Plas%city

and the Brains of Children with

Learning Disabili%es
Lara Boyd, PT, PhD
Professor, Dept. of Physical Therapy
& Djavad Mowafaghian Centre for Brain Health
Canada Research Chair, Neurobiology of Motor Learning
lara.boyd@ubc.ca

Conicts of interest
I have no personal nancial conicts of
interest to disclose
Data I will show were (are) funded by CIHR,
NSERC, MITACS, Lululemon, Eaton FoundaOon
(and other donors), NaOonal InsOtutes of
Health (US)
Salary support from Canada Research Chairs,
MSHFR, Peter Wall FoundaOon, UBC

Overview
I. Dene neuroplasOc change
Present potenOal mechanisms by which
neuroplasOcity may occur in the central
nervous system
Provide examples of posiOve and negaOve
plasOcity

II. Ongoing educaOonal neuroplasOcity

research: Baseline Results
III. Behaviors that enhance neuroplasOcity

Part I. Dene neuroplas@c change

Neuroplas@city
All learning of new facts and skills as well as re-
learning to support recovery from brain damage is
represented neurologically by plasOcity or structural
change in the brain
Both mature and developing brains are constantly
reorganizing
You are doing it right now

Neuroplas@city
Brain plasOcity supports all learning
Brain plasOcity aYer neurological insults
contributes to recovery
Specic intervenOons can facilitate posiOve
plasOcity throughout life

Neuroplas@city is
Experience-Dependent
The adapOve capacity of the brain is highly inuenced by behaviour
There is no drug that promotes neuroplasOcity
NeuroplasOc paZerns can be highly variable from person to
person
NeuroplasOcity can be both posiOve (learning) and
negaOve (addicOon)
The goal of my neuroimaging program is to gain understanding the
factors that sOmulate neuroplasOcity in order to develop
intervenOons that speed and enhance learning

The Dose Problem

What kind of prac@ce changes the brain?
9,600 retrievals over 4 weeks (Nudo et al., 1996)
10,000 repeOOons of skilled movement (myelin;
Borich, et al 2013; Lakhani et al., 2014)
31,500 repeOOons of a nger sequence over 35
days (Karni et al., 1995)
Few dose studies have been run in children

Neuroplas@c Change

NeuroplasOcity is driven by change in:
1. Brain Chemistry
2. Brain structure
3. Brain FuncOon
4. All of the above

Brain Chemistry

(adapted from Kandel, 2013)

Brain Structure

(adapted from Kandel, 2013)

Short vs. Long-term Memory

Short term memory

Long term memory

(adapted from Kandel, 2013)

Brain Func@on
Prefrontal Cortex

Premotor Cortex

(Meehan & Boyd, 2011)

PaNerns of ac@vity can be highly

individual
1.4"
1.2"
Predictor"Weights"

FuncOonally
A"
connected networks
associated with
implicit motor
sequence learning

1"
0.8"

Healthy"
Stroke"

0.6"
0.4"
0.2"
0"
Repeat"

(Wadden, Woodward & Boyd, 2015)

Random"

PaNerns of ac@vity can be highly

individual
Each individual with stroke employed a relaOvely
unique network to support motor learning

S05$

S06$

S07$

S08$

(Wadden, Woodward & Boyd, 2015)

There is no one size ts all approach

to learning
cTBS over cM1

cTBS over cS1

Change Associated with Motor Learning

(Neva et al., 2014)

Network
changes
support
neuroplas@city

(Wadden et al., 2015)

White vs. Gray MaNer Plas@city

(Scholtz et al., 2009)

The Developing Brain

Grey MaZer (outer layers of the cortex)
achieve maturity early in life and the
decline

(Blakemore 2012)

Girls peak at age 11; Boys at age 12

The Developing Brain

White MaZer (connecOons between corOcal
areas) achieve maturity later in life
dierenOally in boys (age 25) vs. girls (age 20)
boys
girls

(Blakemore 2012)

Development and Myelin

(Lakhani et al., preliminary data)

Not all neuroplas@c change is

posi@ve

RepeOOve Use injuries

Chronic pain
Drug and/or Alcohol use
Stress / Anxiety

Chronic Back Pain Alters the Sensory

Cortex

(Flor et al., 1997)

