The Dangerous Joy of Dr. Sex and Other True Stories
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So Gromley went back to his experiment. Flash, flash, flash. He rearranged the electrodes several times before he found the sweet spot.
“Do you remember the first time you drank coffee? It was like, ‘Oh my god, if I’d known how good this was, I’d be drinking coffee all the time.’ Well, [tDCS] wasn’t exactly like the first cup of coffee,” Gromley says. “It was more like a cup you might have in the first month of drinking coffee. It’s like, ‘Hmm, I don’t feel bad. I feel alert. I feel up.’” Actual coffee had long ago ceased to pull Gromley out of his depression, but now he had the electronic kind. He used the machine about once a day for a month, and then he found that he no longer needed it much. Lately, he’s been spending long hours at work—too busy to be depressed.
Of course, one man’s Radio Shack adventure does not a study make, and the effects that Gromley felt could as easily be attributed to the placebo effect as to a tickle of electricity. Needless to say, the researchers I talked to cautioned against trying this sort of thing at home, although they had a grudging respect for anyone with the pluck to do it. “In the past, a lot of scientific discoveries were made by amateurs who experimented on themselves,” according to Peter Bulow, a psychiatrist at Columbia University. He said that a recent safety study found that tDCS causes no damage to brain tissue, but cautioned that any cutting-edge treatment comes with unknown risks. Bulow himself has just submitted a proposal to study the effects of tDCS on 20 depressed patients.
He’s in good company. Teams of researchers are experimenting with battery-powered electrodes at the National Institutes of Health, the Harvard Center for Noninvasive Brain Stimulation, and at the University of Göttingen in Germany, among other centers. They’re exploring tDCS as a treatment for depression, chronic pain, addiction to cigarettes, Parkinson’s disease, as well as motor disorders caused by stroke and neurodegenerative diseases. The gizmo, still only a few years old in its present incarnation, has become the Ronco Brain-O-Matic of the research world: a device that promises endless uses. But it remains to be seen whether it will prove itself as a truly effective therapy for any one disease.
In 1962, a 30-year-old woman shuffled around a hospital in England with a battery pinned to her dress. Two silver electrodes, wrapped in gauze, winked above her brow, like a second set of eyes. She’d spent half her life in mental asylums: when she was a girl, her father had shot himself, and afterward she’d become convinced that other people could see a mark upon her. Nothing had lifted her malaise: not even shock treatment. When she arrived at Summersdale Hospital, she muttered “Get rid of me” in response to questions. Researchers (J.W.T Redfearn and O.C.J. Lippold) attached the two positively charged electrodes to her forehead, with the cathode on her knee, to see whether they could use battery power to ease her out of her depression. They kept her brow area bathed in electricity for as many as eleven hours a day, three treatments a week. She began to sleep soundly, no longer tormented by nightmares; she ate well; she prettied herself up; she found a boyfriend. She became, the researchers said, a “different person.”
That year, she was just one of several dozen people wandering the halls of Summersdale Hospital with electrodes plastered to their foreheads and batteries on their lapels like boutonnieres. In an earlier study, Lippold and Redfearn had found that they could change the personalities of their subjects with electrical stimulation: positively charged electrodes on the forehead caused people to giggle and chat. Under the influence of negatively charged electrodes, people shut down, became silent and apathetic. Some of the patients had so enjoyed the positive electrodes that they asked for the “battery treatment” again. And so Lippold and Redfearn launched this new study; this time they would expose people—many of them severely depressed—to long sessions of electrical stimulation. The patients were allowed to go home with electrodes glued to their heads, the battery still buzzing. Almost half of them experienced miraculous recoveries. A shell-shocked World War II veteran compared the effects to a snoot of a whiskey—“I feel quite all right,” he crowed, after he’d been stimulated.
In the decade that followed, other researchers tried to replicate these effects. They produced inconsistent results. Nowadays it’s clear why: researchers applied currents that were too small and glued electrodes to the wrong parts of the scalp. “They used some parameters of stimulation that we know now are not effective. They didn’t have the information that we have now,” according to Felipe Fregni, an instructor in Neurology at Harvard Medical School. Because the battery-powered electrodes seemed to be unreliable, the medical community lost interest in brain polarization.
