Vini Samy – Brain Blogger Health and Science Blog Covering Brain Topics Wed, 30 May 2018 15:00:03 +0000 en-US hourly 1 Sleep Disorders Demystified Sat, 23 Sep 2006 09:08:19 +0000 Neuroscience_Neurology.jpgSleep is one of our most enigmatic functions. The uncertainties of why we sleep and the utter necessity of sleep are being incessantly investigated. Based on what we do know, it is fairly safe to assume that sleep is certainly vital to our well-being. The necessity of sleep can be determined by each one of us by simply observing and evaluating the effects on our body after just one sleepless night.

If sleep was unnecessary, then it surely could be evolution’s biggest blunder! Also, it would be hard to explain the millions of people that are suffering from various disorders due to the lack of sleep. It was about this that I had wanted to know more about when I started some research about sleep disorders. Apart from the basic knowledge I had on common sleep problems such as sleep apnea, sleep walking, nightmares, insomnia, etc, I did not know much else. Therefore, what I found was so intriguing that I wanted to share it with all of you. I figured if I did not know about these bizarre sleep disorders, there would certainly be one or two people out there who didn’t either!

Fatal familial insomnia is a very rare brain disease in which the patient loses the ability to fall asleep, forever. A genetic mutation of a protein is the underlying cause of this disease that produces plaques in the thalamus of the brain. As the thalamus is vital in regulating sleep and arousal, this leads to grave consequences. There is no treatment yet for this unkind degenerative disorder leaving the wakeful patients to gloomily wait for the day they will finally sleep.

Most people are aware that their bodies are paralyzed while they are asleep. However when we talk about sleep paralysis, it is the condition in which a person experiences an inability to move or speak while being awake. This usually happens just before falling asleep or soon after waking up from sleep, lasting anywhere from a few seconds to few minutes. This is known to be a relatively harmless condition, with a small psychological wound due to the fear experienced during the short paralysis. However, a more rare and fatal form of this sleep paralysis is believed to underlie the cause of death in healthy individuals, mainly in Southeast Asia (due to a genetic component). In these rare cases, extreme muscle atonia occurs during sleep paralysis resulting in the paralysis of the heart and the diaphragm which consequents to death. Scientists are relating this to another condition known as SUNDS (Sudden Unexplained Nocturnal Death Syndrome), which is in turn almost identical to another disorder, Brugada syndrome. This is supposedly an inherited condition, in which the ventricles of the heart beat so fast which is likely to result in a cardiac arrest.

Bedwetting, night terrors, sleep-talking and sleep-walking are things that the majority of us have experienced either in ourselves or someone in our family. These disorders in the sleep patterns are typified by partial arousals and are known as parasomnias. There exists a more severe and a relatively novel form of parasomnia as published in the Canadian Journal of Psychiatry in June 2003: “Sexomnia – A New Parasomnia.” This condition can vary in severity from just troublesome moaning to violent and sexual acts while asleep. Those who suffer from sexomnia do not remember any of their sexual acts that were executed during their sleep. The reported number of violent rape cases that have been committed by people in their sleep shows just how alarming and serious this can be. Due to the unknown fear and associated ignominy, people who suffer from this disorder are reluctant and unwilling to seek help. Sleep researchers have found this to be a medical disorder, quite similar to the other well known parasomnias and encourage sufferers to obtain treatment.

With most of the sleep disorders, treatment involves stress-reduction, sleep techniques and also drugs. However, some of these drugs have been found to be giving rather peculiar side-effects. A very popular sleeping drug, Ambien, seemed to be inducing rare sleep disorders such as sleep-eating (nocturnal sleep-related eating disorder, NS-RED). People with NS-RED, sleep walk their way into the kitchen at night and eat, without having any recollection of it in the morning. People have known to prepare meals even using microwave ovens. Not only is this dangerous as the person is not conscious, this condition can also lead to unwanted weight gain and lower self-esteem. That is not to say that all sleeping pills such as Ambien are ineffective. At the end of the day, it depends on the weighing of the risks versus the benefits on an individual basis.

