Monday, 29 July 2013

Removing the stigma of epilepsy

Emma Renwick, an epileptic, bravely shared her experience of dealing with epilepsy on the ABC Drum program website earlier this year. She did so in an effort to reduce the social stigma associated with epilepsy, in the hopes that her daughter, who also had epilepsy, would inherit a more accepting society.

She provided the full story of her own diagnosis and the lead up to it, as well as her personal and professional struggles coping with the impact of epilepsy.

When driving one Sunday morning she had a momentary 'outage', or loss of time, which almost resulted in a car accident. Weeks later the same thing happened, and again she blacked out while in the shower and almost hit her head on the ground.

She went to the doctor, who ordered a CT scan and referred her to a neurologist. She was diagnosed with epilepsy - Absence epilepsy. While the term epilepsy conjures up images of lying on the ground having fits, there are actually several different forms of epilepsy. They can be divided into two major groups of seizures: focal (partial) or generalised seizures. Most people with epilepsy experience focal seizures. In this type of seizure the activity starts in one area of the brain (often the temporal lobe), and may spread to other brain regions. These can be further divided into:

Focal seizure - awareness retained (formerly known as simple partial seizures): the person experiencing the seizure is conscious and aware of what is happening
Focal dyscognitive seizure (formerly known as complex partial seizures) - awareness altered: the person is unaware of what is happening
Focal seizures evolving to a bilateral convulsive seizure (formerly known as generalised Tonic-Clonic seizures): the seizure activity starts on one side of the brain and them moves to the other hemispere

During generalised seizures the abnormal activity occurs in both brain hemispheres simultaneously. There are numerous types of generalised seizures, one of which is an absence seizure. Absence seizures are of short duration, and can often appear as if the person is 'zoning out'.

There are also 'other' types of seizures, which don't fit within the above categories.

More information can be found here, as well as this useful flowchart:

Epilepsy is the most common chronic brain condition in Australia and affects more than 220,000 people. Yet despite this, Emma reports, there is a high degree of discrimination against people with epilepsy. This includes exclusion, bullying, harassment and even assault at school and in the workplace. This is despite the fact that epilepsy is not contagious, does not develop as a result of any wrongdoing on the part of sufferers, and in many cases, is well controlled with medication.

Emma writes her story in an effort to help end such discrimination, and to further educate people about this very common condition. Read her story here.

ANTS can undertake thorough assessment to help you better understand and manage your epilepsy. Please contact us for more information.

Friday, 26 July 2013

Protecting your brain's 'borders'

With all the current discussion in Federal politics about 'protecting our borders' it's an opportune time to talk about a less controversial border - the one in our brain. It's called the blood-brain barrier (BBB). Our brain houses up to 650 kilometres of blood vessels! These vessels are lined by a structure, the BBB, which regulates the passage of nutrients, proteins, chemical substances and microscopic organisms between the bloodstream and the brain tissue. Basically, it controls what is, and what isn't, allowed to leave the blood supply and enter the brain.

Blood vessels supply our organs with the nutrients that they need, and help to remove waste products. It has long been known that the blood vessels in the brain and spinal cord are particularly good at protecting the brain from harmful substances, through the BBB, but until recently it hasn't been completely understood how this occurs.

Emerging research using imaging techniques has revealed that the blood vessels in the brain

and spinal cord are lined with specialised cells. These cells have molecular passageways embedded in the cell membrane. These passageways will actively block some chemicals, which are likely to be dangerous to the brain, and play a role in pushing other chemicals across into the brain. The entry and exit of these chemicals are controlled by cells called astrocytes and pericytes.

In mouse models, a deficiency in pericytes has been shown to increase the permeability of the BBB to chemicals. And a deficiency in astrocytes has been shown to result in small haemorrhages at the BBB/brain junction.

Using a 'two photon' microscope to probe inside the living brain, researchers have seen these astrocytes and pericytes doing their job, as well as witnessed white blood cells move across from blood vessels into the brain, and back again.

In addition immune system cells, 'microglia', search the brain for harmful substances that have found their way into the brain, and look for damaged or cancerous cells, and remove them.

The practical application of this knowledge is that neuroscientists are now discovering that many neurodegenerative conditions such as Alzhemier's dementia and Parkinson's disease involve defective BBB and related cells.

For example, it is thought that Alzheimer's dementia involves having too much of a chemical called beta-amyloid in the brain. The BBB has a protein that brings the beta-amyloid out of the bloodstream into the brain, and another protein does the opposite. Perhaps keeping the beta amyloid out of the brain might be a prevention, or even a cure, for Alzheimer's dementia.

We look forward to more research in this area, helping us to better understand, and hopefully formulate better treatments for these neurodegenerative diseases.

