On the seizure-detecting instincts of pets

Like something from a futuristic medical thriller, you have mice diagnosing bladder tumours, and dogs detecting prostate cancer, just by sniffing the urine of patients. And like a plot from a Sci-Fi film, dogs are also trained to smell-out malaria. But we are not forward to the future – we are still in the here and now. And it is not just cats, dogs, and mice; pouched rats and nematodes have staked their claim as well. And the number of diseases that pets can presumably detect grows longer by the day (OK perhaps by the year), and these range from diabetic hypoglycaemia, colorectal cancer and migraine, to infections such as Clostridium difficile and tuberculosis. And whilst there are many animals in on the act, they are just bit players on this set – dogs are by far the superstars of the show.

Baxter gives me the sniff test. VirtKitty on Flickr. https://www.flickr.com/photos/lalouque/3881459268/

As weird as it may sound, many of the reports being anecdotal, there are actually grains of truth and crumbs of evidence supporting the claim that pets are not just for Christmas. For example, there is a trail of research studies confirming the effectiveness of seizure detecting dogs; one paper specifically reports that they enabled 90% of subjects to reduce their seizure frequency by 34-50%. Although the time from seizure-detection to the actually seizure varies wildly, from 10 seconds to 5 hours before the epileptic attack, there seems to be enough time in most cases for the subject to take preventative measures.

Roger Hiorns’ Seizure. Hilary Perkins on Flickr. https://www.flickr.com/photos/cowbite/3781509099

But not all dogs are as skilled in the act as others, and your best bet is on alerting dogs which have a stronger bond with their owners. And if you want to pick a dog for its seizure-detecting skills, go for one that scores high in motivation…and low in neuroticism. This is important because the ability of dogs to detect seizures is not always benign; they are known to respond by attacking the subject or their helpers as part of an untrained fight or flight reaction. It is important therefore that seizure-alerting dogs are trained not to be stressed, and to respond appropriately.

Beware of the angry dog. Julija Rauluševičiūtė on Flickr. https://www.flickr.com/photos/cowbite/3781509099

But what are dogs actually detecting when they detect seizures? The conventional theory is that they are responding to subtle changes in behaviour; this may therefore explain why dogs can also warn of impending non-epileptic attacks, an observation that has been duplicated in another paper. The other possibility however is that the dogs are detecting disease-specific odours. This concept should not be surprising because, for example with infections, it has been shown that endotoxins induce a detectable aversive body odour. Similarly with liver disease, exhaled breath is already being considered in sorting out differential diagnoses. One premise behind the disease-odour hypothesis is the existence of disease-specific volatile organic compounds (VOCs). It feels all so exciting-no wonder there is now a well-developed scientific field of exhaled air analytics.

Breath. Andrea Castelletti on Flickr. https://www.flickr.com/photos/daltraparte/3050309593

But as with all things in life, and particularly in science, here are always the naysayers, the gatecrashers to the party. And so it is that, with the case of seizures, there are those who are not convinced that pets possess the guile to pick up seizures. For example, in a small study of 3 subjects in an epilepsy monitoring unit, Rafael Ortiz and Joyce Liporace, reporting in the journal Epilepsy and Behaviour, found that seizure alert dogs were not effective in predicting seizures. In another paper  published in the journal Epilepsy Research, titled Can seizure-alert dogs predict seizures?, Stephen Brown and Laura Goldstein observed that there is “no rigorous data” to support the assertion that seizure alert dogs accurately predict seizures. Another detailed review in Plos One in 2018, by Amélie Catala and colleagues, concluded that appropriate empirical evidence that dogs can alert or respond to epileptic seizures is still missing

By https://wellcomeimages.org/indexplus/obf_images/3c/f4/5188f74ad62c7b5634b55047ac5d.jpgGallery: https://wellcomeimages.org/indexplus/image/V0016630.htmlWellcome Collection gallery (2018-03-23): https://wellcomecollection.org/works/kbcqbc43 CC-BY-4.0, CC BY 4.0, Link

 

But as the overused cliché goes, absence of evidence is not the evidence of absence. So how can we prove that dogs are indeed detecting seizure-specific odours? This is the task Amélie Catala and her colleagues also set out to accomplish when they made 5 dogs to sniff the odours obtained from 5 people with epilepsy. They tasked the dogs to tell apart the odours obtained around the time of the subjects’ seizures, from the odours obtained at other times when there were no proximate seizures. Reporting their findings in Science Report in 2019, under the title Dogs demonstrate the existence of an epileptic seizure odour in humans, they found that all the 5 dogs easily distinguished the seizure-related odours from the non-seizure related odours. But the small scale of the trial (were there just not enough dogs to go round?) justifies the authors’ call for larger trials to confirm their findings.

