BrainHealthCoaching

LightUniversity1

BrainHealthCoaching

P.O.Box739•Forest,VA24551•1-800-526-8673•www.AACC.net

BrainHealthCoaching

LightUniversity2

WelcometoLightUniversityandthe“BrainHealthCoaching”programofstudy.Our prayer is that you will be blessed by your studies and increase your effectiveness inreaching out to others. We believe you will find this program to be academically sound,clinicallyexcellentandbiblically-based.Our faculty represents some of the best in their field – including professors, counselors andministers who provide students with current, practical instruction relevant to the needs oftoday’sgenerations.We have alsoworked hard to provide youwith a program that is convenient and flexible –givingyoutheadvantageof“classroominstruction”onlineandallowingyoutocompleteyourtrainingonyourowntimeandscheduleinthecomfortofyourhomeoroffice.Thetestmaterialcanbefoundatwww.lightuniversity.comandmaybetakenopenbook.Onceyouhavesuccessfullycompletedthetest,whichcoverstheunitswithinthiscourse,youwillbeawardedacertificateofcompletionsignifyingyouhavecompletedthisprogramofstudy.Thank you for your interest in this program of study. Our prayer is that you will grow inknowledge,discernment,andpeople-skillsthroughoutthiscourseofstudy.Sincerely,

RonHawkinsDean,LightUniversity

BrainHealthCoaching

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TheAmericanAssociationofChristianCounselors

• Represents the largestorganizedmembership (nearly50,000)ofChristian counselorsandcaregiversintheworld,havingjustcelebratedits25thanniversaryin2011.

• Known for its top-tier publications (Christian Counseling Today, the Christian CounselingConnectionandChristianCoachingToday),professionalcredentialingopportunitiesofferedthroughtheInternationalBoardofChristianCare(IBCC),excellenceinChristiancounselingeducation, an arrayof broad-based conferences and live training events, radioprograms,regulatoryandadvocacyeffortsonbehalfofChristianprofessionals,apeer-reviewedEthicsCode, and collaborative partnerships such as Compassion International, the NationalHispanic Christian Leadership Conference and Care Net (to name a few), the AACC hasbecomethefaceofChristiancounselingtoday.

• With the needed vision and practical support necessary, the AACC helped launch the

International Christian Coaching Association (ICCA) in 2011, which now represents thelargest Christian life coaching organization in the world with over 2,000 members andgrowing.

OurMission

The AACC is committed to assisting Christian counselors, the entire “community of care,”licensedprofessionals,pastors,and laychurchmemberswith littleorno formal training. It isourintentiontoequipclinical,pastoral,andlaycaregiverswithbiblicaltruthandpsychosocialinsights that minister to hurting persons and helps them move to personal wholeness,interpersonalcompetence,mentalstability,andspiritualmaturity.

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OurVision

TheAACC’svisionhastwocriticaldimensions:First,wedesiretoservetheworldwideChristianChurch by helping foster maturity in Christ. Secondly, we aim to serve, educate, and equip1,000,000 professional clinicians, pastoral counselors, and lay helpers throughout the nextdecade.WearecommittedtohelpingtheChurchequipGod’speopletoloveandcareforoneanother.We recognize Christian counseling as a unique form of Christian discipleship, assisting thechurch in its call to bring believers to maturity in the lifelong process of sanctification—ofgrowingtomaturityinChristandexperiencingabundantlife.Werecognizesomearegiftedtodosointhecontextofaclinical,professionaland/orpastoralmanner.Wealsobelieveselected laypeoplearecalledtocareforothersandthattheyneedtheappropriatetrainingandmentoringtodoso.WebelievetheroleofthehelpingministryintheChurchmustbesupportedbythreestrongcords:thepastor,thelayhelper,andtheclinicalprofessional.ItistothesethreerolesthattheAACCisdedicatedtoserve(Ephesians4:11-13).

OurCoreValues

InthenameofChrist,theAmericanAssociationofChristianCounselorsabidesbythefollowingvalues:

VALUE1:OURSOURCEWearecommittedtohonorJesusChristandglorifyGod,remainingflexibleandresponsivetotheHolySpiritinallthatHehascalledustobeanddo.VALUE2:OURSTRENGTHWearecommittedtobiblicaltruths,andtoclinicalexcellenceandunityinthedeliveryofallourresources,services,trainingandbenefits.VALUE3:OURSERVICEWeare committed toeffectivelyandcompetently serve the communityof careworldwide—bothourmembership and the churchat large—withexcellenceand timeliness, andbyover-deliveryonourpromises.VALUE4:OURSTAFFWearecommittedtovalueandinvestinourpeopleaspartnersinourmissiontohelpotherseffectivelyprovideChrist-centeredcounselingandsoulcareforhurtingpeople.VALUE5:OURSTEWARDSHIPWe are committed to profitably steward the resourcesGod gives to us in order to continueservingtheneedsofhurtingpeople.

BrainHealthCoaching

LightUniversity5

LightUniversityI. Establishedin1999undertheleadershipofDr.TimClinton—hasnowseennearly200,000

students from around the world (including lay caregivers, pastors and chaplains, crisisresponders,lifecoaches,andlicensedmentalhealthpractitioners)enrollincoursesthataredelivered via multiple formats (live conference and webinar presentations, video-basedcertificationtraining,andastate-of-theartonlinedistanceteachingplatform).

II. Thesepresentations,courses,andcertificateanddiplomaprograms,offeroneofthemostcomprehensive orientations to Christian counseling anywhere. The strength of LightUniversity is partially determined by its world-class faculty—over 150 of the leadingChristianeducators,authors,mentalhealthcliniciansandlifecoachingexpertsintheUnitedStates. This core groupof facultymembers represents a literal “Who’sWho” inChristiancounseling. No other university in the world has pulled together such a diverse andcomprehensivegroupofprofessionals.

III. Educational and training materials cover over 40 relevant core areas in Christian—

counseling, lifecoaching,mediation,andcrisis response—equippingcompetentcaregiversand ministry leaders who are making a difference in their churches, communities, andorganizations.

OurMissionStatement

TotrainonemillionBiblicalCounselors,ChristianLifeCoaches,andChristianCrisisRespondersbyeducating,equipping,andservingtoday’sChristianleaders.

AcademicallySound•ClinicallyExcellent•DistinctivelyChristian

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Video-basedCurriculum

• UtilizesDVDpresentations that incorporateover 150 of the leading Christian educators,authors,mentalhealthclinicians,andlifecoachingexpertsintheUnitedStates.

• Eachpresentationisapproximately50-60minutesinlengthandmostareaccompaniedbyacorrespondingtext(inoutlineformat)anda10-questionexaminationtomeasurelearningoutcomes.Therearenearly1,000uniquepresentationsthatareavailableandorganizedinvariouscourseofferings.

• Learning is self-directed and pacing is determined according to the individual time

parameters/scheduleofeachparticipant.• With the successful completion of each program course, participants receive an official

Certificate of Completion. In addition to the normal Certificate of Completion that eachparticipant receives, Regular and Advanced Diplomas in Biblical Counseling are alsoavailable.

Ø TheRegularDiploma isawardedbytakingCaringForPeopleGod’sWay,BreakingFreeandoneadditionalElectiveamongtheavailableCoreCourses.

Ø TheAdvancedDiplomaisawardedbytakingCaringForPeopleGod’sWay,BreakingFree,andanythreeElectivesamongtheavailableCoreCourses.

Credentialing

• LightUniversitycourses,programs,certificatesanddiplomasarerecognizedandendorsedbytheInternationalBoardofChristianCare(IBCC)anditsthreeaffiliateBoards:theBoardofChristianProfessional&PastoralCounselors(BCPPC);theBoardofChristianLifeCoaching(BCLC);andtheBoardofChristianCrisis&TraumaResponse(BCCTR).

• Credentialing is a separateprocess from certificate or diploma completion.However, theIBCC accepts Light University and Light University Online programs as meeting theacademic requirements for credentialing purposes. Graduates are eligible to apply forcredentialinginmostcases.

Ø Credentialinginvolvesanapplication,attestation,andpersonalreferences.

Ø CredentialrenewalsincludeContinuingEducationrequirements,re-attestation,andoccureitherannuallyorbienniallydependingonthespecificBoard.

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OnlineTesting

TheURLfortakingallquizzesforthiscourseis:http://www.lightuniversity.com/my-account/.

• TOLOGINTOYOURACCOUNT

Ø You should have received an email upon checkout that included your username,password,andalinktologintoyouraccountonline.

• MYDASHBOARDPAGE

Ø Once registered, youwill see theMyDVD Course Dashboard link by placing yourmousepointerovertheMyAccountmenuinthetopbarofthewebsite.Thispagewill includestudentPROFILE informationand theREGISTEREDCOURSES forwhichyouareregistered.TheLOG-OUTandMYDASHBOARDtabswillbeinthetoprightofeachscreen.Clickingonthe>nexttothecoursewilltakeyoutothecoursepagecontainingthequizzes.

• QUIZZES

Ø Simplyclickonthefirstquiztobegin.• PRINTCERTIFICATE

Afterallquizzesaresuccessfullycompleted,a“PrintYourCertificate”buttonwillappearnearthetopofthecoursepage.YouwillnowbeabletoprintoutaCertificateofCompletion.Yournameandthecourseinformationarepre-populated.ContinuingEducationThe AACC is approved by the American Psychological Association (APA) to offer continuingeducationforpsychologists.TheAACCisaco-sponsorofthistrainingcurriculumandaNationalBoard of Certified Counselors (NBCC)ApprovedContinuing Education Provider (ACEPTM). TheAACC may award NBCC approved clock hours for events or programs that meet NBCCrequirements.TheAACCmaintainsresponsibilityforthecontentofthistrainingcurriculum.TheAACCalsoofferscontinuingeducationcreditforplaytherapiststhroughtheAssociationforPlayTherapy (APT Approved Provider #14-373), so long as the training element is specificallyapplicabletothepracticeofplaytherapy.It remains the responsibility of each individual to be aware of his/her state licensure andContinuing Education requirements. A letter certifying participation will be mailed to thoseindividuals who submit a Continuing Education request and have successfully completed allcourserequirements.

