| 00:00 | So in this third section we will neurological disorders. Epilepsy migraines. Alzheimer's |
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| 00:08 | . So we'll talk about covid and brain as well and you'll realize that |
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| 00:14 | some of these neurological conditions there is place in the brain. There's a |
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| 00:18 | in the brain. There's a focus fosse or place, for example, |
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| 00:22 | epilepsy that initiates a circuit of cells exhibits and the normal cellular synchrony, |
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| 00:30 | has an impaired cellular circuit. It potentially imbalance and excitation and inhibition and |
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| 00:38 | generating anesthesia that now can spread throughout brain. We will talk about |
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| 00:44 | Let's share some of the similar basic that we understand the cellular mechanisms that |
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| 00:50 | also see in epilepsy, discuss Alzheimer's and we will see as we discuss |
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| 00:58 | neurological conditions, that our knowledge of transmission is very useful here because as |
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| 01:07 | will see that it's not only the structures but also its neurotransmitter systems that |
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| 01:12 | affected and are associated with specific neurological and dysfunctions. So, when we |
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| 01:22 | about neurological disorders, we have to thinking about what are the causes. |
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| 01:30 | course we all want to know what what causes these neurological disorders, these |
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| 01:38 | disorders you'll see in subsequent and subsequent . But what are the causes are |
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| 01:42 | that causes that are hereditary genetic, it something that gets passed on through |
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| 01:52 | a mutation in the gene um something the code that gets passed on through |
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| 02:00 | generations. Isn't sporadic means that it's it's spontaneous isn't part of normal |
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| 02:13 | When we talk about dementia and alzheimer's . No, it's not part of |
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| 02:17 | agent. It's a disorder as a . There's plenty of people that live |
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| 02:26 | into 100 years of age and have hmm. Memories and our sharp but |
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| 02:36 | other conditions that kill them. So cancel authorities are hopeful. Environmental |
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| 02:46 | Nature causes nature as in toxins, , mosquitoes, bugs that bite us |
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| 03:04 | maybe viruses like covid that invade the . And we do not understand completely |
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| 03:14 | long term consequences of this inflammatory cardiovascular disease. But it does have significant |
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| 03:22 | fact on the brain when we talk neurological disorders. Were also talking about |
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| 03:30 | C. N. S. And pianists. So what what what are |
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| 03:36 | causes? Is that the trauma? it a chemical? Is it |
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| 03:43 | Is it some sensory stimulus sound high pitched sound that leads to destruction |
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| 03:50 | generation of for example sound induced or genic seizures. What is the provenance |
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| 03:58 | of these disorders? Yeah. Migraines prevalent as Huntington's disease. Are they |
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| 04:08 | prevalent? Why is there less epilepsy countries like India? Does it have |
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| 04:18 | do with environmental, with hereditary doesn't to be with a dietary which is |
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| 04:25 | exogenous environmental factors. Something in the that potentially in India for curries like |
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| 04:34 | that reduces inflammation and therefore somehow has secondary long term effect on certain neurological |
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| 04:43 | ? What's the pathology and physiology of disorder. What is the pathology or |
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| 04:54 | of physiology because if you have a in the in the in the in |
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| 05:02 | circuit dying south pathology changes the physiology that circuit that changes the metabolism. |
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| 05:09 | changes the glia neuronal interactions. That how that circuit communicates to other circuits |
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| 05:18 | spreading somehow or exacerbating the disease throughout regions of the brain. If it |
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| 05:26 | originating in a specific small region of brain. Symptomology or clinical manifestation of |
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| 05:35 | manifestation is because there are for example types of seizures that are very hard |
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| 05:42 | observe symptoms, symptoms would be somebody in and they're they're exhibiting traumas so |
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| 05:51 | exhibiting rigidity in their hands. It a neurologist a clue this is a |
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| 05:58 | observable outward symptoms that a patient may ticks. For example, somebody experiencing |
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| 06:07 | . That's a that's an outward observable what's inside the brain is also a |
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| 06:12 | manifestation but it doesn't always cannot always observed with the naked eye actually have |
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| 06:18 | use tools such as E. To record a normal synchronization of the |
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| 06:24 | circuits and cells in the brain. neurologists there are scientists, health care |
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| 06:37 | , doctors understand the neurological disorder, causes, understand the papal physiology. |
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| 06:47 | manifestation. There's usually a treatment and treatment courses for pharmaceutical treatments and there's |
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| 07:01 | courses for supportive or alternative treatments for neurological disorders. And I I think |
