Adolfo Cotter,MD

Brain-Mind Interface

Dr. Cotter practices Telemedicine in Primary Care. Conducts a competent, highly responsive Telemedicine practice since 2012, treating a variety of medical conditions from simple to very complex. Proficient with electronic medical records using a wide range of software packages and other forms of computing. Dr. Cotter also practiced Medicine doing Home Care, Urgent Care and Hospital Work.

Dr. Cotter has medical licenses in the states of Michigan, Indiana, and telehealth registration in the states of Minnesota and Florida. The links to the states medical boards are: Florida, http://www.flhealthsource.gov/telehealth/ Minnesota, https://mn.gov/boards/medical-practice/ Indiana, https://mylicense.in.gov/everification/ Michigan, https://www.michigan.gov/lara/0,4601,7-154-89334_72600_85566—,00.html

Dr. Adolfo Cotter founded Cognimetrix in 2007, motivated by a tremendous personal interest in the use of brain imaging data in the development of bionic based software to enhance creativity and intelligence.

Throughout his career, Dr. Cotter has performed brain imaging research in academic institutions such as Unversity of Toronto, University of Pennsylvania, and Emory University. He has also conducted brain imaging research for commercial companies such as at Cerebral Diagnostics.

Dr. Cotter has given lectures in Brain Imaging and attended numerous Brain Imaging meetings where he has presented his research projects. He has experience in brain imaging data acquisition and analysis for technologies such as PET, SPECT, MRI, fMRI and EEG. During his brain imaging analysis work, he has done biostatistics using a variety of software programs.

  • Telemedicine

    The development of technology is not only helping medical imaging to evolve faster but also has an important impact on other aspects of patient care. There has been an ongoing problem of assisting patients in underserved areas. Not many physicians like to relocate to rural areas and the demand in those geographical locations continues to… Continue reading

  • Susceptibility Tensor Imaging (STI)

    STI is a new MRI”technology in development. It consists on creating images and  contrast based on the susceptibility of the tissue to the magnetic field. This susceptibility seems to be based to the anisotropic alignment of the molecules. The tissue ismore susceptible when the angle to the magnetic field is smaller. A recent study in… Continue reading

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  • Too Good to be True

    You hear it often: that’s too good to be true. A long list of hucksters and criminals have used the method of offering exceptionally good opportunities in order to steal people’s money in the past, and so our society does not believe in fantastic opportunities anymore. This is very sad and dangerous for true and… Continue reading

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  • Neurology and Legal Medicine

    I find this combination of specialties fascinating. In my opinion, Neurology has been, and still is in large part a diagnostic specialty, whereas the main goal of medicine is to resolve patients clinical problems. Hopefully with more R&D, neurological treatment will become more useful. Unfortunately, up until now where the practice of Neurology has been… Continue reading

  • Transcranial Doppler (TCD)

    TCD  is the only non-invasive real-time neuroimaging study that can evaluate the characteristics of cerebral blood flow continuously. CT Angiography (CTA ) and Magnetic Resonance Angiography (MRA ) can do snapshots in time. Fluoroscopic angiography is the gold standard and can be used as a confirmatory tool. Some of the applications of TCD are: stroke, vasomotor reactivity… Continue reading

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  • Magnetic Resonance Force Microscopy (MRFM)

    Very impressive advancements have been made in this field. The goal is ultimately to visualize matter at the molecular and atomic level. This of course will resolve and hopefully prove many of the questions and mysteries of atomic physics. Ultrahigh resolution 3D images are currently available and they promise to continue to improve. The key… Continue reading

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  • Diffusion MRI Tractography as a diagnostic tool for Brain Pathology

    Diffusion MRI tractography can be used to evaluate for brain pathology by measuring for pathlength, for example. The pathlength constitutes neuronal brain connectivity between two specified brain locations. An abnormal pathlength could be increased or decreased. A significant change in pathlength should point to a specific brain pathology depending on the location of the path.… Continue reading

