{"id":10888,"date":"2010-11-17T20:12:47","date_gmt":"2010-11-18T01:12:47","guid":{"rendered":"https:\/\/www.windturbinesyndrome.com\/static\/static\/?p=10888"},"modified":"2012-11-08T17:28:04","modified_gmt":"2012-11-08T22:28:04","slug":"wind-turbine-syndrome-and-the-brain-pierpont","status":"publish","type":"post","link":"https:\/\/www.windturbinesyndrome.com\/static\/2010\/wind-turbine-syndrome-and-the-brain-pierpont\/","title":{"rendered":"“Wind Turbine Syndrome and the Brain” (Pierpont)"},"content":{"rendered":"

\"\" \u00b7 . <\/span>Click here to download this article in PDF (color)<\/a><\/p>\n

\"\" \u00b7 . <\/span>Click here to download this article in PDF (B&W)<\/a>\u00b7
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\u2014Nina Pierpont, MD, PhD (11\/15\/10)<\/p>\n

*The following is the text of Pierpont\u2019s keynote address before the \u201cFirst International Symposium on the Global Wind Industry and Adverse Health Effects: Loss of Social Justice?<\/a>\u201d in Picton, Ontario, Canada, October 30, 2010. It is followed by a discussion of several other relevant talks at the symposium by Drs. Alec Salt, Michael Nissenbaum, Christopher Hanning, and Mr. Richard James.<\/p>\n

Abstract<\/span><\/span><\/p>\n

The latest research, as discussed below, suggests the following mechanism for Wind Turbine Syndrome: air-borne or body-borne low-frequency sound directly stimulates the inner ear, with physiologic responses of both cochlea (hearing organ) and otolith organs (saccule and utricle\u2014organs of balance and motion detection).<\/span><\/p>\n

Research has now proved conclusively that physiologic responses in the cochlea suppress the hearing response to low-frequency sound but still send signals to the brain, signals whose function is, at present, mostly unknown. The physiologic response of the cochlea to turbine noise is also a trigger for tinnitus and the brain-cell-level reorganization that tinnitus represents\u2014reorganization that can have an impact on language processing and the profound learning processes related to language processing.<\/span><\/p>\n

New research also demonstrates that the \u201cmotion-detecting\u201d otolith organs of mammals also respond to air-borne low-frequency sound. Physiologic responses and signals from the otolith organs are known to generate a wide range of brain responses, including dizziness and nausea (seasickness, even without the movement), fear and alerting (startle, wakefulness), and difficulties with visually-based problem-solving.<\/span><\/p>\n

Increased alerting in the presence of wind turbine noise disturbs sleep, even when people do not recall being awakened. A population-level survey in Maine now shows clear disturbances of sleep and mental well-being out to 1400 m (4600 ft) from turbines, with diminishing effects out to 5 km (3 miles).<\/span> \u00b7<\/span>\u00b7<\/span><\/p><\/blockquote>\n

Sensory systems change brain functioning<\/h4>\n

I confess I have an odd medical practice. I\u2019m a pediatrician by training, but I\u2019m fascinated by brains and development, and essentially practice psychiatry and child development. I\u2019m interested in how to help children\u2019s brains grow well, and, at the other end of the spectrum, in what derails normal brain functioning in normal people—like Wind Turbine Syndrome—and how to get that functioning back on track.<\/p>\n

So much of brain function is about the sensory systems—vision, hearing, touch—and what the brain does to take basic sensory signals from all over the body and turn them into a coherent picture of where this particular creature—oneself—is at this particular time, and what needs to happen next to meet its needs. Those needs range from the basic and physiologic—like breathing and pumping blood in the right amounts to the different parts of the body—to complex social and language-based needs, like figuring out what your spouse really meant by that last thing he said. Our sensory systems mediate all of these needs.<\/p>\n

Sensory systems change brain functioning. They affect not only what a person or animal feels or thinks at that very moment, but also how that brain will function in the future, even the near future. This is called neuroplasticity, the neural basis of learning<\/span>, for which Eric Kandel won the Nobel prize in 2000.1<\/sup><\/p>\n

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Tinnitus: The brain makes up sound where no sound exists<\/h4>\n

