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Pete Stavinoha welcomes everyone back to the National Academy of Neuropsychology Foundation’s Brain Beat podcast today for yet another discussion on brain health and brain function. This time around, he is joined by Dr. Stephen Hooper, the internationally recognized leader in the field of child neuropsychology who, among his many accomplishments, is the Associate Dean of Medicine, Chairperson of the Department of Health Sciences, tenured Professor in the Department of Psychiatry, and Clinical Professor in the Department of Pediatrics at the University of North Carolina School of Medicine. Together, they explore the intricate world of brain development disorders as our guest shares details from his recent book, Basics of Child Neuropsychology.
Infusing it with his extensive knowledge on neurodevelopmental disorders and the genetic and environmental factors that influence brain development, Dr. Hooper notes that he has actually tailored his book for educators and clinicians who want to understand the complexities of brain function without diving too deep into technical jargon. In this discussion with Pete, he touches on the evolution of neuropsychology, foundational brain development, and neurodiagnostic procedures. Focusing on specific genetic disorders like Down syndrome and 22q11.2 deletion syndrome, Dr. Hooper also explains their manifestations and the importance of evidence-based interventions. Today's fascinating and informative episode finds our experts meeting at the intersection of neuropsychology, pediatrics, and child psychiatry, as they provide a comprehensive overview of how genetic and environmental factors shape brain development while highlighting the ongoing need for effective treatments.
Episode Highlights:
Dr. Steven Hooper and his extensive background in child neuropsychology
The structure and themes of Basics of Child Neuropsychology
Foundational neuropsychology and neurodiagnostic procedures
Brain development stages and the impact of genetic factors
Genetic disorders such as Down syndrome and 22q11.2 deletion syndrome and their neurocognitive, academic, and psychiatric manifestations
Evidence-based treatment options and the need for more research in this areaKey Takeaways:
“I cobbled together things to make it work for that audience so that I can sort of nurture their excitement and interest in this area, as well as not intimidate them with some of the lexicon and the things that we get into with the brain.”
"The brain is really critical at almost everything that we do."
"Genetics truly sort of lay out the blueprint of what things could look like."
"You have this wide constellation of the way things should be, and then the way things evolve when that genetic blueprint is disrupted."
"We have the formation of the neural tube in that first month of life, and it's very, very critical."
"This is a population of kids where there's a high rate of psychiatric illness with a rate of...25% to 30%, having some form of schizophrenia spectrum disorder by the time they're in their late teens to early twenties."
Links:
National Academy of Neuropsychology Foundation website
Basics of Child Neuropsychology
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Dr. Peter Arnett, renowned professor at Penn State University and a past president of the National Academy of Neuropsychology (NAN), welcomes the esteemed Dr. Maureen O'Connor to the Brainbeat podcast today. A board-certified neuropsychologist celebrated for her role as the Director of Neuropsychology at the Bedford Veterans Hospital and her position as an Assistant Professor of Neurology at Boston University, Dr. O'Connor's remarkable expertise centers on Alzheimer's disease and her dedicated mission to develop interventions that enhance patient functioning while alleviating the substantial burden placed on caregivers. Together with our host, she delves deep into the crucial realm of caregiving and dementia, illuminating the emotional, mental, and physical challenges that caregivers confront, while also unveiling the invaluable resources at their disposal. Deftly navigating sensitive topics, including driving cessation and end-of-life care, Dr. O’Connor provides indispensable guidance to those grappling with these intricate issues.
Her illuminating insights offer a profound understanding of the world of dementia caregiving, a role predominantly shouldered by older adults, often family members who find themselves navigating their own health-related concerns. The episode explores the emotional toll on caregivers, characterized by elevated rates of depression, anxiety, and stress, all while shedding light on the social and financial implications of this pivotal role. Throughout the episode, a resounding message emerges—the paramount importance of caregivers prioritizing self-care. The conversation here today underscores the significance of constructing a robust care team, comprising healthcare providers, friends, family, and support groups, all of whom are indispensable for caregivers to deliver optimal care. As the multifaceted dynamics of the caregiver-patient relationship are unveiled, the ever-evolving nature of this profound connection becomes evident. In essence, this latest episode of Brainbeat imparts invaluable insights, serving as a powerful reminder that caregivers cannot pour from an empty cup, and highlights the critical need for self-care and unwavering support in the challenging realm of dementia caregiving.
Episode Highlights:
Older adults as caregivers
Balancing the care of aging parents with young children
The high rates of psychological, social and financial challenges experienced by caregivers
Building a care team
Difficult conversations around topics like driving cessation and end-of-life care
Expanded support to rural caregivers through telehealth services
Prioritizing self-care
The significant impact of preexisting relationships on caregiving dynamicsQuotes:
"You can't pour from an empty cup. You need to care for your own physical and emotional needs."
"Often our dementia caregivers are so involved in caring for their loved one that they're not caring for themselves."
"Not everybody has WiFi for video visits, but we can also think about telehealth as telephone visits."
"These are daughters and sons and spouses and siblings, and that preexisting relationship can be complex, can be challenging."
"The relationship between caregiver and patient is a dynamic one, with evolving needs and challenges."
"Telehealth services are expanding to support rural caregivers, broadening access to care."
Links:
National Academy of Neuropsychology Foundation website
Maureen O'Connor's BU Profile
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Welcome back to an emotionally charged episode of Brainbeat, as your host, Pete Stavinoha, guides you through an extraordinary journey, shining a spotlight on the formidable challenges of battling brain cancer. Our guest, Dr. Tresa Roebuck Spencer, a distinguished board-certified clinical neuropsychologist, brings with her a unique perspective, having transitioned from clinician to patient when diagnosed with glioblastoma in October 2020. As a former President of the National Academy of Neuropsychology, her insights resonate deeply, making this episode an inspiring exploration of hope, resilience, and patient advocacy in the face of adversity.
