I asked Dr. Steven Schlozman — assistant professor of psychiatry at Harvard Medical School, staff child psychiatrist at Massachusetts General Hospital, and author of “The Zombie Autopsies” — to explain such skepticism and describe how he’d propose spending $100 million on the brain.

By Dr. Steven Schlozman
Guest contributor

I’m actually giddy about the President’s proposal. Remember, I’m writing here as a clinician and an educator. I have not been battered by the false promises of the past in this particular arena. To fully appreciate my optimism, do this:

Imagine that you are an anatomy student in the dark days of the 12th century. You look out your window at the primitive road that passes your quarters. The plowed fields in the distance help to distract you from the vexing mystery that sits now on your desk.

There, on your wooden dissecting table, sits a recently removed human brain.

What a mess.

You see, you’ve figured out the heart. You’ve held it and squeezed it and using nothing but observational perseverance, you’ve gleaned that it is intended to pump blood, and that the blood only goes in one direction. You know an awful lot about this organ.

You’ve done okay with other organs as well. You’ve blown air into cadaverous lungs and you’ve measured the extent to which human bladders are wonderfully impermeable. You are, in fact, pretty comfortable that our lungs move air and that our bladders hold liquid.

But what about that brain? You’ve picked it up, squeezed it, turned it over and over in your hands and you’ve tried to understand just what in God’s name this organ could possibly do. There are great big blood-carrying arteries that feed the brain, as well as great big blood-carrying veins that empty it. Perhaps the brain is for cooling the blood?

That’s the best you can do with the tools you have, so you reluctantly write it all down in your journal. (That’s what folks thought for a long time about the brain.) Still, you think, whenever a man is struck in the head, he behaves differently; he seems possessed, alienated from his true self. You just can’t figure out how that mass of gray goo sitting on your dissecting table can account for something as profound as the changing self.

And this is where neuroscience sat for hundreds of years.

Think about this: We physicians really don’t truly understand brain circuitry and yet we alter it in our patients every day. We doctors can’t even begin in any meaningful or understandable way to explain the synergistic, iterative and downright miraculous way that our brains use all of that mysterious circuitry to draw complex conclusions or to make kick-ass music or to write a half-decent sonnet.  We don’t, in other words, have an acceptable grasp of the science that goes into being human.

This isn’t our fault; some of these mysteries just couldn’t be solved until very recently.

It seems to me immensely important that if we want to make reasonable sense of ourselves, we must in turn excite our very culture about how best to understand this story. And this story is in the brain. It is particularly ironic that we fail to understand how little we know about the very organ that helps us to know anything in the first place.

Just as the nascent years of NASA were intended to tap the inherent optimism of public interest in the mysterious, the recent announcement of a newly invigorated effort to make sense of the brain has itself served to ignite a real-time discourse that will without question yield downstream projects.

As a clinician, I’d want this project to consider the enormous burden of psychiatric illness. As a child psychiatrist, I am especially interested in converting whatever is gleaned from these new endeavors into a more proactive stance towards the neuropsychiatric suffering of children and adolescents.

Wouldn’t it be marvelous, for example, if we could develop a truly neurobiological assessment of the possibility for the development of psychiatric disease? We could change the environment for the child at risk and create instead a world that would confer resilience. We could use the very brain plasticity that we’ve only just learned about to set a child’s neural pathways towards a healthier course. The future of health care has got to be at least as proactive as reactive. As of now, we lack the tools to make these predictions with the degree of accuracy that I’d hope more attention to brain science will afford.

While we’re at it, wouldn’t it be great to know more about the exquisite balance between emotion and cognition? How do we make decisions? Clearly, both thoughts and feelings matter. “Only connect the prose and the passion,” wrote Forster, “and both will be exalted.” Would it be possible for us to quantifiably understand how much emotion makes for careful thought? Could that help us to understand not only our interpersonal conflicts but also our international battles? Political scientists have taught us about the dangers of “hot cognitions” for years, but do we really know how hot is too hot?

And finally, what are we doing to our brains as we indulge in ever-expanding technological interaction? Do the neural pathways of our children look different? Is this a good thing, a bad thing, or just a new thing? We don’t know the answers to these very important enquiries, and yet we are raising our children in the most profoundly changed technological world since the advent of the automobile. We had better get a molecular grasp of how the grown-up mind of a digital native will function.

At the end of the day, these goals, and many more, will require a cooperative effort among folks who have until recently kept separate journals and separate lives. Neuroscientists, geneticists, engineers, primary care physicians, cell biologists, pathologists, biochemists, neurologists, neurosurgeons, psychiatrists, teachers, artists, computer scientists, policemen, politicians – and you and me. We all gotta start talking. This dialogue itself is well worth the endeavor.

But that is what’s happening: investment in new psychiatric treatments is on the decline, reports Dr. Steven Hyman, former head of the National Institute of Mental Health and now director of the Stanley Center for Psychiatric Research at the Broad Institute. And that decline has hit even though psychiatric drugs have been highly profitable and one in five American adults now takes at least one, he says.

