CE:s serious couch - Q&A on brains

Tybaltus · Post by **Tybaltus** » Wed Jul 31, 2002 2:55 pm

Originally posted by C Elegans
Sorry Tyb I missed this one previously.

When we sleep, we are in an altered state of consciousness, which always make things that happened in the altered state difficult to remember when we return to our "normal" state. Another reason is that dreams are fragmented, often aburd, and do often not related a lot to our everyday life. The lack of contact points means we have fewer associations to dream events in our already existing cognitive memory network, and we are more likely to remember something the more association points we can connect the event to.

We do in fact dream many dreams over a night, but if we remember anything, it is normally only the last 1-2 dreams we had just before waking up. Sometimes we don't remember anyting at all, and this is probably depending on when in the sleep cycle we awake. We dream mostly during the REM stage, and if you wake up during REM, you will surely remember what you dreamt. If you wake up during a dreamless sleep stage, you will probably not remember any dreams at all, and it is thought that people like you father, who almost never remember his dreams, are people who simply have the kind of sleeping pattern so they always wake up during non-dreaming sleep - after all, dreaming only occurs during about 10% of sleeping time.

For people who wish to remember their dreams better, there are many methods, all based on writing down everything you remember as soon as you wake up.

Is the REM stage the place where you hear the song "Losing My Religeon"? hahahaha. OK Ill shut up now.

Thanks.

That is very interesting, I really thought I had 1 or 2 dreams but that happened 100% of the dreaming time. So there are thousands of dreams that I will never remember. Geez. Thats kind of hypnotizing to think about. I wonder what the dreams were like? Ah well. Dont worry that you missed it. If I think of more, I wont hesitate to ask. I enjoy hearing the synopsis of this stuff.

Craig · Post by **Craig** » Wed Jul 31, 2002 4:08 pm

I meant, Multiple personalties...

C Elegans · Post by **C Elegans** » Wed Jul 31, 2002 4:45 pm

@Tyb: Fortunately not, I hate that song!

REM = Rapid eye movement, it was discovered very early in sleep labs that people move their eyes around a lot in this specific sleep stage.

Originally posted by craig
I meant, Multiple personalties...

Ok, so did you want to know anything more about that? It is really most of all a type of cognitive memory distrubance, where the patient can't integrate memories collected in the different states (ie when s/he was different personalities). The condition is very rare, and few people have a pure form where they have memories at all of the different personalities. It is more like different states than separate "personalities". Sometimes during very special circumstances a person may develop totally separate personalities, if this happens it starts in childhood, usually as a reaction on very severe traumas like contant physical and mental abuse. (I know a patient who had a rather severe form, he had been put in a hole that his father dug for him, and forced to live there for 8-9 moths. The hole was so small he could hardly move, he got air by a pipe and the same pipe was used by his father to throw down water and food. Sometimes the father would throw down excrements, dead rats, etc. )

Tybaltus · Post by **Tybaltus** » Wed Jul 31, 2002 4:48 pm

Originally posted by C Elegans
@Tyb: Fortunately not, I hate that song! REM = Rapid eye movement, it was discovered very early in sleep labs that people move their eyes around a lot in this specific sleep stage.

I know

I was purely joking, though I like the song.

Yshania · Post by **Yshania** » Wed Jul 31, 2002 4:49 pm

Originally posted by C Elegans
It is more like different states than separate "personalities". Sometimes during very special circumstances a person may develop totally separate personalities, if this happens it starts in childhood, usually as a reaction on very severe traumas like contant physical and mental abuse. (I know a patient who had a rather severe form, he had been put in a hole that his father dug for him, and forced to live there for 8-9 moths. The hole was so small he could hardly move, he got air by a pipe and the same pipe was used by his father to throw down water and food. Sometimes the father would throw down excrements, dead rats, etc. )

OMG!!!

Craig · Post by **Craig** » Wed Jul 31, 2002 4:51 pm

I wanted to know how ity is possible, for a person to have two "minds".

I have thought up this, a brain (Memory) is just based on triggered chemical reactions, wouldn't two different ones conflict? Or even overlap? This is purely on the basis my theory is correct.

C Elegans · Post by **C Elegans** » Wed Jul 31, 2002 5:04 pm

@Ysh: I know

It was almost too horrible to accept as reality...but the police could prove it actually happened that way

I just wanted to describe it so people get a general impression on how severe and extreme events that influence the development of Dissociative syndrom.

