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(47) Research on HEALTH: first aid (CPR).

This is Research on HEALTH month on Researchista. It is when Researchers from different medical fields bring their best knowledge and expertise in few words to explain their Research findings and to hopefully help you overcome certain health questions or problems you might have. Please say hi to Sebastian! 

Hi there!

I studied Medicine at the Maastricht University (2010-2016) and became a member of Taskforce QRS (CPR instructor) in 2012. My first cardiopulmonary resuscitation was on a ward in a small town in Germany, where I was at the time following an internship. At that moment, I was a CPR instructor for nearly 3 years and I thought I knew all the steps perfectly. But nothing could prepare me for the real thing….. ☺

 

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Sebastian Sanduleanu, PhD student at Maastricht University

So, what to do when someone has a heart attack? First, let’s distinguish some key concepts:

“Cardiac arrest”

A “cardiac arrest”, not to be confused with a “heart attack” is when the heart stops beating (Figure 1). A heart attack may lead to a cardiac arrest.

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Fig. 1: Cardiac arrest vs. heart attack. Source: http://www.healthzone.org

If a cardiac arrest occurs, blood will stop circulating around the body and breathing will likewise cease within several minutes. Without a supply of oxygen, the cells in the body start to die. Especially brain cells are highly sensitive for low blood oxygen concentrations, after about five minutes of no oxygen brain cells will begin dying leading to brain damage and death.

Other key conceptual differences regarding symptoms:

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Source: http://www.positivemed.com

“CPR”

Cardiopulmonary resuscitation, commonly known as CPR is one of the key elements of first aid. The purpose of CPR is by chest compression to keep oxygenated blood flowing through the body in order to keep the vital organs alive.

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Fig. 2. The BLS/AED algorithm Source: http://www.slideshare.net/adis23/cpr-prezentacija

It is important to know that CPR itself will not restart someone’s heart, it just keeps them alive until a defibrillator (Figure 3) arrives. This is a device which delivers an electrical shock to the heart in order to restart it. These defibrillators are, aside from hospitals, commonly found in sports parks, shopping malls, schools and near to crowded areas. Access is restricted to authorized users, from ambulance workers, (para-) medics to civilians trained in CPR (with a so called BLS = Basic Life Support certification).

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Fig. 3. The automated external defibrilator (AED)

CPR numbers in the Netherlands

Around 10.000 people in the Netherlands face a cardiac arrest outside the hospital every year. A major influence on the survival rate is the high percentage of bystanders, which had already begun CPR before the arrival of the first ambulance (>75%), the connection of an automatic external de-fibrillator (AED) and a shockable heart rhythm early. These findings have been summarized in the chain of survival (Figure 4).

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Fig. 4. The chain of survival.

The survival in the Netherlands is on average 23%, one of the highest in Europe. If there is a shockable rhythm start, the survival rate can be as high as 44%.

For those living in Maastricht: QRS Taskforce Maastricht, purpose and background
In order to improve the survival chances for sudden cardiac arrest (SCA) victims, Taskforce QRS Maastricht (Qualitative Resuscitation by Students), was founded in 2006 by medical students of Maastricht University3. In 2012 a new approach in CPR training, called Maastricht Quantity-orientated Resuscitation Session (M-QRS), was developed that focuses on the number of trained students per training. By comparing the new with the old approach quantitative growth could be assessed. Until now more than 12,937 secondary school students have now been trained by ERC-certified (European Resuscitation Council) CPR instructors with this efficient M-QRS approach. In comparison, a theoretical maximum of 6,469 could have been trained by means of the old approach. Sign up for CPR-training with Taskforce QRS: A civilian rescuer is a CPR trained volunteer that is contacted by 112 emergency rooms per SMS or via a special phone application to directly or after picking up an AED (automatic external defibrillator) go to the location of a victim of a cardiac arrest and to start CPR. Interested? Click on the link! 

(more at: Ghossein, A., Amin, H., Sijmons, J., Olsthoorn, J., Weerts, J., Houben, V. (2014). Taskforce QRS. European Heart Journal, 35(45), 3149-3151).

Heart physiology

The heart pumps oxygen and nutrients around the body through your blood. Waste products, e.g carbon dioxide and urea are removed through your circulation by respectively the lungs (diffusion) and the kidneys (urine filtration). In your lungs, oxygen enters your blood stream and carbon dioxide (a waste product) is removed in a process known as gas exchange (Figure 5).

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Figure 5. Gas exchange in lungs (Pearson, 2013).

All the cells in your body are dependent on oxygen, aside from nutrients to survive. This oxygen is used as energy source in the powerhouses of the cell, the mitochondria in a biochemical activity called metabolism.

 

 Post written by Sebastian Sanduleanu, MAASTRO Clinic, Maastricht University, Maastricht

 

 

With love for Research,

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Academia Food health knowledge research Researcher Special Guest stress struggle

(46) Research on HEALTH: metabolism.

…(drums) and Researchista’s first Special Guest_Professor is Professor Dr. Ronit Shiri-Sverdlov! This is Research on HEALTH month and this month we will talk about metabolism. Let’s recall from school what metabolism is about? Metabolē means change” in Greek and is the set of chemical transformations within the cells of living organisms (that does not only include humans, but also plants and animals). Wikipedia says that this is usually divided into two categories: catabolism – the breaking down of organic matter, and anabolism – the building up of components of cells such as proteins and nucleic acids. Usually, breaking down releases energy and building up consumes energy [Break down food – create new energy = metabolism]. This post is about on side when metabolism does not work.. called Metabolic Syndrome. I hope the post below will inspire to eat fat in a smart way!

