The Role Of The Brain In Addiction

Technology has its mighty hand over every field in the world now. And since the base of technology is science, so how could medical sector not undergo changes! Neuroscience has always been an area of immense complexities and curiosities. Advances in this sector has allowed doctors to dig deeper into the brain and even study minutest of changes that happen due to substance intake.

When we talk about addiction as a brain disease, the reward system of the brain plays a very important role.

Physiologically, limbic system is the brain’s reward system. Mesolimbic and mesocortical pathways (Mid-brain) have our cognitive control and functions which would be both reward related and aversion related. Reward related functions are always stronger and more motivating than aversion, hence drug abuse behavior is stronger in addicts. The reward system connects certain structures in such a way that they generate the feeling of pleasure for certain behaviors or stimulus given to the body. In day-to-day life, it is activated by healthy, life-sustaining activities like eating and socializing. But ‘Drug Abuse’ is another behavior that generates euphoria, which is enjoyed by the mind. And human nature is to repeat those actions that give us some definite satisfaction. The limbic system does more than just giving a reward response. For any behavior to be reinforced, it has to be first registered as pleasant to the mind and body. Limbic system in the brain recognizes our positive and negative emotions, which very well explains, how our body and mind get dependent on any psychoactive mood altering substance.

However, with recent developments, neurobiology has been able to study how addiction is related to the brain. Researchers and scientists studied the brain’s reaction to different substances and discovered that drug abuse actually alters the chemical makeup of the brain, which is what causes addiction and they named it as a ‘Brain Disease.’

Since the brain is placed as the epicenter of human activity, it is the initiation point of every phenomenon that occurs. Whatever we feel, experience or think, all is first registered by the brain and within lesser than nanoseconds, it commands us to act. It communicates through neurons, neurotransmitters, receptors and transporters. Yes, it is very complicated and sounds mystical too (specially to people like me who have not studied biology after high school)

How do Drugs Affect the Brain?
Psychoactive substances interrupt with the communication systems of the brain. They interfere with the way a message is transmitted and sent to its defined destination. No matter how much people say that cannabis would not be called a drug, it is a plant, but the reality remains unchanged, which is, that everything has certain chemical composition. For example, Heroin and Marijuana’s chemical structure are like copies of a natural neurotransmitter. Amphetamines mimic catecholamine neurotransmitters, causing general physiological changes which prepare the body for physical activity and fight-or-flight response. So, the moment the body is intoxicated with a drug containing amphetamines or its derivatives, it starts reacting in unnatural ways by raising blood pressure, increased alertness resulting in sleeplessness, blood glucose levels. They can easily activate neurons, giving various directions to the body to react in a different way, than would a natural neurotransmitter would! Cocaine can make a person delirious, because it releases natural neurotransmitters in bulk and blocks the natural recycling process of neurotransmitters by the brain. Amphetamine causes drug tolerance very quickly and rapidly too.

Chronic addictive drug use causes alterations in the process by which information from a gene is used to synthesize a gene product- RNA or Protein. Nigrostriatal Pathway is a dopaminergic pathway that plays an extensive and unavoidable role in addiction. It comprises of Transcription Factor, which is a protein that controls what all information has to go from the DNA to the messenger RNA. Psychoactive substances block, many of the neural and behavioral alterations that are to be taken to the RNA. Altered dopamine transmission is the first thing that comes to notice in cases of drug abuse.

These have been many studies extensively done by medical science researchers on addiction. There is a wide range of chemicals that people use to reach a euphoric state. But the gist of it all is, that they play with the normal functioning of brain by altering the natural chemicals that ought to be there.

How Does the Reward System Work?
Whenever a person happens to do something that takes him to a different state of mind for a while, like reaching the oomph point in a sexually pleasurable activity, treating the taste buds with a new and a very different flavor or winning an excessive amount of money or any other valuable resource that he could use to be really rich, the brain takes it all in the same way. It activates the same gland and releases the same chemical Dopamine, which functions as a neurotransmitter, in all scenarios that seem to be pleasurable or exciting. Similarly, whenever the body receives an antibody that becomes too exciting for it like any drug, chemical or alcohol, the body releases certain amount of dopamine or cuts down its level. It is a problematic scenario is there is too much or too little of dopamine released by the brain. Drugs are addictive because they release up-to 10 times more dopamine than a natural neurotransmitter can! But when the body gets tolerant to the same drug and its amount, it can even cut down its normal release of dopamine!

