[HN Gopher] Neurosurgeon pioneers Alzheimer's, addiction treatme...
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Neurosurgeon pioneers Alzheimer's, addiction treatments using
ultrasound [video]
Author : gardenfelder
Score : 127 points
Date : 2024-02-29 16:24 UTC (6 hours ago)
(HTM) web link (www.youtube.com)
(TXT) w3m dump (www.youtube.com)
| nabla9 wrote:
| "Brain washing" with focused ultrasound is a thing.
|
| UEF's new JPND projects explore focused ultrasound and multimodal
| interventions to fight dementia
| https://www.uef.fi/en/article/uefs-new-jpnd-projects-explore...
|
| >Focused ultrasound (FUS) is a non-invasive, ground-breaking
| brain stimulation technique suggested for the treatment of
| Alzheimer's disease. FUS promotes transient opening of the blood-
| brain barrier and enhances the microglial-mediated clearance of
| beta-amyloid typically accumulating in the brain in Alzheimer's
| disease. However, the molecular mechanisms underlying these
| beneficial effects are poorly known, which limits the full
| translation of FUS into the therapeutic arena.
|
| >The REBALANCE project coordinated by Professor Tarja Malm at the
| A. I. Virtanen Institute for Molecular Sciences aims to discover
| the key cellular targets and molecular mechanisms underlying FUS-
| induced brain cleaning and therapeutic efficacy in Alzheimer's
| disease. The project partners have previously demonstrated
| therapeutic efficacy for FUS stimulation alone and combined with
| microbubbles.
|
| >We hypothesise that FUS, through the activation of
| mechanosensitive Piezo1 channels, enhances beta-amyloid clearance
| by microglial cells and facilitates the removal of waste from the
| brain into the blood stream. This occurs through the improvement
| of glymphatic flow together with transient increase in the blood-
| brain barrier permeability. Moreover, increased blood-brain
| barrier permeability enables drug delivery into the brain,
| further boosting beta-amyloid clearance,"
| vasco wrote:
| I was waiting for the part where they'd brainwash you using
| this technique and realized it's wash in the more literal sense
| of getting rid of accumulated bad stuff rather than changing
| your thoughts or some sort of amnesia inducing procedure.
| psunavy03 wrote:
| "We're brainwashing you." "WHAT??" "No, I mean we're
| literally washing your brain."
| caycep wrote:
| ....in short, it's a lesion.
| dghughes wrote:
| I saw this on 60 Minutes I'm amazed this isn't worldwide front
| page news. Especially just for treating addiction alone.
| Basically sit in a machine get your head buzzed by ultrasound.
| All better.
| roody15 wrote:
| More of a dystopian nightmare. Rather than seeing an individual
| having agency to make decisions and face consequences ... we
| may be moving to a model of a human as nothing more than a
| fancy automaton. Ohh so Mr Jim is showing addictive traits and
| not performing task X well. No problem let's sap his brain and
| get him fixed up.
|
| Super excited for any breakthroughs with Dementia ... but
| fixing addiction, obesity... or even paranoid wrong think with
| ultrasounds is scary and perhaps harks back to the era of
| lobotomies.
| numinoid wrote:
| It seems you could do this with any technological/medical
| advancement - how is this any different from semaglutide for
| obesity or wellbutrin for addiction? It's just a different
| lever to pull.
|
| Harkening back to lobotomies is a false dichotomy, the
| environment in which research is done today wouldn't even
| allow for an outcome like that.
| BizarroLand wrote:
| I disagree. It's a fair concern.
|
| They are literally shaking small parts of the brain until
| they act differently. It's not as extreme as a lobotomy but
| its lobotomy adjacent and a little scary.
|
| Sure, unlike a lobotomy it probably just jostling areas of
| the brain and not damaging entire sections with an icepick,
| but it's still fair to accept that some people (like
| myself) feel automatic body horror and fear at the idea of
| parts of my brain being damaged.
