BOOKSHELF

A few brain science books that have recently caught our eye

BY BRANDON BARRERA

What is Health? Allostasis and the Evolution of Human Design

by Peter Sterling

Systems enduring disruption will make efforts to stabilize and return to normalcy. These error-correcting processes—mechanisms such as shivering or sweating to regulate body temperature—are part of our physiological regulatory system and are conventionally taught as homeostasis, a feedback-dependent model at the core of modern medical education. But what if a different model of health could shift prescribed therapies for society-wide ailments away from pharmacologically dependent treatments (think obesity, drug addiction, and type 2 diabetes) and offer equitable solutions to societal problems such as climate change? Peter Sterling, Ph.D., a neuroscience professor at the University of Pennsylvania School of Medicine, proposes just that with the concept of allostasis, a model he and Joseph Eyer devised in the 1980s. In What is Health? Allostasis and the Evolution of Human Design (MIT Press), Sterling explains that the allostatic model defines health “as the capacity to respond optimally to fluctuations in demand” and emphasizes “system-level” therapies, such as exercise, that increase the ability for adaptive variation. Sterling dives into the evolutionary history of our dopamine-driven reward system and shows how modern life is inadequately providing the small pulses of “satisfaction” that our biology needs. More importantly, Sterling tacitly admits that his book is meant to offer perspective and aims to elicit critical thinking about current medical practices and societal structure. Sterling’s viewpoint reveals itself to be prescient and, most refreshingly, human. l

OD: Naloxone and the Politics of Overdose by Nancy D. Campbell

A 2020 Centers for Disease Control and Prevention report shows that, in 2018, more than 67,300 drug overdose (OD) deaths occurred across the U.S., a four percent decrease from the previous year, and, hopefully, the beginning of a downward trend.

For many medical professionals and community members on the frontlines of the epidemic, naloxone—a short-acting opioid antagonist that “reverses” ODs and saves lives—is the tool coupled with the social movement responsible for shifting the conversation around OD from hushed-tones to the mainstream. In OD: Naloxone and the Politics of Overdose (MIT Press), science historian and professor of science and technology studies, Nancy D. Campbell, follows naloxone’s journey: from its predecessor nalorphine to its synthesis in 1960, and the near-ubiquity it is approaching today. Campbell asks why it took so long for cultural perspectives to accept overdoses as preventable deaths, stressing the necessity of understanding the complex social and material conditions that lie beneath ODs. If meaningful solutions beyond the technological “fixes” that drugs like naloxone proffer are to be realized, Campbell suggests going further than the science of molecular agonists and antagonists. We should not forget the families, witnesses, drug users, former users, advocates, clinicians, and scientists that are part of the social movement; OD is their story. l

The Future of Brain Repair: A Realist’s Guide to Stem Cell Therapy

by Jack Price

Recovery from stroke can be very different across people—the brain’s plasticity might, after some time, restore some impaired functions to varying degrees. But the brain tissue most deprived of blood flow is considered lost and irreparable. Will this always be so? Jack Price, Ph.D., professor of developmental neurobiology at King’s College London, asks if stem cell therapies and newer technologies could usher in a new era of brain health. The Future of Brain Repair: A Realist’s Guide to Stem Cell Therapy (MIT Press) considers in detail the growth of stem cell therapies from “tentative ideas” into an ambitious clinical program. Readers can expect to learn why brain repair has stymied neuroscientists and the areas where possible breakthroughs might give birth to real regenerative brain treatment, with Price describing pluripotential stem cells as the potential game-changers. He discusses clinical trials for stem cell therapies for Parkinson’s, stroke, and macular degeneration, and the possibility of new licensed therapies. While stem cell therapy has tugged at the imagination with much hyperbole, Price approaches the science with nuance and empirically tinged optimism. l