All language subtitles for The.Brain.That.Changes.Itself.2008.1080p.WEBRip.x264.AAC-[YTS.MX]

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- [Voiceover] There's
always a strong temptation

to think of the brain or
to call a brain a machine

or talk about it as a computer.

- [Voiceover] When I
was in medical school,

we were taught that the
brain is what it is,

and nothing really can change it.

- [Voiceover] I learned that the brain

was pretty much hard-wired,

and that what you've got by the age of 18,

you're left with.

- [Voiceover] All of this work suggests

that we need to radically change
this old view of the brain.

- [Voiceover] I think we're now learning

that, in fact, the brain
is changing all the time,

that the brain is changing
with everything we think,

with everything we experience.

- My name is Dr. Norman Doidge.

I wrote a book called The
Brain That Changes Itself.

(audience applauds)

- I'm here today to describe
what I've come to believe

is the most important
change in our understanding

of the human brain in 400 years.

This idea is revolutionary,
because for four centuries,

mainstream medicine and science

have seen the brain as fixed

and described it as though
it were a complex machine

with parts, each of which
perform one mental function

in a single location in the brain.

This machine metaphor gave
rise to what I have called

the doctrine of the unchanging brain.

A sense that treatment
for many brain conditions

was impossible or unwarranted took hold,

and it spread through the culture,

even stunting our overall
view of human nature.

But what if the idea of the
brain as machine or mechanism

is not only wrong, but
spectacularly wrong?

When I first heard reports
that the human brain

might not be hard-wired,
I had to investigate

and began a series of
travels, and in the process,

met a band of brilliant scientists

at the frontiers of brain science,

who'd made a series of
unexpected discoveries.

These scientific heretics began

to call this new brain
property "neuroplasticity".

Neuroplasticity changes everything.

The brain is not a machine.

It has to be understood on its own terms.

And this is the remarkable story

of the brain that changes itself.

I went to Madison, Wisconsin

to meet with Mitch Tyler and Yuri Danilov,

two people who had worked
with Paul Bach-y-Rita,

perhaps the most important
pioneer of his generation,

the great visionary of neuroplasticity,

who, after some very personal experiences

with the death of his father,

figured out that the
human brain is plastic

and then began to invent

all these extraordinarily
ingenious devices

to help people rewire their brains.

- Given that Paul is a
visual neuroscientist,

and that's what his training was,

he was looking for a way to demonstrate

this idea of this neuroplasticity,

or the brain's ability
to rehabilitate itself.

And the logical extension of that

would have been in the blind population,

developing a blind prosthesis if you will,

or a sensory substitution device.

- Ok, now let's try something
a little different now.

- Ok, it's a telephone.

And the receiver is to the right.

- In sensory substitution, he claimed that

brain is flexible,
plastic, and smart enough

to analyze any information
that you can deliver

accurately to the brain.

- Or you could actually take
signals from a video camera

and presenting this stimulus on the back

of the patient who was blind

and have them be able to
pick up that information

as though it was coming from their retina,

and treat that information the same way.

It's vision.

It doesn't matter where
the signal's coming from.

- [Voiceover] How a
sensation entered the brain

was not important to Bach-y-Rita.

What was important

was what the brain did
with that sensation.

- The source of the signal
really is almost immaterial,

as long as you provide
that signal to the brain

and give it a context
that it's being used in,

the brain will figure out how to use it

and use it to its own ends,

to both rehabilitate and
also to perform the task

that it's trying to accomplish.

- Yea, I'm 54.

And I've been blind for
38 years, totally blind.

- Let's stay inside the lines, Roger.

- I see black, but I
have no eyes whatsoever.

- [Voiceover] Over the years,

that big dentist's chair and
massive computer behind it,

have all shrunk down so
that it pretty well fits

into a pair of glasses
with a mini-camera in it.

- The simplest way I've
described it is when you're kids,

and you're laying in bed,

and one of your brothers or
sisters are drawing on your back

with your finger, and you're
trying to guess what it is.

It's kind of the same
principle in a sense.

This device is drawing it on
your tongue in vibrations.

- Roger, that turn was incredible.

- Yea, it was a sharp one.

I went, "Wait a minute."

It was foolin' me.

- You didn't cut it at all.

- It's drawing images onto your tongue,

and I try to get the whole
image as much as I can

on this little
one-inch-by-one-inch sensor.

It's tracing it like you do
on your back when you're kids,

but it's now tracing it on
your tongue electronically.

- And see if you can try and put your hand

on the top of the arrow.

Little higher.

- I mean definitely people think,

"Well, it's touch."

Well, not for me.

I mean, as soon as I put that on,

within a matter of
seconds, I am seeing it.

I mean, I talk about seeing, because I am.

It's drawing pictures in my head.

- Perfect.

