|
ABSTRACTS 9th Annual Meeting of the International Society for the History of the Neurosciences (ISHN)
Université du Québec à Montréal (UQAM) Go to Meeting Program
The flowering of epileptology: Classification, medical and surgical treatment
Frederick ANDERMANN
Early attempts at classification of the epilepsies defined seizures as large or small, grand mal or petit mal, a terminology which has persisted in some areas to this day. Though some of the historical descriptions of attacks suggest great powers of observation, a rational classification was only begun in the 20th century. There was then some question as to whether some of the minor attacks such as absences were indeed epileptic. The advent of electroencephalography provided a basis for identifying the two major classes of focal or partial and generalized epilepsy. Classification of the epilepsies was entrusted to groups of outstanding epileptologists with particular interest and clinical experience. The first attempt led by Henry Gastaut, included Francis McNaughton, the first full Professor of Neurology at McGill. The International League assumed responsibility for the development of an International Classification of Epilepsies and of Epileptic Seizures. In the late 1980’s a group with Fritz Dreifuss, Jos Roger of the Marseille School and Peter Wolf, a disciple of Dieter Janz laid the foundations of the syndromic classification. This led to recognition of the benign partial epilepsies of childhood, a great boon and comfort to parents of affected children who can now be reassured about the benign prognosis. At that time, the advent of new antiepileptic medications, such as Valproate, particularly effective in idiopathic generalized epilepsies led to improved management and prognosis. Attempts at specific responsiveness in other seizure patterns have been less successful. Recognition of mesial temporal sclerosis and epilepsy by Murray Falconer and his group and William Feindel of Montreal laid the groundwork of the most common surgically treatable epilepsy. After early enthusiasm for surgical treatment, disillusionment followed in many countries and centers. When I asked Dr. Theodore Rasmussen what accounted for this, he replied, “The wrong surgeons operating on the wrong patients.” Despite the flowering of electroencephalography and the development of a rational classification, only few centers continued their efforts on behalf of people with epilepsy. In addition to the MNI and Murray Falconer at King’s Maudsley, Jean Bancaud and Talairach at Ste. Anne, Rossi in Rome and Zemskaya in Leningrad were amongst the few surgeons continuing to work in this field. In some countries, such as Germany and in Japan, surgical treatment of epilepsy was virtually proscribed. Prejudice continued to flourish widely. In the late 80s and 90s the advent of modern imaging gave a new impetus to surgical treatment. The rise of modern epileptology, with specially qualified physicians, led to the realization that there were limits to what medical treatment could accomplish despite the introduction of new molecules. This was followed a virtual explosion of interest in surgical treatment, unfortunately driven in part also by the financial rewards which intensive monitoring promised. This time however this did not lead to an inappropriate selection of surgical candidates but to the development of well planned and organized units in a number of centers not only in North America but also in Brazil, France, Germany, England, Scandinavia, Australia and Japan among others. It was soon apparent that in certain forms of focal epilepsy excellent results could be obtained even with limited technical resources and provided that neurologists and neurosurgeons would abstain from undertaking surgery in patients with far more complicated problems where surgical results were not comparable. This period of great flowering of medical and surgical treatment developed in parallel with advances in neuroscience, which promise eventually to lead to improved solutions to many epileptic problems.
Session IX -- Epilepsy Seminar History of therapy in multiple sclerosis
Jack ANTEL
Although Charcot, in his Lectures on the Diseases of the Nervous System (1877), was able to define the classic clinical-pathologic features of multiple sclerosis (MS), he further stated with regard to therapy that "the time has not yet come when such a subject can be seriously considered." More than 100 years would pass before the era of clinical trials leading to approved therapies for the disease would begin. In the intervening years multiple therapeutic claims were made often in response to a current postulate regarding disease pathogenesis e.g. infection, toxin, ischemic, nutritional (Therapeutic Claims in Multiple Sclerosis – IFMSS, 1982). The initial “modern” therapeutic trial era of MS has to date been directed at the presumed immune mediated basis of MS. Because of the requirement to have well established disease to be certain of the diagnosis in the pre-MRI era and the toxicity of the agents such as cyclophosphamide, the early trials were largely conducted on patients who were evolving from the initial relapsing-remitting (RR) phase of MS into a secondary progressive (SP) phase of disease, characterized by persistent neurologic deficits. The development of recombinant forms of beta interferon (βIFN), coupled with use of MRI as a surrogate marker, allowed large scale studies of all phases of MS, and confirmed the pioneering observations of Larry Jacobs and colleagues, conducted using natural βIFN. Current insights suggest that βIFN acts via immune-modulation rather than by its initially suspected anti-viral effect. The agent is effective against the initial inflammatory phase (RR phase) of MS with little if any effect on the later irreversible tissue destructive phase (SP phase) of disease. Glatiramer acetate is a random polymer comprised of 4 amino acids created initially by Michael Sela and colleagues to mimic the effects of myelin basic protein immunization as an inducer of experimental auto-immune encephalomyelitis (EAE), an animal disorder used as a model of immune mediated CNS demyelination. The agent was subsequently shown to have a protective effect in this model. Clinical trials indicate its effect on the early or RR phase of MS, likely as a result of deviation of the immune response from a pro-inflammatory (Th1) toward an anti-inflammatory (Th2) direction. Multiple other antigen specific and cytokine directed therapies have shown efficacy in the EAE model and have entered clinical trial. Some have had unexpected non-neurologic toxicity or actually enhanced disease activity e.g. tumor necrosis factor (TNF) antibody and soluble receptor indicating the dilemma of moving from the bench to the bedside. Currently there are no approved therapies for the progressive phase of MS. Axonal loss is considered to account for a significant component of the evolving neurologic disability. Only recently have initial therapies aimed at blocking the axonal degeneration that occurs secondary to demyelination and redistribution of sodium channels (eg blocking calcium influx by blocking the Na+/Ca++ exchanger). One hopes that the era of neural-directed therapy will now begin. Session VIII -- Multiple Sclerosis Seminar Filming epileptic and hysterical seizures before 1914: American and European pioneers' achievements
Geneviève AUBERT
The potential of moving pictures for diagnosis and teaching in epileptology was immediately acknowledged by the pioneers of cinematography. However, the difficulties of this undertaking were emphasized by the early users of the new medium. The high expense involved was considered by some to be prohibitive. The technical problems of operating the cumbersome material and the need for good lightning were complicated by the brevity and unpredictability of occurrence of seizures. Nevertheless, as early as 1905, Chase succeeded in capturing seizures at the Craig Colony for epileptics (NY). He would be followed by Weisenburg in Philadelphia, who underlined the scientific value of moving pictures, for instance in the fine analysis of the succession of muscular twitching in Jacksonian convulsions. However, despite a great deal of patience and ingenuity, the beginning of epileptic fits remained difficult to capture. Hysterical seizures were much more easier to record because of their usually longer duration. Furthermore, filming hysterical patients was facilitated by their cooperation and suggestibility. A short sequence of an hysterical attack was filmed by Londe and Richer in Paris around 1900. In Van Gehuchten's film corpus, completed in Belgium before 1914, hysterical seizures are much more numerous and of a higher quality than the few epileptic seizures. In this presentation, a particular attention will be paid to the operating setting of medical cinematography before 1914 and to the physician-patient relationship in this context. Session IX -- Epilepsy Seminar The harmony between the brain, the ear and the hands: the collaborative work between the musician Marie Jaëll (1846-1925) and the neurologist Charles Féré (1852-1907)
Isabelle BARRIERE and Alexander KIM
While the artistic and pedagogical contributions of the Alsatian pianist and composer Marie Jaëll have been acknowledged (Kiener, 1952, Ingelaere, 1997), her scientific work has not received the attention it deserves. The first part of this paper will critically assess the ideas that Marie Jaëll presented in her 1896 monograph, La Musique et la Psychophysiologie. At least four schools of thought had an impact on her attempt to identify the psychological processes involved in piano playing and their physiological underpinnings: the British associationists, evolutionary theories, the works on neurologists and the nascent field of scientific psychology. It will be argued, contra to Corre (1997), that the different levels of information between the brain, the ear and the hand conceptualized by the Alsatian composer are similar to the models of language and visual processing developed at the time by clinicians. The neurologist Charles Féré and the artist joined forces and conducted a number of experiments (Féré & Jaëll, 1902, a, b, c, d), the aim of which was to investigate the influence of music perception on finger activities and strength. Féré who acted as the subject in these experiments also described them in his publication, Travail et Plaisir (Work and Pleasure) (1904). The death of Féré in 1907 put an end to this collaboration, the importance of which was acknowledged by the scientific community: the Alsatian artist gave a lecture at the Society of Physics in Paris and in his review of the objective study of cerebral phenomena, Bohn (1910) drew a parallelism between the results obtained by the musician and the neurologist and those of Pavlov on animals. The original ideas of Comenius (1592-1670) on children's brain and development
Isabelle BARRIERE
