Why kids should use their fingers in Math class

Evidence from brain science suggests that far from being “babyish,” the technique is essential for mathematical achievement.

A few weeks ago I (Jo Boaler) was working in my Stanford office when the silence of the room was interrupted by a phone call. A mother called me to report that her 5-year-old daughter had come home from school crying because her teacher had not allowed her to count on her fingers. This is not an isolated event—schools across the country regularly ban finger use in classrooms or communicate to students that they are babyish. This is despite a compelling and rather surprising branch of neuroscience that shows the importance of an area of our brain that “sees” fingers, well beyond the time and age that people use their fingers to count.

In a study published last year, the researchers Ilaria Berteletti and James R. Booth analyzed a specific region of our brain that is dedicated to the perception and representation of fingers known as the somatosensory finger area. 

Philippe Lissac / Godong / Corbis

Remarkably, brain researchers know that we “see” a representation of our fingers in our brains, even when we do not use fingers in a calculation. The researchers found that when 8-to-13-year-olds were given complex subtraction problems, the somatosensory finger area lit up, even though the students did not use their fingers. This finger-representation area was, according to their study, also engaged to a greater extent with more complex problems that involved higher numbers and more manipulation. Other researchers have found that the better students’ knowledge of their fingers was in the first grade, the higher they scored on number comparison and estimation in the second grade. Even university students’ finger perception predicted their calculation scores. (Researchers assess whether children have a good awareness of their fingers by touching the finger of a student—without the student seeing which finger is touched—and asking them to identify which finger it is.)

Evidence from both behavioral and neuroscience studies shows that when people receive training on ways to perceive and represent their own fingers, they get better at doing so, which leads to higher mathematics achievement. The tasks we have developed for use in schools and homes (see below) are based on the training programs researchers use to improve finger-perception quality. Researchers found that when 6-year-olds improved the quality of their finger representation, they improved in arithmetic knowledge, particularly skills such as counting and number ordering. In fact, the quality of the 6-year-old’s finger representation was a better predictor of future performance on math tests than their scores on tests of cognitive processing.

Many teachers have been led to believe that finger use is useless and something to be abandoned as quickly as possible.

Neuroscientists often debate why finger knowledge predicts math achievement, but they clearly agree on one thing: That knowledge is critical. As Brian Butterworth, a leading researcher in this area, has written, if students aren’t learning about numbers through thinking about their fingers, numbers “will never have a normal representation in the brain.”

One of the recommendations of the neuroscientists conducting these important studies is that schools focus on finger discrimination—not only on number counting via their fingers but also on helping students distinguish between those fingers. Still, schools typically pay little if any attention to finger discrimination, and to our knowledge, no published curriculum encourages this kind of mathematical work. Instead, thanks largely to school districts and the media, many teachers have been led to believe that finger use is useless and something to be abandoned as quickly as possible. Kumon, for example, an after-school tutoring program used by thousands of families in dozens of countries, tells parents that finger-counting is a “no no” and that those who see their children doing so should report them to the instructor.

Stopping students from using their fingers when they count could, according to the new brain research, be akin to halting their mathematical development. Fingers are probably one of our most useful visual aids, and the finger area of our brain is used well into adulthood. The need for and importance of finger perception could even be the reason that pianists, and other musicians, often display higher mathematical understanding than people who don’t learn a musical instrument.

Teachers should celebrate and encourage finger use among younger learners and enable learners of any age to strengthen this brain capacity through finger counting and use. They can do so by engaging students in a range of classroom and home activities, such as:

Give the students colored dots on their fingers and ask them to touch the corresponding piano keys:

youcubed.org

youcubed.org

Give the students colored dots on their fingers and ask them to follow the lines on increasingly difficult mazes:

(The full set of activities is given here.)

The finger research is part of a larger group of studies on cognition and the brain showing the importance of visual engagement with math. Our brains are made up of “distributed networks,” and when we handle knowledge, different areas of the brain communicate with each other. When we work on math, in particular, brain activity is distributed among many different networks, which include areas within the ventral and dorsal pathways, both of which are visual. Neuroimaging has shown that even when people work on a number calculation, such as 12 x 25, with symbolic digits (12 and 25) our mathematical thinking is grounded in visual processing.

A striking example of the importance of visual mathematics comes from a study showing that after four 15-minute sessions of playing a game with a number line, differences in knowledge between students from low-income backgrounds and those from middle-income backgrounds were eliminated.

