Stress and Memory: Whats the

Relationship?
Posted on June 14, 2011 by Dr. Pascale Michelon| 36 Comments

By: Dr. Pascale Michelon

Intuitively, stress does not seem to be a performance booster. We

have all fumbled through documents right in the middle of a stressful presentation or
conversation, unable to find the document we wanted! On the other hand it feels like a little
bit of stress may help arouse us. What does science tell us about the effect of stress on
performance? Is stress good for memory?

What happens in your brain when you are stressed?

In response to physical or psychological stress, cortisol is released in the blood. Cortisol is
often referred to as the stress hormone. It is a corticosteroid hormone produced by the
adrenal cortex in the brain. In normal release, cortisol has widespread actions that help restore
homeostasis (or equilibrium) after stress. It is involved in the activity of the immune system,
the regulation of blood pressure, as well as in the inflammatory response. Cortisol has an
effect on several substances in the body: insulin, amino-acids, gastric secretion, sodium,
potassium, water, copper.

Acute versus chronic stress

Acute stress refers to the one time stressful event that elevates your production of cortisol for
a limited period of time. This type of stress can have a positive effect on memory. A stressful
event usually triggers the production of cortisol but also adrenaline. The cooperation of the
two can help create strong memories for the emotionally stressful event itself. For instance, it
is likely that you remember where you were and what you were doing when you heard about
the September 11th attack for the first time.

Chronic stress refers to a prolonged cortisol secretion. Higher and prolonged levels of
cortisol are not good for the body. They can result in higher blood pressure, lowered
immunity and inflammatory response and decreased bone density. They can also affect the
brain itself.
Long-term exposure to cortisol can indeed result in damage to cells in the hippocampus,
which is a brain structure crucial for memory formation. Thus chronic stress can result in
impaired learning and memory.
Lucien and colleagues (2005) showed that in older adults, long-term exposure to high levels
of cortisol is associated with both memory impairments and a 14% smaller volume of the
hippocampus.
Solutions against stress
There are many tools available to assess ones level of stress. If you feel out of control,
irritable and anxious it is likely that you experiencing high levels of stress.
What to do then to come back to normal cortical levels and good brain functions? Here is a
short list of possible solutions
1- Exercise
2- Relax
3- Get enough sleep
4- Appreciate the good things you have and have done
5- Maintain a good social network
6- Set goals and priorities

Does Brain Training Work?

Posted on October 27, 2011 by Dr. Pascale Michelon| 26 Comments

By: Dr. Pascale Michelon

Cognitive training has attracted a lot of interest in the past few years.
Scientific evidence that training the brain does help boost cognitive functions are slowly
being collected. A recent study reviews research looking at whether cognitive training can
help adults at risk of dementia.

Who is at risk of dementia?

People with mild cognitive impairment (MCI) are thought to be in the intermediate stage
between normal cognitive functioning and dementia. Their risks of developing dementia are
high: per year, 12-15% of the people with MCI are diagnosed with dementia compare to 1-
2% of the general population. Individuals with MCI are thus a perfect target for cognitive
training.

What is cognitive training?

In an ideal world, cognitive training should include repeated practice of tasks that target
specific cognitive functions (attention, language, memory, speed of processing, etc.). The
parallel can be drawn with physical training that requires repetition of movements targeting
specific muscle groups in order to see improvement.
Studies that have looked at the impact of cognitive training on brain functions mostly used
computerized tasks targeting specific cognitive abilities such as auditory processing. Other
studies have looked at the effect of memory strategy training in which participants are taught
how to use general memory techniques to enhance their performance.
Does it work?
The recent review included 10 studies (for a total of 305 participants). It was found that:

Cognitive training has moderate-sized effects on memory performance and global

cognitive measures.
Computer-based cognitive training led to stronger and more generalizable benefits
than memory strategy training.
Cognitive training also led to a reduction of depressive symptoms (in a few studies).
Following cognitive training (but not following memory strategy training), more
training was associated with more effects on memory performance.

In sum
This review shows that cognitive exercises can be beneficial and improve memory
performance in people with mild cognitive impairment. This adds to the evidence that
cognitive training works, as shown in other studies with healthy individuals.
The number of high quality studies is still low but cognitive training has no harmful side-
effects, in contrast to pharmacological interventions to prevent Alzheimers. A good reason to
start exercising your brain asap!

