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Lessons from the Development of Two Boys with Half their Brains

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This second review of "The Brain and Education" series takes up "A Tale of Two Cases: Lessons for Education From the Study of Two Boys Living With Half Their Brains" by Dr. Mary Helen Immordino-Yang, published in Mind, Brain, and Education, Vol.1, No.2. Neuroscientist Dr. Hirotaka Kataoka, Researcher, Benesse Educational Research and Development Center, Benesse Corporation, and I discuss the issues raised by this research.

Brain research has a long history, starting with detailed analysis of the symptoms of patients with brain disorders and clinical findings and then studying the brains of deceased patients to discover the relationship between affected areas of the brain and specific brain functions. One well known example is the research of the French neurologist Paul Pierre Broca and the German neurologist Carl Wernicke on the brain and language in the late nineteenth century. Broca is known for identifying Broca's area (1861), a region of the frontal lobe named after him, based on his research on patients showing impaired language production. Wernicke is known for identifying a region called Wernicke's area (1874) in his research on impaired language comprehension.

Another important study has been the research of American neurologist Harry Frederick Harlow, which demonstrated that emotions, intellect, and other significant brain functioning characteristic of human beings is located in the frontal lobe. In 1848, a 29 year-old American railroad construction foreman named Phineas Gage suffered a dynamite explosion that drove an iron rod (90 cm x 3 cm) through his face, skull, and brain. Although he survived, his personality changed completely. Prior to the accident, he was responsible, discerning, courteous, devout, sociable and well-liked by others. After the accident, however, although he showed improved technical skills and retained his intellectual faculties, he became insolent, irreverent, and easily angered those around him to the point that he was no longer considered reliable and was forced to quit work. He became a drifter and died ten years later. Five years after his death, his skull was studied by Dr. Harlow and others and placed on exhibit at the Museum of the Medical College of Harvard University.

In this way, research on area of brain functioning in such patients has contributed to further research on disorders displaying psychiatric symptoms. In recent years, neurology has made great strides in tandem with progress in radiology and imaging technology that can locate brain function.

In the area of pediatric medicine as well, there has been considerable research involving detailed postmortem examinations of children's brains with psychiatric disorders, which has clarified the relation of brain function. However, due to the fact that most of the research has been undertaken on patients with a congenital brain disorder or cerebral palsy occurring at birth, development of brain function has not been studied, and even less so, its relation to education.

The article discussed here is a research report by Dr. Mary Helen Immordino-Yang, one of the authors of the article in the Part I. She presents the cases of Nico and Brooke, two healthy male adolescents who underwent removal of an entire brain hemisphere to control severe epilepsy. Nico had his right hemisphere removed at the age of three, and Brooke, his left hemisphere at the age of eleven.

Contrary to expectations, although both continue to experience impairment of motor skills, 14-year-old Nico now attends school and enjoys fencing and drawing cartoon characters. Brooke has a job bagging groceries at a local supermarket and attends junior college. Both boys are self-assured and able to fully communicate in daily life. Moreover, they are capable of expressing emotion through the use of prosody (vocal intonation, etc.). Their cognitive abilities and linguistic development are high to a surprising degree.

This degree of high development is not seen in adults after hemispherectomy. Removal of the right hemisphere adversely affects the musical ability (recognition of melody and tempo), spatial expression and understanding, and recognition of facial expression. Removal of the left hemisphere affects linguistic ability (speech, comprehension, reading or writing), and abstract thinking such as calculation, math and logical abilities. This indicates that children's brains are capable of constructing brain function in a flexible manner to adjust to particular neurological trauma. On the other hand, when children sustain strong stress in such cases as abuse, this may also produce the opposite result.

The article analyzes a study which focused on the boys' ability to express and understand emotion through intonation, to express one's feelings, and to discriminate facial expression. Nico, who lacks the right hemisphere, tended to find it difficult to express his emotions and appeared to process them with memorized categories in a way that resembled grammar which is controlled by the left hemisphere. Brooke, who lacks his left hemisphere, enjoyed answering questions as he linked emotion with vocal tone, made judgments strongly relying on intonation and emotion based on his own experience, and sometimes made mistakes.

The program of the brain that responds to music is thought to be located in the right hemisphere, and it may have been compensating for Brooke's loss of his brain's language comprehension program. In my view, the evolution of language development may be related to music and song, and this finding is extremely interesting in its implications for the relation between the processing of emotion and evolution of the brain.

The remarkable development of these children with half their brains owes much, of course, to the care of doctors and other specialists. If we think of what this might mean for education, we see that these two cases provide us with a powerful basis for considering the relation of brain function to learning. For example, students raised in different cultures and social environments approach and deal with problems in the different ways even if they have received the same education.

In closing, I would like to introduce another publication which appears to be about the same boy, Nico. In 2000, Dr. Antonio M. Battro published a book entitled "Half a Brain is Enough: The Story of Nico" This was published by Igaku Shoin in 2008 as "Hanbun no no, shonen nico no ninchi hattatsu to Piaget riron" in translation by Dr. Juro Kawachi, Professor Emeritus, Tokyo University and Kaoru Kawachi.

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