Posts Tagged memory

[BLOG POST] 7 Common Behavioral Effects of Brain Injury and How to Deal With Them – Jumbledbrain

A brain injury can have various physical, cognitive, medical, emotional, and behavioral effects on head injury survivors. Of these changes, behavioral changes can be one of the most challenging for survivors to overcome to live happier and more independently. To help survivors with traumatic brain injury (TBI), families and caregivers should learn to understand their behavior and develop practical ways to address those challenges.

Why Does Brain Injury Affect Emotions?

Behavioral problems following TBI are often the result of damage to the frontal lobe, the area of the brain that controls “executive functions.” Executive functions refer to the set of skills a person uses to plan, create, evaluate, organize, evaluate, reason, communicate, and solve problems. These impairments have a significant impact on how a person behaves.

Common Behavioral Changes Experienced by TBI Survivors

Human behavior is complex and multi-faceted. This means it can be difficult to isolate which behavior is a result of TBI. A TBI patient’s behavior is, after all, influenced by many different factors, like the nature of the injury, their pre- and post-injury experience, their cognitive abilities, or the behavior of other people. But some of the most common behavior changes encountered by TBI survivors include:

1. Memory Problems

Most people diagnosed with a brain disorder may experience memory problems, but they are more common among TBI survivors as a result of an injury from the bony protrusions inside the skull. Typical situations include forgetting a person’s name, losing a train of thought, and difficulty learning new things.

2. Temper Outbursts

Family members of people with TBI often describe their loved one as someone with a quick temper. They may use bad language, throw objects, or slam doors. Drastic changes like the loss of independence and inability to follow a conversation, in particular, can make a person with TBI more prone to these temper outbursts.

3. Depression

Depression among people with TBI can arise because of the struggle to adjust to disabilities and the changes to one’s role in the family and society. Symptoms of depression include feelings of worthlessness, suicidal thoughts, changes in sleep and appetite, and withdrawal from peers.

4. Poor Concentration

TBI affects a person’s attention and concentration abilities, posing a challenge to work, study, and everyday living. Poor concentration manifests itself in difficulty multitasking, following conversations, and processing information. This happens when the lateral intraparietal cortex—the region of the brain responsible for controlling attention—suffers damage.

5. Self-Centered Attitude

It’s common for TBI survivors to show signs of egocentrism. In turn, this could hamper their ability to see things from another person’s point of view which severely impact their relationship with family members, especially if they used to be a caring person. And although it is often taken for granted, the ability to understand another’s perspective is a complex cognitive skill.

6. Aggressive Behavior

Aggressive behavior following a TBI is often impulsive. A person with TBI can easily grow agitated over trivial disagreements. Experts explain that aggression that happens directly after the TBI is the result of delirium and other post-injury medications. Aggression up to three months after TBI, on the other hand, happens as a result of depression, chronic pain, and post-traumatic stress disorder.

7. Lower Sex Drive

A decreased desire or interest in sex is more common among TBI survivors than heightened libido. Disinhibited sexual behavior can be a possible effect of poor awareness and impulsivity. Changes in sexual functioning following TBI can be due to hormonal changes, medication side effects, fatigue, and movement problems.

Coping with a Loved One with Head Injury

People with TBI showing signs of these behavior problems should be evaluated by a doctor so they can receive proper treatment. On top of medical intervention, friends and family of survivors should also actively participate in rehabilitation, recovery, and advocacy.

1. Set Realistic Expectations

Brain injury has lifelong effects. It pays to understand that a person with TBI might already be trying his or her best. Every member of the family can have different abilities, skills, comfort levels, and limitations, so set small goals and acknowledge that every day is an achievement.

2. Get Involved

Behavioral problems are often hard to deal with. But try to resist the temptation of avoiding difficult situations. People with TBI could end up feeling more confused and isolated if left alone. Instead, get involved and familiarize yourself with their day-to-day routine.

3. Encourage Independence

Learning how to comfort a loved one with TBI is a must. But tread carefully: there is a fine line between caring for people and smothering them with affection. Try to instill independence and study their behavior to know the right time to provide comfort.

4. Reinforce Positive Behavior

What used to come easy to a TBI survivor may now feel extremely difficult. Reinforce positive behavior by focusing on the patient’s strengths, rather than pointing fingers or directing behavior.

5. Rediscover Preferences

Stay alert and pay attention to the wants and needs of a person with TBI. Discover new ways they can engage in activities and establish a balance between easy and difficult tasks. And always encourage them to participate, instead of assuming that their injury makes them unable to.

