Wednesday 5 December 2012

The neurobiology of giving

The neurobiology of giving

As many of us are immersed into the final frenzy of Christmas gift buying, the thought of battling the crowds to find that pair of socks for dad can be a daunting one. However recent research suggests that rather than induce a headache, shopping for gifts can actually be good for us. In a 2008 study from the University of British Columbia, subjects rated their level of happiness before being randomly allocated to different spending conditions - to either spend money on themselves or spend money on others (prosocial spending).

Subjects once again rated their level of happiness after spending the money. It was reported that subjects who spent money on others rated themselves as happier than subjects who spent money on themselves. Interestingly, this increase in happiness did not depend on how much money was spent. The researchers also found, however, that when subjects were asked to imagine what they thought would make them happier, most thought it would be personal, rather than prosocial, spending, suggesting that we are largely unaware of the benefits of giving.

Researchers at the University of Oregon used neuroimaging to identify which brain structures may be involved in prosocial or giving behaviours. This revealed that the centres of our brain implicated in pleasure and reward, the caudate, nucleus accumbens and insula, are also activated when people engage in acts of altruistic giving, such as donating money to a charity. So, it would seem that the brain’s pleasure centres do not only respond to what we want and like – they also track what is good for others too!

Neurobiology - giving promotes happinessWho would have thought gift giving is so good for us and that the brain gets the same warm glow from buying that box set of socks for dad as when experiencing the delight of a tasty meal or a lottery win! Makes you want to go out and finish that Christmas shopping!

We’d love to hear your comments (below) or contact us for any queries.

Wednesday 14 November 2012

Non-pharmacological Treatments for Memory Decline

It was recently reported on ABC news (Mon Oct 15, 2012) that drug companies are abandoning research into the development of new drugs for dementia.

The key reasons cited for this trend were the enormous costs involved in drug development and little success with disease modifying drugs, particularly for Alzheimer's Disease, the most common form of dementia.

With dementia widely recognised as a ballooning problem for not only in Australia but across the world over, this then raises the question of what other treatment options are out there?

In fact there are several other potentially promising lines of research investigating non-pharmacological treatments for memory decline. These non-drug based treatments share one thing in common, capitalising on the neuroplastic and regenerative properties of the brain.

One such treatment which has gained increasing attention is cognitive remediation, a psychological intervention which has been particularly investigated in people with schizophrenia. This form of intervention typically involves the use of brain training exercises and teaching of memory strategies, with research overall showing robust benefits for memory and cognition, as well as improvements in quality of life. Cognitive remediation has additionally recently been trialled in people at risk for dementia, with early promising results showing improvements in memory.

Another exciting new intervention is through using mild forms of brain stimulation. These brain stimulation techniques involve the application of small electric currents or brief magnetic pulses into the brain for the purpose of transiently modulating brain activity. These non-invasive forms of stimulation have been shown to be effective in treating depression, and there is now some preliminary research showing that they can also be used to enhance memory in older persons and people suffering from Alzheimer's Disease.

Though the research into these new non-pharmacological treatments to help improve memory is very much preliminary at this stage, with more research these treatments may become more widely available in the future. Most likely these new treatments will be used to supplement existing drug treatments, as additional “booster” treatments to help delay cognitive decline and improve quality of life.

ANTS conducts a Cognitive Remediation Programme based in Sydney's inner west. For more information please contact us.

Researchers at the University of New South Wales are also currently conducting a research trial investigating the use of mild brain stimulation for people at risk for dementia. More information about this trial is available at http://www.cheba.unsw.edu.au/project/brain-stimulation-and-cognitive-training.

Monday 5 November 2012

An unconventional treatment for dementia?

Curry may help combat dementia!Curry may help combat dementia!

Scientists are investigating whether curcumin, a chemical in the spice turmeric, may help to prevent Alzheimer's dementia (AD), the most common form of dementia. Curcumin, a powerful antioxidant and anti-inflammatory, may play a role in clearing the brain of a protein called beta amyloid, which is known to be a causative factor in the development of AD.

India, the largest consumer of turmeric-based curries has the lowest rate of AD in the world.

AD and other forms of dementia are perhaps the single greatest health issue facing Australia in the 21st century, with almost 1 million people in Australia predicted to be living with dementia by 2050. A number of researchers and medical practitioners have recently spoken out about their concerns about the reduction in research dollars spent on finding ways to combat this insidious illness, given the morbidity and prevalence of dementia. Many pharmaceutical companies have stopped or reduced their dementia research programs due to the lack of efficacy of treatments to cure the disease or slow its progress.This is despite advances in neuroimaging technology and diagnostic techniques.

As with most illnesses, prevention is better than cure, and scientists are now focusing on finding ways to stop those at risk of developing AD from doing so.

