Cobbers on the Brain

What are Concussions?

Concussions are caused by force to the head causing a change in head motion andpossible skull deformation. Depending on the force, position and angle of contact,concussions can vary in severity and symptoms. Typical symptoms stem from a cascade of molecular events inside the brain that shift from normal function. Balances of major ions in the brain like potassium, glutamate, and calcium are shifted during concussions, requiring energy in the form of ATP to return to homeostasis. This in turn calls for an influx of glucose to provide the ATP to thecell. After this initial influx in ATP and glucose, there is a depression of both compounds following concussion. The development of free radicals is also a result of concussion, causing damage to DNA and other fragile cell material. Other effects of concussion include damage to axons, synaptic plasticity, and connectivity changes.

Diagnosing/Analyzing Concussions

Diffusion Tensor Imaging: Measures the structure of axons with measures of how much water diffuses (mean diffusivity) and what the directionality of diffusion is (FA).

Fractional Anisotropy:  Measures how water particles diffuse in a particular environment like your brain. Diffusion of particles, and therefore FA value, is affected by many structural differences in the nerve fibers such as size, myelination, volume, density, and orientation. With all of these effectors, FA can be used to evaluate the content of a brain’s white matter, which coordinates communication throughout the brain. In concussions, typically a drop in FA values are seen as a long term effect, possibly due to a decrease in nerve fiber volume. Some cases show an increase in FA value right away, pointing to a possible neuro-inflammatory response.

Treatments for Concussion

While there is no way to stop the cascade resulting from concussions, symptoms can be regulated with plenty of rest and reduced stimulation. Staying away from screens and intense reading can increase the recovery speed, and help alleviate symptoms like headache and difficulty focusing on things. Rest in this case means not doing things that exacerbate symptoms

Further Research

• https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594
• http://advancingyourhealth.org/orthopedics/2015/12/30/key-steps-to-diagnosing-and-treating-concussions/
• http://www.protectthebrain.org/Brain-Injury-Research/What-is-a-Concussion-.aspx

Images

• https://www.ncbi.nlm.nih.gov/books/NBK185339/

What is Addiction?

Addiction is a condition that is caused by an individual using a substance or behavior for the rewarding effects that compel them to continuously repeat the activity despite it being harmful to them. Common substances that induce addictive effects include opioids, cocaine, nicotine, and alcohol, and behaviors such as gambling and video games can be addictive. These substances and behaviors have been scientifically proven to activate pathways in the brain related to reward and reinforcement, and most of them involve the neurotransmitter dopamine. Addiction also affects the brain’s executive functions, so some people who suffer from the disorder may not realize that they are harming themselves or others around them.

The cause of addiction stems from the first initial use of the substance or behavior, but there are many other factors that contribute to the continual use and eventual addiction. Genetic and biological factors contribute to the susceptibility of individuals to the condition, but social, psychological, and environmental factors have been shown to be the most powerful contributors. As many doctors like to say, with any disease, genetics loads the gun, but environment and behaviors pull the trigger.

A Link Between Stress and Addiction

There is an interesting link between stress and addiction. Stress is a known risk factor of addiction along with risk of relapse. The correlation has been assumed for decades, and has recently been proven scientifically through sophisticated human brain imaging and cross examination with other laboratory methods. These studies have shown a correlation between stress and craving and their link to the brain regions responsible for reward and addiction risk.

Stress – The Good and the Bad

Stress is a very broad term that needs some defining before we dive deeper into the link between it and addiction. Stress is defined as a process involving perception and response to a harmful or challenging event or stimulus. Stress responses are meant to be an adaptive response to regain homeostasis. Examples of stressors include loss of relationship, death of a family member, food deprivation, insomnia, and binge use of psychoactive drugs.

Stress is mostly associated with bad and harmful situations, there is also “good stress.” Good stress refers to stimuli that are moderately difficult to deal with, and if the individual handles the situation well, they generate a feeling of mastery, and are usually perceived as pleasurable. However, as intensity of the stimuli increases and is prolonged, the less control an individual has on the situation, and usually the sense of accomplishment and mastery decreases. This can increase the stress response, which as we will see, increases the susceptibility for addiction or relapse.

