![The efficacy of the mechanisms of
plasticity decreases over the lifespan
Frontiers in Aging Neuroscience 2011; Brain Topography 2011
Caterina
Freitas
Age [years]20 80
BrainPlasticityIndex
10
50](https://image.slidesharecdn.com/finalday1asset2-171212191852/75/What-are-most-promising-lifestyle-and-tech-options-to-harness-lifelong-neuroplasticity-and-what-are-key-roadblocks-ahead-18-2048.jpg)
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What are most promising lifestyle and tech options to harness lifelong neuroplasticity, and what are key roadblocks ahead?
This document summarizes a panel discussion on harnessing lifelong neuroplasticity through lifestyle and technology options, and the challenges ahead. The panel was chaired by experts in neuroplasticity and brain health. Panelists discussed using noninvasive brain stimulation techniques like TMS to measure biomarkers of brain circuit dynamics and plasticity. They described ongoing studies measuring lifestyle factors' impacts on brain health through the Barcelona Brain Health Initiative. Another panelist discussed opportunities for brain augmentation through nanotechnology but called for responsible development and public engagement and ethics guidelines to ensure benefits for individuals and society.
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What are most promising lifestyle and tech options to harness lifelong neuroplasticity, and what are key roadblocks ahead?
- 3. What are mostpromising lifestyle and tech options to harness lifelong neuroplasticity, and what are key roadblocks ahead? Chaired by: Dr. David Bach, Founder and President of the Platypus Institute Dr. Álvaro Pascual- Leone, Director of the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center Dr. David Bartrés-Faz, Principal Investigator of the Barcelona Brain Health Initiative (BBHI) Dr. Simone Schurle, Assistant Professor for Responsive Biomedical Systems at the Swiss Federal Institute of Technology
- 4. Towards a BrainHealth Index: Perturbation-based Biomarkers Alvaro Pascual-Leone, M.D., Ph.D. Berenson-Allen Center for Noninvasive Brain Stimulation Division of Cognitive Neurology • Brain Fit Club Beth Israel Deaconess Medical Center & Harvard Medical School
- 5. Disclosures • Scientific AdvisoryBoard Member for Neosync, Starlab, Neuroelectrics, Magstim, Axilum Robotics, Constant Therapy • I will talk about off-label applications of noninvasive brain stimulation • Listed inventor on various patents on combination of noninvasive brain stimulation with EEG and fMRI Alvaro Pascual-Leone, MD, PhD
- 6. www.brainfitclub.org The Brain FitClub at BIDMC 1. Measure 2. Personalize Prescription 3. Supervise Interventions 4. Assess Benefit
- 7. Brain Health Index MonitorProgress Adjust the Plan Personalized Plan
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- 10. 1. (Noninvasive) BrainStimulation offers valuable translatable perturbation biomarkers to bridge the model systems to humans 2. Characterization of the dynamics of such circuits can provide novel insights into the neurobiology of neuropsychiatric diseases and offer new individualized therapeutic opportunities Non-invasive Brain Stimulation Perturbation Biomarkers
- 11. Regional cortical hyperexcitabilityin epilepsy Shafi et al Ann Neurol 2015 Mo Shafi
- 12. TMS: Paired-Pulse Kobayashi etal Lancet Neurol 03 SICI GABA-A ICF NMDA
- 13. Defective ICI in Pain Lefaucheret al Neurology 2007 GABA-A GABA-B
- 14. Identifying inhibitory deficitsin disease Farzan 2010 Brain; Frantseva 2014 Cerebral Cortex Faranak Farzan
- 15. TMS-EEG measures correlatewith cognition Rogasch 2015 Cortex
- 16. Repetitive TMS: Theta BurstStimulation Frontiers Synaptic Plasticity 2011; Brain Topography 2011; Eur J Neurosci 2012 8 s 2 s 200 ms Bursts of 3 pulses at 50 Hz 600 pulses over 192 s Following iTBSBaseline LTD-like Plasticity LTP-like Plasticity Following cTBS
- 17. TBS Frontiers Synaptic Plasticity2011Brain Topography 2011; Eur J Neurosci 2012 Measuring Plasticity in Humans Lindsay Obermann Marine Vernet
- 18. The efficacy ofthe mechanisms of plasticity decreases over the lifespan Frontiers in Aging Neuroscience 2011; Brain Topography 2011 Caterina Freitas Age [years]20 80 BrainPlasticityIndex 10 50
- 19. r = -0.54 p= 0.001 12 10 6 4 0 ADAS-CogScore 2 8 -100 -50 0 50 100 150 T10 MEP Amplitude (% ∆ from baseline) 200 ADAS-Cog score by T10 Plasticity Peter Fried NIDDK NINDS The Mechanisms of Plasticity Predict Cognitive Function
- 20. Age Brain Plasticity CognitiveCapacity Genetic Factors Environmental FactorsIndividual Differences
- 21. Alteration of Mechanismsof Plasticity as measured by TBS LTD-like Plasticity LTP-like Plasticity Oberman et al Eur J Neurosci 2012 Autism Spectrum Disorder Koch et al J Alz Dis 2012 Brem et al Ann Neurol in press Alzheimer’s Disease Fried et al DM2Translatable Phenotype
- 22. CorticalReactivityandE/IBalance CorticalPlasticity TMS in AnimalModels NMDA- dependent LTD-like effect Mechanisms of cortical reactivity and plasticity
- 23. Brain Health Index MonitorProgress Adjust the Plan Personalized Plan
- 24. Barcelona Brain HealthInitiative David Bartrés-Faz Faculty of Medicine and Health Sciences University of Barcelona Alvaro Pascual-Leone Berenson-Allen Center for Nonivasive Brain Stimulation BIDMC Harvard Medical School
- 25. To better understandlifestyle determinants and their mechanisms leading to optimal brain function in advanced age. Prospective on the Catalonia (Barcelona) population 2014 Josefson et al. JAGS 2012•Population is ageing •Ageing is an important risk factor for major brain diseases •Brain diseases are #1 leading cause of disability Maintenance of optimal cognitive performance occurs in around 20% of elders.