@craig: Nobody really knows the answer to your question. How it is possible that one brain can contain two brains? You see it almost more pronounced in so called "split brain" patients, people who have had a special type of brain surgery that cuts the corpus callusum, one of the major pathways between the two brain hemispheres. These patients develop sort of two different types of counsciousness and selves. Personally, I speculate in whether the single mind and sense of single self/personality we have, is a rather thin illusion, the brain actually works both very compartmentalised and then manages to give us an overall, whole impression. But studies of neurologic and neuropsychiatric disorders demonstrate that a lot of different fairly minor damages or distrubances, can cause people to stop perceiving themselves as one. It seems two or more minds in the same brain does not conflict or "overlap", rather, they were there all the time, it is instead the integrational functions (like memory, association etc) that has stopped to work.

So I think the question is not how one brain can contain many minds, rather, how can our brain give us the illusion of consistency and self?

Craig · Post by **Craig** » Thu Aug 01, 2002 6:00 am

So our brain is a democracy and the voting box is gone when you have multiple personality disorder?

C Elegans · Post by **C Elegans** » Thu Aug 01, 2002 2:23 pm

Originally posted by craig
So our brain is a democracy and the voting box is gone when you have multiple personality disorder?

Ehm, well, something like that, yes.

Bloodstalker · Post by **Bloodstalker** » Sat Aug 03, 2002 4:30 pm

I was wondering if you could tell me anything about Alzheimers , like what causes it, how it progresses, and if there are any effective treatments. I would appreciate any information you could give me.

Craig · Post by **Craig** » Sat Aug 03, 2002 5:12 pm

Funny, Sometime I, think, I have Alzheimers

C Elegans · Post by **C Elegans** » Sat Aug 03, 2002 5:48 pm

@Absolutely not Craig, Alzheimer's Disease is a degenerative disease, (the neurons ie nerve cells stops functioning and dies) and the absoutely earliest age where a person can have symptoms, is around there 40's. There have been many major breakthroughs in AD over the last few years, I'll reply more detailed to BS soon...

Bloodstalker · Post by **Bloodstalker** » Sat Aug 03, 2002 5:50 pm

That's fine CE, I wasn't expecting an immediate response. I can wait til you get back to me

C Elegans · Post by **C Elegans** » Sat Aug 03, 2002 6:28 pm

Originally posted by Bloodstalker
I was wondering if you could tell me anything about Alzheimers , like what causes it, how it progresses, and if there are any effective treatments. I would appreciate any information you could give me.

Just before my holiday, I started working in an international multicentre study of Alzheimers Disease (AD). Thus, I can post an essay about this, but I start off with this, and if you have further questions, just post them.

AD is progressive, degenerative disease that cause destruction and malfunctioning in the neurotransmitter systems, ie the chemical messanger system nerve cells communicate with. Studies show that the most consistent findings are disruption of the acethylcholin system and the serotonin system. Post mortem analysis (ie after death) of brains of patients with AD, have shown an increased amount of amyloid plaques and tangles, which leads to death of cells and the terminals where cells receive and send the neurotransmitter substances. In other words, it seems like there is both a reduction of important neurotransmitters, and something that causes cells to die.
Unfortunately the cause of these abnormalitites are not known. There is a genetic component, people with parents that have AD are at higher risk of developing the disease than other people. However, many people develop AD without having any relatives who have had it.

Today, just like with all other neurodegenerative diseases, there is no cure for AD. Treatment include pharmacological treatment to slow down the degeneration and cognitive training to perserve what little memory function the patients still have left. Current research is focused on finding the exact mechanism and causes of AD, as well as finding methods to diagnose the disease as early as possible to prevent the severe symptoms from developing.

Bloodstalker · Post by **Bloodstalker** » Sat Aug 03, 2002 11:33 pm

Thanks CE, but can you help clear up some things for me? I have heard some people say that AD causes the person suffering from the disease to appear to revert to their childhood, is this true? or is it more a loss of mental facilities and memory? Also, how long can a person go before they move into the advanced stages? I guess I would like to understand more about the effect the disease has on the patient, and how it develops.

Also, you said that there were treatments to slow it down, how effective can this be? How much of a slowdown is acheivable currently?

I would also like to know more about some of the treatments and the more effective options that are out there.

I realize this may be requesting a lot of information, but anything you can share would be appreciated.

C Elegans · Post by **C Elegans** » Tue Aug 06, 2002 3:54 am

Sorry for the delay, BS. Just ask more questions if my answer does not cover all you wish to know.

Originally posted by Bloodstalker
I have heard some people say that AD causes the person suffering from the disease to appear to revert to their childhood, is this true? or is it more a loss of mental facilities and memory?

This is not true, it's probably just a way of expressing how the symptoms may be perceived. As you correctly guess, it is the loss of mental abilites and ability to look after oneselves, that some people may express like "going back to childhood". Initially, AD is characterised by memory loss, especially of recent events. As the degeneration progresses, the person will be totally disabled because of the severe loss of cognitive functions and personality changes. Aggression, outbursts, paranoia, no impulse control are all common among AD patients.

