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How to rewire your brain to feel good on Monday

<a href="https://theconversation.com/profiles/cristina-r-reschke-1413051">Cristina R. Reschke</a>, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> and <a href="https://theconversation.com/profiles/jolanta-burke-315263">Jolanta Burke</a>, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> If you hate Mondays, you’re most certainly in good company. After a couple of days off, many of us have difficulty settling back into our routines and work duties. You may even have dread and anxiety that seeps into the weekend in the form of “<a href="https://theconversation.com/three-ways-to-tackle-the-sunday-scaries-the-anxiety-and-dread-many-people-feel-at-the-end-of-the-weekend-187313">Sunday scaries</a>”. You can’t always change your schedule or obligations to make Mondays more appealing, but you may be able to “reprogram” your brain to think about the week differently. Our brains love predictability and routine. Research has shown that lack of routine is associated with <a href="https://journals.sagepub.com/doi/full/10.1177/0003122418823184">decline in wellbeing and psychological distress</a>. Even though the weekend heralds a leisurely and pleasant time, our brain works hard to adjust to this sudden change to a routine. The good news is that the brain does not need to make too much effort when adjusting to the weekend’s freedom and lack of routine. However, it’s a different story when coming back to the less pleasant activities, such as a to-do list on Monday morning. One way to adjust to post-weekend change is introducing routines that last the whole week and have the power to make our lives <a href="https://journals.sagepub.com/doi/full/10.1177/0146167218795133">more meaningful</a>. These may include <a href="https://portal.research.lu.se/en/publications/routines-made-and-unmade">watching your favourite TV programme, gardening</a> or going <a href="https://pubmed.ncbi.nlm.nih.gov/22976286/">to the gym</a>. It is helpful to do these things at the same time every day. Routines improve our <a href="https://pubmed.ncbi.nlm.nih.gov/16448317/">sense of coherence</a>, a process that allows us to make sense of the jigsaw of life events. When we have an established routine, be it the routine of working five days and taking two days off or engaging in a set of actions every day, our lives become <a href="https://journals.sagepub.com/doi/full/10.1177/0146167218795133">more meaningful</a>. Another important routine to establish is your sleep routine. <a href="https://www.nature.com/articles/s41746-021-00400-z">Research shows</a> that keeping consistent sleep time may be as important for enjoying Mondays as how long your sleep lasts or its quality. Changes in sleep patterns during weekends trigger <a href="https://www.mdpi.com/2072-6643/13/12/4543">social jetlag</a>. For instance, sleeping in later than usual and for longer on free days may trigger a discrepancy between your body clock and socially-imposed responsibilities. This is linked to higher stress levels on Monday morning. Try to keep a set time for going to bed and waking up, avoid naps. You might also want to create a 30 minute “wind-down” routine before sleep, by turning off or putting away your digital devices and practising relaxation techniques. <h2>Hacking your hormones</h2> Hormones can also play a role in how we feel about Mondays. For instance, cortisol is a very important multifunction hormone. It helps our bodies to control our metabolism, regulate our sleep-wake cycle and our response to stress, among other things. It is usually released about an hour before we wake up (it helps us feel awake) and then its levels lower until the next morning, unless we’re under stress. Under acute stress, our bodies release not only cortisol, but also adrenaline in preparation for fight or flight. This is when the heart beats fast, we get sweaty palms and may react impulsively. This is our amygdala (a small almond-shaped area in the base of our brains) hijacking our brains. It creates a super fast emotional response to stress even before our brains can process and think whether it was needed. But as soon we can think – activating the brain’s prefrontal cortex, the area for our reason and executive thinking – this response will be mitigated, if there is no real threat. It is a constant battle between our emotions and reason. This might wake us up in the middle of the night when we’re too stressed or anxious. It shouldn’t be surprising then that cortisol levels, measured in saliva samples of full-time working individuals, tend to be higher on Mondays and Tuesdays, with the lowest levels reported on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824866/">Sundays</a>. As a stress hormone, cortisol fluctuates daily, but not consistently. On weekdays, as soon as we wake up, <a href="https://psycnet.apa.org/record/2007-18151-008">cortisol levels soar</a> and variations tend to be higher than on <a href="https://pubmed.ncbi.nlm.nih.gov/11324714/">weekends</a>. To combat this, we need to trick the amygdala by training the brain to only recognise actual threats. In other words, we need to activate our prefrontal cortex as fast as possible. One of the best ways to achieve this and lower overall stress is through relaxation activities, especially on Mondays. One possibility is mindfulness, which is associated with a <a href="https://pubmed.ncbi.nlm.nih.gov/23724462/">reduction in cortisol</a>. <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">Spending time in nature</a> is another method – going outside first thing on Monday or even during your lunch hour can make a significant difference to how you perceive the beginning of the week. Give yourself time before checking your phone, social media and the news. It’s good to wait for cortisol peak to decrease naturally, which happens approximately one hour after waking up, before you expose yourself to external stressors. By following these simple tips, you can train your brain to believe that the weekdays can be (nearly) as good as the weekend.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/199236/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cristina-r-reschke-1413051">Cristina R. Reschke</a>, Lecturer in the School of Pharmacy and Biomolecular Sciences & Funded Investigator in the FutureNeuro Research Centre, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> and <a href="https://theconversation.com/profiles/jolanta-burke-315263">Jolanta Burke</a>, Senior Lecturer, Centre for Positive Health Sciences, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-rewire-your-brain-to-feel-good-on-mondays-199236">original article</a>.

Mind

Retiring early can be bad for the brain

<a href="https://theconversation.com/profiles/plamen-v-nikolov-1112610">Plamen V Nikolov</a>, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a> The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work. <h2>The big idea</h2> People who retire early suffer from accelerated cognitive decline and may even encounter early onset of dementia, according to a I conducted with my doctoral student <a href="https://sites.google.com/binghamton.edu/alan-adelman/home">Alan Adelman</a>. To establish that finding, we examined the effects of a rural pension program China introduced in 2009 that provided people who participated with a stable income if they stopped working after the official retirement age of 60. We found that people who participated in the program and retired within one or two years experienced a cognitive decline equivalent to a drop in general intelligence of 1.7% relative to the general population. This drop is equivalent to about three IQ points and could make it harder for someone to <a href="https://doi.org/10.1017/S0033291700008412">adhere to a medication schedule</a> or <a href="https://doi.org/10.1111/j.1475-%205890.2007.00052.x">conduct financial planning</a>. The largest negative effect was in what is called “delayed recall,” which measures a person’s ability to remember something mentioned several minutes ago. Neurological research <a href="https://doi.org/10.1001/archneur.1991.00530150046016">links problems in this area to an early onset of dementia</a>. <h2>Why it matters</h2> Cognitive decline refers to when a person has trouble remembering, learning new things, concentrating or making decisions that affect their everyday life. Although some cognitive decline appears to be an inevitable byproduct of aging, faster decline can have profound adverse consequences on one’s life. Better understanding of the causes of this has powerful financial consequences. Cognitive skills – the mental processes of gathering and processing information to solve problems, adapt to situations and learn from experiences – are crucial for decision-making. They influence an individual’s ability to process information and <a href="https://www.jstor.org/stable/1818642">are connected to higher earnings</a> and a <a href="https://www.doi.org/10.1257/jep.25.1.159">better quality of life</a>. Retiring early and working less or not at all can generate large benefits, such as reduced stress, better diets and more sleep. But as we found, it also has unintended adverse effects, like fewer social activities and less time spent challenging the mind, that far outweighed the positives. While retirement schemes like the 401(k) and similar programs in other countries <a href="https://www.doi.org/10.1023/B:PUCH.0000035859.20258.e0">are typically introduced to ensure the welfare of aging adults</a>, our research suggests they need to be designed carefully to avoid unintended and significant adverse consequences. When people consider retirement, they should weigh the benefits with the significant downsides of a sudden lack of mental activity. A good way to ameliorate these effects is to stay engaged in social activities and continue to use your brains in the same way you did when you were working. In short, we show that if you rest, you rust. <h2>What still isn’t known</h2> Because we are using data and a program in China, the mechanisms of how retirement induces cognitive decline could be context-specific and may not necessarily apply to people in other countries. For example, cultural differences or other policies that can provide support to individuals in old age can buffer some of the negative effects that we see in rural China due to the increase in social isolation and reduced mental activities. Therefore, we can not definitively say that the findings will extrapolate to other countries. We are looking for data from other countries’ retirement programs, such as India’s, to see if the effects are similar or how they are different. <h2>How I do my research</h2> A big focus of the <a href="https://scholar.harvard.edu/pnikolov/my-research-group-1">economics research lab</a> I run is to <a href="http://www.nber.org/%7Enikolovp/research.html">better understand</a> the causes and consequences of changes in what economists call <a href="https://www.britannica.com/topic/human-capital">“human capital”</a> – especially cognitive skills – in the context of developing countries. Our lab’s mission is to generate research to inform economic policies and empower individuals in low-income countries to rise out of poverty. One of the main ways we do this is through the use of randomized controlled trials to measure the impact of a particular intervention, such as retiring early or access to microcredit, on education outcomes, productivity and health decisions. <a href="https://theconversation.com/profiles/plamen-v-nikolov-1112610">Plamen V Nikolov</a>, Assistant Professor of Economics, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/retiring-early-can-be-bad-for-the-brain-145603">original article</a>.