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  • NY Times article

    Last month, a major step forward was taken towards bringing the science of brain imaging into mainstream clinical practice. It appears imminent that the FDA will approve the use of PET  scans for amyloid plaques as a diagnostic test for Alzheimer’s disease. In my opinion this is a great first step. Next we should look… Continue reading

  • Diffraction Enhanced Imaging (DEI)

    This is a relatively new imaging technology that uses three “physical mechanisms” to generate contrast. Those mechanisms are: 1) X-Ray absorption, 2) Refraction, 3) Ultra small angle scatter rejection. This technology can produce high contrast images with much lower radiation dose compared to conventional radiography. One of the applications this technique might be useful for… Continue reading

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  • Track Density Imaging (TDI)

    When using MRI, in order to increase spatial resolution we need a longer acquisition time. We also need the same to increase signal to noise ratio (SNR). High tesla MRI, although it increases SNR, it has a problem with deep penetration called the skin effect. Deep structures might be difficult to visualize. A new post-processing… Continue reading

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  • Magnetic Resonance Elastography

    The elastic properties of human tissues have been evaluated in a clinical setting by palpation. Although this procedure has often helped clinical diagnosis, it is a subjective procedure and cannot be quantified. More recently a quantifiable technique has been developed using imaging technologies such as  MRI, Ultrasound, Optical Imaging and so forth, whereby the degree… Continue reading

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  • Imaging Genetics

    Imaging genetics has been focused so far in imaging the phenotype. Most of the research done has been related to human behavior.  The phenotype constitutes the biological basis of the clinical manifestation of the specific gene. For example, we could image brain circuitry by using MRI in order to understand the biological basis of schizophrenia… Continue reading

  • Mapping the Mind

    As I mentioned on previous blog entries, I believe the brain and the mind overlap to some degree but also there should be a free brain area without mind and a free mind area without brain. Because our medications act on the brain but not on the mind itself, our knowledge of this interface is… Continue reading

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  • Measures of Cortical Brain Thickness

    Anatomical MRI measures of cortical brain thickness have been recently evaluated. In normal aging there is a decrease in cortical thickness, which presents an anterior-posterior gradient, being more prominent in Frontal and Parietal than in Temporal and Occipital lobes. There are regional differences between both sexes. In Alzheimer’s disease the reduction in cortical thickness is… Continue reading

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  • Nanoantibodies

    Nanoantibodies also known as nanobodies, have advantage over full size antibodies that they are more stable, aggregate less, and they can penetrate very small locations. There are currently attempts to make them cross the blood brain barrier ( BBB ). An idea that I suggest is to bind a nanobody to a nanoparticle, so the… Continue reading

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  • Longevity and Genomics

    Methylation/demethylation of DNA  and/or histones, acethylation/deacethylation of histones and shortening of telomeres appear to be some of the epigenetic factors controlling gene expression over time. The epigenetic control mechanism is affected by the environment and seems to become progressively relaxed or disrupted as we age. Because of this disruption illnesses of aging can appear, including… Continue reading

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  • Selective Plane Illumination Microscopy

    This new technique has the advantage of visualizing in vivo tissues, in real time and at very high resolution. It can visualize cellular events that have fluorescence. It is technically very similar to fluorescence microscopy, but the beam of light comes from the side, thereby generating a selective plane illumination that is captured by a… Continue reading

  • Nanoparticles (NPs)

    Nanotechnology has made possible the production of Nanoparticles. NPs can be made of different materials such as ceramics, carbon and various metals. It also can take different shapes. They can be used in imaging and also to transport drugs. They can be widely used in imaging but in the case of Brain Imaging, its main… Continue reading

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  • Multispectral Optoacustic Tomography (MSOT)

    MSOT uses the photoacoustic principle I explained in a previous blog entry. With this technique one is able to visualize in vivo cellular events with high sensitivity, at a resolution of 100 micrometers. It has a big advantage of being able to visualize physiology and anatomy at the same time without combining two different technologies. It is also… Continue reading

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  • Microscopic Diffusion Tensor Imaging

