2010-02-12 Spike activity

Quick links from the past week in mind and brain news:

Literary critic Marco Roth discusses the ‘rise of the neuronovel‘ on ABC Radio National’s Bookshow. Good discussion except he seems to think all reference to the brain is necessarily reductionist.

PsyBlog looks at research on why the media seems biased when you care about the issue – examining a study finding Pro-Israelis and Pro-Palestinians both report an identical news report is biased against them.

Why won‚Äôt the University of Washington release the data showing that ‘Baby Einstein’ DVDs slowed language development in children? BrainSpin investigates.

New Scientist reports that damage to the back part of the posterior lobe is more likely to lead to feelings of transcendence and spiritual experiences.

More draft DSM-V coverage: an excellent summary of the proposed changes at PsychCentral. Some more comments from New Scientist. It’s for psychiatrists only! says a debate in Psychiatric Times. Good coverage on the legal aspects from In the News.

The Washington Post discusses whether ‘learning styles‘ are scientifically supported or a convenient myth.

To the bunkers! Can battlefield robots take the place of soldiers? asks BBC News.

Neurotopia has some excellent coverage of a recent study on the ‘cocaine vaccine‘.

Can the power of thought stop you ageing? asks BBC News who cover Ellen Langer’s famous experiments in an old folks’ home. Also tackled briefly in a recent Horizon documentary on ageing *cough*torrent*cough*

The Frontal Cortex has a wonderfully lucid piece on a new study finding that the amygdala may be involved in loss aversion – the effect where we put more energy into avoiding losses than acquiring gains.

The older the age of parents at conception, the greater the risk of autism, according to a new study discussed in The New York Times. Although it’s worth saying that even in older patients the chances of your baby developing autism are still very small.

New Scientist reports on a new campaign to get neuroscientists to sign a peace pledge against the militarisation of brain science.

The clean smelling Ed Yong reports on research finding that clean smells promote generosity and fair play while dark rooms and sunglasses promote deceit and selfishness over at Not Exactly Rocket Science.

The Times previews research suggesting that Autism and Asperger’s may be underdiagnosed or wrongly diagnosed in women.

Amnesic shellfish poisoning is memory loss that can be caused by a toxin found in shellfish. Neuroskeptic investigates the curious memory baffling poison.

Dr Petra has a great analysis of the changes to sexual disorders proposed in the draft DSM-V.

There’s an excellent report on NPR on the history of ‘child bipolar disorder’ and its slap down in the draft DSM-V by the brilliant Alix Spiegel.

Terra Sigillata has some excellent background on one of the legislation avoiding ‘synthetic marijuana’ products recently to hit the market.

Bolivia launches Coca Colla, a remake of the popular soft-drink that puts genuine coca-leaf extract back in the recipe, according to The Telegraph.

Slate has an article on how an irrational fear of baby-snatching on maternity wards is driving extreme security measures.

We know you got flow. The BPS Research Digest covers a study on ‘social flow’, when you’re in the zone with your social life.

NHS Choices has a fantastic video where Ben Goldacre explains the placebo effect.

The first prototype of light controlled brain implants for humans is sort-of-announced by a neurodevice company, according to the EE Times.

Neuroanthropology rounds-up a special issue of Psychiatric Times on cross-cultural psychiatry.

Jared Diamond discusses the ‘natural experiments’ of human history in the ABC Radio National Book Show.

The Chronicle of Higher Education has a striking article about the experience of being a university professor during psychosis.

A worry study on the influence on US ‘war on drugs’ aid in Colombia is discussed over at Slate.

“There is no such thing as sexual intercourse”. Pascal Boyer has a stinging critique of post-modern ‘de-constructions’ in the social sciences over at Culture and Cognition.

BBC News covers the research on time perception and enjoyment.

The burglar with the lemon juice disguise

I’ve just re-read the classic study “Unskilled and unaware of it” which established that when we’re incompetent at something we’re often so incompetent that we don’t realise that we’re incompetent. I had forgotten that it starts with a wonderful story about an inept bank robber.

In 1995, McArthur Wheeler walked into two Pittsburgh banks and robbed them in broad daylight, with no visible attempt at disguise. He was arrested later that night, less than an hour after videotapes of him taken from surveillance cameras were broadcast on the 11 o’clock news. When police later showed him the surveillance tapes, Mr. Wheeler stared in incredulity. “But I wore the juice” he mumbled. Apparently, Mr. Wheeler was under the impression that rubbing one’s face with lemon juice rendered it invisible to videotape cameras (Fuocco, 1996).

