Friday, September 27, 2013

Re-thinking the Brain

Topical Reference:
Re-thinking the Brain.  Richard Faull at TEDxAuckland.  September 2nd, 2013.

In this lecture, Dr. Faull, Center for Brain Research, University of Auckland,  describes his research into stem cells and neurogenesis pathways in the adult human brain.  He opens his lecture by stating that as a medical student he was taught that the human brain is fully formed by the age of twenty, with no new brain cell growth after that time.  Dr. Faull states, based on his research findings, that this commonly held dogma is is false, "absolutely, totally garbage".  Research studies in recent years at the Center for Brain Research has revealed that the adult human brain does in fact have stem cells and that it is continuously creating new brain cells.

Dr. Faull compares the human brain with the brain of rats and monkeys, noting that the human brain is incredibly more complex, indicated by the highly folded covered forebrain.  This is contrasted by the smoothness of the rat brain, described by Dr. Faull as the prototype brain.  Dr. Faull explains how each fold in the forebrain contributes to complex functioning and describes various brain regions and their related function.

Since the 1960's it has been recognized that rat, cat, and monkey brains have stem cells left over from the embyro stage.  These stem cells are located in the center of the brain and continue to create new brain cells, a process called neurogenesis.

In studies of rat brain slices from the middle of the brain near the ventricles, it was revealed that new brain cells are created throughout the rat's life.  Dr. Faull describes these new cells as "baby brain cells". These cells migrate down a neurogenesis motor way to the olfactory area in the front of the brain.
In experiments,  when cells in the rat brain are killed, mimicing stroke, Parkinson's, or Huntington Disease, new "baby brain cells" migrate via this neurogenesis motor way to replace lost brain cells and repair the brain.

Following graduation from medical school, Dr. Faull initially pursued neurosurgury.  Realizing how little was known about the inside of the brain, he instead pursued a career in brain research, specializing in the rat brain.  The area of the brain he focused on was the basil ganglia, the area of the brain involved with movement.  It is the basil ganglia that is affected in Parkinson's and Huntington's Diseases.

In 1980, he was approached by a professor of genetics, interested in his studies of the basal ganglia, and in particular, how these studies might shed light on Huntington's Disease.  Huntington is passed on within families due to a dominant gene that kills brain cells in the middle of the basil ganglia. Without a test for the gene, families wanted to know if the gene was present in the family line.  Thus,  following death, brains of parents with Huntington's Disease were provided to Dr. Faull for research.

While doing Huntington's research, Dr. Faull found unexpected and exciting results:  it was evident that the Huntington's brains had been making new brain cells, thus indicating that the human brain must have brain stem cells.  When looking at a slide of a normal brain, it revealed a small band of stem cells. However, a Huntington's brain had many more stem cells.  This seems to imply that the brain was trying to repair itself.

Recognizing the challenge of convincing the scientific community, who firmly held to the original dogma: no new brain cells,  of his findings, Dr. Faull realized that he would need to demonstrate the neurogenesis motor way in the human brain. Thus, PhD students began to search for this motor way, working with stained brain slices from front to back.  Although they were seeing hints of it, because they were slicing across the motor way, initially it was very difficult to find.  Changing strategy, they instead began to  cut larger blocks of sections, longitudinal segments, starting midline out.  These sections were joined together and after three years, they did in fact find segments of the motor way going several mm and cm.

The motor way was a different shape than that found in the rat, however that was explained by differential specialization of the human brain.  When the rat's brain was converted to human by decreasing olfactory section (in the human brain it is small) and increasing the cortex (in the human brain it is larger), the rat's motor way more resembled the human's.

In seeking to publish his results, Dr. Faull and his team had the paper rejected by the first major science journal they submitted to.  They added more information, additional studies, different cell counts, additional stains, and re-submitted to Science journal in the U.S.A.  Here is was accepted and featured on the front cover.

Dr. Faull acknowledges that his findings are "revolutionary and still controversial".   He stresses that an important aspect of his findings is that the human brain, although far more complex, has similar, comparable pathways to animals.  Therefore, what you find in animals, you can apply to humans.

This leads to the next important point.  We know that when you excite the rat's brain, when you place the rat in a stimulating environment, or provide more exercise, the rat's brain makes more brain cells.
Increased stimulation, creative thinking, and exercise all contribute to new brain cells in the human brain.

Dr. Faull concludes with challenges for future study:  how to stimulate normal and diseased brains to create more new brain cells from the stem cells in the brain and to explore if there are motor ways coming off the main motor way to regions of the brain affected by Huntington's or Parkinson's Diseases in an effort to repair the brain.

