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Dr. Marie Gabrielle Laguna

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Medical doctor-internist

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New Small, Thin Electronic Sensors Monitor Brain Injury, Then Melt Away

Mar 4, 2016

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Brain electronic implants can�monitor temperature and pressure within the skull and�then melt away when no longer needed.

A new class of tiny electronic implants monitor temperature and pressure within the skull (which are important parameters after brain injury or surgery) which then melt away when no longer needed. This eliminates the need for another surgery to remove the monitors, which thereby reduces the risk of infection or hemorrhage.

The study, led by John A. Rogers, who is a professor of materials science and engineering at the University of Illinois at Urbana-Champagne, and Wilson Ray, a professor of neurological surgery at the Washington University School of Medicine in St. Louis, was published in Nature last January 18.

This is a new class of electronic biomedical implants,� said Rogers. He said that these kinds of systems have a very flexible potential in terms of usage in clinical practice, where the therapeutic or monitoring devices are usually implanted or taken in, perform a specific function, and then get reabsorbed into the body in a harmless way after their function is no longer deemed as necessary.

New Brain Technology

For example, in the case of a traumatic brain injury or after a brain surgery, it is of utmost importance to monitor the patient's brain for swelling and pressure. Current technology that is being used for this is quite bulky and invasive, Rogers states, and that the wires being used in these devices kind of restrict the patient's movement, thereby also hampering physical therapy as the patients recover. The present devices that are used also require continuous, hard-wired access to the head, which means that this type of technology has other risks such as allergic reactions, infection and hemmorhage, and could sometimes even worsen the inflammation that they are supposed to be monitoring.

The new devices developed by Rogers and team however, use dissolvable silicon technology. The sensors are just about the size of a grain of rice, and are also built on thin sheets of silicon which are�naturally biodegradable. These sensors are configured to function for a period of a few weeks, and then harmlessly and completely dissolve in the patient's own bodily fluids.

Rogers teamed up with Illinois materials science and engineering professor Paul V. Braun to produce the silicon platforms in such a way that they are sensitive to clinically relevant levels of intracranial fluid pressure around the brain. In addition, they also put a temperature sensor and connected it with a wireless transmitter that is almost the size of a postage stamp, which is implanted on top of the skull and under the skin. These devices were tested on rats and matched readings found in conventional devices.

Rory Murphy, a neurosurgeon at Washington University and also a co-author of the paper, says that the ultimate strategy is to have a device that you can place in the brain, or in other organs of the body,�that is entirely implanted, intimately connected with the organ you want to monitor and can transmit�signals wirelessly to provide information on the health of that organ, allowing doctors to intervene if necessary to prevent bigger problems. After the critical period that you actually want to monitor, it will dissolve away and disappear.�

The teams are currently working toward using this technology in human trials, as well as improving its functionality for other clinical applications.

New Microscopic Technology Aids In Reproductive Assistance

Mar 3, 2016

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A new technology allowed scientists to perform clinical sperm analysis without staining the samples.

According to the Centers for Disease Control and Prevention (CDC), around 10% of women in America ages 15-44 have trouble with conceiving or having a full-term pregnancy. ART or Assisted Reproductive Technology, is a procedure in which eggs are fertilized with sperm in vitro and then put back in a woman's uterus, which is often the last option for couples who have a hard time conceiving a child. However, the physical, emotional and financial stress that this procedure brings is high, as the success rate of using ART is just around 20-30%.

In a study recently published in the journal Fertility and Sterility, new technology from the Tel Aviv University has allowed scientists to perform clinical sperm analysis without staining the samples, which usually greatly affects the viability of the sperm.

Sperm cells are usually transparent under usual microscopic methods. Their optical properties are quite similar to their environment, which causes them to have a weak image contrast. If the sperm cells are to be used in fertilization, they cannot be stained, as staining might possibly damage the resulting fetuses.

The important point is to be able to pinpoint strong sperm candidates without the use of staining, while at the same time still being able to determine their viability.

Sperm Cells and ART

The research was led by Dr. Natan Shaked, PhD, who is from the Department of Biomedical Engineering at TAU's Faculty of Engineering, along with his master's student, Miki Hifler, MD. Sperm cells that were used for the study were acquired from the Male Fertility Clinic at Chaim Sheba Medical Center which is�located in Israel.