Thursday, 18 July 2013

See-through brain?

The brain is, understandably, a popular topic for research. Traditionally researchers wishing to study the brain have had to use invasive and time-consuming methods of cutting it up. However, recently a team lead by Dr Karl Deisseroth at Stanford University has developed a method to make brains transparent, allowing them to be studied without having to be sliced up. The process can also be used with other organs, "revolutionising the three-dimensional study of important organs within the body".

The brain is surrounded by lipids that help form the membranes around the cells and bind the tissues together. This membrane blocks the view into the brain. The revolutionary new process referred to as CLARITY replaces the lipids with a clear gel, which preserves the tissues while revealing the internal structure of the brain. The gel is injected into the organ and is absorbed into the tissue. The lipids are then removed, while the rest of the brain remains intact, leaving the neurons, axons, dendrites, proteins and synapses in place and able to be viewed.

Previously these structures could only be seen following the brain being sliced up, and only across tiny slivers of tissue. Researchers then needed to reconstruct three-dimensional data from images of these thin slices to form a three dimensional view of the brain.

Using CLARITY scientists can then use fluorescent proteins and neuro-imaging to see neuronal connections, subcellular structures, proteins, nucleic acids and how cells interact and relate to each other. This opens up the possibility of viewing large networks of neurons with unprecedented ease and accuracy.

The procedure has already been used to investigate the nerves in the post-mortem brain of an autistic boy. They noticed unusual patterns in the neurons, which is likely to help advance the understanding of autism.

We at ANTS look forward to hearing more about how this procedure can be used for advancing our understanding of various neurological and neuropsychological conditions.

Friday, 5 July 2013

Living by values

Values are broad preferences concerning appropriate courses of action or outcomes, which guide ethical action. Commonly held values are honesty, equality, justice and commitment. Value identification, value creation and values-based living are the basis for many religions, philosophies and psychological therapies. A good (though maybe somewhat morbid!) way to identify your personal values is to think about what you would like people to say at your funeral. Or alternatively what you'd like your family to say about you on your 80th birthday, or your partner to say on your golden wedding anniversary.

Values play an important role in good psychological health. In his blog Anger in the Age of Entitlement, Steven Stosny, Ph.D and psychotherapist states that "If you devalue more than you value, your life will be bad, no matter how many good things happen to you. If you value more than you value, your life will be good, regardless of how many bad things happen to you".
That is a very interesting concept, and it explains why:

  • Often the things we think will make us happy don't
  • Why some people who appear outwardly to have everything are not happy, and
  • Why some people who appear to have very little do seem to be happy.

Nelson Mandela is one good example of this. He experienced the death of his father as a child, was expelled from one university and dropped out of another for being a poor student, was imprisoned, experienced the death of two of his children, was not allowed to attend the funeral of his mother and one of his children, and was twice divorced. Despite these setbacks he continued to devote himself to his values of democracy and equality, achieved his goal of democracy in South Africa, and created an important legacy. It is likely that he was able to keep pursuing his goals despite his bad experiences because he was living by his values.

On the other hand, daily we hear about various celebrities, who despite their wealth, status and popularity have drug addictions, convictions for various offences and even on occasion attempt or complete suicide. While we do not know what happens in their personal lives, it is likely that they pursued fame and money thinking that it would make them happy, while ignoring or violating their deepest values. Certainly it is highly unlikely that anyone's deepest values include destroying their bodies and harming other people.

Anything involving the brain that is done repeatedly becomes habituated. Repeatedly pursuing a certain mindset creates neural pathways in the brain that become strengthened until that way of thinking is essentially automatic. If we continue to think about the ways we have been wronged for example, complain about other people and pursue revenge, then resentment will become our automatic way of thinking. If we actively choose to see setbacks as opportunities for growth and pursue compassionate understanding, then we are creating values based thinking, which is likely to lead to more happiness.

The upshot is that values-based living will lead to more happiness and better emotional health. In a practical sense, when something happens in our lives that makes us feel devalued, we are likely to recover more quickly and to have a better overall outcome if we strive to value rather than devalue. For instance, when going through a break up it is better to find ways to feel loved and to love others rather than to blame and demonise the other person.

Certainly easier said than done!

Monday, 27 May 2013

Rates of dementia higher in Indigenous Australians

Indigenous Australians have much poorer health outcomes and higher rates of some illnesses than non-Indigenous Australians. Estimates from the Australian Bureau of Statistics (ABS) show than an Indigenous male born in 2005-2007 was likely to live to 67.2 years, about 11.5 years less than a non-Indigenous male (who could expect to live to 78.7 years). An Indigenous female born in 2005-2007 was likely to live to 72.9 years, which is almost 10 years less than a non-Indigenous woman (82.6 years). They also have higher infant mortality rates, at between 5-13 for every 1,000 births (depending on the state), compared to 4 in every 1,000 for the total population.