6. Confide with Loved Ones

Honesty is the best policy, and confiding in friends and family members can help alleviate the burden. Enlisting others for support can provide a fresh perspective and make it easier to identify triggers and how to avoid them.

7. Bounce Back Quickly

Accept that encountering behavioral problems is a part of life. Avoid getting stuck by teaching

new skills while a person is upset. Bounce back quickly from these obstacles then revisit them again later since people aren’t receptive to learning new things when they’re upset.

Other articles you may like:

Have you or a brain injury survivor you know struggled with these behavioural issues? What advice would you give to others?


Today’s article is written by Hazel Ann Westco.

Hazel Ann Westco is a start-up freelance writer. She is interested in writing blogs and articles related to legal cases mainly in personal injury and employment.  Whenever she has free time she rides her bicycle or motorcycle for a road trip. You can follow her on Twitter using her handle @AnnWestco.

via Guest post: 7 Common Behavioral Effects of Brain Injury and How to Deal With Them | Jumbledbrain

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[ARTICLE] Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial – Full Text HTML

Abstract

Objectives: Memory deficits are common after stroke, yet remain a high unmet need within the community. The aim of this phase II randomized controlled trial was to determine whether group compensatory or computerized cognitive training approaches were effective in rehabilitating memory following stroke.

Methods: A parallel, 3-group, single-blind, randomized controlled trial was used to compare the effectiveness of a compensatory memory skills group with restorative computerized training on functional goal attainment. Secondary outcomes explored change in neuropsychological measures of memory, subjective ratings of prospective and everyday memory failures and ratings of internal and external strategy use.

Results: A total of 65 community dwelling survivors of stroke were randomized (24: memory group, 22: computerized cognitive training, and 19: wait-list control). Participants allocated to the memory group reported significantly greater attainment of memory goals and internal strategy use at 6-week follow-up relative to participants in computerized training and wait-list control conditions. However, groups did not differ significantly on any subjective or objective secondary outcomes.

Conclusion: Preliminary evidence shows that memory skills groups, but not computerized training, may facilitate achievement of functional memory goals for community dwelling survivors of stroke. These findings require further replication, given the modest sample size, subjective nature of the outcomes and the absence of objective eligibility for inclusion.

 

Lay Abstract

Memory problems are commonly reported following stroke but receiving help for these difficulties remains a high unmet need among survivors. Two different approaches to memory rehabilitation are available: memory skills group training and computerised cognitive training; however, it is unclear which approach is more effective. This study compared these two approaches in 65 stroke survivors who all reported memory difficulties. We found that participants who received memory group training were more likely to achieve their memory improvement goals than those who received computerised cognitive training. It was concluded that memory skills group training may be a more effective approach to improve memory function in daily life following stroke, but more research is required.

 

Introduction

Memory impairment is one of the most commonly reported cognitive consequences of stroke (1) and can compromise rehabilitation engagement (2). Despite this, support for memory problems remains a high unmet need within the community (3) and has been identified by patients, researchers and clinicians as a high-priority research area (4).

Memory skills group (MSG) training and computerized cognitive training (CCT) are commonly used approaches to rehabilitate memory. Although both share the fundamental goal of improving everyday memory outcomes (5), there are a number of key differences between these interventions. CCT adopts a restorative approach to rehabilitation, with the theoretical goal of restoring underlying impairment through cognitive exercises (6). Repetitive drill and practice style activities are purported to result in everyday functional gains, although there remains no robust evidence of this transfer (6). By contrast, MSG interventions take a compensatory approach to rehabilitation with a theoretical aim of lessening the disabling impact of impairment (7). In addition, the format of delivery differs. CCT training tasks are generally completed individually, with associated well-recognized advantages of low cost, wide availability and potential for at personalized use at home (8). MSG intervention is facilitated by a trained clinician and is delivered face-to-face in a group format, due, in part, to increased recognition of the multifaceted nature of memory dysfunction and limited economic resources (9).

While a number of comprehensive reviews have explored best-practice recommendations for cognitive impairment following acquired brain injury (10, 11), only a minority of studies included in these reviews were conducted in stroke-only samples. Consequently, the long-held view that MSG training is the treatment of choice in rehabilitating memory has been largely speculative post-stroke and appears to have been based on an absence of evidence, rather than evidence of absence for the effectiveness of CCT (5). The aim of this study was to compare the effectiveness of CCT and MSG training in community dwelling survivors of stroke in achieving individualized, functional memory goals. A further aim was to explore the effect of training on secondary measures of objective, neuropsychological memory tasks and subjective memory ratings. In addressing these aims, we intended to maintain ecological validity by evaluating the interventions as they are clinically implemented (rather than transforming them to be experimentally matched with each other on characteristics such as group vs individual format), with the goal of facilitating clinical translation. We hypothesized that intervention participants (i.e. CCT and MSG) would show greater improvement in performance on outcome measures than waitlist control participants (WC). Given the proposed mechanism of action of each approach, we also hypothesized participants in the CCT group would show greater improvement on neuropsychological tests of memory, while participants in the MSG would show greater improvement on functional measures of memory and strategy use.[…]

