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Как работает наш мозг? | Высшие Мозговые Функции и их РАССТРОЙСТВА | Лекция — Transcript

by Профессор Юсупов Ф. А · 5,560 words · 890 segments · language en · Watch on YouTube

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0:01The topic of today's lecture is higher
0:03brain functions. In literature, you may
0:06encounter the term "higher mental
0:08functions." However, it is more
0:11accurate to call them "higher brain
0:13functions." Why? Because the substrate
0:19of the psyche is the brain—that is,
0:21the biological, anatomical, and
0:23physiological aspect. All of this
0:28determines our function—that is, our
0:30mental function. Therefore, we call
0:33them higher brain functions. That is
0:36correct. How do we differ from animals?
0:40By our legs, arms, or appearance?
0:44Probably not really. Yes. We differ
0:52from animals by our highly organized
0:54matter, the so-called cerebral cortex.
0:59It is precisely the cerebral cortex
1:01that distinguishes us from other
1:02animals. No animal possesses a cerebral
1:06cortex like yours, mine, or that of all
1:09humans. This is called the cerebral
1:13cortex. For a cortex to be called a
1:16cortex, I said in the last lecture what
1:18it must have. The cells must be
1:22clustered, yes, and they must be
1:24arranged in layers. Neurology. Again,
1:27we repeat, the word "cortex" appears
1:30twice. One is the cerebral cortex, and
1:34the second time, by the way, the
1:36adrenal gland—which is not a separate
1:38organ. What is it then? It is an
1:42autonomic ganglion. A sympathetic
1:44autonomic ganglion. Do you understand?
1:48It is a sympathetic autonomic ganglion.
1:52Here we have the brain. Imagine this is
1:55the cerebral cortex. The cerebral
1:58cortex consists of six layers. We will
2:00now examine which layers. And the
2:03cerebral cortex, to increase this area,
2:05equal to how much? 396 cm. It forms
2:11these convolutions. The more
2:15convolutions, the greater the surface,
2:16though not necessarily the functional
2:18activity, but the surface. Greater
2:22volume, greater surface. And
2:25furthermore, with the help of fissures,
2:27it is divided into several lobes. Yes.
2:31In total, we count four. These are the
2:34frontal lobe, the parietal lobe, the
2:37temporal—good, well done. And the
2:40occipital lobe. Four lobes. The great
2:47scientist Brodmann, for convenience,
2:49subdivided the cerebral cortex into
2:51several regions and areas. How many in
2:56total regions? How many? 11 regions and
3:0352 areas. And each area, each region
3:09has its own functional responsibilities
3:11. But before talking about functional
3:16responsibilities, let's look at which
3:18layers the cerebral cortex consists of.
3:21It consists of six layers. Where were
3:23the three layers? In the cerebellum.
3:25Three layers in the cerebellum. But in
3:27the cerebral cortex, there are six
3:29layers. These are the molecular layer,
3:32the external granular layer, the layer
3:34of small and medium pyramidal cells,
3:36the layer of small and medium pyramidal
3:38cells, and the internal granular layer.
3:42Is the fifth layer familiar to you? Of
3:45course, it's familiar. Yes. The
3:47pyramidal tract mainly starts from the
3:49fifth layer, right? This is called the
3:51layer of large pyramidal cells. The
3:54efferent pathway, the motor pathway. It
3:56mainly starts in the fifth layer, yes?
3:58From the cells, as we said, what were
4:00they called? Betz, right? Betz and the
4:04layer of polymorphic cells. And finally
4:06, the sixth layer is the layer of
4:08polymorphic cells. So, how many layers
4:10do we have? Six layers. Now, let's move
4:13on. That was the anatomical view. Now
4:16for the functional view, so we don't
4:18have to study every zone, every field,
4:20every area. The great neurologist Luria
4:26, well, the Soviet scientist Luria,
4:28divided it into three functional blocks
4:31. Our brain is divided into three
4:35functional blocks. The first block is
4:38called the energy block. For the brain
4:41to work, for the body to work at all,
4:43what do we need? Energy, fuel, the
4:46energy block. And this energy block is
4:51maintained by the reticular formation
4:53of the brainstem. And thanks to this,
4:58the brain functions. If we damage the
5:01reticular formation of the brainstem,
5:03what does the patient lose?
