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The rapidity at which the field of neurosurgery has continued to evolve became evident to me during this week’s visit to Musee d’Histoire de la Medicine (Museum of the History of Medicine). We began the tour by observing what, at first, seemed to be ancient hunting tools from the San people of Southern Africa. They were mismatched in size, had asymmetrical designs, and had a mix of smooth and jagged edges. I soon found out that I was staring at the first neurosurgical toolkit used by an early French neurosurgeon. It amazed me at how these rudimentary tools were used to penetrate and tinker with an organ as complex and delicate as the human brain. Even more incredible was how these tools served as the foundation for numerous generations worth of advances in neurosurgical equipment. As we progressed down the glass boxes encasing the toolkits, I noticed them to start to garner a more sophisticated form. They became increasingly symmetrical and gradually adopted a more streamlined appearance. Interestingly, I noticed how aesthetics became more of a priority. Near the beginning of the tour, prosthetic limbs had the appearance of a robotic arm. However, closer to the 19th and 20th century, the prosthetic limb, once decked out in rusted metal, was replaced with a pale tone and easily distinguishable fingers.

Later in the tour, I stumbled across a tool called “La Trephine” meaning “The Trepan”. In medical practice, a trepan is used to create a hole in the skull in order to expose different parts of the brain for operation. Nowadays, with more advanced technology being accessible, a cranial drill is used and is often battery-powered. The trepan in the museum, however, did not look like modern day cranial drills. It was shaped like a “Y” and had a cylindrical bottom where it attached to the brain. In order to use this tool, the surgeon would grab the top parts and twist repeatedly to make circular incisions into the skull until the bone could be removed. I discovered that this tool was commonly used to treat individuals with epilepsy. Past neuroscientists thought that mental disorders could be treated by creating an opening in the skull to allow for the demons to escape. Today, we know that epilepsy is treated with anti-epileptic drugs (AEDs) that decrease membrane excitability by interacting with neurotransmitter receptors and ion channels (Macdonald et al., 1995). This visit was very exciting and allowed me to develop a newfound understanding and appreciation for how far medicine has truly come.

Reference:

Macdonald, R. L., & Kelly, K. M. (1995). Antiepileptic drug mechanisms of action. Epilepsia, 36(s2). https://doi.org/10.1111/j.1528-1157.1995.tb05996.x

Arcimboldo’s paintings have actually been used in previous studies to observe this phenomenon. In a 2011 study, these paintings were shown to individuals with propagnosia (Rossion et al, 2011). To an unimpaired human, the elements of the painting can collectively be viewed as a face due to the object configuration. However, those with deficits in the FFA are able to only recognize the discrete components of the painting, in this case the individual fruits and vegetables. It was interesting to make this connection and it helped me more deeply understand the studies we were talking about by being able to view the stimuli in person myself.

References:

Haeger, A., Pouzat, C., Luecken, V., N’diaye, K., Elger, C., Kennerknecht, I., … & Dinkelacker, V. (2021). Face Processing in Developmental Prosopagnosia: Altered Neural Representations in the Fusiform Face Area. Frontiers in behavioral neuroscience, 15.

Rossion, B., Dricot, L., Goebel, R., & Busigny, T. (2011). Holistic face categorization in higher order visual areas of the normal and prosopagnosic brain: toward a non-hierarchical view of face perception. Frontiers in human neuroscience, 4, 225.

Ballet: A Workout for Brain and Body

The last time I was in Paris, it was for ballet class when I was in the eighth grade. Through the language barrier and intimidation factor of taking a class in a new country, I loved my ballet studio here and the opportunity to connect with girls I couldn’t directly communicate with through an art form we all loved. So, this time when I touched down in Paris, I knew that I wanted to find a way to appreciate the thing that brought me here in the first place. After researching with my roommates, we discovered that we would be in Paris over the 250th anniversary of Marie Antoinette’s wedding and that it was being celebrated with a ballet at the Versailles Royal Opera House. So, on a rainy weekend day, we put on our most Versailles-appropriate dresses and made the hour and a half-long journey to the Opera House. 

The ballet itself was incredible, with historical context provided on a screen above the stage and the dancers carefully telling the story of Marie Antoinette’s life, death, and antics on stage. Amidst the colorful costumes, contemporary take on classical ballet, and endless violin swells, I felt reconnected to my love for dance; the opportunity to experience that same passion in such a unique way was beyond incredible, and I know that the memory of that night is one I’ll cherish forever. 