Hyman writes in the latest issue of Cerebrum, the Dana Foundation magazine:

During the past three years the global pharmaceutical industry has significantly decreased its investment in new treatments for depression, bipolar disorder, schizophrenia, and other psychiatric disorders. Some large companies, such as GlaxoSmithKline, have closed their psychiatric laboratories entirely. Others, such as Pfizer, have markedly decreased the size of their research programs. Yet others, such as AstraZeneca, have brought their internal research to a close and are experimenting with external collaborations on a smaller scale.

What’s going on? Read the full article here — a well-written history of attempted progress despite the lack of fundamental understanding of how mental illnesses actually work. And — in keeping with this week’s widespread talk of the new federal brain mapping initiative — Hyman remains optimistic that new scientific advances will bear fruit. He writes:

Our best hope is that the genetics will unfold over the next several years, due to the efforts of large international consortia that have formed to recruit and to study patients. As genetic clues accumulate, scientists are devising new ways to investigate their neurobiological functions and dysfunctions. One interesting development is to use stem cell technologies to complement the use of laboratory animals with human neurons engineered from skin cells of healthy subjects and from patients. The leading approach is to take a small skin biopsy from the arms of volunteers and to transform skin fibroblasts into neural progenitors and into neurons. Genetic engineering can then be used to add risk-causing mutations to “healthy” neurons and to reverse risk mutations in patients’ neurons. But it is still early in this new field, and it is not yet possible to engineer the specific kinds of neurons implicated in schizophrenia by postmortem studies.

This barrier is likely to fall soon. Whether or not engineered neurons or human neural circuits on a chip prove to be good systems for studying gene function, researchers will make substantial efforts to turn genetic clues into ideas for therapeutics. Many researchers hope that such efforts will help attract the pharmaceutical industry back to psychiatry by demonstrating new paths to treatment development. The emerging genetic results may be the best clues we have ever had to the etiology of psychiatric disorders.

Readers? Do you share his optimism?

Health columnist Judy Foreman wrote:

The recent work by [University of Western Ontario researcher Adrian] Owen, and others, using fMRI brain scanning technology shows that some patients diagnosed as being in a persistent vegetative state may actually have some degree of consciousness and be able to communicate, that is, by sheer thinking, be capable of answering comparatively simple questions such as “are you in pain?”

Owen’s work found signs of consciousness in a seemingly vegetative patient, Scott Routley:

Essentially, Owen trained Routley to answer questions through a kind of game. When he asked Routley to imagine himself playing tennis, a particular part of his brain, the premotor cortex, lit up on the fMRI brain scans “with a very big signal.” (The premotor cortex sends signals to the motor cortex, which actually signals muscles to move.) Routley learned that imagining to play tennis, thus lighting up this part of his brain, meant “yes.”

Now, the plot thickens: New York-based researchers are calling some of Owen’s findings into question — not those MRI scans, but “bedside” brain-wave checks using EEG readings. The Neuroskeptic blog reports on the back-and-forth here beneath the pithy headline “Another Scuffle In The Coma Ward.” It posts an example of the brain-wave data in dispute and explains:

This image shows that in a healthy control, EEG activity was “clean” and generally normal. However in the coma patient, the data’s a mess. It’s dominated by large slow delta waves – in healthy people, you only see those during deep sleep – and there’s also a lot of muscle artefacts which can be seen as ‘thickening’ of the lines.

These don’t come from the brain at all, they’re just muscle twitches. Crucially, the location and power of these twitches varied over time (as muscle spikes often do).

This wouldn’t necessarily be a problem, the critics say, except that the statistics used by Owen et al didn’t control for slow variations over time i.e. of correlations between consecutive trials (non-independence). If you do take account of these, there’s no statistically significant evidence that you can distinguish the EEG associated with ‘hand’ vs ‘toe’ in any patients.

From the challengers’ Jan. 24 press release:

A team of researchers led by Weill Cornell Medical College is calling into question the published statistics, methods and findings of a highly publicized research study that claimed bedside electroencephalography (EEG) identified evidence of awareness in three patients diagnosed to be in a vegetative state.

The new reanalysis study led by Weill Cornell neurologists Drs. Andrew Goldfine, Jonathan Victor, and Nicholas Schiff, published in the Jan. 26 issue of the journal Lancet, reports the statistical results and methodology used by a research team led by University of Western Ontario scientists and published online Nov. 9, 2011, also in the Lancet, was flawed in a number of crucial ways. Due to these errors, the reanalysis concludes it is impossible to determine whether or not these vegetative state study subjects demonstrated any degree of awareness during the testing.

The University of Western Ontario researchers in the original study set out to use bedside EEG technology to identify any changes in brain activity in vegetative patients and also healthy subjects as controls. During the study, each subject was asked to either imagine moving their hand or foot each time they heard an electronic beep. The brain activity following hand or foot commands was recorded using EEG and then compared in the study. The published study claimed that three of the 16 tested vegetative patients successfully performed the task, along with 9 of the 12 healthy controls. The reanalysis of this study is important, the Weill Cornell researchers say, because if the method was indeed valid, it would mark an important breakthrough in the field — the first evidence using a bedside testing method that patients reported to be in a vegetative state could perform high-level cognitive tasks.

