Richard G. Petty, MD

A Stunning Video

For anyone interested in publishing and promoting book, the John Kremer website and blog are essential reading.

John has just published this extraordinary video, and I thought that I would pass it on.

Heart Pressure Medicine for Cocaine Addiction?

Cocaine addiction can be frightfully hard to treat since cocaine affects two key neurotransmitters in the brain: dopamine and glutamate.  So investigators have been looking for ways to interfere with the action of the chemicals in key regions of the brain.

Researchers from Boston University School of Medicine and Harvard Medical School have published new data from a rat study in which they examined the impact of a calcium-channel antagonist called diltiazem, a drug used in the treatment of high blood pressure.

Diltiazem reduced cocaine cravings and the research indicates that calcium channels provide critical links between dopamine and glutamate that drives the intense craving associated with cocaine addiction in a region of the brain known as the nucleus accumbens.

This makes sense: we have known for some time that calcium plays an important role in learning, memory and motivation in this part of the brain. In effect cocaine trains the brain using a dysfunctional form of learning that drives the desire to use the drug.

Though it is still early, this is important research that may give us a whole new approach to treatment. It is unlikely that diltiazem itself with be useful in treating humans, since the amount needed to produce the effect in the brain would likely cause a major drop in blood pressure, but any new approach like this should speed up the search for other effective treatments.

Disturbances in Working Memory in Children

There is news from England about some research that indicates that many children who were thought to have low intelligence actually have a problem with working memory, the ability to hold information in your head and manipulate it mentally. It is largely genetic and if it fails to function normally it can affect long-term academic success into adulthood and prevent children from achieving their potential.

The researchers from Durham University surveyed over three thousand children in 35 schools across the UK using the first tool to enabled them to assess memory capacity in the classroom. They found that ten per cent of school children across all age ranges suffer from poor working memory seriously affecting their learning. Poor working memory is rarely identified by teachers, who often describe children with this problem as inattentive or as having lower levels of intelligence.

The new tool is a combination of a checklist and computer program created after many years of research into poor working memory in children, and it should enable psychologists and teachers to identify and assess children's memory capacity as early as four years old.

The hope is that early assessment of children will enable teachers to adopt new approaches to teaching.

The checklist, called the Working Memory Rating Scale (WMRS), will enable teachers to identify children who they think may have a problem with working memory without immediately subjecting them to a test. A high score on this checklist shows that a child is likely to have working memory problems that will affect his or her academic progress.

Children can be evaluated using the computerized Automated Working Memory Assessment (AWMA). The tools also suggest ways for teachers to manage the children's working memory loads that will minimize the chances of children failing to complete tasks. Recommendations include repetition of instructions, talking in simple short sentences and breaking down tasks into smaller chunks of information.

Pearson Assessment publishes the tools.

This is interesting work, but we still need more research to answer another question: disturbances in working memory have been identified in attention deficit/hyperactivity disorder (ADHD). So the question is whether many of the children found to have defects in working memory may actually have had ADHD.

 

Qi, Prana and Pneuma

I often hear people expressing concern over words like qi (chi), believing that it has something to do with primitive or pagan cultures. In actual fact qi is based upon observations by a culture that looked at the world very differently from that developed in the Western world. It is often mistranslated as “energy” which is not quite accurate.

Some experts now refer to the “subtle systems” of the body, and they appear to be of many types. In China these systems were thought to be the highways of the animating force of the body. In Japan it s known as ki, in India it is prana, the Greeks called it “Pneuma” or in the West were called the etheric or the fifth element, after earth, fire, air and water. There are at least 97 cultures around the world that have claimed the existence of some form of “energy.” We use the term subtle “systems”, to be a little more precise than saying “energies”, for these subtle systems are composed of the inseparable twins: 
1. Subtle energies and
2. The subtle fields that carry them.
Without energy, the fields could not actualize, and without the fields, there would be nothing to carry the energy.

Let’s look at something else.

I have been interested to see whether these different concepts map onto each other. I just found an interesting discussion here, that adds some interesting material, all of which I have been able to confirm.

According to my dictionary the word prana does indeed come from the root "Ãpraa" that expresses the idea of "breathing" or "blowing of the wind." Prana means "breath" and also "life" and "living being". In Genesis God formed us out of dust from the soil, He blew into his nostrils the breath of life and the human became a living being.