So with all these disorders that deal with lack of sleep or disturbed sleep, I wondered if there exists a disorder that brings about too much sleep. And there is: Kleine-Levin Syndrome (KLS). This is a rare syndrome characterized by the need for excessive amounts of sleep with up to 20 hours a day. The patients only seem to be awake for eating and going to the bathroom. During these wakeful periods, individuals seem to be lethargic, confused and irritated. Even though the underlying cause for this condition is yet unknown, this disorder has established itself to be cyclical. When it does appear, KLS lasts for days to often weeks. As soon as these sleep episodes disappear, the person’s sleep patterns and generic behavior become normal. There are medications available to help people stay awake when KLS develops.

Somniphobia, which is of course, fear of sleep. Individuals suffering from this are afraid of going to bed and sleeping. This happens due to some type of unexplained anxiety and is considered a type of anxiety disorder. Therapists believe that there would have been a negative experience in the past which has associated itself with sleep and this fear of sleep could be our mind’s way of protecting individuals from re-experiencing that traumatic event. Counseling and relaxation techniques have been proved helpful in treating this disorder.

So there we are. I am sure that the more I dwell into this mysterious function the more bizarre disorders I will discover. Many studies have also reported that the number and type of sleep disorders have significantly increased in the past decade. May be this is due to our increasingly hectic lives that demand so much out of us, that we continue to steal time from our sleep in order to meet those demands. Whatever it may be, these sleep disorders are destructive and anything but humorous for those who suffer from it.

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Holy Book of the Psychiatric World Fri, 08 Sep 2006 06:45:48 +0000 Opinion2.jpgThe Diagnostic and Statistical Manual of Mental Disorders, DSM, includes descriptions and classifications of most mental disorders. Published by the American Psychiatric Association, the DSM is widely used by mental health specialists to aid them in the diagnosis of a mental disorder. DSM-IV is the fourth edition of this manual which is the product of consistent and careful revisions of the previous versions.

Some say, that due to the involvement of the psychiatrists in the writing of this manual, it reflects a medical model approach to the diagnosis and treatment of mental disorders. Categorical systems such as this are based on the analysis of behavioral symptoms that currently exist or, on the history of the symptoms. By using these as a criterion, patients can be placed into their respective diagnosis. In some ways, this system acts beneficial, but it can also be a drawback to the patient.

The DSM was born to bring about uniformity among mental health professionals when diagnosing a disorder. The need for constancy gave rise to the criteria and classification system of the DSM. An advantage to the classification system used in the DSM-IV is that of reliability. That is, this method of classification facilitates communication by providing consistent and common language for psychologists and other health professionals alike, when diagnosing patients. By using clear, set guidelines, health professionals around the world can ensure, using the same factors, to determine if someone meets a particular diagnosis. As this system focuses on objective symptoms, it steers clear of personal opinions and cultural differences between clinicians and therefore reliability is maintained.

The DSM uses a multiaxial method to diagnosing mental disorders. This is great as it recognizes that a person’s mental health is influenced by lots of other factors. The five axes of DSM-IV classification are:

  • Axis I — clinical syndromes
  • Axis II — personality disorders and mental retardation
  • Axis III — general medical conditions
  • Axis IV — psychosocial and environmental problems
  • Axis V — global assessment of functioning

The multidimensional disposition of DSM-IV encompasses a range of biopsychosocial indicators for which it is used and liked by many. In today’s world, most mental health specialists believe that it is essential to integrate and understand the biopsychosocial parameters when assessing and diagnosing mental disorders. Even though the DSM-IV does not place equal emphasis on the different factors, it nevertheless presents the various factors from which the clients and consultant can operate from.

Another advantage with this system is especially beneficial to the patient. It provides technical information such as the description of symptoms and it also gives information about the prevalence, course, cultural, age, gender and family patterns. These might eliminate uncertainty felt by an individual as they understand that they are not alone. Although the DSM does not discuss the causes of the disorders, it offers information perhaps as to which of their symptoms lead to the diagnosis of a particular disorder. A person might feel better having diagnosed with a specific disorder, rather than to live with a mixture of meaningless symptoms. Pooling of these symptoms and conferring an appellation to it may result in a reduction in stress and fear of the unknown. And even though the DSM does not directly address treatment options, the APA has been publishing treatment guidelines using the DSM criteria. Consequently, understanding the diagnosis permits one to obtain and use other information about treatment and prognosis.

