Schizophrenia is eight different diseases, not one

That is the title of this article I am writing about today. “New research shows that schizophrenia is not a single disease, but a group of eight distinct disorders, each caused by changes in clusters of genes that lead to different sets of symptoms.  The findings sets the stage for scientists to develop better ways to diagnose and treat schizophrenia, a mental illness that can be devastating when not adequately managed, says C. Robert Cloninger, co-author of the study published Monday in the American Journal of Psychiatry. ‘We are really opening a new era of psychiatric diagnosis,’ says Cloninger, professor of psychiatry and genetics at the Washington University of Medicine in St. Louis.  Cloninger says he hopes his work will ‘allow for the development of a personalized diagnosis, opening the door to treating the cause, rather than just the symptoms, of schizophrenia.”  All people are different that is why I believe this approach should work. I know from reading everybody has different problems with this disease.
They go on to say: “Cloninger and colleagues found that certain genetic profiles matched particular symptoms. While people with one genetic cluster have odd and disorganized speech- what is sometimes called ‘word salad’ – people with another genetic profile hear voices, according to the study, funded by the National Institutes of Health.  Some genetic clusters gave people higher risks of the disease than others, according to the study, which compared the DNA of 4,200 people with schizophrenia to that of 3,800 healthy people.  One set of genetic changes, for example confers a 95% chance of developing schizophrenia.  In the new study, researchers describe a woman with this genetic profile who developed signs of the disorder by age 5, when she taped over the mouths of her dolls to make them stop whispering to her and calling her name.  Another patient- whose genetic profile gave her a 71% risk of schizophrenia – experienced a more typical disease course and began hearing voices at age 17.  The average person has less than a 1% risk of developing schizophrenia, Cloninger says.” I know this disease is bad and yet where my life was going and the bad luck I was having I do not know if I could have changed my life around as I did after I received this disease.  After my release from prison and my appeal I wanted to change my life.  With drugs and alcohol I do not know if I ever could.  I had to stop and get some sobriety in my life without doing while I was locked up.
The article goes on to say: “Psychiatrists such as Stephen Marder describe the study as a step forward.  Today, doctors diagnose patients with mental illness with a process akin to a survey, asking about the person’s family history and symptoms, says, Marder, a professor at the David Geffen School of Medicine at the University of California-Los Angeles. ‘It underlines that the way we diagnose schizophrenia is relatively primitive,’ Marder says. Patients may wait years for an accurate diagnosis, and even longer to find treatments that help them without causing intolerable side effects.  Doctors have long known that schizophrenia can run in families, says Robert Freedman, editor in chief of the American Journal of Psychiatry and chair of psychiatry at the University of Colorado Anschutz Medical Campus.  If one identical twin has schizophrenia, for example, there is an 80% chance that the other twin has the disease as well.  In the past doctors looked for single genes that might cause schizophrenia, without real success, Freedman says.” I know the side effects can be horrendous. The people are still left with some negative symptoms.  There really was no family history with me maybe a cousin that I never met.
I goes on to say: “The new paper suggests that genes work together like a winning or losing combination of cards in poker, Freedman says. ‘This shows us that there are some very bad hands out there,’ Freedman says.  In some cases- in which a genetic profile conveys close to a 100% risk of schizophrenia- people may not be able to escape the disease, Cloninger says.  But if doctors could predict who is at high risk, they might also be able to tailor an early intervention to help a patient better manage their condition, such as by managing stress.  Doctors don’t yet know why one person with a 70% risk of schizophrenia develops the disease and others don’t, Cloninger says. It’s possible that environment plays a key role, so that child with a supportive family and good nutrition might escape the diagnosis, while someone who experiences great trauma or deprivation might become very ill.  The study also reflects how much has changed in the way that scientists think about the genetic causes of common diseases, Marder says.  He notes that diseases caused by a single gene – such a sickle-cell anemia and cystic fibrosis – affect very few people. Most common diseases, such as cancer, are caused by combinations of genes. Even something as apparently simple as height is caused by combinations of genes, he says.  Doctors have known for years that breast cancer is not one disease, for example, but at least half a dozen diseases driven by different genes, says study co-author Igor Zwir, research associate in psychiatry at Washington University.  Doctors today have tests to predict a woman’s risk of some types of breast cancer, and other tests that help them select the most effective drugs. 
Those sorts of tests could be extremely helpful for people with schizophrenia, who often try two or three drugs before finding one that’s effective, Cloninger says. ‘Most treatments are trial and error,’ Cloninger says. If doctors could pinpoint which drugs could be more effective, they might be able to use lower doses, producing fewer of the bothersome side effects that lead many patients to stop taking their medication, Cloninger says.” Not only lower doses but also new drugs that work hopefully so people do not have any side effects. I believe it has a lot to do with environment and what a person is going through at the time this disease hits.  Stress has a lot to do with it.