A clinical trial has started at a Sydney retirement village where 100 residents will take supplements of curcumin and be given MRIs. Ralph Martins, a professor of ageing and Alzheimer's disease at Edith Cowan University, who is conducting the research along with the McCusker Alzheimer's Research Foundation, the Brain and Mind Research Institute and the Royal Prince Alfred Medical Imaging Services, said that:

"What we currently know as clinical Alzheimer's [dementia] is probably the end stage of disease, so the disease is cooking in people's brain for as much as 20 years and what we're finding in the healthy normal people is that a third of them will have this toxic amyloid in their brain".

While the research is promising, there are a range of other lifestyle factors, including diet, exercise and 'brain training' (or stimulation to keep the mind active) that are also important to consider in trying to prevent all forms of dementia.

Curry is certainly not enough, but it may be a good start!

If you are concerned that you or a loved one may be developing dementia, we at ANTS can help. The first step is to read our fact sheet on dementia at:

http://neurotreatment.com.au/neuropsychological-information-dementia.aspx

A thorough neuropsychological assessment is a key component of the diagnosis and management of dementia. If you would like to learn more about what we can offer here at ANTS, please don't hesitate to contact us.

Monday 22 October 2012

The Neuropsychology of Depression

Ian Thorpe In his recently released autobiography, Ian Thorpe describes how he has suffered from depression most of his life. Like many young Australians with depression, the 30-year old revealed that he kept the illness behind closed doors to the point that not even his family and close friends were aware of his battle with the mental illness, and rather than seeking professional help he would instead often turn to alcohol. He recalls in his book periods of low mood that would often last a month, during which he contemplated suicide.

Depression is not uncommon in young Australians, with approximately 160 000 individuals between the ages of 16 to 24 years of age living with the mental illness. Like Thorpe, a high percentage of sufferers experience suicide ideation and such individuals are at increased risk of completing suicide.

Depression is mainly known for its affect on mood. A lesser known fact is that sufferers also exhibit a number of neuropsychological impairments. Research has shown that individuals with depression have poorer episodic memory and slower psychomotor speed. In addition, those with depression exhibit difficulties with problem-solving, planning and mental flexibility.

The range of cognitive impairments seen in individuals with depression is the consequent of several biological changes in the brain. One of the most widely researched biological dysfunction concerns a deficiency in Serotonin, an important neurotransmitter that is known to mediate memory and learning. Brain MRI studies have shown that, relative to healthy controls, individuals with depression have decreased activity in the frontal lobe, an areas of the brain important for problem-solving, planning and mental flexibility. In addition, research has shown that depressed people exhibit abnormal activity in the amygdala, an area important for processing emotional aspects of information.

Thorpe described that after years of suffering with depression he finally consulted with his doctor who prescribed medication “but little in the way of explanation”. Ironically, he noted that this consultation isolated him further as he felt he "now had a secret and no one to share it with.”

While most antidepressant medications are thought to improve symptoms of depression by correcting deficiencies in Serotonin, they are not affective in addressing the important psychological component of the mental illness, namely negative and maladaptive thinking-patterns. This is usually addressed by supplementing antidepressants with some form of cognitive therapy. Interestingly, there is some preliminary evidence to suggest that cognitive therapies may in themselves alter neural circuitry and normalise abnormal amygdala and frontal activity. Whether these changes lead to corresponding neuropsychological improvements, however, is yet to be determined.

Monday 24 September 2012

Mental health care for Newton

Successful treatment for Matthew Newton

After a string of assaults and alleged assaults, including domestic violence incidents involving two ex- partners, punching a taxi driver in Sydney and attacking a hotel receptionist in the US, Matthew Newton has recently been released from a high care mental health facility for treatment for bipolar disorder and obsessive compulsive disorder. He previously spent time in a mental health facility in Sydney in late 2010.
His latest treatment has reportedly been a resounding success, with Newton currently free of medication and 'unrecognisable' according to his lawyer, since spending 84 days at the clinic, when he appeared in the Downing Centre Local Court to face charges over the taxi driver assault. His lawyer, Chris Murphy is making a second application to have the matter dealt with under the Mental Health Act, given his diagnoses. An application made earlier this year was rejected.

bipolar brainSection 32 of the Mental Health Act diverts people suffering from mental illness who have been charged with a crime from the criminal justice system and imposes a treatment plan. Charges can be dismissed with the condition that the individual undergo treatment.

Serious psychiatric conditions such as bipolar disorder are known to be associated with higher rates of violence, particularly when an individual is in a manic state.

ABC News Photo Illustration

While this is certainly no excuse for violent behaviour, having a diagnosed mental health condition can help to explain Matthew Newton's actions and can be taken into account as an extenuating circumstance in legal matters. Section 32 of the Mental Health Act exists in part, to help ensure that people who have a mental health condition and engage in criminal behaviour undergo appropriate treatment, which benefits both the individual and the wider community.

