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BIOL 6397 CELLULAR NEUROSCIENCE Mon-Wed 4-5.30 PM - Cellular Neuroscience Lecture 16 Major Neurological Disorders
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00:01 Progress. This is lecture 16 of neuroscience and we will introduce major neurological
00:10 . Start thinking about it from um just the cellular work mechanisms, basic
00:19 uh of these disorders, but also of the clinical language, some of
00:25 clinical understanding. So we will talk the causes of these disorders. So
00:31 are certain terminologies that people use in care practitioners when they describe different
00:40 period. But in particular, in case, neurological disorders causes can be
00:47 , very broad number of causes. talk about epilepsy, talk about how
00:55 epilepsies and some seizures are cause of mutations. They a lot with
01:04 talk about how you can have epilepsy of chemical in insults and intoxicants.
01:18 and also have epilepsy and seizures that triggered by sound. So in many
01:28 , the causes of neurological disorders are but not all pauses and it is
01:37 also clear what is going to cause neurological disorder. So some things we
01:46 some things we don't, we understand things we don't understand prevalence is how
01:52 the disorder is. So is the of the disorder? How many people
02:02 1000 or per million suffer from that . Is it a rare disorder?
02:05 it really common disorder? We will about some of the most common neurological
02:11 . There is pathophysiology. So, changes in anatomy, changes in cell
02:20 , cell numbers and there is physiology gets affected by the pathology. There
02:28 clinical manifestation of the disease which is . So, tremors. So for
02:38 disease, seizures is a symptom for , uh pain and and vomiting symptomology
02:49 migraines. Oh, multiple sclerosis. say again, pain spasms and you
02:59 say, well, pain and you'll also have another neurological disorders.
03:03 . So sometimes the symptoms are sometimes the mechanisms are overlapping but they
03:10 may have their own specific uh mechanisms target specific cells or channels within those
03:19 probably more than that. So you have multiple motor disorders, neurological
03:25 Parkinson's disease, Huntington's disease and others as therapies and medications is a very
03:35 word because the medication, when you about it is you think of a
03:41 , a tablet, something injected in blood vessel. You think of the
03:50 and most of the treatments are pharmacological . But there are a lot of
03:58 treatments that are non pharmacological and that's at the very uh end of this
04:06 , I'm gonna introduce this concept that chopra talks about that is called me
04:18 meta from meta dali from psychedelics. actuality. The term psychedelics means mind
04:30 . For me, coffee is mild . So when you think about
04:35 it's not that scary of a It just depends what substance you're referring
04:40 . Here. You're referring to a mind altering experience that we will have
04:50 effect that may change the pathology of disease. So we'll talk about
04:55 Again, diets, medications and pills not the only thing. In
05:01 when we talk about epilepsy, we talk about food, medical diet as
05:07 diet for the treatment of treatment, electrodes is a treatment in the
05:17 doing surgical resection, taking uh glioblastoma and taking epileptic. Focus out of
05:24 brain is a treatment, there's a wide array of treatments. Um and
05:32 always alternatives, there is always uh bed therapies, cryo therapies, herbal
05:45 , aromatherapy things that people don't necessarily can help you necessarily as much as
05:58 pill. But that is arguable. just depends on what kind of a
06:05 you are and how you approach the in general. You know, some
06:09 like to uh eat water burger and are vegan. So they have a
06:18 understanding of, of the world. for them, a water burger,
06:23 vegan person is an alternative food. for the water burger person, vegan
06:30 is really a part of them, know. So anyways, there's always
06:38 and with alternatives, I think that's most interesting thing because this is for
06:42 emergent techniques. Emergent treatments are coming is with alternatives with somebody inventing something
06:55 . So when we talk about neurological , there's also this thing of burden
06:59 neurological disorders. What's the burden of disease in the United States alone?
