Moonlighting in Neuroscience

 Moonlighting in Neuroscience

            What happens in a child’s brain during institutionalized care that affects his/her ability to think abstractly? General Semantics offered a way to define what I notice in my daughter; she struggles with abstraction. From the outside looking in, it seems to me that she thinks concretely, observes concretely, and does not do well with abstracts thoughts in school or with talking about abstract concepts and feelings at home. Her bias serves her (and us) well in some areas: if we cannot find something in the house, we just ask her because she almost always can recall where she last saw the item; she rarely loses anything; and she rarely misses important dates or deadlines. Her bias does not serve her well, though, in the areas of prime numbers, the periodic table, understanding evaporation, calculating travel time, and understanding the difference between states and towns. And, my concern for her concrete thinking bias extends to my concern for her heart, her feelings; she does not speak of her feelings and only rarely expresses emotion. Also, when asked about her day in school, about church, about her time with friends, she says very little in response; usually, she responds with “good,” and at the most shares something funny that happened. If she does try to share what a teacher explained, often she does not make sense; I think she understood what the teacher said, but she cannot then transfer the content in conversation. And there we stand in the kitchen in some sort of quagmire. I want to understand what she comprehended or experienced that day, and she wants to tell me. But . . .

In my beginning research on this idea that the ability/inability to think abstractly connects to a certain area in the brain, I found a few articles on the effects of institutionalization through search terms like “institutionalization” and “Charles A. Nelson” and “neuroscience.” I found names of others researchers in this similar field. But, I pressed “pause” on my research with search terms, and I attended the adoption conference. I felt confident I would get answers directly from the mouth of Thomas Rector who teaches BioSocial Cognition workshops at these conferences. We met, and he almost undid my question in an hour. When I presented my I-search question and described my daughter (much like I did in my first paragraph here), he responded with a much different answer than I expected. He began to talk to me about genetics and that she simply might be more genetically disposed to think concretely than abstractly. I expressed my observations of her as “deficiencies” and he asked me to consider them as not only her genetic expression of herself, but also to consider that my interpretations carry my own genetic bents. He described a “typical” family as two adults who come together and do not share the same gene pool; who then, we presume, have children, and then the “whole” family share the same gene pool. When we add someone from the outside of this gene pool to the family, the “whole” family interprets this entirely different genetic pool’s behavior through their own “whole” family common gene pool lens. He went on to describe her as a little person with her own genetic makeup, placed in adverse circumstances in an orphanage. Like anyone who tries to survive in adversity, her brain kept leading her to what “worked” for her, and perhaps her genetic disposition allows her to function as a more concrete thinker. Mr. Rector asked me to consider abstract thinking as a learned skill that some people do better than others, based on their talent for it. He noted my enjoyment of “charged” conversation and he predicted that she does not share that enjoyment with me; he predicted correctly, and then we imagined that perhaps she does not need that kind of engagement. He pointed out that I “tolerate” genetic difference each day with friends and acquaintances and strangers; and he admitted the difficulty of parenting a genetic stranger–stating that families do not “normally” have to “tolerate” differentness within their families because they “normally” share the same genetics.

Mr. Rector gave me a new lens with which to see Naika, and we began to discuss parenting her with the mission of helping her develop into an adult with self-esteem and with confidence in her skills and abilities to develop her best future. We talked about looking for opportunities for her to feel successful, to experience internal validation, to experience growth and success patterns. I shared with Mr. Rector that a few weeks before I left for the conference, I had talked to Naika about enrolling her in dance; she has strong muscles, and she moves with quickness, but not fluidity. I envisioned putting her in “modern” dance to increase her fluidity. A few days before I left for the conference, however, she mentioned that she would like to take tap. While I did not speak to that issue in the moment, I thought to myself—no way! That would only reinforce what she already knows how to do—jerky measured moves. As I explained my thought process to Mr. Rector, we both laughed. Tap, we agreed, will serve her well; tap involves patterns, a level of control and predictability, and encourages developing the skill of coordinating with other people (useful for the future). Mr. Rector asked me to consider embracing her self-directedness.

