Increased corpus callosum size in musicians.

Using in-vivo magnetic resonance morphometry it was investigated whether the midsagittal area of the corpus callosum (CC) would differ between 30 professional musicians and 30 age-, sex- and handedness-matched controls. Our analyses revealed that the anterior half of the CC was significantly larger in musicians. This difference was due to the larger anterior CC in the subgroup of musicians who had begun musical training before the age of 7. Since anatomic studies have provided evidence for a positive correlation between midsagittal callosal size and the number of fibers crossing through the CC, these data indicate a difference in interhemispheric communication and possibly in hemispheric (a)symmetry of sensorimotor areas. Our results are also compatible withplastic changes of components of the CC during a maturation period within the first decade of human life, similar to those observed in animal studies.

Do musicians have different brains?

Department of Psychology, Goldsmiths, University of London.

The search for anatomical correlates of special skills dates from the end of the 19th century, when post-mortem brains of gifted individuals, including musicians, were examined for clues as to origins of their prized abilities. Modern neuroimagingtechniques provide the chance to interrogate the brains of living musicians. Structural and functional specialisations have been demonstrated across several sensory, motor and higher order association areas. These specialisations are often instrument- or effector-specific and correlate with aspects of the training history supporting the view that they are the result, rather than the cause, of skill acquisition. Musicians constitute a model, par excellence, for studying the role of experience in sculpting brain processes. A key challenge for the future will be to develop theoretical frameworks within which musicians and other occupationally specialised groups can be studied in order to investigate the nature, scope and limits of neuroplasticity.

PMID: 18624043 [PubMed – indexed for MEDLINE

Cerebellar volume of musicians

There is evidence that the cerebellum is involved in motor learning and cognitive function in humans. Animal experiments have found structural changes in the cerebellum in response to long-term motor skill activity. We investigated whether professional keyboard players, who learn specialized motor skills early in life and practice them intensely throughout life, have larger cerebellar volumes than matched non-musicians by analyzing high-resolution T(1)-weighted MR images from a large prospectively acquired database (n = 120). Significantly greater absolute (P = 0.018) and relative (P = 0.006) cerebellar volume but not total brain volume was found in male musicians compared to male non-musicians. Lifelong intensity of practice correlated with relative cerebellar volume in the male musician group (r = 0.595, P = 0.001). In the female group, there was no significant difference noted in volume measurements between musicians and non-musicians. The significant main effect for gender on relative cerebellar volume (F = 10.41, P < 0.01), with females having a larger relative cerebellar volume, may mask the effect of musicianship in the female group. We propose that the significantly greater cerebellar volume in male musicians and the positive correlation between relative cerebellar volume and lifelong intensity of practice represents structural adaptation to long-term motor and cognitive functional demands in the human cerebellum.

Brain structures differ between musicians and non-musicians

From an early age, musicians learn complex motor and auditory skills (e.g., the translation of visually perceived musical symbols into motor commands with simultaneous auditory monitoring of output), which they practice extensively from childhood throughout their entire careers. Using a voxel-by-voxel morphometric technique, we found gray matter volume differences in motor, auditory, and visual-spatial brain regions when comparing professional musicians (keyboard players) with a matched group of amateur musicians and non-musicians. Although some of these multiregional differences could be attributable to innate predisposition, we believe they may represent structural adaptations in response to long-term skill acquisition and the repetitive rehearsal of those skills. This hypothesis is supported by the strong association we found between structural differences, musician status, and practice intensity, as well as the wealth of supporting animal data showing structural changes in response to long-term motor training. However, only future experiments can determine the relative contribution of predisposition and practice.

Music for the Autism Spectrum

Our model of autism deals with under functioning areas of the brain as well as difficulty with different areas of the brain communicating with each other. Our treatment approach is based on eliminating issues with fuel delivery to the brain as well as activating the under functioning, under commmunicating pathways, and circuits in order to optimize brain function. This is our general approach to autism as well as many other neurological disorders. We know that the brain is changeable, neuroplasticity, and thus we use this information to stimulate targeted areas of the brain through the senses in order to promote positive changes in the patients nervous system. The stimulation should be targeted and specific to the patients particular area of weakness. I am not a fan of generalized right or left brain stimulation as you can create an imbalance as well as correct one. This is particularly important with regard to children on the autism spectrum as each child is so different even if they have some commonalities. Having established that I prefer specific treatment protocols based on a clinical examination by a functional neurologist, I recognize that I am often asked if there is any general type of stimulation or exercises that a parent that has a child with autism can do at home or by themselves that might be in accordance with the concepts of functional neurology, hemispheric integration and neuroplasticity. Something that I have found that seems to be beneficial in most,but not all cases, is musical training. Obviously, this would depend on where the lesion, problem in the brain, is and what you child’s level of function. Although, in Hemispheric Integration Therapy a great emphasis is placed on balancing the right and left sides of the brain. I again reiterate that there are 2 sets of peripheral nerves, 2 cerebellums, 2 basal ganglias etc and one can not simply stimulate on one side or the other and expect an optimum result. Much of the communication between right and left hemispheres is done through an area know as the corpus callosum which musical training has been shown to increase in size. In addition, musicians have shown larger brain areas for motor, auditory, and visual spatial center of the brain. And I think we have heard it said that musical training improves math skills. This is exactly what neuroplasticity is all about and a good example as to how appropriate stimulation cannot only make a pathway or area more efficient but also make it physically larger. This is exactly what the functional neurologist does with his patient’ s except that the exercises and stimulation are directed toward the area which was found to be deficient on functional neurological examination. Both of my children play the piano. I would say that in general, if you have a child on the autism spectrum, musical training is something you may want to investigate as a way to improve his or her functionality. This is not medical advice as I have not had the opportunity to lead examination your son or daughter, but simply a suggestion in response to a question that I am often asked. I personally don’t play an instrument, but have it on my list of things to do simply as I like the neurological implications.

