ADULT GUIDE

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THE SECRET LIFE OF THE BRAIN is a co-production of David Grubin Productions, Inc., and Thirteen/WNET New York in association with Docstar.

Major funding for THE SECRET LIFE Corporate funding is provided by Pfizer Inc Funding is also provided by Park Foundation, PBS, the OF THE BRAIN is provided by the and The Medtronic Foundation on behalf Corporation for Public Broadcasting, The Dana Foundation, National Science Foundation. of Medtronic, Inc. and The Dana Alliance for Brain Initiatives.

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WELCOME TO THE SECRET LIFE OF THE BRAIN

IN THE PAST 12 YEARS, the field of Because of these advances, new neuroscience has advanced more than worlds have opened in medicine and at any time in history. In part, this is due to education. THE SECRET LIFE OF THE technological breakthroughs in viewing the brain — BRAIN, a five-part public television among them, Magnetic Resonance Imaging (MRI), series, co-produced by David Grubin Computer Assisted Tomography (CAT scans), and Productions Inc., and Thirteen/WNET Positron Emission Tomography (PET scans). There New York, will help to expand under- also have been new insights into how neurons and standing of the brain’s overarching role chemicals create messaging systems more complex in our lives, from infancy to old age. and enduring than any computer yet invented. (continued) WELCOME TO THE SECRET LIFE OF THE BRAIN (continued)

These materials are designed to further development cards, along with the essay, that goal. You can use them along with the “Nature, Nurture and the television series in adult education semi- Individual Child.” nars. They will find eager audiences If you want to study diseases of aging, among parents, adults with aging parents, you may wish to use the program cards and professionals in related fields. Their for Program Five, “The Aging Brain: modular format utilizes individual cards Through Many Lives,” as well as the that can be combined in a variety of ways, essay cards, “Minding Your Memory” and depending on the topics you wish to “The Remarkable Plasticity of the Brain.” explore. You can use them to learn about a A companion book to the series also has range of fascinating brain-related issues, been written by neuropsychiatrist Richard among them early childhood development, Restak, M.D. learning problems, cognitive and emotional growth in adolescence, addiction, mood The Table of Contents offers you a disorders, stroke, degenerative diseases variety of topics to choose from, all of of the brain, caregiving and the develop- them written by experts in these fields. ment and enhancement of memory and The cards include background information, wisdom in aging. profiles, topics for discussion, and group and individual activities that can be conducted in your workshop sessions For Facilitators: or at home. Using These Materials We suggest that you photocopy the We suggest that you preview the appropriate cards — as well as the television programs and review this Resources, Glossary and illustration of guide. Then select segments of the the brain on the back cover of this programs and use them with the package — the week before your appropriate topic cards. workshop session and distribute them to participants. The cards have been organized in sets, one set for each of the five programs. Web Site Additional cards address specific issues Thirteen/WNET New York has also devel- raised by the programs: the brain’s oped a Web site. Go to www.pbs.org/brain, plasticity, the debate over nature vs. where you will find interactive and educa- nurture, new understandings of addiction tional features such as a 3-D Brain, Mind and cravings, hope on the horizon for Illustrations, video clips, links, publicity treating memory disorders from “senior tools and information on the national out- moments” to Alzheimer’s disease, and reach campaign. This Guide, as well as how-to cards on caregiving and on run- one for teens, appears on the site in PDF ning a brain-related workshop. We have format, and may be freely downloaded. also added Resources and a Glossary. We hope that THE SECRET LIFE OF THE Mix the cards as you like. If you are BRAIN and these education materials offer giving a workshop to parents, for example, you valuable information and new worlds you may wish to use the early childhood to explore. ADULT GUIDE www.pbs.org/brain

This Guide contains 21 double-sided cards, a set of two for each of the five programs, six essay cards, and cards for a workshop, resources and a glossary. These cards may be copied and used as needed.

TABLE OF CONTENTS

Introduction Program Four by David Grubin, Executive Producer The Adult Brain: To Think By Feeling A What’s Going On: Program One Adult Brain Development The Baby’s Brain: Wider Than the Sky B Lauren Slater: A Profile of Healing from Depression A What’s Going On: Fetal and Infant Development C Brain Health in Adulthood B Elizabeth Traphagen: D Discussion Questions and Activities Portrait of a Cuddled Preemie Program Five C Brain Health in the First Years The Aging Brain: Through Many Lives D Discussion Questions and Activities A What’s Going On: Program Two Brain Development in Aging The Child’s Brain: Syllable From Sound B Kent Miller: A Profile of Stroke Recovery A What’s Going On: C Brain Health in the Later Years Childhood Development D Discussion Questions and Activities B Russell Train: A Portrait of Childhood Dyslexia Essays C Brain Health in Childhood 1. The Remarkable Plasticity D Discussion Questions and Activities of the Brain 2. Nature, Nurture and the Program Three Individual Child The Teenage Brain: A World of Their Own A What’s Going On: 3. Addictions and Cravings Adolescent Development 4. Minding Your Memory B Courtney Hale Cook: 5. Caregivers’ Needs Across a A Portrait of Adolescent Schizophrenia Cognitive Lifetime C Brain Health in Adolescence D Discussion Questions and Activities Resources Glossary Workshop How to Organize a Workshop ADULT GUIDE www.pbs.org/brain

ACKNOWLEDGMENTS

This guide was produced by Sandra Ackerman, a former managing editor of American Scientist, is the Thirteen/WNET New York author of Discovering the Brain. (Washington, D.C.: Institute of Medicine, National Academy of Sciences, National Academy Press, 1990.) Mari Cossaboom is the Director of Outreach for Thirteen/WNET New York. David Grubin, winner of eight Emmy Awards, is the Executive Producer Educational Resources Center Vice President & Director, Education: Sarah Frank of the PBS series, THE SECRET LIFE OF THE BRAIN. Elizabeth Lasley, a science writer, is the co-author of The End of Stress EDUCATIONAL PUBLISHING DEPARTMENT As We Know It: The Connections Between Stress, Health and the Brain. Publisher: Robert A. Miller (Washington, D.C.: The Dana Press and Joseph Henry Press, 2002.) Editor: Marilyn Webb Richard Restak, M.D., is the author of The Secret Life of the Brain, the Associate Editor: Christina L. Draper Designer: B.T. Whitehill companion book to the series. (Washington, D.C.: The Dana Press and Assistant Editor: Jennifer Toro Joseph Henry Press, 2001.) Research: Cameron Cole, Jesse Dillon Marilyn Webb, a former editor-in-chief of Psychology Today, is the author Writers of The Good Death: The New American Search to Reshape the End of Sandra Ackerman Life. (New York: Bantam Books, 1999.) Mari Cossaboom Elizabeth Lasley Richard Restak, M.D. PROGRAM SCHEDULING Marilyn Webb Programs are scheduled to be broadcast on the Advisors dates indicated below. Broadcast times, however, may vary Catherine Didion, Association for Women in Science slightly from area to area. Please check Bernice Grafstein, Ph.D., Society for Neuroscience your local listings. J. Anthony Movshon, Ph.D., New York University Anna Perez-Pelaez, Association of Science-Technology Centers PROGRAM BROADCAST DATES Richard Restak, M.D. Tom Smart, Boys and Girls Clubs of America The Baby’s Brain: Wider Than the Sky Dr. Barbara S. Spector, Association for Education of Teachers of Science January 22, 2002 Maria Sosa, American Association for the Advancement of Science Molly Weinburgh, Association for the Education of Teachers in Science The Child’s Brain: Syllable From Sound January 22, 2002 For THE SECRET LIFE OF THE BRAIN series The Teenage Brain: A World of Their Own Executive Producer: David Grubin January 29, 2002 Producers: David Grubin, Ed Gray, Tom Jennings, The Adult Brain: To Think by Feeling Michael Penland, Amanda Pollack February 5, 2002 Co-producers: Sarah Colt, Annie Wong The Aging Brain: Through Many Lives Associate Producer: Jenny Carchman February 12, 2002 For Thirteen Executive in Charge: William R. Grant Executive Producer: Beth Hoppe Videotaping Rights

THE SECRET LIFE OF THE BRAIN is a co-production of You have the right to tape the programs and play David Grubin Productions, Inc., and Thirteen/WNET New York them for instructional purposes for one year after in association with Docstar. the original broadcast.

Major funding for THE SECRET LIFE OF THE BRAIN is provided by the Video Ordering Information National Science Foundation. THE SECRET LIFE OF THE BRAIN is available Corporate funding is provided by Pfizer Inc and The Medtronic Foundation from PBS Video by calling on behalf of Medtronic, Inc. Funding is also provided by Park Foundation, 1.800.PLAY.PBS. PBS, the Corporation for Public Broadcasting, The Dana Foundation, and The Dana Alliance for Brain Initiatives.

Copyright © 2002 Educational Broadcasting Corporation All Rights Reserved www.thirteen.org Introduction www.pbs.org/brain The Secret Life of the Brain THE SECRET LIFE OF THE BRAIN by David Grubin Executive Producer, THE SECRET LIFE OF THE BRAIN DAVID GRUBIN

MORE HAS BEEN LEARNED ing a period when we have to learn as quickly as about the brain in the last ten years we can in order to equip ourselves to survive. than in the previous one hundred. But contrary to what was once generally With the help of new imaging technologies, sci- believed, the brain continues to evolve and entists can penetrate the brain’s tough protec- change over the course of our lifetimes. tive shell to see the living brain inside. Advances in molecular biology enable scientists to manipu- AND SO, the brain and its capacity for change late genes within living cells and map the cre- became the central theme of our series, and ation of neurons. with this theme came New dyes and a new title, THE microscopes offer SECRET LIFE OF THE surreal, beautiful BRAIN, with an views of brain emphasis on “life.” cells in action, We organized the growing connec- series into five pro- tions and firing grams — the brain of electrochemical the baby, the child, signals. Our goal the teenager, the adult in producing THE and the brain in old SECRET LIFE OF age. Each program is THE BRAIN was framed by a question: to make this revo- Ⅵ How does the lution accessible brain grow from a and relevant to a sperm and egg into wide audience. the most complex thing in the universe? THE CENTRAL Ⅵ How does a child CONCEPT, PHOTODISC acquire language? the theme that we Ⅵ Is there a connec- would pursue in tion between brain every program, emerged slowly. When we development during adolescence, and the began research, exploring brain functions such onset of schizophrenia and the prevalence of as memory, vision, and cognition, we were call- teenage addiction? ing the series SECRETS OF THE BRAIN. But we Ⅵ soon learned that many neuroscientists were How does an adult find the balance between looking at the brain from the point of view of its reason and emotion? development. When we are young, our brains Ⅵ Why do some people remain energetic and are at their most plastic — a real advantage dur- vital in old age, while others do not? (continued) Introduction (continued) www.pbs.org/brain

THE SECRET LIFE OF THE BRAIN monies drift sweetly over the cribs of thousands explores the answers to these questions by of infants, with no real evidence that music does telling stories about the brain’s remarkable life anything for the baby other than to soothe a journey. In our first program we meet a baby well-meaning parent’s anxiety. who was born with a cataract in her eye. In order to develop normally, she needs to have the lens THE BEST ADVICE scientists have for parents clouding her vision removed as soon as possible. is just to relax. The first years of life are only the The visual areas of the brain require the stimula- beginning of a slow process of growth that tion of electrical pulses generated by light strik- fathers and mothers can encourage by simply ing the retina. If the brain cells responsible for spending time enjoying their children. What vision do not form the proper connections early once used to be referred to as “critical periods” on, they never will. Without an of development scientists now call “sen- operation in the first few sitive periods.” We humans months of her life, this could hardly have survived as baby risks blindness in long as we have if our the clouded eye, species were solely even if she has the dependent upon spe- cataract removed cific experiences at later, regardless specific times. of the subse- quent health of As extreme as the the eye itself. cataract story is, the early years of The cataract development are story expresses a like building a foun- large idea: our dation for a house; brains and the world without the founda- IN A R B E tion, the house cannot around us are involved TH F O FE LI T stand, but construction in a delicate duet; our RE EC E S brains change and adapt in TH doesn’t stop there. During response to the environment act- those first years, the infant brain ing upon our genetic endowment. But develop- develops very quickly. Language, cognition, per- ment doesn’t follow a rigid or pre-set course: ception, and the major behavioral systems are The brain consists of many different systems, being put into place. But it is the fine-tuning of each developing at its own pace and in its own these systems over a lifetime that ultimately way, evolving gradually throughout our lives. accounts for who we are.

OF COURSE, THIS IS GOOD NEWS for Now that THE SECRET LIFE OF THE BRAIN is parents. Eager to encourage the intellectual and finished, what strikes me most of all is not only emotional development of our children, some how much scientists have discovered in just the parents worry obsessively about providing last decade, but also how much there still is to “developmentally correct stimulation” and know. Pondering the immensity and power of earnestly turn to science for guidance. Because this small, crinkled organ weighing less than of one well-publicized but misconstrued study three pounds, poet Emily Dickinson tells us: suggesting the beneficial effects of Mozart on “The Brain is wider than the sky … The Brain is the brain, for example, eighteenth century har- just the weight of God.”

Adapted from the Introduction to The Secret Life of the Brain by Richard Restak, M.D. Program One A www.pbs.org/brain The Baby’s Brain: Wider Than the Sky WHAT’S GOING ON PROGRAM DESCRIPTION Fetal and Infant Development As a human grows from by Elizabeth Lasley a fetus to a toddler, how does its brain develop? A baby’s brain starts forming a limited way. Some Program One uses two soon after conception with a few researchers think the cells at the tip of the embryo. By harsh lights, loud nois- case studies to explore the seventh month of gestation es, and bustle of a this question and to there are 100 billion cerebral nerve neonatal unit may con- examine the ways in cells organized into more than 40 tribute to learning diffi- which brain cells are systems to direct language, move- culties that preemies influenced by genetic ment, seeing and hearing. may have later on (see and environmental ELIZABETH TRAPHAGEN’s factors. By applying Eighteen weeks: story). First flutterings of movement. the latest brain research, scientists help the babies ⅷ The synapses that allow in these case studies movement begin form- develop normally. ing as early as five weeks into gestation. By the eighteenth week, the mother-to-be can feel the fetus in motion. PHOTODISC ⅷ The fetus can move its One year: limbs and fingers, hic- Babies begin to walk and talk. cup, stretch, yawn, ⅷ Babies’ brains increase in size and swallow, and suck its complexity, helping them develop thumb by the end of the greater control over the objects first trimester. Although and people in their environment. these are reflex actions, they set Newborns: ⅷ Myelin, a fatty coating that speeds the neural stage for purposeful Babies recognize their mothers’ nerve activity, is forming along the movement after birth. faces and prefer the human face to nerve cells. ⅷ By the second trimester the fetus any other sight. ⅷ The frontal cortex of the brain — can move its feet against the walls ⅷ Vision is their major source of the area associated with the ability of the uterus in a walking pattern information. At about a month, to regulate and express emotion, and touch its hands to its face, babies learn to stare at something. and to think and plan — is show- body and umbilical cord. ⅷ By three months, they can watch ing increasing activity. their hands and follow a moving ⅷ Motor areas of the brain develop Third trimester: object. in a head-to-toe fashion. First Responsive movement. ⅷ Gender differences become appar- babies learn to suckle, then to turn ⅷ All the sensory pathways are ent. Girls respond more to social their heads and smile, then to developing. The fetus can respond stimuli — voices and faces — and reach with their hands, and finally to its mother’s voice, to loud they’re more prone to sobbing to use their legs to crawl and sounds and to bright lights. when another infant cries. Boys walk. ⅷ By the last two weeks of gestation are fussier; they startle more easi- ⅷ Conversation between babies and it can react — through the amniot- ly and are more irritable. Emotional others shapes the language areas ic fluid — to the sweet and bitter centers in the brain develop soon- of the brain. tastes of the food its mother eats. er in girls, while boys show more ⅷ By about eight to ten months, ⅷ activity in areas associated with The cerebral cortex, where these babies show signs of understand- spatial ability and mathematics. stimuli come together into mean- ing words. ingful images, can function only in Program One B www.pbs.org/brain The Baby’s Brain: Wider Than the Sky ELIZABETH TRAPHAGEN: Portrait of a Cuddled Preemie by Marilyn Webb

The contractions began on Memorial Day while Kathy turned her little head when Kathy spoke, curled and Traphagen, her husband Terry and their six-year-old uncurled her tiny fingers on Kathy’s hospital gown, and daughter, Allison, were eating hamburgers at a neighbor- grew calm as she felt Kathy’s heart beat, her breathing, hood picnic. Kathy was only 25 weeks pregnant. Her her touch. And soon, when her little body was able, doctor ordered her hospitalized on complete bed rest. Elizabeth’s digestive system began to “rev up” with For her, there was mainly fear. miniature bottles of breast milk.