07:11 is AAA study From 90 90 to . So 47 years and almost 30
07:20 , 100 million Americans were affected by least one of the more than 1000
07:30 . This translates out there are some and there are some syndromes. Some
07:35 you have taken my undergraduate courses and the talk by Doctor Robert Chad and
07:43 a neurologist and he talked about a of syndromes and he even said that
07:51 you tell this, like the cop delusion, no, not the phantom
07:55 limb is pretty common actually with the crass delusion. If you tell this
08:00 a lot of neurologists may have not heard. So a lot of
08:05 1000 diseases we may not have heard neuroscientists and neurologists about a lot of
08:13 . And a lot of times you a specialty as a neuroscientist and
08:18 You don't treat people with epilepsy and and Parkinson's disease and nema. You
08:27 have a specialty. Uh so many . This translates the cost of 765
08:39 for the more probable conditions including Alzheimer's . A big drain, dementia,
08:46 , low back pain. So, because you're talking about affecting the nerves
08:53 the back or in the neck migraine epilepsy, traumatic brain injury,
08:59 Parkinson's. So, of course, a lot of differences in, in
09:07 states and some regional differences. There's figure that actually describes that I believe
09:13 in this presentation. But some basic , Alzheimer's disease is an aggressive degenerative
09:20 of the brain characterized by dementia and fatal. So, Alzheimer's disease will
09:27 you. There's no cure for Alzheimer's . Treatments are very limited for Alzheimer's
09:34 and these are great actually, exam definitions, just basic definitions of neurological
09:43 , autism, a disorder emerging in childhood characterized by parents of communication and
09:48 interactions and restricted and repetitive behaviors. are descriptions, right? They're not
09:54 . It's not telling you that fragile which has uh you know a
10:02 So he is a description of cerebral motor disorder caused by damage to the
10:08 or pseudo parts to pressure the serious of food. So, mood disorders
10:19 also disorders from the system. Schizophrenia not a big food disorder that's uh
10:27 noted there, epilepsy condition characterized with disturbances of brain electrical activity that can
10:35 to seizures, loss of consciousness and disturbance and even death. So,
10:44 of patients with epilepsy, they don't to the pharmaceutical food medications and in
10:54 Epilepsies, about 20% of patients may . So it's it's it epilepsy can
11:03 lethal epilepsy is one of the conditions interesting that you can have epilepsy early
11:10 in your life. And you could get over epilepsy. Not have it
11:17 sclerosis disease that affects nerve conduction characterized episodes of weakness, lack of
11:23 speech to multiple sclerosis. That's a homos nervous system neurons, parkinson's progressive
11:34 of the brain that leads to difficulty initiating voluntary movements. So, it's
11:39 movement disorder, schizophrenia, psychotic illness delusions, hallucinations is our behavior.
11:51 A lot of people that you see the street that are homeless. A
11:56 of times that will also have mental . Um and psychosis, one of
12:04 paralysis, loss of feeling and the caused by traumatic damage to the spinal
12:08 . So that's car accidents, everything spinal cord injury and stroke and loss
12:18 brain function caused by destruction of the supply, usually leading to permanent sensory
12:24 and cognitive deaths. So these are major descriptions of the neurological disorders,
12:34 about with tall with a murder on . So, and what it does
12:47 a large and increasing number of people various neurological disorders in the US.
12:51 significant variations burden off the trends of disorders across the US states. The
12:57 for these geographic variations need to be further. Sometimes we know the
13:03 Sometimes you can have uh epilepsy that from encephalic encephalitis and there are certain
13:14 that will have ticks that carrying uh virus and when they bite you,
13:21 you can get encephalitis. So the ticks, other states don't have.
13:27 if you have a higher prevalence of in those states is not surprising.
13:33 in other instances, there is no explanation for why there is variation because
13:37 don't know always the causes of the . So these are temporal trends in
13:46 in the aggregate us wide age, disability adjusted life year daily rates.
