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Oliver Sacks, neurologist and author, dead at 82
Renowned neurologist, author wrote books such as The Man Who Mistook His Wife for A Hat

Dr. Oliver Sacks, the neurologist who studied the intricacies of the brain and wrote eloquently about them in books such as Awakenings and The Man Who Mistook His Wife for a Hat, died on Sunday at the age of 82, the New York Times reported.

The British-born Sacks, who announced in February 2015 that he had terminal liver cancer, died at his home in New York City, his longtime personal assistant Kate Edgar told the Times.

Sacks was called “a kind of poet laureate of medicine” and “one of the great clinical writers of the 20th century” by the New York Times.

Using a typewriter or writing in longhand, Sacks authored more than a dozen books, filling them with detailed, years-long case histories of patients who often became his friends. He explained to lay readers how the brain handles everything from autism to savantism, colourblindness to Tourette’s syndrome, and how his patients could adapt to their unconventional minds.

Sacks’ view, as expressed in his 1995 book An Anthropologist on Mars, was that such disorders also came with a potential that could bring out “latent powers, developments, evolutions, forms of life that might never be seen, or even be imaginable.”

“The brain is the most intricate mechanism in the universe,” he said in a People magazine interview. “I couldn’t imagine spending my life with kidneys.”

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“A brain is constantly on fire, which makes electricity.”

Scott Bug Q&A: How Our Brains Are Killing Us.

nytimes.com
Oliver Sacks Dies at 82; Neurologist and Author Explored the Brain’s Quirks
Dr. Sacks explored some of the brain’s strangest pathways in best-selling case histories like “The Man Who Mistook His Wife for a Hat,” achieving a level of renown rare among scientists.
By Gregory Cowles

“And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual, but on what is meant by living a good and worthwhile life — achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the seventh day of the week, and perhaps the seventh day of one’s life as well, when one can feel that one’s work is done, and one may, in good conscience, rest.”

Rest in peace, Dr. Sacks. Nearly every neurologist I know (of my generation) was inspired by him to some degree.

Dr. Oliver Sacks died early this morning after a battle with cancer.

I loved reading his books, which were mostly medical cases where he worked with patients who had neurological disorders. Even though these people often seemed alarming to others, and many of his patients’ disorders were what we call today “invisible illnesses”, Dr. Sacks still Saw them. He listened to them with kindness. He respected them and did not treat them as “less than.”

As a spoonie especially, this is something that drew me to him. If any of you are looking for book recommendations, I suggest his collection of clinical cases called “The Man Who Mistook His Wife for a Hat”.

Study Reveals That Those Who Listen to Emotional and Sad Music Are More Empathetic

Why do you love certain types of music and hate others? It may come down to the way your brain processes information.

Psychologists already know that music preferences are linked to personality, but a new study finds that your taste in music is also associated with the way you think.

Are you an empathizer or a systemizer?

Keep reading

Positives of BPD

(Borderline personality disorder/emotional regulation disorder).
I made a post like this a while ago when I first started to use tumblr. It was pretty brief and choppily written (in my opinion) so as I’ve said, I decided to remake this with more explanation/research included for more understanding and since lots found it and really liked it. Might as well start 2015 off focusing on these positives.

This is important for awareness/understanding and for those of you who have it, as it really helped me overcome feelings of guilt towards having BPD/ERD and the horrible stigma. It helped me gain self-acceptance. That is why I decided to share it here.