5:05Consciousness. The second block is the
5:11block for receiving, processing, and
5:17storing incoming information. So which
5:22one is the second? The second block,
5:25the functional block, is the block for
5:27receiving, processing, and storing
5:33information. This includes everything
5:37located behind the central sulcus,
5:39anatomically. And finally, the third
5:42block. Programming,
5:45planning, and decision-making. Which
5:48lobe is mainly included here?
5:50The frontal lobe. Everything located in
5:53front of the central sulcus. These
5:58fields, these areas of the brain are
6:04connected by linking components,
6:11so-called pathways. And they are also
6:15divided into three types. The first are
6:18projection fibers. Projection fibers.
6:22They connect the brain to the
6:23underlying structures. The brain to the
6:27lower regions. These are mainly simple
6:30sensory pathways, yes, the pyramidal
6:32tract, cerebellar tracts, and others.
6:36Next are association fibers. In the
6:40brain, association fibers create
6:42associations. Associations what
6:47function do they perform? They perform
6:50the function of connecting these fields
6:52and areas within one hemisphere of the
6:54brain. Do you understand? Within one
6:57hemisphere, left or right. And finally,
7:00the third. Smart. Commissural fibers.
7:04Commissural fibers connect one
7:06hemisphere to the other. And one of the
7:09most important, which body? The corpus
7:12callosum. Yes. That is the corpus
7:15callosum. Draw the brain. The cerebral
7:19hemispheres, rather, yes, let's draw
7:21the cerebral hemisphere. Draw here,
7:24what? Anatomical and functional feature
7:28. The main functional anatomical cell
7:31of the nervous system is the neuron.
7:34These are neurons. This gray matter,
7:38these are neurons, or as we call it now
7:40, the cerebral cortex. These are
7:46neurons. of the brain. How many neurons
7:50? Many. Correct. And even more
7:54correctly, a great many. How many, how
7:59many neurons are in my head? Not in the
8:03head, but in the brain would be more
8:05accurate. Or rather, in my cerebral
8:07cortex. That's how you should ask the
8:09question. How many? Millions. a billion
8:16. How many, precisely? Today, equipment
8:21has allowed us to calculate 86 billion.
8:3086 billion. Well, humans are creatures
8:34who love to consolidate, to simplify.
8:36Why nitpick? Let's just write 100
8:39billion. I even forget which one it is.
8:43Well, let's say 100 billion. And
8:47imagine, in your brain, 100 billion
8:49brilliant cells are functioning. To
8:53give you an image—as I said, the
8:55brain likes to think in images. Imagine
8:59, close your eyes, that you have 100
9:01billion dollars in your head. Close
9:04your eyes, you have 100 billion dollars
9:06. 100 billion dollars. Did you imagine
9:09it? It doesn't fit. But 100 billion
9:15dollars does fit. Do you understand? A
9:20person is rich not in that, but rich in
9:22what? In their billions located in the
9:26brain. 100 billion. A person is born
9:33with these ready-made cells, 100
9:35billion. But we do not use all of these
9:39cells. We don't use all these cells.
9:46Born with 100 billion, used a million
9:48or two, the rest were taken away. Our
9:52body has another such feature.
9:55Everything that is not used,
9:58The Almighty takes away. Everything
10:02that is not used, the Almighty takes
10:04away. Remember that. If you won't use
10:08them, that's it. The brain will what?
10:17Gradually, gradually remove those cells
10:19. The moral is, it uses this
10:23nervousness. And patients come to me
10:26and say: "My head hinders me from
10:28working, my brain is a bother. Give me
10:32a chance to rest so that my brain can
10:33rest. My thoughts are bothering me."
10:40Who can say what answer I should have
10:42given? I give it a six. I say: "Alright
10:46, I will help you." I say: "What do the
10:49kidneys do?" They say: "They produce
10:51urine." Do you want your kidneys to
10:54stop producing urine and shut down?
10:55They say: "No, no, absolutely not."
10:58What do you do with the liver? "What
11:00does it do?" It cleanses, right?
11:03Provides enzymes, right? It helps. If
11:06we stop the liver's function, naturally
11:08, there is intoxication and one dies.
11:13What is the function of the brain? To
11:17think. So these thoughts are actually
11:21good. Your function as a doctor, and
11:26your function as a person in general,
11:28is to bring order to these thoughts. Do
11:33you understand? You don't need to
11:35remove these thoughts, you need to
11:37bring order, to ensure there are the
11:39right thoughts, not the unnecessary
11:40ones. So you were born with 100 billion
11:45cells. It must be noted that each cell
11:49has its own functional significance.
