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Published on June 05, 2017

Exercise the key to a robust brainExercise the key to a robust brain

Here’s one more reason to get off the couch and lace up your sneakers: it will pump up your brain volume as well as your muscles.

In one of the latest studies to come out of the Framingham Heart Study, researchers showed a correlation between levels of fitness in middle age and brain volume 20 years later. Those who were the least physically fit in middle age actually had smaller brains later in life.

The study, led by Nicole Spartano, PhD, a post-doctoral fellow at Boston University School of Medicine, included 1,583 participants. Their average age at the beginning of the study was 40 years old and none had any signs of dementia or heart disease. Participants were given before and after treadmill tests and MRIs to compare their level of physical fitness and the size of their brain.

“This Framingham study like many other studies suggests that healthy living with regular exercise – in particular cardiovascular exercise – really helps to maintain brain volume,” said Hyannis neurologist Sean Horrigan, DO. “And if you maintain brain volume as you age then this should translate to maintaining brain health and overall function.”

The functioning of the brain that is most affected by shrinking volume is short-term memory and other cognitive skills such as attention, decision-making, language and visual spatial intelligence, Dr. Horrigan said.

“When the brain shrinks, particularly the pre-frontal cortex and the hippocampus, those are areas that are really important for learning, for memory, for planning and other complex mental tasks,” he explained. “Those are all things in particular that get smaller just with normal aging. The brain also gets smaller because there is a breakdown in the chemical signaling between the neurons and the chemicals the neurons share with one another.”

Brains shrink as people age – even those of healthy people – as part of the aging process, Dr. Horrigan said. Our brains continue to grow in volume until our late 20’s and then from about the age of 30 on, they begin to shrink ever so slightly with each passing decade.

With that in mind, he said that it’s not really fair to compare one person’s brain to another person’s brain. What you should do, instead, is focus on the brain you have with the goal of trying to make sure that its volume at the age of 75 is as close to what it was at 25 as you can.

More and more studies show that regular exercise is the key to improving memory performance later in life. One of the biggest reasons exercise helps with brain health is that blood flow is extremely important for all organs to function properly, including the brain. If you don’t exercise, over time your arteries can narrow and you begin growing fewer new capillaries to feed organs like the brain, Dr. Horrigan said.

“That’s why exercise is so beneficial in general because what you are really trying to promote and strengthen is your vascular system,” he said. “If you can keep challenging your vascular system to stay open and keep a really good blood flow to your brain and other organs, they’re going to work better for you.”

One of the things the Framingham Study looked at was how well the brain was perfused with blood. Brain perfusion, which is the passage of blood and other fluids through an organ, is important for two reasons.

The cause of Parkinson’s disease is unknown.

Parkinson’s disease is the most common form of one of three conditions included in a group of Parkinsonian Syndromes. The others are:

  • Multiple system atrophy (MSA)
  • Progressive supranuclear palsy (PSP)

“While essential tremor is the most common tremor disorder around, telling it apart from Parkinsonian syndrome diseases isn’t always straight forward,” said Dr. Lynch. “While DaTscan can tell the difference between Parkinson’s disease and essential tremor, it cannot differentiate one Parkinsonian syndrome from another.”

Essential tremor is not caused by dopamine deficiency.

How Does DaTscan Work?

DaTscan is able to highlight the very small area in the brain where the dopamine receptors are located. The radiotracer shows if these cells exist in normal numbers and if they are fully functioning.

Since essential tremor is not caused by dopamine insufficiency, DaTscan can be helpful in ruling out Parkinson’s disease in these cases.

“DaTscan will be negative in those cases that have just tremor. That’s probably the main reason why I order the test,” said Dr. Lynch.

The test is also helpful in investigating disease progression, especially when medications stop being effective.

“I don’t use a DaTscan for every single Parkinson’s patient. A good clinical examination by a neurologist is often sufficient. Most of the time, I tend to use it for patients who have an indistinguishable tremor disorder, patients with mild/early symptoms or one where there has been a change in responsiveness to medications, i.e. those previously labeled as Parkinson’s disease but with atypical features where I question the diagnosis,” she said.

And in some cases, DaTscan is ordered to relieve a patient’s worry, as in Roy’s case.

For anyone experiencing worrisome symptoms, early diagnosis is the key.

“It’s another tool in our kit to be confident and ensure a reliable and accurate diagnosis. Early detection with the help of clinical exam and DaT scan is key because there are very effective treatments out there,” said Dr. Lynch. “And if you can slow down disability and improve quality of life as early as possible, that’s the primary goal of care.”

Featured Image: Courtesy of, Essential Tremor Versus Parkinsonian Syndromes.