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Archive for Neuroscience/Mental Health

Autism and Vaccines: Responding to Poling and Kirby

In response to my NeuroLogica blog post on Monday, David Kirby wrote a response in the Huffington Post and Dr. Jon Poling (father of Hannah Poling) wrote an open letter to me, placed in the comment section and posted at Age of Autism. It seems only polite that I respond to their kind attention.The primary focus of my original post (which I further developed yesterday) was that the media is focusing too much attention on what celebrities and politicians are saying about the controversy surrounding the discredited notion that vaccines are a significant cause of autism. Over the past year Jenny McCarthy (now joined by her boyfriend Jim Carrey) has become the major spokesperson for a movement that, at its core, is anti-vaccine and is dedicated to the scientific opinion that vaccines are toxic and cause autism. Recently actress Amanda Peet joined the fray, professing her belief that vaccines are safe, are not associated with autism, and that parents who do not vaccinate their children are “parasites” for depending on other parents who do. (She later apologized for that remark, calling it “divisive”.)

While I appreciate Amanda Peet’s support, I feel strongly that scientific questions should be handled by the scientific community. Celebrities are great when they support causes – but when they second guess the scientific community and decide to advocate for their own scientific conclusions, they are more likely to cause harm than good. (more…)

Posted in: Neuroscience/Mental Health, Public Health, Vaccines

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Can Psychosis be Prevented?

I recently read an article in Discover magazine entitled “Stop the Madness.” It was about a new treatment program that allegedly can prevent schizophrenia and other forms of psychosis. I found it very disturbing.

The PIER (Portland Identification and Early Referral) program was founded by a psychiatrist, Dr. William McFarlane, in Portland, Maine. It has recently expanded to 4 other US sites and there are similar programs in several other countries. PIER is an effort to find and treat patients in the “early stages of deterioration towards psychosis,” so as to prevent the development of psychotic illnesses like schizophrenia, bipolar disorder, and major depression. The program involves various psychosocial interventions and psychotropic drugs.

On the surface it sounds promising, but there is a dark side. I’m particularly concerned about the use of antipsychotic drugs in people who haven’t been diagnosed as psychotic. (more…)

Posted in: Neuroscience/Mental Health, Pharmaceuticals, Science and Medicine

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When “investigative reporting” becomes anti-vaccine propaganda

Introduction: The following is the text of a letter that I mailed to Bob Sliva, General Manager of WXYZ-TV in Detroit in response to arguably the most biased and incompetent “investigative report” about mercury, vaccines, or autism that I have ever seen. I sent the letter by snail mail, because I was always taught that that gets a station manager’s attention far better than e-mail. My plan was to allow the three days until today for the letter to arrive and then to publish the text of my letter here on SBM as an open letter. After I mailed my letter, I worried that no one would bother to look at links that they had to type in themselves, which is why I wanted to post this as an open letter whose link I could then e-mail to the station.

I also worried that maybe I had been insufficiently polite and persuasive, given that one is always urged not to be too insulting or strident when writing to a media outlet. After all, if I were too strident, Mr. Sliva would find it easy to write me off as a biased crank. I also worried that maybe I should have e-mailed Mr. Wilson first. On the other hand, Mr. Wilson is a serial offender. In 2003 and 2004, he did a series on mercury, vaccines, and autism that credulously parroted all the pseudoscience, distortions, and misinformation that we’ve come to expect from the anti-vaccine movement. About two weeks before the “Green Our Vaccines” rally, my routine monitoring of the anti-vaccine underground turned up references to a story that Wilson was working on about the rally and the thimerosal issue. Believers in the myth that vaccines cause autism described Wilson and his earlier report in glowing terms, which sent up huge red flags to me. The original links no longer function, but, thanks to the Wayback Machine, I was able to find the transcripts of the original reports (1, 2, 3, 4, 5). This “reporting” (if you can call it that) somehow garnered an Emmy Award, showing that an award, even a normally prestigious one, is no guarantee of anything resembling scientific accuracy in reporting.

