Health

Curious hole in my head


I entered the world – an impending birth, the doctors called it – at a New York City hospital in the dead of night.

In the first few hours of my life, after six episodes of apnea, the doctors took me to the neonatal intensive care unit. A medical intern student put her little finger in my mouth to test the sucking reflex of an infant. I’m not sucking hard enough. So they rolled my pink cake, 7 pounds-11-ounce body into a brain scanner.

Lo and behold, there’s a huge hole on the left side, right above my ear. I was missing the left temporal lobe, an area of ​​the brain involved in many behaviors, from memory to recognition emotions, and is considered particularly important for language.

My mother, exhausted from work, remembers waking up after sunrise to a neurologist, pediatrician and midwife standing at the foot of her bed. They explained that my brain had been bleeding in her uterus, a condition known as a perinatal stroke.

They told her I would never speak and would need to be institutionalized. The neurologist brought her arm in front of her chest and twisted her wrist to illustrate the physical disability I might have.

In the early days of my life, my parents wondered what my life and theirs would be like. Eager to find out, they enrolled me in a research project at New York University tracking the developmental impact of perinatal stroke.

But month after month, I’ve surprised experts by meeting the typical milestones of children my age. I enrolled in ordinary schools, excelling in sports and studies. The language skills that doctors worried about most when I was born – speaking, reading and writing – turned out to be my career passion.

My case is very unusual but not unique. Scientists estimate that thousands of people, like me, live normal lives despite missing a large part of our brains. Our network of countless neurons has managed to rewind itself over time. But how?

My childhood memories are filled with researchers watching me with pens and clipboards. My brain is scanned several times a year, and I am tasked with solving multiple puzzles, word searches, and visual recognition tests. At the end of each test day, the researchers would give me a sticker, which I keep in a tin by my bed.

When I was about 9 years old, researchers wanted to see how my brain would function when I was exhausted. Sometimes I stay up all night with my mom, eat Chinese food and watch Katharine Hepburn and Spencer Tracy movies. The next day, I walked into the clinic half-consciously, and the scientists would stick electrodes on my scalp. As long ropes fell from my head like Medusa’s snakes, I was finally allowed to drift off to sleep, happily unaware that researchers were looking for abnormalities in my brain waves.

Over the years, the scientists realized that I wasn’t like the other kids in the study: I ​​didn’t have any deficits to track over time. When I was about 15 years old, my dad and I met in the messy Manhattan office of Dr. Ruth Nass, the pediatric neuroscientist who led the study. She questioned whether I really had a perinatal stroke. In any case, she frankly said that my brain was so different from other people’s brains that I could no longer participate in the study.

I do not care. I had other things going on in my life, such as starting high school, cross country practice, and lovers. But I also learned enough about neuroscience to become completely hooked on the subject. When I was 17 and entering my senior year of high school, I wrote to Dr. Nass and asked if I could do an internship in her lab. She readily agreed.

One day in the lab, I asked her if she could show me my research file. We entered a room filled with stacks of plastic bins, each filled with loose folders and papers. She grabbed a document and read it quietly. Then, looking at a piece of paper, she said, “You’re the worst participant because you’re totally fine! You have thrown away all my data. “

Dr. Nass, who passed away in 2019, and her colleagues will continue to publish more research on perinatal stroke. For example, in a 2012 paper, they found that infants with these strokes had higher risk of attention and behavior problems compared with the general pediatric population. Many of these children – recruited between 1983 and 2006 from ‌Southern California and New York City – developed seizures and muscle weakness on one side of the body. Most also have damaged or missing areas, called lesions, in their left hemisphere, like mine. I assume one of those data points is mine.

I majored in neuroscience in college. After graduating in 2015, I spent two years working in a lab working on concussion research. I spent hours in the MRI room, watching other people’s brains appear before me on a computer screen.

But I never thought much about my brain until this spring, when I overheard a story in Wired magazine. about a woman like me: amazingly normal, except for a missing temporal lobe.

For more than a century, the left hemisphere of the brain has been considered the center of language production and acquisition.

This idea was first proposed in 1836 by Dr. Marc Dax, a physician who observed patients injured in the left part of their brain. can no longer say right. 25 years later, Dr. Pierre Paul Broca observed a young people lose the ability to speak and could only utter one syllable: “Tan.” A brain biopsy following the patient’s death revealed a large lesion in the anterior part of the left hemisphere, now known as Broca’s area.

