On May 14, Dr. Keith Ablow, a Fox News contributor and practicing psychiatrist, posted comments on the Fox News website about the American Psychiatric Association and its current revision of the Diagnostic Statistical Manual. 

The DSM was created in 1952 to provide a complete and reliable source of diagnostic categories and descriptions of mental disorders. its formation was guided by two fundamental principles; that the diagnostic categories and criteria that define mental disorders, are supported by substantial scientific evidence, and that they are consistent with public health needs. the DSM is periodically revised to update diagnoses and their defining criteria as new knowledge is generated. the last revision to the DSM was in 1994.

In his article, Ablow made comments about the APA and DSM-V, which I believe are inaccurate and unsubstantiated by scientific evidence. Moreover, they are misleading to the public and potentially harmful in that by undermining the credibility of the psychiatric profession and its scientific underpinnings. they may even deter people in need from seeking treatment.

For this reason, I offer the following comments in response. I believe that I am qualified to do so as Professor and Chair of Psychiatry at Columbia University College of Physicians and Surgeons and the President Elect of the APA.

It is one thing to have a distressing and disabling psychiatric condition that affects one’s perception, cognition and emotions, and impairs quality of life, relationships and well-being.  but it is quite another level of tragedy when that condition goes undiagnosed, or when one is unable to get access to treatment because of stigma and shame or a lack of insurance coverage.  Relief from symptoms and recovery may be postponed or may never happen.  the consequences are not just inconvenience – as with any serious non-psychiatric medical condition, they are real, life-altering and potentially life-threatening.

For decades, the APA has worked diligently to provide definition in the environment of mental health through the development of the Diagnostic and Statistical Manual of Mental Disorders.  since DSM-III, each edition has provided evidence-based guidance in manual form for use by clinicians and researchers to diagnose and classify mental disorders so that patients in need can be effectively evaluated and gain access to treatments.

Since DSM-IV was released in 1994, there has been a wealth of new research and knowledge about the nature and frequency of mental disorders, how the brain functions and its neurobiology, and the lifelong influences of genes and environment on a person’s health and behavior.  Accordingly, the newest edition – DSM-V – will reflect that new body of knowledge.  And people who now suffer from a range of conditions will be the beneficiaries as they become increasingly likely to get an accurate diagnosis and access to treatment for it.

Many of the changes that are being proposed for this new edition were done to better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but are less well-defined under the guidelines of the current DSM-IV edition.  the hope is that by more accurately defining disorders, diagnosis and clinical care will be improved and new research will be facilitated to help improve our understanding.  

The APA recognizes the importance not only of the document, but of the process for creating it and takes this responsibility with the utmost seriousness and as a sacred trust. Contrary to Ablow’s comments, the process for revision is not arbitrary and not politicized.  

For this revision, the APA recruited more than 160 of the top researchers and clinicians from around the world to be members of the DSM-V Task Force, Work Groups and Study Groups.  

These experts in neuroscience, biology, genetics, statistics, epidemiology, social and behavioral sciences, and public health were rigorously vetted for any conflict of interest using guidelines derived from other academic professional organizations and from the federal government itself and have worked assiduously for over five years to scour the scientific literature and determine whether any changes to existing DSM-4 diagnoses and additions were warranted.  they participated on a strictly voluntary basis and come from several medical and health care disciplines including psychiatry, psychology, pediatrics, nursing and social work.

The definition of mental illnesses may at times be a matter of debate – and they should be.  but the importance of mental illness and the need to recognize and diagnose it cannot be understated.  Without them, diagnostic approaches could vary widely.  the treatment of conditions would be uneven.  Payment for services would be difficult, to say the least.

For too long in human history, persons with mental illness were feared, persecuted or ignored. Stigma of mental illness in our society was pervasive. 

However, through biomedical research and enhancement of public awareness we have made great strides in the U.S. to establish a strong scientific basis for our understanding of human behavior and brain disorders that affect mental functions and bring them out of the shadows so that people can recognize symptoms and seek treatment. 

That is why the APA has gone to great lengths, and taken great care, from every angle, to produce a document that incorporates new knowledge to develop the latest guidelines that will benefit practitioners and patients alike.

Dr. Jeffrey Lieberman is the chairman of Department of Psychiatry at Columbia University College of Physicians and Surgeons, and director at the New York State Psychiatric Institute.

