Up to 25% of patients with severe brain damage who appear unresponsive may possess cognitive capabilities and show signs of brain activity indicating higher cognitive function than previously thought, according to a study published by The New England Journal of Medicine.

Cognitive-motor dissociation, where patients retain cognitive abilities despite being unable to move or speak, occurs in 10-20% of individuals with disorders of consciousness. Assessing this condition could assist in predicting prognosis and increasing independence.

Functional MRI (fMRI) and EEG can detect command-following responses and retained cognitive capabilities in patients with cognitive-motor dissociation, despite their outward unresponsiveness.

An estimated 300,000 to 400,000 people globally may have hidden awareness despite brain injuries that prevent them from visibly communicating. Brain-computer interfaces could potentially enable communication for those with consciousness disorders.

The study likely underestimates the number of conscious but physically unresponsive individuals.

Sources: Nature, New Scientist, Evrim Ağacı, KUOW, Medscape, Express & Star, Weill Cornell Medicine, MedPage Today.

This article was written in collaboration with Generative AI news company Alchemiq.

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In a new study published in Nature Wednesday, Weizmann Institute of Science researchers, in collaboration with colleagues from the Hebrew University of Jerusalem, unveiled for the first time how three-dimensional space is represented in the mammalian cortex by the brain's "GPS" system.

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The team of researchers, led by Prof. Nachum Ulanovsky of Weizmann's Neurobiology Department, were surprised to find that this representation is very different from the way in which two-dimensional space is represented, turning several long-standing hypotheses on their heads.

Mammals, including humans, know their position in space, owing to several types of specialized neurons in the hippocampus and its next-door neighbor the entorhinal cortex – regions located deep inside the brain. Head-direction cells, the internal compasses of the brain, indicate to the animal the direction in which its head is turned. Place cells, thought to construct a mental map of the environment, are activated when an animal crosses a specific location. Grid cells, by contrast, respond not to one, but to multiple such locations, and they are thought to provide the brain with a GPS system of sorts.

The study of grid cells and the brain's GPS was awarded the Nobel Prize in 2014. However, these and other studies focused solely on how two dimensions are represented and said very little about the representation of three-dimensional space. To bridge this gap, Ulanovsky and colleagues set out to elucidate how grid cells act in three dimensions in freely behaving bats.

In the past, when grid cells were studied in rodents running on two-dimensional surfaces, they were found to be activated in multiple circular areas, known as firing fields, which are arranged in a symmetrical hexagonal pattern – resembling millimeter graph paper – that tiles the surface. This unparalleled symmetry and periodicity suggest that these cells may be involved in geometric spatial computations that form the core of the cerebral GPS. The entorhinal cortex, where grid cells are located, is the brain area that is first affected in Alzheimer's disease, and it is possible that spatial disorientation, one of the early manifestations of Alzheimer's, is due to the grid cells' dysfunction – and the loss of the hexagonal "millimeter paper" of grid cells.

Mathematically, the optimal way to pack circles in two dimensions is in a hexagonal pattern, like a honeycomb: This is possibly the reason why the circular firing fields of grid cells are represented in the brain in a hexagonal lattice when animals walk over two-dimensional surfaces. Therefore, the researchers expected the activity pattern in three dimensions to be similarly symmetrical and hexagonal. "We and many other researchers hypothesized that we'd see hexagonally stacked balls, like oranges in a grocery store neatly stacked in a pyramid, or any other extremely ordered three-dimensional arrangement," Ulanovsky says.

To test this hypothesis, the researchers, led by doctoral student Gily Ginosar, together with Staff Scientist Dr. Liora Las, recorded the activity of grid cells in bats that had small mobile devices mounted on their heads, as the bats were flying around a room the size of a large living room. Feeding stations at different heights ensured that each bat covered most of the room's volume in every run. Once the data started coming in, the researchers saw that grid cells did not behave as expected when responding to three-dimensional coordinates. "The well-ordered global grid that is the hallmark of their two-dimensional activity was altogether gone," explains Ulanovsky.