Jung is one of the people who said that the Indian prana corresponds to the Greek pneuma. Pneuma means "air in motion" as in breath and wind, and it is connected with the idea of life. There is a further correlation: prana is related to the mind and rendered as "spirit," and pneuma has the same meaning.

The trouble with qi has arisen because the Chinese have never had any interest in discussing the meaning of a concept. So they do not speculate on the nature of qi, but instead perceive it functionally: by what it does. Qi, chi, ki has a similar meaning to prana and pneuma: it is translated as breath, vapor, and energy.

This is different from the New Age idea that everything "has" prana or qi. Only living beings do.

"Jesus answered and said unto him,
Verily, verily I say unto thee, except a man born be born again,
He cannot see the Kingdom of God.
Nicodemus saith unto him,
How can a man be born again when he is old?
Can he enter the second time into his mother's womb, and be born?
Jesus answered: Verily, verily, I say unto thee,
Except a man born of water and the Spirit,
He cannot enter into the Kingdom of God.
That which is born of flesh is flesh and that which is born of Spirit is spirit,
Marvel not that I said unto thee: Ye must be born again.
The wind bloweth where it listeth, and thou hearest the sound thereof,
But cannot tell whence it comes and where it goeth:
So is every one that is born of the Spirit.”
The Bible John 3:3-8


"The term "Spirit" translates the Hebrew word ruah (Rûach), which, in its primary sense, means breath, air, wind. Jesus indeed uses the sensory image of the wind to suggest to Nicodemus the transcendent newness of him who is personally God's breath, the divine Spirit."

J. Cardinal Ratzinger, Catechism of the Catholic Church 1994

Jazz and the Brain

It is remarkable how good the brain is at coordinating multiple regions at once. A new study published in today's issue of the journal Public Library of Science (PLoS) One has used functional magnetic resonance scanning (fMRI) to examine musicians engaged in highly creative and spontaneous jazz improvisation. They found that a large region of the brain involved in monitoring one's performance is shut down, while a small region involved in organizing self-initiated thoughts and behaviors is highly activated. The researchers propose that this and several related patterns are likely to be key indicators of a brain that is engaged in highly creative thought.

During the study, six highly trained jazz musicians played keyboard under two conditions. In the first scenario, called the Scale paradigm, the music was based on a simple C major scale. Using only their right hand, the volunteers first played the scale up and down in quarter notes. Next, they were asked to improvise, though they were limited to playing quarter notes within the C major scale.

The second scenario, called the Jazz paradigm, examined higher-level musical improvisation. This paradigm was based on a novel blues melody that the volunteers had memorized beforehand, and had been written by one of the researchers. Again, using only their right hand, the musicians played the tune exactly as they had memorized it, only this time accompanied through headphones by a pre-recorded jazz quartet. When they were asked to improvise, the musicians listened to the same audio background, but they were free to spontaneously play whatever notes they wished.

The brain scans were nearly identical for the low-level and high-level forms of improvisation, supporting the idea that the change in neural activity was due to creativity and not the complexity of the task.

Much of the change between improvisation and memorization occurred in the prefrontal cortex, the region of the frontal lobe of the brain that helps us think and problem-solve. It is also involved in generating the sense of self. The dorsolateral prefrontal cortex is responsible for monitoring our own performance and it shuts down completely during improvisation, while the much smaller, centrally located region at the foremost part of the brain – the medial prefrontal cortex - increases in activity. The medial prefrontal cortex is believed to be involved in self-initiated thoughts and behaviors, and it becomes very active when a person describes an event that has happened to him or makes up a story.

The suppression of inhibitory, self-monitoring brain mechanisms helps to promote the free flow of novel ideas and impulses. This is an unusual pattern of brain activity that closely resembles the pattern seen in people when they are dreaming.

Another unusual finding was that there was increased neural activity in each of the sensory areas during improvisation, including those responsible for touch, hearing and vision, despite the fact that there were no significant differences in what individuals were hearing, touching and seeing during both memorized and improvised conditions. This suggests that when the brain wants to be creative, a whole range of sensorimotor processing is increased. At the same time systems that regulate emotion were also engaged during improvisation.

As someone who has done a lot of brain imaging, and has spent many hours inside scanners, this whole piece of work is dazzling from a technical point of view. The hardy musicians had to lie on their backs with their heads and torsos inside the scanner and their knees bent upward. They had to use a plastic keyboard, which was shortened to fit inside the scanner and which rested on their knees. A mirror placed over the volunteers' eyes, together with the headphones, helped the musicians see and hear what they were playing.

