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Reversing And Treating Mild Cognitive Impairment With Medications

Posted on December 15, 2013 by 6s79T

Reversing and treating mild cognitive impairment (MCI) with medication are often prescribed for a brain chemical deficiency in conjunction with other therapies or when other treatments are not effective. (see post “Natural Hormone Therapy For Mild Cognitive Impairment” and “A 7- Step Action Plan For Preventing And Treating Memory Loss“). These medications work in several different ways to bring brain chemicals into balance or even enhanced. One mechanism is – the medication imitate (is an analog) of a particular brain chemical, triggering the brain to respond as if it is the brain chemical itself. The other mechanism is – the medications block (bind to) the nonspecific receptors so that the brain chemical itself will not bind to the nonspecific receptors, thereby increasing the availability of the brain chemical for brain functional use. (see post “brain chemical systems and memory“)

The medications that increase dopamine can help regain or enhance attention. The medications that stimulate acetylcholine production can improve memory. The GABA medications relieve anxiety. The serotonin medications treat depression and insomnia both of which adversely affect thinking. Without anxiety and depression, MCI can more easily reversed and the memory issues resolve themselves. At the same time, physical symptoms of many other diseases also resolve once the brain chemical is rebalanced, thus improving the overall physical and mental health.

GABA medications lessen anxiety. Anticonvulsants are a group of GABA medications that are typically used to prevent or treat convulsions or seizures. In low doses, they are also effective to treat mood. How anticonvulsants work to improve mood is not known. Another type of GABA medication is benzodiazepines which are tranquilizers. Some of the benzodiazepines are used to relieve anxiety while others are used to treat insomnia.

Serotonin enhancing medications include antidepressants. Antidepressants are the most common type of serotonin-enhancing medications which can stimulate neurogenesis. Antidepressants also increases the number of receptors for brain chemicals therefore increasing the response to neurotransmitters. Antidepressants are known to improve brain speed. Although all antidepressants increases serotonin, they do not work the same way:

monoamine oxidase (MAO) inhibitors act on (inhibit) mitochondrial enzymes that degrade both dopamine and serotonin. MAO inhibitors cause more serotonin to be available in the synapses. Because of the adverse side effect and the improved efficacy of other antidepressants, MOA inhibitors are not widely prescribed.
tricyclics block the reuptake of dopamine and serotonin, causing an increase in the level of these brain chemicals in the synapses. Because of the adverse side effect and the improved efficacy of other antidepressants, tricyclics are not widely prescribed either.
selective serotonin reuptake inhibitors (SSRIs) can quickly increase the serotonin in the brain, resolving depression. Examples of SSRIs include: citalopram, Escitalopram, Fluoxetine, Paroxetine, Sertraline.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are known as dual reuptake inhibitors that can increase both serotonin and norepinephrine. SNRIs can improve mood and attention. Examples are: Duloxetine, Milnacipran, Venlafaxine.
Bupropion (Wellbutrin) can block the reuptake of dopamine, not serotonin, but it is an effective antidepressant. This medication was found to improve cognition.
Buspirone (BuSpar) affect dopamine and serotonin and is used to treat mild sleep disorders and mild anxiety.

Some blood pressure medication can stop MCI or memory loss such as atenolol because they improve blood flow to the brain.

Acetylcholine medications boost the strength of existing brain signals and can reverse symptoms of MCI, although they do not cure MCI. The improvement may last only as long as the medication is in the body. Examples of acetylcholine-enhancing medications are: Donepezil, Galantamine, Rivastigmine, Tacrine.

Dopamine medications help increase attention which are relatively very successful. Examples are: Atomoxetine HCl, Bupropion, Dexmethyphenidate, Dextroamphetamine, Dextroamphetamine + amphetamine, Guanfacine, Lisdexamfetamine dimesylate, Methamphetamine, Methylphenidate.

Leptin-enhancing medications is for managing leptin levels, although leptin can self-regulate once the brain chemicals are balanced. Leptin-enhancing medications are also prescribed for many other health concerns. Examples are: leptin analog (for weight management), Bupropion (for depression and attention), Topiramate (for seizures, anxiety) and many others.

Reference: book by Eric R. Braverman, MD.

Manifestations of Mild Cognitive Impairment: Attention

Posted on December 12, 2013 by 6s79T

Attention is really a subcategory of memory that is most closely linked to working memory. (see post “The Role of Attention For Working Memory”). Dopamine brain chemical system determines brain’s voltage which in turn determine brain’s ability to focus attention, stay on task, and get job done. It also controls working memory. People with naturally high levels of dopamine have high traditional IQ and can quickly master new skills with intense focus and concentration.

Dopamine deficiency occurs when brain is either burning too much dopamine or not producing enough. Typically dopamine level decreases as we age. Dopamine deficiency decrease brain voltage, leading to decreased attention and mental intensity. Low dopamine slows thinking and decision making, making one feel sluggish and also slow body’s metabolism. Dopamine deficiency also causes craving for temporary energy boosting food: high sugar fast-digesting simple carbohydrates. These food, although can temporary increase dopamine production, but are not healthy carbs as opposed to complex carbs. Because simple carbs cause other problems that actually accelerate aging. (see post “Dietary Habits That Accelerate Aging”). Even a small decrease in voltage has a major impact on cognitive capacity, mood and psychological state.

Attention deficits reveals more with aging. What’s more, attention decreases are one of the initial signs of mild cognitive impairment (MCI) and can begin as early as age 30. There are 4 core forms of attention errors:

Omission is the lack of response to a stimulus. Examples are: not answering a direct question; missing social cues
Commission is the inappropriate response to a stimulus. Examples are: talking over someone in conversation, impulsive buying or behavior
Reaction time is the unusually long delay in response to a stimulus. Examples are: not immediately removing the hand that is touching something hot; watching bleeding before addressing a wound
Variability is the inconsistent response to a stimulus. Examples are: highly distracted thinking. Variability errors are related to more or excessive level of dopamine and hyperactivity, rather than a deficit. This problem of attention is not associated with aging.

Adult attention deficits are rarely hyperactive and the attention problems are the consequence of a slower and less intensive brain. Declining attention of MCI is very different from adult attention deficit hyperactive disorder (ADHD), a clinical diagnosis for people who have never had the ability to focus clearly. The manifestations of adult ADHD are much the same as that of the age-related attention deficit of MCI. There is computerized screening for attention deficit of MCI known as TOVA (Test of Variable Attention). A list that mimics the results of TOVA is presented in this post:

accident prone
avoid new situations and meeting new people
consistent forgetfulness of tasks, even after instructions have been given
easily forgot the task after interruption or distraction, such as a phone call
feeing slow when processing information
frequent interruption of thoughts
frequent misplacing items
difficulty in concentrating on tasks requiring sustained attention
difficulty organizing material for a task
difficulty sticking to a single activity
lose track of time
misses stop signs
not attending to tasks quickly
often acts before thinking
procrastinating
have problems during conversation
- dysphasia
- difficulty following or joining a conversation
- difficulty initiating a conversation
- losing thought in the middle of a conversation
- repeating questions, stories. or statements
- struggling with vocabulary
- using words incorrectly
impulsive behavior (reacting without thinking first)
- agreeing to complete something without thinking about whether it is feasible
- interrupting during conversations
- making rash or quick decision
- impulsive buying

Addiction is one of the causes of MCI (see post”Causes of Mild Cognitive Impairment And How To Reverse It”). Research has found that frequent exposure to addictive behavior decreases the number of dopamine receptors in the brain. With fewer receptors, less dopamine are activated, causing more intense cravings and increased stress. Dopamine genetics appear to predict a very high predisposition for various addictions. Studies have shown that a dysfunction of D2 dopamine receptors in the brain can lead to addiction, aberrant substance-seeking behavior and aggression. There is a correlation between adult ADD and drug abuse. In many instances, people with attention deficits have the same dysfunctional D2 dopamine receptors and are prone to addictive behavior. Addiction disturbs dopamine system which give an initial feeling of rush or excitement, this could lead to the addiction to dopamine which increases the craving for the substance.

