A history of studies about the brain

Today I want to tell you a story about how it has changed the conception of the brain from so many students since centuries ago. 

 

How is assumed, the study of the personal computer of the human being is not new, the beginning of his study are given with the observation, so evidenced a papyrus written in century XVII BC that contains the first references to this body to which already named you brain, in fact repeated seven times in this document describing symptoms, diagnosis and expectations of recovery of two patients with skull fractures (Kandel, Schwartz, Jessell, 2000).

This is known as the first medical treatise and this is 1000 years before Hippocrates. The Papyrus contains 48 clinical histories and includes details of how make sutures, examine the visual and auditory perception and how to treat fractures in the skull of the patients (Tanzi, 2012).

After that, during the second half of the 1st century BC, in ancient Greece were developed different observations about the brain in terms of the functions of this and it was Alcmaeon of Croton of the Pitagoriana school between the VI and V BC who was considered the first time that brain as the place where the mind was located, but not was not until the century IV BC when Hippocrates, based of course on works of Alcmaeon, who postulated that the brain was the organ where the intelligence was based. While Aristotle during the same century, speculated that while the heart was the organ of the intelligence, brain chilled the blood system, this explained it based on the idea that humans are more rational than the beasts because, among other reasons, had the most large brain to cool the hot blood (Bear, Connors and Paradiso, 2001).

Thus, the brain aroused curiosity and motivated cultural practices, for example, Egyptians drew the brain to their dead because they had the belief that would not serve them in the other world, other cultures believed that spinal fluid (which bathes the brain) was where the soul is housed. 

During the Hellenic period, Herophilus of Chalcedon and Erasistratus of Ceos, made contributions that were essential not only to understand the anatomy and physiology of the nervous system, as many other fields of life sciences, his works are now almost forgotten and only known by studies that take them and who rediscovered their findings more than one millennium after. His works consisted in the systematic dissection ofdead bodies, recognizing the brain as the center of the nervous system, and also differentiated the motor nerve of the sensory, and described in detail the eyes, brain, liver and pancreas as well as the salivary and genital organs. 

Thanks to his studies, Herophilus was the first to recognize that the arteries contained blood and not air. While Erasistratus described the heart valves and concluded that the heart was the center of the sensations, but was a valve and was the first to make a clear distinction of the veins and arteries. He believed that the arteries were filled with air and that they drove the animal spirit (pneuma). It was considered that the atoms were an essential part of the body and believed that these revitalizaban the pneuma was circulating through the nerves. But I also thought the nerves moved a frenetic spirit from brain. Observations allowed him to differentiate between the functions of sensory and motor nerves and related them to the brain. Both are known as the founders of the great medical school of Alexandria (Kandel, Schwartz, Jessell, 2000).

This findings, open the knowledge to see neural functions are currently known to detail it is possible to classify them from their duties.

Years later, during the Roman Empire, the Greek anatomist Galen dissected the brains of sheep, monkeys, dogs and other mammals, and concluded that the cerebellum was an important part of the brain, which was more dense than this, and that was in charge of the muscle control, while the brain was soft and was in charge of the sensory process, and theorized that the brain works by the movement of the animal spirits through the ventricles.

In the middle ages and far from Western science, Najab ud-din Muhammad, was the first to describe in detail a number of neurological and psychiatric, disorders including depression, neurosis, impotence, psychosis and mania (Ibrahim, 2002).

For his part, Haly Abbas described the neuroanatomy, Neurobiology and neurophysiology brain and described other disorders such as sleep, memory loss, hypochondriasis, the State of coma, meningitis, epilepsy by vertigo and hemiplegia, and some of the symptoms of schizophrenia were reported during the medieval in Arabic medical literature (Hanafy and Fatma)1996; Khaleefa, 1999).

 

Away from the science of the West, in the 11th century, Alhazen who can be considered the forerunner of experimental psychology and pioneer of the psychology of visual perception due to the contributions of its Loptics ibro, described for the first time that vision occurs in the brain and not in the eyes, he pointed out that personal experience has an effect on what people see and how looks it, therefore it is possible to say that vision and perception are generally subjective.

Moreover, Avicenna’s works of Brain Anatomy were described in the Canon of medicine where explained varied neurological disorders associated with certain psychiatric conditions sometimes including hallucinations, mania, nightmares, melancholy, dementia, epilepsy, paralysis, vertigo and the confusion (Safavi-Abbasi, Brasiliense and Workman, 2007).

