Healthy aging and preserving community memories

The Layton Aging and Alzheimer’s Disease Center in partnership with the Center for Healthy Communities is launching a first-of-its kind study around brain health intervention. The innovative program aims to boost cognitive health within the African-American community in Portland.

The Sharing History through Active Reminiscence and Photo-imagery (SHARP) study asks African Americans who are 55 or older to engage in community memory building while walking through historically black neighborhoods in North and Northeast Portland.

swimming dive copyParticipants will view images of the African-American community in Portland from the 1940’s to 2000’s, and then engage in conversation about what it was like to live and work in those communities.

By promoting both individual memory health and community memory, the study will explore the role that community memory plays in individual health.

The study’s long-term goal is to maintain and increase cognitive health of participants through a multi-layered approach, including physical activity (walking at a comfortable/moderate pace), socializing, conversational remembrance and health education.Billy Webb Elks Club copy

The study investigators chose to target the African American community with healthy aging interventions because data point to disparities in prevalence of Alzheimer’s disease and other dementias among African Americans compared to white Americans.

African Americans face special challenges in maintaining brain health with higher rates of chronic diseases, like hypertension and diabetes, that are risk factors for cognitive health.

Most notably, qualitative data have shown African Americans have a lower perceived risk of Alzheimer’s disease despite their elevated risk.

If you would like to contribute your family images to the SHARP program, contact Raina Croff at croff@ohsu.edu or 503-494-2367.

Read more in The Skanner.

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Raina Croff

 

Raina Croff, Ph.D. is the Senior Research Associate for the Dept. of Public Health and Preventive Medicine.

 

 

 

The SHARP project is sponsored by the CDC-funded Prevention Research Center, the Center for Healthy Communities at Oregon Health & Science University Cooperative Agreement number U48DP005006.

Dietary and lifestyle modifications for migraine prevention

Years ago, my headache mentor at Columbia, Dr. Green, compared a migraineur’s brain to a fancy sports car’s engine. He meant that the brain becomes sensitized to the slightest stimulation and like the engine of a fine sports car, it revs up with the slightest stimulation.

In migraine the 0-60 mph equivalent is a phenomenon of brainstem activation followed by a wave of depolarization (depression of neuronal activity), which originates in the occipital lobes in the back of the head and slowly spreads forward at a rate of 2-5 mm per minute.

This phenomenon is called Cortical Spreading Depression and while we do not understand the exact mechanism of how it is triggered, we know that it can be caused by subtle changes in diet, sleep, stress, dehydration, medications, upper respiratory illness, chronic medical conditions and that it leads to inflammation and pain through blood vessel dilatation. This image of the sensitive migraineur’s brain has stayed with me and is a helpful reminder that modification of these lifestyle risk factors can decrease the frequency of migraine attacks.

Gluten and Other Potential Food Triggers in Migraine

As a resident, I conducted a study aimed to assess the prevalence of migraine in 728 subjects – patients with celiac disease (gluten intolerance) and healthy controls. We were somewhat surprised to find out that 33% of patients with celiac disease suffered from migraine!

The number is probably much higher – possibly up to 45-50% as in our surveys we came across 8 patients with celiac disease who had suffered from debilitating headaches, which were completely resolved with a strict gluten-free diet.

I should point out that Celiac disease may present without any GI symptoms whatsoever. It could often manifest as lack of energy, skin problems, numbness in the extremities or face, headaches or balance difficulties.

Lactose is another common offensive agent, particularly in those who are intolerant. Refined sugar is pro-inflammatory and high-sugar diet invariably causes sugar lows due to increased insulin release.

Hypoglycemia is a known migraine trigger. Other known dietary triggers are tyramine-rich foods such as aged cheeses, beer and wine, chocolate, soy sauce, MSG.

I am not saying that migraine sufferers should all be gluten, lactose and refined sugar-free, however an elimination trial of 4-6 weeks (one food category at a time) is reasonable as they may be hidden triggers for migraine.

