Mind over matter

Family Fun

The June International Psychogeriatrics Article of the Month is entitled ‘Mind over matter – what do we know about neuroplasticity in adults?’ by Vyara Valkanova, Rocio Eguia Rodriguez and Klaus P. Ebmeier

 

Until recently the capacity of the human brain for structural and functional reorganization (brain plasticity) was considered to be limited to critical periods during development. Neuroimaging provides a non-invasive window into the living brain and has been used to study different aspects of brain plasticity during the learning of new skills or after novel experiences. We reviewed the strongest neuroimaging evidence for experience-dependent plasticity in adult humans, and therefore focused on longitudinal studies only (i.e. participants are scanned before and after different interventions, and then the images are compared).

We identified 36 studies that employed different types of training, such as juggling, exercising working memory, meditation, learning abstract information (studying for exams), and aerobic exercise. Although different patterns of results were found, there was consistent evidence that the brain (gray as well as white matter – brain cells as well as neuronal connections) retains much greater plasticity in adults (<75 years old) than is traditionally thought.

Before such research results can be translated into medical practice, there are many questions that still need to be answered. We currently do not know enough about the type and duration of the interventions that are effective, about the upper limits of improvement, how gains can be maintained, and most importantly the exact relationship between structural change and functional improvement. Further, all reviewed studies are in healthy individuals, while the impact of such interventions in patients with dementia is less well studied.

Future research will need to include larger samples and standardised training protocols to allow comparison of studies done at different research centres. Animal studies combining imaging with histological studies [detailed microscopic analysis] can be very useful in understanding the cellular mechanisms underlying learning, which is important when devising effective interventions. Finally, a multimodal imaging approach, where measures derived from complementary imaging modalities is likely to play a major role in increasing our understanding of brain plasticity. It is possible today, for example, to examine the volume of brain grey matter, the quality of anatomical connections between different areas of the brain and the degree of cooperation between different regions of the brain during the same examination, in other words to examine structural and functional brain connectivity. We know now that even the adult brain has a significant potential to change and compensate for any damage, for example after a stroke. Research in this area will have important implications for our ability to harness the natural self-healing and compensation properties of our brains to the greatest effect, in neurodegenerative diseases such as the dementias.

 

The full paper “Mind over matter – what do we know about neuroplasticity in adults?” is available free of charge for a limited time here.

The commentary on the paper, “Expanding the mind – growing the brain…” is also available free of charge for one month here.

 

The effect of exercise on cognitive outcomes in Alzheimer’s disease

Seniors jogging on a forest road

From January 2014, International Psychogeriatrics will be choosing a paper of the month. It is selected by the editorial team to point out a review or an original contribution which they think should be of great interest to most readers. Each paper of the month will be accompanied by a short commentary, provided by an editor, reviewer, or expert in the field.

The first of these is a systematic review on the effect of exercise on cognitive outcomes in Alzheimer’s disease (AD) by Farina et al.

With the global aging of our societies and predicted increase of cognitive impairment and dementia, it is no surprise that there is an increasing interest not only in the research community, but also among clinicians and the general population to learn more about how to focus on modifiable protective factors and how to avoid modifiable risk factors.

However, we should not forget about the various stages of prevention, and especially in the field of psychogeriatrics should also ask what preventative measures might be effective for older adults who have already experienced cognitive impairment.

The number of randomized controlled trials (RCT) investigating the effectiveness of physical activity on cognition is limited for healthy participants and those with MCI, but is even more sparse for those with dementia.

In the January issue of International Psychogeriatrics, Farina and colleagues publish a systematic review titled “The effect of exercise interventions on cognitive outcome in Alzheimer’s disease: a systematic review”. This paper will help readers of International Psychogeriatrics to critically review the evidence for physical activity and cognition provided by RCTs in patients with AD.”

The paper reviewed six studies that considered the effect of exercise in AD patients. Following analysis, the results suggest that exercise can have a positive effect on the rate of cognitive decline. This finding is encouraging and should be considered as another piece of evidence to encourage physical activity for older adults with AD.

While the overall positive result of this systematic review is promising, the limitations when interpreting this finding are plentiful, which Farina and colleagues thoroughly discuss in their paper. Most importantly, the number of studies included and the number of participants in these studies are small, which is a reminder that this area of research is still in its infancy.

The editorial team of International Psychogeriatrics selected this systematic review as paper of the month, since next to reviewing the evidence it discusses in detail what further research is needed in this important area. We also want to encourage other authors who consider writing systematic reviews in the field of psychogeriatrics to consider a submission to International Psychogeriatrics.

The full paper “The effect of exercise interventions on cognitive outcome in Alzheimer’s disease: a systematic review” is available free of charge for one month here.

The commentary on the paper “Physical activity in Alzheimer’s disease: research in its infancy or why we need more randomized controlled trials” is also available free of charge for one month here.

The Mind in Modern Medicine

Blog Post by Ennapadam S. Krishnamoorthy, (ESK) MBBS, MD, DCN (Lond), PhD (Lond), FRCP (Lond, Edin & Glas), MAMS (India), FIMSA, FIPS, an internationally recognized as a leader in the brain-mind interface, the field of Neuropsychiatry. Founder Director of The Neuropsychiatry Group
It is curious that the mind, so important at the turn of the 20th century, is experiencing today a reawakening in scientific and societal consciousness. The founders of modern medical science in the 18th and 19th centuries had clearly conceived the mind to be a representation of the brain; people like Alois Alzheimer demonstrated pathological abnormalities in the brain of people affected with dementia. Indeed, centuries earlier, the father of modern medicine, Hippocrates, had firmly placed “our joys, sorrows, desires and feelings” in the brain. Read more of this post

Dementia Awareness Week: Conversations with an Alzheimer’s Patient, and other books from Cambridge Medicine

Blog Post by Nisha Doshi, Editorial, Cambridge University Press

4th-10th July 2010 is Dementia Awareness Week in the UK, and this year the Alzheimer’s Society have been asking us to think about people we know living with dementia, and how their lives can be made more enjoyable.

From an in-depth study of communication with an elderly female Alzheimer’s patient over four-and-half-years, to a unique collection of dementia case studies from around the world, Cambridge Medicine’s mental health list offers a wide range of resources to help clinicians and family members caring for dementia patients across the globe.

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A Meeting of Minds – Cambridge Clinical Neuroscience and Mental Health Symposium

Blog Post by Jenny Ridge, Academic & Professional Marketing, Medicine

neuroscience logoThe Cambridge Clinical Neuroscience and Mental Health Symposium starts today, with Press authors ready to speak on the most up-to-date research.

Organised by Cambridge Neuroscience, whose mission is to increase our fundamental understanding of brain function and enhance quality of life, the Symposium is a highly significant event for all neuroscientists. The Symposium connects the varied and vast areas of neuroscience research and teaching that takes place across the University of Cambridge and affiliated institutions and is vital to furthering the aims of Cambridge Neuroscience.

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