    Resolution is always a limitation when detailed analysis of the brain anatomy is needed. A partial solution for this problem is the use of Microscopic Diffusion Tensor Imaging. Diffusion Tensor Imaging (DTI) is an MRI technique that displays the white matter tracts by using the diffusion of water as a technique. The applicability of this… Continue reading

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  • Neurogenomics and Human Cognition

    Our cognitive abilities are partially explained by our genes; The rest is explained by the environment. Because the interaction between genes and environment is complex, scientists have, so far, been able to identify only about 5% of the genes responsible for our cognition. Our genes can affect how much the environment is going to influence… Continue reading

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  • Near-Infrared Spectroscopy (NIRS)

    This technique consists of a light emitting diode and two distant sensors attached to the fronto-parietal side of the skull. The concentration of oxygen is calculated by the differential signal between these two sensors. NIRS is used in neonates for the evaluation of the concentration of oxygen and hemoglobin. In consequence it can evaluate the… Continue reading

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  • Do Brain Fitness games really work?

    A recent paper on Nature by Owen A, e tal titled- “Putting Brain Training to the test” actually says that Brain Fitness with computer games seem not to work. The article says that brain training can improve the respective cognitive ability but it will not generalize. I do not see any problem with this last… Continue reading

  • Imaging Apoptosis in the Human Brain

    Imaging neuronal cell death is an emerging field in neuroimaging. It can have many implications. In Alzheimer’s disease we will be able to evaluate if there is cell death, and the actual amount of it happening. In Stroke we will be able to evaluate the penumb zone and the response to treatment. In Cancer we… Continue reading

  • Imaging Neuroinflammation

    The benzodiazepine receptor on the mitochondria of activated microglia constitutes a biomarker for neuroinflammation. The  PET radiotracer C11-PK11195 binds to this receptor, making the use of brain images a key diagnostic tool in disease states characterized by neuroinflammation. Alzheimer’s disease (AD) and Multiple Sclerosis (MS) are two such conditions. There has been a debate if… Continue reading

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  • Fluorescence Molecular Tomography with Computed Tomography (FMT-CT)

    FMT-CT is a new method of fluorescence imaging. It allows image quantification in vivo. Fluorescence imaging has an advantage over PET that it allows non-ionizing radiation to be used, does not need a cyclotron, and it allows the simultaneous comparison of multiple biomarkers. The problem with FMT alone is that there is difficulty with anatomical… Continue reading

  • Imaging the Blood-Brain Barrier (BBB)

    Relatively hydrophilic and/or big molecules have difficulty in crossing the  BBB. This hurdle has kept many promising drug treatments on the sidelines because they cannot reach their target. The same applies for certain radiotracers in brain imaging. In order to overcome this problem Nanoparticles (NP) that target specific transport mechanisms in the  BBB are in… Continue reading

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  • Neuroimaging is useful to assess Neural Stem Cell Implantation

    MRI can characterize neural stem cell implantation by assessing the migration, proliferation and location. This can be achieved by labeling the neuronal “stem cells” with Iron, which can be observed with MRI. After the cells are implanted we see that the concentration of cells diminishes in the implantation area and increases in the final location… Continue reading

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  • Association between White Matter Ischemia (WMI) and Carotid Plaque Morphology

    In a recent study by Patterson AJ, etal. the above relationship was evaluated. Carotid Plaque morphology as evaluated with High resolution in vivo MRI shows that certain plaque characteristics such as- thin or ruptured fibrous caps, large necrotic lipid core or intraplaque hemorrhage may be associated with thromboembolic Stroke. The question they had was if WMI is related to… Continue reading

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  • Near Infrared Fluorescence Imaging

    The use of near infrared light has the advantage of photon penetration. This kind of light is used in near infrared fluorescence imaging. Because there is little NIR fluorescence contrast generated by most tissues, most in vivo studies administer exogenous contrast agents. In relation to the brain, this technique can be used to map the… Continue reading

