A (Sometimes) Long and Winding Road
Recovery from any type of addiction can be a monumental task. Even for those ready to take it on, the road can be a painful one loaded with many obstacles. Although, one that will ultimately pay off with better health, better relationships, and overall better quality of life.
Smooth the Way to Your Independence
So, what can be done to ease the pain of transition from a life of dependence to one of self-control and freedom?
While not a ‘one-size-fits-all’, the following 3 tips are proven strategies that can help soften the blows the various phases of recovery throw at you. And, ultimately, lead you to a life of positive practices that will replace the conditions and substances you seek to avoid.
All of these common-knowledge practices seek to establish harmony in and between the brain and the body. When the ‘mind-body’ connections are performing at their best, you will have the greatest chance at overcoming your struggles (whether recent or lifelong).
Addiction Recovery Tips
- Meditate Daily – Research continues to show how sitting quietly for periods of time with a focus on ‘present moment’ sensations like breathing can allow for greater focus, clarity of thought, and self-regulation. Start at 5 minutes and work to 20 minutes daily.
- Exercise Daily – One of the best ways to control and improve functions of our brain chemicals (neurotransmitters) is to do vigorous exercise daily. Get your heart rate up, do resistive and high intensity activities, and, most importantly, move daily!
- Eat Smart – Eat whole foods, eliminate refined and processed foods (i.e. anything in a bag, box, or can), increase healthy fat and protein intake, limit sugar intake (sugar can be as addictive as heroin or cocaine), and stay well hydrated (that means water).
Stay tuned for Part II of II where we will go over the next 3 addiction recovery tips.
Addiction or, more appropriately, substance use disorder (SUD) is defined as one’s recurrent use of drugs and/or alcohol leading to significant clinical and functional impairment. This impairment may be reflected in the areas of physical and mental health, employment, school, relationships, finances, and more.
One thing is for certain – the vast majority of those struggling with SUD also have underlying challenges with learning and behavior, and may have one or more mental health disorders. While the reasons for these underlying challenges are likely as many as the number of challenges themselves, this shifting of perspective away from the genetic view of addiction offers great hope for those seeking progressive therapies that, in many cases, can have a profound impact on the underlying disorders and the problem behaviors and outcomes associated with SUD.
Newer thinking also dictates that addictive tendencies can be due to factors such as concussion and traumatic brain injury, and metabolic imbalances caused by food allergies, environmental toxicities, nutrient deficiencies, and the like. And let’s not forget stress…
In order for progressive brain-based modalities to be delivered effectively, which provide a tremendous complement to standard mental health strategies implemented during both in-patient and out-patient programs alike, one needs to understand that SUD is not a disease as we would normally think of one (e.g. cancer, Parkinson’s, etc.), and it is not a moral failing or a character flaw on the part of the user. SUD can affect anyone… of any class, race, gender, and ethnicity.
SUD is in fact a ‘brain problem’ that, in many respects, can be measured and needs to be approached as such for maximum gains. Let us consider 5 areas of measurement related to brain function that reveal a great deal about learning, behavior, and mental health status; and, more importantly, let us realize that something can be done to improve upon function in any or all of these areas:
- Brainwave Activity (EEG) – In our brain we have networks related to attention, vision, sensations, relaxation, emotions, vital functions, and more. How much delta, theta, alpha, beta, and gamma brainwave activity we have under different circumstances dictates how well various parts of these networks perform. Quantitative EEG (qEEG) is gaining popularity in select mental health circles as an extremely viable diagnostic tool that can enable us to peer into the inner workings of the brain and these brain networks that make us uniquely human.
- Cognitive Testing – Executive function, cognitive flexibility, simple and complex attention, and processing speed are just a few of the tests of higher cognitive function that can reveal a great deal about how one’s brain interacts with its environment. They are also excellent diagnostic tools for monitoring progress when treating the various subsets of learning and behavioral issues underlying SUD.
- Metabolic Function – Blood sugar, amino acids, urine organic acids, food antibodies, heavy metals, environmental toxins, hormones, neurotransmitters, vital nutrients, genetic variants, and so much more are a mix of both classic and progressive ‘biomarkers’ of brain function. How our bodies handle fuel, utilize nutrients, process hormones, and react to toxins in our environments determines how well our brains handle what is presented to them on a moment to moment basis.
