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Implications of neural reuse for brain injury therapy: Historical note on the work of Kurt Goldstein

Published online by Cambridge University Press:  22 October 2010

Barry Lia
Affiliation:
Dizziness and Balance Center, Otolaryngology/Head and Neck Surgery, University of Washington Medical Center, Seattle, WA 98195-6161. barrylia@uw.edu

Abstract

This commentary suggests how the target article raises new implications for brain injury therapies, which may have been anticipated by the neurologist Kurt Goldstein, though he worked in and earlier era of fervent localization of brain function.

Type
Open Peer Commentary
Copyright
Copyright © Cambridge University Press 2010

I first took interest in Anderson's article by dint of the notion that neural circuits established for one purpose may be exapted for new functions during evolution and development. In a previous BBS commentary (Lia Reference Lia1992), I had proposed an exaptation of the peripheral visual system for the adaptive evolution of enactive focal vision and praxic use of the forelimbs in primates, a crucial feature of our cognitive niche. I applaud Anderson's discussions of the co-determination of organism and environment and of the idea of “neural niche” within the organism itself as most welcome for cognitive science.

But it was implications for therapies for brain injury – which this article raises in closing – which brought to mind the work of Kurt Goldstein (Reference Goldstein1963) for comment. Anderson refers to “network thinking” which “suggests one should look for higher-order features or patterns in the behavior of complex systems, and advert to these in explaining the functioning of the system” (sect. 3.1, para. 6). Writing in 1939, Goldstein was a neurologist primarily occupied with patients' recovery from brain injury. Similar to Anderson, Goldstein was also concerned with method in biological research and ways of conceptualizing the empirical material. The influence of the Gestalt school of psychology upon Goldstein is reflected in the following passage from Goldstein (Reference Goldstein1963), which refers to the “figure” of a performance:

Localization of a performance no longer means to us an excitation in a certain place, but a dynamic process which occurs in the entire nervous system, even in the whole organism, and which has a definite configuration for each performance. This excitation configuration has, in a certain locality, a special formation (“elevation”) corresponding to the figure process. This elevation finds its expression in the figure of the performance. A specific location is characterized by the influence which a particular structure of that area exerts on the total process, i.e., by the contribution which the excitation of that area, by virtue of its structure, makes to the total process. (pp. 260–61)

This foreshadows the dynamic view of functional recruitment and brain organization which neural reuse theories present. Goldstein would likely have appreciated Anderson's hope that “Knowledge about the range of different tasks that potentially stimulate each region [akin to Goldstein's notion of ‘excitation configuration’] may serve as the basis for unexpected therapeutic interventions, ways of indirectly recovering function in one domain by exercising capacities in another” (sect. 7, para. 8, emphasis Anderson's). Such specific knowledge of the “excitation configuration” was unknown and unavailable to Goldstein; he could only infer it. But by taking a holistic, organismal perspective, somewhat akin to Anderson's “network thinking,” Goldstein intuited such an understanding and postulated such an indirect recovery of function in his work with rehabilitation of brain injury. Goldstein's outlook echoes Anderson's “call for an assimilative, global theory, rather than the elaboration of existing theoretical frameworks” (sect. 5, para. 7). This target article may point toward advances which a Goldstein would be striving toward today had he had our modern tools for studying the brain and cognitive function.

References

Goldstein, K. (1963) The organism: A holistic approach to biology derived from pathological data in man. Beacon Press.Google Scholar
Lia, B. (1992) Ontogeny and ontology: Ontophyletics and enactive focal vision. Behavioral and Brain Sciences 15(1):4345.CrossRefGoogle Scholar