The central nervous system is at once brilliantly adaptable and confoundingly vulnerable. The brain can rewire itself to overcome deficits but minor insults to the spine can cause a seemingly insurmountable cataract in the electrical flow of information up and down the spinal cord. Ultimately cutting entire portions of the body off from its central command mechanism.
For most of medical history such spinal injuries could not be cured and only palliative care of their symptoms could be accomplished. Now the field of neuroprosthetics has combined computer science and biology to overcome previously untreatable spinal injuries.
At the forefront is École Polytechnique Fédérale de Lausanne (EPFL) whose multinational team of scientists recently published in the journal Nature, a groundbreaking study where they restored mobility in a paralyzed limb of a non-human primate with a spinal injury.
The How’s and What’s of Spinal Stimulation
To restore the interrupted communication between the motor cortex and motor neurons responsible for moving the monkey’s leg, researchers used a digital brain-spine interface to circumvent the spinal lesion. The wireless apparatus consists of two components: a sensory component and a stimulating component.
In between is a complex computer software program that translates the equally intricate biological wetware of the cerebral cortex.
The first is the 96 microelectrode array implanted in the monkey’s motor cortex, specifically the region of the cortex corresponding to the contralateral paralyzed leg. The electrodes, collectively no bigger than a bean, relay 30,000 samples of electrical activity recorded in this cortical area every second, each registered impulse the germination of conscious movement.
This data is then streamed to a neural decoding software that processes the data in real-time and determines if the impulses recorded are signaling intentional movement of the paralyzed limb.
When it detects the pattern of neural activity indicating voluntary movement of the leg, the application signals the third component of the interface, an implantable wireless pulse generator.
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Upon being triggered, the generator stimulates precise regions of the dorsal roots of the spinal cord below the lesion to create appropriate extension and flexing of the leg for locomotion. Within days of receiving the brain-spine interface, rhesus monkeys regained weight-bearing movement to a leg which had been paralyzed by a unilateral lesion to the corticospinal tract at the thoracic – or chest – level.
Lead researcher Professor Gregoire Courtine has begun clinical feasibility trials for humans using a modified version of spinal stimulation that relies on residual movements instead of a brain interface.
However, since many of the technological components are already approved for research, Courtine anticipates the full brain-spine interface neuroprosthetic to be in clinical trials within the next ten years.
Watch the process on this video from the EPFL
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“Brain on Fire” By Susannah Cahalan Review | Neuronomics
Cahalan’s harrowing memoir proves a grey matter area, is it primarily a tale of medicine or psychology? This is a Neuronomics view and review of the deeply layered account.
In this installation of Neuronomics, Kristen E. Strubberg reviews the 2012 New York Times bestselling autobiography Brain on Fire: My Month of Madness, by New York Post writer Susannah Cahalan. In June of 2018, Netflix adapted Brain on Fire to film staring Chloë Grace Moretz. As an eminent student of the human brain, Kristen breaks down this much appraised journey into Cahalan’s rare disease.
When I went to find a copy of Brain on Fire at what is generously called a book store during these dark digital days, I wove through the aisles to the psychology section. To my sense of order and categorization and based on my knowledge of what the book was about – a memoir of “madness” – psychology seemed appropriate.
I traced the shelves until I came to the crammed corner of testimonials, as I think of them, given far too little space. I run the titles once, twice, it’s not there. Then, on the shelf above I find a copy flaunting a cover that doubles as an advert for the Netflix adaptation. But this is the only copy, out of place, no tell-tale gap in the spines from whence it came.
I contemplate settling for the “tie-in” edition, but I’m curious where the other copies are? It is a highly relevent, relatively new book – where are her sisters? Not on the new release carousal, I already inspected that display.
Thinking again about the book’s story, I realize there is only one other place it could be. I stride a few rows behind Psychology to medicine and there, neatly in row and occupying space only allotted to new and revenue pumping titles, I find the original edition. But why medicine?
This a memoir of “madness,” is it not? Albeit one with a very neurological component, but what psychological malady doesn’t have some roots in the grey matter between the ears?
Brain on Fire: Medicine or Psychology?
As I begun to read, I realized that of the two classifications, medicine is the closer fit for this hybrid retelling of one women’s month from hell.
Brain on Fire is more mystery than traditional memoir. Author Susannah Cahalan keeps the reader engaged as her family and rotating team of specialists struggles to diagnose an elusive ailment that has deranged her mind and convulsed her body.
Throughout the narrative of her harrowing days of illness however, I felt detached from the Susannah whose brain was burning from anti-NDMA receptor autoimmune encephalitis. This is not unlike Susannah the author. Mostly, this is due to to the fact that the author/narrator remembers very little of the actual illness at its apex.
What is Anti-NDMA Receptor Autoimmune Encephalitis?
The NDMA receptor, the target of her self-attacking immune system, is found throughout the cerebral cortex, home of the brain’s higher functions.
As these important receptors became increasingly destroyed by wayward immune cells, the reader can see Susannah’s cognitive function being stripped away as the disease progresses.
Following Susannah’s symptoms, it’s not surprising to learn that the second highest concentration NMDA receptors is the hippocampus, the brain region responsible for consolidating a person’s experiences into memory.
