Sunday, January 10, 2010
TYPES OF MEMORY
First, we’ll look at the different types of memory. For example, we all have memory for music. We can be listening to a song on the radio and have a very distinct feeling associated with that music. The brain processes music and puts that information in one part of the brain. We also have memories for taste and smell. We know the taste of chocolate. We know the smell of burning rubber. We have memories for the things we feel (physical). We can remember the difference between the feel of silk and the feel of sand paper. Each type of memory has a different site in the brain. Two of the more important types of memory are vision and hearing (in this case, words). Visual things are the things we see, such as a familiar place or where we’ve left our car. We also have memory for language, including things that we've heard or read (things we've read we translate into language). Verbal information is stored in the left hemisphere with visual information stored in the right hemisphere of the brain.
Information going into the brain is processed at several stages. I'm going to simplify at this point and discuss what I call immediate memory. Immediate memory really doesn't last very long--perhaps minutes. When do you use immediate memory? When you call information for a phone number, the operator will tell you a seven digit number. If you're pretty good, you can remember those seven digits long enough to dial the phone. That's immediate memory--information that is briefly saved. With people who have a head injury, immediate memory can be "good" or it can be "bad." The problem for most head-injured people, however, is with short-term memory.
There's some variation in how people define short-term memory. I define it as the ability to remember something after 30 minutes. In a head injury, someone's immediate memory may be good, yet they may still have problems with short-term memory. For example, a nurse in the hospital asked a head-injured patient to get up and take a shower and get breakfast. The patient said that he would, but the nurse came back 30 minutes later and the patient was still sitting in bed. When the nurse asked him why he didn't get up and take a shower, he said that the nurse never told him. So immediate memory is something you quickly "spit back", but the problem rests more with short-term memory. For example, someone may tell you to go to the store and get some milk, some eggs, a newspaper, and some dish soap. By the time you get to the store, all that you remember is the milk. In head injury, impaired short-term memory is a very significant problem.
Long-term memory is information that we recall after a day, two weeks, or ten years. For most head-injured people, their long-term memory tends to be good. One patient told me "I can tell you what happened 10 years ago with great detail; I just can't tell you what happened 10 minutes ago." After you get a head injury, short-term memory isn't working, so information has a hard time getting to long-term memory. For example, head-injured people may double or triple their usual study time in preparing for a test the next day. By the time they get to the exam, they are completely blank on the material. People with head injuries have also told me "you know, time just seems to fly by." The little events of the day are sometimes forgotten, making life "fly by" when you look back at events that have happened since the injury.
LOST MEMORIES--TWO TYPES OF AMNESIA
Before we go on with memory, let's talk about two common things that happen with people with head injuries: retrograde and anterior grade amnesia. Amnesia means you lost a memory that you once had. It's as if someone has erased part of your past. Retrograde amnesia means you have lost memories for events PRIOR to the accident. For some people, retrograde amnesia can cover just a minute or even a few seconds. In other words, they'll recall the car coming right at them but are unable to recall the moment of impact. For other people, retrograde amnesia may affect longer periods of time. The last three or four hours prior to the accident are gone. I had one individual who had lost the last year of his life. As people get better from their head injuries, long-term memories tend to return. However, memories tend to return like pieces of a jigsaw puzzle; these bits and pieces return in random order. In general, the smaller the degree of retrograde amnesia, the less significant the head injury.
Another form of memory loss is called anterior grade amnesia. In this case, events FOLLOWING the accident have been erased. A good part of that is due to the brain injury itself. Complex systems in the brain are injured. The chemical balance in the brain is upset. As brain chemistry normalizes and brain systems begin working, memory also starts to work. I've had patients who have spent several months in the hospital but are only able to recall the last to two to three weeks of their stay.
WHY IS MEMORY IMPAIRED?
Why doesn't my short-term memory work? Well, let's quickly review how the brain works. We know the information flows in through the middle of our brain and branches out like a tree. Before that information goes to different areas, it goes through a channeling/filtering system. It's almost like a mail room--this information goes into this box, and that letter goes into that box. When the brain is injured, these middle areas get pressed upon because of swelling (pressure pushes down on the brain). The middle sections of the brain are also resting on the bone of the skull. Because of forward and backward movement of the brain in an accident, they get sheered or torn. A problem develops when there is a large flow of information coming in which the brain can't process, or when information is not being sent to the right place. So the mail room of the brain is not doing its job.
