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Category: brain

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Another study that links following the Mediterranean diet with a beneficial health effect - this time a lower risk of ischemic stroke. Unfortunately, it did not seem to lower the risk of hemorrhagic stroke.

The findings were presented at the American Stroke Association's annual meeting. From Medical Xpress:

Mediterranean diet may lower stroke risk, study finds

A Mediterranean diet may reduce your risk of one type of stroke, new research suggests. People who most closely followed the Mediterranean diet were less likely to suffer an ischemic stroke—caused by a blood clot—compared to people with the lowest adherence to the diet, the study found.

A Mediterranean diet includes plenty of fruits and vegetables, whole grains, legumes, nuts, fish, poultry and olive oil. There is limited consumption of red meat, sweets and saturated fats such as those in meat, butter and full-fat dairy products, according to the researchers.

Sherzai's team analyzed data from more than 104,000 teachers in California, averaging 52 years of age, who are taking part in a long-term study. The participants, 90 percent of who were white, were divided into five groups based on how well they followed a Mediterranean diet.

While closely following a Mediterranean diet was associated with a reduced risk of a stroke caused by a blood clot, the healthy eating plan had no effect on a person's odds for a bleeding (hemorrhagic) stroke, according to the study.

According to the researchers, prior research has shown that people who follow a Mediterranean diet have a lower risk of heart disease, mental decline and death, but there is little information about how the diet affects stroke risk.Wright noted that the study was especially rigorous, since the authors accounted for "other factors that would reduce stroke risks, such as exercise, total caloric intake,body mass index, smoking and menopausal/hormonal status."

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Another positive thing we can do for our brains - meditation.From Science Daily:

Forever young: Meditation might slow the age-related loss of gray matter in the brain

Since 1970, life expectancy around the world has risen dramatically, with people living more than 10 years longer. That's the good news.The bad news is that starting when people are in their mid-to-late-20s, the brain begins to wither -- its volume and weight begin to decrease. As this occurs, the brain can begin to lose some of its functional abilities.

Building on their earlier work that suggested people who meditate have less age-related atrophy in the brain's white matter, a new study by UCLA researchers found that meditation appeared to help preserve the brain's gray matter, the tissue that contains neurons.

The scientists looked specifically at the association between age and gray matter. They compared 50 people who had mediated for years and 50 who didn't. People in both groups showed a loss of gray matter as they aged. But the researchers found among those who meditated, the volume of gray matter did not decline as much as it did among those who didn't.

Dr. Florian Kurth, a co-author of the study and postdoctoral fellow at the UCLA Brain Mapping Center, said the researchers were surprised by the magnitude of the difference."We expected rather small and distinct effects located in some of the regions that had previously been associated with meditating," he said. "Instead, what we actually observed was a widespread effect of meditation that encompassed regions throughout the entire brain."

As baby boomers have aged and the elderly population has grown, the incidence of cognitive decline and dementia has increased substantially as the brain ages.

Each group in the study was made up of 28 men and 22 women ranging in age from 24 to 77. Those who meditated had been doing so for four to 46 years, with an average of 20 years.

The participants' brains were scanned using high-resolution magnetic resonance imaging. Although the researchers found a negative correlation between gray matter and age in both groups of people -- suggesting a loss of brain tissue with increasing age -- they also found that large parts of the gray matter in the brains of those who meditated seemed to be better preserved, Kurth said.

The researchers cautioned that they cannot draw a direct, causal connection between meditation and preserving gray matter in the brain. Too many other factors may come into play, including lifestyle choices, personality traits, and genetic brain differences.

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Experiencing positive emotions such as awe, wonder, and amazement are linked with lower levels of inflammation in the body . Another reason to seek out amazing, awe inspiring experiences - it's good for our mental and physical health. From Science Daily:

Add nature, art and religion to life's best anti-inflammatories

Taking in such spine-tingling wonders as the Grand Canyon, Sistine Chapel ceiling or Schubert's "Ave Maria" may give a boost to the body's defense system, according to new research from UC Berkeley. Researchers have linked positive emotions -- especially the awe we feel when touched by the beauty of nature, art and spirituality -- with lower levels of pro-inflammatory cytokines, which are proteins that signal the immune system to work harder.

