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NEW YORK (Reuters) – Traumatic brain injury, the signature wound of the Iraq and Afghanistan wars, is doubly cruel: it leaves many victims emotionally shattered and cognitively crippled. But because mild and moderate brain injuries do not show up on CT or other imaging, doctors and even family members are often skeptical that any real damage exists.

Now the first experiment of its kind documents exactly what “the invisible injury” – at least the kind caused by blast waves or repeated physical impacts – does to the brain: Crumpled axons, which carry signals between neurons; gummed-up neurons like those in Alzheimer’s disease; strangled blood vessels.

An injured brain is so littered with the chewed-up remains of neurons and other cells that “it looks like autophagy – the brain eating itself alive,” said Lee Goldstein, an Alzheimer’s researcher at the Boston University School of Medicine and co-leader of the study.

The discovery promises to help such injuries be taken more seriously, and might lead to preventives or treatments. It comes at a time when both the Pentagon and the National Football League are struggling with the legacy of head injuries.

Tens of thousands of U.S. troops have sustained such injuries and some have committed suicide or other acts of violence. In one horrific case, an Army staff sergeant who had sustained head trauma is accused of murdering 17 Afghan civilians in March.

The invisibility of many head injuries “is a huge problem,” said retired U.S. Army General Peter Chiarelli, chief executive officer of One Mind, a non-profit group promoting brain research. “The ER doc will say, ‘why am I wasting my time with this guy when I have people with visible injuries?’”

Adding to the urgency: the recent suicides of former pro football players who sustained head injuries during their playing days. The most recent, former San Diego Chargers linebacker Junior Seau, fatally shot himself earlier this month.

MAKING ‘THE INVISIBLE INJURY’ VISIBLE

For the new study, published Wednesday in the journal Science Translational Medicine, scientists compared three groups of brains. Four came from military veterans who had suffered the blast of an improvised explosive device (IED) or a concussion. Four belonged to young athletes who had concussions. And scores were from mice that had been exposed to a blast akin to that from an IED 17 feet (five meters) away packed with 12 pounds (5.4 kilograms) of TNT, comparable to an IED made from a 120-mm artillery round.

None of the brains had obvious injury. “If you hold them in your hand you don’t see any damage,” said neuropathologist Ann McKee of the Boston University School of Medicine and the Veterans Affairs New England Healthcare System, co-leader of the new study. “CT and MRI don’t see it. It takes a microscope, even an electron microscope.”

With that scrutiny the damage was clear. Specialized cells called astrocytes extended what BU’s Goldstein called “little feet” that wrapped themselves around blood vessels. Axons crumbled and wound up in cellular garbage cans. Long strings of proteins called tau formed, as seen in Alzheimer’s disease.

The damage was strikingly similar to what scientists have seen in the brains of ex-football players who had sustained head injuries and, after death, were found to have chronic traumatic encephalopathy (CTE), the condition once known as boxer’s dementia.

CTE can cause depression, aggression, impulsivity and memory loss and has been linked to suicide. “Men become very aggressive, develop a hair-trigger temper, and their judgment is off,” said Goldstein. “These are all part and parcel of damage to the brain.”

Age offered no protection. In the new study, the athletes ranged in age from 17 to 27 when they died. They are the youngest head-injury victims ever found with CTE.

Until this study, scientists could not be sure that head injuries, from an IED or a linebacker, caused the brain or behavioral changes. That’s where the lab mice came in. While anesthetized and in a special tube, they were exposed to blasts akin to those suffered by U.S. troops in Iraq and Afghanistan.

Even though a shock wave barreled through the animals’ skulls at 336 miles per hour, “there was no bleeding, no contusions, no rips in the tissue,” said Goldstein, who led the mouse part of the study. “They looked for all the world like what we see in human cases of traumatic brain injury – the invisible injury that people have been talking about since World War One.”

The mice’s behavior changed, too: they could not remember or learn as well after the blast as before it. “This matches what veterans (exposed to IEDs) say: ‘I’m thinking slow and I can’t remember,’” said Goldstein.

The three lines of evidence – from veterans, athletes and lab mice – suggest a common mechanism by which head injury causes CTE and CTE impairs mental function.

