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Woman of 24 found to have no cerebellum in her brain

• 10 September 2014 by Helen Thomson
• Magazine issue 2986. Subscribe and save
• For similar stories, visit the The Human Brain Topic Guide

A hole at the back (top) where the cerebellum should be (Top image: Feng Yu et al.; Bottom image: Zephyr/Science Photo Library )

DON'T mind the gap. A woman has reached the age of 24 without anyone realising she was missing a large part of her brain. The case highlights just how adaptable the organ is.

The discovery was made when the woman was admitted to the Chinese PLA General Hospital of Jinan Military Area Command in Shandong Province complaining of dizziness and nausea. She told doctors she'd had problems walking steadily for most of her life, and her mother reported that she hadn't walked until she was 7 and that her speech only became intelligible at the age of 6.

Doctors did a CAT scan and immediately identified the source of the problem – her entire cerebellum was missing (see scan, below left). The space where it should be was empty of tissue. Instead it was filled with cerebrospinal fluid, which cushions the brain and provides defence against disease.

The cerebellum – sometimes known as the "little brain" – is located underneath the two hemispheres. It looks different from the rest of the brain because it consists of much smaller and more compact folds of tissue. It represents about 10 per cent of the brain's total volume but contains 50 per cent of its neurons.

Although it is not unheard of to have part of your brain missing, either congenitally or from surgery, the woman joins an elite club of just nine people who are known to have lived without their entire cerebellum. A detailed description of how the disorder affects a living adult is almost non-existent, say doctors from the Chinese hospital, because most people with the condition die at a young age and the problem is only discovered on autopsy (Brain,doi.org/vh7).

The cerebellum's main job is to control voluntary movements and balance, and it is also thought to be involved in our ability to learn specific motor actions and speak. Problems in the cerebellum can lead to severe mental impairment, movement disorders, epilepsy or a potentially fatal build-up of fluid in the brain. However, in this woman, the missing cerebellum resulted in only mild to moderate motor deficiency, and mild speech problems such as slightly slurred pronunciation. Her doctors describe these effects as "less than would be expected", and say her case highlights the remarkable plasticity of the brain.

"These rare cases are interesting to understand how the brain circuitry works and compensates for missing parts," says Mario Manto, who researches cerebellar disorders at the Free University of Brussels in Belgium. The patient's doctors suggest that normal cerebellar function may have been taken over by the cortex – brain scans should reveal the answer.

Read more amazing stories of people experiencing neurological mysteries in Mindscapes.

This article appeared in print under the headline "The woman with a hole in her brain"

How Artistic Brains Differ

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How Artistic Brains Differ

A study reveals structural differences between the brains of artists and non-artists.

By Jef Akst | April 18, 2014

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FLICRK, DIERK SCHAEFERArtists have more neural matter in areas of the brain that mediate the control of fine motor movements and the interpretation of visual imagery, according to a study that used brain scans to compare 21 art students to 23 non-artists, published last month (March 29) in NeuroImage.

“The people who are better at drawing really seem to have more developed structures in regions of the brain that control for fine motor performance and what we call procedural memory,” lead author Rebecca Chamberlain from KU Leuven in Belgium told BBC News. Specifically, the precuneus in the parietal lobe, one area where artists had more gray matter, “is involved in a range of functions but potentially in things that could be linked to creativity, like visual imagery—being able to manipulate visual images in your brain, combine them and deconstruct them,” said Chamberlain. The researchers also found that participants with better drawing skills had greater gray and white matter in the cerebellum and in the supplementary motor area, brain regions that help control fine motor skills and routine movements.

Moreover, the brain scans revealed that such differences in neural matter could be seen on both sides of the artists’ brains. “[The research should help] put to rest the facile claims that artists use [only] the right side of their brain,” Ellen Winner of Boston College, who was not involved in the research, told the BBC.

For more on how the brain helps us create and interpret art, check out next month’s feature on neuroaesthetics.