Previous adult attention-deficit and hyperactivity disorder symptoms and risk of dementia with Lewy bodies: a case-control study.

INTRODUCTION: previous reports have shown that in Dementia with Lewy body (DLB) and attention-deficit and hyperactivity disorder (ADHD) a hypodopaminergic and noradrenergic substrate seems to play a central role in developing the diseases. We investigated the hypothesis that attention deficit may precede DLB expressed as adult ADHD symptoms long before the clinical onset of dementia.

METHODS: patients with DLB, Alzheimer disease type (ADT) and controls were recruited from the membership of the Italian Hospital Medical Care Program in Argentina from 2000 to 2005. The DSM-IV criteria adapted for the identification of adult patients with ADHD and validated to Spanish Wender Utah Rating Scale were used to identify individuals with preceding ADHD symptoms during their adult life. Analysis of categorical variables was carried out using chi-square. Mann-Whitney test was used for continuous variables. Statistical significance was P < 0.05.

RESULTS: a total of 109 patients with DLB and 251 patients with ADT were matched by age, sex and year of education with 149 controls. The frequency of preceding ADHD symptoms in DLB cases was 47.8% in ADT 15.2% and 15.1% in the control group. The prevalence of ADHD symptoms in DLB cases was significantly higher compared with the control group (P ≤ 0.001, OR 5.1 95%CI 2.7-9.6) and also higher when compared with ADT (P ≤ 0.001, OR 4.9, 95%CI 2.8-8.4). Conclusion: we found a higher risk of DLB in patients with preceding adult ADHD symptoms. To date, there is no clear explanation for the association found; however, further investigation will widen our understanding about both disorders.

PMID: 20491888

More Bad News for Adult ADHD Sufferers

Adult ADHD (Attention Deficit Hyperactive Disorder) sufferers have been known to have higher incarceration with rates, the difficulty in school, higher pregnancy rates, higher obesity rates and more difficulty forming relationships. Currently 5 to 10% of school age children are thought to have ADHD. Roughly 50% of those children will grow up to be a adults who suffer from ADHD. A new study in the European Journal of Neurology suggest more bad news for adults with ADHD. The study found that adults with dementia with Lewy bodies had a 47.8% frequency of proceeding ADHD symptoms vs. 15.1 percent in the control group. This suggest that there was approximately a 3 times greater risk of developing dementia with Lewy bodies for those adults with ADHD symptoms when compared to those without ADHD symptoms. Lewy bodies are protein aggregates that develop inside nerve cells and are associated with other neurodegenerative disorders such as Parkinson’s disease and Alzheimer’s disease. Current science has no explanation for the association between the two disease processes, however this study certain to prompt more investigation which may aid in the understanding and treatment of both disorders. Common signs and symptoms associated with Lewy body dementia include variation in cognition (thought processing) and attention, visual hallucinations (usually seeing people or pets that are not actually present ) and Parkinson like movement disorders ( slow to initiate movement,shuffling gait, expressionless face.) Four controllable risk factors if you were pregnant to lower your chances of having a child with adhd include quitting smoking the moment you discover you’re pregnant, don’t drink while you are pregnant, avoid toxin exposure and avoid a high fat diet during pregnancy. Recall that children with ADHD become adults with ADHD and that this new evidence suggests may become seniors with dementia with Lewy bodies.Thus, if you suffer from ADHD, this should give you more motivation to make seeking appropriate treatment a priority in your life.

Lower urinary tract conditions in children with attention deficit hyperactivity disorder: correlation of symptoms based on validated scoring systems.

Department of Urology, Ankara University School of Medicine, Ankara, Turkey.

PURPOSE: We investigated whether certain voiding problems have a higher incidence in patients with attention deficit disorder with hyperactivity compared to age matched controls.

MATERIALS AND METHODS: We used the Conners Parent Rating Scale-revised for attention deficit disorder with hyperactivity and lower urinary tract symptom score to evaluate voiding problems. A total of 62 children with attention deficit disorder and 124 healthy controls were enrolled. We evaluated uroflowmetry patterns in both groups. Residual urine volumes and Bristol stool scale were noted. We examined the correlation between total Conners Parent Rating Scale-revised and lower urinary tract symptom score in patients with attention deficit disorder. Additionally we analyzed each index of the Conners Parent Rating Scale-revised separately in terms of correlation with symptom subgroups for lower urinary tract symptom scores.

