• Changing Brains

    Zazetsky & Luria

    Way back in 2011, I reviewed Norman Doidge’s incredibly inspiring book The Brain That Changes Itself. It tells remarkable stories of various individuals who – long before the idea of adult human neuroplasticity had become widely accepted – managed to defy the odds to overcome adversity by physically changing their own brains. One man was able to regain full control of his speech, movements and faculties, ultimately returning to his beloved lecturing job just a few years after a catastrophic stroke in his mid-60’s. He regained the ability to move and speak fluidly, having been completely paralysed for many months down one side of his body, thanks to years of intensive, daily (and mind-numbingly boring) rehabilitation exercises dreamed up by his neuroscientist son.

    One woman – Barbara Arrowsmith-Young – managed to overcome several profound, life-long, learning disabilities; also using brain training approaches of her own design. She was inspired to give it a go by the work of trailblazing Soviet neuropsychologist Aleksandr Luria (on right of photo) investigating brain injured war veterans (on left of photo). These seemingly miraculous achievements enabled patients to use the brain’s tremendous potential for change, even during adulthood, to defy the advice of medical experts of the day and take control of their own fates. In defense of the experts of the time, what these people had managed to do was unprecedented. Regaining lost cognitive capacities, or further developing those that had never flourished in the first place, had simply never been documented at that point in time, so it had been presumed impossible.

    Arrowsmith-Young has written her own account of her adventures in neuroplasticity

    Each and every time the key ingredients to success in the brain re-training stakes was always: tireless adhesion to gruelingly intensive, daily, long-term training regimes for the brain trainee themselves. The impulse to take a leap of faith to try something that, while seemingly logical, was both completely unproven and deemed by most experts to be a fool’s errand. These interventions yielded benefits either by retraining intact brain areas to take over the function of permanently damaged parts, or by improving the processing capacity of certain chronically under-served brain areas. In the case of the young woman who fixed her own learning disabilities, her difficulties with reading clock faces inspired her to developed clocks with hands not just for the hours, minutes and seconds, but also for the days, weeks, months, years, decades and so on.

    It is now a broadly-accepted fact people can change their brains for the better. Not everything that is touted as brain training actually works of course. Certainly the Mozart Effect is a load of old nonsense. The Tellytubbies project didn’t exactly go to plan. And the manufacturers of brain training apps are apt to vastly overstate the benefits of their rather drab games. Yet is an inviolable truth that, through sheer grit and determination, many people have now overcome incredible neurological adversity, which means that for those with brains that are functioning pretty well in the first place some desirable brain changes must surely also be achievable.

    The Mozart Effect – a load of old nonsense

    Indeed, as described in my first book – Sort Your Brain Out – when aspiring cabbies want to drive one of London’s famous Hackney Carriages (a.k.a. a black cab) they memorise all the major routes and landmarks within a 6 mile radius of central London to pass an exam known as: The Knowledge. In so doing, they increase the density of synapses packed into the rear-most parts of their hippocampi: brain areas critical to their ability to successfully navigate the complexities of London’s sprawling road network, without having to look at map ever again! The original brain imaging studies demonstrating that hippocampal grey matter actually physically changes when comparing drivers’ brains before versus after The Knowledge were published back in 2011.

    Sort Your Brain Out

    These findings were subsequently replicated and extended further by comparing taxi drivers brains to bus drivers brains; re-scanning taxi drivers after retirement etc. Eventually these follow up studies convinced even the most hardened skeptics that neuroplasticity in adults might genuinely be the real deal. Broader acceptance of the idea that adult humans aren’t stuck with whatever brains they end up with by the end of adolescence is empowering. That it is within everyone’s power to affect physical changes to the fabric of their own brain, can genuinely inspire people to take the necessary steps to elevate themselves. But, along the way the simplicity of this message has become corrupted by a combination of those wishing to profit from it, and those pushing back against the hyperbole.