Nose Injuries – When There Is No Doctor

Injuries to the nose are not uncommon; yet, when they happen, people tend to panic. Instead of letting the situations “lead you by the nose”, follow these simple first-aid measures, and stay in control:

Your nose is not merely an organ of smell. It’s a filter, a temperature controller, a passageway and sometimes even an alarm system. It is closely connected with your eyes, mouth, ears and head, both cosmetically and physically. So, when it is injured, to treat it you’ve got to look beyond your nose.

“In order to treat any injury to the nose, you must first understand the nature and extent of the injury,” say ENT surgeons. “Basically, there are three kinds of injuries: those that involve the nose and the head; those that affect the nose and the face; those that pertain only to the nose. Only after the kind of injury has been ascertained can proper treatment or first aid follow.”

The first two kinds of injuries are usually the result of a violent, perilous impact, like a fall from a great height, or a road accident. When the nose and the head are injured – and such cases are obvious even to a layman – the damage is serious and can occasionally be fatal. In all probability the victim will be unconscious and to render first aid would be impossible. Your only course of action is to rush the victim to a hospital and leave him in the hands of the doctors.

If the head is not hurt, that is, if the injury is only to the front of the face, then check the extent of the damage. Any injury to the eye directly, or even to the area around the eye, will need a doctor’s attention. You can try to control the bleeding of the nose, if there is any, but the person should be taken quickly to the hospital. Probably he will need the attention of the ENT surgeon and the ophthalmologist.

Injury to the nose and to the area around it, that is, the sides and below, could mean damage to the sinuses and upper jaw. Ask the victim to make as if he is biting on something. Difficulty and pain in moving his mouth indicate probable fracture of the upper jaw. In this case, too, though you could try to control the bleeding from the nose, the victim needs medical attention. An ENT surgeon and a dental surgeon may have to work together to repair the damage. Therefore, such a case should be quickly taken to the hospital.

The third type of injury is more commonplace. In this kind of injury, first aid can be given, but again, it will depend upon the cause and nature of the injury. Injuries to the nose can be broadly grouped as: external wounds; fractures; obstruction by foreign objects; bleeding from the nostrils.

EXTERNAL INJURIES

External injuries like abrasions, bruises, cuts and punctures can be treated as you do wounds. Clean the affected area, apply an antiseptic and bandage. Slight abrasions or cuts will heal with adequate care. Deep and extensive wounds should be shown to a doctor.

Fractures of the nose are easily detectable from the distorted shape of the nose, the constant pain and swelling. Fractures have to be splinted and set right, which can only be done by an ENT specialist.

Those with children will b familiar with the third type of nasal injury – that is, blockage of the passage due to insertion of foreign objects into the nose. “” Often, the child may not be aware that he has done something he shouldn’t have, says ENT surgeon. “”So the object remains in the nose for days and is discovered only when infection sets in. then, either the parents notice that the child’s nose is swelling, or the child complains of pain in the nose.”

However, even if you know that the child has pushed something up his nose, don’t try to extricate it yourself. You could push it in even further. Sometimes, lightly blowing the nose helps to dislodge the object. But if the object is edged, it may scrape or bruise the nose and bleeding may result. So it’s safest to take the child to a doctor, preferably an ENT specialist, as he is better equipped to deal with the problem.

NOSE BLEEDS

Nosebleeds or epistaxis can occur due to a number of reasons: Sudden climatic changes; a rise in blood pressure; a traumatic injury; high fever.

The air we breathe in has to be homogenised to the body temperature of 34°C before it reaches the lungs. The nose acts as a temperature controller. If the air is cold, the nose warms it; if the air is too warm, the nose cools it. In order to help it carry out its function, the nose is heavily lined with blood vessels. The supply of blood depends upon the difference in the body and atmospheric temperatures. When the temperature outside changes suddenly, as when we move from a warm climate to a cold place, or vice versa, the demands on the blood vessels can be extensive and, consequently, they are likely to rupture, resulting in a nosebleed.

A rise in blood pressure forces the blood vessels to enlarge and sometimes even burst. Since the capillaries in the nose are fine, they rupture more easily. Thus a nosebleed could be a symptom of hypertension. Also, during plane flights, if cabin depressurisation takes place, the difference in air pressure outside the body and within affects the blood vessels and some passengers could experience bleeding from the nose.