 

Big Nose Strikes Again. Bazusa on Flikr. https://www.flickr.com/photos/bazusa/260401471

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This is clearly still a grey area in epilepsy management, but one with a high potential if explored further. Are there any pet-loving neurologists willing to get in on the act? Do come along with your pets!

7 remarkable technologies shaping the future of the brain

The brain is the most enigmatic structure in the universe. But every now and then, the brain malfunctions. And just like Humpty Dumpty, we struggle to put it back together again…at least not to its previous level of complex organisation. But we are remarkably ingenious creatures, obviously because we possess great brains, and we are ever-inventing brilliant schemes to fix the brain (or at least our brains are). And we, or our brains, often conjure up unthinkable technologies (pardon the intended pun!) Over the years this blog has tried to keep up with these improbable schemes, and you can check the veracity of this claim by looking up two of my very old blog posts on this:

6 exciting neuroscience discoveries that will shape neurology

 10 remarkable breakthroughs that will change neurology.

But the developments keep rolling in, so here are 7 remarkable technologies shaping the future of the brain.

Artificial neurones

What if you could just replace your damaged nerves with spare neurones-just as you would replace a faulty spark plug in your car (OK, wrong analogy for many people I know). Well, this may not be a fantasy for too long. This comes from a piece in Popular Science titled Artificial neurones could replace some real ones in your brain. The article says “Swedish researchers have developed a synthetic neuron that is able to communicate chemically with organic neurones, which could change the neural pathways and better treat neurological disorders”. This is just understandable enough for most people and I will go no further. But if you desire the hard science version, with references to biomimetic neurones, (or is it neurons?), you may check out the original study in the journal Biosensors and Bioelectronics ; it does come with a slightly shorter and less convoluted, but totally undecipherable title, An organic electronic biomimetic neuron enables auto-regulated neuromodulation. I will stick to the Popular Science version.

Brain 22. Affen Aljfe on Flickr. https://www.flickr.com/photos/142299342@N06/32794072623 http://www.modup.net/

Bionic memory

One major disorder everyone fears is dementia. The concept of forgetting, not just your experiences but family, friends, and eventually yourself, is frightening. But what if you could rely on an electronic memory. A start in this direction was a report that researchers have built a nano memory cell that mimics the way humans lay down memory. At 10,000 sizes smaller than a human hair, such an external memory will surely prove useful. But just take a breath and imagine what it will be like to be incapable of forgetting! Solomon Shereshevsky on my mind. Some way to go yet. This story is sourced from the website Mashable but the research itself is published in the journal Advanced Functional Materials with the, again, cryptic title Donor‐induced performance tuning of amorphous SrTiO3 memristive nanodevices: multistate resistive switching and mechanical tunability. Stick to the translated version in Mashable.

Artificial-intelligence-503593_1920. Many Wonderful Artists on Flickr. https://www.flickr.com/photos/alansimpsonme/34715802120

Memory implants

Most people do not want extraordinary memories and would just want to access the ones they have laid down. Some of these are however buried so deep in the crypts of their brains, they have become inaccessible. Again, technology may have something to promise them. And this comes in the form of a memory boosting brain implant. This device, developed by US Defence scientists, can detect how we retrieve memory, and predict when this will fail, and kick in to action to save the day. A sort of brain pacemaker you may say. The potential benefit is in head injury, but we can all do with a little help every now and then, when the ‘uhms’ and the ‘aahs’ kick in. This piece comes from Science Alert but the original article is on the website of the Defence Advanced Research Project Agency (DARPA), and it is titled Targeted Electrical Stimulation of the Brain Shows Promise as a Memory Aid. Not a bad one this time.

Machine Learning & Artificial Intelligence. Mike MacKenzie on Flickr. https://www.flickr.com/photos/mikemacmarketing/42271822770 www.vpnsrus.com

Neural prosthetics

Another technology promising to help memory is neural prosthetics. These serve to directly send our short-term memories into long-term storage, bypassing the hippocampus when it is too defective to do the job properly. This comes from a piece in Science Daily titled Scientists to bypass brain damage by re-encoding memories. What the prosthesis does is “to bypass a damaged hippocampal section and provide the next region with the correctly translated memory”. In effect it will make the hippocampus redundant. I’m sure the hippocampus does other things apart from encode memories… but we don’t want to think of that now.

Artificial Intelligence – Resembling Human Brain. Deepak Pal on Flikr. https://www.flickr.com/photos/158301585@N08/43267970922

Thought-evoked movements

Imagine being able to move a robotic limb by just thinking about it. No, not telepathy, but with your brain wired to the limb. This is what a prosthetic technology promises for people with brain damage who are unable to move. The prosthetic is implanted in the part of the brain that initiates our intention to move. The source for this story comes from USC News, and it is titled Neural prosthetic device yields fluid motions by robotic arm. In the example cited in the piece, the surgeons “implanted a pair of small electrode arrays in two parts of the posterior parietal cortex-one that controls reach and another that controls grasp“. You have to see the robotic arm in action. Sci-fi is becoming reality in a brain lab near you soon.

