Brain Biofeedback

Reading a Sign While tDCS Stimulating Wernicke’s

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ShireenJ (@ShireenJ)
2014-10-22, 8:59 AM
@ADDCentre -> MT @mattgallowaycbc: great sign about distracted driving. RT @BrentToderian: Clever. Spread the word.

When that tweet I MT’d came into view on my Twitter feed, it caught my attention, not for its rather obvious message, I mean who’s dumb enough to think texting and driving is a good idea, other than maybe, I guess, people who want what they want when they want it now– Anyway, where was I? Oh yeah, it caught my attention for this reason:

ShireenJ (@ShireenJ)
2014-10-22, 9:00 AM
@ADDCentre I remember practicing as a kid reading signs like that w interlaced narratives till I got good at it. Not any more! Sigh.

After I tweeted that out, I forgot all about it until the ADD Centre tweeted back and said why don’t we add that in to my session? Oh hey, I like!

ADD Centre (@ADDCentre)
2014-10-24, 9:04 AM
@ShireenJ let’s introduce it during training sessions! Are you still activating wernickes?

This week we did. My trainer set up the tDCS — the anode sponge over my Wernicke’s Area, just above and behind my left ear, the ground sponge on my right shoulder, setting it to 2mA (tiny, tiny amount of electrical current) — and I began to read the sign on my iPhone. Oh my.

That was hard.

And dizzying.

I began by trying to read the message in black type. Then after, I don’t know, three or so stuttering tries, I switched to reading the message in blue type. That was harder.

I had trouble following both message lines separately and comprehending them separately, even though I knew what the gist of the whole sign was. After a few reads of the blue message until I was able to follow it from beginning to end, I went back to the one in black. I alternated back and forth like that a few times.

Black fonts are easier to read than blue ones.

At times, my trainer would talk to me at the same time as I was reading — to add on an extra layer of distraction and to get the electrical stimulation to zip along both reading and listening brain networks. Oh my. Just recalling that makes me feel slightly nauseated.

Even though I was only trying to read the messages separately and not even attempting to read them simultaneously, I was getting too dizzy. So after about 3 or 4 minutes, I stopped. My trainer and I chatted for the rest of the 12 minutes of stimulation.

I told her that when I practiced as a kid reading alternating text like that simultaneously, the type was all in black. Harder, she noted. Yup. She was wondering where you could find other interlaced or alternating texts. Good question. I’d wondered too, but after some futile Googling, gotta admit I don’t know. I don’t know if there’s an official jargon name for intertwined text like that or not. If there is and if any reader of this post knows it or how to find interwoven text, please leave a comment letting me know. Thanks!

I will be trying this again. For me, practicing with familiar text fits in with my rehab’s advice on how to improve my reading better than with trying to find novel signs for each session. The OT at Toronto Rehabilitation Institute told me to practice reading text I already knew. When you’re working on higher cognitive functions to regrow and cement those networks, that sounds like sane advice to me for text like this as well.

Brain Biofeedback

Getting More Organized in my Speech

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I spoke to Dr. Lynda Thompson on the phone last week. I hadn’t spoken to her since March. She noticed a big change in me: I was organized. That puzzled me. You get so used to being the way you are — and especially when people keep telling you you’re articulate and neglect to tell you about the deficiencies they see or hear in you until they notice something has improved — that you don’t realize anymore how abnormal your manner of speech (or thinking) is. Also I think of organized as akin to getting things done in an organized fashion.

But she was referring to my speech.

Turns out, the up and down of my speech — the prosody — has improved (and here I thought it was all better . . . apparently not). Also the flow of my speech is smoother. I complete topics; I don’t bounce around as much; I don’t interrupt as much; I talk on a topic in a more organized way.

I thought about that. Yeah, I don’t have such a feeling of sharp impatience when talking anymore, the kind of impatience where you get tired, literally, of talking on a topic and at the same time another thought barges in, and you want to get to it NOW. And you have to fight not interrupting the other person as they’re speaking (though in early years, you couldn’t even fight that urge since interrupting in direct obedience to that NOW command seemed reasonable), yet as soon as the other person stops talking, you’ll jump to the new thought. Sometimes if your mind doesn’t blank out on the topic you were in the middle of, you’ll be cognizant of the fact that really you should finish it, and you will try.

