Your body’s ability to deal with stress is regulated by the autonomic nervous system (ANS). This system monitors the environmental signals, interprets them, and organizes appropriate automatic behavioural responses.  It is composed of a specialized group of neurons that regulate cardiac muscle (the heart), smooth muscles (walls of the visceral organs and blood vessels) and glands.

The autonomic nervous system has two components that balance each other – Protection – the sympathetic nervous system(SNS) and Growth – the parasympathetic nervous system (PNS). What is important to know is that both systems CANNOT operate optimally at the same time. We unavoidably restrict our growth behaviours when we shift into protective mode (stressed).

Protection – the HPA axis and the Immune system

The sympathetic nervous system (SNS) turns UP your nervous system. It helps us handle what we perceive to be emergencies or threatening situations (can include emotional upset as well as physical stress) and is in charge of the flight-or-fight response. The SNS has two systems to protect the body: the Hypothalamus – Pituitary – Adrenals axis (HPA Axis) which responds to perceived external threats, and the Immune system which protects us from threats originating underneath the skin (like attack by virus or bacteria).

1. HPA axis

• When the body perceives that there are no external threats, the HPA axis is inactive and growth flourishes.
• When brain’s hypothalamus perceives an environmental threat, it engages the HPA axis by sending a chemical signal (CRE) to the pituitary gland.
• The pituitary gland (master gland) is responsible for organizing the body to deal with the impending threat.
• The pituitary gland sends a chemical signal (via ACTH) to the adrenals informing them to coordinate the body’s “fight or flight” response via stress hormones.
• HPA axis interferes with both the immune system (protection) and growth systems:
• HPA axis also interferes with our ability to think clearly
  • The processing of information in the forebrain (the center of executive reasoning and logic) is significantly slower than the reflex activity controlled by the hind brain
  • Adrenal stress hormones constrict the blood vessels in the forebrain reducing its ability to function
  • Stress hormones also repress activity in the brain’s prefrontal cortex (the center of conscious, volitional action)
  • In an emergency, the vascular flow and hormones serve to activate the hindbrain (source of reflexes)
  • Stress hormones inhibit neuronal growth, leading to depression. In chronically depressed people the hippocampus and prefrontal cortex are physically shrunken.
    • When the brain’s stress machinery goes into overdrive, it leads to depression.

2. Immune system

• When the immune system is mobilized, it can consume much of the body’s energy supply.
• Adrenal hormones secreted by the HPA axis actively repress the action of the immune system

Growth – the Vagus Nerve

The parasympathetic nervous system turns DOWN the nervous system and helps us to be calm. It is most active when the body is at rest and not threatened in any way. This division is sometimes called the ‘resting-and-digesting’ system since it is chiefly concerned with promoting normal digestion, with elimination of feces and urine, and with conserving body energy. It promotes relaxation, rest, sleep, and drowsiness by slowing our heart rate, slowing our breathing, constricts the pupils of our eyes, increases the production of saliva in our mouth, and allows us to digest our food and grow.

The vagus nerve is the key instrument of the parasympathetic system. Beginning in the medulla oblongata, the nerve travels to all of the organs of the body sending signals to and from the brain. The two previous posts provide lots of information about the vagus nerve and how to activate the relaxation response. Post 1 – The Vagus Nerve, Post 2 – Activating the Vagus Nerve.

Importance of sleep

A recent survey found that more people are sleeping less than six hours a night, and are having difficulties sleeping (because they are unable to turn off their HPA axis). Chronic sleep loss can contribute to health problems such as weight gain, high blood pressure, and a decrease in the immune system’s power, reports the Harvard Women’s Health Watch.[i]

Some important tips for getting a good night’s sleep and allowing the PNS time to heal and relax are:

1. Keep a regular sleep schedule – set a regular time to go to sleep, and to wake up. After dinner, when you are relaxing on the sofa, try not to fall asleep and then wake up late in the night, get up and do something mildly stimulating. On the weekend, catch up on your sleep with naps.
2. Naturally regulate your light/dark cycles – increase light exposure during the day by taking walks outside in the light, use a light therapy box in the winter to offset SAD symptoms. In the evening, turn off the television and electronic devices in your bedroom and close the blinds so outside lights don’t disturb you.
3. Create a relaxing bedtime routine – keep noise down, keep the temperature cool (adjust your thermostat to automatically drop several degrees during the night), and sleep in a comfortable bed.
4. Eat right and get regular exercise – stay away from really heavy meals late at night, avoid alcohol before bed, cut down on caffeine and avoid drinking too much liquid before bed. Having fruit several hours after dinner or before bed puts the system into ‘detox and cleanse mode’ which turns on the pancreas and liver and may keep you awake. If you are hungry before bed, try a light snack of a small piece of turkey or chicken breast, or avocado, or some soaked nuts with some plain yogurt.
5. Get anxiety and stress in check – try the activation of vagus nerve techniques in the previous post to turn on the PNS.

Today, we live in a stressed-out world and an increasing body of research suggests that our hyper-vigilant lifestyle is severely impacting the health of our bodies. Daily stressors and emotional upsets are constantly activating the HPA axis causing emotional and physical disharmony that cause major illness such as cardio vascular issues, depression, digestive issues, glucose/insulin resistance. Further, these stressors are not released from the body (as they would be in a fight or flight situation) and can build up to become chronic fears and concerns.

