Someone needs to rewrite Johnny Got His Gun for the modern era. In a recent article in the New England Journal of Medicine entitled “Willful Modulation of Brain Activity in Disorders of Consciousness” researchers used fMRI machines to attempt to determine the level of awareness in persistent vegetative patients.

The researchers put people in brain scanners and, in one condition, asked them to imagine standing still on a tennis court while swinging an arm to “hit the ball” back and forth to an imagined instructor, and in the other, to imagine navigating the streets of a familiar city or to imagine walking from room to room in their home. These were chosen because they show distinct patterns of brain activity on a scan. (via Mind Hacks).

Out of 54 patients only 5 showed patterns of distinct brain activity. This sort of research has been done before but in this study they took it a step further.

One patient, who had been in a vegetative state since a traffic accident seven years ago, was asked a series of six yes or no questions about simple personal details such as: “Do you have any sisters? Is your father’s name Thomas? Is your father’s name Alexander?“ The researchers instructed the patient to imagine tennis for yes and walking for no.

To blind against the effect of bias, the researchers who asked the questions did not know the answers and they each ended question with neutral word “answer.” Also, the results of the fMRI was read by researchers who were not aware of the questions asked.

The patient’s brain activity indicated the correct answer for 5 out of 6 questions—the last question resulted in no measurable activity to correlate with a response. Now statistically anyone can get 3 out of 6 yes/no questions right, but given the fact that the patient was seemingly able to follow instructions something was going on. This doesn’t mean that the patient is fully conscious and trapped in his body. Something is going on up there but given the state of the patient his level of awareness is likely fleeting and limited at best.

All this sets up an odd legal quandary as vegetative patients already exist in a legal grey area. Most legal statutes rule that it must be ruled by a medical authority that no recovery is possible before—to be crude—the plug is pulled. This sort of evidence casts more light on the state of the individual but it also makes the situation even more unclear: What if the other 49 patients never played tennis before? What if they didn’t quite understand the question? What if they are deaf?

And what if… what if they had asked the patient if he wanted to continue living like this… and what if he said “No.”

Would this classify him as minimally conscious rather than permanently vegetative? If so they would no longer be allowed to abide by his wishes. Maybe this isn’t a modern telling of Johnny Got His Gun, maybe it’s actually Catch 22.

Posted via web from CatCubed’s Random Snippets

BBC News reports Acupuncture ‘boosts IVF chances’ others such as the Chicago Tribune are a bit more sober, yet still misleading, using the headline Acupuncture might help with fertility.

To be true to the meta-analysis study, the headline should really read:

Acupuncture might help one out of ten women get pregnant via IVF treatment at Chinese clinics that have relatively low rates of success; patients in European clinics with high rates of success will get no benefit.

Let me break this down into easy to read bullet points:

• This is not a new study just a meta-analysis of seven previously published studies
• These studies used different methodologies and we don’t know what the selection criteria was or what bias there might have been
• The studies at European clinics showed no effect
• The only studies that showed any effect were Chinese IVF clinic studies
  • Chinese clinic studies were somewhat over-represented in the meta-analysis
  • Chinese clinics had lower rates of IVF success overall
  • Research in China is plagued by plagiarism and fraud
• Since the only positive research came from Chinese research this calls the entire meta-analysis into doubt
• Unless — acupuncture only works in China — Ha!

For a more in depth breakdown on this recent study, read Peter Sanderson’s blog post Misleading acupuncture / IVF headlines.

In another study back in september, acupuncture was shown to have no effect beyond the placebo effect. Again the media distorted this acupuncture study. Others have already done an excellent job dissecting the acupuncture back pain studies here and here.

The only real conclusion to make from all of this is that acupuncture has one solidly empirical benefit: with enough positive manipulation any researcher can get international headlines.

A lot of science geeks enjoy lambasting the press for their excessive use of hype in reporting science and medical news. The excellent Bad Science blog specializes in this sort of media skewering, as do several ScienceBlogs writers and other science bloggers.

One problem with all this finger pointing is the fact that scientists and doctors often infuse quite a bit of hyperbole themselves whenever they discuss their research. The discussion section of any paper is often where the forest of wild tangents lives. This is especially true with basic science research where they use this section to say “See! See! Our research is relevant too! It’s worth the funding since it’ll lead to new cures for the Whathaveyou Syndrome.”

Case in point, I was recently gleaning a few recent cocaine research study news releases and I noticed a distinct lack of reality with the conjecture. All these come from Science Daily which prints articles in their original form from universities and research organizations. This all hyperboles are coming straight from the horses mouth.

