Sleep expert shares his secrets for easing into the upcoming time change

The end of daylight saving time is soon approaching, and while most of us look forward to that “extra” hour of sleep, there are a few things to think about when society’s clock changes, but our biological clock doesn’t.Autumn leafs and alarm clock on wooden table.

With the time change, our streets and roads become darker closer to rush hour. This poses increased danger for drivers, bicyclists and pedestrians alike.

Studies have shown increased accidents due to poor visibility and possibly because of increased drowsiness in darker environments.

Here are some tips to help you get through the upcoming time change.

1. Preparation

Generally speaking, it is easier for us to adapt to the fall time change because it is easier to stay up later than to sleep earlier. However, there are those that do have difficulty staying up later than their usual time, and if time allows, they should try to do so as the days approach the end of daylight saving time. The principle is to keep roughly the same schedule you normally did before the time change.

2. Get a good night’s sleep

Sometimes people try to “take advantage” of the extra hour by staying up late and partaking in things that are known to disrupt sleep further such as alcohol and caffeine close to bedtime.

3. Use light to your advantage

The strongest determinant of your biological clock (or your “circadian rhythm”) is light. The fall time change heralds shorter and darker days. For some, this can lead to disrupted sleep schedules and even depression. If there is natural sunlight, this can be helpful to combat these problems. In the absence of natural light, light box therapy has been used to both adjust people’s biological clocks and to combat seasonal affective disorder, which is a type of depression associated with darker days.

4. Remember safety

Remember that time changes are associated with increased automobile, bicycle and pedestrian accidents. Be careful out there. Also use this time to remind you to make your home safer. Check your batteries on your smoke and carbon monoxide detectors. Check the supplies of any emergency preparedness kits you may have, especially ones for the winter. See that your fire extinguishers are up to date.

What are your strategies for dealing with the time change? Share them in the comments!

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allada_gopal

Gopal Allada, M.D. is a Clinical Associate Professor of Medicine who specializes in Critical Care, Sleep Medicine, Cystic Fibrosis and Pulmonary Medicine.

Five things you should know when caring for a loved one with dementia

Caregiving for a loved one with dementia can be challenging to your family dynamics, your finances, and more. But did you know, it can also be hard on your emotional and physical health?

Research shows that caregivers for persons with dementia are more vulnerable to health problems such as hypertension, diabetes, depression, anxiety and insomnia.

It is important that caregivers take care of themselves as well as their care-recipients.

1. Find, and attend, a support group.

It takes effort to find, and actually attend, a support group, but the effort is worth it. Support groups offer information, guidance, and well, support. It is important to be around others who understand what you are going through.

The Alzheimer’s Association has a variety of support groups across Oregon that serves caregivers and their care-recipients.

Know that the Alzheimer’s Association serves everyone with memory loss, not just Alzheimer’s.

2. Call your county’s Family Caregiver Support program.

The Multnomah County program provides a wealth of information and can connect you to a variety of helpful services. They may even be able to pay for assistance for you- such as a massage, a care provider to give you a break, a gym pass, etc.

This program is free to all and helps people from all walks of life.

3. Find activities outside the home for your family member with dementia.

This will give your family member a chance to get out of the house and give both of you a break. Both the Family Support Program and the Alzheimer’s Association can help you find classes or adult day programs for persons with dementia.

4. Exercise!

Exercise will help your mood and stress levels and protect your body over the years. A good exercise program will also help you sleep better at night.   Find an activity that you enjoy and make sure it gets your heart rate up. A good starting point is to walk with hand weights. Even better–attend an exercise class at a local community center.

5. Ask for help.

What if you can’t do any of the above? Some caregivers are so busy they have little time for self-care.

I recommend picking up the phone and calling either the Family Caregiver Support Program at 503-988-3646 or the Alzheimer’s Association at 1-800-272-3900.

Tell them, “I am a caregiver, I need support, but I don’t know how to do this.”

They will take it from there—and you’ll be glad you called.

The main message I want to convey is to reach out to others for support—even if you think you don’t need it.

You don’t have to walk this road alone—there are people standing by who can, and want, to help!

