Epilepsy

Epilepsy is a neurological condition characterised by repeated seizures. Seizures are caused by electrical activity in the brain, although may appear differently from person to person (not all seizures involve convulsions, despite what you might think).

As with many conditions there is not a single cause that can be identified as a precursor to epilepsy. Genetics (a mutation in the KCNC1 gene has recently been identified as a cause of a progressive inherited form of epilepsy – Muona et al 2015), brain tumours, or head injuries, and the cause of many patients’ epilepsy remains unknown. Several studies have shown that you are more likely to develop epilepsy after a head injury e.g. Christensen et al (2009) found that people were 2% more likely to develop epilepsy after a mild head injury. This rose to 7% more likely following a severe head injury, with risk also increasing slightly with age.

The image below is taken from the EFEPA and shows what to do if someone is having a seizure:

first-aid-for-seizures3_page_2

As mentioned earlier there are different types of epileptic seizures which depends on which part of the brain they originate in. Seizures can be classified by how much of the brain is affected: partial/focal seizures (when only a small part of the brain is affected) or generalised (if most of the brain, or all of it, it affected).

Focal seizures can also originate in different parts of the brain, with the temporal lobe being the most comment (epilepsy.com). The temporal lobe is the part of the brain above your ear, and is responsible for processing hearing, and our memories (this is simplified – it does a bit more than this!). Therefore, one of the common features of temporal lobe epilepsy is memory disturbances (Ko et al, 2013). The famous patient H.M.’s amnesia was caused by an operation to remove the source of his severe temporal epilepsy – this was carried out in the 50s before brain functions were accurately known and too much of the medial temporal lobe was taken away. This destroyed part of the hippocampus, the structure in the brain responsible for memory processing. Due to the nature of his amnesia, he was probably one of the most studied individuals ever in psychology. See this post for more on H.M. and memory research. Operations are carried out to remove part of the temporal lobe in patients now with much better outcomes!

The second most common is frontal lobe epilepsy, where seizures originate in the front part of the brain. They often occur during sleep, and can affect the motor areas of the brain, leading to problems with motor skills (e.g. Beleza & Pinho, 2011). If patients are not eligible for surgery to remove the specific part of the brain responsible for the seizures, anti-convulsive medication and electrical brain stimulation can be helpful in reducing symptoms (Kellinghaus & Luders, 2004).

 

 

 

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Déjà vu

I’m sure you’ve all experienced that feeling where you find yourself thinking that things you are currently experiencing have happened before. Déjà vu (meaning ‘already seen’) can feel kind of creepy, but why does it happen?

Déjà vu has been reported to occur in about 60-80% of the healthy population (e.g. Adachi et al, 2003), but is also thought to be linked to temporal lobe epilepsy (Stevens, 1990). There have been several different theories about why this occurs, including the two sides of the brain not functioning together, a sense of familiarity to one part of an experience being mistakenly applied to it all, a problem with how we perceive the timescale of an event, so that something which is happening at the moment is viewed as happening long ago, or a problem with processing sensory information, so that it is processed and reviewed at the same time (see review by Wild, 2005 for a full list).

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There have also been several attempts to use neuroanatomy to explain déjà vu. Brázdil et al (2012) compared the brains of healthy participants who did or did not experience déjà vu using an imaging technique called source-based morphometry to measure the amount of grey matter (neurons) in different cortical areas. They found a correlation in certain subcortical areas of the brain (the hippocampus, STS, insula cortices, basal ganglia, and thalami) between lower amount of grey matter and an increase in déjà vu experienced. Several of these structures are in the mesial temporal lobe, which could therefore explain the link between increased déjà vu in patients with temporal lobe epilepsy.

Work to establish the anatomical basis of déjà vu in patients with temporal lobe epilepsy has also suggested that these mesial areas of the temporal lobe are involved. Bancaud et al (1994) studied the anatomical basis of déjà vu using electrodes in epileptic patients prior to surgery which were placed in the temporal lobe, the hippocampus, and the amygdala (you may remember from previous posts that the hippocampus is a structure important for memory, whilst the amygdala is thought to be involved in emotional processing).  They found that déjà vu could be induced by stimulating all of these areas, but that it was 10 times more likely to occur if stimulation was in the hippocampus or amygdala, suggesting that these areas are key to experiencing déjà vu.

As well as occurring in epilepsy, déjà vu is a feature of other psychiatric disorders including schizophrenia, anxiety disorders (like PTSD), depression, and dissociative disorders. There have also been reported cases of constant déjà vu, with sufferers constantly feeling as though their current experiences have happened before. For example, one case study of a 23 year old male was reported by Wells et al 2014, who concluded that it was caused by his severe anxiety and tendency of depersonalisation. This patient did not show a memory deficit, although other cases of persistent déjà vu have been reported amongst elderly patients with dementia.