Connecting this experience back to neuroscience, though, was equally as interesting. Having grown up dancing my whole life, I knew there were lessons I’d learned and habits I’d built that stick with me even today (I still find myself measuring eight-counts in music and counting steps as I walk across a room). But, in light of the courses we’re taking here, I thought it would be interesting to explore the connection between dance and the brain. Through my research, I found an interesting study which explored the relationship between dance and neural plasticity. Specifically, researchers observed structural changes in the hippocampal and grey-matter volume of dancers, as well as heightened levels of white-matter function. These physical differences then led to functional improvements in memory, body balance, and several other realms. The researchers thus concluded that dance can, in fact, improve neuroplasticity by integrating brain regions (Teixera-Machado et al, 2019). 

Overall, I think that the opportunity to connect the purposes behind both my visits to Paris was so special, and I’m glad that I had the opportunity to find a way to bring my time here full circle. I know that being here has confirmed my love for both neuroscience and dance, and I am already researching dance studios at home to continue exploring my passions from an ever-increasingly interdisciplinary perspective. 

References:

​​Teixeira-Machado, L., Arida, R. M., & de Jesus Mari, J. (2019). Dance for neuroplasticity: A descriptive systematic review. Neuroscience and biobehavioral reviews, 96, 232–240. https://doi.org/10.1016/j.neubiorev.2018.12.010

Compasses, calculators, and robots, oh my! Today, we attended the Musée des Arts et Métiers to learn all about scientific instruments throughout the ages.  One of my favorite things in the museum was a device from the late 18^th century used to ferment wine. Wine fermentation is truly an art form and has taken centuries to perfect into modern wine we drink from a bottle today and getting to see an original fermentation device was such an intriguing experience.

We also got to view a magnetic drum device, a precursor to the modern calculator we use today. It strangely resembled a typewriter. We also viewed different communication devices from years (and even centuries) past, including the first press-cylinder printer and an original Nokia from the early 2000s. Additionally, we saw a Russian extra-terrestrial rover that could communicate from outer space! Lastly, my favorite thing we got to see was a thermoscope from 1592 that once belonged to Galileo! In fact, with some further research after leaving the museum, I discovered that Galileo actually introduced the first thermoscope thermometry which would eventually evolve to the modern thermal imagery we see today!

Evidently, this invention sprung medicinal science forward towards modern Western biomedicine. Fever has always been one of the most common medical indicators of ailment, and it made me ponder how temperature correlates with neuroscience and potential brain injuries. I found a recent study that discussed the relationship between body and brain temperature in rodents with traumatic brain injuries (TBIs). Previous research had previously indicated that extreme temperature deficits or increases may affect the implications of brain injuries. Researchers decided to compared rats that had acquired traumatic brain injuries to uninjured rats both under general anesthesia and not under general anesthesia. When under anesthesia, there was no significant temperature difference between rats with TBIs and rats without TBIs. However, rats who were under anesthesia had significantly lower temperatures than rats not under anesthesia, suggesting that anesthesia alone caused a decrease in temperature. When rats had not been put under anesthesia temporalis muscle temperature correlated well with brain temperature, but rats with TBIs and rats without TBIs did not differ in temperature. This allowed the researchers to conclude that temporalis muscle temperature is a good indicator of brain temperature, however, brain temperature itself is not necessarily indicative of a TBI. After reading this article, it was very intriguing to consider how far the science of temperature in medicine has come since the days of Galileo.

References: 

Jiang, J. Y., Lyeth, B. G., Clifton, G. L., Jenkins, L. W., Hamm, R. J., & Hayes, R. L. (1991). Relationship between body and brain temperature in traumatically brain-injured rodents. Journal of Neurosurgery, 74(3), 492–496. https://doi.org/10.3171/jns.1991.74.3.0492

Ring, E. F. J. (2007). The historical development of temperature measurement in medicine. Infrared Physics & Technology, 49(3), 297–301. https://doi.org/10.1016/j.infrared.2006.06.029

One of the best parts about coming to Paris has to be all of the delicious food I have been able to try. From a soft croissant or pain au chocolat from the local boulangerie in the morning, to fresh produce from stands and small markets dotting the streets, or a warm quiche from one of our lunch spots near Accent, I have been enjoying every tasty experience while here. The French also highly value time around meals, and so going to a cafe or restaurant is always a relaxing, serotonin-boosting time. One morning for brunch, I had a yummy plate with smoked salmon, eggs, and fresh bread. The contrasting crunch of the baguette’s crust to the warm, chewy interior was delectable. Thankfully the carbohydrates in the bread (in moderation) are as rewarding for our brain to provide it with energy as for our mouths when we taste it. 🙂

A few weeks ago when one of my friends was in town, we decided to check out the Musée Rodin. Auguste Rodin is one of my favorite sculptors, and so I was excited to visit a museum that was solely dedicated to his work. It was a wonderful experience, as it was an intimate way to explore a single artist. It is set in the Hôtel Biron, where Rodin lived toward the end of his life. Some of his sculptures are also displayed throughout the extensive garden. One of the rooms included his late sculptural experiments on dance movement studies. As a dance minor, I have always been fascinated by the link between dance and the brain. Dance demands both attention and memory skills, and significant neuronal growth seen in structures such as the insula and cingulate gyrus demonstrate the beneficial role dance can play in cognitive improvement.