There is also a second type of memory problem. Once information is stored in the brain, the brain has a hard time finding it. For example, you saw a movie but you can't recall the name of the actor in the movie. You can visualize who the actor is, but can't come up with his name. People typically describe a "tip of the tongue" type of thing--"I know what I want to say but I just can't get it out". Its almost as if the brain is saying, "searching, searching" and not finding. Several minutes later, it just comes to you. So think of it as a library in some sense. If I take a book on history and I just put it anywhere in the library, I'm going to have to search that whole library to get that one book. So there are basically two kinds of memory problems: storage problems and retrieval problems.
WHAT CAN I DO TO IMPROVE MY MEMORY?
Work with a Specialist in Memory--One of the most important things is to get help from people who specialize in head injury. Every head injury program has a specialist who teaches memory strategies. In most cases, this is a Speech Therapist (they don't just help people who have slurred speech). In the Neuro-Recovery program, our Speech Therapist teaches 15 different memory strategies and helps you to pick the 2 or 3 that work best for you. There is often a fair amount of testing in order to figure out the best memory strategy for each head-injured person. For some people, one type of memory may be impaired (verbal recall) but another type be intact (remembering visual information). If I know that my verbal memory is not very good, I write things down and encourage visual memory systems to work. Specialists can help you pick out the best memory strategies to help you. Once you find an effective strategy, keep working on it. Think of memory like a muscle. The more you use it, the stronger it gets.
Get Organized--We learn better if we are organized. Many people have told me that, prior to their head injury, they had incredibly messy desks with papers all over. But if someone came in and said, "I need this particular paper", they could pull it out of a big pile and say "here it is." After a head injury, though, the ability to organize gets really messed up. One symptom of not being organized is when someone says, "I've started 50 projects and haven't finished one of them." If you organize information, it tends to help you recall it. For example, if you are constantly losing your car keys or constantly forgetting where you put your wallet, there's one simple technique to use. Put things in the same place. Always put your car keys in one spot on the dresser. Always put your purse in one spot in the house and nowhere else. Being organized helps your memory and you will be less likely to lose things.
Break It Down--Another thing that we can do to help memory is to break it into small bits. If you have something really tough to learn, try to break it down into small bits and then learn each one little bit at a time. Some people call this "chunking;" you are memorizing little "chunks" of information. For example, your brand new VCR has a remote control with 50 buttons on it. Reading the entire manual in one sitting to learn what all of the 50 buttons do is very hard. So, learn one function and then play with that feature for awhile. Once you've learned that, go on to the next button. We've been using this technique for years to learn simple information like a phone number. The wonderful folks at Bell Labs (they invented the phone) figured out that people will learn a 7 digit phone number if you group 3 digits together and then group 4 digits together (a "chunk" of 3 numbers and a "chunk" of 4 numbers).
Using Association-- Association is really important for retrieving important information. For example, you are taking a literature course and you need to remember a famous essayist--Francis Bacon. You might associate the image of a piece of bacon with the name of this person. So if you're trying to think of this explorer, an image of a piece of bacon will come to you. This approach is particularly helpful with learning names. Remembering names is a difficult task for most people in the world; it is especially hard for most people with a head injury.
Get a Daily Planner--Probably one of the best things you can do to help your memory is to use a daily planner. This brings up two important points:
The First Rule of Memory--write everything down in one spot (your daily planner).
The Second Rule of Memory--write it down when it's fresh in your mind.
For example, you go to your doctor's office and you are asked to return for another appointment. Many people have a calendar stuck on their refrigerator or on a wall at home. By the time you get back home, you've forgotten the date or lost the appointment card. Next time, bring a planner to the doctor's office and write your appointment in it just after the doctor tells you the date. Get a medium size planner or something called an organizer. Don't get something that's too small--you're going to be doing a lot of writing. Write complete notes! Some people make notes so short that they later can't figure out what the note means.
Make A "To Do" List--In addition to a planner, make a "to do" list. For example, you may have a number of chores to do around the house but none of them in any particular order. What you can do is get a small pad of paper and write down the things that they have to do. Once you have this list, decide which task to do first, second, third, and so on. This will work if your list doesn't get too long. If the list gets too long, you're going to run into problems.