13:56 kind of a interesting clinical term rates 100 100,000 persons per year for neurological
14:04 from the 19 nineties, 2017. Now Alzheimer's disease, spinal cord
14:22 Alzheimer's disease, there seems to be bump in the 90s and it's staying
14:26 the same, all spinal cord injuries down. The cancer is staying traumatic
14:35 injuries, went down and the is Parkinson's disease is going up, encephalitis
14:43 meningitis is going down. Why are things going down? Why do you
14:49 you have like Alzheimer's steady increase in increase in Parkinson's or something like
14:57 tetanus meningitis going down, vaccines, . But that's really recent. Even
15:04 that's really recent, that's 2000, not that far back. What uh
15:13 this plateau, that's uh indication of other trend. Yeah, I I
15:24 don't, it's, it's also a point that now the last like it
15:28 like 67 years down. So maybe caught up with the variances and that's
15:35 best that we can do with existing and preventions. People are in the
15:41 States, better vaccines, maybe better , maybe people not believing in vaccines
15:49 that never changes. You know, cousin had encephalitis three times. He
15:56 , so just goes to IC Who believes that? Well, I
16:05 , it's, uh, I, don't know if I can that but
16:08 also have to say that, I hope he's not watching this like
16:13 . But I have to say that sometimes what doesn't kill you makes you
16:20 . And there are some consequences from . And I'm not saying that vaccines
16:29 general, but not every vaccine is by pfizer or something. Yeah,
16:38 a human nature. It's a human and it can happen, it happens
16:43 it view across 2000 or 5000 You know, it could be
16:49 You know, There's a big debate emerging about COVID-19. um vaccines,
16:56 know, that, that the, , I guess it's not that the
17:00 is, is vaccines are healthy, the consequences of the vaccines is they're
17:07 to vascular diseases. That's what's really . It's from a and maybe it's
17:13 true and maybe this kind of a is like, you know, you're
17:16 about something that's not there, this VAERS, you know, put uh
17:23 the, into the Highline. But , it's very interesting to think about
17:28 things with some natural causes that causes vaccinations who will drive down some of
17:33 problems, other problems will stay the . So this, let's talk about
17:37 . This disability adjusted life year is measure of overall disease burden expresses a
17:44 number of years lost to due to health disability or early death. So
17:54 you're alive expected live years, let's what's life expected in the United
18:03 Some, some of I think. . Yeah. Uh so if you
18:10 these years, if you're living with that your disability is and years of
18:19 lost, so this is the life you could have had as a,
18:23 know, society member, maybe a society member, maybe as a fire
18:28 member. But this is the disability life here. Now this can get
18:40 too, this this and get So you actually have only adapt if
18:47 have more than one disabilities, they're morbidity. Lot of funds. So
18:52 you have, let's say Parkinson's disease struggle it or you have migraine central
19:02 disorder or epilepsy, so it shortens life span central and this is the
19:10 probably uh noncellular term you will see those parks. Yeah, these are
19:25 Disability Adjusted Life Year rates for 100,000 for neurological disorders in the United States
19:31 2017. So were you seeing uh is all good? All right,
19:43 red is not good and we can kind of a, like a real
19:49 for certain geographical trend if you were about stroke. Welcome to, you
19:56 , southern cooking, the southern you know, Louisiana, Mississippi,
20:03 glo, Red Cleveland. Uh, also because of lack of primary
20:12 lack of primary care, lack of . Uh, yeah, Alzheimer's disease
20:23 other dementias. Well, it's kind interesting that, no, I wanna
20:32 to California. Yeah. Where It's this area here, most Southeast
20:42 area of Parkinson's disease. It's at least, you know, middle
20:48 northern states here. And, I think, let's see. It's
20:57 interesting. Oh, a bully is like Louisiana. This area has a
21:05 of epilepsy again. And metasol sclerosis here. Motor neurone disease, motor
21:12 , epilepsy. Parkinson's disease that seem be like, concentrated in the
21:18 Uh, the Wyoming areas people hate Texas a lot but it seems
21:24 Oh, no, not bad. bad. Yeah, not on
21:30 Oh, yeah, it is. , it seems like Montana should be
21:32 the Texas hit. They're pretty Yeah. I mean, yeah,
21:38 definitely have a lot of heart The stroke is like some good,
21:46 also because we have really good medical in Texas. So, you
21:52 there's a lot of good stroke major atropos in every city here,
21:58 here, especially here. Well, something like specialist in Houston or,
22:06 , there are only 10 others, the ultra specialized on this.
