Archive for June, 2008



Tweet It’s been a year since Gordon Brown arrived in Number 10 Downing Street, uncontested. I don’t normally look to record anniversaries (apart from this and this, and maybe this), nor comment directly on politics. I wish politics were better, of course, and I think the political media must take a lot of responsibility for […]

I had a migraine a few weeks ago. As migraines go it was a breeze, really. There was no piercing headache, just a vice-like tension that I would normally associate with the before- and, to some extent, the after-effects. It was not a muscular tension-headache nor alcohol-related.

I didn’t experience the normal visual aura, but I’m sure it was a migraine because it was preceded by a strange faintness accompanied by shifting vision. I felt funny for most of the following week, then had a severe headache last Friday. The previous day I’d worked out hard in the gym. So I took medical advice. They said it was probably a virus that had triggered the original migraine; it was not surprising for the symptoms to be there a week later. Take paracetamol, they said. You’ll be fine. And so it turned out.

365 Days - Day 208 - Migraine

I’ve had one or two really severe migraines, but I’ve been very lucky. Apart from the couple in my teenage years that would conform to the agonising archetype blighting many people’s lives, I’ve been a light sufferer, by any measure. For 10 years of adulthood I had none. Then just a handful with no pattern or recognizable trigger. And some of those were easily knocked on the head by the early ingestion of paracetamol.

Most recently, my first half-marathon triggered one. And after the London marathon in 2005, I succumbed. In both cases my training had been incomplete: I’d overstretched myself. That would constitute a huge stress: an obvious trigger. I’ve wondered too if the demand for calcium/magnesium following that excessive hammering on bones and joints might not have helped. Too much to know.

Because I’ve escaped lightly, my knowledge of the significant progress of migraine science has been almost (but not entirely) non-existent. I noticed only yesterday, for instance, that Oliver Sacks wrote a book called Migraine in 1970 (with a revised edition published in 1992).

But the subject hove back into my view for a couple of reasons recently. I learned, for instance, that migraine as a neurological condition has a close genetic alignment with epilepsy, and that migraine sufferers are more susceptible to background noise; there is a similar phenomenon (which I don’t fully understand) in relation to eyesight.

My late brother suffered from epilepsy. But, because his epilepsy was apparently brought under control by a similar progress of pharmaceutical research, the family had been largely able to forget the underlying seriousness of a condition which reportedly affects 60 million people worldwide; migraine, by contrast, may affect as many as 300 million. The general impression — certainly one that my brother held — was that the major risk to his health came from the long-term effect of such chronic drug dependency on his vital organs. But it seemed that we could feel blessed that it wasn’t a whole lot worse; going back a generation or two, some family members’ lives had been completely wrecked, and this had chronic knock-on consequences for their carers. These days there are still those whose condition does not respond to treatment.

So, when I was researching my earlier post on Didier Sornette and the housing market, I came across a presentation he delivered in Oxford in January. It revealed some of the wider applications of complexity theory beyond the geophysics where Sornette started. In collaboration with several others, Sornette has published a paper or two explaining how the study of data sets of the brain activity of epileptics (specifically those whose condition does not respond to drugs) showed patterns akin to seismic data of earthquake incidence. The hope is that this might lead to some better method of prediction for sufferers.

The maths is rather intimidating and I’ll try to paraphrase the following as I go along, and link to definitions. Fingers crossed:-

That the pdf [probability density function] of SZ [seizure] energies E follows a power law, and more importantly that its exponent is beta almost equal to 2/3 (as for EQ [earthquake]), has far-reaching, statistical-clinical implications: the mean and variance of E are mathematically infinite, which means in practice that the largest SZ in a given time series controls their values (3). As a consequence, variability is dominant and “typical” has no meaning. The energy pdf, and specifically its heavy tail, also suggests an explanation, at a mathematical-conceptual level, for the proclivity and capacity of the human brain to support status epilepticus, a potentially fatal condition characterized by prolonged/frequent SZ during which the brain does not return to its “normal” state, even when SZ activity abates.