My conversation with Mr. Rector about my I-search question did send me in a different direction when I returned; I began to search for knowledge about parenting a person with a different gene pool. Because my daughter has dark skin, others might assume that my research interest lied in parenting someone with different skin, different hair, and different body composition. Actually, my interest lies more in something that never occurred to me prior to my conversation with Mr. Rector: genetic difference presents itself from the inside out in how a person thinks, responds, reacts, analyzes, expresses, relates, etc. And, as Mr. Rector acknowledged, “unease” can exist when families add a person with a different gene pool in the family; this relationship does not feel “normal” and does not come “naturally” to me or to Naika.

The “Variation in neural development” article introduced me to gray matter and white matter in the brain. In this study, the investigators wanted to find out if the neural structure of children from institutionalized care could benefit from an improved environment (foster care placement). The investigators utilized data/children from the Bucharest Early Intervention Project. This study reports finding “smaller whole brain, white, and gray matter volumes” in previously institutionalized children compared with never-institutionalized children. In fact, the gray matter measures “significantly smaller in children who had ever [italics mine] been institutionalized regardless of placement in foster care” (12930). I used wiki to understand the function of gray and white matter. Gray matter “is associated with processing and cognition” and exists “in the prefrontal cortex” (wiki). Gray matter also functions as a major component of the Central Nervous System and deals with muscle control, sensory perception, hearing, memory, emotions, speech, decision-making, and self-control. Gray matter grows and develops during childhood and adolescence. White matter serves as a connector; it “transmits signals from one region of the cerebrum to another,” and it “modulates the distribution of action potentials—acting as a relay” (wiki). White matter “actively affects how the brain learns and functions” (wiki). Wiki suggests we think of gray matter as the actual computers, and white matter as the network of cables that connect computers together; and Wiki suggests that the brain, in general “can adapt to white-matter damage by finding alternate routes.” From this research article, I learned that gray matter suffers in volume in previously institutionalized children and does not “catch up” once the children live in foster care; white matter, however, can catch up (12930).

As I think about Naika, I can hypothesize that I see evidence of this. After living with us for eight years, her white matter probably has increased. She has made more connections related to living here over the last eight years, and all things around her no longer seem foreign and out of context. Wiki says that white matter continues to develop and peaks in a person’s middle age; she still has quite a bit of time to keep growing her white matter. Her gray matter, however, according to current research will not catch up (Sheridan et al. 12930).

Also, this study states that previously institutionalized children had “smaller . . . volume of the left hippocampus and larger volume in the right amygdala” (Sheridan et al 12927). I used wiki to better understand these structural changes. The left hippocampus plays a central role in memory, functions as part of the limbic system, facilities the consolidation of information from short-term to long-term memory, aids in spatial navigation, connects to parts of the brain involved with emotional behavior. When the left hippocampus undergoes long-lasting trauma or stress, it suffers from atrophy–which can then lead to PTSD, schizophrenia and/or severe depression. I appreciated the note that blueberries can increase the volume of the hippocampus. I found evidence that the amygdala overdevelops in “Prolonged institutional rearing is associated with atypically large amygdala volume and difficulties in emotion regulation” by Nim Tottenham et al. They sought to understand the long-term effects on the “neurobiological development associated with socio-emotional behaviors” in children who “experienced orphanage care (46). They employed MRI “to measure volumes of whole brain and limbic structures; they measured “emotion regulation” with an “emotional go-nogo paradigm”; they assessed “anxiety and internalizing behaviors” by using the “Screen for Schild Anxiety Related Emotional Disorders (SCARED), “the Child Behavior Checklist, and a structured clinical interview” (46). Through their study, they found that “[l]ate adoption was associated with larger corrected amygdala volumes, poorer emotion regulation, and increased anxiety” (46). According to Olive James in “Fosters a Sense of Self-Esteem,” Naika’s experience in an orphanage for 24 months over-qualifies her to have an enlarged amygdala and “abnormal levels of cortisol”; James notes that “[i]n one study, children aged six to 12 who had spent more than eight months in an orphanage” had abnormal cortisol levels; cortisol prepares us to fight, flight, or freeze “when we are threatened” (28).

