Year: 2007

Musicogenic epilepsy is a neurological disorder where epileptic seizures are uncontrollably triggered by music. Gloria Estefan’s Dr Beat is a catchy 80s pop song where she calls for medical assistance because music is irresistibly moving her body, moving her soul and affecting her brain.

Coincidence? I think not.

Doctor, I’ve got this feelin’ deep inside of me, deep inside of me
I just cant control my feet, when I hear the beat
when I hear the beat
Hey doctor, could you give me somethin’ to ease the pain
cause if you dont help me soon gonna lose my brain
gonna go insane

Despite Ms Estefan’s requests, painkillers are unlikely to help with the acute effects of seizure.

First-line treatment is usually a rapid acting benzodiazepine and long-term stabilisation with a common anticonvulsant such as sodium valproate.

While her concerns about her mental health are understandable (people with epilepsy are at a slightly higher risk of developing mental illness), the majority of people with the condition lead full and active lives, so her fear of insanity is largely unfounded.

There are many cases of musicogenic epilepsy in the medical literature but, unfortunately, only a few few are freely available online. One is particularly interesting though and is available as a pdf file.

It’s a 1957 article published in Psychosomatic Medicine that reports three fascinating cases, including a girl who had her seizures triggered by swing music that induced, among other things, hallucinations of a smartly dressed couple.

For those of you wanting something a bit more up-to-date though, YouTube has the a Dr Beat Mylo remix Dr Who video mashup. Same symptoms, new medical staff.

pdf of ‘Musicogenic Epilepsy: Report of Three Cases’.
Link to Dr Beat lyrics.
Link to original Dr. Beat video.
Link to Dr Beat remix Dr Who tribute mashup.

The Financial Times has a slightly bizarre article on the application of neuroscience to architecture that suggests that we’re genetically predisposed to feel relaxed around flowers, the hearth and food, and that homes need to be designed to release certain neurotransmitters.

The piece is about the Academy of Neuroscience for Architecture (ANFA) which aims to use neuroscience in building design and encourage brain research into the effects of buildings.

I’m all for the wider application of neuroscience, and I’m sure there are some relevant findings that could be applied, but the article is full of so many erroneous brain clich√©s that I just despair.

Zeisel is also a director of the Academy of Neuroscience for Architecture (ANFA), an organisation launched in 2003 to encourage scientists to get out of the lab and partner with architects and designers. “It’s the future of the field,” he says. “People might ask what neuroscience has to do with designing an ’emotional’ house but our emotions are managed by our brain,” Zeisel says. “When our brains are happy a certain endorphin gets released, so we need to design homes in order to release that neuro-transmitter.”

Endorphins are the brain’s natural opioids and are released in a wide variety of situations. They are indeed released when we feel pleasure, but are also released when we feel stress or pain.

So designing homes to maximise the release of endorphins will just as likely lead to uncomfortable, stressful hell-holes.

Take our desire for eye contact with others as an example. “A couple of million kitchens are planned each year and probably only about 5 per cent obey the most basic principles for human communication,” [kitchen designer!] Grey says. In most, the person preparing the food at the sink, stove or counter has to face away from his or her family or guests, decreasing sociability in what should be a social zone. “As a result the brain continues to produce adrenalin and cortisol, the hormones associated with fear and anxiety,” he says. “Whereas if they are facing [into the room] then oxytocin, the bonding hormone, and serotonin, associated with relaxation and enjoyment, are released.”

So, it not only makes the common but false link between specific mental states and general neurotransmitters, makes unproven claims between specific activies and the release of these neurotransmitters, but also makes the unsupported claim that facing away from people in the kitchen causes fear and anxiety, while facing towards them causes relaxation and enjoyment.

Zeisel suggests that responses to some features of the home might even be innate. “We are born with genetically developed instincts that make us feel relaxed around flowers, the hearth, food and water,” he says. “It’s simply an emotional need and using those things in the environment will make us feel more comfortable.” On the flip side, places that seem too sterile or too confusing are perceived as dangerous, which can trigger the hypothalamus to release stress hormones.

There’s no evidence that we are genetically predisposed to feel relaxed around “flowers, the hearth, food and water”. Perceiving things are dangerous does indeed lead to the release of stress-related hormones, but there’s no evidence that ‘confusing’ or ‘sterile’ buildings do this.

Of course, buildings that are ‘too sterile’ or ‘too confusing’ might do, but therein lies a circular argument, because you’ve already defined them as having a negative influence.

