Michael Nilsson is a brain researcher at Sahlgrenska University Hospital and is based at Högsbo Hospital. He is researching the impact of culture, environment and physical activity on the ability of the brain to recover after injury or disease.
The initiative for this research came from Michael himself, together with his former colleague and friend Peter Eriksson and Christian Blomstrand, and relates to sensory stimulation for the nervous system for rehabilitation purposes, which may be of significance for people around the world.
“We wish to create a rehabilitation environment that provides the best possible conditions for recovery of function in the brain, and this exciting research has only just begun," says Michael, with ardent belief in the future.
Culture and health
Throughout the ages, people have had an inherent need to engage in various types of cultural activities and have surrounded themselves with culture, in all its forms. This may be anything from cave paintings to dance, music, art, taste or rhythm, and it is from this cultural setting that the brain receives the stimulation it craves. Culture is probably something the brain has always needed and looked for, and Michael, together with his research team, now intends to find out how this affects the brain.
Photo: Helene Davidsson
The researchers also work with the families of patients who have suffered brain injuries by informing them, boosting their morale and reassuring them in their roles as family members and helpers in the rehabilitation process. Insecurity and a non-stimulating environment result in negative signals to the brain about how we experience the situation. If family members, for example, can contribute to patients receiving signals that make them feel reassured, this will result in quicker and better rehabilitation.
Another level of the research is to study the direct impact of various ambient factors on the brain. Studies of rats with stroke have provided very clear results regarding the impact of a positively enriched environment. Sensory stimulation of various kinds may also affect the brain preventively via the brain´s plasticity, i.e. its ability to change or reshape itself.
Photo: Helene Davidsson
“Nerve pathways and new networks in the brain can now be stimulated in various ways, which provides hope for the future. The brain is stimulated, for example, by the environment and cardiovascular training (raised pulse) working together, and this may be important to cognitive rehabilitation," he continues.
Part of the research grant of SEK 20 million from the Sten A. Olsson Foundation for Research and Culture which was received in 2008 is to be used to acquire in-depth knowledge of how the brain is affected by various types of sensory stimulation, primarily dance, rhythm and music. Danish studies show, for example, that music reduces complications when patients who have been under general anaesthetic regain consciousness. Finnish studies show better results in the rehabilitation of stroke patients when they listen to music they have chosen for themselves than if they listen to audio books, for example.
They employ special imaging techniques to study how different types of sensory stimulation affect the brain. This is then combined with clinical and neuropsychological tests.
Top quality
Commission on Accreditation for Rehabilitation Facilities (CARF) is a non-profit organisation that grants accreditation for work in the area of rehabilitation. Last summer CARF reviewed activities in rehabilitation medicine at Sahlgrenska University Hospital focused on injury to and diseases of the nervous system. Only a small number of clinics in Sweden have been reviewed by CARF, and no clinic covering the whole spectrum from rehabilitation after the acute phase to vocational rehabilitation has previously been reviewed. The outcome was the highest possible marks for the whole organisation.
“We are positioning ourselves as a strong research centre where basic research meets clinical research and application. CARF gave us an important stamp of quality, which gives all the staff a boost in the work they do. We have also received Sahlgrenska University Hospitals quality prize and we are nominated for other quality awards, but these have not yet been decided," says Michael.
Photo: Helene Davidsson
Transcranal magnetic stimulation (TMS) has recently started to be used in the research by Michael and his colleagues. This works by magnetic impulses being sent to various parts of the brain to stimulate the brain cells and their various connections in networks and pathway systems. TMS has been successfully used for example in the treatment of depression, epilepsy and pain, and the possibility of the method being used for preparatory treatment in various rehabilitation programmes for people with brain injuries is now being examined. The method is non-pharmacological, which in some cases may make it more cost-effective than methods involving chemical substances.
“We believe in a combination of different methods of treatment in the future, in which medicines can be combined with modern rehabilitation methods. At present there is, however, no medicine in clinical application that stimulates healing and return of function to the brain," says Michael.
Stem-cell research and the legacy of Peter Eriksson
The stem-cell research started by Professor Peter Eriksson is now being taken forward thanks to several highly skilled research leaders and research teams at the Centre for Brain Repair and Rehabilitation (CBR). Cooperation also takes place with several research institutions around the world.
“The researchers in this team are strongly placed internationally and have had many highly regarded studies published in the field of neural stem-cell research," says Michael.
//Sandra Nordström
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