1
00:00:07,197 --> 00:00:10,028
呢次係我第一次跟喺 Pinky the Mouse 後邊

2
00:00:10,028 --> 00:00:12,045
（笑聲）

3
00:00:12,045 --> 00:00:15,180
起碼講畀你知，科學係有趣嘅

4
00:00:15,180 --> 00:00:19,814
科學係違背直覺嘅，令你前所未聞嘅

5
00:00:19,814 --> 00:00:22,166
我接著落嚟呢十幾分鐘就係

6
00:00:22,166 --> 00:00:26,142
同你講科學亦都可以拯救生命

7
00:00:26,142 --> 00:00:28,636
我哋先嚟啲好消息

8
00:00:28,636 --> 00:00:30,168
呢個好消息

9
00:00:30,168 --> 00:00:33,168
同生物醫學研究改善咗好多個嚴重疾病

10
00:00:40,585 --> 00:00:42,485
我哋就由白血病開始講

11
00:00:42,485 --> 00:00:44,920
急性淋巴細胞性白血病，俗稱 ALL

12
00:00:44,920 --> 00:00:47,995
係最常見嘅細路仔嘅癌症

13
00:00:47,995 --> 00:00:49,927
當我仲係學生嘅時候

14
00:00:49,927 --> 00:00:52,927
死亡率係大概 95%

15
00:00:52,927 --> 00:00:57,462
25、30 年之後嘅今日，我哋講梗嘅係

16
00:00:57,462 --> 00:01:00,538
呢種病嘅死亡率下降咗 85%

17
00:01:00,538 --> 00:01:06,531
以致到每年有六千名兒童都救得返

18
00:01:07,290 --> 00:01:10,206
如果你想要真係大嘅數字

19
00:01:10,206 --> 00:01:13,891
我哋不妨嚟睇下心臟病嘅數字

20
00:01:13,891 --> 00:01:16,028
以前，尤其是對四字頭的男性嚟講

21
00:01:16,028 --> 00:01:17,487
心臟病係最犀利嘅殺手

22
00:01:17,487 --> 00:01:22,010
依家，我哋睇到個數字跌咗 63%

23
00:01:22,901 --> 00:01:27,039
令到每年 110 萬個心臟病人
可以救得返

24
00:01:28,426 --> 00:01:31,489
好開心，愛滋病喺上個月

25
00:01:31,489 --> 00:01:34,552
終於被定義為慢性病

26
00:01:34,552 --> 00:01:37,616
即係話，一個人喺 20 歲時
感染到 HIV 嘅話

27
00:01:37,616 --> 00:01:41,027
十幾年前會預期佢仲有


28
00:01:41,027 --> 00:01:43,492
幾個禮拜、幾個月，或者幾年嘅壽命

29
00:01:43,492 --> 00:01:45,880
而依家
佢嘅預期壽命已經延長到幾十年

30
00:01:45,880 --> 00:01:48,460
有可能要到佢六、七十歲

31
00:01:48,460 --> 00:01:51,460
先會因為其他病而去世

32
00:01:51,460 --> 00:01:58,021
現時最致命嘅幾種病未來都會有發展

33
00:01:58,036 --> 00:02:01,367
尤其係其中一個
你可能唔知道嘅，就係中風

34
00:02:01,367 --> 00:02:05,720
呢個病同心臟病
都係呢個國家嘅頭號殺手

35
00:02:05,720 --> 00:02:07,351
我哋而家知道

36
00:02:07,351 --> 00:02:11,801
只要呢個病嘅病人喺病發之內三粒鐘

37
00:02:11,801 --> 00:02:13,998
可以送入急症室嘅話

38
00:02:13,998 --> 00:02:18,661
大概有三成嘅人
可以喺冇殘疾嘅情況下出院

39
00:02:20,881 --> 00:02:25,816
呢啲非常唔簡單嘅事、或者呢啲好消息

40
00:02:25,816 --> 00:02:30,359
令我哋對疾病嘅認知提高咗

41
00:02:30,359 --> 00:02:33,954
從而可以提早發現、介入

42
00:02:34,633 --> 00:02:41,017
提早發現、介入就係
依啲個案可以醫得好嘅原因

43
00:02:41,017 --> 00:02:44,883
同時反映生物醫學研究


44
00:02:44,883 --> 00:02:49,803
真係可以改變數以百萬嘅人嘅生命

45
00:02:49,803 --> 00:02:53,268
但係好唔好彩，唔係全部都係好消息

46
00:02:53,268 --> 00:02:57,669
我哋嚟講講另一個同自殺有關嘅故仔

47
00:02:57,669 --> 00:03:00,876
咁當然啦，自殺本身唔係一種病

48
00:03:00,876 --> 00:03:04,723
但佢會導致死亡

49
00:03:05,224 --> 00:03:08,558
你可能冇發覺到佢有幾咁普遍

50
00:03:08,558 --> 00:03:12,641
喺美國，每一年都有
38,000 宗自殺案件

51
00:03:12,641 --> 00:03:15,416
亦即係話每 15 分鐘就有一單

52
00:03:15,416 --> 00:03:19,542
呢個亦係 15 歲到 25 歲
年齡層嘅第三大死因

53
00:03:20,376 --> 00:03:25,866
如果你知道國家嘅自殺率
比謀殺率多出一倍

54
00:03:25,866 --> 00:03:29,068
同時自殺比交通事故死亡嘅人數
仲要多嘅時候

55
00:03:29,068 --> 00:03:32,392