3D Brain Sculpture STL model. Misanthropic one on Flikr. https://www.flickr.com/photos/22902505@N05/14780918556

Behavioural remote control

Press a button and alter behaviour. Exciting and scary at the same time. But this is what chemogenetics promises, or threatens, depending on your point of view. This one comes from a piece on the website Neuroscience News titled Chemogenetics technique turns mouse behaviour on and off. The technique “achieves remote control by introducing a synthetic brain chemical messenger system that integrates with the workings of naturally-occurring systems”. ‘Integrate’ feels a tad extreme, almost like being assimilated by the Borg. But I suppose it will be no worse than the antipsychotics and sedatives we currently use to control the behaviour of people with schizophrenia and addictive disorders. It surely looks like it has potential, at least in mice for now.

artificial-intelligence-2167835_1280. Many Wonderful Artisits on Flickr. https://www.flickr.com/photos/alansimpsonme/34752491210

Cognitive enhancement

This technology goes beyond just increasing the ability to preserve or retrieve memory. It sets out to make the brain smarter. This piece comes from The Atlantic and is titled Why cognitive enhancement is in your future (and your past). The technology is transcranial direct current stimulation (TDCS) of the deeper reaches of the brain, using electrodes to send small and painless electrical currents. The currents are thought to increase neuroplasticity, and this enables neurons (or perhaps neurones?) to form the connections necessary for learning.

Brains. Neil Conway on Flickr. https://www.flickr.com/photos/neilconway/3792906411

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It is mind-boggling enough just thinking that people out there are thinking of stuff like these! But it is equally reassuring that the future of the brain is bright.

13 unexpected and unusual reports about Parkinson’s disease

Parkinson’s disease (PD) looms large in neurology. As I try to make sense of developments in this field, I am struck by the large number of curious reports emerging all around it. I thought I had covered this comprehensively in my previous blogs, PD-a few curious things and Bee venom acupuncture for PD. On the contrary it looks like I opened a can of worms. I will therefore give the peculiar and the curious one last heave before proceeding to some conventional blogs I have in the pipeline on PD.  Here then are 13 unusual things about PD.

Appendicectomy may delay the onset of PD

Appendectomy. msafari2425 on Flikr. https://www.flickr.com/photos/msafari/6020024188
Appendectomy. msafari2425 on Flikr. https://www.flickr.com/photos/msafari/6020024188

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People with melanoma may have early PD signs

By Unknown - National Cancer Institute (AV Number: AV-8500-3850; Date Created: 1985; Date Entered: 1/1/2001), http://visualsonline.cancer.gov/details.cfm?imageid=2184, Public Domain, https://commons.wikimedia.org/w/index.php?curid=859342
By Unknown – National Cancer Institute (AV Number: AV-8500-3850; Date Created: 1985; Date Entered: 1/1/2001), http://visualsonline.cancer.gov/details.cfm?imageid=2184, Public Domain, https://commons.wikimedia.org/w/index.php?curid=859342

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PD gives rise to cerebellar atrophy

Cerebellum: the brain's locomotion control center. ZEISS microscopy on Flikr. https://www.flickr.com/photos/zeissmicro/14441559904
Cerebellum: the brain’s locomotion control center. ZEISS microscopy on Flikr. https://www.flickr.com/photos/zeissmicro/14441559904

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PD may give rise to a drunk-like state 

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A light skin pigmentation may increase the risk of PD

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People with red hair may run a higher risk of PD

Feuerrotes Haar. Markus Lütkemeyer on Flikr. https://www.flickr.com/photos/helico/363729534
Feuerrotes Haar. Markus Lütkemeyer on Flikr. https://www.flickr.com/photos/helico/363729534

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Coffee consumption may reduce the risk of dyskinesia in PD 

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Hepatitis C virus is a risk factor for PD

By BruceBlaus - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=44967236
By BruceBlausOwn work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=44967236

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A high cholesterol diet may reduce risk of PD in men 

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Milk intake in midlife may predispose to PD

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Drumming classes improve the quality of life of people with PD

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The GyroGlove reduces tremors in PD

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Focal muscle vibration improves gait in PD

Muscles of the forearm and hand, posterior view. Rob Swatski on Flikr. https://www.flickr.com/photos/rswatski/4769875140
Muscles of the forearm and hand, posterior view. Rob Swatski on Flikr. https://www.flickr.com/photos/rswatski/4769875140

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Do you have any unusual reports about PD? Please leave a comment

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