Dietary Changes to Prevent Migraine

  • Celiac disease testing with any unexplained GI or neurologic deficits
  • Trial of lactose-free diet
  • Avoid chocolate and tyramine-rich foods
  • Avoid alcohol, especially beer and wine
  • Avoid concentrated sweets and diets high in sugar
  • Eat small, frequent meals to avoid hypoglycemia
  • Limit caffeine consumption to 1 cup per day, eliminate altogether if possible

Lifestyle Modifications to Prevent Migraine

  • Moderate exercise activity of 30 min 3-4 times per week
  • Maintain normal weight
  • Sleep 7-8 hours a night with a regular sleep schedule (undersleep and oversleep both can trigger migraines)
  • Stress reduction is key – incorporate relaxation and meditation techniques on a daily basis, even if it means slowed, focused breathing for 5 min per day
  • Quit tobacco as it is pro-inflammatory and can be a trigger
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Alexandra Dimitrova, MD is an Assistant Professor in Neurology at OHSU, who sees patients with headache and pain in the Neurology Wellness Clinic. In her practice she integrates traditional neurologic treatments with acupuncture, dietary and lifestyle changes and other complementary and integrative treatments.

The White House BRAIN Initiative in Oregon

Just over two years ago, President Obama made a dedication to support and enhance neuroscience research through the Brain Research through Advancing Innovative Neurotechnologies, or BRAIN, Initiative. The ultimate goal, a comprehensive map of the human brain under normal conditions and in various disease states, is a daunting and perhaps unattainable task.

However, a year after the announcement, tangible goals and measurable outcomes were further defined by a Working Group of scientists, and we are now beginning to see progress towards these goals.

In the first five years, the BRAIN Initiative will focus on the development of new technologies to study the brain in finer detail.

In the second five years, application of these technologies will help us unlock complexities of the brain to reveal new and fundamental discoveries about brain function.

While the White House is leading the charge in terms of coordination and promotion of BRAIN, the actual dollars come from investments committed by federal agencies, private foundations, biotechnology companies, and academic institutions.

Combined, these groups have pledged over $300 million in support of BRAIN-focused research.

One of the major backers is the National Institutes of Health (NIH), which is a federal agency that supports the majority of biological research in the country.

Last September, the NIH made its first investment of $46 million for BRAIN Initiative projects, funding over 100 scientists across the country!

Over the past 15 years, advanced imaging technologies have exploded in the field of neuroscience, allowing us to peer into the living mouse brain with temporal and spatial resolution spanning from the level of individual synapses up to cross-brain circuit function. So, while the idea of developing technologies to advance neuroscience is not new, the BRAIN Initiative is a specific commitment to the need for these technologies, and has kindled a desire in the public and among scientists to see these technologies advance.

Perhaps one of the most important roles of the White House BRAIN team is to unite scientists across disciplines, to inspire collaborations between engineers, neuroscientists, physicists, and computer scientists.

In an effort to advance the goals of the BRAIN Initiative and to strengthen collaborations in our pocket of the country, neuroscientists in Portland and Seattle have formed the Pacific Northwest NeuroNeighborhood.

NeuroFutures2015

The major contributors to the Northwest NeuroNeighborhood – the OHSU Brain Institute, the University of Washington, and the Allen Institute for Brain Science – are hosting the second annual NeuroFutures conference in Portland this summer.

With a focus on advances in neurotechnology and innovation, including topics on various imaging techniques, big data analytics, and brain/computer interfaces, the conference is well aligned with the goals of the BRAIN Initiative.

As the BRAIN Initiative continues to roll out and gain momentum, the hope is that not only BRAIN-supported researchers will benefit from these advances in technology, but that it will expand the discovery capacity for the entire field of neuroscience.

Find out more about how you can support brain research.

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Kateri Spinelli, Ph.D. is a post doctoral fellow in the Department of Neurology.

 

Meet Tianyi Mao: Looking at brain circuits in a new light

The Brain Research Awareness and Information Network (BRAINet) is the volunteer outreach organization of the OHSU Brain Institute. Each month, they come together for a lecture luncheon. Tianyi Mao, Ph.D. was a recent guest speaker.

Our brains are the most sophisticated computing machines on the planet. They are amazingly plastic, yet macroscopically their structures are conserved across individuals within a species.

Information, both internal and external, is processed by such stereotypical brain circuits. It flows from one sub-region in the brain to specific targets.

The same way that knowing a circuit diagram for a microchip informs us about how it works, understanding the sequence of information flow in the brain is an essential step towards understanding brain function in both normal and disease conditions.

