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Written by: Caroline Kim October 12, 2024 Today, we’ll dive into a new series that encompasses cancer, its symptoms, treatments, and more. This week, we’ll focus specifically on breast cancer: the second most common cancer among women, second leading cause of death in women in the U.S. (CDC). The World Health Organization defines breast cancer as “  a disease in which abnormal breast cells grow out of control and form tumors. If left unchecked, the tumors can spread throughout the body and become fatal”. According to Shockney, as many as 1 in 8 (13%) women are diagnosed with breast cancer in their lifetime, and there are currently over 4 million breast cancer survivors in the United States. To put this into perspective, every 2 minutes a woman is diagnosed with breast cancer in the U.S. and approximately 42,250 women in the U.S. are expected to die from breast cancer in 2024 (Shockney). Even on a larger scale, “Breast cancer was the most common cancer in women in 157 countries out of 185 in 2022… Approximately 0.5–1% of breast cancers occur in men” (World Health Organization).  There are several different types of breast cancer: invasive ductal carcinoma (IDC), lobular breast cancer, ductal carcinoma in situ, triple negative breast cancer (TNBC), inflammatory breast cancer, and paget’s disease of the breast (Cleveland Clinic Medical Professional). According to Cleveland Clinic, IDC is the most common type of breast cancer in the U.S., where the cancer develops in the milk ducts and spreads to nearby breast tissue. The second most common breast cancer is lobular breast cancer, where the cancer begins in the lobules and spreads to the nearby tissue (Cleveland Clinic Medical Professional). Cleveland Clinic states that TNBC is less common must much more invasive and aggressive than the other types of breast cancer.  Signs and symptoms of breast cancer include a lump in the breast (often not painful), change in the shape/appearance of the breast, dimpling/redness/change in the skin, and abnormal or bloody fluid from the nipple (World Health Organization). Other symptoms stated by Mayo Clinic include a flattened nipple and a peeling/scaling of the skin. Potential causes and risk factors for breast cancer could include family history, genetics, age, sex, smoking, exposure to radiation, lifestyle, and environmental factors (Cleveland Clinic Medical Professional).  Diagnosis of Breast Cancer can involve physical examinations, mammograms, ultrasounds, MRIs, a biopsy, and genetic tests (Cleveland Clinic Medical Professional). Treatments could include surgery, chemotherapy, radiation therapy, immunotherapy, hormone therapy, medications, and targeted therapy (World Health Organization). Unfortunately, some of these treatment options can have serious side effects such as fatigue, nausea, vomiting, and other gastrointestinal issues (Cleveland Clinic Medical Professional). These various surgeries could mean a mastectomy, lumpectomy, and breast reconstruction surgery (World Health Organization). Complications from these surgeries could entail infections at the surgical site, blood clots, nerve damage, and lymphedema (Cleveland Clinic Medical Professional).  Survival rates for cancer are dependent on several factors such as the invasiveness of the cancer, the stage, and the type; 5-year survival rates are much higher in individuals whose cancer is local (Cleveland Clinic Medical Professional). While there is not anything significant one can do to prevent breast cancer, some good rules to follow include maintaining a healthy weight/lifestyle, scheduling frequent breast cancer screenings, conducting self exams, and opting for a genetic screening (Cleveland Clinic Medical Professional).  Sources: CDC. “Breast Cancer Statistics.” Centers for Disease Control and Prevention , 16 Sept. 2024, www.cdc.gov/breast-cancer/statistics/index.html . Accessed 10 Oct. 2024.  Shockney, Lillie D. “Breast Cancer Facts & Stats 2024 - Incidence, Age, Survival, & More.” National Breast Cancer Foundation , 1 Aug. 2024, www.nationalbreastcancer.org/breast-cancer-facts/ . Accessed 10 Oct. 2024.  World Health Organization. “Breast Cancer.” World Health Organization , 13 Mar. 2024, www.who.int/news-room/fact-sheets/detail/breast-cancer . Accessed 10 Oct. 2024.  Mayo Clinic Staff. “Breast Cancer.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 10 Feb. 2024, www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470 . Accessed 10 Oct. 2024.  Cleveland Clinic Medical Professional. “Breast Cancer.” Cleveland Clinic , 9 Sept. 2024, my.clevelandclinic.org/health/diseases/3986-breast-cancer . Accessed 10 Oct. 2024.