“We have a brain hard-wired to appreciate rewards, and cocaine and other drugs of abuse latch onto this system. We are looking at the potential for new medications that reduce the brain’s sensitivity to these conditioned drug cues and would give patients a fighting chance to manage their urges.” (Subconscious Signals Can Trigger Drug Craving) ¹

“Based on this study, it appears that promising new therapies for addiction may be based on treatments that mute the desire to escalate cocaine intake by blocking the elevation of brain reward thresholds produced by chronic cocaine use.” (Research Helps Explain Why Perception Of Pleasure Decreases With Chronic Cocaine Use) ²

Anyone with an ounce (28.3495231 grams) of scientific skepticism can see right through any of this, tear into the meat of the study, toss out the wild tangents, and hunt for connections to broader theories and future research ideas. This however is not the journalist’s job. There job is to make the science seem more like SCIENCE!

SCIENCE! journalism — as opposed to science journalism — is useful for keeping science interesting and relevant to the public at large, and hopefully inspiring the next generation of scientists. Of course, it also has it’s problems in that distorts the science, but as I mentioned, scientists are pretty good at doing that themselves.

Footnotes

1. I.E., put the addict on an antipsychotic (aka dopamine antagonist). Antipsychotics have fun side effects like the desire to sleep a lot, reduced libido, weight gain, and a general anhedonia (they don’t get too exited about anything). Sure it may deaden the cravings (and possibly protect D2 receptors), but will addicts really willingly take a drug that makes them feel like they are in continual withdrawal?
2. I.E., somehow get the addict to take some sort of anti-psychotic when they are in the middle of their drug binge — even better if it’s their first drug binge. Sorry to burst your bubble but this ain’t gonna happen.
3. The cocaine vaccine while not a panacea shows some promise — if ethically awkward. I’ve been meaning to write something on it but I want to put a bit more research into that post.

So it seems like my Cat Lady hypothesis linking toxoplasmosis and crazy cattitude that I blogged about in August of 2006 seems to have taken root elsewhere in the scientific community. The New York Times is reporting that the crazy idea may not be so crazy.

“That idea doesn’t seem completely crazy,” Sapolsky says. “But there’s no data supporting it.” [Toxo expert Robert Sapolsky of Stanford]

Not yet. But Jaroslav Flegr, an evolutionary biologist at Charles University in the Czech Republic, is looking into it.

It’s a rather simple leap in logic for anyone who knows the effects of toxoplasmosis, so I’m not surprised that someone else glommed onto the idea. However, I like to think that I may have helped it percolate to the surface, so now it can get some actual scientific study.

Recent stem cell advancements have been been exploding across the headlines. If you somehow missed these headlines, the bulk of it is “researchers have figured out how to reprogram adult cell into a state that is nearly indistinguishable from embryonic, pluripotent stem cells.”

Unlike some science stories in the news this isn’t pure hype; it is truly important and has been tested by multiple labs. However, like normal, the media reports are mostly lacking in details and full of loud pronouncements about how this tolls the end of the culture wars and how using embryonic stem cells is now “old-fashioned.”

Like always the truth is more complex. And of course the fabulous ScienceBlogs lays it all out where the media falls flat. PZ Myers, of Pharyngula offers an excellent explanation of the research and it’s implications entitled Stem Cell Breakthrough. Also, the Denialism Blog has a great post about it entitled, Reprogramming adult cells into pluripotent stem cells – what do these new results mean. The blog Framing Science wrote two posts detailing how this is going to effect the future of the stem cell debate: The Next Stage in the Stem Cell Debate Begins! and THE DISCOVERY: What It Means for Framing & News Coverage.

I highly recommend you read these excellent articles, but for those of you who are too busy I offer a few important bullet points:

• “Americans did not make this discovery; Japanese researchers did. It required understanding of gene expression in embryonic stem cells, an understanding that was hampered in our country. ” (PZ Myers)
• This discovery is truly important and has been tested by multiple labs.
• “What the investigators have accomplished is to discover the reset button for the cell, but the way they currently press it is by hitting it hard with a ball peen hammer.” (PZ Myers)
• This new method is still somewhat crude and this means that the cells cannot be used for theraputic purposes as these cells have a higher chance of becoming cancerous than embryonic stem cells.
• This does not spell the end of embryonic stem cells as in order to find a more eloquent way of switching the “reset button” more research using embryonic stem cells will be needed.

Sadly, I think science has already lost the (religiously polarized, scientifically illiterate) American public on this issue. The media has already spin this as a win for the Christian Right and is ignoring that fact that it is really a win for embryonic stem cell researchers — and more importantly that more embryonic stem cell research is needed.