| basisword wrote:
| If my life were ruined and I was dying from alcoholism or
| drug addiction I get the feeling I probably wouldn't be
| thinking about this in a philosophical way. Societal
| impacts or potential abuses would be the least of my
| concerns.
| BizarroLand wrote:
| No, that's fair, my stance very much was from the
| viewpoint of a generically healthy mind and not from the
| viewpoint of a damaged mind.
|
| If I were in that position I might seriously consider the
| value of having 99% of me make it to the other side of
| this misery in exchange for the 1% of my brain that is
| ruining my life.
| touisteur wrote:
| Especially if the alternative is cold turkey, or a good
| old DT... All my heartfelt deep thanks to everyone who
| keeps digging for solutions, workarounds... anything that
| might help there.
| numinoid wrote:
| My issue is more with framing it as a lobotomy analogue
| when in reality the similarity ends at them both being
| brain procedures. My read is that this is more akin to
| something like rehabilitation in that previously damaged
| tissue is being worked on to improve function.
|
| With regards to the body horror thing, that is legitimate
| and there is the possibility that we look back on this in
| 20 years like we do with lobotomy. I personally think
| it's unlikely considering the differences in how research
| is regulated compared to the past.
|
| In general I think we need to reframe how we look at
| medical treatments. Changing the brain is literally the
| point - it's dysfunctional. Whether that be through
| physical manipulation like this or via pharmacology,
| something HAS to change functionally or there will be no
| difference. Until the point that we have nano robots
| carrying out bodily processes for us it's on our brain
| and body to adapt to whatever environmental stress it's
| exposed to, for better (exercising improving health for
| example) and for worse(trauma causing increased
| likelihood of addiction etc). This treatment is no
| different from anything else, all that matters is the
| positive or negative reaction.
| tasty_freeze wrote:
| > They are literally shaking small parts of the brain
| until they act differently.
|
| No, from what other comments have said, they are using
| ultrasound to open the blood/brain barrier so that drugs
| can enter the affected area. They aren't indiscriminately
| shaking the patient's brain and hoping for the best.
| confoundcofound wrote:
| Something tells me you are wholly unaware of the damage that
| addiction and obesity can inflict not just on the person
| afflicted, but on their family, community, and society as a
| whole. The benefits/costs equation is so massively lopsided
| here that you'd be cruel to advocate that people endure years
| of avoidable torment to satisfy your faulty notion of free
| will / agency. I can't think of anything more agency-
| promoting than ridding someone of their addictions.
| BizarroLand wrote:
| What line would you draw between the technology existing
| and being useful to society and people's fundamental and
| inalienable right to refuse ever having it used on them?
|
| Following their original thread, how would you feel if the
| government decided that this could be used for criminal
| correction, or if a company made going through a quick
| brain cleanse a part of the hiring process, or a college
| part of it's onboarding, or the military a part of boot
| camp?
|
| Do we clean every spot to flawless similarity or just clean
| the bad thoughts?
|
| If the latter, who gets to decide what the bad thoughts
| are?
| MisterBastahrd wrote:
| Your argument is akin to being against needles because
| the government might use them to perform lethal
| injections.
|
| I don't know if you've ever known any addicts, but they
| aren't exactly happy about being addicted. Give them a
| treatment that works and is affordable and most of them
| will be just happy to get some targeted head buzzing to
| treat their symptoms.
| MisterBastahrd wrote:
| Have you ever considered that nothing is wrong with you
| because nothing is wrong with you, and not that nothing is
| wrong with you because you are some stoic or heroic figure
| who managed to simply resist temptation?
|
| I've been drunk plenty of times. I've also not consumed
| enough alcohol to be in a drunken state in almost 8 years
| despite having a collection of bourbon worth thousands. A
| good friend of mine, who drank no more than I did for a long
| while, could not stop. He kept going until he wrecked his
| liver and died from organ failure.
|
| I didn't have the strength to overcome alcoholism. I was
| simply never an alcoholic. He was.