The thinking of the Moravian priest Comenius (1592-1670) with respect to children's brain development and learning capacities is best described as original. First his thinking about this topic--enriched by his experience as a teacher and a headmaster--occupied a central place in his religious and philosophical ideas (Drews, 1994, Cauly, 1995). Secondly he expressed his views on a number of aspects of development, including language development (Germain, 1993). One of the outcomes of his views on language learning is his well known Orbis Sensualium Pictus Quadrilinguis (1658), the originality of which lies in the use of pictures to illustrate sentences in four different languages (Germain, 1993, Kushner, 1994, Drews, 1994). The aim of this paper is to explore a less well known work of Comenius, The school of infancy (1633), as well as his classic work, The great didactic (1657). It will be argued that his views on children's early development and on the plasticity of the brain were original in at least two ways. At a time when, according to Descartes, infants were thought to be unable to form memories, Comenius thought that one's early years shape one's development and that infants were sensitive to and processed sensory stimulations. Secondly, according to the Moravian priest, the plastic quality of the young brain enabled the infant to experience two types of processes: learning and unlearning. It will be demonstrated that in assuming these two processes, Comenius adopted the view that changes in children's brains and learning capacities were qualitative rather than quantitative, an issue which is still debated today among developmentalists. Session I -- The Developing Brain and Its Harmony Giovanni Aldini (1803) and the electrical cure for "melancholic madness"
Sherry Ann BEAUDREAU and Stanley FINGER
Giovanni Aldini (1762-1834), nephew of Luigi Galvani, worked with his uncle and then on his own to extend some of his uncle’s findings on electrically-induced muscle contractions in frogs and other animals. In the 1790s he conducted electrical experiments on the bodies of recently executed humans. Often overlooked, however, is the fact that Aldini began to use electricity to help hospitalized mental patients in 1801. His first patients were classified as "melancholics," although his writings suggest some might have had schizophrenia. Aldini described his initial findings, which included some successes and some failures, in a book published in 1803. In this presentation, we shall examine what Aldini wrote about these early hospitalized cases and then ask where he came up the idea of using electroshock therapy to treat mental illness. Did it come from Benjamin Franklin and Jan Ingenhousz, who, on the basis of personal mishaps that resulted in a loss of consciousness, suggested giving strong shocks to the heads of melancholic patients in the 1780s? And was Aldini the first person to document the benefits of strong electrical shocks to the head in cases of mental illness? Most histories of electroshock therapy begin with Ugo Cerletti, who worked in Italy approximately 130 years after Aldini published his initial findings on therapeutic shocks to the head. Cerletti seemed to have no knowledge of what Aldini had done, and he based his work on a mistaken assumption about epileptic convulsions and schizophrenia. By going back to Franklin, Ingenhousz, and Aldini, we hope to show that the concept and application of strong electrical shocks to the head as a method of treating mental illness was discussed and put into action at least two centuries ago. Constructing brain death: Caring for coma and ending treatment at the Massachusetts General Hospital, 1957-1967
Gary S. BELKIN
The Harvard Brain Death Committee was a creation of clinicians at
Massachusetts General Hospital (MGH). MGH Chairman of Anesthesia, Henry
Beecher, conceived of the Committee as a follow-up to a presentation made to
fellow members of the Harvard faculty in the fall of 1967 on the ethical
issues raised by the hopelessly comatose. These concerns reflected years of
writing and thinking about the ethics of human experimentation. It also
built on the work of MGH neurologist and founding director of its EEG
laboratory, Robert Schwab. Schwab had been developing a definition for the
determination of cerebral death for a decade before the Committee met, and
he essentially authored the actual criteria described in the Committee's
landmark Report that appeared on the pages of JAMA
( Donald Olding Hebb as a student: From poet to psychologist
Richard E. BROWN
Donald Olding Hebb was born in 1904 in Chester, Nova Scotia, Canada and completed 11 grades in 9 years at the Chester School. When he was 16, his family moved to Dartmouth, Nova Scotia, and the following year, he entered Dalhousie University in Halifax. He majored in English with the intention of becoming a novelist and after he graduated with a BA in 1925 he taught at his old school in Chester for a year. In 1928, he was teaching school in Montreal, Quebec and started his MA in psychology at McGill University. In 1931, while bedridden with a tubercular infection of the hip, he studied Sherrington's Integrative Activity of the Nervous System and Pavlov's Conditioned Reflexes, and wrote a theoretical MA thesis entitled Conditioned and Unconditioned Reflexes and Inhibition. This thesis contains the first ideas of what we know as the Hebb synapse. In 1934 Hebb started his PhD with Karl Lashley at the University of Chicago, but before he completed his research, Lashley moved to Harvard. Hebb was accepted as a PhD student at Harvard but had to change his research topic. In 1936, Hebb completed a thesis on the vision of rats reared in darkness, and received a Harvard PhD. For the next year, he worked as a Research Assistant for Lashley, as a Teaching Assistant for Professor E. G. Boring, published his PhD research, and completed the research on spatial learning in rats that he had started in Chicago. In 1937 he took up a position as a research fellow with Wilder Penfield at the Montreal Neurological Institute (MNI). This presentation covers Hebb's life and student years from 1904 to 1937. Some old and some new observations on myelin formation
David R. COLMAN
The mechanisms by which the myelin sheath is generated remain elusive, although the widely accepted textbook “windowshade” model accounts for much of the data. When this model was introduced, it was unequivocally state-of-the-art in terms of novelty of the data, and insightful, articulate and compelling interpretation. However, there is now a substantial literature that is incompatible with the conclusions of this work. Taking current data into consideration, we have developed a comprehensive model for the generation of the myelin sheath. Our model - we term it the "ribbon model" - proposes that: (a) Myelinating cells first elongate one or two exploratory cytoplasmic ribbons of membrane along the presumptive internode, closely apposed to the axon. These structures act as guides for the subsequent myelination process. (b) The distal terminus of each ribbon encircles the axon and seals to itself, via strong cadherin-mediated interactions. A stable, transbilayer scaffold of interacting glial/axonal proteins is then set up at each end of the sealed ribbon, providing adhesion between the axon and glial cell, while generating a "molecular sieve" that organizes ion channels along the axonal microdomain. (c) New membrane surface, added via vesicular fusion to the glial ribbons, flatten and extend them against the axon at all non-compact zones; the net result is the expansion of the ribbons to form the myelin helix, but one that is produced with very little actual rotation of membrane around the axon. The Rev. John Wesley's empirical medicine in the 18th century
James G. DONAT
The Rev. John Wesley, M.A. (1703-1791) is commonly remembered as the founder of the Methodist Church. Largely forgotten is the fact that he considered the medical treatment of his followers to be part of his pastoral responsibility. He read widely from the medical works available to him from the 17th and 18th centuries, and selectively followed contemporary trends in the field. He did not do surgery, and passed on complicated cases to physicians. His first medical publication, in 1745-46, was entitled, A Collection of Receits for the Use of the Poor and appeared in 3 editions. This was expanded into Primitive Physick, or, An Easy and Natural Method of Curing Most Diseases, which, in the years 1747-91, was continually revised through 23 editions, containing what Wesley thought to be the best available remedies gathered from a variety of sources, many of which he himself tried. This paper is mainly about the latter of these two works. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Development of surgical care for epilepsy: The contributions of Otfrid Foerster in Breslau and Wilder Penfield and his school in Montreal
William FEINDEL
It is one of the triumphs of modern neurosurgery that many patients with focal cerebral seizures can now be offered a cure or significant alleviation of this devastating condition by operation associated with low mortality and minimal risk of neurological or psychological deficits. In the 1920s in Breslau Otfrid Foerster (1878-1941), a neurologist by training, took up the scalpel in the cause of epilepsy. He made detailed analyses of seizure patterns and applied pneumoencephalography for preoperative localization. During surgery, he used local anesthesia, electrical stimulation, intraoperative hyperventilation and electrocorticography to help localize the epileptic focus. He produced detailed human brain maps as a result of his stimulation findings. The interest of Wilder Penfield (1891-1976) in epilepsy began during his surgical work in New York in the 1920s. With a background of experience in the Spanish metallic techniques for staining glia he came to visit Foerster in 1928. From an examination of Foerster’s surgical specimens of meningocerebral cicatrix he postulated that a vasomotor reflex might be responsible for the initiation of seizures.. Penfield’s experience with Foerster came at a critical period in his career. At the Montreal Neurological Institute from 1934 onward, Penfield and his team continued their interest in vascular physiology of the epileptic brain. He adopted the technique of local anesthesia and electrical stimulation to map the human cortex but greatly extended Foerster’s work by discovering other areas of cortex subserving speech, hearing, vision and, perhaps most crucial of all, memory function. In the early 1950s Penfield and his associates defined the anatomical and pathological features of temporal lobe seizures originating in mesial temporal structures. They introduced what has since been referred to as the “Montreal procedure”, anterior temporal lobectomy including removal of the amygdala and hippocampus. This operation, adopted worldwide and enhanced by modern brain imaging techniques, has achieved postoperative cessation of seizures in more than 75% of patients. The successful development of epilepsy surgery serves as a prime example of a future informed by the past. The early history of the experimental approach to craniocerebral injuries
Moshe FEINSOD
The numerous treaties of the eighteenth and nineteenth centuries on closed and penetrating head injuries are made of assembles of multiple case reports by acute, well versed and very experienced observers. The authors failed, however, to establish logical and practical classification and left the surgeon bewildered, devoid of practical real-time diagnostic abilities and clear decision making guidelines. For many centuries there was a feeling that no progress has been made, and the appalling mortality instigated a mood of helplessness, frustration and pessimistic attitudes whenever craniocerebral injury was encountered. At the same time, however, some far sighted inquisitive surgeons were pioneering an attempt to define the problems encountered and to plan elucidative experimental avenues to solve them. It was the Académie Royale de Chirurgie that started to cultivate, in the mid-eighteenth century, the experimental approach to craniocerebral injuries. Its masters contributed not only to understand the effect of traumatic lesions but also to the organization of the motor system. More important, they identified most of the themes that the nineteenth century experimental investigators will be dealing with – the physics of skull fractures, the mechanisms of concussion, the dynamics of intracranial pressure and space-occupying lesions, the brain control on the heart and respiration, the cerebral circulation and the effect of gunshot injuries. The French surgeon-experimenters were followed soon by the German and rather late by the British and American colleagues. This study will follow the development of the experiments from uncontrolled crude forms to sophisticated, planned, multiparametric studies using new technologies, and the rise of the once demoted surgeon to an indispensable collaborating member, or even the leader, of neurophysiological teams. It will explain why all the knowledge gained was gradually implemented into clinical practice only after many decades while the questions posed by our predecessors continue to intrigue researchers even nowadays. Early American contributions to medical and surgical treatment of epilepsy