Emotional Regulation Disorder (BPD) is a chronic mental disorder of emotional hypersensitivity and dysregulation.
In BPD, neurobiological emotion and systematic reactions fire off rapidly, longer, easily, and with more intensity as they are hypersensitivity and do not regulate, balance out, or process well and the same as others.
This results in its many symptoms in such behavior, moods, reactions, identity, perception, dissociation, thought patterns, etc.
(The fight/flight system is easily triggered, while the system responsible to regulate that is underactive. There are brain structural differences that are responsible for emotions, decisions, behavior, learning, instincts thoughts, perception, stimuli, relations, etc. Additionally, emotions have been shown to fire off longer and hormones, chemicals, transmitters, all play its part in the hypersensitivity and dysregulation. And so on).
It then causes a wide range of symptoms (depressive, dissociative, anxiety, hallucinations, delusions, anger, aggression, suicidal ideations, extreme reactions to real or perceived rejection, abandonment and criticism, etc.) as there are hundreds of ways to recognize ERD/BPD reactions, symptoms, and features.

As the condition influences ‘all’ emotional reactions and functioning, and there is such a wide range of symptoms, it is often described as a version of multiple mental disorders combined. (borderline of multiple conditions)
However, these neurobiological reactions mean the hypersensitivity can affect positive reactions as well.
-For those of you who read this and suddenly think that you have a chronic condition because it says something positive and you say you have them all, stop. It is incredibly disrespect to those of us that have it. You can’t just tell you have it from being able to relate to a post because it says something positive. Posts aren’t some checklist.

Some of the main symptoms of BPD may generate some positive responses or features.
Specifically, with research, analysis, and observations, some hallmark features may be:

-Passionate: As the level of psychological reactions highly differ in those with BPD compared to those without, individuals with the condition experience a higher extremity scale and baseline. For instance, this includes: Depression instead of sadness, humiliation instead of embarrassment, panic instead of nervousness, rage instead of anger, and euphoria instead of happiness, to name a few. Individuals with BPD have been observed to be especially very passionate and reactive as they often react and express this passion and euphoria.

-Lively:
Intense reactions may also result in high euphoria and engaging/active behavior and energy.

-Insightful: Studies on BPD indicated that because of their own hypersensitivity and pain, some people with BPD may easily connect to what is around them. For instance, they were able to easily read facial expressions, behavior, and emotions of those around them in an expression test. People with BPD may take experiences like these and emotions and turn it into insight and understanding, for one example.

-Curious: Observations and studies show unusually high curiosity is common in some people with BPD from the hypersensitivity and connectivity with their emotions, senses, and surroundings.

-High awareness: As a result of being hypersensitive and easily connected to surroundings and outside stimuli, some people with BPD have been observed have high awareness.
Such strong emotions and connections may call for or reinforce high awareness.
For other examples, Marsha Linehan also states they may have higher levels of spiritual experiences more often. Furthermore, people with BPD have been observed to have a high level of comfort, security, and connection to nature and animals, such as pets, as stated by the DSM.

-Compassionate/empathetic: As a result of their own hypersensitivity and pain, many with BPD may portray a high level of empathy and understanding to others.

-Dependent: Dependency is a hallmark symptom of BPD. One main reason for this is the extremity of the hypersensitive emotions, which often generate a huge fear of being alone and abandonment and rejection. Identity symptoms, such as a lack of sense of self, may also result in dependency. Yet, dependency can be a good thing with the proper balance, like for support, closeness, affection, and interconnectivity.

-Protective: This reaction may be common as a result of the intensity and care someone with BPD feels towards a situation or person. It also relates to the high aggression noted in BPD symptoms. Aggression isn’t always a bad thing- aggression can mean protective of someone or the self.

-Loving/appreciative:
Idealization is a main symptom of BPD. Some people with BPD may idealize and glorify another individual in their life because of such strong emotions, reactions, and needs, and they may also be very appreciative because of hypersensitivity and painful experiences.

-Loyal: Idealization, dependency, hypersensitivity, etc- such reactions and features may prompt strong loyalty and devotion.

-Creative: The intensity and hypersensitive highs and lows may generate creativity and expression. An unusually high amount of writers have BPD. High levels of creativity were linked to some individuals with BPD in research cases- new ideas, artistic or musical ability, writing, or other areas of creativity. Fantasizing is a common feature in BPD as well as daydreaming.

