The Brain, Spring 2016 UCI Magazine by UCI Magazine

Spring 2016

MAGAZINE

The

Brain

Stepping Into Spring Bustling students traverse a blooming Aldrich Park, where pink trumpet trees herald the vernal season.

Spring 2016

Steve Zylius / UCI

Contents

Spring 2016 Vol. 1, No. 2

Special Issue: The Brain

22 14

Alzheimer’s: It’s not what you think, says a national expert, turning the disease on its head

Stroke of the Future: In 20 years,

stem cells, genetics and robotics will get patients back on their feet after a blood clot in the brain

D E P A R T M E N T S FLAS H B ACK

PRISM

SPOT L IGHT

S PEC T RUM

About This Issue: For this edition of UCI Magazine, we delve into the world of brain science, which has garnered increased national attention in

recent years. Just about every school at UCI, from engineering to the arts, is conducting research to further our understanding of the most complex organ in the human body and its disorders. Many are collaborating in interdisciplinary efforts to prevent or minimize the damage from stroke, the fifth-leading cause of death in the U.S. It’s expected that 20 years from now, many life-altering advances, some already under development at UCI, could be realized (page 22). Others are among the first to study aquatic concussions, which could have wide-ranging implications for athletes and soldiers who suffer traumatic brain injury (page 36). With an aging baby boomer population, we asked Alzheimer’s expert Dr. Claudia Kawas (page 14) to explain how her research has changed broad assumptions about the disease that afflicts 5.4 million Americans – 5.2 million of them over the age of 65. And in the social sciences, Dr. Alyssa Brewer demonstrates how using prism goggles is altering our view of the brain’s ability to rewire itself (page 30). We hope you enjoy this glimpse into some of the work that UCI researchers are conducting to unravel the mysteries of the brain.

UCI Magazine

36 30

Flipped Reality: Prism goggles trick the brain into rewiring the visual cortex, providing insight into its plasticity

P E R S PE CT I V E

R E FLECTIONS

A NT OURAGE

Heading Off Brain Injuries: An alligator researcher, a crash test dummy and an ex-Boston Red Sox medic join forces to prevent water polo concussions

PA RT ING ZOT !

Spring 2016

Letters to the Editor Winter 2016: “Our Brilliant Future”

UCI Magazine Vol. 1, No. 2 Produced by the University of California, Irvine Office of Strategic Communications Chancellor Howard Gillman Associate Chancellor, Strategic Communications Ria Carlson Senior Director, Media Relations & Publications Cathy Lawhon Managing Editor Marina Dundjerski Design Vince Rini Design

..................................

Visuals Steve Chang and Steve Zylius

Reading UCI Magazine’s debut issue, “Our Brilliant Future,” I couldn’t help but take a trip down memory lane. At my 1975 graduation, I fondly gazed at the structures surrounding Aldrich Park; I would miss them. My M.S. in administration prepped me for careers in public and private sectors. Years later, I left my public sector position as the budget officer for a sizable city to become a project manager for Chevron, where I earned the Chairman’s Award. UCI Extension courses were invaluable along the way. My son is also a graduate, and the UCI health center ingeniously relieved my son-in-law’s debilitating chronic pain. UCI has always been and continues to be an inspiration to me. I have strolled UCI over the last 40 years witnessing its evolution and its arrival at top-tier status. I have evolved as well and have nearly completed writing my first novel. My goal is to get on The New York Times’ best-seller list before UCI reaches its next major milestone. Shine on brilliantly.

Wow! The magazine is terrific. I’m new to UCI (nearly two months on staff). The magazine is gorgeous and informative without too much text (like the info graphics) and has great pictures (and lots of them) and nice pull-quotes. I will definitely use the content and share with others. Great work!

Copy Editor Kymberly Doucette

Michele Cardella Orange

Digital Media Tonya Becerra and Kien Lai

..................................

Contact Have a comment or suggestion? Address correspondence to: UCI Magazine UCI Office of Strategic Communications 100 Theory, Ste. 200 Irvine, CA 92697-5615 949-824-6922 • ucimagazine@uci.edu communications.uci.edu/magazine

Tom Moseley ’72, M.S. ’75 Huntington Beach

Gary Gorlick, M.D. Beverly Hills

Professor Erwin Chemerinsky’s writing (and speaking) proves to this learner that channeling might be for real! Did the great John Steinbeck write his piece? His story “A Different Path” also proves what I have long believed: that a superior brain will eventually succeed, even when raised in early dire circumstances.

Editorial Advisory Committee Jennie Brewton, Katherine Hills ’83 (alumni), Janice Hopkins, John Mouledoux, John Murray (health) and Janna Parris (development) Contributing Writers Elizabeth Beach ’12 , Rosemary McClure, Roy Rivenburg, Heather Shannon, Tom Vasich, John Westcott and Janet Wilson

UCI Magazine is a publication for faculty, staff, alumni, students, parents, community members and UCI supporters. Issues are published in winter, spring and fall. To receive the electronic version of UCI Magazine, email a request to ucimagazine@uci.edu. UCI Magazine is printed with soy-based inks on a recycled paper stock certified by the Forest Stewardship Council. Please recycle.

We Want to Hear From You When submitting a letter to the editor, please include your full name, UCI graduation year or affiliation (if applicable), mailing address, city of residence, phone number and email address. Submissions that do not include this information cannot be published. Contact information is for verification purposes only – not for publication or commercial use. Letters should be 150 words or less and may be edited. They become the property of UCI/the UC Board of Regents and may be republished in any format.

UCI Magazine

To submit a letter via email, send to: ucimagazine@uci.edu Include “Letters to the Editor: UCI Magazine” in the subject line To submit a letter via U.S. mail, send to: Letters to the Editor UCI Magazine UC Irvine Office of Strategic Communications 100 Theory, Ste. 200 Irvine, CA 92697-5615

Support UC Irvine University Advancement www.ucifuture.com 949-824-0142 icare@ucifuture.com UCI Alumni Association www.alumni.uci.edu 949-824-2586 alumni@uci.edu

UCI Libraries, Spe cial

Collections & Arc hives

F L A S H B A C K

First Class

s UCI reaches the end of its two-year 50th anniversary celebration, and with commencement 2016 approaching, it seems fitting to reflect on UCI’s earliest days and its pioneer students. UCI’s first graduating class, in 1966, consisted of just 14 students, who arrived on campus Oct. 4, 1965, for the first day of classes (top photo). In a rare photo of the inaugural class (above), 11 members gather outside Gateway Commons (now Gateway Study Center) prior to a commencement dinner address by mathematics professor Bernard R. Gelbaum (far left). The class of 1966 earned 10 bachelor’s degrees, three master’s and one doctorate. “In your memorable year at Irvine, you have been one of a group of adventurers brave enough to forego the comfortable paths to success, daring enough to gamble with a set of untried ideas and eager enough to cause a quiet revolution in university outlook,” Gelbaum told the graduates on June 25, 1966. “You were endowed with great resources, excellent counsel … and the crucial ingredient of courage.” Fifty years later, more than 9,000 UCI students will follow in their footsteps – joining more than 160,000 alumni. Congratulations to the class of 2016!

Spring 2016

A Perfect Match Yelennia Palacios, 30, exults after learning at UCI’s Match Day event in March that she has been accepted into the family medicine residency program at Scripps Mercy Hospital in Chula Vista. Her husband, Julio, and their son, Solomon, share in her joy. Match Day, an annual ritual that occurs simultaneously at all U.S. medical schools, is when graduating medical students learn where their careers as doctors will start. They’re called to a podium one at a time to open an envelope and read aloud before hundreds of family members, friends and classmates the name and location of the hospital where they’ll spend the next three to seven years pursuing postgraduate medical training. This year, 111 UCI students participated in the emotional ceremony; 24 were paired with programs at UC Irvine Medical Center. Palacios earned her B.S. in biological sciences at UCI in 2007. She entered the UCI School of Medicine through the Program in Medical Education for the Latino Community, an M.D.-master’s program that focuses on the distinctive healthcare needs of Latinos and is the first of its kind in the U.S. She will receive her M.D. on June 4.

..............................................................................................................

“Money isn’t just money. Money is also a ubiquitous mass medium, so if you want to get any kind of message across in a big way, putting it on the money is a great way to do it.” Bill Maurer, dean of social sciences and professor of anthropology April 25, 2016 Los Angeles Times

UCI Magazine

Steve Zylius / UCI

News

P R I S M

“When you look at how we think about aging, we don’t really consider it a disease – it’s just considered a ‘natural’ thing. But I think aging and lifespan research really should be the future of medicine.” Mahtab Jafari, associate professor of pharmaceutical sciences March 7, 2016 The Wall Street Journal

The Shearing Fourth-year students Karim Arabi (left) and Kasim Manekia get their heads shaved during the campus drive for Cuck Fancer, a nonprofit founded by UCI alumnus and three-time cancer survivor Ben Teller ’12. The organization promotes awareness of young adult cancer and provides support for survivors. Over five days in April, Anteaters raised more than $10,000 to help the charity for the third consecutive year and registered dozens for the National Marrow Donor Program. Video: http://bit.ly/ucimag_spring2016_BenTeller

B Y

1 5 40

T H E

N U M B E R S

university days

145

students swabbed for bone marrow registry

$10,000

All Charged Up UCI chemists have invented a nanowire battery material that can be recharged hundreds of thousands of times, moving us closer to batteries for computers, smartphones, cars and spacecraft that would never require replacement. Scientists have long sought to use nanowires in batteries. Thousands of times thinner than a human hair, they’re highly conductive but extremely fragile and don’t hold up well to repeated recharging. Doctoral candidate Mya Le Thai solved the problem by covering a gold nanowire with manganese dioxide and encasing it in an electrolyte made of a Plexiglas-like gel. The combination is reliable and resistant to failure. Hard work combined with serendipity paid off for her, according to the study’s senior author, Reginald Penner, chair of UCI’s chemistry department. “Mya was playing around, and she coated this whole thing with a very thin gel,” he said. “She discovered that just by using this gel, she could cycle the electrode hundreds of thousands of times without losing any capacity.” “That was crazy,” he added, “because these things typically die in dramatic fashion after 5,000 or 6,000 or 7,000 cycles at most.” The researchers think the goo plasticizes the metal oxide in the battery and gives it flexibility, preventing cracking. The work was published in the American Chemical Society’s Energy Letters.

.....................................................

raised

heads shaved

Spring 2016

Faculty Elected to Academy

Woman of the Year

Four faculty members in law, philosophy, chemistry and physics have been elected to the American Academy of Arts & Sciences, which recognizes leaders from the academic, business and government sectors who are responding to challenges facing the nation and the world. They are:

Kate Klimow, assistant vice chancellor of community and government relations at UCI, was named the 74th Assembly District’s Woman of the Year for her lifelong career of supporting local businesses and engaging the community in local events. As assistant vice chancellor, Klimow helps implement programs and strategies to engage community and government leaders in UCI’s teaching, research and public service missions. She currently serves on the boards of several organizations, including the Irvine Chamber of Commerce and Second Harvest Food Bank. “We live in a great area, and I am happy to do what I can to support it,” Klimow said. “I hope more women will begin to get involved and make a difference in their communities.”