We use this rationale to try to understand the circuits of the basal ganglia, which are a collection of brain structures critical for movement control and decision-making.

Dysfunction of the basal ganglia contributes to the physical side effects of many neurodegenerative diseases, most notably Parkinson’s disease and Huntington’s disease. Alterations in basal ganglia circuits also are associated with behavioral perturbations in drug addiction and neurodegenerative diseases.

Our current understanding of the basal ganglion has been limited by the complexity of this circuitry.

In my laboratory, we examine the information flow within basal ganglia and its interaction and coordination with other key brain areas essential of  movement control and drug addiction.

My team seeks to understand how the brain is wired and what happens after a specific circuit in the brain is inactivated. Through the use of innovative tools including large scale brain imaging, calcium imaging, genetics and optogenetics, we are essentially trying to reverse-engineer the brain to help us understand how it works.

One goal of our research program is to investigate how the circuitry changes during different behaviors (e.g. directed vs. habitual), and in animal models of addiction, which have been crucial in understanding the biological and physical manifestations of drug addiction and substance abuse

Our projects that use different tools to investigate different aspects of the basal ganglia circuitry are expected to be synergistic. With complementary approaches, we hope to better understand the cell-type-specific circuitry, a prerequisite for a thorough understanding of basal ganglia function in health and disease.

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This video is a 3D tracing of neuronal connectivity using viral-mediated fluorescent protein expression. It allows us to follow the potential information flow from one macro region in the brain to its next target. To view more brain images, visit our data collection website. 

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Tianyi Mao, Ph.D. is an Assistant Scientist and Principal Investigator for the Mao lab at the Vollum Institute

 

 

 

Would you like to get involved with BRAINet? Join here.

The Neurology Wellness clinic provides an integrated approach to pain

According to a recent Food and Drug Administration report, over 42% of Americans suffer chronic pain and over 10% of those are disabled due to pain.

Undoubtedly our busy schedules with multiple stressors, sedentary lifestyles and poor health habits are contributing to this problem.

Recent years have seen a surge in acupuncture research with strong evidence of its effectiveness for the treatment of chronic low-back pain, migraine and tension headache, carpal tunnel syndrome and most recently – neuropathic pain.

In the Neurology Wellness clinic we apply evidence-based acupuncture, herbal medicine, dietary supplements and lifestyle modification advice for the treatment of headache, musculoskeletal pain such as neck and back pain, muscle spasms, neuropathic pain, TMJ, carpal tunnel syndrome, anxiety and stress and many other painful conditions.

Our team has 2 practitioners:

  • Dr. Alexandra Dimitrova, MD, MA is an Assistant Professor of Neurology at OHSU, who trained in medical acupuncture at Harvard University. Following Neurology residency training at Columbia University, Dr. Dimitrova pursued a Post-doctoral research fellowship at OHSU’s ORCCAMIND (Oregon Center for Complementary and Alternative Medicine in Neurologic Disorders). Her research focus has been to localize and characterize the effect of acupuncture on the peripheral nervous system, correlating the Traditional Chinese Medicine concept of meridians to peripheral nerves. Dr. Dimitrova is funded for these studies by the National Institutes of Health. She strives to be a compassionate and competent physician and to treat the whole person, not just the condition.
  • Ms. Annette (Zoe) Fallian BA, BS, MAOM is a licensed acupuncturist and an adjunct instructor at OHSU, who trained at Pacific College of Oriental Medicine in Chicago and later at Oregon College of Oriental Medicine (OCOM). Using her expertise in acupuncture and herbal medicine, she strives to find a unique and personalized approach to each patient’s condition and address not only the physical, but also the emotional aspects of health and wellbeing.

The Neurology Wellness Clinic is located at the Center for Health and Healing, in the Neurology Department, 3303 SW Bond Ave, Portland, OR 97239. We are accepting new patients and the number to call and schedule is 503-494-7772.

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Alexandra Dimitrova, MD is an Assistant Professor in Neurology at OHSU, who sees patients with headache and pain in the Neurology Wellness Clinic. In her practice she integrates traditional neurologic treatments with acupuncture, dietary and lifestyle changes and other complementary and integrative treatments.

