such as digestion difficulty and sweating abnormalities (National Institute of Health). According to the NIH, “Cerebellar type MSA (MSA-C) is associated with balance and coordination problems (ataxia), difficulty swallowing, speech problems or a quivering voice, and abnormal eye movements”. In addition, those with MSA can develop dangerously high levels of blood pressure while lying down known as supine hypertension; they can also develop postural hypotension, which is a form of low blood pressure (Mayo Clinic Staff). According to Mayo Clinic, additional generalized symptoms of MSA include constipation, less sweating, poor body temperature control, sleep apnea, and difficulty controlling emotions. The parts of the brain most significantly affected by MSA are the Basal Ganglia, Brainstem, and Cerebellum; as each section of the brain is impacted more, the functions associated with that section also deteriorate (Mayo Clinic Staff).  Genes related to oxidative stress, inflammation, and Parkinson’s related genes may influence MSA risk, but there is not a single gene that causes an individual to have MSA (National Institute of Health). Diagnosis of MSA may involve evaluating blood pressure and heart rate, bladder function, brain scans (MRI/PET/DaT), and medical history (National Institute of Health). While there isn’t a cure for MSA, there exists various treatments to slow the progression of the condition and alleviate symptoms. These treatment options include medications to help with blood pressure/motor function, speech therapy, and physical therapy (National Institute of Health).  Sources: National Institute of Health. “Multiple System Atrophy | National Institute of Neurological Disorders and Stroke.” Multiple System Atrophy , 19 July 2024, www.ninds.nih.gov/health-information/disorders/multiple-system-atrophy . Accessed 03 Sept. 2024.  Mayo Clinic Staff. “Multiple System Atrophy.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 2 Aug. 2024, www.mayoclinic.org/diseases-conditions/multiple-system-atrophy/symptoms-causes/syc-20356153 . Accessed 02 Sept. 2024.

Written by: Caroline Kim August 31. 2024 In continuation of the neurodegenerative conditions series, we’ll dive into the topic of Huntington’s Disease. As defined by Mayo Clinic: Huntington’s causes the decay of the nerve cells in the brain affecting an individual's movements, thinking, and mental health. This disease is progressive, generally affects individuals between the ages of 30 and 50; the symptoms of this condition can affect one’s daily activities, work, and overall independence.  Movement symptoms may include involuntary jerking, rigid muscles, abnormal eye movement, difficulty with speech, difficulty swallowing, difficulty walking, and difficulty maintaining balance (National Institute of Health). As listed by Mayo Clinic, cognitive symptoms usually involve trouble organizing, hyperfixation, impulsivity, lack of awareness, and trouble taking in new information. Last but not least, mental health conditions can range through social withdrawal, irritability, sadness, fatigue, thoughts of death, suicide, Obsessive Compulsive Disorder, Mania, and Bipolar Disorder (Mayo Clinic Staff). In a slightly different variation of Huntington’s disease, Juvenile Huntington’s Disease affects younger people and progresses in a slightly different form. In Juvenile Huntington’s, behavioral change includes lack of focus, drop in school performance, and aggressiveness; physical changes include rigid muscles, tremors, clumsiness, and seizures (Mayo Clinic Staff).  It is important to note that Huntington’s is hereditary, and “ follows an autosomal dominant inheritance pattern… means that a person needs only one copy of the nontypical gene to develop the disorder” (Mayo Clinic Staff). Because this is a very genetic disorder, preventative measures do not exist. Diagnosis usually involves a neurological exam as well as a genetic exam for confirmation; this may involve blood tests, MRI’s, and CT scans (National Institute of Health). Like other neurodegenerative disorders, there is no cure for Huntington’s; however, treatments such as physical/occupational/speech therapy, counseling, and medications exist (Cleveland Clinic Medical Professional). Unfortunately, this disease results in death around 10-30 years after symptoms develop, and about 10-15 years after juvenile symptoms (Mayo Clinic Staff). Other complications associated with Huntington’s may include dementia, physical injury, malnutrition, and infections such as pneumonia (Cleveland Clinic Medical Professional).  While Huntington’s disease itself is not necessarily fatal, related conditions and illnesses contribute toward the risk of death (Cleveland Clinic Medical Professional).  Sources: Mayo Clinic Staff. “Huntington’s Disease.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 25 Apr. 2024, www.mayoclinic.org/diseases-conditions/huntingtons-disease/symptoms-causes/syc-20356117 . Accessed 31 Aug. 2024.  Cleveland Clinic Medical Professional. “Huntington’s Disease: What Is It?” Cleveland Clinic , 1 May 2024, my.clevelandclinic.org/health/diseases/14369-huntingtons-disease . Accessed 31 Aug. 2024.  National Institute of Health. “Huntington’s Disease.” National Institute of Neurological Disorders and Stroke , U.S. Department of Health and Human Services, 19 July 2024, www.ninds.nih.gov/health-information/disorders/huntingtons-disease . Accessed 31 Aug. 2024.