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Lindauer

 

Allison Lindauer, N.P., Ph.D. is an Assistant Professor at The Layton Aging and Alzheimer’s Disease Center.

Early diagnosis of Alzheimer’s disease is key goal for OHSU researchers

Alzheimer’s disease is the most common form of dementia and is the sixth leading cause of death in the United States.

Symptoms include memory loss, personality changes and trouble thinking, and the disease typically worsens over time.

Julie Saugstad, Ph.D. and Joseph Quinn, M.D.

Julie Saugstad, Ph.D. and Joseph Quinn, M.D.

Current treatments cannot stop the disease from progressing, but they can slow the development of symptoms temporarily.

Clinical diagnosis is determined by noting the degree of a patient’s mental decline, which is not obvious until there is severe and permanent brain damage.

There are no biomarkers that can be used to predict the onset or distinguish early Alzheimer’s from age-related memory loss.

Extracellular RNA (exRNA) communication is a recently discovered cell-to-cell signaling process that holds enormous promise for improving our understanding of a wide variety of diseases.

In 2013, the NIH Common Fund provided support for 30 research projects designed to explore and enhance scientists’ understanding of exRNA communication in normal and disease states.

18 of these grants were administered by the NCATS including our UH2/UH3 grant to study the clinical utility of microRNAs (small RNAs that do not code for protein) in cerebrospinal fluid as biomarkers of Alzheimer’s.

The Oregon Alzheimer’s Disease Center (OADC), the core program of the OHSU Layton Aging & Alzheimer’s Disease Center, holds CSF samples donated from AD patients and control subjects.

In the UH2 discovery phase, our studies using samples from the OADC revealed approximately 30 microRNAs that are different between Alzheimer’s disease and control cerebrospinal fluid.

In the newly funded UH3 phase, we will validate expression of these microRNAs in a new and larger set of cerebrospinal fluid samples.

Our long-term goals are to detect changes in microRNAs earlier in the disease process, which would allow patients to start treatments sooner and possibly slow or prevent brain function decline and damage, and to potentially gain new information regarding the underlying cause of Alzheimer’s disease.

UH2/UH3 Team:
Julie Saugstad, Ph.D. – Anesthesiology & Perioperative Medicine
Joseph Quinn, M.D. – Neurology
Theresa Lusardi, Ph.D. – Legacy Research Institute
Jodi Lapidus, Ph.D. – Biostatistics
Christina Harrington, Ph.D. – Integrated Genomics Laboratory

Acupuncture and diet changes to treat neuropathic pain

Peripheral Neuropathy is a common neurologic condition, which affects the peripheral nerves. The most common symptoms associated with peripheral neuropathy are burning, tingling pain, which often feels like sharp electric sensation.

Walking, especially on hard or cold surfaces can be very painful, often described as walking on ground glass or stepping on pebbles. When large nerve fibers are involved, patients are more likely to experience sensory loss and weakness in the feet and sometimes hands.painful_feet_L-286x300

Small (microscopic) fiber involvement is typically limited to painful sensory symptoms. Often there are changes in the skin such as thinning and body hair loss, as well as muscle wasting in the feet and hands.

There are many common causes of peripheral neuropathy in the US. This includes diabetes, thyroid disorders, certain auto-immune conditions, vitamin B12 deficiency, alcohol abuse and exposure to toxins such as heavy metals or chemotherapy drugs. HIV, other infections and certain types of cancer can also cause this type of pain.

Clinicians and patients alike are well aware of how difficult it is to treat peripheral neuropathy.

In 2011 the American Academy of Neurology issued the latest guidelines for treatment of neuropathic pain and recommended that 4 therapeutic agents are probably effective for the treatment of neuropathic pain – pregabalin (Lyrica), gabapentin (Neurontin), duloxetine (Cymbalta) and amitriptyline (Elavil).

Unfortunately, these medications are for symptomatic management only and do not affect the disease course and they have various side effects including sedation, leg swelling, paradoxical agitation and weight gain.

It may be worth trying certain dietary changes, aimed to reduce systemic inflammation.