 

Continue —> Journal of Rehabilitation Medicine – Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial – HTML

 

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[WEB SITE] The Benefits of Playing Music Help Your Brain More Than Any Other Activity

Learning an instrument has showed an increase resilience to any age-related decline in hearing.

The brain-training is big business. For companies like BrainHQ, Luminosity, and Cogmed, it’s actually a multimillion dollar business that is expected to surpass $3 billion by 2020. But, do the actually benefit your brain?

 

Research doesn’t believe so. In fact, the the University of Illinois determined that there’s little or no evidence that these games improve anything more than the specific tasks being trained. Luminosity was even fined $2 million for false claims.

So, if these brain games don’t work, then what will keep your brain sharp? The answer? Learning to play a musical instrument.

Why Being a Musician Is Good For Your Brain

Science has shown that musical training can change brain structure and function for the better. It can also improve long-term memory and lead to better brain development for those who start at a young age.

Furthermore, musicians tend to be more mentally alert, according to new research from a University of Montreal study.

 

“The more we know about the impact of music on really basic sensory processes, the more we can apply musical training to individuals who might have slower reaction times,” said lead researcher Simon Landry.

 

“As people get older, for example, we know their reaction times get slower. So if we know that playing a musical instrument increases reaction times, then maybe playing an instrument will be helpful for them.”

 

Previously, Landry found that musicians have faster auditory, tactile, and audio-tactile reaction times. Musicians also have an altered statistical use of multi-sensory information. This means that they’re better at integrating the inputs from various senses.

 

“Music probably does something unique,” explains neuropsychologist Catherine Loveday of the University of Westminster. “It stimulates the brain in a very powerful way, because of our emotional connection with it.”

 

Unlike brain-games, playing an instrument is a rich and complex experience. This is because it’s integrating information from senses like vision, hearing, and touch, along with fine movements. This can result long-lasting changes in the brain. This can also be applicable in the business world.

Changes in the Brain

Brains scans have been able to identify the difference in brain structure between musicians and non-musicians. Most notably, the corpus callosum, a massive bundle of nerve fibres connecting the two sides of the brain, is larger in musicians. Also, the areas involving movement, hearing, and visuospatial abilities appear to be larger in professional keyboard players.

 

Initially, these studies couldn’t determine if these differences were caused by musical training of if anatomical differences predispose some to become musicians. Ultimately, longitudinal studies showed that children who do 14 months of musical training displayed more powerful structural and functional brain changes.

 

These studies prove that learning a musical instrument increases grey matter volume in various brain regions, It also strengthens the long-range connections between them. Additional research shows that musical training can enhance verbal memory, spatial reasoning, and literacy skills.

Long Lasting Benefits For Musicians

Brain scanning studies have found that the anatomical change in musicians’ brains is related to the age when training began. It shouldn’t be surprising, but learning at a younger age causes the most drastic changes.

 

Interestingly, even brief periods of musical training can have long-lasting benefits. A 2013 study found that even those with moderate musical training preserved sharp processing of speech sounds. It was also able to increase resilience to any age-related decline in hearing.

 

Researchers also believe that playing music helps speech processing and learning in children with dyslexia. Furthermore, learning to play an instrument as a child can protect the brain against dementia.

“Music reaches parts of the brain that other things can’t,” says Loveday. “It’s a strong cognitive stimulus that grows the brain in a way that nothing else does, and the evidence that musical training enhances things like working memory and language is very robust.”

Other Ways Learning an Instrument Strengthens Your Brain

Guess what? We’re still not done. Here are eight additional ways that learning an instrument strengthens your brain.

 

1. Strengthens bonds with others. This shouldn’t be surprising. Think about your favorite band. They can only make a record when they have contact, coordination, and cooperation with each other.

 

2. Strengthens memory and reading skills. The Auditory Neuroscience Laboratory at Northwestern University states that this is because music and reading are related via common neural and cognitive mechanisms.

 

3. Playing music makes you happy. McMaster University discovered that babies who took interactive music classes displayed better early communication skills. They also smiled more.

