The Potential of Gesture to Improve Understanding and Recall in People with Communication Difficulties

        Co-speech gestures are a fundamental part of communication that can support a verbal message by supplying additional information or reinforcing important details. Research suggests that the use of co-speech gestures can improve understanding and recall in listeners with communication difficulties, such as those associated with autism spectrum disorder (ASD) or trouble with language comprehension. Many factors influence how beneficial a gesture can be including its clarity, timing, and semantic relationship to spoken words. How much attention is directed towards the gesture is also an important factor in determining its effectiveness.

The article “Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism” by Zielinski & Wakefield (2021) examines how language proficiency affects the degree to which gesture improves understanding. Polish-English bilingual children listened to narratives in both their stronger language, English, and weaker language, Polish. After each story, the children were asked to retell what happened to measure their understanding. The results showed that matching co-speech gestures, but not gestures that provided additional information, improved recall for the narrative told in their less proficient language. An analysis of eye-tracking data showed that more visual attention was directed to co-speech gesture during the Polish narrative than in the English narrative. The researchers theorized that the children focused more on the gestures when it was harder to understand the story because the motions could be used to supplement the spoken message. Since very little visual attention was directed toward the gestures when the narrative was in their first language, it was proposed that co-speech gesture could have improved the children’s ability to retell the English story if they had focused on the gestures more. This study demonstrates how gesture can improve a person’s understanding of a message especially when their language skills are not as advanced. 

Though language proficiency does influence people’s ability to understand spoken narratives, communication differences also have an effect. Research conducted by Dargue, Sweller, & Carter (2021) investigated whether or not gesture could enhance learning for people with autism. A significant characteristic of ASD is difficulty with social interaction caused by a different understanding of interpersonal communication. Existing research suggests that these communication differences can cause issues with learning and recall. This study involved children diagnosed with autism watching two narrative videos, one without gesture and the other with iconic gestures. After each video, they were asked questions to assess their memory of details in the narrative. It was found that iconic gestures, which represent clear, definite actions, events, or things, improved recall. Since this type of gesture is closely associated with the meaning of the dialogue it relates to, it can clarify any potentially ambiguous speech and help people with autism better understand the message which would improve recall. These results indicate that gestures reinforcing the meaning of spoken words can make it easier for autists with communication differences to learn and recall information that is expressed verbally.

        The studies done by Zielinski & Wakefield (2021) and Dargue et al. (2021) both demonstrate that co-speech gesture can improve understanding and recall. Both experiments had small sample sizes so larger research studies need to be done to ensure that these findings are more widely applicable. Though further investigations are necessary, the use of gestures, particularly those that clarify the meaning of spoken words, has the potential to improve learning outcomes for people with communication difficulties.

Sources:

Dargue, N., Sweller, N., & Carter, M. (2021). Short report: Learning through iconic gesture in autism spectrum disorder. Research in Developmental Disabilities, 115, 104000. https://doi.org/10.1016/j.ridd.2021.104000 

Zielinski, N., & Wakefield, E. M. (2021). Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism. Proceedings of the Annual Meeting of the Cognitive Science Society, 43.

Exploring The Effect of Co-Speech Gesture, Language, and Gesture Reproduction on Memory

         

Over time, gestures have been commonly used in addition to speech in order to aid in communication. It has been shown that co-speech gestures support long-lasting and flexible learning. The 2021 article titled “Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism” discusses the effect of co-speech gesture on communication and furthers the idea that it does, in fact, promote memory recall. The purpose of the article was to explore whether a listener’s proficiency in a particular language affects their ability to recall information that was presented to them through a combination of speech and gesture. The 2017 article titled “Make Gestures to Learn: Reproducing Gestures Improves the Learning of Anatomical Knowledge More than Just Seeing Gestures” expands on the role of co-speech gesture, adding that not only does viewing gestures during learning aid in memory recall, but performing gestures during learning does as well, and perhaps to a greater extent.

In the article, “Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism,” bilingual children were given narratives along with co-speech gesture both in their stronger languages and in their weaker languages. Their ability to attend to gestures while being exposed to narratives in their stronger versus weaker languages was measured. Then, these children were asked to recall the narratives. The results showed that children appeared to learn more from gestures when recalling weaker languages as opposed to stronger languages and that a possible reason for this is greater attention to gesture when processing a language that they are not as familiar with.

Similar to this study, the article “Make Gestures to Learn: Reproducing Gestures Improves the Learning of Anatomical Knowledge More than Just Seeing Gestures” also highlights the ability of viewing a co-speech gesture to enhance learning and memory retention, but it adds another aspect of gesture that greater assists this process: gesture reproduction. In the article, groups of participants were asked to watch a video lecture on the anatomy of a forearm. The model in the video made gestures that were related to the content. One group of participants was asked to both watch and imitate the model as they were taking in and processing the information. The second group of participants, however, was only asked to watch. The results of this study were that imitating gestures did improve participants’ recall of the locations and names of structures in the video, which suggests that activating the motor system during the learning stage of a memory can aid in memory consolidation and retrieval. Interestingly, the only significant results of the study occurred when long-term assessment were made. The article comments on the role of sleep in this process, stating that sleep can improve memory over time, as it allows for a reactivation of memory traces, which is further enhanced when procedural memory is involved. Although the first article did not discuss the role of procedural memory specifically, both articles agree that co-speech gesture enhances learning and memory in general, and that this seems to be more effective in children.

