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Q&A with Yaakov Stern on Brain Reserve, Exercise, Cognitive Training, Angry Birds, YMCA and more

I just had the chance to dis­cuss lat­est neu­ro­sci­en­tific research and think­ing with Dr. Yaakov Stern, one of the lead­ing sci­en­tists study­ing how to build a neu­ro­pro­tec­tive cog­ni­tive reserve across the lifes­pan. Dr. Stern leads the Cog­ni­tive Neu­ro­science Divi­sion at the Colum­bia Uni­ver­sity Sergievsky Cen­ter. What fol­lows is a Q&A ses­sion con­ducted via email over the last week.

Alvaro Fer­nan­dez: What do you make of the recent study “Asso­ci­a­tion of Life­time Cog­ni­tive Engage­ment and Low ?-Amy­loid Depo­si­tion”? 

Yaakov Stern: I find these results very intrigu­ing. The con­cept of cog­ni­tive reserve posits that var­i­ous life­time expo­sures such as edu­ca­tion, occu­pa­tion and leisure activ­i­ties may be related to dif­fer­en­tial sus­cep­ti­bil­ity to Alzheimer’s pathol­ogy once it occurs. This paper con­tin­ues a new, ongo­ing theme that cer­tain life­time clo­sures may actu­ally impact on the brain changes or patho­logic find­ings them­selves. While more work needs to be done to under­stand how life­time expo­sures may impact the devel­op­ment of Alzheimer’s dis­ease pathol­ogy, it is clear that both cog­ni­tive stim­u­la­tion and exer­cise help shape the brain through­out the lifes­pan. For exam­ple, ani­mal stud­ies indi­cate that both a stim­u­lat­ing envi­ron­ment and a aer­o­bic exer­cise are asso­ci­ated with neu­ro­ge­n­e­sis, the growth and uti­liza­tion of new neu­rons in the hip­pocam­pus. Thus, life events may con­tribute to what I have called “brain reserve,” but now brain reserve is a much more fluid con­cept than I orig­i­nally imagined.

AF: How do these find­ings link to your work?

YS: These types of obser­va­tions have con­tributed to the design of two inter­ven­tion stud­ies that I am cur­rently run­ning. One of them com­pares peo­ple who engage in a aer­o­bic exer­cise ver­sus stretch­ing and ton­ing for six months. We are com­par­ing these two forms of phys­i­cal exer­cise to see which is more ben­e­fi­cial. F. Before and after this exer­cise period, the par­tic­i­pants receive exten­sive cog­ni­tive eval­u­a­tion and neu­roimag­ing. The neu­roimag­ing stud­ies will help us under­stand what brain changes are asso­ci­ated with any cog­ni­tive improve­ment that we see. One unique aspect of this study is that it is enrolling younger peo­ple that have been included in pre­vi­ous stud­ies. We are recruit­ing indi­vid­u­als who are 30 – 45 and 50 – 65.

AF: What is the cur­rent under­stand­ing on what adults may need, and ben­e­fit from? are pri­or­i­ties and likely inter­ven­tions the same when we talk about younger vs. older adults?

YS: That is exactly what I’d like to find out. The ani­mal stud­ies and some stud­ies of younger adults sug­gest that exer­cise may impact both the cog­ni­tion and the brain across all ages. The goal of my study is to see whether it has sim­i­lar effi­cacy in younger and older indi­vid­u­als, whether the same cog­ni­tive processes are enhanced, and whether the neural basis for improve­ment is the same across these age groups. In the sec­ond ongo­ing study, we are look­ing at the rel­a­tive ben­e­fits of phys­i­cal and cog­ni­tive exercise.

AF: What is the cur­rent under­stand­ing on the rel­a­tive mer­its and short­com­ings of phys­i­cal and cog­ni­tive exer­cise? do you see them as some­how mutu­ally exclu­sive or as synergistic?