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  • Augmenting Cognition

    There are many ways to enhance cognition, such as cognitive training software, meditation, medications, physical exercise, special foods, etc. The use of software seems to be very effective and basically has no side effects. The only adverse event I came across is dizziness, which seldom occurs, and is probably due to motion sickeness from playing… Continue reading

  • Possible Imaging Biomarkers for the Diagnosis of Parkinson’s Disease

    Parkinson’s disease can be present for many years in an asymptomatic phase before becoming clinically evident. Therapeutic approaches might be more effective in the preclinical phase. The possible utility of imaging biomarkers in this case would be to perform a preclinical diagnosis as well as a differential diagnosis with other confounding diseases. Unfortunately there is… Continue reading

  • EEG and fMRI Fusion

    EIt has been shown that when evaluating for the time sequence of brain events, either EEG or fMRI can be inadequate. EEG is known for its high temporal resolution. fMRI is known for its high spatial resolution when compared to EEG. EEG will provide the electrical activity information and fMRI the hemodynamic information. It would… Continue reading

  • Computer Modeling of a specific Brain function

    In a previous entry I specified that I believe there is a computer obsession and I do not to think we can mimic our whole brain in a computer. On the other hand I think we can model a specific brain function in the computer if we base this model on human brain data and… Continue reading

  • Stereology

    New insights await by comparing the findings of neural tracing done with Stereology to results obtained with Diffusion Tensor Imaging. Stereology originated in the 1700’s with the discovery of an association between geometry and probability by Buffon in 1733. But there were problems applying this method to inhomogeneous structures. This issue was overcome with Design-Based… Continue reading

  • Creativity

    I have noticed in myself that the more confident I am, the more creative I become–it takes courage to dive into the unknown. It is as if confidence pushes creativity forward, breaking the barriers for it to express and develop. Of course the more creative people are, and in consequence more successful, the more confident… Continue reading

  • Human Body as a source for inspiration

    It is not possible to create an artificial device better than ourselves. This means that we have to understand better what we are before creating a device that approaches what we are. And we have to inspire ourselves in what we are. Adolfo Cotter, MD Oct 30/2009 Continue reading

  • Analogy between the use of the Calculator and the Tablet sheds light on how we should train our new Physicians

    It really wasn’t that long ago that engineers, scientists and other professionals needed to do complex calculations by hand or slide rule. Once the calculator and computer were invented this activity became obsolete almost overnight, in favour of machines that were much faster and more precise. In my opinion, the same should apply to the… Continue reading

  • Effects of Neuroplasticity in Emotion Regulation

    In a recent interesting project done by Giuliani NR et al (Guiliani NR, et al, Emotion Regulation and Brain Plasticity: Expressive Suppression use predicts anterior insula volume Neuroimage; 2011 58(1) 10-15), they showed that expressive suppression of emotion, significantly increases the volume of the left anterior insula. Interestingly they also found that cognitive reappraisal and… Continue reading

  • Acting without Comprehending

    In my opinion action without theory or theory without action is useless. What I see happening presently is that people just do actions without understanding the why and how the underlying processes occur. Although this can be alleviating in the short term, it can be very dangerous in the long run. By acting without understanding,… Continue reading

  • Reliability of Quantitative Diffusion Tensor Tractography

    MRI Difussion Tensor Imaging has been used to evaluate for structural brain connectivity lately, a technique that has been traditionally done using pathological methods. DTI is based on water diffusion along the brain fiber tracts. The complexity of the brain fibers is a challenge. In a recent study by Wang YV. et al ( A… Continue reading

  • Magnetic Resonance Electrical Impedance Tomography (MREIT)

    This is a relatively new technology in development that is based on injecting current through surface electrodes into the human body. This current will induce a magnetic flux that relates to the conductivity of the tissue. MRI will then capture this magnetic flux. This technology shows a high resolution within a few millimetres. The SNR (signal to noise… Continue reading

  • Susceptibility Tensor Imaging (STI)

    STI is a new MRI”technology in development. It consists on creating images and contrast based on the susceptibility of the tissue to the magnetic field. This susceptibility seems to be based to the anisotropic alignment of the molecules. The tissue is more susceptible when the angle to the magnetic field is smaller. A recent study in… Continue reading

  • Do experiments really help us understand reality better?

