The Crazy Case of Phineas Gage!

Phineas Gage was just a normal railroad construction worker back in the 1800s. But, if you're interested in psychology, I'm sure you've at least heard of him, if not know all about him. One day, as he was filling a hole in the ground with explosive powder, using a tamping iron, a small spark caused the tamping iron to explode out of the ground. It drove straight into his head, under his eye, and exited, landing about 30 yards away. This is a very serious injury! As you can see in the picture below, which is a computer -generated image of his skull, the iron went through his brain!

This is certainly a fatal injury isn't it? Actually no! Phineas Gage survived! He even got up and walked to the cart that drove him to the hospital. Here, you can see him posing with the iron that nearly took his head off!

Can you guess what kind of damage it did to him? Did it cripple him? Did he lose his memory? Nope! All it did was change his personality! I say "all" because he could have been seriously mentally handicapped or worse.
The rod damaged his left frontal cortex. This caused him to lose all social inhibitions. He became aggressive and vulgar. His friends described him as a completely different person. This was one of the first instances suggesting that the brain contributes to personality, so it excited scientists all over the world.
It's still a very interesting case. If you want more information about Phineas Gage, this website explains the details of his accident and the research being done at that time about the brain. 

Synesthesia

Synesthesia is a condition in which the perception of senses are all jumbled up. Someone with this ability perceive one stimulus with more than  one sense. They may be able to smell certain numbers or see different colors and shapes associated with a person. This may seem weird or hard to imagine, but to me, it sounds really cool! Just to check if you have this amazing superpower, take a look at this picture. Can you figure out what shape the 2's are in?

It actually took me a while! So I guess I'm not a synesthete, unfortunately. However, if you were able to figure it out quickly, that doesn't mean you're one. It all depends on how you figured it out. Certain synesthetes can see numbers as certain colors so they would have been able to pick out the triangle of twos fairly quickly. It might have looked something like this.

There are many different types of synesthesia though. Some people can feel certain sounds on their body, some people taste things as colors, while others can see smells as funky shapes! There are a million different ways this condition manifests itself, but it all has to do with "joined perception" of different senses. 

Its origins are very mysterious. One theory is that the brains of these synesthetes have crossed wiring. When babies are born, their brains contain way more connections that are really needed and after time, they are disposed off, but maybe some of these connections, specifically the ones between different sensory processing areas, remain connected through life. This could cause the mixed signals between different senses. 

Although it's not really understood, I think this is really cool condition. The people who have it are sometimes bullied or made fun of as children so they learn to hide it. I don't think it's anything to be ashamed of! In fact, sometimes it can be an advantage! People with this condition are usually better at learning complex theories because they have the added assistance of other senses to help them understand.

If you think you might have this condition, click on this link to try and determine if you have it! It should adjust itself to see which specific type you have since theres many different forms of it!

Korsakoff's Syndrome

Alcohol misuse can cause a lot of issues. But did you know that chronic alcohol abuse can cause problems such as an inability to remember recent events, memory gaps, and even trouble learning new information? These are all characteristics of Korsakoff's Syndrome, which can be caused by alcohol abuse. The actual physiological cause is a deficiency of thiamine. This can be due to anorexia, starvation, vomitings, AIDS, dialysis, as well as heavy drinking. These can all lead to thiamine deficiency.
Korsakoff's Syndrome can cause different types of memory problems. One symptom is retrograde amnesia. This is a loss of memory of events that happened before the onset of the disease. For example, someone might lose memories of their childhood. Another symptom is anterograde amnesia which is a bit more interesting. This is a loss of the ability to form new memories. A person cannot make new memories so they don't remember anything prior to the start of the disease. For example, a person might wake up 25 years after getting this syndrome and not know that its been 25 years! This is what happened to Drew Barrymore in the movie  50 First Dates.
The most interesting symptom of Korsakoff's Syndrome is confabulation. This is where someone has memory deficits and tries to fill in the missing information by guessing. However, they don't realize that they are making up information; they think its true! It isn't the same as lying because they aren't trying to deceive. They can even be influenced to think a certain way. If they are trying to fill in a memory gap, and they are told that something happened, they will believe it and even 'remember' it happening.
This website explains very clearly the causes, symptoms and treatments of Korsakoff's Syndrome. 