Dr. Roebuck Spencer's journey unfolds as a poignant story of unexpected health turmoil that disrupted her life while she was diligently working as a neuropsychologist. Her remarkable account takes listeners on a gripping odyssey through numerous surgeries, radiation treatments, chemotherapy, and clinical trials, offering a comprehensive view of the intricate landscape of brain cancer care. What sets this episode apart is Dr. Roebuck Spencer's dual role as both clinician and patient, providing a profound understanding of the patient experience. Amid her journey, she shares invaluable insights into coping strategies, the importance of mental health awareness, and the significance of transparent communication with healthcare providers. Dr. Roebuck Spencer's story, as shared here today, serves as a poignant reminder that, even in the face of daunting challenges, the human spirit can find strength, hope, and a rekindled appreciation for life. For more on this story, please visit the recent BrainWise article, From Expert to Patient.
Episode highlights:
Dr. Roebuck Spencer's unexpected health crisis that unfolded during a typical workday
Her unique perspective as a neuropsychologist and patient
Dr. Roebuck Spencer's treatment odyssey
Her coping strategies
The impact of Dr. Roebuck Spencer’s diagnosis on her family
The integral role of maintaining a sense of normalcy and engaging in social and physical activities
Advice for cliniciansQuotes:
"Awareness is very good because it has allowed me to compensate quite well."
"I now understand why patients always wanted to show me their pictures."
"I'm not the normal patient in that I'm asking them for strategies.”
"You certainly want clinicians to understand you as a person in a holistic way, not just who you are now going through an illness, but who you were before and how that affects you now."
"I think the awareness is a blessing because I am able to stay more independent, because I'm able to compensate because of that awareness."
"Don't make assumptions about your patient just because they've had brain injury or brain surgery and they may or may not be in a wheelchair or using a cane. Don't assume they're cognitively impaired, either in part or in whole."
Links:
National Academy of Neuropsychology Foundation website
Dr. Tresa Roebuck Spencer
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In today’s episode, host Pete Stavinoha welcomes Dr. Yaakov Stern to the podcast. Dr. Stern is the Florence Irving Professor of Neuropsychology in the Departments of Neurology, Psychiatry, and Psychology, and the Taub Institute for the Research on Alzheimer’s Disease and the Aging Brain, as well as the chief of the Cognitive Neuroscience Division in the Department of Neurology at Columbia. His research work focuses on cognition in normal aging and diseases of aging, including exploring the neural implementation of cognitive reserve, structural and functional imaging of cognitive aging, and modeling the natural history of Alzheimer's disease. As an internationally recognized expert in the field, Dr. Stern joins our host here today to shed light on the concept of cognitive reserve and its connection to aging.
Along the way, Dr. Stern explains the concept of cognitive reserve - the idea that some individuals are able to maintain their cognitive function despite brain changes associated with aging and diseases such as Alzheimer's. He notes that this ability is linked to various factors across a person's lifespan, including education, social networks, diet, and exercise. Together, he and Pete delve into the idea of brain maintenance, which is closely tied to cognitive reserve and is about maintaining the brain better than others. They go on to emphasize the importance of lifestyle factors in improving cognitive reserve, and that, while the concepts of cognitive reserve and brain maintenance may seem complex, they can be understood by looking at the "software" and "hardware" of the brain. This fascinating and instructive episode draws to a close by highlighting the fact that while higher cognitive reserve may not prevent Alzheimer's disease, it can help individuals maintain their cognitive function for a longer period of time.
Episode highlights:
An overview of the concept of cognitive reserve and brain maintenance
The multiple factors that influence cognitive reserve
The relationship between brain maintenance and cognitive reserve
Some threats to cognitive reserve
The role of the environment and the "exposome"
How cognitive reserve relates to aging
The brain’s"software" and "hardware"
Lifestyle factors that can help to improve cognitive reserve
Cognitive stimulation through hobbies and leisure activities
The controversy that surrounded the idea of cognitive reserve in the past
Higher cognitive reserve and Alzheimer'sQuotes:
"The concept of cognitive reserve speaks to individual differences in the resilience to brain changes."
"The idea of brain maintenance is that some people maintain their brains better than others."
"To the extent that you have less of these brain changes, your cognition is going to be more preserved."
"Both concepts are closely tied, with factors that impact cognitive reserve also having an impact on brain maintenance."
"How flexible are they in solution strategy? How trained are they in doing certain things?"
"Healthy diet, exercise seems to be very important.”
"I'm not talking about going and taking a college course if that's not what you're interested in, but just being engaged in something, whether it be a hobby or gardening, leisure activities. All of these things seem to be associated with better reserve."
"The idea that this flexibility of the brain can help people stave off something as powerful as Alzheimer's disease just did not seem logical."
"It's pretty clear, I think people agree that the childhood, the infant phase, is really very important in setting the stage.”
Links:
National Academy of...
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Joining the podcast this week for a discussion of pain management and coping strategies is Dr. Michael Jaffe. Among the many other achievements of his storied career, Dr. Jaffe was once the department head for pain management at San Diego Kaiser Permanente and is currently a private practitioner at Hawaii Brain and Spine in Kailua. As a result, he possesses a great deal of experience and expertise in this highly important field, and is here to share his wisdom and insights with listeners here today.
Beginning with a brief review of his background in pain management and his current practice, our guest moves on to explore the use of opiates in pain management, the dangers of relying solely upon them for treatment, the importance of finding alternative methods, and the complexities of chronic pain itself. He then draws upon his years of experience in pain management to share his insights on the best approach for treating chronic pain, reviews the multifaceted reasons for the overuse of opiates in the United States, and highlights the need for caution when prescribing these powerful medications. A crucial topic with far reaching impact throughout our world today, pain management and its inherent complexity is put under the microscope here today in this thought provoking and informative conversation.
