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.


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.