However, it was Mr. Wilson’s comments and behavior after a post by a friend of mine, Dr. Peter Lipson, that made me realize that dealing directly with Wilson was a waste of time and that I was right to go straight to the General Manager. I’ll show why in an addendum and will also add references to sources that refute Wilson’s one-sided and credulous reporting. It’s funny how such a pit pull of an “investigative journalist” who goes after politicians and others with such tenacity can’t find it in himself to ask even a mildly probing question when interviewing “luminaries” such as Boyd Haley or parents with no scientific background repeating anti-vaccine talking points. In any case, here follows the text of the letter that I sent to Bob Sliva, the Vice President and General Manager of WXYZ-TV:

July 9,2008Bob Sliva
Vice President/General Manager
WXYZ-TV
20777 West Ten Mile Road
Southfield, MI 48037

Dear Mr. Silva:
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Posted in: Neuroscience/Mental Health, Science and the Media, Vaccines

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Should We Study Chelation for Autism?

The National Institute of Mental Health (NIMH) supports doing a study on the effects of oral chelation therapy in autism. The proposal is highly controversial, is drawing criticism from many scientists, but has popular support among parents who believe this type of therapy might help their children with autism. The proposal raises many questions about the ethics of biomedical research.

Chelation and Autism

Chelation therapy is a legitimate FDA approved treatment for heavy metal poisoning. The drugs used for chelation, such as disodium EDTA, bind to heavy metals so that they can be removed from the body. Chelation drugs can be given either orally or intravenously. The treatment is somewhat risky because it can also remove needed electrolytes, like calcium, from the body or causes shifts in the electrolytes that can cause arhythmias and changes in brain function. There are reported cases of cardiac arrest and death due to chelation.

Chelation therapy has a long history of quackery – not for its intended use but for other uses for which there is no evidence. The classic example of this is the use of chelation therapy to treat atherosclerosis to prevent heart disease. This claim persists despite the utter lack of evidence for efficacy and the fact that all proposed mechanisms have been shown to be flawed or false.

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Posted in: Clinical Trials, Medical Ethics, Neuroscience/Mental Health, Vaccines

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Jenny McCarthy, Jim Carrey, and “Green Our Vaccines”: Anti-vaccine, not “pro-safe vaccine”

Jenny McCarthy & Jim Carrey at Green Our Vaccines

Last week, there was a rally in Washington, D.C. How many people actually attended the rally is uncertain. The organizers themselves claim that 8,500 people attended, while more objective estimates from people not associated with the march put the number at probably less than 1,000. Of course, such wide variations in estimates for the attendance at such events are not uncommon. For my purposes it is irrelevant whether 500 or 8,000 attended because even if the lowest estimate is closer to the true number this march represented the largest march on Washington ever for this particular cause, the previous largest having occurred three years ago.

Fortunately for public health interests, the organizers’ timing was very bad (for them, at least) in that they marched last Wednesday, the very day after Barack Obama clinched the Democratic nomination. The media were rife with coverage of the history-making nomination of the first African-American as a nominee of a major party, as well as speculation about when and whether Hillary Clinton would concede and endorse Obama. Drowning out most other news, Obama’s nomination led to almost nonexistent news coverage of the rally, aside from a handful of television appearances by one of its celebrity organizers. Its relative lack of success notwithstanding, however, all who support science- and evidence-based medicine should nonetheless remain concerned about this rally, because it was a dagger aimed at the heart of the most effective public health innovation ever conceived by the human mind, an intervention that has arguably saved more lives over the course of human history than every other medical intervention combined. That this dagger turned out to be a toothpick is fortunate indeed but by no means a reason to dismiss the movement that spawned it as irrelevant.

