One Brain's journey

Today I came across reference to a new therapy called the Dynamic Neural Retraining System (DNRS) that employs the principles of neuroplasticity to cure chemical sensitivities, Cronic Fatique Syndrome, Fibromialgia even Gulf War Syndrome. At first glance it looks a bit like snake oil but on closer examination it caught my interest.  The system was developed by Annie Hopper whose life was devastated by multiple chemical sensitivities that resulted eventually in the lose of her job, her family and even her home.  She began to educate herself in various approaches to treatment and in the process noticed that many of her symptoms were similar to those of persons suffering from Acquired Brain Injury (ABT).  ABT usually results from a blow to the head. She developed DNRS based on methods used to treat ABT and now conducts three-day workshops to provide participants with enough familiarity with the system to carry on treatment on their own. Her website has many testimonials attesting to its effectiveness.  At the time that her life was overwhelmed by these chemical sensitivities, Hopper had a therapy practice employing what is described in her bio as core belief counselling.  I experienced something known as Core Belief Reengineering (CBR) about 15 years ago with some success but nowhere in her bio does it say that the counselling Hopper did was based in CBR.  However, I did make this leap.  About 15 years ago many of my friends were going throiugh the process of CBR with the only practitioner in Eastern Canada. I became intrigued. At the time I was a sucker for anything except chemicals or pharmaceuticals to make me feel better. I had just exited a relationship that in many ways was the most normal I had ever experienced and I was about to turn 50. There were a number of other things going on but suffice it to say I was an anxious mess. I have had anxiety most of my adult life in addition to the other numerous mental health disorders I have made reference to in past posts but pn top of all that I began to experience symptoms of Obsessive Compulsive Disorder (OCD)–probably because of the high level of anxiety. OCD is a devastating disorder and I count myself fortunate that I only had symptoms for a short time.  When my friends doing CBR started to report life-changing results I decided to do it.  I was also intrigued by the term reengineering. I was working as a management consultant at the time and Business Process Reengineering (BPR) was all the rage in the business world with huge global corporations, such as Ford Motor Company, were being transformed by it.  The idea of applying similar principles in a therapeutic model was most intriguing..  Towards the end of my therapy sessions a number of things happened. A chronic pain in my left hip, the result of a shortened ilioibial band, disappeared. The OCD symptoms also went away and then miraculously my asthma seemed to be cured. Now I’m a skeptic and in spite of what I was experiencing, I was hard-pressed to ascribe  these changes to CBR. The disappearance of asthma symptoms I thought could also be due to a new mattress, new pillows and new bedding. I knew, at the time, that one of the main causes of asthma is dust mites and with a new bed I would have been dust mite free.  Having both allergies and ADHD I have seen many different kinds of alternative treatments and most of them leave me cold to the point where am long past any interest in exploring any of them that don’t seem to be backed by solid scientific research such as Cogmed Working Memory Training. Having said this there are few alternative therapies rooted in sound science available to address mental health issues that exploit neuroplaticity other than Cogmed. In fact, DNRS is one for the first I have come across. Taking this into account plus my own experience with CBR and my rather grudging acceptance that some really benficial changes did happen, if not as a result of CBR, at least simultaneous with doing the therapy, I am intrigued and will write further about this in future posts.

Once again a study, this time at Duke University in Durham, North Carolina, examined role of working memory, and some other cognitive functions, in the development of schizophrenia. This time they were studying the pattern of cognitive disorders schizophrenics exhibit as children long before they have symptoms of schizophrenia. Duke researchers drew on the results of a long-term study conducted in New Zealand with more than 1,000 participants and found a consistent pattern of developmental difficulties starting at age seven. Co-author of the study, Richard Keefe, director of Duke’s Schizophrenia Research Group said, “These kids are lagging behind to begin with and they continue to fall behind.”

There were two patterns emerging:

1. Children who later developed schizophrenia had early deficits in verbal and visual learning, reasoning and conceptualization and these remained as they grew older

2. They also developed more slowly than their peers in processing speed, attention, visual-spatial problem solving and working memory

How all this ends up as schizophrenia is still unknown but another co-author in the study, Avshalom Caspi, who is the Edward M. Arnett Professor of Psychiatry at Duke, speculates that a child who struggles to make sense of the world becomes more socially isolated or more delusional.

Keefe said that eventually he hoped that they might be able to intervene, perhaps with anti-psychotic medication, in childhood and head off the adult psychosis. The study suggests that adult psychosis doesn’t just emerge fully formed but has early roots in the developmental process.

