Vodcast 2007 Show Notes
Episode #0006 — October 12, 2007 Welcome to i on NIH! In this months' episode, we have a special interview with an award-winning NIH scientist. We also have an in-depth report on deep brain stimulation as a treatment for Parkinson’s disease. And in our eye-to-eye interview we talk to a researcher from the National Institute of Mental Health about stress.
NARRATOR: FROM THE NATIONAL INSTITUTES OF HEALTH IN BETHESDA, MARYLAND – AMERICA’S PREMIERE MEDICAL RESEARCH AGENCY – THIS IS “I ON NIH”! COVERING HEALTH-RESEARCH TOPICS IMPORTANT TO YOU AND THE NATION, THIS PUBLIC SERVICE VODCAST IS YOUR INFORMATION SOURCE FROM INSIDE ALL 27 INSTITUTES AND CENTERS AT NIH. HALF AN HOUR, ONCE A MONTH, WE’LL SHOW YOU THE EXCITEMENT OF ADVANCES AND THE IMPORTANT INFORMATION THAT COMES FROM MEDICAL RESEARCH. AND NOW, HERE’S YOUR HOST, JOE BALINTFY. HOST: WELCOME TO ANOTHER EPISODE OF EYE ON NIH! NOW IN OUR SIXTH PRODUCTION, WE’LL BRING YOU A SPECIAL INTERVIEW WITH ONE OF OUR INSTITUTE DIRECTORS ABOUT HIS WINNING THE PRESTIGIOUS LASKER AWARD; ALSO, WE HAVE A FEATURE ON DEEP BRAIN STIMULATION AS A TREATMENT FOR PARKINSON’S DISEASE; AND THIS MONTH’S EYE-TO-EYE INTERVIEW TAKES A LOOK AT STRESS. BUT FIRST, HERE’S OUR MONTHLY NEWS UPDATEWITH HARRISON WEIN FROM THE NIH NEWS-DESK. HARRISON… HARRISON: THANKS, JOE. IN THIS EDITION, BIPOLAR DISORDER DIAGNOSES ON THE RISE, A GENE THAT MAY HELP YOU STAY LEAN, AND INSIGHT INTO ELEPHANTIASIS. *A NEW STUDY FOUND THAT DIAGNOSES OF BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS HAS INCREASED BY 40 TIMES OVER THE PAST DECADE. THE NUMBER OF DIAGNOSES IN ADULTS HAS ALMOST DOUBLED IN THE SAME TIME. RESEARCHERS FUNDED IN PART BY NIH FOUND THIS OUT BY ANALYZING DATA FROM DOCTORS AND THEIR OFFICE STAFF ABOUT PATIENT VISITS. THE FINDING SHOWS HOW WIDESPREAD THE DIAGNOSIS OF BIPOLAR DISORDER HAS BECOME, ATHOUGH NOT NECESSARILY HOW MANY PEOPLE TRULY HAVE IT. THE DIAGNOSIS OF BIPOLAR DISORDER IS COMPLICATED BECAUSE ITS SYMPTOMS OVERLAP WITH THOSE OF OTHER MENTAL DISORDERS. THE RESEARCHERS SAY THE RESULTS HIGHLIGHT THE IMPORTANCE OF DEVELOPING BETTER WAYS OF COLLECTING DATA ABOUT BIPOLAR DISORDER. THEY'LL NEED THIS TO ASSESS WHICH CHILDREN HAVE THE DISORDER AND HOW THEY RESPOND TO DIFFERENT TREATMENTS.* *WE COVER THESE AND OTHER NIH RESEARCH STUDIES IN "NIH RESEARCH MATTERS". GO TO WWW-DOT-NIH-DOT-GOV. LOOK FOR THE LINK ON THE RIGHT-HAND SIDE, UNDER "IN THE NEWS," THAT SAYS, "E-COLUMN: NIH RESEARCH MATTERS." * * AND IN THIS MONTH'S HEALTH NEWSLETTER, "NIH NEWS IN HEALTH"… * THIS IS HARRISON WEIN AT THE NIH SCIENCE DESK. * HOST: THANKS HARRISON. IN THIS FIRST SEGMENT OF EYE-ON-NIH, WE HAVE A VERY SPECIAL INTERVIEW. ONE OF OUR VERY OWN SCIENTISTS HAS BEEN AWARDED THE 2007 MARY WOODARD LASKER AWARD FOR PUBLIC SERVICE. DR. ANTHONY FAUCI, DIRECTOR OF THE NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES RECEIVED THE AWARD FOR HIS ROLE IN DEVELOPING TWO MAJOR U.S. PUBLIC HEALTH PROGRAMS, IN AIDS AND BIODEFENSE. TO CONDUCT