Andres Lozano: Parkinson's, depression and the switch that might turn them off

186,413 views ใƒป 2013-04-18

TED


์•„๋ž˜ ์˜๋ฌธ์ž๋ง‰์„ ๋”๋ธ”ํด๋ฆญํ•˜์‹œ๋ฉด ์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค.

00:00
Translator: Joseph Geni Reviewer: Morton Bast
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๋ฒˆ์—ญ: Gyeyoung Choi ๊ฒ€ํ† : K Bang
00:12
One of the things I want to establish right from the start
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์šฐ์„  ํ•œ๊ฐ€์ง€ ๋ฐ”๋กœ์žก๊ณ  ์‹œ์ž‘ํ•˜์ฃ 
00:14
is that not all neurosurgeons wear cowboy boots.
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๋ชจ๋“  ์‹ ๊ฒฝ์™ธ๊ณผ์˜๊ฐ€ ์นด์šฐ๋ณด์ด ๋ถ€์ธ ๋ฅผ ์‹ ์ง€๋Š” ์•Š์Šต๋‹ˆ๋‹ค.
00:17
I just wanted you to know that.
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๊ทธ๋ƒฅ ์•Œ์•„์ฃผ์…จ์œผ๋ฉด ํ•ด์„œ์š”. (์›ƒ์Œ)
00:19
So I am indeed a neurosurgeon,
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์ €๋„ ์‹ ๊ฒฝ์™ธ๊ณผ์˜์ž…๋‹ˆ๋‹ค.
00:22
and I follow a long tradition of neurosurgery,
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๊ทธ๋ฆฌ๊ณ  ์‹ ๊ฒฝ์™ธ๊ณผ์˜์˜ ์˜ค๋žœ ์ „ํ†ต์„ ๋”ฐ๋ฅด์ฃ .
00:26
and what I'm going to tell you about today
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๊ทธ๋ฆฌ๊ณ  ์˜ค๋Š˜ ์—ฌ๋Ÿฌ๋ถ„๊ป˜ ๋ง์”€๋“œ๋ฆด ๋‚ด์šฉ์€
00:27
is adjusting the dials in the circuits in the brain,
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๋‡Œ์˜ ํšŒ๋กœ์˜ ์‹ ํ˜ธ๋ฅผ ๋งž์ถ”๋Š” ๋‚ด์šฉ์ž…๋‹ˆ๋‹ค.
00:30
being able to go anywhere in the brain
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๋‡Œ ์•ˆ ์–ด๋””๋“  ์‚ดํŽด ๋ณผ ์ˆ˜ ์žˆ๊ณ 
00:32
and turning areas of the brain up or down
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๋‡Œ์˜ ํŠน์ • ๋ถ€์œ„๋ฅผ ์ผœ๊ฑฐ๋‚˜ ๊บผ์„œ
00:34
to help our patients.
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ํ™˜์ž๋“ค ์น˜๋ฃŒ์— ๋„์›€์„ ์ฃผ๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
00:36
So as I said, neurosurgery comes from a long tradition.
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๋ง์”€๋“œ๋ฆฐ๋Œ€๋กœ, ์‹ ๊ฒฝ์™ธ๊ณผ์ˆ ์—๋Š” ์˜ค๋žœ ์—ญ์‚ฌ๊ฐ€ ์žˆ์Šต๋‹ˆ๋‹ค.
00:39
It's been around for about 7,000 years.
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์•ฝ 7,000๋…„๊ฐ„ ์กด์žฌํ•ด์™”์ฃ .
00:43
In Mesoamerica, there used to be neurosurgery,
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๋ฉ”์†Œ์•„๋ฉ”๋ฆฌ์นด์—๋„ ์‹ ๊ฒฝ์™ธ๊ณผ์ˆ ์ด ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
00:46
and there were these neurosurgeons that used to treat patients.
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ํ™˜์ž๋“ค์„ ์น˜๋ฃŒํ•˜๋Š” ์‹ ๊ฒฝ์™ธ๊ณผ์˜๋„ ์žˆ์—ˆ์–ด์š”.
00:50
And they were trying to -- they knew that the brain was involved
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๊ทธ๋ฆฌ๊ณ  ๊ทธ๋“ค์€ ๋‡Œ๊ฐ€ ์‹ ๊ฒฝ๊ณ„, ์ •์‹ ๊ณ„ ์งˆํ™˜์—
00:54
in neurological and psychiatric disease.
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๊ด€์—ฌํ•œ๋‹ค๋Š” ๊ฒƒ์„ ์•Œ๊ณ  ์žˆ์—ˆ์–ด์š”.
00:57
They didn't know exactly what they were doing.
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์ •ํ™•ํžˆ ๋ฌด์—‡์„ ํ•˜๋Š”์ง€๋Š” ๋ชฐ๋ž์ง€๋งŒ์š”.
00:59
Not much has changed, by the way. (Laughter)
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๊ทธ๋‚˜์ €๋‚˜ ์ง€๊ธˆ๋„ ๋ณ„๋กœ ๋ฐ”๋€ ๊ฑด ์—†์Šต๋‹ˆ๋‹ค. (์›ƒ์Œ)
01:02
But they thought that,
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ํ•˜์ง€๋งŒ ๊ทธ๋“ค์€ ์ƒ๊ฐํ–ˆ์–ด์š”.
01:03
if you had a neurologic or psychiatric disease,
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๋งŒ์•ฝ ์‹ ๊ฒฝ, ์ •์‹ ๊ณ„ ์งˆํ™˜์ด ์žˆ๋‹ค๋ฉด
01:05
it must be because you are possessed
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๊ทธ ์ด์œ ๋Š” ํ™˜์ž๊ฐ€ ์‚ฌ์•…ํ•œ ๊ธฐ์šด์—
01:08
by an evil spirit.
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์‚ฌ๋กœ์žกํ˜€ ์žˆ๊ธฐ ๋•Œ๋ฌธ์ด๋ผ๊ตฌ์š”.
01:10
So if you are possessed by an evil spirit
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๋งŒ์•ฝ ์‚ฌ์•…ํ•œ ๊ธฐ์šด์— ์‚ฌ๋กœ์žกํ˜€ ์žˆ๋‹ค๋ฉด
01:12
causing neurologic or psychiatric problems,
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์‹ ๊ฒฝ, ์ •์‹ ๊ณ„์— ๋ฌธ์ œ๊ฐ€ ๋ฐœ์ƒํ•˜๊ณ ,
01:15
then the way to treat this is, of course,
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์ด๊ฒƒ์„ ์น˜๋ฃŒํ•˜๊ธฐ ์œ„ํ•œ ๋ฐฉ๋ฒ•์€
01:17
to make a hole in your skull and let the evil spirit escape.
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๋‘๊ฐœ๊ณจ์— ๊ตฌ๋ฉ์„ ๋šซ์–ด ๋‚˜์œ ๊ธฐ์šด์€ ๋นผ๋‚ด๋Š” ๊ฒƒ์ด๊ฒ ์ฃ .
01:23
So this was the thinking back then,
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์ด๊ฒƒ์ด ๊ทธ ๋‹น์‹œ์˜ ์‚ฌ๊ณ ๋ฐฉ์‹์ด์—ˆ์Šต๋‹ˆ๋‹ค.
01:24
and these individuals made these holes.
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๊ทธ๋ž˜์„œ ์ด๋Ÿฐ ๊ตฌ๋ฉ์„ ๋งŒ๋“  ๊ฒƒ์ด์ฃ .
01:28
Sometimes the patients were a little bit reluctant
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๋•Œ๋•Œ๋กœ ํ™˜์ž๋“ค์€ ์ด ์น˜๋ฃŒ๋ฐฉ๋ฒ•์„ ์•ฝ๊ฐ„ ๊บผ๋ คํ–ˆ์–ด์š”.
01:31
to go through this because, you can tell that
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์™œ๋ƒํ•˜๋ฉด ์ด๋Ÿฌํ•œ ๊ตฌ๋ฉ์€
01:34
the holes are made partially and then, I think,
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๋ถ€๋ถ„์ ์œผ๋กœ ์ƒ๊ธธ ๊ฒƒ์ด๊ณ ,
01:36
there was some trepanation, and then they left very quickly
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๋‚˜์œ ๊ธฐ์šด์€ ๋นจ๋ฆฌ ๋น ์ ธ๋‚˜๊ฐ‘๋‹ˆ๋‹ค.
01:38
and it was only a partial hole,
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๊ทธ๋ฆฌ๊ณ  ๊ตฌ๋ฉ์€ ๋‹จ์ง€ ์ž‘์€ ๊ฒƒ์ด์–ด์„œ
01:40
and we know they survived these procedures.
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ํ™˜์ž๋“ค์€ ์ƒ์กดํ–ˆ์Šต๋‹ˆ๋‹ค.
01:42
But this was common.
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ํ•˜์ง€๋งŒ ์ด๊ฒƒ์€ ํ”ํ•œ ์ผ์ด์—ˆ์–ด์š”.
01:44
There were some sites where one percent
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์–ด๋–ค ์œ ์ ์—์„œ ๋ฐœ๊ตด๋œ ์œ ๊ณจ์˜ 1%๋Š”
01:45
of all the skulls have these holes, and so you can see
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๋‘๊ฐœ๊ณจ์— ์ด๋Ÿฐ ๊ตฌ๋ฉ์ด ์žˆ์—ˆ์–ด์š”.
01:48
that neurologic and psychiatric disease is quite common,
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๊ทธ๋Ÿฌ๋‹ˆ๊นŒ ์‹ ๊ฒฝ, ์ •์‹ ๊ณ„ ์งˆํ™˜์ด ๊ฝค ์ผ๋ฐ˜์ ์ด์—ˆ๊ณ 
01:51
and it was also quite common about 7,000 years ago.
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7000๋…„ ์ „์—๋„ ๊ทธ๋žฌ๋‹ค๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ์ฃ .
01:55
Now, in the course of time,
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์ด์ œ ์‹œ๊ฐ„์ด ์ง€๋‚จ์— ๋”ฐ๋ผ
01:57
we've come to realize that
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์šฐ๋ฆฌ๋Š” ๋‡Œ์˜ ๊ฐ ๋ถ€๋ถ„์ด
02:00
different parts of the brain do different things.
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๊ฐ์ž ๋‹ค๋ฅธ ์—ญํ• ์„ ํ•œ๋‹ค๋Š” ์‚ฌ์‹ค์„ ์•Œ๊ฒŒ ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
02:02
So there are areas of the brain that are dedicated
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๋‡Œ์—๋Š” ์„œ๋กœ ๋‹ค๋ฅธ ์—ญํ• ์„ ๋‹ด๋‹นํ•˜๋Š” ๋ถ€๋ถ„์ด ์žˆ๊ณ 
02:03
to controlling your movement or your vision
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๊ฐ๊ฐ์€ ์›€์ง์ž„, ์‹œ๊ฐ,
02:06
or your memory or your appetite, and so on.
