Sunday, October 26, 2014

Something every geeky neuropsychologist should have

With thanks to Les Posen who forwarded the link.

A New Zealand company Brainform offers 3D prints of your own brain from MRI scan files. $430 full scale, $140 half-size. Just the cortex, mind you, no subcortical structures included. No cerebellum either, which the website explains by saying:
"Partly because it looks like a scrotum, partly because the cortex is the most interesting to look at, and partly because sometimes the details of it don't segment out from scans that well."

If you don't have an MRI scan, you can always participate in research that requires an MRI - the site offers a free service linking clients with researchers that are looking for participants (this is also worth knowing if you are looking for subjects). If you don't feel like getting a scan, you can get a stock brain for $360 full scale or $100 half size.

I'm so tempted,

Izabela

A video of a symposium on brain plasticity and healing - with ridiculous number of celebrities

Two days ago University of Alabama had a very interesting symposium. They invited Dalai Lama to discuss brain plasticity with Michael Merzenich  -  who can well be called a father of the whole discipline. To top it up, the symposium was moderated by Dr Norman Doige, the author of the book The Brain that Changes Itself. This is celebrity cast on steroids. I'm looking forward to watching it tonight.

The video of the symposium can be found on: https://www.youtube.com/watch?v=zJlmRISL-QA&list=UUOMZCCUBnjdhjhtNAUfkGqg

A warning - the video appears to be almost 3 hours long, although the comment on the front suggests that the event starts at the 26 minute mark.

cheers,

Izabela

Thursday, October 23, 2014

iPad testing in Multiple Sclerosis

There is an interesting test for Multiple Sclerosis progression that uses the iPad in a very different way - attaching it to the back to assess walking and balance, clipping an apparatus to the screen to assess manual dexterity in a pegboard-like task, and a test very similar to coding, but done entirely on the iPad. Check here for a video summary and the full text of the article by Rudick, R. A., Miller, D., Bethoux, F., Rao, S. M., Lee, J. C., Stough, D., et al. The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool. J. Vis. Exp. (88), e51318, doi:10.3791/51318 (2014) for the full info.

Worth seeing to realize how much the iPad can actually do to facilitate testing.

cheers,

Izabela

A new bunch of gadgets for the elderly

I found a new site with a multitude of cool medical gadgets. The ones for the elderly are on http://www.medgadget.com/geriatrics

I am not sure whether I am impressed or truly spooked. How would you like a chair that measures vital signs through your butt? Just being released by EarlySense from Waltham, Massachusets. Or maybe an airbag for the elderly that opens up when they are falling to protect the hips? A true non-fashion statement, considering that you have to wear it outside your clothes. How about sensors that dob you in to your children if you did not make coffee in the morning? The gizmo in question monitors the use of small appliances to detect if something has happened to an elderly person living alone.

And this is only the first page of the gadgets. Go and have a look.

cheers,

Izabela

Saturday, August 23, 2014

A Technology talk next week and the best IT resource of today

I'm giving a talk about technology in private practice for Pearson in Melbourne this coming Friday, 29.8.2014. I'm organizing nice, juicy lists of useful tricks and gadgets, and having a lovely time researching all sorts of stuff.

If anybody is interested in coming, there should still be spots. Check http://learn.pearsonacademy.com.au/au/courses/176-using-technology-in-psychology-practice-tricks-and-gadgets if interested. Please note, spelling is not mine.

Among all the lovely goodies, the juiciest resource I worked with today was unquestioningly the APS guide to practice management software. Beautifully compiled, with web information, contact details, cost and detailed comparison of features. Lovely.

The address is: http://www.psychology.org.au/Assets/Files/Software-for-Psychologists.pdf

It is from April 2013, so somewhat out of date, but still worthwhile.

cheers,
Izabela

Friday, June 27, 2014

Neuro Pope

The links between John Paul II, miracles and neurological disorders explored in Mind Hacks blog:

http://mindhacks.com/2013/07/09/life-of-a-neuro-pope/

enjoy,
Izabela

Everything Oliver Sacks

I've recently found out that Oliver Sacks has a blog
http://www.oliversacks.com/blog/
He doesn't update it personally, but it is still worth reading

His official website is here:
http://www.oliversacks.com/blog/

and it includes a whole bunch of videos
http://www.oliversacks.com/videos/assorted-videos/

He has also a dedicated YouTube channel
https://www.youtube.com/user/OliverSacksMD
with lots of excellent stuff.

