Neuro Note #5: (TedTalk) Can the Damaged Brain Repair Itself?

While searching for something to write my last neuro note on, I came across this TedTalk from Dr. Siddharthan Chandran, "Can the damaged brain repair itself?", discussing how the brain can spontaneously repair itself by using its own stem cells. This was fascinating to me, because I have been interested in stem cell research for some time. Dr. Chandran opens by talking about the devastating effects of neurological conditions, such as multiple sclerosis and Huntington's disease, and how they affect the people diagnosed with them. He says that thirty-five million people are living with a neurological condition, while the annual cost of these diseases is around 700 billion dollars. The number of people living with neurological conditions today is rising because these diseases are age-related, and people are living longer.

Dr. Chandran made an interesting point in his presentation; the brain can repair itself, but it just doesn't do it well enough. When damage is made to brain cells, it is manifested as disease. This makes sense, because when nerve cells become demyelinated, this can lead to the manifestation of multiple sclerosis. Spontaneous repair can occur from human stem cells in the brain which lays down new myelin over damaged nerves. In one study, Dr. Chandran discusses a patient's shrinking optic nerve as a result of multiple sclerosis. He found that after placing new stem cells in the brain, over a twelve month period, the optic nerve began to repair itself and increase in size. I think it is pretty amazing how our bodies can repair themselves, even after incurring damage.

The topic of stem cell research has been heavily debated in the last ten years, so I think it is difficult to say how many doctors, researchers, and patients would actually be on board with this type of treatment. I believe that there can be many benefits from the use of stem cells, since they have the potential to be generated into basically any type of cell that is needed, such as bone, liver, or nerve cells. I would like to further my knowledge on this topic by looking into more studies, such as the one mentioned by Dr. Chandran, to see how this intervention can affect individuals with other types of neurological conditions. Dr. Chandran's message gives hope to people who live with neurological conditions, and hopefully there will be cures one day for these awful diseases.

You can access Dr. Chandran's TedTalk at the link listed below:

Chandran, S. (July 2013). Can the damaged brain repair itself? [Video file]. Retrieved from:
https://www.ted.com/talks/siddharthan_chandran_can_the_damaged_brain_repair_itself#t-939196

OT 537 Media Project: The Helping Handle

My initial reaction to coming up with a therapeutic tool for occupational therapy intervention was very exciting. I have recently become interested in adaptive equipment and technology, and I was looking forward to getting to make my own device. However, my first thought when I found out I would be making a piece of equipment out of an empty ketchup bottle was, "What in the world am I supposed to do with this?!". It took a lot of brainstorming and trial and error, but I came up with the perfect piece of adaptive equipment for my client, Maurice, who is a retired 83-year-old dairy farmer. 

Introducing, The Helping Handle! 

I used an empty ketchup bottle, felt, duct tape, pebbles, and velcro strips to make this device. I cut a screen out of the front of the bottle, where the label would normally go. I added pebbles to give more weight to the handle and sealed it off with hot glue and a piece of felt. This tool features a window so that my client can scoop or pull objects from a table or floor and bring them closer to him. He is also able to turn light switches off and on as he pleases, and he is able to more independently feed himself with the velcro strips I attached on the side of the bottle, where his adapted spoon and fork would go.

For someone with Parkinson's disease (PD), like Maurice, I thought this tool could be helpful in a variety of ways. I chose to make the tool with contrasting colors because Maurice has cataracts in both eyes, which diminishes his ability to see properly. I wanted to make the colors alternate enough so that he could differentiate objects within the handle, but not so much that a neon color would shock his visual system. I also added weight to the handle because people with PD usually have some sort of tremor. I thought that adding weight would be beneficial for improving his fine motor coordination with certain activities of daily living (ADLs), such as eating. 

Once I came up with the design of this tool, it was not that difficult to make. The only real challenge that I faced while making this was keeping the pebbles inside of the handle. I had to hot glue the pebbles inside to make sure they would not come out. I gave it a test "shake" to see if they would stay. A few of the pebbles came flying out of the tool, So I had to reinforce the pebbles again, and hot glue the edges of the felt so the pebbles would not come out. 

I also designed this tool to allow for more independence with choices and decision-making for my client. He stated that he still likes to make choices about the food he eats and the clothing he wears, and I wanted to be able to give him some of that independence back by helping him pick clothes from his closet, and bring his shoes closer to him so he does not fatigue himself by stooping down to pick them up. This tool will provide increased independence for Maurice so that he does not have to rely on his wife as much, and will allow for more freedom in eating, dressing, and doing things around the house. I have included a number of pictures you can view below: 

 Maurice can hang up his clothes, or pick out his outfit for the day 

I have adapted a fork and a spoon using velcro strips so that he can independently feed himself. 

Using the scooping mechanism, Maurice is able to bring objects closer to him so that he does not fatigue himself by getting up and walking to them, or bending down to pick them up. 

