• 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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  • New Hope for Paralysis Recovery by Dr Jack Lewis

    As 2014 draws to a close my thoughts have recently turned to pondering the greatest neuroscience discoveries of the year. For me I’ve been struck by several developments in an area of biomedical science that during most of my lifetime has been considered beyond the powers of medical therapy to provide a decent remedy.

     

    christopherreeveEver since Christopher Reeve (the actor who played Superman in the much loved films of the late 70’s and 80’s) became paralysed from the neck down during an equestrian accident in 1995, the plight of people who suffer traumatic spinal damage has seemed utterly futile; despite the huge amounts of money various benefactors have ploughed into research. However this year we have seen huge leaps in scientific advancement enabling previously wheelchair-bound people to stand up and take some small but important steps forward under their own volition.

     

    A paralysed person kicked off the 2014 World Cup in Brazil during the opening ceremony using an EEG-controlled robotic exoskeleton. But given that the person in question had to be carried onto the pitch on a golf buggy, as opposed to rising up out of their wheelchair as promised, that feat should only really be considered a drop in the ocean compared to the much more remarkable progress in paralysis rehabilitation we’ve seen over the course of 2014.

     

    DrJackNewsroundAt the beginning of the year I was invited to make an appearance on “Newsround” – the Children’s BBC channel’s daily news show – to explain a totally unexpected and extraordinary breakthrough in rehabilitation research with paralysed army veterans in the USA. A chip was surgically inserted into their spinal cord, below the sites of damage, to apply weak currents of electricity in an effort to reinvigorate the involuntary spinal reflexes that enable us to maintain our balance whilst standing (no input from the brain necessary).

    This unexpected development occurred when, after a few weeks of further intensive rehabilitation exercises, several people regained voluntary movement of their legs for the first time in 2-4 years. Can you imagine how good that must have felt for the people in question? As someone who personally spent three weeks of 2014 with an almost completely paralysed arm after complication during routine surgery, it brings tears to my eyes to think how amazing it must have been to have control over legs that had previously seemed utterly useless for so many long months. It seems that the current injected by the chip had unexpectedly boosted signal strength across the area of damaged spinal cord sufficiently for the electrical messages (action potentials) to get all the way down to the leg muscles.

     

    Geoff RaismanIn 2004 whilst I was doing my PhD at University College London, I attended a talk by Prof Geoff Raisman, now chair of Neural Regeneration at the Institute of Neurology in Queen Square. He presented brand new data that he was clearly extremely excited about in which he showed data that clearly depicted new neuronal growth across the site of a spinal lesion. I cannot remember whether the experiment involved rodents or non-human primates but he made it clear that it would be many years before this pioneering research could ever be used to help paralysed humans. Today, in 2014, this dream is a reality.

     

    OlfactoryCellsInjectedDarek Fidyka was paralysed from the chest down for several years after a knife attack that severed his spinal cord. The 8mm gap that prevented messages sent from his brain to reach the muscles of his leg, penis and bladder were bridged using stem cells extracted from his brain. Mr Fidyka first underwent surgery to remove one of his two olfactory bulbs – the antennae like structures that extend forwards from the brain’s limbic system, running above each nasal cavity and extending smell receptors across the skull and into the nasal epithelium. Because the olfactory receptors come into contact with so many volatile compounds (just think of how potent the gases are that get into your nostrils when you’re downwind of a bonfire) a fair amount of damage happens to these brain cells and so they must be constantly replenished. This means that the olfactory bulbs / neurons of the nasal epithelium are a great source of stem cells.

     

    Darek Fidyka walks with the aid of leg-braces and a walking frameOnce sufficient numbers of Olfactory Ensheathing Cells (OECs) had been cultured and several million of them injected into the gap in his spinal cord a period of intensive rehabilitation exercises got underway. 6 hours per day 5 days per week. A few no-doubt-frustrating weeks later he graduated from walking with the assistance of parallel bars in the rehabilitation gym, to walking with a frame outside the hospital in Wroclaw, Poland where the surgery took place. Perhaps as important he regained some bladder control and sexual function. An incredible achievement for Mr Fidyka, but an absolutely triumph for Prof Raisman and the hundreds of people that have contributed to the groundwork that led to this unbelievable feat of brilliance.

     

    This story was covered in episode 10 of the podcast Geek Chic’s Weird Science – co-presented by yours truly and the gorgeous Lliana Bird – which you can subscribe to on iTunes, absolutely free of charge, by clicking here.

     

    For daily news on the latest advances in neuroscience research you can follow me on Twitter by clicking here.

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