你就會知道呢件事係幾咁唔尋常

56
00:03:33,205 --> 00:03:34,678
而家講到自殺

57
00:03:34,678 --> 00:03:37,678
我哋就嚟講下疾病對自殺有咩影響

58
00:03:37,678 --> 00:03:42,389
因為 90% 嘅自殺案件
都係同精神病有關

59
00:03:42,389 --> 00:03:47,265
例如：抑鬱症、躁鬱症、精神分裂症

60
00:03:47,265 --> 00:03:49,877
厭食、邊緣人格

61
00:03:49,877 --> 00:03:53,210
有好多精神病都會導致自殺

62
00:03:53,210 --> 00:03:56,813
而且呢啲精神病喺好早期就會出現

63
00:03:56,813 --> 00:04:00,309
但係，呢啲病唔單止增加死亡風險

64
00:04:00,309 --> 00:04:01,811
佢仲會增加病發風險

65
00:04:01,811 --> 00:04:07,207
至於殘疾方面，你會睇到世界衛生組織

66
00:04:07,207 --> 00:04:10,755
利用所謂「失能調整生命年」量度殘疾

67
00:04:10,755 --> 00:04:13,183
但呢個其實只不過係

68
00:04:13,183 --> 00:04:15,881
一種除咗經濟學家之外
冇人諗到嘅公式

69
00:04:15,881 --> 00:04:18,289
呢條公式評估因為殘疾而造成嘅損失

70
00:04:21,289 --> 00:04:23,099
正如你所見到

71
00:04:23,099 --> 00:04:26,582
有 30% 嘅殘疾可以歸因於精神病

72
00:04:26,582 --> 00:04:31,190
同中樞神經精神症候群

73
00:04:32,208 --> 00:04:34,620
你可能覺得頭先講嘅嘢無理

74
00:04:34,620 --> 00:04:37,513
我意思係話，癌症點睇
都比精神病嚴重得多

75
00:04:37,513 --> 00:04:40,406
心臟病點睇都比精神病嚴重好多

76
00:04:40,406 --> 00:04:43,700
但係，你可以睇到心臟病同埋癌症
喺名單度仲要排後啲

77
00:04:43,700 --> 00:04:46,258
咁係因為我哋依家講梗嘅係殘疾

78
00:04:46,258 --> 00:04:48,108
究竟係乜嘢令到精神病

79
00:04:48,108 --> 00:04:50,627
譬如話精神分裂、躁鬱症，同埋抑鬱症

80
00:04:50,627 --> 00:04:52,842
最終演變成殘疾呢？

81
00:04:52,842 --> 00:04:55,806
點解佢哋喺個名單度係排第一？

82
00:04:55,806 --> 00:04:57,548
咁，其實係有三個原因嘅

83
00:04:57,548 --> 00:04:59,238
第一，就係佢哋非常之流行

84
00:04:59,238 --> 00:05:04,993
五個人當中就有一個人
喺一生之中罹患其中一種精神病

85
00:05:04,993 --> 00:05:09,429
第二，當然就係因為
當中有啲人因為個病而變咗殘疾

86
00:05:09,429 --> 00:05:11,543
普遍率大概係 4% 到 5%

87
00:05:11,543 --> 00:05:16,767
即二十個人當中就有一個

88
00:05:16,767 --> 00:05:23,474
但係真正令到發病率咁高
令到死亡率咁高

89
00:05:23,474 --> 00:05:26,544
係因為呢啲精神病喺生命好早期就出現

90
00:05:26,544 --> 00:05:30,184
50% 嘅人喺 14 歲嘅時候有精神病

91
00:05:30,184 --> 00:05:32,494
75% 喺 24 歲有

92
00:05:33,254 --> 00:05:39,795
呢個同我哋認為導致發病同死亡嘅
癌症、心臟病、糖尿病、高血壓

93
00:05:39,795 --> 00:05:46,868
——呢啲重大疾病，係好唔同

94
00:05:46,868 --> 00:05:51,343
呢啲精神病確實係年輕人嘅慢性病

95
00:05:52,563 --> 00:05:55,823
咁，我開頭同你哋講咗會有好消息

96
00:05:55,823 --> 00:05:57,467
好明顯，呢個唔算好消息

97
00:05:57,467 --> 00:06:01,407
呢個可以講係我工作裏邊
最困難嘅一部份

98
00:06:01,407 --> 00:06:03,834
亦令我要好認真面對

99
00:06:03,834 --> 00:06:10,791
因為我嘅工作要確保
我哋喺呢啲疾病上高有所進展

100
00:06:10,791 --> 00:06:12,408
我為聯邦政府做嘢

101
00:06:12,408 --> 00:06:15,291
亦即係為你哋做嘢，係你哋畀我人工

102
00:06:15,291 --> 00:06:16,627
可能喺呢個時候

103
00:06:16,627 --> 00:06:19,687
當你知道咗我係做咩嘅
又或者係我冇做咩嘅

104
00:06:19,687 --> 00:06:21,188
你覺得你要炒我魷魚

105
00:06:21,188 --> 00:06:22,830
而我係非常之明白嘅

106
00:06:22,840 --> 00:06:26,019
但係，我想講，我之所以會喺呢度

107
00:06:26,019 --> 00:06:27,904
就係想同你哋講

108
00:06:27,904 --> 00:06:33,331
我哋對呢啲疾病嘅認知將會好唔同

109
00:06:33,331 --> 00:06:39,304
今日講到嘅工作
