Harnessing the brain’s power to reorganise after injury

The online Dana magazine Cerebrum has a great article on neurorehabilitation – the art and science of helping someone to recover from brain injury both by harnessing the brain’s natural ability to adapt, and by teaching the injured person new skills and abilities.

The article discuss both rehabilitation medicine, the practice of training patients to adapt and improve, and the neuroscience techniques which are being developed to try and tackle the problem at the cellular level.

One of the key processes which science is trying to understand and optimise is ‘neuroplasticity‘, the process by which the brain makes new connections, reorganises and routes around damage.

The article sets out six key questions for neuroscience that, when answered, should revolutionise who we can treat brain injury:

1. Since so much of what we think we know about regeneration is derived from experiments on immature nerve cells, are the mechanisms of regeneration in the injured mature nervous system the same as those that apply to the developing embryonic nervous system?

2. Since the vast majority of experiments in regeneration of nerve pathways have been done in rats and mice, how predictive are these experiments for results in human patients? Apart from molecular differences, rodents are much smaller than we are. Nerve fibers may have to regenerate much farther in humans in order to achieve the same level of reconnection that underlies functional improvement in smaller animals.

3. Even if sufficient nerve regeneration can be achieved, will the connections made be specific enough to underlie real function?

4. How helpful are stem cells? Can they survive after transplantation into the human spinal cord or will they be rejected? Can they replace damaged neurons or will they serve only as sources of chemical substances that support survival and growth of the brain’s own nerve cells?

5. Will we be able to identify a single approach that is so fundamental that it can yield dramatic improvements in recovery from brain injury, or will we need to develop a cocktail approach, using multiple treatments simultaneously?

6. Will approaches that enhance regeneration in one circumstance, for example spinal cord injury, also work in other situations, such as stroke or traumatic brain injury?

On a related note, Sharp Brains has picked up on the fact that American TV channel PBS will shortly be broadcasting a special on brain fitness and neuroplasticity.

It’ll probably focus on normal ageing and brain fitness rather than brain injury, but hopefully should tackle some of the neuroscience behind brain changes in general.

There’s a trailer available online.

Link to article ‘Harnessing the Brain’s Power to Adapt After Injury’.
Link to Sharp Brains on PBS neuroplasticity programme.

War, social networks and ethical minefields

Wired has an article in its latest edition that discusses why understanding human networks are becoming key to the US Military’s mission in Iraq and Afghanistan. Unfortunately, the article seems to do little more than uncritically echo military enthusiasm for this new approach while telling us little about the actual science behind the techniques.

But the most interesting story is not the strategy itself, which is hardly new, but how it is causing a rift among anthropologists to the point where conference speakers have been heckled and left in tears for their participation.

The debate centres on the US Military’s Human Terrain System, a project that aims to understand the culture, society and social networks in Iraq and Afghanistan, with a view to using this information to further military objectives.

In contrast, the NYT managed to do a brief but considerably more balanced article and video segment on the project last May, noting that the crux of the matter is that the project has employed numerous anthropologists, as anthropology now plays a key role in US military strategy.

Concerns centre over whether co-operating with the military violates the strict codes of ethics that compels anthropologists to ‘do no harm’ to the cultures they are studying, and to ask for informed consent from the people that are observing to make them fully aware of the purpose of the research.

Critics believe that aiding a military occupation is unethical, as it will inevitably lead to deaths prompted by the intelligence they provide, and requires a level of secrecy – violating both of the ‘do no harm’ and ‘informed consent’ principles.

This has caused an angry rift with accusations of ‘mercenary anthropology’ and, in an interesting parallel to the ethical dilemmas faced by the American Psychological Association, the American Anthropological Association has been forced to issue a report and statement on the issue; disapproving of the project while refusing to ban its members from participating.

Last Thursday, at a panel session on the issue at the American Anthropological Association conference, Zenia Helbig, an ex-Human Terrain System researcher, cried when she was heckled by the audience.

Wired describes the scene as ‘ugly’ and quotes Helbig as implying the hecklers were being driven by conspiracy theories, while Inside Higher Education gives a more nuanced account, suggesting audience reactions were mixed.

The overarching issue is that the military has cottoned-on to the fact that its in-house ‘psyops’ services are inadequate for the complexity of new forms of warfare, and are seeking the collaboration of academic disciplines which have been founded on principles of non-coercion.

The debate essentially centres around whether these principles should be universally applied to all people, or whether they are trumped by loyalty to the national interests of a researcher’s country.

Link to NYT article ‘Army Enlists Anthropology in War Zones’.
Link to abstract of Human Terrain System paper.
Link to Inside Higher Ed article on panel discussion.

Encephalon 37 arrives

The 37th edition of the Encephalon psychology and neuroscience writing carnival has just pulled into town and is hosted on A Blog Around the Clock.

A couple of my favourites include a post on whether smiling actually makes you feel better, and one on some of the hidden motivators for our voting behaviour.

