Archive for category Neuroplasticity

[BLOG POST] Sleep Evaluation and Treatment Support Patient Outcome

(Note:  In this guest blog from Grace Griesbach, Ph.D., and CNS’ National Director of Clinical Research, she explains that proper sleep is a vital component in the rehabilitation of brain injury).

Historically, quotes referring to sleep have been associated with well-being. This is not without substance. The importance of sleep is appreciated when one considers that it is observed across the vast majority of animal species. In humans and other higher mammals, lack of sleep has been demonstrated to impact physical, cognitive and emotional functions negatively. Physical consequences of sleep deprivation include compromised immune responses, as well as hormonal and metabolic alterations that in turn will impact overall health. Sleep also promotes emotional and psychological well-being. As for cognitive functions, sleep has been shown to facilitate learning and memory.

Moreover, animal studies have shown that neural plasticity changes allow for better memory to occur during sleep. Sleep driven neural plasticity is also evident during brain development and during times when healing is necessary. Given the multiple functions of sleep, it is evident that sleep-related problems should not be ignored.

Unfortunately, the prevalence of sleep disorders following brain injury is notably higher compared to the general population. Many of those that have endured a traumatic brain injury or stroke have difficulty initiating or maintaining sleep. Daytime sleepiness (hypersomnia) and fatigue are frequently reported complaints that are associated with insomnia. Apnea, a common breathing-related sleep disorder, is frequently observed during the chronic brain injury period. Apnea is defined as breathing cessation for fixed periods during sleep and contributes to arousals throughout the night; promoting fragmented sleep.

Sleep follows a particular overnight pattern consisting of repeated sleep cycles. Each cycle is comprised of one rapid eye movement (REM) stage and three non-REM stages. These stages are defined by different brain activity patterns that have been associated with particular physiological and neural plasticity processes.

Studies focused on proper sleep closely examine brain wave activity and body physiology throughout the various sleep stages. Some stages are particularly important for memory, emotional well-being, and cognitive function, and may be compromised by interrupted sleep. The golden standard of evaluating sleep is with an overnight polysomnography study performed by a certified sleep technologist. The technologist places electrodes on the scalp of the patient to record brain activity. Breathing, heart rate, oxygen levels, and limb movement are also recorded during sleep. Results from these recordings are sent to a board-certified sleep medicine physician, who creates a report on the diagnosis and a treatment plan.

Centre for Neuro Skills (CNS) offers a comprehensive multidisciplinary approach to rehabilitation. This entails addressing key factors that impact recovery such as sleep. CNS has opened sleep laboratories within the residential buildings of our programs in Dallas, Texas and Bakersfield, California. All CNS facilities can arrange for a sleep evaluation at one of the labs, based on a patient’s needs and treatment plan. Sleep evaluations of CNS patients allow for the detection of sleep-related issues that are likely to hinder recovery. CNS sleep facilities also provide research opportunities to deepen understanding of sleep-related issues after brain injury. Findings from these studies will help improve treatment and develop new therapeutic strategies.

 

via Sleep Evaluation and Treatment Support Patient Outcome – Neuro Landscape

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[JUST ACCEPTED] “Increased Sensorimotor Cortex Activation with Decreased Motor Performance during Functional Upper Extremity Tasks Post-Stroke” – Abstract

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy.

“Increased Sensorimotor Cortex Activation with Decreased Motor Performance during Functional Upper Extremity Tasks Post-Stroke”

By Shannon B Lim, MSc, MPT; Janice J Eng

Provisional Abstract:

