Vincent Walsh will be speaking at WIRED Health 2016 on 29 April in London. From helping humans live longer and hacking our performance, to repairing the body and understanding the brain, WIRED Health will hear from the innovators transforming this critical sector.
Science tells us that the brain is basically a big bundle of electrical wires. But what if you could tweak the running of the network from outside? It turns out we can have some mediating influence on the activity in those wires through methods such as neuro-stimulation. Zapping bits of our brains with electricity can, for example, help to treat mental illnesses.
This is the basis of one of Vincent Walsh's latest projects – a clinic at University College London opening this summer that will use neuro-stimulation to treat patients with depression. "A lot of depression is associated with changes in activity in the dorsolateral prefrontal cortex," explains Walsh. "You've got reduced activity in this area so you give it – the protocol is 3,000 pulses – you give that part of the brain, that neuro-transmitter system, a kick-start."
Walsh is a live wire. When he realised he was "much better at talking than listening" he quit his psychology degree and moved to neuroscience. Now a professor at University College London (UCL), and one of the world's leading researchers on neuro-stimulation, Walsh has established himself as an expert in a very vibrant field. And his UCL clinic is the next big step.
The specific type of neuro-stimulation used here will be transcranial magnetic stimulation, or TMS. Usually a non-invasive technique, it involves positioning a stimulation device carefully on a particular part of the patient's head. TMS has a weighty body of clinical evidence behind it and has been approved by the FDA in the United States, the UK's Nice and several other countries for the treatment of depression.
Walsh says that its efficacy is comparable to that of any drug-based antidepressant. But its use will remain limited for the time being: TMS machines cost tends of thousands of pounds and require specially-trained staff to operate them. Because of this, Walsh's clinic will initially be private, not public. "This is a British invention. It was created with British science, the machines have been developed with British industry – we're still leading it scientifically," he comments. "It just eats away at me that we're not offering it to our patients."
TMS is also tipped to help in the treatment of migraines and has already been approved by Nice in the UK for such purposes. For Walsh, exactly what forms of treatment are most effective remains unclear.
There is another form of neuro-stimulation out there – transcranial direct-current stimulation (tDCS). It's cheaper, easier to use and has already been made available in the form of consumer products. Walsh is still exploring the potential of tDCS, but he is more sceptical of its current benefits. "The stimulation is non-focal," he says. "We put two big electrodes on your head and we have very little idea of where the stimulation is going to go."
Many have wondered whether tDCS could, for example, aid the concentration and performance of elite athletes. Walsh is extremely wary of this. Elite athletes, who are generally young, might not react positively to neuro-stimulation. Experiments so far, he points out, have shown very short-term gains and the costs involved may be prohibitive. "I'm trying to steer away any athlete or coach who even dreams of using brain stimulation," he says. "My advice is it's a waste of money."
TMS, in contrast, is much more precise. While TMS needs to be carried out in a clinical setting, some people may be tempted to try out tDCS at home for long periods, but Walsh explains that the effects of this have never been studied. "We don't know what these things do to the brain if you stimulate people for 50 days in a row," he says.
He adds that one of his own papers on tDCS, from 2010, went on to be highly cited, spawning an array of similar studies – but Walsh has been unable to replicate his own findings. Among several issues with the paper, he says, was the fact that subjects had electrodes placed symmetrically on either side of their heads, an arrangement that Walsh now realises is counter-effective.
Generally, part of the problem with tDCS, says Walsh, is that the barrier to entry for research has been so low. That, he argues, has allowed some bad science to creep in.
At WIRED Health, Walsh will point out that while there may be some specialist benefits to neuro-stimulation, a return to targeting the brain's plasticity with more traditional methods could be just as valid. Struggling with a particular topic at school or at an evening class? Take extra lessons. "We seem to be becoming obsessed with technological ways of learning and trying to short-circuit learning," he comments. "But the truth is that if you want to learn something, you just have to make a fucking effort."
And there are sometimes novel ways to make that effort. Brain-training apps have been criticised by some for offering a false promise of improved cognitive abilities. In 2014, Stanford University published what it called a consensus in the scientific community rejecting the claim that brain-training apps offer an evidence-based way to reduce cognitive decline.
Walsh was part of a collective of scientists who hit back with a counter-claim, in which they argued a growing body of evidence showed that brain training apps could be beneficial in certain cases. "If we'd have had this conversation three years ago, I'd have said don't waste my time," explains Walsh, initially sceptical but now an adviser for brain-training app firm Peak. He says in recent years he's been impressed by the research of neuroscientists such as Barbara Sahakian at Cambridge and Daphne Bavelier at the University of Geneva. Both scientists have produced studies exploring the potential for games to improve cognitive abilities such as multitasking.
The research is ongoing, but Walsh is keen to emphasise that there is no point in discounting all games or brain-training apps. That's why, he says, he's changed his mind on the issue. The comment seems to speak to his work at large, which revels in the power of our brains not just to compute – but to adapt. "There's no point having a mind if you're not going to change it, I guess," he says.
Vincent Walsh will be speaking at WIRED Health 2016 on 29 April in London. From helping humans live longer and hacking our performance, to repairing the body and understanding the brain, WIRED Health will hear from the innovators transforming this critical sector.
Now in its third year, tickets are still available for this incredibly popular one-day event. Discounts are available for NHS and government employees and for people working for health sector startups.
Updated 20/04/16, 10:25: The headline of this story has been changed to better reflect the work of the London clinic. A reference to TMS being proposed for use in sports has also been removed.
This article was originally published by WIRED UK