Take, for example, tinnitus, or ringing in the ears—an important sensory problem in Wind Turbine Syndrome. Ringing, buzzing, sizzling, or waterfall noises—my study subjects described all of these, sometimes in the head as well as the ears.<\/p>\n

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58% of the adults and older teens in my sample of affected families had tinnitus. In the general population, it\u2019s 4%. People with a prior history of hearing loss or industrial noise exposure were especially likely to get tinnitus, but other people in the study also got it, without these risk factors.<\/p>\n

Among people with tinnitus in general, many have damage to their cochlea, the snail-shaped organ of hearing in the inner ear. Because of this damage, many researchers have heretofore thought that tinnitus originates in the cochlea as distorted hearing signals—the cochlea being somehow able to produce nerve signals of sound without the sound being there in the environment.<\/p>\n

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We are now getting quite a different picture of tinnitus. People with auditory nerves (meaning the nerve from the cochlea to the brain) that have been completely cut (for example, because of a tumor on the nerve) also have tinnitus, although, again, there is no input from the cochlea to the brain at all.<\/p>\n

Recently, functional imaging studies (like MRI or PET scans) of people with tinnitus have supported the idea that tinnitus arises not in the ear, but in the parts of the brain that process sound. The trigger is an absence of input from the cochlea or parts of the cochlea. Essentially, your brain makes up sound where no sound exists.<\/span><\/p>\n

It\u2019s like phantom pain that people get when they have lost a limb. There is no nerve input from the limb because it\u2019s gone; nevertheless, the person experiences the limb hurting.<\/p>\n

Tinnitus is like this—it\u2019s phantom noise. It can be an excruciating and unpleasant sensation.<\/p>\n

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This type of change in the brain (like what happens with tinnitus) happens quickly. We learn this from a journal as unimpeachable as the New England Journal of Medicine<\/em>, the gold standard in America for medical research. Describing the pathophysiology of tinnitus, a review article published in 2002 stated:<\/p>\n

Hearing loss leads to a reorganization of the pathways in the central [brain] auditory system. These changes may occur rapidly and lead to abnormal interactions between auditory and other central [brain] pathways.2<\/sup><\/p>\n

What’s happening here is that the cells in the brain are making new connections, not good connections. It\u2019s like chaos in the brain, and the result is hearing a noise that isn\u2019t really there.<\/span><\/p>\n

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Wind Turbine Syndrome & tinnitus<\/h4>\n

Now listen to this story from Wind Turbine Syndrome<\/em>.3<\/sup> A real Canadian family, family A in my study. We\u2019ll call them the Smiths. We’ll call them Frank, Marlene, and their 2\u00bd year old boy, Justin.<\/p>\n

Frank, age 32, is a healthy fisherman who owns his own boat. Turbines, 10 in a row pointing at the house, the closest 1 km away, go online. For the first three weeks, Frank has repetitive popping in his ears, like pressure changes. After three weeks, a continuous headache starts whenever he\u2019s at home. It resolves after several hours every time he leaves the house, and comes back within several hours of coming home. Several weeks after the headache started, tinnitus starts and worsens over the duration of the 5-month exposure, until the family abandoned their home and rented a house in town.<\/p>\n

Marlene, his wife, a 33-year-old accountant, likewise noticed repetitive popping in her ears for the first three weeks. She also noticed she couldn\u2019t hear as well as before. After three weeks, the tinnitus began. The tinnitus continued and worsened over time during the 5 months of exposure, varying according to how much she was at home and how loud the turbines were. After the exposure ended, she told me, the tinnitus resolved, but she noticed a new difficulty understanding conversation in a noisy room. She noticed she had to watch the speaker\u2019s face more closely.<\/span><\/p>\n

During exposure, young Justin, a healthy 2\u00bd-year-old, pulled on his ears and got cranky at the same times that adults in the family noticed more headache and tinnitus. His language development was good before, during, and after exposure, but his mother noticed during exposure that the child began to confuse T with K sounds and W with L sounds, which he had not done before.<\/span> This sound confusion was ongoing six weeks after exposure ended, when I interviewed the parents.<\/p>\n

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Let\u2019s match the research to the clinical account—match medical science to this real family. These two adults experienced pressure changes in their ears for some weeks, one with some loss of hearing. They then developed tinnitus. The tinnitus resolved when the noise exposure ended, but Marlene still noticed subtle differences in her own auditory processing and in her child\u2019s, Justin\u2019s<\/span>.<\/p>\n