YS: My view is that they are syn­er­gis­tic. It makes sense to me that any improve­ments in “brain reserve” would heighten the abil­ity to develop a more “cog­ni­tive reserve.” To explain, we know that both exer­cise and cog­ni­tive stim­u­la­tion affects the brain itself. For exam­ple, they both up reg­u­late a chem­i­cal that is respon­si­ble for increased synap­tic plas­tic­ity. The advan­tage I see to cog­ni­tive train­ing is that it can enhance spe­cific cog­ni­tive func­tions. It may be that peo­ple will be ben­e­fit more from this cog­ni­tive train­ing when they exer­cise, since exer­cise may help the brain be more recep­tive to this train­ing. To test this idea, we are run­ning another study where par­tic­i­pants engage in both videogames designed to enhance cog­ni­tive func­tion (specif­i­cally, atten­tional allo­ca­tion), and also exer­cise. This study is open to peo­ple aged 60 and over. I must say that this study is more demand­ing because it requires both for vis­its to the gym a week and three vis­its to our lab to play the video game. One unique fea­ture of both of our stud­ies is that we have part­nered with all of the YMCAs in Man­hat­tan, so that par­tic­i­pants can con­duct their exer­cise ses­sions in any loca­tion that is con­ve­nient to them.

AF: Why did you select that par­tic­u­lar videogame and not, say, Tetris or Angry Birds?

YS: We are using the Space Fortress game because I believe that it may enhance atten­tional allo­ca­tion and exec­u­tive con­trol. I feel that these are very impor­tant cog­ni­tive func­tions and enhanc­ing them may directly impact on and improve the per­for­mance of many day-to-day activ­i­ties. We are com­par­ing the Space Fortress game with more stan­dard com­puter games, since it is quite pos­si­ble that they may be ben­e­fi­cial as well.

AF: So, your stud­ies will mea­sure the impact of mov­ing from a seden­tary lifestyle to exer­cis­ing at least 4 times a week. Would you expect the result­ing ben­e­fit to be more or less pro­nounced than if some­one already exer­cis­ing at four times per week increase to eight times per week?

YS: I am not sure what the answer to this is. Most exer­cise stud­ies begin with peo­ple who are not reg­u­lar exer­cis­ers because we believe that it will increase the chance that we can see an effect. My guess is that any increase in exer­cise may also be ben­e­fi­cial, but it would be harder to detect.

AF: The YMCA part­ner­ship is fas­ci­nat­ing, a very inno­v­a­tive way to do community-based research. How does it work? Who greets/ supervises/ sup­ports peo­ple? Was it dif­fi­cult to engage them? And, where do the com­put­er­ized cog­ni­tive work­outs take place?

YS: I agree that the part­ner­ship with the YMCA is very excit­ing. Peo­ple par­tic­i­pat­ing in our stud­ies get free access to the gym at any YMCA in Man­hat­tan. Our per­son­nel ini­tially meets par­tic­i­pants at the gym and ori­ent them to what they need to do. The gyms all have res­i­dent train­ers who know about the stud­ies and can give advice as needed. Right now the com­put­er­ized cog­ni­tive work­outs are done at our med­ical cen­ter. We are cur­rently work­ing on the tech­nol­ogy to allow peo­ple to play the games from their home in a way that we can directly mon­i­tor their per­for­mance. This should make it a lit­tle eas­ier for peo­ple to participate.

AF: Who is eli­gi­ble for your stud­ies and how can they sign up?

YS: As I men­tioned above, one study is recruit­ing peo­ple ages 30 to 45 and 50 to 65. The sec­ond, more inten­sive study is recruit­ing peo­ple age 60 and older. Both of these stud­ies are look­ing for indi­vid­u­als who are not reg­u­lar exer­cis­ers, because this should enhance our abil­ity to find an effect of exer­cise on cog­ni­tion. Our coor­di­na­tor can help answer ques­tions about whether you are eli­gi­ble or not. Any­one inter­ested poten­tially par­tic­i­pat­ing in one of these two stud­ies can con­tact Caitlin Slight: cbs2139 at columbia.edu.

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