0:00:07.197,0:00:10.028
呢次係我第一次跟喺 Pinky the Mouse 後邊

0:00:10.028,0:00:12.045
（笑聲）

0:00:12.045,0:00:15.180
起碼講畀你知，科學係有趣嘅

0:00:15.180,0:00:19.814
科學係違背直覺嘅，令你前所未聞嘅

0:00:19.814,0:00:22.166
我接著落嚟呢十幾分鐘就係

0:00:22.166,0:00:26.142
同你講科學亦都可以拯救生命

0:00:26.142,0:00:28.636
我哋先嚟啲好消息

0:00:28.636,0:00:30.168
呢個好消息

0:00:30.168,0:00:33.168
同生物醫學研究改善咗好多個嚴重疾病

0:00:40.585,0:00:42.485
我哋就由白血病開始講

0:00:42.485,0:00:44.920
急性淋巴細胞性白血病，俗稱 ALL

0:00:44.920,0:00:47.995
係最常見嘅細路仔嘅癌症

0:00:47.995,0:00:49.927
當我仲係學生嘅時候

0:00:49.927,0:00:52.927
死亡率係大概 95%

0:00:52.927,0:00:57.462
25、30 年之後嘅今日，我哋講梗嘅係

0:00:57.462,0:01:00.538
呢種病嘅死亡率下降咗 85%

0:01:00.538,0:01:06.531
以致到每年有六千名兒童都救得返

0:01:07.290,0:01:10.206
如果你想要真係大嘅數字

0:01:10.206,0:01:13.891
我哋不妨嚟睇下心臟病嘅數字

0:01:13.891,0:01:16.028
以前，尤其是對四字頭的男性嚟講

0:01:16.028,0:01:17.487
心臟病係最犀利嘅殺手

0:01:17.487,0:01:22.010
依家，我哋睇到個數字跌咗 63%

0:01:22.901,0:01:27.039
令到每年 110 萬個心臟病人[br]可以救得返

0:01:28.426,0:01:31.489
好開心，愛滋病喺上個月

0:01:31.489,0:01:34.552
終於被定義為慢性病

0:01:34.552,0:01:37.616
即係話，一個人喺 20 歲時[br]感染到 HIV 嘅話

0:01:37.616,0:01:41.027
十幾年前會預期佢仲有[br]

0:01:41.027,0:01:43.492
幾個禮拜、幾個月，或者幾年嘅壽命

0:01:43.492,0:01:45.880
而依家[br]佢嘅預期壽命已經延長到幾十年

0:01:45.880,0:01:48.460
有可能要到佢六、七十歲

0:01:48.460,0:01:51.460
先會因為其他病而去世

0:01:51.460,0:01:58.021
現時最致命嘅幾種病未來都會有發展

0:01:58.036,0:02:01.367
尤其係其中一個[br]你可能唔知道嘅，就係中風

0:02:01.367,0:02:05.720
呢個病同心臟病[br]都係呢個國家嘅頭號殺手

0:02:05.720,0:02:07.351
我哋而家知道

0:02:07.351,0:02:11.801
只要呢個病嘅病人喺病發之內三粒鐘

0:02:11.801,0:02:13.998
可以送入急症室嘅話

0:02:13.998,0:02:18.661
大概有三成嘅人[br]可以喺冇殘疾嘅情況下出院

0:02:20.881,0:02:25.816
呢啲非常唔簡單嘅事、或者呢啲好消息

0:02:25.816,0:02:30.359
令我哋對疾病嘅認知提高咗

0:02:30.359,0:02:33.954
從而可以提早發現、介入

0:02:34.633,0:02:41.017
提早發現、介入就係[br]依啲個案可以醫得好嘅原因

0:02:41.017,0:02:44.883
同時反映生物醫學研究[br]