Erwin Chemerinsky, founding dean, Distinguished Professor and Raymond Pryke Chair in First Amendment Law at the School of Law, was honored for his valuable contributions to education and policy in constitutional law, notably free speech, civil rights and civil liberties, and appellate litigation. He frequently argues cases before the nation’s highest courts and serves as a legal commentator for national and local media. R. Benny Gerber, professor emeritus of chemistry, was elected for his distinguished contributions in atmospheric and environmental chemistry, physical chemistry and chemical physics, and theoretical and computational chemistry. His team’s work on vibrational spectroscopy, among the main tools of physical chemistry, helped many other researchers. Separately, he made major discoveries on the formation dynamics of novel rare-gas compounds. Margaret P. Gilbert, the Abraham I. Melden Chair in Moral Philosophy, was recognized for her notable contributions to the field of philosophy, particularly in founding the philosophy of social phenomena. Her theoretical approach to how the world comes into being through the activities in which we regularly engage has had applications within moral, political and legal philosophy and social and political science. Steven R. White, professor of physics & astronomy, was honored for publishing a pioneering algorithm that helped crack quantum mechanics conundrums and led to a new field of computational physics. Building on that, he successfully modeled a quantum spin liquid, a new state of matter invisible to the naked eye that could be key to understanding superconductivity and building quantum computers.

Also elected this year in humanities and arts was UCI alumnus Yusef Komunyakaa, M.F.A. ’80, who won the 1994 Pulitzer Prize for his collection of poetry Neon Vernacular. With this year’s class, UCI has 32 living American Academy fellows. Those newly elected will be inducted at a ceremony Oct. 8 in Cambridge, Mass.

.....................................................

UCI Magazine

.....................................................

“More and more research proves that women aren’t just men with testy hormones. Healthwise, there’s a lot more we need to know about being female and being a mother.” Lawrence Cahill, professor of neurobiology & behavior April 11, 2016 The Orange County Register

Extraordinarius Michael P. Clark, M.A. ’73, Ph.D. ’77, vice provost for academic planning and professor of English, received the 2016 Extraordinarius award, the UCI Alumni Association’s highest honor, at the 46th annual Lauds & Laurels ceremony in May. Clark, who began his professional career in UCI’s Department of English, is a highly respected scholar of early American literature, literary theory, contemporary U.S. fiction and popular culture. Known for his integrity, calm demeanor and consensus building, Clark has played key roles in creating new academic programs in nursing, pharmaceutical sciences, education and statistics. “Mike Clark fully merits the Extraordinarius award not only for his lifetime of truly extraordinary achievements and commitment to UCI, but also and even more so for his incarnation of the UCI ethic of academic excellence, creativity and can-do inventiveness,” said Georges Van Den Abbeele, dean of the UCI School of Humanities.

S P O T L I G H T

Paul Kennedy / UCI Claire Trevor School of the Arts

All the World’s a Stage

he New Swan Shakespeare Festival will return to UCI for a fifth season this summer in its unique and intimate venue under the stars on Gateway Plaza. This year’s plays are “As You Like It,” directed by Eli Simon, Chancellor’s Professor of drama; and “Hamlet,” directed by Beth Lopes, who earned an M.F.A. in directing at UCI in 2011. The New Swan repertory reexamines Shakespeare’s works for a modern audience: “As You Like It” is a “ridin’ the rails” production set in the Great Depression, while “Hamlet” is told as a ghost story, conjuring Hamlet’s deceased father as a cast character. “Shakespeare’s theater was for the people rather than an elite cultural event; thus we created the festival in order to share our work with the widest possible cross section of our community,” says Simon, the festival’s artistic director. “The New Swan Theater itself was designed to foster a direct, visceral and egalitarian relationship between actors and audience.” Assembling the 16-ton, modular, mini-Elizabethan structure is a production in itself. It takes two days to move the theater from storage to Gateway Plaza, another three days to set it up and two weeks to make it operational. (To view a time-lapse video of the construction, see http://bit.ly/ucimag_spring2016_NewSwan.) “We want our audience to feel the emotions, actions and texts as deeply as New Swan Shakespeare Festival actors, directors, designers, and creative and production teams,” Simon says.

Spring 2016

S P E C T R U M

Monteverde, Costa Rica

.....................................................

Observing Fungi in a Mountain Cloud Forest On a cool, fog-shrouded mountain in Costa Rica, Caitlin Looby is finding that warming temperatures are an increasing problem for one of the most ecologically diverse places on Earth. A graduate student in ecology & evolutionary biology, Looby has determined that if the higher-elevation soil becomes similar to lower-elevation soil, which is warmer and drier, it will spur the growth of the type of fungi flourishing at lower elevations that breaks down plant material. And if this degradation of plant material escalates, it will release significantly increased amounts of carbon dioxide into the atmosphere. â&#x20AC;&#x153;Any changes in climate could have important ecological consequences,â&#x20AC;? Looby says, noting that this research could allow for better predictions of how tropical ecosystems will respond to global warming. More: http://bit.ly/ucimag_spring2016_CostaRica

UCI Magazine

Caitlin Looby

Spring 2016

Q&A

P E R S P E C T I V E Howard Federoff CEO, UC Irvine Health Vice Chancellor, Health Affairs

Steve Zylius / UCI

Defining the Future of Medicine Prevention plans tailored to the individual and an interdisciplinary approach to patient care will be key, says new health chief For more than three-quarters of a million people, the front door to the University of California, Irvine leads into a doctor’s office. That’s how many patients visit a UCI hospital or clinic each year. The billion-dollar health enterprise includes UCI Medical Center, various clinics, the medical school, and programs in nursing science, pharmaceutical sciences and public health. It plays a primary role in ensuring the health of the Orange County community, but like so many other hospital systems, it faces challenges from a radically changing and competitive national healthcare system. To meet those challenges and to infuse UC Irvine Health with a new vision and purpose, Dr. Howard

UCI Magazine

Federoff joined UCI in July 2015 as the vice chancellor of health affairs and dean of medicine. In January, he also became CEO for UC Irvine Health (and stepped down as dean), making him – for all intents and purposes – the “top doc” in Orange County. Federoff is also a prolific scientist and inventor. His work has led to 25 patented technologies, and in 2012, he was elected a fellow of the National Academy of Inventors. Federoff talked with UCI Magazine about the future of UC Irvine Health, both as an academic medical center and as a national leader in integrated, high-quality and affordable care for everyone.

Q: Looking back, how did you choose to go into medicine? Did you grow up dreaming of being a doctor? Federoff: I was particularly good at science and math and pursued those. When you have a family member who had a stroke, such as my maternal grandmother, and my dad, who died of colorectal cancer at a very young age in his 50s, I began to merge my interests and realized there might be an opportunity for a successful career in medicine. Those life experiences and my commitment to science made clear that I would want to be both a clinician and a scientist, and ultimately, I pursued both an M.D. and a Ph.D. Q: As a researcher, you’ve made a number of advances in the areas of neurodegenerative diseases and gene therapies, and your discovery of blood biomarkers to predict Alzheimer’s disease received wide attention. How is that work going? Federoff: When I was with the University of Rochester, we envisaged neurodegenerative diseases, such as Alzheimer’s and Parkinson’s diseases, as a group of entities that had peripheral manifestations – those outside the brain. We began our work to define these peripheral biomarkers and discovered that we could predict, with considerable accuracy, who among our seniors would progress to Alzheimer’s. We continue this work and now also study peripheral measures in Parkinson’s patients and those suffering from traumatic brain injury. The larger goal is to develop clinically useful tests that can guide the development of new treatments. Q: As CEO, what are your objectives for UC Irvine Health to continue being the healthcare leader in Orange County? Federoff: UC Irvine Health is the only academic medical center in Orange County, and I want us to continue to be recognized as the provider of choice for high-quality and affordable care. And we want to go even further. To do this, we are looking to develop new and better ways to deliver care. The principle distinction between us and other community healthcare entities within the county is that we actively conduct research, which means those individuals who are delivering the highest quality of care are often in the vanguard, where the research is being conducted. So one will have access to investigational modalities that will only be found at UCI – and not at community hospitals. We are defining the future of medicine.

“I see [the future of medicine] as precision prevention, a model in which medical and lifestyle decisions like diet and exercise are tailored to the individual patient and diagnostic and genetic testing is used to identify and prevent possible future health issues.”

Q: And what is this future of medicine? Federoff: I see it as precision prevention, a model in which medical and lifestyle decisions like diet and exercise are tailored to the individual patient and diagnostic and genetic testing is used to identify and prevent possible future health issues. It’s really broadening the context of precision medicine, and our goal is to improve the health of the community. Q: You’re also charged with starting nursing, pharmacy and population health schools. How will these three schools fit in with your overall vision of health affairs at UCI? Federoff: Part of this future of healthcare involves team approaches that draw upon a wide array of expertise, such as those to be developed in our new schools. It’s exciting to be on the ground floor to create a platform de novo that integrates nursing, pharmacy and population health with medicine into a synergistic healthcare enterprise. We can help define and drive this comprehensive team approach to patient care and, when successful, share our best practices with other entities nationally and globally.

Spring 2016

Alzheimer’s:

It’s Not What You Think Claudia Kawas turns the study of the disease on its head, leading other researchers to change their assumptions By Rosemary McClure

he comment is a startling one, and she repeats it: “If you give me a choice, give me Alzheimer’s disease.” Dr. Claudia Kawas, a professor in UCI’s Department of Neurology, knows exactly what she’s saying. It’s the rest of us who don’t understand. Her point is that Alzheimer’s isn’t what we think it is. Kawas’ groundbreaking 90+ Study, which was the subject of two lengthy “60 Minutes” episodes and exhaustive press coverage, has forever changed what we thought we knew about Alzheimer’s disease. Her vast library of brain tissue samples from study participants who died shows that many people can have the amyloid plaques and tangles associated with Alzheimer’s without the cognitive symptoms, while others can have dementia without the brain changes. Alzheimer’s ranks relatively low for increasing the risk of dementia compared to other conditions found in the brain samples, including white matter disease and microinfarcts (both considered forms of vascular

UCI Magazine

disease), Lewy bodies (associated with Parkinson’s) and hippocampal sclerosis. “If you have Alzheimer’s pathology, your risk of dementia is perhaps twice as likely,” says Kawas, also a professor in the Department of Neurobiology & Behavior. “But if you have microinfarcts, your likelihood of having dementia is four times greater; if you have hippocampal sclerosis, your likelihood is 10 times greater. “That’s why I always say: Give me Alzheimer’s; it only doubles your risk of dementia. I don’t care what’s in my brain; I only care if I can still think.” Mindful Art The paintings on the following pages were created by individuals with Alzheimer’s dementia who took part in Memories in the Making. The program, sponsored by the Alzheimer’s Association, enables patients to share what’s going on inside long after they’ve lost the ability to communicate with words. These pieces were bought at a charitable auction and donated to UCI MIND, where they hang in tribute to the artists’ determination to maintain their independence and dignity through varying stages of the disease.

Steve Zylius / UCI

“Into the Pink Woods,” by Richard and Erma Richard was stoic and did not speak often. Erma had an urge to mother everyone. Together, they worked in harmony to create their paintings, a generosity often found in Alzheimer’s patients. In this piece, Richard is responsible for the bold splashes of color, while Erma added the trees.

Spring 2016

Daniel A. Anderson / UCI

Mathew Blurton-Jones, an assistant professor affiliated with UCI MIND, is investigating the lifestyle factors identified in The 90+ Study for a potential link between the immune system and dementia.