“Sadly, our reanalysis of the research team’s original data shows these particular methods do not work, and it is important that scientists, physicians, and most importantly, the families of severely brain injured patients understand that the conclusions reached in the original study were most likely due to chance findings,” says the corresponding author of the reanalysis, Dr. Schiff, the Jerold B. Katz Professor of Neurology and Neuroscience, professor of neuroscience in the Feil Family Brain and Mind Research Institute and professor of public health at Weill Cornell.

“We see the urgency and need every single day for tests that can be used to help establish awareness and consciousness in brain injured patients. However we won’t help patients or their families by using a flawed research method and data that cannot accurately provide the information we are all hoping to find,” says Dr. Schiff, who is also a neurologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

My personal reaction, after seeing many patients in persistent vegetative states when I visited my late mother, who was also in that condition: I always thought the less consciousness these poor patients had, the better.

Not only were they completely unable to respond in any way to the world around them, they also frequently seemed to be in discomfort, their limbs contracting and their breathing labored, despite the best of care. This is surely a scientific dispute that will take some sorting out, but if in fact Owen’s findings were in error, that may actually be a good thing for patients and comforting to their families.

From the press release:

Stroke the soft body of a newborn fruit fly larva ever-so-gently with a freshly plucked eyelash, and it will respond to the tickle by altering its movement — an observation that has helped scientists at the University of California, San Francisco (UCSF) uncover the molecular basis of gentle touch, one of the most fundamental but least well understood of our senses.

Our ability to sense gentle touch is known to develop early and to remain ever-present in our lives, from the first loving caresses our mothers lavish on us as newborns to the fading tingle we feel as our lives slip away. But until now, scientists have not known exactly how humans and other organisms perceive such sensations.

In an article published online this week in the journal Nature, the UCSF team has identified the exact subset of nerve cells responsible for communicating gentle touch to the brains of Drosophila larvae— — alled class III neurons. They also uncovered a particular protein called NOMPC, which is found abundantly at the spiky ends of the nerves and appears to be critical for sensing gentle touch in flies.

Without this key molecule, the team discovered, flies are insensitive to any amount of eyelash stroking, and if NOMPC is inserted into neurons that cannot sense gentle touch, those neurons gain the ability to do so.

And a bit more fascinating background:

Though it is fundamental to our experience of the world, our sense of gentle touch has been the least well understood of our senses scientifically, because, unlike with vision or taste, scientists have not known the identity of the molecules that mediate it.

Scientists generally feel that, like those other senses, the sense of touch is governed by peripheral nerve fibers stretching from the spine to nerve endings all over the body. Special molecules in these nerve endings detect the mechanical movement of the skin surrounding them when it is touched, and they respond by opening and allowing ions to rush in. The nerve cell registers this response, and if the signal is strong enough, it will fire, signaling the gentle touch to the brain.

What has been missing from the picture, however, are the details of this process. The new finding is a milestone in that it defines the exact nerves and uncovers the identity of the NOMPC channel, one of the major molecular players involved—at least in flies.

The full article in Nature is here. And of course the question that arises: Once we fully understand the biology of the sensation of gentle touch, can we reproduce it artificially? Will we someday pop “gentle touch” capsules on sad, lonely, stressful days?

One of the most vexing emotional and ethical issues in all of medicine is the decision by family members to “pull the plug,” that is, to take a severely ill, non-communicate relative off of the life-support systems keeping him or her alive.

What makes this decision so hard, of course, is, absent a really clear statement ahead of time from the patient about end-of-life wishes, family members basically have to guess. But there may be – not yet, but someday – a way to make this agonizing guesswork a bit easier, thanks to a stunning series of recent experiments by Adrian Owen, who holds the prestigious Canada Excellence Research Chair in cognitive neuroscience and neuroimaging at the University of Western Ontario.

The recent work by Owen, and others, using fMRI brain scanning technology shows that some patients diagnosed as being in a persistent vegetative state may actually have some degree of consciousness and be able to communicate, that is, by sheer thinking, be capable of answering comparatively simple questions such as “are you in pain?” (Obviously, that’s a much simpler question than “do you want to die?”)

The particular patient generating the latest excitement is 39-year old Scott Routley who, 12 years ago, had a car accident that left him with a severe brain injury. By standard tests, doctors thought he was in a persistent vegetative state, or PVS.

A quick primer here. There are various degrees of consciousness. In a coma, a patient looks asleep – the eyes are closed, the person doesn’t move and tests with an EEG (electroencephalograph) look much like the brain of someone under general anesthesia.
A persistent vegetative state is different. The patient’s eyes are open, he or she has regular sleeping and waking cycles and may actually look around, not really “at” anything, but with a so-called “roving gaze.” The person may even have REM, or dream, sleep stages. PVS is so confusing to onlookers – and doctors – that if a group of people watched a video of such a patient, half would say the patient was conscious and half would not. While a coma may last only briefly – as when someone gets whacked with a baseball bat – a vegetative state can last for years. If someone does recover from the vegetative state, at best he or she will be severely disabled.