Connecting the findings of both articles, both viewing and mimicking co-speech gestures appears to aid memory recall, and effectiveness of gesture appears to be influenced by language proficiency. Therefore, an implication of both articles could be that proficiency in a particular language might also influence effectiveness of gesture mimicking. It is possible that individuals remember more information when they reproduce a gesture that is used in addition to spoken information in their weaker languages as opposed to their stronger languages. Another implication that ties both articles together is that because co-speech gesture had a greater impact on recall when the narrative was initially presented in the participants’ weaker languages, perhaps the same is true for amount of narrative-related knowledge participants have. A future study could present one group of participants with factual information via co-speech gesture on a topic that they are very knowledgeable about. On the other hand, they could present another group of participants with information on a topic that they are not familiar with. Then, it could be tested whether lack of knowledge on the topic has a similar effect on recall as a narrative being presented in a participant’s weaker language, and whether reproducing a gesture during learning aids this process more than simply viewing it.

Cherdieu, M., et al. (2017). Make gestures to learn: Reproducing gestures improves the learning of anatomical knowledge more than just seeing gestures. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.01689.


Zielinski, N., & Wakefield, E. M. (2021). Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Though a Visual Attention Mechanism. Proceedings of the Annual Meeting of the Cognitive Science Society, 43(43). https://escholarship.org/uc/item/63r5d3qq.

How Gesturing Applies to a Classroom Setting

Gesturing is something that the vast majority of human beings happen to do and don’t necessarily think about. Non-verbal communication is also believed to make up the majority of communication. The ability to communicate ideas in a classroom setting is imperative. Two studies here give us insight as to how gesturing can be applied to a classroom setting and what this tells us about learning. 

The paper Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism extensively describes the research that investigated the utility of co-speech gestures in regard to language comprehension. The finding of this study showed that bilingual people pay more attention to gestures when interacting in a language they are weaker in. Yet, this example frames attention to gesturing as a downstream effect of poor language comprehension. According to a recent article from the Scientific American Journal, however, new research is coming out from that describes how “Students Who Gesture during Learning ‘Grasp’ Concepts Better.” The article mainly describes a study that was carried out by researchers at UCLA and California State University. The title of the paper is Instructed Hand Movements Affect Students’ Learning of an Abstract Concept From Video and the leading author of the paper, Yunyi Zhang, describes how the main purpose of the study was to recognize exactly how powerful gesturing can be. The study’s setup involved 2 experiments with a different number of subjects participating in each. The first had a total of 60 undergraduate students and the second had a total of 130 undergraduate students, respectively. In the first experiment, students had to watch a narrated video explaining the idea of a certain statistical model. The 60 students were divided into 3 groups. The groups included a control that simply watched the video, and a “match” group that watched the video overlaid with animation and was instructed to imitate the movement of the red bars in the animation with their hands. In addition, there was a “mismatch” group that watched the video overlaid with animation but was instructed to imitate the movement of the red bars in a way that didn’t resemble their movement in the video. The 3 groups watched the video for their specific group 3 times. At the end, all 60 student participants took a quiz, and it was found that the “match” group outperformed the other two groups by a significant margin. The second experiment involved the same exact experimental setup with a larger number of participants, and it yielded very similar results as the “match” group outperformed the other two by a significant margin. Equally as important, it was found that a condition that included a gesturing factor, regardless of whether it was the “match” or “mismatch” group, kept the student participants more engaged. This was tested for based on how the students’ rating of how well they understood the video. 

Both studies shed light on gesturing, but in the study Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism, the effect of gesturing was examined on subjects that were simply asked to take a rather passive role – being asked on what they remember from aspects of a specific storyline. In the study, Instructed Hand Movements Affect Students’ Learning of an Abstract Concept From Video, the student participants were actually instructed to gesture themselves, taking on a more active role. As previously mentioned, students that gestured did, in fact, have better scores. The study, however, did not examine the effect of gesturing on students that simply passively watched the animated video, wheras the study Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism specifically focused on that effect. The implications that are drawn from both of these studies calls for a deeper understanding of what goes into the consolidation of information and learning. Recently, there has been more research and talk on what goes into effective studying, and the term “active learning” is definitely one that has been trending over the past few years. People are starting to realize that by applying information that you happen to learn and engaging in higher-order thinking, you get better results while spending less time. This was definitely reflected in Zhang’s study, where students were called to physically gesture and accurately represent the movement of the red bars in the animation – representative of when the narrator in the study mentioned that one data set had more variation than the other. The findings of studies like these should be shared with educators around the globe, as it allows them a deeper understanding of how to bring about the best results in the classroom.

References: 

Zielinski, N., & Wakefield, E. M. (2021, July 19). Language proficiency impacts the benefits of co-speech gesture for narrative understanding through a visual attention mechanism. Proceedings of the Annual Meeting of the Cognitive Science Society.

