“Header”? More like “Deader.”

By Duke McDaniels

Interior of the Stade de France, 7th-largest stadium in Europe and site of the one-man takedown of the entire French soccer team by Denmark’s Andreas Cornelius.

Before Will Smith was known for causing head injuries, he was better known for their study. In his 2015 film “Concussion,” Smith portrayed Dr. Bennet Omalu, one of the most important scientists responsible for pioneering the study of Chronic Traumatic Encephalopathy (CTE) in American football players. Dr. Omalu’s research is largely responsible for the current interest in the effects of constant concussions on players of contact sports, and when one is aware of and looking for these concussions in the midst of such sports, they cease to be mere accessories of the pastime and become impossible to overlook.

When I finally set off for the Stade de France after an intense internal debate about whether or not to attend the rugby game on the program schedule, this is the attitude I expected to have as a scientifically-inclined spectator. As someone with a generally low interest in professional sports, I had resolved to observe the rugby game to study the frequency of these head injuries in real time. So, when to my great surprise the players jogging onto the field were accompanied by a ball that was significantly more round and checkered than the rugby ball I had expected, I discovered in a shocking twist that what we were actually spectating was the France vs Denmark Nations League game. 

The distinction between rugby and soccer initially appeared to be night and day for me with regards to concussion frequency. 30 massive dudes charging at each other headfirst versus 22 dancing their way across the field with the slightest tap resulting in an Oscar-worthy performance? Come on. However, as I continued my mission of tracking head injuries, I realized they happened much more frequently than I expected. Despite the focus being on the lower parts of the player’s bodies, soccer is still very much a contact sport, and the neurology of the players supports this. A 2019 retrospective study by Mackay et al. found that among the nearly 8000 former professional soccer players they followed, the 15.4% which died across the length of the study were more likely to have a cause of death related to neurodegenerative disease than controls, and were also prescribed dementia medication more frequently (Mackay et al, 2019). While still not on the level of other sports, soccer players are just as much at risk of these types of injuries, as well as their long-term consequences. We as scientists and as fans (if you’re into that sort of thing) have a responsibility to make it known.

Yours truly and the others who tagged along seated in the stadium. Photo credit to Adway Gopakumar.

Mackay, D. F., Russell, E. R., Stewart, K., MacLean, J. A., Pell, J. P., & Stewart, W. (2019). Neurodegenerative disease mortality among former professional soccer players. New England Journal of Medicine, 381(19), 1801–1808. https://doi.org/10.1056/nejmoa1908483

Let them eat cake! Marie-Antoinette in Versailles

This week Zoe, Grace and I went to a ballet at the Royal Opera of Versailles. We took the train down to Versailles in the rain and had a moment of panic when our connecting train was delayed. Thanks to our fantastic Uber driver, however, we made it to the palace just in time for the show. Seeing a ballet was my top bucket list item while in Paris, so this was a highlight of my time here so far. The Malandain Ballet Biarritz performed their contemporary ballet Marie-Antoinette choreographed by Thierry Malandain. The work explored the relationship between Marie Antoinette and Louis XVI from their wedding night in 1770 (she was 15 and he was 14) to the storming of Versailles in 1789. The coolest part of the experience for me was that the ballet depicted specific scenes in Marie Antoinette’s life, like watching the play Perseus with Louis XVI, that happened in the same theater we were sitting in. Being able to watch the ballet that takes place in Versailles from Versailles was definitely a unique experience that added a very special component to the show.

The dancers and orchestra receiving a standing ovation.

The final scene of the ballet was at the beginning of the French Revolution. According to legend, Marie Antoinette’s hair turned white overnight, on the day before she was to be executed. When I researched more about Marie Antoinette’s life after the show, I learned that this is a phenomenon that has been recorded a few times in history that is now referred to as “Marie Antoinette syndrome”. While “Marie Antoinette syndrome”, or the sudden whitening of hair, is largely believed to be a myth, Skellett et al. argue that the historical account of Marie Antoinette can simply be explained by either temporary hair dye washing or alopecia triggered by stress (Skellett et al. 2008). The link between stress and alopecia can be seen in the hypothalamic-pituitary-adrenal (HPA) axis that is involved in regulating stress hormones. Some patients with alopecia areata have had upregulated levels of corticotropin releasing hormone (CRH) receptors in hair follicles (Paus et al. 2009). CRH is a key hormone in the HPA axis that leads to the release of cortisol. Since Marie Antoinette was definitely experiencing extreme amounts of stress the night before her execution, her HPA axis was probably secreting a lot of CRH and a lot of cortisol. This evidence could then help explain the case of “Marie Antoinette syndrome” she experienced.

