Shirah Vollmer MD

The Musings of Dr. Vollmer

White Matter, Matters

Posted by Dr. Vollmer on July 24, 2012,0,1723553.story

“What they found was striking: Brains of children who had remained in institutions had less white matter — the type of tissue that connects different regions of the brain — than orphans who were placed in foster care or children living with their own families.

Reductions in white matter have been found in numerous neurological and psychiatric conditions, including autism, schizophrenia and attention deficit hyperactivity disorder, or ADHD.”

Children need families. This is news, seriously. The LA Times reported today of a randomized studies in which orphans were either sent to foster care or institutions. Those sent to institutions had less white matter in their brains, thanks to imaging studies. Now, we finally have proof that nurture, the factor that I struggle with in some of my posts, is critical to the developing brain. Brains need stimulation. To paraphrase Winnicott,  a baby is nothing without a mother.  Now, we can say with more certainty that intimate connections help a baby develop security by helping the brain develop white matter. The more white matter that develops, the less likely the child will suffer from numerous mental disorders including childhood anxiety. The attachment theorists are having a good day. This study supports the notion that a primary attachment is critical for development. This small window of time, infancy, is key to having the brain grow properly. Now, does this mean that if one misses out on a good attachment, and hence has less white matter, that he/she is bound to have psychiatric disorders? Maybe. Is it harder to compensate for this deficiency as one ages? Always. Still, understanding is still critical to our personal enhancement and empowerment. We now know that as a society, we should try to strengthen families, and not provide alternative ways of raising children. We also know that given an inadequate early childhood experience, mental disorders are more likely, and hence there might be a role for medication to attempt to compensate, however slightly, for these deficits. As a Child Psychiatrist, I feel excited to have data to support what children need from the moment they leave the womb until they are able to enter school. Now, we can have a public relations campaign……White Matter, Matters! You heard it here first!


4 Responses to “White Matter, Matters”

  1. Jon said

    How wonderful to have imaging data that supports observed behaviors. You and many others have seen the results of a lack of nurture in those with psychiatric disorders. Now there is a beginning of a physical/biological understanding to this phenomenon. Now further progress can be made. This is how science should be done.

    • Thanks, Jon for appreciating the wonders of imaging studies to support the value of nurture. The ability to randomize these kids was the key to having good science. I hope we are all around long enough to see how the further understanding of neuroscience either supports or disproves our hypotheses about the developing brain. Thanks Again!

  2. Shelly said

    The reduction in white matter that the article claims leads to autism, schizophrenia, and ADHD– are the levels normal at birth normal and reduce over time? You infer that this reduction is environmentally caused. However, what of the thousands of children who grew up in institutions and did not develop these disorders, or alternatively, children who grew up in loving and supportive homes who still did developed them? How does your linkage between the bond between primary attachment fit into the model then?

    • Shirah said

      I would say that children are born with a brain which needs to be noursihed in order to thrive in the world. Some, unfortunate children, are born with poor wiring, which puts them in a compromised position from birth. Most children though, with a basic amount of attachment develop their white matter and then they can thrive in the world. Some children, born with the right basic neurological functioning, then do not get the emotionl food which is necessary for brain growth. Let’s take physical growth as an example. Most children have a pre-determined height that they will grow into, but they will not grow if they are not given the right amount of food. A few children lack growth hormone, so even with the right amount of food, they cannot grow. This study supports the idea that mental illness is similar. Some children lack normal brain functioning from the beginning. Most start life with normal brain functioning, but without a primary caretaker, they will be impaired. I hope this answers your question.

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