Don’t get high on your own supply – enflurane edition

Another in our occasional series of articles on the importance of the motto “don’t get high on your own supply”. This edition concerns the case of an anaesthetist who was testing some of his own anaesthetics while driving.

From a case report from Forensic Science International:

A 42-year-old anaesthetist firstly was observed sitting in a parked automobile under a bridge, secondly 100 m further. Both times he was holding a handkerchief under his nose. Then he drove on and crashed into a lorry at a red traffic light.

After that an odd behaviour was noticed. The markedly affected physician put something trickle out of a small brown bottle in the handkerchief and inhaled the fumes. During the time interval until the arrival of the police he went asleep and could not be waked up without difficulties.

At first he did not take any notice of the police. Later he was extremly unsure, trembled from head to foot, staggered and swayed from site to site and clutched his car not to fall down. The handkerchief in his car smelled of the content of the brown bottle with the label Ethrane®

Enflurane is a type of ether, of which diethyl ether was an early inhaled anaesthetic.

It was one of the great discoveries of surgery although could be lethal in overdose, or if it caught fire – as it is highly flammable.

Needless to say, it has been replaced by rather safer alternatives, when used correctly, of course.

Link to PubMed entry for case study.

Hallucinating Lilliput

Lilliputian hallucinations are where small figures of animals or people appear as visions, often in the bottom half of the visual field, sometimes as dancing, playful creatures. Last year the German Journal of Psychiatry published a fascinating English-language article about these curious perceptual distortions.

They can appear in a number of conditions, including psychosis and schizophrenia, during alcohol withdrawal-induced delirium tremens, or when part of the retina starts to degrade in macular degeneration.

The article has three case studies that give a flavour of these often surprising hallucinations and goes on to discuss what we know about their cause.

Here’s an excerpt from one of the case studies of an alcohol dependent man (who was drinking about 50 units a day!) who suddenly cut-down on his drinking and started experiencing striking withdrawal effects as a result:

Following this, his sleep had markedly reduced and he started seeing little people all over the house. They were about a foot high, with funny colorful dresses, weird faces, big eyes and mouths. Some of them were also wearing spectacles. They would follow him all around the house and he could hear their footsteps. Patient would also see them drinking his blood (did not elaborate further) and complained of physical weakness as a result. Initially, patient attributed his experiences to some evil spirits present in the house and changed the house. But the experience continued.

Perhaps one of the most surprising causes of these hallucinations is macular degeneration, sometimes diagnosed as Charles Bonnet syndrome, owing to the fact that simple damage to the retina can lead to complex hallucinations that seem to take on a life of their own.

Link to ‘Lilliputian Hallucinations. Understanding a strange Phenomenon’.

Walking the line: the danger of sinus neurosurgery

I’ve just found this gripping article from The Guardian by photojournalist Tom Bible who was diagnosed with a rare and life threatening brain tumour and had an equally rare and life threatening operation to remove it.

The tumour was located in the superior sagittal sinus, one of the major veins that drains blood from the brain.

Operating on it is very dangerous because it is incredibly difficult to stem the bleeding once it’s damaged. As the author mentions in this passage, it’s so dangerous that the operation needs to be carried out while the patient’s heart is stopped:

I now had a challenge: to find a neurosurgeon who was both willing and able to remove my tumour. Dr Thomas recommended two vascular neurosurgeons in the UK. I arranged an appointment with the first one, who subsequently cancelled, saying that it was not the type of operation he would perform. I visited the second neurosurgeon at the National Hospital in London – the leading UK neurosurgery hospital (and one of the most highly rated in the world). He said he had only heard of one of these before. They had had to remove it by resorting to a practice called the ‘cardiac standstill’. In this, they stop the patient’s heart, drain the blood from the body and reconstruct the tumour-infested sinus area, pump the blood back into the body and kick-start the heart again.

Blimey.

