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Tinnitus is caused by a misinterpretation by the brain of signals from the nerves in the ear.

An ear

Symptoms of tinnitus

Tinnitus is a sound that’s heard in one or both ears for which there’s no external source. The sounds appear to originate within the ear and are described as ringing, buzzing, roaring, hissing or whistling. There is nothing actually causing the sounds, it is a misinterpretation by the brain of signals from the nerves in the ear.

Episodes of tinnitus may be brief or it can be a permanent problem. The noise can affect concentration and causeinsomnia. When it’s very disruptive, it can cause anxiety and occasionally leads to depression.

Around 15 per cent of people experience tinnitus at some stage and it’s more likely to occur after the age of 60.


Causes of tinnitus

Tinnitus can be associated with any abnormal condition of the ear and is often linked to hearing loss, particularly related to ageing (presbyacusis).

Common causes of tinnitus include:

Tinnitus that occurs in only one ear should be take more seriously as it may be caused by an acoustic neuroma, a rare tumour that grows around the acoustic nerve that connects the ear to the brain.


Tinnitus treatments

Avoiding exposure to loud noise and earwax build-up can help prevent tinnitus. If there’s a treatable underlying cause, once this is treated the tinnitus should disappear.

Reassurance that the tinnitus isn’t being caused by a serious problem often solves the problem.

Masking the noise with a background radio or a masking device (using white noise) helps to distract the person from the tinnitus.

Counselling and antidepressant therapy may be used if the symptoms are causing anxiety and depression.



August 13, 2012 Posted by | Uncategorized | Leave a comment

‘The Dark Knight Rises’ Review

Tom Hardy as Bane and Christian Bale as Batman in 'The Dark Knight Rises'

Tom Hardy as Bane and Christian Bale as Batman in ‘The Dark Knight Rises’

© Warner Bros Pictures

Christopher Nolan has accomplished what few other filmmakers have ever been able to do. Nolan’s crafted a trilogy in which each film tops its predecessor(s). Batman Begins introduced the caped crusader as a fully fleshed-out character in a film that proved audiences will turn out to see a quality comic book-inspired movie that takes the source material seriously yet doesn’t turn off moviegoers who aren’t familiar with the comics. The Dark Knightfound Nolan delivering the definitive Batman film to date and what’s widely considered to be one of the best comic book films ever made. With his first twoBatman movies, Nolan managed to convert non-believers while satisfying Batman fanatics. Gotham City had its savior in the Batman, and moviegoers had Nolan to thank for saving the flounderingBatman franchise. And now with The Dark Knight Rises, Nolan finishes up the trilogy with one of the best films of 2012.

Nolan had the foresight to gather a well-respected group of actors who, on first glance, weren’t obvious choices to bring the bat-inspired superhero and his friends, associates, and enemies to life on the screen. Prior to being cast as the man to next don the Batsuit, Christian Bale was best known for starring in American Psycho. His credits at that point also included NewsiesLittle WomenVelvet Goldmine, and Laurel Canyon – not exactly a list that immediately makes you think ‘potential Batman.’ Edgy, indie films – yes. Big-budget superhero studio movies – no. But Nolan had faith in Bale’s ability to crawl into any character and wear its skin, even if that skin was covered in a latex suit with pointy ears. He also brought in Michael Cainefor his first major comic book-inspired film, and the chemistry between Bale’s Bruce Wayne/Batman and his loyal servant, Alfred, was magical.

Gary Oldman (Sid and NancyJFKDracula) balanced two franchises with his role as Jim Gordon in Nolan’s Batman series and Sirius Black in the Harry Potter films. As with Caine, Oldman made his supporting Batman character into something special.

The Batman villains proved Nolan’s genius at finding the right peg to fit in the right hole. As I said in my review of BatmanCillian Murphy’s Scarecrow was a spotlight stealer. “His performance is all in the eyes. If the eyes are truly the windows to the soul, then trust me you don’t want to meet Murphy in Scarecrow mode in a dark alley.” Skip forward to The Dark Knight Rises and Tom Hardy’s Bane, and once again the performance is all in the eyes. With his face and voice obscured by a mask, it’s the eyes that need to sell how deep the character’s depravity is, and Hardy’s menacing physicality makes his portrayal of a Batmanvillain worthy of the franchise.

But second only to Bale as Batman, the franchise’s most memorable performance came from another unlikely casting choice. Heath Ledger lives on in films, and his legacy is topped by the final – and perhaps finest – performance of his career as The Joker in The Dark Knight. Again quoting from a past review: “In The Dark Knight, it’s Ledger’s Joker the rest of the cast needs to keep step with. This Joker is nasty-scary, a greasy, grotesque creature lifted straight from the nightmares of coulrophobics. Even those not given to fearing clowns are going to recoil in fright from Ledger’s mesmerizing performance.”

But what does any of the above have to do with reviewing The Dark Knight Rises? Yes, this is basically a love letter to the genius of Christopher Nolan more so than a review of his, unfortunately, final Batman film as director. But truthfully, it’s best to go into The Dark Knight Rises knowing as little as possible about the plot, and a review, no matter how basic, could possibly give away something best left to moviegoers to discover for themselves. With The Dark Knight Rises, Nolan brings the franchise full circle, leaving no doubt the marriage between filmmaker and material has been a loving, albeit too short, affair.

The Dark Knight Rises is everything you could want or hope for in the final film of this Batmantrilogy. Expectations are exceeded, the action is grander, the new additions to the cast (in particular Joseph Gordon-LevittAnne Hathaway, and Marion Cotillard) are outstanding, and the 2 hour and 44 minute running time simply flies by. I couldn’t imagine a more perfect way to wind up this trilogy. It’s incredibly sad to be saying good-bye to Nolan, Bale, Oldman, Caine, and the rest of the Batman gang, but if we have to allow them to move on, at least we have one of the most mesmerizing, entertaining trilogies ever released to show for their efforts.


The Dark Knight Rises was directed by Christopher Nolan and is rated PG-13 for intense sequences of violence and action, some sensuality and language.