In the West, especially in Europe are surprised with contributions from Versalio, which was an anatomist and physician, considered the founder of modern human anatomy and author of one of the most influential in the history of Anatomy books De Humani Corporis Fabrica (on the structure of the human body). His works attained many contributions to Anatomy in general, but his greatest contribution to neuroanatomy was the definition of the system of nerves as: transmission of feelings and movement mode. He believed that nerves are not originating in the heart as described by Aristotle but that settled the nerves in the brain. 

But in Mexico, also there is evidence of trepanation among the Aztecs, the mixtecs and Zapotecs the, albeit in fewer than the European prehistoric skulls or the incas. An important aspect in the history of the study of the brain in Mexico is that when Spain conquered the new continent, brought with it the great corpus medico antiguedad cthesica and age media, which was formed basically by the writings of Hippocrates of Cos and Galen of Pergamon.

So are en the city of Mexico, as heirs to the ancient Greco-Roman, three authors: the first is Pedro Arias de Benavides (1521-1570?), Spanish surgeon originally from Toro, Zamora, who practiced in Mexico, between 1554 and 1564, and on his return to Spain in Valladolid, in 1567, in the book Secrets of Chirurgia, published the case of cranial trauma serious which required surgery in 1561 in the city of Mexico, by a depressed fracture, causing the patient, coma and brain mass, all with a satisfactory evolution exhibition. In his writings, reported that the patient was a 13-year-old boy surnamed Vergara (boy - Ponce León, 1999, 2009). 

After Arias is to Alonso López de Hinojosos, also Spanish, born in Los Hinojosos (1525-1579), province of Cuenca. López de Hinojosos was a surgeon who also has the merit of having published the first book of surgery of America in 1578, left Antonio Ricardo Piamontés presses; In his texts, Summa and Chirurgia collection. Lopez describes carefully, galenic trepanation methods, with their respective indications (boy - Ponce León, 2000). 

However, the most cultivated of physicians who published on the subject in Mexico was the father Agustín Farfán (1532-1604), originally from Seville, Spain. Its first publication called Tratado de Anatomia y Cirugia, also printed by Antonio Ricardo Piamontés, dates back to 1579, a year after the Lopez. Within the anatomical aspects this publication is the first detailed description of the anatomy of the brain, of merely drug court, and their techniques for trepanation and the treatment of fractures of the skull are also dose, similar to those of Arias and Lopez (Chico - Ponce de León, 2004).

Should be noted that publications from the 17th and 18th have also high quality, especially The Medical Encyclopedia, posted in the 17th century and 18th century by  Juan de Barrios, that opens in Mexico and at the continental level the publication of medical journals, with Mercury flywheel, José I. Bartolache, but without references of surgery of skull (Chico - Ponce de Leon, 2008).

On the other hand, another important character in this story is Descartes; what could be said about Descartes? Philosopher French, scientific, recognized as the father of modern philosophy, influenced the math with its Cartesian coordinates system which allowed geometric shapes could be expressed in algebraic form, work for which it is known as the father of analytic geometry. But his contribution to the history of the studies of the brain due to his famous phrase, "I think therefore I am" which sums up all a principle of thinking based on the idea that thought can not be separated from the mind, but that it is possible to develop it based on the information that comes through the senses, and defined thought as the process by which is aware of the information from the senses and based on them He formulated the research method based on perception and the following sentence summarizes his stance on the perception, thought and consciousness: "if what I think was seen with my eyes and this was possible only by the Faculty of judgement which is on my mind".

However, was the microscope which allowed a breakthrough in studies of the brain, of course we are talking about at the end of the 19th century, and this device allowed Camillo Golgi during the 1890s, use chromate silver to reveal the intricate structures of a single neuron.

 Golgi’s technique was used by Santiago Ramón y Cajal and allowed him to formulate the hypothesis that the neuron was the functional unit of the brain, which Ramón Cajal and Golgi shared the Nobel Prize in Physiology or medicine in 1906, for their exhaustive observation, description and categorization of neurons throughout the brain.

Eventually with all these observations, Golgi began to draw their findings and the idea of the neuron as anatomical Unit continued to work on the electrical excitability of neurons that developed Galvani, and studies of DuBois-Reymond, Müller and Von Helmholtz showed neurons were electrically excitable and that their activity was predictably affected the electrical state of adjacent neurons.

But in the year 1860, a man makes history: known with the name of Kevin and diagnosed with epilepsy, this person is treated by neurologist Guillaume Duchenne. Long ago, while trying to find an answer to your medical condition, was involved, they sectioned you Corpus Callosum, that is the nervous tissue that connects the hemispheres of the brain. Kevin not only did not improve their status, but it worsened markedly. I just listened for the left ear, and although the right ear seemed to be in perfect condition, was not receptive at all. 