11:53Each cell has a functional significance
11:55. And throughout life we gain
11:59experience, yes, we start learning to
12:01walk. Yes. We learn to pick things up
12:08with our hands, we learn to speak, to
12:10hear, to see what is necessary. We
12:14acquire experience through trial and
12:16error. Or is everything smooth for you?
12:18We are born and everything is through
12:19trial and error. All of life is trial
12:21and error. I also ask patients this
12:23question. Just now, literally an hour
12:28ago, a patient came in, relatively
12:30severe, she has problems. Poor thing
12:34has been suffering for 25 years,
12:36suffering related to the environment
12:38herself. I say: "This is you." I say
12:42what's next. You have a choice: to
12:47choose this version of life or to
12:48choose that version of life? Depending
12:52on what you choose, the Almighty will
12:54not give you just that one life. There
12:57is life. I say: "This is also life,
13:01naturally, which one did she choose? A
13:05serene life." I say: "Alright." It is
13:13precisely because of this serene life
13:15that Europe ranks first in suicides,
13:17because life is too serene. Every day
13:23is the same thing. Every day is the
13:27same thing. Most of you have been to
13:30Europe, and you dream of going there.
13:33Please, go ahead. That's also good. But
13:37life, what is the meaning of life
13:39defined by? The meaning of life is
13:43found through trial, error, and
13:45overcoming all these obstacles. And at
13:47the end of life, at 90 years old,
13:49you'll say: "This is the life I had."
13:51But at 90, he won't have anything to
13:53say. He only lived for his health.
13:54Remember last time, the vegetative
13:56state I mentioned, right? Here is this
13:59life. And this life, which life you
14:02choose, depends on this cell, the nerve
14:04cell. And in order to adapt like this,
14:09what must we create in the neurons?
14:14Connections, well done, just like in
14:16life, right? Here is a nerve cell,
14:20let's say, one nerve cell, here is a
14:22second cell, here is a third, fourth,
14:25fifth, sixth, seventh, eighth, and so
14:27on. One nerve cell, as they've found
14:30today, has connections with 5,000 other
14:32nerve cells. That's the kind of
14:35connection. And the more of such
14:37connections you have, the better your
14:39adaptation to life, and what will your
14:40intelligence be like? High. You will be
14:44adapted to life, adapted to stress. Why
14:47? Because you have passed through these
14:49cells. And this we call neuroplasticity
14:54, or rather, we call it a neural
14:56network. Many say, the bigger the brain
15:00, the better. Your intelligence does
15:04not depend on the size of the brain.
15:07From the size of the head you choose.
15:09Who has a bigger head size? Ah, it
15:12depends on the neural connections of
15:14the neural network. The larger your
15:16neural network, the better. And what
15:19should you do to increase your neural
15:20network? Work on yourself,
15:23intellectually work on yourself. And
15:26one of the most important things is
15:27considered to be reading. We are now
15:30talking about higher brain functions
15:32too, to live, this is a philosophy of
15:34life. To get out of a situation, for a
15:38person, I told you, how many books, how
15:40many books you need, just for you. Here
15:45I am not talking about the Quran or
15:47religious books. Of course, everything
15:49is written there, but not everyone
15:50understands. Only 5 to 10 books in your
15:53life will be useful. But to find these
15:57books, you must read 10,000 books. And
16:00at the end of the book, you write: "Now
16:02electronic books have appeared." Yes,
16:04e-books. And nothing, you will never
16:06remember anything, my dears. A book
16:10should let you borrow it to read, and
16:11then I will return it to you. It will
16:14be of no use. When you read books, take
16:18pens, mark points, write on top. You
16:22must develop this. You must have your
16:24own take. Why? Because this book is
16:26also written by the same people as you.
16:29Right? Everyone writes their own. And
16:31this way, you will develop an unreal
16:33network. That’s the first thing. The
16:35second. The more difficulties you
16:37encounter in life, the more the neural
16:39network improves. That is, a person
16:41begins to get out of that situation.
16:43How to get out? What do we do? Like you
16:46, this cell will help, this cell, this
16:48cell is helping. And in this way, we
16:52increase the neural network. It’s not
16:54so much about living, but how to live.
