Progress in Brain Research

No abstract text is available yet for this article.

This chapter illustrates that cranial surgery was not limited to Europe. There was however no contribution to improving knowledge outside Europe until medical science departed for the Arab world.

Unlike previous chapters, this is not about the teachings of a specific individual. Rather, it traces the slow changes in milieu and practice in the centuries following the death of Galen. They were to be profound. The Roman Empire fell in the middle of the 5th century. The Christian religion became increasingly dominant in the west, not only in spiritual matters but also in every activity related to culture and learning. The Byzantine Empire became increasingly important in the east. Islam was founded and began to spread in competition with Christianity...

Over the last 50 years the significance of Galen's contributions to the arts of medicine and surgery have been increasingly recognized. Despite his errors, his contributions to medical and surgical practice have been profound. In the present context, his teachings on cranial surgical instruments and technique would continue to be influential throughout one and a half millenia. His technical advice was sound. His error about the anatomy of blood vessels supplying CNS were not of much consequence since the CNS would remain surgically inaccessible until the end of the 19th century...

Celsus gave an adequate description of the bones and sutures of the calvarium. His classification of injuries was simple including fissures and depressions. He is the first to relate specific symptoms to specific tissue injury. In addition, he was aware that fractures could be present in the absence of typical findings. He was also the first to note the meningeal vessels could rupture producing severe localized pain. His treatment was more conservative than that of Hippocrates. Plasters were to be used and if there was no deterioration trepanation was avoided...

This brief chapter has a single purpose which is not directly related to cranial surgery. However, between Hippocrates and Celsus and Galen a number of improvements in the understanding of anatomy had been discovered and this chapter briefly outlines the nature and importance of these advances.

The chapter begins with a review of some of the background thinking during Hippocrates time. The brain was considered to be the location of the soul which was the essence of subjective experience. However, this was not a brain function as such but rather a location where the pneuma reacted with the soul. Hippocrates' monograph on cranial trauma begins with a description of the bones and sutures. He then systematized the classification of cranial injury. He sensibly advised accurate diagnosis into one of the types of injury he described and supported extension of any skin opening to facilitate diagnosis of the bone, the injury of which was his primary concern...

Humankind demonstrates boundless curiosity, mostly expressed through the activities of a small number of individuals, whose achievements affect all members of society. The extent and distribution of pre-historic trepanation and trepanation in contemporary unsophisticated societies are reviewed. In the great majority of cases the intention of trepanation has been therapeutic, even if the understanding of underlying pathophysiology is not the same as that which scientific societies now accept. This review demonstrates variation in surgical technique...

At the end of the late Middle Ages, there had been changes in indications for surgery, with prophylactic trepanation falling out of favor. The management of wounds and the methods for opening the cranium had become fairly standardized. Narrow non-plunging trepans were the preferred drills, and cranial openings were widened by the use of multiple drill holes connected with chisels of which the lenticular was preferred. Concerns about damaging the dura led Theodoric to delay trepanation until the clinical changes reflected separation of the dura from the cranium, at least in his view...

The larger part of this chapter is concerned with the technique of drilling the cranium with a circular saw called a trepan or trephine. The terminology of the instrument is outlined. Safe use of the instrument includes probing the groove produced by its use and angling the drill so that it impinges on bone which hitherto has not been sawn through. There is then an account of how larger openings may be made by drilling multiple small holes and connecting them by means of a chisel.

The period described in this chapter reflects activity prior to the establishment of surgical centers in Europe in the twelfth century. It is a kind of prologue to the reintroduction of high-quality surgical practice. Religious squabbles within Christianity led to European medicine and surgery, the principles of which were written in Greek, being transported eastwards into the region newly dominated by Islam. There the works were translated into Arabic and during three to four hundred years, the works were not only retained but were enriched by contributions from within Arab culture...

The chapter reviews certain topics in outline. It starts with a brief account of the nature of surgery. This is followed by a short account of modern management of cranial trauma including the evolution of notions of anatomy and pathophysiology. It is emphasized that these principles are and must be irrelevant to the management of cranial trauma in the period covered in this book from Hippocrates to the end of the 18th century. Historical errors arising from assuming modern principles applied in historical practice are mentioned...

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There is a well-recognized, yet nuanced, positive relationship between acute physical activity and cognitive function. However, the precise impact of exercise intensity remains ambiguous. We tested learning and memory, working memory and processing speed, and motor speed and accuracy across three distinct exercise intensities. A sample of 207 participants (100 female) between 18 and 44 years (mean age: 22.5±3.7years) completed all study procedures. Utilizing a within-subjects, cross-over design, participants completed moderate (35% VO2 Max), vigorous (70% VO2 Max), and sedentary (no exercise) conditions...

There is a relationship between acute bouts of aerobic exercise and cognition in adults, yet the exact nature of this relationship remains unclear. The current pilot study aims to investigate how different modes of cycling (active-assisted cycling vs recumbent cycling) at different moderate-to-vigorous physical activity (MVPA) intensity levels (prescribed 65-70% Heart Rate Max and self-selected 12-13 Rate of Perceived Exertion) modulate neurocognitive, and behavioral markers of cognition in healthy older adults...

An increasing number of studies have linked engagement in sport or increased physical fitness with improved cognitive performance. Additionally, studies have employed physical activity as an intervention to help with cognition in aging individuals. Despite this, the underlying mechanism (or mechanisms) by which benefits occur remain unclear. We investigated whether improved trainability for individuals engaged in sport or fitness training might underlie such benefits. Specifically, we assessed motor skill performance and learning rates in young adult runners, baseball players, and "control" individuals who did not regularly engage in sport or exercise using an implicit motor sequence learning task...

Physical activity has been viewed as a potential non-pharmacological therapeutic strategy to improve the clinical symptoms and neurocognitive deficits in patients with schizophrenia. However, there are various types of physical activities, and different exercise prescriptions might produce inconsistent benefits. Thus, this study aimed to conduct a systematic review of exercise interventions for patients with schizophrenia, clarifying the benefits of these interventions on cognitive function and clinical symptoms...

Physical exercise confers numerous benefits to brain structure, function and cognition, however, considerable individual variability exists in these effects. Emerging paradigms focused on intraindividual dynamics provide novel opportunities to map and leverage individualized neural architectures underlying exercise-cognition relationships. Progress at the intersection of psychometrics, structural and functional neuroimaging, electrophysiology, and genetics can be integrated to elucidate each individual's potential for improvement, as well as the specific abilities that are most likely to benefit from exercise regimens...

The literature suggesting acute exercise benefits cognitive function has been largely confined to single cognitive domains and measures of reliant on measures of central tendencies. Furthermore, studies suggest cognitive intra-individual variability (IIV) to reflect cognitive efficiency and provide unique insights into cognitive function, but there is limited knowledge on the effects of acute exercise on IIV. To this end, this study examined the effects of acute exercise on three different cognitive domains, executive function, implicit learning, and hippocampal-dependent memory function using behavioral performance and event-related potentials (ERPs)...

Prior research has highlighted the potential impact of aerobic exercise on cognitive functioning, particularly in situations demanding heightened cognitive control. However, the mechanism underlying this cognitive enhancement has remained unknown. To address this issue, this study examined the impact of a 4-week aerobic exercise program on cognitive control processes in young male adults (aerobic exercise group: n=36, aged 21.42±1.13years) in comparison to a control group that received no treatment (n=33, aged 21...