In case outside little, vision, also on the right side, had lost it. Thanks to Kevin practiced studies, Duchenne began to understand how they behave hemispheres of our brain which, as it is known, have an opposite form of acting. Our muscles on one side of the body, move when they follow orders sent by the opposite side of the brain. So, if we move the left hand is as a result of an order sent from the right hemisphere. As a result of this discovery began to get to know some data of certain brain activity correspond to the right hemisphere, as the memory of sounds or the recognition of faces, while the logic or the ability to understand the language, are generally to the left hemisphere functions.

In Mexico, at the same time, Rafael Lavista in 1896 founded the Journal of Pathology and in a work of 1899, it refers to the nervous system and included 150 microscopic studies and some samples of the central nervous system with tumors of the brain, the cerebellum and brain parasites, among others.In this volume, is exhibited an illustration of a cut of left hemisphere, with a tumor at the level of the second frontal gyrus, while another illustration, shows a microscopic preparation of such injury, and both are beautiful lithographs and the first published images of this type in Mexico (Chico - Ponce de Leon, 2008).

In parallel with this work, waiting can be recognized this as a small tribute will provide major contributions, who is the time to mention to Paul Broca. Paul Broca was surgeon, neurologist and anthropologist, one of the most prominent figures of medicine and anthropology in the 19th century. He carried out important work in the field of Oncology and the treatment of aneurysms, as well as its contribution to the understanding of the origins of aphasia, name which refers all impairment of the ability to articulate ideas. Bit was a man of brilliant and passionate with a fervent dedication to the medical treatment of the poorest social strata.

Broca also carried out important research into the limbic region, known initially as the rhinencephalon (olfactory brain), area that is closely linked to human emotions. But perhaps his work more in our days is the discovery of a small region located in the third circovolution of the left frontal lobe of the cerebral cortex, which is called Broca's Area in his honor.

Taking as starting point a small number of experimental tests, bit laid bare that that area of the brain controlling articulated language issue and stands as a fundamental characteristic of human activity headquarters.  

Broca's area was one of the first discoveries that showed the separation of functions existing between both cerebral hemispheres, but more importantly, was one of the first strong evidence of the existence of specific brain functions in very precise areas of the brain, that there is a connection between brain anatomy and their different specific activities, activities which sometimes tend to be categorized as mental.

Of course, Broca  defined the are which has his name thanks to his study made to a patient that he knows in 1861, who had been the victim of a stroke and gave him the name Tan, since it was the single syllable which was able to pronounce for 21 years. When he died, the autopsy revealed that a portion of the left frontal lobe the size of a golf ball had been affected because of the stroke (Shreeve, 2005).

Paul Broca died in 1880, perhaps because of an aneurysm that is very similar to he who had so brilliantly studied. When he surprised the death was working on a detailed study of Brain Anatomy that could not be completed by him, but his student Karl Wernicke continued their investigations (Sagan, 1981; Kandel, Schwartz & Jessel, 2000).

Therefore encountered next to the name of Paul Broca, Karl Wernicke, known for his studies on aphasia (alterations of the expression and/or understanding caused by neural disorders). Together with drill bit, described what would later be called sensory aphasia (inability to understand the meaning of spoken or written language), distinguishing it from the motor aphasia (difficulty to remember the articulatory movements of speech and writing), described by Broca (Shreeve, 2005).

Although both types of aphasia are the result of a brain injury, Wernicke found that the location of it was different. Sensory aphasia is due to a lesion in the temporal lobe. On the other hand motor aphasia is caused by a lesion in the area of drill bit, located in the frontal lobe. 

Wernicke employed different clinical features to formulate a general theory of the neurological bases of language. Also described, in collaboration with the Russian psychiatrist Sergei Korsakoff, a type of brain disease due to a deficiency of vitamin B1 or thiamine, called alcoholic encephalopathy Wernicke or Wernicke-Korsakoff syndrome.

It is worth mentioning the case of another patient, who opened the door to research on inter hemispheric relations of the brain:

"On September 13, 1848 Phineas was working on the outskirts of Cavendish; Vermont in the construction of a railway line. His post was foreman and he was generally described as a capable and efficient man".

One of its functions was to place explosives in holes drilled in the rock; so he filled the hole of gunpowder, placed a detonator, and finally covered it with sand and crushed sand with a heavy metal bar. That day Phineas inadvertently forgot to pour the sand before pressing with bar, so by doing so there was a spark that made it exploded the gunpowder. This explosion in turn caused the metal bar out triggered through Gage's skull and landing almost 30 metres away.