16:56The more serene your life is, the more
16:58your nerve cells remain as they were at
17:00birth. Do you understand? And those
17:05people who have a good neural network
17:06recover better from damage. Why?
17:10Because these connections are good.
17:13Damage is restored faster. And who
17:16recovers best? Children. Why? Because
17:20their right and left hemispheres have
17:22not yet differentiated. And these
17:25centers, responsible for certain things
17:27, do not have clear boundaries between
17:29the fields yet. And so, well, up to the
17:33age of about 10, recovery works very
17:36well. That’s why I have a light envy
17:39of pediatricians. A child will recover.
17:43A sick child was born, they will grow
17:45up eventually. We will show them
17:48certain paths. They will get out of it.
17:51But marketing has even reached the
17:53point of releasing toothpastes that
17:54improve children's tooth growth. Poor
17:59things use that toothpaste, and teeth
18:01grow faster. No, the program is set,
18:04they will grow anyway. Right, but
18:07marketing and business use this, and it
18:09must be used. That is also a neural
18:12network. Knowing how to use things,
18:14knowing how to earn money, is also a
18:15neural network. Otherwise, what are you
18:18studying for? The goal of life, two
18:20main goals. There is a lower hierarchy
18:25and an upper hierarchy. What was the
18:28first lower goal of life?
18:31Survival. The second goal of life was
18:34to receive pleasure. This is the lower
18:36bar. You understood all of this from
18:37the last lecture, right? So, I will
18:39receive pleasure. So, I have two goals.
18:41No. The higher goal, the main goal is
18:46considered
18:49to be happy.
18:52That is the higher goal of a human, and
18:54we will gradually analyze the highest
18:56one together. And historically, it
19:00happened this way. At first, they
19:05thought that little, little people were
19:07sitting in our heads, controlling us,
19:09yes. us.
19:16One is responsible for speech, the
19:18second for hearing, another for
19:20movement, and so on. These little
19:25people, you can consider them to be
19:27nerve cells. Imagine, how many people
19:29do you have in your head?
19:32It's good when you have 100 billion
19:34dollars or 100 billion people.
19:37It's better to have 100 friends,
19:39100 rubles. they say, right? The theory
19:42of narrow localization. That is, one
19:45area is responsible only for this
19:46function, for one function. No, others
19:50said. Why must you be right? It's the
19:53same in life. Why must you be right?
19:56The second theory, the theory of
19:58equipotentiality, that is, all areas of
20:00the brain are the same. And finally, a
20:03third theory appeared. The theory of
20:06our domestic Soviet scientists. The
20:08theory of dynamic localization of
20:10higher functions. damage here means
20:12damaged cells can be replaced by other
20:14cells. This is dynamic and domestic
20:18ones are mainly Sechenov, Pavlov, and
20:20others. I mentioned Luria, right? The
20:25main centers in the cerebral cortex.
20:27Well, now the lecturer is talking about
20:29the main centers of the cerebral cortex
20:31. What do we classify as higher brain
20:34functions? Higher brain functions,
20:36higher cortical functions—that's
20:38speech. speech, gnosis, praxis, memory,
20:44thinking, consciousness. There are
20:49others, but we won't touch on them yet.
20:53For mastering the neurology course,
20:54this will be enough for you. Let's
20:58start with speech. What is speech? It
21:03is a specific form of activity serving
21:05communication between us. So, thanks to
21:09speech, we have a second signaling
21:11system. The first signaling system is
21:14our receptors, right, simple receptors,
21:17pathways, visual, auditory, and so on.
21:21And speech is the second signaling
21:23system. Thanks to speech, we can
21:27explain ourselves. Thanks to it, we can
21:29understand each other. Thanks to speech
21:32, we can know this world. There is
21:35impressive speech. understanding. Yes,
21:40do you understand my speech?
21:42This is called impressive speech. Do
21:44you understand when you read?