At present, there are two available ART methods. One is in vitro fertilization or IVF, in which a woman is given medicine that makes her produce more eggs in her ovaries. These eggs are then placed in a petri dish with a man's sperm cells for the purpose of fertilization, which is done in a period of three to five days. The other method is called intracytoplasmic sperm injection (ICSI), in which a single sperm is injected into a mature egg cell, which is then transplanted into a woman's uterus. The method discovered by Dr. Shaked can be used in both methods, but is more useful in ICSI.

The device, which is a small black box� attached to a microscope, is small, cost-effective, and even easier to use as compared to usual existing interferometric imaging methods. This is then connected to a new kind of software that allows a thickness map of the sample to be viewed, along with other physical parameters that measure the sperm cell's viability at present. The device only costs $1,000, and is very flexible because it can be used in any physician's clinic that already has a conventional microscope.

Dr. Shaked believes that his invention, which uses phase imaging methods to record the passage of light through a sample to determine how thick it is, can accurately tell the quality of sperm cells used in ART, which may surely lead to higher success rates in the procedures.

Meals at 92% of Dining Establishments Serve Oversized Portions

Mar 2, 2016

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Restaurants often serve oversized meals.

The food offered at fast-food restaurants are often considered as one of the biggest contributors to obesity. According to a new study from the Journal of the American Academy of Nutrition and Dietetics, though, 92 percent out of 364 restaurant meals that were measured from both large-chain and non-chain or local restaurants exceeded the recommended calorie limits for one single meal. In�123 restaurants located in three cities across America, the researchers found out that some meal servings, excluding drinks, appetizers or desserts, already sometimes exceeded the caloric�requirements for one whole day.

Senior author Susan B. Roberts, PhD, and director of the Energy Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston, says that the findings they have clear it out that trying to make healthy choices when eating outside is quite a challenge since the combination of tempting options plus oversized portions often overwhelm a person's self-control.

Although fast-food restaurants are often the easiest targets for criticism because they provide information on their portion sizes and calories, small restaurants typically provide just as many calories, and sometimes more. Favourite meals often contain three or even four times the amount of calories a person needs, and although in theory we don't have to eat the whole lot in practice, most of us don't have enough willpower to stop eating when we have had enough,� Roberts adds.

Calorie Analysis

The research was conducted by the HNRCA as well as scientists from the Friedman School of Nutrition Science and Policy at Tufts. They analyzed the calorie content of the most ordered meals in both local�and fast-food restaurants located in Boston, San Francisco, and Little Rock, Ark. Data was collected between the year 2011 and 2014, and meals were compared against human calorie requirements as�well as the standards set by the USDA. Cuisines included in the study were American, Chinese, Vietnamese, Thai, Mexican, Greek, Japanese, Italian and Indian.

Among all of the cuisines compared, American, Chinese and Italian had the highest calorie counts with an average of 1,495 calories in each meal.

The oversized servings seen in restaurants cause dieters to either avoid restaurants entirely, or choose items such as salads that everyone knows are served in reasonable sizes. The standard meals are usually portioned for the hungriest of customers, which is why most people need a good amount of self-control to be able to avoid overeating.

The researchers believe that local ordinances that allow customers to order partial servings at partial prices would make restaurants adjust their usual sizes towards what the average customer wants, as compared to the hungriest person. This, in turn, would allow customers to order anything that they like on the menu, in a more appropriate size. Thus, they would be able to eat out more often without worrying about weight gain.

While a lot of people blame themselves for having weak willpower when it comes to overeating, Roberts says otherwise saying it is our natural for us to do so. Roberts cited Ivan Pavlov's discovery regarding the �cephalic phase of digestion', which is basically a mechanism that makes us hungry and tempted when�we have food at hand. So we order our favourite dishes because that is what tempts us, and then we eat more than we need because the portion is too large,� says Roberts.

Low Survival Rates For Cardiac Arrests Above The 3rd floor In High Rise Buildings

Mar 1, 2016

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Those who live in high-rise buildings had better survival rates from heart attacks if they were living on the first�few floors.

According to a study published in the Canadian Medical Association Journal (CMAJ), residents who live in high-rise buildings had better survival rates from cardiac arrests if they were living on the first�few floors, whereas survival was already negligible for this living above the 16th floor.