Number-line representation of number quantity has been shown to be particularly important for the development of numerical knowledge, and students’ learning of number lines is believed to be a precursor of children’s academic success.

Visual math is powerful for all learners. A few years ago Howard Gardner proposed a theory of multiple intelligences, suggesting that people have different approaches to learning, such as those that are visual, kinesthetic, or logical. This idea helpfully expanded people’s thinking about intelligence and competence, but was often used in unfortunate ways in schools, leading to the labeling of students as particular type of learners who were then taught in different ways. But people who are not strong visual thinkers probably need visual thinking more than anyone. Everyone uses visual pathways when we work on math. The problem is it has been presented, for decades, as a subject of numbers and symbols, ignoring the potential of visual math for transforming students’ math experiences and developing important brain pathways.

It is hardly surprising that students so often feel that math is inaccessible and uninteresting when they are plunged into a world of abstraction and numbers in classrooms. Students are made to memorize math facts, and plough through worksheets of numbers, with few visual or creative representations of math, often because of policy directives and faulty curriculum guides. The Common Core standards for kindergarten through eighth grade pay more attention to visual work than many previous sets of learning benchmarks, but their high-school content commits teachers to numerical and abstract thinking. And where the Common Core does encourage visual work, it’s usually encouraged as a prelude to the development of abstract ideas rather than a tool for seeing and extending mathematical ideas and strengthening important brain networks.

To engage students in productive visual thinking, they should be asked, at regular intervals, how they see mathematical ideas, and to draw what they see. They can be given activities with visual questions and they can be asked to provide visual solutions to questions. When the youcubed team (a center at Stanford) created a free set of visual and open mathematics lessons for grades three through nine last summer, which invited students to appreciate the beauty in mathematics, they were downloaded 250,000 times by teachers and used in every state across the U.S. Ninety-eight percent of teachers said they would like more of the activities, and 89 percent of students reported that the visual activities enhanced their learning of mathematics. Meanwhile, 94 percent of students said they had learned to “keep going even when work is hard and I make mistakes.” Such activities not only offer deep engagement, new understandings, and visual-brain activity, but they show students that mathematics can be an open and beautiful subject, rather than a fixed, closed, and impenetrable subject.

Some scholars note that it will be those who have developed visual thinking who will be “at the top of the class” in the world’s new high-tech workplace that increasingly draws upon visualization technologies and techniques, in business, technology, art, and science. Work on mathematics draws from different areas of the brain and students need to be strong with visuals, numbers, symbols and words—but schools are not encouraging this broad development in mathematics now. This is not because of a lack of research knowledge on the best ways to teach and learn mathematics, it is because that knowledge has not been communicated in accessible forms to teachers. Research on the brain is often among the most impenetrable for a lay audience but the knowledge that is being produced by neuroscientists, if communicated well, may be the spark that finally ignites productive change in mathematics classrooms and homes across the country.

(Source: The Atlantic)

I knew that was going to happen… The truth about premonitions

 Uncanny and creepy, premonitions that turn out to be authentic can feel profound. But is there science to explain them?

Around seven years ago, Garrett, was in a local Pizza Hut with his friends, having a day so ordinary that it is cumbersome to describe. He was 16 – or thereabouts – and had been told by teachers to go around nearby businesses and ask for gift vouchers that the school could use as prizes in a raffle. There were five other teenagers with Garrett, and they’d just finished speaking to the restaurant manager when suddenly, out of nowhere, Garrett’s his body was flooded with shock. He felt cold and clammy and had an “overwhelming sense that something had happened”. He desperately tried to stop himself crying in front of his peers.

“It was like I’d just been told something terrible,” the now 23-year-old from the southwest of England says (his name has been changed on his request). “I couldn’t tell you exactly what it was, but I just knew something had happened.” Garrett returned home and tried to distract himself from a feeling he describes as grief. The phone rang. His mum answered it. A few hours earlier – around the time Garrett was in the restaurant – his grandfather had died from a sudden heart attack while on a cruise.

