Vascular Contributions To Alzheimers Disease
People with dementia seldom have only Alzheimers-related changes in their brains. Any number of vascular issuesproblems that affect blood vessels, such as beta-amyloid deposits in brain arteries, atherosclerosis , and mini-strokesmay also be at play.
Vascular problems may lead to reduced blood flow and oxygen to the brain, as well as a breakdown of the blood-brain barrier, which usually protects the brain from harmful agents while allowing in glucose and other necessary factors. In a person with Alzheimers, a faulty blood-brain barrier prevents glucose from reaching the brain and prevents the clearing away of toxic beta-amyloid and tau proteins. This results in inflammation, which adds to vascular problems in the brain. Because it appears that Alzheimers is both a cause and consequence of vascular problems in the brain, researchers are seeking interventions to disrupt this complicated and destructive cycle.
Chapter 6: What Happens Inside Peoples Brains When Theyre Depressed
There have been studies showing a change in brain activity when mood shifts, but there is now also research showing a change in brain shape that appears to be associated with severe mood disorders. The brain shrinks, or rather, certain parts of it do. One of those parts is called the hippocampus. This part is associated with making and being able to recall memories. If mood symptoms are severe or go on very long, the hippocampus shrinks. This chapter shows you the evidence that this shrinkage really occurs. The same process appears also to be occurring in frontal lobes as well, though not elsewhere in the brain. This brain shrinkage, called atrophy, has long been associated with Alzheimers dementia; but lately it has also been associated with obesity, and even with back pain, and very clearly with depression. The good news is that treatments can reverse this shrinkage, at least to a significant extent.
|Here is the problem, described in the next 4 chapters, and the hoped-for results of treatment, detailed in Chapter 11:|
|Cellular Connections During Mood Disorders||Results of Effective Treatments|
Link to Chapter 7: Why do some parts of the brain atrophy during major depression?
Too Little Sleep Could Shrink Your Brain
A new study published online in Neurologysuggests that getting too little sleep could lead to a shrinking brain.
The study involved 147 adults with an average age of 54 years. They underwent two brain scans, one at the start of the study and one an average of three and half years later. Before getting the scans, participants completed a questionnaire about their sleep habits.
A total of 35 percent of the participants met the criteria for poor sleep quality. They scored an average of 8.5 out of 21 points on the sleep questionnaire. It looked at how long people slept, how long it took them to fall asleep at night, use of sleeping medications, and other factors.
Results show that participants with poor sleep quality had shrinkage in one part of their frontal cortex. They also had deterioration in three other parts of the brain that are involved in reasoning, planning, memory and problem-solving. The results were more pronounced in people over 60 years old.
There are some things you can do to help improve your sleep. Go to bed at the same time each night and wake up at the same time very morning. Avoid things like alcohol and caffeine, especially late in the afternoon. Create a sleep-friendly environment: cool, dark and quiet. Turn off all electronics an hour before bedtime.
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What Are The Symptoms Of Brain Atrophy
- Dementia: A non-specific disease often presenting with a wide range of symptoms. It is most commonly associated with a decline in memory and other thinking skills. Cognitive ability is often limited severely enough to reduce a persons ability to perform everyday tasks, causing them to have to rely on help from others. Dementia is characterized by worsening judgment, poor concertation, personality changes, and emotional disturbance. Alzheimers disease is the most common type of dementia and accounts for nearly 60 to 80 percent of all cases.
- Seizures: Occur due to sudden, abnormal electrical activity in the brain. Seizures often present as uncontrolled jerking movements , but can be subtle, presenting as a momentary loss of awareness .
- Aphasia: The inability to comprehend and formulate language. This symptom will occur due to injury of the centers of the brain responsible for language. For a person to be diagnosed with aphasia, the decline in four communication modalities must be documented. These include deficiencies in auditory comprehension, verbal expression, reading, and writing, as well as functional communication.
Hippocampal Atrophy With Depression
The hippocampi are easy to measure for size, so much of this research focuses there, though the story so far looks very similar for the frontal lobes.
Heres one study that showed smaller hippocampi in patients who remained depressed for several yearsSheline:
Notice that for depression lasting less than 1000 days about 3 years patients with depression dont seem to have lost much volume. But those patients whose depression lasted longer had smaller hippocampi.
What is this hippocampus thing, anyway? In addition to playing a role in emotion, its also a part of the brain that is associated with the process of making new memories. Alzheimers disease leads to severe hippocampal shrinkage, and thus severe problems with memory. In the diagram below, you can see the left one, very near the middle of the brain, outlined in purple. For more pictures which will help you understand just where this structure is, see the Brain Tour about the hippocampus.
The hippocampus has also been shown to be smaller in patients who have had bipolar disorder for a long time.DeickenAgain we see the pattern of increased volume loss with increasing duration of illness:
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Changes Have Staying Power
The investigators were curious how long this reshaped brain might last, so they asked the mothers to return for final scans two years after their babies were born.