However, as with most things with life, there is another side to this coin. As wonderful as it may be to categorize a person with a disorder, it is also possible that at that very moment, that person loses his individuality and becomes a representation of that disorder and a mere statistical figure. When one gets labeled with a certain disorder, the stigma and the presumption by others that the patient conforms to a stereotypical behavioral pattern of that disorder can work against the one suffering from it. Also, because this system is categorical, it does not give way for dimensions of a disorder. So one either has or not has a disorder. As there is no continuum, some people who are on the less severe end of the disorder may still be given the label of having that disorder and may feel abnormal and more disparate from the society than they truly are.

Another disadvantage is to do with this model being a medical model. Hence treatment is inclined towards medical interventions. Every type of “abnormal” behavior is seen as a symptom and the core purpose comes solely down to eradicating or alleviating these symptoms. The focus is mainly on medications rather than psychosocial, rehabilitation or healing therapies. A huge concern with this is that medications, and other medical interventions may be over emphasized and this in turn diminishes the need for therapy.

On the whole, the DSM provides plenty of information to guide the classification and diagnosis of mental disorders. It offers us with a mutual ground when discussing diagnoses and also facilitates communication & treatment.

Nevertheless, the DSM needs to develop into a more amicable resource that aims to reduce the stigmatization of mental disorders. Pinning of a label from DSM to a person leads to grave consequences. Hopefully, there will be a day where being diagnosed with autism or schizophrenia will hold similar implications as being diagnosed with cancer or pneumonia. Hope that day arrives soon.

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Memory Storage Begins Before Bedtime Tue, 16 May 2006 17:00:00 +0000 Neuroscience and Neurology CategoryMost of us remember pulling an all-nighter and last-minute cramming before an exam despite the fact that your parents and your professors have told you to get a good night’s sleep before an exam. For years, people have believed that sleeping helps to reinforce what we have learned. However the following study reveals the reasoning behind the unanticipated success that most all-nighters have experienced!

To read full story go to Science News.

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Obsessive Compulsive Disorder Linked to Exaggerated Perception of Error in Brain Tue, 09 May 2006 21:35:00 +0000 Neuroscience and Neurology CategoryMost people are familiar with the detective who has Obsessive Compulsive Disorder (OCD) appearing in the television series “Monk“. OCD is an anxiety disorder that makes life difficult for 1 in 50 adults in the USA.

The following article reveals research that is one step closer to bringing relief to OCD sufferers.To read the full article, visit BBC News.

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In a Stroke Patient, Doctor Sees Power of Brain to Recover Thu, 27 Apr 2006 14:50:00 +0000 Neuroscience and Neurology CategoryWhen a person suffers from a stroke, usually the blood supply to part of their brain is abruptly disrupted and as a consequence brain cells die due to the lack of oxygen and nutrients. The more severe the stroke, the more likely the families have to listen to heartrending terminology from the doctors. Words such as coma, vegetative state, brain death or cortical death — terms holding similar connotations yet different definitions — can leave both the families and the doctors with a controversial decision to be made.

To read the full story, go to the Washington University in St. Louis.

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Brain Imaging Techniques or Technocolor Phrenology Sat, 01 Apr 2006 04:00:00 +0000 Neuroscience and Neurology CategoryBrain imaging techniques are increasingly being utilized to investigate cognition. This branch of research is referred to as cognitive neuroscience. Some have suggested that these techniques run the danger of simply emerging as “techno-color phrenology”, where no insights are actually gained about the cognitive processes themselves. It is dubious whether these techniques have contributed to our understanding of the cognitive process under investigation beyond simply locating brain areas.

Cognitive Psychology is a relatively new, nevertheless one of the most well-known and applied branches in psychology. It examines the internal mental state of the person in order to understand the external behavioral condition. Cognition, the mental processes of an individual, are central to this field of psychology. It values the existence of beliefs, desires and motivations and the meaning they hold. These mental states arise and form due to the incoming sensory information, which are then integrated and processed in various ways. The processing of this information is believed to provide an insight to the comprehension of human thinking. There are many domains within cognitive psychology which deals with memory, perception, thinking, problem solving, language and decision-making. Unlike other areas of psychology, Cognitive psychology does not reject scientific investigations as a convincing way of learning. Therefore there exists an aspect of psychology which is widely associated with both cognitive psychology and neuroscience and is known as cognitive neuroscience.