A dynamic balance needs to exist between the two divisions of the autonomic nervous system, so that they can continuously make fine adjustments. As a society we need to find new ways to release our fears and stressors and add relaxation time and techniques to our daily life.

Footnotes

Over the next 3 posts, Rebecca and I will be introducing you to the Vagus Nerve, what it is, what its functions are, and how you can use that knowledge for optimal brain-body health. Why is this nerve important? Why should we care?

Research has found that the neurotransmitter acetylcholine acts as a brake on inflammation in the body^[4]. Stimulating your vagus nerve sends acetylcholine throughout your body, not only making you feel relaxed, but also putting out the fires of inflammation – something that happens in response to stress^[1]. Further to this, acetylcholine is also responsible for learning and memory.  You can’t learn or heal though, if you stay in stress mode.

The vagus nerve is the 10^th cranial nerve in your body. It is a very long nerve running from the hypothalamus area of your brain, chest, diaphragm, and to your intestines.  It wraps around your heart and core area (Hara point and solar plexus centre) – areas traditionally considered to be the seat of intuition and compassion.

The vagus nerve activates the parasympathetic nervous system (PNS), which manages your relaxation response, and in turn, helps you to control the health of your immune cells, organs and tissues, and even your stem cells. Twenty percent of the fibres of the vagus nerve control the organs which ‘maintain’ your body (the heart, digestion, breathing, glands). The other 80 percent of its fibres send information from your gut to your brain. (We will be writing more about the gut-brain relationship in another blog article).

One of the key roles that the vagus nerve plays, is acting as the “reset” button after your internal alarm system has been set off – i.e., in response to some type of perceived threat (a stress response). This nerve then communicates with the rest of your body to tell you that the threat is gone and that all of your bodily functions can now return to normal, healing mode.

Research has linked the vagus nerve to improved neurogenesis (creation of new brain or neuronal cells), and increased brain-derived neurotrophic factor (BDNF) factor.  BDNF is like a fabulous super-food for your brain cells.  It helps with repair of brain tissue, actual regeneration throughout the whole body.

These ^[5] and other researchers have found that stem cell growth is directly connected to vagus nerve activity.  Activating the vagus nerve can stimulate stem cells to produce new cells and even repair and rebuild your organs.

In the third installment of this blog, we will discuss further how the sympathetic and parasympathetic nervous systems work. For now, it is important to know that if you are living in stress mode, your body is unable to heal itself. The hormones that are triggered by stress actively block the healing and resting response of the body. Stress can create a number of negative effects including: depression, anxiety, insomnia, anger, difficulty with decision making, violence, difficulty with thinking and attention.

Fortunately, there are many ways to activate the vagus nerve and turn your relaxation response back on. An easy, inexpensive way to do this is to just breathe.  When you take a deep inhalation through the mouth, relax and expand your diaphragm, your vagus system kicks in, and your parasympathetic nervous system is activated. Then exhale via the nose and feel the stress leaving your body. The result? Your cortisol levels are reduced, and your brain heals.

Next:  Activating the Vagus Nerve.

Reference(s)

1. Sloan, R. P., et al. 2007. RR interval variability is inversely related to inflammatory markers: The CARDIA study. Mol Med 13 (3-4):178-84.
2. “Ultra-Longevity” by Mark Liponis, MD
3. “Prime-Time Health” by William Sears, M.D. with Martha Sears, RN
4. Pavlov, V.A., and K.J. Tracey. 2005. The cholinergic anti-inflammatory pathway. Brain Behav Immun 19 (6):493-99.
5. Theise, N.D., and R. Harris. 2006. Postmodern biology: (adult) (stem) cells are plastic, stochastic, complex, and uncertain. Handb Exp Pharmacol (174):389-408.
6. Your Brain on Food by Gary L. Wenk.
7. The vagus nerve is located within the brain stem. It enters the nucleus tractus solitarius and then travels through the parabrachial nucleus. It then splits upward into a path which stimulates the thalamus (this path affects the central cortex), and a lower path into the limbic system (“your primitive brain where security is important). The limbic system oversees a number of anatomical/functional regions. The hypothalamus is responsible for ‘fight or flight’ responses, feeding/survival, and mating. The amygdala is where you feel joy, humour, anger, etc. In mammals, it appears that it is where all of the species-specific programmed actions come from; thus, it is crucial for survival. In Post-Traumatic Stess Disorder (PTSD), the activity of the amygdala is altered. The limbic system also contains the four brain reward systems.

For more than 15 years, stimulation of the vagus nerve has been used as a treatment for epilepsy and depression.  The Canadian Health Protection Branch approved Vagus Nerve Stimulation (VNS) in March 1997, with special focus on epilepsy patients over the age of 12 whose partial onset seizures are not well controlled by medication. The U.S. Federal Drug Administration has also approved VNS for the treatment of both epilepsy and depression. It appears that depression is a condition that is common amongst people with epilepsy. The February 2000 issue of Annals of Neurology reported that older adults who are clinically depressed are six times as likely to have a seizure as their peers. This suggests that a common factor may be underlying both the cause of depression and seizures.  (Interestingly, the ‘diet to stop seizures’ is the ‘ketogenic diet’ and this same diet seems to be implicated in treating concussion, and even serious mood disorders such as schizophrenia).

