Reading the Brain: FDA Approves First Scan for Diagnosing ADHD (Alice Park)

It’s the first test to diagnose the behavioral disorder using brain wave patterns, but it won’t be the last. The idea of reading the brain’s activity for clues to mental illness is gaining ground.

 

As Roxanne Khamsi reported in TIME recently, researchers are learning enough about the signature patterns of normal, and abnormal brain activity that they believe it may be possible to diagnose mental illnesses ranging from depression, schizophrenia, autism and attention deficit-hyperactivity disorder (ADHD) by studying readouts of brain waves, much in the way they now rely on elecrocardiograms (EKGs) to diagnose heart problems.

 

The Food and Drug Administration (FDA) approved Neba Health’s device for children aged six years to 17 years. It relies on electroencephalogram (EEG) readings, which track electrical impulses released by active nerves. The test lasts 20 minutes and records the frequency of impulses emitted every second. By studying the resulting wave pattern, doctors can determine with relative confidence whether the child has ADHD, which is characterized by difficulty concentrating and paying attention.

 

As Khamsi wrote, researchers are also investigating how more sophisticated brain imaging techniques, including functional MRI (fMRI) could also improve diagnosis of ADHD:

Other researchers have found evidence that such fMRI scans might also help diagnose attention-deficit/hyperactivity disorder (ADHD), schizophrenia and depression. In an experiment appearing in the forthcoming July issue of Psychiatry Research, Dr. Jonathan Posner of Columbia University and his colleagues looked at 22 children with ADHD who were not yet on medication and compared them with 20 youngsters around the same age without the disorder. Compared with the healthy children, those with ADHD had, on average, less coordinated brain activity between regions such as the prefrontal cortex, an area at the front of the brain thought to be involved in decisionmaking, and the caudate, a region located toward the base of the brain involved in controlling impulses. Such patterns could one day help identify children at highest risk of developing ADHD and provide them with behavioral or educational support to address symptoms early on, when such interventions might have the biggest impact.

It’s also possible that brain waves can inform treatment of mental illnesses:

“I am most interested in us[ing] resting-state fMRI to really examine the effects of treatment,” says Posner. He also published a paper in JAMA Psychiatry last spring showing that antidepressants successfully quieted hyperconnectivity in the brains of individuals with chronic depression.

That trial compared brain scans from 32 people with depression with those from 25 healthy counterparts and confirmed that the former group had more activity in what is known as the default mode network, a collection of disparate brain regions that makes up the baseline, or default level of brain activity necessary to keep a body functioning. When a person performs a mental task, this default network is suppressed. But in the depressed patients, this network was overactive, and that was associated with increased rumination — or overfixating on a thought that could contribute to depression.

The patients with depression were then given a 10-week course of either the antidepressant Cymbalta (duloxetine) or a placebo. At the end of the trial, patients who received the drug showed similar connectivity patterns to those seen in healthy individuals, but the depressed participants who received placebo did not. (The study received some funding support from the pharmaceutical company Eli Lilly, which markets Cymbalta.)

Experts say that advanced in brain imaging technology are making it possible to discern patterns of activity that could distinguish normal cognitive development from cases of autism, ADHD or other disorders. With autism in particular, having such a non-invasive way of identifying infants who are at risk may help them to avoid some of the condition’s more severe symptoms:

With autism, for example, doctors are “really desperate for a biological marker to help with diagnosis and [measuring] treatment response,” says Daniel Smith, senior director of discovery neuroscience at Autism Speaks. Currently, most children are diagnosed around the age of 2, when the behavioral symptoms of inattention and repetitive actions tend to emerge. More studies suggest, however, that intervening with behavioral therapy in children as young as 6 months old could reduce, or even normalize, some of the aberrant brain changes responsible for the disorder, so diagnosing the condition as early as possible could become critical.

Doctors don’t expect that such tests will serve as the only diagnostic tool for detecting complex mental health conditions such as ADHD — indeed, the FDA says the device should be used in combination with medical and psychological evaluations. But they could become an important way of improving diagnosis and identifying patients at earlier phases of their disease, when treatments may be more effective.

