By Vivy Tran.

Time is brain.

This is the maxim that a group of UCLA undergraduates herald throughout Los Angeles at community health fairs.  These students are found trailing the Brain Attack Team at Ronald Reagan hospital or loading health education materials in their cars.  Together, the members of the Stroke Force team of students have been banded under one goal, to address the gaping lack of knowledge of strokes and of brain damage in their community.

Dr. Sidney Starkman, head of the Brain Attack Team, started Stroke Force when he noticed a clear disparity between stroke education and stroke treatment.  In the emergency room, students saw the clear impact of this need themselves.

Strokes simply go unnoticed.

The third leading cause of death in the United States, strokes are surprisingly little known in the public.  There are 795,000 strokes a year in the United States, approximately one stroke every 45 seconds.  Despite the breadth of its impact, only 57% of the population can name one symptom.  Consequently, is not uncommon to have stroke patients coming into the Emergency Room hours and even days after the onset of stroke.  Many patients claim they deferred medical attention simply because they could not understand what their symptoms meant.  For students, it is disheartening to have to witness the patient tell their stories and then be refused the potential treatment they could have been given.

Daily we are bombarded with reminders for heart attack and cancer, yet matters of the brain are often discarded.  For those without any formal neuroscience course, neurological problems are seen as abstract, and thus incongruous with a common person’s life.

Stroke Force is unique in that beyond learning from the Brain Attack team, the students strive to empower the community with this newly acquired knowledge.  The students aim to convert these difficult neurological concepts to practical use by educating others.  Participating in community health fairs and presentations, the students aim to invigorate their community peers to learn about strokes and teach others what they know.

Stroke education and stroke treatment are inextricably tied.  Tissue plasminogen activator (tPA), the only FDA approved drug for acute stroke, is only approved to be given within three hours of stroke onset.  This strict time window is one reason only 2% of potential stroke patients receive the proper treatment nationally.  Patients can never qualify for proper treatment by remaining unaware about the disease.

“Stroke survivors have told me that the worst news they received from doctors wasn’t that their paralysis, inability to communicate, or visual deficits would be permanent, but that all of this could have been avoided if they had just known how to prevent or deal with a stroke,” said David Yao, a veteran of Stroke Force.

Just this last February, the UCLA Stroke Center was named on the American Heath Association/American Stroke Association’s “Target:Stroke” honor roll, recognizing its more than 50% tPA administration rate to eligible ischemic stroke patients.  In essence, this means patients have acknowledged their stroke and arrived to the hospital within the strict three-hour time window.  This honor distinguishes less than 1% of stroke centers around the country.

“The recent placement of the UCLA Stroke Center on the American Heart Association’s ‘Target: Stroke’ Honor Roll [informs us] that our efforts to spread awareness of the dangers of stroke and the importance of getting immediate medical attention after a stroke don’t go unheard,” said Nandie Khahera, Stroke Force Education coordinator.  “It shows me that they want to be informed and that large niche of stroke awareness is something we try to fulfill on a daily basis.”

Despite this relative success within the Los Angeles community, Stroke Force aims to invigorate the community with continual efforts toward educating their peers regarding stroke.  Within the last few months, these students have presented to over 800 members of the community.  They have often had to change their slides and information with updated increased stroke incident numbers from the American Heart/Stroke Association.  This is just a reminder that the mission of Stroke Force still stands to be completed.

For the time being, however, Stroke Force has found its place within this community.

“Together, we are helping each other learn how to improve the population’s health overall,” said Jeni La, Stroke Force Internal Affairs and Campus Relations coordinator.  “I may be teaching them how to recognize a stroke and what to do in case of a stroke, but I’m also learning from them.”

Complementing student learning with student-led teaching, as exemplified by the efforts of Stroke Force, is an important method of education that we should all consider as we continue toward our own academic paths.

By Adrienne Law

For those living outside of California, it is not uncommon for the state to have a blissful reputation for its sun, surf, and recreation. At the same time, the Golden State has been considered to be the marijuana capital of the country.

In the last decade, Marijuana has been involved in California legal policy changes. Perhaps due to its prominent legal status as well as its effects behavior, the science behind marijuana has been an area of great interest, especially among the scientific community.

According to the National Organization for the Reform of Marijuana Laws, in California, those caught with recreational marijuana are fined $100 due to a bill passed last January. Only medical marijuana is legal in the state, and that requires a license indicating physician approval.

Proponents of legalizing marijuana think that people without a license should stop invading dispensaries with medical marijuana. On the other hand, opponents point to a moral issue: will legalization cause young people to think drugs are okay?

Marijuana has actually been used for a variety of ailments, such as anxiety and nausea. Additionally, it is a cannabanoid, a type of drug known to stimulate appetite–one medical use is treatment for anorexia nervosa. Thus, marijuana is clinically relevant.

