Wednesday, January 30, 2013

The Resilient Brain (great example of Positive Biology)

In general, I'm not a betting man. Intellectual humility cautions against sticking one's neck out too far into terrain that is too complex to understand, let alone reasonably predict with any confidence.

But some bets are unavoidable. You must gamble on an outcome as inaction or hesitation itself is a bet, and a potentially worse bet (namely, certain disaster). The gamble on which areas of scientific research will yield the greatest health benefits for human populations this century is one such bet. Should we invest most research dollars into research on cancer, heart disease, Alzheimer's disease, etc.?

I am willing to go out on a limb here and make the following bet: I bet that, in the year 2100, when my grandchildren's generation reflects upon the greatest advances in science and medicine in the 21st century, they will say that the most significant advances in medicine came from research that studies "positive" rather than "negative biology".

I have expounded upon positive biology before (see this presentation, and this paper and this paper, and finally this post).

When, in the year 2100, society reflects back on the scientific and medical accomplishments of the 21st century, I predict they will take the view that the greatest innovations that improved human health came from not from the study of pathology itself (e.g. any specific chronic disease, like heart disease or stroke, or any of the 200+ types of cancer). Instead, the real "game changers" came from research on exemplar examples of health. Research that examined why some rare individuals (who engage in risky behavior) are immune to HIV, why some rare individuals can live a century free from the chronic diseases that afflict most decades earlier, why some individuals possess exceptional resilience to overcome adversity, why some experience more optimism, gratitude and flow than others, etc.

If I am correct about this prediction, it means that we must shift away from the fixation on the study of pathology, and tackle, with the same about of zeal, resources, talent and energy, the study of health and happiness. We must shift from the paradigm of negative biology to a more balanced approach which places equal importance on positive biology.

I was inspired to write this post when I came across this story in Scientific American about "super agers", individuals whose brains possess a special resiliency which protects their memory from the decline of aging. The original study mentioned in the article is here. And the abstract from the study is below:

It is “normal” for old age to be associated with gradual decline in memory and brain mass. However, there are anecdotal reports of individuals who seem immune to age-related memory impairment, but these individuals have not been studied systematically. This study sought to establish that such cognitive SuperAgers exist and to determine if they were also resistant to age-related loss of cortical brain volume. SuperAgers were defined as individuals over age 80 with episodic memory performance at least as good as normative values for 50- to 65-year-olds. Cortical morphometry of the SuperAgers was compared to two cognitively normal cohorts: age-matched elderly and 50- to 65-year-olds. The SuperAgers’ cerebral cortex was significantly thicker than their healthy age-matched peers and displayed no atrophy compared to the 50- to 65-year-old healthy group. Unexpectedly, a region of left anterior cingulate cortex was significantly thicker in the SuperAgers than in both elderly and middle-aged controls. Our findings identify cognitive and neuroanatomical features of a cohort that appears to resist average age-related changes of memory capacity and cortical volume. A better understanding of the underlying factors promoting this potential trajectory of unusually successful aging may provide insight for preventing age-related cognitive impairments or the more severe changes associated with Alzheimer's disease.