The bar, which was a meter long and less than 3 cm in diameter and weighed 6 pounds he entered his skull through the left cheek and came out on top after passing through the anterior cerebral cortex.

Surprisingly not only Gage did not die instantly, but it was conscious at all times. The Chronicle of the time tells even that spoke a few minutes. After the accident led him on a cart several kilometers up to the consultation of Dr. Harlow; one of the doctors of the people who would be who would leave us proof of its evolution.

Survive an explosion, a wound like that, and the rudimentary medicine of the time and still be able to walk and speak rationally is surprising; no less surprising is that two months later Dr. Harlow would consider that Gage was fully recovered, giving discharge.

Apparently the physical recovery of Gage was complete; However in the words of the own Harlow: "the equilibrium or balance among his intellectual ability and his animal propensities had destroyed". After the acute phase, Gage became irregular, irreverent, blasphemous and impatient. At times he was stubborn when carried it the opposite, but on the other hand despite the fact that I was continually thinking about future plans "abandoned them much before preparing them"; and it was very good when it comes to "find always something that you should not be". All this despite the fact that prior to the accident was a responsible man. His marriage ended, since his wife considered that he was no longer the same as before and was much more aggressive (Macmillan, 2008). 

The case of Gage is regarded as one of the first scientific evidence suggesting that the frontal lobes lesion could alter aspects of personality, emotion and social interaction. Prior to this case (and quite some time after) the frontal lobes were silent structures (without function), and unrelated to human behavior.

Antonio and Hanna Damasio neurologists studied to depth the case of Phineas Gage, as well as other similar cases, and raised the theory of somatic marker, which suggest that there is a relationship between the frontal lobes, the emotions and the way in which human beings make decisions. Because of this the case Gage is considered as historical, since the remains of the skull and the bar used to do a simulation by computer of the possible trajectory, concluding that the bar had affected the medial area of both frontal lobes, so it is considered as the beginning of the study of the biological basis of behavior, and was also key to the deepening of the knowledge of the possible location of brain lesions (Damásio, Grabowski, Frank, Galaburda, Damasio, 1994). 

Some years later, at the beginning of the 20th century, the Russian psychologist Alexander Luria, perfected several techniques to study the behavior of people who suffered some kind of injury in the central nervous system and completed a battery of psychological tests designed to establish difficulties in psychological processes such as attention, memory, language, executive functions, perception and motor skills calculation, etc., even though at the time there were no methods for diagnosis by the image, the application of this extensive battery offered and continues to offer to the neurologist sufficient data so that it would be able to locate the place and the extension of the injured area, as well as offer a detailed summary of all the difficulties, especially cognitive psychologist of the subject affected by neurological injury (Rufus-Campos, 2006). 

 Note: Images were taken from different Internet sites except the image of Broca's area. All Images have Copyright.

References:

Bear, M., Connors, B.W and Paradiso, M.A. (2001) Neuroscience: Exploring the Brain. Baltimore: Lippincott.

Chico-Ponce de León, F. (2008)  Historia de la cirugía de tumores cerebrales. En Aguirre-Cruz, Ma. Lucinda y Julio Sotelo Morales, eds. Tumores Cerebrales. Editorial Médica  Panamericana, México.

Chico-Ponce de León, F. (2009) Historia de la cirugía de cráneo, de los tumores cerebrales y de la epilepsia en México. Neurocirugía. 20. 388-399.

Chico-Ponce de León, F.(2004)  El doctor Rafael Lavista y las primeras intervenciones sobre tumores cerebrales y cirugía de la epilepsia en México 1892. Arch Neurocien. 9. 226- 232.

Chico-Ponce de León, F., Goodrich, J.T., Tutino, M., Gordon, C. (2000)  First published record of a neurosurgical procedure in the North American Continent, Mexico City, By Pedro Arias de Benavides, 1561: Secretos de Chirurgia, Valladolid, Spain, 1567. Neurosurgery. 47: 216-222.

Chico-Ponce de León, F.,Valadés, D (1999) el funcionamiento del cerebro a las luces de la doctrina cavitaria. Primera imagen hecha por un americano. “Rhetorica christiana”,              Roma-Perugia, 1576. Salud Mental. 22: 29-36.

Damasio H., Grabowski T., Frank R., Galaburda AM., Damasio AR (1994) The return of Phineas Gage: clues about the brain from the skull of a famous patient. Science 264 (5162): 1102-5.