The brain functions underlying mental activity can be mapped out. Brain imaging techniques, such as Functional Magnetic Resonance Imaging (fMRI), Positron emission tomography (PET) and electroencephalogram (EEG) are ways of investigating these cognitive processes. Monitoring brain activity during behavioral or cognitive operations helps localize the regions of the brain involved in that specific task. That is, it provides a brain-behavior relationship. Another advantage of these brain imaging techniques are that it allows us to observe the changes in brain activation according to the activity performed in a living, conscious individual.

fMRI explains the use of MRI to measure the hemodynamic response related to neural activity in the central nervous system. fMRI is a non-invasive technique that is used to scan a particular location in the brain to understand its role. It has a good spatial resolution, but poor temporal resolution. PET is a “nuclear medicine medical imaging” system that creates a 3-D map of the functional processes in the body. That is, PET is used to measure the blood flow to different parts of the brain, as this imaging is based on the supposition that areas of high radioactivity are linked with brain activity. PET is a valuable technique for detection of certain disorders, as it targets the radio-chemicals used for specific bodily functions (Sarter et al., 1996). Electrical activity of the brain can be measured by placing electrodes on the scalp. Recordings can be made from these electrodes and the resulting traces are known as EEG. Although this technique is used for various purposes, in cognitive neuroscience, it is used to study the function of the brain by recording EEGs while manipulating the behaviors of the subject. All these types of brain imaging techniques are used in conjunction with each other. For example, fMRI are used together with EEG, which has a much higher recording frequency.

As impressive as these techniques are, they have received just as much criticism as they have been praised. Questions have been raised about its reliability and more so of how much ‘science’ it comprises. fMRI and PET scans published in articles show colorful images of the brain, which makes it seem less scientific and more decorative and fancy. Science and scientists prefer raw data that are open to interpretation and improvement. However, the results from these scans show a flawless photo displaying the exact brain regions involved in specific activities. The ideas and findings these imaging techniques reveal seem to be too rigid and structured. A notorious criticism has been that neuroimaging techniques are nothing more than “Technicolor phrenology” (Faux, 2002). It raises questions of the authenticity of the data as to how much it has been manipulated using techniques such as Photoshop. Also, brain imaging can portray and yield pictures that are far too removed from the truth. With the manipulation of colors and editing of the raw graphics, these images may imply much more precision than actually exists.

Since the invention of these techniques, much research has provided us with a greater understanding of the cognitive processes that exist. The consistency and the validity of these techniques can be explored from the many articles that have been written on this subject. Even though most cognitive functions have been correlated with a brain region, cognitive neuroscience strives to travel farther and discover other existing, but undiscovered, regions that might aid in certain cognitive processes.

If we only look at the enormous research that has been done with the help of these procedures, it is apparent that imaging techniques such as the fMRI and PET do more than just confirm cognition happens in the brain. They map out brain areas that are associated with their respective behavior or cognition patterns. They provide us with a deeper understanding about the functions themselves. Each study provides a further piece in helping complete the bigger puzzle.

The idea of linking each and every human ability with particular areas in the brain seems all too unrealistic and impractical. An argument put forth by R. Grant Steen, says that fMRI and such techniques are nothing but a tool for the psychologists and the neuroscientists alike to visualize and understand something that is not directly seen through human eyes. That is, just as the biologists use microscopes to understand about the DNA and the genes, so do the psychologists, to understand cognitive processes such as decision-making. On the other hand, the accuracy and the legitimacy of these techniques need to be scrutinized. By just indirectly measuring blood flows, fMRI scans cannot provide us with definite area and the cognitive function it governs. This is also due to the lack of erudition this technique seems to have about the brain being a series of networks. Much work has proved that most mental tasks require a combination of structures in their brain working in sync. Then again, behavioral psychologists, argue that it is not necessary to have brain maps to understand cognitions and behaviors. According to them, biological factors are only a small factor in the way humans behave and think (Dobbs, 2005). It is the environment and its re-enforcers that we need to consider in order to obtaining an extensive knowledge of how and why we behave or think in certain ways.