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Presenterfor

BrainHealthCoaching

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PresenterBiographyDaniel Amen,M.D., isaphysician;doubleboardcertifiedpsychiatrist, teacher,and five-timeNew York Times bestselling author. He is widely regarded as one of the world’s foremostexpertsonapplyingbrainimagingsciencetoeverydayclinicalpractice.Dr.AmenistheFounderof Amen Clinics in Newport Beach, San Francisco, California; Bellevue, Washington; Reston,Virginia; Atlanta and New York City. Amen Clinics have the world’s largest database offunctionalbrainscansrelatingtobehavior,totaling73,000scansonpatientsfrom90countries.Dr.Amen isaDistinguishedFellowoftheAmericanPsychiatricAssociationandhe is the leadresearcherontheworld’slargestbrainimagingandrehabilitationstudyonprofessionalfootballplayers.AlongwithPastorRickWarrenandDrs.MarkHymanandMehmetOz,Dr.Amenisoneof the chief architects on Saddleback Church’s “Daniel Plan,” a 52-week program to fosterhealththroughreligiousorganizations.TheDanielPlanisnowbeingexportedaroundtheworldtohelpchurches,synagoguesandallreligiouspeoplebecomehealthy.

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BrainHealthCoachingTableofContents:

Module1BHC101:ChangeYourBrain,ChangeYourLife,andtheBrainsandLivesofOthers...................11BHC102:9PrinciplestoChangeYourBrainandYourLife...........................................................24BHC103:BrainBehaviorSystems:Functions,Problems,andSolutions......................................35BHC104:SubtypingADD,Anxiety,Depression,Addictions,andObesity....................................60Module2BHC105:Neuroimaging:LookingattheBrainChangesEverything.............................................79BHC106:AmenClinicsMethod:Healinginthe4Circles...........................................................132Module3BHC107:BrainHealthySupplements........................................................................................146BHC108:BoostingBrainReserve...............................................................................................159BHC109:PhysicalExercise.........................................................................................................171BHC110:BrainHealthyNutritionPrinciples..............................................................................177Module4BHC111:ScienceofChangeandSelf-Control............................................................................216BHC112:KillingtheANTs:DirectingYourThoughts..................................................................228BHC113:InnovativeTreatments................................................................................................239BHC114:DecreasingtheRiskforBrainAging,Alzheimer’s,andOtherFormsofDementia.....246BHC115:CreatingBrainHealthyCommunities..........................................................................254

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BHC101:

ChangeYourBrain,ChangeYourLife,

andtheBrainsandLivesofOthers

DanielAmen,M.D.

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Summary

Inthisintroductorysession,Dr.DanielAmenlaysthefoundationfortheBrainHealthCoaching

Course. Brainhealth is essential to ahealthy, happy life, yetmillionsofAmericansdealwith

brain issues at some point in their lives. Alzheimer’s disease, depression, and obesity are

rampant in today’s society, and they all have a common factor: brain health. Dr. Amen

describes themissionandmethodsofAmenClinics inorder toprovide thebackdrop for this

course. Brainhealth isan issuethatshouldnotbeoverlooked ifpeopledesireto livea long,

healthylife.

LearningObjectives

Participantswill:

1. Beintroducedtothetopicofbrainimaging

2. Identifytheimportanceofbrainhealth

3. Exploretherelationshipbetweenobesity,depression,andAlzheimer’s

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I. Introduction

A. ProgramMission

1. Brainhealthisthecenterofoverallhealthandsuccess.

2. Ourwhy, passion, and purpose is to help people achieve “Brain Healthy Lives” in

everywaypossible.

B. BrainsRuntheWorld

1. Stockmarket

2. Localmarket

3. Hugecorporations

4. MomandPopshops

5. Governments

6. Schools

7. Churches

8. Families

9. You

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II. TheProblem

A. BrainRelatedProblemsAffect200millionAmericansatSomePointinTheirLives:

1. Brainfogandmemoryproblems

2. Depressionandanxiety

3. Insomnia

4. Attentionalissues

5. Beingoverweightorobese

B. Alzheimer’sDiseaseisExpectedtoTripleintheNext30Years

1. Nocureonthehorizon

2. Startsinthebraindecadesbeforethereareanysymptoms

3. Affects50%ofpeopleovertheageof85

C. NewAlzheimer’sGuidelines–FourStages

1. Normal

2. Noobvioussymptoms,butwherenoxiouschangesarealreadybrewinginthebrain,

“pre-clinicalstage”

3. Mildcognitiveproblemsemerge

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4. MeetsclinicalcriteriaforAlzheimer’sdisease1

D. DepressionisoneoftheGreatestKillersofOurTime

1. Affects50millionAmericansatsomepoint

2. Riskfactorsfor:

• Alzheimer’sdisease

• Heartdisease

• Cancer

• Diabetes

• Obesity-2

E. ObesityisaSeriousNationalCrisis

1. Twothirdsofthenationalpopulationisoverweight,and37.5%areobese.

2. The2008medicalcostsofobesitywere$147billion.

3. Obesityrelateddiseaseaccountsfor leadingcausesofdeath(hypertension,stroke,

heartdisease,andcancer).

4. It is a risk factor for over 30 medical illnesses, including Alzheimer’s disease,

depression,andsuicide.3

F. CDCStatistics

1. NostatemettheHealthyPeople2010goalof<15%obese.

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2. In2000,nostatehadmorethan30%obese.

3. Now,12statesdo4

III. TheAnswer:Obesity,Depression,andAlzheimer’sAreRelated

A. TerrifyingStatisticsandStudies

1. 140Studiesreportasweightgoesup,thesizeandfunctionofthebraingoesdown.

2. People who were overweight, compared to healthy weight, had 4% less brain

volumeandtheirbrainslookedeightyearsolderthanhealthypeople.

3. Peoplewhowereobesehad8%lessbrainvolumeandtheirbrainslooked16%older

thanotherpeople.5

4. 2011–n36,“normal”group,asweightwentup,lowerprefrontalcortexperfusionin

areasassociatedwithattention,reasoning,andexecutivecontrol.6

5. 2011 – n76, elevated body mass in NFL players associated with lower

prefrontal/temporalperfusionanddecreasesinreasoning,attentionandmemory7

B. FatisNotInnocuous

1. Largestendocrineorgan

2. Storestoxins

3. Releaselipiddroplets

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4. Producepro-inflammatorycytokines(IL-6,IL-1,IL-8,TNFalpha,IL-18)

5. Promoteinsulinresistance

6. Decreasetestosteroneinmen8,9

C. AnyoneConcerned?

1. Someanxietyisgood!Peoplewithlowlevelsofanxietygotojailanddieearly.But,

fearjustgetsyoustarted.Feelingamazingkeepspeoplegoingforthelong-term.

2. Thenumberonefactorassociatedwithlongevityisconscientiousness.

3. The“don’tworry,behappy”peopledietheearliest fromaccidentsorpreventable

illnesses.

4. Appropriateworryandanxietywillkeepyouontrack.

IV. AmenClinics

B. TheBigIdea

Witha little forethought and theAmenClinicsMethod, you canboost your brainand

improveeverythinginyourlife!

C. World’sLargestDatabaseofFunctionalBrainScans

1. SixClinics

2. Nearly90,000SPECTstudies

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3. Onpatientsfrom111countries

4. CollaborationswithColumbia,NYU,UCLA,ThomasJefferson,Duke, JohnsHopkins,

U/BritishColumbiaandUC,Irvine

D. ScientificPublishing

1. >50peerreviewedSPECTarticles

2. HowSPECTchangesclinicalpractice

3. AmenClinicsMethodimprovesoutcomes

4. PredictingADHDtreatmentresponse

5. Suicide,murder

6. Effectsofbrain-directednutrients

7. Braineffectsoffootballconcussions

8. Rehabilitatingbraintrauma

9. Braineffectsofobesity

10. BraineffectsofmeditationandEMDR

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E. TheTwoBigGoals

1. ThatImagingisusedinclinicalpractice

2. Studyhownaturalthingscanhealthebrain

F. OtherResources

1. Over2.5millionbooks

2. NineNYTbestsellers

3. NinePBSspecialsonthebrain/health

4. Showsaired>70,000times

5. Raised>$50milliondollarsforPBS

6. 12weekhighschoolcourseonbrainhealth,42states,andsevencountries

7. Collegecourse

8. Co-CreatorofSaddlebackChurch’s“DanielPlan,”withRickWarren,MehmetOz,and

MarkHyman

Thefastestwaytogetreallywellistofindthehealthiestpersonyoucanstandand

spendasmuchtimearoundhimorheraspossible.

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9. Planted brain health and/or brain imaging into drug treatment centers, including

Salvation Army ARC Anaheim, Beacon House, Sierra Tucson in Arizona, and the

HanleyCenterinFlorida

10. PartofFranklinCovey’sProductivitySolutionBringingBrainHealthtoBusinesses

11. BrainHealthCommunity

12. BrainHealthyNutraceuticals

G. ChangeYourBrain,ChangeYourLife501©(3)foundation

1. Missionis:

• Education

• Research

• Service

2. Managestheresearchscandatabase

H. AmenClinics:ATrustedResource

1. Clinicshavetreated:

• Hundredsofphysicians

• NobelLaureates

• Politicalfigures

• >150NFLplayers,“HallofFame”athletes

• PulitzerPrizewriters

• Oscarwinningactors

• Legendarymusicians

• Religiousleaders

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2. Over5,000medicalandmentalhealthprofessionalshavereferredpatients.

3. Manyoftheirownfamilymembers

4. 38%ofourpatientsarereferredbyourpatientsortheirfamilyorfriends.

I. BrainHealthModules

1. NinePrinciplestoChangeYourBrainandLife

2. Brain-BehaviorSystems:Functions,Problems,andSolutions

3. SubtypingADD,Anxiety,Depression,Addictions,Obesity,andAggression

4. Neuroimaging:HowLookingattheBrainChangesEverything

5. AmenClinicsMethod/Healingin4Circles

6. Brain-DirectedSupplements

7. BoostingBrainReserve

• BrainEnvy

• Motivation

• AvoidBad

• DoGood

• Hormonesandthebrain

8. PhysicalExercise

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9. Nutrition/Gut-BrainConnections

10. ScienceofSelf-Control

11. KillingtheANTsandDirectingThoughts

12. InnovativeTreatments

13. DecreasingtheRiskforBrainAging,Alzheimer’sandOtherFormsofDementia

14. CreatingBrain-HealthyCommunities

15. CoachingOtherstoBrainHealth

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Endnotes1Sperling,etal.(2011)TowarddefiningthepreclinicalstagesofAlzheimer’sdisease:Recommendationsfromthe

National InstituteonAging-Alzheimer’sAssociationworkgroupsondiagnosticguidelines forAlzheimer’sdisease.

