Boosting Brain Power: Can Brain Training Really Enhance Cognitive Function?

In a world where mental sharpness is as prized as physical health, the allure of brain training programs promising enhanced cognitive functions and a shield against decline is understandably compelling. The question, however, remains: do these brain exercises truly live up to their claims?

The Science Behind Brain Training

Brain training, often encapsulated in tasks designed to boost various cognitive abilities, has surged in popularity over recent years. According to Yuko Hara, PhD, from the Alzheimer's Drug Discovery Foundation, these activities are geared towards fortifying specific cognitive functions through repeated practice.

Dr. Manuel Montero-Odasso from the Gait and Brain Lab emphasizes that such cognitive training hinges on intensifying attentional demands to bolster focus, memory, and concentration. This is achieved through neuroplasticity—the brain's remarkable ability to form new synaptic connections. Essentially, engaging in new cognitive activities can potentially stimulate the brain's frontal regions, fostering new neural pathways.

Neuroplasticity involves the formation of new neural connections in response to learning or experience.

Does It Really Work?

The notion that these exercises can build a "cognitive reserve" to delay or even prevent conditions like Alzheimer's is supported by some neuroscientists, including Michael Merzenich, PhD, a professor emeritus at the University of California, San Francisco. Merzenich suggests that a combination of brain training and physical exercise could be crucial in managing brain health.

However, the effectiveness of brain training programs has been a hotbed of debate. While some studies show that these exercises can improve performance on specific tasks, the transfer of these enhancements to daily cognitive functions or the broader prevention of cognitive decline remains uncertain. Critics argue that improvements in task performance may not necessarily translate into real-world benefits, pointing to the need for more comprehensive and clinically rigorous studies.

Henry Mahncke, PhD, CEO of Posit Science, argues that effective brain training should focus on reducing the "cognitive noise" or inefficiencies that increase with age. By refining the brain's processing speed and accuracy, these programs can potentially rejuvenate cognitive functions.

What Does the Research Say?

Noteworthy among the body of research is the ACTIVE study, which indicated that certain types of cognitive training could reduce the risk of dementia. Participants who engaged in speed-of-processing training displayed significantly lower dementia incidence compared to those who received no training.

Additionally, the SYNERGIC study led by Montero-Odasso found that combining physical exercise with cognitive training significantly improved cognitive scores among older adults with mild cognitive impairment, suggesting a synergistic effect of multi-domain interventions.

Beyond Formal Programs

It's not just about formal training programs. Engaging in a variety of mentally stimulating activities like puzzles, learning new skills, or even social dancing can also contribute to cognitive health. The novelty and challenge of these activities can stimulate the brain and possibly delay cognitive decline.

The Verdict

So, does brain training work? The answer is nuanced. While there's evidence supporting the benefits of specific brain training interventions, the general consensus suggests a more measured approach. The effectiveness of brain training might depend significantly on the type of activity, its intensity, and the individual's baseline cognitive function.

For those interested in exploring brain training, it may be worthwhile as one component of a holistic approach to cognitive health that also includes physical exercise, a healthy diet, and social engagement.

As we continue to unravel the complexities of the human brain, what's clear is the potential of our grey matter to adapt and evolve. Whether through high-tech apps or traditional puzzles, nurturing our cognitive abilities is undeniably a wise investment in our future mental health.

Navigating the Future of Brain Health

As research continues to evolve, the pursuit of maintaining and enhancing brain function through cognitive exercises remains a dynamic and promising field. The intersection of technology and neuroscience offers unprecedented opportunities to innovate and refine brain training methodologies. Future studies and technological advancements are likely to deepen our understanding of how to most effectively engage our brains in meaningful ways.

Integrating Brain Training into Everyday Life

For those eager to integrate brain training into their daily routine, the approach should be balanced and varied. Here are a few practical tips:

1. Diversify Your Activities: Engage in different types of cognitive exercises to challenge various parts of your brain. This could include a mix of memory games, problem-solving tasks, and puzzles.

2. Consistency is Key: Regular practice is crucial. Just as with physical exercise, the benefits of brain training accumulate over time.

