The era of cyborgs is coming: brain transplants will make us immortal | Science

Transplantation of various organs has long been no longer a miracle: the heart, kidneys, liver, bone marrow successfully take root in the new body. However, until now, an operation to transplant the brain from one person to another has been inaccessible, although medical scientists are tirelessly searching for a solution to this problem.

The central part of the nervous system requires a special approach. When will doctors perform such operations without problems? What is the cost of a brain transplant? And who will the person (the body that received the brain) become: himself or the one who was the previous owner of the new organ? These and other questions interest many. But perhaps the most intriguing question remains: will the transplant provide eternal life and human consciousness? To answer them, you need to take a short excursion into history.

Brain transplantation is the surgical transfer of the brain to another body while preserving the patient’s identity.

History of development: is it possible to do a brain transplant?

Experiments have been conducted since the last century on experimental animals:

In the mid-20s, for the first time on the planet, scientists S. Bryukhonenko and S. Chechulin, thanks to the autojector and artificial blood circulation machine they created, proved the possibility of the separate existence of a dog’s head without a body. She could move her eyes, tongue, respond to touch, and, moreover, swallow pieces of food. The animal's head lived on the platter for almost two hours.
And in the mid-50s, V. Demikhov “sewed” the second head on twenty dogs.
In the early 70s, the American neurosurgeon R. White was able to keep a monkey brain alive in an isolated state for two days. A few years later, White was able to transplant rat and monkey heads into other animals that lived twice as long as the isolated monkey brain. The scientist was unable to achieve a connection between the spinal cord and the brain stem, so the motionless torso served as an artificial assistant to the life of the head. Brain death in both cases occurred due to edema developing at different times
In the early 80s, a partial brain transplant was successfully carried out by D. Krieger from one mouse into the brain cavity of another in order to replace the diseased area with a healthy one. Only one attempt out of eight was unsuccessful.

Lung transplant surgery

Various lung transplant procedures have been developed to suit specific situations.
The most well known are: single lung transplantation, where the left or right lung is transplanted into the recipient while the contralateral native lung remains in place; and bilateral lung transplantation, where both lungs are transplanted. The decision to undergo a single or double lung transplant depends on the indication for transplantation and recipient factors, as well as donor availability. New evidence suggests that bilateral lung transplantation results in long-term survival because it provides more functional lung tissue as a buffer against lung dysfunction. For the same reason, marginal donor organs are more likely to be used when implanted as bilateral lung transplants. Specific indications also require double lung transplantation. Although not an absolute indication, bilateral transplantation for pulmonary vascular disease with elevated arterial pressure is the best option because it avoids the complications of hemodynamic instability and severe primary graft dysfunction after surgery.

Although the above-mentioned lung transplant procedures are by far the most common, alternative procedures have been developed that may be used in unique situations. The donor lung can be non-anatomically reduced in volume to fit into a smaller recipient. Combined heart/lung transplantation is reserved for cases where irreversible heart disease occurs in combination with irreversible lung disease.

Surgical method

In general, most lung transplant centers avoid the routine use of cardiopulmonary bypass for lung transplantation. For a single lung transplant, the diseased lung is excised and a new lung is implanted while the patient is supported on the contralateral native lung. If the patient cannot be supported in this manner due to significant hypoxia, hypercarbia, or hemodynamic instability, then cardiopulmonary bypass (CPB) is used.

Lung transplant surgery

The initial technique of venous anastomosis for lung transplantation consists of anastomosing the atrium from the donor to the recipient using a dressing suture material. Atrial anastomosis, originally described in 1950, offers advantages over direct pulmonary vein anastomoses because it allows for a larger surface area of stiffer tissue and limits the number of anastomoses to one. Tension sutures have long been used experimentally for venous anastomosis in large animals to reduce the risk of thrombosis. In addition, anastomosis of the two pulmonary veins separately during a single lung transplantation has also been reported in clinical practice.

