Today we discuss the science of delusion, how changes in the length of our days can cause changes in our behavior, and a potential new life saving drug to fight the current opioid crisis.
Today we discuss the science of delusion, how changes in the length of our days can cause changes in our behavior, and a potential new life saving drug to fight the current opioid crisis.
Delusion Science
S.A.D. About Day Length
Fentanyl Vaccine
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Find episode transcripts here: https://curiosity-daily-4e53644e.simplecast.com/episodes/delusion-science-sad-about-day-length-fentanyl-vaccine
NATE: Hi! You’re about to get smarter in just a few minutes with Curiosity Daily from Discovery. Time flies when you’re learnin’ super cool stuff. I’m Nate.
CALLI: And I’m Calli. If you’re dropping in for the first time, welcome to Curiosity, where we aim to blow your mind by helping you to grow your mind. If you’re a loyal listener, welcome back!
NATE: Today you’ll learn about the science of delusion, how changes in the length of our days can cause changes in behavior, and a potential new life saving drug to fight the current opioid crisis.
CALLI: Without further ado, let’s satisfy some curiosity!
[SFX: WHOOSH]
CALLI: So, what is the biggest delusion you have about yourself?
NATE: Ooh, good question. So, I don’t feel like I have any delusions but sometimes when I explain to people the true fact that if I practiced a bit more that I could play in the NBA, they tell me I’m delusional. So, I mean, there’s that, I guess. Why do you ask?
CALLI: Yeah, um, sorry but that’s definitely unrealistic.
NATE: Your opinion.
CALLI: I ask because I came across something absolutely FASCINATING online: the science of delusion.
NATE: How can there even be a science of delusion? What does that even mean?
CALLI: Well, first off, a delusion is an idea someone has that they fixate on even when there are mountains of evidence against that idea. There have been a ton of instances, both in current times and throughout history, where people become overpowered by their delusions and it can have some pretty dire consequences.
NATE: Like what might actually happen if I actually played in an NBA game?
CALLI: Yeahhh, sorry. Scientists are looking at delusions today with a critical eye to try and see what is it in the brain that causes this to happen.
NATE: Okay, so when someone is paranoid and thinks everyone is out to get them, scientists might be able to see what part of the brain is firing up when that’s happening?
CALLI: Yeah! You can tell them over and over that it’s not true and even provide evidence, but they won’t believe you, so researchers want to know why that is. Anyway, the research I found approaches the topic from a more historical context to see if science can help us debunk some famous cases of delusions.
NATE: And what science did they find?
CALLI: Neurologists found that people who are overcome by their delusions have some sections of the brain that are deteriorated. This causes a kind of disconnect between the sensory and emotional parts of the brain. So, the patients basically can’t connect their emotions with tangible things that they are seeing, hearing, or perceiving. So I can tell you over and over that you can’t play in the NBA, but no matter what I say, your brain won’t believe it. BUT when they looked into these kinds of cases throughout history, it wasn’t that simple.
NATE: Okay, what kinds of historical cases did they look at and why would they need to be debunked?
CALLI: Because throughout history, cases of delusion were commonly blamed on things like demonic possession, an internal imbalance, or “the humors” which is described as someone having too much black bile in their body. Researchers wanted to know what was really going on. Let’s look at a very famous example: a woman named Madame X.
NATE: Madonna?! Kidding, kidding.
CALLI: Pretty sure this woman didn’t have a record put out. But, Madame X was a Parisian woman in the 1800s who was convinced she was dead. Even though she was walking around, she was absolutely sure that her body had died and that she didn’t need to eat food. In her mind, to fully die, she needed to be burned to ash. She ended up going to an asylum and telling the doctors all of this.
NATE: Okay, what did the doctors think? If she came into the asylum she was obviously… not dead.
CALLI: So her neurologist’s name was Dr. Jules Cotard who thought that she was suffering from melancholia or depression. But THEN, this delusion kept popping up with more and more people claiming that they were also dead. It’s extremely rare to see today but Dr. Cotard, at the time, kept finding these patients so he coined the term “Walking Corpse Syndrome” or Cotard syndrome.
NATE: And what were some other symptoms of Walking Corpse Syndrome?
CALLI: Well it’s the belief that you’re dead or that you don’t actually exist, right? But some other symptoms include voices in your head telling you that you’re dead, or that you are missing limbs, or that your insides are rotting.
NATE: Tough stuff. So, scientists found that there was some brain deterioration there, but what else did they find?