Metabolic Syndrome: beyond simple fat accumulation

Everybody knows that consuming a healthy diet and doing physical exercise regularly are essential for keeping our health in optimal condition and our body in good shape. Although there are general guidelines that may help in defining what a healthy diet is, the term ‘healthy’ very much depends on individual needs and opinion. What is healthy can influenced by genetics, gender, age, cultural habits, nutrient availability, and socioeconomic state, amongst others. The notion that continuous malnutrition increases the risk of developing the metabolic syndrome and the associated metabolic complications is widely accepted.

Why does eating an unhealthy diet lead to detrimental effects on our organs including the liver, in some but not all individuals? Surprisingly, the effect of unhealthy diet on our body goes beyond the amount of fat.  In fact, it is all about location!

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Professor Dr. Ronit Shiri-Sverdlov, Maastricht University

From an evolutionary perspective, it has become clear that metabolism is a vital process, which is characterized by the efficient use of energy, as well as the ability to store excess energy for periods of food deprivation. In contrast to our ancestors, current industrialized habits are hallmarked by an excess intake of fat and sugar-enriched foods in combination with physical inactivity. This metabolic imbalance turned our former ‘survival’ state into a serious health problem, currently known as obesity, in which abnormal amounts of fat accumulates throughout the body. Nowadays, nearly one-third of the global population is overweight or obese. Lately, it has become apparent that not only adults suffer from obesity, but also children. As more and more individuals are getting obese, the metabolic syndrome is considered a major health threat.

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Adapted from http://www.struggle.pk

Before taking a closer look at the liver, it is first important to understand the concept of the Metabolic Syndrome. The Metabolic Syndrome is an ‘umbrella term’ for a cluster of factors that increases the risk of developing fatty liver disease, type 2 diabetes and cardiovascular disease.

It involves a complex interplay between different organs, including the fat tissue, intestines, pancreas, brains, cardiovascular system and the liver, in which lipid homeostasis is dysregulated and metabolic inflammation is taking the lead. The liver is one of the most essential organs involved in metabolism, as it does not only regulate the storage and degradation of nutrients such as fats, carbohydrates and amino acids, but it is also involved in the detoxification of harmful compounds.

What is the exact link between the liver and the Metabolic Syndrome?

When we eat too much fat, the excess fat is transported to the liver, where it will be taken up and start to accumulate. Thus, the more fat that we eat, the more fat that accumulates inside our liver cells. Accumulation of fat in the liver is common in our society: it is present in approximately 15 percent of the general population and 90 percent of the people are currently obese. This simple accumulation of fat in the liver is still reversible and, therefore, not necessarily considered harmful. This condition, however, starts to become problematic, once the unhealthy lifestyle continue for long period of time. Accumulation of fat in the liver increases the risk of developing liver inflammation. Ultimately, liver inflammatory can lead to severe, non-reversible liver damage, including liver failure and other associated complications such as cardiovascular disease. Therefore liver inflammation is considered a major health threat.

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 Why does continuous intake of fatty meals can cause severe complications to our body?

When our body is in a healthy condition, specific receptors on the plasma membrane of liver ensure that the fat will be taken up and further processed. Before fat can be broken down for direct energy supply or storage, it must first enter the lysosomes. These cellular acidic organelles are small vesicles inside our cells, which contain enzymes that are capable of breaking down the fat. Once the fat has been degraded into smaller lipid particles, it can leave the lysosomes and can be either stored in the cytoplasm of the cell or can return to the blood.

When the levels of fat intake are continuously high, as observed in obese people, the fat circulates longer in the blood and consequently get oxidized. We have shown that unlike non- oxidized fat, when oxidized fat is taken up by the cells, it accumulates inside the lysosomes. The accumulation of the oxidized fat inside the lysosomes is associated with the development of liver inflammation.

What did we conclude? It is not the accumulation of fat, but rather the location by which the fat accumulates, which triggers the inflammatory response in the liver. Therefore, the actual accumulation of oxidized fat in the lysosomes could be the actual trigger for the inflammatory response. These pioneering results have shed new lights on the possible underlying mechanisms which are leading to the Metabolic Syndrome and opened new venues for the treatment and prevention of the associated clinical complications.

by Professor in Hepatic Inflammation and Metabolic Health, Dr. Ronit Shiri-Sverdlov, Maastricht University UMC+ (Maastricht University Medical Centre = Academic Hospital+Maastricht University), Genetics and Cell Biology Department.

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Maastricht UMC+

With love for Research,

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Academia enthusiasm Fashion Fashionista first years of PhD Photoshoot research Researchista

fashionista #3: Maaspuntweg & Stenenwal.

So, we went to see the Maas from the other side. Please meet our guest, miss Laurien Nagels-Coune who is also the first intern at Researchista, you probably heard about her before 😉 This story is not so much about a Research topic, since Laurien is in her first year of PhD. This story is a personal story about the start of a junior Researcher. 

For those who are unfamiliar with Researchista-fashionista project, this aims to bring Researchers to model on the streets of Maastricht to bring some light on both, the Researcher and a street (or two) of this serene medieval city. On top of that, Researchista-fashionista is concerned with some aspects of the fashion industry and wishes to promote eco-healthy clothing. So, in this shoot we wear 100% biological and organic materials produced 100% in Europe and provided by the shop, called ‘EcoLinea’ from Platielstraat 10 (Vrijthof), where honestly,  everything you find in that shop, like.. every-single-wool/cotton/allmaterials-thing is organic (and they still have sales on!).

First, a little something about the location of the shoot. Tadam! This is the center of Maastricht. You see on the left, the central train station and then few central locations. I marked with a red and orange line the streets and place of our 3rd shoot at this idyllic river bench. Taking pictures with Mr. Mullenberg Peter and his assistant is always a lot of joy, the atmosphere is relaxed and the jokes are funny. This helps everyone to get in the mood to shoot the story.