We bring up the unfortunate affairs of Mr. Wheeler to make three points. The first two are noncontroversial. First, in many domains in life, success and satisfaction depend on knowledge, wisdom, or savvy in knowing which rules to follow and which strategies to pursue. This is true not only for committing crimes, but also for many tasks in the social and intellectual domains, such as promoting effective leadership, raising children, constructing a solid logical argument, or designing a rigorous psychological study. Second, people differ widely in the knowledge and strategies they apply in these domains (Dunning, Meyerowitz, & Holzberg, 1989; Dunning, Perie, & Story, 1991; Story & Dunning, 1998), with varying levels of success. Some of the knowledge and theories that people apply to their actions are sound and meet with favorable results. Others, like the lemon juice hypothesis of McArthur Wheeler, are imperfect at best and wrong-headed, incompetent, or dysfunctional at worst.

Perhaps more controversial is the third point, the one that is the focus of this article. We argue that when people are incompetent in the strategies they adopt to achieve success and satisfaction, they suffer a dual burden: Not only do they reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it. Instead, like Mr. Wheeler, they are left with the mistaken impression that they are doing just fine. As Miller (1993) perceptively observed in the quote that opens this article, and as Charles Darwin (1871) sagely noted over a century ago, “ignorance more frequently begets confidence than does knowledge” (p. 3).

This effect has since been named the Dunning-Kruger effect after the authors of the study.

Link to PubMed entry for study.

Broken hearted

Photo by Flickr user Gabriela Camerotti. Click for sourceThe Wall Street Journal has an article on a curious medical condition called ‘broken heart syndrome’ where grief or strong emotion seems mimic a heart attack.

The piece starts with a case description of a lady who had just experience the death of her husband from a heart attack and her reaction which seemed to also be a heart attack:

When doctors performed an X-ray angiogram expecting to find and treat a blood clot that had caused Mrs. Lee’s symptoms, they were surprised: There wasn’t any evidence of a heart attack. Her coronary arteries were completely clear.

Doctors eventually determined that Mrs. Lee had suffered from broken-heart syndrome, a name given by doctors who observed that it seemed to especially affect patients who had recently lost a spouse or other family member. The mysterious malady mimics heart attacks, but appears to have little connection with coronary artery disease. Instead, it is typically triggered by acute emotion or physical trauma that releases a surge of adrenaline that overwhelms the heart. The effect is to freeze much of the left ventricle, the heart’s main pumping chamber, disrupting its ability to contract and effectively pump blood.

The condition is also known as Takotsubo cardiomyopathy and it’s probably worth saying that the idea that the condition is caused by a spike of adrenaline is still under debate although the WSJ article does a good job of looking at alternatives further down the piece.

Link to WSJ on ‘broken heart syndrome’ (via @dreamingspires)

The draft of the new ‘psychiatric bible’ is published

The draft version of the American Psychiatric Association’s DSM 5, the psychiatric ‘bible’ that defines the revised criteria for diagnosing mental illness, has finally been published.

It’s a masterpiece of compromise – intended to be largely backwardly compatible, so most psychiatrists could just get on diagnosing the few major mental illnesses that all clinicians recognise in the same way they always did, with some extra features if you’re an advanced user.

One of the most striking extra features is the addition of dimensions. These are essentially mini questionnaire-like ratings that allow the extent of a condition to be numerically rated, rather than just relying on a ‘you have it or you do not’ categorical diagnosis.

For example, the proposed dimension of emotional distress in depression is available online as a pdf and you will recognise the format if you’ve ever filled out a mood questionnaire. Take this item for example: “I felt worthless…” Never / Rarely / Sometimes / Often / Always.

One of the most striking changes is to the diagnosis of schizophrenia, which, although the core features remain the same, has changed radically in some ways. This is interesting because many people thought it would be largely untouched with just the addition of dimensions, but actually it’s been fundamentally restructured.

For many years, schizophrenia has been divided into various subtypes: paranoid schizophrenia, disorganised schizophrenia, catatonic schizophrenia, and the like, that reflect different symptom profiles.

