Brain activity pattern may be early sign of schizophrenia | Hacker News Reader

Brain activity pattern may be early sign of schizophrenia

news.mit.edu

77 pointschablent16 comments

> “That really gets at the heart of how we can translate this clinically, because we can get in earlier and earlier to identify aberrant networks in the hopes that we can do earlier interventions, and possibly even prevent psychiatric disorders"

Get the evidence for the intervention before deploying it, please. The existing track record of mental illness "prevention" efforts isn't very good. The most infamous example is probably critical incident stress debriefing, which some studies found increased PTSD risk.

This exactly. Often times "intervention" means some heavy life debilitating medication. Sure it may stop the psychosis, but at a heavy and possibly life long price. There is no accountability for health care in this country, only "disaster prevention" taken at all cost to the mad patient.

I believe that with increased data collection and the push for ML systems, we will see that the emperor truly has no clothes. Lots of intervention methods have no positive outcome on long term recovery, but there is no transparency about outcomes, costs, decisions, medications, etc.

> Often times "intervention" means some heavy life debilitating medication.

Lobotomies and electro-shock "therapy" didn't cure patients, they just made patients more manageable. The tranquilizers (later rebranded as "anti-psychotics") served the same purpose: treatment without cure.

"Akathisia is a movement disorder characterized by a feeling of inner restlessness and inability to stay still. [...] Complications include suicide. [...] Akathisia is frequently associated with the use of dopamine receptor antagonist antipsychotic drugs." [0]

[0] https://en.wikipedia.org/wiki/Akathisia

> Sure it may stop the psychosis, but at a heavy and possibly life long price.

The terrible medications aren't even necessary to help people recover from psychotic states. The Quakers found that putting their psychotics in an "asylum" and feeding them four meals a day allowed most patients to recover over time [1][2].

[1] https://books.google.com/books?isbn=0786723793 [2] https://en.wikipedia.org/wiki/Lunatic_asylum#Humanitarian_re...

> [...] we will see that the emperor truly has no clothes. Lots of intervention methods have no positive outcome on long term recovery,

Many common medical interventions 'miss the forest for the trees'. "Stress" (biological/emotional) is the major factor in most conditions, but this is not covered very well in medical training.

> Lobotomies and electro-shock "therapy" didn't cure patients

ECT is very useful for some things:

ECT is used for refractory major depression (aka treatment resistant depression (TRD)), which is major depression which doesn't respond to drug therapy (that is what 'refractory' means).

It is very effective in that role: http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.201...:

> ECT is often effective for severely depressed patients who have not responded to multiple medication trials or who are at imminent risk of suicide. This issue's Treatment in Psychiatry highlights the safety and efficacy of ECT while stressing the importance of the pre-ECT medical evaluation and consent process.

> Electroconvulsive therapy (ECT), which has been in use for 75 years, is an important treatment for severe and treatment-resistant depression. Although it is acknowledged as the most effective acute treatment for severe mood and psychotic disorders, it remains controversial because of misperceptions about its use and lack of familiarity among health care professionals about modern ECT technique. The authors present an illustrative case of a patient for whom ECT is indicated. They review the basic and clinical science related to ECT’s mechanism of action and discuss clinical issues in the administration of a course of ECT, including the consent process.

More information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514332/:

> The clinical efficacy of ECT in TRD is well established, with 60% to 90% rate of acute response in TRD [3], and it is indicated specifically in severe psychotic depression, catatonia and delirious mania.

It's a very effective last-ditch therapy for some very serious disorders.

> ECT is very useful for some things:

ECT's cheerleaders promote their machines. The ECT-resistance claims there is considerable evidence against the use of electrically-induced brain damage [0]. Who am I to believe? I'm biased towards the detractors, as I have personally witnesses the harm perpetrated under the mental health industry's usual practices.

Dr. Breggin says there was recently a breakthrough in class action lawsuits against ECT manufacturers [1].

[0] http://www.ectresources.org/ [1] https://www.madinamerica.com/2018/10/huge-breakthrough-ect-l...

> (aka treatment resistant depression (TRD)), which is major depression which doesn't respond to drug therapy

There are some drugs that are somewhat useful for helping people out of their depressed state, while the actual causes of their condition are addressed. These drugs fell out of favor as their patents expired, and as less-effective "anti-depressants" were patented. Each generation of anti-depressant is less effective than the generation which preceded it. The SSRIs are the least-effective anti-depressants of all - these drugs might help some patients not because of their effect on Serotonin, but on the neurosteroids [2].

[2] https://en.wikipedia.org/wiki/Neurosteroid#Role_in_antidepre...