Mind

The best exercises to boost your brain health after 60

<a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a> Have you ever thought about why we have a <a href="https://theconversation.com/fr/topics/cerveau-21903">brain</a>? The obvious answer might be “to think”. But scientist Daniel Wolpert came up with a completely different explanation at the <a href="https://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains">2011 meeting of the Society for Neuroscience</a>: <blockquote> “We have a brain for one reason and one reason only: to produce adaptable and complex movements” </blockquote> <h2>Use your brain to stay efficient</h2> The brain, in other words, is the orchestra conductor which orders the body’s movements. We call the faculties that allow us to interact with our environment cognitive abilities. These include concentrating, learning, reasoning, adapting and communicating with others. Every one of them is key in enabling us to go about our routine and help us maintain a good lifestyle. So, how can we best take care of our brains so that they can stay as efficient as long as possible? Contrary to popular belief, the brain does not deteriorate continuously with age. Instead, it only sees the number of its brain cells drop and connections deteriorate <a href="https://www.bmj.com/content/344/bmj.d7622">from the age of 45 onwards</a> as part of a normal ageing process. But cerebral plasticity, although reduced, is present until the end of life. Each individual will build up a cognitive reserve throughout their lives. The more positive, rich and stimulating the lifestyle, the more powerful and effective the reserve. In other words, it’s possible to moderate the effects of age on cognition. <h2>The benefits of physical activity on cognitive capacity after 60</h2> In fact, much research shows indeed that physical activity improves cognitive capacity, even after the age of 60. From increased memory, better reactivity to greater planning skills, the <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-072720-014213">benefits are endless</a>. Despite this, few older folks engage in <a href="https://theconversation.com/fr/topics/activite-physique-adaptee-apa-146288">physical education</a> adapted to their bodies on a regular basis. Poor motivation and access to these exercises are some of the factors don’t help. With that in mind, many carers might be tempted to offer older people monotonous, routine activities because of their diminishing physical, cognitive and sensory abilities. And indeed, for a long time, the range of sports on offer and research in this field revolved around the same triptych: gentle gymnastics, walking and yoga. However, you’ll reap more benefits by <a href="https://www-sciencedirect-com.ezproxy.u-paris.fr/science/article/abs/pii/B9780444633279000175">combining different training methods</a>. <h2>Three ingredients to train the brains of senior citizens</h2> Researchers are currently attempting to crack the winning formula that would flex older people’s cognitive, as well as physical muscles. It’ll consist of three main ingredients: First ingredient: complex physical and motor stimulation of at least moderate intensity. Moderate cardio workouts not only improve cardiorespiratory health but also make the brain more <a href="https://www.nature.com/articles/22682">efficient</a>. Overall improved cardiofitness, in turn, allows the brain to receive more oxygen and even to generate <a href="https://www.pnas.org/doi/full/10.1073/pnas.1015950108">new neurons in the hippocampus</a>, where memory is lodged. It therefore makes sense for programmes designed to boost cognitive function to include cardio. But it is also <a href="https://journals.sagepub.com/doi/abs/10.1111/1467-9280.t01-1-01430">necessary to combine them with muscle-strengthening, flexibility and balance exercises to achieve greater benefits</a>. In addition, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763413001012">researchers</a> emphasise the importance of adding situations requiring complex motor skills and coordination, as these would have a significant impact on cognitive functions (e.g. memory, attention and mental flexibility), particularly in the elderly. Second ingredient: fire up those brain cells during exercises Incorporating cognitive stimulation, such as remembering information for a period of time and executing it, anticipating actions, or planning a move, is another winning strategy. When cognitive stimulation is combined with physical activity, it can produce <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">synergistic effects</a> and, as a result, be more effective on cognitive functions. _Third ingredient: group activities that lead to social interaction. _ Working out as part of a group has been shown to help us <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001756">persevere through it</a>. What this winning formula could look like in practice is still being researched. At present, there are two broad types of exercises that have caught our attention that could help older people stay sharp. <h2>Opting for cooperative and oppositional team sports</h2> Team sports offer much more than just physical exercise sessions. What’s particularly great about them is that they don’t only challenge cardiorespiratory balance, but tap into the whole body’s physical skill-set. Take basketball or handball, for example: to move around the court, dribble or score, balance, coordination and flexibility are essential. Muscular strength is also required for passing, recovering the ball and moving around. These team sports can be suitable even after the age of 60, provided they are properly supervised. From a cognitive point of view, these activities create situations that are always new, rich and stimulating. We call this double combination of stimuli <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">simultaneous training</a>. A number of researchers have highlighted the importance of this cognitive involvement in team sports and encourage their practice, particularly among the elderly. Recent studies, such as <a href="https://linkinghub.elsevier.com/retrieve/pii/S162748302100129X">the one carried out in 2022</a> by French researchers, have shown that participation in team sports improves short-term visuospatial memory (which enables people, for example, to remember the location of certain objects for a limited period of time) and planning skills in the elderly. <h2>Get your body moving with exergames</h2> Another promising avenue are exergames – video games that require players to move around to play. Named after the contraction of “exercise” and “games”, they grew popular in the 2000s thanks to Nintendo’s Wii and Switch and Microsoft’s Kinect. Exogames have been thought out to exercise different fitness skills, such as balance, endurance, strength, and coordination, while simultaneously stimulating cognitive functions. Among older people, <a href="https://psycnet.apa.org/record/2011-27707-001">several research studies</a> show that this type of training helps to improve many physical and cognitive abilities. In 2020, a new generation of exergames emerged, making use of interactive walls to create an even more immersive gaming experience, such as Neo Xperiences’ Neo-One, Sphery’s ExerCube and Lü’s Aire interactive. In these games combining real and virtual worlds, physical objects (such as balls) and digital objects coexist and interact in real time. A <a href="https://link.springer.com/article/10.1007/s11357-023-00952-w">recent study</a> compared an exergame programme assisted by an immersive wall with a walking and muscle-strengthening programme. Its results suggest that this new generation of exergames may be more effective on cognitive abilities than traditional training. Combining physical and cognitive exercises offers the best chance to keep one’s brain health while keeping fit. This is essential for an active and fulfilling life, whatever your age.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, Doctorante en sciences du mouvement, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, Maitre de conférences HDR, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, Maître de conférences en STAPS, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-best-exercises-to-boost-your-brain-health-after-60-237162">original article</a>.

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Do mobile phones cause brain cancer? Science makes definitive call

The question of whether mobile phones - specifically the electromagnetic radiation or radio waves emitted by these devices - cause cancer has been debated and researched for a long time, and now scientists have made a definitive call. A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. The systematic review, led by the Australian Radiation Protection and Nuclear Safety Agency (Arpansa), examined over 5,000 studies, which included 63 observational studies on humans published between 1994 and 2022 and is "the most comprehensive review to date" according to review lead author, associate prof Ken Karipidis. “We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. They found no overall association between mobile phone use and cancer, even if people have used it for a long time (over 10 years) or spend a lot of time on their phones. “I’m quite confident with our conclusion. And what makes us quite confident is … even though mobile phone use has skyrocketed, brain tumour rates have remained stable,” Karipidis continued. Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. Karipidis said people hear the word radiation and assume it is similar to nuclear radiation, “and because we use a mobile phone close to the head when we’re making calls, there is a lot of concern.” He clarified that “radiation is basically energy that travels from one point to another. There are many different types, for example, ultraviolet radiation from the sun." “We’re always exposed to low-level radio waves in the everyday environment.” While exposure from mobile phones is still low, it is much higher than exposure from any other wireless technology sources since they are used close to the head, Karipidis said. The association between mobile phones and cancers came about from early studies comparing differences between those with and without brain tumours and asking about their exposure history. According to Karipidis, who is also the vice-chair of the International Commission on Non-Ionizing Radiation Protection, the results from these kind of studies tend to be biased, as the group with the tumour tend to overreport their exposure. Based on these early studies WHO’s International Agency for Research on Cancer (IARC) designated radio-frequency fields like those from mobile phones as a possible cancer risk, but Karipidis said "this classification doesn’t mean all that much”. This is because the IARC has different classifications of cancer risk, with some substances classified as a “definite” carcinogen (such as smoking), and others as “probable” or “possible” carcinogens. Tim Driscoll, a professor at the University of Sydney and chair of the Australian Cancer Council’s occupational and environmental cancers committee, also backed the systematic review. “I think people should feel reassured by this study … but it’s worthwhile just remembering that the studies aren’t perfect, but the weight of evidence certainly is that mobile phones should be considered safe to use in terms of any concerns about increased risk of cancer,” Driscoll said. Images: Shutterstock

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Can a 10-year-old be responsible for a crime? Here’s what brain science tells us

<a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> The age a child can be arrested, charged and jailed in Australia is back in the spotlight. Last year, the Northern Territory became the first jurisdiction to raise the age of criminal responsibility from ten to 12. Now its new, tough-on-crime government has pledged to <a href="https://www.sbs.com.au/nitv/article/incoming-chief-minister-says-age-of-criminal-responsibility-to-be-lowered-to-10-years-old/a1xm9jy9c">return it to ten</a>. It comes after Victoria <a href="https://www.abc.net.au/news/2024-08-13/victoria-youth-justice-reform-criminal-age/104217160">walked back</a> its earlier commitment to raise the age to 14, settling instead on 12. But the United Nations Committee on the Rights of the Child says 14 should be the absolute <a href="https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-24-2019-childrens-rights-child">minimum</a>. It raised this age from its earlier recommendation (in 2007) of 12, citing a decade of new research into child and adolescent development. So what does the science say? What happens to the brain between ten and 14? And how much can those under 14 understand the consequences of their actions? <h2>Who is an adolescent?</h2> Our research shows adolescence is a <a href="https://pubmed.ncbi.nlm.nih.gov/30169257/">critical period</a> for development. It’s the time children’s experiences and explorations shape how they develop cognitive skills (including critical thinking and decision making), as well as social and emotional skills (including moral reasoning). Adolescence also lasts longer than we tend to think. Important brain development begins during late childhood, around eight to nine years. Intense changes then follow during early adolescence (ages ten to 14). But these changes continue well into the twenties, and full cognitive and emotional maturity is not usually reached until around age 24. However, everyone’s brain matures at a different rate. That means there is no definitive age we can say humans reach “adult” levels of cognitive maturity. What we do know is the period of early adolescence is critical. <h2>What does puberty do to the brain?</h2> Puberty is a defining feature of early adolescence. Most of us are familiar with the changes that occur to the body and reproductive systems. But the increase in puberty hormones, such as testosterone and oestrogen, also trigger changes to the brain. These hormones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453017313252?via%3Dihub">increase most sharply</a> between ten and 15 years of age, although gradual changes continue into the early twenties. Puberty hormones change the structures in the brain which process emotions, including the amygdala (which encodes fear and stress) and ventral striatum (involved in reward and motivation). This makes adolescents particularly reactive to emotional rewards and threats. <a href="https://doi.org/10.1016/j.cortex.2019.04.024">Our research</a> has shown the brain’s sensitivity to emotions increases throughout early adolescence until around 14 or 15 years old. At the same time, changes in puberty have <a href="http://dx.doi.org/10.1037/pspp0000172">been linked</a> to increased sensation seeking and impulsive behaviours during early adolescence. This context is crucial when we discuss the behaviour of children in the ten to 14 age range. The way their brains change during this period makes them more sensitive and responsive to emotions, and more likely to be seeking experiences that are new and intense. <h2>How do adolescents make decisions?</h2> The emotional context of puberty influences how younger adolescents make decisions and understand their consequences. Decision making relies on several basic cognitive functions, including the brain’s flexibility, memory and ability to control impulses. These cognitive abilities – which together help us consider the consequences of our actions – undergo some of the <a href="https://doi.org/10.1523/JNEUROSCI.1741-13.2013">steepest development</a> between ages ten and 14. By age 15, the ability to make complex decisions has usually <a href="https://doi.org/10.1037/lhb0000315">reached adult maturity</a>. But adolescents at this age remain highly susceptible to emotions. So while their brain may be equipped to make a complex decision, their ability to think through the consequences, weighing up costs and benefits, can be clouded by emotional situations. For example, <a href="https://doi.org/10.1111/cdev.12085">research has shown</a> 13-14 year-olds were more distracted from completing a task and less able to control their behaviour when they viewed images that made them feel negative emotions. The social world of teenagers also has a significant impact on how they make decisions – especially in early adolescence. One study found that while older adolescents (aged 15-18) are more influenced by what adults think when weighing up risk, adolescents aged 12-14 <a href="https://journals.sagepub.com/doi/full/10.1177/0956797615569578">look to other teenagers</a>. Experiments <a href="https://doi.org/10.1177/0272431616648453">have also shown</a> adolescents aged 12-15 make riskier decisions when they are with peers than by themselves. Their brain responses also suggest they experience a greater sense of reward in taking those risks <a href="https://doi.org/10.1093/scan/nsy071">with peers</a>. <h2>How do teens understand the consequences of their actions?</h2> The concept of <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp2122/Quick_Guides/MinimumAgeCriminalResponsibility">criminal responsibility</a> is based on whether a person is able to understand their action and know whether it is wrong. Moral reasoning – how people think about right and wrong – depends on the ability to understand another person’s mental state and adopt their perspective. These skills are in development <a href="https://doi.org/10.1016/j.biopsych.2020.09.012">across adolescence</a>. Research suggests it may take more effort for adolescent brains to process <a href="https://doi.org/10.1162/jocn.2009.21121">“social” emotions</a> such as guilt and embarrassment, compared to adults. This is similar when they make <a href="https://doi.org/10.1080/17470919.2014.933714">moral judgements</a>. This evidence suggests teenage brains may have to work harder when considering other people’s intentions and desires. Young adolescents have the cognitive ability to appreciate they made a bad decision, but it is more mentally demanding. And social rewards, emotions and the chance to experience something new all have a strong bearing on their decisions and actions in the moment — possibly more than whether it is right or wrong. <h2>Early adolescence is critical for the brain</h2> There are also a number of reasons adolescent brains may develop differently. This includes various forms of neurodisability such as acquired brain injury, fetal alcohol spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and intellectual disability, as well as exposure to trauma. Teenagers with neurodevelopmental disorders will likely cope differently with decision making, social pressure, impulse control and risk assessment, and face <a href="https://www.mcri.edu.au/images/research/strategic-collaborations/Flagships/Neurodevelopment/Neurodevelopment_Flagship_Brochure.pdf">extra difficulties</a>. Across the world, they are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30217-8/fulltext">disproportionately incarcerated</a>. In Australia, Indigenous children and adolescents are incarcerated <a href="https://www.indigenoushpf.gov.au/measures/2-11-contact-with-the-criminal-justice-system#:%7E:text=On%20an%20average%20day%20in%202021%E2%80%9322%2C%20there%20were%3A,AIHW%202023d%3A%20Table%20S76a">in greater numbers</a> than their non-Indigenous peers. Each child matures differently, and some face extra challenges. But for every person, the period between ten and 14 is critical for developing the cognitive, social and emotional skills they’ll carry through the rest of their life.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237552/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, Professor of Adolescent Health The University of Melbourne; Director, Royal Children's Hospital Centre for Adolescent Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, Research Fellow, School of Psychology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-10-year-old-be-responsible-for-a-crime-heres-what-brain-science-tells-us-237552">original article</a>.