Professor Joan Meyers-Levy of the University of Minnesota’s Carlson School of Management is another academic interested in how our surroundings affect our physical and mental states. Her research shows that when people are in a room with high ceilings, it activates sections of the right brain associated with freedom and abstract thinking. In low-ceilinged rooms, more constrained thinking is brought to the fore. “There’s a preference in terms of real estate for high ceilings and it‚Äôs [not only] the sense of power and wealth that conveys but also [the fact that] vertical space could have a beneficial mental influence,” she says.

To be completely fair to Meyers-Levey, her study [pdf] was a perfectly reasonable investigation into the effect of ceiling height on priming – an effect where an initial stimulus quickens your ability to react to related things.

However, the brain is not even mentioned in the paper, let alone measured in any way. The bit about high-ceilings activating the ‘right brain’ has just been added, seemingly from nowhere, by the journalist.

Two papers were recently published in Cell about the application of neuroscience to architecture, but importantly, they speculate, but don’t actually reference any studies that have looked at the influence of building design on the brain. The article then goes on to repeat several of the speculations as fact.

I think the article may be a candidate for the Dr Alfred Crockus Award for the Misuse of Neuroscience.

As an aside, Crockus fans may be interested to hear that he’s been tracked down to the hitherto unknown but undoubtedly endorphin stimulating ‘Boston Medical University Hospital’.

UPDATE: Christian just reminded me that he wrote an article for The Psychologist late last year that looked at how psychology is being increasingly used in architecture. It also discusses specific scientific research on psychology and building design. It’s an excellent antidote to the Crockus from the FT.

Link to ropey FT article.
Link to Psychologist article ‘Is there a psychologist in the building?’.

YouTube hosts a classic video of one of the famous ‘split-brain’ patients who had his corpus callosum surgically cut to treat otherwise untreatable epilepsy, effectively separating the two hemispheres of the brain.

This procedure is intended to stop seizures spreading across the brain and its effects were first studied in depth by Roger Sperry, who won a Nobel prize for his work demonstrating that the patients experienced, in certain situations, a sort of split consciousness.

Split-brain patients have been incredibly important in cognitive neuroscience, because the procedure prevents information travelling from one side of the cortex to the other.

The left-most and right-most areas of your vision go directly to the opposite hemisphere, and the same goes for touch information from your hands. Information from the left hand goes to your right hemisphere and vice versa.

In people who have an intact corpus callosum, the information is then communicated to the other hemisphere as well, so the whole brain has access. In split-brain patients, only one hemisphere has access.

Sperry worked with neuropsychologist Michael Gazzaniga who used this effect to demonstrate how each hemisphere could be specialised for different functions.

In the video, Gazzaniga runs Joe, a split-brain patient, through one of these experiments and demonstrates various interesting effects.

For example, it shows how Joe can read words that appear to the right because they get transmitted to the left hemisphere which is specialised for language.

However, Joe can’t read words that appear to the left, because they get transmitted to the language-limited right hemisphere, but he can draw what the word describes with the appropriate hand, because the right hemisphere is specialised for spatial functions.

He can then look at his own picture, making the information available to the left hemisphere, and only then can he name it.

There have been many variations on these experiments that have demonstrated a number of curious effects about brain specialisation and consciousness, some of which are described in a Scientific American article by Gazzaniga.

One of the most interesting things is that the patients don’t feel that their conscious mind is any different, but their split consciousness can be demonstrated experimentally, as shown in the video.

Link to split-brain video.
Link to copy of SciAm article ‘The Split Brain Revisited’.

A paper in the British Journal of Oral and Maxillofacial Surgery reports on a remarkable case of a man who tried to commit suicide with a crossbow and shot an arrow through his neck into his brain. Thankfully he survived with seemingly little long-term impairment.

The arrow missed all major blood vessels and did not seem to seriously damage any crucial brain areas, although the gentleman lost some sight due to severing part of the optic nerve.

The case report reads:

A 25-year-old man, presented to the accident and emergency department, after having fired an 18-inch arrow with a metal point from a crossbow just beneath his chin in an attempt to kill himself.

He was known to be addicted to cocaine, was depressed, and had been feeling low for several months. He had tried to explain his state of mind to his girlfriend, and a month later he attempted suicide.

The entry point of the arrow was apparent through the anterior part of the neck, and close to the midline. There was no active bleeding. The arrow crossed the mouth and had passed behind the soft palate, which resulted in mechanical trismus and therefore a potentially difficult intubation.

