Exceptional autism brains

As promised, this blog further demonstrates both the complexity of our brain and the relationship between brain and behaviour, this time with reference to Autism Spectrum disorders.

Autism Spectrum disorders (ASD) are pervasive developmental disabilities characterised by marked difficulties with social interaction and communication and restricted and repetitive interests and behaviours. As the name implies, the condition is on a continuum, meaning that the range and severity of the difficulties people with an ASD experience can vary widely.

There are a number of subtypes, the most common being autistic disorder and Asperger's disorder. ASDs are reasonably common, with as many as 1 in 110 children affected. They are more prevalent in boys than girls.

While there is no cure, the best possible outcomes are achieved through early intervention (such as social skills training), which is why getting a clear diagnosis is an important first step.

Research on ASDs is in its relatively early stages and there is still a lot of debate surrounding the cause, diagnosis and subtypes. One area of debate surrounds a subtype , sometimes referred to as regressive autism, where children develop normally until a certain age, at which point they not only stop developing in certain areas, but and they lose skills gained (such as the ability to communicate in age-appropriate ways).

The brains of boys with regressive autism are different

A ground-breaking study recently conducted at the MIND Institute at the University of California has found that compared both to children without ASD and to those with a different form of ASD, boys who go on to develop regressive autism show abnormal brain growth as early as four months of age. In "the largest study of brain development in preschoolers with autism to date", involving 180 subjects, it was found that these boys experienced a growth spurt during which their brains grew six percent larger between the ages of four and 19 months. There was no evidence of this occuring in girls.

The data was based on head circumference measurements taken from paediatric visits in infancy and magnetic resonance imaging (MRI) scans done at age three. The boys with regressive autism had normal head circumference at birth. This significantly increased by as early as approximately four months and most commonly between four to six months, well before symptoms of ASD became evident.

The important outcome of this study, as noted by the researchers is that "rapid head growth beginning around four-six months of age may be a risk factor for future loss of skills"

The ability to detect possible autism from routine tests at such an early age is invaluable as the importance of early intervention can not be overstated. Neuropsychologists are involved in the diagnosis of ASD and can also assist in developing appropriate interventions. Clinical Psychologists, Psychologists, Speech Therapists and Occupational Therapists are also often involved in interventions for children with ASD and their parents.

Thanks again to Karen Wallace for alerting me to this fascinating article.

On behalf of Jamie Berry and the whole Advanced Neuropsychological team, we wish all our followers, readers and their families a wonderful holiday season. Stay safe!

Our exceptional brain (continued)

As discussed in our earlier blog, Neuro-what-ology, neuropsychology has evolved along with our burgeoning understanding of the human brain. Two recent studies further illuminate the complexity and awesomeness of this vital organ, and the relationship between brain and behaviour.

Studies such as these are vital to the practice of neuropsychology as they help inform assessment practices and treatment programs and assist with interpretation of results.

Also, they make a great dinner party conversation topic!

Thanks to Karen Wallace, Clinical Neuropsychologist, and fellow ANTSer for sniffing out these great articles.

Synaesthesia and the visual cortex

The first study concerns synaesthesia – a condition where people experience a sense separate to the one being stimulated, such as seeing colours while reading words. Dr Devin Terhune and colleagues from the University of Oxford in the UK found that there is a "fundamental" difference between the brains of people with and without synaesthesia.

People with synaesthesia appear to have an overactive visual cortex, the part of the brain that is responsible for processing visual information, located in the Occipital lobe at the back of the brain.

Over time, this overactivity appears to create changes in the regions of the brain responsible for processing information about letters, colours and numbers during development.

The researchers stimulated the visual cortex of individuals with and without synaesthesia by producing a magnetic field from a coil applied to the scalp. In both cases stimulation resulted in ‘phosphenes’, or flashes of light or other visual images, but those individuals without the condition required three times greater stimulation in order to experience phosphenes.

The researchers hoped that the findings could be used to reduce or eliminate synaesthesia, or even to train those without it to learn digit or word-colour associations, which could be useful when studying mathematics, English or music.

The study was published on November 18, 2011 in Current Biology.

If you’d like to read about the second study, stay tuned...and visit our blog again next week.

If you’d like more information about Advanced Neuropsychological Treatment Services, please visit our website or contact us via our online enquiry form.

World focuses attention on tragic outcomes of road traffic accidents

The ‘Pinky Ad’ and Road Safety

Who could forget those ads that ran on Australian television a few years ago about young male drivers – the ones with the pinky finger that targeted risky driving in young males by implying that speeding is linked to an inferiority complex to do with, let’s just say, an aspect of the male anatomy.
While the approach was light-hearted (if a bit sexist!), the subject matter is not. Road accidents are the leading killer of people aged between 15 to 29 years. Globally 1.3 million people die each year on the roads and between 20 and 50 million people sustain non-fatal injuries. It is projected that based on current rates, if no action is taken, road accidents will result in 1.9 million deaths by 2020.
Now the world is collectively sitting up and taking notice.