CALLI: Well they were trying to approach it from a neurological perspective as well as understanding the historic background. From the historical side of things, if you put Madame X’s situation in context, she walked into that asylum just three years after the end of the siege of Paris. It was also the end of the Franco-Prussian war which left the population of Paris starved, guilt-ridden, and ashamed. These were massive traumatic events which, if not the cause, definitely added to the delusion itself. They found that it’s a balance of psychological trauma and physical changes, which is totally separate from the diagnoses that she received while she was alive.
NATE: That actually makes a lot of sense. So, what happened to Madame X in the end? Was she able to get treatment?
CALLI: Unfortunately, no. Dr. Cotard himself fell ill and died before he could help cure her. She eventually starved herself to death.
NATE: That’s a sad ending.
CALLI: Yeah, it is. Especially now that we have more concrete ways to address these delusions through things like treatment for depression or PTSD or medical treatments for brain injuries.
NATE: I guess we have Madame X to thank for inspiring these treatments!
CALLI: It’s a sad ending but at least there’s hope for the future.
[SFX: WHOOSH]
NATE: Calli, winter is here. And you know what that means, some seasonal mood changes.
CALLI: Yeah, I actually know exactly what you mean. I feel like like every year as the seasons change and days get shorter, and the nights get longer I feel a bit…off…for a while and I think I know where you’re going with this.
NATE: Right! Researchers have seen mood and behavior changes when the days get shorter for a long time. There is the aptly named SAD, Seasonal Affective Disorder, where some people get depressed as daylight decreases. Even if you don’t deal with depression, many people say the decreasing light makes them feel different, and act differently.
CALLI: Yeah, I actually deal with SAD myself and I am usually sitting in front of a special light in the winter.
NATE: Well, there you go! Bright light therapy can really help with SAD. But even though scientists have noticed these changes, and found therapies for them, they haven't been able to explain why it happens….until now.
CALLI: Oh wait, seriously?! What kind of study did they do? I know we have talked in the past about big meta-analyses, or following some participants for years at a time.
NATE: Well, they looked at mice. Which might seem odd at first, but mouse brains function just like ours do. They wanted to see what effect changing light had on our neurons, and our behaviors. That's a big ask though, the brain has about 86 billion neurons, and 85 billion other non-neuron cells!
CALLI: That is so many! How do you even whittle something like that down?
NATE: Well when they looked at the brain, they found one area particularly interesting, it's called the suprachiasmatic nucleus, or SCN. This is a bundle of about 20,000 neurons that we know is responsible for keeping time in our bodies. It handles the circadian rhythm, our natural 24 hour cycle. This rhythm impacts a wild amount of things: our body temperature, how hungry we are, when we release hormones, and even just our daily behaviors.
CALLI: If it's buried so far in the brain though, how does changing light affect it? Is it just that our eyes see the light, or is there more of a process of feeling the days shorten?
NATE: It’s a little of both. The SCN connects to special photosensitive cells in the eyes to keep track of changing light. And in this most recent study, researchers found that as the days changed, the SCN changed how much the brain used specific neurotransmitters, like dopamine, which can really affect your mood! Changing light means the SCN changes how neurons release neurotransmitters, especially in the areas of your brain that control things like stress and metabolism.
CALLI: Holy crap, so the light changes how our brain actually…works? Its activity?
NATE: Yes! And that can change how we act and feel. They found the actual link between seasonal light change and mood!
CALLI: So now that we know what's happening, do we have better therapies to treat it than, “Here, sit in front of this lamp?”
NATE: Hopefully those can come soon! Since the changes happen in such a specific area of the brain, the SCN, we have a new area to target when we are trying to help people deal with SAD and other seasonal issues!
CALLI: Man, that's great news! The more you know, the more you can treat!
NATE: Exactly, and right now I’m going to treat myself to some sunlight before the days get too short!
CALLI: Nate, it’s snowing outside.
NATE: Sunny snow?
[SFX: WHOOSH]
CALLI: So, two stories that are constantly in the news these days are opioid addiction and vaccines. I found a really interesting new study that actually combines the two. Researchers have recently created a Fentanyl vaccine that can get rid of the effects of the drug.
NATE: Ooh, I didn’t know that they were even working on something like that. This has the potential to help so many people!
