brain surgery

UCLA doctors make history ‘jump-starting’ brain of 25-year-old coma patient.

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  • Currently, post-coma patients require life-threatening brain surgery
  • A new test by UCLA used new device to pulse ultrasound into the brain
  • The scientists targeted the sensory hub (thalamus) with 10 pulses
  • Within 3 days, the 25-year-old man was conscious, fist-bumped his doctor

A 25-year-old man has become the first coma patient to regain consciousness without life-threatening surgery.

The man, who has not been identified, had his brain jump-started with new ultrasound technology in an experiment by UCLA.

Within days of waking up, he was fully conscious, responding to questions, and even gave his doctor a fist-bump.

It is the first time such an approach has been used to treat severe brain injury.

The procedure marks a significant step in medical understanding that could save and transform millions of lives.

Groundbreaking: Scientists have successfully 'jump-start' a man's brain after a coma using incredibly low-energy ultrasound pulses. The device targeted the thalamus (highlighted here in green), which is the brain's 'sensory hub' controlling waking up, alertness and arousal

Groundbreaking: Scientists have successfully ‘jump-start’ a man’s brain after a coma using incredibly low-energy ultrasound pulses. The device targeted the thalamus (highlighted here in green), which is the brain’s ‘sensory hub’ controlling waking up, alertness and arousal

‘Until now, the only way to achieve [brain function] was a risky surgical procedure known as deep brain stimulation, in which electrodes are implanted directly inside the thalamus,’ said lead author Dr Martin Monti, UCLA professor of neurosurgery.

‘Our approach directly targets the thalamus but is noninvasive.

‘It’s almost as if we were jump-starting the neurons back into function.’

The study, published in the journal Brain Stimulation, focused on the thalamus as that is the part of the brain that is most impaired after a coma.

This is the brain’s sensory hub – an egg-shaped structure relaying signals from different regions and regulating waking, alertness and arousal.

Currently, medications prescribed to coma victims only target the thalamus indirectly.

Before the procedure began the patient showed only minimal signs of consciousness and recognizing speech.

HOW DOES THE NEW PROCEDURE WORK?

Currently, the only way to regain brain function after a coma is through a surgical procedure.

The procedure, dubbed deep brain stimulation, involves implanting electrodes directly inside the thalamus.

The UCLA study used a device about the size of a coffee cup.

It was developed by co-author Professor Alexander Bystritsky in his bio-tech firm Brainsonix.

The researchers placed the device on the man’s head and activated it to send pulses of ultrasound into the thalamus.

They activated it 10 times over 10 minutes, each time for 30 seconds.

By activating the device, they were creating a sphere of acoustic energy that could be aimed at different regions of the brain to stimulate tissue.

The device has incredibly low energy levels.

It emits less energy than a conventional Doppler ultrasound.

He could perform small, limited movements when asked but his reactions were slow.

The treatment involved a device developed by co-author Professor Alexander Bystritsky in his bio-tech firm Brainsonix.

The device – about the size of a saucer – was placed on the side of the man’s head, sending pulses of ultrasound into the thalamus.

This procedure, called low-intensity focused ultrasound pulsation, creates a small sphere of acoustic energy that can be aimed at different regions of the brain to excite brain tissue.

It was repeated 10 times, once a minute for 30 seconds each.

By the day after the treatment, the patient’s responses had improved measurably.

Three days later, the patient had regained full consciousness and full language comprehension.

He could reliably communicate by nodding his head ‘yes’ or shaking his head ‘no’.

He even made a fist-bump gesture to say goodbye to one of his doctors.

‘The changes were remarkable,’ Dr Monti said.

According to the researchers, the device is uniquely safe due to its low energy levels.

It emits less energy than a conventional Doppler ultrasound, thereby minimizing its impact on other delicate parts of the brain.

The researchers plan to test the procedure on more patients this year to develop the treatment.

Ultrasound devices capable of penetrating the human brain are already being tested for other conditions including tremors, chronic pain, and even dementia.