Findings from The 90+ Study are causing practitioners and researchers across the country to rethink their assumptions and look for new explanations for dementia – such as the one recently advanced by UCI’s Mathew Blurton-Jones: that the immune system may be in play. As we age, our immune system deteriorates, making fewer B and T cells, he says, and “our mouse data would predict that this aging of the immune system would impair the ability to clear amyloid from the brain.” People who age successfully are often more healthy in multiple ways, including their immune health. “Many of the beneficial lifestyle factors that Claudia studies are also associated with improved immune health,” says BlurtonJones, an assistant professor affiliated with the UCI Institute for Memory Impairments and Neurological Disorders. UCI MIND, where Kawas serves as clinical core director, is internationally recognized for its research accomplishments in disorders of the brain, particularly those that are age-related. It is also home to one of 29 Alzheimer’s Disease Research Centers across the country funded by the National Institute on Aging. The lifestyle factors referenced by Blurton-Jones are among the reasons that The 90+ Study rocketed into the limelight. The headlines are intriguing: “Secrets From the Oldest-Old,” “Do You Want to Live Past 90?”and “90 and Beyond.”

Studying Nonagenarians The landmark study that sparked the headlines got its start in the early 1980s, when 14,000 members of the Orange County retirement community Leisure World – now renamed Laguna Woods Village – were surveyed about their habits and lifestyles. Flash forward to 2003, as Kawas and her co-principal investigator, Maria Corrada, an epidemiologist in the Department of Neurology, conceived the idea of The 90+

UCI Magazine

Study and obtained a $6 million grant from the National Institutes of Health to launch it. The goal was to gather data about the oldest-old – the fastest-growing age group in the U.S. – utilizing information from the original survey and updates on the remaining Laguna Woods Village participants. Kawas and Corrada reasoned that because little was known about people over 90 – they were traditionally ignored in research studies – the impending “silver tsunami” of aging baby boomers presented a public health priority to promote the quality as well as the quantity of life. Surprisingly, the 90+ team was able to round up nearly 1,700 subjects out of the original 14,000, making the study one of the largest ever done on this group. “We wanted to know how long and how well they lived,” Kawas says. Many members of the original group still live in Laguna Woods Village. Others are spread throughout the U.S. and abroad. Each is examined physically and cognitively every six months. Recently, brain scans were added to the tests, opening up new avenues for research.

“I always say: Give me Alzheimer’s; it only doubles your risk of dementia. I don’t care what’s in my brain; I only care if I can still think.” “The mean age is 96; almost one-third live at home with minimal or no support,” Kawas says. A third of the group show no signs of dementia, while another third have dementia, and the final third are “somewhere in between.” Most of those in the study have agreed to donate their brains after death. In the past dozen years, Kawas has spent a great deal of time getting to know Laguna Woods Village and its nonagenarian residents. “They’ve had 90-year-old mayors on more than one occasion. They have clubs, their own TV station. They make me feel tired and old,” she says, laughing. They’ve also taught her a lot about aging. “People who exercised definitely lived longer than people who didn’t exercise,” Kawas says. As little as 15 minutes a day, on average, made a difference in promoting longevity. “Forty-five minutes a day is best.

“The Farm & Silo,” by Tim Dunn Diagnosed with Alzheimer’s at 52, Tim Dunn had to give up his job as a science teacher when he could no longer lead the students. He relied on his humor and art to battle on, once drawing a man wearing a T-shirt that read: “I have Alzheimer’s. What’s your excuse?” Dunn painted this work in the midstage of his illness, when he had become less vocal but more bold in his artistic expression. “Life is like a bridge game,” he said. “You just play the hand you are dealt.”

Spring 2016

And it doesn’t help to do a lot more. Three hours a day is no better than 45 minutes.” Keeping active mentally and socially – such as playing board games and attending book clubs – also helped.

Among other findings: n Taking vitamins E, A or C made no difference in longevity. n Drinking green or black tea made no difference. n People who drank moderate amounts of alcohol or coffee lived

longer than those who abstained.

n People who were overweight in their 80s and 90s lived longer than

normal-weight or underweight people did. Those who were overweight in their youth did not live as long.

n Almost 80 percent of people 90 and older are disabled. Dementia

and disabilities are more common in women than men.

n About half of people over 90 with dementia do not have sufficient

brain neuropathology to explain their cognitive loss.

.................................................................

National Outlook Kawas’ pioneering research at UCI has set the stage for others. “When I started, everyone asked me what I could possibly find interesting in studying the oldest-old,” she says. “Now every place in the world has these studies.” Meanwhile, the number of nonagenarians is exploding, making the research even more relevant. Over the past century, the U.S. has added 27 years to life expectancy, with about 2 million people currently over age 90. It’s estimated that by 2050 there will be more than 10 million. One out of every 50 people will be 90-plus. “I can remember when there were so few centenarians that the president wrote a birthday card for each one,” Kawas says. “There’s no way that could happen today.” Of course, one of the major downsides to increased life expectancy is dementia. “Age is far and away the biggest risk factor for dementia, no matter what you’ve heard about head trauma or other factors,” Kawas says. “And right now dementia costs the nation more than cancer and heart disease put together. We need to know how to lower the risk.” Her sobering conclusion if we don’t: “I’m pretty convinced that the risk of dementia after age 65 doubles with every five years of life through and past age 100. It doesn’t mean you can’t get past 100 without it, but your odds aren’t good.”

UCI Magazine

‘I’ll Never Forget It’ By Heather Shannon Sometimes it’s just a gesture – a small demonstration of respect and compassion – that makes all the difference. Nancy Edwards and her family discovered that difference at the UC Irvine Institute for Memory Impairments and Neurological Disorders. She first visited UCI MIND in 2003 after family members noticed changes in her personality. The woman who had made friends all over the world – in Indonesia, Turkey, China, Hong Kong and wherever else her husband’s work in the oil industry took her – became argumentative and confused. “She had always had a lot of empathy for people,” her husband, Bill Edwards, recalls. “We didn’t know what was going on.” He realizes now that, because of her medical background as a physical therapist and her work with Alzheimer’s patients, his wife probably knew exactly what was happening. Nancy Edwards underwent testing and evaluation at UCI MIND’s internationally recognized Alzheimer’s Disease Research Center – so designated by the National Institutes of Health – which focuses on brain disorders, particularly those related to age. The Edwards family treasures the memory of what happened after her battery of written and spatial awareness exams were completed. Knowing that she had been a physical therapist, neuropsychologist Malcolm Dick said, “Nancy, let’s you and I go over your tests, and you tell me what the results are.” In that moment, Dick gave her respect as a clinician, Bill Edwards says, and he could see the positive effect it had on his wife. “I’ll never forget it,” he says. “Every time I see him, I thank him for that.” Nancy Edwards was 57 years old when she was diagnosed with Alzheimer’s and began her comprehensive treatment plan. She was 68 when she died last year. Throughout those 11 years, the ADRC provided emotional assistance and reality checks to her husband and their daughters. “The staff and doctors let us know what was going to happen in terms of the progression of the disease, and they were very sympathetic to what we were going through,” Bill Edwards says. Today, he serves on the UCI MIND leadership council to help provide the same aid to others. In addition, he and his family established the Nancy Imlay Edwards Foundation to support further research. They are heartened by the knowledge that in death, she continues to help people as she did in life. “Almost no money is being spent on Alzheimer’s, relative to other diseases,” he says. “If only we had 50 times as much funding, we could do something about it.”

“Washington Mountains,” by Kay Joseph Although she had never painted before, Kay Joseph would become one of the most prolific painters in the program. Her talent earned praise and recognition at a time when her other skills were beginning to slip away. “Her painting provided a means of communication and a boost to her self-esteem,” recalled her son, Tom Joseph. “Memories in the Making allowed my mother to hold on just a little bit longer.”

Spring 2016

Music vs. Alzheimer’s Favorite songs from a person’s past can ease depression, agitation and other symptoms of dementia, says a UCI researcher who donates iPods to nursing homes By Roy Rivenburg

n the battle against Alzheimer’s disease, Joshua Grill invokes a deceased jazz singer, iPods and a 35,000-year-old vulture bone that cavemen fashioned into a flute. Grill, an associate professor of psychiatry & human behavior at UCI and associate director of the campus’s Alzheimer’s Disease Research Center, says certain songs can temporarily disrupt the grip of dementia. Music is a powerful force, he explains, one that taps into the deepest recesses of the mind. As evidence, he points to MRI images of the brain reacting to speech versus song. Spoken words activate just one section of the organ, Grill notes, whereas melodies light up multiple regions. In Alzheimer’s patients, music memory is one of the last things affected by the disease, he says. In one case, a man with advanced dementia continued to play trombone in a Dixieland band and could even learn new tunes, Grill says. In another, an elderly drummer who hadn’t hit the skins in decades was able to jam with his daughter, although he promptly forgot about the session after it ended. Music’s hold on mankind is longstanding, Grill says, citing the discovery of vulture bone flutes made by ancient humans. It can stir emotions, conjure memories and even reduce pain after surgery, he says. Against that backdrop, researchers have begun experimenting with music and dementia. Although more studies are needed, Grill says, anecdotal evidence and case reports indicate that favorite or meaningful songs

UCI Magazine

from a person’s past may ease depression, anxiety, apathy, agitation and other conditions associated with Alzheimer’s disease. Some dramatic examples can be found in the documentary “Alive Inside.” In a scene that Grill shows at seminars, a nearly catatonic dementia patient jolts to life when his caregiver hooks up an iPod playing jazz great Cab Calloway, a favorite artist from the man’s youth. After listening to the song, the patient remains alert and talkative. Grill, who serves as education director for UCI MIND, cautions that music therapy can’t reverse memory loss, but he believes it can soothe other symptoms for which there are no FDA-approved medications. With that in mind, he launched Music for the MIND, which collects donated MP3 players, iPods and iTunes gift cards for nursing home residents. The program partners with Music & Memory, a nonprofit that distributes the items and trains staffers at facilities for seniors. Says Grill: “We should be bringing music to everyone with Alzheimer’s.”

Interested in compiling a playlist of memory-awakening songs for your own elderly loved one? To get you started, we asked several UCI scientists for the top tunes they’d want on their iPods:

Kerry Burnight Co-founder and director, Elder Abuse Forensic Center

• “What a Wonderful World,” by Louis Armstrong • “Son of a Preacher Man,” by Dusty Springfield • “You’re in My Heart (The Final Acclaim),” by Rod Stewart (“This is ‘our song’ with my husband,” Burnight says.)

Playlist: http://bit.ly/ucimag_spring2016_playlist_Burnight

..................................................... Maria Corrada Associate professor of neurology and epidemiology

• “Musica,” by Haciendo Punto en Otro Son (“This group’s

music reminds me of an amazing aunt, Ita, who was full of life, full of music and died way too young,” Corrada says.) • “Vamos a Andar,” by Silvio Rodriguez (“This was used in my high school graduation as a sort of anthem, sending us out into the world.”) • “Buscando America,” by Ruben Blades Playlist: http://bit.ly/ucimag_spring2016_playlist_Corrada

.....................................................