In the October 2005 the Annals of Neurology, ColumbiaUniversity researchers found that depression and suicide attempts may be due to underlying neurochemical pathways common to epilepsy development.

What are the benefits of stimulating the Vagus Nerve?

As you may remember from our previous blog post, the vagal nerve is the main instrument of the parasympathetic nervous system. Its branches begin in the medulla oblongata and travel deep into the body sending signals to, but mostly from the organs (especially the gut).

There are several locations where the vagal nerve comes out to accessible zones for stimulation:

• Muscle that constricts the pharynx (rami pharyngei)
• Behind the eye balls (radix oculomotoria)
• Hard and soft palate (nervus palatinus)
• In the surface of the ear canal and lobe (ramus auricularis)
• Tongue (ramus lingualis)[i]

When properly stimulated the Vagal Nerve can:

• Turn on neurogenesis, helping our brains sprout new brain cells.
• Rapidly turn off the stress, hyper-arousal, and fight/flight via the relaxation response.
• Sharpen our memories.
• Fight inflammatory disease.
• Help you resist high blood pressure.
• Block the hormone cortisol and other oxidizing agents that age and deteriorate the brain and body
• Block systemic (body-wide) inflammation – a major factor behind aging and poor health.
• Help us overcome depression and anxiety.
• Help us sleep better.
• Raise levels of human growth hormone.
• Help us overcome insulin resistance.
• Turn down allergic responses.
• Lower chances of getting stress and tension headaches.
• Help spare and grow our mitochondria- this is a key to maintaining optimal energy levels and not harming our DNA and RNA.
• Affect our overall ability to live longer, healthier, and more energetic lives.

Activating the Vagal Nerve with Machinery:

Vagal Nerve Stimulation involves inserting a pacemaker-like nerve stimulator in your chest connected to the left side of your vagus nerve. (See animation and more info about the procedure: https://www.epilepsymatters.com/english/trevagus.html).

Every two to five minutes, the vagus nerve is stimulated, causing one’s diaphragm to contract. The device costs between $15 and $20 K, and it is not covered by the Ontario Health Insurance Plan (OHIP), however some costs may come out of a hospital’s budget. There is a long waiting list to get approved for this procedure. The following centres in Ontario are able to perform the procedure:  Hospital for Sick Children, St. Michael’s Hospital, TorontoWesternHospital, Ottawa GeneralHospital, Ottawa Children’s Hospital, Kingston  General Hospital and London Health Sciences Centre-University Campus.

Activating the Vagus Nerve without Machinery

Vagus nerve stimulation can be turned on easily though a number of breathing and relaxation techniques:

• Deep/slow belly breathing.
• ‘OM’ Chanting
• Cold water face immersion after exercise
• Filling the mouth with saliva and submerging your tongue to trigger a hyper-relaxing vagal response.

Deep Breathing To practice deep breathing, inhale through your nose and exhale through your mouth. Remember to:

• Breathe slowly.
• Breathe deeply, from the belly.
• Exhale longer than you inhale.

You can proceed as follows: take a deep inhalation into your belly (i.e. expanding your diaphragm) to the count of five, pause, and then exhale slowly through a small hole in your mouth. While at rest most people take about 10 to 14 breaths per minute. To get into parasympathetic/ relaxation/ healing mode it is ideal to reduce your breath to 5 to 7 times per minute. Exhaling through your mouth instead of nose makes your breathing more of a conscious process, and helps you to observe your breath more easily.[ii]

As you reduce your breaths per minute and get into parasympathetic mode, your muscles will relax, dropping your worries and anxieties. The oxygen supply to your body’s cells increases and this helps produce endorphins, the body’s feel-good hormones. Tibetan monks have been practicing ‘conscious breathing’ for decades, but there is nothing mysterious about it. You can enhance your experience by imagining that you inhale IN love, and exhale OUT gratitude. These ancient techniques also will improve memory, fight depression, lower blood pressure, or heart rate, and boost your immune systems — and it’s free!

‘OM’ Chanting An interesting study was performed by the International Journal of Yoga in 2011, where ‘OM’ chanting was compared with pronunciation of ‘SSS’ as well as a rest state to determine if chanting is more stimulatory to the vagus nerve. The study found that the chanting actually was more effective than either the ‘sss’ pronunciation or the rest state.

Effective ‘OM’ chanting is associated with the experience of a vibration sensation around the ears and throughout the body. It is expected that such a sensation is also transmitted through the auricular branch of the vagus nerve and will produce limbic (HPA axis) deactivation.[iii]

How to chant? Hold the vowel (o) part of the ‘OM’ for 5 seconds then continue into the consonant (m) part for the next 10 seconds. Continue chanting for 10 minutes. Conclude with some deep breathing and end with gratitude.