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It was December, it was winter and it was cold on Maaspuntweg (from ‘Maas’-the river, ‘punt’ – the point, ‘weg’ – the way, now you also know some Dutch!). We went directly to the back of the Bonnenfanten Museum, in the yard of the cafeteria ‘Ipanema’, where we plan to shelter ourselves for tea. Wrong day, the place was closed 😀 I leave it to yourselves to admire how Laurien is being impervious to cold! She was on the table for almost an hour pretending that winter never happened and here is her story…

PhD life in Maastricht: a first impression.

Dear readers, join me at this delightful location. During my master, I would often bike via this path after crossing the Sint Servaas bridge. Biking to the Randwyck campus was always quite a journey because I lived on Maastricht’s Belgian side, almost close enough to the border to receive the Belgian network on my phone.

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Don’t get me wrong though, I did not mind the bike ride at all. My favorite part was this path. I am fond of watching the water from the Maas. When thinking about it, it might be all the fun times at the Belgian seaside that installed this love of water in me. Nevertheless, three years ago I started riding my bike via this path all the way to Randwyck. I was over the moon with getting accepted in one of the neuroscience programs at the faculty of psychology and neuroscience.

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The courses were immensely interesting and intense, resulting in a flow like state most of the time. Admittedly, there were also some times that it got too intense for me. I had to get used to problem-based learning (PBL) for starters. Coming from the University of Leuven, PBL was quite the opposite of what I was used to. A wonderful advantage was that I had to keep up with the material. The perfectionistic procrastinator in me had to get on with it. A downside – that was especially hard to adjust to – was the compulsory attendance. I used to travel a lot during my studies in Leuven, as I was in a long-distance relationship. During those trips, I studied the manuals and the course materials. Sometimes I would ask friends to record an important lecture. This more introverted type of learning also worked for me.

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Nevertheless, PBL made me keep up with the work, and perhaps that was just what I needed to push me into a flow state. When left on my own, I often want to fully understand all the material that is given to me. That might sound like a positive trait, but in all fairness, dissecting an entire methods section meticulously is not very efficient in every course. Maastricht’s educational system forced me to step back regularly and look at the big picture…… and then step back in and read another article.

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After this Master my cravings for neuroscience grew stronger and I decided to apply for a PhD grant together with my mentor. At the time of the grant application I was doing an internship in California, so I had to fly back to defend my project. I felt like a million dollars when getting on that plane. The mere thought that someone else thought I was important enough to fly me back to Europe was thrilling. Even more thrilling was actually getting this grant of course.

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What makes neuroscience such a good match for me is its interdisciplinary nature. Neuroscience is the biology of psychology, the biology behind our mind… In cognitive neuroscience we often measure the brain activity during specific tasks or mental activities. These psychological experiments are elegantly designed and intensely piloted to answer very complex – and sometimes even philosophical – questions that touch the core of our human mind. As a neuroscientist, you can delve into psychology, biology, mathematics and computer science all at the same time.

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The first year of my PhD has passed now.  I am sure that many other PhD students would agree with this statement: time flies by so fast. The past year has been a small success for me as I got to experience the thrill of data collection in living human beings and I presented a poster at my first conference. I often ruminate about what I could have done better or about slow progress, but I force myself to ban those thoughts and be content. I learned a lot and developed quite some skills, and that is all that really matters in the end. In addition, I am trying this mantra ‘I did my best and that is good enough’.

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One personal tendency that helped me in the past year is systematic organization. My need for agenda’s, planning and to do lists is never satisfied. Notebooks and cute folders clutter my desk. I note everything down and I date every note. Paper beats not only rock but also technology. A fountain pen and a blank page do the trick infinitely better than an empty word document in my world. When it comes to creative experimental design or writing that is, of course. I could not miss my computer when it comes to data analysis.

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But hej, I am for sure not the archetype boring office mouse. Next to my OCD-like organization attempts, I also enjoy socializing with my colleagues. I feel blessed to have a few of my former classmates as colleagues because it made the transition from student to PhD-er so much easier.

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I have always been a talkative person over a good coffee. Time spent enjoying lunch or coffee with my colleagues is an energy boost for me. Also it is time spent exchanging ideas, supporting each other and having a good laugh.

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In conclusion, the past few years here in Maastricht have been wonderful, a challenging but also quite a rewarding adventure. I am looking forward to the next few years of my PhD …..

Laurien

When we went to EcoLinea to choose the clothes for the shoot, we got this combination…. it felt like we were mirroring each other, myself as a graduated PhD and Laurien as a first year PhD who is really in her very first months of a hopefully not very long journey. I felt very inspired and wrote these verses that do not rhyme 🙂 but who cares, I just wanted to pass on a message. It is for you, Laurien! and all other starters in the PhD/Research world.

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Photo credit: Photostique, Peter Mullenberg

Models: Laurien and Researchista

Clothing: Ecolinea, Maastricht.

With love for Research,

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“Bonefun!

So, here we are sister,
Passing on the (PhD) flag with care,
In the little heaven of Maastrich.

Not much rhymes with what you are about to face.
And I do not mean to dramatize,
Neither to remind you of the sleepless nights,
But no matter how smart and strong you are,
Get ready to face it.
Hard work, discipline, dissapointment and again.

It might brake you down,
But you have passion and compassion to glue yourself back.
It might cover you in that extra layer of glorious pride,
But you have kindness to remind yourself of who you are.

It might take you down to unvisited inside depressive places,
It might take you up to ego heavens,
It might be the biggest dissapointment,
It might be the best thing you have done in your life,
It might be your worse decision.
One thing is certain, in time all struggles remain aloof,
The skills you will acquired, your hard work and the Dr. in front of your surname,
will undust your memory from time to time,
and will remain with you for(ever?) a long time.

It will stay part of you, Research & you.
Even if you change the colour of your hair,
The surname in your passport.

And one day,
When you are done,
The world is yours.
Till you become unemployed.

