Jordan Grafman received his B.A. from Sonoma State University in Rohnert Park, California in 1974 and his Ph.D. in Human Neuropsychology from the University of Wisconsin-Madison in 1981. Dr. Grafman then joined the Vietnam Head Injury Study at Walter Reed Army Medical Center in Washington, D.C. as Neuropsychology chief. In 1986, Dr. Grafman became a senior staff fellow at the National Institute of Neurological Disorders and Stroke at the National Institutes of Health. In 1991, he was named Chief of the Cognitive Neuroscience Section, a position he still holds.

Dr. Grafman also is on the faculty at Johns Hopkins University, holds a number of other adjunct faculty positions at Washington area universities, and is a co-principal investigator with the Defense and Veterans Head Injury Program.

Co-editor of the Handbook of Neuropsychology as well as several other texts on the frontal lobes, head injury, and neuroplasticity, Dr. Grafman is the author of over 200 publications. He is recognized for his work on the functions of the human prefrontal cortex, recovery of function following brain injury, and learning and memory.

Jorge Allen asks:
Dear Dr. Grafman,
Does the finding that, "It's as if the two abilities, linguistic and visual-spatial, had to duke it out for space in Michelle's brain- and language won", have any implication for educators? Should we consider depth in favor of breadth, since the brain is anyway going to favor some skills over others? Does this finding give us an answer as to why high school students tend to not master the basics despite seemingly being so sophisticated with computers, and other technological gadgets?

Grafman's response:
Our genes assign to our brain all the functions we normally think of as being associated with humans: memory, language, reasoning, motor skills, and planning. Genes also code, more or less, where in the brain these functions reside. The exact location is consistent across individuals and cultures. Environment and education play an important but smaller role in influencing the exact location and prominence of these functions in the brain. I think that the education system generally needs to offer breadth of curriculum until the rest of the environment -including parents and friends - influences the student to focus his or her talents. Then depth of knowledge becomes very important. There is no doubt that specializing in some skills will have some cost on the brain representations of other functions. In most normal people the cost can be negligible, but in patients it could be significant. It is the rare person, like Leonardo Da Vinci, who can specialize in so many skills that cut across disciplines to such a degree that the person significantly contributes to each discipline he or she has an interest in. As a society, we have a contract with individuals not to be so rigid in training them into specialty areas until they are more mature. In the past, such premature vocational assignments led to rigid class distinctions in education (and subsequent societal privileges) in other countries. Some countries still require a professional specialization like premedical training to begin as early as 15 or 16 years of age.

Robert asks:
My question pertains to brain damage from drug use. I decided to get sober 2 years ago. I was wondering how I can assess the damage and possibly do exercises to strengthen or rewire my brain. I'm 31 now and from ages 16 to 29 I was a habitual drug user. I had some positive effects from a prescription antidepressant, but now I feel there might be more I can do to to help recover a bit more brain power. I remember the classes at my hospital said drugs take a toll on the frontal lobes. If there is any help or reading suggestions, it would be much appreciated. Thank You, and the show is very fascinating.

Grafman's response:
The National Institutes on Drug Abuse (http://www.nida.nih.gov/) and Alcohol Abuse and Alcoholism (http://www.niaaa.nih.gov/) each have www sites that contain information pamphlets describing the short and long-term effects of various legal and illegal drugs on the brain. There is no doubt that many illegal and legal drugs, if used often and for a long time, will have a negative long term effect on the functions of the frontal lobes resulting in loss of insight, poor planning, reasoning, problem-solving, and social behavior. Since many drugs affect the same brain systems that usually become activated in response to rewarding experiences, the drugs also compete with those experiences in inducing pleasure and often overwhelm the pleasures that come from relationships, art and music, eating and similar activities. It is good that you are questioning the use of the drugs you have been using. That is an important step to changing your behavior, but the changes require that you stop taking the drugs and integrate back in a normal life so your brain reward systems can respond to the usual stimuli that activate them like the taste of chocolate or a close loving relationship. It is possible to reverse the effects of certain drugs on the frontal lobes but you must act now to do so.

Andrew Howe asks:
If I'm not mistaken, you said that the brain may be in a way 'competing' with itself for processing space. When it comes to capacity for memory and processing, do you think that choosing some activities over others may result in a trade-off in how strong your brain is in certain types of analysis or in performing tasks? If for instance, I were to spend half of my life playing video games, do you think my aptitude to adapt and respond to certain types of stimuli and complex situations might be altered? Is there evidence that the brain ever stops 'learning new tricks' or being able to adapt?

Grafman's response:
Neurons can adapt throughout their lifetime. However, most of the functions that we consider human - like reasoning - depend upon networks of neurons. When the networks are sparsely populated -as can happen during aging - it can restrict our ability to learn new kinds of information or skills. Not that we can't learn them at all, but it may take us longer or we may not become quite as refined in the skill as younger persons.

What happens when you play a certain kind of video game a great deal? You may become very good at playing that game. Let's imagine that playing this game required visual perception, visual attention, language comprehension, motion detection, motor control, and thematic understanding. Of course, we use all these functions daily for many different tasks, including playing video games. The key would be how repetitive the video game was and how often you played it. If the video game had a few cognitive requirements with little thematic processing, that would diminish your general ability to develop a thematic understanding of events as they unfold in real life. If you are processing motion on a computer monitor, that is very different than processing motion when you engage in a team sport such as ice hockey. These are costs and balances in participating in any activity-a sort of brain ledger.