THIS INTERVIEW, EYE-ON-NIH WAS DELIGHTED TO WORK WITH FORMER ABC NEWS MEDICAL CORRESPONDENT AND CURRENT COMMUNICATIONS DIRECTOR FOR THE NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES, GEORGE STRAIT. GEORGE STRAIT – “DR. FAUCI, FIRST OF ALL CONGRATULATIONS AND WELCOME TO EYE ON NIH.” DR. FAUCI: THANK YOU (NODS) GEORGE STRAIT – “DR. FAUCI WHAT DO YOU THINK THAT THE DECISION BY THE LASKAR FOUNDATION SAYS ABOUT YOUR ROLE AS DIRECTOR OF NIAID?” DR. FAUCI: WELL, ACCORDING TO… THEY RECOGNIZE THAT AS A SCIENTIST AND… ADMINISTRATION… ENTERED A REALM WHERE SCIENTISTS GENERALLY DON’T GO… THEY SPOKE ABOUT MY… ACOMPLISHMENTS… USING POSITION… HELP TO FORMULATE AND EXECUTE POLICIES THAT HAD A MAJOR IMPACT… BUT ALSO IN THE PROTECTION OF THE COUNTRY…THREAT OF BIOTERROR. GEORGE STRAIT – “I WONDER IF WHEN YOU FIRST CAME TO NIH, YOU THOUGHT YOU WOULD BE SUCH A PUBLIC, PUBLIC SERVANT.” DR. FAUCI: NO ACTUALLY THAT WAS THE FARTHEST FROM MY MIND. PEOPLE ASKED ME ABOUT, HOW DID YOU GET TO WHERE YOU ARE… IS THAT IT’S A COMBINATION OF THE TRAINING THAT YOU HAVE, THE POSITION THAT YOU’RE IN… CIRCUMSTANCES BEYOND YOUR CONTROL TEND TO DICTATE HOW YOU WILL UTILIZE THE POSITION THAT YOU HAVE. WHEN I STARTED IN THIS FIELD…WHEN I STARTED IN THIS FIELD… I ORIGINALLY CAME TO GET A LOOK AT WHAT THE SCIENCE WAS LIKE. DR. FAUCI: WHEN I FIRST DID THOSE FIRST COUPLE EXPERIMENTS… I NEVER IN MY WILDEST DREAMS IMAGINED I WOULD BE DOING THIS. GEORGE STRAIT: A LOT OF THE IMPACT OF POLICY, IS THROUGH COMMUNICATIONS. DR. FAUCI: RIGHT, VERY MUCH SO. GEORGE STRAIT: “BUT THIS VERY PUBLIC SORT OF SPOKESPERSON ROLE, IS IT VALUED AT INSTITUTIONS LIKE NIH?” DR. FAUCI: HISTORICALLY NO… I THINK THE NIH IN GENERAL IS DOING MUCH MUCH BETTER… THAT REQUIRES SUPPORT AND BY-IN OF LEADERS… YOU HAVE TO MAKE YOUR CASE PUBLICLY… SOMETHING DONE MUCH MORE AND MUCH MORE EFFECTIVELY. GEORGE STRAIT: “…WHAT DID YOU LEARN ABOUT COMMUNICATING… AS A RESULT OF HIV BEING THROWN IN THE MIDDLE OF YOUR LAP?” DR. FAUCI: WHAT BECAME CLEAR TO ME IS THAT WHEN YOU HAVE RESPONSIBILITY… YOU GOT TO GET TO 30-40 THOUSAND FEET… IDEAS OUT THERE THAT MAY NEED TO BE LISTENED TO, IF NOT FOLLOWED. DR. FAUCI: BECAUSE YOU’RE NOT USED TO DEVOTING YOUR LIFE TO HEALTH AND SAVING LIVES… THAT’S A VERY STARK CONTRAST, BUT IT’S AN EYE OPENER AND MADE ME MUCH BETTER AT WHAT I DO. GEORGE STRAIT: “DO YOU THINK THOSE EARLY EXPERIENCES HELPED… BIOTERROISM, ANTHRAX AND PANDEMIC FLU?” DR. FAUCI: WELL, IT PREPARED ME BECAUSE I HAD LEARNED VERY WELL OVER YEARS… ABOUT HOW, WHAT YOU TELL THE PUBLIC… HOW HONEST YOUR ARE, HOW THAT CAN ENORMOUSLY SWAY WHAT MILLIONS OF PEOPLE THINK… NOT BEING AFRAID TO SAY YOU DON’T KNOW WHAT’S GOING ON. GEORGE STRAIT – “DURING YOUR HISTORY HERE AT NIH… WHAT ARE SOME THINGS THAT HAVE GONE WELL, AND WHAT ARE SOME OF THE THINGS THAT HAVEN’T GONE AS WELL AS THEY MIGHT?” DR. FAUCI: WELL I THINK THAT EARLY ON WE THE GOVERNMENT CLEARLY COULD HAVE DONE BETTER IN THE HIV SAGA. AND I THINK THAT WAS PART THE FAULT OF SOCIETY… AND SOME