Game your brain: the new benefits of neuroplasticity

That is the title of this article I am writing about. “Merzenich runs Posit Science from a suite of offices in downtown San Francisco.  He has a team of 36 people, including neurologists, computer scientists and game designers. Using the same brain plasticity principles that he and Tallal used to treat children with Fast ForWord, Posit has developed an online software package called BrainHQ, a set of brain-training exercises aimed not only at treating neurological conditions, but also to arrest the normal cognitive decline that comes with age, and to improve the cognitive abilities of normal individuals. ‘I’ve looked at old brains, brains of animals we’d expected would die within months,’ Merzenich says. And you look at the various capabilities of these brains and everything that disadvantages them.  And which of these capabilities can we reverse by intensive, progressive training? All of them.  Their decline is inherently reversible.  As far as we can see, the same is true for humans.” I once used a game by Posit my old boss had us try it out.  It had a lot to do with memory and I am pretty good at that.  I have a new computer now and it is not on this one.  It does help I was better if I used it every day.
Why is this article being written because this could help schizophrenia people. “To understand how Posit Science tackles neurological diseases, let’s consider schizophrenia.  Schizophrenics typically suffer from hallucinations, delusion and disorganized reasoning.  These symptoms result from an excess dopamine and noradrenaline, the neurotransmitters that modulate the reward feedback-loop control-arousal levels in the brain.  Underlying this chemical reaction are what Merzenich calls ‘failure modes of plastic brain’: weakness in the neurological apparatus, specifically in working memory- - a cognitive skill that indicates a person’s capacity to manipulate information, such as computing sums- - and the ability to make predictions.  Antipsychotic medication, which suppresses these neurotransmitters, is effective in mitigation symptoms such as hallucinations but doesn’t fix the cognitive structure. ‘Drugs are an extremely primitive method to treat the neurology,’ Merzenich says. ‘We’re manipulating machinery that is controlled by dozens of variables, by powerfully distorting one particular chemical.  What we’re doing instead is replacing that chemical approach with strategies that actually correct the neurological underpinnings of these problems. And the only way is to have the brain correct itself.’”  The only thing I kept is my memory from before my illness. That does not mean I do not have to work on it, I do.  These programs work for a variety of things that we need as schizophrenics.

The article goes on to say: “Using BrainHQ, monitored schizophrenic patients can work on computer exercises that specifically target those cognitive weaknesses.  Two recent studies led by Sophia Vinogradov, vice chair of psychiatry at the UCSF, have shown that 50 to 80 hours of using BrainHQ significantly improved not only patients’ working memory and learning, but also their social functioning and ability to distinguish reality.  Posit Science is currently conduction studies to gain US Food and Drug Administration approval to treat schizophrenia, brain injury and stroke. “We’re transforming neuroscience-based software into medicine,’ Merzenich says.  To show how BrainHQ’s exercises work, Merzenich instructs Wired to take a 36-part cognitive assessment that lasts three hours and purports to measure everything about cognitive abilities.  ‘It allows us to tailor a programme to someone’s specific needs,’ says Merzenich.  In all, there were more than 40 exercises. One, called Hawk Eye, aims to sharpen visual perception and expand one’s field of view.  A set of identical birds flashes briefly on-screen, except for one of a different colour that needs to be identified.  A simpler exercise is Sound Sweeps, which tests auditory accuracy by requiring subjects to identify whether a sound, which might last only milliseconds, is going up or down in frequency.  Even harder is Mixed Signals, which requires subjects to watch a string of symbols, listen to a piece of information and react when they match. As new levels are unlocked, colourful fireworks explode on-screen.  The exercises in Merzenich’s brain gym are simple but strangely compelling.” I used the bird one before it is hard to get used to and find that bird that is different when it flashes.  I would like to be measured to see which I could use and find out a little more about myself.  They came along way since I used their programs.  There is so much information here that this is going to be in three parts.  I will put up part two tomorrow and finish this next week.