 

4. Musicians can process multiple things at once. As mentioned above, this is because playing music forces you to process multiple senses at once. This can lead superior multisensory skills.

 

5. Musical increases blood flow in your brain. Studies have found that short bursts of musical training increase the blood flow to the left hemisphere of the brain. That can be helpful when you need a burst of energy. Skip the energy drink and jam for 30 minutes.

6. Music helps the brain recover. Motor control improved in everyday activities with stroke patients.

7. Music reduces stress and depression. A study of cancer patients found that listening and playing music reduced anxiety. Another study revealed that music therapy lowered levels of depression and anxiety.

 

8. Musical training strengthens the brain’s’ executive function. Executive function covers critical tasks like processing and retaining information, controlling behavior, making, and problem-solving. If strengthened, you can boost your ability to live. Musical training can improve and strengthen executive functioning in both children and adults.

 

And, wrap-up, check out this awesome short animation from TED-Ed on how playing an instrument benefits your brain.

 

via The Benefits of Playing Music Help Your Brain More Than Any Other Activity | Inc.com

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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] 7 signs of executive dysfunction after brain injury

 

 

7 signs of executive dysfunction after brain injury Main Image

7 signs of executive dysfunction after brain injury

Thu 26 Jan 2017

Executive dysfunction‘ is not, perhaps, a particularly well known term, but the effects of brain injury that it covers are very common indeed. It is used to collectively describe impairment in the ‘executive functions’ – the key cognitiveemotional and behavioural skills that are used to navigate through life, especially when undertaking activities and interacting with others.

 

Although executive dysfunction is a common problem among many brain injury survivors, it is most commonly experienced following an injury to the frontal lobe.

The importance of executive functions is shown by the difficulties caused when they don’t work properly and someone has problems with executive dysfunction. Since the executive functions are involved in even the most routine activities, frontal injuries leading to executive dysfunction can lead to problems in many aspects of life.

Here we list the most common effects of executive dysfunction, with some examples of common issues that brain injury survivors can face:

Difficulties with motivation and organisation

  • Loss of ‘get up and go’, which can be mistaken for laziness
  • Problems with thinking ahead and carrying out the sequence of steps needed to complete a task

Rigid thinking

  • Difficulty in evaluating the result of actions and reduced ability to change behaviour or switch between tasks if needed

Poor problem solving

  • Finding it hard to anticipate consequences
  • Decreased ability to make accurate judgements or find solutions if things are going wrong

Impulsivity

  • Acting too quickly and impulsively without fully thinking through the consequences, for example, spending more money than can be afforded

Mood disturbances

  • Difficulty in controlling emotions which may lead to outbursts of emotion such as anger or crying
  • Rapid mood changes may occur, for example, switching from happiness to sadness for no apparent reason

Difficulties in social situations

  • Reduced ability to engage in social interactions
  • Finding it hard to initiate, participate in, or pay attention to conversations
  • Poor judgement in social situations, which may lead to saying or doing inappropriate things

Memory/attention problems

  • Finding it harder to concentrate
  • Difficulty with learning new information
  • Decreased memory for past or current events, which may lead to disorientation

Find out more

If you or someone you care for is affected by executive dysfunction, it is important to seek support. Speak to your doctor about your symptoms, and ask about referral to specialist services such as counselling, neuropsychology and rehabilitation.

You can find out more and get tips and strategies to help manage your condition on our executive dysfunction after brain injury page.

Headway groups and branches can offer support in your area, and you can contact our helpline if you would like to talk things through.

via 7 signs of executive dysfunction after brain injury | Headway

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[WEB SITE] Cognitive Assessment: Neurocognitive Assessment Battery Online for the detection of cognitive deterioration (CAB).

General Cognitive Assessment Battery (CAB)

Innovative online neuropsychological test. Study brain function and complete a comprehensive online screening. Precisely evaluate a wide range of abilities and detect cognitive well-being (high-moderate-low). Identify strengths and weaknesses in the areas of memory, concentration/attention, executive functions, planning, and coordination.

WHO IS IT FOR?

    • For my own evaluation
    • For a family member
    • For my patients
    • For my students
    • For a research study

TOTAL PRICE 49.95

 

Cognitive assessment battery to study brain function and cognitive performance

  • Assess current state of the user’s cognitive skills
  • For children 7 years and older and adults.
  • The complete battery lasts about 30-40 minutes.

The General Cognitive Assessment Battery (CAB) from CogniFit is a leading professional tool that makes it possible to get study the brain function of children 7 years and older and adults in depth, using online cognitive tasks. The results from this neuropsychological tool are useful for understanding the user’s cognitive state, strengths, and weaknesses. This can help determine whether or not the cognitive changes that the user may be experiencing are normal, or if they reflect some kind of neurological disorder. Any private or professional user can easily use this cognitive assessment.