Edward J. FINE
From 1886 to 1910, American neurologists and neurosurgeons made significant contributions to the surgical and medical treatment of epileptics and to theories about the physiology and pathology of epilepsy. Five months after the British neurosurgeon Victor Horsley reported successful treatment of epilepsy by principles of cerebral localization and surgical removal of epileptic foci of several epileptics in June 1886, the American surgeon Roswell Park (1852-1915) localized the site of the lesion, performed craniotomy and successfully removed an “arachnoid cyst pressing on the left frontal and parietal lobes of a patient with daily focal motor seizures. In May 1888, William W. Keen (1837-1932) using Horsley’s principles of cerebral localization and a electrical stimulator, found the cortical location for movement of the fingers, removed scar tissue from this area and achieved control of a 20 year old man’s focal motor seizures without causing loss of function. In September 1888, Park, Keen and Charles K. Mills of Philadelphia organized an international seminar in Washington, DC on cerebral localization. There they, Victor Horsley, and David Ferrier interchanged ideas about the localization of the motor, sensory and speech areas of the human brain. In 1913, Park established principles for successful surgical treatment of epilepsy by urging early surgical management of epileptics who had intractable seizures after adequate medical treatment for 3 years and “that every scar is followed by another…and we are forced to make the second scar less irritating than the first”. The establishment of Craig Colony in 1892, a comprehensive center for epileptics in Sonyea, NY by Buffalo philanthropist William P. Letchworth (1823-1910) and neurologist Fredrick Peterson (1859-1938), improved medical treatment of epilepsy by construction of buildings with safety features, and developed vocational training of epileptics. William P. Spratling (1862-1915), the first Medical Director of Craig Colony, established the first American residency program for training neurologists specializing in epilepsy, determined the therapeutic dose of triple bromide therapy, established that diet and exercise could reduce seizure frequency and severity. Spratling wrote the first American textbook (1904) based upon the principle of cortical genesis of seizures. His residents demonstrated the pathology of status epilepticus. James Munson (1881-1918), the neuropathologist to Craig Colony, discovered that epileptics with syphilis had endarteritis of cerebral blood vessels. He also established a national center for collection of injuries to epileptics. Letchworth and Spratling established the National Association for the Care and Treatment of Epileptics, the world’s first society for this disease in 1900. Supported by Local Funds from Veterans’ Affairs Medical Center, Buffalo, NY. Session IX -- Epilepsy Seminar Benjamin Franklin, mental illness, and the electrical cure
Stanley FINGER and Sherry BEAUDREAU
Benjamin Franklin (1706-1790) had a life-long interest in assisting the mentally ill. In the 1750s, while helping to fund and set up the first hospital in the American colonies, he saw to it that the needs of patients with mental problems were addressed. And later in his life, while in France, he headed a commission to evaluate Mesmer's claims about animal magnetism and healing using objective, scientific methods. Less well known is that Franklin, the leading electrician of his day, also attempted to treat mentally ill patients with electric shocks. This presentation will examine this part of Franklin's medicine. First to be examined will be one of his cases from the 1750s, an hysteric who exhibited seizures. In this context, we shall address the question of what hysteria signified in 18th-century medicine. Second, we shall examine a novel suggestion made by Franklin and his Dutch physician friend, Jan Ingenhousz, in the 1780s--namely that electricity applied to the head/brain may benefit hospitalized mental patients with severe melancholia. It will be seen that the latter idea, which was presented to officials in charge of mental institutions in France and England, arose not from Franklin's earlier experience with hysteria, but from accidents that he and Ingenhousz men had while conducting electrical treatments and experiments. Oddly, Franklin and Ingenhousz are never mentioned in historical reviews on electrical shocks to the head for serious mental problems, although they might well have been the first to put the idea into circulation. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine The "Bulgarian treatment" for Parkinsonism
Paul FOLEY
At the beginning of the 20th century, few avenues remained unexplored in the effort to identify an approach which might at least ameliorate the neurological sequelae of encephalitis epidemica (~1915-1925), particularly the especially common parkinsinoid syndrome. Amongst the more successful--and colorful--approaches was the "Bulgarian treatment", which became popular in Western Europe in the mid-1930s and remained a significant component of antiparkinsonian therapy until the advent of L-DOPA in the 1960s. Originally conceived in the early 1920s by Ivan Raev, a Bulgarian herbal healer, as a complete program which included phytotherapeutic, dietetic and psychotherapeutic components and promoted in a semi-mystical light, the method was brought to Italy in the 1930s, largely as the result of familial connections between the Bulgarian and Italian royal houses. Here the treatment was scientifically examined in clinics established by Queen Elena for this purpose, the essential component ultimately being identified as being the administration of a belladonna root extract. From here the method spread to Germany, other European countries and the United Staes. After a number of controversies regarding the chemical basis of the therapy and the relative merits of belladonna root from Bulgarian and other sources, standardized root extracts (such as "Homburg 680") became the standard means of application in Europe, while defined combinations of the tropane alkaloids presumed to underlie its efficacy (such as "Rabellon") were more popular in English-speaking countries. Both forms of the treatment were ultimately displaced in the 1950s by synthetic anticholinergic agents, as a result of which interest in the factors responsible for the superiority of the Bulgarian method to other solanaceous plant-based therapies waned. Session XIII -- Movement Disorders Irritable glue: The Haller-Whytt controversy over the mechanism of muscle contraction
Eugenio FRIXIONE
The ultimate source of animal motion has remained a largely neglected topic in historical accounts of the famous controversy between Albrecht von Haller and Robert Whytt over the phenomenon of irritability. Haller conjectured that the power to actively contract in response to adequate stimuli (i.e., irritability) would most probably reside in a special gluten or glue joining the elementary particles supposed to constitute every minimal muscle fiber. This property would be inherent to such glue, he suggested, just like attraction and gravity are inherent to matter in general. Haller’s hypothesis was sharply criticized by Whytt, who among other objections pointed out that glue extracted from muscles is totally unresponsive and inert. Instead, Whytt believed that an "active sentient principle" distributed throughout the animal body, and persistent for some time after death, was obviously behind all motions elicited by any stimulus, even in isolated body parts. Whatever difficulty in explaining the exact relation of this "principle" to the muscular substance, he maintained, should be ascribed to mere ignorance about the true nature of the soul. Whytt and Haller argued back and forth over this issue, never moving towards an agreement. In the absence of other credible explanations for the mechanism of muscle contraction the field seemed to enter a dead end, but not for long. Some of the factors possibly involved in dissipating this intellectual barrier, thus opening the way for a new kind of thinking on muscle physiology, will be discussed. Session III -- Muscle and Energy James Parkinson: Shaking up neurology in the late eighteenth century
Christopher GARDNER-THORPE
James Parkinson (1755-1824) is well known as the author of the text The Shaking Palsy, published in 1817 as the first known description of paralysis agitans, the condition subsequently named Parkinson’s Disease by Jean-Martin Charcot (1825-1893), the famous Parisian neurologist. Parkinson was one of several doctors who, during the course of the Long Eighteenth Century, promulgated within their localities their experiments in science and medicine. They were polymaths indeed. Parkinson lived during the time of Erasmus Darwin (1731-1802), the physician in Litchfield whose far-reaching views led thinking on evolution and other scientific topics. The cleric William Paley (1743-1805) gathered together ideas prevalent in the scientific community around this time too and Charles Bell (1774-1842) after whom was named a variety of facial palsy, demonstrated the value of good art work in explaining anatomy and pathology. Long in time, the eighteenth century was long in the list of ideas, scientific and philosophical that helped shake up the medicine and science of the (perhaps even longer) nineteenth and twentieth centuries. Lessons from each century should help forge our ideas in the twenty-first. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Mass hysteria presenting as a psychogenic movement disorder: A report with movie documentation by Van Gehuchten
Santiago GIMENEZ-ROLDAN1 and
Geneviève AUBERT2
Contemporary collective illnesses in Western countries is usually expressed as anxiety related to fear of HIV-infection among health-system personnel, “Pokemon contagion” versus photosensitive epilepsy, or concern on potential chemical and biological terrorist attacks. Outbreaks of bizarre motor behaviour nowadays are mostly restricted to some cultural groups in developing countries. The report of an episode of mass hysteria by Arthur Van Gehuchten (1861-1914) with movie documentation is a unique opportunity to study changing patterns of mass hysteria. Following the appearance of bizarre muscular jerks and walking unsteadiness in a 15-year old orphangirl, thirteen other female teenagers developed similar symptoms in the ensuing 2-3 weeks. Proximal and axial jerks, occasionally stimulus-sensitive, caused severe difficulty in walking. The attending physicians first suggested food poisoning, which was discarded afterwards. Later on they proposed a trip to the seashore which resulted incomplete resolution of the symptoms in a matter of hours. Although Van Gehutchen suggested hysterical chorea and hysterical tachycardia, the current label would probably be psychogenic myoclonus. Rather than “epidemic hysteria”, this outbreak should be better viewed nowadays as an unfashionable way of expressing collective exaggerated emotions. Session XIII -- Movement Disorders Reasonable groundings of Hartley's eighteenth-century neural "vibration" theory but excessively parsimonious reactions
