neurology – Go Retire Psychiatrist

I read this really interesting article on the web about how slow humans think, “The Unbelievable Slowness of Thinking.” That’s just me all over. The gist is of it is that we think slower than you’d imagine creatures with advanced brains would think. I don’t have a great feel for what the stated rate feels like: 10 bits/second. It doesn’t help much to look up the definition on Wikipedia, “…basic unit of information in computing and digital communication.” It’s a statistical thing and I barely made it through my biostatistics course in medical school. In fact, the authors calculated that the total amount of information a human could learn over a lifetime would fit on a small thumb drive.

Anyway, I tried to dig through the full article in Neuron and didn’t get much out of it except I recognized the story about Stephen Wiltshire, a guy with autistic disorder who could draw New York’s skyline from memory after a helicopter flyover. I saw it on an episode of the TV show UnXplained.

I was amazed even if he processes at only 10 bits/second, according to the authors.

By the same token, I thought the section called “The Musk Illusion” was funny. It refers to the notion many of us have that our thinking is a lot richer than some scientists give us credit for. That’s the Musk Illusion, and it refers to Elon Musk the billionaire bankrolling Neuralink to make a digital interface between his brain and a computer “to communicate at an unfettered pace.” How fast do the authors of this paper think the system works? It flies at about 10 bits/second. They suggested he might as well use a telephone. The scientists weren’t that impressed judging from the quotes in the Reception section of the Wikipedia article about Neuralink.

Anyway, regardless of how slowly we think, I believe we’ve made a lot of progress for a species descended from cave dwellers who were prone to falling into piles of mastodon dung. I bet it took considerably longer than 10 bits/second for them to figure out how to climb out of that mess.

Reference:

Jieyu Zheng, Markus Meister,

The unbearable slowness of being: Why do we live at 10 bits/s?

Neuron

2024,

ISSN 0896-6273,

Abstract: Summary

This article is about the neural conundrum behind the slowness of human behavior. The information throughput of a human being is about 10 bits/s. In comparison, our sensory systems gather data at ∼10 bits/s. The stark contrast between these numbers remains unexplained and touches on fundamental aspects of brain function: what neural substrate sets this speed limit on the pace of our existence? Why does the brain need billions of neurons to process 10 bits/s? Why can we only think about one thing at a time? The brain seems to operate in two distinct modes: the “outer” brain handles fast high-dimensional sensory and motor signals, whereas the “inner” brain processes the reduced few bits needed to control behavior. Plausible explanations exist for the large neuron numbers in the outer brain, but not for the inner brain, and we propose new research directions to remedy this.

Keywords: human behavior; speed of cognition; neural computation; bottleneck; attention; neural efficiency; information rate; memory sports

This is one of the latest Rounding@Iowa podcasts and it’s about new treatments for Azheimer’s Disease, with one specific agent called Lecanemab.

I’m an old psychiatrist, and I remember my clinical impresson of the previous medications for Alzheimer’s Disease, one of which was Donepezil. The scientific literature seemed to suggest that patients and families were more impressed with Donepezil than clinicians were.

According to Dr. Shim, one of the participants in the podcast, it’s been 20 years since there has been a new treatment for Alzheimer’s Disease-and the long term effectiveness of Lecanemab is uncertain.

In addition, there are significant risks associated with the agent as well. As you can guess, it’s very expensive, and while Medicare pays for some of the cost, the podcast participants mentioned that it was difficult to get some treatment monitoring imaging studies covered.

Patients and their physicians need to have a full discussion of the risks and benefits of treatments for Alzheimer’s Disease. It’s just as important to avoid the use of certain drugs that are known to worsen cognitive function, such as benzodiazepines and anticholinergics.

88: Modifiable Risk Factors for Breast Cancer – Rounding@IOWA

In this episode of Rounding@IOWA, Dr. Gerry Clancy sits down with breast cancer experts Dr. Katherine Huber‑Keener and Dr. Nicole Fleege for a discussion of modifiable and non‑modifiable risk factors, modern screening tools, and practical strategies clinicians can use to guide prevention and early detection. CME Credit Available: https://uiowa.cloud-cme.com/course/courseoverview?P=0&EID=82146 Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Nicole Fleege, MD Clinical Assistant Professor of Internal Medicine-Hematology, Oncology, and Blood and Marrow Transplantation University of Iowa Carver College of Medicine Kathryn Huber-Keener, MD PhD Clinical Associate Professor of Obstetrics and Gynecology – General Obstetrics and Gynecology University of Iowa Carver College of Medicine Financial Disclosures: Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 0.75 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 0.75 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-035-H99 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.)