Game your brain: the new benefits of neuroplasticity Part two

This is the second part of last week’s article I am writing about. “On average, cognitive decline in humans starts when we’re between the ages of 20 and 30.  At the onset of this steady downfall, the brain slows down and its reliability deteriorates. Listening becomes less accurate. Peripheral vision narrows.  Attention and memory begins to falter.  To make matters worse, this gradual decline is usually accompanied by social withdrawal, egocentrism and a loss of confidence.  As Merzenich like to put it, everything is going to hell.  This problem is compounded by our laziness.  When we get older, we rest on our laurels, auto-piloting our behaviours, operating effectively throughout the day using skills that we learned when we were younger.  The problem with that approach is that our brain can be maintained only by a life of continual learning- - but, as older people effectively decide to stop challenging the brain, like an unused car, the learning machinery slowly seizes up. ‘Like every organ in our bodies, the brain undergoes changes in how it performs.  You see it in your muscles, your bones, your hair- - and you feel it in your brain,’ says Adam Gazzaley, a neuroscientist at the University of California, San Francisco. ‘That is not helped by people seeking comfort and a less demanding life when they are older.  The fact is that the brain is still plastic even when they are 70 or 80 years old. It can still be optimized - - but instead, many people unwittingly accelerate its deterioration.’” That is what worries me about getting older what problems will I face? Life is continuing learning about everything. One thing I have to learn is how to slow down I do all things pretty fast.  Really have to slow down on my reading.
The article goes on to say: “Gazzaley is best known for demonstrating some of the mechanisms behind cognitive decline.  He showed, for instance, that as we get older we are more susceptible to interference- - be that in the form of distractions, irrelevant information or multitasking.  The problem with older adults is that they don’t filter information, and consequently they overprocess irrelevant information that they can’t seem to ignore.  One of the consequences of interference is poor memory: it’s difficult to recall something that was never properly imprinted in the brain in the first place.  One evening in 2008, Gazzaley had a strange vivid dream about video game. In that game, the player was driving a car along a winding road in the mountains and, at random intervals, a sign would pop up on the screen.  If the sign had the right shape and colour, the player had to shoot it down while steering the car.  Gazzaley realised that he could design a video game to induce improvements in the brain.  Later that day, Gazzaley called Matt Omernick, a friend who worked at the now-defunct games company LucasArts Entertainment, and recounted his dream.  Omernick liked the idea and spoke to Eric Johnston, the legendary games developer who created the classic Monkey Island series, and Noah Falstein, who had been on of LucaArts’ first game designers and was now Google’s chief game designers. ‘I explained to them the concept and Matt drew it out,’ Gazzaley says. ‘I didn’t have any funding, but they wanted to work on it anyway.  They said to me, ‘We spent our whole careers teaching teenagers how to kill aliens.  We’re ready to use our skills to do something of impact.’”  They all made games for people now they would use their skills to help people use their brain better.  I never played games although I do know that my grandkids play them all the time.  If they can make something for people with schizophrenia to use that works that would be great.
I am going to end this second part with: “Like FastWord, Gazzaley’s game, called NeuroRacer, was designed according to the rules of how plasticity is induced in the brain.  Gazzaley’s team used an ‘adaptive staircase algorithm’ that constantly matched the difficulty of the game to the player’s skill. ‘Adaptivity is at the core of our game mechanics because that’s how you tap into plasticity,’ Gazzaley says. ‘Between 70 to 80 per cent difficulty is the sweet spot.  That’s where the player gets into a flow state and plasticity is maximal.’  When the game was completed, Gazzaley recruited 174 people, with ages ranging from 20 to 80.  In the first phase of the study, they tested the multitasking skills of their participants, confirming that older players had more multitasking deficiencies than younger ones.  They recruited 46 participants aged 60 to 85 and put them through a four week training period with NeuroRacer. ‘After training period, the multitasking skill levels of the older guys exceeded even the levels of the 20- year olds who had played the game once,’ says Gazzaley, ‘ Those levels were sustained six months later.’ Also, Gazzaley found that the older players not only improved their ability to multitask, which the game explicitly trained, but others abilities, such as working memory and sustained attention.” It is good that the older guys were able to keep the skill level that they had achieved. I know this is long and I will finish it tomorrow with the last part.  I feel this is important for all schizophrenics to learn about and maybe it can help.  That is one reason I do not want to paraphrase it.