- Eye Movements – Generally ignored in the mental health arena from a diagnostic perspective, eye movements of all types are directly related to the brain regions that control them. From primitive abilities of finding visual targets that involve parts of the brainstem and emotional centers like the amygdala (fear response), to fast eye movements controlled by our higher functioning frontal lobes; eye movements deliver a wealth of information related to SUD and its underlying causes. Videonystagmography (VNG) is one type of diagnostic tool used to measure these types of functions.
- Balance and Coordination – More and more, addiction based programs are implementing movement based activities such as Tai Chi and yoga. From both balance and relaxation standpoints, there is good reason to do so. Our sense of self is largely influenced by our ability to physically interact with our environment. When one has severe balance or coordination impairment, as is seen in conditions like schizophrenia, mental function and behavior will likely be impaired. Measurement tools such as dynamic posturography and standard tests of movement and coordination can be utilized to measure these abilities.
The inherent beauty of any of these tools, that can reveal a wealth of information about cognitive, behavioral, and mental functions, is that they can in turn be utilized to track progress when one enters into a collaborative treatment program with their mental health specialists and qualified functional neurologist. The blending of the ‘brain’ and the ‘mind’ sciences is long overdue and is proving to be clinically effective with regard to its impact on addiction and SUD, and the underlying disorders that are being shown with greater clarity to be the root cause of them.
John is a 66-year-old grandfather and successful businessman from Asheville, NC who plays tennis and counts flying among his favorite hobbies. But he is concerned that his memory is starting to slip. There’s no family history of Alzheimer’s disease or dementia.
John, however, did have a car accident and subsequent skiing accident in which the fall he suffered was so serious that his helmet broke. He also admits that he is often dizzy, fatigued, easily angered, and frustrated over his physical and mental limitations.
Intervention for balance and cognitive decline
John underwent comprehensive Brain Training at a frequency of three times per day over the course of five days. His brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount of therapy without exceeding fatigue limits that might promote worsening of his symptoms as is often the case in more conventional rehabilitation programs.
Understanding the relationship between physical functions such as balance, timing and eye movements and higher cognitive functions like memory (both major challenges in his case), we implemented the following Brain Training procedures: EEG neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, electrical stimulation, breathing exercises, lifestyle changes and home care therapies.
Outcomes with Brain Training
John reported midway through his five-day training program that he had “one of his best games of tennis.” He also said he felt less dizzy and improvements in his mood and memory were noticeable to him and others. “I walk better, talk better and feel better,” he said.
Actual measurable, objective improvements recorded with post-intensive diagnostic testing included:
- Interactive Metronome (Timing): 14% improvement in timing accuracy and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. becoming more ‘in-sync’ with a specified reference tone).
- Videonystagmography (Eye movements): Significant improvements in numerous aspects of oculomotor functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.
- Computerized Assessment of Postural Stability (Balance): 24% improvement in balance under the most challenging circumstances (eyes closed on an unstable surface – noted as PSEC on charts below below). Near complete normalization of a hazardous posterior center of pressure (tendency to carry his body or sway to the rear):
Implications Following Treatment
After his treatment was completed, John says he was able to recapture the moments of joy and sense of accomplishment he experienced through playing tennis and flying his aircraft, his two favorite hobbies; as well as being more engaged with his family.
He reports his memory has improved, he has fewer symptoms of dizziness and fatigue, and most important – he is now a safer, happier pilot following his specific Brain Training program.
At the time of presentation to APEX Brain centers in Asheville, NC in late 2015, Jackie was a 55-year-old, soon to be retired professional female. Post-concussive symptoms of debilitating headaches, memory loss, learning and behavioral issues, fluctuations in heart rate, and difficulty handling visual stimulation such as driving, busy public places and computer screens were preventing her from leading a normal life. Prior to traveling to APEX from Charlotte, NC, Jackie had sought care from several different doctors in her area. Vestibular therapy and chiropractic care had given her some relief of symptoms, although her other experiences were not so positive. At one point a provider told her that she was mentally ill. Jackie was outraged and, as many with post-concussion syndrome report similarly, she offered this statement: “I’m not crazy. I didn’t have any of these symptoms before I had the injury and I am definitely not making them up”. This is the unfortunate reality of many who suffer with brain injury.
