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With goggles, 'split-brain' theory comes into focus
By Ellen Barry, Globe Staff, 4/2/2002
http://www.boston.com/dailyglobe2/092/science/with_goggles_split_brain_theory_comes_into_focusP.
shtml
For years, as the age of psychoanalysis gave way to the age of
neurobiology, Frederic Schiffer has labored alone on an idea about the
brain.
In his Newton office, he would fit patients with odd-looking wraparound
goggles blocking light completely from one side. With vision stimulating
first one side of the brain and then the other, he would explore
differences that emerged. He would set up left-brain-right-brain
dialogues he describes as ''couples therapy.'' Sometimes he called the
hemispheres by different names, and told them not to pick on each other.
His colleagues, he said, tended to ''stand off and snicker.''
''The goggles just are unappealing to academics,'' said Schiffer, an
associate attending psychiatrist at McLean Hospital in Belmont. ''They
think they're kind of weird.''
But new research shows that Schiffer's results bear some striking
similarities to results for a promising new treatment for depression.
Patients who felt happier when Schiffer's goggles forced them to look
right were also more likely to improve when their left brains were
''tickled'' by a magnetic pulse, according to a new study by Schiffer
and Alvaro Pascual-Leone, a researcher at Beth Israel Deaconess Medical
Center, published in the March issue of Neuropsychiatry,
Neuropsychology, and Behavioral Neurology.
And, while Pascual-Leone cautions that the correlation between his own
results and Schiffer's was more a ''tantalizing curiosity'' than a
breakthrough, he said the links were strong enough that Schiffer's
goggles deserve more research.
Brain researchers have explored the split between the brain's two
hemispheres for hundreds of years. In the 1960s, Roger Sperry observed
patients whose nerve fibers had been severed, separating the two
hemispheres completely, and began sketching which side controlled
particular cognitive tasks. The left side, they concluded, seems to
house language skills, analytical and categorization tasks; the right
has been widely associated with novelty, creativity and sometimes
emotion.
By the 1980s, motivational speakers and pop psychologists urged people
to draw - or cook, or manage employees - using their repressed right
brain.
The stark right-brain, left-brain dichotomy has been dismissed by most
scientists as simplistic quasi-science, but neurologists have never lost
interest in ''laterality'' and whether an inbalance can lead to
psychiatric symptoms. Electroconvulsive therapy, regarded by some
psychiatrists as a very effective treatment of depression, is frequently
used on a single nondominant side of the brain in order to stimulate it
into activity.
Schiffer's research falls distinctly outside the norm, though. Not only
does he believe that one hemisphere of the brain can be more active than
the other, he believes that they house separate personalities that
sometimes wage a battle for dominance. Seven years ago, he brought this
theory into practice by intentionally stimulating one side of the brain
during a therapy sesssion.
In about 30 percent of subjects, he reported instantaneous dramatic
results: With goggles blocking light on one side, and then flipped
around to block the other, the patient would report completely different
emotions and perceptions. Gradually, Schiffer concluded that many of his
patients had one underdeveloped personality that resided in one
hemisphere and could be treated intensively when the subject was wearing
the goggles. By stimulating the healthier half, he thought it was
possible to alleviate depression.
''What I think is useful to me as a clinician is the concept of an
intact, immature mind,'' he said. ''It's not just an id, it's a real,
live person you can relate to.''
Schiffer presented his theory in his 1998 book ''Of Two Minds: The
Revolutionary Science of Dual-Brain Psychology,'' and was featured on
the TV news magazine ''20/20'' - but to his disappointment, the work
failed to attract other researchers. He knew that it had not been
submitted to the rigorous, randomized double-blind studies that bring
new techniques into the mainstream. But he did not expect attacks from
critics like Emory University psychology professor Scott Lilienfeld, who
complained angrily to ''20/20'' that goggle therapy was ''entirely
unsubstantiated as a psychological treatment'' and should not be widely
disseminated.
''It sounds simplistic. People don't like simplistic,'' said Marcel
Kinsbourne, a professor of cognitive studies at Tufts University. ''It's
done clinically in his office in Newton. When it was presented, it was
done very casually. That doesn't mean it's not right.''
Meanwhile, prestigious laboratories were investigating brain laterality.
There was increasing excitement about transcranial magnetic stimulation,
or TMS, in which a pulsed magnetic field is passed from a hand-held coil
through the skull to stimulate electric activity in the brain. Painless
magnetic fields focused on the frontal lobe are said to have
antidepressant effects similar to electroconvulsive therapy. Approved as
a depression treatment in Canada, Israel and parts of Europe, TMS is
still a ''nonestablished method'' in this country, said Pascual-Leone,
who had researched the technique in Spain before moving to Boston.
Certain that the effects of TMS on one hemisphere would mirror the
effects of visual stimulation, Schiffer dropped off a pair of his
goggles to Pascual-Leone's office five years ago. He made this
prediction: Subjects who responded strongly to left-side visual
stimulus - meaning their right brain was activated - would also respond
to right-side TMS.
Pascual-Leone tested the glasses on 37 depressed patients, and found
that 20 reported an improved mood when stimulus was directed to their
left brain, and 15 felt worse. After two weeks of TMS, the first 20 felt
42 percent less depressed, as measured by the Hamilton Depression Rating
Scale. The second 15 reported a much smaller improvement of 11 percent.
''I was actually surprised to see it,'' said Pascual-Leone. ''Of course
it is exactly the prediction Fred Schiffer could and did make.''
As interesting as the corellation is, Pascual-Leone said, it's
''difficult from a physiological point of view what it means'' until one
method or the other is more thoroughly tested.
Schiffer said he hopes that the correlation will finally attract
researchers to his thesis - and popularize the use of goggles in
therapy. But he knows, from years of trying, that launching a new idea
will always be an uphill battle.
''I got a call last week from someone who gets good results with a
colored strobe light,'' Schiffer said. ''I'm busy, I don't have time to
pursue it. You have to have some really compelling notion to pull people
away from their own work.''
Ellen Barry can be reached by e-mail at barry@globe.com.
This story ran on page C7 of the Boston Globe on 4/2/2002.
© Copyright 2002 Globe Newspaper Company.
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