The human brain is the most mysterious organ in the body and one of the most complex enigmas known in the universe. Scientists are still trying to find out what causes our dreams, why one day we suddenly forget who we are or where the limit of consciousness is. Nor have they managed to clarify where our mind ends or begins and where our brain. Unraveling these enigmas, among many others, is still a pending issue. To do so, we must start with what little we know for sure. Here is one of the irrefutable truths of neuroscience: at the end of the 19th century, Santiago Ramón y Cajal placed neurons as individual elements of the nervous system, which made him the first Spaniard to receive a Nobel Prize in Medicine in 1906.
These cells intercommunicate by establishing a network of connections. Its job is to receive stimuli from the environment and transmit them in the form of nerve impulses to another neuron or a motor cell that will produce a response. Our thoughts, emotions and memories are encoded in these brain waves. Neural connections function normally in healthy humans, but can be disrupted by disease, injury, or failure to thrive. When it happens, we find patients with depression, schizophrenia or a bipolar disorder. Also Alzheimer’s, Parkinson’s, multiple sclerosis and other types of neurological diseases. The development of technology has brought new techniques to discover how the brain changes in the face of disease and to be able to more rigorously detect which areas are damaged.
Artificial intelligence: the algorithm that teaches us where to look
Today, there are many modalities of brain scans that are used for clinical diagnosis alongside technologies such as artificial intelligence. Research teams around the world have developed algorithms that are capable of analyzing thousands of MRIs and learning how to detect abnormalities to tell doctors where to look. Ng Wai Hoe, medical director of the National Institute of Neuroscience in Singapore, explains in the Bankinter Foundation’s 2019 neuroscience report how he uses AI applied to reading MRI results. “In brain injury cases, the goal is to allow the AI to do a quicker review of the scan, flag it for the radiologist, and say ‘hey, you need to look at this image immediately,'” explains Ng Wai Hoe. “In fact, we have already started it in our ER and we see that it has made possible a faster triage of patients and a more immediate intervention.”
Another of the most mentioned uses of this technology by experts is its ability to personalize treatments. Each disease is different in each patient. For example, depression alters brain waves differently in each person, and the development of new technologies makes it easier to find a way to identify the specific aspects of this disease and an individual way of dealing with it. In the same report, Ricardo Gil Da Costa, a cognitive neurophysiologist who has worked at the National Institute of Health in the United States for years, assures that “the more data that is collected, the more patient treatments can be personalized using AI.” Da Costa gives a practical example as an example: in a migraine it is already possible to know when the inflammation is rising up to 72 hours before the first symptoms appear, which makes it possible to act preventively and reduce the duration and severity of crises.
Wearables: a scanner of neuron activity
All these advances suggest that it would be very useful to have devices to monitor the health of our neurons. “A device that patients can use at home for a while each day to analyze information from their body, personalize it and tell them when a crisis is coming in their specific case,” explains Da Costa. This device already exists: it is a system called Brain Station that performs wireless electroencephalography: it is placed on the forehead of patients and scans brain activity.
Wearables such as this are spreading in the diagnosis and treatment of mental and neurological diseases. They are no longer used only as wristwatches to know what rhythm the heart beats while doing sports. Now there are initiatives that even use them to try to deduce the intentions of the people who wear them, which can be useful for patients with mental problems. A project of the German Institute for Artificial Intelligence has designed devices so small that they can be worn on clothing and that analyze the behavior of the wearer. Applying artificial intelligence, the system learns the way the user does things, their experience and skills. For the time being, thanks to all this information gathered with those wearables they can observe fatigue and tiredness and hope to be able to detect depression soon.
Virtual reality: when rehabilitation becomes a game
Other technologies are also being reinvented: it is the case with virtual reality, which is linked to the world of entertainment and video games but also shows promise for rehabilitating patients with neurological diseases. Begoña Benito attests to this. She is 49 years old, she is an administrative worker and has been diagnosed with multiple sclerosis for three years. Until then, some of her symptoms were confused with the tiredness of the day: she had fatigue and sometimes her limbs went numb. But what she was experiencing was that the neurons in her nervous system were losing myelin, a white substance that covers these cells and makes it easier for nerve impulses to be transmitted normally from one neuron to the next.
As a consequence, this disease causes problems with mobility, balance, problems with the limbs, sensory, visual, cognitive alterations and fatigue, according to Dr. Virginia Meca, a neurologist and coordinator of the Demyelinating Diseases Unit at Hospital de la Princesa, who proposes to use virtual reality glasses to rehabilitate patients with this disease. “Before starting this project we saw difficulties in patients to maintain rehabilitation. We thought that turning the process into a game could be attractive for them to complete this part of their treatment, ”says Meca. Although they still do not have conclusive results, Begoña Benito, who has been wearing the glasses since December, assures that they are helping her physically and cognitively. “I have improved in memory and balance. The physical is rehabilitated a lot, which is the most obvious, but also the mind”.
When putting on the glasses, patients can choose between several screens that offer them different activities that help them exercise. “Although it does not replace conventional rehabilitation, it helps us improve adherence,” says Dr. Arancha Vázquez, a rehabilitation doctor at the same hospital. The goal is for patients to be able to do the exercises at home. “We try to adapt the resources of Social Security, because this treatment is applied in public health,” says Vázquez. In the future, they also seek to apply it to other diseases with similar symptoms.
“We can take some of the lessons we’ve learned from gamification and apply them to medical interventions to encourage adherence and facilitate engagement,” agrees Walter Greenleaf, a scholar at the Virtual Human Interaction Lab at Stanford University, who conducts research on new interventions for depression, autism, Asperger syndrome and addictions.
“When it comes to treating addictions, we can offer the patient a virtual environment to practice their refusal skills or their confidence; with patients with autism spectrum disorder, we can rehearse social interactions and exaggerate non-verbal communication, body language, facial expressions…” explains Greenleaf. The applications of this technology to help in the recovery of patients are multiple.
Now that virtual reality is no longer used just for gaming, Big Tech has invested billions of dollars in developing this technology. “And they’re not going to recoup that investment through the training industry and the video game industry,” says Greenleaf. “The medical sector is one of the sectors that is investing the most in this area.”
Glossary
Neuroscience. Science that studies how the nervous system works. It tries to answer what the structure of the brain is, how cognitive abilities develop and how brain diseases arise. It is nourished by biology, psychology or neurotechnology, among others.
demyelinating diseases. They are those that affect the production of myelin in the central nervous system. Myelin is a white substance that covers nerve fibers and facilitates the transmission of signals between them. Demyelination can lead to organ and muscle malfunction. One of the most common diseases is multiple sclerosis. At the moment, demyelinating diseases have no cure, although they are treated to minimize symptoms.