Written by: Caroline Kim August 24, 2024 Today we’ll discuss the infamous neurodegenerative disease that is the 7th leading cause of death in the United States: Alzheimer's disease. This brain disorder affects a person’s memory, thinking, and ability to carry out everyday tasks. Experts estimate that over 6 million Americans are affected by it, and of this statistic more than 70% are aged 75 years or older (Mayo Clinic Staff).  More specific symptoms regarding memory loss may include repeating statements/questions, misplacing items, getting lost in familiar places, and forgetting names (Mayo Clinic Staff). Poor thinking and judgment symptoms could be in the form of difficulty managing finances, wearing the wrong outfit for the weather, or not knowing how to cook (Mayo Clinic Staff). Behavioral patterns may involve social withdrawal, distrust, aggression, wandering, and delusion (Mayo Clinic Staff).  Age is the most significant risk factor for Alzheimer’s, but other factors such as family history, and lifestyle can also impact one’s risk. Those who have a biological parent/sibling diagnosed with Alzheimer’s have a 10-30% increased risk for developing the condition. Other risk factors include traumatic head injury, high blood pressure, high cholesterol, diabetes, smoking, and obesity (Cleveland Clinic Professional). While there is no known cure for Alzheimer’s, there are treatment options to alleviate the symptoms of the condition. Treatments may target maintaining a healthy brain, behavioral management, and delaying/slowing symptoms. On average, Alzheimer’s patients over the age of 65 generally only live up to 4-8 years after diagnosis, but younger patients may live up to 20 years after diagnosis of the condition (Cleveland Clinic Professional). Some of the main features of Alzheimer's include amyloid plaques, fiber tangles, and diminished neurons in the brain (National Institute of Health). Damage to the brain begins in the hippocampus and entorhinal cortex which control memory; later it progresses to regions such as the cerebral cortex which are responsible for reasoning, behavior, and language (National Institute of Health). “ The early loss of synaptic connections is one of the main hallmarks of cognitive decline associated with Alzheimer's… there is a reduction in glucose entering the brain and also a decrease in energy production that can affect neurons due to their high energy needs… there is some evidence suggesting decreased neurogenesis in areas of the brain involved in memory and learning.” (National Institute of Health). For more details on how Alzheimer’s affects the biology of the brain, I would highly recommend referencing the link under the homepage of this blog! Sources: National Institute of Health. “Alzheimer’s Disease Fact Sheet | National Institute on Aging.” Alzheimer’s Disease Fact Sheet , 5 Apr. 2023, www.nia.nih.gov/health/alzheimers-and-dementia/alzheimers-disease-fact-sheet . Accessed 24 Aug. 2024.  CDC. “What Is Alzheimer’s Disease?” Centers for Disease Control and Prevention , 26 Oct. 2020, www.cdc.gov/aging/aginginfo/alzheimers.htm . Accessed 24 Aug. 2024.  Mayo Clinic Staff. “Alzheimer’s Disease.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 10 July 2024, www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447 . Accessed 24 Aug. 2024.  Cleveland Clinic Professional. “Alzheimer’s Disease: Causes, Symptoms, Treatment & Stages.” Cleveland Clinic , 13 June 2024, my.clevelandclinic.org/health/diseases/9164-alzheimers-disease . Accessed 24 Aug. 2024.  National Institute of Health. “What Happens to the Brain in Alzheimer’s Disease? | National Institute on Aging.” What Happens to the Brain in Alzheimer’s Disease? , 19 Jan. 2024, www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease . Accessed 24 Aug. 2024.

Written by: Caroline Kim August 17, 2024 A topic briefly mentioned last week was the neurodegenerative disorder known as Apraxia of Speech (AOS). There are two variations of Apraxia: acquired AOS and childhood AOS. Acquired AOS can affect individuals of any age and is due to damage in parts of the brian that are responsible for speech and communication; this may be due to events such as a stroke, head injury, or brain tumor (National Institute of Health). In the latter condition, childhood AOS is present from birth and can be characterized as a developmental condition, suggesting that it may be genetic (National Institute of Health).  Childhood apraxia is a rare condition affecting only 1-2 children per 1000 (Cleveland Clinic medical professional). Mayo Clinic describes childhood AOS as a speech disorder in which the brain has difficulty planning the movement of speech; this includes trouble controlling the jaws, lips and tongue during speech. It is important to note however, that childhood AOS is not due to weakness/paralysis of muscles in the jaw.  Symptoms of childhood AOS include but are not limited to less babbling in ages 7-12 months, late start of speech in 12-18 month olds, and leaving out sounds when speaking, and vowel/consonant distortions (Mayo Clinic Staff). Additional symptoms may involve groping for sounds and errors in tone/stress/rhythm (National Institute of Health).  Causes for Apraxia are often ambiguous, but may be due to brian injury, brain conditions, stroke, genetic condition, or metabolic condition (Mayo Clinic Staff). According to Mayo Clinic, children with apraxia often also have accompanying problems with communication such as delayed motor development, fine motor skills, and social interactions. In childhood AOS, research is benign conducted to explore the hereditary factors and abnormalities in the brain that could be responsible for AOS (National Institute of Health).  