Bilateral lung transplants are performed as sequential single-lung transplants using a split-throat incision or bilateral anterolateral thoracotomies when preferred and technically feasible.

The sequential transplant strategy not only avoids cardiopulmonary bypass in most cases (60%-75%), but also avoids the tracheal anastomosis that was used in the original 2-lung en bloc transplant surgery. Tracheal anastomosis was fraught with anastomotic complications associated with unstable blood supply to the transplant respiratory system at this level.

Lung transplant

After opening the chest, each of the native lungs is mobilized. The lung with the poorest function is removed first, and implantation of the first graft begins. Afterwards the lung is perfused and ventilated. The recipient is then dependent on the function of that lung as the contralateral side is removed and a second lung is implanted. Hemodynamic instability, elevated pulmonary arterial pressure, or hypoxemia necessitate the use of cardiopulmonary bypass. Ultimately, only ~25% of recipients without pulmonary vascular disease require LSS.

Is a brain transplant possible: what scientists say

According to A. Bordey, an employee at Yale University, a brain transplant is possible, but to achieve the desired effect, a spinal cord transplant is also necessary, otherwise the person will be deprived of independent movement. As for preserving the soul and individuality, it is difficult to predict and give an unambiguous answer.

After all, when the body grows and develops, the brain also changes, therefore, during transplantation and regeneration, a person’s personality will certainly change. Only one shock will leave its mark.

According to the professor, after transplantation of this organ, the individual will not be granted immortality. After all, the brain also ages. Advances in science have successfully made it possible to replace kidneys, other organs, and even the heart with artificial ones, but it is impossible to replace the brain in this way. This is fraught with neurodegeneration, which will lead to the formation of tumors or decreased intelligence.

According to another scientist from the same university, H. Abbed, the transplant is quite real, but for now in the future. When the problem of connecting the patient’s brain to the spinal cord is successfully resolved. While the task is unsolvable, the latter’s injuries are fraught with irreversible consequences.

When this becomes a reality, then, according to the professor, the patient will acquire a personality along with the transplanted brain - after all, it is he who is responsible for this feature.

But another scientist K. Slavin is convinced that it is not far off when neurosurgery will be able to connect the body to the brain, and not vice versa. And such bodies will be created artificially. At the same time, the person will retain his entire personality. But he also agrees with the opinion of other scientists that even this will not ensure immortality. To solve this problem, you need to find a means that can “start” the renewal process at the cellular level.

What opportunities does it open?

If in the future science advances the development of technology in this direction to such a level that human brain transplantation becomes a completely common procedure, this will make it possible to use it, for example, in the following situations:

in case of bodily injuries incompatible with life;
for the treatment of oncological diseases;
with dangerous congenital bodily defects;
to get rid of severe mental illnesses that can only be treated by relieving symptoms;
for complex burns covering most of the body;
with functional organ failure.

It can also be used for gender reassignment, for transplanting a thawed cryopreserved brain into a grown body and solving other problems.

Is it possible to replace the brain with another carrier while maintaining consciousness and personality?

It is possible to make a biological cell capable of an infinite number of divisions, without depending on the type of cell. But it is clear that the human body is imperfect.

Eternal life for a biological individual can be achieved in two ways. Varying in their complexity and capabilities that these solutions will provide.

1. Controlled endless division of a biological cell 2. Transfer of consciousness to another more fail-safe medium.

We need to study the theory specifically according to point 2, because it does not mean copying a personality, when your brain is copied into someone else, but at the same time you remain yourself, but the transfer of your brain to another medium, so that you do not cease your existence, thought continuum, self-awareness.

Utopia? An inevitable reality.

While it is quite easy to replace a damaged biological body with a new one without loss of functionality, the brain, alas, is almost impossible. Because it won't be you anymore.

Why is this needed? The biological mind is vulnerable. First of all, before other biological life forms. (bacteria, viruses, etc.). Not to mention the lack of power, damage.

