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治愈大腦須先破壞

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When something goes wrong with your body, doctors usually have to put things back together,

當你的身體出現問題時,醫生通常不得不把東西放回一起,
like by stitching a wound or setting a broken bone. But sometimes, healing your body requires taking it apart—
比如縫合傷口或接骨。但有時,需要把它分開——
like when you have to get an infected appendix removed—And that's true for the brain, too.
就像你必須去除被感染的闌尾一樣,大腦也是如此。
For some people with certain psychiatric or neurological diseases, the best way to fix the brain is to damage it.
對于某些某些精神或神經疾病患者來說,修復大腦的最好方法就是破壞它。
Just really, really carefully. Surgery for brain conditions has a messy history.
真的,真的得認真,大腦手術的歷史。
Unregulated lobotomies where doctors would essentially cut off the brain's frontal lobe to "cure" things
醫生會利用未調節的額葉切除術通過切斷大腦額葉來“治愈”疾病。
like schizophrenia were widespread in psychiatric hospitals across the US in the 1940s and ‘50s.
就像20世紀40年代和50年代美國精神病醫院普遍存在的精神分裂癥一樣。
At the time, the procedure was crude and often left people lethargic, with a dulled personality, and unable to function on their own.
當時,這種手術還不是很成熟,患者做完手術常常感覺昏昏欲睡,反應遲鈍,無法自主工作。
Thankfully—like, really thankfully—we know a lot more about the brain now than we did back then,
謝天謝地,現在我們對大腦的了解比以前多得多,
and our technology has gotten better as well.
技術也更加純熟。
Today, surgery for neurological and psychiatric conditions is a lot more specific and targeted.
今天,神經和精神疾病的外科手術更加明確具體,治療上更有針對性,
It's also much safer, and really only used when other treatments, like medication, don't work.
也更安全,而且只在其他治療方法(如藥物)不起作用時才加以使用。
One of these surgeries is the corpus callosotomy, also known as a split-brain surgery.
其中一個手術是胼胝體切開術,也被稱為裂腦手術。
This procedure involves severing the corpus callosum, the band of nerves that connects the two hemispheres of the brain.
治療過程包括切斷胼胝體——連接大腦兩半部分的神經帶。
It's designed to help those with severe epilepsy when typical medications and treatments aren't working.
治療對象是那些典型藥物和臨床治療無效的重癥癲癇患者。
Specifically, the surgery helps ease seizures, which are caused by abnormal electrical firing in the brain, from spreading from one hemisphere to the other.
具體而言,這種手術有助于緩解由腦中異常點火從一半擴散至另一半引起的癲癇發作。
It won't stop the seizures completely, but it will at least keep them confined.
它不會完全根治,但至少會限制發作頻率。
And the good news is, it's effective. In a 2013 study in the journal Neurosurgery,
好消息是,這種治療是有效的。2013年發表在《神經外科》雜志上的一項研究中,
50 people who went through the procedure had a statistically significant drop off in the frequency and severity of seizures.
據統計,50名接受該手術的患者癲癇發作的頻率和嚴重程度均有所下降。
And the outcomes were even better if they had the procedure done when they were younger.
如果他們在年輕時完成手術,結果會更好。
Also importantly, this surgery helps reduce atonic or drop seizures:
重要的是,這種手術有助于減少張力或癲癇發作:
seizures where the person loses control of their muscles and falls to the ground, putting them at risk for injury.
癲癇發作時,患者會無法控制肌肉,摔倒在地,有受傷危險。
We don't really know why they happen, but corpus callosotomys reduce their frequency.
我們不知道為什么會發生這種癥狀,但是胼胝體減少了發癥頻率。
That 2013 study found that 40% of the patients had no more drop seizures after the surgery, and 64% had the frequency reduced.
2013年,一項研究發現,術后40%患者的癲癇癥不再發作,64%的患者癲癇發病率降低。
And in a 2014 study of 26 patients in the journal Epilepsy & Behavior, drop attacks went down by half or more in 65% of patients.
2014年發表在《癲癇與心電圖》雜志上的一項針對26名患者的研究表明:65%患者的發病率降低了一半或者更多。

治愈大腦

Now, there are side effects and risks to the procedure, like headaches, stuttering or other trouble with speech, and coordination problems.