As his lawyer made the point via Twitter, you "can't cure mental illness with 'You stop that!'".

With appropriate diagnosis and treatment, most people with mental health conditions can lead happy, safe and fulfilling lives.

Monday 27 August 2012

Modern day Phineas Gage

Tomography scans of Eduar

As a psychology student one of the first things you learn about in class is the classic case of Phineas Gage, a 19th century construction worker who was unfortunate enough to have an iron rod driven completely through his head, damaging a substantial part of the left side of his brain, and surviving the whole ordeal.

Phineas Gage, who’s injury resulted in damage to the left frontal lobe, is often documented to have been left with profound behavioural and personality changes, not surprising given that the frontal lobe is responsible for higher mental functions important for social situations, such as reasoning and decision-making.

The case is significant in the field of neuropsychology because it influenced early discussion (and findings) that damage to specific parts of the brain can affect specific functions while leaving other functions intact. The case of Phineas Gage has also been popularised in the media, being mentioned in episodes of shows such as House, Medium and Ripley’s Believe it or Not (Fridge Magnet anyone?).

Amazingly, a 24-year old Brazilian construction worker recently sustained a very similar injury (though the injury was to the right side), and like the classic case, the worker was not only conscious moments after sustaining the injury but he was also able to talk and explain to doctors what happened. The worker reportedly felt little pain and looked as if nothing had happened following the accident.

As can be seen from the photo, the iron bar (which had fallen from the fifth floor of a building) entered the back of the worker’s skull and exited between his eyes. He reportedly narrowly escaped losing one eye and permanent left-sided paralysis.

The doctors who treated the Brazilian worker remarked that the iron bar entered a “non-eloquent” part of the brain that does not have a specific known function. Though, with the patient reportedly still in hospital for at least two more weeks, only time will tell as to whether this man will ultimately develop any of the long-standing behavioural and personality changes sustained by his 19th century counterpart.

As argued by Dr Hamberger, Clinical Neuropsychologist at the Neurological Institute of New York, the lack of reported concern by the worker that a 1.8 metre long iron bar has penetrated his head may be evidence in itself of more subtle higher-level cognitive changes that won’t be immediately apparent before more detailed neuropsychological testing, such as self-awareness and insight.

Wednesday 11 July 2012

The neuropsychology of smell

The power of the nose

The neuropsychology of smell Have you ever smelt something that immediately took you back to your childhood, to a happy or difficult time in your life or to a certain place? Could you remember exactly how you felt or what you were thinking or doing when you last smelt it, even if it was a long time ago?

It's a common experience to associate an aroma with a memory, which can often arouse quite vivid feelings. The reason that our sense of smell is so powerful is that unlike other senses it does not have to pass through a brain structure known as the thalamus but is directly processed by the olfactory system in the brain. It is also part of the limbic system, which also plays a role in processing emotions and memories.

Compared to many animals, the human olfactory system takes up a relatively small part of the brain and our sense of smell is quite weak. However, the importance of human olfaction is demonstrated by studies that show we can us it among other things, to identify relatives, choose partners and determine age

A new study by Assistant Professor Johan Lundström, an experimental neuropsychologist at the Monell Chemical Sciences Centre in the United States, demonstrates how well we can use our sense of smell to determine age. And debunks the myth that old people smell bad!

Assistant Prof Lundström and colleagues had people from three age groups (20-30 years, 45-55 years and 75-95 years) sleep with pads located under their arms for 5 nights. The pads were then placed in jars and other participants were asked to group the jars according to age. Participants were able to easily group the armpit pads by age group and even by gender.

Surprisingly, despite the common conception that older people have an unpleasant odour, younger people rated the arm pads of the oldest age group as being fairly neutral and not unpleasant.

The group rated as most unpleasant was men aged 45-55 years.

The work of neuropsychologists is varied and valuable. To learn more about what we do and about our services, visit our website

Sunday 24 June 2012

New research shows promise for children with dyslexics

What is dyslexia?

Dyslexia is a language based problem Dyslexia is a language based problem characterised by a persistent difficulty with reading and spelling. Symptoms include difficulties learning letter-sound relationships, slow and effortful reading and making many mistakes when reading and spelling.

It is largely independent of IQ, meaning that someone with a high or low IQ can have dyslexia. One way that dyslexia is identified is a significant discrepancy between IQ and scores on standardised tests of reading and spelling.

Dyslexia is thought to affect as many as 10% of Australians.

While it does not affect intelligence or learning capacity directly, reading difficulties can affect learning in the classroom as children who can't read well find it hard to keep up with the rest of the class and often have difficulties with not only English but other subjects, particularly those that require absorbing a lot of written information.