Kim Green Assistant professor of neurobiology & behavior

• “The Loneliness of a Middle Distance Runner,” by Belle & Sebastian (“Reminds me of my undergraduate days,” Green says.) • “Waterfall,” by The Stone Roses • “World Leader Pretend,” by R.E.M. Playlist: http://bit.ly/ucimag_spring2016_playlist_Green

..................................................... Joshua Grill Associate director, Alzheimer’s Disease Research Center

• “Know How,” by Kings of Convenience, featuring Feist • “England,” by The National • “Neat Little Rows,” by Elbow Playlist: http://bit.ly/ucimag_spring2016_playlist_Grill

..................................................... Claudia Kawas Professor of neurology and neurobiology & behavior

• “What a Wonderful World,” by Louis Armstrong • “Side by Side,” by Kay Starr • “Water Music,” by George Frideric Handel

Playlist: http://bit.ly/ucimag_spring2016_playlist_Kawas

.....................................................

Can Super Mario Defeat Dementia? Music isn’t the only medium that shows promise against Alzheimer’s disease. Video games may help preserve or even improve memory, according to UCI research. Craig Stark, professor of neurobiology & behavior, recently led a study in which nongamers who played “Super Mario 3D World” for 30 minutes a day over two weeks saw their scores on memory tests rise 12 percent. In contrast, two-dimensional game players’ recall abilities remained static. Although more research is needed, Stark says, the results offer hope for combating age-related cognitive decline. Based on the findings so far, he recommends five categories of games for their memory-enhancing potential: • 3-D arcade/platformer games, such as “Super Mario 3D World” and “Rayman Legends” • Open-world crafting/exploration games, such as “Minecraft” • Open-world shooter/exploration games, such as “Fallout,” “Grand Theft Auto,” “Skyrim” and “The Witcher” • First- or third-person shooter games, such as “Halo,” “Call of Duty,” “Destiny” and “Splatoon” • Multiplayer strategy and online battle arena games, such as “League of Legends,” “Smite” and “Defense of the Ancients”

Frank M. LaFerla Dean, Francisco J. Ayala School of Biological Sciences

• “Strangers in the Night,” by Frank Sinatra (“This song

was playing in the background when my first daughter was born, and it seemed so appropriate as I immediately fell in love with someone who had been a stranger a few moments earlier,” LaFerla says.) • “Let’s Hang On,” by Frankie Valli & the Four Seasons • “What a Wonderful World,” by Louis Armstrong Playlist: http://bit.ly/ucimag_spring2016_playlist_LaFerla

UCI professor of neurobiology & behavior Craig Stark, here holding a 3-D printed model of his own hippocampus, says that “video games may be a nice, viable route” to maintaining cognitive health.

..................................................... Andrea Tenner Director, UCI MIND

• “For Once in My Life,” by Stevie Wonder • “Let It Be,” by The Beatles • “Unchained Melody,” by The Righteous Brothers Playlist: http://bit.ly/ucimag_spring2016_playlist_Tenner

More selections available online. Steve Zylius / UCI

Spring 2016

Stroke of the Future In 20 years, stem cells, genetics and robotics will get patients back on their feet after a blood clot in the brain By Janet Wilson

Illustrations by Don Dufur

UCI Magazine

Editor’s Note Someone in the U.S. dies from stroke about every four minutes. Since 1995, it has dropped from being the third-highest cause of death to the fifth-highest, thanks to public education, rapid response systems pioneered by UCI and others, and advances in powerful drugs to dissolve clots and tools to remove them. However, stroke remains a leading cause of disability. One in five women will suffer one, according to the Centers for Disease Control & Prevention, and nearly 25 percent occur in people under the age of 65. Each year, approximately 600 patients are treated by UCI’s stroke specialists. In this story, we follow the progress of a hypothetical stroke patient 20 years from now, when many life-altering advances could be realized, from stem cell therapy to customized treatment based on genetic profiling. These possibilities are noted throughout the story in italics.

Robert, 17, Edward, 16 (we call him Eddie), and Sonya. This afternoon I’m driving to Riverside to show a client a house we’ve listed. It’s been a rough few years, the worst since the Great Recession of 2007-09, but thankfully, the real estate market is coming back. My phone buzzes. It’s Sonya. “Daddy, Mommy fell and she can’t get up.” That’s weird. She was fine when I left half an hour ago. Maybe she broke her leg. Sonya sounds calm. I’m so proud of her. I call 911 and turn around off the freeway. At the medical center, I run from the parking lot into the emergency room. There are a whole bunch of doctors and nurses around Leticia.

Day One: The Stroke

..................................................... My 7-year-old, Sonya, hears me fall as I turn off the water. I lie there in the shower; I can’t move my left leg or arm. She runs in, stares and pulls a towel over me. Just as we practiced if there was ever an emergency, she finds my cellphone in my purse, waves it in front of my eye to unlock it and calls for help. When the emergency crew arrives, they ask me my name, my age, where I am and what day it is. “My name is Leticia Lopez. I live in Norco, and I’m 45,” I whisper. “It’s Sunday, Oct. 26, 2036.” They ask me to stick my tongue out straight. I can’t. They ask me to lift my left arm. I can’t. The taller one says there’s no time to dress me. They lift me, dripping, onto the gurney and into the ambulance. At Corona Regional Medical Center, they take a CT scan right away. It’s so noisy and cold. I just want to curl up and sleep. A nurse turns a video monitor toward me. “Leticia, I’m Dr. Ali Razmara with the University of California, Irvine,” says the man on the screen. “I’m a neurologist. You’ve had an ischemic stroke. A blood clot has formed in your brain. We’re going to try to stop the damage.” I’m Joseph, and I’m 46. I met my wife 20 years ago at the Cerritos mall, where I was a security guard at the time. She was doing temporary Christmas work. “I have to act fast; I hear you’re leaving soon,” I told her. People still chuckle at that story. We have three kids:

I hear a voice, so calm, so soothing. I can’t tell where it’s coming from. Someone turns a video monitor toward me. “Mr. Lopez, I’m Dr. Ali Razmara with UCI. Your wife has had an ischemic stroke because of a thrombus, a blood clot that’s blocking part of her brain. I want to start her on tPA, a tissue plasminogen activator.” The drug will spread through her brain and could break up the clot, he says. The first four to six hours are critical. Billions of cells could be lost if she doesn’t receive treatment. “We have to act fast; we don’t want her leaving us,” he says. They quiz me about any warning signs: Slurred speech, stomachache, headache, uneven walking? There were none. She was fine at 2 o’clock – I kissed her goodbye as she was about to get in the shower. That’s good, they say. It’s barely 3 o’clock. There’s a slight risk the tPA could cause internal bleeding, but more likely it could save her life. A nurse hands me consent forms and prepares an IV drip.

Spring 2016

“They quiz me about any warning signs: Slurred speech, stomachache, headache, uneven walking? There were none.”

Dr. Razmara comes back on the telestroke screen – that’s what they call it, like Skyping for doctors to diagnose and treat patients. “We’d like to airlift Leticia to UC Irvine Medical Center,” he says. “We’re a nationally certified comprehensive stroke center, and we’ve got good specialists here. It looks like your wife has had a pretty major stroke.” “Yes,” I say. “Thank you.” I pick up the kids, and when we arrive in Orange, Dr. Razmara hustles us through low-ceilinged hallways and double doors. They ask the kids to stay in the waiting room. Leticia looks at me and closes her eyes.

He will thread a tiny tube through an artery in Leticia’s groin all the way up to her brain – dodging major organs, monitoring every millimeter on a live computer screen, backing out a bit and going in again, if needed – until he reaches the right spot and then will suck the clot or its remnants down the tube and out of her body. She’ll receive local anesthesia. There are major risks. “Yes,” I say. “Do it. Please.” My eyelids feel like they have gum or glue stuck to them. I’m so thirsty, but they won’t give me water. They’re worried I can’t swallow. My right thigh hurts. Joseph explains why. The clot is out of me. “You’re doing great,” he says. I can’t move my left side. I’m tethered to a catheter, a feeding tube and an IV, and I can’t stop drooling. Other than that, I’m doing great. Leticia is sleeping. I feel like the day has been a series of miracles.

Day Two: In-Patient

.....................................................

An IV is attached to her right arm; they’re pumping in the clot-busting tPA and other drugs to protect her neurons from permanent damage. An attendant attaches metal clamps – robotic stimulators – along Leticia’s left side, on her foot, fingers, lips and cheek. They will pulse rapidly on her skin, which could reorganize the blood flow in her brain, opening alternate arteries wide to rush in oxygen and reverse the stroke. Dr. Shuichi Suzuki, a brain surgeon, introduces himself. He wants to perform a thrombectomy to remove the clot.

Dr. Wengui Yu says the medication and tactile stimulation helped, but there is damage to Leticia’s brain and it’s swelling. They want to do a craniotomy the next day, creating a small flap in the skull to relieve the pressure. “Yes, whatever you think is best,” I say again. “Thank you for everything.” A resident hurries in and whispers. Dr. Yu looks sad when he turns to me. Leticia’s brain has begun swelling rapidly. It doesn’t look good. They have one option, he explains, but it’s very high-risk. They can remove a large section of her skull. I don’t know what to do. “Can you give me a minute?” I say. My cellphone rings. I hear a calm voice. It’s Dr. Razmara; the resident paged him. He tells me that if it was his sister or mother, he would do the surgery – yes, knowing the risk. It answers my question. We stay by the elevator downstairs from the operating

UCI Magazine

room for hours. My phone buzzes constantly – worried friends, family and our pastor. Near midnight the elevator door finally opens and the surgeon emerges. I’ll never forget that smile. Oh, my God, she’s going to be okay. “Mr. Lopez, the swelling went down much faster than we thought it would, as soon as we gave her brain some breathing room,” she says. More miracles. The left side of my head hurts. It’s been shaved, and the hair in the back feels stiff, like it has dried blood in it. My beautiful curls are gone.

Day Three: Advanced Medical Treatment

.................................. Dr. Steven Cramer visits me in my room the next morning. He says we’ve made it through the crisis.

We’re on our way. He explains that he’s both a medical doctor and a researcher specializing in brain injuries, particularly strokes. “Your brain is already galvanized for repair,” he says. “After a stroke, it goes to work right away trying to rebuild the smoldering ruins. You don’t even have to think about it. But we can help the process a lot.” UCI is on the front lines of stroke care, he explains. There have been tremendous advances in the 21st century by interdisciplinary researchers here and elsewhere to help people recover from stroke: neurointerventionists, engineers, occupational therapists, psychologists, data programmers, biologists, dance specialists, gaming theorists, statisticians. My head swims, but I listen. “You’re pretty lucky, though you may not think so right now,” Dr. Cramer says. “We’re still tackling

how to get treatments to people in rural and poor parts of the world.” Most people think only children’s brains can change, he says, but over the last several decades, scientists have found that adult brains also have “plasticity,” meaning they have an extraordinary ability to change their structure and function. “When part of the brain has been blown up and you’ve suffered damage that’s causing paralysis, say, you want the remaining elements to start communicating differently, in order to get your limbs working again,” he says. By combining stem cell therapy in the next few days with intensive physical rehabilitation for the next month or two, they will deliver a one-two punch to the stroke’s worst effects. Dr. Cramer says that my brain has a lot of potential for rewiring itself if I work hard and that I have a strong chance of a full recovery. Parts of it will even be fun. That afternoon, they take cell samples from my skin that have not developed for specific body functions. Using my own cells reduces the risk that my body will reject the treatment. They make a cocktail of those and specialized drugs and inject them into the injured area. They implant a tiny device to stimulate brain activity. Both treatments should foster new electrical connections to send signals to nerve endings throughout my body. Part of my right brain isn’t working, but just like a car detours off the 405

A ‘Spoke and Hub’ System

Rapid response is critical when treating stroke, which occurs when a brain blood vessel is blocked by a clot or bursts. When brain cells don’t get oxygen, they can perish in minutes, says neurologist Dr. Steven Cramer, who established the UC Irvine Health Comprehensive Stroke & Cerebrovascular Center, one of the nation’s first. “It’s what I call a FedEx nightmare,” he says. “You have 100 billion customers – the cells – and if you’re two minutes late with the oxygen, they all die.” UCI spearheaded the creation of a “spoke and hub” system: County policy now requires paramedics to take patients suffering stroke symptoms either to “hub” hospitals with neurovascular specialists available 24/7 or to “spoke” hospitals that can quickly transfer them to hubs if necessary.

