Andrés Lozano, the doctor that talks with neurons Head of Neurosurgery at Toronto Western Hospital, and considered one of top world researchers in his specialty, Andrés Lozano is a pioneer in the use of deep brain stimulation for stopping alzheimer

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Andrés was born in Seville in 1959 in the neighborhood of Triana, but moved when he was a child with his family to Canada. However, he has never lost a connection with his city. Graduated from Ottawa University, he received his doctorate in Experimental Medicine in Montreal. With years of study and research, his tenacity, good deeds, and fascination for the human brain´s mysteries have made Andrés Lozano a pioneer in deep brain stimulation, as one of those closest to understanding the human mind.

Doctor Lozano is author of more than 750 articles covering his research, for example, his publication in July 2017 titled, ´What Have We Learned About Movement Disorders from Functional Neurosurgery?´. His most recent advances in the HIFU technique are raising a lot of interest among the international medical community. HIFU can be defined as a noninvasive treatment, based on focused ultrasound on the damaged area of the thalamus, which allows essential tremors or those linked with Parkinson’s disease to be weakened. They trust him to address other parts of the brain relating to neurological illnesses as well such as alzheimer, epilepsy, and neuropathic pain.

Deep brain stimulation technique has been used for illnesses such as Parkinson´s disease for more than two decades (with more than 100,000 patients in the world operated on successfully), but its advances have taken him to explore the possibility of using it to either improve or cure a different type of pathology, such as depression, obesity, obsessive compulsive disorder (OCD), chronic anorexia nervosa, and alzheimer, on which his currently focusing his scientific desires. From his office at Toronto Western Hospital, where he also manages the Division of Neurosurgery at the University of Toronto and has worked for more than 25 years, Andrés Lozano shares with Sevilla World about his work and findings.

He has managed to locate, for example, the area of the brain where depression lies hiding itself and has figured out that sadness shows up there with hyperactivity. In this case type, his team reduces that abnormal movement, promoting patient improvement (seen in 60 percent of treated patients currently). This is only one type of application for this technology that consists of electrode placement within the circuits that are not functioning properly in the brain: “The objective is to send electrical stimulation through a pacemaker that will be implanted in the patient. Once they are given this pacer, the electrical stimulation tries to adjust the activity of those circuits, turning it up if there is a fall in activity or turning it down if, on the contrary, there is accelerated activity. More than 100,000 patients have received deep brain stimulation. Represented among them are also Spaniards and a good number of Sevillians.

For Those that Have Already Tried Everything

Until resorting to a consultation, patients throughout the world are affected by illnesses that still in 2016 do not have a cure but are what Doctor Lozano´s studies are trying to help improve. Generally, we talk to people who have already tried other types of treatments unsuccessfully. The line of research supported by his institution opens up a horizon of hope for them.

– Of all your contributions, which or of what field of study do you consider most important?

– The deep brain stimulation is widely accepted for treatment of patients with Parkinson´s disease and dystonia. But, thanks to the successful treatment of these disorders, they are now researching possible treatment of other diseases. In addition to depression, anorexia and OCD, we are also researching Tourette syndrome and Alzheimers. These studies converge at different stages of development, but it is a very active area where possible benefits and adverse side affects of the treatment are being evaluated. Nevertheless, the path remaining ahead is much longer than the journey up to now.

 

In this sense, he predicts that very significant advances will be made over the coming years for those with Alzheimers disease, “ We are taking note of the circuits that control memory and cognitive function to hopefully stimulate them in a way in which their functions improve and remain in good condition for a long period of time. We are talking of mechanisms that will continue damaging if this illness persists. Our objective is to help activate them and keep them in good condition.” Many times, their advances happen by chance discoveries, as occurred precisely with memory. Several years ago, while trying to control the appetite of someone with obesity, they discovered that the electrodes were producing a second affect. The patient had noted a great increase in their memory capacity, and this circumstance offered them trails to explore if Alzheimer’s could be addressed in this way.

It is not a cheap treatment, as Doctor Lozano has recognized in several interviews. We are talking about 15,000 euros at present. Nevertheless, I anticipate that the cost will reduce with time.

– Can you imagine a future where we don´t resort to a psychologist or psychiatrist but rather electrodes in order to reduce problems such as sadness?
-The rise of deep brain stimulation is allowing us to explore areas of the brain that until today were through discovering or when we were lacking knowledge. It is very similar to the exploration of galaxies and the discovery of new planets. It is allowing us to learn so much about the brain and to confirm if the adjustment of circuits that are functioning incorrectly would be beneficial for patients with neurological or psychiatric disorders , and among them depression. We hope to be able to treat a good number of mental illnesses in the future with this technology. Much of these appeared reflected in an article over our public research in the magazine, Neuron. Treatment for patients in a state of coma to see if electrical stimulation could wake them up is an example of one of the interesting possibilities that could open up in this field of study.

 

Cosmetic Neurosurgery?

With everything, we talk of a practice that is not exempt of debate. Where could we arrive with brain stimulation? Has ethics been a problem in the development of Doctor Lozano´s work? Does it make sense to imagine a future where he practices a sort of cosmetic neurosurgery, a world of patients that would be allowed to pay for an operation in order to make them more intelligent or to enjoy a better memory even though they are healthy? In definite, where would we be able to arrive? “There are certain limits”,  he recognizes right away: “We are able to stimulate the brain circuits that are functioning improperly, but if there is great damage or the circuits are disappearing due to a sickness or injury, then we are limited in our possibilities. We are still not aware of the limits of this type of treatment. Would one be able to use deep brain stimulation to improve normal functions, for example, in order to have better memory? Although it is probable that it is possible, there is a series of important ethical matters that rise up about that. For example, should one perform it simply because one can perform it? Who will have access to this type of technology? These are questions that require discussion, and society has to make some important decisions in order to guide these types of procedures in the future”.

Andrés Lozano, explains in May 2017 in Valencia his HIFU method for deep brain stimulation, applied to Parkinson´s disease patients.

Collaboration with Doctors and Spanish Institutes

In constant contact with Spanish colleagues, Doctor Lozano does not doubt taking into account that the country has among its ranks some of the best scientists in the world. “There is a long tradition in Neuroscience beginning with Ramon and Cajal, who won the Nobel Prize in Medicine and Physiology at the beginning of the twentieth century. Yes, I think that Spanish scientists, especially those who are young, should increase there trips abroad in order to learn and improve interactions and later to cary this new understanding back to our country. On the other hand, scientists outside of Spain need to visit and understand the tremendous activity that exists there and the scientific potential of the country. I appreciate working with a good number of Spanish doctors, the tasks that they accomplish is first class. To collaborate with colleagues from my country is one of the most enjoyable aspects of my career.”

Lozano travels to the Peninsula one or two times per year – “It is always wonderful to return to my roots and work with professionals from my country” -; he hopes that the collaboration with the Spanish institutes increases in the future. “The brain is a learning machine. We do not have a clear understanding of its enormous capacity, how it develops, or how the information is accumulated and processed within it. These are the challenges driving the future.With time and talented scientists, such as those in Spain, we will be able to release many of the mysteries of the brain and medicine, science, and humanity.”

 

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