    Juggling changes your brain

    The optimism that greeted these early studies was somewhat dampened when the results of studies into other areas of skill acquisition turned out to be much more underwhelming. For example, juggling induces surprisingly fast (but later, it transpires, relatively short-lived) changes in brain areas involved in processing movements of visual objects in space. So while quick brain changes were possible in the first week, beyond that juggling didn’t really seem to confer any benefits. Add into the mix the emergence of various brain training products trying to exploit the newfangled idea that certain games might improve specific cognitive capacities to a degree that delivers benefits in real life, but not a shred of data to prove this, and the baby of neuroplasticity was on the verge of being thrown out with the dirty brain training bathwater.

    Let’s not throw the neuroplasticity baby out with the bathwater

    A large scale study conducted jointly between a couple of high profile Oxbridge scientists failed to show any meaningful benefits from the brain training games and training regime they devised. That is what happened in that widely broadcast news story. But as SCIENTISTS FAIL TO SHOW MUCH is a pretty lousy headline the BBC went instead for: BRAIN TRAINING GAMES DON’T MAKE US SMARTER. I’ve ranted elsewhere about this so I won’t take up any more precious column inches here by repeating myself, save to point out that in the eyes of the general British public the adult neuroplasticity movement was another case of emperor’s new clothes. To redress this cruel imbalance – I offer a few pearls from the the neuroplasticity literature with a view to convincing you that despite the various cases of snake oilsmanship out there – brain’s really CAN physically change in a way that propels you positively forward in life, if only you can adopt the appropriate lifestyle.

    I am of the opinion that, despite the various setbacks, it is still worth keeping an eye on the research hitting the science press that investigates adult human neuroplasticity. It has such huge potential in terms of motivating people to adopt a more positive lifestyle that I find myself determined to wait for a clearer picture to emerge on this potentially revolutionary insight into the nature of the human brain. So this month’s blog is an update on some of the recent published research investigating the potential for neuroplastic change in the adult human brain.

    Keyboard musicians change their brains

    Musical people were among the first to come under the scrutiny of scientists looking for the tell-tale signs of neuroplastic change in the brains of professional versus amateur musicians (e.g. Gaser and Schlaug, 2003). Since then the timing of the grey matter changes in musicians brains have been captured by Groussard et al (2014). They demonstrated observable changes in the left hippocampus and right superior/middle frontal regions after just a few years, but only after more extensive musical training were further structural changes observed in the right insula, supplementary motor area and left superior temporal cortex. Another recent study demonstrated that pro keyboard players brains exhibit clear differences in the volume of gray matter in brain areas dedicated to:

    1) precision control over movements (operating the keyboard, striking correct keys with appropriate timing, rhythm, tempo, expression etc)

    2) sound-processing brain areas (enabling efficient conversion of vibrations into the tones, timbres and musical textures we hear in elaborate music)

    3) brain regions that monitor where everything is terms of time and space.

    Drummers change their brains

    In 2017, Amad and colleagues published a paper demonstrating that: not only did the skill level of the participants improve considerably over the course of eight weeks-worth of half-hourly drumming sessions three times per week, but that their brain’s functional connectivity changed significantly too. Specifically, the resting state functional connectivity between a brain area known to be very important in musical perception – the posterior part of the superior temporal gyrus – and ALL other brain areas (i.e. every other voxel) increased by a significant margin.

    Sanskrit scholars change their brains

    In an interesting tangent in the neuroplasticity research a paper published in 2016 by James Hartzell and colleagues essentially applied the basic logic of the taxi driver study – committing a large amount of information in memory is likely to result in significant brain changes – to a different information domain. Rather than scanning the brains of people who had been engaging in memorising an important body of information for about 2 years, they scanned the brains of people who had been doing it their whole lives. Pandits are Indian scholars who learn 10,000-40,000 word long Sanskrit texts so that they can recite it from memory. They are not just “word perfect” but each word is pronounced absolutely perfectly as well.

    While it was not possible to scan them before and after they underwent all those brain changes, and so it is impossible to know for sure whether the various differences in brain structure occurred over the course of training, or whether they were there all along (i.e. they were accepted into Pandit training due to pre-existing aptitude for verbal memorisation), it is still interesting to note the various huge differences observed in the Pandits versus the age-matched, control subject brains. Firstly, they had significantly larger grey matter volumes in the lateral temporal lobes, on both the left and rights sides, both hippocampi were larger than usual and they found enlargements of the tissue across the entire anterior cingulate cortex. That their brains seemed to have undergone such significant changes is perhaps no surprise given how intensive Pandit training is.