In between PVS and severe disability is the so-called minimally conscious state (MCS). If you ask minimally conscious people to move a hand or look somewhere specific, they do so often enough that it’s clear they are responsive, while a PVS patient can never do that. (All these states, by the way, are different from “locked-in syndrome,” in which a person is fully conscious and cognitively intact but is unable to move except, in some cases, to blink their eyes to communicate.)

After his accident, Scott Routley couldn’t communicate and the usual tests showed no signs of awareness. Owen, who told me he has believed for 15 years that some PVS patients like Routley are “actually conscious but can’t show it.” Owen is now convinced that Routley is “definitely not” in a persistent vegetative state. (He has also documented Routley’s responsiveness with an EEG, a simpler technology than fMRI.)

Essentially, Owen trained Routley to answer questions through a kind of game. When he asked Routley to imagine himself playing tennis, a particular part of his brain, the premotor cortex, lit up on the fMRI brain scans “with a very big signal.” (The premotor cortex sends signals to the motor cortex, which actually signals muscles to move.) Routley learned that imagining to play tennis, thus lighting up this part of his brain, meant “yes.”

Owen then trained Routley to imagine himself walking through a familiar house from room to room. When Routley did this, a totally different part of his brain lit up, the parahippocampal gyrus, which helps people navigate through space. Routley learned that imagining this activity meant “no.” In a series of sessions, Routley was able to correctly answer questions like “Is the sky blue?” “Are bananas yellow?” convincing Owen that Routley could communicate “yes” and “no.” He then asked Routley if he was in pain, and Routley answered “no.” Routley was also able to show that he knew he was in a hospital, that he knew the year of his accident and knew what the current year was. “This guy is conscious, he just clinically appears vegetative,” Owen told me.

I think this is fabulous. And scary. It would be wonderful to know what an uncommunicative relative really wants. And terrible to depend too much on technology that, like the humans who invent it, might be wrong. And so far, none of this means that doctors should perform fMRIs on everyone with severe brain injuries, says Robert Truog, a professor of medical ethics, anesthesia and pediatrics at Harvard Medical School. But it could provide a way, Truog says, to ask some severely brain-damaged patients whether they value their life as it is “before we would make a decision to give comfort measures only.” I agree we should proceed, but with caution. More importantly, so does Owen. “I don’t think we should ask someone if he wants to live because we can’t do anything about it – there is no legal framework that supports euthanasia,” he said. But that legal framework may already be in the works.

But before he could say more, he had to get off the phone: The lawyers were calling.

Judy Foreman, a health reporter in Boston, just completed a book about chronic pain: “A Nation in Pain: Healing Our Biggest Health Problem.”

Just ask Jason Crigler, musician, father and survivor of a massive brain hemorrhage from which doctors said recovery would be unlikely.

In August 2004, Crigler, a much-sought-after New York City guitarist with a two-months pregnant wife, was playing onstage at a Manhattan nightclub when, suddenly, he had a brain hemorrhage. He threw off his guitar and jumped down from the stage. He was rushed by ambulance to St. Vincent’s Hospital where his family was told the bleeding was severe.

A neurosurgeon offered this grim prognosis: even if Jason lived though the night (and the chances of that were slim) he’d likely have little brain function left and the old, pre-injury Jason would probably never return. (The cause of the hemorrhage, the family would later learn, was an arteriovenous malformation, or AVM — an abnormal collection of blood vessels in his brain that burst.) “The doctor said he wouldn’t be the Jason we knew and loved,” Jason’s sister, Marjorie said this week, speaking to an auditorium full of brain science students and faculty at MIT. “Most of his doctors didn’t think this recovery was possible.”

At the time, Jason was 34 years old.

But Jason, a Manhattan kid who picked up the guitar at 16, proved the doctors wrong. Today, he’s back playing music, taking his daughter to school and speaking publicly about his medical odyssey. He credits three essential forces with pulling him back to life: his music, fatherhood and his family’s unyielding, persistent faith in his recovery. (I would also add a fourth factor: extremely good luck when it came to health insurance and the ability to move to Massachusetts for care. As one of Jason’s doctors put it: “If you’re going to have a brain injury, this is the state to do it in.”)

Indeed, from the very beginning, Crigler’s wife, parents, in-laws and sister (who kept a journal of the saga) refused to accept the bleak portrait doctors painted. Though at the beginning things did seem bad. “It is so disturbing to see my brother curled in a human knot,” Marjorie wrote shortly after his injury.

There were a barrage of medical complications both major and minor — infections, meningitis, seizures, recurring urinary tract problems, his skin flaking off in patches due to the long hospitalizations. For some time he lay in a coma (a tube draining fluid from his brain disconnected accidentally, exposing his brain to the air for two minutes.)

