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Behavioral And Neural Effects Of Bihemispheric Brain Stimulation On Stroke Recovery
Researchers in the Neuroimaging and Stroke Recovery Laboratory at Beth Israel Deaconess Medical Center / Harvard Medical School are using a novel treatment for chronic stroke patients. The non-invasive technique of dual-hemisphere transcranial direct current stimulation (tDCS) uses electrical stimulation to modulate brain activity while simultaneous engaging the paretic arm/hand in sensorimotor activities. They studied chronic stroke patients who had movement problems after a stroke in a randomized clinical trial. The patients were divided into groups receiving either the electrical stimulation or placebo stimulation while receiving occupational therapy (OT) at the same time. After only 5 treatment sessions, patients receiving real stimulation and OT significantly improved in their motor functions, while control patients (receiving placebo stimulation and OT) showed no significant improvement. Functional magnetic resonance imaging showed increased brain activity in areas that control limb movement on the affected side for patients who received the real tDCS. It is important to notice that these changes were found in patients whose strokes had occurred on average about 3 years prior to the study, when patients are typically considered to be stable and unlikely to experience further improvement. This new treatment offers hope for patients debilitated by strokes.

Food And Drug Administration Moves Towards Greater Openness
The Food and Drug Administration is taking steps towards greater openness. The Associated Press reports that FDA Commissioner Margaret Hamburg "announced Tuesday she has created a task force to make recommendations on how the agency can release more information in such areas as drug evaluation and enforcement matters. She wants a report in six months." Deputy Commissioner Joshua Sharfstein will head the task force, which will represent all of the FDA"s major divisions as well as its law enforcement branch. It will hold two public meetings with the first on June 24. "The FDA has long operated under strict confidentiality rules," the AP reports, and in opening up information, one sensitive issue will be what to do with unpublished clinical trial data from drug manufacturers. Despite such concerns, "Hamburg said she believes the need for secrecy may have been taken too far, and is harming the FDA"s credibility within the medical community and among consumers" (Alonso-Zaldivar, 6/2).
News of the day
Arizona Jail Could Be E-Health Test, But Slow To Take The Necessary Steps
A troubled county jail, where hundreds of lawsuits have stemmed from mistakes in managing the inmates" health information, would be a perfect testing ground for electronic medical records, the Arizona Republic reports. But Maricopa County officials have not acted on repeated recommendations to implement such a system, "even when faced with hundreds of lawsuits and the loss of accreditation for CHS operations."
Medical Devices

Study Rewrites Textbook On Key Genetic Phenomenon

Because females carry two copies of the X chromosome to males" one X and one Y, they harbor a potentially toxic double dose of the over 1000 genes that reside on the X chromosome. To compensate for this imbalance, mammals such as mice and humans shut down one entire X-chromosome through a phenomenon known as X-inactivation. For almost two decades, researchers have believed that one particular gene, called Xist, provides the molecular trigger of X-inactivation. Now, a new UNC study appearing online July 1 in the journal Nature disputes the current dogma by showing that this process can occur even in the absence of this gene. "Our study contradicts what is written in the textbooks," said senior study author Terry Magnuson, Ph.D., Sarah Graham Kenan Professor and chair of genetics, director of the Carolina Center for Genome Sciences and a member of the UNC Lineberger Comprehensive Cancer Center. "Everybody thought that Xist triggers X-inactivation, but now we have to rethink how this important process starts." Previous studies showed that the Xist gene was active or "turned on" early in the course of X-inactivation and that disruptions in the gene resulted in irregular X-inactivation, eventually leading to the accepted assumption that Xist was the trigger. But it wasn"t clear in the literature if this genetic phenomenon would initiate if Xist isn"t present, said lead study author Sundeep Kalantry, Ph.D., postdoctoral fellow in the UNC department of genetics. Kalantry used three different molecular techniques to look at X-inactivation in the embryos of mice that were genetically engineered to contain a defective Xist gene on their future inactive X-chromosome. He discovered that the genes on this X-chromosome could be silenced regardless of whether they produced Xist. But while Xist was not absolutely required to start X-inactivation, without it genes along the X-chromosome eventually became active again. Thus, Xist appears to stabilize silencing of the X-chromosome over the long term. Unlike most genes, the Xist gene doesn"t code for a protein. Rather, it acts at the level of RNA - a copy of the DNA genetic sequence - which serves to recruit protein complexes through a process known as epigenetics. These proteins then form a molecular scaffold along the inactive-X chromosome that can stably silence the genes contained within it. The UNC researchers are now actively investigating how this chromosomal remodeling begins in the first place. "If we can figure out the mechanism that triggers X-inactivation, we can potentially apply this knowledge to diseases that have an epigenetic component," Kalantry said. "So it can have implications not only in fundamentally understanding X-inactivation but also to gain insight into the increasing array of illnesses where the epigenetic machinery has gone awry such as in prostate and breast cancers." Along with Magnuson and Kalantry, study co-authors are Sonya Purushothaman, undergraduate student; Randall Bryant Bowen, research technician; and Joshua Starmer; Ph.D., postdoctoral fellow. The research was supported in part by the National Institutes of Health and by an American Cancer Society Postdoctoral Fellowship. University of North Carolina


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