July 28, 2012 Posted by | Uncategorized | Leave a comment

Alyson Hannigan and Jason Biggs Talk About ‘American Reunion’

Jason Biggs and Alyson Hannigan in 'American Reunion'

Jason Biggs and Alyson Hannigan in ‘American Reunion’

© Universal Pictures


The entire American Pie gang returns for American Reunion, the fourth film of the comedy franchise which is hitting theaters nine years after American Wedding (aka American Pie #3). Heading up the R-rated antics are Jason Biggs, who will forever be known as ‘The Pie Guy’, and Alyson Hannigan who uttered the memorable “One time, at band camp…” line in the first film. Biggs and Hannigan play Jim and Michelle, the now-married couple who’ve hit a rough patch in their marriage after discovering that being parents has put a damper on their love life. They hope to reignite the spark at their 13 year high school reunion, however they soon discover that getting back together with the old gang is much more time-consuming and energy-sapping than having a toddler around.

Together at the LA press conference for the Universal Pictures release, Biggs and Hannigan discussed what it was like to revisit these characters and how it felt to play a couple once again.

Jason Biggs and Alyson Hannigan American Reunion Press Conference

Jason, can you talk about how your character has grown up but he still has that teenage boy part of his personality?

Jason Biggs: “I love that Jim has grown up and Jim and Michelle are married now and he’s got a kid and he means well. But, in his mind, he has grown up. The problem is he finds himself, much like in the first film, and frankly all of the American Pie films, he finds himself in a situation where he’s once again sexually frustrated. When Jim is sexually frustrated, he ends up making some poor decisions. When he makes some poor decisions…”

Alyson Hannigan: “We make a movie. “

Jason Biggs: “We make a film. When we make a film, we get rich. When we get rich… No, I’m kidding. The thing that I love now that Jim is 31 – how old would he be? 30, 31? We’ve been trying to figure out the age of our characters. We’re not exactly sure.”

Alyson Hannigan: “We didn’t do much research.”

Jason Biggs: “And so, the truth is, after you’re 30 years old, men still masturbate. There are still sexual problems that happen, that arise for guys.”

Alyson Hannigan: “Jason, do you want to tell us something?”

Jason Biggs: “I’m masturbating right now as we speak, right under the table. Is that what you meant?”

Alyson Hannigan: “No.”

Jason Biggs: “I don’t even know what your question was.”

Jason, when you read the dominatrix scene, were you like, “Is that all you’ve got, guys? I’m Jason Biggs!”

Jason Biggs: “Yeah, I’m like, ‘C’mon guys, step up to the plate. Don’t be a pussy. Let’s do this, all right?’ Sorry about my language. It’s that time of day. I’m also that type of person always so… Actually, it’s funny because the dominatrix scene was in the earlier drafts and I was like, ‘This is great. This is funny. I think that’ll be really funny. But what’s the next step? There’s more to do here.’ And so, if there was any sort of concern I had with the very, very early drafts, and I mean a minor concern, because when I tell you that this script was in the shape it was, it blew my mind. Jon and Hayden came in and you read the script and I was like, ‘Did these guys write the first American Pie?’ They did such justice, I felt, to Adam Herz’s original screenplay and the characters that he had originally created, and I think it comes across on screen. I feel like this movie is more like the first one than any of the other ones.”

Alyson Hannigan: “They were like the perfect combination of the Weitz Brothers and Adam.”

Jason Biggs: “Actually, they were. The Weitz Brothers directed the first film and Adam wrote it. I’d say that’s pretty accurate. So, if there was anything, I was just, ‘Okay, let’s keep [going]. How much further can we go?’ That’s one of the biggest challenges because now that you have these characters who are in their 30s, it’s tougher to credibly find these situations where you can push these boundaries and put them in these ridiculous scenarios that are believable, aren’t gratuitous, that aren’t awkward/just illegal in some way. I mean, they’re older. Some of the things they did in the previous films would be not acceptable for a 30 year old. They had to update it, if you will, so that’s why the penis scene, I think, works organically – ‘organ’ being the appropriate root word there.”

Alyson, in that scene was it natural to you that Michelle would become the dominatrix?

Alyson Hannigan: “Yeah. I mean, she was in the first film, right?”

Jason Biggs: “She was. You made me your b*tch.”

Alyson Hannigan: “Absolutely. Still are.”

Jason Biggs: “I always will be.”

Alyson Hannigan: So yeah, I definitely am, and especially if she is feeling responsible for letting the sparks fade a little on their sexual life because she’s been so focused on being a mom. So she sees this weekend as a way to reinvigorate their lives and remind themselves of where they started. So yeah, definitely.”

There are a lot of themes in the movie that are very relatable, that are real life problems. What did you gravitate towards the most?

Alyson Hannigan: “Definitely balancing the married relationship now with parenthood I could relate to. My situation wasn’t as extreme as Jim and Michelle’s, of course, but when my daughter was first born, we were definitely all-consumed with just her. It was probably like quite a few months where we realized, ‘Okay, wait, we do need to actually set aside a date night instead of trying to fit it in between diaper changes or whatever?’ But you just get so wrapped up and it was brilliant and there was no problem there, but it was like, ‘Okay, we can’t do this for 18 years. We need to still have our couple times.’ So we try to have a date night every week, even if it’s just going to dinner and having a dinner that’s not interrupted by a 3-year-old. That’s just nice.”

What about you, Jason? Was there anything that you related to, such as the dad/son relationship or somebody still trying to find themselves as an adult?

Jason Biggs: “That’s certainly a good one. For me, the biggest change in my life personally since the last film has been getting married. Getting married for me has kind of shifted my focus in such a profound way. You just realize you can’t be so selfish anymore. There’s someone else. And it’s not just about the other person, but it’s about the relationship as well. Your priorities are realigned. Now the next step will be kids and I can’t imagine what that’s going to do, but that’ll be a game changer. It’s just interesting to see Jim wrestle with those same sort of big ideas where it’s not just about him anymore.”