Ah, Maastricht, you keep on surprising us all,
You little bubble of heaven,
Placed at the river bench,
Embracing us at the Bonnenfanten wander place.

White verses,
Researchista’s muse”

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Business enthusiasm Researchista

(45) 1 year of Researchista: facts & feelings

2016: January Irina decides, it’s now or never ever ever will she take this courage to start her journey in entrepreneurship and makes visible to the public her Facebook page, called Researchistaraising immediately her deep concern about: “Does more knowledge create more happiness? Or rather, more unhappiness?To perceive (understand) is to suffer” said Aristotle. More you learn, more you understand that you need to learn more about it.. Socrates famous quote: “”I know that I know nothing”. So, does more knowledge create more unhappiness? At the same time, can more happiness create more knowledge?”

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Having recently graduated, all she wanted  was to help other PhD students by sharing her ideas, her stories or by inviting others to speak on her blog.

2016: 14 February The blog goes on-air! http://www.researchista.com is officially launched with its first post on.. Love during PhD.

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2016: March Researchista hosts her first Special Guest Dr. Jimmie Leppink, who writes for PhD students about: My first paper,  Tips on improving your writing, Writing and Research design, Guest writer preview.

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Dr. Jimmie Leppink, First Special Guest at Researchista

Twitter account – check.
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2016: April From her genuine concern about the health of PhD students, Researchista invites over the life Coach Danielle Branje, to discuss about anxiety in professional life (see: “Trust more, stress less“, “Prevention is the key“, “Tips to trick anxiety in your professional life”).

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Coach Danielle Branje, upcoming support to PhD students in 2017 on PhD Helpbox section

2016: May Researchista’s first media appearance in the Maastricht University newspaper, “The Observant”. And she wants to let the world know, Research does not exist only in the academia and it was not made only for PhD students to struggle!

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Photo by http://www.manorlux.com for the “Magic 3 and the Earth” story (types of Researchers)

2016: June Researchista participates at the TEDx Pitch Night event in Maastricht and here is what she said:

It is in this month that an entire month (during Mondays), our Special Guest Hasmik Matevosyan tells us based on her Research finding what’s happening in fashion industry.

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Special Guest, Hasmik Matevosyan

SoundCloud account – check.

2016: July When everyone went for holidays, Researchista picked a moment to hope that it will pass unnoticed, (but for some this became the only thing Researchista ever did?) and did her first Researchista-fashionista photoshoot. Her name has a fashionista touch, remember? 

It was the moment when many Researchers from my academic environment think I am doing it all wrong, the month of double-face self-palming from colleagues I know wondering to themselves of what I did I do. I wonder, is it because of this picture? 😀

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First Photostique photoshoot for Researchista fashionista

Ever since, I am asked if I am trying to sell Research with my body or if I am trying to become a modeler. It did not matter what I wrote in that post, because those who gave me such feedback clearly haven’t read it 😛 carefully. Research on FASHION is just one of the multiple topics Researchista will approach.. so get ready to not get bored 🙂

2016: August Our Special Guest tells PhD students and others alike what are the secrets of high performance, how to generate brilliant ideas and on public speaking.

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Paul Rulkens, http://www.agripacci.com

2016: 9th of September Researchista is launching her first product.

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http://www.facebook.com/playourtaxes A Board Game made out of Researchista’s PhD thesis.

It was a special experience!

2016: October is Research on FOOD month… and here a wild month unleashes, because the posts were so interesting and we’ve got a lot of feeback. It starts with the transition of a civilization  and vertical farming by Michelle Jongen from Botanica Innovare and continues with the first Special Guest from abroad, Dr. Beatrice D’Ippolito, York University

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Dr. Beatrice D’Ippolito, York University

Even more, together with my friend, Diana Z. from Busy Avocado, we embark in a little Research journey on our own, here is what my friend says about food labels.

This month, Dr.-to-become Carolin Hoffman is telling her story on 2nd Researchista fashionista shoot.

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Dr.-to-become Carolin Hoffman, Maastricht University

2016: November is the Research on BRAIN month, hosting a series of very nice Guests from Maastricht University and abroad. We start with Dr. Joao Correia on brain & language, we continue with Dr. Gojko Žarić on brain & reading and almost ends with the post on brain & hearing problems from Laurien.

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Dr. Joao Correia, Maastricht University

2016: December As an extention to Research on BRAIN month, Researchista pays a particular attention to a less researched topic, called “MISOPHONIA“, suggested by Dr. Mercede Erfanian, Amsterdam. This month we host our first guest from the USA, Dr. Jennifer Jo Brout!

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Dr. Jennifer Jo Brout

Also, Researchista was nominated in the Business Development and Knowledge Transfer  contest, event organized by the School of Business and Economics at the University of Maastricht. Thank you!

Indubitably, the year had to end with one more Researchista-fashionista photoshoot! This is the story of Laurien, upcoming on first Monday of 2017. Subscribe to the blog 😉

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I learned this year that marketing speaks in mysterious ways, 2016 was the year of social media and marketing exercises.

Have a happy 2017! Everything will be ok…

With love for Research,

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Fashion Fashionista Photoshoot research Researcher Researchista

fashionista# 2: Maasboulevard.

This photoshoot is part of Researchista_fashionista story. The location of our second photoshoot is one of the main streets in Maastricht: Maasboulevard. It is main because it runs through the junction between Stationstraat, a street that takes you from the train station directly to the city centre… and with thee mmm, street itself. Basically, it’s at the cross-road of things. And also! not least important, it flows next to the river bank of the Maas. This is where you can have a promenade and buy a ticket for a boat ride to Belgium..voila! or should I better say, gezellig!

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Say hello to Carolin!