 

NeuroMarketing: This is crazy, but I'm @GoDaddy, So Use Me Maybe?

Hey! I just met you - and this is crazy - but I'm @GoDaddy, so use me, maybe?

It all connects - we just have to look beyond the cells of our limbic panopticons to see how.

Hack the Hippocampus: Memory Principles for Ads

Rita J. King

EVP, Science House

 

You may never forget the GoDaddy kiss, but were any of the Super Bowl ads memorable for the right reasons?

“The GoDaddy kiss is pretty hard to shake,” Adam Albrecht, Chief Creative Officer at Engauge, told me. “It featured a passionate, if not shocking kiss between two complete opposites. Depending on which side of the lunchroom you sat on in high school the kiss was either horrifying or a fantasy come true. But this uber-awkward kiss demonstrated exactly how GoDaddy wants you to think about their brand. And as hard as I try, I'm not sure I'll ever be able to erase the image or the message behind it from my memory.”

Yes, that kiss will be hard to shake — but does such a technique create a memorable message, or just a memorable ad? With ads costing $3.8 million dollars per thirty second spot (that’s over $4,000 per frame) can companies afford to overlook the ad’s sole mission: highlighting the product, service or brand and not just the ad itself?

I’ve recently been collaborating with Memory Layer, a company that works with brands and ad agencies on creating memory in ads. Memory experts James Jorasch and Chris Harwood have designed a system for improving the memorability of ads. Memory Layer “hacks the hippocampus,” (the part of the brain that lets memories in) through five principles of memory. Here’s a glimpse of the Principle WHEEL of Memory (weight, harmony, entanglement, engagement and leveraged attention) from Memory Layer, and how these principles relate to a few of this year’s Super Bowl spots:

Weight  The brain evolved to see the world through the senses, so abstract ideas that cannot be directly sensed carry little value. Instead, tangible weight must be given to an idea. Two commercials this year demonstrated this principle well. Tide’s “Miracle Stain” took the lowly stain and raised it to exalted levels - creating a solid image in the mind of the audience.

Although the first GoDaddy ad is getting all the attention, its second spot, “Your Big Idea,” succeeded in turning an abstract notion into a concrete vision. It takes the possibility of someone else stealing a great idea and filing for a domain name before you and turns into the vision of what could have been if only you had acted. By showing people in other parts of the world all talking about the same idea, the spot makes the rush to move first on an idea tangible. In classic GoDaddy style, the reward is obnoxiously portrayed by a cackling winner on his private jet--but the point is made.

Harmony  Like a crew rowing in unison, the elements of an ad should operate toward a single key message. When the elements are more organized and harmonious, the brain is better able to process the message. One of the best examples of this principle in this years lineup of ads is Best Buy’s “Asking Amy” spot. Amy Poehler has lots of questions about the products. The Best Buy employee dutifully follows her around to answer them. While most of the answers are never shown, they are implied, and Amy leaves the store happy and thankful. Best Buy is advertising the expertise of their staff, which shows in the knowledgable and patient service provided in this commercial.

Entanglement  A commercial may be memorable without it being valuable, if what ends up being remembered is the content rather than the product or brand. You may remember a wish granting genie played by Kaley Cuoco, helping an average suburban family live out their wishes. But who or what was it for? Without firmly entangling the message to memorable content you end up with a $4 million showcase for the Big Bang Theory star and not an ad for the Toyota RAV4 in “Wish Granted.”

On the flip side is the Meatloaf-belting candy-coated commercial “Love Ballad.” The protagonist of the commercial is itself an M&M wrestling with the idea of love. In the first half, the M&M claims he would do anything for love and we see scenes of what that means to him. This is followed by what we humans want to do to the M&M’s we love: eat them in a variety of ways. This is something that he won’t do. You cannot remove the M&M from the story without ruining the narrative, as the narrative is dependent on the candy.

