She's awake- or is she?

Scientists, doctors, and even families are often confused by one question. Is the person who is in a coma and vegetative state actually conscious or not? This haunting question has caused many families to be ripped apart from their loved ones as tough decisions have to be made once the patient is confirmed to be in a permanent vegetative state.

            According to studies conducted by UCLA psychologists, “the difference between being conscious and unconscious is a bit like the difference between driving from Los Angeles to New York in a straight line versus having to cover the same route hopping on and off several buses that force you to take a zig-zag route and stop in several places.” This research puts light on the fact that consciousness is not as simply as many people may think it is. Simply knowing if that loved one in coma is conscious or not is not an easy task for even doctors with years of experience as 43% of the cases are misdiagnosed according to Bor.

            What this new research has to offer is that it shows that consciousness is not simply focused in one aspect of the brain. It is true that the thalamus plays an incredibly important role in consciousness; however, in reality consciousness is dispersed throughout the brain. Scans of people under anesthesia shows how the brains of people in comas and vegetative states may act. Under anesthesia, the signals between the neurons are scattered everywhere and it is difficult to reach the final destination which is similar to patients in a coma who cannot come back. The question then becomes whether or not it is possible to still bring these patients back into a functional state of consciousness.

            Interestingly enough, a famous case of a twenty three year old woman who was in a vegetative state showed immense improvement in her situation. There was even a man who stayed in a coma for thirteen years and then suddenly came back. In order to understand these cases, researchers have used EEGs to track brain activity as well as fMRI scans. By putting patients who are in a vegetative state under the scanner, researchers have found that many of them are actually not completely unconscious. Some even have portions of their brains that work exactly like the normal healthy patients.

            Newer therapy such as deep brain stimulation which stimulates the thalamus as well as the prefrontal cortex have been used to bring certain patients to conduct a limited number of activities such as being able to press buttons and follow simple commands. However, it is still a long way to go before adequate treatment is found since the surface has only been scratched with our understanding on what it means to be conscious. Not only that, a severe issue has become that patients who do come back suffer from extreme amnesia, memory, as well as behavioral problems. A scan of their brains reveals that their brains have shrunk in size significantly with the large amount of damage. Not only has their personality changed, but they are no longer the same person. In the coming days, the new question may become how to deal with patients who have come back from a coma as that poses a whole new issue in itself.

Bor, D. (2012).The Ravenous Brain: How the new science of consciousness explains our insatiable search for meaning. New York: Basic Books.

University of California- Los Angeles. (2013, October 17). Psychologists report new insights on human brain, consciousness. ScienceDaily. Retrieved October 11, 2014 from

www.sciencedaily.com/releases/2013/10/131017173646.htm 

The Line Gets Blurrier Between Being Knocked Out or Awake.

       The article that I chose to interpret is called Awake or Knocked Out? The Line Gets Blurrier by James Gorman, published by The New York Times. I found this article quite interesting because I have always wondered about the question it is intending to answer. The article relates to the concept of consciousness as discussed in the Ravenous Brain by Daniel Bor. In his section, A Thin Veil Between Life and Death, he discusses the vegetative state which is characterized by having some sort of sleep-wake cycle and sometimes opening one’s eyes, but no awareness that oneself is in a vegetative state. The news article focuses on unconsciousness, consciousness and the differences between them.

 According to James, it is a continuing struggle to determine what consciousness is and where it comes from in the brain. One of the contributors to this problem is the fact that the word consciousness has multiple definitions. However, since the discovery and use of ether as an anesthetic in 1846, a lot has been learned about the unconscious mind. Currently, researchers use anesthetic drugs, such as propofol and dexmedetomidine, alongside different types of brain scans to observe which parts of the brain turn off and on. For example, a study by The Journal of Neuroscience found that the command for opening one’s eyes could be completed without the need for higher level thinking parts of the brain. Dr. Alkire found from his research that the brain stem and other primitive parts of the brain turn on first when coming into consciousness. Meanwhile, other research from Adrian Owen shows that consciousness is not a simple on or off method, it is a process that involves varying levels of gradation. Currently, we define consciousness as to whether one can respond to commands or not. One question we are still struggling to answer is that if a patient has no recollection of an event, was he even aware of it? How could we ever answer this question?