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Hello, Carolin!14470692_10153785434906846_1458698556_n

This story is about how the body’s immune system could attack the brain in a way that leads to a “wrong” diagnosis of psychotic disorders such as schizophrenia or bipolar disorder. Let’s start at the beginning:

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A self-destructing body

Put simply, autoimmunity is when your body’s immune system attacks your own body. The ‘normal’ healthy function of the immune system is, of course, to recognise and “clean up” foreign structures that do not belong to the inside of the body, such as microbes. The system consists of several components, including white blood cells, some of which are specialised cells (B-cells). These cells produce antibodies that are responsible for recognising the foreign invader – the antigen. Those antibodies can be imagined as red flags with two arms holding on to the antigen and signaling the rest of the crew that what they have found here has to be cleaned up. Unfortunately, it is not uncommon for those antibodies to make a mistake and hold on to something that is actually a (healthy) part of the body. This leads to an immunity attack, possibly inflammation, without any foreign aggressor. This can happen in any part of the body, leading to many different complications. You may have heard of rheumatoid arthritis, a disease where the immune system attacks proteins in the joint. This is caused by such a ‘mistake’, and it leads to the destruction and inflammation of insulin dependent diabetes (Type 1 Diabetes), where the insulin producing beta-cells in the pancreas are destroyed by an autoimmune attack.

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The brain on fire

For me, the most fascinating cases are when auto-antibodies are targeting the brain. In particular, I am interested in those autoimmune reactions which lead to psychiatric symptoms. The connection might not be very obvious, but I am studying the role of autoimmunity in psychotic disorders (e.g. schizophrenia or bipolar disorder) and also the pathologic mechanism of the so-called autoimmune encephalitis (brain inflammation).

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 A different view on psychotic disorders

Perhaps I should mention that I am coming from a biomedical background, so I have a “special” approach to psychiatric/mental disorders. To me, everything in the body has a biological explanation and what is projected externally (behaviour, personality, indicators of mental state, etc.) has an internal origin in the organs, in this case the brain. I am aware that not everyone might agree with this theory, but the study of the mind (psychology and psychiatry) and the brain/nervous system (neurology) is definitely starting to fuse, and diseases are starting to be called “neuropsychiatric”. In the future, I think that all mental diseases will be explained by neuronal changes and the discipline of (neuro-)psychiatry will be a subspecialty of neurology. This will, therefore, also include psychotic disorders such as schizophrenia and bipolar disorder. Currently, we know very little about the underlying mechanisms of these diseases or, shall I say, “disorders”, “syndromes” or “collection of patients with similar symptoms”. Likely, these cohorts of patients do not all suffer from the same disease. Instead, there are different groups of patients with a different set of genetic and environmental factors leading to neuronal changes via different ways. One mechanism, in a subset of these patients, could be an autoimmune disease, for example.

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Latest research on immune factors in psychotic disorders 

This hypothesis of an autoimmune cause in psychosis is not as absurd as it may first seem. It is well accepted that a unsregulated immune system and genes, important for immune regulation, are linked to developing psychotic disorders. A big game-changer was the discovery, within the last 10 years, of several autoimmune diseases, which target neurotransmitter receptors and ion-channels, crucial for functioning and communication of cells in the brain (neurons). This autoimmune inflammation of the brain also leads to symptoms that look very similar to schizophrenia, but commonly co-occur with “neurological” symptoms, such as movement disorders, epileptic seizures, and loss of consciousness. Interestingly, some research groups are starting to find auto-antibodies in blood and cerebrospinal fluid (the liquid around the brain) that potentially bind the brain. My research builds on these findings. Via a  collaboration with many different hospitals all over Europe, I received a large cohort of blood/serum samples from psychotic patients (around 600 samples) and healthy controls (250 samples). These large samples provided me the opportunity to test for the presence of auto-antibodies that attack the brain. It seems that these auto-antibodies are more common in diseased individuals than in the  controls. However, these results are preliminary and I don’t want to give away too much at this point …

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Finding signs of inflammation in brains of schizophrenic patients

Another study, that I started recently, may further help us understand the link between autoimmunity and psychotic disorders, this time using brain tissue from post-mortem schizophrenia patients. In this project, we are using methods to ‘colour’ certain cells or structures in the brain. We expect to find markers that point towards a presence of the immune system, such as immune cells and antibodies, and to make a distinction between brains of healthy individuals and individuals with psychotic disorders. Overall, we hope to find ways to identify those patients that might be “misdiagnosed” with a psychotic disorder and be able to treat the biological cause of their disease.

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 Treating the cause and not the symptoms

Why we think this is important? Well, it might make a big difference for the patients because they could get a very different treatment. For autoimmune disorders, there are already several possible treatments out there which might also be successful in “autoimmune psychosis”. So, I hope that one day the diagnosis of schizophrenia & co. will be altered, and instead, we can use a diagnosis of diseases so that we can treat the cause and maybe even cure it (let’s dream big)!

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So, after the Researchista part, here’s another note on the Fashionista:

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If I was at risk for any addiction, it would probably be shopping. I can spend the whole day checking clothes and at times buying many more things than my closet can handle.

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This year, I made the resolution to buy less and focus on sustainable, high quality materials. I am making an effort, but there is definitely room for improvement…

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photostique-04976I also like sewing my own clothes or recycling old things. For example, the dress I am wearing in the photo-shoot I created from a cotton fabric that my mother brought me from a holiday in Malaysia. Unfortunately, I usually don’t have the time to sew my own clothes… However, in the end, these unique pieces are always worth the effort.

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by Carolin Hoffman, PhD student at Department of Neuroscience, School for Mental Health and Neuroscience (FHML), Maastricht University,  Early-Experienced Researcher.

This street was inviting and a good place for exploration and reflection along the river. Here is a little poetic touch out of this reflection on Research developments on body’s immune system on Maasboulevard.

