Brain Health | Vanguard Neurologist

Our Site Network	Dr. Perlmutter »	Vanguard Neurologist »	Perlmutter Health Center »

Low Cholesterol Associated with Impaired Brain Function

September 20th, 2010

Data from 789 men and 1,105 women from the Framingham Heart Study has found that those who had the lowest total cholesterol performed significantly more poorly on tests of similarities, word fluency, and attention/concentration than patients with higher cholesterol levels. Those in the lowest total cholesterol group (a level of under 200) were 49% more likely to perform poorly and 80% more likely to perform very poorly than were participants in the highest total cholesterol group (240 to 380). The finding should not be taken as a warning against those with high cholesterol taking medication to lower it; the study applies to those with naturally low cholesterol levels, and previous studies have shown that both high and low cholesterol have led to poor cognitive performance.

The study findings were published in the journal

Psychosomatic Medicine

Mayo Clinic Discovers Potential Link Between Celiac Disease And Cognitive Decline

September 16th, 2010

From

ScienceDaily

Mayo Clinic researchers have uncovered a new link between celiac disease, a digestive condition triggered by consumption of gluten, and dementia or other forms of cognitive decline. The investigators’ case series analysis — an examination of medical histories of a group of patients with a common problem — of 13 patients will be published in the October issue of Archives of Neurology

There has been very little known about this connection between celiac disease and cognitive decline until now,” says Keith Josephs, M.D., Mayo Clinic neurologist and study investigator. “This is the largest case series to date of patients demonstrating cognitive decline within two years of the onset of celiac disease symptom onset or worsening.”

Says Joseph Murray, M.D., Mayo Clinic gastroenterologist and study investigator, “There has been a fair amount written before about celiac disease and neurological issues like peripheral neuropathy (nerve problems causing numbness or pain) or balance problems, but this degree of brain problem — the cognitive decline we’ve found here — has not been recognized before. I was not expecting there would be so many celiac disease patients with cognitive decline.”

The next step in the research will be to investigate the measure and nature of the connection between the two conditions.

“It’s possible it’s a chance connection, but given the temporal link between the celiac symptoms starting or worsening and the cognitive decline within a two-year time span, especially the simultaneous occurrence in five patients, this is unlikely a chance connection,” says Dr. Josephs. “Also, these patients are relatively young to have dementia.”

Theories to explain the connection between celiac disease and cognitive decline include the following, according to Dr. Murray:

Nutritional deficiency

Inflammatory cytokines — chemical messengers of inflammation that could contribute to problems in the brain

An immune attack on the brain that may occur in some patients with celiac disease

The cognitive decline that occurred in three of the celiac disease patients studied, according to Dr. Josephs, is relatively unique in its reversal in two of the patients and stabilization in one patient. Typically, cognitive decline continues to worsen, he says. “This is key that we may have discovered a reversible form of cognitive impairment,” he says.

William Hu, M.D., Ph.D., Mayo Clinic neurology resident and study investigator, says that the reversal or stabilization of the cognitive symptoms in some patients when they underwent gluten withdrawal also argues against chance as an explanation of the link between celiac disease and cognitive decline.

Currently, the investigators do not know which celiac disease patients are at risk for cognitive decline; this deserves future investigation, says Dr. Hu.

Dr. Murray suggests that recognizing and treating celiac disease early will likely prevent most consequences of the disease, including symptoms in the gut or the brain. For celiac disease patients who have already developed cognitive decline, closely following a gluten-free diet may result in some symptom improvement, he says. For those with cognitive decline without a confirmed diagnosis of celiac disease, he does not recommend a gluten-free diet, however.

Physicians can play an important role in keeping alert to a potential celiac disease and cognitive decline connection, says Dr. Hu.

“For patients who come in with atypical forms of dementia, we need to consider checking for celiac disease, especially if the patients have diarrhea, weight loss or a younger age of onset — under age 70,” he says.

To conduct this case series analysis, the researchers identified 13 Mayo Clinic patients with documented cognitive impairment within two years of onset of symptoms or severe exacerbation of adult celiac disease. All celiac disease had been confirmed by small-bowel biopsy, and any patients for whom an alternate cause of cognitive decline could be identified were excluded from the analysis. Patients included five women and eight men, with a median onset of cognitive decline at age 64 that coincided with onset or worsening of symptoms of diarrhea, the presence of excess fat in the stools and abdominal cramping in five patients. The most common reasons for seeking medical help were amnesia, confusion and personality changes. The average score on the Short Test of Mental Status among the 13 patients was 28 out of 38 possible total, indicating moderate cognitive impairment. Ten patients experienced loss of coordination and four experienced symptoms of peripheral neuropathy. Four patients demonstrated deficiency in folate, vitamin B-12, vitamin E or a combination of these deficiencies, although supplementation did not improve the patients’ cognitive decline. Three patients’ cognitive decline either improved or stabilized when they completely withdrew from gluten consumption. A brain autopsy or biopsy was completed in five patients, and there was no evidence of Alzheimer’s disease or any other well-known causes for dementia.