Blasts in a war zone and head trauma on a gridiron both break axons and stretch neurons, said McKee, a football fan who has four bobble-head dolls of retired NFL quarterback Brett Favre in her office. That stretching makes their membranes more porous, allowing calcium ions to flood into the neuron and activating enzymes that alter tau proteins just as they are altered in Alzheimer’s. As a result, said McKee, “the neuron is no longer functional.”

It may not even take such dramatic impacts to impair mental skills. A second study released on Wednesday showed that some college football and hockey players had lower scores on thinking and memory tests after a season of enduring repeated but minor hits to the head.

The players, outfitted with special helmets that measured head impacts, experienced an average of 469 during the season, scientists led by Thomas McAllister of the Geisel School of Medicine at Dartmouth reported in the journal Neurology.

TREATING AND PREVENTING

There are no approved treatments for traumatic brain injury. One experimental drug from BHR Pharma, a subsidiary of Besins Healthcare SA, is in the last stage of human testing.

But the study suggests the military should re-examine soldiers’ protective gear. Heavy helmets that protect against impacts and even bullets “are like putting a bowling ball on top of a match stick,” said Goldstein, exacerbating the destructive acceleration and deceleration from a blast wave.

When the mice’s heads were immobilized, though, an identical blast produced no brain damage. That finding “has invaluable implications for future safety measures,” said psychologist Jennifer Wilde of the University of Oxford, who was not involved in the study. Namely: “special helmets to help keep soldiers heads still during a blast.”

The results also suggest that head trauma should be treated immediately instead of waiting for symptoms. The BU scientists “are working on field-deployable treatments,” Goldstein said, including anti-inflammatory drugs and agents that target leaky blood vessels.

The U.S. military tries “to identify TBI as soon as possible and provide effective treatment,” said Pentagon spokesperson Cynthia Smith. That policy pertains “regardless of whether the injury is obvious and severe, or subtle and hidden.” All service members in a vehicle collision or rollover or within 150 feet of a blast undergo a mandatory medical evaluation.

The new study also confirms the physical reality of psychological illnesses that the military and others have sometimes dismissed. “Post-traumatic stress disorder has been regarded as a purely psychological illness, because we’ve been looking at brains with CT and MRI,” said neuropathologist Bennet Omalu, chief medical examiner of San Joaquin County in California and co-founder of the Brain Injury Research Institute. BIRI hopes to examine Seau’s brain, which the BU lab is also in the running for.

“CT and MRI don’t have the resolution to show the cellular and sub-cellular changes you can get from a concussion or sub-concussive injury,” said Omalu. “Now we can see that PTSD is likely to be a manifestation of traumatic brain damage.”

(Reporting by Sharon Begley; Editing by Michele Gershberg and Eric Beech)

Story By: by Robert Krulwich

A hundred years ago — and that’s when this picture was taken, in 1912 — men didn’t leave home without a hat. Boys wore caps. This is a socialist political rally in Union Square in Manhattan. There may be a bare head or two in this crowd, but I think those heads are women’s.

Here’s another rally, Union Square again. This time it’s an Occupy Wall Street demonstration. A hundred years have passed. Same place. Same kind of crowd. But this time: hardly a hat.

Flip back one more time. We’re back, I think, in Union Square, with Emma Goldman arriving by car. She’s another socialist (this isn’t an essay about lefties, it’s about hats) and there she is, the only woman in a sea of men wearing a sea of hats.

So what happened? Why did guys stop wearing headgear in midcentury America?

The turning point, most people say, was John F. Kennedy’s inauguration. Before Kennedy, all presidents wore top hats on their first day at work. Kennedy brought one, but hardly ever put it on. Fashionistas say Kennedy, one of our most charismatic presidents, made hats un-happen. And, chronologically speaking, after JFK, guys everywhere, even balding ones like astronaut John Glenn, went topless.

Astronaut John Glenn, left, and President John F. Kennedy, center, inspect the Friendship 7 Mercury capsule on Feb. 23, 1962, which Glenn rode in orbit. At right is Vice President Lyndon B. Johnson.

