{"id":6919,"date":"2022-03-08T19:03:19","date_gmt":"2022-03-08T18:03:19","guid":{"rendered":"https:\/\/www.sciencefocus.com\/?p=113085"},"modified":"2022-03-08T19:24:13","modified_gmt":"2022-03-08T18:24:13","slug":"damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients","status":"publish","type":"rss_feed","link":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/rss_feed\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients\/","title":{"rendered":"Damaged areas of the brain could explain confusion in dementia patients"},"content":{"rendered":"<p class=\"rssexcerpt\"><\/p><p class=\"rssauthor\">By Amy Barrett\n                \t\t<\/p><p class=\"rssbyline\">Published: Tuesday, 08 March 2022 at 12:00 am<\/p><hr class=\"no-tts wp-block-separator\"\/><?xml version=\"1.0\" encoding=\"UTF-8\" standalone=\"yes\"?>\n<!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<html><body><p>The cause of the confusion that people with dementia experience when something unexpected happens could be down to a specific network in the brain. New research has developed our understanding of these neural connections, and will help patients and their loved ones better manage situations that are potentially upsetting.<\/p>\n<p>A new study by doctors and researchers from universities in Cambridge and Oxford compiles a decade\u2019s worth of data to reveal how changes to the brain in dementia patients, including those with Alzheimer\u2019s, <a href=\"\/\/dx.doi.org\/10.1523\/JNEUROSCI.1622-21.2022&quot;\" target=\"&quot;_blank&quot;\" rel=\"&quot;noopener&quot; noopener noreferrer\">affect their reactions to novel scenarios<\/a>.<\/p>\n<p>To do this, they used a technique called magnetoencephalography, which can scan the brain 1,000 times per second. This allowed them to see exactly how a person\u2019s brain should respond to an unexpected event, and compare it to the brain of a dementia patient.<\/p>\n<p>\u201cThis is called the mismatch negativity test, where you can put people in a scanner and then play the same stimulus \u2013 here we use a beep as an auditory stimulus \u2013 lots of times and then occasionally change it,\u201d said <a href=\"\/\/ftd.neurology.cam.ac.uk\/directory\/tomcope&quot;\" target=\"&quot;_blank&quot;\" rel=\"&quot;noopener&quot; noopener noreferrer\">Dr Thomas E Cope<\/a>, one of the study\u2019s authors at the MRC Cognition and Brain Science Unit and Department of Clinical Neurosciences at the University of Cambridge.<\/p>\n<p>\u201cThen, when you change it, the brain responds to that change.\u201d<\/p>\n<p><strong>Read more about dementia:<\/strong><\/p>\n<ul><li><a href=\"&quot;https:\/\/www.sciencefocus.com\/news\/listening-to-music-with-personal-meaning-may-help-ease-the-symptoms-of-alzheimers-disease\/&quot;\">Listening to music with personal meaning may help ease the symptoms of Alzheimer\u2019s disease<\/a><\/li>\n<li><a href=\"&quot;https:\/\/www.sciencefocus.com\/the-human-body\/exercise-better-than-medicine-for-dementia-patients-with-depression\/&quot;\">Exercise \u2018better than medicine\u2019 for dementia patients with depression<\/a><\/li>\n<\/ul><p>In the test, the change could just be a different pitch of note, or a new rhythm. How the brain responds to this, though, works in the same way as any real-life surprise, like a change of topic mid-way through a conversation, or the room\u2019s furniture being moved around.<\/p>\n<p>In a healthy brain, the response is in two phases. The first correlates with the auditory system \u201cnoticing the sound\u201d, said Cope, while the activity that follows is a different area of the brain recognising the difference. \u201cThe brain reacts when it knows the sound was different. [The brain tells you to] pay attention to it, think about it, see what you need to do with it.\u201d<\/p>\n<p>But in patients with dementia, Cope and the team found a reduction in the second phase. Their brains weren\u2019t telling them that there had been a change, and it was not telling them what to do about it either.<\/p>\n<p>This could be why many people with dementia struggle when unexpected events occur.<\/p>\n<p>\u201cIf people with Alzheimer\u2019s disease are in their home environment and they\u2019re surrounded by things they are used to, they\u2019re alright really. They can muddle along. But then if one day something small changes \u2013 the kettle\u2019s broken, say \u2013 and they need to respond differently, they can\u2019t. They just can\u2019t work out what to do.\u201d<\/p>\n<p>Using magnetoencephalography combined with more familiar MRI scanning, the team showed that this second phase lay in specific areas of the brain, which together make up something called the multiple demand network.<\/p>\n<p>\u201cThese are all the bits of the brain that are much bigger in us than in animals like dogs and rats,\u201d said Cope. \u201cThough our vision cortex and our auditory cortex is about the same as that in a dog, our \u2018thinking bits\u2019 of the brain, the intelligence networks, are the ones that have got massively bigger in us.\u201d<\/p>\n<div class=\"&quot;image-handler__container\" image-handler__container--full=\"\" style=\"&quot;padding-bottom:\" calc=\"\"> <picture><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=300%2C200,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=300%2C200,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=355%2C237,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=355%2C237,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=405%2C270,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=405%2C270,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=554%2C370,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(max-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=554%2C370,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><source media=\"&quot;(min-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=620%2C414,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(min-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=620%2C414,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><source media=\"&quot;(min-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=408%2C272,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(min-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=408%2C272,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><source media=\"&quot;(min-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?webp=true&amp;quality=90&amp;resize=556%2C371,\" https:=\"\" type=\"&quot;image\/webp&quot;\"><source media=\"&quot;(min-width:\" data-srcset=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=556%2C371,\" https:=\"\" type=\"&quot;image\/jpeg&quot;\"><img class=\"&quot;wp-image-113105\" align=\"\" size-full=\"\" image-handler__image=\"\" image-handler__image--full=\"\" no-wrap=\"\" js-lazyload=\"\" data-src=\"&quot;https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2022\/03\/MRI-GettyImages-548557055-0e0e89f.jpeg?quality=90&amp;resize=620%2C414&quot;\" width=\"&quot;620&quot;\" height=\"&quot;413&quot;\" alt=\"&quot;An\" older=\"\" adult=\"\" wearing=\"\" a=\"\" hospital=\"\" gown=\"\" about=\"\" to=\"\" undergo=\"\" an=\"\" mri=\"\" scan.