Tuesday, July 16, 2013

Brain Mapping

Hardly a day seems to go by without reading of another study proving a certain area of the brain is responsible for a certain function----often the functions are emotional, such as love, empathy, anger, etc.  And many times the conclusion is that this new key piece of research will aid in the development of a new drug to treat associated disorders.  While I do pay attention to and read them, I have just never been able to get too excited about them.  And today, I learned I'm not the only one!

http://www.scienceagogo.com/news/20130610213820data_trunc_sys.shtml  Scientists from Case Western University today issued a "scathing rebuke" of brain mapping as a basis for isolating specific functions to limited areas of the brain.  Their basis for this rebuke is detailed in the link, and you can read all about there.  Thank you, CWU, for rethinking this. 

But here, you get to read MY ideas about brain imaging and its limits.  I have had parents offer to bring me multiple imaging reports and actual images before an evaluation of their child.  I gratefully acknowledge the offer and then decline.  To me, it is all about function.  I have seen children with perfect MRI's who are in a wheelchair with a feeding tube and a trach---and on the flip side of the coin have seen children who can walk, talk, run, jump and only have issues with attention and focus who have serious deformities in specific regions of the brain.  How can this be?  Well, honestly, I don't know.  And frankly, neither does anybody else.  Nobody.  And here is why:

The brain is a very complex network of neural connections.  Because of this, it is almost impossible to assign function to one small location.  Often times studies are only looking at the cortex (the only area of the brain that can be "mapped" with the cap full of electrodes) and ignores the fact that the cortex functions SOLELY on information from the lower regions of the brain.  This is a common trap that not only imaging researchers, but also tutors, physicians and therapists fall into.  But it is a mistake---and that mistake is a blog post for another day.  :)

Back to function----While imaging shows up if there is activity in a region of the brain, it does not show the quality of that activity.  It doesn't show if it is speedy and efficient or slow and sluggish.  It doesn't show what happens if environmental factors change, such as the amount of background noise or eating something with red dye in it.

The imaging also ignores the principle of neuroplasticity.  Especially in young children---but shown to be possible in anyone---alternate regions of the brain can pick the function of injured or even removed sections.  And we ALL need to rely on neuroplasticity constantly.  This is how our brain improves and repairs.  Certainly not something to be ignored.

If you are in a traumatic injury situation, stay out of the way.  Let the doctors do their thing.  Trauma professionals are VERY good at what they do.  If they want imaging, you wouldn't catch me arguing the point. 

I am not saying imaging is never good.  I am saying for chronic neurological issues, it should not be the only basis for moving forward in children.  Function is the goal and where I focus in designing programs of stimulation and organization for my clients.