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Comments

• [1] Julie from Minneapolis November 20, 2008 - 04:04PM

  The end of this segment actually caused me to gasp "oh my god" out loud at my desk. Really excellent work, as always.

  
  
• [2] C.L. Ball November 20, 2008 - 04:04PM

  Jad Abumrad's objections to the diagnostic brain scans for mental illness are bizarre are anti-scientific. Abumrad is essentially denying the bio-chemical basis of mental illness when he says he wants the problem solved on the therapist's couch. Furthermore, doubts over the therapist's ability to accurately diagnosis the illness is the very reason for pursuing clinical brain scan technology.

  Linking this to SIDS is also strange. The doctors who developed the thymus gland theory on SIDS should have compared thymuses of SIDS-death babies w/ babies that did *not* die from SIDS. If they had modern imaging technology, they might have been able to.

  
  
• [3] Ani from miami, fl November 29, 2008 - 12:48AM

  Awesome work. But wait...you never explained what caused the infants' sudden death?!

  
  
• [4] sara from California November 30, 2008 - 02:18AM

  Abumrad was correct: biological reductionsim has been the siren song of psychiatric illness and has led to many destructive 'therapies.'

  Unfortunately, the argument is not a fuzzy attachment to a couch and ambiguity. The fact that we can observe gross alterations in a brain thru imaging may have little specificity when it comes to effective treatment.

  Modern models have established that experience shapes brain structures. Psychotherapeutic relational experience can modify what is seen on an fMRI. Baxter showed that OCD brains change after CBT as much as after medication.

  Both Krulwich & Abumrad were surprisingly uninformed in the way they posed their 'argument.' Krulwich seemed gaga about the

  reductionist fantasies of the MDs excited about their new tool; the SIDS history simply clarified that 'evidence-based' medicine can be woefully misguided.

  I doubt anyone would really need to have imaging to assess the value of their psychotherapy; the proof is in

  how fully human one feels - not how big the hippocampus !

  
  
• [5] Patrice December 05, 2008 - 03:43PM

  Awesome, awesome show.

  
  
• [6] Tom from New Jersey December 05, 2008 - 05:22PM

  Today, doctors try to prevent SIDS by not allowing babies get Slow Wave Sleep (Stage 3 and Stage 4 NREM sleep combined). Is this safe?

  If a baby sleeps on their stomach they go through all 4 stages of NREM sleep and then through REM sleep in a typical 90 minute sleep cycle.

  But, if you put a baby to sleep on it's back it goes through the first 2 stages of NREM sleep and then skips to REM sleep without going through Stage 3 and Stage 4 NREM sleep.

  Before 1992 over 90% of U.S. babies slept on their stomach or side. Now, over 75% of U.S. babies sleep on their backs.

  When humans are awake the memories they make are stored in their hippocampus. Then, during SWS, they are transferred to their Neocortex for permanent storage. This doesn't happen for babies anymore since they don't get SWS. Tummy Time is while they are Awake so SWS won't occur here either. Since 1992 we've had a huge increase in toddlers with neurodevelopmental issues specifically PDD-NOS.

  What I'm trying to get at is that I think a possible unintended consequence of the SIDS "Back to Sleep" Campaign is that it has caused the Autism Epidemic.

  http://tummysleepcentral.blogspot.com/2008_03_01_archive.html

  
  
• [7] Natasha from Monterey, CA December 14, 2008 - 10:19PM

  As I listened to the segment about radiation of enlarged thymus glands in babies, my jaw dropped. I was one of those babies. And in July I had my thyroid removed: I had thyroid nodules with strange cells. Because of my history of radiation, the chances of thyroid cancer were high. I had a lot anger that the doctors had radiated my thymus, causing me to lose my thyroid decades later; and now, to learn that their reason for thinking my "enlarged" thymus was a danger was misguided, brings that anger back. Thank you for the show.

  
  
• [8] Laura B. from ypsilanti, MI December 14, 2008 - 10:20PM

  This amazing story about SIDS, the thymus, the poorhouse, and gravediggers simply astounded my husband and I. We were rapt. The ending left me open-mouthed with astonishment. The story spiraled out and out and out and then came home with a bang. One of the best stories I've heard on the radio, ever. RadioLab is eclipsing This American Life as my favorite program. The next time pledge drive rolls around, I will tell my local station that it is for RadioLab that I am pledging.

  (applauds!)

  
  
• [9] Ryan S. from Washington, DC December 19, 2008 - 04:31PM

  I'd like to echo the high praise for the last segment, fascinating and well-presented. Does anybody know the title of the piano music that was playing at the end of graverobbing/thymus story? It was perfect.

  
  
• [10] Thomas L. Rodebaugh from Washington University December 25, 2008 - 11:14PM

  I love the show. Unfortunately, my scientific background leaves me quite disappointed in the first part of this segment.