“You think about the first movie, the whole movie rests upon how all these guys just want to get laid. It’s very me, me, me. Get me laid. You mentioned Jim and his dad, too. That’s really interesting. That’s a great part of the film for me. I’ve actually found this, as I’ve gotten older too, that my dynamic with my parents has changed quite a bit. There’s a beautiful moment in the film. It’s funny because a lot of my favorite moments in this movie are not really the funny ones but the more poignant, sweeter moments. Actually, that’s always been the case with the whole franchise. I love when Jim offers his dad advice in this movie and it’s kind of flipped. I think that’s really, really cool. That’s another genius thing, I think, from our writer-director guys that they came up with. I found that my relationship with my old man has changed considerably. As an adult, it’s a different thing. It’s like he’s a new person to me and it’s great. We have a totally different relationship than when I was growing up as you’re supposed to. But that resonates with me quite a bit. That’s cool.”

Are there any characters that you wanted closure for?

Alyson Hannigan: “I love the MILF guys’ storyline. I love that we really don’t know why they broke up but they’re back together.”

Jason Biggs: “And when we say ‘broke up,’ listen, Johnny Cho plays the role in a way that maybe is a little…I don’t know what you guys thought…but we’re not saying they were gay. We’re not saying that they broke up.”

Alyson Hannigan: “No, just their friendship.”

Jason Biggs: “We never intended that. I mean, they’re buddies.”

Alyson Hannigan: “We weren’t saying that they were in a relationship.”

Jason Biggs: “Right. But people have been questioning. I’ve heard that people have been like, ‘Is he gay or…?’ And then when you just said broken up, I was like I wonder if people are going to think that’s what we’re trying to imply.”

Alyson Hannigan: “No.”

Jason, what was the conversation like when you were discussing how to show your junk and the variations on how the lid would smash it? And Alyson, now that two of your onscreen husbands, Jason Segal and Jason Biggs, have both shown their goods, do we have you to blame for that?

Alyson Hannigan: “I guess.”

Jason Biggs: “She brings it out in guys. I don’t know what it is.”

Alyson Hannigan:” Obviously, I think with this, Jason Biggs, it was about time – because we’ve spent three movies listening to and talking about it and the pie got to see it – it was about time we all got to see it.”

Jason Biggs: “The penis has been a major player in the American Piefranchise.”

Its own character?

Jason Biggs: “It has been its own character.”

Alyson Hannigan: “It’s like the Rosebud.”

Jason Biggs: “Yeah. Nailed it. So it was about time.”

Alyson Hannigan: “We needed the reveal.”

Jason Biggs: “Yeah, it was about time. The conversation went something like I kept pushing the guys, Jon and Hayden, our writer/directors for that pie scene. ‘What’s going to be the pie scene this time, guys?’ Some earlier drafts felt like it was missing. I gave them carte blanche, just a blank canvas. I was like, ‘Guys, I will literally do anything as long as it makes sense in the context of the film and for the character and as long as it’s funny. As long as I think it’s funny.’ Jon wrote me one day and said. ‘Would you be willing to show your…?’ I was like, ‘Yes! Absolutely! If it’s funny.’ I laughed out loud and they pitched me the idea and I was like, ‘That sounds great.'”

Alyson Hannigan: “And as far as the technicalities of doing the scene, which was my first day of shooting by the way…”

Jason Biggs: “Yeah! Welcome back to the franchise, Alyson! Here’s my penis.”

Alyson Hannigan: “Yay! It was quite technically difficult because I had to sort of become his eyes because he couldn’t lean down and see, because then he wasn’t squishing it enough.”

Jason Biggs: “It was not easy.”

Alyson Hannigan: “And there are so many positions and we had to decide which one was the funniest.”

Jason Biggs: “Yeah. Two o’clock, or the Eiffel Tour, or the Sydney Harbor Bridge, or the straight-up hot dog bun.”

Alyson Hannigan: “The dead insect on the windshield.”

Jason Biggs: “Exactly. Yes. The drugged astronaut. The purple nurple. The options were endless. I should also tell you that I used to star in Puppetry of the Penis in Sydney, Australia when it first came out, so that’s why we had so many options. I was very skilled.”

Alyson Hannigan: “It was good you took out all the piercings for the scene.”

Jason Biggs: “Yeah, two of the holes closed. Bummer!”

Alyson Hannigan: “Not the hole he wanted to close either.”

Jason Biggs: “Yeah, that’s right. I pee through my mouth now. It’s very strange.”

Alyson Hannigan: “We’re a little punchy. Sorry!”

April 6, 2012 Posted by | Uncategorized | 1 Comment

Brain Wired in an ‘Astonishingly’ Simple Grid Structure

A new brain imaging study shows that the human brain is wired in a simple and orderly 3-dimensional grid, akin to a checkerboard, with no diagonal paths.

“Far from being just a tangle of wires, the brain’s connections turn out to be more like ribbon cables — folding 2D sheets of parallel neuronal fibers that cross paths at right angles, like the warp and weft of a fabric,” Van J. Wedeen, MD, from Massachusetts General Hospital (MGH), the Martinos Center for Biomedical Imaging, and Harvard Medical School in Boston, explained in a statement. “This grid structure is continuous and consistent at all scales and across humans and other primate species,” he added.

The highly detailed images were obtained with the Connectom diffusion magnetic resonance imaging (MRI) scanner installed at MGH’s Martinos Center for Biomedical Imaging last fall. The scanner can visualize the networks of crisscrossing fibers in 10-fold higher detail than can conventional scanners.

Detail from DSI scan shows fabric-like 3-dimensional grid structure of connections in monkey brain. Van Wedeen, MD, Martinos Center and Department of Radiology, Massachusetts General Hospital and Harvard University Medical School

“This one-of-a-kind instrument is bringing into sharper focus an astonishingly simple architecture that makes sense in light of how the brain grows,” Dr. Wedeen said.

Their report is published online March 30 in Science.