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| 07:12 | modern medicine is learning from alternative Alternative treatments. Coexist with modern |
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| 07:19 | Which is undoubtedly lifesaving alternative treatments I come into play where you have to |
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| 07:27 | heal and become healthy and strong. you may say that what is an |
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| 07:36 | treatment? Well exercise, diet alternative medicines and such. So this |
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| 07:44 | a very good report from Jama, is Journal of American Medical Association of |
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| 07:53 | . They did an original investigation, collaborators and it goes and examines neurological |
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| 08:04 | across the United States, which is relevant to us. Of course. |
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| 08:07 | don't think that neurological disorders are somehow to the United States is very prevalent |
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| 08:13 | burdensome Throughout the world. But they at the history of that from 90s |
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| 08:18 | 2017 and I will post a full of this article. This is some |
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| 08:23 | takeaway. So In 2011 and this goes all the way to 2017. |
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| 08:30 | in 2011 About 100 million Americans were by at least one. The more |
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| 08:39 | 1000 neurological disorders. So how It's more than 1000 before neurological |
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| 08:46 | some of them are very rare. some of them are extremely rare, |
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| 08:57 | burden for the societies. And when talk about the burden, I guess |
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| 09:01 | talked about the monetary burden, but a lot more than just the money |
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| 09:06 | linked to to to to this But the cost of 765 billion. |
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| 09:12 | the more prevalent conditions like Alzheimer's chronic low back pain stroke, |
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| 09:20 | supple of traumatic brain injury and Parkinson's . And so this is just right |
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| 09:26 | probably within inflation. It's a trillion just for these neurological disorders in the |
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| 09:36 | States. Now this is Just mind to me and this is again stops |
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| 09:45 | 2017 and then we just have to that things are getting better in |
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| 09:51 | with a health crisis. Although accurate on incidents, problems, mortality, |
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| 09:56 | death rate and disability from neurological disorders the trends are important for evidence based |
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| 10:02 | care planning and resource allocation. There a lack of national and state level |
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| 10:10 | data in the US as well as citizens. For used by health care |
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| 10:17 | . That just makes me laugh because can get on our phones and pay |
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| 10:23 | bills and transfer money around the world send videos and put different features on |
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| 10:32 | faces and stuff. But we cannot really, there's no data that's good |
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| 10:44 | from all of these massive disorders. just think about it and it shows |
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| 10:49 | the systems break down at the state the federal level is evidenced by covid |
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| 10:56 | months. So this is, you , not from this article, but |
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| 11:04 | further descriptions will be taken from this , but here are some of the |
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| 11:11 | disorders that you may know and we know. We already discussed some of |
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| 11:19 | and we'll discuss a couple of them greater extent. Alzheimer's disease. His |
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| 11:26 | is a progressive degenerative disease of the characterized by dementia and is always |
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| 11:36 | So it leads to death because as degenerate and you first lose memory and |
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| 11:43 | later your brain cannot take care of body, Let's go over your |
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| 11:48 | Some of the vital body functions the is not capable of performing them |
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| 11:55 | a disorder emerging in early childhood to and autism A A this is an |
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| 12:01 | order. Alzheimer's is a aging It happens in aging, false and |
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| 12:08 | is a developmental early emerging early childhood characterized by impairment and communications and social |
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| 12:19 | and restricted and repetitive behaviors. So is a increasing prevalence of autism and |
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| 12:26 | autism is being grooved under autism spectrum and quite a few rare syndromes that |
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| 12:34 | not have a home explanation, diagnosis treatment quite often get grouped under this |
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| 12:41 | spectrum disorders if they have these communications and behavioral problems, cerebral palsy, |
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| 12:51 | motor disorder caused by damage to the before, during or soon after |
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| 12:58 | So if if Alzheimer's disease may eventually a motor disorder component, it doesn't |
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| 13:09 | so autism does not necessarily have might it be a little bit of |
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| 13:15 | abnormalities or not? Doesn't want suitable is the motor disorder depression is a |
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| 13:23 | disorder. These are major disorders of nervous system. Depression is a serious |
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| 13:34 | of movement characterized by insomnia, loss appetite and feelings of dejection. Different |
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| 13:42 | of the brain responsible for different Some parts of the brain are responsible |