One more of the Royal Opera house
Girls night out

References:

Paus, R., & Arck, P. (2009). Neuroendocrine perspectives in alopecia areata: does stress play a role?. The Journal of investigative dermatology129(6), 1324–1326. https://doi.org/10.1038/jid.2009.111

Skellett, A. M., Millington, G. W., & Levell, N. J. (2008). Sudden whitening of the hair: an historical fiction?. Journal of the Royal Society of Medicine101(12), 574–576. https://doi.org/10.1258/jrsm.2008.080337

Wait…is this soccer? Photo Post #2

 

This past Friday, we all made the transition from obnoxious American sports fanatics to obnoxious European sports fanatics! Adorning French face paint, we headed up to the top of the stadium to rugby, I mean, football, which was surprisingly brutal physically for the players. I counted 6 potential head injuries for my chosen player, #7. Luckily, it seems that there actually has been extensive research into both the implications of soccer-related head injuries and how they can be prevented as early as youth soccer leagues. In fact, one study looked at implicating behavioral skills training, or BST, into youth soccer programs to demonstrate and enforce a safer means of “heading” the ball that leads to less physical duress. These researchers found that there was vast improvement amongst the players after BST as opposed to players without BST, so perhaps this practice should be implemented in more youth sports programs.

References:

Quintero, L. M., Moore, J. W., Yeager, M. G., Rowsey, K., Olmi, D. J., Britton‐Slater, J., Harper, M. L., & Zezenski, L. E. (2019). Reducing risk of head injury in youth soccer: An extension of behavioral skills training for heading. Journal of Applied Behavior Analysis. https://doi.org/10.1002/jaba.557

 

Exploring Saint-Louis Hospital

Ally Grubman

This was a picture I took on the way to the dermatology museum on the Saint-Louis Hospital campus in Paris. While we didn’t get to actually visit the museum on this trip, the hallway outside of it had many pictures and portraits of patients with dermatological illnesses. These illnesses were interesting to look at and related to the paper we were talking about in class at the time. Mainly, some of the portraits of the patients had chancres, the main symptom of early syphilis, which is what our last paper was about. This helped me visualize the illness we had just been talking about and put it all into perspective. Can’t wait to go back and actually see the museum next time!

Photo Post 2

Image 2: Various types of cheese at cheese tasting.

Early in our trip, we visited Fromagerie, a cheese shop, in Paris. I have never been a huge fan of cheese; however, being able to experience the unique tastes of various cheeses native to France was memorable. In class, we discussed a paper on how cheese palatability could provide some stress relief (Fourman et al., 2021). Although cheese may not be my preferred comfort food of choice, it was nonetheless eye-opening to learn about the various cheese making techniques implemented in all parts of Europe. 

Photo Post 1

This picture was taken when our class went to a Nations League game (soccer) played between the French and Denmark national teams. The game took place at the Stade de France, undoubtedly the biggest sports stadium I had ever been to. The crowd erupted with every French possession and goal. This experience related to our NBB 402W class as we discussed how white matter tracts and brain structural changes take place with repeated blows to the head. Studies have shown that as many as 22% of soccer injuries are concussions, thus increasing the chances of neurocognitive complications for players in the future (Levy et al., 2012). 

Chocolate, Chocolate, Read All About It!

The other day, our class visited a chocolate museum/ factory called Le muse gourmand du chocolat in the 10tharrondissement. The museum was in a very hip and up-and-coming neighborhood with lots of great restaurant options and young people. Upon entering the museum, the smell of chocolate flooded my senses and instantly made my mouth water. I couldn’t wait to make my own chocolate!

On our way down to the basement where the pastry chef was waiting for us, we saw beautiful and intricate sculptures made of chocolate, including the Eiffel Tower! I was very impressed and couldn’t wait to try out my hand at chocolate making and decorating. In the room, there was a large table with marshmallows, orange peels, and chocolate blocks for us to cover in chocolate and decorate. The pastry chef provided us with milk chocolate, dark chocolate, and white chocolate — I liked the milk chocolate best! I enjoyed adding hazelnuts and coconut flakes to the chocolate dipped marshmallows. It was my first-time trying chocolate covered orange peels, as well, and I discovered that those are not my favorite.

We also made our own chocolate bars. The pastry chef taught us how to add designs to the chocolate bar by combining the different types of chocolate. My favorite design was the “latte art flower”. This was done by covering the mould in a singular type of chocolate, such as milk chocolate, and then a horizontal strip of a different type of chocolate was added to the middle of the mould. A toothpick was used to create an up and down swirl pattern, and once I got to the end, I dragged a straight line in the middle back to the beginning of the bar. The result can be seen in the picture below!