Gross, CG. (2009) A hole in the head: More tales in the history of neuroscience. The MIT Press. Cambridge, Mass. USA.

Ibrahim, B. (2002), Islamic Medicine: 1000 years ahead of its times, Journal of the Islamic Medical Association. (2), p. 2-9 [7].

Kandel, E.; Schwartz J.H, Jessell, T.M (2000) Principles of Neural Science. New York: McGraw-Hill.

McMillan, M. (2008) Phineas Gage – Unravelling the myth The Psychologist. British psychological Society.  21(9): 828-83.

Rufo-Campos, M. (2006)   La neuropsicología: historia, conceptos básicos y aplicaciones. Rev. Neurol. 2006; 43 (Supl 1): S57-S58

Safavi-Abbasi, S., Brasiliense, SL., & Workman, RK. (2007), The fate of medical knowledge and the neurosciences during the time of Genghis Khan and the Mongolian Empire, Neurosurgical Focus 23 (1), E13.

Sagan, C. (1981) El cerebro de Broca: referencias sobre el apasionante mundo de la ciencia. España. Grijalbo.

Shreeve, J. (2005) Cornina’s brain: all she is… is here. National Geographic. Vol. 207. num. 3.  6-12.

Tanzi, R. (2012) Neurosurgery before Neurosurgery. At Dana Foundation Blog. Available at: http://danapress.typepad.com/weblog/2012/12/neurosurgery-before-neurosurgery.html

Leaving aside the DSM: patients deserve better diagnostics

Last Friday, may 3rd, 2013, National Institute of Health Mental (NIMH) of the United States announced that decide to abandon the Diagnostic and statistical Manual of Mental Disorders (DSM),  after decades of being used as the means of diagnosis for excellence not only in the United States but at many other countries for the treatment of the mental diseases that attack humans from infancy to old age.

 

The news comes a few days before that the Fifth version of this Manual comes to light after some changes that can be considered minimum, especially in the subject of neurodevelopmental, among which was the reconsideration of Asperger syndrome as part of the autism spectrum disorders.

This news is announced with a tone of sarcasm by different media and social networks to refer to the DSM as the Bible of Psychiatry, which was of course used as a clinical diagnostic tool for most of the mental health disorders and which was translated into several languages in order to unify internationally, regardless of phenotypic aspects.

However, this does not mean that we  should burn the DSM and much less that new version shouldn't be  received favorably, unlike what many journalistic notes say, separation is not divorce, it is only the gate to allow further diagnostic tools for the treatment of mental illness. 

On the web site of the American Psychiatric Association, it was announced very recently  that at 22de may of 2013 would appear the fifth version DMS after two years of intense reviews involving more than 13 000 thousand comments, more than 12,000 e-mails and the work of at least 13 working groups, thus achieving unified criteria among the scientific community.

Although had been mentioned in various clinical forums that the Manual had a tradition of reductive of sufferings, it seemed impossible that this could change, as the length and breadth of the planet was used as the wand able to choose not only the treatment of patients, but its future development having medical, educational and legal inference.

One of the main problems is that continuous attributing illness to each clinical entity based on principles that do not necessarily occur together in time and space in the symptomatology of the patient and that it did not allow in many cases, to carry out further studies of contrast.

The story began in 1952 when the first version of the Manual was published under various research that emerged after the second world war who sought to evaluate mental health in surviving soldiers in the fields of combat the problem and that returned home confused.

Previously, in 1949, the World Health Organization had published the classification and statistics International of diseases (ICD) which included a special section for the first time for mental disorders.

Over the years the DSM had several reviews, the second published in 1968, the third in 1980, the fourth in 1994 and the fifth waiting be published on May 22, 2013.

The reasons for which the National Institute of Mental Health of the United States decides to put away the Diagnostic Manual may be many, from voices that cry out that it is not possible to classify nosologic entities  from a group of symptoms, such as disorders of autism spectrum disorders or attention deficit, which did not allow to physicians give clear attention to patients to the desperate claim of several researchers who watched as nationwide increased the number of cases of autism and attention Deficit, depression and bipolar disorders.

The truth is that neurocognitive and physiological, genetic research have given breakthroughs and not can continue to be ignored, so that the look will now rest on a project that has already gone way called Research Domain Criteria (RDoC) seeking to be considered irregular psychological component to the understanding of mental illness in cognitive terms, as well as neural and genetic differences.

While the DSM criteria allowed the overlaps in Diagnostics, for example it was possible to recognise a child with Down syndrome and autism, usually granted a single diagnosis of the classification, which would let physicians in a professional helplessness that sometimes you should work in a despite health and conditions of the patient.