Robert B. GLASSMAN
Building upon a conjecture endorsed by Isaac Newton, in 1749 David Hartley published an extensive theory of neural “vibrations,” coupled to an ambitious theory of psychological associations. A few decades later, Joseph Priestley republished and popularized Hartley's theory of associations but, wielding Occam's razor, extirpated the theory of vibrations. As late as the 1880s, a grappling with the mind/brain puzzle in very similar terms appears in the writings of T. H. Huxley and Henry Maudsley. I argue here that the notion of neural vibrations was a good presumptive insight, and that theory and speculation in behavioral and neural sciences have been inhibited for much of the past two and a half centuries by excessive empiricist conservatism That antitheoretical bias remains. While acknowledging that hindsight can be seductive, I attempt here to identify instances of reasoned, or reasonable implicit, historical groundings for the idea of neural “vibrations,” and suggest that more theoretical openness, with more adventuresome empiricism, historically might have led to more scientific progress regarding neuroelectric oscillatory dynamics. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Watching chimpanzees and thinking about the nervous system: The Yerkes years
Stephen GLICKMAN
I last visited with Donald Hebb in the Fall, 1984, the year before his death, and approximately 26 years after Hebb (and Peter Milner) had signed my dissertation. During that meeting, after noting that he considered himself a Comparative Psychologist, Hebb reminisced about the years he had spent at the Yerkes Laboratories of Primate Biology in Orange Park, Florida. He told me that the 5-year period at Yerkes was the most significant intellectual experience of his life. Hebb added that observing chimpanzee behavior was “like watching human beings with the veneer of culture stripped away.” In an article devoted to the evolution of mind, and comparisons between human and animal minds, Hebb described chimpanzees in captivity: “…as unpredictably explosive as a fireworks display, sometimes viciously aggressive without cause and capable of being angered by trivial things; terrified at the sight of a toy animal or a model of a human head…and in these and other ways reminding us of human fears, hostilities and abhorrences, each of which is familiar by itself but which in their totality make a picture of man that we have not seen clearly.” Hebb’s publications from the Yerkes period involve a set of 7 papers / abstracts dealing with fear and emotional expression, as well as sex and individual differences, in chimpanzee behavior. The papers are notable for perceptive observation of behavior as well as methodological innovation. The majority of these articles also make little, if any, reference to underlying physiology. However, Hebb was also writing the book that established his reputation in the field: The Organization of Behavior. In one of the chimpanzee papers, there is a highly speculative discussion of central representations of orderly thought processes, (the “phase sequence”). And, in a paper on the behavior of the bottlenose dolphin, which also emerged from Hebb’s stay in Florida, there is a good dose of “neurologizing,” including a discussion of the unique behavioral characteristics that emerge in a large-brained mammal. Mindful that this presentation is for the ISHN, I will link Hebb’s animal-watching in Florida with a set of persistent themes that drove his neurophysiological theorizing, i.e., construction of a “phyletic” scale ranging from “lower” to “higher” mammals, recognition of the importance of central cognitive processes (e.g., set and attention)--particularly in “higher” mammals, and a focus on ontogeny and the effects of early experience. Session V -- Donald O. Hebb Seminar The discovery of motor cortex
Charles GROSS
Although the modern study of the physiology of the cerebral cortex began with Fritsch and Hitzig's discovery that electrical stimulation of the cortex produces movements and the extension of their work by Ferrier, the background of these discoveries can be found in late 17th and 18th century ideas about the neural control of movement, electricity and the nervous system, the functions of the cortex and the localization of function, found in the work of Willis, du Petit, von Haller, Swendenborg and others. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine What is a Kernohan?
Duane E. HAINES1, J.A. LANCON2, and
A.Y. ZUBKOV3
There are a number of clinical examples to which the name of the discoverer/describer is applied that are especially interesting or instructive. Perhaps one of the more interesting is what is called the Kernohan notch phenomenon. This brainstem syndrome characteristically may include long tract and cranial nerve signs, but in contrast to the general rule of alternating deficits, these deficits are on the same side of the head and body. In 1929 James Watson Kernohan (b. 1896, d. 1981) offered an explanation for the observation that some patients have a hemiplegia of the extremities that is ipsilateral to a brain tumor located in a supratentorial location. In general, the tumor mass displaces the brainstem at the midbrain-thalamus junction such that the crus cerebri on the opposite side is forced against the edge of the tentorium cerebelli. This creates a "notch" and consequent damage to the corticospinal fibers in the crus; the result is a hemiplegia on the side of the lesion. Kernohan was born and received his Medical training (in Obstetrics, Medicine and Surgery) in Northern Ireland. He came to the US, and to the Mayo Clinic, in 1922 and stayed at the Mayo until his retirement in 1962. Although his interest started in general pathology, he soon devoted his energies to the new field of neuropathology. His interests encompassed neuropathology as broadly defined, but focused on tumors of the spinal cord, brain abscesses, metastatic brain lesions, and vascular lesions/tumors of the spinal cord. One of his most significant contributions was the development of a classification system for brain tumors. This paper reviews the unique features of the cases described by Kernohan, reviews the man himself, and present the view that the combination of deficits described are more appropriately called the Kernohan syndrome rather than the Kernohan notch phenomenon. Session XII -- Brain Trauma and Death Technological metaphors and the anatomy of representations in eighteenth-century French materialism
Timo KAITARO
The eighteenth-century French materialists, like La Mettrie and Diderot, are sometimes mistaken for “mechanistic materialists”, who according to this interpretation have simply generalized the Cartesian animal-machine hypothesis to man. But in fact, in so far as they had recourse to mechanical metaphors, they used them, not to prove that like Cartesian animal-machines men are soulless automata, but to point out that certain kinds of material entities can have representational properties that are not reducible to the properties that matter has in Cartesian metaphysics. Since such properties were considered to be properties of the brain or of the body as a whole, it was no longer necessary to attribute representational properties to specific parts of the brain, as it was in dualistic theories in order to explain the interaction between the mind and the brain. This explains the fact that it was the dualists, like Charles Bonnet, and not the materialists, who postulated discrete and localizable representations in the brain. By correlating mental phenomena with specific events in the brain the dualists were able to propose what the materialists did not even attempt at giving: mechanistic explanations of mental phenomena. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine A modern chimera: Dementia in antiquity
Axel KARENBERG
OBJECTIVE: This poster disproves recently published studies which presume that the ancient Greeks developed a medical notion of dementia. METHOD: We analyzed classical medical and philosophical treatises including key authors such as Plato, Aristotle, "Hippocrates" and Galen. We also examined almost a millennium (400 BC to 400 AD) of various relevant literary texts. RESULTS: Ancient medical texts did not contain any description or classification remotely comparable to the modern meaning of dementia. A few literary sources mention dementia-like states with regret or in the context of fighting the mental decline associated with old age. CONCLUSION: Greco-Roman physicians ignored dementia because elderly people were rare (less than 3% of the population was older than sixty-five), progressive cognitive impairment was not part of medical theory and the physician’s primary role was to treat conditions with positive therapeutics. Before the relatively recent medicalization of old age, intellectual decline was considered normal. Although the word ‘dementia’ is ancient, its contemporary meaning and conceptualization originated as late as 1700. Further studies, including a computerized key-word search of ancient literature, are necessary to evaluate the personal fates and social roles of individuals suffering from diminished cognitive abilities more precisely. Session VI -- Poster Session 1 "The orang lives almost next door": The correspondence between John Fulton (New Haven, Connecticut) and Willem Verhaart (Batavia, Java)
Peter J. KOEHLER
Between 1937 and 1959 John Fulton (1899-1960), Sterling professor of physiology at Yale University (New Haven) and Willem Verhaart (1889-1983), neuropsychiatrist at Batavia Medical School (Java, Dutch East Indies) corresponded on neuroanatomical topics. Verhaart had easy access to primates’ brains in Batavia and stayed at Fulton’s lab as a Rockefeller fellow (1938-9), learning techniques of surgery and histology of the primate’s brain in order to apply it in his own lab. The correspondence relates of their undertakings in research, the preparations for Verhaart’s stay in New Haven, the failure of several research plans because of WWII, the camp experiences in Asia by Verhaart, the period of restoration after the war and the political changes (independence) in Indonesia that finally lead to Verhaart’s return to the Netherlands in 1950, where he became professor of histology and Director of the Neurological Institute at Leiden University. The correspondence shows close relationships in the world of neuroscience at both sides of the Atlantic and is another example of the change from a German to an English/American orientation in medical science. Session XI -- The Makers and Shapers of Neuroscience Electrophysiology in mid-20th century America: II. EEG and the beginnings of clinical neuroscience
Lawrence KRUGER1,
David MILLETT2, and
Russell A. JOHNSON3, 4