The author eventually had the operation in the US, and gives a compelling description of the process from first symptoms to the extended procedure that eventually also needs the radiation-based gamma knife treatment.

Link to Guardian article ‘Brain storm’.

Inner space at the final frontier

The Psychologist has a truly fantastic article on astronaut psychology, treating off-world mental health problems, and the interpersonal dynamics of the space mission.

It is thoroughly fascinating, exceptionally well-written and even contains an interview with astronaut Dr Jay Buckley “a crew member with STS-90, Space Shuttle Columbia’s 16-day Neurolab mission in 1998. The seven-member crew conducted life science experiments focusing on the effects of microgravity on the brain and nervous system.”

I think I’ve just wet myself.

One of my favourite bits is where it discusses what measures they take to maintain the astronauts’ mental health.

This is no small problem and the article notes that psychological problems have been the leading medical cause of long-duration mission terminations.

Depression is apparently a key problem. The article ominously notes that no-one has yet had to use the on-board antidepressant medication, but it does describe a computerised psychological treatment for depression as part of the on-board software package the ‘Virtual Space Station’.

The Virtual Space Station’s depression module will follow the problem-solving treatment (PST) approach to therapy. James Cartreine, the principal investigator on the Virtual Space Station project, says his team chose this form of intervention because it is empirically supported and has high face validity – in other words, it’s immediately apparent to users of the Virtual Space Station how the interactive programme is going to help them.

‘The active ingredient of PST is behavioral activation,’ says Cartreine, ‘getting people with depression to do something – and helping them to feel good about their efforts, whether or not their efforts were successful.’

Because of its focus on identifying problems and working out possible solutions, PST can help combat feelings of hopelessness and helplessness, which is particularly appropriate for people isolated in space in a confined environment. The fact that it’s tangible – it’s geared towards solving observable problems as opposed to cognitive problems – also makes it suitable for astronauts, who have proven to be accepting of the intervention. ‘Astronauts are physical scientists, engineers and programmers – they’re not necessarily used to thinking about their thought processes,’ says Cartreine.

If you’re interested in how the same topic looked in 1959, we discussed some unintentionally hilarious articles from a special issue of the American Journal of Psychiatry on a rather Freudian ‘space psychiatry’ from that very same year.

 
Link to Psychologist article ‘New horizons’.

 
Full disclosure: I’m an unpaid associate editor of The Psychologist and I’ve always wanted to be an astronaut.

When I get that feeling, I need sociosexual healing

New Scientist has an article on the psychology and biology on sleeping around – which has been given the wonderfully gentle and inviting name of ‘sociosexuality’ in the research literature.

Rather predictably, the article contains the rather tired ‘men spread their seed, women look for long term partners’ evolutionary psychology explanation, but also does a good job of countering this with some interesting and sometimes surprising studies from the sex research literature.

One of the most interesting bits is where it notes that foetal testosterone exposure is correlated in men with masculine facial features and number of sexual partners in adulthood, and exactly the the same holds for women:

Another factor with strong links to sociosexuality is masculinity. Boothroyd found men with more masculine-looking faces scored higher on sociosexuality, and it seems to be the same story for women. Sarah Mikach and Michael Bailey of Northwestern University in Evanston, Illinois, examined how women’s sociosexuality related to the degree to which they looked, felt or behaved in a masculine way. They found that heterosexual women who had high numbers of sexual partners were more likely to show higher levels of masculinity.

The researchers argued that these women behave in a way that is more typically male and this could be due to early – probably prenatal – exposure to androgens, such as testosterone, that organise typically “male” brains differently from typically “female” brains (Evolution and Human Behavior, vol 20, p 141). Supporting this idea, Andrew Clark of McMaster University in Ontario, Canada, found a higher rate of sociosexuality in women with a smaller ratio of index to ring finger length – which some researchers believe corresponds to higher prenatal androgen exposure (Evolution and Human Behavior, vol 25, p 113).