Researchers claim that our ability to focus is being undermined by information overloading (email, text messages, phone calls and other electronic disruptions) with the technological progress. The stimulation provokes a dopamine release similar to a response to addiction. Not only the attention level is affected, so is the level of addiction. Too much information, even when only doing one task at a time causes distraction. Researchers proved that when people are faced with overwhelming array of choices, they are apt to make no decision at all. The prefrontal lobe houses working memory than can hold only seven different pieces of information at any given time. Any more must be processed into long term memory. When the brain are exposed to information overloading, the brain instinctively struggles to figure out what to keep and what to put into storage. In order to reduce the distracting effects of information overloading, several strategies can be used. Make a practice of filtering out all the extraneous information. Frequently prioritize attentions to get rid of the extraneous noise that is clogging up the thinking.

A comprehensive protocol that may reverse the attention problems of MCI and bring dopamine chemical into balance is presented in post “A 7- Step Action Plan For Preventing And Treating Memory Loss”.

Reference: book by Eric R. Braverman, MD.

Manifestations of Mild Cognitive Impairment: Memory

Posted on December 8, 2013 by 6s79T

Memory is central to the entire function of the brain. Memory problems typically occur when the brain processing speed become slower than usual. Slower brain speed is directly linked to a loss of the brain chemical acetylcholine which regulates sensory input and long term memory retrieval. Very few people have naturally high acetylcholine levels which promotes creativity. People with high acetylcholine not only have distinct creative flair but also are intuitive and empathetic as well as with intelligence, strong immediate memory. The trait of intuitiveness is to embrace the intangible part of life through spirituality, literature, art, science, imagination and empathy. Intuitiveness requires a vision of life that’s beyond the sensory type (only be influenced by sensory perceptions. Without acetylcholine, this transformation in reasoning can not happen.

Besides governing brain processing speed, acetylcholine is also the building block for myelin (the substance surrounds neurons to insulate the nervous system similar to coatings of electrical wires). Myelin thickens with use. As myelin increases, it builds neuron connections that make the thinking process faster. The decay of myelin leads to cognitive and memory decline when the messages that brain chemicals carry get disrupted. Without the proper amount of myelin and acetylcholine, the brain can short-circuit.

Levels of acetylcholine naturally decrease with age. Slower brain speed causes fewer memories to be transferred from short-term working memory to long-term storage. The result is that memory traces get lost in the process. The typical symptoms associated with a slowed brain is the general absentmindedness such as can not remember where anything is. Other signs are: unable to visualize once-familiar objects, people, or places, “blank out” when trying to remember, even midway through a sentence or a task. This type of forgetfulness is not equivalent to “memory loss” because as we age, memory is still stored in the brain. The problem resides in the increasing difficulty in retrieving past experience efficiently and accurately. New memory creation is not totally blocked.

Memory loss does progress beyond forgetfulness. The rate of memory deterioration differs among different individuals. Before age of 60, the frequency of unable to recognize places usually is not more than once every few months. If the brain ages faster by additional factors (see post “Causes of Mild cognitive impairment”) than the rest of the body, overall memory decline could occur at earlier ages. As discussed in post “Manifestations of MCI: personality and mood”), Memory loss can worsen those of symptoms associated with early MCI: anxiety, insomnia, and depression. Brain speed peaks at age of 30s. Brain speed loss can begin as early as 30s if the brain is not maintained in a healthy way. Brain speed loses 7-10 milliseconds for each decade. At 50s and beyond, slight brain speed change start to produce noticeable memory deterioration. Severe brain speed loss may lead to dementia.

Memory creation involves four stages – acquisition, consolidation, storage, and retrieval. see post “How Do We Remember: Memory Acquisition, Consolidation And Retrieval” for detail. Different aspects of memory are ruled by one of the each brain chemical systems. Memory deterioration occurs in the order of: verbal memory issue, visual memory problem, immediate memory loss, and working memory impairment. The temporal lobes which are regulated by GABA, store verbally presented information. Deficits in verbal memory (forget what is heard shortly) increased the risk of progression to Alzheimer’s disease. The occipital lobe store visual perceptions (faces, colors, shapes, designs, surroundings, pictures, symbols). If immediate memory (verbal and visual memory lasting only about 30 seconds before being transferred to long term memory) falters, new information can not be absorbed. Immediate memory (or short term memory) are briefly stored in the parietal lobes which are regulated by acetylcholine. Working memory is the most important form of memory (see post “What Is Working Memory? The Effect of Aging”). This is the memory process that retain new information as well as connect it to information already learned. It determines thinking, abstract reasoning, problem solving and complex cognitive capacity. The frontal lobes which are regulated by dopamine, handles working memory which is critical to executive function. Long term memory correlates working memory. Working memory is the last to deteriorate, making it undetected while other domains of memory starting to show problems.

Memory deterioration of MCI begins with problems in understanding visual images and spatial relationships. This is shown by the changes in vision – difficulty determining color and contrast, difficulty judging distance, difficulty reading, inability to recognize faces in photographs. When four or more of the symptoms occurs an ophthalmologist should be seen immediately and the “A 7- Step Action Plan For Preventing And Treating Memory Loss” may be followed. Day to day activities also start to show signs of memory problems associated with MCI. These symptoms include:

consistent problems recalling recent events
constantly ask for information to be repeated
difficulty completing tasks used to be done effortlessly (household tasks, financial tasks)
difficulty remembering short list of items, appointments, birthdays
difficulty getting form one place to another, finding familiar streets or location previously been to
excessive use of reminder notes or to do lists
forgetting month, years
forgetting recently learned information
misplacing common items daily
reduced interest in hobbies/activities
trouble learning how to use a new tool, appliance or electronic machine

Memory is influenced by perception, feeling and experience. Different people being exposed to the same event, may describe the event detail differently. As we age, events of long ago could be retrieved (remembered) differently. The answer could vary significantly if a person is being asked to recall an earlier year event at 50s and 70s. This post provides the general rules for enhancing memory “How To Improve Memory – General Principles“. Memory loss is reversible. “A 7- Step Action Plan For Preventing And Treating Memory Loss” is the protocol for overall brain health and for how to maintain a 30 year-old-brain for the rest of the life. All components of memory can be enhanced. Memory is not the only cognitive problems associated with MCI. A closely related memory issue is attention. (see next post “Manifestations of Mild Cognitive Impairment Attention” ).