- I mean this was very emotional for me,

and I told my wife the same thing.

I said, "Maybe someday, I'll
be able to see your face

"for the first time ever in my life."

- [Voiceover] We have senses
that we don't know we have

until we lose them, and
balance is one of them.

- In this helmet, we have a
little two-axis accelerometer.

And what it does is converts
your head-position information

into a little signal that's presented

on the tongue display here.

- [Voiceover] Once Bach-y-Rita realized

that you could get sensory modules

that seem to process one
sensation to process another,

he turned to a very important problem,

the problem of balance.

- Now what I'm gonna have you do

is go ahead and just put it in.

And your job is to actually
keep that little, red square

in the middle of the box.

So, it actually moves in response

to the position of the helmet.

- [Voiceover] Today, you
can see Cheryl Schiltz

riding a bike, which seems
like a very ordinary event.

But actually it's most extraordinary,

because Cheryl Schiltz is a woman

who had her balance apparatus
almost completely obliterated

as a side effect from a
medication she received.

- One morning when I
tried to get out of bed,

I literally fell to the floor.

I tried to get up, tried to
get on my hands and knees,

and I was just wobbling around,

and I just would fall again,

and I'd fall again,

and I remember looking,

and it was more of like a
never-ending sense of tumbling.

And the doctor told me that
it is a permanent condition,

but you'll learn to get used to it.

And actually the worst word
of it all was "permanent".

"Permanent" made things stop.

It made it stop that

this is just the only way it will ever be.

- So how is Cheryl able to ride a bike?

- When we first met
Cheryl, she was a wobbler,

a self-described person
with a balance problem

and on disability.

But she was wobbling profoundly.

What I also realized is
that this is her world.

This is something that
she lives with every day.

- I always had this
constant noise in my head,

and not a noise that,
like, you hear noise,

but this feeling of noise.

If you could hear confusion,
that's what it sounds like.

And my brain was really, really confused,

because it didn't know what to do.

It was so consumed with
just trying stand up

and stay straight.

When I put that device in,

it was just like "Ohhhh."

It was like I stepped out of that room,

and I'm standing on the side
of the ocean or something.

It was just like, "Oh my gosh. It's quiet.

"It's still, and it feels so good."

It's like I came back.

- [Voiceover] Bach-y-Rita thought

that the brain could rewire itself

by unmasking alternate pathways

or sprouting new ones.

What Cheryl's brain is doing,

is receiving the signals from her tongue

and sending them to the
part of her brain stem

that normally processes touch.

It's then that her brain
redirects this information

to the area that deals with balance

by unmasking dormant pathways.

- So the analogy, that I
think I inherited from Paul,

is that, in the normal nervous system,

you have your major pathways.

They're sort of like the
freeways in your brain

that handle large volumes of information

and do it very efficiently.

But if there's an accident on the highway,

you can either sit in
traffic and not do anything,

or you can get off on the secondary road.

- [Voiceover] Over time,
what the brain does

is it takes those back roads

and turns them into the superhighways

and reroutes the information

so that we're taking the existing pathways

and making them more efficient.

- By having that sensation on my tongue,

I had to reroute my
patterns and my thoughts

and how my brain was functioning

to focus on that input, if you will.

- Cheryl was able to pick up that signal

within a couple of minutes

and learn how to move head
left, right, front, back,

and pick up the signal and
maintain upright posture.

Perfect posture.

She stood with military precision almost.

And we were amazed by that.

- And when we realized that
she's stabilizing her body,

we decided to try to remove
the device from the mouth

and see how long she can stay

and keep the balance afterwards.

- And what we found was,

when we took the strip from my mouth,

that there was a residual.

It would follow a little bit, you know.

The longer we did it,
the longer the residual.

- So then when we
continued the exploration

of this residual effect,

we figure out that the effect
have ability to accumulate.

With each training session,
it's getting longer.

- Suddenly, there was
a profound realization

that these people don't have to use

this device all the time,

that there's something more
than just sensory substitution.

It's a neuro-rehabilitation.

The brain is learning how to change itself

by use of this device.

That's the big breakthrough.

- The greatest thing
is, is I'm not dependent

on the device anymore.

It truly, indeed, without
a doubt, rewired my brain

in some fashion, how
I honestly don't know,

but it did.

Hi!

- Hey, Cheryl.

- Good to see you.

- It's good to see you.

- The idea that the brain
could change its function,

that it could morph, it could adapt

to new tasks was really radical.

And it took Paul some forty years

to demonstrate that that was possible.

And we're just at the front edge

of finally realizing Paul's vision

of being able to take
this idea and run with it.

- So she'll do that for
a while, and I'd like,

I think she'd like to do
this as long as possible

so that she gets the long record.