A new study has found something that may help!

Researchers from the Department of General Psychology at the Unitersity of Padova have found that reading materials with spacing between the letters can help dyslexic children read faster and better. They found that extra wide letter spacing doubled the reading accuracy and increased reading speed by 20 percent in a sample of 94 dyslexic children aged between 8 and 14 years.

It appears that this approach worked because children with dyslexia are more affected by letter spacing: when letters are too close together they have difficulty identifying letters.

Children without dyslexia did not benefit from the extra wide spacing.

The researchers advised that extra letter spacing could be a way to get children with dyslexia to read more, which is a key way of improving reading skills.

"Practitioners only know too well that getting dyslexic children to read more is a key component in achieving long-lasting improvements in reading skills," says the study. "Extra large letter spacing, which could even be optimised adaptively on an individual basis, can certainly contribute to achieving this goal."

To learn more about dyslexia, see our video explaining dyslexia and what Henry Winkler (Fonzie from Happy Days) did to help manage his condition.

 

Monday 11 June 2012

Early detection of mental health issues

Healthy Australian Kids

Early detection of mental health issues The Australian government, supported by the Australian Medical Association (AMA) has proposed an initiative, which will be part of the The Healthy Kids Check, to screen Australian 3 year olds for signs of psychiatric and developmental conditions such as autism

Under this voluntary program parents can bring their children to be assessed by General Practitioners (GPs), who will then refer children who display troubling behaviour to psychologists and paediatricians for further assessment and, if necessary, treatment.

Wednesday 6 June 2012

Newly researched attention deficit may affect learning in the classroom

A new attention disorder?

A recent study conducted by Imran Dhamani and team of Macquarie University has identified an attention difficulty which may affect as many as 1 in 2 children in a classroom - and it's not ADHD.

Friday 25 May 2012

Research reveals the part of your brain responsible for a song getting stuck in your head!

If you've ever had a song stuck in your head, you'll be interested in the latest research investigating the brain region responsible for recognition of familiar tunes revealed as part of a study into Semantic dementia.

Semantic dementia research

Semantic dementia (SD) is a rare type of dementia characterised by a loss of semantic memory, memory for generalised concept based factual information (i.e, general knowledge). The most common symptoms, particularly early on, are an impaired ability to retrieve words from memory and impaired comprehension of word meanings. It also affects patients' ability to recognise objects and sounds.

Wednesday 16 May 2012

Parenthood changes your brain!

Anatomy of a parents brain

Parents may not be surprised by the finding that being a parent actually changes your brain (some may be surprised that the changes are good ones!). Research shows that parents have different patterns of brain activity in some areas than non-parents.

One study found that hormonal changes that occur in pregnancy increase the number of dendrites in the brain. Dendrites are the projections from a neuron (or brain cell) that act to facilitate communication between neurons. So, the more dendrites, the more chance of neural connections. The neural connections that are created during pregnancy have been shown in rat studies to enhance memory and learning. This is likely to be because learning and memory are important in raising young.

Thursday 10 May 2012

Mental health and the federal budget

The 2012-13 federal budget has been released, and according to some expert commentators, there is good and bad news for mental health arising from the budget.

The good news is:

  • Overall funding for mental health has not been cut.
  • Funding for the Mental Health Nurse Incentive Program, providing incentives for community based general practices to engage mental health nurses, has been maintained.
  • The government will provide $21 million to fund additional allied mental health services for patients under the Better Access initiative, whereby treatment for those with diagnosed mental health problems is partially covered by Medicare.
  • New spending of $115m over five years is directed towards better mental health care for veterans.
  • From 2014-2015 $9.1m will be provided to the Australian Bureau of Statistics to conduct its Survey of Disability every three years, rather than every six years.

Monday 7 May 2012

Positive thinking changes your brain!

Psychology has for some time now borrowed from the philosophies and practices of Buddhism (e.g., meditation and mindfulness), to help treat conditions like depression and anxiety and to help people increase their general psychological well-being.

New breakthroughs in neuropsychology and neuroscience have allowed us to better understand how these practices work to actually rewire the brain to allow for more calmness and greater happiness.

Wednesday 18 April 2012

Molly in recovery

Molly Meldrum

Molly's letter

Molly Meldrum, the well known TV personality who suffered a severe head injury after a fall on 15 December last year, appears to be recovering well. He has written an open letter expressing his thanks for the attention and well-wishes he received after his fall.

Part of the letter is reproduced on this news site

Molly said: "My life changed forever when I fell off the roof".

"I can't say my life flashed before my eyes, but I have had plenty of time to reflect in the past few weeks, and I realise just how lucky I am".

"I wish I could reply to all the cards and messages, but it's impossible - it would take all year and I'd never get my book finished!" he wrote.