Diet modifications

Gluten intolerance has been reported in as high as 34% of patients with unexplained peripheral neuropathy. While positive blood tests for Celiac Disease are diagnostic, it may be worth trying a 4-6 week trial of strict gluten-free diet, regardless of test results as certain patients may have gluten intolerance and test negative for celiac disease.

Other dietary changes include a trial of lactose-free diet or refined carbohydrate-free diet, as both are known to be pro-inflammatory and may increase pain sensation. These dietary trials should be performed sequentially and for 4-6 weeks at a time.

Acupuncture

TsaoTreatment-1207-178

Recently we examined the evidence for acupuncture in the treatment of peripheral neuropathy. We systematically reviewed 46 clinical trials and included 13 qualifying randomized controlled trials of acupuncture against sham acupuncture or standard medical therapy and concluded that acupuncture is effective in the treatment of diabetic neuropathy, Bell’s palsy, Carpal Tunnel Syndrome and it is most likely effective for the treatment of HIV-related neuropathy.

In the Neurology Wellness Clinic at OHSU we routinely treat patients with peripheral neuropathy and some of our best results are with idiopathic neuropathy (meaning of unknown cause). A typical treatment course consists of weekly sessions with electroacupuncture for 6-8, sometimes 10 weeks, followed by gradual spacing out to every other week, every third week, once a month and eventually maintenance treatment once every 2-3 months.

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Dimitrova-Alexandra


Alexandra Dimitrova, MD is an Assistant Professor in Neurology at OHSU, who sees patients with headache and pain in the
Neurology Wellness Clinic. In her practice she integrates traditional neurologic treatments with acupuncture, dietary and lifestyle changes and other complementary and integrative treatments.

A look back at a neuroscience meeting of the minds in the Pacific Northwest

Earl Blumenauer

Congressman Earl Blumenauer (D-OR)

A Congressman, a National Institutes of Health (NIH) director, a leader of a national advocacy group, and a scientist-turned-advocate shared a stage last month in Portland, OR, to talk about the importance and impact of neuroscience research nationwide.

This Neuroscience Town Hall was the final event of the NeuroFutures conference, organized and sponsored by the OHSU Brain Institute, the University of Washington, and the Allen Institute for Brain Science, which brought together scientists and clinicians in the Pacific Northwest to share recent discoveries in basic and translational neuroscience research.

Prior to the town hall, attendees browsed the gallery of 11 patient advocacy groups during the cocktail hour, including the Oregon chapters of the Alzheimer’s Association and NAMI, and the Parkinson’s Resources of Oregon, just to name a few.

Indeed, advocacy was the central topic for all of the speakers of the town hall.

Congressman Earl Blumenauer (D-OR) opened the discussion with praise for the “ecosystem for innovation in research” that exists in the Pacific Northwest, citing a history of positive collaborations between advocates, scientists, physicians, and the public. This collaborative environment is essential for “focusing on the overall arena of neuroscience,” which is the goal of the Congressional Neuroscience Caucus that he founded in 2010.

Caucus events are standing room only, which he attributes to the nature of the topic: “Neuroscience is one of the few areas that actually brings people together… intrigues instead of divides.”

Walter Koroshetz

Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke (NINDS)

In a light-hearted turn in the conversation, Congressman Blumenauer jokingly suggested that perhaps neuroscience can help us answer the question of “why well-educated Republicans are more skeptical of the science than well-educated Democrats,” especially with respect to climate change.

But all jokes aside, the Congressman emphasized that we do need “objective, analytical ways to get these points across… for the betterment of society,” and neuroscience could be the catalyst for reaching across the aisle.

Next to speak was Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke (NINDS), who started his segment with “What he said, that’s what I think too,” prompting laughter from the crowd.

Dr. Koroshetz emphasized that the NIH is able to fund over $31 billion in research grants, because of the generosity of tax payers. In fact, the NIH is a great analogy to the electoral system, since the NIH structure is very democratic: “anyone can submit a grant, and grants are reviewed by peers.”

Mark Rasenick

Dr. Mark Rasenick, Professor at the University of Illinois, Chicago, and chair of the Advocacy Committee for the American Brain Coalition

From an NIH funding perspective, Dr. Koroshetz told the audience “Current public health issues are heavily weighted towards neurological issues.”