會改變我哋對呢啲疾病嘅認知

110
00:06:39,304 --> 00:06:45,366
而且既精彩，又帶嚟真正轉變

111
00:06:47,385 --> 00:06:48,826
但我想講

112
00:06:48,826 --> 00:06:54,002
最重要嘅改變發生喺概念上

113
00:06:56,375 --> 00:07:01,762
到目前為止，我同你講嘅都係精神病

114
00:07:02,600 --> 00:07:06,082
其實，「精神病」呢個詞依家已經過時

115
00:07:06,094 --> 00:07:08,768
而且啲人認為無論係咩理由

116
00:07:08,768 --> 00:07:15,208
用「行為疾病」嚟稱呼會比較政治正確

117
00:07:16,028 --> 00:07:18,317
因為佢哋講到尾都係行為失常病

118
00:07:18,317 --> 00:07:20,494
亦係精神上嘅疾病

119
00:07:20,494 --> 00:07:22,383
但係我想提醒嘅係

120
00:07:22,383 --> 00:07:29,623
呢兩個詞已經沿用咗一個世紀有多
其實限制咗我哋嘅發展

121
00:07:30,223 --> 00:07:34,106
若然要有所發展

122
00:07:34,106 --> 00:07:38,652
我哋就要將呢啲疾病諗成係腦部嘅疾病

123
00:07:39,672 --> 00:07:42,202
嗱，而家你哋有啲人會諗：

124
00:07:42,202 --> 00:07:44,747
「噢，天啊，又嚟啦。

125
00:07:44,747 --> 00:07:47,203
我哋又要聽咩生化失調，

126
00:07:47,203 --> 00:07:49,568
聽咩藥物嘅嘢，

127
00:07:49,568 --> 00:07:52,580
或者聽咩簡化咗嘅概念，

128
00:07:52,580 --> 00:07:57,711
按自己過去嘅經歷製作化學分子，

129
00:07:58,801 --> 00:08:10,146
亦都可能借自己經驗去了解
抑鬱症或精神分裂症。」

130
00:08:11,517 --> 00:08:13,131
當我哋講到大腦嘅時候

131
00:08:13,131 --> 00:08:21,242
佢絕對唔係乜嘢單維度
簡單嘅嘢或者還原論

132
00:08:21,242 --> 00:08:27,300
當然，呢個都係要睇下
你用咩規模、用咩範圍諗

133
00:08:27,300 --> 00:08:32,443
但係呢個器官係超現實嘅複雜

134
00:08:34,872 --> 00:08:40,368
而且無論你係想像緊
大腦皮質嘅一百億個神經元

135
00:08:40,368 --> 00:08:43,488
又或者連接所有嘢嘅一百萬億個突觸

136
00:08:43,488 --> 00:08:47,975
我哋依家先至啱啱開始知道點樣研究佢

137
00:08:47,975 --> 00:08:51,261
我哋依家啱啱先開始嘗試搞清楚

138
00:08:51,261 --> 00:08:58,220
我哋應該點樣理解
呢個咁複雜、負責信息處理嘅機器

139
00:08:58,220 --> 00:09:04,940
同埋點樣用我哋嘅思想
去了解支持我哋有思想嘅大腦

140
00:09:04,940 --> 00:09:08,209
其實進化真係同我哋開咗個大玩笑

141
00:09:08,209 --> 00:09:13,967
我哋仲未有辦法自己研究返自己嘅大腦

142
00:09:13,967 --> 00:09:17,192
但因為你今日會聽到嘅一啲技術

143
00:09:17,192 --> 00:09:19,047
我哋終於有進展

144
00:09:19,047 --> 00:09:21,829
開始將零碎嘅知識併合起嚟

145
00:09:21,829 --> 00:09:25,642
你或者會覺得研究行為
或者認知能力好保險

146
00:09:25,642 --> 00:09:28,750
因為你有實質嘅嘢可以觀察

147
00:09:28,750 --> 00:09:31,379
而且行為同認知能力

148
00:09:31,379 --> 00:09:39,109
相比起嘗試研究
呢個咁複雜、神祕嘅器官簡單得多

149
00:09:39,109 --> 00:09:43,332
咁而家繼續我之前
同你哋講過嘅大腦疾病：

150
00:09:45,384 --> 00:09:51,732
抑鬱症、強迫症、創傷後壓力症候群

151
00:09:51,732 --> 00:09:57,758
雖然我哋未有辦法
可以深入了解呢啲病嘅病理

152
00:09:57,758 --> 00:10:00,506
或者個腦點受呢啲病影響

153
00:10:00,545 --> 00:10:05,851
但係我哋已經搵到一啲異常嘅神經連接

154
00:10:06,145 --> 00:10:11,591
或者係患有呢啲病嘅病人
個腦嘅信息傳遞有咩差別

155
00:10:11,591 --> 00:10:13,731
我哋叫呢個情況做「腦功能聯結圖譜」

156
00:10:13,731 --> 00:10:17,499
你可以將「腦功能聯結圖譜」
當成係大腦嘅線路圖

157
00:10:17,499 --> 00:10:20,479
我之後會再講多啲呢樣嘢

158
00:10:20,785 --> 00:10:22,513
最重要嘅一點就係

159
00:10:22,513 --> 00:10:29,913
當你開始研究心理病
即係五個人就有一個患上嘅病

160
00:10:29,918 --> 00:10:34,543
你會發覺大腦嘅神經連接方式
可以好唔同

161
00:10:34,543 --> 00:10:37,290
但係連接方式卻係有跡可尋

162