If you want to rate your own sociosexuality, they’ve also put the questionnaire online.

Unusually for the normally rather coy New Scientist, the article is open-access. Is this a sign that New Scientist are realising that science is like love – it’s better when it’s free, or are they just using sex as a way of getting short-term affection?

We’ll see how we feel in the morning.

Link to NewSci on ‘The dizzying diversity of human sexual strategies’.

Awesome multi-slice brain puzzle

The photos are of a mysterious and inventive brain puzzle that seems to have popped up on various places on the web.

It allows you to 3D slice an MRI brain scan in multiple ways, and unlike other puzzles, it needs to be assembled with the picture on the inside.

Curiously, the various web pages which discuss it don’t say where it’s from, so we don’t know whether it’s just someone’s one-off brilliant idea, or whether it’s a commercially available product.

Like all great puzzles, it’s conceptually very simple – just a brain scan printed out in slices and cut to fit the the surfaces on the relevant section of blocks – but it looks devilishly difficult to complete.

And once it’s done, you have a genuinely useful 3D scan model to play with.

If you don’t get it right away, have a look at some of the other photos and it will all become clear.

UPDATE: Grabbed from the comments (thanks prlwytzkofsky).

It was made by Neil Fraser, a software engineer at Google. See
here and here. Cool stuff indeed!

Link to photos (thanks Sandra!)
Link to more photos and more links!

Mental illness in children: medical issue or fig leaf?

Dana’s online mind and brain magazine Cerebrum has a critical and thought-provoking article arguing that mental illnesses like ADHD and child bipolar disorder are too often being used as fig leaves for social problems that we prefer to think of as blame-free genetic disorders that can be treated with simple-solution medications.

The piece is by distinguished psychologist Jerome Kagan, considered one of the founders of developmental psychology, who discusses the various social changes that have encouraged differences and misbehaviour to be medically diagnosed and treated – particularly during the last two decades.

The article is timely, owing to it coinciding with recent revelations from an ongoing trial where parents are suing drug makers over the use of antipsychotic medication in children.

The documents show that pharmaceutical company Johnson and Johnson aimed to carry out research on child bipolar disorder with a specific intention of boosting sales of their medication, as well as countering unfavourable coverage from the media and spinning ‘no result’ studies on the drug.

We usually think of ‘social factors’ as increasing risk for mental illness in the individual, but we also need to remember that there are strong social factors that affect how we think about disorders in terms of their causes, effects and treatments.

One of the strongest social factors is financial pressure, and, as covered by Wired, drug companies are notorious for ‘cooking the books’ in an attempt to bury negative data and spin positive findings in the best possible light.

This has just been reported in yet another damning study on drug company data handling published in the most recent edition of PLoS Medicine.

Link to Dana article ‘The Meaning of Psychological Abnormality’.
Link to PLoS Medicine study on bias in drug trials submitted to the FDA.

The myth of urban loneliness

New York Magazine has an extensive and interesting piece arguing that ‘urban loneliness’ – the idea that people in densely populated cities are more lonely than people in the country, may be a myth.

The article looks at recent concerns, partly driven by popular books, that single living and hence loneliness is massively increasing in America.

However, the article also examines more recent research that has suggested that this may not be the case, and that while single living is increasing, social isolation is not, owing to the fact that earlier studies used measures of social participation based on the norms of society a generation ago.

The article covers research suggesting that the structure of urban society is changing, so city-dwellers make connections in different ways and at different stages in life. There is little evidence, however, for a great social crisis or that we’re simply becoming less social.

It’s a fascinating article that explores some intriguing social research that rarely gets widely discussed.

The writer largely riffs on a new book by neuroscientist John Cacioppo and writer William Patrick on the science of loneliness which also has a rather spiffy website.

Link to NYMag article ‘Alone Together’.
Link to Loneliness book website.