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Who is next to share a story on Researchista fashionista? 😉

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With love for Research,

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Jumping pose, Researcher style

Photo credits: PhotostiquePeter Mullenberg (A beautiful vespa scooter was provided with the courtesy of Photostique, bedankt!). Editing Credits: Rose Education Consultancy, Claire Willis. Outfits: happy people in a self-made dress by Carolin and Vanilia dress on Researchista.

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fashionista #1. Lage Barakken.

This photoshoot is part of Researchista_fashionista story.

# 1: Lage Barakken street.

p.s. Before anything, this is not how Researchers dress for work. I do not want to make Research sexy, neither do I want to promote a distorted image of people doing Research. I just want to make sure to remind that Researchers are creative people 🙂 About the Research story of Researchista you will hear in that last photo-shoot of this project, till then… get to know my other peers and their Research quests and findings.

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This is Maastricht (by summer) Wyck district, Lage Barakken street, which in English translates as “low barracks“. Here is what the “Dutch Review” says about it. photostique-05556.png

So, here I was out of my place, walking through one of the shortest streets in Maastricht, Lage Barakken, in search for some history… to find it right at the corner. Few minutes away from the train station, hundreds of people pass daily by this exquisite hotel behind my back, disguised in a white fortress.

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It’s facade is still echoing the “Belle Epoque“…

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Source: Facebook page of Hotel Beaumont

… can you hear the music?

Every day, people enjoy peacefully their meal at these wide opened windows, while observing the passers by or gather loudly in group meetings in conference rooms. Buses and taxes are crowding in at the main entrance when things are happening in Maastricht.

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Wearing: Louboutin, classic black… the most sexy shoes in the world.

It is a family business that started in 1912 and is currently carried out by the 4th generation of family, a very creative family probably :).   I could not not share with you this Christmas wish, how great to preserve the sense of humour at all times :).

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“Turn that frown, upside down” (Facebook page of “Hotel Beaumont”).

It probably hosted many notorious people that visit Maastricht with various occasions until now. The polite waiters and room organizers take a break to inhale some fresh air or fresh cigarette on the Lage Barakken side to restart their work briefly after, and this what others were doing for years and years since 1912.

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Ten years after, at its opposite corner, which at the moment happened to be a shoe shop (really nice one), one of the first cinemas in Maastricht, Cinema “Palace” opened.

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cinematreasures.org

I only know from two friends of mine who went there when they were small that the cinema was very big at that time. photostique-05620.pngphotostique-05628.png

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At the moment, Maastricht is having almost 4 cinema houses.

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That was a little tour for you on the short street of Lage Barakken. Well, I also missed on telling you that this street is cut in half by the Stationstraat, that as the name suggest, it is the street of the station (main train&bus station) that leads you directly into the city center. I missed on capturing it’s clock in the middle, it’s postal office where cheerful people work, the bar opposite to the old cinema and the new student building arising that will probably bring even more dynamics to the area.

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Now that we are done with the tour of the street, and since we are on the street where I live, I would like to invite you at the terrace of the building house where I reside, for a final little chat. Wearing these Sergio Rossi shoes, it all feels a bit different 😀

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Wearing: Stijl Fashion Group (Danish designers),  Shoes: Sergio Rossi from Kymyka, Maastricht

Ok, I have to admit that the most difficult thing for me since I launched Researchista is to keep my excitement down!!! 🙂 I have met so many interesting people and did things that I have never done before, that sometimes it makes it difficult for me to stay calm.

I am a Researcher, but above all, I am a woman, who feels comfortable in her own element. I am a feminist since I was in my first university year in an environment where feminism is still a very fearful word. In some villages of my home country the expression “an unbeaten wife is like an uncleaned house” still holds, if you know what I mean. With these pictures, I do not aim to promote beauty through expensive shoes, although, I have to admit these are the most fancy shoes I probably ever wore. I do not aim to objectify the image of women or promote a false image of the Research community.

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Shoes & bag: Louboutin PINK from Kymyka, Maastricht

I simply do not need excuses to wear red lipstick or enjoy a beautiful dress with a pair of high heels. It is a choice. It is my self-expression.

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Louboutin pink purse and heels from Kymyka Shoes and Bags, Maastricht

This week, we are opening up an important topic and that is Fashion in Research. It must be difficult to avoid buying clothes from big chain brands (e.g. H&M, Zara), this became so habitual, but at the same time, we are also in charge for nurturing the dangerous treatment of workers in clothing industry and there must be an alternative! See what is the solution proposed by our Special Guest, Hasmik Matevosyan, a specialist in this area. By the way, the shoes and the bag I wear here are not part of retail fashion industry.

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Call: Are you a Researcher? Do you live in Maastricht? If you want to join me next time, leave me your letter at researchista@researchista.com. Let’s expand the horizons together! 🙂

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With my partners in crime:

Photographer, Peter Mullenberg from Photostique.

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Ms. Ecaterina Onica, usually an interior designer, but this time, my make-up artist.

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And since it’s fashion month, and you got to have a statement bag or a pair of earrings-statement, I picked a statement pose instead. Now waiting for my invitation to the Vogue Netherlands 🙂 and I am not joking 🙂

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Photography by: Photostique. All the pictures here were painted by the master in picturing, Mr. Peter Mullenberg. Thank you!*****

Credits: I would like to personally thank very much Nadja van der Borgh from Kymyka Shoes and Bags, who is the official distributor Louboutin unforgettable shoes that I am wearing. Also, to thank Sanne Pieters and Bart Kramp from Stijl Fashion Group, who are in charge of these wonderful outwears from Danish designers.

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(44) Research on BRAIN (extended): Misophonia

The quest into the unknown land of ‘misophonia’ continues. It is not included in any diagnostic manuals, it is not widely acknowledged by the medical community. Yet people who suffer from misophonia exist and here is what they are confronted with, in the words of Dr. Jennifer Jo Brout, the founder of International Misophonia Research Network, a New York State Certified School Psychologist, a Connecticut Professional Licensed Counselor, with a Doctorate in School/Clinical-Child Psychology, based here in the Connecticut, the United States of America.