On the other hand, in the case of autistic spectrum disorders, usually pediatrician only could treat only observable symptoms, it doesn’t matter were they could begin as perinatal, genetic or environmental difficulties that may occur as roots of  the symptoms leaving the children and their families under cover of drugs that were not always prescribed whereas clinical laboratory studies.

In this sense one of the potential benefits of the removal of the traditional psychiatric model is that it will be possible, on the one hand analyze further disorders, whereas influential factors, from genetic, environmental, and clinical and on the other hand, will force mental health professionals require greater diagnostic tools.

In this context, it may be possible to see people beyond the label which is granted, in addition to any other forms of treatment as well as the magic pill cure it all to which traditional Psychiatry we had used.

Neurocognitive research will finally have application beyond than only basic research, although to all power, it will be a great responsibility, as Spider man says, it is also true that psychological research and neuroscience is under scrutiny because of several works that have been considered lacking in ethics, so will just be waiting for the benefit of patients and their families who deserve, no doubt much more respect, including more and better health care professionals.

Meanwhile, it should not be forgotten that the context of the United States is very different from the rest of the countries, however, as I mentioned elsewhere, there to continue the investigations underway and wait for the response from the international scientific community.

References

American Psychiatry Association (2013) DSM-5 Development. Available at: http://www.dsm5.org/Pages/Default.aspx

Drummond K (2013) Federal Institute for mental health abandons controversial "bible" of psychiatry. Available at: http://www.theverge.com/2013/5/3/4296626/nimh-abandons-controversial-bible-of-psychiatry

Dzib Goodin (2013) The disorder or attention: pay attention!. Available at: http://talkingaboutneurocognitionandlearning.blogspot.com/2013/04/the-attention-deficit-disorders-or-pay.html

  

Dzib Goodin, A (2010) Alteraciones del desarrollo por dificultades perinatales y la confusión con los trastornos del espectro autista. Revista de Neuropsicología. 5 (1) 4-9.

Dzib Goodn, (2012) Austism spectrum disorders: detection of abilities and not dis-abilities. Available at: http://talkingaboutneurocognitionandlearning.blogspot.com/2012/07/autism-spectrum-disorders-detection-of.html

Mind Hacks (2013) National Institute of Mental Health abandoning the DSM. Available at: http://mindhacks.com/2013/05/03/national-institute-of-mental-health-abandoning-the-dsm/

Reese, H. (2013) The real problem of psychiatry. The Atlantic. Avaliable at: http://www.theatlantic.com/health/archive/2013/05/the-real-problems-with-psychiatry/275371/

Toor, a. (2013) Controversial update to "bible" of psychiatry fuels debate over foundations of mental health: One book raises big questions. Avaliable at: http://www.theverge.com/2013/4/19/4243060/dsm-5-bible-of-psychiatry-mental-health-revisions-spark-boycott

The Attention Deficit Disorders or: pay attention!

The idea that made me write this entry arose over a photograph that I took of a cardinal bird, honestly I just saw the cardinal but my good friend Roberto Estévez made me a comment: it seems the bird is looking at you!.

My response to that comment was that surely the bird was watching paying attention to every detail since they are being a wild creature there are around several predators, also because it has to compete for food.

Two days later, my husband went to a meeting to another city and when he called explained me he was surprised and upset with so many people around, because it looks like everybody was absorbed by sending messages on their cell phones and they seemed not to look at who was at their side, making any walk a struggle for space and attention. Even drivers seemed to not be pay attention or remember that there was a  junglearound them.

An extra element to write this was the constant news about how more and more children are diagnosed with Attention-Deficit Disorder all of them highlighting that is alarming the number of cases submitted.

What "experts" don’t know

Ok, who am I to say experts don’t know something?, Maybe they don’t say this because to much complexity don’t sell enough magazines, but the thing is the attentional process is given to the survival of the species (not a school term) to provide tied sensory mechanisms to protect themselves from the dangers of the environment or to provide the capacity of food and caring for the offspring.

Imagine a rabbit focused on its inteligent phone screen or just looking at the female bunny front him without paying attention to the smell of possible predators, without looking at if something strange moves around, without listening to the movement of the wind and the leaves. While you are reading this, the rabbit was already attacked byyour cat, a hawk, a more attentive rabbit fornicated with the beautiful rabbit it was trying to conquest and our rabbit lost the chance of eating and of course, it  lost its cell phone in the confusion. 

What happens when a species loses its capacity of adaptation to the environment or they are unable to respond to the warning signs?, simple, extinguishes!. Therefore the capacity of attention to the environment is so important.

