Tremors, seizures and paralysis: this brain disorder is more common than multiple sclerosis – but often goes undiagnosed

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Imagine suddenly losing the ability to move a limb, walk or speak. You would probably recognise this as a medical emergency and get to hospital.

Now imagine the doctors at the hospital run some tests and then say, “Good news! All your tests were normal, clear scans, and nothing is wrong. You can go home!” Yet, you are still experiencing very real and disabling symptoms.

Unfortunately, this is the experience of many people with functional neurological disorder. Even worse, some are blamed and reprimanded for exaggerating or faking their symptoms.

So, what is this disorder, and why is it so challenging to recognise and treat?

Kateryna Kon/Shutterstock

What is functional neurological disorder?

Neurological disorders are conditions that affect how the nervous system works. The nervous system sends and receives messages between the brain and other parts of your body to regulate a wide range of functions, such as movement, speaking, vision, thinking and digestion.

To the untrained eye, functional neurological disorder can resemble other conditions such as stroke, multiple sclerosis or epilepsy.

But, unlike these conditions, functional neurological symptoms aren’t due to damage or a disease process affecting the nervous system. This means the disorder doesn’t appear on routine brain imaging and other tests.

Functional symptoms are, instead, due to dysfunction in the processing of information between several brain networks. Simply put, it’s a problem of the brain’s software, not the hardware.

What are the symptoms?

Functional neurological disorder can produce a kaleidoscope of diverse and changing symptoms. This often adds to confusion for patients and make diagnosis more challenging.

Symptoms may include paralysis or abnormal movements such as tremors, jerks and tics. This often leads to difficulty walking or coordinating movements.

Sensory symptoms may involve numbness, tingling or loss of vision.

Dissociative symptoms, such as functional seizures and blackouts, are also common.

Some people experience cognitive symptoms including brain fog or problems finding the right words. Fatigue and chronic pain frequently coexist with these symptoms.

These symptoms can be severe and distressing and, without treatment, can persist for years. For example, some people with functional neurological disorder cannot walk and must use a wheelchair for decades.

Diagnosis involves identifying established diagnostic signs and ensuring no other diagnoses are missed. This process is best carried out by an experienced neurologist or neuropsychiatrist.

Older woman sits in a wheelchair in her lounge room.
Functional neurological disorder can affect movement and some people may be unable to walk. Fit Ztudio/Shutterstock

How common is it?

Functional neurological disorder is one of the most common medical conditions seen in emergency care and in outpatient neurology clinics.

It affects around 10–22 people per 100,000 per year. This makes it more common than multiple sclerosis.

Despite this, it is often under-recognised and misunderstood by health-care professionals. This leads to delays in diagnosis and treatment.

This lack of awareness also contributes to the perception that it’s rare, when it’s actually common among neurological disorders.

Who does functional neurological disorder affect?

This condition can affect anyone, although it is more common in women and younger people. Around two thirds of patients are female, but this gender disparity reduces with age.

Understanding of the disorder has developed significantly over the past few decades, but there’s still more to learn. Several biological, psychological, and social factors can predispose people.

Genetics, traumatic life experiences, anxiety and depression can increase the risk. Stressful life events, illness, or physical injuries can trigger or worsen existing symptoms.

But not everyone with the disorder has experienced significant trauma or stress.

How is it treated?

If left untreated, about half the people with this condition will remain the same or their symptoms will worsen. However, with the help of experienced clinicians, many people can make rapid recoveries when treatment starts early.

There are no specific medications for functional neurological disorder but personalised rehabilitation guided by experienced clinicians is recommended.

Some people may need a team of multidisciplinary clinicians that may include physiotherapists, occupational therapists, speech therapists, psychologists and doctors.

People also need accurate information about their condition, because understanding and beliefs about the disorder play an important role in recovery. Accurate information helps patients to develop more realistic expectations, reduces anxiety and can empower people to be more active in their recovery.

