A Weekend of Neuroscience

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What do you do after spending a weekend immersed in a course with Drs. Nancy Byl, Alison McKenzie and Mike Merzenich, all prominent researchers in the neuroscience and physical therapy worlds? First, you give your brain a break by indulging in fantastic San Francisco vegan cuisine; and then you share it in a blog post!

Erin and I spent a weekend in July attending a course entitled “Sensorimotor Processing Dysfunction and Movement Dysfunction: Focal Dystonia and Complex Regional Pain Syndromes”.   We spent cold summer San Francisco days at UCSF learning from the masters and wanted to share some of the pearls of wisdom we gained. Though we could write a book about all we learned, we are going to try to condense it to our top 5, here we go:
1) The plastic brain: for better or for worse. For worse: dystonia is aberrant plasticity and learning. For better: we can use the principles of plasticity to improve and drive change!

2) Principles in treatment focal dystonia in the plastic brain: re-differentiate input, provide non-stereotyped and richly variable input, closely attended and rewarded behaviors.  In simple terms:  unlearn the abnormal, relearn the normal.
3) Treatment of dystonia should include a team approach and include education and comprehensive neurorehabilitation (wellness to pedagogy to specific retraining).  The team approach should include stress reduction, relaxation and mindfulness as keys to set the brain up for optimal improvement.
4) Objectives of learning based sensorimotor retraining for dystonia include: quieting the excessive sensory and motor “noise”, improve sensory discrimination, inhibit involuntary co-contractions, improve the sensory inputs and motor outputs, enhance the ability to relax muscles.
5) Move beyond the traditional rehab approach to cervical dystonia and target retraining the CNS to restore normal postural righting.  Use learning based sensorimotor retraining with vestibular, sensorimotor and postural retraining
Overall, we were encouraged by the hopeful and positive message of the course that while dystonia may be a result of neuroplasticity gone bad; we can influence change through training the brain to relearn movement.  We have been incorporating a lot of these concepts into practice for the last year, but there is nothing like hearing from the masters themselves and coming back armed with great treatment ideas and rationale.  


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