Instead, the three-dimensional firing fields of the grid cells, shaped in this case as spheres rather than circles, were packed like a box full of marbles. They were not completely disordered, but were certainly less organized than the three-dimensional equivalent of a hexagonal lattice – as the new arrangement allowed the "marbles" some extra degrees of freedom. Whereas any noticeable global order was lacking, the spheres did commit to a local order wherein the distance between one sphere and its nearest neighbors remained constant.

To offer a mechanistic explanation of this phenomenon of local rather than global order, the experimental team – Ginosar, Las and Ulanovsky – collaborated with theoreticians Dr. Johnatan Aljadeff, a former postdoctoral fellow at Weizmann and now a professor at the University of California in San Diego, and Prof. Haim Sompolinsky and Prof. Yoram Burak from the Hebrew University of Jerusalem. Together they constructed a model that uses principles, borrowed from statistical physics, that describe the interaction between particles. The model revealed that the spherical firing fields of grid cells seem to interact in almost the same way as particles do – they are "attracted" to one another when at a distance and are "repelled" once they get too close. In particular, the balance of forces acting on particles could explain the local order that kept the spheres at constant local distances from one another, while avoiding any global lattice. Compared to other models that were used in the past to predict the three-dimensional organization of grid cells' firing fields, the new model was the most loyal to the experimental data.

Taken together, the surprising experimental data and theoretical model offer a new way of looking at the neural basis of three-dimensional navigation and the role that grid cells play in this cognitive process. While previous models extrapolated a similar three-dimensional arrangement from the two-dimensional grid, the work of Ulanovsky and colleagues and their "box of marbles" model show that things are much more complex. Since no periodic lattice is formed in three-dimensional space, the classical theories for understanding the intriguing behavior of grid cells will need to be revised.

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Studies have already pointed to the adverse effects of cannabis on various cognitive abilities among adolescents. Now, new research could shed light on the manner in which this damage is done and its long-term physical manifestations.

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A comprehensive study recently published in the scientific peer-reviewed journal JAMA Psychiatry, which examined the effects of cannabis (marijuana) on adolescents' neurodevelopment, indicates a possible link between the drug and changes to the thickness of the cerebral cortex, causing it to become too thin or to erode.

The study tested 1,598 MRI brain scans from 799 human subjects, with the aim of examining the impact of cannabis consumption on the development of the cerebral cortex. The study was a continuation of earlier testing on animals, which showed that a developing brain is sensitive to the effects of cannabis on receptors in the brain.

Complementary research conducted over a five-year period, as stated, presented concerning indications. The bottom line, the researchers said, is that cannabis use among adolescents could correlate to neurological developmental changes.

Dozens of researchers from numerous countries contributed to the study.

In the United States, more than one-third of 12th graders consume cannabis, and 78% of those who experiment with the drug for the first time are between the ages of 12-20.

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BrainQ, an Israeli medical technology startup working on an AI-based therapeutic solution to reduce disability following stroke, has announced that the US Food and Drug Administration has awarded its device "breakthrough status."

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The designation, which was based on BrainQ's latest randomized controlled clinical trial results for ischemic stroke patients, provides BrainQ with the opportunity to work closely with the FDA to expedite development plans and premarket clearance. Results of the trials are slated to be presented at the American Heart Association's 2021 International Stroke Conference from March 17–19.

Breakthrough status also gives BrainQ access to the new Medicare Coverage of Innovative Technology (MCIT) pathway, allowing for Medicare coverage to be provided concurrently with FDA market authorization.

Stroke is one of the leading causes of disability, affecting 800,000 people every year in the United States alone. In the days and weeks following stroke, the brain attempts to repair damaged neural pathways and develop new ones to restore function, but often with limited success. This results in chronic disability for about 50-70% of survivors.