The study was led by Ian Drennan, a paramedic with York Region Paramedic Services, and a researcher with Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto.

As the number of high-rise buildings continues to increase and as population density rises in major urban centers, it is important to determine the effect of delays to patient care in high-rise buildings on survival after cardiac arrest,� he writes.

Building Floors and Survival Rates

Simply put, the further a patient who is experiencing cardiac arrest is from the first floor, the lower is the survival rate. Out of 8216 people who had cardiac arrests and were living in private residences and were treated by responders from 911, around 3.8 percent survived who were to be discharged from the hospital. From the 5993 or 73 percent of the people living below the 3rd floor, 252 or 4.2 percent were able to survive having a cardiac arrest, whereas only 48 or 2.6 percent of the people living above the 3rd floor were able to survive. The researchers also analyzed the survival rate per floor, and it was found that only 0.9 percent of resident were able to survive after cardiac arrest on the 16th floor, and there�were even no survivors above the 25th floor. It was also important to note that the use of the automated external defibrillators or AED, was quite low.

The research also looked at the interval between when an emergency vehicle arrives and when 911-responders are able to reach a patient experiencing cardiac arrest. The authors say that the total�response time would be quite dependent on how long the responders reach the patients upon arrival at the scene, as traffic patterns do not usually change. Previous studies have only measured the interval between the call to 911 and the arrival of the vehicle to the scene, but not the time to actually reach the�patient.

The researchers provide several solutions so that 911-responders might be able to improve time on patient contact, such as access to elevators for emergency service that has no public interference,�similar to access of firefighters, as well as advance emergency alerts to building staff before the responders arrive, and also better placement of AEDs so as to give more access for the usage of�bystanders.

Other related solutions were to provide CPR/AED training for people living in high-rise residences, a national online registry that will be used for public-access defibrillators for first-responders, and the use of smartphones to alert volunteer first responders for those experiencing cardiac arrest.

Associate Professor Marcus Eng Hock Ong, from the Department of Emergency Medicine in Singapore General Hospital says that Singapore has a multipronged approach to address high-rise residential out-of-hospital cardiac arrests. A large public campaign is currently underway to enrol residents' committees as first responders and to train one million people over the next five years.”

Improved Neonatal Outcomes For Pregnant Trauma Patients

Feb 29, 2016

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Pregnant mothers who have traumatic injuries get better experiences when treated at designated trauma centers.

According to new study results published online in the Journal of American College of Surgeons, pregnant mothers who experience traumatic injuries get better experiences when treated at hospitals�that have a designated trauma center, as compared to those who are treated at non-trauma hospitals. These pregnant patients are less likely to have premature births, have a low birth weight baby, or have a meconium at delivery (which is a sign of fetal distress).

Around 8 percent of women who are pregnant experience traumatic injuries such as fractures, superficial or open wounds. According to study coauthor Major John T. Distelhorst, DO, MPH, and also a U.S. Army Preventive Medicine Physician at Fort Bragg, North Carolina, Previous research has shown that even minor injuries in pregnancy can result in serious maternal and neonatal morbidity. In cases of injury, pregnant women have had poor neonatal outcomes, so we wanted to know whether the trauma system could better help these women.�

Trauma centers are medical facilities that specialize in monitoring and appropriately meeting the needs of injured patients. In non-pregnant populations, receiving care at trauma centers has certainly shown to decrease the risk of death and also improve outcomes after injury. On the other hand, there hasn't been�much data regarding the impact of care in trauma centers with regards to women who are pregnant. The purpose of the study that was performed was to check whether there is a correlation between the type of hospital (trauma vs. non-trauma) at which women who are pregnant receive care, to maternal and neonatal outcomes.

Pregnancy and Neonatal Outcomes

The researchers used two databases for this study: the Washington State Birth Events Records Database and the Comprehensive Hospital Abstract Recording System. A total of 3,429 injured pregnant women who were hospitalized in Washington State between 1995 and 2012 were considered, and their neonatal�outcomes were examined.

