Methods of Studying the Brain

History of brain treatments

Trepanning is a surgical procedure where a hold is drilled into the skull using a surgical tool, in the 17^th and 19^th century. The process involved drilling into the skull and removing a piece of bone. In ancient times trepanning was done as a tribal ritual to let evil spirts ‘escape’ out of the head. It was performed to cure, headaches, and many mental illness for instance; Huntington’s, Parkinson, schizophrenia and epilepsy.

Lobotomy is a surgical procedure in which the nerve pathways in a lobes of the brain are severed from those in other areas. The procedure was used as a radical therapeutic measure distributed patients, who had mental illnesses.

Moreover, lobotomy was used in mental institutions where the patients wouldn’t understand and known it is been done. (ETHICS)

Also, the patients would often could out of the procedure with black eyes from the surgery and they would be given darken glasses to cover up the bruising ( ETHICS)

A few years later Thorine a chemical lobotomy was designed which was better as there wasn’t a risk of surgery. 2,900 lobotomies were performed. The last one to be performed was in 1967 due to the patient dying of brain haemorrhage.

EEG stands for electroencephalogram which is a recording of the brains activity. Small sensors are attached to the scalp to pick up the electrical signals produced when brain cells send message to each other. Helped to monitoring and diagnosing conditions affecting the brain.

Invasive methods

Invasive methods are a therapeutic technique that involves breaking the skin. It involves the injection or a placement of a device into the body. Invasive pain management therapies have been used to treat neck and back pain. Invasive methods are done by open surgery or laroscopy.

Non – invasive

Non-invasive is a therapeutic technique which doesn’t involve invading or breaking the skin. Therefore, the produce does not involve tools that can beak the skin or physically enter the body. For example; x-rays, CT scans, MRI, and ECG. Until recent years, exploratory surgery was routinely performed when a patient was critically ill and the source of illness wasn’t known.

MRI scanner

X-RAY machine

Deep Brain Stimulation

Deep stimulation is a surgical procedure (invasive technique) which is performed under local anaesthetic. It is perform in this situation so that the patient can talk and have brain movement to say the procedure has worked.

Deep stimulation is the main type of surgery used to treat Parkinson’s disease. Parkinson’s is not cure able however; it may help to control the movement of the symptoms.

Deep brain stimulation involved very fine wires with electrodes at the tip of the brain, which send electrical impulse to the targeted part of the brain. These are connected to extensions that are tunneled under the skin behind the ear and down the neck. They are connected to a pulse generator, which is placed under the skin around the chest.

With Deep Brain Stimulation treating disease of mental health, some people not understand what is mean done and therefore their careers give permission for it to be done and this isn’t technical right the patient themselves hasn’t full agreed to it. Furthermore, the patient isn’t de-brief before the surgery to make sure they full understand what the procedure is and this is all unethical to society.

Lesion Production

Brain Lesions can be caused by injury, infection, and problems with immune system. There cause is still unknown. There are several of types and some of the effects can cause great harm to you whereas, some are harmless. In lesions, nerve cells die, leaving behind damages areas of the brain. Then after time the brain function in those parts of the brain decrease. Disease such as; Parkinson’s, huntingsons’ Alzheimer’s and some types of dementia are a group of brain lesions. Some drug additions can be linked to lesions.

Symptoms of a brain lesion vary depending on the type, location and size of the lesion. Symptoms include;

• Headache
• Nauseas
• Change of vision
• Memory loss
• Seizures
• Fever

There are different types of Brain lesions. For instance abscesses and Alzheimer’s and other dementias.

Abscesses are areas of infection, including inflamed tissue. This isn’t a common however, they’re life threating. Brain abscesses often occur after an infection. Moreover, it can also appear after an injury or surgery.

Alzheimer’s disease and other dementias – these are another group of brain lesions. In these lesion, the nerve cells die which leaves behind damaged areas to the brain. then

Problems which can occur from brain Lesions are:

• Mood changes
• Personality changes
• Behaviour can change
• Mental ability can change
• A loss of memory
• Having pain in joints and having difficulty to move

Producing lesion is purposely destroying an area on the brain to research and investigate specific areas of the brain. From this you can see exactly which parts do which function.

There are three ways to make an lesion.

• Chemically – to destroy the neurons
• Electrical current – to also destroy the neurons
• Surgically – This involves cutting a part of the brain

Carbon nanotubes

Carbon nanotubes are tubes which have a very small diameter for example it can be as small as one nanometer. This is a very new invention and scientists are hoping to build tiny transistors for computer chips and other electronic devices. Each day carbon nanotubes have more research on and so they are very new.

Carbon nanotubes are electrodes which are surrounded by carbon atoms in the shape of a coil. They are really thin! Thinner than a piece of hair.