POLITICAL… BAGGAGE… AND THE LACK OF INTEREST… TO STAND UP AND SAY, WE’RE ABOUT HEALTH… I THINK THE EARLY MONTHS TO A YEAR WE COULD HAVE DONE MUCH BETTER… I THINK WHAT WE DID WELL WAS THE ULTIMATE GETTING INVOLVED WITH THE ACTIVISTS… I THINK WE DID THE BIODEFENCE WELL… LET THE PEOPLE WHO WERE THE SCIENTISTS IN FRONT OF THE CAMERAS… BUT ONCE YOU GOT OVER THAT AND SENDING OUT THE PEOPLE, THAT WAS A GOOD THING, THAT WAS A GOOD THING. GEORGE STRAIT – “THANKS, AGAIN CONGRATULATIONS.” DR. FAUCI: THANK YOU, THANK YOU HOST: IN THIS NEXT FEATURE, WE’RE TAKING A CLOSE LOOK AT DEEP BRAIN STIMULATION – OR DBS. THIS TREATMENT IS VERY CLOSE TO HOME FOR ONE OF OUR COWORKERS, BILL SCHMALFELDT. BILL HAS PARKINSON’S DISEASE AND, EARLIER THIS YEAR, JOINED A CLINICAL TRIAL AT VANDERBILT UNIVERSITY MEDICAL CENTER IN NASHVILLE TO TEST HOW WELL DBS MAY WORK AS A TREATMENT FOR PATIENTS IN THE EARLIER STAGES OF THE DISEASE. BILL LET US TURN THE CAMERA ON HIM, ALONG WITH DR. JOSEPH PANCRAZIO, A RESEARCHER WITH THE NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE. WE STARTED BY DISCUSSING WHAT EXACTLY IS PARKINSON’S DISEASE … Dr. Pancrazio: It’s a disorder that starts… it belongs to a class of disorders that we would call, basically motor dysfunctions. And this is a disorder that affects a region of the brain called the basal ganglia. It’s a region that is, that has a lot to do with control of movement. Dr. Pancrazio: Several years ago the option was to remove the section of the brain that was responsible for the aberrant activity. So we’re talking about rather severe and irreversible, these are irreversible procedures, called… where regions were removed. And the other options involved medical treatments… Now the option here with deep brain stimulation is really exciting to us because now we’re talking about not just treating cells and molecules, we’re talking about treating actual networks of activity. Where talking about treating the aberrant of conduction of activity in the brain to relieve the symptoms. V/O: Often promoting the importance of medical research through the NIH Radio News Service and NIH Research Radio Podcast, Bill made the decision to volunteer for a clinical trial, and was selected for the surgical treatment: DBS, which is major brain surgery. Bill: The surgery is done into 3 separate phases. I went down on June 5th and had these little, if you can see them here, these little gold portions of the screws implanted into my scalp. These little 4 things here and I included a picture I guess you can look at those. And then they did the MRI’s and the CAT scans so they could use that for the plotting of the approaches they’re going to take for actual surgical procedure. Bill: This is the platform that they used to hold the drivers for the probes that move a micro millimeter at a time into the parts that they want to test and then stimulate. I think I’ve included the picture that I’ve called “Bill Schmalfeldt in the Matrix.” It just looks like the scene from the