Kathy had already lost three babies to miscar- riages. “We’d been going through this for two and a half years,” Terry says. “We’d start, you know, and then, the.... disappointment. Start. And disappointment.” He and Kathy dreaded losing another.

But Elizabeth, born three weeks later, became a “preemie survival miracle.” Recent medical advances in neonatal care have given the possibility of life to infants as precarious as 24 weeks old. Elizabeth weighed three pounds and was fourteen inches long — all red, with translucent skin, and unnaturally long fingers and toes.

Just two or three decades ago, babies this young and this small generally died. And yet, while THE SECRET LIFE OF THE BRAIN they are now beating those grim odds, preemies often have learning problems that can plague them for years. A premature baby’s brain cannot easily coordinate such While immature lungs may no longer be a problem, the basic functions as eating, sleeping and breathing. It has immature brain still is. neither the ability to focus or sort the important from non-important stimuli of a full term baby, nor the essen- “We wanted to give Elizabeth a chance to be equal tial myelin coating that allows brain messages to speed to her peers,” Kathy says. So the Traphagens enrolled along. Preemies continue to be hyperactive throughout her in an experimental program — run by Dr. Heidelise life, unless there is an intervention — like this — to nor- Als, at Children’s Hospital in Boston — designed to malize brain function early on. A little before what reduce stimuli that might overwhelm her still would have been her due date, the Traphagens finally underdeveloped brain. brought Elizabeth home.

Elizabeth spent the nearly three months, until she would A year after Elizabeth’s birth, although she would have have been born, living in an environment that simulated been only nine months old had she been a full-term Kathy’s womb. Doctors turned the lights down so she baby, Kathy happily notes,“She is performing as a one- could open her eyes, even if she could only barely see. year-old. She’s starting to take steps and say ‘Daddy.’” They kept noise at a minimum. They helped her to curl her legs, to pull her arms into a fetal position, and to Elizabeth still sees a physical therapist. Dr. Als tests her bring her fingers to her mouth — as she would have in regularly against her one-year-old peers. The good news: the womb — because all that seemed to soothe her. She is performing in the accelerated range. “Because she was so early, I think we’ve acquired some perspec- And Kathy and Terry held her daily, putting her on their tive on that ‘social pressure for children to achieve.’ The chests, skin to skin, cuddling her as if she were a baby important things are her being happy and healthy,” kangaroo. Elizabeth seemed to recognize Kathy. She Kathy says. “The rest will all come.” Program One C www.pbs.org/brain The Baby’s Brain: Wider Than the Sky Brain Health in the First Years by Elizabeth Lasley Don’t go overboard. The best way to stimulate your the fetus. Some research shows that if mothers are unborn baby is with your own voice, by talking, reading and severely stressed during pregnancy, their babies can singing. There are no gimmicks that will increase a child’s be over-reactive. Reaction to stress is individual, though, intelligence while still in the womb. In fact, some neonatal and pregnancy hormones can also buffer mother and specialists believe that over-stimulation during gestation child against the outside world. Don’t worry if you have can send brain development off on a wrong track. to keep working. Just try to find ways to keep your stress levels low. Eat wisely. Good nutrition during pregnancy is important for healthy brain development. Eat a balanced diet contain- Follow your instincts. Despite the plethora of smart toys ing adequate protein, complex carbohydrates, and 300 calo- on the market, the best type of stimulation for your baby is ries over your usual intake. Supplementing your diet with just the type that mothers and adults love to give: cuddling, the B vitamin, folic acid, has been shown to reduce the risk singing, rocking, touching. Research shows that a moth- of neural tube defects (see Hot Fact below). er’s singsong, up-and-down “baby talk” helps the child learn language. Swear off alcohol. Children born to alcoholic mothers often show a pattern of deformities, known as fetal alcohol Nutrition after birth. When it comes to feeding a new- syndrome, including low birth weight, slow growth, brain born, experts agree that “breast is best.” But high-quality and skull abnormalities, and learning and behavioral difficul- formulas are also a good choice, and cuddling while bottle- ties. This condition is perhaps the easiest defect to pre- feeding provides the same level of physical comfort. After vent: Don’t drink during pregnancy. No “safe” limits have weaning, make sure that your baby gets an adequate been determined. amount of fat in his diet! Babies need fat for their brains to develop properly since it aids the production of myelin, Avoid stress, or try to manage it. The brain manages the sheath that surrounds nerve cells and helps them to stress through hormonal responses that ultimately reach transmit signals quickly.

Hot Fact: Vitamin B Helps Prevent Brain Defects

By taking supplements of the the brain fails to develop; affected women even know they are preg- common B vitamin, folic acid, babies are either stillborn or die nant), and because half of all preg- women can greatly reduce their shortly after birth. nancies are unplanned, all women chances of having a baby with a Studies throughout the 1980s of childbearing age should take brain abnormality called a neural and 1990s have shown that folic folic acid whether they are trying tube defect, which currently acid can prevent up to 70 percent to conceive or not. This amount affects about 4,000 pregnancies a of neural tube defects, though how can be found in vitamin supple- year in the United States. it works is still unclear. Folic acid ments or in some very highly forti- This defect occurs when the plays a key role in chemical reac- fied breakfast cereals (check the neural tube, a structure in the tions throughout the body including labels). developing embryo that becomes the manufacture of DNA, the As of 1998, all enriched grain the brain and spinal cord, does not genetic material from which all products in the U.S. have been for- close properly. In the most com- cells and tissues are made. tified with 140 micrograms of folic mon condition, spina bifida, the The U.S. Public Health acid per 100 grams of grain. A 2001 spinal cord and back bones are Service recommends that women study published in the Journal of affected; results can include paral- of childbearing age take 400 micro- the American Medical Association ysis, lack of bowel and bladder grams of folic acid daily. Because (JAMA) shows a 19 percent control and learning disabilities. In the neural tube closes 24-28 days decline in neural tube defects after a condition called anencephaly, after conception (before most fortification began. Program One D www.pbs.org/brain The Baby’s Brain: Wider Than the Sky

DISCUSSION QUESTIONS

1. A newborn baby is bombarded with sights, sounds, emerges some time after six months, when the prefrontal smells and sensations; yet the cortex — which has to make cortex has begun to develop. How about the first signs of sense of all this information — has only barely begun to stranger anxiety — when the baby noticeably shows prefer- function. Before two to four months of age, babies can’t ence for parents and other familiar folks? This is when true even detach their gaze at will. Can you think of times when attachment begins, and it means that the baby’s frontal lobes nothing you did would get a baby to stop crying? Is it possi- are developing as well. ble that the swing, the music, the jiggling, were actually over-stimulating the baby even more? On the other hand, 3. Although there are slight differences in brain develop- babies also crave novelty. What’s an appropriate level of ment between baby boys and girls, cues from the family envi- stimulation, and how does your baby tell you, “Enough ronment that influence gender differences can’t be ruled out already?” even for the most “enlightened” and egalitarian parents. What signals do you give, or plan to give, your children? 2. In babies, memory equals recognition. What early forms Does Daddy play more roughly with the boys than with the of recognition have you noticed in your child? Have you seen girls? Does each of you spend more time with a child of the any reactions to music that you played or sang while preg- same sex? Have you noticed any differences in memory or nant? When did your baby first begin looking for dropped in emotional behavior among your children, even in the first toys? This is a sign of object permanence — the baby’s year? Are the boys more fussy and more prone to anger? awareness that something out of sight still exists — which Do the girls hit their “memory milestones” sooner?

ACTIVITIES

While there is nothing as meaningful to a baby as a par- new plaything for the day, rewarding her natural curiosity ent’s love, attention and warmth, the following activities and encouraging her to keep exploring. This is how she may enhance brain development, stimulating the child’s learns. senses to form and strengthen neural pathways in the audi- tory and visual cortexes. 3. Six to twelve months: A baby is industriously exploring the larger world. 1. One-and-a-half to three months: A baby is learn- a. Give him a cabinet he is allowed to open, one filled with ing to smile. To help him practice focusing, play tracking plastic kitchen food containers, pots and pans. games. Move your head slowly from side to side. At first he b. Place several different containers (for example, a shoe- may be able to follow only large objects moving slowly box, basket, plastic-ware or cardboard milk carton) and through a limited range, but soon he will be tracking even small, speedy movements. He uses his vision (and hearing several choices of things that can rattle inside a and other senses) to form memorized images. These images container (blocks, jar lids, tennis balls) on the floor. Help create new neural pathways in the brain, which become the him to put these together as noisemakers. As he shakes foundation for future memory and learning. Recommended: his creation, describe in words the sound he’s hearing, An unbreakable mirror in the crib and mobiles with highly say “brushing,“ ”jingling,” “shuffling.” Then help him contrasting colors and patterns. transfer the contents into a container made of some other material, so he can hear the difference. 2. Nine to fourteen months: A baby is learning to c. Play games such as peek-a-boo, hide and seek, or dra- explore. Find an empty container with a lid that she can matic play with animal figures leaving and returning. easily open (cigar box, egg carton) and put a safe house- These focus on the concept of object permanence, rein- hold item or toy inside. She will enjoy opening the lid to see forcing the idea that objects and people continue to what is there. Change the item daily and let her discover the exist even when we can’t see them. Program Two A www.pbs.org/brain The Child’s Brain: Syllable From Sound WHAT’S GOING ON PROGRAM DESCRIPTION Childhood Development Program Two of by Sandra Ackerman THE SECRET LIFE OF Dr. Benjamin Spock, the Two to three years old: THE BRAIN explores world-famous pediatrician, once Children display independ- how experience shapes called a child’s development “the ence and take a more active the remarkably plastic most ordinary and extraordinary on role in everyday tasks. brains of children earth.” Although it has occurred bil- ⅷ Trillions of synapses are lions of times before, no two brains as they encounter now produced as the brain develop in exactly the same way. language. First they launches a child into two learn to speak and Twelve to eighteen months: vital projects — to find his Toddlers begin to develop memo- place in the world and understand speech ry. They love repetition. to become competent at and then, when they daily life. are slightly older, they ⅷ By 12 months, a key memory area has tackle the complex matured enough so skill of reading. that toddlers can imi- tate — and likely recall — events that occurred weeks, even months earlier. ⅷ As she gains experience, the earli- ⅷ Toddlers never seem to © RENZO MANCINI/ THE IMAGE BANK est circuits may be modified, tire of hearing the reversed, or even overlain by new same story or throwing ones. Nevertheless, the original a ball. Repetition brain patterns receive enough use strengthens neural con- to keep them ready to shape reac- nections, helping chil- tions to challenges or circum- dren reinforce their skills, teaching ⅷ The brain’s main job in childhood is stances that may arise even them to pay attention to what is to sort out which synapses to decades later. new and to process more complex keep and which to discard. information. Six to twelve years old: ⅷ Synapses that are used often ⅷ The urge toward independence As their synapses grow stronger, grow stronger, while those little the neural pathways become from parents is joined by an used become candidates for elimi- increasing need to be like increasingly well trodden so they nation. expend less effort with each one’s peers. ⅷ Because the child’s own experi- attempt. ⅷ ences help determine which The wish to be like “everyone Eighteen to twenty-four months: synapses will be strengthened or else” represents an important I, Me, Mine. discarded, every brain is a unique milestone in brain development. ⅷ It is preparing children for a life- ⅷ The child develops a sense of self product. time of groups — family, play- and, sometimes, selfishness. Three to six years old: mates, schoolmates, co-workers, ⅷ Children begin to sketch patterns Self-control comes with time as neighbors — by tuning certain for future adult behavior, including the frontal lobes mature. Before neurons to patterns of speech, responsibility, self-respect, atti- this happens, a toddler can’t wait appearance, and general attitude. tudes about work, even what to for something he wants and may The human brain is keyed to rec- expect in a mate. take it from another child. ognize emotions on the human ⅷ Toddlers are just beginning to learn ⅷ These patterns — synapses con- face, which is the foundation for the concept of sharing. necting specific neurons — come such adult skills as tact and coop- directly from what a child sees eration. around her. Program Two B www.pbs.org/brain The Child’s Brain: Syllable From Sound

RUSSELL TRAIN: A Portrait of Childhood Dyslexia by Marilyn Webb

Eight-year-old Russell Train is a beautiful child: tow-headed, University Hospital. “For example, in the word ‘cat,’ the with huge blue eyes and an engagingly impish smile. He sounds are ‘ca,’ ‘ah,’ ‘t’ and we just blend them all together. would prefer to spend his summer watching TV and playing When we grow up speaking, we just say them as one Nintendo. Instead, he is sitting at a table with a reading spe- sound, but when we have to map that sound into print, cialist, moving tiny colored blocks into small rows to build there are actually three sounds that make up the word words. The blocks represent what the mouth does with let- ‘cat.’” ter-sounds — such as “lip-popper” for the letters ‘B’ or ‘P,’ or “tongue-toucher,” for ‘L.’ Russell is about to go into third Reading requires the brain to coordinate high-level process- grade but he is having trouble reading. es. First, it must recognize visual shapes as meaningful let- ters. Then, it must assign sounds, then meaning, to these letters; finally, it must make sense of the combined let- ters as a word. All the while, it must keep these sound-letters mentally “on-line” long enough to decode a full sentence.