He echoed the Congressman’s sentiment that we need a unified neuroscience effort, and that The White House BRAIN Initiative “floats all boats,” instead of focusing on certain diseases.

Support for basic research is imperative: “A recent major advancement in neuroscience comes from organisms that are more basic than bacteria”, speaking about optogentics, with allows us to turn individual nerve cells in the living brain on and off with light.

In order to “reduce the burden of mental health disorders in this country,” Dr. Koroshetz concluded with the need to bring together basic research, disease research, and patient support.

Dr. Mark Rasenick, Professor at the University of Illinois, Chicago, and chair of the Advocacy Committee for the American Brain Coalition, started his remarks by asking the crowd how many of us have participated in advocacy events. Only a handful of attendees raised their hands. Dr. Rasenick advised the audience: “To increase the enterprise of neuroscience, all of us need to be engaged… in activities on the Hill.”

As a scientist and advocate, the question turns to what to lobby for, since there is not enough money to go around.

Katie Sale

Katie Sale, Executive Director of the American Brain Coalition

From this perspective, lobbying for neuroscience research in general, in addition to specific diseases, will bring support for the field as a whole.

Dr. Rasenick concluded with a fantastic analogy for engagement across sectors: “Neuroscience is a big tent, and we all need to live in that tent, and tighten the wires to make that tent supportive.”

Katie Sale, Executive Director of the American Brain Coalition (ABC), piggy-backed on this analogy and the theme of the night: “We need to speak with one voice, and bring everyone together.”

As the nation’s largest organization of neuroscience-focused patient advocacy groups, the ABC is doing exactly that. Working through the Congressional Neuroscience Caucus, the ABC pulls together a clinician, a scientist, and a patient advocate for briefings on a wide range of topics – from mental illness and neurodegenerative diseases, to the effects of physical activity and music on the brain.

Summing up the collaborative spirit echoed by all the speakers, Ms. Sale concluded the night with a positive sentiment: “Step by step, we can all make a difference.”

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spinelli

 

Kateri Spinelli, Ph.D. is a post doctoral fellow in the Department of Neurology.

 

Research affirms use of thrombectomy procedure for stroke treatment

Stroke is the fifth leading cause of death in America and a leading cause of adult disability, according to the National Stroke Association. For patients who experience strokes and the physicians who treat them, time is brain.

Time is brain.

Time is brain.

A mechanical thrombectomy is a groundbreaking stroke treatment that our doctors use to return patients to full function at an astonishing speed – often within a matter of hours of having a stroke.

Because this procedure can remove the clot so quickly, the greater the patient’s chance of a full recovery.

The typical treatment for an acute stroke patient is an IV of a clot-busting, brain-saving drug called tPA that dissolves clots and improves blood flow to the brain. But dissolving the clot can take a few hours. In addition, an IV of tPA must be started within 3 hours of the onset of the stroke.

For patients with more severe stroke, TPA alone is not an effective option. The thrombectomy procedure can be started up to 8 hours after the onset of a stroke so it has a much longer time window than that of TPA, which gives the patient a better chance of recovery.

Hormozd Bozorgchami, M.D., Oregon Stroke Center at OHSU

Hormozd Bozorgchami, M.D., Oregon Stroke Center at OHSU

How it works: The treating physician quickly removes the clot by inserting a catheter into the patient’s groin, during an angiography, and then guides  it through a blood vessel until it reaches the clot. At the end of the catheter is a basket-like stent — a small expandable tube — that, once open, restores blood flow through the artery. The stent with the blood clot stuck to it is then carefully removed.

Our use of this procedure was recently bolstered by the findings of two trials published in the New England Journal of Medicine. The studies confirmed what our physicians have long seen after performing mechanical thrombectomies on their patients: The procedure improves patient outcomes.

Local television news station KGW recently spotlighted OHSU’s pioneering use of the procedure and spoke with Rod Moore, a patient of Dr. Hormozd Bozorgchami with the Oregon Stroke Center at OHSU. Mr. Moore is an example of how quickly many patients recover after this procedure. After the clot was removed, Mr. Moore, while still lying on the operating table, reached out and tried to grab Dr. Bozorgchami with his previously paralyzed arm.

