There is something you should know about epilepsy and cannabis | Jokubas Ziburkus | TEDxVilnius

as a first-year graduate student I was walking down the hallways and all of a sudden I heard a noise that noise was coming from one of the laboratories what was that I asked myself what was it it's like shooting ducks in the pond came the voice from the electrophysiology lab what I was absolutely amazed by that when I worked in electrophysiology lab I saw that this sound was actually voltage that was converted into audio sound and it was coming from a neuron a single neuron to which an electrode was attached is the way neurons talk it's fascinating and from that point on I was hooked on electrophysiology and hooked the neurophysiology I wanted to know how these neurons talk how they communicate with each other how they create neural networks and that information in neural network gets spread through the brain I wanted to know everything including how neurons work right now while you're listening to my talk right at this millisecond if we were to take a division of the brain or the whole brain and very roughly divided into two types of neurons we would have excitatory neurons and inhibitory neurons all of these neurons produce very fast potentials that are called action potentials these are little electrical sparks and these electrical sparks caused the release of a chemical called neurotransmitter so if you have an excitatory neuron when it produces the spike or an action potential this very fast electrical change the excitatory neurons releases excitatory neurotransmitter excites a part of the brain the inhibitory neuron they also produce these fast electrical changes and they release an inhibitory neurotransmitter and that inhibitory neurotransmitter dampens the activity of the brain and so this is constant up and down up and down in different regions of the brain is encoding our perceptions our memories our emotions our motor functions and this complete picture is it's formed by interactions of these excitatory and inhibitory networks that are precisely balanced and acting precisely in time playing out the rhythms playing out the rhythms playing out neuronal beats if we look even further into different subtypes of neurons in the brain of course we're not just limited by excitatory neurons and inhibitory neurons the brain is a very complex structure and so another way we can approximate the structure and function of different brain cells is subdividing them further into different subtypes and so if we were to look in the brain we actually have approximately 150 different subtypes of neurons and if we were to stimulate those neurons and place an electrode and listen to how there's near on stalk how they produce their dialect da da da da da da we hear that we have 150 dialects these are different languages that each neuron speaks it's a different dialect and these dialects interact precisely in each one of these 150 neurons subtypes has this precise role in creating this up or down oscillation and we now know in the last few decades that individual neurons play a very precise role in producing this fast electrical change and having these rhythms these oscillations that are controlled that are precisely controlled but of course that's all of our brains are not normal and unfortunately some of our brains have neurological disorders and so neurological disorders is where you have these neuronal beats neuronal rhythms that are upset so perhaps not surprising that after finishing graduates I pursued my studies in epilepsy why epilepsy well epilepsy presents a disorder neurological disorder that is actually a dysfunction of brain rhythms and one would argue that any neurological disorder any neurological disorder is really impaired brain rhythms in the brain and they would be absolutely right in my opinion however with epilepsy the diagnosis of epilepsy comes from actually recording abnormal electrical activity in the brain and ascribing or determining a specific syndrome of epilepsy based on that electrical activity and so how the neurons sound during seizures they scream what do I mean by scream well if you talk dialect normally that's one thing but what happens to you if you scream and you scream non-stop what happens to your vocal cords they burn and you lose your voice the same happens during seizures is that neurons during seizure scream if at normal brain activity neural are firing is not that frequent it's actually a pretty pretty quiet brain that produces some electrical sparks here and there and releases neurotransmitters excitatory inhibitory but during seizures this organization of beats is lost the beats become abnormal the cells get hijacked by this pathology and now they start playing the wrong beats and so the challenge that we took upon ourselves is to understand what contribution these different subtypes of neurons have in producing seizures and since I told you that there's excitatory cells and inhibitory cells you would probably guess the textile Ettore cells and the ones that start the seizures and are responsible for spreading the seizures these large electrical discharges across the brain so according to the words of my mentor it takes crazy people like myself and himself to insert electrodes in multiple cells at the same time and try to understand what these cells do during seizures and that's exactly what we did and what we saw was completely