Biological intelligence is difficult to standardize—no two brains are the same. As a result, it cannot be trained instantly. Read - release an “expansion unit” that can be connected to any brain - and you can already solve the range of tasks for which it is designed.

If we create a technology... an artificial eternal brain, then on the one hand, we can scale it as much as we like with an increase in performance, without damaging the scalable part, on the other hand, we can connect it to a biological body in the same way as a natural brain. At the same time, be content with all the benefits and pleasures of the biological body, knowing that you are immortal. In any case, the transfer technology (not copying!) is described below. She doesn’t care from which media to which she transfers.

Technology of consciousness transfer. High Level Design

There are only 2 axioms that have been empirically confirmed and are intuitive for people. Not requiring proof. There is the original brain/consciousness. Let's call it X. Let X consist of some units xi, losing which X practically does not lose functionality (well, or gets closer to the ideal - DOES NOT lose functionality). For a biological brain, these will be neurons or clusters of connected neurons.

1. From the point of view of the interested subject X: if X is copied into Y, then X is destroyed, then Y will be the counterpart of X at the time of copying. But entity X will no longer exist. In practical terms, this means that if your brain was copied and you were killed, then your copy will live, but not you. She will think like you, do the same as you. But at the moment of your death you will cease to exist for yourself. Those. your conscious existential thought continuum will be interrupted. What seems paradoxical is that for everyone else you will live (if they do not know that you were copied), but for yourself you will not. A sort of philosophical paradox.

2. If X dies from m to n xi, where m>=1, n>=m, then X will not die. Let me explain in practice. You drink a bottle of vodka. One or more neurons die (let's say). Or they hit you hard on the head. The neurons died, but after that you did not stop being yourself. All the memories that you had. all the skills, your self-awareness - everything is preserved. Those. you have not ceased to exist. And after a blow/glass of vodka, you are you, and not your copy. All thanks to the noise immunity of the drive (brain). It’s another matter if you were seriously hit and/or you also drank before that. So much so that they lost consciousness. The neocortex turns off, but it does not collapse (does not die). the phrase “conscious existence” is not applicable. Existence remains. But self-conscious existence (the existence of a neural network that stores information about itself and the world) still continues.

A small lyrical digression. And here is an interesting situation. De facto, human consciousness continues to exist. Those. the brain functions and it remains the same brain X of view of brain X. But others perceive it as a loss of consciousness. It's funny. And if you copy X into Y, and destroy X, then for those who do not know about copying, “X” will continue to consciously exist and from their point of view it will be X. But from the point of view of X, X will not continue to exist. Because no more X.

What follows from this in practice? From the first axiom - that the system cannot be transferred completely. Those. if we do not transfer the system completely, then we can transfer and not copy. (sufficient condition) From the second axiom - that the system should be transferred along the minimum possible components of this system. The temporary absence of which will not affect the functioning of the system (a necessary condition)

This means that we can replace the minimum possible set of xi's in X in parallel with the corresponding yi's. In this case, each element xi must be associated with yi (for now, for simplicity, we are considering the ratio 1:1). In this case, we must ensure that the same functions are performed as xi performed. Those. many functions that xi performed will remain in yi, but at the same time yi will have new properties that we need so much.

The simplest iterative example. We take the brain, replace one neuron with a silicon analogue, which is designed immediately to “get along” with biological neurons. And so all the neurons one by one. On the one hand, because you temporarily lose one neuron at a time - you do not stop life and your conscious existence, self-awareness. You practically do not lose anything (at the time of replacement). And immediately after the replacement you will have everything the same as before the replacement. Those. you don't lose anything at all. You purchase another media. And since X is not completely copied into Y with the subsequent destruction of X (where Y is another medium), then it will not be your double, but you.

(...technology development....)