ABS research also shows that Indigenous Australians on average also have higher rates of cardiovascular disease, cancer, diabetes, kidney disease and asthma.

A ground-breaking recent study has also found that they are more likely to suffer from dementia.

A three-year study titled Koori Growing Old Well Well was conducted between 2009 and 2012 across five urban and regional Indigenous communities in New South Wales. It involved 336 participants aged over 60 years. Preliminary results revealed that at 21 percent the prevalence of dementia is three times the rate of non-Indigenous Australians. It also found that there is an earlier age of onset amongst Aboriginal Australians, with almost three quarters of participants with dementia being aged between 60 and 70 years, compared to other Australians where the majority of people with dementia are aged over 70 years.

The poorer overall health of Aboriginal Australians plays a role in their higher rates of dementia. Risk factors for some forms of dementia include high blood pressure, obesity, smoking and diabetes.

The lead researcher, Professor Tony Broe reported "Aboriginal people in urban areas have a high incidence of many of the risk factors that have been linked to dementia in studies around the world".

Some issues with research in this field are that some Indigenous people are reluctant to share their health issues and do not want to accept that their loved ones have dementia.

These results have prompted doctors to call for appropriate services tailored specifically for the Indigenous community. Professor Broe says the findings will be used to develop education and services for older Indigenous people with dementia and for their families.

Tuesday, 21 May 2013

Could previous researchers have been wrong about the role of amyloid in Alzheimer's disease?

Amyloid proteins in the brain have long been implicated as the culprit behind Alzheimer's disease. Amyloid are insoluble protein aggregates that arise from inappropriately folded proteins and polypeptides. These form tangles or plaques. They have been associated in the pathology of more than 20 serious neurodegenerative disorders, including Alzheimer's disease. They’re thought to disrupt the seamless workings of the neurons responsible for memory and movement.
Recent studies in the US and in Australia, have however found that amyloid may not be as destructive as previously thought.

Two recent US studies have found that amyloid proteins may in fact play a protective rather than a destructive role in the brain. The studies run by Professor Lawrence Steinman of Stanford University found that treating mice with multiple sclerosis (MS) with amyloid proteins reduced brain inflammation and reversed MS-related paralysis.

A second study extended the finding to show that small portions of several notorious amyloid-forming proteins (including tau and prion proteins) can also alleviate symptoms in mice with the condition — despite the fact that the fragments can and do form the long tendrils, or fibrils, previously thought harmful to nerve health. This supported previous research showing that Alzeimer's disease is much worse in animals born without the genes that produce amyloid.

He reported, "we were so fixated on the idea that amyloid is bad for the brain that if one goes back and looks at the old literature and the new literature, one finds there's a lot of publications where people have ignored these kinds of experiments in humans where, for instance, lower levels of amyloid are associated with earlier dementia".

In another recent Australian study run by Dr Bryce Vissel of the Garvan Institute of Medical Research, researchers have found that the amyloid plaques that are characteristic of Alzheimer's disease appear much later in the disease than previously thought, and after the development of cognitive symptoms. This indicates that neurodegenerative processes such as memory loss and executive dysfunction occur independently of amyloid plaques.

Instead it is proposed that inflammation in the brain is the leading cause of brain damage and neurodegeneration in Alzheimer's disease. Lawrence suggested that amyloid proteins may soak up harmful molecules that are responsible for inflammation.

The studies suggest that anti-amyloid therapies may not be the best way to manage the disease, and that therapies focusing on reducing inflammation may be more beneficial.

Friday, 17 May 2013

The importance of wearing helmets

Australia is one of the few countries in the world with mandatory helmet laws for motorcyclists and bicycle riders. They were introduced in 1991 in New South Wales and have been the subject of controversy since. A recent study provides evidence supporting the importance of wearing helmets in reducing the risk and severity of head injury, particularly for bicycle riders.

Dr Michael Dinh from the University of Sydney and colleagues studied 348 adult patients admitted to hospitals following bicycle and motorcycle accidents in Sydney for one year between 2008-2009.

They found that cyclists who didn't wear helmets were almost 6 times more likely to suffer a head injury than those wearing helmets, and more than 5 times more likely to suffer a severe head injury. The benefits for motorcyclists were not as marked but still significant, with those without helmets 2 times more likely to suffer a head injury and 3.5 more likely to suffer a severe head injury compared to those without helmets.

Head injuries are rated on a scale from mild to extremely severe, based on a ranges of factors including level of consciousness following the incident and length of coma.