Study co-author Vijay Krishnamoorthy, MD, assistant professor of anesthesiology at the University of Washington says that Our study showed that about 16 percent of pregnant patients at non-trauma�hospitals actually had severe injuries, implying that some of these patients might have been under triaged, as all of their care occurred at non-trauma hospitals. It might be explained by the EMS system or the fact that the patients were driven in a private vehicle to a non-trauma hospital. But we would like to learn more about how women are brought to the hospital.�

As trauma treatment systems differ from one place to another, the researchers hope that their findings will pave a way to other researches using data from other populations in the United States. Dr. Distelhorst says that their data only includes the Washington State, which has a regionalized an inclusive trauma system. He says that their results can help improve the care that is given to injured pregnant women and their soon-to-be-born children, and could also possibly help in the improvement of trauma systems located in other states.

Dr. Krishnamoorthy adds that if this finding holds true in other places, it may change triage practice, which could possibly result to pregnant patients with injuries, even moderate ones, being treated in trauma hospitals instead of normal ones.

Gene therapy for rare bleeding disorder shows long term correction, safety and efficacy

Feb 27, 2016

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A rare bleeding disorder, called factor VII deficiency, has been corrected in a dog model by hematology scientists using a single injection of gene therapy.

Because of its success in the dog model,�it is now considered to have a big potential in treating humans with the same bleeding disorder. The technique was said to be safe, effective, and long-lasting.

The research was published online last December 23 in the journal Blood. Team leader Paris Margaritis, D. Phil, a hematology researcher at the Raymond G. Perelman Center for Cellular and Molecular Therapeutics (CCMT) which is a part of The Children's Hospital of Philadelphia (CHOP), says that their findings are very important for patients suffering from factor VII deficiency. These dogs have the type of mutation found in the majority of patients with this disorder, so this approach could lead to a sustained gene therapy in people,� adds Margaritis.

Factor VII (FVII) Deficiency

Factor VII (FVII) deficiency is quite a rare disorder, present only in about 1 in 300,000 to 500,000 people. In this disorder, a genetic mutation causes the lack of production of a blood clotting factor, causing people with this disorder to have severe bleeding after surgery or injury, and females with this disorder may have excessive menstrual bleeding as well.

FVII varies in severity, but with around 40 percent of patients having the severe phenotype of the disease. Patients are usually treated with habitual infusions of the clotting factor that is missing. In contrast to hemophilia, another clotting disorder that is more popular and most likely is seen in males, FVII equally affects both males and females.

The gene therapy technique that was used involved using a bioengineered adeno-associated virus (AAV), which is quite harmless, as a vector to deliver the gene related to the clotting factor that FVII patients lack. Over the past decade, researchers at CHOP have been using gene therapy techniques for hemophilia B and have conducted clinical trials for such. Margaritis actually leads a laboratory focused on both hemophilia as well as FVII.

We developed a unique animal model of this disease after identifying dogs with naturally occurring factor VII deficiency,� said Margaritis. He further adds that their previous investigations have led to them being able to design the missing gene that FVII patients lack, which they also inserted into the virus vectors that they used in the study.

The scientists at CHOP collaborated with scientists at the University of North Carolina (UNC), who have had a long history of using dogs for hematology research.

Tim Nichols, M.D., who is professor of Medicine and Pathology at the UNC School of Medicine, was able to characterize FVII in four individual dogs. Using the vectors supplied by CHOP, Nichols injected the dogs with varying doses and monitored their outcomes for years. The dogs that were treated expressed levels of clotting factor VII that would be considered to be therapeutic in humans, and was stable for a long time. The treatment was also considered to be safe, as the dogs' kidney function, liver function, and blood measurements were quite normal.

This current study definitely is a big step towards using this gene therapy treatment for humans, and may specifically benefit young children suffering from the disorder.

Four factors help predict later cognitive function and motor performance for children with low birth weight

Feb 26, 2016

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Medical complications during birth, maternal education, early motor condition, and early cognitive condition are predictive of kids’�cognitive and motor function.

Published in the January issue of Research in Developmental Disabilities, a new study by NYU's Steinhardt School of Culture, Education and Human Development has revealed that four factors, namely medical complications during birth, maternal education, early motor condition, and early cognitive condition, are able to help in predicting later on cognitive and motor function for children that are premature and who also have low birth weight.

Previous researches have shown that children born early have an increased risk of having neurodevelopmental impairment. The occurrence of severe types of disabilities have been reduced�among these premature children due to advances in medical science, but mild impairments still occur until later childhood, which is a big challenge for these children in their everyday lives.