My chocolate bar creations. You can see the fun “latte art” designs in three of the bars.

Not only was this a very fun experience, but I was also able to understand the cognitive and mood enhancing effects of chocolate firsthand! Many studies have been performed to look at the cognitive effects of chocolate, and when researching the topic, I came across an interesting study that used Steady State Probe Topography (SST), a technique I have not learned a lot about. This technique was used to evaluate neurocognitive changes in response to cocoa flavanols during a spatial working memory task. SST is associated with activity cortico-cortico and thalamo-cortical loops of the brain. The study found that there was a correlation between increased neural efficiency and the cocoa flavanol consumption in the spatial working memory task (Camfield et al., 2012).

I am excited and ready to continue the chocolate decorating process! Yum!

Reference:

Camfield, D. A., Scholey, A., Pipingas, A., Silberstein, R., Kras, M., Nolidin, K., Wesnes, K., Pase, M., & Stough, C. (2012). Steady state visually evoked potential (SSVEP) topography changes associated with cocoa flavanol consumption. Physiology & behavior105(4), 948–957. https://doi.org/10.1016/j.physbeh.2011.11.013

Big Brain Energy at the Eiffel Tower

Cynthia Martucci

This past Wednesday, a few of us visited the Eiffel Tower for a picnic on the grass. It was a lovely evening filled with friends, food (i.e. cheese, wine, and baguettes in typical French fashion), and laughs, set underneath the iconic setting of the Eiffel Tower. We definitely were not the only ones enjoying the scenery, as the park was packed with couples, family, and friends soaking up the sun on this fine summer night.

 

Figure 1: Rachel, Sam, Lauren, and I in front of the Eiffel Tower during our picnic.

Constructed for the 1889 Worlds Fair, the wrought-iron lattice structure has become an emblem of the city and is recognized worldwide. The tower is actually the most visited monument with an entrance fee in the world! When Gustave Eiffel designed the tower, he decided to engrave the names of 72 French scientists, engineers, and mathematicians. I had never realized this scientific connection on my visits to Paris before, and began to wonder whether there were any links to neuroscience. It requires a closer look at the arch, but they are there! One such name I found is Marie François Xavier Bichat. His name appears on the first floor of the tower, 14th on the west facing side.

Figure 2: Portrait of Marie-François-Xavier Bichat.
(source: https://www.wonders-of-the-world.net/Eiffel-Tower/Pantheon/Marie-Francois-Xavier-Bichat.php)

Xavier Bichat lived from 1771 to 1802, and trained in medicine in Lyon before moving to Paris. He was interested in investigating the pathology of diseases, and in 1799 he left his career as a surgeon to devote his time to experimental physiology, dissection, and autopsies to understand pathological anatomy. He is quoted to have slept in the morgue some nights in order to continue with as many dissections as possible. One of his greatest contributions was identifying and introducing 21 types of tissues as the basic elements of organs. Of even greater interest to us as neuroscience students is this pioneer’s understanding of the brain and nervous system. In his doctrine of life, he claims that the center of the animal life was the brain, and that of the organic life was the heart. For him, “life rests upon a tripod made of respiration, circulation, and nervation” (Haller 1981). He did, though, acknowledge that there is a dependent relationship between the heart and brain, in that the heart provides blood flow to stimulate cerebral tissue. In addition, he identified the importance of the ganglionic nervous system, and described it as a network of tiny, independent brains within the chest cavity. Overall, it is clear that Xavier Bichat deserves to have his name permanently inscribed on the Eiffel Tower and visible to the millions of visitors every year.

Figure 3: A fun throwback from a previous trip I had taken to Paris.

Reference:

Clarac, F., Barbara, J. G., Broussolle, E., & Poirier, J. (2012). Figures and institutions of the neurological sciences in Paris from 1800 to 1950. Introduction and Part I: Neuroanatomy. Revue neurologique168(1), 2-14.

Haller, J.S., 1981. American Medicine in Transition, 1840–1910. University of Illinois Press, Chicago, p. 13.

Chocolate on Mind & Mood

Ever since I was a little girl, I’ve loved chocolate. The evidence of this is immortalized in my house’s hallways where there is more than one framed photo of me with chocolate frosting or ice-cream smeared all over my face. So, when I heard that one of our excursions on this program was a chocolate-making workshop, I knew that it was my time to shine. 

On our trip to the chocolate museum, we had the opportunity to create and decorate multiple kinds of candies and chocolate bars to get a hands-on experience before exploring the museum full of chocolate facts. Though my work might not have been the prettiest in the room, I had fun exploring and trying new techniques in the process. In fact, I felt like six-year-old me all over again by the end of the workshop, with melted chocolate on my hands, face, and all over my apron.

