TMS Treatment for Schizophrenia

Among some of the more severe mental disorders is Schizophrenia, which is characterized by serious changes to a person’s thoughts and behavior. The disorder is best known in popular culture by it’s psychotic symptoms, such as affected individuals hearing voices that are not there. Known as Auditory Verbal Hallucinations, these types of hallucinations are experienced by nearly 70% of those with the disorder, and can be absolutely terrifying for those that have them. Thus, many treatments for the disorder focus on the quieting of these voices, such as antipsychotic drugs. The causes of schizophrenia are generally not well understood, though it is commonly believed that an imbalance in dopamine may play a role amongst other things, such as damage to myelin sheaths being a potential cause.

In an attempt to further treatment, a research team at the University of Caen in France worked with schizophrenic patients to see if Transcranial Magnetic Stimulation (TMS) could lessen the voices being heard. TMS is a method used in neuroscience to temporarily alter brain function utilizing a strong magnetic field, and can be precisely tuned to a specific brain region using methods such MRI. The team gave 26 patients TMS treatment and 33 other patients a sham treatment, and tested them using the Auditory Hallucinations Rating Scale to keep track of the voices they were hearing. Those in treatment received 20 Hz high-frequency pulses for 2 sessions a day for 2 days. The team was able to target the treatment to a part of the left side of the brain in the temporal lobe. The article states that said area is associated with language, which is most likely Wernicke’s area. The patients were then re-evaluated after 2 weeks and 34.6% of those that had TMS showed more than a 30% decrease in auditory hallucinations, versus 9.1% in the control group. The article states that this is the first controlled trial to see whether or not TMS would be a useful treatment.  

With this study comes the question of how this can be commercially applied as a treatment for schizophrenia, as the logistics are difficult given the nature of TMS. Similarly to this, TMS has been proven be promising in the treatment of depression. However, going to a doctor’s office for TMS twice daily for weeks on end is difficult for most people to accomplish.TMS is also something patients cannot do on their own unlike taking a pill once daily, as a very specific area of the brain has to be targeted and the machinery can be difficult to operate. A potential solution to this would be a mass produced portable device for TMS, but this has yet to be developed. For now, further research and development is needed to better mental illness treatment. 

Sources: 

https://www.sciencedaily.com/releases/2017/09/170904181720.htm

https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

Head Shape and the Brain

In The New York Times article, written by C. Claiborne Ray, "How does the Shape of a Head Affect the Brain?" the question of cranial deformation in various cultures is analyzed. Ray questions the long-term effects of these traditions in cultures, specifically Mayan artificial cranial deformation practices such as flattening the frontal bone and how this would affect brain development since these practices are performed in infancy up to four years of life. Ray, as well as researchers, is interested in this practice because during this time in life the brain is still rapidly developing, specifically the frontal lobe.

Several researchers have inquired about this practice and published articles in the Journal of Neurosurgery, The American Journal of Physical Anthropology, and The Journal of Anthropology as mentioned in the article. There are varying view points on the harm physical mutilation does to the brain. Some researchers think it could have lead to developmental delays, vision impairment, or object recognition impairments, such as those in The American Journal of Physical Anthropology journal entry listed in Ray's article. Others believed the flattening of the skull did more damage to the bone and face structure than the brain itself. These researchers believed practices like these would not have produced any impairments, such as the journal entry in Anthropology also listed in Ray's article. It is interesting the fascination with the skull ancient cultures had like some people had in the 19th century with the popular practice of phrenology invented by Franz Joseph Gall.

Phrenology is the study of the shape of the skull being linked to traits about the person, like truthfulness, wit, and individuality to name a few. The places where the skull was bumpier had a direct correlation with the prevalence of that trait in the individual. This was a very popular practice in the 19th century and individuals would pay large sums of money to get their skull read.  Although phrenology is more concerned with personality traits whereas cranial deformation is concerned with physical appearance and beauty, it is interesting to see the connection between times and cultures trying to make sense of the brain or mind with physical representation. Although ancient cultures would use the skull more for beauty purposes, the fascination with the the skull and the connection to the outside world, be it physical beauty or personality trait, crosses time and culture.


https://www.nytimes.com/2018/01/01/science/head-shape-brain.html?rref=collection%2Ftimestopic%2FBrain&action=click&contentCollection=health&region=stream&module=stream_unit&version=latest&contentPlacement=9&pgtype=collection

New Noninvasive Way to Stimulate Deeper Brain Areas

For years, neuroscientists have been looking for a way to stimulate deeper brain regions that does not involve surgery. When it comes to stimulating brain areas there are really only two options: invasive surgery to stimulate deeper brain regions or noninvasive surface level stimulation. There are major pros and cons to both of these methods. Deeper brain stimulations such as ECOG, or electrocorticography, requires surgery where they remove part of the patient’s skull and place electrodes on the brain. This provides better localization and allows them to target deeper brain areas, but it is obviously extremely invasive and is only performed on people who already need brain surgery for medical reasons. Surface level stimulation such as EEG, or electroencephalography, involves the patient wearing a skull cap with electrodes on it. The benefits are it is noninvasive and can be used on a wider range of people. However, researchers are restricted to only stimulating surface level structures in the brain and it also has poor localization.