Mind

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Migraine is many things, but one thing it’s not is “just a headache”. “Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided. Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function. Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands. In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect. <iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Aspirin For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication. Triptans For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”. Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack. However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers. <h2>What about preventing migraines?</h2> The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol. Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives. Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached. It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more. <hr /> <iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>‘Nothing works for me!’</h2> In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP. The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections. These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist. Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away. Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives. Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>. </div>

Body

Think you’ve decided what to buy? Actually, your brain is still deciding – even as you put it in your basket

<a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> You are standing in the cereal aisle, weighing up whether to buy a healthy bran or a sugary chocolate-flavoured alternative. Your hand hovers momentarily before you make the final grab. But did you know that during those last few seconds, while you’re reaching out, your brain is still evaluating the pros and cons – influenced by everything from your last meal, the health star rating, the catchy jingle in the ad, and the colours of the letters on the box? Our recently published <a href="https://www.nature.com/articles/s41598-024-62135-7">research</a> shows our brains do not just think first and then act. Even while you are reaching for a product on a supermarket shelf, your brain is still evaluating whether you are making the right choice. Further, we found measuring hand movements offers an accurate window into the brain’s ongoing evaluation of the decision – you don’t have to hook people up to expensive brain scanners. What does this say about our decision-making? And what does it mean for consumers and the people marketing to them? <h2>What hand movements tell us about decision-making</h2> There has been <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-psych-010419-051053">debate within neuroscience</a> on whether a person’s movements to enact a decision can be modified once the brain’s “motor plan” has been made. Our research revealed not only that movements can be changed after a decision – “in flight” – but also the changes matched incoming information from a person’s senses. To study <a href="https://doi.org/10.1038/s41598-024-62135-7">how our decisions unfold over time</a>, we tracked people’s hand movements as they reached for different options shown in pictures – for example, in response to the question “is this picture a face or an object?” When choices were easy, their hands moved straight to the right option. But when choices were harder, new information made the brain change its mind, and this was reflected in the trajectory of their hand movements. When we compared these hand movement trajectories to brain activity recorded using neuroimaging, we found that the timing and amount of evidence of the brain’s evaluation matched the movement pattern. Put simply, reaching movements are shaped by ongoing thinking and decision-making. By showing that brain patterns match movement trajectories, our research also highlights that large, expensive brain scanners may not always be required to study the brain’s decision evaluation processes, as movement tracking is much more cost-effective and much easier to test on a large scale. <h2>What does this mean for consumers and marketers?</h2> For consumers, knowing our brains are always reevaluating decisions we might think of as “final” can help us be more aware of our choices. For simple decisions such as choosing a breakfast cereal, the impact may be small. Even if you have preemptively decided on a healthy option, you might be tempted at the last minute by the flashy packaging of a less healthy choice. But for important long-term decisions such as choosing a mortgage, it can have serious effects. On the other side of the coin, marketers have long known that many purchase decisions are <a href="https://www.sciencedirect.com/science/article/pii/S0969698912000781">made on the spot</a>. They use strategies such as attractive packaging and strategic product placement to influence people’s decisions. New ways of studying how people’s brains process information – right up to the last minute – can help marketers design more effective strategies. <h2>Opportunities for further research</h2> Further research in this area could explore how different types of information, such as environmental cues or memories, affect this continuous decision evaluation process in different groups of people. For example, how do people of different ages process information while making decisions? Our finding – that hand movements reflect the inner workings of the brain’s decision making process – could make future studies cheaper and more efficient. The ability to fine-tune marketing in this way has implications beyond just selling products. It can also make public strategic messaging far more effective. This could include tailoring a public health campaign on vaping specifically for people aged under 30, or targeting messaging about superannuation scams more effectively at those of retirement age. The act of reaching for a product is not a simple consequence of a decision already made; it’s a highly dynamic process. Being aware of what influences our last-minute decision-making can help us make better choices that have better outcomes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234167/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, Senior Research Fellow in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, Research Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, Associate Professor in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/think-youve-decided-what-to-buy-actually-your-brain-is-still-deciding-even-as-you-put-it-in-your-basket-234167">original article</a>.

Mind

After 180 years, new clues are revealing just how general anaesthesia works in the brain

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773932/pdf/BLT.15.159293.pdf/">Over 350 million surgeries</a> are performed globally each year. For most of us, it’s likely at some point in our lives we’ll have to undergo a procedure that needs general anaesthesia. Even though it is one of the safest medical practices, we still don’t have a complete, thorough understanding of precisely how anaesthetic drugs work in the brain. In fact, it has largely remained a mystery since general anaesthesia was introduced into medicine over <a href="https://www.tandfonline.com/doi/full/10.3109/08941939.2015.1061826">180 years ago</a>. Our study published <a href="https://doi.org/10.1523/JNEUROSCI.0588-23.2024">in The Journal of Neuroscience today</a> provides new clues on the intricacies of the process. General anaesthetic drugs seem to only affect specific parts of the brain responsible for keeping us alert and awake. <h2>Brain cells striking a balance</h2> In a study using fruit flies, we found a potential way that allows anaesthetic drugs to interact with specific types of neurons (brain cells), and it’s all to do with proteins. Your brain has around <a href="https://onlinelibrary.wiley.com/doi/10.1002/cne.21974">86 billion neurons</a> and not all of them are the same – it’s these differences that allow general anaesthesia to be effective. To be clear, we’re not completely in the dark on <a href="https://linkinghub.elsevier.com/retrieve/pii/S0165614719300951">how anaesthetic drugs affect us</a>. We know why general anaesthetics are able to make us lose consciousness so quickly, thanks to a <a href="https://www.nature.com/articles/367607a0">landmark discovery made in 1994</a>. But to better understand the fine details, we first have to look to the minute differences between the cells in our brains. Broadly speaking, there are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591655/">two main categories of neurons in the brain</a>. The first are what we call “excitatory” neurons, generally responsible for keeping us alert and awake. The second are “inhibitory” neurons – their job is to regulate and control the excitatory ones. In our day-to-day lives, excitatory and inhibitory neurons are constantly working and balancing one another. <a href="https://www.nature.com/articles/npp2017294">When we fall asleep</a>, there are inhibitory neurons in the brain that “silence” the excitatory ones keeping us awake. This happens <a href="https://askdruniverse.wsu.edu/2018/01/07/why-do-we-get-tired/">gradually over time</a>, which is why you may feel progressively more tired through the day. General anaesthetics speed up this process by directly silencing these excitatory neurons without any action from the inhibitory ones. This is why your anaesthetist will tell you that they’ll “put you to sleep” for the procedure: <a href="https://www.nature.com/articles/nrn2372">it’s essentially the same process</a>. <h2>A special kind of sleep</h2> While we know why anaesthetics put us to sleep, the question then becomes: “why do we stay asleep during surgery?”. If you went to bed tonight, fell asleep and somebody tried to do surgery on you, you’d wake up with quite a shock. To date, there is no strong consensus in the field as to why general anaesthesia causes people to remain unconscious during surgery. Over the last couple of decades, researchers have proposed several potential explanations, but they all seem to point to one root cause. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709148/#:%7E:text=At%20presynaptic%20part%2C%20voltage%2Dgated,anesthetics%20to%20inhibiting%20neurotransmitter%20release.">Neurons stop talking to each other</a> when exposed to general anaesthetics. While the idea of “cells talking to each other” may sound a little strange, it’s a <a href="https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/action-potentials-and-synapses">fundamental concept in neuroscience</a>. Without this communication, our brains wouldn’t be able to function at all. And it allows the brain to know what’s happening throughout the body. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="Two branching structures in orange, green, blue and yellow colours on a black background." /></a><figcaption>Colourised neurons in the brain of a fly. Adam Hines</figcaption></figure> <h2>What did we discover?</h2> Our new study shows that general anaesthetics appear to stop excitatory neurons from communicating, but not inhibitory ones. <a href="https://www.jneurosci.org/content/40/21/4103">This concept isn’t new</a>, but we found some compelling evidence as to why only excitatory neurons are affected. For neurons to communicate, proteins have to get involved. One of the jobs these proteins have is to get neurons to release molecules called <a href="https://my.clevelandclinic.org/health/articles/22513-neurotransmitters">neurotransmitters</a>. These chemical messengers are what gets signals across from one neuron to another: dopamine, adrenaline and serotonin are all neurotransmitters, for example. We found that general anaesthetics impair the ability of these proteins to release neurotransmitters, but only in excitatory neurons. To test this, we used <a href="https://www.eneuro.org/content/8/3/ENEURO.0057-21.2021">Drosophila melanogaster fruit flies</a> and <a href="https://imb.uq.edu.au/research/facilities/microscopy/training-manuals/microscopy-online-resources/image-capture/super-resolution-microscopy">super resolution microscopy</a> to directly see what effects a general anaesthetic was having on these proteins at a molecular scale. Part of what makes excitatory and inhibitory neurons different from each other is that they <a href="https://journals.physiology.org/doi/full/10.1152/physrev.00007.2012">express different types of the same protein</a>. This is kind of like having two cars of the same make and model, but one is green and has a sports package, while the other is just standard and red. They both do the same thing, but one’s just a little bit different. Neurotransmitter release is a complex process involving lots of different proteins. If one piece of the puzzle isn’t exactly right, then general anaesthetics won’t be able to do their job. As a next research step, we will need to figure out which piece of the puzzle is different, to understand why general anaesthetics only stop excitatory communication. Ultimately, our results hint that the drugs used in general anaesthetics cause massive global inhibition in the brain. By silencing excitability in two ways, these drugs put us to sleep and keep it that way.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229713/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, Research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/after-180-years-new-clues-are-revealing-just-how-general-anaesthesia-works-in-the-brain-229713">original article</a>. </div>

Body

Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a> <h2>The big idea</h2> Social ballroom dancing can improve cognitive functions and reduce brain atrophy in older adults who are at increased risk for Alzheimer’s disease and other forms of dementia. That’s the key finding of my team’s <a href="https://doi.org/10.1123/japa.2022-0176">recently published study</a> in the Journal of Aging and Physical Activity. In our study, we enrolled 25 adults over 65 years of age in either six months of twice-weekly ballroom dancing classes or six months of twice-weekly treadmill walking classes. None of them were engaged in formal dancing or other exercise programs. The overall goal was to see how each experience affected cognitive function and brain health. While none of the study volunteers had a dementia diagnosis, all performed a bit lower than expected on at least one of our dementia screening tests. We found that older adults that completed six months of social dancing and those that completed six months of treadmill walking improved their executive functioning – an umbrella term for planning, reasoning and processing tasks that require attention. Dancing, however, generated significantly greater improvements than treadmill walking on one measure of executive function and on processing speed, which is the time it takes to respond to or process information. Compared with walking, dancing was also associated with reduced brain atrophy in the hippocampus – a brain region that is key to memory functioning and is particularly affected by Alzheimer’s disease. Researchers also know that this part of our brain can undergo neurogenesis – or grow new neurons – <a href="https://doi.org/10.1073/pnas.0611721104">in response to aerobic exercise</a>. <figure><iframe src="https://www.youtube.com/embed/unmbhUvnGow?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Research shows those who regularly dance with a partner have a more positive outlook on life.</figcaption></figure> While several previous studies suggest that dancing has beneficial effects <a href="https://doi.org/10.1093/ageing/afaa270">on cognitive function in older adults</a>, only a few studies have compared it directly with traditional exercises. Our study is the first to observe both better cognitive function and improved brain health following dancing than walking in older adults at risk for dementia. We think that social dancing may be more beneficial than walking because it is physically, socially and cognitively demanding – and therefore strengthens a wide network of brain regions. While dancing, you’re not only using brain regions that are important for physical movement. You’re also relying on brain regions that are important for interacting and adapting to the movements of your dancing partner, as well as those necessary for learning new dance steps or remembering those you’ve learned already. <h2>Why it matters</h2> Nearly 6 million older adults in the U.S. and 55 million worldwide <a href="https://doi.org/10.1016/j.jalz.2019.01.010">have Alzheimer’s disease</a> or a <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">related dementia</a>, yet there is no cure. Sadly, the efficacy and ethics surrounding recently developed drug treatments <a href="https://doi.org/10.1080/21507740.2022.2129858">are still under debate</a>. The good news is that older adults can potentially <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">lower their risk for dementia</a> through lifestyle interventions, even later in life. These include reducing social isolation and physical inactivity. Social ballroom dancing targets both isolation and inactivity. In these later stages of the COVID-19 pandemic, a better understanding of the <a href="https://doi.org/10.1177/23337214211005223">indirect effects of COVID-19</a> – particularly those that increase dementia risk, such as social isolation – is urgently needed. In my view, early intervention is critical to prevent dementia from becoming the next pandemic. Social dancing could be a particularly timely way to overcome the adverse cognitive and brain effects associated with isolation and fewer social interactions during the pandemic. <h2>What still isn’t known</h2> Traditional aerobic exercise interventions such as treadmill-walking or running have been shown to lead to modest but reliable improvements in cognition – <a href="https://doi.org/10.1177/1745691617707316">particularly in executive function</a>. My team’s study builds on that research and provides preliminary evidence that not all exercise is equal when it comes to brain health. Yet our sample size was quite small, and larger studies are needed to confirm these initial findings. Additional studies are also needed to determine the optimal length, frequency and intensity of dancing classes that may result in positive changes. Lifestyle interventions like social ballroom dancing are a promising, noninvasive and cost-effective path toward staving off dementia as we – eventually – leave the COVID-19 pandemic behind.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/194969/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, Associate Professor of Medicine and Neurology, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/kick-up-your-heels-ballroom-dancing-offers-benefits-to-the-aging-brain-and-could-help-stave-off-dementia-194969">original article</a>. </div>