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๊ธฐ์–ต๋ ฅ, ์‹์š• ๋“ฑ์„ ์กฐ์ ˆํ•ฉ๋‹ˆ๋‹ค.
02:09
And when things work well, then the nervous system
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์ด๋Ÿฐ ๊ธฐ๋Šฅ์ด ์—ญํ• ์„ ์ž˜ ํ•  ๋•Œ, ์‹ ๊ฒฝ๊ณ„๋Š”
02:11
works well, and everything functions.
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์ œ ๊ธฐ๋Šฅ์„ ํ•˜๋ฉฐ ๋ชจ๋“ ๊ฒŒ ์ œ๋Œ€๋กœ ๋Œ์•„๊ฐ€๊ณ  ์žˆ๋Š”๊ฒ๋‹ˆ๋‹ค.
02:13
But once in a while, things don't go so well,
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ํ•˜์ง€๋งŒ ๊ฐ„ํ˜น ์ผ์ด ์ž˜ ์•ˆ๋  ๋•Œ๊ฐ€ ์žˆ์–ด์š”.
02:15
and there's trouble in these circuits,
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ํšŒ๋กœ์— ๋ฌธ์ œ๊ฐ€ ์ƒ๊ธฐ๊ณ 
02:18
and there are some rogue neurons that are misfiring
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๋‚˜์œ ๋‰ด๋Ÿฐ์ด ์ž˜๋ชป๋œ ์‹ ํ˜ธ๋ฅผ ์ „๋‹ฌํ•˜๊ฑฐ๋‚˜
02:21
and causing trouble, or sometimes they're underactive
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ํ™œ๋™์„ ํ•˜์ง€ ์•Š์„ ๋•Œ๋„ ์žˆ์ฃ .
02:24
and they're not quite working as they should.
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์ž๊ธฐ๊ฐ€ ํ•ด์•ผ ํ•  ์ผ์„ ์•ˆํ•˜๋Š” ๊ฒ๋‹ˆ๋‹ค.
02:26
Now, the manifestation of this
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์ด๋Ÿฐ ์ผ์˜ ์ง•ํ›„๋Š”
02:28
depends on where in the brain these neurons are.
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๋‡Œ ์† ์–ด๋Š ๋ถ€์œ„์— ์ด๋Ÿฐ ๋‚˜์œ ๋‰ด๋Ÿฐ์ด ์กด์žฌํ•˜๋Š”๊ฐ€ ์ž…๋‹ˆ๋‹ค.
02:31
So when these neurons are in the motor circuit,
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๋งŒ์•ฝ ์šด๋™ ํšŒ๋กœ์— ์ด๋Ÿฐ ๋‰ด๋Ÿฐ์ด ์žˆ๋‹ค๋ฉด
02:33
you get dysfunction in the movement system,
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๋ชธ์„ ์›€์ง์ด๋Š”๋ฐ ์žฅ์• ๊ฐ€ ์˜ต๋‹ˆ๋‹ค.
02:36
and you get things like Parkinson's disease.
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์ด๋กœ ์ธํ•ด ๋‚˜ํƒ€๋‚˜๋Š” ์งˆ๋ณ‘์ด ํŒŒํ‚จ์Šจ ๋ณ‘์ด์ฃ .
02:38
When the malfunction is in a circuit that regulates your mood,
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๋‰ด๋Ÿฐ์˜ ์˜ค์ž‘๋™์ด ๊ฐ์ •์„ ์ฃผ๊ด€ํ•˜๋Š” ํšŒ๋กœ์—์„œ ์ผ์–ด๋‚˜๋ฉด
02:41
you get things like depression,
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์šฐ์šธ์ฆ์ด ์˜ค๊ฒŒ ๋˜์ฃ .
02:44
and when it is in a circuit that controls your memory and cognitive function,
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๊ธฐ์–ต๋ ฅ๊ณผ ์ธ์ง€๋Šฅ๋ ฅ์„ ์กฐ์ ˆํ•˜๋Š” ๋ถ€์œ„์— ์ด์ƒ์ด ์ƒ๊ธฐ๋ฉด
02:47
then you get things like Alzheimer's disease.
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์•Œ์ธ ํ•˜์ด๋จธ์™€ ๊ฐ™์€ ๋ณ‘์— ๊ฑธ๋ฆฌ๋Š”๊ฑฐ์ฃ .
02:50
So what we've been able to do is to pinpoint
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๋”ฐ๋ผ์„œ ์šฐ๋ฆฌ๊ฐ€ ํ•  ์ˆ˜ ์žˆ๋Š” ์ผ์€
02:53
where these disturbances are in the brain,
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๋‡Œ์˜ ์–ด๋Š ๋ถ€์œ„์—์„œ ์ด์ƒ์ด ์ผ์–ด๋‚ฌ๋Š”์ง€๋ฅผ ์งš์–ด๋‚ด๊ณ 
02:55
and we've been able to intervene within these circuits
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๊ทธ ํšŒ๋กœ๋ฅผ ์กฐ์ ˆํ•˜์—ฌ
02:58
in the brain to either turn them up or turn them down.
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๋‡Œ๊ฐ€ ๊ทธ ํšŒ๋กœ์˜ ์‹ ํ˜ธ ์ „๋‹ฌ์„ ๋†’์ด๊ฑฐ๋‚˜ ๋‚ฎ์ถ”๋„๋ก ํ•˜๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
03:02
So this is very much like choosing the correct station
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์ด๊ฒƒ์€ ๋งˆ์น˜ ๋ผ๋””์˜ค์—์„œ
03:04
on the radio dial.
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์•Œ๋งž๋Š” ์ฃผํŒŒ์ˆ˜๋ฅผ ์ฐพ๋Š” ๊ฒƒ๊ณผ ๊ฐ™์€ ์ผ์ž…๋‹ˆ๋‹ค.
03:06
Once you choose the right station, whether it be jazz or opera,
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์žฌ์ฆˆ๋“  ์˜คํŽ˜๋ผ๋“  ๋งž๋Š” ์ฃผํŒŒ์ˆ˜๋ฅผ ๋งž์ท„๋‹ค๋ฉด
03:09
in our case whether it be movement or mood,
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์šฐ๋ฆฌ์˜ ๊ฒฝ์šฐ ์šด๋™์ด๋“  ๊ฐ์ •์ด๋“ 
03:11
we can put the dial there,
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๋‹ค์ด์–ผ์„ ๊ฑฐ๊ธฐ์— ๋งž์ถฐ ๋‘” ์ฑ„๋กœ
03:13
and then we can use a second button to adjust the volume,
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๋˜๋‹ค๋ฅธ ๋ฒ„ํŠผ์„ ์ด์šฉํ•ด์„œ
03:16
to turn it up or turn it down.
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์†Œ๋ฆฌ๋ฅผ ๋†’์ด๊ฑฐ๋‚˜ ๋‚ฎ์ถ”๋Š” ๊ฒ๋‹ˆ๋‹ค.
03:18
So what I'm going to tell you about
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์ œ๊ฐ€ ๋ง์”€๋“œ๋ฆด ๋‚ด์šฉ์€
03:19
is using the circuitry of the brain to implant electrodes
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๋‡Œ์˜ ํšŒ๋กœ๋ฅผ ์ด์šฉํ•ด์„œ ์ „๊ทน์„ ์ด์‹ํ•˜์—ฌ
03:23
and turning areas of the brain up and down
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๋‡Œ์˜ ๊ฐ ๋ถ€์œ„๋ฅผ ํ™œ์„ฑํ™”์‹œํ‚ค๊ฑฐ๋‚˜ ๋น„ํ™œ์„ฑํ™”์‹œ์ผœ์„œ
03:25
to see if we can help our patients.
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์น˜๋ฃŒ์— ๋„์›€์„ ์ค„ ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
03:27
And this is accomplished using this kind of device,
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๊ทธ๋Ÿฐ ์ผ์€ ์ด๋Ÿฌํ•œ ๊ธฐ๊ธฐ๋ฅผ ์ด์šฉํ•ด์„œ ์ด๋ฃจ์–ด์ง€๋Š”๋ฐ์š”
03:29
and this is called deep brain stimulation.
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'๋‡Œ ์‹ฌ๋ถ€ ์ž๊ทน์ˆ ' ์ด๋ผ๊ณ  ๋ถˆ๋ฆฝ๋‹ˆ๋‹ค.
03:32
So what we're doing is placing these electrodes throughout the brain.
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์šฐ๋ฆฌ๊ฐ€ ํ•  ์ผ์€ ์ด ์ „๊ทน์„ ๋‡Œ์— ์œ„์น˜์‹œํ‚ค๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
03:35
Again, we are making holes in the skull about the size of a dime,
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์ด๋ฒˆ์—๋„ ๋‘๊ฐœ๊ณจ์— ์ž‘์€ ๋™์ „ ํฌ๊ธฐ์˜ ๊ตฌ๋ฉ์„ ๋‚ด์•ผ ํ•ฉ๋‹ˆ๋‹ค.
03:39
putting an electrode in, and then this electrode
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๊ตฌ๋ฉ์œผ๋กœ ์ „๊ทน์„ ๋„ฃ์œผ๋ฉด
03:41
is completely underneath the skin
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์ „๊ทน์€ ์™„์ „ํžˆ ํ”ผ๋ถ€ ์•„๋ž˜๋กœ ๋“ค์–ด๊ฐ€๊ณ 
03:43
down to a pacemaker in the chest,
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ํ‰๋ถ€์˜ ์‹ฌ๋ฐ• ์กฐ์ ˆ๊ธฐ๊นŒ์ง€ ๋‹ฟ์Šต๋‹ˆ๋‹ค.
03:45
and with a remote control very much like a television remote control,
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๊ทธ๋ฆฌ๊ณ  ํ…”๋ ˆ๋น„์ „ ๋ฆฌ๋ชจ์ฝ˜๊ณผ ๊ฐ™์€ ์›๊ฒฉ ์กฐ์ ˆ ์žฅ์น˜๋ฅผ ์ด์šฉํ•ด์„œ
03:50
we can adjust how much electricity we deliver
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๋‡Œ์˜ ํŠน์ • ๋ถ€๋ถ„์—
03:53
to these areas of the brain.
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ํ˜๋ ค์ฃผ๊ณ  ์‹ถ์€ ์ „๋ฅ˜๋Ÿ‰์„ ์ •ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
03:55
We can turn it up or down, on or off.