One of the things I find interesting about déjà vu is that it is a feature of several psychiatric disorders as well as something which occurs in most of the healthy population. It doesn’t seem that psychiatrists are entirely sure about why is occurs in some people but not others, and like with several other areas of psychology – more research is needed to be sure of it’s true course. Thanks for reading this week’s post, I’ll try to be back soon with more new material!

Brain Plasticity

Although you might think that the structure of your brain is formed before you are born and does not change, this actually isn’t the case. As we grow and learn, the brain is constantly making new connections and pathways between different areas. It used to be believed that anything which had not been developed by a ‘critical period’ during childhood would be lost, with little change after this time, although we now know this is not true.

For example, our different skills and experiences can help to shape our brain. This has been particularly studied using musicians, as extensive practice and repetition of certain fine-tuned motor actions can result in more of the motor cortex being involved in directing the actions of the hand and fingers.

Pascual-Leone et al (1995) found that novices learning to play a simple exercise on a piano over 5 days showed an increase in size in the cortical areas involved in the movement of the fingers. Schlaugh (2001) carried out fMRI to compare the size of the intrasulcal length (part of the motor cortex) in professional musicians and controls, and found it was much longer for musicians in the right hemisphere (which controls the left hand). This is shown in the image below, taken from this paper.

music

It is through the process of brain plasticity that new memories are formed. Motor memories such as becoming more accomplished at music are one type of memory which alter the brain structure, but our personal memories also change our brain. This occurs through the process of Long-term Potentiation (LTP), which is the process of connections between cells at synapses strengthened. It mainly occurs in the hippocampus and other cortical areas responsible for our long term memories. This process is illustrated by the image below:

Long-Term-Potentiation1

Brain plasticity is also encouraged in treatment and rehabilitation from brain injury. For example, after a stroke it has been found that giving excitatory stimulation to the damaged areas can improve function (e.g. improving language function – Szaflarski et al, 2011). Just by encouraging movement in people who have had a stroke can also help them to regain function of limbs on their impaired side.

Thank you for reading and don’t forget to check back next week for another post!

 

Seeing Inside The Brain

Have you ever wondered how scientists work out that certain structures in the brain are responsible for certain functions? For example, that the back part of the brain is responsible for vision, or that the back of the frontal lobe is what enables us to move. This information has been gathered using various neuroimaging methods in experiments where participants have to perform a specific action, for example processing face stimuli, while their brain is scanned to see which area is showing the highest activity. This pattern of activity is compared to brain activity while participants are carrying out a different visual task. Subtracting one pattern of activity from the other leaves activity in the structure active during processing face stimuli. Kanwisher et al (1997) did an experiment similar to this, and identified an area on the fusiform gyrus specialised for processing face stimuli, which is now know as the fusiform face area.

In this post, I will give a quick overview of the 4 main methods used in neuroimaging experiments: fMRI, CT, PET, and EEG.

1. fMRI

Also know as functional magnetic resonance imaging, this method works by measuring the changing amount of oxygen in the blood, which equates to changing neural activity. If an area is needed to be active for a particular task, more blood flows to that area as it needs more oxygen, just like how blood flows to your muscles during exercise. The fMRI scanner sends out magnetic fields, which hit protons in the hydrogen atoms in your blood. The signals reflected back to the scanner from the protons are strongest in the blood with the most oxygen in, so we are able to detect the areas of the brain which are most active.

Some of you might have seen an fMRI scan which looks a bit like this:

fmri_scan

The researchers are able to add colour to the areas of the brain showing varying amounts of activity.

2. CT

A CT (Computed Tomography) scan uses X-rays to map structures in the brain. As X-rays are absorbed by bones well, but not by water, you can use CT scans to identify different types of tissue in the brain e.g. tumors or lesions. In the image below, you can see the ventricles (black areas) compared to brain tissue (grey areas)

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3. PET

Positron Emission Tomography detects the positrons emitted as a radioactive tracer which has been injected into the blood, decays. This uses the same kind of principle as fMRI in that areas which are active have the highest blood flow, and so more positrons will be emitted from areas which are the most active. It is used to identify degenerative disorders such as Parkinson’s disease. The scan below shows PET scan results for healthy individuals and those with Parkinson’s:

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4. EEG

Electroencephalography maps brain activity by measuring the electrical activity of the brain by picking up signals from electrodes placed on the scalp. This is slightly less precise that other methods, as it picks up signals from a large amount of neurons. However, it has high temporal resolution, meaning it can detect changes in brain activity almost as soon as they occur. As this method is cheaper than the others, it is often used in research.

The image below shows a participant during an EEG experiment:

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I hope you found this interesting, let me know if you find this kind of thing interesting and check back next week for a new post! 🙂