countering to ative we saw the pain Hammett ourselves actually start the seizures which you have here on top is the inhibitory cell in blue when that inhibitory cell this blue thing is actually producing lots of spikes and then after a while it fails to produce a spike and this excitatory cell over here that's in red it produces a whole bunch of uncontrolled activity and that activity spreads across the brain and that's what causes the seizures and so every time the inhibition fails and it doesn't produce a spike the excitation produces a seizure it runs away and it causes damage to the brain and this was absolutely fascinating for us to find that and the studies that we did we did these studies and brain slices taken from rodent brains and you will say well what does that have to do with human brain and human being and what one behold five or so years later the similar pattern of inhibitory neurons starting the seizures and failing during the seizures and excitatory information running away and causing abnormal activity was discovered and confirmed in living human epileptic brains in general I think this is a remarkable and most fascinating thing about the science is that you can have an isolated cell isolated Network in the dish and that activity that you record you can also find in the living human brain that's absolutely fascinating so one way that we can understand these neurons is looking at their spikes and we can convert these spikes into voltage but what we also want to know is how does this activity how do these brain waves these oscillations up and down look like and so in the last two decades neuroscientists have invented and other scientists many different ways of visualizing cell activity right now we can visualize movement of single molecules in one cell activity of one cell or hundreds of cells at the same time or networks and we can visualize this activity a hundred times per one set and we can visualize this activity real-time that's absolutely fascinating and so this is an example of what looks like a brainwave it's abnormal epileptic brain wave that is propagating in the slice where the red color here shows a very massive amount of activity abnormal activity that propagates through this tissue and it's absolutely fascinating we can actually now tell where this abnormal activity begins as a shown here how it travels through brain tissue we can measure the speed of these propagations we can measure the characteristics of this oscillations we can accomplish a lot using imaging and that presents a completely different view and understanding of how neural networks function how they spread this activity across the brain so now that we understand these abnormal oscillations one of the things that we want to do is neuro scientists and neurologists one of the biggest challenges that we have is to actually how to control these abnormal brain rhythms how to stop and control abnormal rhythms how to reset the brain as a rhythmic structure of silat airy structure into the right kind of oscillation and again you can view the drugs and pharmaceuticals that you take actually reset these rhythms they reset the rhythm they reset your mood the depression they do preset seizure they stop seizure they stop Parkinson's tremors you are changing the beats in these neurons with drugs or with electrical stimulation for the past few years smart work has been motivated and has concentrated on a dravet syndrome the dravet syndrome is a catastrophic form of epilepsy it happens in very young children it's catastrophic because children can have up to hundreds of seizures a week those seizures are untreatable uncontrollable in many cases it's catastrophic because children do not develop properly they're having too many seizures for their brain to process other activity and it's catastrophic because up to 20 percent of these kids die after seizure for known reasons and so this is what motivates me to understand how the brain works and to try to invent or understand new ways and potentially alternative ways in which we can treat this abnormal brain activity and what may come as a surprise to you is that these children along with many other children autistic children Asperger's children cancer children are using cannabis are using cannabis extracts to improve their way of life to control them controllable conditions of course that stirs up a lot of emotions children cannabis what are you talking about this is wrong this is right this is wrong here the deal that the devil is in the details okay so let's try to understand some of these details we know that marijuana has been used for centuries with the reported medicinal effects there is multiple publications report medicinal effects there are synthetic drugs that are compounds of cannabis that are used as medications and recently there's been an increase in use of these extracts and even more so the second half of the 20th century we discovered an endocannabinoid system so what is under cannabinoid system and the cannabinoid system consists of endocannabinoids these are chemicals that are produced naturally in your body without taking a puff they're naturally produced in your body and they can bind two types of receptors cb1 receptor cannabinoid receptor one and cb2 receptor cannabinoid receptor 2 and these receptors are very widely distributed throughout the body with cb1 receptors dominant in the brain and it will cause the