With this vital memory-maker also being besieged by this disease, the fact that her recall from her time in the hospital remains inaccessible fits the picture of her illness.
Susannah Cahalan from the Second Hand
All the stories and descriptions are second hand accounts from family and Cahalan’s medical records. While a blessing for the author – who wants to remember the worst demons unleashed – it sets this book apart from other memoirs of mental illness or neurological trauma.
Brain on Fire in some ways bridges V. S. Ramachandran and Oliver Sacks’ neurological mysteries, and the pathos of a brain reassembling after disease such as Lori Schiller’s The Quiet Room. But the second pillar of the bridge has a hole, admitted by the author in her preface, because the emotional torrent associated with the disease is digested retroactively. Albeit from myriad sources composed contemporaneously.
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Uncertain revelations toward reaching enduring truths
Cahalan tries to venture conclusions about self and deeper self, and provides clear neurological scaffolding for the self, but she admittedly is not certain if she can pull any enduring revelations about herself from the ordeal.
As such, the book boils down to a medical mystery novel that it is superb accomplishment. However as a window into the deeper truths of the mind, or a catharsis from emotion and personal triumph, it is lacking.
Write to Kristen E. Strubberg at firstname.lastname@example.org
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Breakthrough: How Brain Takes Shape In Utero Discovered
The geography of the human brain is covered in wrinkles. Deep fissures separate peaks of grey, squishy tissue. These strange convolutions, however, are a key to many of humanity’s higher functions such as cognition, touch, memory, movement – name an ability and it has a wrinkle with its name on it. Anatomically the ridges are called gyri (singular gyrus) and the creases are called sulci (singular sulcus). The hilly geography of the human brain allows for the cerebral cortex – the topmost layer of the brain – to maximize surface area and hence mental capacity. Surprisingly, the primary sulci and gyri are observed in relatively the same location from person to person. How these conserved formations develop in utero have stymied scientists for decades. A novel experimental approach may now have solved the mystery.
Obviously, for a brain to develop many biological factors are in play. DNA, for starters, holds the genetic codes that dictate the development of cells which eventually differentiate into the neurons and glia that compose the human brain. Genetics also play a critical role in the regionalization of brain function. Yet research has not found any codes that mold the specific folded shape of the cortex.
Recent morphogenetic models focus on the brain being tugged and pulled into shape by the nascent neurons and glia. The theory proposes that as the brain cells migrate and mature during gestation, they contour the smooth fetal cortex into the essential sulci and gyri seen in an adult brain.
Now scientists at Harvard University have demonstrated that the characteristic folds of the brain are determined by the “mechanical instability” of the fetal brain tissue growing within the confined space of the skull. The multinational research team led by Professor L. Mahadevan, demonstrated this theory by using a “3D-printed layered gel mimic” of the fetal brain based on MRI scans.
The model was then submerged in a solvent. The outermost layer of elastomer gel, representing the cortex, absorbed the solvent causing it to expand. This swelling caused “mechanical compression” on the inner layers of the gel that mimicked the resulting elastomer/cortex layer as it came to “buckle“. The resulting model exactly replicated the sulci and gyri – the ridges and creases – seen in human brains. In short, the researchers showed that the amniotic environment of a maturing fetal brains plays a significant role in giving human brains their characteristic crinkles.
While genetic and molecular factors are still important influences to the specialization of the human cortex, articulating the physical development is important for many fields of medicine. It is well documented that aberrations in our signature sulci and gyri cause cognitive and neurological deficits. This includes growing research that links cortical misfolding to aspects of Autistic Spectrum Disorders.
Knowing the anatomical origins of these cortical hallmarks may lead to a better understanding of brain malformation and help develop more comprehensive therapies and interventions.
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Neuronomics: Brain Word Map Revealed
Researchers at University California-Berkley have mapped what they are colloquially dubbing the “brain thesaurus” in their findings published in Nature. Neuroscientists have long been aware of the human brain’s semantic system or areas of the cerebral cortex that associates words and the knowledge store-house that comes with them. What about individual words? Does every word have a corresponding micro-region? That’s what postdoctoral fellow Alex Huth sought to discover.
Six native English-speaking volunteers (including Huth himself) laid in a functional MRI(fMRI) for two hours while listening to natural narrative on The Moth Radio Hour. The fMRIs tracked increased blood-flow to regions of the brain as they listened. Researchers then “transcribed and annotated” the stories heard during the scans with “the time each word was spoken” and compared them with the correlating fMRI image.
The data the researchers collected were then put through a spacial algorithm called PrAGMATiC, that weighed words with similar meanings. Finally, PrAGMATiC mapped the weighted words on a flattened or 2-D cortical diagram color-coded by the following semantically related groups: visual, tactile, numeric, locational, abstract, temporal, professional, violent, communal, mental, emotional and social.
Not only were the researchers able to map words to specific foci on the cerebral cortex, Huth and his colleagues observed a consistent global pattern of words-groups between the individual scans. Huth believes this conserved mapping of semantically related words may eventually help individuals who have lost the facility of speech due to trauma or disease.
To explore the map more, visit the experiment’s interactive website here.
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