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| 13:47 | mood. Others are responsible for motor and motor commands. And depression is |
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| 13:55 | to the mood centers. Epilepsy is condition characterized with periodic disturbances of brain |
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| 14:03 | activity that can lead to seizures, of consciousness and sensory disturbances and also |
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| 14:10 | . Professor apologies. Um I wanted ask for the disorder of depression. |
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| 14:21 | exactly or does it have to Is the disorder itself depression anyway, |
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| 14:31 | to the depression that we learned of like in the past tests? Is |
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| 14:38 | correlated at all? Excellent classroom. you're wondering whether long term depression is |
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| 14:49 | same as this nervous system disorder. . And the answer is no. |
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| 14:58 | term depression is a cellular mechanism, mechanism driving away the synopsis of weakening |
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| 15:09 | synopsis, potentially eliminating the synopsis, term depression and a uh conscious cerebral |
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| 15:22 | could represent forgetting but it is not that is a mood depression and it |
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| 15:35 | not necessarily that during the depression, activity is suppressed and that the sena |
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| 15:42 | are not active. It is really down to the connectivity and the interactions |
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| 15:48 | these circuits and the waves, the that they generate and the master of |
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| 15:54 | driver already. So, excellent It's it's it's different. So I |
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| 16:02 | it's long term, potentially. Ation memory, long term depression is forgetting |
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| 16:12 | erasing the synapses that are not Just as a part of a regular |
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| 16:20 | of brain activity. And this is mood disorder that's that's linked with a |
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| 16:28 | of times with chemical imbalance. It have a pathology in severe cases of |
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| 16:34 | depression. It can be uh neuronal and you will see also you can |
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| 16:41 | stimulate the brain to try to reduce depression and chronic depression. So epilepsy |
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| 16:54 | see these electrical storms. Do you these electrical storms? In other |
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| 16:59 | if you were to put an e G over a depressed person's brain, |
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| 17:04 | you see an electrical storm? And that wouldn't be a diagnosis for |
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| 17:11 | but you would see these electrical activities are abnormal in patients that have |
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| 17:21 | And it's really a description. This just short description of these disorders. |
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| 17:26 | sclerosis. It's an auto immune disorder means it's a disorder against yourself. |
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| 17:35 | a progressive disease that affects nerve conduction by episodes of weakness, lack of |
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| 17:41 | and speech disturbance. It's D Myelin . There is a d Myelin Nation |
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| 17:49 | is happening in multiple sclerosis in the nervous system in the cerebral cortex And |
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| 18:00 | is a disease that typically starts in 30s epilepsy. Again the onset of |
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| 18:06 | diseases, autism developmental epilepsy is most during early childhood and during latter, |
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| 18:14 | , late late years aging during Multiple sclerosis, thirties, forties Parkinson's |
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| 18:23 | typically appears in the forties schizophrenia, the thirties, forties spinal paralysis. |
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| 18:30 | , it could be different if it's to injury, then you cannot predict |
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| 18:33 | that happens. So, different timelines . Now Parkinson's disease, a progressive |
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| 18:40 | of the brain that leads to difficulty involved in initiating voluntary movement. |
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| 18:48 | it's a motor disorder. Cerebral policy a motor disorder involving different parts of |
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| 18:56 | brain, different neurotransmitter systems, a severe psychotic illness characterized by |
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| 19:02 | hallucinations and bizarre behavior and schizophrenia and . You can have actually neuronal |
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| 19:11 | So you can have neuro degeneration and . It's not just a psychotic episode |
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| 19:17 | psychiatric disorder. It's actually has a of physiology of neuronal cell laws. |
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| 19:25 | paralysis is a loss of feeling. caused by traumatic damage to the spinal |
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| 19:31 | , uh such as after car accident another serious accident stroke. So, |
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| 19:39 | see National Institute of neurological disorders and . Because stroke happens in the brain |
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| 19:45 | feeds the brain, it's the blood , it's a loss of brain function |
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| 19:50 | by a disruption of the blood A rupture of the blood vessel, |
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| 19:54 | example, usually leading to permanent sensory motor or cognitive deficits. Okay, |
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| 20:04 | I think that these are Actually it's neurological disorders. These are descriptions that |
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| 20:13 | should be familiar with and you can that there are rather broad descriptions for |
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| 20:19 | diseases. The key point, this supposed to be in burden neurological. |
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| 20:25 | is the key point? What is current burden of neurological disorders? And |
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| 20:32 | this analysis basically found that the three burdensome neurological disorders in the US was |