This normalized cognitive test is completely online and lasts about 30-40 minutes. After completing the evaluation, a report will automatically be generated with the user’s neurocognitive profile. This report gathers useful information and presents data in an easy-to-understand format to make it possible to understand the functioning of different cognitive skills. It also provides valuable information that can help detect the risk of some disorder or problem, recognize its severity, and identify support strategies for each case.

We recommend using this neuropsychological assessment to better understand cognitive function, or cognitive, physical, psychological, or social well-being, and where there are symptoms or difficulties related o concentration/attention, memory, reasoning, planning, or coordination. We recommend using this complete cognitive test to complement a professional diagosis, and never to substitute a clinical consultation.[…]

 

Visit Site —> Cognitive Assessment: Neurocognitive Assessment Battery Online for the detection of cognitive deterioration (CAB).

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[WEB SITE] 7 signs of executive dysfunction after brain injury

7 signs of executive dysfunction after brain injury Main Image

 ‘Executive dysfunction‘ is not, perhaps, a particularly well known term, but the effects of brain injury that it covers are very common indeed. It is used to collectively describe impairment in the ‘executive functions’ – the key cognitiveemotional and behavioural skills that are used to navigate through life, especially when undertaking activities and interacting with others.

Although executive dysfunction is a common problem among many brain injury survivors, it is most commonly experienced following an injury to the frontal lobe.

The importance of executive functions is shown by the difficulties caused when they don’t work properly and someone has problems with executive dysfunction. Since the executive functions are involved in even the most routine activities, frontal injuries leading to executive dysfunction can lead to problems in many aspects of life.

Here we list the most common effects of executive dysfunction, with some examples of common issues that brain injury survivors can face:

Difficulties with motivation and organisation

  • Loss of ‘get up and go’, which can be mistaken for laziness
  • Problems with thinking ahead and carrying out the sequence of steps needed to complete a task

Rigid thinking

  • Difficulty in evaluating the result of actions and reduced ability to change behaviour or switch between tasks if needed

Poor problem solving

  • Finding it hard to anticipate consequences
  • Decreased ability to make accurate judgements or find solutions if things are going wrong

Impulsivity

  • Acting too quickly and impulsively without fully thinking through the consequences, for example, spending more money than can be afforded

Mood disturbances

  • Difficulty in controlling emotions which may lead to outbursts of emotion such as anger or crying
  • Rapid mood changes may occur, for example, switching from happiness to sadness for no apparent reason

Difficulties in social situations

  • Reduced ability to engage in social interactions
  • Finding it hard to initiate, participate in, or pay attention to conversations
  • Poor judgement in social situations, which may lead to saying or doing inappropriate things

Memory/attention problems

  • Finding it harder to concentrate
  • Difficulty with learning new information
  • Decreased memory for past or current events, which may lead to disorientation

Find out more

If you or someone you care for is affected by executive dysfunction, it is important to seek support. Speak to your doctor about your symptoms, and ask about referral to specialist services such as counselling, neuropsychology and rehabilitation.

You can find out more and get tips and strategies to help manage your condition on our executive dysfunction after brain injury page.

Headway groups and branches can offer support in your area, and you can contact our helpline if you would like to talk things through.

via 7 signs of executive dysfunction after brain injury | Headway

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[BLOG POST] Where does the controversial finding that adult human brains don’t grow new neurons leave ongoing research?

Scientists have known for about two decades that some neurons – the fundamental cells in the brain that transmit signals – are generated throughout life. But now a controversial new study from the University of California, San Francisco, casts doubt on whether many neurons are added to the human brain after birth.

As a translational neuroscientist, this work immediately piqued my interest. It has direct implications for the research my lab does: We transplant young neurons into damaged brain areas in mice in an attempt to treat epileptic seizures and the damage they’ve caused. Like many labs, part of our work is based on a foundational belief that the hippocampus is a brain region where new neurons are born throughout life.

If the new study is right, and human brains for the most part don’t add new neurons after infancy, researchers like me need to reconsider the validity of the animal models we use to understand various brain conditions – in my case temporal lobe epilepsy. And I suspect other labs that focus on conditions including drug addiction, depression and post-traumatic stress disorder are thinking about what the UCSF study means for their investigations, too.

In the brain of a baby who died soon after birth, there are many new neurons (green in this image) in the hippocampus. Sorrells et alCC BY-ND

When and where are new neurons born?