Background: Current literature has focused on identifying neuroplastic changes associated with stroke through tasks and in positions that are not representative of functional rehabilitation. Emerging technologies such as functional near-infrared spectroscopy (fNIRS) provide new methods of expanding the area of neuroplasticity within rehabilitation.
Purpose: This study determined the differences in sensorimotor cortex activation during unrestrained reaching and gripping after stroke.
Methods: 11 healthy and 11 chronic post-stroke individuals completed reaching and gripping tasks under three conditions using their 1) stronger, 2) weaker, and 3) both arms together. Performance and sensorimotor cortex activation using fNIRS were collected. Group and arm differences were calculated using mixed ANCOVA (covariate: age). Pairwise comparisons were used for post-hoc analyses. Partial Pearson’s correlations between performance and activation were assessed for each task, group, and hemisphere.
Results: Larger sensorimotor activations in the ipsilesional hemisphere were found for the stroke compared to healthy group for reaching and gripping conditions despite poorer performance. Significant correlations were observed between gripping performance (with the weaker arm and both arms simultaneously) and sensorimotor activation for the stroke group only.
Discussion: Stroke leads to significantly larger sensorimotor activation during functional reaching and gripping despite poorer performance. This may indicate an increased sense of effort, decreased efficiency, or increased difficulty after stroke.
Conclusion: fNIRS can be used for assessing differences in brain activation during movements in functional positions after stroke. This can be a promising tool for investigating possible neuroplastic changes associated with functional rehabilitation interventions in the stroke population.

Supplemental Digital Content 1. Video abstract .mp4

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via JUST ACCEPTED: “Increased Sensorimotor Cortex Activation with Decreased Motor Performance during Functional Upper Extremity Tasks Post-Stroke”

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[NEWS] Stroke: Rewiring eye-brain connection may restore vision

Many people who have a stroke also experience vision impairment as a result. New groundbreaking research looks at the mechanisms that play a role in this damage and shows that it may be reversible.

a person's eye looking up

New research may offer people who have lost some of their vision due to a stroke renewed hope that they may regain it.

A stroke can affect different parts of the brain. When it occurs in the primary visual cortex, which is the region of the brain that processes visual information, the lack of oxygenated blood can mean that the neurons (brain cells) active in that region incur damage.

In turn, this will affect people’s ability to see, and they may experience various degrees of vision loss. While some people who experience vision loss after a stroke may spontaneously regain their sight, most individuals do not.

So far, specialists have believed that damage to the primary visual cortex neurons causes a set of cells in the eye’s retina called “retinal ganglion cells” to become atrophied, meaning that they lose their ability to function.

When retinal ganglion cells become atrophied, it is highly unlikely that a person will ever recover sight in the affected area.

However, a new study, the findings of which appear in the journal Proceedings of the Royal Society B, has uncovered more information about the brain damage mechanisms relating to impaired eyesight.

“The integration of a number of cortical regions of the brain is necessary in order for visual information to be translated into a coherent visual representation of the world,” explains study co-author Dr. Bogachan Sahin, Ph.D., who is an assistant professor at the University of Rochester Medical Center in New York.

“And while the stroke may have disrupted the transmission of information from the visual center of the brain to higher order areas,” he adds, “these findings suggest that when the primary visual processing center of the brain remains intact and active, clinical approaches that harness the brain’s plasticity could lead to vision recovery.”

Therapies should ‘encourage neuroplasticity’

In the new study, the researchers worked with 15 participants who were receiving care at Strong Memorial and Rochester General Hospital for vision damage resulting from a stroke.

The participants agreed to take tests assessing their eyesight. They also had MRI scans to monitor their brain activity and an additional test that looked at the state of the retinal ganglion cells.

First, the investigators found that the health and survival of the retinal ganglion cells were highly dependent on activity in the associated primary visual area. Thus, the retinal cells connected to inactive brain areas would atrophy.

At the same time, however, the team surprisingly noted that some retinal cells in the eyes of people who had experienced vision impairment were still healthy and functional, even though the person had lost sight in that part of the eye.

This finding, the researchers explain, indicates that those healthy eye cells remained connected to fully active brain cells in the visual cortex. However, the neurons failed to correctly interpret the visual information that they received from the corresponding retinal ganglion cells, so the stimuli did not “translate” into sight.

“These findings suggest a treatment protocol that involves a visual field test and an eye exam to identify discordance between the visual deficit and retinal ganglion cell degeneration,” notes the study’s first author Dr. Colleen Schneider.

“This could identify areas of vision with intact connections between the eyes and the brain, and this information could be used to target visual retraining therapies to regions of the blind field of vision that are most likely to recover,” Dr. Schneider adds.

In the future, the researchers hope that their current discovery will allow specialists to fine-tune current therapeutic approaches or develop better strategies that will stimulate the damaged brain-eye connections to “rewire” correctly.