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| 20:40 | Alzheimer's disease and other dementias and The burden of individual neurological disorders |
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| 20:51 | marred moderately two widely by states and absolute numbers of incident prevalence. See |
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| 21:05 | cases and disability. We'll talk about disability Dalley adjusted life. Years of |
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| 21:11 | disorders except for the ones listed such as meningitis, encephalitis. Brain |
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| 21:20 | . TB. I it's going to with the brain infections and encephalitis after |
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| 21:25 | across all U. S. States From 1990 to 2017. So they |
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| 21:32 | on the rise. The large and number of people have various neurological disorders |
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| 21:39 | us with significant variations across geographical So let's let's look some of these |
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| 21:47 | here dolly. This is this standardized disability adjusted life year. Let's |
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| 21:59 | to understand what this dolly is is . It's basically these are like healthy |
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| 22:08 | years and then you know, overall bargaining may get sick sometimes at some |
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| 22:17 | in your life and then you have disease or disability and years you live |
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| 22:24 | a disease plus years of life lost of the disease. So you may |
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| 22:34 | a life expectancy of let's say 80 years when you're going on |
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| 22:42 | Getting sick sometimes getting cold, broken , something like that. And then |
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| 22:47 | serious happens? You live with this or disability that causes early death and |
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| 22:54 | combination of these years lived and years life lost. This is dolly. |
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| 23:02 | hmm. And you can see that for for stroke it's decreasing for traumatic |
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| 23:13 | injury is decreasing for things like idiopathic , it's not changing. But for |
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| 23:20 | disorders you have increases like in in in Parkinson's disease seemingly have increases in |
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| 23:31 | and dementia and multiple sclerosis and motor disease. And you can see a |
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| 23:38 | clear decrease here and encephalitis. Tetanus meningitis going down. And I said |
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| 23:44 | a fly. This may change because encephalitis is an inflammation due to a |
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| 23:50 | infection of the brain. We are in the middle of covid that infects |
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| 23:57 | brains and causes information and neuro degeneration neurological damage since consequences. So this |
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| 24:07 | actually made change in the next few . This is something that I'm not |
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| 24:16 | test you on or regional differences. I wanted to draw your attention to |
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| 24:22 | differences and where people are experiencing. is the red zone means that there |
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| 24:28 | more Higher rate for 100,000 people. if you were talking about the |
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| 24:37 | this is a stroke area right Louisiana Mississippi Alabama? That's not good |
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| 24:49 | here. So again, what are factors that are influencing this? Alzheimer's |
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| 24:59 | and other dementias. Why is it uh in uh uh what is that |
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| 25:10 | , south Carolina? Why is it Alzheimer's disease is more prevalent in this |
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| 25:19 | in the southeast region? Why is that motor disease is more prevalent on |
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| 25:28 | West Southwest freedom, multiple sclerosis. what is this like in Dakotas, |
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| 25:46 | migraines pretty prevalent. Right then that's thing is that the map is pretty |
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| 25:54 | or yellow. You know that there a high prevalence of that disorder. |
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| 26:01 | again, if you live in Mississippi a higher prevalence of migrants and if |
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| 26:08 | live in in new york state meningitis level. So meningitis again, there's |
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| 26:19 | Southern States cancer. There's a cancer here. Midwest pretty large, it's |
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| 26:29 | politis is viral diseases. And meningitis are southern Louisiana seems to be like |
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| 26:37 | big episode right there. There's a of variability. Regional variability across the |
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| 26:51 | States, We call this diagram, parts of the brain as they express |
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| 26:59 | one receptor, but different parts of brain as we discussed, are responsible |
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| 27:03 | different functions. And so diseases will the basal ganglia that we mentioned here |
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| 27:20 | we'll talk about basil ganglia in greater . So it depends on what part |
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| 27:26 | the brain has affected the hippocampus basil ? Amygdala cerebellum, you will have |
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| 27:34 | different manifestation of the disease? You affect the different neurotransmitter system? So |
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| 27:44 | happens in a lot of neurological disorders a neuron o death. Okay. |
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| 27:54 | what we know about neuronal debt is once neurons die in the C. |
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| 28:02 | . S. They don't regenerate. neurological disorders are often neurodegenerative disorders. |
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| 28:15 | means that neurons degenerate and they don't back. So there's a permanent loss |
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| 28:25 | a function a partial loss of And and it's it's it's it's |