These outcomes also have implications for hospital care. The study found that patients who suffered severe head injuries from not wearing a helmet cost hospitals 3 times as much in treatment. For those who suffered a severe head injury, median hospital costs for non-helmeted patients were $72,000 while for those with helmets the figure was $24,000.

Older riders were more likely to wear helmets than younger riders. The average age of helmet wearing cyclists was 41, compared to 35 for non-helmet wearers, and for motorcyclists the average ages were 31 for those wearing helmets and 25 for those who did not.

The study was published in the Medical Journal of Australia. It supports previous research on the subject. In 2011 Dr Jake Oliver and colleagues from the University of New South Wales and the Sax Institute studied the number of head injuries before and after the mandatory helmet laws came into effect. They found that head injuries fell by up to 29%.

There are clear benefits from helmet wearing that clearly outweigh concerns about mandatory helmet laws reducing the number of cyclists. Studies such as those by Dr Dinh and Dr Oliver have also prompted debate about the usefulness of mandatory helmet laws in the US. More information can be found here.

Monday, 22 April 2013

Using neuroimaging to differentiate between Bipolar Disorder and Borderline Personality Disorder

Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are often confused and misdiagnosed. Both disorders involve dysregulation of emotional responses as key diagnostic criteria. BD is a mental illness involving a set of significant 'mood swings'. The most common form of Bipolar involves 'highs' (or mania) and 'lows' (depression). BPD is a type of personality disorder, or a set of long-standing traits and behaviours associated with significant distress or disability. A key feature of BPD is affective liability, meaning that people with BPD have difficulty stabilising their moods and therefore can demonstrate erratic mood swings. They are also prone to depression. More information about both disorders can be found on the website of the Black Dog Institute.

As it is personality based BDP tends to be a long-term disorder, whereas BD can come and go and with the right treatment can be cured or well managed. Appropriate treatment and management requires proper diagnosis. Unfortunately until now there have been no biological markers for psychiatric disorders.

However, some promising new research has found that there may be a way to differentiate between BD and BPD at a biological level. Professor Gin Malhi from the Sydney University has found biological differences in the brains between people with the two conditions. Professor Malhi and colleagues scanned the brains of people with BD (who were not depressed at the time of the study), BPD and controls with no mental illness while they undertook a task that focuses on emotional responses and is cognitively taxing (the emotional Stroop task). They found a significant difference in the response of the emotional circuits in the brain of the two patient groups and between the patients and controls during the task.

Individuals with BP drew more on the dorsomedial prefrontal cortex of the brain, whilst people with BPD showed heightened activity in the amygdala, a lower level part of the brain which coordinates emotional responses and processes negative emotions such as fear. Professor Malhi reported that people with BPD were not able to regulate this "key node in the lower part of the brain that co-ordinates emotional understanding". In contrast, people with BP were able to function quite normally when well, and just needed to expend more effort in the brain than controls.

While the results are very promising, Prfessor Malhi stresses the need for replication of the study.

He concluded: "for the first time in the past two decades we have the technology to see the brain functioning [but] these insights and understanding have to be translated into clinical practice."

Friday, 19 April 2013

Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V)

The DSM is the 'bible' for mental health practitioners around the world. It is used to diagnose disorders affecting mood, personality, identity, development and cognition. It has recently undergone a major revision from the previous edition, the DSM-IV (released in 1994), and is set to be released in May 2013.

There have been many significant changes from the previous edition. Keep reading to find out about some of the most important changes.

New or amended diagnoses
Autism Spectrum Disorder (ASD)
This is one of the most important changes, given the prevalence and severity of ASD in the community. ASD is characterised by communication deficits, difficulties interpreting nonverbal communication, social difficulties, issues coping with change to routines, and intense focus or obsessions with inappropriate items. Some symptoms must be shown from early childhood. The symptoms fall on a continuum, with some individuals showing mild symptoms and others having much more severe symptoms. ASD is a single umbrella disorder which incorporates four separate disorders from the DSM-IV: autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified.Researchers from the DSM-V workgroup found that these separate diagnoses were not consistently applied across different clinics and treatment centres, and that a single disorder improves diagnosis of ASD.

Disruptive Mood Dysregulation Disorder
This is characterised by severe outbursts or tantrums and prolonged irritable mood in children. It was included to capture children who display these characteristics and are misdiagnosed with Bipolar Disorder and/or Attention Deficit Hyperactivity Disorder.

Hoarding Disorder
Public interest in hoarding, the compulsive collection of possessions that may or may not have monetary value, is demonstrated by the popularity of reality television shows and docu-dramas dealing with this issue. Hoarding will now be listed as a separate condition from obssessive compulsive disorder in recognition of its unique symptoms and effects.