But I am the son of a hat designer. And my father, Allen S. Krulwich, had a different explanation. The president who de-hatted America, he thought, was Dwight Eisenhower.

Here’s my dad’s logic.

In the 1950s — and this was one of Ike’s grand accomplishments — he built a vast highway system across America. Interstates went up everywhere. Cities extended roads, turnpikes, highways, and suburbs appeared around every major city. People, instead of taking a bus, a tram, a train to work, could hop into their new Chevy or Ford and drive.

Before Eisenhower, many more people used public transportation. After Eisenhower, they used a car. That, my father thinks, created the critical Head-To-Roof Difference.

A person of average height standing in a bus, tram or subway car has, roughly, three feet between the top of his head and the roof.

If he chooses to wear a hat, (which depending on the hat can extend his height 3 to 18 inches), there is still lots of room above him. So he keeps his hat on.

Now imagine the same person, sitting in the drivers’ seat of his car. The Head-To-Roof distance is much narrower, so narrow that to stay comfortable, a man would feel it proper to remove his hat.

Until cars became the dominant mode of personal transport, there was no architectural reason to take your hat off between home and office. With Dwight Eisenhower’s interstate highway system came cars, and cars made hats inconvenient, and for the first time men, crunched by the low ceilings in their automobiles, experimented with hat-removal, and got to like it.

Yes, there may have been other motivations; Kennedy had great hair; so did the Beatles, fashion was changing wildly at the time, but if we are looking for a president to blame — and my father, whose business suffered in the 1960s and 1970s — wanted to blame someone, I’m going to stand with him: I blame Ike, because Ike built the highways that created the cars that lowered the roofs that crushed the hats that changed the fashion that ruined the business that supported the Krulwiches.

It's often been reported that North Koreans are a few inches shorter than their counterparts south of the border. Is that true?

This statistic, or versions of it, have been quoted for some time. In 2010 the late Christopher Hitchens put the difference at six inches in an article in Slate titled "A Nation of Racist Dwarfs".

A difference is also obvious between North and South Korean children.

"The height gap is approximately 4cm (1.6in) among pre-school boys and 3cm (1.2in) among pre-school girls, and again the South Koreans would be taller."

Schwekendiek points out that the height difference cannot be attributed to genetics, because the two populations are the same.

"We're dealing with the Korean people," he says, "and Korea is interesting because it basically hasn't experienced any immigration for many centuries."

Martin Bloem is head of nutrition at the World Food Programme, which has been providing food aid to North Korea since 1995. He says poor diet in the early years of life leads to stunted growth.

"Food and what happens in the first two years of life is actually critical for people's height later," he says.

In the 1990s North Korea suffered a terrible famine. Today, according to the World Food Programme, "one in every three children remains chronically malnourished or 'stunted', meaning they are too short for their age".

South Korea, in contrast, has experienced rapid economic growth. Bloem says "economic growth is one of the main determinants of height improvement".

So while North Koreans have been getting shorter, South Koreans have been getting taller.

"If you look at older Koreans," says Schwekendiek, "we now see a situation where the average South Korean woman is approaching the height of the average North Korean man.

"This is to my knowledge a unique situation, where women become taller than men."

The secretive nature of North Korea makes it difficult to find reliable data for analysis.

Schwekendiek has studied refugees, but he rejects the notion that people driven to cross the border to South Korea are the most disadvantaged and therefore most likely to be stunted.

The refugees, he says, "come from all social strata and from all regions".

He has also studied data collected by the North Korean government and by international organisations working in North Korea, which he says support his findings.

It seems that this height statistic reveals a tragic fact – that as South Koreans have got richer and taller, North Korean children are being stunted by malnourishment.

Story By: Fresh Air from WHYY

by Edward Humes

Edward Humes is the author of several books, including Force of Nature: The Unlikely Story of Wal-Mart’s Green Revolution.

On trash incineration programs

“The image in America is so poor that it’s really had a difficult time getting traction, and in some places it has been attempted, it has been disastrous because of mismanagement,” he says. “The entire city of Harrisburg [Pa.] is bankrupt now because of the way they failed to manage their trash burners. So it’s gotten a black eye in the U.S.”

