Health
Florida brain tumor patient plays guitar during his surgery: ‘This is wild’
The idea of having brain surgery while awake might seem amazing enough — but one Florida man took it a step further and played the guitar while doctors removed his tumor.
The neurological team from the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine wanted the patient, Christian Nolen, to play notes on the instrument so they could evaluate and protect his manual dexterity while being as aggressive as possible in removing the tumor.
The surgeon and patient both spoke with Fox News Digital about the experience.
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Nolen, who is an avid guitar player, had a tumor on the right frontal lobe of his brain that was starting to cause symptoms.
“Christian was having issues with the left side of his body, particularly his left hand,” Ricardo Komotar, M.D., director of the brain tumor program at Sylvester, told Fox News Digital via Zoom.
“He was noticing issues with his dexterity that affected his ability to play the guitar.”
The neurological team from the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine asked Christian Nolen to play guitar during his surgery so that they could evaluate and protect his manual dexterity. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
Nolen needed surgery to confirm the diagnosis and determine the type of tumor — as every tumor has different treatment options, Komotar noted — and also to remove as much of it as possible.
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The surgery was scheduled for 10 days after the tumor was discovered — and Nolen was surprised when the doctors asked if he’d be willing to remain awake and play the guitar for the procedure.
“When a tumor is involving or near a critical part of the brain — something that controls the ability to speak or understand language or move — we want to do the surgery awake to continually monitor the patient, so you know if you start to violate normal brain functions,” Komotar said.
Dr. Ricardo Komotar of Sylvester Comprehensive Cancer Center is director of the brain tumor program at the University of Miami Miller School of Medicine. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
When the patient is asleep, the doctor said, the surgery team doesn’t have the ability to get feedback.
“The surgeries actually become much more dangerous because you can take out a tumor that involves normal brain function and cause real harm without knowing it,” he said.
Given the importance of guitar-playing in Nolen’s quality of life, Komotar said there was “no better way” to monitor his manual dexterity and the effect of the tumor than to have him take up the instrument in the operating room.
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When the doctors posed the option to Nolen, he said that at first it “didn’t seem real.”
“I’d only really heard of procedures of that nature being done in shows and movies,” he told Fox News Digital in an email. “I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
He added, “The risk of being sedated for the entire procedure outweighed any fear or anxieties around the procedure itself.”
Given the importance of guitar-playing in Nolen’s quality of life, his surgeon said there was “no better way” to monitor his manual dexterity and the effect of the tumor than to have him take up the instrument in the operating room. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
Prior to the procedure, Nolen said he was introduced to members of the surgical team and was told in-depth about what to expect.
The anesthesiology team put Nolen to sleep for the beginning of the open craniotomy, but he was awakened during a delicate part of the two-hour procedure. Once he was oriented on what was happening, the care team gave Nolen a guitar and asked him to play.
“Upon awakening, it was quite overwhelming to see everything around me and to fight the natural reaction to sit up,” Nolen recalled.
“I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
After one of the members of the care team placed a “reassuring hand” to prevent Nolen from sitting up, he said it took only a second for him to remember what was happening.
“I just had to breathe and stay calm,” he said.
During surgery, he tried his best to play through some of the songs he had been practicing, including tunes by artists like the Deftones and System of a Down.
Nolen had a tumor on the right frontal lobe of his brain that was starting to cause symptoms. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
As the surgeons removed the tumor, they continuously monitored Nolen’s hand function while he played the guitar.
“As we were finishing the case at the very back of the tumor, we noticed that his hand function started to decline,” said Komotar. “The tumor was touching and interfacing with the part of the brain that controls hand movement. Fortunately, we were able to remove the entire tumor and not injure his hand.”
“This is wild,” Nolen said during the surgery.
What to know about awake procedures
While a patient playing guitar during surgery is not an everyday occurrence, Komotar told Fox News Digital that he and the rest of the specialized neurosurgical team perform awake surgeries several times a week, for a total of a couple of hundred times a year.
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“Most patients are intrigued by the process,” he said. “We tell them that they’re going to be able to speak and move their hands or limbs so we can constantly examine them.”
The doctors also reassure the patients that they won’t feel any pain, likely won’t remember the entire procedure, and will remain very comfortable — “which is the result of our world-class neuroanesthesia team,” added Komotar.
Research has proven the benefits of doing procedures with awake anesthesia instead of deep general anesthesia, the doctor noted.
Prior to the procedure, Nolen was introduced to members of the surgical team and was told in-depth about what to expect. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits,” he said.
There are also improvements in discharge and recovery.
“The less anesthesia you use during your procedure, the better the patient wakes up,” he said. “The faster they wake up, the sooner they are up and walking around, and the sooner they go home.”
Komotar added, “And inherently, the longer you’re in the hospital, the more complications you have.”
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits.”
Guitar-playing isn’t the only activity that patients can do during an awake craniotomy.
Anything that doesn’t increase pressure in the head, such as playing the violin, is fair game, Komotar said.
Some patients sing during brain surgery, which allows the surgeon to monitor their ability to form and understand words as they remove tumors in areas that involve language.