The subtypes are currently a mess. It’s possible for two people to be diagnosed with schizophrenia with not a single psychological symptom in common and the groupings were made on a rather ad-hoc basis.

In the draft version the subtypes have been completely eliminated and instead, the replaced by dimensions, reflecting the fact most of the symptoms occur in different patients at different severities and that symptom profiles can change over time.

There is also a long overdue fix. Catatonic schizophrenia is a subtype that describes a pattern where patients have movement problems: catatonia – like being ‘frozen’ in one place or having an unusual symptom called waxy flexibility where no movement is initiated but if a limb is moved, it just stays there – a bit like a bendy doll.

It’s an unusual condition that was first described by the psychiatrist Karl Kahlbaum in 1874, but which isn’t actually specific to schizophrenia. In fact, it is more likely to turn up alongside severe depression and bipolar disorder, or in some types of brain damage, and is treated in a completely different way to schizophrenia, responding best to anti-anxiety drugs and ECT.

For reasons of misguided convenience, and against the best knowledge that was around for a century, it got classified as a subtype of schizophrenia. In a move that will have older psychiatrists rolling their eyes in a ‘I told you so’ sort of way, it is now a specifier that can just be plonked onto pretty much any other diagnosis if it occurs.

One of the changes likely to have the widest and most controversial effects is the creation of the ‘Psychosis Risk Syndrome‘ – a sort of something’s-a-bit-strange-but-you’re-not-completely-mad state, where people might have hallucinations, delusion-like ideas and disorganised thoughts, but not to the extent that they are completely disabled by them.

This is drawn from research on what has been called the ‘prodromal’ or ‘at risk’ mental state with the hope that it could identify and treat patients before they become properly psychotic.

One difficulty is that only about a third of people identified as being ‘at risk’ actually become psychotic at a later date. This wouldn’t be particularly worrying were it not for the fact that people in this ‘at risk’ state (perhaps better called 1-in-3 chance state) are often prescribed antipsychotic drugs.

As the first effective treatment for madness, antipsychotics are some of the most important drugs in medical history, but they are also some of the most toxic with long-lasting effects on the body and brain. The thought of giving them out to large numbers of people who might never become psychotic frightens many.

There is also the issue that this diagnosis might pathologise lots of eccentric but perfectly functional people. Research has shown that about %10 of Joe Public have higher levels of hallucinations and delusion-like ideas than the average psychotic inpatient but are rarely bothered by their experiences.

In other words, lots, and I mean lots, of people have unusual experiences – hearing voices, magical ideas, expansive moments – that never cause them any problems, but these people could now be diagnosed with a form of not-quite-mental-illness.

The other diagnoses that have received a radical rethink are the personality disorders which have been completely reconceptualised. Interestingly, the idea has been brought more in line with psychological definitions of personality and the consequent disorders are described as being disruptions to the self (identity integration, integrity of self-concept, and self-directedness) and interpersonal relations (empathy, intimacy and cooperativeness, and complexity and integration of representations of others).

A new child diagnosis of Temper Dysregulation Disorder with Dysphoria has been added. If this seems unremarkable it’s actually big slap in the face for a small but vocal group of US psychiatrists who have been pushing the idea of ‘child bipolar disorder’ – arguing that sad children who have tantrums are showing a juvenile form of ‘manic depression’.

This has become popular, almost entirely in the US, and has led to the alarming rise in children taking antipsychotics. The LA Times reports that this new diagnosis has been created in large part to stop kids being diagnosed with child bipolar. That’s the slap.

Many of the other changes are largely bug fixes. The much discussed change where Asperger’s syndrome and autism have been combined into autism spectrum disorder fixes the anomaly that the only difference between Asperger’s and high functioning autism was a technical point about what age the child started talking.

Post-traumatic stress disorder has been tightened up so it doesn’t rely solely on someone’s self-definition of trauma, preventing PTSD being diagnosed after seeing disasters on TV or after being troubled by upsetting but everyday events, such as insults at work.

The sexual disorders see quite a few additions including hypersexual disorder, that attempts to define being too interested in sex as a mental illness, and paraphilic coercive disorder, that is likely to cause legal controversy as it defines being turned on by forcing people into sex as a psychiatric problem, rather than a moral failing.

Binge-eating disorder has been added, addiction diagnoses for specific drugs have been created (included cannabis withdrawal), gambling addiction has been added, and the manual mentions ‘internet addiction’ in the non-committal, we need more information category.