Alzheimer’s&Dementia,7(3),280-922Kessler, R.C., Chiu, W.T., Demler, O., Merikangas, K.R., & Walters, E.E. (2005). Prevalence, severity, and

comorbidityoftwelve-monthDSM-IVdisordersintheNationalComorbiditySurveyReplication(NCS-R).Archivesof

GeneralPsychiatry,62(6).617-273CDCwebsite:http://www.cdc.gov/obesity/data/adult.html4Ibid5Rajietal.(2010).Brainstructureandobesity.HumanBrainMapping,31.353-3646Willeumier,K,Taylor,D,&Amen,D.(February19,2011).ElevatedBMIisassociatedwithdecreasedbloodflowin

the prefrontal cortex using SPECT imaging in healthy adults. Nature Obesity, retrieved from

http://www.nature.com/oby/journal/vaop/ncurrent/full/oby201116a.html7Willeumier, K, Taylor, D, & Amen, D. (2012). Effects of elevated body mass in professional American football

playersonrCBFandcognitivefunction,TranslationalPsychiatry,2,e68,doi:10.1038/tp.2011.678CecchiniMetal.(2007).Drugresiduesinthebodyfollowingcessationofuse:impactsonneuroendocrinebalance

andbehavior.MedHypothesis.;68(4)868-799Fontana L. (2009). Neuroendocrine factors in the regulation of inflammation: excessive adiposity and caloric

restriction.ExperimentalGerontology,44(1-2):41-5

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BHC102:

NinePrinciplestoChangeYourBrain

andYourLife

DanielAmen,M.D.

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Summary

Whenyouchangeyourbrain,youcancompletelytransformyourlife.Dr.DanielAmendevotes

this session to talking about nine different principles that can help people understand the

powerofthebraintochangelives.Ahealthybrainisessentialtoahealthylife,andevenifthe

brainhasbeendamagedinthepast,therearewaystochangethebrainandgainbackpartof

whatwas lost. Thispresentation focusesonhow thebrain impacts aperson’s life, andwhat

helpsandhurtsthebrain.Ultimately,itispossibleforeventhepeoplewiththemostdamaged

brainstoimprovetheirlivesbyimprovingtheirbrains.

LearningObjectives

1. Participantswillexplorethenineprinciplesthatpeoplecanusetochangetheirbrains.

2. Participants will identify practical ways people can do or cease doing to help their

brains.

3. Participantswillanalyzeandunderstandhowdifferentactivitiesandhabits impactthe

brain.

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I. Principle1:YourBrainisInvolvedinEverythingYouDo

A. HowYou…

1. Think

2. Feel

3. Act

4. Interact

B. ItisanOrganof…

1. Judgment

2. Personality

3. Intelligence

4. Decisions

II. Principle2:WhenYourBrainWorksRight,YouWorkRight

A. WhenYourBrainisTroubled,YouHaveTroubleinYourLife

B. WhenPeopleHaveaHealthyBrain,TheyTendtoBe:

1. Happier

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2. Healthier

3. Wealthier

4. Moresuccessful

C. WhenPeopleHaveanUnhealthyBrain,TheyTendtoBe:

1. Sadder

2. Sicker

3. Poorer

4. Lesssuccessful

III. Principle3:TheBrainistheMostComplicatedOrgan

A. TheComplexBrain

1. 100billionneurons,trillionsofsupportingcells

2. Moreconnectionsthanstarsintheuniverse

3. 2%ofbody’sweight,uses20-30%ofkcals

4. 20%oftheoxygenandbloodflow

5. Yourbehavioracceleratesbrainagingoritcandecelerateit.

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B. EverythingStartswithUnderstandingThisDiagram

C. IsYourBrainAboveorBelowtheLine?14WarningSigns

1. Memory<10yearsago

2. Lowenergy

3. Lowmood

4. Irritability

5. Anxiety,stress,worry

6. Shortattentionspan

7. Brainfog

8. Impulsive,baddecisions

9. Insomnia

Brainreserve

Becomesymptomatic

Troublezone

Activ

ity

Age

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10. Highbloodpressure

11. Highbloodsugar

12. Weightissues

13. Sexualdysfunction

14. Non-compliantforhealth

IV. Principle4:TheBrainisVerySoft,HousedinaHardSkull

A. TheBrainisVerySoft

1. Thebrain is theconsistencyofsoftbutter, tofu,custard,orbetweenaneggwhite

andgelatin

2. Itisprotectedbytheskull

B. TheSkullisReallyHard

1. Ithasmanysharpridges

2. Thebrainwasnotmeantforhitstothehead

C. BrainInjuriesMatter

1. Brain injuriesareamajorcauseofpsychiatric illness,butvery fewpeopleknow it

becausetheygotoapsychiatristratherthanlookingatthebrain.

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2. Mildtraumaticbraininjuriesruinpeople’slivesandnobodyknowsit.

D. HiddenTrauma

1. Researcherslinkpastbraintraumato:

• Alcoholismanddrugabuse

• Homelessness

• Dementia

• Depression,anxietyattacksandsuicide

• Learningproblems

• Howwouldyouknowunlessyoulooked?1

2. Unrecognizedbraintrauma

E. TBIsAffectPrefrontalCortex91%oftheTime

1. Focus

2. Forethought

3. ImpulseControl

4. Organization

5. Planning

6. Judgment

7. Empathy

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8. Insightandlearningfrommistakes

V. HurtingandHelping

A. Principle5:ManyThingsHurttheBrain

1. BrainInjuries

2. DrugsAndAlcohol

3. Obesity

4. LackofActivity

5. PoorDiet

6. Insomnia/Apnea

7. Nicotine/Caffeine

8. EnvironmentalToxins

9. Diabetes,HighBloodPressure

10. LowOmega3Ratio

11. LowHormoneLevels

12. ChronicStressWithoutHighLevelsOfDHEA

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13. EmotionalTrauma

14. UntreatedDepression

15. PoorDecisions

16. UnhealthyPeerGroup

17. NotKnowingYourOwnBrain’sVulnerability

B. Principle6:ManyThingsHelptheBrain

1. ItAllStartswith“BrainEnvy”

2. GreatDecisions

3. MentalWorkouts

4. Activity

5. Nutrition

6. Sleep

7. CleanEnvironment

8. PhysicalHealth

9. HealthyWeight

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10. AppropriateAnxiety

11. SatisfyingRelationships

12. PositivePeerGroup

13. ANTKilling

14. StressManagement

15. Supplements,suchasMV,O3s,VitaminD,BrainNutrients

16. KnowingtheHealthofyourBrain

C. Principle7:OneSizeDoesNotFitEveryone

1. Most problems, such as obesity, ADD, or depression, are not single or simple

disorders.

2. Outcomesinpsychiatryarenobetterthaninthe1950s.

D. Principle8:FunctionalNeuroimagingisanEssentialTooltoHelpPeopleWhoSuffer

1. Howdoyouknowunlessyoulook?

2. Healthybrainvs.Unhealthybrain

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E. Principle9:TheBrainCanChange

1. TheRightInterventionsHelp

2. TheWrongInterventionsHurt

Endnotes1Burton,T.(January29,2008).Studiesciteheadinjuriesasfactorinsomesocialills.WallStreetJournal.Retrieved

fromhttp://online.wsj.com/article/SB120156672297223803.html

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BHC103:

BrainBehaviorSystems,Functions,

Problems,andSolutions

DanielAmen,M.D.

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Summary

The brain system includes many different parts that play different roles. Each of these

individualpartsofthebrainhavedifferentfunctions,andalongwiththesefunctions,different

problemsandsolutions.Inthispresentation,Dr.DanielAmengoesthroughtheanatomyofthe

brainanddescribesthedifferentsectionsandtheirfunctions.Whendamageoccursindifferent

areas of the brain, the consequences can differ. Through informative teaching and revealing

brainscans,Dr.Amenusesthispresentationtohelpshed lightonthe issuessurroundingthe

brain.

LearningObjectives

1. Participantswillexplorethedifferencesbetweenmaleandfemalebrains

2. Participantswillidentifytheproblemsandsolutionsuniquetoeachpartofthebrain

3. Participantswillunderstandtheimportanceofhavingahealthy,well-functioningbrain

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I. BrainSystemApproach

A. Leftvs.RightHemisphere

1. Leftsideseesthetrees

2. Rightsideseestheforest

B. LeftHemisphere

1. Logical

2. Precise

3. Details

4. Communicates

5. Concernedabouttime

6. Happier,morepositive

7. Doesn’tseeproblems

C. RightHemisphere

1. Bigpicture

2. Creative,artistic

3. Canputaroomtogether(decorates)

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4. Anxious,fearful,negative

5. Focusesonproblems

6. Admitstoproblems

7. Operatesonhunches

D. ComparingMaleandFemaleBrains

1. Femalebrainismoreactiveinalargepercentageofthebrain..

2. Maleshadpartsofthecerebellummoreactive.

3. Femalestrengths

• Empathy

• Intuition

• Collaboration

• Self-control

• Appropriateworry

4. Femalevulnerabilities

• Anxiety,depression

• Insomnia

• Eatingdisorders

• Pain

• Can’tturnthoughtsoff

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5. Womenhaveanxietytwiceasmuchasmen

• 23% of women between the ages of 20 and 60 are currently taking

antidepressantmedication.

• WomentendtorespondmoretoSSRIs.

6. Cellnumbersandconnections

• Menhavemoretotalnumberofneurons.

• Womenhavemoretotalnumberofdendriticconnections,increaseddensity

7. CorpusCallosum

• Largerinwomen,allowinggreateraccesstobothsidesofthebrain

8. Unilateralvs.bilateraltendencies

• Mentendtobemoreleft-sided.