0:02:44.883,0:02:49.803
真係可以改變數以百萬嘅人嘅生命

0:02:49.803,0:02:53.268
但係好唔好彩，唔係全部都係好消息

0:02:53.268,0:02:57.669
我哋嚟講講另一個同自殺有關嘅故仔

0:02:57.669,0:03:00.876
咁當然啦，自殺本身唔係一種病

0:03:00.876,0:03:04.723
但佢會導致死亡

0:03:05.224,0:03:08.558
你可能冇發覺到佢有幾咁普遍

0:03:08.558,0:03:12.641
喺美國，每一年都有[br]38,000 宗自殺案件

0:03:12.641,0:03:15.416
亦即係話每 15 分鐘就有一單

0:03:15.416,0:03:19.542
呢個亦係 15 歲到 25 歲[br]年齡層嘅第三大死因

0:03:20.376,0:03:25.866
如果你知道國家嘅自殺率[br]比謀殺率多出一倍

0:03:25.866,0:03:29.068
同時自殺比交通事故死亡嘅人數[br]仲要多嘅時候

0:03:29.068,0:03:32.392
你就會知道呢件事係幾咁唔尋常

0:03:33.205,0:03:34.678
而家講到自殺

0:03:34.678,0:03:37.678
我哋就嚟講下疾病對自殺有咩影響

0:03:37.678,0:03:42.389
因為 90% 嘅自殺案件[br]都係同精神病有關

0:03:42.389,0:03:47.265
例如：抑鬱症、躁鬱症、精神分裂症

0:03:47.265,0:03:49.877
厭食、邊緣人格

0:03:49.877,0:03:53.210
有好多精神病都會導致自殺

0:03:53.210,0:03:56.813
而且呢啲精神病喺好早期就會出現

0:03:56.813,0:04:00.309
但係，呢啲病唔單止增加死亡風險

0:04:00.309,0:04:01.811
佢仲會增加病發風險

0:04:01.811,0:04:07.207
至於殘疾方面，你會睇到世界衛生組織

0:04:07.207,0:04:10.755
利用所謂「失能調整生命年」量度殘疾

0:04:10.755,0:04:13.183
但呢個其實只不過係

0:04:13.183,0:04:15.881
一種除咗經濟學家之外[br]冇人諗到嘅公式

0:04:15.881,0:04:18.289
呢條公式評估因為殘疾而造成嘅損失

0:04:21.289,0:04:23.099
正如你所見到

0:04:23.099,0:04:26.582
有 30% 嘅殘疾可以歸因於精神病

0:04:26.582,0:04:31.190
同中樞神經精神症候群

0:04:32.208,0:04:34.620
你可能覺得頭先講嘅嘢無理

0:04:34.620,0:04:37.513
我意思係話，癌症點睇[br]都比精神病嚴重得多

0:04:37.513,0:04:40.406
心臟病點睇都比精神病嚴重好多

0:04:40.406,0:04:43.700
但係，你可以睇到心臟病同埋癌症[br]喺名單度仲要排後啲

0:04:43.700,0:04:46.258
咁係因為我哋依家講梗嘅係殘疾

0:04:46.258,0:04:48.108
究竟係乜嘢令到精神病

0:04:48.108,0:04:50.627
譬如話精神分裂、躁鬱症，同埋抑鬱症

0:04:50.627,0:04:52.842
最終演變成殘疾呢？

0:04:52.842,0:04:55.806
點解佢哋喺個名單度係排第一？

0:04:55.806,0:04:57.548
咁，其實係有三個原因嘅

0:04:57.548,0:04:59.238
第一，就係佢哋非常之流行

0:04:59.238,0:05:04.993
五個人當中就有一個人[br]喺一生之中罹患其中一種精神病

0:05:04.993,0:05:09.429
第二，當然就係因為[br]當中有啲人因為個病而變咗殘疾

0:05:09.429,0:05:11.543
普遍率大概係 4% 到 5%

0:05:11.543,0:05:16.767
即二十個人當中就有一個

0:05:16.767,0:05:23.474
但係真正令到發病率咁高[br]令到死亡率咁高

0:05:23.474,0:05:26.544
係因為呢啲精神病喺生命好早期就出現

0:05:26.544,0:05:30.184
50% 嘅人喺 14 歲嘅時候有精神病

0:05:30.184,0:05:32.494
75% 喺 24 歲有

0:05:33.254,0:05:39.795
呢個同我哋認為導致發病同死亡嘅[br]癌症、心臟病、糖尿病、高血壓