“This study breaks new ground by describing the cascade of processes that occur after a stroke in the visual center of the brain and how this ultimately leads to changes in the retina,” says senior author Brad Mahon, Ph.D.

By more precisely understanding which connections between the eye and brain remain intact after a stroke, we can begin to explore therapies that encourage neuroplasticity with the ultimate goal of restoring more vision in more patients.”

Brad Mahon, Ph.D.

via Stroke: Rewiring eye-brain connection may restore vision

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[WEB SITE] The Adult Brain Does Grow New Neurons After All, Study Says

Study points toward lifelong neuron formation in the human brain’s hippocampus, with implications for memory and disease

The Adult Brain Does Grow New Neurons After All, Study Says

Cerebral cortical neuron. Credit: Getty Images

If the memory center of the human brain can grow new cells, it might help people recover from depression and post-traumatic stress disorder (PTSD), delay the onset of Alzheimer’s, deepen our understanding of epilepsy and offer new insights into memory and learning. If not, well then, it’s just one other way people are different from rodents and birds.

For decades, scientists have debated whether the birth of new neurons—called neurogenesis—was possible in an area of the brain that is responsible for learning, memory and mood regulation. A growing body of research suggested they could, but then a Nature paper last year raised doubts.

Now, a new study published today in another of the Nature family of journals—Nature Medicine—tips the balance back toward “yes.” In light of the new study, “I would say that there is an overwhelming case for the neurogenesis throughout life in humans,” Jonas Frisén, a professor at the Karolinska Institute in Sweden, said in an e-mail. Frisén, who was not involved in the new research, wrote a News and Views about the study in the current issue of Nature Medicine.

Not everyone was convinced. Arturo Alvarez-Buylla was the senior author on last year’s Nature paper, which questioned the existence of neurogenesis. Alvarez-Buylla, a professor of neurological surgery at the University of California, San Francisco, says he still doubts that new neurons develop in the brain’s hippocampus after toddlerhood.

“I don’t think this at all settles things out,” he says. “I’ve been studying adult neurogenesis all my life. I wish I could find a place [in humans] where it does happen convincingly.”

For decades, some researchers have thought that the brain circuits of primates—including humans—would be too disrupted by the growth of substantial numbers of new neurons. Alvarez-Buylla says he thinks the scientific debate over the existence of neurogenesis should continue. “Basic knowledge is fundamental. Just knowing whether adult neurons get replaced is a fascinating basic problem,” he said.

New technologies that can locate cells in the living brain and measure the cells’ individual activity, none of which were used in the Nature Medicinestudy, may eventually put to rest any lingering questions.

A number of researchers praised the new study as thoughtful and carefully conducted. It’s a “technical tour de force,” and addresses the concerns raised by last year’s paper, says Michael Bonaguidi, an assistant professor at the University of Southern California Keck School of Medicine.

The researchers, from Spain, tested a variety of methods of preserving brain tissue from 58 newly deceased people. They found that different methods of preservation led to different conclusions about whether new neurons could develop in the adult and aging brain.

Brain tissue has to be preserved within a few hours after death, and specific chemicals used to preserve the tissue, or the proteins that identify newly developing cells will be destroyed, said Maria Llorens-Martin, the paper’s senior author. Other researchers have missed the presence of these cells, because their brain tissue was not as precisely preserved, says Llorens-Martin, a neuroscientist at the Autonomous University of Madrid in Spain.

Jenny Hsieh, a professor at the University of Texas San Antonio who was not involved in the new research, said the study provides a lesson for all scientists who rely on the generosity of brain donations. “If and when we go and look at something in human postmortem, we have to be very cautious about these technical issues.”

Llorens-Martin said she began carefully collecting and preserving brain samples in 2010, when she realized that many brains stored in brain banks were not adequately preserved for this kind of research. In their study, she and her colleagues examined the brains of people who died with their memories intact, and those who died at different stages of Alzheimer’s disease. She found that the brains of people with Alzheimer’s showed few if any signs of new neurons in the hippocampus—with less signal the further along the people were in the course of the disease. This suggests that the loss of new neurons—if it could be detected in the living brain—would be an early indicator of the onset of Alzheimer’s, and that promoting new neuronal growth could delay or prevent the disease that now affects more than 5.5 million Americans.

