[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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