According to wiki, the amygdalae resemble two almonds in the deep center and toward the base of the brain. Research shows the amygdalae (also part of the limbic system) process memory, and they play a primary role in decision-making and emotional reactions. The reported larger volume in the right amygdala from the Sheridan et al study connects to the following in wiki: “stimulations of the right amygdala induced negative emotions, especially fear and sadness.” Wiki connects the amygdala to sense of smell and also emotional learning (memories associated with emotional events which then can elicit fear behavior when stimulated). The amygdala generates our “Fight, Flight or Freeze” responses, autonomic nervous system responses (such as in heart rate), and can alter our stress-hormone release. In general, the research shows the amygdala connected to: PTSD, anxiety disorders, fear and aggression, sexual orientation, and alcoholism.

As I think about Naika, I think of her acute attention to smell. When we brought her into our home, this little one with a different gene pool, she (apart from everyone else) would regularly notice smells in rooms, houses, new places, clothes, the kitchen, etc. The therapists who worked with us in those early years told us that she might even have cell-level memories stimulated by smells. Also, we learned about “Fight, Flight or Freeze” in those early years and about her most likely over-developed amygdala. I found it rewarding, now then, to actually find studies that validated what we learned from social workers and therapists in the early days. Just recently, Naika came out of her room at a late hour; she stopped when she came close to the kitchen where I typed away on my paper, and she turned to go back in her room. She had almost gone back in to her bedroom when I asked her, “Naika, what are you doing?” She replied, “I was going to get a melatonin.” I said, “Well, that’s fine. Why did you stop?” She answered with a shrug of her shoulders and an “I don’t know.” I just smiled. Based on my understanding of the amygdala, her behavior exemplifies a decision-made in a perceived threatening situation. She thought for some reason that I would not let her have a melatonin or that I might get angry that she still roams the house at this late hour, and she abandoned her mission—suppressed her perceived need. My other children do not behave that way. They would simply ask, and I do not think her behavior comes from personality. Genetic development altered by experience seems plausible; but an overdeveloped amygdala seems likely based on research.

My reading of research thus far validated my belief that some of what I see as “difference” in Naika reflects brain development—not “just” genetic difference. So, I pressed on. Wang et al.’s study “Neural Representation of Abstract and Concrete Concepts: A Meta-Analysis of Neuroimaging Studies” answered my original I-search question most clearly. Before I could decode the study, however, I had to look up the word meta-analysis. I learned that meta-analysis focuses on “contrasting and combining results from different studies in the hope of identifying patterns;” it aims to offer a “thorough summary of several studies” (wiki). In this meta-analysis, the investigators set out to make sense of studies done on “neural correlates of abstract and concrete concepts” that disagree with one another. Through meta-analysis and multilevel kernel density analysis (MKDA)[1], the investigators settled on the following:

Abstract concepts elicit greater activity in the inferior frontal gyrus and middle temporal gyrus . . . while concrete concepts elicit greater activity in the posterior cingulate, precuneus, fusiform gyrus, and parahippocampal gyrus . . . These results suggest greater engagement of the verbal system for processing of abstract concepts and greater engagement of the perceptual system for processing of concrete concepts. (Wang et al 1459)

Further, mental imagery seems to align itself closely with a perceptual experience even when a physical stimuli does not exist (1460). And, I learned about two theories and a hypothesis that try to speak to a fundamental inquiry: “whether concepts of represented by words or by nonlanguage factors, such as perceptual and motor experiences.

As I think of Naika, I recognize the battle she had on her hands when she first arrived to us—the battle of context. Even though she perhaps heard the words we said, she had only Haitian context to draw from to make sense of the word; and without context clues, where does a person store a new word or concept? Now, eight years later, she does undeniably have more context with which to make connections.

