Saturday, March 13, 2010

6. The Brain Trust Program ---- by Larry McCleary M.D.

A leading neurosurgeon reveals secrets for increasing brain function at any age.
The Brain Trust Program ---- By Larry McCleary M.D. (2007)
Penguin Group (USA) Inc., 375 Hudson Street, New York, NY 10014, USA

ABSTRACT: Brain, like the muscles, heart, and other organs, is made up of flesh and blood and requires proper care to maintain its optimum state of well-being. This is much more important because brain cells do not reproduce as opposed to other kind of cells. Because of which whatever we accumulated good or bad in our brain lasts longer. They stick with you a lifetime. This book reveals the secrets and gives a plan to enhance the brain power.

Finally the book is very interesting to read with easy to follow guidelines for optimum brain health. There are exercises for the brain. There are recommended cocktail recipes to follow and eliminate the discomfort of Hot Flashes and Migraine Headaches. The cocktails are Ketogenic Cocktail, Anti-Excitatory Cocktail and Anti-migraine Cocktail.

The entire brain constitutes about 2% of the body weight and consumes 20% of the energy. As such it is ten times metabolically active than the rest of the body. So what we eat is very very important. We first look into the structure of the brain, what its needs are, what happens when the needs are not met and how to provide them for optimal function.

As far as we know, human brain is the last one in the evolution of neural mechanisms from single neural traits to billions of human neurons. The following are the anatomical layers of human brain.

At the base of the brain, just where spinal cord enters the skull, is the brain stem which controls all our automatic survival functions, breathing, heart beat, swallowing etc.

Sitting atop the brain stem, we have thalamus, hypothalamus and basal ganglia. These we can see in all rudimentary brains, reptiles, birds etc. Thalamus receives the sensory information, basal ganglia acts on that information and hypothalamus regulates the inside activity of the body, appetite, thirst, body temperature, hormonal activity etc.

Sitting at the lower back of the brain is the cerebellum, which controls the balance of our body by controlling the muscles, as in writing, painting, playing the piano etc.

For every creature survival is basic and new skills are needed for existence. New biological systems evolved for hunting for food, escaping from predators etc. Limbic system evolved, which controls emotional traits, such as fear, anxiety and anger as well as memory and spacial navigation. components in limbic system are hippocampus, which influences memory; Cingulate cortex which prioritize the events what we perceive; amygdala processes emotional traits such as aggression and fear.

The latest addition to brain in the evolution is the neocortex which appears only in mammals and humans. This is an intricately folded sheet of brain cell (neuron) circuitry. It has plasticity associated with it to rearrange itself as need demands.

The neocortex has four distinct regions, called lobes, that each performs a particular function.

Occipital lobe located in the back of the brain, interprets signals coming from eyes.

Frontal lobe located behind the forehead takes care of the planning and execution of our muscles. In the very front of the frontal lobe is the prefrontal cortex(PFC). PFC is the one which creates mental images from the information it gets, and designs an execution method to get the things done. The prefrontal area is the most highly wired part of the brain.

Temporal lobes are on either side of the brain, the right one controlling sound and the left one speech and language.

Parietal lobes which are located on either side of the brain just above the temporal areas, deal with complex sensory messages coming from touch, feeling nice and smooth, rough etc.

The main work horse in the brain is the neuron, they are billions in number, which receive, transmit , store and retrieve information. The other cellular structures in the brain are of supportive nature, the star shaped astrocytes provide physical and metabolic support to the neuron, Oligodendrocytes produce a type of fatty insulation called myelin which acts as an insulator in the nerve signal transmission. The last one microglia is a brain's trash collector, collects and disposes of harmful foreign substances. The neuron cell bodies and their surroundings make up what is called a gray matter and the connections coming out of neurons with its myelin insulation make up what is called white matter.