You can transport yourself anywhere. You can increase your computing power as much as you like, etc. You can live as long as you like and adapt to changes in the outside world in any way you like. If you fantasize, the possibility of transferring yourself (when the appropriate technologies are available) into, say, a piece of drifting interstellar dust is not excluded. But from a purely practical point of view, one must also have action potential. Conscious dust must be able to do something, otherwise why exist. But this is already philosophy.

Questions that the creation of technology can bring closer to resolution

Replacing neurons directly inside the brain requires fairly advanced technology.

Perhaps you can simply connect an electronic one to a biological brain. Through the wire into the ear... Before the transfer begins - biological - complete. Electronic - empty. Biological - X, electronic - Y. X is connected to Y so that initially the consciousness of X is distributed between the system of storage devices X + Y

Copying. We turn off a neuron/section in the biological brain. We copy to Y. The copied area did not disappear anywhere, and after copying to Y and deleting it to X, the consciousness remained unharmed, because X continues to see everything that is in Y. So, piece by piece from X to Y. Until X becomes empty.

If how to “turn on” a section in Y is even more or less clear, then how to “turn off a section” in X...

Conclusion

Only the fundamental possibility of transferring consciousness to any medium has been proven. It doesn’t matter where we will transfer from where to. From a biological brain to a silicon one, from a silicon brain to a plasma, from a plasma to quarks, or somewhere else, into a parallel universe. The only requirement is that the source system (the one from which the transfer of consciousness occurs) must be noise-resistant. Those. it must be able to lose at least one element of which it consists without significant loss to itself. In this case, the significance of the losses will be expressed in the size of memory failures of one kind or another. This is a necessary condition. And it is sufficient that the system should not cease to exist when this single element is turned off. Such a system will be portable.

Yes, this will require technology. But it's possible.

https://habr.com/ru/post/151376/

How is a brain transplant done?

As mentioned above, half a century ago the scientist R. White managed to transplant a monkey’s head into the body of another. Dr. Canavero suggests using a similar technique. According to him, the main problem remains manipulation of the spinal cord on both sides.

Transplanting a head along with the brain requires cooling the body to a certain temperature, after which the spinal cord is removed and one is replaced with the other, plus it will be necessary to connect the new body and head, for which glue (inorganic polymer) is used. This method has been used on experimental dogs and other animals.

The complexity of the operation lies in the reverse alignment of all the arteries, muscles, nerves and many other connections. However, when even a few of them are restored, one can already hope that the patient will not be immobilized. Electrical stimulation of the spinal cord is then used to teach new functions to nerve cells.

The operation will require a huge number of doctors—at least a hundred—to carry it out in one and a half days. The heads must be removed in a single step, no more than 60 minutes are allotted for their reconnection - the human brain cannot remain longer than this time, since a constant flow of oxygen and blood is necessary. When asked how much a brain transplant costs, neurosurgeon Canavero said the operation would cost at least £9 million in the future.

To carry out a brain transplant operation, according to scientists, a team of hundreds of doctors will be needed

In popular culture

This concept was first encountered in science fiction literature of the early 20th century. As a rule, the authors stated that such operations in the world he created were carried out to preserve the consciousness of socially significant people, and in order to hide crimes by changing bodies. Also in some works you can find a description of brain transplantation as a technique for prolonging life.

In the works of Alexander Belyaev, “The Inventions of Professor Wagner,” the brain of a person who died in an accident is transplanted into the body of an elephant. In the work “The Head of Professor Dowell,” a head is transplanted onto the body of someone who died in an accident.
In the horror films Frankenstein (1931), The Curse of Frankenstein (1957), and The Revenge of Frankenstein, the monster created by Frankenstein comes to life after a brain transplant.
Possible ethical problems of brain transplantation are described in Robert Heinlein's novel “I Fear No Evil.”
Science-fiction comedy "Brains on One Side".
In the mini-series Spiral, the brain of an elderly scientist is transplanted into the body of a dead guy with a gangster past. Due to the influence of the pituitary gland, the personality of the professor in the new body begins to transform into a criminal, dangerous due to his high intellectual abilities.