Researches have shown that around 40 to 70 percent of preterm born children have minor neurodevelopmental impairments. Examples of these impairments are cognitive delays, speech and�language disorders, and motor problems such as trouble with coordination and balance. These children sometimes also experience lower adaptive behavior, or the integrated ability of cognitive and motor skills, as well as social and emotional control that people use in their day-to-day tasks.

Study author Tsu-Hsin Howe, who is an associate professor of occupational therapy at NYU Steinhardt, says that a better understanding of the risk factors that underlie these impairments in preterm children can help health care experts in devising a prevention plan for the patient while the child is still young, as�well as identify those who can be helped with this intervention.

The study aimed to identify predictors of neurodevelopmental outcomes in very low birth weight children at five years old, and also examined the contribution of early cognition and motor assessments to these premature children's developmental outcomes.

Participants in the study included 126 Taiwanese children who were born prematurely (at or before 32 weeks) who also had low birth weight (less than or equal to 1.5 kilograms, which translates to around 3.3 pounds), and who were also five years of age when the study was conducted. At the time of the study, the children were not experiencing any severe disabilities.

The participants were evaluated using neurodevelopmental assessments in order to see whether the status of their overall cognitive function and motor performance. Other information used in the study, such as demographics and the children's adaptive behavior, was acquired from the parents. Among those�examined, the researchers then determined which factors would be able to help in predicting the children's developmental outcomes.

It was revealed in the study that around more than 50 percent of intelligence and around 30 percent of motor performance and adaptive behavior can be elucidated by examining four factors: medical complications at birth, maternal education, early motor assessments and early cognitive assessments of these preterm children.

Consistent with previous studies, we found significant associations between children's early developmental assessments and later outcomes, emphasizing the benefit of conducting detailed assessments of movement at one year of age. However, medical complications at birth were the most reliable predictor of preterm children's overall developmental outcomes,� says Howe.

Depressive symptoms do not vary between seasons

Feb 23, 2016

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In a new research published in Clinical Psychological Science, which is a journal under the Association for Psychological Science, a large scale survey involving US adults shows no evidence that the symptoms of depression vary between seasons.

These results are quite contradictory with the notion that depression occurs seasonally.�Steven LoBello, professor of psychology at Auburn University at Montgomery and also a senior author of the study, says that when he talks to colleagues, thinking that the changing of seasons is associated with depression is more-or-less a given fact and the same way of thinking is also widespread in our culture.

We analyzed data from many angles and found out that the prevalence of depression is very stable across different latitudes, seasons of the year, and sunlight exposures,� says LoBello.

Seasonal Affective Disorder

Seasonal affective disorder (SAD), is a seasonal pattern� modifier for diagnosing depression and was officially included in 1987 in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In order to be diagnosed as clinically depressed with seasonal variation, patients must be assessed using criteria for major depression, as well as recurring episodes in specific seasons. For most patients, symptoms increase during fall and winter, and decrease when spring and summer comes.

Recent studies, however, have challenged the idea of SAD, including the fact that patients are usually asked to recall episodes over the course of the previous year or even earlier than that. Another point is that the criteria that is used to diagnose SAD do not really line up with the criteria that is being used to diagnose major depression.

The researchers investigated data acquired last 2006 as part of the Behavioral Risk Factor Surveillance System (BRFSS), which is a phone-based survey that is done every year. They examined data from a total of 34,294 people who were aged 18-99. The symptoms that were experienced were measured using PHQ-8, which basically assesses how many times patients experienced depressive symptoms in the past two weeks. This method has been established as a reliable method for the diagnosis of depression as recommended by DSM diagnostic criteria.

Analysis of the data showed that there was no correlation between symptoms of depression and season-related measures. To be more specific, people who answered the surveys during the winter months, or times of lower light exposure, did not have significantly higher depressive symptoms, as compared to those who answered the survey at other times of the year.

Looking at the subsample of 1,754 participants that were also diagnosed to be clinically depressed, the researchers also found the same conclusion: there were still no seasonal differences in symptoms.Because of this, the researchers have concluded that it is doubtful that major depression with seasonal variation is actually a legitimate psychiatric disorder.

Depression is known to be an episodic disorder, and it people would as well experience depressive symptoms in the colder months. The researchers however say that being depressed during winter is not�evidence that one is depressed because of winter.�

Putting all of these together, seasonal depression might not be the prevalent disorder that it's previously thought to be.