Analysis of the compound action potential of peripheral nerve, selective nerve block and correlation with human sensory reports, principally from the St. Louis “axonologists” (Erlanger, Gasser, Bishop) in the 1930s, was paralleled by methods for stereotaxic electrophysiological mapping of the brain in Chicago (Gerard, Marshall and Saul). This was soon followed by detailed topographic mapping of the sensory fields of the cerebral cortex in Baltimore (Marshall, Woolsey and Bard); work that laid the foundation for the discovery of multiple representation of tactile, visual and auditory modalities (Marshall and Talbot, Woolsey and Walzl, etc.) in a variety of species, including man (Woolsey and Rasmussen). Some of these findings were correlated with studies of electrical stimulation of human cerebral cortex in Montreal (Penfield, Jasper and Rasmussen). In the post-WWII period, Marshall and his colleagues at the National Institutes of Health in Bethesda devised instrumentation for correlating slow direct current (DC) events with EEG, pH, blood flow and metabolic measures. The introduction of microelectrode technology led to functional subdivisions and the recognition of vertical cortical modules called “columns” or “stripes” (Mountcastle et. al. and Hubel and Wiesel). Discovery of the attributes of the rodent cortical ‘barrel’ fields (T.A. Woolsey) led to the modern era of detailed event-related functional mapping, subsuming anatomical, metabolic and electrophysiological approaches. Session IV -- Electrophysiology Wilder Penfield and Soviet neuroscience
Boleslav L. LICHTERMAN
Was it a mere coincidence that both the Montreal Neurological Institute and the Central Neurosurgery Institute in Moscow were established in the same year, 1934? My presentation deals with the relationships between Wilder Graves Penfield (1891-1976), a founder and a director of the Montreal Neurological Institute, and his Russian colleagues. It is based upon published accounts, archival sources (archives of the Russian Academy of Sciences, Russian Academy of Medical Sciences, The Burdenko Neurosurgery Institute) and witness accounts of Prof. Zemskaya from St. Petersburg. The first Russian publication by Wilder Penfield (On the Mechanism of Headaches) appeared in 1936 in a special issue of Sovetskaya Khirurgija (Soviet Surgery) dedicated to Andrei Polenov (1971-1947), a founder of the Leningrad neurosurgical school. Penfield visited Soviet Russia for the first time in 1943 within the British-American-Canadian surgical mission and spent three weeks in Moscow and its vicinity. There he got to know Nikolai Burdenko (1876-1946), the Surgeon-in-Chief of the Red Army and a founder of the Central Neurosurgery Institute. The only detailed and informal obituary of Burdenko outside the USSR was written by Penfield. His second visit to Soviet Russia in Fall 1955 was a fortnight lecture tour at neuroscience institutions in Moscow and Leningrad. Penfield’s outlook at Soviet life and neuroscience is sympathetic and sometimes naïve. In 1958 he was elected a foreign member of Academy of Sciences of USSR. His three major books on neuroscience were translated into Russian. It is telling that the Russian edition of Epilepsy and the Functional Anatomy of the Human Brain (Moscow, 1958) is dedicated to Ivan Pavlov. During the Cold War era Penfield was one of a very few channels of communication between the neuroscience communities of the USSR and the West. In the 1950s two young Soviet neurosurgeons (Dr. Aleksandra Zemskaya from Leningrad and Dr. Yuri Savchenko from Omsk) spent several months at the Montreal Neurological Institute. Upon their return they introduced Penfield’s approaches to epilepsy surgery to their home institutions and became leading figures in this field. Penfield also corresponded with a director of the Burdenko Neurosurgery, Institute Boris Egorov (1892-1972). In 1962 a Nobel Laureate in physics, Leo Landau (1908-1968), had a severe head injury in a traffic accident and was hospitalized at the Burdenko Neurosurgery Institute. Wilder Penfield was invited for a consultation. His notes in Landau’s case records provide us a glimpse of Penfield the clinician. Penfield’s contacts with Russian neuroscientists and neurosurgeons might be viewed as an interesting example of knowledge transfer in the context of Soviet politics. Session VII -- Special Lecture The Gentleman's Magazine and the advent of medical electricity
Hannah Sypher LOCKE and Stanley FINGER
Edward Cave began publication of The Gentleman’s Magazine or Trader’s Monthly Intelligencer in 1731 at his printing press at St. John’s Gate. What began as a collection of articles and news items published in other newspapers eventually came to attract a greater number of original submissions from contributors in many fields. The Gentleman’s Magazine is perhaps best remembered for covering the scientific work of the day, and in the period from 1745-1760, its contents reveal that there was a great interest in electricity as a phenomenon, as well as its potential medical applications. Of particular interest was finding cures for diseases considered incurable by traditional means. Patients with nervous system diseases such as epilepsy and palsy were therefore often the subject of early medical trials of electricity. The Gentleman’s Magazine was an integral part of the public discourse on medical electricity, as it published a broad range of articles, including accounts of cures from amateurs, medical cases from doctors, and extracts from academic journals. Tracing the roots of medical uses of electricity therefore yields insights from a variety of people, from those who witnessed its miraculous effects first hand and felt moved to write in, to those members of prestigious academic societies who strove to understand and explain electricity’s power in curing illness. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Jonathan Swift's language: Mind and brain in life and death
Marjorie Perlamn LORCH
Jonathan Swift (1667-1745) was a leading figure in 18th century Ireland; famous and infamous for his political satire. He also wrote extensively on mind/brain relations as well as language reform and machine translation. The chronic illnesses he suffered throughout his life involving vertigo, deafness and nausea have been of interest to medical historians since Ménière's disease was first described in 1861. However, the behaviour Swift exhibited during the final 3 years of his life was cause of much speculation amongst his contemporaries (Dr. Johnson, Alexander Pope, Sir Walter Scott, etc) and for the past 250 years since his death. The symptoms Swift displayed of cognitive changes, memory impairment, personality alterations, language disorder and facial paralysis have all been apportioned differing levels of significance. In the 18th century issues concerning madness and rationality were a major social concern of the day. In the first half of the 19th century Sir William Wilde (1835) exhumed Swift's skull to allow phrenological scrutiny. Fifty years later issues of cortical organization of cognitive function led to another exhumation and investigation of Swift's skull and brain cast (Bucknill, 1882). In the 20th century Osler (1902) used Jonathan Swift as a representative case study, Russell Brain (1952) presented Swift's last illness as a demonstration of both modern understanding of disease process and psychoanalytical approaches to personality. In the last 10 years, Swift's cognitive impairments have again been reinterpreted (Crichton, 1993). These various attempts to re-diagnose Swift’s final mental state and re-examination of his skull, death mask and brain cast reveal much about the changing issues of interest to clinicians and theorists regarding interpretations of language, behaviour and cognition from the 18th century to the present day. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Neurology in cartoons: Caricatures of neurological diseases and neurologists since the 15th century
Lorenzo LORUSSO
During the Renaissance, different artists began to draw medical illustrations from various viewpoints. In Italy, Leonardo da Vinci (1452-1519) was the first to study cerebrospinal nerves, as well as the first to dissect the brain and describe body muscles and their functions. Like artists of his day, da Vinci was determined to depict all aspects of human life. He followed condemned criminals to the gallows to draw their fear-distorted faces. He sought to portray the emotional as well as the physical qualities of man. These were the first caricatures in medicine. Later, other European artists described satirical aspects of medical activities. In Germany, the illustrator Hans Weiditz (1520-1536) became famous for drawing twenty-four portraits of ancient, medieval physicians. He was a discerning caricaturist of sixteenth-century medical practice. In seventeenth- and eighteenth-century England, many artists were caricaturists: Williams Hogarth (1697-1764) satirized the degradation of English society of his time, including medical malpractice. Thomas Rowlandson (1756-1827) furnished a touch of broad humour, characteristic of the artist’s lusty and rollicking style. James Gillray (1757-1815) was a famous political caricaturist but brought the solace of laughter to suffering. In Spain, Francisco Goya (1746-1828) made satirical reference to Neurology in his magnificent series of etchings entitled “Caprices”. In France, Honoré Daumier (1808-1879) purged quackery with humour. He attacked fakers, frauds and faddists while upholding the good physician. Jean-Martin Charcot (1825-1893) was the foremost neurologist of his time, making La Salpêtrière in Paris the centre of neuropsychiatric research. His clinical activity was the object of irony by French newspapers, especially his cure of hysteria by hypnosis. Pungent caricatures on the personality and political activity of Camillo Golgi (1843-1926) were popular in Italy. Cartoons were and are the popular portrait of developments in neurology when scientific language is to difficult to disseminate. Session X -- Poster Session 2 "I could see, and yet, mon, I could na' see": William Macewen, the agnosias, and brain surgery
Macolm MACMILLAN
Two little noticed cases in which William Macewen used symptoms of visual agnosia to plan brain surgery on the angular gyrus are reviewed and evaluated. In both cases he found lesions to the angular gyrus and these positive results are analysed in the historical context of the dispute over its proposed role as the visual centre of the brain. Macewen’s first patient, Thomas Muir, was rendered unconscious in 1886 when hit on the head by a piece of falling coal. Using the words included in my title, Muir summed up what had happened to him: he could not recognise people unless they spoke, he could distinguish his Bible only by the embossing on its cover, etc. This agnosia lasted only two weeks, after which he was seized with paroxysms of left-sided head pain that alternated with periods in which he had almost uncontrollable impulses to kill his wife and children. Macewen discovered Muir’s ‘alexia’ when he saw him for these homicidal impulses, eleven months after the accident, and concluded that it clearly indicated a lesion in “the posterior portion of the operculum or in the angular gyrus.” He found part of the internal table had separated and was pressing on the supramarginal convolution with a portion of it having been driven into the angular gyrus. The bony growth on that piece was removed, the bone replaced, and the wound dressed. When the wound healed Muir’s homicidal impulses disappeared. Macewen’s second patient, ‘J.C.,’ was a fifty-two year old businessman seen in 1892 for a purulent mastoid discharge. Macewen found symptoms of cerebellar abscess and also that J.C., although not aphasic, could only understand what was said to him by guessing at the speaker’s intent. Slightly later, J.C.'s symptoms became worse in that he became unable to understand what he saw. Now describing him as ‘psychically blind’ as well as ‘word deaf,’ Macewen suspected there was a cerebral abscess pressing on the angular gyrus and the first temporal convolution as well. Four days after treating the cerebral abscess, J.C.'s visual agnosia disappeared, and four days later again he understood speech. Published, unpublished, and manuscript material on the cases and their follow-up is presented and the significance of Macewen’s changing descriptions of the symptoms and their bases explored. Session II -- Visual Neuroscience "Neuropsychiatry": From political beginning to synergistic present