    The experimental approach was introduced many years ago with the goal of factual analysis of reality based on testing and gathering data from nature. For this purpose we use our senses to gather information from reality. There has been a debate if what we sense is real or distorted by our emotions, experiences, thoughts, feelings… Continue reading

  • Argument vs Diplomacy

    As I mentioned in my previous blog, the current scientific method requires rigorousness and precision. In order to achieve those objectives, scientific argument is essential. My observations tell me that scientific argument has been progressively displaced by diplomacy. In our society many scientists do not like too much argument taking this more like a personal… Continue reading

  • The Utility of the Scientific Method

    During my observations, I realize that many occurrences in nature and life do not appear to obey scientific logic. Some of those occurrences are for example: human behaviour, human relationships, life and death, spirituality, natural disasters, etc. On the other hand there are processes that do obey this logic. In my opinion the rigorous and… Continue reading

  • The Instant Information Age should Transform the way we Learn and Educate

    Today, very large amounts and varieties of data are instantly available to any budding scientist or clinician, more and more so even on mobile devices. While this can sometimes be overwhelming and as I mentioned in my previous blog, too much knowledge can be counterproductive for creativity, there is an upside to this “information overload”… Continue reading

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  • Transcranial Doppler (TCD)

    TCD is the only non-invasive real-time neuroimaging study that can evaluate the characteristics of cerebral blood flow continuously. CT Angiography (CTA ) and Magnetic Resonance Angiography (MRA ) can do snapshots in time. Fluoroscopic angiography is the gold standard and can be used as a confirmatory tool. Some of the applications of TCD are: stroke, vasomotor reactivity testing,… Continue reading

  • The Number Mania

    There are numbers used everywhere these days. Numbers are important, but they have their specific utility. Life is not all about numbers!! For example, clinical medicine has become a number game….but nothing can replace a true and good clinical judgment, a history well taken, and a thorough and detailed physical exam… Many doctors see patients in… Continue reading

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  • No Reply

    Science has always made efforts to standardize the nomenclature so to facilitate communication. Now what we are seeing is deficient communication because people do not reply. This is becoming a true epidemic. Now, what does it mean no reply? May be they are busy and will reply later, or they are ashamed, or they are… Continue reading

  • About Publishing and Publishers

    In general, I find publishers quite annoying. How can somebody freely express their ideas, if publishers impose so many rules regarding the number of words, number of pages, style, content, etc….? The rigid structure only inhibits creativity. Also, a lot of politics is involved in order to publish with many of the publishers. As I have been saying on… Continue reading

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  • Social Achievement vs Intellectual Performance

    People keep saying, “Oh, it’s not what you know, but who you know”. Everybody is becoming a great social achiever!! My question is how much knowledge do those people have?? Which people are hired, the more creative, intelligent and knowledgeable ones or the more social?? Can somebody tell me if this makes sense?? Unless we… Continue reading

  • Stealing Ideas

    In the ultra-competitive world we live in today it seems to me that stealing research ideas has become commonplace. Of course, why not? People figure that nothing will happen to them. Everyone clearly knows that stealing money or objects is a criminal act, so why don’t we feel the same way about stealing ideas? Is… Continue reading

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  • Positive Emotions have a Positive Effect on Creativity

    I continue to review the Dalai Lama’s book “The Art Of Happiness In A Troubled World” From the discussions in the book I can infer that positive emotions can be beneficial to creative thinking. When we feel happy and have other positive emotions we tend to make more associations, we see the bigger picture better… Continue reading

  • The Brain’s Dark Energy

    Just as there is dark energy in the universe, there is dark energy in our own brain. It is dark because it is of unknown origin. Brain imaging results suggest that the brain works harder when it is daydreaming than when it performs a specific task, but we don’t exactly know why. This is interesting… Continue reading