Treating common co-existing conditions, such as anxiety or depression, can also be helpful.

Man in grey sweatshirt lies in bed with arm over head.
Symptoms can include headaches and brain fog. PeopleImages.com – Yuri A/Shutterstock

A dark history

The origins of the disorder are deeply rooted in the sexist history of its pre-scientific ancestor – hysteria. The legacy of hysteria has cast a long shadow, contributing to a misogynistic bias in perception and treatment. This historical context has led to ongoing stigma, where symptoms were often labelled as psychological and not warranting treatment.

Women with functional symptoms often face scepticism and dismissal. In some cases, significant harm occurs through stigmatisation, inadequate care and poor management. Modern medicine has attempted to address these biases by recognising functional neurological disorder as a legitimate condition.

A lack of education for medical professionals likely contributes to stigma. Many clinicians report low confidence and knowledge about their ability to manage the disorder.

A bright future?

Fortunately, awareness, research and interest has grown over the past decade. Many treatment approaches are being trialled, including specialist physiotherapy, psychological therapies and non-invasive brain stimulation.

Patient-led organisations and support networks are making headway advocating for improvements in health systems, research and education. The goal is to unite patients, their families, clinicians, and researchers to advance a new standard of care across the world.

Benjamin Scrivener, PhD Candidate, Faculty of Medical and Health Sciences, University of Auckland, Waipapa Taumata Rau

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

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  • Unprocessed – by Kimberly Wilson

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    First, what this is not: hundreds of pages to say “eat less processed food”. That is, of course, also advisable (and indeed, is advised in the book too), but there’s a lot more going on here too.

    Though not a doctor, the author is a psychologist who brings a lot of data to the table, especially when it comes to the neurophysiology at hand, what forgotten micronutrients many people are lacking, and what trends in society worsen these deficiencies in the population at large.

    If you only care about the broadest of take-away advice, it is: eat a diet that’s mostly minimally processed plants and some oily fish, watch out for certain deficiencies in particular, and increase dietary intake of them where necessary (with taking supplements as a respectable next-best remedy).

    On which note, a point of criticism is that there’s some incorrect information about veganism and brain health; she mentions that DHA is only found in fish (in fact, fish get it from algae, which has it, and is the basis of many vegan omega-3 supplements), and the B12 is found only in animals (also found in yeast, which is not an animal, as well as various bacteria in soil, and farm animals get their B12 from supplements these days anyway, so it is arguable that we could keep things simpler by just cutting out the middlecow).

    However, the strength of this book really is in the delivery of understanding about why certain things matter. If you’re told “such-and-such is good for the brain”, you’ll up your intake for 1–60 days, depending on whether you bought a supermarket item or ordered a batch of supplements. And then you’ll forget, until 6–12 months later, and you’ll do it again. On the other hand, if you understand how something is good or bad for the brain, what it does (for good or ill) on a cellular level, the chemistry and neurophysiology at hand, you’ll make new habits for life.

    The style is middle-range pop-science; by this we mean there are tables of data and some long words that are difficult to pronounce, but also it’s not just hard science throughout—there’s (as one might expect from an author who is a psychologist) a lot about the psychology and sociology of why many people make poor dietary decisions, and the things governments often do (or omit doing) that affect this adversely—and how we can avoid those traps as individuals (unless we be incarcerated or such).

    As an aside, the author is British, so governmental examples are mostly UK-based, but it doesn’t take a lot to mentally measure that against what the governments of, for example, the US or Canada do the same or differently.

    Bottom line: there’s a lot of great information about brain health here; the strongest parts are whether the author stays within her field (psychology encompasses such diverse topics as neurophysiology and aspects of sociology, but not microbiology, for example). If you want to learn about the physiology of brain health and enjoy quite a sociopolitical ride along the way, this one’s a good one for that.

    Click here to check out Unprocessed, and make the best choices for you!

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  • Grapefruit vs Lemon – Which is Healthier?