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Dr. Jennifer Jo Brout, International Misophonia Research Network.

Differentiating Disorders: Misophonia and Sensory Over-Responsivity

As all researchers know, almost comically, well, uncovering new scientific knowledge is no easy task. Whether you are engaged in investigating a well-trod topic, or, like me, you are forging relatively new territory, there are often not simple solutions to the complex problems we encounter. Perhaps you have recently read about the disorder I study and advocate for, misophonia, on this blog. Misophonia is a neurologically based disorder in which auditory, and sometimes visual, stimuli are misinterpreted within the central nervous system, leading sufferers to have unpleasant reactions to sounds others would consider barely noticeable.

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Source: internet.

When misophonia sufferers are exposed to particular “trigger sounds,” the fight/flight response is set off within the body. For these individuals, hearing a noxious noise can feel akin to being confronted with a wild animal, as their hearts race and muscles tense.

Because misophonia (does not appear in diagnostic manuals, such as DSM-5 or ICD-10) is only recently gaining wider recognition in the public and scientific communities, studying this disorder presents a unique set of challenges. 

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Though there is a scant amount of research on misophonia at this point, fortunately, there is a large body of research that has been developed over the past 15 years on a similar disorder, Sensory Over-Responsivity (a subtype of Sensory Processing Disorder). Individuals suffering from Sensory Over-Responsivity react to all types of sensory information as thought it were dangerous, and their fight/flight systems can be activated by seemingly inoffensive sights, smells, tastes, touches, or sounds. In both, misophonia and Sensory Over-Responsivity, certain sounds can leave sufferers feeling angry, fearful, disgusted, and “out of control.”

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Source: Internet.

Though it may seem natural that the research on Sensory Over-Responsivity be used to inform our understanding of misophonia, this has, largely, not taken place. We may ask ourselves, why are these two highly similar disorders rarely compared in misophonia academic articles, or articles in the popular press? My answer to this question is an unfortunate one: for the most part, researchers are not used to working within a cross-disciplinary model.

While psychology researchers, audiology researchers, and occupational therapy researchers may be competent and successful within their own fields, they are often not accustomed to reaching beyond them to integrate other types of research into their own work. There is a long pragmatic and political history behind the lack of cross-disciplinary research work that is not necessarily the fault of academic researchers or clinicians. However, in the “age of information” that we are living in, sharing valuable knowledge between researchers from different disciplines should now be as quick and easy as doing a google search, and as common. As it is, this lack of information sharing trickles down to the public, and often leads Misophonia and Sensory Over-Responsivity sufferers to find inaccurate information about their own conditions.

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Unfortunately, another important problem facing both misophonia and Sensory Over-Responsivity is that neither disorder has been accepted into the diagnostic manuals (DSM-5 or the ICD-10). It is difficult to understand the logic behind this fact, as studies have estimated that up to 20% of children are affected by sensory-based disorders. Likewise, tens of thousands of people have gathered on social media platforms to form support groups for misophonia, helping one another fill the gaps left by a large portion of the mental health community. There is a long political history involving how a disorder gains entry into diagnostic manuals, and though the National Institute of Health has taken steps recently to try to change this process, this change comes long after the damage has been done. Therefore, what we are left with is two disorders that “don’t exist,” that are not reimbursable by insurance, and for which research funding is extraordinarily difficult to come by.

Sensory Over- Responsivity and Misophonia share more than symptoms. They share neglect from the medical and psychiatric communities, which has resulted in the dissemination of more than enough inaccurate and confusing information to do damage to sufferers lives. My hope is that going forward, receptive practitioners and researchers from all facets of the healthcare community can work cooperatively to study and treat these disorders, discovering important knowledge and improving sufferers’ quality of life.

This post is written by Dr. Jennifer Jo Brout  (who is also the mother of adult triplets, and is a Misophonia sufferer herself) and Miss Madeline Appelbaum, a recent alumna of Reed College (Oregon, USA), with a particular interest in educational psychology. Madeline wrote an undergraduate thesis on the effects of autonomous and controlled motivation to learn on college students.

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Madeline Appelbaum, Intern at International Misophonia Research Network

International Misophonia Research Network (Amsterdam)

With love for Research,

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(43) Research on Brain (extension): Misophonia.

Hatred of sound: Misophonia.

Have you ever thought that hearing other people’s chewing can be disturbing to the level of a disease? … When I learned from Mercede that there are barely 40 scientific articles published on misophonia the world (her opinion) on this topic, I thought, this simply can not be. How is it possible that in all this detailed investigation of human body to which research progressed until now, only few studies have been made? This is Research on Brain (and its related parts) month on Researchista. Let’s get to learn about something one day, one of us or someone we know could experience. At least we will know what’s it called.

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Dr. Mercede Erfanian.

Misophonia is a relatively new neurobehavioral syndrome or disease. It is characterized by high hearing sensitivity that research shows it can result from exposure to specific sounds like gum chewing, lip smacking, crunching, etc.

Originally, it was described by Pawel and Margarette Jastreboff (2001) . They say that individuals with misophonia show increased physical excitement like sweating, heart racing, high body temprature, which are along with emotional distress. It seems majority of these sounds are repetitive and pattern-based, irrespective of sound strength (decibel level).

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Misophonia. Source: internet.

The potential triggers that can cause misophonia can be:other people’s chewing, throat clearing, slurping, finger tapping, foot shuffling, keyboard tapping, and pen clicking. These sound triggers vary across individuals, and suggesting that learning history, individual differences, and context may play a role in aversive responding.

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Source: internet.