Spring 2016

when it’s jammed to the 55 and 5 freeways, my central and left brain will find new paths. “This is what we mean by plasticity,” the surgeon explains. They also culture my bone marrow cells to make them multiply and administer them intravenously to improve immunity and healing. That night, I dream I’m back in high school, tap-dancing on a stage that gets higher and higher. Sophia joins me in her witch costume. I realize it’s nearly Halloween. “You’re my cute witch,” I tell her. “You’re my hero.”

Days Four and Five: Under Construction

..................................................... A “greenie” – that’s what I call the attendants because of their scrubs – transforms one side of my bed into a wheelchair with the push of a few buttons and gives me a sponge bath. I’m dying to take a shower – my hair is still caked – but I’m terrified I’ll die if I do. A counselor told me my fear is normal, because the shower is where I had my stroke. An occupational therapist named Gigi Oh introduces herself and attaches small devices to my left shin and wrist. They’re like Fitbits but lighter and better equipped to monitor medical recovery. She tells me they’ll track how often I move my hand and leg. She sets a timer to remind me with a little ping to periodically attempt to move my limbs – and sets target numbers. I try as hard as I can to move anything on my left side. I think I feel something, but I’m not sure. The devices register zero. She downloads an app on my phone that shows me my chances for recovery, based on a database of thousands of patients who have undergone similar treatments. Eightythree percent. For the first time, I feel hope. Gigi interviews me about my goals – what I want to do when I get better. I tell her about our real estate business and that I need to use a computer. I tell her I’m the one who runs the house – cooking, cleaning, getting the kids to school and team practices. “What do you like to do for you?” she asks.

Biological Breakthroughs

I can’t think of anything. Finally I say, “Any kind of dance. I used to love to dance.” As I drift off that night, the ping sounds. My left leg twitches. Professor David Reinkensmeyer, a UCI biomedical engineer, visits early the next day. His lab and Cramer’s have worked together closely for years. He’s invented “robotic exoskeletons” – personalized robots for different body parts, such as my damaged arm and leg – that will respond to my healing brain’s intention to move and help me practice “the right moves” to restore gait, balance and strength. I’ll also use a game board and other tools. My care team is designing a personalized program based on my genetic profile and the pattern of my brain damage. They’ve winnowed the database of stroke survivors to 20 with very similar profiles to mine who made major or total recoveries. By looking at everything from their diets and medications to the times of day that they exercised, my caregivers will aim to do the same for me. Professor Reinkensmeyer hands me a cap that looks like a fishing net covered with hundreds of LED lights. It’s called a “geodesic sensor net.” It works for stroke patients like an EEG does for heart patients. It will allow the physicians and therapists to monitor how my brain is responding as I practice physical activities, showing when I have good focus and when I lose it. Maybe when the kids see me wearing this, they’ll laugh instead of looking so scared. After Professor Reinkensmeyer leaves, Gigi wheels me down the hall to a physical therapy room. She attaches an exoskeleton to my left leg, then straps me into a soft harness tethered to a robot on the ceiling. It lifts me high, and I swing like a baby, my feet lightly touching the floor. It’s scary, but it feels good. The sling and brace will allow me to safely practice standing, balancing and walking. As I get better, the greenies will deliberately shake me so that my brain can better learn how to self-correct the variability caused by my stroke. None of it seems possible.

In the future, stem cells, electronic drumming devices and other therapies could allow brains with blocked arteries to quickly open healthy alternate pathways, detouring around a stroke and preventing cerebral injury, paralysis, slurred speech and other impacts. Investigators at UCI’s Sue & Bill Gross Stem Cell Research Center will soon test whether stem cells taken from our skin and bone marrow could be grown into healing agents. And Professor Ron Frostig’s team found that stroking the whiskers of rats with blocked brain arteries reversed ischemic strokes. Similar tactile stimuli at key body points could do the same in humans; clinical trials are expected by 2018.

UCI Magazine

Two Weeks After Stroke

..................................

One of my best friends, Marika, visits. I’m so happy to see her. We joke about how we used to slay the boys in high school with our jazz routine. Sitting in my wheelchair, I tap my left leg up and down unconsciously. Joseph starts shouting. “Did you see that? She moved her leg! Marika, take a video with your phone!” He demands I do it again – and I can!

Three to Eight Weeks After Stroke

..................................

I get pretty good at wheeling myself into the bathroom or down the hall with my right hand. Too good. Gigi rolls in a prototype wheelchair one day with long metal arm bars angled toward the ceiling. It’s based on a technology called LARA, for leveractuated resonance assistance. “Try to move the wheelchair with both

arms,” she says. I look at her like she’s crazy. She props my arms on each bar and helps me push down. The chair rolls forward. I use my right arm to prop my left arm back up, then attempt to push down with both again. It takes a few tries, but I can do it! I start crying. Gigi pretends not to notice.

the computer screen light up with the points I’ve earned. Next the attendants tell me to turn a wheel in the center of the board with my fingers – fine motor coordination. I can’t do it. Just keep trying, they say. I do it for my kids. I test out the video game Guitar Hero with the cool blue MusicGlove, invented by Professor Reinkensmeyer’s students, which responds to me pinching my fingers together or tapping them by making it look and sound as if I’m playing songs on the screen. My scores are pretty lousy at first, but I slowly start racking up points. My kids get a kick out of the games when they visit and like watching a YouTube video of old-time rapper Dr. Dre using a fullbody exoskeleton that UCI invented. It’s got 3 billion views. The hot water feels good, but I’m still scared. I never used to be scared of anything happening to me. It’s been one month since I fell. Each day, I work hard to get out of bed, transfer to the toilet, move my arm and – toughest of all – walk. I thought it would be like learning to ride a bicycle again: easy. It’s not. I have to think about every step.

“As I get better, the greenies will deliberately shake me so that my brain can better learn how to self-correct the variability caused by my stroke.” I also play on a console with a computer screen. Instead of a keyboard, there are brightly colored buttons. Student researchers put a plastic mallet in my left hand and tell me to bang on the big red and green buttons. It helps restore gross motor functions. It feels pretty satisfying when I manage to hit one and see

Balance, right foot, left foot. I pray a lot more than I used to, for patience. It helps to see other patients recovering. I practice “cooking” and “shopping.” With the exoskeleton on my left arm, I toggle computer keys to “lift” an egg on the video screen and crack it into a pan. I “lift” a block of

Spring 2016

wood, and on the screen it looks like I’m taking products from grocery store shelves and putting them into a shopping cart. My brain is on fire. That’s what Dr. Cramer tells me. It’s renewing itself, growing new neurons and synapses. He can see it on the telerehabilitation monitors. Keep it up, Leticia, keep dancing. I tap my left foot as hard as I can every chance I get. “Are you ready for the holodeck, Captain?” Gigi says with a smile one day. We head to a room with big 3-D displays and patients wearing virtual reality goggles. Eddie has begged us to get him a set, but I’ve never tried them. She sets up a simulation to play virtual golf. Ha! I’ve never played in my life. The robots help me to bend over to place the ball, balance and swing. I walk on a treadmill along a 3-D virtual course after hitting each ball. The greenies ask me to play a round with another patient. The system will handicap us to about the same level, so it will be a good match. I’m still a terrible golfer, even with help from robots. But I laugh while I’m trying, which feels good. I play nine holes and beat my partner by two strokes. I’m tired, but the time flew by. Back in my room, Gigi tells me that she analyzed data from my golf session. I moved my leg in many directions, showed better balance reactions, and improved my hand movement. The weight shifting and other transitions are similar to cooking, she notes. She shows me my progress on my cellphone. I exceeded the target amount for today. Congrats!

Day 56: Christmas Eve

..................................................... Dr. Cramer says I can go home. He’s reviewed the data from my brain and the robots. I’m medically stable, and my movement is strong enough that I can keep practicing there.

“My brain is on fire. That’s what Dr. Cramer tells me. It’s renewing itself, growing new neurons and synapses.” Gigi gives me two more devices – smaller exoskeletons made of metal and plastic and Velcro for my hand and leg. They’ll help me walk safely and use my fingers, but only as much as I need. “They’ll keep turning themselves down as you get better, so don’t get used to them,” she says. She tells me there’s a rehabilitation holodeck at my local 24-hour gym.With so many baby boomers experiencing disabilities and losing mobility, holodecks are also at YMCAs, community centers and other locations now. “They’re not as high-tech as the hospital’s, but they’re still fun,” Gigi says. “And you can work out with some of the friends you’ve made through the UCI support network.” She’ll be checking all my movement data. “Don’t even think about becoming a couch potato,” she warns. I’m so glad to be home. Sophia and I always put up the Christmas tree, and they waited for me. She whirls around the sweet-smelling branches so fast I’m worried she’s going to knock it over. I force myself to hang ornaments slowly, one after the other, using my hand exoskeleton. It beats video games any day.

Engineering Ways Forward

Transformative technologies already help people with paraplegia and other challenges regain mobility. Slings, braces, electronic implants and computer games are used in rehabilitation, and additional advances are in the works: l UCI’s Brain Computer Interface Lab

developed an implant for a man with spinal cord injury that enabled him to walk again last year – treatment that could aid stroke survivors too.

l Cognitive scientists and big data experts

are setting up databases that cross reference injuries, outcomes, DNA profiles

UCI Magazine

and other information. It’s part of a major future trend: customized medicine. l Video game theorists and psychologists

specializing in motivation are developing mind-engaging products to keep people practicing critical repetitive movements and doing other restorative exercises.

l Lightweight robotic devices can be

significant spurs to correct physical therapy. The ArmeoSpring arm brace, based on Professor David Reinkensmeyer’s engineering, is now used at 700 clinics and hospitals worldwide, and his LARA wheelchair lever prototype is being commercialized.

Months Three Through Six: Home

.................................. Joseph stretches my left side every morning. It hurts, but I know he has to do it. Then I spend three hours at my local holodeck relearning movements with help from my exoskeletons. I videoconference with Gigi twice a week and see her once a week at her office, where she adjusts my exercises and changes devices. I track on my phone whether I’m meeting my targets. The help from my exoskeletons is decreasing. I begin paying bills online. I never thought I’d be happy to do this! Dr. Cramer calls. He wonders if I’d like to participate in a research study. I’d have a small sensor implanted under my skin to measure sweat, sugar levels, heart rate and other factors to detect future health problems. I might also be asked to wear a necklace or bracelet to measure things. It could help us know very quickly if I’m at risk for another

stroke, diabetes or other problems. He says that in the near future everyone may be “microchipped” – and grateful for it. “Sign me up,” I say.