Engagement  In order for an advertisement to be truly experienced it must engage the audience. The more the viewers imagine, the more of the brain is used and in turn the more memorable the message becomes. The Mercedes-Benz “Soul” ad for their all-new CLA car succeeded brilliantly here, encouraging viewers to dream along with the protagonist as he envisions a future of the benefits associated with the car: riches, love, fame and adventure, offered to him in a deal with the devil played by Willem Dafoe. The audience is right there with him as a vision of the future (which includes Usher and Kate Upton) unfolds. In the end he sees, through the window, a billboard with the car’s reasonable price on it. Since he realizes that the glories promised by the car are within his reach and budget, he doesn’t need the tempting deal with the devil to own it.

Leveraged Attention  With millions of people watching a Super Bowl ad, this attention is far more valuable when it is leveraged to help remember the message. Hyundai had two commercials that used their attention in vastly different ways. The first, “Epic Playdate”, squandered most of it. It lent its focus to the guest band and the crazy antics an average suburban family can have in a day. Only after the frenetic action of the commercial do we really focus on the car, and then only for a couple of seconds. Hyundai’s “Stuck” commercial, however, took advantage of attention to bring the feature of the Sonata to the fore, illustrating why the turbo feature is helpful by having the action of the ad focus on the car passing other highway nuisances.

@RitaJKing

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Have ADHD? Pay Attention to this:

“It is primarily the (drug company’s) responsibility to monitor the safe use of their products,” Health Canada told the Star.


Dr. Derryck Smith, an ADHD specialist in B.C., says monitoring side effects is the government’s job. “That’s why we have Health Canada,” he said. “There’s no point in making the reports if (the regulator is) not going to be monitoring.”

What's the message here?  It's that people suffering from ADHD, their families and the dedicated front line service providers doing their best to assist them are on their own.

When you have people killing themselves, that's just not damned good enough.

Mental Illness: Curing the Solution?

“The mentally ill make up a large segment of people charged with crimes in Canada, especially youths, who are often found by judges to be primarily in need of hospitalization, not jail.”

      - Jospeh Brean, National Post

We used to view left-handedness as a problem that needed solving; this approach was like force-feeding people apple seeds then stigmatizing them with a genetic proclivity towards cyanide poisoning.  In far too many places, homosexuality is still viewed the same way.  Much more broadly, mental illnesses and learning disabilities are seen as problems that need fixing rather than latent abilities and responses to conditions that are themselves at least partially causative.  Given the long, historical connection of mental illness to leadership, drive and innovation, this is an approach we take to our own social detriment.

I have ADHD (or to be more precise, have been diagnosed with a series of traits ascribed to the term Attention Deficit Disorder, defined as a learning disability), so I can speak from first-hand knowledge.  Focusing on one task at a time has been a lifelong challenge of mine.  This isn’t to say I can’t do it; just as, say, connecting ideas or events together or understanding different points of view is difficult for others, one learns to cope.  As we hope of everyone, I find ways to manage my challenges and build my strengths.

There are several accommodations I employ to help me stay centered; exercise, routine, music, caffeine and yes, periodically Dexedrine are part of this regimen.  This is no different than wearing glasses or watching your calories.  Too much of any one thing is bad; an overdose of any substance or activity is harmful, regardless of who you are.  Along with this - everyone has strategies for self-regulation.  This can be going to the gym, managing diet, writing a "to-do" list, having a cup of coffee in the morning to jump-start your cognitive engine.  People with alternative cognitive abilities might need more involved strategies to hold the line, but for most of 'em, with the right internal and external accommodations they can function normally, yet retain their exceptionality.

I’ve always laughed at the idea of being “disabled” – my ability to cycle through thought trains quickly (and several of them in short succession) has always meant I can consider more variables in shorter time frames than others.  Discipline and experience have helped me develop the internal tools to focus that process towards a given end.  In practice, this means I often jump ahead to where the narrative puck is going to be, whether it’s in a conversation or in broad social trends.  It's like filling in the blank spots on a temporal map rather than waiting for the next sequence in a chain.  Some people call this intuition; Carl Jung called it “seeing around corners.”  To me, it’s just the way I think – and I’m hardly alone in this.

You tell me – is a capacity like that really a disability to be managed, or rather a skill to be nurtured?

Time will tell.  Or, you can just ask.