Reference: book by Eric R. Braverman, MD.

Manifestations of Mild Cognitive Impairment: Personality And Mood

Posted on December 7, 2013 by 6s79T

Mild cognitive impairment is the stage of cognitive impairment with noticeable symptoms, but the problems are not severe enough to interfere with daily life or independent function. For a more detailed introductory information of mild cognitive impairment, see post “Three Phases of Age-Related Cognitive Impairments” and “Causes of Mild Cognitive Impairment And How To Reverse It”. This post is part of the series of posts describing how to identify MCI with symptoms in the areas of mood, memory, and attention – Manifestations of Mild Cognitive Impairment:

Manifestations of Mild Cognitive Impairment: Personality And Mood
Manifestations of Mild Cognitive Impairment: Memory
Manifestations of Mild Cognitive Impairment: Attention

The earliest symptoms of mild cognitive impairment are often also associated with personality and temperament problems (e.g. anxiety, depression). Anxiety typically becomes an issue which can lead to a number of mental health problems. Insomnia is one of them that exacerbates anxiety and depression. Increased anxiety and/or other mental health issues are almost always linked to the brain chemical imbalance which also have their roles in cognition function. Increased personality and mood problems create damage to the brain and brain chemical imbalance or deficiency, thus causing various symptoms of cognitive impairments. It is very hard to concentrate or remember when anxious or depressed feelings become dominant.

Anxiety initially produces an increase in brain speed, though. This may come from pending final exam or has to get a job done, for example. Anxiety and stress often make an individual better able to focus initially. This type of positive effect is due to the increased dopamine related chemicals – stress hormone adrenaline and cortisol. Afterward, exhaustion ensues, resulting form a decrease in the calming neurotransmitter GABA caused by increased stress hormone. (see post “Brain Waves, Brain Chemical Systems and Memory”). After a while, the stress induced extra energy faded and eventually leading to a loss of dopamine energy (dopamine is the neurotransmitter for active cognitive tasks -working memory, attention and beta brain waves). A vicious stress loop is created , rewiring the brain and interfering neurogenesis. Long term exposure to stress hormone such as cortisol (see post “How Stress Affect Memory”) has been found to damage neurons in the hippocampus involved with memory, learning.

When the brain is deficient in GABA (the inhibitory neurotransmission system that has the role to balance excitatory neurotransmission, GABA is the brain stabilizer), the brain wave or brain electricity is generated in bursts. This is known as brain arrhythmia. (The term “arrhythmia” refers to any change from the normal sequence of electrical impulses.) The electrical impulses may become too fast, too slow, or erratic when a dysrhythmia (a disturbance or irregularity in the rhythm of the brain waves as recorded by electroencephalography) occurs. Restless, anxious, nervous and irritable feeling become prevalent. Once the brain loses its balance, its stability is lost. Various personality and mood problems may develop or the cognitive thinking displays this or that symptoms: difficulty concentrating, inconsistent attention patterns, blurred thinking, verbal memory and working memory impairments. GABA is also involved in the production of endorphins – the feel good hormones that are produced in the brain during physical and mental relaxation.

Scientists have discovered that roughly 80% of the signaling in the brain is carried out by two brain chemicals (glutamate and GABA) that balance each other. (see this post for a detailed scientific review of “The Role of Glutamatergic Neurotransmission System In Aging Brain”). Glutamate is the excitatory neurotransmission system and GABA is the inhibitory neurotransmission system. These 2 systems interact and balance each other to ensure cognitive tasks can be completed without excitotoxicity. Glutamate excites neurons, increasing neurogenesis and facilitating learning and memory. Glutamate is released every time new information is learned. GABA is also present to guarantee neuron were not over shooting. However, under stress, GABA is imbalanced, leading to too much glutamate, causing excitotoxicity. Instead of increasing learning, excess uncontrolled release of glutamate actually kills neurons, hinders the neurogenesis. During times of excess stress or anxiety, this neuronal loss make one feel rigid instead of being able to think clearly. Coping skills are interfered. Before an individual can even realize the problem, the stress cycle begins again. For stress reduction, see “A 7- Step Action Plan For Preventing And Treating Memory Loss”.

When GABA is imbalanced and when anxiety is prevailing , insomnia may trouble an individual. Decreasing serotonin level (aging is a factor that decreases serotonin) can also cause insomnia. When serotonin level begin to wane, brain can not modulate the energy created by the dopamine system. The brain is overloaded all day long and at the same time the delta wave (deep rest brain waves associated with serotonin system) signal increases, blocking alertness (dopamine), creativity (acetylcholine), and relaxation (GABA) and leading to depression (decreased serotonin). Disrupted sleep further hinders the REM (rapid eye movement) sleep (the deepest most restorative phase) which is one of the biggest age accelerator. Not only the brain energy can not be restored, but it also creates its own stress loop that is hard to break. Insomnia associated with serotonin imbalance affect cognition in a variety of different ways: slowed reaction time, less efficiency in learning new information or retrieving memories, frequent overwhelming confusion and impaired decision making. There is correlation between a lack of REM sleep and the onset of depression and psychomotor retardation (the slowing of thought, speech, affect and reduction of physical movements). The resulting fatigue and depression affect both physical and cognitive functions as well as mood stability. Insomnia can be treated by enhancing the brain chemicals GABA and serotonin. Treatment of insomnia also bring other diminishing brain chemicals into balance. Sleep apnea is a common medical condition that is not easy for people to realize. The condition is characterized by dozens or even hundreds of “mini awakenings” that fragment the sleep duration. The result is the constantly roused consciousness which cause an individual tired in the morning. During sleep apnea, the person momentarily stops breathing. When the brain did not get enough oxygen, if forces the “mini-awakenings” in order to breathe, creating multiple sleep interruptions. The brain’s constant vigilance causes lack of REM energy restoration sleep, resulting in a slow brain in the day. Lack of oxygen also damage existing neurons that may further exacerbate cognitive impairments. Insomnia also disrupt memory consolidation. Scientists have discovered that brain needs to be fully rested to maximize information consolidation. Memory are consolidated and moved into long-term storage and this process is continued and enhanced during sleep.

The effect of depression on cognitive impairment and their associations have long been discovered. Both dementia and depression are associated with atrophy of the hippocampus – the part of brain for long-term memory creation. Neurons are found to be damaged gradually in both medical conditions. The natural consequence of depression is the neuron loss and brain electrical loss which in turn cause significant problems in personality, temperament and thinking (cognition). Untreated depression could lead to Alzheimer’s while untreated memory loss in turn leads to more severe depression. Neurogenesis can be recreated through treating depression with anti-depressant, therefore reversing MCI and stopping dementia.

Anxiety and depression are not the only mood problems with MCI. Other personality and mood issues associated with MCI include: tendency to become easily upset or rattled; increased suspiciousness, diminished initiative, growing apathy, focusing exclusively on self, inappropriate behavior or comments, increased stubbornness, lack of emotional control, withdrawal from friends and family and others.

