Could We Treat Alzheimer's with Light and Sound? | Li-Huei Tsai | TED

譯者: Chia-Yu Hsu 審譯者: Zoe Walmsley

Hello, everyone.

大家好！

It is a tremendous pleasure to be here

非常開心今天能在這裡

to share with you my story.

跟各位分享我的研究。

You’ve all heard of brainwaves.

大家都聽過腦波這個詞。

For a long time, neuroscientists didn't know what they meant.

有很長一段時間， 神經科學家不清楚它的作用。

But we slowly come to understand their purpose.

但我們慢慢地了解腦波的作用。

The brain generates waves with different paces or frequencies

透過調控神經細胞的活動，

to transmit information and thoughts

腦部產生不同速度或頻率的波，

by coordinating the activity of nerve cells.

來傳遞訊息及想法。

These waves are a little like the effect

腦波的作用有點像樂隊指揮，

of the orchestra conductor waving a baton

揮動指揮棒，

to keep the musicians synchronized.

讓音樂家能同步演奏。

I'm going to talk today

今天我要談的

about the waves that have the so-called gamma frequency.

是所謂伽瑪頻率的腦波。

These gamma waves are particularly important

伽瑪波相當重要，

for synchronizing brain activity to process new information

因為大腦在處理新訊息時

需要伽瑪波去整合及同步腦部活動，

from the senses and for learning and memory.

它對學習及記憶也十分重要。

You might be surprised to learn

聽到這個你可能會很驚訝──

that when these gamma waves are weaker than they should be,

伽瑪波低於應有的強度時

this may contribute to Alzheimer's disease.

有可能造成阿茲海默症。

Indeed, my laboratory and others have shown

事實上，我的團隊 和其他實驗室已經證實──

that in people with Alzheimer's

阿茲海默症患者 及阿茲海默症小鼠模型──

and in laboratory mice that model the disease,

gamma waves at the frequency of 40 hertz

伽瑪波頻率在 40 赫茲時的

have reduced power and synchrony than they should be.

強度和同步性都低於應有的標準。

So back in 2015,

回溯到 2015 年，

we got an idea.

我們想到，

What if we artificially boosted these waves?

是否能以外力提升腦波強度？

Would that affect Alzheimer's disease?

會不會對阿茲海默症起作用？

We have to know the answer because we are an aging society.

處於高齡化社會，我們必須找出解答。

As we have made progress in treating many other health problems,

由於許多健康問題都有治療方法，

we've begun living long enough to develop others.

人類平均壽命增長， 長到發展出其他問題。

In the last 20 years,

過去 20 年中，

the Alzheimer's Association estimates

阿茲海默症協會的數字顯示──

死於心臟病的數字下降約 7%，

deaths from heart disease declined by about seven percent.

But the number of deaths from Alzheimer's disease

死於阿茲海默症的人數 增加了 145%。

increased 145 percent.

One in three seniors in the US dies [from] Alzheimer’s disease

在美國，平均三位長者 就有一位死於阿茲海默症，

or another dementia, they say.

或是其他失智症。

還有超過 1,100 萬人

And more than 11 million people

無償照顧患有阿茲海默症的親人。

provide unpaid care

for their loved ones with Alzheimer's.

So this means that probably most of us in this room

這代表在座可能有很多的人

have known and loved someone with Alzheimer's.

也有認識或深愛的人得到阿茲海默症。

I am no exception.

我也不例外。

One day when I was four,

我四歲的時候，

I went out with my grandmother.

有一天和外婆出門。

And when I looked up to her to say,

當我抬頭跟她說：「我們回家吧。」

"Let's go home,"

She said, "Home.

她說：「家，家在哪？」

Where is home?"

So to see if we could treat Alzheimer's disease

因為想知道改變腦波 是否能治療阿茲海默症，

by changing brainwaves,

we tried out different approaches.

我們試了好幾種方法。

By working with my colleagues,

我跟幾個同事──

Emery Brown and Ed Boyden at MIT,

麻省理工學院的艾瑪理 · 布朗 及愛德華 · 博伊登──

we figured out that we could entrain

找到促進刺激伽瑪波的方法：

or stimulate increased gamma waves

以該頻率的 LED 燈向小鼠閃爍。

by simply showing mice lights blinking at that frequency.

This really works.

這方法真的有效。

Showing mice 40-hertz flickering light --

用 40 赫茲的閃光燈照射小鼠，

and we demonstrated later,

接著放 40 赫茲的嗡嗡聲──

placing of 40-hertz buzzing sound -- creates a 40-hertz disco

打造 40 赫茲的迪斯可舞廳──

that increases the power and synchrony

藉此提高整個腦中 伽瑪波的強度及同步性。

of these waves across the brain.