Make a "Modified To Do" List--I commonly hear the same problem, "I've got 50 projects going but I haven't finished any of them." This is a combined problem of memory deficits and organizational deficits. One solution is to buy a small dry-erase board and put it up in the home (or office). On the board, you are only allowed to list five items on the "To Do" list. You cannot add another item to the board until you have completed one of the items already on the board. Make a "Modified To Do List" and put it somewhere in your house where the whole family can see it. Family can also offer suggestions to help you to get projects organized. This will in turn help family members get a better understanding of what the head-injured person has to deal with. When you get organized and use the Planner/To Do List, you'll feel better about yourself because you will be getting things accomplished.
THINGS THAT CAN AFFECT MEMORY
Fatigue and Sleep--Memory can be affected by a number of things. Some of these influences can affect even people without a head injury. If you do have a head injury, these effects are multiplied. For example, if you're tired, your memory tends to be poor. If you have to learn something really important, it's best to learn it when you’re fresh. Generally, most people with head injuries learn better in the morning than in the late afternoon. So if you've got something really important (a test for school), studying the night before the exam may not be very useful. The best time to study is in the morning. In addition, people with head injuries commonly have sleep disorders. Its very important that you talk with your doctor about getting your sleep pattern back to normal. If you wake up tired, you're going to make memory problems worse. (See the sections of this book on Sleep Disorders and Fatigue.)
Strong Emotions--Very emotional situations will distort your memory. If someone comes into a bank and waves a gun at you, this will create a very emotional situation (intense fear). Even though there are five people looking at the same person, you will get five different descriptions of the robber (that's one reason why they have cameras in banks). Being afraid, mad, or anxious will alter your memories. What should you do in emotional situations? You can't always control your emotions, but there are situations where you will need to recall important information. For example, going to a doctor's office can be a very emotional experience (many people are afraid or anxious). Most head-injured people find this a very stressful situation. One approach is to bring a family member or friend along. Another approach is to tell your doctor of your memory problems and ask the doctor if you can write down important information.
I have included a Memory Sheet for Doctors’ Appointments. When you get to the doctor's office, you may be so nervous that you forget to tell your doctor ALL of your problems. The next time you see your doctor, you may recall some of the old problems that you forgot on the first visit. A common complaint of doctors who work with head-injured patients is, "Every time I see this person, I hear a new problem." Using the sheet of paper at the back of this book can help you organize your thoughts. Doctors deal better with information when it is presented in a quick and organized form. For each problem, I left a little space for you to write down what the doctor recommends. In this way, you can bring your memory sheet to future appointments and keep track of your progress. For example, maybe you're not sleeping and one medication approach is being tried. If that approach doesn't work or has a limited effectiveness, you will want to keep track of that and bring it up the next time you see your doctor. If you don't write these problems down and monitor them, you'll be less likely to make progress with them.
Certain types of medications (pain killers, for example) can affect memory. In the hospital, people can be on fairly significant amounts of pain killers because they have broken bones or other injuries. Some medications can make you tired, which in turn makes your memory worse. It is important to have an ongoing dialogue with your doctor about your medications. People have told me, "I'd rather be in a little bit pain so I can be more alert." Sometimes the goal of pain medication is not to get rid of all the pain, but to control it. Talk with your doctor about your medications and the possible effect of medications on memory.
AN ELECTRICAL AND CHEMICAL MACHINE
Let's start looking at the building blocks of the brain. As previously stated, the brain consists of about 100 billion cells. Most of these cells are called neurons. A neuron is basically an on/off switch just like the one you use to control the lights in your home. It is either in a resting state (off) or it is shooting an electrical impulse down a wire (on). It has a cell body, a long little wire (the "wire" is called an axon), and at the very end it has a little part that shoots out a chemical. This chemical goes across a gap (synapse) where it triggers another neuron to send a message. There are a lot of these neurons sending messages down a wire (axon). By the way, each of these billions of axons is generating a small amount of electrical charge; this total power has been estimated to equal a 60 watt bulb. Doctors have learned that measuring this electrical activity can tell how the brain is working. A device that measures electrical activity in the brain is called an EEG (electroencephalograph).