The enchanting Encephalon 59

The 59th edition of the Encephalon psychology and neuroscience writing carnival has just appeared online on the wonderfully named Ionian Enchantment and has all the latest in the last fortnight’s mind and brain writing.

A couple of my favourites include an interesting piece on the development of dance classes for people with Parkinson’s disease from the new Dana Press Blog and a great piece on recent research looking at the cognitive neuroscience of poverty from The Mouse Trap.

I’ve not discovered the Dana Press blog before but it looks really promising with some great posts and offers to review new mind and brain books before they’re released.

Anyway, more of the new and interesting in this month’s Encephalon.

Link to Encephalon 59.

Not connecting with faces in the street and in the brain

Not Exactly Rocket Science has a great write-up of a recent study that may explain why some people are born without the ability to recognise faces – a condition known as congenital prosopagnosia.

Face recognition is particularly associated with a part of the temporal lobe called the fusiform gyrus. Although it’s controversial whether this area is specifically for faces, or is more generally specialised for perceptual expertise of which faces are just the most important example, it’s clear that it is key for understanding faces.

Cibu Thomas from Carnegie Mellon University discovered the problem by focusing on two major white matter tracts that link the fusiform area to other parts of the brain. Both have names that positively trip off the tongue – the inferior longitudinal fasciculus (ILF) and the inferior fronto-occipito fasciculus (IFOF). Thomas studied the tracts using a technique called diffusion tensor imaging (DTI), which measures the flow of water along their length.

The flowing water revealed severe problems with the structural integrity of both white matter tracts in the brains of prosopagnosics. Normal individuals didn’t show any problems, nor did areas of white matter in the prosopagnosics that connected areas completely unrelated to face processing.

In other words, the fibres that connect important perceptual areas in the brain may be much thinner in people who have problems recognising faces.

The image on the left shows the connections between the temporal and the occipital lobes in the participants with the condition and the controls.

As usual, the Not Exactly Rocket Science write-up is clear, concise and engaging, and if you’d like to know a bit more what it’s like to live without recognising faces The Guardian recently published a personal account of day-to-day life from someone with prosopagnosia who can’t even recognise himself in the mirror.

Link to ‘Faulty connections responsible for inherited face-blindness’.
Link to Guardian article ‘I don’t recognise my own face’.

Grounding the helicopter parents

The New Yorker has an extended review and discussion of various new books critical of the increasing trend for parents to be overinvolved in their children’s lives owing to the trend for ‘intelligence boosting’ products and activities.

It’s a nicely balanced article that highlights some of the worst trends in ‘overparenting’ while also pointing out some of the flaws with the recent wave of criticism.

To get some perspective, look at “Huck’s Raft: A History of American Childhood” (2004), by Steven Mintz, a professor of history at Columbia. Mintz’s story begins with the beginning of the United States, and therefore he describes children with troubles greater than overparenting: boys dispatched to coal mines, and girls to textile mills, at age nine or ten.

As for the current outbreak of worry over the young, Mintz reminds us that America has seen such panics before—for example, in the nineteen-fifties, with the outcry over hot rods, teen sex, and rock and roll. The fifties even had its own campaign against overparenting, or overmothering—Momism, as it was called. This was thought to turn boys into homosexuals. For the past three decades, Mintz writes, discussions of child-rearing in the United States have been dominated by a “discourse of crisis,” and yet America’s youth are now, on average, “bigger, richer, better educated, and healthier than at any other time in history.”

There have been some losses. Middle-class white boys from the suburbs have fallen behind their predecessors, but middle-class girls and minority children are far better off. Mintz thinks that we worry too much, or about the wrong things. Despite general prosperity—at least until recently—the percentage of poor children in America is greater today than it was thirty years ago. One in six children lives below the poverty line. If you want an emergency, Mintz says, there’s one

Over-involvement is certainly a risk, however, and this can be seen even in the very beginning of infancy. One of the key skills psychologists talk about in early life is the ability to self-soothe – in other words, learning to independently manage discomfort and strong emotions.

