TEDIndia 2009
Aditi Shankardass: A second opinion on developmental disorders
Aditi Shankardass: Teškoće u učenju - drugo mišljenje
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Dijagnoza razvojnih poremećaja djece najčešće se zasniva na promatranju ponašanja, no Aditi Shankardass je znala da je potrebno promatrati procese u samom mozgu. Objašnjava nam na koji način izuzetan EEG uređaj otkriva pogrešne dijagnoze mijenjajući tako život djece.
Aditi Shankardass - Neuroscientist
Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis. Full bio
Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis. Full bio
Double-click the English transcript below to play the video.
00:16
When I was 10 years old,
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U dobi od 10 godina,
00:19
a cousin of mine took me on a tour of his medical school.
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rođak me odveo u razgledavanje medicinskog fakulteta.
00:22
And as a special treat,
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I kao "poslasticu"
00:24
he took me to the pathology lab
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odveo me na odjel patologije.
00:26
and took a real human brain
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uzeo pravi ljudski mozak
00:28
out of the jar
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iz staklenke
00:30
and placed it in my hands.
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i položio ga na moje dlanove.
00:32
And there it was,
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Promatrala sam ga tako,
00:34
the seat of human consciousness,
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to sjedište čovjekove svjesnosti,
00:36
the powerhouse of the human body,
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upravljačku stanicu ljudskog tijela
00:38
sitting in my hands.
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kako leži u mojim rukama.
00:40
And that day I knew that when I grew up,
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Toga dana odlučila sam da ću kada odrastem,
00:42
I was going to become a brain doctor,
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postati liječnik, neurolog ili
00:44
scientist, something or the other.
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znanstvenik, zasigurno nešto od toga.
00:47
Years later, when I finally grew up,
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Godinama kasnije,
00:50
my dream came true.
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moj se san napokon ostvario.
00:52
And it was while I was doing my Ph.D.
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I to u vrijeme rada na doktoratu
00:54
on the neurological causes
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o neurološkim uzrocima
00:56
of dyslexia in children
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disleksije u djece
00:58
that I encountered a startling fact
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naišla sam na zapanjujuću činjenicu
01:00
that I'd like to share with you all today.
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koju bih danas htjela podijeliti s vama.
01:04
It is estimated that one in six children,
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Procjenjuje se da jedno od šestero djece
01:06
that's one in six children,
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ponavljam, jedno od šest djece,
01:09
suffer from some developmental disorder.
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pati od neke vrste razvojnog poremećaja.
01:13
This is a disorder that
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Govorim o poremećaju koji
01:15
retards mental development in the child
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usporava mentalni razvoj djeteta
01:17
and causes permanent mental impairments.
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i uzrokuje stanje trajnog mentalnog oštećenja.
01:21
Which means that each and every one of you here today
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To znači da svatko od vas ovdje prisutnih
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knows at least one child that is suffering
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poznaje barem jedno dijete koje pati
01:27
from a developmental disorder.
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od razvojnog poremećaja.
01:30
But here's what really perplexed me.
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No, evo što me uistinu iznenadilo.
01:32
Despite the fact that each
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Usprkos činjenici da baš svaki
01:34
and every one of these disorders
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od navedenih poremećaja
01:36
originates in the brain,
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ima svoje izvorište u mozgu,
01:39
most of these disorders
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za većinu ovih poremećaja
01:41
are diagnosed solely on the basis
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dijagnoza se, gotovo isključivo postavlja
01:43
of observable behavior.
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na osnovi promatranog ponašanja.
01:46
But diagnosing a brain disorder
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Ali dijagnosticiranje neurološkog poremećaja
01:48
without actually looking at the brain
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bez uvida u same neurološke procese
01:51
is analogous to treating a patient with a heart problem
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može se usporediti s liječenjem pacijenta sa srčanim tegobama
01:54
based on their physical symptoms,
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na osnovi vidljivih simptoma,
01:56
without even doing an ECG or a chest X-ray
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bez da napravimo EKG ili rentgensku snimku prsnog koša
01:59
to look at the heart.
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kako bi utvrdili stanje srca.
02:01
It seemed so intuitive to me.
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Činilo mi se tako intuitivno, logično
02:04
To diagnose and treat a brain disorder accurately,
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da bi precizno postavili dijagnozu neurološkog poremećaja i liječili ga,
02:07
it would be necessary to look at the brain directly.
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potrebno je izravno proučiti neurološke procese.
02:10
Looking at behavior alone
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Promatrajući samo ponašanje
02:12
can miss a vital piece of the puzzle
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moguće je izgubiti bitan dio slagalice
02:15
and provide an incomplete, or even a misleading,
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što će nam stvoriti nepotpunu, pa čak i pogrešnu
02:18
picture of the child's problems.
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sliku djetetovih problema.
02:21
Yet, despite all the advances in medical technology,
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Pa ipak, usprkos napretku medicinske tehnologije,
02:24
the diagnosis of brain disorders
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dijagnoza neuroloških poremećaja
02:26
in one in six children
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kod jednog od šestoro djece
02:28
still remained so limited.