Hutson, M. (2021a, April 13). Students who gesture during learning “grasp” concepts better. Scientific American. https://www.scientificamerican.com/article/students-who-gesture-during-learning-grasp-concepts-better/

Wearing Masks Inhibits Expression Recognition and Influences Embodied Cognition and Learning

         Masks! The great debate extends into the classroom. Does mask-wearing aid or inhibit learning? One narrative asserts that masks weaken children's social skills and discourage their ability to learn language. An opinion piece written in the New York Times by Judith Danovitch, an associate professor of psychological and brain sciences at the University of Louisville, claims that masks may encourage learning. Her article, "Actually, Wearing a Mask Can Help Your Child Learn," claims that face coverings do not impact children's development. Danovitch calls attention to children in cultures and communities whose educators wear head coverings or masks regularly. In her experience, these children develop language and social skills similarly to kids in other cultures. Children who are congenitally blind learn to speak, read, and socialize as well. Her evidence portrays no slowing or alteration of development. Instead of looking at a teacher's mouth, Danovitch proposes that gesture and context fill in lost understanding. She even claims that mask-wearing may improve a child's self-control and focus. Danovitch cites research, saying more than half of the gaze time of a typically developed two-year-old is on the eyes rather than the mouth. In addition, children may develop a heightened ability to discern others' thoughts and emotions based on looking at their eyes alone. Thus, they may portray an increased level of emotional intelligence. However, does this piece, written by a professor and research psychologist, point at an imperative side of the mask debate, or does the inability to view full facial expressions impact how developing children learn?

        A vast part of learning, especially language learning, is influenced by gesture. Dr. Elizabeth Wakefield, associate professor of neuroscience and developmental psychology at Loyola University Chicago, defines gesture as hand movements that accompany spoken language and express information through their form and trajectory. Gesture is vital and is even utilized by those who cannot see it. Dr. Wakefield explains that those who are blind person will gesture like a sighted individual. Gesture is natural, and there is an expansive collection of literature that supports gesture-based learning. Dr. Wakefield asserts that when teachers and children gesture, they retain that information for longer. Gestures aid across all developmental stages and all grade levels.

       Gesture-based learning is so powerful that it does not matter whether the student or the teacher gestures; memory in either case is prolonged. Dr. Wakefield's work focuses on determining that gesture shapes visual attention. She tracked eye movements and confirmed that gesture draws the eye to a location but then asked: does it predict learning? In her experiment, a confederate teaches children about a missing addend in an equivalence problem. One intervention (or lesson taught) utilized gesture, the other did not. Both trials tracked children's eye movement. During the gesture trial, participants attended most to the gesture space (the math problem) and the confederate's mouth, their gaze correlating with the confederate's speech. In other words, during this learning event, children followed along with what the confederate taught by looking at her mouth and following along with the problem's steps via the confederate's gestures. In the trial without gesture, the children followed speech alone and spent less time following along with the problem. Dr. Wakefield concluded that learning with gestures allowed for a deepened learning event. Children who learned with gestures were better able to generalize this problem and apply it to other math problems than children who did not learn with gestures. Dr. Wakefield also completed another study asking about how gesture supported learning in a weaker language. Children were given two narratives about Tweety Bird and Sylvester - one in English, their stronger language, and one in Polish, their weaker language. Some narratives were assisted by gestures, and others were not. Wakefield and Zilenski found that children attended more to gestures when they accompanied the Polish (or weaker) language narrative and benefited more from these gestures. They could also recall more plot points from the weaker language if a matching gesture was associated with the explanation. Adults, too, completed the same trial, but it was found that children benefit more from gestures associated with language and communication than adults. Therefore, gestures support language learning and recall, especially for children. Gestures are vital, and these studies bolster Danovitch's claim that gesture impacts learning and attending to it is vital for context, content, and recall. 

      How, then does gesture and learning apply to masks and facial expressions? Does Dr. Wakefield's research correlate with Judith Donovtich's assertions that children learn and develop just as effectively by attending to gesture and context than facial expressions and the mouth? A study by Carmelo M. Vicario and Anica Newman from the School of Psychology, University of Queensland, Brisbane, Australia, highlights that facial expressions influence learners' attention to gestures. There is a body of research that supports "embodied cognition" theory or the concept that cognitive representations are facilitated by and firmed within a physical context. Thus, we physically simulate ideas to understand them better. Reed and Farah displayed in their 1995 study that physical simulation is an effective learning tool. Mimicry supports learning, too, but it also hinders upon social attitudes. Leighton et al. (2010) displayed that social attitudes directly and specifically affect mimicry, with pro-social priming producing a larger mimicry effect than anti-social priming. Social attitudes, specifically those with positive affect (positive emotions), affect our tendency to imitate behavior unconsciously. Due to these findings, Vicario and Newman hypothesized that pro-social (happy) as opposed to anti-social (angry) facial expressions influence the recognition of implicit social attitudes portrayed by a certain hand posture. Closed hand posture means an anti-social attitude, whereas open hand posture means a pro-social attitude. The trials tested this hypothesis by first projecting a hand posture on the screen. The participants were then shown a facial expression, which the researchers called an emotional primer. After the emotional primer, they were presented with another hand posture stimulus. When that popped up, they were to press one of two buttons, which identified if this hand posture was different or the same. In other words, the participants were asked to determine as fast as they could whether the test stimulus, a hand posture, a gesture, was the same as the ready signal, the first-hand posture on the screen. The results concluded that emotion and embodiment are linked - exposure to facial expression and varying social attitudes affect the recognition of hand gestures. It is not as simple as saying that priming a pro-social attitude means that gestures are better recognized. This experiment incorporated gestures with meanings such as the open hand or closed fist. These emotional gestures also impact our perception of social attitudes and may influence how we perceive the correlating verbal speech. Vicario and Newman assert that facial expressions may create an expectation for a pro-social or anti-social response, which affects the recognition of a hand gesture. This study displays that there is a relationship between emotion and gesture and that social attitude may be the link. 