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neuroscience, neural control, culture, brain, Artistic and art

Ballet dancers' brains adapt to stop them getting in a spin

reposted from:
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_26-9-2013-17-43-4

News: health Ballet dancers' brains adapt to stop them feeling dizzy by Sam Wong27 September 2013 Scientists have discovered differences in the brain structure of ballet dancers that may help them avoid feeling dizzy when they perform pirouettes. The research suggests that years of training can enable dancers to suppress signals from the balance organs in the inner ear. The findings, published in the journal Cerebral Cortex, could help to improve treatment for patients with chronic dizziness. Around one in four people experience this condition at some time in their lives. Normally, the feeling of dizziness stems from the vestibular organs in the inner ear. These fluid-filled chambers sense rotation of the head through tiny hairs that sense the fluid moving. After turning around rapidly, the fluid continues to move, which can make you feel like you’re still spinning. Ballet dancers can perform multiple pirouettes with little or no feeling of dizziness. The findings show that this feat isn’t just down to spotting, a technique dancers use that involves rapidly moving the head to fix their gaze on the same spot as much as possible. Researchers at Imperial College London recruited 29 female ballet dancers and, as a comparison group, 20 female rowers whose age and fitness levels matched the dancers’. The volunteers were spun around in a chair in a dark room. They were asked to turn a handle in time with how quickly they felt like they were still spinning after they had stopped. The researchers also measured eye reflexes triggered by input from the vestibular organs. Later, they examined the participants’ brain structure with MRI scans. In dancers, both the eye reflexes and their perception of spinning lasted a shorter time than in the rowers. Dr Barry Seemungal, from the Department of Medicine at Imperial, said: “Dizziness, which is the feeling that we are moving when in fact we are still, is a common problem. I see a lot of patients who have suffered from dizziness for a long time. Ballet dancers seem to be able to train themselves not to get dizzy, so we wondered whether we could use the same principles to help our patients.” The brain scans revealed differences between the groups in two parts of the brain: an area in the cerebellum where sensory input from the vestibular organs is processed and in the cerebral cortex, which is responsible for the perception of dizziness. The area in the cerebellum was smaller in dancers. Dr Seemungal thinks this is because dancers would be better off not using their vestibular systems, relying instead on highly co-ordinated pre-programmed movements. “It’s not useful for a ballet dancer to feel dizzy or off balance. Their brains adapt over years of training to suppress that input. Consequently, the signal going to the brain areas responsible for perception of dizziness in the cerebral cortex is reduced, making dancers resistant to feeling dizzy. “If we can target that same brain area or monitor it in patients with chronic dizziness, we can begin to understand how to treat them better.” Another finding in the study may be important for how chronic dizzy patients are tested in the clinic. In the control group, the perception of spinning closely matched the eye reflexes triggered by vestibular signals, but in dancers, the two were uncoupled. “This shows that the sensation of spinning is separate from the reflexes that make your eyes move back and forth,” Dr Seemungal said. “In many clinics, it’s common to only measure the reflexes, meaning that when these tests come back normal the patient is told that there is nothing wrong. But that’s only half the story. You need to look at tests that assess both reflex and sensation.” The research was funded by a Health Foundation / Academy of Medical Sciences Fellowship and the Medical Research Council. Y Nigmatullina et al. ‘The Neuroanatomical Correlates of Training-Related Perceptuo-Reflex Uncoupling in Dancers’ Cerebral Cortex, 27 September 2013. doi:10.1093/cercor/bht266 See the press release of this article

http://www.eurekalert.org/pub_releases/2013-09/icl-bdb092513.php


Public release date: 26-Sep-2013
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Contact: Sam Wong
sam.wong@imperial.ac.uk
44-207-594-2198
Imperial College London 

Ballet dancers' brains adapt to stop them getting in a spin

Scientists have discovered differences in the brain structure of ballet dancers that may help them avoid feeling dizzy when they perform pirouettes.

The research suggests that years of training can enable dancers to suppress signals from the balance organs in the inner ear.

The findings, published in the journal Cerebral Cortex, could help to improve treatment for patients with chronic dizziness. Around one in four people experience this condition at some time in their lives.

Normally, the feeling of dizziness stems from the vestibular organs in the inner ear. These fluid-filled chambers sense rotation of the head through tiny hairs that sense the fluid moving. After turning around rapidly, the fluid continues to move, which can make you feel like you're still spinning.

