Think Neuro

Thyroid eye disease, also known as Graves’ ophthalmopathy or Graves’ orbitopathy, is an autoimmune condition that primarily affects the tissues and muscles around the eyes. It is most commonly associated with an overactive thyroid gland (hyperthyroidism), particularly in individuals with Graves’ disease, an autoimmune disorder that affects the thyroid.

Alexander M. Solomon, MD, is a neuro-ophthalmologist and strabismus surgeon at Pacific Neuroscience Institute in Santa Monica and Torrance, CA. Dr. Solomon’s personal philosophy is that each patient is an individual and that diagnosis and optimal management of any disease is best carried out in conjunction with patient and family education, and understanding.

For decades, people thought physical exercise benefited only the body. But every year we learn how incorrect that was, and Dr. David Merrill, director of PNI’s brain health center, is one of the people pushing our knowledge forward. It turns out that exercise builds the brain by prompting the production of brain derived neurotrophic factor, or BDNF. “Trophic” compounds cause things to grow, and BDNF helps create new connections among neurons, which is how we learn. In short, BDNF is fertilizer for the brain, Dr. Merrill says. In a perfect world, we would be able to take BDNF in a pill, like a vitamin. But it’s a big, clunky molecule that doesn’t pass easily from blood to brain. Exercise gets the job done, boosting BDNF and keeping our brains nimble. That fact makes exercise crucial as we age. Pumping iron, and therefore pumping up BDNF, promotes brain plasticity: the ability to change, grow and adapt to the insults that come with growing older. Listen to this episode to hear how you can boost BDNF through exercise and stay sharp into your golden years.

Dr. Akanksha Sharma is a neuro-oncologist and palliative medicine specialist at the Pacific Brain Tumor Center at Pacific Neuroscience Institute in Santa Monica, CA. To provide extra resources to brain cancer patients suffering from brain tumors such as glioblastoma and their caregivers. Dr. Akanksha Sharma is a neuro-oncologist and palliative medicine specialist at the Pacific Brain Tumor Center at Pacific Neuroscience Institute in Santa Monica, CA. To provide extra resources to brain cancer patients suffering from brain tumors such as glioblastoma and their cargivers, Dr. Sharma opened a Supportive Care Clinic in 2020. The clinic offers services to deal with symptoms, quality of life, caregiver burden and distress, and help alleviate suffering.

PacificBrainTumor.org | 310-829-8265

In movement disorders such as Parkinson’s disease, essential tremor, and dystonia, normal function can be restored to the circuitry of the brain, resulting in significant improvement in function and quality of life. The goal of deep brain stimulation surgery is to modulate the activity of a specific brain region.

In DBS, thin electrodes are placed in the disruptive areas of the brain and small electrical pulses normalize or eliminate the irregular signals. DBS is the non-permanent suppression of overactivity in the autopilot structure of the brain called the basal ganglia.

Like a pacemaker for the brain, the battery (pulse generator) is implanted under the skin of the chest, and leads (wires) are tunneled under the skin via the deep part of the brain through a quarter-sized opening in the skull. The system is fully implanted under the skin, so there are no external wires or devices. The stimulator is fully programmable and therefore adjustable over time, as the disease changes. Patients can use a simple hand-held device to turn the DBS on or off, and adjust various other parameters if needed.

Neuro-oncologist and palliative care specialist, Dr. Akansksha Sharma, talks about radiation treatment for brain tumors. Radiation oncology includes techniques such as external beam radiation therapy (EBRT) and brachytherapy. External beam radiation therapy involves the use of a machine, such as a linear accelerator, to deliver radiation beams from outside the body to the tumor site. The treatment is carefully planned and delivered over a series of sessions, usually on a daily basis. Brachytherapy, on the other hand, involves the placement of a radiation source directly into or near the tumor, allowing for a higher dose of radiation to be delivered locally while minimizing exposure to surrounding healthy tissues.

When he’s not being a world-class neurosurgeon caring for patients with brain or pituitary tumors, Dr. Garni Barkhoudarian trains younger surgeons on the science and art of neurosurgery. As director of the Neuroanatomical Skills / Microdissection Anatomy Lab, he advances the procedures and technology used for minimally invasive surgery. Neurosurgeons can enter PNI’s fellowship program, and research fellows from around the world can learn these advanced techniques taking them into their practices and back to their home countries. In college, Josh Emerson wanted to study the neuroanatomy of whales and dolphins, but when he realized he’d have to spend time on boats he switched to human neuroanatomy instead. A talented artist, he often doodled the things he studied. One day, he drew a human spinal cord, complete with a herniated disk. A visiting surgeon looked over his shoulder, took out a $100 bill, handed it to him and told him to see a colleague about doing more medical illustrations. Emerson has never looked back. A medical illustrator for over two decades he is the Microdissection Lab Manager at PNI, where he works closely with Dr. Barkhoudarian. Josh has moved on from pen and ink to computer-aided animation. Listen to this podcast to learn how this pair works together to map some of the smallest, most important structures in the human body.

Dr. Amit Kochhar talks about symptoms, and diagnosis of paralysis due to facial nerve syndromes. Facial paralysis is devastating to one’s identity. Patients with facial paralysis experience physical, social, and emotional changes. At PNI, our specialists treat all types of facial paralysis and related conditions. Every face is unique and our team takes a compassionate, patient-centric approach to designing a unique facial paralysis treatment for each individual.

For more information: 310-829-8701

https://www.pacificneuroscienceinstitute.org/eye-ent/facial-nerve-disorders/

https://www.pacificneuroscienceinstitute.org/eye-ent/people/amit-kochhar/

Barbara S. Giesser, MD, FAAN, FANA, is an internationally recognized clinician and award-winning educator who has specialized in the care of persons with Multiple Sclerosis since 1982. Her approach to the diagnosis and management of persons with MS combines advanced diagnostics and a personalized medication plan for each patient with an emphasis on integrating lifestyle and wellness strategies into the neurologic treatment plan.

Learn about disease modifying therapies for the treatment of Multiple Sclerosis in this PNI Minute.

For more information: 310-582-7613 | pacificbrainhealth.org

Sandra Narayanan, MD, Vascular Neurologist and Neurointerventional Surgeon at the Pacific Stroke and Neurovascular Center at Pacific Neuroscience Institute, explains the difference between hemorrhagic and ischemic stroke.

The main difference between the two types of stroke is the underlying cause of the brain damage. In ischemic stroke, the damage is caused by a lack of blood supply, while in hemorrhagic stroke, it is caused by bleeding into the brain tissue. Both types of stroke are medical emergencies and require immediate medical attention to prevent further damage and improve outcomes.

Dr. David Merrill is a psychiatrist who specializes in older adults. He has a PhD in the neurobiology of aging, and he directs PNI’s Brain Health Center. His colleague Dr. Karen Miller, has a PhD in geropsychology–the psychology of older people. She is the senior director of PNI’s Brain Wellness and Lifestyle Program. Molly Rapozo is a registered dietician nutritionist. They work as a trio to help older people stave off the ravages of dementia through diet, exercise, and cognitive training.

Their work is crucial because, despite some recent, modest advances on a drug to treat Alzheimer’s, there just isn’t a pill that can keep our brains in tip-top shape as we age. What we have are some behaviors that are proven to protect the brain from premature dysfunction. Listen to this podcast to learn what our all-star team knows about the best strategies.