Ringel, Steven P. MD
Readers of Neurology Today may recall my enthusiastic endorsement of earlier editions of The Best American Science Writing. This year's collection, edited by Gina Kolata, is no exception. This well-known science writer selected articles that engaged me immediately and might change the way we view the world. Seven of the 20 articles are about the brain, an indication of how interested the public has become in recent discoveries in neurology and the neurosciences.
THE NEUROBIOLOGY OF DECEPTION
In “Looking for the Lie,” Robin Henig reviews the neurobiology of deception and attempts to find a more reliable lie detector than the polygraph. The US Department of Defense Polygraph Institute at Fort Jackson, SC, is developing technology to record physiological properties that change with lying: thermal scanners, eye trackers, pupillometers, cerebral blood flow recordings, evoked potentials, and functional MRI (fMRI). The MRI studies show differing patterns of brain metabolism in the anterior cingulate cortex and superior frontal gyrus with spontaneous versus rehearsed lies.
Event-related potentials can predict 260msec after a true-false statement is flashed on a screen whether someone intends to lie. That's right — big brother can evaluate your intentions and visualize your thought processes as you plan and execute a confabulation. It will indeed be a brave new world if these ‘credibility assessment’ tools gain traction!
All of us have become accustomed, if not addicted, to the World Wide Web, but did you ever imagine that a neurological entity would be discovered through the Internet? In “Face Blind,” Jonathan Davis describes how an individual with a life-long inability to recognize faces — developmental prosopagnosia — established a Web site to find others like him. Hundreds of people responded and Internet registries were established. Epidemiologic studies estimate that six million people in the US may have trouble recognizing faces. fMRI studies show reduced blood flow in the fusiform face area of the visual cortex when prosopagnosics look at faces.
Fans of Oliver Sacks — and I'm among them — know that he had a very stimulating and unorthodox childhood that fostered his curiosity. In “Stereo Sue,” Sacks describes his lifelong fascination with stereoscopes, his experiments as a child with taking three-dimensional pictures and going to 3-D movies. (Are you old enough to remember putting on red-green Polaroid glasses to watch the horror film “House of Wax”?)
Sacks, a self-described “stereophile” who collects stereograms and books about stereoscopy, is a member of the New York Stereoscopic Society. It's therefore easy to understand why this talented neurologist studies individuals with childhood strabismus who never have been able to see things in three dimensions. Although it was thought that these people never develop binocular cells, Sue was delighted to experience stereopsis for the first time in 50 years following visual exercises. Parenthetically, Sacks also recalls his own transient loss of stereoscopy when he was confined to a small, windowless hospital room for three weeks.
DBS FOR DEPRESSION
In 2004, a public health nurse participated in a clinical trial using deep brain stimulation (DBS) for her own treatment-resistant depression. Twelve patients participated, and she was one of the eight in which the depression lifted. In “A Depression Switch,” David Dobbs describes her case and others in early trials by Andres Lozano, a neurosurgeon, and Helen Mayberg, a neurologist, using DBS in area 25 of the brain.
Dr. Mayberg and her colleagues suggest that depression involves abnormal patterns of activity in both limbic and cortical regions, particularly in area 25. Although this procedure still awaits testing in a large randomized trial, the results could change the way physicians think about depression. Current pharmacologic approaches support a neurochemical model of mood disorders, but the observation that stimulation of the deep midline brain region overcomes depression has led to a network model of depression that puts greater emphasis on pathways and regions accessible with electrical or surgical treatments.
Although not yet FDA-approved, a new technology makes it safer for vascular neurosurgeons to bypass large cerebral aneurysms. In “With Lasers and Daring, Doctors Race to Save a Young Man's Brain,” Denise Grady describes how, without having to occlude the artery, a hand-held exciser-laser is used to burn a hole between each end of a graft and the diseased vessel after the graft is sutured into place. For those of you concerned about runaway health care costs, the exciser is $500,000. Given the few cases that require this type of surgery, it is unlikely that you will see it soon in your hospital.