Cold Water Physical exercise causes an increase in sympathetic activity (HPA axis – fight/flight, stress response), along with parasympathetic withdrawal (resting, digesting, healing, immune system), resulting in higher heart rates (HR). Studies have found that cold water face immersion appears to be a simple and efficient means of immediately accelerating post-exercise parasympathetic reactivation via the vagus nerve, stimulating the reduction of heart rate, motility of the intestines, and turns on the immune system. It is also effective in a non-exercise environment to activate the vagus nerve.

In cold-water face immersion, subjects remained seated and bend their head forward into a basin of cold water. The face is immersed so that the forehead, eyes, and at least two-thirds of both cheeks were submerged. Water temperature was kept at 10–12°C.[iv]

A variation on this technique, called The Dive Reflex, has been developed by Steve Mensing and many people online have found it very valuable for relieving stress and depression. Here are the details: https://www.emoclear.com/thedivereflex.htm.

Increased Salivation The calmer the mind and the deeper the relaxation, the easier the stimulation of salivation is. When the mouth is able to produce copious amounts of saliva, you know that the Vagus Nerve has been stimulated and your body is in the parasympathetic mode.

To stimulate salivation, try relaxing and reclining in a chair and imagine a juicy lemon. As your mouth fills with saliva, just rest your tongue in this bath (if this doesn’t happen, just fill your mouth with a small amount of warm water and rest your tongue in this bath. Just the practice of relaxing will stimulate the secretion of saliva). Now relax further, and feel your hands, feet, hips, back of the neck and head all relaxing. Breathe deeply into this feeling and stay here as long as you can.

There are many other ways to stimulate the vagus nerve and transfer your body into the healing, digesting and resting phase. Start with these suggestions and you may find that it becomes much easier to rest and relax!

References

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Today Rebecca and I watched an amazing video presentation by Dr. Kristin Willeumier, Ph.D, a neurobiologist and Director of Research at the Dr. Daniel Amen Clinics. Dr. Willeumier and Dr. Amen bring a very uplifting message: people CAN rehabilitate brain function IF they follow a regimented recovery plan… even if the brain injury occurred many years ago. Please get the word out by tweeting and sharing both the video and slide share. Many thanks!

Slide Share

SUMMARY: DR DANIEL AMEN BRAIN REHAB PROGRAM PROTOCOL FOR CONCUSSION

BRAIN RECOVERY PLAN: PART A STOP HURTING YOUR BRAIN
Avoid:
Brain injuries, High blood pressure, Drugs, Diabetes, Alcohol, High sugar diets, Obesity, Environmental toxins, Sleep apnea, Chronic stress, Smoking, Lack of exercise.

BRAIN RECOVERY PLAN: PART B START HELPING THE BRAIN
Enhance:
Social connections, Green tea, New learning, Exercise, Great diet (whole foods nothing processed), Coordination exercises, Calorie restriction, Gratitude (strengthens cerebellum and frontal cortex areas), Omega 3s, Meditation, Supplements, Vitamin D 3, Healthy sleep (deep REM sleep, 7-8 hours a night).

NUTRIENTS:
• High potency multi-vitamin daily
• Omega 3 – 5.6 grams High Potency Pure Fish oil per day. Reduces inflammation in body, expands blood vessels, and improves blood flow to the brain. Lowered inflammation in body means improved weight loss.
• Dr Amen’s Brain Boost Formula – vinpoticine, ginko biloba (both to improve blood flow to brain), Phosphatidylserine (helps rebuild cell membranes), huperzine A (boosts memory), Acetyl-l-carnitine, N-acetylcysteine , alpha-lipoic acid (both are potent antioxidants which protect neurons).
• Additional notes on nutrients: vitamin D3 (responsible for many metabolic actions in body), green tea extract helps protect the ends of your DNA.

LIFESTYLE:
Address individual player needs, such as treating depression, anxiety, alcoholism, ADD, dementia or using Hyperbaric Oxygen (HBOT).

Weight loss for obese players – If you are overweight, get lean as this is extremely important for recovery. A large body equals a small brain (dinosaur syndrome). Carrying extra fat puts stress on your body coordination, as well as raises your level of inflammation.

Healthy Diet – nothing packaged. Whole foods diet only. Low-glycemic diet is in line with keeping inflammation in the body low and preventing metabolic syndrome.

Calorie Restriction – Aim for a nutrient dense, low calorie diet of 1800 to 2000 calories a day. Low calorie intake also means less free radical damage from metabolizing food, and this translates into longevity for you.

Sleep – if you have sleep apnea, have it addressed with an oxygen device, or through some other method (i.e., weight loss). Sleep apnea is very common with concussion.

AVOID:

High blood sugar and Diabetes – Sugar is inflammatory and damages your brain and tissues. Make smart choices around food, diet and lifestyle. Alcohol is processed into sugar in your body.

High blood pressure – high pressure in your vein means less oxygen to your brain. It also means damage to your veins (including the ones in your brain).

Exposure to environmental toxins or molds – these toxins create neurotoxins and stress in your body, leading to accelerated brain degeneration.

Chronic stress – stress hormones such as cortisol raise your levels of inflammation and help you to put weight on. If you are experiencing personal, marital or family stress, address it through counselling and support early on.

THINGS TO DO TO SUPPORT BRAIN RECOVERY:

Exercise – Daily exercise boosts the feel-good hormone ‘serotonin’, which addresses prevention of depression. Exercise also improves blood flow to the brain.