(Credit:YouTube/Kennedy Krieger Institute)

(CBS News) Autism experts frequently tout the importance of children getting diagnosed early, since studies have shown early invention leads to better outcomes later in life. A new study shows that a simple diagnostic test that checks how a child controls his or her head posture might provide another clue for pediatricians and parents.

10 early warning signs of autismExperimental drug reduces autism symptoms in mice, gov’t study showsComplete coverage: Latest developments in autism

Typically, red flags that might lead to an autism diagnosis are issues with social and communicative traits, such as avoiding eye contact or not playing with others. but Dr. Rebecca Landa, the study’s author and director of the Center for Autism and Related Disorders at Kennedy Krieger Institute in Baltimore, says certain disruptions in a child’s motor development may provide important clues.

For the study, researchers assessed infants in a simple “pull-to-sit” task that measures posture control by firmly – yet carefully – pulling a child’s arms from a position of lying flat on his/her side back into a sitting position (as seen in the videos below). Typically infants achieve this type of posture control by the time they are four months old.

In one experiment, researchers gave this task to 40 infants who were considered to be genetically high-risk for the disorder because a sibling has autism. They researchers were looking specifically at “head lag” – the inability to control head posture – at 6, 14, 24 and 30 months of age.

The researchers found 90 percent of subjects eventually diagnosed with autism exhibited head lags as infants, and 54 percent of kids who met social and communication delays criteria exhibited head lag, while 35 percent of children who did not meet that criteria exhibited the lag.

In a second experiment, Landa and her team examined only six month olds at a single point in time to check for head lag, and found 75 percent of the high risk infants displayed head lag compared with 33 percent of low-risk infants, further emphasizing that head lag is more common in infants that may develop autism.

Landa’s study is to be presented at the International Meeting for Autism Research on may 17 in Toronto.

“While previous research shows that motor impairments are linked to social and communication deficits in older children with autism, the field is just starting to examine this in younger children,” she said in an Institute news release. “Our initial research suggests that motor delays may have an important impact on child development.”

If some parents try the test at home and are worried, Landa emphasized to the Baltimore Sun that a head lag at six months does not mean a child is definitely going to have autism, but rather is a potential sign that a pediatrician should explore further. baltimoresun.com/health/blog/bal-poh-autism-test-for-infants,0,1502094.story

“We don’t want to scare parents,” she said. “If I go to the doctor because I’m having problems with balance, he’s not going to assume I have a brain tumor. when a baby shows a head lag there are so many other things it can be. but this is a very real indicator of something wrong with development and easy things can be done to help.”

Dr. Alycia Halladay, director of environmental research for the advocacy and research group Autism Speaks, told WebMD that the findings are “intriguing” but a head lag’s diagnostic value remains uncertain.

“The first step is to replicate these outcomes in larger studies in multiple sites,” she said.

The study adds to recent research aimed at diagnosing autism at an early age. A recent study found differences in nerve connections seen in infants’ brain scans might signal autism, CBS News medical correspondent Dr. Jon LaPook reported.

About 1 in 88 children has autism, according to recent government estimates.

This video from the Kennedy Krieger Institute shows a typical neck/head development at four months:

This video shows an example of a head lag:

SEATTLE – it was a clue – the kind of clue medical researchers notice.

Intent on finding answers about autism, now estimated to affect 1 of every 88 children, they followed it, poking and prodding and scanning, prying open its secrets.

It was a curious little observation that, for any individual child, didn’t mean much. But over time, measurements from hundreds of children suggested an intriguing trait: as a group, preschoolers diagnosed with autism tended to have larger heads.

That meant something was going on with their brains. But what?

The clue, pursued with the help of MRI scans that peered into sleeping babies’ brains, led researchers to a stunning discovery: Long before symptoms appeared, 6-month-old babies – who were much later diagnosed with autism – already had marked differences in their brains’ “wiring,” the white matter that connects different regions.

To Dr. Stephen Dager, a principal investigator for the University of Washington arm of the multisite Infant Brain Imaging Study, the finding was a shock. Researchers began the scans at 6 months only because they wanted a baseline.

What they found, almost by accident, appears to be the earliest biomarker for autism.

