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Can the brain be equipped with a pacemaker?
20 13, andrew johnson, a patient with Parkinson's disease in New Zealand, uploaded a video: he sat quietly in front of the camera and then turned off his deep brain stimulation device. After a few seconds, he began to tremble violently and his muscles trembled, which is a typical symptom of Parkinson's disease. After a few minutes, he slowly turned on the device again, and the tremor eased and disappeared, so he could walk more easily in the camera.

This video proves that some symptoms of Parkinson's disease can be relieved after deep brain stimulation. We can't help wondering, what is deep brain stimulation and what diseases can it cure?

Evolution of pacemaker

Deep brain stimulation is a neuromodulation technique. Mainly through the electrodes implanted in the brain, high-frequency electrical stimulation is released to control the related nerve nuclei, and the electrical stimulation signal interferes with abnormal nerve electrical activity, thus alleviating the symptoms of patients with dyskinesia. It is also called "brain pacemaker" therapy.

When we hear about pacemakers, we usually think of pacemakers. Patients with chronic heart disease rely on this small pacemaker to survive. With the development of new technology, batteries shrink, electrodes become smaller and more accurate, and pacemakers become smaller and more complex. Doctors can also know the real-time state of patients' hearts through wireless telemetry and make health plans for patients.

Nowadays, cardiac pacemakers have been transformed into "brain pacemakers"-deep brain stimulation, which is used to treat mental illness. In the United States, deep brain stimulation has been approved to treat Parkinson's disease. It can also relieve other diseases, such as obsessive-compulsive disorder, depression, chronic pain and epilepsy, and may even cure Alzheimer's disease.

Before talking about deep brain stimulation, we have to mention another treatment with a black history-lobotomy.

The Black History of Neuroscience

In 1930s, people were at a loss for many central nervous system diseases (commonly known as mental diseases). For some extremely dangerous mental patients, doctors have to use large doses of sedatives or even opium, which will lead to addiction and can only temporarily alleviate the condition.

After World War II, doctors spent decades developing psychiatry, and finally they came to the conclusion that the best way to treat a series of mental diseases is to "destroy" the physical structure of patients' brains. One of the most famous is the lobotomy invented by Portuguese doctor Antonio Egas moniz. Moniz's team sawed a hole in the patient's skull, and then injected ethanol into the frontal lobe through the hole, killing nerve fibers in the area and cutting off the connection between the frontal cortex and the rest of the brain.

After the operation, the patient survived and the symptoms were relieved. Although the patient didn't recover enough to leave the hospital, moniz still claimed that his operation was successful. Next, moniz did more similar operations. Fortunately, all his patients survived without serious sequelae. Although there are side effects such as slow reaction and personality change, it is still within the acceptable range.

Soon, lobotomy was recognized by more and more countries, and Antonio Igas moniz won the 1949 Nobel Prize in Medicine for this technique. At that time, people firmly believed that as long as such minor operations were performed, those violent patients would become as smart as small pets.

However, with more and more patients undergoing surgery, more and more serious sequelae began to be exposed one by one: these patients became dull, numb and dull like walking dead. The side effects are very serious and permanent. Thousands of postoperative patients lost their memories with family and friends, and some even committed suicide because of serious sequelae.

1970 or so, most countries have legislated to prohibit this dangerous operation.

A long and cautious road

People realize that operations such as frontal lobectomy, which simply cut off the connection between the prefrontal cortex and other parts of the brain, will cause irreversible and permanent damage to people's spirit. So scientists began to pay attention to the therapy that does not destroy the brain structure, and deep brain stimulation came into being.

In fact, people found that the process of deep brain stimulation was an accident. In order to accurately locate the "diseased area" of the brain, the doctor inadvertently inserted the electrode directly into the brain, and suddenly found that the effect was similar to that of lobectomy, except that the patient's symptoms recurred after the stimulation stopped.

Anyway, this is enough to be a surprise. Inspired by this, in the 1960s, people began to experiment with deep brain stimulation technology, which was first used to treat primary tremor, and then extended to dyskinesia, and all achieved remarkable results.

Compared with the rough treatment of lobectomy, deep brain stimulation only uses electricity to stimulate some nerve nuclei in the deep brain. Doctors who correct abnormal brain circuits can turn on or off electrical stimulation at any time, and can also adjust the intensity of electric shock. You can also use EEG scanning to accurately find out the correct area for placing electrodes, thus minimizing side effects. This technique greatly shortens the operation time and improves the accuracy of treatment.

Spark of hope

Now people begin to think about more diseases related to specific brain circuit activities: depression, obsessive-compulsive disorder, Tourette's disease (a hereditary neuromotor disease) and so on.

Among the potential applications of deep brain stimulation, the most exciting one is the treatment of Alzheimer's disease.

If you find yourself in the early stage of Alzheimer's disease without any treatment, you will be in considerable trouble in your later life. After 6 to 8 years, you will have amnesia, cognitive decline, and you can't take care of yourself until you die.

As we know, Alzheimer's disease is caused by the brain's "hardware" failure, the most obvious symptom is the gradual loss of memory, and the circuits in the brain that control memory have the greatest "power". Therefore, if the electrode is placed near the memory control circuit, the activity of the circuit can be enhanced, and it is possible to restore the memory of the patient by increasing the "power".

In addition, deep brain stimulation is also effective for another common mental illness-obsessive-compulsive disorder.

The challenge of treating obsessive-compulsive disorder is that the condition of this disease is very complicated. Patients with obsessive-compulsive disorder may have invasive thinking, repetitive movements, a habitual behavior that needs precise control, or a combination of the above symptoms.

Recent research shows that deep brain stimulation can reduce the condition of patients with severe obsessive-compulsive disorder by 60%. It seems that it will take a long time to be completely cured, but it is undoubtedly a great boon for patients with obsessive-compulsive disorder.

Trouble caused by complex checkpoints

We seem to see the infinite prospect and dawn of deep brain stimulation, which is like a very attractive panacea that can solve the messy brain of human beings in one stop. However, don't jump to conclusions, because reality is always more complicated.

For example, the brain has a super power-the ability to adapt and reshape itself after trauma. This super power will make deep brain stimulation difficult. For example, if someone is unfortunately involved in a car accident and needs to learn to walk again, brain plasticity is very useful. However, for patients receiving deep brain stimulation, the previously incurable mental symptoms will reappear after the brain rewires itself.

Moreover, the complexity of the brain also increases the difficulty of deep brain stimulation, because people still don't know which area of the brain plays a therapeutic role, or whether electric shock to the same structure can treat multiple diseases at once. So we will continue to explore all kinds of knowledge of the brain.

However, medical scientists believe that deep brain stimulation is not a panacea, but it is also an effective special brain surgery for mental patients who are not effective in taking drugs.

This article comes from the seventh issue, 20 16, of the magazine "The Mystery of Big Technology * Science". Readers are welcome to pay attention to the micro signal of our big technology: hdkj 1997.