Mood instability are among the easiest brain reversals that is possible because they appear during the mildest brain chemical deficits. The importance of mood to learning and cognition can not be emphasized enough. Studies have demonstrated that people with psychological distress have increased risk of developing Alzheimer’s disease than those who had better coping skills. The “A 7- Step Action Plan For Preventing And Treating Memory Loss” provides a comprehensive protocol for reversing MCI , preventing cognitive impairments in a systematic way.

Reference: book by Eric R. Braverman, MD.

Three Phases of Age-Related Cognitive Impairments

Posted on December 3, 2013 by 6s79T

The brain’s cognitive energy is what keep us thinking clearly and remembering. Cognitive energy is directly related to the number of neurons and the speed of neurons being fired together. The formula for this thinking and information processing cognitive activities is: cognitive energy = voltage (number of neurons) X processing speed (the speed at which neurons are fired). Brain ages as part of the chronological aging process during which time brain processing speed and voltage declines. However this process is not completely irreversible and brain aging can be significantly delayed or prevented through care, maintenance and training because the brain is such an adaptable, malleable organ with the most flexibility of neuroplasticity and lasting capability for regeneration – neurogenesis. Invisible brain aging could begin as early as 30s. Brain processing speed loses 7-10 milliseconds for each decade. An initial change in brain speed is the sign of a potential ongoing development of mild cognitive impairment. However, this condition is reversible and preventable. What is important is to prevent MCI from deteriorated into the advanced stage of irreversible cognitive impairment – Alzheimer’s or other forms of dementia that inflicts 50% of the people between 80-85s. While Alzheimer’s disease usually progress gradually spanning 15-20 years, it always begins with MCI which can start during 30s or 40s. However, Alzheimer may not be the destiny, because through maintenance and training, the gradual progressive trajectory continuum of cognitive impairments associated with an aging brain can be stopped at the pre-MCI and MCI stages. see post “A 7- Step Action Plan For Preventing And Treating Memory Loss”.

Brain aging may not be noticeable while the aging of other parts of the body start to manifest itself. This preclinical stage of the age-related decrease in cognitive function at the start of the trajectory is known as preclinical MCI or pre-MCI. Pre-MCI is so mild that there is no evidence of observable changes in social or occupational functioning. Very subtle cognitive alternations that may be detected years before the first sign of most basic symptoms of MCI begin to emerge. Studies have shown that pre-MCI could begin a full 20 years before any significant MCI symptoms occur. Research also demonstrated that by the age of 40, 25-50% of the people are already affected by MCI, even though only 1% will show any symptoms. This is why brain health maintenance is not a task for elders, prevention and training should start as early as 30s.

The next stage of the progression of age-related cognitive impairment is Mild Cognitive Impairment (MCI). One or two small changes in thinking might be noticeable in people with early MCI, most of whom remain this way for the rest of life without treatment. At the earliest stages of MCI, people rarely exhibit any severe symptoms. The only change to complain is they are not doing complex tasks as comfortably and effortlessly as they can do before. Most people with MCI still function well in daily activities with less efficient or accuracy. The standard progression of MCI symptoms are grouped into 3 categories – alterations in personality/temperament, memory, attention and focus. Neurological and psychological symptoms often occur and reinforce each other at the same time. Changes in personality and temperament can be the emerging signs of MCI such as agitation, anger, anxiety, depression, fear of being alone, frustration, mood swing, paranoia, self-neglect. Mild memory and/or cognitive problems starts to emerge during MCI stage such as:

occasionally not remembering things a few minutes ago
declining spatial perception
decreased creativity
difficulty learning new tasks
difficulty store new memory
difficulty decision making
past memory loss
impaired abstract thinking
slower response time
difficulty in intellectual growth

Attention is the crucial component for working memory (see post “The Role of Attention For Working Memory”). Deficiency in attention and focus is associated with MCI. Symptoms of attention loss are linked to decreased brain chemicals – dopamine, acetylcholine, GABA, and serotonin:

less able to concentrate and focus
commission errors
complex attention errors
omission errors

When cognitive impairment is sufficiently severe to the extent that it significantly interfere with daily functions, the third final stage of cognitive impairment – Alzheimer’s disease or other forms of dementia may be diagnosed. (see post “Age-Related Memory Loss Diseases – Amnesia With Age”). Physical characteristics of Alzheimer’s disease can be traced back to pre-MCI and MCI stage. Several brain anatomical and bio-neurological alterations mark the presence of Alzheimer’s disease. Nerve fibers become tangled and neurofibrillary tangles may seriously damage neurons. There are accumulations of insoluble beta-amyloid protein plagues in the brain that cause healthy brain tissue to degenerate and interferes brain cells communication. Blood flow to the brain also significantly decreased in Alzheimer’s. Earliest signs of Alzheimer’s are:

verbal memory loss (e.g. repeatedly ask the same question)
unfamiliarity with simple daily routines
Dysphasia
unawareness of location, time
confusion about familiar places
difficulty with abstract thinking
placing objects in unsuitable places
extreme mood swing
more pronounced personality disorder

Through a maintenance, screening, and treatment program outlined in “A 7- Step Action Plan For Preventing And Treating Memory Loss”, the progression of Alzheimer’s disease can be slowed and risk of progression into Alzheimer’s can be reduced.

Natural Hormone Therapy For Mild Cognitive Impairment

Posted on November 30, 2013 by 6s79T

Maintaining the proper hormone balance is critical to every aspect of the health as we age. There are more than 100 types of hormones that act as brain chemicals. When the stress hormone cortisol increases, feelings of anxiety and unclear thinking may be surge. Cognitive capacity begins to wane associated with normal aging process that can be attributed to the decreased production of hormones. Many of the same hormones that increase brain speed are also associated with neurogenesis. Hormone deficiency can lead to increased tiredness, anxiety and cognitive impairments. It is not so difficult to bring back optimal levels of hormones via natural bioidentical hormone therapy, though. Bioidentical hormones, as opposed to the traditional synthetic hormones, are most often derived from plant sources that are “bioidentical” to the natural hormone the body makes. Their molecular structures are same as the natural hormone produced in the body.

Bioidentical hormone supplementation is one of the most effective preventative treatment against the development of dementia as well as a successful intervention to reverse mild cognitive impairments. Bioidentical hormone supplements work as nutrients – supplying the body and brain with the same hormones it makes – to enhance brain speed and cognitive functions. The production of brain chemicals (dopamine, acetylcholine, GABA, and serotonin) can be enhanced. (see post “brain chemical systems and memory“).

Human growth hormone (HGH), DHEA, testosterone are the hormones that can increase dopamine levels, leading to increased attention. The most effective hormone for increasing acetylcholine for faster processing speed and enhanced memory is estrogen. The hormone that balances GABA to lessen anxiety is progesterone. Melatonin is the hormone that increases serotonin to reduce depression and insomnia. Hormone therapy is suggested as the preferred treatment when diet, exercise and life style changes can not achieve the result of reversing mild cognitive impairment (MCI) and when hormone deficiency is present. Listed here are the hormone supplements that the brain needs to reverse or treat MCI.

