The Meds That Impair Decision-Making

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Impairment to cognitive function is often comorbid with Parkinson’s disease. That is to say: it’s not a symptom of Parkinson’s, but it often occurs in the same people. This may seem natural: after all, both are strongly associated with aging.

However, recent (last month, at time of writing) research has brought to light a very specific way in which medication for Parkinson’s may impair the ability to make sound decisions.

Obviously, this is a big deal, because it can affect healthcare decisions, financial decisions, and more—greatly impacting quality of life.

See also: Age-related differences in financial decision-making and social influence

(in which older people were found more likely to be influenced by the impulsive financial preferences of others than their younger counterparts, when other factors are controlled for)

As for how this pans out when it comes to Parkinson’s meds…

Pramipexole (PPX)

This drug can, due to an overlap in molecular shape, mimic dopamine in the brains of people who don’t have enough—such as those with Parkinson’s disease. This (as you might expect) helps alleviate Parkinson’s symptoms.

However, researchers found that mice treated with PPX and given a touch-screen based gambling game picked the high-risk, high reward option much more often. In the hopes of winning strawberry milkshake (the reward), they got themselves subjected to a lot of blindingly-bright flashing lights (the risk, to which untreated mice were much more averse, as this is very stressful for a mouse).

You may be wondering: did the mice have Parkinson’s?

The answer: kind of; they had been subjected to injections with 6-hydroxydopamine, which damages dopamine-producing neurons similarly to Parkinson’s.

This result was somewhat surprising, because one would expect that a mouse whose depleted dopamine was being mimicked by a stand-in (thus, doing much of the job of dopamine) would be less swayed by the allure of gambling (a high-dopamine activity), since gambling is typically most attractive to those who are desperate to find a crumb of dopamine somewhere.

They did find out why this happened, by the way, the PPX hyperactivated the external globus pallidus (also called GPe, and notwithstanding the name, this is located deep inside the brain). Chemically inhibiting this area of the brain reduced the risk-taking activity of the mice.

This has important implications for Parkinson’s patients, because:

  • on an individual level, it means this is a side effect of PPX to be aware of
  • on a research-and-development level, it means drugs need to be developed that specifically target the GPe, to avoid/mitigate this side effect.

You can read the study in full here:

Pramipexole Hyperactivates the External Globus Pallidus and Impairs Decision-Making in a Mouse Model of Parkinson’s Disease

Don’t want to get Parkinson’s in the first place?

While nothing is a magic bullet, there are things that can greatly increase or decrease Parkinson’s risk. Here’s a big one, as found recently (last week, at the time of writing):

Air Pollution and Parkinson’s Disease in a Population-Based Study

Also: knowing about its onset sooner rather than later is scary, but beneficial. So, with that in mind…

Recognize The Early Symptoms Of Parkinson’s Disease

Finally, because Parkinson’s disease is theorized to be caused by a dysfunction of alpha-synuclein clearance (much like the dysfunction of beta-amyloid clearance, in the case of Alzheimer’s disease), this means that having a healthy glymphatic system (glial cells doing the same clean-up job as the lymphatic system, but in the brain) is critical:

How To Clean Your Brain (Glymphatic Health Primer)

Take care!

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  • The Two-Second Advantage – by Vivek Ranadive and Kevin Maney

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The titular “two-second advantage” can in some cases be literal (imagine you got a two-second head-start in a boxing match!), in other cases can refer to being just a little ahead of things in a way that can confer a great advantage, often cumulatively—as anyone who’s played Monopoly can certainly attest.

    Vivek Ranadivé and Kevin Maney give us lots of examples from business, sports, politics, economics, and more, in a way that seeks to cultivate a habit of asking the right questions in order to anticipate the future and not just be ahead of the competition—some areas of life don’t have competition for most people, like health, for example—but to generally have things “in hand”.

    When it comes to personal finances, health, personal projects, and the like, those tiny initial advantages that lead to incremental further improvements, can be the difference between continually (and frantically) playing catch-up, or making the jump past breaking even to going from strength to strength.

    Check out today’s book on Amazon!