Depression is partially a case of 'exhaustion' due to 'biological stress' (with 'emotional stress' as the usual contributing factor). Its causes and appropriate treatments have been discussed in the scientific literature, but the actual findings are incompatible with the patent medicine industry's business model.

Thanks for your comment, as the process which culminated in this response was quite worthwhile for me.

> These drugs fell out of favor as their patents expired

That's literally the opposite of what happens: Patent-expired drugs can be made more cheaply, and become more popular, precisely because there's no patent holder exerting a pressure to keep prices up.

Really, your whole post reads like a screed with no scholarly foundation to it.

> That's literally the opposite of what happens: Patent-expired drugs can be made more cheaply, and become more popular, precisely because there's no patent holder exerting a pressure to keep prices up.

The parents who got ripped off by the Epi-Pen manufacturers would probably disagree with this assessment of "what happens".

As a counter-point, I offer Wikipedia's assessment of the current usefulness of the old drugs:

  New research into MAOIs indicates that much of the concern 
  over their supposed dangerous dietary side effects stems 
  from misconceptions and misinformation, and that it is 
  still underutilized despite demonstrated efficacy.

- https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor

I emphasize, "misconceptions and misinformation". Robert Whitaker got his start writing about the harm done on patients by the SSRIs when they first launched. These drugs should be "last resort", not first.

> Really, your whole post reads like a screed [...]

I have some personal experience witnessing patients' struggle against professionals who think their patients require palliative drugs. My aunt's friend is dying of anti-psychotic-induced liver failure -- she was always a little 'off' to me, now I know why. My friend was misdiagnosed by industry and is forced to take harmful drugs. I am confident that my reading of these situations is basically correct.

Medicine has come a long way since the days of bloodletting and calomel (mercury) therapies. It has further yet to go.

It's hard for all of us to attain perspective on whatever field we're studying. Here's a neat HN comment I just ran across:

"One of our group leaders in our research institute learned physics at the dawn of quantum mechanics, saw theory translate into practical applications (e.g. laser technology), and then boost and transform theory again. She is 90+ now. It was great to hear from her how long it took for the right theories to overcome the barriers of adoption, how fashion works in science, and how many things we think as new are actually really old stuff in new clothes." - https://news.ycombinator.com/item?id=13998273 (emphasis added)

> [...] with no scholarly foundation to it.

you're cute. I have actually made many trips to the science library to check references. Sometimes I buy copies of these books for my own personal library. I try to provide references and links for all my comments which challenge the status-quo.

I can state with confidence that the core of "mental illness" was figured out decades ago, and was in the science libraries by late 1970's. Everything the scientists knew then should have leaked into practice by now. But our medical professionals are still being trained with theories that are demonstrably false and harmful (e.g. anti-dopamine drugs for "psychosis", SSRIs as first resort rather than withdrawn from use, etc). Maybe you think modern medicine is marvelous, but from my perspective I see a lot of my friends and family's doctors "missing the forest for the trees".

Sanity will eventually prevail, but there is a monetary bias against its implementation.

Resting-state functional MRI (fMRI) based studies are not used to make clinical assessment yet, and the researchers themselves will admit that it is not ready for application. The prediction accuracy in most replicable studies hover around 80-85%. Also, fMRI only tells you part of the story, and multi-modal data fusion is key to get the full picture of what it happening in the brain. Once the accuracy reaches close to 99%, it will eventually find clinical application.

I'm not talking about direct use of fMRI, but rather that some mental health experts are so laser-focused on the problem of untreated mental illness (not without reason, it should be said) that they argue for widely deploying interventions merely because those interventions are supposed to work rather than because they're demonstrated to work.

I guess we are talking about different topics :)

Another understudied issue is that it may be multiple interventions in parallel that will have a stabilizing or healing result; speaking primarily of non-medicated options.

TL;DR: "a part of the brain known as the superior temporal gyrus, which is involved in auditory processing, is highly connected to brain regions involved in sensory perception and motor control. However, in patients who developed psychosis, the superior temporal gyrus became more connected to limbic regions, which are involved in processing emotions"

News should be written like emails, the most important info should be at the top, an not near the end or scattered so you have to read the whole thing to understand what is going on.

That last part of the second sentence should not appear in the article at all, it is inaccurate. It suggests that the limbic system in general is involved in processing emotions, which is not the case although it has often been presented that way for non-scientific reasons.

I've been interested if I could do something like this research at home. http://neurosky.com/ is what I used I use for brain monitoring. Maybe someone here can give me some tips.

Looks like a fun thing to experiment - what headset to you recommend?

> patients who developed psychosis, the superior temporal gyrus became more connected to limbic regions

Increased correlation between auditory and emotional neural regions. This is a little flimsy.

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