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์šฐ๋ฆฌ๋Š” ์ „๋ฅ˜ ์–‘์„ ๋Š˜์ด๊ฑฐ๋‚˜ ์ค„์ด๊ฑฐ๋‚˜ ์•„์˜ˆ ๋Š์„์ˆ˜๋„ ์žˆ์ฃ .
03:58
Now, about a hundred thousand patients in the world
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ํ˜„์žฌ๊นŒ์ง€ ์ „ ์„ธ๊ณ„์—์„œ ์ˆ˜๋ฐฑ ์ˆ˜์ฒœ๋ช…์˜ ํ™˜์ž๋“ค์ด
04:00
have received deep brain stimulation,
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๋‡Œ ์‹ฌ๋ถ€ ์ž๊ทน์ˆ ์„ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค.
04:02
and I'm going to show you some examples
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๊ทธ๋ฆฌ๊ณ  ์ง€๊ธˆ๋ถ€ํ„ฐ๋Š” ์ด ์‹œ์ˆ ์„ ์‚ฌ์šฉํ•˜์—ฌ
04:03
of using deep brain stimulation to treat disorders of movement,
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์šด๋™ ์žฅ์• , ์ •์‹  ์žฅ์• , ์ธ์ง€ ์žฅ์•  ๋“ฑ์„
04:06
disorders of mood and disorders of cognition.
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์น˜๋ฃŒํ•œ ์˜ˆ๋ฅผ ๋ณด์—ฌ๋“œ๋ฆฌ๊ฒ ์Šต๋‹ˆ๋‹ค.
04:11
So this looks something like this when it's in the brain.
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์ „๊ทน์ด ๋‡Œ ์†์œผ๋กœ ๋“ค์–ด๊ฐ€๋ฉด ์ด๋Ÿฐ ๋ชจ์Šต์ž…๋‹ˆ๋‹ค.
04:13
You see the electrode going through the skull into the brain
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๋‘๊ฐœ๊ณจ ์†์œผ๋กœ ์ „๊ทน์ด ๋“ค์–ด๊ฐ€๋Š” ๊ฒƒ์ด ๋ณด์ด์‹œ์ฃ .
04:16
and resting there, and we can place this really anywhere in the brain.
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๊ทธ๋ฆฌ๊ณ  ๋‡Œ ์–ด๋””๋กœ๋“  ์œ„์น˜์‹œํ‚ฌ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
04:19
I tell my friends that no neuron is safe
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์ €๋Š” ์นœ๊ตฌ๋“ค์—๊ฒŒ ์–ด๋–ค ๋‰ด๋Ÿฐ๋„
04:21
from a neurosurgeon, because we can really reach
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์‹ ๊ฒฝ์™ธ๊ณผ์˜๋กœ๋ถ€ํ„ฐ ์•ˆ์ „ํ•˜์ง€ ์•Š๋‹ค๊ณ  ๋งํ•ฉ๋‹ˆ๋‹ค.
04:23
just about anywhere in the brain quite safely now.
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์™œ๋ƒํ•˜๋ฉด ์šฐ๋ฆฌ๋Š” ์ •๋ง๋กœ ๋‡Œ ์† ์–ด๋””๋“  ์ „๊ทน์ด ๋‹ฟ๊ฒŒ ํ•  ์ˆ˜ ์žˆ๊ฑฐ๋“ ์š”.
04:26
Now the first example I'm going to show you is a patient
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์ฒซ๋ฒˆ์งธ๋กœ ๋ณด์—ฌ๋“œ๋ฆด ํ™˜์ž๋Š”
04:29
with Parkinson's disease,
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ํŒŒํ‚จ์Šจ ๋ณ‘ ํ™˜์ž์ž…๋‹ˆ๋‹ค.
04:30
and this lady has Parkinson's disease,
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์ด ๋ถ€์ธ๊ป˜์„œ๋Š” ํŒŒํ‚จ์Šจ ๋ณ‘์„ ์•“์œผ์…จ๊ณ 
04:32
and she has these electrodes in her brain,
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๋‡Œ ์†์œผ๋กœ ์„ธ๊ฐœ์˜ ์ „๊ทน์„ ๋„ฃ์—ˆ์Šต๋‹ˆ๋‹ค.
04:35
and I'm going to show you what she's like
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์ „๊ทน์ด ๊บผ์กŒ์„๋•Œ ์ด๋ถ„์ด ์–ด๋–ค ๋ชจ์Šต์ธ์ง€
04:36
when the electrodes are turned off and she has her Parkinson's symptoms,
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ํŒŒํ‚จ์Šจ ๋ณ‘์˜ ์ฆ์ƒ์„ ๋ณด์—ฌ๋“œ๋ฆฌ๊ฒ ์Šต๋‹ˆ๋‹ค.
04:39
and then we're going to turn it on.
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๊ทธ๋ฆฌ๊ณ  ๋‹ค์‹œ ์ „๊ทน์„ ์ผœ๋ณด๋„๋ก ํ•˜์ฃ .
04:42
So this looks something like this.
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์ž, ์ด๋Ÿฐ ๋ชจ์Šต์ž…๋‹ˆ๋‹ค.
04:44
The electrodes are turned off now, and you can see that she has tremor.
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์ง€๊ธˆ์€ ์ „๊ทน์ด ๊บผ์ ธ ์žˆ์–ด์š”. ๋–จ๋ฆผ ์ฆ์ƒ์„ ๋‚˜ํƒ€๋‚ด๋Š” ๊ฒƒ์ด ๋ณด์ด์‹œ์ฃ .
04:49
(Video) Man: Okay. Woman: I can't. Man: Can you try to touch my finger?
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(์˜์ƒ) ๋‚จ์ž: ์ž ํ•ด๋ณด์„ธ์š”. ์—ฌ์ž: ๋ชปํ•˜๊ฒ ์–ด์š”. ๋‚จ์ž: ์ œ ์†๊ฐ€๋ฝ์„ ๋งŒ์งˆ ์ˆ˜ ์žˆ๊ฒ ์–ด์š”?
04:53
(Video) Man: That's a little better. Woman: That side is better.
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(์˜์ƒ)๋‚จ์ž: ์กฐ๊ธˆ ๋‚ซ๋„ค์š”. ์—ฌ์ž: ์ด ์ชฝ์ด ๋‚˜์€๊ฒƒ ๊ฐ™์•„์š”.
04:56
We're now going to turn it on.
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์ด์ œ ์ „๊ทน์„ ์ผœ๋ณด๊ฒ ์Šต๋‹ˆ๋‹ค.
05:00
It's on. Just turned it on.
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์ผœ์กŒ์–ด์š”. ๋ฐฉ๊ธˆ ์ผฐ์ฃ .
05:06
And this works like that, instantly.
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์ฆ‰์‹œ ์ž‘์šฉ์„ ํ•ฉ๋‹ˆ๋‹ค.
05:09
And the difference between shaking in this way and not --
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๋–จ๋ฆผ ์ฆ์ƒ์„ ๋‚˜ํƒ€๋‚ด๋Š” ๊ฒƒ๊ณผ ์ •์ƒ์ƒํƒœ์˜ ์ฐจ์ด๋Š”-
05:12
(Applause)
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(๋ฐ•์ˆ˜)
05:17
The difference between shaking in this way and not is related to the misbehavior
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์ฐจ์ด๋Š” ํ™˜์ž์˜ ์‹œ์ƒํ•˜ํ•ต์— ์กด์žฌํ•˜๋Š”
05:21
of 25,000 neurons in her subthalamic nucleus.
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25,000๊ฐœ์˜ ๋‰ด๋Ÿฐ์ด ์˜ค์ž‘๋™ ํ•˜๊ณ  ์žˆ๊ธฐ ๋•Œ๋ฌธ์ž…๋‹ˆ๋‹ค.
05:25
So we now know how to find these troublemakers
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์ด์ œ๋Š” ๋ฌธ์ œ๋ฅผ ์ผ์œผํ‚ค๋Š” ์›์ธ์„ ์ฐพ์•„์„œ ์ด๋ ‡๊ฒŒ ๋งํ•ด์ค„ ์ˆ˜ ์žˆ์–ด์š”.
05:28
and tell them, "Gentlemen, that's enough.
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"์—ฌ๋Ÿฌ๋ถ„, ๊ทธ ์ •๋„๋งŒ ํ•˜์‹œ์ฃ .
05:29
We want you to stop doing that."
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์ด์ œ ๊ทธ๋งŒํ–ˆ์œผ๋ฉด ์ข‹๊ฒ ์–ด์š”."
05:30
And we do that with electricity.
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๊ทธ๋ฆฌ๊ณ  ์šฐ๋ฆฌ๋Š” ์ „๊ธฐ๋ฅผ ์ด์šฉํ•ฉ๋‹ˆ๋‹ค.
05:32
So we use electricity to dictate how they fire,
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์ „๊ธฐ๋ฅผ ์ด์šฉํ•ด์„œ ์‹ ํ˜ธ ์ „๋‹ฌ์„ ์ง€์‹œํ•˜๊ณ 
05:35
and we try to block their misbehavior using electricity.
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์ „๊ธฐ๋ฅผ ์ด์šฉํ•ด์„œ ์˜ค์ž‘๋™์„ ๋ง‰์Šต๋‹ˆ๋‹ค.
05:38
So in this case, we are suppressing the activity of abnormal neurons.
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์ด ๊ฒฝ์šฐ ์šฐ๋ฆฌ๋Š” ๋น„์ •์ƒ์ ์ธ ๋‰ด๋Ÿฐ์˜ ํ™œ๋™์„ ์–ต์ œํ•ฉ๋‹ˆ๋‹ค.
05:42
We started using this technique in other problems,
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๋‹ค๋ฅธ ๋ฌธ์ œ์—๋„ ์ด ๊ธฐ์ˆ ์„ ํ™œ์šฉํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
05:44
and I'm going to tell you about a fascinating problem
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๋˜๋‹ค๋ฅธ ๋Œ€๋‹จํžˆ ํฅ๋ฏธ๋กœ์šด ๊ฒฝ์šฐ๊ฐ€ ์žˆ๋Š”๋ฐ์š”
05:46
that we encountered, a case of dystonia.
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๋ฐ”๋กœ ๊ทผ์œก ๊ธด์žฅ ์ด์ƒ์ฆ ์ž…๋‹ˆ๋‹ค.
05:49
So dystonia is a disorder affecting children.
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์ด ๋ณ‘์€ ์–ด๋ฆฐ์ด๋“ค์—๊ฒŒ ๋ฐœ์ƒํ•˜๋Š” ์งˆํ™˜์ž…๋‹ˆ๋‹ค.