Any trauma inflicted on the nose – say, when you fall while running and hit your nose on the ground, or when a child is hit on the nose by a ball while playing – ruptures the blood vessels inside the nose. Often, in these cases, the bleeding may seem heavy, but if there is no fracture, it may not be grave. However, once you’ve stopped the bleeding, you should get the patient checked by the doctor.

Sometimes the trauma can be light, as when a person digs in too hard to clean the nostrils. In that case, the bleeding stops spontaneously after a few minutes.

A high fever may sometimes be accompanied by a nosebleed. Again, this is because of the nose having to adapt to the difference in temperatures of the body and the air outside. ENT surgeon says, “This is occasionally seen in typhoid cases where the temperature rises very high.”

When bleeding from the nose occurs, you should first prop up the patient. Don’t let him lie flat. If you do that, the blood will rush back and enter the throat making him choke or cough, thus increasing the pressure on his blood vessels and forcing out more blood. “Sometimes the blood that is thus forced back goes into the stomach and the patient then vomits it out through the mouth,” says ENT surgeon. “At such times, everyone panics because the patient has vomited blood. They don’t realise he’s merely throwing out what he has swallowed.”

Ideally the patient should be made to sit up; head bent over a bowl so that the blood can drip down from the nose. Pinch closed the nostrils, letting the patient breathe through his mouth. Often, this stops the bleeding. Or you could put an ice pack on the nose. To make the pack, put some crushed ice in a clean kerchief or cloth and pack it closely over the nose. Use crushed ice, not chunks, because it can be moulded around the nose, and even pressure applied. If ice is not at hand, give the patient a freshly-cut onion, or crushed garlic pods, or ammonium bicarbonate, to smell. The strong odour will repulse his sense of smell, forcing the nostrils to contract, and this stops the bleeding.

NOT SERIOUS

Nosebleeds are generally not serious. “In a normal person, the bleeding stops on its own after about five minutes,” says ENT surgeon. “That it lasts for a long time and that the flow is heavy are only impressions. What happens is that, in the absence of muscles in the nose, the tightly-packed blood vessels cannot contract. So the bleeding continues till clotting sets in. and that normally occurs in about five minutes. But if the bleeding does continue longer, don’t panic. Pinch the nostrils or use an ice pack to stanch the flow, which will happen after a while provided there is no serious damage. However, even if the bleeding stops you should get the injury examined by an ENT specialist to preclude complications later.”

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Accurate Diagnosis & Patient Comfort at the Core of Innovation in ECG/EKG, EEG, and MRI Technologies

Over the past decade, researchers have made several undeniable breakthroughs in curing diseases that were once thought to be deadly and incurable. And this feat can be attributed to significant improvements in diseases diagnosis and testing.

In recent years, newer as well as safer methods of disease testing have been developed to avoid incorrect diagnosis among patients and to ensure they do not have to undergo any additional harm. Development of the latest diagnostic tests and procedures – such as electrocardiogram (ECG), electroencephalography (EEG), and magnetic resonance imaging (MRI) – enables physicians to make accurate decisions about their patients.

Thanks to constant innovation and dedication of healthcare companies and research organizations, diagnostic testing has helped achieve tangible improvements in not just the survival of patients but also in their overall health and quality of life.

Portable and Wearable ECG/EKG Monitors a Prominent Innovation in Cardiovascular Health

The electrocardiogram (ECG) has played a crucial role in understanding cardiovascular diseases. Its wide scope of application encompasses clinical diagnosis and prognosis of cardiovascular diseases, biomedical recognition, health assessment, fatigue study, and others. Ongoing research in the technology is mainly focused on accuracy of ECG diagnosis and application, big data mining for ECG, and improved ECG instrumentation.

Remote ECG monitoring systems are fast becoming commonplace medical devices for remote as well as long-term physiological monitoring. These devices are not just targeted for elderly and frail patients but also for healthy individuals merely looking to monitor overall wellbeing.

Wearable technology is one of the most prominent innovations in the field and continues to be used in everyday clinical practice.

Qardio, Inc., a global digital health company, launched a revolutionary wearable ECG monitor in January 2017. The QardioCore is reportedly the first wearable medical ECG/EKG monitor that lets users monitor heart health without any patches or wires. This innovation is a far cry from conventional ECG monitors used in hospitals, which are known to be bulky and burdensome. By contrast, this wearable device is designed for monitoring anywhere and anytime.