Well, I think the key point is ‘variability is dominant and “typical” has no meaning’, which we liberal artists would tend to capture with the expression ‘to be in a constant state of flux’ although that does not quite cover the sense of unbounded potential for an extreme spike. The problem is that we like to convince ourselves that there is some “normal”, some stability. And, on the surface, so it may appear.

And then Sornette explains:-

In seismology, it has been recognized that the many small, undetected EQ provide a major if not dominant contribution to the triggering future of EQ of any size (7). Prolonged recordings of brain cortical electrical activity (ECoG), the equivalent of seismographs, from epileptic humans and animals contain frequent, low intensity, short bursts of abnormal activity unperceived by the patient and observers and interspersed with infrequent, but longer, more widespread, and more intense bursts (convulsions) (4). The SZ-EQ analogy, including the evidence presented here for an inherent capacity of SZ to trigger future SZ, suggest that a workable prediction scheme should use the triggering by, not only past perceived (clinical) SZ, but also the myriad of unperceived (subclinical) abnormal neuronal bursts.

Sornette’s applied work highlights the cross-disciplinary relationship of the science of complexity and reminds us too that some part of our population suffers from extreme non-linearities in their day-to-day lives. And how more vivid can it be, as the picture above shows, than the fractal manifestation that is the migraine aura; when I first used to experience it, it would mark the beginning of hours of debilitation.

Meanwhile, news was reported a few weeks ago that untreatable epilepsy in children responded to a high-fat/low-carbohydrate diet. This is not particularly new. I notice now that Mark’s Daily Apple picked up a Science Daily report back in January to similar effect. Mark was also the original pointer to the picture above (thanks again Mark). So-called ketogenic diets have been known to be effective in treating even the worst sufferers from epilepsy as far back as the 1920s. And I even found a 1910 medical report quoted on a low-carb forum where a doctor had noted high levels of candy consumption among two chronic epileptic sufferers, one adult, one child, he’d been asked to treat. Drug therapies became preferred later because the higher-fat diets were found to be more difficult to follow, ostensibly for cultural reasons. Today there is a shortage of dieticians to help apply what you might call a clinical diet, where each gram of carbohydrate is very closely measured.

Well, it makes more and more sense to me that diet — and our modern carb-laden diet — has much more to answer for than we allow when we think that we are eating a “healthy mixed diet”. But it’s a struggle to remove easy grain-based carbs, and one has to wonder whether it is a sustainable option for the planet as a whole. Since I can afford it, I’m making the switch, but mainly because of the evidence that grains may play a role in activating cancer genes. I can’t ignore those pointers; I’m 43 and since January the oldest surviving member of my immediate family. Both my parents lived ostensibly healthy lives. That alone should predict that at least one would still be with us since my grandmother was alive just 7 years ago at 91.

Because of the complex, fast-moving chain of events that led to my brother’s death in January, it was hard for the surgeons to provide the family with a satisfactory narrative. I missed the chance to speak in person with the clinician; I was racing down the interstate in (melo)dramatic fashion in order to arrive before what turned out to be a technical pronouncement of death. My brother’s state on arrival in hospital the previous day was not materially different from when I arrived 10 minutes after the certification; he was on life-support simply for the purposes of organ-donation.

But that does not matter. What was described was a total neurological event — a seizure that affected all his vital functions. SUDEP — or sudden unexplained death in epilepsy — is what I understand it to have been, although that was not the word the doctor used. Or perhaps it was status epilepticus.

It’s ironic that neither SUDEP nor status epilepticus was something we knew about beforehand, or ever discussed as a possibility within our family. As I said, my brother’s principle pre-occupation in terms of epilepsy-related health (based on counselling I assume he received quite early on in his life) was that his long-term health would be compromised by the medicine he took rather than the diet he was exposed to. I think it made him fatalistic. I have no recollection that a low-carbohydrate diet would have improved his teenage outcomes, and it was something my mother would surely have responded to, had she known.