        Emotion and gesture are linked. Facial expressions determine how the social attitudes of a gesture are perceived. This multi-faceted approach encourages better learning with more context and understanding. If one piece is disregarded, like not being able to see full facial expressions, then the meaning of that gesture is lost on the child, and the narrative the teacher is portraying becomes lost. The students must work harder to interpret that gesture's social attitudes and emotional meaning. Therefore, the gesture does not corroborate learning. Therefore, Donovitch's theory that educators' mask-wearing may encourage learning does not correlate with some gesture-based learning because facial expressions help facilitate that process. Understanding the social attitudes behind a gesture allow for increased learning. Further study could be conducted asking if pro-social attitudes and gestures encourage students to attend to them more than their anti-social counterparts. Do gestures linked with facial expressions promote specific affect (mood) and does certain affect encourage deeper learning and attending? Do certain emotional gestures that convey a certain mood also cause more attending because they portray something like happiness or sadness? Mask-wearing influences learning, especially gestured-based learning, because facial expressions affects students' perception of gesture. 

References: 

Vicario, C. M., & Newman, A. (2013). Emotions affect the recognition of hand gestures. Frontiers in Human Neuroscience, 7. https://doi.org/10.3389/fnhum.2013.00906

Danovitch, J. (2021, August 18). Opinion | Actually, wearing a mask can help your child learn. The New York Times. https://www.nytimes.com/2021/08/18/opinion/masks-schools-covid.html

Zielinski, N., & Wakefield E. (2021). Language proficiency impacts the benefits of Co-Speech gesture for narrative understanding through a visual attention mechanism. https://escholarship.org/uc/item/63r5d3qq#main

Implementing Co-Speech gestures to help neurogenic disorders.

    Co-speech gestures are the non-verbal expressions and movements that assist speech, playing a crucial role in improving our understanding of language. Gesture is frequently seen as secondary in spoken language, gaining less attention within language research. Through recent studies implementing hand gestures has been shown to increase language comprehension while also forming long-term memory and knowledge, leading to new findings that involve gesture to help in brain disorder therapy.

    

    In the research article, "Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism" Natalia Zielinski and Elizabeth M. Wakefield presented the study of co-speech gesture. Specifically, how hand movement and gestures influence language proficiency in bilingual children. Through visual attention, children whose primary language is English and whose secondary language is Polish were given two videos of someone telling a story in English and Polish with both matched or mismatched gestures. They were asked to recall the story based on their memory. Through this study, they found that children have a harder time recalling the story in English even though it was their first language and had matched gestures. On the other hand, the children had no issue when recalling the story in Polish although it was presented with mismatched gestures. Overall, body language and gestures boost memory for story points in weaker language compared to stronger language and help better comprehend what is being communicated to them. 

     Considering the benefits of hand movements and comprehension of speech in Natalia Zielinski and Elizabeth M. Wakefield's study, there are other benefits of how gesture can also play a part in improving those with neurogenic communication disorders. In the article, "The Role of Gesture in Communication and Cognition: Implications for Understanding and Treating Neurogenic Communication Disorders," Sharice Clough and Malissa C. Duff also take part in discussing the theories of how gesture and speech are related. Similarly to the first article they both present how gesture can help people to communicate more effectively as well as remember information better. However, in this article, the understudy of gestures in people with neurogenic communication disorders is emphasized. Those who suffer traumatic brain injuries force damage to the frontal lobe and temporal lobes leading to deficits in functioning, speed processing social cognition, and memory. Gesture is examined in three ways through the research of aphasia which is a left hemisphere stroke. One, characterizing gesture use, two, inhibiting gesture use to rehabilitate language, and three, boosting gesture use to facilitate communication. Treatments for these deficits are crucial as people with TBI have a hard time with non-verbal cues, therefore gestures help with word retrieval. Often, gesture is inhibited in some therapy protocols however, implementing the synergetic nature of speech and gesture helps to reach the goals of improving neural damage. Successful communication involves implementing and interpreting verbal and non-verbal signals which emphasize that using gestures can leverage language improvement as it can regenerate certain regions of the brain through the primary of gesture in spoken language. 