Rusty Gage, president of the Salk Institute for Biological Studies and a neuroscientist and professor there, says he was impressed by the researchers’ attention to detail. “Methodologically, it sets the bar for future studies,” says Gage, who was not involved in the new research but was the senior author in 1998 of a paper that found the first evidence for neurogenesis. Gage says this new study addresses the concerns raised by Alvarez-Buylla’s research. “From my view, this puts to rest that one blip that occurred,” he says. “This paper in a very nice way… systematically evaluates all the issues that we all feel are very important.”

Neurogenesis in the hippocampus matters, Gage says, because evidence in animals shows that it is essential for pattern separation, “allowing an animal to distinguish between two events that are closely associated with each other.” In people, Gage says, the inability to distinguish between two similar events could explain why patients with PTSD keep reliving the same experiences, even though their circumstances have changed. Also, many deficits seen in the early stages of cognitive decline are similar to those seen in animals whose neurogenesis has been halted, he says.

In healthy animals, neurogenesis promotes resilience in stressful situations, Gage says. Mood disorders, including depression, have also been linked to neurogenesis.

Hsieh says her research on epilepsy has found that newborn neurons get miswired, disrupting brain circuits and causing seizures and potential memory loss. In rodents with epilepsy, if researchers prevent the abnormal growth of new neurons, they prevent seizures, Hsieh says, giving her hope that something similar could someday help human patients. Epilepsy increases someone’s risk of Alzheimer’s as well as depression and anxiety, she says. “So, it’s all connected somehow. We believe that the new neurons play a vital role connecting all of these pieces,” Hsieh says.

In mice and rats, researchers can stimulate the growth of new neurons by getting the rodents to exercise more or by providing them with environments that are more cognitively or socially stimulating, Llorens-Martin says. “This could not be applied to advanced stages of Alzheimer’s disease. But if we could act at earlier stages where mobility is not yet compromised,” she says, “who knows, maybe we could slow down or prevent some of the loss of plasticity [in the brain].”


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The Adult Brain Does Grow New Neurons After All, Study Says – Scientific American

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[ARTICLE] Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial – Full Text

Abstract

Background

After discharge from hospital following a stroke, prescriptions of community-based rehabilitation are often downgraded to “maintenance” rehabilitation or discontinued. This classic therapeutic behavior stems from persistent confusion between lesion-induced plasticity, which lasts for the first 6 months essentially, and behavior-induced plasticity, of indefinite duration, through which intense rehabilitation might remain effective. This prospective, randomized, multicenter, single-blind study in subjects with chronic stroke-induced hemiparesis evaluates changes in active function with a Guided Self-rehabilitation Contract vs conventional therapy alone, pursued for a year.

Methods

One hundred and twenty four adult subjects with chronic hemiparesis (> 1 year since first stroke) will be included in six tertiary rehabilitation centers. For each patient, two treatments will be compared over a 1-year period, preceded and followed by an observational 6-month phase of conventional rehabilitation. In the experimental group, the therapist will implement the diary-based and antagonist-targeting Guided Self-rehabilitation Contract method using two monthly home visits. The method involves: i) prescribing a daily antagonist-targeting self-rehabilitation program, ii) teaching the techniques involved in the program, iii) motivating and guiding the patient over time, by requesting a diary of the work achieved to be brought back by the patient at each visit. In the control group, participants will benefit from conventional therapy only, as per their physician’s prescription.

The two co-primary outcome measures are the maximal ambulation speed barefoot over 10 m for the lower limb, and the Modified Frenchay Scale for the upper limb. Secondary outcome measures include total cost of care from the medical insurance point of view, physiological cost index in the 2-min walking test, quality of life (SF 36) and measures of the psychological impact of the two treatment modalities. Participants will be evaluated every 6 months (D1/M6/M12/M18/M24) by a blinded investigator, the experimental period being between M6 and M18. Each patient will be allowed to receive any medications deemed necessary to their attending physician, including botulinum toxin injections.

Discussion

This study will increase the level of knowledge on the effects of Guided Self-rehabilitation Contracts in patients with chronic stroke-induced hemiparesis.