Although there’s no way of knowing how many people worldwide feel that they “sensed” a loved one’s death before being told, it’s a phenomenon that’s been explored in everything from Star Wars to Downtown Abbey to Kung Fu Panda 2. Perhaps one of your own relatives has a story similar to Garrett’s – perhaps you dismissed it, perhaps you treat it as family lore. Is there any evidence to suggest this phenomenon is real – that humans can sense one another’s passing from a distance, that Garrett’s emotional afternoon was anything more than a coincidence? In a word, no. Meanwhile, it is well documented that the human mind is a bundle of bias: false memories, grief hallucinations and confirmation bias can easily explain these experiences. Besides which, for every person who feels a shiver when their loved one dies, there are hundreds more who were quietly eating pizza or happily riding a rollercoaster or bored doing maths homework completely unaware of their loss.

Ripple effects: ‘There are many accounts of crisis telepathy.’ Illustration: Eva Bee/The Observer

But are these dismissals too quick? Too easy? Some scientists claim that the complex world of quantum physics could be used to explain the paranormal (other scientists say they’re unbelievably wrong.) What can stories like Garrett’s tell us about what we do and don’t know? What we are and aren’t willing to believe? About the disconnect between what some claim to experience and others claim is impossible?

Brian Josephson is your prototypical professor. With tufts of white hair atop his head, a knitted vest and a glasses chain keeping his specs safe, he says via Zoom that, “The academic community is a kind of club. You’re supposed to believe certain things and you run into problems you disagree with.” In 1973, he was awarded the Nobel Prize in physics for his work on superconductivity. Later, during his time as a professor at the University of Cambridge, he began using quantum mechanics to explore consciousness and the paranormal.

Quantum entanglement – nicknamed “spooky action at a distance” by Albert Einstein – describes the (proven) phenomenon of two spatially separated particles influencing each other, even over large distances. While the phenomenon is subatomic, academics such as Josephson have theorised that quantum entanglement could explain phenomena like telepathy and psychokinesis.

“There are many accounts of crisis telepathy,” says Dean Radin, a parapsychologist and author of Entangled Minds: Extrasensory Experiences in a Quantum Reality. “Does entanglement explain these effects? No, in the sense that entanglement as observed today in the physics lab, between pairs of photons, is extremely fragile and typically lasts only minuscule fractions of a second. But also, yes, in that we are at the earliest stages of understanding entanglement.”

Radin says studies in quantum biology show that entanglement-type effects are present in living systems (academics from Oxford have successfully entangled bacteria) and he believes the human brain could in turn have quantum properties. “If that is subsequently demonstrated – I think it’s just a matter of time – then that would go a long way towards providing a physical mechanism for telepathy,” he says.

Put down your pen, scrunch up your letter to the editor. You only need an explanation for telepathy if you believe in telepathy in the first place, and experiments purporting its existence have been widely debunked. Josephson and Radin are regularly criticised by peers. In 2001, when Royal Mail released a set of stamps to celebrate the 100th anniversary of the Nobel Prize, there was outrage when Josephson wrote in an accompanying booklet that quantum physics may lead to an explanation for telepathy. In this very newspaper, academics branded the claim “utter rubbish” and “complete nonsense”.

When reviewing Entangled Minds for The Skeptic’s Dictionary, philosophy professor and professional sceptic Robert Carroll wrote that Radin’s book was “aimed at non-scientists who are likely to be impressed by references to quantum physics”.

Garrett has no idea what happened to him on the day his grandad died, but he is certain that it happened. He believes in some kind of “interconnectedness” between people. “I think if it’s happened to you, then there’s an underlying accepting of it,” he says.

This is a sentiment shared by the self-described “naturally sceptical” Cassius Griesbach, a 24-year-old from Wisconsin who lost his grandfather in 2012. Griesbach says that he “shot awake” on the night his grandad passed and began to sob uncontrollably. “It felt like something just rocked me, physically,” he says. When his dad called moments later to say his grandad had died, a teenaged Griesbach replied: “I know.”

Griesbach doesn’t blame anyone for being sceptical of his story. “The further you get away from it, the more I would like to write it off as a coincidence,” he says, “But every time I sit down and think about it, it feels like it’s something else.” Griesbach is “not super religious” and doesn’t believe in ghosts. “ If it is something to do with actual science, I would think that would be science that we are nowhere near yet, you know?”

Many would disagree, arguing that the answer lies in the social sciences. In 2014, Michael Shermer married Jennifer, who had moved from Köln to California and brought with her a 1978 radio belonging to her late grandfather. Shermer tried in vain to fix it before tossing it in a drawer, where it lay silent until the couple said their wedding vows at home months later. Just as Jennifer was keenly feeling the absence of her grandfather, the radio began to play a romantic song. It continued all night before it stopped working for good the next day.