The Finer Details of This Episode:
Peter's background in pain management and his current private practice
The importance of finding alternative methods for pain management beyond relying on opiates
The importance of empowering patients to take an active role in their own self care and recovery through education, motion, and non-opiate therapies
The role of the Hawaii Medical Board and its focus on reducing opioid prescriptions
The importance of addressing the root cause of pain, rather than just masking the symptoms
Strategies for coping with chronic pain, including the use of mindfulness and physical therapy
The benefits of involving family and loved ones in the pain management process
The value of seeking out a multidisciplinary approach to pain management
Overuse of opioids in the United StatesQuotes:
"We need to be looking at the root cause of the pain, not just masking the symptoms."
"It's important to involve family and loved ones in the process, because they can often provide a lot of support and encouragement."
"Mindfulness can be a very powerful tool in managing chronic pain."
"A multidisciplinary approach is really important in managing pain effectively."
"We need to be more proactive in finding alternative methods for managing pain."
"Opiates work really well for acute pain, but the studies for the use of opiates for chronic pain are very lacking and really just modest benefit at best."
"Maybe 20% helps with chronic pain using these high dose opiates. And whereas we used to think that opiate substance use disorder was a small percentage of people we started on opioid therapy, we now know that opiate use disorder affects about 25% of people."
"It's really up to the doctors to kind of rein in the liberal riding of opiates."
"The studies show that if you get people moving and not in bed rest and actually doing active recovery, they'll recover faster."
"There are many non-pharmacological treatments that can be very effective in managing chronic pain."
Links:
National Academy of Neuropsychology Foundation website
Dr. Jaffe
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Dr. Wendy Suzuki, a celebrated international authority on neuroplasticity and award-winning professor of neuroscience and psychology at New York University joins the podcast today. Dr. Suzuki has been named one of the top ten women changing the way we see the world by Good Housekeeping and her Ted Talk has received over 55 million views. She is also the author of Good Anxiety and Healthy Brain Happy Life.
Dr. Suzuki contends that the topic of exercise and its effects on the brain is an important one, as it has been shown to have numerous benefits for both physical and mental health. In this episode, she will be discussing the ways in which exercise can improve brain function and overall well-being. She will also delve into the science supporting her beliefs in this area and offer her valuable advice regarding exercise regimens. The information and recommendations that Dr. Suzuki parts here today are particularly relevant as many people may be seeking ways to improve their brain health during the pandemic, when opportunities for physical activity may be limited. It truly is a no-brainer that you owe it to yourself to exercise your right to listen in to today’s fascinating and potentially life changing episode.
The Finer Details of This Episode:
How Dr. Suzuki became interested in neuroscienceThe numerous benefits exercise has for the brainThe hippocampusNeurotrophic factors and the impact of exercise upon themThe benefits of high-intensity interval training (HIIT)Finding an exercise routine that is enjoyable and sustainableThe potential impact of exercise upon managing stress, anxiety, and sleep qualityQuotes:
"Exercise has been shown to be one of the most powerful interventions for brain health."
"The hippocampus is a key brain region that is affected by exercise and it's involved in memory and learning."
"Exercise has been shown to increase the production of neurotrophic factors, which support the survival and growth of neurons."
"High-intensity interval training (HIIT) has been shown to be particularly effective for improving brain function and overall health."
"It is important to find an exercise routine that is enjoyable and sustainable in order to maximize the benefits for the brain."
"Exercise can be a useful tool for managing stress and anxiety, and it can also improve sleep quality."
Links:
National Academy of Neuropsychology Foundation website
Wendy Suzuki
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Today on the Brain Beat podcast, Dr. Cheryl Silver takes over the mic. As a pediatric neuropsychologist for the past 40 years, she’s had the opportunity to evaluate children, adolescents, and young adults with learning disabilities throughout the state of Texas. After graduating from college in 1973 and getting her Phd some years later, Dr. Silver found a deep curiosity in the brains and behaviors of children who struggled to read and do math. So today, with much experience under her belt, she walks us through the signs of learning disabilities in early childhood, what a learning disability actually is, and, perhaps even more importantly, what it isn’t.
There’s a lot more to learning disabilities than just a diagnosis, and Dr. Silver knows that; it’s tedious work to get the care you need for your children, especially when insurance companies don’t consider private evaluations as medical care. With that said, she provides advice on accessible treatment and accommodations for those with specific disabilities and lauds the brain for its adaptability and resilience. So join Dr. Silver for this incredibly informative episode of Brain Beat and continue to learn about the immense intricacies of the brain that can impact our learning.
The Finer Details of This Episode:
What is a learning disabilityEarly signs of learning disabilitiesLegal definitions of disabilitiesGetting a diagnosisTreatment and accommodations The brain’s resilienceQuotes:
“A learning disability is usually thought of as a specific problem in learning; you might say a narrow problem in learning in a person who otherwise has good intelligence.”
“It sounds pretty specific, and that it should stand out to parents among other areas where the child seems to be developing normally and otherwise competent.”
“Learning disabilities happen, as I said, as a result of differences in the way the brain develops and the way that certain parts of the brain work.”
“I would say we know less about math disabilities than we know about reading disabilities.”
“One thing I tell parents that they need to know is insurance companies often will not pay for that kind of private evaluation. The insurance companies say we cover medical problems, and learning to read and learning to do math and learning to spell are not medical reasons.”
”The parents need to get a written report, and the evaluator needs to know how to define the problem so that it meets the qualifications for considering it to be a learning disability.”
“So that really speaks then to the resilience and the need for the kinds of supports, interventions, and accommodations that you're describing throughout childhood so that kids can maintain that resilience and figure those pathways out for themselves, so that they are able to be successful, perhaps even in spite of something that may affect them– potentially lifelong.”