Now, researchers might have just discovered a method that is the best of both worlds, called temporal interference. The method involves beaming multiple electric frequencies that are too high for neurons to respond to from electrodes on the skull’s surface. Where the frequencies intersect in the brain end up canceling each other out and whatever the difference is between the frequencies stimulates that area of the brain. So for example, if you deliver 1,000 hertz and 1,001 hertz to an area in the brain, they will cancel each other out and that area will react as if you were stimulating it with 1 hertz. However, all of the other areas that the 1,000 hertz is going through will not react because the frequency is so high that it moves faster than our brains can process. It is a similar concept to why we cannot hear sonar. This method provides researchers with precise localization, which they further tested by aiming electricity at certain areas in mice’s motor cortices. This resulted in the mice moving their fore-paws, whiskers, or ears.

With this new method, comes a lot of practical questions. The major one being that this study was done with rats, so how will it work on humans? In an attempt to begin to answer this question, the study’s senior author and co-director is testing the method on people without disorders to see if it works in the human brain. There are other questions such as, how it would be used on patients with complex diseases, like Parkinson’s, who would need continuous stimulation. Also, would patients wear a portable electricity-delivery device? Another concern is making sure to avoid brain areas that would cause motor contractions or speech and vision impairments. One hope that researchers have, is that temporal interference can be developed for patients with epilepsy and provide them with an alternative to the extremely invasive procedure of ECOG. This method is something that neuroscientists have been wanting for a long time and if it is proved to be effective and safe through more research, temporal interference could be used to help people with a range of neurological and psychiatric disorders.

https://www.nytimes.com/2017/06/01/health/new-electrical-brain-stimulation-technique-shows-promise-in-mice.html?rref=collection%2Fsectioncollection%2Fhealth

A Shock in Time Saves Nine: Understanding How “A Tiny Pulse of Electricity Can Help the Brain Form Lasting Memories”

We’ve all experienced, at one point or another, the inability to recall information that we thought we had memorized. Whether it’s items on a grocery list or terms for a test, our lapses demonstrate that the process of memorization is far from infallible. These types of memory failures inspired Michael Kahana and his team at the University of Pennsylvania to search for ways to improve our ability to memorize.

Earlier this month, NPR did a segment on Kahana’s research called “A Tiny Pulse of Electricity Can Help the Brain Form Lasting Memories.” The article begins by describing how Kahana and his team study the brain. There are many methods which scientists can use, each with their own advantages and disadvantages. To understand memory dysfunction, Kahana must study regions that are buried deep within the brain, which can be hard to access. Therefore, he studies the brains of patients with epilepsy; doctors have already inserted specialized wires into the brains of these patients to monitor electrical activity. This allows researchers to study the depths of their brains! This technique is called Electrocorticography, or more affectionately, ECOG. It allows researchers like Kahana to figure out exactly when and where the brain is activated. Thus, he can determine how the brain accomplishes a task, such as memorization.

Using this technique, Kahana’s team was able to figure out the specific pattern of activity demonstrated when the brain successfully memorized a list of words. No surprise here: this activation pattern was different when a person was successful in memorizing than when forgetting would occur. In other words, the way our brain works as we try to memorize can actually determine if we will be able to recall the information at a later time!

An image from Kahana’s research team.
The dots in red indicate where on the brain,
a pulse of electricity caused a change in memorization ability    

Once Kahana knew how a successfully memorizing brain ought to look, he set out to improve our ability to memorize. In the experiment described by NPR, Kahana continued to work with the patients with epilepsy. He gave them a list of words to memorize. As the patients memorized, a computer monitored the activity of their brain. If it appeared their brain cells were not being activated in the memory-forming pattern, a pulse of electricity would be delivered to the brain. When this pulse of electricity was delivered to the area involved in recalling words (officially called the lateral temporal cortex), the researchers noted a significant increase in the patients’ ability to remember. In effect, Kahana’s team was able to modify the brain’s activity, prompting a higher rate of successful memorization.

The ultimate goal of this research is to create a wearable device that would recognize upcoming memory lapses and correct the brain’s course. This could be especially useful for patients with Alzheimer’s. While this research certainly is promising, it is important to consider the limitations of this study. One of the members of Kahana’s team, Michael Sperling, explains that any findings from patients with epilepsy may not apply to unaffected brains. Those with epilepsy tend to have a variety of other conditions that affect the memorization process.