“It’s just one of those anomalous experiences,” says Shermer, a science historian, professional sceptic and author of The Believing Brain: from Spiritual Faiths to Political Convictions. How We Construct Beliefs and Reinforce Them as Truths. “Randomness and chance play a big role in life and in the world, and our brains are designed to see patterns not randomness.” Shermer argues that experiences like Garrett’s and Griesbach’s are statistically more likely than we think.

“You have billions of people worldwide having dozens of dreams [each] at night,” he says. “The odds are pretty good that on any given night, somebody’s going to have a dream about somebody dying who actually dies. That’s inevitable.” At the same time, he argues, we ignore all the times we suddenly sob or shudder and it turns out that no one’s died – or the times when someone does die and we don’t feel anything at all.

There are other prosaic explanations. While Garrett’s grandfather’s death was sudden and unexpected, Griesbach’s grandfather was hospitalised the week before he died, when he shot awake in the middle of the night, Griesbach’s first thought was, “It happened” – he knew his grandfather had passed. But is that surprising when he’d spent a week by his bedside?

John Bedard, a 36-year-old in Los Angeles, woke suddenly on the night his parents died. He was 10 and sleeping at a friend’s house when he awoke, “just knowing something was wrong”. He called his brother, sobbing. When his brother picked him up, he told Bedard their parents had died in a motorcycle accident.

And yet, there were clues that “something was wrong” much earlier. The sleepover wasn’t planned – Bedard had gone to friends to play when “it started getting later and later” and nobody came to pick him up. It was a Sunday night – an unusual night to have a sleepover. Bedard was uneasy when he went to bed.

Despite these answers, explanations continue to be toyed with. Rupert Sheldrake is a biologist and parapsychologist who conceived of “morphic resonance”, the idea that interconnections exist between organisms. He believes the human mind has fields that stretch beyond the brain, much like electromagnetic fields. This, he says, explains why we can seemingly tell when someone behind us is staring at us, or why we sometimes think of someone right before they call. (Sheldrake’s work has been called “heresy” in the journal Nature.)

“I’m not talking about the supernatural; I think these things are totally natural. I think they’re normal, not paranormal,” he says. When it comes to experiences like Garrett’s, he says empirical studies are impossible. “You can’t ask somebody to die at a randomly selected time to see if their nearest and dearest respond… So unfortunately, the evidence for cases to do with death has to be circumstantial.”

Shermer is not a Sheldrake fan. “The idea that a biologist like Rupert Sheldrake is going to uncover some new force of nature that somehow Einstein and everybody else has missed… is just so unlikely to have happened, that almost any explanation like the ones I’ve been giving you are way more likely.” Josephson’s rebuke of such criticisms: “People say that [science is] always subject to revision and yet they’re secretly convinced that certain things can’t happen.”

What can and can’t happen doesn’t change what many feel has happened – Garrett, Griesbach and Bedard all believe something strange and unexplainable occurred when they lost their loved ones. At the very least, these stories undeniably offer comfort.

“As far as looking into it, I don’t even know what there is to look into,” Griesbach says – after all, the phenomenon doesn’t even have a name. “I think the best thing that we could do for people is validate how they feel and let them grieve. Because whenever people have that happen, they’re also grieving. That is one of the most important times to just be a kind human to somebody.”

(Source: The Guardian)

Covid linked to risk of mental illness and brain disorder, study suggests

 One in eight people who get coronavirus also have first psychiatric or neurological illness within six months, research finds

One in eight people who have had Covid-19 are diagnosed with their first psychiatric or neurological illness within six months of testing positive for the virus, a new analysis suggests, adding heft to an emerging body of evidence that stresses the toll of the virus on mental health and brain disorders cannot be ignored.

The analysis – which is still to be peer-reviewed – also found that those figures rose to one in three when patients with a previous history of psychiatric or neurological illnesses were included.

It found that one in nine patients were also diagnosed with things such as depression or stroke despite not having gone to hospital when they had Covid-19, which was surprising, said the lead author, Dr Max Taquet of the department of psychiatry at the University of Oxford.