Nanotechnology is used often as it has a lot of uses. For example; sunscreens, self cleaning glass and clothes with UV protection.

Uses for nanotubes are

• Brain tumour research
• Possibility of using the nanotubes to directly deliver cancer fighting drugs into the brain
• Medical uses for instance; bone scaffolding and cell therapy. This is achieved by drugs or silencing genes
• Carbon nanotubes recently used to control the damage caused by a stroke, dental implants or synthetic muscles.

Ethnics on carbon nanotubes is it is still experimental and we don’t know how it will effect individuals in the long term. It’s still be researched and developed.

Stereotaxic surgery

Stereotaxic surgery is also called stereotactic. It is brain surgery where a brain tumour is removed with using image if the brain to guild the surgeon to a target within the brain. Neuro-navigation is a technique which may have an external frame attached to the head or imaging markers attached to the scalp to orient the surgeon in his approach. The term stereotactic came from Greek and Latin roots which meant ‘touch in space’.

Stereotaxic surgery is used for many reasons, which include:

• Brain tumors
• Deep Brain Stimulates
• Monitoring activity of brain for instance; scanning
• Monitoring and treating Parkinson’s

Side effects for stereotaxic is that is have very few immediate effects than the normal radiosurgery, as the area being treated is smaller. However, you are likely to have hair loss, feel sick, feel fatigue, dizzy, have headaches or have rashes appear on your skin. These are common side effects of regular external radiotherapy to the brain. Doctor’s normal give does of steroid before the treatment or straight after to help prevent side effects due to swelling in the brain.

Function Magnetic Resonance Imaging (FMRI)

FMRI is a technique for measuring the metabolic changes that occur in brain activity. It uses a powerful magnetic field and radio waves frequency pulses to produce detailed pictures of soft tissues, bone and other internal body structure. It works by detecting the change in blood oxygenation and flow that occur in response to neural activity. When an area is more active it consumes more oxygen and to meet this increased demand blood flow increase to the active area.

It can be used to examine the brain’s anatomy, determines which part of the brain are handling critical functions, evaluate the effect of stroke or disease. FMRI is the only technique which can detect abnormalities within the brain.

This is a picture of an FMRI scanner, which is a large tube that contains powerful magnets. You lie inside the tube straight and as still as possible during the scan.

Magnetoencephalography (MEG)

MEG measures ongoing brain activity with millisecond time resolution. It works by detecting magnetic fields which are created by the brain’s electrical signals. MEG is used for finding out about diseases such as; Parkinson’s and Alzheimer’s. But also is used for research to measure the time course of brain activity and can detect epilepsy, as well as detect areas of the brain that are most important to avoid during surgery.

MEG has to be carried out in a shielded room often in the night when there are no other electrical devices on. This is because the fields are a billion times smaller than the earth’s magnetic field. The patient will sit inside a helmet of special sensors that detect the tiny magnetic signals produced by the brain, as shown below;

Transcranial Magnetic Stimulation (TMS)

TMS is a magnetic method used to stimulate small regions of the brain. During the procedure, a magnetic field generator, or ‘coil’, is placed near the head of the person receiving the treatment. The stimulation take approximately around 20 to 30 minutes. While receiving the stimulations, the patient is normally fully awake, no anaesthetic needed. There are minimal side effects.

TSM is used to treat depression, pain relief, feeling of euphoria of fear and patient who do not response well to antidepressant medication.

The procedure is associated with mild and minimal side effects, including:

• feelings of light headedness
• temporary hearing problems, due to the sometimes loud magnet noise
• mild headaches
• tingling in the face, jaw, or scalp

Ethics

Informed Consent – disclosure of all significant risks, both those known and those suspected possible.

Potential Benefit must outweigh risk

Equal distribution of risk – Particularly vulnerable patient populations should be avoided.

Positron Emission Tomography (PET)

PET stands for positron emission tomography. PET scans are images which can clearly show the part of the body which being investigated which could consist of abnormal areas of the body or brain and can highlight how well certain areas of the body are functioning.

A PET scan works by detecting radiation inside the body, and images are made my passing x-rays through the patient’s body. Radioactive substances are injected into the body. The level of radiation is very small and the radioactive substance has a short decay time and neither of these will damage your body. A PET scan is pain free, and you should are able to return home on the same day without any side effects or restriction function adequately. Scans usually take around 30-60 minutes.