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    Our Verdict

    When comparing grapefruit to lemon, we picked the lemon.

    Why?

    Grapefruit has its merits, but in the battle of the citrus fruits, lemons come out on top nutritionally:

    In terms of macros, grapefruit has more carbs while lemons have more fiber. So, while both have a low glycemic index, lemon is still the winner by the numbers.

    Looking at the vitamins, here we say grapefruit’s strengths: grapefruit has more of vitamins A, B2, B3, and choline, while lemon has more of vitamins B6 and C. So, a 4:2 win for grapefruit here.

    In the category of minerals, lemons retake the lead: grapefruit has more zinc, while lemon has more calcium, copper, iron, manganese, and selenium.

    One final consideration that’s not shown in the nutritional values, is that grapefruit contains high levels of furanocoumarin, which can inhibit cytochrome P-450 3A4 isoenzyme and P-glycoptrotein transporters in the intestine and liver—slowing down their drug metabolism capabilities, thus effectively increasing the bioavailability of many drugs manifold.

    This may sound superficially like a good thing (improving bioavailability of things we want), but in practice it means that in the case of many drugs, if you take them with (or near in time to) grapefruit or grapefruit juice, then congratulations, you just took an overdose. This happens with a lot of meds for blood pressure, cholesterol (including statins), calcium channel-blockers, anti-depressants, benzo-family drugs, beta-blockers, and more. Oh, and Viagra, too. Which latter might sound funny, but remember, Viagra’s mechanism of action is blood pressure modulation, and that is not something you want to mess around with unduly. So, do check with your pharmacist to know if you’re on any meds that would be affected by grapefruit or grapefruit juice!

    PS: the same substance is quite available in pummelos and sour oranges (but not meaningfully in sweet oranges); you can see a chart here showing the relative furanocoumarin contents of many citrus fruits, or lack thereof as the case may be, as it is for lemons and most limes)

    Adding up the sections gives us a clear win for lemons, but by all means enjoy either or both; just watch out for that furanocoumarin content of grapefruit if you’re on any meds affected by such (again, do check with your pharmacist, as our list was far from exhaustive—and yes, this question is one that a pharmacist will answer more easily and accurately than a doctor will).

    Want to learn more?

    You might like to read:

    Top 8 Fruits That Prevent & Kill Cancer ← citrus fruits in general make the list; they inhibit tumor growth and kill cancer cells; regular consumption is also associated with a lower cancer risk 🙂

    Enjoy!

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  • Trout vs Carp – Which is Healthier?

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    Our Verdict

    When comparing trout to carp, we picked the trout.

    Why?

    Both have their strong points!

    In terms of macros, trout has slightly more protein and fat, and/but also has less cholesterol than carp. So, we pick the trout in the macros category.

    In the category of vitamins, trout has much more of vitamins A, B1, B2, B3, B5, B6, B7, B12, C, D, E, K, and choline, while carp has slightly more vitamin B9. In other words, an easy win for trout here.

    When it comes to minerals, however, trout has more potassium and selenium, while carp has more calcium, copper, iron, magnesium, manganese, phosphorus, and zinc. A fair win for carp this time.

    You may be wondering about heavy metals: this will vary depending on location, as well as the age of the fish (younger fish have had less time to accumulate heavy metals than old ones, so if you’re visiting the fishmonger, choose the smaller ones) and the lives they have led (e.g. wild vs farmed), however, as a general rule of thumb, trout will generally have lower heavy metals levels than carp, all other things (e.g. location, age, etc) being equal.

    In short, enjoy either or both in moderation, but trout wins on 3/4 categories today.

    Want to learn more?

    You might like to read:

    Farmed Fish vs Wild Caught: Antibiotics, Mercury, & More

    Take care!

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  • What people with autism want you to know

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    Since taking office, Health and Human Services Secretary Robert F. Kennedy Jr. has made several false and misleading claims about autism. In a press conference on April 16, Kennedy said that “autism destroys families” and that children with autism “will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go on a date.” 