Each of the billions of neurons "spit out" chemicals that trigger other neurons. Different neurons use different types of chemicals. These chemicals are called "transmitters" and are given names like epinephrine, norepinephrine, or dopamine. Pretty simple, right? Well, no. Even in the simplified model that I'm presenting, it gets more complex.
IS THE BRAIN ONE BIG COMPUTER?
Is the brain like a big phone system (because it has a lot of connections) or is it one big computer with ON or OFF states (like the zeros and ones in a computer)? Neither of the above is correct.
Let's look at the brain using a different model. Let's look at the brain as an orchestra. In an orchestra, you have different musical sections. There is a percussion section, a string section, a woodwind section, and so on. Each has its own job to do and must work closely with the other sections. When playing music, each section waits for the conductor. The conductor raises a baton and all the members of the orchestra begin playing at the same time playing on the same note. If the drum section hasn't been practicing, they don't play as well as the rest of the orchestra. The overall sound of the music seems "off" or plays poorly at certain times. This is a better model of how the brain works. We used to think of the brain as a big computer, but it's really like millions of little computers all working together.
GETTING INFORMATION IN AND OUT OF THE BRAIN
How does information come into the brain? A lot of information comes in through the spinal cord at the base of the brain. Think of a spinal cord as a thick phone cable with thousands of phone lines. If you cut that spinal cord, you won't be able to move or feel anything in your body. Information goes OUT from the brain to make body parts (arms and legs) do their job. There is also a great deal of INCOMING information (hot, cold, pain, joint sensation, etc.). Vision and hearing do not go through the spinal cord but go directly into the brain. That’s why people can be completely paralyzed (unable to move their arms and legs) but still see and hear with no problems.
Information enters from the spinal cord and comes up the middle of the brain. It branches out like a tree and goes to the surface of the brain. The surface of the brain is gray due to the color of the cell bodies (that's why it's called the gray matter). The wires or axons have a coating on them that's colored white (called white matter).
TWO BRAINS--LEFT AND RIGHT HEMISPHERE
We have two eyes, two hands, and two legs, so why not two brains? The brain is divided in half, a right and left hemisphere. The right hemisphere does a different job than the left. The right hemisphere deals more with visual activities and plays a role in putting things together. For example, it takes visual information, puts it together, and says "I recognize that--that's a chair," or "that's a car" or "that's a house." It organizes or groups information together. The left hemisphere tends to be the more analytical part; it analyzes information collected by the right. It takes information from the right hemisphere and applies language to it. The right hemisphere "sees" a house, but the left hemisphere says, "Oh yeah, I know whose house that is--it's Uncle Bob's house."
So what happens if one side of the brain is injured? People who have an injury to the right side of the brain "don't put things together" and fail to process important information. As a result, they often develop a "denial syndrome" and say "there's nothing wrong with me." For example, I treated a person with an injury to the right side of the brain--specifically, the back part of the right brain that deals with visual information--and he lost half of his vision. Because the right side of the brain was injured, it failed to "collect" information, so the brain did not realize that something was missing. Essentially, this person was blind on one side but did not know it. What was scary was that this person had driven his car to my office. After seeing the results of the tests that I gave him, I asked, "Do you have a lot of dents on the left side of your car?" He was amazed that I magically knew this without seeing his car. Unfortunately, I had to ask him not to drive until his problems got better. But you can see how the right side puts things together.
The left side of the brain deals more with language and helps to analyze information given to the brain. If you injure the left side of the brain, you're aware that things aren't working (the right hemisphere is doing its job) but are unable to solve complex problems or do a complex activity. People with left hemisphere injuries tend to be more depressed, have more organizational problems, and have problems using language.
VISION--HOW WE SEE THINGS
Information from our eyes goes to areas at the very back of the brain. We've all seen cartoons where the rabbit gets hit on the head and the rabbit sees stars. This can actually happen in human beings (trust me, not a good thing to do at home!). If you take a hard enough blow to the back of the head, this brain area bangs against back of your skull. This stimulates it and you can see stars and flashing lights. Remember those two hemispheres? Each hemisphere processes half the visual information. Visual information that we see on the left gets processed by the right hemisphere. Information on the right gets processed by the left hemisphere. Remember, wires that bring in information to the brain are "crossed"--visual information from the left goes to the right brain.