Picking out one voice against background noise is an example of brain (or central) auditory processing, which means how your brain takes signals coming from your ears and puts them together into language, music, the song of a hermit thrush, or other recognizable and meaningful sounds.<\/p>\n

To pick out one sound from background noise, your brain processes simultaneous signals from both ears, integrating the signals into a new type of perception that transcends what either ear can do alone. (It\u2019s sort of like depth perception with two eyes.)<\/p>\n

Hearing in background noise is one aspect of brain auditory processing, and one that audiologists often test. Distinguishing language sounds is another critical part of how the brain processes sound, especially for children learning language.<\/p>\n

So, what do we have? We have the New England Journal<\/em> telling us that auditory pathways in the brain reorganize rapidly when there are deficits in the input from the ears, producing tinnitus. (Let\u2019s not ignore that this \u201creorganization\u201d represents deterioration in function—not an improvement. Contrast this to the process of brain organization that occurs as a child learns language<\/span>.) We have this research on the one hand, and on the other, younger healthy adults telling us their observations of their own hearing and hearing-related processes as they passed through a substantial bout of noise exposure.<\/p>\n

Marlene described the noise, by the way, as, “Not noisy like a chainsaw; more like pulsating annoyance. To another person it wouldn\u2019t sound loud.”<\/p>\n

I suspect that in a child as young as Justin, 2\u00bd, who was removed from exposure so quickly, this process is entirely reversible. But such effects are less likely to be reversible with older age or longer exposure. That\u2019s a basic principle of how brains develop.<\/p>\n

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Noise exposure, even at relatively low sound levels, fouls up the parts of the brain responsible for figuring out language sounds, and the parts responsible for understanding and learning and remembering things we hear or read<\/h4>\n

I\u2019m basing this interpretation of the Smith\u2019s experience on the tinnitus research and also on another area of research—on the effects of other types of environmental noise (like airport or traffic noise) on children’s learning.<\/p>\n

Learning to read is a language-intensive process that is especially sensitive to the effects of noise in school or at home. This effect is distinct from the effects of noise on attention or working memory,4<\/sup> and is correlated with measures of sound processing such as speech recognition.5<\/sup><\/p>\n

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In one study, for example, a German city closed an old airport and built a new one. Researchers had the opportunity to follow the reading skills of both sets of children over time. Those living near the airport that closed showed improvement in their reading. The ones near the new airport slowed down in their learning after the airport opened.6<\/sup><\/p>\n

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Another study looked at the effects of noise on both reading and auditory processing in children who lived in an apartment building next to a busy highway. Auditory processing, again, is what your brain does with the signals from your ears to turn them into meaningful language or other sounds.<\/p>\n

The higher the children lived in the building, the quieter were their apartments and the better their reading and auditory discrimination scores, which means, for example, distinguishing the word goat<\/em> from boat<\/em>. The study factored out the effects of parent education and income, and then found that children exposed to more noise were more delayed in their reading. The amount of delay in reading was explained by how badly the children were doing distinguishing language sounds from each other, which also worsened with more noise.7<\/sup><\/p>\n

In other words, the presence of noise in the environment degraded how these children\u2019s brains processed language sounds, which in turn degraded their ability to learn to read. It wasn\u2019t that the noise just kept them from hearing things they needed to learn; the noise actually harmed their brain\u2019s ability to process language, even when that language was coming in through their eyes, as it does when we read.<\/span><\/p>\n

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Moreover, these effects of noise on reading occur at sound levels far less than those needed to produce hearing damage.<\/span>8<\/sup> Children at higher grade levels are more affected, and longer exposure produces larger deficits, other studies have shown.9<\/sup><\/p>\n

In my wind turbine study, 7 out of the 10 school-age children and teens did worse in school during exposure to turbines, compared to before or after, including unexpected problems in reading, math, concentration, and test performance, noticed by both teachers and parents. Teachers sent notes home asking what was wrong with the children.<\/p>\n

Subtle as these effects are, they have serious implications. Noise exposure, even at relatively low sound levels, fouls up the parts of the brain responsible for figuring out language sounds (what we call language processing) and the parts responsible for understanding and learning and remembering things we hear or read (what we call language-based learning). <\/span><\/p>\n