Then, in the 1980s, researchers found a much more powerful way to stimulate isolated buttons of the brain. Called repetitive transcranial magnetic stimulation (rTMS), the technique uses electromagnetic radiation—which can easily pass through the skull—to create localized electrical fields near the surface of the brain. The effects of rTMS are dramatic and reproducible. Place the machine’s wand on one part of the scalp and the patient will lose her ability to talk; move the wand to another spot and her leg will jerk.
In essence, rTMS is a souped-up version of the old battery-and-electrodes treatment. But it also comes with greater risks: it can trigger seizures, an arm that won’t stop shaking or a patient who slumps over in his chair. However, such side effects are rare, and rTMS has proven to be a powerful tool for mapping the brain and modulating brain activity; in the 1990s, researchers began using it (along with other new technologies) to draw blueprints of neural function. This new knowledge, in turn, meant that the battery treatment became relevant again—because now scientists could design a more effective tDCS machine. In the late 1990s, a team at the University of Göttingen enlarged the electrodes and covered them in sponges in order to allow more current to pass through the skull. They also created new protocols for placement of the electrodes, aiming them with greater accuracy at hotspots such as the motor cortex. Just a few years ago, these design changes began to pay off in studies that showed promising results: the new, improved battery treatment could quicken the tongue and the hand. It could make people smarter and faster, if only by a small margin. When German researchers trained the positive electrode on the motor cortex, their human subjects became significantly faster at learning to hit a keyboard in response to a visual cue.
Other researchers confirmed this provocative finding: brain stimulation could enhance performance in healthy people. For instance, a 2005 study from the National Institute of Neurological Disorders and Stroke (NINDS, an affiliate of NIH) found that tDCS stimulation revved up people’s verbal abilities. They were able to generate longer lists of words starting with, for instance, F or W within a time limit. This has implications for victims of stroke and other neurodegenerative conditions—if tDCS can enhance the performance of healthy people, perhaps a machine could help pull lost words and hand movements out of damaged brains. For some patients, a wearable brain machine represents one of the few, dim hopes for recovery.
Georg Gabriel leans back in an office chair, so that it makes little creaking sounds underneath him. We’re in a narrow room in an NIH complex. A lab assistant is standing behind Gabriel, running a tape measure around his scalp and carefully parting tufts of his white hair to mark him up with a Sharpie pen. Gabriel, who has been measured and Sharpied a lot these days, barely notices. “They told me that my life expectancy with this affliction was about five years,” he tells me, with disarming good cheer. He’s pink with apparent health, this 78-year-old man who until recently swam several miles a week. This morning, for his last session of tDCS testing, he’s dressed in business casual: button-down shirt, “Nantucket red” slacks faded to a soft pink and boat shoes. He looks entirely put together. What you can’t see is his brain: the nerve cells are dying off throughout the cortex; and the parietal lobe—that switching-house of sensation—may have already shrunk down. Gabriel has a rare condition called corticobasal syndrome, a degeneration of brain tissue with symptoms that often mimic Parkinson
’s disease. His movements are slow and dreamy. Earlier this morning, the lab worker put him through a battery of tests to rate his motor skills. On a finger-tapping test, Gabriel punched at a lever with such labored movements that I found myself leaning forward in my seat, willing him on.
Now the lab assistant glues one sponge electrode just above and behind Gabriel’s left ear and another above his right eye; Gabriel is about to perform all the tests again, this time under the influence of tDCS stimulation. While the lab worker winds tape around his head, Gabriel tells me that the NIH researchers have asked him for permission to do an autopsy on his brain. He remarks, crossing one leg over the other casually, that he’s inclined to give it to them. “That’s a ‘no brainer’ decision,” he quips, and then chortles at his own joke.