The area of the brain that controls movement is in a very narrow strip that goes from near the top of the head right down along where your ear is located. It's called the motor strip. If I injure that area, I'll have problems controlling half of my body. If I have a stroke in the left hemisphere of my brain, the right side of the body will stop working. If I have an injury to my right hemisphere in this area, the left side of my body stops working (remember, we have two brains). This is why one half of the face may droop when a person has had a stroke.
HEARING AND LANGUAGE
In the general population, 95 percent of people are right-handed, which means that the left hemisphere is the dominant hemisphere. (For you left-handers, the right hemisphere is dominant.) With right-handed people, the ability to understand and express language is in this left temporal lobe. If I were to take a metal probe, and charge it with just a bit of electricity, and put it on the "primary" area of my left temporal lobe, I might say "hey, I hear a tone." If I move this probe to a more complex area of the temporal lobe, I might hear a word being said. If I move the electrical probe to an even more complex area, I might hear the voice of somebody I recognize; "I hear Uncle Bob's voice." We have simple areas of the temporal lobe that deal with basic sounds and other areas of the temporal lobe that look at more complex hearing information.
The right temporal lobe also deals with hearing. However, its job is to process musical information or help in the identification of noises. If this area is damaged, we might not be able to appreciate music or be able to sing. Because we tend to think and express in terms of language, the left temporal lobe is more critical for day-to-day functioning.
The vision areas and the hearing areas of the brain have a boundary area where they interact. This is the area of the brain that does reading. We take the visual images and convert them into sounds. So if you injure this area (or it doesn't develop when you are very young), you get something called dyslexia. People who have dyslexia have problems that may include seeing letters backwards or have problems understanding what written words mean.
If something lands on my left hand, this information will be transmitted to the right side of my brain. It goes to the area of the brain next to the area that deals with movement. The tactile area of the brain deals with physical sensation. Movement and feeling are closely related, so it makes sense that they are next to each other in the brain. Because movement and tactile areas are located close to each other, it is not uncommon for people with a brain injuries to lose both movement and feeling in parts of their body. Remember--tactile information from the left side of the body goes to the right brain, just like movement and vision.
FRONTAL LOBES--Planning, Organizing, Controlling
The biggest and most advanced part of the brain is the frontal lobe. (It's called the frontal lobe because it's in the front part of brain.) One job of the frontal lobe is planning. You have probably heard of "frontal lobotomies." At the turn of the century, this surgery was done on people who were very violent or who were in a psychiatric hospital because they were very agitated. Doctors used surgery to damage this area of the brain. Following this surgery, people became very passive and less violent. At first, scientists saw this as a great thing. Neurosurgery could stop behavioral problems such as violence. The problem was that the patients stopped doing a lot of other things. They didn't take care of themselves and they stopped many activities of daily living. They basically sat there. In head injury, individuals with frontal lobe impairment seem to lack motivation and have difficulty doing any task that requires multiple steps (e.g., fixing a car or planning a meal). They have problems with planning.
The frontal lobe is also involved in organizing. For a lot of activities, we need to do step A, then step B, then step C. We have to do things in order. That's what the frontal lobes help us do. When the frontal lobe is injured, there is a breakdown in the ability to sequence and organize. A common example is people who cook and leave out a step in the sequence. They forget to add an important ingredient or they don't turn the stove off. I've met a lot of patients who've burned or melted a lot of pans.
Additionally, the frontal lobes also play a very important role in controlling emotions. Deep in the middle of the brain are sections that control emotions. They're very primitive emotions that deal with hunger, aggression, and sexual drive. These areas send messages to other parts of the brain to DO SOMETHING. If you're mad, hit something or someone. If you're hungry, grab something and eat it. The frontal lobes "manage" emotions. In general, the frontal lobe has a NO or STOP function. If your emotions tell you to punch your boss, it's the frontal lobes that say "STOP or you are going to lose your job." People have often said to me "a little thing will set me off and I'm really mad." The frontal lobes failed to stop or turn off the emotional system.
