Deep Brain Stimulation for the Soul

See the effect of the "mind control" surgery, when patients turn their electrodes off.
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A PET scan of the brain at the level of the basal ganglia, normal on the left and Parkinson's on the right, showing less activity in dopamine-producing areas

Over the past decade, tens of thousands of people with certain types of Parkinson's disease (and OCD, depression, Tourette's, and other neuropsychiatric conditions) have benefitted from deep brain stimulation. The treatment involves putting electrodes through a person's skull and into the most central parts of parts of their brain, then portably delivering incremental shocks to control the brain's signaling. But only more recently have the results of the surgery, which still sounds surreal, been made tangible and widely accessible by patients who've chosen to put themselves on YouTube.

Just for background, the operational setup looks something like this, though not always with two generators:

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(Brown University)

Andrew Johnson, for one, is a 39-year-old from New Zealand who was diagnosed with Parkinson's disease when he was 35. That constitutes early-onset, not the norm. As he writes on his blog, Young and Shaky, his daughter was two years-old at the time, and he and his wife were expecting their second child. The disease progressed rapidly, so he got his stimulator put in relatively shortly after he got the diagnosis. (Johnson recently did a Reddit Ask-Me-Anything on his experience, which was interesting and poignant.)

To fully appreciate the effect that DBS had for Johnson, watch how his symptoms return when he shuts the power off:

YouTube as the vehicle it's become for demonstrations and support, reassures patients on massive scales and them right questions of physicians. This strange science feels real, comprehensible, somehow not far removed from Mentos and Coke, but with wires in human brains.

Here's a similar demonstration in Portuguese, in case English isn't your thing. (And also because of some cliché about science and medicine being universal languages, and understanding the massive range of people affected by a disease puts things into perspective for patients who feel alone. Which is totally true.)

And this woman just had DBS put in to treat her essential tremor (not Parkinson's).

I'm not exactly sure what she's drinking there, but would note that caffeine is usually not good for people with tremors. Anyway, these sorts of testaments are great because they normalize the promise and future of surgical treatments for neuropsychiatric conditions. The results of decades of neurology research culminating in accessible, humanizing stories. 

I found this photo from early work on the technology that would become DBS, back in 1966. The Associated Press caption at the time read, "Dr. Robert Heath, head of Tulane's department of psychiatry and neurology, experiments planting deep-brain electrodes in a human skull. For good or bad, control of the mind is here, with its potential for relieving mental depression and physical pain, for hiding memory, or for brain-washing. On a small scale, electric stimulation or other methods are being used on people for psychiatric or medical aid, while research seeks more knowledge. At Tulane University in New Orleans, some 58 persons, most of them mental patients, have been implanted with deep brain electrodes."

No one ended up using it for "brain-washing" ... that we know of.

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November 11, 1966. YouTube was still a gleam in our collective eye. (AP)


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A woman lies on an operating table during a brain surgery at the National Neurology Institute in Budapest December 15, 2012. The operation involves stimulation of certain areas of the human brain with high-frequency electricity, is carried out with the patient awake and communicating with the doctors during certain phases of the operation. (Bernadett Szabo / Reuters)


"Smaller" by Andy McDowell, Auckland, NZ


"For good or bad, control of the mind is here." I'd say brain rather than mind, if you're one to draw the distinction, though that does resonate more unsettlingly. The electrodes control the brain; the Internet videos control (and console) the mind.

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James Hamblin, MD, is a senior editor at The Atlantic.

 
 
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