“ADHD is a disorder that can affect learning in a major way, but not because of these brain differences that create problems with written language or numbers, but it's a pervasive condition that affects a child's ability to pay attention.”
Links:
National Academy of Neuropsychology Foundation website
Dr. Cheryl Silver Profile
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Dr. Peter Arnett, past president of NAN and Penn State Professor, welcomes Dr. Michelle Braun to this episode of Brain Beat to talk about Alzheimer’s Disease, debunk related myths, and discuss methods that help reduce the risk of falling victim to the disease. Dr. Braun is a Yale and Harvard trained neuropsychologist and a national leader in the field of brain health and cognitive functions. As a former Psychiatry instructor at Harvard Medical School and Assistant Director of Inpatient Mental Health, Dr. Braun is passionate about empowering individuals to boost brain health and reduce the risk of Alzheimer’s. Since her start in the industry, she has been featured on PBS, NPR, Fox, CBS, and I Heart Radio; been recognized as 2022’s Woman of Influence by Success Magazine; and is a member of the 40 under 40 Class of 2013 by the Milwaukee Press Journal. Presently, Dr. Braun writes a popular column on brain health and psychology and has presented for the Alzheimer’s Association over the past 17 years.
On today’s episode though, Dr. Braun and Dr. Arnett open up the conversation by debunking the many myths surrounding Alzheimer’s disease. While Alzheimer’s is widely recognized as a genetic disease, more often than not environmental factors impact its onset just as much, if not more so. That’s why Dr. Braun finds it so important to talk about the healthy behaviors that reduce our risk of disease. Today she not only discusses the benefits of exercise and nutrition for cognitive functioning, but the paradoxical impact of alcohol on the brain as well. And as both she and Arnett draw this episode to a close, she finds it important to note that it is never too late to improve brain health. In fact, most of her research has been conducted on adults over the age of 60. So listen in to today’s episode to learn about how you too can decrease your risk for Alzheimer’s disease regardless of how old you are or how busy your schedule is - you might just be surprised at how simple it can be.
The Finer Details of This Episode:
Making accurate scientific information accessible to the publicDebunking Alzheimers’ mythsWhy Alzheimers is just as environmental as it is geneticBest methods to reduce the risk of Alzheimers (EXCELS)The brain benefits of exercise Nutrition’s impact on cognitive functioningGuidance on healthy alcohol consumptionWhy it’s never too late to improve brain healthQuotes:
“It's usually been a surprise for many patients over the years that all of the things that are marketed to the general public are based in pseudo-science.”
“So it's important to know that Alzheimer's is really characterized by two abnormalities at a level of cellular functioning. And so one of those is called beta amyloid plaques. And the second is called neurofibrillary tangles.”
“And so it's important to note again, that there are atypical forms of Alzheimer's where you see those cells gathered in different parts of the brain. But for the majority of people, it starts there in the medial temporal lobes, and starts to kind of spread forward and back over time impacting different cognitive functions along the way.”
“So if we reconceptualize Alzheimer's as more of a chronic disease, as opposed to something that just happens in later life, that really empowers us to change our trajectory over time. And that's exactly what the research supports.”
“And if we look at the dose, so to speak, that's recommended, it's 115 minutes a week of moderate intensity cardiovascular exercise, meaning that you're huffing and puffing to the degree that you can still talk, but you can't sing. So that's something that we call the talk test.”
“Just moderate it...
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Jennifer Reuter joins Dr. Heidi Rossetti on today's episode. Jennifer is an expert in meditation and yoga and is currently serving as the Blue Lotus Kailua Wellness Studio Director on the island of Oahu, Hawaii. She has over 20 years of experience leading yoga teacher training certificate programs, meditation, immersions, yoga and meditation retreats, monthly meditation meet-ups, and weekly yoga and meditation classes. Today, Jennifer discusses mindfulness and meditation and their relationship to how we operate.
In the opening segment of the episode, Jennifer narrates her past personal struggles with depression, frustration, anxiety, and stress that drew her to the yoga specialty. She then differentiates meditation and mindfulness, defining mindfulness as more than just paying attention and including traits like kindness, friendliness, non judgment, and receptivity. She compares meditation to yoga since both seek to cultivate wholeness. In addition, Jennifer explains contemplative neuroscience and changes in the body and brain due to contemplative practice. She further highlights the benefits of meditation to improve quality of life, for example, increased attention span, stability, ability to concentrate, physical healing, peace, and decreased metabolism, heart, and breathing rates. Other subjects Jennifer touches on include mindfulness in the age of digitalization, self-compassion, and self-soothing – topics that are both timeless and timely, especially given the many challenges that the world presents us with these days.
Episode Highlights:
Jennifer's journey to the Yoga space The difference between meditation and mindfulness The concept of contemplative neuroscience Positive neuroplasticity versus negative neuroplasticity The value of meditation The plight of not paying attention Mindfulness in the age of digitization Defining self-compassion Myths around self-compassion Differentiating self-compassion and self-pity Self-regulating and self-soothingQuotes:
"Doing what I thought was right was literally sucking the joy right out of my life. And it was then that I discovered yoga, and a whole new world began to open up for me."
"I've been able to uncover and reclaim lost places in myself and develop a greater understanding, appreciation, and compassion for myself. And experientially, I just feel this interconnection with others, the planet, this moment, how it's all woven together, and my sense of belonging to it. And this is that larger perspective I've been able to taste and explore outside my little self."
"When one studies mindfulness and learns that paying attention is only half of the practice, and that's the easy part, the other half of mindfulness is how we pay attention. So it invokes quality of our heart as we pay attention, invoke kindness, friendliness, non judgment, and receptivity."
