Neuroscience/Mental Health

Archive for Neuroscience/Mental Health

BrainPlus IQ: Lying with Advertising

BrainPlus IQ: If it turns your brain blue, consult a doctor.

BrainPlus IQ: If it turns your brain blue, consult a doctor.

I got an email urging me to check out a wonderful new product that boosts brain performance: it “doubles IQ, skyrockets energy levels, and connects areas of the brain not previously connected.” It is BrainPlus IQ, a dietary supplement that falls into the category of nootropics, substances that enhance cognition and memory. After looking into it, my first thought was that if it doubles your IQ you might become smart enough to realize you have been scammed. The advertising for this product is as reprehensible as anything I have seen (and I have seen a lot).

The link in the email was to a “Discovery” website article titled “Anderson Cooper: Stephen Hawking Predicts, “This Pill Will Change Humanity” and It’s What I Credit My $20 Million Net Worth To.” According to the article, Stephen Hawking said his brain is sharper than ever because he uses BrainPlus IQ. It quotes Denzel Washington, saying he gave a speech at a science convention (unnamed) in New York City, saying BrainPlus IQ enabled him to memorize movie lines after reading them just once. He brought to the stage MIT scientist Peter Molnar, who said he had tested BrainPlus IQ against Adderall in 1,000 patients and found it was 600% more effective and subjects doubled their IQ in 10 days. It has “absolutely no harmful ingredients, it’s non-addictive, and 79% of participants double their IQ within 24 hours.” It was supposedly described as “Viagra for the brain” in Forbes magazine. (more…)

Posted in: Herbs & Supplements, Neuroscience/Mental Health

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Declining Dementia

A human brain showing fronto-temporal lobe degeneration, often associated with dementia

A human brain showing fronto-temporal lobe degeneration, often associated with dementia

Dementia is a significant health burden of increasing significance as our population ages. Worldwide the prevalence of dementia is 5-7% in people 60 years and older, with risk doubling every 5 years after age 60. About 5.4 million Americans are living with dementia.

Dementia is a general category referring to a chronic decline in overall cognitive function. The most common cause of dementia is Alzheimer’s disease, accounting for about half of cases. There is also a category of mild cognitive impairment (or cognitive impairment not dementia) that is milder and does not meet the diagnostic criteria for full dementia.

Declining prevalence

There is some good news, however. A recent study published in JAMA finds that in the US the prevalence of dementia in those 65 and older declined between 2000 and 2012, from 11.6 to 8.8%. This is both statistically significant and clinically significant.

This also mirrors evidence from other countries also showing a decline in dementia prevalence over the last 20 years, including the UK, Denmark, and Sweden.

The big question, of course, is what is causing this decline? If we can determine the major factors then perhaps we could use that knowledge to further decrease dementia risk.

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Posted in: Neuroscience/Mental Health

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A New Collaborative in Neuroscience

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A recent comment in the journal Nature makes a bold proposal – to form a true multi-lab cooperative to perform collective research into the deep questions of neuroscience. There are two aspects of this proposal that are extremely interesting: the potential to make significant progress in answering the biggest questions in neuroscience, and the collaborative approach to research being proposed.

How does the brain work?

It is often difficult to answer questions about the current state of scientific knowledge to the general public because there is a lot of background knowledge about science itself that is necessary. As a result I find two common tropes – that scientific knowledge is binary (we either understand something or we don’t) and that we “have no idea” how something works, even when we have lots of ideas. Communicating about the brain almost always falls for these tropes.

Scientific knowledge is better understood using a metaphor of depth. The real question is not whether or not we understand how the brain works, but how deep is our knowledge about brain function. Because the brain is so complex we can simultaneously say that we know a great deal about brain function and there is a great deal we don’t understand.

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Posted in: Neuroscience/Mental Health, Science and Medicine

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Update on CCSVI and Multiple Sclerosis

Balloon dialatation of a stenosed jugular vein, the "liberation procedure" wrongly promoted as treating multiple sclerosis.

Balloon dilation of a stenosed jugular vein, the “liberation procedure” wrongly promoted as treating multiple sclerosis.

In 2009 CCSVI was proposed by Italian vascular surgeon, Dr. Paolo Zamboni – that multiple sclerosis (MS) is caused by chronic blockage of the veins that drain the brain. Since that time we have seen the evolution of a medical pseudoscience. It has been a fascinating case study in how science sorts out what works and what doesn’t, and how patients, believers, and the public react to this information. The story is ongoing and there are some interesting updates.

Background on CCSVI

CCSVI stands for chronic cerebrospinal venous insufficiency. Zamboni believes that blockages in the veins that drain blood from the brain cause back pressure in the brain, decreasing blood flow and leading to secondary inflammation, and further that this results in the clinical diseases we collectively known as MS. Zamboni’s interest in MS is not random. His wife has MS, and it is interesting that he is a vascular surgeon and found what he believes is a cause of MS that can be treated by vascular surgeons. This does not mean his ideas are wrong, it just means he has a clear bias and his data needs to be looked at carefully and independently replicated.

His initial study found that 100% of the patients he examined with MS had cranial venous blockage. That is also curious. We rarely find 100% correlations in medicine, even for solid theories. It is a huge red flag for systematic bias.

The MS community was appropriately skeptical. While the exact cause of MS remains unknown, we have been studying it for decades and there is a lot we do know. We know, for example, that MS is primarily an autoimmune disease, and the pathology is largely caused by inflammation. We now, in fact, have a long list of effective treatments for some types of MS that suppress the immune system and inflammation. There are still some types, such as chronic progressive MS, that do not respond to the best treatments.

The idea that MS was caused by vascular blockage was therefore a radical idea that flew in the face of existing research. Occasionally, however, radical ideas turn out to be true, and so some MS researchers set out to test Zamboni’s hypothesis.

(more…)

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Parkinson’s Disease: A Detective Story

brainstorms
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.

The disease

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…)

Posted in: Basic Science, Book & movie reviews, Neuroscience/Mental Health

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Past Life Regression Therapy: Encouraging Fantasy

Buddhists believe in reincarnation. Some psychotherapists do too.

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…)

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New Study Questions fMRI Validity

fmri
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…)

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MEND Protocol For Alzheimer’s Disease

Post-mortem cross sections of a healthy brain (left) and a brain with advanced Alzheimer disease (right), showing characteristic shrinkage.

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…)

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PET Scans Predict Coma Outcome

3x3

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.

(more…)

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Zap Your Way to Learning?

halo-sport-tdcs-headphones-640x390
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.

(more…)

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