Another interesting change is to conversion disorder, traditionally known as ‘hysteria’, where medical symptoms appear – such as paralysis – without the usual tissue or nerve damage. The Freudian theory is that the mind is ‘converting’ trauma into physical symptoms to protect consciousness from the mental pain, but the last remnants of Freud have been removed.

Previously, the clinician had to attribute motivations, unconscious or otherwise to the symptoms, but now they just have to appear without being explained by “a general medical condition, the direct effects of a substance, or a culturally sanctioned behavior or experience”.

The related cluster of dissociative and somatoform disorder have also been subtly de-Freuded, as American psychiatry presumably wishes to finally put the old Viennese ghost to rest.

As for the scientific basis of the disorders as distinct separate entities rather than somewhat cobbled together pragmatic descriptions, a quote in The New York Times article hits the nail on the head:

The good news, said Edward Shorter, a historian of psychiatry who has been critical of the manual, is that most patients will be spared the confusion of a changed diagnosis. But “the bad news,” he added, “is that the scientific status of the main diseases in previous editions of the D.S.M. — the keystones of the vault of psychiatry — is fragile.”

Link to draft version of the DSM-V.
Link to Washington Post coverage.
Link to New York Times coverage.
Link to LA Times coverage.
Link to Wall Street Journal blog coverage.
Link to NPR coverage via Integral Options Cafe.

On a literary trip

The Guardian books blog has a fantastic short piece on fictional mind-bending drugs from literature, stretching from the nightmare-inducing hallucinogens of William Burroughs to Pan Galactic Gargle Blaster from Hitchhikers’ Guide to the Galaxy.

The most famous invented drug is probably soma in Aldous Huxley’s Brave New World. It was an integral part of the story because it was an integral part of the authorities’ control mechanism ‚Äì they were literally keeping the people doped up and happy. Sounds alright to me: a permanent state of blissed-out semi-catatonia. In fact, given my choice of fictional narcotics, soma would probably be first.

Nor would I mind sampling some melange/spice from Frank Herbert’s Dune (long life, heightened awareness and possible extrasensory properties, cool blue eyeballs); septus from Iain Banks’s Transition (the ability to flit between parallel worlds and inhabit others’ bodies); Dylar from Don DeLillo’s White Noise (no more fear of death); the various hallucinogens drunk with the old moloko in A Clockwork Orange (a nice quiet horrorshow starring Bog and all his angels); Can-D in Philip K Dick’s The Three Stigmata of Palmer Eldritch (allows you to participate in a group hallucination). I also quite like the sound of the Pan Galactic Gargle Blaster in Hitchhikers’ Guide to the Galaxy, described as “like having your brains smashed out by a slice of lemon wrapped round a large gold brick”. Well, it beats aspirin and sniffing exhaust pipes.

However, it misses out one of the most wonderful examples: the feathers from Jeff Noon’s Vurt and Pollen novels that produce shared hallucinations that are a cross between Jung’s collective unconscious and the internet.

Link to ‘Literature’s most mind-blowing drugs’.

A varied diet

A 1964 article from the Archives of Surgery discusses how to treat psychotic patients who may have ingested inedible objects.

It reports on one remarkable case where the following list of objects was found in one patient’s stomach. They also helpfully provided a photo of all the objects laid out on a table.

Nickels (173), Pennies (161), Quarters (3), Dimes (26), Military buttons (22), Insignia clasps (5), Nails (50), Staples (5), Screws (16), Metal bolt (1), Metal nuts (4), Overall buckles (19), Metal cap top with keys (8), Lock key (1), Crucifix (2), Bottle caps (2), Knife handle (1), Fork handle (1), Spoon handle (1), Complete fork (bent double) (1), Dessert spoon (1), Rifle shell (unexploded) (1), Pieces of lead (14), Brass ball (1), Pieces of brass (3), Pins and needles (27), Watch parts (22), Broken earring (1), Rings with chain (2), Pieces of wire (7), Nondescript pieces of metal (16), Empty cigarette package (with tinfoil) (1), Official War Department letter (wrapped in cellophane) (1), Piece of glass (1), Streetcar tokens (2), Several small packages of cancelled postage stamps wrapped in cellophane.

Rifle shell? Blimey.