Mind

Best-selling author diagnosed with "aggressive" brain cancer

Best-selling author Sophie Kinsella has shared that she has been fighting "aggressive" brain cancer since the end of 2022. The British writer took to Instagram to reveal she was diagnosed with glioblastoma 18 months ago, and shared why she chose to keep the devatstsing news out of the spotlight. The 54-year-old said she wanted to "make sure my children were able to hear and process the news in privacy and adapt to our new normal" before going public with her diagnosis. "I have been under the care of the excellent team at University College Hospital in London and have had successful surgery and subsequent radiotherapy and chemotherapy, which is still ongoing," she told her followers on Instagram. "At the moment all is stable and I am feeling generally very well, though I get very tired and my memory is even worse than it was before!" Kinsella said she is "so grateful to my family and close friends who have been an incredible support to me, and to the wonderful doctors and nurses who have treated me." She also thanked her readers for their "constant support", adding how the reception of her latest novel The Burnout, released in October 2023, "really buoyed me up during a difficult time." She ended her statement by saying, "To everyone who is suffering from cancer in any form I send love and best wishes, as well as to those who support them." "It can feel very lonely and scary to have a tough diagnosis, and the support and care of those around you means more than words can say." Image credits: Getty Images

Caring

Does intermittent fasting have benefits for our brain?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Intermittent fasting has become a popular dietary approach to help people lose or manage their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8683964/">weight</a>. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and <a href="https://pubmed.ncbi.nlm.nih.gov/27810402">improve overall health</a>. Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like <a href="https://link.springer.com/article/10.1007/s11011-023-01288-2">Alzheimer’s disease</a>. This is not a new idea – the ancient Greeks believed fasting <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839325/">enhanced thinking</a>. But what does the modern-day evidence say? <h2>First, what is intermittent fasting?</h2> Our <a href="https://pubmed.ncbi.nlm.nih.gov/35487190/">diets</a> – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains. Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast. Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods. <h2>4 ways fasting works and how it might affect the brain</h2> The brain accounts for about <a href="https://theconversation.com/how-much-energy-do-we-expend-thinking-and-using-our-brain-197990">20% of the body’s energy consumption</a>. Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain. 1. Ketosis The goal of many intermittent fasting routines is to flip a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">metabolic switch</a>” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. <a href="https://www.ncbi.nlm.nih.gov/books/NBK493179/">Ketones</a> – chemicals produced by this metabolic process – become the preferred energy source for the brain. Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844723/">cause symptoms</a> of hunger, fatigue, nausea, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754590/">low mood</a>, irritability, constipation, headaches, and brain “fog”. At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to <a href="https://www.science.org/doi/10.1126/science.aau2095">preserve brain function</a> and prevent <a href="https://pubmed.ncbi.nlm.nih.gov/32709961/">age-related neurodegeneration disorders and cognitive decline</a>. Consistent with this, increasing ketones through <a href="https://pubmed.ncbi.nlm.nih.gov/31027873/">supplementation</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/31757576/">diet</a> has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively. 2. Circadian syncing Eating at times that <a href="https://pubmed.ncbi.nlm.nih.gov/32480126/">don’t match our body’s natural daily rhythms</a> can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to <a href="https://pubmed.ncbi.nlm.nih.gov/22010477/">chronic disease</a>. Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in <a href="https://pubmed.ncbi.nlm.nih.gov/36599299/">expression of genes in tissue</a> and helps the body during rest and activity. A 2021 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827225/">study of 883 adults</a> in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions. 3. Mitochondria Intermittent fasting may provide <a href="https://pubmed.ncbi.nlm.nih.gov/35218914/">brain protection</a> through improving mitochondrial function, metabolism and reducing oxidants. Mitochondria’s <a href="https://www.genome.gov/genetics-glossary/Mitochondria">main role is to produce energy</a> and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to <a href="https://www.nature.com/articles/s41574-021-00626-7">mitochondrial dysfunction during ageing</a>. Rodent studies suggest alternate day fasting or reducing calories <a href="https://journals.sagepub.com/doi/10.1038/jcbfm.2014.114">by up to 40%</a> might protect or improve <a href="http://www.ncbi.nlm.nih.gov/pubmed/21861096">brain mitochondrial function</a>. But not all studies support this theory. 4. The gut-brain axis The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/">gut and the brain communicate with each other</a> via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health. In mice, intermittent fasting has shown promise for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">improving brain health</a> by increasing survival and <a href="https://pubmed.ncbi.nlm.nih.gov/12354284/">formation of neurons</a> (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion. There’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470960/">no clear evidence</a> on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646955/">lower meal frequency</a> (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging. Some research has suggested calorie restriction may have a protective effect against <a href="https://academic.oup.com/nutritionreviews/article/81/9/1225/7116310">Alzheimer’s disease</a> by reducing oxidative stress and inflammation and promoting vascular health. When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed <a href="https://pubmed.ncbi.nlm.nih.gov/26713821/">cognitive improvement</a> when participants followed a calorie restricted diet for 12 months. Another study found a 25% calorie restriction was associated with <a href="https://pubmed.ncbi.nlm.nih.gov/30968820">slightly improved working memory</a> in healthy adults. But a <a href="https://www.sciencedirect.com/science/article/pii/S0022316623025221?via%3Dihub">recent study</a>, which looked at the impact of calorie restriction on spatial working memory, found no significant effect. <h2>Bottom line</h2> Studies in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740746/">mice</a> support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed. Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749464/">older adults</a> whose nutritional needs may be higher. Further, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/">prolonged fasting</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9042193/">severe calorie restriction</a> may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions. If you’re considering <a href="https://www.nejm.org/doi/10.1056/NEJMra1905136?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">intermittent fasting</a>, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-intermittent-fasting-have-benefits-for-our-brain-223181">original article</a>. Image: Getty

Body

Young boy beats rare brain cancer in world first

A 13-year-old boy from Belgium has become the first person in the world to be cured from a deadly brain cancer. Lucas Jemeljanova was only six-years-old when he was diagnosed with diffuse intrinsic pontine glioma (DIPG), a rare and aggressive brain cancer which kills 98 per cent of sufferers within five years. He was randomly assigned to receive everolimus, a type of chemotherapy drug during a clinical trial. The drug is commonly used to treat kidney, pancreas, breast and brain cancer, but up to this point has not been successfully used to treat DIPG. Seven years later, Lucas has responded well to the treatment and has no trace of cancer, and has officially been in remission for five years. His doctor, Jacques Grill said that Lucas "beat the odds" and his case "offers real hope". Lucas was one of the first few people enrolled in the BIOMEDE trial in France, which was testing potential new drugs for DIPG. The drug works by preventing the cancer cells from reproducing and decreasing blood supply to the cancer cells, and it is an FDA approved prescription drug for cancer. Doctors were initially hesitant to stop the treatment until a year ago and a half ago. "I didn’t know when to stop, or how, because there was no reference in the world," Dr Grill told the AFP. "Over a series of MRI scans, I watched as the tumour completely disappeared," he added. Seven other children who were also in the trial have been considered "long responders", as they haven't had any relapses for three years after their diagnosis, but only Lucas was cured. The reason behind his complete recovery is still unknown, but it could be because of "biological particularities" in his tumour. "Lucas' tumour had an extremely rare mutation which we believe made its cells far more sensitive to the drug," Dr Grill added. DIPG is typically found in children between ages five and nine. The cause of the tumour is unknown but some of the first symptoms include problems with eye movement and balance, facial weakness, difficulty walking and strange limb movements. Researchers are currently trying to reproduce the difference seen in Lucas' cells. "Lucas is believed to have had a particular form of the disease," Dr Grill said. "We must understand what and why to succeed in medically reproducing in other patients what happened naturally with him." However Dr Grill said that this process won't be quick. "On average, it takes 10-15 years from the first lead to become a drug – it's a long and drawn-out process." Images: Facebook

Caring

Does running water really trigger the urge to pee? Experts explain the brain-bladder connection