Dr. Faull's findings result in new questions and potential research explorations regarding the injured or diseased brain.  New considerations can be given to potential rehab and treatments for these client populations.  As a neuro music therapist working in catastrophic brain injury,  I seek for ways to stimulate the brain's potential for a neuroplastic response, working towards rehab goals.  Recognizing the importance of the brain's ability to adapt itself is an important element of rehab.  The concept that the brain can produce new brain cells adds a whole new dimension to the importance of brain stimulation, especially as soon as possible following trauma.

A model that I  developed for use with ABI clients, dependent on their rehab goals,  is Therapeutic Music Education in which clients learn to play, at an elementary level, the piano keyboard. Among the various goals areas potentially addressed with this model is cognitive rehabilitation, in particular executive functioning.  The experience of learning to read music can serve as a strong neural stimulus, and this is used to support cognitive rehab.  Dr. Faull's research findings regarding the potential for brain stimulus and creative thinking to have a role in the creation of new brain cells, gives me the desire to learn more and to seek out other research on this topic so that I can further explore the rehab potential of this.  I was also interested, due to the motor component of piano playing,  that exercise can be a stimulus for new brain cell growth.  Perhaps this combination of brain stimulus through the new learning experience of reading music and the motor action of executing the notation may better support the stimulation of new brain cell growth.

Another area of interest is the neurogenesis motor ways.  Their existence begs the questions:  can the new brain cells be stimulated to migrate to specific brain sites or can new motor ways be stimulated?

 Although as he acknowledged, these finds are revolutionary, they provide not only new concepts to consider or explore, they also provide encouragement to those working with or living with brain injury or disease.  Although great gains have been made in recent years regarding our knowledge of the brain, I believe to date we have only discovered the "tip of the iceburg" and that there is so much yet to learn.  The brain is far too complex, in my opinion, for one to state "it can never.....".  Although at this stage Dr. Faull's finding may be controversial,  they are encouraging and result in yet more questions to explore.

Thursday, September 26, 2013

Music Entrainment for Infants

1. I watched a video on this subject through the PBS "Music Instinct" website. This video presents something called the Gato Box, and is presented by Dr. Joanne Loewy. Here is a link: 

2. Summary/Review:
As an individual who has little experience thinking in this field, I found this video very interesting. Even thinking about the idea of music as a tool for entrainment in the human body at any age and stage is quite intriguing. 

In this video, Dr. Loewy introduces us to a musical tool called the Gato Box, which is a small box-like instrument used percussively to mimic the sound of a heartbeat as a tool to entrain the baby's heart rate. Loewry, using her hands, softly beats to the beat that the baby's heart rate should be at in order to help it with the task at hand: sucking from a bottle of milk. This rhythm basis, as performed using the Gato Box, supports the baby's movement and speed of movement for sucking. This is paralleled to when a runner goes to run on a treadmill at the gym, and may use music at a certain tempo in order to help them continue running at a particular pace. 

The point of the Gato Box is to simply recreate the heart sounds, making it a natural sound for the infant to latch onto, therefore Dr. Loewy does not use a mallet, but her hand to keep the sound soft. The instrument itself is all hollow, so it creates a quiet and enclosed sound as to emulate what the baby would have heard in the womb.  Loewy also mentions how this tool helps transition the baby from an awake to a sleep state, guiding the heart rate with the rhythm created.

3. Reflections:

First of all, I found this video and article very interesting. In further reading about Dr. Loewy, it seems that she has done quite a bit of research in this field, and is currently the Director of the Louis Armstrong Center for Music and Medicine in New York City.

As I mentioned above, the idea of influencing physical movement with sound is so interesting to me, and to think that this can be used as such an effective tool with an individual at such a young age is truly amazing. I loved the parallel made about going to the gym, as that is something that I can identify with, and the use of rhythm in that case is quite an important tool in both keeping my focus, and my speed within the body. It was interesting to see not only how quickly the baby responded to this rhythmic pulse, but also how effective it was in serving several purposes: helping the baby do a necessary task (eating), transitioning, and finally moving into sleep.

I have a lot of friends who have babies, and it made me wonder if any of them have ever used a similar technique to help their own children eat, or sleep. As an adult, it made me think about times in my own day-to-day living where I find some kind of sound or rhythmic stimulus helpful in performing a task. For example, I tend to prefer to sleep with a fan on. I am not sure what it is about the frequency that the fan creates, or this "white noise" that aids me in sleeping, but I am definitely more interested to know why this is the case (which may or may not be completely related to this idea of entrainment).

Overall, it was an interesting video, and interesting to think about the many research possibilities in such an interesting field of Music and Science.