Research that suggests the virus can have an impact on the brain and the central nervous system is emerging. Photograph: MachineHeadz/Getty Images/iStockphoto

The researchers used electronic health records to evaluate 236,379 hospitalised and non-hospitalised US patients with a confirmed diagnosis of Covid-19 who survived the disease, comparing them with a group diagnosed with influenza, and a cohort diagnosed with respiratory tract infections between 20 January and 13 December 2020.

The analysis, which accounted for known risk factors such as age, sex, race, underlying physical and mental conditions and socio-economic deprivation, found that the incidence of neurological or psychiatric conditions post-Covid within six months was 33.6%. Nearly 13% received their first such diagnosis.

The data adds to prior research by Taquet and others that showed nearly one in five people who have had Covid-19 are diagnosed with a psychiatric disorder within three months of testing positive for the virus.

In the latest analysis, the researchers found that most diagnoses were more common after Covid-19, than after influenza or other respiratory infections – including stroke, acute bleeding inside the skull or brain, dementia, and psychotic disorders.

Overall, Covid-19 was associated with increased risk of these diagnoses, but the incidence was greater in patients who required hospital treatment, and markedly so in those who developed brain disease.

The question was how long these conditions might persist after diagnosis, said Taquet. “I don’t think we have an answer to that question yet.”

He added: “For diagnoses like a stroke or an intracranial bleed, the risk does tend to decrease quite dramatically within six months … but for a few neurological and psychiatric diagnoses we don’t have the answer about when it’s going to stop.”

The likelihood that a proportion of patients who were given psychiatric or neurological diagnosis after Covid-19 had underlying illness that just hadn’t been diagnosed previously, could not be entirely ruled out – but the analysis indicated that this was not the case, he suggested.

Patients with influenza and other respiratory infections saw their doctor more often than patients with Covid-19, he said, adding that diagnoses such as an intracranial bleed or stroke could not be hidden for long and were usually diagnosed in emergency rooms.

Although the study does not prove that Covid-19 is directly behind these psychiatric and neurological conditions, research that suggests the virus can have an impact on the brain and the central nervous system is emerging.

The analysis should also be also interpreted with caution, given it is possible that the first entry of a diagnosis into the electronic database might not represent the first occurrence of the condition. Such records are also typically lacking in other relevant information such as housing density, family size, employment and immigration status.

Dr Tim Nicholson, a psychiatrist and clinical lecturer at King’s College hospital who was not involved in the analysis, said the findings would help steer researchers in the direction of which neurological and psychiatric complications required further careful study.

“I think particularly this raises a few disorders up the list of interests, particularly dementia and psychosis … and pushes a few a bit further down the list of potential importance, including Guillain-Barré syndrome.”

(Source: The Guardian)

Why ages 2-7 matter so much for brain development

 Rich experiences—from play to the arts and relationships—fundamentally shape a young child’s development.

When Albert Einstein was a child, few people—if any—anticipated the remarkable contributions he would make to science. His language development was delayed, worrying his parents to the point of consulting a doctor. His sister once confessed that Einstein “had such difficulty with language that those around him feared he would never learn.” How did this child go from potential developmental delays to becoming, well, Einstein?

Part of the answer to that question is symbolized in two gifts that Einstein received from each of his parents when he was 5 years old. When Einstein was in bed all day from an illness, his father gave him a compass. For Einstein, it was a mysterious device that sparked his curiosity in science. Soon after, Einstein’s mother, who was a talented pianist, gave Einstein a violin. These two gifts challenged Einstein’s brain in distinctive ways at just the right time.

Children’s brains develop in spurts called critical periods. The first occurs around age 2, with a second one occurring during adolescence. At the start of these periods, the number of connections (synapses) between brain cells (neurons) doubles. Two-year-olds have twice as many synapses as adults. Because these connections between brain cells are where learning occurs, twice as many synapses enable the brain to learn faster than at any other time of life. Therefore, children’s experiences in this phase have lasting effects on their development.

Sam Falconer / theiSpot

This first critical period of brain development begins around age 2 and concludes around age 7. It provides a prime opportunity to lay the foundation for a holistic education for children. Four ways to maximize this critical period include encouraging a love of learning, focusing on breadth instead of depth, paying attention to emotional intelligence, and not treating young children’s education as merely a precursor to “real” learning. 

ENCOURAGE A LOVE OF LEARNING

Young children need to enjoy the process of learning instead of focusing on performance. Educators and parents can emphasize the joys of trying new activities and learning something novel. We need to help children understand that mistakes are a welcome, normal part of learning.