0:05:39.795,0:05:46.868
——呢啲重大疾病，係好唔同

0:05:46.868,0:05:51.343
呢啲精神病確實係年輕人嘅慢性病

0:05:52.563,0:05:55.823
咁，我開頭同你哋講咗會有好消息

0:05:55.823,0:05:57.467
好明顯，呢個唔算好消息

0:05:57.467,0:06:01.407
呢個可以講係我工作裏邊[br]最困難嘅一部份

0:06:01.407,0:06:03.834
亦令我要好認真面對

0:06:03.834,0:06:10.791
因為我嘅工作要確保[br]我哋喺呢啲疾病上高有所進展

0:06:10.791,0:06:12.408
我為聯邦政府做嘢

0:06:12.408,0:06:15.291
亦即係為你哋做嘢，係你哋畀我人工

0:06:15.291,0:06:16.627
可能喺呢個時候

0:06:16.627,0:06:19.687
當你知道咗我係做咩嘅[br]又或者係我冇做咩嘅

0:06:19.687,0:06:21.188
你覺得你要炒我魷魚

0:06:21.188,0:06:22.830
而我係非常之明白嘅

0:06:22.840,0:06:26.019
但係，我想講，我之所以會喺呢度

0:06:26.019,0:06:27.904
就係想同你哋講

0:06:27.904,0:06:33.331
我哋對呢啲疾病嘅認知將會好唔同

0:06:33.331,0:06:39.304
今日講到嘅工作[br]會改變我哋對呢啲疾病嘅認知

0:06:39.304,0:06:45.366
而且既精彩，又帶嚟真正轉變

0:06:47.385,0:06:48.826
但我想講

0:06:48.826,0:06:54.002
最重要嘅改變發生喺概念上

0:06:56.375,0:07:01.762
到目前為止，我同你講嘅都係精神病

0:07:02.600,0:07:06.082
其實，「精神病」呢個詞依家已經過時

0:07:06.094,0:07:08.768
而且啲人認為無論係咩理由

0:07:08.768,0:07:15.208
用「行為疾病」嚟稱呼會比較政治正確

0:07:16.028,0:07:18.317
因為佢哋講到尾都係行為失常病

0:07:18.317,0:07:20.494
亦係精神上嘅疾病

0:07:20.494,0:07:22.383
但係我想提醒嘅係

0:07:22.383,0:07:29.623
呢兩個詞已經沿用咗一個世紀有多[br]其實限制咗我哋嘅發展

0:07:30.223,0:07:34.106
若然要有所發展

0:07:34.106,0:07:38.652
我哋就要將呢啲疾病諗成係腦部嘅疾病

0:07:39.672,0:07:42.202
嗱，而家你哋有啲人會諗：

0:07:42.202,0:07:44.747
「噢，天啊，又嚟啦。

0:07:44.747,0:07:47.203
我哋又要聽咩生化失調，

0:07:47.203,0:07:49.568
聽咩藥物嘅嘢，

0:07:49.568,0:07:52.580
或者聽咩簡化咗嘅概念，

0:07:52.580,0:07:57.711
按自己過去嘅經歷製作化學分子，

0:07:58.801,0:08:10.146
亦都可能借自己經驗去了解[br]抑鬱症或精神分裂症。」

0:08:11.517,0:08:13.131
當我哋講到大腦嘅時候

0:08:13.131,0:08:21.242
佢絕對唔係乜嘢單維度[br]簡單嘅嘢或者還原論

0:08:21.242,0:08:27.300
當然，呢個都係要睇下[br]你用咩規模、用咩範圍諗

0:08:27.300,0:08:32.443
但係呢個器官係超現實嘅複雜

0:08:34.872,0:08:40.368
而且無論你係想像緊[br]大腦皮質嘅一百億個神經元

0:08:40.368,0:08:43.488
又或者連接所有嘢嘅一百萬億個突觸

0:08:43.488,0:08:47.975
我哋依家先至啱啱開始知道點樣研究佢

0:08:47.975,0:08:51.261
我哋依家啱啱先開始嘗試搞清楚

0:08:51.261,0:08:58.220
我哋應該點樣理解[br]呢個咁複雜、負責信息處理嘅機器

0:08:58.220,0:09:04.940
同埋點樣用我哋嘅思想[br]去了解支持我哋有思想嘅大腦

0:09:04.940,0:09:08.209
其實進化真係同我哋開咗個大玩笑

0:09:08.209,0:09:13.967
我哋仲未有辦法自己研究返自己嘅大腦

0:09:13.967,0:09:17.192
但因為你今日會聽到嘅一啲技術

0:09:17.192,0:09:19.047