Common dementia drug found to be helpful for Parkinson’s patients

Feb 22, 2016

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Researchers have discovered that a commonly used drug for dementia is able to help prevent debilitating falls for patients suffering from Parkinson's Disease.

Published in The Lancet Neurology, the research, led by Dr. Emily Henderson, a Parkinson's UK Research Fellow based in the University of Bristol, shows that patients with Parkinson's who were taking the oral drug rivastigmine were 45% less likely to fall and were more stable while walking, compared to the patients who were taking placebo.

Around 127,000 people in the United Kingdom and around 7 million people worldwide are afflicted with Parkinson's Disease. Seventy percent of these patients will fall at least once in a year, and one-third of these patients experience repeated falls, which then sometimes result in fractures and admission to hospitals.

With the degeneration of dopamine producing nerve cells, people with Parkinson's often have issues with unsteadiness when walking. As part of the condition, they also have lower levels of acetylcholine, a chemical which helps us to concentrate, making it extremely difficult to pay attention to walking,� says Henderson.

She adds, We already know that rivastigmine works to treat dementia by preventing the breakdown of acetylcholine, however our study shows for the first time that it can also improve the regularity of walking, speed, and balance. This is a real breakthrough in reducing the risk of falls for people with Parkinson's.�

Rivastigmine and Dementia

The study included 130 patients who had fallen in the previous year. Half of the people were given rivastigmine, while the other half were given placebo for a length of eight months.

People affected by Parkinson's, their carers, and health and social care professionals have said that preventing falls and improving balance is the biggest unmet need for people living with the condition, other than finding a cure,� says Dr. Arthur Roach, who is the Director of Research at Parkinson's UK. He adds that tasks that might be quite simple for us, such as walking up the stairs, or getting up from bed in the middle of the night to get a glass of water, are definitely more dangerous when you have a big�tendency to fall down. When this happens, a patient may break his or her bones, thus requiring emergency admission into a hospital.

This trial shows that there may be drugs already available, being used for other purposes, that can be tested to help treat Parkinson's. This takes us a step closer to improving the quality of life and finding better treatments for people with Parkinson's.�

Caroline Maxwell, a participant in the study who is from Northamptonshire, was diagnosed with Parkinson's 13 years ago. She says that a few years back, she had a bad fall while carrying her sewing machine across the room. She got admitted to the hospital for a week and it really brought down her confidence levels.

I'm at the stage where I would walk much better with a replacement joint, but because I fall so frequently my surgeon is reluctant to operate. Falling on my replacement hip would put in an even worse situation than what I'm in now,� she says.

In finding a treatment that helps reduce the number of falls in Parkinson's patients, Caroline would be able to get the replacement hip that she needed and she says that she would have the confidence to go shopping by herself, without the need to be picked up by strangers if she fell.

Cellular ‘switch’ that the brain uses to distinguish safety from danger

Feb 21, 2016

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In this new pathway, the neurons unusually acted from a long distance, which is why they were called long-range inhibitory projections, abbreviated LRIPs.

The goal of the study by Dr. Basu and colleagues was to check what role LRIPs have when it comes to learning and memory. The researchers first silenced these�neurons in mouse brains, and the mice were given a brief foot shock.

Twenty-four hours after the initial shock, the mice were returned to the same room. The mice exhibited a fear response, which means that they remembered the shock. This means that LRIPs are not involved in the formation of fear memories.

Interestingly, though, when the mice were placed in a different room, they still exhibited the fear response. Normal and healthy mice only exhibit the fear response when returned to the same room in which the shock was conducted, which shows that healthy mice are able to distinguish between safe and unsafe environments.

Further experiments revealed the LRIPs are activated by stimuli such as light, sound or shocks, which then send an inhibitory signal from the entorhinal cortex into the hippocampus. This process allows neurons in the hippocampus to switch on which then produces a memory.Attila Losonczy, MD, PhD, who is also an assistant professor of neuroscience at CUMC, a principal�investigator at the Zuckerman Institute, and co-author of the study, says that these findings are very intriguing for the human brain. The study suggests that any alterations in these pathways activity,�particularly a disruption of the timed delay, may contribute to pathological forms of fear response, such as posttraumatic stress, anxiety or panic disorders.�

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