Dr. Gary Steinberg: How to Improve Brain Health & Offset Neurodegeneration
Added: May 20, 2024
In this podcast episode, Dr. Andrew Huberman interviews Dr. Gary Steinberg, a professor of neurosurgery, neurosciences, and neurology at Stanford University School of Medicine. Dr. Steinberg is an expert in cerebrovascular architecture, which involves understanding how blood flow to the brain supplies oxygen and nutrients to neurons and removes waste products. The discussion covers a range of topics including strokes, aneurysms, hemorrhages, traumatic brain injuries (TBIs), and the importance of lifestyle factors in maintaining brain health and offsetting neurodegeneration.Key takeaways
Dr. Gary Steinberg emphasizes the critical role of cerebrovascular health in maintaining brain function. Proper blood flow is essential for delivering oxygen and nutrients to neurons and removing waste products.
The health of the heart is directly linked to brain health. Factors like exercise, a healthy diet, and managing obesity and hypertension benefit both the heart and the brain.
Innovations in neurosurgical techniques, such as functional MRI scans, intraoperative stimulation, and minimally invasive procedures, have significantly improved outcomes for patients with brain conditions.
Adequate sleep is crucial for reducing stroke risk. Strokes often occur during sleep, possibly due to circadian rhythms, making it essential to prioritize good sleep hygiene.
Research on neuroprotection, including the use of mild hypothermia and stem cell therapies, shows promise in promoting recovery and neuroregeneration after brain injuries like strokes.
Reducing Stroke Risk Factors
Dr. Steinberg begins by discussing strokes, which are often caused by clots blocking blood vessels or by hemorrhages from burst blood vessels. He explains that factors increasing the risk of clots include genetic mutations like Factor V Leiden, smoking, high cholesterol, hypertension, and the use of certain medications like oral contraceptives. He emphasizes that lifestyle changes such as quitting smoking, managing cholesterol levels, and controlling blood pressure can significantly reduce the risk of strokes.
Importance of Heart Health for Brain Health
The conversation then shifts to the importance of heart health in relation to brain health. Dr. Steinberg explains that the brain consumes a significant amount of oxygen and nutrients compared to its size, making it essential to maintain healthy blood flow. He highlights that lifestyle factors like exercise, a healthy diet, and managing risk factors like obesity and hypertension benefit both heart and brain health.
Advancements in Neurosurgery Techniques
In his neurosurgical practice, Dr. Steinberg shares a case where he operated on a patient with a vascular malformation near the speech area of the brain. By using functional MRI scans and intraoperative stimulation, he was able to safely remove the malformation without causing speech impairment. He also discusses advancements in minimally invasive neurosurgical techniques, such as operating through vessels, using focused radiation, and employing focused ultrasound for conditions like essential tremor and Parkinson's disease.
Understanding Transient Ischemic Attacks (TIAs)
Dr. Steinberg explains transient ischemic attacks (TIAs), which are temporary strokes that can cause symptoms like weakness, confusion, slurred speech, and facial paralysis. TIAs are warning signs of potential future strokes and should be taken seriously. Treatment for TIAs may involve lifestyle changes, medication to prevent blood clots, and managing underlying risk factors like hypertension and high cholesterol.
Lifestyle Factors and Brain Health
The discussion also touches on lifestyle factors that can impact brain health, such as alcohol intake, drug use, and smoking. Dr. Steinberg warns that excessive alcohol consumption, cocaine, and methamphetamine use can damage blood vessels and increase the risk of strokes. He emphasizes moderation in alcohol consumption and avoiding hard drugs to reduce the risk of stroke.
Traumatic Brain Injuries and Concussions
The conversation then moves to traumatic brain injuries (TBIs) and concussions, which are common in sports like football, construction work accidents, and car accidents. Dr. Steinberg explains the importance of monitoring symptoms after a head injury, avoiding excessive alcohol intake, and getting adequate rest to support brain recovery. He also mentions the use of eye tracking tests to assess brain function post-concussion.
Benefits and Risks of Preventative MRI Scans
The topic of preventative MRI scans is discussed, with Dr. Steinberg highlighting the benefits and risks of total body scans. While these scans can detect potential health issues like tumors or aneurysms, they can also lead to unnecessary worry and invasive procedures for minor findings. He advises caution in interpreting scan results and consulting with specialists for further evaluation.