Global Decade of Action for Road Safety

May 11 marked the beginning of the global Decade of Action for Road Safety 2011-2020. The aim of the ‘Decade’ is to prevent death and injury from road traffic events. At least 20 countries, including Australia, are involved in the Decade, their governments having committed to improving safety management and enhancing health and related services.

Road Accidents and Traumatic Brain Injury

One of the most tragic outcomes of road accidents is Traumatic Brain Injury (TBI). TBI is an acquired brain injury caused by physical damage to the brain, either as a result of an external force striking the head or the brain impacting with the skull. The force causes the brain to move within the skull, causing internal damage.
There are different levels of severity raging from mild to extremely severe which are determined by factors including recall of events before and after the incident and level of coma. The more severe the TBI, the poorer the prognosis.
Cognitive and psychological outcomes can include memory difficulties, difficulties with higher level thinking skills (e.g. planning/organisation), slowed speed of information processing, mood and personality change, depression and anxiety.
A 2008 report by the Australian Institute of Health and Welfare and the Research Centre for Injury Studies found that there were more than 22,700 hospitalisations involving TBI in Australia in 2004-05. After falls, transportation use was the second highest external cause of TBI, at 31% of all cases, which represented over 7,000 people.
Nearly 70% of the cases were males, who acquired TBI at more than twice the rate of females.

TBI and Clinical Neuropsychology

While the main aim of the Decade is to prevent TBI, another important aim is to improve management of and services for those who experience a TBI. Clinical neuropsychology is critical in the assessment and rehabilitation of TBI. A neuropsychological assessment can provide detailed information on the impact of the TBI on various aspects of cognition (thinking skills) and expert advice regarding the trajectory of brain recovery and remediation/rehabilitation strategies to allow for the best possible outcome.
If you or someone you know has had a TBI and would like more information on our assessment and rehabilitation services, please contact us.
And please slow down on our roads over this holiday period.

Neuro-what-ology?

For the clinical neuropsychologist (or those in training) a dinner party can be an interesting experience. When the talk inevitably turns to “what do you do” neuropsychologists need to be prepared for the fact that most people a. have never heard of neuropsychology; b. don’t understand what neuropsychologists do; and c. (the best bit) usually want to know more.

So what is clinical neuropsychology?

Clinical neuropsychology is a specialisation within the field of psychology which involves the assessment, diagnosis and treatment of psychological disorders associated with conditions affecting the brain.

Clinical neuropsychologists conduct evidence-based neuropsychological assessments to develop a profile of an individual’s cognitive strengths and weakness. This neuropsychological profile helps to identify the root causes(s) of presenting problems and informs treatment programs.

There are a number of reasons why clinical neuropsychology is not a widely known or understood specialisation. One important reason relates to the complexity of the brain. Our current understanding of how the brain works has been informed by centuries of research. Clinical neuropsychology has evolved along with important developments in our understanding of brain structure and function and this will no doubt continue as we deepen our understanding of this complex organ.

A brief history of our evolving understanding of the brain

Written records about the brain and nervous system have been found as early as 1700 B.C. However, it was not until the 17th century A.D. that serious investigations about the brain and its functions were undertaken, and not until the 20th century that scientists began to fully appreciate the relationship between structure and function. Some key developments were:

1600’s

• Rene Descartes introduced the concept of the relationship between the mind and the body, coining his famous phrase “I think, therefore I am”.
• Thomas Willis published his ‘Anatomy of the Brain’. One of his most important contributions was a discussion of cerebral circulation.

1800’s

• Franz Josef Gall founded the science of Phrenology, which involved studying the topography of a skull as an indicator of brain anatomy. He introduced the concept of the brain being composed of various sections, each of which he proposed was responsible for a psychological trait.
• While his ideas were later largely discredited, the idea of linking brain structure to function was an important development, leading to the theory of localisation.
  
• Neurologists Paul Broca (and later Carl Wernicke) used this theory, together with investigations of brain damaged people, to determine that there were two distinct yet related areas of the brain responsible for language production and language comprehension.

1900’s

• Hans Berger developed the first electroencephalograph (EEG), a device for recording the electrical activity in the brain.
• Procedures such as Lobotomies and Electro-shock Therapy, while controversial, helped advance understanding of the relationship between brain structure and function and the outcomes of damage to certain brain regions.
• In 1953 patient HM, who went on to become one of the most important patients in the history of brain research, underwent a bilateral medial temporal lobe resection to treat medication-resistant epilepsy. As a result, HM became densely amnesic and was largely unable to form new memories.
• HM participated in hundreds of research studies and helped advance our understanding of memory, learning
• and their relationship with brain structure and other cognitive functions.
• A key finding was the importance of the role of a brain structure called the hippocampus in forming new memories.
• Experiments on epilepsy patients who had the two halves (hemispheres) of their brain surgically separated advanced our understanding of lateralisation.
• In the 1970’s and 1980’s scanning and imaging devices such as CT and MRI allowed for detailed mapping of the brain’s structure.

2000’s

• Advances in brain imaging technology have improved understanding of brain structure and techniques such as functional MRI have enhanced understanding of the relationship between structure and function.
• The aging population and increasing prevalence of dementia has resulted in an explosion of research in the field. Neuropsychology is critical for the diagnosis and management of dementia.