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| 28:37 | So several devastating neurological disorders is described involved death of neurons. Look at |
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| 28:46 | disease and this is interesting because when talk about certain neurological disorders we can |
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| 28:53 | about them as they were led to neurotransmitter systems. It's a dopamine |
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| 29:00 | Then you have dopamine dysfunction in Parkinson's and you have dopamine dysfunction in |
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| 29:07 | You can talk about neurological disorders like on the structure basil ganglia. If |
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| 29:19 | have an effect of basil ganglia you're to have motor disorders that are associated |
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| 29:31 | this motor disorders are associated with damage basal ganglia. So in Parkinson's disease |
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| 29:40 | is associated basal ganglia circuit is a Neuron disease. So neurotransmitter dopamine is |
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| 29:48 | 80% of the dopamine utilizing neurons and nigra are lost. So you don't |
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| 29:57 | what substantial migraine is. Uh give 1 2nd actually. So let me |
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| 30:07 | back a little bit and talk about ? We just started talking about basal |
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| 30:12 | and I said that neurological disorders are to have your own old death. |
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| 30:19 | It's interesting although neurons are the longest sauce in the body, a lot |
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| 30:24 | them died during migration and differentiation. this was during the developmental processes and |
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| 30:31 | the sorting of the synapses in during developmental processes. You can have these |
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| 30:40 | disorders that we discussed, autism spectrum . You can have abnormal synapse |
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| 30:48 | densities of the synapses during the differentiation of circuits, connectivity in the |
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| 30:53 | as part of the development. neuronal death. In Parkinson's disease, |
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| 31:01 | dopamine neurons that die off in basal and we'll come back and look at |
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| 31:05 | tomb. Huntington's disease is also linked basal ganglion. Uh But it's overproduction |
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| 31:16 | glued inmates which kills neurons and basal . And in Parkinson's disease you may |
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| 31:26 | Parkinson ian tremors rigidity, you may have hallucinations and Huntington's, It's people |
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| 31:34 | twisting and with uncontrollably it's this Now we're talking about clinical manifestation or |
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| 31:43 | of these diseases, but as it to the death of specific neurons in |
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| 31:50 | neurotransmitter expressing neurons modulated expressing neurons. Alzheimer's disease, you have a build |
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| 32:01 | uh senile plaques and this build up also cause neuronal death. And there |
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| 32:11 | be further neuro degeneration in Alzheimer's disease to death blows to the brain. |
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| 32:18 | by the way this is taken from Institute of Health blows to the |
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| 32:23 | traumatic brain injury or the damage caused stroke can kill neurons outright or slowly |
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| 32:31 | them off the oxygen and nutrients they to survive. So you have a |
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| 32:36 | to the brain that damages the blood . You can have actual tissue damage |
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| 32:42 | you can cut off the oxygen and supply to an area of the brain |
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| 32:47 | slow neural degeneration, spinal cord you have destruction of communication between brains |
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| 32:57 | and muscles. So between the spinal and the muscles between C. |
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| 33:01 | S. And and and the spinal and neurons lose their connections to accidents |
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| 33:09 | below the side off the injury so still may be alive but they have |
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| 33:17 | ability to communicate. And what is here is that one method of cell |
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| 33:26 | of this neuro degeneration is excessive So glutamate, excited toxicity and is |
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| 33:35 | here in Huntington's disease. So when talk about basal ganglia, we had |
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| 33:40 | very basic definition of basal ganglia, motor commands and the very broad picture |
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| 33:46 | you could have identified on the exam easily. Now basil ganglia has parts |
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| 33:54 | it. These three structures caught in entertainment and global palette jas they are |
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| 34:03 | a part of the system that controls in the brain. So motor, |
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| 34:08 | motor cortex will initiate the motor commands the control of movements and a lot |
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| 34:17 | these actually complex patterns of motor Complex motor motion is mediated by basal |
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| 34:29 | . You have it here at corpus connecting two hemispheres and caudate nucleus is |
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| 34:36 | in light blue here. Putem in the green and glorious palace in purple |
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| 34:47 | . So there's another uh part also is implicated and is important as we |
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| 35:00 | about this is a self Holomisa sub nucleus. Then we talked about the |
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| 35:11 | as the fear processing center, emotional center and substantial Niagara right here. |
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| 35:21 | black substance ah This is a sub , This was part of the motor |
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| 35:35 | and the substantial black black substance, Niagara is also part of the motor |