And, the study goes on to illuminate exactly which parts of the brain show activity in correlation to concrete and abstract concept stimuli. In general, the left inferior frontal gyrus and middle temporal gyrus and left precentral gyrus show stronger activation for abstract concepts (1462-1463). These parts of the brain control the following: cognitive function such as the go/no go response, language production and verb comprehension, phonological processing during working memory tasks, contemplation of distance, recognition of faces, and access to word meaning while reading (1463). And, damage to this area can produce non-fluent aphasis (high content but not fluid speech), alexia (inability to read) and agraphia (inability to copy), and “deficits in phonological and syntactic processes” (wiki and Wang et al. 1463).

As I reflect on Naika’s conversations with me, I can identify a lack of fluidity. I would not expect to find lesions necessarily on her brain, but I can at least attest to the difficulty she has in telling a story or even retelling a moment with clarity and her desired effect. Typically, she gets hung up on the meaning of a word, or forgets exactly what the person said that she tried to describe, etc.

Then, in general, the parahippocampal gyrus, left precuneus, posterior cingulate, left fusiform gyrus (“found to be more active in the learning of new concrete words than abstract words [Mestres-Misse et al., 2008]”, angular gyrus, and culmen show stronger activation for concrete concepts (Wang et al 1464). These parts of the brain relate to the following: memory encoding and retrieving, encoding and recognizing environmental scenes (not faces), mental imagery concerning the self, episodic memory, verbally describing scenes, noticing pain, responding to emotion (both positive and negative), processing color, faces, and bodies, perceptions of emotions in faces, mentally generating visual features of objects” (wiki and Wang et al 1463). Damage to these areas can lead to the Gerstmann syndrome (which carries effects like finger agnosia (cannot distinguish between fingers), alexia, acalcula (inability to use arithmetic operations), agraphia, and left-right confusion (wiki).

At the end of this meta-analysis, the investigators state: “These results suggest greater engagement of the verbal system for processing of abstract concepts and greater engagement of the perceptual system for processing of concrete concepts, likely via mental imagery” (Wang et al 1466). As I read and reread the study and their findings, I found myself making sense in my own brain of what I witness at home; perhaps one explanation for Naika’s struggle with abstract thoughts and feelings comes from that gap in her verbal development. She lived with her birth mom for six months; she lived in an orphanage in Haiti for two years where they spoke Creole; and then she came to us. She did not utter a word for six weeks. Then, when she did speak, she spoke only to Natalie (her new sister) in the bathtub. Her verbal foundational wall surely has holes in it, and if abstract processing calls for engagement of verbal systems, it makes sense that she would struggle.

Whether Naika had started to speak in Creole in the orphanage or not apparently matters in terms of her future, also. In “Early adolescent outcomes of institutionally-deprived and non-deprived adoptees. II: Language as a protective factor and a vulnerable outcome,” Croft et al say, “For the children over 18 months on arrival . . . [Naika came to us at 30 months], the presence of even very minimal language skills (imitation of speech sounds) at the time of arrival was a strong beneficial prognostic factor for language and cognitive outcomes, but not for social/emotional/behavioural outcomes” (31). Croft et al conclude that “[m]inimal language probably indexes some form of cognitive reserve that, in turn, indexes the degree of institutional deprivation” (31).

The orphanage workers told us she rarely spoke. When my husband visited her at the orphanage, she said nothing for two-and-a-half days.