-High nociception (pain tolerance): Studies indicate alterations between pain processing in over half of those with BPD, as opposed to individuals without. It has shown an alteration in acute pain processing- they have a higher tolerance for such. Individuals with BPD were far more likely to tolerate it, despite being hypersensitive psychologically. The result of this comes from different systematic responses and antinociception and may be a result of long-term self harm behavior in some cases.

-Discipline: Obsessive compulsive features are on a spectrum amongst many disorders, and some are quite common in BPD. This includes intrusive thoughts in the thought pattern/processes, repetitive behavior as a result of anxiety and distress, and perfectionism, to name a few.
Research observes that with the proper balance and use, people with BPD may also display high levels of self-discipline, work orientation, and drive connected to these features of perfectionism, repetition, etc.

-Sarcastic/funny:
The DSM and other observations state some people with BPD may often express sarcasm and humor.

-Bold:
One of the main symptoms of BPD is impulsiveness; however, research states this may be tied to a positive trait in some individuals with BPD- boldness, bravery, and ability to speak their mind.

-Spontaneous: Living free, acting on the moment, open minded, adventurousness, which is all related to the connections, reactions, and impulsiveness.

-Alluring/Interesting: Such extreme reactions and expressions are shown or felt to others. Because of the intensity, many people note the interesting and/or alluring behavior or energy of someone with BPD in observation.
There are books and other psych writings noting individuals with BPD as “sirens”- Interesting and intense, yet, impulsive, aggressive, and hypersensitive.
Other studies have stated foundings of “physical attractiveness” patterns-however, not entirely realistic, hormonal differences found amongst BPD individuals may relate.

-Individualistic: BPD is a complex disorder that has hundreds of symptoms and features. There is a lot of depth, changeability, intensity, and reactions.
Furthermore, some features may allow one to cultivate such individuality.

-Strong: On a psychological level, people with BPD are often described as feeling the some of the most intense, agonizing reactions, and one needs to be quite strong to handle them.

-Intense: Overall, people with BPD are intense and hypersensitive individuals. The listed^ features may be noted with intensity.  BPD is also called, “Emotional Intensity Disorder.”

Marsha Linehan
states, “Although it is likely that emotion dysregulation is most pronounced in negative emotions, borderline individuals also seem to have difficulty regulating positive emotions and their sequelae.”

Breakdown of Baymax’s neurological scan of Hiro in Big Hero Six

Getting the chance to see Big Hero Six for a second time, on my computer, allowed me to pause the screen and check out all the cool details more carefully.  I was especially interested in the scene where Baymax is scanning Hiro’s neurological functioning.  I wanted to see if the writers and animators just phoned this bit in with a bunch of made-up jargon and figures, or if they actually did their research to add an extra level of authenticity.  I was happy to find that it was the later of these two options.  Even more so than I had hoped for.  They didn’t just do the research, they clearly got a real neurologist to consult on this…  It’s a super impressive facsimile of what a real, super high-tech neuro-scan would look like, right down to being gender and age-specific.

Check it out:

On the viewer’s left side of the screen, just below ‘diagnosis’ there is a list of symptoms.  After ‘no physical injury’ it reads ‘GPR54 detected.’ GPR54, also known as the ‘Kisspeptin receptor’ mitigates endocrine functioning during puberty.  Its activation causes the release of gonadotropin hormones.  In short, it is the mechanism that ‘turns on’ the gonads and basically readies the body for sexual procreation.  All of the aches and pains and weird feelings that occur during puberty are a result of the body adjusting to changes in the gonadal system.   The Kisspeptin receptor usually becomes active around age 11 in girls and 12 in boys.  Hiro is 14, which suggests he’s a bit of a late-bloomer in regards to his physical development, but this is not especially uncommon among children who are intellectually precocious.  No one really knows why this is; it’s just a common correlational finding.  