The complex multiaxial system with five 'levels' or axes of disorders will be removed. The DSM-V will instead present a simplified list of 20 chapters by grouping related disorders.

Rejected diagnoses
A number of proposed diagnoses were subsequently rejected and will not be included as separate disorders in the DSM-V. These include: Anxiety Depressive-Syndrome, Attenuated Psychosis, Hypersexual Disorder, Parental Alienation Syndrome and Sensory Processing Disorder.

Certain specifics of the DSM-V will not be made public until its release. However, more details about what has been publicly released can be found at the DSM-V development website.

While various websites publish diagnostic criteria from the DSM-IV (and likely the DSM-V once its released), a trained, experienced psychologist, neuropsychologist or psychiatrist is the best person to help you clarify or confirm a diagnosis of a psychological disorder. If you would like more information about our neuropsychological services, please contact us.

Friday, 5 April 2013

Right brain/left brain

If further proof was needed that the human brain is a fascinating organ, because of the way our brains are organised, there is a slight but discernible difference between the left and right sides of our faces.

Our brains are composed of approximately 100 billion neurons (nerve cells), with 50 billion neurons in each half. However, only approximately 250 million neurons join the two halves, meaning that our left and right brains are mostly unconnected and work separately. One result of this is our faces are unsymmetrical.

Many actors and other famous people (such as David Caruso, pictured) are known for having a 'good side' - preferring to be photographed on one side of their face than the other. Research shows support for the assertion that the different sides of our faces are different and one side is actually considered to be more attractive than the other.

Professors Kelsey Blackburn and James Schirillo from the University of Wake Forest asked undergraduate university psychology students to rate the attractiveness of 20 volunteers who had been photographed on both their left and right sides, about 37 degrees from the centre on each side. Some photographs were untouched, while other photos has been Photoshopped so that they were mirror-reversed so the left side looked like the right and vice versa.

As well as asking them about their preferences, the researchers examined the students' pupils. The size of one's pupil is related to the intensity of our emotional response to stimuli. In general, the students preferred the left face of the both men and women — regardless of whether they were shown the untouched left face, or a left face which had been mirror-reversed to look like a right face. This was regardless of the gender of the person in the photo, and the gender of the person doing the judging. And the pupils of the volunteers opened larger when they rated the faces more attractive.

The echoism app, developed by artist Julian Wolkenstein shows a combined image of two photos of either the left or right side of people's faces, with most of these photos posted on line being very different from the people's actual image. This indicates that 'symmetrical' faces don't look quite right. Judge for yourself whether you think the right or left images are more attractive.

Wednesday, 13 March 2013

The psychopathic brain

A very interesting article by Dr Karl Kruszelnicki revealed that psychopathology, characterised by features such as egocentricity, a lack of empathy, remorse and poor impulse control, may be associated with the orbito-frontal cortex in the human brain. The orbito-frontal cortex (OFC) is located in the pre-frontal area of the frontal lobes behind the eyes, as indicated by the green shading on the image to the right.

The OFC controls those behaviours which are known to be impaired in psychopaths, including impulse control, planning and calculating risk. It also has a role in processing odours, and research has shown that psychopaths have a poor sense of smell.

Shamay-Tsoory, Harari, Aharon-Peretz, and Levkovitz (2010) proposed that psychopathy is associated with impairments in theory of mind (TOM) which is also associated with the OFC. TOM is the ability to understand what another person may be thinking and feeling, and to be able to appreciate their perspective. Shamay-Tsoory et al. showed that people with lesions in the OFC performed poorly on complex TOM tasks, particularly those drawing on affective TOM, which involves interpreting emotions. People with psychopathic tendencies had similar difficulties on complex TOM tasks as those individuals with lesions in the OFC.

The authors suggested that psychopaths may not appreciate the emotions, fears and sorrow of other people, which allows them to behave callously without feelings of remorse.

The OFC also has extensive projections to a part of the brain called the amygdala. The amygdala is involved in processing fearful and sad facial expressions and emotions and has a role in instrumental learning. Several neuroimaging studies have shown that people with psychopathic tendencies have reduced amygdala volume (Kiehl et al., 2001; Tiihonen et al., 2000).


Kiehl, K.A., Smith, A.M., Hare, R.D., et al. (2001). Limbic abnormalities in affective processing by criminal psychopaths as revealed by functional magnetic resonance imaging. Biological Psychiatry, 50, 677-684.

Shamay-Tsoory, S. G., Harari, H., Aharon-Peretz, J., & Levkovitz, Y. (2010). The role of the orbitofrontal cortex in affective theory of mind in criminal offenders with psychopathic tendencies. Cortex, 46, 668-677.