Treatment of childhood apraxia often involves speech therapy in which the “ speech-language pathologist teaches the child to practice the correct way to say words, syllables and phrases” (Mayo Clinic Staff). While there aren’t many preventative measures for childhood apraxia, diagnosing it at an early stage and working with a speech-language pathologist can be beneficial. In more progressive and severe cases of AOS, alternative communication methods may be sought out such as sign language or an electronic communication device (National Institute of Health). For more material on the neurochemistry and research on childhood AOS, reference the link on the main home page under “Neuroscience of AOS”.  Sources: Mayo Clinic Staff. “Childhood Apraxia of Speech.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 5 Aug. 2023, www.mayoclinic.org/diseases-conditions/childhood-apraxia-of-speech/symptoms-causes/syc-20352045 . Accessed 10 Aug. 2024.  Cleveland Clinic medical professional. “Childhood Apraxia of Speech (CAS) / Developmental Verbal Dyspraxia (DVD) / Developmental Apraxia of Speech (Das).” Cleveland Clinic , my.clevelandclinic.org/health/diseases/17911-childhood-apraxia-of-speech . Accessed 10 Aug. 2024.  National Institute of Health. “Apraxia of Speech.” National Institute of Deafness and Other Communication Disorders , U.S. Department of Health and Human Services, www.nidcd.nih.gov/health/apraxia-speech . Accessed 10 Aug. 2024.  Fiori, Simona et al. “Neuroanatomical correlates of childhood apraxia of speech: A connectomic approach.” NeuroImage. Clinical  vol. 12 894-901. 4 Nov. 2016, doi:10.1016/j.nicl.2016.11.003

Written by: Caroline Kim August 10, 2024 In today’s piece on neurodegenerative diseases, the topic of interest is Ataxia. As defined by healthline, ataxia refers to medical issues with muscle movement which may ensue trouble with balance, eating, writing, and speech. This condition is a progressive disease meaning it worsens over time, and can affect individuals of any age(Seladi-Schulman). Ataxia results from damage to the nerve cells in the part of the brain known as the cerebellum, and may also be due to genetics (Seladi-Schulman).  A nota ble distinction I’d like to make before diving into this condition is the difference between ataxia and apraxia. Cleveland Clinic defines apraxia as a brain condition “making it hard for you to do or describe actions you already know how to do… because your brain has a problem with processing these actions” whereas ataxia is described as “problems with coordinating muscle movements… your brain doesn’t have any problem with processing or describing the tasks”. In simpler terms, apraxia leans toward difficulty processing movements through the brain and ataxia leans towards challenges in physical movement.  Healthline distinguishes 3 specific kinds of ataxia: cerebellar ataxia, sensory ataxia, and vestibular ataxia. As indicated by the name, cerebellar ataxia affects either the midline cerebellum or lateral cerebellum. Damage to the midline cerebellum results in vision change, lack of coordination, and tremors during movement (Seladi-Schulman). The latter of the two affects the outer regions of the cerebellum, often resulting in ataxia to one side of the body, speech problems, and difficulty reaching. Sensory ataxia indicates damage to the nerves in the spinal cord, vision system, or peripheral nerves which allow the body to control its locations and movements; damage to these nerves can result in symptoms such as trouble walking and standing with their feet together with their eyes closed (Seladi-Schulman). Vestibular ataxia impacts the vestibular system (nerves connecting the inner ear to the brain) causing dizziness, difficulty hearing, and difficulty balancing.  As previously discussed, ataxia can be genetic, but it can also be acquired due to things such as head injury, stroke, hypothyroidism, and cerebral palsy (Mayo Clinic Staff). Some tests to diagnose this condition may involve imaging tests, blood tests, spinal taps, and genetic tests; while no cure exists, intervention to alleviate symptoms exist (Seladi-Schulman). Some of these treatment options may include medications for nerve pain, muscle relaxants, assistive devices, and therapy (Seladi-Schulman). According to Mayo Clinic, additional risk factors for ataxia include multiple sclerosis, heavy drinking, multiple system atrophy, and vitamin deficiency. Some extra precautions one can take to lower their risk of ataxia include a healthy diet, reducing exposure to drugs/alcohol/chemicals, treating any infections with care (Cleveland Clinic medical professional).  Sources: Seladi-Schulman, Jill. “Ataxia: Definition, Types, Causes, Diagnosis, Treatment.” Healthline , Healthline Media, 19 Dec. 2023, www.healthline.com/health/ataxia . Accessed 09 Aug. 2024.  Mayo Clinic Staff. “Ataxia.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 30 Jan. 2024, www.mayoclinic.org/diseases-conditions/ataxia/symptoms-causes/syc-20355652 . Accessed 10 Aug. 2024.  Cleveland Clinic medical professional. “Ataxia: What It Is, Causes, Symptoms, Treatment & Types.” Cleveland Clinic , my.clevelandclinic.org/health/symptoms/17748-ataxia . Accessed 10 Aug. 2024.