"Our findings demonstrate that positive emotions are associated with the markers of good health," said Jennifer Stellar, a postdoctoral researcher at the University of Toronto and lead author of the study, which she conducted while at UC Berkeley.

While cytokines are necessary for herding cells to the body's battlegrounds to fight infection, disease and trauma, sustained high levels of cytokines are associated with poorer health and such disorders as type-2 diabetes, heart disease, arthritis and even Alzheimer's disease and clinical depression.

In two separate experiments, more than 200 young adults reported on a given day the extent to which they had experienced such positive emotions as amusement, awe, compassion, contentment, joy, love and pride. Samples of gum and cheek tissue, known as oral mucosal transudate, taken that same day showed that those who experienced more of these positive emotions, especially awe, wonder and amazement, had the lowest levels of the cytokine, Interleukin 6, a marker of inflammation.

In addition to autoimmune diseases, elevated cytokines have been tied to depression. One recent study found that depressed patients had higher levels of the pro-inflammatory cytokine known as TNF-alpha than their non-depressed counterparts. It is believed that by signaling the brain to produce inflammatory molecules, cytokines can block key hormones and neurotransmitters -- such as serotonin and dopamine -- that control moods, appetite, sleep and memory.

In answer to why awe would be a potent predictor of reduced pro-inflammatory cytokines, this latest study posits that "awe is associated with curiosity and a desire to explore, suggesting antithetical behavioral responses to those found during inflammation, where individuals typically withdraw from others in their environment," 

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Much has been written about boxing, concussions, and brain damage, but this is the first time I've read about mixed martial art fighters also having such problems. But it makes sense. From Medscape:

Fight Exposure Linked to Reduced Brain Volume

The more boxers and martial arts practitioners experience head trauma, the more likely they are to have lower brain volume, particularly caudate and thalamus volume, according to a new study. Lower brain volume in these fighters correlated with reduced processing speed, the study also found.

These results "suggest that greater exposure to head trauma is related to detectable brain structural and performance deficits in active fighters," the authors, led by Charles Bernick, MD, Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, Nevada, conclude.

The analysis included 224 adults, aged 18 to 44 years, who were participants in the Professional Fighters Brain Health Study, a longitudinal cohort study of boxers and mixed martial arts (MMA) fighters. The participants included 93 boxers and 131 MMA fighters.The length of professional fighting in this group ranged from 0 to 24 years, with a mean of 4 years. The number of professional fights ranged from 0 to 101, with a mean of 10 fights.

The study also included a control group of 22 age- and education-matched participants with no history of head trauma who did not play a sport associated with head injuries from high school onward.Participants were assessed at baseline and then annually for 4 years. Researchers measured cognitive function with a computer-based battery consisting of tests of  verbal memory, processing speed, and other functions. They used MRI to assess brain volumes.

The study found that increasing exposure to head trauma, as measured by the number of professional fights or years of professional fighting, was generally associated with lower brain structural volumes, particularly subcortical structures. The most consistent relationship between exposure variables and brain volume was seen in the thalamus and caudate. 

The thalamus acts as a "gateway" to the cortex and when affected can influence many neurologic functions, said the authors. It and the caudate are vulnerable to volumetric loss through several mechanisms. Rotational movement of the head brought on by punches in boxing or MMA can result in diffuse axonal injury in white matter tracts, they note.

For the most part, brain structure volumes were lower for boxers than MMA fighters or controls. This could be due to several factors, the authors write. "Perhaps the most obvious explanation is that boxers get hit in the head more. In addition to trying to concuss (ie, knock out) their opponent, MMA fighters can utilise other combat skills such as wrestling and jiu jitsu to win their match by submission without causing a concussion."

