Chapter 20

It’s Not Just About Growing Older. Of Course.
Many other things can befall us that can contribute to our neurological struggles

  1. For a first-person account of autism (there are several wonderful books) see Temple Grandin’s (1995) Thinking in Pictures …. and Other Reports from My Life with Autism. Vintage, New York. lists more than 9,000 books about autism. Dr. Grandin very generously came to our laboratory to allow us to repeat several studies that had been conducted to evaluate aspects of her neurological capabilities at the University of Kansas several decades ago. Her abilities had substantially improved, helped no doubt by her very active professional life. Just because you’re autistic does NOT mean that your brain is not plastic!Two other very interesting severely autistic individuals with books written by or about them were also studied extensively by the scientists on my research team. Tito Mukhopadhyay wrote a fascinating first-person book called The Mind Tree which beautifully illustrates some of the main operational differences between his rather astounding autistic brain, and yours; Dov Shestack’s mother Portia Iversen wrote a book about his autism (Strange Son), and about her families almost unbelievable efforts to help him have a better and more fulfilling life.You might be interested to know that Temple Grandin’s doctoral thesis was all about brain plasticity. Working with one of the world’s leading brain plasticity scientists at the University of Illinois, she showed that if pigs were housed in plastic boxes (a common strategy for rearing them) they develop powerful snouts because of their insatiable desire to root—which is tough when all you have to root into is a very hard plastic shell. The resulting changes in their brains (they had highly over-developed motor and sensory cortices that exaggerated the representations of their snout and its movements) were very easily recorded in their plastically-altered brains.For a more scientific treatment of autism, you might begin with a book by the Harvard neurologist Martha Herbert (written with K Weintraub) (2012) The Autism Revolution: Whole-Body Strategies for Making Life All It Can Be. Ballantine, New York; or Schreibman L (2007) The Science and Fiction of Autism. Harvard Press, Cambridge.
  2. About one in five Americans incur one or more “mild” or “moderate” TBI’s in the course of their lifetimes. See More than 30% of soldiers in Iraq or Afghanistan have incurred a TBI; about 80% have been exposed to at least one IED, or to an equivalent blast force.TBI’s induce immediate, widely distributed damage to axonal connections in the brain in both white matter and cortical gray matter (e.g., see Browne KD et al, 2011, Mild traumatic brain injury and diffuse axonal injury. J Neurotrauma 18:1747; Wang HC, 2010, Experimental models of traumatic axonal injury. J Clin Neurosci 17:157;Warner MA et al, 2010, Assessing spatial relationships between axonal integrity, regional brain volumes, and neuropsychological outcomes after traumatic axonal injury. J Neuro Trauma 27:2121). Animal models have shown that the concussive shock commonly breaks stiff structural elements in axons (microtubules), which provide channels for conveying crucial building blocks and neurotransmitters to brain synapses (e.g., Tang-Schomer et al, 2012, Partial interruption of axonal transport due to microtubule breakage accounts for the formation of period varicosities after traumatic axonal injury. Exp Neurol 233:364.) Of course all kinds of other secondary consequences of this moment of wide-spread trauma arise later in the brain.The description of the IED explosion-exposed brain looking like a hurricane had passed through comes from beautiful first-hand descriptions and images of the sequelae in microanatomy in the cortex, shown to me by an Iowa State University scientist, Diana Peterson.
  3. For an introduction to the problems in cognitive abilities attributable to a treated HIV infection, see, for example, Valcour VG et al (2004) Cognitive impairment in older HIV-1-seropositive individuals: prevalence and potential mechanisms. AIDS 18:S79.
  4. For a general description about cognitive problems that plague schizophrenic patients, see, e.g., Elvevag B, Goldberg TE (2000) Cognitive impairment in schizophrenia is the core of the disorder. Crit Rev Neurobiol 14:1; Keefe RS, Harvey PD (2012) Cognitive impairment in schizophrenia. Handb Exp Parmacol 213:11.
  5. For an entry into the strange world of hemispatial neglect syndrome, see Parton A et al (2004) Hemispatial neglect. J Neurol Neurosurg Psychiatry 75:13; or Degutis JM, Van Vleet TM (2010) Tonic and phasic alertness training: a novel behavioral therapy to improve spatial and non-spatial attention in patients with hemispatial neglect. Front Hum Neurosci doe:pii: 60. 10.3389/fnhum.2010.00060. Every Neurology textbook describes the wonderfully curious folk that lose not just half their visual field, but also, half of their body image—denying, for example, that that leg that we see so clearly attached to them is not theirs. Others, with brain tumors, can grow EXTRA body parts (e.g., are certain that they have two left legs). I was tempted to provide the obvious explanations for these phenomena, but resisted, to save the requisite page or two or three. If you enjoy this kind of strange-but-true story and have not yet read it, see Oliver Sacks’ still very fun (1986) The Man Who Mistook His Wife For A Hat And Other Clinical Tales.
  6. All of these patients benefited from intensive use of the brain training programs mounted at Schizophrenia, hemispatial neglect (stroke) and autistic patients were participating in clinician-supervised (prescribed) training; others found their way to our programs, in an environment in which we could also objectively document training benefits. All five patient conditions described here are the subject of important ongoing training outcomes trials being conducted by scientists in the university research community supported by our Brain Plasticity Institute or Posit Science research teams. Updates on those trial outcomes shall be posted at and at