Written by: Caroline Kim August 8, 2024 In this week’s topic of neurodegenerative diseases, we’ll explore what is known as the Creutzfeldt-Jakob disease- a rare condition that leads to dementia. According to the CDC, this condition affects 1-2 individuals per 1 million population members annually, usually older adults. Mayo Clinic describes this neurodegenerative disease as a faster progressing and fatal version of Alzhiemer’s disease.  Symptoms of Creutzfeldt-Jakob Disease (CJD) include but are not limited to impaired thinking, memory loss, personality changes, vision impairment, difficulty with speaking/swallowing/coordination, and insomnia (Mayo Clinic Staff). This disease often results in death within the year, but MayoClinic notes that it often is due to tangential medical issues that progress from the disease such as heart failure/trouble swallowing.  This disease is caused by a prion protein which is usually produced in the body; however, when they encounter infectious prions they morph into a more atypical and problematic shape (Mayo Clinic Staff). Other human diseases from prion proteins include Kuru, Fatal Familial Insomnia, Gerstmann-Straussler-Schenker disease (NIH). (Because CJD cannot be spread by coughing/sneezing/contact, the risk of getting it is low; there are 3 main types of  CJD: Sporadic, Inheritance, and Iatrogenic (Mayo Clinic Staff). In sporadic cases, which account for approximately 85% of the cases, the infectious prion proteins already exist in the body for an unknown reason, ensuing the CJD (CDC). In familial cases (less than 15%), patients may test positive for genetic changes associated with CJD. In the very rare Iatrogenic cases, CJD is caused by medical contamination such as injections, transplants, and brain surgery; in surgical cases where transfer resulted from contaminated instruments, it is because the standard cleaning procedures do not kill the prion proteins (Mayo Clinic Staff). In a fourth scenario, variant CJD can be contracted from ingesting beef, though this is very unlikely (Cleveland Clinic medical professional).  Diagnosis for this condition includes utilizing EEGs to identify abnormalities associated with CJD, Cerebrospinal fluid-based tests that check for proteins, and MRIs for imaging (NIH). While there is no known cure for CJD, treatment for the associated symptoms exists (Cleveland Clinic medical professional). This is not a disease that is truly “preventable” by any means including lifestyle. Risk factors are also limited to older age (60’s+), though variant CJD has been known to affect a slightly younger age group as well (CDC).  Sources:  CDC. “Classic Creutzfeldt-Jakob Disease.” Centers for Disease Control and Prevention , 13 May 2024, www.cdc.gov/creutzfeldt-jakob/about/index.html#:~:text=Classic%20CJD%20occurs%20worldwide%20in,million%20population%20members%20per%20year . Accessed 03 Aug. 2024.  Mayo Clinic Staff. “Creutzfeldt-Jakob Disease.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 28 Jan. 2023, www.mayoclinic.org/diseases-conditions/creutzfeldt-jakob-disease/symptoms-causes/syc-20371226 . Accessed 03 Aug. 2024.  NIH. “Creutzfeldt-Jakob Disease.” National Institute of Neurological Disorders and Stroke , U.S. Department of Health and Human Services, www.ninds.nih.gov/health-information/disorders/creutzfeldt-jakob-disease . Accessed 03 Aug. 2024.  Cleveland Clinic medical professional. “Creutzfeldt-Jakob Disease (CJD): Symptoms & Treatment.” Cleveland Clinic , 21 April. 2022, my.clevelandclinic.org/health/diseases/6001-creutzfeldt-jakob-disease . Accessed 03 Aug. 2024.

Written by: Caroline Kim July 27, 2024 Epilepsy is described by Cleveland Clinic as the  “long-term (chronic) disease that causes repeated seizures due to abnormal electrical signals produced by damaged brain cells”. These seizures are caused by bursts of electrical activity in the brain, which ensues changes in awareness/consciousness, muscle control, sensations, behavior, and emotions (professional). It is important to note that epilepsy can affect anyone and is not limited to any specific group. Data shows that in just the U.S., as many as 3.4 million individuals have epilepsy of which 470,000 are children; worldwide, there are 65 million people with epilepsy (professional).  Epilepsies are categorized by where they start in the brain, the individual's level of awareness, and the variance of muscle movement (professional). There are two main categories of seizures: focal onset seizures and generalized onset seizures. Focal onset aware seizures are described by Cleveland Clinic as starting in “one area, or network of cells, on one side of your brain”. Symptoms of focal seizures include awareness but changes in the senses, emotions, muscle jerking (often in the arms/legs), seeing flashing lights, and dizziness (professional). The counterpart is Focal onset impaired awareness seizures, in which the individual experiences a loss of consciousness, confusion, blank stare, and repetitive movements (professional). The latter of the two main seizure types is described as affecting “a widespread network of cells on both sides of your brain at the same time”, and can be further categorized as an absence seizure, atonic seizure, tonic seizure, clonic seizure, tonic-clonic seizure, or myoclonic seizure (professional). Cleveland describes absent seizures as a momentary loss of awareness with minor muscle movements (blinking, lip smacking, and chewing motions); atonic seizures are characterized by a “droop” in which muscle control is lost. On the flip side, tonic seizures carry a component of muscle stiffening in which the individual's body becomes tense. Clonic seizures involve muscle jerking, tonic-clonic seizures involve a combination of both muscle jerking and stiffness, and myoclonic seizures shock like twitching/muscle jerking (professional). Under the category of generalized seizures there are subcategories of infantile spasms where infants under the age of 6 months can experience as many as hundreds of seizures in a day; additionally febrile seizures affect children between the ages of 6 months and 5 years (Nationwide Children's).  