22:16 you're, um, it's the amount doctors that are available. How soon
22:24 you see them to, how close are located to you? Some of
22:28 specialist neurologist special is just like a specialist. You know, you don't
22:32 them like you're family doctor and if see them it will be again a
22:42 up in two or three months and you need to see somebody first time
22:47 probably will have to wait unless you're the hospital, you're gonna have to
22:50 to see that specialist. Like people um uh a and that would be
23:08 Um there, there is definitely a genetic components, couple of chromosomes,
23:15 of them is chromosome 18 and that affected by it. Um so,
23:20 some of the sort that have no but even still you may have a
23:26 that why did you develop the Uh the mutation and both all,
23:34 did you still develop disease? Um And some of those mutations, if
23:43 non genetically can be sporadic when it's , then we don't know why and
23:50 caused the, the, the, an additional mutation to occur or a
23:56 to a car in the first I'm looking at the maps that I
24:01 , like geographically sort of isolated area it probably we're seeing. Oh,
24:20 suggesting the inbreeding in that part of country uh in, in very crude
24:28 , but maybe you are somewhat correct suggest that maybe there are more closed
24:35 , uh, and not as urban culturally a little different. So,
24:40 , I mean, yeah, it's, it's, it's a,
24:42 a good thing. Yeah. It's good, uh, intellectual,
24:47 thinking about this meningitis again. Look meningitis and the Louisiana and that's where
24:58 lot of bugs are. So, cancers, you're looking again and,
25:09 it's kind of a broad, widely map. Uh but there are
25:16 So there are definitely geographical variations in geological disorders To remember different parts of
25:23 brain and the CB- one receptors that located in the brain. And I'm
25:28 this diagram just to remind you of parts of the brain that have different
25:35 . And you can have a different of the brain that is affected,
25:41 will result in neurological dysfunctions, motor that may affect basal ganglia. For
25:50 , because it's involved in motor Uh if you have cerebral cortex,
25:57 know the different parts of the cerebral are responsible for different areas. So
26:00 of the epilepsy and seizures a lot times would be associated with temporal
26:08 And again, where the disease if it has to do with the
26:13 dysfunction, for example, no, the brain stem, it's going to
26:20 uh certain pa pathways, certain uh of the brain communicating to each other
26:27 areas of the brain that are responsible , for different functions. So
26:37 although neurons are the longest living cells the body makes me feel good.
26:43 numbers of them die during migration and . The lives of some neurons can
26:49 abnormal turns. Some diseases of the are the result of a natural death
26:54 neurons. So again, let's look some of these diseases. Parkinson's disease
27:01 that produce neurons that dopamine died off basal Galia, an area of the
27:07 that controls body movement, this causes and initiated when you talk about dopamine
27:17 that are going into basal ganglia. dying in Huntington's disease. A genetic
27:25 causes overproduction of para transmitter called So if Parkinson's is do the contact
27:36 kills neurons, they don't get But it's the same area of the
27:41 as the fact that therefore, uh also a movement disorder with T and
27:50 a famous case of Hunter's disease as J Fox. Uh And if you
28:01 him, he displays a little suit the Alzheimer's disease, unusual build around
28:10 and neuro cortex and hippocampus. Now in hippocampus and Neocortex. Alzheimer's is
28:17 to control memory plasticity encoding so that a campus doesn't store memories, but
28:24 is responsible for encoding and recalling the memories. That's what happens with people
28:31 dementia is that they start forgetting stories, names, faces, they
28:38 to uh ask somebody their name quite . The person has to reintroduce
28:45 Short term memory goes first with Alzheimer's . Later to long term memory
28:51 Uh So when my grandmother, for , had Alzheimer's disease, my father
28:57 the closest person to her and she his name for the longest time and
29:06 who he was for the longest And at some point I would go
29:11 her and all she knew was my . So she would call me by
29:16 name and think, oh, that him. That was the longest,
29:21 longest long term memory that my grandmother and the closest uh human association that
29:27 had. And after that, uh was in the hospice after she forgot
29:35 my father is really, she was the hospital. So uh it's not
29:40 uh memory, you'll have physical damage different parts of the brain and nervous
29:46 , you'll have death in the neurons you'll basically die because your brain stops
29:54 care of the body. Imagine if plaques start broadly innovating that cortical area
29:59 responsible for sensory motor functions, the plaques will spread everywhere from these
30:08 areas. Brain stem that will start your breathing. Heart rate. People
30:14 swallow, they cannot feed themselves uh to the brain, traumatic brain
30:22 the damage caused by a stroke, build neurons outside or slowly starve them
30:28 the oxygen and nutrients they need to . So if you have a traumatic
30:33 injury, which would be uh penetrating injury and basically cut through the brain
30:41 and cut through the blood vessels and permanent damage to oxygen and nutrients.