I have thought for a long time that schizophrenia is one of the saddest disorders as it seems as if one’s mind turns against oneself but there is another disorder that it is even sadder where one’s mind does something quite similar. That disorder is Obsessive Compulsive Disorder (OCD). One of the required symptoms for a diagnosis of OCD is that the person must be conscious of their obsessive or compulsive behavior but be helpless to do anything about it. I know at least one person who has OCD and my heart goes out to her. Many times when she is exhibiting symptoms, she is in tears. I have, for a brief time in the past, had OCD symptoms and so have some understanding of how this plays out. In my case the behavior was checking and it was like I had forgotten whether I had locked a door again and again and again. I had, as a child, seen my father do this (so maybe it’s a family trait) and at the time a part of me marveled at the fact that I was repeating this simple action so many times. In my case it passed and has not returned. It happened at a time of great stress so I do have a worry that it could, at some point, return but the person that I was describing earlier has it most of the time and spends much of that time locked in her apartment because it is so painful for her to go outside. Her behavior is also checking but it involves looking at every scrap of paper she comes across to see if one of her friends or family has left her a personal message. A mutual friend who was trying to help her by walking with her one time asked her, “Do you really think that a friend would leave a note for you on the street in the gutter.” The friend with OCD just looked down and cried.

I am so glad that my own symptoms were so short lived but I also hope that this new study will lead to the possibility of earlier intervention and perhaps head of the disorder–at least for schizophrenia.

A recent study by British and German scientists found that the part of the brain usually associted wtih long-term memory may also be associated with working memory.  The study focused on the hippocampus which has traditionally been thought to have a role in long-term memory, spatial memory and navigation.  This is also one of the first parts of the brain to suffer in patients with Alzheimer’s disease.

The study looked at patients with temporal lobe epilepsy which causes problems in the hippocampus leading to short-term memory problems.  The researchers said, “The patients could not distinguish the studied images from new images after 60 minutes but performed normally after five seconds.”  Professor Emrah Duzel of University College London went on to say  that a striking deficit emerged even at five seconds when the subjects were asked to recall the detailed arrangements of objects within scenes in photographs.

The study concluded that there are two distinct short-term memory networks within the brain.  The other one that is separate from the hippocampus remains intact in patients with hippocampus-related disorders.

Nathan Cashdollar, also from University College London said, “This is the fist functional and anatomical evidence showing which mechanisms are shared between short-term and long-term memory and which are independent.”

The findings of this study, I think, are interesting in showing that there are distinct elements to short-term memory and that they are located in different areas of the brain.  When I was in Dr. Attila Turgay’s (one of the leading experts on ADHD in Canada) office last year he did three separate tests for short-term memory: verbal, numerical and spatial.  It was only spatial short-term memory with which I had trouble.  If indeed this function is located in a different part of the brain than either verbal or numeric working memory it does make sense that one aspect of working memory would by dysfunctional while the other two are intact.

For the most part this blog has been about the wonder and awe of neuroplasticity. It has been about discoveries in neuroscience that bring hope and joy into the lives of people who just a decade or so ago would be thought to have disorders making their lives miserable and that would likely do so for the rest of those lives. But there is a down side to it all. Neuroplasticity can work in reverse to make your life more difficult. A new study from the Life and Health Sciences Research Institute at the University of Minho in Portugal using, what else, lab rats, shows that the brain tends to reprogram itself in response to stress and that reprogramming can serve to reinforce the behaviors responsible for the stress and causing problems in the first place.

According to the study’s lead researcher Dr. Nuno Sousa in an article in Science magazine, “Behaviors become habitual faster in stressed animals than in the controls, and worse, the stressed animals can’t shift back to goal-directed behaviors when that would be a better approach.”

Take heart though, even though your brain may have rewired itself for the worse, it still has the potential to unlearn these habits and learn new more advantageous ones.

Dr. Sousa said, “The brain is a very resilient and plastic organ. Dendrites and synapses retract and reform and reversible remodeling can occur throughout life.”

That problems with working memory may have a role in schizophrenia has been touched on before in this blog and now a new study indicates what that role might be. Previously scientists thought that the one problem with the disorder could be with automation processing of ordinary tasks i.e. learning by repetition to do things on auto pilot. Dutch researcher Tamar Van Raalten studied the role of working memory in automation and established that it is not the automation process but the processing of new information that was the cause of problems.

Van Raalten, using an fMRI scanner, asked subjects to perform tasks in which they had to remember a series of letters, something that would be accompished in working memory, and discovered that the more the tasks were repeated, the lower the brain activity became in the areas of the brain associated with working memory. But this activity was not compensated for by other areas of the brain involved in long term memory. By automating the letter series the subjects were releasing working memory capacity allowing it to process new information. Van Raaltlen concluded that this restructuring of incoming information was another function of working memory, a process known as chunking. For example to remember 1232673445 you would clump numbers together as you might a phone number, 113 276 3445 . This allowed working memory to be freed up to process new information. Her initial conclusion, in observing schizophrenic patients performing the same tasks, was that their working memory was less efficient and automation did not proceed as well as with healthy subjects. Van Raalten went on to observe that schizophrenic patients process less information than healthy subjects. However, the testing revealed automation proceeded as well as with healthy subjects but subsequently, working memory was not released to deal with new tasks. Further testing revealed that the working memory in schizophrenic subjects struggled with the processing of information that continually changed, leading to the conclusion that Schizophrenics may have more of a tendency to adopt automatic strategies in circumstances that demand flexible behavior.