You can watch the story, and view pictures of the procedure here.

 

NeuroFutures 2015: Neuroscience innovation in the Pacific Northwest

Last month, scientists and clinicians in the Pacific Northwest spent three days sharing new discoveries, igniting collaborations, and discussing the future of neuroscience research at the NeuroFutures meeting in Portland.

Stimulating research talks covered advances in clinical technologies, such as deep brain stimulation for depression, retinal prosthetics, and advanced MRI imaging to study myelination, sleep, and ADHD, as well as basic science discoveries that are the building blocks for how we understand the cellular basis of brain function.NeuroFutures

From tadpoles to rodents to non-human primates, many of the basic science speakers focused on tracking neuronal circuits, both anatomically and functionally, and pairing these data with specific behaviors or disease states.

This combination of basic and translational research, with a focus on technology development and whole-brain function, is precisely aligned with the goals of the White House BRAIN Initiative, which inspired OHSU, the University of Washington, and the Allen Institute for Brain Science to establish the annual NeuroFutures meeting in 2014.

In addition to the scientific and clinical talks, a section on Policies and Initiatives featured talks from Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke (NINDS), and Dr. Carlos Peña, director of the Division of Neurological and Physical Medicine Devices at the U.S. Food and Drug Administration (FDA).

Dr. Koroshetz shared updates from the BRAIN Initiative, including newly published discoveries from researchers that were awarded BRAIN grants through NINDS.Walter Koroshetz

Dr. Peña gave an overview of the FDA approval process for neurological devices, encouraging researchers to contact his office early in the research and development phase, to learn what requirements are needed for pre-clinical trial data.

Other highlights from the meeting included a thought-provoking talk from Hank Greely, JD, who spoke about the ethical considerations that scientists and physicians should consider when working with neurodevices in patients.

This topic was complimented by panel discussions on neurodevices and biologics, where the general opinion was positive yet realistic about the current and future treatment options for patients with neurological diseases, from depression to Alzheimer’s Disease.

town hallThe scientific portion of the conference concluded with a workshop and tutorial on brain mapping tools from the Allen Brain Institute.

The final night of the conference featured an exciting “meeting of the minds” Neuroscience Town Hall. Congressman Earl Blumenauer (D-OR), Dr. Koroshetz, Dr. Mark Resnick, Professor and Advocate at the University of Illinois, Chicago, and Katie Sale, Executive Director of the American Brain Coalition took the stage to share their thoughts and perspectives on the BRAIN Initiative and the role of advocacy organizations in promoting neuroscience research.

Everyone in the group emphasized the need to consider neuroscience as a whole, in addition to thinking about individual diseases.

This theme translates well to the goals of the BRAIN Initiative: the development and integration of various technologies and experts from many fields, to advance the wide goal of understanding brain function in normal and diseased states.

In his opening remarks, Congressman Blumenauer praised the Pacific Northwest as an “ecosystem for innovation in research.”

The NeuroFutures conference as a whole perfectly echoed this sentiment, showcasing exciting advances in both clinical and basic neuroscience research, and a bright future for neuroscience in the Pacific Northwest.

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spinelli

 

Kateri Spinelli, Ph.D. is a post doctoral fellow in the Department of Neurology.

 

Three questions for Sean Speese

Sean SpeeseSean Speese, Ph.D., is an Assistant Professor at the OHSU Jungers Center for Neurosciences Research.

His career has spanned 17 years of research in invertebrate model systems. 

What questions are you trying to answer in your work?

Our main overarching goal is to understand how cells regulate expression of specific genes in time and space. For example, neurons in our brains are quite large, highly arborized and can span long distances.

However, these cells are tasked with responding locally to cues in the brain, which requires them to precisely regulate gene expression in time and space. The ability of neurons to perform these actions is critical for learning and memory and gets disrupted in various neurological diseases.

What is the most important aspect of support that OHSU provides to you currently and how would you like this or other support to grow in the future?

