Cerebrum Fall 2021

accelerometer based on signals from the inner ear] “tells with great precision how the head is moving through space. The proprioceptive system [which tallies input from muscles throughout the body] tells you how limbs are positioned, relative to the body,” says Cullen, professor of biomedical engineering, neuroscience, and otolaryngology at Johns Hopkins University, These signals come through the spinal cord and converge in the cerebellum, “where the brain computes its prediction based on an internal model of sensory flow…. when there’s a difference between proprioceptive and vestibular input and what the brain expects, there’s an error signal, which the athlete can then correct on the fly.” The cerebellum also receives signals from the ventral striatum, bringing in higher-level cognitive functions. All this happens within milliseconds, she says. More generally, the brain’s comparison of an internal model deeply entrenched by the motor learning of endless practice, and the sensory input of the act itself, underlies highly skilled performance. To pitch a cut fastball in baseball with pinpoint precision or execute flawless vibrato on the violin, “you certainly need an intimate relationship in terms of movement and expected feedback,” she says. How things go wrong is an ongoing area of research, Cullen says. But given the complex orchestration of brain processes, it’s no small surprise that overarousal creates “THE WAY THE GENERAL PUBLIC VIEWS ELITE ATHLETES IS THAT THEY HAVE ‘THE LIFE.’ THEY JUST GET TO PLAY SPORTS.”

problems. “What skilled athletes and musicians do are voluntary movements. Cortical areas such as the medial prefrontal cortex encode higher levels of representation and the importance of certain motor behaviors. When the stakes are higher, you pay more attention; but if the stress level gets too high, it can get counterproductive, interfering with the volitional component of movement and flipping you into a reflex, reactive mode. You lose focus on where you are; anxiety becomes a distraction from what you’re trying to do.” A Silver Lining? The dark side of performers’ lives may enlighten the public at large about mental health and illness. “Fifteen years ago, people didn’t talk about this,” says Katrina Gay , chief development officer at National Association for the Mentally Ill. “When athletes and elite influencers share their journey, it encourages people in their own struggles with mood disorders and anxiety. It encourages them to seek help.” The willingness of an admired figure like Simone Biles to make substantial sacrifices for her mental well-being inspires others to do likewise, says Gay. “I’ve noticed more people willing to take a time-out, a mental health break from their own work.” The power of example may be particularly important for groups reluctant to seek help for mental health problems, such as men and racial minorities . A 2020 paper in Academic Psychiatry cited the example of wrestler/action movie star Dwayne “The Rock” Johnson, who has talked openly and tweeted about his depression. “You are not alone,” he told his millions of followers. Kevin Love, a five-time National Basketball Association All-Star, also inspired countless performers and others when he began advocating for mental health awareness after suffering a panic attack during a game in November 2017. His powerful essay for the Players Tribune in 2020 about living with anxiety and depression has helped remove the stigma about seeking treatment that has long plagued high-profile performers. “Talk to somebody. You would be amazed at how freeing it is just to talk to somebody and tell them the truth about what you’re going through. And listen, I’m not trying to sell you some fairy-tale version of mental health. It took me years and years—hell, it genuinely took 29 years for me to realize what I needed. I needed medication. I needed therapy. I still need those things now, and I probably always will.” l

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