- [Voiceover] Paul
Bach-y-Rita's importance

lies in being a visionary,
the first of his generation

to really understand the
full potential of plasticity,

and to begin to apply it so
that it could help people,

and to describe a new brain,

a brain that evolves in a
changing world to change itself.

Sadly, Paul Bach-y-Rita
is no longer with us.

A couple of years ago, he
developed a brain tumor

and passed away.

- The first thing he
said when he learned was,

"But oh, I have to hurry.

"I still have many things
that I want to do."

He was a man with a mission,

and, I mean, he dedicated
all his life to that.

- Did he have a sense that the
wave was starting to break,

and suddenly plasticity
was just on the brink

of becoming accepted for the first time?

- He said, "Well, you know,

"I just planted some seeds,

"and hopefully others will continue."

- So what we're realizing is,

we're still proving Paul right.

And Paul's visionary
concepts from forty years ago

are just now being realized.

I think he got a glimpse
of that realization.

And when you see the film clip
of Cheryl dancing with Paul,

I think Paul finally got a
glimpse of the realization,

the first instance of really seeing

his idea coming to fruition.

- [Voiceover] I already knew
enough about the science

of the brain to know that
brain plasticity was possible.

But then I had the extraordinary good luck

to meet an amazing neuroplastician,

Barbara Arrowsmith Young,

who, as it happened, was living
in our backyard as it were,

in Toronto.

- What I'm doing here at Arrowsmith School

and in this program is actually
changing cognitive capacity.

The students that I work with

are predominantly students
with learning disabilities.

- Would that be 10 minutes before,

or would that be now?

- We're really walking

into the territory of their weaknesses.

We're going in and targeting
the area of difficulty.

And do you know why you use the eye patch?

- No.

- 'Cause this eye right here

talks to this brain area over here.

- Barbara Arrowsmith Young

was one of the first
neuroplasticians I met.

And she was a person who was born

with a devastating array
of learning disabilities.

Many of her cognitive areas

were quite retarded, in
fact, in development.

She had trouble speaking clearly.

She didn't know where
her limbs were in space.

But her most devastating
difficulties had to do

with a difficulty in understanding
how to relate symbols.

This problem was so devastating for her

that she really couldn't
understand conversations

as they were happening in real time.

- Growing up, I felt very stupid.

My teacher told my parents
that I had a mental block

and that I wouldn't learn
the way other children do,

and that I would have a struggle in school

throughout my schooling.

And being very, very
literal, I actually thought

that I had a wooden cube in my head

that was making learning difficult.

I developed all sorts of coping strategies

to try to cover up.

Ok, fabulous. You were good.

- One day, one of her very close friends,

and a fellow student,

gave her a book by Alexander Luria,

called A Man with a Shattered World.

And it described a person who had deficits

that were very much like
what Barbara suffered from.

It was the story of a Russian soldier

who had shrapnel in his head.

And he too had trouble
with grammar and logic,

and cause and effect, and
couldn't read a wristwatch.

- He talked about the person
that couldn't tell time,

couldn't understand concepts,

the person that really felt
that they were not able

to process or understand
information in real time.

And it was an incredible ah-ha moment.

- [Voiceover] That
soldier's lesion was caused

by the shrapnel that had been lodged

in the part of the brain
that integrates signals

from the occipital lobe,
which processes vision,

the temporal lobe, which
processes sound and language,

and the parietal lobe,
which processes touch.

So now she knew the junction,
or area of her brain,

that was underperforming.

The problem was, Luria was never
able to provide a treatment

for the poor soldier he was treating.

- Then I also came across a paper

by a neuroscientist, Mark
Rosenzweig, out of Berkeley,

and he was looking at neuroplasticity

and that the brain wasn't fixed,

that the brain actually could change,

that through very specific
stimulation and exercise,

you could change the brain
at a physiological level,

which then allowed effective
learning to go forward.

It made me realize,

"You know what?

"I don't need to be stuck
with this learning disability.

"I don't need to live the
rest of my life with it.

"There's a possibility here
that I may actually be able

"to do something about it
and rewire my own brain."

- Because she couldn't read clocks,

what she did for her first exercise

was very simple and elegant.

- [Barbara] I took a number of flashcards.

I made up a number of times,

and I drew the clock faces.

- Then she would add a
minute-hand and a second-hand

and a hand for the week
and the month and the year.

And a number of weeks into it,

she started to notice some
extraordinary changes.

- It was incredible.

It was like blinders came off.

- Just by these incremental exercises,

she was building up new connections

in those processing areas

so that they could start to function,

eventually at an average level,

and then at an above-average level.

- What I believe this work does

through specific cognitive exercises,

is actually stimulate the function

of the underlying brain area to change it,

to rewire it, to strengthen
it, to improve it,

and they can walk out of this program

and never have to look back.