| astockwell wrote:
| Careful, that was literally the exact same selling point of
| Electroconvulsive therapy 80 years ago.
| vkou wrote:
| If you've got a better treatment for a case of severe
| depression that's resisted all other attempts at therapy and
| medication, we're all ears.
|
| If not, I suggest we leave it up to the patients and their
| doctors to determine whether or not ECT is improving their
| lives, or not.
| pedalpete wrote:
| SAINT protocol tCMS from Magnus Medical
| https://www.magnusmed.com/
|
| Not available to everyone yet.
| caycep wrote:
| So...there's a distinction:
|
| Electroshock therapy for behavioral modification in schools:
| bad
|
| Modern Electroconvulsive therapy under anesthesia: actually
| effective and arguably lifesaving for severe clinical
| depression.
| andy_ppp wrote:
| I'm reminded of this particularly beautiful TED Talk... https
| ://www.ted.com/talks/sherwin_nuland_how_electroshock_th...
| SimbaOnSteroids wrote:
| Low citation on the original paper, none of the paper that cite
| Rezai's paper have citations.
| caycep wrote:
| Also I think the big originators of FUS
| thalamotomy/pallidotomy were Bob Gross from Emory and Jeff
| something something at UVA
| caycep wrote:
| it happens to diplomats in Cuba all the time!
| qiine wrote:
| ok you made me laugh
| amelius wrote:
| I didn't watch the video, but I assume it is not just
| ultrasound, but a very focused beam / beams of ultrasound in
| combination with MRI to hit just the right spot.
| grouchomarx wrote:
| ultrasound is used to temporarily open the blood brain
| barrier so that drugs can target plaque buildups
| amelius wrote:
| That's quite a different mechanism.
| m3kw9 wrote:
| Maybe can be used on healthy subjects to prevent Alz
| mateo1 wrote:
| I'm pretty sure the BBB is there for a reason, unavoidably
| there will be some side effects.
| alexpotato wrote:
| So the following things are basically happening or exist right
| now:
|
| - we can map the brain structure using fMRI
|
| - we can change the structure (or parts of it) using ultrasound
|
| - we can (or soon will be) able to read thought patterns via LLMs
| analyzing brain waves
|
| To me, that sounds like we are not far off from being able to
| take an iterative approach to live brain modification.
|
| Both scary and fascinating at the same time.
| 4gotunameagain wrote:
| > we can (or soon will be) able to read thought patterns via
| LLMs analyzing brain waves
|
| source ?
|
| who says that the brain waves we can measure hold information
| like that in a useful level of granularity ?
|
| you can have something that distinguishes "angry" from "happy"
| etc, sure, but thought patterns ?
| chriskanan wrote:
| Here are a couple papers related to this topic, but the
| primary focus has been on showing that LLM embeddings
| correlate with neural activity better than alternatives. But
| given one has neural recordings, one could train a model to
| take them as input and output what was heard. How well that
| would work, I think, is an open question.
|
| https://www.biorxiv.org/content/10.1101/2023.06.27.546708v1
| https://www.biorxiv.org/content/10.1101/2022.07.11.499562v3
| nickphx wrote:
| Wouldn't the model need to be trained on some valid data
| before being used to guess/approximate output from input?
| bgnn wrote:
| yeah. yet people believe AI can do new things without
| training.
| lawlessone wrote:
| - we can use magnetic pulses to temporarily alter the
| conciousness of part of the brain, create the feeling of a
| "presence of God" etc. Note: I am not say there is or isn't a
| god(s). Just that this is how some people interpret the
| experience.
|
| The LLM thing sounds a bit off though. I think whatever article
| you read on this may have misinterpreted it.
| codedokode wrote:
| > - we can map the brain structure using fMRI
|
| fMRI has poor spatial (about 1mm) and temporal (about 1s)
| resolution.
| seydor wrote:
| it s just amazing to see the amyloid plaque removal
| seehafer wrote:
| Great to see Dr. Rezai getting his due. One of the pioneers of
| neuromodulation; he's been involved in deep brain stimulation
| since the early days.