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Know Your Brain to Train It Well

Posted on July 5, 2011 by Dr. Pascale Michelon| 18 Comments

By: Dr. Pascale Michelon

If you are interested in improving your brain fitness and performance the first step is to
understand how the brain works. It is important to understand that different parts of the brain
support different functions. This matters because when trying to train your brain, you will
have to either perform a range of activities to train your whole brain or select a few specific
activities to train only some functions (or brain areas). Here is some basics information to get
you started.

The hemispheres
The brain weights approximately 3 pounds. It has two hemispheres (or sides). The right
hemisphere controls muscles on the left side of the body and the left hemisphere controls
muscles on the right side of the body.
Also, in general, sensory information (for instance information coming
from the eyes) from the left side of the body (left eye) is dealt with by the right hemisphere
and information from the right side of the body (right eye) is dealt with by the left
hemisphere.
More complex brain functions usually involve parts of both hemispheres and sometimes one
hemisphere more than the other (such as language, which is lateralized mostly to the left
hemisphere for right-handed people).
The cortex
The cortex, which literally translated means rind or peel is the outermost layer of the
brain. In each hemisphere, the cortex can be divided into 4 lobes: occipital, temporal, parietal
and frontal. Years of research have shown that each lobe has very specific functions.

The frontal lobes (in red here) are involved in motor control, emotional control,
judgment, problem solving, sexual behavior, socialization, language, memory, and
planning.

The parietal lobes (in yellow) are involved in visual attention, manipulation of
objects and integration of information coming from the senses from various parts of
the body.
The occipital lobes (in blue) are devoted to vision.
The temporal lobes (in green) are involved in memory (memory for language, faces
and places), audition, language and object perception.

The cerebellum and brain stem

The cerebellum (the transparent blue ball here) is located at the base of the skull. It is
involved in coordinating movements, and balance.
The brain stem (in purple) is located deep in the brain and leads to the spinal cord. It is
involved in breathing, heart rate, reflexes, sleep, balance, digestion, blood pressure, and
temperature.

How Memory Works

Posted on July 12, 2011 by Dr. Pascale Michelon| 17 Comments

By: Dr. Pascale Michelon

 People who complain about their memory lapses often say I have
such a bad memory! But what memory are they talking about?
Evidence coming from years of research have shown that memory is not a unique system.
Our brain contains different types of memory. The first distinction made by researchers is
between short- and long-term memory.

Short-term memory and long-term memory

Short-term or working memory is the memory system that you use to temporarily hold
information in your mind (max. of a 1mn). One example is when you look up a phone
number in the phone book: you hold that number in your mind (probably by repeating it to
yourself) only until you dial it.
The frontal and parietal parts of your brain are crucial for this type of memory.
Long-term memory is the memory for events that can last from 1mn to decades. Long-term
memory capability seems unlimited.
The second distinction made by researchers is within long-term memory. It is between
explicit and implicit memory.

Explicit memory and Implicit memory

Explicit (or declarative) memory is the conscious and intentional recollection of previous
events. By opposition, implicit (or procedural) memory is an unconscious, unintentional
recollection of past events. Implicit memory contains these types of knowledge that cannot be
translated into words such as driving, playing the piano, riding a bike, etc.
Explicit and implicit memories do not rely on the same brain structures. They are distinct
systems in the brain. Explicit memory depends mostly on the temporal and frontal parts of
your brain. The hippocampus in the temporal lobe is crucial. It is the first structure to be
damaged by Alzheimers disease.
Implicit memory relies on various structures in the brain, depending on the type of
knowledge involved. Procedural memory (how to ride a bike, etc) relies mostly on the
cerebellum.

Two types of explicit memory

Explicit memory can be furthers dissociated into episodic and semantic memory.
Episodic memory, also called autobiographical memory, consists of the recollection of
specific events in the life of a person. For instance, what you had for breakfast this morning is
an episodic memory.
Semantic memory consists in all the explicit memories that you have that are not
autobiographical. For instance, you know that Paris is in France but dont remember
specifically when or where you learned that information. It has become general knowledge in
your mind, it is no longer part of a specific episode of your life.

Aging in the memory systems

The effect of age is not the same on the different memory systems. Implicit memory and
semantic memory are relatively spared by age. In contrast, age greatly affects working
memory. It also affects episodic memory, not such much in the recollection of past
autobiographical events but in the registration of new
events into memory.
As you see it is not that simple! Next time you complain about your memory, keep in mind
that parts of it still probably work very well. And remember that memory can always be
improved: Keep using it!