Aldosterone regulates sodium and potassium levels and maintains appropriate blood volumes. It may have a protective effect on hearing and verbal memory. Researcher discovered that people with age-related hearing loss may have only half the aldosterone needed.
DHEA and DHEA-S; Dehydroepiandrosterone (DHEA) is produced by adrenal glands, testicles and brain, DHEA is the precursor of all sex hormones. Its level begins to decrease in 50s. Decreased DHEA level is associated with memory loss and decreased cognitive function, because lower DHEA level increases stress hormone cortisol levels, which can lead to MCI. DHEA supplementation can enhance neurogenesis and increase dopamine production. It is also used to treat chronic fatigue, depression, menopause, osteoporosis and protect brain from Alzheimer’s disease. DHEA-S have been shown to be associated with better cognitive function, primarily related to better working memory, concentration.
Erythropoietin (EPO) is produced by kidney that regulates blood cell production in the marrow. Studies have shown that EPO improves hippocampus-related memory transfer by controlling neuron plasticity, synaptic connectivity. This memory enhancing effect is not related to its blood production function but are due to the direct effect on neurons in the brain.
Estrogen, Estradiol, Estriol, Estrone; Estrogen is produced by ovary, brain and in smaller amounts by some other tissues. Estrogen prevent brain aging by stimulating acetylcholine production. Bioidentical estrogen therapies lead to significant improvements in information processing in menopausal female and better score on attention test in younger female. Estradiol, estriol, estrone are bioidentical estrogen extracted from yams or soybean. Estradiol is not used to treat MCI, instead it is used for preventing neurodegenerative disease. Estriol is a topical cream that may reduce symptoms of menopause.
Human growth hormone (HGH) is produced by the pituitary gland. HGH stimulates the production of insulin-like growth factor (IGF-1). IGF-1 can help in forming new brain and muscle cells, new blood components, and better metabolism. HGH decreases with aging significantly. HGH deficiency is associated with memory impairments. Slight supplementation promotes an improvement in total body functioning including many areas of cognitive functions, mood and energy level. HGH therapy has been shown to decrease the symptoms of MCI and increase brain speed after just 6 months of use. HGH therapy enhances the neurogenesis throughout the brain.
Increlex, or insulin like growth factor (IGF) can increase muscle mass and increase blood flow throughout the body including brain. Increased blood flow may enhance neurogenesis.
Melatonin is the hormone that regulates serotonin. Melatonin supplementation may improve some cognitive impairments.
Parathyroid hormone (PTH) naturally increases with age. Excess PTH is linked to cognitive decline. Hyperparathyroidism that occur with osteoporosis can lead to calcifications throughout the body and also in the brain, reducing processing speed. Surgical removal of one or more parathyroid glands may be an treatment for protecting the brain against MCI.
Pregnenolone is produced from cholesterol which is the precursor of many other hormones including testosterone, cortisone, progesterone, estrogen, DHEA and others. Pregnenolone appears to block stress hormone cortisol. Pregnenolone also works as anti-inflammatory agent that protects the brain from shrinkage.
Progesterone is produced by corpus luteum after ovulation and in smaller quantity by the adrenal gland. Progesterone is the precursor of corticosteroids and testosterone. It has multiple roles in the body, affecting every tissue. Progesterone level can decrease to nearly zero with aging. Progesterone supplementation has been shown to help with anxiety, sleep which indirectly affect cognition.
Testosterone deficiency has been linked to amyloid accumulation, chronic fatigue, depression, MCI. Maintaining testosterone levels correlates with brain speed and has been shown to enhance neurogenesis and specifically visual memory, IQ as well as prevent MCI.
Thyroid T3 and T4 deficiency (hypothyroidism) decreases brain metabolism and are associated with reduced concentration, memory disturbances, depression, decreased cognitive function.
Vasopressin also known as antidiuretic hormone is secreted by the posterior pituitary gland. It also regulate stress hormone cortisol secretion and acts as a chemical messenger in the brain, regulating multiple processes including memory, sleep, behavior and thought
Vitamin D is a hormone produced by the skin with sunlight exposure. It has anti-inflammatory property and stimulates brain chemical production. Vitamin D strengthens overall health and combats aging.

Reference: book by Eric R. Braverman, MD.

Brain Boosting Foods And Supplements

Posted on November 20, 2013 by 6s79T

An essential group of foods and supplements that boost brain function as well as overall health are the diet and nutrition that have antioxidants properties. Over the years, the body generates chemicals known as free radicals that have the effect of oxidizing or “rusting” cells and damage functional biomolecules (protein, DNA, cell membrane). (see free radical theory of aging). Antioxidants are free radical scavengers that can counter the destructive effects of free radicals by effectively quenching hyper reactive electron. Not all antioxidants can neutralize all free radicals. Some antioxidant can only specifically counteract a certain groups of free radicals. Numerous foods contain antioxidants in different combination and amount. Therefore, the importance of a balanced diet combined with supplementation can never overstressed.

Fruits are an essential source of antioxidants and brain boosting foods. Raspberries, blackberries, strawberries, and blueberries – known as “brainberries” – all have strong antioxidant effects. Other fruits containing significant amount of antioxidants are apples, peaches, pomegranates, plums, kiwis, grapefruit, and grapes. Grape contains chemical resveratrol and quercetin that are potent antioxidants. Dried fruits may also contain antioxidants. Check labels to be sure the dried fruits does not contain preservatives , added sugar or other unhealthy additives.

Vegetables are the other groups of brain boosting foods with varieties of antioxidants. Broccoli, cabbage, cauliflower, Brussels, sprouts, kale, chard, carrots, chili peppers, bell peppers, parsley, asparagus, avocados, radishes, zucchini, beets, peas, seaweed, and artichokes contain a variety of effective antioxidant components. Different from other ingredients, cooking generally does not inactivate antioxidants, rather enhance their activity. Hundreds of nutritional studies concluded that those who regularly eat more vegetables and fruit than average are significantly less vulnerable to cancer and cardiovascular diseases.

Garlic is one of the most healthiest ingredients as an antioxidant, antibacterial, antifungal agent. It reduces blood pressure, maintains healthy cholesterol level, increases blood circulation. Beans are a group of foods with antioxidants and fiber. Black, red, broad, kidney and pinto beans contain high amount of antioxidants. Nuts and seeds are another brain boosting foods with varieties of antioxidants. Examples are pistachios, almonds, pecans, walnuts, hazelnuts. Spices and many herbs contain powerful antioxidants: cumin, cloves, cinnamon, turmeric, mustard, ginger, oregano, basil, sage, thyme, and tarragon.

Whole grains and cereals including barley, millet, oats, and corn are all loaded with vitamin E – an antioxidant vitamin widely used in preventing cancer, coronary heart disease, diabetes, boosting immune system, enhancing cognitive functions. Whole grains are healthy, but processed grains (or simple carbs) are not.

Tea extracts also are antioxidant abundant.

Moderate consumption of dark chocolate can raise alertness and improve cognitive function due to the ingredient flavonoids. Flavonoids has anti-inflammatory properties and can reduce the risk of cardiovascular diseases as well.