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ostaje tako nepotpuna.
02:32
And then I came across a team at Harvard University
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Tada sam naišla na grupu znanstvenika sa Sveučilišta u Harvardu
02:35
that had taken one such advanced medical technology
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koji su uzeli naprednu medicinsku tehnologiju
02:38
and finally applied it,
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i konačno ju primjenili,
02:40
instead of in brain research,
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umjesto u svrhu istraživanja mozga,
02:42
towards diagnosing brain disorders in children.
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u svrhu dijagnosticiranja neuroloških poremećaja u djece.
02:46
Their groundbreaking technology
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Njihova revolucionarna tehnologija
02:48
records the EEG, or the electrical activity
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bilježi EEG ili električnu aktivnost
02:51
of the brain, in real time,
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mozga u stvarnom vremenu,
02:54
allowing us to watch the brain
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omogućujući nam da promatramo mozak
02:56
as it performs various functions
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dok izvodi različite operacije
02:59
and then detect even the slightest abnormality
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otkrivajući nam i najmanja odstupanja
03:01
in any of these functions:
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u svakoj od promatranih operacija,
03:03
vision, attention, language, audition.
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vid, pažnja, govor, sluh.
03:06
A program called Brain Electrical
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Program nazvan "Mapiranje električne aktivnosti mozga"
03:08
Activity Mapping
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(Brain Electrical Activity Mapping)
03:10
then triangulates the source
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tada locira izvor
03:12
of that abnormality in the brain.
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te abnormalnosti u mozgu.
03:14
And another program called
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Dok druga aplikacija
03:16
Statistical Probability Mapping
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"Mapiranje statističke vjerojatnosti" (Statistical Probability Mapping)
03:18
then performs mathematical calculations
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tada izvodi matematičke izračune
03:21
to determine whether any of these abnormalities
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kako bi ustanovila je li neka od tih
03:23
are clinically significant,
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abnormalnosti klinički značajna,
03:25
allowing us to provide a much more accurate
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omogućujući nam da mnogo preciznije
03:27
neurological diagnosis
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postavimo neurološku dijagnozu na osnovi
03:29
of the child's symptoms.
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utvrđenih simptoma kod određenog djeteta.
03:31
And so I became the head of neurophysiology
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Tako sam postala voditelj Neurofiziologije
03:34
for the clinical arm of this team,
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kliničkog odjela ovog tima.
03:36
and we're finally able to use this technology
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Napokon smo u mogućnosti koristiti ovu tehnologiju
03:38
towards actually helping
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kako bismo pomogli
03:40
children with brain disorders.
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djeci s neurološkim poremećajima.
03:42
And I'm happy to say that I'm now in the process
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Drago mi je što mogu reći kako je u tijeku
03:44
of setting up this technology here in India.
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implementacija ove tehnologije ovdje, u Indiji.
03:48
I'd like to tell you about one such child,
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Ispričala bih vam priču o jednom takvom djetetu,
03:51
whose story was also covered by ABC News.
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čiju priču je prenio i ABC News.
03:55
Seven-year-old Justin Senigar
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Sedmogodišnjak Justin Senigar
03:57
came to our clinic with this diagnosis
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došao je na našu Kliniku s dijagnozom
03:59
of very severe autism.
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vrlo teškog oblika autizma.
04:01
Like many autistic children,
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Kao kod mnoge djece s autizmom
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his mind was locked inside his body.
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njegov je um bio zatočen u tijelu.
04:06
There were moments when he would
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Bilo je trenutaka kada se
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actually space out for seconds at a time.
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s vremena na vrijeme "isključio" na nekoliko sekundi.
04:11
And the doctors told his parents
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A liječnici su objasnili roditeljima
04:13
he was never going to be able
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kako nikada neće biti sposoban
04:15
to communicate or interact socially,
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komunicirati ili funkcionirati u društvu,
04:17
and he would probably never have too much language.
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i da vjerojatno neće govoriti.
04:21
When we used this groundbreaking EEG technology
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Kada smo primjenom ove revolucionarne EEG tehnologije
04:24
to actually look at Justin's brain,
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"virnuli" u Justinov mozak,
04:27
the results were startling.
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dobiveni su nas rezultati zapanjili.
04:30
It turned out that Justin was almost
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Utvrđeno je da Justin
04:32
certainly not autistic.
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gotovo sigurno nema autizam.
04:34
He was suffering from brain seizures
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Imao je moždanu disfunkciju
04:37
that were impossible to see with the naked eye,
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koju je bilo nemoguće registrirati,
04:40
but that were actually causing symptoms
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ali koja je uzrokovala simptome
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that mimicked those of autism.
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slične onima kod autizma.
04:45
After Justin was given anti-seizure medication,
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Nakon što je Justinu propisan odgovarajući lijek,
04:48
the change in him was amazing.
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promjena u njegovom ponašanju bila je zapanjujuća.
04:51
Within a period of 60 days,
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Unutar 60 dana,
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his vocabulary went from two to three words
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njegov se rječnik povećao s dvije- tri riječi
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to 300 words.