This period is also the time to establish a growth mindset—the belief that talents and abilities are developed through effort instead of being innately fixed. Educators should avoid labeling children or making universal statements about their ability. Even compliments such as “You’re so smart” are counterproductive. Instead, emphasize persistence and create safe spaces for learning. Children will learn to love learning if we show enthusiasm over the process rather than fixating on results. 

FOCUS ON BREADTH, NOT DEPTH

One way to avoid focusing on results during this phase of development is to emphasize the breadth of skill development over depth. Exposing children to a wide variety of activities lays a foundation for developing skills in a range of fields. This is the time to engage children in music, reading, sports, math, art, science, and languages.

In his book Range, David Epstein argues that breadth of experience is often overlooked and underappreciated. Focusing on excellence in a single activity may be appropriate at some point in life. But the people who thrive in our rapidly changing world are those who first learn how to draw from multiple fields and think creatively and abstractly. In other words, our society needs well-rounded individuals.

Well-roundedness is especially important for children from ages 2 to 7. Their developing brains are ready to soak in a wide range of skill sets. This “sampling period,” as Epstein calls it, is integral. This is the window during which to develop children’s range. There is plenty of time for them to specialize later.

DON’T OVERLOOK EMOTIONAL INTELLIGENCE

Yes, we want children to read well and learn the fundamentals of math. But we should not disregard emotional intelligence. The advantages of learning during this first critical period of brain development should extend to interpersonal skills such as kindness, empathy, and teamwork.

Daniel Siegel and Tina Payne Bryson explain the importance of developing children’s empathy in their book The Whole-Brain Child. Empathy begins with acknowledging one’s feelings. Therefore, they suggest helping children in this age group to first label their emotions (“I feel sad”) and then tell the story about what made them feel that way (“I feel sad because I wanted ice cream and you said no”). Once children practice labeling emotions, educators can start asking questions that encourage them to consider others’ feelings.

One way to encourage care for others is to include children in what adults do for others. Even allowing young children to help with chores can make them more helpful and considerate people.

DON’T TREAT YOUNG CHILDREN’S EDUCATION AS MERELY A PRECURSOR TO “REAL” LEARNING

Children’s brains can uniquely absorb information during this critical phase. If intelligence is defined as the ability to learn, children between the ages of 2 and 7 may be the most intelligent humans on the planet.

Research suggests that some skills cannot be learned nearly as well after this first critical period of brain development. For example, research shows that children in this age range are best suited to learn the patterns of language development, enabling them to master a second language to the same level as a native language. However, once children reach age 8, their language learning proficiency decreases, and second languages are not spoken as well as native ones. The same age effect is found when learning musical abilities such as perfect pitch.

It is noteworthy that Einstein’s parents did not enroll him in physics lessons—the field that would lead him to a Nobel Prize. Instead, Einstein’s father included him in his work as an engineer. His mother signed him up for violin lessons because she wanted him to love and appreciate music. Both activities worked to develop his young mind holistically. It is tempting to think of early childhood education as a precursor to “real” education. But these may be the years that matter most. 

(Source: Edutopia)

Warning of serious brain disorders in people with mild coronavirus symptoms

UK neurologists publish details of mildly affected or recovering Covid-19 patients with serious or potentially fatal brain conditions

Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned.

Neurologists are on Wednesday publishing details of more than 40 UK Covid-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom.

The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication.

Artificially coloured MRI scan of a human brain. Photograph: Daisy-Daisy/Alamy Stock Photo

A dozen patients had inflammation of the central nervous system, 10 had brain disease with delirium or psychosis, eight had strokes and a further eight had peripheral nerve problems, mostly diagnosed as Guillain-Barré syndrome, an immune reaction that attacks the nerves and causes paralysis. It is fatal in 5% of cases.

“We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust.

“What we’ve seen with some of these Adem patients, and in other patients, is you can have severe neurology, you can be quite sick, but actually have trivial lung disease,” he added.

“Biologically, Adem has some similarities with multiple sclerosis, but it is more severe and usually happens as a one-off. Some patients are left with long-term disability, others can make a good recovery.”

The cases add to concerns over the long-term health effects of Covid-19, which have left some patients breathless and fatigued long after they have cleared the virus, and others with numbness, weakness and memory problems.

