The human brain is the most mysterious organ in the body and one of the most complex enigmas known in the universe. Scientists keep trying to find out what causes our dreams, why suddenly one day we forget who we are or where the limit of consciousness is. Nor have they been able to clarify where our mind ends or begins and where our brain. Unraveling these enigmas, among many others, remains a pending issue. To do this, you have to start with what little we know for sure. Here is one of the irrefutable truths of neuroscience: at the end of the 19th century, Santiago Ramón y Cajal located neurons as individual elements of the nervous system, which made him the first Spaniard to receive a Nobel Prize in Medicine in 1906.
These cells intercommunicate establishing a network of connections. Their job is to receive stimuli from the environment and transmit them in the form of nerve impulses to another neuron or to a motor cell that will produce a response. Our thoughts, emotions and memories are encoded in these brain waves. Neural connections function normally in healthy humans, but can be disrupted by disease, injury, or lack of development. When it happens, we find patients with depression, schizophrenia, or bipolar disorder. Also Alzheimer’s, Parkinson’s, multiple sclerosis and other types of neurological diseases. The development of technology has brought new techniques to discover how the brain changes in the face of disease and to be able to more rigorously detect which areas are damaged.
Artificial intelligence: the algorithm that teaches us where to look
Today, there are many brain scan modalities that are used for clinical diagnosis alongside technologies such as artificial intelligence. Research teams around the world have developed algorithms that are capable of analyzing thousands of resonances and learning to detect abnormalities to warn clinicians where to look. Ng Wai Hoe, Medical Director of the National Institute of Neuroscience of Singapore, explains in the 2019 neuroscience report from the Bankinter Foundation how it uses AI applied to the reading of MRI results. “In brain injury cases, the goal is to allow the AI to do a quicker review of the scanner, mark it for the radiologist and say ‘hey, you have to look at this image immediately,’ explains Ng Wai Hoe. “In fact, we have already started it in our emergencies and we see that it has made possible a faster triage of patients and a more immediate intervention.”
Another of the most mentioned uses of this technology by experts is its ability to personalize treatments. Every disease is different in every patient. For example, depression alters brain waves differently in each person, and the development of new technologies makes it easier to find a way to identify the specific aspects of this disease and an individual way to approach it. In the same report, Ricardo Gil Da Costa, a cognitive neurophysiologist who has worked at the National Institute of Health of the United States for years, assures that “the more data that is collected, the more it is possible to personalize the treatments of patients using AI.” Da Costa gives a practical case as an example: in a migraine you can already know when the inflammation is increasing up to 72 hours before the first symptoms appear, which makes it possible to act preventively and reduce the duration and severity of crises.
Wearables: a scan of the activity of neurons
All these advances suggest that it would be very useful to have devices to monitor the health of our neurons. “A device that patients can use at home for a while each day to analyze the information in their body, personalize it and that can tell them when a crisis is coming in their specific case,” explains Da Costa. This device already exists: it is a system called Brain Station that performs an electroencephalography without wires: it is placed on the forehead of patients and scans brain activity.
Wearables like this are spreading in the diagnosis and treatment of mental and neurological diseases. They are no longer used just as wristwatches to know how fast your heart beats while doing sports. Now there are initiatives that even use them to try to deduce the intentions of the people who wear them, which can be useful for patients with mental problems. A project of the German Institute for Artificial Intelligence has designed devices so small that they can be worn on clothing and that they analyze the behavior of whoever wears them. Applying artificial intelligence, the system learns the way the user does things, their experience and skills. At the moment, thanks to all this information collected with those wearables they can observe fatigue and tiredness and hope they can detect depression soon.
Virtual reality: when rehab becomes a game
Other technologies are also reinventing themselves: it happens with virtual reality, which is linked to the world of entertainment and video games but also shows promise for rehabilitating patients with neurological diseases. Begoña Benito attests to this. She is 49 years old, an administrative worker and has had multiple sclerosis diagnosed for three years. Until then, some of her symptoms were confused with the fatigue of the day: she was fatigued and sometimes her limbs fell asleep. But what was happening to her was that the neurons in her nervous system were losing myelin, a white substance that covers these cells and that makes it easier for nerve impulses to be transmitted normally from one neuron to the next.
As a consequence, this disease causes problems with mobility, balance, problems with the extremities, sensory, visual and cognitive alterations and fatigue, as explained by Dr. Virginia Meca, neurologist and coordinator of the Demyelinating Diseases Unit at Hospital de la Princesa, who proposes using virtual reality glasses to rehabilitate patients with this disease. “Before starting this project, we saw difficulties in patients to maintain rehabilitation. We think that turning the process into a game could be attractive for them to comply with this part of their treatment ”, says Meca. Although they still do not have conclusive results, Begoña Benito, who has been wearing the glasses since December, assures that they are helping him physically and cognitively. “I have improved my memory and balance. The physical, which is the most obvious thing, is rehabilitated a lot, but also the mind ”.
When putting on the glasses, patients can choose between several screens that propose different activities that help them to exercise. “Although it does not replace conventional rehabilitation, it helps us improve adherence,” says Dr. Arancha Vázquez, a rehabilitation physician at the same hospital. The goal is for patients to be able to do the exercises at home. “We try to adapt the resources of Social Security, because this treatment is applied in public health,” says Vázquez. In the future, they also seek to apply it to other diseases with similar symptoms.
“We can take some of the lessons we’ve learned from gamification and apply them to medical interventions to encourage adherence and facilitate participation,” agrees Walter Greenleaf, a scholar at the Virtual Human Interaction Lab at Stanford University, who conducts research on new interventions for depression, autism, Asperger’s syndrome, and addictions.
“When it comes to treating addictions, we can offer the patient a virtual environment to practice their refusal skills or their confidence; with patients with autism spectrum disorder, we can rehearse social interactions and exaggerate non-verbal communication, body language, facial expressions… ”, explains Greenleaf. The applications of this technology to aid in the recovery of patients are multiple.
Now that virtual reality is no longer used just for gaming, big technology has invested billions of dollars in the development of this technology. “And they are not going to recoup that investment through the training and video game industry,” Greenleaf says. “The medical sector is one of the ones that is investing the most in this area.”
Neuroscience Science that studies how the nervous system works. It tries to answer what is the structure of the brain, how cognitive abilities develop and how brain diseases arise. It draws on biology, psychology or neurotechnology, among others.
Demyelinating diseases. They are those that affect the production of myelin in the central nervous system. Myelin is a white substance that covers nerve fibers and facilitates the transmission of signals between them. Demyelination can lead to muscle and organ malfunction. One of the most common diseases is multiple sclerosis. At the moment, demyelinating diseases have no cure, although they are treated to minimize symptoms.