Just thinking about it makes me queasy.

“Words are the children of reason and, therefore, can't explain it. They really can't translate feeling because they're not part of it. That's why it bugs me when people try to analyze jazz as an intellectual theorem. It's not. It's feeling.”
--Bill Evans (American Jazz Pianist, 1929-1980)

“Jazz tickles your muscles, symphonies stretch your soul.”
--Paul Whiteman (American Musician and Bandleader, called the King of Jazz for popularizing a musical style that helped to introduce jazz to mainstream audiences during the 1920s and 1930s, 1890-1967)

“Jazz music is an intensified feeling of nonchalance.”
--Françoise Sagan (French Novelist and Dramatist, 1935-2004)

Human Taste Perception

It is remarkable that we still know so little about one of our most important senses: taste. Despite the significance of taste to survival and gratification much of what is written in basic books is outdated and we have only a rudimentary understanding of how our taste buds operate and how their sensations are translated into comprehensible sensations.

Taste provides both us with pleasure and protection: we use taste to evaluate everything that we put in our mouths. Taste mediates recognition of a substance and the final decision process before it is either swallowed and taken into the body, or rejected.

A new primer written by scientists at the Monell Center in Philadelphia and Florida State University is published in today’s issue of Current Biology. It provides a clear and accessible overview of recent advances in understanding human taste perception and its underlying biology.

Within the past few years, identification of receptors for sweet, bitter and umami (savory) taste has led to new insights regarding how taste functions. The Current Biology primer reviews the current state of knowledge regarding how taste stimuli are detected and ultimately translated by the nervous system into the perceptual experiences of sweet, sour, salty, bitter, and umami.

These perceptual evaluations are related to the function and the consequences of taste evaluation. These can range from pleasurable emotional reactions to the critical life-dependent response that causes a person to spit out a bitter potential toxin.

Paul Breslin, a sensory scientist at the Monell Center, had this to say,

“For all mammals, the collective influence of taste over a lifetime has a huge impact on pleasure, health, well being, and disease. Taste's importance to our daily lives is self-evident in its metaphors - for example: the 'sweetness' of welcoming a newborn child, the 'bitterness' of defeat, the 'souring' of a relationship, and describing a truly good human as the 'salt' of the earth."

Are Antidepressants Effective?

An important story has been flashed around the world, but unfortunately some of the interpretations of the story have been intemperate. In a study published in PLOS Medicine a  team of researchers from the University of Hull team concluded the drugs actively help only a small group of the most severely depressed. They based this on a meta-analysis of all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available.

The researchers reviewed data on 47 clinical trials, both published clinical trial data, and unpublished data secured under Freedom of Information legislation.

They focused on four antidepressants: fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone) and paroxetine (Paxil).

Many of the reports in the media have taken this research to mean that antidepressants are no better than placebo. That is not the case. The medications can be very effective and even life saving in people with severe depression. However, the effect in people with mild depression is no greater than placebo.

What this tells us is that the over-prescription of antidepressants for normal variations in mood is probably not justified. We are all allowed to be miserable from time to time, but that does not mean that we need to take medications.

Not surprisingly, some of the manufacturers have strongly disputed the findings.

The biggest worry after reading some of the news reports is that some people might stop their medications abruptly, and that can cause many problems. And some folk really do need to be on the medications and stopping them without clear guidance can be very risky.

Fast Foods, Exercise and Your Liver

We have known for many years that insulin resistance can cause non-alcoholic fatty liver disease (NAFLD). Now a new study published in the journal Gut reports that too much fast food and too little exercise can harm the liver in a matter of weeks.

In an experiment looking a lot like Morgan Spurlock’s Super Size Me, Swedish researchers selected 18 thin, healthy volunteers - 12 men and 6 women - to attempt a 5 to 15% body weight increase by eating at least two fast-food-based meals per day for four weeks. The participants in this intervention group also restricted their level of physical activity to no more than 5000 steps a day. A comparison group, matched for age and sex, ate a normal diet and maintained normal exercise levels.

The plan was to see if doubling calorific intake and increasing total body weight had any impact on participant's liver health.

Changes in major liver enzymes, such as alanine aminotransferase (ALT), and in hepatic triglyceride content (HTGC) were used to indicate liver damage. Abnormally high ALT levels are frequently seen in people who consume a lot of alcohol or who have been infected with the hepatitis C virus. HTGC measures fatty acid levels in the liver; too much fat in the liver leads to a condition called fatty liver disease.