Background

The most common motor deficit following stroke is spastic hemiparesis [1]. More than 90% of patients with hemiparesis recover some lower limb function after a stroke, but rarely with a level of ease or speed that would allow for independent and comfortable ambulation in everyday life, outdoors in particular [123]. In the upper limb, the proportion of patients that recover daily use of the arm is estimated between 10 and 30% [45678]. Consequently, around half of stroke survivors do not resume professional activities, and two thirds remain chronically disabled [9].

In parallel, most patients in chronic stages have their rehabilitation discontinued or converted into “maintenance” therapy, as professionals often estimate that they might no longer progress [7101112131415]. Others benefit from reinduction periods, prescribed according to subjective or ill-defined criteria. It has not been demonstrated that this conventional rehabilitation system now fits current knowledge on behavior-induced brain plasticity and on the potential for motor recovery in chronic spastic paresis [161718]. Indeed, a significant body of evidence demonstrates that high intensity of rehabilitation (the opposite of “maintenance therapy”) correlates with motor function improvement in chronic stages [161920]. One way to achieve sufficient amounts of physical treatment might be to adequately guide and motivate the patient into practicing self-rehabilitation [1820]. It has been confirmed that programs of exercises given by the therapist to be performed at home are appreciated by patients not only for the structure they give to everyday life, but also as they represent in themselves a source of motivation and hope, particularly when these programs are associated with ongoing professional support [2122].

We hypothesize that there is confusion between the lesion-induced plasticity of the central nervous system – essentially during the first 6 months post-lesion – and the behavior-induced plasticity, which lasts indefinitely [16172324252627]. The latter justifies initiatives to organize chronic and intense physical rehabilitation work [1718232425262728]. Even though previous, short-term open studies evaluating self-rehabilitation programs in spastic hemiparesis suggested the possibility of functional improvement, to our knowledge there are no large-scale prospective randomized controlled protocols that test the effectiveness of long term self-rehabilitation programs in spastic hemiparesis as against conventional rehabilitation systems, especially in chronic stages [2930313233343536].

Technically, which home rehabilitation exercises might be recommended? From a neurophysiological point of view, muscle overactivity chronologically emerges as the third fundamental feature of motor impairment that begins in the subacute phase in hemiparesis, following paresis and soft tissue contracture that appear in the acute phase [373839]. One recognizable form of muscle overactivity is spasticity (hyper-reflectivity to phasic stretch), which is potentiated by muscle shortening [3738]. Hypersensitivity to stretch in an antagonist muscle also impedes voluntary motoneurone recruitment for the agonist muscle, a phenomenon called “stretch-sensitive paresis” [40]. As none of the three fundamental mechanisms of motor impairment (paresis, muscle shortening, and muscle overactivity) is distributed symmetrically between agonists and antagonists, there are force imbalances around joints, hindering active movements and deforming body postures [41]. Each of these three mechanisms of impairment, particularly the two most important, which are muscle shortening and muscle overactivity, can be specifically targeted with local treatment, muscle by muscle, aiming to rebalance forces, joint by joint [28]. For the less overactive muscles around each joint, an intensive motor training will aim to break the vicious cycle Paresis-Disuse-Paresis [37]. For their shortened and more overactive antagonists most importantly, a daily program of self-stretch postures at high load combined with a program of maximal amplitude rapid alternating movements, potentially associated with botulinum toxin injections, will aim to increase muscle extensibility and reduce cocontraction, breaking the vicious cycle: Muscle shortening-Overactivity-Muscle shortening [284243] (www.i-gsc.com). Significant preliminary results obtained using prescription and teaching of self-rehabilitation programs within a Guided Self-rehabilitation Contract (GSC) led us to hypothesize that this method practiced over the long term might enhance active motor function in chronic hemiparesis beyond 1 year following stroke [184445464748].

From a social point of view, stroke is the leading cause of acquired disability in Western countries. For the Steering Committee on Stroke Prevention and Management in France, the yearly cost of stroke is €5.9 billions, the cost of care in medical and social facilities is €2.4 billions and the cost of daily allowances and disability pensions is €125.8 millions [49]. Additionally, several studies have shown that indirect costs were proportional to direct costs [50]. Stroke thus accounts for a large share of health expenditures. In that regard as well, devising a feasible and effective guided self-rehabilitation program might offer financial advantages for our health systems.[…]

 

Continue —> Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial | BMC Neurology | Full Text

Fig. 2

Fig. 2Template of diary in Guided Self-rehabilitation Contract

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[NEWS] Thunderbirds fund cutting-edge rehab enhancements for Barrow

Above: The Thunderbirds Charities gift to Barrow Neurological Foundation is being used to acquire four new devices, similar to this robotic hand. These instruments enable therapists at the Barrow Neuro-Robotics Rehabilitation Center to personalize therapy based on a patient’s abilities.

