Brain at Risk

There is no doubt that the brain is the most precious organ of a human being. Whereas there is much public education about taking preventive care of other organs, one does not really care about preventing deterioration of brain, thereby causing much misery to the individual, the family, and the society. As neuroscientists, we are in a privileged position to know and to educate people about the importance of brain protection from the ravages of risk factors. Although a certain degree of age-associated cognitive decline may occur in some individuals, one can certainly take steps to prevent brain dysfunction to a reasonable degree from birth to the advanced stages of life. In familial disorders, we can persuade families to get genetic counseling before planning a family. Advising patients to avoid radiation and teratogenic drugs in pregnancy is equally important. Careful management of peripartum period helps in minimizing the sequel of hypoxic-ischemic damage to the fetal brain. The most common challenge to brain in adolescence and youth is head injuries. Avoidance of rash or drunken driving and wearing of helmets will prevent the brain damage due to road traffic accidents. We should educate people about the preventable adverse effects of alcoholism, subclinical vitamin deficiency, hypothyroidism, and HIV on the brain. With the advancing age, cerebrovascular disease poses a great threat to the functional abilities of an individual.

Silent infarctions have been found to cause impairments in judgment and executive planning. This is particularly true about developing countries where the prevalence of stroke has assumed epidemic proportion.[1] Vascular dementia is thought to be an important contributor to cognitive dysfunction in India and an interaction between the Alzheimer's Disease pathology, vascular risk factors, and strokes are now proposed.[2] There seems to be a genetic component to the development of cerebrovascular disease, and our group has identified the genetic polymorphism associated with the risk of developing stroke in patients from Andhra Pradesh.[3] Controlling risk factors such as hypertension, diabetes, and smoking go a long way in reducing the risk of stroke in high-risk individuals. Despite all precautions, one may still develop degenerative dementias such as Alzheimer's disease. It is very sad to see the mental disintegration of the entire personality of a human being, especially when he happens to be a near and dear one. Collaborative studies from our institute are underway to identify markers for preclinical diagnosis of diagnosis of neurodegenerative diseases, thereby identifying the brain at risk. Interestingly, many studies have shown that regular physical activity reduces the amyloid load in the brain thought to be causative for brain degeneration. A few studies from worldwide have shown that mentally challenging but enjoyable activities not only enrich one's quality of life but also delay the onset of dementia. A study from our own Neurology Department of NIMS Hyderabad, published in the official journal of the American Academy of Neurology has highlighted the role of using more than one language in delaying the onset of dementia by at least 4.5 years.[4] Other studies have shown that the mere process of learning a new language or learning to play a musical instrument or doing iPad based mental exercises has a protective and even a therapeutic influence on cognition. Above all, a positive outlook throughout one's life not only keeps the brain in a happy and calm state but also optimizes its functions. As neuroscientists, we should popularize the concept of “brain at risk” and protect it for its maximum function.