 

 

Stroke survivors continue to heal through the power of music

The Backstrokes: Marlane Venner, Brad Caster, Carol and Ed Edmo, Lee Jordan, Lynn Sweeney, Anne Tillinghast,
Phil Liu and his mother Ellen.

Back in early 2013, we heard about a group of stroke survivors who found their voice and some healing through music in a group known as The Backstrokes. We’re pleased to report that the music group continues to play together…

Since the original blog post, The Backstrokes have been going strong.

We have been joined by guitarist, Keith Parkhurst–a long-time Portland musician, who is naturally good at connecting with people, and finding out what songs they like to sing.

Most of our core group still attends regularly, and we continue to celebrate noticeable improvement in speech and overall communication skills, showing that ongoing recovery continues to be possible even ten years or more after a stroke.

Some of our members also attend speech therapy at the Portland State University Aphasia Program. According to them, singing on a weekly basis, or more, is helpful in “speeding up” the results of those efforts.

Liz & Kate Sterry, Marlane Venner and Anne Tillinghast at the recent Heart & Stroke Walk finish line.

Last fall, we were very happy to add a second group that invites members to bring instruments they already play, or are learning.

The goal of this group is to develop the skills needed to play along with others in impromptu settings.

This is not only an attempt to engage more of the brain in healing, but also to try to facilitate more social and community involvement, which can be severely limited by impaired speech.

For the past two years, Marlane Venner, has been attending both Backstrokes groups, as well as volunteering with us at two skilled nursing facilities.

In spite of numbness and partial paralysis in her right hand, she is also learning to play the ukulele.  In the past few months, her speech has improved enough to start telling me about herself and her life.

She happily states that she is “getting better!” She attributes this, in part, to the variety of  social interactions around each music activity, and from “pushing the envelope” in learning new skills.

This growing friendship is profoundly rewarding on a personal level, and professionally, it encourages us to keep trying new ways to engage people to play music, or in Marlane’s words, to keep “pushing the envelope!”

Learn more at thebackstrokes.com

Hear The Backstrokes play on this KOIN news report from 2013:

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Anne Tillinghast is passionate about inspiring others to sing and play music. She worked at the Oregon Stroke Center at OHSU for 13 years before starting The Backstrokes group for Stroke Survivors in 2012. Her varied work experience also includes singing to help teach language skills in developmental preschool classrooms, and using camp songs to wrangle sixth-graders during their week’s stay with the Multnomah County Outdoor School program.

Your health questions answered: What can I do to lower my risk of stroke?

You ask. OHSU health experts answer. This month, one of our stroke experts is on the hot seat. 

Q: Stroke runs in my family: What can I do to lower my risk?

A: The most important thing you can do to lower your risk of stroke is to keep your blood pressure under control.

Also, conditions such as high cholesterol and diabetes can run in families and increase your stroke risk.

If you have an irregular heartbeat (atrial fibrillation), talk to your doctor because it can increase your chance of stroke, especially as you age.

Your lifestyle plays a part, too.

For example, quitting smoking cuts your risk of stroke in half. Moderate exercise, such as brisk walking for 30 minutes daily, also can help keep you healthy.

Diet counts, too.

Reduce your consumption of red meat and processed foods, and eat more fruits and vegetables instead.

Managing stress also can lower your blood pressure, thus lowering your risk.

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Helmi Lutsep, M.D. is vice chairwoman of neurology and sees patients at the OHSU Stroke Center, which was recently recognized by the American Heart Association and American Stroke Association for achieving the highest level of performance in stroke care. 

Researcher seeks better ways to care for people post-concussion

The research surrounding concussions has been a heavy topic of discussion and strides are being taken to incorporate research findings into clinical and practical care of people post-concussion.

This attempt to provide evidence-based care to our athletes was recently punctuated at the the Sports and Health Research Program Stakeholders Board Meeting, organized by the Foundation for the National Institute of Health (NIH) in Washington DC.

In attendance were several NIH funded investigators, NIH program officers and representatives from organizations such as the NFL, NHL, FIFA and the Olympic team.

During this meeting, I shared an update on my research, which uses inertial sensors for on-site gait and balance testing after college athletes have sustained a concussion.

My team is particularly interested in investigating how balance and gait measures change after injury and how long those abnormalities last for individuals hoping to return to their sport.