 

 

Battle Of Waterloo Might Not Have Happened If It Wasn’t For Neurosurgeon Jean Massot: How Medicine Changed The Course Of History

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Napoleon Bonaparte’s failed attempt to invade Russia in 1812 may not be as widely known as his defeat at the Battle of Waterloo two years later, but it is largely credited as the beginning of the end for the French commander. A new study presents compelling evidence to suggest that the true reason for Napoleon’s blunder in Russia was not due to his poor military judgement but rather the skilled hands of a French brain surgeon.

napoleon

 

In 1812, Napoleon and his Grande Armée marched to Russia in an attempt to conquer the eastern lands in the name of the newly founded French Republic, according to The History Channel. Much to the surprise of Napoleon, instead of finding the Russian military, he found Moscow razed to the ground and the beginning of an early winter — rather than stay and fight the French, Russian General Mikhail Kutuzov ordered his troops to burn down the capital city and retreat to the East. As a result, there were no supplies for the French troops to use when they arrived in Moscow and many of them died in the harsh Russian winter.

At the time, people criticized Kutuzov’s decision as crazy and impulsive. But in retrospect, historians speculate that if Kutuzov had stayed to challenge Napoleon, the battle may not have ended in favor of the Russians. According to the recent study, however, Kutuzov’s impulsive military tactics may have been influenced by two life-saving operations he received nearly 40 years earlier. Researchers at the Barrow Neurological Institute in Arizona believe that a head injury Kutuzov received in 1774, while fighting the Turks in Crimea, destroyed his frontal lobe and altered his personality and behavioral pattern.

The Brain’s Control Panel

The frontal lobe is commonly referred to as the control panel for our personality, and is believed to have a large influence over our emotional expression, problem solving skills, memory, language, sexual behavior, and, most importantly, our judgement.

“It seems that the more primitive regions of the brain drive impulses to pursue larger rewards, but the frontal lobes take a longer view of the situation and put the brakes on these urges in situations when larger rewards may not be the most profitable ones in the long term,” said Dr. Stan Floresco, a researcher at the Brain Research Centre at the University of British Columbia,in a 2014 statement about a study he conducted involving the human decision-making process.

The Barrow team proposes that the damage to Kutuzov’s frontal lobe can explain why  he left the Russian stronghold open to French invasion. The gunshot to the head that the general received in 1774, and a second one that he received in 1788, would have surely killed Kutuzov if not for the intervention of the French brain surgeon Jean Massot. Massot’s surgeries on Kutuzov’s brain two are considered the hallmarks of modern brain surgery, and without a doubt saved the general’s life, albeit with some side effects.

“The other generals thought Kutuzov was crazy, and maybe he was,” lead researcher Dr. Marc C. Preul said in a statement. “The brain surgery saved Kutuzov’s life, but his brain and eye were badly injured. However ironically, the healing resolution of this situation allowed him to make what turned out to be the best decision. If he had not been injured, he may well have challenged Napoleon and been defeated.”

Preul and his team scoured the globe for 200-year-old evidence to back this claim. Unfortunately, it is unknown what happened to the remains of Kutuzov’s brain. It was last mentioned during his autopsy in 1813, according to the statement. Records of eyewitness accounts from the time, however, back the researcher’s hypothesis, as they claim that Kutuzov’s personality was indeed altered after his two brain surgeries.

According to Preul, the team’s finding are not just a story of the early days of brain surgery but also “a story of how medicine changed the course of civilization.”

Source: Kushchayev SV, Belykh E, Fishchenko Y, et al. Two bullets to the head and an early winter: fate permits Kutuzov to defeat Napoleon at Moscow. Journal of Neurosurgery . 2015

Patient Turned Researcher Helps Advance Understanding of Brain Tumors

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Interested in seeing images of his brain, Steven Keating, currently a graduate student at the MIT Media Lab, volunteered for a research study while attending school in Canada in 2007. When researchers returned his brain scans, they delivered some startling news.

