Can Cognitive Behavioral Therapy Really Help Refractory Patients?

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The patient's all wearing eye tracker so we can see what they're eating at all times. And even under video surveillance, there are one way mirror in a laboratory setting when patients are very well aware that they're there to be studied if they're going to binge. The problem with cognitive behavioral therapy versus the limitation of it, is that many of these patients go back to their old behaviors.

My guest is Casey Halpern, M.D., Chief of Stereotactic and Functional Neurosurgery and Professor of Neurosurgery at the Perelman School of Medicine at the University of Pennsylvania. Dr. Halpern’s research and clinical practice focus on using deep brain stimulation to treat compulsive and movement disorders (e.g., binge eating disorders, bulimia, obsessive-compulsive disorder (OCD) and Parkinson’s disease essential tremor, dystonia). We discuss using deep brain stimulation to help patients who suffer from movement and compulsive disorders and applying this treatment to patients afflicted with binge eating. We also explore applications of this technology to other conditions such as OCD, anorexia and tremor, and the future therapeutic directions of the use of non-invasive brain stimulation approaches, including transcranial magnetic stimulation and ultrasound, for the treatment of other psychiatric illnesses and conditions. This episode will interest those curious about the biology of eating, anorexia, bulimia, compulsive thoughts and behaviors, and movement.

For the full show notes, visit hubermanlab.com.

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Timestamps

(00:00:00) Dr. Casey Halpern & Disordered Eating & Brain Stimulation

(00:03:35) Sponsor: LMNT

(00:08:28) Neurosurgeon’s View of the Brain, Neurosurgery Specialization

(00:13:05) Deep Brain Stimulation & Other Unexpected Positive Effects

(00:17:20) Obsessive Compulsive Disorder (OCD), Prescriptions & Cognitive Therapies

(00:25:40) Brain Areas in OCD, Risk, Rewards & Addiction

(00:29:30) Sponsor: AG1

(00:32:27) Facial and Vocal Ticks, Stimulants, Stress & Superstition

(00:39:28) Nucleus Accumbens, Reward Circuits, Eating Disorders & Obesity

(00:47:18) Stimulation of Nucleus Accumbens, Continuous vs. Episodic Stimulation

(00:49:49) Binge Eating Disorder & Loss of Control Eating

(00:53:02) Developing Binge Eating Disorder: Predisposition, Environment, Stress

(01:02:07) Electrodes in Nucleus Accumbens, Identifying “Craving Cells”

(01:11:41) Effects of Stimulation, Interrupting Craving, Intermediate Stimulation

(01:16:46) Anorexia, Obesity & Compulsions, Potential Treatments for Anorexia

(01:23:14) Non-Invasive Brain Stimulation, Transcranial Magnetic Stimulation

(01:32:27) MRI-Guided Focused Ultrasound: Tremor, Essential Tremor & Parkinson’s

(01:36:40) Future of Non-Invasive Brain Stimulation, Epilepsy & Depression

(01:41:51) Pre-Behavioral States in Compulsion & Awareness, Mood Provocation

(01:48:02) Machine Learning/Artificial Intelligence & Compulsion Predictions

(01:53:05) Neurosurgeon Hands, Resistance Training & Deadlifts

(01:59:00) “Neurosurgeon Calm,” Quality Time & Prioritization, Neurosurgeon Training

(02:09:53) Daily Habits: Sleep, Exercise, Mediation

(02:11:59) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Neural Network Newsletter, Instagram, Twitter, Facebook, LinkedIn

Title Card Photo Credit: Mike Blabac

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