"Mindfulness helps us shift from reactive states, where we might feel caught up, to receptive and freeing states."
"So mindfulness is this witnessing. It's a quality of consciousness that is kind, receptive, acknowledging what's happening without getting entangled."
"It's possible for the mind, body, and breath to join together in a moment. And when that occurs, there's a sense of being here and now. "
"With meditation and your strategy, whatever tool you're using, it's to let go of the striver, the one that wants to do. So relax back and learn to stop controlling. And so if you can relax with your technique, it gets really good. That takes a lot of practice."
"Self-compassion it's the ability to tune into our own feelings, to feel the feels, resonate with them, and then respond to them."
"If we want a...
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On this episode of the Brain Beat Podcast, Dr. Peter Arnett will be acting as host and Dr. John DeLuca, Senior Vice President for Research and Training at the Kessler Foundation and professor at Rutgers medical school, will be talking about cognitive rehabilitation. Dr. DeLuca is internationally recognized in this field, has written over 350 articles and book chapters on this topic, and is a co editor for the Encyclopedia of Clinical Neuropsychology. Having received over $38 million in research grants, his most recent work pertains to cerebral mapping of human cognitive processes using functional neuroimaging in addition to developing research techniques to improve cognitive impairment.
The pair open up this episode by talking about cognitive rehabilitation and why these treatments are not as accessible as they should be. As a truly individualized plan for care, cognitive rehabilitation seeks to assuage any issues related to a brain injury or trauma a patient may have. Symptoms typically come in forms of memory loss or fatigue, but cognitive rehabilitation can also be used to treat attention deficit disorders in children. One approach to treat these symptoms is spaced learning, a technique that stresses the importance of intervals. Dr. DeLuca goes on to discuss more cognitive rehabilitation approaches like recording lectures and joining book clubs, and draws the episode to a close by reiterating just how important this individualized treatment plan is, and why it’s a shame that access to it isn’t more fair.
Episode Highlights:
Cognitive rehabilitation as a program treating the entire patientHow patients can access cognitive rehabilitation treatmentsThe importance of individualized careRehabilitation techniquesSpaced LearningWhy anxiety and depression might prohibit memory retrieval Unfair access to healthcareQuotes:
“A cognitive rehabilitation program treats the entire patient.”
“One of the interesting things about the pandemic is that teleservices, telerehabilitation, and telemedicine have become more of an acceptable way to obtain treatment. I would certainly say before the pandemic, that would have been a huge challenge.”
“A cognitive rehabilitation approach may start off with quite a few sessions, but it could end up where let's just say a few months from now, you're meeting once a month with a therapist to deal with the lingering issues, which may be for example, fatigue.”
“It doesn't have to be a full blown severe brain injury that you go for cognitive rehabilitation, it can be more subtle problems.”
“So even when there are areas of the brain that are damaged, when you provide cognitive services, the brain can actually reroute those kinds of things that need to be done to make sure that the tasks or the behaviors can be once again functional.”
“We always want to help our patients. And, and sometimes, you know, you have to be able to try to get the treatment that you need. Unfortunately, it may not be the easiest thing in the world.”
Links:
National Academy of Neuropsychology Foundation website
Kessler Foundation
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Helen Bundy Medsger, LBD Peer Mentor, Support Group Facilitator and Support Services Volunteer, Lewy Body Dementia Association, is Heidi’s very special guest on today’s episode. For over 30 years, Helen has been the primary caregiver and health care advocate for two generations of her family who have suffered from Parkinson’s Disease with Lewy Body Dementia, and three members of her family have succumbed to the disease: her father, sister and youngest brother. In addition to being an advisor to Lewy Body Ireland, she is the facilitator of the North Bay Lewy Body Dementia Support Group, is a support services volunteer for the Lewy Body Dementia Association, a trained LBD caregiver peer mentor, and a member of the University of California – San Francisco (UCSF) Memory & Aging Center’s Family Advisory Council. Helen is also a member of the Dementia Community Research Advisory Panel at the Global Brain Health Institute, a former LBD consultant to the Care Ecosystem Study at UCSF’s Memory & Aging Center, and a speaker for various organizations on the topic of caregiving LBD. Most recently, she was federally appointed one of two caregiver representatives to the Advisory Council on Alzheimer’s Research, Care, and Services under the U.S. Dept. of Health and Human Services making recommendations to the HHS Secretary and Congress.
Heidi and Helen open the episode by discussing the traumatic experience of trying to treat and care for a family member with Lewy Body Dementia, especially when there was a lack of research and a high misdiagnosis rate. Helen details the symptoms and behavioral changes her father underwent, and notes that no medications slow or stop the progression of LBD. To those with family members suffering from LBD, Helen emphasizes how important it is to allow the patient to express their desires early in the disease process when they’re still capable of doing so, and highly recommends that social and physical engagement is absolutely paramount for LBD patients. Helen adds that, in addition to the patients themselves, the family and loved ones also deserve and need help during this emotionally draining time, and understands that while therapeutic support groups might not be for everyone, some form of therapy can do so much for those dealing with the brunt of caregiving duties. She delves into her sister’s experience getting involved in LBD research and how beneficial that experience was, and addresses the healthcare system and why it’s not conducive for those with LBD. Helen draws the conversation to a close by directing the audience to the LBD Association website for additional resources.
Episode Highlights:
Helen on losing family members to LBDLBD as the most expensive form of dementiaYoung onset isn’t all that rare for LBD patientsThe effectiveness of PET scans (specifically DaTscan), cardiac MIBG, sleep studies, and biomarker testing currently in developmentPatient sensitivity to medications; no medications slow or stop the progression of LBDThe importance of the patient expressing desires early in the disease processThe importance of social and physical engagementTherapy options for family members and loved ones LBD as a systemic diseaseWhy getting involved in research can be a good thingWhy doctors need to be patient with those with LBDQuotes:
“It wasn't until 1996 that he passed away–that the first diagnostic criteria for LBD was published. And to be honest, I really thought his diagnosis was a one-off, just a random occurrence in the family.”