• Womentendtousebothsidesmoreoftenthanmen(relyonhunchesmore).

9. LimbicSystemsize–Largerinfemales

• Bondingcenter,primarycaretakerforchildren,elderly

• Bondingiseasier

• Largernestinginstinct

• Womenhaveagreaterincidenceofdepression

• Depressionisthe#1reasonforhospitalizationinwomen18-44afterhavinga

baby.

10. InferiorParietalLobe

• Largerinmen,especiallyontheleftside

• Estimatestime

• Judgesspeed

• Visualizesobjectsin3-D

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• Solvesmathproblems

• GetsyoufrompointAtopointB

II. PrefrontalCortex

A. TheBrain’sSupervisor

1. Dorsallateralpre-frontalcortex:Short-termmemory

2. Inferiororbitalprefrontalcortex:Impulseandmoodcontrol

B. PrefrontalCortexFunctions

1. Focus

2. Forethought

3. ImpulseControl

4. Organization

5. Planning

6. Judgment

7. Empathy

8. Insightandlearningfrommistakes

9. Theprefrontalcortexistheexecutivepartofthebrain

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C. PrefrontalCortexProblems

1. Shortattentionspan

2. Impulsivity

3. Procrastination

4. Disorganization

5. Poorjudgment

6. Lackofempathyandinsight

7. Brutalhonesty

8. Conflictseeking

D. ConditionsAffectingthePrefrontalCortex

1. Badhabits–smokingandobesity

2. ADHD

3. Schizophrenia

4. Antisocialpersonalitydisorder

5. Braintrauma

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6. Frontaltemporaldementia

7. Certainformsofdepression

E. PrefrontalCortexSupport

1. Goalsetting

2. Exercise

3. Diet(moreprotein)

4. EPAfishoil

5. Brainrehabstrategies

6. Stimulatingsupplements

7. Stimulatingmedications

8. Neurofeedback

9. rTMS

10. HBOT

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F. StimulatingMedications

1. Ritalin/Concerta/Metadate/Daytrana

2. Adderall/Vyvanse

3. Dexedrine

4. Provigil/Nuvigil

5. Strattera

6. Wellbutrin

7. Amantadine

8. Abilify

G. Supplements

1. Greentea

2. Rhodiola

3. Ginseng

4. Ashwaghanda

5. L-tyrosine

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6. Phenylalanine

7. Iron

8. Zinc

III. CingulateGyrus

A. GearShifter/Integration

1. PosteriorPart:Memoryintegration

2. AnteriorDorsalPart:Thoughtshifting

3. AnteriorVentralPart:Emotionalshifting

B. AnteriorCingulateFunction:GearShifter

1. Cognitiveflexibility

2. Shiftattention

3. Gofromideatoidea

4. Seeoptions

5. Gowiththeflow

6. Cooperation

7. Errordetection

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C. AnteriorCingulateProblems

1. Gettingstuck

2. Worrying

3. Holdinggrudges

4. Obsessions

5. Compulsions

6. Addictions

7. Oppositional/argumentative

8. Seetoomanyerrors

9. Automaticallysayno

D. ConditionsAffectingtheAnteriorCingulateSystem

1. Toolow:

• Lowmotivation

• Mutism

• Lowmovement

2. Toohigh:

• Anxietydisorders

• PTSD

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• OCDspectrum

• Someeatingdisorders

• Addictions

• Oppositionaldefiantdisorder

E. AnteriorCingulateHelp

1. Distraction

2. Options/sovereignty

3. Paradox

4. Exercise

5. Diet(morecarbohydrates)

6. DHAfishoil

7. Boostserotoninwithmedsorsupplements

8. RisperdalandZyprexatocalmtheanteriorcingulateandprefrontalcortex

F. SerotoninMedications

1. Prozac

2. Zoloft

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3. Lexapro

4. Celexa

5. Paxil

6. Luvox

7. Anafranil

G. Supplements

1. 5HTP

2. Inositol

3. Saffron

4. B6

5. L-tryptophan

6. St.John’sWort

IV. BasalGanglia/Insula

A. Movement,Anxiety,Motivation

1. Caudate:thoughts

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2. Putamen:Motor

3. NucleusAccumbens:Pleasure

4. Insulacortexisdividedintotwoparts:

• Anterior:Emotionalprocessing

• Posterior:Auditoryandvisualprocessing

B. BasalGanglia/InsulaFunctions

1. Blendsfeelingandmovement

2. Controlsbody’sidle

3. Involvedwithmotivation

4. Helpscontrolsmoothmovement(likehandwriting)

5. Sensesemotionalandphysicalpain

C. BasalGanglia/InsulaProblems

1. Increased:

• Anxiety,panic

• Conflictavoidant

• Predictstheworst

• Excessmotivation

• Pain

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2. Decreased:

• ADDlikesymptoms

• Decreasedmotivation

• Movementdisorders

3. Whenanxietyistoolowpeople:

• Getintotrouble

• Makebaddecisions

• Aremorelikelytobearrested

• Areinvolvedinriskybehavior

• Dieearlier

D. ConditionsAffectingtheBasalGanglia

1. Toolow:

• Motordisorders

• Lowmotivation

• Apathy

2. Toohigh:

• Panic

• Generalizedanxiety

• Somatoformdisorders

• Tourette’s

• PTSD

E. CalmingMedications

1. Buspar

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2. BenzosL

3. Anti-epilepticmedications

• Neurontin

• Lyrica

• Lamictal

• Depakote

• Trileptal

4. Propranolol

F. Supplements

1. Magnesium

2. Relora

3. HolyBasil

4. B6

5. Theanine

6. GABA

7. Valerian

8. Kavakava

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V. TemporalLobes

A. Memory,Mood,Music,andLearning

1. Lateralaspect–auditory

2. Medialaspect–hippocampus/memory,amygdala/emotionalreactions

3. Underside–visualprocessingandfacialrecognition

B. TemporalLobeFunctions

1. Languageusage

2. Memory

3. Moodstability

4. Listening/reading

5. Socialcues

6. Rhythm,music

7. Spiritualexperience

8. The“What”pathway

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C. TemporalLobeProblems

1. Emotionalinstability

2. Memoryproblems

3. Feelingsofpanic

4. Aggression

5. Headaches

6. Learningproblems

7. Illusions,déjàvu

8. Mildparanoia

9. Unusualreligions/sexualexperience

D. ConditionsAffectingtheTemporalLobes

1. Toolow

• Learningproblems

• Memoryproblems

• Dementias

• Temporallobeepilepsy

• Aggression/suicidal

• Braintrauma

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2. Toohigh

• Seizures

• Irritability

• Panic

• Mysticism

• Spiritualorreligiousexperiences

E. TemporalLobeTreatment

1. Ketogenicdiet

2. Meds/supplementsformoodstability,irritabilityormemory

3. Neurofeedback

F. TemporalLobeMedications

1. MoodStability–Antiepilepticmeds

• Neurontin

• Lyrica

• Lamictal

• Depakote

• Dilantin

2. Memory

• ACEI–Aricept,Exelon

• Namenda

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G. Supplements

1. Moodstability

• GABA

• B6

• Fishoil

2. MemorySupport

• Bloodflow–ginko,vinpocetine

• Acetylcholine–acetyl-l-carnitine,huperzineA

• Membrane–phosphatidylserine

3. System+SymptomClusters=TargetTreatment

VI. DeepLimbicSystem

A. LimbicSystemComponents

1. Medialthalamus

2. Amygdala

3. Hippocampus

4. Hypothalamus

5. Inferiororbitalprefrontalcortex

6. Anteriorcingulate

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B. LimbicSystemFunctions

1. Integrates/gatessensoryinformation

2. Setsemotionaltone

3. Bonding

4. Chargedmemories

5. Senseofsmell

6. Libido

C. LimbicSystemProblems

1. Sad,moody

2. Negativethoughts

3. Lowmotivation

4. Socialisolation

5. Lossoflibido

6. Pain

7. Activitytoolow

• Decreasedreactiveness

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8. Activitytoohigh

• Depression

• Cyclicmoodchanges

• Pain

• Sensoryoverload

D. LimbicHelp

1. Exercise

2. Feedingtheanteater(Cognitivetherapy)

3. Healingsmells(lavender)

4. Gettingalongbetterwithothers

5. Fishoil

6. Antidepressants,medications,orsupplements

E. LimbicMedications

1. Mood

• Highlimbicsystem,lowprefrontal:UseWellbutrin

• Highlimbicsystem,highcingulate,lowprefrontal:UseEffexororCymbalta

• Highlimbicsystem,highcingulate,butprefrontalisnormal:UseSSRI

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2. Pain

• Cymbalta

• Lyrica

• Neurontin

F. Supplements

1. Mood

• Highlimbicsystem,lowprefrontal:SAMe

• Highlimbicsystem,highcingulate,lowprefrontal:5HTP+SAMe

• Highlimbicsystem,highcingulate,butprefrontalisnormal:5HTP

2. Pain

• SAMe

• Fishoil

VII. Cerebellum

A. CerebellarFunctions

1. Processingandintegration

2. Coordination

3. Impulsecontrol

4. Organization

5. Speedofthought(likeclockspeedofcomputer)

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6. Lefthemisphereisconnectedtotherightfrontallobeandviceversa

7. Crossedcerebellardiaschisis

B. CerebellarProblems

1. Coordinationproblems

2. Slowedwalking

3. Slowedthinking

4. Slowedspeech

5. Disorganization

6. Impulsive

7. Poorconditionedlearning

C. CerebellarHelp

1. Coordinationexercises

2. Juggling

3. Dancing

4. Tabletennis

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5. Gratitude

6. Stimulants

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BHC104:

SubtypingADD,Anxiety,Depression,

Addictions,andObesity

DanielAmen,M.D.

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Summary

Intheearlydaysofbrain imaging, itwasthoughtthattherewouldbeaconsistentpatternof

abnormalbrainactivityconnectingADD,anxiety,schizophrenia,andbipolardisorder.However,

itwassoonfoundthatalloftheseissueshadmultipletypeswithineachdisorder.Thisledtoa

breakthrough in practice and a better understanding of how best to treat each of these

problems. In this presentation, Dr. Daniel Amen identifies the different subtypes of ADD,

Anxiety,Depression,Addictions,andObesityandprovidesinformationregardingthebestways

totreateachsubtype.