    Action video gamers seem to end up with better connected, more cognitively flexible brains

    Ever since significant differences in cognitive flexibility were found between those who have intensively played action video games compared to a control group who have not (Colzato et al, 2010), the race has been on to find evidence of adult neuroplasticity that might account for these improvements. In 2017, Gong et al published a brain imaging paper where they compared the white matter of hardcore gamers to non-gamers. They found significantly strengthened structural connections between prefrontal, limbic and visual regions known to be involved in cognitive control (e.g. task-switching tasks) and sensorimotor (hand-eye coordination) skills. Another 2017 paper, this time by Schenk and colleagues, showed that the performance of regular video gamers in a “weather prediction” game (a probabilistic learning task) was superior to non-video gamers and this was related to stronger activation of various brain areas involved in semantic memory (hippocampus), visual imagery (precuneus) and cognitive control.

    It is still relatively early days when it comes to realising the full potential (and fundamental limitations) of human neuroplasticity. But what seems abundantly clear is that what was once a trickle of relevant papers is turning into something of a stream and as we head into the 2020’s I have no doubt that it will turn into a torrent. That torrent will hopefully be instrumental in helping to propagate the message that, no matter how old we are, there are always things we can do to change the very fabric of our brain in a meaningful fashion that actually improves cognition.

    In addition to these monthly blogs I also tweet about interesting neuroscience articles I come across on a regular basis (@drjacklewis). And in spring 2019 I will be launching a new YouTube channel called Virtual Vive Sanity. In each episode I explore a new Virtual Reality realm and share some neuroscientific pearls of wisdom to help everyone optimise their experiences. I feel very strongly that VR has huge potential, not just to provide excellent entertainment, but to accelerate various types of therapy, improve cognitive skills, fitness and well being. This channel aims to introduce newcomers to the basics and to open experienced VR users eyes to its transformational potential, while learning from our encounters with the dark potential of other new technologies to maximise the benefits while reducing the risks. Watch this space…

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  • Resilient Brains

    What is Resilience?

    There are more definitions for resilience than you could shake a stick at. Here we look at resilience from the context of an adolescent’s capacity to endure periods of intense stress without any long term negative impact on their mental health. Some brains are simply better able to weather the psychological duress of having to deal with the types of common childhood stresses known to leave kids vulnerable to mental health issues. These include poverty, neighbourhood violence, struggling schools and mental health problems of the parent(s). If you take a few moments to mull it over, it becomes obvious how these circumstances could leave children frazzled by an overwhelming burden of worry.

    Here’s one perspective. If parents have no room for financial manoeuvre, only just managing to keep up with the bills week after week, then there won’t be any spare cash to help the kids to get their hands on the material goods that they covet; whether it’s clothing, toys or tech. Children from all walks of life can show a spiteful streak when it comes to giving hell to whichever kid happens to stick out in the playground for being different and there are many all too obvious signs of being poverty-stricken that may lead to being singled out. If the merciless teasing becomes relentless then it has the has the potential to become problematic. While the bullying aspect might seem like a relatively minor issue in the stress-inducing stakes compared to going to bed cold and hungry, but the child’s perception in these matters is everything. The social stigma attached to being less well off than everyone else can damage self-esteem, particularly when it’s the source of daily playground mockery.

    If a kid is made to feel ashamed over and over again at school, for whatever reason, then chronically elevated stress levels can be potentially damaging to some of the critical processes of neurodevelopment. And as we shall discover below, brain pathways that connect frontal lobe regions with those on the inner surface of the cortex, appear to be particularly important in the resilient brain.

    The other three sources of childhood stress could also be viewed as relentless, thereby having potential for impeding important neurodevelopmental processes: the ever-present threat of getting sucked into neighbourhood violence, the perpetual turmoil induced by a primary caregiver whose mental illness makes home life a living hell and schools in which teachers struggle to wrestle order from chaos – all can send levels of a child’s cortisol (one of the stress hormones) shooting up on a daily basis over extended periods of time.