“Who knew you could see a difference at 6 months of age?” said Dr. Evan Eichler, a UW professor of genome sciences and autism researcher not involved in the brain study. “That tells us something really important.”

Like other scientists focused on autism, the UW researchers are eager to find ways to diagnose the disorder earlier so children can get help earlier.

“If these subtle early brain-wiring findings hold up, then it may help us understand the mechanism and the parts of the brain that are implicated, and areas of potential weakness to target with intervention,” said Dager, a UW professor of radiology.

At this point, intervention primarily means behavioral therapy. the earlier it begins, the more likely it is to alter autism’s grip on a child, said Annette Estes, a clinical psychologist and co-principal investigator for the UW site of the study, published recently in the American Journal of Psychiatry.

Ultimately, though, what everyone wants – particularly now that “personalized medicine” has begun to create gene-specific drugs – is to put an end to autism. the disorder can rob children of social and communication skills, leaving them to shun contact and lock themselves into rigid, repetitive behaviors.

There’s no blood, genetics or physical test – including measuring an individual child’s head – that can predict or diagnose autism. instead, diagnosis depends on a set of behavioral differences, in the early years often so subtle that they’re missed.

“All we know about autism diagnosis, right now, are the symptoms that are expressed,” Dager said.

Like polio in the early stages, he said, the only help currently available to children with autism is the equivalent of the iron lung – treating symptoms, but not the underlying disorder.

Now, as scientists did with polio, “we’re trying to go back, to understand the why.”

That quest has gained greater traction in the past few years, thanks to technological advances in imaging and genetics, an influx of funding from private foundations and the willingness of thousands of families to participate.

From genetics to a mother’s metabolism during pregnancy, findings are pouring in from far-flung corners of the research world.

Most scientists believe this neurodevelopmental disorder results from genes, environment and “a kind of luck of the draw,” Dager said.

“It’s a mysterious disorder, so there’s been a lot of effort trying to understand it.”

Higher risk of autism

For their study, Dager, Estes and a host of other researchers zeroed in on the brains of children statistically at higher risk of autism because they have a sibling who already had been diagnosed.

Other studies, said the study’s senior author, Dr. Joseph Piven at the University of North Carolina, Chapel Hill, looked at children only after diagnosis, and never followed children over time, as this one does.

“You can’t just study them at one point in time,” he said. “(Autism) is an unfolding of a condition, both in terms of behavior and of brain.”

To set up the study, the first of its kind, the researchers had to painstakingly calibrate the imaging machines at many different sites, because tiny inconsistencies could obscure or render meaningless the subtle differences they were looking for.

In Seattle, the scans took place at night at Seattle Children’s, where researchers depended on parents, some of whom flew in from distant states, to coax babies to snooze in the giant MRI tube.

What exactly did Dager and his colleagues see when they peered into those baby brains? Immediately, nothing discernible.

But later, after all the scans were sliced and diced and analyzed, researchers looking at results from 6-month scans found differences between babies who demonstrated autism symptoms at 24 months and those who did not.

The differences in those 6-month scans involved the babies’ “white-matter fiber tract development” – the wiring connecting regions of their brains.

“The early nature of these brain changes was really surprising,” Estes said.

So far, the evidence discovered with this type of MRI, called diffusion tensor imaging, or DTI, points not to just one region of the brain, but to a whole-brain problem, Dager said.

The findings, he cautions, are preliminary.

Researchers are careful to note they can’t diagnose an individual 6-month-old from a brain MRI. However, “this suggests that perhaps in the future we will be able to do that,” Estes adds.

“There’s real excitement about this,” she said, in part because it helps reassure distraught parents that their parenting didn’t cause autism. “This is already present at 6 months of age.”

looking through them

Amy Schley was pregnant with Alexis when she saw a flier for Dager’s study at a doctor’s office.

She and her husband, Brian, were concerned because their older daughter had been diagnosed with autism about two years earlier.

When Alexis was 1 month old, the couple signed up for the study.

“I ended up doing it because it would help them figure out what causes autism,” Amy Schley said.

Knowing Alexis would be evaluated by Estes and other behavioral experts as part of the study, she said, was reassuring. “We would catch the problem early if there was one.”

That didn’t happen with Alexis’ older sister.

“I think back; she had signs at 6 months old, but I didn’t know,” Schley said.

