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Could sound really help shape the minds of babies?

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The research was conducted on a group of mice

Expectant mothers often play music to their unborn babies, many convinced of its positive impact on their child, even though its effect has never been scientifically-proven.

However, now, research from Johns Hopkins could have added weight to that theory for the first time, with their mice studies reporting that sounds appear to change “wiring” patterns in areas of the brain.

And their study has found that this could happen earlier than scientists previously assumed, even before the ear canal opens.

The experiments involve newborn mice, which have ear canals that open 11 days after birth. In human foetuses, the ear canal opens prenatally, at about 20 weeks gestation.

The findings may eventually help scientists identify ways to detect and intervene in abnormal wiring in the brain that may cause hearing or other sensory problems.

“As scientists, we are looking for answers to basic questions about how we become who we are,” says Patrick Kanold, professor of biomedical engineering at The Johns Hopkins University and School of Medicine. 

“Specifically, I am looking at how our sensory environment shapes us and how early in foetal development this starts happening.

“In these mice, we see that the difference in early sound experience leaves a trace in the brain, and this exposure to sound may be important for neurodevelopment.”

Prof Kanold started his career in electrical engineering, working with microprocessors, a natural conduit for his shift to science and studying the circuitry of the brain.

His research focus is the outermost part of the brain, the cortex, which is responsible for many functions, including sensory perception. Below the cortex is the white brain matter that in adults contains connections between neurons.

In development, the white matter also contains so-called subplate neurons, some of the first to develop in the brain, at about 12 weeks gestation for humans and the second embryonic week in mice.

The current research, which Prof Kanold began at his previous position at the University of Maryland, addresses two questions, he says: When sound signals get to the subplate neurons, does anything happen, and can a change in sound signals change the brain circuits at these young ages?

First, the scientists used genetically engineered mice that lack a protein on hair cells in the inner ear. The protein is integral for transforming sound into an electric pulse that goes to the brain; from there it is translated into our perception of sound.

Without the protein, the brain does not get the signal.

In the deaf, 1-week-old mice, the researchers saw about 25 to 30 per cent more connections among subplate neurons and other cortex neurons, compared with 1-week-old mice with normal hearing and raised in a normal environment.

This suggests that sounds can change brain circuits at a very young age, says Prof Kanold.

In addition, say the researchers, these changes in neural connections were happening about a week earlier than typically seen.

Scientists had previously assumed that sensory experience can only alter cortical circuits after neurons in the thalamus reach out to and activate the middle layers of the cortex, which in mice is around the time when their ear canals open (at around 11 days).

“When neurons are deprived of input, such as sound, the neurons reach out to find other neurons, possibly to compensate for the lack of sound,” says Prof Kanold.

“This is happening a week earlier than we thought it would, and tells us that the lack of sound likely reorganises connections in the immature cortex.”

Anatomist Mark Molliver of Johns Hopkins is credited with describing some of the first connections between neurons formed in white matter, and he coined the term subplate neurons in 1973.

These primordial subplate neurons eventually die off during development in mammals, including mice.

In humans, this happens shortly before birth through the first few months of life. But before they die off, they make connections between a key gateway in the brain for all sensory information, the thalamus, and the middle layers of the cortex.

“The thalamus is the intermediary of information from the eyes, ears and skin into the cortex,” says Kanold.

“When things go wrong in the thalamus or its connections with the cortex, neurodevelopmental problems occur.”

In the same way that lack of sound influences brain connections, the scientists thought it was possible that extra sounds could influence early neuron connections in normal hearing mice, as well.

To test this, the scientists put normal hearing, 2-day-old mouse pups in a quiet enclosure with a speaker that sounds a beep or in a quiet enclosure without a speaker.

The scientists found that the mouse pups in the quiet enclosure without the beeping sound had stronger connections between subplate and cortical neurons than in the enclosure with the beeping sound.

However, the difference between the mice housed in the beeping and quiet enclosures was not as large as between the deaf mice and ones raised in a normal sound environment.

These mice also had more diversity among the types of neural circuits that developed between the subplate and cortical neurons, compared with normal hearing mouse pups raised in a quiet enclosure with no sound.

The normal hearing mice raised in the quiet enclosure also had neuron connectivity in the subplate and cortex regions similar to that of the genetically-engineered deaf mice.

The research team is planning additional studies to determine how early exposure to sound impacts the brain later in development. Ultimately, they hope to understand how sound exposure in the womb may be important in human development and how to account for these circuit changes when fitting cochlear implants in children born deaf.

They also plan to study brain signatures of premature infants and develop biomarkers for problems involving miswiring of subplate neurons.