The neuron receives input from dendrites and sends output through axon. We can imagine dendrites as fingers of the neuron and axon as the tail of neuron. The neuron receives information through its dendrites from chemical messengers called neurotransmitters, converts into electrical impulses and transmits them out through its axon. At the end of the axon these electrical impulses are converted to chemical neurotransmitters and reach dendrites of another neuron. The gap between dendrites of one neuron and axon of another neuron is called synapse. Thousands of these synapses formed between neurons. Present estimate is 10.000 synapses for each neuron. There is no physical contact in the synaptic connections. These connections are not fixed either, they are changed and rearranged throughout our life time as we learn new things. This is what is called plasticity in the brain.

As we experience new things, the brain builds a complex network of synaptic interconnections among brain cells. Each new thing we learn, experience, see, hear, feel,say, or do hooks up a new circuit. Repetition solidifies the circuits we build, but they weaken or disconnect entirely with disuse or neglect. In short our mental abilities follow the saying "use it or lose it".

Groups are formed within these billions of neurons called clusters and the clusters form regions where each function of the brain is concentrated. For example vision is controlled by a cluster of brain cells at the back of the head.

The central player in this complex activity, neuron, is simply an information relay station which uses chemical ions to do the job. The main chemical ions are positive Ca, Na, K and negative Chlorine(cl) ions. These ions go back and forth through membranes in the cell and facilitate the initiation and transmission of neural signals. Let us say the ions are at a stable state and the dendrites receive a chemical transmitter; It triggers the movement of ions and the generation of neural signal, which is electrical in nature, handed to the axon for further transmission. After the signal generation, the ions have to come back to the stable state to process inputs from dendrites. If we consider each neuron might have 10,000 synapses and there are 100 billion neurons, moving ions around for each signal is a huge energy consuming operation. This is the reason why brain which is 2% of the body consumes 20% of the total energy.

The information pulse reaching the axon end emits what are called neurotransmitters, which are specific to the message it is carrying, and these neurotransmitters swim through the synaptic gap and reach the dendrites of another neuron. The neurotransmitter is a small chemical compound. The information carried by neurotransmitters is converted to electrical impulses by moving, charged ions (Ca,Na,K,Cl ) in and out of the cell membrane. The electrical impulse generated because of the movement of charged ions is fed through the axon and goes to the next neuron.

Following are some of the active neurotransmitters and their identified functions:

Glutamate excites neurons.

GABA calms neurons.

Acetylcholine(ACH), regulation of autonomic functions(heart rate,blood pressure etc.). Also involved in storage and retrieval of information. A shortage of ACH identified in Alzheimer's.

Dopamine(DA) involved in brain functions of smooth coordinated movements. Identified as major player in Parkinson's disease.

Norepinephrine (NE) keeps tabs on our internal environment; regulates our body temperature, metabolic rate and appetite.

Serotonin, is a feel-good transmitter, lack of it causes depression.

Taurine, also an amino acid, regulates volume of signals in the case of trauma, loss of blood, over stimulation etc.

When the baby was born it has very minimal skills for survival. The autonomous systems are going on but the skill level is nothing, 100 billion or so neurons are not wired yet. It starts building synaptic connections consuming about two thirds of the energy created (adult brain consumes only 20 percent of energy). Each new learning experience simulates a new hookup. Repetition solidifies the hookup with a myelin coating.

Now we can see memory as a process of retaining learned experiences. We can broadly divide memory into two areas, procedural memory and declarative memory.

Procedural memory consists of skills obtained by practicing a procedure repeatedly until it is etched in the brain and becomes automatic; riding a bike, typing etc. The synaptic connections are formed in basal ganglia, cerebellum and spinal cord. This is the reason why we retain the skill of typing or riding a bike at any time without going through the manual.

Declarative memory involves with the storage of facts. This can be further divided into two areas semantic memory, which includes storage of learned facts and concepts, and episodic memory formed because of an emotional event taking place. Episodic memory is also called flashbulb memory almost instantly generates lasting interconnections between brain cells. The synaptic connections are formed within the hippocampus and neocortex.

How this is all happening in brain ? when multiple messages are coming, neuron has to transmit message, refresh itself to receive next message and transmit, the procedure goes on and on. It is estimated that each neuron has synaptic connections to 10,000 other neurons. There about 100 billion neurons. one can see the enormous amount of energy required for the proper functioning of the brain.