Tiihonen, J., Hodgins, S., Vaurio, O., et al. (2000). Amygdaloid volume loss in psychopathy. Society for Neuroscience Abstracts, 2017.

Tuesday, 5 March 2013

The neuropsychology of humour

Humour is very important to humans, and therefore to psychology. According to Brownell and Gardner (1998):

Humour plays a powerful and unique role in human life,
with wide-ranging effects on many aspects of functioning.
Humour is a basic ingredient of binding in society; it provides
an effective means of communicating a wide range of ideas,
feelings and opinions.

Lacking, or losing (such as through brain injury) a sense of humour can very be damaging to one's social interactions and self-esteem. Having difficulty appreciating and understanding humour is a key feature of many psychological and neuropsychological conditions, including Autistic Spectrum Disorders, psychotic conditions, certain acquired brain injuries and some forms of dementia.

For these reasons there has been extensive neuropsychological research on humour. This research has shown that damage to the right hemipshere, particularly the frontal lobe most disrupted the ability to appreciate humour. Interestingly, this was also correlated with other cognitive processes, such as visual search, ability to focus attention and to hold relevant information in mind and mentally manipulate it (working memory). This makes sense, as appreciating a joke involves: being able to listen and focus on the joke, holding relevant information in mind and relating it back to the punchline, and/or scanning cartoons or other visual material. Humour is a complex business!Disorders of humour such as foolishness and a tendency toward making inappropriate jokes have also been reported in patients with damage to the frontal lobes.

It is thought that the right frontal lobe may be unique in integrating cognitive and affective information, to allow us to appreciate jokes and other emotive material.

Neuroimaging studies have revealed that the physical expression of laughter involves the amygdala (emotion centre), thalamic, hypothalamic and subthamalic regions (sensory relay areas) and the brainstem, as well as the premotor/frontal area through to the motor cortex (to aid the motor movements involved when laughing). These studies have confirmed that the perception of humour involves the right frontal cortex, as well as the prefrontal cortex (higher level executive area and personality), temporal regions (memory centres) and possibly the cerebellum.

Because they are associated with different parts of the brain, disorders of laughter can occur independently of disorders of humour. Difficulties with expressing laughter are most commonly associated with a type of stroke known as pseudobulbar palsy, when laughter can be intermixed with crying. 'Laughing' seizures are associated with a tumour in the hypothalamus. These individuals may have an intact sense of humour but may have difficulty expressing laughter approriately.

Finally, just to show that neuropsychologists have a sense of humour, the following (mildly edited) joke is taken from the Humour in Neuropsychology webpage:


A group of 40-year-old buddies discuss and discuss where they should meet for dinner. Finally it is agreed upon that they should meet at the Gausthof zum Lowen restaurant because the waitresses there have low cut blouses.

10 years later, at 50 years of age, the group meets again and once again they discuss and discuss where they should meet. Finally it is agreed that they should meet at the Gausthof zum Lowen because the food there is very good and the wine selection is good also.

10 years later at 60 years of age, the group meets again and once again they discuss and discuss where they should meet. Finally it is agreed they should meet at the Gausthof zum Lowen because they can eat there in peace and quiet and the restaurant is smoke free.

10 years later, at 70 years of age, the group meets again and once again they discuss and discuss where they should meet. Finally it is agreed that they should meet at the Gausthof zum Lowen because the restaurant is wheel chair accessible and they even have an elevator.

10 years later, at 80 years of age, the group meets again and once again they discuss and discuss where they should meet. Finally it is agreed that they should meet at the Gausthof zum Lowen because that would be a great idea because they have never been there before.

Brownwell, H.H., & Gardner, H. (1988). Neuropsychological insights into humour. In J. Durant, & J. Miller (Eds.), Laughing matters: a serious look at humour (pp.17-34). New York, Wiley.

Tuesday, 26 February 2013

Sports stars: a great example of brain-behaviour relationships

New research has found that athletes have a superior ability to rapidly process pictures, and to quickly learn unpredictable and dynamic visual information. This ability appears to give them the edge on the sporting field (or court..or arena).

In a study conducted by Jocelyn Faubert and colleagues from the University of Montreal, 102 professional athletes, 173 amateur athletes and 33 non-athletic students were asked to track and describe a series of abstract moving pictures on a screen. This was repeated 15 times over five days. The task was deliberately neutral and unrelated to sport, so that the results could not be assumed to be related to the athlete's greater familiarity with the tasks.

The professional athletes processed the visual information much faster than the other groups and improved their performance markedly over the five days. The other two groups started similarly, but the amateur athletes soon improved and had a much faster learning speed than the non-athletic students.

The results are a great addition to our understanding of the relationship between sporting prowess (behaviour) and cognition (brain), because previous studies have not found a significant relationship between sporting ability and performance on other cognitive tests.