LearningObjectives

1. Participantswillidentifythedifferentsubtypesofeachdisorder

2. Participantswillunderstandthehowthesamedisordercandifferbasedonwhichparts

ofthebrainarefunctioningimproperly

3. Participantswillexploredifferenttreatmentoptionsforeachsubtype

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I. UnderstandingBrainTypes

A. Dr.Amen’sInitialWork

1. Firststartedbrainimagingworkin1991,lookingfortheonepatternassociatedwith

ADD,anxiety,schizophrenia,andbipolardisorder.

2. Itwassoonclearthattherewasnotonepatternassociatedwithanyoftheillnesses.

3. Alltheillnesseshadmultipletypes.

4. Depressionis likechestpain–youdonotgiveallpeoplewithchestpainthesame

treatment;youneedtofindoutwhatiscausingitandtreatitaccordingly.Obesityis

thesameway;thereisnoone-size-fits-allcure.

5. Thisoneidealedtodramaticbreakthroughsinpractice.

B. KnowtheBrainType

1. ADHD

2. AnxietyandDepression

3. Addiction

4. Obesity

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C. SevenBrainTypesAssociatedwithADHD

1. Classic–PFC/CB–DA

• Lowactivityinprefrontalcortexandthecerebellum

• AccordingtotheDSMclassification,sixofnineinattentivecriterianeedtobe

met, and six of nine hyperactivity/impulsivity criteria. If both of those are

met,thediagnosisisclassicADDorclassiccombinedtypeADHD.

• Scansshowlowfrontallobeactivity,lowcerebellumactivity

• Thistyperespondswelltodopaminergicinterventions.

2. Inattentive–PFC/CB–DA

• Meetthecriteriafortheinattentive,butnotthehyperactiveandimpulsive

• The same pattern as classic, except the classic hyperactive/impulsive type

hasgreaterdecreasesthantheinattentivetype.

• Thosewiththeclassiccombinedtypetendtobeextroverts,whichgoeswith

lowerfrontallobeactivity–theinattentiveisnotquitesolow.

• Bothofthesetypesrespondtodopaminergicinterventions,eithermedicines

orsupplements

3. Over-focused–AC/PFC–DA/S

• Lowprefrontalcortexandhighcingulate

• We see this specific type especially in children and grandchildren of

alcoholics; these children tend to have an impulsive/compulsive pattern in

theirbrain.

• WhentheyhaveADDandthat’s theprimarypresentingsymptomology, it’s

calledover-focusedADD

• This type respondswell to a combination of Ritalin and Prozac. Ritalin by

itself will make them over-focused, Prozac by themselves will demotivate

themandtheywon’tbeabletofocus.

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4. Limbic–Limbic/PFC–NE/DA

• Lowprefrontalcortexandhighlimbicbrain

• They tend to be sad but not depressed,more dysthymic,with all theADD

symptoms.

• ADDisaneurodevelopmentaldisorder,somethingthatyoucanseeevidence

of most of a person’s life. The inability to focus, restlessness, impulsivity,

talkingtoomuchinclass,andotherADDsymptomswillhavebeengoingon

thewholetime,butinadditionthere’sthissmolderingsadness.

5. TemporalLobe–TLs/PFC–DA/GABA

• Lowprefrontalcortexandtemporallobesymptoms

• All the ADD features, either combined or inattentive, and temporal lobe

symptoms: Mood instability, irritability, temporal problems, learning

problems.

• TreatmentincludesGABAergicinterventionsanddopamine,inthatorder.

6. RingofFire–Hyper–GABA,SandDA

• Ahotbrain–dramaticallyoveractive

• Eighttimesoutof10,theyaremadeworsewithstimulants,andthat’swhat

theygetputon,becausethey’resohyperactive.

7. Anxious–GABA,DA

• Highbasalganglia

• Anxious,tense,nervous

• RespondwelltoGABAanddopamine

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D. SevenBrainTypesAssociatedwithAnxietyandDepression

1. PureAnxiety–BG–GABA

• Onlyanxietysymptoms

• Theonlythingabnormalisthatthebasalgangliaisup.

• TreatwithGABA

2. PureDepression–Limbic–DA/NE

• Justsad,notanxious,notobsessive,justsad

• Highlimbicsystem

• UseWellbutrinorSAMe

3. Mixed–DA/NE&GABA

• Depressionandanxietyruntogether70%ofthetime

• UseGABAoradopaminergic,SAMEorWellbutrin

4. Over-focused–S

• Cingulateandlimbic

• Serotoninintervention

5. Cyclic–GABA

• Bipolarpatients

• Lithiumoranticonvulsant

6. TemporalLobe–GABA

• Increaseinbipolardisorderdiagnoses

• What is really occurring is the mood instability, irritability, and temper

problemsthatcomefromtraumaticbraininjurythatpeoplearemislabeling

asbipolar.

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7. Unfocused–Endtoxin,boostDA

• Lowactivitybrains

• Sad,butresultingfromaninfection,toxin,oranoxia.

• Difficulttotreatbecausethedepressionisnottheprimaryproblem

E. SixBrainTypesAssociatedwithSubstanceAbuse

1. Impulsive–PFC–DA

• Lowfrontallobeactivity

• Tend to smoke, abuse stimulants, caffeine, energy drinks, and

methamphetamine

2. Compulsive–AC–S

• Highcingulate

• Theycan’tstopthinkingabouttheirdrugofchoice.

3. Impulsive-Compulsive–AC/PFC–DA/S

• Needsacombinationofdopamineandserotonin

4. Sad–Limbic–DA/NE

5. Anxious–BG–GABA

6. TemporalLobe–TLs–GABA

F. FiveBrainTypesAssociatedwithObesity

1. Impulsive:PFC–DA

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2. Compulsive–AC–S

3. Impulsive-Compulsive–PFC/AC–DA/S

4. Sad–Limbic–DA/NE

5. Anxious–BG–GABA

II. UnpackingtheTypes

A. BrainType1:TheImpulsiveOvereater

1. Poorimpulsecontrol

2. Getseasilydistracted

3. Lowprefrontalactivity

4. Theprefrontalcortexisthebrain’sbrake.

5. CommoninADD

6. Associatedwithlowdopaminelevels

7. Shortattentionspan

8. Distractibility

9. Disorganization

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10. Impulsivity

11. ADDnearlydoublestheriskforobesity.

12. Theharderyoutry,theworseitgets.

B. ImpulsiveTypePlan

1. Boostdopamine,strengthenprefrontalcortex

2. Structuredgoalsetting

3. Intenseexercise

4. Ahigher,high-qualityproteindiet

5. EPAfishoil

6. Supportdopamine

• Phentermineorstimulants

• Greentea,l-tyrosine,rhodiola,ginseng,zinc,ferritin

7. Calmingmedsorsupplementsmakethisworse.

C. BrainType2:TheCompulsiveOvereater

1. Symptoms

• Stuckonthoughtoffood

• Compulsivelydriven

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• Feelnocontrol

• Nighttimeeaters

• Worry

• Troublesleeping

2. Carbsboostserotonin.Proteinboostsdopamine.

3. Exercisewill boost serotonin, but sowill pasta. People can get addicted tobread,

cookies, candy, because they’re trying to treat an underlying depression or

compulsivity.

D. BrainType2:Help

1. Raiseserotonin

2. Learnhowtodistractyourselfwhenyougetathoughtinyourheadmorethanthree

times.

3. Intenseexercise

4. Ahigher“smart”carbohydratediet

5. DHAfishoil

6. Supportserotonin

• SSRIs

• 5HTP,inositol,saffron,l-tryptophan,SJW

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E. BrainType3:TheImpulsive-CompulsiveOvereater

1. CombinationofType1and2

2. Toomuchactivityinattentionregion

• Overthinkandgetstuck

• Lowserotonin

3. Toolittleprefrontalcortexactivity

• Troublesupervisingbehavior

• Lowdopamine

4. Treatmentistoraiseboth

F. BrainType4:TheSADOvereater

1. Medicatefeelingsofsadnesswithfood

2. Calmemotionalstorms

3. Depression

4. Lowenergy

5. Lowself-esteem

6. Painsymptoms

7. Tendtogainweightinwinter(duetoVitaminDlevels)

• LowvitaminDlevelsareassociatedwithleptinresistance

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G. BrainType4Help

1. LearntokilltheANTs(automaticnegativethoughts)

2. Intenseexercise

3. Balanceddiet

4. Balancedfishoil

5. SupportDA/NE

• Wellbutrin

• SAMe

H. BrainType5:TheAnxiousOvereater

1. Eattosoothanxiety

2. Nervous

3. Predictstheworst

4. Physicaltension

5. Highbasalgangliaactivity

I. BrainType5:Help

1. BoostGABA

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2. LearntokilltheANTs(automaticnegativethoughts)

3. Meditation,hypnosis,deepbreathing,HRVtraining

4. Intenseexercise

5. Balanceddiet

6. DHAfishoil

7. SupportGABA

• Magnesium

• Relora

• HolyBasil

• B6

• Theanine

• GABA

• Valerian

• Kavakava

J. NeurotransmittersandADD

1. Dopamine–focusandmotivation

2. Serotonin–mood,sleepandshiftingattention

3. GABA–calmsthebrain

4. Acetylcholine–memoryandlearning

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III. ReviewingADDTypes

A. Type1:ClassicADD

1. Lowdopamine

2. Shortattentionspan

3. Distractibility

4. Disorganization

5. Procrastination

6. Poorimpulsecontrol

7. Restlessandhyperactive

B. Type1:ClassicADDSupport

1. Supportdopamine

2. Stimulatingsupplementsormedications

3. Exercise

4. Specificdiet

5. EPAomega3fattyacid

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C. Type2:InattentiveADD

1. Troublefocusing

2. Nothyperactiveorimpulsive

3. Introverted

4. Morecommoningirls

5. Fewerbehaviorproblems

6. Lowprefrontalcortex

D. Type2:InattentiveADDSupport

1. Supportdopamine

2. Higherproteindiet

3. Stimulatingsupplementsormedications

E. Type3:Over-focusedADD

1. Troubleshiftingattention

2. Stuckinloopsofthinking

3. Lowserotoninanddopamine

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4. Excessiveanteriorcingulateactivity