    Often there is little hope of making a meaningful impact on the external factors that conspire to send cortisol levels rocketing (poverty, parental mental illness etc) so the focus has shifted to trying to understanding the key factors involved in determining whether a child ends up with a resilient brain or not. Can interventions aimed at helping to build resilience in young people actually work? And what makes the critical difference in the makeup of brains that are able to endure high levels of stress without any long term complications and those brains that succumb?

     

    Building Resilience

    According to Harvard University’s Center on the Developing Child, resilience is built up over the course of childhood and involves four special ingredients. Two of these relate to a sense of meaningful attachment – close supportive relationships with specific adults and a broader range of looser connections that embed a child within a defined community. The last two components relate to the development of specific cognitive capacities that improve a young person’s well-being by making them feel both able and in control.

    The first ingredient is supportive adult-child relationships. This might be a parent or relative, but it could also be a teacher, trainer, coach or anyone else that can be relied upon to provide support when it is needed. A person the child knows will take the time to listen to them, offer guidance and essentially help them to feel that they do not have to take on the trials and tribulations of life alone. The second ingredient is feeling a part of some kind of broader cultural tradition, one that might give the child a sense of hope and faith that transcends the mundane goals of normal, everyday activities. Usually groups that provide this are centred around one or other of the mainstream religions.

    As I outlined in my latest book The Science of Sin, while science is great at identifying the critical factors that lead to good physical and mental health, it usually comes up short when finding fixes for the problem of social isolation. Being a part of a sports team or hobby group can provide a sense of being part of a community, but these options pale in comparison to traditions that provide an overarching philosophy on how to live a good life, a dedicated building in which to come together with other members of the community and a policy of encouraging acceptance of well-intentioned strangers. I don’t believe in God myself, but I have seen the capacity for people’s religions to give them a sense of hope and support in the face of inconquerable odds. For this reason I can see why the Harvard Institute on Child Health would have observed that helping children to connect with others from their traditional faith group can help them become more resilient.

    One of the two cognitive facets that needs nurturing to build resilient brains is the development of self-efficacy: feeling able and in control. The other is the ability to adapt to change and self-regulate behaviour. This boils down to being able to maintain a sense of being in control, even when adjusting to changes that are beyond the child’s control. Learning to self-soothe – calming yourself down when emotions start running high – is a key component of this skill. Mindfulness meditation has been identified a great way to develop such skills. It has been implemented in schools struggling with poverty and violence with phenomenal outcomes in terms of improved attendance and scholarship (Read about a compelling example of this here).

     

    What Does A Resilient Brain Look Like?

    During the first decade of life various miraculous processes culminate in the reinforcement of one particularly important brain pathway in the corpus callosum – the huge bundle of brain wires that connects the left and right hemispheres of the brain. A recent study by Galinowski and colleages investigated the structural differences in the corpus callosum of adolescents who had all endured significant and prolonged life stresses, yet some were deemed at low risk of developing mental illnesses (resilient) whilst others were at a high risk of psychological complications (vulnerable). But before we get into that, some context…

    Over the course of childhood our brains go through a series of vast and incredible changes. In the womb the outer cortex of every human foetus’s brain starts out as the tip of an extremely narrow and short tube. Over the course of the pregnancy, brain cells in this structure multiply at an astonishingly fast rate, migrating to form a six-layered sheet of densely interwoven brain wires (neurons) and a vast diversity of support cells (glia), eventually taking on its familiar, walnut-like, wrinkly, appearance by the time of birth. Having successfully made it’s way out of the womb and into the big wide world, the infant’s brain cell multiplication steps up a gear to achieve it’s full complement of 86 billion neurons by the age of five. From here on brain growth is mostly a case of making those neurons larger, developing the system of myelination whereby glial cells called oligodendrocytes apply a layer of electrical insulation to the brain wires to speed up the transmission of messages and each of those neurons make thousands of connections (synapses) with other neurons. MRI scans can track both of these processes with serial brain scans conducted at various stages of development – the progression of myelination can be observed by taking measure that correlate with white matter integrity and other measures can be used to track changes in the thickness of the surrounding grey matter. Interestingly, when a human brain reaches adolescence, rather than getting bigger and bigger, creating more and more synapses, the brain shifts gear .