我哋終於有進展

0:09:19.047,0:09:21.829
開始將零碎嘅知識併合起嚟

0:09:21.829,0:09:25.642
你或者會覺得研究行為[br]或者認知能力好保險

0:09:25.642,0:09:28.750
因為你有實質嘅嘢可以觀察

0:09:28.750,0:09:31.379
而且行為同認知能力

0:09:31.379,0:09:39.109
相比起嘗試研究[br]呢個咁複雜、神祕嘅器官簡單得多

0:09:39.109,0:09:43.332
咁而家繼續我之前[br]同你哋講過嘅大腦疾病：

0:09:45.384,0:09:51.732
抑鬱症、強迫症、創傷後壓力症候群

0:09:51.732,0:09:57.758
雖然我哋未有辦法[br]可以深入了解呢啲病嘅病理

0:09:57.758,0:10:00.506
或者個腦點受呢啲病影響

0:10:00.545,0:10:05.851
但係我哋已經搵到一啲異常嘅神經連接

0:10:06.145,0:10:11.591
或者係患有呢啲病嘅病人[br]個腦嘅信息傳遞有咩差別

0:10:11.591,0:10:13.731
我哋叫呢個情況做「腦功能聯結圖譜」

0:10:13.731,0:10:17.499
你可以將「腦功能聯結圖譜」[br]當成係大腦嘅線路圖

0:10:17.499,0:10:20.479
我之後會再講多啲呢樣嘢

0:10:20.785,0:10:22.513
最重要嘅一點就係

0:10:22.513,0:10:29.913
當你開始研究心理病[br]即係五個人就有一個患上嘅病

0:10:29.918,0:10:34.543
你會發覺大腦嘅神經連接方式[br]可以好唔同

0:10:34.543,0:10:37.290
但係連接方式卻係有跡可尋

0:10:37.290,0:10:42.594
而且某啲連接方式就係[br]造成心理病嘅元兇

0:10:42.594,0:10:44.607
呢個同我哋平時認識嘅大腦疾病

0:10:44.607,0:10:48.081
例如亨丁頓舞蹈症、柏金遜症[br]或者阿茲海默症，有啲唔同

0:10:48.081,0:10:50.223
呢啲病之不過損壞你部份大腦皮質

0:10:50.223,0:10:53.054
但我哋而家講梗嘅問題係塞車[br]有時候係繞道

0:10:53.054,0:10:55.885
又或者係大腦線路本身就係咁樣連接

0:10:55.885,0:10:57.660
以至大腦本身點樣運作

0:10:57.660,0:11:01.548
如果你想嘅話，你可以攞心肌梗塞[br]即係心臟病

0:11:01.548,0:11:03.344
同心律不整嚟比較

0:11:03.344,0:11:05.334
心臟病表示有啲心臟組織死咗

0:11:05.334,0:11:08.733
而心律不整就係因為[br]心臟內部溝通有問題

0:11:08.733,0:11:11.032
令到成個器官冇辦法運作正常

0:11:11.032,0:11:12.313
兩個病都可以致命

0:11:12.313,0:11:15.130
但係，淨係得一個有著重大毛病

0:11:15.134,0:11:16.794
當我哋諗到呢啲病嘅時候

0:11:16.794,0:11:22.223
我哋不妨深入啲睇下[br]其中一個病，精神分裂症

0:11:22.223,0:11:28.250
因為我認為呢種病有助明白[br]點解要將精神病諗成係大腦疾病

0:11:28.250,0:11:33.878
精神分裂症係一種包含精神病症狀嘅病

0:11:33.878,0:11:37.320
而我哋就係用呢啲症狀去診斷呢種病

0:11:37.320,0:11:39.565
症狀可以係︰妄想症、幻覺、諗嘢有問題

0:11:39.565,0:11:41.014
同埋專注力問題

0:11:41.014,0:11:44.174
患者通常係 18 至 24 歲

0:11:45.753,0:11:49.025
呢幾張係國家心理衛生研究院嘅[br]Judy Rapoport 同佢啲同事

0:11:49.025,0:11:53.103
喺研究早發性精神分裂症細路仔嘅時候

0:11:53.103,0:11:55.241
掃描出嚟嘅

0:11:55.241,0:12:00.150
你可以睇到上高，紅、橙、黃嘅地方

0:12:00.159,0:12:02.291
灰色神經組織比較少

0:12:02.291,0:12:04.259
佢哋追查呢啲細路仔五年

0:12:04.259,0:12:06.517
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[br]或者顳上回