The letter comes not long after the recording of an interview by journalist Jennifer Keyte which will air on Today Tonight. It will make fascinating viewing.

Prognosis and recovery

Molly appears to be making a good recovery from his head injury, particularly given his age (66) and the severity of his injury. He appears to be alert and very articulate.

However, an article on news.com.au reveals that he also tires easily, becomes stressed under pressure and is walking slowly.

These are common outcomes of head injury or traumatic brain injury (TBI). Depending on many factors, including the severity of the TBI and the part of the brain affected, slowed processing, fatigue and difficulties managing stress are to be expected following a TBI. These can be short or long term effects. Again, depending on a number of factors, many skills are also often retained. These tend to be those skills that have been well practised, such as literacy skills.

The human brain is complex, as are the outcomes of TBI. To learn more about how the outcomes of TBI can be assessed, please contact us

Saturday 7 April 2012

Teenagers, sleep and brain changes

Adolescents are renowned for their ability to sleep and for their erratic behaviour.

A recent study examining adolescent brain activity during sleep reveals what is happening in the brains of adolescents (that may help explain their behaviour!).

The study, led by Dr Ian Campbell and Prof Irwin Feinberg at the University of California, involved 67 adolescents. The researchers took electroencephalogram (EEG) recordings of their brainwaves while sleeping. They found that there was a 60% drop in the activity of delta waves in the brain as the children moved through puberty, particularly between the ages of 12 and 16 years. Delta waves occur during non-rapid eye movement sleep, the phase of sleep where the brain recuperates from its activity during the day.

Changes in brainwaves indicate that pruning of brain cells occurs at this time. As discussed in our earlier blog, Neuroplasticity in Children, pruning involves brain cells and the connections between them being removed, leading to changes in brain efficiency.

Another researcher, Prof Mick Hunter of the University of Newcastle, stated that "People don't realise what massive changes occur in adolescence in a very short period of time. There are so many changes - physiologically, mentally and socially". These changes appear to be interdependent.

These findings may have implications for the study of mental illness such as schizophrenia. It may be that errors that occur during the rapid process of brain reorganisation at the end of adolescence give rise to mental illness.

Mental illness can be associated with cognitive difficulties. To learn more about the relationship between mental illness and cognition, contact us.

Wednesday 28 March 2012

Sleep and cognition: or, your brain needs sleep!

Most people are likely to be familiar with the expression "sleep on it" - meaning that sleep can be beneficial to problem solving and decision making.

Emerging evidence shows that sleep is even more important to brain health and cognition, particularly memory, than we realise.

It has been known for some time that sleep apnoea, a sleep disorder, is a risk factor for certain types of dementia.

A new Australian study has found that another sleep disorder is associated with memory problems. People with rapid eye movement sleep disorder (RBD) have twice the risk of developing memory problems and Parkinson's disease. RBD is a sleep disorder that involves abnormal behaviour during the sleep phase where rapid eye movement occurs. People with RBD tend to act out their dreams.

The study found that a third of the people with RBD developed mild cognitive impairment or Parkinson's disease within four years of being in the study. This is a rate that is more than twice that of people without RBD. Behavioural neurologist Dr Brendon Boot was the lead author of the paper, which has been published in the Annals of Neurology.

He says being able to identify those patients who are a greater risk of mild cognitive impairment or Parkinson's disease will mean earlier treatment for those affected.

Early invention is vital because as these disorders advance they destroy brain cells.

Saturday 24 March 2012

New evidence regarding ECT

Mention ECT (Electroconvulsive therapy) to most people and they are likely to imagine a scene out of One Flew Over the Cuckoo's Nest with a patient being involuntarily strapped to a table and given a painful electric shock.

However, ECT is actually a humane and effective treatment for patients with mood disorders like severe depression, particularly in cases when alternative treatments have been ineffective.

Current techniques involve first anaesthestising the patient and then electrically inducing a seizure.

Whilst it has been used successfully in clinical practice for 70 years, until now it has not been well understood how or why it works. Prof Ian Reid and his team from the University of Aberdeen in Scotland found that ECT changes the way different parts of the brain communicate. By comparing the brains of people before and after the treatment using brain imaging they showed that ECT reduces the strength of overactive connections between parts of the brain that control mood and those that control thinking/concentrating.

This finding could help improve diagnosis and treatment of mental illness and other disorders including schizophrenia, autism and dementia.

One of the possible side effects of ECT is memory loss. A neuropsychological assessment can be used in conjunction with ECT to monitor any changes in cognition. To find out more about our neuropsychological assessment services contact us.

Wednesday 14 March 2012

Mental health and the community

mental health ABC TV's Australian Story program on Monday 5 March reported the heart-breaking story of Adam Salter, a man with a history of psychosis, who was shot and killed by police in November 2009 following a call made by his father that he was trying to stab himself.