Seizures can be triggered for a variety of reasons including stress, sleep troubles, alcohol/drug use, illness, hormonal change, caffeine, dehydration, and flashing lights (professional). Cleveland Clinic states that in up to 70% of cases, the causes of seizures are unknown, but a few possibilities include genetics, head injuries, brain infections, mesial temporal sclerosis, immune disorders, developmental disorders, metabolic disorders, and brain abnormalities. Additional risk factors for epilepsy include premature birth, low birth weight, brain bleeds, cerebral palsy, and Alzheimer’s (American Association of Neurological Surgeons). Some tests utilized to diagnose epilepsy and seizures are electroencephalography (EEG), magnetic resonance imaging (MRI) brain scans, blood tests, computer tomography scans (CT or CAT), and lumbar punctures (spinal tap); treatments include anti seizure medications, diets, and surgeries (Nationwide Children's). Other treatment options may involve Vagus Nerve Stimulation, Responsive Stimulation, and Deep Brain Stimulation (NIH).  Sources: professional, Cleveland Clinic medical. “Epilepsy: What It Is, Causes, Symptoms, Diagnosis & Treatment.” Cleveland Clinic , my.clevelandclinic.org/health/diseases/17636-epilepsy . Accessed 27 July 2024.  Nationwide Children's. “Epilepsy.” Causes, Symptoms, Diagnosis and Treatment , www.nationwidechildrens.org/conditions/epilepsy . Accessed 28 July 2024.  American Association of Neurological Surgeons. “Epilepsy.” AANS , 15 Apr. 2024, www.aans.org/patients/conditions-treatments/epilepsy/ . Accessed 28 July 2024.  NIH. “Epilepsy and Seizures.” National Institute of Neurological Disorders and Stroke , U.S. Department of Health and Human Services, www.ninds.nih.gov/health-information/disorders/epilepsy-and-seizures . Accessed 28 July 2024.

Written by: Caroline Kim July 13, 2024 In this week’s study of neural conditions, we dive into the topic of a neurovascular disorder: migraines. All of us have experienced various versions of a headache throughout our lives, but migraines may be a more serious matter. Mayo clinic describes migraines as a “headache that can cause severe throbbing pain… usually on one side of the head… often accompanied by nausea, vomiting, and extreme sensitivity to light and sound” (Mayo Clinic. “Migraine.”). In more severe cases, these migraines can last several days.  The progression of a migraine can be broken down into 4 stages, prodrome, aura, attack, and post-drome, though not all are experienced by everyone. The prodrome takes place a few days prior to the migraine with symptoms including constipation, moodiness, neck stiffness, and more. The aura consists of visual disturbances, tingling sensations, and difficulty speaking, which indicate an oncoming migraine or may occur throughout a migraine (Mayo Clinic. “Migraine.”). Next in this sequence, the actual migraine attack consists of throbbing pain on one or both sides of the head, nausea, vomiting, and light/sound sensitivity. The post drome is subsequent to a migraine and can include confusion and feeling fatigued (Mayo Clinic. “Migraine.”). The pain from these migraines is said to be caused by “the activation of nerve fibers within the wall of brain blood vessels traveling inside the meninges (three layers of membranes protecting the brain and spinal cord) ( ninds.nih.gov . “Migraine.”). An individual’s risk for a migraine may increase with weather changes, stress, motion sickness, head trauma, medications, anxiety, depression, obesity, tobacco, and more ( ninds.nih.gov . “Migraine.”). According to the NIH, women are 3 times more likely to experience migraines; additionally, migraines are genetic, therefore running in the family ( ninds.nih.gov . “Migraine.”).  Migraine treatments may vary; home remedies involve naps, fluids, and ice packs may help to alleviate some of the migraine symptoms ( ninds.nih.gov . “Migraine.”). In more severe cases, drugs for acute treatment are used such as ibuprofen such as advil, triptan drugs that increase serotonin in the brain, ergot derivative drugs that bind to serotonin receptors on brain cells, or nonsteroidal anti-inflammatory drugs ( ninds.nih.gov . “Migraine.”). In today’s research, Hopkins medicine suggests that “ chemical compounds and hormones, such as serotonin and estrogen, often play a role in pain sensitivity for migraine sufferers” while fluctuations in blood flow to the brain may be contributors ( hopkinsmedicine.org . “How a Migraine Happens.”). For more on the brain chemistry of migraines, see under “Read Recommendations” on the home page! Sources: Mayo Clinic. “Migraine.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 7 July 2023, www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201 . Accessed 13 July 2024.  ninds.nih.gov . “Migraine.” National Institute of Neurological Disorders and Stroke , U.S. Department of Health and Human Services, www.ninds.nih.gov/health-information/disorders/migraine . Accessed 13 July 2024.  hopkinsmedicine.org . “How a Migraine Happens.” Johns Hopkins Medicine , 26 Nov. 2019, www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens#:~:text=Serotonin%20is%20a%20chemical%20necessary,estrogen%20levels%20affect%20women%20only . Accessed 13 July 2024.