Later in life, my brother ate a standard North American diet, and there is no suggestion that this was a contributory factor to his SUDEP, but I have to wonder. Not least because the science of low-carb and the science of earthquakes both point to epilepsy from different perspectives. And scientists like Sornette and De Vany are using the same maths across these various domains.

Changing diet may not be a panacea, and I may already have sown the seeds of my own demise, but you don’t not pay into a pension scheme because you didn’t pay in before. That sort of fatalism does lead to literal and metaphorical penury. But above all else, these findings all suggest that a lot more critical reporting should be applied to questions of public health, preventative medicine, exercise, diet fads and even agricultural subsidy. That obviously ain’t happening at the moment. Indeed, the recent coverage of the ketogenic diet in the BBC/Lancet does not consider whether a lower carb diet contributes to a reduced risk of seizure more generally, and therefore might act to forestall a sufferer reaching the kind of tipping point that Sornette’s science is point toward. It is dealt with in the specific of untreatable epilepsy with no extrapolation that more general metabolic risk factors need to be considered or highlighted for all sufferers.

Well, when I asked in one of the leading cookery shops with a vast, if not complete, array of cookery titles if they had anything on the paleo diet, they had no clue what I was talking about, unsurprisingly. So there is much work to be done. That said, Nassim Taleb‘s advocacy in The Sunday Times the other day certainly has led to more Googling of “paleo diet” and other associated terms, from what I can see here, including searches for Prof De Vany.

Photo credit Auntie P @ Flickr (CC)

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If I had to nominate a piece of music to emulate Alan Yentob’s fMRI scan experience, I wonder if Andreas Scholl‘s performance of Vivaldi’s Stabat Mater would do the trick. I bought it at random in the Music Discount Centre CD shop near St Paul’s many years ago and could not stop listening to it — a complete accident, and something so arch I would have run a mile in the opposite direction if you’d suggested that I’d be forever captivated by the purity of this counter-tenor voice.

Well, to keep ploughing a furrow of recycling BBC programmes, here is a link (valid for about six days) to a show from Tuesday on Radio 3 where Scholl was interviewed (about 15 mins in), proving the virtue of my wall-to-wall listening to Radio 3 the past two months.

For students of corporate hubris (like me) it’s always interesting to hear experts in their particular field — let alone a virtuoso of the highest standing — explain how they tackle performance. When it is mastering the Erbarme Dich within the Bach St Matthew Passion, we should all sit up and pay attention:-

Scholl: Whenever you open your mouth and try to do justice to this piece, it is only possible with 100% heart, soul, body, technique. Everything needs to come together in that moment.

Sean Rafferty (Presenter): And a degree of humility, I think.

Scholl: Absolutely. The right perspective I would say. You should not walk out in a sense as if you composed the Matthew Passion or like the greatest moment will be me singing the Erbarme Dich. That’s vanity and that will destroy the piece. But also it will not help to walk out and thinking: ‘Mr Bach, I am not worthy of singing your music’. Because if you open your mouth you better are worthy to do that, better are good enough. So you either think you can do it then you give it everything. But if you have doubts that you can really bring justice to this piece then you should not sing it. It’s all or nothing with Bach, I would say.

So, it’s crucial to be neither too confident nor too humble. Well, Andreas Scholl may not be everyone’s bag, and I dare anyone to tell me the Pergolesi is better. I will stop now as I am at the very limit of my musical knowledge.

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music must-see


Just a public service announcement to readers in the UK with access to the BBC iPlayer and who missed the programme Imagine last week: Alan Yentob following in the footsteps of Oliver Sacks’ book Musicophilia: Tales of Music and the Brain (US edition). There is just one day left to download it; you can then keep it for 30 days. Do it: it’s worth it. The streaming landing page is here.