| nickpsecurity wrote:
| I've seen two papers on stimulation and entrainment of brain
| waves. Is there any place that has a huge pile of resources on
| that? Everything from introductory to cutting-edge papers?
| caycep wrote:
| "neuromodulation" mostly means deep brain stimulation since
| it's by far the most effective and clinically - if you pubmed
| stuff, there's reams of reams of papers (probably written by
| someone else than Ali Rezai...). That being said, anything re
| above neurophysiology is mostly still handwaving, bc
| honestly, we still don't know exactly how it works.
| novok wrote:
| I wonder if deep loud bass music in clubs leverage something
| similar inadvertently.
| throwawaymaths wrote:
| that's infrasound, not ultrasound
| babypuncher wrote:
| it's also not the sound that is doing the healing here. the
| sound waves are used to create an opening in the blood-brain
| barrier so that the drugs which do the actual healing can get
| where they need to go.
|
| i suspect a nightclub that plays music which opens the blood-
| brain barrier would lead to some peculiar outcomes
| throwawaymaths wrote:
| could look great in the short run but go very, very sideways
| (ultrasound could fragments plaques, possibly below size
| detection limit, but then nucleate the formation of even more
| plaques if your'e not fixing the underlying problem):
|
| https://www.sciencedirect.com/science/article/abs/pii/S00222...
| CommanderData wrote:
| There needs to be a better way at delivering drugs to the brain.
|
| The BBB is essential for the brain from cytokines. An imbalance
| of immune system function inside the brain can cause havoc long
| term.
|
| I read regarding the BLB (barrier for the Cochlear). A
| compromised BLB is thought to be the cause for many hearing
| ailments such as Tinnitus and hearing loss. An experiment was
| done where blood was injected directly into the cochlear fluids
| and this resulted in extreme hearing loss in mice.
|
| A drug delivery method in a controlled fashion is what has been
| needed yesterday.
| bookofjoe wrote:
| Havana syndrome?
| serguzest wrote:
| Correct me if I am wrong. there are already treatments discovered
| for removing plaques, but it turned out that plaques aren't the
| real cause of cognitive decline. That's what I read before.
| caycep wrote:
| Yes, but this is a surgeon. Surgeon like to cut/burn things.
| This is a new form of lesion therapy, but at its heart,
| it's...lesion therapy
| pedalpete wrote:
| That's not exactly correct. Amyloid plaque is a hallmark of
| Alzheimer's and is still believed to be the primary cause of
| cognitive decline.
|
| However, that doesn't mean removing the plaques will replace
| cognitive abilities.
|
| If you think of neurons like plumbing, the plaques clog up the
| tubes, and the neural connections are no longer firing.
| Removing the plaques doesn't mean a whole doesn't exist in the
| tube, it just means you've unclogged it, meaning the contents
| can now spill out.
|
| This isn't to say that amyloid plaques are the only marker in
| age related cognitive decline.
|
| My suspicion (and I do some work in the field) is that many
| different diseases are being lumped into a single thing that we
| don't completely understand. There is a lot more which will be
| learned in the next decade.
| mike_ivanov wrote:
| I suspect unreported (and drastic) side effects in _some_ cases,
| particularly when the layout of the patient 's brain doesn't
| perfectly align with the operator's expectations.
| jerrysievert wrote:
| my father had a similar focused ultrasound treatment for tremors.
| he went from spilling everything that he tried to carry to rock
| solid with his right hand. it was a life-changing event for him,
| and now he is impatient for the treatment for his left hand.
|
| he was even able to go back to his woodworking hobby, that he
| thought he'd never be able to do again.
|
| they did multiple MRI's to make sure they could hit the exact
| location, and they appear to have done so.
| maherbeg wrote:
| Could this be used for removing calcified plaques or even soft
| plaques in hearts?
| bgnn wrote:
| Ultrasound is routinely used to break kidney stones. With more
| precision like this, why not? I don't know if there would be
| risks though.
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