Bijal MEHTA
The origin of neuropsychiatry (or behavioral neurology) did not begin from an amicable collaboration of the disciplines of neurology and psychiatry but rather was created for political and military reasons. The original intent for the term "neuropsychiatry," introduced after World War I, was to appease both military neurologists and psychiatrist so that both divisions would treat patients who did not solely fit the criteria of either a purely "neurologic" patient or a purely "psychiatric" patient. The compartmentalization of medicine led to the separation of these two disciplines, and shortly after World War I it was thought that this "artificial" division created by necessity would have dissolved. However, neuropsychiatry continued to develop. The topic of this contribution is to look at what "allowed" neuropsychiatry to continue to exist and evolve during the 20th Century? The paper discusses the history of neuropsychiatry from being a branch of psychiatry or neurology into a more holistic, but not yet independent, discipline. It also illustrates the development of the concept of synergy in its current and future application to both clinical and research neuropsychiatry. Session X -- Poster Session 2 Electrophysiology in mid-20th century America: I. EEG and the beginnings of clinical neuroscience
David MILLETT1,
Lawrence KRUGER2, and
Russell A. JOHNSON3, 4
The human electroencephalogram (EEG) was pioneered by Hans Berger during the late 1920s. Hallowell Davis’s laboratory at Harvard was the setting for the first American demonstration of the alpha rhythm in 1934, followed by the first recording of an ictal EEG by Davis, William Lennox, and Fred and Erna Gibbs. That same year, the human EEG was independently pursued by Herbert Jasper at Brown University, by Lee Travis at the University of Iowa, and in Alfred Loomis’s private laboratory in New York. In many ways, this enthusiastic assembly of investigators and their work on the EEG laid the foundations of clinical neuroscience in America. First, electroencephalography demonstrated that action currents, the fundamental processes of the nervous system initially demonstrated in peripheral nerve preparations, were applicable to higher brain function and correlated with different states of consciousness. Second, early work on the human EEG demonstrated that neurological diseases could be classified, understood, and possibly treated on the basis of abnormal electrographic patterns, making EEG applicable to both normal and pathological brain function. Finally, work on the human EEG during the 1930s promised advances in the treatment of epilepsy, and provided rational justification for the nascent field of American neurology and its practitioners who attempted to separate themselves from their continental roots in neuropsychiatry and neuropathology. Session IV -- Electrophysiology The Organization of Behavior in retrospect
Peter M. MILNER
I first read parts of the manuscript of The Organization of Behavior in 1947 and although I was not a psychologist I found it fascinating. So much so, in fact that I came to McGill and studied with Hebb for my PhD in psychology. The book has three parts. The early chapters review the scene in theoretical psychology during the 1940s. They include kind but uncompromising obituaries of the behaviourist and gestalt schools of psychology, which were flourishing at the time (and did not appear particularly sick). They also include Hebb’s rationale for favouring a cognitive neural theory that would incorporate the mental concepts rejected by other materialist theories. This brought constructs like attention and ideas back into psychology, but without the vitalist overtones. This is a very forward looking part of the book and had a great influence on the course of psychological and neuroscientific thought during the next half century. The second part of the book was Hebb’s attempt to demonstrate how ideas might be represented in the nervous system. Using the neurophysiology and neuroanatomy of the day, he postulated a model in which sensory input organizes the connections in an initially randomly connected group of neurons. The new connections form complex loops he called “cell assemblies”, whose activity represents the generating stimuli. Impulses circulate around the loops for a time after a stimulus has been presented, corresponding to an idea. Cell assemblies that are active at about the same time acquire connections with each other so that when one is fired, others may follow suit, explaining trains of thought. Much of the neural information on which this model was based has been revised during the last half-century, and this part of the book has suffered in consequence. It served its purpose when it was written, but is now of diminished theoretical value. I shall not say very much about the third part of the book, which is wide ranging review of psychological problems and phenomena to which Hebb applies his theory with a rather wide brush. The freedom to talk about ideas, motivations and emotions without being accused of vitalism was probably intoxicating to a generation that had been restricted to studying only observable behaviour. Session V -- Donald O. Hebb Seminar The framing of MS: 1824-1924
T. Jock MURRAY
Although it is commonly said that Charcot discovered and named MS (multiple sclerosis) in 1868, neither of these statements is true. He acknowledged those who described the disease before his famous 1868 leçons and paid particular tribute to his friend and colleague Vulpian who first used the term sclérose en plaque disseminée. Although others knew of the peculiar disorder that caused paraplegia and showed scattered grey patches of degeneration at autopsy, the great contribution of Charcot was to brilliantly frame the clinical and pathological features so that others could then diagnose the disorder. A flurry of case reports and case series were published over the next few decades but his description was little changed until well into the 20th century. This talk will outline the views and approaches to paraplegia in young adults before MS was defined by Charcot, using some sample cases, such as Saint Lidwina of Scheiden, Margaret Davies, Augustus d’Este, Heinrich Heine, Alan Livingston and Margaret Gatty. Some of these would be regarded as “probable MS” due to some missing detail, but others were clearly clinically definite MS. There were many developments in clinical and pathological medicine, as well as in the use of the microscope, staining techniques and the arrangements in the French hospitals that led to the observations of Ollivier d’Angers, Carswell, Cruveilhier, Frerich, Rindfleisch, Rokitansky, Leyden, Frommann, Türck, Vulpian and others, that preceded the Charcot leçons and these influences came together when Charcot strode onto the stage at the Salpêtrière in 1868. The publications of Charcot’s students and the international contributions over the next half century will be discussed, leading to the major ARNMD conference on MS in New York in 1921 and the subsequent discussions and reports. Although the understanding of MS advanced with changes in scientific knowledge and techniques during the period, little changed in the empirical approach to management and therapy. I will also indicate that many of the fundamental questions we are pondering today were raised in the 19th century. Session VIII -- Multiple Sclerosis Seminar A pivotal figure of the "terror in a wheelchair": An attempt at etiological diagnosis of Georges Auguste Couthon's paraplegia
Régis OLRY and Genevieve DUPONT
In July 1899, a women bequeathed to the Musee Carnavalet the old wheelchair covered with lemon-yellow velvet, which belonged to her great-grandfather Georges-Auguste Couthon. In the early 1790s, Couthon had been with Robespierre and Saint-Just one of the pivotal figures of the Terror. Nicknamed the "Attila of Lyon", he was responsible for re-Jacobinizing the rebel city, and will always be remembered as the rapporteur of the terrifying law of prairial on June 10, 1794. Two years before his death, Couthon was completely paraplectic, a disease supposed to have been caused in his younger days (before 1787), when he hid one night long in a sunk draining trap to escape a jealous husband. His paraplegia does not seem to have led to sexual disorders (he had a first son on December 17, 1787, and a second one on January 21, 1790), increased gradually (he was still able to walk on crutches in October 1791, but no more in May 1792), and was spastic (it took about fifteen minutes to lie him on the plank of the guillotine on July 28, 1794; it would not have been a problem to lie a condemned person with a flaccid paraplegia). Moreover, Couthon also suffered from headaches and coercive hiccup. Dr Augustin Cabanes a posteriori diagnosed a “chronic dorsolumbar pachymeningitis originally localized to the roots of the lumbosacral plexus”. The aim of this presentation is to rebuild the chronology of Couthon’s symptoms in order to try to throw a new light on the real etiology of his paraplegia. Session X -- Poster Session 2 A history of computational neuroscience: Still searching for the engram
Marsha R. PENNER and S.N. BURKE
The last decade of the twentieth century witnessed tremendous growth in neurobiology and in information technology, and many aspects of these developments have merged to facilitate new computational approaches to studying and understanding the brain. Computational neuroscience refers to a field devoted to interpreting the information content of neuronal signals by modeling many levels of the nervous system. Although in the grand scheme of things, the field of computational neuroscience may seem new, the central question this field addresses is certainly not: how is information represented and stored in the brain? At one level, realistic brain models involve large-scale simulations that include as much cellular detail as possible. For example, at the level of a single neuron, the Hodgkin-Huxley (1952) model of the action potential in the squid giant axon describes the velocity and shape of the action potential with great accuracy. At the network level, simplifying brain models consider how to interpret the information encoded by the activity of a large neuronal population. In his now famous book, D.O. Hebb (1949) was one of the first to describe a mechanism whereby information can be represented in the brain in ensembles of nerve cells he called cell assemblies and phase sequences. Other notable contributions include that of Pitts and McCulloch who (1947) addressed the issue of pattern recognition; Steinbuch (1961) who proposed the learning matrix that is the starting point for most other computational models; and David Marr who introduced the notion of feedforward inhibition to the learning matrix. Of course, there are many others who have also made substantial contributions to this field. In this presentation, the contributions of these pioneers will be discussed as well as the work of other less well-known, and contemporary scientists. Session VI -- Poster Session 1 From synapse to genome: The evolution of Hebb's neurophysiological postulate
Aryeh ROUTTENBERG
In The Organization of Behavior Hebb defined, in but 4 succinct lines, 4 key elements that are necessary to modify the synapse to encode for new memories.