In Daniel Bor’s book he discusses the vegetative state and how only half of VS patients recover and regain consciousness, and that the longer one is in VS the less likely recovery can occur. VS is a form of unconsciousness that can be linked with brain injury, infection or drug overdose. There are two types of VS, one lasting longer than a month is referred to as persistent vegetative state and one lasting more than a year is referred to as permanent vegetative state. Like the news article mentioned, it can be difficult to discern the difference in consciousness and VS. Reflexes such as grinding of the teeth, smiling and weeping may occur during a VS. These reflexes can be difficult for doctors and loved ones to interpret as just random reflexes instead of intentional and conscious actions. To determine consciousness doctors look for intentional movements such as the eyes following stimuli, and speech as indicators. However, this is not a completely successful method with over 43% of patients being misdiagnosed. As the news article mentioned, research could be done using anesthetics and many different brain scans ranging from PET, CT or even MRI to discern the active regions of the brain during unconsciousness. This research can help us learn about the vegetative state and maybe how to avoid it in the future.

Gorman, James. "Awake or Knocked Out? The Line Gets Blurrier." The New York Times. The New York Times, 16 Apr. 2012. Web. 14 Oct. 2014. <http://www.nytimes.com/2012/04/17/science/studying-states-of-consciousness.html?module=Search&mabReward=relbias%3As%2C%7B%222%22%3A%22RI%3A13%22%7D>.

Lack of Quality Sleep: Symptom or Cause of Depression?

Usually when we think of treatments for mental illnesses like depression, we think of things such as antidepressants, talk therapy, or a combination of the two. However, what about sleep therapy? A new study has been researching a new type of therapy called cognitive behavioral therapy for insomnia, abbreviated CBT-I. Throughout this therapy, clients are taught skills to reserve time in bed only for sleeping – a concept that is different from “sleep hygiene”. The New York Times article by Benedict Carey explains how in 2008, Dr. Manber of Stanford tested CBT-I and used sleep hygiene as a control treatment; she found that 60 percent of patients who received the CBT-I therapy and an antidepressant, versus 33 percent who received simple sleep hygiene therapy and an antidepressant, recovered fully from their depression. Carey further explains how scientists are now speculating that instead of poor sleep being just a symptom of depression, the relationship may actually be bidirectional; in other words, poor sleep may precede depression for some. Several studies have now shown that insomnia doubles a person’s risk for later developing depression.

These findings are relevant to and support Daniel Bor’s claims in his book, The Ravenous Brain, that psychiatric illnesses, such as depression, may be caused by “shrunken” consciousness (Bor 242). Shrunken consciousness, Bor explains, can be caused by something as simple as lack of sleep, for an astounding amount of people (243). He further explains, like the news article does, that conventional wisdom used to state that sleep problems were a symptom of psychiatric disorders, rather than a potential cause (245). However, these notions today are becoming increasingly challenged. Bor even goes on to talk about Paul Peppard’s research study, in which he studied those suffering from sleep apnea, which causes individuals’ sleep to get disrupted by pauses in their breath every few minutes throughout the night. In Peppard’s study, he actually found that those with sleep apnea, who therefore had disrupted sleep, were more likely to suffer from depression.

In our busy day-to-day lives we sometimes forget the importance of giving high priority to getting a good night’s sleep. However, based on these recent studies, as well as Daniel Bor’s explanations in his book, lack of sleep is more hazardous than we think. Besides it being simply annoying and difficult to function every day on a few hours of sleep, lack of proper sleep may actually put one at greater risk for developing a psychiatric illness such as depression.

Carey, Benedict. "Sleep Therapy Seen as an Aid for Depression." The New York Times. The New York Times, 18 Nov. 2013. Web. 14 Oct. 2014. <http://www.nytimes.com/2013/11/19/health/treating-insomnia-to-heal-depression.html?pagewanted=all>.

Bor, Daniel. The Ravenous Brain: How the New Science of Consciousness Explains Our Insatiable Search for Meaning. New York: Basic, 2012. Print.