There’s much more great mind and brain writing in the mix (including a raft of new student writers), so have a browse and see what catches your eye.

Link to Encephalon 37.

SciAmMind on Smart Kids, Sex Bias and Psychopaths

The latest Scientific American has just hit the shelves and two of the feature articles are available online: one with tips for raising hard-working and motivated children from developmental psychology research, and another on whether neuropsychology helps us understand the gender bias in fields like maths and physics.

However, there is another, stand out article on psychopaths that describes what the term actually means in psychology.

It’s something that’s commonly but wrongly confused with psychosis, largely because they’re both unfortunately shortened to ‘psycho’, despite them being completely different.

This month, the articles in the print edition look particularly good. They cover everything from people who want to be amputees, to the psychology of terrorism, to psychedelic drug therapy, to phantom limbs and more.

Link to article on raising smart kids.
Link to article on gender and scientific achievement.
Link to article on psychopaths.

No eye deer – an amazing brain injury

Retrospectacle has found an amazing case of a five year-old boy who impaled his left frontal lobe on a deer antler after he tripped and fell while carrying it.

The business end of the antler (which was thankfully no longer attached to a deer) went through his eye socket and into his brain.

Luckily, the young lad made a full recovery with no loss of eyesight and no long term brain damage.

Brains of children (particularly those under the age of 8) can make recoveries from injuries that would be much more serious in adults.

This is because young brains are still very ‘plastic’. In other words, they are still growing and re-shaping.

These recoveries can sometimes be quite astonishing. For example, as we’ve reported previously, some young kids can make a full recovery even when they’ve had half their cortex removed.

Interestingly, this child’s injury from the deer antler is similar to an ‘ice pick lobotomy’, detailed in a fantastic Neurophilosophy article.

One difference, however, is while both the ice pick and the deer antler have entered the brain the same way, the ice pick would be moved side to side to cause damage over a much wider area.

Link to Retrospectacle on amazing deer antler injury.

How to Good-Bye Depression

It’s rare than someone comes up with a truly novel treatment for mental illness, but Hiroyuki Nishigaki’s book may be a genuinely original contribution to the field.

It’s entitled How to Good-Bye Depression: If You Constrict Anus 100 Times Everyday. Malarkey? or Effective Way?

Needless to say, it’s contribution to psychiatry is only equalled by its contribution to the development of the English language.

The description of the book is a wonderful read in itself and the reviews are absolutely priceless.

I feel better already.

Link to book details on Amazon.

In search of evidence-based bullshit

Monday morning is not the best time to be told to ‘bridge the quality chasm’ and ‘identify your value stream’. I was having the misfortune of starting my week with a talk that introduced new health-service management ideas based on psychological sounding ideas such as ‘lean thinking’ and ‘connected leadership’.

Now, I’ve got no problem with things sounding like bullshit, as long as they work. After all, medicine is one of the few places where you can get away with calling the practice of squirting cold water in the ear ‘vestibular caloric stimulation’.

No-one minds that much, because it’s been very well researched and is known to have a profound, albeit temporary, effect on a number of neurological conditions.

So if I wanted to find out whether any of these new management techniques made an organisation more efficient, the first thing I’d do is find out what the research says.

In health and medicine, the ‘gold standard’ for finding our whether an intervention has an effect is the randomised controlled trial or RCT.

It’s a simple but powerful idea. You get a group of people you want to study. You measure them at the beginning. You randomly assign them to two groups. One gets the intervention, the other doesn’t. You measure them at the end. If your intervention has worked, one group should be different when compared to the others.

Of course, it gets a bit more complex in places. Making the comparison fair and deciding what should be measured can be tricky, but it’s still a useful tool.

After my traumatic Monday morning experience I went to see what randomized controlled trials had been done on management techniques.

To my surprise, I found none. Not a single RCT in any of the business psychology literature.

Now, this may be because I know little about organisational psychology, and literature searches are as much about knowing the key words as knowing what you want. So maybe RCTs are called something completely different, or I’m just looking in the wrong places.

So, if you know of any RCTs done on leadership and management techniques, please let me know, I’d be fascinated to find out.

I could completely wrong, but if I’m not, I want to know why are there no randomised-controlled trials in organisational psychology?

And as a corollary, are we spending millions on organisational interventions to supposedly help patients that have been tested no further than the pseudoscience we reject for every other area of medicine?

UPDATE: Some interesting comments from organisational psychologist Stefan Shipman:

It may be that the complexity lies in that organizational research is always secondary to doing business. I can remember in some of my early research that I attempted to implement a new human resources program in one department. The program was successful in its early stages and was (despite my suggestions) implemented company wide.

I think your post absolutely speaks to the frustration of all organizational psychologists because the zeal of organizations to find “new” ways of doing business that are hopefully more effective. This zeal often reduces the “completeness” of research. As organizational psychologists we accept the conditions under which real world research can be done. We encourage the assignment of conditions but accept that some ideas or programs might “leak” into other parts of the organization.