Patients recovering from stroke, traumatic brain and spine injuries will now have a leg up in their recovery journeys, thanks to a $350,000 grant from Thunderbirds Charities to Barrow Neurological Foundation.
An estimated 13.8 million Americans live with a disability caused by a brain or spinal cord injury, and each year, Barrow records more than 30,000 outpatient visits in the Neuro-Rehabilitation Center.

With this gift from Thunderbirds Charities, Barrow will acquire four cutting-edge devices for its Neuro-Robotics Rehabilitation Center, which provides personalized therapy to deliver better outcomes in less time. These robotics include:

• A body weight-supported treadmill that uses augmented and virtual reality to simulate challenges in everyday life, such as walking a golf course.

• A robot-assisted shoulder and arm rehabilitation device with intelligent gravity compensation and virtual reality to work on skills needed for daily function.

• A sensor-based device used to work on balance and posture training.

• An interactive surface for upper extremity, cognitive and sensory retraining to allow patients to practice motor skills.

Barrow has been at the forefront in the use of robotics, which mimic normal human movements and can be programmed to support or challenge a patient’s abilities. Many of these devices incorporate an interactive component, creating a game-like experience for the patient to conquer.

“These new robotics will help Barrow patients relearn how to stand, walk and perform skills that many take for granted, while also providing our therapists with more advanced tools to monitor progress,” said Katie Cobb, president of Barrow Neurological Foundation. “We want to thank Thunderbirds Charities for providing these life-changing tools for our patients’ continued recovery.”

“Barrow’s Neuro-Robotics Rehabilitation Center is making a positive, profound impact on the health of patients recovering from severe and debilitating injuries, and we are honored to be able to support such a great mission,” said Carlos Sugich, President of Thunderbirds Charities.

via Thunderbirds fund cutting-edge rehab enhancements for Barrow | AZ Big Media

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[NEWS] Vitamin D Deficiency Linked to Loss in Brain Plasticity

Feb 21, 2019 | Original Press Release from the University of Queensland

Vitamin D Deficiency Linked to Loss in Brain Plasticity

Perineuronal nets (bright green) surround particular neurons (blue). Fluorescence labelling reveals just how detailed these structures are. Credit: Phoebe Mayne, UQ

University of Queensland research may explain why vitamin D is vital for brain health, and how deficiency leads to disorders including depression and schizophrenia.

 

via Vitamin D Deficiency Linked to Loss in Brain Plasticity | Technology Networks

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[NEWS] Pill that reverses brain damage could be on the horizon

 

Researchers at the University of Pennsylvania have made important progress in designing a drug that could recover brain function in cases of severe brain damage due to injury or diseases such as Alzheimer’s.

brain cellsVitaly Sosnovskiy | Shutterstock

The work builds on a previous study where the team managed to convert human fetal glial cells called astrocytes into functional neurons. However, that required using a combination of nine molecules – too many for the formula to be translated into a clinically useful solution.

As reported in the journal Stem Cell Reports, the team has now successfully streamlined the process so that only four molecules are needed – an achievement that could lead to pill for repairing brain damage.

We identified the most efficient chemical formula among the hundreds of drug combinations that we tested. By using four molecules that modulate four critical signaling pathways in human astrocytes, we can efficiently turn human astrocytes — as many as 70 percent — into functional neurons.”

Jiu-Chao Yin, Study Author

The researchers report that the new neurons survived for more than seven months in the laboratory environment and that they functioned like normal brain cells, forming networks and communicating with one another using chemical and electrical signaling.

“The most significant advantage of the new approach is that a pill containing small molecules could be distributed widely in the world, even reaching rural areas without advanced hospital systems,” says Chen.