3. Combine Mental and Physical Exercise: Incorporate physical activities that also require mental engagement, such as yoga, dancing, or team sports, which can enhance cognitive function and overall health.

4. Stay Social: Engage in social activities that challenge your brain. Book clubs, group learning, and social gatherings stimulate conversation and cognitive skills.

5. Monitor Your Progress: Use apps or journals to track your progress. Monitoring improvements can motivate you to stick with your brain training regimen.

Ethical and Commercial Considerations

As brain training becomes more commercialized, it's essential to approach these tools with a critical eye. Consumers should be wary of claims that seem too good to be true and seek programs that have robust scientific backing. Transparency about the benefits and limitations of these tools, as provided by reputable sources, will be crucial for informed decision-making.

The Role of Healthcare Providers

Healthcare providers can play a significant role in guiding patients through the maze of brain health options. By staying informed about the latest research and understanding the individual needs of their patients, clinicians can recommend the most appropriate and effective strategies for maintaining cognitive health.

Looking Ahead

The journey to unlocking the full potential of our cognitive capabilities is ongoing. With continued research, innovation, and public interest, the future of brain training holds exciting possibilities. Whether it's through sophisticated software or simple daily activities, the goal remains the same: to keep our minds sharp and resilient as we age.

In conclusion, while brain training alone is not a magic bullet for preventing cognitive decline, it represents a promising piece of the puzzle. When combined with a healthy lifestyle and active social engagement, it has the potential to contribute significantly to our cognitive longevity and quality of life.

Stay tuned for more insights and updates on cognitive health at MyRationalThoughts.com (https://www.myrationalthoughts.com). Join the conversation and share your experiences with brain training in the comments below or on our social media platforms. Together, let's explore the fascinating world of brain health and push the boundaries of what our minds can achieve!

The Excessive TV-Watching will cause Dementia, Depression and Parkinson’s Disease

In a digital age where screens often dominate our daily lives, a recent study published in the International Journal of Behavioral Nutrition and Physical Activity offers a thought-provoking insight into the health implications of our viewing habits. This comprehensive analysis, led by Dr. Hanzhang Wu of Tianjin University of Traditional Medicine, China, reveals a concerning correlation between excessive television-watching and an increased risk of dementia, Parkinson's Disease (PD), and depression.

The Study: A Deep Dive into Digital Habits and Health

The research tapped into the UK Biobank, analyzing data from 473,184 individuals aged 39-72 years, followed from 2006 to either a diagnosis of dementia, PD, depression, death, or the study's end. Participants reported their non-work related activities, including exercise, TV-watching, and computer use, alongside undergoing MRI scans to measure brain volume.

The Findings: TV Time and Its Toll

The study's results paint a stark picture: those who indulged in over four hours of TV daily faced a 28% higher risk of dementia, a 35% higher risk of depression, and a 16% greater risk of PD compared to those who watched less than an hour. These figures stand as a cautionary tale against the sedentary lifestyle often associated with excessive TV consumption.

A Silver Lining: Moderate Computer Use

Contrastingly, the study found that moderate computer use (30-60 minutes per day) appeared somewhat protective, lowering the risks for dementia, PD, and depression. This finding challenges the blanket notion that all screen time is detrimental, suggesting that the content and context of digital consumption are key factors.

Exercise: A Vital Substitute

Perhaps most strikingly, replacing just 30 minutes of computer time with structured exercise significantly reduced the risks for dementia and PD. This highlights the immense value of physical activity as a cornerstone of neurological health.

Understanding the Underlying Mechanism

The researchers speculate that the negative impact of prolonged TV-watching might stem from its sedentary nature, which is linked to low-grade inflammation. This inflammation could contribute to neuroinflammation and neurodegeneration, accelerating the onset of diseases like dementia and PD.

Limitations and Considerations

While the study offers valuable insights, it's crucial to note its reliance on self-reported data, which can be subject to recall bias. Additionally, there may be other confounding variables not accounted for in the research.

The Takeaway: Rethinking Our Screen Habits

This study serves as a wake-up call to reassess our daily routines. It suggests that while moderate, purposeful screen use (like computer work) can be part of a healthy lifestyle, excessive, passive screen time (like prolonged TV-watching) might have dire health implications.