如今,這種手術有副作用和風險,比如頭痛、口吃或其他語言障礙,以及協調問題。
But reducing seizures typically improves quality of life dramatically, so for some patients, it makes the most sense.
但癲癇發病率的減少通常會顯著改善生活質量,因此對一些患者來說,這是最有意義的。
Surgery is also used to treat severe cases of obsessive compulsive disorder, or OCD, which causes recurrent,
外科手術也用于治療重癥強迫癥,這種病會復發、
intrusive thoughts and repetitive behaviors.
影響人的思想和做出重復性行為。
Scientists are increasingly confident that the neurological root of the disorder is a small hook of tissue towards the front of the brain called the anterior cingulate cortex.
科學家們愈加相信,這種神經疾病的根源來自大腦前部的一個叫做前扣帶皮層的小鉤。
This region, also called the ACC, is involved with the regulation of emotion.
這個區域,也被稱為前扣帶腦皮質,與情緒調節有關。
It serves as a connector between the brain's limbic system, which deals with emotions, and the prefrontal cortex, which handles cognitive control.
它連接著大腦邊緣系統(處理情緒)和前額皮質(處理認知控制)。
In OCD, the ACC is hyperactive. So people whose OCD isn't treatable with medications or therapy sometimes undergo surgery to try and modify its activity.
在強迫癥中,前扣帶腦皮質極為活躍。因此,強迫癥患者不能通過藥物或療法進行治療,有時需進行手術,嘗試改變其行為。
One way to do this is by using deep brain stimulation, or DBS:
一種治療方法是進行腦深層刺激手術——
a procedure that places a small electrode inside the brain by the target brain region.
將一個小電極按目標大腦區域放置在大腦內部。
The electrode sends out pulses to disrupt abnormal activity in that region and restore normal patterns,
電極發出脈沖干擾該區域的異常活動并使其恢復至正常模式,
and multiple studies have shown that it helps manage symptoms.
多項研究表明,腦深層刺激手術能有效控住癥狀。
From what we can tell, it's also safe in the long term, according to a follow up study on six patients published in 2016 in PLOS One,
根據2016年發表在《公共科學圖書館·綜合》上的一項針對6名患者的后續研究,從長遠來看,該手術也是安全的,
and it improves the quality of life for patients.
能提高病人的生活質量。
Like all brain surgeries, it does come with its side effects, like headaches or lightheadedness,
和所有的腦部手術一樣,腦深層刺激手術也會帶來副作用,比如頭痛或頭暈,
but many of them can be managed by adjusting the frequency and strength of pulses.
但大多可以通過調整脈沖的頻率和強度來控制。
Finally, deep brain stimulation is also used to treat Parkinson's,
最后,腦深層刺激手術也用于治療帕金森氏癥,
to help ease the tremors and movement problems characteristic of the disease.
幫助緩解患者的顫抖和活動問題。
Many Parkinson's symptoms are caused by the death of neurons in the brain that produce the neurotransmitter dopamine.
許多帕金森氏癥的癥狀是由大腦中產生神經遞質多巴胺的神經元死亡引起的。
Dopamine regulates several pathways in the brain, including ones involved in movement.
多巴胺調節大腦中的各個通路,包括活動的通路。
So without enough of it, multiple brain regions become overactive.
因此,如果多巴胺減少,多個大腦區域就會變得過于活躍。
To treat symptoms, surgeons will sometimes cut or burn out those regions,
為了治療這些癥狀,外科醫生有時會切除這些區域,
but deep brain stimulation is safer and more easily adjusted,
但是腦深層刺激手術因其更安全,更易于調整,
so it's become the preferred procedure.
所以成為治療首選。
DBS can't replace that lost dopamine or anything, but like with OCD, it can help normalize brain activity by stopping those extra signals.
腦深層刺激手術無法更換失去的多巴胺或任何事物,但就像強迫癥一樣,它可以通過阻止這些額外的信號來恢復大腦的正常活動。
And it seems to work. A 2014 meta-analysis of six trials, which included over 1000 patients,
這似乎很有效。2014年的一項薈萃分析對6項試驗進行了分析,其中包括1000多名患者,
found that it significantly improved motor signs of Parkinson's, functionality, and quality of life.
發現它能顯著改善帕金森病的運動癥狀、功能和生活質量。
And similar results have been replicated in more recent studies, too.
最近的研究結果也與此類似。
All this goes to show that, even if the brain is a unique and special part of the body, it's also just another organ.
所有這些都表明,即使大腦獨一無二,它也只是我們身體的一個器官。
Sometimes, diseases and disorders make it work against you, and surgically changing it can be the best way to heal.
有時疾病使身體不受我們控制,手術可能是最好的治療方法。
Thanks for watching this episode of SciShow Psych! If you'd like to learn more about surprising neurological treatments,
感謝收看本期的心理科學秀。如果你想了解更多關于神經治療的知識,
you can watch our episode about — of all things — LSD.
可以觀看我們關于LSD的節目內容。

重點單詞   查看全部解釋    
specific [spi'sifik]

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adj. 特殊的,明確的,具有特效的
n. 特

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band [bænd]

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n. 帶,箍,波段
n. 隊,一群,樂隊

 
widespread ['waidspred]

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adj. 分布(或散布)廣的,普遍的

 
intrusive [in'tru:siv]

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adj. 打攪的,侵擾的

 
recurrent [ri'kʌrənt]

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adj. 再發生的,周期性的,循環的

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coordination [kəu'ɔ:di'neiʃən]

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n. 協調

 
unique [ju:'ni:k]

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adj. 獨一無二的,獨特的,稀罕的

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hemisphere ['hemisfiə]

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n. 半球

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frequency ['fri:kwənsi]

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n. 頻繁,頻率

 
healing ['hi:liŋ]

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n. 康復,復原 adj. 有治療功用的

 
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