The effect reaches key parts of the brain,

對大腦一些重要部位很有效，

such as the prefrontal cortex,

例如前額葉皮質，

where we do planning and reasoning

掌管我們計畫和推理的能力，

and the hippocampus where we create memories.

還有對形成記憶的海馬迴。

So the light and sound stimulation approach

聲光刺激的方法

seems cool and flashy.

聽起來又酷又炫，

也是真的炫人眼目。

Literally.

But what amazes the most is that it produced profound

不過最讓人驚豔的是 它所產生的廣泛作用──

and widespread benefits

in mice engineered to model this disease.

在模擬病症的小鼠模型上。

Mice exposed to gamma light and sound stimulation

暴露在伽瑪聲光刺激下的小鼠

had major reductions in protein build-ups,

蛋白堆積的情況大幅減少，

amyloid plaques and tau tangles

類澱粉斑塊和磷酸化蛋白糾結也降低，

that are hallmarks of Alzheimer's progression.

這些是阿茲海默症進程的指標。

The stimulation preserved more of the connections

這刺激有助於神經細胞間 透過突觸的連結，

or synapses that bind nerve cells into circuits.

讓神經細胞組成的迴路正常運作。

More cells survived, so the brain decayed less.

越多細胞存活，腦部衰壞就越少。

The brain naturally has open spaces known as ventricles.

大腦中的腔隙空間稱為腦室。

And in the brain of mice left untreated,

那些沒有接受治療的小鼠，

these ventricles became very big.

牠們的腦室變得非常大。

But in the brain of mice exposed to gamma-wave stimulation,

而接受伽瑪波刺激的小鼠，

these ventricles are closer to the size of healthy mice.

腦室的大小則比較接近健康的小鼠。

And consistent with all of these physical differences,

與所有的生理差異一致的發現還有：

Alzheimer's mice exposed to light and sound stimulation

受過聲光刺激的阿茲海默小鼠

show better performance on learning and memory tests

在學習和記憶測試的表現上，

遠勝其他沒有接受治療的小鼠。

than untreated mice did.

We are still studying why stimulating gamma waves works.

我們還在研究伽瑪波為什麼有效，

But we have made some key observations.

目前已有一些重大發現。

The brain has immune cells known as microglia

大腦有種免疫細胞稱作微膠細胞，

that are supposed to maintain health by removing waste.

負責清除廢物，維持大腦健康。

These cells change their form and activity

微膠細胞經過伽瑪波的刺激後，

following gamma wave stimulation.

細胞的型態和活動會產生變化。

We've also seen that the blood vessels in the brain

我們也發現，

腦血管對這樣的刺激也有反應，例如：

respond to the stimulation.

These vessels widen their diameters to increase blood flow, for instance.

腦血管變寬、直徑加大、血流增加。

血液循環的改善

This improved circulation may play a key role

是代謝廢物的重要關鍵。

in flushing out waste as well.

So, mice are nice.

小鼠的研究很不錯，

But people are the point.

但人類才是重點。

So my group and others have begun testing

除了我的，還有一些其他團隊

gamma light and sound stimulation in humans.

開始進行伽瑪聲光刺激的人體測試。

We've developed a delivery device

我們發展出一套配送裝置,

that our volunteers can use in their homes.

讓志願受試者能在家進行試驗。

It’s a poster-sized light box with a speaker underneath

一個海報大小的燈箱，下方有個喇叭，

to produce synchronized 40-hertz sensory stimulation.

同步發出 40 赫茲的感官刺激。

A little tablet in the middle allows them to play videos

中間有個小平板電腦，

讓受試者做試驗時同時看影片。

when they are getting stimulated.

Recently, we have begun to see data

最近，這項前導床研的數據開始進來。

emerge from these pilot clinical studies.

安娜貝爾·辛格，之前是我們 麻省理工團隊的一員，

Annabelle Singer, a former member of our MIT team

and now a professor at Georgia Tech,

現在是喬治亞理工學院的教授，

recently published encouraging results

最近發表了令人鼓舞的結果，

showing that gamma light and sound stimulation

研究結果顯示伽瑪聲光刺激

entrains stronger gamma waves in people.

能讓人體產生更強的伽瑪波。

And their brains show increased connectivity and synchrony.

受試者腦神經連結更強，同步性更高。

My group has made some similar findings,

我的團隊也有類似的發現，

including signs of preservation of brain volume

我們觀察到腦容量不萎縮，

and cognitive improvement.

及認知功能的改善等跡象。

A private company we co-founded, Cognito Therapeutics,

我們參與創辦的私人公司── Cognito Therapeutics，

has also seen benefits in human testing,

也在人體試驗看到成效，

including reduced brain atrophy and improvement in mental functioning.

包含腦萎縮減緩及心智功能的改善。

While we still have more work to do

雖然現在離確定臨床整體功效

to determine the full clinical efficacy,

還有不少路要走，

we have provided a lot of evidence that this approach appears safe.

