Dr. Atila Turgay, one of the leading experts in Canada on ADD/ADHD passed away in April. He had been Chief Of Staff at Toronto’s Scarborough Hospital, although recently he had returned to private practice. He was also on the faculty of medicine at the University of Toronto. You can read more about Dr. Turgay at Dr. Kenny Handelman’s blog here. I saw him just before he left his post at the hospital and set up his office at Davisville and Yonge in the heart of Toronto. My reason for being there was a review of medication I had been prescribed for ADD since the physician who was currently writing the prescriptions had not originally either prescribed them nor done the diagnosis. Dr. Turgay performed the shortest test I had ever encountered for the three aspects of working memory. The first two were not uncommon. He asked me to remember a string of seven numbers and then repeat them backwards. He did a similar one for verbal working memory. Then he sat right opposite me and asked me to observe him, without moving, until he asked me to replicate what he did with his fingers and hands. What he did seamed simple enough. His hands were reversed with one finger on one hand touching a finger on the other. But when my turn came to replicate it I could not–even after a couple of tries. I had seen Dr. Turgay describe this test in several lectures sponsored by the Attention Deficit Resource Network but this was my first opportunity to actually do it. His conclusion, after these three short tests, was that I had an impairment in visual/non verbal working memory. Some years ago I did a completed psycho-educational assessment valued at close to $2,000 and a similar component, lasting at least half an hour, had reached the same conclusion.
My visit only lasted a few minutes and the medical part of it was over before I knew it. He concurred with the medication I was taking and with dosages and schedules. Then he quizzed me on my background and interests, as it turned out, to see if I might be of service to the ADD/ADHD community. It wasn’t his suggestion but this meeting was one of the reasons I started this blog. I heard him speak on a couple of times and my appointment with him two years ago only lasted perhaps 20 minutes but I will miss him. Not only was he a great resource to the ADD/ADHD community he was, in my experience, a kind and caring individual.
It was on reading his obituary and remembering his visual/non-verbal working memory test that led to a mini-ah ha moment. I had always marveled that one of the profound and noticeable effects of even a small dose of ritalin would lead to a great improvement in my hand-writing. I’m no expert but I would bet that there is a large component of visual/non-verbal working memory skill in handwriting.
In the last post, I promised to write more about a recent study on mindfulness and its effect on mind fitness. They study was conducted by Amishi Jha of the Department of Psychoogy and Center for Cognitive Neuroscience at the University of Pennsylvania and Elizabeth Stanley of Georgetown University. Their conclusion was that mindfulness training made a measurable improvement on mood and working memory in a Marines training for deployment in Iraq. The program called Mindfulness-based Mind Fitness Training (MMFT) was designed to produce protective results on the psychological health in individuals who were enter into situations that would produce extreme stress (read combat) and was incorporated into pre-deployment training. Study participants included 48 males with an average age of 25 from a detachment of Marine reservists. The experimental group comprised 31 Marines with 17 in the control group. The MMFT group attended an eight week course. The effect of the training on mood was measured by the Positive and Negative Schedule (PANAS) while working memory improvement was measured using the Operation Span Task. Working memory capacity degraded and negative mod increased over time in the control group during training. The MMFT group, on the other hand, experienced improved working memory capacity and a decrease in negative mood. You can read more about the study in the journal, Emotion as well as the latest edition of Joint Force Quarterly, the advisory journal of the Join Chiefs of Staff.