0:12:12.479,0:12:15.672
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

0:12:19.696,0:12:21.347
如果你想將佢諗得實質啲

0:12:21.347,0:12:23.750
你可以將正常發育諗成係皮質質量減少

0:12:23.750,0:12:25.896
或者皮質灰色神經組織流失

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而精神分裂就係[br]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[br]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

0:12:36.525,0:12:41.339
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

0:12:43.021,0:12:44.420
但係，睇真啲

0:12:44.420,0:12:48.585
你會發覺佢哋已經過咗另一個臨界點

0:12:48.585,0:12:51.677
佢哋係好早期嘅時候[br]就過咗個大腦嘅臨界點

0:12:51.686,0:12:55.065
應該唔使等 22 或者 20 歲

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而係 15 或者 16 歲嘅時候

0:12:57.013,0:13:00.943
你就可以開始睇到[br]大腦嘅發育軌跡已經好唔同

0:13:00.943,0:13:04.990
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

0:13:10.804,0:13:13.736
我哋從阿茲海默症、柏金遜症[br]亨丁頓舞蹈症知道

0:13:13.736,0:13:20.494
大腦疾病要起碼有十年長[br]行為先至會有變化

0:13:20.494,0:13:27.694
我哋而家所用嘅工具[br]可以畀我哋提早好多偵測到腦嘅變化

0:13:27.694,0:13:34.066
早到喺症狀出現之前就偵測得到

0:13:34.066,0:13:37.497
但係最重要嘅[br]我哋返返去我哋一開始嗰度

0:13:37.497,0:13:44.439
醫學界嘅好消息就係提早發現、介入

0:13:44.439,0:13:48.441
如果我哋等到心臟病發個陣時先救

0:13:48.441,0:13:53.837
我哋呢個國家就會有[br]110 萬條生命白白冇咗

0:13:53.837,0:13:56.736
呢個就正正係我哋而家所做嘅嘢

0:13:56.736,0:14:01.074
因為我哋認為一個人[br]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[br]出咗嚟先做到嘢

0:14:07.563,0:14:11.444
所以呢樣唔係提早偵測或者介入

0:14:11.538,0:14:13.868
我想講嘅係[br]我哋仲未完全準備好咁樣做

0:14:13.868,0:14:15.528
我哋冇全部嘅知識

0:14:15.528,0:14:18.871
我哋甚至乎唔知道個工具會係咩

0:14:18.871,0:14:23.016
亦都唔知道喺每一個案件中[br]我哋應該準確搵咩嘢

0:14:23.016,0:14:27.736
先至可以喺行為症狀浮現之前[br]就可以知道一個人有心理病

0:14:27.746,0:14:30.496
但係，頭先講到嘅嘢[br]提示咗我哋應該點樣去諗

0:14:30.496,0:14:31.777
同埋應該點樣走

0:14:31.777,0:14:33.625
我哋會不會好快就會到嗰度？

0:14:33.625,0:14:37.519
我認為呢樣嘢[br]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

0:14:40.033,0:14:43.511
一個就著觀念轉變同埋科技進步[br]諗咗好多嘢嘅人

0:14:43.511,0:14:46.647
講到呢樣嘢會點發生，佢就係蓋茨︰

0:14:46.647,0:14:50.126
「我哋永遠都高估咗[br]未來兩年會發生嘅變化

0:14:50.126,0:14:55.666
並且低估咗未來十年會發生嘅變化。」

0:14:55.666,0:14:57.377
多謝大家

0:14:57.377,0:14:59.111
（掌聲）