World focuses attention on tragic outcomes of road traffic accidents

The ‘Pinky Ad’ and Road Safety

Who could forget those ads that ran on Australian television a few years ago about young male drivers – the ones with the pinky finger that targeted risky driving in young males by implying that speeding is linked to an inferiority complex to do with, let’s just say, an aspect of the male anatomy.
While the approach was light-hearted (if a bit sexist!), the subject matter is not. Road accidents are the leading killer of people aged between 15 to 29 years. Globally 1.3 million people die each year on the roads and between 20 and 50 million people sustain non-fatal injuries. It is projected that based on current rates, if no action is taken, road accidents will result in 1.9 million deaths by 2020.
Now the world is collectively sitting up and taking notice.

Global Decade of Action for Road Safety

May 11 marked the beginning of the global Decade of Action for Road Safety 2011-2020. The aim of the ‘Decade’ is to prevent death and injury from road traffic events. At least 20 countries, including Australia, are involved in the Decade, their governments having committed to improving safety management and enhancing health and related services.

Road Accidents and Traumatic Brain Injury

One of the most tragic outcomes of road accidents is Traumatic Brain Injury (TBI). TBI is an acquired brain injury caused by physical damage to the brain, either as a result of an external force striking the head or the brain impacting with the skull. The force causes the brain to move within the skull, causing internal damage.
There are different levels of severity raging from mild to extremely severe which are determined by factors including recall of events before and after the incident and level of coma. The more severe the TBI, the poorer the prognosis.
Cognitive and psychological outcomes can include memory difficulties, difficulties with higher level thinking skills (e.g. planning/organisation), slowed speed of information processing, mood and personality change, depression and anxiety.
A 2008 report by the Australian Institute of Health and Welfare and the Research Centre for Injury Studies found that there were more than 22,700 hospitalisations involving TBI in Australia in 2004-05. After falls, transportation use was the second highest external cause of TBI, at 31% of all cases, which represented over 7,000 people.
Nearly 70% of the cases were males, who acquired TBI at more than twice the rate of females.

TBI and Clinical Neuropsychology

While the main aim of the Decade is to prevent TBI, another important aim is to improve management of and services for those who experience a TBI. Clinical neuropsychology is critical in the assessment and rehabilitation of TBI. A neuropsychological assessment can provide detailed information on the impact of the TBI on various aspects of cognition (thinking skills) and expert advice regarding the trajectory of brain recovery and remediation/rehabilitation strategies to allow for the best possible outcome.
If you or someone you know has had a TBI and would like more information on our assessment and rehabilitation services, please contact us.
And please slow down on our roads over this holiday period.

Neuro-what-ology?

For the clinical neuropsychologist (or those in training) a dinner party can be an interesting experience. When the talk inevitably turns to “what do you do” neuropsychologists need to be prepared for the fact that most people a. have never heard of neuropsychology; b. don’t understand what neuropsychologists do; and c. (the best bit) usually want to know more.

So what is clinical neuropsychology?

Clinical neuropsychology is a specialisation within the field of psychology which involves the assessment, diagnosis and treatment of psychological disorders associated with conditions affecting the brain.

Clinical neuropsychologists conduct evidence-based neuropsychological assessments to develop a profile of an individual’s cognitive strengths and weakness. This neuropsychological profile helps to identify the root causes(s) of presenting problems and informs treatment programs.

There are a number of reasons why clinical neuropsychology is not a widely known or understood specialisation. One important reason relates to the complexity of the brain. Our current understanding of how the brain works has been informed by centuries of research. Clinical neuropsychology has evolved along with important developments in our understanding of brain structure and function and this will no doubt continue as we deepen our understanding of this complex organ.

A brief history of our evolving understanding of the brain

Written records about the brain and nervous system have been found as early as 1700 B.C. However, it was not until the 17th century A.D. that serious investigations about the brain and its functions were undertaken, and not until the 20th century that scientists began to fully appreciate the relationship between structure and function. Some key developments were:

1600’s

• Rene Descartes introduced the concept of the relationship between the mind and the body, coining his famous phrase “I think, therefore I am”.
• Thomas Willis published his ‘Anatomy of the Brain’. One of his most important contributions was a discussion of cerebral circulation.

1800’s

• Franz Josef Gall founded the science of Phrenology, which involved studying the topography of a skull as an indicator of brain anatomy. He introduced the concept of the brain being composed of various sections, each of which he proposed was responsible for a psychological trait.
• While his ideas were later largely discredited, the idea of linking brain structure to function was an important development, leading to the theory of localisation.
  
• Neurologists Paul Broca (and later Carl Wernicke) used this theory, together with investigations of brain damaged people, to determine that there were two distinct yet related areas of the brain responsible for language production and language comprehension.

1900’s

• Hans Berger developed the first electroencephalograph (EEG), a device for recording the electrical activity in the brain.
• Procedures such as Lobotomies and Electro-shock Therapy, while controversial, helped advance understanding of the relationship between brain structure and function and the outcomes of damage to certain brain regions.
• In 1953 patient HM, who went on to become one of the most important patients in the history of brain research, underwent a bilateral medial temporal lobe resection to treat medication-resistant epilepsy. As a result, HM became densely amnesic and was largely unable to form new memories.
• HM participated in hundreds of research studies and helped advance our understanding of memory, learning
• and their relationship with brain structure and other cognitive functions.
• A key finding was the importance of the role of a brain structure called the hippocampus in forming new memories.
• Experiments on epilepsy patients who had the two halves (hemispheres) of their brain surgically separated advanced our understanding of lateralisation.
• In the 1970’s and 1980’s scanning and imaging devices such as CT and MRI allowed for detailed mapping of the brain’s structure.

2000’s

• Advances in brain imaging technology have improved understanding of brain structure and techniques such as functional MRI have enhanced understanding of the relationship between structure and function.
• The aging population and increasing prevalence of dementia has resulted in an explosion of research in the field. Neuropsychology is critical for the diagnosis and management of dementia.

How we use our knowledge to help you

Understanding how the brain functions is just one of the many skills that clinical neuropsychologists need to master. Our knowledge of brain anatomy informs our clinical assessments, allowing us to provide informed diagnoses and to draw conclusions about functional implications and rehabilitation techniques for a wide range of conditions affecting the brain, from learning disorders to dementia.

Contact us today to find out more about how our neuropsychological services can help you.

And please feel free to use this information to impress your friends at your next dinner party!

References

http://www.mybrain.co.uk/public/learn_history2.php
http://www3.niu.edu/acad/psych/Millis/History/2002/neuro.htm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539424/
Images courtesy of google images