    Kennedy has a history of making false claims, including the myth that vaccines are linked to autism. He also falsely claimed that autism is an “epidemic” caused by environmental toxins. Autism spectrum disorder is a brain development condition (not a disease) that affects how people socialize and communicate. It also impacts everyone differently.

    Leading organizations like The Autism Society of America say that Kennedy’s statements are harmful and stigmatizing to autistic people. To understand this further, Public Good News spoke to four people with autism about their experience and their thoughts on misconceptions about it. Here’s what they said. 

    [Editor’s note: The contents of these interviews have been edited for length and clarity.]

    McCabe (he/they) is a policy manager for the Autistic Women & Nonbinary Network, a grassroots organization of self-advocates who are autistic and gender diverse.

    I have both [attention-deficit/hyperactivity disorder] and autism, which is a fairly common comorbidity. I have sensory issues: Loud noises will send me into a tailspin. 

    One of the earliest signs, when I was a very young toddler, was that if my parents tried to take me to a mall, I would have a total meltdown. It’s that echoey, loud. I do so much better if I’ve got my headphones.

    I was assigned female at birth, and like many other people assigned female at birth, my symptoms were different; they weren’t as overt for either diagnosis. I had another very common backstory where I had a whole bunch of mental health misdiagnoses. Until early adulthood, I was diagnosed as bipolar, as having absence seizures when I was instead having shutdowns. I had depression and anxiety, and it took until I was actually in law school as an older adult, after being out living on my own in the world for over a decade, to go, “Wait a second: None of this is working! Like, if it’s just anxiety that’s making it hard for me to socialize with people, then why is the anxiety medication doing nothing?” And I got some helpful diagnoses.

    It was such a relief. Being overwhelmed in the mall, I finally felt like it was okay to wear my headphones when I got into a loud, echoey space, which is not how it should be. That’s a permission I had to give myself because I had been socialized to mask so hard. 

    And I wish that wasn’t my story. I wish that was no one’s story. I wish that everyone was able to just reach for accommodations without feeling any judgment. And actually, that’s something that some of Secretary Kennedy’s statements have not been helping with lately.

    Part of the reason why the misinformation about vaccines is so harmful, aside from the fact that it’s just completely scientifically unsound, is that it paints an autism diagnosis as something so horrible that you would rather risk your child’s life than risk them having autism. 

    That devalues autistic lives. I’m not less of a person because of my autism diagnosis.

    Measuring a person’s value by their ability to contribute through taxes or sports or poetry or art—none of that is relevant. That is also devaluing human life. 

    Humans are worth their life, even if they’re not ever able to do anything, and so acting as though it is a tragedy to not be able to do something like date or have a job, it’s just devaluing, and not just to autistic people, but to anybody. 

    There are many people who don’t do any number of those things, and their lives are not tragedies, and they’re not destroying their families.

    There’s been such a focus on trying to find a cure or trying to find the cause. When you’re so focused on the biological or genetic aspect, and all the grant money is going to that, everything else gets pushed aside. 

    But as an autistic person, I’m not interested in what causes autism. If someone wants to study that, that’s cool, but I’d much rather they spend time studying best ways to train someone in the use of alternative and augmentative communication, because even though that is a lifeline for so many autistic people, most of the studies done on that have nothing to do with autism. 

    We’re not looking into things to help with sensory overwhelm or just even looking into what is the return on investment for various services and supports.

    Gardiner (he/him) is a Black, queer, and disabled community organizer and the director of policy and advocacy at the Autistic People of Color Fund, which provides microgrants to autistic people of color.

    I was diagnosed when I was around 3, back in the late 1980s, early ’90s, which is unusual for someone my age. Most people in this age bracket don’t get diagnosed until later. 