The study also found that processing speed was correlated with reduced volume in several cortical and subcortical structures. Reduction in processing speed, said the authors, is consistent with repeated concussions and is considered a clinical component of chronic traumatic encephalopathy.

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Very important research looking at some professional football players who started playing tackle football before the age of 12, and comparing them to those who started later. It discusses the issue of whether children should be playing tackle football before the age of 12 - these and other results suggest NOT. Wait till older (or don't play tackle at all).This article came from Boston University through Futurity:

Is This Kid Too Young For Football?

Researchers from Boston University School of Medicine found that former National Football League (NFL) players who participated in tackle football before the age of 12 are more likely to have memory and thinking problems as adults.

The study contradicts conventional wisdom that children’s more plastic brains might recover from injury better than those of adults, and suggests that they may actually be more vulnerable to repeated head impacts, especially if injuries occur during a critical period of growth and development. "

“This is one study, with limitations,” adds study senior author Robert Stern, a professor of neurology, neurosurgery, and anatomy and neurobiology and director of the Alzheimer’s Disease Center’s Clinical Core. “But the findings support the idea that it may not make sense to allow children—at a time when their brain is rapidly developing—to be exposed to repetitive hits to the head.”

In the study, researchers reexamined data from Boston University’s ongoing DETECT(Diagnosing and Evaluating Traumatic Encephalopathy Using Clinical Tests) study, which aims to develop methods of diagnosing chronic traumatic encephalopathy (CTE) during life. CTE is a neurodegenerative disease often found in professional football players, boxers, and other athletes who have a history of repetitive brain trauma. It can currently be diagnosed only by autopsy.

For this latest study, published in the journal Neurology, scientists examined test scores of 42 former NFL players, with an average age of 52, all of whom had experienced memory and thinking problems for at least six months. Half the players had played tackle football before age 12, and half had not. Significantly, the total number of concussions was similar between the two groups.

Researchers found that the players exposed to tackle football before age 12 had greater impairment in mental flexibility, memory, and intelligence—a 20 percent difference in some cases. These findings held up even after statistically removing the effects of the total number of years the participants played football. Both groups scored below average on many of the tests.

Stamm says the researchers were especially surprised by the scores on a reading test called the WRAT-4, which has participants read words of increasing difficulty....The low scores may be significant, she says, because they suggest that repeated head trauma at a young age might limit peak intelligence. She emphasizes, however, that there may be other reasons for a low score, and that more research is needed.

The authors chose age 12 as the cutoff because significant peaks in brain development occur in boys around that age. (This happens for girls a bit earlier, on average.) Around age 12, says Stern, blood flow to the brain increases, and brain structures such as the hippocampus, which is critical for memory, reach their highest volume.

Boys’ brains also reach a peak in their rate of myelination—the process in which the long tendrils of brain cells are coated with a fatty sheath, allowing neurons to communicate quickly and efficiently. Because of these developmental changes, Stern says, this age may possibly represent a “window of vulnerability,” when the brain may be especially sensitive to repeated trauma.

Stern adds that a study by another group of researchers of the number and severity of hits in football players aged 9 to 12, using accelerometers in helmets, found that players received an average of 240 high-magnitude hits per season, sometimes with a force similar to that experienced by high school and college players.

With approximately 4.8 million athletes playing youth football in the United States, the long-term consequences of brain injury represent a growing public health concern. This study comes at a time of increasing awareness of the dangers of concussions—and subconcussive hits—in youth sports like football, hockey, and soccer. In 2012, Pop Warner football, the oldest and largest youth football organization in the country, changed its rules to limit contact during practices and banned intentional head-to-head contact. 

“Football has the highest injury rate among team sports,” writes Christopher M. Filley, a fellow with the American Academy of Neurology, in an editorial accompanying the Neurology article. “Given that 70 percent of all football players in the United States are under the age of 14, and every child aged 9 to 12 can be exposed to 240 head impacts during a single football season, a better understanding of how these impacts may affect children’s brains is urgently needed.”