Reawakening from the Black Hole of Unconsciousness

  In her article “Bringing Back the Unconscious: The Latest Science on Awakenings”, Claudia Wallis examines the mysteries of unconsciousness and the borderline that separates it from wakefulness and awareness. Her discussion begins by introducing the remarkable story of 23-year old George Melendez, who had suffered from a traumatic brain injury that left him “all but dead” due to a tragic car accident. After the medics revived him, the injuries left him in a minimally conscious state. Melendez was awake and occasionally aware of his surroundings but could not respond reliably. Although it was heartbreaking for his mother and stepfather to hear the news from the doctor that there was not much else they could do to save him, the parents never lost hope and continued to care for their son. Four years later, a doctor had prescribed Melendez the common sleep drug zolpidem (Ambien) to help with his consistent thrashing and moaning throughout the night. Extraordinarily, Melendez had woken up. It turned out that he did not suffer from any memory loss except of the car accident. 

 As specified in the article, studies have shown that although Ambien does not have the same effect on every patient suffering from impaired consciousness, it has proved beneficial to an estimated one in every 15. Furthermore, continued research has identified a measurable pattern of brain activity that may indicate which minimally conscious patients can potentially awaken further. A new study team led by neurologist Nicholas Schiff examined the brain activity of three minimally conscious patients that responded positively to Ambien. Prior to treatment with the drug, all three showed the same unusual pattern of brain activity when monitored by the electroencephalogram (EEG), a system used to measure the electrical activity of the brain. It showed a low frequency spike of activity that was synchronized throughout both halves of the brain. This abnormal pattern disappears when the patients were given Ambien. Schiff suspected that the unusual EEG pattern reflected that crucial parts of the cerebral cortex were able to function properly, but the trauma disconnected them from other critical brain circuits that were needed in order to fire normally. He explains that Ambien turns on the level of joint connections between three important brain regions by activating up neurons that are sensitive to the neurotransmitter GABA. Ambien creates a buzz that many would experience when consuming alcohol, which is enough to turn on many brain circuits. 

            Daniel Bor attempts to link consciousness with information processing throughout his book The Ravenous Brain. One of the many topics he discusses questions why human consciousness fluctuates throughout our lives in contrast to other creatures. He relates this idea to his personal experience of general anesthesia when he had to undergo surgery due to a knee injury. Immediately after he regained consciousness, Bor recalled feeling “pleasantly drunk.” Remember, Bor did not suffer from any major traumatic brain injury, and so he was able to regain consciousness easily from the anesthesia. Patients who have suffered from brain damage are not able to regain this consciousness. However, this state of minimal wakefulness was what Melendez was able to reach after an initial dose of Ambien. The manner in which Ambien contributes to the link between consciousness and information processing can be further explained by understanding Bor’s overview of the structure of the brain.

            The creative processing of the human brain reveals a schematic in which three evolutionary versions of the brain are interconnected within our neurological system. The most primitive or “reptilian” brain includes the midbrain and brain stem. It is surrounded by the limbic or “early mammalian” system and is the root to instinct behavior. Finally, the neocortex or “late mammalian” system makes up the outer shell and is responsible for complex mental activity. These “three brains” normally work together and are highly interconnected. Traumatic brain injury results in the severing of these connections. Therefore, these patients suffer from its negative impacts on basic functions of survival and consciousness.

Bor also explains that anesthetic agents increase the production of GABA and dampens neuronal activity throughout the cortex. During this state, neuronal firing is more synchronized with strong spikes that pulse through the cortex in slow rhythms. It can be understood that there exists an association of slow neuronal activity and being heavily unconscious or under the state of minimal consciousness. This was demonstrated in Schiff’s study of the EEG patterns in the patients suffering from brain injuries. 