- 26. Disease DisabilitySymptoms Diagnoses Treatment Health Brain resilience Preservedfunction Resilience promotionPrevention Brain health maintenance is best adressed from current brain health Altered function
- 27. Relevance of modifiablelifestyles to maintain brain health at old age 35% of cases with dementia are atributed to a combination of these 9 risk factors Removal of APOE effects only reduces risk -7%
- 28. Erickson et al.PNAS 2011 Lifestyles and Brain Health: Lifespan & individualized perspective Previous, reported Current, intervention Modulation by genetic background Wirth et al. J Neurosci 2014
- 29. Cognitive activity Physicalactivity Nutrition Socialization Sleep Vital plan General health Lifestyle pillars in BBHI
- 30. 30 BBHI apprach: combiningobservational and interventional studies Longitudinal prospective cohort + 5,000 participants Phase I : lifestyle questionnaires / scales 1,000 participants Phase II: in person assessment 250 control, health education 500 participants Phase III: Intervention 40-65 years old, no neuropsychiatric diagnosis PRE-POST: MRI, EEG, TMS, Neuropsychological assessment, gait analysis, voice recording, blood samples… ICT-based, mobile Apps, personalized... 250 personalized coaching
- 31. 31 Phase I: HealthyHabits Monitor https://club.bbhi.cat Peers comparison
- 32. • ICT-based intervention •500 participants • Personalized • Individualized coaching support • Motivation, adherence • Smartphones, wearables and Apps • Tracking and monitoring • Managing and communication • Automatic alert systems Phase III: mHealth for monitoring and adherence 32
- 33. In summary….. • TheBBHI combines a follow-up study cohort and a multimodal intervention to investigate the impact of positive lifestyles on brain health. • The study is focused on middle-aged healthy individuals and incorporates biological-based measures for the investigation of the mechanisms through with such lifestyles exert its effects. • It provides individual web-based/APP feedback to participants and uses mobile Health technologies and a personalized coach approaches, aiming to increase engagement and adherence.
- 34. Simone Schürle, PhD ResponsiveBiomedical System Lab ETH Zurich Department of Health Science and Technology Institute for Translational Medicine
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- 39. 39 06.10.201 7 Nanostructures: a platformfor brain repair and augmentation Image source: Vidu et al. Front Syst Neurosci. 2014; 8: 91.
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- 41. 41 06.10.201 7 Human Enhancement Body Brain Humanenhancement aims to improve the quality of life over its course, at any age and stage, by enhancing our functional capabilities.Performance Age
- 42. 42 Human Enhancement 4 mainpathways 1) Manipulation and extension of our body and brains 2) Modifications of our genes, our own biological mass 3) Alterations on a molecular and pharmacological level 4) Changes of our environment
- 43. 43 Call for Codeof Ethics Key Issues 1) Equity and Social Justice 2) Maintaining Humanness and Autonomy 3) Transparency and Access to Information
- 44. 44 Concluding Notes ▪ Responsibleresearch and tech development ▪ Engagement of the public in this conversation Need for ethical guidelines and frameworks that ▪ help innovation to foster ▪ benefit individuals and society ▪ and prevent catastrophe
- 45. Lunch break Please beback at 12.30pm US Pacific Time/ 3.30pm Eastern Time for a fascinating afternoon!
- 46. Thank you, Speakers& Participants!
- 47. Thank you, SummitSponsors!
- 48. Thank you, SummitPartners!
- 49. To learn more,visit sharpbrains.com