1. Neuroplasticity, Brain Reserve, and Aging:
How to ImproveYourBrain Performance
by Growingthe Sizeof Your Hippocampus,
At Any Age
MajidFotuhi,MDPhD
MedicalDirector:NeuroGrowBrainFitnessCenter
AffiliateStaff:JohnsHopkinsMedicine

2. Neuroplasticity in the Human Brain:
Translational Research
2

3. Objectives
1. Basic Anatomy of Cognition
2. Memory Loss and Brain Atrophy with
Aging
3. Brain Reserve & Neurogenesis
4. Six Ways to Grow Your Brain
5. Reversing Brain Atrophy in Elderly, in 3
Months

5. Synapses

6. Blood Vessels

7. Brain is a Highly Vascular Organ
Zlokovic et al. Neurosurgery 43(4), 877–78, 1998

8. Anatomy of Cognition: Cortex
Executive function
Language
Navigation
Calculation
Abstract thinking
Long term memory

9. Short-term Memory &
Consolidation: Hippocampus
Cortex Hippocampus

10. Hippocampus

11. Neurons in Hippocampus

12. Objectives
1. Basic Anatomy of Cognition
2. Memory Loss and Brain Atrophy with
Aging
3. Brain Reserve & Neurogenesis
4. Six Ways to Grow Your Brain
5. Reversing Brain Atrophy in Elderly, in 3
Months

13. 13
With Aging,
Hippocampus Atrophies Faster
than the Rest of the Brain
 Hippocampus shrinks by about 0.5% per
year after age 40.
 That is the main reason memory lapses
become more frequent after age 40.

14. What Causes
Atrophy in Hippocampus?
Obesity
Smoking
Diabetes
Concussion
Alzheimer’s
Insomnia
Sleep Apnea
Stress
Depression

15. Depression1 Obesity2
Cortisol / Stress3 Insomnia4
11
1- Sheline, (1996). PNAS, 93(9);3908-13.
2- Brain Research, 2009, Pages 186–194
3- Lupien et al (1998), Nature NeuroSci 1 (1), 69-73
4- Ho et al; J Clin Neurol. 2012 Jun;8(2):130-8
More Depression, Obesity, Stress, and
Insomnia, Smaller Hippocampus

16. More Traumatic Brain Injury (TBI),
Smaller Hippocampus
8

17. More Football, Smaller Hippocampus
Singh, JAMA neurology, 2014
12

18. Multiple Risk Factors,
Much Smaller Hippocampus
18
Multiple
Risk Factors
No
Risk Factors
Hippocampus
Hippocampus

19. 19
Diabetes
Hypertension
Obesity
Sleep Apnea
Insomnia
Head Trauma
Genes
Stress
Brain-healthy Diet
Physical Fitness
Cognitive Stimulation
Quality sleep
Peace of Mind

20. Objectives
1. Basic Anatomy of Cognition
2. Memory Loss and Brain Atrophy with
Aging
3. Brain Reserve & Neurogenesis
4. Six Ways to Grow Your Brain
5. Reversing Brain Atrophy in Elderly, in 3
Months

21. “Brain Reserve”

22. Four Ways to Build a Bigger Brain Reserve

23. Before and After

24. Neurogenesis in Hippocampus
Bischofberger, Nature Neuroscience, 2007

25. Epigenetics:
Factors That Modulate Your Genes
http://journal.frontiersin.org/article/10.3389/fcell.2014.00049/full

26. Objectives
1. Basic Anatomy of Cognition
2. Memory Loss and Brain Atrophy with
Aging
3. Brain Reserve & Neurogenesis
4. Six Ways to Grow Your Hippocampus
5. Reversing Brain Atrophy in Elderly, in 3
Months

27. 1. More Exercise,
Bigger Hippocampus
Erikson, PNAS 2011
27

28. Arch Gen Psychiatry, 2010
More Exercise, Bigger Hippocampus,
Even After 3 Months
After
Before
28

29. More Exercise: More Neurogenesis
Van Praag, Trends in Neurosciences, 2009

30. 2. More Omega-3 Fatty Acids,
Bigger Hippocampus
30

31. 31
Pottala J V et al. Neurology 2014;82:435-442
More Omega-3 Fatty Acids,
Bigger Hippocampus

32. Draganski et al. J Neurosci 2006; 26:6314–7
3. More Learning,
Bigger Hippocampus
32

33. 33
4. Better Sleep,
Bigger Hippocampus
Canesa, American Journal of Respiratory Medicine, 2011

34. 5. More Meditation,
Bigger Hippocampus
34
Holzel , Psychiatric Research, 2011

35. 6. More Neurofeedback,
Bigger Cortex
Ghaziri et al. Clin EEG Neurosci 2013; 44 (4) 265-72

36. Neurofeedback
36
 Performed by a certified EEG neurofeedback specialist
 Live EEG feedback is provided through auditory and visual
responses to help the patient move brain activity towards an
optimal state
 Benefits are long-lasting

37. 37
Hippocampus Grows Bigger
When You Start Early

38. Objectives
1. Basic Anatomy of Cognition
2. Memory Loss and Brain Atrophy with
Aging
3. Brain Reserve & Neurogenesis
4. Six Ways to Grow Your Brain
5. Reversing Brain Atrophy in Elderly, in 3
Months

39. Brain Fitness Program: Overview
Initial
appointment
with
neurologist
Diagnostics Follow-Up
Brain Fitness
Program:
Level 1
Level 2
Level 3
33

40. Brain Fitness Program: Initial Exam
40
Psychology

41. Brain Fitness Program:
Comprehensive Diagnostic Tests
41
Brain MRI Neurocognitive Evaluation
Carotid Ultrasound
Sleep Health
Assessment
Cardiopulmonary Testing
Brain Mapping qEEG
Blood Test

42. Brain Fitness Program:
A Personalized Set of Interventions
36
Brain Coaching and Counseling Cognitive Skills Training Neurofeedback Training
Weekly Monitoring

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Mood
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Anxiety
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Sleep
Memory Attention Concentration
37
Brain Fitness Program:
One example: 69 year old with ?Alzheimer’s

44. Brain Fitness Program:
Statistical Analysis of 127 Patients with MCI
7% 9%
84%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Low or No Impact Moderate Impact High Impact
38
≥3 areas of cognitive
function Improved, p<0.05

45. 2.86 cm3
3.14 cm3
42
MRI Results
Before
After

46. 7.29
7.92
7.94
6.5
6.7
6.9
7.1
7.3
7.5
7.7
7.9
8.1
Baseline 3 Months 1 Year
Sustained Benefits
40
HippocampusVolume(cm3)
8.6% increase in HC volume

47. 47
Diabetes
Hypertension
Obesity
Sleep Apnea
Head Trauma
Genes
Stress
Brain-healthy Diet
Physical Fitness
Cognitive Stimulation
Brain Fitness Program

48. Summary
1. Basic Anatomy of Cognition
2. Memory Loss and Brain Atrophy with
Aging
3. Brain Reserve & Neurogenesis
4. Six Ways to Grow Your Brain
5. Reversing Brain Atrophy in Elderly, in 3
Months

49. THANK YOU