One coronavirus patient described in the paper, a 55-year-old woman with no history of psychiatric illness, began to behave oddly the day after she was discharged from hospital.

She repeatedly put her coat on and took it off again and began to hallucinate, reporting that she saw monkeys and lions in her house. She was readmitted to hospital and gradually improved on antipsychotic medication.

Another woman, aged 47, was admitted to hospital with a headache and numbness in her right hand a week after a cough and fever came on. She later became drowsy and unresponsive and required an emergency operation to remove part of her skull to relieve pressure on her swollen brain.

“We want clinicians around the world to be alert to these complications of coronavirus,” Zandi said. He urged physicians, GPs and healthcare workers with patients with cognitive symptoms, memory problems, fatigue, numbness, or weakness, to discuss the case with neurologists.

“The message is not to put that all down to the recovery, and the psychological aspects of recovery,” he said. “The brain does appear to be involved in this illness.”

The full range of brain disorders caused by Covid-19 may not have been picked up yet, because many patients in hospitals are too sick to examine in brain scanners or with other procedures. “What we really need now is better research to look at what’s really going on in the brain,” Zandi said.

One concern is that the virus could leave a minority of the population with subtle brain damage that only becomes apparent in years to come. This may have happened in the wake of the 1918 flu pandemic, when up to a million people appeared to develop brain disease.

“It’s a concern if some hidden epidemic could occur after Covid where you’re going to see delayed effects on the brain, because there could be subtle effects on the brain and slowly things happen over the coming years, but it’s far too early for us to judge now,” Zandi said.

“We hope, obviously, that that’s not going to happen, but when you’ve got such a big pandemic affecting such a vast proportion of the population it’s something we need to be alert to.”

David Strain, a senior clinical lecturer at the University of Exeter Medical School, said that only a small number of patients appeared to experience serious neurological complications and that more work was needed to understand their prevalence.

“This is very important as we start to prepare post-Covid-19 rehabilitation programs,” he said. “We’ve already seen that some people with Covid-19 may need a long rehabilitation period, both physical rehabilitation such as exercise, and brain rehabilitation. We need to understand more about the impact of this infection on the brain.”

(Source: The Guardian)

Acclaimed scientist gets brain surgery for alcohol addiction

Microbiologist Frank Plummer has been on the frontlines of the battle against of some of the world's most alarming epidemics, from HIV to Ebola - but his illustrious career masked a growing reliance on alcohol. Now, the researcher has become the guinea pig in a clinical trial investigating whether brain implants can help treat alcohol use disorder.

Alcohol was always a big part of Frank Plummer's life.

At the beginning of his research career, in the early 1980s in Nairobi, he began to lean on scotch to relax, and to the handle stress, disappointment and grief related to his work.

Microbiologist Frank Plummer is recognised globally for his research into the HIV virus

He and his colleagues were feeling the visceral urgency of their work as they watched the African HIV crisis unfold.

"I felt just like a fire fighter or something but the fire didn't go out," Dr Plummer, 67, told the BBC.

"It just kept going and going and going. There was this sense that you needed to do something and that the world needed to do something. And I was trying to draw attention to it and get money to continue our work. So it was a time of intense pressure."

Dr Plummer's research subjects were Kenyan women, sex workers, some who were found to have a natural immunity to the virus.

It was pioneering research, and over the 17 years Dr Plummer spent in Kenya, he and his colleagues made groundbreaking discoveries made about how HIV spreads - breakthroughs that have helped inform how we reduce transmission risk and that raised the possibility a vaccine against the virus could be developed one day.

In those stressful times, five or six glasses of scotch a night were giving him room to exhale after hectic days and weeks.

When he returned to Canada, he took a leadership position at Winnipeg's National Microbiology Laboratory, one of a handful of laboratories in the world with the capacity to work with highly pathogenic viruses like Ebola.

The University of Manitoba and the University of Nairobi have long collaborated on HIV research

At the lab they dealt with the outbreaks of Sars in 2003 and the H1N1 influenza in 2009. It was there Dr Plummer contributed to the development of Canada's Ebola vaccine.

It was vital, exciting, and stressful work, with 12-hour days that began with coffee and would end with several glasses of scotch. His drinking escalated to about 20 ounces of the booze a night.

It didn't seem to affect his work - until 2012, when it caught up with him.

