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Hassan Rasouli, who recently started reacting after being in vegetative state at Sunnybrook Hospital, photographed with his daughter Majgan and wife Parichehr Salasel at the hospital on Bayview Ave.,Toronto, April 24, 2012. (Fernando Morales/The Globe and Mail)
Hassan Rasouli, who recently started reacting after being in vegetative state at Sunnybrook Hospital, photographed with his daughter Majgan and wife Parichehr Salasel at the hospital on Bayview Ave.,Toronto, April 24, 2012. (Fernando Morales/The Globe and Mail)

Health news in 2012: It was all about the brain Add to ...

It could be remembered as the year of the brain.

News headlines in 2012 were often dominated by stories about the vital organ, ranging from the legal battle over the fate of a comatose patient to studies that highlighted long-term brain damage caused by multiple concussions – a concern for both athletes and kids engaged in contact sports.

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There were other health-related issues that made the news, of course. In New York, Mayor Michael Bloomberg led the charge against super-sized sugary drinks as a way of tackling the obesity epidemic. But it will likely take a far more fundamental change to trim waistlines. One surprising study revealed a sedentary lifestyle – and sitting especially – takes a greater toll on our health than previously thought.

Here is a snapshot of four major health stories of 2012:

Top court weighs end-of-life care

The Supreme Court of Canada began hearing evidence this month in a historic artificial-life-support case. The court will decide who has the final say about the withdrawal or continuation of life-support treatment – doctors or the family.

The case involves Hassan Rasouli, who developed a severe brain infection after undergoing surgery at Sunnybrook Health Sciences Centre in Toronto. Hospital physicians concluded he is in a vegetative mental state and has no realistic hope for recovery. They want to remove Rasouli from the life-sustaining ventilator. But his family has objected, insisting Rasouli has shown signs of consciousness.

Similar “vegetative” patients have long presented a challenge for physicians and medical ethicists. They may not be able to respond to the outside world, but can doctors really be certain they lack any awareness of their surroundings?

Adrian Owen, a neurologist at the University of Western Ontario’s Brain and Mind Institute, says he has developed a way to assess these patients.

Using a functional MRI scanner, he looks for signs of brain activity in response to specific questions. For instance, he will ask the patient to imagine playing a game of tennis. If the patient is conscious, the part of the brain directing movement will “light up” even though the body remains motionless.

Owen used this technique on Rasouli as part of a larger study of patients who appear to be non-responsive. He won’t discussed the specifics of the Rasouli case, but his report concluded that “the patient was not persistently vegetative but at a very low level of a minimally conscious state.”

The Supreme Court is expected to release its decision in several months.

Meanwhile, Owen continues to refine the procedure. In a study published early this year, he showed that a patient’s consciousness can be analyzed by using electroencephalography – a senor-laden cap that picks up electrical activity along the scalp.

“We can do it at the bedside,” he explained. That means patients could be examined in nursing homes and hospitals without relying on access to costly MRI equipment. What’s more, the procedure provides an avenue for communicating with patients who can no longer speak or move.

Concern grows over concussions

Researchers at Boston University released the largest study to date on concussions. They examined the brains of 85 deceased athletes who had suffered multiple concussions in their professional careers.

The findings revealed that 68 of them showed evidence of chronic traumatic encephalopathy (or CTE), a degenerative brain disease believe to develop after repeated head trauma. Symptoms include headaches, depression, explosive behaviour and, eventually, dementia.

Earlier studies had also hinted that concussions could have long-lasting effects. So in November, when Jovan Belcher, a linebacker for the Kansas City Chiefs, shot himself after shooting his girlfriend, there was much speculation about concussions being partly to blame for his mental state.

Doctors can’t say what caused Belcher to snap. But there is now greater recognition that concussions pose a serious health risk.

“That public awareness has been translated into a lot of grassroots concern about collision sports for children and youth,” said Dr. Charles Tator, a neurologist and founder of ThinkFirst Canada which is now part of Parachute, a safety-advocacy group.

Unfortunately, there is no effective treatment other than cognitive and physical rest following a concussion, and making sure that the patient has fully recovered before heading back to the game, noted Tator, a professor of neurosurgery at the University of Toronto.

Mind control of a robotic arm

U.S. researchers provided fresh hope for people suffering from various forms of paralysis.

They have developed a system called BrainGate, which allows a patient to move a robotic arm. A sensor the size of an Aspirin is implanted in the part of the brain governing movement. The sensor picks up the patient’s thoughts and translates them into signals that manipulate the robotic arm.

Cathy Hutchinson, a 59-year-old woman who can neither speak nor move, is among the first patients to try it out. A video, released in May along with the publication of a study in the journal Nature, shows her using the robotic arm to raise a coffee to her lips. The robotic arm was mounted on a dolly sitting next to her.

BrainGate is not yet ready to be rolled out to the public, acknowledged the senior author of the study, John Donoghue, director of the Institute for Brain Science at Brown University in Providence, R.I.

It is a rather cumbersome contraption to say the least. The brain implant is connected to the robotic limb by a thick wire cable that’s attached to the top of the patient’s skull. The researchers are working on a wireless system so that patients would not need to be tethered to the robotic device.

The sitting disease

We’ve long known that our sedentary lifestyle is taking a toll on our health. But even if you are meeting your daily exercise requirements – a minimum of 30 minutes for an adult – that may not be enough to compensate for all those hours of uninterrupted sitting at work and at home, according to a study released in October.

The study was based on an analysis of 18 previous studies involving almost 800,000 people. The findings, published in the journal Diabetologia, revealed that those who sit the most were twice as likely to develop diabetes and heart disease as those who sit the least. Those figures held true even for those who exercised regularly.

Long periods of sitting can lead to an elevation in blood-glucose levels, which is a risk factor for diabetes as well as heart disease, noted the lead author of the study, Dr. Emma Wilmot at the University of Leicester in Britain.

The researchers recommend that people should get up and move around as frequently as possible.

“Rather than focusing on getting 30 minutes of exercise, we need to start looking at what we do with the other 23 and a half hours in the day,” Wilmot said.

 

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