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Jul 12, 2013

Heading, Literally, into the Future

GEN's John Sterling gets on top of the head transplant controversy.

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    John Sterling

    As a kid, I was a huge science-fiction movie fan. One my favorites was the original and classic Frankenstein (1931), where an abnormal-brain transplant was involved. Another, which was actually a comedy and not sci-fi, was The Thing with Two Heads (1972).

    What made me think of these two movies was a journal article in last month’s issue of Surgical Neurology International entitled “HEAVEN: the head anastomosis venture project outline for the first human head transplantation with spinal linkage (GEMINI).” Yep, you read it right, human head transplants, although in reality the recipient would be getting a new body, not a new head.

    The author is Italian neuroscientist Sergio Canavero, M.D. And the good doctor, who by all accounts appears to have his own head screwed on right, is dead-on serious about what he terms “total cephalic exchange.” He believes the technology is already available to move forward on this project.

    When I first got a heads up about this story I thought it was a joke. But a quick Google search revealed that it was being covered online by U.S. News, London’s Daily Mail, CBS News, ABC News, and The Atlantic, among others. And when you delve into the details of Dr. Canavero’s article, you can see that he has come up with a fairly reasonable rationale for his optimism. He says all he needs is $30 million in capital and about two years to refine the procedure.

    Head transplants have been performed on dogs and rats with various degrees of success. But the milestone experiment belonged to Robert White, M.D., Ph.D., who in 1970 somewhat successfully transplanted the head from one monkey to another. I say somewhat because the monkey did regain consciousness with the aid of a breathing machine, but was paralyzed from the neck down and died after eight days.

    There have been no major issues connecting blood vessels. The problem arises when dealing with the spinal cord. How do you successfully connect these intricately bundled nerves? Dr. Canavero believes that polyethylene glycol (PEG) is the answer to fusing the two cords. The donor, he points out in his journal article, “is a brain-dead patient, matched for height and build, immunotype, and screened for absence of active systemic and brain disorders.” He maintains that such a procedure would be beneficial—in reality, life saving—for individuals suffering from muscular dystrophy, tetraplegics who are often prone to multi-organ failure, and for those with intractable cancer without evidence of brain metastases. All noble goals.

    But, I must admit, this whole business leaves me uncomfortable. Indeed, when I conducted an informal poll among friends and acquaintances I pretty much saw the scrunched-up-face response that people usually display when they encounter something distasteful. I tried to figure out why. Most folks seem to readily accept limb, lung, heart (even with its historical romantic connections), and even face transplants. Then it hit me. I believe people, at least those I talked to, were repelled by the head transplant concept because in truth we are our heads. Our personality, emotions, thoughts, feelings, opinions, and view of life all are born and reside in that organ that sits on top of our body and contains the brain, eyes, ears, nose, mouth, and jaws. The thought of “us” moving to a headless body just might be too much for many people to stomach.

    Also, and I am neither a neurosurgeon nor an expert in neurology, I get the feeling that the technical aspects of doing this operation are more difficult than we might have been led to believe. Again, just a feeling. And then there are the ethical issues surrounding such an undertaking. I wouldn’t even know where to begin to address such issues.

    Jerry Silver, Ph.D., was in the lab when Dr. White did the monkey head transplant.

    “I remember that the head would wake up, the facial expressions looked like terrible pain and confusion and anxiety in the animal,” Dr. Silver, now at Case Western Reserve University, said to CBSNews.com. “It was just awful. I don’t think it should ever be done again.”

    He believes such an operation on humans is “light years away” and could cost as much as $13 million, citing Dr. Canavero’s own estimates.

    “It’s complete fantasy that you could use PEG in such a traumatic injury in an adult mammal,” continued Dr. Silver during his CBSNews.com interview. “But to sever a head and even contemplate the possibility of gluing axons back properly across the lesion to their neighbors is pure and utter fantasy in my opinion. Just to do the experiments is unethical. This is bad science, this should never happen.”

    For now, I agree with him. What about you? Feel free to comment below.


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