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  3. Whenever I speak to educators and interested laypeople about neuroplasticity

Whenever I speak to educators and interested laypeople about neuroplasticity

游客2023-12-03  35
问题     Whenever I speak to educators and interested laypeople about neuroplasticity—the ability of the adult brain to change in function and structure—one of the questions I often get is whether neuroplasticity can be tapped to treat truly devastating brain diseases such as Alzheimer’s or schizophrenia. After all, neuroplasticity has been used to treat stroke, depression, dyslexia, and other diseases or injuries of the brain. The jury is still out on Alzheimer’s(though since this disease involves massive neuronal death, my bet is that the answer will, sadly, be no). But to my surprise, the answer to schizophrenia might just be yes.
    In schizophrenia, which affects about 1. 1 percent of American adults, patients suffer from visual and auditory hallucinations, delusions,an absence of emotion, and cognitive deficits. All told, that seemed to be just too much for an approach based on neuroplasticity, which involves retraining the brain, to handle.
    But it turns out that at least some of the symptoms of schizophrenia can be lifted with brain training. In a study published in the July issue of the American Journal of Psychiatry, scientists led by Sophia Vinogradov of the University of California, San Francisco, describe what they call " neuroplasticity-based auditory training" to improve memory in people with schizophrenia. Basically, what they did was to assign 55 patients with schizophrenia to receive a cognitive-training program developed by Posit Science or to play a computer game that required just as much time and concentration. The Posit program, similar to one the company developed to improve memory in the elderly, emphasizes basic auditory and speech perception: participants used it one hour a day, five days a week, for ten weeks. The better they got, the harder the program got: it automatically adjusts the level of difficulty to keep the patients’ performance at a constant level so they stay engaged.
    Fisher and her colleagues found that the brain-trained group showed noticeably bigger improvements in cognition and verbal working memory than the game-playing control group. The emphasis on auditory training reflects the belief of UCSF’s Michael Merzenich, a pioneer in neuroplasticity and cofounder of Posit, that this is the portal to improved memory and, possibly, cognition. The idea is that if you hear more clearly, then your brain makes fewer errors in encoding the information contained in speech.
    It’s hard to argue with even preliminary success, odd as it seems that merely hearing better could bring about such improvements in memory(and not just memory for heard words: it improves memory for seen words as well). "This emphasis on perceptual processes is a critical insight of the Posit Science approach and a clear distinction from other cognitive-training programs," says Green. " The significance of the new study," he says, is that "it addresses cognitive training at a more basic neurobiological level than any previous strategy. We can hope that the dramatic effects they have reported will prove to be replicable and durable and that they will extend to meaningful effects for patients’ lives. "
    Hope is all well and good. But schizophrenia is notable not only for its severity, but for the yawning gap between what’s known to be effective and what treatments patients actually receive. Green asks rhetorically, "if cognitive training for schizophrenia worked, would we not all know it by now?" In fact, researchers do know it, and some clinicians know it, but by one estimate fewer than 15 percent of schizophrenics get it(or other treatments, rehabilitation and support that would let them live independently). In fact, in a paper earlier this year in Schizophrenia Bulletin, scientists led by Robert S. Kern of the Geffen School of Medicine at the University of California, Los Angeles, were quite upbeat in their assessment of treatments for schizophrenia— none of them the problematic antipsychotic medications that in too many cases are all that people with schizophrenia receive.
    Take cognitive-behavior therapy. Its basic premise is that people can be taught to think about their thoughts differently. It is effective in depression where people are taught to think about their tendency to catastrophize—"I had a bad date: no one will ever love me because I am worthless and unlovable". But in something as serious as schizophrenia? Yes, Kern and his colleagues find. It turns out that, with cognitive-behavior therapy, patients who hear voices and feel persecuted can learn to see these symptoms as almost normal in that many people experience them when, say, they are sleep deprived, under extreme stress, drunk or stoned or as "just" the manifestations of a neurobiological glitch and not real. The approach is surprisingly effective, a 2008 review found.
    Similarly, exercises to improve attention, learning and memory, reasoning and problem-solving—which 90 percent of people with schizophrenia have problems with—also help, as this study found, and make a meaningful difference in whether the person can live independently and hold a job. The tragedy is that—due to an overburdened medical system, inadequate insurance and an inability to pay, as well as simply ignorance about how to find help—few patients with schizophrenia receive what works. [br] It can be inferred from Paragraphs Six and Seven that______.
选项 A、cognitive training turns out to be effective to treatments for schizophrenia
B、both Green and Robert Kern doubt the effectiveness of cognitive training
C、patients of schizophrenia can only receive 15% of treatments for schizophrenia
D、patients of schizophrenia can always get effective treatments
答案 A
解析 推理判断题。从第七段第四、五句：But in something as serious as schizophrenia?Yes，Kern andhis colleagues find．可推断出，认知训练对精神分裂症确实有效果，故[A]“事实证明，认知训练对精神分裂症的治疗有效果”为正确答案。第六段中Green对认知训练的有效性提出了委婉的质疑，而Robert Kern和其他科学家们对精神分裂症的治疗评估很乐观，因此[B]“Green和Robert Kern都怀疑认知训练的有效性”错误，故排除；[C]“精神分裂症患者只能接受精神分裂症百分之十五的治疗”是对第六段第四句的曲解，原文是说估测数据显示只有15％的病人能够有幸接受认知训练的治疗，故排除；[D]“精神分裂症患者总能受到有效的治疗”，第六段第二句就指出“有效的治疗与患者实际上能接受到的有效治疗之间存在很大差距”，即治疗方法虽有效可行，但并不是所有人都有机会获得，故排除。
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