But again: fatigue.

Fatigue empties the mind, and you need something new to keep talking and thinking. Eventually though, not even something new will counter the fatigue, and you just have to get off the phone. Bye!

The ADD Centre changed the parameters of my neurofeedback settings this week. The 16Hz has normalized. So we’re doing a regular-old protocol of enhancing 13-15 Hz, as well as reducing 20-35 Hz (a normal busy brain range unlike my previous one of 19-30). We’re sticking to reducing 2-5 Hz and as a secondary 7-10 Hz. To celebrate I read a bit of the Thompsons’s neuroanatomy book during tDCS. Heh.

This past weekend, after I spoke to Dr. Thompson, I felt an uptick in intelligence. I didn’t feel or notice anything in particular, like I was processing faster for example. It was strictly a felt experience. And I don’t know how it will manifest. I’ll have to hope if people see changes, they’ll tell me. Then I can go, ah-ha, that was what the uptick was about!


Brain Biofeedback

Reconnecting with Old Knowledge While Under tDCS

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As part of my psychology degree I studied neurophysiology and physiology, not knowing I was studying for the needs of my future self. But that was a long time ago. How much could I remember now? Even if I hadn’t been injured and had my photographic memory intact, how much could I have been able to recall? And with a brain injury poking holes in my long-term memory and making short-term and learning difficult, it seemed hopeless.

Yet with a lot of effort, I was able to briefly recall and use enough of my old neuro knowledge to write on the hypothalamus a few years ago. Still, it cost me so much in energy it’s not often I can do that. And I couldn’t retain what came out of my own head. The weirdness and irony of that! Blogging isn’t just for others; it’s also to remind me of what I know deep in the recesses of my mind.

So last week I asked my brain biofeedback trainer a question about the seizure chapter Dr. Lynda Thompson had given me to read. She suggested I bring the chapter with me to discuss today. I did.

After some wrestling between the tDCS unit and my hair preventing electrical conduction, we got the unit stimulating my Wernicke’s Area (language and integration), and I flipped to the Mechanisms section of the chapter (I think Dr. Thompson had told me to skip that part, but you know me, I like a challenge plus something about GABA had jumped out at me, and that’s what I wanted to discuss). Using the finger under the line method of reading, I read out a bit at a time, at the same time saying what I thought it meant.

I began with the anatomical part under discussion, and to my surprise I remembered the Latin terms and so was able to locate where the ventrobasal nuclei is in the thalamus. Having my trainer — just like good teachers used to do for us in school — confirming or correcting my memory and interpretations boosted my confidence. I began to feel less hesitant and more competent as I proceeded through the section explaining the SMR and polarization link between the ventrobasal nuclei and thalamic reticular nucleus. And then I had to recall the first bit of info of the section in order to connect the GABA part to the SMR part. Total mind blank. Soooo typical after brain injury when trying to learn.

So back I flipped to the start of the section; I read out the relevant sentence and talked my way into connecting the end with the beginning. It took a couple of tries, and I did remember that rephrasing a new piece of knowledge helps to encode it. I hesitate to say cement it in my head because holding on to new knowledge feels like grasping mist.

Anyway, learning neuroscience like that — talking it through and then interpreting and adding to my old knowledge with someone who knows the subject while a tDCS is stimulating activity in the language integration of my brain — felt good.

Brain Biofeedback

Talking Neurofeedback and Epilepsy During tDCS

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The TTC decided to revert to its old 10-minutes-between-trains routine. And the new “improved” numbers-for-names signage at Yonge/Bloor station discombobulated me as it always does. And so I was rather late. (Going from appointment to appointment in this city is always so much fun.) Still, I didn’t feel too anxious when I rushed into the Toronto branch of the ADD Centre, but my heart rate exposed the lie of that. On top of which, there was a new client after me who was going to be on time, and so I had to choose what part of therapy to skip. Easy! HRV. Naturally, the tDCS refused to connect, making the whole late thing worse. And my right shoulder and shirt, and jacket around the right collar, shoulder, and sleeve got rather soaked. So did my hair over my left ear but that wasn’t so bad. I told my trainer we need a blow dryer for times like this!