You can even sign up for a newsletter
http://www.oliversacks.com/contact/oliver-sacks-newsletter/

He's also got a Facebook and a Twitter page - just search on Oliver Sacks.

Fun,
Izabela

Sunday, June 22, 2014

Last report from the Wild West

I never did get around to writing a post about a seminar on brain training that I attended in March, and it deserves a mention.

It was a whole day seminar on cognitive training by the Murdoch Childrens Research Institute, and the speakers included Professor Torkel Klinberg, the creator of Cogmed, as well as a wide variety of well-known names among Melbourne neuropsychologists. I strongly recommend the slides of presentations that can be accessed on http://debbiecations.wix.com/cogntive-training-#!slideshow/c19lk.

I was particularly interested in the last part of the day, which was a debate. I was looking forward to seeing Professor Torkel Klinberg on one side of the equation, Professor Jennie Ponsford on the other side and Associate Professor Stephen Bowden as the chair. In my mind a debate cannot get better than that.

I've previously bugged Stephen Bowden re. his opinion on brain training. He is, after all, well known as the ultimate skeptic, intent on scientific proof. However, he claimed not to be involved in this area, so I was out of luck.

But he did not disappoint in the debate. One of the questions he posed was about the appropriate level of proof required before we recommend an intervention. He described three descending levels of proof: a meta-analysis, two randomised controlled studies and then one randomised controlled study.
The answers of the panel clarified my view on cognitive training, at least as far as Cogmed is concerned: Prof Ponsford admitted that most rehabilitation interventions have one randomised controlled study behind them, with not many interventions having two. Professor Klinberg said that he does not have to concern himself with level of proof, because he already has a meta-analysis that supports Cogmed. Hmm, that _was_ convincing.

And that's why this is the last post on brain training. I've decided to build a homestead in Neuropsychology's western reaches and to start offering Cogmed in my practice. As I now have a commercial interest in brain training, I no longer feel I can post on the topic in this forum. Also, it strikes me that my previous posts were meant to convince me as much as my readers, and I decided that I no longer need convincing.

So, final greetings from the Wild West, and it's back to the usual program of reporting the latest technological gimmicks.

cheers,
Izabela

Saturday, May 24, 2014

Playing with biofeedback

I am checking out the biofeedback possibilities of the iPhone. Not that I'm planning to seriously get into biofeedback, but it is a fun new way of avoiding report writing. If anybody has some experience and knowledge about this topic, please send us a guest post.

There are several interesting options out there:

a) heart rate and heart rate variability
It turns out that iPhone 5 rear camera can be used as a heat rate monitor. You put a finger on it, the flashlight lights up and it works pretty much like an oximeter. There are a few apps that use this option:

  • Cardiio app measures heart rate and feeds back your fitness level
  • Stress Check measures heart rate variability and records self-reported level of stress
  • iRelief does breathing exercises while measuring heart rate and then feeds back percentage of coherence (whatever that is)
  • CalmZone has some nice sounds and gives you some feedback on your heart rate variance (same as variability?)
  • StressCheck meaures heart rate variability and reports your stress level, with an ability to record data over time (mind you, this is buggy in the free version, may be better in the non-free app)

I have to admit that I haven't been really impressed by any of these. None of them does all they should, which would be feedback on heart rate variability, with clear explanations and maybe visual feedback, e.g. colour change, as the parameters improve. Also, I have to admit that I am still not  comfortable with the idea of heart rate variability, and can't quite wrap my head around it. OK, I've never tried terribly hard, but then again, if it takes trying terribly hard, then explaining it to the clients is going to be a tricky task.