A Landmark in Human Neuroanatomy

In a statement, Thomas R. Insel, MD, director of the National Institutes of Mental Health said, “Getting a high resolution wiring diagram of our brains is a landmark in human neuroanatomy. This new technology may reveal individual differences in brain connections that could aid diagnosis and treatment of brain disorders.”

As reported in the Science paper, Dr. Wedeen’s team scanned the brains of living humans and the postmortem brains of 4 types of monkeys: rhesus, owl, marmoset, and galago. They found that the wiring of the mature brain appears to mirror 3 primal pathways established in embryonic development.

During early development, the researchers explain, the brain’s connections form along perpendicular pathways, running horizontally, vertically, and transversely. This grid structure appears to guide connectivity as do lane markers on a highway. This structure may help enforce a more efficient, orderly way for the fibers to find their proper connections, and for the structure to adapt through evolution, the researchers say.

Obtaining highly detailed images of these pathways in the human brain has long eluded scientists, in part because the many folds, nooks, and crannies in the human cortex obscure the structure of its connections.

Dr. Wedeen’s team is part of the Human Connectome Project Harvard/MGH-University of California, Los Angeles, consortium that aims to optimize MRI technology to more accurately and precisely image the human brain.

Converging Lines of Evidence

This paper is “very interesting,” Olivier Coulon, PhD, CNRS research fellow in the Laboratory for Information Science and Systems in Marseilles, France, told Medscape Medical News. “To my knowledge, it’s the first that reports such organization at the whole brain level,” he pointed out.

The findings are consistent with observations made in a previous paper, he said, “although in that paper only the medial frontal cortex was studied and the orthogonal organization of fibers was described at a gross scale without any notion of the fine grid described by Wedeen et al.”

“What is interesting,” he added, “is the fact that it is consistent with how we think cortical sulci or folds are organized. There have been a few papers describing the cortical folds as organized according to an orthogonal grid.

“We recently published a short conference paper in which such organization becomes clearer thanks to a flat angle-preserving projection of the cortex on a rectangular domain,” he added. “A longer paper should follow this year.”

“All these papers,” Dr. Coulon said, “are converging to propose evidence that there is a genetically-driven organization, which could help to find an invariant structure beyond the apparent great variability of the brain (cortex and fibers). Developmental studies and the improvement of fetal MRI acquisitions should help to clarify all these ideas in the future,” he concluded.

Dr. Coulon is principal investigator in the BrainMorph Project, which is funded by the French Agence Nationale de la Recherche and dedicated to the development and validation of surface-based brain morphometrics methods.

Dr. Wedeen’s research was funded by grants from the National Science Foundation, the National Institutes of Health, and the Human Connectome Project. The authors have disclosed no relevant financial relationships.

Science. Published online March 30, 2012. Abstract

April 6, 2012 Posted by | Uncategorized | Leave a comment

Immunotherapy Promising for Intractable Epilepsy

March 29, 2012 — Immunotherapy may be effective in treating medically intractable epilepsy in patients with specific clinical and serologic markers, new research suggests.

The seizure freedom we saw in our study is better than any antiepileptic drug ever studied.

According to investigators a “striking” 67% of patients with daily seizures who were resistant to treatment with 2 or more antiepileptic drugs (AEDs) were free of seizures after receiving immunotherapy.

“The seizure freedom we saw in our study is better than any antiepileptic drug ever studied,” senior investigator Sean Pittock, MD, from the Mayo Clinic in Rochester, Minnesota, told Medscape Medical News.

“This is very exciting and there is growing literature to support autoimmunity, not just in epilepsy, but in other areas of neurology as well — dementia, movement disorders, and neurodegenerative diseases.”

The results, published online March 26 in the Archives of Neurology, suggest an autoimmune basis for intractable epilepsy.

History of Autoimmune Disease

Dr. Pittock noted many of the patients he sees have a personal history of autoimmune thyroid problems, lupus, or type 1 diabetes or a family history of rheumatoid arthritis.

“There is something different about these patients,” he said, pointing out that his team found neural autoantibodies in most patients.

Table 1. Neural Autoantibodies

Antibody Percentage
Voltage-gated potassium channel complex 56
Glutamic acid decarboxylase 65 22
Collapsin response-mediator protein 5 6

The researchers led by Amy Quek, MBBS, also at the Mayo Clinic, found Ma2, N-methyl-D-aspartate receptor, and ganglionic acetylcholine receptor in 1 patient each.

The observational retrospective case series included 32 patients with partial seizures. Most (81%) had failed treatment with 2 or more AEDs and 38% had seizure semiologies that were multifocal or changed with time.

Head magnetic resonance imaging was normal in 47% of patients at onset. Electroencephalogram abnormalities included interictal epileptiform discharges in 20 patients, electrographic seizures in 15, and focal slowing in 13.

Patients received immunotherapy with intravenous methylprednisolone, intravenous immune globulin, and combinations of these drugs with plasmapheresis or cyclophosphamide.

New Subspecialty

After a median of 17 months, 81% of patients reported postimmunotherapy improvement. The median time from seizure onset to initiating immunotherapy was 4 months for responders and 22 months for nonresponders (P<.05).

Table 2. Epilepsy Outcomes (n=27)

Outcome Percentage
Seizure freedom 67
Seizure improvement 15
No change 18

All voltage-gated potassium channel complex antibody–positive patients reported initial or lasting benefit (P<.05). One voltage-gated potassium channel complex antibody–positive patient was seizure free after thyroid cancer resection and another responded to antiepileptic drug change alone.

When autoimmune epilepsy is suspected on clinical grounds, the authors suggest cerebrospinal fluid evaluation and comprehensive screening for neural autoantibodies are indicated.

Selective autoantibody testing is not advised because no single neural antibody is definitively associated with seizures.

In the absence of other treatment options, a trial of 6 to 12 weeks of immunotherapy is justified, the authors suggest. Long-term immunosuppressive treatment, overlapping with gradual taper, should be considered for patients whose seizures respond favorably to the initial trial of immunotherapy.