The persistent eating of inedible objects is known as pica although rarely does it occur in such as spectacular fashion.

Link to PubMed entry for 1964 study.

Brain skulls on the front, splatters on the back

You wait ages for a neuroscience-themed dress to appear (and believe me, I have) and then two come along at once.

After my discovery of neuro streetwear for the female fashonista last week, comes a brain themed tutu dress for the riotgrrl neuroscientist.

The description is actually quite poetic:

Brain skulls on the front, splatters on front and back. Distressed style: Imagery has unique cracks, splatters, smears, asymmetry, fading. Adjustable halter straps tie behind your neck for customizable fit. Shredded cotton ruffles underneath tulle ruffles to prevent see-through look. All garment edges raw (hemless) for a deconstructed / shredded look. Shredded cotton bust ruffles.

I have no idea what ‘shredded cotton bust ruffles’ are but surely a great name for an all-girl indie band.

Link to Brianskull tutu dress.

One Hundred Years of Memory Loss

Image from Wikipedia. Click for sourceNeurology journal Brain has a fantastic article on the close parallels between the effects of semantic dementia, a degenerative brain disease that causes the loss of memory for the meaning of words and objects, and the novel A Hundred years of Solitude where a magical disease affects villagers’ memory for ‘the name and notion of things’.

The novel is by the Nobel-prize winning Colombian writer Gabriel García Márquez and is famous for founding the magical realism style of fiction where fantastical things seem to happen in an otherwise ordinary world.

What is interesting about One Hundred Years of Solitude is that while the memory loss closely resembles the effects of semantic dementia, it was written before the condition was recognised by neurology.

Unfortunately, the article isn’t available online but this an excerpt from the article which captures the main themes:

In One Hundred Years of Solitude, García Márquez created a literary depiction of collective semantic dementia before the syndrome was recognized in neurology. The memory plague section of the novel also provides an inspiring and human account of one town’s fight against “the quicksand of forgetfulness”.

Why does García Márquez envision a world in which people lose their ability to communicate the names of everyday things? He gives some insight into his use of magical realism in the opening lines of the novel, in which he describes the village of Macondo in its earliest days: “the world was so recent that many things lacked names, and in order to indicate them it was necessary to point”. With this description, García Márquez implies that the ability to assign a name to an everyday object is a defining human achievement that has developed over time. In this light, the insomnia plague forces Macondo villagers into a primitive state by robbing them of their ability to remember “the name and notion of things”.

Remarkably, García Márquez’s probing investigation of the power of words and everyday names leads him to a striking literary enactment of the clinical syndrome of SD [semantic dementia] and the problems faced by SD patients. His fictional characters, just like the SD patients discussed here, are acutely aware of the “infinite possibilities of a loss of memory”. Both patients and characters attempt to preserve semantic meaning in more permanent forms that are free from the devastating effects of a neurodegenerative process and a fantastical plague. As such, García Márquez achieves a masterful portrayal of SD not just in his description of the plague’s ravaging effects on semantic knowledge, but even more vividly in his account of the affected people’s ability to maintain hope through various coping strategies – to preserve their fragile self-identity in the pages of word lists and pocketbook diaries.

 
Link to PubMed entry for article.

Nine Legendary Hypochondriacs

ABC Radio National’s Late Night Live has a fascinating discussion with the author of a new book on nine famous hypochondriacs: James Boswell, Charlotte Bronte, Charles Darwin, Florence Nightingale, Alice James, Daniel Paul Schreber, Marcel Proust, Glenn Gould and Andy Warhol.

I’m not sure Daniel Paul Schreber is necessarily the best example of someone with hypochondria is he is famous for writing a personal account of being genuinely mentally ill and floridly psychotic. However, I’ve not read the book and the programme focuses on better known figures so I am open to being convinced (certainly his delusions included lots of beliefs about his body changing in curious ways).

Link to Late Night Live on hypochondria.

Bonuses generate more heat than light

The engaging behavioural economist Dan Ariely has just become a columnist for Wired UK and in his first article he describes how the promise of performance-related pay often backfires leading people to do more but perform worse.