When the tDCS machine is on, Gabriel says he can’t feel it at all. No tingling. No nothing. Neither Gabriel nor I know whether this is a “sham” stimulation or real. The electrodes might be attached to some area of the scalp where they would have little effect on motor function, or they could be aimed at prime real estate in the brain, one of the spots that the researchers hope will respond to exactly this kind of stimulation.
During most of the testing—Gabriel has to kiss the air, pretend to vacuum and wave goodbye—he continues to move in slo-mo. But on the finger-tapping test, he suddenly seems to gather himself. He looks as if he’s been put on fast-forward, his hand jerking so fast that it doesn’t seem part of him. His high score without the electrodes was 49; now, electrified, he fires off 66 taps. Even the lab assistant blinks with surprise.
After the testing is over, we learn that Gabriel was in fact receiving real rather than sham stimulation. Today, the positive electrode was placed over the area of the scalp that corresponds to the parietal lobe. However, until the data is compiled for all the patients in the study—and further studies that will surely follow this one—it’s impossible to say whether DC stimulation can in fact enhance the plasticity of damaged brains.
“All of our good results to date have been in healthy subjects. I haven’t seen convincing evidence that you can do much to help a brain that is badly damaged. It may be that there’s no point in trying to polarize busted tissue,” according to Eric Wassermann, the chief of brain stimulation in the Office of the Clinical Director at NIH’s NINDS and one of the designers of this study. Despite inconsistent results so far, he and other researchers continue to explore DC stimulation for patients with widespread brain degeneration.
Such patients have been bypassed by recent advances that have helped, for instance, sufferers of Parkinson’s Disease. In the past few years, surgeons have begun to use a technique called deep brain stimulation (DBS) to quiet the tremors and stiff gait that become debilitating during a Parkinsonian decline. After drilling small holes in the scalp, the surgeon threads wires deep into the brain to implant a chip near the cluster of cells that is sending out errant signals. For Gabriel, such a focal intervention would not work. In cases such as his, where disease sprawls across a lobe, tDCS could offer an edge. And, too, a cheapo electrical thinking cap, if it works, would offer a huge advantage over other stimulation techniques: No drills bore through the skull. No wires snake through brain tissue. No pacemaker-like machines get implanted under the skin.
I ask Wassermann what the tDCS machine might look like, if it ever hit the market—would it resemble an iPod?
“The brain-pod!” Wassermann jokes. “It should play music, receive calls and…shoot like a gun.” Then he grows serious. “It could be very simple and wearable.”
Wassermann believes that if we’re ever to have a Brain-Pod in the United States, it would likely be tested and developed by the military first. But he doesn’t rule out the chance that a private company would bankroll tDCS, if it continues to perform in the lab. “It is unlikely that any [company] would do this unless they were guaranteed a market share, and the only way they could be guaranteed a market share would be if they had a patent on some important part of the process. I think we know so little about it at this point that there may be patent-able parts.”
However, Wassermann is not eager to put this device into the hands of consumers; he’s concerned about the ethical problems it poses. “I would not be in favor of this being an iPod. Not yet. Not until the issues of safety and fairness have been resolved.”
A while ago, someone suggested to Wassermann that he take some tDCS machines to a nearby university and wire up half the students in a classroom before they took a test. Would the battery-powered kids do better? “I thought the ethics of that sort of application were questionable because you don’t want to advantage people who can afford something that others can’t,” Wassermann says.
Of course, these machines could be as cheap as clock radios or coffee makers. So arguing about the ethics of Brain-Pods might be an exercise in futility; if tDCS turns out to produce strong effects, the machines will pop up everywhere, whether we like it or not. “It’s an interesting phenomenon, if this were an effective treatment, to have it get completely loose,” Wassermann says. “I’m not excited enough about [tDCS] as a panacea or a great social evil at this point to be very worried. But if it were very potent, it will be all over the place. The Chinese would flood the market with gizmos. This could get completely out of control. It could be like blogging. Everybody could be a brain manipulator.”