Me and a friend at the chocolate making workshop

Later in the museum, though, my friends and I found an interactive exhibit that explained chocolate’s effects on the body. The information detailed the effects of chocolate on the skin, bones, digestive system, mood, and multiple other bodily systems. Naturally, as a product of the fact that I’ve been thinking a lot about neuroscience lately, this made me wonder about the effects of chocolate on the brain. I had read literature regarding chocolate’s effect on mood and cognition but was curious as to whether or not it could have a more direct physical effect on brain structure and function. 

One paper I found explored the relationship between methylxanthines found specifically in chocolate, such as caffeine and theobromines, on neuronal plasticity. This study did acknowledge that in research, animal models exposed to higher levels of methylxanthines

Chocolate-making equipment. We dipped all of the candies into white, milk, or dark chocolate and then decorated them with the supplies in the middle of the table.

can protect neurons from dysfunction and even death in the case of a stroke. This work eventually could potentially be translated to neurodegenerative disease, which is a fascinating real-world implication. This effect can also be translated to other methylxanthine-rich foods and beverages, such as tea and coffee. As someone who is an avid coffee and chocolate fan, I can’t complain about the findings of this paper. 

While we’re on the topics of chocolate, Paris, and chocolate in Paris, I figured I would leave you with an insider tip: the best hot cocoa in Paris is undoubtedly at Cafe De Flor. So, if you want to protect your neurons while also having a delicious drink break, head over to the 6th arrondissement and pick up a cup.  

References:

Camandola, S., Plick, N., & Mattson, M. P. (2019). Impact of Coffee and Cacao Purine Metabolites on Neuroplasticity and Neurodegenerative Disease. Neurochemical research44(1), 214–227. https://doi.org/10.1007/s11064-018-2492-0

The French Willy Wonka

Like a French reenactment of Willy Wonka and the chocolate factory (minus the Oompa Loompas), we visited ChocoStory this week to learn a little more about the ins and outs of chocolate making and decorating! From marshmallows to orange peels to chocolate solids, we experimented with several forms of chocolate goodies, even making our own candy bars! Some chose to decorate their delectable treats with corn flakes or Rice Krispie’s, others opted for hazelnuts or coconut flakes.

 

A picture of me and Joon while decorating our chocolate marshmallows.

Kennedy and I decorating our chocolate bars. 

For the majority of our decorating experience, we were given a choice between either milk or dark chocolate. Personally, I prefer milk chocolate, but several of my fellow chocolate decorators around me opted for dark chocolate, which made me wonder why some people may prefer dark chocolate over milk chocolate, or vice versa. This led me to an article on PubMed that investigated the tolerance for bitterness in chocolate ice cream suing solid chocolate preferences. To compensate for the natural bitterness of cacao, many candy/dessert companies will add high levels of milk, sugar, or corn syrup to increase the palatability of the product. Given the current obesity epidemic occurring in the United States and beyond, many experts are concerned about the amount of fattening additives in chocolate desserts. Thus, researchers sought to manipulate the amount of bitterness in chocolate desserts and subsequently observe consumer preferences. The goal of this study was to uncover the threshold for bitterness in chocolate products among a sample of frequent chocolate consumers. The sample was divided into groups that tasted varying levels of bitterness in chocolate, with a control group tasting baseline, “normal” chocolate and each subsequent group tasting increasing bitterness. Added bitterness was simulated using sucrose octaacetate (SOA), a safe food additive that is still strongly bitter at micro molar concentrations. Samples of varying bitterness were manufactured into ice cream at the Berkey Creamery at Pennsylvania State University (PSU). Subjects were recruited from the PSU community via email and indicated their chocolate preferences (milk vs dark) beforehand. As predicted, the group of subjects who indicated that they preferred milk chocolate had a lower bitterness threshold. On the other hand, the participants who had previously indicated that they preferred dark chocolate had a higher tolerance for the bitter SOA additive. Based on this study, I can conclude that I likely would also have a lower bitterness tolerance compared to say Joon who used more dark chocolate than me while decorating.

Overall, I learned a lot of new techniques about chocolate making and decorating through this experience, including how chocolate makers will add other ingredients in order to decrease the bitterness in milk chocolate, and that a lower bitterness tolerance correlates with a preference for milk over dark chocolate.

 

References:

Harwood, M. L., Loquasto, J. R., Roberts, R. F., Ziegler, G. R., & Hayes, J. E. (2013). Explaining tolerance for bitterness in chocolate ice cream using solid chocolate preferences. Journal of Dairy Science, 96(8), 4938–4944. https://doi.org/10.3168/jds.2013-6715