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No higher risk of pregnancy complications in women with MS – study

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Women with multiple sclerosis (MS) may not be at a higher risk of pregnancy complications like gestational diabetes, emergency caesarean section or stillbirth than women who do not have the disease, new research has found.

However, the study did find that babies born to mothers with MS had a higher chance of being delivered by elective caesarean section (c-section) or induced delivery, and of being small for their age when compared to babies of women who did not have the disease.

“Women with multiple sclerosis may be understandably concerned about the risks of pregnancy,” says study author Professor Melinda Magyari, of the University of Copenhagen.

“While previous research has shown there is no higher risk of birth defects for babies born to women with MS, there are still a lot of unknowns around pregnancy and MS.

“We wanted to find out if women with MS are at risk for a variety of pregnancy complications.

“We found overall their pregnancies were just as healthy as those of the mothers without MS.”

The study involved 2,930 pregnant women with MS who were compared to 56,958 pregnant women without MS. All women gave birth between 1997 and 2016.

Researchers found no difference in risk of several pregnancy complications between women with MS and women without it.

No differences were found in risk of pre-eclampsia, gestational diabetes, placenta complications, emergency c-section, instrumental delivery, stillbirth, pre-term birth, congenital malformations or low Apgar score. Apgar score is a test of a newborn’s health, including measures like heart rate, reflexes and muscle tone immediately after birth.

Researchers did find that 401 of the 2,930 women with MS, or 14 per cent, had an elective c-section, compared to 4,402 of the 56, 958 women without MS, or eight per cent, who had an elective c-section.

After adjusting for other factors that could increase the likelihood of having an elective c-section, such as prior c-section and mother’s age, women with MS were 89 per cent more likely to have an elective c-section.

Researchers also found women with MS were 15 per cent more likely to have an induced delivery than women without the disease.

Also, women with MS were found to be 29 per cent more likely to have babies that were born small for their gestational age compared to women without MS.

Overall, 3.4 per cent of women with MS had babies small for their gestational age, compared to 2.8 per cent of women without MS.

“We think the reason more women with MS have babies by elective c-section or induced delivery may have to do with MS-related symptoms such as muscle weakness, spasticity or fatigue that might affect the birth,” Professor Magyari says.

“Any of these could make a mother more tired and lead to delivery complications that could prompt the clinician and woman to take extra precautions.”

Researchers also found that mothers with MS were 13 per cent less likely to give birth to babies with signs of being deprived of oxygen, or asphyxia.

Professor Magyari said the higher prevalence of elective c-sections among women with MS most likely explains the corresponding lower odds of asphyxia.

A limitation of the study is the lack of data on the mothers’ smoking, which could cause babies to be born small for their gestational age.

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Neuro physio

Community neurorehab gym continues to expand

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The West Berkshire Therapy Centre was established on the back of £145,000 worth of fundraising

A community therapy centre which enables neuro patients access to the physio-led exercise which can support their recovery continues to expand in response to demand for its services.

West Berkshire Therapy Centre was opened in 2014 to bridge the gap in existing community resources, and initially opened for 20 hours a week with ten items of equipment.

Since that time, the Thatcham centre has expanded into premises twice the size of its initial home, and now has 17 items of equipment which clients can access 35 hours each week.

While the centre has been forced to close during lockdown periods, the investment in its offering has continued, with a further £17,500 being spent to upgrade equipment.

In addition to its regular clientele of around 260 people, around 200 more will be referred to the centre from the Berkshire Long COVID Integrated Service, led by Dr Deepak Ravindran, who has worked closely with the centre for several years.

As well as the anecdotal evidence from clients who attest the positive effect West Berkshire Therapy Centre has, the centre’s work has been proven to improve client mobility by an average of ten per cent, psychological outlook by 15 per cent and weight loss by three per cent.

All clients are assessed by the centre’s physio before being prescribed an individual exercise programme. The centre prides itself on its client-centred approach and some of the equipment in the gym has been designed and built specifically in response to what clients said were important to them.

West Berkshire Therapy Centre was created by the West Berkshire Neurological Alliance, a group of 23 local neuro charities, which recognised the need for greater specialist provision for people living with neurological conditions in the area.

John Holt was instrumental to the creation of both the Alliance and the Centre. Having supported his wife in living with MS for over 40 years, he took the lead on ensuring greater provision and support was there for those who needed it.

“I’m not from a medical background, I’m a food technologist, and while I was chair of a trade association during my career, I was used to working with competitors and business enemies, that was just what happened for the greater good of us all,” he says.

“So I was rather shocked when I got involved with the local voluntary sector and found that wasn’t the case. I was very proactive in all of our charities working together as I know the importance of working as one alliance.

