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Sunday, August 05, 2007


Foto: Nature.

Applying tapes or permanent external cranial wood splints to newborns, prehispanic peruvians deformed their skulls with aesthetic ends. With more resources (1920), some researchers began to carried out electroencephalograms and soon later (1935), brain surgical lobotomies. From 1952, brain valve shunts was implanted to deviated ventricular liquid toward peritoneal liquid with therapeutic ends. 2 years ago the first brain chip was implanted in an immobilized adult, allowing him directly interact with an external computer. It is expected that soon, nano-calculators and nano-sensors will be inserted in different brain areas, with medical, sports or calculus ends. Now, the newly born cyborg-age, is reinforced with the technical advantages of Deep Brain Stimulation (DBS). From 1987 (France) and for some years in the John Hopkins and Cleveland Clinic/USA, the DBS is employed to improve motor altered performances (tremor, rigidity, stiffness, slowed movement, walking problems or Parkinson drugs´ side effects), of patients affected by Parkinson´s Disease (PD). The DBS (employee in patients that don't respond to the habitual medication), consists on introducing 4 fine lead electrodes in an intracranial specific area (thalamus), connected to external generators of electric pulses of low voltage (pacemakerlike unit), inserted in the intraclavicular region. The pulses block anomalous neuronal discharges generated in the inferior thalamic nuclei (that control aspects of conscience and awake states), normalizing neuronal discharges of the area and linking them with systems of the cerebral cortex (front lobe), committed in vigil state.

Now, Nicolás D. Schiff (Cornell Medical School/USA), has began to employ DBS, in a patient with Minimally Conscious State : MCS (intermittences of vigil states -self/environment- : opening of eyes, movement of 1 or 2 fingers of feets), with success. Until recently, severe brain injuries, with but of 12 months of affectation, were unmanageable. Recent studies, however have demonstrated an unexpected preservation of extensive neuronal nets in patient with MCS, existing the possibility that their residual functional brain capacity will works normally again. Dr. Schiff and colleagues have demonstrated in a blind double study of 6 months that central, bilateral, thalamic DBS, improved the behaviour of one patient (38 years, with MCS, for 6 years, after a traumatic event: continuous kicking on his head). In this case, the DBS improved specific cognitive behaviors of the patient (to recognize people, to speak), the control of his arms and the handling of their feeding tube. The study advises not stop early therapeutic measures in patients with coma or vegetative states, after extensive brain injuries. The case also represents the culmination of years of knowledge of brain imagenology, rehabilitation techniques, physical stimulation and data of animal studies that delineated the circuits but important of vigil states.



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