But despite these setbacks, family and friends stayed by his side, constantly managing the kind of small, tedious daily tasks that helped Jason — haltingly, painfully, over years — gain his autonomy back. When he was unable to talk or move, the Crigler clan played music for him, they read him the newspaper, made jokes and sat around his hospital bed cracking each other up.

The family would visualize Jason healthy and walking and playing the guitar and encouraged him to do the same. They told him they loved him over and over again. “Most importantly, we had an open mind,” Marjorie said.

About four months after the brain injury, Jason told me he reached the maximum $1 million cap on his New York health insurance. So his wife, Monica began searching for rehab centers that would both accept Jason and be affordable. She called Spaulding Rehabilitation Center in Boston and after hearing Jason’s case, an administrator agreed to admit him with Medicaid pending.

So the family moved to Cambridge in February 2005 and Jason entered Spaulding in a vegetative state. He spent six months there as an inpatient. His progress was slow — videos show him struggling to pick up colored bean bags and essentially unresponsive to questions. Monica said that period was so stressful, she was sure she would lose her baby.

Psychologist Chris Carter, director of continuity for brain injury and spinal cord services at the Spaulding Rehabilitation Network worked with Jason and his family during that time. He said Jason’s “level of injury was pretty severe and traumatic…his level of consciousness was impaired and he had limited recall.”

Carter was one of the doctors who didn’t believe Jason would fully recover. “I think the general consensus was we didn’t think he’d get much past [the point where] he needed someone home with him all the time. The idea that he’s getting around and writing music and all the things he does, we didn’t think it was a remote possibility.”

While the brain has a remarkable capacity for plasticity and resilience, Carter said, “it doesn’t happen in a vaccuum. It requires a stimulating environment that challenges the brain and teaches it new things — you’re forming new connections in new parts of the brain. It also requires lots of repetition, over and over and over again, that’s how those new connections get formed — the more these cells fire together, they begin to wire together.”

Carter added that Jason is “an important lesson: be careful about predicting the future.”

After Spaulding, against the advice of doctors who thought Jason should move to a skilled nursing facility because he was unable to function on his own, the family decided to bring Jason home and provide around-the-clock care. He couldn’t eat or bath alone and he often would shake violently through the night. But the family persevered: There were massage therapists and little notes and reminders plastered all around the house and outings to experience the world again. They tried to rebuild familiar connections to jump-start his memory. Marjorie said: “We were able to create an environment, a mindset which said, ‘Jason can recover, Jason is an adult, What is Jason’s point of view?’ We helped him to keep his autonomy even though he didn’t really have it – we were able to give Jason a very positive cocoon.”

It didn’t immediately work: during a short vacation to New Hampshire, Jason was asked on video what his favorite activity had been. “Breakfast,” he said blankly. He explained that because he was eating breakfast when the question was asked and because he remembered nothing of the previous day’s activities, that was the only answer he could come up with.

(Actually, Jason still has about a year-and-a-half gap in his memory. He recalls getting into the ambulance after the initial brain bleed, but then remembers nothing — not the birth of his daughter, his early rehab, nothing — until the following Christmas, about 18 months later, he says.)

But at home, Jason truly woke up. A key reason was his daughter, Ellie, born in March 2005.

“It suddenly sunk in that I’d missed my daughter being born,” Jason said. This realization made him depressed. But the depression itself marked a turning point, since up until this time he hadn’t felt much of anything. The depression, he recalls, “was a trigger to next phase of recovery. It was something that shot through me.” He added: “When I finally made that connection, when Ellie was about a year old, I realized, ‘I am her father’ and I became even more motivated to be a father who could be with her.”

And over time, different facets of Jason’s emotional and physical past — including the reality of what had happened and what he’d lost — began to come into clearer focus. His consciousness started to reawaken.

Still, doctors continued issuing a stream of negative predictions: One said Jason would always have double vision; another said one hand would never be good for anything; another said, “the recovery will hit a plateau.”

But Marjorie said these comments forced some wholesale rethinking.

“What if progress is the plateau?” she said. “What if the plateau is that he’s always making little inklings of progress?”

The way to do that was to keep Jason’s mind engaged in the things that mattered. The family played music for him, for instance, but not just anything on the FM dial as background noise. They played music that personally resonated with Jason: Classical Indian music, American blues, records he’d played on.

Music, in many ways, laid the foundation for recovery.

“It was a huge motivator,” said Jason, who had achieved some degree of fame before the injury, having performed with Norah Jones, Marshall Crenshaw, John Cale. “It had been my profession, the thing I loved to do. I was hell bent to get it back.” (Even when he first began to play again and his hands were clenched clawlike in utter pain after 10 minutes.) “I was determined to not have that taken away from me.”

That discipline and work ethic, the playing and replaying, helped Jason’s brain to rebuild, he said. “Having that motivation, something that you want to get back to, something you want, it’s a huge thing in terms of the body’s ability to recover,” he said, adding: “Music had a powerful impact on my memory returning.”