21:48This is impressive speech, expressive
21:50speech. That is, I, you can speak, yes,
21:55express yourself using the articulation
21:57apparatus. This is expressive or we
22:02also call it motor. The speech center
22:07in humans is located predominantly in
22:09the left hemisphere, for some in the
22:11right hemisphere. What does this depend
22:16on? Is a person right-handed or
22:19left-handed? It matters for life. Well,
22:25let's leave it for the end, so you have
22:27a debate, right? What is the
22:33significance of knowing where the
22:34speech center is located, or functional
22:36brain asymmetry, it's called functional
22:38brain asymmetry, that is, left
22:40hemisphere dominance or right
22:41hemisphere dominance. Raise your hand,
22:47who is right-handed? The majority,
22:50right? Raise your hands, who is
22:52left-handed? Raise your hands, who is
22:55both right-handed and left-handed. In
23:05medicine, particularly in neurology,
23:06there are methods to determine if you
23:08are a true right-hander or true
23:10left-hander. Extend your hand. Everyone
23:18extend your hand, close your eyes. Open
23:28your eyes. Now look, join your palms
23:33with your eyes closed and clasp your
23:35hands together. Clasped together. Now
23:44open your eyes and look from above,
23:46which hand it is, which hand's thumb is
23:48on top. And people were bragging here,
23:56about millet, millet? Yes,
24:01this is one of the tests. Now raise
24:05your hand if your left hand ended up on
24:07top. The number will increase. Next
24:16test. Here I am. However is comfortable
24:22. Now look at which hand is on top.
24:31Which hand is on top?
24:37Now raise your hand if your left hand
24:39is on top. Quite a lot. Third test. The
24:48third test. I usually check patients,
24:51too. I say, "Clap your hands." They
24:55clap like this. Does a person really
24:58clap like this? Or clap like this? Or
25:02just clapped.
25:08Which hand is on top?
25:10The right.
25:13Now raise your hand. Those whose left
25:15hand was on top. These are the true
25:18lefties.
25:25Wait, for females there is another test
25:27.
25:30Which one?
25:36Pick up a child. Which hand is
25:44supporting? No, this is the main
25:50support.
25:53This is not for men. Well, men, unless
25:58you are that,
26:01then there are no questions. Speech
26:07impairment. Impairment of formed speech
26:12due to brain damage is what we call
26:13aphasia. Impairment of formed speech is
26:18what we call aphasia. Basically, there
26:22are three types of aphasia. Motor
26:26aphasia, damage to the Broca's center.
26:30Broca's center, or Broca. As you prefer
26:34. Where the stress falls. It's located
26:39in the posterior sections of the
26:41inferior frontal gyrus, and any damage
26:43there causes what in patients? Motor
26:47aphasia. The second type of aphasia is
26:52sensory aphasia. Develops from damage
26:57to the Wernicke's center. Located in
27:02the posterior sections of the temporal
27:04lobe. And finally, the third, this is
27:10incorrect. And the third, amnestic
27:12aphasia. Now, let's see how we can
27:15distinguish motor, sensory, and
27:16amnestic aphasia. A patient comes to
27:20you, and you must determine where their
27:22lesion is located. Who can say, how do
27:26you distinguish motor aphasia from
27:28sensory? Yes, if you speak to the
27:34patient, they follow your instructions
27:36and try to perform them, but cannot
27:37speak. This is the simplest way for you
27:44to understand motor aphasia. You can
27:49assume they follow instructions, they
27:51understand me, but cannot speak. This
27:54points to motor aphasia. But there are
27:57others. There are dysphasias, there is
28:02speech impairment resulting from damage
28:04to peripheral organs of articulation,
28:06that is, cranial nerves. We will cover
28:10this next. So I won't touch upon it, so
28:14as not to confuse your fresh brain
28:16cortex nerve cells, which are just
28:18forming what? Neural networks. Yes,
28:22neural networks. I said last time, the
28:26more difficult the material you master,
28:28and I will repeat this every time, the
28:30more your neural networks will grow. I
28:35noticed last time, when I was teaching
28:37the autonomic nervous system, there
28:38were doctors sitting here. I also give
28:41lectures to doctors to make my life
28:43easier, so I don't have to lecture them
28:45separately; I've done everything for
28:46you. But it was a bit difficult for the
28:48students to master the autonomic
28:50nervous system. That was a professional
28:51level, a medical level. But if you've
28:54mastered this, then it means. A
29:00distinctive feature of motor aphasia is
29:02that if a patient follows instructions
29:04and understands me, but cannot speak.