Gluten brain, gluten headache, gluten adhd, gluten cognitive, gluten perlmutter

Low Levels Of Vitamin D Link To Cognitive Problems In Older People

September 12th, 2010

From ScienceDaily.com:

Researchers from the Peninsula Medical School, the University of Cambridge and the University of Michigan, have for the first time identified a relationship between Vitamin D, the “sunshine vitamin”, and cognitive impairment in a large-scale study of older people. The importance of these findings lies in the connection between cognitive function and dementia: people who have impaired cognitive function are more likely to develop dementia.

The study was based on data on almost 2000 adults aged 65 and over who participated in the Health Survey for England in 2000 and whose levels of cognitive function were assessed. The study found that as levels of Vitamin D went down, levels of cognitive impairment went up. Compared to those with optimum levels of Vitamin D, those with the lowest levels were more than twice as likely to be cognitively impaired.

Vitamin D is important in maintaining bone health, in the absorption of calcium and phosphorus, and in helping our immune system. In humans, Vitamin D comes from three main sources – exposure to sunlight, foods such as oily fish, and foods that are fortified with vitamin D (such as milk, cereals, and soya drinks). One problem faced by older people is that the capacity of the skin to absorb Vitamin D from sunlight decreases as the body ages, so they are more reliant on obtaining Vitamin D from other sources.

According to the Alzheimer’s Society, dementia affects 700,000 people in the UK and it is predicted that this figure will rise to over 1 million by 2025. Two-thirds of sufferers are women, and 60,000 deaths a year are attributable to the condition. It is believed that the financial cost of dementia to the UK is over £17 billion a year.

Dr. Iain Lang from the Peninsula Medical School, who worked on the study, commented: “This is the first large-scale study to identify a relationship between Vitamin D and cognitive impairment in later life. Dementia is a growing problem for health services everywhere, and people who have cognitive impairment are at higher risk of going on to develop dementia. That means identifying ways in which we can reduce levels of dementia is a key challenge for health services.”

Dr Lang added: “For those of us who live in countries where there are dark winters without much sunlight, like the UK, getting enough Vitamin D can be a real problem – particularly for older people, who absorb less Vitamin D from sunlight. One way to address this might be to provide older adults with Vitamin D supplements. This has been proposed in the past as a way of improving bone health in older people, but our results suggest it might also have other benefits. We need to investigate whether vitamin D supplementation is a cost-effective and low-risk way of reducing older people’s risks of developing cognitive impairment and dementia.”

Green Tea – Good for the Brain

September 2nd, 2010

It seems that hardly a day does by that we don’t hear about some new health benefit associated with drinking green tea. Whether it’s cancer prevention, boosting immunity, raising alertness, or even treating the common cold, it seems like there’s no end to the virtues of this centuries old practice. Many of the benefits of drinking green tea are thought to be associated with it’s high content of flavonoids, plant derived antioxidants that may be responsible for the extensive scientific support relating green tea consumption to decreased risk for cancer as well as heart attacks.

One particular flavonoid, EGCG, not only serves as a powerful antioxidant, but in addition has been shown to reduce the formation of amyloid plaque, a brain damaging protein associated with Alzheimer’s disease. In research recently published in the Journal of Neuroscience, investigators found that brain cells from mice genetically altered to develop Alzheimer’s disease produced 54% less amyloid plaque when treated with EGCG. The ability of EGCG to reduce this damaging protein as well as the powerful antioxidant activity of this chemical found in green tea led the researchers to speculate that green tea could be effective not only in treating the disease, but also in preventing it in the first place.

Green tea may contain as much as 450 mg ECGC per cup. To replicate the EGCG consumption in this study, a person would need to drink about 4 cups a day. Fortunately, this healthful beverage is now available without caffeine.

Binge on broccoli to boost the brain

August 24th, 2010

From DNAindia.com:

Eating certain fruit and vegetables could boost the memory, particularly broccoli, according to British research.

The study conducted by King’s College London,provides scientific backing to the theory and has major implications for the prevention and treatment of Alzheimer’s disease, the Royal Pharmaceutical Society said.

Extracts found in five fruits and vegetables —broccoli, potatoes, oranges, apples and radishes — were found to contain substances that act in the same way as drugs used to treat the disease. Broccoli had the most.

Alzheimer’s, for which there is no cure, is the most common form of dementia among older people.

It seriously affects their ability to carry out daily activities, impairing parts of the brain that control thought, memory and language. Most of the drugs used to treat the disease act as inhibitors of acetylcholinesterase, the enzyme responsible for the breakdown of the neurotransmitter acetylcholine.

It has been previously suggested that some common vegetables might have anti-acetylcholinesterase activity, but no detailed investigation has ever been carried out. The King’s College London research confirms this activity in all five of the fruit and vegetables.

Broccoli was found to have the most potent activity and was taken forward for further tests to identify the agent responsible.

These were found to be glucosinolates, a group of compounds found throughout the cabbage family. “As yet, it is unproven that eating broccoli, for instance, would have a beneficial effect on Alzheimer’s disease.

“As yet, it is unproven that eating broccoli, for instance, would have a beneficial effect on Alzheimer’s disease,” said professor Peter Houghton, from King’s College London.

“But the long-term effects of regularly consuming these compounds in vegetables belonging to the brassicaceae might certainly be beneficial in reducing a decline in acetylcholine levels in the central nervous system.”