Kay Tye is an assistant professor at MIT’s division of Brain and Cognitive Sciences who learned of Jason after moving into his old house in Cambridge and receiving a copy of a film about his recovery called “Life. Support. Music.” Tye invited Jason to MIT, and after hearing him speak said she believes it was the emotional connection Jason had to music that helped restore his memory. “When you talk about waking up the brain, emotion is the key,” Tye said. “Emotions are key to survival…and things that are emotionally salient are more easily remembered, more easily retrieved.”

Jason’s family provided that constant flow of emotionally salient stimuli, she said, and “the music could have evoked emotions that may have created the pathway for him to begin to do everything else. It was something that kept pulling him back.”

The actual rituals of playing music helped: the metronome, using a kitchen timer for timing practices, restringing and tuning his guitar, learning other people’s music, all of it strengthened the pathways toward remembering. When he finally played his first gig, in lower Manhattan two years after the injury, he and has family agreed: He’d finally come back.

These days Jason and his sister speak about his recovery at hospitals, schools, brain injury conferences and rehab centers. She’s writing a book.

Though it’s certainly true that many people with brain injuries don’t recover in the ways Jason has, the majority of patients with comparable injuries “don’t get the amount of care and support that he did,” says Carter, the Spaulding psychologist. “We would have a higher percentage of patients recovering if his care and support were more the rule than the exception.”

And Jason continues to recover.

“I deal with the injury every day,” Jason said, speaking from his home in Stratham, New Hampshire. “My eyes are not what they were, my hands are not what they were, fatigue is a huge issue. There’s this crushing fatigue that comes on out of nowhere.”

He’s had two eye surgeries and braces to fix teeth that shifted from living with tubes in his mouth for so long.

But he’s functioning, writing music, performing again. Indeed, his very relationship with music has deepened. He told the crowd at MIT: “My experience is so far beyond what it was before my injury; technically there are things I can’t do now which I did before, but it doesn’t matter…things changed and I have this more direct pipeline between my head and my hands.

In the old days I’d be super critical of myself — as an artist, you go through these negative things in your mind. But now, I’m in this blissful beginner’s mind – I can just play what I feel. My injury put me in this mental state of being a beginner in my approach to playing but I also have 20 years of experience, so I can more directly express myself on my instrument.”

Finally, he said, although what happened to him on stage eight years ago was utterly random, it taught him a few things about the world. First, to doctors, he says: “They don’t have to give false hope to people with these kinds of injuries, but they don’t have to shut everything down either.” And to everyone else: “We can’t always control the things that happen to us, but we can control the way we deal with the things that happen.”

The second reason is that it’s the latest cool development to come out of the BrainGate project, which showed that it’s possible to “read out” brain signals in paralyzed people and convert them into actions, previously by moving a computer cursor and now a robotic arm. The journal Nature has just published the robotic-arm results, and posted the video above. Read the full press release from Brown University here. From Brown:

Researchers in the BrainGate collaboration of the Providence Veterans Affairs Medical Center, Brown University and Massachusetts General Hospital describe experiments in which two participants with tetraplegia used the investigational* BrainGate BCI [Brain-Computer Interface] to precisely control robotic arms to reach and grasp for objects in three-dimensional space. They controlled the robots by thinking about moving their own arms and hands. This is the first demonstration of 3D control of robot arms by neural activity of people.

On a particularly poignant day in the research, one of the participants used a robot arm to pick up a bottle of coffee, bring it to her lips and tip it to take a drink through a straw. It was the first time she had served herself anything to drink for nearly 15 years. Her smile after she had taken a sip was especially inspiring because her success indicated that the BrainGate team’s research has moved substantially closer toward the goal of restoring independence for people who have lost functional control of their limbs.

Suggestion: The smile comes at about 3:30 in the video. Don’t miss it.

Did you know that meditating actually changes your brain? So does falling in love. So does playing Tetris, having an ice cream headache and tweeting too much.

It seems that just about every week we encounter another dazzling breakthrough in brain science that promises to reveal the deep relationship between our lives and our brains. My reaction to such flashy headlines is usually: “No duh.” It’s not that I don’t find the capabilities of modern neuroscience astounding, or because I’m not curious about the mysteries of human nature. I just find the conclusion “it’s in our brain” (whatever “it” is) to be, well, obvious.

The brain is our master organ. It is responsible for taking every input we receive and synthesizing this astounding mass of signals to allow us to navigate the world. The brain takes wavelengths of light and allows us to appreciate a Cézanne or a Rothko. It takes an impossible array of social cues and grants us embarrassment and pride. So, how could our most important experiences not show up in the brain? Where else could they be?

A fascinating study published recently in the journal Neuron takes a critical look at the way the media tend to report on neuroscientific findings. The authors determined that media coverage of brain research tends to lead to three exaggerated conclusions:

First, popular reports of neuroscience suggest that the presence of some phenomenon in the brain somehow proves that it is real. The authors call this “the brain as biological proof.” If the results of neuroimaging show us that looking at the faces of people we love reliably lights up certain brain regions, or if traumatic experiences write themselves onto the brain, then those feelings must be real. This trend implies that the many nuanced parts of our daily lives not yet recorded in the brain have not been scientifically validated and may therefore be subjective and false.