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| 35:43 | . Alright, so substantial Niagara and sub thalamic nucleus. It's also part |
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| 35:50 | this motor control systems. So now understand several components of the basal |
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| 36:05 | Yeah. So what happens to neurons basal ganglia? How do they |
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| 36:15 | There's usually no blow to the brain cause Parkinson's disease or Huntington's disease? |
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| 36:22 | why do these neurons die? And die Because there is programmed cell death |
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| 36:26 | apoptosis. And you know that there a whole mechanism that can trigger |
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| 36:36 | And you have apoptosis in cancer program off and you can have neurological diseases |
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| 36:45 | also resolved from programmed cell death. is a naturally activated. Okay, |
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| 36:56 | , this is an interesting thing that two disorders Huntington's and uh and Parkinson's |
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| 37:03 | both associated with basal ganglia. But have very different type of physiology causes |
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| 37:09 | the disease. Huntington's disease is caused a dominant gene then produces this very |
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| 37:17 | protein, Huntington's and what it does it has these repeats for glutamine center |
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| 37:26 | . But if it has more than repeats for gluten means it can cause |
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| 37:33 | disease. And these abnormally long Huntington's , globs of them accumulate and trigger |
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| 37:42 | degeneration. And we're still trying to out normal Huntington's uh function. I |
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| 37:58 | it counterbalances made counterbalance the trigger of of programmed cell death, but it |
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| 38:07 | also rise from normal processes of neuronal . Just going already Now, this |
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| 38:16 | an interesting story I I'd like for to to read it's Parkinson's disease is |
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| 38:22 | a disease of aging and the vast of cases occur after age of |
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| 38:27 | However, in 1976 and again in , several relatively young drug abusers in |
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| 38:40 | , mm hmm. And California developed parking Sony in symptoms within a few |
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| 38:46 | . This was extraordinarily extraordinary because usually accumulate over many years. And medical |
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| 38:53 | work unraveled that they have taken the versions, a synthetic narcotic that contained |
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| 39:02 | TP. Ah so this street unfortunately, especially chemical drugs and of |
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| 39:11 | derived drugs, I even tell my that anything that is a natural drug |
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| 39:18 | plant derived drug, it will It will smell like cannabis or marijuana |
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| 39:26 | have a smell. You can see if it is a hallucinogen like mushrooms |
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| 39:34 | , it will have a smell. can see it it looks like a |
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| 39:39 | , it looks like a mushroom. that is illicit synthetic. You sometimes |
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| 39:48 | not see it. The molecules are small most of the time it won't |
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| 39:54 | a smell and it won't have a smell that carries and anything synthetic is |
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| 40:02 | much more dangerous and mystery and has proven so to be more lethal than |
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| 40:08 | of the natural street drugs, so speak. So it was chemical and |
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| 40:20 | and it was byproduct M. T. P. This illicit drug |
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| 40:34 | caused this massive Parkinson's disease. So many things that are synthetic that can |
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| 40:46 | these acute neurological dysfunction. So it's just a blow to the brain or |
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| 40:51 | damage but chemical toxicity that can accurately a chronic neurological dysfunction. Now |
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| 41:04 | P. T. P. The why it's interesting, it supports the |
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| 41:06 | that common forms of Parkinson's disease might caused by chronic exposure to slowly acting |
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| 41:12 | chemical in the environment, something that maybe stimulated in PTP. Unfortunately no |
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| 41:21 | toxin has been identified and M. . T. P. Can actually |
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| 41:28 | a form of programmed cell death. we know that mm hmm. Now |
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| 41:37 | disease is different. You will also neuro degeneration or cell death in Alzheimer's |
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| 41:49 | . This is the hallmarks of path physiology of Alzheimers disease is you have |
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| 41:54 | formation of these beta amyloid plaques extra early and the formation of neuro february |
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| 42:02 | inside the cells. And when these neurons february tangles form inside the |
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| 42:10 | they impair sell transport exceptional transport and the amyloid plaques start aggregating and calcify |
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| 42:23 | with starting pinching on the axons of preventing them from firing abnormally, all |
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| 42:32 | in part together with inflammation to neuro . But if you look at the |
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| 42:43 | off newer degeneration that you see in alzheimer's disease is astounding. Would you |
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| 42:49 | on the left as you see an of the healthy brain aged healthy |
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| 42:56 | And this is Alzheimer's written brain where massive shrinkage of the cortical tissue. |
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| 43:05 | is significant loss the specialty of the matter. So a common theme again |