“My ultimate dream is to develop a simple drug delivery system, like a pill, that can help stroke and Alzheimer’s patients around the world to regenerate new neurons and restore their lost learning and memory capabilities,” he continued.

Now, the years of effort the team has put into simplifying the drug formula has finally paid off and taken the researchers a step closer towards realizing that dream.

via Pill that reverses brain damage could be on the horizon

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[BLOG POST] 7 principles of neuroscience every coach and therapist should know – Your Brain Health

What does neuroscience have to do with coaching and therapy?

Short answer: EVERYTHING!

If you’re a coach or therapist, your job is to facilitate change in your client’s

  • thinking (beliefs and attitudes)
  • emotions (more mindfulness and resilience)
  • behaviour (new healthy habits).

Coaching builds the mental skills needed to support lasting change. Skills such as:

  • mindfulness
  • self-awareness
  • motivation
  • resilience
  • optimism
  • critical thinking
  • stress management

Health and wellness coaching, in particular, are emerging as powerful interventions to help people initiate and maintain sustainable change.

And we have academic research to support this claim: check out a list of RCTs in table 2 of this paper).

How can neuroscience more deeply inform coaching and therapy?

Back in the mid-1990s when I was an undergrad, the core text of my neuroscience curriculum was ‘Principles of Neural Science’ by Eric Kandel, James Schwartz and Thomas Jessell. Kandel won the 2000 Nobel Prize in Physiology or Medicine for his research on memory storage in neurons.

A few years before his Nobel, Kandel wrote a paper A new intellectual framework for psychiatry’. The paper explained how neuroscience can provide a new view of mental health and wellbeing.

Based on Kandel’s paper, researchers at the Yale School of Medicine proposed seven principles of brain-based therapy for psychiatrists, psychologists and therapists. The principles have been translated intopractical applications for health & wellness, business, and life coaches. 

One fundamental principle is,

“All mental processes, even the most complex psychological processes, derive from the operation of the brain.”

And another is:

“Insofar as psychotherapy or counseling is effective . . . it presumably does so through learning, by producing changes in gene expression that alter the strength of synaptic connections.”

That is, human interactions and experience influence how the brain works.

This concept of brain change is now well established in neuroscience and is often referred to as neuroplasticity. Ample neuroscience research supports the idea that our brains remain adaptable (or plastic) throughout our lifespan.

Here is a summary of Kandel, Cappas and colleagues thoughts on how neuroscience can be applied to therapy and coaching…

Seven principles of neuroscience every coach should know.

1. Both nature and nurture win.

Both genetics and the environment interact in the brain to shape our brains and influence behaviour.

Therapy or coaching can be thought of as a strategic and purposeful ‘environmental tool’ to facilitate change and may be an effective means of shaping neural pathways.

2.  Experiences transform the brain.

The areas of our brain associated with emotions and memories such as the pre-frontal cortex, the amygdala, and the hippocampus are not hard-wired (they are ‘plastic’).

Research suggests each of us constructs emotions from a diversity of sources: our physiological state, by our reactions to the ‘outside’ environment, experiences and learning, and our culture and upbringing.

3.  Memories are imperfect.

Our memories are never a perfect account of what happened. Memories are re-written each time when we recall them depending on how, when and where we retrieve the memory.

For example, a question, photograph or a particular scent can interact with a memory resulting in it being modified as it is recalled.

With increasing life experience we weave narratives into their memories.  Autobiographical memories that tell the story of our lives are always undergoing revision precisely because our sense of self is too.

Consciously or not, we use imagination to reinvent our past, and with it, our present and future.

4. Emotion underlies memory formation.

Memories and emotions are interconnected neural processes.

The amygdala, which plays a role in emotional arousal, mediate neurotransmitters essential for memory consolidation. Emotional arousal has the capacity to activate the amygdala, which in turn modulates the storage of memory.

 

5. Relationships are the foundation for change 

Relationships in childhood AND adulthood have the power to elicit positive change.

Sometimes it takes the love, care or attention of just one person to help another change for the better.

The therapeutic relationship has the capacity to help clients modify neural systems and enhance emotional regulation.

6. Imagining and doing are the same to the brain.

Mental imagery or visualisation not only activates the same brain regions as the actual behaviour but also can speed up the learning of a new skill.

Envisioning a different life may as successfully invoke change as the actual experience.

