Category Archives: Brain

Brain Awareness Week: Brain Health and the Female Patient 

March 12, 2021

Taking place between March 15-21, 2021, Brain Awareness Week is a global campaign aimed at promoting brain science and research while working to further public awareness of brain health. As a field of medicine, brain health belongs at the forefront of patient health, especially in the case of women as it is considered a vital marker of female health. However, the female brain has been largely overlooked in research efforts and by the scientific community in the past spotlighting a pressing need for increased consideration of the aspect as a facet of overall health.  

Currently, it is estimated that 3.3 million women aged 65 and above have Alzheimer’s disease (AD) in the United States – comprising approximately 67% of the AD patient population comprising approximately 67% of AD patients. Overall, women face an increased risk of developing AD due to hormonal shifts that occur during menopause which can increase the risk of neurological changes. Furthermore, women above the age of 60 are twice as likely to develop Alzheimer’s disease over the course of the rest of their lives as they are to develop breast cancer yet the condition is not widely recognized as a women’s health issue. As current and emerging clinical data indicate, the disproportionate prevalence of neurodegenerative diseases in female patients necessitates more comprehensive medical intervention and the development of targeted prevention initiatives.

The Female Brain and Alzheimer’s Disease

According to recent research from investigators at Weill Cornell Medicine  women in mid-life have approximately 30% more Alzheimer’s-related plaques than men of the same age. As part of their study, researchers evaluated 121 middle-aged participants without AD symptoms and with the presence of some risk factors such as genetic risk or a family history of disease. They discovered that women also had a 22% lower brain glucose metabolism indicative of lower energy levels in the brain, as well as 11% more brain shrinkage. Both of these neurological biomarkers were associated with menopause.

Noting the significantly increased brain changes associated with AD in female participants, the team of researchers set out to identify relevant risk factors, including age, education, cholesterol levels, smoking status, dietary habits, exercise levels, diabetes, menopause, hormonal therapy, and hysterectomy among others. They found that menopause was the primary predictor of Alzheimer’s disease-related changes in women’s brains and while hormonal therapy was also associated with the condition, women undergoing treatment exhibited fewer negative brain changes.

Although additional research in this field is necessary, the latest findings point to the need to address Alzheimer’s disease-related risks in female patients at an earlier age and with more strategic interventions. Further study is needed to determine what types and doses of hormonal therapeutics may prove beneficial for brain function while also minimizing the potential for adverse health effects.

Menopause, Hormonal Risk Factors, and Neurological Health

Although menopause is not often associated with the brain, approximately 80% of women going through menopause experience at least some neurological symptoms ranging from insomnia and memory loss to depression and anxiety. Left unaddressed, these changes may escalate to serious neurological conditions.

Despite being the only neurodegenerative condition that affects more women than men, Alzheimer’s disease in the female patient remains under-recognized. Gaps in knowledge and scientific literature highlight the need to explore the specific factors that contribute to women’s increased vulnerability to a number of conditions that negatively impact overall brain health. A growing understanding of the varying reasons underlying cognitive changes in both women and men as well as the sex differences in neurological aging and function will likely change the way AD and other neurodegenerative conditions are treated.

Due to advances in research, there are newly discovered opportunities to identify, address, and act upon telling risk factors before clinical symptoms of neurological conditions emerge. Doing so will require comprehensive training and medical education for physicians, enhanced public awareness, and strategic prevention initiatives. Compelling evidence exists revealing the significant benefit of specific medical and lifestyle practices on female brain health; lifestyle interventions can be both safer and better tolerated than traditional pharmacologic approaches while also being just as effective. Most importantly, prevention and treatment protocols should be tailored to each patient’s unique risk profile and needs and incorporate brain health as part of a holistic view of patient care.

The Neurologic Complications of COVID-19 

February 16, 2021

The neurologic features of COVID-19 infection still remain under investigation as a growing number of reports indicates the potential for cognitive symptoms in certain patient cases. Recent research has examined high-resolution magnetic resonance imagery to reveal microvascular brain injury and inflammation in COVID-19 patients who have died, however, no evidence of direct SARS-CoV-2 viral attack in tissue samples has been reported.  The damage is reportedly caused by thinning and leaky brain blood vessels tied to the viral infection, per a letter recently published in the New England Journal of Medicine.

Continue reading →

The Cognitive Complications of COVID-19

November 25, 2020

At this time, the long-term complications of COVID-19 remain unknown although there is evidence of changes aside from acute symptoms referred to as “long COVID.” Several case studies have reported neurological problems in severely affected COVID-19 patients – such complications may arise from associated stroke, inflammatory syndrome, immune responses, and other health factors.

Currently, there is little clinical information concerning the nature and prevalence of cognitive consequences post-COVID infection, the full spectrum of their severity, or the connection between hospitalization status. Emerging evidence points to potential cognitive deficits associated with the virus, revealing significant brain function impacts in the worst cases of infection, according to a recent non-peer-reviewed study.

Cognitive Performance in COVID-19 Survivors

Led by Imperial College London doctor, Adam Hampshire, the study encompassed a cohort of over 84,000 participants who performed cognitive tests aimed at assessing brain performance, including word recall and puzzles. Data for analysis was gathered from the Great British Intelligence Test. The research team controlled results for age, gender, education level, income, racial-ethnic group, and pre-existing medical conditions.

The study revealed that participants who recovered from suspected or confirmed COVID-19 performed worse on cognitive tests in multiple domains than expected given their age and demographic profiles. Observed cognitive defects were of “substantial effect size,” especially among individuals who had been hospitalized with COVID-19. Furthermore, deficits scaled with symptom severity with the worst cases of illness showing a cognitive impact equivalent to a 10-year decline in global performance in patients aged between 20 and 70 years.

“Our analyses … align with the view that there are chronic cognitive consequences of having COVID-19,” the researchers wrote in a report of their findings. “People who had recovered, including those no longer reporting symptoms, exhibited significant cognitive deficits.”

Study Limitations

Hampshire and his team’s results are worrisome, however, their findings are yet to be reviewed by other researchers. Experts warn that the latest results should be interpreted with caution as the cognitive health of participants pre-COVID infection was not known or accounted for in the study. In addition, the study’s findings do not reflect long-term recovery, indicating that the cognitive effects may only be present for the short term. Study’s findings can not be entirely reliable as they do not compare before and after scores, involved a large number of people who self-reported having COVID-19 with no positive test measure

Nonetheless, the latest study alongside other emerging research on the potential cognitive repercussions of COVID-19 illness add to a growing list of concerns. While current literature signals potential for cognitive complications, it warrants further investigation and understanding of the duration of such cognitive deficits. Forthcoming studies should aim to identify the extent to which cognition is affected after infection and whether permanent neurological damage to brain function is possible.