05:51
It's a genetic disorder, and it involves a twisting motion,
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์œ ์ „์  ์งˆ๋ณ‘์ด๊ณ , ๋ชธ์„ ๊ผฌ๋Š” ์ฆ์ƒ์„ ๋‚˜ํƒ€๋‚ด์ฃ .
05:55
and these children get progressively more and more twisting
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์ด ์งˆํ™˜์„ ๊ฐ€์ง„ ์–ด๋ฆฐ์ด๋“ค์€ ์ ์  ๋” ์‹ฌํ•œ ์ฆ์ƒ์„ ๋‚˜ํƒ€๋ƒ…๋‹ˆ๋‹ค.
05:57
until they can't breathe, until they get sores,
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๊ฒฐ๊ตญ์—” ์ˆจ์„ ์‰ฌ์ง€ ๋ชปํ•˜๊ฑฐ๋‚˜, ๋ชฉ์ด ๋ถ“๊ณ , ์š”๋กœ ๊ฐ์—ผ์„ ์ผ์œผํ‚ค๋ฉฐ
05:59
urinary infections, and then they die.
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์‚ฌ๋ง์— ์ด๋ฆ…๋‹ˆ๋‹ค.
06:01
So back in 1997, I was asked to see this young boy,
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1997๋…„๋„์—๋Š” ํ•œ ์†Œ๋…„์„ ์ง„์ฐฐํ•˜๊ฒŒ ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
06:05
perfectly normal. He has this genetic form of dystonia.
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์™„์ „ํžˆ ์ •์ƒ์œผ๋กœ ๋ณด์ด์ง€๋งŒ ์œ ์ „์„ฑ ๊ทผ์œก ๊ธด์žฅ ์ด์ƒ์ฆ์„ ๊ฐ€์ง€๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
06:08
There are eight children in the family.
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์ด๋“ค ๊ฐ€์กฑ์—๋Š” ์ด ์—ฌ๋Ÿ๋ช…์˜ ํ˜•์ œ๊ฐ€ ์žˆ๋Š”๋ฐ,
06:10
Five of them have dystonia.
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๊ทธ์ค‘ ๋‹ค์„ฏ๋ช…์ด ๊ทผ์œก ๊ธด์žฅ ์ด์ƒ์ฆ์„ ์•“๊ณ  ์žˆ๊ตฌ์š”.
06:13
So here he is.
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์—ฌ๊ธฐ ์†Œ๋…„์˜ ์‚ฌ์ง„์ด ์žˆ๋„ค์š”.
06:15
This boy is nine years old, perfectly normal until the age six,
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์ด ์†Œ๋…„์€ ์•„ํ™‰์‚ด์ž…๋‹ˆ๋‹ค. ์—ฌ์„ฏ์‚ด๊นŒ์ง€๋Š” ์ •์ƒ์ด์˜€์ฃ .
06:20
and then he started twisting his body, first the right foot,
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ํ•˜์ง€๋งŒ ์˜ค๋ฅธ ๋ฐœ์„ ์‹œ์ž‘์œผ๋กœ ๋ชธ์„ ๊ผฌ๊ธฐ ์‹œ์ž‘ํ–ˆ๊ณ ,
06:24
then the left foot, then the right arm, then the left arm,
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์™ผ์ชฝ ๋ฐœ, ์˜ค๋ฅธ ํŒ”, ์™ผ ํŒ”, ๋ชธํ†ต
06:27
then the trunk, and then by the time he arrived,
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๊ทธ๋ฆฌ๊ณ  ๋ณ‘์›์— ์˜จ ์‹œ์ ์—๋Š”
06:31
within the course of one or two years of the disease onset,
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์ฆ์ƒ์ด ๋‚˜ํƒ€๋‚œ์ง€ ์ผ ์ด๋…„ ์ง€๋‚œ ์ƒํ™ฉ์ด์—ˆ๊ณ 
06:34
he could no longer walk, he could no longer stand.
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๋”์ด์ƒ ๊ฑท์ง€๋„ ์„œ์ง€๋„ ๋ชปํ•˜๋Š” ์ƒํƒœ์˜€์Šต๋‹ˆ๋‹ค.
06:36
He was crippled, and indeed the natural progression
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๋ถˆ๊ตฌ์˜ ๋ชธ์ด ๋˜์–ด ์žˆ์—ˆ๊ณ ,
06:39
as this gets worse is for them to become progressively twisted,
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์งˆํ™˜์ด ์ง„ํ–‰๋ ์ˆ˜๋ก ์ ์  ๋ชธ์„ ๊ผฌ๋Š” ์ฆ์ƒ์ด ๋‚˜ํƒ€๋‚ฉ๋‹ˆ๋‹ค.
06:42
progressively disabled, and many of these children do not survive.
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์ ์  ์žฅ์• ๊ฐ€ ์‹ฌํ•ด์ง€๊ณ  ๋‹ค์ˆ˜์˜ ์–ด๋ฆฐ์ด ํ™˜์ž๋“ค์€ ์ƒ์กดํ•˜์ง€ ๋ชปํ•˜์ฃ .
06:48
So he is one of five kids.
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๋‹ค์„ฏ๋ช…์˜ ์•„์ด ์ค‘ ํ•œ๋ช…์ž…๋‹ˆ๋‹ค.
06:50
The only way he could get around was crawling on his belly like this.
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๋Œ์•„๋‹ค๋‹ ์ˆ˜ ์žˆ๋Š” ์œ ์ผํ•œ ๋ฐฉ๋ฒ•์€ ์ด๋ ‡๊ฒŒ ๋ฐฐ๋กœ ๊ธฐ์–ด๋‹ค๋‹ˆ๋Š” ๋ฐฉ๋ฒ• ๋ฟ์ž…๋‹ˆ๋‹ค.
06:54
He did not respond to any drugs.
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์–ด๋–ค ์•ฝ๋ฌผ๋„ ํšจ๊ณผ๋ฅผ ๋ณด์ด์ง€ ์•Š์•˜๊ตฌ์š”,
06:56
We did not know what to do with this boy.
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์ด ์•„์ด๋ฅผ ์–ด๋–ป๊ฒŒ ์น˜๋ฃŒํ•ด์•ผ ํ• ์ง€ ๋ชจ๋ฅด๋Š” ์ƒํ™ฉ์ด์—ˆ์Šต๋‹ˆ๋‹ค.
06:58
We did not know what operation to do,
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์–ด๋–ค ์ˆ˜์ˆ ์„ ํ•ด์•ผ ํ• ์ง€,
07:00
where to go in the brain,
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๋‡Œ์˜ ์–ด๋Š ๋ถ€์œ„๋ฅผ ๋ด์•ผ ํ• ์ง€ ๋ชฐ๋ž์ฃ .
07:02
but on the basis of our results in Parkinson's disease,
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ํ•˜์ง€๋งŒ ํŒŒํ‚จ์Šจ ๋ณ‘์„ ์น˜๋ฃŒํ•œ ์˜ˆ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ
07:05
we reasoned, why don't we try to suppress
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ํŒŒํ‚จ์Šจ ๋ณ‘์—์„œ ์–ต์ œํ•ด์ค€ ๋‡Œ์˜ ๋ถ€์œ„๋ฅผ
07:07
the same area in the brain that we suppressed
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์ด๋ฒˆ์—๋„ ์–ต์ œํ•ด๋ณด๋ฉด ์–ด๋–จ๊นŒํ•˜๋Š”
07:10
in Parkinson's disease, and let's see what happens?
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์ƒ๊ฐ์„ ํ•˜๊ฒŒ ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
07:14
So here he was. We operated on him
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๊ทธ๋ž˜์„œ ์ด ์•„์ด์—๊ฒŒ ์ˆ˜์ˆ ์„ ์‹œํ–‰ํ–ˆ์Šต๋‹ˆ๋‹ค.
07:16
hoping that he would get better. We did not know.
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์•„์ด๊ฐ€ ๋‚˜์•„์ง€๊ธธ ๋ฐ”๋ผ๋ฉด์„œ์š”. ๊ฒฐ๊ณผ๋Š” ์–ด๋–ป๊ฒŒ ๋  ์ง€ ๋ชฐ๋ž์Šต๋‹ˆ๋‹ค.
07:19
So here he is now, back in Israel where he lives,
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์ง€๊ธˆ ์ด ์†Œ๋…„์€ ๊ณ ํ–ฅ์ธ ์ด์Šค๋ผ์—˜์— ์žˆ์Šต๋‹ˆ๋‹ค.
07:24
three months after the procedure, and here he is.
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์ˆ˜์ˆ  ์‚ผ๊ฐœ์›” ํ›„ ์†Œ๋…„์˜ ๋ชจ์Šต์ž…๋‹ˆ๋‹ค.
07:28
(Applause)
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(๋ฐ•์ˆ˜)
07:36
On the basis of this result, this is now a procedure
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์ด๋Ÿฐ ๊ฒฐ๊ณผ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ
07:39
that's done throughout the world,
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์ด์ œ๋Š” ์ „ ์„ธ๊ณ„์ ์œผ๋กœ ์‹œํ–‰๋˜๊ณ  ์žˆ๋Š” ์ˆ˜์ˆ ์ž…๋‹ˆ๋‹ค.
07:40
and there have been hundreds of children
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๊ทธ๋ฆฌ๊ณ  ์ˆ˜๋ฐฑ๋ช…์˜ ์–ด๋ฆฐ์ด๋“ค์ด
07:41
that have been helped with this kind of surgery.
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์ด ๋ฐฉ๋ฒ•์œผ๋กœ ๋„์›€์„ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค.
07:46
This boy is now in university
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์ด ์†Œ๋…„์€ ์ด์ œ ๋Œ€ํ•™์— ๋‹ค๋‹ˆ๊ณ  ์žˆ๊ณ ,
07:48
and leads quite a normal life.
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์ •์ƒ์ ์ธ ์‚ถ์„ ์‚ด๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
07:50
This has been one of the most satisfying cases
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์ด๊ฒƒ์€ ์ œ ๊ฒฝ๋ ฅ์„ ํ†ตํ‹€์–ด์„œ
07:52
that I have ever done in my entire career,
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๊ฐ€์žฅ ๋งŒ์กฑ์Šค๋Ÿฌ์šด ๊ฒฝ์šฐ ์ค‘์˜ ํ•˜๋‚˜์ž…๋‹ˆ๋‹ค.
07:54
to restore movement and walking to this kind of child.
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์–ด๋ฆฐ์ด๊ฐ€ ์šด๋™์„ฑ์„ ๋˜์ฐพ๊ณ  ๊ฑธ์–ด๋‹ค๋‹ ์ˆ˜ ์žˆ๊ฒŒ ๋˜์—ˆ์ฃ .