Next it reads ‘High levels of GnRH.’  GnRH is short for gonadotropin-releasing hormone.  This is a peptide hormone that regulates the release of additional hormones in the anterior pituitary gland within the hypothalamus.  These hormones are released in pulses or waves and it’s often different between boys and girls.  In girls, the pulses tend to occur at a varied rate throughout the menstrual cycle, with big surges occurring just prior to ovulation.  In boys, meanwhile, GnRH is secreted in pulses at a more constant frequency.  Detection of high levels of GnRH in Hiro indicates a pulse of the hormone is occurring and his gonads are in a state of spermatogenesis (i.e. his body is creating sperm… which is likely much more information than anyone needs regarding a cartoon character). 

After that it reads ‘increased pituitary activity.’  Again, the pituitary gland is the main generator for these hormones.  Electrical activity generating in the pituitary causes the release of various hormones.  The pituitary is involved in all manner of state and trait-based functioning.  In this case, the heightened activity is most likely connected to the pulse of GnRH. 

Next it reads ‘High Testosterone.’ Testosterone is an androgen steroid hormone secreted in the testicles of males and the ovaries of females.  Higher levels of testosterone during physical development aids in the tissue growth of secondary sexual characteristics, as well as augmenting muscle and bone mass, and the growth of body hair.  Secretion of testosterone from the adrenal glands is also associated with stress, helping to ready muscles tension and blood flow in so-called ‘fight-or-flight’ situations.  Heightened testosterone in Hiro just means that his body is going through the process of puberty; that his body is at an accelerated process of physical development (i.e. a ‘growth spurt’). 

Next, it reads ‘vocal fluctuation,’ which is pretty straightforward.   During puberty, the larynx grows and expands at a fast pace, altering the pitch and vibration of vocal folds.  Similar to GnRH, the hormones that aid in the growth of the larynx also occur in surges or pulses and this is why adolescent voices sometimes seem to ‘crack’ or suddenly fluctuate. 

Finally, it the readout reads ‘emotional instability.’  This is a complex one.  Obviously, a significant portion of Hiro’s emotional issues is related to his morning over his brother’s death.  Nevertheless, emotional instability is highly common during the process of puberty, a byproduct of hormonal fluctuations as well as differential activity in the brain.  Up in the picture, on the viewer’s right side, there are two side-views of Hiro’s brain.  The first is a baseline image, the picture Baymax took when he first met Hiro.  The second is a current image.  These are both imitations of what full side-view brain scans look like on a functional MRI (magnetic resonance imaging). 

Hiro’s baseline shows relatively normative brain activity, with electrical activity occurring in a broad, spectral fashion.  In the second image, however, the electrical activity is more focal, concentrating in the lower mid-brain region.  This is where the hypothalamus is, and the concentrated activity indicates that the pituitary is in the process of triggering the release of all manner of hormones. 

Structurally, the hypothalamus resides right next to the amygdala, part of the limbic system, and a primary component to emotion.  The amygdala is believed to be the part of the brain that connects thoughts and memories to physical sensations.  Put simply, it is what creates emotion.  Being situated so closely to the hypothalamus, an increase in limbic system activity may be merely a byproduct of increases of growth-related hormones during adolescence.  And this often contributes to greater emotional instability tied in with growth spurts. 

Furthermore, the increased activity in the midbrain region often acts to reduce activity in other areas, especially the frontal lobes.  The frontal lobes are the area of the brain most associated with decision-making, foresight, and judgment.  Apparently, there is only so much electrical activity that can occur in the brain at any given moment.  And a concentration of activity in the lower regions can actually reduce such activity in the upper regions.  So, when an adolescent makes a rash decision, acts out, or shows poor judgment, it may often be a result of reduced activity in frontal lobes that occur as a result of heightened activity elsewhere.  And we see this actually occur later on in the movie when Hiro makes a very rash decision and tries to get Baymax to kill Professor Callaghan.  Not only is Hiro still morning Tadashi and feels extremely betrayed by Professor Callaghan, but he’s also at a stage of development where his frontal lobes are at a lower-than-average level of activity… which can lead to rash, impulsive decision-making.  Fortunately, Gogo, Honey and the gang are there to stop Baymax and prevent Hiro from a decision he would ultimately regret.