Alzheimer's Disease Case Study: Ronald Reagan

Before Lauren gave this presentation, I was not aware that former President Ronald Reagan had Alzheimer's disease. His roles included being a husband, father, son, brother, and patriotic American. His occupations included riding horses, acting, and taking care of his ranch and horses. I was aware of some of the symptoms of Alzheimer's, including forgetfulness and memory loss, but did not know about some of the other symptoms, including difficulty sleeping. I noticed in Lauren's goals for Reagan that she included a sleep management program to help him get a restful night's sleep. I did not know that Alzheimer's could cause irregular, inconsistent sleep patterns, as Ronald had. I also learned that he had acquired a blood clot after being thrown off a horse in 1989, which Nancy believes is a big cause of his Alzheimer's. He did not get diagnosed until 1994.

One of Ronald's main concerns was to not be a burden on Nancy, since she was his primary caretaker. Lauren introduced caregiver education as part of her treatment program, which would be very helpful in improving both Nancy's and Ronald's quality of life. Her long-term and short-term goals for Ronald were very reasonable. I learned a lot about Alzheimer's and about former President Reagan. Her presentation was very insightful and informative!

Neuro Note #4: (TedTalk) What you can do to prevent Alzheimer's

I came across this TedTalk while looking for something to write my next neuro note on. I try to write about things that we are learning about in class, that way I can elaborate on my knowledge and understanding on that particular topic. In this TedTalk, Lisa Genova, author of the book, "Still Alice" talks about how we can prevent Alzheimer's disease by making new neural pathways and increasing our cognitive reserve. I thought that this topic was interesting because there is currently no cure for Alzheimer's and I wanted to see how what she talked about could help my future patients and clients. She explains that individuals with Alzheimer's disease have increased amyloid plaques, tangles, and brain shrinkage caused by microglia, and that this is due to losing synapses in the brain. People can start developing these plaques and tangles as early as age 40, but are unaware that anything is wrong because they typically do not show any signs of Alzheimer's until later into their 70s and 80s.

One thing that I found very interesting was that sleep deprivation and poor sleep habits in general can significantly increase the amount of amyloid plaques in the brain. Even one night of sleep deprivation can increase the amount of plaque. I can't speak for everybody, but I know I won't be pulling any more all-nighters in school. Lisa goes on to say that people have an increased risk for developing Alzheimer's disease if they have poor sleep habits, cardiovascular disease, diabetes, high blood pressure, obesity, if they smoke, or have high cholesterol. The brain has about 100 trillion synapses, which makes up our cognitive reserve. This number can vary at any given time, and can be increased by making new connections in the brain. We can train our brains to combat Alzheimer's if we have more years of formal education, a higher degree of literacy, and engage regularly in mentally stimulating activities, which will create more neural pathways and increase our cognitive reserve. Lisa also put an emphasis on participating in activities that are meaningful, which is a big buzzword in the field of OT. Doing things like crossword puzzles wouldn't necessarily help with making new neural pathways, but rather meeting new friends, learning a new language, or reading a book would have a significantly higher impact.

From an occupational therapy perspective, I believe this is something that needs to be researched even more. Hospitals and healthcare providers would save so much money buy implementing preventative care into their practice rather than treating the symptoms after their patients have already been diagnosed. I personally love that the engagement in purposeful and meaningful activities can be a useful tool to help prevent the onset of Alzheimer's, even if someone is genetically predisposed to it. I would love to incorporate this into my practice if I end up working with individuals with Alzheimer's disease. Lisa mentioned three lessons she learned from her grandmother that she mentioned at the end of the talk, and they really stood out to me: "Having the diagnosis doesn't mean you're dying tomorrow; keep living.  You won't lose your emotional memory. You are more than what you can remember."

I really enjoyed this TedTalk and would recommend it to anyone who is curious about Alzheimer's prevention. The link for the talk is listed below:


Genova, L. (April 2017). What you can do to prevent Alzheimer's. [Video file]. Retrieved from: https://www.ted.com/talks/lisa_genova_what_you_can_do_to_prevent_alzheimer_s#t-791251

MD Case Study: Jonah Marlin

Before I gave this presentation, I knew a little about muscular dystrophy from knowing Jonah through my church. I knew he was in a power wheelchair and that was his main form of getting around, but I truly did not understand how much it affected his life. When I interviewed his dad, I learned that he has difficulty with transferring in and out of the bed, toileting, and self-feeding, which were his primary concerns that I addressed in the presentation. It never occurred to me that the muscles become so weak that he could not do anything for himself. The one thing that broke my heart was when Jonah's dad said the hardest part about having DMD is not being able to play with kids his age because he can't run around and keep up with children in school.