29:09That is motor aphasia. Did you
29:11understand what sensory aphasia is? In
29:16sensory aphasia, the patient does not
29:18understand the doctor, does not
29:20understand you, and does not understand
29:22me. And they don't understand their own
29:28speech. Secondly, you see, they don't
29:32understand what they are saying and
29:33don't understand you. This is called
29:38sensory aphasia. And it's a lesion of
29:40the temporal lobe, Wernicke's area. But
29:44patients are encountered, this is
29:46already amnestic aphasia. The third,
29:49amnesia. What do we have here? A memory
29:53impairment. The patient knows what it's
29:58used for, but cannot name what he's
30:00talking about. You can draw with this,
30:08you can write with this, you can get
30:10information with this, yes, you can,
30:11but he cannot name it. He might say
30:16pencil, he might say it, but he won't
30:18say felt-tip pen. Or whatever else it's
30:20called, I forgot myself. Uh.
30:22Marker, now it's called a marker. In
30:24our day, it was a felt-tip pen. Whoever
30:26had a felt-tip pen was considered, oh,
30:29just super. That was the time. What is
30:33gnosis? The ability to recognize
30:36objects through sensory perception.
30:39Write this down. I have five senses:
30:44sight, hearing, smell, touch, and taste
30:47. And how is it easier to remember?
30:54From the top down, you know, eyes, ears
30:57, nose, and so on. And one more is
31:01highlighted under several questions.
31:04Intuition, feelings, foresight. We use
31:09these sense organs to know the world.
31:14Some of you have visual, some auditory,
31:16some olfactory, some, and so on. This
31:19is also connected to memory, right? At
31:21the same time, we can analyze memory
31:23here. Can we boast about our sight? I
31:27can't. We can boast about our hearing,
31:32we can boast about our smell, touch,
31:34taste. But nature evolved in such a way
31:42that it gave humans a cerebral cortex
31:44and left the rest. Here you go, think,
31:51and. But it didn't give animals
31:55consciousness, just sense organs. I
32:01probably told you about this, didn't I?
32:05What are animals? Animals have no
32:08consciousness, they have a body. What
32:12is an angel? An angel has higher
32:14consciousness; why is there no body?
32:17But the Almighty created us with both a
32:19body and consciousness. Is that clear?
32:22You should be proud that you are humans
32:24, not ants. Sense organs, sight—the
32:27best vision was given to certain
32:29species of animals. Yes. Who?
32:34The eagle, the hawk. They can see for
32:38several kilometers. The best hearing.
32:44Bats. The best hearing. They hear it
32:50too because of that. They don't see,
32:54but they detect it. Sharks smell blood
33:01from 100, 50 kilometers away. And when
33:07they studied this, it turns out they
33:09have these various electronic charges
33:11that detect these changes. Sometimes
33:15such people appear, perhaps one is
33:17sitting among you right now, staying
33:19quiet. Have you seen the movie "Perfume
33:22"?
33:23That is a masterpiece, you understand?
33:25That is a masterpiece. That is art. To
33:29create such a film. It's a movie about
33:32smells, you understand? He knows all
33:37the scents in the world, all the scents
33:38in the universe, and he wanted to
33:40create the perfect scent. But people
33:44didn't understand. He didn't want to
33:47kill; he just wanted to strip the skin.
33:52Not strip, but to extract the essence.
33:55But people didn't think, people didn't
33:56understand that. But in the end, he
33:59created it all. Yes. That’s why I’m
34:03saying, maybe one of you is sitting
34:05here. There are such people. There are
34:12people with hearing. Hearing doesn't
34:14just mean listening to rustles or music
34:16. What is music? Music is, in quotes,
34:21the voice of the Almighty. The ability
34:26to listen to music has great
34:27significance. Why does classical music
34:31go deep inside us? We feel it with our
34:34whole body, with our whole being, as
34:36they say. Total agnosia, when all
34:38sensory organs are affected, is almost
34:40incompatible with life, right? Visual
34:44agnosia, a disorder of object
34:46recognition through visual perception.
34:49What does agnosia mean? Lack of
34:52recognition. Auditory agnosia. Can you
34:56hear the rustle? Yes. Close your eyes.
35:03Can you hear what this is?
35:06A marker.
35:09Your hearing is normal. Congratulations
35:11. Close your eyes. Close your eyes.
35:20Don't open them. Don't open your eyes.
35:28What is this?
35:30Alright.
35:30Which one?
35:32I don't know.
35:33Color.
35:34I don't know.
35:35Yes.
35:38This whole hand. Don't open your eyes.
35:43No, I didn't open them.
