At the final conference of the project in December 2015 science communicator Levin Sottru asked three senior scientists – a physician, a biomedical engineer and a philosopher – how they experienced their participation in Störung/הפרעה.
Prof. Andreas Schulze-Bonhage
is head of Freiburg Epilepsy Center at the University Hospital. He investigates new treatment options for epilepsy and he is specialized in neurotechnological interventions.
Prof. Schulze-Bonhage, how did you, as a physician, come to work on the dance/science project “Störung”?
The project is fascinating for me, because it is very interdisciplinary and connects a classical approach based on natural science with a practical approach through the expertise of dancers in the area of movement. This can in turn generate new ideas and questions for science. At the center for epilepsy we are not primarily involved with treating Parkinson’s patients, but we do consider movement disorders in our research. Some of our medical examinations can provide information on how the brain functions. We, for example, frequently record bioelectrical activity directly from the brain. Projects that focus specifically on Brain-Computer-Interfaces are a main component of the cluster of excellence BrainLinks-BrainTools.
Dancing lessons for people with Parkinson’s are at the center of the project. You have yourself participated in these. What was your personal experience?
It is fascinating to see how the feeling for your own body and for what other people do change very quickly under the instruction and in interaction with dancers. It seems as if interaction with another person influences my movement patterns and modulates how I experience my own body. This opens up therapeutic approaches which have as yet not been sufficiently focused on or understood in medicine. It may be possible to influence malfunctioning neural circuits in other ways than we know from our direct approach in medicine. Which neural circuits are activated when we copy another person’s movements is a different question. This phenomenon and its correlates are an exciting field for basic research. One of the papers at the conference has of course already mentioned the system of mirror neurons, which may fulfill an important role in this context.
Most of the people with Parkinson’s report that participation in the project has helped them and that they feel more comfortable in their bodies. What is your explanation for this positive evaluation?
Learning how to move more freely, to be less afraid of trying new movements, to have more control over your body – all of this allows patients to be more confident and feel better. The psycho-social component of this disease is large. Many patients withdraw, because they are embarrassed of appearing in public with their disorder. A second aspect are mechanisms that activate the brain through imitation and modulation of movement, through the use of rhythm and melodies in specific ways. What happens exactly in this context cannot yet be determined.
Do you have ideas for continuing the project?
We have had intense exchange with scientists from Germany, England, and Israel, for instance about how to potentially quantify and make study protocols available for patients as a continuation of this project. Ideally, this could result in the recognition of new possibilities for treatment covered by insurance. This conference has also led to more projects for basic research. There was a poster on an exciting fMRI project, which will be carried out by the department for stereotactic neurosurgery at Freiburg’s university hospital. It will also become apparent what scientists in the fields of psychology, robotics, and medicine can think up together with dancers. Project applications for more interactional, interdisciplinary projects of this sort are already being formulated.
Dr. Shelly Levy-Tzedek
is head of the Cognition Aging Rehab, Dept. of Physical Therapy, Member of the Zlotowski Center for Neuroscience and of the ABC Robotics Initiative at the Ben Gurion University in Beer Sheba.
Dr. Levy-Tzedek, what brings you, as a Biomedical engineer, to a dance/science project?
I have been studying movement for more than a decade and within that, how movement changes with age and disease. I have particularly been researching new ways in which Parkinson’s symptoms can be alleviated and the effect that dance has is truly fascinating. As a result of this project, I started three new lines of research with Parkinson’s patients involving dance-like movements.
You have also been participating in some of the classes and workshops. What was your personal experience there?
Expressing yourself with the body, connecting to other people through movement, finding hidden parts in yourself can be very liberating. It was also very good to see first hand how the effect is on Parkinson’s dancers as they’re called here. I took a lot from it and I hope I will be able to use that in my personal life as well as in my research.
Talking about research, many or all of the Parkinson’s patients were saying it somehow changed their perception of their body and bodily movements. What can you see about that? Is there a real positive effect? What happens to the perception of the body?
We have several hypotheses as to what goes on when people in general, and people with Parkinson’s in particular, are dancing. One hypothesis states that the basal ganglia – the area which is most effected in Parkinson’s – are stimulated as a result of hearing external rhythm which music provides. An area that is slowly atrophying or dying away as a result of the disease can thus be reactivated. Another option we use to enable movement is cueing. When we use stimuli from the surrounding, for instance when a fellow dancer leads us, if we hear the rhythm of music, of a metronome, or if we’re being moved, these stimuli serve as a tactile cue enabling us to then move in other ways. We mustn’t forget that dance also provides an opportunity to repeatedly try actions which are normally difficult for people with Parkinson’s. It could be moving backwards, turning, pausing and then starting a new movement or doing several things at the same time. All these things are required when they dance and can help them cope with everyday challenges. Lastly, I believe that the social aspect of it should not be ignored. By providing a social support network we are improving the quality of life regardless of the movement per se.
