Frances Jensen at TEDMED: “No more hand-me-down drugs”

Image by Steve Case via TwitPic: http://twitpic.com/31dosf

Before Children’s Hospital Boston’s own Frances Jensen, Director of Epilepsy Research, took the stage yesterday, Richard Saul Wurman, organizer of TEDMED and the TED conferences, spoke warmly of Children’s participation and sponsorship of this year’s event. A generous gift from the Hassenfeld Family Initiatives enabled that participation, and Wurman thanked the Hassenfelds and Children’s for bringing “such interesting people” to TEDMED 2010. With that, Jensen began her talk about the importance of understanding the developing brain.

“No more hand-me-down drugs,” she said as she showed a video created by Ellen Grant, founding director of a new fetal-neonatal neuroimaging and developmental science center at Children’s. The video — a sped-up version of a fetal brain developing and folding — testified to the astonishing changes the brain undergoes from fetus to age 4, and helps explain why drugs designed for adults don’t always work for kids. Jensen’s quest to understand these age-specific patterns has culminated in a phase I clinical trial in newborns with seizures, the first trial in 60 years for the generic diuretic bumetanide.

When her two sons were teens, Jensen decided to look into the neuroscience literature to glean what could be going on in the teenage brain. She was puzzled by a dichotomy: her sons were very well organized in some areas of their lives, but not in others: “What was that pile in the corner of the room, was it compost or was it laundry?” Jensen noted that brain development proceeds back-to-front, and the last to develop is connectivity in the frontal lobes, the seat of critical thinking skills and judgment. Teenagers, still lacking this connectivity, are armed with cognitive power, but not yet with the power to control it. Armed with this understanding, Jensen now talks directly to teens. Her talks include a potent warning about substance abuse: Teens’ brains are surging developmentally, making them more susceptible and more likely than adults to become addicted to drugs with less exposure, and to have more severe brain damage as a result.

Other speakers in this session on “wellness” and preventative medicine included the CEO of Whole Foods, John Mackey, talking about his company’s programs to motivate employees to stay healthy, and TV personality Dr. Oz, who, together with his wife and college-age daughter, talked about how honesty in family relationships can improve health. The last talk of the session, by pediatric hematologist/oncologist Barton Kamen, was entitled, “When should an adult see a pediatrician?” He showed data illustrating that outcomes for young adults (age 15-late 20s) who have cancer do dramatically better if they see a pediatric oncologist rather than an adult specialist. This is partly because of the use of “metronomic” chemotherapy, or giving more frequent, lower doses of chemotherapy, an approach initially proposed and tested in animals in the lab of Judah Folkman, and shown to be more effective and reduce side effects.

Given the common threads, perhaps the session could have been titled “Understanding and Investing in Our Future” or “Your Teenager Will Someday Run the World” implying the need to better serve this frequently underserved and misunderstood segment of our population: the adolescent.