Nasotracheal fibreoptic intubation [camera through the nose] was eventually completed. With the patient anaesthetised, plain radiographs and computed tomograms (CT) were taken urgently; these showed that the arrow had passed up through the brain, and the tip was protruding through a comminuted fracture of the skull vault.

In view of the location, and to assess soft tissue damage further, a magnetic resonance cerebral angiogram was taken, which showed the anatomy clearly, in particular no vascular injury.

The patient was therefore transferred to the nearest neurosurgical centre for definitive treatment. Under general anaesthesia and together with the maxillofacial surgeons, the arrow was withdrawn gently along the precise path of its insertion. This was followed by profuse bleeding from behind the soft palate and base of skull, which had been anticipated and was controlled by a post-nasal pack. No further intervention proved necessary.

His recovery was uneventful, but he lost the sight in his right eye as a result of damage to the right optic nerve. No other neurological deficit was documented. The patient was given psychiatric care for several months for further management of his depression, which had been the cause of his attempted suicide.

Link to PubMed entry for case report.

A funny article in the medical journal Headache discusses Harry Potter’s difficulties with what seems to be a recurrent migraine. This isn’t the first time that Harry has turned up in the medical literature. In fact, he’s made almost 20 appearances so far.

However, this is the first to consider his neurological problems in detail:

Harry Potter and the curse of headache.

Sheftell F, Steiner TJ, Thomas H.

Headache. 2007, Volume 47, Issue 6, p911-6.

Headache disorders are common in children and adolescents. Even young male Wizards are disabled by them. In this article we review Harry Potter’s headaches as described in the biographical series by JK Rowling. Moreover, we attempt to classify them. Regrettably we are not privy to the Wizard system of classifying headache disorders and are therefore limited to the Muggle method, the International Classification of Headache Disorders, 2nd edition (ICHD-II; pdf). Harry’s headaches are recurrent. Although conforming to a basic stereotype, and constant in location, throughout the 6 years of his adolescence so far described they have shown a tendency to progression. Later descriptions include a range of accompanying symptoms. Despite some quite unusual features, they meet all but one of the ICHD-II criteria for migraine, so allowing the diagnosis of 1.6 Probable migraine.

The young wizard also appeared in a recent fMRI study [pdf] that investigated which brain areas would be most active when children and adults thought about themselves compared to others.

In the study, participants were brain scanned while being shown short descriptions and were asked to indicate whether they best described themselves or someone else.

One difficulty is that the ‘someone else’ needs to be well known to both children and adults, so Harry Potter was chosen.

In the final study, when participants judged that the phrase described themself, rather than Harry, the medial (midline) part of the frontal lobes were relatively more active.

Interestingly, this area was significantly more active in children than adults, possibly suggesting that this task requires more effort for children and becomes easier as we age.

Link to PubMed entry for Harry Potter headache article.
Link to abstract of self vs other study.
pdf of self vs other study.

An article in this week’s Science News discusses whether the brain stem may play a more central role in consciousness than it’s usually given credit for.

It focuses on children with hydranencephaly, a where the cortex fails to develop in children and instead, the space is filled with cerebral spinal fluid.

Typically, affected children survive only a few months after birth, but those that do survive seem to remarkably more conscious than you would guess based on theories that suggest the cortex is where all the action happens to support consciousness.

Swedish neuroscientist Bjorn Merker wrote an article [pdf] in February’s Behavioural and Brain Sciences journal arguing that these cases suggest we need to rethink our ideas about how the brain supports conscious thought, and perhaps, even consciousness itself.

Merker argues that the brain stem supports an elementary form of conscious thought in kids with hydranencephaly. It also contains auditory structures capable of preserving hearing in someone without a cortex. In contrast, optic nerve damage in hydranencephaly frequently impairs vision, regardless of what the brain stem does.

Self-awareness and other “higher” forms of thought may require cortical contributions. But Merker posits that “primary consciousness,” which he regards as an ability to integrate sensations from the environment with one’s immediate goals and feelings in order to guide behavior, springs from the brain stem.

If he’s right, virtually all vertebrates‚Äîwhich share a similar brain stem design‚Äîbelong to the “primary consciousness” club. Moreover, medical definitions of brain death as a lack of cortical activity would face a serious challenge. At the very least, physicians could no longer assume that individuals with hydranencephaly don’t need pain medication or anesthesia during invasive medical procedures.

Link to Science News article ‘Consciousness in the Raw’.
pdf of BBS article ‘Consciousness without a cerebral cortex’.