Last week I celebrated with our chief residents as they graduated from the program and began their independent careers as neurosurgeons. This week I welcome our two newest residents, who are just beginning the seven-year program. The start of a new academic year always makes me feel contemplative, as I reflect on how neurosurgery has evolved since I was a resident. So much has changed – the technology is more advanced, the imaging is so much better, the tools are more precise — but I don’t think any of those are the most significant changes of the past few decades. To me, the single biggest change has been the broadening of our understanding of brain functioning – and specifically, brain health.
Think about all we’ve learned over the past few decades about heart health and lung health — we know that smoking has a terribly detrimental effect on the lungs, and we know that a Mediterranean diet and moderate exercise can significantly improve heart health. What we’ve learned about brain health hasn’t made the news as much, but it’s just as important — from where I sit even more important — than either of those.
Building awareness of the importance of brain health, and then getting individuals to change their habits accordingly, is a campaign that remains in its infancy. With so many of us Baby Boomers now worried about dementia, there’s been a proliferation of memory-enhancing advice and products (some worthwhile, some not). What Boomers tend to ignore, however, is how much their brains are at risk of damage from diabetes, vascular disorders, and infections — and you can’t protect your brain against those by doing more crossword puzzles.
In spite of all the great technology we have now, the single best solution for brain conditions is to prevent them from starting. The most frustrating kind of patient we doctors face are the ones who spend years ignoring their health, develop a preventable condition, then expect modern medicine to fix it. An ounce of prevention truly is worth a pound of cure. It’s not easy to change a lifetime of brain-damaging habits, but it can (and must) be done.
To have a healthy brain, you need healthy systems all around. In general, if it’s good for the heart it’s good for the brain, because you need a robust blood supply to keep your brain well nourished. That means a heart-healthy diet for starters, but also 30 minutes a day of exercise, which not only protects your heart but also benefits the hippocampus and induces the release of protective hormones in the brain.
Beyond diet and exercise, though, your brain depends on many other lifestyle factors that you can choose to amend. For example, we are a perennially sleep-deprived society, but we are not doing our brains any favor when we cut corners here. Not getting enough sleep leads to a decreased attention span as well as deficits in problem solving and reasoning. Stress is another big culprit. Although some stress is good for you, persistent and extreme stress can decrease both your white matter and your hippocampal mass.
None of us can completely eliminate stress, but to protect your brain health it’s important to learn to manage it – through mindfulness, meditation, yoga, and other stress-reduction strategies. They do work. Mindfulness training and meditation have been shown to reduce cortisol levels, increase the size of the cortex and corpus callosum, and increase the size of the anterior cingulate cortex, which regulates empathy and executive function. Music can also help. Listening to music has been shown to decrease anxiety, lower blood pressure, and improve mood. And as most of you know, maintaining social ties and staying active and connected have been shown to keep the brain healthy overall.
I look forward to training many more of the young residents and neurosurgeons who are learning all the high-tech tricks of our trade — but I’d be very happy if they never had to treat a patient with a preventable brain condition. The more we can do to understand and promote brain health, the better. (Find out more about the Weill Cornell Brain and Spine Center.)
