Jun 25, 2016

Brain Parts, Whole Transplant, or a Completely New Head for Stroke Survivors? Um, Seriously?

I was having a rotten day. The mail guy came early and, as a result, my payment was one day late; I received the wrong change at the supermarket that ended up being a thirty-minute wait to get the error corrected; and the bank, PNC, wouldn't eliminate the overdraft charge of $36.00 because it was the website's fault. Small potatoes, right?

Yeah. I suppose so, but that realization came a few days later. A bad day for most stroke survivors means a rise on the anxiety scale and frustration "outta here!" Not all stroke survivors have high anxiety, but most, especially in the beginning. So I got to thinking, I need new parts for my brain to calm the matter. My injuries were to the frontal and parietal lobes. Could I replace them? I was "out there" and knew it, but I did some research to find out anyway.

The first article I came across was this: First Successful Brain Transplant, I read, written

"Recently, scientists at the University of California – North by Northeast performed the first successful human brain transplant.

"Said the lead neurosurgeon, Dr. Cranial Head, MD, 'This is a breakthrough of unprecedented magnitude. I’m ecstatic that all our research and hard work finally paid off. We couldn’t be more pleased with how things turned out.'

"The patient, who only agreed to be called Jose Ivanovich O’Malley, III for anonymity reasons, suffered a massive anterior communicating arterial stroke that left him severely incapacitated. He was a veterinarian at a local clinic before his stroke. His family heard about the research Dr. Head’s team was doing with rats and contacted him about the possibility of his first human subject. Dr. Head agreed immediately, 'I saw this as the perfect opportunity to advance our research out of animals and into humans. We’ve had great success – recently – with brain transplants in rats so it was only logical to start human trials.'

“This new brain transplant surgery is quite remarkable, actually,” said Dr. Head. “My colleague, Dr. Inis Wu, and I first came up with the idea 40 years ago while we were competing in a triathlon. It came out of the blue, really, neither of us are quite sure why we thought of it but here we are.

"What’s remarkable about the surgery is that it is done all under local anesthetic and the patient is kept talking throughout the procedure, except for the time when the brains are switched (during this time the patient is placed on life support).

"In this case, the transplanted brain came from a local high school physics teacher who suffered a sudden and unexpected heart attack. He was not only young but also in good health. His family has chosen to also remain anonymous. The transplanted brain is removed from the original body and cooled to halt neuronal death. The end of the severed spinal column is treated with a new nanoglue that automatically starts splicing individual axons to the new spinal cord when the transplant brain is placed on top.

“It’s incredible,” said Dr. Head, “we actually don’t have that much work to do because with this new nanoglue the process of reconnecting nerve fibers is automatic. It only takes 4 minutes. We just inspect the brain and spinal cord to make sure everything is lined up correctly. The nanoglue is also applied to areas like the optic nerves, that need to be spliced into the new brain."

"After the surgery, Jose made a speedy recovery. Within 24 hours he was moving his limbs and within a week he was walking and talking. His wife said, 'It’s a miracle. We thought that Jose was gone forever but Dr. Head saved him. He doesn’t know who any of us are, of course, because he has a new brain but we are all willing to work with the new Jose and learn to love him and hope he will learn to love us.' When asked if he planned on returning to work, Jose stated that he couldn’t wait to return to teaching physics. 'I’ve always had a love of physics. There’s something about gravity research that really attracts me.' Jose doesn’t remember any of his past self or his work as a veterinarian but has accepted the story of the doctors and his new family.

"Disclaimer: the previous post is meant to be humorous. Surgeons have not performed and cannot at the present time perform brain transplants. It is not possible to perform a brain surgery at this time, regardless of what you might have read online or heard."

Uh, that comment really wasn't necessary, I said to myself. Dr. Cranial Head gave it away. And so did the erroneous anonymity of the patient. I continued researching.

A PBS Nova segment focused on growing brains, or parts of them, in the laboratory setting. Tony Atala, director of the Wake Forest Institute for Regenerative Medicine and head of one of the premier tissue-engineering labs in the country, says, "That's kind of out there. As a scientist, you never say never, because you never know what will be within the realm of possibility several centuries from now. But certainly to replace a lobe today, that would be science fiction with current technology."

How about an entire head transplant? Paul Root Wolpe, a bioethicist at the Emory Center for Ethics at Emory University, said, "You are talking about a fundamental kind of change whereby a body becomes simply a means of supporting a head, where your sense of what it means to be a whole human being has been compromised in a very new way," he says.

Wolpe continues, "One's very sense of selfhood would be at stake. In the West we tend to think of the brain as the locus of self, but culturally that is a very new idea, and it's still not shared in many cultures, he says. Consider Japan, where the locus of self is thoracic and abdominal. That's why when you commit seppuku you disembowel yourself, you don't cut your head off, because you're attacking yourself at the seat of selfhood.

"The notion that if you put his head on someone else's body that the resulting individual would be him and not the other person simply because the hybrid had his brain is. What you may end up finding is that when you transfer a brain from one body to another, the resulting organism is not solely what one would think of as the person whose brain it was but also has enormous components of the person into whose body it goes."

Wolpe adds, "It means wiping the slate clean and now having a pre-birth-level brain in a 60-year-old person or whatever. I'm not sure of the medical problem that that solves."

[Neither do I].

The Huffington Post posted this article: Human Head Transplants Now Possible, Italian Neuroscientist Says. [Now we're getting somewhere].
"In a provocative [uh oh] new paper, an Italian neuroscientist outlines how to perform a complete human head transplant, arguing that such a surgical procedure is now within the realm of possibility.

Dr. Sergio Canavero, of the Turin Advanced Neuromodulation Group in the project called GEMINI which was published in the journal Surgical Neurology International, says, “The greatest technical hurdle to such endeavor is of course the reconnection of the donor’s and recipient’s spinal cords. It is my contention that the technology only now exists for such linkage. This paper sketches out a possible human scenario and outlines the technology to reconnect the severed cord."

He went on to say, with the prohibitive cost of $13 million, the procedure might be addressed. And even some commenters on Reddit said they would be willing to donate their heads if given the option. [And so, once again, the wackiness starts].

Dr. Canavero said that "a clean-cut must be performed to disconnect and reconnect the donor’s head at the spine. Then, special adhesives—such as polyethylene glycol (PEG)—would be used to fuse the donor’s head and spine to the recipient."

But not everyone is so inclined to go along with Dr. Canavero's plans.

“It’s complete fantasy, that you could use PEG technology in such a traumatic injury in an adult mammal,” Dr. Jerry Silver, a neurologist at Case Western Reserve University told CBS News. “To sever a head and even contemplate the possibility of gluing axons back properly across the lesion to their neighbors is pure and utter fantasy in my opinion. This is bad science, this should never happen.”

Think about it for a minute. We would have gotten rid of our selves, the people in your life you love,  the people you despise. We would have brand new neuroses and/or psychoses. The easiest part would probably be re-connecting blood supplies, but the broken nerves in the central nervous system and the spinal cord in a mammal? 

That's complicated stuff right there.