    Natalia Zielinski and Elizabeth M. Wakefield's study as well as Sharice Clough and Malissa C. Duff's findings provide evidence of how co-speech gestures help cognitive improvements, like memory, however, the second article further explains the implementation of gestures by utilizing them to improve cognitive impairments. The first article gives a deeper background about co-speech amongst children who are bilingual and presents gesture study in language complexity while the second article touches on the usage of gestures in brain damage like Aphasia, Alzheimer's, and TBI. Knowing how gesture helps overall communication, this is able to be implemented in various studies as well. Proving that even if there is or isn't damage to your brain, hand movements combined with speech can overall be beneficial. Implementing both of these studies can help to shine lighter on co-speech research and the molecular aspects of gesture implementations. Overall, gesture is very important when it comes to memory and recall and may help many people communicate.

References: 

Clough, Sharice, and Melissa C. Duff. “The Role of Gesture in Communication and Cognition:     Implications for Understanding and Treating Neurogenic Communication Disorders.” Frontiers, Frontiers, 21 July 2020, www.frontiersin.org/articles/10.3389/fnhum.2020.00323/full. 

"The Role of Gesture in Communication and Cognition: Implications for Understanding and treating Neurogenic Communication Disorders"

Zielinski, N., & Wakefield, E. M. (2021, July 19). Language proficiency impacts the benefits of co-speech gesture for narrative understanding through a visual attention mechanism. Proceedings of the Annual Meeting of the Cognitive Science Society. https://escholarship.org/uc/item/63r5d3qq 

Repetitive transcranial magnetic stimulation (rTMS) treatment for traumatic brain injury

Traumatic brain injuries (TBIs) are alterations in brain function or other brain pathology induced by external forces. The location of the injury as well as its severity is what today allows us to identify and further understand the cognitive deficits and symptoms resulting from damage to the brain structure. Considering that all TBI patients present their own unique set of functional impairments and symptoms, the development of a safe and personalized framework of treatment that targets these is crucial for rehabilitation interventions. 

In the research article titled Neuromodulatory Interventions for Traumatic Brain Injury, Dr. Pape and colleagues emphasize the importance of understanding the mechanism behind neuromodulation and improving this technique for the future of TBI rehabilitation. In the TBI treatment field, neuromodulation has been recognized as a promising tool due to its potential to facilitate the recovery of somatosensory and higher-order skills damaged in TBI. Neuromodulation is the alteration of nerve activity through targeted stimulation that aids in modulating neuronal pathways in order to support repair and alteration. In other words, this intervention is the result of inducing plasticity as well as engaging mechanisms of metaplasticity (long-term potentiation (LTP) or depression (LTD) mechanisms).

One of the most noninvasive techniques used in rehabilitation is called repetitive transcranial magnetic stimulation (rTMS). The effects of this technique can be optimized by the precise manipulation of strength and focality of stimuli, which in turn induces a greater or slower neuronal depolarization, or induces a secondary activation or other brain networks outside of the stimuli radius. According to Dr. Pape, the adoption of techniques like TMS paired with a learning-based intervention is a good step toward the future of rehabilitation in enhancing the functional recovery of each unique TBI patient.

Similarly, in the research article Repetitive transcranial magnetic stimulation promotes neurological functional recovery in rats with traumatic brain injury by upregulating synaptic plasticity-related proteins by Dr. Qian and colleagues, the study closely examines and further expounds on the use of rTMS and its mechanism of action in the brain. With the use of rat models with moderate TBI, the researchers measured mRNA and protein levels of those involved in synaptic plasticity like NMDAR1 and CREB, brain-derived neurotrophic factor (BDNF) known as a long-term potentiation (LTP) regulator, BDNF-tropomyosin receptor kinase B (TrkB), and synaptophysin (SYN). Their findings showed that rTMS increased these protein levels and their mRNA expression which are linked to long-term potentiation. In addition, rTMS seemed to invert the deficit of the protein SYN as well as support the restoration and reorganization of the synaptic brain structure. With this in mind, it is this production of these proteins that leads to the function of the metaplastic mechanism of LTP that results in the neuromodulatory effects observed after rTMS treatment on TBI.

Ultimately, both studies illustrate the importance of understanding rTMS and its neuromodulatory effectiveness in order to treat TBI. Now that the scientific field has started to recognize repetitive transcranial magnetic stimulation (rTMS) to be a promising tool for the future of rehabilitation in TBI, there needs to be more research developed to further understand this tool and its limitations, and create a framework of neuromodulatory treatment that works across all TBI patients.