A balanced diet is crucial but may not be sufficient because of exposure to an environment that can not be perfect and free of pollution. The optimal combination and dosage of supplementation depend on age, gender, weight, and health condition. Supplementation with daily multivitamin and mineral is necessary. Vitamin D can be produced in the skin via sun exposure. Vitamin D is essential for calcium absorption and is important in bone health (see post “Vitamin D Deficiency And Healthy Aging”). Vitamin C has a diverse health benefits including better visual acuity, immune function, and reduced risk of cancer and cardiovascular disease.

Essential fatty acids can not be synthesized by body and has to be supplied from diet. Omega-3 is the essential fatty acid essential for the health and well-being of the brain. It boosts immune system, enhance blood circulation and counteract chronic inflammation. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are omega-3 fatty acids that is abundant in brain boosting foods-fish and fish oil supplementation. Recent studies have suggested that consumption of one type of omega-3 fatty acid in particular, docosahexaenoic acid (DHA) is important for memory function.

Coenzyme Q10 (or ubiquinol) and resveratrol are available as antioxidant supplements that enhance health.

Probiotics can be complemented to ensure digestion and absorption. Under normal condition, guts are teemed with healthy microbes that promote digestion, nutrients absorption and immune system function. Stress, dietary changes, intestinal infection and medication-(e.g. antibiotics) can deplete the natural healthy microbes. Probiotics can restore the natural intestinal microbial defense system. Yogurts, sauerkraut, kefir, kimchi can protect intestinal microbial system.

Ginkgo biloba can boost brain function , enhance memory, increase alertness, increase blood flow to the brain. Turmeric (ginger related) is known for many therapeutic benefits. Studies has suggested that turmeric consumption improves mental acuity in elders. Acetyl-L-carnitine (ALC) is an amino acid that is important to cellular energy metabolism. A study examining subjects who were over one hundred years old discovered that ALC facilitates an increased capacity for physical and cognitive activity by reducing fatigue and improving cognitive functions.

Eight Techniques To Improve Mind And Prevent Brain Aging

Posted on November 15, 2013 by 6s79T

Over the past three decades, a paradigm shift has reshaped the field of neuroscience that changed the way we view the potential of our brain and the way the brain ages. Our mental capacity, including memory and cognition, are designed to improve throughout the life span. The brain is designed to improve with use. Although some brain cells die as we age, neurogenesis never stops. Our neuronal endowment is so vast that even if a thousand brain cells gets lost in a day for the rest of the life span, it would still be only less than 1% of the total. The brain is a highly adaptable and dynamic organ capable of generating new neurons and improving as we age. The brain has an almost unlimited capacity for reshaping itself over the years for adapting and improving while accumulating knowledge and recording experiences. Aging brain can be turned into a learning organ whose limits for enhancement are still unexplored. The book by Michael J. Gelb and Kelly Howell (the creator of Brain Sync® program) illustrated eight scientifically proven techniques to improve mind that will unleash the potential of brain for a synergy of improvement.

1. Think counterclockwise

Think counterclockwise is the technique of holding a positive mind set (attitude) on promoting both physical and mental health. Research has proved that people or elders who frequently revive those memory in earlier years and maintain a youthful mind set generally have higher IQ score, better memory, dexterity, hearing, vision and general well-being. Simply have a positive mind set makes far more difference than any to be gained from exercise and healthy diet. Emphasis of the positive mind set implied the influence of expectation can exert. Studies discovered that people with more positive and optimistic expectation about aging and longevity had outlived the group with more pessimistic expectation. Thoughts (mind sets) and habitual patterns can be rewired in the brain because neurons (brain cells) are so plastic and adaptable that neuron connections can be rewired for resilience and brilliance.

2. Be a Lifelong Learner

The brain gets sharper the more it is used. Learning is one of the simple secrets to revitalize and improve mind. Perhaps how to learn is more important than what is learned. Effective learning require development of curiosity, interests and getting out of the comfort zone. The process of learning something new is more important than the result. There are seven essential rules for strengthening memory as part of the healthy aging strategies – positive mind set, full attention, use preferred learning style, relate new information to existing memory, review notes and use repetitive recitation, teach what is to be remembered, use mnemonics. See this post for how to use mnemonics to enhance memory “Types of Mnemonics – a memory improvement strategy”. Mental sports such as bridge and chess are beneficial activities for cognition maintenance. This post has a more thorough discussion of memory enhancement principles “How To Improve Memory – General Principles”.

3. Exercise for More Brain Power

Physical fitness is crucial to overall health and mental acuity. It is one of the most effective way to ensure that brain is getting enough oxygen and nutrients. Here are some suggestions for getting the most out of the fitness program – exercise the activities that are the most fun; overcome inertia, gradually increase the level of challenge. Make it as a routine and not over do it to prevent injury. Different type of exercise complement each other. Cardiovascular exercises, strength and resistance training and flexibility/balance/poise exercises are different areas of fitness program. Cardio aerobic exercise focuses on strengthening endurance of cardiovascular system. Strength and resistance training increases muscle strength and muscle tones. Some of the flexibility and balance exercise activities are: balance training devices, the Alexander technique, and Tai chi.

4. Diet For Nourishing the Brain

There are several essential elements for healthy diet – maintain hydration, multiple moderate meals, eat antioxidant rich meal, avoid or minimize harmful foods, use nutritional supplements, enjoy dining. This post “Dietary Habits That Accelerate Aging” detailed the dietary habits and foods that accelerate aging. Some of the brain boosting foods are: Ginkgo biloba, turmeric, acetyl-L-carnitine, to name a few. Some antioxidant foods with high ORAC (oxygen radical absorption capacity which is a rating scale used to measure the antioxidant level of various foods) are able to improve mind: fruits and veg, garlic, beans, nuts, spices and herbs, whole grain and cereals.

5. Create A Brain Enhancing Environment

Every aspect of environment stimulates brain for better or worse. The sights, sounds, textures, aromas, and other sensation affects brain. “Environment modifies life but does not govern life”. One of the simplest things to do for improving mind is to create a brain-enhancing environment. The brain’s cognitive wiring and synaptic organization can be altered by the external environment. The sounds from everyday life affect brain and body. Noise can cause a range of stress-related ailments. To reduce the brain-polluting effects of noise, apply “Mozart effect” in practice. The notion of “Mozart effect” derives from a study published on nature showing that students who listened to Mozart’s sonata improved their scores on a spatial-reasoning test, while those sat in silence showed no improvement. Light has a profound effect on body and mind. Natural sunlight is healthy. Full-spectrum lighting is healthier than incandescent or fluorescent light. A balanced combination of brightness and contrast makes it easier to read and focus. The vital importance and healing benefits of nature have long been documented. It is shown that simple and brief interactions with nature can produce marked increase in cognitive control. Air and aroma can have strong effect on mood and memory. Aromatherapy have been practiced for millennia. Aromatherapists recommend jasmine, lavender to help overcome stress and lemon, peppermint to boost concentration and memory. Arts and aesthetics nurtures soul. Display artworks at residence, studio.