I learned that individuals with MD are typically diagnosed at age 5, which is when Jonah was diagnosed, and that his form of muscular dystrophy, Duchenne's muscular dystrophy, is the most common form. I learned that DMD is caused by a defective gene called dystrophin, which is responsible for making protein in the muscle, and that individuals with DMD have a 50% chance of passing it on to their children. DMD also causes pseudohypertrophy, which is false enlargement of the muscles in the calves, due to an increase in creatine kinase in the muscle. His calves are not large because of the muscle fibers, but because of scarring and fat buildup on the muscle.

Overall, my main takeaway from this project was that there needs to be more research done to find a cure for DMD. Most males diagnosed with DMD do not live past their twenties, which significantly decreases their quality and longevity of life. Just because people have DMD, does not mean that they don't have something to offer to the world. You can learn more about Jonah and his little brother, Emory, at www.fightdmd.com.

HD Case Study: Charles Sabine

Huntington's Disease is a degenerative neurological disorder that affects the nerve cells in the brain and causes them to break down. HD is genetic, and parents who have the disease have a 50% chance of passing on the disease to their children. Charles Sabine, a 57-year-old former journalist and producer has the disease, as well as his older brother, who is in the late stage of HD. Charles' father passed away from HD. Charles has difficulty with feeding and dressing independently, maintaining control over body movements, and cognitive deficits. Occupational therapy interventions for Charles could include energy conservation, compensatory strategies, adaptive equipment for eating, as well as postural changes to decrease his level of fatigue. People who have HD do not die directly from the disease, but from choking due to weakness in muscles used for respiration.

Before Alicia's presentation, I was not aware that this disease was hereditary and could be passed on to children. Charles did not choose to find out he had the gene for HD until he was in his 40s, which is typically a later age of onset. I don't know how I would feel if I knew someone in my family had the disease and I had a chance of getting it. On one hand, knowing would help me feel prepared on how to handle it whenever I did develop symptoms. On the other hand, not knowing would make me appreciate my life and live every day like it's my last.

Neuro Note #3: TransFatty Lives

For my third Neuro Note, I decided to watch the Netflix documentary, "TransFatty Lives". This documentary depicts what life is like for Patrick O'Brien, a 30-year-old film maker and director from New Jersey who has been diagnosed with ALS, or amyotrophic lateral sclerosis. I chose this documentary because Professor Lancaster had mentioned it in class, and I knew a few of my other classmates that had watched it and recommended it. In our Neurological Aspects of OT class, we just learned about ALS, and I thought watching this documentary would enhance my knowledge and understanding of this diagnosis.

Before I started OT school, I had no idea what ALS was. I had heard about people doing the Ice Bucket Challenge a few years ago, and my Facebook feed was blowing up with videos of people participating in the challenge. I knew that this disease was debilitating, but I didn't realize how crippling it was until I learned about it in class and watched this documentary.

Patrick's story begins when he is first diagnosed with ALS at the age of 30 in the Spring of 2005. Before his diagnosis, Patrick was a creative, out-of-the-box film maker who had a very lively, outgoing personality. There was no one else like him. His doctors gave him 2-5 years to live. On a trip he took six months ago, he first began to notice his leg trembling. Through the documentary, Patrick deals with his worsening symptoms, including weakness, trembling, and severe muscle fatigue. Eventually, Patrick loses his ability to walk, feed himself, dress himself, shower himself, and perform all the other activities of daily living that we often take for granted.

Though Patrick was diagnosed with a terminal illness, he was still able to find love. He met Laura in the Winter of 2006, and they fell in love. He jokes about still being able to have sex, despite his diagnosis. Patrick is ecstatic when Laura gives birth to their son, Sean Patrick.

As his condition worsens, the one thing that Patrick said that matters most to him is his son. It broke my heart when Patrick said he couldn't hold him, play with him, or be there with him when he got older. All he wanted was to watch his son grow up, but Laura moved to Florida, while Patrick stayed in Maryland.

In 2010, Patrick moved to a facility in Boston, Massachusetts that gives individualized care to people with ALS.

While watching this film, there were a few things Patrick said that really stood out to me. "You can’t help it, so you may as well go with it and stay positive". "When there's nothing you can do, simply surrender." That one absolutely broke my heart. And finally, “Thank God I still have my mind, that’s the only thing I have left to control”. He goes on to say that he has become a better person, and has witnessed those around him being transformed as well. He stopped focusing on the things that weren't important, and started focusing on the things that were important to him. 

It breaks my heart that this fatal disease has no cure. It has really opened my eyes to what Patrick and others living with ALS, as well as their caregivers, have to deal with on a daily basis. Things we take for granted, like eating, walking, and even playing with our children, were stripped away from Patrick. Despite his diagnosis, he still finds purpose in his life by using social media and blogging as a platform to educate people and advocate for his disease and others living with ALS. I would highly recommend this documentary to anyone who wants to increase their knowledge and understanding of ALS.

You can access the documentary at the link posted below:


O'Brien, P. (Director). (2015). TransFatty Lives [Documentary]. Retrieved from: https://www.netflix.com/search?q=transfatty.