=\"\" title=\"&quot;Researchers\" recorded=\"\" patients=\"\" brain=\"\" activity=\"\" using=\"\" magnetoencephalography=\"\" machine=\"\" in=\"\" conjunction=\"\" with=\"\" getty=\"\" images=\"\"\/><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/picture><\/div><div class=\"&quot;caption-hold&quot;\"><figcaption class=\"&quot;wp-caption-text&quot;\"><span class=\"&quot;caption-copy&quot;\"><i class=\"&quot;icon-arrow\" icon-camera-circle=\"\"\/> Researchers recorded patients\u2019 brain activity using a magnetoencephalography machine in conjunction with an MRI machine (pictured) \u00a9 Getty Images<\/span><\/figcaption><span class=\"&quot;im-image-caption&quot;\"\/><\/div>\n<p>Cope said this multiple demand network has also been shown to be affected in patients with schizophrenia.<\/p>\n<p>\u201cIn dementia syndromes, at least one of the areas in the multiple demand network is damaged or shrunk. Whereas in schizophrenia, they\u2019re not damaged or shrunk, they\u2019re just not connected properly. And we know those patients also have this reduced ability to respond to change. So, I think our results probably explain that as well.\u201d<\/p>\n<p>While there is no treatment that can repair or replace a person\u2019s multiple demand network, Cope said the findings will help patients better understand what is happening to them, and how they can make change easier.<\/p>\n<p>\u201cWhat I say to my patients and their relatives in clinic is: we know that you\u2019re going to struggle, particularly when things change.<\/p>\n<p>\u201cNow that may be as simple as when you\u2019re in the middle of a conversation and then suddenly start talking about something else, and your relative will get lost because they won\u2019t realise that you\u2019ve moved on to a new topic.<\/p>\n<p>\u201cIt\u2019s really important to just recognise yourself whenever there\u2019s a change, and to then signpost that very clearly. Help them through that change. And try to understand why the brain is having a problem with responding to change.\u201d<\/p>\n<p>Cope said he also recommends guiding patients to a more familiar activity when something unexpected happens.<\/p>\n<p>\u201cYou say, OK, the kettle\u2019s broken, but we don\u2019t need to fixate on that. Let\u2019s move on and make some toast or something, because, the toaster is not broken and that might be a routine or something else that they\u2019ve practised.\u201d<\/p>\n<section class=\"&quot;highlight\"><div class=\"&quot;highlight__content\" editor-content=\"\"> <h4>About our expert<\/h4>\n<p><strong>Dr Thomas E Cope<\/strong> is a clinical lecturer and official fellow of Murray Edwards College, University of Cambridge. He teaches neuroscience and psychology, and works with patients with dementia to understand more about the disease\u2019s impact on the brain.<\/p>\n<p> <\/p><\/div> <\/section><\/body><\/html>\n<hr class=\"no-tts wp-block-separator\"\/>","protected":false},"excerpt":{"rendered":"<p>By Amy Barrett Published: Tuesday, 08 March 2022 at 12:00 am The cause of the confusion that people with dementia experience when something unexpected happens could be down to a specific network in the brain. New research has developed our understanding of these neural connections, and will help patients and their loved ones better manage [&hellip;]<\/p>\n","protected":false},"author":24,"featured_media":6920,"template":"","categories":[1],"acf":{"readingTimeMinutes":"5"},"uagb_featured_image_src":{"full":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients.jpg",1200,800,false],"thumbnail":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients-150x150.jpg",150,150,true],"medium":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients-300x200.jpg",300,200,true],"medium_large":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients-768x512.jpg",768,512,true],"large":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients-1024x683.jpg",800,534,true],"1536x1536":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients.jpg",1200,800,false],"2048x2048":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2022\/03\/damaged-areas-of-the-brain-could-explain-confusion-in-dementia-patients.jpg",1200,800,false]},"uagb_author_info":{"display_name":"importmanagerhub@sprylab.com","author_link":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/author\/importmanagerhubsprylab-com\/"},"uagb_comment_info":0,"uagb_excerpt":"By Amy Barrett Published: Tuesday, 08 March 2022 at 12:00 am The cause of the confusion that people with dementia experience when something unexpected happens could be down to a specific network in the brain. New research has developed our understanding of these neural connections, and will help patients and their loved ones better manage&hellip;","_links":{"self":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/rss_feed\/6919"}],"collection":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/rss_feed"}],"about":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/types\/rss_feed"}],"author":[{"embeddable":true,"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/users\/24"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/media\/6920"}],"wp:attachment":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/media?parent=6919"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/categories?post=6919"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}