Children with dyslexia like Russell’s are otherwise quite smart, but they have a hard time joining the letter-sounds. They also have trouble holding dif- ferent sounds in their short-term memories long enough to put them together as words.

At Lindemood-Bell, reading is broken into its components. Each of the small, colored blocks that Russell moves on the table represents a dif- ferent sound-feel in his mouth, giving each letter a specific sound, look and tactile feel. Those © MARJORY HARDY TRAIN sounds, he then learns, represent letters. By arrang- ing them, he can build words by recognizing and connect- “I have this thing in my brain that’s called dyslexia,” Russell ing the physically separate sound-blocks. later explains, “It means... I don’t know... something in the brain. I don’t really know much about it.” What Russell does By the program’s end, Russell saw that his reading and know is that reading was easy when he first started, writing were improving. At first he resisted going, throw- because the words were short and simple. But when they ing tantrums at home and dreading that “it’d be really bor- started getting bigger, figuring them out became difficult. ing and other things,” he says. “Now it’s not really boring. Once I got the hang of it, it was kind of fun and it was After he was diagnosed, Russell’s parents — Bowdoin and pretty helpful.” Marjory Train — enrolled him in a program called Lindemood- Bell, a center near Washington, D.C. Dyslexia can refer to a Testing showed that his comprehension had improved as number of different processing disturbances in the brain, but well. Dr. Eden predicts that brain scans will show increased specialists said Russell’s problem was auditory. activity in crucial areas of his brain, that his brain will actually be altered with this training. “Russell’s a better reader,” Dr. “Many children who have dyslexia really never understand Eden says, but the true test came in the fall. “He still has a the concept that there are several sounds in words,” tutor,” Marjory Train says, “but the program gave him the explains Guinevere Eden, a neurologist at Georgetown push he needed to read in the third grade.” Program Two C www.pbs.org/brain The Child’s Brain: Syllable From Sound Brain Health in Childhood by Sandra Ackerman

Possible Snags in Brain nosed with ADHD, not everyone Development: agrees on a medical basis for the The vast majority of children are diagnosis. Some experts view intellectually curious and emo- ADHD as a behavioral disorder. tionally resilient, but the course Other experts use medical imag- of development does not always ing to pinpoint three sites run smoothly. Books and charts where ADHD brains differ from that give overly detailed time- the norm. Another research lines for a typical child’s behavior team recently identified a particu- can cause needless alarm in par- lar gene in which a minute variation ents. Healthy, bright children each © ZIGY KALUZNY/ STONE may be linked to the disorder. While have their own paces of development it is controversial, the best-known treat- and most achieve the necessary goals in due ment for ADHD today is the anti-hyperactivity time. Some problems, however, can interfere and drug methylpheniade (sold as Ritalin®). More effec- may need professional attention. tive therapies with fewer side effects will likely become available as more is known about the biolog- Learning disorders: ical and psychological factors of this disorder. Dyslexia and attention deficit/hyperactivity disorders (ADHD) Mood disorders. ● Dyslexia refers to, among other things, difficulty in Depression and anxiety are serious brain illnesses matching printed letters and words with the sounds that can persist for months or years. Until recently, of spoken language. At present, one of the most they often went unnoticed in the young. If left effective treatments are programs — like the one untreated they can interfere with crucial periods of Russell Train is in — that teach children to slow brain development by draining a child’s energy, down and focus on each sound in a word and then scrambling the sustained attention that is so impor- link the sound with its constituent letters. tant during the school years, and blocking out both Meanwhile, researchers continue to work on new small and large pleasures in life. Nowadays most approaches. healthcare professionals are trained to recognize early warning signs, to help worried parents find informa- ● ADHD has the dubious honor of being a disorder tion, and to discuss possible therapies. Mood disor- whose very existence is still under debate. Although ders respond well to treatment. about five percent of schoolchildren have been diag-

Hot Fact: Empathy is Partly Built-In/Partly Taught

The simple expression “I cuitry of the brain. It paves the way when they say, “Remember how know how you feel” represents a for the kinds of social grouping you felt a little while ago when Ben remarkable achievement. A child that helped shape human evolution wouldn’t give up the puzzle you must come to realize not only that and still characterizes human wanted? Well, when you grabbed she is a person, but also that there behavior today. Also, the ability to the truck from Jane, you made her are other people in the world, and acknowledge and give expression feel sad and angry too.” After — the real breakthrough — that to another person’s feelings is these early lessons, children grow other people can have the same probably uniquely human. in empathy more from the exam- feelings she has. All this happens Empathy does not emerge ples they observe in the adults by about age three! full-blown, but must be helped around them than from any amount The ability to recognize emo- along both by example and instruc- of direct instruction. tions on a face is built into the cir- tion. Adults do this unconsciously Program Two D www.pbs.org/brain The Child’s Brain: Syllable From Sound DISCUSSION QUESTIONS

1. Think of a child who you know. What are some of the and cultural norms. How much importance would you assign features of her emerging sense of empathy that you can see? to each of these two factors? Do you think they work in How did it develop? How can you recognize it? What can you more or less the same way in all children? What might do to further encourage it? families do to encourage or discourage gender-specific behavior? And how healthy do you think that would be? 2. Recent scientific research suggests that boys and girls differ not just physically, but mentally, temperamentally and 3. Do you think that attention deficit disorder is over- psychologically. From your own experience, do you think this diagnosed or under-diagnosed in children? Does medicating is true? How is it expressed? No one has yet figured out how children interfere with their natural development or help them much gender differences are built into the brain by the to behave in a more socially appropriate way? Do you think child’s genes and how much comes from parental attitudes there might be other solutions? What might you suggest?

ACTIVITIES

LANGUAGE DEVELOPMENT you look at picture books — naming the things he is We’ve all heard the doctors and psychologists say, “Read seeing. Point out vehicles or signs of different colors or to your baby! Talk to your baby often!” In addition to the sizes; label those foods or toys that he is familiar with. emotional focus and cuddling involved, here are some c. Narrate daily events such as the steps in changing a ideas for stimulating language development in toddlers. diaper or in taking a bath. A child will repeat these words, each time becoming more proficient at using and 1. Loading and Dumping pronouncing them. Expand on what your toddler is say- How to play: Once a baby knows how to pick up a variety ing by labeling actions, feelings and so on. of small toys or blocks (usually starting at about eight months), you can show her how to drop them one by one d. Between 15 and 18 months, babies will begin to enjoy into a large plastic cup or pail. Offer running commentary: language games that ask them to identify things, such “Now we’re putting the blue block in the cup . . .” Next, let as: “Where’s your ear?” and “Where is Mommy?” Their her dump them out and start all over again. vocabulary will grow quickly, but their pronunciation isn’t likely to keep pace. Resist the temptation to correct What it teaches: Labeling and cause-and-effect. Advancing pronunciation; most babies mispronounce their words. from chewing on or randomly shaking an object to trying something new with it is an important step toward language Instead, emphasize the correct pronunciation in your development, the beginning of understanding the relation- response. ship between actions and objects. Later, toddlers will begin e. Often, it can be difficult to understand what young chil- to use two-word “action-object” phrases, for instance dren are trying to express. It is important to convey to a “drop ball” or “more milk.” child that you are very interested in what she has to say, but that you are having trouble understanding her. 2. Communication It can be tempting to pretend you understand the child, a. Physically get down to the toddler’s eye level instead of or to ignore what the child is trying to communicate. looking down at him. Make eye contact when talking. This does not result in a learning experience for you or Place yourself face to face with him. for the child. Simply put, the child has not successfully b. Use every opportunity to label objects and events — in communicated, and you have not received his or her the grocery store, as you drive or ride on the bus, while message. Program Three A www.pbs.org/brain The Teenage Brain: A World of Their Own WHAT’S GOING ON PROGRAM Adolescent Development DESCRIPTION New research has shown that by Sandra Ackerman during puberty, just as the In the teenage years — as in ⅷ By adolescence, the brain brain begins to teem with the prenatal period — our brains is carrying on many impor- hormones, the prefrontal manufacture excessive numbers of tant functions at once, but cortex, the center of reasoning brain cells, then prune them to cre- not all with the same effi- and impulse control, is still a ate specific circuits that will set up ciency. Some develop- work in progress. For the first lifelong patterns. As the mature ments occur rapidly in time, scientists can offer an infrastructure takes shape, the early adolescence, while explanation of what parents brain begins to show new skills others take more time and already know — adolescence is that are critical to healthy adult life. experience. a time of roiling emotions and At about age fifteen, adolescents Beginning around their poor judgement. As the brain increase the quest to moderate the twentieth birthdays, adoles- matures, teenagers also face powerful effects of feelings on cents become better at special risks — from addictive behavior. thinking ahead and antici- drugs and alcohol that can pating the unexpected. ⅷ The amygdala, important hijack the brain, to the chaos of in processing emotions, schizophrenia, which strikes grows larger and forms most often during adolescence. new connections with other brain regions, lead- ing to greater emotional ⅷ But when a little-understood pre-

integration. PHOTODISC disposition towards schizophrenia ⅷ The frontal lobes launch a exists, this reorganization can go host of new connections awry (see COURTNEY HALE COOK’s to the limbic system, or story). “emotional brain,” a cir- cuit made up of sites that By the early twenties, more allow us to have feelings, complex and thoughtful behavior comes into play. to recognize and think about them, ⅷ This important step comes about and to produce physical and emo- through reorganization in the pre- ⅷ A wave of growth adds more sig- tional responses. frontal cortex, the executive center naling fibers to neurons in the lan- ⅷ New synapses continue to form, of the brain. guage centers and to those in the giving teens more expertise in rec- ⅷ The hippocampus continues to add “association” cortex, where the ognizing their feelings and in new synapses, and the strength of brain translates data from our choosing how to deal with them. these connections builds. The hip- senses into mental perceptions. As the brain’s “attention system” pocampus bucks the trend of ⅷ Both new and existing fibers matures, adolescents develop pruning synapses during adoles- become more efficient signal sharper mental focus. cence and continues to add rather transmitters by taking on more than eliminate — understandable myelin, a fatty white insulation. ⅷ Brain mechanisms for paying since its job is memory formation. As a result, the speed of signaling attention, filtering out distractions ⅷ The new synapses boost short- among brain sites increases, and and shifting attention from one thus the amount and the variety of topic to another, are housed in the term memory, which allows us to keep in mind several thoughts at information that contributes to prefrontal cortex, the front part of each idea or action. the frontal lobes. the same time, even to see thoughts in relation to one anoth- ⅷ Deposits of myelin occur long past ⅷ The maturing of this structure er, for example when we consider adolescence, to an average age of sharpens focus and sustained various outcomes before taking thirty-two — when people begin to attention. action. exhibit “maturity.” Program Three B www.pbs.org/brain The Teenage Brain: A World of Their Own

COURTNEY HALE COOK: A Portrait of Adolescent Schizophrenia by Marilyn Webb In the eighth grade, Courtney Hale Cook tried out for “I thought that I was an actor in another dimension who King Arthur in Camelot in his Iowa school play. He got the was playing the role of a schizophrenic named Courtney part of Lancelot instead. He came to realize that role was Cook,” he remembers, “and in actuality I was not living better suited to his personality. my life but I was portraying another dimension that…ah…in reality, really didn’t exist. And that was actually a comforting idea because the things I was going through were so awful that I didn’t want to experience reality.” His personality suddenly dis- appeared. Courtney was seventeen and scared.

According to neuroscientist Nancy Andreasen, what he describes is typical of the illness. “Schizophrenia effects the highest human func- tions,” she says, “in the parts of us that are most evolutionarily advanced — our ability to think at high conceptual levels, our ability to talk.”

Researchers now believe the illness is caused by damage, malfunction or an abnormal growth pattern in the prefrontal cortex, an important center for the executive mental and physical func-

THE SECRET LIFE OF THE BRAIN tions of the brain. It is also the area that experi- ences the most growth during the teenage years, when adolescents are already in hormonal turmoil. In becoming Lancelot, Courtney imagined this hero would try wrestling. So, by his junior year in high school, “The tragedy of schizophrenia is that it typically begins at Courtney had not only been a hit in the play, he’d also a time when we’re just beginning to discover who we become the second best wrestler on the school team. “I are, to differentiate ourselves from the other kids and was looked up to by a lot of people,” he says. “I was from our parents,” Dr. Andreasen says. “That’s the task respected, well liked, seen as a hero.” But by his senior of being a teenager. So people with schizophrenia develop year, things had changed. this devastating blow. It’s a sense of having your identity just slip between your fingers. You know you’re not there “When the hallucinations and strange thoughts started, I anymore, you’re losing yourself, you’re losing your mind, no longer felt like myself,” he says. “My hard work took a you’re losing your connection with your family, your plunge. I no longer ran or lifted weights. I didn’t do the friends. Ultimately, you may be losing your future.” things I really enjoyed about wrestling. It freaked out my coaches because they knew something was going on Typically, schizophrenics don’t see a doctor for about a with me and nobody knew what. It just got worse and year. They are afraid that others will make fun of them or worse.” lock them up. But before that could happen, Courtney tried to commit suicide. That’s when he finally got help. Courtney couldn’t concentrate. His grades plummeted. He saw green halos around people and gnats in the air. Visual Today, after proper medication and extensive psychotherapy, images seemed reversed, like a photographic negative. Courtney is finally in college, where he’s begun wrestling What was in the dark appeared two-dimensional; the rest again. “I’d rather have lived the life I live now,” he says, seemed to pop out, like an other-worldly 3-D. There was a “confusing and painful as it has been, than never to have thin line between his dreaming and waking states. And he been born at all.” For him, there’s hope, since the Courtney was terrified to tell anyone. Cook he once was has begun the long journey back. Program Three C www.pbs.org/brain The Teenage Brain: A World of Their Own Brain Health in Adolescence by Sandra Ackerman

Don’t go overboard. ● Recreational drugs can hinder the brain’s storage of Adolescents are known for their attraction to anything new information. new — a trait that serves them well at a time when so ● The use of steroids in sports not only has powerful and many things are new physically, mentally and in their unpredictable effects on physical development but also relations with others. This attraction allows them to may interfere with the neuronal circuits that play a key step up to challenges that daunt many adults, but it role in the regulation of mood. may also lead them to experiment in ways that can The rapid development of the brain can leave cause grave physical harm. adolescents especially vulnerable to mood disorders. The adolescent brain is especially vulnerable to ● Scientists have not yet found the causes of schizo- damage, precisely because it is in the midst of a phrenia or the physical factors that unleash it, but they great bout of pruning and rewiring. are learning to spot the early signs and to control its ● Signaling circuits created at this time or those that are effects more thoroughly and safely. particularly active quickly grow stronger. While the ● Since a predisposition to schizophrenia may appear in brain is pruning it is also strengthening the synapses adolescence, anything that masks the onset of this ill- that are used frequently. These synapses receive rein- ness — for instance, drug or alcohol abuse — may forcement and gain a host of connections, making it cause delays in treatment, with grave or even life- more difficult to eradicate these connections later if threatening results. they prove harmful — for instance, if a smoker decides to quit or a heavy drinker swears off alcohol. Of course the highly impressionable adolescent brain ● Using tobacco in the teenage years makes the risk of offers great opportunities for setting down beneficial dependence dangerous because substance abuse, long-term patterns as well. food disorders or addictions developed at this age are ● The “use it or lose it” principle is very much in evi- much harder to break than those acquired later on in dence now, as the synapses that receive the most use life. Likewise, adolescent drinkers face a high risk of will gain the most strength and durability. long-term alcohol abuse. ● The connections that receive little use wither away.