Aphasia: Broca's vs. Wernicke's

Aphasia is a disorder caused by damage to the area of the brain that controls language. It can cause difficulty speaking, comprehending speech, writing, gesturing, and reading. Specific types of aphasia are characterized by the different areas of the brain that are damaged and the slight differences in symptoms. There are two types of aphasia that are very similar but have profound differences. They are Broca's aphasia and Wernicke's aphasia. Broca's aphasia involves damage to Broca's area. This is in the  left frontal lobe. Wernicke's area is in the left temporal lobe. They are connected via the arcuate fasciculus.

 Broca's aphasia, also known as nonfluent aphasia, is difficulty in forming or comprehending coherent, complex sentences. People with this type of aphasia often speak awkwardly, in very simple sentences because they can no longer understand complex grammar. They often leave out helping verbs, prepositions, and other flowery words. They only speak with nouns and verbs, and sometimes have trouble with even that. They also have trouble with sentences like "the man was bitten by the dog". This seems simple, but the inversion of the noun and the verb throw them off.

This video shows a patient with damage to Broca's area trying to describe a picture. A simple description of this picture is  "a mother is washing dishes while two children use a stool to steal cookies from a cookie jar" You can see how difficult this is for her.

Wernicke's aphasia, on the other hand,  is also known as fluent aphasia. The real problem is speech comprehension. They don't really understand what they hear. They also have speech impairment but in a different way. They speak fluently, unlike the woman in the Broca's aphasia video. However, they cannot recall words so they make up words instead. There are two different types of made-up words and patients use either or both of them. One type is  paraphasia. An example of this is if the patient wanted to say "cook", but said "took" or "sook" instead. The other type is neologism. This is a total made up word. For example, if they wanted to say "cook" and said "skucker" instead. Also, unlike patients with Broca's aphasia, they don't even notice that their speech is impaired, or that they don't understand something. This type of aphasia can be difficult to treat since the patient doesn't even realize that something is wrong.

In this video, you can see that the man with Wernicke's aphasia doesn't realize that he is answering the questions wrong. He doesn't seem to even understand what is being asked of him. 

As you can see, these disorders seem similar but are actually very different. People with these disorders usually respond well to speech therapy. 

Phantom Limbs: Ghosts of Amputated Body Parts!

 Can you imagine having one your your arms or legs amputated? The horror of losing a body part probably stays with you forever. Amputations are not done for fun, though. Its usually to save someone's life. But how scary must it be to wake up one morning thinking "Wow my leg really hurts! I wonder what's wrong with- Darn it! I forgot! I don't have a leg!"
 This is the phenomenon of Phantom Limb Syndrome. Almost all amputees report feeling pain or other sensations in the limb that has been amputated. Scientists used to think that this was due to damaged nerve endings in the stump sending weird signals to the brain. They used to amputate more of the stump in order to remove the damaged nerves. This, as we now know, would not help the patients. In fact, it would cause more phantom limb pains!! Phantom Limb Syndrome is actually due to the rewiring of the brain's somatosensory cortex. Since the person no longer has a certain limb, all the space in the brain dedicated to that limb is now a waste. So, the brain rewires that area to correspond to another body part. The homunculus is a representation of the post-central gyrus and the are of the body that it receives sensory information from.

 An individual who has lost their arm, usually has the hand area taken over by the face area. Someone who has lost a leg sometimes has the leg area taken over by the genital area! Because of this, if someone felt a sensation on their face, for example,  they would also feel it on their phantom arm. This video explains the phenomenon of phantom limb syndrome very clearly. 

Phantom pain can also occur in people who were born without a certain limb. This is because the nerves that would usually innervate the missing limb cause pain. 

 There are many treatments for phantom limb syndrome including medication and therapy. One treatment that is very interesting is the mirror box treatment developed by V.S. Ramachandran. It involves having the patient sit next to a mirror with the amputated stump hidden from view. The limb on the other side is seen in the mirror and looks like the patient has both limbs. The patient moves the limb and in the mirror it looks like both limbs are moving. This can help the patient reposition the phantom limb in less painful positions, or unclench. 