30:47 the same can happen with a It's a rupture of blood vessel in
30:52 brain, spinal cord injury can disrupt between the brain and muscles. When
30:59 lose their connections to axons located below site of the injury. These neurons
31:05 still live but they lose the ability communicate. And one of the known
31:16 by which one of the known ways which cells die is what is called
31:24 toxicity. In this case, it's . It says glutamate that is being
31:29 . It overexcites neurons, there's too castle production and during the diseased neurons
31:38 through apoptosis or necrosis. These processes too much glut calcid can lead to
31:47 degeneration, neuronal cell death. So could basically just say that Huntington's is
31:54 disease of cito toxicity in a Yes. Uh with, with glutamate
32:01 . Yeah. Oh, the neurotransmitter . Yeah. So based on
32:07 you know, it's a collection of , bod nucleus, put a globe
32:18 pa and collectively these structures are called little gang. And they're very important
32:26 the brain systems to control movement. , amen. Well, it was
32:36 it so all complicated circuit in each of these nucleon function won't have much
32:45 to get into it. But um a it's a good uh way to
32:53 that basal ganglia is not just one but is a collection of structures.
33:01 have other structures, the mammal or of the hypothalamus and mix them up
33:13 to be important, you know, nucleus. So this is nucleus,
33:26 . Another view, this is corpus . It's the fiber bundle that inter
33:31 it to hemisphere. So the two can talk to each other.
33:36 you have white matter and you have matter. And these are the sort
33:40 the again, the tainment and gloss a substantial of NRA uh mammary
33:51 Oh So there is multiple areas in brain that the degenerate. Substantial.
34:00 is one of these areas that And by degenerating, it reduces or
34:08 the brain of a central the neurons diseased basal ganglia, commit suicide.
34:18 is really, really interesting box that read through because it's a lot of
34:29 information and I kind of just we it. So Several devastating neurological diseases
34:37 the slow progressive death of neurons. with Parkinson's disease have usually more
34:42 More than 80% of those have been neurons in their substantial. Remember that
34:48 means like stress the nucleon. And if you, you lose that
34:52 that small part of the brain, lose all of the A meme that
34:57 being generated there, which is In this case, 80 of those
35:03 are are dead. So what makes I grow vulnerable neurons of the
35:14 Oh, no. The cameras moving . I got, I got
35:22 So this and other regions slowly degenerate , and the so, so Huntington's
35:32 , the disease? Oh, wait second. Uh I just,
35:38 just give it a, this is hunting of disease. And you can
35:43 that this is normal, normal. . That's normal brain. And you
35:53 see a significant degeneration and loss of entertainment. And I think this
36:06 So in figure a we have Parkinson's and this is substantial Nigra right
36:15 This is a a uh uh uh don't know if it's been stained or
36:20 oxidized, exposed by oxidation. But is the area of the substantial Igra
36:26 there's no more of the of the neurons that you can find all
36:36 So the symptoms might be similar. as far as you know, motor
36:43 , there might be some specifics that specific to the structure is different.
36:50 do these neurons die? Ironically, that natural forms of cell death are
36:56 . The process called program cell death apoptosis is essential for normal brain
37:03 So certain neurons commit suicide as part the program by which the nervous system
37:08 , all cells have cell, several genes that trigger set of enzymes that
37:13 cellular proteins. And DNA some forms cancer occur when normal programmed cell death
37:20 prevented and cells proliferate wildly. Some diseases may result when programmed cell death
37:28 unnaturally activated. I think this disease caused by a dominant gene. So
37:35 the cellular uh the molecular mechanisms of disorder, A gene that goes for
37:43 large brain protein called a normal molecule a chain of 10-34 glutamine at one
37:52 . one of these. So we that what it means. AT two
38:02 3. So develop Huntington's disease, abnormal long hunting that aggregate lobs of
38:10 accumulate and trigger neuronal degeneration. So normally have 10-34 people with repeat or
38:19 than 40 glutamine develop hunt hunting this . So the normally long hunting tends
38:29 , trigger neuronal degeneration. Function of Huntington isn't known, but it may
38:34 counterbalanced and triggers some program of And Huntington's disease may arise from normal
38:40 of neuronal degeneration, gone or would the excess glutamine kind of be
38:47 the exit toxicity? I'm gonna Yeah, I somehow the expression of
38:54 the molecular underlying mechanism is these alligator chains, but it effects glutamate.
39:09 , but it affects, it but also we're talking about these particular
39:16 called a nucleus containment, basal Uh So based on the global fact
39:25 function of global is not all of brain is the specific areas of the
39:32 that are dying. So, Parkinson's is usually a disease of aging of
39:38 vast majority of cases occur after age 60. That means that Huntington's disease
39:45 occur early, um, in the majority of cases over 60.