Of the original 25 mothers, 11 women had not given birth to a second child or were not pregnant again during this time.
These scans found that the changes detected in the new mothers right after a babys birth remained.
If the thought of a shrinking brain is alarming it shouldnt be, says Robert Froemke, PhD, neuroscientist at New York Universitys Langone Medical Center.
Instead, think of it as the brain is making itself smarter and more efficient.
Theres a difference between an apparent reduction in gray matter and the brain shrinking, he told Healthline. The brain itself doesnt shrink. Its not at all clear what actually goes on when gray matter is reduced.
Froemke offers an easier way to understand this change.
Think about this as a form of spring cleaning. Its making things more organized, streamlined, coherent to prepare mothers for the complexity and urgency of childcare, he said. If neurons are closer together, or neural connections reorganized to disregard irrelevant synapses and preserve important synapses, or otherwise able to more effectively, reliably, and rapidly process critical information, its easier to imagine why this might make sense, and help the maternal brain respond to the needs of her baby.
For a new parent, that is whats important.
Using Hightech Tools To Assess Alcoholic Brain Damage
Researchers studying the effects of alcohol use on the brain are aided by advanced technology such as magnetic resonance imaging , diffusion tensor imaging , positron emission tomography , and electrophysiological brain mapping. These tools are providing valuable insight into how alcohol affects the brains structure and function.
Longterm heavy drinking may lead to shrinking of the brain and deficiencies in the fibers that carry information between brain cells . MRI and DTI are being used together to assess the brains of patients when they first stop chronic heavy drinking and again after long periods of sobriety, to monitor for possible relapse to drinking .
Memory formation and retrieval are highly influenced by factors such as attention and motivation . Studies using MRI are helping scientists to determine how memory and attention improve with long-time abstinence from alcohol, as well as what changes take place when a patient begins drinking again. The goal of these studies is to determine which alcoholinduced effects on the brain are permanent and which ones can be reversed with abstinence.
Another hightech tool, electroencephalography , records the brains electrical signals . Small electrodes are placed on the scalp to detect this electrical activity, which then is magnified and graphed as brain waves . These brain waves show realtime activity as it happens in the brain.
The P3 component is reduced in alcoholics compared with control subjects.
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What Happens To The Brain As We Age
Brain aging is inevitable to some extent, but it is not uniform; it affects everyone, or every brain, differently.
Slowing down brain aging or stopping it altogether would be the ultimate elixir to achieve eternal youth. Is brain aging a slippery slope that we need to accept? Or are there steps that we can take to reduce the rate of decline?
At around 3 pounds in weight, the human brain is a staggering feat of engineering, with around 100 billion neurons interconnected via trillions of synapses.
Throughout a lifetime, the brain changes more than any other part of the body. From the moment the brain begins to develop in the third week of gestation to old age, its complex structures and functions are changing, networks and pathways connecting and severing.
During the first few years of life, the brain forms more than 1 million new neural connections every second. The size of the brain increases fourfold in the preschool period, and by age 6, it reaches around 90% of its adult volume.
The frontal lobes are the area of the brain responsible for executive functions, such as planning, working memory, and impulse control. These are among the last areas of the brain to mature, and they may not develop fully until around
Prevention And Prognosis Of Cerebral Atrophy
Cerebral atrophy is not usually preventable, however, there are some things you can do to reduce your risk. These include:
- Regular exercise: This can be as simple as taking frequent walks every day. By following a regular workout regimen, you can minimize the possibility of cerebral atrophy.
- Minimizing vitamin deficiencies: Ensuring that you eat a balanced and healthy diet, particularly eating foods rich in vitamins, such as B12, will give you the best chance of preventing cerebral atrophy.
- Drinking enough water: Dehydration can lead to the increase of stress hormones and acute brain damage. Therefore, it is recommended to drink plenty of water every day to stay hydrated.
- Consuming fruits and vegetables: It is recommended to eat five servings of fruits and vegetables every day. These may include blackberries, blueberries, cranberries, cherries, strawberries, spinach, raspberries, plums, broccoli, beets, oranges, and red bell peppers. They are not only delicious to eat but are packed with vitamins and minerals as well as being rich in antioxidants.
The level of brain functioning is directly related to the area of the brain affected by cerebral atrophy. In the majority of cases of focal atrophy, fatal outcomes are not particularly common but can still cause impairment of normal functioning. Cerebral atrophy outcomes will generally vary from person to person, with advanced stages often leading to complete dementia.
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Is It Possible To Reverse Brain Atrophy
Until recently, many scientists considered the brain to be a relatively unchanging organ. However, research is increasingly showing how the brain adapts its structure and functioning throughout life.
It is currently unclear whether or not it is possible to reverse brain atrophy. However, the brain may alter how it works to compensate for damage. In some cases, this may be enough to restore functioning over time.