- I was diagnosed with
Stage 3 breast cancer

two days before my 35th birthday.

Happy birthday, you have cancer.

And I was told that I was
gonna have to do chemotherapy.

I knew about the nausea, the
fatigue, things like that.

And I certainly got those in spades.

But I also found that there's
thing called chemo-brain.

So chemo-brain is almost like a fog

that just sort of descends on you.

And it makes it really difficult

to kind of process information.

I would struggle for a
word in conversation,

so I didn't have that sort of word recall

that most people have.

It's major memory problems.

We take for granted that we
know where we put our keys.

I mean, everyone's lost their keys, right?

But it's a much more
profound thing than that.

It's this fog that descends on you,

and you can't make out the details.

- Well, in any case in which
there's diffuse brain injury,

as a consequence of something
like intensive chemotherapy,

basically the brain is
operating with increasing noise.

Basically it's struggling
to represent information

in detail with high accuracy.

- Mike Merzenich is the driving force

behind scores of innovations

of practical applications
for brain plasticity.

Merzenich's special
ability is training people

to think and perceive better

by working on brain processing areas

called brain maps.

Our brains represent the external
world through these maps.

And their borders were
believed to be fixed,

but Merzenich discovered that these maps

can actually grow and
strengthen with exercise.

- Good morning.

Thank you for calling Scientific Learning.

How can I help you?

- Well, Scientific Learning
focuses on problems in children,

and we're basically trying

to improve the capacities of children

through driving their brain plastically

in positive or corrective directions

and in ways that would improve
their academic performance.

- One of the systems that he co-developed

is called Fast ForWord, and it's basically

a way of treating auditory
learning disabilities,

disguised as a computer game.

- These exercises are game-like.

From the kid's perspective, they're fun.

(computer beeps twice)

But in fact, they're
intensive, serious exercises,

and they're actually
optimized to drive the child

as far as possible in a corrective,

or a more normal or
more powerful, direction

as fast as possible.

- One of the things that's so
powerful about Fast ForWord

is that, before the program,
kids with reading difficulties

have very unusual scans, very,
very different from normal.

But as they start to
improve on the exercises,

and as they start to
get better at reading,

Merzenich was able to show

that their brain scans also normalized.

- [Computer Voice] The fish are swimming.

- [Voiceover] But
Merzenich's scientific work

is not just for children.

- Ready? So this exercise
is called Bird Safari.

- [Voiceover] He has been able to prove

that plasticity exists
from cradle to grave.

And studies show that the elderly can use

his brain fitness program
to sharpen their memories

and function as well as they did

when they were from 10
to 25 years younger.

- Well, old brains slow down.

And old brains, again,
represent information

in lower fidelity,

You can think of it as a
little bit like a radio station

that's no longer quite
tuned to the station.

Older brains forget
most of what they hear.

Older brains forget most of what they see.

A younger brain remembers
most of what it hears,

remembers most of what it sees.

This is machinery that
also contributes greatly

to controlling how we feel about life,

how we operate in life,

how closely we can attend to the things

and enjoy the things of the world in life.

And it's really important that
the average older individual

keep this machinery in good shape.

- [Computer Voice] Click the
matching arrows in order.

If you hear,

(computer beeps twice)

click the Up arrow twice.

- [Voiceover] The brain fitness program

is this great computer program.

It's got several different, sort of games

that really press you
to expand your memory.

- [Voiceover] What were the first changes

you actually noticed?

- I noticed my attention span lengthening.

That was the first thing that I noticed.

But after a couple weeks,
and I started seeing changes,

then I thought there really
is something to this.

This is really worth my time.

It meant that I was
gonna be able to function

the way I used to.

It meant that I wasn't gonna
be limited by chemo-brain.

- Well, it was a typical Friday morning.

I proceeded to go out to
play tennis with a local pro

that I've played with for about 25 years.

And he says to me, "Mike,

"your game is not what it usually is."

And I said, "My balance is slightly off."

But I continued to play.

- Michael Bernstein was an eye surgeon,

who would work with
very small instruments,

operating inside an eye.

And he was a classically trained
pianist and a tennis buff,

who, in the prime of
life, at the age of 54,

suffered an incapacitating stroke

that made it impossible for
him to move half of his body.

- [Michael] The left hand, the left arm,

and left leg were paralyzed.

The speech therapist and
the occupational therapist

said it would be very slow
and not to expect too much.

- Michael Bernstein was
one of the first people

to go to the newly-opened
Taub Therapy Clinic

in Birmingham, Alabama,
to try a new treatment

called constraint-induced therapy.

Dr. Edward Taub developed the therapy

for stroke victims.

It can even work on people

who have been paralyzed for years.

- Alright, go Molly, go.

Really let go of it.