I’m referring, of course, to the antivaccinationist movement, and the rally was known as the “Green Our Vaccines” rally, led by the celebrity couple Jenny McCarthy and Jim Carrey and organized and funded by Talk About Curing Autism (TACA), Generation Rescue (upon whose board McCarthy now sits), and a panoply of other groups that promulgate the myth that either vaccines containing mercury in the form of their thimerosal preservative or vaccines themselves cause autism.
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Posted in: Neuroscience/Mental Health, Politics and Regulation, Public Health, Science and the Media, Vaccines

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Monkey business in autism research

NOTE: I had originally planned on posting Part II of a series on cancer screening. However, something came up on Friday that, in my estimation, requires a timely response. I should also inform readers that, because next Monday is a holiday here in the U.S., I haven’t yet decided whether I will be doing a post next week or not. Stay tuned and check back.

I get e-mail.

Sometimes the e-mail is supportive. Other times, as you might imagine, given some of my posts, it is anything but. On Friday afternoon, I happened to notice an e-mail from an “admirer” of mine that said something like this:

You are a complete jack-ass.

- Generation Rescue

Appended to the e-mail was a link to this article on the Age of Autism blog.

Generation Rescue, as you may recall, is an organization that promotes the idea that vaccines cause autism, and this e-mail almost certainly came from the founder and head of GR, a man named J.B. Handley. In case you don’t know who he is, Handley is a man who is, even by the standards of antivaccinationists, incredibly boorish and possessed of a bull-in-a-china shop manner that alienates even some potentially sympathetic people, although parents who believe that vaccines cause autism seem to love him. He is also quite–shall we say?–flexible in his notions of how vaccines cause autism. Until about a year ago, the Generation website stated unequivocally:

Generation Rescue believes that childhood neurological disorders such as autism, Asperger’s, ADHD/ADD, speech delay, sensory integration disorder, and many other developmental delays are all misdiagnoses for mercury poisoning.

About a year ago, it changed to:

We believe these neurological disorders (“NDs”) are environmental illnesses caused by an overload of heavy metals, live viruses, and bacteria. Proper treatment of our children, known as “biomedical intervention”, is leading to recovery for thousands.

The cause of this epidemic of NDs is extremely controversial. We believe the primary causes include the tripling of vaccines given to children in the last 15 years (mercury, aluminum and live viruses); maternal toxic load and prenatal vaccines; heavy metals like mercury in our air, water, and food; and the overuse of antibiotics.

The kind interpretation is that GR was changing its hypothesis given that the data being published consistently and strongly refuted the myth that mercury in vaccines somehow cause autism. In reality, though, it’s fairly clear that GR was pivoting effortlessly to a hypothesis that not only was nearly completely unfalsifiable but also allowed GR to continue to blame vaccines for autism, which is what it’s really about. More recently, as I have pointed out before, antivaccinationist rhetoric has also pivoted even further and equally as effortlessly to blame unspecified “toxins” or “combinations of toxins” in vaccines. Be that as it may, having felt the love, I have to admit that Mr. Handley sure does know how to charm a guy. When he draws my attention to some abstracts so politely, abstracts that he clearly considers to be very important evidence, how can I refuse to take a look? After all, Mr. Handley himself apparently very much wanted to point me in the direction of these three abstracts, and it would be downright churlish of me to deny him and refuse to look at the studies with as open a mind as possible.
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Posted in: Basic Science, Medical Academia, Neuroscience/Mental Health, Politics and Regulation, Public Health, Vaccines

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Near Death Experiences and the Medical Literature

MIRACLE MAX: See, there’s a big difference between mostly dead, and all dead. Now, mostly dead: he’s slightly alive. All dead, well, with all dead, there’s usually only one thing that you can do.

INIGO: What’s that?

MIRACLE MAX: Go through his clothes and look for loose change.

The Princess Bride

Can you trust anyone when they purport to tell you what the medical literature says? No. As an example we will use the issue of near death experiences, or NDE’s.