But early in vitro demonstrations of activity-independent synaptogenesis by Stanley Crain and Constantino Sotelo and an abundance of evidence that followed indicated that synapses can form in the absence of activity. Thus, a strong genetic component in determining the formation and sculpting of synaptic connections needs to be taken into account by any comprehensive theory of synaptic growth in the adult. Hebb’s proposal did not encompass the role that genetics might play in determining activity-independent wiring of connections. Cast in another metaphor the current view of synaptic plasticity is one of relative contribution of genetic (nativism) and environmental input (empiricist) determinants. If time permits I will discuss a recent study which demonstrated the relative contribution of a) an input-independent genetic program and b) an input-dependent post-transcriptional regulatory mechanism to axonal growth within the hippocampus. Session V -- Donald O. Hebb Seminar Avicenna and Ibn Tufayl on the emergence of the mind
Gül RUSSELL
The principle of associative learning was first introduced by Ibn Sina (Avicenna; d. 1039) in Book VI of the Kitab al-Shifa (there is for example, no Artistotelan foundation). It was further developed in a unique narrative (Hayy ibn Uyakzan) by Ibn Tufayl (d. 1185). Ibn Tufayl’s work provides a graphic exposition as well as an explanation of the emergence and development of the mind of a child (initially cast up on a desert island as a baby and fostered by a gazelle), solely by sensory experience, association, and reasoning, without innate ideas. It will be argued that Ibn Tufayl’s explanation is based on his creation of a coherent synthesis out of Avicenna’s psychological theories from three distinct areas. The significance of Ibn Tufayl’s work is enhanced by the evidence both for John Locke’s familiarity with its Latin translation (the Philosophus autodidactus, Oxford, 1671), and for its importance as a major source for Locke’s early ‘drafts’ of the Essay on Human Understanding, also in 1671 (Russell, 1994: 2002). A proper historical perspective on the evolution of the concept of "associative learning" will need to take into account Ibn Tufayl’s work along with Locke’s Essay. *Russell, G.A., "The Impact of the Philosophus autodidactus: John Locke, the Pocockes, and the Society of Friends" in The ‘Arabick’ Interest of the Natural Philosphers in Seventeenth-Century England, G.A. Russell, ed. (Leiden: Brill, 1995), pp.224-266. Russell, G.A., "An Arabic Source for Locke’s Essay on Human Understanding: New Evidence" in the Abstract book, 38th International Congress on the History of Medicine (1-6 September, 2002), p. 329; also in the Journal of the History of the Neurosciences, Basic and Cliical Perspectives, Vol. 11, No. 4, December 2002, p.414. Session I -- The Developing Brain and Its Harmony Phrenology and the emergence of modern Western culture
Sid J. SEGALOWITZ
The explosive reception that greeted phrenology was out of all proportion to the scientific arguments made in its favor. I will outline an argument that its attractiveness had to do with aspects incidental to its issues in neuroscience. First, cultural changes related to religious developments starting in the late Middle Ages favored Phrenology over the Cell Doctrine in its view of humans as individuals. Second, Phrenology represented an approach more in tune with peoples' view of the human mind in terms of faculty psychology. These two factors mutually reinforced each other, especially in the context of the Protestantism. Thus, Phrenology filled a cultural as well as intellectual need developed during the Enlightenment that was in full fashion by the Industrial Revolution in Europe and North America. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Luigi Galvani and neuroscience
Raffaella SIMILI and Miriam FOCACCIA
In 1791, Luigi Galvani, professor of Anatomy and Obstetrics at the University of Bologna, published a memoir entitled De Viribus electricitatis in motu musculari, in the transactions of the Bolognese Istituto delle Scienze. In this work he summarised the results of a long series of experiments on electro-physiology that he began in the early 1780s. In this seminal memoir, Galvani presented his ideas on the relation between electrical forces and the contraction of animal muscles. His crucial discovery was that the contraction of the muscles of some dead animals, and frogs in particular, was due to an electrical spark obtained by an electrical machine. Galvani concluded that he had discovered the presence in nature of a new kind of natural electricity, detectable by studying the contractions of animal muscles. The discovery of animal electricity was an extraordinary response to the solution of all the problems faced by the supporters of the old theory of irritability. The point is that Galvani, faithful to Malpighi’s and Newton’s ideas, believed in an organism understood as a dynamic system of communication, with a proper internal organisation based on the brain, not the heart, as Haller held. From this point of view, Galvani also kept in touch with the anti-Hallerian positions of Robert Whytt and William Cullen. In the last part of the De Viribus, Galvani claimed: “Now inasmuch as we have already shown that electric fluid is carried through the nerves of the muscles, it must therefore be transmitted through all of the nerves. Furthermore all these nerves must draw it from a single common source, namely the cerebrum. Otherwise [...] they do not seem to be adapted to activating and secreting one and the same fluid. We believe, therefore, that the electric fluid is produced by the activity of the cerebrum, that it is extracted in all probability from the blood, and that it enters the nerves and circulates within them in the event that they are hollow and empty, or, as seems more likely, they are carriers for a very fine lymph or other similarly subtle fluid which is secreted from the cortical substance of the brain, as many believe. If this be the case, perhaps at last the nature of animal spirits, which has been hidden and vainly sought after for so long, will be brought to light with clarity. But however this may be, I think no one in the future will have doubts concerning their electrical nature in view of our experiments”. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine The long 18th century: When mind escaped the cells
C.U.M. SMITH
From the times of Nemesius to those of Descartes and Willis, the mind was located in the brain, especially its ventricles or cells, and communicated with the rest of the body via conduits formed by hollow nerves. Both Descartes and Willis liberated the rational soul from this confinement. They also ensured that the animal spirits of the medievals lost their spiritual dimension and, becoming fully corporeal, were open to investigation by the techniques of natural science. These corporeal spirits also escaped the brain, this time to pervade the entire neuromuscular system. This paper reviews these developments in the work of Descartes, Willis, Swammerdam, Haller, Cullen, Whytt and Erasmus Darwin. Allusion is made to the panpsychist ideas of Leibniz and the work of Abraham Trembley and La Mettrie as well as the reception of eighteenth century neuropsychology in the wider English culture of Samuel Johnson, Richardson, Smollett and Laurence Sterne. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine The energetics of thought
Theodore L. SOURKES
The discovery of the Law of Conservation of Energy in the 1840s had consequences for psychological theory. Does the process of thinking involve a novel form of energy that is not recognized by physical science? E. L. Youmans (1821-1887), commenting (1865) on “the correlation and conservation of forces,” stated, “mental operations are dependent upon material changes in the nervous system.” Kurd Lasswitz (1848-1910) introduced the term “psychophysical energy,” based upon the electrical activity of the brain. At the beginning of the 20th century Alfred Lehmann, Professor of Psychology at Copenhagen, sponsored experiments in his laboratory that attempted to measure psychical energy as a net increase in metabolism during mental work. He claimed that intense mental effort led to a net increase in oxygen utilization, and that this verified the existence of a specific psychic energy. Hans Berger (1873-1941) adopted Lehmann’s views. In his lectures on psychophysiology (1921), he stated that “When psychical energy arises, an equivalent amount of another type of energy decreases. Psychical energy is derived by transformation of physical energy, and can again be converted back into it.” Chemical and electrical activity of the brain were the specific sources of that energy. The energy balance experiments of the Benedicts in 1933, performed with the Atwater respiration calorimeter, showed that the increase of only a few percent in heat production during intense mental effort is probable due to attendant slight changes in muscular and cardiac activity. Modern approaches to the problem include the Kety-Schmidt procedure for measuring cerebral oxygen utilization and PET scanning techniques. Their pertinence to “psychic energy” will be assessed. Session III -- Muscle and Energy The "Neurosciences Research Program" of Francis O. Schmitt (1903-1995) as seen from a German perspective
Frank W. STAHNISCH
Probably no other researcher, in the 20th-century, has done more to foster the interdisciplinary and integrative approach in the neurosciences than the second institute professor F. O. Schmitt at MIT in Boston. Inspired by his postdoctoral studies in England and Germany between 1927 and 1929, his journey to European science institutions in 1959, and driven by his urge to integrate different research means into basic biophysical science, he organised two seminar series at MIT in 1960 and 1961. These meetings can be seen as the nucleus of the Neurosciences Research Program (NRP), which Schmitt inaugurated at the American Academy of Arts and Sciences in Brookline, Massachusetts. The impact of NRP as well as that of the legendary Boulder meetings at the University of Colorado is well known to neuroscientists and historians of neuroscience: Schmitt managed to bring together an international group of eminent researchers from various disciplines and stimulate their productive interaction in the study of the nervous system. But we do not have an adequate account of what caused his political intentions in the neurosciences in the first place and what prompted researchers from all over the world to engage in the conferences and events organised by F. O. Schmitt. In the first part, this paper traces some of Schmitt's reflections exposed in his autobiographical account in The Never-Ceasing Search (1990). These personal considerations shall then be related to the historical state of the neurological, psychiatric, and basic sciences of the 1960s in Germany to investigate what non-American participants could have interested in the content and structure of NRP. In the second part, based on the method of Oral History, illustrative personal accounts of some major German neuroscientists are presented. How did they perceive their endeavours in relation to the general development of neuroscience into an interdisciplinary research field? Their views shall be compared to the state of essential topics in the Neurosciences Research Program Bulletin and central German neuroscientific journals between the 1960s and 1980s. The results shall give further hints as to how important interdisciplinary work is perceived in the neurosciences and their research organisation. Session XI -- The Makers and Shapers of Neuroscience Fibers and vibrations: Transition models of brain function in the 18th century