7. We don’t always know what our brain is ‘thinking’.

Unconscious processes exert great influence on our thoughts, feelings, and actions.

The brain can process nonverbal and unconscious information, and information processed unconsciously can still influence therapeutic and other relationships. It’s possible to react to unconscious perceptions without consciously understanding the reaction.

 

via 7 principles of neuroscience every coach and therapist should know – Your Brain Health

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[WEB SITE] Electrical stimulation in brain bypasses senses, instructs movement

Date:December 7, 2017
Source:University of Rochester Medical Center
Summary:The brain’s complex network of neurons enables us to interpret and effortlessly navigate and interact with the world around us. But when these links are damaged due to injury or stroke, critical tasks like perception and movement can be disrupted. New research is helping scientists figure out how to harness the brain’s plasticity to rewire these lost connections, an advance that could accelerate the development of neuro-prosthetics.
FULL STORY

The brain’s complex network of neurons enables us to interpret and effortlessly navigate and interact with the world around us. But when these links are damaged due to injury or stroke, critical tasks like perception and movement can be disrupted. New research is helping scientists figure out how to harness the brain’s plasticity to rewire these lost connections, an advance that could accelerate the development of neuro-prosthetics.

A new study authored by Marc Schieber, M.D., Ph.D., and Kevin Mazurek, Ph.D. with the University of Rochester Medical Center Department of Neurology and the Del Monte Institute for Neuroscience, which appears in the journal Neuron, shows that very low levels of electrical stimulation delivered directly to an area of the brain responsible for motor function can instruct an appropriate response or action, essentially replacing the signals we would normally receive from the parts of the brain that process what we hear, see, and feel.

“The analogy is what happens when we approach a red light,” said Schieber. “The light itself does not cause us to step on the brake, rather our brain has been trained to process this visual cue and send signals to another parts of the brain that control movement. In this study, what we describe is akin to replacing the red light with an electrical stimulation which the brain has learned to associate with the need to take an action that stops the car.”

The findings could have significant implications for the development of brain-computer interfaces and neuro-prosthetics, which would allow a person to control a prosthetic device by tapping into the electrical activity of their brain.

To be effective, these technologies must not only receive output from the brain but also deliver input. For example, can a mechanical arm tell the user that the object they are holding is hot or cold? However, delivering this information to the part of the brain responsible for processing sensory inputs does not work if this part of the brain is injured or the connections between it and the motor cortex are lost. In these instances, some form of input needs to be generated that replaces the signals that combine sensory perception with motor control and the brain needs to “learn” what these new signals mean.

“Researchers have been interested primarily in stimulating the primary sensory cortices to input information into the brain,” said Schieber. “What we have shown in this study is that you don’t have to be in a sensory-receiving area in order for the subject to have an experience they can identify.”

A similar approach is employed with cochlear implants for hearing loss which translate sounds into electrical stimulation of the inner ear and, over time, the brain learns to interpret these inputs as sound.

In the new study, the researchers detail a set of experiments in which monkeys were trained to perform a task when presented with a visual cue, either turning, pushing, or pulling specific objects when prompted by different lights. While this occurred, the animals simultaneously received a very mild electrical stimulus called a micro-stimulation in different areas of the premotor cortex — the part of the brain that initiates movement — depending upon the task and light combination.

The researchers then replicated the experiments, but this time omitted the visual cue of the lights and instead only delivered the micro-stimulation. The animals were able to successfully identify and perform the tasks they had learned to associate with the different electrical inputs. When the pairing of micro-stimulation with a particular action was reshuffled, the animals were able to adjust, indicating that the association between stimulation and a specific movement was learned and not fixed.

“Most work on the development of inputs to the brain for use with brain-computer interfaces has focused primarily on the sensory areas of the brain,” said Mazurek. “In this study, we show you can expand the neural real estate that can be targeted for therapies. This could be very important for people who have lost function in areas of their brain due to stroke, injury, or other diseases. We can potentially bypass the damaged part of the brain where connections have been lost and deliver information to an intact part of the brain.”

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Materials provided by University of Rochester Medical CenterNote: Content may be edited for style and length.

 

via Electrical stimulation in brain bypasses senses, instructs movement — ScienceDaily

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