    But I was diagnosed, and so I went through special ed. And some of it was good, some of it was bad. I had applied behavior analysis (ABA), [but] a lot of it is designed to focus on making the kid look less autistic, as opposed to actually just helping people out with quality of life concerns. 

    I did get accommodations for low-noise classrooms and things like that, and I kind of grew up with a lot of shame around being autistic because my parents were super ableist and a lot of other things. I dealt with ableism at school, along with racism, and it was really hard for me to kind of make my way through school because of the bigotry, because of the ignorance, because of the lack of supports that actually matched my needs. 

    There was a strong focus on making me look less autistic, as opposed to dealing with the stuff that actually affected me, like being overloaded, being overwhelmed, being bullied by classmates, dealing with racism. 

    And I dealt with a lot of disproportionate discipline. I would get in-school suspensions because I was stressed out and having meltdowns after being bullied by kids in the sixth grade. And instead of dealing with the bullies, my teacher would send me to the office and/or have me suspended. 

    School exclusions like that are very common for disabled students of color like me. And I feel like this kind of exclusionary policy, this idea that autistic students don’t have anything to contribute, [focuses] on looking less autistic [as] opposed to improving people’s quality of life. 

    There are so many misconceptions, and it makes it harder for us to be heard. It makes it more difficult for us to get services. 

    There’s such an array of skills and abilities that people have that it’s presumptuous to assume that everyone has the same capabilities, regardless of where they lie on the spectrum. Robert F. Kennedy Jr. fell into this trap of treating autism as though it’s monolithic when he said that autistic people would never be able to pay taxes or play baseball or do anything like what non-autistic people do.

    He’s not concerned about quality of life. He’s concerned about causes and the puzzle of being autistic as opposed to actually improving our quality of life and finding [out] about what happens to autistic adults. 

    I’d like to see more focus on finding accommodations that make life easier. So, for example, being able to step out if things get too noisy or finding ways to learn how to cope with social difficulties without telling people to stop flapping their hands. 

    And [support to] help them find jobs that work for them, help them find life-skill techniques that work for them, help them find communities that work for them, as opposed to just trying to mold someone into looking as though they’re not autistic.

    Get people home- and community-based services, get people comprehensive supports, get people into employment, get people into higher education, get people good mental health care. Get people food and shelter and housing. Don’t just focus on making people look less autistic. Try to improve our lives, or work with us to improve our lives.

    Risa (she/they) is not using her real name because of her employer’s policies. She’s a researcher, content creator, speaker, and trainer. 

    I was misdiagnosed with bipolar disorder as a teenager, and that’s an experience that, unfortunately, is more common among autistic women and those in other marginalized genders by society. I eventually got diagnosed as being autistic in my late 20s. 

    Once I got diagnosed and I started embracing my autistic identity, I started slowly thriving. For instance, I used to get [into] an existential crisis writing an email, and now I’m an international keynote speaker and researcher.

    I also received ABA as an adult, and my ABA therapists did agree with me that ABA may not be needed for many autistic people if society was more accepting with more support. That’s partly why these misconceptions are so devastating. 

    Some of the misconceptions that I came across before were that, if I was able to self-advocate or have friends, that I couldn’t be autistic. And I do feel like those were things that were used to justify not diagnosing me with being autistic sooner. 

    Every autistic person is unique, but I do think that there’s a lot of stereotypes. People often assume that someone with high support needs can’t have a rich or meaningful quality life. 

    I believe we need to look at ways to add more supports into society and more access to services. And also, when we’re talking about, like, the employment rate, it’s not acknowledging that for some autistic people, some of the barriers to employment have more to do with biases and the hiring process. And also, that we’re underrepresented in higher education, which is also bigger for employment.

    I’m concerned that, when we focus on autism and make certain assumptions, we’re not looking at what we can do as a society to include people more.

    Autistic lives are not tragic: We’re complex, we’re all different, we are worthy, and we deserve support and understanding.

    Javier (she/her) is a Latina mother and wife who works at an elementary school. 