 In Practice: Balancing Screen Time with Active Living

For individuals and healthcare professionals alike, the message is clear: balance is key. Integrating regular physical activity into our routines and being mindful of our screen habits could be crucial steps in safeguarding our neurological health.

As we navigate a world increasingly oriented around digital screens, this study underscores the importance of staying active and engaged in a variety of activities. It's not just about cutting screen time; it's about enhancing our overall lifestyle to nurture our physical and mental well-being.

Snoring Could Be Harming Your Brain

Snoring and Your Brain: What the Nightly Rumble May Mean for Your Brain Health

Do you snore, or know someone who does? While it may be a source of light-hearted teasing or frustration within a family, the implications of snoring could be far more serious than we think. Recent research from the Faculty of Medicine at the University of Paris-Cité suggests that habitual snorers might be fast-forwarding the aging process of their brains and inadvertently compromising their brain health.

The underlying factor in the harm caused by snoring is the deprivation of deep sleep, the phase of sleep crucial for physical and mental restoration. The study finds that the regular, loud snorers with obstructed breathing, often the tell-tale signs of sleep apnea, stand at higher risk of developing symptoms of grave conditions like stroke, Alzheimer's disease, or general cognitive decline. 

The evidence for this alarming theory lies in the presence of tiny lesions on the brain, known as white matter hyperintensities. These biomarkers give an indication of the brain's health status and are more prevalent with age or uncontrolled high blood pressure. However, these lesions appeared more abundantly in participants with severe sleep apnea compared to those with mild or moderate conditions. This suggests a correlation between the severity of sleep-disordered breathing and the state of the brain's health.

Astonishingly, the study found that for every 10% decrease in deep sleep, there was an increase in these white matter hyperintensities, equivalent to the brain aging 2.3 years. This process signifies a decrease in the integrity of the axons, the elongated part of a nerve cell that allows communication between cells. Alarmingly, the same 10% reduction of deep sleep was also associated with reducing the integrity of these axons, leading to an effect similar to the brain appearing 3 years older.

This groundbreaking research emphasises the importance of quality sleep and paints a grim picture of the potential implications of untreated snoring. However, as the understanding of the relationship between snoring, deep sleep, and brain health continues to evolve, individuals have the opportunity to take control of their sleep health.

So, if you or a loved one is a chronic snorer, consider seeking professional medical advice. Simple lifestyle changes, or in more severe cases, medical interventions, could not only lead to quieter nights but also contribute significantly to preserving your cognitive health. In essence, protecting your sleep could mean protecting your brain, and that's something worth losing a little sleep over.

The Role of Multivitamins in Memory Boost and Slowing Cognitive Aging

We've all heard the adage, "An apple a day keeps the doctor away," but recent research suggests that a multivitamin might be a worthwhile addition to our daily routine. A study co-authored by Dr. JoAnn Manson, a professor of medicine at Harvard Medical School and Brigham and Women's Hospital, has offered some enlightening insights into the benefits of daily multivitamin supplementation, particularly for older adults.

The research is part of the second Cocoa Supplement and Multivitamins Outcome Study (COSMOS), a collaborative effort between Brigham and Columbia University. The findings, which have been published in the American Journal of Clinical Nutrition, suggest that regular multivitamin intake can not only enhance memory but also slow cognitive aging.

Nutrition and Cognitive Health

The human brain requires an array of nutrients to function optimally. Deficiencies in certain micronutrients, such as vitamin B12, thiamin, other B vitamins, lutein, magnesium, and zinc, can accelerate cognitive decline, hence emphasizing the importance of a nutritionally balanced diet for maintaining brain health.

In the trial, 3500 participants aged 60 or older took part in a web-based memory test. Those in the multivitamin group outperformed the placebo group in memory tests and word recall, an outcome that's roughly equivalent to slowing age-related memory loss by about three years. The benefits were noticeable from the first year and lasted throughout the three-year trial duration.

Multivitamins and Cardiovascular Health

An intriguing pattern that emerged from the COSMOS trial, as well as the earlier COSMOS-Mind study, was that participants with a history of cardiovascular disease showed the most significant improvement from multivitamin supplementation. This improvement could potentially be due to their lower initial nutrient status, but this area needs further exploration.

