Sunday, May 29, 2011

Live from the sky, somewhere over the prairies

It’s been a while, science-loving friends, and I apologize. I could list all the things that have kept me away from this blog in the past month, but then I might scare away anyone who is considering the postdoc life. Instead, I will reward your patience with brain news hot off the press: a report from a neuroethics conference I just attended in Montreal called Brain Matters. As with previous conference reports, I will share my insights in bullet-proof format, as my foggy jet-lagged brain cannot write a coherent paragraph at the moment.

  • The conference brought together a large variety of professionals: neuroscientists, lawyers, bioethicists, philosophers, psychiatrists, you name it. As it turns out, psychiatrists know a joke or two.
  • We heard quite a bit about how the media handles neuroscience news. The consensus is that in most cases (but not all), the answer is poorly. The blame gets tossed around. Journalists hype research too much, but it’s not their fault, they need to sell papers. Researchers hype research too much, but it’s not their fault, they need to get funding. I voted to shift the blame onto grad students. I also thought we could solve the problem easily by making everybody read Scientific Chick. It didn’t take as well as I had hoped.
  • We also heard quite a bit about deep brain stimulation (DBS), a potential treatment for a variety of illnesses and conditions that involves sticking a stimulating electrode in the brain and leaving it there. Right now, this works relatively well for treating advanced cases of Parkinson. The problem is that it comes with side effects and that people undergoing this type of treatment are reporting things like “no longer feeling like themselves”. This brings us to an important question: What does it mean to feel like yourself? One of the most fascinating talks of the conference involved an in-depth discussion of personal identity and how it is or isn’t affected by brain interventions like DBS.
  • There was also a discussion of self-experimentation. Should willing neuroscientists be allowed to stick electrodes in their own brains to advance our knowledge of neuroscience? The speaker argued that we allow people to skydive and bungee jump without having them fill endless forms and run their proposal to do something crazy through an ethics board, so self-experimentation should be no different. I mean, do you want the Nobel Prize or not?
  • One of the most interesting talks was on placebos. The researcher argued that antidepressants work only marginally better than placebos in most cases (though not all cases), and so we should really ask ourselves whether the small improvement is worth the side effects. I thought of a genius business venture that involves selling sugar pills for every possible condition. Then I remembered that this already exists. It’s called homeopathy.
  • Speaking of placebos, everyone always assumes that they only work because you think you’re getting an active drug. Some researchers were skeptical about this, and so they carried out this fascinating study that involved giving placebos to people with irritable bowel syndrome, but also telling them that they’re getting placebos the entire time. Guess what? They felt better anyway.

This blog post is already dragging on too long, but these were just a few of all the very interesting topics and discussions we had over two days. I hope to be back with regular science programming very shortly, so stay tuned for the latest and greatest!

6 Responses to “Live from the sky, somewhere over the prairies”

TherExtras said...

Well worth the wait, SC! Hilarious AND useful. Watch for a link to this post to show up on my blog.

I once heard a physician give a talk (I swear it was the guy who did early research on how cystic fibrosis affects the digestive system) and reveal how he and a couple of other MDs did the pilot study work on themselves. It involved precise measurements of intake and output, if you get my drift.

Looking for more interesting fun here after you rest-up.
Barbara

veach glines said...

Wait, what? Telling someone they are not getting drugs, just placebos, while treating them...was sufficient?

I'm interested in your thoughts on "why".

Suppositions:

These patients were going to get better on their own, anyway.

Their affliction(s) were psychosomatic.

Interaction with medical professionals was sufficient to alter some aggravating behavior.

Patient self-evaluation "false positives" because they want to report what the experimenter wants to hear.

(?)

Thanks for sticking around, Barbara. :)

veach, you ask a very good question. My two cents:

- Patients would have gotten better on their own: Not necessarily. For many ailments, yes, there can be some spontaneous improvement. That said, in this study that I mention, the researchers controlled for that by having a cohort that didn't get the placebo.

- Afflictions were psychosomatic: We have to be very careful here: it's not because a placebo works that the affliction is necessarily "all in the head" - e.g. psychosomatic. Some diseases with proven biological causes can improve with a placebo.

- Interactions with a medical professional: in some cases, yes, that would do it. But here again they controlled for this.

- False positives: Difficult to rule out. Seeing as I'm no specialist in IBS, I'm not sure what measures they would use to determine if there was improvement or not. Looks like I'll have to blog about this. :)

So why did this work? The answer is still out there. Some people think that a placebo is akin to Pavlovian conditioning: the brain associates a ritual with a feeling. This is a very concrete pathway in the brain and has been shown to work in a variety of contexts. But the truth is, I'm not sure exactly what is going on. I'll see what I can find.

TherExtras said...

Based on the marginal more improvement of antidepressants over placebo while there were dramatic improvements in some - wouldn't decreasing overall dosage recommendations be logical and decrease side-effects?

Barbara

Seemingly said...

As a sufferer of Crohn's, a cousin of IBS, I can tell that stress and anxiety plays a role in the disease's development, although exact causes are still unknown. Traditional medical science also have a very poor track record of treating IBS, and most medications have limited effect if any.

From this point of view, the best remedy is still good ol' human compassion, which can be given through any form, either with active medication or sugar placebo.

I would not recommend this approach on afflictions where the cause and the symptoms are well defined and well understood. Keep taking them heart pills!

Anonymous said...

Interesting insight on DBS. It shows that being yourself is a property of the self that cannot be “tapped in” from the outside environment. In other words, we are “doomed inside the brain”.
Being happy about my unhappiness, works for me most of the times, is just the aspirin that always will take care of my headache, regardless of any other techniques I try.

 
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