Archive for March 28th, 2010

28
Mar
10

This Isn’t a Nutrition Blog…Or the Fat Addiction

I don’t want to turn this into a nutrition blog, but I find some of the recent studies coming out on the science very interesting.  The evidence that there is an epidemic of obesity in our country is overwhelming.  And, more and more evidence is accumulating that dieting is not the answer.  It’s going to take more than just telling people to eat better and exercise more.

One aspect of nutrition that has probably been under-appreciated is the interaction of nutrition and neuroscience.  Well, thanks to a new study published in Nature Neuroscience, that may not be the case much longer.

Addiction to certain drugs, like cocaine and heroin, are accompanied by changes in the level of specific neurotransmitter receptors in the brain.  In a process called negative feedback, as the neurotransmitter level increases, the number and sensitivity of its receptors decrease.

The neurotransmitter most closely associated with addictions is dopamine.  Dopamine is active in the “reward” or “pleasure” centers in the brain.  One of these reward centers is called the striatum.  The authors showed that in rats exposed to chronic high fat foods, the level of the dopamine receptor D2 in the striatum is decreased.  That means that it would take even more fatty food to get the same pleasure response.  In other words, this is the first clear evidence that fatty foods are addictive.

deep brain stimulatorFrom a neurosurgical perspective, this is very interesting.  Neurosurgeons are able to modulate brain activity in specific regions of the brain by implanting electrical stimulators.  Current surgical techniques for the treatment of obesity (called bariatric surgery) are principally performed by general surgeons.  Procedures including gastric bypass, banding, stomach stapling, and others are accompanied by severe side effects.  They also carry risks of vitamin deficiencies.  Furthermore, although there are many successful outcomes from the surgery, there are failures as well.  A deep brain stimulator could be a very attractive alternative.

28
Mar
10

Video of a Craniotomy in 1932

Someone posted on Youtube footage from a craniotomy in 1932.  From the British Medical Association Library, the video shows a “Prefrontal Tuberculoma: Removal with complete recovery by Prof. R. E. Kelly and Dr. Henry Cohen.”

The film is full of historical gems:

  • A diagnositic pneumoencephalogram which demonstrates compression of the right lateral ventricle with midline shift.
  • A hand-powered Souter’s craniotome.  Even after watching it several times, I cannot completely understand how it worked.
  • Manual dissection and excision of the tumor.
  • Tumor histology with silver stains
  • Post-operative follow-up evaluation of the patient.  Although the patient had a significant hemiparesis, he looked remarkably good.

It really is incredible.  Advance upon advance has dramatically changed the way modern neurosurgery is performed.  Yet, there is an eerie similarity in the video as well.  Maybe it’s because, like what Sir Isaac Newton said, if we see a little further, it is by standing on the shoulders of these giants.

(H/T Mindhacks)




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