Usually, we balance out our experiences so the costs appear minimal if you engage in a favorite activity. A significant effect might occur only if your game playing exceeded normal use. Because these kinds of real-life situations are rarely studied in a brain research laboratory setting, we don't know the range of situations in which plasticity trade-offs of varying significance occur.

Mark Falge asks:
Dear Dr. Grafman, Fascinating work! I was curious regarding the last segment 'The Power of Half'. I thought that certain centers of the brain were basically defined for certain functions and that if those areas were damaged then those functions could not be performed. In the last segment it seemed that these damaged areas were recreated in an undamaged area. Is that correct? If so, what part of the brain is responsible for directing the recreation of those areas on the undamaged side? Is there a blueprint somewhere in the brain of the brain that decides that these high priority functions need to be duplicated? DNA in every cell? Just curious. Thank you,

Grafman's response:
You are right that each sector of the brain has its own functional responsibilities. Here is where it gets tricky. For almost every task we can think of, there is more than one way to accomplish it. Say for example, you want to go from home to work. You can look at the street signs along the way or you can determine where to turn by noticing the shape or size of buildings along the route. Either strategy gets you to work. If brain damage destroys tissue that stores just one of the strategies, you can use the other to find your way to work. Now you may be a bit slower in getting there, but get there you shall.

In that sense, the old functions that resided in the damaged areas don't simply re-appear in the other hemisphere, you just learn how to use intact strategies to compensate for the impaired processes. On the other hand, it is possible that more than one function resides in a specific brain sector with the secondary functions redundant with those in the hemisphere that was damaged. Normally they might be inhibited, but with the brain damage they are released from the inhibition and now they wind up sharing cortical space with the functions that are normally there. They may not work quite as well as the functions usually stored in the damaged part of the brain, but they may work sufficiently well to help people a bit in their daily activities (sort of a spare-tire idea). There is not much evidence for this latter kind of plasticity at the moment.

Finally, in infants and children, there is a sequence in which certain functions become mature and stored in various sectors of the brain. So if a very young child or infant has brain damage, the cortex treats learning on a first-come, first serve basis. This developmental process is not haphazard as cognitive functions tend to wind up in the brain where they usually appear or almost exactly where they would have appeared in the damaged hemisphere-except now they are on the other side of the brain. Eventually the cortical space gets crowded and you are limited in subsequent learning. The exact order of cognitive processes stored depends partly on the demands the world places upon you (education, the home, parents, siblings, friends and the rewarding value of you responding to those demands) and your genetic predisposition.

Kyle Patton asks:
Dr. Grafman, Interesting piece. I saw in your section of FRONTIERS that when half of Michelle's brain was removed she retained the ability to speak (as you know, the ability moved). My question is what in the body (i.e. force, drive) caused the linguistic ability, or any ability that moved to occur, and where does this ability reside (brain stem, DNA or..)?
Thanks,
Kyle

Grafman's response:
Your brain is a complicated piece of machinery. It is subdivided along cognitive processes with each brain sector supporting a specific cognitive process. Most general functions we recognize-everything from eating to reasoning about a physics problem- tend to engage a subset of the brain sectors and cognitive processes. The exact sector in the brain where these cognitive processes are stored along with the exact nature of the cognitive processes we have inherited is a partnership between nature and nurture. Your experiences help shape your brain and your genes reflect that shaping so that over generations your experiences can mold the genetic information that is passed on. Each part of your brain supports specific functional processes from the brain stem (more primitive functions like sleep and wakefulness, breathing) to the cerebral cortex (highly evolved cognitive processes like reasoning and social cognition). These processes and functions are represented in the brain at the network level - scores of neurons devoted to a particular brain process that is housed in a particular brain sector. Of course each neuron had to be genetically programmed to function within a network of neurons in a particular brain sector and each neuron has a set of genetic instructions that it obeys to migrate to that sector of the brain from the area in which it was created.

Caleb asks:
Why is the frontal lobe so important in humans?

Grafman's response:
The prefrontal cortex is the crowning achievement of the human brain. The cognitive processes stored there help us plan, reason, problem-solve and really distinguish us from other primates like monkeys and apes. Another way to value the role that the prefrontal cortex plays in daily life is to observe what happens to people when the brain is impaired by brain damage or a dementia.

For example, there is a form of dementia called frontotemporal dementia (also known as Pick's disease). This progressive neurological disease strikes people between 50 and 70 years old primarily, and people generally pass away from this disease after about 6-8 years after diagnosis. Frontotemporal dementia ravages the frontal and anterior temporal lobes. Often the first symptoms the patient with this diagnosis shows are changes in appropriate social behavior (people begin to break social rules and disobey social norms out of character with their past behavior) or demonstrate problems in executing planned behaviors. These changes in behavior are different than the severe memory deficits and other impairments seen in other dementias such as Alzheimer's disease and are due to damage to neurons in the frontal lobes. Unfortunately, there are no medications to treat frontotemporal dementia.

Our ability to forecast the future and the consequences of our present behavior on the future is governed by our frontal lobes. It is the essential ingredient in our cognitive make-up that gives us an advantage over stronger or faster predators. This is why it is so important to us as humans to understand the functions of the frontal lobes.