Before awake surgeries, the doctors reassure patients that they won’t feel any pain, likely won’t remember the entire procedure, and will remain very comfortable. Nolen is shown at left; Dr. Ricardo Komotar is at right. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
There are some risks involved with awake cranial surgery, Komotar acknowledged.
“Seizures can definitely be worsened by doing awake surgery,” he told Fox News Digital. “If someone has a history of seizures, we try to avoid electric brain stimulation, which is part of the technique.”
The biggest risk of doing awake brain tumor removal is that about 5% to 10% of patients don’t “tolerate” being awakened, Komotar said.
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“Even with world-class anesthesia, they might wake up either too startled or too in pain to be examined,” he said. “They might be confused, agitated or unable to follow commands.”
If that happens, the care team puts the patient back to sleep and proceeds with a more conservative tumor removal.
“He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
Without having continuous feedback from the patient, the surgical team can’t be as aggressive with the tumor removal, Komotar noted. “We only take out what we know is definitely safe, and we leave anything that’s questionable.”
The road to recovery
Nolen’s surgery went smoothly and the entire tumor was removed.
“Christian did terrific,” Komotar said. “He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” the patient said. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
The first couple of weeks after surgery were a little tough for Nolen, the patient said, mainly due to post-surgery restrictions.
“The days were really dragging,” Nolen told Fox News Digital. “However, with a strong support system, I’ve been able to focus on the positives.”
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He is now back to working out at the gym and playing the guitar, with significant improvement in his left hand.
“A case like this spotlights the value of multidisciplinary care.”
He’s awaiting the final pathology results, with follow-up treatment likely consisting of six weeks of radiation and chemotherapy.
Both Komotar and Nolen emphasized that the success of the surgery hinged on the collaboration of the entire care team.
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” said Nolen. “They have also provided me with quite a few programs for emotional support.”
“A case like this spotlights the value of multidisciplinary care,” added Komotar.
“It’s not possible to remove a tumor like this and get the patient home so quickly and in such good health without an entire comprehensive team — neuro anesthesiologists, great intensive care specialists, nurses, techs, great oncologists — all working together.”
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Health
Alzheimer’s prevention breakthrough found in decades-old seizure drug
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A drug that has long been used to treat seizures has shown promise as a potential means of Alzheimer’s prevention, a new study suggests.
The anti-seizure medication, levetiracetam, was first approved by the FDA in November 1999 under the brand name Keppra as a therapy for partial-onset seizures in adults. The approval has since expanded to include children and other types of seizures.
Northwestern University researchers recently found that levetiracetam prevented the formation of toxic amyloid beta peptides, which are small protein fragments in the brain that are commonly seen in Alzheimer’s patients.
The medication was found to prevent the formation of amyloid-beta 42 in both animal models and cultured human neurons, according to the study findings, which were published in Science Translational Medicine.
The effect was also seen in post-mortem human brain tissue obtained from individuals with Down syndrome, who are at high risk for Alzheimer’s disease.
The medication was found to prevent the formation of amyloid-beta 42 in both animal models and cultured human neurons. (iStock)
“While many of the Alzheimer’s drugs currently on the market, such as lecanemab and donanemab, are approved to clear existing amyloid plaques, we’ve identified this mechanism that prevents the production of the amyloid‑beta 42 peptides and amyloid plaques,” said corresponding author Jeffrey Savas, associate professor of behavioral neurology at Northwestern University Feinberg School of Medicine, in a press release.
“Our new results uncovered new biology while also opening doors for new drug targets.”
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The brain is better able to avoid the pathway that produces toxic amyloid‑beta 42 proteins in younger years, but the aging process gradually weakens that ability, Savas noted.
“This is not a statement of disease; this is just a part of aging. But in brains developing Alzheimer’s, too many neurons go astray, and that’s when you get amyloid-beta 42 production,” he said.
The effect was also seen in post-mortem human brain tissue obtained from individuals with Down syndrome, who are at high risk for Alzheimer’s disease. (iStock)
That then leads to tau (“tangles”) — abnormal clumps of protein inside brain neurons — which can kill brain cells, trigger neuroinflammation and lead to dementia.
In order for levetiracetam to function as an Alzheimer’s blocker, high-risk patients would have to start taking it “very, very early,” Savas said — up to 20 years before elevated amyloid-beta 42 levels would be detected.
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“You couldn’t take this when you already have dementia, because the brain has already undergone a number of irreversible changes and a lot of cell death,” the researcher noted.
The researchers also did a deep dive into previous human clinical data to determine whether Alzheimer’s patients who were taking the anti-seizure drug had slower cognitive decline. They reported that the patients in that category had a “significant delay” in the span from cognitive decline to death compared to those not taking the drug.
“This analysis supports the positive effect of levetiracetam to slow the progression of Alzheimer’s pathology,” the researcher said. (iStock)
“Although the magnitude of change was small (on the scale of a few years), this analysis supports the positive effect of levetiracetam to slow the progression of Alzheimer’s pathology,” Savas said.
