Imaginative rats, living in the now after brain injury, and remembering Ady Barkan

"I can only live in the present. That is the beauty of it all, and that's what I have to make peace with," Claire Snyman said.

November 3, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Let's head into the weekend with some food for thought about a future when a lifetime of immunosuppression might not be necessary after organ transplantation, and how a rat's imagination might help humans regain lost movement. Happy Friday!

health A kidney transplant trial explores a path away from immunosuppression drugs Life-changing kidney transplants have a price in the form of lifelong challenges from the immunosuppression drugs that prevent rejection of the precious new organ. Their side effects and toxicities can lead to a transplant failure rate of 30% to 50% at the 10-year mark. Results from a new trial presented yesterday at the American Society of Nephrology Kidney Week 2023 Annual Meeting suggest a stem cell therapy might help patients stop taking their immunosuppressants within a year of  transplant. In the trial, participants received an HLA-matched kidney from a sibling, meaning six antigens were the same. Next, they got a single-dose stem cell therapy derived from the donor's blood, mixing their immune cells. Compared to patients who got the standard transplants, 63% of those who got the stem cell therapy stopped taking their immunosuppressants for at least two years. Future research would involve donors not so closely matched to recipients. STAT's Annalisa Merelli has more. in the lab Rats! We're not the only ones who can imagine Ryan M. Kelley/AFP Via Getty Images So I'll admit it: At first I found it hard to imagine that rats, like us, can think of places and things not directly in front of them. And then I found it hard to fathom how scientists figured that out. Reporting yesterday in Science, researchers explain how they eavesdropped on electrical signals in rodent brains by blending virtual reality with brain-computer interfaces implanted in their lab rats' hippocampi. The experiments also involved spherical treadmills and tasks called Jumper and Jedi. The conclusion: Rats can, in fact, imagine.  The scientists hope to use what they learned not just to better understand human imagination, but also to develop prosthetic devices that would help paralyzed people move around. That's based on previous research showing that people with injuries to the hippocampus, an area of the brain that plays an important role in learning and memory, struggle to imagine future scenarios. It's still a far-off possibility, STAT's Jonathan Wosen tells us. health  Remembering activist Ady Barkan After the ice-bucket challenge was launched nine years ago, the campaign  drew attention to ALS and the dearth of treatments for it. While Ady Barkan also had ALS, his activism was targeted not at his disease, but, via his group Be A Hero, at a health care system that fails many Americans. Barkan's death at age 39, announced Wednesday, came seven years after his diagnosis. He'd long been involved in progressive causes, joining Occupy Wall Street, promoting rights for immigrants and workers, and urging an end to mass incarceration. Later, he was arrested in his wheelchair in a Senate office building while protesting the Supreme Court nomination of Brett M. Kavanaugh. He opposed pharma in his fight to provide Medicare for all, even as his illness brought on paralysis. "That's the paradox of my situation," he told The New York Times in 2019. "As my voice has gotten weaker, more people have heard my message. As I lost the ability to walk, more people have followed in my footsteps."

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closer look Living with a brain injury means living in the present Photo illustration: Casey Shenery for STAT  Eleven years ago, doctors removed an expanding mass from Claire Snyman's brain. Now, if you ask her how old she is, she has to stop and think before she remembers she's 47. STAT's Isabella Cueto spoke with Snyman about her decade of learning to live this way. What was your recovery from surgery like? I felt no pain in my head, in my brain. What I didn't realize was the fatigue. The other thing I wasn't aware of was the mental health aspect of it. I think because of the challenges I went through in accessing care, because I had medical negligence happen to me, I had PTSD after my surgery. And you've lost some memories. That's a hard thing to know as a parent and as a wife. I can only live in the present. That is the beauty of it all, and that's what I have to make peace with. Read the full interview. politics Senate readies vote on Biden's NIH pick The Senate could confirm President Biden's nominee to head the National Institutes of Health as soon as Monday, moving oncologist Monica Bertagnolli closer to the permanent position almost two years after former director Francis Collins stepped down. Majority Leader Chuck Schumer filed cloture on Bertagnolli's nomination Thursday, meaning the full Senate is likely to vote early next week. STAT's Sarah Owermohle tells us the chamber is expected to approve her nomination despite resistance from Senate HELP Chair Bernie Sanders (I-Vt.), who held up her confirmation process and urged 'no' votes last month because of disagreements with the White House over drug pricing policy. Half of Republicans on that committee joined Democrats to advance her nomination. Others who opposed putting the current National Cancer Institute director at the top of NIH interrogated the agency's infectious disease work  and Bertagnolli's stance on funding gender-affirming care research. covid-19 14% of Americans report they've had long Covid, new study estimates Coming up with a census of people who have long Covid has been challenging, in part because there is no test for a condition marked by mental and physical symptoms that arise and persist after acute infection. A new study in PLOS One wades into these murky waters, using the WHO definition (new symptoms persisting at least three months after initial infection) and surveying nearly half a million Americans in late 2022.  The researchers split people into three groups: those who never to their knowledge had Covid (53%), those who did and recovered without long Covid (47%), and those who did and developed long Covid (14.4%). That works out to 1 in 7 overall, and 3 in 10 people who contract Covid-19, ending up with long Covid, they said, while acknowledging that self-reports may not provide the most reliable data. There were differences: Vaccinated people were less likely to have long Covid and it was more common in women than men. Long Covid was also more common in white people, middle-aged people, and people with lower incomes or educational attainment.

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Thanks for reading! More Monday,

elizabeth.cooney@statnews.com

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