Features of brain transplantation

Although this is not as large-scale an operation as a head transplant, and does not require the movement of all muscles, vessels, nerves and tendons, however, other difficulties arise - his reaction to the replacement of the torso, a different configuration of the skull, is unknown. There are also other obstacles without overcoming which a successful brain transplant is impossible:

Restoration of pathways in the central nervous system (reinnervation). A huge number of nerve fibers and conductors are closely connected to the brain, a significant part of them passes through the spinal cord, and if they are destroyed, they are, as a rule, unable to recover. It is necessary to artificially regenerate them.
The problem of tissue rejection. Their incompatibility causes swelling; it can manifest itself literally in a couple of hours, and sometimes it makes itself felt only after a while, for example, several days. Edema during transplantation is the main cause of brain death with its own distinctive features. It will be necessary to solve tissue compatibility problems and suppress rejection.
Regeneration of nerve tissue. They themselves are practically not restored, and a human brain transplant is always associated with brain damage.
Protective reaction of the body. She does not accept foreign bodies, so her behavior during transplantation of a new organ is unpredictable and may even stop functioning. To block the patient's immunity, he is prescribed immunosuppressants before surgery. The success rate increases, just like getting the disease.

A human brain transplant is an extremely complex operation. The technique of conducting it involves not only solving problems with maintaining the integrity of the brain, but also how the shock will be perceived by the body and how much it will affect the psyche. In addition, it will be necessary to reconnect all tissue areas, nerves, and vessels with each other to the greatest precision. If nerve fibers are damaged, the brain will not send signals to the body, which means that an incorrect reaction to stimuli will occur and control over the corresponding tissues will be lost. As a result, the new body will become “uncontrollable.”

To implement this task, S. Canavero intends to use human brains that have undergone cryo-freezing of bodies. According to the scientist, it is possible that he will be able to breathe life into the first frozen patient as early as 2021.

Avatar and others

Let's remember the classic movies. "RoboCop", which "killed" the bad guys, was a robot with the brain of a person (a murdered policeman), practically invulnerable. In the films "Surrogates" and "Avatar", the artificial body was remotely controlled by thought. The human operator is in comfortable conditions (say, sitting in front of a monitor with a can of beer), but his consciousness is “included” in his cyber double. And through the so-called “brain-computer interface” he moves it as he wants. If he wants, he goes to work, if he wants, he runs into battle and frees the hostages. An avatar, instead of a person, can put out a fire, eliminate a nuclear power plant accident, and wander around other planets.

Article on the topic

The brain rules! In 15 years we will control a computer with our thoughts

“Some technologies already exist, others can be created in 5-10 years,” says Dmitry Itskov. — The TELESAR V robot has been developed at Keio University in Japan. Everything it sees and hears is transmitted to the operator, who wears a helmet with three-dimensional image displays. The robot is also equipped with sensitive fingers that transmit tactile sensations.”

Russia also has developments in the field of robotics. Several institutes are conducting research on controlling a computer “with the power of thought.” And doctors are working on reproducing the human body, growing organs for it. “An artificial bladder, mammary gland, blood vessels, and trachea have already been obtained. You can grow almost any organ, even the most complex,” says Dmitry Shamenkov, director of the Center for Cellular and Biomedical Technologies of the 1st Moscow State Medical University. “There are tissue printers: a 3D model is created, it is seeded with cells, and the organ is grown.”

The Institute of Synthetic Polymer Materials of the Russian Academy of Sciences has created a neural-like system capable of recognizing odors - an “electronic nose”.

So, constructing a body with a humanoid skeleton, a set of muscles and sensors is not a problem for modern science. It is possible, after all, to make a primitive iron robot powered by batteries. But how to “include” human consciousness or transplant the brain? “It is clear that the preservation of personality, our “I”, is associated with the preservation of memory. The problem of creating artificial memory, although complex, is solvable, says Alexander Frolov, head of the laboratory of the Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences. “One can imagine a variant of “rewriting” consciousness, when a prosthesis imitating a neural network is implanted into the brain instead of the damaged area and then included in a distributed memory system.”

