Category Archives: Understanding the Brain

Yesterday, I watched a very impressive two-part television documentary made by Stephen Fry, entitled "The Secret Life of the Manic Depressive" and filmed in 2006. The documentary is about his struggle with manic depression, which he prefers to call "bipolar disorder" as this is its official name and definitively does not involve a state of continuous depression. Bipolar disorder is often treated with mood stabilizing medications and, sometimes, other psychiatric drugs. However, these are not always effective and often cause a lot of side-effects.

The second part of the documentary is about Stephen wondering whether he should consider taking drugs or other kinds of psychiatric treatment, as it looks like his symptoms are getting worse over time. So in this part he visits a few people he knows and that have also been diagnosed with bipolar and are using some form of therapy. Among them is Andy Behrman, also known as "Electroboy". According to his website www.electroboy.com, "after two unsuccessful years of experimenting with all different combinations of medication to stabilize his wild mood swings, he opted for intensive bouts of electroshock therapy," [Ed.] also known as "electroconvulsive therapy", or ECT in short, "as a last resort. He was temporarily cured."

This, of course, brings back memories of one of the famous scenes of the movie "One flew over the cuckoo’s nest", in which Jack Nicolson rallies the patients of a mental institution together to take on the oppressive Nurse Ratched, a woman more a dictator than a nurse. He finally receives ECT to calme him down. As you can see from the picture at left, the applied ECT therapy used to be quite agressive, leading to brain convulsions and seizures or even memory loss, and has therefore been classified as "high risk" by the American Food and Drug Administration, or FDA for short.

Coincidentally, the American Psychiatric Association recently stated that the FDA should move the procedure to a medium risk state as they believe the current devices are not as brute force as their older siblings. Opponents, however, state that ECT may lead to memory loss and all sorts of other complications. If you want to decide for yourself, please check out the following YouTube movie: http://www.youtube.com/watch?v=zYl13Relzbs.

My personal opinion is that, though the doctors try to do a professional job, the applied therapy is not very patient specific and the majority of parameters are determined purely on a trial-and-error basis. Adding this to the fact that ECT is not the primary therapy, but merely serves to evoke a seizure (like you have during an epileptic insult), which is the actual therapy, makes me wonder whether there aren’t any prospects of developing a better therapy, which is better tailored to the disorder at hand and, of course, better to the patient.

Anyway, this was my sermon for the late Monday morning. If you are interested in watching "The Secret Life of the Manic Depressive", just let me know and I’ll see what I can do.

Wouter 

I’m writing this little contribution on Saturday night. Most people must be either watching the World Championships Ice Skating or enjoying themselves in the nightlife. Maybe you are lucky and you are in the Oosterpoort (Groningen) tonight listening to a concert by ‘Gare du Nord‘. Or you prefer to immerse yourself in the sounds of fabulous guitar solos and keep dancing like there’s no tomorrow. 

But there will be a tomorrow. And the more successful last night was, the harder the Sunday morning is. With a liver getting in overdrive and a brain complaining about a lack of water, you wonder why you cannot sleep any further. Soon you realize it must be that annoying beep in your head. Maybe standing next to the big loudspeakers was not a good idea after all. Well, let’s first take a shower, the beep will be gone during the course of this lazy Sunday.

Or not… Imagine this beep will stay with you. Always. More than a million people in Holland suffer from a disease called Tinittus. In about 10% of the cases the beep (or noise) is so loud that it limits them in their daily life. No effective treatment exists until today. But we are working on it. Brain stimulation can be an effective treatment method. And in our group we are developing the ‘uStim’-stimulator: it can stimulate the brain in a unique manner so that we can stop the beep. We use technology to manipulate faulty activity in the brain.

Sounds interesting? Keep reading this blog for updates about this little device. Oh, and keep enjoying yourselves on (Saturday) nights. But just as with all things in life: keep it safe. Unless you are watching the World Championships Ice Skating. I cannot think of any way how you can harm yourself while doing that…

Marijn van Dongen 

"Electrical stimulation of certain hypothalamic regions in cats and rodents can elicit attack behaviour," is what we can read in Nature today. But also "Neurons activated during attack are inhibited during mating, suggesting a potential neural substrate for competition between these opponent social behaviours." If the same holds for human beings, which is highly probable, then we are not far away from the situation in which we can replace Cialis by a healthy dosis of instant neurostimulation or switch the neurostimulator to Arousal Mode No. 2 to beat the guy that left the bar with another one’s girlfriend. As long as they do not take my Erdinger, I’m fine.

© Thinkstock

Jokes aside, it is known that both regions in the brain are closely located to one another, together with the part that controls voluntary urination. So my advice: don’t try this at home.

It looks like the best way to detect the onset of an epileptic insult is by doing a wavelet transform on the acquired ECoG. However, which morphological features to look at is far from trivial. For the first generation of closed-loop neurostimulators it is therefore probably best to acquire the complete ECoG signal at full resolution and do the morphological analysis in the digital domain entirely. In a later phase, the (analog) frontend (sense amplifier) can be made more specific, thereby releasing the burden from the analog-to-digital converter and the signal processing in the digital domain.