Let me emphasize: Noise exposure, even at low levels that don\u2019t damage hearing, can do this.<\/p>\n

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The Balance Organs: A protean<\/a> presence in the brain, in terms of what types of sensations they draw on and how the information is used by the brain<\/h4>\n

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There is another set of organs in the inner ear, the organs of balance (called the vestibular organs), consisting of the utricle and saccule (the two otolith or \u201cear rock\u201d organs, where microscopic stones control our perception of gravity and movement in a straight line) and the semicircular canals, which detect rotations of the head in three planes.<\/p>\n

The balance system is probably the least well known of all the senses for both the general public and physicians. It\u2019s a different kind of sense. It has some dedicated organs (the vestibular organs in the inner ear, just described), but these organs do not function on their own, not without the cooperation (and brain integration) of multiple sensory signals from all over the body.<\/p>\n

We use this sense not just for balance (staying upright), but also for telling where we are in space and how fast and in what direction the different parts of our bodies are moving, at all times.<\/p>\n

The vestibular sense feeds back instantaneously, for example, on the eye movement muscles and on posture-maintaining muscles in the neck and back. It also adapts to gravity by controlling tension in the arteries and smaller blood vessels all over the body, and how hard the heart is pumping, to keep the blood evenly distributed whether you are standing up, lying down, or standing on your head.<\/p>\n

Balance and motion detection requires input from the eyes, from stretch receptors in the muscles and joints all over the body, from touch receptors in the skin, and, it is now known, from stretch and pressure receptors in and around internal organs and the great blood vessels in the chest and abdomen.10<\/sup> As well as requiring signals from the inner ear—the utricle, saccule, and semicircular canals.<\/p>\n

This is a remarkable feat of brain integration, especially when the signals don\u2019t all agree with one another. The brain has to figure out which signals to downweight or ignore if they don\u2019t all agree, or if the signals from one channel are distorted.<\/p>\n

Even fish have otolith organs and semicircular canals. The cochlea, or specialized hearing organ, evolved later, our type specifically in mammals. The brain essentially grew up, through evolution, with vestibular neurons and signals already in place. As a consequence, our systems for detecting movement, gravity, pressure, and vibration have a protean presence in the brain, going everywhere, both in terms of what types of sensations they draw on, and how the information is used by the brain.<\/span><\/p>\n

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In fish and amphibians, the otolith organs are much better detectors of low-frequency noise and vibration than are these animals\u2019 own versions of sound-detecting organs<\/span>.11,12 <\/sup>We now know that even in mice\u2014a mammal\u2014low-frequency, air-borne sound is detected by the otolith organs<\/a><\/span>.13<\/sup> In humans, detection of low frequency sound by the otolith organs has been shown only using bone-conducted sound, meaning a source of vibration placed right against the head.<\/p>\n

At 100 Hz, the tone of a moderately low note on the piano, healthy adults can detect a bone-conducted vibration at 15 dB below<\/span> their own normal hearing thresholds, probably through the utricle.14,15 <\/sup>\u201cDetection\u201d in this case means that the vibration triggers an automatic reflex in muscles around the eyes or in the neck, a response that can only be due, we know, to vestibular stimulation.<\/p>\n

All this by way of saying that we are getting nearer to understanding the pathophysiological mechanisms causing Wind Turbine Syndrome.<\/p>\n

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Wind Turbine Syndrome resembles inner ear pathology witnessed by otolaryngologists<\/h4>\n

The symptoms of Wind Turbine Syndrome directly mirror the symptom clusters that practicing otolaryngologists have seen for years in patients with balance problems due to vestibular inner ear pathology.16,17 <\/sup>With vestibular pathology, however, the symptoms are not known to come and go with noise exposure. Very importantly, the symptoms associated with vestibular pathology are not just about balance or dizziness, as I\u2019ll review in a moment. Indeed, the symptoms clinically reveal the linkages between the balance-processing parts of the brain, and cognition and memory—linkages only now being described through experiments and functional brain imaging.<\/span><\/p>\n

Over 90% of my sample of affected people, both adults and children, had cognitive difficulties during wind turbine exposure—problems that lingered and resolved slowly after exposure ended. These included difficulties with reading, math, spelling, writing, multitasking in kitchen and home, remembering a series of errands, maintaining a train of thought in a telephone conversation, following the plot of a TV show, following recipes, and following directions to put together furniture.<\/p>\n