Intervention for balance and cognitive decline
Jackie underwent comprehensive Brain Training at a frequency of 3 times per day over the course of 15 days (with 2 days off between each week for much needed rest and recovery). Her brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure she was receiving the proper amount of therapy to be effective without exceeding fatigue limits that could potentially promote worsening of her symptoms. Modalities implemented included, but were not limited to: neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, electrical stimulation, breathing exercises and home care therapies.
Outcomes after Brain Training
Jackie reported prior to brain training that she would have a constant headache of 6 on a 0-10 scale (0 being no pain and 10 being the worst possible pain) that would escalate into an 8-9 of 10 by the end of the day. The week after her program she reported the headaches were finally manageable at a level of 3-4 of 10 and would not escalate. Jackie has had continued success and reported at 3 weeks after her program that she is headache free, unless she spends too much time in front of a screen or in a busy public place. She also reports that when this occurs, her ‘at home’ brain exercises will relieve them. Aside from headaches, Jackie has reported that she no longer feels like she is in a constant brain fog. Her heart rate has also normalized and no longer fluctuates or spikes.
Actual, measurable objective improvements recorded with post-intensive diagnostic testing include, but are not limited to:
- Cognitive Testing: Jackie showed an increase in her Neurocognition Index of 11%. This is a standardized overall score of cognitive performance. Significant improvements in specific areas of memory (one of her biggest concerns) are as follows: 65% in composite memory, 33% in verbal memory, and 67% in visual memory.
- Interactive Metronome: 56% improvement in motor timing accuracy and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. premature response to a specified reference tone).
- Videonystagmography (VNG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.
Implications for others:
Diagnostic and functional tests can be used to direct an effective Brain Training program and improve post-concussion symptoms. Increased sensory and environmental sensitivities are common symptoms of post-concussion syndrome. There are several areas of your brain that process information from your environment and from your body. If these areas are damaged then it becomes difficult for the brain to process sensory input, resulting in fogginess, memory and cognitive issues, impaired processing of pain, and the many other symptoms seen after concussions. The frustration felt by individuals being made to feel they are “crazy”, as Jackie noted, is entirely unnecessary and driven by a health care system that is largely focused on diagnostic testing and lacking significantly in functional treatment options. There is great hope for partial and full recovery in most cases of concussion given a thorough investigation and functional interventions addressing the physical, cognitive, metabolic and lifestyle factors that influence brain health.
If you or someone you care about is experiencing ANY of these symptoms, or anything out of the ordinary related to a head or brain injury, call APEX Brain Centers now at 828.708.5274. You may also email us at [email protected] for more information and to set up a free consultation.
At the time of presentation to APEX Brain Centers, Roger was a 70-year-old male struggling with severe balance problems, clumsiness, fatigue, and a general disinterest in life. He used to enjoy life as a family man, successful entrepreneur and golfer. Just over 10 years prior he had undergone radiation therapy for cancer that damaged his 8th cranial nerve (the balance and hearing nerve). He had also undergone prism therapies and surgery for eye position abnormalities, which have caused further insult to his ability to maintain good balance and to learn effectively. Although not listed as a primary complaint, he also suffered from significant cognitive decline in several areas as evidenced by very low to low average scores on standardized cognitive testing.
Roger sought care at APEX Brain Centers in Asheville, NC in May of 2015 and underwent an intensive course of Brain Training. He was admitted into in an individualized program directed by extensive diagnostic testing, and led by clinicians highly experienced in functional neurology. What follows is a sampling of some of the cutting-edge clinical interventions and amazing functional gains Roger experienced during his time at APEX.
Intervention for balance and cognitive decline
Roger underwent comprehensive Brain Training at a frequency of 3 times per day over the course of 15 days (with 2 days off between each for much needed rest and recovery). His brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount therapy to be effective, but not too much so as to be counter-productive. Modalities implemented included, but were not limited to: neurofeedback (NFB), Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, whole body vibration, electrical stimulation, breathing exercises and home care recommendations.