“The researchers told me I had an abnormality near the smell center in my brain, but that lots of people have abnormalities and I shouldn’t be alarmed,” says Steven. However, as a precaution, researchers advised Steven to get his brain re-scanned in a few years.

Brain tumor patient turned researcher

 

 

 

 

 

 

 

 

 

Steven’s next set of brain scans, performed in 2010, showed no changes. But in July 2014, he started smelling a strange vinegar scent for about 30 seconds each day. He immediately had his brain scanned and learned that the strange smell was associated with small seizures due to the presence of a brain tumor called a glioma. Steven’s glioma had grown to the size of a baseball.

Steven met with E. Antonio Chiocca, MD, PhD, chair of the Department of Neurosurgery at Brigham and Women’s Hospital (BWH), who performed image-guided brain surgery on Steven last summer in BWH’s Advanced Multimodality Image Guided Operating (AMIGO) suite.

Since his surgery, Steven has gone through rounds of proton radiation and chemotherapy. He began another round of chemotherapy at Dana-Farber Cancer Institute in February 2015. Steven says he is extremely grateful for his care team, including Chiocca; Patrick Wen, MD, director of the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center; Keith Ligon, MD, PhD, a neuropathologist at Dana-Farber/Brigham and Women’s; and Helen Alice Shih, MD, associate medical director of the Francis H. Burr Proton Therapy Center at Massachusetts General Hospital.

Ever curious, Steven asked to have his surgery videotaped and his genome sequenced, and this information was used to print 3-D models of his brain and tumor. He also has been working with Chiocca and others on 3-D printing research and has given various talks and presentations about his work and his patient experience. Most recently, Steven was invited to the White House for discussions on the importance of allowing patients to have access to their health data.

Chiocca said it has been wonderful working with Steven, both as a patient and researcher. While it’s pretty rare that patients ask for their surgery to be filmed, he said it is valuable for them to participate in the research side of their care when possible.

“It is very easy for a patient to become depressed by their disease,” says Chiocca. “But Steven’s approach of being actively involved to raise consciousness and funding for more research for this type of tumor is remarkable. I’m just so proud to have been involved in his care.”

Having a hard time focusing? Research identifies complex of neurons crucial to controlling attention

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Our ability to pay attention to certain things while ignoring distractions determines how good we are at a given task, whether it is driving a car or doing brain surgery. A research team at McGill University has for the first time convincingly identified a network of neurons in a particular area of the brain, the lateral prefrontal cortex, that interact with one another to promptly filter visual information while at the same time ignoring distractions. It’s a discovery with potentially far reaching implications for people who suffer from diseases such as autism, ADHD and schizophrenia.

neuron

The researchers recorded brain activity in macaques as they moved their eyes to look at objects being displayed on a while ignoring visual . These recorded signals were then input into a decoder running on a which mimicked the kinds of computations performed by the brain as it focuses. With some startling results.

“The decoder was able to predict very consistently and within a few milliseconds where the macaques were covertly focusing attention even before they looked in that direction,” says Julio Martinez-Trujillo, of McGill’s Department of Physiology and the lead author of the paper. “We were also able to predict whether the monkey would be distracted by some intrusive stimulus even before the onset of that distraction.”

But what was even more interesting was that the researchers were able to manipulate the computer’s ability to “focus” by subtly manipulating the neuronal activity that had been recorded and input into the machine. In effect, by manipulating the interactions of the neurons, the researchers were able to induce “focused” and “distracted” states in the computer.

“This suggests that we are tapping into the mechanisms responsible for the quality of the attentional focus, and might shed light into the reasons why this process fails in certain neurological diseases such as ADHD, autism and ,” says Sébastien Tremblay, a doctoral student at McGill University and the first author of the paper which was published in the current edition of Neuron. “Being able to extract and read the neuronal code from higher-level areas of the brain could also lead to important breakthroughs in the emerging field of neural prosthetics, where people who are paralysed use their thoughts to control objects in their environment.”