<a href="https://theconversation.com/profiles/james-overs-1458017">James Overs</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a>; <a href="https://theconversation.com/profiles/david-homewood-1458022">David Homewood</a>, <a href="https://theconversation.com/institutions/melbourne-health-950">Melbourne Health</a>; <a href="https://theconversation.com/profiles/helen-elizabeth-oconnell-ao-1458226">Helen Elizabeth O'Connell AO</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/simon-robert-knowles-706104">Simon Robert Knowles</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> We all know that feeling when nature calls – but what’s far less understood is the psychology behind it. Why, for example, do we get the urge to pee just before getting into the shower, or when we’re swimming? What brings on those “nervous wees” right before a date? Research suggests our brain and bladder are in constant communication with each other via a neural network called the <a href="https://www.einj.org/journal/view.php?doi=10.5213/inj.2346036.018">brain-bladder axis</a>. This complex web of circuitry is comprised of sensory neural activity, including the sympathetic and parasympathetic nervous systems. These neural connections allow information to be sent <a href="https://doi.org/10.3390/diagnostics12123119">back and forth</a> between the brain and bladder. The brain-bladder axis not only facilitates the act of peeing, but is also responsible for telling us we need to go in the first place. <h2>How do we know when we need to go?</h2> As the bladder fills with urine and expands, this activates special receptors detecting stretch in the nerve-rich lining of the bladder wall. This information is then relayed to the “periaqueductal gray” – a part of the brain in the brainstem which <a href="https://www.nature.com/articles/nrn2401">constantly monitors</a> the bladder’s filling status. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=454&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=454&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=454&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=570&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=570&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=570&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The periaqueductal gray is a section of gray matter located in the midbrain section of the brainstem. <a class="source" href="https://en.wikipedia.org/wiki/Brainstem#/media/File:1311_Brain_Stem.jpg">Wikimedia/OpenStax</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></figcaption></figure> Once the bladder reaches a certain threshold (roughly 250-300ml of urine), another part of the brain called the “pontine micturition centre” is activated and signals that the bladder needs to be emptied. We, in turn, <a href="https://pubmed.ncbi.nlm.nih.gov/16254993/">register this</a> as that all-too-familiar feeling of fullness and pressure down below. Beyond this, however, a range of situations can trigger or exacerbate our need to pee, by increasing the production of urine and/or stimulating reflexes in the bladder. <h2>Peeing in the shower</h2> If you’ve ever felt the need to pee while in the shower (no judgement here) it may be due to the sight and sound of running water. In a 2015 study, <a href="https://doi.org/10.1371/journal.pone.0126798">researchers demonstrated</a> that males with urinary difficulties found it easier to initiate peeing when listening to the sound of running water being played on a smartphone. Symptoms of overactive bladder, including urgency (a sudden need to pee), have also been <a href="https://www.alliedacademies.org/articles/environmental-cues-to-urgency-and-incontinence-episodes-in-chinesepatients-with-overactive-urinary-bladder-syndrome.html">linked to</a> a range of environmental cues involving running water, including washing your hands and taking a shower. This is likely due to both physiology and psychology. Firstly, the sound of running water may have a relaxing physiological effect, increasing activity of the parasympathetic nervous system. This would relax the bladder muscles and prepare the bladder for emptying. At the same time, the sound of running water may also have a conditioned psychological effect. Due to the countless times in our lives where this sound has coincided with the actual act of peeing, it may trigger an instinctive reaction in us to urinate. This would happen in the same way <a href="https://www.simplypsychology.org/pavlov.html">Pavlov’s dog learnt</a>, through repeated pairing, to salivate when a bell was rung. <h2>Cheeky wee in the sea</h2> But it’s not just the sight or sound of running water that makes us want to pee. Immersion in cold water has been shown to cause a “cold shock response”, <a href="https://pubmed.ncbi.nlm.nih.gov/19945970">which activates</a> the sympathetic nervous system. This so-called “fight or flight” response drives up our blood pressure which, in turn, causes our kidneys to filter out more fluid from the bloodstream to stabilise our blood pressure, in a process called “<a href="https://link.springer.com/article/10.1007/BF00864230">immersion diuresis</a>”. When this happens, our bladder fills up faster than normal, triggering the urge to pee. Interestingly, immersion in very warm water (such as a relaxing bath) may also increase urine production. In this case, however, it’s due to activation of the parasympathetic nervous system. <a href="https://doi.org/10.1007/s004210050065">One study</a> demonstrated an increase in water temperature from 40℃ to 50℃ reduced the time it took for participants to start urinating. Similar to the effect of hearing running water, the authors of the study suggest being in warm water is calming for the body and activates the parasympathetic nervous system. This activation can result in the relaxation of the bladder and possibly the pelvic floor muscles, bringing on the urge to pee. <h2>The nervous wee</h2> We know stress and anxiety can cause bouts of nausea and butterflies in the tummy, but what about the bladder? Why do we feel a sudden and frequent urge to urinate at times of heightened stress, such as before a date or job interview? When a person becomes stressed or anxious, the body goes into fight-or-flight mode through the activation of the sympathetic nervous system. This triggers a cascade of physiological changes designed to prepare the body to face a perceived threat. As part of this response, the muscles surrounding the bladder may contract, leading to a more urgent and frequent need to pee. Also, as is the case during immersion diuresis, the increase in blood pressure associated with the stress response may <a href="https://doi.org/10.1172/JCI102496">stimulate</a> the kidneys to produce more urine. <h2>Some final thoughts</h2> We all pee (most of us several times a day). Yet <a href="https://doi.org/10.5489/cuaj.1150">research has shown</a> about 75% of adults know little about how this process actually works – and even less about the brain-bladdder axis and its role in urination. <a href="https://www.continence.org.au/about-us/our-work/key-statistics-incontinence#:%7E:text=Urinary%20incontinence%20affects%20up%20to,38%25%20of%20Australian%20women1.">Most Australians</a> will experience urinary difficulties at some point in their lives, so if you ever have concerns about your urinary health, it’s extremely important to consult a healthcare professional. And should you ever find yourself unable to pee, perhaps the sight or sound of running water, a relaxing bath or a nice swim will help with getting that stream to flow.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/james-overs-1458017">James Overs</a>, Research Assistant, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a>; <a href="https://theconversation.com/profiles/david-homewood-1458022">David Homewood</a>, Urology Research Registrar, Western Health, <a href="https://theconversation.com/institutions/melbourne-health-950">Melbourne Health</a>; <a href="https://theconversation.com/profiles/helen-elizabeth-oconnell-ao-1458226">Helen Elizabeth O'Connell AO</a>, Professor, University of Melbourne, Department of Surgery. President Urological Society Australia and New Zealand, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/simon-robert-knowles-706104">Simon Robert Knowles</a>, Associate Professor and Clinical Psychologist, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-running-water-really-trigger-the-urge-to-pee-experts-explain-the-brain-bladder-connection-210808">original article</a>.

Mind

The science of dreams and nightmares – what is going on in our brains while we’re sleeping?

<a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Last night you probably slept for <a href="https://www.sciencedirect.com/science/article/pii/S2352721816301292">seven to eight hours</a>. About one or two of these was likely in deep sleep, especially if you’re young or physically active. That’s because <a href="http://apsychoserver.psych.arizona.edu/jjbareprints/psyc501a/readings/Carskadon%20Dement%202011.pdf">sleep changes with age</a> and <a href="https://www.hindawi.com/journals/apm/2017/1364387/">exercise</a> affects brain activity. About three or four hours will have been spent in light sleep. For the remaining time, you were likely in rapid eye movement (REM) sleep. While this is not the only time your brain is potentially dreaming – we also dream during other sleep stages – it is the time your brain activity is most likely to be recalled and reported when you’re awake. That’s usually because either really weird thoughts or feelings wake you up or because the last hour of sleep is nearly all <a href="https://www.researchgate.net/profile/Elizaveta-Solomonova/publication/320356182_Dream_Recall_and_Content_in_Different_Stages_of_Sleep_and_Time-of-Night_Effect/links/5a707bdb0f7e9ba2e1cade56/Dream-Recall-and-Content-in-Different-Stages-of-Sleep-and-Time-of-Night-Effect.pdf">REM sleep</a>. When dreams or your alarm wake you, you’re likely coming out of dream sleep and your dream often lingers into the first few minutes of being awake. In this case you remember it. If they’re strange or interesting dreams, you might tell someone else about them, which may further <a href="https://link.springer.com/article/10.1007/s00426-022-01722-7">encode</a> the dream memory. Dreams and nightmares are mysterious and we’re still learning about them. They keep our brains ticking over. They wash the thoughts from the day’s events at a molecular level. They might even help us imagine what’s possible during our waking hours. <h2>What do scientists know about REM sleep and dreaming?</h2> It’s really hard to study dreaming because people are asleep and we can’t observe what’s going on. Brain imaging has indicated certain <a href="https://www.sciencedirect.com/science/article/pii/S1087079216300673#sec3">patterns of brain activity</a> are associated with dreaming (and with certain sleep stages where dreams are more likely to occur). But such studies ultimately rely on self-reports of the dream experience. Anything we spend so much time doing probably serves multiple ends. At the basic physiological level (indicated by <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409">brain activity, sleep behaviour and studies of conciousness</a>), all mammals dream – even the platypus and echidna probably experience something similar to dreaming (provided they are at the <a href="https://www.wired.com/2014/07/the-creature-feature-10-fun-facts-about-the-echidna/#:%7E:text=It%20was%20long%20thought%20that,re%20at%20the%20right%20temperature.">right temperature</a>). Their brain activity and sleep stages align to some degree with human <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409#b0630">REM sleep</a>. Less evolved species do not. Some <a href="https://www.sciencedirect.com/science/article/pii/S2468867319301993#sec0030">jellyfish</a> – who do not have a brain – do experience what could physiologically be characterised as sleep (shown by their posture, quietness, lack of responsiveness and rapid “waking” when prompted). But they do not experience the same physiological and behavioural elements that resemble REM dream sleep. In humans, REM sleep is thought to occur cyclically every 90 to 120 minutes across the night. It prevents us from sleeping too deeply and being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972941/">vulnerable to attack</a>. Some scientists think we dream in order to stop our brains and bodies from getting too cold. Our core body temperature is typically <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00210-1/fulltext">higher while dreaming</a>. It is typically easier to <a href="https://www.tandfonline.com/doi/pdf/10.2147/NSS.S188911">wake from dreaming</a> if we need to respond to external cues or dangers. The brain activity in REM sleep kicks our brain into gear for a bit. It’s like a periscope into a more conscious state, observing what’s going on at the surface, then going back down if all is well. Some evidence suggests “fever dreams” are far less common than we might expect. We actually experience <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00053/full">far less REM sleep</a> when we have a fever – though the dreams we do have tend to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830719/">darker in tone and more unusual</a>. Spending less time in REM sleep when we’re feverish might happen because we are far less capable of regulating our body temperature in this stage of sleep. To protect us, our brain tries to regulate our temperature by “skipping” this sleep stage. We tend to have fewer dreams when the weather is hot <a href="https://www.tandfonline.com/doi/abs/10.1080/23744731.2020.1756664">for the same reason</a>. <h2>A deep-cleaning system for the brain</h2> REM sleep is important for ensuring our brain is working as it should, as indicated by studies using <a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">electoencephalography</a>, which measures brain activity. In the same way deep sleep helps the body restore its physical capacity, dream sleep “<a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">back-flushes</a>” our neural circuits. At the molecular level, the chemicals that underpin our thinking are bent out of shape by the day’s cognitive activity. Deep sleep is when those chemicals are returned to their unused shape. The brain is “<a href="https://www.science.org/doi/abs/10.1126/science.1241224">washed</a>” with cerebrospinal fluid, controlled by the <a href="https://theconversation.com/on-your-back-side-face-down-mice-show-how-we-sleep-may-trigger-or-protect-our-brain-from-diseases-like-als-181954">glymphatic system</a>. At the next level, dream sleep “tidies up” our recent memories and feelings. During <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">REM sleep</a>, our brains consolidate procedural memories (of how to do tasks) and emotions. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">Non-REM sleep</a>, where we typically expect fewer dreams, is important for the consolidation of episodic memories (events from your life). As our night’s sleep progresses, we produce more cortisol - the <a href="https://psycnet.apa.org/record/2005-01907-021">stress hormone</a>. It is thought the amount of cortisol present can impact the type of memories we are consolidating and potentially the types of dreams we have. This means the dreams we have later in the night may be <a href="https://learnmem.cshlp.org/content/11/6/671.full.pdf">more fragmented or bizarre</a>. Both kinds of sleep help <a href="https://www.researchgate.net/profile/Jb-Eichenlaub/publication/313545620_Daily_Life_Experiences_in_Dreams_and_Sleep-Dependent_Memory_Consolidation/links/5c532b0ba6fdccd6b5d76270/Daily-Life-Experiences-in-Dreams-and-Sleep-Dependent-Memory-Consolidation.pdf?ref=nepopularna.org">consolidate</a> the useful brain activity of the day. The brain also discards less important information. <h2>Random thoughts, rearranged feelings</h2> This filing and discarding of the day’s activities is going on while we are sleeping. That’s why we often dream about things that happen <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264574">during the day</a>. Sometimes when we’re rearranging the thoughts and feelings to go in the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921176/">bin</a>” during sleep, our level of consciousness allows us to experience awareness. Random thoughts and feelings end up all jumbled together in weird and wonderful ways. Our awareness of this process may explain the bizarre nature of some of our dreams. Our daytime experiences can also fuel nightmares or anxiety-filled dreams after a <a href="https://www.sleepfoundation.org/dreams/how-trauma-can-affect-dreams">traumatic event</a>. Some dreams appear to <a href="https://rai.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1467-9655.2010.01668.x">foretell the future or carry potent symbolism</a>. In many societies dreams are believed to be a window into an <a href="https://digitalcommons.ciis.edu/cgi/viewcontent.cgi?article=1050&context=ijts-transpersonalstudies">alternate reality</a> where we can envisage what is possible. <h2>What does it all mean?</h2> Our scientific understanding of the thermoregulatory, molecular and basic neural aspects of dreaming sleep is <a href="https://www.nature.com/articles/nrn2716">good</a>. But the psychological and spiritual aspects of dreaming remain largely hidden. Perhaps our brains are wired to try and make sense of things. Human societies have always interpreted the random – birds wheeling, tea leaves and the planets – and looked for <a href="https://brill.com/display/book/edcoll/9789047407966/B9789047407966-s003.xml">meaning</a>. Nearly every human society has regarded dreams as more than just random neural firing. And the history of science tells us some things once thought to be magic can later be understood and harnessed – for better or worse.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210901/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, Director, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-science-of-dreams-and-nightmares-what-is-going-on-in-our-brains-while-were-sleeping-210901">original article</a>.