Clinical experience suggests that immunotherapy should not be used alone to control seizures, but should be used in combination with antiepileptic drugs to optimize seizure control.

Many questions remain, Dr. Pittock told Medscape Medical News. These include the natural history of autoimmune epilepsy, the selection criteria for patients with epilepsy most likely to benefit from an autoimmune evaluation, the timing for immunotherapy trial, and optimal duration of long-term immunotherapy maintenance.

“There’s a whole new subspecialty emerging in neurology,” Dr. Pittock said. “It’s known as autoimmune neurology and we are working with the American Academy of Neurology (AAN) to launch courses exploring this area.”

Dr. Pittock will be teaching a course on this topic next month at the AAN’s 64th Annual Meeting in New Orleans, Louisiana. He will be presenting with Drs. Josep Dalmau, Andrew McKeon, and Mark Keegan.


Perhaps the failure of new antiepileptic drugs is because some of these patients have autoimmune-mediated epilepsy.

In an accompanying editorial, Gregory Bergey, MD, from Johns Hopkins University in Baltimore, Maryland, noted that although the study was not a placebo-controlled trial and all patients were treated, two-thirds achieved seizure freedom for a median of 10 months and 44% became seizure free within 12 months of treatment.

“The typical investigational antiepileptic drug trial produces seizure freedom in fewer than 10% of patients even if seizure freedom is defined as only a 12-week period,” Dr. Bergey writes.

Screening for autoantibodies is not required for entry into investigational antiepileptic drug trials, he pointed out.

“Perhaps the failure of new antiepileptic drugs is because some of these patients have autoimmune-mediated epilepsy,” he writes.

Dr. Bergey added that the study is another reminder that “we need to broaden our concept of symptomatic chronic epilepsy from the structural realm into more dynamic processes not limited to acute inflammatory or infectious pathologies.”

Although not part of a controlled series, the subjects in the current study represent an extensive group of patients with diverse autoantibodies treated with immunotherapy.

“What is the true scope of autoimmune epilepsy in our populations of drug-resistant epilepsy? This is not known, but certainly at present it is probably being underdiagnosed,” he writes.

If a clear symptomatic cause for a patient’s epilepsy is identified such as mesial temporal sclerosis, cortical dysplasia, or cavernous malformation, then autoantibody testing is probably unnecessary, he noted.

“However, if imaging is unrevealing or suggests inflammation or focal swelling, then such screening may be warranted.”

EUROIMMUN provided assay kits for identifying autoantibodies in this study. Dr. Pittock is a named inventor on patents that relate to functional assays. He receives research support from Alexion Pharmaceuticals, the Guthy-Jackson Charitable Foundation, and the National Institutes of Health. Editorialist Dr. Bergey has disclosed no relevant financial relationships.

Arch Neurol. Published online March 26, 2012.

April 1, 2012 Posted by | Uncategorized | Leave a comment

Cerebellar dysfunction in MS

Samuel Pleasure

Samuel Pleasure, MD, PhD, is Professor of Neurology at UCSF. He got his MD and PhD (Neuroscience) degrees at the University of Pennsylvania and then trained in neurology and neuroscience at UCSF. He has authored numerous scientific papers on the basic mechanisms of brain development and how they relate to human neurodevelopmental disorders. He has clinical interests in epilepsy and multiple sclerosis.

Cerebellar dysfunction is a common feature in MS and is frequently among the more difficult to manage problems since it causes ataxia, dysarthria and incoordination. My assumption has always been that these symptoms are largely due to demyelination in the cerebellum or its afferent or efferent connections. A recent study in Annals of Neurology (Shields et al., February 2012) has introduced me to a new way to think about this problem in MS. The authors previously showed that Nav1.8, a voltage gated sodium channel, is ectopically expressed in Purkinje cells in the cerebellum in several models of MS and also in tissue taken from MS patients. This channel is normally not expressed in the central nervous system but rather is typically limited to the peripheral nervous system. In this study the authors examined mice that are genetically engineered to express Nav1.8 in Purkinje cells in order to test whether there are functional consequences to this misexpression. Indeed, these mice do develop motor coordination defects consistent with cerebellar dysfunction and isolated Purkinje cells from these mice have electrophysiologic defects. The authors then went on to induce EAE in mice that are genetically lacking the Nav1.8 gene and found that these mice fail to develop the typical cerebellar phenotypes seen in the EAE model used by the authors. Lastly, mice with EAE and with ectopic Nav1.8 expression in Purkinje cells responded positively to Nav1.8 antagonists with decrease in their cerebellar deficits.

What does this all mean? When taken along with other recent studies showing changes in metabotropic glutamate receptor subunit expression in the cerebellum, it implies that we are approaching a new understanding of a variety of the phenotypes seen in demyelinating disease. It seems that neurons in these diseases may be subject to a variety of changes in gene expression leading to the ectopic mixexpression of deleterious genes (when in the wrong context) such as Nav1.8 or perhaps the loss of other genes required for normal physiologic function. This may explain some of the more evanescent symptoms seen in MS that don’t seem to necessarily correlate with inflammatory activity. In addition, in some of these cases, as perhaps with Nav1.8, treatment with antagonists may be useful to treat clinical manisfestations of MS.


April 1, 2012 Posted by | Uncategorized | Leave a comment

Top 10 MTV Video Music Awards Moments

The MTV Video Music Awards have a well-earned reputation as an occasionally out of control, but always interesting awards celebration. These are 10 of the top moments through the years.

10. 1995 – Courtney Love Disrupts Madonna Interview

Madonna - MTV Video Music Awards interview 1995Video Still courtesy MTV

First she threw things and then, after being invited up by MTV’s Kurt Loder, Courtney Love took over in inimitable fashion.

9. 1988 – Guns ‘n Roses – “Welcome to the Jungle”

Guns 'n Roses at the 1988 MTV Video Music AwardsVideo Still courtesy MTV

For many years, this performance defined rock at the MTV Video Music Awards. This is the glory that was Guns ‘n Roses.