Written by: Caroline Kim July 6, 2024 Our brain, the control center of our bodies, is very complex and powerful. Today, we begin a series focused on the topic of neural conditions. There are so many unique topics that we can cover, but we’ll start with one of the more common medical conditions known as a stroke. According to the CDC, “ A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts… A stroke can cause lasting brain damage, long-term disability, or even death” ( CDC. “About Stroke.” ).  There are two main types of strokes: an ischemic stroke and a hemorrhagic stroke. The ischemic stroke is the more common case, and occurs when there is a blockage in the brain's blood vessels due to something such as a blood clot. The latter occurs when arteries in the brain rupture, causing brain bleeds, pressuring the brain cells and ultimately damaging them ( CDC. “About Stroke.” ). Another notable condition is the TIA (transient ischemic attack/”mini stroke”), where blood flow in the brain is very temporarily blocked; over 33% of those who have a TIA and do not receive treatment subsequently experience a major stroke within a year ( CDC. “About Stroke.”). In other words, a TIA is a key indicator that the individual may experience a major stroke in the near future. After experiencing a stroke, there are several complications that may ensue: paralysis, difficulty eating, difficulty talking, memory loss, impaired judgment/thinking, emotional/lifestyle changes, and bodily pain (Mayo Clinic Staff. “Stroke.”).  As provided by Mayo Clinic, symptoms that are experienced during a stroke include difficulty speaking/understanding, numbness in the face/arms/legs, vision problems, headaches, and difficulty walking; immediate medical care should be sought if one side of the person droops (when smiling), paralysis, or slurred speech (Mayo Clinic Staff. “Stroke.”). In 2021, 1 in 6 deaths from cardiovascular disease was due to stroke, About 185,000 strokes—nearly 1 in 4—are in people who have had a previous stroke, and Stroke is a leading cause of serious long-term disability (CDC. “Stroke Facts.”). This being said, strokes are a very serious condition and preventative measures as well as being able to identify stroke symptoms are crucial. As always, we will dive into the chemistry and biology behind strokes and what occurs in the body during a stroke. In ischemic strokes, “interrupted cerebral blood flow depletes the brain of oxygen and glucose, which leads to disrupted ATP synthesis and energy deficiency, as well as impaired ion homeostasis and acid-base imbalance… result in cerebral neuropathological changes, such as brain edema, neuroinflammation, and neural cell death, eventually underpinning severe neurological deficits” (Qin). Following an ischemic stroke, the reduction of cerebral blood flow limits the glucose and oxygen availability most notably in neurons; in conjunction, “may eventually lead to cellular excitotoxicity and mitochondrial dysfunctions, which serve as the initiating session of ischemia-induced damage and subsequently cause other cascade of injuries” (Qin). Excitotoxicity and signaling pathways are major factors accounting for the science of a stroke, and for more in depth reviews, please reference source (4) and the home page for helpful links.  Certain factors that increase an individual’s risk for stroke such as people over the age of 55, Men, and those of African American/Hispanic background. More factors include the following: lack of exercise, obesity, drinking in excess, drugs, smoking, high blood pressure, diabetes, high cholesterol, heart disease, and family history of stroke (Mayo Clinic Staff. “Stroke.”). This being said, counteracting some of these variable factors such as being more active and reducing alcohol intake can help prevent stroke. Antiplatelet drugs and anticoagulants (blood thinning medications) may also be implemented to prevent stroke/more strokes (Mayo Clinic Staff. “Stroke.”).  Sources: CDC. “About Stroke.” Centers for Disease Control and Prevention , 15 May 2024, www.cdc.gov/stroke/about/index.html#:~:text=A%20stroke%2C%20sometimes%20called%20a,brain%20become%20damaged%20or%20die . Accessed 06 July 2024.  Mayo Clinic Staff. “Stroke.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 30 Apr. 2024, www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113 . Accessed 06 July 2024.  CDC. “Stroke Facts.” Centers for Disease Control and Prevention , 14 May 2024, www.cdc.gov/stroke/data-research/facts-stats/index.html . Accessed 06 July 2024.  Qin, Chuan, et al. “Signaling Pathways Involved in Ischemic Stroke: Molecular Mechanisms and Therapeutic Interventions.” Nature News , Nature Publishing Group, 6 July 2022, www.nature.com/articles/s41392-022-01064-1 . Accessed 06 July 2024.

