8 ms·

"If brain activity is suboptimal, the device provides a small zap, undetectable to the patient, to strengthen the signal and increase the chance of memory forma

by warent 7y ago

"If brain activity is suboptimal, the device provides a small zap, undetectable to the patient, to strengthen the signal and increase the chance of memory formation." I always wonder if things like this are worded like so for the layperson to understand? Because to me it sounds like an incredibly crude and hackish way to do anything. "Yeah, just shock the brain and it forms better memories! We're not entirely sure how or why, or what the implications are, but it seems to work for some reason!"

temikus 7y ago
You’d be surprised but that’s how a lot of medicine works. Your common paracetamol (Panadol) has a mechanism of action that is “not completely understood”. We’ve come a long way in the past 100 years but certain areas are still pretty much trial and error.
- manjana 7y ago
  Same goes for our theory regarding depression for instance. We say the cause is a chemical imbalance, but this has never been measured; same goes for many mental conditions since it's next to impossible to measure the causal element given it's happening inside the brain.
  - jdietrich 7y ago
    >We say the cause is a chemical imbalance "We" don't say that; pharmaceutical sales reps say it. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020392 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
    - grumdan 7y ago
      In particular, this shows that it's not that it's not been measured. It's been measured and not found to be an incorrect explanation of what's happening.
- puranjay 7y ago
  So much of medicine is like this. My in-laws are doctors and so many of their diagnoses eventually end up as "we have no idea what's happening, but these steroids should help. Why, we have no clue."
  - nerdponx 7y ago
    And yet doctors reject all manner of so-called "alternative" therapies on the grounds that they have no plausible mechanism of action. A family member of mine had a somewhat-debilitating chronic condition in high school, which only got better with a combination of what today are garden-variety alternative therapies (acupuncture, elimination diet, et al). Today, as a doctor, pooh-poohs a lot of that stuff. It's confusing and disappointing to see.
    - bradleyjg 7y ago
      Do a well designed study and it won’t be “so called ‘alternative’” anymore. We may not know why various real medical interventions work but we have better than “I’ve got a cousin” evidence that they do.
      - alexandercrohde 7y ago
        I can't speak to this from personal experience, but I constantly hear the accusation that any sort of solid study on say herbals is going to cost millions of dollars, and that no big-pharma company would even bother to sponsor such a study because they can't patent the result (because it's an herb).
        bradleyjg 7y ago
        There’s at least one pot based drug on the market. So I think there must be some way to profit from medicines that were known anecdotally to be medicinal in herb form.
        krageon 7y ago
        They could patent a delivery mechanism, or isolate some compounds from the herb that work almost as well (that's not exactly an unusual result either). These arguments fall down because they don't make any sense.
antonvs 7y ago
You get better memory, and the PTSD is a free bonus!
- Kirth 7y ago
  Just buy our other product to remove unwanted memories ;)
  - apoph3nia 7y ago
    "Is it live, or is it Memorex?"
ForHackernews 7y ago
A huge amount of medicine, and especially neuroscience, is like this. Nobody really knows why ECT works, for instances. Similarly, I don't think the mechanism behind TMS is well understood: https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulation https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulat...
- imperio59 7y ago
  That's because ECT and TMS don't work and have never been proven to be safe and effective by clinical trial. They were "grandfathered in" by the FDA but don't actually work and cause memory loss amongst other terrible side effects. See http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citizen-Petition.pdf http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citi...
  - ForHackernews 7y ago
    You shouldn't conflate those two, as they're very different things. TMS is currently undergoing lots of trials. ECT does have significant negative side effects, but it does seem to help some people. You may be right that it wouldn't be approved as a new treatment today.
    - Amygaz 7y ago
      Just a word of caution, keep in mind that all those trials are designed around very crude observation or short term duration. Also, lot of things are going into trial that shouldn't. That being said I do have an uncle with Parkison who had a neurostimulator implanted (DBS) 15 years ago. It worked quite well for a while, more than any medication at the time. It doesn't anymore, and he has lost cognitive abilities also, which is most likely due to the progressive nature of the disease, rather than DBS. This technique has been in clinical trial for 20+ years...
      - epmaybe 7y ago
        Side note regarding DBS: There's some interesting research in grafting a nerve (I could be misremembering, but it's definitely a nerve graft) onto the substantia nigra (a part of the brain that we know produces dopamine), and then doing DBS on that region. Early stages, phase I trial, but a neat idea nonetheless.
d2161 7y ago
Yep that's cuz we practice Evidence Based Medicine. If it works, it works, we don't care for the mechanism. Mechanism of action is only ever a hypothesis anyways. But as a 2nd point, we don't always do things by evidence either. Obstetrics is an example of an entire field where there is not much evidence, and people practice what was passed down to them. The reason is because often you cannot do an RCT in an ethical way with Obs. Additionally, often times when we prescribe a medication/treatment, there is a really significant chance it won't do anything for you. The number needed to treat before one person experiences a benefit could be quite high, like 10 or 15. We still do it if the benefit outweigh the risk. TLDR: We don't care how it works just that it works. Some fields like obstetrics have little evidence for many things. And just cuz there is evidence, doesn't mean it'll help most of the ppl who get it.
- rczhang 7y ago
  This is not Evidence-based Medicine. EBM does not say to we shouldn't care about the mechanism of action. EBM will say that treatments without a randomized control trial can only be weakly recommended. In a perfect EBM world, everything would be strictly tested. You're describing why we have trouble practicing "pure" EBM.