Coordination Exercises – The cerebellum at the back of the brain houses 50% of the brain’s neurons yet makes important connections to the frontal lobes (executive area responsible for judgement, focus, and impulse control). Exercising the back of the brain actually helps to strengthen the front of the brain. Tips: play tennis, table-tennis, Tai Chi, yoga, juggling, so gym exercises. (Can also dance and swim).

Brain Learning Games/New Learning – enhances the ability of your brain to make new neural connections.

Hyperbaric Oxygen – increases vasculature in the brain. This is especially good for people who have experienced significant brain injury.

Main takeaway points: Boost acetylcholine to the brain, use brain-enhancing nutrients (see below), boost coordination exercises, achieve and remain normal weight, avoid inflammatory toxins, substances (no more than 2 servings of alcohol per week, no sugar, avoid marijuana and recreational drugs, get at 7-8 hours of sleep, exercise daily, limit daily calories to between 1700 and 2000 a day to help keep free-radical formation low, and to enhance longevity).

Finally,
Practice Gratitude and Meditation: performing these activities help to keep your brain from shrinking and help strengthen the cerebellum and frontal lobes.

DR WILLEUMIER’S SLIDE SHARE NOTES:
• 1. Amen Clinic NFL Brain Imaging Brain Rehab Study.
• 2. Our NFL Story Started in 1991. In 1991, brain SPECT imaging work. Brain injuries greater part of psychiatric problems than most people knew. Saw many high school and college football players with brain injuries on scans who had troubled behavior.
• 3. Middle Linebacker UC, Berkeley Arrested for Domestic Violence Healthy College Player.
• 4. ESPN Highlights and Arrests. As a fan I watched highlights. Then who was arrested that day. Thought there must be serious brain damage among many active and retired players.
• 5. Just imagine someone like Ron Yary hitting you 30 -50 times a game.
• 6. NFL Position On Brain Trauma Started Committee on MTBI in 1994, “Said they didn’t know if football caused long term brain damage, more studies needed.” Curiously, had the same position in 2009?? NFL acting like many employers with worker’s compensation claims – delay, deny, and blame the employee … steroids, alcohol, laziness.
• 7. The Problem with the NFL Position. IF YOU DON’T ADMIT YOU HAVE A PROBLEM, YOU CANNOT DO ANYTHING TO SOLVE IT. Many, many brain damaged retired players are currently left without help or hope.
• 8. 2000 Brent Boyd Minnesota Vikings Offensive Guard 6 Seasons.
• 9. Brent Came to see us for: Headaches, Depression, Fatigue, Memory Problems, Dizziness. He was also overweight.
• 10. Clear Evidence of Serious Brain Trauma Healthy BB.
• 11. NFL Hired Doctor’s. Scans mean nothing. They say his problems not work-related. Deny his claim. Brent gets traumatized twice: once by his brain injuries, and again by being called a liar or a faker.
• 12. 2007 Anthony Davis College Football Hall of Fame Running Back from USC and NFL Player.
• 13. Healthy At age 54, brain looked 85.
• 14. Before Treatment After Treatment.
• 15. Los Angeles Chapter NFLPA• AD Invites me to speak February 2009• Meet many players who clearly needed help• Someone has to answer question, “Does playing football in the NFL cause brain damage?”• Team up with Reggie Berry, Marvin Smith and Dr. Joe Wu to design our study• LA Chapter helps us recruit our first players.
• 16. Where To Get The Money?• First arm of study paid for by me (Dr Amen) personally to insure independence• Total cost is about $5,000 a player• Most of researchers who helped volunteered their time.
• 17. Study Design• Brain SPECT imaging (blood flow)• Conners’ CPT (Continuous Performance Test)• QEEG (Quantitative Electroencephalography)• MCIS (Mild Cognitive Impairment Screen)• Microcog (Measures 9 different cognitive scales).
• 18. Current Status of Our Study• 115 Active and Retired Players• From 27 teams• All positions• Ages 25 – 85.
• 19. Reported Number of Concussions• 0 = 14%• 1-2 = 24%• 3-5 = 19%• > 5 = 43%.
• 20. Important Numbers• Obese = 48% • Microcog = below• Sleep apnea = 30% average in all• Depression = 28% categories except• Dementia = 19% spatial processing and reaction time• CPT = 81% abnormal.
• 21. Outcomes• > 90% had brain trauma pattern on brain SPECT and QEEGs• Severe decreased activity … across whole brain• Results are HIGHLY STATISTICALLY SIGNIFICANT!
• 22. Damage Seen Across Whole Brain.
• 23. •Confirmation Number: 82635741 Damage Seen Across Whole Brain.
• 24. 20 Year Player Damage across whole brain.
• 25. Offensive Lineman 12 yr NFL.
• 26. Running Back 4 yr NFL.
• 27. Defensive Back 3 yr NFL.
• 28. Linebacker 10 yr NFL.
• 29. Wide Receiver 8 yr NFL
• 30. Tight End 8 yr NFL.
• 31. Quarterback 18 yr NFL.