Written by: Caroline Kim June 29, 2024 In continuation of our most recent blog, we will discuss yet another prominent topic within the realm of pediatric psychology: Autism Spectrum Disorder (ASD). The NIH defines ASD as “... a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave”, with symptoms generally emerging by the age of 2. Common symptoms include difficulty communicating with others, repetitive behaviors, inconsistent eye contact, and restricted interests ( nimh.nih.gov . “Autism Spectrum Disorder.”). As this is a spectrum disorder, the kind of symptoms and their severities vary.  It is estimated that ASD affects 1 in 36 children  and 1 in 45 adults in the U.S. ( Autismspeaks.org .). It is also important to note that boys are four times as likely to have autism than girls, and that statistics vary slightly across different racial and ethnic groups. The CDC provides data tools on their websites, allowing for a visualization of how ASD varies geographically and ethnically.  While the primary causes of autism are not yet clear, research suggests that the conjunction of an individual’s genes can lead to ASD: “ the number of genes predicted to carry risk for ASD has steadily increased, now reaching well into the hundreds” (State) . Among these are having a sibling with ASD, having older parents, having a low birth weight, and having certain genetic conditions ( nimh.nih.gov . “Autism Spectrum Disorder.”). UCLA health also notes that while genetic factors contribute more towards ASD, environmental factors can also play a role: “ Autism is hereditary and therefore does run in families. A majority (around 80%) of autism cases can be linked to inherited genetic mutations.” (Bell).  According to the NIH, “Numerous studies have also shown that autism can often be comorbid with other neurological and psychiatric disorders… moreover, there are several medical conditions comorbid to autism such as immunological disorders, gastrointestinal diseases, sleep-related breathing disorders, and there are several genetic syndromes commonly associated with autism” (Marotta). Another key detail to be noted is that autism is known to develop during fetal development and early brain development, suggesting that it is not something that can develop later in life (Bell). In researching the neurochemistry behind ASD, neurotransmitters are a large topic, considering “a neurotransmitter system dysfunction can lead to impairments in the processes of brain development, determining autism” (Marotta). For further detailed information on the linkage of neurotransmitters with ASD and the biology of ASD, I highly recommend reading “The Neurochemistry of Autism” (source (5) )and “The Emerging Biology of Autism Spectrum Disorders” (source (6)).  While there is no known cure for ASD, a variety of early intervention and treatments exist. Some options may include behavior/communication therapy, educational therapy, or family therapy; while medications for autism itself do not exist, there are medications that alleviate symptoms such as hyperactivity (MayoClinic).  Sources: Autismspeaks.org . “Autism Statistics and Facts.” Autism Speaks , www.autismspeaks.org/autism-statistics-asd#:~:text=Autism%20Prevalence&text=1%20in%2036%20children%20in,rate%20of%201%20in%2044.&text=In%20the%20U.S.%2C%20about%204,diagnosed%20with%20autism%20than%20girls . Accessed 28 June 2024.  nimh.nih.gov . “Autism Spectrum Disorder.” National Institute of Mental Health , U.S. Department of Health and Human Services, www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd . Accessed 28 June 2024.  Bell, Ashley. “Is Autism Genetic?” UCLA Med School , 19 Apr. 2024, medschool.ucla.edu/news-article/is-autism-genetic#:~:text=Yes%2C%20a%20majority%20of%20autism,mutations%20that%20run%20in%20families . Accessed 28 June 2024.  MayoClinic. “Autism Spectrum Disorder.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 6 Jan. 2018, www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934 . Accessed 28 June 2024.  Marotta, Rosa, et al. “The Neurochemistry of Autism.” Brain Sciences , U.S. National Library of Medicine, 13 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7139720/ . Accessed 28 June 2024.  State, Matthew W, and Nenad Šestan. “Neuroscience. the Emerging Biology of Autism Spectrum Disorders.” Science (New York, N.Y.) , U.S. National Library of Medicine, 14 Sept. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3657753/ . Accessed 28 June 2024.

Written by: Caroline Kim June 26, 2024 Pediatric psychology is a topic spanning various different conditions and treatments. One of the most prominent being Attention-deficit hyperactivity disorder, or, better known as ADHD. Common symptoms to this condition include inattention and hyperactive/compulsive behavior such as distraction, difficulty following directions, difficulty in organizing tasks, fidgeting, difficulty waiting their turn, and constant talking (Mayo Clinic. “Attention-Deficit/Hyperactivity Disorder (ADHD) in Children.”). A key component to understanding this disorder is being informed on the neuroscience and genetics behind ADHD. A detail that took me by surprise was that “although genetic studies have not isolated a gene for ADHD, there may be several genes contributing to the vulnerability for developing this disorder. For example, twin studies have shown a significant heritability for ADHD (4) as high as 76%. In addition, the parents and siblings of children with ADHD have an ADHD diagnostic probability 4-5 times higher than the general population, and boys are more vulnerable than girls ” (Konopka, Lukasz M.). Many neuroscientists focus on the brain parts that may cause the symptoms of ADHD such as the dorsolateral prefrontal cortex, ventral lateral prefrontal cortex, insula, anterior cingulate, and default networks and functions linked to neurotransmitter systems (Konopka, Lukasz M.). According to Konopka, neuroscientists generally agree that “ADHD patients primarily struggle with improper utilization of the neurotransmitter dopamine, and, to a lesser extent, norepinephrine”. For this reason, ADHD medications work to balance