Archive for June, 2008

Jun 12 2008

Real vs Psychogenic Pain

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I recently received the following question:

Dr. Novella,

I’ve been listening to The Skeptic’s Guide to the Universe for over a year now. I’ve recently returned to school for nursing and appreciate the NeuroLogica blog, as well. Words can’t describe how much I look forward to them each week. I don’t know where you find the time to keep up with the blog and the podcast!

I’m sure you receive tons of email everyday, but I’m hoping you’ll have an opportunity to respond to my question through one of your outlets. I live in a “new agey” town where “woo” thinking and southern spirituality often result in non-evidence-based approaches to health. A friend of mine suffered a bad leg fracture 1.5 years ago. She has been relatively immobile and has complained about constant pain ever since. This resulted in a roller coaster of doctors and opiates. She was recently diagnosed with Reflex Distrophy Syndrome. I’ve read a bit about this online and am not sure if this disorder is anything beyond a psychogenic pain manifestation, atrophy, or drug-seeking behavior. Of course, I’m not privy to her medical records and may be missing the whole story. I value your medical expertise and would be thrilled if you could weigh in on RDS/CRPS in general.

I can’t thank you, Rebecca, Bob, Evan, and Jay enough for helping me realize that I am not alone. Please keep up the good work! I continue to look forward to your skeptical contributions.

Sincerely,
Alicia

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Jun 11 2008

The 100 MPG Car

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OK, I’m ready. I want my electric car. I would rather not pay $4.00 a gallon for gasoline (I know, I’m a spoiled American), I would rather not continue to pour carbon dioxide from my tailpipe into the atmosphere, and I am a hopeless technophile and electric cars are just cool.

So I was interested to read that NREL, the National Renewable Energy Laboratory, has created a prototype plug-in solar hybrid that gets 100 mpg. That is exactly what I want my next car to be because it seems that it where the technology is (or at least will be soon). I have been following this technology for a while, and while the tech media generally is heavy on the hype, it seems to me that we are genuinely getting close and this is a viable technology.

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Jun 10 2008

Ether of the Mind: Chalmers and Dennett on Dualism

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Consciousness is undoubtedly one of the most complex and interesting phenomena in the universe. Wrapping our minds around the concept of mind has vexed philosophers and scientists for centuries – perhaps because it is the task of the brain trying to understand itself. This has led to many theories and bizarre beliefs about consciousness – that it is non-physical, that it is due to quantum weirdness, or that it requires new laws of nature to explain. And yet modern philosophers and neuroscientists are increasingly of the opinion that perhaps it’s not such a hard problem after all. Perhaps the real trick is realizing that it’s not even a problem at all.

Yesterday I wrote my most recent reply to Michael Egnor’s rather lame attempt at defending what is called cartesian dualism – the notion that consciousness requires the addition of something non-physical. Ironically he invoked the writings of David Chalmers to his cause, not realizing (or not caring) that Chalmers is a harsh critic of cartesian dualism and rather supports what he calls “naturalistic dualism.” Chalmers believes that the “something extra” required to explain consciousness is a new law of nature, not a non-physical spiritus.

Today I will discuss Chalmers’ proposed solution (actually he points the way to a solution but acknowledges he does not yet have one) and its major critic, Daniel Dennett.

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Jun 09 2008

Michael Egnor, Cartesian Dualism, David Chalmers, and the Hard (non)Problem

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I’m assuming my readers are enjoying reading a debate about neuroscience and dualism between a creationist neurosurgeon and a skeptical neurologist. I hope you are enjoying reading it at least as much as I am writing it. One of the best ways to learn about a topic is to confront your own misconceptions about it or those of others. I have therefore found this ongoing debate between Dr. Egnor and myself to be quite instructive.

Dr. Egnor has issued his latest response, and it is chock-full of instructive misconceptions and misrepresentations. The debate is about a particular version of dualism, which Egnor defends, that states that the functioning of the brain does not and cannot account for everything we observe and experience as our mental selves – consciousness. Therefore something else is needed – something not physical, spiritual if you will. I take the materialist neuroscientific position – that the brain is a completely adequate explanation for consciousness and so far the evidence points consistently in that direction. Further – Egnor’s version of dualism (and perhaps all versions of dualism – more on that later) in fact add nothing to our ability to explain consciousness, in precisely the same way that Intelligent Design adds nothing to our ability to explain the diversity of life.

Confused About Chalmers

Egnor builds his latest blog entry, The Hard and Easy Problems in the Mind-Brain Question, around philosopher David Chalmers. If one relied upon Egnor’s article to understand the dualism debate or David Chalmer’s position in it, this would lead only to profound confusion. Egnor writes:

David Chalmers, a leading philosopher of the mind and a particularly lucid thinker on the matter of consciousness, published a paper in the Journal of Consciousness Studies in 1995 entitled “Facing Up to the Problem of Consciousness.” This seminal paper has given rise to much debate, and I believe that Chalmers clarifies the issues in the mind-brain debate in a very important way.

Chalmers, who is probably best described as a property dualist, notes:

Consciousness poses the most baffling problems in the science of the mind. There is nothing that we know more intimately than conscious experience, but there is nothing that is harder to explain. All sorts of mental phenomena have yielded to scientific investigation in recent years, but consciousness has stubbornly resisted. Many have tried to explain it, but the explanations always seem to fall short of the target. Some have been led to suppose that the problem is intractable, and that no good explanation can be given.

Egnor makes it sound as if Chalmers is defending his position, but he isn’t. Egnor notes that Chalmers would be considered a property dualist, but he does not define property dualism nor explain how it is related to the version of dualism Egnor promotes – Cartesian Dualism. Cartesian dualism, named after Rene Descartes, holds that mind substance is something different than brain substance or physical matter. The mind (at least part of it – that part that cannot currently be reliably measured by science – i.e. god-of-the-gaps) is non-materialist – not matter, and cannot be fully explained by matter.