Outcomes after Brain Training
Subsequent to his Brain Training program, Roger reported subjective improvements in the vast majority of his pre-intensive complaints. More profound than that; his wife was quoted as saying, “it’s like I have my old husband back”. She noted that he used to be the life of the party and had been slowly deteriorating over time to the point of sitting in his chair all day and sleeping more and more often. He was finally plugging back into life, putting an end to his isolation and apathy. As is demonstrated by his balance testing, he is also experiencing a renewed ability to maintain balance, allowing him to be safer and more efficient in navigating his physical environment.
Actual, measurable objective improvements recorded with post-intensive diagnostic testing include:
- Cognitive Testing: Increase in his Neurocognition Index of 48%. This is a standardized overall score of cognitive performance. Increases in various aspects of memory, attention, processing speed and more as great as 21%.
- Interactive Metronome: 56% improvement in task average with motor timing, and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. responding prematurely to a pre-set reference tone).
- Computerized Assessment of Postural Stability (CAPS): 20.5% improvement in balance on an unstable surface with eyes closed – bringing him from severe to mild reduction in balance compared to his peers. Elimination of a posterior center of pressure (CoP); significantly reducing his risk of falling backwards.
- Videonystagmography (VNG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.
With an alarming increase in the number of baby boomers and seniors experiencing balance issues and cognitive decline (that are in fact related), it is important to recognize the symptoms of these potentially debilitating disorders and, more importantly, that something can be done about them. Early intervention is key, as the longer one waits and the more function is lost, the more difficult it is to recover and have full engagement with life!
Optimal brain health is not something you achieve overnight.
It is the culmination of the vast number of decisions you make on a daily basis; week after week, month after month, and year after year.
The choices you make today, and every day, will determine how your greatest asset will serve you at any stage of life!
Due to the ever-growing demand for information in this 21st century, and the lightning speed at which it is expected, we are often asked by folks if we have resources to teach them how to ‘Build Better Brains’.
In the absence of a comprehensive Brain Training program, and, in addition to it, it is the small things you do every single day that will dictate how well your brain and body functions well into your golden years. There is no quick fix. I repeat, there is no quick fix! While there are always the unforeseen circumstances that cause our health to decline, our brain and body health is largely well within our control.
Due to this demand for information, and realizing more and more that many folks are truly beginning to care about, and for, their brains; I have launched the ‘Train Your Brain Podcast with Dr. Michael Trayford’. This podcast was designed to deliver practical, everyday tips for building the best brain possible. Some will be familiar and some brand new, although it is the routine application of these tips that will help insulate you from one of the greatest fears of our time – that of a declining brain!
The daily tips will cover evidence-based topics and applications in the areas of physical, cognitive, metabolic, and lifestyle health; all of which impact and dictate the effectiveness of your greatest asset. I hope you will join us, and join in the conversation as we will be taking listener calls and questions, exploring popular topics in greater detail, conducting interviews, and putting listener ideas into action as the series progresses.
So, whether you’re dealing with neurological conditions such as brain injury (TBI), concussion, ADHD, dementia, memory loss, anxiety, depression, MS, Parkinson’s, PTSD, addiction and more; wanting to elevate performance in sports, academics and business; or simply looking to sharpen your mind and prevent or delay cognitive decline – this podcast is for YOU!
You can listen in daily at www.TrainYourBrainPodcast.com and/or subscribe on iTunes by searching for the Train Your Brain Podcast with Dr. Michael Trayford. See you on the air!
Every breath you take, every move you make (enter the distinct guitar sounds of The Police’s wildly popular 1983 hit) is controlled by your brain’s innate timing system. Whether physical movements or production of thoughts, your brain’s ability to time these magical feats appropriately is the difference between unnoticed normal everyday functioning and disastrous consequences.
Most can relate to the impact timing has on the way we move. We’ve all seen someone with Parkinson’s disease or brain injury, or simply decline in function with aging, struggle with what most of us take for granted (i.e. walking, tying shoes, speaking, etc.). Our ability to effortlessly time movement is taken for granted… Until that ability is lost.