“I've heard it time and time again referred to LBD as the most common dementia you've never heard of.”
“So, the one qualifying statement I want to make in all of this, and that's something I'd like to direct to the physicians: just...
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Dr. Peter Arnett, Immediate Past President of NAN, hosts the podcast this week and welcomes Dr. Igor Grant, who will be talking with us today about cannabis. Dr. Grant is a Distinguished Professor and Director of the HIV Neurobehavioral Research Program and the Center for Medicinal Cannabis Research at UCSD who has served as Chair of the UCSD Department of Psychiatry from 2014 to 2019. He's a neuropsychiatrist who graduated from the University of British Columbia School of Medicine and received specialty training in psychiatry at the University of Pennsylvania, and additional training in neurology at the Institute of Neurology in London. Dr. Grant's academic interests focus on the effects of various diseases on the brain and behavior, emphasizing neuropsychological translational studies in HIV and drugs of abuse. He has contributed to approximately 800 scholarly publications and is the principal investigator of several NIH studies. In addition, NAN has recognized Dr. Grant with the Nelson Butters Award for research contributions to clinical neuropsychology and the Distinguished Lifetime Contribution to Neuropsychology Award. Dr. Grant is the Past President of the International Neuropsychological Society, otherwise known as INS, which honored him with the Paul Satz INS Career Mentoring Award. In addition to all these accomplishments, he is also the Founding Editor of the Journal of the International Neuropsychological Society, otherwise known as JINTS.
In this episode, Dr. Grant tells us about the history of the Center for Medicinal Cannabis Research and what it learned about the specific diseases or conditions that can be aided by cannabis. He provides insight into anecdotal evidence that THC was useful in diabetes and HIV/AIDS patients for relieving neuropathic pain. Dr. Grant, however, expresses concern over the long-term durability of this effect because the studies were relatively short-term. He comments on the proportion of THC used in different interventions, the regulations surrounding cannabis, which is considered a Schedule I drug, and gives an example of guidelines a typical doctor should follow when deciding to use cannabis.
Dr. Grant then talks about the benefits and risks of medical cannabis, sharing its impact on cognitive function if one already has a dementing disorder and preexisting anxiety or depression. He sheds light on his ongoing research and funding sources for research and elaborates studies of cannabidiol on people with early psychotic symptoms. Dr. Grant reveals that CBD and THC may help in breaking addiction. Other studies Dr. Grant delves into include one to help people with sleeping disorders and autism, a NIDA -supported study looking at kids experimenting with drugs from age 9 and following them through teen and early childhood, the dynamics and effects of abstinence, and the impact of cannabis on driving safety. Finally, he addresses gaps in our knowledge of cannabis that need to be pursued and impediments to research and discoveries in cannabis.
Episode Highlights:
The history and work of the Center for Medicinal Cannabis Research
Diseases or conditions that can be aided by cannabis
Benefits of marijuana to patients with HIV/AIDs and diabetes
The role of THC in managing neuropathic pain
Cannabis regulations
Guidelines for doctors to determine whether to prescribe cannabis
Risks and benefits of medical cannabis
The impact of THC on the cognitive function of a person with a dementing disorder
The dynamics and effects of taking THC with preexisting anxiety and depression
Dr. Grant's ongoing research
Sources of funding for research
A study on cannabidiol in people with early psychotic symptoms
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r. Pete Stavinoha joins Dr. Heidi Rossetti on today's episode. Dr. Stavinoha is a board-certified clinical neuropsychologist and Professor of Pediatrics at the University of Texas, MD Anderson Cancer Center, and a fellow of the National Academy of Neuropsychology. In addition, he works with children, adolescents, and young adults with a variety of neurologic illnesses and neurodevelopmental disorders. Dr. Stavinoha has authored over 100 peer-reviewed articles and co-authored two books for parents that have been translated into multiple languages, including Stress-Free Discipline: Simple Strategies for Handling Common Behavior Problems and Stress-Free Potty Training: A Commonsense Guide to Finding the Right Approach for Your Child. In this episode, Dr. Stavinoha shares his wealth of pre-birth to adulthood brain development knowledge.
Dr. Stavinoha begins by talking about what happens with the brain in gestation. He then details the neural tube, the development and function of the forebrain, midbrain, and hindbrain, cell proliferation and migration, and potential complications in premature birth that affect brain development. He talks at length about factors that impact fetal brain development, emphasizes the value of good nutrition in brain development, and discusses other strategies such as exercise, stress management, and music, among others, that parents can employ to optimize brain development in utero. Dr. Stavinoha then converses about what happens in the brain in early childhood, the impact of the environment around the child on brain development, how infant and early childhood behavior reflects what's going on in the developing brain, and addresses common misperceptions parents have about their child's behavior or brain. He also offers some sage advice for parents, and shares what they can expect when their child has a pediatric neuro-psych assessment as well as where to find someone qualified to do that type of assessment with their child. Filled with a vast amount of quality information and advice from a proven leader in the field, today’s episode is truly a masterclass in brain development that parents and non-parents alike need to hear.
Episode Highlights:
· The brain in gestation
· The neural tube and the development and functions of the forebrain, midbrain, and hindbrain
· Cell proliferation and migration
· Potential complications in premature birth that affect brain development
· Factors that impact fetal brain development
· The importance of good nutrition and a healthy lifestyle for brain development
· How to optimize brain development in utero
· Synapses and their function in brain development
· The effect of the environment on brain development
· The importance of security, predictability, and protection from toxic stress in early childhood
· Toxic stress: What it is and its impact on brain development
· Tolerable stresses and how they build resilience
· Impact of the COVID pandemic on children
· Sensitive periods and critical periods in childhood
· The need to emphasize reading with your child
· Brain plasticity and how it changes throughout a child's growth.