Mind

If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear

<a href="https://theconversation.com/profiles/arash-javanbakht-416594">Arash Javanbakht</a>, <a href="https://theconversation.com/institutions/wayne-state-university-989">Wayne State University</a> Heart in your throat. Butterflies in your stomach. Bad gut feeling. These are all phrases many people use to describe fear and anxiety. You have likely felt anxiety inside your chest or stomach, and your brain usually doesn’t hurt when you’re scared. Many cultures tie cowardice and bravery more <a href="https://afosa.org/the-meaning-of-heart-qalb-in-quran/">to the heart</a> <a href="https://byustudies.byu.edu/article/bowels-of-mercy/">or the guts</a> than to the brain. But science has traditionally seen the brain as the birthplace and processing site of fear and anxiety. Then why and how do you feel these emotions in other parts of your body? I am a <a href="https://scholar.google.com/citations?user=UDytFmIAAAAJ&hl=en">psychiatrist and neuroscientist</a> who researches and treats fear and anxiety. In my book “<a href="https://rowman.com/ISBN/9781538170380/Afraid-Understanding-the-Purpose-of-Fear-and-Harnessing-the-Power-of-Anxiety">Afraid,</a>” I explain how fear works in the brain and the body and what too much anxiety does to the body. Research confirms that while emotions do originate in your brain, it’s your body that carries out the orders. <h2>Fear and the brain</h2> While your brain evolved to save you from a falling rock or speeding predator, the anxieties of modern life are often a lot more abstract. Fifty-thousand years ago, being rejected by your tribe could mean death, but not doing a great job on a public speech at school or at work doesn’t have the same consequences. Your brain, however, <a href="https://doi.org/10.1006/nimg.2002.1179">might not know the difference</a>. There are a few key areas of the brain that are heavily involved in processing fear. When you perceive something as dangerous, whether it’s a gun pointed at you or a group of people looking unhappily at you, these sensory inputs are first relayed to <a href="https://doi.org/10.1038%2Fnpp.2009.121">the amygdala</a>. This small, almond-shaped area of the brain located near your ears detects salience, or the emotional relevance of a situation and how to react to it. When you see something, it determines whether you should eat it, attack it, run away from it or have sex with it. <a href="https://theconversation.com/the-science-of-fright-why-we-love-to-be-scared-85885">Threat detection</a> is a vital part of this process, and it has to be fast. Early humans did not have much time to think when a lion was lunging toward them. They had to act quickly. For this reason, the amygdala evolved to bypass brain areas involved in logical thinking and can directly engage physical responses. For example, seeing an angry face on a computer screen can immediately trigger a <a href="https://doi.org/10.1006/nimg.2002.1179">detectable response from the amygdala</a> without the viewer even being aware of this reaction. <figure><iframe src="https://www.youtube.com/embed/xoU9tw6Jgyw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In response to a looming threat, mammals often fight, flee or freeze.</figcaption></figure> <a href="https://doi.org/10.1038/npp.2009.83">The hippocampus</a> is near and tightly connected to the amygdala. It’s involved in memorizing what is safe and what is dangerous, especially in relation to the environment – it puts fear in context. For example, seeing an angry lion in the zoo and in the Sahara both trigger a fear response in the amygdala. But the hippocampus steps in and blocks this response when you’re at the zoo because you aren’t in danger. The <a href="https://doi.org/10.1176/appi.ajp.2016.16030353">prefrontal cortex</a>, located above your eyes, is mostly involved in the cognitive and social aspects of fear processing. For example, you might be scared of a snake until you read a sign that the snake is nonpoisonous or the owner tells you it’s their friendly pet. Although the prefrontal cortex is usually seen as the part of the brain that regulates emotions, it can also teach you fear based on your social environment. For example, you might feel neutral about a meeting with your boss but immediately feel nervous when a colleague tells you about rumors of layoffs. Many <a href="https://theconversation.com/trump-the-politics-of-fear-and-racism-how-our-brains-can-be-manipulated-to-tribalism-139811">prejudices like racism</a> are rooted in learning fear through tribalism. <h2>Fear and the rest of the body</h2> If your brain decides that a fear response is justified in a particular situation, it activates a <a href="https://doi.org/10.1093/med/9780190259440.003.0019">cascade of neuronal and hormonal pathways</a> to prepare you for immediate action. Some of the fight-or-flight response – like heightened attention and threat detection – takes place in the brain. But the body is where most of the action happens. Several pathways prepare different body systems for intense physical action. The <a href="https://doi.org/10.3389/fnins.2014.00043">motor cortex</a> of the brain sends rapid signals to your muscles to prepare them for quick and forceful movements. These include muscles in the chest and stomach that help protect vital organs in those areas. That might contribute to a feeling of tightness in your chest and stomach in stressful conditions. <figure><iframe src="https://www.youtube.com/embed/0IDgBlCHVsA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Your sympathetic nervous system is involved in regulating stress.</figcaption></figure> The <a href="https://www.ncbi.nlm.nih.gov/books/NBK542195/">sympathetic nervous system</a> is the gas pedal that speeds up the systems involved in fight or flight. Sympathetic neurons are spread throughout the body and are especially dense in places like the heart, lungs and intestines. These neurons trigger the adrenal gland to release hormones like adrenaline that travel through the blood to reach those organs and increase the rate at which they undergo the fear response. To assure sufficient blood supply to your muscles when they’re in high demand, signals from the sympathetic nervous system increase the rate your heart beats and the force with which it contracts. You feel both increased heart rate and contraction force in your chest, which is why you may connect the feeling of intense emotions to your heart. In your lungs, signals from the sympathetic nervous system dilate airways and often increase your breathing rate and depth. Sometimes this results in a feeling of <a href="https://theconversation.com/pain-and-anxiety-are-linked-to-breathing-in-mouse-brains-suggesting-a-potential-target-to-prevent-opioid-overdose-deaths-174187">shortness of breath</a>. As digestion is the last priority during a fight-or-flight situation, sympathetic activation slows down your gut and reduces blood flow to your stomach to save oxygen and nutrients for more vital organs like the heart and the brain. These changes to your gastrointestinal system can be perceived as the discomfort linked to fear and anxiety. <h2>It all goes back to the brain</h2> All bodily sensations, including those visceral feelings from your chest and stomach, are relayed back to the brain through the pathways <a href="https://www.ncbi.nlm.nih.gov/books/NBK555915/">via the spinal cord</a>. Your already anxious and highly alert brain then processes these signals at both conscious and unconscious levels. <a href="https://doi.org/10.1176/appi.ajp.2016.16030353">The insula</a> is a part of the brain specifically involved in conscious awareness of your emotions, pain and bodily sensations. The <a href="https://doi.org/10.1038%2Fs41598-019-52776-4">prefrontal cortex</a> also engages in self-awareness, especially by labeling and naming these physical sensations, like feeling tightness or pain in your stomach, and attributing cognitive value to them, like “this is fine and will go away” or “this is terrible and I am dying.” These physical sensations can sometimes create a loop of increasing anxiety as they make the brain feel more scared of the situation because of the turmoil it senses in the body. Although the feelings of fear and anxiety start in your brain, you also feel them in your body because your brain alters your bodily functions. Emotions take place in both your body and your brain, but you become aware of their existence with your brain. As the rapper Eminem recounted in his song “Lose Yourself,” the reason his palms were sweaty, his knees weak and his arms heavy was because his brain was nervous.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210871/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/arash-javanbakht-416594">Arash Javanbakht</a>, Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/wayne-state-university-989">Wayne State University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-anxiety-is-in-my-brain-why-is-my-heart-pounding-a-psychiatrist-explains-the-neuroscience-and-physiology-of-fear-210871">original article</a>.

Body

These 8 food and drink favourites are bad for your brain

Bad foods for your brain Following a healthy diet is essential to maintaining optimal brain health. Avocados and fatty fish; bone broth, berries and broccoli – they’re all brain-boosting superstars. But there are plenty of foods that have the opposite effect and can sap your smarts, affecting your memory and mood. Therefore, it’s important to cut or reduce the following food from your diet to mitigate their effects. Fried foods Fried chicken and French fries won’t just widen your waistline, they are also bad for your brain. In a study published in 2016 in the Journal of Nutritional Science, people who ate diets high in fried foods scored poorly on cognitive tests that evaluated learning, memory and brain function. Conversely, those who ate more plant-based foods scored higher. “Scientists think it may have something to do with inflammation and reduction in brain tissue size,” says Kristin Kirkpatrick, co-author of Skinny Liver. “When you look at aspects of one of the great brain studies – the MIND diet – it clearly shows which foods may cause or reduce inflammation in the brain. Fried foods are on the NO list, while berries, olive oil, whole grains and food containing omega 3 are on the YES list.” Sugar-sweetened beverages You probably know to stay away from soft drinks. But you should also beware of fruit juice, energy drinks and sweet tea. Why, you ask? The same reason soft drink is among the bad foods for your brain: sugar. “High amounts of sugar causes neurological damage” because it triggers inflammation, says the Academy of Nutrition and Dietetics’ Wesley Delbridge. A study published in 2017 in Alzheimer’s & Dementia backs that up. Researchers found that people who regularly consume sugary drinks are more likely to have poorer memory, smaller overall brain volume, and a significantly smaller hippocampus – the part of the brain important for learning and memory – than those who don’t. Instead of drinking fruit juice or sweet tea high in sugar, try sweetening water or tea with slices of oranges, lemons, or limes. Refined carbs White rice, white bread, white pasta and other processed food with a high glycemic index don’t just cause major spikes in blood sugar, they also rank with the ‘bad foods for your brain’. Specifically, these foods can have a negative effect on your mental health. A study, published in 2015 in The American Journal of Clinical Nutrition found that food with a high glycemic index can raise the risk of depression in post-menopausal women. Women who ate more lactose, fibre, fruit and vegetables, on the other hand, showed a significant decrease in symptoms of depression. Swap the white carbs for complex carbs like whole wheat bread, brown rice, quinoa, barley, and farro. All of these contain fibre, which nurtures your gut bacteria and regulates inflammation – all good things for your brain health. Excess alcohol There is a sweet spot for alcohol consumption, according to neurologist Dr David Perlmutter and author of Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar. While the occasional glass of red wine is okay, drinking in excess can be toxic to your brain function, no matter your age. Research, including a study published in 2017 in the peer-reviewed medical trade journal BMJ, found that moderate drinking can damage the brain. The hippocampus is particularly vulnerable. To protect your brain, limit alcohol consumption to no more than one standard drink per day for women and two per day for men. According to Australia’s national alcohol guidelines, one standard drink is defined as containing 10 grams of alcohol. Artificially sweetened beverages Instead of a sugar-sweetened beverage, maybe you turn to the occasional diet soft drink. But make a habit of it and you could be upping your risk of dementia and stroke, suggests a study published in 2017 in Stroke. Researchers found that participants who drank diet drinks daily were almost three times as likely to have a stroke or develop dementia when compared to those who didn’t. “We seek out diet soft drinks for its sweet delivery of liquid,” says Kirkpatrick. “That sweet taste remains on our taste buds, making us crave more.” To kick the habit, she suggests going cold turkey. “Eliminate all sources of sweet from the taste buds to retrain the brain not to want it in the first place,” she says. “Sprucing up water with lemons, limes or berries, or having flavoured seltzer without added sugar can help, as well.” Processed meats If you like to eat processed meats, you may run a greater risk of developing dementia, suggests an April 2020 study published in Neurology. Although the study does not prove cause and effect, the researchers found that dementia was more common among participants who ate highly processed meats, such as sausages, cured meats and pâté. People without dementia were more likely to eat a diverse diet that included fruit, vegetables, seafood and poultry, according to the findings. Highly processed foods are most likely the primary cause of results linked to the reduction in brain tissue size and inflammation, which impacts brain health, says Kirkpatrick. Fast food For starters, the high levels of saturated fat found in greasy burgers and fries can make it harder to fight off Alzheimer-causing plaque. Plus, the level of sodium found in the average fast-food fix can cause brain fog. How so? High blood pressure, often brought on by eating too many salty foods, can restrict blood to the brain and negatively impair focus, organisational skills and memory, suggests a review of studies published in 2016 in Hypertension. To break a fast food habit, Kirkpatrick suggests this trick: “Start with altering what you order,” she says. “Avoid fried options and opt for more whole grains and plants.” Then reduce the number of days you buy fast food by half. Tuna While the occasional tuna sandwich is no big deal, you might want to think twice before making it your go-to lunch. That’s because tuna – as well as swordfish, shark (flake), bill fish and deep sea perch – has higher levels of mercury than many other types of seafood. A study published in Integrative Medicine shows that people with high levels of the heavy metal in their bloodstream had a 5% drop in cognitive function. But you don’t have to banish seafood from your plate forever. Advice from Food Standards Australia New Zealand (which reflects the fish we eat in our region and its mercury content) recommends 2-3 serves per week of fish and seafood, including canned or fresh tuna (one serve equals 150g), except for fish such as orange roughy (deep sea perch), catfish, shark (flake) or billfish (swordfish/marlin), which you should only consume 1 serve per week and no other fish that week. Try swapping these varieties of fish for omega-3-rich sources such as wild salmon and lake trout, which have been associated with better brain health, says Kirkpatrick. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/food-home-garden/the-8-worst-foods-for-your-brain" target="_blank" rel="noopener">Reader's Digest</a>.