Watch Video

8. 1990 – MC Hammer – “U Can’t Touch This”

MC Hammer at MTV Video Music Awards 1990Video Still courtesy MTV

I’m not sure if there have ever been more people onstage in a single performance before or since at the MTV Video Music Awards. Few performers did dance spectacle better than MC Hammer.

7. 1993 – Neil Young and Pearl Jam – “Keep Rockin’ in the Free World”

Neil Young and Pearl Jam at 1993 MTV Video Music AwardsVideo Still courtesy MTV

One of the more serious music moments at the MTV Video Music Awards: two generations rock together in a singularly intense fashion.

6. 1994 – Michael Jackson and Lisa Marie Presley Kiss

Michael Jackson and Lisa Marie Presley - 1994 MTV Video Music AwardsPhoto by Frank Micelotta / Getty Images

It was really not that big of a surprise to see the newlyweds together, but the kiss was a bit of a shocker. The biggest kiss in MTV Video Music Award history until another pair of kisses almost 10 years later.

5. 2000 – Eminem – “The Real Slim Shady”

Eminem - 2000 MTV Video Music AwardsPhoto by Frank Micelotta / Getty Images

It was a whole sea of Slim Shadys who started out in the open air and then followed Eminem into the theater to take over the stage.

4. 2001 – *NSYNC with Michael Jackson – “Pop”

*NSYNC with Michael Jackson - 2001 MTV Video Music AwardsPhoto by Frank Micelotta / Getty Images

What better way to close out a performance of the song “Pop” than with the King of Pop himself, Michael Jackson. Justin Timberlakebeatboxing while MJ dances is a moment to treasure.

3. 2009 – Taylor Swift Wins Best Female Video and Is Interrupted by Kanye West

Taylor Swift and Kanye West at 2009 MTV Video Music AwardsPhoto by Christopher Polk / Getty Images

Everyone was a little surprised that Taylor Swift, country singer, won the award for Best Female Video, but what Kanye West did next was an even bigger surprise.

2. 1992 – Nirvana – “Lithium”

Nirvana - 1992 MTV Video Music AwardsPhoto by Frank Micelotta / Getty Images

One of the moments when everything seemed a little out of control. Krist Novoselic tosses his guitar into the air. It lands whacking him in the head and he stumbles offstage. Kurt Cobain starts tearing into the amps and everything descends to chaos.

1. 2003 – Madonna, Britney Spears, and Christina Aguilera

Madonna and Britney Spears - 2003 MTV Video Music AwardsPhoto by Scott Gries / Getty Images

September 2, 2011 Posted by | Uncategorized | Leave a comment

Josh Hartnett Talks About ‘Bunraku’

Josh Hartnett in 'Bunraku'Josh Hartnett in ‘Bunraku’

© ARC Entertainment

Josh Hartnett stars as The Drifter in writer/director Guy Moshe’s action thriller Bunraku co-starring Gackt, Woody HarrelsonRon Perlman, and Kevin McKidd. The Drifter is a mysterious stranger who’s on a mission to take down the powerful Nicola (Perlman), a vicious crime boss who rules the city with the help of his evil henchmen. Mixing different genres (including old-school Westerns) and drawing inspiritation from Japanese puppet theatre, Bunraku takes audiences into a bizarre new world where guns no longer exist and where gangs rule the streets.

In support of Bunraku‘s release on Video on Demand on September 1st (followed by a theatrical release on September 30th), Josh Hartnett talked about being a part of such a unique project, Guy Moshe’s vision, and tackling some very intense action scenes.

Exclusive Josh Hartnett Bunraku Interview

How does the final cut of the film compare to the vision you had in your head after seeing the script?

Josh Hartnett: “You know, I didn’t know what to expect when I read the script. The script was secondary in the process of getting to know this movie because Guy came out to New York – Guy Moshe, the director – came up to New York and showed me kind of a pre-made digital mock-up of a few scenes. We talked about his references for the film far before I ever read the script. He asked me not to read it before he showed me all these visual things. It kind of reminded me of the way that Robert Rodriguez did Sin City. It was the visuals first, and then he tried to figure out what to do with the script.”

“I really respected Guy’s obvious enthusiasm and his excitement and his ability to push himself to the point that most people would kind of stand back and say, ‘This may come across as totally absurd.’ He just pushed through it. And I think he accomplished something that’s unique and definitely something that other people aren’t doing. I’m proud to be able to work with him on this.”

“I read the script before I actually said yes, but the first thing I saw and the thing that stuck in my mind were the references he had. He referenced a lot of French new wave films and Kurosawa films, of course, and Sergio Leone films of course. And he was looking to do something that was kind of ’60s-centric, you know, and yet he wanted to bring in new technology to create this world. The reason that I think that he titled it Bunraku is because he wanted it to be an obvious staged world that you’re involved in. Do you know what Bunraku means?”

I do now, but I didn’t before this film.

Josh Hartnett: “Okay. Well, puppeteers are onstage with these life-size puppets and they’re performing melodramas and mysteries. It’s a traditional Japanese form of theatre, and Guy wanted this to be just as far removed from reality, in that he’s telling a parable. And it reminded me a lot when I read the script of something like Star Wars, actually, orHidden Fortress – the Kurosawa film that Star Warsis based on. It has this sort of little guys versus an evil empire storyline and the little guys all band together in a hilarious way and are guided by a sage, in this case Woody Harrelson’s part as the bartender. In Star Wars‘ case, the Obi-Wan Kenobi part with Alec Guinness. It had a lot of similarities to it.”

Do you believe, knowing all the references that Guy was intending to work off of, that’s what actually comes across on the screen?

Josh Hartnett: “You tell me.”

I think so. I think he captured it.

Josh Hartnett: “Good. Being so close to it, I had certain expectations before I saw it. But I saw a lot of the visuals before we finished because they were cutting together these little short reels with music. You could kind of get a sense of how it’s going to look and how it’s going to feel.”