• 32. Damage Seen Especially In Prefrontal, Temporal and Cerebellar Regions – judgment, focus, and impulse control memory, learning, emotion & moods physical coordination and thought coordination
• 33. Brain Rehab Program• Damage so high, we added a “pragmatic” rehab component• Brain healthy strategies • weight loss for obese players • coordination exercises • healthy diet • recommended sleep apnea evaluations • avoid toxic substances (drugs, much alcohol).
• 34. Brain Rehab Program• High potency multiple vitamin• Omega 3 supplement, 5.6 grams a day• Brain and Memory Power Boost Formula – vinpocitine, gingko, PS, huperzine A, acetyl-l- carnitine, n-acetylcysteine, alpha lipoic acid• Other recommendations for individual player needs, such as treating depression, anxiety, alcoholism, ADD, dementia or using HBOT.
• 35. Preliminary Results• 30 players with follow up scans/cognitive tests• 25 showed improvement• Especially in: • Memory (69%) • Attention (53%) • Mood (38%) • Motivation (38%) • Sleep (25%).
• 36. MicroCog Before After p value #> 50% betterGeneral cognitive 31.8 (24.1) 43.4 (25.7) <0.000 14 functioningGeneral cognitive 24.7 (20.1) 35.2 (23.5) 100%+• Attention 21 25 2%• Reasoning 3 13 > 400%+• Memory 14 66 > 470%+.
• 39. “Little” Ed White.
• 40. John Hauser (74) Before After %• General Cognitive Fun. 19 42 121%+• Information Processing 55 90 64%+• Attention 12 58 383%+• Reasoning 39 50 28%+• Memory 23 39 70%+.
• 41. Gern Nagler (77) Before After %• General Cognitive Fun. 63 77 22%+• Information Processing 42 70 66%+• Attention 45 73 62%+• Reasoning 75 75 0%• Memory 50 86 72%+.
• 42. Tight End 8 yr NFL Before After 8 mos.
• 43. Tight End 10 yr NFL Before After 18 months.
• 44. Offensive Tackle 12 yr NFL Before After 18 months.
• 45. Defensive Tackle 2 yr NFL Our interventions plus 40 Sessions of HBOT.
• 46. Conclusions• Based on our sample, playing football in the NFL puts players at risk for brain damage & long-term cognitive and mood problems• Preliminarily: The brain has potential to improve with a comprehensive rehab program• More studies immediately needed to evaluate components of our study and other interventions such as HBOT, neurofeedback, and meds such as memantine and modafinil.
• 47. Conclusions• General brain health principles should be taught to all active and former players• More intense brain rehab offered to current and former players• Targeted supplements, such as omega 3s and the ones we used• Start using brain imaging tools, like SPECT and QEEG on any player with a concussion.
• 48. Conclusions• Implications go beyond NFL to: • High school and college athletes • Military personnel (15% of soldiers returning from Iraq and Afghanistan have brain injuries) • 2 million people each year who acquire brain injuries.
• 49. NFL/Amen Clinics Collaboration?• We have a great cohort for a long term study• We have a waiting list of dozens of players and could easily recruit hundreds more, players trust us• We could add DTI and genetic markers• Help us on design better studies• Help us find funding to continue our work.
• 50. If I Was The Commissioner• Be an advocate and a leader for brain health among football players, stop the bad press with genuine care and concern• Invest in unbiased studies, with researchers who have a sense of urgency• Evaluate all players coming into the league to establish baseline level of brain function.
• 51. If I Was The Commissioner• Treat concussions early and effectively• Work to identify retired players who are troubled and get them the help they need• It will be less expensive in the long run• Lawyers and legal battles are very expensive.
• 52. BRAIN RECOVERY PLAN: PART A STOP HURTING YOUR BRAIN Brain injuries  High blood pressure Drugs  Diabetes Alcohol  High sugar diets Obesity  Environmental toxins Sleep apnea  Chronic stress Smoking  Lack of exercise.
• 53. BRAIN RECOVERY PLAN: PART B START HELPING THE BRAIN Social connections  Green tea New learning  Exercise Great diet  Coordination Calorie restriction  Gratitude Omega 3s  Meditation Supplements, Vit D  Healthy sleep.
• 54. With Gratitude to all of our players, Los Angeles Chapter of the Retired NFLPA, especially Reggie Berry and Marvin Smith, Independent Football Veterans Conference, with special thanks to Dave Pear and Robert Lee.
• 55. With Gratitude to Our Research Team Most Have Donated Their Time, Kristen Willeumier, PhD, Amen Clinics, Joe Wu, MD, UC, Irvine Andrew Newberg, MD, Univ of Pennsylvania, Robert Thatcher, PhD, Applied Neuroscience, Yi Jin, MD, NeoSync Technologies Jim Fallon, PhD, UC, Irvine.
• 56. Daniel G. Amen, MDdocamen@amenclinics.com 949-266-3749
• 57. Fred McNeill on the cover of GQ

Late in October, Rebecca was asked to give a lecture at the Aurora Leisure Centre about Nourishing the Mind. Below is the pdf of the PowerPoint presentation for your information, as well as the key summary points and two brain-friendly recipes for you to try.