07:57
(Applause)
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(๋ฐ•์ˆ˜)
08:04
We realized that perhaps we could use this technology
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์šฐ๋ฆฌ๋Š” ์ด ๊ธฐ์ˆ ์„
08:07
not only in circuits that control your movement
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์šด๋™์„ ์กฐ์ ˆํ•˜๋Š” ํšŒ๋กœ ๋ฟ ์•„๋‹ˆ๋ผ
08:09
but also circuits that control other things,
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๋‹ค๋ฅธ ๊ฒƒ๋“ค์„ ์กฐ์ ˆํ•˜๋Š” ํšŒ๋กœ์—๋„ ํ™œ์šฉํ•  ์ˆ˜ ์žˆ์ง€ ์•Š์„๊นŒ ์ƒ๊ฐํ•˜๊ฒŒ ๋˜์—ˆ๊ณ 
08:11
and the next thing that we took on
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๋‹ค์Œ์œผ๋กœ ์šฐ๋ฆฌ๊ฐ€ ์‹œ๋„ํ•œ ๊ฒƒ์€
08:12
was circuits that control your mood.
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์ •์‹ ์„ ๊ด€์žฅํ•˜๋Š” ํšŒ๋กœ์ž…๋‹ˆ๋‹ค.
08:15
And we decided to take on depression,
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์šฐ์šธ์ฆ์„ ์น˜๋ฃŒํ•ด๋ณด๊ธฐ๋กœ ํ–ˆ์ฃ .
08:17
and the reason we took on depression is because it's so prevalent,
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์šฐ์šธ์ฆ์ด์—ˆ๋˜ ์ด์œ ๋Š”, ์šฐ์šธ์ฆ์ด ๋งค์šฐ ์ผ๋ฐ˜์ ์ด๋ฉฐ
08:19
and as you know, there are many treatments for depression,
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์—ฌ๋Ÿฌ๋ถ„๋„ ์•„์‹œ๋‹ค์‹œํ”ผ, ์•ฝ๋ฌผ ์š”๋ฒ•, ์ •์‹  ์š”๋ฒ• ๋“ฑ
08:22
with medication and psychotherapy,
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์‹ฌ์ง€์–ด ์ „๊ธฐ ์ถฉ๊ฒฉ ์š”๋ฒ•๊นŒ์ง€
08:24
even electroconvulsive therapy,
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๋‹ค์–‘ํ•œ ์น˜๋ฃŒ๋ฒ•์ด ์žˆ์ง€๋งŒ
08:26
but there are millions of people,
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์ˆ˜๋ฐฑ๋งŒ๋ช…์˜ ํ™˜์ž๋“ค ์ค‘
08:27
and there are still 10 or 20 percent of patients with depression
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10์—์„œ 20 ํผ์„ผํŠธ๋Š” ์น˜๋ฃŒ ํšจ๊ณผ๊ฐ€ ์—†์œผ๋ฉฐ
08:30
that do not respond, and it is these patients that we want to help.
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์ด ํ™˜์ž๋“ค์„ ๋•๊ณ  ์‹ถ์—ˆ๊ธฐ ๋•Œ๋ฌธ์ž…๋‹ˆ๋‹ค.
08:33
And let's see if we can use this technique
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์ด ๊ธฐ์ˆ ์„ ์ ์šฉํ•˜์—ฌ
08:35
to help these patients with depression.
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์šฐ์šธ์ฆ์„ ์น˜๋ฃŒํ•  ์ˆ˜ ์žˆ๋Š”์ง€ ๋ณด๋„๋ก ํ•ฉ์‹œ๋‹ค.
08:38
So the first thing we did was, we compared,
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์šฐ๋ฆฌ๊ฐ€ ์ฒ˜์Œ ํ•œ ์ผ์€
08:39
what's different in the brain of someone with depression
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์šฐ์šธ์ฆ ํ™˜์ž์˜ ๋‡Œ์™€
08:41
and someone who is normal,
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์ •์ƒ์ธ์˜ ๋‡Œ์— ์ฐจ์ด๊ฐ€ ์žˆ๋Š”์ง€๋ฅผ ๋ณด๋Š” ๊ฒƒ์ด์—ˆ์Šต๋‹ˆ๋‹ค.
08:43
and what we did was PET scans to look at the blood flow of the brain,
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PET ์Šค์บ”์„ ํ†ตํ•ด ๋‡Œ์˜ ํ˜ˆ๋ฅ˜๋ฅผ ์ธก์ •ํ•œ ๊ฒฐ๊ณผ
08:46
and what we noticed is that in patients with depression
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์šฐ์šธ์ฆ ํ™˜์ž์˜ ๋‡Œ๋Š”
08:49
compared to normals,
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์ •์ƒ์ธ์— ๋น„ํ•ด
08:51
areas of the brain are shut down,
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์ž‘๋™ํ•˜์ง€ ์•Š๋Š” ๋ถ€์œ„๊ฐ€ ๋งŽ๋‹ค๋Š” ๊ฒƒ์ด์—ˆ์Šต๋‹ˆ๋‹ค.
08:52
and those are the areas in blue.
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ํŒŒ๋ž€์ƒ‰์œผ๋กœ ํ‘œ์‹œ๋œ ๋ถ€๋ถ„์ด์ฃ .
08:53
So here you really have the blues,
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์ •๋ง๋กœ ์šฐ์šธํ•จ(blue=ํŒŒ๋ž€์ƒ‰)์ด ์žˆ์Šต๋‹ˆ๋‹ค.
08:55
and the areas in blue are areas that are involved
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ํŒŒ๋ž€์ƒ‰ ๋ถ€๋ถ„์€
08:59
in motivation, in drive and decision-making,
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๋™๊ธฐ ๋ถ€์—ฌ, ์˜์‚ฌ ๊ฒฐ์ • ๋“ฑ์„ ๋‹ด๋‹นํ•˜๋Š” ๋ถ€์œ„์ด๊ณ 
09:01
and indeed, if you're severely depressed as these patients were,
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์ด ํ™˜์ž๋“ค๊ณผ ๊ฐ™์ด ์‹ฌ๊ฐํ•˜๊ฒŒ ์šฐ์šธ์ฆ์„ ์•“๋Š” ๊ฒฝ์šฐ
09:04
those are impaired. You lack motivation and drive.
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์ด ๋ถ€์œ„๊ฐ€ ๋ง๊ฐ€์ ธ ์žˆ์–ด ๋™๊ธฐ ๋ถ€์—ฌ๊ฐ€ ๋˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
09:07
The other thing we discovered
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์šฐ๋ฆฌ๊ฐ€ ๋ฐœ๊ฒฌํ•œ ๋˜๋‹ค๋ฅธ ์‚ฌ์‹ค์€
09:08
was an area that was overactive, area 25,
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๊ณผ๋„ํ•˜๊ฒŒ ํ™œ๋ฐœํ•œ 25๋ถ€์œ„์ž…๋‹ˆ๋‹ค.
09:11
seen there in red,
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๋นจ๊ฐ„์ƒ‰์œผ๋กœ ํ‘œ์‹œ๋˜์–ด ์žˆ์ฃ .
09:12
and area 25 is the sadness center of the brain.
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25๋ถ€์œ„๋Š” ์Šฌํ””์„ ์ฃผ๊ด€ํ•˜๋Š” ๋ถ€๋ถ„์ž…๋‹ˆ๋‹ค.
09:15
If I make any of you sad, for example, I make you remember
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์ œ๊ฐ€ ์—ฌ๋Ÿฌ๋ถ„์„ ์Šฌํ”„๊ฒŒ ๋งŒ๋“ ๋‹ค๋ฉด, ์˜ˆ๋ฅผ ๋“ค์–ด,
09:18
the last time you saw your parent before they died
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์—ฌ๋Ÿฌ๋ถ„์ด ๋ถ€๋ชจ๋‹˜์ด ๋Œ์•„๊ฐ€์‹œ๊ธฐ ์ง์ „ ๋ชจ์Šต์„ ๋ดค๋‹ค๊ฑฐ๋‚˜
09:20
or a friend before they died,
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์นœ๊ตฌ๊ฐ€ ์ฃฝ๊ธฐ ์ „์˜ ๋ชจ์Šต์„ ๋ดค๋‹ค๋ฉด
09:22
this area of the brain lights up.
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๋‡Œ์˜ ์ด ๋ถ€๋ถ„์ด ํ™œ๋™์„ ํ•ฉ๋‹ˆ๋‹ค.
09:23
It is the sadness center of the brain.
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์Šฌํ””์„ ๋‹ด๋‹นํ•˜๋Š” ๋ถ€๋ถ„์ด์ฃ .
09:25
And so patients with depression have hyperactivity.
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๋”ฐ๋ผ์„œ ์šฐ์šธ์ฆ ํ™˜์ž๋“ค์—๊ฒŒ ๊ณผํ•˜๊ฒŒ ํ™œ์„ฑํ™”๋˜๋Š” ๊ณณ์ž…๋‹ˆ๋‹ค.
09:28
The area of the brain for sadness is on red hot.
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๋‡Œ์˜ ์Šฌํ”” ๋ถ€์œ„๊ฐ€ ์•„์ฃผ ๋ถ‰๊ณ  ๋œจ๊ฒ์ฃ .
09:30
The thermostat is set at 100 degrees,
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100๋„์— ๋งž์ถฐ์ ธ ์žˆ์Šต๋‹ˆ๋‹ค.
09:33
and the other areas of the brain, involved in drive and motivation, are shut down.
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๊ทธ๋ฆฌ๊ณ  ๋™๊ธฐ ๋ถ€์—ฌ ๋ถ€์œ„๋Š” ์•„์˜ˆ ํ™œ๋™์„ ๋ฉˆ์ท„์Šต๋‹ˆ๋‹ค.
09:36
So we wondered, can we place electrodes in this area of sadness
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๊ทธ๋ž˜์„œ ์šฐ๋ฆฌ๋Š”, ์Šฌํ”” ๋ถ€์œ„์— ์ „๊ทน์„ ๋†“๊ณ 
09:39
and see if we can turn down the thermostat,
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์˜จ๋„ ์„ค์ •์„ ๋‚ฎ์ถ”์–ด
09:41
can we turn down the activity,
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ํ™œ์„ฑํ™” ์ •๋„๋ฅผ ์•ฝํ™”์‹œํ‚ฌ ์ˆ˜ ์žˆ์„์ง€,
09:43
and what will be the consequence of that?