- [Voiceover] The patient's
good arm is constrained

in a mitt, so it can't be used,

forcing their paralyzed arm

to try rudimentary tasks.

- Keep going.

- The axiom in rehabilitation was

that there was nothing you
could do with these people

that would make them improve,

that would enable them to use
their affected extremities

any better than they could.

- Judy had trouble communicating.

She had a very serious
stroke October 24th.

- One of the techniques that
we use is called shaping.

It's a kind of training technique
in which you get a person

to improve their motor response,

their motor function, in very small steps.

- The essence of the cure is
this incremental training.

Concentrated practice
helps rewire the brain

by triggering plastic changes.

After there has been massive brain death,

new neurons are recruited
to take over lost functions.

- Pick that up, and back up.

- [Voiceover] You don't
try and get a person

to perform a perfect movement

if they have just the rudimentary ability.

You just try to get them to
improve just a little bit.

- Good, good. Stretch it out.

Stretch, stretch, stretch.

- They're children's games to us,

but to the patients,

they're major life challenges.

- Hello Mr. Taylor, how are you?

- Fine, thanks.

- Good effort, that's great.

Alright, show us what's
on your other hand.

- This one?

- That's the mitt.

- He wears it all day here,
and then when he goes home,

he wears it for as many of
his waking hours as he can.

- So that he can't use his good hand?

- Right.

Alright, ready, set, go.

Really control it, really control it.

- People who've had stroke
or traumatic brain injury

frequently don't use
the more affected arm,

not because they can't use it.

They don't use it, because they've learned

not to try to use it.

- Nice.

Take it back.

31.74, that's better.

That's seven seconds faster.

- What we find after CI therapy

is that the healthy part of the brain

is recruited to produce
movements of the affected arm,

and that is what we call neuroplasticity.

- Taub's technique developed

because he had spent years
doing a form of research

that involved something
called deafferentation.

Afferent nerves are
basically like sensory nerves

that feed information from
the limbs to the spine.

Ed Taub deafferented some monkeys

so that they couldn't use their arms.

Then he decided to take
their deafferented arms

and put them in slings.

- This is a unilaterally
deafferented animal.

The right hand is the
afferented, the right arm.

And the left arm is normal.

- You deafferent one limb in a monkey,

and the monkey doesn't
use that limb again.

However, on the basis

of this really rather short intervention,

one week of placing the
animal in a restraining device

that prevented him from
using the intact arm,

he began using the deafferented arm.

And then, when you removed him
from the restraining device,

he would use the limb again
for the rest of his life.

- When the animal is very hungry,

we can increase his
motivation sufficiently

to try and force him to
use the deafferented limb.

With adequate training,
the afferented animals

were capable of carrying out

virtually every major
category of movement.

- Taub was now very
excited, because he wondered

if this thinking could now be applied

to human beings who suffered strokes.

- If you could get the same result

in human beings after stroke,

you would then have an enormously powerful

and effective way of treating stroke,

and traumatic brain injury,
and other types of damage

to the central nervous
system in human beings.

- Keep going.

- It turns out that
Taub's technique is good

for many conditions beyond stroke victims.

He's used it with people with
all kinds of brain damage,

including soldiers returning from Iraq,

people who have had their brains damaged

by chemotherapy and radiation.

It's even been used with
children with cerebral palsy

and proven to be effective.

- Squeeze my finger, and let him out.

- Oh, get it, get it, get it.

- Good girl. We're almost done.

- Sometimes, the process goes slowly,

and sometimes it goes remarkably rapidly.

When it goes rapidly, it's
almost like a miracle.

- [Voiceover] Michael
Bernstein is now back at work,

using his hands in very
fine motor activities.

- I only spent 10 days
of therapy with Dr. Taub,

and the result was amazing.

Ok, sit back.

I could almost sense

that each hour of doing a different task,

I improved.

I couldn't make that
movement, or that movement,

or that movement, or that.

Simple movements that are
required in daily life

that you couldn't do
because of the stroke.

Ok, sit back.

(classical music plays on piano)

I hadn't touched a piano in 41 years,

and I decided to get this
performance together.

And I sent out invitations

and invited Dr. Taub and his wife.

- The bottom line is that you can teach

an old dog new tricks.

That principle is at the heart

of a revolution in rehabilitation.

(classical piano music plays)

(audience applauds)

- [Voiceover] Encore, encore!

- One of the most
important lessons I learned

on this quest to
understand neuroplasticity

is something I call the plastic paradox.

The paradox is this,
that the same plasticity

that allows us to change our brains

and produce more flexible behaviors

is also the source of many
of our most rigid ones.

All people start out
with plastic potential.

Some of us, as we grow and develop,

enhance that flexibility.

For others, the spontaneity, creativity,

and unpredictability
of childhood gives way

to a routinized existence
that repeats the same behavior

and turns us into rigid
caricatures of ourselves.

