September 21

Masters of the Obvious

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An article from NY Times columnist Nicholas Bakalar caught my eye recently. Its title, “Brain scan find spot linking stress, asthma” intrigued me, so I read on. The title seemed to imply validation of the long held folk lore that linked an asthma sufferer’s becoming upset or stressed with the onset of an asthmatic attack. For instance, as Mr. Bakalar states:

Previous research has shown that college students with asthma have a greater airway inflammation when they are exposed to an allergen during exam week than when the exposure occurs at a less stressful time.

Okay, that makes sense.

Way back in the olden days, when we were GPs in Arkansas, we were taught about the “full bucket theory” of allergy, which stated that one’s ability to withstand allergic exposure can be thought of as an empty bucket with a finite capacity. Each allergen or offending agent adds contents to the bucket, such that when enough of these possibly even mild allergic insults combine, the bucket becomes full and spills over in symptoms. Which explains the increase in asthmatic episodes during finals pretty well. During times of stress, stress hormones, such as cortisol, are elevated, and these in turn elevate blood sugar, and set in motion a whole cascade of inflammatory pathways, that begin to fill the bucket, so to speak.

In the asthma study reported on by Mr. Bakalar, the researchers exposed six volunteers with mild allergic asthma to one substance that caused muscle constriction and one that caused inflammation (to mimic the two phases of asthma after exposure to an allergen: airway muscle constriction that causes the feeling of chest tightness and the release of cytokines that cause inflammation. ) They then scanned the subjects’ brains while having them read words shown on the screen. Some words–for example, curtains–were emotionally neutral, others–lonesome–were designed to provoke negative emotions, and still others–wheeze, suffocate–were emotionally charged relative to asthmatic fears.

Lo and behold, they learned that in asthmatics exposed to asthma provoking substances and asked to read words like suffocate and wheeze
the areas of the brain that govern emotion light up like a Christmas tree on the brain scans, but don’t when they read emotionally neutral or even negative words.

Duh!

What it seems to me is that a lot of research dollars were spent to “prove” what should have been obvious.

Imagine the scenario: you’re asthmatic, some guy gives you something that will make you wheeze in a lab test, then has you read words that exemplify your greatest fears–wheeze, cough, suffocate! And your brain’s emotion centers respond by becoming emotional.

What will they think of next?

Perhaps they could have spent those dollars better to elucidate the connection between asthma, allergy, and the intake of inflammatory cereal grains?


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