We will avoid the obvious paradox in this entry, sort of the ‘everything I say is a lie paradox’ that will cause computers in the Federation to shut down.

Why am I going to comment on this issue? Well, this months Skeptic has a back and forth between Michael Shermer and Deepak Chopra about life after death.

No. I am not going to comment on whether there is life after death. I am more interested in life during life, thank you very much. I’ll let the afterlife take care of itself.

But in their point counterpoint, they both refer to a Lancet article about NDE’s and it then begs the question:

Does anyone actually read or understand the literature they quote ?

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Posted in: Clinical Trials, Neuroscience/Mental Health, Science and the Media

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On Being Certain

Neurologist Robert A. Burton, MD has written a gem of a book: On Being Certain: Believing You Are Right Even When You’re Not. His thesis is that “Certainty and similar states of ‘knowing what we know’ arise out of involuntary brain mechanisms that, like love or anger, function independently of reason.” Your certainty that you are right has nothing to do with how right you are.

Within 24 hours of the Challenger explosion, psychologist Ulric Neisser had 106 students write down how they’d heard about the disaster, where they were, what they were doing at the time, etc. Two and a half years later he asked them the same questions. 25% gave strikingly different accounts, more than half were significantly different, and only 10% had all the details correct. Even after re-reading their original accounts, most of them were confident that their false memories were true. One student commented, “That’s my handwriting, but that’s not what happened.”

Just as we may “know” things that clearly aren’t true, we may think we don’t know when we really do. In the phenomenon of blindsight, patients with a damaged visual cortex have no awareness of vision, but can reliably point to where a light flashes when they think they are just guessing. And there are states of “knowing” that don’t correspond to any specific knowledge: mystical or religious experiences. (more…)

Posted in: Book & movie reviews, Neuroscience/Mental Health

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Mercury emissions from coal-burning power plants and autism: Is there a correlation?

ResearchBlogging.orgOn April 30, outside the courthouse in Dallas, a press conference/rally was held. This particular rally was in response to a new study published by a group led by Dr. Raymond F. Palmer in the Department of Family and Community Medicine at the University of Texas Health Science Center in San Antonio, whose conclusion was that autism prevalence correlates strongly with proximity to mercury-emitting coal-burning power plants and other industrial sources of airborne mercury, the implication being that such sources of mercury may be causal or contributory to the development of autism. Unfortunately, the rally was reported by the media as though this study were slam dunk evidence that mercury environmental mercury is a definite contributor to the development of autism. For example, there is some video (also here) from local news sources of the rally, in the first of which it is stated as fact that mercury caused autism in the child featured in the story and in the second of which a mother who thinks that mercury causes autism is quoted credulously. This study has had much less play in the national news, but antivaccination activists, such as the ones at the Age of Autism website, a site whose main theme is that either mercury in the thimerosal preservative that used to be in childhood vaccines before 2002 or vaccines themselves cause autism, both promoted the rally and posted a glowing and credulous take on the study, as did “alternative medicine” and antivaccinationist website NaturalNews.com.

My first thought upon reading of this is that it is yet more vindication of the science showing that the claim that mercury in thimerosal-containing vaccines is a failed hypothesis. After all, as I have predicted time and time again, as the scientific and epidemiological evidence continued to mount that thimerosal is just plain not associated with autism or autism spectrum disorders, even the most diehard adherents to this belief are starting to realize that they were backing a losing horse, especially since thimerosal was removed from all childhood vaccines other than the flu vaccine in 2001, leaving only trace amounts from the manufacturing process and there is no sign that autism prevalence is falling. That’s why lately, their effort has shifted from primarily demonizing mercury to blaming other “toxins” in vaccines, even to the point that their efforts to demonize some ingredient–any ingredient–in vaccines often reaches ridiculous levels of blatant silliness, such as touting sucrose as one of those “toxins.” Indeed, I was puzzled. If environmental mercury is the new cause of autism, then the rationale antivaccinationists use to demonize vaccines and portray their children as “vaccine-damaged” is much less potent. Why on earth would they tout this study, which, even if a good study (and it’s not), would weaken their arguments against vaccines immeasurably and take power away from their whole new propaganda slogan “Green Our Vaccines”? The only reason I could think of is that perhaps they somehow think that if mercury in the environment can be linked to autism that maybe–just maybe–they can convince people that they were right about mercury in vaccines all along. Indeed, this seems to be the sort of tack that David Kirby took a year ago when he started arguing that mercury emissions from coal-burning power plants in China (which do reach California), coupled with mercury emission from crematoria in which cadavers with mercury fillings were burned, were contributing to the continued increase in the autism caseload in California despite the elimination of thimerosal in 2001.