Now let’s return to the attention deficit deficit issue, psychologists and teachers believe that children do not have the ability to pay attention, just because does not see me as I speak them or have no view stuck on the Board or on the display, and also dare to be multitasking! that sounds, what do  these children believe?.

Let`s go by steps: attention is not an action, it is a process which involves all the senses and other superior processes such as working memory. 

Although someone can have their eyes focused on a screen, that person can hear the click, click of the keys, other noises of the environment, as the television or Spotify, or even  he or she can smell the environment, for example if something is burning, and we can’t  forget is feeling  the position of  his or her body over the chair. 

So I am sorry but even if someone ask me to pay attention to only onething, there is no way to disconnect the cranial nerves or sensory areas and even less the information flowing between the areas of association or biochemical information flow, or erase years of evolution, that is foolish.

What you have is selective attention, which is captured naturally if a stimulus is interesting, enjoyable, or dangerous. Yes, if I see someone going to hit me I move to avoid any contact because we usually react quicklier to fast movements different than slow movements.

Selective attention is one of the problems of many children, but does not only tell someone pay attention!, when I hear that I wonder to which put attention?, do to your speech, to the intensity of your words, your choice or how you move your mouth?.

There is evidence that we evolved to looking at the lips and face of other persons to recognize emotional emphasis in speech, and of course the gestures.

But attention cannot be sustained for long time, eyes tend to move, noises of the environment will cause that there is another source of attention, and it’s not only an extreme noise, in a classroom where you can hear the thoughts, even the hint of a pencil or a pen on the paper can cause a rotation of our heads to find the focus of noise. And if someone pulls out a pencil tip during an examination?, if... we are going to flip, because naturally, the ears are intensified, since that may depend on our life.

Many people then, to forget these natural principles, but it doesn’t mean they don’t knkow it,  I believe they sometimes forget that we are not experts, but how can we avoid years of evolution and selection natural and that attention as a mean of survival depends on the environment, then says that if a child not focuses attention on one single thing  has a  damaged brain.

Schools of the 16th century, which were basically churches built to avoid the temptations, where you can hear a yawn to far because of those wonderful domes and the acoustics that allows you to hear every note of praise choir, it was clear that meditation was the best way to listen to God, but if we see them as laboratories, it was certainly possible to maintain attention because after the first time of admiration, there isn't much to see.

But today at any place away from home or school, children face the streets, where cars are moving at a certain speed, there are many people talking, they must  pay attention to traffic lights or the movement of the cars to know when crossing the streets, and pay attention to so many other persons around and even notice if the light is red or if a driver may decide that being in a hurry is worther than a life. Also  if mom is  texting while crossing street, so she is not careful while people is crossing and hit eachother, and there is a bicycle in the opposite direction... and trees move and birds singing…

Attention on the natural environment

We have asked children to  focus  on something or someone, do not you look anything else!, and at the same time have increased the transit accidents, in particular those fatal accidents because people are not able to attend all stimuli a round such as number of passengers in the car, number of cars around, number of hours of monotonous journey or level of danger at the intersections  are factors of the most serious accidents.

To this we must be add that we learned to pay attention to the voice that speaks or the screen. Ups, if you drive don't send text messages!.

What do happen to children in the family environment?, children vie for attention of parents or caregivers that are between the cell phone, Facebook, twitter, television, problems at work, trying to finish a proposal while cooking, the dog barks, siblings yells, brother shouts stronger and if they ask for a little attention with the wonderful phrase as “look what I did!”, sometimes only receives a: “not now”,  “I can't answer”, “leave me alone”, “perhaps later”, and sometimes a good!, without even looking at what the child  did, or sometimes only receives a grunt in response. Who can meet the request of the child when there are many things by turning at the same time?.

Teachers complain that they are between 15 and 20 children, all looking for their  attention, talking, making noises, of course they want a little peace!, but their  reaction is to say to everybody: if you sit down and cab be quiet, you will look prettier!, and if any of them dare to stand up without permission no doubt some children will win a visit to the and a flight non stop with all expenses paid to the psychologist’s office, who is faithful friend of the ignorance of the neurodevelopmental but who knows very well how not only apply harmless tests and without context, also know how to ask money for them as if they  are useful.

Attention to the brain

I won't say that attention-deficit disorder does not exist, the brain studies show differences in anatomical and electrophysiological brain mechanisms in children affected with one of three types of 3 attention deficit disorders. Hey! Wait a second: 3?  everyone is talking only about deficit of attention disorder!, when have you seen a happy meal with three toys?. The popular side of the disorder usually don’t talk  about it, but there are three types, the hyperactivity, inattention, and the combined type attention deficit disorder.