The doctor asked if their baby looked at them. Schley said she did. But now, with Alexis as a comparison, she realizes it wasn’t really at them. “It was more like she was looking through us.”

She babbled, as babies are supposed to do. But not at her parents.

When she played with a toy, she didn’t turn to check in with her parents.

Balance and motor skills lagged. if she climbed a few stairs, she’d panic, unable to get down.

She didn’t process stimulation well and would often scream in public.

Schley and her husband, first-time parents, didn’t add up the clues.

“The first kid, you don’t know. It’s such a subtle difference,” she said. “I didn’t really know until I had a normal kid to compare it to.”

Mutations in genes

many parents were hoping genetics researchers would find a single “autism gene.”

So it was with mixed emotions they greeted a trio of studies published in the journal Nature this month, one authored by the UW’s Eichler, reporting that researchers studying more than 600 families with one child with autism had found mutations in hundreds of different genes – possibly in as many as a thousand.

Most weren’t “random genes,” Eichler said, but were associated with early brain development. and while autism can run in families, in some cases these were new mutations, unique to the child.

The researchers also found that fathers were more likely than mothers to transmit tiny genetic glitches to offspring, and that risk increased with the father’s age.

Other researchers are targeting metabolism as a possible factor. A study recently published in Pediatrics reported that mothers who are obese or who have diabetes are more likely to have a child with developmental delays, including autism.

Vaccines, shunned by some wary parents, have been investigated repeatedly, and researchers have found no link with autism.

Controversy also has dogged a statistic regarding the prevalence of autism, recently released by the Centers for Disease Control and Prevention – up an astounding 78 percent over the past decade. the jury’s still out on the central question: is autism occurring more frequently, or simply being diagnosed more often?

Such questions may help explain why, after decades of work and at least $1 billion spent in the past 10 years alone, science has no neat answer about autism’s cause, much less a cure.

[This unedited press release is made available courtesy of Gamasutra and its partnership with notable game PR-related resource GamesPress.]

London, UK – April 19, 2012 –Today, Ubisoft announced House, M.D.™: Critical Cases is now available onFacebook. Based upon the hit television show, HOUSE, the gameallows fans to join House and his team at Princeton-PlainsboroTeaching Hospital to investigate and uncover medical mysteries.Working alongside their favourite characters from the show andtheir Facebook friends, players race against the clock to diagnoseand cure the most critical cases.  House, M.D.: Critical Cases is licensed through UniversalPartnerships & Licensing on behalf of NBCUniversal TelevisionConsumer Products Group.

Interact with Characters from the Show

Consult with House and his team on the most mysterious cases byrunning lab tests, investigating symptoms and examiningenvironmental causes to diagnose patients. 

Manage your Own Hospital

Run your own Princeton-Plainsboro Teaching Hospital by screeningclinic patients, managing lab resources and overseeing pharmacysupplies.

Work alongside your Facebook Friends

Hire friends to help out and perform diagnostic tests, treatreferrals and revive crashed patients to save as many lives aspossible. 

Exclusive to Facebook

House, M.D.: Critical Cases is specifically designed for socialgamers. It’s easy to pick up and play, plus it’sabsolutely free.

House, M.D.: Critical Cases can be found on Facebookhere: https://apps.facebook.com/housemd-game

Ubisoft is a leading producer, publisher and distributor ofinteractive entertainment products worldwide and has grownconsiderably through a strong and diversified line-up of productsand partnerships. Ubisoft has offices in 26 countries and has salesin more than 55 countries around the globe. it is committed todelivering high-quality, cutting-edge video game titles toconsumers. for the 2010-11 fiscal year Ubisoft generated sales of€1,039 million. To learn more, please visit: ubisoftgroup.com.

© 2011 Universal Network Television LLC. House M.D. is atrademark and copyright of Universal Network Television LLC.Licensed by Universal Studios Licensing LLC.  all RightsReserved. Software © 2011 Ubisoft Entertainment. all RightsReserved. Ubisoft and the Ubisoft logo are trademarks of UbisoftEntertainment in the US and/or other countries.