 

References:

Pape, T. L., Herrold, A. A., Guernon, A., Aaronson, A. & Rosenow, J. M. (2020). Neuromodulatory interventions for traumatic brain injury. Journal of Head Trauma Rehabilitation, 35(6), 365-370. https://doi.org/10.1097/HTR.0000000000000643

Qian, F. F., He, Y. H., Du, X. H., Lu, H. X., He, R. H., & Fan, J. Z. (2023). Repetitive transcranial magnetic stimulation promotes neurological functional recovery in rats with traumatic brain injury by upregulating synaptic plasticity-related proteins. Neural Regeneration Research, 18(2), 368. https://doi.org/10.4103/1673-5374.346548

Co-speech Gesture on Overall Language Comprehension

    Understanding language is a complicated and intricate task with many facets to comprehend. Whether it be wagging a finger in disapproval or playing charades, gestures and actions are key factors in our overall understanding of language being both aides to and other forms of communication. Pro-speech gesture is the term for actions performed in place of a word while co-speech gestures are actions performed in tandem with speech, and post-speech gestures modify a word spoken before, and all of these forms of gestures have been shown to assist in learning and understanding language. 

    In a study provided by Tieu et al. titled "Linguistic inferences without words", the research team aimed to prove the power of co-speech gestures along with other forms of visual aid and how their usage can trigger linguistic inferences that allow for language comprehension. This was done through a series of experiments involving about 100 Amazon Mechanical Turk workers each, one involving gesture and one involving visual animation, both aiming to observe the strength of the videos presented in guiding inferences that appeared in text below the videos. Their results showed similar yet interesting results in both experiments. For the gesture experiment, the researchers concluded that the gestured information was joined and stored among speech information possibly showing that iconic information behaves like normal speech, thus assisting in comprehension and retention. The animation experiment gave similar results but proved a very different hypothesis, showing that content that had not been seen before in a linguistic context was still able to be divided in the same way the gestural information was, thus showing presuppositions are likely not generated via lexical learning, but can possibly be generated spontaneously "on the fly". However, these inference generations are usually thought to be language-specific in many cases, thus more research regarding co-speech gestures and multilingual understanding is to be done.

    In a similar study by Zielenski and Wakefield titled "Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism", the researchers aim to focus on the ability of co-speech gestures to aid in language comprehension for multi-lingual children. The researchers ran their experiment with an experimental group of 17 English-Polish bilingual children ages ranging from six to eight wherein the children were presented with a series of videos in both English and Polish and were asked to recall as much information as possible from the stories presented in them. The storyteller in the videos would have co-speech gestures with some of the information. The overall results showed that information recall was much weaker when the story was presented in Polish rather than English, but also showed that recall of events for the Polish videos was strengthened when co-speech gestures were present. The results of their study also revealed that co-speech gesture was more helpful in Polish rather than in English, showing that co-speech gesture could be more helpful in polyglots' weaker languages. This experiment once again illustrates the utility and aid that co-speech gesture can provide in the expression of spoken language.

    Both of these experiments exemplify and provide proof of the effectiveness and value of co-speech gesture in overall language comprehension. The first experiment shows that not only co-speech gestures but other visual aid not paired with speech can help in understanding language, while also showing the multi-modality of language comprehension as a whole. The second experiment takes this idea and further deepens its implications by looking at its effectiveness in actively learning a second language. These experiments provide a substantial amount of information regarding such an interesting topic since language is so fundamental to our world's functioning and definitely encourage others to look into and research the topic in more depth.

 Sources:

Neuroscience News. (2019, April 26). Meaning without words: Gestures and visual animations reveal cognitive origins of linguistic meaning. https://neurosciencenews.com/gestures-visual-linguistics-12063/

Schlenker, P. (2019). Gestural semantics. Natural Language & Linguistic Theory, 37(2), 735–784. https://doi.org/10.1007/s11049-018-9414-3

Tieu, L., Schlenker, P., & Chemla, E. (2019). Linguistic inferences without words. Proceedings of the National Academy of Sciences, 116(20), 9796–9801. https://doi.org/10.1073/pnas.1821018116

Zielinski, N., & Wakefield, E. (n.d.). Language Proficiency Impacts the Benefits of Co-Speech Gesture for Narrative Understanding Through a Visual Attention Mechanism.

Women’s Heads in the Wall, Boys and Football: What Now?

 In a recent article “The Hidden Epidemic of Brain Injuries From Domestic Violence” By Christa Hillstrom, the long-term effects of domestic violence on women’s brains explains why the damage goes unnoticed in today’s society. There is a severe lack of knowledge on this topic that can be considered a crisis and impairs our ability to properly deal with its dire consequences. 

The article follows a young woman who discovers the severity of the brain damage she sustained as a victim of domestic violence, while also including stories from other women who have gone through similar situations. After escaping a long-term violent relationship, the woman finds herself cognitively impaired and unable to carry out simple tasks. It is important to note there are also football players who are referenced throughout the studies, as they sustain similar long-term brain damage due to the harsh sport; not to mention that they have much more research allocated towards their cause. After taking a look at the woman’s brain, the doctors and researchers affirm that the frequency and magnitude of blows to the head had an effect on the severity of long term ailments- alterations to the brain structure and function. This is a pattern that is observed among many of the women who come in with both diagnosed and undiagnosed traumatic brain injuries.