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  • Wouldn’t It Be Nice To Have Regenerative Superpowers?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The Best-Laid Schemes of Mice and Medical Researchers…

    This is Dr. Ellen Heber-Katz. She’s an internationally-renowned immunologist and regeneration biologist, but her perhaps greatest discovery was accidental.

    Unlike in Robert Burns’ famous poem, this one has a happy ending!

    But it did involve the best-laid schemes of mice and medical researchers, and how they did indeed “gang gagly“ (or in the English translation, “go awry”).

    How it started…

    Back in 1995, she was conducting autoimmune research, and doing a mouse study. Her post-doc assistant was assigned to punch holes in the ears of mice that had received an experimental treatment, to distinguish them from the control group.

    However, when the mice were later checked, none of them had holes (nor even any indication there ever had been holes punched)—the experiment was ruined, though the post-doc swore she did her job correctly.

    So, they had to start from scratch in the new year, but again, a second batch of mice repeated the trick. No holes, no wounds, no scarring, not disruption to their fur, no damage to the cartilage that had been punched through.

    In a turn of events worthy of a superhero origin story, they discovered that their laboratory-made autoimmune disease had accidentally given the mice super-healing powers of regeneration.

    In the animal kingdom, this is akin to a salamander growing a new tail, but it’s not something usually found in mammals.

    Read: A New Murine Model for Mammalian Wound Repair and Regeneration

    How it’s going…

    Dr. Heber-Katz and colleagues took another 20 years of work to isolate hypoxia-inducible factor-1a (HIF-1a) as a critical molecule that, if blocked, would eliminate the regenerative response.

    Further, a drug (which they went on to patent), 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA), chemically induced this regenerative power:

    See: Drug-induced regeneration in adult mice

    Another 5 years later, they found that this same drug can be used to stimulate the regrowth of bones, too:

    An injectable hydrogel-formulated inhibitor of prolyl-4-hydroxylase promotes T regulatory cell recruitment and enhances alveolar bone regeneration during resolution of experimental periodontitis

    And now…

    The research is continuing. Here’s the latest, a little over a month ago:

    Epithelial–mesenchymal transition: an organizing principle of mammalian regeneration

    Regrowing nerves has also been added into the list of things the drug can do.

    What about humans?

    Superpowered mice are all very well and good, but when can we expect this in humans?

    The next step is testing the drug in larger animals, which she hopes to do next year, followed eventually by studies in humans.

    Read the latest:

    Regrowing nerves and healing without scars? A scientist’s career-long quest comes closer to fruition

    Very promising!

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  • Black Coffee vs Orange Juice – Which is Healthier?

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    Our Verdict

    When comparing black coffee to orange juice, we picked the coffee.

    Why?

    While this one isn’t a very like-for-like choice, it’s a choice often made, so it bears examining.

    In favor of the orange juice, it has vitamins A and C and the mineral potassium, while the coffee contains no vitamins or minerals beyond trace amounts.

    However, to offset that: drinking juice is one of the worst ways to consume sugar; the fruit has not only been stripped of its fiber, but also is in its most readily absorbable state (liquid), meaning that this is going to cause a blood sugar spike, which if done often can lead to insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, and more. Now, the occasional glass of orange juice (and resultant blood sugar spike) isn’t going to cause disease by itself, but everything we consume tips the scales of our health towards wellness or illness (or sometimes both, in different ways), and in this case, juice has a rather major downside that ought not be ignored.

    In favor of the coffee, it has a lot of beneficial phytochemicals (mostly antioxidant polyphenols of various kinds), with no drawbacks worth mentioning unless you have a pre-existing condition of some kind.

    Coffee can of course be caffeinated or decaffeinated, and we didn’t specify which here. Caffeine has some pros and cons that at worst, balance each other out, and whether or not it’s caffeinated, there’s nothing in coffee to offset the beneficial qualities of the antioxidants we mentioned before.

    Obviously, in either case we are assuming consuming in moderation.