    During adolescence the outer cortex of the human brain doesn’t simply get thicker and thicker. More new synapses are being created as the teen increases their repertoire of skills and abilities, but that is not the only process that is taking place at this stage in neurodevelopment. The synapses connecting together brain areas involved in supporting the improvement of their language, thinking, movement, memory and reasoning skills ARE being selectively bolstered, reinforced with extra synaptic connections to make the communication between relevant brain areas more efficient. Yet another process is simultaneously underway across the whole brain which causes the outer cortex to become thinner, overall, during the teenage years and beyond. The countless unused brain pathways are trimmed away, while those that are being used on a regular basis are maintained. As the former process of “synaptic pruning” progresses at a much faster rate than the latter, the net result is a thinning of the cortex. The rate at which different parts of the brain go through this process of cortical maturation has been tracked by an incredible team of neuroscientists in Paul Thompson’s lab. The process seems to reach completion first in the sensory parts of the brain at the back and sides of the brain, and last in the parts of the frontal cortex supporting higher level cognitive functions.

    Going back to the resilience study, Galinowski and colleagues observed that the integrity of the white matter tracts (NB neuronal brain wires wrapped in myelin are less dense than the outer cortex which is jammed full of synapses and cell bodies so it looks white in brain scans rather than grey) was higher in the front-most part of the corpus callosum in the brains of resilient adolescents versus vulnerable ones. When they ran tracer studies to see which brain areas were connected to each other by these particular information superhighways, the areas in question were frontal lobe regions involved in self-regulation and the anterior cingulate cortex; a brain area that should be familiar to anyone who’s read The Science Of Sin. The dorsal part of the ACC is known to be involved in the perception of physical and emotional pain specifically; and processing “conflict” more generally.

    The upshot is that the critical pathways that were observed to have better integrity (NB better system of insulating myelin to facilitate information exchange) in the more resilient adolescents may well be instrumental in enabling the prefrontal cortex to consciously dampen feelings of psychological turmoil. Presumably when supportive adult-child relationships and connections with the community are fostered in the first 10 years of life, as well as the facilitation of development of self-efficacy and self-control, these are the critical pathways that are protected against the negative impact of chronic stress. Now that we know where to look in the brain for hallmarks of resilience, we should be able to get a better handle on the effectiveness of other interventions that aim to nurture the capacity to endure an excess of stress without incurring psychological damage in the long run. Watch this space…

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  • #SelfishlyHelpful

    One of the main pieces of science that underpins The Science of Sin is that social isolation damages people’s physical and mental health (a fact of life first identified 40 years ago!). I also make the point that the seven deadly sins can be thought of as perfectly natural human inclinations that are useful in moderation, but inevitable damage social connections when they get out of control. Put this all together and what have you got? Well, the way I see it, it should be possible to motivate people to rein in their pride, greed, sloth, lust, gluttony, envy and wrath for entirely selfish reasons – with the primary aim of improving their own health.

    This is where the inspiration for #SelfishlyHelpful came from. Something that I hope could motivate even the least likely people to start behaving more benevolently towards other. And for those who are already charitably-inclined, it might help them to find ways to motivate the more self-centred people they come across in life to look for opportunities to help other people in their community. As the weeks have gone by since this thought first occurred to me, the more I think about it – the more I stumble upon evidence of my own #SelfishlyHelpful behaviour. It turns out I’ve been doing it for years. I was just thinking of it more in terms of how intrinsically-rewarding acts of apparent altruism are. For example…

    It occurred to me recently that for many years now I’ve been tweeting about interesting neuroscience articles I come across on a daily basis and writing a monthly blog for entirely #SelfishlyHelpful reasons. Yet I have never received a penny for the many thousands of hours of effort I’ve invested in these exploits, so clearly any reward I might gain is intrinsic (feels good) rather than extrinsic (for material gain).

