Weekly Head Voices #222: Scotty, we need more power!

Welcome back everyone!

It’s now early(ish) Friday morning of the weekend after, but I would like to get the 222d edition of the WHV out, namely the one covering the two weeks from Monday, April 19 to Sunday, May 2, 2021.

My excuse for skipping a week is that the second week was spent on vacation. Exhibit A is shown below:

Figure 1: Scene from an unexpected and sublime run on the St Francis beach.

Figure 1: Scene from an unexpected and sublime run on the St Francis beach.

The rest of this post has (imagine the following in Bill Hader’s Stefon voice):

  • migraines and science
  • scifi ipads
  • VR
  • a life tip

Let’s go!

Brain glitch

I lost almost half a work day to a visual migraine.

Looking at my notes, it seems that these only started during the past few years, although it could be that I just didn’t record the previous ones.

It starts out with bright spots in the middle of your field of vision, which slowly grow until they form jiggly circles. This is not ideal, but at least you can now look through their centres. Haha.

It looks eerily identical to the illustration on the linked website.

After half an hour to about an hour, sometimes a headache will hit, and sometimes not. This time it was unusually intense, and I had no choice but to detach from work for a while.

Looking back at my notes now, I really appreciate the time-stamped entries as the migraine developed all the way to its end.

Lesson reaffirmed: Take good notes, no matter what.

Fascinating scientific review of migraine and metabolism

After a related chat with a friend who reported that in his case blood sugar played a role (he can’t skip breakfast, and can’t eat too sweet), my permanently foraging internet tentacles entirely coincidentally dredged up this publication in Nature Reviews Neurology titled “The metabolic face of migraine - from pathophysiology to treatment” (pubmed, PDF fulltext).

The article is pretty dense, but here are some interesting observations:

The first is from box 1: In some humans, when brain energy demands outstrip metabolic reserves, rendering them vulnerable to disruption of cortical homeostatis (energy balance), there is a whole cascade of events that, according to the article’s authors, might be started by the pannexin channels in neurons. (These channels act as sensors of cortical homeostasis.)

It’s quite straight-forward then that (haha):

The final result of this cascade is trigeminovascular activation and calcitonin gene-related peptide release in the extradural space, which leads to headache.

Following from there, they postulate two alternate pathways that cause respectively migraine with and without aura (visual effects).

In other words, when your brain requires more energy than you have available, and you are one of the many genetic variants who suffer from this mechanism, you could be in for some migraine when your body reacts to the imbalance.

On top of that, the authors present one more good reason to become fat-adapted:

These increases in lipolysis and ketogenesis can also be interpreted as counter-​regulatory responses to a cerebral energy deficit. Given that ketone bodies are an efficient alternative fuel for the brain when glucose availability is low, their elevation would be expected to restore brain energy homeostasis. However, the Western carbohydrate-​laden diet means that in most people in Western countries the brain is not keto-​adapted so does not have the enzymatic composition and transporters to make use of ketone bodies produced during an energy crisis.

Box 2 in the article provides the following quite intriguing “Suggested approach to improving mitochondrial function and energy metabolism in migraine” (emphasis mine, so that you can skim over if you want):