    I always knew I was different, but I couldn’t pinpoint how, and I did not get diagnosed until I was an adult. 

    As a child, I was a late talker. Loud noises would overwhelm me, and if I got too hungry, I would get really hangry (more than what was normal for a kid), and I was terrified of thunderstorms, even up until late elementary school. 

    I flew under the radar. One teacher noticed I had issues, but no one else was concerned about my social issues because I was quiet and I wasn’t causing any trouble. But it’s really hard because then you get mental health issues because you don’t know why you’re different, and you get depressed and anxious. 

    Some people just say, “Oh, you don’t seem autistic,” but that’s because I’ve had to mask and work really hard to appear as neurotypical as possible. I hate having to do that. 

    But if I want to get a job in this society, I need to mask and hide some of my autistic traits. I can’t be, like, visibly stimming, or, sometimes, I might rock back and forth to calm myself down. I know I can’t do that in public because then people think that’s weird.

    And, as far as [Kennedy’s recent claims], autism is a spectrum, and so there are some people who will go on and get married or pay taxes and all these things. But also, on the other end, there are people who won’t. And the people who can’t do those things, their life is just as valuable as mine. 

    Just because I got married, I have a job, I pay taxes, I have a kid, it does not automatically mean my life is worth more. All our lives are worth the same, all our lives have meaning. It just looks different.

    This article first appeared on Public Good News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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  • Fisetin: The Anti-Aging Assassin

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    Out With The Old…

    Fisetin is a flavonoid (specifically, a flavonol), but it’s a little different than most. While it has the usual antioxidant, anti-inflammatory, and anti-cancer properties you might reasonably expect from flavonoids, it has an extra anti-aging trick up its sleeve that most don’t.

    ❝Fisetin is a flavonol that shares distinct antioxidant properties with a plethora of other plant polyphenols. Additionally, it exhibits a specific biological activity of considerable interest as regards the protection of functional macromolecules against stress which results in the sustenance of normal cells cytoprotection. Moreover, it shows potential as an anti-inflammatory, chemopreventive, chemotherapeutic and recently also senotherapeutic agent❞

    ~ Dr. Grynkiewicz & Dr. Demchuk

    Let’s briefly do some due diligence on its expected properties, and then we’ll take a look at its bonus anti-aging effects.

    The flavonol that does-it-ol

    Because of the similar mechanisms involved, there are three things that often come together, which are:

    • Antioxidant
    • Anti-inflammatory
    • Anticancer

    This list often gets expanded to also include:

    • Anti-aging

    …although that is usually the last thing to get tested out of that list.

    In today’s case, let’s kick it off with…

    ❝Fisetin (3,3′,4′,7-tetrahydroxyflavone) is a dietary flavonoid found in various fruits (strawberries, apples, mangoes, persimmons, kiwis, and grapes), vegetables (tomatoes, onions, and cucumbers), nuts, and wine that has shown strong anti-inflammatory, anti-oxidant, anti-tumorigenic, anti-invasive, anti-angiogenic, anti-diabetic, neuroprotective, and cardioprotective effects❞

    ~ Dr. Harish Pal et al.

    Read more: Fisetin and Its Role in Chronic Diseases

    Understanding its anticancer mechanisms

    The way that fisetin fights cancer is basically “all the ways”, and this will be important when we get to its special abilities shortly:

    ❝Being a potent anticancer agent, fisetin has been used to inhibit stages in the cancer cells (proliferation, invasion),prevent cell cycle progression, inhibit cell growth, induce apoptosis, cause polymerase (PARP) cleavage, and modulate the expressions of Bcl‐2 family proteins in different cancer cell lines (HT‐29, U266, MDA‐MB‐231, BT549, and PC‐3M‐luc‐6), respectively. Further, fisetin also suppresses the activation of the PKCα/ROS/ERK1/2 and p38 MAPK signaling pathways, reduces the NF‐κB activation, and down‐regulates the level of the oncoprotein securin. Fisetin also inhibited cell division and proliferation and invasion as well as lowered the TET1 expression levels. ❞

    ~ Dr. Muhammad Imran et al.