One of the critical events that helped me launch my career at OHSU is being awarded the Oregon Scientist Development Award through the Medical Research Foundation (MRF).  This provided critically needed funding to generate preliminary data for my initial grant submissions to the NSF and NIH.

In the future I hope to see OHSU continue to support young researchers asking basic biological questions in model organisms.

If you could pick one brain health tip to share with our readers, what would it be? What do you prioritize when it comes to your own brain health?

I can’t say that this advice will apply to everyone as we all have varying genetic backgrounds and outside environmental factors, but there is a growing body of evidence indicating that regular exercise can improve brain health and function.

I myself use exercise as one of the main ways to promote my own brain health. In particular, I enjoy riding my mountain bike fast through the woods. The graduate students will attest that it is not uncommon for me to show up in lab with scrapes from a recent bike crash.

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Want to hear more from Dr. Speese? He’s the featured speaker at OMSI’s Science Pub Hillsboro on August 31.

 

Three questions with memory expert Matt Lattal

lattal-webMatt Lattal, Ph.D., is an associate professor of behavioral neuroscience in the OHSU School of Medicine and faculty member in the Neuroscience Graduate Program. 

What projects are you currently working on how do you collaborate with fellow faculty members? 

Work in my lab is focused on two very broad questions: How do memories form? And once they are formed, how can they be eliminated or inhibited? We know a lot about the behavioral conditions and cellular and molecular processes that are involved in normal memory formation. In my lab, we are especially interested in the mechanisms that are involved in the development and inhibition of particularly salient memories – those involving trauma or drugs of abuse. We have found that repeated exposure to cues associated with trauma or abused substances results in a weakening of the learned behavioral responses (fear or drug-seeking) through a process known as extinction.

Our lab is particularly interested in trying to promote this extinction process by pairing extinction trials with manipulations of cellular and molecular memory mechanisms. Recent work has focused on histone acetylation – we have found that general or specific histone deacetylase (HDAC) inhibitors coupled with extinction can result in a persistent suppression of these salient memories, presumably because HDAC inhibitors relax the protein complex that packages DNA, thereby promoting transcription and long-term memory formation. We focus on systemic manipulations and manipulations within a specific circuit involving the medial prefrontal cortex, amygdala and hippocampus.

There are many opportunities for fellow faculty to participate in my research. My lab is primarily a behavioral lab. We manipulate cellular and molecular processes, but we do this in vivo, with a behavioral measure as an experimental endpoint. I like to collaborate with people who are interested in some of these cellular and molecular processes (e.g., histone acetylation), but at a level of molecular analysis that is beyond the scope of what we do in my lab. For example, some of my collaborations have included researchers who help us examine how individual HDACs operate at a molecular level to regulate expression of specific genes involved in memory.

What is the most important aspect of support that OHSU provides to you currently and how would you like this or other support to grow in the future? 

The main thing that OHSU has provided me is an amazing intellectual environment. It is an extremely collaborative place and I can’t count the number of collaborations that I have had with other PIs since I’ve been here. I am always open to collaborating with anyone looking to examine memory effects that may develop from pharmacological, genetic or other manipulations. A great way to foster an already collaborative environment is to continue to invest in new assistant professors who bring the latest approaches and technologies with them.

A hypothetical: If you could have one tool that would solve a seemingly impenetrable problem in your work, what would it do? You have unlimited resources to design this tool, so think big. 

This is a hard one. I study learning and memory, which are unobservable processes. We can’t ask rats and mice to articulate their experiences, so we have to make inferences about learning and memory from their behavior. When you throw genetic, viral or pharmacological manipulations into the mix, you have to think very critically about situations in which your behavioral measure may reflect processes other than memory (such as sensory perception, motivation and motor performance processes). You can look at brain changes, but these, too, come with assumptions about how cellular processes (such as long-term potentiation or changes in dendritic branching) translate into memory representations. We also know that memory is extremely fallible in people, so even giving animals the ability to introspect and articulate their memories verbally would not be of much help. So the impenetrable problem in my field is getting access to an accurate neurobiological readout of what memory is. If I could wave my magic science-fiction wand, that readout is what I would like to have. But it would also mean that we wouldn’t need to answer any more questions, which would make my life much less interesting.