5. AnteriorCingulateGyrus

• Brain’sgearshifter

• Gofromtasktotask

• Movefromideatoidea

• Beflexible

• Gowiththeflow

• Errordetection

6. Tendtogetstuck

7. Worry

8. Holdgrudges

9. Upsetifthingsdon’tgotheirway

10. Argumentative,oppositional

11. Seetoomanyerrors

12. Familymembersalsogetstuck

F. Type3:Over-focusedADDSupport

1. Supplementsormedicationstosupportserotoninanddopamine

2. DoNOTdowellonahighproteindiet

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G. Type4:TemporalLobeADD

1. HallmarkADDsymptoms

2. Temporallobesymptoms

3. Learning

4. Memory

5. TemperOutbursts

H. Type4:TemporalLobeADDSupport

1. SupplementsormedicationstoboostGABAandstabilizethetemporallobes

2. Thensomethingtoboostdopaminetohelpfocus,inthatorder

3. Highproteinandhealthyfatdiet

I. Type5:LimbicADD

1. HallmarkADDsymptomsplus:

• Sad

• Negative

• Glasshalfempty

• Poorappetite

• Moresociallyisolated

2. Help:

• StimulatingsupplementsormedicationsthatsupportDA/NE

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J. Type6:RingofFireADD

1. Moody

2. Easilydistracted

3. Toomanythoughts

4. Overlysensitivetolights,sounds,andtouch

5. CausesofRingofFire

• Earlybipolar?

• Allergies

• Inflammation

• Delayedmaturation

K. Type6:RingofFireADDSupport

1. Specialdiet

2. Supplementsormedicationstocalmthebrain

3. SupportGABAandserotonin

L. Type7:AnxiousADD

1. HallmarkADDSymptoms,plus:

• Anxious

• Nervous

• Tense

• Predicttheworst

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2. Support:

• Deeprelaxationtechniques

• SupportGABAanddopamine

• Stimulantsaloneusuallyincreaseanxiety

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BHC105:

Neuroimaging:LookingattheBrain

ChangesEverything

DanielAmen,M.D.

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Summary

AsinterestingasSPECTbrainscansare,whyshouldcliniciansusethem?Dotheyreallyhelp?In

this presentation, Dr. Daniel Amen will be breaking down the complicated process of

neuroimaginganddemonstratingtheclinicalsignificanceofbrainscans.Outcomesinpsychiatry

have not significantly changed in the past decades. Without looking at the brain, making

psychiatric diagnoses is like throwing darts in the dark. Brain imaging has the potential to

significantlychangethefaceofpsychiatry,asitallowsclinicianstoidentifytheneurobiological

causesofdifferentmentalhealthissues.Dr.Amendescribesthestep-by-stepprocessofSPECT

imaging, comparing and contrasting itwith other forms of scans. This presentationwill help

viewersunderstandhowbrainimagingworksandwhyitissobeneficialinpractice.

LearningObjectives

1. Participants will explore the history of psychiatry and understand the need for brain

imaging

2. ParticipantswillunderstandhowbrainSPECTimagingworks

3. Participantswill examine 50 brain scans and identify the neurobiological problems of

eachscan

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I. WhyBrainSPECT?

A. Dr.Amen’sBackground

1. Childhood

2. Infantrymedic

3. X-raytechnician

B. BrainSPECTImaging

1. Imaging+Psychiatry=Revolution

2. SPECTlooksatbloodflowandactivitypatternsinthebrain.

• Single

• Photon

• Emission

• Computed

• Tomography

C. SPECTTellsYouThreeThings

1. Goodactivity

2. Toolittleactivity

3. Toomuchactivity

4. Thefirstideaoftreatmentistogetridofthetoxin

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D. WithoutImaging

1. DiagnosesstillmadesimilartohowLincolnwasdiagnosedwithdepressionin1840

2. DSMishurtingus,becauseitisnotbasedonunderlyingphysiology.

3. Givingsomeoneadiagnosisofdepressionislikegivingadiagnosisofchestpain.

4. Psychiatristsaretheonlymedicalspecialistswhorarelylookattheorgantheytreat.

• Cardiologistslook

• Neurologistslook

• Orthopedistslook

• Allotherspecialtieslook

• Psychiatristsguess

5. Throwingdartsinthedark

6. Thereisareasonthatmostpsychiatricmedicationshave“BlackBox”warnings.

Symptoms= Diagnosis= Treatment

Depression

6of9sxsDepression Antidepressants

Anxiety AnxietyDisorder Anti-anxietymeds

Attention

6of9sxsforinattention

6of9sxsforhyper/impulsivity

ADHD Stimulants

ExplodesIntermittently IntermittentExplosiveDisorderI.E.D.Angermanagement

??meds

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E. It’sNotWorkingVeryWell

1. Psychiatricoutcomeshavenotimprovedindecades.

“Theunfortunate reality is that currentmedicationshelp too fewpeople togetbetter

andveryfewpeopletogetwell.”–Insel,NIMH1

2. Antidepressantseffectssimilartoplacebo,exceptforseverelydepressed2

3. Antipsychoticsandstimulantsarenomoreeffectivethanin1954.

4. Takingmultiplepsychmedsislinkedtosuicide.3

F. NotLookingattheBrainHurtsPatientsandFamilies

1. Symptombaseddiagnosesaremisleading–manyroadstodepression,symptomstell

nothingofunderlyingphysiology.

2. Leadtoone-size-fits-alltreatments–nounderstandingofillnesssubtypes

3. Often completely miss TBI, toxicity or infections – often the cause of psychiatric

symptoms

4. Missesthatsomepsychiatricmedicationsaretoxic

5. Miss a huge opportunity to decrease stigma and increase compliance – what if

mentalhealthwasreallybrainhealth?

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G. NotLookingattheBrainHurtsSociety

1. Organizations like the NFL/NHL remained in denial for decades about long-term

effectsofTBI–ourSPECTimagingworkhelpedthemchangeeverything.

2. MilitaryPersonnelwithTBIareoftenleftwithoutappropriatehelpandhope–how

doyouknowifaTBIwassignificantunlessyouactuallylookatbrainfunction?

3. Costlydementiasnotdiagnoseduntillateinillness–eventhoughAlzheimer’sstarts

in the brain decades before people have any symptoms, so no prevention or early

treatment can occur. Soldier TBIs are going to increase the risk for dementia.We

needtostopthisfromhappening.

H. IneffectivelyTreatedBrainProblemsareExtremelyExpensiveandPainful

1. Underachievement

2. Schoolfailure

3. Jobfailure

4. Relationshipproblems

5. Legalproblems

6. Failedtherapyattempts

7. Failuretosuccessfullytransitiontocivilianlife

8. Suicideisdevastating

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9. Multiplefailedmedicaltrails

10. Residentialtreatmentcancost~$100,000ayearfortroubledteens

11. 28daydrugtreatmentis~$20-80,000/month

12. Psychiatrichospitalstaysoften>$2,000aday

13. Permanentdisabilityisextremelycostly

14. ThomasInsel,DirectorofNIMH,APAMeeting2005

• Trial and error diagnosis will move to an era where we understand the

pathophysiologyofmentaldisorders

• Wearegoingtohavetouseneuroimagingtobeginto identifythesystems

pathologythatisdistributedineachofthesedisordersandthinkofimaging

asabiomarkerformentalillnesses.

• Endgameistogettoindividualizedcare

• The DSM-IV has 100% reliability and 0% validity. We need to develop

biomarkerstodevelopthevalidityofthesedisorders

• Developtreatmentthatgoesafterthecorepathology

I. ReasonsWeDon’tLook

1. Imagingisnotpartofourtrainingortradition.

2. Mostpsychiatristsdonotknowhowtoreadbrainscanimages.

3. Theydonotknowwhattodowiththeinformation.

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4. Most psychiatrists, through disuse, have forgotten their neuroanatomy and brain

circuitryandrelymoreontheDSM-IVfordiagnoses.

5. Mostpsychiatriststhinkbrainproblemsmustbeblatantlyobviousbeforetheyorder

scans.

6. Therearemanymythsandmisconceptionsaboutimaging.

7. Political bodies (APA/NIMH) are dragging their feet about imaging and actively

holdingthefieldback.

II. MythsaboutBrainScans

A. Myth#1:ScansMakeDiagnoses

1. Scans help with additional information (the BIO of a bio/psych/social/spiritual

evaluation).

2. Shouldneverbeusedinisolation

3. TheDSMisNOTbasedonunderlyingneuroscienceandwillnevercloselycorrelate

withimaging.

4. Scansaddvaluableinformationonfunctionordysfunctionofcertainbrainregions.

B. Myth#2:NotEnoughResearchonImaging

1. Literally thousands of functioning imaging articles on tens of thousands of

neuropsychiatricpatients

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2. Examples:2,548abstractsonamenclinics.com

• Dementia–210studieson13,261subjects

• ADHD–93studieson2,010subjects

• BrainInjury–454studieson>5,000subjects

• Treatmenteffects–107studies,2,695subjects

• Normal–76studieson4,111subjects

• OCD–99studieson2,155subjects

• Autisticspectrumdisorders–63studieson2,051subjects

• Epilepsy–253studies,7,382subjects

• Violence–41studies,1,468subjects

C. Myth#3:ScansLeadPeopletoUseMoreMedicine

1. Scanshelpususemoretargetedmedicinesandlesstoxicmedicines.

2. MakesyouopentoothertreatmentssuchasHBOT,neurofeedbackandmeditation

3. Scanshaveshownpsychotherapyandmeditationchangebrainfunction.

D. Myth#4:ScansareDangerous

1. RadiationofaSPECTstudyisaboutthesameasaroutineheadCTscan.

2. Lastyear,therewere20millionnuclearproceduresdoneintheU.S.,including8,000

performedatBostonChildren’sHospital.

3. NoevidenceofharmfromSPECTorPETstudy

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4. Psychiatrists are not used to ordering imaging tests so they tend to be

uncomfortablewithanyradiation.