39:51 in 1976 and again, in several relatively young drug abusers in
39:57 This is a very interesting story to from young drug abusers. Maryland and
40:03 developed severe Parkinsonian symptoms within a few . So they basically got the,
40:11 use of drug. The Noro is T P. Uh, this was
40:19 because usually symptoms accumulate over many So there is an early diagnosis of
40:26 disease. You know, you're looking that and it could be from the
40:33 you got diagnosed to the time you and maybe 2030 40 years, uh
40:40 know, depending on, on, the disease. So in this case
40:45 the severity of it, right. if you are diagnosed with Parkinson's
40:50 that means your symptoms are not as . And that means that if you
40:55 and there's no cure, the disease progress. The symptomology will get
40:59 the pain will get worse, the spasms will get worse. You
41:03 all of it will get worse. it takes years in this case a
41:08 days and these uh people developed Parkinson's . Medical detective work graveled because of
41:16 addicts infliction. Each had taken street of a product that contained the chem
41:22 MP T P. The incompetent base on chemists who had synthesized the illegal
41:28 , tried to shortcut the procedure, creating a chemical byproduct that kills dopamine
41:35 . M BT P has since helped understand Parkinson's disease better. We now
41:41 that M BT P is converted into brain to MP P plus, dopamine
41:48 cells are selectively vulnerable to it because membrane dopamine transporters is stake and V
41:56 plus or dopamine and they selectively accumulate chemical like a trojan horse inside the
42:04 once inside the cell and B P energy production and mitochondria and the neurons
42:10 die because their A T P is . So the fact that that B
42:15 supports the idea that common forms of disease might be caused by chronic exposure
42:21 slowly enacting toxic chemical in the Unfortunately, no one has identified such
42:32 toxic research has shown that M BT can induce a form of program so
42:40 a substantial library. So, isn't interesting? So illicit speed drive causes
42:49 investigation that there's a whole discovery of P and basically a mistake set for
42:56 neurotransmitter that loads it up and keeps in those neurons uh and upsets the
43:04 A T P and mitochondrial function and death. The neurons of Parkinson's spats
43:10 be generated for a similar reason. 5% of Parkinson's cases are added and
43:16 of several different genes are not known cause these rare types of the
43:22 One hypothesis is that Parkinsonian gene encodes that are misfolded, aggregate accumulated neurons
43:31 trigger or facilitate the death of the by understanding how and why neurons
43:38 You may eventually be able to devise of cellular suicide prevention that hold a
43:45 a variety of terrible neurological diseases. it's one of the ways to,
43:51 prevent neurological disorders in general is to after these all the suicide program.
44:01 that or degrading pathways stop dus from into the suicide mode or death
44:16 With the help for self help of disease. On the cellular level.
44:26 the outside, you have the amyloid on the inside, you have your
44:31 and on the growths on the This is a disease where you will
44:36 a loss of tissue across large swaths cortex of some part of area as
44:45 . This is more of the pathology the Alzheimer's disease. But in Alzheimer's
44:50 , you will also have neuro So a common theme. Look at
44:55 brain and severe Alzheimer's disease. Look the brain and severe Parkinson's and severe
45:00 disorders. There is a common theme . There's neuro degeneration, neurons don't
45:07 . So have your bone regrows after break in your cells form and
45:12 So brain structures kind of do that if we're outside that period of critical
45:18 of plasticity, critical period of development there's a lot of plasticity and recovery
45:24 different injuries. Ok? I wanted talk to you about the stimulation.
45:32 I think I started the select room and uh I don't wanna keep you
45:38 here today. But when we come , we're gonna talk about deep brain
45:44 and how it is being used to Parkinson's disease and other disorders. And
45:49 talk about vagus nerve stimulation. In , the company E Therapy, which
45:55 Vegas nerve stimulation therapy, uh is Texas based company and I believe they
46:02 located, it's not gonna use some or somewhere in between that has developed
46:08 , some of these electrodes that you that in that case, in their
46:12 , they implanting them by the neck to target the, the ba
46:17 Ok. But we'll talk about how would implant where you would implant.
46:23 , and why the brain stimulation as treatment for some severe, uh,
46:31 dysfunctions or? All right. yeah. I MD A yes.
46:51 , yeah. Uh, otherwise you have it implanted in the medical center
46:58 people's brains. It's a medical Yeah. Ok. Hard to
47:06 Right. But, uh, Elon is gonna get, it's so nice
47:17 , like, come up and, I get that.
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