A Balanced Perspective

Despite the promising findings, Dr. Manson stressed that multivitamins are not a magic bullet. They should complement a healthy diet and lifestyle, not replace them. It's also crucial to remember that the trials tested recommended dietary allowances, not megadoses of micronutrients. High doses might not only lack the same cognitive benefits, but they might also lead to toxicity or interfere with the absorption of other nutrients.

Safety and Quality

The multivitamins used in the trial, including Centrum Silver, were found to be safe, without any clear risks or safety concerns. Importantly, Dr. Manson clarified that these benefits are not brand-specific; other high-quality multivitamins should also confer similar advantages. As a rule of thumb, consumers should always check for quality-control documentation, such as seals from the US Pharmacopeia, National Science Foundation, ConsumerLab.com, or other auditors.

Looking to the Future

This research offers an exciting glimpse into the potential benefits of multivitamin supplementation as a safe, accessible, and affordable approach to protecting cognitive health in older adults. Yet, there's more work to be done. Future research needs to pinpoint who is most likely to benefit and delve deeper into the biological mechanisms involved. It's also up to expert committees to evaluate the research and determine whether changes in nutritional guidelines are warranted.

In summary, a daily multivitamin could be a small addition to our routines with potentially significant benefits for our cognitive health. Yet, it should serve as a complementary strategy to a balanced diet and healthy lifestyle, not a substitute. As always, remember to discuss any new supplements with a healthcare provider to ensure they're right for your personal health situation.

Had COVID? Part of the Virus May Stick Around in Your Brain

If you or someone you know is experiencing "brain fog" after COVID-19, scientists now have a possible explanation — and it might not bring much comfort.

Researchers in Germany found that part of the virus, the spike protein, remains in the brain long after the virus clears out.

 

These investigators discovered the spike protein from the virus in brain tissue of animals and people after death. The finding suggests these virus fragments build up, stick around, and trigger inflammation that causes long COVID symptoms.

About 15% of COVID patients continue to have long-term effects of the infection despite their recovery, said senior study author Ali Ertürk, PhD, director of the Institute for Tissue Engineering and Regenerative Medicine at the Helmholtz Center Munich in Germany.

 

Reported neurological problems include brain fog, brain tissue loss, a decline in thinking abilities, and problems with memory, he said.

"These symptoms clearly suggest damages and long-term changes caused by SARS-CoV-2 in the brain, the exact molecular mechanisms of which are still poorly understood," Ertürk said.

 

The researchers also propose a way the spike protein can get into the brain in their preprint report published online before peer review April 5 on bioRxiv.

Delivered by circulating blood, the spike protein can stay inside small openings in the bone marrow of the skull called niches. It can also reside in the meninges, thin layers of cells that act as a buffer between the skull and the brain. From there, one theory goes, the spike protein uses channels to enter the brain itself.

The hope is researchers can develop treatments that block one or more steps in this process and help people avoid long COVID brain issues.

 

'Very Concerning'

"This is a very concerning report that literally demonstrates the SARS-CoV-2 spike protein in the skull-meninges-brain axis in postmortem individuals," said Eric Topol, MD, director of the Scripps Research Translational Institute in La Jolla, CA, and editor-in-chief of Medscape, WebMD's sister site for medical professionals.

Having the spike protein accumulate in structures right outside the brain and causing ongoing inflammation makes sense to Topol. The clustering of spike proteins would trigger an immune response from this niche reservoir of immune cells that cause the inflammation associated with long COVID and the symptoms such as brain fog, he said.

 

Problems with thinking and memory after COVID infection are relatively common. One research team found 22% of people with long COVID specifically reported this issue, on average, across 43 published studies. Even people who had mild COVID illness can develop brain fog later, Ertürk and colleagues note.

 

So why are researchers blaming the spike protein and not the whole COVID virus? As part of the study, they found SARS-CoV-2 virus RNA in some people after death and not in others, suggesting the virus does not need to be there to trigger brain fog. They also injected the spike protein directly into the brains of mice and showed it can cause cells to die.

Researchers also found no SARS-CoV-2 virus in the brain parenchyma, the functional tissue in the brain containing nerve cells and non-nerve (called glial) cells, but they did detect the spike protein there.