Full details of the story can be found here.

The police involved on the day and in follow-up investigations of the matter were criticsed by the deputy state coroner of NSW at an inquest into Mr Salter's death in 2011.

Mental health advocates have described Mr Salter's medical and psychological treatment as a "failure of care".

While this is an extreme example of how mental health issues are not always dealt with well within the community, it is not an isolated incident. It has been well documented that mental health continues to carry a stigma within the community and does not always receive the same level of care and attention as physical illnesses. In Mr Salter's case, he was admitted to a mental health facility during a psychotic episode in 2008 as an involuntary patient and discharged without follow-up by the community mental health team and without his family being advised of his high risk of relapse. He is not alone. A Mental Health Council of Australia report, Consumer and Carer Experiences of Stigma from Mental Health and Other Professionals, which reports the results of a study of 400 mental health patients and 200 carers, found that 29% of patients reported feeling shunned or avoided by health professionals. Fourty-four percent of the carers believed that doctors behave differently towards patients when they find out that they have a history of mental health issues. Close to three quarters (73%) of the respondents said they had experienced stigma or discrimination in the last 12 months because of their mental illness.

Mental illness is not uncommon. One in five Australians suffer from a mental illness. The impact of mental illness is felt by the sufferer, their family, friends, workplaces and the broader community. It is important that mental health is treated seriously and that appropriate care is provided, including follow-up, appropriate referrals, case management and consultation with the family. An important component is community education.

We here at ANTS certainly recognise the importance of mental health and of educating the community. We run Mental Health First Aid Training programs to help increase knowledge about common mental health problems and to teach people and organisations to deal with mental health crises.

To learn more about our programs and our services more generally, contact us. We look forward to hearing from you.

Monday 5 March 2012

Neuroplasticity in children

Neuroplasticity in children

The neuroplasticity of children’s brains has been well established. Children’s brains are able to reorganise themselves so that for instance if a young child suffers a brain injury to a part of the brain responsible for language another part of the brain will take over that function. The same does not occur in adulthood, and depending on which part of the brain is damaged, the adult may lose all or some language functions, while the child’s will be relatively spared.

Plasticity is greatest in the first few years of life because it is during this time that the brain is ‘wiring’ itself, working out which connections (or synapses) within the brain should be strengthened and which should be pruned. Anyone who has been exposed to a foreign language as a young child can attest to the effortless learning that occurs during this period, especially compared to the much more effortful process of learning a language as an adult.

The neuroplasticity of children’s brains has led to significant debate in the neuropsychological field about whether the outcomes of brain injury are better for children than adults. The example given above of the brain reorganising itself has been put forward as evidence supporting this view. However, there are several reasons why, depending on the severity of the injury, children actually tend to have worse outcomes than adults following brain injury.

Ironically, one reason is related to the process of brain wiring and forming synapses that contributes to neuroplasticity. During childhood there are certain ‘critical periods’ for development during which if a child is exposed to a certain experience or information they will benefit most from it. Some critical periods are essential (for example aspects of perception); and if a child does not receive the right stimulus during this period they will not develop the ability, for others learning is possible after the critical period but more difficult. Children who suffer brain injury may spend long periods of time recovering and not have the opportunity to be exposed to the appropriate experience or information during these critical periods.

Another reason is that different aspects of cognition develop at different rates. During infancy and early childhood basic processes such as perception and attention undergo rapid development whereas in later childhood and adolescence higher order linguistic and spatial functions are primary. Executive functions develop in late adolescence and early adulthood. The cognitive processes are hierarchical, so the higher order processes depend on the lower level ones. If a brain injury occurs in early childhood this may not only affect the processes developing at the time of the injury but also the development of higher level processes later in childhood.

Rehabilitation that occurs as soon as is possible after the injury is the best way to minimise the impact of the injury, for children and adults. The first step in any brain rehabilitation program is a thorough neuropsychological assessment.

If you’d like more information about Advanced Neuropsychological Treatment Services assessment and rehabilitation services please contact us.

References

Sparrow, S.S., & Davis, S. (2000). Recent advances in the assessment of intelligence and cognition. Journal of Child Psychology and Psychiatry, 41(1), 117-131.

Anderson, V., Northam, E., Hendy, J., & Wrennall, J. (2001). Developmental neuropsychology: A clinical approach. East Sussex: Psychology Press.


Thursday 16 February 2012

Plasticity in brains of middle age and older adults

Following on from our last post about brain neuroplasticity, this blog focuses on the ability of the brains of middle aged and older adults (ages 50 +) to change in response to environmental input.

This is particularly good news because of all individuals who were told their brain was fixed, none were given this message more so that people in this age group!