Les Posen recommends a set of sensors with a dedicated computer program from emWave for heart rate variability training. They also have an option of attaching a sensor to an iPhone and monitoring heart rate variability on the go. Probably a more accurate and elegant option (but more expensive, drat).  Has anybody tried this in clinical practice?

b) skin conductivity
I like this idea of biofeedback much more. As Michael Carr-Gregg explained in his recent talk - you just tell the client that it works the same as a lie detector test, with more anxiety causing more sweating and more skin conductivity. Simple and convincing. He uses the sensors while teaching relaxation training to teenagers, so that they can see that it works.
The sensor is called eSense, fits on fingertips, attaches to an iPhone/iPad and can be linked to an app called eSense GSR. Very tricky to buy, as the original company's website is buggy, but can be bought from third parties for around $100. Don't try Amazon - they don't want to sell it to Australia. Seems a much better option for an average neuropsych who does not want to get too deep into biofeedback, but may want to convince a client that relaxation works.

c) breathing
There are apps that use the iPhone's accelerometer to teach deep belly breathing. You put your phone on your stomach and breathe away. One of these is BellyBio. Feels a touch silly, somehow, but I am impressed with the creative use of sensors.

And that's all I've discovered. If anybody knows a nice and useful gadget, please write a guest post or let me know at IzaWalters at gmail.com, and I'll post it up.

cheers,
Izabela

Simple, customised mobile phone

With thanks to Katie Kirby and Gloria Smith-Tappe:

OwnFone was launched in Australia last month:
Some reviews:
   

I have had a look at the website and I'm very impressed: instead of a keypad, you can set up from one to 11 buttons with a name or a photograph. A very nice, simple design. And not too expensive (handset under $100 + plans from $20 per month). You can even make free changes to the buttons up to three times a year.Very impressive.

cheers,

Izabela

Tuesday, April 1, 2014

Izabela's second trip to the Wild West

I enjoyed my first trip into brain training, which I wrote about a few posts back. It was reasonably easy and felt like a success. My useful field of view improved quickly and I noticed a change in real life. Not surprisingly, I decided to do it again. This time it was working memory.

Now, working memory is my personal weakness. In the interest of full disclosure, I have a digits forward span of 7 and digits backwards span of 5. Visually, I can do a block span of 5 consistently, and repeat a sequence of up to 7 blocks inconsistently. I can reverse five blocks consistently, and 6 inconsistently. Not bad, somewhere in the Average range, but not great either.

In practice, this interfered a bit with my functioning. Telephone numbers had to be copied down in chunks of 4, and double-checked for errors. I could at times feel overwhelmed, for example when integrating information from multiple sources when writing complex reports. Yes, I know that this is normal, but I wanted a better function.
When report-writing, I needed more frequent breaks than optimal, and felt that my brain power got used up by about 3pm. And I developed a whole system for avoiding inattentive, 'silly' mistakes - very important to prevent in a private practice. Working at home and being interrupted by requests from Dear Daughter resulted in feeling overloaded and frequently snapping at her. Thus, I avoided working when she was not at school or asleep. As all mums do, I also snapped a lot in the morning, during the school run.
Not an uncommon set of problems, really, but worth improving on. Especially that I could do my own training AND acquire Cogmed coaching credentials all at the same time and price. Mind you, the price was 1,500 and it did hurt the wallet.

So, I did the full Cogmed training, and it was tough. 45-60 minutes of major effort for 25 days. The effort was not that surprising - after all working memory tasks are by definition effortful. So I persevered, despite serious sweat running down my brow. I wonder, however, how one keeps ADHD kids doing these tasks. Now I understand the requirement of a training aide to supervise all the kiddie sessions, and a coach to call every week with feedback and reinforcing chat. Trust me, if you do Cogmed, or if you are a training aide you really need someone to support you.

There are three versions of the program: for preschoolers, children and adults. The children and adult tasks are the same, apart from the interface - the adult interface is more boring. I chose the kiddie version and strongly recommend everybody does the same - when you are trying to remember multiple locations, it really helps if you are tracking aliens rather than gray circles. Also, exploding asteroids is fun.

One of the tasks was digits backwards. By the end of training I could reverse up to 11 digits (very occasionally, mind you). This was not auditory working memory only - by this stage I coded some of these digits visually, some auditorily and some by meaning. Nevertheless, I believe that my actual auditory working memory store did stretch, if only by a digit or so.