Three Groups at Risk

The most widely accepted and common association between stress and addiction is that drugs are used as a coping strategy to deal with stress or to self-medicate. There is sufficient evidence to this theory, and it can be categorized into three types. The first type involves adolescents experiencing negative life events such as loss of a parent, parental divorce, or a single parent family. The second type involves trauma and maltreatment, such as childhood sexual and physical abuse. The third type includes lifetime exposure to stressors and the impact is has cumulatively. These stressors are mostly unpredictable events, such as victims of gun violence, loss of parent, or natural disaster. Unsurprisingly, it has been found that the more of these uncontrollable events an individual experiences in their life, the more likely they are to become addicted to a substance or relapse, despite factors such as race, gender, or family history of drug abuse.

Brain Pathway Disfunction

Scientists have also studied neurobiological mechanisms explaining the effect stress has on addiction. Drugs of abuse such as alcohol, nicotine, and opioids all activate dopamine pathways, which is associated with higher craving. Additionally, stress exposure increases dopamine release. Because both stress and drug abuse both activate similar brain pathways, they both result in changes to neuronal synapses, enhancing the effect of each.

A Vicious Cycle

The link between stress and addiction creates a vicious cycle because they both feed into each other. The more stressed someone is, the more likely they are to abuse drugs, and drug abuse itself creates a very stressful environment for the body. They best way to avoid addiction is simply to never try drugs in the first place, but that can be easier said than done with social pressures and acceptance of drug use in pop culture. In our increasingly fast paced world, stress is tough to avoid, so staying stress and addiction free really comes down to making healthy decisions in all aspects of life.

Images:

https://www.google.com/search?safe=off&biw=1082&bih=565&tbm=isch&sa=1&ei=WXrrW-uCJY6ksAXRxqmYAw&q=stress+and+addiction&oq=stress+and+addiction&gs_l=img.3..0j0i24l4.236183.238454..238624…0.0..1.163.1953.14j6……1….1..gws-wiz-img…….0i67j0i8i30.W3_prnFKycU#imgrc=LojOaK9Nh8DJbM:

https://www.google.com/search?q=dopamine+and+addiction&safe=off&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiz7e7a3dLeAhVxmK0KHY4WC-cQ_AUIFCgC&biw=1082&bih=614#imgrc=eo551pZVRyzTIM:

At the end of class the other day a friend was telling me about her time working in an ER in which she helped many overdose patients. Almost all of them would say something along the lines of “it wasn’t supposed to do this.. It normally doesn’t do this..” After many days receiving these answers she finally asked one of the patients, “so if it wasn’t supposed to do this, what is it supposed to do?” “Help me forget.”

Humans turn to vices daily, using them to help mitigate our lives. These can be healthy or harmful depending on the vice and reasoning behind it. Addiction can stem from any activity that generates a pleasure response in your brain. This is called the reward pathway. It involves the release and transmission of dopamine from the ventral tegmental area (VTA) to the limbic system and frontal cortex where it binds to its receptors. Once bound to the receptor this reward takes place teaching us the actions and situations surrounding the stimulus. Naturally, this pathway enhances certain behaviors necessary for survival such as eating, drinking, sex and social interaction.

Drugs however don’t play by the rules. They take over the system, not only increasing the levels of dopamine but physically changing the brain. Depending on the drug, different areas are affected in different ways primarily by changing the density of receptors (decreasing D2 receptors), blocking re-uptake of dopamine, or triggering the release of excess dopamine. They all work in the same way, increase the dopamine present to therefore prolong the euphoria. This has now changed the behaviors from survival to drugs. Every need is now encompassed by and inferior to the need for drugs.

There is a great lack of self control in drug addiction. Even when the drug is no longer pleasurable and enjoyable the abusers must continue. This lack of self control stems from the reduced concentration of D2 receptors in the brain which regulate the frontal areas responsible for self control. It becomes compulsive and impulsive. This is not the same as an addiction to your phone where you still truly have control over the actions. They truly have lost all control, yet as a society we act as though they are still fully functioning and can stop at the drop of a hat. We have unrealistic expectations for those suffering from abuse. As a society we must change the narrative surrounding this, likely needing to categorize addiction as a mental illness rather than just a personal problem. It not only destroys them but those around them as they slowly lose the one they love to drugs.