On the largest active landfill in the United States, Puente Hills, which is more than 500 feet tall and has been collecting garbage for more than 60 years

“It’s actually filled a valley that used to be a dairy farm and is now a mountain built of trash. … It’s 500 feet tall, so when you stand atop it, you’re standing on the biggest man-made structure in California. It is a plateau of garbage. The smell varies. One day I was up there and it smelled like Christmas trees because they were mulching pine trees up there. Other times, it is the most noxious, rotting, sulphuric smell, and literally, it burns the nostrils as you inhale it. But the smell is not as impressive as the sheer scale of this place. It has 130 tons of garbage contained in this mountain. It is a high point in the south end of Los Angeles, so you can see the entire basin of Los Angeles by standing on a mountain of its trash.”

On how trash is estimated by the EPA

“Every landfill weighs the stuff that comes in, [but] the EPA doesn’t do that. They purport to measure trash and issue an official trash bible every year, but it’s an indirect method. They calculate how much stuff we manufacture in the U.S. and what its life expectancy is, and they crunch these numbers and they sort of predict how much trash will be thrown away. And unfortunately, it vastly underestimates the trash that we make.”

On China trading trash as an export/import product

“They’re finding value in material we’re not able to find value in and paying relatively little for it — shipping it immense distances with enormous environmental impact involved in that, and then using it to manufacture products they’re shipping back to us. And we’re buying and basically turning it into trash again, and then it’s an endless cycle. It’s an incredibly wasteful process. You think of all of these 12,000-mile journeys with giant cargo vessels shipping this material. The perverse economies of it work because of the nature of our consumer economy, but it’s an incredibly wasteful process.”

Paper or plastic?

“The correct answer is neither, if you want to have the best solution. … In terms of the actual greenhouse gas impact, a paper bag tends to be higher.”

Story By: by Eric Whitney, Colorado Public Radio

The Colorado Coalition for the Homeless runs the Stout Street Clinic in Denver, helped Dale Miller get a CT scan.

Dale Miller spends his days on the streets of downtown Denver selling a newspaper called The Homeless Voice. He’s been having some health problems, but he can’t afford to see a doctor on the $10 to $15 a day he makes selling papers.

A local charity clinic called the Colorado Coalition for the Homeless recently helped him get a CT scan at no cost to him. Miller fully understands, though, that someone has to pay for his care.

“The state’s paying for that, ya dig? I mean, it’s not free,” says Miller. “I’ve got my itemized bill in my backpack for my last Thursday’s visit, and it was like $450 for the doctor, $1,100 for the lab work, and the state’s paying for that.”

The state’s actually only paying for a small part of those bills. Colorado has an indigent care program that helps charity clinics and hospitals cover bills like Miller’s. But it only pays about 10 cents on the dollar. That’s starting to change as Colorado is adding people to its rolls for Medicaid, the state and federal health program for the poor and disabled.

“It is historic. We’ve never done that in the past, so this is definitely a new foray for us, into this area,” says Colorado Medicaid Director Suzanne Brennan.

The state is one of just a few that is expanding Medicaid ahead of a bigger push called for in 2014 by the federal health law. Starting in mid-May, Colorado will begin offering Medicaid to adults like Miller who make less than $1,080 per year (that’s 10 percent of the federal poverty line, or $90 per month) — but there’s a catch. Though the state estimates that there are 50,000 people who meet the income bar, Colorado will only be able to offer the health coverage to 10,000 people. Those people will be chosen by lottery in each county.

Like most states, Colorado has limited Medicaid, mainly to cover poor kids, pregnant women, the disabled and some elderly. That’s because the federal government offers states a dollar-for-dollar match to help cover those populations, but nothing for adults without kids. So most states don’t cover them, no matter how poor they are.

But the Affordable Care Act has a provision that extends that federal match to help states cover adults who don’t have kids. Colorado is the seventh state to take advantage of it. The state has spent years crafting a way to come up with its share of the match.

“We passed legislation that allowed us to do this, and it’s related to the hospital fee, and it’s allowed us to do this for the first time,” Brennan says.