When facing with misophonic triggers individuals also show behavioral responses that often include anger (ranging from irritation to rage), anxiety, and disgust, avoidance, and escape behavior. (called “misophonic responses”).

It is important to know that some individuals can have impairments in daily functioning (e.g., occupationally, interpersonally, academically) and the can develop other behavioral health problems due to misophonia. A group of investigated individuals that have misophonia have developed ways to cope with it, but still report that the condition is very difficult to manage and negatively affects various aspects of their lives.

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Misophonia has not been formally recognized (yet?) as a specific type of neurological, audiological, or psychiatric disorder. However, it has shown high co-occurring appearances? with-non-psychiatric and psychiatric disorders (e.g., tinnitus, hyperacusis, migraine headaches, autism spectrum disorder, posttraumatic stress disorder, borderline personality disorder, and obsessive compulsive disorder).

 

Here at .. Amsterdam… we would like to raise awareness and lead more research in this area. Although, the Netherlands has been very active, the country where this topic has been discussed much more widely than in other parts of the world, we realise that not many know about and would like to carry more research in this area. If it happens that you know neuroscientists or .. or simply wish to learn more about and support our raising awareness campaign, do that here (link gogo)

To be continued…

Post written by Mercede Erfanian, Research Fellow

International Misophonia Research Network (Amsterdam).

 

 

With love for Research,

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(42) Research on BRAIN: do-your-own-little Research.

This post of Researchista’s fantastic experience of using Research to learn Dutch faster has been erased by mistake and it awaits one day for it to be reproduced.

It was one very good of a post…

Until the inspiration comes again!

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With love for Research,

R.

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(41) Research on brain: hearing.

And here is Laurien back again with a crash intro on what is happening in our brain when we hear something! Did you hear that? 😉

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PhD Laurien Nagels-Coune

A ringing in your ear?

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Source: http://well.blogs.nytimes.com/2012/12/03/living-with-a-sound-you-can%E2%80%99t-turn-off/

The first post in this BRAIN research series was about language. Next to spoken words, there are plenty of other sounds in our daily life. They are the source of joy and comfort but what if a certain sound drives you mad? Tinnitus is the fancy term for ‘having a ringing in your ear’. It is in fact the perception of sound in absence of any actual sound.

Now, before I go on, I have to emphasize that I am no expert in this field. My PhD is focused on muscle-independent communication for locked-in patients. These are patients who lost most motor capacities and are in essence ‘locked-in’ their own bodies, yet let me tell you more about this another time 😉 . I am writing about tinnitus now because it is a scientific side project of mine and I will collaborate in a clinical investigation soon on it. As a clinician, I have always found it fascinating how such a seemingly insignificant disorder can drive one mad, but try to listen to a few of these 11 tinnitus sounds by the British tinnitus association. Personally, I can imagine going mad when being forced to listen to sound 8 or 11 for even a day.

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In April I went to a studium generale lecture here in Maastricht by Prof. dr. Robert Stokroos and Dr. Iris Nowak-Maes. Perhaps some of you were there as well? I remember that extra chairs were brought in to accommodate the immense turn-up that evening. Prof. dr. Stokroos confirmed the immense proportion of this seemingly insignificant disorder:

Source:http://www.geeksandbeats.com/wp-content/uploads/2014/04/shutterstock_24666676.jpg

About a million people in the Netherlands have to deal with tinnitus, about 60.000 of those are seriously hindered in their daily lives. Tinnitus costs around 2.3 percent of the yearly care budget.”

Ok, so now that we know what tinnitus is. We also know how severe its consequences are in our society. So let’s cut to the chase.

What causes tinnitus? The most common cause is exposure to noise, such as a noisy work environment. People that have been in warfare for example often develop tinnitus. What happens is that the cochlea, the ‘snail house’, of the ear gets damaged.

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Source: http://www.webmd.com/a-to-z-guides/inner-ear

Specifically, there are tiny hair cells in this snail house that get damaged. But where does neuroscience come in? Well in most cases, damage to these little hair cells causes hearing loss in a specific frequency range. This is because the hair cells are grouped per frequency. What is interesting now is that often the tinnitus frequency is exactly in this frequency range! So what might be happening? Animal models suggest that when the hair cells are damaged, there is differentiation of nerves going from the cochlea to the brain. Our auditory part of the brain starts to have increased spontaneous activity.  So what is a disease of the ear, soon becomes a disease of the brain.

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Image adopted from Adjamian, P., Sereda, M., & Hall, D. A. (2009). The mechanisms of tinnitus: perspectives from human functional neuroimaging. Hearing research, 253(1), 15-31.

What is often seen in animal models is that there is some reorganization of the auditory cortex (part C of the above figure). You can see that the top red regions stop responding to high frequencies but start reacting on lower frequencies that were close to them. You can see how damage to a specific part of the ear, can change the workings of the brain.

The above is just a common way of thinking about tinnitus. However, be careful dear readers, little is still known about this fascinating topic. One in four tinnitus patients do not have hearing loss namely and reorganization of the auditory cortex has not been confirmed as a cause of tinnitus in humans. However, motivated neuroscientists keep learning and understanding this disease better and better. Once the mechanisms are unraveled, the way is open to treatment and interventions. However, my take home message to those readers that haven’t developed tinnitus yet is: Protect your ears J As always, prevention is better than treatment!

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Source: http://www.oaklandaudiology.com/wp-content/uploads/2014/03/Pixmac000088050972.jpg

Tinnitus remains a hot topic in the field of neuroscience, we don’t understand it fully yet. There is still a lot more to discover about auditory perception. For example, another strange disorder that involves the hatred of certain specific sounds…   but our next guest will unravel the neural correlates of this phenomenon in next week’s post.

by Laurien Nagels-CounePhD student in Cognitive Neuroscience at FPN, Maastricht University

With love for Researchers,

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