This begins when babies are getting into sleep routines in the months after being born. There is a temptation to attend to the baby and soothe it as soon as it cries but this can have the opposite effect and the child actually sleeps worse because they don’t have the opportunity to learn to settle themselves.

A recent large study helped to confirm this and found that parents that encouraged independence and self-soothing by not attending to their baby at every cry reported that their child had extended and more consolidated sleep.

Link to New Yorker ‘The Child Trap’ article.

Making Sense of Bastards

A 2005 article from business psychology journal Organization Studies discusses the psychology of being a bastard. It has a serious point, but is just hilarious for the contrast between the academic language and the subject matter.

The serious point behind the article, written by psychologist David Sims, is to look at how people in business organisations make narratives or stories about someone being a ‘bastard’ to demonize them and persuade others of the fact.

This can be to discount someone else opinion, undermine their status, or to create a dragon against which they can valiantly fight for their own glory.

However, because of the subject matter, it’s frequently funny as it analyses the varied types of company bastards as they’re constructed within organisations. Just some of the section headings are pure genius:

Narrative 1: Clever Bastard
Narrative 2: Bastard ex Machina
Narrative 3: Devious Bastard
A Narrative Understanding of Bastards
Making Sense of Bastards

Link to ‘You Bastard: A Narrative Exploration of the Experience of Indignation within Organizations’ (thanks Olwyn!).
Link to DOI entry for same.

The perils of not realising scaffolding is a metaphor

Life magazine have recently put their entire photo archive on Google Images and the Too Many Interests blog has picked out some of the most surprising psychology images.

The image on the right is my favourite, and probably results from psychologists trying to answer the question ‘how many babies does it take to change a lightbulb?’

The answer is, of course, just one, but as long as the baby has the appropriate scaffolding.

Yes, I’m making Jerome Bruner jokes.

Yes, I really should get out more.

Yes, I know I’ve promised that before.

Link to selection of psychology images from Life (via AHP).
Link to all Life psychology images on Google.

Adultery for heroin users

A list of ingredients found by chemical analysis that have been used to cut street heroin sold in New York City from 1991 to 1996.

As reported in a 2000 review paper on trends in NYC heroin adulterants:

Acetaminophen (Analgesic)
Aminopyrine (Anti-inflammatory)
Amitryptaline (Anti-depressant)
Antipyrine (Body water measurement)
Benzoczine (Anesthetic)
Caffeine (Stimulant)
Cocaine (Stimulant)
d-metamphetamine (Stimulant)
Diphenhydramine (Anti-histamine)
Doxepin (Anesthetic)
Ephedrine (Stimulant)
Lidocaine (Anesthetic)
Hydroxyzine (Anxiety medication)
Methylparben (Chemical preservative)
Methocarbamol (Muscle relaxant)
Nabumetone (Arthritis treatment)
Nicotinamide (Coenzyme)
Phenylbutazone (Anti-inflammant)
Phenylpropanlamine (Dexatrim / caffeine)
Potassiumchloride (Potassium supplement
Rocaine (Local anesthetic)
Propoxyphene (Analgesic – Darvon)
Sodium Bicarbonate (Acid indigestion)
Quinine (Malaria treatment)
Theophylline (Bronchial dialator)
Thiamine (Dietary supplement)
Thiopental (Barbiturate)
Thioridazine (Nausea medication)
Tripolidine (Allergy medication)
Disodium ethylenediame tetraacetic (Chelating agent for metals)

The study notes that the most common non-dope ingredients in street heroin are lactose, milk sugar, sucrose, cellulose, mannitol and other inert ingredients, but there is an increasing trend for heroin to contain psychoactive chemicals or additional substances to alter its effect through changing how it is absorbed into the body.

Interestingly, the paper also notes that professional heroin cutters are expensive, charging up to $20,000 for a kilo of heroin. This is likely due to the skill and knowledge needed to select ingredients that will have certain effects, which can be different for ‘smokers’, ‘snorters’ and ‘injectors’.