    I initially started doing these things because the TV agent that represented me 8 years ago told me that anyone who wants to be a successful TV presenter needs to have two things: 1) a Twitter account and 2) a website. When I asked why, she replied that she had no idea (!), but that people whose advice she trusted had told her so. The received wisdom was that these activities were vital to any 21st century broadcaster’s survival. That was good enough for me.

    I arbitrarily set myself the goal of tweeting three brain-related articles that hit the lay press each and every weekday, plus one blog per month on a brain-related topic that had made me sit up and take notice. After a few years I started asking myself why I was bothering to stick to this quota like my life depended on it. There seemed to be no tangible return on my investment of time and resources.

    Retrospectively I realised that what kept me at it was the impetus to keep checking the neuroscience newsfeeds on a daily basis as this habit helped me to stay abreast of the latest developments across many neuroscience sub-disciplines. And what kept me blogging was the opportunity to regularly explore certain areas of neuroscience in greater depth.

    My tweets help others by drawing attention to brain-related articles that are usually a) interesting and relevant to people’s daily existence b) well-written and c) factually accurate. I know people find these articles helpful because people occasionally take the time to get in touch to thank me for making them aware of a tasty nugget of neuroscience. There is clearly a selfish benefit for me as well because, while I don’t get any financial remuneration for this kind of work, always being up to date on what’s going on across a wide range of brain research topics often comes in handy. When I’m asked a question by a client about the latest developments in neuroscience, whether it is a TV production company developing a series idea, a PR company I’m working with on a project for one of their clients, a host during a live TV or radio interview, or an audience member after one of my many annual keynote speeches, I can answer the vast majority of questions off the top of my head.

    Similarly with the blog: people sometimes drop me an email out of the blue (usually when I’ve removed something they’ve come to rely on!) to say what a useful resource it is – so they clearly find it helpful. The selfish part is that, as I was effectively forcing myself to stick to a schedule of writing a science story once a month for 8 years, by the time I got the opportunity to write a book, not only did the publisher have a sense of what the end product would look like – but it also gave me the opportunity to develop my writing style so that, through trial and error, I could do the job adequately well.

    My aim from here on is to encourage others to do the same, but in a wide variety of different contexts. Whether it’s volunteering in their local community with the express intention of helping others to improve their own social connections – with other volunteers, those that they benefit from their charitable enterprises and others they meet along the way. The basic premise is that the act of helping others naturally encourages those on the receiving end of the freely-given assistance to try to reciprocate: to do something to return the favour. If they’re unable to return the favour in some material sense, they should at least be willing show their gratitude in other ways. This gratitude is useful in the sense that it will go some way towards reducing the recipient’s baseline levels of psychological pain or, in more common parlance, the inner turmoil that we all experience each day.

    A #SelfishlyHelpful act of community volunteering should not only reduces social pain (which I argue is generated in the dorsal Anterior Cingulate Cortex, an area implicated in many of the seven deadlies) but also fosters an increased sense of feeling socially accepted as a member of a community. It doesn’t necessarily mean you’ll make a new friend every time you help others, but it increases the chances that someone might smile and wave from the other side of the road the next time your paths cross, which can bolster feelings of social connection in small but meaningful ways. Increasing a person’s sense of being socially connected to people in their community is the secret sauce that leads to incremental improvements in physical health and psychological wellbeing that have lead several recent meta-analyses to emphasise the importance to taking steps to reduce social isolation.

    As someone who just received an email from a teacher from an East London state school I gave a talk at last week, saying that all the students were “really buzzing with enthusiasm” after the talk and that I’d “undoubtedly changed the path of many of their lives”, I can personally attest to the benefits of being #SelfishlyHelpful in terms of making people feel like trying to help others for zero remuneration is entirely worthwhile on a number of different levels. So as you mull over what you’ve just read, think to yourself… “where could I volunteer my services in the local community”? And bear in mind that, when you come to giving your time freely to others, it is you, not they, who will be the one that benefits the most…

    In addition to these monthly blogs, I tweet interesting brain articles (@drjacklewis), do a regular science podcast with the divine Lliana Bird (Geek Chic’s Weird Science) and will soon be launching a brand new YouTube channel where I take people on a variety of Virtual Reality adventures….

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