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๊ทธ ๊ฒฐ๊ณผ๋Š” ์–ด๋–ป๊ฒŒ ๋‚˜ํƒ€๋‚ ์ง€ ์ƒ๊ฐํ•ด ๋ณด์•˜์Šต๋‹ˆ๋‹ค.
09:45
So we went ahead and implanted electrodes in patients with depression.
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์šฐ๋ฆฌ๋Š” ์šฐ์šธ์ฆ ํ™˜์ž์˜ ๋‡Œ์— ์ „๊ทน์„ ์‚ฝ์ž…ํ–ˆ์Šต๋‹ˆ๋‹ค.
09:48
This is work done with my colleague Helen Mayberg from Emory.
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์ €์˜ ๋™๋ฃŒ์ธ ์—๋ชจ๋ฆฌ ๋Œ€ํ•™์˜ ํ—ฌ๋ Œ ๋ฉ”์ด๋ฒ„๊ทธ์”จ๊ฐ€ ์‹œ์ˆ ์„ ํ–ˆ์Šต๋‹ˆ๋‹ค.
09:51
And we placed electrodes in area 25,
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๊ทธ๋ฆฌ๊ณ  25๋ถ€์œ„์— ์ „๊ทน์„ ๋†“์•˜์ฃ .
09:53
and in the top scan you see before the operation,
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์ œ์ผ ์œ„์˜ ์‚ฌ์ง„์ด ์ˆ˜์ˆ ์„ ํ•˜๊ธฐ ์ „
09:55
area 25, the sadness area is red hot,
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25๋ถ€์œ„์˜ ๋ชจ์Šต์ž…๋‹ˆ๋‹ค. ์•„์ฃผ ๋นจ๊ฐ„๊ฒŒ ๋ณด์ด์‹œ์ฃ .
09:57
and the frontal lobes are shut down in blue,
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์ „๋‘์—ฝ์€ ํŒŒ๋ž—๊ฒŒ ํ™œ๋™์ด ๋ฉˆ์ถฐ์žˆ์Šต๋‹ˆ๋‹ค.
10:00
and then, after three months of continuous stimulation,
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๊ทธ๋ฆฌ๊ณ  ๋งค์ผ 24์‹œ๊ฐ„์”ฉ 3๊ฐœ์›”,
10:02
24 hours a day, or six months of continuous stimulation,
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๋˜๋Š” 6๊ฐœ์›” ๋™์•ˆ ๊พธ์ค€ํ•œ ์ž๊ทน์„ ์ฃผ์—ˆ์Šต๋‹ˆ๋‹ค.
10:05
we have a complete reversal of this.
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๊ทธ ๊ฒฐ๊ณผ ์™„์ „ํ•˜๊ฒŒ ์—ญ์ „์‹œํ‚ฌ ์ˆ˜ ์žˆ์—ˆ์ฃ .
10:07
We're able to drive down area 25,
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25๋ถ€์œ„๋ฅผ
10:10
down to a more normal level,
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์ •์ƒ์ ์ธ ์ƒํƒœ๊นŒ์ง€ ํ™œ์„ฑ์„ ์•ฝํ™”์‹œ์ผฐ์Šต๋‹ˆ๋‹ค.
10:12
and we're able to turn back online
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๊ทธ๋ฆฌ๊ณ  ๋‡Œ์˜ ์ „๋‘์—ฝ ํ™œ๋™์„
10:14
the frontal lobes of the brain,
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๊ฐ•ํ•˜๊ฒŒ ๋งŒ๋“ค์–ด ์ฃผ์—ˆ์ฃ .
10:15
and indeed we're seeing very striking results
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์‹ฌ๊ฐํ•œ ์šฐ์šธ ์ฆ์ƒ์„ ๋ณด์ด๋˜ ํ™˜์ž๋“ค์—๊ฒŒ์„œ
10:17
in these patients with severe depression.
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์•„์ฃผ ๋†€๋ผ์šด ๊ฒฐ๊ณผ๊ฐ€ ๊ด€์ฐฐ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
10:20
So now we are in clinical trials, and are in Phase III clinical trials,
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์ง€๊ธˆ์€ ์ž„์ƒ์‹œํ—˜์ด ์ง„ํ–‰์ค‘์ด๊ณ  3๋‹จ๊ณ„์— ์žˆ์Šต๋‹ˆ๋‹ค.
10:23
and this may become a new procedure,
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์ด ๋ฐฉ๋ฒ•์€ ์ƒˆ๋กœ์šด ์‹œ์ˆ ์ด ๋  ์ˆ˜ ์žˆ์ฃ .
10:25
if it's safe and we find that it's effective,
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์‹ฌ๊ฐํ•œ ์šฐ์šธ์ฆ์„ ์•“๋Š” ํ™˜์ž๋“ค์„ ์น˜๋ฃŒํ•  ์ˆ˜ ์žˆ๋Š”
10:27
to treat patients with severe depression.
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์•ˆ์ „ํ•˜๊ณ , ๋ฌด์—‡๋ณด๋‹ค ํšจ๊ณผ์ ์ธ ๋ฐฉ๋ฒ•์ž…๋‹ˆ๋‹ค.
10:31
I've shown you that we can use deep brain stimulation
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๋‡Œ ์‹ฌ๋ถ€ ์ž๊ทน์ˆ ์„ ํ†ตํ•ด์„œ
10:34
to treat the motor system
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ํŒŒํ‚จ์Šจ ๋ณ‘, ๊ทผ์œก ๊ธด์žฅ ์ด์ƒ์ฆ ๋“ฑ์˜ ํ™˜์ž์—์„œ
10:36
in cases of Parkinson's disease and dystonia.
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์šด๋™ ์˜์—ญ์„ ์น˜๋ฃŒํ•˜๋Š” ๊ฒƒ์„ ๋ณด์—ฌ๋“œ๋ ธ์Šต๋‹ˆ๋‹ค.
10:39
I've shown you that we can use it to treat a mood circuit
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๋˜ํ•œ ์šฐ์šธ์ฆ์˜ ๊ฒฝ์šฐ ์ •์‹  ํšŒ๋กœ์˜ ์น˜๋ฃŒ์—๋„
10:41
in cases of depression.
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์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ฒƒ์„ ๋ณด์—ฌ๋“œ๋ ธ์ฃ .
10:43
Can we use deep brain stimulation to make you smarter?
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์šฐ๋ฆฌ๋Š” ์ด ๋ฐฉ๋ฒ•์„ ์ด์šฉํ•ด์„œ ๋” ๋˜‘๋˜‘ํ•ด ์งˆ ์ˆ˜๋„ ์žˆ์„๊นŒ์š”?
10:47
(Laughter)
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(์›ƒ์Œ)
10:49
Anybody interested in that?
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๊ด€์‹ฌ ์žˆ์œผ์‹  ๋ถ„ ๊ณ„์‹ ๊ฐ€์š”?
10:52
(Applause)
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(๋ฐ•์ˆ˜)
10:54
Of course we can, right?
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๋ฌผ๋ก  ํ• ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ทธ๋ ‡์ฃ ?
10:57
So what we've decided to do is
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์šฐ๋ฆฌ๊ฐ€ ํ•  ์ผ์€
10:59
we're going to try to turbocharge
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๋‡Œ์˜ ๊ธฐ์–ต ํšŒ๋กœ๋ฅผ
11:02
the memory circuits in the brain.
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๋งค์šฐ ํ™œ์„ฑํ™”์‹œํ‚ค๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
11:04
We're going to place electrodes within the circuits
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๊ธฐ์–ต๊ณผ ์ธ์ง€ ๋Šฅ๋ ฅ์„ ์กฐ์ ˆํ•˜๋Š”
11:07
that regulate your memory and cognitive function
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ํšŒ๋กœ์— ์ „๊ทน์„ ์œ„์น˜ํ•˜๊ณ 
11:09
to see if we can turn up their activity.
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ํ™œ์„ฑํ™”์‹œํ‚ฌ ์ˆ˜ ์žˆ๋Š”์ง€ ๋ณด๋Š” ๊ฒƒ์ด์ฃ .
11:13
Now we're not going to do this in normal people.
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์ •์ƒ์ ์ธ ์‚ฌ๋žŒ์—๊ฒŒ๋Š” ์‹œ๋„ํ•  ์ˆ˜ ์—†์Šต๋‹ˆ๋‹ค.
11:15
We're going to do this in people that have cognitive deficits,
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์ธ์ง€ ์žฅ์• ๊ฐ€ ์žˆ๋Š” ์‚ฌ๋žŒ์—๊ฒŒ ์‹œํ–‰ํ•ด ๋ณด์•˜์Šต๋‹ˆ๋‹ค.
11:18
and we've chosen to treat patients with Alzheimer's disease
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์ธ์ง€ ๋Šฅ๋ ฅ๊ณผ ๊ธฐ์–ต์— ์žฅ์• ๊ฐ€ ์žˆ๋Š”
11:22
who have cognitive and memory deficits.
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์•Œ์ธ ํ•˜์ด๋จธ ํ™˜์ž๋ฅผ ์„ ์ •ํ•˜์˜€์ฃ .
11:24
As you know, this is the main symptom
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์—ฌ๋Ÿฌ๋ถ„๋„ ์•„์‹œ๋‹ค์‹œํ”ผ
11:26
of early onset Alzheimer's disease.
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์•Œ์ธ ํ•˜์ด๋จธ ์งˆํ™˜์˜ ์ดˆ๊ธฐ ์ฆ์ƒ ์ค‘ ํ•˜๋‚˜์ž…๋‹ˆ๋‹ค.
11:28
So we've placed electrodes within this circuit
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์šฐ๋ฆฌ๋Š” ๊ธฐ์–ต ํšŒ๋กœ์˜ ํ†ต๋กœ์ธ
11:30
in an area of the brain called the fornix,
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๋‡Œ๊ถ์ด๋ผ๊ณ  ๋ถˆ๋ฆฌ๋Š” ๋ถ€์œ„์—
11:32
which is the highway in and out of this memory circuit,
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์ „๊ทน์„ ์œ„์น˜ํ•˜๊ณ 
11:35
with the idea to see if we can turn on this memory circuit,
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์ด ๊ธฐ์–ต ํšŒ๋กœ๋ฅผ ํ™œ์„ฑํ™”์‹œํ‚ฌ ์ˆ˜ ์žˆ๋Š”์ง€ ๋ณด์•˜์Šต๋‹ˆ๋‹ค.
11:39
and whether that can, in turn, help these patients
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๋งŒ์•ฝ ํ™œ์„ฑํ™”๊ฐ€ ๋œ๋‹ค๋ฉด
11:42
with Alzheimer's disease.