Initial evidence that brain training works!

The data came from the Iowa Healthy and Active Minds Study and investigated the efficacy of attention-based visual 'brain training' exercises. Brain training exercises are typically computer based programs which present activities that aim to restore or improve cognitive functioning in various areas, usually: attention, memory, communication and planning/organisation. They can be used as part of a program of cognitive remediation for people who have sustained brain damage, or to miminise cognitive decline that occurs naturally with age.

Participants in the experimental groups underwent brain training exercises with different levels of supervision and follow up. The training came in the form of a game that challenged participants to visually process multiple things on the screen at once. A control group underwent crossword puzzle training sessions. Progress was measured by assessing particiants' "useful field of view", what they are able to attend to out of the corner of their eye, which is known to shrink with age.

Initial findings showed improvements in the useful field of view and performance on other cognitive tests of the experimental groups compared to the control group. This distinction indicates that it is the content of the training itself that is having the effect, rather than general stimulation.

The findings add to what scientists are beginning to learn: brain training has the potential to strengthen neural connections in the brain and may help to keep people of all ages mentally sharp! There are a broad range of online options for brain training exercises for those of us trying to keep our brains active and 'plastic'.

If you have sustained a brain injury and are looking for a specific treatment program, please contact us to find out more about our cognitive remediation services.

And stay tuned for more information about neuroplasticity...

Wednesday 8 February 2012

What do you mean my brain is plastic?

Plastic brain image It's strange but true, our brains are like plastic!

What this means is that our brains can be 'moulded'. As we learn, think, grow and gain new experiences our brains change and reorganise themselves. The fancy scientific term for this is "neuroplasticity".

While the neuroplasticity of children's brains has been well established, until fairly recently it was thought that adult's brains were fixed or hard-wired and unable to be moulded. Hence cliches like "you can't teach an old dog new tricks".

Well, luckily for anyone over the age of 18, it it turns out that you can!

The next series of blogs focuses on research and case studies that demonstrate that our brains have the ability to adapt to our environment and that we can keep on learning and improving throughout out lives. Another big thanks to ANTS-er Karen who is on top of all the fascinating neuro news!

Brain adapts when a limb is damaged

A fascinating study undertaken by Prof Lutz Jancke and colleagues at the University of Zurich in Switzerland has shown that when a limb is damaged and immobilised the thickness in the cerebral cortex (brain matter) associated with that part of the body reduces.

In a study that is the first of its kind, 10 right-handed people who had broken their dominant (right) arms had MRI brain scans within 48 hours of their accidents before their arms where placed in plaster/slings and again 16 days later while immobilised. The researchers also measured signals sent from brain to the right arm and the dexterity of their non-dominant left hand.

They found that the thickness of the motor cortex (brain cells that control movement) on the left side of the brain (which controls the right arm) decreased significantly in response to the arm's lack of use, and the signals from that part of the brain to the hand reduced. Whereas the dexterity of the left hand increased, as did the thickness of the part of the brain controlling movement in the left hand - in this case particularly the pre-motor cortex, which is involved in planning complex movements.

Dr Penelope McNulty of Neuroscience Research Australia said about the study:

"It just shows how dynamic the brain remodelling really can be. As far as I'm aware, this is one of the first studies to show that inactivity produces plasticity in the human brain."

This study has implications for the treatment of many conditions where there is loss of use of a part of the body, such as strokes.

It also reinforces that when it comes to the brain you need to use it or lose it!

We'd love to hear from you! Maybe you have a story about how your brain has changed, or maybe you'd like to know more about how to make the most of your exceptional brain. You can post a comment below or contact us here.

Monday 23 January 2012

Nature v's Nurture? New Evidence regarding Intelligence

Nature vs Nurture Nature v's Nurture

For decades, scientists, educators and psychologists have debated the contribution of our genes v's our environment to our intellectual functioning.

New research has quantified the contribution of both.

In a longitudinal study of almost 2,000 people, professors at the University of Edinburgh, University of Aberdeen and University of Queensland determined that genes are responsible for 40% of our lifetime intelligence, with the other 60% being determined by the environment.

The study commenced 80 years ago when intelligence tests were administered to almost all children born in Scotland in 1921 and 1936. Professor Deary from the University of Edinburgh tracked down 2,000 of these individuals who agreed to be re-tested and to supply gene samples for DNA analysis. They were aged from 65 to 79 years at the time of re-testing. Researchers examined the test scores and more than half a million genetic markers.

They found that intelligence was remarkably stable across the lifespan, but there were also examples of people whose functioning improved or worsened over time. The study of genetic DNA Helix markers allowed Professor Deary, Professor Visscher and colleagues to create an estimate of to what extent genetic differences affect how intelligence changes across a lifetime.