To see the effect of bonuses on performance, Nina Mazar (assistant professor of marketing, Toronto University), Uri Gneezy (professor of economics and strategy, University of California, San Diego), George Loewenstein (professor of economics, Carnegie Mellon, Pennsylvania) and I conducted three experiments. In one we gave subjects tasks that demanded attention, memory, concentration and creativity. We asked them, for example, to assemble puzzles and to play memory games while throwing tennis balls at a target. We promised about a third of them one day’s pay if they performed well. Another third were promised two weeks’ pay. The last third could earn a full five months’ pay. (Before you ask where you can participate in our experiments, I should tell you that we ran this study in India, where the cost of living is relatively low.)

What happened? The low-and medium-bonus groups performed the same. The big-bonus group performed worst of all.

Link to ‘Bonuses boost activity, not quality’ in Wired UK.

Full disclosure: I’m a contributing editor to Wired UK. I have never received a bonus in my life, but if I do, I hope to spend it beautiful on women and fast cars, although, in reality, I will probably buy a laptop.

2010-02-05 Spike activity

Quick links from the past week in mind and brain news:

Sex addiction is a feminist victory, according to an article in Slate, apparently because it allows man shaming. Malevolence-based medicine rears its ugly head.

The BPS Research Digest covers research finding CBT-based self-help books might do more harm than good for people who worry a lot.

The public are asked for their opinion on the recent news that The Lancet retracts the Wakefield autism paper, by The Onion.

Neurophilosophy has an excellent piece on big news that the first evidence for navigation essential grid cells in the human brain.

Why does time fly by as you get older? NPR has a great segment that tackles the cognitive science of changing time perception with age.

Neuroskeptic has an excellent piece on a new fMRI scanning technique that manages 10 scans a second over a thin slice. If you’re not reading Neuroskeptic, you should be, it’s great.

Any Freemasonry in the family? The Independent has a piece on one man’s experience of trying gay ‘conversion’ ‘therapy’ in the UK.

The Economist looks to the February 10th release of the first draft of the new psychiatric manual, the DSM-V. Doesn’t mention that it is likely to unleash a bun-fight of biblical proportions.

Mind Hacks is a top 30 science blog according to The Times and a top 100 blog for psychology students according to News42. Shakira todavía no me ha llamado.

H+ Magazine covers the announcement that the next $10 million X Prize is for a brain-computer interface. I shall propose ‘fingers’ as my entry.

There’s a thought-provoking piece on whether racism is partly due to perceptual illusions over at The Vision Revolution.

Fora.tv has an excellent talk about the new book ‘The Harvard Psychedelic Club’ about how the psychedelic revolution emerged from the Harvard psychology department, based on the new book of the same name.

Reactive action is quicker action, according to research covered by Not Exactly Rocket Science.

Nature has an excellent short article on writer Jorge Luis Borges interest in neuroscience but it’s locked behind a paywall because this information can kill! It’s for your own good.

“We have buried Trials 15, 31, 56…” The Carlat Psychiatry Blog covers jaw-dropping evidence of drug companies Eli Lilly, AstraZeneca hiding evidence and lying about drug harm.

The Daily Mirror has a poor write-up but a genius headline over the recent internet and depression flap: “Does being inter the net bring you down loads?”

Is Telephony Making Us Stupid? Carl Zimmer’s The Loom covers Mark Twain’s article about the dangers of the telephone.

NPR has a good short piece on Haiti, imposing Western ideas about <a href="Mental Health Disaster Relief Not Always Clear Cut
http://www.npr.org/templates/story/story.php?storyId=122981850&ft=1&f=1001″>trauma and how some treatment can do more harm than good.

Teaching abstinence makes teens delay sex? Dr Petra presents the evidence behind the media hype.

The Washington Post reports that the US Defense Department starts an investigation into military mental health care after an exposé by Salon.

A new London exhibition on the history of the ‘Bedlam’ hospital and the development of mental health care in the UK is covered by The Guardian. Only runs until February 12th.

In the News is a fantastic forensic psychology blog.

The founder of the Baby Einstein sues the university for access to raw data for a study reporting that the DVDs actually slowed language development, reports Advances in the History of Psychology.

Eureka brain special and more fighting

The Times has just released its monthly science magazine, Eureka, with a special issue on the brain and all the articles freely available online.

There doesn’t seem to be a way to link to a whole issue, but inside you’ll find an excellent piece on the use of transcranial magnetic stimulation (TMS) to temporarily switch off bits of the working brain, a profile of neurosurgeon Huma Sethi, an article on commercial brain-computer interfaces, a remarkable piece on how old injuries can ‘return’ to affect phantom limbs as well as an exploration of the link between brain activity and sporting skill.