    Read more: Fisetin: An anticancer perspective

    There’s also more about it than we even have room to quote, here:

    Fisetin, a Potent Anticancer Flavonol Exhibiting Cytotoxic Activity against Neoplastic Malignant Cells and Cancerous Conditions: A Scoping, Comprehensive Review

    Now For What’s New And Exciting: Senolysis

    All that selectivity that fisetin exhibits when it comes to “this cell gets to live, and this one doesn’t” actions?

    It makes a difference when it comes to aging, too. Because aging and cancer happen by quite similar mechanisms; they’re both DNA-copying errors that get copied forward, to our detriment.

    • In the case of cancer, it’s a cell line that accidentally became immortal and so we end up with too many of them multiplying in one place (a tumor)
    • In the case of aging, it’s the cellular equivalent of “a photocopy of a photocopy of a photocopy” gradually losing information as it goes

    In both cases…

    The cell must die if we want to live

    Critically, and which quality differentiates it from a lot of other flavonoids, fisetin has the ability to selectively kill senescent cells.

    To labor the photocopying metaphor, this means there’s an office worker whose job it is to say “this photocopy is barely legible, I’m going to toss this, and then copy directly from the clearest copy we have instead”, thus keeping the documents (your DNA) in pristine condition.

    In fisetin’s case, this was first tested in mouse (in vivo) studies, and in human tissue (in vitro) studies, before moving to human clinical studies:

    ❝Of the 10 flavonoids tested, fisetin was the most potent senolytic.

    The natural product fisetin has senotherapeutic activity in mice and in human tissues. Late life intervention was sufficient to yield a potent health benefit.❞

    ~ Dr. Matthew Yousefzadeh et al.

    Read in full: Fisetin is a senotherapeutic that extends health and lifespan

    There’s lots more science that’s been done to it since that first groundbreaking study though; here’s a more recent example:

    Fisetin as a Senotherapeutic Agent: Biopharmaceutical Properties and Crosstalk between Cell Senescence and Neuroprotection

    Want some?

    We don’t sell it, but here for your convenience is an example product on Amazon

    Enjoy!

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  • Building Your Brain At Every Age

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    There is a famous myth that the brain doesn’t finish developing until the age of 25.

    Or rather, there is a famous incorrect belief, since the fact it’s a myth is, sadly, not so well-known as it could be.

    The reality is that the 2006 study the “brain doesn’t finish developing until 25” people are referring to examined the development of the brain up to the age of 25, and that was where the study ended, because the study was about the adolescent brain, and in any case all studies have to stop somewhere or else nothing would get published.

    This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.

    The study didn’t misrepresent this, by the way, but the popular press did!

    Another 2012 study looked at various metrics of brain development, and found:

    • Synapse overproduction into the teens
    • Cortex pruning into the late 20s
    • Prefrontal pruning into middle age at least (that’s where they stopped looking)
    • Myelination beyond middle age (that’s where they stopped looking)

    Source: Experience and the developing prefrontal cortexcheck out figure 1, and make sure you’re looking at the human data not the rat data

    You can read much more about the original study, here: The Brain As A Work-In-Progress

    There’s more (there’s always more)

    Those latter bulletpoints listed there are about pruning and myelination (that is, encasing neurons in protective sheathes of myelin), so what about actual brain growth?

    It was long believed that brain growth could not occur later in life, due to expending our innate stock of pluripotent stem cells. However, this was mostly based on rodent studies.

    Rodent studies are often used for brain research, because it’s difficult to find human volunteers willing to have their brains sliced thinly (so that the cells can be viewed under a microscope) at the end of the study.