This Tuesday, June 7th, we had the opportunity to visit the Musee de Moulages at the Hospital Saint-Louis. The museum houses “a unique collection of wax dermatological models”, as coined by the subtitle on the front cover of the museum pamphlet.

Reflecting upon my visit, I can concur that this museum has a unique collection indeed. With collections of wax models displaying pathologies such as syphilis, tuberculosis, eczema, acne, elephantiasis, tumors, and much more, the museum leaves a lasting impression. 

The first week of the program, we learned about the “gut-brain axis” with the first target article. Upon visiting the dermatology museum, I began to wonder if the same kind of connection exists between the brain and the skin, a “skin-brain axis”. Considering that the skin is the largest organ in the body, I postulated that this connection must exist in some form or another. Before diving into the current scientific literature, I speculated on different relationships that might exist between the brain and the skin: How do neurological variables such as stress manifest in the skin? How does skin pathology affect the brain? What kinds of information does the skin communicate to the brain and through what mechanisms?

I found that the “brain-skin” connection does exist, and lends itself to a great intersection of research involving different fields of study such as psychology, neurobiology, dermatology, immunology, etc. Stress and skin conditions have been known to be associated for centuries, and modern research has established the existence of a causal relationship as psychological stress can lead to the onset and/or aggravation of multiple skin diseases. Many studies also reveal that stress accelerates skin aging (Lee et al., 2020; Rinnerthaler et al., 2015) and exacerbates skin inflammation (Chen et al., 2014). Not surprisingly, anxiety has been proven to increase susceptibility to skin diseases which one study claims is due to the disruption of cutaneous homeostasis via prolonged sympathetic nervous system activation (Öksüz et al., 2020). In addition, the relationship between depression and chronic wounds has been investigated as these conditions often have a high comorbidity (Hadian et al., 2020). 

However, in my opinion, the most interesting finding of my literature review of the skin-brain axis concerned the affective function of the skin. The discriminative properties of the skin have been well identified, however, the discovery of a new class of nerve fiber, unmyelinated C-fiber afferents, has led to a new understanding of skin function as a coder of emotional touch. C-tactile mediated touch such as massage therapy has exciting implications for clinical treatments of both physical and psychological symptoms of chronic skin conditions like eczema. 

All in all, neuroscience is a wonderfully interdisciplinary subject that has interesting implications on nearly all areas of biology and different clinical practices – including dermatology!

Chen, Y., & Lyga, J. (2014). Brain-skin connection: stress, inflammation and skin aging. Inflammation & allergy drug targets, 13(3), 177–190. https://doi.org/10.2174/1871528113666140522104422

Hadian, Y., Fregoso, D., Nguyen, C., Bagood, M. D., Dahle, S. E., Gareau, M. G., & Isseroff, R. R. (2020). Microbiome-skin-brain axis: A novel paradigm for cutaneous wounds. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 28(3), 282–292. https://doi.org/10.1111/wrr.12800

Lee, C. M., Watson, R., & Kleyn, C. E. (2020). The impact of perceived stress on skin ageing. Journal of the European Academy of Dermatology and Venereology : JEADV, 34(1), 54–58. https://doi.org/10.1111/jdv.15865

Lloyd, D. M., McGlone, F. P., & Yosipovitch, G. (2015). Somatosensory pleasure circuit: from skin to brain and back. Experimental dermatology, 24(5), 321–324. https://doi.org/10.1111/exd.12639 

Öksüz, Ö., Günver, G., Oba, M. Ç., & Arıkan, K. (2020). Psychiatry to dermatology; panic disorder. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 81, 316–320. https://doi.org/10.1016/j.jocn.2020.09.071 

Rinnerthaler, M., Bischof, J., Streubel, M. K., Trost, A., & Richter, K. (2015). Oxidative stress in aging human skin. Biomolecules, 5(2), 545–589. https://doi.org/10.3390/biom5020545

One of my favorite places I have visited so far in Paris has to be The Sainte-Chapelle. It is a royal chapel in the Gothic style set within the Palais de Justice de Paris and was consecrated on April 26, 1248. It contains some of the most beautiful stained glass I have seen. The way the sun shines through the 15 large windows floods the chapel with a rainbow of color. This reminded me of learning about how the brain processes information from our eyes to perceive color. After light hits the rods and cones in the retina, the optic nerve connects to the thalamus to process those signals. The visual cortex helps us recognize what we see. I would recommend anyone visit the chapel for a highly stimulating experience!