E. Myth#5:ScansChangeMomenttoMoment

1. Lessthan3%variabilityover3weeks(Mena)

2. Needtodosomethingtochangethescan

3. Timeof cyclematters, as itdoes changeduringawoman’smenstrual cycle, if she

hasPMS

4. Agematters–a studywasdonewith8,000scans toshowbrainchangesover the

lifespan.

F. EarlyLessons

1. Illnessesarenotsingleorsimpledisorders–theyallhavemultipletypes.

2. Mildtraumaticbraininjuriesareamajorcauseofpsychiatricillness.

3. Undiagnosedbraininjuriesareamajorcauseofhomelessness,drug/alcoholabuse,

depression,panicattacks,ADHD,andsuicide.

4. Infectiousdiseaseisacommoncauseofpsychiatricillness.

5. Judgesanddefenseattorneyssoughthelptounderstandcriminalbehavior.

6. >500convictedfelons,including90murderers

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7. Thisworktaughtthatpeoplewhodobadthingsoftenhavetroubledbrains.

8. Manyofthesebrainscouldberehabilitated.

G. RadicalIdea

1. What ifweevaluatedand treatedbrains, rather thansimplywarehousing them in

toxic,stressfulenvironments?

2. Wecouldsavetremendousamountsofmoneybymakingpeoplemorefunctionalso

whentheygotoutofprison,theycouldwork,supporttheirfamilies,andpaytaxes.

3. “Asocietyshouldbejudgednotbyhowittreatsitsoutstandingcitizens,butbyhow

ittreatsitscriminals.”–FyodorDostoevsky

4. Insteadofjustcrimeandpunishment,whatifwethoughtofcrime,evaluation,and

treatment?

H. CouldFunctionalNeuroimaginghavePreventedTragedies?

1. In 1994, the NFL formed concussion committee, yet it has never sponsored a

functionalbrainimagingstudytostudyplayers.Instead,itstudiedrats.

2. In2009,GoodellsaidtoCongress,“NFLdidn’tknowifplayingfootballcaused long

termbraindamage.Theywerestillstudyingtheissue.”

3. NFLactedlikemanyemployers–delay,deny,andblametheemployeewhenthey’re

hurt.

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4. Theproblemwith theNFLposition is that if youdon’tadmityouhaveaproblem,

you cannot do anything to solve it! Many brain damaged NFL players were left

withouthelporhope.

5. In2009-2011,AmenClinicpartneredwiththeLAchapterofNFLPAandperformed

the first large functional imaging studyonplayers. Brain SPECT imaginghelped to

changeeverything.

6. ActiveandretiredNFLplayershaddamageseenacrosstheirwholebrains.

7. As a result, in 2011 the NFL radically changed its position on TBI and now have

postersonconcussionsineverylockerroom.

I. BrainRehabProgram

1. Damagesohigh,weperformeda“real-world”rehabilitationstudy

2. Brainhealthystrategies(diet,exercise,weightlossifneeded)

3. Brain boosting supplements (5.6 grams fish oil, B6, B12, folic acid, gingko,

vinpocetine,huperzineA,NAC,carnitine,andalphalipoicacid)

4. Significant rehabilitation is possible. In a study of 65 players, there was 80%

improvement,especiallyin:

• Memory(69%)

• Attention(53%)

• Mood(40%)

• Motivation(40%)

• Sleep(25%)

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J. PsychiatryisinTrouble

1. Ifyoudon’tadmityouhaveaproblemyoucannotdoanythingtochangeit.

2. Outcomes are not better today than they were decades ago in depression,

schizophrenia,bipolardisorder,andADHD,despitedecadesofresearchandbillions

ofdollars(Insel,2009).

3. Thenomenclatureismisleading.

4. Bynotusing functional imaging routinely in clinical practice,wehurtpatients and

theirfamilies,wehurtoursociety,andwediminishourprofession.

5. Patientsaremislabeledandmistreated.

6. Within 10 years, it will be malpractice not to use functional imaging in complex

cases.

III. DifferentTypesofScansAvailableToday

A. SPECT–SinglePhotonEmissionComputedTomography

1. Usesaradioisotope,typicallyTe99,combinedtoapharmaceutical,eitherHMPAOor

ECD,tomeasureregionalcerebralbloodflow.

2. Mayalsomeasurereceptoractivity

3. Longexposure

4. Imagehappensininjectionroom

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5. Upto6hoursafterinjectiontoscan

B. PET–PositronEmissionTomography

1. Usesradioisotopestomeasureglucosemetabolism,rCBF,orreceptoractivity

2. Usedmoreinacademicsettings–improvedresolution

3. Shortexposure

C. fMRI–FunctionalMagneticResonanceImaging

1. Measuresbloodflowchanges

2. Veryshortexposure

3. Whatisreallybeingmeasured–anxiety?

4. Domagnetschangethebrainallbythemselves?

5. Noradiation

6. Canrepeatscansasoftenasdesired

D. qEEG–QuantitativeElectroencephalography

1. Useselectrodesplacedonthescaletomeasurebrainwaveactivity

2. Immediateexposure

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3. Scalpplacementslimitinformationfromdeepbrainstructures

E. MEG–Magnetoencephalography

1. Useselectrodesplacedonthescalptomeasurebrainwaveactivity

2. Immediateexposure

3. Scalpplacementscanlimitinformationfromdeepbrainstructures.

IV. HowSPECTChangesPsychiatricDiagnosisandTreatment

A. WhatcanSPECTTellCliniciansandPatientsthatTheyCannotObtainThrough:

1. History

2. Mentalstatusexaminations

3. Physicalexaminations

4. Neuropsychologicaltesting

B. BetterQuestions

1. HaroldBursztajn,M.D.,Harvard,says“SPECTdoesn’tgiveyoutheanswer,itteaches

youtoaskbetterquestions.

2. Ithelpstounderstandunderlyingphysiology.

3. Isthebrainoveractive,underactive,injured,ortoxic?

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C. SPECTHelpsPreventMistakes

1. Stimulatinganoveractivebrainorcalmingonethatisoveractive

2. Missingtoxicityorspaceoccupyinglesion

3. SPECTisamuchhigheryieldstudy

D. AidsintheDiagnosisandTreatmentofSubstanceAbusers

1. Breaksthroughdenial

2. Increasescompliance–“Brainenvy”

3. Helpsunderstandco-morbidity

4. Followtreatment

5. Educationandprevention4

E. SPECTDecreasesStigma,IncreasesCompliance

1. Patientsandfamilyseeproblemsasmedical,notmoral

2. Dramaticallydecreasesshame,guilt,self-loathingandanger

3. Increasesforgivenessandcompassion

4. Increasescompliance

5. Wehavenothingelseinpsychiatrythatisthispowerfulorimmediate

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V. CommonSPECTPatternsthatInformDecisionMakinginPsychiatry

A. Scalloping/OverallDecreasedPerfusion

1. Toxicity

2. Chemotherapy

3. Environmentaltoxin

4. COpoisoning

5. Anoxia

6. Infection

7. Hypothyroidism

8. Severeanemia

B. ScallopingInterventions

1. Stopthetoxin!

2. Treatinfections

3. Brainrehabprogram

• Avoidbad

• Dogood

• Neurofeedback

• HBOT

• Medsorsupplements

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C. OverallIncreasedPerfusion

1. Bipolardisorder/mania

2. Inflammatoryprofess,i.e.,SLE

3. ADHDthatistypicallymadeworsebystimulants

D. OverallIncreasedInterventions

1. Workupandtreatpotentialinflammation,suchasSLEorfoodallergies

2. Eliminateallergens

3. Calminginterventions,suchasmagnesium,GABA,oranticonvulsants

E. TraumaticBrainInjury:MoreCommonthanMostKnow

1. Focaldeficits

2. Asymmetries

3. Prefrontalcortexflattening

4. Decreasetemporalpoles

5. Contra-coupsites

6. Crossedcerebellardiaschesis

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7. TBIInterventions:Brainrehabprogram

• Avoidbad

• Dogood

• Neurofeedback

• HBOT

• Medsorsupplementsthatareareaspecific

F. Hyperfrontality

1. OCDSpectrum

2. ODD

3. Autisticspectrum

4. Getsstuck,worried,rigid,inflexible

5. Over-focuseddepressionoranxiety

G. HighPrefrontalCortexInterventions

1. Increaseserotonin

2. Exercise

3. Supplementssuchas5HTPorSt.John’sWort

4. SSRIs

5. Risperidone

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H. Hypofrontality

1. ADHD

2. Schizophrenia

3. TBI

4. Medications

5. Predictsrelapseinalcoholics

6. Lackofconscientiousness

7. Formsofdepression

I. LowPrefrontalCortexInterventions

1. Exercise

2. Stimulatingsupplements,suchasgreentea,l-tyrosine,rhodiola

3. StimulantsifADHD

4. Stimulatingantipsychoticsifneeded,Abilify

5. StimulatingantidepressantorSAMeifdepressed

6. Brainrehabifneeded

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J. TemporalLobeHypoperfusion

1. Temporallobeepilepsy

2. Temporallobedysrhythmia

3. Dyslexia

4. Moodinstability

5. Intermittentexplosivedisorder

K. TemporalLobeInterventions

1. Ketogenicdiet

2. Neurofeedback

3. HypobaricOxygentreatment(HBOT)

4. Anti-epilepticmeds

5. Memoryenhancingsupplements–gingko,vinpocetine,huperzineA

6. Memoryenhancingmedications

VI. Research

A. BrainTrauma

1. 107studieson3,335

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2. Abdel-Dayem,1998,228patients

• 41patientswhohadmildTBIwithoutlossofconsciousnesshadanormalCT,but

28SPECTstudieswereabnormal

3. Jacobs,1996,136patients

• AnormalSPECTscanisareliabletoolintheexclusionofclinicalsequelaeofmild

head injury.At 12monthspost injury, apositive SPECT study is also a reliable

predictorforclinicaloutcome.

4. Abu-Judeh,1999,32patients

• SPECTvaluableandsensitiveforevaluationofrCBFchangesfollowingmildTBI;

• Thesechangescanoccurwithoutlossofconsciousness;

• SPECTismoresensitivethanCTindetectingbrainlesions;and

• Changesmayexplainaneurologicalcomponentofthepatient’ssymptomsinthe

absenceofabnormalitiesusingotherimagingmodalities.

