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…)
Several snarks were painfully maimed in the writing of this blog post
I read a lot of the pseudo-medical websites. The writing is at best pedestrian, often turgid, and, at its worst, incoherent. It is rarely either engaging or clever.
Wit, the clever bon mot, the amusing turn of phrase or retort, is rare at best. So rare I cannot think of an example. It is ironic that those who engage in fantastical treatments are so often lacking in cleverness with language and thought. The closest you get to humor are the painfully-lame cartoons at the Natural News. I am sure that the readers will flood the comments with examples of all the clever writing I have missed in the world of pseudo-medicine just to prove me wrong. Not that the reality-based world is much better. It is the rare author on the internet whose style keeps me coming back for more.
But for some reason I found “Dear Science Based Medicine, Just a Few Questions About Acupuncture” funny and engaging, at odds with most of the purple quasi-paranoid articles I normally read. Just the right amount of chatty snarkiness to be enjoyable, at least for me. So refreshing given the style of the usual pro-acupuncture comments. Your millage may vary. (more…)
People in a vegetative state, usually as a result of brain trauma or anoxia (lack of oxygen) by definition have no signs of conscious awareness or activity. The definition, therefore, is based largely on the absence of evidence for consciousness.
Of course, arguments based upon the absence of evidence are only as compelling as the degree to which evidence has been properly searched for. In recent years technology has advanced to the point that our ability to detect the possible subtle signs of consciousness in those presumed to be vegetative has increased – mainly through functional MRI scans (fMRI) and electroencephalograms (EEGs).
There has been a steady stream of studies demonstrating that a small minority of patients thought to be vegetative actually display some signs of minimal consciousness. The latest such study was recently published in Neuroimage: Clinical by a research team from the University of Cambridge.
But let’s back up a bit first. Even prior to evaluating vegetative patients with fMRI and advanced EEG techniques, several studies showed that a detailed neurological exam specifically designed to detect the most subtle clinical signs of consciousness could find such signs in some patients who were diagnosed as being vegetative by more standard neurological exam. According to one study as many as 41% of patients diagnosed as vegetative were really minimally conscious, meaning they had subtle signs of consciousness, but still cannot wake up, converse, or act purposefully. (more…)
Sally Satel and Scott Lilienfeld have written a new book, Brainwashed: The Seductive Appeal of Mindless Neuroscience. Its purpose is not to critique neuroscience, but to expose and protest its mindless oversimplification, interpretive license, and premature application in the legal, commercial, clinical, and philosophical domains.
The brain is a wondrous thing: “…the three pound universe between our ears has more connections than there are stars in the Milky Way.” Trying to understand how it works and how it generates conscious awareness and subjective feelings is a daunting task. Neuroimaging is one of the tools we are using to study it. Unfortunately, people get so enthusiastic about its possibilities that they are constantly tempted to read more into the images than is really there. This has given rise to a new phrenology that interprets our mental characteristics with pretty colored pictures. We are easily impressed by pictures; after all, a picture is worth a thousand words.
Brain imaging can’t show us what is going on in the mind of the person. It shows areas that have increased oxygen consumption. A spot lights up when a person thinks or acts, but that doesn’t tell us much. Single blobs that light up in the brain have been interpreted as centers for things like love, rewards, hate, and belief in God. This is sometimes referred to as “blobology.” They found an area in one person that lit up when he thought about an actress he loved. That area was thought to be a “reward” center. But it also lit up when he thought of Ahmadinejad! So they did some fancy footwork and rationalized that he believed that the Jewish people would endure and therefore he derived pleasure from the idea that Ahmadinejad would fail. That’s pretty far-fetched. Occam’s razor would suggest that maybe the area that lit up was reacting not to pleasure, but to something else. People tend to read what they want to see into ambiguous patterns like a Rorschach test. Mental functions are rarely limited to a single spot in the brain; multiple areas are involved and interconnected. Researchers are increasingly moving away from blobology and towards pattern analysis where they look at the patterns of activation across the entire brain. (more…)