Ubisoft Limited. Registered number: 2409000 England & Wales.Registered office: First Floor, Chertsey Gate East, London Street,Chertsey, Surrey, KT16 8AP

Information contained in this e-mail is intended for the use ofthe addressee only, and is confidential and may also be privileged.If you receive this message in error, please advise us immediately.If you are not the intended recipient(s), please note that any formof distribution, copying or use of this communication or theinformation in it is strictly prohibited and may be unlawful.Opinions, conclusions and other information in this message that donot relate to the official business of Ubisoft Limited shall beunderstood as neither given nor endorsed by it. Attachments to thise-mail may contain software viruses which may damage your systems. 

Researchers in Germany find that mental health practitioners tend to diagnose ADHD using their intuition and unclear rules of thumb, not recognized diagnostic criteria.

PROBLEM: The rates of ADHD diagnosis in the developed world have become almost inflationary, increasing annually by an average of three percent from 1997 to 2006 and 5.5 percent from 2003 to 2007 in the U.S. but how accurate are these diagnoses?

METHODOLOGY: Researchers led by University of Basel’s Katrin Bruchmueller surveyed 1,000 child and adolescent psychotherapists and psychiatrists across Germany, 473 of whom participated in the study. they received one of four case vignettes, and were asked to give a diagnosis and a recommendation for therapy. in three out of the four cases, the described symptoms and circumstances did not fulfill ADHD diagnostic criteria. The gender of the child was included as a variable as well, resulting in eight cases.

RESULTS: Many mental health practitioners seem to proceed heuristically and base their decisions on unclear rules of thumb. The respondents more readily diagnosed ADHD when the case involved a male patient and presented prototypical symptoms, such as impulsiveness, motoric restlessness, and lack of concentration. they were, for instance, twice more likely to conclude ADHD with the boy version of the vignettes than with the girl vignettes. interestingly, even the therapist’s gender played a role in the diagnostic as male doctors diagnosed ADHD more frequently than their female counterparts.

CONCLUSION: ADHD is over-diagnosed because doctors rely too much on their intuition and not on defined, established diagnostic criteria.

SOURCE: The full study, “Is ADHD Diagnosed in Accord With Diagnostic Criteria? Overdiagnosis and Influence of Client Gender on Diagnosis,” is published in the Journal of Consulting and Clinical Psychology.

WASHINGTON, March 31 (UPI) — Lupus patients often downplay pain and other symptoms to their physician and family and friends, a U.S. survey indicates.

The survey of 1,000 adults conducted by Roper indicated 87 percent of those diagnosed with lupus report playing down symptoms to their families, while 52 percent said they minimized symptoms to their doctor.

However, 72 percent of physicians surveyed said they did not think their patients minimized symptoms.

“We are seeking further Congressional support for adequate training of healthcare professionals to better recognize, diagnose and treat lupus,” Margaret Dowd, president of the Lupus Research Institute, said in a statement. “The survey confirmed the need for greater professional understanding of the disease.

The Lupus Research Institute is urging every member of Congress to join the new Congressional Lupus Caucus to raise awareness of lupus among patients, their caregivers, healthcare professionals and researchers. The more people know about lupus, the quicker symptoms are recognized and the more effective the treatment.”

A complex autoimmune disease, lupus affects more than 1.5-million U.S. adults, primarily women.

The survey was conducted on behalf of Human Genome Sciences and GlaxoSmithKline. No margin of error was provided for the survey.

Routinely giving children electrocardiograms could detect some cases of potentially fatal heart problems, but it would also cause many false-alarms along the way, a new study suggests.

An electrocardiogram, or EKG, is a fairly simple test that uses electrodes placed on the skin to record the heart’s electrical activity. They’ve long been used to help diagnose heart disease in people with chest pain or other symptoms of heart trouble.

But the idea of using EKGs to screen symptom-free people for heart problems is controversial.

That’s partly because EKGs are imperfect; they don’t detect all heart abnormalities that can cause sudden death, and they can falsely suggest problems where there are none.

It would be great to have a test that clearly catches those silent heart problems, with a low risk of “false-positives.”

But the EKG is not that,” said Dr. Laurel Leslie of Tufts Medical Center in Boston, the senior researcher on the new study.

Right now, the U.S. Preventive Services Task Force recommends against EKG screening for people at low risk of heart disease.

Children and teenagers are at very low risk of having potentially fatal heart disorders. But whenever a young person dies suddenly of cardiac arrest, it’s a shock — and often widely publicized, especially deaths among young athletes.