  • Individualism as Beneficial for Creativity

    I am reviewing a very interesting book from the Dalai Lama called “The art of happiness in a troubled world” The book mentions that individualism, and the sense of independence can be beneficial for Creativity. I find this statement related to my previous entry, where I mentioned that self- confidence can be beneficial for Creativity.… Continue reading

  • Biomimetics

    There is nothing more inspiring in science than nature itself. Scientists who create without studying nature are in effect acting like our creator, and ignoring what the real creator provided us for inspiration. Leonardo Da Vinci, for example, used nature to get inspired in his creations. The same applies to medicine and in neuroscience.  If… Continue reading

  • Creativity and Self Confidence

    I have noticed in myself that the more confident I am, the more creative I become–it takes courage to dive into the unknown. It is as if confidence pushes creativity forward, breaking the barriers for it to express and develop. Of course the more creative people are, and in consequence more successful, the more confident… Continue reading

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  • Research Grants System is Unfair

    In my opinion, scientific grants have been allocated unfairly to certain kinds of research, and the trend seems to be for the worse.  There is a recent paper published by Peter A Lawrence entitled “Real lives and white lies in the funding of scientific research,” which exemplifies my thinking.  The criterion of grant approval seems… Continue reading

  • Changing Data

    I have been told lately from different sources that some scientists in academia and industry are manipulating data in order to enhance their chances of having their research accepted by a peer-reviewed journal or to simply provide the necessary evidence to support the ambitions of their corporate masters. In every case it comes down to… Continue reading

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  • Era of Addictions

    Marketing is a business tool to excite people and make them enthusiastic to buy. If the product or service we are selling is worthwhile for society and for people in general, marketing is a blessing. On the other hand, if what we are selling is of low quality, or harmful in some way to us,… Continue reading

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  • The True Cost of the Business Oriented Practice of Medicine

    As North America continues a multi-year struggle with an extended economic downturn, and tight budgets have become the new normal, this is impacting the provision of healthcare as well. The resources to diagnose, treat and take care of patients are becoming scarce. In consequence, this is seen as a business opportunity by some, helping develop… Continue reading

  • Research Bias is Increasing

    As a society we have long been concerned about scientists working in industry or academia who may be influenced to write papers suited to satisfy the needs of the people financing the project. Many people I talk to are concerned that the current economic climate in western industrialized nations is aggravating this problem. Furthermore, this… Continue reading

  • Politics and the Economy are Interfering with Medical Teams’ Delivery of Patient Care

    Despite some positive economic metrics as of late, most people feel we have all seen better times, and this impacts the decision-making of individual medical care providers as they try and balance economic pressures with quality patient care. During economic downturns it is common to see an increase in mental problems such as anxiety, depression,… Continue reading

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  • Telemedicine Usefulness and Risks Considered

    Worldwide, the practice of telemedicine has been growing very fast over the last decade. As with other service delivery models, a number of market factors have converged to influence this rapid growth – aging demographics and a related increase in chronic illnesses, technological developments and the pressure to deliver more cost effective services, to name… Continue reading

  • Helping Prevent a Society of Idiots

    Throughout history the advance of technology has produced both positive and negative consequences. Technology can help us be more efficient and hopefully produce better quality work. On the other hand, more than ever before we are becoming dependent on helpful devices that are so intelligent, in some ways we are not using our brains enough.… Continue reading

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  • Prescribing Creative Activities in the Treatment of Dementia

    Creativity improves the overall sense of well being in patients with  Dementia. It helps them gain more meaning/purpose associated with their lives and makes them emotionally resilient. During the creative activity the whole brain seems to be working in unison, which should promote the formation of new synapses and neurons, including those related to memory. Also, the activities are often… Continue reading

  • Computer Obsession

    Although artificial intelligence and technology, in general, are very important human achievements, I think our society is obsessed with computers. How is it possible that some scientists believe that we can compare our brain to a computer? Why not comparing our brain to an airplane or a fancy car?  We have to understand that we… Continue reading

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