Research Papers and Brain on Fire

Question 1

Environmental Enrichment Ready for Clinical Application in Human Post-stroke Rehabilitation: Some say will not be applicable in humans, due to:

Answer 1

When rats have env enrichment, it is 24 hours, and also has more physical activity

Can’t put 24 hours for a stroke unit, and also participants are much older

Doesn’t make sense to try it in the first place:

Mostly single patient rooms for the fear of infections, costly

Question 2

Explain that rats in standard housing are considered impoverished, and env enrichment Is to bring the impoverished rats at a normal standard.

Answer 2

Patients say unit is unstimulating and boring, not enjoy the environment

Patients accessed are seen as impoverished

Aids with recovery?

Question 3

Differentiate between recovery and compensation.

Answer 3

Recovery: True recovery would require the regrowth of the missing limb

Compensation: the cat has great difficulty in moving around but over a period of months eventually adapts and can be surprisingly agile

Question 4

What are some issues that we need to keep in mind when using laboratory animals as models for understanding the neural basis of rehabilitation? (3)

Answer 4

• humans, have a relatively larger amount of white matter compared to gray matter than smaller-brained mammals that are normally used in laboratory studies
• Animal studies generally have well-defined injuries with far less variance than in human conditions
• rarely include very large injuries because smaller injuries generally show a much better response to therapies than larger injuries.
• Human clinical trials typically choose patients with larger injuries
• common to make unilateral injuries when studying treatments for motor cortex injuries but bilateral injuries when studying cognitive functions
• Bilateral injuries are needed in such studies in rats because unilateral lesions produce only very small deficits
• Humans tend to have unilateral damage

Question 5

What is metaplasticity?

Answer 5

metaplasticity reflects a change in the biochemical, physiological, or morphological state of neurons or synapses that alters their subsequent ability to change state.

Question 6

What is cognitive reserve?

Answer 6

• refers to the differences in cognitive capacity in older people related to a lifetime of intellectual activities

The hypothesis is that cognitive reserves stemming from previous learning experiences play a protective role in coping with neurodegenerative diseases.

Question 7

What is disuse syndrome? What is this an example of?

Answer 7

without rehabilitation after injury to the motor cortex, the area regulating hand movements becomes smaller

• Maladaptive plasticity (use it or lose it)

Question 8

The single most effective post-injury experience in brain-injured laboratory animals is _____________________ _______________________________. List three critical features of this experience:

Answer 8

complex housing

• novel and changing environment, a lot of exercise, and social interaction.

Question 8

What are bFGF, BDNF, EGF, EPO, and FGF-2? What do they stand for? As a group what are they? Why are they important?

Answer 8

• Basic Fibroblast GF
• BDNF (brain-derived neurotrophic factor)
• epidermal growth factor (EGF)
• erythropoietin (EPO)
• Fibroblast Growth Factor-2

Neurotrophic factors
- Chemical compounds that supports growth and differentiation of neurons
- Important for supporting survival of neurons in adulthood

Question 9

Describe another manipulation not already explored in this guide that is described in the article as being another effective experience to promote rehabilitation following brain injury.

Answer 9

Tactile stimulation, promote same things as complex housing

Increase neurotrophic factors

Question 10

letter cancellation test (Dr Bertisch, part 3)

Answer 10

access concentration and memory
- cross out certain words or letters in a normal length newspaper
e.g. cross out all h’s

Question 11

How did Dr. Bertisch access her visual working memory?

Answer 11

presented a picture of a shape for a few seconds and ask to draw from memory

Question 12

How did Dr. Bertisch access her ability to conjure up words from memory?

Answer 12

asked to name as many f, a and s words she could

Question 13

Testing verbal functioning (Dr. Bertisch)

Answer 13

using analogies, capable of complex analytical thinking

Question 14

What does Dr. Bertisch suggest for Susannah?

Answer 14

Individual and group rehabilitation, individual psychotherapy

Question 15

In NMDA encephalitis, the cerebrospinal fluid had…

Answer 15

higher than normal white lymphocytes
- dark spots were inflammatory microglia cells

Question 16

In part 3 Dr. Bertisch said her behaviours resembled:

Answer 16

negative symptoms of schizophrenia:
- inexpressiveness, blankness, lack of feeling, and monotone, and monosyllabic speech

Question 17

Capras delusion

Answer 17

• thinking others around are imposters
• Issue with ventral “what” pathway, no emotional connection
• might emerge from structural and circuitry complications in the brain, such as when the parts of the brain responsible for our interpretations of what we see

Question 18

deja vu

Answer 18

when we feel a strong sense so intimacy and familiarity but not connected to anything we experienced before.

Question 19

ataxia

Answer 19

lack of coordinated movement

Question 20

perseverative dysgraphia

Answer 20

a disorder which a patient draws and redraws lines or letters

Question 21

The clock test

Answer 21

susannah squished the numbers only on the right side

• shows inflammation on right hemisphere, left visual neglect

had numbness of left side of body, parietal lobe also involved in sensation

Question 21

intravenous steroids

Answer 21

form of immunotherapy that suppresses inflammation created by the body’s immune system

Question 22

corticosteroids

Answer 22

subdue the inflammation and quiet the immune system

Question 23

dysarthria

Answer 23

a motor speech impairment caused by a weakness of the muscles of the face, throat or vocal cords

Question 24

phonemic paraphasia

Answer 24

where you substitute one work for another that sounds similar

Question 25

anti-NMDA encephalitis (7)

Answer 25

• multistage disease
• initial flu-like symptoms, psychiatric issues
  -seizures only in 75% patients
• language and memory deficits arise
• rigid body movements
• autonomic symptoms, blood pressure and heart rate that facilitate too high and low

catatonic stage: height of the disease but precede breathing failure, coma and sometimes death.

• 50% instigated by an ovarian tumour (teratoma)

Question 26

psychotic behaviour was often a sign of improvement because

Answer 26

the stages of recovery often occur in reverse order