In October, a group of researchers gathered around a conference table at the Harvard Center for Noninvasive Brain Stimulation. Fregni, his hair slicked to the side in the manner of a 1920s tycoon, wielded a remote control, flashing images onto a white board. About twenty-five scientists—from Thailand, Brazil, Bolivia, Israel, and Germany, among other countries—crowded the room. Most of them knew little about tDCS, and so Fregni was delivering an introductory lecture, what might have been called Brain Zapping 101. The graphs Fregni projected on the wall created a frisson of excitement. The audience oohed and aahed. They lifted digital cameras and snapped photos. You could feel it—the buzz that this technology is beginning to generate among the clique of researchers enchanted by both brains and gadgets.
At the end of his lecture, Fregni announced he would demonstrate tDCS. Did anyone in the audience want to try it out? Silence. The scientists gazed around, waiting for someone else to shoot a hand into the air. And then the room erupted into laughter at the collective reluctance to be wired up.
Before I quite realized what I was doing, I heard myself say, “I’ll do it.” My hand waved in the air, seemingly of its own accord. It was one of those moments when your body reacts while you’re brain lags a second behind. My heart seemed to beat everywhere, my hands, my feet, my face. Why hadn’t anyone else—any of the experts—volunteered? Now, I was teetering toward the front of the room. Shirley Fecteau, another Harvard researcher, guided me to a chair.
She and Fregni placed the sponge-covered electrodes on the top of my head, in the two spots where I might grow bunny ears, if I were a character in a fairy tale. This position, which targets the prefrontal cortex, is used to treat depressed patients. Someone wrapped an Ace bandage around my head so tightly that I began to feel headachy. I have lots of hair, and so the bandage began to slide upward. Someone pushed it back in place and I could feel fingers on my scalp, checking the position of the electrodes. Clearly, the Ace bandage alone wouldn’t do the job. So Fecteau found a giant elastic band and stretched it vertically around my head so it cut into my cheeks. For the rest of the experiment, it squashed my windpipe, like an especially tight strap of a birthday-party hat.
Fregni showed the control box to the audience, a black brick with a meter and a few knobs on its face. The wire from that box dangled along my arm and went up beyond the line of my vision—to my head. That’s when it hit me: They really were going to send electricity through my skull. Fregni turned the switch. The sponge on the left side of my scalp began to prickle, the way poison ivy will after you scratch it. The elastic band made me gasp for breath. The Ace bandage strangled my forehea
d. The room flashed as members of the audience took photos, and I tried not think about how I must look with all the elastic pinching my face and my hair sticking every which way. Rather than an elevated mood—which the treatment was supposed to bring on—I felt mortified to be on display in mental-patient drag.
Fregni kept me hooked up for only five minutes, long enough to demonstrate the equipment but not to have much of a clinical effect. Then he freed me. I shuffled back to my chair, still trying to smooth my wet hair back into place. And now, as if by delayed reaction, euphoria overwhelmed me. I felt all fluttery, as if I’d just stepped off a roller coaster. Maybe the electrodes gave me the high. Or maybe I was just elated to leave the stage. It’s hard to say.
In the midst of my intoxication, a thought came to me: I’ve touched my own brain. Before this moment, I had always thought of my brain as imperious and remote, like a queen who issued commands from a red-velvet room high up in a tower. “Worry ceaselessly!” my brain might decree, and I would have no choice but to obey. But now, I had tried to turn the tables. I had sent my prefrontal cortex a command made out of electricity. “Cheer up!” I’d ordered. And now, maybe, just maybe, it had heard me.
Vermin Supreme Wants to Be Your Tyrant
Vermin Supreme—a 43-year-old activist and street-theater performer—swaggers toward Faneuil Hall to take on the Democrat groupies. Inside the building tonight, nine candidates will debate each other live on CNN. Vermin Supreme plans to stay outside, where the TV trucks splash spotlights onto the cobblestones. A tribe of John Kerry people wave blue signs and scream in unison: “Ker-REEE, Ker-REEE.” Many of them wear that mob-zombie expression on their faces—the glassy look of people who have been yelling one word for so long that it has turned into nonsense.