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This study is important because it shows (once again) that spatial skills may be developed by what a child does in childhood. The trend for girls to only be given dolls or stereotypically "girl" toys is not that good for mental development (but good for nurturing). All children need to play with blocks, puzzles, and to create and build. They all need to go out and actively explore their environment, which also is good for developing spatial reasoning skills (as shown by earlier research). Think about it: when you actively explore the streets and land around you, you develop "mental maps" of how to get around, and this is good for spatial skills. Bottom line: encourage both boys and girls to build, create, do puzzles, play board games, and explore their outside environment. From Science Daily:

Playing with puzzles, blocks may build children's spatial skills

Play may seem like fun and games, but new research shows that specific kinds of play are actually associated with development of particular cognitive skills. Data from an American nationally representative study show that children who play frequently with puzzles, blocks, and board games tend to have better spatial reasoning ability.

"Our findings show that spatial play specifically is related to children's spatial reasoning skills," says psychological scientist and lead researcher Jamie Jirout of Rhodes College. "This is important because providing children with access to spatial play experiences could be a very easy way to boost spatial development, especially for children who typically have lower performance, such as girls and children from lower-income households."

Being able to reason about space, and how to manipulate objects in space, is a critical part of everyday life, helping us to navigate a busy street, put together a piece of "some assembly required" furniture, even load the dishwasher. And these skills are especially important for success in particular academic and professional domains, including science, technology, engineering, and math (STEM).

Jirout and Newcombe analyzed data from 847 children, ages 4 to 7, who had taken the revised WPPSI [Wechsler Preschool and Primary Scale of Intelligence], which included measures of cognitive skills that contribute to general intelligence. The children's spatial ability was specifically measured via the commonly-used Block Design subtest of the WPPSI, in which children are asked to reproduce specific 2D designs using cubes that have red, white, and half-red/half-white faces. The researchers also examined survey data from parents about the children's play behavior and joint parent-child activities.

The data revealed that family socioeconomic status, gender, and general intelligence scores were all associated with children's performance on the block design task. Children from the low-socioeconomic status group tended to have lower block design scores compared to children from either the middle- or high-socioeconomic status groups. And boys tended to have higher block design scores than did girls, though only after several other cognitive abilities, such as vocabulary, working memory, and processing speed, were taken into account.

Importantly, how often children played with certain toys was also tied to their spatial reasoning skills. Children who played with puzzles, blocks, and board games often (more than six times per week) had higher block design scores than did children who played with them sometimes (three to five times per week), or rarely/never.

None of the other types of play (e.g., drawing, playing with noise-making toys, and riding a bicycle, skateboard, or scooter) or the parent-child activities (e.g., teaching number skills, teaching shapes, playing math games, telling stories) included in the survey data were associated with children's spatial ability.

In line with previous findings, parents reported that boys engaged in spatial play -- playing with puzzles, blocks, and board games -- more often than girls, even after spatial ability was taken into account.

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Finding an increased risk of dementia and Alzheimer's with so many common over-the-counter medications such as Benadryl and  Chlortrimeton (the first generation allergy drug that so many people took for years) was an unpleasant surprise. Note: they found the link with high doses or heavy use (3 or more years). Some examples of common anticholinergics (from Wikipedia) are: atropine, benztropine (Cogentin), chlorpheniramine (Chlor-Trimeton), dimenhydrinate (Dramamine), diphenhydramine (Benadryl, Sominex, Advil PM, etc.), doxylamine (Unisom), hydroxyzine (Atarax, Vistaril), ipratropium (Atrovent), oxybutynin (Ditropan, Driptane, Lyrinel XL), tolterodine (Detrol, Detrusitol), tiotropium (Spiriva), and bupropion (Zyban, Wellbutrin). The message here: only take medications when absolutely needed and for as little a time as necessary. The study was done on older adults, so now the question is: what about children or young adults who take these drugs for years? Is there a similar increased risk later in life? From Medical Daily:

Common Over-The-Counter Anticholinergic Drugs Like Benadryl May Increase Your Risk Of Alzheimer's

Anticholinergic medications span a range of common drugs and include antihistamines, sleep aids, antidepressants, cardiovascular meds, gastrointestinal drugs (for diarrhea, incontinence, diverticulitis, and ulcers), and muscle relaxants. Now, a new study confirms the link between these everyday medications and dementia. Taking anticholinergic drugs at high doses or for a long time may significantly increase your risk for developing Alzheimer's disease and other dementias, say researchers from University of Washington School of Pharmacy.

“If providers need to prescribe a medication with anticholinergic effects because it is the best therapy for their patient, they should use the lowest effective dose, monitor the therapy regularly to ensure it's working, and stop the therapy if it's ineffective,” Dr. Shelly Gray, a professor and director of the geriatric pharmacy program at the UW School of Pharmacy said in a release.

On average, older people take four or five prescription drugs and two over-the-counter drugs each day. Clearly, drugs are an important part of medical care for older people; however, older people are more sensitive to the effects of many pills, including anticholinergics, which block the neurotransmitter acetylcholine and so effect the nervous system. While the drugs are too numerous to mention, those with anticholinergic effects — and these effects are sometimes dependent on the dose — include Benadryl, Sominex, Xanax, Ativan, Valium, Luminal, Skelaxin, Limbitrol, and Tavist.

For the current study, the researchers investigated a previously reported link between anticholinergics, both prescription strength and over-the-counter, and dementia by employing more rigorous methods than in the past. Specifically, the researchers conducted a longer follow-up of more than seven years and more accurate use assessment via pharmacy records, which included nonprescription choices. The team tracked nearly 3,500 seniors participating in a long-running study, the Adult Changes in Thought (ACT), a joint project of UW and the National Institute on Aging.

The most commonly used medications in the study, the researchers discovered, were tricyclic antidepressants like doxepin (Sinequan), antihistamines like chlorpheniramine (Chlor-Trimeton), and antimuscarinics for bladder control like oxybutynin (Ditropan). People taking at least 10 mg/day of doxepin, 4 mg/day of diphenhydramine, or 5 mg/day of oxybutynin for more than three years, the researchers estimated, would be at greater risk for developing dementia. Importantly, substitutes are available for some of these drugs.  

While this study is the first to show a dose response — meaning, the more you use anticholinergic medications the greater your risk of developing Alzheimer’s — it also is the first to suggest this higher risk may persist, and may not be reversible, even years after you stop taking these drugs. 

Source: Gray S, Crane P, Dublin S, et al. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia. JAMA Internal Medicine. 2015.

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Exercise has health benefits at all ages! From Medical Xpress:

Study indicates exercise sharpens the young adult brain

Regular physical activity improves brain function even in young adults considered in their prime and at the height of cognitive ability, according to a new University of Otago study.

They took 52 tertiary students, aged from 18 to 30, and put them through a series of cognitive tests on a computer while measuring oxygen availability in the frontal lobe of their brains, as well as their self-reported exercise frequency. Dr Machado says their "surprising" findings, just published online in the journal Psychophysiology, show that both blood supply to the brain and cognitive functioning appear to benefit from regular exercise in young adults.

"This provides compelling evidence that regular exercise, at least 5 days per week, is a way to sharpen our cognitive ability as young adults – challenging the assumption that living a sedentary lifestyle leads to problems only later in life," she says... "The exercise could involve brisk walking or more vigorous activity, and could be made up of a few 10 minute bouts of exercise, rather than one single block of exercise," she says.

The researchers also found that body mass index was not a key factor in how well the brain functioned, indicating that regular engagement in physical activity may be more important than body weight.