 It is important to consider that the reason why Ambien may have worked for these patients is that the specific injury had not damaged the neurons in the brain that release GABA. Their minimal state of consciousness resulted when neurons in their brains (assuming that these were the neurons that became damaged due to the injury) were not able to respond to the release of neurotransmitter. However, I wonder how these connections can be reestablished if the neurons themselves are damaged. The drug surely can’t rapidly rebuild a damaged neuron, considering that Melendez was able to eat breakfast by himself the following morning after the Ambien dosage. So the drug may have some other effect on neighboring neurons that do not normally function in the interconnection between the “three brains.” Although Ambien may have given these patients’ their normal, healthy lives back, research must continue to understand the mechanisms of how such an immediate, remarkable “cure” can be reached.

Wallis, Claudia. "Bring Back the Unconscious: The Latest Science on Awkenings." Time. Time, 23 Nov. 2013. Web. 14 Oct. 2014. <http://healthland.time.com/2013/11/22/bringing-back-the-unconscious-the-latest-science-on-awakenings/>.

What Underlies Autism?

Historically, autism has been thought to be a disease that is defined by a social impairment. Recently, however, neuroscientists have uncovered other causes that may underlie autism. These scientists claim that it is not social impairment that is at the root of autism, but rather it is with hyper-connected neurons within the mind.

Kaustubh Supekar and his colleague, Vinod Menon, from the Stanford University School of Medicine have conducted research that provides that autism is a result of these hyper-connected neurons. The study can be found here: http://www.sciencedaily.com/releases/2013/11/131107123039.htm. These individuals used one of the most advanced neuroimaging datasets available today to view the neuron connections in children. The results show that individuals with autism had neurons with more connections, or synapses, than normal individuals. Furthermore, those with more severe cases of autism had even more interconnections, displaying a direct relationship with autism and the connected neurons.

Daniel Bor, neuroscientist and author of The Ravenous Brain, touches on autism in his book. Bor asserts that autism is caused by an extreme consciousness of the mind. This extreme consciousness may be attributable to the hyper-connected neurons that Supekar and Menon found in their study.

Many people and scientists believe that autism is a lack of mental ability and entails mental retardation. This is not the stance that Bor, Supekar, Menon take, however. Supekar and Menon argue that many of the children in their study were “high-functioning” and averaged IQs of above 70. Furthermore, Bor assures his readers that autistics are not mentally retarded. The Wechsler IQ test that is used in many cases is biased because it also focuses on linguistic ability, which autistics struggle with. On other IQ tests, autistics averaged 30-70 points higher. He sites the example of Albert Einstein, an autistic who is considered one of the most intelligent beings of all time. Moreover, he explains that although their over consciousness may make these individuals better at certain tasks, it impairs their social skills. It is not the bad social skills that create autism though; it is the over conscious mind and focus on patters and organization that impairs their social skills.

These hyper-connected neurons that Supekar and Menon speak of explain why many autistic individual’s, specifically those with Asperger’s syndrome, are able to preform at very high levels in certain tasks. It also goes hand in hand with Bor’s theory of an overabundance of consciousness. Bor states, “If autistics have a wider consciousness than others, from the main thesis of this book it would follow that they would then also have a more patterned, structured mind. This, I would argue, is one of the hallmark features of autism, and one of the most common symptoms, from the most disabled autistic child to the most towering genius classed as having Asperger’s syndrome” (236). Thus, since autistic individuals are more concerned with patterns and organization than others, such as organizing things or repeating certain tasks, they have developed more structured minds. This would explain Supekar’s and Menon’s theory of why the autistic participants had such hyper-connected neurons. 

All three scientists argue that current forms of treatment for autism are insufficient, because the actual cause is not popular belief. There are pharmacological methods however, such as the drug Arbaclofen, which have shown promising results. This drug would help lower the amount of consciousness in autistic individuals by restoring a balance between neuronal firing and neuronal suppression. With these findings, the former behavioral methods, used to treat the social impairment, can be forgotten and the ones that target the true issue within the neurons can be implemented more.

Do Infants Possess Awareness?

Awareness is a concept that is heavily debated and researched. An important distinction that has yet to be discovered is when infants become truly conscious. In The Ravenous Brain by Daniel Bor, Bor asks important questions relating to what defines the start of consciousness. Is it when the fetus is “kicking and punching away on a regular basis,” or when the fetus “wakes up in the sudden, shocking moment of birth?” He gives even more examples of times when consciousness could begin in an infant. His personal experience from watching his baby daughter leads him to think that there could be a “strong sense of awareness soon after birth,” but he cannot confirm this because the behavioral approach tends to fall short due to the lack of signs of awareness so early on in development.