Guidelines for Penile Transplantation

After the first penile transplant, Guangzhou Military Command General Hospital issued a joint statement outlining the psychological issues associated with penile transplantation and a list of 10 principles to help surgeons decide whether to perform the procedure. These guidelines recommend that the procedure be limited to severely injured individuals who do not wish to undergo traditional reconstructive surgery.

The guidelines also state that the results of each procedure should be peer reviewed and that all study subjects should be informed of any early results that are “less than optimal,” as this event may influence future clinical decisions and clinical outcomes.

Penile transplantation should only be performed on patients with severe penile injury.
Penile transplantation must be performed at appropriate institutions in accordance with protocols approved by institutional review boards.
Institutions should have surgical and transplant expertise, and transplant teams should include multidisciplinary experts such as plastic surgeons, immunology/transplantation specialists, infectious disease and oncology specialists, drug therapy specialists, physical therapists, pharmacology specialists, patient advocates and members of the media.
Appropriate selection criteria must be established and the risk/benefit ratio must be considered for each individual patient.
Patients and their families should be provided with specific informed consent documents explaining the risks, benefits, alternatives, and innovative nature of the procedure.
Penile transplant candidates must undergo a thorough psychiatric and psychological assessment, including an assessment of their psychosocial support system.
Patients with known psychological and psychiatric diagnoses, poor coping skills, poor support systems, or a history of non-compliance are poor candidates for penile transplantation.
Due to the novelty of the procedure, gradual steps and the collection of additional evidence based on research conducted in this area are necessary to ensure its proper application.
Expert review of the penile transplant procedure is mandatory to ensure compliance with medical standards of care and objective evaluation of the results.
The ethics of performing a new procedure with unknown outcomes must be carefully evaluated and weighed against the potential benefits for a selected group of patients with severe penile injury following evaluation of such penile transplant candidates by medical ethicists.

Based on hospital regulations, the 10 guidelines mentioned above must be implemented before allogeneic penile transplantation. We believe that they are necessary and fundamental guidelines, although the procedure, which is still in a trial phase, may also create unpredictable problems. Therefore, permission to perform such surgery should be strictly limited to avoid causing more severe physical and emotional harm to patients and prevent the occurrence of serious mental illness.

Presumption of consent for transplantation

In the Russian Federation, there is a law adopted back in 1992, according to which a person after death is a donor by default. In the event of sudden death or injury that cannot be cured, the person automatically becomes a donor. The concept of “death” means the cessation of brain function, but the possibility of further vital activity of other healthy organs. They primarily use the entrails of young people who have died due to car accidents or other accidents. Old people or sick people cannot be donors. Also, according to federal law, the presumption of consent to organ donation in Russia applies to all citizens over the age of 18. Transplantation of children's body parts is not practiced.

A forced transplant is not possible if a person or his relatives personally refuse to donate during their lifetime after death. As a result, many lawsuits arise regarding the failure of the pathologist to clarify consent to organ removal after death. For reasons of humanity, after reporting a death, doctors usually do not ask relatives for permission to harvest organs. People who are heartbroken are unlikely to soberly assess the situation and, as already mentioned, in most cases perceive this as an outrage against the deceased.

Before refusing automatic consent to a transplant, it’s worth thinking about what will happen if at least every tenth person signs a refusal? In this case, there will be a total shortage of organs, and accordingly the mortality rate will increase sharply. Demographic indicators will become significantly lower. Unfortunately, most people easily refuse to donate their own body parts when they no longer need them. However, if a transplant is necessary, expressing consent for organs after the death of another person occurs in 99% of cases.

A person most often learns about the presumption of consent only after encountering it in person. The state, unfortunately, does not consider it necessary to inform citizens about this. According to the law, the doctor has every right not to ask permission from the relatives of the deceased, and they learn about the removal of several body parts from the pathologist’s report.