"My liver packed it in," he says. "Before that I knew I drank a lot but I didn't think I had a problem."

The diagnosis of chronic liver failure was followed by a liver transplant. He had to watch his alcohol intake to preserve his new liver - but he found his alcohol had become a powerful thirst.

Dr Plummer tried treatment - rehab programmes, support groups, counselling, medications - but any relief was temporary. He would inevitably slip back into drinking.

"It was pretty hopeless cycle and it was very tough on my family and my wife, Jo, and on my children and my stepchildren," he says. "I was in the hospital a lot, I almost died several times."

He went looking for help - "a more robust clinical solution, perhaps one not yet discovered" - and was referred to two neurosurgeons at Toronto's Sunnybrook Hospital.

Frank Plummer was awake during the surgery

They were recruiting patients for an experimental procedure being conducted in North America for the first time, using deep brain stimulation (DBS) to help patients with treatment-resistant alcohol use disorder. The surgical trial is testing how safe and effective DBS is for alcohol addiction.

DBS has been used for over 25 years to help treat movement disorders like Parkinson's disease. Roughly 200,000 DBS surgeries have been performed around the world, many for the nervous system disorder.

In recent years, it's been explored as a treatment for a range of other diseases. At Sunnybrook, clinical trials are underway exploring DBS for use in disorders like post-traumatic stress disorder, obsessive-compulsive disorder, major depressive disorder, and alcohol use disorder.

What changes is the part of the brain being targeted, says Dr Nir Lipsman, the trial lead investigator and the neurosurgeon who performed Dr Plummer's surgery.

"[For] things like Parkinson's disease we target motor circuits in the brain, in addiction, alcohol use disorder, we're targeting reward, pleasure circuits of the brain," he says.

The DBS surgery performed on Frank Plummer targets the brain's nucleus accumbens, or pleasure centre

DBS treatment involves implanting an electrical device directly into a patient's brain to stimulate circuits where there is abnormal activity , or dysfunctional "wiring", and help reset them. DBS is frequently described as a type of "pacemaker" for the brain.

Electrodes are inserted into a targeted region of the brain to recalibrate activity in that area using electrical impulses - controlled by a pacemaker-like device placed under the skin of the patient's chest - and ease cravings.

Dr Plummer was the trial's first patient and underwent the experimental surgery just over a year ago. A total of six people are expected to eventually participate - all with a history of chronic alcohol use disorder proven resistant to other types of treatment.

Patients are awake for the surgery.

Dr Plummer says the worst part of the procedure were the noise and vibrations when surgeons drilled into his skull in order to implant the electrodes.

"It was a large drill that drills about a 25 cent piece out of your skull on both sides - that wasn't painful but it was annoying," he says.

Frank Plummer, seen with his wife Jo, says he has rediscovered life since the surgery

The brain pleasure centres being targeted in this study - the nucleus accumbens - is also involved in mood, anxiety and depression.

That factor is potentially key since many addiction disorders frequently coexist with mood disorders, the neurosurgeon says.

The surgeon says Dr Plummer has seen an improvement in both his cravings and his mood.

In those who've had the surgery, "we are seeing some signs, some early signs that we are having an impact on those kind of behaviours and those kind of measures that we want to influence", says Dr Lipsman.

The surgeons hope the study will shift some of the stigma around addiction disorders. Addictions are still often seen as a weakness or a failure of willpower, which can prevent people seeking treatment.

"We need to change the way we view addiction, change the way we view alcohol use disorder as a condition in its advanced stages, in the treatment resistant stages as being driven by circuits in the brain that are not functioning properly," he says.

But he cautions the research is in early stages - and that it's not a silver bullet.

"It's not just put in the implant, say goodbye and you're done," he says. Patients should still continue their conventional treatment for their alcohol addictions, like therapy or rehab programmes.

"It's really about viewing this as part of a larger strategy to treat what is an incredibly complex and challenging condition."

Any results from DBS are not instantaneous - it can take weeks to feel a change. For Dr Plummer, after a little while, "life just became so much better, so much richer."

"I suddenly decided that I wanted to write a book about my experiences as a scientist, and experiences living in Kenya," he says.

He's back to getting up early, writes daily and has returned to HIV research with the hopes of developing a vaccine for the disease.

He drinks occasionally but says he doesn't have the same compulsion or the physical dependency as before.

"Life is on the table again," he says.

(Source: BBC)