In sum, my neuroscience reading led me to overwhelmingly conclusive findings. Research shows that “previously institutionalized children have lower IQ, deficits in language use, and executive function;” and, “these children exhibit impairments and delays in a variety of social-emotional domains and a very high prevalence of mental health problems” and “deficits in cognitive function,” “language production and comprehension,” “ADHD and other forms of psychopathology,” “language delays,” and “reduced academic achievement” (Sheridan et al. 12930). In fact, evidence of neural structural difference in pre-institutionalized children seems overwhelmingly convincing. I shall add Robin Harwood’s et al meta-analysis found in their “Preadoption Adversities and Postadoption Mediators of Mental health and School Outcomes Among International, Foster, and Private Adoptees in the United States to the mix; in the paragraph in which they cover prevalent research over the last 20 years, they report findings that children who have spent time in an institution for care: “lag in physical growth”; have “sensory processing difficulties”; internalize, externalize, and suffer from attention problems; show “delays in social skills”; have “speech, language, and learning deficits”; experience “lower cognitive scores” and suffer “general developmental impairment” (Harwood et al 409). Also, Beckett et al, in “VI. Institutional Deprivation, Specific Cognitive Functions, and Scholastic Achievement: English and Romanian Adoptee (ERA) Study Findings,” state the following: “institutional deprivation tends to have a lasting deleterious effect on all aspects of cognition and not just on a few highly specific functions (138). Kumsta et al conducted studies that “clearly support the concept of a coherent syndrome” defined by four patterns found in children with institutional deprivation: quasi-autism (QA), disinhibited attachment (DA), cognitive impairment (CI), and Inattention/Overactivity (IA/OA).

As I read about research of institutionalized children and the effects it has on their brain, I began to wonder what determines the formation of a person’s brain? Could a child’s DNA experience compromise? I began to notice sentences in the neuroscience studies that suggested “long-term changes in neural systems” (Tottenham et al 47). In the Sheridan et al study, they state: “the deprived environment of an institution does not provide adequate experience onto which to scaffold normal brain development;” and if that proves true, then we should see “differences in neural structure and function” (12927). Oliver James in “Fostering a Sense of Self-Esteem,” published in Brain & Behavior writes: “The likeliest explanation is that early deprivation changes brain chemistry and brainwave patterns, like a thermostat establishing a default position” (28). I began to notice a thread of belief in the conclusions of these studies—a belief in their “enduring biological effect,” a belief that these children undergo “biological programming during a critical period of early development, early sustained neurobiological insult, or dysregulation associated with the damaging effects of exposure to stress-related hormones” (Harwood 410). I began to revisit my search terms.

I thank Ann Wilson again for suggesting Charles A. Nelson as a starting place. I found a book review of The Great Brain Debate: Nature or Nurture; in the review, Nelson and Irving I. Gottesman use the words “epigenetic programming” and applaud the author (John E. Dowling) for “solid examples of what elements of brain development and brain function are under genetic control and which are largely guided by experience” (1204). In Nelson’s words, Dowling “begins a consideration of how genes and experience can influence the course of brain and behavioral development” (1204). With this “tip,” I began to use “epigenetics” and “adoption” and “institutionalized care” and “brain development.” These search terms led me to “Epigenetics of early child development,” and “Epigenetic Influence of the Social Environment” and “Attachment-Focused Psychotherapy & Epigenetics: What your grandparents past [sic] on.” Similar to my experience with reading neuroscience studies, I needed some translation help as I started to read epigenetic studies. “Genetics and the Brain” in my Google Search bar led me to dana.org. There, I learned the following:

• The brain consists mostly of proteins that serve as the framework for “neurotransmitters, hormones, enzymes, and other chemicals.”
• A gene backs up each protein, and a gene contains a “spiral of DNA.”
• The gene’s DNA functions as the “template” for transcription into the protein.
• Gene expression = Epigenetics
• The types of genes active at any given time in any given type of tissue changes; and, not all DNA/genes express the same proteins.
• “A gene may also be switched on or off temporarily or permanently by drugs, lifestyle, environmental forces, or stress.”

I also learned that researchers have narrowed their research to “two chemical processes:” Methylation—which “attaches a small chemical tag, or group of atoms, to the DNA of a gene which blocks the transcription process”; and a “process [that] involves histones, proteins that provide a core for DNA to wrap around.” “Modification of histones” can ease or complicate the ability for the “DNA to unwind,” which will either ease or complicate the transcription process.” I learned that animal studies, twin studies, and adoption studies all play a part in studying epigenetic effects. The time I spent on dana.org informed my reading of the epigenetic studies I found.