Stem Cells

Stem cells are a class of undistinguishable cells that are able to differentiate into specialised cell types. It is most like that stem cells come from two main sources, for example:

• Embryos (embryonic stem cells)
• adult stem cells

Stem cells are unspecialised cells which are restarting themselves through cell division and have the potential to develop into many different cell types which plays a central role in generation and for the generation to come of the body. Stem cells act as an internal repair system, dividing to replace other cells which are lost through wear and tear. Each time a stem cell divides, each new cell may either remain a stem cell or become another type of cell with a more specialised function for example; bone or muscle cells.

Stem cells can give growth to any tissue in the body and, from this it can provide nearly limitless potential for medical applications. Current studies are researching how stem cells may be used to prevent or even cure disease e.g Parkinson’s, diabetes, heart disease and even Alzheimer’s

Ethical implications

Embryonic stem cell research poses a moral dilemma. It forces us to choose between two moral principles:

• The duty to prevent suffering
• The duty to respect the value of human life

In the case of embryonic stem cell research, it is impossible to respect both moral principles. To obtain embryonic stem cells, the early embryo has to be destroyed. This means destroying a potential human life. But embryonic stem cell research could lead to the discovery of new medical treatments that would stop the suffering of many people.    

There is two issues of stem cells, one that we highly value the duty to prevent suffering and the other the duty to respect the value of human life. A potential humans life is a risk of life or not. It is more ethical to take stem cells from a bone borrow of an individual to help saves someone’s life as to do so it needs constant from the individual for the bone borrow to be given. Whereas, a less ethical view is were a stem cell could be taken from a embolic cord where the mother of the child may have given constant and mean it can go ahead however, the baby might not have wanted that therefore this is morally wrong.

Foetal Brain-tissue Grafting

A method of treating diseases, such as; parkingsons and huntingtons by grafting brain cells from human foetuses onto the affected area of the human brain. Human adults cannot grow new brain cells however, developing unborn foetuses can, this is because, grafting foetal tissue stimulates the growth of new brain cells in affected adult brains.

Use of foetal brain tissue is consequent from aborted embryos or foetuses. The ethical issues related to a therapeutic approach, which is relevantly modern and therefore not only concern the possible side effects for a graft-receiving patient, but also the relationship between the requirements for foetal tissue and the decision-making process for induced abortion.

Although for human embryos and foetuses have been the subject of biomedical studies, and, in principle, their use has therefore not been seen as ethically objectionable, the above points made it necessary to reconsider the moral issues.

Bibliography

http://link.springer.com/article/10.1007/BF02700424

http://medical-dictionary.thefreedictionary.com/Fetal+tissue+transplantation

History of brain treatments

http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0ahUKEwjN8NXE35bQAhUWz2MKHYl8BFcQFggpMAA&url=http%3A%2F%2Fwww.brain-surgery.com%2Fhistory-of-brain-surgery-1%2F&usg=AFQjCNGfniG_DTtMu0pnbq76NH6vFoSU4Q&bvm=bv.137904068,d.d2s

A good website to go on to first, as it gave an over view of the different methods but also different times e.g the Hippocrates and how life was like for treating the brain then.

https://www.britannica.com/topic/lobotomy

lobotomy surgery and how it is done and why it is done.

http://www.ancient.eu/Trephination/ –

Brothwell, D, Diseases in Antiquity (Charles C Thomas Pub Ltd, 1967).

http://www.imaginis.com/faq/what-does-non-invasive-mean

Invasive and non-invasive

http://www.frca.co.uk/article.aspx?articleid=252

Very good website to start on however no pros or cons one it.

http://internationaljournalofcaringsciences.org/docs/Vol1_Issue3_02_Lavdaniti.pdf

History on the technique

http://emedicine.medscape.com/article/304235-overview

Good over view and background information

Deep Brain Stimulation

https://www.parkinsons.org.uk/content/deep-brain-stimulation-surgery-parkinsons

how deep stimulation is used to treat Parkinson’s.

http://www.neurosurgery.pitt.edu/centers-excellence/epilepsy-and-movement-disorders-program/deep-brain-stimulation-movement-disorders

This website explains how deep stimulation can cure certain things and what disorders it helps to cure.

http://www.youtube.com/watch?v=WW-SWAnphFU

video of the deep stimulation back ground information and how it was performed

http://videos.howstuffworks.com/sciencentral/2937-deep-brain-stimulation-video.htm

Another video of how it works and what its done.

https://www.ncbi.nlm.nih.gov/pubmed/25597042

good for information on ethics for DBS. Clearly layout and simple to understand

http://link.springer.com/article/10.1007/s12152-015-9240-9

very very complex site and not good for getting information.

http://www.webmd.com/brain/brain-lesions-causes-symptoms-treatments

Lesion Production

http://www.webmd.com/brain/brain-lesions-causes-symptoms-treatments

http://www.emedicinehealth.com/brain_lesions_lesions_on_the_brain/page10_em.htm