the supply of neurotransmitters associated with ADHD (Professional, Cleveland Clinic medical.). ADHD is one that affects many worldwide; according to the 2022 CDC data, an estimated 7 million U.S. children were diagnosed with the disorder, and boys are 7% more likely to be diagnosed than girls (CDC. “Data and Statistics on ADHD.”). This disorder has also been known to be associated with (40%) anxiety and (50%) conduct problems, according to the CDC. Below is a chart (1) produced by the CDC regarding other conditions associated with ADHD by age. Additional CDC data and charts show that between 2016 and 2022, the total number of children receiving ADHD behavior treatment has increased. (CDC Co-occurring Conditions with ADHD – Interactive Data Charts 1) ADHD symptoms can pose a variety of challenges for the individual, and can make everyday tasks more difficult. According to Mayo Clinic children with ADHD often struggle in the classroom/academics, have higher risk for accidents/injuries, struggle with self-esteem, and have an increased risk for substance abuse. Implications of co-existing conditions/disorders are prevalent, and treatment is a path that can help alleviate many symptoms for these children. Treatment for ADHD can vary depending on the severity of the symptoms; treatment may involve behavior therapy and/or medications. Some behavioral therapy methods include parent training in behavior management, behavior therapy with children, and behavior intervention in the classroom (CDC. “Treatment of ADHD.”). The CDC also provides a list of tips such as creating routines, encouraging organization, and setting goals. Treatment by medication has higher risks for younger children, so behavioral treatment is often utilized first; stimulants are the most commonly used medication, but non-stimulants were also approved as of 2003 (CDC. “Treatment of ADHD.”). Sources: CDC. “Data and Statistics on ADHD.” Centers for Disease Control and Prevention, 16 May 2024, www.cdc.gov/adhd/data/index.html. Accessed 26 June 2024. CDC. “Treatment of ADHD.” Centers for Disease Control and Prevention, 15 May 2024, www.cdc.gov/adhd/treatment/index.html. Accessed 26 June 2024. Mayo Clinic. “Attention-Deficit/Hyperactivity Disorder (ADHD) in Children.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 25 June 2019, www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889. Accessed 26 June 2024. Konopka, Lukasz M. “Understanding Attention Deficit Disorder: A Neuroscience Prospective.” Croatian Medical Journal, U.S. National Library of Medicine, Apr. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4009719/. Accessed 26 June 2024. Professional, Cleveland Clinic medical. “ADHD Medications: How They Work & Side Effects.” Cleveland Clinic, 6 Oct. 2022, my.clevelandclinic.org/health/treatments/11766-adhd-medication. Accessed 26 June 2024.

Written By: Caroline Kim January 16, 2024 Slowly but surely, this blog will develop into one with focuses in the neural medicine and biology. Today, we’ll start off with an introduction to a related field and how the two work hand in hand. It will probably be a good idea to begin this journey about BME (biomedical engineering) and neuroscience by defining the two terms. Michigan Tech. defines Biomedical Engineering as “... advances that improve human health and health care at all levels and is the application of the principles and problem-solving techniques of engineering to biology and medicine”(1). As the field is very extensive, the more specific terminology varies person to person. This is where the integration of neuroscience comes in. My main interests lie in neuroscience, within the medical field, and neural engineering is certainly a field that intrigues me. Others take on the task of honing in on prosthetics or medical imaging. I view neuroscience as the study of the “how of the brain” whereas psychology might be considered more as the “why of the brain”; it has multitudes of applications whether it be in a research laboratory, medical engineering, neurosurgery, etc. Within my main scope of interests lie the application of NeuroHealth and NeuroTech. John Hopkins describes Neurohealth as “improving, restoring, and augmenting normal and impaired neural function, focusing on the diagnosis, prognosis, and treatment of nervous system disorders” and NeuroTech as “designing and deploying tools to sense and control the brain and human behavior, including neuromorphic engineering, prosthetic devices, and robots” (2). What we can conclude from here is that neuro technology is a necessary component of neuro health, and can be brought together through biomedical engineering. Advances in neuro engineering have made significant impacts today; the NIH states “... restored mobility to people with paralysis, relieved symptoms of movement disorders, reduced chronic pain, restored the sense of hearing, and provided sensory perception to individuals with sensory deficits”(3). One kind of approach involves utilizing interfaces with the nervous system to moderate neurological activity, ranging from external worn devices to more invasive methods that involve implants (NIH) (3). Deep Brain Stimulation has been involved in repairing motor impairment, Spinal Cord Stimulation for chronic pain, and neural devices to mitigate siezures/hearing/sight (NIH) (3). An more common devices would be cochlear implants, which works to restore hearing. As there are an extensive amount of different neuro technologies in medicine, we’ll spend the upcoming time diving more in depth into neuroscience in medicine. Sources: Technological University, Michigan. “What Is Biomedical Engineering?” Michigan Technological University, 2024, www.mtu.edu/biomedical/department/what-is/. Accessed 16 Jan. 2024. Biomedical Enginering, John Hopkins. “Neuroengineering.” Johns Hopkins Biomedical Engineering, 21 Sept. 2021, www.bme.jhu.edu/research/research-areas/neuroengineering/. Ereifej, Evon S et al. “Neural engineering: the process, applications, and its role in the future of medicine.” Journal of neural engineering vol. 16,6 063002. 12 Nov. 2019, doi:10.1088/1741-2552/ab4869