Written by: Caroline Kim October 5th 2024 In this week’s continuation of the psychology series, we’ll dive into Bipolar Disorder, exploring what the condition entails. The National Institute of Mental Health (NIMH) is “characterized by dramatic shifts in mood, energy, and activity levels that affect a person’s ability to carry out day-to-day tasks”. The NIMH states that in the past year, 2.8% of adults had Bipolar Disorder and that 4.4% of Americans experience the condition at some point in their lives; in children, 2.9% have bipolar disorder and was more prevalent in females. It is important to note that Bipolar Disorder can significantly disrupt day to day life and that severe impairments from the condition are not uncommon.  There are 3 types of bipolar disorder that we will discuss today: Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder. Bipolar I Disorder is defined by the NIMH as manic episodes that last at least 7 days, with severe symptoms that require medical attention; depressive episodes also occur and last for at least 2 weeks. Experiencing 4 or more of these cycles within a year are characterized as “rapid cycling” (National Institute of Health). Bipolar II Disorder is described as “ a pattern of depressive episodes and hypomanic episodes… hypomanic episodes are less severe than the manic episodes in bipolar I disorder” ( National Institute of Health). Last but not least is Cyclothymic Disorder in which there is a recurrence of hypomanic and depressive symptoms that are not as severe to be characterized as episodes. Other more specific types of Bipolar Disorder exist and are often caused by other medical conditions or substances. “The average age of onset is 25 years, but, more rarely, it can start as early as early childhood or as late as in your 40s or 50s” (Cleveland Clinic Medical Professional).  Symptoms of Bipolar Disorder vary from manic episodes to depressive episodes. Common manic episode symptoms include but are not limited to being more energetic/active than usual, feeling overconfident, needing less sleep, being talkative, and making impulsive/poor decisions (Mayo Clinic Staff). In very severe cases, symptoms of psychosis can occur, including hallucinations and delusions (Cleveland Clinic Medical Professional). On the other hand, depressive episodes consist of feeling sad/hopeless, disinterest, change in eating/weight fluctuations, sleeping too much/too little, and thoughts of suicide (Mayo Clinic Staff). In mixed episodes, individuals may experience a mix of manic and depressive symptoms (negative feelings and high energy), which is described by some as the worst part of the disorder (Cleveland Clinic Medical Professional). The main causes of Bipolar Disorder include genetics and biological differences. Those with a sibling or parent with the condition are much more likely to develop the disorder; in addition, those with the condition appear to have a physical change in their brains (Mayo Clinic Staff). Other risk factors could include stress, anxiety, or substance abuse. A few co-occuring conditions with Bipolar Disorder could be anxiety disorders, eating disorders, ADHD, and borderline personality traits/disorders. If left untreated, Bipolar Disorder can lead to substance abuse, suicide/attempts of suicide, financial problems, poor school performance, and difficulty getting along with others (Mayo Clinic Staff).  Diagnosis of the disorder involves a physical exam, review of medical history, medical tests, and mental health evaluations ((Cleveland Clinic Medical Professional). Treatment options for Bipolar Disorder include medications and psychotherapy. According to the NIMH, common medications include mood stabilizers and atypical antipsychotics as well as medications that target sleep or anxiety. Options for psychotherapy may include talk therapies, cognitive behavior therapies, and interpersonal focused therapies. These can assist with managing troubling emotions, thoughts, and behaviors; they can also help alleviate insomnia and interpersonal relations (National Institute of Health). A few other listed treatment options include Electroconvulsive therapy (ECT) , Repetitive transcranial magnetic stimulation (rTMS) , and light therapy (National Institute of Health).  Sources: National Institute of Health. “Bipolar Disorder.” National Institute of Mental Health , U.S. Department of Health and Human Services, www.nimh.nih.gov/health/statistics/bipolar-disorder . Accessed 04 Oct. 2024.  Mayo Clinic Staff. “Bipolar Disorder.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 14 Aug. 2024, www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955 . Accessed 04 Oct. 2024.  Cleveland Clinic Medical Professional. “Bipolar Disorder.” Cleveland Clinic , 9 Sept. 2024, my.clevelandclinic.org/health/diseases/9294-bipolar-disorder . Accessed 04 Oct. 2024.