RESULTS: Mean ± SD total lower urinary tract symptom score was 11.1 ± 2.9 in patients with attention deficit disorder with hyperactivity and 3.2 ± 1.3 in controls, a difference that was statistically significantly (p <0.001). With the exception of constipation, mean scores of all lower urinary tract symptom subindices were significantly higher in patients with attention deficit disorder compared to controls. Symptoms evaluated in lower urinary tract symptom score were mostly correlated with attention deficit disorder index of the Conners Parent Rating Scale-revised. If a child with attention deficit disorder has a high index in the Conners Parent Rating Scale-revised, he or she is more likely to have urgency. Also, if a child with attention deficit disorder has a high hyperactivity subscale score, he or she is more likely to have enuresis.

CONCLUSIONS: Voiding problems are more common in children with attention deficit disorder with hyperactivity than in age matched controls. Urgency and enuresis are the outstanding problems in children with attention deficit disorder. Simultaneous use of the Conners Parent Rating Scale-revised and lower urinary tract symptom score questionnaire should be encouraged in patients with attention deficit disorder to allow a structured and quantitative evaluation of these overlapping problems.

ADHD and Bedwetting

Parents who have children that suffer from ADHD as well as doctors and therapists who treat these families are well aware that there is a higher rate of difficulty with regard to bladder control for these children. This most times is at night but may also be a problem throughout the day as well. In addition to an obvious sign of delayed development, this also has considerable social stigma attached to it. A recent study in the Journal of Urology confirms and brings into objective evidence what those of us in the field already know. Yes, children who have ADHD are far more likely to have issues with bladder urgency and eneuresis ( bed wetting.) In fact, the higher the child scored on the Connors Parent Rating Scale a psychometric tests for ADHD, the more likely he or she was to have urgency.

In the functional neurology model, this association between ADHD and bladder control makes perfect sense. An under developed cortex or higher brain is going to give one less ability to resist a socially inappropriate urges as well as a lower reflexes such as relating to your bladder. Let’s combine the two situations to make an example. When your bladder fills, you will have the urge two empty your bladder. This is what you do as an infant. It is a reflex. As your higher brain develops you become aware that it is socially inappropriate to empty your bladder whenever it feels full. It is your higher brain which is able to inhibit the bladder reflex to empty your bladder. Thus, if you’re higher brain is not developed sufficiently you will not be able to inhibit the lower bladder reflex and you will have urgency and daytime as well as night time accidents. Now, let’s look a situation in which the child is able to control his bladder during the day but has issues with bed wetting at night. In this situation, your cortex or higher brain is less active at night when you are sleeping. Therefore, you have less ability to inhibit the lower bladder reflex and thus your bladder empties. In the second case, the child’s cortex is sufficiently developed to inhibit the bladder reflex during the day however with decreased cortical activity at night, his ability to inhibit the bladder reflex falls below threshold and he loses his ability to inhibit.

The trick of course is to find the appropriate exercise to stimulate the under functioning area of the brain (the area of dysfunction must be localized) in order to accelerate its development and address both the issue with ADHD and bladder control. This of course is the job of the functional neurology practitioner.

Help for ADHD Without Medication

ADHD is currently estimated to affect 5 to 10% of school aged children. This means we all know a child or adult with ADHD whether that be a son, nephew, husband or brother who suffer from ADHD. Boys are affected 3 times more than girls. The standard treatment for ADHD is stimulant medications such as Ritalin, Adderal, Vyvanse, Concerta and Dexetrine. Stimulant medications are effective in reducing ADHD symptoms in approximately 70% of children and adults. But the stimulant medications have side effects such as trouble sleeping, loss of appetite, mood swings, anxiety, irritability, heart palpitations, headaches, upset stomach, slower growth and weight gain and repetitive movements or sounds (tics.) Many parents do not want their young children on medication and many are trying to avoid the aforementioned side effects. Additionally, if the medications work for 70% of those suffering with ADHD then it stands to reason that 30% of children and adults do not respond to this treatment. A new study in Lancet determined that use of a restricted elimination diet improved symptoms of ADHD in78% of children. The children were ages 4 to 8 and had an ADHD diagnosis. The study was notable as a relatively large testing sample, 100 children participated in the study. The results come as no surprise to those of us that use these types of interventions to treat children with ADHD and learning disabilities but it is nice to have some validation. The study did not find that measuring IgG (antibodies) levels for food sensitivities were helpful but practitioners who supervise parents introducing these types of treatments find that IgG food sensitivity test are useful and help guide parents in what may be a difficult diet to implement, particularly at first. My experience has found IgG food sensitivity tests to provide a considerable amount of direction and comfort to parents. The testing period may have been too short to see a significant change in IgG levels in this particular study. Therefore, if you have a loved one who suffers with the frustration that is ADHD, be aware of the elimination diet as a tool to help your child get off of the stimulant meds, or perhaps achieve greater reduction of symptoms for those having success with the stimulants. This of course may be of greatest benefit for the 30% for whom stimulant medication is ineffective. If you are interested in this type of approach consult a physician who treats ADHD and is familiar with dietary and nutritional interventions.