I didn’t intend to review Jon Palfreman’s book Brain Storms: The Race to Unlock the Mysteries of Parkinson’s Disease, but after reading it I decided it was too good not to share. Palfreman is an award-winning science journalist who has Parkinson’s himself. He has done a bang-up job of describing Parkinson’s disease, its impact on patients, and how science is working to understand and treat it.
Parkinson first described the disease in 1817. It is characterized by shaking, rigidity, slowness of movement, and difficulty with walking. There is a decrease in dopamine in the basal ganglia in the brain. One million Americans have Parkinson’s disease. The incidence increases with age; by age 80 one in fifty people are affected.
Some very strange phenomena have been observed. Parkinson’s disease is less common among smokers and coffee drinkers. When a patient becomes frozen and unable to take the next step, if you draw a line on the floor they will step over the line and walk on. Patients who can’t walk can run, ride a bike, or ice-skate. Some patients appear to have strong responses to placebos, with reversal of symptoms for long periods. Exposure to vibration seems to decrease symptoms; in the late 1800s patients were treated with vibrating chairs until controlled studies showed they didn’t work. (more…)
Buddhists believe in reincarnation. Some psychotherapists do too.
I recently got an e-mail from a PR firm about an “internationally certified regression therapist,” Ann Barham, who has written a book and who claims to help patients to “heal enduring challenges, release unhealthy patterns and beliefs, and find their way to more happiness and success.” They offered me the opportunity to review her book and/or interview her; I declined, but I was interested in learning more about past life regression therapy, so I elected to “interview Dr. Google” instead.
In past life regression therapy, therapists use hypnosis, leading questions, and strong suggestions to encourage patients to imagine that reincarnation is real and to imagine their past lives. Events and people from past lives are blamed for symptoms and problems in the patient’s current life. Finding a past life cause for current problems supposedly helps patients deal with them. The technique is also used in healthy people to promote spiritual advancement and self-understanding. There is no such thing as reincarnation, and the memories of past lives are nothing but fantasy. (more…)
One way to describe our overall editorial stance at SBM is that we are criticizing medical science in a constructive way because we would like to see higher standards more generally applied. Science is complex, medical science especially so because it deals with people who are complex and unique. Getting it right is hard and so we need to take a very careful and thoughtful approach. There are countless ways to get it wrong.
One way to get it wrong is to put too much faith in a new technology or scientific approach when there has not been enough time to adequately validate that approach. It’s tempting to think that the new idea or technology is going to revolutionize science or medicine, but history has taught us to be cautious. For instance, antioxidants, it turns out, are not going to cure a long list of diseases.
One recent technology that is very exciting, but insiders recognize is very problematic, is perhaps even more problematic than we thought –functional MRI scans (fMRI). A new study suggests that the statistical software used to analyse the raw data from fMRIs might be significantly flawed, producing a flood of false positive results.
An fMRI primer
MRI scanning uses powerful magnets to image soft tissue in the body. The magnets (1.5-3 Tesla, typically) align the spin of hydrogen atoms in water molecules with the magnetic field. The time it takes for the atoms to align and then relax depends on the characteristics of the tissue. The MRI scan therefore sees subtle differences in tissue (density, water content) and uses this information to construct detailed images. (more…)
Post-mortem cross sections of a healthy brain (left) and a brain with advanced Alzheimer disease (right), showing characteristic shrinkage.
The medical profession is currently engaged in a simmering debate about what is the best overall approach to take toward the relationship between science and health care. I would say that the current dominant model is Evidence-Based Medicine (EBM). We, of course, advocate for a number of tweaks to EBM we call Science-Based Medicine (SBM).
SBM essentially advocates for an ironic-sounding holistic approach to scientific evidence. All evidence should be considered in its proper context with an eye toward the strengths and weaknesses of each kind of evidence, and in the context of the institutions of science and medicine. SBM represents a higher standard of overall evidence, which we feel is justified given the degree to which medical interventions are adopted prematurely (as evidenced by later reversals).
At the same time there are those, in the minority but with an established presence, who are essentially arguing for lowering the standard of science in health care. They exist on a spectrum, at one end including those who would abandon science entirely in favor of spirituality and philosophy-based medicine. At the other end are those who claim to endorse science but want to change the rules of scientific medicine to include a much lower standard of evidence. This is more pseudoscience than antiscience. Chief among them, in my opinion, are proponents of what they call “functional medicine.” Functional medicine essentially uses science incorrectly, but still cloaks itself with the imprimatur of science. (more…)
A new study shows that 42 really is the answer to life, the universe, and everything. OK, not really, but it does show that 42% of healthy brain activity is the minimum threshold for consciousness.
Disorders of consciousness, also referred to as coma when severe enough, can be a difficult situation to assess sufficiently to make reliable predictions about outcome. Part of the problem is that once someone is not able to maintain consciousness, we lose much of the neurological exam, and therefore it becomes more difficult to assess brain function other than to say that they are not conscious.