psychoactive effect from the cannabis plant the cb2 receptors are distributed mostly in the periphery with the most predominant expression of CVT receptor in the spleen and that's the organ that is responsible for amassing your immune response so where does cannabis come in here well would we know of course we all heard about THC bad drug THC it's a part of cannabis and this is all we know about cannabis pretty much we just say cannabis is THC drug and and that's it and so what we have to know is that cannabis plants can't a cannabinoids what are cannabinoids cannabinoids is a whole group of chemicals that have different structures the second most prevalent cannabinoid in cannabis is shown here abbreviated a CBD or cannabidiol there's other cannabinoids that are expressed and it's over 70 of them that are found in the in the cannabis plants and on top of that cannabis plants and these extracts from cannabis plants not only can take an AB noise but they also contain these aromatic substances that are called terpenes so you will find terpenes and other fruits and vegetables limonene and lemon carry filling and cloves and hops lavendar will have line Alou and what we know is that these terpenes on their own have very strong biological activity and sometimes very beneficial biological activity too so they have medicinal properties the terpenes themselves and what has become a predominant thought is that perhaps this isolated compounds like THC or cannabidiol CBD may not be as effective as using the extract from the whole plant you don't just eat one thing from the beet you eat the whole beet to get the benefit of the beet however with that comes the worry that you are actually if you're talking about the children you are trying to give children a drug that is containing THC so let's understand this a little bit better THC has actually been shown to be anticonvulsant except in about 10% of all the cases where it can be broken violent it has other medicinal benefits that have been documented and THC bonds to the cb1 receptor in the brain causing the high affect can add a dial on the other hand the second most prevalent cannabinoid in the plant has been shown to have only anticonvulsant facts and this cannabinoid does not bind cb1 receptor so it's not psychoactive so how can we deal with this thing that we have th see we have CBD we have this plant we have medicinal effects we need to understand more about this plant we need to understand a lot more about these substances do a lot more research get a lot more funding so we can help these children we can help these children have better lives we can understand better the plant and the as it concerns THC so for example here is an analogy so your doctor tells you that you know you can probably have a glass of cognac before you go to bed it comes your heart it's good for you right would you give a 40% alcohol contact to your child you'd never do that but there's something else inherent in that connieyc that makes you feel good it's not just the alcohol so what if you could remove the alcohol what if you could bring down the alcohol level to 0% or half percent the same as cough syrup in the pharmacies and you knew that this cognac now that has no alcohol helps other children from seizures and from other neurological disorders what would your decision be then would you give that cognac to your child then if you eliminate it in the case of cognac alcohol and in the case of cannabinoids or cannabis you eliminated potentially THC and so I think it is time for broader specters of the society sectors of the society and more conservative sectors of the society to understand this diseases to relate to the disease's to understand the pain of the children and the parents the catastrophic pain that they're going through it is time to stop stigmatizing the parents and sending them away as neurologist because they bring up an illicit substance because there are plenty of drugs that are pharmaceuticals that can debilitate children and adults as well and so it is time for us to seek alternative ways to envision neurological disorders and treat neurological disorders and so what I thought is the last few minutes of the talk is I'm actually going to invite a musician a friend of mine arkady got this month to come on stage and instead of playing you the seizures that we've recorded in the lab with the electrodes let's change this a little bit let's have a musician interpret the seizures for you that's key is understanding them let's seek alternative ways to understand it let's seek alternative ways to treat it for the benefit of humanity and let's accept simple facts that thousands of parents are advocating and thousands of parents are giving cannabis yes cannabis and cannabis extracts to their children let's just face the facts and so this is the notes that Arkady is going to play for you and these notes are electrical recordings of seizures in these neurons in brain slices where the first two traces are individual neurons and the bottom two traces are networks this is three minutes of data recorded from the brain networks that is now received data that is now going to get played by Arkady you

Channel: TEDx Talks

Views: 153,180

Keywords: TEDxTalks, English, Lithuania, Science (hard), Brain, Drugs, Music (performance), Music (topic), Neurology, Neuroscience

Id: YJ1yxEbx1Bg

Length: 22min 1sec (1321 seconds)

Published: Thu May 07 2015