The correlation presents that persistent hits to the head had larger consequences, in congruence to the extensiveness of the injury. Although widely speculated, this information was confirmed in the study as the women’s personal anecdotes aligned with their hospital records.  It was found that most domestic violence survivors who acquired brain injuries from their time as victims were living with physical and mental impairments- constant headaches, sensitivity to light, recurring forgetfulness, irritability, etc. The symptoms can be discreet due to the fact that they are seemingly normal onset, and grow worse with time. This results in many of these survivors being unable to carry out their daily tasks due to the neurological damage which they sustained, ruining their lives.

Perhaps with the use of transcranial magnetic stimulation in more clinical settings, we can learn and help more domestic violence survivors. In the study “Neuromodulation ​in Neurorehabilitation: ​Now and the Future,​” Theresa Paper and fellow researchers focus on noninvasive neuromodulation methods, specifically transcranial magnetic stimulation which can be used to improve cognitive functions. It has been proven that the repetition of these brain stimulation methods allow for the neural pathways to become stronger, quite similar to working out a muscle. With a focus on damaged functions or impaired pathways, we can acknowledge that these methods have grown to aid in rehabilitation and recovery. 

In truth, there is a deficiency of awareness when it comes to the world today on the battle wounds of domestic violence survivors- the topic is considered taboo and there is no urgency to take action. Consider the government released warning claiming that, “lack of data-gathering on traumatic brain injuries in abused women makes it impossible to confront the crisis in a meaningful way”-stark in comparison to, say,  the public consciousness of football players' risks when it comes to playing the game. By recognizing the problem, it is possible to share the solution.

With the help of researchers and doctors, there is hope- they can now push against the negative narratives against debilitated survivors. Using TMS methods for traumatic brain injury (TBI) victims may be a form of cognitive therapy and an advanced recovery path. By using these methods less sparingly, we can help more people recover and live more normal lives. In fact, it can be argued that these should be included in welfare checkups, in addition to MRI and CT brain scans, as preventative measures. This goes for women and children of concerned families, or even those who play rigorous sports. If it is possible, we can prevent and even reverse these issues before they grow to be long-term and long lasting.

References:

Hillstrom, C. (March 1, 2022).The Hidden Epidemic of Brain Injuries From Domestic Violence. The New York Times Magazine. https://www.nytimes.com/2022/03/01/magazine/brain-trauma-domestic-violence.html 

Bender Pape, T. L., Herrold, A. A., Guernon, A., Aaronson, A., & Rosenow, J. M. (2020). Neuromodulatory interventions for traumatic brain injury. Journal of Head Trauma Rehabilitation, 35(6), 365–370. https://doi.org/10.1097/htr.0000000000000643

Neuromodulatory methods as treatment for traumatic brain injury

            Traumatic brain injuries (TBI) are brain dysfunctions caused by an outside force. While there are a variety of treatments currently being used for TBI, research has been conducted into the use of neuromodulatory methods as a treatment for TBI. Neuromodulation works by using chemical or electrical signals to target specific regions of the brain or nervous system to alter irregular nerve activity occurring there. It is typically used to treat conditions that cause symptoms such as chronic pain, movement disorders, epilepsy, and psychiatric disorders. Standard methods of invasive neuromodulation include deep brain stimulation (DBS), cortical stimulation, and peripheral nerve stimulation, while noninvasive methods include transcranial magnetic stimulation (TMS) and direct current stimulation (tDCS). Previous findings have shown that transcranial magnetic stimulation (TMS) can improve motor function and mood regulation, leading many researchers to believe that TMS could be a potential treatment for the symptoms of several neurological disorders, including traumatic brain injuries.

            The article "Neuromodulatory Interventions for Traumatic Brain Injury" by Dr. Theresa Pape discusses how repetitive TMS (rTMS) can be used to treat traumatic brain injuries. As opposed to other noninvasive neuromodulation forms, rTMS can target multiple sites at varying levels of intensity, making it of great interest to researchers. In addition, rTMS can cause activations in other areas of the brain that aren't being targeted. In the article, Dr. Pape describes a study that was conducted on patients in states of disordered consciousness following a TBI in which participants were given either amantadine, a drug that has been shown to improve consciousness in coma patients, or rTMS before receiving both to observe whether they could alter the activity of separate regions that control dopamine production. They found that using the two treatments together had better outcomes on consciousness than using them individually.

            Similar research is being conducted to determine how neuromodulatory interventions can impact other symptoms of TBI. The article "Biomarker-guided neuromodulation alleviates memory loss in traumatic brain injury patients" details how Dr. Michael Jacob Kahana at the University of Pennsylvania and his team placed electrodes in TBI patients experiencing memory loss to predict when they would experience memory lapses. Their technology uses machine learning to determine when participants need to receive stimulation. A previous study conducted by Dr. Kahana and his team, published in 2017, found that when participants received stimulation before incorrectly remembering something, memory improved, but when stimulation was received when memory was functioning well, memory worsened. Their new study published in 2023 delivered stimulation to participants only before memory failed, leading to a 15% increase in the probability participants would recall a word from a list.

            Although these studies utilize different methods, both show significant evidence for the use of neuromodulation to treat TBI and display even more positive results when used in tandem with another form of treatment than when used alone. The benefits of neuromodulation in TBI patients are due to their capacity to improve neuroplasticity. However, these methods pose several risks to patients, including seizures, which aren't yet entirely understood. Thus, more research must be done to establish neuromodulation as a safe and effective treatment for TBI.

