Can you expand your brain?

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Robert Friedman

Majid Fotuhi, chief medical officer of the NeurExpand Brain Center, examines an MRI of the brain. The center, which will soon open a branch in Columbia, helps patients with memory problems by working to increase brain size through lifestyle improvements, memory exercises and biofeedback.
Photo by Christopher Meyers

“Just because your brain can’t hop on a treadmill doesn’t mean it can’t exercise,” said Dr. Majid Fotuhi, chief medical officer of the NeurExpand Brain Center set to open in November on the Howard County General Hospital campus.

The center, which Fotuhi will head, will treat “anyone who has concerns about memory and brain functions,” he said. “Our memory makes us who we are. It shapes the kind of life we live.”

Fotuhi, a Baltimore-based neurologist, is fast becoming recognized by experts, from Dr. Mehmet Oz to RealAge author Dr. Michael Roizen, as being on the cutting edge of treating brain and memory problems.

Fotuhi already operates one center in Lutherville, and plans call for another one next year in Chevy Chase. Executives of the company that has been formed to run the brain centers have set a goal to open some 100 centers around the country in the next five years, according to the Baltimore Business Journal.

“What this [center] is designed to do is to focus on what you can do to make your brain stronger and improve your memory,” said David Abramson, who helped put together the new company. He said that he sees a significant business opportunity among the millions of aging baby boomers concerned about their brain functions.

Memory loss isn’t inevitable

Whereas memory specialists have long concentrated on the physiological elements of the brain, the centers will move to improve the brain’s functioning by treating the lifestyle — eating, sleeping, exercising — of the individual to whom the brain belongs.

“Slowing of memory and memory loss is a common occurrence as we age,” said Fotuhi, a Harvard Medical School graduate who got his Ph.D. in neurology from Johns Hopkins University.

“But it doesn’t have to happen,” he said. “Through physical and mental activities, people can keep their brain and memory in good shape and ward off Alzheimer’s.”

A recent article in AARP Magazine noted that “a mounting stack of studies suggests that the condition of the body somehow affects the condition of the brain…Being obese quadruples the risk of [Alzheimer’s]. Diabetes can speed up brain shrinkage, as can high blood pressure,” as well as sleep apnea, depression and everyday stress.

Depression, which used to be treated almost exclusively by psychiatrists going into mental histories and prescribing drugs, can now be greatly relieved, according to mental health specialists, through a change in lifestyle — especially increased exercise.

And Fotuhi said not only could memory loss be averted, it could also improve through a 12-week, individualized program devised at the center and meant to grow the brain.

“The best remedy for late-life Alzheimer’s disease is mid-life intervention,” he said.

While the program costs several thousand dollars, “all our testing and treatment protocols are covered by Medicare and major insurances,” Fotuhi said. “Patients do not need to have a major neurological disease to qualify.”

Fighting brain shrinkage

The treatment aims to expand the hippocampus, the portion of the brain deep within the temporal lobes that controls short-term memory and determines which remembrances are stored long-term. It’s the hippocampus that “makes you, you.” said the 51-year-old Fotuhi.

It’s also the part of the brain that shrinks with age more than any other. “When you get older, the hippocampus has a tendency to shrink, usually .5 percent each year after 50, which would mean shrinkage of 10 percent in 20 years,” said Fotuhi.

And the size of your hippocampus matters. “Changes in its size bring noticeable changes in a person’s memory and cognitive function,” he said. When it comes to peak brain performance, bigger is undeniably better.

But can natural shrinkage with age be reversed? Yes, Fotuhi said. 

He pointed to research published a few years ago in the Proceedings of the National Academy of Sciences in which one group of seniors did stretching exercises, while another group walked 45 minutes four days a week, both for a year.

MRIs showed that while areas of the hippocampus in the stretchers shrank by about 1.5 percent during that period, those of the walkers increased by about 2 percent, “effectively reversing age-related loss in volume by 1 to 2 years,” the researchers said.

Furthermore, the increased brain volume was associated with improved memory function and oxygen consumption in the walkers compared with the stretchers.

In a book published in 2008, Fotuhi suggested that a great workout for the brain would be doing the New York Times crossword puzzle daily.

He has also recommended that older adults put on their dancing shoes. Dancing is the perfect activity to keep the brain young, Fotuhi said. He told CNN that he began ballroom dancing when he was a student at Harvard Medical School, and that he and his wife Bita have mastered the tango.

Dancing, crossword puzzles and other lifestyle changes may sound simple, but they’re based on sound science, Roizen said in an interview.

“I think that what Dr. Fotuhi is recommending is something that helps you expand your current brain power. Whether exercise or memory games, his treatment is at the forefront of medicine,” said Roizen, who heads the Wellness Clinic at the Cleveland Clinic and wrote the introduction to Fotuhi’s newest book, published in September.

In the book, Boost Your Brain: The New Art + Science Behind Enhanced Brain Performance, Fotuhi calls the hippocampus “the gateway for new memories and essential for learning; as such, it is a major player in the quest for a bigger, stronger brain.”

Look at the hippocampus as if it were the brain’s librarian, Fotuhi suggests in Boost Your Brain. “It processes all new information and decides what to keep and what to discard....The good stuff — that which the hippocampus deems storage-worthy — is sent to various parts of the cortex for long-term storage.” What is deemed forgettable may be held for a short-time, then is tossed.

How the program works

Fotuhi stressed that his 12-week program is not in any way akin to the “miracle” cures promised on TV  infomercials for various health concerns. Rather, it is an individualized treatment plan with proven results.

“I take pride in the fact that 90.6 percent of the patients who have gone through this program have significant improvement of their memories,” he said.

”The one-size-fits-all approach does not work, and we need to assess each person’s current brain health and make a plan with that in mind,” he said.

The plan starts with a doctor visit and extensive testing. Among other things, the participants give their health history, get blood-flow exams, physical stress tests and mental memory tests. An EEG (electroencephalography) checks out brain-wave function.

After physical and mental habits are assessed, the doctor explains how to immediately embark upon a drug-free personalized treatment program.

Patients meet with a “brain coach” who helps them with tasks to boost memory, including memorizing a list of random items. Neurofeedback therapy — biofeedback applied to the brain using EEG — is also part of the program.

Some patients, such as those who had a concussion in the past, require more training than others to enhance their brain function and are offered cognitive training. 

Stress reduction strategies and meditation are also offered as ways to improve memory and increase brain size. Treatments for sleep disorders and apnea are also available.

In Boost Your Brain, Fotuhi said that “with a greater understanding of how to stave off brain atrophy, it’s likely that just as we have experienced an increase in lifespan over the past century, we will see an increase in our ‘brain span’ — the portion of our lives that we live in peak cognitive condition.

“Memory, creativity, mental agility — our ability to respond quickly or ‘connect the dots’ — all can be improved with a bigger brain,” Fotuhi said.

For more information on the NeurExpand Brain Center, call (443) 393-6280 or visit www.NeurExpand.com/BeaconHow.