 This video shows that phantom sensations can be induced in people who haven't had amputations. This is more of an illusion than the actual rewiring of the brain that happens in phantom limb syndrome but it produces similar effects. 

Addiction

I would say I’m addicted to watching TV, reading, and eating chocolate (which I’m doing right now). Lots of people say they’re addicted to things, but are they really? Addiction is when you do something that’s pleasurable, but you do it so much that you develop a compulsive need to continue doing it. It interferes with your normal life. The most common addictions are to drugs and alcohol, but people can become addicted to other activities like gambling and video games too.

The actual biological state of addiction is when a person’s body has adapted to the presence of a drug so much that the body can’t handle being without it. There’s also a behavioral perspective, where people are dependent on something to cope with daily life. There are actually stages of addiction. The first stage is dependence, where the person spends most of his time looking for the object of his addiction. Eventually, he becomes tolerant. This is where his body gets used to it. So, in order to get the same effect, he needs to consume more of the substance. The symptoms of addiction vary depending on the substance or activity and the person. Being without this substance, or activity, leads to withdrawal symptoms, which also vary based on the same factors. For example, symptoms of opiate (heroin, morphine, codeine, etc.)  withdrawal include anxiety, muscle aches, insomnia, and sweating. It can also lead to diarrhea, vomiting, shaking, and cramps. On the other hand, withdrawal from cocaine abuse can cause depression, vivid and unpleasant dreams, fatigue, paranoia. As you can tell, withdrawal from cocaine causes less of the physical symptoms that are associated with other drugs like heroin. More concrete ways to tell if someone is suffering from addiction or withdrawal are blood tests and urine analysis, where there will be actual physical evidence of the drug.

According to Medical News Today, chocolate is a valid substance to be addicted to. Maybe I need rehab!

Guillain Barré Syndrome: Do we really need Myelin Sheaths?

     Guillain Barré Syndrome is one of several demyelinating diseases. Demyelinating Diseases do just what the name implies, they demyelinate neurons. This is a very serious issue because myelin sheaths on axons are more than just decoration. They are used to transmit impulses quickly down the length of an axon. The speed of transmission in an unmyelinated axon is about 0.7m/s (2mi/hr). This is about the speed that you jog. You might think that this is fast enough because a human body is about 2 meters tall so an impulse travelling to your feet would only take about a second or two. And you would be partly right. This is fast enough for information that needs to be sent to your digestive tract and other not-super-important stuff. However, if you start to trip, you need to reposition your body within a split second.  This is where myelinated neurons come into play. Neurons innervating skeletal muscle are myelinated. This myelination increases speed of transmission to about 120m/s (270mi/hr). So now that you can see how important myelin sheaths are, lets talk about what it would be like to lose that myelination.

       There are two types of glial cells that assist with myelination: Schwann Cells and Oligodendrocytes. Schwann Cells wrap around axons in the peripheral nervous system while Oligodendrocytes hug axons in the central nervous system. Guillain Barré Syndrome occurs when specifically the peripheral nervous system is attacked and becomes demyelinated. The initial symptoms of this disease include weakness and tingling in the legs. These sensations slowly spread upwards to the upper body and arms. The brain being unable to transmit commands efficiently to the muscles causes the weakness. It can increase in intensity until some muscles can’t be used at all. This can be very severe because it leads to the individual becoming paralyzed. If the muscles used for respiration are affected, it can be potentially fatal. The tingling is because the sensory receptors cannot transmit information to the brain. It can manifest in an inability to feel heat, pain, and other sensations. Or, the brain might receive weird, altered signals that result in tingling, creepy-crawly, or even painful feelings.

      It is an autoimmune disease which means that it’s not a virus or bacteria destroying the myelin, its your own body. Sometimes, it can be caused be preceded by an infection. A virus or bacteria could have changed the cells in the nervous system so the immune system thinks they are foreign, or it could have made the immune system more belligerent and care less about what it attacks.

      Sadly, there is no cure for this syndrome; only therapies that try to lessen the intensity of the symptoms and treatments for its complications. 

     This article explains Guillain Barré Syndrome in a little more depth, as well as explains many of the complications and their treatments.  

NY Times: Guillain Barré Syndrome