What Should You Do
If youre a moderate or light drinker trying to decide whether to cut back for health reasons, you probably want to consider a variety of factors:
- Moderate drinking still seems to be good for your heart. More than 100 observational studies have linked moderate drinking to a reduced risk of heart attack, ischemic stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes.
- Moderate drinking has also been associated with a lower risk of gallstones and diabetes.
- For women, even moderate drinking can increase the risk of breast cancer. If youre a woman at average risk, a drink per day can increase your lifetime risk of breast cancer from 8.25% to 8.8%
- The social and psychological benefits of moderate alcohol consumption. One thing health statistics havent measured is the enjoyment of moderate drinking. It is fine to enjoy a glass of wine as the perfect accompaniment to a good dinner, or celebrate a happy occasion with a cocktail with friends.
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Being A Vegan Can Make You A Pinheadfor Real
According to a study in the journal Neurology, eating a meatless diet makes you six times more likely than your meat-eating buddies to have brain shrinkage. Chronic stress also shrinks your brain, as does chronic pain. Lack of sunshine can also play a role, and poor sleep quality has a huge effect. Even your religious affiliation can make your brain shrink faster. But don’t freak out. It’s not all bad news. There are some simple things you can do to bulk up your brain, and they don’t involve lifting weights.
Memory Loss And Distortion
People with dementia tend to have problems with short-term memory. They may remember things from long ago but forget what happened this morning. Memory distortions also occur. People with dementia may confuse people in their memories, or combine two or more memories. Sometimes, they think an old memory is a new one. Memory issues are an early sign of dementia.
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How Is Cerebral Atrophy Diagnosed
Medical personnel have several means of diagnosing cerebral atrophy:
- Medical history and physical exam: Your physician will document your medical history and ask questions about your symptoms. He or she will be interested to know when they started, their frequency and severity, and how theyve persisted or changed over time.
- Brain-function tests: To ascertain possible cognitive impairment, your doctor may administer certain brain-function tests, such as those for language or memory.
- Magnetic resonance imaging and CT scans: Imaging scans of the brain can reveal physiological change, such as swelling or evidence of brain shrinkage.
The diagnosis of cerebral atrophy will depend in part on the suspected cause or causes. If, for example, your physician thinks that you may have a neurological disorder, he or she will conduct the tests that medical science has devised for identifying those conditions.
Introduction To The Next Six Chapters
When mood shifts, some parts of the brain change their activity. However, here were going to look not at brain activity, but at very size and shape of the brain itself, as mood changes occur. In other words, well be looking not at what the software is doing, but at the hardware;itself. Surprisingly, in the last 5 years it has become clear that changes in chemicals like serotonin are only a tiny part of the story. Instead, research attention is now focused on changes in genes and proteins that control the size and sometimes even the life or death of cells involved in mood.
The focus in these next 6 chapters will be on brain changes in depression. Other conditions like bipolar disorder will be included where possible, particularly in the section on how medications work.
Well start by looking at what happens if depression arrives and stays a long time: unremitting depression, we could call it. Unfortunately, there is now very good evidence that what happens is brain shrinkage, in several important regions of the brain . These include the frontal lobes and older, more central structures called the hippocampi, which are involved in memory as well as mood .
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Can I Prevent Cerebral Atrophy
There is no clear-cut evidence that cerebral atrophy is preventable, but taking certain steps reduces the possibility of its early or severe onset. These include exercising regularly, regulating blood pressure, and eating a healthy diet. Foods rich in antioxidants and omega-3 fatty acids are good for your gray matter.
Use It Or Lose It: Hearing Loss And Brain Function
Talk to audiologists about hearing, and theres one phrase that youll hear time and again: Use it or lose it.;
The longer you wait to seek treatment, the brain has trouble understanding and processing information, says Pulido, who is a fellow with the American Academy of Audiology.;
That is, you may hear the sounds of someone talking, but your brain will struggle to understand the actual words being used. Some people may;feel like they have cognitive decline;when it’s really just hearing loss.
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Hard Wiring Of The Brain Shrinks
The gray matter of the brain in the cerebral cortex controls most of the brain’s complex mental functions. The cortex is filled with neurons that connect by fibers to different regions of the brain and to other neurons inside the brain and spinal cord. The nerve fibers are the white matter of the brain or the “hard-wiring.”
These nerve fibers have shorter, more numerous fibers called dendrites that branch out like the roots of a tree to allow the neurons to “talk” with other neurons. A neuron can communicate with as few as five or as many as 10,000 other neurons at a time.
These two parts of the brainthe white matter or hard wiring and the dendritesare the ones most affected by the shrinkage that alcoholism can cause.
Of course, brain shrinkage is not the only damage alcohol abuse can do to the brain. Alcohol can cause chemical changes in the brain that affect the function of the neurotransmitters.