Surprising Findings

Investigators were surprised to find spike protein in the skull niches of people who survived COVID and died later from another cause. Ertürk, lead author and PhD student Zhouyi Rong, and their colleagues found spike protein in 10 of 34 skulls from people who died from non-COVID causes in 2021 and 2022.

 

They also found COVID can change how proteins act in and around the brain. Some of these proteins are linked to Parkinson's disease and Alzheimer's disease, but have never before been linked to the virus

Another unexpected finding was how close the findings were in mice and humans. There was a "remarkable similarity of distribution of the viral spike protein and dysregulated proteins identified in the mouse and human samples," Ertürk said.

Future Treatments?

Tests for protein changes in the skull or meninges would be invasive but possible compared to sampling the parenchyma inside the brain. Even less invasive would be testing blood samples for altered proteins that could identify people most at risk of developing brain complications after COVID illness.

It will take more brain science to get there. "Designing treatment strategies for these neurological symptoms requires an in-depth knowledge of molecules dysregulated by the virus in the brain tissues," Ertürk said.

Parkinson Disease

Parkinson disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed, but not halted, by treatment. The 2 major neuropathologic findings in Parkinson disease are loss of pigmented dopaminergic neurons of the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites.

Signs and symptoms

Initial clinical symptoms of Parkinson disease include the following:

• Tremor
  
• Subtle decrease in dexterity
  
• Decreased arm swing on the first-involved side
  
• Soft voice
  
• Decreased facial expression
  
• Sleep disturbances
  
• Rapid eye movement (REM) behavior disorder (RBD; a loss of normal atonia during REM sleep)
  
• Decreased sense of smell
  
• Symptoms of autonomic dysfunction (eg, constipation, sweating abnormalities, sexual dysfunction, seborrheic dermatitis)
  
• A general feeling of weakness, malaise, or lassitude
  
• Depression or anhedonia
  
• Slowness in thinkin

Onset of motor signs include the following:

• Typically asymmetric
  
• The most common initial finding is a resting tremor in an upper extremity
  
• Over time, patients experience progressive bradykinesia, rigidity, and gait difficulty
  
• Axial posture becomes progressively flexed and strides become shorter
  
• Postural instability (balance impairment) is a late phenomenon

Nonmotor symptoms

Nonmotor symptoms are common in early Parkinson disease. Recognition of the combination of nonmotor and motor symptoms can promote early diagnosis and thus early intervention, which often results in a better quality of life.

Diagnosis

Parkinson disease is a clinical diagnosis. No laboratory biomarkers exist for the condition, and findings on routine magnetic resonance imaging and computed tomography scans are unremarkable.

Clinical diagnosis requires the presence of 2 of 3 cardinal signs:

• Resting tremor
  
• Rigidity
  
• Bradykinesia
  

Management

The goal of medical management of Parkinson disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects.

Symptomatic drug therapy

• Usually provides good control of motor signs of Parkinson disease for 4-6 years
  
• Levodopa/carbidopa: The gold standard of symptomatic treatment
  
• Monoamine oxidase (MAO)–B inhibitors: Can be considered for initial treatment of early disease
  
• Other dopamine agonists (eg, ropinirole, pramipexole): Monotherapy in early disease and adjunctive therapy in moderate to advanced disease
  
• Anticholinergic agents (eg, trihexyphenidyl, benztropine): Second-line drugs for tremor only
  

Treatment for nonmotor symptoms

• Sildenafil citrate (Viagra): For erectile dysfunction
  
• Polyethylene glycol: For constipation
  
• Modafinil: For excessive daytime somnolence
  
• Methylphenidate: For fatigue (potential for abuse and addiction)
  

Deep brain stimulation

• Surgical procedure of choice for Parkinson disease
  
• Does not involve destruction of brain tissue
  
• Reversible
  
• Can be adjusted as the disease progresses or adverse events occur
  
• Bilateral procedures can be performed without a significant increase in adverse events
  

Prognosis

Before the introduction of levodopa, Parkinson disease caused severe disability or death in 25% of patients within 5 years of onset, 65% within 10 years, and 89% within 15 years. The mortality rate from Parkinson disease was 3 times that of the general population matched for age, sex, and racial origin. With the introduction of levodopa, the mortality rate dropped approximately 50%, and longevity was extended by many years. This is thought to be due to the symptomatic effects of levodopa, as no clear evidence suggests that levodopa stems the progressive nature of the disease.