There’s been this debate about whether ECG screening would be practical and effective in preventing these tragic deaths,” said Leslie.

Some countries, including Italy and Israel, already have mandatory EKG screening for young athletes. The U.S. is not one of them

There have also been questions about whether EKG screening could be a good idea in kids being prescribed stimulants for attention-deficit hyperactivity disorder — though that is not currently recommended.

One of the prime arguments against such screening is that heart disorders that are detectable by EKG are so rare in kids that the risk of false-positives outweighs the potential benefits.

High risk of false alarms

For the new study, published in the journal Pediatrics, Leslie and her colleagues tried to gauge the potential effectiveness of routinely screening symptom-free kids for three heart disorders: hypertrophic cardiomyopathy, long QT syndrome and Wolff-Parkinson-White syndrome.

The three conditions, while rare, are the most common EKG-detectable causes of sudden cardiac death in kids, said Angie Mae Rodday of Tufts, who also worked on the study.

Using data from 30 studies on the heart conditions, the researchers calculated that EKG screening would have a very low risk of false reassurance — that is, giving an OK to kids who actually have the heart problems.

But it would carry a high risk of false alarms. Even under the best scenario the researchers considered, 59 percent of kids with a positive EKG screen would, in fact, not have any of the three heart conditions.

That’s related to the fact that these are rare disorders,” Rodday said.

Based on the studies the researchers reviewed, the three heart conditions together occur at a rate of 188 cases for every 100,000 kids.

Sudden death from heart problems is rarer still. in the U.S., estimates range from less than one to about six such deaths for every 100,000 children and teens.

False alarms from screening tests are always concerning because of what comes after.

In this case, Leslie noted, there’s the anxiety that positive results cause parents and kids, and the cost and burden of follow-up testing. Abnormal EKGs would typically be followed by an echocardiogram, a more expensive test that looks at the structure and motion of the heart.

This study is just one step in considering whether routine EKG screening is worthwhile, Rodday said.

There’s also logistics — like who would do all of that screening? Some pediatricians have EKG devices in their offices.  But some of these disorders are pretty hard to interpret,” Leslie noted.

That means it may take a pediatric cardiologist to interpret the results. and there are only about 1,500 pediatric cardiologists nationwide.

And then there’s cost, Leslie said.  People point out that EKGs are inexpensive,” she said, noting that the actual test runs about $10 to $25. But that’s a lot when multiplied by millions of kids, and there’s also the cost of interpreting those tests — and then any follow-up that may be needed.

For now, Leslie and Rodday suggested that parents who have concerns talk with their pediatrician. There may be some cases where screening could be considered — like when there’s a family history of sudden cardiac death before the age of 50.

The best bet is to talk to your pediatrician,” Rodday said.

Health bosses raise awareness of ovarian cancer symptoms

4:10pm Tuesday 6th March 2012 in News

MARCH is ovarian cancer awareness month and hospital chiefs are keen to raise awareness of the symptoms to ensure early detection and treatment.

According to statistics, 17 women in the town will be diagnosed with ovarian cancer in 2012 but knowing the signs including persistent pelvic/stomach pain, increased stomach size, persistent bloating and having difficulty eating could help patients seek advice early.

Nigel Holland, gynaecological consultant at the trust, said: “If ovarian cancer is diagnosed at an early stage the outcome is good. “However, because some of the symptoms of ovarian cancer can be vague and similar to those of more common conditions, it can be difficult to diagnose.”

Women are also advised to tell their GP if there are two or more cases of ovarian or breast cancer in their close family.

Visit ovarian.org.uk.

more News stories

there are few medical diagnoses more life changing than Parkinson’s disease. This neurodegenerative disorder is detected in some 70,000 people in the U.S. each year; Michael J. Fox and Muhammad Ali are best known for having Parkinson’s disease.

As a neurologist, I find it particularly tragic that most of these patients are referred late and do not find out they have Parkinson’s until they are already suffering from the severe tremors, walking difficulties, loss of smell and other physical manifestations of the disease.

Parkinson’s occurs when dopamine-producing cells, which control aspects of movement, diminish in the brain. we know that the disease starts working its damage long before physical symptoms show up. Parkinson’s can take as long as 12 years or more to develop, and the first mild symptoms are often mistaken as part of the normal aging process.