00:10:37,290 --> 00:10:42,594
而且某啲連接方式就係
造成心理病嘅元兇

163
00:10:42,594 --> 00:10:44,607
呢個同我哋平時認識嘅大腦疾病

164
00:10:44,607 --> 00:10:48,081
例如亨丁頓舞蹈症、柏金遜症
或者阿茲海默症，有啲唔同

165
00:10:48,081 --> 00:10:50,223
呢啲病之不過損壞你部份大腦皮質

166
00:10:50,223 --> 00:10:53,054
但我哋而家講梗嘅問題係塞車
有時候係繞道

167
00:10:53,054 --> 00:10:55,885
又或者係大腦線路本身就係咁樣連接

168
00:10:55,885 --> 00:10:57,660
以至大腦本身點樣運作

169
00:10:57,660 --> 00:11:01,548
如果你想嘅話，你可以攞心肌梗塞
即係心臟病

170
00:11:01,548 --> 00:11:03,344
同心律不整嚟比較

171
00:11:03,344 --> 00:11:05,334
心臟病表示有啲心臟組織死咗

172
00:11:05,334 --> 00:11:08,733
而心律不整就係因為
心臟內部溝通有問題

173
00:11:08,733 --> 00:11:11,032
令到成個器官冇辦法運作正常

174
00:11:11,032 --> 00:11:12,313
兩個病都可以致命

175
00:11:12,313 --> 00:11:15,130
但係，淨係得一個有著重大毛病

176
00:11:15,134 --> 00:11:16,794
當我哋諗到呢啲病嘅時候

177
00:11:16,794 --> 00:11:22,223
我哋不妨深入啲睇下
其中一個病，精神分裂症

178
00:11:22,223 --> 00:11:28,250
因為我認為呢種病有助明白
點解要將精神病諗成係大腦疾病

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00:11:28,250 --> 00:11:33,878
精神分裂症係一種包含精神病症狀嘅病

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而我哋就係用呢啲症狀去診斷呢種病

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症狀可以係︰妄想症、幻覺、諗嘢有問題

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同埋專注力問題

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患者通常係 18 至 24 歲

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呢幾張係國家心理衛生研究院嘅
Judy Rapoport 同佢啲同事

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喺研究早發性精神分裂症細路仔嘅時候

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掃描出嚟嘅

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你可以睇到上高，紅、橙、黃嘅地方

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灰色神經組織比較少

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佢哋追查呢啲細路仔五年

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將佢哋同同年紀嘅細路比較

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你可以發現

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特別喺好似背外側前額葉皮層
或者顳上回

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都有大量嘅灰色神經組織損失

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呢個發現好重要

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如果你做研究模型嘅話，個發現好重要

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如果你想將佢諗得實質啲

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你可以將正常發育諗成係皮質質量減少

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或者皮質灰色神經組織流失

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而精神分裂就係
呢啲灰色神經組織損失得太多

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當你損失到一定數量嘅時候
過咗一個點嘅時候

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我哋就界定咗呢個人有呢個病

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因為佢哋有幻覺同埋妄想嘅症狀

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呢個係我哋可以觀察到嘅

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但係，睇真啲

