Brainstorm: This fMRI scan highlights areas that are most active during two thought processes: One (SMA) is active when subjects think about tennis, the other (PPA) lights up when they imagine roaming through a familiar space. Credit: Anna Rose Childress, University of Pennsylvania

A new way to create and interpret real-time brain scans could help addicts control their cravings

MIT Technology Review, November 23, 2010, by Lauren Gravitz  —  Technology might not be advanced enough yet to let people read someone else’s mind, but researchers are at least inching closer to helping people to read and control their own. In a study presented last week at the Society for Neuroscience meeting in San Diego, scientists used a combination of brain-scanning and feedback techniques to train subjects to move a cursor up and down with their thoughts. The subjects could perform this task after just five minutes of training.

The scientists hope to use this information to help addicts learn to control their own brain states and, consequently, their cravings.

Scientists have previously shown that people can learn to consciously control their brain activity if they’re shown their brain activity data in real time—a technique called real-time functional magnetic resonance imaging (fMRI). Researchers have used this technology effectively to teach people to control chronic pain and depression. They’ve been pursuing similar feedback methods to help drug users kick their addictions.

But these efforts have been difficult to put into practice. Part of the problem is that scientists have had to choose which part of the brain to focus on, based on existing knowledge of neuroscience. But that approach may miss out on areas that are also important for the particular function under study.

In addition, focusing on a limited region adds extra noise to the system—much like looking too closely at just one swatch of a Pointillist painting—the mix of odd colors doesn’t make sense until you step back and see how the dots fit together. Psychologist Anna Rose Childress, Jeremy Magland, and their colleagues at the University of Pennsylvania have overcome this issue by designing a new system of whole-brain imaging and pairing it with an algorithm that let them determine which regions of the brain are most centrally involved in a certain thought process.

“I think it’s very exciting, and I think it’s likely to be just the tip of a large iceberg of possibilities,” says Christopher deCharms, a neuroscientist and founder of Omneuron, a company dedicated to using real-time fMRI to visualize brain function. “It’s a small case demonstration that you can do this and you can do it in real time.”

Childress asked 11 healthy controls and three cocaine addicts to watch a feedback screen while alternately envisioning two 30-second scenarios: Repeatedly swatting a tennis ball to someone, and navigating from room to room in a familiar place. By analyzing whole-brain activity, researchers found that a part of the brain called the supplementary motor area was most active during an imagined game of tennis. They then linked this pattern to an upward movement of a computer cursor. They did the same with the navigation task, linking it to downward movement of the cursor. After four cycles or fewer—less than five minutes of training—the subjects had learned to alternate between the two states of mind, as well as associate each one with its corresponding cursor position. From there onward, they could move the cursor up or down with their thoughts.

“Conventional technology used up until now monitors a designated region of the brain, but the data tend to be noisy,” Childress says. As a result, it’s harder for researchers to determine what regions of the brain are important to control for feedback exercises. “But whole-brain information cancels out a lot of the noise.”

The researchers found that both addicts and healthy people could control their state of mind equally well, something Childress says is encouraging for future studies. “The patients who have trouble controlling their craving could still demonstrate control over this sort of non-emotional test,” she says. That confirms what earlier studies had suggested: Addicts’ cognitive control issues are not linked to more general thinking, but instead limited to more emotionally charged thoughts, like cravings.

However, Childress’s team will need to develop specialized tasks to figure out how to apply this to addiction and other disorders. For therapy, “You really need feedback from localized regions that have to do with their disease, and have people learn to control them,” says Rainer Goebel, a professor of psychology at the University of Maastricht in the Netherlands who has done similar work with depression patients.

The University of Pennsylvania researchers are now developing just such a training program. For example, researchers might show cocaine addicts images or videos that involve stereotyped cocaine images, classify the brain region, and then use brain training to teach people how to dampen the activity in that part of the brain.

Pressure drop: A device developed by a company called Ardian was used to destroy nerves in patients’ renal arteries, reducing their blood pressure by up to 30 percent.  Credit: Ardian

New treatment may be a way to control hypertension when drugs don’t work

MIT Technology Review, November 23, 2010, by Karen Weintraub  —  A California company has shown how to dramatically lower blood pressure in hard-to-treat patients by destroying tiny nerves in the kidney.

The nerves are located inside the main arteries leading to the kidney. They affect blood pressure by controlling the release of sodium and an enzyme called renin, and by managing blood flow from the kidneys themselves.

The procedure was developed by Ardian, a medical device company based in Mountain View, California. Previous studies have shown that these nerves are overactive in many people with high blood pressure, says Murray Esler, who led the new research. By destroying these nerves in about 50 people, Esler could reduce those patients’ uncontrolled high blood pressure by nearly 30 percent. A study describing the work was presented today at the American Heart Association, and the work is published in The Lancet.

Previous research has suggested that high blood pressure dramatically increases the risk of death. But effective medication may only reduce blood pressure up about 10 percent, says Esler, associate director of the Baker IDI Heart and Diabetes Institute, in Melbourne, Australia. This is the first controlled trial to explore the impact that destroying these nerves would have on high blood pressure, Esler says.