Types of coma
Two types of coma in particular are of interest: the persistent vegetative state, also called unresponsive wakefulness syndrome (UWS), and the minimally conscious state (MCS). Both are severe impairments of consciousness. In UWS, by definition, the patient may have sleep-wake cycles, open their eye, have roving eye movements, and grimace, but they do not have any interaction with their environment. They do not respond to voice, look at faces, or move in response to stimuli.
The company Halo Neuroscience is now offering a device, the Halo-Sport, which they claim enhances sports performance through “neuropriming.” Their website claims:
Neuropriming uses pulses of energy to increase the excitability of motor neurons, benefiting athletes in two ways: accelerated strength and skill acquisition.
Regular readers of SBM can probably see where this is going.
A proper threshold of evidence
Before I get into the details of this product, I want to back up and discuss some basic principles. There is a clear pattern that has played itself out countless times on SBM or with regular authors on SBM in their other outlets. A person, company, or industry makes a clinical medical claim. We examine the evidence and find it wanting, and state so. Believers in the claim then attack us for being shills, closed minded, and/or failing to do our research.
A cargo cult pseudo airplane. How much of psychology is like this?
Last year I reviewed Tomasz Witkowski and Maciej Zatonski’s book Psychology Gone Wrong where they pointed out that many of psychology’s accepted beliefs and therapies were not based on good evidence. Now Witkowski has written a new book, to be published later this year, Psychology Led Astray: Cargo Cult in Science and Therapy, that is certain to ruffle a lot of feathers. He compares psychology to cargo cults. He says, “the cargo cult phenomenon is virtually absent in physics, chemistry, and mathematics, yet it runs rampant in both psychology and sociology.” He uncovers cargo cult practices in psychology, unmasking therapies that are devoid of science, dangerous, and even cruel, especially those directed at children.
Richard Feynman was the first to compare the contemporary social sciences, including psychology, to a cargo cult. For those not familiar, the term “cargo cult” originates with the natives in Melanesia, who were awestruck by the planes that landed on their islands during WWII bringing all kinds of supplies. They had no understanding of what airplanes were or where they came from. Magical thinking led them to create bamboo replicas of planes and control towers in the superstitious belief that it would attract planes and bring them material goods. Similarly, many psychology researchers have been imitating the methods of science without really understanding how science is supposed to work. They go through the motions, but their research designs are so poorly thought out and the methodology so poor that their results are meaningless. And then they use those meaningless results to guide therapy. They have been led astray, have deceived themselves, and have harmed patients. (more…)
The Mirror declares, ‘Scientists develop Matrix-style technique of ‘feeding’ information directly into your brain.’ Discovery News went with, “Novices ‘Download’ Pilots’ Brainwaves, Learn To Fly.” Most other outlets spoke of ‘uploading’ information to the brain, and learning in seconds.
The one thing I was certain of from reading these headlines is that this was not what was happening. Brain-machine interface technology is progressing rapidly, but we are a long way away from downloading information from or uploading information to the human brain.
The news outlets reported that electrical activity was recorded from pilots and then used to stimulate the subject. They also reported that this enhanced learning by 33%.
What actually happened
Here is the actual study: “Transcranial Direct Current Stimulation Modulates Neuronal Activity and Learning in Pilot Training.”
Lumosity is a company that provides online and mobile games that it claimed are scientifically designed to enhance memory, focus, mental flexibility, and even stave off dementia. In a recent decision, the Federal Trade Commission (FTC) concluded that Luminosity’s claims are not based on adequate scientific evidence. They imposed a $50 million judgement against Lumos Labs, the company who sells Lumosity, and allowed them to settle for $2 million.
Being mentally active
The idea behind “brain training” is not a bad one, it’s just easy to misrepresent as something it isn’t. The basic notion is that using your brain makes it function better. It is better to be mentally and physically active than inactive. This overview summarized the evidence: (more…)
What is autism? What causes it? Is it genetic? Is it a consequence of something in our environment or lifestyle? What’s an “idiot savant” or an “autistic savant”? What happens when autistic children become adults? Why are so many of their parents scientists, academics, and engineers? If your grandfather’s Uncle Fred was a socially inept inventor with a lot of strange quirks, do you think he might have been autistic? Is autism really becoming more prevalent, or are we just getting better at diagnosing it? What’s happening with these people and what can be done to give them a better life?
Sorry to burden the list of recommended reading with yet another book, but if you are on the autism spectrum, if you know anyone who is autistic, if you think there is an epidemic of autism, if you think vaccines or environmental toxins cause autism, or if you are just interested in autism and want to understand it better, you will benefit from reading this new book by Steve Silberman: NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. You will walk away from the book with new insights and a new appreciation of the “neurodiverse.” (more…)