“People who were living with neurological conditions were often having to fend for themselves when it came to community rehab, and that’s why we wanted to create the West Berkshire Therapy Centre.”

Having been established on the back of £145,000 in fundraising, five years later the demand for its services was such it had to expand into larger premises and invest in more equipment.

The centre – which is funded by voluntary contributions for sessions and through fundraising – now has eight part-time staff and a core of volunteers to support clients with whatever rehabilitation issues they have.

While most clients have neurological conditions – including stroke, Parkinson’s, MS and Post-Polio Syndrome – the centre has broadened its reach to include large numbers of people with arthritis, heart and lung conditions, sight impairments as well as amputees.

“We’re completely pan-disability and will support anyone who needs us. Our clients talk to us and we listen and adapt,” says John.

“I think many clients come to us because we are a safe place for them and they’re among people who understand the challenges they face.

“It is very important that we talk about things openly. For example, we talk about how hard it is when you can’t get to the bathroom in time and you wet yourself.

“When you face issues like that, it can be the start of a spiral downhill, you might then stop going to work or stop leaving the house, but we share these kinds of things.

“By having this interaction, it becomes a place people aren’t afraid to open up.”

With the centre having been closed for much of the past year, John and the team are ready to welcome back regular and new clients, including the many who are recovering from Long COVID.

“Many of our clients won’t have exercised for several months, but we hear very often that people have waited 20 years for a centre like this, so a few months hasn’t been long in comparison,” says John.

“But we are very much looking forward to re-opening and supporting our clients in regaining any progress and fitness they may have lost. Hopefully we are on the right track now after three lockdowns and clients can come back to us regularly.

“Long COVID is a new condition for us, as it has only come into being in the past few months, but we are ready to support people with their symptoms and in them using exercise as part of their recovery.”

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Brain tech company secures funding to increase support post COVID-19

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CBS Health will help clinicians utilise more digital services

An online brain assessment platform has secured funding to enable its work in telehealth to continue to support people as the world emerges from the COVID-19 pandemic.

Cambridge Brain Sciences (CBS) is planning to expand its operation through a funding round from Canadian Shield Capital, a Toronto-based private equity investment firm, closely aligned to Hatch, a global engineering consultancy.

The investment will allow Candian-based CBS to further its work in digital health, especially around mental health, and respond to the need for accurate and reliable quantified measures of brain function and brain health – hailed as being essential to so many people who have suffered psychologically from the effects of COVID-19.

The funds will allow CBS to grow its sales and customer support teams rapidly, which will enable it to roll out its flagship product, CBS Health, further.

It will also enable it to expand on CBS Health features to help continue to refine and develop its cognitive care platform for healthcare professionals treating the growing mental health, brain injury and ageing patient populations.

The COVID-19 global pandemic has seen many healthcare practitioners to adopt platforms such as CBS Health to manage patients remotely.

As a result of lockdowns and ‘stay at home’ guidance, there has been exponential growth in patients seeking treatment for mental health conditions brought on, or exacerbated by, the pandemic, as well as individuals recovering from COVID-19 suffering with longer term neurological symptoms.

CBS Health has also grown as a result, and offers a web-based platform or integration which allows healthcare professionals to administer the CBS tasks standalone or alongside other established and validated complementary assessments (such as the PHQ-9, a standard scale for assessing the severity of depressive symptoms).

Assessments can be combined into a single session and administered in person or remotely via email—an option from which clinicians have benefitted greatly throughout the COVID-19 global pandemic.

The investment also contemplates further collaboration between CBS and Hatch, building upon an earlier successful pilot for a dedicated CBS platform to address corporate workplace mental health and safety at large scale industrial operations, construction sites and infrastructure projects.

“CBS is excited to be closing this round of financing which builds upon a long-term relationship with Canadian Shield and an earlier successful pilot with Hatch,” says Marc Lipton, president and CEO of Cambridge Brain Sciences.

“The funding will allow us to further accelerate the growth of our core CBS Health product especially amongst mental health practitioners, as well as to strategically explore, with Hatch, large corporate applications for workplace mental health and safety.”

“CBS brings many years of academic discipline and rigorous digital measurement of cognitive health, with applications in mental health, brain injury recovery, healthy ageing, and soon workplace safety,” says Andrew W. Dunn, managing partner at Canadian Shield Capital.

“The growing awareness of, and attention to, mental health conditions and CBS’ engaging and efficient approach gives it enormous runway.”

James Marzocca, global managing director for project delivery at Hatch, adds: “We see great potential to apply CBS testing as a non-invasive diagnostic to assess fitness for duty for individuals reporting to worksites where mental alertness is essential for their own safety and the safety of others.”

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