6. Cultivate Healthy Relationships

Many studies proved the importance of vibrant social interaction for healthy aging. Socially engaged people have reduced risk of cognitive diseases. Studies also shown that strong social integration and social networks can help people recover from a wide range of ailments. One study showed that social isolation affects people of all ages and that it is more prevalent now than ever before. The emerging discipline of social neuroscience argue that our brain are wired to thrive through social interaction and that stress is associated with isolation.

7. Rest Peacefully to Delay Resting in Peace

Insomnia is as worse as lack of nutrients and oxygen. Besides the obvious benefit of providing time for cell regeneration and energy restoration, regular sound sleep sets up for optimal functioning of mind and body. It strengthens immune system, improves mood, sharpens alertness and attention, facilitates memory consolidation and creative thinking, reduces risk of a range of diseases. In addition, there are multiple dimensions of rest other than sleep. Physical rest (breathe outdoor), mental rest (relaxation exercises), social rest (apply social connection to relax and rejuvenate), spiritual rest (daily meditation, prayer, contemplation). Meditation practice is found to correlate with the thickness of the prefrontal cortex and the cortical plasticity. One research reported that individuals who had been practicing transcendental meditation for years had a biological age averaging twelve years younger than their chronological age.

8. Liberate The Mind by Synchronizing The Brain

From years of research on neurobiofeedback, brain wave training or brain wave entrainment has been shown to have many of the benefits of meditation (reduce stress, enhance cognition) and optimize all aspects of cerebral function. Long term use of brain wave synchronization technology may delay deterioration of the brain traditionally associated with aging. Brain wave entrainment may also be helpful in improving intelligence throughout life. Here is a series of posts that explains what are brain wave patterns, and what is brain synchronization, and the types of brain wave entrainments to improve mind.

Brain Waves, Brain Chemical Systems and Memory
What Is Gamma Brain Waves The Role In Cognition
Neurobiofeedback and Cognition Improvement
Types of Brain Wave Entrainment – Brain Wave Synchronization

The Role of Glutamatergic Neurotransmission System In Aging Brain

Posted on November 12, 2013 by 6s79T

Glutamate was only relatively recently recognized as the major excitatory neurotransmitter in human brain. Glutamate as a neurotransmitter is ubiquitous in nature and has diverse metabolic roles within the CNS. It is important to note that in addition to its role as a neurotransmitter, glutamate also functions as a metabolic precursor to GABA and as a component of the natural antioxidant glutathione. GABA (gamma-aminobutyric acid) is the major inhibitory neurotransmitter involved in the tight regulation of the excitatory neurotransmission. Neurons in every region of the brain use GABA to fine-tune neurotransmission to ensure optimal excitatory neurotransmission but limit excitotoxicity (or excitotoxic damage – effects due to excess excitatory neurotransmitter release). Excessive activation of glutamatergic system can damage neurons by activating proteases, lipases, endonucleases and nitric oxide synthases and by generating more free radicals. GABA occurs in 30-40% of all synapses and is the second most abundantly distributed neurotransmitter in the brain. Only glutamate is more widely distributed. Metabolic studies have determined that virtually all of the glucose (energy) that enters the CNS is eventually converted to glutamate.

Glutamate was initially studied in neuropsychiatric diseases. It has been found and hypothesized that neuropsychiatric diseases are the consequence of imbalance or dysfunction of the monoaminergic neurotransmission systems (dopamine, seretonin, and norepinephrine). It was discovered that antidepressants and antipsychotics that modulate monoaminergic neurotransmission also modulate glutamatergic neurotransmission. This finding leads to the belief of glutamatergic system’s contribution to the pathophysiology or pathogenesis of neuropsychiatric diseases. Since this time, the implication of the glutamate system in the brain diseases has expanded and recent research has focused on glutamatergic neurotransmission as the therapeutic approach to disorders as diverse as various psychiatric disorders, (age-related) neurodegenerative diseases, cognitive impairments, amyotrophic lateral sclerosis (ALS: a type of motor neuron disease) and others.

Glutamate system – the interaction and participation of glutamate with specific membrane receptors in neuro-plastic changes in the efficacy of synaptic transmission are responsible for many neurological functions, including cognition, memory, behavior, movement, sensation. Our knowledge of the glutamatergic synapses had advanced enormously in the last decade, primarily through applications of molecular biology techniques to the study of glutamate receptors (GluRs: ionotropic and metabotropic) and transporters.

NMDA receptor – one of the ionotropic glutamate receptors – have a capacity for a type of neuroplasticity known as long term potentiation (LTP) which is crucial to long-term memory creation and storage. (see post “memory processes”). NMDA receptors are most densely concentrated in the cerebral cortex, especially hippocampus (important for declarative memory), amygdala (emotional memory), and basal ganglia.

AMPA receptor, – one of the metabotropic glutamate receptors – are widely expressed in the CNS and mediate fast excitatory neurotransmission in response to glutamate binding. A physiological role for AMPA receptor in the neocortical and hippocampus synapses has been implicated in learning and memory. Stress hormones have also been found to affect AMPA receptor. This effect is believed to be one of the reasons for the observed inverted U facilitative and suppressive effect of stress hormone corticosteroid on synaptic plasticity and cognition. (see post “How Stress Affect Memory?”).

One significant progression in aging brain is the broad range of chemical changes, more specifically, changes in the amount of neurotransmitters. Studies has revealed marked alterations in neurotransmitters as well as their receptors in different regions of the brain as part of the normal aging process. These include monoamine neurotransmitter – dopamine and serotonin. An overwhelming number of studies have reported age-related changes in dopamine synthesis, binding sites and number of receptors. Decreasing levels of different serotonin receptors and the serotonin transporter have also been shown to occur with age. Glutamate content in the brain tends to decrease with age. This tendency of decrease associated with aging have been found in cerebral cortex (parietal cortex, basal ganglia, hippocampus, motor cortex), and to a lesser degree, the frontal white matter. The age-related decrease of glutamate in parietal cortex and basal ganglia is significantly larger than other regions. On the other hand, the glutamate release from neurons to the extracellular synapse doe not appear to change with age from both in vitro and in vivo studies. Although there are only few studies investigating the glutamate trafficking (the process of absorb of glutamate by transporters on the neuron cell membrane and recycle it for re-release), loss of transporter system for re-use of glutamate was found associated with aging. Moreover, glutamate receptors system are also affected. A decrease with age in the density of glutamatergic receptors of the NMDA has been reported. Decreases in glutamatergic AMPA receptor density have also been reported in prefrontal (important for working memory) and parietal cortex. More significantly is the finding of the decrease of NMDA and AMPA receptors in hippocampus (the cortex for declarative memory) and this observation was correlated with age-related memory impairments.

Not only the functional aspects of glutamatergic neurotransmission declines with age that could contribute to the neurodenegrative neuropsychological diseases. Aging also increased susceptibility of brain to glutamate excitotoxicity (damage of neurons), perhaps due to the change of GABA inhibitory system in its capacity in balancing the excitatory neurotransmission. Increased vulnerability to glutamate excitotoxity is believed and implicated by studies to contribute to the development of a number of age-related neurodegenerative diseases when more neurons are being damaged.

