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The brain is the most complex organ in the human body. It is a computer, an engine, the seat of cognition, and the author of every small breath a person takes.
Unfortunately, this means that when the brain “breaks” it is often very hard to fix. One of the most entrenched and devastating “breakings” of the brain is schizophrenia — a mental health disorder that can ruin lives. Now, reported the The Times of Israel, Israeli scientists have now found a way to use deep brain stimulation (also known as DBS) to alleviate some of the symptoms of schizophrenia.
The researchers have also begun to understand the mechanisms by which those symptoms occur in the brain. Hopefully, this will lead to a new era in the treatment of this incurable disease.
Define a Disease by its Symptoms
Schizophrenia is a mental disorder that often develops in a person’s twenties and remains with them for the rest of their life. Its symptoms include hallucinations, disordered thinking, delusions in which people persistently believe that something not true is true, paranoia, and social withdrawal.
There are 21 million people in the world with schizophrenia, and of those about one third have types of the disease which are treatment resistant. In addition, on average, people suffering from schizophrenia die nine years earlier than people without the disease do.
One of the main issues with schizophrenia is that it is a disease that is primarily defined by its symptoms rather than the mechanisms in the brain that cause the symptoms, and it is hard to treat something if you do not know what causes it.
Now, in a breakthrough research published in Nature Communications, a team of Israeli scientists have not only discovered the mechanisms behind one of the primary symptoms of schizophrenia, but they have also found a way to treat it using deep brain stimulation.
A Prediction Machine
As Dr. Nir Asch, a doctor and researcher in the psychiatric department of Rambam Health Care Campus in Haifa University told the Times of Israel, “Basically, the brain is a prediction machine. It tries to predict what will happen. It builds a model. It asks, ‘What is the situation? What is happening around me?’ Then it receives the evidence from the world through the senses.”
In schizophrenia, the machine becomes stuck. Patients with the disease are unable to change their internal model of the world even as reality changes, thus the delusions and paranoia. According to ZMEScience, in order to understand this symptom, the authors focused on a part of the brain called the globus pallidus externus (GPe), a structure in the deep brain inside the basal ganglia. It helps determine decision making and action.
Though the researchers could not give the two African green monkeys they were studying schizophrenia, they could find ways to mimic the specific symptoms related to decision making and action by giving them PCP, an NMDA receptor antagonist which is known to cause schizophrenia-like symptoms especially related to the prediction and adjustment elements of thinking.
While on PCP, the monkeys were given tasks that depended on adaptation, all the while their brain activity was being recorded. The monkeys became less able to learn, and less able to adapt, and the balance between the pre-frontal cortex and the basal ganglia became unmoored.
To try and re-balance the brain, the scientists applied DBS, a low-frequency stimulation of 13 Hertz, to the GPe and found that it made it easier for the monkeys to correct behavior in a useful, informed way after a mistake. That is to say, their brains were able to adjust.
Though the study was done on monkeys, and only two monkeys, at that, it is still a sign of hope. After all, monkey brains and human brains are not that different from one another. And though DBS cannot cure schizophrenia it can perhaps relieve one of the most damaging symptoms of it — the inability of the brain to adapt to reality. Thus it could herald a new world in schizophrenia treatment.
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