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Over the past year I have seen a number of studies looking at alcohol consumption and health effects. Overall it seems that the effects of alcohol are complex and frequently result in a J-curve: abstainers have a higher mortality rate or problems, light or moderate drinkers do the best, and then heavier drinkers have the most problems and higher mortality rates. The following two studies support this. From Science Daily:

Drinking moderate amounts of alcohol is linked to reduced risk of heart failure, large study finds

Evidence already exists for the beneficial effects of drinking moderate amounts of alcohol on the risk of developing a number of heart conditions; however, the role it plays in the risk of developing heart failure has been under-researched with conflicting results. Now, a large study of nearly 15,000 men and women shows that drinking up to seven drinks a week in early to middle age is associated with a 20% lower risk of men developing heart failure in the future when compared to people who did not drink at all, and a more modest 16% reduced risk for women.

They defined a drink as one that contains 14g of alcohol, equivalent to approximately one small (125ml) glass of wine, just over half a pint or a third of a litre of beer, and less than one shot of liquor such as whisky or vodka. The study participants were divided into six categories: abstainers (people who recorded having drunk no alcohol at every visit by the researchers), former drinkers, people who drank up to seven drinks a week, or between 7-14 drinks, 14-21 drinks, or 21 or more drinks a week.

From Science Daily:

If you're over 60, drink up: Alcohol associated with better memory

For people 60 and older who do not have dementia, light alcohol consumption during late life is associated with higher episodic memory -- the ability to recall memories of events -- researchers report.

Moderate alcohol consumption was also linked with a larger volume in the hippocampus, a brain region critical for episodic memory. The relationship between light alcohol consumption and episodic memory goes away if hippocampal volume is factored in, providing new evidence that hippocampal functioning is the critical factor in these improvements.

Findings from animal studies suggest that moderate alcohol consumption may contribute to preserved hippocampal volume by promoting generation of new nerve cells in the hippocampus. In addition, exposing the brain to moderate amounts of alcohol may increase the release of brain chemicals involved with cognitive, or information processing, functions.

Although the potential benefits of light to moderate alcohol consumption to cognitive learning and memory later in life have been consistently reported, extended periods of abusing alcohol, often defined as having five or more alcoholic beverages during a single drinking occasion is known to be harmful to the brain.

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Try standing on one leg with your eyes open, Can you do it for longer than 20 seconds? From Science Daily:

Ability to balance on one leg may reflect brain health, stroke risk

Struggling to stand on one leg for less than 20 seconds was linked to an increased risk for stroke, small blood vessel damage in the brain, and reduced cognitive function in otherwise healthy people, a study has shown. One-legged standing time may be a simple test used to measure early signs of abnormalities in the brain associated with cognitive decline, cerebral small vessel disease and stroke.

The study consisted of 841 women and 546 men, average age of 67. To measure one-leg standing time, participants stood with their eyes open and raised one leg. The maximum time for keeping the leg raised was 60 seconds. Participants performed this examination twice and the better of the two times was used in the study analysis. Cerebral small vessel disease was evaluated using brain magnetic resonance imaging.

Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with cerebral small vessel disease, namely small infarctions without symptoms such as lacunar infarction and microbleeds. They noted that: 34.5 percent of those with more than two lacunar infarction lesions had trouble balancing, 16 percent of those with one lacunar infarction lesion had trouble balancing, 30 percent of those with more than two microbleed lesions had trouble balancing, 15.3 percent one microbleed lesion had trouble balancing.

Overall, those with cerebral diseases were older, had high blood pressure and had thicker carotid arteries than those who did not have cerebral small vessel disease. However, after adjustment for these covariates, people with more microbleeds and lacunar infarctions in the brain had shorter one-legged standing times. Short one-legged standing times were also independently linked with lower cognitive scores.

Small vessel disease occurs due to microangiopathy of arterioles in the brain, making these arteries less flexible, which can interfere with blood flow. Small vessel disease typically increases with age. Loss of motor coordination, including balance, as well as cognitive impairment has been suggested to represent subclinical brain damage. Tabara and colleagues also found a strong link between struggling to stand on one leg and increased age, with marked shorter one-leg standing time in patients age 60 and over.