The brain is such a complex organ that many of its functions and processes are still unknown to the scientific community. For example, brain diseases are very common despite physicians and researchers knowing what the metabolic pathways affected are. Any attempt to “fix” it could end up being more hazardous than beneficial. Additionally, these disorders can be difficult to navigate and classify due to the variety of signs and symptoms. It’s only in the past few decades where mental health conditions have finally gained enough attention from medical professionals and now those who suffer from them can get better diagnosis and treatment.
Probably one of the most feared mental conditions due to its dramatic symptomatology is Alzheimer’s disease. A prevalent disease that lacks a clear understanding of its cause. Growing up, I remember seeing both of my parental grandparents suffering from it. I remember the immense toll it took not only in them but also on the entire family. Certainly, all chronic conditions affect the lifestyle of patients and their families, but this experience taught me how much dementia could disturb relationships and change the dynamics of a family. Some characteristics of the condition that we know are its genetic component, degeneration of brain cells, and the failed Acetylcholine metabolism. A better understanding of its molecular basis has caused the development of drugs that can be effective depending on the stage the patient is on.
But cells in most organs constantly deteriorate and die. What’s the difference? Many injuries can potentially be healed by our own bodies by mechanisms that ensure a full recovery. The cellular functions division and proliferation are amplified when tissues suffer damage, guaranteeing to heal. However, the brain is a unique type of tissue. The nervous system cellular components don’t possess this feature, thus traumatic or cognitive brain damages cause a permanent condition. Many examples of sports injuries are examples of this. Professional boxers suffered the loss of normal brain functions at a very young age. “Despite the comparable amount of sports training (both groups were professional) and the similar age of the athletes, the results suggest a specific deterioration of executive processing in boxers. We interpret these results as a consequence of repetitive head blows associated with professional boxing.” (Di Russo and Spinelli, 2010).
A similar instance that caused controversy in the sports world was born after a study that explained concussions in professional football players and their decline in mental and cognitive abilities. To cite an example, one study “found that retired NFL players with at least three concussions are three times more likely to be diagnosed with depression compared to players that do not report any concussions during their playing career. This suggests that those players with a greater number of concussions are more likely to be diagnosed with depression.” (Thomson et al. 2020) A popular case of the potential risks of contact sports occurred when New England Patriot’s player Aaron Hernandez was convicted for murder despite having a promising career. After committing suicide, he was diagnosed with chronic traumatic encephalopathy (CTE), a neurodegenerative disease that includes irreparable brain damage, aggressive impulses, lack of self-control and rage behaviors. How might have his condition influenced the crime he committed?
The authors of Frequency and Outcomes of a Symptom-Free Waiting Period After Sport-Related Concussions explain how “the passing of state laws related to youth concussion management. These factors, as well as increased media attention to concussions, have increased public awareness of concussion and changed the culture of reporting and managing injuries for many groups of athletes, further allowing recommendations to be realized in practice”. These new understandings will hopefully create a change of behavior and even rules for contact sports such as professional football or boxing. As a life-long soccer fan, I can understand the motivations behind people rejecting the idea of changing the game, but adjustments seem to be on the horizon in order to maintain a safe place for athletes and children who practice those sports.
Knowing the severity of the neurodegenerative conditions previously explored, the motivation behind developing medicine to ease the symptomatology of such diseases is understandable. Drugs can potentially alleviate many brain conditions such as Alzheimer’s or Parkinson’s diseases. For many decades, the solutions had been pain management and end-of-life support, but promising drugs have been developed to replace either the affected neurotransmitter themselves or intermediates that participate in their metabolism.
However, exploring the utility of drugs is much more complex because they fulfill other purposes, not only as medication. In the same way drugs can offer mitigation to cognitive diseases, they can also alter the nervous system for worse. For example, we observe the effect of multiple illicit drugs on the brain functioning. Some exert their effect by activating reward pathways or inhibiting pain, thus provoking an artificial sense of joy or happiness. This, however, is not without harmful consequences. The long-term effects of such drugs impede or diminish natural effects in our intrinsic reward pathways by interfering with the feedback mechanisms in place. The consequence is seen when more substances are needed in order to create the same response after using it for a while.
One common example of an alteration in the regular function of neurons is caused by cocaine. This illicit drug performs its function by interfering with the regular metabolism of Dopamine, which is not recycled back to the presynaptic neuron and it remains in the synaptic gap activating postsynaptic receptors. No wonder why Cocaine and similar molecules create cravings, dependence and powerful addictions difficult to overcome thanks to the significant changes it provokes in the biochemistry of the brain.
Another idea to consider is how much we know about the mechanisms and influence of drugs. The secondary effects caused in our brain and other organs can be unknown depending on the dose, clinical history, and other social determinants of health. We know that both illegal and therapeutic drugs cause changes in the physiology of the brain, and many times that is the goal of their use. But how much do we know about the long-term alterations? The plasticity of the brain is what allows us to learn and become who we are, but this same adaptability also means that this organ will malleate if the biochemical conditions change.
Lastly, two people can react to the same stressor or traumatic event in two opposite ways. One medication can alter the mind of one person while not provoking the same effect on the next one. We may never completely understand how the brain works, but its beauty relies on the complexity and how it can respond differently depending on the individual.
References
Di Russo, F., & Spinelli, D. (2010). Sport is not always healthy: Executive brain dysfunction in professional boxers. Psychophysiology, 47(3), 425–434. https://doi.org/10.1111/j.1469-8986.2009.00950.x
Pfaller, A. Y., Nelson, L. D., Apps, J. N., Walter, K. D., & McCrea, M. A. (2016). Frequency and Outcomes of a Symptom-Free Waiting Period After Sport-Related Concussion. The American journal of sports medicine, 44(11), 2941–2946. https://doi.org/10.1177/0363546516651821
Thomson, R., Carabello, D., Mansell, J., & Russ, A. (2020). Depression Following Concussion in Retired Professional Football Players. International Journal of Athletic Therapy & Training, 25(2), 54–56.