· How infant and early childhood behavior reflects what's going on in the developing brain
· Common misperceptions that parents have about their child's behavior or brain
· Ignore – the single best solution to a temper tantrum
· Brain...
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Dr. Nada Gligorov, the Director of Graduate Studies and Associate Professor at the Alden March Bioethics Institute at Albany Medical College, joins Peter Stavinoha on the podcast today to talk about neuroethics. Prior to joining the Bioethics Institute, she was Associate Professor of Medical Education at the Icahn School of Medicine at Mount Sinai. Dr. Gligorov has published in leading journals in bioethics and philosophy including the Hastings Center Report, the American Journal of Bioethics, Neuroscience, Neuroethics, and the Monist. She has served as a member of the American Philosophical Association's Committee on philosophy and medicine from 2018 to 2020, and she's currently the chair of the American Society for Bioethics and Humanities, Neuroethics Affinity Group. She is also the author of a book titled Neuroethics and the Scientific Revision of Common Sense which she discusses with Peter here today.
Dr. Gligorov kicks off the episode by describing what neuroethics is and gives us an overview of her book Neuroethics and the Scientific Revision of Common Sense. She defines common sense and talks about neuroimaging and the different aspects of it, and then sheds more light on neuro privacy, mental privacy, the safeguards to mental privacy, and additional issues that could arise from doing neuroscience research. She also discusses the concept of freewill, the friction between neuroscience and freewill, her thoughts on the neuroethical issues related to impairments or alterations of consciousness and making decisions for others at the end of life. The implications of neurodegenerative or neurologic injuries, brain injuries, dementia, that result in a loss of cognitive capacity, and those kinds of conditions when cognitive capacity for decision making has been impaired are also covered, and our guest delves further into neurologic compromise and cognitive enhancement She finishes up by sharing her understanding of parents making decisions on behalf of their kids and by exploring pain as a mental state, giving some insight into the cognitive influence of pain through the placebo and nocebo effects. A true expert in her field, Dr. Nada Gligorov possesses a great deal of wisdom and knowledge which she generously shares with listeners in today’s thought provoking conversation.
Episode Highlights:
● Description of Neuroethics
● Overview of Neuroethics and the Scientific Revision of Common Sense
● Common Sense
● Neuroimaging
● Neuro and mental privacy
● Safeguards to mental privacy
● Issues arising from neuroscience research such as incidental findings
● The concept of free will
● Neuroscience vs. freewill
● Making decisions for others at the end of life
● Implications of neurodegenerative or neurologic injuries
● Neurologic compromise, cognitive enhancement and the implications
● Drawing the line between enhancement and treatment
● The placebo and nocebo effects as they relate to pain
Quotes:
“Common sense morality is an everyday way in which we talk about other people, meaning that the way in which we explain and predict our own behavior related to morality, and the way in which we explain and predict other people's behavior.”
“It’s through the popularization of neuroscience and the fact that we hear about neuroscience research in the popular media and from other sources as well that we have started to incorporate some of those scientific facts into our...
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Dr. Peter Arnett, Immediate Past President of NAN, hosts the podcast this week and welcomes Dr. Munro Cullum, PhD, ABPP, Professor of Psychiatry, Neurology, and Neurological Surgery at UT Southwestern Medical Center, where he holds the Pamela Blumenthal Distinguished Professorship in clinical psychology, to the show. A board-certified clinical neuropsychologist, Dr. Cullum has been involved in research, teaching, and clinical practice in neuropsychology, serving his field in multiple roles at the national level and contributing to major organizations over the past 30 years of his career. Currently the President of the Sports Neuropsychology Society, Dr. Cullum’s research focuses in part on the short and long term effects of concussions, and today he brings his vast amount of knowledge and experience in this area to this informative and fascinating conversation.
He begins by describing how he got started in studying sports concussions, and then goes on to examine baseline testing, the validity concerns associated with it, and alternative assessment models to be considered. He also reviews such aspects of concussions as common symptoms, recovery times and protocols, lingering symptoms, post-concussion syndrome, as well as how anxiety and depression can become factors in concussions. Neuroimaging, managing athletes with concussions, blood testing, and the risk of later life problems are also explored. The episode concludes as Dr. Cullum shares his advice regarding when athletes should consider retirement, Chronic Traumatic Encephalopathy and Traumatic Encephalopathy Syndrome, as well as his final thoughts for listeners. Bringing information from the forefront of research into the science of concussions, Dr. Cullum offers a masterclass here today in understanding and treating this increasingly common condition as he continues to fulfill his stated mission of educating the general public about this timely and essential topic.
Episode Highlights:
Dr. Cullum’s start in studying sports concussionBaseline testing for athletes and validity concerns surrounding itAlternative assessment modelsSome of the most common concussion symptomsRecovery times and protocols for concussionsLingering symptoms and their risk factorsDr. Cullum’s perspective on post-concussion syndromeAnxiety and depressionCircumstances warranting neuro imagingManaging athletes following concussionsBlood testing for concussionsThe risk of later in life problems related to concussionsHis advice for when athletes should consider retirementChronic Traumatic Encephalopathy (CTE) concernsTraumatic Encephalopathy Syndrome (TES)Dr. Cullum’s final thoughtsQuotes:
“If you think about it, most of us either have experienced or know someone who's experienced a concussion or someone will have traumatic brain injury.”
“It always falls back to clinical decision making, I think, regardless of what the scores necessarily suggest.”
“To experience a concussion, you just have to shake up the brain enough to cause that brief disruption in normal cognitive efficiency or cognitive functioning to produce symptoms.”