In “Mind Games,” John Cassidy describes how functional neuroimaging is used by “neuroeconomists” to explore the brain regions that activate when people make rational or emotional choices in financial decisions. In scenarios with less information and more risky propositions, enhanced activity in the amygdala and frontal cortex causes some people to be risk-averse. In people with brain injuries in areas that process emotions, risk aversion is less prominent. Who knows, maybe the next generation of neurologists will be assisting Wall Street tycoons with their investment strategies?
In “Probing a Mind for a Cure,” Stacey Burling follows the life of “an articulate and gentle theologian” who becomes increasingly profane, combative, and inarticulate. Since he is a patient at the University of Pennsylvania Memory Disorder Clinic, the article also describes the latest research by John Trojanowski and his wife Virginia Lee at Penn's Center for Neurodegenerative Disease Research. Burling skillfully describes the personal tragedy of the Presbyterian minister while weaving in research progress in this field.
BROADER THEMES IN SCIENCE AND MEDICINE
Beyond the scope of neurology and neuroscience, the anthology touches on broader themes in science and medicine. In separate articles, three prominent physician medical writers point out the changing landscape of medical practice. In one, Lawrence Altman, describes the protracted recovery of a 97-year-old man who undergoes repair of a dissecting aortic aneurysm. In addition to highlighting the difficulties of providing care to the elderly, we learn that the patient is Michael DeBakey, the famous Baylor cardiovascular surgeon who developed the surgical procedure.
In “Truth or Consequences,” Jennifer Couzin follows six graduate students who accused Elizabeth Goodwin, the director of their genetic lab at the University of Wisconsin, of data falsification. Goodwin resigned and is still under investigation, but three of the students have quit school and two have started over. A fraud investigator provided a sobering commentary: “It's never a good career move to become a whistleblower.”
Figure. Dr. Ringel w...Image Tools
In “Hollywood's Science Guru,” Gregory Moore features John Underkoffler, a former MIT professor of engineering-cum-science advisor for eight major studio films, including Ang Lee's “Hulk” and Steven Spielberg's “Minority Report.” If you aspire to be a part of the motion picture industry, this story may stoke an ember burning inside you.
Almost every day we learn about a new paleontology discovery that redefines our evolutionary history. But did you know that Mary Schweitzer discovered remnants of tissue in dinosaur bones and suggested in Science that dinosaur fossils are not millions of years old, but rather were fossilized as recently as a few thousand years ago? As pointed out by Barry Yeoman in “Schweitzer's Dangerous Discovery,” many doubt that the field of molecular paleontology she invented is valid. Not surprisingly, biblical literalists who believe that God created life less than 10,000 years ago are intensely interested in her observations.
Two articles combine studies of evolution with theories of global warming. In one, researchers who study butterfly migrations, mosquitoes laying eggs, and the extinction of mountain-dwelling toads, convincingly show that global warming is altering evolution. In another, we learn that geologists and paleoclimatologists line up in two camps — those who are proponents of the greenhouse theory of global warming and those who see it as an oversimplification of a complex picture of natural variation. This scholarly dispute was not adequately discussed in Al Gore's popular movie “An Inconvenient Truth.”
There are stories here about computers and men. How about a computer network that evolves its own software to adapt itself so it can solve problems? This thinking machine — not a person — has its own patent. And then there's the story of Grigory Perelman, a reclusive Russian theoretical mathematician who refused to accept a prestigious Field Medal, the mathematician's Nobel Prize, because he didn't want to be distracted from doing his work.
There's much more fascinating reading here than I can provide in a brief overview. But this much is clear: whether you want to learn about how theoretical physicists are trying to unite theories of general relativity and quantum mechanics — something Einstein could not accomplish — or what happens to the proteins in the eggs you cook — this collection of articles will stimulate your appetite for learning.