    However, in 2018 and 2019, there was a flurry of studies that (using brain tissue samples from the autopsies of formerly healthy humans) proved, disproved*, and then re-proved, that neurogenesis (creation of new brain cells) occurs in adult humans:

    *This middle one was a mistake; in an effort to disprove the prior work of Dr. Maura Boldrini et al., the next research team (Dr. Shawn Sorrels et al.) accidentally destroyed the evidence they were looking for, and then proclaimed “look, it’s not there”. It then took a follow-up study by Dr. Elena Moreno-Jiménez et al. to fix the error. If you’ll pardon the pun, because actually the accident in the middle study was due to the fixing process they used (in the sense of chemical tissue fixation to preserve them for study).

    You can read those studies in order, here:

    That third study corrected the mistake made in the second study, by using a shorter fixation time for the cell samples they wanted to look at, and found that there were tens of thousands of newly-made brain cells in samples from adults ranging from 43 to 87.

    There was still room for doubt

    Since those studies, it’s been generally considered no longer contentious that humans do, indeed, do neurogenesis throughout life—at least in the hippocampi, which is where the tissue that was tested came from, and the hippocampus is a focal point for a lot of such research as it’s almost entirely responsible for memory.

    Thus, to get philosophical for a moment, it could be argued that that’s the part of the brain that’s the most uniquely “us” (since it contains more or less our entire conscious life experience), and other parts of the brain serve as processing apparatus of various kinds. So, it’s an important bit of gray matter.

    However, scientists (Dr. Marta Paterlini et al.) wanted to check that those newly-formed neurons really were newly-formed. The reason this was in question was that it wasn’t known whether the predecessors of these new neurons, neural progenitor cells, were still able to proliferate.

    The alternative explanation (if it turned out they weren’t) would be that those “new” neurons found in aged brains were, in fact, old neurons in a state of arrested development (because they had been considered “new” on account of their cellular features that mark them as in an early stage of neural development).

    Good news: the study confirmed the existence and division of those precursor cells that generate new neurons in adults.

    Specifically, they examined brain tissue from human brains aged 0 to 78 using a lot of very hi-tech methods including:

    • Flow cytometry ← this is a lot fancier than it sounds like, and essentially involves rapidly laser-scanning tens of thousands of cells one at a time. And you thought photocopying a workbook was arduous!
    • Single nucleus RNA sequencing ← this one is what it sounds like
    • RNAscope ← think of this as a “noise-cancelling” microscope for looking at RNA in the context of in situ hybridization
    • Xenium ← when sci-fi shows have a fuzzy image and someone says “enhance” and now it has details, that’s what this software does, but for looking at RNA
    • Carbon-dating ← yes, really! It may seem funny to use carbon-dating to tell the age of a brain cell (with an undertone of “are we really that old now?”, but measuring C14 decay was a reliable way to know definitively when a given cell was formed (because, being carbon-based life as we are, our cells can be carbon-dated just like any carbon-containing sample from an archeological site).

    Using these technologies, they were able to detect not just various stages of neuron development, but also many actively dividing cells, and the progenitor cells of which we spoke above.

    Notably, some adults had many neural progenitor cells while others had very few, suggesting differences in brain regenerative potential. Almost certainly this is linked to overall brain health, but identifying the cause(s) of the difference was not part of this study, so we can’t say for sure.

    You can find the paper here: Identification of proliferating neural progenitors in the adult human hippocampus

    What to do with this information

    The practical take-away here is that our brain, at any age, is a developing thing and will continue to rejuvenate itself given the chance. So, we have to give it that chance.

    This means looking after our brains with such things as:

    And of course: don’t smoke, and don’t drink alcohol. They are terrible for everything, and brain health is near the top of the list for each of them.

    See also: What Happens To Your Body When You Stop Drinking Alcohol ← for a timeline of physical recovery, including repairing the damage done to the brain by alcohol

    Want to learn more?

    You might like this book we reviewed a little while ago:

    The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity – by Dr. Norman Doidge

    Take care!

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