A radio program featured on Radio National in March of 2018, in which Lynne Malcolm interviewed Niels Birbaumer, a leading brain researcher

THIS IS AN EDITED TRANSCRIPT OF THE SHOW

Lynne Malcolm: Now that we know that the brain is more changeable than we ever thought possible, are we taking full advantage of neuroplasticity?

Niels Birbaumer: The possibility of modifying the connections in the brain is infinitive. So in the course of our lifetime, the changes and the connections between the brain are constantly modified. Of course we cannot say how much and how vast the limits are, but there are very few brain areas which are not plastic, meaning there are very few brain areas which do not learn, and if you know this then the possibilities of all these areas to modify themselves and to modify the environment is enormous.

Niels Birbaumer is excited about the virtually limitless capacity of the brain to remould itself. He believes that we can now use neuroplasticity to bring hope to people with a wide range of disorders, including depression, addiction, the effects of a stroke, and even the extremes of locked-in syndrome and psychopathy. He has explored the potential of brain plasticity in his own research at the Institute of Medical Psychology and Behavioural Neurobiology in Tubingen, Germany, and the Wyss Centre for Neuroengineering in Switzerland.

Lynne Malcolm: An area where the brain’s ability to learn and change can make a huge difference to people’s lives is after they’ve had a stroke.

Niels Birbaumer: Yes, the stroke situation is particularly interesting and successful. As you know, stroke it is extremely frequent and gets more and more frequent. It’s now, at least in Europe, it’s the major cause of disability these days, so the costs for our health system is enormous. And one-third of these stroke victims recover without any treatment after about a year. One-third is getting a little bit better but they cannot go back to work. And one-third is completely paralyzed, particularly their upper limbs, and so they are incapacitated.

So we developed particularly for the hand, for those one-third of patients who cannot move any fingers and cannot move the arm anymore after one year after stroke we developed a robotic system where they think a particular movement. The thought of that movement creates an electric change in the brain which you can record with the EEG or you can record it with an electrode implanted in the brain. And the thought ‘I want to move the hand’ is immediately transmitted to an exoskeleton, to like a robotic hand which is fixed to the arm and moves the hand. So the patient thinks, and immediately after the thought the hand moves the way he wants to move it.

So the brain relearns around the lesion, around the area which is destroyed from the stroke, the brain learns that the voluntary thought to move the hand is moving the hand. And after about 20 hours of this training you can observe that the muscles slowly regain control. And then you can transmit the control from the brain to the muscles. Not in all cases but in about two-thirds of the cases. And if they have an implanted device of course they can go home and can use that device at home. If they don’t have an implanted device, it’s not as good but they still can move. And people who were completely paralyzed now can walk on stairs, they can grab a glass. Some of them can even learn to each with a knife and fork. If you have an implanted device you can of course move anything voluntarily the way you like, directly from the brain. So I believe this is one of the futures of rehabilitation in chronic stroke.

Niels Birbaumer has written a book called ‘Your Brain Knows More Than You Think’ and in this book, he explores his research over 40 years into the potential of brain plasticity to help a range of conditions previously thought to be intractable.

Lynne Malcolm: Throughout your book you express great hope and optimism in the brain’s plasticity to cure and perhaps solve many problems. Not everything can be cured and solved that away though, can it.

Niels Birbaumer: Of course not, but we really don’t know what is not possible. We know from research and experience what is possible. And so if you ask me, and that is of course a relevant question, what are the limits of plasticity, where we cannot proceed then, I don’t see a limit in the plasticity itself.

In all those instances where I found an incurable situation for different types of disorders, I found, it’s a question of the societal condition.  The brain is always capable of changing itself. My optimism is grounded in the fact that I haven’t found an incurable condition of the brain, in the majority of different brain disorders, but I have always found an incurable society or an incurable situation or an incurable financial burden which has nothing to do with the capacity of the brain. So, as long as societal obstacles can be changed, much more is possible

Lynne Malcolm: I do sense some frustration though on your behalf, that these ideas aren’t really being taken up as much as you’d like them to be.

Niels Birbaumer: Yes, sure, … it’s very interesting and it’s very positive, but it is frustrating if you see that science cannot achieve what it’s for, but that doesn’t mean that the overall attitude is positive. And it’s clear that when you think about the enormous effects which computer interfaces will have in stroke, this is a very satisfying situation. The frustration that I experience from some fields is outweighed by the positive outcomes, when I see my completely paralyzed patients communicating again for the first time.

I am very interested in learning how can we better treat diseases and disorders which are characterized by an increasing volition, like drug addiction, crime and extreme eating. All these disorders are so difficult to treat.

I think we can understand and develop new treatments if we understand how to control and to manipulate specific aspects of volition. That’s not a new thought.

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Professor Birbaumer has endorsed my manuscript. This dedicated man has spent fifty years of his life, researching and writing about neuroplasticity.  I am grateful to say, he has written the Forward to my memoir!