Welcome back to BrainBeat, the podcast dedicated to exploring the world of brain health where, this week, host Dr. Heidi Rossetti is joined by Dr. Pauline Maki, a leading researcher on women's brain health from the University of Illinois. Together, they explore the menopausal transition, unpacking what science says about how fluctuating hormones impact memory, mood, sleep, and cognitive aging. This essential episode separates evidence-based fact from common fiction surrounding menopause and cognition.

The discussion details measurable cognitive changes, particularly a temporary dip in verbal memory, and Dr. Maki explains how physical symptoms like hot flashes and sleep loss are directly tied to brain health and memory. She goes on to clarify the confusing data on hormone therapy and dementia risk, highlighting its appropriate uses while cautioning against its use solely for prevention. The conversation also stresses the critical health disparities faced by Black and Brown women, who often endure more severe and prolonged symptoms, underscoring the need for personalized care.

Episode Highlights:

[00:00] How Menopause Affects Cognition and Memory

[06:52] Distinguishing Menopause Symptoms from Alzheimer’s Disease

[09:05] The Truth About Hormone Therapy, Cognition, and Dementia Risk

[13:04] Managing Symptoms: The Link Between Hot Flashes, Sleep, and Brain Health

[19:36] Critical Health Disparities in Menopause for Black and Brown Women

[24:05] Building a Resilient Brain: Proactive Lifestyle Strategies

[30:17] The Future of Menopause Research and Personalized Treatment

Key Takeaways:

"There's really one domain of cognitive abilities that changes longitudinally as we as women transition from being premenopausal to perimenopausal…That's our ability to listen to verbal material, to encode it, and then... recall what you learned verbally."

"The science that I've been doing over the past 15 years links hot flashes themselves with declines in verbal memory, with changes in brain circuitry underlying memory performance.”

“The more hot flashes women have, the more Alzheimer's disease biomarkers they have in their blood."

"Black and brown women who live in poverty... showed persistent declines into the post-menopause.”

"Menopause is an opportunity to build resilience in our brains.”

"The good news about menopausal hormone therapy is that it's effective for treating, we think, cognitive issues related to sleep deprivation because it does improve sleep in women whose sleep is disrupted by hot flashes."

"Evidence suggests that 40% of our risk of dementia is under our control with those lifestyle factors. And so that's really good news for women."

Links:

BrainWise | Brain science for healthy living

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
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• The structure and themes of Basics of Child Neuropsychology
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• Foundational neuropsychology and neurodiagnostic procedures
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• Brain development stages and the impact of genetic factors
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• Genetic disorders such as Down syndrome and 22q11.2 deletion syndrome and their neurocognitive, academic, and psychiatric manifestations
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• Evidence-based treatment options and the need for more research in this area

Key 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

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
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• Balancing the care of aging parents with young children
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• The high rates of psychological, social and financial challenges experienced by caregivers
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• Building a care team
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• Difficult conversations around topics like driving cessation and end-of-life care
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• Expanded support to rural caregivers through telehealth services
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• Prioritizing self-care
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• The significant impact of preexisting relationships on caregiving dynamics

Quotes:

"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

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
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• Her unique perspective as a neuropsychologist and patient
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• Dr. Roebuck Spencer's treatment odyssey
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• Her coping strategies
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• The impact of Dr. Roebuck Spencer’s diagnosis on her family
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• The integral role of maintaining a sense of normalcy and engaging in social and physical activities
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• Advice for clinicians

Quotes:

"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

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
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• The multiple factors that influence cognitive reserve
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• The relationship between brain maintenance and cognitive reserve
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• Some threats to cognitive reserve
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• The role of the environment and the "exposome"
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• How cognitive reserve relates to aging
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• The brain’s"software" and "hardware"
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• Lifestyle factors that can help to improve cognitive reserve
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• Cognitive stimulation through hobbies and leisure activities
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• The controversy that surrounded the idea of cognitive reserve in the past
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• Higher cognitive reserve and Alzheimer's

Quotes:

"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...

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
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• The importance of finding alternative methods for pain management beyond relying on opiates
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• The importance of empowering patients to take an active role in their own self care and recovery through education, motion, and non-opiate therapies
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• The role of the Hawaii Medical Board and its focus on reducing opioid prescriptions
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• The importance of addressing the root cause of pain, rather than just masking the symptoms
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• Strategies for coping with chronic pain, including the use of mindfulness and physical therapy
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• The benefits of involving family and loved ones in the pain management process
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• The value of seeking out a multidisciplinary approach to pain management
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• Overuse of opioids in the United States

Quotes:

"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

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 neuroscience
• The numerous benefits exercise has for the brain
• The hippocampus
• Neurotrophic factors and the impact of exercise upon them
• The benefits of high-intensity interval training (HIIT)
• Finding an exercise routine that is enjoyable and sustainable
• The potential impact of exercise upon managing stress, anxiety, and sleep quality

Quotes:

"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

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 disability
• Early signs of learning disabilities
• Legal definitions of disabilities
• Getting a diagnosis
• Treatment and accommodations
• The brain’s resilience

Quotes:

“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