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你會發覺佢哋已經過咗另一個臨界點

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佢哋係好早期嘅時候
就過咗個大腦嘅臨界點

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應該唔使等 22 或者 20 歲

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而係 15 或者 16 歲嘅時候

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你就可以開始睇到
大腦嘅發育軌跡已經好唔同

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但行為方面就冇

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點解呢個好重要呢？

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第一，因為喺腦疾病病人當中

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行為會係最遲受到影響嘅一樣嘢

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我哋從阿茲海默症、柏金遜症
亨丁頓舞蹈症知道

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大腦疾病要起碼有十年長
行為先至會有變化

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我哋而家所用嘅工具
可以畀我哋提早好多偵測到腦嘅變化

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早到喺症狀出現之前就偵測得到

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但係最重要嘅
我哋返返去我哋一開始嗰度

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醫學界嘅好消息就係提早發現、介入

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如果我哋等到心臟病發個陣時先救

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我哋呢個國家就會有
110 萬條生命白白冇咗

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呢個就正正係我哋而家所做嘅嘢

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因為我哋認為一個人
只要有是旦一種呢啲腦疾病

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就會有行為障礙症

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我哋只能夠等到行為徵狀
出咗嚟先做到嘢

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所以呢樣唔係提早偵測或者介入

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我想講嘅係
我哋仲未完全準備好咁樣做

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我哋冇全部嘅知識

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我哋甚至乎唔知道個工具會係咩

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亦都唔知道喺每一個案件中
我哋應該準確搵咩嘢

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先至可以喺行為症狀浮現之前
就可以知道一個人有心理病

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但係，頭先講到嘅嘢
提示咗我哋應該點樣去諗

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同埋應該點樣走

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我哋會不會好快就會到嗰度？

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我認為呢樣嘢
喺未來幾年係會發生嘅

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但係，喺我結束之前，我想引用

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一個就著觀念轉變同埋科技進步
諗咗好多嘢嘅人

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講到呢樣嘢會點發生，佢就係蓋茨︰

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「我哋永遠都高估咗
未來兩年會發生嘅變化

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並且低估咗未來十年會發生嘅變化。」

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多謝大家

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（掌聲）