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na 300 riječi.
04:58
And his communication and social interaction
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a njegove komunikacijske i socijalizacijske vještine
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were improved so dramatically
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napredovale su tako dramatično,
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that he was enrolled into a regular school
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da je uključen u redovnu školu
05:05
and even became a karate super champ.
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te čak postao prvak u karateu.
05:09
Research shows that 50 percent of children,
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Istraživanja pokazuju da gotovo 50 posto djece,
05:11
almost 50 percent of children
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gotovo 50 posto djece
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diagnosed with autism
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kojima je postavljena dijagnoza autizma
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are actually suffering from hidden brain seizures.
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zapravo pate od skrivenih moždanih disfunkcija.
05:20
These are the faces of the children
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Ovo su djeca
05:22
that I have tested
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koju sam testirala
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with stories just like Justin.
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čije su priče sliče Justinovoj.
05:27
All these children
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Sva ta djeca
05:29
came to our clinic with a diagnosis
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došla su na našu Kliniku s dijagnozama
05:31
of autism, attention deficit disorder,
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autizma, poremećaja pažnje,
05:34
mental retardation, language problems.
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mentalne retardacije, govorno-jezičnih problema.
05:38
Instead, our EEG scans revealed
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Umjesto toga, naša EEG pretraga otkrila je
05:41
very specific problems hidden within their brains
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vrlo različite poremećaje "skrivene" u njihovom mozgu
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that couldn't possibly have been detected
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koje nije bilo moguće otkriti
05:46
by their behavioral assessments.
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procjenom njihova ponašanja.
05:49
So these EEG scans
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Ove EEG pretrage
05:51
enabled us to provide these children
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omogućile su nam davanje
05:53
with a much more accurate neurological diagnosis
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mnogo preciznije neurološke dijagnoze
05:56
and much more targeted treatment.
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te preciznije određivanje ciljane terapije.
06:00
For too long now, children with developmental disorders
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Predugo su djeca sa razvojnim poremećajima
06:03
have suffered from misdiagnosis
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patila zbog pogrešnih dijagnoza
06:05
while their real problems have gone undetected
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dok su pravi problemi ostajali neotkriveni
06:07
and left to worsen.
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a stanje im se pogoršavalo.
06:09
And for too long, these children and their parents
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I predugo, ta djeca i njihovi roditelji
06:12
have suffered undue frustration and desperation.
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pate zbog nepotrebne frustracije i očaja.
06:15
But we are now in a new era of neuroscience,
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Danas ulazimo u novu eru neuroznanosti,
06:18
one in which we can finally look
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u kojoj je napokon moguće promatrati izravno
06:21
directly at brain function in real time
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moždanu aktivnost u stvarnom vremenu
06:24
with no risks and no side effects, non-invasively,
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bez rizika i nuspojava, neinvazivno,
06:27
and find the true source
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i naći pravi uzrok
06:29
of so many disabilities in children.
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mnogih razvojnih poremećaja u djece.
06:32
So if I could inspire
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Ako potaknem
06:34
even a fraction of you in the audience today
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samo dio vas u publici danas
06:37
to share this pioneering diagnostic approach
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da podijelite ovaj pionirski dijagnostički pristup
06:40
with even one parent whose child
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s bar jednim roditeljem čije dijete
06:42
is suffering from a developmental disorder,
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pati zbog razvojnih poremećaja,
06:45
then perhaps one more puzzle
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možda još jedna slagalica
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in one more brain will be solved.
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u još jednom mozgu bude složena.
06:49
One more mind will be unlocked.
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I još jedan um bude oslobođen iz okova.
06:51
And one more child who has been misdiagnosed
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I još jedno pogrešno dijagnosticirano dijete
06:53
or even undiagnosed by the system
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ili koje zdravstveni sustav nije otkrio
06:56
will finally realize his or her true potential
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napokon shvati i upozna svoj pravi potencijal
06:59
while there's still time
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dok još ima vremena
07:01
for his or her brain to recover.
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za oporavak njegovog mozga.
07:03
And all this by simply watching the child's brainwaves.
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I sve to jednostavno promatrajući moždane valove djeteta.
07:06
Thank you.
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Hvala vam.
07:08
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Aditi Shankardass - NeuroscientistAditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis.
Why you should listen
Aditi Shankardass is a neuroscientist trained across three disciplines of the field: neurophysiology, neuroanatomy and neuropsychology. She has also worked across different levels of the field, from cellular to cognitive neuroscience, and been based in research labs as well as diagnostic clinics. Currently, she leads the Neurophysiology Lab of the Communicative Disorders Department at California State University.
Much of Shankardass' work has been devoted to the use of an advanced form of digital quantitative EEG (electroencephalography) technology that records the brain's activity in real time, and then analyzes it using complex display schematics and statistical comparisons to norms, enabling far more accurate diagnoses for children with developmental disorders. She is also actively involved in public outreach to increase understanding of brain disorders as a board member of the Global Neuroscience Initiative Foundation and a consultant for the BBC Science Line.
Aditi Shankardass | Speaker | TED.com