35:45Whose hand is this?
35:46A girl's. A young lady's.
35:49Well done. Whose hand is this?
35:56This is a boy's.
35:58Oh no, a young lady's. A boy's. Wait.
36:01Don't open your eyes.
36:02I'm not opening them.
36:03Don't open your eyes.
36:05It seems to me it's a young lady's.
36:06Rough. This is a finger. Whose hand?
36:12A finger.
36:15Yes.
36:17And now
36:19a boy's.
36:20This is called stereognosis. Open your
36:23eyes. Stereognosis. Recognition of
36:27objects through sensory perception.
36:30Do you understand? If they don't
36:33recognize it through sensory perception
36:34,
36:35don't know what it is, we call it
36:37astereognosis. Gustatory agnosia.
36:41Recognition by taste. There is litmus
36:45paper. We check the taste and olfactory
36:50receptors of patients. The most
36:54interesting trick. When I was
37:00specializing in pain at the Sechenov
37:02Academy in Moscow, you know it, right,
37:04they gave us these test tubes. They
37:09told me there were scents in these test
37:11tubes. You have to recognize the smell
37:14of these test tubes, what scent is
37:15inside. And there was a monetary reward
37:18for that. The lecturer left, and we
37:21looked at the test. Well, a person is
37:24always curious, right? And down there,
37:28in small letters, it said raspberry,
37:30cherry. And we learned the order and
37:33started sniffing. Cherry, raspberry,
37:37apple. Someone almost even said, yeah,
37:43this is meat and so on. And there were
37:49so many scents, and we were there—
37:51there were 12 of us, and he says: "Yes,
37:53come here." And including me, I also
37:56took a sniff; naturally, we all know
37:58the order. And the question remains:
38:01who should be given the prize? We gave
38:05it correctly. And in the end, the
38:08professor says: "Comrade," he was still
38:10from the post-Soviet era. He says: "
38:13Comrades, this was a test of you."
38:16There was no scent there at all. They
38:18were empty. They were empty. We through
38:22imagination, since it was written, it
38:24meant there had to be a scent.
38:28And you actually feel it, you
38:30understand? But they were empty. This
38:36is called—there are also
38:38psychological tricks, yes, that were
38:40probably conducted on you too, in your
38:42first or second year, were they not?
38:45They were conducted on us in our first
38:46year and our sixth year. How have we
38:49actually grown in life? Well, there are
38:52those who have grown, and those who
38:54have remained the same, even though I
38:55did great. But memory still goes on,
38:58right? Practical, practically, let's
39:01master memory. Memory is one of the
39:04mental functions. One of the mental
39:06functions. Notice, I am not talking
39:09about a person, but mental functions
39:11and types of mental activity. Memory is
39:17one of the mental functions and types
39:19of mental activity intended to store,
39:21accumulate, and reproduce information.
39:28How many types of sensory organs does a
39:30human have? Which ones?
39:36Sight, hearing, smell, taste, and touch
39:39. There are just as many types of
39:42memory, although they distinguish motor
39:48, visual. Memory, visual memory,
39:51auditory memory, olfactory memory. And
39:55you can make use of this, too. And
39:58where is it used? In shops, in
40:04marketing, in hotels. They create a
40:09special scent there. This scent is only
40:11there. You encounter the scent, and
40:16somewhere you find a similar scent, and
40:18it draws you there. Do you understand?
40:25It's a neural network. Whoever has more
40:28neural networks will live.
40:31Qualitatively better. Qualitatively
40:35better. And a person should live not
40:38for the result, but for the process. Do
40:42you understand? A person is interested
40:45not in the result—the result is
40:47something you've achieved. You
40:48graduated from the institute, you got
40:50your diploma. For you, life is
40:52interesting as a process of learning.
40:55That is good. I always thought so, too.
40:58"Student years, my golden years," they
41:00say, but there is nothing golden about
41:02them. Every day I went to classes, to
41:05lectures, modules, exams—where is the
41:07gold? But when you graduate, it turns
41:10out they were indeed the golden years.
41:12What kinds of memory disorders are
41:13there? Hypomnesia, the very name
41:17implies reduced memory, yes,
41:19forgetfulness, hypermnesia. Hence, you
41:24might ask yourself: what is the memory
41:27capacity of a human? What is the memory
41:30capacity? This relates to the creation
41:33of artificial intelligence. Can we
41:36create artificial intelligence? Yes,
41:39they are being created. And some
41:42professions will be left by the wayside
41:44. They already are. Why? Because
41:47artificial intelligence handles it
41:49perfectly, even better. You know,
41:55it’s the same with the medical
41:57profession. The laboratory appeared.
