Brain Heal Thy Self

By Norman Doidge, M.D.
Published: Wall Street Journal Saturday/Sunday Edition, 2/7-8/2015

Dr. Doidge teaches at the University of Toronto’s Department of Psychiatry and is a researcher at Columbia University Center for Psychoanalytical Training and Research.

These excerpts are retrieved from the Wall Street Journal’s Review section C, pages 1 & 2.In the late 1970’s Mark Rosenzweig, University of California, Berkeley found that with environmental stimulation, animal brains grew in key areas. Michael Merzenich, University of California, San Francisco, discovered that if an animal stopped using a body part, the brain area that processed sensory input from that part weakened or was taken over to perform another function. Their studies showed that the brain’s circuitry changes microscopically with experience and activity. Their findings have been replicated many times since.

The mainstream view in neuroscience and medicine today is that the living brain is actually “neuroplastic”, meaning that it’s “circuits” are constantly changing in response to what we actually do out in the world. As we think, perceive, form memories or learn new skills, the connections between brain cells also change and strengthen. The brain is hardly hard wired, it’s circuits rapidly form, unform and reform.

This capacity is the foundation for the brain’s distinctive way of healing. If an area is damaged, new neurons can often take over old tasks. Nor are we just neurons. Our memories and experiences are also encoded in the patterns of electrical energy produces by our brain cells, like a musical score. As with an orchestra, when one member of the string section is sick, the show can still go on if a replacement has access to the musical score.

This new “plastic” understanding has major practical implications for how we treat brain problems and maintain brain health.

Dementia affects 15% of people over the age of 70. Alzheimer, the most common form of Dementia, presents a brain that’s losing overall plasticity, shrinks and loses neuronal connections.

Research has found that both mental and physical exercise can lower the risk of experiencing Dementia. The research last year that was a culmination of a 2235 men for 30 year study, conducted by Dr. Peter Elwood, Cochrane Institute of Primary Care and Public Health at Cardiff University in the UK. When they maintained a healthy diet; maintain a normal weight with a body mass index between 18 and 25; limiting alcohol to a glass of wine per day; and didn’t smoke. Also walking 2 miles a day, biking 10 miles a day or engaging in some other regular, vigorous physical exercise, resulted in a 60% reduction in the risk of Dementia.

Most people assume that Alzheimer’s disease is result of the theory: “all in your genes”, but neurologist and Dementia researcher, Dr. Tiffany Chow of the Rotman Research Institute and the University of Toronto points out, environmental factors interact with genetic makeup to eventually allow or deny Dementia a foothold. Even having multiple copies of the genetic materials associated with risk is not sufficient to produce Alzheimer’s. For the majority of people it is how you live that matters. Dr. Elwood’s study and 10 others showed that exercise in mid life was associated or correlated with lower rates of Dementia.

Dr. Kirk Erickson, University of Pittsburgh, published in the Proceedings of the National Academy of Sciences, revealed that the hippocampus significantly enlarged from regular aerobic exercise. This area of the brain turns short term memories into long term. This area is the first to degenerate with Alzheimer’s. Earlier studies showed that aerobic exercise increased the brain’s gray and white matter in the frontal lobes, areas involved in planning and goal directed activity.

How does this healing work? Exercise triggers the growth of new brain cells in the hippocampus. It also releases a “neurotrophic growth factors” that is a stimulus causing the brain to grow, create new neuron synaptic connections and stay healthy.

Dr. Frederick Gage, Salk Institute, University of Pittsburgh, suggests that new cells arise from long walks and vigorous exercise going back to our evolutionary nomadic life causing stress from being injected into new unexplored places, conditions and adaptations needed to survive in the ever changing environment. In response to a “be prepared” life style, the brain’s constant anticipation of change releases new cells and growth factors that create a more plastic state. This adds further protection to the brain’s health.

In conjunction with these studies, it has been found that Parkinson’s disease symptoms can be reduced with some form of regular exercise. Published in journal “Neurology” 2011, Dr. J. Eric Ahlskog, Mayo Clinic reviewed evidence that vigorous exercise that increased the heart and a need for oxygen including walking, swimming and other physical activities. This deserves a “central place” in the treatment of Parkinson. The exercising is difficult to perform and the patient is caught in the ever tightening noose. It is important to have early exercise intervention. The condition does not “stay still’ but constantly progresses and the gets worse. Because our plastic brains are ‘use it or lose it” organs, lack of walking, etc. results in those circuits controlling walking then “wither” with disuse. When people with dormant brain circuits try to walk, they fail, “learn” that they can’t walk and stop trying. This is called “learned nonuse”, a phenomenon first seen in human beings who have suffered a stroke, caused by a blood clot or bleeding that cuts off the blood supply and oxygen to the brain tissue and killing it. Shock ensues, neurons die, chemicals leak out of cells and harm others, rampant Inflammation and blood flow around the dead tissue is interrupted. All of these events disrupt functioning not just where the stroke occurred but throughout the brain. This period last approximately 6 weeks. Rehabilitative treatment historically usually began at the end of this period.

Physicians once treated such dire problems by waiting six weeks to see what mental functions their stroke patients still had. Dr. Edward Taub, University of Alabama at Birmingham, neuroscientist, discovered “learned nonuse’, has had striking results with patients who have lost the use of limbs from strokes and haven’t gotten better with conventional rehabilitation. He learned that the “plasticity” of the brain provided the opportunity to receive better options of care. He used the cross training technique of rehabilitating the non functional extremity. For example, he would sling the paralyzed arm and rehabilitate the other arm. We learned long ago that there is a transfer across the central nervous system of nerve energy to stimulate the opposing anatomical part.

Dr. Taub’s brain scan studies showed that when patients recovered from this treatment, neurons adjacent to the injury begin to take over from the damaged or dead neurons. More recently, the approach has worked with stroke patients who can no longer speak and having movement problems that occur from multiple sclerosis, cerebral palsy and even movement problems that occur after radiation to the brain for cancer. “Learned nonuse” seems to occur in response to many brain problems, so dormant neuronal circuits are awaiting to be revived are far more common than has been generally appreciated.

Among the most exciting new neuroplastic treatments are those that deal with the “noisy brain”. These brains fire out of synchronization or at the wrong rates in conditions like multiple sclerosis, Parkinson’s disease, traumatic brain injuries, learning disorders, autism and some cases of chronic pain.

Clinical studies in Toronto, Harvard and Israel has shown that low-intensity lasers applied to the back of the neck can diminish stroke and brain injury symptoms. New forms of “conscious walking” that allow Parkinson’s patients to learn to use healthy parts of their brains to take over from damaged areas can sometimes get them moving again.

The basic neuroplastic principle of “use it or lose it” and the benefit of forming new brain connections through intensive learning also apply to people without brain problems. Physical exercise produces some new cells in the memory system, but mental exercise preserves and strengthens existing connections in the brain, giving a person a “cognitive reserve” to fend off future losses and to perfect skills.

Dr. Merzenich, neuroscientist, is a pioneer that has developed the ”brain exercises” concept. The brain exercises have been evaluated by the National Institutes of Health study and published by George Rebok of the Johns Hopkins School of Medicine and colleagues in the Journal of the American Geriatrics Society. They found that people who did the brain exercises, called “Brain HQ”, showed benefits 10 years later. They did not just improve on the brain exercises; their cognitive function improved in daily life. Their mental sharpness increased. They could process information with greater speed and accuracy as if they were ten years younger.