Hot Fact: New Images Bring New Insights

For years, scientists believed adulthood. their brains every two years, were brain development began in the “Before the development of we able to see the second wave of womb and ended in kindergarten. MRI it just wasn’t feasible to follow overproduction a full decade later. They thought that while learning an individual child, so no one had And that was very surprising. continued for many years more, ever been able to watch brain “What our new findings the brain’s physical structures development from childhood show is that the adolescent brain were set by about age five. through adolescence,” explains is far more flexible, far more adapt- We now know that brain neuroscientist Jay Giedd. able than we had ever realized development is much more dynam- “We knew that the process before,” he says, “that there’s ic. But this knowledge remained of overproduction and selective enormous potential for change hidden until just a few years ago elimination [of brain cells and even through the teen years.” when magnetic resonance imaging synapses] happened in the womb, These years offer an unsur- (MRI) began to yield images of a maybe even in the first eighteen passed opportunity for adolescents profound, system-wide reorganiza- months of life. But only by follow- to build the brain they will want to tion of the brain in preparation for ing the same children, by scanning use throughout their lives. Program Three D www.pbs.org/brain The Teenage Brain: A World of Their Own

DISCUSSION QUESTIONS

1. Think about a teenager you know. Do you see What might you tell a teenager about the “wisdom” you signs of thinking before taking action, working toward a have gained? long-term goal, perceiving and responding to the feel- ings of others? What do you think influences that 3. Adolescents in stories, films and situation come- behavior? What do you think interferes with it? How dies appear all too often as stock characters: the freak, might it be encouraged and reinforced? the rebel, the victim of moods, or the nerd. Given what you now know about ongoing brain development in 2. Think back to your own adolescence in the light of adolescence, can you name an adolescent figure who, what is now known about brain development. Do any in your view, presents a truer picture of the adolescent moments or situations in your memory now seem to experience? What makes this character a more accu- correspond to the brain processes and transformation rate portrayal? Why do you think adolescents aren’t that have been featured in this program? What do you portrayed this way more often? do now that you didn’t do then? How do you do it?

ACTIVITIES

1. Just say “No”? Design a hypothetical public- a. Record events or things that happened to you or service ad campaign — for TV, radio, magazines, others during the week. newspapers, public posters, or carried on music b. Write down your objective observations — per- videos — to discourage drinking, cigarette smoking, ceptions only — without using value-laden words. use of drugs, all kinds of risky behavior. Which behav- c. Notice the feelings these objective events aroused ior(s) would you address first and which later, or not at in you — joy, sadness, anger, silliness, embarrass- all? How would you best reach different age groups of ment, threat, insecurity, hurt, happiness, giggles. adolescents — or different interest groups (e.g., tele- vision watchers versus Internet surfers)? What would d. Take notice in your journal of what you inferred you say? Do you think current prevention campaigns from both the objective events and from your emo- address some of the important developmental issues? tional reactions: e.g., “He doesn’t like me.” How would you change them? e. Ask yourself why you feel that way. What are you assuming? 2. As the frontal lobes launch a host of new f. What options or choices might there be for other connections, teens become capable of recognizing ways to think about each event? the feelings they experience and of thinking about them. In order to help them strengthen these emerg- g. What other actions could you have taken? ing pathways they can be encouraged to examine the process of their own thinking. Keeping a journal is a Patterns are likely to emerge indicating ways a teen great way to do this. Here are some other things you responds to typical situations. Once aware of the pat- might suggest: terns, he may find it easier to select a wider range of different responses. Program Four A www.pbs.org/brain The Adult Brain: To Think by Feeling WHAT’S GOING ON PROGRAM DESCRIPTION Adult Brain Development Program Four of by Elizabeth Lasley THE SECRET LIFE OF The adult brain is in its Stress can energize— THE BRAIN reveals prime. The fully developed or debilitate. how the thinking and cortex allows for reason, planning, ⅷ Elsewhere in the brain, the analysis and forbearance, with the feeling areas of hypothalamus sets off the life’s emotional color coming fight-or-flight syndrome in the brain interact from the limbic structures response to stress. constantly, and how deeper inside the brain. ⅷ This response mobilizes our lives are gov- Adults (ideally) are in charge of the heart, lungs, endocrine themselves and their actions. glands, and immune sys- erned by emotion tem to deal with sudden ⅷ The prefrontal cortex, the area of and the interaction of emergencies. the cortex behind the forehead, emotion with our comes into its own, keeping emo- thought processes. tional impulses in check. ⅷ Brain circuits linking the rational cortical areas with the emotional centers are now fully myelinated, allowing Usually the nervous system and for better integration of immune system work together, emotion and reason. RYAN MCVAY/PHOTODISC but when this balance is upset, Emotions are an disease can result. important part of ⅷ decision-making, as our Multiple sclerosis (MS), a disease emotional and “rational” in which the immune system mis- selves can now interact, takenly attacks the myelin sheath, guiding our assessments appears in adulthood. Many suffer- of situations and our ers believe there is a link between ability to make decisions. stress and the onset of the dis- ⅷ But when overactivated — as in ease but among scientists, the ⅷ Confronted with something new, times of emergencies or chronic jury is still out. stress — the stress response can the brain does a quick search: ⅷ An estimated 80 percent of new lead to illness. High levels of the Have we been here before? mothers will experience the “baby hormone cortisol are produced, What did we do? What was the blues.” outcome? Memories, emotions, which is linked to depression ⅷ and even physical sensations take and to long-term effects — After a stroke, 20 percent of form, influencing many decisions including memory impairment — patients will have severe depres- we make. on the brain. sion, and another 20 percent will experience milder bouts. ⅷ ⅷ In general, depression strikes The hub of this process is the ven- Depression is associated with twice as many women as men — tromedial prefrontal cortex. decreased survival rate. People with damage to this area, either because of genetic, hormon- ⅷ from injury or stroke, may not be al, psychological, or social factors Depression can be linked to heart able to recognize their own emo- (see Profile of LAUREN SLATER). disease and even to death from a tions and may have trouble gaug- heart attack. ing those of others. Program Four B www.pbs.org/brain The Adult Brain: To Think by Feeling LAUREN SLATER: A Profile of Healing from Depression by Marilyn Webb

Lauren Slater was only ten when she first crashed, Slater’s life around. Today, twelve years later, she is a although the darkness had begun much earlier, maybe clinical psychologist, author of a best-selling book, and a even when she was just three or four. In truth, she can’t wife and mother. Yet she measures her success only by remember a time when that dullness wasn’t there, how long she’s stayed out of a mental institution. when a blackness wasn’t her daily shadow. “To feel depressed… to me… is to feel… dead,” she says, “that all of the normal things — the coffee in the morning, the shoes you put on your feet, the work you go to every day, the child you have, the man you love — all of those things are drained of their meaning, or ability to give comfort. They are no longer even familiar. You look at these things — and they are gruesome. That, to me, is how I experience depression. It’s despair because it’s as though I have died and I am looking at the world, but I can no longer have access to it, and I can’t explain to anybody where I am.”

Where does depression come from? Genes? The environment? And what works best to

THE SECRET LIFE OF THE BRAIN alleviate its symptoms? A pill? Psychotherapy? To Dr. Slater — and to other researchers — today’s best Severe depression, Lauren says, isn’t just sadness. It’s answer is biology and environment, chemicals and the terror, the dread, the slowed thinking, the lack of counseling. “I have a depressed brain,” Lauren says. concentration and the numbness. It is absolute alone- “I think my brain is grooved or ‘wired’ either to make ness and pain — so much pain that by the age of ten me depressed or to give me the proclivities towards she often couldn’t stop sobbing. depression. There is a biochemical basis. But the fact that I had a difficult childhood, well, I think the “I always had a feeling that my mother hated me,” environment shapes the brain, the same as the brain she says. “That I was repulsive. I used to keep elabo- shapes the environment.” rate lists of all the things — this is so bizarre, actually — but I had a pad of paper that I would keep in my pocket. Prozac and drugs like it raise the levels of the chemical I was obviously old enough to write, six, seven, eight. serotonin in the brain, which causes depression to lift. And I would write down all the things I had possibly Why this is, scientists really don’t know. But within five done wrong — if I could just figure it out, then I days after she took her first pill, Lauren says, all of her could remedy it.” symptoms were gone.

Soon Lauren couldn’t eat and she began to cut up her “Depression must do something to your ability to hear, arms. By fourteen, she’d gulped down a near fistful of your ability to see, because I could hear things clearly, pills, trying to commit suicide. That’s when she was hos- see things clearly. Colors were different. And there was pitalized — for the first of five times, all before the age this sense that I could feel. In some ways, depression is of twenty-five. the absence of feeling. Suddenly I could feel pleasure, I could feel happiness, I could feel sadness. It was a That year, her doctor prescribed Prozac, the first antide- whole new range of possibilities.” And that was when pressant that ever worked for her. It turned Lauren successful psychotherapy could finally really begin. Program Four C www.pbs.org/brain The Adult Brain: To Think by Feeling Brain Health in Adulthood by Elizabeth Lasley

Cherish your connections. hormone cortisol, which is implicated in depression, Research shows that isolation is a major factor in ill- stress-related illnesses, memory disturbance, even ness. People with few social connections or who osteoporosis and mature-onset diabetes. Since corti- report unsatisfactory relationships with the people in sol levels are often high to begin with during times of their lives are more likely to develop stress-related ill- stress, don’t compound the problem by choosing ice nesses. Studies show impairment of the immune sys- cream or potato chips as your coping mechanism. tem in people under chronic stress — those caring for a family member with Get treatment for depression. Alzheimer’s disease, for example, or those Everyone experiences highs and lows. in the middle of a divorce. People who But if a persistent low mood is interfering are terminally ill with cancer or AIDS with your life, see a doctor. Some of report less severe pain if they are the signs of clinical depression are strongly connected to family and feelings of guilt, worthlessness or friends. In a landmark study in the emptiness; feeling that life is not mid-1990s, women with breast worth living or thoughts of cancer who took part in support suicide; restlessness, groups lived longer than those irritability or anxiety; who did not participate. an inability to enjoy things that used to Watch your diet. bring pleasure; What does food and an excessive have to do with preoccupation mood? Potentially, with physical quite a bit. A diet symptoms. high in fat raises levels of the stress JOAQUIN PALTING/PHOTODISC

Hot Fact: Experience Can Rewire the Brain

Scientific evidence shows that expe- obsessive-compulsive disorder showed a rience can rewire the brain even in clear abnormality in a part of the brain adults. The brains of violinists, for exam- involved with movement. ple, have more synapses (connections) Some of these patients took representing the fingers of the left hand, medication for ten weeks, after which which articulate the notes by pressing another imaging scan showed that the down on the strings. abnormality was gone. Another group of Research also shows that when peo- patients, who received psychotherapy ple “practice” mental health — in the only, showed the same improvement. form of psychotherapy — they can make Whatever changes they had made with very real changes in their brains. In one their therapists’ help had altered their imaging study, a group of patients with brains for the better! Program Four D www.pbs.org/brain The Adult Brain: To Think by Feeling DISCUSSION QUESTIONS

1. Do you know people who are prone to depression or ill- treatment in favor of lifestyle and attitude adjustments. How ness? Do they have any traits in common, such as poor eat- far does the diet, exercise and attitude mantra go as sound ing habits, a sedentary lifestyle, a large amount of stress advice, and when does it do a disservice by carrying an coupled with an inability to handle it? implication of responsibility to the point of blame? Have you known or read about anyone who chose to forgo medica- How about those people with high confidence levels and tions in favor of taking charge of her own health, and what great attitudes — do they tend to be physically healthy as was the outcome? What is the best way to achieve a bal- well? Of course, not all illness is our own fault, and severe ance? mood disorders need medical treatment not just lifestyle modifications. But research is showing that by taking basic 3. Can you make a purely rational decision? Or do your steps to stay healthy we can reduce our risk of many stress- emotions have the final say in the choices you make? related illnesses and lighten the emotional load of the illness- Think back on some of the important decisions you have es that do occur. made in the past such as where to attend college, when to have a child, what job offer to accept. Why did you Have you experienced long-term changes in mood, or the make the decision you did? Did you go on gut-level relief of depression, after adopting such lifestyle improve- instinct or was your choice “thought out?” In retrospect, ments — or do you know someone who has? What did would you qualify this as a good or bad decision? they do that was of most help? Think about your decisions last week, significant and not so significant. When did you think through decisions and 2. The idea that we can influence our own health by atti- when did you choose impulsively? Was it problematic to tude and lifestyle has pitfalls. Someone who can’t pull out of make decisions based on intuition? On purely rational a serious mood disorder without medical help may feel inad- grounds? What were the differences? And what were the equate or guilty, or — even worse — may neglect medical differences in outcome?