    In short:

    • orange juice has negatives that at least equal, if not outweigh, its positives
    • coffee‘s benefits outweigh any drawbacks for most people

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  • Body by Science – by Dr. Doug McGuff & John Little

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    The idea that you’ll get a re-sculpted body at 12 minutes per week is a bold claim, isn’t it? Medical Doctor Doug McGuff and bodybuilder John Little team up to lay out their case. So, how does it stand up to scrutiny?

    First, is it “backed by rigorous research” as claimed? Yes… with caveats.

    The book uses a large body of scientific literature as its foundation, and that weight of evidence does support this general approach:

    • Endurance cardio isn’t very good at burning fat
    • Muscle, even just having it without using it much, burns fat to maintain it
    • To that end, muscle can be viewed as a fat-burning asset
    • Muscle can be grown quickly with short bursts of intense exercise once per week

    Why once per week? The most relevant muscle fibers take about that long to recover, so doing it more often will undercut gains.

    So, what are the caveats?

    The authors argue for slow reps of maximally heavy resistance work sufficient to cause failure in about 90 seconds. However, most of the studies cited for the benefits of “brief intense exercise” are for High Intensity Interval Training (HIIT). HIIT involves “sprints” of exercise. It doesn’t have to be literally running, but for example maxing out on an exercise bike for 30 seconds, slowing for 60, maxing out for 30, etc. Or in the case of resistance work, explosive (fast!) concentric movements and slow eccentric movements, to work fast- and slow-twitch muscle fibers, respectively.

    What does this mean for the usefulness of the book?

    • Will it sculpt your body as described in the blurb? Yes, this will indeed grow your muscles with a minimal expenditure of time
    • Will it improve your body’s fat-burning metabolism? Yes, this will indeed turn your body into a fat-burning machine
    • Will it improve your “complete fitness”? No, if you want to be an all-rounder athlete, you will still need HIIT, as otherwise anything taxing your under-worked fast-twitch muscle fibers will exhaust you quickly.

    Bottom line: read this book if you want to build muscle efficiently, and make your body more efficient at burning fat. Best supplemented with at least some cardio, though!

    Click here to check out Body by Science, and get re-sculpting yours!

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  • Chickpeas vs Pinto Beans – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing chickpeas to pinto beans, we picked the pinto beans.

    Why?

    Both are great! And an argument could be made for either…

    In terms of macros, pinto beans have slightly more fiber and slightly more protein, while chickpeas have slightly more carbs, and thus predictably higher net carbs. In the category of those proteins, they both have a comparable spread of amino acods, with pinto beans having very slightly more of each amino acid. All this adds up to a clear, but moderate, win for pinto beans.

    When it comes to vitamins, technically chickpeas have more of vitamins A, B3, B5, C, K, and choline, but the margins are so small as to be almost meaningless. Meanwhile, pinto beans have more of vitamins B1, B6, and E, and/but the only one where the margin is enough to really care about is vitamin E (a little over 2x what chickpeas have). So, an argument could be made either way, but we’re going to call this category a tie.

    The story with minerals is similar; chickpeas have more copper, iron, manganese, phosphorus, and zinc, all with small margins, while pinto beans have more potassium and selenium, and/but also less sodium. We’d call this either a tie, or a very slight win for chickpeas.

    Adding up the sections gives for a very modest win for pinto beans, but as we say, an argument could be made for either.

    Certainly, enjoy both!

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    Take care!

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  • How to be kind to yourself (without going to a day spa)

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    “I have to be hard on myself,” Sarah told me in a recent telehealth psychology session. “I would never reach my potential if I was kind and let myself off the hook.”

    I could empathise with this fear of self-compassion from clients such as Sarah (not her real name). From a young age, we are taught to be kind to others, but self-kindness is never mentioned.

    Instead, we are taught success hinges on self-sacrifice. And we need a healthy inner critic to bully us forward into becoming increasingly better versions of ourselves.

    But research shows there doesn’t have to be a trade-off between self-compassion and success.

    Self-compassion can help you reach your potential, while supporting you to face the inevitable stumbles and setbacks along the way.

    What is self-compassion?

    Self-compassion has three key ingredients.

