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Q&A with Yaakov Stern on Brain Reserve, Exercise, Cognitive Training, Angry Birds, YMCA and more

Posted Feb 14 2012 4:41pm

I just had the chance to discuss latest neuroscientific research and thinking with Dr. Yaakov Stern, one of the leading scientists studying how to build a neuroprotective cognitive reserve across the lifespan. Dr. Stern leads the Cognitive Neuroscience Division at the Columbia University Sergievsky Cen­ter . What follows is a Q&A session conducted via email over the last week.

Alvaro Fernandez: What do you make of the recent study “ Association of Lifetime Cognitive Engagement and Low β-Amyloid Deposition ”? 

Yaakov Stern: I find these results very intriguing. The concept of cognitive reserve posits that various lifetime exposures such as education, occupation and leisure activities may be related to differential susceptibility to Alzheimer’s pathology once it occurs. This paper continues a new, ongoing theme that certain lifetime closures may actually impact on the brain changes or pathologic findings themselves. While more work needs to be done to understand how lifetime exposures may impact the development of Alzheimer’s disease pathology, it is clear that both cognitive stimulation and exercise help shape the brain throughout the lifespan. For example, animal studies indicate that both a stimulating environment and a aerobic exercise are associated with neurogenesis, the growth and utilization of new neurons in the hippocampus. Thus, life events may contribute to what I have called “brain reserve,” but now brain reserve is a much more fluid concept than I originally imagined.

AF: How do these findings link to your work?

YS: These types of observations have contributed to the design of two intervention studies that I am currently running. One of them compares people who engage in a aerobic exercise versus stretching and toning for six months. We are comparing these two forms of physical exercise to see which is more beneficial. F. Before and after this exercise period, the participants receive extensive cognitive evaluation and neuroimaging. The neuroimaging studies will help us understand what brain changes are associated with any cognitive improvement that we see. One unique aspect of this study is that it is enrolling younger people that have been included in previous studies. We are recruiting individuals who are 30 – 45 and 50 – 65.

AF: What is the current understanding on what adults may need, and benefit from? are priorities and likely interventions the same when we talk about younger vs. older adults?

YS: That is exactly what I’d like to find out. The animal studies and some studies of younger adults suggest that exercise may impact both the cognition and the brain across all ages. The goal of my study is to see whether it has similar efficacy in younger and older individuals, whether the same cognitive processes are enhanced, and whether the neural basis for improvement is the same across these age groups. In the second ongoing study, we are looking at the relative benefits of physical and cognitive exercise.

AF: What is the current understanding on the relative merits and shortcomings of physical and cognitive exercise? do you see them as somehow mutually exclusive or as synergistic?

YS: My view is that they are synergistic. It makes sense to me that any improvements in “brain reserve” would heighten the ability to develop a more “cognitive reserve.” To explain, we know that both exercise and cognitive stimulation affects the brain itself. For example, they both up regulate a chemical that is responsible for increased synaptic plasticity. The advantage I see to cognitive training is that it can enhance specific cognitive functions. It may be that people will be benefit more from this cognitive training when they exercise, since exercise may help the brain be more receptive to this training. To test this idea, we are running another study where participants engage in both videogames designed to enhance cognitive function (specifically, attentional allocation), and also exercise. This study is open to people aged 60 and over. I must say that this study is more demanding because it requires both for visits to the gym a week and three visits to our lab to play the video game. One unique feature of both of our studies is that we have partnered with all of the YMCAs in Manhattan, so that participants can conduct their exercise sessions in any location that is convenient to them.

AF: Why did you select that particular videogame and not, say, Tetris or Angry Birds?

YS: We are using the Space Fortress game because I believe that it may enhance attentional allocation and executive control. I feel that these are very important cognitive functions and enhancing them may directly impact on and improve the performance of many day-to-day activities. We are comparing the Space Fortress game with more standard computer games, since it is quite possible that they may be beneficial as well.

AF: So, your studies will measure the impact of moving from a sedentary lifestyle to exercising at least 4 times a week. Would you expect the resulting benefit to be more or less pronounced than if someone already exercising at four times per week increase to eight times per week?

YS: I am not sure what the answer to this is. Most exercise studies begin with people who are not regular exercisers because we believe that it will increase the chance that we can see an effect. My guess is that any increase in exercise may also be beneficial, but it would be harder to detect.

AF: The YMCA partnership is fascinating, a very innovative way to do community-based research. How does it work? Who greets/ supervises/ supports people? Was it difficult to engage them? And, where do the computerized cognitive workouts take place?

YS: I agree that the partnership with the YMCA is very exciting. People participating in our studies get free access to the gym at any YMCA in Manhattan. Our personnel initially meets participants at the gym and orient them to what they need to do. The gyms all have resident trainers who know about the studies and can give advice as needed. Right now the computerized cognitive workouts are done at our medical center. We are currently working on the technology to allow people to play the games from their home in a way that we can directly monitor their performance. This should make it a little easier for people to participate.

AF: Who is eligible for your studies and how can they sign up?

YS: As I mentioned above, one study is recruiting people ages 30 to 45 and 50 to 65. The second, more intensive study is recruiting people age 60 and older. Both of these studies are looking for individuals who are not regular exercisers, because this should enhance our ability to find an effect of exercise on cognition. Our coordinator can help answer questions about whether you are eligible or not. Anyone interested potentially participating in one of these two studies can contact Caitlin Slight: cbs2139 at columbia.edu.

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