Scientists were able to conclude that there are four critical areas which should be optimized in the brain for smooth operation.

First is the flow of calcium. Regulated calcium flow through cell membranes is needed for synaptic connections.

Second is the balance of insulin and glucose(blood sugar). Glucose is the main fuel source for the neuron and brain takes about 100 grams per day from the blood. Insulin also needed for glucose absorption. In the case of Insulin resistance(Diabetes), the glucose and insulin balance in the blood gets disturbed and glucose absorption decreases raising glucose levels in the blood.

Third is the availability of adequate growth factors for regeneration and repair. Our ability to learn and remember depends upon the ability of the brain to connect neurons through synapses. This development comes as gradual we grow and depends upon the availability of growth promoters, NGF, NT3, BDNF etc. Our Fluidity of thought depends upon uninterrupted, high speed communication among the interconnected brain cells.

Fourth is the control of inflammation. Inflammation is the body's immune response to invading bacteria and organisms. In the case of brain it is the microglia which is defending us against the cellular debris being accumulated in a life time ( neurons live with us until death).

The author created what is called a Brain Trust Program to achieve a healthy brain during our life time; Basics of that are nutrition, supplementation and exercise for the body and brain, good night sleep. I will just try to give a glimpse of that program. Remember, one should not eat too much of anything.

Brain friendly diet --- what to eat:
Fresh fruits, Fresh Vegetables and spices. Berries, spinach and dark green leafy vegetables, coffee, avocados, eggs, nuts, seeds and red wine.
Spices: turmeric, cinnamon, ginger.
Herbs: sage and rosemary.
Nuts and seeds: Flax seeds, sunflower seeds, sesame seeds, pumpkin seeds.

Brain-Friendly Diet: What not to eat:
Trans-fats, Concentrated sweets: large quantities of sugar, corn syrup and high-fructose corn syrup. Flavour enhancers and artificial sweeteners. Pesticides, Hormones and antibiotics.

Supplemental Nutrition for the brain:
No matter how careful we are in selecting and eating nutritional foods, as we become old day by day and the bad affects of little things we did (eating poor quality diet, smoking, drinking in excess, being a couch potato, or engaging in high-risk-of-head -injury behaviors) accumulate in our lifetime and leads to neurodegeneration. This is because we are staying with the neurons we were born with throughout our life. There are basically two culprits in this area.

The first one is calcium ion transportation. Neuron moves calcium ions back and forth for creating electrical pulses and they should be at optimal levels either side of the cell membrane, for receiving messages from neural transmitters and generating and transmitting message pulses. Because of accumulated damage this ion transport will not happen at the optimal levels and neurons decay and die in due course. Brain health slowly deteriorates.

Second one is the creation of free radicals at the energy generation site, mitochondria, in the cell. Free radicals are charged chemical substances which attach themselves to other substances and change the nature and properties of the substance. That is when we need antioxidants to nullify and suppress the bad effect of free radicals.

Supplements --- better to take:

Krill oil : It is a fish oil. Provides EPA and DHA essential for building brain and brain extensions.
increases levels of anti oxidants in the body.

The B Vitamin Group: Best for preserving, restoring, improving brain function and memory.

Magnesium: Can be obtained from dark green leafy vegetables and nuts. Natural calcium blocker. Research has demonstrated that magnesium supplementation improved memory and other troublesome symptoms in patients with dementia.

Taurine: Taurine is a naturally occurring sulfur containing amino acid. Adding taurine increases brain levels of acetylcholine(ACH), the most critical neurotransmitter involved in memory. As ACH levels fall, memory fails. Taurine levels are low in Alzheimer's disease and in diabetes.

Acetyl-Carnitine(ALC): Drives fat molecules into energy furnaces in the cell to boost energy. The acetyl part helps making ACH, the neuro transmitter. Appears to retard age-related drop in nerve growth factors.

