(Note: neu­ro­feed­back is a form of biofeed­back that mea­sures brain waves and that, accord­ing to prac­ti­tion­ers, pro­vides good “brain train­ing” for spe­cific clin­i­cal con­di­tions).
A few weeks ago Dr. David Rabiner wrote a great post on How Strong is the Research Sup­port for Neu­ro­feed­back in Atten­tion Deficits?, con­clud­ing that

- “It is for these rea­sons that neu­ro­feed­back is under­stand­ably regarded as an unproven treat­ment approach for ADHD at this time by many ADHD researchers.

- How­ever, these stud­ies do pro­vide a solid basis for sug­gest­ing that if par­ents choose to pur­sue neu­ro­feed­back for their child, there is a rea­son­able chance that their child will ben­e­fit even though we can’t be sure that it is the spe­cific EEG train­ing that is respon­si­ble for the ben­e­fits. Thus, although the effi­cacy of neu­ro­feed­back has yet to be con­clu­sively con­firmed in a ran­dom­ized, placebo-controlled trial, it is impor­tant to place this lim­i­ta­tion in the con­text of the sup­port­ive research evi­dence that has been accumulated.

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Dr. Yaakov Stern is the Divi­sion Leader of the Cog­ni­tive Neu­ro­science Divi­sion of the Sergievsky Cen­ter, and Pro­fes­sor of Clin­i­cal Neu­ropsy­chol­ogy, at the Col­lege of Physi­cians and Sur­geons of Colum­bia Uni­ver­sity, New York.

He is one of the lead­ing pro­po­nents of the Cog­ni­tive reserve the­ory, which aims to explain why some indi­vid­u­als with full Alzheimer’s pathol­ogy (accu­mu­la­tion of plaques and tan­gles in their brains) can keep nor­mal lives until they die, while oth­ers –with the same amount of plaques and tan­gles– dis­play the severe symp­toms we asso­ciate with Alzheimer’s Dis­ease. He has pub­lished dozens of peer-reviewed sci­en­tific papers on the subject.

The con­cept of a Cog­ni­tive Reserve has been around since 1989, when a post mortem analy­sis of 137 peo­ple with Alzheimer’s Dis­ease showed that some patients exhib­ited fewer clin­i­cal symp­toms than their actual pathol­ogy sug­gested. These patients also showed higher brain weights and greater num­ber of neu­rons when com­pared to age-matched con­trols. The inves­ti­ga­tors hypoth­e­sized that the patients had a larger “reserve” of neu­rons and abil­i­ties that enable them to off­set the losses caused by Alzheimer’s. Since then, the con­cept of Cog­ni­tive Reserve has been defined as the abil­ity of an indi­vid­ual to tol­er­ate pro­gres­sive brain pathol­ogy with­out demon­strat­ing clin­i­cal cog­ni­tive symp­toms. (You can check at the end of this inter­view a great clip on this).

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Key take-aways

- Life­time expe­ri­ences, like edu­ca­tion, engag­ing occu­pa­tion, and leisure activ­i­ties, have been shown to have a major influ­ence on how we age, specif­i­cally on whether we will develop Alzheimer’s symp­toms or not.

- This is so because stim­u­lat­ing activ­i­ties, ide­ally com­bin­ing phys­i­cal exer­cise, learn­ing and social inter­ac­tion, help us build a Cog­ni­tive Reserve to pro­tect us.

- The ear­lier we start build­ing our Reserve, the bet­ter; but it is never too late to start. And, the more activ­i­ties, the bet­ter: the effect is cumulative.

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The Cog­ni­tive Reserve

Alvaro Fer­nan­dez (AF): Dear Dr. Stern, it is a plea­sure to have you here. Let me first ask you this: the impli­ca­tions of your research are pretty astound­ing, pre­sent­ing major impli­ca­tions across sec­tors and age groups. What has been the most unex­pected reac­tion so far?

YS: well…I was pretty sur­prised when Read the rest of this entry »