Because there are no simple tests to detect Parkinson’s in its early stages, it can take up to two to three years to accurately diagnose the disease. By the time someone has their first physical sign (tremor, rigidity or shuffling gait), 50 percent to 70 percent of the brain cells that produce dopamine, which controls movement, have already died.

Unfortunately, there is little that we physicians can offer patients at that point other than damage control. if we could intervene earlier on, we might be able to stave off or delay the progression of disease through neuroprotection.

In Pasadena, we have the first-FDA approved radiopharmaceutical imaging agent that can help physicians evaluate patients with suspected parkinsonian syndromes (PS) and related diseases. It is called DaTscan. Despite the unavailability of a simple blood test, tools like DaTscan can offer evidence that may help lessen diagnostic uncertainty and confusion for early-stage Parkinson’s patients and their families.

When DaTscan is combined with a single photon emission computed tomography (SPECT) brain scanner, it produces visual evidence of the amount of dopamine transporter cells, allowing physicians to determine whether occasional tremors are the result of Parkinson’s or some other cause.

DaTscan has been in available in Europe for more than 10 years; the FDA approved the imaging agent for use in the U.S. in January 2011; I scanned the first patient in Pasadena with it on Sept. 6. I believe that DaTscan will revolutionize both neuroimaging and the treatment of Parkinson’s as more and more hospitals and physicians learn about this method.

DaTscan can also detect Parkinson’s Disease by detecting early risk factors (red flags) alone or in combination, that may appear more than a decade before physical symptoms, such as , decreased or lost sense of smell or certain sleep disorders, but these uses are not yet FDA approved.

Just think how much we could slow down this difficult disease and improve lives of patients and their caregivers if we are able to act before the symptoms of Parkinson’s become debilitating and ensure that treatment recommendations are appropriate. I am certain that early detection is the future for Parkinson’s disease.

Dr. Jerome Lisk is a physician at Southern California Movement Disorder Specialists, 65 N. Madison Ave. Suite 410, Pasadena. 626-792-6683. socalmds.com

Friday January 27, 2012

ASHLEY FALLS — A local herd of cattle was not actually infected with a rare bacteria as previously suspected, according to state regulators who have lifted a ban on milk sales at Twin Rivers Farm in Ashley Falls.

The state Department of Public Health acknowledged in a terse statement Thursday that the initial diagnosis of the farm’s owner as having contracted brucellosis, which is what prompted the farm’s initial quarantine, was incorrect.

Neither the DPH nor the state Department of Agricultural Resources have any further health concerns at this time, according to the statement.

As to what led health officials to diagnose brucellosis in the first place, officials were silent. The statement acknowledging negative test results from the farm contained no other information and a spokeswoman didn’t return calls for further comment.

Twin Rivers Farm made news across the state on Sunday after officials distributed an alarming consumer alert linking raw milk sold at the farm to brucilla, a bacteria that hasn’t been seen in this state in over two decades.

Only about 22 of the 680 gallons of milk Twin Rivers sells a week are raw; the rest are taken off site and pasteurized, a process that eradicates the bacteria.

Public health officials said the germ’s appearance in the state would have “significant implications” for the state’s livestock. according to the Centers for Disease Control and Prevention, brucellosis can cause fever, sweats, headaches, back pains and physical weakness in humans, leaving chronic, long-lasting symptoms in some cases.

Although the state’s initial release didn’t indicate who had contracted brucilla, the farm’s owner, Robert Kilmer, told The Eagle last week that he was the case referenced by the health officials.

Kilmer, who wasn’t available for comment Thursday, previously told The Eagle he strongly doubted his milk was to blame for his sickness. He said his herd of about 270 was vaccinated for the germ and that no one else exposed to the milk had gotten ill.

Advocates for raw milk, who are currently pushing legislators to ease restrictions on sales of the product, also were critical of the state’s focus on unpasteurized milk as the cause of Kilmer’s illness.

“It seemed like they jumped to a conclusion too quickly,” said Winton Pitcoff, the coordinator of the Raw Milk Network of the Northeast Organic Farming Association’s Massachusetts chapter. “And now they aren’t doing enough to acknowledge that the end result is good news.”

A spokesman for the Department of Agricultural Resources said the agency “just wanted to take the necessary precautions.”

To reach Ned Oliver:,or (413) 496-6240.On Twitter: @BE_NedOliver