Alpha-Lipolic Acid: Is an antioxidant which dissolves both in water and fat. Because of this it can go straight to mitochondria in the cell, where free radicals breed and thrive. In diabetic complications, sugar in the blood attaches to and permanently alters proteins in the body. It is called glycation resulting spots on the skin, cataracts etc. Helpful in peripheral neuropathy.

Coenzyme Q10(CoQ10): It is a fat-or oil-soluble antioxidant found in cellular membranes. A powerful defender against oxidation and free radicals and is a key player in energy production. Production of CoQ10 falls off with age and when taking statin drugs for cholesterol lowering.

Vitamin D: Is a fat soluble antioxidant and an anti inflammatory agent. A rising tide of inflammatory compounds that increase with age will ultimately disrupt the cell-to-cell communication connections, short circuit the memory and if unchecked lead to brain cell death leading to Alzheimer's disease.

Huperzine A: By slowing the breakdown of ACH, it makes ACH more available for communication network in the brain. In one study patients with Alzheimer's improved in their cognitive function.

Vinpocetine: A potent antioxidant. Required nutrient for people with artery narrowing.

What Not to Take: IRON. Iron is a pro-oxidant-that is, a substance that reacts vigorously and easily with oxygen.

There are two prominent brain related crippling abnormalities.

For the women at the beginning of menopause, inadequate estrogen leads to fewer sugar shuttles for energy conversion in the brain cells. This leads to an energy crisis which leads to a surge of norepinephtine(NE) in the hypothalamus. This is the cause of hot flashes, which is a simple body reaction to raise the low sugar level and brain starvation. This results in an accumulation of the brain chemical glutamate. This brain chemical excites the cells, putting an added energy demand on an already strained system.

The way to avoid this problem is to get the estrogen to optimal level or bypass this system and provide energy alternate means with ketogenic diet providing ketone bodies (which do not require shuttles) as an alternate fuel source to blood sugar.

Ketone bodies, or simply ketones, are the natural by-products of fat burning; they are basically partially burned fats. They are produced if we go without eating for a prolonged period or when we restrict dietary carbohydrates.

Migraine Headaches: A migraine originates entirely within the brain itself, painlessly, with a burst of unusual firing from one or more small clusters of brain cells. This is caused by the buildup of calcium and sodium within the cells. The cause of this buildup is found out to be an energy-production deficit. (The calcium and sodium ions movement is crucial in the case of synaptic message transportation.)

This abnormal firing activity releases an array of compounds which may cause inflammation or a cause of opening or narrowing arteries. The current thinking is the irritation of the pain sensors on the surface of the blood vessels and brain coverings by these compounds causes migraine headache pain.

A low magnesium levels were found in brains of migraine patients. Supplementing with magnesium can help prevent migraines and can make them less painful and of shorter duration.

Finally the book is very interesting to read with easy to follow guidelines for optimum brain health. There are exercises for the brain. There are recommended cocktail recipes to follow and eliminate the discomfort of Hot Flashes and Migraine Headaches, Ketogenic Cocktail, Anti-Excitatory Cocktail and Antimigraine Cocktail. I am giving those three cocktails as written in the book. Please read the book and understand before using them.
Box 7.1 Ketogenic Cocktail
Take whole cocktail one to three times per day.
1-2 tablespoons MCT oil (about 15 grams/tablespoon)
1 teaspoon to 1 tablespoon flaxseed oil
50mg EPA
Box 7.2 Anti-Excitatory Cocktail
Take whole cocktail twice per day
400 milligrams magnesium 10 milligrams thiamin
75 micrograms huperzine A 50 milligrams GABA
5 milli grams vinpocetine 1 gram taurine
Plus 1 milligram melatonin at bedtime
Box 7.3 Antimigraine Cocktail
Please note that the antimigraine cocktail represents the recommended total daily
intake of these nutrients, to be taken in place of and not in addition to the amounts
of these nutrients recommended in chapter 5. Take this cocktail twice a day.
400 milligrams magnesium
1 gram taurine
100 milligrams coenzyme Q10
100 micrograms huperzine A
10 milligrams vinpocetine
Plus Ketogenic cocktail(page 203) twice daily (if migraines are still problematic
after a trail of the above cocktail)

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