When Ritalin Isn’t Quite Right

Neuron cell

Neuroanatomist Jill Bolte Taylor’s “stroke of insight” continues to be an Internet sensation. Her inspirational story is well-known – waking up to a rare form of stroke and living to report about it.

“I found deep inner peace in my right hemisphere,” says Dr. Taylor. “Things like creativity require you to be in the present. The left (hemisphere) puts you in the past and future. Our society rewards left-hemisphere performance.”

Dr. Taylor’s fascinating Zen-like testimony raises interesting questions about the functions of the brain’s hemispheres. But not all stroke victims are as lucky as Taylor. Stroke is the third leading cause of death in the United States. Over 140,000 people die each year in the United States alone.

Another type of brain disorder has seen a drastic increase in the past 20 years. People – primarily kids – with Attention-Deficit Hyperactivity Disorder (ADHD) typically have trouble paying attention and controlling impulsive behaviors. Hardcore stimulants such as methylphenidate (Ritalin, Concerta, Metadate-ER) and amphetamine (Dexedrine, Dexedrine Spansules, Adderall and Adderall XR) are often prescribed for treatment.

Kid with Ritalin pill on tongueBut is a stimulant like Ritalin always the most effective treatment option? ElMindA, a startup based in Israel, is developing a device to analyze the brain’s electrical activity that may soon help physicians diagnose brain disorders and assess the benefits of treatment for ADHD more objectively – as well as speed up treatment decisions for stroke patients.

Electroencephalography (EEG) records electrical activity produced by the electrical action of neurons firing in the brain. The recording is obtained by placing electrodes on the scalp with a conductive gel or paste. The ElMindA platform, while based on EEG technology, involves several proprietary patents. It performs both functional brain imaging and brain treatment.

As reported in MIT Technology Review, the ElMindA system uses EEG data “to calculate a number of different parameters, including the frequency and amplitude of electrical activity in particular brain areas, the origin of specific signals, and the synchronicity in activity in two different brain areas as patients perform specific tests on a computer.”

"We usually find patterns of activity which are very unique for the specific state of the patient," says Amir Geva, founder of the company and head of the biomedical laboratory at Ben-Gurion University.

There are specific frequencies of brain signals related to mental and bodily functions. For example, anxious people tend to produce an overabundance of high Beta waves (12 to 30 Hz) while people with ADD/ADHD tend to produce an overabundance of low Alpha/Theta (4-12 Hz) brain signals.

a device to analyze the brain’s electrical activity may soon help physicians diagnose brain disorders and assess the benefits of treatment for ADHD more objectively

The Defense Advanced Research Projects Agency (DARPA) has also taken a recent interest in using EEG technology to measure brain signals. The agency’s budget for the next fiscal year includes $4 million to start up a program called “Silent Talk.”

This program has three goals: 1) to map a person’s EEG patterns to his or her individual words, 2) to see if those patterns are generalizable – if everyone has similar patterns, and 3) to “construct a fieldable pre-prototype that would decode the signal and transmit over a limited range.”

The end result of such research? Soldiers communicating on the battlefield by thought alone.

Clearly EEG, a technology dating to Richard Canton’s research with rabbits and monkeys in 1875, shows renewed promise in exploring neural pathways. At this point, however, it’s not clear whether ElMindA technology will be involved in the Pentagon’s research.

An ElMindA system clinical trial is about to begin at Harvard Medical School. The trail will test its effectiveness in diagnosing patients with ADHD and predicting which treatments are most effective. "Many children are getting Ritalin without any objective diagnosis," says Geva. "And many adults don’t get Ritalin, even though they might be helped by it."

Brain with stethescope and pillsThe researchers at Ben-Gurion University are also characterizing EEG patterns to improve stroke therapy. Intensive rehabilitation after stroke can improve speech and motor problems – the brain must rewire itself to compensate for damaged circuits. ElMindA aims to use its device to determine more quickly whether a patient should switch treatments.

Stroke may produce insight (and best-selling books), but it’s not something to mess with. Jill Bolte Taylor would probably be the first to say this – her stroke almost killed her. Nor is a stimulant like Ritalin always an appropriate treatment for ADHD – its side-effects include sleep disorders, tics, depression, and anxiety.

Although EEG has been around for some time, using the brain’s electrical activity for rehabilitation and other types of diagnosis – or even for communication – is breaking new ground.

Because of its small footprint, the ElMindA system may prove to be more practical for daily use than magnetic resonance imaging – and help prevent the overdiagnosis of disruptive stimulants like Ritalin.

 

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