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Symphony of Neurology: Understanding brain stimulation



TBrain stimulation studies are advancing so fast, and the findings are so puzzling that the reader may feel tempted simply to order a brilliant cap from Amazon to understand everything later.

Over the past month, scientists have reported that they are improving the memory of older people by using an electrical current that has passed through the cap and restoring some cognitive function in a brain-damaged woman with implanted electrodes. More recently, the Food and Drug Administration approved smartphone incentives designed to alleviate attention deficit problems by delivering electrical current through a patch on the forehead.

Last year another group of scientists announced that they also created a brain implant that increases memory. Throughout this time, the "do-it-yourself" subculture continues to grow, by people who are experimenting with placing electrodes in the skulls or brain-adjusting faces.

Forecasting the place where all these efforts are directed, and how and when they can come together with a great methodology, is an exercise in rank speculation. Neurostimulation covers too many different techniques for different applications and different quality. The only sureties are the usual: that the genius hood will not arrive soon, and that any brain-fake that provides real benefit is likely to come at risk.

What can brain scan us for? (Alamy)

Nevertheless, the field deserves to be observed because it implies some elementary properties of brain function. Unlike psychiatric drugs or psychotherapy, current impulses can change people's behavior very quickly and reliably. Turn on the current and things happen; turn off and the effect stops or goes down.

To begin to appreciate the latest science, it helps to have a working picture of the brain's electrical system – a metaphor. Metaphors can be risky when applied to the brain; they are inherently inadequate and the choice of one of them risks supporting intervention, including brain stimulation, with unknown risks.

The metaphor of the orchestra is a good place to start. The sound of the brain is very similar to Mozart's, with many different, specialized neural tools in sync.

"In conducting, at any moment, you work to coordinate all the instruments to play at the same rate, with the same intensity," says James Conlon, music director of the Los Angeles Opera and Chief Conductor of the RAI National Symphony Orchestra in Turin , Italy. "I am constantly moving between listening, guiding and following: back and forth, approve sound, accept or make corrections."

Brain scientists often compare brain function with a symphony. "If you watch an orchestra after the show begins, the cello player looks at the person next to him or her and not the conductor," says Michael Gazaniga, a psychologist at the University of California at Santa Barbara. "The same thing happens in the brain. The question for me is whether the brain has a conductor?

The most rough form of electrical intervention is electroconvulsive therapy, or ECT, which delivers a fainting current through the brain, providing at least temporary relief to some people with severe depression. Doctors have used ECT for almost a century, although treatment remains controversial for many patients. Metaphorically speaking, ECT is similar to stopping the performance of the orchestra and sending musicians, from Rover to Tympanists to rest.

Electrical stimulation can improve coordination between regions of the brain (Alamy)

A more purposeful form of electrical therapy, called deep brain stimulation or DBS, has been used to manage conditions such as Parkinson's disease and epilepsy. In DBS, the electrode is wound into a specific area of ​​the brain that is destructive; stimulating and paradoxically pushing the activity in this particular region.

If a particularly strong part is excluded, "it can affect the whole system, and the whole orchestra sounds off," says Dr. Helen Mayberg, director of the Center for Advanced Therapy Schemes at the Sinai Mountain Medical School; she has developed DBS strategies for severe depression. "You can think about firing everyone in this stretch" – sends the Percussion House constantly, "says Mayberg. – The accuracy is absolutely critical.

Recent brain stimulation studies use a technique other than ECT or DBS but can still be understood from an orchestra perspective. In one study, scientists from Boston University found that they can improve working memory in older people by optimizing the so-called rhythmic "connection" between the frontal and temporal areas of the human brain.

In the brain, the activities of remote regions are coordinated through low-frequency theta waves. Researchers used electrical stimulation supplied through the cap to boost these waves, enhancing coordination between the two brain areas and, in the older, improving the memory.

"We think what we are doing is basically synchronizing these two separate zones," says Robert M.G. Reinhart, a neuroscientist at Boston University and one of the authors of this study. In fact, the stimulation acts as a conductor of the orchestra, listening, synthesizing and guiding.

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In another recent study, a team of brain scientists found that they can dull or overturn the symptoms of fatigue, poor concentration and mental mist in a woman who has suffered severe brain trauma in a car crash 18 years earlier. They have done this by providing a steady current during the waking hours with two electrodes implanted on both sides of the thalamus, a deep brain area, often described as a central switching center of the brain. Metaphorically, they increased the volume-or, perhaps, led the conductor to clap his hands and look firmly at the musicians.

Of course, metaphor is simply a metaphor, and only one step to deciphering the intimate mystery of consciousness. But in the age of technological attack, of ever-increasing technology and claims of both small and large, it is better to have some mind-guide in mind than nobody.


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