Day 180: Stepping Out

.................................. Gigi says it’s time to get rid of the exoskeletons. I can move well enough without them. I feel somewhat uncoordinated, but free. I tell her I saw a story online about Parkinson’s disease patients learning to dance. I want to try it. She says I should contact iMove at UCI. Kelli Sharp, a biologist and assistant professor of dance science, emails a few hours later with a schedule of dance classes for recovering stroke survivors in Riverside and Orange counties. She says they’re highly effective for people with chronic brain injuries. Twenty years ago, she and another UCI dance professor began working with kids with cerebral palsy. Their techniques were proven to restore mobility and

reduce anxiety. Ballet or tap might be tough, but I’m an ideal candidate for ballroom dancing. Joseph can be my partner. “I’ll always be your partner,” he says. “Just don’t move too fast.” Anatomy & neurobiology professor David Reinkensmeyer contributed to this report. While this story is about a hypothetical patient in the future, it includes the experiences of Maria Ortiz and her family with their permission.

Dancing Back to Health

Assistant professor of dance science Kelli Sharp – who first studied regenerative spinal cord function, then earned a doctorate in physical therapy – researches how to help ballerinas extend their careers, using the brain to strengthen connections in neuromuscular systems. She also utilizes dance to explore how to help people with neurological disorders both emotionally and physically. “So they’re up, they’re moving, and functional MRIs and other work shows the pathways in their brains are changing,” she says. They’re regaining function, and they’re experiencing great satisfaction.” Sharp works with other UCI researchers to track molecular changes in patients’ brains as they do exercises to improve everything from hindquarter strength to perceiving where their hand is in space as it holds a cellphone.

Spring 2016

d e p p i l F Flipped yReality tilaeR Prism goggles trick the brain into rewiring the visual cortex, providing insight into its plasticity By John Westcott

he first thing you notice after you strap on Dr. Alyssa Brewer’s prism goggles is the nausea. A roiling hits the stomach and grows worse as you begin to move. The world is strangely out of kilter. You reach out to grab hold of something, but it’s not there. Just putting one foot in front of the other takes an enormous effort. “Welcome to the world of unreality” is what the UCI associate professor of cognitive sciences likes to say when unlucky subjects first peer out of the goggles. They’re an ingenious way to unhinge a person’s sense of reality. The environment one sees is completely flipped; the two prisms inside are tilted so that what you see on the left is really on the right, and what’s on the right is really left. Brewer is intentionally tricking the brain, forcing it to find a way to adapt to this strange new reality. Her subjects stumble and lurch, grasping at air. It’s the supreme test of the visual and vestibular systems, pathways in the brain that use what you feel and see to enable navigation of the three-dimensional world around you.

UCI Magazine

Such mind boggling helps Brewer and other scientists learn how the brain works. She hopes experiments like this will lead to new treatments for post-traumatic stress disorder and stroke, perhaps even Alzheimer’s disease and chronic pain. Paradoxically, flipping reality right to left is a far bigger challenge to the brain than turning things upside down. That’s apparently because of the way its two hemispheres communicate with each other. “We are not entirely sure why this is the case, but one hypothesis is that the difference is due to the wiring and connectivity of the brain,” Brewer explains. “The representation of the body is split between the two hemispheres. The left side of the brain is controlling the right side, and vice versa. The visual information from both sides of visual space, for the most part, doesn’t come together until pretty far along the visual processing pathways. We were actually surprised by how different the experiences are.” The brain is also surprised. When someone wears the goggles, the cerebellum – or lower brain – protests, sending urgent signals of distress and disequilibrium to

Spring 2016

Steve Zylius / UCI

the cerebral cortex. In turn, the visual and motor regions of the cerebral cortex – or higher brain – frantically try to realign what you see with commands for how to move through space. “You get this warning from your brain that something is very wrong,” Brewer says. “You get motion sickness, and every head movement you make multiplies the motion sickness.” But just as she suspected, the brain does adapt. Usually, after a week or so of using only the prism goggles to view the world, subjects who were initially so disoriented they could hardly stand, let alone walk, find their footing and become quite adroit at navigating their new environment. “You’re forcing the brain to rewire itself,” Brewer says. “And you end up with two different maps in your visual cortex: one that matches the normal visual world to

spatial movements and one that matches the flipped visual world to the same movements. When subjects came back three months later and did the study again, it only took about a day for them to readjust to the goggles, suggesting that these changes persist for extended periods of time.” It’s a form of neuroplasticity in which the brain develops new neuronal connections in response to altered circumstances. Scientists used to believe the adult brain was mostly static, that it couldn’t change in significant ways after an early developmental period. But the explosion of brain research that Brewer and others have fostered in recent decades shows that the lump of gray matter sitting atop our shoulders is far more resilient than we once thought.

Participants in the prism goggle experiment have varied reactions, says Dr. Alyssa Brewer (left), associate professor of cognitive sciences. While she can only tolerate the eyewear for minutes at a time, her colleague Brian Barton (right) has adapted to the point where he can accomplish such complex tasks as walking through a maze with relative ease.

UCI Magazine

Steve Zylius / UCI

“You’re forcing the brain to rewire itself. And you end up with two different maps in your visual cortex.” Discerning Reality

.................................. Brewer and her colleagues first began fiddling with prism goggles in 2008, shortly after she arrived at UCI. Subjects in the two-week experiments were required to view the world exclusively through the contraptions and wear blackout masks for sleeping and showering. Brewer found that the prisms caused more than just visual confusion. The brain employs a broad network of input to discern reality, including sound and touch. As a result, a goggle wearer’s hand almost instinctively reaches for an object seen on, say, the right, even though he or she knows it’s on the left. An hour after one woman took off her goggles, she still automatically turned her head to the right when someone to the left called her name. Individual reactions to the goggles can vary greatly. Brewer says she personally can’t handle more than a few minutes of wear. And that’s an improvement. “I couldn’t even get out of the chair,” she recalls of her first time. On the other hand, her colleague Brian Barton, a postdoctoral fellow who has worked with Brewer on several research projects over the years, adapted to the goggles with lightning speed. He can accomplish such difficult tasks as walking through a maze or preparing cupcake batter with relative ease. “I was in the lab with a graduate

student and Dr. Brewer, both of whom had just tried the goggles on and were unable to navigate the roughly 15-foot walk to the nearest doorway,” Barton says. “To everyone’s surprise, I was able to navigate not only to the first door, but through another, down the hallway and back, through the two doors to my chair.” Brewer is not sure why, but she suspects Barton’s frequent forays into three-dimensional video games have primed his brain for the imaginary goggle world. Barton agrees, saying that video games probably gave him practice in dealing with conflicting visual information. They have also identified a genetic difference that affects brain plasticity. These are the types of insights Brewer hopes will illuminate brain function.

Unexpected Directions

.................................. Brewer’s journey into the world of science wasn’t always a smooth one, though she knew as early as second grade that she was destined to be a scientist. Later in elementary school, she was the odd girl out in her rocketry class – not because she was odd, but because she was a girl. The only one. “No one else in the class would talk to me,” she recollects. “Even the teacher never spoke to me once during the whole class.” But the shunning did not discourage Brewer. She was determined to

do what she loved. “I discovered I can be really stubborn,” she says. “It just made me work harder.” That stubbornness helped her persevere through isolation and other annoyances, such as suggestions that a woman should pursue a more suitable – and easier – profession in order to raise a family. Brewer, a mother of two, proved all the doubters wrong. She earned dual degrees in medicine and neurosciences at Stanford University, believing both would be valuable in pursuing her ultimate goal: using brain research to find unorthodox solutions to intractable medical problems. The two fields put her in a position to search for new answers. Her research sometimes took her in unexpected directions. She briefly worked with scientists studying radiation effects on specific cancer markers and imaging changes in the heart during exercise. But Brewer was more fascinated by the brain, and by the time she arrived at UCI in 2007, Brewer was looking for new ways to study neuroplasticity. She had worked with patients with retinal damage and developmental deficits in graduate school. But it occurred to her that working directly on the brain held the greatest promise for future treatments. Brewer had encountered a professor during grad school at Stanford who shifted the visual field of owls using prisms, making their hunting swoops frustratingly inaccurate until they eventually adapted to the new match between their visual and motor worlds. She began testing humans to see if they responded in similar ways. In the beginning, her subjects sometimes unwittingly walked in circles as they tried to navigate their altered environment.

Spring 2016

Steve Zylius / UCI

Contagious – in a Good Way

..................................................... “It’s a lot like looking through a camera while you’re walking,” Brewer says. “You get this jittery effect. Then you go in the wrong direction because of the prisms, and that makes the jittery effect even worse. You also can’t see your feet because of the goggles, which adds to the disorientation.” Simply sitting in a chair was initially a trying experience for some of her subjects. Scribbling a word was almost impossible. “Writing the letter ‘m’ in the dark is easy,” she says, “but when you try to write it while watching, your hand appears to move in the opposite direction. You write the letter ‘n,’ and then you find yourself writing backward over it.” But by the end of the two-week test, participants were negotiating their new environment about as well as they had their more familiar world. In addition to observing the behavioral improvement, Brewer employs groundbreaking neuroimaging techniques that map the physical changes in the brain as it adapts. Images from functional MRIs – which measure

the fluctuating oxygen levels in clusters of neurons – indicate changes in the visual and motor brain regions after someone has worn the goggles. Brewer and her colleagues have spent hundreds of hours sifting through the raw data. It’s painstaking work, but it’s proving that the visual cortex is capable of profound change even in adulthood. This is promising news for those seeking solutions to disorders such as stroke, which often causes vision loss or other visual disturbances. “We are starting related studies exploring how different types of visual training could be effective for rehabilitation of visual deficits,” she says. “Perhaps the still-healthy brain hemisphere could take on the function of the damaged hemisphere for a particular visual behavior. We see this type of interhemispheric change in the normal brains of our subjects who adapted to two weeks of reversed vision.” There is even tantalizing evidence from other studies that neuroplasticity can be contagious, in a good way. Once it takes hold in certain areas of the brain, as it appears to do in the goggle experiments, neighboring tissue may become more receptive to change. Brewer is teaming up with researchers at Stanford University, Baylor College of Medicine and the University of Texas Health Science Center at Houston to dig deeper into these and associated issues. And her experiments with the goggles continue, now with the new goal of determining how different senses, like hearing and touch, interact with the visual adaptations that her subject’s brains undergo. “Because the prism goggles produce such dramatic changes in part of the visual cortex,” she says, “we are hopeful that these changes make the brain as a whole more susceptible to restructuring – to being more ‘plastic.’ Such an increase in this plasticity could make other treatments more successful, especially for conditions like PTSD and drug addiction.” To conquer such intractable disorders, Brewer notes, it helps to view them from a different perspective. Video: http://bit.ly/ucimag_spring2016_FlippedReality

“An increase in this plasticity could make other treatments more successful, especially for conditions like PTSD and drug addiction.”