Story

Attempts at lung transplantation date back to 1946, when Soviet scientist Vladimir Demikhov attempted a lung transplant in a dog—the first lung transplant in Russia and the world. This transplant ultimately failed due to a bronchial anastomosis, and difficulties with this anastomosis would plague clinical lung transplantation for the next 40 years.

On June 11, 1963, Dr. Hardy reported the first human lung transplant; however, the patient died of renal failure after 18 days. The first real survivor of this early era of lung transplantation was patient Fritz Derome in Belgium in 1971. However, this patient lived only 10 months. The failure of this early experience in clinical lung transplantation can be summarized by insufficient immunosuppression and difficulties with bronchial anastomosis.

The introduction of cyclosporine in 1978 led to significant improvements in survival rates for liver and kidney transplant patients. This led to renewed interest in heart/lung transplantation at Stanford and lung transplantation at Toronto in 1981.

The first successful orthotopic heart-lung transplant was completed by Reitz and colleagues in 1981 and showed that the grafted lung could survive and function in the recipient (a woman with idiopathic pulmonary hypertension). Studies conducted by Cooper's group in Toronto showed that the use of corticosteroids was found to be a significant factor in bronchial anastomotic weakness. When using cyclosporine, the use of corticosteroids can be reduced, which will lead to improved bronchial healing. In 1986, the Toronto Lung Transplant Program reported the first successful simultaneous transplants for two patients with pulmonary fibrosis.

Toronto is the first research center and the leading city in the United States for lung transplants.

This team followed up with the first successful double lung transplant, first with the en bloc technique, which used a tracheal anastomosis, and then evolved into a bilateral sequential transplant technique that not only improved airway healing, but also had the added benefit of avoiding cardiopulmonary bypass if it necessary. This method remains the standard technique used to this day.

Brain surgery for epilepsy

Approximately 30% of patients with epilepsy continue to suffer from seizures despite taking medications due to so-called. pharmacoresistance. In these cases, the appropriateness of neurosurgery should be considered.

Surgery removes the part of the brain where seizures occur without affecting surrounding areas. The success of the therapeutic method depends on the surgical site. After a procedure in the temporal region, up to 70% of patients get rid of seizures; with surgery in other areas, the success rate is lower.

There are patients whose illness is serious and whose attacks are severe, often associated with falls and injuries. However, sometimes it is not possible to perform surgery to eliminate them. In other cases, a surgical technique can be used to interrupt the pathways that carry seizures from one hemisphere of the brain to the other, which can change the course of the seizures.

In particularly severe cases of epilepsy, where there is no hope of controlling the disease with antiepileptic drugs or surgery, vagus nerve stimulation can be used. This is the 10th cephalic nerve, affecting the functioning of several organs of the abdominal and thoracic cavities, transmitting sensations from the intestines to the brain. Vagus nerve stimulation is performed using a device similar to a pacemaker. It is placed under the skin under the left collarbone.

Unique stereotactic surgery

A unique treatment option for epilepsy is the treatment of medial temporal epilepsy (seizures spreading from the internal structures of the temporal lobe) using a stereotactic method. The most common cause of this type of epilepsy is hippocampal sclerosis. The disease occurs as a result of brain damage in childhood, for example, during long periods of fever, meningitis.

Stereotactic surgery is intended for patients with clearly defined, localized epileptic seizures, where removal of the lesion means treatment of the disease. This is an intervention using a special electrode, through which the surgeon performs targeted thermal destruction of the tissue that is the cause of epilepsy. The results of this method are comparable to those of open neurosurgery, but with minimal burden to the patient.

Unsolved problems in the GEMINI project

In order for the immune system to reject the donor organ to a lesser extent, it is necessary to ensure the histocompatibility of the donor and recipient. An important role is played by the system of leukocyte antigens, which determines the engraftment of tissues in the human body. It is necessary to find a match for Spiridonov that is ideal for him as a donor.