Neurobiofeedback – Applications In Cognition Improvement

Posted on November 8, 2013 by 6s79T

Biofeedback refers to any technique that monitors and regulates the physiological functions using instruments which can provide information on the status of physiological activities such as brain wave pattern (by EEG), heart rate, muscle tone, skin conductance, and pain perception. Using the feedback information generated from the instrument, it is possible and easier to tweak and self-regulate those parameters in an attempt to manipulate them for intended health optimization objectives. Biofeedback is used to improve health, cognition, and to diagnose and treat diseases. Almost all types of sensory modalities and many physiological data can be detected and measured by instruments:

Electroencephalograph (EEG: measure brain waves) is to treat cognitive impairments, psychological and psychiatric disorders, migraines and generalized seizures.
Hemoencephalography (HEG: measure relative amount of oxygenated and unoxygenated blood in the brain) is used to treat migraine and cognitive impairments.
Electromyograph (EMG: detect electrical action potential of muscle contraction ) can be used to treat anxiety, chronic pain and a range of other medical conditions.
Skin thermometer (measure skin temperature) can be use to treat edema, chronic pain, anxiety, and stress and other medical conditions.
Electrodermograph (EDG: measure skin conductance) can be use to treat anxiety, stress, and hyperhidrosis.
Photoplethysmograph (PPG: measure the relative blood flow or blood volume pulse) is for the treatment of edema, chronic pain, hypertension, and some other medical issues.
Electrocardiogram (ECG: measure the electrical activity of the heart) is for diagnosis and treatment of heart disease, fibromyalgia, asthma and a number of other medical problems.
Pneumograph (or respiratory strain gauge: measures relative expansion/contraction of the chest and abdomen and respiration rate) is for treatment of chronic pulmonary obstructive disorder (COPD), hypertension, panic attack and stress.
Capnometer (or capnography: measure end-tidal carbon dioxide in expired air) is used with Pneumograph
Rheoencephalograph (REG: measure brain blood flow) is a technique for the conscious control of brain blood flow.

Neurobiofeedback (neurofeedback or brain wave biofeedback) also called neurotherapy is the biofeedback techniques that use Electroencephalograph (EEG) to monitor brain wave activities for health improvement, diagnosis and treatment purposes, particularly the cognition improvement and mental health optimization. This can be used in any brain wave entrainment sessions (see post “Types of Brain Wave Entrainment – Brain Wave Synchronization”) to facilitate the adjustment and timing of brain wave entrainment parameters based on the feedback information provided from EEG data. HEG is also belong to the neurobiofeedback. Positive neurobiofeedback is used for generating the desired brain activity while negative neurobiofeedback is for reducing or removing the brain activity that are not desirable. One example of negative neurobiofeedback is to reduce anxiety and stress through regulating the balance between beta wave and theta wave. Positive neurobiofeedback will increase the gamma brain wave to enhance any cognitive activities requiring complex coordination of memory, abstract reasoning, language and problem solving.

Neurobiofeedback techniques have been clinically applied in the field of diagnosis and treatment of cognitive impairment diseases. This can be done by comparing the brain wave activity pattern of healthy brain with that of diseased brain. EEG patterns in Alzheimer’s brain are distinguishly different from that of healthy brain. ADHD (attention-deficit hyperreactive disorder) and MCI (mild cognitive impairments) patients also have different EEG pattern from healthy adults. This post (brain waves) describes what brain waves are associated with different brain states (either in active cognitive alertness state or in deep relaxation state). Generally speaking, the more alertness or consciousness the brain activity is, the faster the brain waves (the larger the frequency is).

The effectiveness of neurobiofeedback in ADHD treatment is inconclusive, although several studies produced positive results. EEG models (the patterns of EEG) for identifying ADHD has been proposed. The brain wave pattern of ADHD brain features too many slow theta wave (associated with deep relaxation mode) and not enough faster beta wave (associated with attention, cognitive activities or anxiety/stress). Neurofeedback, when combined with brain wave entrainment technology, is generally designed in an attempt to stimulate the ADHD brain to produce more beta wave and/or gamma wave (associated with enhanced cognitive function) if possible.

Alzheimer’s disease is the most common form of dementia – a neuro-degenerative disease that have extensive memory and cognitive impairments. EEG has been used as a tool for diagnosing AD for several decades. Mild cognition impairment (MCI) precedes Alzheimer’s disease and is the early stage of progression of Alzheimer’s disease. EEG patterns of Alzheimer’s brain (and MCI brain) showed three major differences from that of a healthy brain:

slowing of the EEG:

Shifting of the brain wave spectrum to the lower frequencies can be observed in MCI/AD brain. MCI/AD is associated with increased power of delta (0-4 Hz) and theta bands (4- 8 Hz) and decreased power in alpha (8-12 Hz), beta (12-40 Hz) and gamma waves (30-100 Hz). If the brain produces too many theta wave relative to beta or gamma wave, there will be a corresponding decrease in reaction time, possible difficulty in memory recall, difficulty in learning new things.

reduced complexity of EEG signal:

Studies observed that EEG of MCI and AD brain seems to be more regular than those of healthy brain with similar age. Fewer neurons interact with each other due to MCI/AD induced loss of neurons. Neural activity patterns and dynamics become simpler and more predictable.

perturbations in EEG synchrony:

This is reflected in the decrease of coherence in fast rhythm waves. Numerous studies have reported decreased synchrony in MCI and AD brain under rest condition (the spontaneous EEG). Many different measures of synchrony have been used in the studies of EEG of Alzheimer’s brain. These quantitative measures of synchrony reported decreased magnitude and phase coherence in the EEG of MCI and AD patients. The measure is sufficiently detailed to separate depressed MCI from healthy ones with similar age. The full frequency directed transfer function (fFDTF) was significantly reduced in MCI and AD group compared to control. It was found that the parietal to frontal direction of the information flux was weaker as well, specifically for alpha and beat wave. Decreased phase synchrony was also reported. A general decrease of global field synchrony correlates with cognitive decline and AD. However, this difference in global field synchrony was not observed in patients with mild cognitive impairments. Robust difference in the spatial distribution of EEG phase synchrony were found between AD patients and healthy subjects. Some researchers also recorded EEG of MCI and AD brain when certain cognitive (working memory) tasks are involved. Relative increase of EEG synchrony can be observed during these tasks. Overall, differences in brain wave patterns of these three features can be quantitatively analyzed using sophisticated computational programs, thus enable diagnosis as earlier as possible.

Brainwave entrainment techniques (e.g. binaural beats or music modulation), combined with neurobiofeedback, have been reported to reduce the symptoms of Alzheimer’s disease. Using EEG (and MRI) neurobiofeedback, the impact of the brain wave synchronization treatment can be scientifically measured. The combined techniques aims to reduce the excess undesirable theta or delta wave and induce and stimulate the brain to generate more beta and gamma wave. One advantage of neurobiofeedback and brain wave stimulation to modify brain states is without any side effects from medication treatment. For how brainwave entrainment works on modify and optimize brain health see post “Types of Brain Wave Entrainment – Brain Wave Synchronization”.

Other medical uses of neurobiofeedback are also documented. These include migraine, mental/behavior problems (depression, anxiety, aggression, insomnia, addiction), stroke (brain damage as a consequence of blockage of blood supply) and others.