Second, media coverage of brain science indicates that brain variation reveals important essential differences between groups of individuals. Coverage of “the autistic brain” or “the gay brain” reinforces inaccurate notions that groups of people share some homogenous trait that makes them fundamentally different from the rest of us.

Third, portrayals of the brain in the press tend to suggest that it is an organ that itself must be optimized in the service of living to our maximum potential. We should give the “Sodoku Workout” a try to keep out brains young and parents should directly cultivate “strong brains” in their children. This trend misplaces emphasis on cultivating a strong brain as the key outcome, rather than as a means to the desired end.

The fact that a three-pound lump of cells in our heads is responsible for every one of our thoughts, feelings and behaviors is one of the great miracles of the universe. But we have misplaced our desire to understand our world with an over-emphasis on looking for answers in the brain. Neuroscience has immense potential to reveal the machinery of our lives, but we currently expect too much of this young science. As a result, we are unfortunately learning to undervalue things that we have always known are real without neuroscientific evidence. Looking at our loved ones feels good. Not all gay people are alike. Parenting means tending to all of our children’s’ needs. Tetris is wickedly addictive.

Jonathan M. Adler is a regular contributor to CommonHealth and an Assistant Professor of Psychology at Franklin W. Olin College of Engineering in Needham, Massachusetts

Calling Neo. It doesn’t matter if you choose the blue pill or the red pill, your brain is the matrix.

Forgive my funning with some very serious findings just out in the journal Science: Your brain’s connections are not a tangled mass of spaghetti. Rather, they criss-cross each other in an orderly grid, “like the warp and weft of fabric,” says Dr. Van Wedeen of Massachusetts General Hospital, the Martinos Center for Biomedical Imaging and Harvard Medical School.

But really, how could I help but think of a matrix — or the cinematic greatness of The Matrix? Another helpful image, from the National Institute of Mental Health’s press release: The street map of Manhattan.

The brain appears to be wired more like the checkerboard streets of New York City than the curvy lanes of Columbia, Md., suggests a new brain imaging study. The most detailed images, to date, reveal a pervasive 3D grid structure with no diagonals, say scientists funded by the National Institutes of Health.

“Far from being just a tangle of wires, the brain’s connections turn out to be more like ribbon cables — folding 2D sheets of parallel neuronal fibers that cross paths at right angles, like the warp and weft of a fabric,” explained Van Wedeen… “This grid structure is continuous and consistent at all scales and across humans and other primate species.”

The discovery of this “astonishingly simple” structure of brain connections brought a ringing assessment from the chief of the National Institute of Mental Health, which helped fund the work: “Getting a high resolution wiring diagram of our brains is a landmark in human neuroanatomy,” said NIMH Director Thomas R. Insel in a press release. “This new technology may reveal individual differences in brain connections that could aid diagnosis and treatment of brain disorders.”

Dr. Wedeen describes his team’s work and its potential implications in the video above. It helps to watch his hand gestures as he says:

“What we discovered is that the fiber architecture of the brain is more or less a simple as you can possibly imagine. Each pathway, rather than being an isolated pathway, is a component in a three-dimensional grid. The pathways in the top of the brain are all organized like woven sheets so that the fibers only run in two directions in the sheet and in a third direction perpendicular to the brain, and these sheets all stack together. So the entire connectivity of the brain follows three precisely defined directions.

Now, these directions are a little bit hard to spot, because in embryological life they’re simple directions but then in the adult brain they get very folded and curled up, and so that surface of the brain that you see, with all its folds, has pulled the wires around with it, and so these three directions have now become greatly curved….

But fundamentally, the geometry of the brain is described by a three-dimensional grid…So as a result of this, we now have a way of seeing the structure of the brain as a single unified whole. It no longer seems like a bunch of uncorrelated or isolated connections. The entire connectome fits together into a single framework which expresses developmental rules, and, we speculate or hypothesize, functional rules as well.”

I asked Dr. Wedeen to explain a bit more about his work. Please stay tuned for excerpts of our conversation. For now, more of the crystalline press release:

Knowledge gained from the study helped shape design specifications for the most powerful brain scanner of its kind, which was installed at MGH’s Martinos Center last fall. The new Connectom diffusion magnetic resonance imaging (MRI) scanner can visualize the networks of crisscrossing fibers – by which different parts of the brain communicate with each other – in 10-fold higher detail than conventional scanners, said Wedeen.

“This one-of-a-kind instrument is bringing into sharper focus an astonishingly simple architecture that makes sense in light of how the brain grows,” [Wedeen] explained. “The wiring of the mature brain appears to mirror three primal pathways established in embryonic development.”

As the brain gets wired up in early development, its connections form along perpendicular pathways, running horizontally, vertically and transversely. This grid structure appears to guide connectivity like lane markers on a highway, which would limit options for growing nerve fibers to change direction during development. If they can turn in just four directions: left, right, up or down, this may enforce a more efficient, orderly way for the fibers to find their proper connections – and for the structure to adapt through evolution, suggest the researchers.