No doubt, the adult human brain is able to learn throughout life and to change and adapt – a capability brain scientists call neuroplasticity, the brain’s ability to reorganize itself by rewiring connections. Yet, a central dogma in the field of neuroscience for nearly 100 years had been that a child is born with all the neurons she will ever have because the adult brain cannot regenerate neurons.

Just over half a century ago, researchers devised a way to study proliferation of cells in the mature brain, based on techniques to incorporate a radioactive label into new cells as they divide. This approach led to the startling discovery in the 1960s that rodent brains actually could generate new neurons.

Neurogenesis – the production of new neurons – was previously thought to only occur during embryonic life, a time of extremely rapid brain growth and expansion, and the rodent findings were met with considerable skepticism. Then researchers discovered that new neurons are also born throughout life in the songbird brain, a species scientists use as a model for studying vocal learning. It started to look like neurogenesis plays a key role in learning and neuroplasticity – at least in some brain regions in a few animal species.

Even so, neuroscientists were skeptical that many nerve cells could be renewed in the adult brain; evidence was scant that dividing cells in mammalian brains produced new neurons, as opposed to other cell types. It wasn’t until researchers extracted neural stem cells from adult mouse brains and grew them in cell culture that scientists showed these precursor cells could divide and differentiate into new neurons. Now it is generally well accepted that neurogenesis takes place in two areas of the adult rodent brain: the olfactory bulbs, which process smell information, and the hippocampus, a region characterized by neuroplasticity that is required for forming new declarative memories.

Adult neural stem cells cluster together in what scientists call niches – hotbeds for cultivating the birth and growth of new neurons, recognizable by their distinctive architecture. Despite the mounting evidence for regional growth of new neurons, these studies underscored the point that the adult brain harbors only a few stem cell niches and their capacity to produce neurons is limited to just a few types of cells.

With this knowledge, and new tools for labeling proliferating cells and identifying maturing neurons, scientists began to look for postnatal neurogenesis in primate and human brains.

What’s happening in adult human brains?

Many neuroscientists believe that by understanding the process of adult neurogenesis we’ll gain insights into the causes of some human neurological disorders. Then the next logical step would be trying to develop new treatments harnessing neurogenesis for conditions such as Alzheimer’s disease or trauma-induced epilepsy. And stimulating resident stem cells in the brain to generate new neurons is an exciting prospect for treating neurodegenerative diseases.

Because neurogenesis and learning in rodents increases with voluntary exercise and decreases with age and early life stress, some workers in the field became convinced that older people might be able to enhance their memory as they age by maintaining a program of regular aerobic exercise.

However, obtaining rigorous proof for adult neurogenesis in the human and primate brain has been technically challenging – both due to the limited experimental approaches and the larger sizes of the brains, compared to reptiles, songbirds and rodents.

Researchers injected a compound found in DNA, nicknamed BrdU to identify brand new neurons in human adult hippocampus – but the labeled cells were extremely rare. Other groups demonstrated that adult human brain tissue obtained during neurosurgery contained stem cell niches that housed progenitor cells that could generate new neurons in the lab, showing that these cells had an inborn neurogenic capacity, even in adults.

But even when scientists saw evidence for new neurons in the brain, they tended to be scarce. Some neurogenesis experts were skeptical that evidence based on incorporating BrdU into DNA was a reliable method for proving that new cells were actually being born through cell division, rather than just serving as a marker for other normal cell functions.

Further questions about how long human brains retain the capacity for neurogenesis arose in 2011, with a study that compared numbers of newborn neurons migrating in the olfactory bulbs of infants versus older individuals up to 84 years of age. Strikingly, in the first six months of life, the baby brains contained lots of chains of young neurons migrating into the frontal lobes, regions that guide executive function, long-range planning and social interactions. These areas of the human cortex are hugely increased in size and complexity compared to rodents and other species. But between 6 to 18 months of age, the migrating chains dwindled to a thin stream. Then, a very different pattern emerged: Where the migrating chains of neurons had been in the infant brain, a cell-free gap appeared, suggesting that neural stem cells become depleted during the first six months of life.

Questions still lingered about the human hippocampus and adult neurogenesis as a source for its neuroplasticity. One group came up with a clever approach based on radiocarbon dating. They measured how much atmospheric ¹⁴C – a radioactive isotope derived from nuclear bomb tests – was incorporated into people’s DNA. This method suggested that as many as 700 new cells are added to the adult human hippocampus every day. But these findings were contradicted by a 2016 study that found that the neurogenic cells in the adult hippocampus could only produce non-neuronal brain cells called microglia.

