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Power Up Your Brain

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Power Up Your Brain

The pathway to enlightenment.
David  Perlmutter, M.D. F.A.C.N
David Perlmutter, M.D. F.A.C.N More by this author
Jul 21, 2011 at 10:00 AM

When I was young, I didn’t have the opportunity to spend much time with my father because he maintained a very busy practice in neurosurgery in south Florida. Clearly, he too recognized this shortcoming in our relationship, and one day he came up with a solution: he invited me to the operating room to watch him remove a tumor from the base of a patient’s brain. What a way to spend a Saturday afternoon, especially considering that I was a young teenager at the time!

I soon made these visits to the operating room a regular part of my weekends. In retrospect, I believe my dad even made the effort to schedule surgery on Saturdays so I could join him. And, of course, he taught me the proper procedures to maintain a sterile operating room. These procedures would take many hours, so, to pass the time, my father would explain the specific function of that part of the brain upon which we were operating. “This area,” he would say, for example, “is called Broca’s Area, named for Pierre-Paul Broca, a French fellow who, back in 1861, determined that this area controlled speech.” Over time, he described the entire brain in detail, always weaving some bit of historical color into the description.

These experiences at a very impressionable age provided me with a rich and expansive understanding of neuroscience. Later, the idea that specific parts of the brain were dedicated to specific functions was reinforced by the brain research I pursued in college. Medical school further stressed this connection between particular functions and specific parts of the brain. Hearing of this relationship from so many sources, including my dad, certainly demonstrated that this mentality was pervasive throughout the medical field. And this concept was further reinforced during my years of neurology training. Indeed, it was often said that neurologists learned functional brain anatomy “stroke by stroke.” That is to say, whenever a patient was admitted to the hospital with a stroke in a particular area of the brain, neurologists would note the physical disability that correlated with it and thereby identified which function the damaged brain area served.

This simple mechanical structure/function relationship began to unravel, at least for me, in the late 1980s, when I began to note that some patients would regain considerable function of a particular area of the body following a stroke, even though there had been no observable change in their brain imaging studies. So, while a patient’s MRI continued to show damage in, for example, the part of the brain that controls the left hand, not infrequently the brain would somehow “heal” and functionality of the left hand would return. As more and more neurologists, therapists, and patients observed this unusual phenomenon, neuroscientists began to offer explanations that contradicted the prevailing view of the brain’s abilities.

To this day, I vividly recall what would later become a turning point for me in my understanding of the brain. “Michael,” a 58-year-old graphic designer from North Carolina, came to see me in 1988. He reported that 14 months prior to his visit he suddenly became unable to speak. “I knew what I wanted to say, but I just couldn’t produce the words,” he recounted with perfect fluency. My first thought was that he had experienced a transient ischemic attack (TIA), characterized by a brief decline in blood supply to a particular region of the brain—in this case, an area associated with language expression. But, as he continued, he revealed that his speech had been compromised for at least six months following the attack. There was nothing “transient” about it. And while his recovery had been profound, clearly he wanted to do everything he could to prevent any further brain events.

We reviewed an MRI scan of his brain that had been taken just two months prior to his visit at our clinic, and there, for all to see, was evidence of severe damage and loss of tissue, not only in the area associated with speech, but also in the adjacent areas associated with facial movement and control of the right arm. Nonetheless, his examination revealed no deficits whatsoever. What had happened? Clearly, his brain hadn’t “healed”—at least not physically—because the area of his initial stroke was still damaged, according to the MRI. Yet, his brain had adapted; that is, it had begun to use alternative pathways to regain functionality of the related affected part of his body.

Of course, the accepted paradigm at the time considered this concept fanciful. Now, however, we know that the brain does have the ability to change and reorganize itself in regard to the functions it performs. This process is called neuroplasticity, and it is a gift on par with neurogenesis, the brain’s ability to generate new cells throughout our lifetimes.

About Author
David  Perlmutter, M.D. F.A.C.N
Dr. Perlmutter is a frequent lecturer at symposia sponsored by such medical institutions as Columbia University, the University of Arizona, Scripps Institute, and Harvard University. He has contributed extensively to the world medical literature wit Continue reading