Ballet dancers can perform multiple pirouettes with little or no feeling of dizziness. The findings show that this feat isn't just down to spotting, a technique dancers use that involves rapidly moving the head to fix their gaze on the same spot as much as possible.

Researchers at Imperial College London recruited 29 female ballet dancers and, as a comparison group, 20 female rowers whose age and fitness levels matched the dancers'.

The volunteers were spun around in a chair in a dark room. They were asked to turn a handle in time with how quickly they felt like they were still spinning after they had stopped. The researchers also measured eye reflexes triggered by input from the vestibular organs. Later, they examined the participants' brain structure with MRI scans.

In dancers, both the eye reflexes and their perception of spinning lasted a shorter time than in the rowers.

Dr Barry Seemungal, from the Department of Medicine at Imperial, said: "Dizziness, which is the feeling that we are moving when in fact we are still, is a common problem. I see a lot of patients who have suffered from dizziness for a long time. Ballet dancers seem to be able to train themselves not to get dizzy, so we wondered whether we could use the same principles to help our patients."

The brain scans revealed differences between the groups in two parts of the brain: an area in the cerebellum where sensory input from the vestibular organs is processed and in the cerebral cortex, which is responsible for the perception of dizziness.

The area in the cerebellum was smaller in dancers. Dr Seemungal thinks this is because dancers would be better off not using their vestibular systems, relying instead on highly co-ordinated pre-programmed movements.

"It's not useful for a ballet dancer to feel dizzy or off balance. Their brains adapt over years of training to suppress that input. Consequently, the signal going to the brain areas responsible for perception of dizziness in the cerebral cortex is reduced, making dancers resistant to feeling dizzy. If we can target that same brain area or monitor it in patients with chronic dizziness, we can begin to understand how to treat them better."

Another finding in the study may be important for how chronic dizzy patients are tested in the clinic. In the control group, the perception of spinning closely matched the eye reflexes triggered by vestibular signals, but in dancers, the two were uncoupled.

"This shows that the sensation of spinning is separate from the reflexes that make your eyes move back and forth," Dr Seemungal said. "In many clinics, it's common to only measure the reflexes, meaning that when these tests come back normal the patient is told that there is nothing wrong. But that's only half the story. You need to look at tests that assess both reflex and sensation."

###

The research was funded by a Health Foundation / Academy of Medical Sciences Fellowship and the Medical Research Council.

For more information please contact:

Sam Wong
Research Media Officer
Imperial College London
Email: sam.wong@imperial.ac.uk
Tel: +44(0)20 7594 2198
Out of hours duty press officer: +44(0)7803 886 248

Notes to editors

1. Y Nigmatullina et al. 'The Neuroanatomical Correlates of Training-Related Perceptuo-Reflex Uncoupling in Dancers' Cerebral Cortex, 27 September 2013. doi:10.1093/cercor/bht266

2. About Imperial College London

Consistently rated amongst the world's best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment - underpinned by a dynamic enterprise culture.

Since its foundation in 1907, Imperial's contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges.

In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.

Website: http://www.imperial.ac.uk

3. About the Health Foundation

The Health Foundation is an independent charity working to continuously improve the quality of healthcare in the UK. We want the UK to have a healthcare system of the highest possible quality – safe, effective, person-centred, timely, efficient and equitable. We believe that in order to achieve this, health services need to continually improve the way they work. We are here to inspire and create the space for people, teams, organisations and systems to make lasting improvements to health services. Working at every level of the healthcare system, we aim to develop the technical skills, leadership, capacity, knowledge, and the will for change, that are essential for real and lasting improvement.

You can follow the Health Foundation on Twitter:http://www.twitter.com/healthfdn

4. About the Academy of Medical Sciences

The Academy of Medical Sciences is the independent body in the UK representing the diversity of medical science. Our mission is to promote medical science and its translation into benefits for society. The Academy's elected Fellows are the United Kingdom's leading medical scientists from hospitals, academia, industry and the public service. We work with them to promote excellence, influence policy to improve health and wealth, nurture the next generation of medical researchers, link academia, industry and the NHS, seize international opportunities and encourage dialogue about the medical sciences. http://www.acmedsci.ac.uk

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