In the early 1870s, Dr. Carl Wernicke, a neurologist, saw that some patients could speak fluently, but their words made no sense. One of these patients had a stroke in the back of her left temporal lobe, and Dr. Wernicke concluded that this part of the brain – now known as Wernicke’s area – was right. serves as a second center for languagealong with Broca’s area.

But other neuroscientists have argued that language processing is even broader and not limited to specific brain regions.

“I believe language in the brain is distributed throughout the brain,” says Jeremy Skipper, head of the Language, Action and Brain Lab at University College London (and my former university psychology professor). whole brain.

Studies have shown that written words can activate the part of the brain associated with the meaning of the word. For example, the word “phone” activates a field related to hearing“Kick” activates an area engage in foot movementand “garlic” partially activated odor treatment.

Dr. Skipper said the brain regions traditionally attributed to language have a lot of other functions. “It just depends on what other parts of the brain they’re talking to and at what time and in what context.”

The Wired article described an anonymous woman from Connecticut who had no idea she was missing her left temporal lobe until she underwent an unrelated brain scan as an adult. Over the past few years, the article explains, she has been part of a research project led by Evelina Fedorenko, a cognitive neuroscientist at the Massachusetts Institute of Technology.

In April, I wrote Dr. Fedorenko an email told her about my missing left temporal lobe and offered to be part of her research. She replied four and a half hours later, and soon I booked a plane ticket from my home in rural Colorado to Boston.

There are currently eight people involved, myself included, in Dr. Fedorenko’s Interesting Brain Project, she told me. I haven’t met them yet, but four of us are thought to have suffered a perinatal stroke, which resulted in damage to our left hemisphere of the brain. Two participants had benign cysts in the right or left hemisphere, one had a stroke in the right hemisphere, and one had brain tissue removed in the left hemisphere because of a tumor.

“The brain has amazing neuroplasticity,” said Hope Kean, a PhD student in Dr. Fedorenko’s lab who is running the Interesting Brain study as part of his thesis.

It seems that the networks in the brain line up in a particular way, but if you lose important brain regions at an early age – when the brain is still very plastic – these networks can reroute, Ms. Kean said.

I went to Dr. Fedorenko’s laboratory in Cambridge on a hot July day. I lie on a bed that slides into the narrow tube of the MRI machine, with a cagelike device placed over my head. Miss Kean put a mirror over my head so I could see a screen on the back of the scanner. As the machine started to make a loud bang, I remembered all the times I’d dozed off as a kid, lulled to sleep by its resounding sounds.

On the screen, words flashed rapidly and a voice read them aloud, forming random sentences like “Only found the slightest hint of heel in teen shoes.” Then the words turn to a jumbled assortment of letters, making confusing sounds.

After the scan was complete, the researchers and I gathered around the computer screen, where I saw part of my brain for the first time. I stared in disbelief, amazed that my nervous system might have rerouted around this large, oblong hole where my temporal lobe should have been in the posterior void. my left temple and eye socket.

In the brain of the average person, the sentences I hear and read in the scanner strongly activate the left temporal and frontal lobes, while meaningless sounds are not.

The researchers’ studies found that Connecticut patients’ brains adapted by switching sides: For her, these sentences were activated right temporal and frontal lobesaccording to a case study published in the journal Neuropsychologia.

However, my brain surprised everyone.

Preliminary analysis of the scan results shows that, even without my left temporal lobe, I still process sentences with my left hemisphere.

“I would have thought that any early damage to the large left hemisphere would lead to a migration of the language system to the right hemisphere!” Dr. Fedorenko said. “But this way, science is great. Surprise often means exciting discoveries”.

According to Dr. Fedorenko, one possible reason behind this finding is that my lesion was mainly in the front of the left hemisphere, leaving enough healthy tissue in the back for the language system to develop.

Over the next few years, I will be flying back to the lab for more scans and tests, and Dr. Fedorenko hopes to recruit more people with unusual brains to participate in this study.

I still think about the research I was involved in as a child and about all the other children who had perinatal strokes that left many of them severely disabled. For some mysterious reason, my brain grew around its missing lobe, while they struggled to do so. Why wasn’t I born with developmental and cognitive problems, but what about them? Why is my left side giving me the syllables, words, and phrases that have enriched my life?

It is these questions that make me grateful to have been involved in this study – and once again to be a research participant.



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