Neurological studies show that children with attention deficit have a slow brain development a lower overall, but specifically the cerebellar, volume especially in portions postero inferior (lobes VIII to X) as well as the vermix, the volume of the nigra substance in the right frontal gyrus and putamen are at the same time lower than the brains of healthy children, however it is worth mentioning that this can not be seen with a test in a doctor's Office.

The main problem with the diagnosis of the call children epidemics, i.e attention deficit deficit  and never well recognized autism, is that manuals of diagnostic observed clinical and non-neurological shunts, what I mean is diagnostics are based on subjective observations reported by parents, teachers based on questionnaires that analyze the inattention, impulsiveness, and hyperactivity under criteria such as "often"regardless of the contexts in which behaviors are manifested.

Occasionally apply two or three tests, is observed to the child, and as an immediate response to the problem, it prescribes a pill, and is sent to the world with a diagnosis that for better or for worse will follow throughout all  life.

But, what if the child was not the problem?, andif the problem is the environment?, and if rather than ask parents how the child behaves asked how parents and teachers to behave with the child?, what do happen when children ask something? Do we ignore them?, if when children speak they are ignored  so we push them to  do something extrem like a stop breathing and vomiting the carpet so that caregivers give them 2 seconds of attention.

Yes, because like the screen that jumps so we notice we have received a new message, an update or a new email, the child jumps, makes noise, not to disturb the world, but to say: "here I am,  pay me attention!".

The environment is chaotic, certainly to survive must pay attention to many stimuli, but is not the case  that we are becoming psychotic, reality is that way, or  the car will run and hit us, the boss asks us something that we don't know how to do because we lost the sticky note where we detailed instructions, overflowing emails and accounts invoices do not stop. The reality is that each one must find a way to adapt to the environment and does not expect the environment adapts to each of us.

References:

Bernfeld, j. (2012) ADHD and factor analysis Are there really three distinct subtypes of ADHD? Applied Neuropsychology Child. 1 (2) 100-104.

Fernandez Perrone, a., Fernández - Mayoralas DM, & Fernandez-jaen, a. (2013) of attention deficit/hyperactivity disorder: inattentive to the restrictive type type. Revista de Neurología. 56 (Supl 1) S77-S84.

Kiyonaga, a., & Egner, T. (2013) Working memory as internal attention: Toward an integrative account of internal and external selection processes. Psychonomic Bulletin & Review. 2 (2) 228-242.

Klauer, SG., dinghys, TA., Neale, VL., Sudweeks, JD., Ramsey, DJ. (2006) The impact of driver vigilance on near-crash risk: An analysis using the 100-Car naturalistic driving study data. Available at: http://trid.trb.org/view.aspx?id=786825

Koziol, LF, Budding, & D. (2012) ADHD and sensory processing disorders: Placing the diagnostic issues in context. Journal of Applied Neuropsychology Child. 1 (2) 137-144.

Mules, f., Gandia, r., rock, p., Etchepareborda MC., Abad, l. (2012) update drug of attention deficit/hyperactivity disorder: intervention models and drugs. Revista de Neurología. 54 (Suppl 3) S41-S53.

Ramos-Quiroga, JA., Chalita, PJ., Vidal, r., Bosch, r., Palomar, g., Prats, l., and houses, M. (2012) diagnosis and treatment of attention deficit disorder / hyperactivity in adults. Revista de Neurología. 54 (Supl 1) S105-S115.

Schmidt, EA., Schrauf, M., Simon, M., Fritzsche, M., Buchner, j., Kincses, WE. (2009) Drivers' misjudgement of vigilance state during prolonged, monotonous daytime driving. Accident Analysis & Prevention. 41 (5) 1087-1093.

 Tivesten E., Wiberg, H. (20013) What can the driver's own description from combinated sorces provide in an analysis of driver distraction and low vigilance in accident situactions?. Accident Analysis & Prevention. 52 (2) 51-63.

Tye.Murray, N., Spehar, BP., Myerson, j., Hale, S., Sommers, MS. (2013) Reading your own lips: Common coding theory and visual speech perception. Psychonomic Bulletin & Review. 115-119 (1) 20. 

Whitehead, JW. (2013) The psycho.therapeutic school system: pathologizing childhood. Huffington Post: The Blog. Available at: http://www.huffingtonpost.com/john-w-whitehead/the-psychotherapeutic-sch_b_3037194.html?utm_hp_ref=%40education123