When it comes to transplanting such a complex of organs as the head, it is difficult to determine who is the donor and who is the recipient. Considering that the donor organ is the head, programmer Valery is the organ donor. But considering that all of a person’s consciousness is located in the brain, it turns out that the donor complex of organs is not the head, but the whole body. After all, individuality and personality will be preserved from the head.

The brain can spend only 7 minutes in a separated state. Further irreversible damage will occur. The transplant will take much longer. It is unknown how Canavaro will resolve the issue of extending brain viability for this period.

It is necessary to find a place to conduct a head transplant experiment. And it’s not just about proper equipment and conditions. In many countries (including the Russian Federation) organ transplantation is prohibited by law. If we look at the situation from the other side and take the body as a donor complex of organs, then the law does not provide for transplantation of the entire human body.

Canavaro envisions the implementation of Dzhemeni's project in China. Spiridonov has already opened a charity fundraiser for his trip to the United States to begin preparations for the operation. However, Valery is a citizen of the Russian Federation and permission from the Russian Federation is required to perform a brain transplant.

Opinion of doctors with scientific degrees

At the training camp in Turin, Sergio Canavaro was laughed at and his statement was treated with skepticism. The Gemini project plan did not sound convincing to American and British scientists. However, the world community was optimistic about the upcoming operation. Some scientists agreed with the Italian's theory and allow the fusion of the head and body using polyethylene glycol proteins.

A professor at one of the universities of Chicago, Konstantin Slavin, is confident that performing a cephalosomatic anastomosis is quite possible. The only thing the scientist doubts is the ability of a full psychological recovery of the body after a head change.

Neurosurgeon Khalid Abbed believes that it will be possible to talk about human brain transplantation in 1015 years. But today it is possible to repair mechanical damage and ruptures in spinal cord neurons using polyethylene glycol.

Canavaro is not the first scientist to become interested in transplanting such a complex set of organs as the head. After all, back in 1954, the Soviet scientist Demikhov quite successfully transplanted the head of another onto the neck of one dog. The professor repeated this procedure 20 times. The dogs' vital activity lasted for up to a month. Without the use of immunosuppressive drugs. His experiments served as the foundation for heart transplantation in the future.

Today, the possibilities of medicine have gone much further than in 1954. Who knows, maybe it will be Canavaro who will take this huge step in cephalosomatic anastomosis. And perhaps his works will serve as an equally important discovery. Perhaps this will be the restoration of broken connections in the spinal cord.

Author of the article: neurologist Lidiya Rashidovna Magdoteva

How will the cephalosomatic anastomosis proceed?

The brainstem will be separated using a special silicon nitrate knife with a diamond blade. With its help, tissue damage can be reduced many times over.

The body and head of the experimental subject are cooled to 150C. This is necessary to slow down processes in tissues, including reducing oxygen consumption.

All large blood vessels will be clamped and then connected using special tubes.

The section of the brain and spinal cord trunks will be connected to each other using polyethylene glycol. This is a special bioglue that promotes the restoration and connection of adipose tissue and neurons.

Special implants will be inserted into the spinal cord, affecting neurons and causing them to regenerate.

After the operation, the person will be put into an artificial coma for a month. So that all efforts are directed towards recovery. And to avoid movement.

Sergio Canavaro is convinced that once the patient is brought out of the coma, he will be able to speak and have full control of the facial muscles. Within a year, with the help of physiotherapeutic procedures, massage and drug therapy, it will be possible to restore control over the body and restore motor activity to the limbs.

The cephalosomatic anastomosis will last about 36 hours. The cost of the operation will be $11 million.

The entire project of Canavaro and the Chinese professors was called GEMINI (twins). Sergio did not provide studies conducted in experiments with primate head transplants. But he stated that they were prepared for publication and would soon be released by one of the scientific publishers.