by warent 7y ago

temikus 7y ago

You’d be surprised but that’s how a lot of medicine works. Your common paracetamol (Panadol) has a mechanism of action that is “not completely understood”. We’ve come a long way in the past 100 years but certain areas are still pretty much trial and error.

manjana 7y ago
Same goes for our theory regarding depression for instance. We say the cause is a chemical imbalance, but this has never been measured; same goes for many mental conditions since it's next to impossible to measure the causal element given it's happening inside the brain.
- jdietrich 7y ago
  >We say the cause is a chemical imbalance "We" don't say that; pharmaceutical sales reps say it. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020392 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
  - grumdan 7y ago
    In particular, this shows that it's not that it's not been measured. It's been measured and not found to be an incorrect explanation of what's happening.
puranjay 7y ago
So much of medicine is like this. My in-laws are doctors and so many of their diagnoses eventually end up as "we have no idea what's happening, but these steroids should help. Why, we have no clue."
- nerdponx 7y ago
  And yet doctors reject all manner of so-called "alternative" therapies on the grounds that they have no plausible mechanism of action. A family member of mine had a somewhat-debilitating chronic condition in high school, which only got better with a combination of what today are garden-variety alternative therapies (acupuncture, elimination diet, et al). Today, as a doctor, pooh-poohs a lot of that stuff. It's confusing and disappointing to see.
  - bradleyjg 7y ago
    Do a well designed study and it won’t be “so called ‘alternative’” anymore. We may not know why various real medical interventions work but we have better than “I’ve got a cousin” evidence that they do.
    - alexandercrohde 7y ago
      I can't speak to this from personal experience, but I constantly hear the accusation that any sort of solid study on say herbals is going to cost millions of dollars, and that no big-pharma company would even bother to sponsor such a study because they can't patent the result (because it's an herb).
      - bradleyjg 7y ago
        There’s at least one pot based drug on the market. So I think there must be some way to profit from medicines that were known anecdotally to be medicinal in herb form.
      - krageon 7y ago
        They could patent a delivery mechanism, or isolate some compounds from the herb that work almost as well (that's not exactly an unusual result either). These arguments fall down because they don't make any sense.

antonvs 7y ago

You get better memory, and the PTSD is a free bonus!

Kirth 7y ago
Just buy our other product to remove unwanted memories ;)
- apoph3nia 7y ago
  "Is it live, or is it Memorex?"

ForHackernews 7y ago

A huge amount of medicine, and especially neuroscience, is like this. Nobody really knows why ECT works, for instances. Similarly, I don't think the mechanism behind TMS is well understood: https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulation https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulat...

imperio59 7y ago
That's because ECT and TMS don't work and have never been proven to be safe and effective by clinical trial. They were "grandfathered in" by the FDA but don't actually work and cause memory loss amongst other terrible side effects. See http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citizen-Petition.pdf http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citi...
- ForHackernews 7y ago
  You shouldn't conflate those two, as they're very different things. TMS is currently undergoing lots of trials. ECT does have significant negative side effects, but it does seem to help some people. You may be right that it wouldn't be approved as a new treatment today.
  - Amygaz 7y ago
    Just a word of caution, keep in mind that all those trials are designed around very crude observation or short term duration. Also, lot of things are going into trial that shouldn't. That being said I do have an uncle with Parkison who had a neurostimulator implanted (DBS) 15 years ago. It worked quite well for a while, more than any medication at the time. It doesn't anymore, and he has lost cognitive abilities also, which is most likely due to the progressive nature of the disease, rather than DBS. This technique has been in clinical trial for 20+ years...
    - epmaybe 7y ago
      Side note regarding DBS: There's some interesting research in grafting a nerve (I could be misremembering, but it's definitely a nerve graft) onto the substantia nigra (a part of the brain that we know produces dopamine), and then doing DBS on that region. Early stages, phase I trial, but a neat idea nonetheless.

d2161 7y ago

Yep that's cuz we practice Evidence Based Medicine. If it works, it works, we don't care for the mechanism. Mechanism of action is only ever a hypothesis anyways. But as a 2nd point, we don't always do things by evidence either. Obstetrics is an example of an entire field where there is not much evidence, and people practice what was passed down to them. The reason is because often you cannot do an RCT in an ethical way with Obs. Additionally, often times when we prescribe a medication/treatment, there is a really significant chance it won't do anything for you. The number needed to treat before one person experiences a benefit could be quite high, like 10 or 15. We still do it if the benefit outweigh the risk. TLDR: We don't care how it works just that it works. Some fields like obstetrics have little evidence for many things. And just cuz there is evidence, doesn't mean it'll help most of the ppl who get it.

rczhang 7y ago
This is not Evidence-based Medicine. EBM does not say to we shouldn't care about the mechanism of action. EBM will say that treatments without a randomized control trial can only be weakly recommended. In a perfect EBM world, everything would be strictly tested. You're describing why we have trouble practicing "pure" EBM.