Anything that involves unvaried
repetition, our careers,

cultural activities, skills
repeated, and neuroses,

can lead to rigidity.

- For a while, people had this notion

that plasticity must be a good thing.

It's a good thing that
the brain can change,

because we can learn new things.

And that's true.

But if plasticity is an
intrinsic property of the brain,

it's neither good nor bad,
it's just the way it is.

- Alvaro Pascual-Leone is
elegant, charismatic, warm,

mellifluous, expressive, and
whenever he does something,

he radiates a very serious
sense of playfulness.

- I'm just going to start with
a relatively low intensity

so you have a sense of what it feels like.

I've done this enough that I have a sense

of where your motor cortex is going to be.

TMS stands for transcranial
magnetic stimulation,

and it is a way to
stimulate, to apply currents

to specific parts of the brain,

but without having to cut open the skin,

crack open the bone, and expose the brain.

(machine pops loudly)

- Oh wow, that was my bicep.

(machine pops loudly)

- That's sort of more your little finger.

- You know, one of the things
that we've learned from TMS

is that we can use it to map the brain.

We can use it to understand

how brain activity relates to behavior.

We can also use it to modify the brain.

We can use it, depending on
the parameters of stimulation,

to actually increase activity
in a part of the brain,

or to suppress activity
in a part of the brain.

So I'm just going to
target your language area.

Then, we'll give you a little
feel of what it is like

when people are trying to speak and can't

because of a stroke in that area.

- Go ahead.

One, two, three, four, five,

(machine clicks rapidly)

six, seven, eight, nine. (voice shakes)

It's getting tough.

I was so slurring my speech.

- Mmm-hmmm.

- Pascual-Leone is now expanding his work

to look at the autistic
spectrum, which includes

the childhood disorder
of autism and Asperger's.

And his working hypothesis is

that they're both a product of
hyperplasticity in the brain.

If the brain is plastic,
and we believe it is,

can plasticity itself,

can the mechanisms of
plasticity themselves

be abnormal in certain conditions?

Could it be that one
has too much plasticity?

And we think that autism,
autism spectrum disorders,

are exactly that.

- There are certain things
in autism and Asperger's

that involve a hypersensitivity,
and he's wondering

whether these
hypersensitivities are related

to a very over-connected brain

that's formed many, many
plastic connections.

- So that autism can generate
an abnormal plasticity,

an excessive plasticity in fact.

When the brain is excessively connected,

it doesn't function well.

There is recurrent thoughts,

there is intrusions of thoughts,

there is repetitive behaviors,
ritualistic behaviors.

If we are right, if the
hypothesis is correct,

then we would be able to use

the capacity of brain
stimulation to modulate activity

to suppress that plasticity
tendency, and therefore,

hopefully, to help with the
symptoms of disease themselves.

Pascual-Leone's remarkable
experiments have shown

that we can change and
restructure our brain anatomy

simply by using our imaginations.

- One of the things I became interested in

is the question of how do the maps change

when you simply think of things,

when you don't do anything
other than thinking.

We took normal subjects,

and we sat them in front
of a piano and asked them

to learn to do a five-finger
movement exercise.

They just had to go from
thumb to little finger,

back to thumb, back to little
finger at a given rate.

And we found that over
these five days of practice,

the part of the brain that
controls finger flexions,

got larger and larger and larger.

But we had another group of subjects

who simply sat in front of the piano

and imagined themselves moving.

And we made sure that they did not move,

but simply mentally rehearsed the actions.

What we found in them is
that the brain changed

in exactly the same way as in those

that actually physically practiced.

So the idea is that

just thinking will change your brain.

And what that ultimately means is

that one needs to be careful
with what one thinks.

- This beautiful experiment
complements the work

of Nobel Prize-winning
psychiatrist Eric Kandel,

who showed that thinking
actually turns on genes

inside neurons to form new
connections between brain cells.

And this idea is further
complemented by brain scans

which show that psychoanalytic, cognitive,

and other psychotherapies also
change the brain's structure

through the use of thought alone.

- I think we're now
learning that, in fact,

the brain is changing all the time,

that the brain is changing
with everything we think,

with everything we experience,

that plasticity is an intrinsic
property of the brain.

And it's not something you
can switch on and switch off.

It's simply there.

And so the challenge is
to learn enough about it

so that you can guide the changes.

- My name's Derek Steen.

I'm 41 years old.

Grew up here in San Diego.

And was involved in a pretty traumatic

motorcycle accident in 1985.

- When we wish to perfect our senses,

neuroplasticity can be a blessing.

But when it works in the service of pain,

it can be a curse.

- There's days where I just
feel phantom pain in the hand,

and it feels like my hand's
being crushed in a vice.