Game your brain: the new benefits of neuroplasticity Part three

This is the third part of an article I am writing about.  “Last year, Gazzaley cofounded a company called Akili Interactive Labs, which is developing an upgrade of NeuroRacer called Evo.  Like Posit Science, Akili is seeking FDA approval for EVO as a possible software-based treatment for ADHD. ‘Most people associate medicine with drugs, and that’s the result of a big, successful brainwashing campaign by pharma companies,’ Gazzaley says. ‘But when it comes to brain health, drugs don’t work very well- - and the drug companies know that. If you look across the world’s top – ten pharma companies, four have withdrawn research from neuroscience.  That’s not because we’ve cured any of these diseases. Hopefully now we’ll start thinking of software and hardware as a form of medicine.’  Gazzaley has been preparing to open a new neuroscience laboratory at the University of California, San Francisco. ‘We’re going to be able to record real-time EEG data as you play one of our games,’ Gazzaley says.  ‘The challenge won’t just be correlated to your performance, but also directly by neural process in your brain.’ He gives Wired a copy of the November 2013 issue of the scientific journal Nature.  The cover headline is ‘Game Changer’ and the image shows the cartoon of an old balding man driving a car through NeuroRacer’s mountainous roads. ‘Before I’d developed NeuroRacer, I used to give talks to groups of colleagues and present my data on cognitive decline and its mechanisms, and they would love it, find it fascination.  But when I gave talks about it to a public audience of older people, like the American Association of Retired Persons, it was horrifying.  If you give a lot of talks you get good at reading subtle signs in the audience.  Every year at the AGM, I had over a thousand people in the audience, all grey, and at the end of my talk, I could just see them asking ‘Is this it?  Is this the end of the movie?’ There was this feeling like that was not really the right ending.’ He points to the Nature cover. ‘That is the right ending.’” It all sounds promising. It is the right ending if it can rewire the brain so that schizophrenics feel that they are doing better my having participated in sound research.
I will end this article with: “Older adults are often advised to keep their minds sharp, but such advice is so generally as to be useless.  ‘It’s true that we lose abilities as we get older, but I believe that most of that loss is driven by a lack of effort to sustain brain fitness,’ says Alvaro Pascual-Leone, a neurologist at Harvard Medical School and one of the most-cited scientists in the field of brain plasticity. ‘We’re lazy, we don’t get out of our comfort zones, we stop learning new things.  The fact is that whatever you do, from activities to relationships to thoughts, ultimately enters the brain and affects it.  But we can harness that property of the brain for our own benefit. Ultimately, it’s a message of hope for people.’  The science of neuroplasticity illuminates the dynamic evolution of our brains throughout life, documenting how different experiences can dramatically change it. Its most pertinent insight, however, is that we can take control of such transformation.  Merzenich’s and Gazzaley’s brain training exercises provide us with a tool to do it.  They are a gym for the brain, a place where we can go to strengthen and expand our cognitive capabilities, which, to a very large extent, define who we are and determine what we are capable of.” How far can we go?  Makes me which I was younger and get into a field where the possibilities are endless with the brain.  It is the new frontier. 