Yves TURGEON1 and
Harry WHITAKER2
Eighteenth century models of brain function marked a conceptual change, notably the emergence of physiological psychology and the development of neuroscientific concepts. Theoretical systems such as David Hartley's notions of vibrations in the brain and Charles Bonnet's speculations on the structure and function of nerve fibers may be regarded as recurring attempts to reconcile rational philosophy with contemporary advances in the physical and biological sciences. Charles Bonnet’s (1720-1793) major philosophical works, Essai de Psychologie (1755) and Essai analytique sur les facultés de l'âme (1760), represented one more step in the development of pre-scientific psychology, serving as one focal point for the transition from the metaphysical philosophy represented in cell doctrine to the scientific neuropsychology that developed in the latter half of the 19th century. Bonnet's brain model, based upon a notion of fibers and movements, compares favorably to the independently developed vibration model of David Hartley (1705-1757) and to ideas of Etienne Bonnot de Condillac (1715-1780). 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine The contributions of Derek Denny-Brown, the Boston City Hospital, and Harvard University to 20th century American neurology
Joel A. VILENSKY1 and Sid GILMAN2
A neurological division at Boston City Hospital (BCH) began in 1876 and ended in 1993. During much of this period the division was a component of Harvard University, and from 1941 to 1967 it was under the direction of Derek Denny-Brown (DD-B). Under DD-B the division became one of the premier neurological training centers in the U.S., transforming American neurology from a previous association with psychiatry into an independent specialty more aligned with internal medicine. BCH was dedicated on May 24, 1864, with the neurological division established 12 years later under the “electrician,” Dr. Samuel Webber. In 1925 the Rockefeller Foundation offered Harvard $350,000 to establish an associated Neurological Unit (NU) at BCH. The Unit opened in 1930 with a 56-bed ward, library, research laboratories, and conference rooms under the direction of Stanley Cobb, who was followed in 1934 by Tracy Putnam. In 1939 Putnam moved to Columbia and was replaced by New Zealand-born, Sherrington-trained DD-B, who arrived in 1941. DD-B immediately began an ambitious research program that initially centered on projects begun during WWII such as craniocerebral trauma and peripheral nerve injury, but eventually expanded to include multiple sub-disciplines of neurology, with a concentration on movement disorders. Much of the latter research involved studies of the effects of cerebral and spinal lesions on over 400 monkeys, all of which were filmed, and were charted on a regular basis. DD-B’s clinical training in London (under Gordon Holmes, Charles Symonds, and MacDonald Critchley) had instilled in him the importance of internal medicine and neuropathology to neurology. In his training program, his residents approached neurological disorders from the perspectives of medicine and pathology, and in 1952 DD-B published an article in the NEJM, “The Changing Patterns of Neurologic Medicine,” that elaborated upon his views and became a model for neurological training across the country. DD-B’s training program was so successful that at one time 50% of the Chairman of U.S. Departments of Neurology had received some training at the NU. Similarly, his program attracted fellows from around the world, including Ian McDonald, Roger Bannister, Ralph Ross Russell, and staff members such as Lahut Uzman, Flaviu Romanul, and Simeon Locke. DD-B was a self-reliant scientist who made his own equipment, conducted experiments himself, created illustrations and hand-wrote articles. He was described as the “conscience of neurology” because he sharply criticized residents and professors alike whose research reflected less than full scientific rigor. DD-B retired from the NU in 1967 but continued his research at the New England Regional Primate Center almost until his death in 1981. During the 1970s, Harvard was forced to withdraw from the BCH, and the NU became a component of Boston University. A separate Neurological Unit was laterestablished at the Beth Israel Hospital in Boston, which has continued under the direction of Clifford Saper. Session XI -- The Makers and Shapers of Neuroscience Visual neuroscience before the neuron
Nicholas J. WADE
Visual neuroscience is considered to be a contemporary concern, based in large part on relating characteristics of neural functioning to visual experience. It presupposes a detailed knowledge of neural activity for which the neuron doctrine is a fundamental tenet. However, long before either the neuron doctrine had been advanced or the nerve cell had been described attempts were made to estimate the dimensions of nerve fibers from measures of visual resolution. In the seventeenth century, the microscopes of Hooke and Leeuwenhoek were unable to resolve structures as small as nerves adequately. However, it was not Hooke's microscope that led to an estimate of the dimensions of nerve fibers but his experiments on the limits of visual resolution. Hooke determined that a separation of one minute of arc was the minimum that could normally be seen. Descartes had earlier speculated that the retina consisted of the terminations of fibers of the optic nerve, and that their size defined the limits of what could be seen. Estimates of the diameters of nerve fibers were made on the basis of human visual acuity by Porterfield in 1738; he calculated the diameters of nerve fibers in the retina as one 7,200th part of an inch (0.0035 mm), based on the resolution of one minute as the minimum visible. In the same year, Jurin questioned the reliability of such estimates because of variations in visual resolution with different stimuli. The measurement of visual acuity was refined by Mayer in 1755, using dots, gratings, and grids as stimuli. In the 1830s, Treviranus fused the microscopic and acuity approaches to determining the dimensions of nerve fibers. His indirect estimates of the dimensions of retinal fibers were close to those derived from microscopic observation. However, the suggestion that the retina consisted of terminations of nerve fibers influenced Treviranus's detailed illustrations of its microscopic structure. Contrary to the situation that obtained after the microscopic structure of the retina had been established, a function of vision (acuity) was used to determine the dimensions of the structures (retinal elements) that were thought to mediate it. Session II -- Visual Neuroscience Medieval cell doctrine as the origin of Western models of brain function
Harry WHITAKER
Medieval cell doctrine originated in Aristotle’s cognitive model and was further developed in the 5th century by the early church fathers and in the 10th century by Avicenna. From the 11th to the 17th centuries MCD not only explained brain function, it accounted for the sequelae of brain injury. The major components of MCD are (a) Formation of the mental image, (b) Cognitive operations on the mental image, (c) Storing the mental image in memory, (d) Information Transfer (movement) and (e) Localization in the brain. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Claude-Francois Lallemand and the tradition of clinical-pathological correlation at the debut of the 19th century
Harry WHITAKER1 and
Claudio LUZZATTI2
Lallemand’s Recherches anatomo-pathologiques sur l'èncephale et ses dépendances went through s everal editions between 1820 and 1834. It is another milestone in the tradition of compendia such as those of Wepfer and Morgagni. At the same time it furnished the data that inspired J.B. Bouillaud to defend Gall’s language localization hypothesis that culminated in the work of Broca; It also furnished data that Marc Dax used to argue that language was localized in the left hemisphere. 18th Century Neuroscience Symposium -- Function in the "Long" 18th Century:
The Transition from Medieval Cell Doctrine to Cortical Localization Doctrine Kindling: A model of neural plasticity and behavioral consequences
Amanda J. WINTINK and Lisa E. KALYNCHUK
In 1964 Graham Goddard employed a technique that involved the repeated administration of an electrical current to the amygdala while investigating the effects on memory. The technique has since become infamously known as "kindling" after it was first described in 1967 (Nature, v214) but coined in 1969 (J Comp Physiol Psych, v68). Since then the kindling phenomenon has been instrumental as a model of epileptogenesis: The anatomy, electrophysiology, and biochemical mechanisms underlying kindling have been thoroughly investigated. However, separate lines of kindling research have detailed the behavioral consequences of kindling that further model several of the pathologies comorbid in individuals with temporal lobe epilepsy, such as memory impairments, anxiety, fear, panic, and schizophrenia-like behavior. The kindling model is attractive not only because of the ability to examine seizure behavior in a progression manner but also because the behavioral consequences often develop in a similarly progressive manner. After almost 40 years of study, the kindling model remains a viable and influential tool for studying neural plasticity and the behavioral consequences. Session VI -- Poster Session 1 Hughlings Jackson's neurological method
George K. YORK and David A. STEINBERG
This study aims to show the development of John Hughlings Jackson’s method of case analysis. Physicians in mid-Victorian England did not use a systematic method of clinical case study. Many, but not all, followed Moritz Romberg’s 1840 classification of neurological diseases into disorders of increased and decreased sensation and movement. Robert Bentley Todd and Charles Edouard Brown-Séquard advocated an inherently physiological approach to analysis of sensory and motor signs and symptoms. We examined Hughlings Jackson’s published works up to his lecture on the method of study of diseases of the nervous system, given at the London Hospital in June 1864. In his first papers, he collected cases of patients with similar diseases in different anatomical locations, and therefore had different symptoms. Under Brown-Séquard’s influence, he then collected cases with different pathology in the same anatomical location. He became dissatisfied with this method because it did not lend itself to the study of physiology, and he was interested in learning how the nervous system works. He therefore turned to collecting cases with the same anatomy, tissue pathology and symptoms, assuming that a patient’s symptoms indication normal and abnormal physiology. His method of collecting cases of patients with what we now call focal lesions was a scientific method that had not been previously applied to neurology. It proved a durable technique. Hughlings Jackson himself showed the power of his method by publishing a series of thirty-eight patients with mitral stenosis, middle cerebral artery embolism, aphasia and right hemiparesis. This study supported Broca’s assertion that there is a center for language in the left inferior frontal lobe. Hughlings Jackson went on to use his tripartite method of scientific case analysis to produce his theory of cerebral localization. Session XI -- The Makers and Shapers of Neuroscience
ISHN 2004 Annual Meeting -- Abstracts http://www.ishn.org/abs2004.htm
Last updated 12 August 2004 |