Can the Brain Change?

In my medical school days (late 1960’s) The brain was thought to have localized areas that performed certain functions and these areas did not change. Once they were damaged they were gone and nothing could be done about it.

This “localization” concept started in 1861 with Dr. Paul Broca, a surgeon. One of his patients could not speak after suffering a stroke. Since they did not have MRIs or CT or PET scans then, they performed a lot of autopsies to understand what happened anatomically. At autopsy the area of brain damage that caused loss of speech became known as Broca’s area.

Dr. Carl Wernicke found another area of damage in the brain that correlated with the inability to understand language, so it was called Wernicke’s area.

Gradually names were allocated to various areas of the brain indicating their function as depicted on this image.

But scientists eventually carried this concept way too far. They began to believe that:

1. The brain was hard-wired to “one function, one location”. So if an area was damaged the brain could not reorganize to recover the lost function.

2. In the adult brain nerves did not regenerate nor could the brain produce new neurons

But are these two concepts true?

Let’s find out…

Even while I was still in high school, several years before I started medical school, an innovative, brilliant and kind man began to think differently. He went to medical school, and then delved into research as a neuroscientist.

But it was an event in his life that changed his life path and his thinking about the brain.

Meet Dr. Paul Bach-y-Rita and his family.

His Father:

Pedro Bach-y-Rita, the Catalan poet and scholar

His Brother

Dr. George Bach-y-Rita

In 1959 his 65 year old widowed father Pedro Bach-y-Rita had a large stroke which paralyzed his face, half of his body (right side) and left him unable speak.

His brother George, a medical student in Mexico, brought his father from New York (where he taught in a college) to Mexico to take care of him.

George was frustrated by his father’s lack of progress after 4 weeks of rehabilitation therapy. He had no training in rehab med, but that turned out to be a good thing. George had not been influenced by the pessimistic current thinking in rehab medicine and brain function.

So he designed his own innovative rehab program.

Since Pedro couldn’t walk George figured he could start moving about by crawling. A diminutive man, only 118 pounds, George could help move him. At first he supported his father in beginning the crawling motions. Soon Pedro could support his weak side against the wall and crawl without assistance. Eventually he was crawling outside in the garden much to the consternation of the neighbors who thought it was disgraceful that a man of Pedro’s renown was crawling.

But Pedro and George persisted.

George continued to create activities that imitated how babies learn. Pedro played games on the floor. George rolled marbles to him and Pedro had to catch them. He threw pennies on the floor and Pedro had to pick them up with his weak right hand.

George turned normal activities into exercises. Pedro cooperated and practiced, practiced, practiced.

Eventually he fully recovered and was able to return to full-time teaching again at City College in New York. He stayed active 7 more years after his stroke until he died on a hiking trip at 9,000 feet in Bogota, Columbia.

At autopsy in 1965 – a huge part of the brain had died. Paul and the doctor performing the autopsy thought, “There was no way Pedro should have fully recovered”. The damaged area was in the brain stem, 97% of the nerves going from the spine to the cerebral cortex had died.

Shocked and amazed Dr. Paul realized that meant that the brain had to reorganize and could reorganize. The brain could change!

Paul Bach-y-Rita embraced this paradigm shift and went back to medicine at 44 years old training in residency programs in neurology and rehabilitation medicine. He developed methods that his brother Dr. George had used with his father.

People under us care recovered in astounding ways. A person with one side of the body still affected 20 years after a stroke recovered the use of those limbs. A woman known as a Wobbler because her balancing system had been severely damaged by an antibiotic could stand and walk straight again, see smoothly and was freed from the prison of always feeling like she was falling with Dr. Paul’s inventions.

He even developed programs integrated with computers that helped blind people “see”. For more about Dr. Paul Bach-y-Rita read Dr. Norman Doidge’s book, The Brain That Changes Itself.

Other doctors and scientists have continued in the same type of research and treatment and have their own fascinating stories.

For help with the residual effects of stroke and other brain injuries take a look at these sites:

http://www.uab.edu/citherapy/

www.taubtherapy.com/‎

Blessings,

Dr. Jo