
The Man With A 'Battery Operated Brain' - Libertatea
http://www.npr.org/blogs/krulwich/2013/06/25/195521917/the-man-with-a-battery-operated-brain?ft=1&f=1007
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mercuryrising
This might be a little dated now (a year or two), but I had a class with some
emphasis on deep brain stimulation. The overall consensus from the professor
was that we know that it does work, we know how the electronics and everything
work, but we don't know what's happening in the brain to make it work. We
don't know why we see the results we do with DBS, and they're sometimes pretty
phenomenal results (like this tremor remover). Depression, chronic pain,
tremors, and probably many things we don't know yet can be solved by putting
some electrodes deep inside your brain and outputting a constant current.

The one trouble spot is that the brain really, really does not like when
foreign objects are embedded in it. The electrode goes in, punctures the blood
brain barrier, and works for a while. When you put something foreign in the
brain, astrocytes (brain cells that form the blood brain barrier) will form
around the electrode and create a new blood brain barrier around it, causing
the electrode that was once inside the brain to be on the outside.

Also, the stimulation current seems to 'overdrive' the nearby neurons, causing
them to die. This reduces the effectiveness of DBS, as living neurons are now
farther away, reducing the effectiveness of the stimulation.

Patients need to be awake during surgery so the doctors know when the
electrode is placed correctly -
[https://www.youtube.com/watch?v=M_fjiEOb40M](https://www.youtube.com/watch?v=M_fjiEOb40M)

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kghose
Very accurate summary! I would add

* The current best guess is that the electrical stimulation inactivates the neurons (acting as a reversible lesion). Older surgeries used to do a real lesion near that brain region.

* Parkinson's is, unfortunately, a progressive disease. So the decrease in efficacy of the stimulation is partly related to the fact that this disease itself is getting worse. We typically hear that DBS buys a patient about another decade (which is a lot).

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etrautmann
I'd be very surprised if electrical stimulation simply acts as local
inhibition. This is inconsistent with other electrical stimulation experiments
(eg: driving muscle movements by stimulating in M1), and would not provide the
correct manipulation to the basal ganglia.

The problem in Parkinson's is that the Substantia Nigra and a certain class of
excitatory neurons start dying off, leading to less dopamine release. The
electrical stimulation is thought to stimulate the remaining neurons to
release additional dopamine to compensate for this loss.

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refurb
Remember that the shaking you see in Parkinson's patients is not due to the
disease, but that a side effect of the medication. Untreated Parkinson's
patients "freeze".

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kryten
Simply awesome.

The people who research, design and implement these "hacks" deserve infinitely
more credit and acknowledgement than all of us.

It really annoys me that the superficial celebrity turds on legs get so much
attention and the people making real differences to the world go unknown and
unacknowledged.

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51Cards
I know nothing about this procedure or what percentage of patients would be
eligible for it but... my complete lack of education on the topic aside... on
the face that has to be one of the most remarkable medical videos I have
possibly ever seen. Seemingly groundbreaking.

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contingencies
I remember reading from multiple sources that MDMA is able to suspend
Parkinsons, apparently through its primary effect, ie. flooding the brain with
seratonin. Could someone more clued up on brain science please explain how the
mechanism of deep brain stimulation (DBS) is related to that route of
suspension, if at all?

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cadr
I heard about this years ago, and thought it was science fiction that would
never actually happen. Then I saw in a Facebook feed that my high school
physics teacher has one. Funny how these can sneak up on you.

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nooron
So awesome.

It's not appropriate to post to Hacker News, but if anyone's interested in
reading a funny, lay-person friendly commentary on the economics and ethics of
cognition enhancing surgery and technology, I've got a really interesting
paper lying around called Wireheading Rawls. I'd be happy to send it to anyone
interested.

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ccarter84
I would as well - old econ reading is a little rusty, so layperson is probably
the right level to restart my brain at.

ccarter84 (at) the all-surveilled google mail

Thanks!

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neoyagami
i hope some day there will be a cure for my LHON :)