I have been fascinated by the idea of mindfulness ever since I first heard it described in a bar by a tennis pro who was trying to seduce my tennis partner…the most unlikely circumstances indeed. I have headed down a lot of blind allies since then including attending a class on mindfulness meditation by some well-meaning practitioners of Tibetan Buddhism. For awhile I thought that I was confused about the idea of separating mindfulness from meditation or was it the idea that I could be meditating and doing something else such going for a walk or eating a meal? Recently, in bookstore specializing in psychology and spirituality I came across a most-unlikely guide–The Idiot’s Guide To Mindfulness. In this book was all that I had been searching for–instructions on how to practice mindfulness in any activity and completely removing it from its Tibetan Buddhist roots (not that I have anything against Tibetan Buddhism). Now it is quite possible that it is entirely coincidental but since I began reading the book and trying to be completely in the moment I have felt better, happier. In addition, a few weeks ago, I started Nordic walking in the cemetery right across the street from where I live. Nordic walking is an exercise that seems to lend itself to mindfulness practice.
While doing it, you are traveling much slower than you would if you were running. The rhythmic nature of using the poles and swinging your arms is quite natural and requires little attention from the conscious mind so you are more aware of your surroundings and you walk more upright than you would if you were…well just going for a walk. All of this adds up to the perfect setting for the practice of mindfulness. I have been seeing the cemetery in whole new ways and I have lived beside it, or near it, almost all of my life.
Now I have come across a study that concludes that mindfulness, which the study defines as the ability to be aware and attentive of the present moment without emotional reactivity or volatility, improves working memory as well as mood.
In the next post I will talk more about this study.
I have been a fan of natural health products since I managed to lower my blood pressure with Omega 3 capsules and so am a little more friendly to reports such as this one from a study conducted at the Center for Learning and Memory at Tsinghua University in Beijing. Guosong Liu, the center’s director, found that magnesium, “led to significant enhancement of spatial and associative memory in both young and aged rates.” Magnesium is found in some fruits and most leafy vegetables but the study made use of a new magnesium compund–Magnesium-L-threonate (MgT)–but the new compound was just a more efficient way of delivering magnesium to the brain. Mr. Liu said, “Half the population of industrialized countries has a magnesium deficiency which only worsens with age.” He went on to say, “If normal or even higher levels of magnesium can be maintained, we may be able to affect cognitive function.” Mr. Liu is a former professor at MIT in Boston and is co-founder of Magceutics, a California-based company developing pharmaceuticals for the prevention and treatment of age-dependent memory decline and Alzheimer’s disease. He claims that if you consume less than 400 milligrams of magnesium per day, you could be at risk for allergies, asthma and heart disease.
Just last week, I was telling a friend about this research and he mentioned that he had been told by a natural health practitioner to take a magnesium supplement for Restless Leg Syndrome, (RLS) a condition in which, legs at rest, usually when you are just lying down to go to sleep, feel as if they are twitching. I have RLS and thought that perhaps a magnesium supplement would improve my cognitive functioning as well as my sleep if it could stop that dreadful sensation of leg twitches. I would love to report at the end of this post that I immediately went out to the health food store and got some but…I forgot.
An interesting post on the blog tweetingdonal on wordpress here, quotes a study about working memory looking at its effects on other cognitive functioning, specifically decision making. The effect according to this site is known as cognitive load theory. The study asked volunteers to memorize two numbers and then walk down a hallway and, at the end, choose a dessert, either chocolate cake or fruit salad. A different sample was asked to memorize a seven digit number (pretty well the limit on working memory capacity) and then walk down the same hallway (while saying the number to themselves) and also choose from the same two desserts. Almost twice as many people in this sample chose the chocolate cake as compared to the previous sample who had only memorized two digits. The theory is that when working memory is filled to capacity, it either has to jettison one of the bits to access other cognitive functions such as decision making or suffer the consequences. In this case it would be “just give me the damn cake.” The blog does not speculate on why the choice was the cake but perhaps it was the most visible or the easiest to say. The important point, of course, is not the choice but how it was made without contemplation or consideration
This is scary to a person with working memory problems, namely me, as it suggests that my decision, perhaps even important ones, are not a result of choice but of expedience. I like to think that everything I do represents who I am and, more importantly, who I want to be. I believe the conclusion from the study based on what I do know about the way working memory functions. There is another down side to this and I’ll pursue it in the next post…