Thursday, March 19, 2009

A return to the TMS lab




Yesterday Cubby and I returned to the TMS lab at Harvard’s Beth Israel Deaconess Medical Center to commence another round of studies. Those of you who are new to TMS can read some of last year’s posts here:

http://jerobison.blogspot.com/2008/11/summary-of-my-tms-posts.html

This spring, we have two studies going on. One is measuring brain plasticity, comparing people with Asperger’s to nypicals (people who don't have autism.) The other study involves the use of TMS to change cognitive processes – altering the way we think.

Today I’d like to tell you a little bit about the brain plasticity study. I’ll begin with a definition. Brain plasticity is a phrase that describes the brain’s natural ability to form new connections. What does that mean, you ask? Here’s an example from my own life . . . .

A few years ago, I was shoveling snow in my driveway when I felt something tear. By the next morning, pain had set in and I couldn’t lift my right arm anymore. I’d damaged my shoulder. I could still type with my right arm, but I could not make the sweeping motions to move the mouse for my computer.

I was in real trouble. The computer and the mouse were essential to my job, and I suddenly found myself unable to do the work. Luckily I am self-employed and not subject to arbitrary dismissal.

Some people would have seized that opportunity to quit work for a month-long binge, but not me. I resolved to stay at it, and master that mouse. I began training my left arm in mouse management. Within a week I had become proficient enough that I wasn’t really handicapped at the computer anymore.

Now, five years later, my shoulder has healed fully but I remain ambi-mouserous.

That is a perfect example of brain plasticity in action. Over the space of a week, my brain formed the necessary connections to move the mouse smoothly with my left hand. The essential elements were always there, but the paths needed clearing to work smoothly. You might imagine that as the mental equivalent of clearing overgrowth from an old railroad line to make a bike path. Once it was clear I could run it fast and smooth. Before that, I stumbled and hacked.

*
So how does that relate to autism, you ask? After all, anyone can clear brush or get a shoulder injury. Here is the answer:

For several years, neuroscientists have thought that people with autism might have more brain plasticity than nypicals. The tests we did in Alvaro’s TMS lab (http://www.tmslab.org/ ) bear that out, and they do so in a dramatic way. What the testing shows is that people like me DO indeed have more plasticity. We are now unraveling what that means in terms of life skills, advantages, and handicaps.

The evidence suggests that plasticity helps me adapt to something like a shoulder injury much faster than a nypical person. I seem to be able to compensate rapidly for changes in my senses. That could be very significant in some work environments. For example, if I flew helicopters in the Army, I’d be able to switch from visual flying to night vision goggles faster than nypical people. That could be a life-saving benefit.

When it comes to clearing paths in my mind, I’ve got a Caterpillar bulldozer, where nypicals have machetes.

But if I try to do too many things, my greater plasticity can bring me to a halt. I can see that in my son, Cubby. He knows more about certain organic chemistry than his professors, but when he takes four courses he loses it all in disorganization and confusion. That too is a result of his greater plasticity.

Scientists theorize that people who are disabled by autism may live in a state of perpetual confusion because their brains change even faster than mine, so much so that they never find stability.

Here’s another fascinating discovery that’s come from the lab . . . that bulldozer in my mind makes much bigger tracks that the nypical’s machete. That means my “return to normal” is slower than it is for nypicals. That’s the counterpoint to my rapid adaptation. De-adaptation is several times slower.

I’ve seen that in real life, when I switch from driving my boat with “regular eyes” to the night vision goggles. I adapt almost instantly, while other people on the boat are slower to adjust. But then when I take the goggles off, I am the one who’s slower to return to normal. That may well happen because I form stronger and deeper paths, thanks to my greater plasticity.

This may be a tremendously important discovery when it comes to growing up. If we can identify a specific brain difference like plasticity, and we can associate that with advantages and differences in brain function (like the examples I gave) we may be able to shape the learning environment of tomorrow’s kids to achieve far greater life successes.

That’s a great goal to work toward.

Stay tuned for more essays on this, and feel free to paw through my blog archives for older material. If you’d like to do further research, Alvaro Pascual Leone and the other scientists I’m working with can be found at http://www.tmslab.org/ Another blog you may find interesting is Running A Hospital, by Paul Levy, the Chief of Beth Israel Medical Center

http://runningahospital.blogspot.com/

If you'd like to learn more about participating in these groundbreaking studies, I encourage you to write directly to Shirley or Lindsay, two of BIDMC's wonderful scientists:

Lindsay Obermann
Beth Israel Deaconess Medical Center
Harvard Medical School
loberman@bidmc.harvard.edu

Shirley Fecteau
Beth Israel Deaconess Medical Center
Harvard Medical School
sfecteau@bidmc.harvard.edu


Added February 2010 . . .