Rethinking neurogenesis research

Now the largest and most comprehensive study conducted to date presents even stronger evidence that robust neurogenesis doesn’t continue throughout adulthood in the human hippocampus – or if it does persist, it is extremely rare. This work is controversial and not universally accepted. Critics have been quick to cast doubt on the results, but the finding isn’t totally out of the blue.

So where does this leave the field of neuroscience? If the UCSF scientists are correct, what does that mean for ongoing research in labs around the world?

Because lots of studies of neurological diseases are done in mice and rats, many scientists are invested in the possibility that adult neurogenesis persists in the human brain, just as it does in rodents. If it doesn’t, how valid is it to think that the mechanisms of learning and neuroplasticity in our model animals are comparable to those in the human brain? How relevant are our models of neurological disorders for understanding how changes in the hippocampus contribute to disorders such as the type of epilepsy I study?

In my lab, we transplant embryonic mouse or human neurons into the adult hippocampus in mice, after damage caused by epileptic seizures. We aim to repair this damage and suppress seizures by seeding the mouse hippocampus with neural stem cells that will mature and form new connections. In temporal lobe epilepsy, studies in adult rodents suggest that naturally occurring hippocampal neurogenesis is problematic. It seems that the newborn hippocampal neurons become highly excitable and contribute to seizures. We’re trying to inhibit these newborn hyperexcitable neurons with the transplants. But if humans don’t generate new hippocampal neurons, then maybe we’re developing a treatment in mice for a problem that has a different mechanism in people.

Perhaps our species has evolved separate mechanisms for neuroplasticity, distinct from those used by species such as rats and mice. One possibility is that there are other sites in the human brain where neurogenesis occurs – its a big structure and more exploration will be necessary. If it turns out to be true that the human brain has a diminished capacity for neurogenesis after birth, the finding will have important implications for how neuroscientists like me think about tackling brain disorders.

Perhaps most importantly, this work underscores how crucial it is to learn how to increase the longevity of the neurons we do have, born early in life, and how we might replace or repair neurons that become damaged.

via Where does the controversial finding that adult human brains don’t grow new neurons leave ongoing research?

 

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[WEB SITE] Researchers prove that precisely timed brain stimulation improves memory

brain

Credit: Wikimedia Commons

Precisely timed electrical stimulation to the left side of the brain can reliably and significantly enhance learning and memory performance by as much as 15 percent, according to a study by a team of University of Pennsylvania neuroscientists published in Nature Communications. It is the first time such a connection has been made and is a major advance toward the goal of Restoring Active Memory, a U.S. Department of Defense-sponsored project aimed at developing next-generation technologies to improve memory function in veterans with memory loss.

“Our study has two novel aspects,” said Youssef Ezzyat, a senior data scientist in Penn’s psychology department in the School of Arts and Sciences and lead author on the paper. “We developed a system to monitor brain activity and trigger stimulation responsively based on the subject’s brain activity. We also identified a novel target for applying stimulation, the left lateral temporal cortex.”

In previous work by the Penn team, led by Michael Kahana, professor of psychology and RAM program principal investigator, and Daniel Rizzuto, director of cognitive neuromodulation, electrical pulses were delivered at regular intervals, independent of a subject’s success at learning. For example, during a free-recall memory task, researchers presented words on a screen for the patient to learn, and they applied brain stimulation with every other word in an effort to improve the outcome. In this case, the stimulation was not in response to specific brain-activity patterns.

In the current study, they took a different tack, one that included monitoring a patient’s brain activity in real time during a task. As the patient watched and attempted to absorb a list of words, a computer tracking and recording brain signals would make predictions based on those signals and then prompt an electrical pulse, at safe levels and unfelt by the participants, when they were least likely to remember the new information.

“During each new word the patient viewed, the system would record and analyze brain activity to predict whether the patient had learned it effectively. When the system detected ineffective learning, that triggered stimulation, closing the loop,” Ezzyat said.

After stimulation was turned off, the system would again listen to the subject’s brain activity, waiting for the next appropriate opportunity to generate the pulse.

The study involved 25 neurosurgical patients receiving treatment for epilepsy. Patients participated at clinical sites across the country, including the Hospital of the University of Pennsylvania, Thomas Jefferson University Hospital, University of Texas Southwestern, Emory University Hospital, Dartmouth-Hitchcock Medical Center and Mayo Clinic. All subjects had already had electrodes implanted in their brains as part of routine clinical treatment for epilepsy.

To build the models that used brain activity to make predictions, each participant performed the free-recall memory task during at least three 45-minute sessions before the Penn team introduced any closed-loop stimulation; multiple sessions increased the confidence that the brain activity linked to ineffective learning reflected a true pattern rather than an accidental blip. Patients then took part in at least one session involving brain stimulation.