But what does the study say itself? Is it good evidence that airborne mercury from coal-fueled power plants is an important contributor to the development of autism? I will argue no, because the study’s flaws are so innumerable that it is well nigh uninterpretable. For simplicity’s sake, to summarize its findings, I’ll quote a Science Daily press release about it:
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The North Carolina Board of Medical Examiners, Dr. Rashid Buttar, and protecting the public from practitioners of non-science-based medicine

One of the most contentious and difficult aspects of trying to improve medical care in this country is enforcing a minimal “standard of care.” Optimally, this standard of care should be based on science- and evidence-based medicine and act swiftly when a practitioner practices medicine that doesn’t meet even a minimal requirement for scientific studies and clinical trials to support it. At the same time, going too far in the other direction risks stifling innovation and the ability to individualize treatments to a patient’s unique situation–or even to use treatments that have only scientific plausibility going for them as a last-ditch effort to help a patient. Also, areas of medicine that are still unsettled and controversial could be especially difficult to adjudicate. Unfortunately, with medicine being regulated at the state level, there are 50 state medical boards, each with different laws governing licensure requirements and standards for disciplining wayward physicians, our current system doesn’t even do a very good job of protecting the public from physicians who practice obvious quackery. The reasons are myriad. Most medical boards are overburdened and underfunded. Consequently, until complaints are made and there is actual evidence of patient harm, they are often slow to act. Also, in my experience, they tend to prefer to go after physicians who misbehave in particularly egregious ways: alcoholic physicians or physicians suffering from other forms of substance abuse; physicians who sexually abuse patients; or physicians who are “prescription mills” for narcotics. These sorts of cases are often much more clear-cut, but most importantly they don’t force boards to make value judgments on the competence and practice of physicians to nearly the extent that prosecuting purveyors of unscientific medicine does.

Dr. Rashid Buttar: Autism and cancer

The reason I’ve been thinking about this issue again is because last Friday it was announced that one of the most dubious of dubious physicians of which I have ever become aware, Dr. Rashid Buttar of North Carolina, was, after many years of practice, finally disciplined by the North Carolina Board of Medical Examiners. Basically, the Board restricted his practice so that he could no longer treat children or cancer patients (more on why those two particular restrictions were imposed below). Once hailed as a hero by antivaccinationists and even once having testified to the Subcommittee on Wellness & Human Rights on autism issues, he is now disgraced.

Dr. Buttar runs a clinic called the Center for Advanced Medicine and Clinical Research, which features on its front page this quote:

“All truth passes through 3 phases: First, it is ridiculed. Second, it is violently opposed, and Third, it is accepted as self-evident.”- Arthur Schopenhauer, 1788-1860.

I can’t resist mentioning that any time I see this particular quote, I know that I’m almost certainly dealing with someone who is far on the fringe, because what one first has to realize about the quote is that non-”truth” never makes it past phase one or two–and rightly so. Right off the bat, we can see that Dr. Buttar has a greatly inflated view of his own importance.
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Posted in: Cancer, Health Fraud, Medical Ethics, Neuroscience/Mental Health, Politics and Regulation, Vaccines

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