Obtaining detailed images of these pathways in human brain has long eluded researchers, in part, because the human cortex, or outer mantle, develops many folds, nooks and crannies that obscure the structure of its connections. Although studies using chemical tracers in neural tracts of animal brains yielded hints of a grid structure, such invasive techniques could not be used in humans.

Wedeen’s team is part of a Human Connectome Project Harvard/MGH-UCLA consortium that is optimizing MRI technology to more accurately to image the pathways. In diffusion imaging, the scanner detects movement of water inside the fibers to reveal their locations. A high resolution technique called diffusion spectrum imaging (DSI) makes it possible to see the different orientations of multiple fibers that cross at a single location – the key to seeing the grid structure.

In the current study, researchers performed DSI scans on postmortem brains of four types of monkeys – rhesus, owl, marmoset and galago – and in living humans. They saw the same 2D sheet structure containing parallel fibers crossing paths everywhere in all of the brains – even in local path neighborhoods. The grid structure of cortex pathways was continuous with those of lower brain structures, including memory and emotion centers. The more complex human and rhesus brains showed more differentiation between pathways than simpler species.

Among immediate implications, the findings suggest a simplifying framework for understanding the brain’s structure, pathways and connectivity.
…
“Before, we had just driving directions. Now, we have a map showing how all the highways and byways are interconnected,” said Wedeen. “Brain wiring is not like the wiring in your basement, where it just needs to connect the right endpoints. Rather, the grid is the language of the brain and wiring and re-wiring work by modifying it.”

Carolyn Johnson describes the study in The Boston Globe. She writes:

Partha Mitra, a neuroscientist at Cold Spring Harbor Laboratory who was not involved in the research, said the effort to find the wiring diagram of the brain is important, but that the general findings of the paper are not surprising. He said he is interested in seeing a more quantitative description of the grid-like structures and validation of the findings using other techniques besides the imaging technology.

And Ed Yong writes on Discover Magazine’s “Not Exactly Rocket Science” blog:

Opinion is divided on the new study. “It’s really ingenious what they’ve done,” says Tim Behrens from the University of Oxford, who is particularly impressed with the idea that the white matter forms interwoven sheets. “It’s really quite convincing,” he says. “There’s no way that the sheets are there by chance.”

David van Essen from Washington University in St Louis agrees, but he and Behrens both say that Wedeen’s technique is more sensitive at measuring right angles than other angles. They feel that the right-angled connections of the white matter remain to be proven.

Last month we wrote about medical students practicing yoga while learning about a range of related research, including new studies by Chris Streeter, an associate professor of psychiatry at Boston University School of Medicine. Her work suggests that yoga may improve levels of a key neurotransmitter in the brain involved in mood and anxiety.

Well here’s Streeter’s latest article on yoga’s impact on the brain; it suggests that practicing yoga may “help in treating patients with stress-related psychological and medical conditions like depression, anxiety, high blood pressure and cardiac disease.”

Here’s the news release:

An article by researchers from Boston University School of Medicine (BUSM), New York Medical College (NYMC), and the Columbia College of Physicians and Surgeons (CCPS) reviews evidence that yoga may be effective in treating patients with stress-related psychological and medical conditions such as depression, anxiety, high blood pressure and cardiac disease. Their theory, which currently appears online in Medical Hypotheses, could be used to develop specific mind-body practices for the prevention and treatment of these conditions in conjunction with standard treatments.

It is hypothesized that stress causes an imbalance in the autonomic nervous system (parasympathetic under-activity and sympathetic over-activity) as well as under-activity of the inhibitory neurotransmitter, gamma amino-butyric acid (GABA). Low GABA activity occurs in anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. According to the researchers, the hypothesis advanced in this paper could explain why vagal verve stimulation (VNS) works to decrease both seizure frequency and the symptoms of depression.

“Western and Eastern medicine complement one another. Yoga is known to improve stress-related nervous system imbalances,” said Chris Streeter, MD, associate professor of psychiatry at BUSM and Boston Medical Center, who is the study’s lead author. Streeter believes that “This paper provides a theory, based on neurophysiology and neuroanatomy, to understand how yoga helps patients feel better by relieving symptoms in many common disorders.”

An earlier study by BUSM researchers comparing a walking group and a yoga group over a 12-week period found no increase in GABA levels in the walking group, whereas the yoga group showed increased GABA levels and decreased anxiety. In another 12-week BUSM study, patients with chronic low back pain responded to a yoga intervention with increased GABA levels and significant reduction in pain compared to a group receiving standard care alone.

In crafting this neurophysiological theory of how yoga affects the nervous system, Streeter collaborated with Patricia Gerbarg, MD, assistant clinical professor of psychiatry at NYMC, Domenic A. Ciraulo, MD, chairman of psychiatry at BUSM, Robert Saper, MD MPH, associate professor of family medicine at BUSM, and Richard P. Brown, MD, associate clinical professor of psychiatry at CCPS. They are beginning test these theories by incorporating mind-body therapies such as yoga in their clinical studies of a wide range of stress-related medical and psychological conditions.