Columbia's NeurExpand Brain Center takes aim at memory loss
By By Pete Pichaske and For The Baltimore Sun
Mar 13, 2014 | 8:16 AM
Here's a no-brainer for you: Your memory doesn't have to get worse with age. In fact, you can actually grow the short-term memory portion of your brain -- and possibly even stave off the onset of Alzheimer's disease.
Or so says Dr. Majid Fotuhi, a Harvard- and Johns Hopkins-trained neurologist who has operated a brain center in Lutherville for the past two and a half years, and who this winter opened an even larger brain center in Columbia, a 6,000-square-foot facility on Charter Drive, behind Howard County General Hospital.
"Research in the past four or five years has provided compelling evidence that we can increase the size of our brain," Fotuhi says. "It sounds too good to be true, but it is (true). There are a dozen different ways that, not only can we reverse the effects of aging, we can actually boost our brain -- literally."
Fotuhi, 51, is something of a rock star in the world of neurology. He has appeared on numerous television shows, from "The Dr. Oz Show" to PBS, and authored many articles and three books on memory and the brain, including his most recent, "Boost Your Brain: The New Art & Science Behind Enhanced Brain Performance." He speaks frequently at conferences and seminars and was the keynote speaker at the most recent Howard County 50+EXPO, a wildly popular event for adults 50 and older. "This is a topic that people are very, very interested in," says Starr Sowers, who organized the expo as manager of the county Office on Aging's Health & Wellness Division.
The human brain has fascinated Fotuhi since he was 7 or so, and his father talked to him about "brain plasticity," the ability of the brain to change its structure and function. That fascination led him into the field of neurology. He earned a master's from the Harvard-MIT Division of Health Sciences and Technology at Harvard Medical School and his Ph.D. in neurosciences at Johns Hopkins University. He still teaches at both schools.
His fascination, coupled with recent discoveries about memory and the brain, also led him to open the NeurExpand Brain Center. In addition to the Lutherville and Columbia locations, a center is planned in Chevy Chase.
"We have put our finger on a very important discovery," Fotuhi says. "Your brain is not a fixed structure, like your nose or a computer. Your brain is an ever-changing organ. … It has the potential to increase in size, to get better with aging. … And we are seeing it, seeing the results in our patients."
Fotuhi's centers operate on a few key premises -- all of them, he says, rooted in the latest research. One is that the hippocampus, a thumb-sized part of the brain's cerebral cortex important to short-term memory, naturally shrinks with age (an average of .5 percent a year after age 50). Another is that memory loss and Alzheimer's can be the result of many different factors, not just the brain-ravaging toxins that most potential cures for Alzheimer's focus on, but also insufficient sleep, anxiety, depression, strokes, concussions, poor diet, lack of exercise -- the list is long. Another premise is that with proper treatment, shrinkage of the hippocampus, and thus a person's memory loss, can be reversed.
Fotuhi takes a multidisciplinary approach to diagnosing and treating memory loss in his patients. Those patients typically are in their 50s, 60s and 70s and stumbling more and more over such once-simple tasks as remembering names or why they just walked into a room. Initially, patients are given a "head-to-toe" physical and a set of tests, out of which emerges a picture explaining the reasons for the memory loss. Based on that individualized snapshot, a 12-week program is devised. The programs vary, but they likely include brain games tailored to their problem, counseling, neurofeedback, and recommendations for physical exercises and meditation.
Established in Howard County for its large and growing senior population, the brain center has a staff of about 15, including a clinical team composed of board-certified neurologists, neuropsychologists who oversee the "Brain Fitness" program and serve as "brain coaches," clinicians who conduct cognitive assessments, neurology technicians who perform brain mapping, and exercise physiologists who provide fitness assessments and nutrition guidance.
Success is measured by performance on brain exercise tests and MRIs that measure the volume of the hippocampus.
Fotuhi says his patients have increased the size of their hippocampus anywhere from 1 to 8.6 percent. A 5 percent increase, he notes, makes up for 10 years of shrinkage for patients older than 50.
"We have some mild successes, a lot of very good successes, and a few just amazing stories -- people who transform into someone much younger," he says. "Everybody improves. And the majority of people have 30 percent improvement in their memory retention, concentration, executive function."
Towson resident Charles Grevers turned to the brain center in 2013 after a double heart attack and series of mini-strokes left him barely able to communicate. "My brain was clogged, my speech was garbled," recalls Grevers, now 77. Holding a conversation, he says, "was like trying to walk a mile with blisters on your feet."
Grevers, a retired landscape designer, went through the center's three-month program. The change, he says, was "amazing."
"In those three months I became who I am now. I can hold my own anyplace, in any conversation," he says. "It was so challenging, yet so nurturing."
Grevers still flexes his brain with a regular diet of memory exercises and visits the brain center monthly. And he plans to participate in another three-month program this year. "I'm fixed now, but I still need to keep it up," he says.
Dr. Richard Caselli, a neurology professor at the Mayo Clinic College of Medicine based in Scottsdale, Ariz., and co-author of the book "Alzheimer's Disease and Its Varients: A Diagnostic and Therapeutic Guide," says Fotuhi's approach is "not dissimilar" to that being used elsewhere to treat memory loss and Alzheimer's. Among those using the idea, he says, is the Mayo Clinic's own HABIT (Healthy Action to Benefit Independence & Thinking) program in Rochester, Minn., a brain and body wellness program for people with mild cognitive impairment.
Caselli says more and more trials and studies are focusing on the benefits of such activities as exercise, brain games and meditation to keep the brain healthy. "Generally speaking, it's hard to argue with healthful interventions like that," Caselli says. "And the idea of trying to put them together in a cohesive program to prevent or treat memory loss is certainly reasonable."
Caselli says the jury is still out on the effectiveness of such an approach. But he says the ballooning elderly population, and the resulting ever-rising number of people suffering from memory loss and Alzheimer's, has people hungry for answers and willing to try something new.
"People want something," Caselli says. "I'm as big a skeptic as anyone about what the be-all and end-all will be, but patients feel they want to be trying something rather than just sitting and waiting for dementia to take them."
Fotuhi expresses no doubts about the effectiveness of his interdisciplinary approach to memory loss -- and its importance.
"I think we're really onto something," he says. "It's a complete myth to think that with aging you must decline. If you let things be and follow the common path, then you will decline. … But you don't have to."