Brain Healing and Parkinson's Disease

BOOK REVIEW OF "THE BRAIN'S WAY OF HEALING”.

I have been revisiting the book

"The Brain's Way of Healing"

by Dr Norman Doidge, which I first read about a two years ago now, in order to refresh my knowledge of the stages of the fundamental processes by which "neuroplastic" (or neurological re-wire) healing occurs.

This is a book near the top of my "must read" recommendations for anyone with chronic illness or trauma, not just because it contains "need to know" understandings, but precisely because it proves to us that there are indeed very many possibilities for things we can do or try, right now, beyond the medical or surgical, which have huge potential to reduce our suffering.

In this way, the book restores hope, and, ironically, that restoration of hope is, in itself, part of the neuroplastic healing process, through supporting the neuromodulation and neurorelaxation stages described below. Conversely, the removal of hope (for example, through what is said to us at the point of a diagnosis), or leaving people despondent, really exacerbates the noisy brain which is now known to be a root cause of neurodegeneration. So, the provision of proof that all is not lost means the reading of this book is in of itself a virtuous circle, and indeed can be part of starting a healing (brain detoxification) process.

Here are my notes, taken as annotated excerpts from the book, on the stages of neuroplastic healing - according to Dr Doidge, this works by modulating or downregulating the abnormal and noisy brain wave activity which occurs in nervous system dysregulations, that are either blocking clear movement and sensory signals or are over-exciting pain responses. It is worth noting that such “noisy brain” problems have been identified as a key element of Parkinson’s Disease,

BUSY, ANXIOUS THOUGHTS AND PARKINSON'S DISEASE.

Neurostimulation

"Neurostimulation helps to revive dormant circuits in the hurt brain, leading a healing process through an improved ability of the noisy brain to regulate and modulate itself. Some forms of stimulation begin from an external source (such as light, sound, vibration), but other forms are internal (thoughts, visualizations)."

Neuromodulation

"Neuromodulation restores the balance between excitation and inhibition in the neural networks and quiets the noisy brain. People with a variety of brain problems can't regulate sensation properly. They are often too sensitive to outside stimulation, or, alternatively insensitive to it. Neuromodulation restores the balance. One way neuromodulation works is by resetting the brain's overall level of arousal by acting on subcortical brain systems, such as the recticular activating system (RAS) of the brainstem, and the autonomic nervous system (ANS)."

Neurorelaxation

"Once stress responses are turned off, the brain can accumulate and store the energy that will be needed for the efforts of recovery, through relaxation and catching up on sleep. Many people with brain problems are exhausted and poor sleepers. Sleep allows waste products and toxic buildups to be discharged from the brain through the cerebral spinal fluid. This helps explain why loss of sleep leads to deterioration in brain function: too much sleep deprivation leads to a toxic brain. The neurorelaxation phase appears to correct this."

Neurodifferentiation

"In the final phase of healing, the brain is rested, and the noisy brain has been modulated and is much quieter, because the circuits can regulate themselves. The person is able to pay attention again, and is ready for learning, which involves the brain doing what it does best: making fine distinctions or "differentiating", e.g. training to make increasingly subtle distinctions in sounds."

I will end this review part with a further nugget of wisdom from Dr Doidge's book, which is helpful in that it teaches us not to give up at the first hurdle, because there are no one size fits all solutions to any of this, so that it is important to try and try again, to keep exploring the different possibilities for neuroplastic healing, in the spirit of curiosity and play, and seek the optimal solutions which fits us best. In particular, I believe modalities which personally bring us some sense of joy, fun, interest or achievement are likely to be the ones which work for us.

"An individual's progress is never, in this neuroplastic approach, dependent solely on the technnique, or the disease or the problem alone. We don't treat disease, we treat people. No two brains are alike, and no two brain problems are identical."

Dr Doidge on Dopamine

The book includes a chapter devoted to Parkinson’s Disease itself and covers a case where a man progressively reduced his symptoms through a regime of a lot of mindful walking outside in nature. However, the book also provides an important clarification on the role of (lack of) dopamine in the problematic part of the brain in PD. A common misconception is that dopamine is the neurotransmitter required for movement, and hence that without it we can't move our muscles. This is not quite the case. Actually, the main muscle movement neurotransmitter is Acetylcholine, which is released by the Vagus nerve. Dopamine is actually a reward chemical that is implicated in motivation, and is required only to motivate and hence initiate movement. The best explanation of this I've found is from the book:

"... dopamine is essential to feel that it is worth making a movement... [it is needed] to feel motivated to move in the first place, particularly for habitual, automatic forms of movement. The greater the [reward] of an [anticipated] outcome, the faster people move to bring that outcome about, as more dopamine is released, giving people a sense of pleasure and energy boost. [Greater dopamine release] also strengthens the [neural pathways] involved in that movement, so that the movement will be easier next time."

This has practical value, since if there is no motivation to move, there is no dopamine released through joyful, pleasurable or rewarding movement, and so the system atrophies further in a vicious circle as the neural connections involved in movement continue to weaken: movement becomes even harder and more painful next time, decreasing the pleasure and the motivation to move even more. As Dr Doidge reminds us through the book

“neurons which fire together wire together, neurons which fire apart wire apart”.

This is why movement therapies are essential for people with PD to prevent rapid degeneration, because it is very much "a use it, or lose it" condition. Movement therapies which have some pleasurable quality or reward association, such as engaging in competitive sports or dancing to music, or the example of walking in awe inspiring natural settings, are likely key.