ACTIVITIES STRESS MANAGEMENT c. Biceps and upper arms by flexing your biceps. Here are some techniques to d. Shoulders by slowly shrugging them. help you manage stress: e. Back of the neck by gently pressing the head 1. Exercise helps to release pent-up energy. back. Be careful not to snap it. 2. Deep muscle relaxation techniques (for exam- f. Front of the neck by slowly touching the chin ple, from Healthwise Handbook: A Selfcare to the chest. Manual for You) may reduce stress and its relat- ed health problems. Tense each muscle for 4 to 3. There are a number of self-assessment stress 10 seconds and then give yourself 10 to 20 sec- tests online, including those on the following onds to release and relax. Here is how to tense Web site: muscle groups: http://stress.about.com a. Hands by clenching them. b. Wrists and forearms by extending them and bending your hands back at the wrists. Program Five A www.pbs.org/brain The Aging Brain: Through Many Lives WHAT’S GOING ON PROGRAM DESCRIPTION Brain Development in Aging The longstanding by Elizabeth Lasley belief that we lose vast numbers of brain cells as A mature brain functions Many people regain we age turns out to be differently from a younger one, functions lost after stroke wrong. As we grow but the years after “fiftyish” can be or traumatic brain injury. older, many mental a time when mental powers reach ⅷ The brain continues to functions remain intact their peak. rewire and reshape itself and may even provide ⅷ The older brain shows a slight throughout life — even the brain with advantages decrease in taking in and using when damaged — so that form the basis for new information. It may result healthy brain cells may wisdom. The aging brain from a decrease in cells in an area take over and new con- is also far more resilient that regulates our get-up-and-go. nections form. than was previously ⅷ Once something believed. is learned, however, Stanley Kunitz: Poet at age 95 it sticks. ⅷ The ability to learn new movements (such as t’ai chi), is just as fast and com- deposits, known as plaques, plete in older people especially in areas responsible for as in younger ones. memory and spatial navigation

THE SECRET LIFE OF THE BRAIN (which is why patients forget Other types of where they are). memory may decline ⅷ In Parkinson’s, cells die in an area with age. crucial to motor coordination, ⅷ Many of us begin to resulting in tremor and halting have moments movements. ⅷ when we can’t come up with Some therapists think that much ⅷ Scientists believe genes may names or phone numbers. of the disability following a stroke increase the risk of disease, but Although we may have more trou- may be due to lack of use, and they are also researching environ- ble focusing, we often have better not to nerve cell death in the brain, mental factors. problem-solving skills — thanks to and that specific exercises may a lifetime’s experience. help patients regain use of The senses can become less reli- their affected limbs (see Profile able and may contribute to a feel- ⅷ In a healthy, older brain, the net of KENT MILLER). ing of losing one’s “mental edge.” loss of brain cells is minimal and the brain retains its structural ⅷ The mature brain continues to pro- ⅷ About half of those between 75 integrity. Researchers are now duce new cells — most notably in and 85 suffer from cataracts, but looking elsewhere to explain mem- the hippocampus, a structure cru- vision can be dramatically ory impairments that may accom- cial to memory formation. improved through surgery. pany aging. The older brain is vulnerable ⅷ As many as one third of people ⅷ Brain cells send messages using to disease, particularly the over 75 may suffer from macular chemicals called neurotransmitters. neurodegenerative disorders degeneration, which can some- Some researchers believe that (involving death of specific nerve times be treated with laser therapy. the aging brain loses some of the cells), including Alzheimer’s and ⅷ Hearing loss is common in aging, receptors for a neurotransmitter Parkinson’s diseases. especially “high-tone” loss, which important in memory formation ⅷ In Alzheimer’s, abnormal frag- makes it difficult to hear speech. and thet are looking for ments of a protein called beta- Hearing aids are the best remedy. medications that might amyloid build up to form sticky reactivate those receptors. Program Five B www.pbs.org/brain The Aging Brain: Through Many Lives KENT MILLER: A Profile of Stroke Recovery by Marilyn Webb

During the night, Kent Miller tried to get out of bed to “I’m basically a cripple, is what it boils down to. I decid- go to the bathroom but he couldn’t move. “My left ed I didn’t want to be crippled for the rest of my life. In side,” he recalls, “was completely paralyzed.” this particular sickness, at least you’ve got the ability to improve yourself.” After three frustrating years, Kent enrolled in a study at the University of Alabama, in Birmingham.

According to Edward Taub, the study’s director, while the neurons in a stroke’s epicenter shrivel and die, those in the surrounding area — called the penumbra — are just in shock. They stop functioning temporarily and then, slowly, they come back to life. The trick for recovery is to prevent the muscles and joints from degenerating in those areas controlled by the penumbra so they can resume motion when the dormant neurons “wake up.”

If degeneration occurs, the body can still be retrained, and the brain can grow new connec- tions even years after the initial stroke. Dr. Taub THE SECRET LIFE OF THE BRAIN utilizes a method he calls “Constraint-Induced Movement Therapy.” Simply put, a functioning limb Earlier that day, the Oklahoma Tax Commission had tried is physically restrained so the weak limb can slowly to get one of his clients — the owner of a convenience learn to function again. Then both limbs can work store — to pay her sales taxes. Kent was an accountant. together again as a team. “I got in the middle of it, like an idiot,” he says. “I should have just told her to pay up.” Kent trained hard with a physical therapist, each day painful and wrenching. “I was stabbing Play-Doh with a Kent’s wife Sharon called an ambulance. As it took him fork with my left hand and I kept missing. I used to be to the hospital, as he lay on the hospital bed, unable to pretty coordinated. Used to be,” Kent says. “But, you get up or move half his body, his mind kept churning. know, physically stabbing at it, that’s not as bad as the “At the time, I was only sixty,” Kent says. “I needed to mental thing of missing.” Describing the experience, work and make money. What happens to my family, he breaks into tears. what happens to me? Just a lot of things go through your head. You feel worthless. You can’t do the things After two weeks, Kent could cut his own meat with a you used to do. Physically and mentally.” knife and fork, hold a roll while eating, open a car door, turn on a light switch with either hand and drink from a With a stroke, either bleeding or a clot prevents oxygen glass of water. To him, these were all miracles. from reaching a portion of the brain, and the neurons in that area wither and die. The resulting disabilities “You take for granted you’ve got two arms and two legs depend on the location of those neurons. Kent was and two hands. Being able to use the left hand again lucky. His stroke didn’t affect his mind, his memory, his means a whole lot to me,” he says. “I can focus on speech or his concentration. But the paralysis of his left things other than the fact that I’ve had a stroke and that leg and arm drastically changed the way he thought I can’t use my left side very well. It’s the focus on the about himself. future. The hope. Being able to do things ‘normal.’” Program Five C www.pbs.org/brain The Aging Brain: Through Many Lives Brain Health in the Later Years by Elizabeth Lasley

Use tools to sharpen your memory. Probably every- An ounce of prevention. There are no magic charms one over fifty who forgets a name worries about to ward off Alzheimer’s disease, but some comparatively Alzheimer’s disease. But trouble with names is a nor- simple measures may reduce your risk of developing the mal part of aging. They are difficult to remember disease. because they’re arbitrary. You may remember that your ● Vitamin E acts as an antioxidant, it mops up toxic new neighbor is dark-haired, burly and outgoing; these compounds called free radicals that are produced as a are integral parts of who he is. But whether his name is by-product of metabolism. Check with your doctor Henry, Willy or Stan has no special relevance, except first to be sure of the right dosage for you and that perhaps to his parents. taking it will not interact negatively with other med- ● You can train yourself to remember names simply by ications such as blood thinners. providing some kind of context. One memory aid involves visualizing each person you meet in a differ- ● Physical activity also helps keep memory sharp and ent part of your house—Phil in the armchair, Bob and may be a factor in long-term brain health (see Hot Katherine sitting next to each other on the sofa. Fact, below). Taking care to avoid falls and head ● Simple organizational changes such as setting up a injury is another preventive measure; head trauma consistent spot for glasses and keys can simplify increases the risk of Alzheimer’s. things. If you have difficulty concentrating, try setting aside small blocks of time to do one thing and noth- ● Finally, try to avoid, manage or cope with stress. ing else. For example, don’t try to read a new biogra- Long-term exposure to stress hormones, though not phy while watching TV. linked directly to Alzheimer’s disease, has been shown to damage nerve cells, particularly in that Improve your lifestyle to guard against stroke. Even memory nexus, the hippocampus. though many doctors believe that a surprising amount of recovery is possible, strokes account for 30 percent of On the horizon for Alzheimer’s disease. The female all deaths. Among women, they are the second leading hormone estrogen has been shown to improve memory. cause of death (heart disease is the first) and claim Among postmenopausal women, estrogen replacement twice as many lives as breast cancer. The most com- lowers the risk of Alzheimer’s disease by 54 percent. mon type of stroke occurs when fats and other sub- But don’t go on “the Pill” just yet. Because this stances build up in the blood vessels then break off and hormone increases the risk of breast cancer and cannot obstruct the flow of blood to the brain. You can reduce be given to men without feminizing side effects such your chances of having a stroke by following a low-fat, as breast enlargement, scientists are working on low-cholesterol diet, quitting smoking, keeping alcohol “designer” estrogens that target brain function without consumption minimal, and exercising regularly. causing unwanted side effects.

Hot Fact: Exercise Helps the Brain

The easiest way to protect your brain is to maintain Other animal studies have shown that exercise a program of regular, moderate exercise. also helps raise the number of new cells that the Studies show that exercise improves memory brain produces. A regular exercise routine provides and lifts depression, in addition to being good structure to the day and brings people out of isola- for the heart, lungs and waistline. Experiments in tion — two important boosters of brain health. animals reveal that exercise raises levels of Physical activity can also protect older people by substances called trophic factors, which nourish improving muscle tone and balance, which can and protect brain cells. reduce the risk of falls and head injury. Program Five D www.pbs.org/brain The Aging Brain: Through Many Lives DISCUSSION QUESTIONS

1. One research group has studied 1,200 people between with Huntington’s disease (which causes memory loss, the ages of seventy and eighty. After keeping track of these movement problems, and dementia)? Would knowing your people for ten years, the researchers found that the ones fate make you live your life differently, or would you just start who kept their excellent mental functioning had three traits carrying the burden of the disease that much earlier? in common: they were physically active, they were mentally active, and they felt that they were making a contribution to 3. In other cultures, older people are respected and their families and communities. How many “successful revered because of their wisdom and experience. This was agers” do you know? What qualities do they share? true in our culture too, until recently. Nowadays, however, America glorifies youth, and all too often the elderly are seen 2. At present there is no definitive laboratory test for as comical, querulous and infirm. As the country’s popula- Alzheimer’s disease and no cure, though some medications tion ages, what steps could we take as a society to give can help ameliorate the symptoms. Because scientists have older people a more active role to play? Raise the retirement identified many of the genes that confer an increased risk for age, for example? Have mediation sessions in nursing the disease, it’s possible that a genetic test will become homes, where minor grievances are aired before a panel of available. Would you want to know whether you were at risk older, volunteer judges? Encourage senior citizens to write for developing an incurable disease? What if having the articles, stories and plays to share their insights? gene meant that the disease was a certainty, as is the case

ACTIVITIES

MEMORY BOOSTERS

1. Shake up the automatic activities of the day. 5. Replace TV with other forms of stimulation. Brush your teeth with the opposite hand, take the side Try gardening, playing chess or even memoir writing. streets when you’d normally take the thoroughfare, 6. Create new associations. reorganize your desk at work. Instead of waking up to the smell of coffee, take a whiff 2. Stay involved. of vanilla extract first thing. It may sound off-the-wall, Defer retirement, mentor others in your field, take up but creating new associations — even arbitrary ones — challenging causes, travel to exotic lands, step up your is tantamount to brain-building. role with grandchildren. 7. Talk (and listen) to people you would normally ignore. 3. Fill up your senses and trick them occasionally. Practice memory boosting. Ask the bus driver his name, Memory is not just for sights and sounds, but for tex- start a conversation, recall his name on the next occa- ture, emotions and even smell. Explore an Indian or sion. If he tells you his son is taking tuba lessons, make Asian market and get to know the spices and unfamiliar a note to ask him how the boy is progressing. Boosting foods. Build new memories with different senses. memory is about not only overthrowing old routines but 4. Find hobbies, take classes or do work that uses also about creating new, more dynamic ones. different parts of the brain. Even if you have two left feet, ballroom dancing may be Adapted from www.myprimetime.com just the thing. Reading, from short stories to Tolstoy, is a For more information on improving your memory, visit: great brain-builder, as are classes in anything from http://www.premiumhealth.com computers to astrophysics. http://www.memorytalk.com Essay 1 A www.pbs.org/brain The Remarkable Plasticity of the Brain by Richard Restak, M.D.

C onsider this page of the guide on stances and conditions. Instead, the at birth) brain defects result from a THE SECRET LIFE OF THE BRAIN brain continually adapts. Indeed, plas- disruption of plasticity as expressed in that you are now reading. It occupies ticity underlies everything the brain the normal programs of neuronal a certain amount of space: 8 1/2 inch- does. Even as you read these words, growth, development and migration. es wide by 11 inches long. Over time, your brain is changing. the dimensions aren’t going to change As they increase in size and complexi- much (assuming, of course, that you Plasticity is most evident during infan- ty inside the womb, the brain’s cells don’t tear it up). But you may bring cy. From a tiny ball of cells the brain interact with one another. Newly about various minor alterations: Fold emerges, grows and organizes itself. formed neurons establish connections it to fit into a briefcase, or with each other that continue crumple it a bit or spill to increase on the basis of some drops of coffee on experience. With each new it. But this normal wear experience new connections and tear doesn’t bring are formed. Change the expe- about any basic modifica- rience, and you change the tion to the size of the brain. For instance, if you page. deprive the baby’s brain of light and sound and human We formerly thought of contact, it will not develop the human brain in simi- normally. Abnormalities will lar terms — that once it also occur if, because of pre- reached a certain level of mature birth, the brain enters development it remained the world too soon and is pretty much the same overwhelmed with more except for some biologi- stimuli than it is equipped to cal wear and tear (loss of handle. some neurons) accumu- lated in the interval During childhood, the sec- between infancy and old ond life stage, a new kind of age. That assumption is plasticity takes precedence. turning out to be wrong. During gestation, neurons proliferate. At the conclusion THE SECRET LIFE OF THE BRAIN The brain remains a of infancy, a sculpting dynamic structure that process begins, becoming the alters from year-to-year, dominant force shaping the day-to-day, even moment- brain. The brain at this point to-moment over our lifespan. Thanks Next come the formation of the major contains many more neurons than it to what neuroscientists call plasticity, brain regions and a migration of neu- requires, so excess neurons are pruned the brain possesses amazing capacities rons from their original sites of gener- away according to the most funda- for change. Without plasticity, the ation to their final positions. mental tenet of brain operation: “Use brain would be similar to a machine, a Disastrous consequences can ensue it or lose it.” In practical terms, this structure with strictly limited powers whenever one of these processes goes means that the neuronal connections of adaptation to changing circum- awry. Indeed, most congenital (present that are used are strengthened and