On the other hand, it might be a bit more difficult for one to consider that the disorganized thoughts of those with schizophrenia or similar conditions has anything to do with timing. This is in fact a growing area of research where disorganized or uncoordinated thoughts are being related to uncoordinated motor activity such as walking and speech. When movements are improved through various types of physical training, individuals experience more efficient thought processing and communication of these thoughts. Through this lens it is quite easy to see how our thoughts, and even emotions, can be impaired by improper mental timing.
Can I improve my brain’s timing???
Musicians, dancers and other athletes would tell you… Absolutely! Simply involving yourself in activities that revolve around a regular beat or rhythm (cadence) will help to strengthen your mental timing ability. The obvious here would include activities such as music and dance.
But what if there are problems with my brain???
Previously mentioned brain injury and Parkinson’s disease would be natural barriers to improving timing in the brain. Studies also show that key physical abilities (bio-markers) such as balance and eye movements are impaired in those experiencing cognitive decline with aging. Challenges in these and other abilities will undoubtedly have an impact on our ability to improve timing. Addressing the physical and metabolic aspects of these conditions would be the logical first step in improving mental timing in any situation. For those with severe impairment, and for those looking to be the best they can be, there are other options.
Can my mental timing be measured and improved???
Fortunately, yes! With sophisticated measurement and training tools such as the Interactive Metronome, those with neurological conditions and peak performers alike can have their brain’s timing measured quite accurately. This particular program utilizes auditory (sound) cues to first measure and then train one’s mental timing capacities. Through matching body movements to a standardized metronome beat, the computer software can determine (down to the millisecond) how accurately one is timing. Numerous aspects of timing can be measured including early and late timing tendencies, left vs. right side of body differences, upper vs. lower body timing differences, consistency in timing from one beat to the next, and much more. Armed with this information, experienced clinicians such as those at APEX Brain Centers in Asheville, NC can design and deliver specific Brain Training programs to repair the deficient timing issues to the highest degree possible.
What does this all mean for me???
With intact and efficient mental timing our risk of injury due to falling decreases… Thought processing and problem solving become more efficient… Attention and focus get sharper… Memory formation and retrieval becomes much easier… Certain unwanted behavioral traits improve… Academics and test taking require less effort and produce less anxiety… Our limits of physical performance can skyrocket…
I believe you get the point. There are few aspects of humanism that are not positively impacted by an improvement in our brain’s innate timing abilities. Go exercise that rhythm – your brain will thank you!
Everyone that signs up for a 5 or more day full intensive training program at APEX Brain Centers in Asheville, NC, that is! (Unique offer details below).
While technology and all that come with it can cause significant impairment for many, it can also be used to provide an extreme advantage when it comes to Training your Brain. The ever-growing list of hi-tech applications (apps) for mobile devices and tablets is astounding, many of which hold significant promise for re-training brain dysfunction, and for improving upon already strong performance in those looking to reach their peak potential. As with anything, there is a downside – apps used improperly and not under expert guidance can, in some cases, be counter-productive, and even harmful!
The following are the main areas of apps for brain performance:
- Memory and Attention: We have all heard of that brain training program that begins with ‘L’ that most folks pronounce incorrectly! While this and many other similar apps are quite useful and largely without side-effects, they may not be providing all they claim in the absence of a comprehensive brain health program.
- Eye movements: The secret is out, eye movements are directly related to our higher, more human, cognitive brain functions. A simple Google search of ‘eye movements and cognition’ should get you rolling there! The challenge is that these sensitive windows into higher brain function can very easily be trained incorrectly, leading to further dysfunction or significantly limiting peak performance. User beware: Expert direction is essential with these type of apps!
- Neurofeedback/Biofeedback: By far the newest and most concerning area of mobile brain training, app stores are piling up with programs that will help you regulate your brainwaves, heart rate, muscle tension, and more. Common sense should let you know that training your brainwaves in the absence of higher education in neurophysiology and neuroplasticity might not be a very wise choice. Once again, user beware!
Although just a sampling of what’s available in the various app stores in the cyber world, the take home message here is that ANY effort in training your brain should be directed by a qualified health care provider trained in these areas of brain performance for maximum benefit and decreased probability of side-effects.