Another major hurdle facing the team is the transition from delivering electrical pulses from within the brain to sending them from an external, wearable device. Despite the research yet to be done, this team is very optimistic that they can create a memory-boosting device “within the next half a dozen years or so” (Sperling, 2018). So don’t forget to be on the lookout for this new technology!

Citations:

Ezzyat, Y., Wanda, P. A., Levy, D. F., Kadel, A., Aka, A., Pedisich, I., Kahana, M. J. (2018). Closed-loop stimulation of temporal cortex rescues functional networks and improves memory. Nature Communications,9(1). doi:10.1038/s41467-017-02753-0

Hamilton, J. (2018, February 06). A Tiny Pulse Of Electricity Can Help The Brain Form Lasting Memories. Retrieved February 23, 2018, from https://www.npr.org/sections/health-shots/2018/02/06/583633391/a-tiny-pulse-of-electricity-can-help-the-brain-form-lasting-memories

Is Mind Reading in Our Future?

If you are anything like me, you love binging True Crime dramas after a long, stressful day. However, sometimes these detective shows spark a little uneasiness in me, because putting the "perp" away all too often relies on eye-witness accounts of the crime. It's common knowledge that eye-witness accounts are unreliable, but no other options have been available, until now. Dan Nemrodov, of the University of Toronto-Scarborough, has developed a technique to reconstruct images of mental perceptions of faces using EEG.

EEG, also known as electroencephalography, uses surface electrodes to monitor the firing activity of millions of neurons in a predetermined brain region. In this study, subjects' EEG recordings were measured as they were shown images of faces; these recordings were then used to digitally reconstitute the mental image in the subjects' brains using an algorithm. This is possible because when we see an image, "our brains creates a mental percept, which is essentially a mental impression of that thing," explains Nemrodov. EEG was used to capture the mental percept and recreate a representation of how the image was processed in the brain. 

Nemrodov has also been able to use fMRI to achieve the same purpose. fMRI indirectly measures brain activity by tracking oxygen movement in the bloodstream. When an area of the brain is activated in response to the visual stimulus, oxygen is dumped into that region, which is registered by the fMRI machine; this analysis utilizes the BOLD (Blood Oxygen Level Dependent) Effect. Although fMRI has exceptional spatial resolution, temporal resolution is key in recreating mental images. Therefore, EEG's superior temporal resolution makes it the neuroimaging technique of choice for reconstruction studies. 

Implications of this study are immense. In addition to replacing eye-witness accounts, the ability to map mental representations of visual stimuli and recreate the images also has a wide range of clinical applications. This technique could be used in assisting mute individuals to communicate, and potentially provide an accurate neuronal representation of other brain processes, such as memory and imagination. 

https://www.sciencedaily.com/releases/2018/02/180222145037.htm 

https://www.epilepsy.com/learn/professionals/diagnosis-treatment/basic-science-eeg

By: Sarah Darnell

The Future of Sight

The Future of Sight

By: Olajumoke Bamgbose

Usually when looking at neuroscience, the idea that once the nerve has been damaged the nerve is no longer able to function has been the main narrative. Since we know that mature neurons do not divide, it makes sense that once a nerve is damaged it’s usually no longer functioning. This common principle, naturally, also applies to sight. One of the main players in the game of sight is the optic nerve. It has been accepted that optic nerve damage usually leads to blindness, which can sadly be a later symptom in glaucoma.

The good news is that the more a topic is research the more information is learned. In class, we discussed lesion studies and how this technique can aid in the advancement of knowledge. A recent study published in Nature Neuroscience has recently used the practice of killing cells in particular area of the brain, this technique allowed them to successfully regenerate the nerve that was killed. This is an example of why dissociative techniques are used in labs, they not only give insight on the function of particular parts of the brain but it can also be used to manipulate cells and try new things with them.

This study was successfully able to regenerate the sight of mice with damaged optic nerve. Neurobiology professor, Andrew Huberman and his team at Stanford University crushed the optic nerve in one of the eyes of a few mice. Since the optic nerve was crushed, the mice were no longer able to see but through the use of nerve growing chemicals and nerve visual stimulation the scientist were able to restore sight in the mice. The chemicals and stimulation of the optic nerve functioned to salvage the axons of the cell and allow them to stretch and return back to the location of their original connection. The chemicals and stimulations used on the nerve made it able to grow and connect back to the correct site was sufficient to restore vision. This discovery led to insight on regenerating neurons and now further test are being planned in hopes of one day using a similar therapy in humans with damaged optic nerves, specifically glaucoma.

http://time.com/4399255/mice-blindness-cure/

https://med.stanford.edu/news/all-news/2016/07/first-ever-restoration-of-vision-achieved-in-mice.html