- Plasticity can also
result in phantom pain

because of the reorganization
that's taking place

after the amputation.

There is a mis-wiring.

Maybe some of the touch input

is going and activating
pain areas in the brain.

- Our guide to neuroplasticity and pain

is one of the most intriguing
of the neuroplasticians,

V.S. Ramachandran.

Ramachandran is the magical
wizard of modern neuroscience.

He is the man who uses
illusions to combat illusions

and imagination to change
the brain and its contents.

- Many patients with phantom
limbs can move their phantom.

But I found that in some patients,

maybe as many as a third,

the phantom is immobilized.

The patient will say things like,

"It's frozen in stone."

- After the amputation, my body actually,

I could still feel the left arm

in the sling sitting on my stomach.

When I would try to make
that phantom hand move,

it created pain.

- Hey Derek, how are you doing?

- Good.

- Good to see you back here again.

- Thank you.

- No one really knew what triggered

the movement or pain in a phantom.

Ramachandran wondered, was it possible

that the face maps in
people with amputated limbs

had somehow invaded the
maps for their arms.

- What do you feel?

- I can feel a stroking
across the phantom hand.

- Stroking right across the phantom hand?

- And my face.

- First of all, in normal
people, the entire skin surface

is mapped onto the
opposite side of the brain.

Now it turns out,
there's a systematic map,

but the hand region on the map

is right next to the face
region in that brain map.

- How about, let's go back there.

- It's towards the little finger.

- Towards the little pinkie, you said?

- After the arm has been amputated,

there's a massive sensory loss.

There's no sensory input to
the hand region of the brain.

If you now touch the patient's face,

the message goes not only to
the face area, as it should,

but also invades the vacated territory

corresponding to the missing hand.

- Here?

- Index finger.

- Here?

- Thumb.

- If I,

- I can feel the tapping on the hand.

- You feel the tapping on the hand.

- Mm-hmm.

- Here was striking
evidence for plasticity

in the adult human brain.

In three weeks after
amputation, the face input

now activates the original
hand area of the brain.

- Ramachandran wondered
if it would be possible

to fight one illusion, a
phantom limb, with another.

What if he could trick the brain

to think that the limb was moving

by giving it some kind of false input?

- So I want you to look in the mirror.

Put your right hand there.

And look at the reflection
of the right hand.

Position the phantom sort of, roughly,

so that it's kind of superimposed.

- He asked me to come
down to his office one day

and said he had something
new he wanted me to look at.

And he explained to me
that he had a student

that had built a mirror-box.

- Do you feel anything in your phantom?

- I can feel my phantom.

And I sat down, I put my hand
in the box, and I'm hurting.

The phantom pain's flaring up.

And I look in the box.

And he said, "Look at your right hand,

"and start moving your fingers,

"and imagine your phantom
left-hand fingers moving."

- What you're doing here
is using one illusion,

namely vision, to negate, quote-unquote,

the illusion of pain.

Because pain, too, is
an illusion of sorts.

- Now I want you to tell me,

what do you feel when you do that?

- I can feel slow movement

and resistance in the phantom hand.

It was very shocking.

Imagine moving your fingers and having

(laughs)

a spirit go through and not touch.

- So what we saw in
Derek was quite amazing.

Initially, he said the
phantom was moving again

when he looked in the mirror.

When he closed his eyes,

of course the phantom was
immobilized and didn't move.

When he opened his eyes
again, it started moving.

So we immediately knew that
vision provides a critical role.

You need to restore that
whole visual-motor congruence.

And that's what seems to relieve the pain.

- So Derek, we want to try something

a little bit different, ok?

So, where's your phantom now?

- I can,

- Sort of roughly in that region?

- Yeah.

- Ok.

Another thing we have recently observed,

this is very striking, and
it's absolutely amazing.

It blew my mind when I first saw it.

I'm gonna put my hand here.

- Ok.

- And I'm just gonna either
stroke it, or tap it,

or do something with
it, and I want to know

if you feel anything on
your face, on your shoulder.

You have a patient with a phantom limb.

And the patient simply
watching the normal person

being poked, and stroked, and touched,

he starts feeling the
pokes, touches, and strokes

in his missing phantom hand.

- I can feel a vague tapping.

- And this blew my mind.

It's almost like X Files.

It's empathy carried to the extreme.

Now, why does it happen?

Again, it turns out,

there's a perfectly logical explanation

based on what we know of
the anatomy of the brain.

If I am a normal person
and somebody touches me,

sensory neurons in my brain fire.

- I feel tapping.

- You feel tapping on your phantom?

- Yes.

- Astonishingly, some of these neurons,

touch-neurons in my brain,

will fire when somebody touches you.

And these are called mirror
neurons, for obvious reasons.

