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Reversing the Damage of a Stroke

For one patient, a decade of recovery took determination, persistence and the courage to weather repeated setbacks.

Strange as it may seem, the stroke Ted Baxter suffered in 2005 at age 41, leaving him speechless and paralyzed on his right side, was a blessing in more ways than one. Had the clot, which started in his leg, lodged in his lungs instead of his brain, the doctors told him he would have died from a pulmonary embolism.

And as difficult as it was for him to leave his high-powered professional life behind and replace it with a decade of painstaking recovery, the stroke gave his life a whole new and, in many ways, more rewarding purpose.

Before the stroke, Mr. Baxter’s intense work-focused life as a globe-trotting executive in international finance had eroded his marriage and deprived him of fulfilling relationships with family and friends. Unable to relax even on vacation, he rarely took time to smell the roses. Now, he told me, he leads a richer, calmer, happier life as a volunteer educator for stroke victims and their caregivers and for the therapists who treat them.

The stroke began with a cramping pain in his leg after a long international flight during which he wore compression hose to support his varicose veins. He didn’t take the pain seriously until suddenly he couldn’t talk or move the right side of his body. The clot that caused his leg pain had broken loose and cut off blood flow to the left side of his brain.

He nearly died. But once stabilized, the doctors discovered that he was born with a hole in his heart that had allowed the clot to bypass his lungs and go directly to his brain. Two of his siblings turned out to have the same defect, called patent foramen ovale, which they subsequently had repaired.

Mr. Baxter readily admits that his Type A personality, which was the driving force behind his professional success, was also a major factor that helped him reverse the extensive losses he suffered when the clot severely damaged his brain. And it inspired him to recount his 14 years of recovery and renewal in a fascinating book, “Relentless: How a Massive Stroke Changed My Life for the Better,” an apt title for what it took for him to regain full physical function, comprehension and intelligible speech.

His mantra, which could help many others facing a devastating health setback, is that recovery takes determination, focus, resiliency, persistence and courage — the courage to weather repeated setbacks and frustrations. He admits, however, that it can also take the financial resources and personal support he had to get the kind of help that can make a difference.

At first, his goal was to get right back in the saddle, working nonstop in finance. But after months of intense rehab, he still could neither use nor understand language, spoken or otherwise.

“It took seven or eight months for me to realize I wasn’t going back to my job,” he said. “I didn’t even understand that the words coming from my mouth weren’t making any sense.”

The learning curve was steep: “I couldn’t read; I couldn’t write. I could see the hospital signs, the elevator signs, the therapists’ cards, but I couldn’t understand them,” he wrote. The aphasia — the inability to understand or express speech — “had beaten and battered” his pride.

But he refused to give up. With age and prestroke physical conditioning on his side, he had convinced himself that “100 percent recovery was possible as long as I pushed hard enough.”

Mr. Baxter figured if he could get his body functioning again, his language facility might also return. The brain, he learned, was plastic and capable of renewal. So he devoted countless hours to physical therapy, worked out in the gym long and hard, and had his left arm tied behind his back, forcing himself to use the right. He found that as his physical abilities improved, so did his comprehension and communication skills.

When what he tried to say came out garbled, many people assumed he was either mentally slow or a foreigner with limited English. As one of his speech therapists said of people with aphasia, “It’s hard to understand that they have their intellectual faculties and know what they want to say, but they don’t have the ability to communicate it.”

Mr. Baxter researched and enrolled in several different aphasia programs throughout the country. For many hours a day, he did language practice, starting with books and flash cards for preschoolers and doing endless repetitions to relearn speech until eventually — after years of hard work — he was finally able to read books and have real conversations.

His original therapists at the Rehabilitation Institute of Chicago, admittedly amazed at the progress he made, asked what benefited him the most and solicited his help developing a new, intensive aphasia program. He was also invited to participate in Archeworks, a design program in Chicago for students working to solve urban problems.

“I faced the challenge of using my right hand, making new friends, and communicating effectively with a team,” he wrote. He was building things with his hands and tools and suddenly he realized he was problem-solving, a skill he had used often in finance.

Sports also aided his recovery. As he slowly regained use of his right side, he took lessons in golf and boxing, aided by watching others do things correctly.

“If I could see somebody do something, then I could follow it and mimic what they did,” he wrote. “I had to focus on visualization — picturing the task, the actions needed to perform that task, and the intended result.”

Art therapy was another helpful pursuit, which he said reduced his stress, countered depression and improved his self-esteem and emotional health. With art as a new source of fulfillment came an invitation to join a museum board that gave him additional conversational practice and “withered away my aphasia every day.”

Gradually, Mr. Baxter said he “started to realize that by doing more for others, I’d be happier with myself.”

Living now in Newport Beach, Calif., with his second wife, the 55-year-old stroke survivor devotes his life to inspiring other survivors and their caregivers. “I go to universities and hospitals to present my story — what I had experienced, how I rehabbed myself, how it changed my life for the better, and what it took to get my life back,” he wrote.

“Sometimes, I can’t believe how far I’ve come,” he said. He credited family members and friends who “never gave up on my recovery, nor did they ever treat me as if I were lost, and because of that, I never felt lost. None of it would have worked without a positive attitude.”

 

 

Source: Reversing the Damage of a Stroke

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Stress Changes The Brain, And This Could Be How It Happens

The results of a new brain imaging study may have just answered a big question about how stress changes the brain. Using a combination of genetic editing and brain scanning in mice, researchers found that stress triggers a chemical cascade that radically changes how brain networks communicate, and the results could sharpen our understanding of anxiety disorders in humans.

Breaking down the research

Stress serves an important purpose in preparing us to react to danger. Anything the brain perceives as threatening triggers multiple brain networks to synchronize and communicate, all in just a fraction of a second. With systems humming, we make immediate decisions to survive the threat.