Enter the iPad…
All clients entering into a 5 or more day full intensive training program at APEX Brain Centers in Asheville, NC through May 31, 2015 will receive a FREE iPad Mini with Retina Display (or comparable device) as a valuable aid to your brain training program, and to help you continue progress once discharged. All you would need to do is have an iTunes account to purchase any needed applications (typically less than $35.00), and the desire to make your brain the best possible brain it can be.
This special offer is not to be combined with any offers and you must reference this post at the time of consultation or admission for validation purposes. Let us help you harness the power of technology and put you in the driver’s seat on your journey to Building a Better Brain!
History: B.M. is a 52 y.o. male with a history of hypertension (high blood pressure), hyperglycemia (elevated blood sugar), borderline hyperlipidemia (elevated blood fats), excessive weight gain, fatigue, numbness in both feet, dairy intolerance, depression, cognitive struggles, osteoarthritis, and gout. His last evaluation and laboratory analysis was performed approximately 4 years prior to evaluation at APEX Bran Centers in August of 2013. Persistent and worsening symptoms and rapidly declining health forced him to seek drastic change before it was too late. He was not taking any medications at the time of evaluation, or at any time during his therapeutic program.
Evaluation: August, 2013 – B.M. measured 5’ 8” tall and weighed in excess of 250 pounds. His blood pressure was 148/78 and heart rate recorded at 82 beats per minute. Salivary pH was 6.0. Upon re-assessment in late 2013, B.M. was weighing in at just under 200 pounds with reductions in blood pressure and heart rate noted as well. See below for the full listing of abnormal laboratory tests and their comparative measurements taken just over 2 months after beginning an intensive metabolic recovery program. All critical laboratory values are highlighted.
||1st Test – 8/28/13
||2nd Test – 11/4/13
||Unable to be calculated,
||triglycerides too high!
|Vitamin D (25-OH):
|C – reactive protein (cardiac):
Assessment: Based on evaluation and testing performed in August of 2013, it was evident that B.M was experiencing dangerous abnormalities in blood sugar handling and cardiovascular health, among others. In fact, he was displaying all the signs of Type II Diabetes and full blown Metabolic Syndrome (more on Metabolic Syndrome from the Mayo Clinic). Peripheral neuropathy and cognitive/emotional dysfunction were a direct reflection of his poor blood sugar handling as these conditions are consistent with poor lifestyle choices and impaired fuel delivery. B.M. was instructed to consult with his primary care physician for possible endocrine/cardiology consults due to the extreme and dangerous elevations in some of these values. He understood that most of these changes were driven by lifestyle choices and opted for a more holistic approach!
Intervention: B.M. was immediately placed on a rigorous course of medical food supplementation (3-5 times per day) specific for clients with blood sugar handling issues and Diabetes. This was supplemented with an unlimited quantity of green vegetables and approved whole food protein bars. In addition, he was placed on essential fatty acids, other key fats, and Vitamin D to assist with his metabolic struggles. Progressive cardiovascular and muscle resistance exercise protocols were implemented as tolerated. Subsequent to an 8 week program, at which time most of his functional gains were made, he was placed on additional supplements to complement the findings of his repeated laboratory analysis in November of 2013.
Results: In addition to the profound changes realized with standard laboratory testing outlined above, B.M. had a significant reduction in his weight and waist:hip ratio (a reliable predictor of cardiovascular risk and/or health). Energy levels increased while pain levels dropped, allowing for him to resume an increasingly active and productive lifestyle with work and leisure activities (including long distance cycling). His peripheral neuropathy all but vanished, save for the occasional tingling in the feet. Cognitive and emotional stability was regained with vast improvements in thinking and depressive episodes. Pain and other symptoms subsided concurrent with improvements in metabolic function and weight loss. His overall health status, risk of a dangerous vascular event, and potential longevity were all markedly improved. By all accounts B.M. is in a much better place with regard to his health, distancing himself from Type II Diabetes and significant cardiovascular risk. To this day he continues to experience the benefit of his hard work. As with many individuals, he does slip from time to time; but he knows full well that he is largely in control of his physiology, and he gets himself back on track when needed so as not to reach the alarming state of health he once was in!
