Tuesday, 31 March 2009

The promise of real-time health care


The battle against chronic illness is long, expensive and can involve a lot of guesswork. But closer monitoring of our body in real time is improving chances for better long-term health – and, ultimately, quality of life.

Over the past decade, the evolution of medical technology has produced sophisticated, hi-tech and non-invasive tools. Devices like advanced brain scans and semi-invasive blood sugar sensors are opening exciting new doors to research – and in the face of new data, whole medical disciplines are shifting focus as science debunks theories of the past.

For a long time, brain researchers could only theorize about how the brain worked; there was no way watch it in living colour.

But thanks to neuroimaging, “what we know today compared to a decade ago blows your mind,” says Stan Kutcher an expert in adolescent mental health based at Dalhousie University in Halifax.

“Explanations for mental disorder [used to be] what I would call ‘brainless,' ” Dr. Kutcher says. They were “based on theories of mind or psychological models in which the brain did basically nothing.”

This was because, until recently, data gleaned from CAT scans and EEGs wasn't sufficiently sharp.

“The data was overwhelming, but it wasn't specific enough because both psychoneuroendocrinology and our special EEG analysis of function were still so far removed from what was actually going on inside the brain itself. They were very, very rough tools. So it was like trying to have sex wearing five condoms. You're sort of in the general area, but you haven't got a clue what should be going on.”

But where brain scans of the mid- to late eighties proved there were structural differences in the brains of people with mental disorders compared with healthy ones, today we can also actually watch the brain in action as it functions, both in health and in disease: “How does the brain control anger, listen to music, read, express love?” Dr. Kutcher asks.

Answers to those questions are being found, thanks to today's functional MRIs and PET scans – technology that has eclipsed former scanning methods. Dr. Kutcher believes that will soon lead to direct diagnosis. The hope is that brain illness – from injury to stroke to mental illness – will become precisely and accurately diagnosable, in turn making targeted, consistently successful treatments possible.

“I wouldn't be surprised if in the next 15 to 20 years two things happen,” Dr. Kutcher says. “We will have abandoned our current nomenclature, which is based on science and symptoms, for one based on a much better understanding of brain dysfunction and the symptoms that are a result of that … and at that time neuroimaging may well become diagnostic.”

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