Thursday, 19 January 2012

Brain training. Light up the parts that memory can't usually reach

Chiaravalloti ND, Wylie G, Leavitt V, Deluca J. Increased cerebral activation after behavioral treatment for memory deficits in MS. J Neurol. 2012 Jan [Epub]

Deficits in new learning and memory are common in persons with multiple sclerosis (MS), though few studies have examined the efficacy of memory retraining in MS. Previous research from our laboratory has demonstrated that the modified Story Memory Technique (mSMT. A non-medical, behavioral memory therapy) significantly improves new learning and memory in MS.

The present double-blind, placebo-controlled, randomized clinical trial was designed to examine changes in cerebral activation following Story memory technique treatment. Sixteen individuals with clinically definite MS were randomly assigned to treatment (n = 8) or placebo-control (n = 8) groups, matched for age, education, and disease characteristics. Baseline and follow-up fMRI (functional MRI) was collected during performance of learning and memory tasks.

No baseline activation differences on fMRI (functional magnetic resonance imaging) were seen between groups. After treatment, greater activation was evident in the treatment group during performance of a memory task within a widespread cortical network involving frontal, parietal, precuneus, and parahippocampal regions.

All participants in the treatment group showed increased activation in frontal and temporal regions in particular. In contrast, the control group showed no significant changes in cerebral activation at follow-up. A significant association was found between increased activation in the right middle frontal gyrus and improved memory performance post-treatment.

The increased activation seen likely to reflect increased use of strategies taught during treatment when learning new information. This study is the first to demonstrate a significant change in cerebral activation resulting from a behavioral memory intervention in an MS sample. Behavioral interventions can show significant changes in the brain, validating clinical utility.

Brain training. Can you make a story to remember these images. Will test next week.

It has been reported previously that brain training for learning things can have positive benefit in memory tasks. The LINK METHOD of learning is a method whereby you may make simple associations between items in a list, linking them with a vivid image containing the items. Taking the first image, create a connection between it and the next item (perhaps in your mind smashing them together, putting one on top of the other, or suchlike.) Then move on through the list linking each item with the next. The STORY METHOD is very similar, linking items together with a memorable story featuring them. The flow of the story and the strength of the images give you the cues for retrieval. This type of brain training was used in this study.

If you think your braining training is doing so good, you might like to see evidence that this is doing something in the brain, in support of the idea. Using functional magnetic resonance, which is imaging that detects a radioactive oxygen dye. When your brain is active it needs energy and uses oxygen in this this process. So the dye accumulates where the brain is active. This can be seen by the scanner.

The report showed that people who have used the Story Method technique were using additional bits of their brain in memory tasks. Probably it is providing some form of plasticity of the nerve circuitary that is facilitating memory formation.

This study demonstrates that behavioral interventions can have a positive effect on brain function in people with cognitive disability caused by MS. This is an important step in validating the clinical utility of cognitive rehabilitation.

15 comments:

  1. Story and Link Methods are common memory training techniques that you will see in both commercial and textbooks on the subject. The extension to MS persons' is a step in the right direction to suggest non-invasive method to improve cognitive deficits.

    To the Mousedoctor - with respect, methinks you do the humble blueberry an injustice. Alas, for MS patients all that a neurologist can currently offer as a 'top of the line' or should that be 'end of the line drug' is natalizumab - and how do you have that frank conversation about PML, death and the risk profile? 181 cases and 38 deaths according to your post of 30 November 2011. Other than aggressive cases I cannot understand why this drug is being offered as first line therapy??

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  2. Re: "181 cases and 38 deaths according to your post of 30 November 2011. Other than aggressive cases I cannot understand why this drug is being offered as first line therapy?"

    If you are JCV negative the risk of PML is less than 1 in 10,000. MS is a bad disease; some MS'ers are more than willing to take the risk of PML to control their MS.

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  3. Up until 4/1/2012, 201 total cases of PML and 42 deaths.
    Maybe Tysabri should not be given to JC positive patients anymore. Who can do something towards this direction?

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  4. Re: "Maybe Tysabri should not be given to JC positive patients anymore. Who can do something towards this direction?"

    You can't stop MS'ers choosing to go onto natalizumab if they are JCV seropositive; if they have active disease the risk may be worth it. In addition, the risk really only increases after year 1, and in particular year 2. So MS'ers go onto it hoping that there will be something else they can switch to once they enter the high risk phase.

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  5. "methinks you do the humble blueberry an injustice"

    Not at all.....one of my fave 5 a day especially when it is borovnicevec....Govorite Slovensko?

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  6. Is anybody working on ways to stop JCV negative people from turning positive? eg by means of a vaccine

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  7. Re: "Is anybody working on ways to stop JCV negative people from turning positive? eg by means of a vaccine."

    Not that I am aware of; I suspect the market is uncertain for big pharma to take a punt and the infection to rare for government to get involved.

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  8. Brain Retrainer said...
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  9. The guy in the brain training image to the far right is called Moqtada Sadr.

    He is founder of the Lebanese para-military terror group Hizbollah (Google him).

    So here is my attempt for a storyline :)

    Moqtada Sadr was heaving Fish for dinner when he read in the Newspaper that Jimmy Carter (White man's Caricature) had plans with the Saudis (Bearded guy to the left) so Sadr had an Idea (Light Bulb) to raise Cash (Coins) and create a para-military movement.

    How can you not remember that?

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    1. The answer is even more bizarre than that! It certainly illuminated how the good MD's mind works! I'll have to ask him again what the answer is.

      BTW excuse the pedantry but Moqtada Al Sadr is the head of the Iraqi Mehdi militia the Hezbollah leader is Hussein Nasrallah.

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    2. PS the guy with the teeth looks like a caricature of Ted Kennedy.

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    3. Indeed - excuse the mind slip (I have MS after all).

      The Hizbullah founder is called Moussa al-Sadr

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  10. Nice one Tony, not my story..but I remember mine a year on..I bet with yours you will too. Mine is more crytic:-). However through pictorial associations you can remember things which is the point of the story.

    However by mentioning that name, the blog is no doubt now being monitored by the CIA and MI6, indeed the hit rate for the day went up by 1,000.

    I have enlighted MD2, who is sworn to secrecy

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    Replies
    1. Be sure you hide my IP address too :)
      Must be covered by the blogspot privacy agreement

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    2. Secrecy is my watchword! No doubt we'll be hearing from Theresa May ;-)

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