Our research uses wireless inertial sensors, attached to the athletes ankles and waist to objectively quantify subtle abnormalities that reflect impaired balance or coordination, often missed by routine examination.

Interestingly, the inertial sensors we use in our research were developed by a local start-up company here in Portland called APDM.

Our team of researchers represents a multidisciplinary and multi-institutional collaboration between myself, the principal investigator in the Department of Neurology, and Dr. Jim Chesnutt M.D. (co-investigator) in the Department of Orthopedics and Rehabilitation.

We collaborate with three local universities: Portland State University, Lewis & Clark University, and George Fox University.

The funding provided by the NIH has been pivotal in moving forward the relationship between the sports and scientific communities here in Portland.

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Laurie King, Ph.D., PT studies the clinical implementation of emerging practices and technology for improving assessment and rehabilitation in patients with neurologic disorders such as Parkinson’s disease and traumatic brain injury. 

We’re celebrating Take Your Sons and Daughters to Work Day

Last Thursday, April 23, we celebrated Take Your Sons and Daughters to Work Day here at the OHSU Brain Institute. Today, we welcome a very special guest blogger, seven-year-old Patrick…

Today I went to work with my mom. I loved it. I hope I can go next year.

I pet pupys named Hope, Carolina, and Hunter, (they were very nice.)

I got trivia from the shcool nursing. I liked answering the quetions.

I learnd that I HAVE TO wear a helmet when riding a bike, because if I don’t I mite get a concussion.

I loved being at OHSU!!!!!

Patrick, age seven

I’m looking at brains!

My mom carried my stuff for me.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Patrick is a second grader at The International School in Portland. His mom is the Social Media Coordinator for the OHSU Brain Institute.

Reflections: Memory, melody and jazz

We’re gearing up for the Portland screening of the film “Una Vida” on Monday, April 27. A panel discussion from three neuro-experts will follow the film, including artist Tim DuRoche. Tim will share his expertise on New Orleans jazz and the intra-psychic impact of music on the mind. Today, he talks memory and music as our “On the Brain” guest blogger…

UNAVIDA-POSTERAs I look forward to the screening and post-film discussion of Nicholas Bazan’s Una Vida on April 27 at OMSI’s Empirical Theater, I’ve been doing a lot of thinking about jazz, memory and how music acts as such a powerful beacon – whether we realize it or not.

Because jazz spans the 20th century, it is a floodgate for mood and memory, flickering gone reflections: a first kiss, a 50th anniversary, chestnuts roasting on an open fire, many innumerable rites of passage.

Jazz players are often hired for musical situations known as “casuals” —which can be a corporate gig, wedding reception, art opening, Christmas-time-at-the-Fred-Meyer-deli— it’s pretty hard to do this for too long without getting “the request.” I began to think about this years ago: that a request is often about wanting access to something that is more than a simple song.

Some musicians play cooly with a listener’s insatiable appetite for reminiscence and avoid the request or are resentful of the simple pleasure that comes with “playing our song” for those requesting not only our permission to embark, but our trust and collaboration as a harbormaster of these kernels of identity and remembrance.

Honoring the request can be an inescapably intimate act —profound, really—to be trusted with the raw materials of someone else’s memory…to act as a conduit, accelerating and reversing time for another, suggesting, reminding, or date-stamping snapshots of desire and a life together through a song and a dance.

You wouldn’t want to shatter a five-year- old’s hopes for Santa, so why would you toy with the fragility of emotion that is welled-up between the box-step of “Deep Purple” or the faraway-from-home-in-a-trench immediacy of “I’ll Be Home for Christmas?”

There are certain songs (and times like the winter holidays brings them out in spades), fire-lit songs that make you feel like cardigan-clad Perry Como or Jimmy Stewart. These songs move us. Every time. They’re simple. Yet they remind us of what’s important. Perhaps what’s been lost.

And it was music that tripped the switch. It’s palpable. Chord struck. Juxtaportation commences. Moment shared. It’s part of the social contract and the möbius strip of the creative exchange and it happens so often between total strangers.

It is a remarkable illustration of Martin Buber’s idea that all real living is meeting.

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Tim DuRoche

 

Tim DuRoche is a jazz musician, radio-host, writer and public artist living in Portland. He works as director of programs for the World Affairs Council of Oregon

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