The presentation (as a pdf file): Nourishing the Mind Presentation

• Complex carbohydrates – 5-7 servings of vegetables and fruits per day, eat with protein and fibre, green drinks with flax (see recipe below), add black beans or kidney beans to any recipes asking for ground beef and half the meat.
• Essential fatty acids – fish 2-3 times per week (mercury-free, PCB-free coldwater fish such as Atlantic salmon, cod, mackerel, herring, sardines, anchovies), nuts and seeds, flax oil – good quality fish oil supplement – use oils for salad dressing, not to be heated.
• Phospholipids – choline from eggs, organ meat and lecithin, brain booster supplement include phosphatidylcholine (PC), phosphatidylserine (PS) and/or choline. DMAE not available for sale in Canada.
• Amino acids – 2-3 servings of good quality, animal and vegetable protein per day
• Vitamins and Minerals – 5-7 servings of vegetables and fruits per day (heard this before?), multivitamin and mineral supplement with at least 25 mg of B complex, 10 mcg of B12, 100 mcg of folic acid, 200 mg of magnesium, 3 mg of manganese, 10 mg of zinc. (Source: Patrick Holford, New Optimum Nutrition for the Mind)
• Water – urine should be straw-coloured – about 1 – 1.5 litres/day but varies depending on activity, altitude and heat
• Keep brain active – learn, create, laugh, move

GREEN POWER SMOOTHIE

½ cup papaya juice
1 banana
1 cup frozen berries (blueberries are my favourite)
½ cup grated beet
1 large handful spinach or other greens like kale
1 tsp spirulina (marine algae)
2 tbsp flax
Water to desired consistency

Put all ingredients except flax into blender. Blend until smooth. Add flax and blend to mix. You could also add a scoop of protein powder to make this even more powerful!

2 tsp coconut oil
1 onion, diced
2 tsp curry powder
1-2 tbsp spelt flour
1 cup water
2/3 cup diced red pepper
2/3 cup diced yellow pepper
1 cup diced zucchini
1 cup diced butternut squash
1 19oz can chickpeas,
½ cup vegetable broth
1 apple, unpeeled and diced
½ cup raisins (or dates)

In large skillet over medium heat, melt oil and add onions, sauté until soft. Stir in curry powder and sprinkle with 1 tbsp flour. Add water stirring constantly. Add vegetables and bring to a boil. Cook for 10 minutes, stirring often. Add water as needed. Add chickpeas, apple, raisins and broth. Reduce heat and simmer for 10 minutes.

Serve over coconut rice.

1 tbsp coconut oil
1 medium onion, chopped
1 tbsp fresh ginger
2 cloves garlic
½ tsp turmeric
½ tsp sea salt

Sauté above ingredients in a large pot with lid for about 5 min, then add the ingredients below:

1 ¾ cups brown basmati rice
15 oz. can coconut milk
2 cups water
½ tsp grated lime zest

Bring to a boil over high heat. Cover and reduce heat to low, simmer for 15-20 min.

Note on oils: Extra virgin olive oil is a polyunsaturated fat and cannot be heated higher than 350 degrees Fahrenhuit; neither can any of the oils of EFAs. When cooking with heat, use either ghee, butter or coconut oil.

Here are our notes from Dr Amen’s lectures:

Pre-frontal cortex – makes up 30% of the human brain

• Executive function
• Focus, forethought, judgement, empathy, learning from mistakes
• Problems:
  • Impulse control problems
  • Not much empathy
  • Short attention span
  • Procrastinate
  • Don’t learn from mistakes
• Low activity shows up in:
  • Smoking
  • Internet gambling
  • ADD (looking for stimulation)
  • Weak conscience
  • Low persistence
  • Low energy, depression
• Suggestions for helping:
  • Write out goals – emotional, health, relationships, work, money, physical
  • Exercise – intense aerobic exercise
  • Diet – high protein, low carb diet
  • Fish oil – will increase energy and concentration
  • Need to boost dopamine levels – green tea, L-tyrosine, Rhodiola

Cingulate Gyrus

• Brain gear shifter, go from idea to idea – flexible
• See options, helps you to cooperate
• Error detection
• Problems:
  • Works too hard
  • Deficit in serotonin
  • People get stuck on a worry or obsession, hold grudge, compulsions, addictions
  • Always fault-finding, micro-managers, rigid and inflexible, oppositional
  • Looks on the surface to be selfish and inflexible
• Suggestions for help:
  • Distract yourself – move when you see yourself stuck on a thought
  • Offer them options so they don’t feel trapped
  • Gratitude – 5 things I’m grateful for today
  • Diet – high carb, low protein
  • Boost serotonin with 5-HTP, L-tryptophan, St. John’s Wort, Saffron, a little Dark Chocolate
  • Exercise – aerobic + coordination, e.g., dance

Limbic System – deep in brain

• Emotional brain, mood
• Sets the emotional tone – positive or negative
• Bonding, connection
• Processes pain, smell, libido
• Problems:
  • If works too hard, feel sad, depressed, negative, hopeless, helpless
  • ANT – automatic negative thoughts – have to correct and remove ANTs
  • Tend to isolate themselves
  • Less interested in things that are fun, have a lot of pain
• Suggestions for help:
  • SAMe for depression and pain
  • Exercise 4 x per week at least
  • Fish oil – omega-3
  • Write it out – talk back to the distorted fact – is it true?