UCI Magazine

Where you see a pirouette, we see brain research taking a turn. By better understanding the brain, we can strengthen a dancerâ&#x20AC;&#x2122;s abilities. And by studying her movements, we can better rehabilitate brain injuries. At the University of California, Irvine, a deeper understanding of the relationship between the brain and the art of dance is emerging. Dr. Kelli Sharp, an accomplished bioscientist in the department of dance, is spearheading a research initiative to discover how dance movement can help retrain motor function in people with neurological disorders.

Shine Brighter. Visit uci.edu/innovation

Heading Off Brain Injuries An alligator researcher, a crash test dummy and an ex-Boston Red Sox medic join forces to unravel the mystery of water polo concussions

Jocelyn Lee / UCI

By Roy Rivenburg

lligators and water polo don’t normally cross paths – except in James Hicks’ lab. The UCI professor of ecology & evolutionary biology, best known for studying reptile hearts, recently turned his attention to another amphibious creature: the human water polo player. Joined by an intriguing cadre of UCI scientists – including a former Boston Red Sox team doctor and a neurologist who once probed violinist brains – Hicks is among the first to investigate aquatic sport concussions. The multidisciplinary project, which now encompasses four studies, could also benefit soldiers and has drawn military funding. The research comes amid a flurry of concern over head injuries in athletes. Football has been the main focus, but Hicks hopes to change that. He got interested in water polo concussions while watching his three sons play the sport. “People who’ve never seen a game may not realize how physical it is,” he says. “Head-butts and elbows. Balls

UCI Magazine

flying up to 50 mph. I’ve witnessed players get dragged out of the pool in a daze after a blow to the head, and I’ve sat in an emergency room while my kid received stitches from being struck in the face. I began to wonder what the concussion rate was.” He couldn’t find an answer. Although the NCAA Injury Surveillance Program compiles reams of statistics (“I can check how many linebackers get knee injuries,” Hicks says), water sport mishaps are largely a mystery. In 2012, the NCAA began tracking water polo concussions, but so far only a handful of teams have signed up to supply data, officials say, and the results haven’t been made public.

Dummies and Radar To fill the gap, Hicks enlisted help from UCI’s Exercise Medicine & Sport Sciences Initiative, a health research arm he directs, and Huntington Beach-based USA Water Polo, a national governing body for the sport.

UCI, a powerhouse in the aquatic sport’s epicenter – Orange County – seemed an ideal setting to study the issue. Hicks, who also serves as UCI’s interim vice chancellor for research, and his colleagues initially set up a three-pronged approach: n Head shots. David Reinkensmeyer, a professor of anatomy & neurobiology and biomedical engineering who specializes in robotics, contributed a crash test dummy head and radar gun to measure the impact of balls thrown at different speeds and inflation levels. Result: Underinflated balls reduced the risk of head injury. Engineering students also experimented with a padded skull cap, discovering that it softened the intensity of hits by at least 20 percent. But the slightly larger headgear isn’t allowed by the NCAA, on grounds that it creates a competitive advantage. n Player input. Neurology chair Dr. Steven Small, who has used MRI machines to analyze the brain waves of violinists and baseball sluggers, helped draft an online survey to gauge the prevalence of “seeing stars” among USA Water Polo members. Overall, 36 percent reported at least one concussion. That rose to nearly 50 percent for goalies, who are most vulnerable during practice, when balls are repeatedly hurled at them in drills.

n Live tracking. Anteater men’s water polo coach Marc

Hunt, who admits to having had his “bell rung” a few times as a player for UCI, let researchers stick electronic sensors in his team’s caps to monitor how often the athletes suffered blows to the skull. “I was surprised to see how frequently our goalies were getting hit,” Hunt says.

Something in the Blood? One of the newest recruits to UCI’s water polo project is Dr. Massimo Fiandaca, an Italian-born associate professor of neurology and neurological surgery who once worked as a team physician for the Red Sox and co-invented a blood test that predicts Alzheimer’s disease. With researchers at Georgetown University, the University of Rochester and UCI, he is now devising a blood screening method that could revolutionize concussion diagnosis. Currently, athletes who don’t want to be pulled out of games can subvert field tests designed to detect mild concussions, he says. Players often underperform on preseason baseline exams so they won’t appear impaired after getting clocked during a game, he explains. An objective measurement would solve that problem. Fiandaca’s group believes it has discovered a blood component – or biomarker – that changes in reaction to traumatic brain injury. UCI hopes to run trials with its soccer and water polo players this summer to determine how soon after impact the indicator shows up.

Helping Soldiers in Combat Military officials are also interested in Fiandaca’s research, which could be used to identify concussions in howitzer operators, demolition crews and other troops who encounter explosion-related pressure waves. Soldiers on the battlefield are like athletes in a game, the doctor says: “The individual doesn’t want to let his teammates down and will often deny injury to stay in the contest.” His group recently secured Department of Defense funding to see if repeated concussions increase a soldier’s risk for Parkinson’s disease or other problems later in life. Several mysteries remain. Why, for example, can some people “take a punch” but others can’t? The answer might be a combination of brain wiring and physical strength, Fiandaca says. There’s also anecdotal evidence that injury risk is reduced if a player sees a blow coming. In the end, Hicks explains, “concussions are not really the issue. It’s more about cumulative hits. We know boxers exhibit neurological symptoms as they age. But we don’t know the effects on water polo players.” Video: http://bit.ly/ucimag_spring2016_Concussion In UCI’s survey of USA Water Polo members, goalies reported more concussions than other players, especially during practice sessions.

Glenn Feingerts / UCI Athletics

Spring 2016

Leaping Ahead UCI junior Lloyd Sicard sails over a hurdle in April at the 24th annual Big West Challenge, where he set a meet record for the 110-meter race and earned the conferenceâ&#x20AC;&#x2122;s Track Athlete of the Week award. Sicard, the 2014 Big West Freshman of the Year, holds the Anteater record of 13.60 in the 110 hurdles, which he set last May in the NCAA West Preliminary Round.

Glenn Feingerts / UCI Athletics

R E F L E C T I O N S

Fight Call .............................................................................................................. By Julia Reinhard Lupton

lthough Iâ&#x20AC;&#x2122;ve been teaching Shakespeare at UCI since 1989, I didnâ&#x20AC;&#x2122;t start hanging out in the theater until the New Swan Shakespeare Festival came into being five years ago. I still base most of my teaching and scholarship on the texts of Shakespeare, but I have been gleaning insights of another order from observing

actors and designers stage the plays. How do theater makers approach a problem, tell a story, transmit an experience or build interest in their projects? And how can I extend those techniques to my work as a teacher, a scholar and a designer of programs?

UCI Magazine

I witnessed my first fight call during dress rehearsals for “The Comedy of Errors” at the start of the first season of the New Swan Shakespeare Festival. Half an hour before curtain time, the stage manager called the actors to run through every scene that involved fencing, wrestling or dances with lifts – any tricky physical routine that might endanger the actors or audience. Watching a fight call is kind of like watching a movie trailer. You see all the action bits in sequence, played before your eyes in triplicate: first in slow motion, then at half speed and then at full tilt. A fight call leaves the actors limber, loose and ready to go. And the lucky observer (me) knows exactly how the falls are faked and the slaps kept happy. Fight calls require trust: What looks like a sword fight happening in real time is actually a dance unfolding in rehearsed time. The actors learn to rely on each other and their muscle memory to take each other through to a safe and smooth finish. Specially trained fight choreographers work with the actors to create the illusion of spontaneous physical violence. Bam! Kapow! Not. Now I see fight calls everywhere. When my teenage son and I badger each other (my driving and his clothes, my memory and his memes), we are stage fighting, letting bursts of hostility bounce off each other like bubbles, not rocks. When I ask my students to debate the gender politics of a Shakespeare play, I try to give each group plenty of ammunition. “I’d never set you up for failure,” I reassure them. I want everyone who participates in our agon of words and ideas to rise from the ground triumphant. When I anticipate trouble in a faculty meeting by sounding out a compromise in advance, I am engaging in a kind of fight call. If most meetings fall far short of ballet, I am relieved if they are closer to a tennis game than a riot. In devised or physical theater, the actors use the push and pull of their interlocking bodies to assume all the parts in a story – not just the human characters, but the furniture, the architecture and even the weather. In the original productions of UCI director Annie Loui, the whole rehearsal is an extended fight call. I try to be like Annie when I bring diverse groups on campus into new shared arts enterprises (UCI Illuminations). Annie builds ships at sea out of bodies that move responsively with and against each other. I plan events that require many partners and processes to work in concert. The event is a ship, but so is the great university that floats it. Fight call and physical theater are not just about combat. These arts visualize the rhythm of thinking itself

– the taking apart and putting together that animates all sorts of intellectual and creative work, from chemistry to choreography. When I decide to cook from a recipe, the deliberate gathering and orchestrating of ingredients boosts my speed and confidence on those other evenings when I compose meals directly from the fridge.

“Fight call and physical theater are not just about combat. These arts visualize the rhythm of thinking itself.”

I even like to think about my religious practice as a kind of physical theater. When I pray with others, light Sabbath candles or make a Passover Seder, I am not replacing everyday experience with something mystical or otherworldly. Instead, I am using prayer to decompose and recompose the blur of normal reality in order to live more fluently. The seven days of creation are neither fact nor fiction. Instead, they are a fight call for the world and a recipe for the creative process. Divide, organize and assemble; constellate, animate and populate; rest and repeat. A class, a meeting, a meal, an argument, a collaboration and a prayer service: They share elements of stage combat, including the benefits of rehearsal, the real risk of failure, and the horror and joy of trusting others. A little scary? I try to figure out how to do it in slow motion first and then work my way up to full speed. Any actor will tell you that that’s the best way to keep “The Comedy of Errors” from becoming, well, a comedy of errors. Lupton is a professor of English and director of Illuminations: The Chancellor’s Arts & Culture Initiative.

Spring 2016

Twist and Shout Anteaters hit the floor at the 2016 Care-a-thon, a dance party benefiting the neonatal intensive care unit at UCI Medical Center. Organized by the Student Alumni Association, the annual event brings together hundreds of students, alumni, faculty and staff who solicit pledges and dance for six hours. This year’s Care-a-thon, held in the Student Center’s Pacific Ballroom, raised more than $30,000. Donations will support stem cell research to find a cure for chronic lung disease in premature babies. Since the dance marathon’s inception in 2008, more than $100,000 has been raised, making the Care-a-thon UCI’s largest student-run philanthropic event.

Steve Zylius / UCI

A N T O U R A G E

Sanjay Manaktala ’05 performs at the Punch Line Sacramento comedy club. American audiences are more joke-tolerant than their counterparts in India, he says.

Sachin Bansal / Pixelchazer

From Computer Consultant to Comic Bored working in the software industry, UCI alumnus finds his true calling on India’s fledgling stand-up circuit .............................................................................................................. By Roy Rivenburg

Doing stand-up comedy in India isn’t the usual career path for computer science graduates. But it’s keeping UCI alumnus Sanjay Manaktala ’05 busy these days. Against a din of barroom blenders, blaring televisions and the occasional heckler, the New York City native is helping to pioneer the South Asian nation’s budding joke industry, which has swelled from just a few comics five

UCI Magazine

years ago to more than 150 now, he says. A former software consultant for Accenture and Symantec, Manaktala, 32, caught the comedy bug in 2010, shortly before an overseas job transfer to Bangalore, India. “From my first time bombing at a pizza restaurant, I was more or less hooked,” he says.

