Fotuhi - Neuroplasticity - Harvard course
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Neuroplasticity, Brain Reserve, and Aging:
How to Improve Your Brain Performance
by Growing the Size of Your Hippocampus,
At Any Age
Majid Fotuhi, MD PhD
Medical Director: NeuroGrow Brain Fitness Center
Affiliate Staff: Johns Hopkins Medicine
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Neuroplasticity in the Human Brain:Translational Research
2
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Objectives1. Basic Anatomy of Cognition2. Memory Loss and Brain Atrophy with
Aging3. Brain Reserve & Neurogenesis4. Six Ways to Grow Your Brain5. Reversing Brain Atrophy in Elderly, in 3
Months
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Synapses
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Blood Vessels
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Brain is a Highly Vascular Organ
Zlokovic et al. Neurosurgery 43(4), 877–78, 1998
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Anatomy of Cognition: CortexExecutive function
Language
Navigation
Calculation
Abstract thinking
Long term memory
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Short-term Memory & Consolidation: Hippocampus
Cortex Hippocampus
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Hippocampus
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Neurons in Hippocampus
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Objectives1. Basic Anatomy of Cognition2. Memory Loss and Brain Atrophy with
Aging3. Brain Reserve & Neurogenesis4. Six Ways to Grow Your Brain5. Reversing Brain Atrophy in Elderly, in 3
Months
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With Aging, Hippocampus Atrophies Faster
than the Rest of the Brain Hippocampus shrinks by about 0.5%
per year after age 40.
That is the main reason memory lapses become more frequent after age 40.
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What CausesAtrophy in Hippocampus?
Obesity Smoking Diabetes
Concussion
Alzheimer’s
Insomnia
Sleep Apnea
StressDepression
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Depression1 Obesity2
Cortisol / Stress3 Insomnia4
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1- Sheline, (1996). PNAS, 93(9);3908-13.2- Brain Research, 2009, Pages 186–1943- Lupien et al (1998), Nature NeuroSci 1 (1), 69-734- Ho et al; J Clin Neurol. 2012 Jun;8(2):130-8
More Depression, Obesity, Stress, and Insomnia, Smaller Hippocampus
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More Traumatic Brain Injury (TBI), Smaller Hippocampus
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More Football, Smaller Hippocampus
Singh, JAMA neurology, 2014
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Multiple Risk Factors, Much Smaller Hippocampus
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MultipleRisk Factors
No Risk Factors
HippocampusHippocampus
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19
DiabetesHypertensionObesitySleep ApneaInsomniaHead TraumaGenesStress
Brain-healthy DietPhysical FitnessCognitive StimulationQuality sleepPeace of Mind
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Objectives1. Basic Anatomy of Cognition2. Memory Loss and Brain Atrophy with
Aging3. Brain Reserve & Neurogenesis4. Six Ways to Grow Your Brain5. Reversing Brain Atrophy in Elderly, in 3
Months
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“Brain Reserve”
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Four Ways to Build a Bigger Brain Reserve
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Before and After
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Neurogenesis in Hippocampus
Bischofberger, Nature Neuroscience, 2007
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Epigenetics: Factors That Modulate Your Genes
http://journal.frontiersin.org/article/10.3389/fcell.2014.00049/full
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Objectives1. Basic Anatomy of Cognition2. Memory Loss and Brain Atrophy with
Aging3. Brain Reserve & Neurogenesis4. Six Ways to Grow Your Hippocampus5. Reversing Brain Atrophy in Elderly, in 3
Months
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1. More Exercise, Bigger Hippocampus
Erikson, PNAS 2011
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Arch Gen Psychiatry, 2010
More Exercise, Bigger Hippocampus, Even After 3 Months
After
Before
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More Exercise: More Neurogenesis
Van Praag, Trends in Neurosciences, 2009
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2. More Omega-3 Fatty Acids, Bigger Hippocampus
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Pottala J V et al. Neurology 2014;82:435-442
More Omega-3 Fatty Acids, Bigger Hippocampus
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Draganski et al. J Neurosci 2006; 26:6314–7
3. More Learning, Bigger Hippocampus
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4. Better Sleep, Bigger Hippocampus
Canesa, American Journal of Respiratory Medicine, 2011
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5. More Meditation, Bigger Hippocampus
34Holzel , Psychiatric Research, 2011
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6. More Neurofeedback, Bigger Cortex
Ghaziri et al. Clin EEG Neurosci 2013; 44 (4) 265-72
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Neurofeedback
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Performed by a certified EEG neurofeedback specialist Live EEG feedback is provided through auditory and visual
responses to help the patient move brain activity towards an optimal state
Benefits are long-lasting
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Hippocampus Grows Bigger When You Start Early
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Objectives1. Basic Anatomy of Cognition2. Memory Loss and Brain Atrophy with
Aging3. Brain Reserve & Neurogenesis4. Six Ways to Grow Your Brain5. Reversing Brain Atrophy in Elderly, in 3
Months
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Brain Fitness Program: Overview
Initial appointmen
twith
neurologist
Diagnostics Follow-Up
Brain Fitness
Program: Level 1
Level 2
Level 3
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Brain Fitness Program: Initial Exam
40
BFP
MedicineNeur
ology
Psychology
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Brain Fitness Program: Comprehensive Diagnostic Tests
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Brain MRI Neurocognitive Evaluation
Carotid Ultrasound
Sleep HealthAssessment
Cardiopulmonary Testing
Brain Mapping qEEG
Blood Test
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Brain Fitness Program: A Personalized Set of Interventions
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Brain Coaching and Counseling Cognitive Skills Training Neurofeedback Training
Weekly Monitoring
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4/18/13 7/29/130
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Mood0
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Anxiety
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Sleep
Memory Attention Concentration
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Brain Fitness Program:One example: 69 year old with ?
Alzheimer’s
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Brain Fitness Program: Statistical Analysis of 127 Patients with MCI
Low or No Impact Moderate Impact High Impact0%10%20%30%40%50%60%70%80%90%
7% 9%
84%
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≥3 areas of cognitive function Improved,
p<0.05
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HC
2.86 cm3
HC
3.14 cm3
42
MRI ResultsBefore
After
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Baseline 3 Months 1 Year6.5
6.7
6.9
7.1
7.3
7.5
7.7
7.9
8.1
7.29
7.927.94
Sustained Benefits
40
Hipp
ocam
pus V
olum
e (c
m3 )
8.6% increase in HC volume
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DiabetesHypertensionObesitySleep ApneaHead TraumaGenesStress
Brain-healthy DietPhysical FitnessCognitive StimulationBrain Fitness Program
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Summary1. Basic Anatomy of Cognition2. Memory Loss and Brain Atrophy with
Aging3. Brain Reserve & Neurogenesis4. Six Ways to Grow Your Brain5. Reversing Brain Atrophy in Elderly, in 3
Months
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THANK YOU