About 10 percent of the patients who had the procedure saw little or no benefit. Esler says this compares favorably to a typical drug, which might only have a 50 percent response rate. Patients in both groups continued to take medication during the six-month study, though the dosages were lowered for some of those who had the surgery. None of the patients involved in the trial suffered any significant ill effects.

Doctors slid a catheter into each of a patient’s two renal arteries, and blasted the nerves with heat high enough to destroy them but not damage the surrounding arterial wall. Some participants have been followed for more than two-and-a-half years so far, and their blood pressure has remained lower, suggesting the nerves do not grow back and that improvements last long-term, Esler said.

The procedure can be performed in 40 to 60 minutes with an overnight hospital stay, says Andrew Cleeland, Ardian’s president and CEO. The cost has not been determined yet, but will likely be on the order of $10,000, Cleeland says.

The company is awaiting U.S. Food and Drug Administration approval to begin a similar research trial in the United States with 350 patients whose high blood pressure isn’t controlled by medication. The company already has permission to do the procedure in Europe, and will begin commercializing it early in 2011, Cleeland said.

Future research will also explore the potential benefit of the Symplicity Catheter System on diabetes, after a pilot study suggested that destroying the nerves also improved clinical markers of diabetes.

Randall Zusman, director of the division of hypertension at the Massachusetts General Hospital Heart Center, questions how big the potential market really is. He says only a handful of his 3,000 current patients are as drug-resistant as the patients in Esler’s research. “When you make a concerted effort—five drugs or more—you’re going to get most people under control,” Zusman says.

But both Zusman and Aram Chobanian, a hypertension expert at Boston University, say they were impressed by the size of the drop in blood pressure, and look forward to seeing more research.

“The effects on blood pressure are quite remarkable,” says Chobanian. No existing drug has done more to lower blood pressure, he says. “The initial data provided here are very impressive.”

One interface: Libox offers a consistent interface for accessing and sharing music, video, and photos from any device.   Credit: Libox

A new service called Libox aims to make it easier for people to access content, no matter what gadget they’re using

MIT Technology Review, November 23, 2010, by Erica Naone  —  Nowadays most people own a multitude of devices capable of displaying photos and playing music and video. But these gadgets are often made by different manufacturers, run different operating systems, and don’t communicate well with each other. A startup called Libox, which launched yesterday, hopes to solve this problem by offering a service that makes it easy for a user to access photos, video, and music from almost any Web-connected device.

Founder Erez Pilosof says he started Libox, based in Tel Aviv, Israel, after thinking about his biggest annoyances as a consumer. Managing media and sharing it “seemed very limited and tedious and problematic,” he says. Pilosof wanted to build a service that provided a consistent experience no matter how a user wanted to access her media.

Libox allows users to sync and share media through its desktop applications and a Web application that can be accessed from a browser. The Web application uses HTML, a Web technology that can be accessed by Apple’s iPhone and iPad, as well as Android smart phones and a variety of other mobile devices. Within a few months, Libox plans to launch native mobile applications optimized specifically for the iPhone, Android, and the iPad.

To use the basic service, which is free, a user has to install Libox’s software on a desktop machine. This software finds and processes all media files on the machine and processes new ones when the user loads them. Unlike many other syncing services, Libox does not move users’ data to its own servers. Instead, the company uses peer-to-peer sharing algorithms to distribute data across a user’s devices. For example, when a user accesses a song from a smart phone, Libox might stream that song to the phone from the user’s desktop machine.

Algorithms that attempt to predict what content a user wants to access help the architecture work smoothly, says Pilosof. Those algorithms might detect that a user has been listening to five songs a great deal then store those songs locally on the user’s smart phone to make them easier to access.

Libox users can also share media with each other. The technology then functions in much the way it does when syncing between multiple devices owned by one user, and the company’s algorithms again try to predict how best to distribute content. If a friend tends to access shared photos right away, Libox will prioritize transferring those files as soon as they’re available.

Libox is designed to handle high-definition video and audio files, and Pilosof says the software can handle all major digital media formats, along with many that are less well-known. Although the basic service is free, the company plans to make money by making revenue sharing deals with content providers interested in using its technology to deliver content to users and to provide extra services, such as backup plans.

Libox isn’t the only company thinking about syncing content across devices. Apple offers MobileMe, which helps users sync content across a variety of Apple products. And at its recent developer conference, Google previewed technology that will allow users to stream music from a desktop computer to an Android phone.

Most users are familiar with syncing one device, such as an iPod or iPhone, to a desktop computer, says Michael Cote, an analyst with the research firm RedMonk. But Cote adds that Google and other companies could bring about a broader way of syncing content–one that allows users to store media easily on multiple devices.

But Libox may face legal problems if the entertainment industry takes exception to the way it could allow sharing of copyrighted material. The music industry has historically been suspicious of services that let consumers share music files, and Sonal Gandhi, an analyst with Forrester Research who covers media and entertainment, says that record labels have sometimes issued legal challenges to such services.

Other experts expect that consumers will have a lot of need for services that help them organize and access their data no matter where they are. “It’ll be a multiple-device world for a very long time,” says Kevin Burden, head of ABI Research’s mobile-devices group. But Burden foresees an even more serious potential roadblock than the music industry: the likely end of unlimited data plans for mobile devices. “This is going to get people thinking long and hard about what they pull down over the air,” Burden says, and this could make syncing services like Libox less useful.

……..see you next week.