Colorado hospitals volunteered to pay a new fee to state Medicaid, and that money pulls in the federal matching funds. That, in turn, allows the state to offer Medicaid to more people. It’s a win for the hospitals, because more people on Medicaid means fewer unpaid hospital bills.

But the combined funding still isn’t enough to cover all 144,000 adults in Colorado below the federal poverty level — which is $11,170 for a single person — even though Brennan says that was the original goal.

“We did research around the country to understand this population, and based on what we know are their needs, we reduced the number of people who would be eligible for this program,” she says.

They reduced it by a lot, capping enrollment for now at 10,000 people, that’s less than 10 percent of adults below the poverty line in Colorado. But the state expects the new Medicaid enrollees to rack up bills twice as high as the average Medicaid recipient.

It expects higher bills because poor people without insurance typically don’t go to the doctor as often as people with coverage. They may not see a doctor at all until their conditions become dire.

Dr. Marti Shulte treats a lot of people like that at the clinic run by the Colorado Coalition for the Homeless in Denver.

“The complications I see in a 45-year-old, I might not have seen in private practice,” Shulte says. Complications include conditions “like amputations or foot ulcers from diabetes, or renal disease in a diabetic who’s 43 instead of what I might have seen in somebody who’s 60 or 65.”

Colorado, and the Obama administration, say that giving Medicaid to more people will mean they can avoid expensive complications like that, because it will cover primary care to help people stay healthy in the first place.

But Republicans are fighting Medicaid expansion, at both the federal and state level. Colorado GOP State Senator Shawn Mitchell says it’s just too expensive.

“The state can’t afford it, the economy can’t maintain it, and we’re just lying telling people we can cover everything we put on paper that we cover,” Mitchell says.

Democrats say America can afford the huge Medicaid expansion in the 2010 health law, and that it will actually save money long-term.

That’s if the Supreme Court doesn’t strike it down.

This story is part of a partnership with Colorado Public Radio, NPR and Kaiser Health News.

There’s also the metal pole extending from her kneecap down to her ankle, along with countless screws, keeping her left leg intact.

“My body was destroyed,” said Matson, an artist living in Brooklyn. ”My whole life was put on hold for months, and no one seemed to care.”

It happened in October, 2010, on what Matson and her boyfriend, James Paz, thought was an innocuous bike ride home from a concert.  

“I was riding in front of Michelle, about 10 feet in front of her,” Paz said.  “I heard a loud scraping, scratching noise, there was a second of blackness, and then I was flying through the air.”

What had lofted Paz into the air was a speeding driver who, according to witnesses, fled the scene. Paz hobbled to his feet, noted the mangled remains of his bike and scanned the area for Matson. 

When he did not see her, he panicked.

“I was screaming her name,” Paz said. “Then I saw her lying in the middle of the right-hand lane of the road … at that time I didn’t know if she was alive.”

No charges have been filed in the case.

Matson’s story is a reminder of a growing problem in many of the nation’s busy, sprawling urban landscapes: More people are using bikes for transportation amid a culture and infrastructure designed for automobiles.

Although New York police and the city’s Department of Transportation report increasing bicyclists, the number of bike deaths has remained steady. In fact, overall traffic deaths have dropped by 39% since 2001, according to the NYPD.

But that statistic offers little comfort to Matson.

It’s not just the facts of the incident — or even the tiny particles of debris from the New York City street still in Matson’s body — that have left her upset. It’s what Matson describes as investigative inertia by the New York City Police Department when it came to her case.

“There were no legal repercussions for the driver whatsoever, because the NYPD chose not to investigate the hit-and-run,” Matson said. “It blows my mind that this is even possible … people get in worse trouble for double-parking.”

In 2010, in more than 6,000 New York City traffic accidents involving cyclists, 36 people died, according to the state Department of Motor Vehicles. Transportation Nation reported that no criminal charges were filed against the drivers involved.

One woman — the mother of an artist named Mathieu Lefevre, who was killed on a bike — is on a crusade to learn more about his death and to make roads safer for cyclists. There is a growing sense among the city’s cycling community that to many authorities, bicyclists don’t matter.