Meditation can Change your Brain

Posted on September 1, 2011 by Dr. Pascale Michelon| 29 Comments

By: Dr. Pascale Michelon

What we do on a daily basis can affect our brain health, thanks to

neuroplasticity, the lifelong ability of the brain to change. In other words, new brain cells
(neurons) and connections between neurons can grow, based on our experiences. Previous
studies have shown that becoming expert at a specific activity (music, language, navigation,
etc.) changes the brain areas involved in this activity. These areas are highly stimulated and
usually get bigger as more neurons and connections are generated. Could practicing
meditation change the brain too?

Meditation has been practiced for millennia. Originally, it was intended to develop spiritual
understanding and awareness. Some studies have shown that meditation can reduce stress,
promote relaxation, and bolster the immune system. Others suggest that meditation may boost
cognitive abilities such as attention.

A 2009 study, conducted by Luders and colleagues at UCLA, scanned and compared the
brains of 22 meditators and 22 non-meditators (controls) to examine the effect of meditation
on brain structures. There were 9 men and 13 women in each group. Age ranged between 30
and 71 years (mean age: 53). Years of meditation practice ranged between 5 and 46 years
(mean: 24.18 years) and included different styles of meditation.

Compared to non-meditators brains, meditators brains showed more gray matter

(increased brain volume) in several regions (the orbito-frontal cortex, the thalamus, and
the hippocampus on the right and inferior temporal cortex on the left). No regions were
bigger in the controls brains than in the meditators brains.

The brain areas that were larger in the meditators brains are involved in functions that
are highly stimulated during meditation. The orbito-frontal cortex (in the front part of the
brain) deals with emotion regulation. The thalamus is involved in regulating the flow of
sensory information. The hippocampus has several roles but is primarily involved in memory
trace formation. Thus it is possible that a long practice of meditation did trigger these brain
changes, thanks to neuroplasticity.

It is not know so far how many years of meditation are needed to trigger similar changes. It is
also not know whether these structural changes are directly related to any behavioral changes.

Lets note that the changes observed in the meditators brain were small. Also, this study
does not provide any indication that meditation is the CAUSE of the changes. Although the 2
groups were carefully matched based on age, gender and education there may be factors other
than meditation that caused the brain differences observed.

Healthy Food for a Better Brain

Posted on July 26, 2011 by Dr. Pascale Michelon| 13 Comments

By: Dr. Pascale Michelon

We have all heard about special diets for people with heart problems.
But did you know that some foods are also specifically good for brain health? Here are the
main components of our diet that seem to have a positive effect on brain functions:

Omega-3 fatty acids

These acids (e.g., DHA) are normal constituents of cell membranes and are essential for
normal brain function. Fatty acids can be found in fish (salmon), kiwi, walnuts. In contrast,
trans or saturated fats have been shown to decrease cognitive performance. These are found
in dairy products, meat, and butter.

Antioxidant foods
The brain is highly susceptible to oxidative damage, which explains why antioxidants are
needed for good brain health. They are found in a variety of food: Alpha lipoic is found in
spinach, broccoli and potatoes; Vitamin E is found in vegetable oils, nuts, green leafy
vegetables; Curcumin is found
in the curry spice; Vitamin C is found in citrus fruit and several plants and vegetables. Berries
are well known for their antioxidant capacity.

Flavonoids
These have antioxidant effects. They are found in cocoa, green tea, Ginko biloba tree, citrus
fruits, wine and dark chocolate.
Folic acid (or folate)
Folate is generated by the liver after the intestine has absorbed vitamin B. Adequate levels of
folate are essential for brain function. It is found in spinach, orange juice and yeast.

How do I get all these?

The best advice is to eat a balanced diet, similar to the Mediterranean diet.

One last word about food and the brain

Surprisingly what happens in your guts can also influence your brain functions.
Several gut hormones such as leptin (which sends signals to the brain to reduce appetite),
ghrelin (which acts as an appetite stimulant) or insulin (which is secreted by the anticipation
of meals and during digestion) have been found to enhance memory formation through their
action on the hippocampus, a brain structure essential for memory formation. These
hormones have an influence on the plasticity (the ability to change) of the connections
between neurons in the hippocampus.

What is Mild Cognitive Impairment?

