Neuroplasticity- MoreThan Just Movement

12/27/2009

Neuroplasticity- more than just movement

Neuroplasticity is defined as the ability of brain cells and neural networks (brain circuits) to change or increase their connections in response to new activities in order to promote better brain function and improved performance. There are many activities that can enhance neuroplasticity or brain function. It is not too surprising to learn that many of the same activities that improve quality of life also promote Neuroplasticity. In other words, the brain has developed in ways to further help us get the most out of activities that improve our quality living.

The benefits of exercise and physical activity are highlighted in the posting Neuroplasticity- Practice Makes Perfect.  This article will focus on non-movement activities that improve brain function and promote neuroplasticity.

Don’t forget about stress!  Animal studies show that exercise helps protect nerve cells from the toxic effects of MPTP that would otherwise cause parkinsonism. When mice were exercised and stressed they had more cell damage from this toxin than the mice that exercised but were not stressed. Interestingly the stressed and exercised mice also had more cell damage compared to mice that did not exercise. Stress is a big part of life and chronic stress affects more than our mood and anxiety. Consider adding exercises that include mindfulness training, relaxation and stress management techniques such as Yoga and Tai chi. Add mindfulness training and stress reduction techniques to your daily life routine. 

Emotional health is important! Treating depression is an important part of helping us live our best. Depression is common in Parkinson’s and for some may even begin before the movement symptoms. Research shows that depression is associated with lower levels of brain derived nerve growth factor (BGDNF) a substance that helps support the health and numbers of brain cells. Interestingly medical treatment of depression is associated with an increase in measured levels of growth factors. Whether this is a direct affect or indirectly related to the benefits of treated depression such as a greater participation in exercise, improved relationships and social life, creative outlets or positive thinking is not known. Talk about your mood with family and your healthcare provider. Don’t feel that you should be depressed because you have Parkinson’s. Seek treatment if needed.

‘Rethink your thoughts’! Cognitive behavioral therapy (CBT) is based on the idea that our mood can be influenced by our thoughts and beliefs- both positive and negative. We learn to associate these positive or negative thoughts with everyday activities. Sometimes we are not even aware of, or understand what has generated these thoughts. Negative thoughts influence our behavior and affect our mood causing depression and anxiety. CBT helps identify those negative thought patterns and beliefs and replace them with thoughts that are more positive or lead to more positive adaptation. Successful CBT requires brain re-learning. Work is just beginning to explore how CBT can help change the course of mood symptoms in Parkinson’s but research in other areas do reinforce the benefits of this therapy on brain activity. Patients with chronic fatigue syndrome that use CBT have increase in volume of frontal brain regions when compared with those that do not.  Think about those thoughts and the internal dialogue  that drives your mood in a negative or positive direction. Work on changing that dialog. A trained mental health counselor can help you in this process. 

Exercise strengthens your mind! The accompanying article on Neuroplasticity and exercise explores how movement helps brain activity in motor areas of the brain. Movement also helps sharpen our cognitive skills. Research in older people and in people with a form of dementia called Alzheimer’s disease shows that exercise helps cognitive function. Recent studies are beginning to show that this is also the case in Parkinson’s. More information on the effects of exercise on the mind can be found at Move to remember- exercise to help cognitive abilities.  This is just one more reason why you should stay active, chose exercise that is challenging, creative and rewarding.

Use your imagination and the power of imagery! Imagery can help performance and is often used by Olympic level athletes. Their performance is enhanced by both physical and imagined practice. Measures of electrical activity related to movement in key areas of the brain shows an increase level of activity when imagery is combined with movement. A research study of physical therapy for Parkinson’s patients showed that imagined performance coupled with the actual activity (engaging the mind and body) improved outcomes. Don’t just go through the motions in exercise class. Use your mind to visualize your movement and your body’s response to practice as well as visualize the improvement you would like to see with practice. Yoga and Tai chi are examples of exercise activities that combine the mind and imagery in practice.

More on the power of the mind! In one study, people with Parkinson’s that have a higher level of education have less problems with depression, sleep, hallucinations and medicine induced hallucinations. Although there could be many reasons for this, it is possible that education is creating new nerve cell connections and brain activities- further strengthening key regions for brain function.

Harness the power of relaxation! Meditation and various mindfulness techniques help us increase our ability to relax and reduce the effects of chronic stress. Meditation improves outcomes in so many medical conditions from heart, HIV, cancer, to blood pressure.  Brain imaging and brain wave studies of Buddhist monks show changes in brain wave activity in regions of the frontal lobe with meditation. This area of the brain is involved in movement, thinking and mood control. The basal ganglia (brain region affected by Parkinson’s disease) projects to the frontal lobes and changes in this region are seen in people with Parkinson’s. A more specific form of Zen Buddhist mind training called integrative mind body training (designed to focus on attention and self-regulation of body changes) enhances brain  and autonomic nervous system(learn more about the autonomic nervous system in relaxation response) activity more than simple relaxation training when measured  5 days after training. Of interest is the finding that people who meditate had a measureable increase in thickness in the brain cortex in areas associated with attention and this change was most significant in older patients suggesting that meditation can ‘offset’ age related cell loss. 

Taken together, this information highlights the long-term problems with stress and the importance of taking the steps to improve mood, reduce life stress, better manage stress or change how we react to everyday stress. Adding techniques such as meditation or even simple deep breathing improves how we react to stress and helps us elicit the relaxation response. This exercise improves brain and nervous system activity and research is proving that it can even improve brain size. 

References

Behavioral Brain Research 2005. 165:210.

International Journal of  Neuoropsychopharmacology.  2008. 11;1169.

Cognitive and Behavioral Neurology 2007. 20;68.

Brain 2008. 131; 2172-80.

Proceeds National Academy of Science 2009. 106;8865

Neuroreport 2005. 28; 16: 1893-7.

Author:  Monique L. Giroux, MD Medical Director Booth Gardner Parkinson’s Care Center at Evergreen Hospital Medical Center, Kirkland WA