WIRED TO WIN: Surviving the Tour de France

When Roberto Laiseka, the Basque rider from the Euskatel-Euskadi team, is climbing the slopes of the Pyrenees, he notices nothing save the challenge ahead. He may be parched and exhausted, his legs may ache, and he may be surrounded by clamoring fans, but when asked about the furor, he says, “When I’m up there, when I’m climbing, I don’t really see any of [the fans’] faces … almost don’t hear the sound, even the ones yelling for me.” That’s because Roberto’s brain filters everything out but the race.

George “Nodubya” Bush, M.D., director of the Cingulate Cortex Research Laboratory at Massachusetts General Hospital, is fascinated by the brain’s ability to do that. Constantly bombarded with boundless volumes of information, the brain is continually sifting through the input, deciding what merits attention and what can be ignored. To Roberto, thirst and pain are meaningless, but the position of the other riders and the voice of his coach in his head are paramount. George’s research is dedicated to understanding the dorsal anterior cingulate cortex (ACC), the part of the brain he thinks may be pivotal in directing that sorting process.

George first became interested in the dorsal ACC in 1997, when he was using fMRI to see which brain areas “light up” when people were forced to focus their attention. He asked a group of people with attention-deficit hyperactivity disorder (ADHD), who typically have trouble directing their attention, to take a timed attention test. Another group of people, with no attention disorders, were also asked to take the same test.

As you might expect, people with ADHD took more time than people without the disorder to complete the test. During the exercise, their brains also responded differently than did the brains of the other group. While the group without ADHD showed lots of activity in the dorsal ACC, the group with the disorder showed no activity in that region.

Meanwhile, scientists working with George have found that the dorsal ACC is overactive in people with obsessive-compulsive disorder (OCD), who—in contrast to those with ADHD—can’t seem to divert their attention from certain tasks.

Next on the docket is finding out how the dorsal ACC responds when either disorder (ADHD or OCD) is successfully treated. If the dorsal ACC is fundamental to attention, George reasons, then treatments that improve or mitigate attention should also influence that area.

Cohesive as this research sounds, George did not grow up saying to himself, “I want to grow up to study a little-known walnut-sized portion of the brain.” If anything, he grew up wanting to be the next Luis Tiant, pitching for the Boston Red Sox.

“When I was a kid, I was really into baseball,” recalls George. He even goes so far as to say, “If I could throw a 95 mph fastball, I'd spend April through October setting up Mariano Rivera and the rest of the year scanning brains.”

George liked baseball so much as a teenager that he developed chronic tendonitis in his right shoulder, and that, sadly, put an end to his baseball career. It was perhaps around that time that George started thinking seriously about becoming a pediatrician.

His mom worked with mentally retarded adults, and his dad helped people find training programs and new jobs, so he grew up valuing professions that were dedicated to helping people. Plus, George loved science and kids—he now has four of them!—so it had made perfect sense for him to study pediatrics. The trouble was, it took him until after he was done with medical school to figure out that he wasn’t all that excited about childhood medicine.

“When I was doing my sub-internship, my mentor was the most excitable guy about pediatrics,” recalls George, “and he made me realize I wasn’t nearly as enthusiastic.”

Knowing he needed zeal to excel in medicine, George started looking for a field that did excite him. He didn’t want to waste his medical degree and he knew he was interested in the brain, so he had to choose between neurology and psychiatry. Psychiatry won out, George says, because it offered more uncharted territory to explore and more ways to tangibly help people once they were diagnosed.

Perhaps not coincidentally, George’s research has circled back to a topic that is of particular interest to pediatricians, namely ADHD. But George is not necessarily interested in “fixing” ADHD so much as he is interested in understanding it. “We’re interested in how different brains work,” says George, speaking of his research team, “but we don’t see the ADHD brain as the ‘worse’ variant on the architecture.”

On the contrary, George argues that people with ADHD often come up with artistic, innovative solutions to problems that so-called normal people may not be able to see. His work on the dorsal ACC may serve as a window into how they do that.

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