    1. Self-kindness

    This involves treating yourself with the same kindness you would extend towards a good friend – via your thoughts, feelings and actions – especially during life’s difficult moments.

    For instance, if you find yourself fixating on a minor mistake you made at work, self-kindness might involve taking a ten-minute walk to shift focus, and reminding yourself it is OK to make mistakes sometimes, before moving on with your day.

    2. Mindfulness

    In this context, mindfulness involves being aware of your own experience of stress or suffering, rather than repressing or avoiding your feelings, or over-identifying with them.

    Basically, you must see your stress with a clear (mindful) perspective before you can respond with kindness. If we avoid or are consumed by our suffering, we lose perspective.

    3. Common humanity

    Common humanity involves recognising our own experience of suffering as something that unites us as being human.

    For instance, a sleep-deprived parent waking up (for the fourth time) to feed their newborn might choose to think about all the other parents around the world doing exactly the same thing – as opposed to feeling isolated and alone.

    It’s not about day spas, or booking a manicure

    When Sarah voiced her fear that self-compassion would prevent her success, I explained self-compassion is distinct from self-indulgence.

    “So is self-compassion just about booking in more mani/pedis?” Sarah asked.

    Not really, I explained. A one-off trip to a day spa is unlikely to transform your mental health.

    Instead, self-compassion is a flexible psychological resilience factor that shapes our thoughts, feelings and actions.

    It’s associated with a suite of benefits to our wellbeing, relationships and health.

    Massage therapist massaging woman's back
    A one-off trip to a day spa is unlikely to transform your mental health.
    baranq/Shutterstock

    What does the science say?

    Over the past 20 years, we’ve learned self-compassionate people enjoy a wide range of benefits. They tend to be happier and have fewer psychological symptoms of distress.

    Those high on self-compassion persevere following a failure. They say they are more motivated to overcome a personal weakness than those low on self-compassion, who are more likely to give up.

    So rather than feeling trapped by your inadequacies, self-compassion encourages a growth mindset, helping you reach your potential.

    However, self-compassion is not a panacea. It will not change your life circumstances or somehow make life “easy”. It is based on the premise that life is hard, and provides practical tools to cope.

    It’s a factor in healthy ageing

    I research menopause and healthy ageing and am especially interested in the value of self-compassion through menopause and in the second half of life.

    Because self-compassion becomes important during life’s challenges, it can help people navigate physical symptoms (for instance, menopausal hot flushes), life transitions such as divorce, and promote healthy ageing.

    I’ve also teamed up with researchers at Autism Spectrum Australia to explore self-compassion in autistic adults.

    We found autistic adults report significantly lower levels of self-compassion than neurotypical adults. So we developed an online self-compassion training program for this at-risk population.

    Three tips for self-compassion

    You can learn self-compassion with these three exercises.

    1. What would you say to a friend?

    Think back to the last time you made a mistake. What did you say to yourself?

    If you notice you’re treating yourself more like an enemy than a friend, don’t beat yourself up about it. Instead, try to think about what you might tell a friend, and direct that same friendly language towards yourself.

    2. Harness the power of touch

    Soothing human touch activates the parasympathetic “relaxation” branch of our nervous system and counteracts the fight or flight response.

    Specifically, self-soothing touch (for instance, by placing both hands on your heart, stroking your forearm or giving yourself a hug) reduces cortisol responses to psychosocial stress.

    Middle-aged man hugging himself
    Yes, hugging yourself can help.
    http://krakenimages.com/Shutterstock

    3. What do I need right now?

    Sometimes, it can be hard to figure out exactly what self-compassion looks like in a given moment. The question “what do I need right now” helps clarify your true needs.

    For example, when I was 37 weeks pregnant, I woke up bolt awake one morning at 3am.

    Rather than beating myself up about it, or fretting about not getting enough sleep, I gently placed my hands on my heart and took a few deep breaths. By asking myself “what do I need right now?” it became clear that listening to a gentle podcast/meditation fitted the bill (even though I wanted to addictively scroll my phone).The Conversation

    Lydia Brown, Senior Lecturer in Psychology, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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