(Large sponge on right shoulder is the ground. Smaller sponge at Wernicke’s Area over left ear and behind a bit is the active part that stimulates brain activity underneath it. Both need to be wet to conduct the weak 2mAmp current through my skull into my brain. For some reason, the device wouldn’t work this week without the sponges being thoroughly soaked, dripping)

In the end, the client was late, and there would’ve been time to do it all anyway. But five minutes of deep breathing is not my fave thing to do, so all good. My breathing rate was excellent during all the training screens as it is pretty much automatic. See brain biofeedback screen, begin to breathe rhythmically and deeply.

Dr. Lynda Thompson had given me a copy of her chapter on neurofeedback for epilepsy, and I’d read it last week at a quiet café because I would do anything not to be at home. Straining the brain on anatomy and neuroscience while drinking coffee seemed like the ideal way to stay out. Today, during tDCS, I talked to my trainer about the chapter and about one detail about GABA in particular that jumped out at me. She was unable to answer my question on that, but I learnt an awful lot about all sorts of other things on biofeedback training, about how one is certified, and who at the ADD Centre is (all and only the senior trainers are because you need work experience and to be supervised, never mind all the reading, including Dr.Thompson’s book, before you can sit the accreditation exam). I’ll need to remember to bring my copy next week so we can go over all the scientific details that my memory was no match for.

Brain Biofeedback

Wernicke’s Area Connects You in Conversation: I’m Listening

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Listening is a skill, an art, can be learned or unlearned due to abuse; but it’s also something your brain is wired to do — unless you have a brain injury.

In the last few days, I began to wonder if my listening skills were improving. I decided to test them out during brain biofeedback this week, specifically during the tDCS portion.

I had talked to Dr. Lynda Thompson and had (re-)learnt that Wernicke’s Area is involved in integration of language, in understanding what you read and hear so that you know what you want to say and can link that to what you heard. If you can hear and understand better, then it’s easier to know what you want to say and more obvious to you how to link your part of the conversation to theirs. (The expression of that is done by Broca’s Area in the frontal lobes, so that has to work too to actually speak.)

In addition, I have a great deal of trouble understanding the other in a conversation when they cover up their face, especially their mouth, because they’re hiding the non-verbal part of language. I must rely on the gestural, prosody, and and facial expressions parts of language much more than pre-brain injury because my ability to understand spoken words is so lousy. I also unconsciously lip read, which helps me focus and so sink into the conversation better.

By talking during the tDCS, I’m using conversational networks, the ones involved in spoken communication, and so the tDCS stimulates them. And that’s probably why the first time I conversed with my trainer during tDCS (instead of reading during it), I didn’t have to “warm up” later that day to a group conversation. That usually entails listening for awhile then pulling hard out of my blank mind what I want say. For once though, on that day, I was able to plunge right into the conversation — I heard and generated related thoughts in real time — rather like a normal person.

So I thought if Wernicke’s Area is about hearing, then if I tried to actively listen, maybe that would help repair my listening skills.

I decided I needed to face my trainer fully during our conversation to pick up on all that non-verbal language. I didn’t expect the rather powerful connection that created and found it a bit overwhelming. Also, at first, it was effort-full to say the least. The problem I finally realized was that I was putting my focus on listening itself instead of on the content of what my trainer was saying. Focussing on content instead of on the act of listening makes listening easier. But that means you also have to have some modicum of curiosity — no curiosity equals lots and lots of effort to stay connected. Little curiosity and bad focus post-brain injury means listening ability sucks majorly. So you need to have your attention and curiosity treated to some extent before trying to listen. Mine have been.

Anyway, I relaxed into the conversation, remembering to listen more than talk, trying to also recall my old listening skills which included relating to what the other is saying. That felt effort-full too! But I guess it’s like riding a bike again. If you focus too much on the act of riding, you’ll fall off. When you focus on where you want to go, you’re a bit wobbly at first, but eventually muscle memory kicks in and after a little practice (or maybe a lot with respect to cognitive skills) it comes back.