41:59Run the tests, and you'll get all the
42:01norms and pathologies. Computed
42:03tomography. Computed tomography.
42:06Artificial intelligence will soon be
42:07reading the results. A human isn't
42:09needed there to determine that.
42:11Artificial intelligence. And that's why
42:17you should already think about which
42:18path to choose. The artificial one
42:23hasn't reached everywhere yet. It
42:31hasn't reached the elusive, the psyche,
42:33but it will. It will reach you, but it
42:37hasn't reached the psyche yet. That's
42:44why there are so many psychotherapists
42:46and psychiatrists in Europe, where
42:47everyone has their own family
42:49psychiatrist and so on. Why? Because a
42:56doctor in Europe doesn't interact with
42:57the patient. The patient arrives, takes
43:00tests, has a CT scan, and everything is
43:03ready with the results. And the
43:05treatment is prescribed: "Leave." I'm
43:08not scolding them. Civilization is
43:10doing the right thing. But who will ask
43:13about the soul? The head will ache
43:17forever. I gave a lecture to doctors
43:19yesterday about headaches. Right. The
43:22head aches, they take pills, and
43:24nothing helps. But the essence was
43:26right here. I am a neurologist myself,
43:29I'm pointing incorrectly. It’s spoken
43:32of right here. I love you with all my
43:35heart. The heart doesn't think, so it
43:40would be more correct to say: "I love
43:41you with all my brains."
43:47And just imagine, you go on a date, and
43:49he says: "I love you with my
43:51six-layered pyramidal tract and lists
43:58all six layers, 11 fields, areas and
44:03how many? 52 fields, right? Yes, that
44:11person has hypermnesia, don't marry him
44:13, he will remember everything. I must
44:19note that today the hippocampus is
44:20responsible for memory. We used to say
44:27that neurons don't regenerate. It turns
44:31out that hippocampal neurons do
44:33regenerate. That's good. It’s
44:36encouraging, the hippocampus. There is
44:40long-term memory, and besides this
44:41classification, there is short-term.
44:45Types of amnesia, retrograde amnesia.
44:50Let me list the types of amnesia, yes.
44:53Retrograde amnesia. Loss of memory for
44:56events preceding the acute period of
44:58the illness. Everything that preceded
45:01it, the patient has forgotten.
45:05Anterograde amnesia, loss of memory for
45:07events during the acute period of
45:09illness or not? Well done. No need to
45:13write it down mechanically. Don't
45:15believe me, believe yourself.
45:17Anterograde amnesia, loss of memory for
45:19events occurring after the onset of the
45:21illness. Congrade amnesia, loss of
45:26memory for events of the acute period
45:28of illness, fixation amnesia, the
45:30inability to remember current events.
45:36Fixation amnesia most often develops in
45:38those who like to consume alcohol. And
45:42thanks to this, perhaps, they quit
45:44later on. They say:" I don't remember
45:46anything. "Total amnesia is a loss of
45:49memory for events occurring before,
45:51during, and after the acute period of
45:53an illness. And, in general, every
45:57branch of neurology is a whole novel.
46:00What are movies built on? On what?
46:02Someone loses their memory and doesn't
46:04know where they are or who they are,
46:06and so on. To date, a polypeptide, in
46:11particular RNA, has been identified as
46:13responsible for memory. You must keep
46:19one more piece of information in mind.
46:21There is such a concept as biological
46:23memory. Remember, there is brain memory
46:25, and there is biological memory. Look,
46:27in a nutshell. Here you are, here is
46:31your mother, here is your father. Who
46:34does your mother have? A mother and a
46:36father. And so, what do we call this?
46:41A genetic tree, yes, and so on. Our
46:47body is biological memory. Your body,
46:52your cells in the DNA and RNA contain
46:54the memory of billions of years of the
46:56people who created you. Do you
47:00understand? And one of the most
47:05important parts of medicine is
47:06determining this, who needs what, and
47:08to find out what happened. Everyone
47:13wants to know their own history, but
47:14most want to know the future. But it is
47:18better to live
47:20here and now.

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