Food & Wine

Finding a live brain worm is rare. 4 ways to protect yourself from more common parasites

<a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> <a href="https://www.theguardian.com/australia-news/2023/aug/28/live-worm-living-womans-brain-australia-depression-forgetfulness">News reports</a> this morning describe how shocked doctors removed a live worm from a woman’s brain in a Canberra hospital last year. The woman had previously been admitted to hospital with stomach symptoms, dry cough and night sweats and months later experienced depression and forgetfulness that led to a brain scan. In the <a href="https://wwwnc.cdc.gov/eid/article/29/9/23-0351_article">case study</a> published in Emerging Infectious Diseases journal, doctors describe removing the live 8cm-long nematode (roundworm) from the brain of the 64-year-old woman who was immunosuppressed. The worm was identified as O. robertsi which is native to Australia, where it lives on carpet pythons. The woman may have come into contact with worm eggs via snake faeces while foraging for Warrigal greens to eat. It’s important to note this is an extremely rare event and headlines about brain worms can be alarming. But there are more common parasites which can infect your body and brain. And there are ways you can minimise your risks of being infected with one. <h2>Common parasites and how they get in</h2> Parasitic infection is extremely common. Arguably the most widespread type is pinworm (Enterobius vermicularis also called threadworm), which is thought to be present in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522669/">over a billion people</a> worldwide, especially children. Pinworms grow to around 1cm in length and are specific to human hosts. They cause intense bottom itching and get passed from person-to-person. It’s a myth that you can get it from pets. <a href="https://www.cdc.gov/parasites/giardia/pathogen.html#:%7E:text=Giardia%20duodenalis%20is%20a%20protozoan,Giard%20of%20Paris%20and%20Dr.">Giardia</a> (Giardia duodenalis) is also very common and can contaminate food, water and surfaces. This water-borne parasite is associated with poor sanitation and causes stomach symptoms like diarrhoea, cramps, bloating, nausea and fatigue. Giardia cysts (little sacs of immature parasite) spread disease and are passed out in faeces, where they can remain viable in the environment for months before being consumed by someone else. They can also be ingested via foods (such as sheep meat) that is raw or undercooked. <a href="https://www.cdc.gov/dpdx/hookworm/index.html">Two types</a> of hookworm – Necator americanis and Ancylostoma duadonale – are found in soil. Only Ancylostoma duodenale is an issue in Australia and is typically found in <a href="https://www.cdc.gov/dpdx/hookworm/index.html">remote communities</a>. When a person is infected (usually via barefeet or contaminated footwear) these worms enter the bloodstream and then hit the lungs. From the bronchi in the upper lungs, they are swallowed with secretions. Once in the gut and small bowel they can <a href="https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections#:%7E:text=Transmission,these%20eggs%20contaminate%20the%20soil.">cause anaemia</a> (low iron). This is because they are consuming nutrients and affecting iron absorption. They also release an anticoagulant that stops the human host’s blood clotting and causes tiny amounts of blood loss. Fortunately, these very common parasites do not infect the brain. Across the world, it’s estimated <a href="https://pubmed.ncbi.nlm.nih.gov/22491772/">30–50% of people</a> are infected with Toxoplasma. Most people will be asymptomatic but many carry the <a href="https://theconversation.com/one-in-three-people-are-infected-with-toxoplasma-parasite-and-the-clue-could-be-in-our-eyes-182418">signs of infection</a>. The parasites can remain in the body for years as tiny tissue cysts. These cysts can be found in brain, heart and muscle. Infants can be born with serious eye or brain damage if their mothers are infected during pregnancy. People with compromised immunity – such as from AIDS or cancer treatment – are also at risk of illness from infection via pet cats or uncooked meat. <h2>Then there are tapeworms and amoebas</h2> Tapeworms can infect different parts of the body including the brain. This is called <a href="https://www.cdc.gov/parasites/resources/pdf/npis_in_us_neurocysticercosis.pdf">neurocysticercosis</a> and is the leading cause of epilepsy worldwide. Neurocysticercosis is uncommon in the Western world and infection is usually via eating pork that is uncooked or prepared by someone who is infected with tapeworm (Taenia solium). It is more likely in locations where pigs have contact with human faeces via sewerage or waterways. <figure class="align-right zoomable"><figcaption></figcaption></figure> Tapeworm larvae can infect muscle and soft tissue. Brain tissue can provide a home for larvae because it is soft and easy to get to via blood vessels. Brain infection can cause headaches, dizziness, seizures, cognitive impairment and even dementia, due to an increase in <a href="https://www.cdc.gov/parasites/cysticercosis/gen_info/faqs.html">cerebral spinal fluid pressure</a>. <a href="https://www.cdc.gov/parasites/naegleria/general.html">Naegleria fowleri</a> is an amoeba found in lakes, rivers and springs in warm climates including <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/public+health/water+quality/naegleria+fowleri#:%7E:text=How%20common%20are%20Naegleria%20fowleri,frequently%20found%20in%20the%20environment.">in Australia</a>. People swimming in infected waters can have the parasite enter their body through the nose. It then travels to the brain and destroys brain tissue. The condition is <a href="https://www.cdc.gov/parasites/naegleria/general.html#:%7E:text=Top%20of%20Page-,What%20is%20the%20death%20rate%20for%20an%20infected%20person%20who,States%20from%201962%20to%202022.">almost always fatal</a>. <h2>Yikes! 4 ways to avoid parasitic infection</h2> That all sounds very scary. And we know being infected by a snake parasite is very rare – finding one alive in someone’s brain is even rarer. But parasites are all around us. To minimise your risk of infection you can: 1. avoid undercooked or raw pork. Freezing meat first may reduce risks (though home freezers <a href="https://www.cdc.gov/parasites/trichinellosis/prevent.html">may not get cold enough</a>) and it must be cooked to a <a href="https://www.sciencedirect.com/science/article/pii/S0924224418301560#:%7E:text=and%20time%20conditions.-,Cooking%20at%20core%20temperature%2060%E2%80%9375%20%C2%B0C%20for%2015,relied%20upon%20in%20home%20situations.">high internal temperature</a>. Avoid pork if you are travelling in places with poor sanitation 2. avoid jumping or diving into warm fresh bodies of water, especially if they are known to carry Naegleria fowleri. Although only a <a href="https://www.cdc.gov/parasites/naegleria/graphs.html">handful of cases</a> are reported each year, you should assume it’s present 3. practise good <a href="https://www.cdc.gov/handwashing/when-how-handwashing.html#:%7E:text=Follow%20Five%20Steps%20to%20Wash%20Your%20Hands%20the%20Right%20Way&text=Wet%20your%20hands%20with%20clean,for%20at%20least%2020%20seconds.">hand hygiene</a> to reduce the risk of rare and common infections. That means washing hands thoroughly and often, using soap, scrubbing for at least 20 seconds, rinsing and drying well. Clip and clean under fingernails regularly 4. to avoid soil-borne parasites wear shoes outside, especially in rural and remote regions, wash shoes and leave them outside.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212437/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Canberra Health This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/finding-a-live-brain-worm-is-rare-4-ways-to-protect-yourself-from-more-common-parasites-212437">original article</a>.

Body

9 ways to exercise your brain

While many people can say they are dedicated to keeping their bodies in shape, exercising applies to more than just the muscles, bones and fat in our bodies. We should all be working out the neural pathways and connections in our brains too. So whether you’re trying to get your brain back into shape or you just want to keep it as strong as it is now, below are some top tips on how to help exercise your mind to good health. 1. Read as much as you can Whether it’s a newspaper, magazine or book, reading is a fantastic basic brain exercise. Remember, the more challenging the reading material is the more of a workout you are giving your brain. Like with any new exercise regime, start small and work your way up to a level that you find challenging. 2. Learn new words Increasing your vocabulary is a great way to exercise the language portion of your brain. A word-of-the day calendar is a great way to ensure you keep on top of this throughout the year. 3. Put pen to paper (not fingers to a keyboard) From fictional stories to keeping a journal, writing is a good workout for the brain, as it requires lots of thinking. A study published in the Human Brain Mapping journal found that both planning and writing a story by hand combines handwriting and cognitive writing processes, which are predominantly associated with memory and integrating information from diverse sources. 4. Do puzzles Easy to fit into your daily schedule, simple puzzles like crosswords and Sudoku help to get your brain doing some basic work, while more complex puzzles will give your brain a stronger workout. So although more complicated puzzles may take days to solve and complete, they’re worth the effort as these types of games can help keep you sharp, as well as slow memory loss and mental decline. 5. Switch to your non-dominant hand While this might sound like an odd one, switching to your non-dominant hand from time to time has been shown to stimulate the parts of the brain that control your muscles. Experts also say that using your other hand helps your brain to better integrate its two hemispheres. 6. Get talking For a basic brain workout, get chatting! Next time you catch up with family or friends try talking about more challenging topics (such as politics, religion etc.) where you engage in deep discussion – without arguing. It’s a great way to keep your mind active while having fun, get to know others better and to share your thoughts. 7. Back to school Education has obvious benefits and going back to school is a great way to get your brain working again, to challenge yourself and to do something satisfying. You don’t have to sign up for a whole degree, there are many free short courses as well as certificate courses that you can do online. 8. Eat well Just like with the body, when you exercise you need to give your brain the right fuel so it operates at optimal health. The Open Training Institute says, “Skipping breakfast can reduce thinking skills by 40 per cent, as your brain is starved of that much needed sugar hit”. Furthermore, certain foods are good for improving brain function like dark chocolate, which increases blood flow to the brain increasing alertness and clarity. “Blueberries for example pack a powerful punch of antioxidants and can improve memory, while green leafy veggies and fresh herbs are full of vitamin K, which improves cognitive function.” 9. Exercise Being active doesn’t only keep your body healthy it can also make you more alert. The Open Training Institute says, “Low-intensity exercise like yoga or walking can dramatically reduce sleepiness, amp up energy levels and attention span.” And the benefits of keeping active don’t stop there. “More intensity can even improve cognitive function by five to 10 per cent.” Image credit: Shutterstock

Mind

Hot flushes, night sweats, brain fog? Here’s what we know about phytoestrogens for menopausal symptoms