This study revealed that "[Professional athletes] appear to be able to hyper-focus [on complex visual information] for short periods of time resulting in extraordinary learning functions," according to Jocelyn Faubert. The cognitive requirements for interpreting the visual information parallel situations such as driving, crossing the street and perfoming sport activities. Overall, they are smarter at learning how to interpret the "real world in action".

This coincides with previous research which showed differences between athletes and non-athletes in a part of the brain which regulates motion perception.

The study did not explore whether these abilities were innate or acquired through practice. This would be an interesting area for further research.

Thursday, 21 February 2013

The Neurobiology of Suicidality: development of a blood test?

A blood test to determine if a person is suicidal may sound like science-fiction, but if recent research in Australia is anything to go by, such a technology may be within reach of medical practitioners sooner than you think.

According to the Australian Bureau of Statistics, suicide is the most common cause of death for young Australians, aged between 15 and 40. Consequently, research in the early detection of suicidality is vital. While there are several observable behavioural warning signs of suicide, a growing number of studies have looked at the neurobiology of suicidality, in an attempt to determine reliable chemical warning signs. According to Dr. Guilemin from the University of New South Wales, most studies in the area have so far looked at the imbalances of a neurotransmitter called Serotonin in the brain. However, after decades of research the link between Serotonin and suicidal behaviour remains unclear.

More recently, another neurotransmitter in the brain, known as quinolinic acid, has come to the attention of researchers. In a study recently published in Neuropsychopharmacology, higher levels of quinolinic acid were found in individuals hospitalised after a suicide attempt compared to a healthy control group. Moreover, high levels of quinolinic acid were also related to higher scores on a self-report and assessor-report scale assessing suicide intent.

Importantly, the hospitalised patients in the study underwent a ‘washout period,’ where they did not receive any antipsychotic or antidepressant medication, which was argued to rule out the possibility that different levels of the neurotransmitter were due to differences in medication between the groups. Furthermore, the authors noted that quinolinic acid was high in all suicide attempt patients, regardless of whether they were given a diagnosis of depression or not. Consequently, this may suggest that higher levels of the neurotransmitter may be specifically linked to suicidality rather than more general depressive symptoms (Serotonin, on the other hand, is more reliably linked to depression). Interestingly, quinolinic acid in the suicide attempt group normalised to that of the control group six months later.

Previously, it has been suggested that abnormal activation of N-methyl-D-aspartate (NMDA) receptors in the brain may be in some way responsible for suicidal behaviour, consistent with the general findings that medications that blocks NMDA receptors appear to alleviate such symptoms. Quinolinic acid may therefore be an important part of this mechanism, given that this neurotransmitter is known to trigger and activate NMDA-Receptors.

Of course, even if an excess of quinolinic acid is found to be a reliable indicator of suicidality it does not necessarily make it in any way a direct cause, and future research is required to determine how effective medication that manipulates this neurotransmitter will be in reducing suicidality. As the authors of the study point out, suicidality is a complex phenomenon and such things as psychological factors may in fact be a more immediate cause, with the observed excess of quinolinic acid being a secondary trigger. Consequently, psychological therapies would continue to play a critical role in treatment.

Monday, 11 February 2013

How the brain organises our visual world

We live in a world in which we are bombarded with thousands of visual images every day. Recently researchers at the University of California provided a unique insight into how the brain organises and stores these visual images.

In the study, subjects watched hours of movies which included scenes from everyday life, whilst their brain activity was captured using functional magnetic resonance imaging (fMRI). They collected imaging data on 1,705 categories of objects (e.g. dog, building, road, furniture) and actions (e.g. jump, spin, hit, touch).

They then created a map to show how images of these objects and actions were organised by the brain. What they found was that the brain works efficiently to categorise images enabling similar images to be stored together in compact brain regions.

The graph below, taken from this study, shows how the brain links categories which are semantically related. To make it easier to identify, researchers have shown similar categories using the same colour. For instance, images to do with “person” are shown in green, whilst animal images can be seen clustered together in yellow. Images related to vehicles are identified by pink.

From this we can see how the brain links related categories together. Categories that are represented similarly in the brain are plotted at nearby positions. For example, information about humans shares the same neighbourhood in the brain as information about animals. Categories that have less in common, however, are located further away from each other in the brain. The graph below shows how to the brain, “person” and “talking” are represented as being more similar and having more in common than “kettle” and “talking”.

©University of Berkley

This study suggests that rather than each category being stored in its own distinct brain region, the brain is able to determine whether or not diverse categories share overlapping or common features and then group them accordingly in a continuous space. The brain actively ascertains the relationships between categories in order to work out where to store images. This more effectively utilises the relatively limited brain space available, given the size of our brains, and helps the brain to be more efficient by minimising the number of neurons required to represent each feature of an image.