On the other hand, we have talked about how the frontal lobes plan activities. The frontal lobes may fail to plan for some types of emotion. For example, sexual interest involves some level of planning or preparation. Without this planning, there is a lack of sexual interest. A lack of planning can also affect the expression of anger. I've had some family members say "You know, the head injury actually improved him, he's not such a hot-head anymore." If you listen very carefully, you're also going to hear "he's not as motivated anymore." Remember, the frontal lobe plans activities as well as controls emotions
You will find some brain fitness workouts that can help your mind process information more quickly, and more efficiently, as well as the ability to perform multiple tasks at the same time. You can get help to concentrate more and increase your brain reflection speed; you will find simple but very effective brain training games and exercises like solving math problems to achieve greater mind fitness..
You may be the smartest person in the world and you don’t even know it. If you’re not the most intelligent person in the world yet, then, welcome to your gym! There is always a chance to exercise and improve.
Included you will find some free famous brainteasers, and puzzles that are fun and good for brain stretching exercise. Below is a list of activities described in more detail:
Brain Training Activities
Brain Reflection Test This is a simple but effective exercise to test the reflection of your brain, the faster the better, try to get a score of 0.20 second on the first reflection test, also there is a second Reflex Test, try to get 58 points in that one, If you do achieve these two goals then you’re very fast, and we should congratulate you!
Brain Creativity Being creative is a good thing; in fact it’s essential if we want to make our life better. Stimulating areas of your brain is a healthy process, in this page we will try to wake up (if dormant) the brain creativity potential, this game has 25 levels, let’s see how far you could go.
Memory Test Here you will be able to test your memory, testing it will help you improve it, this game stimulates many areas in your brain responsible for storing and retrieving information, you will be enhancing your memory while still having fun. You can also check this memory game which will check your ability of remembering faces and images … it’s a classic game but effective.
Brain Stretching This is one way to stretch your brain, the objective is moving a number of disks from one pole/ peg to an other in a cetrain way. You will have to make an effort to arrange the disks the right way, and that in itself is a good exercise that can stretch your brain when playing.
IQ Booster There are three games about chess that can possibly help you improve your intelligence., you can play chess which is simply the best strategy game, also this second Strategy Game called 8 Queens, and finally another Brain Game called (Chess Knight).
These are very good workouts, chess can help you gain the ability of good thinking and making creative strategies, if you don’t know how to play chess, then either check for the rules online before playing, or just jump to the next game.
Sudoku – Brain Stimulation In this page you can either play Sudoku, or solve an already existing Sudoku puzzle that you have, a very nice strategy game and one of the fastest growing games of the 21 century, simple but is considered to be a good brain stimulation and training.
Spatial Intelligence This is about Rubik’s Cube puzzle, a very challenging game, which can stimulate many parts of your brain that you usually don’t stimulate, including visual memory and spatial intelligence.
Math Problems: It’s nice to be an athlete, but certainly it’s super nice to be a Mathlete. Well this is your chance. This is not a complicated Math Game, in fact it’s a very easy test, however the point is not just to solve the questions provided, but to solve as many questions as possible in a short time, a very good score would be 21 points in this exercise.
Brain Concentration This brain concentration game is a little bit hard, but that’s the point, the harder the game the more stimulation you get, this can help you gain the ability to concentrate better. The game depends on the level you choose, you can start with the lowest level and as you learn the rules of the game you can pick higher levels in this concentration game.
Brain Exercise This brain exercise is about being able to arrange the numbers in the right order in a very short time, this game depends on the level you choose, it’s a classic simple game, but a very effective exercise. Have fun and good luck!
Cognitive Training This training is a lot of fun and simple but can help your cognitive and prediction sense along with your reflection skills, a good player would be someone who predicts well where the exact spot that the ball would hit and therefore have a fast reaction to be in the right spot, a good score is 2 points different than your opponent (which is the computer in this case). Cognitive training game cannot be played with a touchpad, because your reaction is way slower than a mouse when using a touchpad. So if you have a laptop you might get a mouse to play this game.
Finally you can read about Intelligence and read about the IQ or take an IQ Test if you want, please note that the tests are just for brain training purposes and don’t determine your actual level. Some games can be addictive so play responsibly.
Please enjoy the mental fitness activities that are offered free of charge. Welcome to your Brain Gym and have a fun workout and get fit!!!!