Want to hear more from Dr. Lattal? In 2014, he provided memory improvement tips on OPB’s “Think Out Loud.” Listen to the broadcast here.

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This blog post originally appeared on OHSU’s internal “Inside the SOM” blog, authored by Rachel Shafer, Senior Communications Specialist in the OHSU School of Medicine.

Meet Peter Steyger: The man behind breakthrough research into hearing loss

Peter Steyger underwent speech therapy in 1968 at the University of Manchester with Gordon Campbell and his mother, Peggy Steyger.

Peter Steyger underwent speech therapy in 1968 at the University of Manchester with Gordon Campbell and his mother, Peggy Steyger.

As a child, Peter Steyger, Ph.D. was cured of meningitis, but the drug that saved him also caused his hearing loss.

Now a neuroscience researcher, Dr. Steyger recently found that patients stricken with dangerous bacterial infections are at greater risk of hearing loss than previously recognized.

We sat down with Dr. Steyger to learn some more about his research and what comes next.

That’s a great photo of you and your mom with your speech therapist. Can you tell us a little more about it and how your own experiences shaped your research?

The photo was taken of me with my mother, Peggy Steyger, and Gordon Campbell, a speech therapist and coach for my mother, who was to teach me how to listen and talk. Gordon Campbell was at the University of Manchester (UK) at the time, where my mother and I would attend sessions with him to improve our own daily speech therapy sessions.

At the time of the photo, I was about six years old, and had been receiving speech therapy for close to three years.  This speech training allowed me to be mainstreamed and obtain a regular grammar school education.

I was in speech therapy because I had lost my hearing though meningitis, streptomycin treatment (an aminoglycoside like gentamicin or kanamycin) and as the recent manuscript showed,  the combination of infection-induced inflammation likely potentiated the ototoxic effect of these aminoglycosides.

My own experience has informed my research, primarily through the realization that most ototoxicity experiments are done in healthy pre-clinical models, and yet aminoglycosides are only given to very sick patients to save their lives.

What’s been the most interesting development in your area in the last two years?

One of the most interesting developments in auditory neuroscience that has affected our research in ototoxicity is the realization that the cochlea is not an immunologically-privileged site, and that in fact the cochlea and inner ear does in fact respond to vascular and immunological activation.

Lower power image of the cochlear coils, containing hair cells

Lower power image of the cochlear coils, containing hair cells

This has been characterized by our colleague, Dennis Trune, who established that the cochlea is immunologically activated by middle ear infections, and this could alter auditory function. More importantly, these inner ear changes may alter auditory function.

What’s next for you? What projects are you currently working on/looking forward to?

To follow up on our existing data and determine if other sources of inflammation (e.g., viral, fungal) can also potentiate aminoglycoside-induced hearing loss, i.e., establish whether it is inflammation in general that potentiates drug-induced hearing loss, or if there is something specific about bacterial-induced inflammation that potentiates drug-induced hearing loss.

We also want to determine if individuals with bacterial infection and inflammation have a greater prevalence of hearing loss, and does that hearing loss occur to a greater extent than in other individuals treated with aminoglycosides without systemic inflammation (i.e., prophylactically).  

What is the most important aspect of support that OHSU provides to you currently and how would you like this or other support to grow in the future?

Peter Steyger

Peter Steyger, Ph.D.

OHSU has a vast array of research expertise in a wide variety of areas that are surprisingly (to me) integrated when it comes to translating bench science into bedside practice.

I have found our basic and clinical colleagues to be very collegial, collaborative and supportive. This is further enhanced by the seed-funding of newly-innovative ideas (acorns) into thriving translational and clinical research projects by OCTRI (oaktrees; the Oregon Clinical and Translational Research Institute) that support our communities statewide and globally.

 

Learn more about Dr. Steyger’s recent study:

OregonLive: Antibiotic could cause hearing loss in preemies, study indicates
U.S. News & World Report: Certain antibiotics linked to hearing loss, mouse study finds
KPSU Learning to Grow [PODCAST]: Hearing loss caused by antibiotics is worse in sick patients?

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