But what facilitates all of those brain networks to connect and communicate? That’s been a difficult question to answer in the human brain, because doing so would require examining brain function during the split-second window of facing a threat.

Enter our friends the mice to help solve the problem. Researchers followed a trail of previous studies and zeroed in on the neurotransmitter noradrenaline (aka norepinephrine, a chemical that floods the brain during stress) as a likely facilitator of brain-network connectivity.

The twist was that they had genetically manipulated the rodents’ brains to allow for selectively controlling when noradrenaline was released (not possible in human brains). While controlling the chemical faucet, they also scanned the mouse brains using fMRI to see what would happen.

And what happened, it turns out, was pretty amazing. The release of noradrenaline “rewired” the mouse brains, allowing different brain networks to instantly cross-communicate. But the neurotransmitter wasn’t just facilitating communication, it was restructuring neural connections beyond anyone’s expectations.

“I couldn’t believe that we were seeing such strong effects,” said the study’s first author Valerio Zerbi, a brain imaging specialist from the University of Zurich.

The researchers found the strongest rewired effects in brain areas responsible for processing sensory stimuli (auditory and visual, for example), and in the amygdala, the epicenter of the brain’s threat response system.

What does this mean for us?

It’s the part about threat response that may hold the most promise for better understanding what stress does to our brains.

Allowing for the fact that this was research in mice, the particular dynamic studied here is probably quite similar between us and our rodent counterparts. If noradrenaline rewires the human brain as it appears to rewire the brains of mice, it’s possible the long-term effects of stress are more profound than we’ve realized.

Previous research has linked the flood of noradrenaline to changes in brain connectivity, but it seems likely we’ve underestimated the effects, especially in the small but powerful part of our brain sitting at the center of anxiety disorders: the amygdala.

At a minimum, this research opens new doors for better understanding how both acute and chronic stress effects the brain, and could enlighten new ways of deconstructing anxiety conditions, now the most prevalent mental health disorders worldwide. The study was published in the journal Neuron.

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David DiSalvo is the author of the best-selling book “What Makes Your Brain Happy and Why You Should Do the Opposite”, which has been published in 15 languages, and the books “Brain Changer: How Harnessing Your Brain’s Power to Adapt Can Change Your Life” and “The Brain in Your Kitchen”. His work has appeared in Scientific American Mind, Forbes, Time, Psychology Today, The Wall Street Journal, Slate, Esquire, Mental Floss and other publications, and he’s the writer behind the widely read science and technology blogs “Neuropsyched” at Forbes and “Neuronarrative” at Psychology Today. He can be found on Twitter @neuronarrative and at his website, daviddisalvo.org. Contact him at: disalvowrites [at] gmail.com.

Source: Stress Changes The Brain, And This Could Be How It Happens

New Study Discovers Neurons That Rewrite Traumatic Memories – Andréa Morris

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An estimated one-third of people will suffer from stress or fear-related disorders at some point in their lifetime. Certain traumatic memories can stick with us and wreak havoc, causing chronic anxiety, depression, phobias and post-traumatic stress disorder (PTSD). One of the most successful trauma treatments available is a behavioral therapy called “exposure therapy.”

A method that involves re-exposing the patient to traumatic stimulus in a controlled environment in an effort to break the association of fear or anxiety. A new study out today in the journal Science examines how exposure therapy works on a cellular level and shows the effectiveness of this type of therapy relies principally on recall neurons rewriting traumatic memories.

Neuroscientist don’t yet fully understand how neurons store our memories. The mystery fuels a considerable debate in the field: Do exposure-type therapies work by suppressing a memory trace of fear and replacing it with a new memory trace of calm and safety? Or does the process involve a rewriting of the neurons that are active during traumatic recall?

Although the authors of this new study say suppression may still play a role, they were able to observe for the first time neuronal reprogramming of long-term traumatic memories.

Researchers at the Swiss Federal Institute of Technology, Lausanne (EPFL) discovered long-lasting trauma (remote fear) reduction in the brain is correlated with activation of the same neurons involved in memory storage. Looking at mouse brains, the scientists zeroed in on a group of neurons in the dentate gyrus.

The dentate gyrus is part of the hippocampus; an area critical for memory encoding, retrieval, and abatement of fear. Previous studies show the dentate gyrus plays a crucial role in generating contextual memories of fear. It also appears to generate new neurons, a process called neurogenesis.

The mice in this study were genetically modified to carry a gene that emits a signal–a fluorescent protein–following neuronal activity. The researchers used a fear-training exercise to give the mice long-lasting traumatic memories. This allowed the scientists to pinpoint a group of neurons in the dentate gyrus involved in storing and recall of long-term traumatic memories.

The mice then went to therapy (fear-extinction training) a mouse-in-a-lab approximation of exposure therapy. The scientists discovered that some of the neurons active during the recall of traumatic memories were still active when the rodents no longer showed fear. And the less the mice were afraid, the more cells were reactivated. It’s the first indication that this group of neurons in the dentate gyrus may be involved in storing memories as well as reducing the impact of traumatic memories.

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The researchers put the mice through exposure therapy again, this time reducing the excitability of the recall neurons. With the recall neurons turned down, the mice showed less fear reduction (exposure therapy less effective) compared to the controls. The researchers then dampened the excitability of other neurons in the dentate gyrus, but found these other neurons didn’t seem to influence fear reduction.

Finally, the researchers excited the recall neurons during exposure therapy and saw that the mice showed a decrease in fear, demonstrating that the particular group of neurons in the dentate gyrus involved in recall are also critical for fear reduction.

“Our findings shed, for the first time, light onto the processes that underlie the successful treatment of traumatic memories,” says neuroscientist Johannes Gräff, whose lab conducted the study.

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