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25 November 2020, 12:01
RBC Style spoke with Academician Stark about neurotherapy, which can help quickly recover from stroke and brain injuries. Together with colleagues, he is engaged in the treatment of brain diseases and the development of its potential.
Neurophysiology is opening up more and more opportunities to help patients with impaired brain function or complex trauma. Russian scientists are betting heavily on neurotherapy. Through training in the MRI machine, patients can learn to exercise on their own, causing activity in the desired parts of the brain and creating new neural connections. In the long run, this changes the structure of the brain and restores disturbed processes.
Academician of the Russian Academy of Sciences, Doctor of Biological Sciences, Professor of the Federal Research Center for Fundamental and Translational Medicine, Novosibirsk
You are dealing with “network diseases”. What does this concept mean?
Neural networks are a tool for a new networked neuroscience, the emergence of which should be attributed to the early 2000s, when networks were discovered using functional magnetic resonance imaging (fMRI) technology, located in different parts of the brain and including a number of brain formations, often located far from each other. friend, but working together, in sync.
These are areas of the brain, different in their functional tasks, united by the implementation of a number of global mental procedures: thinking about the future, about close and “necessary” people and their relationships, in other words, reflecting the person’s worldview. Therefore, today the state of a healthy and diseased brain should be understood and described in terms of network vocabulary.
Experiments with interactive brain stimulation can use different types of feedback. On the left is a comparatively simple example: when the subject copes with the task, the yellow circle against the background of a section of the brain becomes brighter and increases in size, in case of failure it turns pale and decreases. On the right is a rather complex representation of feedback in the form of a computer game in which two divers compete in the speed of reaching the bottom.
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What is neurotherapy?
Neurotherapy – the therapeutic development of networked neuroscience – is a collection of non-invasive interventions in the central nervous system designed to help us think and act meaningfully.
Neurotherapy is a collective term. On the one hand, this is a purely practical medical therapeutic and restorative technology, the meaning of which is to teach the patient (subject) volitional (cognitive) methods of controlling usually unconscious physiological parameters of the body: blood pressure, respiration, muscle strength, physical characteristics of the brain, and others.
On the other hand, this is a fundamentally new interactive methodology based on the innate abilities of a person at crucial moments in life (illness, reaching peak shape, a dangerous situation) to access their self-regulation resource, effectively use it, that is, turn it from a potential mechanism into an actual one, using methods and means of computer biocontrol based on the vital mechanism of adaptive feedback.
What disorders and diseases can we talk about using neurotherapy?
Neurotherapy is indicated and useful for any type of disease in which the participation of neural networks is expected: hypertension, convulsive states, bronchial asthma, chronic pain, restoration of movement and speech after a brain accident. In other words, the range of diseases and disorders is unlimited.
Today, based on the results of neuroimaging studies, we have information about which parts of the brain are interested in the formation, for example, of chronic pain syndrome, various kinds of addictions, the consequences of severe cerebral accidents, and others.
Take a widespread brain injury – stroke (cerebral infarction), in which movement is significantly impaired. Using neurotherapy, a person can be trained on the optimal mechanism for repairing this defect. “Study” takes place in a tomograph, and then the acquired skill is transferred into ordinary life using mobile devices of the “BOSLAB” class, which the patient can use at home. The possibility of communication between the patient and the therapist via the Internet in off- and online mode is preserved.
One example of learning (sagittal top view and axial bottom): when the hand is actually squeezed into a fist, the cortical motor areas are activated; a similar process occurs when trying to reproduce a similar brain response by an effort of will. In the case of the right hand, areas in the left primary motor cortex – the target region (shown in red) are activated. Areas activated by neurofeedback (volitional control techniques at the patient’s discretion) are marked in green; yellow – areas activated when trying to self-regulation using the imagination of action. It can be seen that in this case, adjacent brain zones begin to work with a slight overlap of the target region.
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What is the peculiarity of neurotherapy that distinguishes this technology from other existing methods and methods?
Computer neurotherapy technology. Learning to control physiological functions occurs in an online computer circuit: the subject (patient) is most often shown on the monitor a simple “metaphor” closely related programmatically to the localization of the lesion – for example, a thermometer, a moving object of a simple shape, a simple game, in other words, an animated film adaptation, the visual image of which can be changed by will. The subject observes the dynamics on the monitor, learning with the help of instructions or independently changing them in the “desired” direction.
Usually there are two options for learning to control physiological characteristics: according to the instructions of a trainer (doctor, psychologist) or independently, relying solely on oneself, on one’s so-called mental resource. The execution of an interactive task is accompanied by certain visualized changes in the structures of the brain, which is subsequently converted into a newly acquired skill or a system of skills necessary for an independent free life.
From all that has been said, a wide range of neurotherapy use follows: a) from educational and educational procedures, the analysis of the intentions of a healthy person striving to reach the peak of form in a favorite business; b) to a number of serious diseases, which were mentioned, requiring support of bio-management technology.
What is the advantage of neurotherapy?
The main advantage is the guarantee of a non-violent transition in the learning process from a scenario in which the patient, as usual, is a passive object of intervention, to an active participant in the entire treatment and recovery process. This point is the main (key) advantage of neurotherapy, it is based, as already mentioned, on the vital (life) mechanism – adaptive feedback, for which the biofeedback tools are designed. Being in the feedback loop in real time receives information (visual, auditory, tactile) about the effectiveness of his volitional attempts and forms options for maintaining the newly acquired skills.
A significant part of the methods and techniques of neurotherapy, and finally, their therapeutic effectiveness depends, as follows from the network paradigm, on the activity of central mechanisms localized in the brain. That is why today neurotherapy is regarded as one of the most interesting and promising practical areas of modern neuroscience.
In the process of neurofeedback, new neural networks with strong and weak connections are formed in the brain. At the same time, the greatest increase in the strength of functional connections was noted between the pre-wedge network and the network for detecting significant objects. I, II, III – start, intermediate and finish stages of the experiment with a two-week interval between measurements.
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What successes have Russian scientists achieved in the field of neuroscience?
For the first time in Novosibirsk, at the beginning of the 2000s, independently of our foreign colleagues, a system was constructed based on visualization of the processes occurring in the brain as a result of teaching control in a tomograph. We call this technology interactive brain stimulation (therapy) and is considered a new generation of neurotherapy.
In the scientific direction, one should focus on the study of neurovascular cohesion, consisting of neural and capillary networks, between which special cells are located – astrocytes. The neurovascular cohesion is the central module where healthy and pathological events in the brain are enacted. With the help of fMRI, you can see the processes that take place there. We observe zones of activity in certain points of the brain for any type of its activity: speech, motor, mental.
What discoveries in the field of neurotherapy can be called revolutionary?
The most significant discovery of interactive science, neurotherapy, is undoubtedly direct volitional interventions in brain networks in a number of widespread diseases, which have already been mentioned. An even more promising line of development is the ability, knowing the architecture of neural networks responsible for simple and complex human actions, to change (reconstruct) them, create new, non-existent neuroarchitectures and, thus, improve human mental functions.
Where can you find a neurotherapy specialist?
They must be done, created. Modern neurotherapy is closest to restorative medicine, rehabilitation of conditions after complex diseases: strokes, severe stress disorders, deep addictions, chronic pain. Specialists in this field of activity are trained at the Research Institute of Molecular Biology and Biophysics at the Federal Research Center for Fundamental and Translational Medicine and the Scientific and Research Firm “KOMSIB” in Novosibirsk.