This iReport is part of an assignment:
Living with autism
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Posted April 17, 2008
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amherst, Massachusetts
amherst, Massachusetts
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Autism and Asperger's - using magnetic energy to unravel its secrets
On more than one occasion, I've had people ask me, "If you could take a pill and get rid of your Asperger's, would you do it?" I've always said, "No! I'm proud to be Aspergian and I wouldn't change it for anything." Asperger's is an essential part of who I am. In fact, its how my brain is wired. My brain's unusual wiring manifests itself in many ways. I say unexpected things. I have weird mannerisms. I come to surprising conclusions when solving problems. To most people, my mind just works in strange ways. When I was younger, that troubled me to no end. I always knew I could take pills to change the way I act. But my Aspergian impulses are pretty powerful, so I'd need a powerful pill to hammer them into submission. And I shudder to think of the side effects. I still remember seeing my parents in the state hospital, slowly wandering, mindless, and tranquilized into submission. The orderlies even had a name for it. They called it, "doing the Thorazine shuffle." Today's brain pills may not have such dramatic side effects, but the complaints of sexual dysfunction, dry mouth, weight gain, or insomnia are well documented. Pills go in our mouths, dissolve, and affect the whole body. Pills aren't intelligent. They can't pick the one part of the brain that's troubled and fix it. Body-wide dispersion is okay for fighting infection, or lowering fever. But it's not okay for a pill that affects the working of the mind, at least, not for me. But I've always wondered, What if there was an alternative to pills? If I could pick a part of my mind and change it and make it better, would I do it? Until now, such questions were merely fantasies. No more. Right now, neuroscientists are working to make that dream a reality. In fact, one of the leading teams is right near me, at Beth Israel Deaconess Medical Center - a part of Harvard Medical School. A group of researchers led by Dr. Alvaro Pascual-Leone is using focused magnetic fields to deliver energy to small parts of the brain without surgery. This energy can enhance or inhibit the functioning of specific areas of our brains, allowing treatment of small parts of the brain without affecting the whole. This technique is so precise that regions as small as 1 percent of the brain's total volume can be treated. The process is called Transcranial Magnetic Stimulation, or TMS. The TMS energy is delivered by electromagnets held alongside the head. It's clean, noninvasive and painless. The TMS energy causes the brain to form new connections and pathways. It provides the "push" to make the brain change. The brain changes in subtle ways throughout life, but TMS can accelerate and shape that change in a beneficial way. I was immediately attracted to and comfortable with the idea of TMS, because it uses processes I knew from my time in electronics. When I worked at Candela Laser, we designed high-energy power supplies that were essentially the same as those used in TMS. And I used powerful electromagnets in both audio and laser work. When I began talking about this, some of my friends said, "Aren't you scared having those magnets by your head?" I'm not scared, because the systems I used before were far more powerful than these. Admittedly, they were not focused into my head, but we engineers have a long history of co-existing with magnetic fields without ill effect. In addition to my own experimentation, Dr. Pascual-Leone and others have done extensive research to validate the safety of magnetic therapy. It's also been extensively researched in the context of MRI machines, which generate even more powerful magnetic fields. All my life, I have worked hard to train and develop my brain. I've had good success teaching my strong parts, like logical reasoning, to take the place of weak parts, like social empathy. That has made my life far better, but it has limits. Now, TMS offers the possibility of removing some of those limits by targeting specific roadblocks within my mind, and enhancing or removing them. The possibilities of TMS are staggering. Right now, the technology is helping restore brain function in stroke survivors. It's helping chronically depressed people return to happy lives. A Google search reveals many articles and papers on the successful use of TMS in these areas. The process has been fine tuned over the past twenty years, and it's now a mainstream therapy for certain conditions in Europe. Based upon that success, Dr. Pascual-Leone's team has set their sights on using TMS to help the autistic mind here in Boston. I have decided to join Dr. Pascual-Leone's team to assist in conducting and shaping this research. We both hope my Aspergian mind will provide insights to move the work ahead. I'll be in an unusual position, since I'll be an experimental subject who is at the same time involved in formulating the experiments. And throughout the process, I'll be writing and telling the story to the wider world. The prospect is both exciting and scary. It's exciting because TMS may help my mind develop new abilities, and it may allow me to accomplish things I could not even have dreamt of before. But it's scary for the same reason . . . I may change in unexpected and even unwanted ways. What if I don't like the result? But it's irresistible too, because the process of shaping and delivering powerful pulses has always fascinated me. In fact, it was one of the things I specialized in when I worked in electronics. The similarities between the equipment in their lab and devices I'd worked with were immediately obvious to me. As a child, I read a book called Flowers for Algernon. It's the story of a team of scientists who find a way to make people smarter. As a test subject, they choose a mildly retarded janitor. And he becomes a genius, but it doesn't last. After a little while, his intelligence fades before his eyes. Will I suffer the same fate? I sure hope not, and my logical mind tells me such a possibility is extremely small. As always, I prefer to focus on the opportunities life offers. And I've got an ace in the hole . . . TMS is not permanent unless it's reinforced by repeated treatment. Otherwise, the effects of TMS fade with time. That means we pay close attention to our results, and reinforce the beneficial ones while abandoning those that don't work out. All my life, I've been blind to social cues, facial expressions, and body language that others read instinctively. I can't look someone in the eyes and know how they feel. Those parts of my brain just don't work. You might say, those circuits aren't hooked up. What if TMS could help my brain make those connections? What would it mean to me, at age fifty? How could I know? It's like asking a blind person what it might be like to see. Wiring differences like that create big problems for thousands, even millions, of people. What if we could address those problems without changing the essence of who we are? What if we could remove the anger from a person who suffers from uncontrollable rages? We can do it today, with heavy tranquilizers. Can you imagine using TMS to do it without medication, leaving the essential person unchanged? Existing tools - heavy medication, electroconvulsive therapy, or lobotomy, are like sledgehammers in the mind. Suddenly, there's the prospect of tiny tweezers to pick out microscopic slivers instead. The most exciting possibility is that of extending this therapy to more profoundly autistic people. What if we could offer a non verbal person the power of speech? Today that's a dream, but it may become a reality through techniques pioneered in the Beth Israel Deaconess labs. Some people read about TMS and the phrase "a cure for autism" comes to mind. I'm aware such talk generates tremendous controversy. Dr. Pascual-Leone is quick to say TMS does not "cure" autism, but that does not stop the gut reaction many people feel. On the one side, we have parents desperate to "fix" their kids. On the other, we have grownups on the spectrum, who say, "We don't want to be fixed, and we have the right to live our lives in peace." That's what I've always said too, while faced with existing sledgehammer treatment options. Now, with the possibility of gradual growth and change through a process that's the mental equivalent of physical therapy, I have to rethink that position. The idea that I can change and hopefully improve my brain in a gentle, progressive, and reversible way is just fascinating, and irresistible. TMS could offer the ability to make our brains work better. I invite you to accompany me on this journey, as we learn some of the implications of fine-tuning the mind. I look forward to sharing the story of our research as we move ahead. The TMS lab is supported in part by grants from the Nancy Lurie Marks Family Foundation and Autism Speaks. Check my blog for useful links and more to read . . . http://jerobison.blogspot.com John Elder Robison, author of Look Me in the Eye, my life wirh Asperger's
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