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| 43:13 | is neuro degeneration is Alzheimer's disease also allergic disease. Now it adds a |
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| 43:19 | alkaline, it's covid energetic neurons of . Is it basil ganglia that's involved |
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| 43:26 | alzheimer's disease? No memory loss of . It's hippocampus is the other part |
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| 43:33 | the brain, hippocampus and the plaques often originating hippocampus and these plaques can |
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| 43:40 | migrate throughout the brain, sort of once they originate in hippocampus go and |
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| 43:46 | invading more and more of the cortex spreading throughout the cortex. Ah This |
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| 43:57 | the damage that you would see in disease. I didn't mean to jump |
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| 44:02 | slides but I did. I'm sorry The open ergic neurons in Parkinson's patients |
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| 44:10 | degenerate for similar about 5% of Parkinson's are inherited. And what you see |
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| 44:19 | that you seem normal brain here in top. And this black substance substantial |
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| 44:29 | . And you see a significant loss substantial nigra neurons in the bottom picture |
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| 44:36 | with Parkinson's disease. Left is a brain showing the car date and the |
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| 44:49 | and right is showing massive reorganization the and size of these structures in Huntington's |
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| 45:03 | . So by understanding how and why self destruct. By understanding this program |
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| 45:13 | death, we may be able to strategies to prevent neural degeneration. On |
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| 45:21 | other hand, I feel that neuro is just the way that the brain |
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| 45:27 | with whatever neurological pathways, physiological autoimmune issues it's experiencing true. So |
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| 45:40 | , ganglia, Parkinson's Huntington's Parkinson's Huntington's over expression of huntington's aggregation. |
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| 45:59 | disease. I said, oh, neuro transmission, then amyloid plaques, |
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| 46:07 | plaques and you're a federally tau different parts of the brain cortex, |
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| 46:20 | affected in Alzheimer's disease. Now, and stimulation. I really enjoyed this |
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| 46:33 | . Very difficult to diagnose to treat disorders. And what we, what |
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| 46:42 | section talks about is how, over the years and actually quite unethically |
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| 46:52 | the years, the destruction or brain and brain brain surgeries and stimulation of |
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| 47:02 | brain, which is more humane have in useful therapies for brain disorders. |
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| 47:10 | it is not always drugs drugs, that you have to feed. It |
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| 47:15 | something about the connectivity and you may to limit that connectivity, destroy the |
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| 47:22 | or change the pattern and electrical And this is what the stimulation |
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| 47:30 | But if you look at historically this here, surgery for movement disorders such |
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| 47:35 | Parkinson's began in 1880s victor. a pioneering british neurosurgeon who treated patients |
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| 47:43 | spontaneous movements by removing part of his cortex that normal movement sees, but |
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| 47:51 | patient's limb was paralyzed too. So the 1880s, 90s, 19 |
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| 48:05 | the 19 forties and seventies, surgeons that making small lesions in the global |
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| 48:10 | stalinist or sub atomic nucleus could often the tremor rigidity and acne asian Parkinson's |
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| 48:16 | without inducing paralysis. So now you these neurosurgeons in the 40s, |
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| 48:24 | 60s, seventies and essentially just slashing these areas that we know are involved |
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| 48:37 | the motor control in basal ganglia through apologists of the Islamic area. And |
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| 48:45 | you're helping this tremors basically without causing now, so you've gotten much better |
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| 48:52 | precision will scalp. You're not taking big chunks of the brain. |
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| 48:57 | introduction of L dopa. L dopa a precursor for dopamine and Parkinson's disease |
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| 49:04 | many years was treated and still is treated with L dopa. There was |
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| 49:09 | backlash against unjustified types of new surgery unjustified types of neurosurgery, Have you |
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| 49:17 | heard of frontal lobotomy. So, treat psychiatric disorders to treat schizophrenia, |
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| 49:29 | was lobotomy. So we're done where knives would be placed through the, |
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| 49:35 | the nose and the connections to the cortex would be severed, would be |
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| 49:40 | off with a scalpel. There was backlash against that because it was making |
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| 49:45 | into vegetables and a great movie to about that is one flew over the |
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| 49:50 | nest. It's an old movie with Nicholson, I believe from the late |
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| 49:56 | , early 90s that talked about how with psychiatric behavioral problems would be placed |
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| 50:03 | the psychiatric wards and turned into vegetables the surgeries because the drugs that they |
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| 50:10 | taking would not work or make this worse. So, so surgical treatments |
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| 50:18 | awhile fell out of favor. But we've come up with what we call |
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| 50:26 | brain stimulation, the ability to employment inside the brain and stimulate these |