In the interest of time, energy, and paper, I will not write as in depth about this final stretch of my research; instead, I will highlight intriguing concepts I found in these studies. In “Epigenetic Influence of the Social Environment,” Champagne and Curley explore the epidemiological studies done to discover the effects of early neglect and abuse on the brain. Some studies they review involve children, some involve rhesus macaques, some studies involve mice; to conclude this section, they state: “plasticity in maternal behavior in response to environmental conditions is one route through which the quality of the environment can shape offspring physiology, brain, and behavior” (189). In the next section, with attention to similar types of studies, they assert that “neural circuits involved in emotionality are susceptible to modulation in response to early life experiences;” and “neural systems that regulate anxiety, social behavior, and cognition” can experience alteration (potentially long-term) as a result of early life adversity (190 and 193). This section refers to methylation and histones and the connection of these chemical processes to early childhood and maternal abuse, daily and prolonged maternal separation, and prenatal stress. Then, a section in this chapter refers to chemical change that can occur in adulthood in response to “chronic social defeat.” All of these described circumstances lead to changes in gene expression. Further, the chapter explores “Transgenerational Epigenetic Effects.” I learned of research that suggests “two distinct pathways via which epigenetic modifcations are currently believed to be involved in the transmission of traits across generations” (198): 1) “epigenetic inheritance—an epigenetic mark gets incorporated into the DNA and then passed on to the next generations “through the germline” and 2) “experience-dependent epigenetic modification”—early life experience impacts transgenerationally as “natural variations in postnatal maternal care have been associated with altered gene expression and receptor levels” (198). Finally, continued study of epigenetics may suggest to us (if current study already does not) that “environmental conditions and social experiences of previous generations” influence us—at the genetic level (198).

The article I found, titled “Attachment-Focused Psychotherapy & Epigenetics” helped me better understand the above-mentioned chapter; the source comes from a “.com”—a website promoting a certain type of therapy. Still, the following paragraph proves helpful as a summary of the transgenerational implications:

This suggests that Jews whose great-grandparents were in concentration camps . . . young immigrants from Africa whose parents survived brutal civil wars . . . and adults who grew up with alcoholic or abusive parents, all carry with them more than just memories. Our experiences and those of our forebears are never gone, even if they have been forgotten. They become a part of us, a molecular reside on our genetic scaffolding . . . You might have inherited not just your grandparent’s [sic] eye color and freckles, but also their predisposition toward depression . . . On the other hand, if your parent or grandparent, who was born to a maltreating family, was adopted at an early age by a nurturing, supportive, and loving family, then they and you will be privy to an epigenetic boost. (Becker-Weidman)

At this point in my narrative, I admit my shameless quoting from this Becker-Weidman source; however, my jaw dropped when I finally landed here:

Elena Grigorenko at Yale . . . stated, ‘Our study shows that the early stress of separation from a biological parent impacts long-term programming of genome function. This might explain why adopted children may be particularly vulnerable to harsh parenting in terms of their physical and menthal [sic] health. Parenting adopted children might require much more nurturing care to reverse these changes in genome regulation. (Becker-Weidman)

In our early days with Naika, therapists taught us this kind of parenting that Becker-Weidman advocates, but never did they connect the parenting style with the opportunity to “’reverse these changes in genome regulation’” [Elena Grigorenkoa qtd in Becker-Weidman]. I witnessed the improvements in the climate of our home as a result of the parenting-training, but this I-search project has taken my understanding of the parenting-model to a new level.

Finally, with a nod to my original question again regarding abstract thinking, I did find (and insert as Appendix D) “Strategies” to implement to help my daughter in this area—to reverse (?) alterations in her genome regulation due to adverse early life experience. I will keep a copy of Appendix D for my own reference and guidance. Thank you, truly.

 

[1] (MKDA represents—1) a literature review, 2) creation of a compound table based on the literature reviews, 3) a test of the coordinates in the table against a random set of coordinates which prevents bias, and 4) creation of an interpretation of the results.