Probably my favourite is an article on how forensic science and criminology are increasingly using neuroscience, and there’s also an account of a writer’s experience of being brain scanned and a description of the Total Recall project which aims to digitally record everything about day-to-day life.

There’s also a piece by me, where I go to head-to-head with Baroness Susan Greenfield in the Fight Club section where we debate ‘Is screen culture damaging our children‚Äôs brains?’.

Greenfield goes for the usual “maybe.. perhaps… could it be?… tada! compulsive gambling and schizophrenia!” argument, so I hope I’m a little more evidence-based. Anyway, you can read for yourself.

I also debated exactly the same thing with psychologist Tracey Alloway live earlier today, and you can read the transcript here. It’s more in-depth but is less coherent and has typos and bad jokes.

Also don’t miss out on the fantastic downloadable brain poster, which is available online as a (big) jpg file.

I’m still reading through all the articles but the ones I’ve read so far have been excellent. A motherlode of neuroscience reading.

Time to think

Bioemphemera has found some wonderfully left-field brain illustrations by Dutch graphic designer Rhonald Blommestijn. The image on the left is a brain made out of clocks.

Blommestijn’s blog is full of strikingly surreal eye-candy that manages both to inspire a feeling of wide-eyed wonder and illustrate scientific themes.

They’re certainly very original takes on the subject and the neuroscience images are particularly vivid.

Link to Bioephemera on Blommestijn’s brain illustrations.
Link to Blommestijn’s blog.

On communicating through the coma-like state

A study just published in the New England Journal of Medicine reports on how a subset of patients diagnosed as being in a coma-like state can be trained to show specific brain activity to answer yes / no questions despite seeming to be unconscious and unresponsive.

Many news reports seem to suggest that researchers have found a way of ‘reaching inside coma’ with a brain scanner to communicate with patients but the findings are much more modest, only 5 out of 54 patients could reliably produce specific brain activity on command and only one was tested who could answer simple yes / no questions in this way.

Despite this, the study is still incredibly impressive and it indicates that some patients who seem unconscious may have a much richer inner life than we assume and it may be possible to communicate with some of them by measuring their brain activity.

The researchers put people in brain scanners and, in one condition, asked them to imagine standing still on a tennis court while swinging an arm to “hit the ball” back and forth to an imagined instructor, and in the other, to imagine navigating the streets of a familiar city or to imagine walking from room to room in their home. These were chosen because they show distinct patterns of brain activity on a scan.

This was tested both on healthy people, for a comparison of how activity should normally look, and in brain injured patients in a coma-like state.

Only 5 of the 54 patients responded with distinct brain activity, similar to the type found in all the healthy comparison participants, but in this subset, it indicated that they were likely following simple verbal commands.

This has been established before, but one criticism of these past studies was this this could just be an automatic response to the words in the command. We know that the brains of unconscious people respond briefly but automatically to words, even the person is not aware of hearing them.

The brain activity for the ‘tennis’ and ‘walking’ commands was much longer and more sustained than we might expect from the normal automatic response to words, so this was unlikely, but you might still argue that these are automatic, non-conscious responses.

To rule this out in one patient, the researchers asked six yes/ no questions about simple personal details and instructed the patient to imagine tennis for yes and walking for no.

Crucially, during the questions, the researchers prompted the patient with just the word “answer?”, meaning any different reactions that showed up couldn’t be just an automatic response to the word itself which was always the same.

Out of these six simple questions, the patient ‘responded’ correctly to 5, suggesting that they were genuinely understanding, considering and making a conscious response. This was in a patient who had no external signs of consciousness.

The scans for a couple of the questions are in the image above (click for a bigger version). You can see how different the responses are, but also how serious the brain damage is.

Importantly, these correct answers do not necessarily mean that the patient was completely mentally fine but ‘trapped’ their body. One common test used on definitely conscious patients after brain damage asks lots of these yes / no type questions (like “Do cinemas show films?” / “Are bottles edible?”) to test understanding.

Some patients can be fully conscious but their language so damaged that they can’t answer these questions, others can manage the less complex ones (the easiest are usually simple personal details) but not others, for the same reason.