This neuron, which I call a Gandhi neuron,

is actually dissolving the barrier

between you and another human being.

That neuron doesn't know the difference

between whether he's being
touched or you're being touched.

How 'bout if I do that?

Clinically they may be important,

because these neurons may be
revived using visual input,

and it may be one reason

there's recovery from paralysis
using visual feedback.

The idea of neural plasticity
is quite beyond any doubt now.

There is a tremendous
amount of malleability,

and we can tap into this,

maybe even to enhance brain function,

certainly to accelerate
recovery of brain function.

It's essentially a new era of research

in brain plasticity and
clinical applications.

- And this is a double letter.

Two, three, four,

eight, sixteen, twenty-four.

- [Voiceover] When Michelle
was just a few weeks old,

I noticed that she didn't
have all the normal movements

that the other babies had had.

And I remember telling Wally,

"Something's wrong with Michelle."

- I went to visit Michelle Mack,

because I wanted to test the upper limits

of human neuroplasticity.

Something catastrophic
happened in Michelle's brain

when she was in the womb.

We don't know what it was,

but for some reason one of her
hemispheres never developed.

Michelle Mack is a woman who was born

with just half a brain.

- I was born missing the
left hemisphere of my brain.

My parents weren't given
enough information,

because at that time,
there were no MRI machines,

and that my brain would only progress

until I was about 11 and then stop.

- Carol brought Michelle

to the National Institutes
of Health in Maryland,

because she'd read an
article by Dr. Jordan Grafman

that contradicted everything
she had learned about the brain

and been told about Michelle's prognosis.

- It's dramatic.

It includes not only the
cortex, but her left thalamus,

it's all missing.

- Dr. Grafman had worked with people

who had severe brain damage,

including a lot of Vietnam vets,

and was able to show
that brain development

could take place after a trauma.

- And it's important to merge

the sort of brain anatomy picture

with the person as a whole.

Michelle's brain works
much in the same way

that our brains might work,

but the functions that
are available to her

are somewhat more restricted.

- Some of the things she has trouble with

are when something is very vague.

- Anything that's not concrete.

- Grafman's theory provides
a compelling explanation

as to how Michelle's right hemisphere

took over so many of the functions

that are normally governed by the left.

- We know that now that she
can perform certain skills

that the left hemisphere
ordinarily subserves,

they must now be located
in the right hemisphere.

So we know she's had
some dramatic plasticity

to enable her to have
normal verbal skills,

normal verbal memory.

- You also have a number
of special skills.

What are some of those?

- Memorizing dates.

- Do you remember when I came here last?

- Yes.

- When was that?

- That was in June of 2003.

- Do you remember what day that was?

- Yes, that was Thursday,

June 5th.

- Let's say we had a
family reunion in Colorado.

- Sunday, July 9th to Sunday, July 16th,

2000.

- How about July 17th, 1989?

- That was a Monday.

- And how did you do that?

- I don't know.

- Hi. Hello.

- Hello, how are you doing?

- I'm fine.

- Well, we've learned from her

these general concepts about plasticity.

And I think now what
we're going to try to do

is to study them in more detail.

You have part of your brain
missing from that area,

but you talk pretty much
- [Michelle] Normally.

- like I do.

Right, exactly.

So we want to see what the
limits are of this plasticity

and whether, under some restrictions,

we can influence the
plasticity in some way

to promote certain functions

that the family and the
child would benefit from.

- I want people to see that
I function on a normal level,

even though there's some things

that I'll never be able to do.

- When I think of Michelle,
it's hard to imagine

a better test or illustration
of the resilience

of human neuroplasticity.

It may be easy for some people to dismiss

these fantastic case studies

as anomalies that have little bearing

on the lives of the rest of us.

- Many people react by saying,

"But that's just one patient.

"It's an N of 1."

But my usual rhetorical
response to this is to say:

Well, look. Supposing I
bring a pig to this podium,

and I say, "This pig can talk."

You'll say, "Really?"

And I wave my wand and it starts talking.

What would your reaction be?

You're not gonna say, "Well,
that's just an N of 1.

"Show me another pig."

You'd say, "My God, that pig is talking!"

And yet, the reaction of some
of my colleagues is to say,

"Show me another talking pig."

- To understand that we
have within our hands

this incredible power to
drive changes in the brain

that accounts for our behavior,

that is in fact the very
basis of what we are,

of the person that we are,

you know, what a gift.

- The brain that I met in my travels

turns out to be both a more resilient,

and a more vulnerable,
brain that we had imagined.

By being more resilient,

it stirs up an incredible
amount of hope for people

with all sorts of brain
and psychological problems.

What we have been introduced to here

is the first generation
of neuroplasticians.

They're just beginning to
elaborate and elucidate the limits

and what neuroplasticity can do.

Much awaits us down the road.