How we use our knowledge to help you

Understanding how the brain functions is just one of the many skills that clinical neuropsychologists need to master. Our knowledge of brain anatomy informs our clinical assessments, allowing us to provide informed diagnoses and to draw conclusions about functional implications and rehabilitation techniques for a wide range of conditions affecting the brain, from learning disorders to dementia.

Contact us today to find out more about how our neuropsychological services can help you.

And please feel free to use this information to impress your friends at your next dinner party!

References

http://www.mybrain.co.uk/public/learn_history2.php
http://www3.niu.edu/acad/psych/Millis/History/2002/neuro.htm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539424/
Images courtesy of google images

Garry McDonald

Best known for his screen character Norman Gunston and show bearing the same name and endeared by the Australian community for his portrayal of Arthur Beare in ‘Mother and Son’ with Ruth Cracknell. Spoke candidly of his struggle with major depression and anxiety during an interview with Andrew Denton in an episode of ‘Enough Rope’. Speaking of depression and the symptoms, he said:

I couldn't get out of bed, I couldn't concentrate, I'd go to work and I'd just, was like a fog.

He went on to describe an extraordinary event, while waiting thirty minutes to see his doctor; he ended up sitting on the kerb at the edge of the road, almost in a foetal position.

And I went off to the doctors to see the GP and I remember they said, 'oh you can see him in half an hour'. And I went outside and sat in the gutter, well on the, on the sort of edge you know. And it was like you had this sort of extraordinary hangover. And you know eventually I mean you do, you end up being in the foetal position, it was extraordinary.

We all need a break sometimes, take some timeout, get away from it all, the pressures of work, the commitments, the dead-lines and work related stress factors. Usually we only need a couple of days at the shack, a weekend fishing up in the mountains or down the coast, a short getaway; but sometimes it’s more serious than that. We ignore the signs, press on regardless, keep up appearances, maintain the pace, but in the end the human brain will protect itself, it will shun the overload, it will take a break regardless.

Gary now an advocate for mental health awareness, a board member of Beyondblue, an Australian national depression initiative, for which he was recently awarded by becoming an Officer of the Order of Australia. He recommends walking on a daily basis, saying this is the best advice he received from any psychologist and the best advice he could offer to anyone struggling with severe depression.

Take a twenty minute brisk walk each morning; it’s very, very good.

It’s good advice, though exercise would possibly be the last thing you want to do when suffering from depression or anxiety, it doesn’t need to be intense exercise like one of Forrest Gumps marathons, try a little gardening, take a stroll in the park, walk the dog to the store to buy it a treat each morning, something for yourself too. The main thing is to get up, get going, anything to get you off the sofa. Exercise will help release good brain chemicals (endorphins) that will help counter depression; exercise is also a good detox, reducing bad chemicals in the immune system; exercise also raises the body temperature which can produce a calming effect, compensating feelings of anxiety.

Exercise has some positive psychological effects too, you will increase confidence levels and emotional feelings of self worth, by maintain goals and nurturing a sense of achievement on a daily basis. It’s also a great distraction, takes your mind off all the worries and junk thoughts that are holding you down. You may even meet people, a little social interaction along the way, a smile or a good morning greeting from other people in the neighborhood can have a positive effect on your mood. The journey through depression is a one step at a time process, but it starts with a single step and culminates in a new lifestyle, a new you, with your life back on track, maybe better than ever before.

Geoff Bullock

Geoff Bullock christian singer, song writer, the author of Power of your love, former worship pastor at the Hills Christian Centre (Hillsong Church) in Sydney. In an interview with Terry Allen, says he wrote many of his songs as a result of an undiagnosed mental illness. Geoff described his symptoms as feelings of rejection and a lack of affirmation and a feeling of isolation, and that most of his works are about brokenness being repaired in the most extraordinary way.

One of the most influential Christian singer-songwriters of this generation; in 2003 Geoff was diagnosed with bipolar disorder type 2. It's been a long road, but Geoff still continues to write songs and books.

It's a fine line

We have all heard the saying "there's a fine line between genius and insanity". There have been many great and inspired people through the ages, who have achieved fame and accolades, the same have also been mentally ill or psychologically impaired. Many who suffered the constant change of depression, battling mood swings from the lowest of lows to the highest of highs. In the high times they created masterpieces of literature inspired art or music, the same ones when enduring the low times, destroyed their own works, burned their literature, trashed their inventions or inflicted themselves with horrendous self-harm and in some cases, ultimately; chose death.

"On a clear day, you can see forever", who said that? Whoever it was, was no stranger to depression, because that's what it's like. When you are up, anything is possible, the thoughts flow freely, nothing can stop the creative process, a torrent of energy that knows no bounds. You make plans, big plans, long-term goals and visions, you can see it all so clearly, you set things in motion, make commitments, appointments and agendas. The problem is, when time comes to meet the commitments, attend the appointments, it's not a clear day anymore, cognitive functioning is diminished, you can't see it how you did the week before, a dull grey memory clouds the brilliance of yesterday.