Posted on June 21, 2011 by Dr. Pascale Michelon| 11 Comments

By: Dr. Pascale Michelon

Mild Cognitive Impairment (MCI) can be considered as the transition

phase between normal memory and Alzheimers disease. It is usually divided into two broad
subtypes. Amnestic MCI significantly affects memory. Non-amnestic MCI affects other
functions of the brain such as language, attention and reasoning. Most of the research has
focused on Amnestic MCI, which has been linked to Alzheimers disease. The following
criteria are usually used to diagnose amnestic MCI:

Memory complaint, preferably corroborated by another person

Poor performance on memory tests
Normal performance on tests of other cognitive domains (language, attention,
executive functions, verbal ability)
Largely normal activities of daily living
No dementia

Do I have MCI?
Many people nowadays live with MCI without knowing it. How can you dissociate memory
lapses associated with normal aging and memory problems associated with MCI? A good
way to dissociate the two is the degree and frequency of the episodes of forgetfulness.
The forgetfulness of normal aging is minor. You forget where you put your car keys or where
you parked your car in the parking garage. You cannot remember the name of a former co-
worker when you meet unexpectedly at the grocery store. This is nothing to worry about.

Red flags should go up if you start forgetting things you typically remember, such as doctors
appointments or your weekly bridge game. This happens to everyone now and then, but if a
pattern develops, it could be a symptom of MCI.

Although people feel that they are the best judges of the state of their memory, this is often
not true. The perception of forgetfulness tends to vary from person to person. Someone who
is scrupulous about her mental functioning and is proud of her memory may notice very
slight changes in her memory. She will then overestimate her forgetfulness. On the other
hand, someone who lives a simple routine life may miss significant memory changes. He will
then underestimate his forgetfulness. Very often a more objective assessment of your
memory will come from someone you trust and knows you well.

The best way to know for sure whether one has MCI is to undergo testing with a
neuropsychologist. The doctor will use simple behavioral tests to determine whether memory
is indeed affected and if it is, whether other domains of cognition are also affected.

MCI and Alzheimers Disease

If I show signs of MCI, what are the chances that I will develop Alzheimers disease?
Research has shown that out of 100 people with normal memory, only one or two a year
would develop AD. In sharp contrast, out of 100 people showing signs of MCI, 15 will
develop AD per year.
Experts estimate that over longer periods of time, 80 to 90% of people with MCI will develop
AD. Note that 10% will not. Why? Research is on-going

What can I do if I have MCI?

Experts have good news! They suggest that adopting a healthy life-style (healthy diet, enough
sleep, enough physical exercise, less stress, appropriate weight and cholesterol level, etc.) and
regularly participating in challenging intellectual activities may be able to alter the course of
MCI.

Exercise to Protect your Brain from Silent

Strokes
Posted on October 7, 2011 by Dr. Pascale Michelon| 21 Comments

By: Dr. Pascale Michelon

 Silent strokes increase both the chances of a future major stroke and
the risks of cognitive decline and dementia. It is thus good to learn that physical exercise may
help protect the brain from silent strokes.

What is a silent stroke?

A silent stroke is a stroke that does not lead to any outward symptoms. Most people
experiencing a silent stroke are not aware of what is going on. Even though symptoms are not
showing, the damage to the brain is real. The blood supply to a tiny part of the brain is
disrupted, resulting in a lesion, that is permanent damage to the brain cells (neurons) in this
area.

Physical exercise and silent strokes

As discussed in a previous post elsewhere, being physically active is associated with better
cognitive performance in general.
A recent study shows that physical exercise is also associated with lower risks of silent
strokes. 1,238 clinically stroke-free adults (mean age 70 9 years) participated in the study.
About 43% reported that they did no regular exercise, 36% that they did light physical
activity (such as golf or walking); and 21% reported moderate to intense exercise (such as
tennis, swimming, racquetball, hiking or jogging regularly).
Six years later, researchers scanned the brains of the participants. The scans showed that 16%
had experienced silent strokes. Participants who reported engaging in moderate to intense
activity were 40% less likely to have experienced silent strokes than those who got no
regular exercise. Risks of experiencing silent strokes were not different between those who
engaged in light exercise and those who did no regular exercise.

How much should I exercise?

Physical exercise should be considered as one of the main pillars of brain health along with a
balance diet, mental stimulation and challenge and stress management.
Guidelines indicate that one should exercise at least 3 days a week for at least 30 minutes
each time. Aerobic exercise may be the best type of exercise, although, strength training has
also been linked to better cognitive health in a few studies. It is never too late (or too early) to
start exercising. Seems worth the sweat!

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