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| 50:33 | And historically again, there's presidents, ancient Greeks and Egyptians were early advocates |
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| 50:38 | therapeutic power of electrical shocks. There shops electrical shocks who used electrical yields |
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| 50:46 | race and direct application of such fish help alleviate pain, headache, |
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| 50:55 | got depression and even epilepsy. So idea of shocking the body to get |
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| 51:04 | of neurological dysfunctions such as depression and goes back to ancient greek and Greece |
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| 51:11 | Egypt. And the modern use of deep brain stimulation started in the 1980s |
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| 51:20 | the early 2000s. This deep brain was approved from Parkinson's disease. And |
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| 51:28 | there's deep brain stimulation is also approved other conditions. And the way that |
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| 51:39 | deep brain stimulation works is that it these very high frequency shocks of |
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| 51:46 | You have an electrical generator that is to you and the electrodes. It's |
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| 51:54 | deep brain stimulation because you have to not the superficial but the deep areas |
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| 52:00 | the brain. And these are deep salam IQ nucleus, cottage attainment basil |
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| 52:09 | . We've used a deep brain structure we're talking about deep brain stimulation and |
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| 52:13 | can see the deep brain stimulation. plant. The lecturers implant them in |
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| 52:17 | nuclei as a specific regime that generates specific frequency frequencies can be devised by |
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| 52:25 | neurologist. So it can be adjusted remotely by a neurologist now through all |
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| 52:31 | the devices that we have and it also record activity in the brain to |
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| 52:39 | when to turn on the stimulation. it was both actually recording and stimulating |
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| 52:44 | that are implanted there and being tested many different conditions. It's actually approved |
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| 52:51 | major chronic depression is being tested for . C. D. Tourette's |
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| 52:57 | chronic pain, alzheimer's disease and But it's a it's a commitment and |
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| 53:04 | do this deep brain stimulation. Obviously it's a surgical procedure. You're implanting |
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| 53:10 | electrode inside the brain. So you're try to do everything possible with the |
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| 53:16 | treatments whether it's exercise diet drugs therapies you do this in plantations. But |
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| 53:24 | lot of times if nothing else works of cutting pieces of the brain as |
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| 53:32 | was 20 years ago. We now to stimulate those pieces of the brain |
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| 53:38 | this is just what we walked Is this natural progression of neurosurgical applications |
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| 53:45 | particular with the stimulation as one of treatments. Not just always drugs. |
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| 53:51 | talk about drugs when we talk about , we'll talk about anti epileptic |
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| 53:56 | common anti epileptic drugs drugs and their of action. But this is your |
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| 54:01 | the circuits. It's different. And is another illustration of having this plane |
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| 54:09 | section and implanting an electrode here and ballot is or in the sub atomic |
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| 54:18 | to achieve the best, basically control tremors. Because Parkinson ian tremors when |
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| 54:27 | get uncontrollable is very difficult for people perform just very basic mundane tasks, |
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| 54:35 | tasks and another stimulation. If we're about stimulation, we really now are |
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| 54:43 | cutting out pieces of the brain We're not cutting the brain anymore. |
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| 54:47 | cutting out pieces of the brain. talk about hemispheric rejections or surgical resection |
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| 54:52 | epilepsy and epileptic fozie. But for other conditions you really are not doing |
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| 54:58 | , you're doing surgeries for cancers and epilepsy. But if you have Parkinson's |
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| 55:09 | it's it's it's usually implantation, Nobody is cutting out a piece of |
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| 55:14 | brain. And so if you're there's another vagus nerve stimulation. In |
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| 55:20 | the company is here in in in . Um Woodlands area. I believe |
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| 55:29 | have began this and this procedure is here in Herman Memorial Hospital as as |
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| 55:35 | as the deep brain stimulation and plants being performed here in in texas and |
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| 55:41 | And here you are stimulating cranial This cranial nerve comes out of brain |
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| 55:46 | , its cranial nerve, 10 vagus and it runs very extensively throughout your |
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| 55:51 | , innovating a heart too. And nerve stimulation is now approved for epilepsy |
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| 55:58 | also a severe chronic depression. And we don't necessarily understand all of the |
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| 56:06 | mechanisms how come shocking the vagus nerve nerve can stop apple of sea or |
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| 56:11 | in the C. N. But there is enough of the efficacy |
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| 56:15 | the treatment where these techniques are approved for treatment of these very severe neurodegenerative |
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| 56:25 | |
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