Ingredients that affect the vaporisation point of heroin will be more important for smokers, while adulterants that increase absorption through the nasal passages will obviously be more important for snorters.

For injectors, cutters need to be able to select ingredients that aren’t going to gum up needles or cause too much damage to the users’ veins.

Additionally, some ingredients are added purely for their psychoactive effect to give a different experience and ‘brand’ the dope.

However, owing to the cost of a professional cutter, some dealers just cut it themselves with whatever they think is reasonable, meaning all kinds of potentially fatal ingredients end up in the average bag of smack.

Link to closed-access paper ‘The Re-Engineering of Heroin’.

New RadioLab on the psychology of choice

The excellent RadioLab has returned with a new series and the first is a programme on the psychology of how we make choices, and what can go wrong when brain damage prevents us from making decisions.

The RadioLab team talk to psychologist Barry Schwartz, author of the ‘Paradox of Choice’ on why more choice means people tend to be less happy with their decision, to neuropsychologist Antoine Bechara on how a famous case of frontal lobe damage helped us understand why emotion plays a role in even the most mundane of choices, and to the ubiquitous Malcom Gladwell on the role of the unconscious.

As usual, it sounds beautiful and discusses some great research (the cake and working memory study is one of my favourites).

Interestingly, the programme lets slip that science-writer Jonah Lehrer’s fortchoming book is on choice and perhaps it’s no accident that Lehrer is a contributor to the programme so perhaps we can consider this a preview of some of the material he’ll cover.

Let’s hope so as it’s another great edition of RadioLab.

Link to programme webpage with streaming audio and mp3.

2008-11-21 Spike activity

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

The Situationist has a fantastic video example of a classic experimental philosophy set-up.

The TSA’s ‘behavior detection‘ is wrong more than 99 percent of the time, reports USA Today. Maybe that’s because it’s based on some rather dodgy techniques, as we reported in August last year.

Science Daily reports on an elegant experiment allows who said what to whom to be worked out from the brain scan data. Only from very limited stimuli, but an intriguing study none-the-less.

Can everyone be an Einstein? No, is the short answer, but The Times has a longer one in a nicely balanced article on brain improvement techniques.

Neuroskeptic says Freddie Starr ate my hamster, sorry, it should be Prozac made my cells spiky.

To the bunkers! BBC News reports IBM to build computers that work like brains. Although I’d be more impressed if we could get Microsoft to build software that works like software.

New Scientist reports that coping-with-stress related brain changes occur during menstruation.

Atypical antipsychotics no better than older antipsychotics. We should be used to this headline by now, but this time, it’s a study in kids reported by The Psychiatric Times.

BBC News reports heavy drinkers lie to their doctors about how much they drink. Pope still Catholic (and probably still claiming he doesn’t masturbate).

There’s an excellent interview with Mary Roach, one of my favourite science writers, over at Neuronarrative.

Oprah Magazine has an OK article about neuroscience. Yes, Oprah Magazine. That’s it, we’re mainstream. Neuroscience is over. What else is cool?

Does involving parents really help students learn? Depends on how they’re involved, reports Cognitive Daily.

Science News reports that the brain reorganizes to make room for maths. Which is lucky, because in my brain the space has always been occupied by Batman.

Fred Goodwin, one of the world’s leading bipolar researchers has his radio show pulled over undisclosed payments from drug companies, reports Furious Seasons

Not Exactly Rocket Science has an excellent piece on evidence that graffiti and litter strewn environments encourage crime.

A video lecture on the brain’s visual system is featured by Channel N.

An interpretative dance inspired by the cerebral activation patterns induced by the inflection of regular and irregular verbs, found by the wonderfully eclectic Frontal Cortex. With video of said dance.

The Guardian has an excellent excerpt from Malcom Gladwell’s new book.