“They talk about special effects all the time these days and how you can heighten things and create these fantastic superhero movies where some of the characters will do things that are just physically impossible at every turn. I liked that this was pretty much all the stunts, all the fight sequences, were in camera and that it was just the background that was heightened. It’s more of an art piece, really, surrounding these spectacular fights than it is a CGI-infused over-the-top action films.”

Your fight scenes look really brutal.

Josh Hartnett: [Laughing] “I was in pretty good shape.”

Was it difficult for you, because this is not the type of film you normally do?

Josh Hartnett: “I was getting a little fat before this film. [Laughing] But it whipped me right in shape. It was a challenge for me, for sure. Before I did this film I was sitting on my ass all the time and they made me go to the gym and learn some brutal fight moves. We had a good time – nobody really got hurt.”

“We worked with these terrific stunt guys and they were all trained in MMA. They got me a month and a half before we started filming, and I mean the first day I couldn’t do 20 sit-ups. I was not in good shape. They got me to quit smoking. I started really going to the gym three or four hours a day with them. You can see some of it, I’m sure, when the DVD comes out. I’m sure that they’ll have some of the behind-the-scenes stuff. We just did a lot of choreographed training. It was not so much about being bulked up but being ready to do some pretty interesting moves.”

Were there any mishaps during the action scenes?

“The only time I really got hurt on this film was doing that jump from building to building. Obviously I wasn’t jumping from building to building, but I was jumping quite a long ways to a pad. I was supposed to jump to a pad but I kind of leaped over the pad because I was playing a little game with the camera operators, seeing how close I could get to the actual camera. I think I did something to my hamstring and that swelled up, and then my sciatic nerve started to pinch. My whole left leg turned into a mess for about three months.”

“But the training was just kind of stage choreography, really, combined with a lot of physical, twice a day physical training. But it was mostly focused on the choreography because everybody had to be doing it exactly right, especially for the sequence in the prison. I mean, it’s a long, uncut sequence and the timing had to be correct. It had to be that way, and you don’t spend five days doing it. I think we did that whole scene in like three hours or something. We just shot it really quickly. We didn’t have a lot of time on this film. It’s not a huge budget, so we had to make sure that our choreography was all pre-planned and worked out to the end.”

Not only do they put you through a lot of physical stunts, but you also hold your body very differently in this movie. Was that something that just came with the character?

Josh Hartnett: “No. I mean, there are little tricks, you know? You can make the shoulders of your jacket too tight or you can wear a lot of heavy, restrictive garments. Or you can put some sort of pebble in your shoe which I think Dustin Hoffman did in Midnight Cowboy. You can do all sorts of things to give yourself physically a different demeanor. But with this, it just came organically through all the training and the fighting. His mentality is just so straight line; he doesn’t beat around the bush, so I just wanted to be up front and center. He’s not very sly. He’s no-holds-barred.”

I always find it really interesting when a character doesn’t have a name. You’re just known as ‘The Drifter’ in Bunraku. Did you, in your own mind, give him a name?

Josh Hartnett: “Harold. [Laughing] No, I didn’t. I let him remain a mystery. Okay, so, we came up with this whole backstory which I don’t want to give too much away because I don’t want to spoil it, but it had a lot to do with his family being taken away from him and who he was raised by. And, what we decided is that he was raised by gypsies and he traveled a lot. All the while he had this idea in his mind that he was going to avenge his father’s death and find out who he really is. But he got caught up in this training and this world…and maybe there was a little bit of fear. The idea that we had was that he was never really given a name – that he had a name as a young boy, but that he lost it over time in a sort of fantastical way. It’s not meant to be strictly…obviously this movie doesn’t even take place in the real world and I don’t want to be Freudian.”

September 2, 2011 Posted by | Uncategorized | Leave a comment

5 ways to revitalize your spirit

Tip #1: Practice Mindfulness

Jon Kabat-Zinn, Ph.D, founder of the Stress Reduction Clinic at the University of Massachusetts Medical Center, summed up mindfulness when he said, “Wherever you go, there you are.”

Mindfulness is paying attention to the present moment and not thinking about what someone said to you this morning, talking on the phone while replying to an email, or worrying about the future.

Once a day from now on, I want you to put sincere effort into being fully present. Give your undivided attention to what you’re doing. If you have a lunch date, enjoy being with that person, rather than thinking about that client meeting you had in the morning or stressing about the pile of work sitting on your desk. Even the most mundane tasks, like making dinner, can come alive. Notice the smells, tastes, textures.

Here is a description of what mindfulness is, adapted from Full Catastrophe Living, by Jon Kabat-Zinn. Mindfulness is…

  • Being yourself.
  • Not judging yourself, over-analyzing what you’re going to say, or getting caught up in your thoughts.
  • Accepting and appreciating what each moment offers.
  • Allowing things to be the way they are, without getting caught up in expectations, hopes, wishes, and experiences.
  • Being patient with yourself and other people. Not being impatient or anxious for certain things, pleasant and unpleasant, to happen.
  • Trusting yourself and your feelings.

Tip #2: Read Books That Inspire You

What are you interested in? What inspires you, motivates you, moves you? For example, you may dream of having a life coach to keep you on track with your goals. If you can’t afford the $300 to $500 per month fee, go to the bookstore. There are plenty of helpful books to help you assess where you are now, where you want to be, and learn from people who have done it. These are some books I’ve read and enjoyed:

  • The Best Year of Your Life: Dream It, Live It, Plan It, by Debbie Ford
  • The Power of Now: A Guide to Spiritual Enlightenment, by Eckhart Tolle
  • The Four Agreements: A Practical Guide to Personal Freedom, by Don Miguel Ruiz
  • Anatomy of the Spirit, by Carolyn Myss

Tip #3: Give Thanks at Meals

See if this scenario is familiar – you’d love to go for lunch but you have too much to do, so you grab a sandwich to go and bring it back to your desk. Within minutes, your sandwich is gone, you’re still hunched over at the computer, and you can barely remember how it tasted.