Prescriptions to make your Brain Great

Protect

• Head injuries can ruin your life
• Avoid toxic substances: alcohol, drugs, toxic fumes, medicines
• Sleep – more than 6 hours per night
• Brain diet – lean protein, complex carbs (green leafy vegetables), good fat (omega-3, fish, avocados, walnuts)
• Water
• Multivitamin/mineral supplement
• Fish oil supplement 1-2 grams/day (or flax seed oil for vegetarians)

Best food choices for the brain

1. Avocados
2. Bueberries
3. broccoli (folate)
4. green tea (theonine)
5. oatmeal
6. oranges
7. red bell peppers
8. salmon
9. spinach (B vitamins)
10. tuna
11. turkey
12. walnuts (omega -3)

Eat from the rainbow – increase amount of antioxidants by eating from every colour.

Work your Brain

• helps your brain make connections
• learn things that are new and different – 15 minutes / day – Lumosity.com, TEDx videos
• exercise – boosts blood flow, BDNF (grow new neurons), Serotonin – especially aerobic combined with coordination (e.g., dancing) – more than 2 times/week

Prevent Alzheimer’s Disease

• Risk factors – head injury, untreated ADD, depression, heart disease, genetics, drink too much alcohol, obesity, smoking, diabetes
• Need to get diagnosed early – Brain SPECT imaging can see 5 years before dementia starts to show – loss of smell identification (loss of strawberry, pineapple, lemon, natural gas)

The following enhance brain health:

• + social connections
• New learning
• Great diet
• Sleep
• Exercise
• Physical healthy
• Healthy anxiety (helps get things done)
• Meditation
• Gratitude
• ANT killing

At 25 (males 28) the brain finishes developing

Also suggest visiting Dr. Mercola’s interview with Dr. Amen at: https://articles.mercola.com/sites/articles/archive/2012/10/28/psychiatry-needs-spect-imaging.aspx

Incoming search terms:

• limbic system nutrition

Yesterday, Helen and I came across this video on TED Talks and were enthralled not only with what Joe Dispenza was discussing, but with the fabulous images he shared of a neuron creating new connections. We hope that you find it as fascinating as we did. Included below are our notes made while watching the video.

https://www.youtube.com/watch?v=rCxo9GwbP_8&feature=relmfu

[Helen (www.insightfulnutrition.ca) and I watched this video last week, but today it has been removed from YouTube. There are several other videos available from Joe Dispenza, and we encourage you to learn from him: https://www.youtube.com/watch?v=VMN_Sd9qdIE]

1.Neo-Cortex – newest, most evolved part of brain; highly specialized

2.Limbic – also known as the mammalian brain – internal chemical brain which regulates internal chemical orders

3.Cerebellum – reptilian brain – seat of subconscious mind – oldest part of brain

• Each of these brains has their own anatomy and circuitry, own individual biocomputer, own physiology and chemistry, own history, own sense of time and space
• In the brain, neurons store and communicate information between and among each other
• Neo-cortex – seat of conscious awareness, loves to gather information
• Learning > new information leads directly to new connections – actual physical change to the brain
• New information is biologically wired into cerebral architecture
• Remembering > maintaining the connections – the more you communicate the more bonded you become – start to form neuro networks which are fired and wired together to create a neuro community
• Mind is the brain in action – experience enriches your brain neurologically (more connections); then it produces a chemical that is called a feeling or emotion; this chemical is released by the limbic brain; this allows you to remember this experience
• Routine lulls the brain to sleep – stress can cause you to make immediate connections (eg, memories of 9-11)
• Your body is your unconscious mind, it does not know the difference between the actual experience in reality that produces the emotion and the emotion that you fabricate by thought alone
• Limbic brain produces neurochemicals
• Stress response – when you can’t turn it off, you’re heading for disease
• Pay attention to how you are feeling – called metacognition > observe who we are being (like observing yourself from outside yourself)
• Metacognition allows us the ability to modify our behaviours and change how we react/do a better job
• Frontal lobe – seat of our awareness – home of the you and the me
• As you think of who you want to be, the frontal lobe acts like a volume control and begins to lower the volume on the circuits in the brain that are connected to the old self
• It begins to silence the old circuits – this allows you to observe and no longer participate
• Next step is to biologically break down the old connections so no longer biologically connected to the old self
• Changes to neural connections can be made with persistence and amplitude
• BDNF – growth factor – goes from the neuron back across the synaptic cleft – can actually steel from neighbouring, weaker connections
• Allows old memories to lose their strength – so you can actually prune away old memories / old self
• Can happen in moments!
• Knowledge > happens in the mind – Experience > happens in the body
• Limbic mind makes a new batch of chemicals – instructing the body chemically
• Repeated exposure to a new thought makes it become real – to point where you no longer have to think about it
• In the example, neurochemically conditioned the body to memorize compassion as well as the conscious mind
• Mind and body activate the cerebellum – the seat of the subconscious mind – so that compassion becomes a habit, then a state of being!

Incoming search terms:

• joe dispenza ted
• ted talks joe dispenza