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์•Œ์ธ ํ•˜์ด๋จธ ํ™˜์ž๋ฅผ ๋„์šธ ์ˆ˜ ์žˆ๊ฒ ์ฃ .
11:44
Now it turns out that in Alzheimer's disease,
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์ด์ œ ์•Œ์ธ ํ•˜์ด๋จธ ์งˆํ™˜์˜ ๊ฒฝ์šฐ
11:46
there's a huge deficit in glucose utilization in the brain.
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๋‡Œ์˜ ํฌ๋„๋‹น ํ™œ์šฉ์— ์žฅ์• ๊ฐ€ ์žˆ๋‹ค๋Š” ๊ฒƒ์ด ๋ฐํ˜€์กŒ์Šต๋‹ˆ๋‹ค.
11:50
The brain is a bit of a hog when it comes to using glucose.
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๋‡Œ๋Š” ํฌ๋„๋‹น ํ™œ์šฉ์„ ๋…์ฐจ์ง€ ํ•˜๋Š” ๊ฒฝํ–ฅ์ด ์žˆ์Šต๋‹ˆ๋‹ค.
11:54
It uses 20 percent of all your --
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๋ฌด๊ฒŒ๋Š” ์ „์ฒด์˜ 20% ๋ฐ–์— ์ฐจ์ง€ํ•˜์ง€ ์•Š์ง€๋งŒ
11:56
even though it only weighs two percent --
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-- ๋ฌด๊ฒŒ์˜ ๊ฒจ์šฐ 20%์ธ๋ฐ--
11:57
it uses 10 times more glucose than it should based on its weight.
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๋ฌด๊ฒŒ ๋น„์œจ์— ๋น„ํ•ด ์—ด๋ฐฐ๊ฐ€ ๋งŽ์€ ํฌ๋„๋‹น์„ ์‚ฌ์šฉํ•˜์ฃ .
12:00
Twenty percent of all the glucose in your body is used by the brain,
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์—ฌ๋Ÿฌ๋ถ„ ๋ชธ์— ์žˆ๋Š” ํฌ๋„๋‹น์˜ 20%๋Š” ๋‡Œ๊ฐ€ ์‚ฌ์šฉํ•˜๋ฉฐ
12:03
and as you go from being normal
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์ •์ƒ ์ƒํƒœ์—์„œ
12:05
to having mild cognitive impairment,
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์ธ์ง€ ์žฅ์• ๊ฐ€ ์žˆ๋Š” ์ƒํƒœ๋ฅผ ๊ฑฐ์ณ
12:08
which is a precursor for Alzheimer's, all the way to Alzheimer's disease,
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์•Œ์ธ ํ•˜์ด๋จธ๋กœ ์ง„ํ–‰๋ ์ˆ˜๋ก
12:10
then there are areas of the brain that stop using glucose.
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๋‡Œ์—์„œ ํฌ๋„๋‹น์„ ํ™œ์šฉํ•˜๋Š” ๋ถ€์œ„๊ฐ€ ์ ์–ด์ง‘๋‹ˆ๋‹ค.
12:13
They shut down. They turn off.
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ํ™œ๋™์„ ๋ฉˆ์ถ”๋Š” ๊ฑฐ์ฃ . ๊บผ์ง€๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
12:15
And indeed, what we see is that these areas in red
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๊ทธ๋ฆฌ๊ณ  ๋‡Œ์˜ ๋ฐ”๊นฅ์ชฝ์—
12:17
around the outside ribbon of the brain
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๋นจ๊ฐ„ ๋ถ€๋ถ„์„ ๋ณด์‹œ๋ฉด
12:19
are progressively getting more and more blue
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์™„์ „ํžˆ ํ™œ๋™์„ ๋ฉˆ์ถœ ๋•Œ ๊นŒ์ง€
12:21
until they shut down completely.
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์ ์  ๋” ํŒŒ๋ž—๊ฒŒ ๋ณ€ํ•˜๋Š” ๊ฒƒ์„ ์•Œ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
12:24
This is analogous to having a power failure
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์ด๊ฒƒ์€ ์ •์ „์ด ์ผ์–ด๋‚˜๋Š” ๊ฒƒ๊ณผ ๊ฐ™์€ ํ˜„์ƒ์ž…๋‹ˆ๋‹ค.
12:27
in an area of the brain, a regional power failure.
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๋‡Œ์—์„œ ๋ถ€๋ถ„์ ์ธ ์ •์ „์ด ์ผ์–ด๋‚˜๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
12:29
So the lights are out in parts of the brain
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์•Œ์ธ ํ•˜์ด๋จธ ํ™˜์ž์—์„œ๋Š”
12:32
in patients with Alzheimer's disease,
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๋‡Œ์˜ ๊ทธ ๋ถ€๋ถ„๋งŒ ๋ถˆ์ด ๊บผ์ง‘๋‹ˆ๋‹ค.
12:34
and the question is, are the lights out forever,
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๊ทธ๋ฆฌ๊ณ  ๊ถ๊ธˆํ•œ ์ ์€, ๋ถˆ์ด ์˜์›ํžˆ ๊บผ์ ธ ์žˆ๋Š” ๊ฒƒ์ผ๊นŒ์š”
12:37
or can we turn the lights back on?
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์•„๋‹ˆ๋ฉด ๋‹ค์‹œ ์ผค ์ˆ˜ ์žˆ์„๊นŒ์š”?
12:40
Can we get those areas of the brain to use glucose once again?
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๋‹ค์‹œ ํฌ๋„๋‹น์„ ํ™œ์šฉํ•˜๋„๋ก ๋งŒ๋“ค ์ˆ˜ ์žˆ์„๊นŒ์š”?
12:43
So this is what we did. We implanted electrodes in the fornix
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๊ทธ๋ž˜์„œ ์šฐ๋ฆฌ๋Š” ์ด๋ ‡๊ฒŒ ํ•ด๋ณด์•˜์Šต๋‹ˆ๋‹ค.
12:45
of patients with Alzheimer's disease, we turned it on,
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์•Œ์ธ ํ•˜์ด๋จธ ํ™˜์ž์˜ ๋‡Œ๊ณต์— ์ „๊ทน์„ ๋„ฃ๊ณ  ์ผฐ์Šต๋‹ˆ๋‹ค.
12:48
and we looked at what happens to glucose use in the brain.
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๋‡Œ์˜ ํฌ๋„๋‹น ํ™œ์šฉ์— ์–ด๋–ค ๋ณ€ํ™”๊ฐ€ ์ผ์–ด๋‚˜๋Š”์ง€ ๊ด€์ฐฐํ–ˆ์ฃ .
12:52
And indeed, at the top, you'll see before the surgery,
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์œ„์ชฝ์ด ์ˆ˜์ˆ  ์ „์˜ ๋ชจ์Šต์ž…๋‹ˆ๋‹ค.
12:55
the areas in blue are the areas that use less glucose than normal,
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ํŒŒ๋ž€์ƒ‰ ๋ถ€์œ„๊ฐ€ ์ •์ƒ๋ณด๋‹ค ํฌ๋„๋‹น ์‚ฌ์šฉ์ด ์ ์€ ๋ถ€์œ„์ž…๋‹ˆ๋‹ค.
12:58
predominantly the parietal and temporal lobes.
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์ฃผ๋กœ ๋‘์ •์—ฝ๊ณผ ์ธก๋‘์—ฝ ๋ถ€์œ„์ž…๋‹ˆ๋‹ค.
13:00
These areas of the brain are shut down.
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๋‡Œ์˜ ์ด ๋ถ€์œ„๊ฐ€ ํ™œ๋™์„ ๋ฉˆ์ถ˜ ์ƒํƒœ์ž…๋‹ˆ๋‹ค.
13:02
The lights are out in these areas of the brain.
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๋ถˆ์ด ๊บผ์ ธ ์žˆ๋Š”๊ฑฐ์ฃ .
13:05
We then put in the DBS electrodes and we wait for a month
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์ „๊ทน์„ ๋„ฃ๊ณ  ํ•œ๋‹ฌ ๋˜๋Š” ์ผ๋…„์„ ๊ธฐ๋‹ค๋ ธ์Šต๋‹ˆ๋‹ค.
13:08
or a year, and the areas in red
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๋นจ๊ฐ„์ƒ‰์œผ๋กœ ํ‘œ์‹œ๋œ ๋ถ€๋ถ„์ด
13:09
represent the areas where we increase glucose utilization.
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ํฌ๋„๋‹น ํ™œ์šฉ์ด ์ฆ๊ฐ€๋œ ๋ถ€๋ถ„์„ ๋‚˜ํƒ€๋ƒ…๋‹ˆ๋‹ค.
13:12
And indeed, we are able to get these areas of the brain
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๊ทธ๋ฆฌ๊ณ  ์šฐ๋ฆฌ๋Š” ๋‡Œ์˜ ์ด ๋ถ€๋ถ„์ด
13:15
that were not using glucose to use glucose once again.
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๋‹ค์‹œ ํฌ๋„๋‹น์„ ํ™œ์šฉํ•˜๋„๋ก ๋งŒ๋“ค ์ˆ˜ ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
13:18
So the message here is that, in Alzheimer's disease,
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์ด๊ฒƒ์ด ์šฐ๋ฆฌ์—๊ฒŒ ์ฃผ๋Š” ๋ฉ”์„ธ์ง€๋Š”
13:20
the lights are out, but there is someone home,
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๋ถˆ์€ ๊บผ์ ธ ์žˆ์ง€๋งŒ ๋ˆ„๊ตฐ๊ฐ€๋Š” ์ง‘์— ์žˆ๋‹ค๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
13:23
and we're able to turn the power back on
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๊ทธ๋ฆฌ๊ณ  ์šฐ๋ฆฌ๋Š” ์ด ๋ถ€์œ„์˜ ์ „์›์„ ๋‹ค์‹œ ์ผค ์ˆ˜ ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
13:25
to these areas of the brain, and as we do so,
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๊ทธ๊ฒƒ์„ ํ†ตํ•ด์„œ
13:27
we expect that their functions will return.
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๊ธฐ๋Šฅ์ด ๋Œ์•„์˜ฌ ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€ํ•  ์ˆ˜ ์žˆ์ฃ .
13:30
So this is now in clinical trials.
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์ด๊ฒƒ ๋˜ํ•œ ์ž„์ƒ ์‹œํ—˜์ด ์ง„ํ–‰์ค‘์ž…๋‹ˆ๋‹ค.