You may often ask yourself, “Does my ability to maintain healthy balance have anything to do with how well I think, remember, and solve problems?” Well, maybe that exact thought (or anything close to it) has never actually crossed your mind, but it very well should. Assessment and treatment of impaired balance is being looked at as the “Holy Grail” for higher level thinking by many experts in the brain world!
The Benefits (and Consequences) of Bipedalism
Our ability to stand on two legs is nothing short of remarkable. Becoming bipedal is possibly our greatest feat as human beings. Balancing on the stilts we call legs requires a tremendous amount of brainpower. And walking, that’s an even greater accomplishment! Then why isn’t everyone talking about this? While standing, and even more so while walking, we are constantly in a state of falling. Think about this, when someone’s brain is “offline” due to alcohol consumption, disease, or simply waking up from a deep sleep, they have a dramatic increase in their likelihood of falling.
Our brain requires constant and precise input from the many sensory receptors located in our eyes, inner ears (vestibular system), and muscles and joints (proprioceptive system). Any damage to these systems, or changes in our brain’s control over these systems, will lead to measurable changes in our ability to balance and walk. It works both ways.
The Connection Between Balance and Cognition
Now that you understand the very basic connections between the brain and our ability to maintain balance, you can begin to see why it is essential to maintain healthy balance. Bipedal locomotion (walking on two legs) has long been associated with our larger and more complex human brains. From our early ancestors’ rudimentary tool making abilities to our descendants’ possibilities of inhabiting other planets in the future (for better or for worse), only humans are capable of generating the cognitive power to do such things. As much as I love my dogs, I cannot see them ever being able to sit and type an article as I sit to type this one (that is, at least while they remain on four legs)!
Over the past several decades, the research has been accumulating to support the fact that our ability to move through our environment (spatial navigation) is directly related to our ability to learn and remember. A groundbreaking paper published in the Journal of Vestibular Research, Does Vestibular Damage Cause Cognitive Dysfunction in Humans, demonstrates that the degree of damage to the vestibular system is directly correlated to changes in the hippocampus, which is a key component of memory and higher cognitive function.
A more recent paper published in the journal Stroke entitled Association of Postural Instability With Asymptomatic Cerebrovascular Damage and Cognitive Decline discusses the irrefutable link between poor balance, cognitive decline, and small blood vessel disease in the brain. Subjects that had a reduced ability to stand on one leg were clearly shown to have lower cognitive functions of memory and spatial awareness. The lead author of this study urged that those with postural instability (impaired balance) should receive special attention as they may be at greater risk of cognitive decline.
Noted in an article entitled Poor Balance Tied to Small-Vessel Disease, Cognitive Decline by Pauline Anderson on Medscape referencing the above-mentioned paper was the simple neurological observation of people’s ability to “rise, stand and walk” as “the single most important part of entire neurologic examination.” This was quoted from Dr. Jose Biller from Loyola University’s Department of Neurology. As with any general observation test, if someone is unable to “rise, stand and walk” they are clearly in moderate to advanced stages of balance impairment, and, very likely, moderate to advanced stages of associated cognitive decline. More sophisticated testing of balance is required to pick up abnormalities long before they are visible.
Dynamic posturography, or computerized assessment of postural systems, is the gold standard for measuring such abnormalities. Testing of eye movements with videonystagmography (VNG) and neurological evaluation of muscles and joints will help determine if the associated systems of balance are impaired.
Please read my blog The Importance of Early Screening for Alzheimer’s, Dementia, and Cognitive Decline to find a more comprehensive list of physical tests that can be performed.
What to Do if You Are Having Balance Problems
With early detection of balance problems, you are in the driver’s seat and have the full ability to act on repairing these abnormalities to the highest degree possible. As with anything else in your body, (or your house, your car, etc.) the longer you wait to act, the less likely you will be able to fully recover much needed function and perform at your highest ability. If you have been having problems standing or walking, make an appointment with a practitioner who specializes in balance issues for further screening as soon as possible. The better your ability to balance, the better your ability to think, so do not hesitate to get checked out!