  1. Individualize supplementation of micronutrients. To ensure that all micronutrients needed for mitochondrial function are available, laboratory tests can be used to individualize supplementation with minerals, hydrophobic and lipophilic vitamins and trace mineralsthat are deficient.
  2. Reduce oxidative stress and increase antioxidants. Measurement of oxidative and/or nitrosative stress levels and antioxidant status in individuals could detect a potential mismatch between oxidative stress levels and antioxidant capacity and enable therapeutic adjustments to be made, although studies are needed to prove that such an approach improves migraine management. Strategies to reduce oxidative stress could include elimination or reduction of processed food, food with a high glycaemic index and alcohol, use of green or blue light filtering glasses, interruption of hormone-based contraception, lifestyle changes and addition of antioxidants,such as polyphenols, coenzyme Q10, α-lipoic acid or β-hydroxybutyrate mineral salts, to the diet.
  3. Stabilize blood glucose levels. An oral glucose tolerance testshould be undertaken in patients with migraine and clinical features that suggest glucose intolerance or a family history of glucose intolerance. Patients with reactive hyperinsulinaemia and reactive hypoglycaemia are likely to benefit from stabilization of blood glucose levels, which can often be achieved with dietary adjustments.
  4. Provide an alternative energy substrate for the brain. For patients with compromised energy metabolism, an alternative source of fuel for the brain, in addition to glucose and lactate, might be beneficial. This source can be generated with a ketogenic diet and/or use of exogenous ketogenic substances, such asmedium-chain triglycerides or exogenous ketone body salts. Further placebo-controlled trials are needed to validate ketogenic therapies in migraine.

4/20 iPad Pro supercomputers straight outta SciFi

On 4/20 I tuned into a liveblog (I think it was the one by Ars Technica) of Apple’s release event.

Apple is currently evolving the computing landscape quite substantially, so I find it immensely interesting to see what they are bringing next.

They did a whole bunch this time, but what struck me as the most significant, is that they introduced two new iPad Pro tablets with M1 chips.

You know, that same M1 chip powering the super fast and energy-efficient laptop on which I’m typing up this post.

In addition to sticking a desktop-class processor (err, desktop-class performance, but mobile-level battery efficiency) back into a mobile device that you can also buy with 2 terabytes of built-in storage (I find this a bit surreal), the new Liquid Retina XDR display on the top-end iPad Pro has 10000 of a new kind of micro-led just for the back-lighting and thus is able to offer 1000 nits of full-screen brightness and adaptively up to 1600 nits on portions of the screen, all of that with a contrast ratio of 1 to…. ONE MILLION.

As I was reading this, and later listening as the excitement led (…) me to tune in to the video stream, one of my inner voices marvelled at the sheer technological innovation on display (sorry can’t stop) here.

I’m curious to see how this new class of supercomputer-level tablet device is going to change how we humans interact with the digital world.

Oculus Quest 2

On that topic…

On the weekend that we returned from vacation, we welcomed an Oculus Quest 2 VR headset into the family.

In the early 2000s, the TU Delft Graphics research lab that I was part of had an AR / VR research line, so I got some exposure to state-of-the-art equipment then.

Fast-forward 15 years, and the self-contained Oculus Quest 2 at $299 is mind-blowingly good.

Specifically the head tracking is phenomenal.

Graphics elements in VR are rock-solid in virtual space as you move your head (and yourself) around. The resolution is high enough that you could even work on a document if you would like. With the most recent firmware update, Quest 2 now does 120 Hz.

In short, when you put on the headset, immersion is total.

No more outside world.

You can double tap on the side of the helmet to switch on reality (viewing your surroundings through the 4 cameras mounted on the outside), and double tap to switch reality off and go back into VR.

Facebook (they own Oculus) has some interesting work-focused ideas with this:

When I saw that video for the first time, before having tried out the Quest 2, I thought “haha look at fb faking VR”.

I was wrong.

It’s pretty much spot-on.

(We’re not playing office-office with the kids though, beat saber is much more fun in 3D!)

Flip it

During a recent chat with a busy friend, seeing if we could have coffee somewhere, I reminded us both (you have to imagine this in Afrikaans, but failing that in English with a thick Afrikaans accent):

Remember that the moments of relaxation and humanity are the anchors. All of the rest should flow around that.

This is so easy to forget.

We (and I also mean I) postpone the chat, or the run, or time with the family, because of work.

It should be the other way round!

Figure 2: Awesome ritual in St Francis where people make a whole celebration of the sunset. We were there thanks to GOU#1’s tip.

Figure 2: Awesome ritual in St Francis where people make a whole celebration of the sunset. We were there thanks to GOU#1’s tip.