               Luckily, there has been new research finding strong signs of awareness in very young infants. In an article on livescience.com, writer Stephanie Pappas outlines the study published in the journal, Current Biology. The study was conducted by Maria Laura Filippetti and her colleagues in which they focus on the infants’ awareness of their own bodies based upon an adult study. That study found that adults believe that a rubber hand is their own when they see it on video when their real hand is stroked at the same time. Filippetti tested 40 newborns ranging from 12 hours to 4 days old who were shown a video of the baby’s face being stroked by a paintbrush. They also delayed stroking by five seconds and then proceeded to repeat the test, but with the baby’s face being shown as upside down. The researchers found the babies to view the screen longest when shown the video of their faces right side up, which indicates they likely have an awareness of their face. The findings imply that “babies are born with the basic mechanisms they need to build body awareness.” More testing definitely needs to be done, but the findings do correlate with Bor’s opinion that he made from observing his daughter. Awareness could definitely start very soon after birth.

Pappas, By. "Babies Are Born with Some Self-Awareness." LiveScience. TechMedia Network, 21 Nov. 2013. Web. 14 Oct. 2014. <http://www.livescience.com/41398-baby-awareness.html>.

How Does the Brain Afford to Pay Attention?

How Does the Brain Afford to Pay Attention?

Attention is a phenomenon that takes place when our brains fire neurons in a particular region reinforcing a particular idea, concept, or object. An article titled, “Brain regions ‘tune’ activity to enable attention,” by Michael C. Purdy describes how the brain selectively attends to a certain stimulus. Purdy states, “If areas of the brain involved in detecting a stimulus are at maximum excitability, you would be much more likely to notice the stimulus.” Because the stimulus of interest is emphasized in the brain, it remains a subject of focus, which enables one to remain attentive to it, and ignore the other stimuli that are present. In The Ravenous Brain by Daniel Bor, these neurons are directed based on a competition between the various information the brain receives. An example Bor uses regards a fearing stimuli that is consistently being paid attention to. Bor states, “If you’ve experienced fear of wasps, and one is buzzing around, anything remotely wasp-like suddenly is mistaken for a wasp….the neurons relevant to the details of a wasp are so active that these primed neurons are latching onto any tiny hint of it.” With that said, the fear of wasps is constantly being strengthened by the repetitive firing of neurons pertaining to that particular stimulus, and the competition of focus is that which will win the “battle,” so to speak. Furthermore, any similar buzz-sound or any insect that is present and flapping its wings may trigger the same firing neurons, for they are considered related and significant for that situation.

Another example to better explain this occurrence would be at a venue where many people are present and it’s raining. Let’s say you are looking for a friend that had a bright yellow umbrella. The stimulus you are looking for, (the yellow umbrella), will be the primary focus of interest and you would ignore anything that is not relative to this. This is because the brain would focus on anything that may appear as a potential yellow umbrella. It is almost as though the object you are looking for is magnified or exaggerated, or “more vivid” in Bor’s terms. Purdy describes this event as “excitability” in the parts of the brain associated with the certain item of concentration. Additionally, the other information the brain processes is not paid attention to because the brain will “ignore irrelevant sensory stimuli” according to Purdy. Only neurons that relate to or concern the stimulus that is capturing your concentration will be those that are then in your attention and everything else is overlooked or unnoticed. Both Purdy and Bor explain this event similarly in respects to the way in which the brain fires neurons to a specific region, an area that affects a specific thought, idea, or object.

Bor, D. (2012). Pay Attention to that Pattern! In The ravenous brain: How the new science of consciousness explains our insatiable search for meaning (p. 124). New York: Basic Books.

Washington University in St. Louis. (2014, January 16). Brain regions ‘tune’ activity to enable attention. ScienceDaily. Retrieved October 6, 2014 from www.sciencedaily.com/releases/2014/01/140116084844.htm