Looking ahead, the research team aims to find people who have genetic forms of Alzheimer’s to participate in testing, Savas said.
Limitations and caveats
The study had several limitations, including that it relied on animal models and cultured cells, with no human trials conducted.
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Because the study was observational in nature, it can’t prove that the medication caused the prevention of the toxic brain proteins, the researchers acknowledged.
Savas noted that levetiracetam “is not perfect,” cautioning that it breaks down in the body very quickly.
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The team is currently working to create a “better version” that would last longer in the body and “better target the mechanism that prevents the production of the plaques.”
“You couldn’t take this when you already have dementia, because the brain has already undergone a number of irreversible changes and a lot of cell death.”
The medication’s common documented side effects include drowsiness, weakness, dizziness, irritability, headache, loss of appetite and nasal congestion.
It has also been linked to potential mood and behavior changes, including anxiety, depression, agitation and aggression, according to the prescribing information. In rare cases, it could lead to severe allergic reactions, skin reactions, blood disorders and suicidal ideation.
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Funding for the study was provided by the National Institutes of Health and the Cure Alzheimer’s Fund.
Fox News Digital reached out to the drug manufacturer and the researchers for comment.
Health
Seniors over 80 who eat specific diet may be less likely to reach 100 years old
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Older adults who avoid meat in their golden years may be less likely to reach age 100 than their meat-eating counterparts, new research suggests.
Researchers tracked more than 5,000 adults aged 80 or older who were enrolled in the Chinese Longitudinal Healthy Longevity Survey.
Between 1998 and 2018, data showed that those who did not eat meat were less likely to reach their 100th birthday than those who consumed animal products regularly.
The findings seem to contradict previous studies that have linked vegetarianism and plant-based diets to lower risks of heart disease, stroke, diabetes and obesity.
Most evidence supporting the benefits of plant-based diets comes from studies tracking younger populations, the researchers noted.
The findings contrast with previous research praising plant-based diets for their positive influence on heart health. (iStock)
The study, published in The American Journal of Clinical Nutrition, points to losses in muscle mass and bone density with age, shifts that can increase the risk of malnutrition and frailty in the “oldest old.”
As people enter their 80s and 90s, the nutritional priority often shifts from preventing long-term chronic diseases to maintaining day-to-day physical function, experts say.
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“The headline ‘vegetarians over 80 less likely to reach 100’ sounds surprising, because it contrasts with decades of data linking plant‑forward diets to lower chronic disease risk earlier in life,” Erin Palinski-Wade, a New Jersey-based registered dietitian, told Fox News Digital.
“However, once you see that this research is limited to adults over the age of 80 who are also underweight — and that this link disappears with the consumption of eggs, dairy and fish — the results are less surprising.”
While diets earlier in life tend to emphasize avoiding long-term disease, older age necessitates nutrients and weight maintenance, experts say. (iStock)
In those over 80, restricting animal proteins may be less likely to promote longevity, according to Palinski-Wade, who was not involved in the study.
Eliminating all animal protein — particularly in a population that may already experience diminished hunger cues — can make it more difficult to meet adequate protein needs, potentially increasing the risk of nutrient deficiencies, the nutritionist said.
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In addition to a higher tendency to be underweight, older populations also face a greater risk of bone fractures due to lower calcium and protein intake.
Potential limitations
The lower rate of vegetarians reaching 100 was only observed in participants identified as underweight, the researchers noted. No such association was found in people who maintained a healthy weight.
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Because being underweight is already linked to greater frailty and mortality risk, the researchers noted that body weight may partly explain the findings, making it difficult to determine whether diet itself played a direct role.
Those incorporating animal-sourced products other than meat were just as likely to live to 100. (iStock)
Additionally, the shortened lifespans were not found in people who continued to eat non-meat animal products, such as fish, dairy and eggs.
Older adults with these more flexible diets were just as likely to live to 100 as those eating meat, as these foods may provide the nutrients necessary for maintaining muscle and bone health, the researchers noted.
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“This is an observational study, so it can only show associations, and does not prove that avoiding meat directly reduces the odds of reaching 100,” Palinski-Wade added.
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The researchers suggested that including small amounts of animal-sourced foods could help older seniors maintain essential nutrients and avoid the muscle loss often seen in those who stick strictly to plants.
Eliminating all animal protein — particularly in a population that may already experience diminished hunger cues — can make it more difficult to meet adequate protein needs, potentially increasing the risk of nutrient deficiencies. (iStock)
Palinski-Wade offered some guidance for those looking to optimize nutrition later in life.
“For adults in their 80s and beyond, especially anyone losing weight or muscle, the priority should be maintaining a healthy weight and meeting protein and micronutrient needs — even if that means adding or increasing fish, eggs, dairy or well‑planned, fortified plant proteins and supplements.”
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Strict vegan or very low‑protein patterns at that age should be carefully monitored by a dietitian or clinician, with attention to B12, vitamin D, calcium and total protein, according to Palinski-Wade.
“Younger and healthier adults can still confidently use plant‑forward or vegetarian patterns to lower long‑term chronic disease risk,” she added.
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