Looking to capitalize on the growing trend of remote patient monitoring, especially to maintain heart health, medical device companies are working on devising new and innovative methods of tracking patient health. One such example is startup AliveCor’s Heart Monitor. The monitor comprises a case that can be simply attached to the back an Android device or an iPhone, while the test is administered and results are revealed through the company’s mobile app AliveECG. This gives new meaning to the concept of having health at your fingertips.

Increased Focus on making EEG Technology Minimally Invasive

Generation after generation, scientists and researchers have tried to understand the human brain. The 18th century pseudoscience of “bumpology”, which believed that the shape of a person’s skull lent insights into their mental state and personality, was discredited as a science 50 years after its introduction. It was nearly a century later that studying the electrical activity inside a living brain came to be the go-to technique to understand various neurological conditions.

Although the technique, called electroencephalography (EEG), was rather invasive initially, contemporary research and modern technology have enabled the development of non-invasive methods to study brain function, pathology, and behavior.

In recent years, the many intrinsic advantages of EEG have allowed the technique to expand its application scope to include diagnosis of conditions such as epilepsy, seizures, dizziness, head injuries, brain tumors, headaches, and sleep disorders. After a groundbreaking move away from analog to digital recordings, automated and integrated computer-EEG systems have opened doors to adaptable and accessible research methodologies. These systems have also become relatively portable and cheap.

Capitalizing on recent technological innovations, Maryland-based BrainScope raised U$16 million in August 2017 to be dedicated toward research and development of mobile, non-invasive devices to assess traumatic brain injury. In September 2016, the company launched “Ahead 300″, the third version of its commercial product BrainScope One. It comprises an EEG headset and a handheld display equipment to help clinicians conduct 4 tests to determine the existence of a traumatic brain injury. These tests – two cognitive performance and two sensor-based tests – have the potential to allow the device to eliminate one third of unnecessary CT scans.

For several developing regions and countries, access to costly diagnostic technologies such as EEG means overcoming a number of geographic and economic constraints. However, penetration of the Internet and proliferation of smartphone usage has brought these countries closer to gaining access to advanced technologies. The Bhutan Epilepsy Project, for instance, has been tackling the aforementioned challenges by using a smartphone-based EEG. Developed by the Technical University of Denmark, the device and overall setup amounts to less than US$500, is highly portable, and is easy to use.

Constant Innovation in MRI Hardware and Software

Perhaps one of the most common and widely-used diagnostic/medical imaging technique, magnetic resonance imaging (MRI) has been highly valued for its versatility. MRI has a wide range of applications in the field of medical diagnosis, ranging from neuroimaging, cardiovascular, and musculoskeletal to angiography, liver, and gastrointestinal. And even though the effect of this imaging technique on the improved health outcome of a patient is uncertain, its role in the diagnosis and treatment of various disorders is irrefutable. Based on recent developments, GE Healthcare has been among the front-runners in MRI technology.

Innovation in design is crucial in MR technology and this can add immense value to patient-friendly medical imaging. Take the 2011 Optima MR430s, for instance. This GE Healthcare innovation marked a major leap in MR imaging as it was designed for specific targeted anatomy, be it an arm or a leg, rather than traditional whole-body systems. Overcoming the challenges of immobilization and patient confinement, this innovative scanner has helped improve patient experience. For physicians, this has meant fewer demands on a full-body scanner, smarter investment options, relieving patient backlogs, and low total cost of ownership.

In the last couple of years, however, major advances in MRI technology have been on the software side. This has resulted in more simplified cardiac imaging workflows, faster contrast scans, and allowing MR scans of the lungs.

In September 2016, the US FDA granted approval to the MAGnetic resonance image Compilation, or MAGiC, software by GE Healthcare. This is reportedly a first-of-its-kind multi-contrast MRI technique that delivers eight contrast media in a one acquisition. This is done in a fraction of the time taken by traditional imaging, primarily by allowing users to flexibly manipulate MR images retrospectively. This has led to fewer rescans and therefore considerable time and cost savings.

Cardiac MRI has been a rather limited field owing to lengthy exam times, complexity, and high cost. RSNA 2015 saw GE Healthcare introduce a new MRI technology, one with the potential to simplify cardiac MR to a great extent. The ViosWorks cardiac MRI software helps create what the company calls a 7-D cardiac MRI exam.

Conclusion

Advances in diagnostic/medical imaging over the last five years alone have revolutionized practically every aspect of medicine. Access to detailed imaging has enabled physicians to see things from a new perspective. With doctors realizing just how accurate and valuable these tests can be and manufacturers investing in research and development, the day isn’t far when exploratory surgery will become obsolete.