What are your wishes for continuing, further develop, evolve the project Störung?
On a personal level, I can say that Störung has given me several ideas and brought up specific questions that I will take further in my research. We are also trying to start more dance groups in Israel, for example at the Soroka hospital right next to the Ben Gurion University. I will spread a good word about the Störung workshops and I hope we can raise the number of people exposed to this beneficial way of dealing with Parkinson’s. In addition, having junior scientists in both Israel and Germany learn of novel ways of looking at research, of incorporating the people being researched in formulating the scientific questions, I think, has far reaching implications that we can’t necessarily pinpoint right now. We would have to ask this question again in five years and see where everybody is and what it has done to them. It would also be great to see Germans and Israelis keeping on working together. Groups from different countries coming together, working in parallel and then comparing notes has been a fantastic aspect of Störung. For me, it has been a pleasure and privilege to be part of the project. I hope there will be many more opportunities like this.
PD Dr. Oliver Müller
is a philosopher at the University of Freiburg. Within the cluster of excellence BrainLinks-BrainTools he leads projects on philosophical and ethical questions concerning neurotechnological interventions
and brain-machine interfaces.
Dr. Müller, what brings you, as a philosopher, to the dance/science project “Störung”?
For one thing, the long tradition of collaborating with Freiburg’s theater. We have tried to shed light on phenomena created through modern biotechnologies in various ways. Such technologies not only change the lives of patients but also our way of life, offering more and more opportunities to transform the healthy part of the population. This entails many questions that we as a society must discuss—and theater offers a space for doing this. I consider dance a particularly valuable way of exploring subjective experience of movement disorder and thereby gaining insights about people’s identities. While scientists from BrainLinks-BrainToolds can explain movement disorder through objective methods and develop forms of therapy based on these explanations, dancers can explore the subjective dimension of the disease. Both perspectives belong together even though they seem at times incompatible. The tension between these approaches is what interests me as a philosopher.
People with Parkinson’s are at the center of the project. You yourself also participated. What was your personal experience?
For me it was a sort of observation through participation. I found fascinating that we were able to bring such diverse groups together: Parkinson patients on the one side and professional dancers on the other. The latter learned to understand how the world is experienced for the patients. At the same time, we wanted to bring dancers’ expertise together with the work of doctoral researchers within the cluster of excellence BrainLinks-BrainTools as a third group. These groups explored together what it could mean to not be able to realize a movement as intended, to not be able to control an impulse, and how tremor is influenced by dance. Dance often makes movements more fluid – freer, so to speak. This is difficult to explain scientifically. Moreover, I noted that we can approach Parkinson’s disease in multilayered ways. We managed to communicate with increasing precision about how the disease is perceived, what happens in interaction, and how non-verbal forms of understanding develop. Observing all of this was extremely fascinating for me.
Many of the people with Parkinson’s report that participation in the project has had huge benefits for them and that they feel more comfortable in their body. How do you explain this?
This is an interesting question also philosophically, since phenomenologically, from the patients’ point of view, they obviously do feel better. Social interaction, rhythm, dance movements all contribute to alleviating symptoms of the disease. We therefore think about creating an interdisciplinary project that aims at learning to explain the subjectively experienced dimension with scientific methods. For the future we hope that the health service will cover such dance therapy and that in the long term more Parkinson’s patients will have this opportunity to improve their quality of life.
Do you already have an idea of how to continue the project?
I believe that all participants will continue to think and talk about the project. A first step has been to try to continue the dance classes in their current form. This is a question of funding, which is now running out. Participants from theater can of course try to network in the field of Parkinson’s disease research and therapy. We, from the scientific perspective, are trying to design a project with our partners from Israel, which is to deepen research in this field. We are looking to install an experiment based “Science and Art Lab”, which is to bring scientific and artistic expertise together on a new level. If this proves successful, I can imagine transferring this approach to other questions and to collaboration with other partners, and to thereby enrich scientific work through engagement with different perspective and methods. Additionally, we want to reflect ethical and social questions in this lab. This would fit perfectly with the approach of BrainLinks-BrainTools’ outreach activities.