References

Bell, J. (2023, August 23). Biomarker-guided neuromodulation alleviates memory loss in traumatic brain injury patients. NeuroNews International. https://neuronewsinternational.com/biomarker-guided-neuromodulation-alleviates-memory-loss-in-traumatic-brain-injury-patients/ 

Bender Pape, T. L., Herrold, A. A., Guernon, A., Aaronson, A., & Rosenow, J. M. (2020). Neuromodulatory interventions for traumatic brain injury. Journal of Head Trauma Rehabilitation, 35(6), 365–370. https://doi.org/10.1097/htr.0000000000000643 

Transcranial Magnetic Stimulation, TBI, and PTSD: How Does TMS Impact Different Forms of Neurological Dysfunction?

      Recently, researchers and doctors have been promoting noninvasive treatment methods to treat traumatic brain injury (TBI) and Post-Traumatic Stress Disorder (PTSD). These noninvasive methods involve neuromodulation, which alters brain activity by stimulating specific regions to modulate or control dysfunction. An emerging treatment method that utilizes neuromodulation is transcranial magnetic stimulation (TMS). This targeting of specific regions modulates dysfunctional and functional pathways as a means of helping the brain repair itself in order to repair the neural circuitry impacted. TMS is versatile in that it cannot only target specific regions of the brain, but also fire frequencies at varying rates, at varying intensities.  

    Dr. Theresa Pape chronicles the current research related to TBI in the article "Neuromodulatory Interventions for Traumatic Brian Injury," exploring the mechanisms of neuromodulation, arguing for the further use of transcranial magnetic stimulation in research and medicine.  Traumatic Brain Injury is not internal, but external, and is caused by physical force, for instance a car crash. There are also varying levels of TBI that can of course have varying effects on patients, meaning that treatment methods must be flexible to these differences. To account for the heterogenous expression of mild and severe and TBI in patients, Theresa Pape utilizes and promotes heterogenous forms of treatment for those who have experienced TBI, particularly emphasizing the need to integrate traditional treatment methods with TMS in order to maximize results. Both TMS and traditional psychological methods of treatment can stimulate and retrain pathways in the brain that are essential for functioning, increasing plasticity in regions of the brain that are damaged from external trauma.  

    Pape et al. discovered that engaging in these psychological training exercises while plasticity is induced by TMS optimizes rehabilitation. She also paired the drug amantadine with TMS treatment and saw more statistically significant improvements over time compared to the just the implementation of TMS alone. This study heavily suggests that the integration of multiple treatments is more beneficial than implementing one treatment method, and the literature review heavily emphasizes the gaps in information that exist when it comes to optimally treating TBI. In particular, the impacts of different frequencies and the rate of firing of these frequencies in relation to different disorders has not been studied nearly enough. 

    In 2021, Harris & Reese researched the impact of different frequencies stimulation via TMS on PTSD patients. They tested the effects of high-frequency TMS and low-frequency TMS on individuals with PTSD. They found that high frequency TMS had a significantly stronger treatment effect, and reduced PTSD symptoms in patients, but higher treatment doses are not associated with more improvement in treatment. Despite these results, researchers indicated that both high and low frequency TMS can be beneficial, depending on the region of the brain stimulated. High-frequency TMS excites neurons, whereas low-frequency TMS inhibits neurons. Therefore, high-frequency stimulation can be used to stimulate inhibited pathways, and low frequency stimulation can be used to inhibit stimulation of overly excited pathways. However, in this study, high-frequency TMS appeared to produce the best treatment outcomes for patients with PTSD. This study illustrates that specific frequencies of firing also matter when it comes to stimulation and modulation of different regions of the brain impacted by the disorder.  

    There are, of course, risks associated with these non-invasive methods of neuromodulation. The specific long-term effects of TMS on different patients for both TBI and PTSD are, for the most part, not known. The scale of alteration of brain activity over time is not known, and the optimal time of application is still poorly understood. In addition, many of the studies conducted have smaller sample sizes, and they often only test one method of treatment as opposed to integrating multiple styles of treatment, which can limit our understanding of how to best integrate the tried-and-true methods of treatment, and more novel forms of treatment.  

    In short, while we have collected detailed results on the general impact of TMS in the short term, we need to collect more specific information and the impact of different frequencies on different conditions of neural dysfunction. We also need to define the treatment parameters more specifically, for TBI and PTSD.  

References: 

Harris, A. D., & Reece, J. (2021). Transcranial magnetic stimulation as a treatment for posttraumatic stress disorder: A meta-analysis. Journal of Affective Disorders, 289, 55–65. https://doi.org/10.1016/j.jad.2021.04.003 

Pape, T., Herrold, A. A., Guernon, A., Aaronson, A., & Rosenow, J. M. (2020). Neuromodulatory interventions for traumatic brain injury. Journal of Head Trauma Rehabilitation, 35(6), 365–370. https://doi.org/10.1097/htr.0000000000000643 

Pape,