The American Academy of Neurology notes that the following clinical features may help predict the rate of progression of Parkinson disease :
Older age at onset and initial rigidity/hypokinesia can be used to predict (1) a more rapid rate of motor progression in those with newly diagnosed Parkinson disease and (2) earlier development of cognitive decline and dementia; however, initially presenting with tremor may predict a more benign disease course and longer therapeutic benefit from levodopa
A faster rate of motor progression may also be predicted if the patient is male, has associated comorbidities, and has postural instability/gait difficulty (PIGD)
Older age at onset, dementia, and decreased responsiveness to dopaminergic therapy may predict earlier nursing home placement and decreased survival
Patient Education

Patients with Parkinson disease should be encouraged to participate in decision making regarding their condition. In addition, individuals and their caregivers should be provided with information that is appropriate for their disease state and expected or ongoing challenges. Psychosocial support and concerns should be addressed and/or referred to a social worker or psychologist as needed.

Prevention of falls should be discussed. The UK National Institute for Health and Clinical Excellence has several guidance documents including those for patients and caregivers.

Other issues that commonly need to be addressed at appropriate times in the disease course include cognitive decline, personality changes, depression, dysphagia, sleepiness and fatigue, and impulse control disorders. Additional information is also often needed for financial planning, insurance issues, disability application, and placement (assisted living facility, nursing home).

Scientists have finally decoded the bizarre behaviors of brain cells — and recreated them in tiny computer chips.

The tiny neurons could change the way we build medical devices because they replicate healthy biological activity but require only a billionth of the energy needed by microprocessors, according to a University of Bath press release.

Neurons behave similar to electrical circuits within the body, but their behavior is less predictable — especially when it comes to parsing the relationship between their input and output electrical impulses. But these new artificial brain cells successfully mimic the behavior of rat neurons from two specific regions of the brain, according to research published Tuesday in Nature Communications.

“Until now neurons have been like black boxes, but we have managed to open the black box and peer inside,” University of Bath physicist Alain Nogaret said in the release. “Our work is paradigm changing because it provides a robust method to reproduce the electrical properties of real neurons in minute detail.”

The ultimate goal is to use these neurons to build medical devices that can better cater to patients’ needs, like a smarter pacemaker that can respond to new stressors and demands on a person’s heart — essentially upgrading devices to be more in tune with the body.

Julian Paton, a physiologist at the universities of Auckland and Bristol, said in the release that recreating biological activity was exciting because it “opens up enormous opportunities for smarter medical devices that drive towards personalized medicine approaches to a range of diseases and disabilities.”

We might soon be able to communicate telepathically

At least, that’s the gist of a new report about neural implant technology by the Royal Society, that was reviewed by The Independent. The document hypes some of the more exciting things brain-computer interfaces could make possible, but also warns that brains hooking to the computers ( watching too many SciFi movies!!) could also compromise individual privacy.

“Not only thoughts, but sensory experiences, could be communicated from brain to brain,” the report reads. “Someone on holiday could beam a ‘neural postcard’ of what they are seeing, hearing or tasting into the mind of a friend back home.” - Little bit of exaggeration.... Do you guys think that way? 

To make sure that these neural implants of the future are used to benefit people and society, the Royal Society is calling for a government probe into the tech, The Independent reports. Otherwise, companies like Facebook and Tweeter that are already working on their own systems will be able to dictate how the tech is used on their own terms.