“Cyclists and pedestrians are being killed and seriously injured all over our city, once every 35 hours in fact,” New York City Councilman James Vacca said at a hearing this year. “And the drivers are literally getting away with it.”

CNN repeatedly contacted the NYPD for comment about Matson’s hit-and-run and the department’s policy about cycling accident investigations, but did not receive a response.

Cyclists who think police are biased against them are fueled by another statistic: In 2011, the NYPD issued 10,415 criminal court summonses to truck operators. During the same year, 34,813 summonses were issued to bicyclists.

“While there may be some lawbreaking among the cycling population, very few if any of those transgressions of the law are resulting in death or serious injury,” said Paul Steely White, executive director of Transportation Alternatives, a bicycling advocacy group. “But when a trucker runs the red light or speeds, the consequences very often are deadly.”

There are also problems, in the eyes of lawmakers and advocates alike, with how crashes are investigated.

According to statements made by the NYPD, only traffic accidents involving imminent or actual death are investigated. Those cases are handled by one of 19 members of a special unit called the Accident Investigation Squad, or AIS.

“Their role is to utilize their special training to conduct a more comprehensive investigation, employing a variety of techniques in order to establish speed, analyze skid marks and other physical characteristics of the accident scene,” said John Cassidy, executive officer of the Transportation Bureau of the NYPD, at a City Council hearing in February. “In essence, reconstruct the accident so that a more definitive cause, possibly resulting in criminal charges, may be determined.”

But with only 19 detectives, AIS resources are stretched, so members of the unit are not always deployed, even when death is imminent, according to activists.

“Staffing for these crashes is not what it should be,” said Steve Vaccaro, an attorney with Rankin and Taylor, a law firm specializing in cases involving bicycling accidents. “This resource is not what it should be if we’re going to have these investigations.”

The issue has hit the blogosphere. Advocates are pushing for a law that would force police to investigate all serious bike accidents.

For Matson and Paz, virtually no investigation of their case occurred, they say. That leaves Matson, who still struggles with a debilitating injury to her left leg, with little legal recourse after her accident.

“If you lose your limbs in a [bike] crash, you don’t get an investigation,” said White, the bicycling advocate. “Without that investigation, it’s virtually impossible to hold reckless drivers accountable when they do break traffic laws and they seriously injure pedestrians or cyclists.”

Perhaps not surprisingly, a year and a half after her hit-and-run, Matson has refused to ride a bike.

Story By: Talk of the Nation

From the muscle-bound dad in The Incredibles, to the dinosaurs running wild in Jurassic Park, to Brad Pitt aging backward as Benjamin Button, Ira Flatow and guests look at the evolving technology used to create characters and visual effects on the silver screen.

Story By: by Nancy Shute

The brains of people who grow up speaking two languages are wired differently, and those differences protect them from dementia as they age.

That’s the news from two studies out this month from a scientist in Canada who has spent decades trying to figure out whether being bilingual is bad or good. “I’ve been doing this for 25 years,” Ellen Bialystok, a distinguished research professor of psychology at York University in Toronto, tells Shots. “Suddenly people are interested. I figure it’s because everybody’s scared about dementia.”

Since about 20 percent of Americans are bilingual and as many as 60 percent of people in big cities like Los Angeles grew up speaking two languages, this is no small issue.

Not so long ago, it was thought that being bilingual was a disadvantage, because bilingual children have smaller vocabularies in both languages and are slower in word recall. But more recent research finds that bilingual children are better at “executive processing,” which includes being able to pay attention, plan and organize thoughts.

That’s the focus of one of the studies, which concludes that kids who grow up speaking two languages are better at switching between tasks than kids who spoke only one language. Researchers gave 104 children a common executive function test on a computer that asked them to sort images of either colors or animals on a computer screen. This “switching” task tests working memory and the ability to change from one rule to another.

The children who were bilingual in French, Chinese or Spanish were better at switching categories – in essence, multitasking. That may well be because they learn early on to toggle between the two sets of rules for English and their other language. Bialystok is one of the authors of this study published in the journal Child Development.

