SILENCE- neurobiology of everyday life, course by University of Chicago

This presentation involves keen research analysis and thesis on Broca's Aphasia which affects speech in humans. Using a live example, I have tried my level best to describe the neurobiology disorder as a part of my project on Coursera by Professor Mason, University of Chicago and explained in detail how this course has proved to be helpful to understand neurobiology of everyday life.

1. SILENCE Neurobiology of everyday life -Anvi Joshi

2. My father had acute Cerebrovascular Accident which led to total Broca’s aphasia. I decided to write about how this CVA is affecting his nervous system as well as his motor abilities. I analyzed his medical reports, described his experiences, researched more about Aphasia, cited Professor Mason’s lecture and have put this together into this project. I have briefly stated about impaired parts and pathways and how they affected his everyday life, which parts were working well and concluded with how this course proved to be helpful in understanding neurobiology of everyday life This Photo by Unknown Author is licensed under CC BY-SA

3. Acute Cerebrovascular Accident led to ischemic stroke in left frontal parenchyma in Broca’s area and it resulted in total Aphasia. Speech was highly affected in this case and patient was unable to speak at all. But, he was able to understand what others were saying and also write down accurately with his hands. He could comprehend language and also formulate complex sentences and write them down. His primary tests including blood pressure, heart rate were in normal range and he didn’t execute any other visible symptoms of motor disability. On performing certain essential blood tests it was found that his lipid profile deviated a lot from normal ranges with elevated Low Density Cholesterol levels and triglycerides along with high WBCs. MRI Scanning concluded that patient had medium sized ischemic stroke in left frontal parenchyma and small chronic ischemic focus in right occipital periventricular white matter.

4. Broca’s Aphasia Broca’s aphasia also known as non-fluent/expressive aphasia is a devastating condition which primarily affects Broca’s area in left frontal parenchyma. Patients with this condition have problem in speaking, uttering words and forming complex sentences. They usually don’t have issue in language comprehension and understanding part. They are also able to formulate sentences and they know what to say but are unable to express it. This devastating condition takes place due to a various reasons including stroke in Broca’s area. In this case it was clearly a non- hemorrhagic stroke due to deposition of plaque which restricted flow of blood vessel. Plaque was formed due to lipid substance- Low density cholesterol as concluded from medical reports. In many cases, this aphasia causes paralysis or weakened muscles in right side of the body as motor controlling center - Primary motor cortex lies in close proximity to Broca’s area. Fortunately, in this case it didn’t affect motor abilities of the patient. He was able to understand language accurately and also able to write things down to convey message.

5. There are many conditions which may lead to Broca’s aphasia including- CVA, dementia, Alzheimer’s disease, brain tumors, and even history of myocardial infarction as in this case. Patient had undergone angioplasty- stent surgery 8 years ago due to myocardial infarction and without medical guidance suddenly stopped prescribed course of medications. This led deposition of lipids in brain blood vessel and may have caused stroke- as analyzed by the physician.

6. Hearing is taken in via the Primary Auditory Cortex and received by Wernicke’s area in the left hemisphere where language component of hearing is comprehended, it also receives inputs from Primary Visual cortex. So, all sorts of language inputs from any source is comprehended by this area. Wernicke’s area also repeats whatever we receive via Primary auditory cortex which helps in understanding language. Information comprehended from this area is then sent to Broca’s area to express it. Primary motor cortex controls laryngeal muscles which helps in making sound and thus stroke in Broca’s area affects speech production. In language comprehension and speech production, Tempero -parietal junction plays important role as well. There’s a lexical interface present which makes meaning out of heard words and helps in speech production. In Broca’s aphasia, there’s usually some difficulty in language articulation as well, which is partial as it is connected to Wernicke’s area in language circuitry. But, everyone has slightly different neocortex and in my example it did not affect language comprehension at all.

7. Apart from impaired parts, many other functions were working really well. On his primary tests, his blood pressure and heart rate were normal. Apart from this, his haemoglobin rate was normal as well. Other motor abilities like recognizing faces, forming sentences, movements of arms and legs were perfect. Walking and doing other life skills were possible as well. It was very much frustrating for him as he was feeling overwhelmed emotions at that time and wanted to express it but couldn’t do so which made him collapse emotionally. His speech recovered gradually and now, after two years of the stroke he is able to communicate properly with no difficulties but, he trembles while verbally expressing when he gets overwhelmed with some emotions especially nervousness and rage. After medical treatment with drugs like blood thinners, he was doing speech therapy for few months which helped him to recover with words faster.

8. Basic Language circuit

9. About this course This course has been a great source to understand phenomena around me accurately. In terms of my social interactions, I now have better understanding of neurobiological problems faced by my closed ones and also know how to deal with them in a way where they will feel comfortable with me. Many people in my social circle face problems like strokes, vertigo, hot flashes and I could not understand their way of behaviour which was frustrating for me as I used to feel very bad for not be able to understand their exact problem; but now after completing this course and learning so much about brain, I can better understand where are they standing and what are they facing and also help them with their daily chores, without hindering their independence and making them feel loved and understood. Being a medical student, this course has helped me a lot with my neuroscience part of curriculum as it contains pretty good information on anatomy and physiology of brain with laboratory videos as well which are even helping me in enhancing my laboratory skills and knowledge.

10. Not only my social circle but this course has also helped me in understanding my own brain functioning better. How our brain physiology is connected to embodied emotions, my circadian rhythm, optic and auditory illusions and why do we experience them what exactly happens when we experience them was so well explained by professor Mason. Her way of teaching complex circuits and processes in a more simplified manner is really amazing. Nervous system, being a very complex system in human body is difficult to learn which was made easier in this course by her. Everyday examples which keep happening around us would have such complex and interesting neurobiological events taking place inside us is so much fascinating. She has also recommended books and videos that would help interested students to dive deep into this topic. Neurobiology is an emerging, and interesting topic for not only students and scientists but also common people to understand themselves better. In my opinion, everyone should have knowledge of neurobiology and this course is best way to have it.

11. Thank you to everyone! Special thanks to Professor Mason, Department of neurobiology, University of Chicago