“They could bring huge economic benefits to the UK and transform sectors like the NHS, public health and social care,”  report co-chair Christofer Toumazou from Imperial College of London told The Independent. “But if developments are dictated by a handful of companies then less commercial applications could be side-lined. That is why we are calling on the government to launch a national investigation”

READ MORE: Brain-Computer Interface Will Make People Telepathic, Scientists Say [The Independent]

Paedophilia Symptoms can be caused by Brain Tumours in the right orbitofrontal cortex

In 2000, a 40-year-old man was rushed to the University of Virginia Hospital emergency department while experiencing a severe headache. Perhaps he was faking it to escape the dire situation he had been in. In the previous year, he had developed an unusual increasing interest in porn, including child porn. While he had a pre-existing interest in porn dating back to his teenage years, he denied a previous attraction to children. He had been in a stable marriage for two years. He did not have a history of psychiatric disorders or prior deviant sexual behaviour.

Throughout the year 2000, he collected a large number of porn magazines and increasingly visited Internet porn sites to satisfy his obsession with child porn. He started soliciting prostitution which he had not done before.

He desperately concealed his activities but continued to act on his sexual impulses, completely unable to restrain his sexual urges. He even made subtle sexual advances toward his stepdaughter. She informed her mother and she discovered his preoccupation with child pornography.

He was removed from the home, found guilty of child molestation and was ordered to undergo rehab for sex addiction or go to jail. While in rehab, he solicited sexual favours from staff and other patients and was expelled.

Sixteen years earlier, he had had a head injury that left him unconscious for two minutes, followed by two years of migraines. During the neurologic examination, he solicited female staff for sexual favours and was unembarrassed when he peed on himself. He confessed he had had suicidal thoughts and rape fantasies. He complained of balance problems and an MRI scan was performed on him. An egg-sized brain tumour was discovered in his brain. Once it was removed, his sex obsession disappeared.[1]

The tumour was located in the right lobe of the orbitofrontal cortex, an area of the brain responsible for inhibition, judgment and impulse control. It was the first case that brain damage was linked to paedophilia. While his knowledge of right and wrong was intact, the tumour had destroyed his control of sexual impulses.

Seven months after the tumour removal and completing the rehab program, he returned home. He complained of headaches and secretly collected porn again. An MRI scan revealed that the tumour had come back and after it was removed, his behaviour disappeared.

In another similar case, a 64-year-old well-respected pediatrician was caught while enacting sexually inappropriate behaviour towards a child in a kindergarten doctor’s office. He clearly had lost all judgment because his paedophilic urges were carried out in a risky manner leaving the office door wide open. His wife observed he had gradually changed with easy frustration and irritability followed by subtle behavioural disinhibition. His MRI scan revealed a large tumour that displaced the hypothalamus, which is responsible for sexual orientation and compressed the orbitofrontal cortex. After the tumour was removed, all the abnormal behaviour including paedophilic urges, disappeared.[2]

These two cases raise an interesting question: to what extent are these two men culpable? Recent studies have estimated 25–87% of prison inmates suffered some sort of traumatic brain injury (TBI) in their life and indicated associations between TBIs and criminal-like behaviour.[3] [4] [5] TBI-related problems can complicate their management and treatment. They can experience mental health problems such as severe depression, anxiety, anger control issues, self-restraint, alcohol and substance abuse.

This makes it difficult for them to respond to disciplinary action in prison, to understand and remember rules, and anger issues can get them in dangerous incidents with other inmates. They also have a higher rate of recidivism.

The spirit of the law is that responsibility for a crime is reduced when a defendant’s cognitive ability is compromised by illness or injury. This means that people need to be tested soon after being arrested. Many people who are in prison shouldn’t be there due to this lack of diagnosis. There needs to be increased health screenings and rehab treatments and improved coordination between family, community mental health services, GPs and the school system. The justice system will have to move away from retribution and focus more on rehabilitation.

It doesn’t change the purpose of the justice system to reform their behaviour and provide safety for the rest of society. But the sentencing and treatment might have to depend on how modifiable their behaviour is. If a criminal is utterly beyond repair, brain damage or not, (s)he still needs to be locked away. But it might help many others who might benefit from treatment as the two examples in this answer.

Footnotes

[1] Right Orbitofrontal Tumor With Peadophilia Symptom and Constructional Apraxia Sign

[2] Peadophilia emerging in a 64 years old peadiatrician

[3] Brain Injury Rate 7 Times Greater among U.S. Prisoners

[4] https://www.braininjuryaustralia...

[5] Traumatic brain injury: a potential cause of violent crime?