Finally, the readout also shows Hiro’s heart rate and body temperature, both of which are in the normative range. 

Below the brain scans on the right-hand side is a list of abbreviations of hormones and neurotransmitters.   First is GnRH (or gonadotropin-releasing hormone) already covered above.  Next is LH, which stands for luteinizing hormone.  For girls, luteinizing hormones supports ovarian theca cells in later stages of the menstrual cycle.  In boys, luteinizing hormones helps to activate leydig cells in the testis, assisting in the production of testosterone. 

After that is a figure for FSH.  FSH stands for follicle-stimulating hormone.  FSH is a specific type of luteinizing hormone that activates pubertal maturation.  In girls, FSH is crucial to determining which egg is selected in ovulation.  FSH seems to be able to determine which egg follicle is the strongest and most ready for ovulation (i.e. which egg has the greatest chase of being fertilized and growing into a healthy baby).  In boys, FSH induces sertoli cells to secrete androgen-binding proteins… it helps to activate cells associated with male sexual development. 

Next is T, also known as T3 or Triiodothyronine.   This is a thyroid hormone that plays a significant role in multiple areas of bodily functioning, including metabolism, body temperature, and heart rate.  Elevated levels of T3 is a critical component to adolescent development.  It helps navigate metabolism so to give growing regions the extra energy needed for cellular generation (tissue growth).  For his size and weight, Hiro’s T3 level of 170 definitely suggests he is going through a growth spurt.   

Next is E2, which stands for estradiol.  Estradiol is both a steroid as well as a sex hormone.  It is the primary sex hormone in girls, helping to activate genes whose expression allows further development of the vagina as well as breast growth.  In boys, estradiol acts to help keep nascent sperm cells from dying off prematurely.  Significant heightened E2 levels in boys is a primary indicator of the genetic condition known as Klinefelters syndrome (also known as intersex or XYY syndrome).  At 22, Hiro’s E2 level is a touch high, but well within the normative range for a boy his age. 

And finally, there’s F, which totally perplexes me.  There’s no hormone I can think of that is abbreviated as F. So what’s Hormone F?  I’m still not sure and my best guess is that it’s an in-joke for fans of the anime, Dragonball Z.  

So all of this, this entire business that took me half an hour to write, is detailed in a single scene that lasts maybe ten seconds.  It’s really impressive the amount of detail and research that went into this one scene. 

Corpus callosum.

The corpus callosum is a wide, flat bundle of neural fibers beneath the cortex and it connects the left and right cerebral hemispheres, allowing interhemispheric communication. It is the largest white matter structure in the brain.

Clinical conditions related to corpus callosum activity: 

  • Epilepsy: the symptoms of refractory epilepsy can be reduced by cutting the corpus callosum in an operation known as a corpus callosotomy. This is usually reserved for cases in which complex or grand mal seizures are produced by an epileptogenic focus on one side of the brain, causing an interhemispheric electrical storm. The work up for this procedure involves an electroencephalogram, MRI, PET scan, and evaluation by a specialized neurologist, neurosurgeon, psychiatrist, and neuroradiologist before surgery can be considered.
  • Other diseases: Anterior corpus callosum lesions may result in akinetic mutism or tactile anomia. Posterior corpus callosum (splenium) lesions may result in alexia (inability to read) without agraphia. Also: alien hand syndrome; agenesis of the corpus callosum (dysgenesis, hypogenesis, hypoplasia); malformations of the corpus callosum; septo-optic dysplasia (deMorsier syndrome); multiple sclerosis with the symptom Dawson’s fingers; mild encephalopathy with a reversible splenial lesion, a rare encephalopathy (or encephalitis) of unknown origin with a transient lesion in the posterior part of the corpus callosum, mostly associated with infectious diseases.

(Picture by Neurons want food).