This post may be only relevant to cerebellar stroke survivors, or not, I don’t know. I’ve been meaning to write a cursory post about a sensation that @Augustus brought up a few posts ago, Start-Stop-Work. In his post he declares, my body literally feels like it is shutting down. This feeling is one that I still have to this day, almost six years on after being blitzed by four strokes to the cerebellum, it is also a sensation a close friend of mine, also a cerebellar stroke survivor, gets and we bring it up in almost every conversation as it is so overwhelming that it makes you feel like your body and brain are going to pack it in, and you’ll just keel over and die on the spot. I initially tried to research this disquieting sensation but found very little evidence of it in medical journals, but science moves ever onwards and thanks to advances in technology, the cerebellum is coming more into focus and it is much easier to trail through the many medical journals using AI, which was in its infancy when I had my stroke.
The cerebellum, once relegated to core motor skills is now considered to be the neural networks primary prediction engine, both in physical and abstract cognitive tasks. This has lead me to what they call prediction error signalling. So, basically, when that horrendous feeling of the brain and body being about to shutdown arises, it is a prediction error signalling mismatch. The brain goes into overload and can’t predict what is happening and the following occurs; protective alarm systems go off and generate an intense feeling of impending failure, high cognitive workloads directly affect the central nervous system and overloads it, altered signals through the autonomic nervous system network can cause that system to suspect system failure when there isn’t actually any threat of it. All of this leads to what neuroscience calls catastrophic interoceptive prediction error.
So, without needing to completely understand or dive deeper into the neuroscience behind it, how can we rehabilitate this? Well, this is what I am still looking into. One method that I have been exploring is the brain reward function.
The brain likes to be rewarded, especially the basal ganglia, and that is the rerouting pathway that should be used because a damaged cerebellum can blunt the reward prediction error coding that would normally let the forebrain know everything is okay. All right, boffin stuff aside, in principle this is quite simple, but how effective it is, I don’t yet know as I have only started practicing it. The technique I am going to focus on is called audio biofeedback and I wrote about it a long time ago here, in 2022. I should have carried on with it back then, but time has allowed neuroscience to study further with it in respect to the cerebellum, and everything is worthy of revisiting. Hindsight is a wonderful thing and all that.
- Heart-Rate Sonification Protocol which translates to turning your heart rate into sounds or music. An app I am trialing at the moment is Yudemon HRV and it is free. (The apps I link to are on the Apple App Store, if you use a different operating system, just type the name of the app in whichever App Store you use).
- The “Unwind” Ambient Gating System, this is a principle of matching audio biofeedback to brainwaves, now I haven’t tried this as it ain’t cheap. The one I looked at called Flowtime costs £188.00 on Amazon and I haven’t done enough homework on how effective it might be. It translates brain waves into soothing sounds, thus, “If the autonomic nervous system begins spiking into a panic/shutdown zone, the music becomes slightly static or dissonant. The moment the user implements a grounding technique, the audio instantly clears into a crisp ocean sound, providing an immediate neural reward for stabilising the nervous system.”
- Rhythmic Entrainment, this is a practical way to reward the cerebellum through binary beats. Beta Waves: 15Hz – 20Hz are ideal for general daily physical tasks, like chores or walking as the brain responds to these sounds when using muscle control and physical movement. Gamma Waves: 30Hz – 40Hz when doing more complex tasks or movements. The exception is Alpha Waves: 8Hz – 12Hz which stimulates the brain through relaxation, if these were used during the aforementioned activities it could cause a prediction error signalling mismatch.
Any-old-hoo, just some food for thought in tackling this rather crippling and distressing sensation of feeling as if the body and brain are going to conk out completely. There is so much to explore here and I think it may be key to rehabilitating many of the curious disabilities incurred after cerebellar stroke. I have no idea if any other survivors with different types of strokes experience this as I’ve only heard it mentioned by cerebellar stroke survivors.
This dysmetria of thought affects how prediction error signalling can mismatch responses, behaviour and thought processes and the consequence of catastrophic interoceptive prediction error, but that is only the tip of the iceberg.
refocus 