Written by: Caroline Kim September 21, 2024 In our last section on our neurodegenerative diseases, we’ll dive into a rather well known condition: Parkinson’s disease. This is the second most common neurodegenerative disease, affecting approximately 1 million people in the U.S. and 10 million people globally ( Parkinsongs.org ). This progressive disease causes deterioration in neurons, affecting daily life as symptoms worsen. Primary symptoms of Parkinson’s as noted by the National Institute of Neurological Disorders and Stroke, include tremors, muscle stiffness, bradykinesia, and postural instability. Other relevant symptoms and conditions include mental health problems, difficulty swallowing/chewing, speech changes, bladder/bowel problems, difficulty sleeping, cognitive problems, orthostatic hypotension, and fatigue (National Institute of Health. “Parkinson’s Disease.”). Some of these terms are less obvious; bradykinesia is described by the NINDS as “ ... a slowing down of spontaneous and some automatic movement”. Another one of these symptoms, orthostatic hypotension, is essentially a “sudden drop in blood pressure when a person stands up from a lying down or seated position” ( National Institute of Health. “Parkinson’s Disease.”).  The exact cause for Parkinson’s is unknown, but relevant factors include genetics and environmental factors; exposure to certain toxins and pesticides can increase one’s risk of developing Parkinson’s (Mayo Clinic Staff). Those of older age (50+) and males have a higher risk of developing this condition (Mayo Clinic Staff). Diagnosis of Parkinson’s involves evaluation of medical history, lab/diagnostic tests, and blood tests, CT scans, genetic testing, MRI’s, PET scans, spinal taps, and skin biopsies (Cleveland Clinic Medical Professional). While there is no cure for this disease, as is the case with many other neurodegenerative conditions, treatments exist. Treatment often entails medications or sometimes even device implants for deep brain stimulation (Cleveland Clinic Medical Professional). According to Cleveland Clinic, experimental treatments such as stem cell transplants, neuron-repair treatments, and gene therapies are also implemented.  Now we can take a closer look at how Parkinson’s affects the brain. While this condition affects various parts of the brain, the region known as the substantia nigra, which produces dopamine and controls purposeful movement; according to the NINDS, studies have shown that individuals with parkinsons have a loss of 60-80% of the dopamine producing cells in this region. Another significant brain impact is that “ People with PD also lose the nerve endings that produce the neurotransmitter norepinephrine—the main chemical messenger to the part of the nervous system that controls many automatic functions of the body, such as pulse and blood pressure” ( National Institute of Health. “Parkinson’s Disease.”). Other changes in the brain involve lewy bodies and mitochondrial changes. According to Mayo Clinic, clumps of protein, known as lewy bodies, are heavily associated with Parkinson’s; in addition, the alpha-synuclein found within these lewy bodies form in clumps which cells can not break down.  Sources: Parkinsongs.org . “Statistics.” Parkinson’s Foundation , www.parkinson.org/understanding-parkinsons/statistics . Accessed 21 Sept. 2024.  National Institute of Health. “Parkinson’s Disease.” National Institute of Neurological Disorders and Stroke , U.S. Department of Health and Human Services, 4 Sept. 2024, www.ninds.nih.gov/health-information/disorders/parkinsons-disease . Accessed 21 Sept. 2024.  Mayo Clinic Staff. “Parkinson’s Disease.” Mayo Clinic , Mayo Foundation for Medical Education and Research, 5 Apr. 2024, www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055 . Accessed 21 Sept. 2024.  Cleveland Clinic Medical Professional. “Parkinson’s Disease: What It Is, Causes, Symptoms & Treatment.” Cleveland Clinic , 30 Aug. 2024, my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview . Accessed 21 Sept. 2024.