Matrix where Neo is hooked in… So it increases the comfort level of the surgery. It decreases the time actually spent on the table, and then for the third phase you go in, in my case, it was almost three weeks later, to have the neurostimulator put in. V/O: Bill and Dr. Pancrazio explain that phase two is by far the most technically challenging. Dr. Pancrazio: Well it is basically like taking, imagine taking a car antenna and trying to shove it into a pea. [Bill: through a melon.] So you got a large sphere… and trying to target that extremely small location. So having very precise alignment features that are available in these kinds of stereotactic frames; doing all that terrific imaging work because none of this would work unless we knew where in the brain to actually go after. It’s been enabled by studies, pet studies… MRI studies… So all this imaging data and imaging technology has been absolutely critical in the development and implementation of deep brain stimulation. Bill: This is the frame they used on me. You’ve seen pictures of those huge stereo type tactic frames that actually have to bolt your head into place and leave you actually clamped to the table now at Vanderbilt they’ve pioneered the use of this thing. It’s individually made for the patient. Dr. Pancrazio: So the progression towards these kinds of frameless surgeries is something that’s going to make the entire process far less painful. Bill: The worst thing about the whole surgery was having the injection of the skin numbing medication. The doctor… said this is going to feel like giant hornets stinging and he was not far off. Other than that, because the brain is insensate, mine more so than others, it was really not that much pain or discomfort involved. V/O: Joking and modesty aside, signing up for a clinical trial and basically volunteering for brain surgery, is commendable, says Dr. Pancrazio… Dr. Pancrazio: I think that one of the common features for many of the patients, who are participating in clinical trials like this as well as undertaking DBS as an option, is they’re still pioneers. This is an area and this is something that we spoke about a little while ago, this isn’t a pill you’re taking necessarily. This is a commitment in a sense to have something implanted within your brain and to receive electrical stimulation as a means to deliver therapeutics. Now the good news is it’s very targeted. You know this is a very small, relatively small, very busy… if you don’t get the stimulation right. But it really is something that’s very new, it’s something that, you know, our society has a lot of questions about. What does it mean for us and it’s something that I think that every patient who’s participating in a trail is a pioneer. V/O: Bill keeps perspective on this treatment… Bill: (And) the nice thing about it is if they find the cure for Parkinson tomorrow out comes the wires apply the cure… absolutely reversible. Dr. Pancrazio: And that’s a common feature of many of our