<a href="https://theconversation.com/profiles/caroline-gurvich-473295">Caroline Gurvich</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jane-varney-963066">Jane Varney</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/jayashri-kulkarni-185">Jayashri Kulkarni</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> While some women glide through menopause, <a href="https://pubmed.ncbi.nlm.nih.gov/26271251/">more than 85%</a> experience one or more unpleasant symptoms, which can impact their physical and mental health, daily activities and quality of life. Hot flushes and night sweats are the most common of these, affecting <a href="https://pubmed.ncbi.nlm.nih.gov/29393299/">75% of women</a> and the symptom for which most women seek treatment. Others include changes in weight and body composition, skin changes, poor sleep, headaches, joint pain, vaginal dryness, depression and brain fog. While menopause hormone therapy is the most effective treatment for menopausal symptoms, it is sometimes not recommended (such as following breast cancer, as there is conflicting evidence about the safety of menopause hormone therapy following breast cancer) or avoided by people, who may seek non-hormonal therapies to manage symptoms. In Australia it is estimated <a href="https://pubmed.ncbi.nlm.nih.gov/26224187/">more than one-third</a> of women seek complementary or alternative medicines to manage menopausal symptoms. But do they work? Or are they a waste of time and considerable amounts of money? <h2>What’s on the market?</h2> The <a href="https://pubmed.ncbi.nlm.nih.gov/30868921/">complementary or alternative interventions</a> for menopausal symptoms are almost as varied as the symptoms themselves. They include everything from mind-body practices (hypnosis, cognitive behavioural therapy and meditation) to alternative medicine approaches (traditional Chinese medicine and acupuncture) and natural products (herbal and dietary supplements). There is some evidence to support the use of <a href="https://pubmed.ncbi.nlm.nih.gov/23435026/">hypnosis</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/22336748/">cognitive behaviour therapy</a> for the treatment of hot flushes. Indeed these therapies are recommended in <a href="https://www1.racgp.org.au/getattachment/bfaa5918-ddc4-4bcb-93cc-d3d956c1bbfd/Making-choices-at-menopause.aspx">clinical treatment guidelines</a>. But there is less certainty around the benefit of other commonly used complementary and alternative medicines, particularly nutritional supplements. The most popular <a href="https://pubmed.ncbi.nlm.nih.gov/26224187/">nutritional supplements</a> for hot flushes are phytoestrogens (or plant estrogens). This trend has been driven in part by <a href="https://www.dailymail.co.uk/femail/article-11915645/HRT-not-supplement-created-experts-women-RAVING-effects.html">supplement companies</a> that promote such agents as a safer or more natural alternative to hormone therapy. <h2>What are phytoestrogens?</h2> Phytoestrogens are plant-derived substances that can show oestrogen-like activity when ingested. There are numerous types including isoflavones, coumestans and lignans. These can be consumed in the form of food (from whole soybeans, soy-based foods such as tofu and soy milk, legumes, wholegrains, flaxseeds, fruits and vegetables) and in commercially produced supplements. In the latter category, extracts from soy and red clover yield isoflavones and flaxseed gives us lignans. Because declining oestrogen levels drive menopausal symptoms, the theory is that consuming a “natural”, plant-based substance that acts like oestrogen will provide relief. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528788/original/file-20230529-17-mh3zlk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Soy-rich foods on a table: edamame, soy milk, soy sauce" /></a><figcaption>Phytoestrogens can be consumed in foods like tofu or soy milk. <a class="source" href="https://www.shutterstock.com/image-photo/soy-bean-tofu-other-products-187030769">Shutterstock</a></figcaption></figure> <h2>What does the evidence say?</h2> In the case of isoflavones, initial support came from <a href="https://pubmed.ncbi.nlm.nih.gov/23562010/">epidemiological data</a> showing <a href="https://pubmed.ncbi.nlm.nih.gov/15919681/">women in Asian countries</a>, consuming a traditional, phytoestrogen-rich diet (that is, one including tofu, miso and fermented or boiled soybeans), experienced fewer menopausal symptoms than women in Western countries. However, several factors may influence the effect of dietary phytoestrogens on menopausal symptoms. This includes gut microbiota, with research showing only around <a href="https://pubmed.ncbi.nlm.nih.gov/15919681/">30% of women</a> from Western populations possess the gut microbiota needed to convert isoflavones to their active form, known as equol, compared to an estimated 50–60% of menopausal women from Japanese populations. Circulating oestrogen levels (which drop considerably during menopause) and the <a href="https://academic.oup.com/humupd/article/11/5/495/605995">duration of soy intake</a> (longer-term intake being more favourable) may also influence the effect of dietary phytoestrogens on menopausal symptoms. Overall, evidence regarding the benefit of phytoestrogens for hot flushes is fairly mixed. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001395.pub4/full">Cochrane review</a> synthesised study results and failed to find conclusive evidence phytoestrogens, in food or supplement form, reduced the frequency or severity of hot flushes or night sweats in perimenopausal or postmenopausal women. The review did note genistein extracts (an isoflavone found in soy and fava beans) may reduce the number of hot flushes experienced by symptomatic, postmenopausal women, though to a lesser extent than hormone therapy. Another <a href="https://pubmed.ncbi.nlm.nih.gov/36253903/">recent study</a> showed marked reductions in hot flushes in women following a low fat, vegan diet supplemented with daily soybeans. However, it was questioned whether concurrent weight loss contributed to this benefit. In Australia, <a href="https://ranzcog.edu.au/wp-content/uploads/2022/05/Managing-menopausal-symptoms.pdf">clinical guidelines</a> do not endorse the routine use of phytoestrogens. <a href="https://www.nice.org.uk/guidance/ng23/chapter/Recommendations#managing-short-term-menopausal-symptoms">Guidelines for the United Kingdom</a> note some support for the benefit of isoflavones, but highlight multiple preparations are available, their safety is uncertain and interactions with other medicines have been reported. <h2>Can phytoestrogens help the psychological symptoms of menopause?</h2> Less research has explored whether phytoestrogens improve psychological symptoms of menopause, such as depression, anxiety and <a href="https://theconversation.com/brain-fog-during-menopause-is-real-it-can-disrupt-womens-work-and-spark-dementia-fears-173150">brain fog</a>. A recent systematic review and <a href="https://pubmed.ncbi.nlm.nih.gov/33987926/">meta-analysis</a> found phytoestrogens reduce depression in post- but not perimenopausal women. Whereas a more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9022873/">recent clinical trial</a> failed to find an improvement. Some research suggests phytoestrogens may reduce the <a href="https://www.sciencedirect.com/science/article/pii/S0960076015301254?via=ihub">risk of dementia</a>, but there are no conclusive findings regarding their effect on menopausal brain fog. <h2>The bottom line</h2> At present there is uncertainty about the benefit of phytoestrogens for menopause symptoms. If you do wish to see if they might work for you, start by including more phytoestrogen-rich foods in your diet. Examples include tempeh, soybeans, tofu, miso, soy milk (from whole soybeans), oats, barley, quinoa, flaxseeds, sesame seeds, sunflower seeds, almonds, chickpeas, lentils, red kidney beans and alfalfa. Try including one to two serves per day for around three months and monitor symptoms. These are nutritious and good for overall health, irrespective of the effects on menopausal symptoms. Before you trial any supplements, discuss them first with your doctor (especially if you have a history of breast cancer), monitor your symptoms for around three months, and if there’s no improvement, stop taking them.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/204801/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-gurvich-473295">Caroline Gurvich</a>, Associate Professor and Clinical Neuropsychologist, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jane-varney-963066">Jane Varney</a>, Senior Research Dietitian in the Department of Gastroenterology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/jayashri-kulkarni-185">Jayashri Kulkarni</a>, Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/hot-flushes-night-sweats-brain-fog-heres-what-we-know-about-phytoestrogens-for-menopausal-symptoms-204801">original article</a>. Images: Getty

Body

Turning down the volume of pain – how to retrain your brain when you get sensitised

<a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> For every feeling we experience, there is a lot of complex biology going on underneath our skin. Pain involves our whole body. When faced with possible threats, the feeling of pain develops in a split second and can help us to “detect and protect”. But over time, our nerve cells can become over-sensitised. This means they can react more strongly and easily to something that normally wouldn’t hurt or would hurt less. This is called “<a href="https://sitn.hms.harvard.edu/flash/2022/sensitization-why-everything-might-hurt/#:%7E:text=When%20neurons%20responsible%20for%20sensing,subset%20of%20chronic%20pain%20patients.">sensitisation</a>”. Sensitisation can affect anyone, but some people may be more prone to it than others due to possible <a href="https://doi.org/10.1111/jabr.12137">genetic factors, environmental factors or previous experiences</a>. Sensitisation can contribute to chronic pain conditions like fibromyalgia, irritable bowel syndrome, migraine or low back pain. But it might be possible to retrain our brains to manage or even reduce pain. <h2>‘Danger!’</h2> Our body senses possible threats via nerve endings called <a href="https://www.sciencedirect.com/topics/neuroscience/nociceptor">nociceptors</a>. We can think of these like a microphones transmitting the word “danger” through wires (nerves and the spinal cord) up to a speaker (the brain). If you sprain your ankle, a range of tiny chemical reactions start there. When sensitisation happens in a sore body part, it’s like more microphones join in over a period of weeks or months. Now the messages can be transmitted up the wire more efficiently. The volume of the danger message gets turned way up. Then, in the spinal cord, chemical reactions and the number of receptors there also adapt to this new demand. The more messages coming up, the more reactions triggered and the louder the messages sent on to the brain. And sensitisation doesn’t always stop there. The brain can also crank the volume up by making use of more wires in the spinal cord that reach the speaker. This is one of the proposed mechanisms of central sensitisation. As time ticks on, a sensitised nervous system will create more and more feelings of pain, seemingly regardless of the amount of bodily damage at the initial site of pain. When we are sensitised, we may experience pain that is out of proportion to the actual damage (<a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hyperalgesia">hyperalgesia</a>), pain that spreads to other areas of the body (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327510/">referred pain</a>), pain that lasts a long time (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573040/">chronic or persistent pain</a>), or pain triggered by harmless things like touch, pressure or temperature (<a href="https://www.ncbi.nlm.nih.gov/books/NBK537129/#:%7E:text=Allodynia%20is%20defined%20as%20%22pain,produce%20sensation%2C%20causing%20pain.">allodynia</a>). Because pain is a biopsychosocial experience (biological and psychological and social), we may also feel other symptoms like fatigue, mood changes, sleep problems or difficulty concentrating. <h2>Neuroplasticity</h2> Around the clock, our bodies and brain are constantly changing and adapting. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557811/">Neuroplasticity</a> is when the brain changes in response to experiences, good or bad. Pain science research suggests we may be able to <a href="https://www.nih.gov/news-events/nih-research-matters/retraining-brain-treat-chronic-pain">retrain</a> ourselves to improve wellbeing and take advantage of neuroplasticity. There are some promising approaches that target the mechanisms behind sensitisation and aim to reverse them. One example is <a href="https://pubmed.ncbi.nlm.nih.gov/21306870/">graded motor imagery</a>. This technique uses mental and physical exercises like identifying left and right limbs, imagery and <a href="https://www.physio-pedia.com/Mirror_Therapy">mirror box therapy</a>. It has been <a href="https://www.tandfonline.com/doi/full/10.1080/24740527.2023.2188899">tested</a> for conditions like <a href="https://www.ninds.nih.gov/health-information/disorders/complex-regional-pain-syndrome">complex regional pain syndrome</a> (a condition that causes severe pain and swelling in a limb after an injury or surgery) and in <a href="https://www.ncbi.nlm.nih.gov/books/NBK448188/#:%7E:text=Phantom%20limb%20pain%20is%20the,underlying%20pathophysiology%20remains%20poorly%20understood.">phantom limb pain</a> after amputation. Very gradual exposure to increasing stimuli may be behind these positive effects on a sensitised nervous system. While results are promising, more research is needed to confirm its benefits and better understand how it works. The same possible mechanisms of graded exposure underpin some recently developed <a href="https://mhealth.jmir.org/2019/2/e13080/">apps</a> for sufferers. Exercise can also retrain the nervous system. Regular physical activity can <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.01317.2012">decrease the sensitivity</a> of our nervous system by changing processes at a cellular level, seemingly re-calibrating danger message transmission. Importantly, exercise doesn’t have to be high intensity or involve going to the gym. Low-impact activities such as walking, swimming, or yoga can be effective in reducing nervous system sensitivity, possibly by providing new evidence of perceived <a href="https://doi.org/10.1097/j.pain.0000000000002244">safety</a>. Researchers are exploring whether learning about the science of pain and changing the way we think about it may foster self-management skills, like pacing activities and graded exposure to things that have been painful in the past. Understanding how pain is felt and why we feel it <a href="https://doi.org/10.1111/1756-185X.14293">can help</a> improve function, reduce fear and lower anxiety. <figure><iframe src="https://www.youtube.com/embed/eakyDiXX6Uc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>But don’t go it alone</h2> If you have chronic or severe pain that interferes with your daily life, you should consult a health professional like a doctor and/or a pain specialist who can diagnose your condition and prescribe appropriate active treatments. In Australia, a range of <a href="https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/212772/ACI-chronic-pain-services.pdf">multidisciplinary pain clinics</a> offer physical therapies like exercise, psychological therapies like mindfulness and cognitive behavioural therapy. Experts can also help you make lifestyle changes to improve <a href="https://painhealth.csse.uwa.edu.au/pain-module/sleep-and-pain/">sleep</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584994/">diet</a> to manage and reduce pain. A multi-pronged approach makes the most sense given the complexity of the underlying biology. Education could help develop <a href="https://www.sciencedirect.com/science/article/abs/pii/S0738399121006467">pain literacy and healthy habits</a> to prevent sensitisation, even from a young age. Resources, such as children’s books, videos, and board games, are being developed and tested to improve <a href="https://doi.org/10.1016/j.jpain.2022.07.008">consumer and community understanding</a>. Pain is not a feeling anyone should have to suffer in silence or endure alone. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/202850/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/turning-down-the-volume-of-pain-how-to-retrain-your-brain-when-you-get-sensitised-202850">original article</a>.

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Turning down the volume of pain – how to retrain your brain when you get sensitised