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The Remarkable Plasticity of the Brain (continued) those that are not used fade away. The ing one’s career results in the forma- tips of the fingers undergoes measura- neurons established during gestation tion of new networks composed of ble changes in blind readers of Braille and infancy are thinned out in millions of nerve cells. Conversely, who have stopped reading for as short response to experiences. Unused or networks are lost or diminished in a period as a weekend. rarely used pathways disappear, while number and complexity if the adult heavily trafficked pathways flourish loses interest in people and events, Plasticity in the older person involves and elaborate. Thanks to this process limits his or her experiences, or fails new challenges and opportunities. of forming, reforming and strengthen- to learn new things or develop new Old age was once thought of princi- ing neuronal connections, young chil- skills. Most interesting is the finding pally as a holding operation, an dren vastly increase their abilities to that important brain changes can attempt to retain past gains while pay attention and remember and occur in extremely short periods of yielding as little as possible to decline begin mastering the universe. time. For instance, the area of the or disease. We now know that such a brain that receives impulses from the view is unduly pessimistic. The During adolescence, plasticity healthy brain of the aged per- involves a second growth spurt son retains a marvelous plas- accompanied by a second round STEM CELLS: ticity and can change for better of pruning. This time the growth or for worse. Indeed, the brain THE FUTURE OF PLASTICITY and pruning takes place largely of the older person can contin- in the frontal lobes — those ue to function healthily and areas just behind the forehead Recent research on stem cells offers creatively, or it can slip in its involved in such eminently hope that damaged or destroyed neurons may powers due to lack of use or to human activities as foreseeing someday be replacable. abuse. Thus the older person Essentially, stem cells are primitive the likely consequences of one’s has a choice: Accept the stereo- unspecialized cells that can “morph” into mature actions, planning, reasoning and types about aging and sit in a cells while continuing to multiply and provide a controlling one’s emotions. corner, or remain active and constant source of new cells. Think back to the vibrant. last time you suffered a cut or broke a bone. Since their frontal lobes are not Stem cells in the skin and bone account for the fully developed, adolescents healing that took place. Stem cells also give birth While the aging brain may be a sometimes exhibit such frontal to the cells in the liver, the lining of the intestines, bit slower in learning, manipu- lobe-based difficulties as impul- and all the cellular constituents of the blood. The lating and rapidly retrieving siveness, foreshortened attention discovery of stem cells within the brain suggests new information (one of the spans, and failure to realize the they are capable of turning into adult neurons. reasons most contestants on possible negative consequences of “Stem cells can divide, move around in game shows tend to be young their actions. Once the growth the brain, end up in specific locations and then adults), it remains highly plas- and pruning process has been suc- fully differentiate into neurons,” explains Fred tic and adaptable. For cessfully completed, adolescents Gage, Professor of Genetics at the Salk Institute. instance, research on elderly may become more thoughtful. “It isn’t as if a mature brain cell is undergoing college professors shows that cell division but, rather, that the process of devel- they often outpace their During adulthood, plasticity opment is continuing in the adult brain. And that’s younger colleagues when it continues but without the dra- really a key feature in understanding the larger comes to integrating new matic level of pruning observed picture of what plasticity is all about.” knowledge with existing in childhood and adolescence. In Thus a two-part strategy may soon be in knowledge. But one doesn’t the adult, plasticity involves the place for the treatment of dementia: the induction have to be a college professor formation and maintenance of of nerve cell multiplication and the replacement to possess these talents. neuronal circuits that can vary in of irretrievably lost neurons with stem cells of As Cicero wrote in 44 B.C. in richness and variety depending either adult or fetal origin. Both of these strate- his essay “On Old Age,” on one’s interests and activities. gies could potentially treat presently incurable “Intellectual activity gives diseases and even provide a few more years of Learning a new language, buoyancy to the mind.” enhanced functioning in the normal aging brain. improving one’s tennis or chang- Essay 2 A www.pbs.org/brain Nature! Nurture and the Individual Child by Sandra Ackerman

“She gets that easygoing temperament According to psychologist Eleanor “The concept of nature versus nurture from her father,” a mother may say, as Maccoby, we are neither and we are is so ingrained in our thinking,” says her two-year-old sits happily dumping both. “Children’s genetic predisposi- Sharon Ramey, professor of neurobi- sand from one pail into another. Or, tions and their parents’ childrearing ology, psychology and pediatrics at applauding an eight-year-old after his regimes,” Dr. Maccoby says, express- the University of Alabama, “it’s first school concert, the parents may ing the predominant view of develop- almost impossible to get beyond.” say, “Those preschool music classes mental experts, “are now seen to be really made a difference!” Throughout most of the twen- tieth century, the scientific In everyday life we often consensus swung back and seek to explain children’s forth between two incompati- actions as either an inherit- ble positions, pointing first to ed tendency or a direct environment and then to result of learned experi- heredity as the primary force ence. Perhaps because chil- that determines how a child dren keep surprising us will think, feel and behave. with new skills, traits and Only in the 1990s did a ever-changing behavior, we school of thought emerge with try to maintain continuity enough foundation in both by tracing new develop- genetics and psychology to ments back to some famil- begin studying how the two iar source. What parent forces may work together. hasn’t thought, “He didn’t The new focus on gene-envi- get his sarcastic tongue ronment interactions finally from my side of the fami- allows us to begin answering ly,” or “What are they one of the oldest riddles in teaching her in kinder- child development: Why is it garten to make her so that full siblings, with the bossy?” same two parents, are often so different from one another? From generation to genera- tion, the more curious URSULA MARKUS/PHOTORESEARCHERS Although all siblings emerge among us have wondered from the same gene pool, each how we can each start out one receives a unique set of as a single fertilized cell genes: some from the mother and yet become a unique “I” with our closely interwoven. They function and others from the father, some dom- own thoughts, feelings and behavior. jointly to affect children’s develop- inant and others recessive, and so on. This is the ancient debating ground of ment.” And these genes do not develop in a nature vs. nurture: are we the biologi- vacuum. cal legacy of our parents or blank But the notion of two interacting slates on which our experiences writes influences rather than a single direct As early as the first few months of our identity? one has always met with resistance. pregnancy, the fetus’s first environ-

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Nature! Nurture and the Individual Child (continued) ment — the mother’s womb — WHATEVER HAPPENED TO impacts its genetic blueprint. The THE MOZART EFFECT? mother’s state of health, her rest and nutrition and her levels of stress dur- The works of Wolfgang Amadeus Mozart are a perennial ing pregnancy affect her growing favorite among music lovers, but in the mid-1990s they received a child. sudden surge of attention from a group with a completely different focus: parents of young children. Then, even in the most stable family, This new popularity arose from a single scientific paper pub- each child’s experience will be differ- lished in 1993, in which a research team showed that listening to ent. The parents may be new at rais- Mozart’s music improved the performance at certain mental tasks of ing children or old hands at it; the sib- elementary school students. Gradually, as the story was reported to lings are older, younger, all of one sex larger and less specialized audiences, this finding grew in perceived or the other, or mixed; household cir- importance, until the so-called “Mozart effect” was said to increase babies’ overall ability to learn or even in some way to enhance their cumstances may be comfortable or brain for life. At the same time, though, further scientific studies did difficult; the family may exist in a not confirm these results, and soon the exaggerated claims for the long-established network of friends Mozart effect began to appear to be just that. and relatives, or may just have settled In 1999, a new paper clarified the specific findings of the origi- in a new geographical location. All nal study: not only did the students’ improved performance on the test these factors together form the fail to carry over to other kinds of schoolwork, but it also proved to be child’s microenvironment, rather short-lived. The furor over the Mozart effect has largely died and they produce major down, but the story of its popular rise and fall lingers as a warning and lasting effects. against trying to generalize from a single isolated effect the tremen- dously complex process of learning in the developing brain. Genes can set up a tenden- cy or predisposition toward certain likes or dislikes, talents, levels of PHOTODISC energy, and even self- image. But these ten- dencies may fit well or How the child responds to such a label, and badly into the child’s what she has made of her own inherited environment — above traits and experiences so far, will have an all his home environ- impact on the way her family perceives and ment — in ways that fur- treats her, which may in turn modify her ther shape the child’s traits self-image and her dealings with parents and view of himself. In a and siblings, and so on, in a cycle lasting family fond of sports and well into adulthood. Paradoxical as it games, for example, a less seems, each child takes part in creating actively inclined child may the very environment that helps to shape be encouraged to join in, or her as a unique person. he may be labeled as lazy or a loner, or perhaps be appointed the storyteller of the group. Essay 3 A www.pbs.org/brain Addictions and Cravings by Richard Restak, M.D.

Drug abuse is a brain disease. We able to watch the equivalent of an Scientists learned this from early know this because addictive drugs incredibly scintillating game of pin- experiments with rats. When lab rats mimic the action of one or more of the ball, as the pleasure centers light up eat or become sexually aroused, brain’s neurotransmitters. And as a and play off one another in response dopamine levels increase in the areas result of this successful mimicry, the to the steak. mentioned above. But the same thing brain is fooled into responding as it happens when rats inject themselves would to the natural neurotransmitter. If you don’t fancy steak, think about with addictive drugs like cocaine, for “The drugs do that,” says Steven whatever else “turns you on” — a example, by pressing a lever or turning Hyman, director of the National term, incidentally, that provides an a wheel. They will repeat these behav- Institute of Mental Health, “by tap- apt description of what is happening iors hundreds of times to experience ping into the brain-reward sys- the pleasure set off by the tem and fooling that system.” cocaine.

The brain-reward system is Liz, a patient at the Caron made up of areas of the brain foundation in Wernersville, collectively referred to as the Pennsylvania, which specializes pleasure centers. Most impor- in the treatment of cocaine and tant is a pathway that starts in other substances of abuse, the brainstem and extends described a similar craving. upward to areas deep within “When I started getting high I the brain that spring into action loved it more than anything,” whenever we experience pleas- Liz said. “It started to be the ure. Dopamine is the neuro- most important thing in my life. transmitter common to struc- I didn’t feel normal if I wasn’t tures all along this mesolimbic high.” reward pathway. Increasing the level of dopamine in these Liz’s experience illustrates the areas increases their neuronal key feature of addiction, firing rate; decreasing the according to George Koob, dopamine level decreases the professor of pharmacology at firing rate. The Scripps Institute in La PHOTORESEARCHERS Jolla, California. “In drug As an example of the power of addiction your behavioral the mesolimbic reward system, repertoire has narrowed such imagine yourself biting into and savor- in your brain when you are experi- that drugs become the focus of your ing a piece of succulent, tender filet encing pleasure. Whether it is movies, whole life. Your pleasure centers have mignon (assuming you’re not a vege- skiing, travel or parties, the brain’s been usurped, taken over by the tarian). As you chew that first morsel response is the same: activation, the drugs. You no longer seek natural of steak, neural messages fire within “turning on,” of those pleasure cen- pleasures because the drug is driving this dopamine pathway. If electrodes ters. the system.” could be inserted safely into those areas of your brain and the results dis- Unfortunately, these same areas are When a person takes an addictive played on a monitor, you would be also “turned on” by drugs of abuse. drug, a massive surge of dopamine

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Addictions and Cravings (continued) takes place within the pleasure cir- In addition, drugs exact a harsh and relapse within six months. In the vast cuits. This surge is far in excess of painful penalty for the user who majority of those drug treatment fail- what occurs when the person experi- decides to quit. As a result of previous ures, a powerful craving precedes the ences a normally pleasurable event use, the brain has become pro- return to drug use. This sequence like the aforementioned steak. The grammed not only for the pleasure occurs even among those who are surge is so great that it even eclipses initially associated with drugs, but seemingly motivated and highly com- the pleasure of orgasm. The message also for the anticipation of drugs, and mitted. In essence, craving too often transmitted to the rest of the brain for the people and events usually asso- wins out over resolve. from the pleasure centers is: “This is ciated with the drug experience. the most rewarding, exciting, impor- Merely returning to the neighborhood Unfortunately, no drug presently tant moment that you could possibly where drugs are available sets off exists that on its own can be reliably have as a human being.” Indeed the an intense craving. Even if the user depended on to control drug abuse experience is so overwhelmingly sig- doesn’t take the drug under such cir- simply by altering dopamine or its nificant that it builds within the struc- cumstances, he or she experiences effect in the pleasure circuit. Any suc- ture of the brain a powerful desire to many of the actual effects of the drug. cessful treatment must prepare the repeat it. The heart rate picks up, tingling can addict for the craving that will emerge be felt in the head or other body parts, upon return to the previous environ- Not surprisingly, the treatment of buzzing sensations are experienced ment. Upon completion of a course of addiction isn’t easy. Why give up the along with lightheadedness and, in treatment, most addicts feel confident possibility — however elusive — of many instances, even a bit of the drug- that drug use is behind them. But as recapturing the initial “rush” that associated euphoria. they will discover upon discharge accompanied the first few drug-taking from their treatment programs, their experiences? How can you “Just say So powerful is the craving for drugs most difficult challenge lies ahead. ‘No’” when the drug of abuse has lit- that 80 percent of those who have erally taken over the brain’s structure completed drug treatment programs and functioning?

Hot Fact: Addictive Drugs “Light Up” the Brain

In order to understand the exchanging of cocaine. messengers — principally brain-basis of addiction and “peek Dr. Childress not only found dopamine — occurring in these inside of the brain of the addict that the cocaine-related video- sites after cocaine administration. during desire,” Roseanne tapes induced a craving for drugs But no activation occurred Childress, a University of in addicts, but also found that she when the addicts looked at the Pennsylvania psychiatrist, has could detect on the PET scan “a hummingbird videos. Nor did Dr. looked with a positron-emission clear signature for desire” in tell- Childress detect any activation tomography (PET) scanner at color tale areas of their brains. The ante- when a control group of normal activity-image recordings of the rior cingulate, the amygdala, and volunteers watched either the brains of addicts. After placing her the nucleus accumbens — three hummingbird or the cocaine-relat- subjects inside the scanner, she key way stations in the mesolimbic ed videos. Dr. Childress’s studies projects on a small screen in front pleasure-reward system — lit up provide a scientific demonstration of them a videotape of either non- on the PET scan image, which of the powerful forces driving the drug associated scenes (Dr. meant those areas had become addict toward continued drug use Childress uses pictures of hum- activated. This finding was consis- as well as help her investigate the mingbirds) or scenes of people tent with previous animal studies treatment of drug addiction. simulating the buying, using and that showed a gush of chemical Essay 4 A www.pbs.org/brain Minding Your Memory by Marilyn Webb

It’s one thing when you can’t Alzheimer’s Disease find your keys. It’s quite another when you put them Neuroscientists have two theo- inside the toaster, or worse, try ries about plaques and tangles. to use them to start it. In both theories, neurons die, thereby reducing electrical and Neuroscientists have found neurochemical transmissions in that the causes of memory key areas for cognition in the lapses differ between normal, brain. Some think that a mole- aging adults and people who cule called tau, which supports suffer from Alzheimer’s dis- the structure inside the nerve ease. The good news is that cells, starts to disintegrate, both kinds of memory prob- causing the cells to slowly curl lems may soon be treatable. up and die. In autopsy and in imaging studies, the twisted Alzheimer’s disease creates a cells appear to be full of tangles. patchwork of tangles and Other scientists think a run- plaques within certain sections away enzyme process makes of the brain, causing brain beta-amyloid, a protein inside cells to die in those areas and the cells, overproduce and whole systems to shut down. break off. Beta-amyloid bits Although this cell death can clump together and form con- first appear as memory lapses, gestive plaques. those who are stricken with MEL CURTIS/PHOTODISC New medications — such as Alzheimer’s disease very soon Cognex, Aricept, Exelon and develop more serious cogni- Raminyl — are currently on the tive difficulties, forgetting not market. They can temporarily only where their keys or glass- important for both memory and new slow down cognitive degeneration and es are, but even why they use them. learning — weakens. memory loss by aiding the fading neu- They develop dementia — a serious rochemical transmission. But these disruption of a broad range of both The treatment and potential cure of medications only control symptoms, mental and motor functions. Alzheimer’s disease will require that and only for a period of time, rather scientists learn how to diagnose it than treat or cure the cell death or the The brains of those who experience early and to slow down and compen- underlying disease. normal aging do not suffer this mas- sate for the death of brain cells. The sive cell death. They experience a treatment of normal, age-associated However, researchers have developed decline in the strength of the synapse memory lapses lies in learning how to a new vaccine — proven effective in impulses in very specific memory cir- stimulate the neurons just enough, so mice and currently in clinical testing cuits. Certain crucial receptors on the that they make their proper, appropri- trials with people — that could retard cells in these circuits — called NMDA ately speedy connections. Scientists plaque formation and perhaps reverse receptors — become less sensitive. have made progress on both fronts. it completely. But even if it works, the And nerve impulse transmission —