At the end of the four weeks, the researchers found that:

• Fast-food consumers had put on an average of 6.5 kg (14.3 lbs.)
• Five participants increased their weight by 15%
• One person gained 12 kg (26.4 lbs.) in two weeks
• Sharp increases in ALT occurred after just one week on the fast food diet
• The average ALT level increased four-fold from 22 U/l to of 97 U/l over the 4 weeks
• ALT rose to liver damage levels in 11 participants
• No changes were seen in levels in the comparison group
• The increases in ALT levels were linked to weight gain and increased sugar and carbohydrate intake. One subject developed fatty liver disease, and there was a large rise in liver cell fat content in the other participants

Although nobody should be surprised that gorging on junk food and becoming a couch potato is bad for the body, the speed and extent of the liver damage is alarming.

“Don't dig your grave with your own knife and fork.”
--English Proverb

“I saw few die of hunger; of eating, a hundred thousand.”
--Benjamin Franklin (American Author, Inventor and Diplomat, 1706-1790)

RP On The Radio... Again... and Again

I am pleased be able to let you know that starting this week I am going to be doing a regular slot on Donna Seebo's show on www.bbsradio.com.

We are going to be doing regular updates on Integrated Medicine and the science that underpins it.

I shall let you know when the shows are on, and I shall be attaching the broadcasts to my website.

Here is a little piece that I just recorded for the station.

Download seebo_advert2.mp3

Acupuncture for Hay Fever

A study from Melbourne, Australia has found that acupuncture can significantly reduce the symptoms of persistent allergic rhinitis (PAR), a.k.a. hay fever. This was a randomized, single-blind, sham-controlled trial included 80 patients with PAR aged 16-70 years, who were randomly assigned to real or sham acupuncture. Three key acupuncture points, Yingxiang L.I.-20, Yintang M-HN-3 and Fengchi GB-20, plus one supplementary point (determined individually on the basis of traditional Chinese Medicine pattern differentiation) were used for each participant. After a one-week baseline period, participants were treated twice weekly for eight weeks and followed up for another 12 weeks. Nasal obstruction, sneezing, rhinorrhea and nasal itch were each self-assessed daily on a 5-point scale, and individual symptom scores were added to give a sum of the symptom scores: total nasal symptom score (TNSS). A secondary outcome was use of PAR relief medication. At the end of eight weeks' treatment, the weekly mean difference in TNSS from baseline was significantly greater with real (-17.2) than with sham acupuncture (-4.2) and these benefits persisted three months after the end of treatment. Comparisons of relief medication scores revealed a significant decline in the use of medication in the real acupuncture group between baseline and Week 8 of treatment, the reduction being still apparent at the end of follow-up.

This research is convincing. The effect size is not enormous, and we do not know how long the effect will last, but it does suggest another approach for people who have chronic symptoms and for whom medications are ineffective, or who do not want to take medications, or have side effects from them.

It may be relevant that some years ago it was shown that needling the Fengchi point - which lies at the base of the skull at the back of the head - increases some components of cerebral blood flow. That may give us a mechanism of action of the acupuncture in this trial.

“I am pretty sure that, if you will be quite honest, you will admit that a good rousing sneeze, one that tears open your collar and throws your hair into your eyes, is really one of life's sensational pleasures.”
--Robert Charles Benchley (American Humorist, Critic and Parodist, 1889-1945)

“The nose is for breathing, the mouth is for eating.”
--English Proverb

“Warmth, moisture, food-these are the causes that activate latent germs and arouse them to activity. They exist, all except the food, in the mouth, nose and throat at all times. The food is thrown out into these, as excretions, in disease. The germs feed on the excretions. They are scavengers. They were never anything else and will never be anything else. They break up and consume the discharge from the tissues. This is the function ascribed to germs everywhere in nature outside the body and is their real and only function in disease. They are purifying and beneficial agents. The medical profession has worked itself into hysteria over the germ theory and is using it to exploit an all too credulous public. Germs are ubiquitous. They are in the air we breathe, the food we eat, the water we drink. We cannot escape them. We can destroy them only to a limited extent. It is folly to attempt to escape disease by attempting to destroy or escape germs. Once they are in the body, the physician has no means of destroying them that will not, at the same time, destroy the patient. We cannot avoid germs. We must be proof against them. We have to accept them as one of the joys of life.”
--Herbert Shelton (English Evolutionary Philosopher, 1820-1903)