CALLI: You are absolutely right. One of the worst problems facing the world today is the opioid crisis, with nearly 10 million KNOWN opioid users per year and over 55,000 drug overdose deaths. A whopping 91 percent of those deaths were because of fentanyl, and those numbers are on the rise while other opioid deaths are on the decline.
NATE: Oh wow. What is it about fentanyl that’s making these numbers so huge??
CALLI: So fentanyl is a synthetic opioid, meaning it’s not harvested organically like opium. It’s synthesized in a lab, and is around 100 times more potent than morphine. It’s been prescribed for severe pain since the 1990s, and is one of the leading causes of the opioid epidemic in the United States, because it only takes around 2 milligrams of fentanyl to kill a person. Drugs like heroin are usually mixed with fentanyl to give them an extra kick. Treatments exist, like Naloxone, which can be used in an emergency to prevent a fatal fentanyl overdose, and daily medications like methadone can reduce cravings and withdrawal – but all that depends on people actually seeking treatment. Which leads me to a team of researchers at the University of Houston who thought, if we can’t stop people from using fentanyl… what if we can stop people from FEELING fentanyl?
NATE: This is kind of a novel concept. A vaccine that stops you from feeling the effects of a drug? How does that even work?
CALLI: The vaccine is a sort of cocktail that combines many components from vaccines already approved for human use. First, a small fentanyl-like molecule is attached to a larger carrier protein called CRM197, which is then mixed with another molecule called dmLT that adds an extra immune boost. When you mix these compounds together, it manipulates the brain to recognize fentanyl as a threat. Which is a good thing - fentanyl has a natural painkiller effect, similar to morphine, so whenever you take it, it doesn’t FEEL like a threat. With our bodies now feeling like they’re under attack, we start to produce antibodies to stop the pleasure chemical from reaching the brain.
NATE: Okay, that’s really cool. So it’s a lot like a flu shot?
CALLI: Yeah, yeah, exactly. And the best part is that it ONLY targets fentanyl opioids. So if you stub your toe and need to take a pill for your pain, you’ll still get that relief - unless you take fentanyl for the pain, then all you’ll get is a throbbing toe.
NATE: Okay, if you’re taking fentanyl for a stubbed toe, either you’re doing something wrong or you managed to cut your toe off. Overall, this sounds really great but how did they test the vaccine?
CALLI: This isn’t gonna sound pretty. Lab rats were given three doses of the fentanyl vaccine at three-week intervals. Another group of rats received a placebo. Researchers would take blood samples regularly, which showed a build-up of anti-fentanyl antibody levels over time in the vaccinated rats. Once vaccination was complete, the rats were given a dose of fentanyl. To see if the vaccine was effectively blocking the painkiller effect, the researchers tested the rats' pain responses by heating up the rats' tails for around 10 seconds and seeing how long they took to pull away.
NATE: Geesh. That sounds… mean.
CALLI: Well, in another experiment, they put the rats onto a hotplate and timed out how long it took them to lick their legs. It may be cruel, but it showed results: the vaccinated rats pulled away from painful experiences quicker than the control group in both experiments, showing that the vaccine was blocking the painkiller effect of fentanyl. And when the rats were examined post-mortem, it was discovered the vaccine lowered the amount of fentanyl in the brain.
NATE: Well, the bad news for that study is I’m not aware of any sort of opioid crisis in rats. So when will we see this vaccine become available for humans?
CALLI: Okay, this is the really good news. You know how a lot of times on this show, we say that further research is needed? There’s some but probably sooner than you think. The vaccine didn’t show any negative effects after multiple rounds of testing, so the researchers are preparing for human trials now. Considering how bad the fentanyl crisis is becoming, I wouldn’t be surprised to get an update on this soon!
[SFX: WHOOSH]
NATE: Let’s recap what we learned today to wrap up.
CALLI: Scientists have been looking into both the neurological symptoms and historical context of people suffering from delusions. Turns out that delusions such as walking corpse syndrome are caused by a combination of brain deterioration and trauma or PTSD.
NATE: Researchers have long known that changing seasonal sunlight affects mood, but they’ve been unable to describe why, until now. Researchers found neurotransmitters use changed with seasonal light in one very specific part of the brain. Targeting this area could help treat SAD and other seasonal conditions.
CALLI: With fentanyl overdoses on the rise every day, a team of researchers have discovered a way to turn fentanyl effectively useless: a vaccine that eliminates the painkiller effect of fentanyl. Experimental trials were so successful that the researchers are preparing for human trials now, meaning that soon, fentanyl abuse could become a thing of the past!