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Minding Your Memory (continued) tangles and cell death remain serious These new cells seem to know where ing a puzzle, taking up astronomy problems. to go and how to fit into existing brain or weaving, postponing retirement. circuits. But as we age, synaptic recep- All of these stimulate the neurons Controversial stem cell research could tors start to flag. The strength of the to stay in the habit of forming new provide help if scientists can 1) find impulses sent along the neural path- connections and drilling the old ways to stimulate the body’s normal ways likewise seems to get weaker. ones. Here too, it’s use it or lose it. production of stem cells so they dif- ● Estrogen — In studies of post- ferentiate into the necessary neurons, Why don’t the receptors stay in menopausal women, estrogen has or 2) learn how to transplant cells shape? How do we get them to stay in been shown to increase normal from embryo, fetal or adult stem cell shape? And, if they aren’t in tip-top memory skills and to slow down tissue that will form the brain cells shape, how can we compensate for the development and progression needed, we will be well on our way to this loss of memory and/or learning of Alzheimer’s disease. a cure for Alzheimer’s disease. But sci- processing speed? entists must also learn how to “tell” stem cells where to go in the brain, Many other problems besides normal The Disputed and how to “know” what cells to aging may be involved, and many of ● Ginko biloba — Health stores sell transform into to repair or keep up these can be reversible. The first line it, but the jury is still out on with cell damage or death. of defense is to get a proper diagnosis. whether and how well it works. It Illnesses that can cause memory loss if seems to stimulate blood flow. left untreated include: thyroid disease, Alzheimer’s Disease Hopes ● Vitamin E — Acts as an anti-oxi- diabetes, high blood pressure, infec- Hope for Cures: dant and also may stimulate blood tion, depression, stress, alcoholism, flow but — like ginko biloba — ● Stem Cells— As soon as political vitamin deficiencies and dehydration. dosages haven’t been studied. Both constraints and ethical questions It can also be caused by certain med- of them may exacerbate bleeding are resolved scientists hope for a ications. Among more serious illness- problems, especially for those who fast-paced effort toward a cure. es, some causing dementia mimicking are on blood thinners. ● Vaccine—Scientists now know that Alzheimer’s disease, are mini-strokes, ● Diet — What you eat — or the a promising vaccine may stop or tumors and AIDS. Currently, there are vitamins you take — may turn out reverse plaque formation. But they a range of things neuroscientists are to be important for mental func- don’t know whether or not plaque finding helpful for strengthening wan- tioning, especially the B vitamins formation causes Alzheimer’s dis- ing circuits. (particularly B12), folate and vita- ease or if removing the plaques will min C. Again, correct dosages be a cure. Age-Associated Memory haven’t been determined. Temporary Treatments: Balms (The Reputed, ● A group of drugs show some suc- Disputed and Undisputed) The Undisputed cess in boosting a key neurotrans- ● Make lists — Some sage said: “The mitter, acetylcholine. The Reputed best memory is never as strong as ● ● Anti-inflammatory medications Physical exercise — not only helps the weakest ink.” may slow down a response that sagging stomachs and thighs, but ● Pay better attention — What we some scientists believe may cause strengthens memory as well, possi- forgot might be what we never plaques, tangles or both. bly by increasing blood flow or an took in to start with. enzyme or chemical that stimulates the speed with which impulses ● Find one of the hundreds of memo- jump the synapses between neu- ry skills books, courses or Web Normal Aging rons. When in doubt, work out. sites. Neuroscientists now know that brain ● Mental exercise — crossword puz- cells are being generated constantly. zles, learning a new language, solv- Essay 5 A www.pbs.org/brain Caregivers’ Needs Across a Cognitive Lifetime by Marilyn Webb

I n most American families today, billion hours of caregiving a year. caregiver’s health often suffers as someone is receiving at-home, unpaid Their work saves our health care sys- well. Women are trying to juggle caregiving. It may be a premature tem about $200 billion a year, but for child-rearing, job and family, along infant or a disabled child, teenager, these caregivers and their families, with the stress of taking care of parent or spouse. This caring someone who is seriously ill. is rarely covered by health insurance. Yet, the amount Caregivers are a silent majority of care required by chronic — a secret work force that disability is so vast that it most of us will join. We drive threatens to plunge us into a an autistic child or an aging national health care crisis. parent to a doctor’s appoint- ment. We shop for an ill sibling Over the past century, mod- or friend. We monitor medica- ern medicine has added an tions. We help with physical extra twenty-seven years to therapy. We scrub or bathe or life, giving new hope to par- comb. We take the brunt of ents of premature infants, unintended anger or emotional and life itself to those who outbursts. We sit in quiet des- would otherwise have died peration, torn between love of ailments from typhoid to and grief, and battling dark heart attacks. We live longer, feelings of duty, isolation, fury but often with chronic illness and guilt. or disability as a result. Caregivers need emotional and More Americans now live physical help. And so, hun- long enough to develop cog- dreds of organizations now nitive afflictions like provide publications, on-line Alzheimer’s disease. Babies resources and illness-specific born as early as 24 weeks support groups. Their credo? WILL & DENI MCINTYRE/ PHOTORESEARCHERS into pregnancy survive. Take care of yourself, or you Miracle cures save our lives won’t be able to care for others. but they have also launched a widespread need for high-intensity, the physical and emotional toll is long-term caregiving, most of it done enormous. Infancy at home by families. A recent study of 10,000 seriously ill Your baby has arrived three months Americans found that the impact of early, so tiny that she needs special By conservative estimates, about 26 their need for long-term care was care. But you need care too, so start million Americans are full- or part- devastating. Thirty-four percent of building a team. Here are ways peo- time caregivers, 96 percent of them the patients needed large amounts of ple can pitch in: caring for other family members. care, causing more than half the fam- Seventy-two percent are women: the ilies to suffer crises that included ● Drive parents to and from the patients’ wives, daughters, mothers bankruptcy and the loss of their hospital. or sisters. Together, they put in 24 homes, savings or jobs. The main (continued) Essay 5 B www.pbs.org/brain

Caregivers’ Needs Across a Cognitive Lifetime (continued)

● Prepare meals or coordinate ● Coordinate schedules for support Adulthood and Aging others to do so. staff, therapy and helpful friends. About 15 to 21 percent of families ● Grocery shop or run errands. ● Give yourself time off — to take a are caring for an adult with a cogni- tive impairment, including ● Do laundry, clean the house, shovel walk, get a massage, or do some work Alzheimer’s and Parkinson’s dis- the walk, or feed the pets. of your own. eases, stroke and head injury. They ● Sit with parents or meet may behave in ways that are pro- them for lunch. Hospitals foundly changed, making them can be lonely. CAREGIVING TIPS seem like strangers. Grieving, com- ● Baby-sit for other children. munication and emotional prob- ● Set up a telephone infor- lems, the poignancy of their condi- mation “tree.” 1. Take charge of your life. Don’t tion coupled with guilt and stress can make you feel depressed and ● let another’s ailment always Offer to baby-sit, do alone. chores, or provide meals take center stage. when the baby comes 2. Love and value yourself. You’re Build a circle of care. Use local home. doing a hard job and need quali- resources to find adult day care. ty alone-time. Consider using home health care Childhood and Adolescence 3. Watch out for signs of depres- programs and local organizational resources such as Meals on Wheels. With an ill child, you need to sion. Get professional help If you need to, talk with a profes- plan for the long haul. when you need it. sional counselor or chaplain. Look Explosive or irrational behav- 4. Accept people’s offer of help for disease-specific or caregiver-ori- iors can be disruptive or cause and suggest specific things they ented support groups. Find things embarrassment, even chaos can do. that friends or family members for the rest of the family. might do to help you take breaks, And then there are the over- 5. Educate — and empower— small vacations and long weekends. whelming feelings of failure yourself about your loved one’s Eat a balanced diet. Get enough and grief. The support of condition. sleep. Exercise or find another way family and friends is a must, 6. Be open to ideas that promote to reduce stress. Plan for your own as is taking time for yourself. your loved one’s independence. future. While caring for your off- 7. Trust your instincts. Most of the As time goes on, you may find that spring, guard against your time they’ll lead you in the right there is a spiritual side to caregiving own isolation, depression and direction. for someone you love, a poignant exhaustion. The goal is to 8. Grieve for your losses, and then softness and intimacy that can grow keep it all in balance. Family allow yourself to dream new between the two of you. Find enjoy- and friends can help with the ments you still share: music, following: dreams. TM 9. Stand up for your rights as a singing, outings, Scrabble , movies, telling jokes, writing memory books ● Research diagnoses and caregiver and a citizen. or playing cards. treatments at local libraries 10. Seek out other caregivers. or online. There is strength in knowing ● Help keep track of medical you are not alone. bills and manage paper- work. from The National Caregiver’s Association’s Caregivers HandBook Glossary A www.pbs.org/brain

Addiction: The compulsive use of a sub- Brain imaging: By the use of new elec- reactions. Deficiencies of dopamine arise stance or activity that can cause harm to tromagnetic techniques physicians can in Parkinson’s disease. thinking, emotions and behavior. take highly detailed pictures of the brain. Three examples of this technology are Dyslexia: A disorder manifested by Adrenaline: A hormone that arouses positron emission tomography (or PET difficulty in learning to read, particularly and heightens emotional responsiveness. scans), magnetic resonance imaging (or when a significant discrepancy exists MRIs), and computerized tomography (or between intellectual ability and reading A chronic disease charac- Alcoholism: CAT scans). Analysis of the electroen- performance without an apparent terized by excessive or compulsive use of cephalogram (EEG) is another, different physical, emotional or cultural cause. alcohol. way to study brain activity. Endorphins: Neurotransmitters in Alzheimer’s disease: A progressive, Brain (neuronal) plasticity: The ability the brain that block pain signals to the neurodegenerative disease — and the of intact brain cells to take over the func- nervous system, reducing pain. most common cause of dementia — that tions of damaged cells. The human brain results in the death of nerve cells in the remains plastic (or pliable) throughout life Epilepsy: A symptom of neurological brain and gradually destroys the ability to (which is how we are able to learn at any dysfunction characterized by seizures or remember, learn, reason and imagine. age), but it is massively more so in early changes in behavior resulting from abnor- life. malities in the electrical activity of the Amyloid plaque: Clusters of dead and brain. dying brain cells and amyloid protein Cerebellum: The portion of the brain — fragments, that are one of the character- located at the back of the head — that Frontal lobes: The front parts of the istic structural abnormalities found in the helps coordinate movement, posture, cerebral hemispheres that are involved in brains of those with Alzheimer’s disease. balance, coordination and rhythmic planning, reasoning, judgement, organiz- ing, problem solving, selective attention, Amygdala: A part of the brain — movements, and is important in aspects of learning and memory. personality and a variety of higher cogni- shaped like an almond and located deep tive functions. inside, near the inner surface of each Cerebral cortex: The outer layer of the temporal lobe — involved in our emo- brain that covers the cerebrum and man- Hippocampus: Part of the limbic sys- tions, emotional learning, and memory. ages most high-level functions, including tem that plays a crucial role in learning, thought processes and controls the lower, processing and storing long-term memo- Anencephaly: The lack of brain forma- ries. tion due to a congenital defect in neural older, more automatic parts of the nerv- tube closure. ous system. Left cerebral hemisphere: Controls the right side of our bodies, coordinates Cerebrum: The largest area of the brain, Attention-Deficit Disorder/ learned movement patterns, enables lan- Attention-Deficit Hyperactivity consisting of two hemispheres or halves — the right and left cerebral hemisphere, guage expression and comprehension Disorder (ADD/ADHD): A disorder that and processes abstract symbolic thought. involves attention and focusing problems, which are in constant communication. most commonly (and controversially) This network of Cortisol: A hormone produced by the Limbic system: treated with the drug Ritalin. structures, located deep within the brain, adrenal glands that increases resistance just above the brain stem, plays an to stress. Autism: A complex disability that typi- important role in human emotion, learning cally appears during the first three years Dendrites: Tree-like branches or and memory. of life and affects the normal develop- “cables” of nerve cells that receive and ment of the brain in areas of learning, The four parts of the two cerebral process electrical signals to other neu- Lobes: social interaction and communication hemispheres that are demarcated, front- rons. Typically each neuron possesses skills. to-back, side-to-side, and by major tens of thousands of dendrites, seldom grooves in the surface of the brain. The longer than a hundred thousandth of a Axon: A branch or a nerve cell that occipital lobes, located in the back of the meter. (Compare this with the 1.3 yards of transmits outgoing signals to other neu- brain, are primarily responsible for vision. an axon!) rons, muscles or glands of the body, and The frontal lobes are involved in move- may be as long as 1.3 yards in length. Depression: A serious mood disorder ment, complex judgment, emotional regulation, problem solving, decisions, The lower part of the brain marked by a combination of symptoms Brainstem: planning and creativity. The parietal lobes that controls basic bodily functions; that affect one’s ability to work, eat and are involved in higher sensory-motor directs our reflexes, vital signs, and auto- enjoy once pleasurable activities. coordination and language functions. matic control of the eye, face and head; Dopamine: A chemical in the brain that Temporal lobes located above and behind and helps us interpret sensations of taste, acts as a neurotransmitter, stimulating the ears are involved in memory, hearing, hearing, vision and balance. receptors on adjacent nerve cells and language and emotion. producing in them a cascade of chemical (continued) Glossary B www.pbs.org/brain (continued)