我們已經證明這是個安全的方法。

Our participants use their devices consistently

受試者持續使用試驗裝置，

and tolerate gamma wave stimulation well.

對伽瑪波刺激沒有不良反應。

Unlike a drug,

跟藥物不同的是，

this stimulation is completely non-invasive

伽瑪波刺激完全是非侵入性，

and has minimal side effects,

且副作用很小，

which could make this approach very accessible.

讓這個療法能被更多人使用。

We are now working to launch a new study

我們目前正要開始 一項新的伽瑪波刺激研究，

of whether gamma-wave stimulation can effectively delay

看它能不能延緩阿茲海默症的發病。

the incidence of Alzheimer's disease.

Given the prevalence of Alzheimer’s disease in our aging population

由於阿茲海默症多發於高齡人口，

and how safe this gamma light and sound stimulation approach appears to be,

伽瑪頻率聲光刺激又是如此安全，

I sometimes dream of a gamma society

讓我有時幻想一個伽瑪社會，

where we integrate gamma wave stimulation into our daily environment

將伽瑪波刺激融入日常生活環境，

through our lighting or even our video entertainment.

成為燈光照明、 甚至影音娛樂的一部分。

Maybe we will have a better world

或許就能有個更好的世界，

and a brighter future

更光明的未來，

if we can keep our brainwaves,

隨時讓我們的腦波、

and therefore our mind and memory, well stimulated.

且更進一步地 讓心智和記憶刺激得當。

Thank you.

謝謝。

(Applause)

（掌聲）

Chris Anderson: Thank you so very much.

克里斯 · 安德森： 謝謝如此精彩的演講。

I actually would have so many questions,

我有許多問題想向您請教，

but the clock is not our friend.

但可惜時間有限，

I'm going to ask you one.

我就只問一個。

The cause of Alzheimer's,

阿茲海默症的病因，

like, the implication of what you're saying,

您言下之意，

is that it's possible that an actual causal factor

是說實際的原因

is this falloff in the gamma brainwaves.

可能是由於伽瑪腦波衰弱而引起。

Is that how you see it or what is the picture?

您是這個意思嗎？這是您的看法嗎？

Li-Huei Tsai: You know, obviously,

蔡立慧：大家都知道，

阿茲海默症的病因十分複雜，

the causes for Alzheimer's disease are very complex.

There are a lot of genetic factors and environmental factors.

其中包含許多遺傳和環境因素。

But one thing is that this compromise of the gamma waves

但我們確知的是

伽瑪波的衰退早在病程初期就開始。

happens very early in the course of the disease.

And you know, as I alluded to earlier,

而且，就像我剛剛提到的，

it has tremendous effects on many different cell types,

這變化會對很多不同類型的細胞、

不同的腦部功能產生劇烈的影響。

many different functions in the brain.

So it is very likely

所以也很可能

that these impaired gamma waves leads to the build up

受損的伽瑪波是導致

蛋白累積和病理變化的原因。

of the protein aggregates and pathology.

不過我也想指出

But I would also like to mention

that this impairment of these other cell types

某些細胞類型和腦部處理程序的損傷

and other processes in the brain

can also impact the strength of the gamma waves.

也會影響伽瑪波的強度。

So if you think about the pathophysiology of the disease,

從阿茲海默症的病理生理學來看，

it's like a runaway train that eventually crashes.

它就像台失速列車，終會撞毀。

So I think that this light and sound approach,

我覺得這個聲光刺激的方法，

what it does is to give a break of this process

它的作用是讓整個過程暫停，

and give the brain an opportunity to heal.

給大腦一個機會去癒合。

CA: So you are not necessarily arguing that gamma-ray therapy

安德森：所以您不是在強調

伽瑪波療法能徹底預防阿茲海默症，

would be a complete prevention of Alzheimer's,

but that it could, in combination with other things

而是如果與其他方法結合， 或許能發揮絕大的效用。

it could play an absolutely critical role.

蔡：這取決於何時開始。

LHT: It depends on when do you start the treatment.

So if you start early --

如果在療程一開始就進行──

so that’s why we are now testing

這正是我們現在正在測試的，

whether this approach can delay the incidence of the disease.

看看這個方法能否延緩 阿茲海默症的發生。

CA: If you start early enough, you really believe,

安德森：您真的認為， 如果開始得夠早，

單單以這個方法就能確實 延緩阿茲海默的發病嗎？

that alone could delay materially the onset of Alzheimer's.

LHT: We'll see, we're starting a clinical trial.

蔡：現在還不知道， 我們才剛開始臨床試驗。

CA: Thank you so much, thank you for your work.

安德森：非常謝謝， 謝謝您的研究工作。

(Applause)

（掌聲）