A further interesting finding was that whilst only five subjects were included in the study, the authors were able to ascertain that different people share similar semantic layouts. That is, all of the subjects tended to use very similar cortical maps to store visual images. As well as providing us with a unique insight into brain organisation, the results of this study have implications for improving computer image recognition systems and creating other brain-machine interfaces.

Researchers have produced an interactive version of the brain map which provides a detailed insight into the visual function and organisation of the brain which can be found by following the link:

Wednesday, 6 February 2013

A back to school blog - beware pen colour!

Teachers - beware pen colour! A recently published US study has found that the colour of the pen used by teachers when marking student's work has an impact on student-teacher relationships. The research, led by Professor Richard Dukes and Associate Professor Heather Albanesi from the University of Colorado involved 199 undergraduate university students who provided feedback on four versions of an essay (either low-quality or high-quality) which had marks and comments from a teacher in either red or aqua coloured pen. They were asked to provide feedback on:

  • Whether they agreed with the mark given
  • What mark they would give the paper
  • Various qualities of the teacher, including whether the teacher appeared to be knowledgeable, organised, nice, enthusiastic and had a good rapport with students

They found that while there were no differences between the perceptions of the quality of the work based on pen colour, perceptions of the teachers were higher for the essays marked in aqua compared to red. Professor Dukes reported that it the colour red is "loaded with emotion". It appeared the use of a red pen equates in the student's mind to "shouting" in the same way as writing in all capitals.

The main message of the research, according to Professor Dukes was that teachers should avoid using red pen if they want to convey constructive, critical comments to students. It "adds emotional loading" to the feedback, and if the teacher does not intend this negative emotion to be part of the communication, it would be worthwhile to rethink the pen colour.

"When the student ..performs well.. and receives a high grade, the situation is a "win-win" (teacher and student are feeling good about the process)," says Dukes. "However, when the student does not perform well, at least some of the blame is put upon the teacher."

This may also be related to the study of colour psychology, which claims that colours evoke emotions, can dramatically affect moods and are powerful communication tools. In the study of colour psychology, red has been found to evoke feelings of anger and hostility, while colours such as blue and green are soothing. There are also physiological responses related to the colour red, it increases the pulse and heart rate, and raises blood pressure and increases the appetite by increasing the metabolism.

Tuesday, 22 January 2013

An update on Molly Meldrum

Molly's recovery

Readers may recall that in December 2011 Molly Meldrum was admitted to hospital after a fall at his home in Melbourne. He was in an induced come for approximately 10 days and in Post Traumatic Amnesia (PTA) for almost one month. From the limited details released by the media, Molly appeared to have sustained at least a severe Traumatic Brain Injury (TBI).

It has emerged that on February 27, 2012, less than 10 days after coming out of PTA, Molly checked himself out of hospital. At that point he could walk and talk, was physically much better, had likely had enough of being in hospital and (incorrectly) assumed that he was well enough to go home.

Thursday, 17 January 2013

Autism - making the most of a disABILITY

Recently, Louis Theroux explored the lives of children with Autism and their families in a documentary called 'Extreme Love'. It was most recently aired on ABC2 on Sunday 13 January.

One of the best scenes in the documentary (in my opinion) involves Louis asking a family whether they would take away their son's autism if they could. They said no because some of his quirks related to his condition made him lovable, fun and interesting to be around. According to his mother, none of her other children could make her laugh or make her think about things the way he could.

This child was very high functioning and, understandably, the answer was quite different for those families whose child/ren were low functioning or difficult to manage.

Friday, 11 January 2013

Should we be concerned about the effects of mobile phones?

It has been suggested that mobile phones do fry your brains Numerous articles and studies have suggested that regular use of mobile telephones may be harmful to our health. It has even been suggested that mobiles fry our brains. Given that mobile telephone are becoming more and more prevalent, are being used by younger and younger children, and for many of us are our primary means of communication, it is important that we understand the effects of these devices on our brain functioning. It is also important that we do not make false assumptions about the erroneous effects of mobile phones.
The public concern about mobile phones is based on the fact that wireless phone signals cause electromagnetic fields from which radiation is emitted. The World Health Organisation has found that radiation is a possible human cancer-causing agent.
It is however difficult to measure to what extent radiation from mobile phones heats human brain tissue. A recent study by researchers from the Memorial Sloan-Kettering Cancer Center and the Alcatel-Lucet Bell Laboratories in the US found that MRI scans can directly study how mobile phones heat the human brain. Research is in its early stages however and there are no conclusions as yet.