Stress Response and Cor@sol

An inverted U relaOonship with health
Just the Right Amount of Cor@sol
Posi@ve eects on
memory, immunity,
pain sensi@vity

Too liNle Cor@sol

Low MoOvaOon
Low Arousal

Too Much Cor@sol

Anxiety
Memory impairments
Health Issues weight gain

Cor@sol and the

Brain
Inverse relaOonship
between corOsol and
brain derived
neurotrophic factor
(BDNF)

(Issa 2010)

Control

PreNatal Stress

Control

PreNatal Stress

General Health impacts brain

func@on and development
Obese children show smaller brain volumes
and less neuroplasOcity relaOve to their
healthy weight counterparts
Diabetes + Obesity makes this relaOonship
worse

Managing Stress (and Cor@sol)

Adults who pracOced Buddhist meditaOon
signicantly decreased corOsol and blood
pressure in 6-weeks.
Six hours of sleep vs. eight increases corOsol in
the bloodstream by 50% in adults.
Exercise: if intense increases corOsol but
rebounds to lower levels
moderate intensity exercise reduces corOsol

Summary: Neuroplas@city
All brains are neuroplasOc
Younger brains are even more neuroplasOc
than older ones
NeuroplasOcity occurs at the chemical,
structural and funcOonal level
These changes translate into change in
behaviour and learning
Overall Health (Stress, Anxiety, Drugs and
Obesity) can impact these processes

Part II. Ongoing Educa@onal

Neuroplas@city Research:
Baseline Results

Brain Behaviour Rela@onships

in Children
There is a growing body of work invesOgaOng the
inuences of learning and development in
Children
We are interested in mapping relaOonships
between brain and behaviour in school aged
children with highly varied cogniOve and
achievement levels
Understanding the scope of neuroplasOc change
will enable the renement of educaOonal
intervenOons

MRI Scan 1

Cogni@ve Educa@onal
Tes@ng

3 Months

1 year

MRI Scan 2

MRI Scan 3

Cogni@ve Educa@onal
Tes@ng

Interven@on
EducaOon Arrowsmith or TradiOonal
Children with LD or typically developing

Study Team: Todd Handy PhD, Alex MacKay PhD, Vanessa LaPointe PhD, Brad
Hale PhD, Kim Fitzer MSc, PhD (cand), Bimal Lakhani PhD, Jennifer Ferris BA,
Angela Auriat PhD, Katherine White BA

Inclusion Criteria
Inclusion Criteria
Aged 9 and 17 years
Right Handed (for MRI)
Normal IQ
Exclusion Criteria
Outside the age range of 9-17
History of head trauma, a major psychiatric diagnosis,
neurodegeneraOve disorder or substance abuse
Taking drugs known to hamper neuroplasOcity
Co-morbid diagnosis of Downs Syndrome
ContraindicaOons to MRI

Demographics

52 children enrolled

22 girls (average age 12.2; 9-15 years)

30 boys (average age 12.4; 9-16 years)

Segmen@ng the Brain

Decision Speed

White maNer volume and Grey maNer

thickness relate to speed of decision
making
White MaNer Thickness

Decision Speed

Right Hemisphere
LeY Hemisphere
Grey MaNer Thickness

LeY Hemisphere
(Ferris et al., preliminary data)

Right Hemisphere

Decision Speed

Middle Frontal Gyrus Grey maNer

thickness relates to speed of decision
making

LeY Middle Frontal

(Ferris et al., preliminary data)

Right Middle Frontal

Dierent regions contribute to

processing speed in high and low
performers

(Ferris et al., preliminary data)

Dieren@al rela@onship between

white maNer and math performance

(Ferris et al., preliminary data)

Dieren@al rela@onship between

grey maNer and reading performance

low

(Ferris et al., preliminary data)

high

White maNer imaging of Brain

Structure

Myelin Water Imaging

Myelin maps aligned with segmented data

Callosal Myelin
relates to Reading
Comprehension
Word aZack scores have
been related to callosal
integrity using diusion
imaging (Andrews et al.,
2009)
This is the rst to show
myelin signal is also
important
Poorer readers have less
myelin in all regions of the
callosum
(Lakhani et al., preliminary data)

Cogni@ve uency,
delayed recall, and
reading correlate
with myelin
thickness

(Lakhani et al., preliminary data)

Why Myelin?