“By developing patient-specific, personalized, machine-learning models,” Kahana said, “we could program our stimulator to deliver pulses only when memory was predicted to fail, giving this technology the best chance of restoring memory function. This was important because we knew from earlier work that stimulating the brain during periods of good function was likely to make memory worse.”

With this finding, the four-year RAM project comes closer to a fully implantable neural monitoring and stimulation system. The researchers said they believe there is great potential for the therapeutic benefits of this stimulation, particularly for people with traumatic brain injury and Alzheimer’s disease.

“Now we know more precisely,” Rizzuto said, “where to stimulate the brain to enhance memory in patients with memory disorders, as well as when to stimulate to maximize the effect.”

Michael Sperling, clinical study investigator at Thomas Jefferson University Hospital, added, “We are now able to monitor when the brain seems to be going off course and to use stimulation to correct the trajectory. This finding took an incredible amount of effort by not only the researchers but also by our patients, who were extraordinarily dedicated to participating in this project so that others might be helped.”

More information:
Youssef Ezzyat et al. Closed-loop stimulation of temporal cortex rescues functional networks and improves memory, Nature Communications (2018). DOI: 10.1038/s41467-017-02753-0

Journal reference:
Nature Communicationswebsite

Provided by:
University of Pennsylvania

via Researchers prove that precisely timed brain stimulation improves memory

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[WEB SITE] Tickling the brain with electrical stimulation improves memory, study shows

Tickling the brain with electrical stimulation improves memory, study shows
Credit: Mayo Clinic

Tickling the brain with low-intensity electrical stimulation in a specific area can improve verbal short-term memory. Mayo Clinic researchers report their findings in Brain.

The researchers found word recall was enhanced with stimulation of the brain’s lateral temporal cortex, the regions on the sides of the head by the temples and ears. Patients recalled more words from a previously viewed list when low-amplitude  was delivered to the brain. One patient reported that it was easier to picture the words in his mind for remembering.

“The most exciting finding of this research is that our  for language information can be improved by directly stimulating this underexplored brain area,” says Michal Kucewicz, Ph.D., a Mayo Clinic researcher in the Department of Neurology and co-first author. Dr. Kucewicz compares the stimulation to “tickling” the brain.

Memory impairments are a prevalent, costly problem in many brain diseases. Medication and behavioral therapies have limited effectiveness in many cases. “While electrical stimulation of the brain is emerging as potential therapy for a wide range of neurological and psychiatric diseases, little is known about its effect on memory,” says Gregory Worrell, M.D., Ph.D., a Mayo Clinic neurologist and senior author of the article.

The Mayo researchers are part of a multicenter collaboration led by Michael Kahana, Ph.D., University of Pennsylvania in Philadelphia. This collaboration includes seven academic medical centers.

“The next step for this project is to determine how to best apply electrical current in terms of the exact location within this area of the brain, timing and parameters of stimulation,” says Brent Berry, M.D., Ph.D., a Mayo Clinic researcher in the Department of Physiology and Biomedical Engineering and co-first author.

In this Brain paper, Drs. Kucewicz and Berry, and colleagues focused their study on four areas of the brain known to support memory for facts and events that can be consciously recalled.

The memory testing was done with patients undergoing evaluation for surgery to address seizures. These patients agreed to have their memory investigated using the electrodes implanted in their brains for surgical evaluation. It is common for people with epilepsy to have memory problems because the brain circuits that underlie memory function often are affected by epilepsy.In the study, patients were instructed to read a list of words—one at a time—from a computer screen. Electrical stimulation was applied some of this time. Patients then attempted to freely recall the words in any order.

Among 22 patients, the researchers found enhanced memory performance in the four patients with stimulation of the lateral temporal cortex but not among those with the other brain regions stimulated.

“These findings may lead to new stimulation devices that treat deficits in memory and cognition,” says Jamie Van Gompel, M.D., a Mayo Clinic neurosurgeon specializing in  stimulation and an author in the study.

The authors note study limitations include pain and seizure medications that may affect patient performance, the hospital setting that may disrupt ‘ sleep and wake cycles, and the fact that epilepsy affects memory.

 Explore further: Neuroscientists improve human memory by electrically stimulating brain

More information: Michal T Kucewicz et al. Evidence for verbal memory enhancement with electrical brain stimulation in the lateral temporal cortex, Brain (2017). DOI: 10.1093/brain/awx373

via Tickling the brain with electrical stimulation improves memory, study shows

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