Midbrain: The portion of the brainstem Obsessive-compulsive disorder Ritalin (methylphenidate): A contro- below the cerebral hemispheres and con- (OCD): A potentially disabling condition versial, central nervous system stimulant sisting of the thalamus, hypothalamus and whereby a person becomes trapped in a that has the paradoxical effect of quieting the limbic system. pattern of repetitive thoughts and behav- individuals (usually children) who have an iors that are senseless and distressing abnormally high level of activity or atten- Motor cortex: The region of the cortex but extremely difficult to overcome. tion-deficit hyperactivity disorder (ADHD). close to the parietal lobes concerned with voluntary muscle movement. Parkinson’s disease: A progressive, Schizophrenia: A psychotic mental dis- neurodegenerative disease characterized order that interferes with the ability to Neurofibrillary tangle: Accumulations by the death of nerve cells in a specific think clearly, manage emotions, make of twisted protein fragments inside of area of the brain. Parkinsonian patients decisions and relate to others. It may nerve cells found in the brains of are deficient in the neurotransmitter include delusions and hallucinations, Alzheimer’s disease patients and associ- dopamine and may display such symp- alterations of the senses, an inability to ated with the demise of brain cells. toms as tremors, speech impediments, sort and interpret incoming sensations, an movement difficulties and often dementia inability to respond appropriately and an The set of network- Neural pathways: later in the course of the disease. altered sense of self. ing connections between neurons, that are responsible for brain activity. There Post-traumatic stress disorder Serotonin: A neurotransmitter present are an estimated ten million pathways in (PTSD): A psychiatric disorder that can in certain regions of the brain that plays the brain. occur following traumatic events. Left an important role in depression and is untreated, symptoms can be severe used in regulating aggressive behavior. The earliest form of brain Neural plate: enough and last long enough to signifi- tissue, present as a sheet of cells, in the cantly impair the person’s daily life. Spina bifida: A condition caused by a developing embryo for just a few days in neural tube defect that can lead to paral- the third week after conception. Prefrontal cortex: Located behind the ysis and other serious medical conditions. forehead, the prefrontal cortex is part of Origin of the entire brain Neural tube: the frontal lobe of the cerebral hemi- Stem cells: Relatively undifferentiated and spinal cord, which forms from the sphere. It allows us to make decisions, cells that can divide and cycle throughout neural plate during the fourth week after judgments, and future plans as well as life to become more specialized cells, conception. First, the neural plate elon- modulates emotional tone. It is involved for example, liver, brain, or skin cells. gates and folds along its midline into a in such highly abstract functions as per- “groove.” Then the lips of the fold zipper sonal responsibility, morality and self- Stroke: Occurs when blood flow to an shut in two directions, beginning in the control. area of the brain is interrupted. It can middle of the embryo and progressing result from a blood clot blocking a blood both toward the head and toward the Prozac: One medication in a class of vessel, or a blood vessel rupture, either of “tail” of the embryo. drugs called selective serotonin reuptake them causing death or damage to specific inhibitors (SSRIs) that may help to correct brain cells. The type of disability that A birth defect that Neural tube defect: neurotransmitter imbalances, and to results (paralysis, loss of speech, etc.) occurs when the neural tube does not treat depression, panic disorder, obses- depends on the location of the dead or form correctly. The two major types of sive-compulsive disorder (OCD), and post- damaged cells. neural tube defects are anencephaly, or traumatic stress disorder (PTSD). lack of brain formation and spina bifida, in Synapse: Gaps in the circuitry of the which the neural tube fails to close at its Pruning: A process in brain development brain between the junction of an axon of posterior end. whereby unused synapses (connections one neuron and the dendrite of another. among brain cells), are shed. The passing of a signal across this gap is Neurons: Nerve cells, specialized for mediated by neurotransmitter chemicals the storage and transmission of informa- Psychosis: A severe mental and behav- and causes brain activity to move along tion, make up the central nervous system. ioral disorder in which a person is unable specific circuits. They consist of a cell body, a single axon to distinguish reality from fantasy. that conveys electrical signals to other Tau protein: The major protein that neurons and a host of dendrites, that Receptor: A molecular structure on a makes up the neurofibrillary tangles found receive incoming signals. There are about nerve cell membrane that is specialized in the degenerating nerve cells in the 25 types of neurons in a human brain. to respond to neurotransmitters. brains of those with Alzheimer’s disease.

Neurotransmitter: A molecule that Right cerebral hemisphere: Controls Thalamus: A large egg-shaped mass at acts as a chemical messenger for con- the left side of the body, manages nonver- the base of the cerebral hemispheres that veying information between neurons at bal processes, gives us our bearings in is the chief center for the transmission of synaptic junctions. Some familiar neuro- space, and is important for hand-eye sensory impulses to the cerebral cortex. transmitters are acetylcholine, serotonin, coordination and emotional processing. dopamine and glutamate. Resources A www.pbs.org/brain

BOOKS Eliot, Lise, Ph.D. What’s Going On In Program Three There? How the Brain and Mind Develop The Teenage Brain: A World of Their Own The Secret Life of the Brain in the First Five Years of Life. New York: Richard Restak, M.D. Bantam Books, 2000. Babbit, Nikki. Adolescent Drug & Alcohol Abuse: How to Spot It, Stop It, and Get In a companion book to the series, neu- Gopnik, Alison, Andrew N. Meltzoff, and Help for Your Family. Sebastopol: O'Reilly ropsychiatrist Richard Restak reveals Patricia K. Kuhl. The Scientist in the Crib. & Associates Inc., 2000. what neuroscience is uncovering about New York: HarperPerennial Library, 2000. the intricate magic of the brain. Published Cobain, Bev. When Nothing Matters by The Dana Press and Joseph Henry Luddington-Hoe, Susan M., Ph.D. and Anymore: A Survival Guide for Depressed Press, 2001. Susan K. Golant. Kangaroo Care: The Best Teens. Minneapolis: Free Spirit You Can Do to Help Your Preterm Infant. Publishing, 1998. New York: Bantam Doubleday Dell GENERAL INFORMATION Publishing, 1993. Karp, David Allen. The Burden of Sympathy: How Families Cope With Carter, Rita and Christopher Donald Frith. Madden, Susan L., M.S. and Jane Mental Illness. New York: Oxford Mapping the Mind. Berkeley: University of Stewart. The Preemie Parents' University Press, 2001. California Press, 2000. Companion: The Essential Guide to Caring for Your Premature Baby in the Hospital, Kindlon, Dan J. and Michael Thompson. Conlan, Roberta, ed. States of Mind: New at Home, and Through the First Year. Raising Cain: Protecting the Emotional Life Discoveries about How Our Brain Makes Boston: Harvard Common Press, 2000. of Boys. New York: Ballantine Readers Us Who We Are. New York: John Wiley & Circle, 2000. Sons, 2001. Pipher, Mary Bray. Reviving Ophelia: Czerner, Thomas B. What Makes You Saving the Selves of Adolescent Girls. Tick? The Brain in Plain English. New York: Program Two New York: Ballantine Readers Circle, John Wiley & Sons, 2001. The Child’s Brain: Syllable From Sound 1995. Damasio, Antonio R. Decartes’ Error: Davis, Ronald D. and Eldon M. Braun. The Smith, McLaughlin, Miriam and Peyser Emotion, Reason, and the Human Brain. Gift of Dyslexia: Why Some of the Hazouri. Addiction: The ‘High’ That Brings New York: Avon Books, 1995. Smartest People Can't Read and How They Can Learn. New York: Perigee, 1997. You Down (Teen Issues). Berkeley The Dana Sourcebook of Brain Science: Heights: Enslow Publishers, Inc., 1997. Resources for Secondary and Post- Flick, Grad L., Ph.D. Add/Adhd Behavior- Tornval Mueser, Kim. Coping With Secondary Teachers and Students. Change Resource Kit: Ready-To-Use Schizophrenia: A Guide for Families. Washington DC: The Dana Press, 2001. Strategies & Activities for Helping Oakland: New Harbinger Publications, Access the online edition at Children With Attention Deficit Disorder. 1994. www.dana.org. Nyack: Center for Applied Research in Education, 1997. LeDoux, Joseph. The Emotional Brain: The Mysterious Underpinnings of Emotional West, Thomas G. In the Mind's Eye: Life. New York: Simon & Schuster Trade, Visual Thinkers, Gifted People With Program Four 1998. Dyslexia and Other Learning Difficulties, The Adult Brain: To Think by Feeling Computer Images and the Ironies of Creativity. Glendale: Prometheus Books, Golant, Mitch and Susan K. Golant. What 1997. To Do When Someone You Love Is PROGRAMS Depressed: A Practical, Compassionate Wodrich, David L. Attention- and Helpful Guide for Caregivers. New Program One Deficit/Hyperactivity Disorder: What Every York: Henry Holt Paper, 1998. The Baby’s Brain: Wider Than the Sky Parent Wants to Know. Baltimore: Paul H. Brookes Publishing Co., Inc., 1999. Matsakis, Aphrodite. I Can't Get Over It: A Handbook for Trauma Survivors. Oakland: Bruer, John T. The Myth of the First Three New Harbinger Publications, 1996. Years: A New Understanding of Early Brain Development and Lifelong Learning. New York: Free Press, 1999.

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Redfield Jamison, Kay, Dr. An Unquiet ONLINE RESOURCES Focus Adolescent Services Mind: A Memoir of Moods and Madness. www.focusas.com New York: Random House, 1997. GENERAL INFORMATION National Foundation For Depressive Schiraldi, Glenn R. The Post-Traumatic Dana Foundation Illness, Inc. Stress Disorder Sourcebook: A Guide to www.dana.org www.depression.org Healing, Recovery, and Growth. New York: Mental Health InfoSource McGraw Hill, 2000. National Institute on Drug Abuse www.mhsource.com www.nida.nih.gov Slater, Lauren. Prozac Diary. New York: National Institutes of Health (NIH) Schizophrenia Home Page: Penguin, 1999. www.nih.gov A Not-For-Profit Information, Education, and Support Center Solomon, Andrew. Noonday Demon: An National Institutes of Mental Health www.schizophrenia.com Atlas of Depression. New York: Scribner, www.nimh.nih.gov 2001. Society for Neuroscience Brain Briefings www.sfn.org/briefings Program Four The Adult Brain: To Think by Feeling Program Five PROGRAMS The Aging Brain: Through Many Lives Anxiety Disorders Association of America Program One Friel McGowin, Diana. Living in the www.adaa.org Labyrinth: A Personal Journey through the The Baby’s Brain: Wider Than the Sky Maze of Alzheimer's. Valencia: Delta, National Alliance for Caregiving 1994. Talaris Research Institute www.caregiving.org www.talaris.org National Center for Post Traumatic Stress Larkin, Marilynn and Lynn Sonberg. When The Preemie Place Someone You Love Has a Stroke. New www.ncptsd.org www.thepreemieplace.org York: Dell Publishing Co., 1995. National Depressive and Zero to Three Manic-Depressive Association McCrum, Robert. My Year Off: www.zerotothree.org www.ndmda.org Recovering Life After a Stroke. New York: Broadway Books, 1999. Well Spouse Foundation www.wellspouse.org MacE, Nancy L. and Peter V. Rabins, M.D. Program Two The 36-Hour Day: A Family Guide to The Child’s Brain: Syllable From Sound Caring for Persons With Alzheimer’s Program Five Disease, Related Dementing Illnesses, American Academy of Child and and Memory Loss in Later Life. New York: Adolescent Psychiatry The Aging Brain: Through Many Lives www.aacap.org Warner Books, 2001. Alzheimer’s Association Tanzi, Rudolph E. and Ann B. Parson. Children and Adults with Attention- www.alz.org Decoding Darkness: The Search for the Deficit/Hyperactivity Disorder www.chadd.org Alzheimer’s Disease Education and Genetic Causes of Alzheimer's Disease. Referral (ADEAR) Center Cambridge: Perseus Books Group, 2000. International Dyslexia Association www.alzheimers.org www.interdys.org Webb, Marilyn. The Good Death: The National Family Caregivers Association New American Search to Reshape the National Attention Deficit Disorder www.nfcacares.org End of Life. New York: Bantam Doubleday Association Dell Publishing, 1999. www.add.org National Institute on Aging www.nia.nih.gov National Stroke Association Program Three www.stroke.org The Teenage Brain: A World of Their Own

Family Caregiver Alliance www.caregiver.org Workshop A www.pbs.org/brain

How to Organize a SECRET LIFE OF THE BRAIN Workshop by Mari Cossaboom

You don’t have to be a neuroscientist to before! Keep these goals in mind as you pre- organize an educational workshop about the pare an agenda, and refer to them frequently brain. With a little planning, some practical to make sure you are staying on track. strategies, and content-rich multi-media Enhance the workshop content by involving resources such as videotapes of the series people from your community. Invite experts THE SECRET LIFE OF THE BRAIN, this Guide from health care or educational facilities in your and the www.pbs.org/brain Web site, you community. They can make abstract informa- can create an informative, interactive tion more relevant to participants by relating it workshop. Below are a few steps you can to programs in your area or to research that is take to ensure success. taking place at local institutions. Use this opportunity to inform participants about local PLANNING resources for people with brain diseases or vol- unteer options. Identify your target audience. Are you trying to attract teens, parents, caretakers or senior Assess your resources. There are a few logis- citizens? Knowing your audience will help you tical things you need to know before determin- focus the content of the session. Although the ing the structure and the size of the workshop. brain is a universally fascinating subject, each Do you have access to equipment such as group has different interests. Teens may be VCRs and computers? How many people can interested in addiction and sexual develop- the room seat comfortably? What materials ment, new parents might want information such as this Guide, other handouts, reference about language development, and seniors books and videotapes are available? might want to know about brain fitness and Prepare your space and equipment before- healthy aging. hand. Check equipment to make sure it is in Establish goals for the workshop. Keep working order and that you know how to oper- them realistic and attainable in the time you ate it. Cue tapes ahead of time so you are not have allotted. Determine one or two points fumbling to find the right segment. Arrange that you want participants to take away from lighting for the best viewing if you are going to the session. Consider your target audience and use video. Lights should be left on as much as their prior knowledge of the brain. Don’t set possible during the video to reinforce the fact a goal to teach the group neurochemistry from that it is a part of an educational activity, not A to Z if they have never heard of the subject passive entertainment.

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STRATEGIES tion by posing open-ended questions that invite dialogue. Each section of this guide includes Preview THE SECRET LIFE OF THE BRAIN. questions designed to encourage discussion by Select short segments that are most relevant to groups. the focus of your workshop. Using carefully selected, brief video segments can make Summarize. At the end of the session, briefly abstract scientific concepts come alive. The review the topics covered and the activities the series’ use of dynamic visual imagery and cut- group has done. Ask participants to share with ting-edge technology allows you to take partici- the group something they have learned. This pants on impossible “field trips” inside the gives you another opportunity to elicit questions human brain that will make neuroscience acces- and fill in any information gaps. It may also give sible to virtually everyone. you clues about topics for a follow-up session. Prepare participants for viewing the segments. Begin with an introductory activity that engages participants and lets them know what to expect. You might introduce new vocabulary or a new idea or conduct a related hands-on activity. Check out the detailed activity plans based on video clips from THE SECRET LIFE OF THE BRAIN on the project Web site at www.pbs.org/brain. RESOURCES Provide participants a focus for viewing. This THE SECRET LIFE OF THE BRAIN will be one can be a specific task or responsibility to keep of your most useful resources. in mind while the video is on. Ask them to lis- A fully-illustrated companion book, by Richard ten for a definition of a particular word, to Restak, M.D., has been published by the Dana watch for a specific event or even to take note Press and the Joseph Henry Press. of their reactions to the segment. This keeps everyone attentive and directs the learning The five one-hour programs may be taped off experience to the workshop objectives. the air for educational use for one year after the last broadcast. Use the Pause and Rewind buttons for rein- forcement of key messages or to assess the The full set of videotapes is also available audience’s level of comprehension. Stop the for purchase through PBS Home Video. video to find out if participants understand the Call 1.800.PLAY.PBS. scientific concept just described. If they don’t, This guide may be reproduced for use in educa- rewind and play it again. Sometimes, it may tional groups. Additional copies can be ordered take two or three viewings to process the infor- through [email protected]. It also can mation fully. be downloaded from the Web site. Encourage interaction among the group. THE SECRET LIFE OF THE BRAIN Web site Arrange seating so that people can see each (www.pbs.org/brain) is an excellent resource for other and speak comfortably. Build in time for detailed activity plans based on the series, video questions and discussion. Stimulate conversa- clips and tools for publicizing your workshop.