Interventions for reducing disability after strokes that are currently approved for use are relevant for only the first few hours after the stroke occurs. Only about 5% of victims in the US currently arrive at the hospital in time to benefit from these treatments. BrainQ aims to extend this window of opportunity from the acute phase to the sub-acute phase, offering a treatment that can be used in the days and weeks following stroke, helping the wider stroke population who have residual disability.

BrainQ is developing an AI-powered electromagnetic field therapy that aims to enhance recovery and reduce disability after neurological damage caused by stroke. The therapy is based on biological insights retrieved from brainwaves, using proprietary machine learning algorithms that translate into a frequency-tuned low intensity electromagnetic field. BrainQ's therapy is delivered via a cloud-connected wearable device and is designed for scalable and portable treatment, with the flexibility to be accessed from home.

"We're excited that the FDA has granted BrainQ a Breakthrough Device Designation," said BrainQ co-founder and CEO Yotam Drechsler.

"Stroke is a debilitating condition with limited recovery options, creating a huge unmet need in the US. COVID-19 has only made things worse by limiting patients' access to treatment facilities. FDA Breakthrough Designation is an important milestone in our mission to reduce disability for these patients and treat them in the comfort of their homes," Drechsler pointed out.

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Researchers at Ben-Gurion University of the Negev developed a new method for rapidly diagnosing brain blood vessel pathology that may lead to neurodegenerative diseases and neurological and psychiatric conditions, the university announced Tuesday. 

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The novel method is based on analyzing EEG, i.e., brain activity patterns using proprietary algorithms. The method was developed by Dr. Dan Milikovsky and Prof. Alon Friedman from Ben-Gurion University's Departments of Physiology and Cell Biology, Cognitive and Brain Sciences. 

The findings show that patients with Alzheimer's disease and other brain conditions display nonconvulsive epileptic seizure-like activity that can be detected by EEG recordings. 

This abnormal activity reflects pathological changes in dysfunction of the brain blood vessels, which contribute, according to recent studies, to the pathogenesis of various neurodegenerative and other neuropsychiatric disorders.

The technology was successfully tested on animals and dozens of patients and is now being validated on large databases of EEG records of thousands of patients.     

"This new approach for diagnosing neurological conditions based on analysis of changes of blood vessels in the brain can be valuable for the early detection of Alzheimer's disease and other neurological conditions at the stage when treatment can still slow down disease progression," said Josh Peleg, CEO of BGN Technologies, the technology transfer company of Ben-Gurion University.

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Cerebral catheterization is one of the most advanced treatments to treat a stroke and can reduce the risk to patients. Residents of the north currently have no access to cerebral catheterization units other than the one at the Rambam Healthcare Campus in Haifa and at the Galilee Medical Center in Nahariya, putting at risk some of the 800,000 residents in the Galilee, Golan Heights, and Jezreel Valley.

Brain catheterization is administered about 6-8 hours after a stroke.

Dr. Erez Onn, the director of the Padeh-Poriya Medical Center said the new access to this technology means that more lives will be saved.

"Establishing the service will provide immediate treatment for stroke victims in need of brain catheterization, and will prevent the precious loss of time that occurs when they are transferred to a remote center," Onn said.

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The latest cleared product, HealthICH, uses artificial intelligence to automatically identify suspected internal brain bleeding based X-rays, CT scans, and MRIs. This can significantly reduce turnaround time and increase the radiologists' confidence in their diagnosis, Zebra said.

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Intracranial hemorrhage accounts for about 10% to 20% of all strokes and can occur as a result of traumatic injury, ruptured arteries, stroke or cancer. Its 30-day mortality rate ranges from 35% to 52% with about half occurring in the first 24 hours.

Established in 2014, Zebra Medical uses artificial intelligence and machine learning algorithms for the automated analysis of radiological scans.

Last month, the company announced it had received FDA clearance for its automated chest x-ray triage product that uses deep learning technology to analyze chest x-ray images in order to detect and prioritize lung trauma.

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