  Let me amplify Sara from CA’s comments by noting that it’s bizarre to suggest that brain scans are needed because otherwise we cannot determine if a therapy works. It's equally strange to suggest that until brain scans, the sole product of psychotherapy research was a series of therapists simply claiming that their treatments work.

  I know there are pressures to keep the show brief and simplified without being too simplified, but this is too simplified.

  Worse, the simplification makes the segment self-contradictory. If the algorithm was right 85% of the time (and this was considered a good outcome), then a reasonable listener could ask: Compared to what? Compared to usual assessments. This means that established clinical methods were right 100% of the time and were considered a good standard.

  In other words, the algorithm was *aspiring* to the accuracy of methods that we already have available.

  I look forward to the day when we have a method for assessing mental disorders via brain scans. In the meantime, we have treatments that work, reliable methods for assessing those disorders, and reliable and relatively objective means of assessing change. The previous sentence could specify "non-biological" at every step of the way, and to the extent that that term means anything, the statement would still be true.

  If the folks at Radiolab aren't aware of the above, then they have a great opportunity: There's a whole range of scientific inquiry left for them to explore!

  As I mentioned, I admire the show a great deal. I have encouraged friends and students to listen to it. I wouldn't be bothering to write this message at all if the segment had been a standard NPR show. But this is Radiolab. I expect a lot from y'all.

  Best,

  tom

  
  
• [11] Burk from San Rafael, CA January 02, 2009 - 05:33PM

  I was puzzled by the ending of this piece. Has the concept of controls not occurred to the presenters? The thymus/SIDs story bears little relation to the current fMRI/depression story because the algorithm that discriminates depression from normal in the latter used controls. It was fed known normal (control) and depressed patients for learning and testing. The thymus/SIDs story made quite evident that no one looked at the population at large at the time to check on normal vs non-normal status in children of that age, matched for "age, and intelligence quotient ... and no history of ... neurological disorder or head injury", etc., as did Cynthia Fu's group. They did not do the proper controls, and this is one way that scientific critique has advanced over the years. The Nobel prize really does mean something!

  Fu CHY, Mourao-Miranda J, Costafreda SG, Khanna A, Marquand A, Williams SCR, Brammer MJ. Pattern classification of sad facial processing: toward the development of neurobiological markers in depression. Biological Psychiatry 2008;63:656-662.

  
  
• [12] Lucia from New York January 03, 2009 - 05:48PM

  I love Radiolab for a lot of reasons, mainly because it makes me think about the world in a new way. It points out relationships among things I never would have connected. It's sort of a springboard, a jumping off point for me to go and do my own investigations. So I don't have the same criticisms of its scientific method that the above commenters have.

  I do want to say something about the potential usefulness of brain scans to diagnose disease. As someone who is being treated for severe depression, I know about the stigma that still surrounds the disease. It is not a question of merely going to a doctor because you "feel sad." It is much deeper, and more devastating, than that. A depressed person constantly questions the reality of depression as a disease; I get angry with myself for not being able to "just get over it." If someone could look at my brain and say for sure that there is something different about it, that there is a concrete physical reason for this disease, and suggest a more effective treatment....how could that be a bad thing? I would see that as one more lifeline to pull me out of this darkness. Provided of course that there were enough controls and the studies were repeatable, and all of the other precautions were followed.

  There is always danger when we look at current medical practice and say "This is THE truth." It is safer to say "This is the best we can do right now," and continue to support researchers who strive for better diagnostic tools and treatments. Thank you to Radiolab for providing a platform for the discussion!

  
  
• [13] pam from london January 23, 2009 - 12:46PM

  Great show, as always. And that MUSIC at the very end (I think it was used somewhere towards the beginning as well) – please tell us what it was! I almost sprung tears just listening to the music alone.

  
  
• [14] John Maples PhD from miami florida January 26, 2009 - 10:48AM

  Love your work so the following is not critical as much as pointing out a bubble in the glue. This show of Dec. 05 2008 "..Cure what ails you" had some interesting subtle aspects. The "pattern" matching of the brain scans was done with AI software (that the researchers called computer modeling). This type of software is similar to what caused the financial crisis (www.sciam.com/article.cfm?id=after-the-crash

  and points out a very human dependence on computer output as being right regardless of real world logic. AI programs can match most things using a defined data base with and repeat this with great success. The same programs frequently (most of the time) don't work with real world data. When they do work it is difficult to understand what the computer algorithm is doing. Your story on the thymus fit right into this picture... probably without you realizing it but maybe not. Assumptions made from data that was in "error" or "opps" [I have to mention Colbert's 'truthiness' here. Truth is what we vote it to be?] You covered your concerns and doubts. Reinventing the wheel and repeating the mistakes of the past are increasing at an alarming rate. Learning comes from making mistakes, but there are few publications on "what did not work" or "how I failed". Please do more of these types of 'thymus' programs. The financial crisis modeling is a great example. NPR covered it somewhat but not in this light. Other examples are assumptions in DNA genetics that were way wrong. The so called noble gases is another example. Thalidomide is another example. Einstein didn't even know that other galaxies existed because there was great resistance that ours was not special (earth centric, solar system centric, universe centric, the human ego vs science). Mix human financial, political, fame ego into science and the need to check "assumptions" is enormous.