Also, how long can a person go before they move into the advanced stages? I guess I would like to understand more about the effect the disease has on the patient, and how it develops.

This varies a lot, and there are different subtypes of AD with different patterns. The very severe form that can affect people as young and 45-50, often has a faster progress. It is not impossible to become entirely institutionalised in just a few years. The most common age to get inital symptoms in, is much later though, over 70. The time intervall between people noticing the symptoms and the patient having to be institutionalised can be 10 years.

However, recent research indicates that the pathological process actually starts much earlier than when symptoms manifest themselves. There are indications that a special type of minor cognitive impairment that is present already in the early middle age, is a sign of AD developing. Should this hold true, it is not at all unique to AD, in fact most progressive neurodegenerative diseases are believed to start long before symptoms can be observed. An example is Parkinson's disease, the patient will not start shaking and get rigid until about 80% of the dopaminergic neurons in the basal ganglia are already lost. That's why earlier diagnosis is so important, when we notice the symptoms, it isn't much left to save, thanks to the brain's capacity to compensate for damage.

So, when a person starts to appear forgetful and confused, the AD has most likely progressed quite far and the brain is at a point where it can no longer uphold the compensatory mechanism. So far there has been no way to study the development of the plaques and tangles in living patients, they can only be studied in a dead brain. What has been observed in living patients, is decrease of Acethylcholinergic transmission and loss of nicotine receptors, as well as overall cell death, ie you see holes in the brain with MRI. These observations seem to correlate with severity of memory loss. What causes the personality changes is not known.

Also, you said that there were treatments to slow it down, how effective can this be? How much of a slowdown is acheivable currently?

Slow down of the degenerative process is farily efficient, I don't know exactly how much slower the progression of the disease gets, I can check that if you wish. Training, such as memory training within highly structured cognitive programs, also helps slow the process of memory loss down.

I would also like to know more about some of the treatments and the more effective options that are out there.

AFAIK there are presently 4 medicines used to slow down the cognitive impairment, ie the loss of memory and attention. All 4 works in the same way, they are cholinesterase inhibitors, ie they slow down the rate at which acethylcholinesteras breaks down the acethylcholin (the important neurotransmitter I mentioned earlier). I don't know if any of those 4 medicines are considered more efficient than another, I can check if you wish.

For the paranoid, aggresive and delusive symptoms seen in many AD patients, antipsychotic medicine of the same type used for schizophrenia and other psychosis, are used.

Other treatment include behavioural therapy programs and cognitive training programs, there are many different types around, the best is probably what is called "error free learning" developed by British reseachers. Most other programs are similar to this one. Again, if you want me to name anything specific, I can check that for you.

Maharlika · Post by **Maharlika** » Tue Aug 06, 2002 4:13 am

Isn't cutting corpus callosum...

...a method used for patients with a certain type of epilepsy called gram mal(sp?)

What happens next is that there is a decrease in coordination between senses. (i.e., you are holding a cup but if your eyes can't see what you're holding then you don't know what it is even if you're holding it)

C Elegans · Post by **C Elegans** » Tue Aug 06, 2002 4:22 am

Re: Isn't cutting corpus callosum...

Originally posted by Maharlika
...a method used for patients with a certain type of epilepsy called gram mal(sp?)

What happens next is that there is a decrease in coordination between senses. (i.e., you are holding a cup but if your eyes can't see what you're holding then you don't know what it is even if you're holding it)

Yes, cutting the CC was a method used formerly to treat very severe epilepsia (EP). Grand mal is not a type of EP, but it a type of seizure that some EP patients get (as opposed to petit mal, another type of seizure that does not involve the typical muscle spasms and chewing seen in Grand mal seizures).

The CC is a large bundle of nerves connecting the two brain hemisperes, that's why the cutting of it resulted in the so called "split brain" phenomena which is what you describe.

Bloodstalker · Post by **Bloodstalker** » Wed Aug 07, 2002 7:27 pm

Thank you CE, I appreciate it.

If you could check on the rate the disease can slow, and the effencincy of the meds ,I would be grateful...Or if it is too much, could you point me to any web sights with more info? I don't want to work you to death

C Elegans · Post by **C Elegans** » Wed Aug 07, 2002 9:08 pm

As far as I could find out, the medicines slow the progression of cognitive deficits with approximately 10-20%. Some patients get better initially, whereas some won't get better but cease to decline. After 3-6 months, it seems declination starts again, but significantly slower than for patients who are not treated. The cognitive training programs seems to have a similar effect size, the best treatment is most likely a massive combined treatment program where pharmacotherapy, cognitive training and social intervention like optimising the environment for the patient, are included.

Here is a good article with some general information, and here is the US Alzheimer's Association. It is not always easy to find the relevent information of websites, so always feel free to ask!