Maintaining Healthy Blood Pressure and Cholesterol
In terms of lifestyle factors for preventing strokes, Dr. Steinberg recommends maintaining a healthy blood pressure and cholesterol level. While guidelines have evolved over time, keeping systolic blood pressure below 120 is considered beneficial for reducing stroke risk. He shares a personal anecdote about managing his own blood pressure and the importance of individualizing health recommendations based on each person's needs.
The Importance of Self-Care
Dr. Steinberg also stresses the significance of adequate sleep, avoiding excessive caffeine intake, and not pushing oneself too hard in terms of exercise and work. He reflects on his own experience of fainting due to overexertion and the importance of prioritizing rest and self-care. By balancing ambition with self-care practices like meditation, journaling, and slowing down, individuals can optimize their brain health and reduce the risk of neurodegenerative conditions.
The Importance of Hydration and Electrolytes
Hydration is another critical factor for proper brain and body functioning. Dr. Steinberg mentions the role of electrolytes such as sodium, magnesium, and potassium in maintaining optimal brain function. He recommends using electrolyte drinks like Element to ensure proper hydration and electrolyte balance.
Sleep Deprivation and Stroke Risk
The relationship between sleep deprivation and stroke risk is also explored. Dr. Steinberg explains that strokes often occur more commonly during sleep, possibly due to circadian rhythms. He advises individuals to prioritize adequate sleep and monitor their blood pressure to correlate any symptoms with vital signs.
Cautionary Tale: Neck Manipulation Risks
The conversation delves into the topic of chiropractic care and the potential risks associated with neck manipulation. Dr. Steinberg shares a cautionary tale about a patient who experienced a stroke following a neck adjustment. He recommends avoiding neck manipulation by chiropractors to prevent such incidents.
Advancements in Stroke Recovery
The podcast also explores the concept of plasticity in the brain and the potential for recovery after a stroke. Dr. Steinberg discusses recent advancements in stem cell therapy and other treatments that promote neuroregeneration and functional recovery in patients with brain injuries. He highlights the importance of physical activity and exercise in promoting brain health and recovery after a stroke. Constraint therapy, where patients are encouraged to use the affected limb to stimulate neural plasticity and improve motor function, is one such method.
Neuroprotection and Hypothermia in Brain Injury Research
Dr. Steinberg shares insights from his research on neuroprotection after brain injuries, particularly strokes. He explains the mechanisms of cell death in the brain following a stroke and the challenges in translating preclinical findings into clinical treatments. Despite the limitations, he mentions the success of mild hypothermia as a neuroprotective strategy in some cases. Neuroprotection involves protecting the brain from damage caused by strokes, traumatic brain injuries, and other conditions. Hypothermia has been shown to reduce metabolic activity and block detrimental pathways in the brain.
Caution Against Unproven Stem Cell Therapies
The conversation then shifts to platelet-rich plasma (PRP) therapy. Dr. Steinberg explains that while PRP has been FDA-approved for certain conditions, there is limited evidence to support its effectiveness in improving brain health or preserving brain tissue. He cautions against seeking unproven stem cell therapies, especially from clinics outside the country, due to potential risks and lack of regulation.
Vagal Nerve Stimulation for Stroke Patients
Vagal nerve stimulation is another treatment discussed, which has been FDA-approved for chronic stroke patients. Dr. Steinberg explains that vagal nerve stimulation, coupled with intensive physical therapy, has shown modest but meaningful improvements in stroke patients. The vagus nerve plays a crucial role in connecting the brain and body, and its stimulation can lead to improvements in brain function.
Challenges in Translating Research
Dr. Steinberg also touches on the challenges of translating research into clinical therapies, citing the need for more funding, collaboration with industry, and regulatory approval. He shares his experience with developing stem cell therapies for stroke patients and the long and costly process of bringing these treatments to market.
Proactive Steps for Brain Health
In conclusion, Dr. Steinberg emphasizes the importance of taking proactive steps to protect and improve brain health. He encourages listeners to make healthy lifestyle choices, seek evidence-based treatments, and stay informed about the latest developments in neuroscience. He expresses optimism about the future of stem cell therapies and brain stimulation techniques in treating various brain conditions.
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