Instead, start each meal with a pause – take a deep breath and give thanks for the food your about to eat. Or, say a prayer, whatever has meaning for you. Buy a beautiful plate, placemat, mug, or food container to use.

Tip #4: Book a Monthly Massage

Once a month, treat yourself to a relaxation massage. If it is out of your budget, consider going to a massage school student clinic in your area. Treatments by massage therapists-in-training are often 1/4 of the regular cost.

Tip #5: Forgive 

Forgiving yourself and others can be liberating. Many people carry past hurts inside them and are unable to let them go. Start by forgiving yourself – if something you say or do causes misunderstanding or may be interpreted as hurtful, don’t let it sit and don’t beat yourself up over it.

Give a sincere apology and then do something to psychologically cleanse, such as taking that thought and imagining yourself throwing it in the garbage can or taking a warm shower when you get home. You can also try these affirmations:

  • “Life is too short to beat myself up over what’s done in the past. I choose to forgive myself and forgive others.”
  • “I know how much it hurts me when other people are mad or hold grudges at me. I don’t want to be the one who makes other people feel that way.”

September 2, 2011 Posted by | Uncategorized | Leave a comment

30 Interesting Facts about Human Brain

Brain is the central organ of the human body. It is extremely complex and sophisticated. The functions of the brain were found by the ancient Egyptians and Greeks in 400 BC. It was Hippocrates who first discovered that brain played an important role in sensation and intelligence. Nowadays, everyone understand the importance of having the brain, but most of us don’t know much about it, so here are some interesting facts for you.
(image credits: jepoirrier)
1) There are no pain receptors in the brain, so the brain can feel no pain.
2) The human brain is the fattest organ in the body and may consists of at least 60% fat.
3) Neurons develop at the rate of 250,000 neurons per minute during early pregnancy.
4) Humans continue to make new neurons throughout life in response to mental activity.
5) Alcohol interferes with brain processes by weakening connections between neurons.
6) Altitude makes the brain see strange visions – Many religions involve special visions that occurred at great heights. For example, Moses encountered a voice emanating from a burning bush on Mount Sinai and Muhammad was visited by an angel on Mount Hira. Similar phenomena are reported by mountain climbers, but they don’t think it’s very mystical. Many of the effects are attributable to the reduced supply of oxygen to the brain. At 8,000ft or higher, some mountaineers report perceiving unseen companions, seeing light emanating from themselves or others, seeing a second body like their own, and suddenly feeling emotions such as fear. Oxygen deprivation is likely to interfere with brain regions active in visual and face processing, and in emotional events.
7) Reading aloud and talking often to a young child promotes brain development.
8 ) Information travels at different speeds within different types of neurons. Not all neurons are the same. There are a few different types within the body and transmission along these different kinds can be as slow as 0.5 meters/sec or as fast as 120 meters/sec.
9) The capacity for such emotions as joy, happiness, fear, and shyness are already developed at birth. The specific type of nurturing a child receives shapes how these emotions are developed.
10) The left side of your brain (left hemisphere) controls the right side of your body; and, the right side of your brain (right hemisphere) controls the left side of your body.
11) Children who learn two languages before the age of five alters the brain structure and adults have a much denser gray matter.
12) Information can be processed as slowly as 0.5 meters/sec or as fast as 120 meters/sec (about 268 miles/hr).
13) While awake, your brain generates between 10 and 23 watts of power–or enough energy to power a light bulb.
14) The old adage of humans only using 10% of their brain is not true. Every part of the brain has a known function.
15) A study of one million students in New York showed thatstudents who ate lunches that did not include artificial flavors, preservatives, and dyes did 14% better on IQ tests than students who ate lunches with these additives.
16) For years, scientists believed that tinnitus was due to a function within the mechanics of the ear, but newer evidence shows that it is actually a function of the brain.
17) Every time you recall a memory or have a new thought, you are creating a new connection in your brain.
18) Memories triggered by scent have a stronger emotional connection, therefore appear more intense than other memory triggers.
19) Each time we blink, our brain kicks in and keeps things illuminated so the whole world doesn’t go dark each time we blink (about 20,000 times a day).
20) Laughing at a joke is no simple task as it requires activity in five different areas of the brain.
21) The average number of thoughts that humans are believed to experience each day is 70,000.
22) There are two different schools of thought as to why we dream: the physiological school, and the psychological school. While many theories have been proposed, not single consensus has emerged as to why we dream. Some researchers suggest that dreams serve no real purpose, while other believe that dreaming is essential to mental, emotional and physical well-being. One theory for dreaming suggests dreams serve to clean up clutter from the mind.
23) The Hypothalamus part of the brain regulates body temperature much like a thermostat. The hypothalamus knows what temperature your body should be (about 98.6 Fahrenheit or 37 Celsius), and if your body is too hot, the hypothalamus tells it to sweat. If you’re too cold, the hypothalamus makes you start shivering. Shivering and sweating helps get your body’s temperature back to normal.
24) Approximately 85,000 neocortical neurons are lost each day in your brain. Fortunately, his goes unnoticed due to the built-in redundancies and the fact that even after three years this loss adds up to less than 1% of the total.
25) Differences in brain weight and size do not equal differences in mental ability. The weight of Albert Einstein’s brain was 1,230 grams that is less than an average weight of the human brain.
26) A living brain is so soft you could cut it with a table knife.
27) There are about 100,000 miles of blood vessels in the brain.
28) London taxi drivers ,famous for knowing all the London streets by heart, have a larger than normal hippocampus, especially the drivers who have been on the job longest. The study suggests that as people memorize more and more information, this part of their brain continues to grow.
29) The brain can live for 4 to 6 minutes without oxygen, and then it begins to die. No oxygen for 5 to 10 minutes will result in permanent brain damage.
30) Our brain often fools us. It often perceives things differently from the reality. Look at those pictures. Square A and B are actually the same shade of gray.

August 6, 2011 Posted by | Uncategorized | Leave a comment