Res@ng state brain ac@vity

The brain is never at rest Even when people are seemingly doing
nothing oscillatory paZerns of brain acOvity are evident.

The importance of funcOonal MRI acOvity at rest is not enOrely
clear it likely serves a stabilizing or restoraOve funcOon

Default mode network (DMN)

Res@ng state fMRI

AcOvity in the
aZenOonal network

(bilateral posterior cingulate gyrus,

right paracingulate, and right
precuneus)

at rest are related to

aZenOon scores

(Auriat et a., preliminary data)

What kind of change is possible

in brain and behaviour of
children with LD?
Learning DisabiliOes refer to a number of disorders which may aect
the acquisiOon, organizaOon, retenOon, understanding or use of verbal
or nonverbal informaOon. These disorders aect learning in individuals
who otherwise demonstrate at least average abiliOes essenOal for
thinking and/or reasoning
Learning disabiliOes are lifelong.
Source: hZp://www.ldac-acta.ca/learn-more/ld-dened/ocial-
deniOon-of-learning-disabiliOes

MRI Scan 1

Cogni@ve Educa@onal
Tes@ng

3 Months

1 year

MRI Scan 2

MRI Scan 3

Cogni@ve Educa@onal
Tes@ng

Interven@on
EducaOon Arrowsmith or TradiOonal
Children with LD

Func@onal MRI

Clocks Task

1 handed clock

3 handed clock

4 handed clock

Clocks Task in the MRI

+
Time
0s

2s

Response 4s
True/False

Shi`s in PaNerns of ac@vity when performing the

clocks task

Time 1 acOvity during clocks, corrected

Time 2 acOvity during clocks, corrected

Time 2 > Time 1 acOvity during clocks, corrected, p = 0.000707

(Hayward, Ferris et al., preliminary data)

Brain Mapping at UBC:

Res@ng State Func@onal MRI

Subtle changes in
res@ng state
ac@vity
Anterior Default Mode Network
Baseline

3 Months
(Auriat et a., preliminary data)

Change in Myelin Water Content

(Lakhani et al., preliminary data)

Myelin Change

(Lakhani et al., preliminary data)

Summary: Ongoing Educa@onal

Plas@city Research
IdenOed key areas of white maZer change
that are associated with Reading and Math
May enable future, targeted intervenOons

Grey and White maZer development appear

to move in opposite direcOons
AcOvity in the aZenOonal network at rest
relates to aZenOon scores
Brain change appears to be possible in
children with learning disabiliOes

Part III. Behaviors that enhance

neuroplas@city


Principles of Experience Dependent
Plas@city
1. Use it or lose it
2. Use it and improve it
3. Specicity
4. RepeOOon
5. Intensity
6. Time maZers
7. Salience maZers
8. Age maZers
9. Transference
10. Interference

(Kleim and Jones, 2008)

Exercise and Brain Plas@city

Exercise Enhances
Blood Flow
Blood Vessel Formation
Cerebral White and Grey Matter
Neuron and Synapse Growth
Before
Neural Growth Factors
Neurotransmitters

After

A single session of aerobic

exercise enhances learning
Motor Learning

Serum BDNF

(Mang, Snow, Campbell, Ross & Boyd, 2014, 2015)

A single session of aerobic

exercise enhances learning
Immediate post exercise

Reten@on (the next day)

(Mang, Snow, Campbell, Ross & Boyd, 2015)

How does exercise work on

the brain?
Long-term Poten@a@on

Increases plas@city

Intracor@cal inhibi@on

Reduces Inhibi@on

(Mang, Snow, Campbell, Ross & Boyd, 2014; Neva, Mang & Boyd, 2015)

Higher Fitness linked with

healthier white maNer in the
brain in children

(Chaddock-Heyman 2014)

Summary: Behaviors that

enhance plas@city
PracOce! Behaviour is the largest sOmulant of
neuroplasOc change
Exercise primes the brain to learn
Both acute and chronic eects
Exercise reduces corOsol and increases BDNF
Likely facilitates an overall environment of
excitability in the brain that favors plasOcity

Age of Brain Repair

Brain Behaviour lab @UBC_BrainLab

#BBL PracOce what we preach #SFN2015