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Balance-disordered patients in clinical practice also struggle with short-term memory, concentration, multitasking, arithmetic, and reading. Patients with inner ear fluid leakages, for example, present with symptoms of dizziness, headache, stiff neck, and disturbed sleep, accompanied by marked mental performance deficits compared to baseline.18<\/sup><\/p>\n

This kind of inner ear leakage can be set off by whiplash injuries, mild head trauma, or pressure trauma to the ear. The fluid leak is associated with an imbalance of fluid pressures in the inner ear, known as endolymphatic hydrops, which distorts both balance and hearing. (M\u00e9ni\u00e8re\u2019s disease, in which balance and hearing disturbances fluctuate, is endolymphatic hydrops that comes and goes for unknown reasons.)<\/p>\n

Tellingly, Dr. Alec Salt, who will speak next on infrasound effects on the inner ear, has discovered experimentally that infrasound exposure causes temporary endolymphatic hydrops.19<\/sup> This is a possible mechanism for the balance disturbances, tinnitus, headache, and cognitive problems of Wind Turbine Syndrome.<\/p>\n

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The balance system is closely linked to emotions, especially fear, anxiety, and panic<\/h4>\n

So far, I have talked about how the absence or distortion of hearing signals<\/em> from the inner ear affects thinking and learning at the brain level, and how distortion of balance signals<\/em> from the inner ear affects thinking, memory, and concentration at the brain level. There is one more subject in this cluster of sensory\/brain-function linkages, which I would like to discuss.<\/p>\n

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The balance system is closely linked to emotions, especially fear, anxiety, and panic.<\/span> When my foot slides on ice under some new snow and I fling my arms out to regain balance, I have a moment of panic. My husband has fear of heights for reasons directly attributable to his brain\u2019s style of balance signal integration. I don\u2019t, and love to sit on the edge of cliffs over the ocean, watching seabirds.<\/p>\n

When he sees me doing this, or if he gets near the edge himself or goes to the top of a tall building, he feels dizzy and nauseated (which are direct balance problem symptoms) and also panicked and irrational—afraid that he or I might fall or even jump off.<\/p>\n

(I didn\u2019t have a full sense of this until recently, he\u2019s so controlled and calm, but now I understand why he doesn\u2019t want to take me back to Newfoundland—where there are huge, wonderful seabird cliffs\u2026)<\/p>\n

In some studies of balance-anxiety linkages, up to 80% of people with panic disorder have measurable disorders of balance processing. The places where people panic are those in which they \u201close their bearings,\u201d so to speak, due to distortion of balance signals and their own brains\u2019 particular style of dealing with distorted balance signals. Grocery stores have been always a big culprit.<\/p>\n

In my wind turbine study, 2\/3 of the adult subjects (14 out of 21) experienced a highly disturbing collection of symptoms when exposed to high levels of turbine noise. They felt movement inside their chests, described as quivering, jitteriness, or pulsation, and then an uncomfortable urge to flee—to get out of there. Or, if the feeling awoke them at night, panic, with racing heart, a feeling they could not breathe, or the sense that there just had been an alarming noise—like a window breaking—and that they had to get up to check the house.<\/p>\n

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Wind Turbine Syndrome panic symptoms linked to previous history of motion sensitivity<\/h4>\n

None of these people had had panic attacks in their lives before. Several had histories of anxiety or depression, but altogether, among all the adults in the study, a previous mental health problem was not significantly associated with the presence of this panic symptom. What was associated with the panic symptom, with a highly significant statistical relationship, was a previous history of motion sensitivity.<\/span><\/p>\n

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Even a tough cowboy from Missouri, a welder who raises horses, had this symptom awakening him at night near turbines. Once he and his family moved into town, he slept like a baby. No more panic awakening. (It was his wife who had to tell me about it, however.) Even the physician in my study had this symptom. Toddlers and preschool children in my study had a similar symptom—awakening in the night in states of high alarm and unable to go back to bed or to sleep.<\/p>\n

In short, noise impinging on the ear is not just about hearing, we are learning, but also about how the brain organizes itself around sound.<\/span><\/p>\n

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Summary<\/h4>\n