1. In search of a brain-health index

For Pascual-Leone, a healthy brain “has the necessary network of connections to enjoy a full life.” And this network, like the needs it responds to, changes over time. “It’s not about having a 17-year-old brain in a 90-year-old body. It’s about having the best, healthiest brain possible at any age,” says the neuroscientist.

One of the intrinsic properties of the “most important organ of the 21st century”, in the words ofMontserrat Bernabeu, head of the Acquired Brain Injury Unit at Institut Guttman, is plasticity: its ability to adapt to changes around it, whether environmental or due to illness, by modifying its structure (and its functional capacity) based on experience. Pascual-Leone’s hypothesis is that extreme changes in this ability may be the cause of mental illnesses like autism and schizophrenia and that one way to treat these conditions would be to modify this capacity for plasticity using non-invasive brain stimulation techniques such as transcranial magnetic stimulation.

In addition to any possible conditions a person may develop, the brain’s capacity for plasticity also changes naturally over time and, along with it, so does their cognitive ability. Therefore the aim is to learn about these changes in order to boost or direct them to benefit individuals and their health. According to Pascual-Leone, it is important to have reliable measurements of brain health for each age and individual and include them in medical check-ups. “Just like we measure blood pressure or monitor diabetes, we need an objective index of brain health,” he says. 

Technological momentum

Thanks to advances in the fields of neuroimaging, robotics and informatics, neuroscience has changed radically in recent years. “To understand how our brain works, we have to study how it interacts with the world around it. A still snapshot of a moment in time isn't enough,” explains Gustavo Deco, ICREA researcher at Pompeu Fabra University.

Deco studies how the brain behaves in silico, using computer models. The greatest advantage is being able to analyze disturbances that it wouldn’t be ethical to test in humans or animal models because their effects are not yet known. “We’re still in the experimental phase but we can already do computer simulations of how a specific person’s brain works and try to improve plasticity by stimulating specific regions,” says Deco.

Computers also allow us to manage an enormous amount of information (big data) in the two large neuroscience projects currently underway: in Europe, The Human Brain Project, and in the United States, the BRAIN Initiative. These two initiatives have different approaches but, according to Richard Frackowiak, professor at the École Polytechnique Fédérale De Lausanne (Switzerland), “They will revolutionize how we understand neuroscience in a magical way.”

New technology is also having a huge impact in the field of rehabilitation, where advances in robotics are moving millions of dollars every year. “We’ve shown that the benefits of robot-assisted rehabilitation last even after the treatment has ended,” explains Hermano Igo Krebs of the Massachusetts Institute of Technology (USA). “In the United States, robotics therapy isn't any more expensive than the standard treatment over 36 weeks.”

So far the results of using robotics has been very positive in terms of improved mobility of the upper limbs, but not so much for the lower limbs. Krebs and his team have invented a new approach for the latter. “Our latest ‘toy’ is called MIT-Skywalker and it changes the paradigm on how to improve leg mobility,” he explains.