Brain on fire

When a new discovery in medical science is made, there's always the danger that gullible and/or hopeful people will misinterpret the results.  The danger is especially high when the discovery has to do with something simple and accessible, such as the find that trans-cranial electrical brain stimulation leads to higher cognitive function.

[image courtesy of the Wikimedia Commons]

A year ago, some researchers at Oxford University found that a painless, non-invasive application of "electrical noise," delivered through electrodes attached to the scalp, improved attention, accuracy, and memory, and that the effect lasted for weeks or months.  The procedure is called TRNS (transcranial random noise stimulation), and shows great promise in helping individuals with cognitive impairment -- and perhaps even us ordinary folks who just want a boost in our thinking ability.

"Performance on both the calculation and rote learning tasks improved over the five days, and the former improvements were maintained until six months after training," study leader Dr. Roy Cohen Kadosh told reporters.  "Research has shown that by delivering electricity to the right part of the brain, we can change the threshold of neurons that transmit information in our brain, and by doing that we can improve cognitive abilities in different types of psychological functions...  Our neuro-imaging results suggested that TRNS increases the efficiency with which stimulated brain areas use their supplies of oxygen and nutrients...  Participants receiving TRNS showed superior long-term performance, compared to sham controls, six months later."

So far, pretty cool.  But of course, when a researcher discovers something like this, it opens the door for the greedy to take advantage of the gullible by creating their own electrical stimulation devices, and claiming that "research shows" that they'll help you to think better.

"A headset for gamers, take charge... Overclock your brain," claims one company that sells home electrical stimulation devices.  Another one states: "Can you learn 20-40% quicker, reduce pain, feel better, increase energy or reduce stress with tDCS?  Research studies say, YES!"

There's even a forum on Reddit devoted to the subject -- complete with claims that TRNS can treat everything from autism to schizophrenia.  Less publicized, though, are the accounts of people who have burned their scalps because of leaving the electrodes on too long, or using a unit that delivers a higher-than-recommended voltage.

Through all of this, there have been some voices calling for reason.  Dr. Hannah Maslin, also of Oxford, published a paper calling for regulation of these devices.  "It is becoming increasingly easy for individuals to buy brain-modulating devices online that promise to make the user’s brain work faster, or more effectively, or more creatively," Maslin writes.  "Such devices can involve passing electrical currents through one’s brain or using electromagnetic fields to penetrate the scalp and skull to make neurons fire.  Yet, when purchased outside clinical settings, these devices are unregulated, with no system in place to ensure their safety.  With the market for enhancement technologies expanding, and with devices already crossing international borders, controlling which products are approved for sale is a global issue, potentially requiring international regulatory harmonization."

Steven Novella, neurologist at Yale University, put it even more bluntly.  "Any device with medical claims that it's meant to affect our biological function should be appropriately regulated.  Regulation is the only thing that creates the motivation to spend the money and take the time to do the proper research."

Of course, I'm expecting that this will bring howls of anger from the alternative-medicine crowd, who get their jollies claiming that the medical establishment is actively trying to keep us all sick so that they can make more money.  The truth, of course, is that regulation is about protecting people from their own ignorance.  TRNS does show great promise in improving memory and cognition -- but putting those devices in the hands of people who don't know how to use them correctly is asking for trouble.

So if you're tempted by the hype, my advice is to put away your credit card and read some of the actual research.  It may be that eventually TRNS units will be available for use for ordinary folks, but right now they're (rightfully) in the hands of the medical researchers.  Heaven knows I'd like to think more clearly; but I'm not going to cave in to that desire and end up burning a hole in my scalp.

Call me a Nervous Nellie, but I'm just going to err on the side of caution in this instance.

Sleepless in upstate New York

Any regular reader of Skeptophilia who pays attention to the timestamp on my posts knows that I'm a bit of an insomniac.

I have suffered from chronic insomnia since I was a teenager.  It started with bizarre, vivid dreams, which often would wake me up (sometimes because I'd thrashed around so much I'd fallen out of bed).  Once awakened in the wee hours, it takes me long enough to fall back to sleep that I frequently just give up and get up.  Most of the conventional sleep aids haven't helped; the mild ones (like valerian and melatonin) are ineffective, and the stronger ones worry me because of their capacity to become addictive.  So mostly, I've just put up with it, living and working on a chronic sleep deficit, and trying to catch time to take catnaps whenever I can.

So, naturally, I was pretty intrigued when I ran across an article called "Life Without Sleep," by Jessa Gamble.  Her piece begins with a bit of a history of sleep deprivation, and includes the efforts by the military to come up with a way to combat fatigue in soldiers (most of which, by the way, were either ineffective in the long term or had dreadful side effects).  But my attention really perked up when she started talking about two potential therapies for chronic insomnia -- transcranial direct-current stimulation (TCDS) and transcranial magnetic stimulation (TMS) -- which work not by getting you to sleep, but by reducing the amount of sleep you need.

TCDS and TMS both work on the same principle; using an external energy source to trigger neuronal firing in the brain.  Both of these treatment modalities are, pretty much, what they sound like.  TCDS involves placing electrodes on the scalp, and introducing a electric current into the brain; TMS places the head in a powerful magnetic field.  Both of them have been used, with results that I'd file in the "interesting" column, to treat depression, anxiety disorders, and schizophrenia.  Both have no known long-term side effects, although TMS apparently has a low risk of causing seizure or fainting.  (For me, the main risk of TCDS is that I would spend the entire time worrying that I was participating in a reenactment of the climax of One Flew Over the Cuckoo's Nest.)

According to Gamble, both of these treatments show great promise in helping with insomnia.  About TCDS, she says:

After a half-hour session of the real treatment, subjects are energised, focused and keenly awake. They learn visual search skills at double the speed, and their subsequent sleep — as long as it does not fall directly after the stimulation session — is more consolidated, with briefer waking periods and longer deep-sleep sessions.

TMS apparently has shown similar results:

Using a slightly different technique — transcranial magnetic stimulation (TMS), which directly causes neurons to fire — neuroscientists at Duke University have been able to induce slow-wave oscillations, the once-per-second ripples of brain activity that we see in deep sleep. Targeting a central region at the top of the scalp, slow-frequency pulses reach the neural area where slow-wave sleep is generated, after which it propagates to the rest of the brain...  TMS devices might be able to launch us straight into deep sleep at the flip of a switch. Full control of our sleep cycles could maximise time spent in slow-wave sleep and REM, ensuring full physical and mental benefits while cutting sleep time in half. Your four hours of sleep could feel like someone else’s eight. Imagine being able to read an extra book every week — the time adds up quickly.

What I'm imagining, at the moment, is not feeling chronically exhausted, and not having to worry about falling asleep at the wheel during my ten-minute drive home from work (a fear I deal with on more days than I'd like to admit).  I imagine not constantly wondering when I'm going to have time to take a nap so I can actually be wide awake after eight o'clock at night.

It's a happy picture.

Of course, the worrywart side of me wonders what the long-term effects of this might be.  We still understand very little about why animals need sleep, and less still about why they dream.  Messing about with a physiological system we don't fully comprehend seems rather foolhardy.  On the other hand, the tests that have been done so far support the contention that TCDS and TMS are relatively safe, are non-invasive, and show great promise in dealing with chronic insomnia, a condition which according to the National Sleep Foundation plagues 10-15% of adults.

I'd volunteer to give it a try, even given the iffy status of the risks.

But right now, I think I'd better wrap this up, because the coffee's done brewing, and given how little sleep I got last night,  I could sure use a cup or two.  Or five.