  Thank you for what you do. Keep it up.

  John

  
  
• [15] MJG February 06, 2009 - 09:19PM

  Hi RadioLab -

  I recently read the beginning of Bill Bryson's "Mother Tongue," a history of the English language. Bryson makes a quick connection between the part of our throat that allows us to talk, breathe and eat simultaneously (epiglottis? I no longer have the book with me to confirm) and SIDS. I believe he stated the development occurs at the same time that children can fall victim to SIDS. Hearing your show and reading his book was a strange overlap.

  Your work is excellent. It is compelling to those of us who are interested in learning but who hadn't considered ourselves science-focused.

  Keep making the hippo dance.

  
  
• [16] MJG February 06, 2009 - 09:19PM

  Hi RadioLab -

  I recently read the beginning of Bill Bryson's "Mother Tongue," a history of the English language. Bryson makes a quick connection between the part of our throat that allows us to talk, breathe and eat simultaneously (epiglottis? I no longer have the book with me to confirm) and SIDS. I believe he stated the development occurs at the same time that children can fall victim to SIDS. Hearing your show and reading his book was a strange overlap.

  Your work is excellent. It is compelling to those of us who are interested in learning but who hadn't considered ourselves science-focused.

  Keep making the hippo dance.

  
  
• [17] ginny fredricks from austin texas February 12, 2009 - 05:37PM

  The show on SIDS and thymus just aired here today- I only caught the last part ,but heard enough to know it was about me!! The baby born 2 years before me died of SIDS- so they radiated my thymus to reduce the chances for another SIDS death!! Two years ago I had my thyroid out after several years of biopsies and ultrasounds to be sure all the nodules on my thyroid were benign. They were, but once they started growing, we decided to take it out- I kinda knew there was a link, but this show definitely confirmed it. My mom was also given DES to prevent miscarriages- though she'd never even had one!!! The wonderful world of medicine-

  
  
• [18] Jason from baltimore, md February 19, 2009 - 04:01PM

  Normally I'm very pleased with Radiolab's exploration of different subjects on science. It's never in great depth, but that's the point; it's meant to get you thinking and curious enough to investigate further on your own. But this show, particularly this last segment concerns me for the same reasons others have stated.

  I have absolutely no qualms with using brain imaging for research purposes. I think the discussion of these findings contributes greatly to our understanding of the human mind. I also agree that psychological disturbances have physiological correlates.

  My problem is also a charge of reductionism in that you cannot EQUATE objective data with subjective experience, or vice versa. Seeing the brain at work in terms of data and quantities is not the same as knowing how that person thinks and feels, the qualities of his or her experience.

  Besides brain scanning every mental illness patient being a ludicrously expensive way to diagnose, it is also a fundamentally alienating act against the patient. The sense that there is something broken that needs fixing becomes reinforced. No one has ever found going into an fMRI comforting or consoling. The patient is further disempowered by not being an active partner in his own diagnosis, in the understanding of his or her symptoms.

  I think the previous segment of this show should be mentioned. When Emanuel's father decided nothing was wrong with him, decided not to let the doctors and the teachers call him retarded, he let his son become himself. I think it's great he got help later with his autism, but his father did spare him a life inside a box. Making boxes and putting people into them is what reductionist medicine does.

  We cannot take our minds to a mechanic and get it back "good as new." This has been an extremely destructive metaphor and we need to move beyond it.

  
  
• [19] John from Boston March 22, 2009 - 09:15PM

  At least twice during the thymus segment Dr. Sapolsky says that "20,000 to 30,000" people died of thyroid cancer as a result of thymus radiation therapy. Could you please list the studies that support this conclusion?

  
  
• [20] Graham from Ann Arbor May 01, 2009 - 01:31AM

  As a faithful listener of radiolab for some time now, I must admit I am very disappointed in the treatment of fMRI in the episode "Diagnosis." My respect for Dr. Kandel notwithstanding, the current literature regarding fMRI is not so conclusive as this program would lead the listener to believe. The brain is a complex system of networks, and increased metabolism in one area reflects more than input to or output from that area. Serious questions have been raised about the means by which data are analyzed in fMRI studies - particularly the group analysis described in this episode - as well as the way in which these results are interpreted. Rather than contribute to the popular infatuation with a technique whose worth is far from established, I encourage someone - anyone - at radiolab to be more responsible in their presentation of science.

  For a better explanation of these problems to which I refer, please see the articles below.

  What we can and cannot do with fMRI

  http://www.nature.com/nature/journal/v453/n7197/full/nature06976.html

  Puzzlingly high correlations in fMRI studies of emotion, personality, and social cognition

  http://www.edvul.com/voodoocorr.php