Unfortunately, while I managed to get a pre-test (see results above) I had not much luck getting myself re-tested. I can just say that after the training I can hold in mind the entire 8 digits of a phone number or a credit card number when copying them onto various online forms. So I remember one more digit forward than before the training. The training was in September, and if anybody wants to check this n=1 experiment for persistence of working memory effects, I'm game. We'd just have to think up some other task instead of digits backwards, as it was one of the tasks being trained.

Now, did the results generalise? I was expecting to be able to work longer without mental exhaustion, and that seemed to happen. I can now comfortably work until 5pm, and report writing became a bit easier. This is always nice, even if the effect was small. Whether this was an effect of Cogmed or placebo effect, it is hard to say. This levels of mental energy and being able to work a lot persisted till Christmas, but took a dip over the start of the year, when I got truly fed up with the heat. The mental energy has now come back. However, I am not entirely sure that the cognitive effect of Cogmed was worth the money.

What I did not expect, was that the training would stop me snapping at Dear Daughter.  After about a fortnight, I noticed that I became overloaded less and less often when she interrupted something. By the end of the training, my snapping completely disappeared - I no longer lose my temper.  This effect, I am glad to say, is continuing to this day, and has not diminished.
Surprisingly, this effect, which I was not expecting, ended up to be the most worthwhile outcome of Cogmed training. I think that ultimately, this one was worth the money I paid.

Cheers,
Izabela

Friday, January 31, 2014

Dictate your reports - a new option

I've been thinking of dictating my reports for a long time. Those of us who do it say that it speeds up the work. But somehow, I have never got around to buying Dragon Dictate, teaching it to understand my accented English and learning how to dictate, which is a skill in itself.

It seems that there is a new and free option for doing that for Mac users (with thanks to Les Posen, who sent the information in his email). If you have the new operating system (Maverics, free update from the app store), it includes a nice dictation software. Tap the fcn key twice, wherever you are, and you are ready to dictate.

The thing worked quite nicely, translating my accented English into good typing. It was even able to transcribe 'neuropsychology', neuropsychologist' and 'frontal lobes' correctly. It was a shame that temporal lobe ended up being a 'love', and it had some unusual ideas about 'stroke', but it is a good start.

Importantly, you can download extra software and all the transcription happens on your Mac, with no information being sent to the server - a good feature for ensuring privacy.

Worth having a try.
Cheers,
Izabela

Wednesday, January 29, 2014

Q interactive rumours

I have received an email from the USA saying that WMS-IV, WIAT-III has become available. They also said that WISC-V will be available on iPad this year.

I have checked, and WMS-IV and WIAT-III have not yet arrived in Australia. But they are coming closer. I wonder how long it'll take them to cross the ocean?

cheers,
Izabela

Medical food for dementia

This is not exactly technology, but it feels to be geeky enough to include here.

Katie Kirby sent a great post about Souvenaid, which is marketed as a medical food for dementia, with the company claiming that it increases synapse production, thus helping with memory in the early stages of the disease. It comes in small bottles, like a flavoured drink, and is supposed to include fish oils and other goodies in just the right proportion to improve brain function. I have to admit that it sounds good, apart from the price, which currently hovers around $20 for a 4-bottle pack - very expensive as it is supposed to be consumed once a day for a long period of time.

Here are links sent by Katie:

The NPS (National Prescribing Service) has just published its analysis of 3 RCTs involving Souvenaid:

Response from Nutricia:

It strikes me that a synapse-producing supplement could be of much more use in a population that is not actively losing neurons. I wonder how long it will take HSC students to start chugging it.


cheers,
Izabela

Friday, January 17, 2014

Excellent autism detection video

I'm back from holidays and ready to do some posting. To start with, an excellent video on autism

http://www.essentialbaby.com.au/toddler/toddler-health/what-autism-looks-like-in-toddlers-video-20140117-30yff.html

This is a brilliant series of comparisons between normal toddlers and those with Autism Spectrum Disorder, with commentary highlighting the differences in their behaviour. Without doubt worth a look - the best training video I've seen in a long time, and only 9 minutes long.

Enjoy,
Izabela