Written by: Caroline Kim September 14, 2024 The topic of this week’s post will be about Neonatal Encephalopathy, which affects 2-6 per 1000 births (Russ). As defined by Molloy, NE is a “ clinical syndrome of disturbed neurologic function in the first week after birth in an infant born at or beyond 35 weeks of gestation, manifest by a subnormal level of consciousness or seizures, often accompanied by difficulty with initiating and maintaining respiration, and depression of tone and reflexes”. We’ll discuss the symptoms, causes, risks, and treatments in detail throughout today’s post.  Severity of this condition is determined upon factors such as how long the brain is without oxygen flow, how much of the brain is impacted, and how the individual’s brain recovers (National Institute of Health). In most cases, this is caused by a lack of oxygen to the brain either during pregnancy or birth but can also be caused by infection in the mother’s uterus during pregnancy, a genetic disorder, or an intraventricular hemorrhage (Riley Children’s Hospital). While this condition directly affects the brain, the condition can affect the heart, lungs, liver, and other internal organs; symptoms that show right after birth include respiratory problems, a subnormal level of consciousness, seizures, and depressed reflexes (Riley Children’s Hospital). Symptoms later on could involve being highly alert, showing low signs of energy, not eating, trouble hearing, seizures, organ failures, and slow heart rates ( Nationwide Children’s ).  Risk factors for NE include abnormally high/low blood pressure in the mother, heart problems in the baby, emergency c-sections, labor and delivery issues, and problems with the uterus (Cleveland Clinic Medical Professional). Additional risk factors as stated by the National Institute of Health include anemia in the fetus, internal bleeding by the mother or fetus, premature birth, trauma to the skull, and poor positioning of the baby during birth. Diagnosis for NE consists of blood tests, testing the umbilical cord/placenta, lumbar punctures, ultrasounds, EEGs, and MRIs. While there is no known cure for NE, treatments such as therapeutic hypothermia and supportive care are utilized; this could involve a cooling system for therapeutic hypothermia and speech/physical therapists for supportive cure ( Nationwide Children’s). According to Nationwide Children’s Hospital, NE does predispose children to higher risks of developing other neurological conditions such as cerebral palsy, ADHD, epilepsy, and developmental disorders.  Sources: Molloy, Eleanor J., et al. “Neonatal Encephalopathy and Hypoxic–Ischemic Encephalopathy: Moving from Controversy to Consensus Definitions and Subclassification.” Nature News , Nature Publishing Group, 12 Aug. 2023, www.nature.com/articles/s41390-023-02775-z#:~:text=NE%20and%20hypoxic%E2%80%93ischemic%20encephalopathy,is%20a%20subgroup%20of%20NE . Accessed 13 Sept. 2024.  Riley Children’s Hospital. “Neonatal Encephalopathy.” Riley Children’s Health , 1 Sept. 2024, www.rileychildrens.org/health-info/neonatal-encephalopathy#:~:text=Points%20to%20Remember-,Key%20Points%20to%20Remember,also%20affect%20other%20organ%20systems . Accessed 13 Sept. 2024.  Nationwide Children’s. “Neonatal Hypoxic-Ischemic Encephalopathy.” Nationwide Children’s Hospital , 1 May 2022, www.nationwidechildrens.org/conditions/health-library/neonatal-hypoxic-ischemic-encephalopathy . Accessed 13 Sept. 2024.  Russ JB, Simmons R, Glass HC. Neonatal Encephalopathy: Beyond Hypoxic-Ischemic Encephalopathy. Neoreviews. 2021 Mar;22(3):e148-e162. doi: 10.1542/neo.22-3-e148. PMID: 33649088. Cleveleand Clinic Medical Professional. “What Is Hypoxic-Ischemic Encephalopathy (HIE)?” Cleveland Clinic , 1 May 2024, my.clevelandclinic.org/health/diseases/hypoxic-ischemic-encephalopathy-hie . Accessed 13 Sept. 2024.  National Institute of Health. “Hypoxic Ischemic Encephalopathy | National Institute of Neurological Disorders and Stroke.” National Institute of Neurological Disorders and Stroke , 19 July 2024, www.ninds.nih.gov/health-information/disorders/hypoxic-ischemic-encephalopathy . Accessed 13 Sept. 2024.

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.