Opinion: Disease and damage to the brain causes significant loss of life and disability in NZ so we must look after this precious organ, explains Malvindar Singh-Bains.

From a young age we need to take special care of our brains.

The human brain is the final frontier of medical research: You can replace a kidney, a lung, a liver, even a heart, but it is currently impossible to replace a sick brain. Unfortunately, brain diseases continue to result in significant loss of life and disability in New Zealand.

For example, we have a rapidly aging population and the number of people living with dementia is estimated to increase by close to 300 per cent to 170,000 by 2050. Cerebrovascular diseases (such as stroke) are currently the third largest cause of death in New Zealand (next to cancer and heart disease). Currently there are no “cures” for a single neurodegenerative condition that causes the deterioration and death of our brain cells. We only have treatments for some symptoms these conditions cause, and these treatments do not always work.

Human brain disease is not restricted to older people either. Around 36,000 people of all ages in New Zealand suffer from traumatic brain injuries every year. Traumatic brain injuries are the leading cause of long-term disability among children and young adults. Furthermore, young people may end up becoming carers for older individuals, such as their parents, who may be living with neurodegenerative conditions such as Alzheimer’s disease, Parkinson’s disease or Huntington’s disease. In the case of a hereditary condition such as Huntington’s disease, children have a 50 percent chance of inheriting the gene that causes the disease, which means they have a 50 percent chance of suffering from the condition themselves.

It sounds grim, but what these statistics do is emphasise the importance of the work that is being done around the world to understand and find the answers so we can finally cross that final frontier to curing the human brain.

My own work in this area focuses on understanding changes to cells within the human brain in Huntington’s disease and Alzheimer’s disease. I rely heavily on studying precious human brain tissue generously bequeathed to the Neurological Foundation of New Zealand Human Brain Bank which is located within the Centre for Brain Research in the University of Auckland.

Some of the discoveries I have been involved in include identification of brain cell death patterns within regions of the human brain affected by Huntington’s disease and generally neglected in medical research. These patterns can help explain why patients suffer from different symptoms in Huntington’s disease. For example, my studies into two brain regions, called the globus pallidus and cerebellum, have shown these areas are affected in Huntington’s disease, and have an important role in presenting the different and variable symptoms that patients with this disease experience.

Around 36,000 people of all ages in New Zealand suffer from traumatic brain injuries every year. Traumatic brain injuries are the leading cause of long-term disability among children and young adults.

These findings mean we are closer to fully unlocking how Huntington’s disease affects the human brain, which has implications for the development of treatments and delivery of therapeutics to treat the cause and symptoms of the condition. In Alzheimer’s disease, I have recently published evidence that changes to our brain’s immune cells (microglia) and blood vessels in the human cerebellum are vital components of disease progression in Alzheimer’s disease and could be key targets for future drug development.

But as well as carrying out this crucial research, it is also important that we get the message out about looking after your precious brain. It is really important for young people to be aware that wearing protective gear for sports, or a helmet while riding a bike, or “looking before you leap” head first into a watering hole is incredibly important for reducing the impact of traumatic brain injury on the brain. And it’s not just about the physical injury like a bump on the head, it’s also about unseen injuries caused by the impact of the brain pushing against the skull if an injury does take place.

The other important message that needs to be heard is about dropping the stigma and raising the profile of neurological conditions that affect many families who engage with us at the Centre for Brain Research. We listen to the families and individuals impacted by these conditions and we know that they want to be heard and understood by those who may not comprehend the challenges associated with memory impairment, movement and behavioural disturbances.

For example, after hearing the challenges faced by young people at risk of Huntington’s disease, we formed the Huntington’s Disease Youth Organisation of New Zealand, a charity dedicated to educate, advocate and support young people impacted by this condition. Currently we are raising funds for a youth worker who can support young people across New Zealand.

In terms of overall brain health, I like to follow the mottos: “What is good for the heart is good for the brain” and “what you put in, is what you get out.” When I speak to school age children, I actually describe how high-fat and high-sugar foods are key fuel sources for diabetes and obesity, which in turn are risk factors for brain conditions such as stroke. I think if kids are old enough to read and write, they are old enough to learn about how to protect their beautiful brains!

Of course, the brain health message is not just for the young. The old saying definitely applies: “If you don’t use it, you lose it!” Just like we exercise our bodies to stay healthy, we need to keep our brains stimulated, and that becomes just as important as we age. We need a multi-component lifestyle to keep our brains as healthy as we possibly can. For example, increasing physical activity (30 minutes a day at least five times a week), cognitive stimulation (Sudoku puzzles, chess, reading books), social activities (friends, family, community groups), good sleep, and good management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension). In short, brain training, heart training and body training all achieved with a multi-component lifestyle.

Dr Malvindar Singh-Bains is a research fellow at the Centre for Brain Research

This article reflects the opinion of the author and not necessarily the views of the University of Auckland.

Used with permission from Newsroom Be kind to your brain 13 December 2019.

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