“Kids tend to take longer to recover than adolescents who take longer to recover than adults.”
“We really need to get these folks back to their pretty normal routines as quickly as possible.”
“We have to be mindful of the potential symptoms that can occur unrelated to the concussion itself,...
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Updating The Seven Sins of Memory with Dr. Daniel Schacter
Dr. Daniel Schacter, professor and past chair of psychology at Harvard University and world leader in the neuroscience of memory, joins Heidi on the podcast today to provide an update on his now 20 year old seminal work, The Seven Sins of Memory: How the Mind Forgets and Remembers. Throughout his illustrious career, Dr. Schacter has made pioneering contributions that have shaped our understanding of memory, and his work, including over 400 peer-reviewed articles, has garnered numerous accolades, including election to the American Academy of Arts and Sciences and the National Academy of Sciences. He has received several awards for his research, including the Warren Medal from the Society of Experimental Psychologists, Award for Distinguished Scientific Contributions from the American Psychological Association, and he has recently completed an updated 20th anniversary edition about the Seven Sins of Memory that will be published in the fall.
Today, Dr. Schacter begins by sharing what he has learned about memory since he first published his book, reviewing the seven sins, and highlighting his most surprising findings regarding them. He then conducts a masterclass on memory, addressing such topics as Highly Superior Autobiographical Memory (HSAM), the impact of the pandemic, recent media and political messaging, technology, and virtual learning upon our memories, as well as the role memory plays in such complex situations as racism. He also explores memory’s role in imagining our future, how its vices can also be virtues, the projects he is most excited about currently, and finishes up by sharing his advice regarding brain and memory health. An undisputed expert in the field, Dr. Schacter has most likely forgotten more about memory than many of us actually know about it, rendering this truly an episode you will not soon forget.
Episode Highlights:
What Dr. Schacter has learned over the past two decades about the ways memory is imperfectThe seven sins of memoryHis most unexpected findingsHighly Superior Autobiographical Memory (HSAM), anti-transcience, and the struggles of those who exhibit themHow our memories of the tumultuous events of the past year and a half might play out in our livesHow media or political messaging after the election or the Capitol Riot might affect memories of those eventsHow the sins of memory play a role in our understanding of, or reaction to, such complex situations as our troubled history with racismHow the ubiquitous nature of technology has changed our memoryDifferences in our memory for things that we did or learned virtuallyThe impact on the memory of having a copious photographic record of your lifeHow the vices of memory can also be virtuesMemory’s role in imagining our futureThe role of emotion in memoryTechniques we can use to improve memoryThe projects in his lab that he is most excited about at the momentDr. Schacter’s advice regarding brain/memory healthQuotes:
“I was impressed that in looking back over 20 years by how much more we've learned both at the basic science level, and also at the applied level.”
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Dr. John Randolph is a board-certified clinical neuropsychologist, brain health coach and consultant, and member of the Adjunct Faculty at the Geisel School of Medicine at Dartmouth College. He earned his PhD in Clinical Psychology, with an emphasis in Neuropsychology at Washington State University, and completed clinical and research fellowships in Neuropsychology and Neuroimaging at the Geisel School of Medicine at Dartmouth. He's Past President of the New Hampshire Psychological Association, a National Academy of Neuropsychology (NAN) Fellow, and recent Program Chair for a national conference focused on the science of brain health. He's also the author of the recently released general audience book, The Brain Health Club: Using the Power of Neuroscience to Improve Your Life. He works with individuals, groups, and organizations interested in developing better strategies to enhance brain health.
Today Dr. Randolph joins host, Dr. Peter Arnett, to discuss how brain health relates to successful aging, which day-to-day activities we can do to improve memory function, and what kinds of physical exercise are best for the brain (and for how long). Dr. Randolph explains the crucial role that social engagement plays in brain health, and how increased isolation has been particularly challenging during the pandemic. The benefits of “cross training” with crossword puzzles, reading, woodworking, and other mental activities daily are also addressed. Dr. Randolph talks about the importance of a Mediterranean-style diet, sleeping well, and stress management for cognitive functioning. Finally, he reminds listeners that it’s never too late to make changes toward better brain health, and encourages us to take gradual steps toward this goal.
Episode Highlights:
Successful aging is intimately related to brain healthExercise, social activity, mental activity, brain-healthy diet, managing stress, sleeping well are all very important not just for brain health, but for the overall aging processModerate activity for 30 minutes a day, 5 days per week is best for maintaining brain health, but any level of activity is beneficialThe brain is nourished by social interaction and being around people we care aboutThree types of social activity that really matter: how frequently we’re active with other people; how large our social network is; and social supportThese are associated with brain health and also reduce the risk of developing dementiaCOVID has been a particularly challenging time in terms of maintaining social connections, even with the advent of Zoom calls and FaceTimeCross Training with the brain, and doing a variety of different mental activities each day, helps to prevent memory problemsMixed evidence for whether computerized games helpBenefits of Mediterranean-style dietFindings on health benefits of wine and dietary supplements are inconsistent - the most important priority is to have a balanced dietIt’s never too late to start making important changes to help promote better brain healthSleep is critically important for cognitive functionThere are a lot of simple, free things you can do every day to promote brain health - focus on taking gradual stepsQuotes:
“Successful aging is really intimately related to brain health.”
“We know that there are certain day-to-day activities we can engage in that also really help promote brain health. And these include things like exercise, social activity, mental activity, eating a brain-healthy style of diet, like the Mediterranean style diet, managing stress, sleeping well - these are all things that we have a certain amount of control over, and we know can really improve not just brain health, but the overall aging...
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Brain Beat is a podcast series produced by the National Academy of Neuropsychology Foundation. Each episode features experts discussing current topics related to brain health and brain functioning. Tune in to fine tune your understanding of the mind!