I’ve been doing a lot of experimentation with music over the past few years, not least trying to understand why I like what I like, how my tastes evolve, and what relationship there might be to my own cognitive function at different times. For example, for the past two months I’ve been listening almost exclusively to classical music radio, barely a CD and almost no pop.

The key points for us here in Imagine were the results of a functional magnetic resonance imaging scan of Alan Yentob’s brain while he listened to three different pieces of music: one that made him happy (Is This the Way to Amarillo), one that annoyed him (some angry heavy metal), and a piece with deep emotional significance for him (one of Strauss’s Four Last Songs sung by Jessye Norman (US version).

There were two unexpected results. One was that the first song didn’t annoy Yentob (OK, that was my conclusion). The second was that the fMRI scan showed Yentob’s brain literally “bathed in blood” during the most poignant musical choice; the first two songs activated regions of the brain more usually associated with music.

Then there was the autistic and blind pianist, Derek Paravicini, who’d come to music at an early age, and as an adult demonstrated extraordinary virtuosity — able to reproduce a piece of complex jazz immediately after hearing it for the first time.

But here you need to pay attention, because it was made plain — then sort of glossed over later by some Yentobian editorialising — that turning the early latent musical genius into what we saw on screen took years of patient mentoring by the music teacher; that his ability to express his musicality through the keyboard was painstakingly earned, and perhaps more so than for an unencumbered musician. The boy’s ability to coordinate and apply appropriate fingering had been deeply limited by his disabilities (blindness/autism). There is probably a whole separate programme here on the process of releasing latent talent, particularly among those with learning impairments.

Finally, a group of Tourette‘s syndrome sufferers, who displayed uncoordinated tics when gathered in a room, became immediately transformed and synchronised as musicians when they started a drumming exercise. This apparently supernatural effect suggests a deep-rooted social component to our experience of music, and one that I’ve sought out myself over the past few years as part of my own evolutionary fitness experiments. But I suspect my choirmaster would dispute how readily I become synchronised with my co-singers.

For those who can’t get the BBC, here are couple of YouTube’s. The first with Sacks talking about rhythm, and the second from Derek Paravicini’s website, which is ostensibly a UK TV documentary made specifically about him, featuring among others Jools Holland and Simon (not Sacha) Baron- Cohen.

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So, I was fretting about underdogs in the last post. This past weekend, the Sunday Times Magazine ran a long interview with Nassim Taleb in which he was described as “now the hottest thinker in the world”, charging up to $60,000 per speaking engagement, with the great and good beating a path to his door — from the world’s leading banks to NASA.

Interestingly, the interview by Bryan Appleyard included lunch and, naturally, had Nassim following Art De Vany‘s dietary prescriptions of evolutionary fitness. Well, some of my most loyal readers will have heard it here first.

For other reasons (and by accident) I found an old email pitch yesterday that I made in 2003 to a magazine on corporate governance; let’s say this was during my ugly duckling phase:-

Also, I have an interview idea which you might be interested in. Have you heard of a book Fooled By Randomness by Nassim Nicholas Taleb–a maths professor and hedge fund trader from the US? He is in town in a few weeks and I thought I might try and get a hold of him. Although his background is in quantitative trading, he has some interesting things to say about luck and probability in a business context, and it has struck me that this could provide some interesting reflections from a corporate governance point of view. The underlying theme would be that over-remunerating senior executives is even more hazardous than we think if both success and failure may owe more to luck than judgement, backed up by a good dose of sound mathematics of course.

Let me know if you think it a bit too outlandish. My owns sense is that Taleb and others are leading market thinkers and their ideas will permeate downwards in due course.

I didn’t get a commission.

Back in those days, even though Fooled By Randomness was a bestseller, you could still turn up at the now-disappeared Financial World Bookshop in Bishopsgate and hear Taleb talk for nothing to a small and select audience of besuited quants and the odd unshaven, head-scratching scribe. And you try and tell that to the young people of today — will they believe you? No.

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