Regardless of its flaws, brain imaging has undoubtedly become the fundamental step to facilitate the understanding of the structure-function correlation. These techniques need to be valued, at the same time improved, as we learn more about the brain and its functions. Just because these techniques are imperfect, it seems asinine to discard their uses or what it discovers. As Marcus Raichle, a Washington University neurologist pointed out, throwing away the findings of imaging techniques would be similar to that of questioning the existence of stars due to a faulty telescope.

Regard it as a valuable tool, or as “the new phrenology”, no one can deny the numerous amounts of information and insight that these techniques have bestowed us with. These techniques are largely used to try and pin down some very complex behaviors of a very complex organ. Taking this into consideration, one has to be pleased about how far we have come in understanding the complexity of the brain through the capacity of such techniques. It is not to say that further upgrades and enhancement of these techniques based on the current concepts and theories will move us further from contemplating whether these techniques have done more than simply confirm that cognition happens in the brain.


Sarter, M., Berntson, G. G., & Cacioppo, J. T. (1996). Brain Imaging and Cognitive Neuroscience. American Psychologist , 51(1),13-21.

Faux, S. “Cognitive neuroscience from a behavioral perspective: A critique of chasing ghosts with Geiger counters.” The Behavior Analyst, 25:161-173, 2002

Dobbs, D. (2005, April). “Hard Science or Technicolor Phrenology?”

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The Parkinsonian Personality: A Habit of Highly Successful People? Fri, 03 Mar 2006 21:59:00 +0000 Psychiatry_Psychology2.jpgParkinson’s Disease. As soon as we hear this, we think “neurodegenerative”, “dopamine”, “Levodopa”, “tremor”, “basal ganglia”, and so on. However, it is odd for one to associate Parkinson’s to Personality.

Some common personality types exhibited by most individuals with the disease are obsessiveness, industriousness, reservedness, rigidness, cautiousness and punctuality. The most distinct characteristic underlying these traits is the lack of novelty-seeking.

This Parkinsonian Personality has created an inquisitive approach to the disease for nearly a century. Scientists are now increasingly showing more awareness towards this aspect of Parkinson’s. The world’s most reviled dictator, Hitler, seemed to exhibit the Parkinsonian Personality. This and the other motor symptoms of Parkinson’s disease are allegedly a key factor for his downfall. However there has been an incessant effort to discover if it is these personality traits that trigger the cause of the disease or are these traits the mere consequences of the disease itself. This ultimately leads us to the dilemma of “The chicken or the egg? — Which came first?” That is, one has to investigate if the individuals that possess these particular traits exposes them to certain perils that leads to that person being the recipient of the disease. Or, on the other hand, are these qualities the by-products or the results of having Parkinson’s Disease?

If we lean towards the latter argument, then we can assign the low dopamine level in patients to be the culprit that leads to the emergence of these unwholesome personality traits. Dopamine and its vital role in pleasure and motivation have been well recognized. The decrease of this chemical therefore reduces the enjoyment and enthusiasm experienced by the patient. Without this strong reinforcement, a person tends to accommodate a safe, less-risky behavior that develops into the Parkinsonian Personality.

However a recent study in the Scientific American suggests that this Parkinsonian Personality is not dopamine dependent. The authors of this research studied patients with the disease but were not on medication yet and suggested that the established association could be due to the medication. Therefore they construed that the traits are not explicit to the disease rather it “possibly reflects a psychological response to a chronic disease.”

As signs of this disease only start to emerge after about 80% of the dopamine in the brain has been lost, this could explain why the certain personality types materialize long before the person is diagnosed. With this in mind, one can understand the conjecture behind breakthrough headlines such as “Risk takers are less likely to get Parkinson’s disease” and “Risk-takers ‘escape Parkinson’s.” An article titled “Some Good News About Bad Habits” and other similar articles discusses the implausible benefits of smoking, intake of alcohol, caffeine consumption and its association to Parkinson’s Disease. However, a study published in MedlinePlus in February 2006, rectifies this claim by explaining that this could just be a behavioral response of a person who has a low impulsive sensation-seeking tendency, is cautious and just hates being risky!

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