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Comment by rcthompson | Hacker News Reader

Bizarre. What if we can fully rouse patients with this treatment, but only temporarily? Imagine being dependent on a daily morning tCDS treatment to wake up every day. Maybe this will be incorporated into an implantable device, like a pacemaker for the brain (not in the sense of providing periodic pulses, but rather in the sense of being required for normal functionality).

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There's actually precedent for that. [1] Uses there include epilepsy, Parkinson's and depression treatment. But extending beyond that, my search also found this [2], for Alzheimer's treatment.

[1] http://en.wikipedia.org/wiki/Brain_pacemaker

[2] http://medicalcenter.osu.edu/mediaroom/releases/Pages/Ohio-S...

Also encephalitis lethargica, the treatment of which even got turned into a movie (and book and play): http://en.wikipedia.org/wiki/Awakenings.

(Spoiler: The patients, unfortunately, developed a tolerance for the treatment within a few months.)

Yes, I vaguely remember hearing about "brain pacemakers" before, thank you for reminding me. But I'm using the term a little more metaphorically: just like a patient's heart might just stop without a pacemaker, in this case the patient would lose consciousness if the "brain pacemaker" was deactivated. To put it more bluntly, imagine that you were revived from a vegetative state, but your consciousness now effectively has an on/off switch.

http://i.imgur.com/lSjkmNj.gif

Well, the Parkinson's thing isn't all that complicated - simple wire w/ ~ 1.5mm electrode sending out a 130Hz square wave at ~ 3 volts. It's been FDA approved for over a decade now, and ~100k implants have been done worldwide.

The interesting part is that no one knows why it works as well as it has.

tDCS, and TMS, on the other hand, have barely measurable effects or widely variable effects, and no one has really figured out how to make them practical. Useful for all sorts of psych papers and hypothesis generation, though.

The Alzheimer's bit - well, it's an interesting story. It's always a brave cowboy surgeon that even thinks about operating on an Alzheimer's brain for a number of reasons - safety, brain-wide neurodegeneration (thus not immediately obvious how something focused like surgery can help), poor cognitive baseline, etc.

The group that's probably the furthest along is the Toronto group - they tend to be pretty liberal about where to implant electrodes, and are always looking for new indications to implant stimulators (i.e. generate new IP, etc). They were initially looking to stick the thing into the hypothalamus to control weight gain, since everyone in north america is overweight and there's a huge market.

Well, turns out when they turn the thing on, the guy suddenly remembers every sexual encounter he's had since puberty in vivid detail.

Hence the pivot to Alzheimer's, with at least 2 pilot studies done w/ ~40 subjects using the currently available Medtronic Inc devices, and a new biotech startup.

The effects so far are modest - essentially the subjects deteriorated but more slowly than expected. No one suddenly started remembering things like they could when they were younger...

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