13:32
We are going to operate on 50 patients
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์ดˆ๊ธฐ ์•Œ์ธ ํ•˜์ด๋จธ ์งˆํ™˜์ธ
13:34
with early Alzheimer's disease
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50๋ช…์˜ ํ™˜์ž๋“ค์—๊ฒŒ ์‹œ์ˆ ์„ ์ง„ํ–‰ํ•˜์—ฌ
13:36
to see whether this is safe and effective,
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์•ˆ์ „ํ•˜๊ณ  ํšจ๊ณผ์ ์œผ๋กœ
13:38
whether we can improve their neurologic function.
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์‹ ๊ฒฝ๊ณ„ ๊ธฐ๋Šฅ์„ ๊ฐœ์„ ํ•  ์ˆ˜ ์žˆ๋Š”์ง€ ๋ณผ ๊ฒƒ์ž…๋‹ˆ๋‹ค.
13:41
(Applause)
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(๋ฐ•์ˆ˜)
13:49
So the message I want to leave you with today is that,
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๊ทธ๋ž˜์„œ ์ œ๊ฐ€ ์˜ค๋Š˜ ์—ฌ๋Ÿฌ๋ถ„๊ป˜ ๋“œ๋ฆฌ๊ณ  ์‹ถ์€ ๋ง์”€์€
13:52
indeed, there are several circuits in the brain
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๋‡Œ์—๋Š” ๋‹ค์–‘ํ•œ ์งˆํ™˜์„ ์ผ์œผํ‚ค๋Š”
13:54
that are malfunctioning across various disease states,
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์—ฌ๋Ÿฌ๊ฐ€์ง€ ์˜ค์ž‘๋™ ํšŒ๋กœ๊ฐ€ ์žˆ๋‹ค๋Š” ์‚ฌ์‹ค์ž…๋‹ˆ๋‹ค.
13:58
whether we're talking about Parkinson's disease,
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๊ทธ๊ฒƒ์ด ํŒŒํ‚จ์Šจ ๋ณ‘์ด๋“ ,
14:00
depression, schizophrenia, Alzheimer's.
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์šฐ์šธ์ฆ, ์ •์‹ ๋ถ„์—ด, ์•Œ์ธ ํ•˜์ด๋จธ๋“  ๋ง์ž…๋‹ˆ๋‹ค.
14:03
We are now learning to understand what are the circuits,
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์ด์ œ ์šฐ๋ฆฌ๋Š” ํšŒ๋กœ๋ฅผ ์ดํ•ดํ•˜๊ณ 
14:06
what are the areas of the brain that are responsible for
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์–ด๋–ค ๋ถ€์œ„๊ฐ€ ์–ด๋–ค ๊ธฐ๋Šฅ์„ ๋‹ด๋‹นํ•˜๋Š”์ง€,
14:09
the clinical signs and the symptoms of those diseases.
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์งˆํ™˜์˜ ์–ด๋–ค ์ž„์ƒ์  ์ฆ์ƒ์— ๊ด€์—ฌํ•˜๋Š”์ง€ ์•Œ์•„๋‚ด๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
14:11
We can now reach those circuits.
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์ด์ œ ์šฐ๋ฆฌ๋Š” ๊ทธ ํšŒ๋กœ๋ฅผ ์ด์šฉํ•ด์„œ
14:13
We can introduce electrodes within those circuits.
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์ „๊ทน์„ ์‚ฝ์ž…ํ•˜๊ณ 
14:16
We can graduate the activity of those circuits.
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ํ™œ์„ฑํ™” ์ •๋„๋ฅผ ์กฐ์ ˆํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
14:19
We can turn them down if they are overactive,
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๋ฌธ์ œ๋ฅผ ์ผ์œผํ‚ค๋Š”
14:22
if they're causing trouble, trouble that is felt throughout the brain,
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๊ณผํ•œ ํ™œ์„ฑ์€ ๋‚ฎ์ถ”์–ด์ฃผ๊ณ 
14:25
or we can turn them up if they are underperforming,
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ํ™œ์„ฑ์ด ๋‚ฎ์œผ๋ฉด ๋†’์—ฌ์ค„ ์ˆ˜ ์žˆ์ฃ .
14:28
and in so doing, we think that we may be able to help
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๊ทธ๊ฒƒ์„ ํ†ตํ•ด์„œ ์šฐ๋ฆฌ๋Š”
14:30
the overall function of the brain.
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๋‡Œ์˜ ์ „๋ฐ˜์ ์ธ ๊ธฐ๋Šฅ์„ ํ–ฅ์ƒ์‹œํ‚ฌ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
14:33
The implications of this, of course, is that we may be able
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์šฐ๋ฆฌ๋Š” ์•„๋งˆ๋„
14:35
to modify the symptoms of the disease,
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์งˆ๋ณ‘์˜ ์ฆ์ƒ์„ ์กฐ์ ˆํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋  ๊ฒƒ์ž…๋‹ˆ๋‹ค.
14:37
but I haven't told you but there's also some evidence
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์šฐ๋ฆฌ๊ฐ€ ์ „๊ธฐ๋ฅผ ์ด์šฉํ•ด์„œ ๋‡Œ์˜ ์†์ƒ์„ ๋ณต๊ตฌ์‹œํ‚ฌ ์ˆ˜ ์žˆ๋‹ค๋Š”
14:39
that we might be able to help the repair of damaged areas of the brain using electricity,
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๋ช‡๊ฐ€์ง€ ์ฆ๊ฑฐ ๋˜ํ•œ ๋ฐœ๊ฒฌํ–ˆ์Šต๋‹ˆ๋‹ค.
14:44
and this is something for the future, to see if, indeed,
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์ด๊ฒƒ์€ ๋ฏธ๋ž˜์—
14:46
we not only change the activity but also
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ํ™œ์„ฑ ์ •๋„ ๋ฟ ์•„๋‹ˆ๋ผ
14:48
some of the reparative functions of the brain
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๋‡Œ์˜ ๋ณต๊ตฌ ๊ธฐ๋Šฅ ๋˜ํ•œ
14:50
can be harvested.
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์–ป์„ ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
14:52
So I envision that we're going to see a great expansion
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์ €๋Š” ์šฐ๋ฆฌ๊ฐ€ ์ด ๊ธฐ์ˆ ์„
14:55
of indications of this technique.
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์—„์ฒญ๋‚˜๊ฒŒ ํ™•์žฅํ•ด์„œ ์‚ฌ์šฉํ•  ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€ํ•ฉ๋‹ˆ๋‹ค.
14:57
We're going to see electrodes being placed for many disorders of the brain.
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๋‡Œ์˜ ๊ฐ์ข… ์งˆํ™˜์„ ์น˜๋ฃŒํ•˜๊ธฐ ์œ„ํ•ด ์ „๊ทน์„ ์‚ฝ์ž…ํ•˜๊ฒŒ ๋  ๊ฒƒ์ž…๋‹ˆ๋‹ค.
15:00
One of the most exciting things about this is that, indeed,
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๊ฐ€์žฅ ํฅ๋ถ„๋˜๋Š” ์ ์€
15:03
it involves multidisciplinary work.
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์—ฌ๋Ÿฌ ๋ถ„์•ผ์˜ ์œตํ•ฉ์ด ํ•„์š”ํ•˜๋‹ค๋Š” ์‚ฌ์‹ค์ž…๋‹ˆ๋‹ค.
15:05
It involves the work of engineers, of imaging scientists,
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์—”์ง€๋‹ˆ์–ด, ์ด๋ฏธ์ง€ ๊ณผํ•™์ž,
15:08
of basic scientists, of neurologists,
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๊ธฐ์ดˆ ๊ณผํ•™์ž, ์‹ ๊ฒฝ ๊ณผํ•™์ž,
15:10
psychiatrists, neurosurgeons, and certainly at the interface
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์ •์‹ ๊ณผ ์˜์‚ฌ, ์‹ ๊ฒฝ์™ธ๊ณผ์˜์‚ฌ ๋“ฑ์˜ ํ˜‘์—…์ด ํ•„์š”ํ•ฉ๋‹ˆ๋‹ค.
15:13
of these multiple disciplines that there's the excitement.
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๊ทธ๋ฆฌ๊ณ  ์ด๋Ÿฌํ•œ ์œตํ•ฉ ์†์— ์žฌ๋ฏธ๊ฐ€ ์ˆจ์–ด์žˆ์Šต๋‹ˆ๋‹ค.
15:16
And I think that we will see that
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๊ทธ๋ฆฌ๊ณ  ์šฐ๋ฆฌ๋Š” ๋ณด๊ฒŒ ๋˜๊ฒ ์ฃ .
15:18
we will be able to chase more of these evil spirits
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์ด๋Ÿฌํ•œ ์‚ฌ์•…ํ•œ ๊ธฐ์šด์„
15:22
out from the brain as time goes on,
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๋‡Œ์—์„œ ์ซ“์•„๋‚ด๊ณ ,
15:24
and the consequence of that, of course, will be
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์‹œ๊ฐ„์ด ๊ฐˆ์ˆ˜๋ก ๋” ๋งŽ์€ ํ™˜์ž๋“ค์„
15:26
that we will be able to help many more patients.
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๋„์šธ ์ˆ˜ ์žˆ๋‹ค๋Š” ์‚ฌ์‹ค์„์š”.
15:28
Thank you very much.
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๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค.
์ด ์›น์‚ฌ์ดํŠธ ์ •๋ณด

์ด ์‚ฌ์ดํŠธ๋Š” ์˜์–ด ํ•™์Šต์— ์œ ์šฉํ•œ YouTube ๋™์˜์ƒ์„ ์†Œ๊ฐœํ•ฉ๋‹ˆ๋‹ค. ์ „ ์„ธ๊ณ„ ์ตœ๊ณ ์˜ ์„ ์ƒ๋‹˜๋“ค์ด ๊ฐ€๋ฅด์น˜๋Š” ์˜์–ด ์ˆ˜์—…์„ ๋ณด๊ฒŒ ๋  ๊ฒƒ์ž…๋‹ˆ๋‹ค. ๊ฐ ๋™์˜์ƒ ํŽ˜์ด์ง€์— ํ‘œ์‹œ๋˜๋Š” ์˜์–ด ์ž๋ง‰์„ ๋”๋ธ” ํด๋ฆญํ•˜๋ฉด ๊ทธ๊ณณ์—์„œ ๋™์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค. ๋น„๋””์˜ค ์žฌ์ƒ์— ๋งž์ถฐ ์ž๋ง‰์ด ์Šคํฌ๋กค๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ์ด๋‚˜ ์š”์ฒญ์ด ์žˆ๋Š” ๊ฒฝ์šฐ ์ด ๋ฌธ์˜ ์–‘์‹์„ ์‚ฌ์šฉํ•˜์—ฌ ๋ฌธ์˜ํ•˜์‹ญ์‹œ์˜ค.

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