A side effect of epilepsy treatment: new ideas about the brain Health

Seattle (AP) – Although Janet Hoffman still uses her brain, last month she donated a little of it – to science.

Hoffman needed surgery – her surgeon in Seattle looked into her brain, where he found a trigger for epileptic seizures that had disrupted her life for 30 years. But to get to that, he singled out a little healthy tissue the size of a Lima bean and with her blessing quickly sent it to some researchers who wanted to study brain cells while they were still alive.

Here is how Hoffman joined a long line of patients with epilepsy who helped scientists uncover the basic secrets of the brain – knowledge that can pay off in the best ways to measure consciousness in patients with brain injuries and new treatments for various diseases.

Research volunteers such as Ruth Nal, who made another contribution to the California hospital ward, read aloud the suggestions as a network of surgically implanted sensors closely monitored how her brain worked.

Since she was still going to have electrodes implanted, she wondered why not help.

“Besides,” she added, “I would have guests.”

Epilepsy disrupts the electrical activity of the brain, causing periodic seizures that include strange sensations, behaviors, emotions, and sometimes loss of consciousness. Most people with epilepsy do not need surgery and can control seizures with medication. But if surgery is needed, researchers may be asked to rob procedures to get a rare opportunity to study the brain directly.

For decades, studies of patients with epilepsy have revealed brain secrets, such as how the two halves work differently. And research from HM, now a deceased man from Connecticut, who is called the most famous patient in the history of neurology, has revealed key ideas about how memory works.

The disease has a long history of discovering the importance of the brain for memory, emotions and everything we call ourselves, says Christoph Koch, chief scientist at the Helen Institute in Seattle, where Hoffman cells were analyzed. “Seizures have taught us more about the brain and the mind and the relationship between them than any other disease,” he said.

Hoffman’s brain cells were taken to the institute for “life support” in a refrigerator equipped with artificial cerebrospinal fluid and oxygen. In the lab, researcher Herman Tung cut a pearl of the brain into thin sheets for viewing with a powerful microscope, preparing it for a series of three-part experiments.

Resting for an hour after slicing, Hoffman’s brain cells were ready for their stellar rotation under the microscope.

Researcher Catherine Baker found one brain cell and recorded its electrical activity. She introduced a dye that propagated into the filamentous dendrites of the neuron to detect its shape.

Baker removed the cell nucleus for the third stage: reading which genes are off and which are on.

About three-quarters of such donations at the Helen Institute come from patients with epilepsy; the rest come from cancer surgeries. The Helen Institute is creating an online atlas that makes information about hundreds of human brain cells available for free study. The institute hopes this will open a new path, other than brain scans and animal research, to tackling diseases such as Alzheimer’s and autism.

For the 57-year-old Hoffman, the decision to contribute to the study was simple, even beyond her own epilepsy. She cared for her grandmother with dementia for years.

“It was the easiest decision I’ve ever made,” she said. “This will be my chance to change the situation.”

Dr Andrew Co., who performed Hoffman’s surgery at Harborview Medical Center in Seattle, stressed the importance of making sure patients understand the difference between what is needed for therapy and what is optional for research. Harborview Co. is talking to patients about treatment, and the research coordinator is discussing the possibility of participating in research, he said.

Nal, a California woman, also underwent surgery. But before that, doctors had to find the place that caused her seizures.

To do this, surgeons often implant arrays of 100 or more sensors into the patient’s brain and inside it to eavesdrop on its activity and catch the trigger that causes the seizure. Patients monitored in this way may spend a week or more in the hospital room while doctors await seizures.

At this time, patients have nothing to do. For researchers in the field of neurology, a group of people with implanted electrodes in the brain and a lot of time is a golden opportunity.

“You rarely have the opportunity to study the brains of waking people in such detail,” says Dr. Joshua Rosenov of Northwestern University.

In some cases, researchers use implanted electrodes for stimulation. A few years ago, to study the role of a particular part of the brain in facial perception, Dr. Joseph Parvizi of Stanford University activated this area in a 41-year-old patient. The man was looking at Parvizi, who was next to his hospital bed, when the stimulation began.

“You just turned into someone else,” patient Parvizi said. “You have a droopy nose and went to the left. You’re almost like someone I’ve seen before, but someone else. It was a trip. “

Other times brain electrodes are used to monitor what happens when patients perform certain mental tasks. Patients can sniff odors, do math, sing, read certain words or sentences aloud, listen to music or speech, look at faces on a screen, name objects in images, stick out their tongues, or do other things designed to create a specific brain. activity. All the time, scientists are monitoring what is happening in their brains.

“There is an explosion of research in this area because it is very important to know the timing of events in the brain, which areas light up first and which ones afterwards,” Parvizi said. “And if area A catches fire, what does zone B do?”

Nalla’s brain monitoring has provided data for several articles published over the past couple of years. One of her experimental tasks sounds a little strange: during her hospital stay in 2013, she was asked to repeat over and over again the phrase, “I never said she stole my money,” each time emphasizing a different word. These changes have changed the meaning of the proposal.

Researchers turned to her for help to learn how the brain produces and controls speech, perhaps it was a step towards helping people who cannot speak. This goal struck Nalla of Waterford, who recalled that his uncle’s voice had been muffled by Lou Gehrig’s illness.

Looking back, she said she would encourage others to take the same step. “It’s something that makes you feel good later,” she said. “Let your life be determined by the life you change.”

Two weeks after Hoffman’s surgery, a scar bends from the top of her right ear to the line of hair growth on her forehead. “So far so good,” she said. “No seizures.” Part of her brain is gone, but she doesn’t feel like nothing is missing. In fact, happy memories surfaced, “something I hadn’t thought of since childhood.”

The contribution of brain cells to science “makes me so proud and so satisfied,” she said. “It makes me feel more connected to the human race.”

Ritter reported from New York.

The Department of Health and Science Associated Press receives support from the Department of Scientific Education of the Howard Hughes Medical Institute. AP is solely responsible for all content.