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The basic cause of dyslexics' temporal processing impairments is
probably
a congenital mild impairment of the development of magnocellular
neurones;
so I am collaborating with Prof. Tony Monaco (Wellcome Inst. of Human
Genetics)
to find out whether they are linked with genes known to be associated
with
neurodevelopmental problems. With Prof. Angela Vincent (Inst. Mol.
Medicine)
I am also attempting to find out whether antibodies may attack
magnocellular
neurones during foetal development.
In addition I collaborate with Mr T. Aziz FRCS (Neurosurgery), Prof.
M.Glickstein (UCL) and Prof. A.
Gibson
(Barrow Neurological Inst., Phoenix, Arizona) on the role of the
posterior
parietal cortex, basal ganglia and cerebellum in the control of
movement. In patients with movement disorders such as Parkinson's
disease (PD) we insert stimulating electrodes in the movement control
network from which we can record large low frequency (4-15 Hz)
field potentials that correlate with the patients' involuntary
movements. Deep brain stimulation there can stop
these
oscillations and thus greatly improve the movement
disorders.
Also we have recently discovered that an upper brainstem nucleus, the
pedunculopontine nucleus (PPN), is very important in
controlling
proximal muscles for posture and locomotion; this area is
over-inhibited in many patients, which is a major cause
of their inability to move, akinesia.
We have found that we can overcome this inhibition by stimulating the
PPN directly and can thus return previously chairbound patients to a
useful life.
In patients with intractable central neuropathic pain the pain seems
to be caused by spontaneous oscillations in the 'central pain matrix'
(periaqueductal, periventricular grey (PAG/PVG), globus pallidus,
thalamus, anterior cingulate, insula, orbitofrontal
cortex).
We have found that if we drive the PAG/PVG by stimulating at c.10 Hz we
can eliminate the oscillations and reduce the patients' feelings of
pain
very considerably. This stimulation also changes autonomic
function; and the degree of pain reduction correlates strongly with the
degree of blood pressure reduction that we achieve.
It seems likely that negative mood swings may also be associated with spontaneous uncontrolled oscillations in the limbic system; hence we may be able to use stimulation of the anterior thalamus or cingulate cortex to relieve intractible depression
Teaching and Administration
I
continue
to enjoy tutorial teaching very much and will defend this to the last
because
I believe that it is the best way to teach. I believe strongly
that
the benefits of Oxford's tutorial teaching should be made available to
all those
with the ability to benefit from it, irrespective of income, class,
colour
or creed (despite Chancellor Gordon Brown's allegations of my 'elitism'
over the Laura Spence affair!). I have also tried to relieve the
load of rote learning endured by medical students during their
preclinical
course; the course should emphasise only what is important for
clinical
medicine, and encourage students to go into greater depth only in areas
which really interest them. Thus we must preserve the strengths of the
final Honours course in which students can specialise in what they find
most interesting. Our job is to teach students how to teach themselves,
to think clearly and logically and to evaluate evidence critically,
without
being overburdened with memorising facts.
University and College administration takes up more and more wasted
time. The current climate of 'accountability', lack of trust in
people's commitment to do their job conscientiously, has spawned
a proliferation of forms to fill in that nobody reads. I fill in
as few as I can get away with!
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Neural Basis of
Dyslexia |