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Wired for Action: Nine Inch Nails in your brain

Categories: Neurosciences


Ever wish you could put your brain on remote control? Some people have to.

Our brain's activity comes from certain chemicals released by nerve cells. Their release sends an electrical current down the cells' extensions. That activity is triggered in two ways. The first is voluntary. I tell my fingers to type this. The second is automatic. My fingertips signal back the feel and the pressure of the keys. This feedback helps calibrate the degree of muscle contraction to flex my finger onto the keys, while involuntarily tuning the smooth and unwavering motion needed.

Our daily motions are precisely calibrated by the brain's autonomic nervous system. It grades the tension in, and interaction between our muscles: allows balance and other sub-conscious tweaks. This system's other roles include controlling the cells that dilate our pupils in the dark, squeeze out tears and contract our intestines. It paces the contractions of our heart, and our diaphragm for breathing, without our thinking about it.

The system's malfunction spells trouble. Imagine reaching for a soda, but now with a shaky tremor. Or taking a step, only to have your foot not move or plant itself the way you intended. Spilling a drink is a nuisance, falling down a health hazard. Imagine your muscles becoming too rigid with no control on your part. Millions of Americans are affected by such tremors and unwanted rigidity, including those with Parkinson's. The degeneration in cells secreting the necessary chemicals for autonomic function can be initially treated by medication stimulating greater release from still viable cells, or supplementing the chemical. This, plus exercise and physical therapy can help the tremor, rigidity and ""freeze ups"". A team approach to such therapy helps. When that's no longer enough, remote control can be chosen.

Placing long, thin electrodes into the brain's deep relay switches containing cells controlling the interactions of our involuntary nervous system, pacing them much like with pacemakers in the heart, and dialing them in to the right frequencies, can restore the smooth functioning of our voluntary movement, relieve tremor, rigidity, and improve balance. A small electrical packet under the skin allows remote control of the relay switches.

When his shoulders slowly stiffened, and his back became more humped over, Harry paid little attention, thinking it related to his 60-something age. Then a tremor appeared: his gait became more shuffled and his arms did not swing normally. Parkinson's was diagnosed. Initially the medication helped, but periods of rigidity and body freezing occurred, and became more frequent. Work became difficult, he sold his business, his self-image and social life suffered. He opted for deep brain stimulation.

A three-dimensional MRI scan provided the holographic imagery necessary for targeting the deep brain relays with the electrode. The neurosurgeon placed it precisely with image guidance in a special operating suite in less than 30 minutes.

Later that day, Harry's life changed with a flip of the switch. His posture, flexibility, gait, appearance and sense of self all improved. Targeted physical therapy and an exercise program became possible. The team of neurologist, neurosurgeon, physical therapists, all continue to work with Harry, optimizing his well-being. The remote-control packet under his skin is checked regularly by his nurse navigator, and adjusted when needed with a magnetic wand.
Remote control? In Harry's case, it's a no-brainer.

Dr. Michael Brant-Zawadzki is executive medical director of the Hoag Hospital Neurosciences Institute.

Hoag has urgent care health facilities or hospitals in Newport Beach, Costa Mesa, Irvine, Tustin, Huntington Beach, Fountain Valley, Aliso Viejo, Orange and Anaheim Hills.
To view the original article on The Orange County Register clickhere.