Music helps you focus on your own thoughts, but only if you like it

That is the title of this article I am writing about. “When we listen to music we enjoy, it makes us feel different. Truly beloved songs inspire a different state of mind than the average pretty background noise.  A study published Thursday in Scientific Reports pinpoints the changes in neurological activity behind that experience. In a small study (with 21 young adults, total), participants with different genre preferences were exposed to entire songs while in an MRI. They were exposed to a like genre, a disliked genre, and their self-reported favorite song.  They were looking for changes in brain activity that related to preference for the music being listened to, as opposed to changes that might occur based on differences in the musicality or lyrics of the tune.”  That is great that they are looking at this.  Music I believe helps people in many ways.
It continues to say: “If your favorite artist is Beyonce, her dance anthems probably make you feel as focused as a classical music lover listening to Beethoven – and that’s pretty crazy.  The researchers wanted to understand how people could have the same feeling associated with their favorite music (greater self-reflection and inward thought) regardless of genre.  When listening to a preferred genre or a favorite song, the participants had greater connectivity between regions of the brain called the default mode network (DMN).”  I know when I am angry all I have to do is put on music that I like and even if I do not like it calms me down.  I listen to music on my headphones on the way to work and when I leave work.  It makes things a lot better for me.
The article goes on to say: “The DMN is associated with that switch we can flip between inner and outer thought.  When the DMN is active, you’re not focused on what’s happening in the physical world around you – you’re using internal stimuli, like memories and your imagination.  Of course, you probably already knew that your favorite music could make you zone out.  The study authors hope that these findings will encourage innovative music therapy in individuals who have conditions associated with poor DMN activity and connectivity, like autism and schizophrenia.”  I never did listen to music when I was in psychosis.  Although when I was in the State Hospital the first thing I asked for was a stereo.  I did listen to it when I was sick in the state hospital and the delusions were still there when I had my second breakdown in the hospital.  Although I still wanted to listen to my tapes, also when I have a problem I listen to music it helps a lot.

Difficulty assessing effort drives motivation deficits in schizophrenia, study finds

That is the title of this article I am writing about. “Individuals with schizophrenia often have trouble engaging in daily tasks or setting goals for themselves, and a new study from San Francisco State University suggests the reason might be their difficulty in assessing the amount of effort required to complete tasks.  The research, detailed in an article published this week in the Journal of Abnormal Psychology, can assist health professionals in countering motivation deficits among patients with schizophrenia and help those patients function normally by breaking up larger, complex tasks into smaller, easier-to-grasp ones.”  The tasks they set themselves up for maybe too large and they need to make them smaller and easier to grasp.  That makes sense if you have to clean house just start small and clean a little of a room or just one room at a time.
I wonder if that is easier to do. “This is one of the first studies to carefully and systematically look at the daily activities of people with schizophrenia - - what those people are doing, what goals are they setting for themselves,’ said David Gard, an associate professor of psychology at SF State who has spent years researching motivation and emotion. ‘We knew that people schizophrenia were not engaging in a lot of goal-directed behavior.  We just didn’t know why.’ In 2011, Gard received a grant from the National Institute of Mental Health to study the reasons behind this difficulty in goal setting.  An earlier article detailing other research from this study, published in May in the journal Schizophrenia Research, showed that when people with schizophrenia do set goals for themselves, they set them for the same reasons as persons without: to connect with others.  But motivation deficits are still common among these individuals, and his latest study set out to pinpoint the reason.” I haven’t set any goals for myself in a long time.  I have been thinking about it for some time.  I do feel a need to change some things in my life.  I have become to set in my ways again.
How did they figure out what might work? “Through a series of cognitive assessments and random phone calls, Gard and his colleagues at SF State and the University of California, San Francisco collected data from 47 people with and 41 people without schizophrenia.  Participants were called four times a day, randomly throughout the day, for a week and asked about their current mood, as well as what they were doing; how much enjoyment they were getting out of it; and what their goals for the rest of the day were.  The results were coded by variables such as how much pleasure they were getting out of their daily activities and how much effort was involved, then compared that with the results from the cognitive assessments.  Gard and his fellow researchers found that, while people with schizophrenia engage in low-impact, pleasurable goals - - such as watching TV or eating food for enjoyment - - as much as others, they have a greater difficulty with more complex undertakings or goals requiring more effort.”  That is what I have to do is stop watching so much TV and start reading again I haven’t read a real book in over five years.  Start my walks again get out of the house.
The article ends with: “There’s something breaking down in the process around assessing high-effort, high-rewards goals,’ Gard said.  When the reward is high and the effort is high, that’s when people with schizophrenia struggle to hold in mind and go after the thing they want for themselves.  The findings indicate that health-care providers who want to help individuals with schizophrenia set goals for themselves should break larger tasks into smaller, simpler ones with rewards.  For example, instead of guiding a patient specifically toward the larger goal of getting in physical shape, a provider could instead encourage them to gradually walk a little bit more every day. That’s something we would do for everyone else, but it might have been avoided in patients with schizophrenia because we thought they weren’t experiencing as much pleasure from their activities as they actually are,’ Gard added.  We can help them to identify things that are pleasurable and reward them toward larger goals.” I believe I will give it a try and just start smaller and walk around the lake to get my mail like I used to and build up my walking again and get out of the house.