And this, from Feb 2010 . ..

Here are some of my other TMS autism stories:

Brain Health, Body Wealth TMS

Look Me In The Eye: Brain Plasticity and TMS

Look Me In The Eye: A return to the TMS lab

Look Me In The Eye: Brain Plasticity and how it affects us

Look Me In The Eye: A summary of my TMS posts

10 comments:

cath c said...

fascinating. i can totally see this in action with my son.

Niksmom said...

John, all of your posts on this topic have fascinated me. The way you describe brain plasticity in this post is so clear, thanks. Put in these terms, I can se something akin to this with my five year old. I can't wait to read more about the studies and the promise it may hold for many, many people.

Thomas said...

I saw this and thought it might interest you:
http://www.nytimes.com/2009/03/17/health/17auti.html?_r=2&scp=1&sq=somoli%20autism&st=cse
"An Outbreak of Autism, or a Statistical Fluke?" about what appears to be a cluster of autism among Somali refugee children settled across various regions.

Jan said...

John - great discription of brain plasticity - loved the real life story of your shoulder injury. the recovery and overload side of it is fascinating too. I have seen the overload factor in my own sons with adhd and wonder if there is a relationship. interestingly, Colorado College offers courses in a way that helps people like Jack (Cubby) by offering intense course study one subject at a time in a shorter period of time. I don't know who else does that, but it has been a very successful option for those that benefit.

Keep the posts coming - we all have a lot to learn.

PLANET3RRY said...

ambi-mouserous... Aspergian humor is SO Hilarious! The neurotypical would have used something else, but I bet with the brain plasicity, that you made that word with the "bulldozer".

I had a few thoughts and my own theories about myself and what is now defined as my brain "plasticity".

The Road Less Traveled BECOMES the Road Most Traveled
You mentioned that Autistics (at some threshold) can change to a different interaction with the world faster but then going back is more difficult for the Autistic. My observation is for me, this is a result of a survival instinct that tells me to be ready to go into a heightened state, if needed. However, when there are too many stimuli, this breaks down. The flying of a helicopter, although a complicated series of tasks, I would treat as ONE experience. So going to the NightVision Goggles, is "just part of the territory". The Pilot would be trained to do that. However, coming back out of the Night Vision goggle, I would have to "reset" the entire procedure to put me back into a "normal" mode AND this would be different, because you would be "warm-reseting" during flight NOT walking up to the helicopter.

So, if I am putting on the nightvision goggles on ALOT, then I might just do the WHOLE trip in Night Vision, to avoid having to think about having them on.

It's a derivative of the schedule, flowchart, routine, etc. that dictates our logical minds for stuff to process.

I think that this plasticity is what made soccer so important for me. As most autistics are known for their athletic prowlness, I was introduced to soccer at 8yo. I some how made the connections for when I was on the soccer field. The more I practiced, the better that I could play. It's almost as if I could keep all 22 players and the ball in time-space in my mind, so that I would know what I needed to do, what the ball would do and what would the other players do. And as I became older and more accustom to my abilities, I could expand to more abstract thinking, such as passing the ball into space or being able to kick the ball with accuracy rather than brute force.

And of course, with soccer being a team sport, this helped with social aspects. I could see my teammates as examples on how people interacted with each other.

And so now, I am a marathon runner. I can move my body in space even in a crowd, but if I stop, then I am "returning to normal", so I tend to prefer to stay in traffic.

So, this is very very interesting... and I would imagine that since autism has a spectrum of activators and inhibitors to the brain, I am anxious to see some of the results.

nandsmommy said...

I really like your post. My nypical brain really appreciates your ambimouserousness. I'm so pleased with the direction of the research, and the wonderful goal it is working toward.

Thank you for participating in the study, and that you for writing about it all.

Woof.

Polly Kahl said...

Very interesting, John. Keep up the great work.

Michelle O'Neil said...

The slower "return to normal" rings true for my kid. I can't imagine what it's like being in her body and mind. Those living with autism are the bravest people I know.

Donna Nagy said...

Mr. Robison,

I just finished reading you book, fantastic! My grandson was diagnosed on April 11, 2006, a day that changed our lives forever. Before his diagnosis I did a lot of research and found that my son (my grandsons uncle) could have been the subject for many of the research papers I read. Thank you for giving me hope that at some point in my sons near future he may be willing to seek the help needed for him.

Dr. David Webb, PhD said...

Pretty amazing stuff.