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Jun 06 2008

Drinking the Anti-Vaccine Kool-Aid

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It’s not enough to mean well. You have to get the science right.

I believe that Jim Carrey and Jenny McCarthy mean well. They think they are saving the world from greedy corporations, corrupt government, and arrogant doctors. In their minds they are enlightened saviors, leaders of a “green” army alerting the rest of us to the dangers of toxins and the malfeasance of those in charge. Yesterday they lead a “green our vaccines” rally in Washington DC to help save the world.

But it’s not enough to mean well. Carrey and McCarthy get the science terribly, hopelessly, and tragically wrong. In fact, meaning well is part of what makes them dangerous. They display that toxic brew of arrogance and self-righteousness, combined with the power of celebrity to do real damage.

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Jun 05 2008

Anti-Aging Science and Fiction

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Last weekend was the World Science Festival in New York City. On the final day of this 5-day event there was a presentation on anti-aging called, 90 is the new 50. The theme of the talk was advances in anti-aging medicine with the bottom line message being that great advances is human longevity are right around the corner.

I certainly hope this is true, but I still take a sideways skeptical glance at such claims. Longevity research is a funny field in that it seems to me to be completely legitimate science and yet it cannot seem to get away from the whiff of pseudoscience that seems to surround it. Why is that?

Part of it, I think, is justified. But let me back up and put things into perspective. Modern medicine (including nutrition, sanitation, and medical treatments) has prolonged life expectancy from around 40 a century and a half ago to around 80 today. So, in essence, science has already produced a significant increase in human longevity. It seems reasonable to expect that this trend will continue as biology and medicine continue to advance.

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Jun 04 2008

Dr. Offit Article on Vaccines and Autism in the NEJM

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Dr. Offit is an infectious disease and vaccine specialist who has been extremely active in defending the science of vaccine safety and effectiveness against ideological attack from antivaccinationists. He has recently published an excellent article in the New England Journal of Medicine in which he reviews the Hannah Poling case – the case of the girl with a mitochondrial disorder who developed encephalopathy following a series of vaccines. He makes many very good points and the entire article is worth reading.

I wrote previously about the Hannah Poling case. This remains a vexing case because it in no way supports the claim that there is a link between vaccines and autism, but it is a complex case and is easily presented by antivaccine activists as if it does support a link. Dr. Offit echoes my position that the details of the case, when put into proper perspective, do not support claims for such a link.

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Jun 03 2008

Monkey Controls Robotic Arm With Its Mind

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This is the next step in the progress toward brain-computer interfaces. Previously researchers had enabled human subjects to control the cursor on a computer screen with an EEG-computer interface. After a significant training period, through thoughts alone the subject could move the cursor on the screen. This seems like a small accomplishment but it was a significant proof of concept. Also, while modest, such an interface could enable quadraplegics to communicate or control external devices, like a wheelchair.

Researchers at Duke University led by project leader Miguel Nicolelis have previously published research in which they trained monkeys to manipulate a cursor onscreen using only a brain interface, without having to move any part of their body.

Last week in Nature online was published the results of similar research from from the University of Pittsburgh led by Dr. Andrew Schwartz. He took the next step by connecting the interface to a robotic arm. First they mapped the activity in the frontal and parietal lobes – the parts of the brain responsible for movement of the arm – while the monkeys moved their limb normally. Then they connected these signals (produced from a few hundred neurons) to a computer controlling a robotic arm. The monkeys were then able to move the robotic arm by moving their own arm. Since the signals had been mapped the researchers were able to match the robotic arm movements to the monkeys own arm. Eventually the monkeys learned how to move the robotic arm without moving their own arm. They were then able to control the arm well enough to feed themselves with it, while they were otherwise restrained and unable to move their own limbs.

This is an exciting development in this line of technology – the interface of brain and computer. This shows how quickly the brain can adapt to controlling an external device, and even separate the movements from the movements of the body. From this point better and more exquisite control is only a matter of more precise mapping and measurement of neuronal firing. This is like coming up with the basic concept of a printed circuit – from there continued progress of computing power was almost assured.

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Jun 02 2008

More on FC in the Courtroom and the Oakland Case

Previously I wrote about the case of parents of a 14 year old cognitively impaired girl who were charged with sexual abuse based upon testimony given through facilitated communication. The case was, by all accounts, an incompetent witch hunt which was fortunately dismissed, but only after great harm was done to the family. I discussed the case as it was reported in the mainstream media, but since then I have had the opportunity to discuss the case in detail with James Todd, an expert witness for the defense in the case, and there are aspects of this case that are significantly different than reported. (In fact the case is even worse than what was discussed.) In this follow up I will give more details about the case and discussion the role of FC in the courtroom in more detail.

Facilitated Communication

First, some more background on FC. The technique involves a facilitator physically holding or aiding a client (called the participant) who is cognitively or verbally impaired to communicate by typing on a keyboard, pointing to letters on a card, or similar method. The method was developed by Australian author Rosemary Crossley in 1980. In 1992 the Facilitated Communication Institute was founded at Syracuse University. By that time the technique was quite popular, but has yet to be studied scientifically. As carefully controlled studies began to emerge, however, it was clear that FC was little more than wishful thinking given action by the ideomotor effect. The communication was being done entirely by the facilitators, not by the clients. By 1994 the American Psychological Association put out a position paper stating that FC has no basis in scientific evidence. Since that time FC has been marginalized and is generally considered to be a harmful pseudoscience.

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