Calling Dr. Doolittle

“Despite evidence that use of the impaired upper extremity has a positive effect on the neurophysiological consequences after stroke, recent studies in rats paint a very different picture. Restricting the unimpaired forelimb in rats with sensorimotor cortex lesions results in prevention of dendritic growth in the uninjured cortex, exaggeration of the neuronal injury, and more severe behavioral deficits.”

RJ Nudo. “Remodeling of cortical motor representations after stroke: implications for recovery from brain damage.”  Molecular Psychiatry (1997) 2, 188–191.

The observation above comes after the author’s brief discussion of Edward Taub’s “constraint-induced movement therapy,” a stroke rehabilitation technique that has proven quite successful in humans.

For the record, I am appalled by Taub’s research technique, which involved cutting afferent ganglia (transmitters of sensory information to the central nervous system) then forcing the monkeys to learn to use their disabled limbs.

Dante Alighieri would have found a spot for Taub.

Was all that cruelty necessary? Couldn’t any moderately impaired stroke patient have told Taub that affected limbs improve with use?

Time and again, I return to the “hard science” literature looking for insights about stroke recovery. I come away with models and brain maps, but little insight. Invariably, I retreat to experience.

How has my brain adapted to tissue loss? I suppose an MRI might tell me what neurons are firing where, but that information won’t help my penmanship or Frisbee toss. Effective rehabilitation requires writing and tossing. Lots of it.

Until someone can convince me that I am wrong, I will continue to understand the brain (and its attendant neural patterns) not as a thought creator, but (as rills left in a hillside’s soil provide evidence of a heavy rain) the result of thinking.

Tipping my hat to Taub, I have typed this post using only (well, almost only) my left (affected) hand.

Regarding this post’s title…  Dr. Doolittle talked to the animals. Dr. D was the original “dog whisperer.” When I was a child, he was also my favorite fictional character. Rather than monitoring the brains of maimed rats, Dr. D would have protected them. Had he arrived too late for that, he would have asked the poor critters how he might relieve their suffering.

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