So does it do you any good when you’re grown up? That’s been a big question in research on the bilingual brain. The second recent study adds to growing evidence that being bilingual as a child helps a lot later in life.

It reviews the state of research on bilingual adults, and finds they maintain better executive functioning later in life than monolingual people. That extra “cognitive reserve” may allow the brain to better cope with the damage caused by dementia, thereby delaying symptoms. (Being physically and mentally active has also been shown to have cognitive benefits.) The article, also co-authored by Bialystock, is in the current issue of Trends in Cognitive Sciences.

But what about those of us who aren’t bilingual? Are we doomed?

“The kind of story we’re telling about bilingualism and dementia is not that bilingualism is the only inoculation against dementia, but rather, bilingualism is one of the many things we know that contributes to cognitive reserve,” Bialystok says. “It’s why you’re supposed to do crossword puzzles and exercise and learn a musical instrument. If you’re not bilingual but you’re active and engaged, you’re getting cognitive reserve.”

Still, bilinguals do have a natural advantage, she notes, because they can stay active and engaged without making a huge effort.

“Nobody spends all day every day doing crossword puzzles, but everybody spends all day every day talking,” Bialystok says. “It’s a way to get massive doses of this stimulating activity without doing anything special.”

WASHINGTON (Reuters) – U.S. regulators gave the nod to an imaging test from Eli Lilly and Co. that can for the first time help doctors detect brain plaque tied to Alzheimer’s disease, the company said.

The U.S. Food and Drug Administration approved the radioactive dye, called Amyvid, to help doctors rule out whether patients have Alzheimer’s, the most common form of dementia, Lilly announced late on Friday.

The dye binds to clumps of a toxic protein called beta amyloid that accumulates in the brains of patients with Alzheimer’s. Doctors can then see the plaque light up on a positron emission tomography, or PET, scan.

Patients with Alzheimer’s always have some brain plaque, so its absence in the test would tell doctors to look for other causes of mental decline, such as depression or medications, Lilly has said.

But Lilly, which plans to sell the drug through its unit Avid Radiopharmaceuticals Inc, said the test should not be used to diagnose Alzheimer’s, since brain plaque can also be tied to other neurologic conditions and may occur naturally in older people with normal mental states.

An FDA advisory panel recommended against approving the dye last year, saying doctors might have trouble interpreting scans of the plaque, and the FDA rejected Amyvid last March.

Since then, Eli Lilly said it has worked to identify better ways of training doctors to use the test.

Dr. Daniel Skovronsky, CEO of Avid, said one in five patients who are diagnosed with Alzheimer’s turn out not to have the disease after an autopsy.

“The approval of Amyvid offers physicians a tool that, in conjunction with other diagnostic evaluations, can provide information to help physicians evaluate their patients,” he said in the company’s statement from Friday.

There is currently no cure for Alzheimer’s, a mind-robbing disease that affects more than 35 million people worldwide and gets worse with age.

But an early hint that something is wrong might improve the success of drugs meant to prevent or delay disease progression, researchers believe.

Avid has been in the lead in the race for imaging agents for Alzheimer’s, which are estimated to have a potential global market anywhere from $1 billion to $5 billion.

General Electric Co and Bayer AG are developing rival products.

Lilly, as well as Pfizer Inc, are the farthest along in developing experimental medicines to treat Alzheimer’s. Lilly expects to release final data for its contender, solanezumab, as soon as this summer.

(Reporting by Anna Yukhananov; editing by Todd Eastham)

When Kaiser Health News asked for questions during the Supreme Court arguments this week, one that didn’t seem to get addressed in court was this:

What happens to people who have already benefited from the law? This would include seniors who got rebates in the Medicare prescription drug “doughnut hole,” for example. Would they have to give the money back to … the manufacturers? The government?

The answer, according to Tom Goldstein, publisher of SCOTUSblog, “The only phrase that comes to mind, and it’s not exactly a legal one is: ‘God only knows.’ “

That’s just for starters.

Watch Goldstein, legal analyst Stuart Taylor and NPR’s Julie Rovner dissect this eventful week with KHN’s Mary Agnes Carey.

Here’s the video of their conversation: