Healthy Brain, Happy Life (23 page)

MY TEACHING SECRET WEAPON

One of the best and most powerful teaching tools to make something memorable to students is novelty or the element of surprise. Something that is novel or surprising focuses attention, engages emotional systems, and is therefore highly memorable or “sticky,” as neuroscientists like to say.

Let me explain.

I was once teaching a 120-student core curriculum course called “Brain and Behavior” for nonscience majors, and we were coming up to my favorite part of the syllabus, the classes on memory. I wanted to introduce this section in a very memorable way, and I started thinking about ways that I could do that. At our next teaching meeting I introduced this idea to my teaching assistants (TAs) and then asked them to brainstorm. Erik had a fantastic idea. He said he knew a graduate student in our program who moonlighted as a popular underground burlesque performer with the stage name Dr. Flux (remember, I work in New York City!) and one quick e-mail confirmed that he would be happy to participate in our little scheme.

On the day of the introduction to memory lecture, I started as I usually do, describing the basic concept of memory. Suddenly Dr. Flux burst through the door in a nerdy-looking suit covered by a lab coat, surprising everyone, including me. I was surprised because I had not seen him in full costume before and half of his shaved head was covered with an inch-thick layer of what looked like gold sparkle dust. On cue one of the TAs turned on some music, and Dr. Flux started strutting in front of the classroom, doing a risqué dance number. At this point the students were turning to one another and to me, wondering what was going on. Then Dr. Flux took off his lab coat and ripped off most of the rest of his clothes (held together by Velcro) under which he revealed a rather small pair of bright gold booty shorts (he had failed to mention just how tiny the shorts were when he had first described his act to me).

Dr. Flux then began undulating to the music right next to me at the front of the classroom, at one point even doing a back bend. Finally, he pulled on a bright orange hazard suit and dramatically left the room.

You should have just
seen
the look on the students’ faces. 
After Dr. Flux walked out the door, without missing a beat, I turned to the class and asked, “So what makes things memorable?”

One young man way in the back of that big classroom, who had never raised his hand before, put his hand up. I called on him and he said with certainty, “Gold booty shorts!”

I said, “
Yes!
”

I explained that the demonstration used to start off our section on memory was in itself memorable because it was novel (gold booty shorts), surprising (gold booty shorts), emotional (stripping to reveal the gold booty shorts in the context of a classroom), and attention grabbing (gold booty shorts). I guarantee that those students will remember that introduction to memory for a very long time.

CAN
EXERCISE CHANGE YOUR BRAIN? THE RESULTS SHOW

The great thing about the “Can Exercise Change Your Brain?” course is that I had more than just anecdotes to tell about how this class was so different from any other class I taught; I had actual experimental evidence. As you will remember, in this class, we asked the question, Could once-a-week aerobic exercise (plus affirmations) for a semester (fifteen weeks) improve memory encoding relative to students in a different elective neuroscience class that didn’t include exercise? At the end of the study, we had relatively small numbers of students in the exercise class and the control class. The deck was stacked against us because of both the small number of subjects and the low number of exercise sessions they completed during the study.

We examined the results of the memory-encoding task (which is supposed to depend on the part of the hippocampus where new cells are born) to see if there was any difference in the performance of the two classes. We were all thrilled to find a significant improvement in the exercise group relative to the control group in one measure. We found that the exercise group responded to the correct stimulus in the memory-encoding task significantly faster than the control group. Processing speed is one aspect of cognition that has been reported to improve with exercise, and we were able to see this in this study.

Now, previous studies had shown that rats performed significantly better on a task after exercise, just like our memory-encoding task. We didn’t see an overall improvement in performance (that is, more correct choices), but one big difference was that the experimental rats got much more exercise than the control group rats—sometimes running ten kilometers a day (rats love to run). We didn’t see an overall improvement in memory in my students, but we seemed to see just the first hint of an improvement on the task in the form of reaction time. This was important because it told me that with just once a week of increased exercise, you can start to see a significant effect on some measure of the memory-encoding task in healthy young adults.

This finding lit a fire under me like no other result I had gotten before because it suggested something very exciting. If we could start seeing reliable effects in healthy young adults with just once-a-week exercise, what would we see if the subjects increased their exercise to three or four times a week? Now
that
was exciting and is among the questions we are pursuing now.

Now, the other question from this first study was whether the effects we saw were due to the increase in aerobic exercise alone, the positive affirmations (the intentional component) alone, or the combination of the two. As I mentioned, there was a huge motivational shift in terms of interaction in the course, and many of the students commented on how the affirmations that we said in class stayed in their head all week. We focused on the mood component of intenSati in another study I did soon after the exercise study in students, this time focused on a patient population group: individuals who had suffered traumatic brain injury (TBI).

EXERCISE EFFECTS ON MOOD IN TRAUMATIC BRAIN INJURY

A collaboration that developed after a talk I gave at NYU’s medical school campus about my exercise class was with Dr. Teresa Ashman, from the Rusk Institute of Rehabilitation Medicine at New York University Langone Medical Center. Ashman specializes in the rehabilitation of patients with TBI. This seemed like an ideal population to try our exercise intervention on for a variety of reasons. First, these patients suffer from a range of cognitive deficits, including difficulty with attention, motivation, and memory. Depression and fatigue are also common in TBI patients. We reasoned that long-term exercise might have the potential to improve the cognitive problems seen in these patients as well as improve or alleviate the depressive symptoms. So we set about to design a simple experiment in which we tested subjects before and after an eight-week exercise intervention that consisted of twice-a-week group exercise. Control subjects did no exercise for the same time period.

I went to the first session of the experiment after the participants had been chosen for the study, ready to give them all a big welcome and pep talk, to tell them why we were doing this work, and to encourage them to the best of my ability to come to as many of the exercise sessions as they could over the next eight weeks. The age of the participants ranged from the twenties to the sixties (you can suffer from TBI at any age). Luckily, I met a positive and expectant attitude in the room that day, and I was confident that we had a great and engaged group of subjects.

I then asked the exercise instructor, Amanda Berlin, to lead the whole group in a short and easy three-minute exercise demonstration. The participants looked a little unsure about standing up and exercising at the introductory session, but all joined in eventually and seemed to enjoy it. Well, almost everyone. When the demo was over, I turned around and saw a young woman walking toward me with a pinched red face who looked like she was about to cry. Her name was Angelina. I immediately asked her what was wrong. “That was torture for me!” she spat out. “The music was way too loud and too fast and the bright lights in the room really hurt my eyes!”

I could tell that Angelina really wanted to be a part of this study, but she was so frustrated by the demonstration that I worried she wouldn’t return. Ashman and I assured her that we would make sure that the music was slower and the lights lower next time, and that she could do the workout sitting down if that was easier. We then introduced her to the instructor, and assured her that Amanda would take great care of her. Eventually, Angelina calmed down.

During the eight weeks that the test participants were meeting for exercise class, I got regular updates on attendance and made sure that the instructor had all the support she needed to run the classes efficiently and easily. At the end of eight weeks, I was touched to get an invitation from the participants, who invited me to come to their last class so I could see their progress.

I arrived in the NYU medical school classroom and immediately noticed that the room was buzzing with energy. Everyone was excited to be there, and the participants were all saying how they could not believe how quickly the eight weeks had passed. When everyone had arrived, Amanda started class, and I could not help but notice that her music was as fast as the music in any local gym in New York City. Not only was the music fast but everyone was keeping up. I saw the group jumping and punching in perfect time to the music—they clearly knew what they were doing.

But it was what I saw in the front row of the class that made my day, week, month, and year. It was Angelina. I had hardly recognized her, but there she was, with a huge smile on her face doing the workout like a pro. I looked twice to be sure that it was her, and sure enough, it was! I spent the whole rest of the hour marveling at what I was seeing.

After the workout and meditation were over, we all sat in a circle. I asked, “Do you all know how amazing you are?” The whole group was beaming.

I continued. “Do you know what a difference I see from where you all started eight weeks ago? What happened?”

They all then started pointing at one another and talking all at once. One beautiful young woman said that she learned how to smile again in this class, and she had also invited her therapist to come to this last class so she could see. Another woman said that she was just so inspired by seeing the improvement in everyone else each week. They all credited Amanda for being a wonderful leader. Angelina described her amazing transformation, which was actually a gradual but continuous process. She said the first week of class she could not even feel her feet under her body during the exercise, but by the second week she could. She could not do both the arm movements and the leg movements at the same time so she worked on one at a time. But soon enough, everything just came together, and after regular attendance, she could suddenly do all the movements—all at once. I can’t describe the look of joy and accomplishment that she had on her face as she spoke.

A real transformation had taken place in that exercise group, and it was one of the most beautiful things that I had ever seen. And the study was not even over yet. The participants had all taken cognitive and mood tests at the start of the exercise regime. Luckily we had really focused on the mood aspect of the change and had a wide range of different mood and quality-of-life assessment forms we had given them to fill out. Now, they would retake all the same tests to determine if they had changed relative to the nonexercising control group. What we found reflected exactly what I saw in that final exercise class. There was significant improvement in mood and quality-of-life measures for those who had done the exercise class compared to the TBI patients who had not. As measured by the various surveys they took, the exercising TBI group had decreased scores on a depression and fatigue index and increased scores for positive affect and quality of life. I got a glimpse of all of those changes when I saw the group in exercise class. It turned out that none of our measures of memory or attention had changed, but this might have been because, although the group eventually worked themselves up to quite high levels of aerobic activity, it took several weeks to get there. In other words, while we saw clear improvements in mood, we might not have had an intense enough level of aerobic activity over the eight weeks to see improvements in cognitive functions.

The paper Ashman, our research team, and I wrote after we completed the TBI study turned out to be my first published report about the effect of exercise in a patient population group. What a thrill! Our findings suggested that eight weeks of twice-a-week exercise could significantly improve mood, positive affect, and quality of life measures and decrease fatigue in TBI patients. While our study size was small, this was an exciting result. But then, we had to ask ourselves, What was really underlying this effect? Was it the exercise? Was it the fun and interactive group environment? This study alone could not answer those questions, but future studies can be done to tease those important factors out. The important point is that our results suggested that intentional exercise can improve a range of mood and fatigue measures in patients with TBI. I was more than happy to take that as a start.