neurointerfaces or the technologies that we’re using to treat disease is that many of them can be replaced or removed immediately if the cure becomes available to a patient. HOST: For more information on Deep Brain Stimulation, visit www.ninds.nih.gov. And for information on clinical trials, visit www.clinicaltrials.gov. And be sure to turn into Bill’s NIH Research Radio podcasts at www.nih.gov/news. HOST: IN THIS MONTH’S EYE-TO-EYE INTERVIEW, WE TALKED WITH DR. ESTHER STERNBERG FROM THE NIH’S NATIONAL INSTITUTE OF MENTAL HEALTH. IN THIS CANDID CONVERSATION, WE LEARN WHAT STRESS IS, HOW WE CAN MINIMIZE IT, AND WHAT RESEARCH IS REVEALING. WE STARTED BY ASKING, WHO IS AFFECTED BY STRESS? Dr. Sternberg: STRESS AFFECTS EVERYBODY. AND IT HAS FOR AS LONG AS HISTORY CAN REMEMBER… HOWEVER STRESS AS WE KNOW IT, WAS DEFINED ABOUT 50-60 YEARS AGO… A BAD THING HAPPENS TO YOU… STRESS RESPONSE… YOU CAN DO SOME THINGS ABOUT IT. V/O: HOW DOES STRESS WORK? Dr. Sternberg: JUST IMAGINE THAT YOU’RE WAKING UP IN THE MORNING WITH AN EMPTY SAC… AS THE DAY GOES ON IT GETS HEAVIER AND HEAVIER… A SINGLE STRESSOR ISN’T LIKELY TO MAKE YOU SICK… IF YOU HAVE ONE AFTER ANOTHER AND DON’T HAVE TIME TO RELAX… THE REASON IS… ONE OF THE MOST POTENT ANTI-INFLAMMATORY HORMONES OUR BODY MAKES. V/O: DO YOU HAVE ANY TIPS to prevent or at least minimize the effects of stress? Dr. Sternberg: GET AS MUCH SLEEP AS YOU NEED… YOU NEED TO GO OFF LINE… WHATEVER IT IS TO GET AWAY FROM THOSE THINGS THAT YOU FIND STRESSFUL. V/O: WHAT IS RESEARCH TEACHING US ABOUT STRESS? Dr. Sternberg: YOU KNOW, FOR A LONG TIME WHEN WE THINK ABOUT ULCERS… THEN WHEN… BUT THE FACT IS THAT NOT EVERYBODY… TURNS OUT STRESS IS A COMPONENT… SO THERE ARE THESE KINDS OF DISCOVERIES… EXPLAIN A LOT ABOUT WHAT WE DIDN’T UNDERSTAND… THE PUBLIC HAS ALWAYS KNOWN: STRESS CAN MAKE YOU SICK. V/O: HAS RESEARCH SHOWN STRESS-FACTORS RELATED TO SPECIFIC ILLNESSES? Dr. Sternberg: STRESS FACTORS… CAN ACTUALLY CAUSE GROWTH OF OVARIAN CANCERS. SO IT’S NOT THAT THE STRESS CAUSES THE CANCER… BUT THE STRESS COULD MAKE IT WORSE… SO WE’RE BEGINNING TO UNDERSTAND… HOW THINGS LIKE EMOTIONS… CAN BE TRANSDUCED THROUGH THESE NERVE CHEMICALS… ON CANCER GROWTH, ULCERS… ALL SORTS OF DISEASES. THAT REALLY MAKES IT IMPORTANT… ENTIRE CONTEXT OF WORLD… AND BRING THEM BACK TO WELLNESS. Dr. Sternberg: THERE’S ANOTHER INTERESTING AND EXCITING AREA OF RESEARCH… DRUG THERAPY. WE KNOW… WHAT MAKES THE ADRENAL GLANDS PUMP OUT CORTISONE… DEVELOPING DRUGS TO BLOCK THAT HORMONE… THIS IS THE NEXT FRONTIER FOR TREATING PTSD… DEPRESSION. …IN CLINICAL TRIALS. THEY’RE PRE-CLINICAL RIGHT NOW… STRESS DISORDERS BUT DEPRESSION. V/O: FOR MORE INFORMATION from the National Institute of Mental Health, visit www.nimh.nih.gov HOST: THANKS FOR JOINING US FOR THIS EPISODE OF EYE ON NIH. BE SURE TO TUNE IN AGAIN NEXT MONTH. WE’RE WORKING ON STORIES ABOUT DIABETES, CHRONIC OBSTRUCTIVE PULMONARY DISORDER AND MUCH MORE. SEE YOU NEXT TIME. FOR EYE ON NIH, I’M JOE BALINTFY.  NIH Vodcast Questions? |