All of the patients in coma-like states were clearly very brain damaged, so it could be that even the one who could make conscious responses might not have full understanding. On the flip side, it could also mean that some of the other patients may have been conscious but could not understand the task, and so did not show up on this test. You can see it’s a tricky area.

However, the discovery that it is possible to communicate, even in a simple terms, with a patient previously though to be in a coma is huge news and this research is likely to lead to further work trying to detect which patients are conscious and to develop methods to communicate with them.

Link to study summary in NEJM
Link to good write-up from New Scientist.

Neuro street wear

Herb is a hip Berlin fashion label who have a fantastic collection of women’s clothing with a subtle brain scan motif.

The label is the work of designer Angela Herb and there are actually two collections inspired by the MRI scan.

It’s definitely a street wear collection but the clothes have a wonderfully understated futuristic feel.

Unfortunately, it seems like clothes are exclusively sold through boutiques in Germany so you may have to contact the label directly if you want to get hold of something from outside the country.

We occasionally feature mind and brain t-shirts on Mind Hacks but rarely anything this stylish.

Link to Herb collection one.
Link to Herb collection two.

Death of a gladiator

Roman gladiators took part in one of the most brutal sports in history, many dying by traumatic brain injury during their matches. A medical study published in Forensic Science International examined the skulls of deceased fighters, discovered in a gladiator graveyard from Turkey, and reveals exactly how they died and even what weapons delivered the fatal brain injury.

The graveyard was discovered by archaeologists in 1993 but this study is the result of applying modern forensic medicine, which more typically attempts to discover the cause of death by looking at human remains after a crime, to the ancient bones.

Gladiator matches were not free for alls. Each gladiator had a certain attack and defence weapon combination, and these were matched between pairs of fighters so none had an unfair advantage. Men of equal, speed, strength and skill were also matched together to ensure a fair fight.

Since no point system existed, fighting was always pursued until a decisive outcome, which could be any of the following alternatives: defeat through death, defeat due to injury preventing further combat, defeat due to exhaustion, a win, with the bestowal of a palm branch or a laurel crown, or a draw, with both opponents being allowed to depart the Arena alive. This was the most unlikely case, since the superiority of one fighter had to be proved to enable the public to reach a verdict.

The final decision of the loser’s fate resided within the hands of the games‚Äô organizer. To this end he appealed to the mood of the plebs. Upon the cry of iugula (lance him through), it was expected of the vanquished that he would set an example of the greatness of manhood (exemplum virtutis) and would motionlessly receive the death thrust. The turning down of the thumb signified to the spectators, not that the gladiator should be put to death, but rather that the gladiator was dead.

After the final blow, arena servants carried the combatant on a stretcher into the carcass chamber and gave the twitching body a deathblow. It is not known exactly how this execution was performed. The executor, a costumed arena servant, associated with the Roman god of death “Dis Pater” or the Etruscan counterpart “Charun” carried a deadly hammer accompanying the gladiator on his last journey.

The first task of the investigators was to work out whether the damage to the skulls was due to an earlier blow the fighter survived, the death blow, or whether the bones had been damaged since the fighter was buried.

Living bone contains fluid-filled vessels, grease, and collagen fibres, which makes it more durable, flexible and, most importantly, it doesn’t splinter when broken. This allowed the research team to work out which skull fractures happened at the time of death. Furthermore, any sign of fracture healing shows that the gladiator survived the injury.

Once this had been established the researchers could start to match up the deadly fractures with the types of weapon they knew existed at the time.

Two examples of skulls are on the right, with the likely weapons that delivered the final blow illustrated in the white boxes underneath – one a hammer and the other a trident. These were identified by looking at the unique damage patterns caused by the impact of specific weapons.

Out of the 10 skulls with deadly fractures, the cause of death in 7 was a puncture wound from weapons such as a trident, javelin, pointed hammer or sword, and, interestingly, three were caused by being hit by the blunt force of a shield.

Deadly blows were either over the frontal area (above the eyes and forehead) or the parietal area (above and slightly behind the ears), whereas all the blows that the gladiators survived were at the front of the skull.

The researchers suggest that this is because death blows were usually given after the gladiator had been beaten and so were more likely to be from behind, whereas survivable blows were more likely to occur in training where less deadly weapons were used.

Link to PubMed entry for ‘Head injuries of Roman gladiators’.