Today, his “IT Guy” spoof videos and gentle riffs on dating and Indian culture have garnered more than 4 million YouTube views, attracted media coverage from CNN Travel and Forbes India, and recently landed him a slot opening for British comic-actor Russell Brand in Mumbai and New Delhi.

“From my first time bombing at a pizza restaurant, I was more or less hooked.”

I have a maid in Bangalore who asked me on her first day on the job if she could work from home. Not surprisingly, what tickles American funny bones doesn’t necessarily fly with South Asian crowds, who skew older and often bring children along, Manaktala says. “In India, the comedy scene is still fairly new, so the joke IQ – what people laugh at – is still being developed,” he explains. “In the U.S., you can say whatever you want. … In India, you can get in trouble if you start bashing the government without having a well-thought-out joke behind it.” Topics such as poverty and rape are completely offlimits, Manaktala says, but police corruption is fair game. My old American girlfriend and I had this role-playing thing called the naughty cop fantasy. I would dress like a policeman and say, “You’ve been a naughty girl.” And she’d say, “Oh, my God, what are we going to do?” When I tried that over here, my Indian girlfriend said, “Oh, my God, here’s a hundred bucks.”

Manaktala initially kept his comedy moonlighting secret from his parents, who moved to the U.S. before he was born. “The No. 1 rule for a typical South Asian family is to keep your mother and father happy with your life on paper,” he says. “So I only told them I was doing stand-up once I started to earn a little money at it.” In an average week, Manaktala performs one corporate gig (“which pays my rent in one shot”), works a couple of bar shows and tests new material at open-mike nights. When he started, the only pure humor venue was a British Comedy Store outpost in Mumbai that opened in 2010 and ignited India’s stand-up scene, Manaktala says. “I moved to Bangalore around the same time and started approaching bars and pubs, pushing comedy as an alternative to karaoke,” he recalls. Although Manaktala was not a class clown growing up, “I did talk a lot in school and use humor as a way to flirt with the ladies,” he says. The other night, this girl invited me back to her place, but my cellphone was about to die, and when I looked at her phone and realized she wouldn’t have my charger, I didn’t go. Some jokes fare better online than live. “I have this bit on YouTube about a job interview at Google,” Manaktala says. “When I tell the story in bars, only 20 percent of the crowd understands the context and laughs. But online, it gets love from techies all over the world and has more than 200,000 hits.” He hopes his other jokes will also find a wider audience and eventually enable him to perform internationally. But for now, Manaktala says, he’s content doing stand-up in his parents’ homeland: “My mom jokes that she came to America so her kids would have a better life, only to have her son travel back and become a starving artist.” Video: http://bit.ly/ucimag_spring2016_Sanjay

Manaktala opened for British comic-actor Russell Brand (right) in Mumbai and New Delhi.

Praveen Kumar

Spring 2016

Class Notes

Sonja Berggren ’69, French

Liza B. Krassner ’81, psychology

Odd objects lurk in Sonja Berggren’s garage: a fake human leg, a giant bird mask, boxes of costumes. In recent years, the space has been transformed into a makeshift prop warehouse for Long Beach-based Panndora Productions, a small theater company that Berggren and a friend co-founded over coffee in 2002. A member of UCI’s pioneer freshman class (it was so long ago, she jokes, that her transcripts are “chiseled in stone in some cave”), the Ojai transplant worked as a high-powered labor lawyer and private school board president before catching the acting bug and taking classes at South Coast Repertory and Yale University. Today, in addition to directing plays and sponsoring an annual script competition and festival with Panndora, Berggren serves on advisory boards for Long Beach Opera, the New York Foundation for the Arts and two other Southern California theater groups.

.....................................................

Deadly parasites, hula dancing and John Travolta’s older brother all figure into the life of Liza B. Krassner. When not on the job as an administrator for UCI’s Program in Public Health, the University Hills resident produces films, supports autistic youth and volunteers at a jazz radio station, among other sidelines. Originally from the Philippines, Krassner came to California in 1976 and soon enrolled at UCI, where she met her future husband, Stuart, a founding biology professor who studied microscopic parasites. More recently, after their son was diagnosed with autism, Krassner conceived and helped bankroll two documentaries for a film company led by former actor-singer Joey Travolta. “Through the Heart of Tango” and “Hula Is My Language” show the benefits of dance for autistic and special-needs children. Krassner’s next documentary, slated for release this year, focuses on an autism center she visited in the Czech Republic.

.....................................................

Toshiki Tajima, Ph.D. ’75, physics Michl Binderbauer, Ph.D. ’96, physics Their holy grail holds a gaseous blob of super-hot plasma. In a nondescript building on the outskirts of Orange County, Toshiki Tajima, Michl Binderbauer and their colleagues at Tri Alpha Energy toil over an experimental fusion reactor that may someday upend the power industry. Unlike most fusion chambers, Tri Alpha’s reactor vessel uses nonradioactive fuel and relies on high-energy particle beams to shape and control the fiery plasma. The promising technology is based on concepts developed with the late Norman Rostoker, a pioneering UCI physicist who co-founded Tri Alpha. If successful on a larger scale, the maverick process could solve the riddle of how to harness fusion reactions to produce virtually limitless and pollution-free energy. Tajima, who is also a UCI physics professor, serves as Tri Alpha’s chief science officer. Binderbauer is the company’s chief technology officer.

Jermaine Griggs ’05, social ecology It all started with a piano that his grandma won on “The Price Is Right.” After learning to play the instrument at age 7, Jermaine Griggs was soon proficient enough that several parents at his Long Beach church began asking him to teach their children. That’s when inspiration struck. At 17, Griggs bought the domain name HearandPlay.com and launched a music instruction business. By the time he enrolled at UCI, nearly 200 orders a month were rolling in. Griggs hired people from his dorm to help, some of whom are still with the company. Fifteen years later, HearandPlay.com is a multimillion-dollar enterprise that teaches people to play piano and guitar by ear. Hundreds of thousands of aspiring musicians have downloaded Griggs’ free online lessons or enrolled in his premium courses, enabling him to fund various philanthropic efforts, including Operation Jump Start, which helps students from humble backgrounds get into and graduate from college.

UCI Magazine

To submit or view additional class notes, go to: engage.alumni.uci.edu/classnote.

Kaveh Azartash, Ph.D. ’10, biomedical engineering Dhonam Pemba, Ph.D. ’13, biomedical engineering Led by a cartoon penguin, Kaveh Azartash and Dhonam Pemba are infiltrating the turf of Rosetta Stone and Berlitz. They produce video games designed to wire preschoolers’ brains to more easily master foreign languages. Azartash and Pemba got the idea after struggling to learn Chinese as grad students and finding out that the brain’s ability to acquire languages is shaped at an early age. Working with animators, scientists and educators, the duo created Mochu the penguin and various game apps and e-books that expose young children to 4,000 sounds from 12 languages. Once those language seeds are planted, the brain becomes permanently more adept at grasping new tongues, says Azartash, an Iran native who came to the U.S. at 18. Pemba is a London-bred Tibetan born in Darjeeling, India. Through their company, Kadho Inc., the alums are also developing games to improve memory, creativity and athletic performance.

In Memoriam Norman M. Weinberger, founding faculty member

Jean Aldrich, founding first lady

Norman M. Weinberger, a leading figure in the field of neurobehavioral research and a mainstay of the School of Biological Sciences for 50 years, died Feb. 14. Weinberger was a young postdoctoral fellow at UCLA’s Brain Research Institute in 1965 when James L. McGaugh, founding chair of UCI’s Department of Psychobiology (now the Department of Neurobiology & Behavior), recruited him to join the fledgling faculty and get the unit up and running. A few years later, he served as chair of the department and, a few years after that, as acting dean of the School of Biological Sciences. Weinberger was a founding member of the Center for the Neurobiology of Learning & Memory and of the doctoral program in the history and philosophy of science within the School of Humanities. In addition to his appointment in the Francisco J. Ayala School of Biological Sciences, he was a professor of cognitive sciences in the School of Social Sciences. Weinberger became a research professor in 2004 and remained active in his laboratory until his death. His research focused on the storage of sensory information.

Jean Hamilton Aldrich, wife of UCI’s founding Chancellor Daniel G. Aldrich Jr., died March 23, at age 96 in Irvine, the city she watched grow into a diverse technology and business hub centered around a top-level research university that was once just her husband’s vision. While the campus was under construction, she threw herself into health and arts projects. She sat on the boards of a home for the developmentally disabled and South Coast Repertory. Once the campus opened, Jean Aldrich started the first Town & Gown group, comprising faculty wives and women from Newport Beach and Costa Mesa. (There was no city of Irvine then.) She also served on scholarship selection committees and defused a student demonstration with hot chocolate, cookies and prayer – courtesy of the family pastor. She even filled in for her husband at the French Consulate once, giving a speech completely based on her knowledge of high school French. After her husband’s retirement from UCI in 1984 and his death six years later, she remained connected to the campus and community. In 1990, she was honored with the UCI Founders Award for her tireless dedication and support. More: http://bit.ly/ucimag_spring2016_Jean_Aldrich

Spring 2016

P A R T I N G

Z O T !

Zapping Zika Scientists in the lab of UCI vector biologist and professor Anthony James ’73, Ph.D. ’79 inject a mosquito under a microscope during a training session. James and his colleagues have altered mosquitoes’ gene expression by using RNA-interfering molecules to modify their ability to transmit dengue viruses and are now working on Zika. “Most of the species that we’re going after are invasive,” James says. “We’re trying to manipulate the ecology back to what it was.”

UCI Magazine

Steve Chang / UCI

Scholarships. World-changing research. Brilliant new faculty. For a bright student struggling to pay tuition, your donation to The UCI Fund can make all the difference. For pioneering medical researchers and scientists, your contribution holds the power to restore a child’s eyesight, combat Alzheimer’s disease, safeguard the environment, or create wonderful new products and technologies. Your generosity also enables the campus to support faculty who enrich UCI’s academic atmosphere and attract the best students. The UCI Fund sends vital resources to the areas of greatest need, helping the university take advantage of unique opportunities or meet unexpected challenges. Through your partnership, UCI is better able to recruit and retain top students and faculty, maintain the beauty and innovation of the campus, and strengthen the university’s growing reputation as a premier research institution. Learn more at give.uci.edu/UCIFund. University of California, Irvine Shine brighter.

NONPROFIT U.S. POSTAGE PAID SANTA ANA, CA PERMIT NO. 1618

UCI Alumni Association Newkirk Alumni Center 450 Alumni Court Irvine, CA 92697-1225 Change service requested

Your gifts are making a world of difference. Thank you! Through your donations, we’re finding cures for deadly diseases, making world-changing discoveries, and inventing life-changing devices and technologies. Your generosity funds the scholarships, fellowships, laboratories and leading-edge research that make it all possible. Because of you, our campus, community and world will have a brighter future. Learn more at give.uci.edu. University of California, Irvine Shine brighter. “Polluted air takes a toll on children, the elderly and wildlife. To help clean our skies, I’m studying how atmospheric aerosols contribute to smog. Your scholarship support has helped tremendously along the way and ensures that I will graduate with the knowledge and skills needed to help heal our planet. I am so grateful.”

— Nujhat Ali UCI biological sciences major