While the outcomes show that both genes and environment play an important role in our intellectual functioning, genes are somewhat easier to study. Measuring detailed environmental factors is, according to Geneticist Professor Peter Visscher from the University of Queensland: "very very difficult". The researchers hope that this study will provide impetus for further research on the specific factors that are important for development of intelligence.
This research is critically important because intelligence is a predictor of many factors including lifespan, health and income. Understanding what influences our cognitive abilities may help us better manage conditions which affect the brain, such as dementia.

Friday 20 January 2012

Molly goes into rehabilitation

Ian Molly Meldrum Molly Meldrum has recently been transferred from hospital to a private rehabilitation centre, Epworth Rehabilitation Home.

Reportedly, the focus of his rehabilitation will be on improving his memory. Specifically, according to his brother, Brian, "getting things into the short term memory to the extent that they're passed onto the long term memory". There are ongoing reports that he is disoriented, has memory lapses, can only participate in limited conversation and that his recovery is likely to be gradual and prolonged.

Given his age and the likely severity of his traumatic brain injury, these outcomes are unsurprising. However, a rehabilitation program will ensure that Molly has the best possible recovery.

What is rehabilitation

Rehabilitation can be physical or cognitive, and in the case of traumatic brain injury, usually both. Our focus will be on cognitive rehabilitation.

Cognitive (thinking skills) rehabilitation has two components: restoration of functions that can be restored (remediation) and using intact skills to compensate for impaired skills (compensation). Processes that lend themselves well to restoration are things like unilateral visual inattention, where an individual does not attend properly to objects/information on one side. With practice and use of specific techniques to draw the patient's focus to the neglected side, this can often be restored.

Memory, particularly in cases of severe injury and with older patients, is often very difficult to restore. Compensation is the best option for treating memory problems. Common memory compensation techniques are using calendars, labelling objects, placing commonly used items in the same place each time, asking others to provide reminders and using techniques that optimise use of the memory process least impaired (e.g. if visual memory is better than verbal memory the use of charts/pictures can help).

The first step and the cornerstone of treatment for traumatic brain injury is a thorough neuropsychological assessment to identify level of functioning and pinpoint strengths and weaknesses. For more information about our assessment and treatment services, visit the ANTS website or contact us.

Wednesday 4 January 2012

Molly Meldrum and TBI in the elderly

Ian Molly Meldrum On 15 December 65 year-old Ian “Molly” Meldrum fell 3 metres downstairs whilst putting up Christmas decorations in his home, striking his head and fracturing his skull. He was hospitalised, sedated and placed on a ventilator to help him breathe.

From the little information released by the media on his condition and recovery since the fall it appears that:
  • Molly was unconscious for several days and possibly more than a week – although it is understood that he was in an induced coma for part of that time
  • He regained consciousness after Christmas but remains disoriented and confused
  • He is only able to respond to basic commands and is unable to carry on a conversation
  • He can recognise close family members at times but this is inconsistent
These factors suggest that Molly sustained a traumatic brain injury (TBI) that was at least in the severe and possibly extremely severe, range.

Today’s ABC news report predicts that Molly has “a very, very long haul ahead of him”.

Research supports this assertion. Older age is an important predictor of worse outcome after TBI, even with relatively minor head injuries. A study by Mosenthal and colleagues (2002) found that elderly patients had twice the in-hospital mortality of younger TBI patients, the mortality rate increasing for each decade over 50 years. Elderly survivors of TBI are more likely to have a severe disability or be in a persistent vegetative state. The incidence of complications and poorer outcome after surgery are also worse for older patients.

The best predictors of a favourable outcome following TBI are younger age and lesser severity of TBI.
While this doesn't bode well for Molly, he does appear to be making some progress and all signs are that his functioning will continue to improve. It is also likely that he is getting the best possible care, which can make all the difference in ensuring the best possible recovery.

The thoughts of the ANTS team are with Molly and his family and we wish him a speedy recovery.

If you would like more information about TBI, cognitive rehabiliation or other ANTS services, please contact us.

References
Mosenthal, A.C., Lavery, R.F., Addis, M., et al. (2002). Isolated traumatic brain injury: Age is an independent predictor of mortality and early outcome. Journal of Trauma, 52(5), 907-911.
http://www.couriermail.com.au/news/molly-still-faces-an-uphill-battle/story-e6freon6-1226236078834
http://www.theaustralian.com.au/news/nation/meldrum-remains-in-intensive-care-faces-long-haul-to-recovery/story-e6frg6nf-1226236011605
http://www.heraldsun.com.au/news/more-news/molly-meldrum-recognises-brother/story-fn7x8me2-1226233539168
http://www.clinicalgeriatrics.com/articles/Traumatic-Brain-Injury-Elderly?page=0,8