“Some patients find it more helpful than conventional drugs… for example, people in chronic pain can find that they are unresponsive to typical pain treatments like morphine and anti-inflammatories (and) can find help in marijuana,” said Dr. Anna Taylor, a postdoctoral neuroscience student in the laboratory of Dr. Christopher Evans, the director of UCLA’s Opioid Research Center and the Shirley and Stefan Hatos Center for Neuropharmacology.

Marinol, the medical form of marijuana, has different biological effects compared to recreational marijuana.

“[Marinol] is in a pill form and takes a longer time for the effects to be felt by the patients,” Evans said.

However, smoking marijuana has a quicker effect.

“Patients who are in pain, would prefer to have a faster onset of effects that happen in smoking as they would like to get rid of the pain quicker,” Taylor said.

According to the Drug Enforcement Agency, which classifies drugs by their potential abuse and medical benefits, Marinol is a schedule III drug. Schedule III drugs have a greater medical use and less chance of being abused.

“But there are still consequences of chronic use,” Evans said.

General scientific studies cited in The Neurobiology of Addiction by George F. Koob and Michel Le Moal suggests that marijuana causes various harmful effects from impairment in driving to schizophrenic symptoms. However, it is not as physically addictive as other drugs.

“Brain images taken of drug addicts show that marijuana addicts have less brain damage than addicts in other drugs,” Taylor said.

Drug researchers also know that there is minimal to no withdrawal effects for marijuana compared to alcohol and cocaine withdrawal.

But does medical marijuana really work? There have been studies published where patients with chronic pain rate their pain level before and after smoking marijuana. Results show they actually rate the pain levels the same.

“Marijuana is not necessarily effective in taking away pain,” Taylor said. “It helps with the coping of pain.”

Taylor mentioned that there are big industries that are trying to develop drugs mimicking marijuana’s medicinal effects.

“Chronic pain patients tend to respond less to drugs, so researchers are trying to discover alternative treatments,” Taylor said.

But finding medical marijuana equivalents is not easy because it is difficult to target specific types of pain.

“The problem of chronic pain is that it is diverse and different medications [are used] for the specific type of pain,” Taylor said.

A few examples are nerve disease, side effect of diabetes, and HIV AIDS. Other general treatments for these diseases include gabapentin (an antiepileptic), tricyclic antidepressants, and other cannabanoid agents. Morphine and oxycontin are also sometimes used.

Besides relieving chronic pain, marijuana is also known to decrease stress due to the release of dopamine in the brain, a neurotransmitter associated with the sensation of reward.

“A reason why marijuana is addictive is that it causes dopamine release in the brain and puts you in a different state of mind,” Evans said. “There (are) a lot of people who try it once or twice, but it’s a matter of taking it again and again that it becomes problematic.”

Research shows that marijuana is related to neural circuitries that, when aroused, give the patient a euphoric effect.

“Marijuana inhibits specific neurons that prevent dopamine release, which is why it takes away stress,“ Taylor said.

Since marijuana has caused controversy, funding for its research has been known in the scientific community to be hard to obtain, causing a scarcity of research on the topic.

Regardless, Evans thinks that young people should be aware of differences between different drugs.

“In universities, hopefully there are less marijuana abusers because of the population’s higher level of education,” Evans said. “But young people generally should still be aware of the drugs out there.”

One of the ways UCLA neuroscience could assist with Evans’s cause and our cause is to find ways to educate students about the biological effects of drugs like marijuana. It is then up to college educated individuals to raise awareness, especially in underserved communities. Perhaps then we’ll be known for more than just sun and surf.

By Sherry Soliman

For many patients diagnosed as being in a vegetative state, the prospects of recovery are grim. They are alive in body only, unable to interact or communicate with the world around them. No one knows what occurs in the minds of these individuals or if they have any awareness of their surroundings.

However, all of that may be about to change by a team of international scientists offering a glimpse into the minds of these patients. For the first time, brain scans showed that patients who demonstrated no external signs of alertness could understand the spoken commands of others. One patient could even answer basic biographical questions.

The study was published in the New England Journal of Medicine and provided hope for different means of communicating with those deemed no longer awake to the outside world.

Dr. Adrian Owen, one of the lead neuroscientists on the study, noted that some patients may have cognitive abilities beyond what they appear capable of achieving. Indeed, some estimates place the misdiagnosis of the vegetative state as high as 40%.

In the present study, the group of 54 subjects tested included 23 in vegetative state and 31 in a minimally conscious state. Patients in a vegetative state are thought to have absolutely no awareness of their environment. Whereas those in a minimally conscious state display deliberate behavior frequently enough for physicians to distinguish it from responses that are exclusively reflexive or unconscious (they may sometimes laugh or cry and might even reach for objects). These types of diagnoses are usually made at the bedside through a set of neurological exams to determine the degree of awareness.
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