B. Dementia

1. 210studieson13,261subjects

2. Jobst,1997,319autopsyconfirmed

• SPECT alone had 89% sensitivity, 80% specificity, and 83% accuracy; and the

combinationofSPECTandCTwas80%sensitive,93%specific,and88%accurate.

3. Hirao,2006,122patients

• SPECTchanges inposteriorcingulatecortexcloselyrelatedtoentorhinalcortex

inpatientswithAD

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4. Borroni,2006,31patients

• SPECT pattern and severity of memory deficits predict risk of progression to

probableADinMCIsubjects

C. Violence/Suicidal

1. 75studies,>1500patients

2. Amen,2007,41murdersvshealthycontrols

• SPECTshowedsignificantprefrontalcortexdeficits,moreglobaldeficitsinolder

adults

3. Soderstrom,2002,32patients

• Aberrantfrontotemporalactivitymostfrequentlyseeninviolentbehavior

4. Hirono,2000,20patients

• Resultsindicatedanassociationbetweenaggressionanddecreasedperfusionin

theleftanteriortemporalcortex

5. Amen,2009,15completedsuicides

• Markeddecreases,especiallyintheprefrontalcortex,AC,andarea25

D. ImagingHelpwithViolentBehavior

1. Identifysystemsinvolvedwithviolenceanddirecttreatment

• Prefrontal

• Temporallobe

• Anteriorcingulate

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2. Optimizebrainfunctionbeforerehab

3. Helpmotivatetreatment

4. Helpunderstandaberrantbehavior

E. WhatDoesHisSoulLookLike?

1. Multiplemurderswithradicallydifferentbrains

2. Threetypesofviolence

• Frontallobeviolence–impulsive

• Cingulategyrusviolence–compulsive

• Temporallobeviolence–littleornoreason

F. ToxicExposure

1. Rea,2003,30patientswithtoxicmoldexposure

• 86%hadabnormallowactivity

2. Kao,1994,18childrenwithviralencephalitis

• SPECTabnormalmoreoftenthanCT/MRinacutephaseandprovidedbetter

location

• AcuteencephalitislocallyincreasedrCBF

• Afteracuteepisodes,SPECTreturnstonormalinmost

• Normal SPECT in subacute phase usually indicates a good outcome after a

year

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G. SubstanceAbuse

1. Andinoff,2006,35cocainevs37normals

• Decreasedbilateralorbitalfrontalprefrontalcortex

2. Kucuk,2000,10teenagerswithinhalantabuse

• Seriousdecreasedoverallactivity

3. Okada,1999,16solventabusers

• Overalldecreasedactivity

4. Botelho,2006,17heroinaddicts

• Overalldecreases,especiallyintheprefrontalcortex

H. TreatmentResponse

1. 107studies,2695patients

2. Shi,2003,320patientswithbraininjuryandHBOT

• HBOTincreasedSPECTandtreatmentresponse

3. Cho,2007,34childrenwithADHD,Ritalin+vs–

• SPECTcorrectlyclassified88%,responderslowerAC

4. Lee,2005,23ADHD,Ritalinimprovedi/oprefrontalcortex

5. Matthew,1996,10SADpatientsandlighttherapy

• Increasesinrespondersinprefrontalcortexandanteriorcingulate

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6. Amen,2006,6policeofficersandEMDR

• DecreasedrightlateraltemporallobeandincreasedLDLPFC

7. Shimizu,2006,51Alzheimer’swithdonepezil

• Increasedfrontallobes

8. Vangu,2003,15patientsbeforeandafterECT

• Increaseinprefrontalcortex/temporallobesintreatmentresponders

9. Hoehn-Saric,1991,6patientswithOCD

• ProzacdecreaseshyperfrontalityinOCD

I. SPECTTreatmentPredictionBiomarkers

1. Cho2007(n34)–ADHDchildrennon-responderstostimulantshadhigherrCBFinAC

andrightBG.88%classifiedcorrectly

2. Amen 2008 (n157) –ADHD deactivation PFC pole + with concentration stimulant,

activationassociatedwith–stimulantresponse

3. Navarro2004(n47)–Lateonsetseveredepression, leftfrontal-cerebellarperfusion

ratiopositivepredictivevalueoftreatment94%

4. Brockmann2009(n93)–Depressionhyperfrontality+SSRIresponse,low–SSRI

5. Langguth2007(n24)–DepressionrTMSrespondersincreasedACrCBF

6. Richieri2011(n18)–DepressionrTMSnon-responderswithlowerPFCrCBF

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7. Hanada2013(n45)–Depression,older,non-responderslowermiddlefrontalcortex

andinsularrCBF

J. AnsweringImportantQuestions

1. Scientificevidence?

• >1800articleshousedonwebsiteaboutSPECTinclinicalpsychiatricpractice

2. HasDr.Amen’steampublishedresearch?

• >40peerreviewedarticles

3. Can’tdoctorstellclinically?

• Howcanyou tellwithout looking? Largeoutcome studies saymostpsychiatric

treatmentsarenotbetterthanplacebo.

4. Expense?

• Considercostofhavinganineffectivelytreatedpsychiatricdisorder.

5. Radiationdosewithscans?

• ExposureislessthanmostCTscans,whichareroutinelyorderedwhenneeded.

6. Willitimproveoutcomes?

• ACI seems complex patients who failed 3 providers and 6 medicines, after 6

months >75% show improvement across all measures, 85% have improved

qualityoflife.

7. DoesACImakediagnosesonlyfromscans?

• No,weusescansinthecontextoffullbio/psycho/social/spiritualevaluations

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8. Willscansgiveafinaldiagnosis?

• Theydon’t.Youhavetotalktopeople.Scansgivetheunderlyingphysiologyof

whatyouaretreatingtobetterguidetreatmentplan.

VII. BrainSPECTImagingMadeRidiculouslySimple

A. HowSPECTWorks

1. Innuclearimaging,radioisotopesareused.

2. Theyactliketracersorlightbeams,suchasaflareatseatotrackalostboat.

3. Radioisotopes are unstable atoms that emit gamma rays or photons that can be

measuredbygammacameras.

4. Theseradioisotopesareattachedtomedications(radiopharmaceuticalRP)thatare

easilytakenupbycertainorgans,suchasthebrainorheart.

5. TheRPcanbeinjected,swallowed,orinhaled.

6. A camera detector takes a pictures ofwhere RP has gone, giving images of living

tissueactivity.

B. Technetium

1. Technetiumhas22reportedisotopes,massnumberrangingfrom90-111

2. Tc99(43protons,56neutrons)

3. Half-life=6.01hours

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4. Needafull24hoursbetweenscans

C. UnitsofRadioactivity

1. Becquerel(Bq)

• 1Bq=oneradioactivedecaypersecond

2. Curie(Ci)

• 1Ci=3.7x1010radioactivedecayspersecond

• Typicalpatientdoseis20-25millicuriesofTc

D. SPECTRadiopharmaceuticals

1. Currently,twoclinicallyavailabletracers

2. Ceretec(HMPAO,Exametazime)

3. Neurolite(ECD,Bicisate)

4. Bothhaveadvantagesanddisadvantages

E. HMPAOCeretec

1. 80%takenupinafirstpassextraction

2. Peakuptakewithinseveralminutesofinjection

3. Takenupthroughblood-brainbarrier(BBB),convertedtoanothershapethatcannot

crossbackoverBBB

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4. Remainsfixedinbrainforseveralhours

5. Measuresregionalcerebralbloodflow

6. Advantages

• Seemstoprovidemorestableimagingovertime

• Main tracer uptake is in the cerebellum,which contains half of the brain’s

neurons

• AmenClinicdatabaseismadeupalmostexclusivelyofHMPAOscans

7. Disadvantages

• It canbe takenupoutsideof thebrainandcauseartifacts thatneed tobe

understoodanddealtwith

F. ECDNeurolite

1. EntersbraintissuethroughBBB

2. AlsoconvertedtoaformwhichcannotpassbackthroughtheBBB

3. Advantages

• Major advantage is that there is no extra-axial uptake, such as in the tear

ductsorparotidglands,andartifactislessofaproblem.

4. Disadvantage

• In our experience, ECD underperfuses the temporal lobes, which needs

adjustmentincomparingittoHMPAOscans

• ECDdoesnotseemasstableovertime,anditsmostintenseuptakeisinthe

occipitallobes,asopposedtothecerebellum

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G. OtherTracesandAgents

1. Xenon133gas,bloodflowtracer

2. DaTscanforDAreceptors

3. Iodine123amphetamine(IMP)

• Iodine-123-QNB, an acetylcholine muscarinic antagonist, for Alzheimer’s

disease

• Iodine-123-Iodine labeled ligands IBZM and IBZP for imaging dopamine

systeminParkinson’sdisease

• Iodine-123labeledligandsforimagingthebenzodiazepineandtheserotonin

receptors

H. SafetyofSPECT

1. BrainSPECTimagingisasafeprocedure

2. Radiation fromTc-99mHMPAO is 0.7 rem (Roentgen equivalentman) per 20mCi

dose

3. SimilartobonescanorheadCT

4. 43%oftheaverageannualbackgroundradiationinU.S.

5. OSHAgives5remayearasasafeexposure

6. Devous,pastpresidentofSNM,writes:

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“SPECTandPEThavenomore risk thanMRI-basedprocedures... Indeed, thereareno

data that have ever demonstrated any harm to humans by radiation exposure at

diagnostic imaging levels. In fact, current data support the presence of radiation

hormesis:thatlowlevelsofradiationexposureinducebeneficialeffectsofcellularrepair

andimmunesystemenhancement…ThereforeitshouldbeconcludedthatneitherSPECT

norPETbrainimagingproceduresareassociatedwithanyparticularriskoveractivities

ofdailylivingandcertainlyshouldnotbeconsideredtobeanymore“risky”thanMRIor

anyofitsassociatedfunctionalimagingderivatives.”

I. TheGammaCamera

1. Gamma camera collects photons emitted from patient, enabling scientists to

reconstruct a picture of where the gamma rays originated and determine how a

particularorganorsystemisfunctioning.

2. Componentsmakingupthegammacameraare:

• Collimator

• Detectorcrystal

• Photomultipliertubearray

• Positionlogiccircuits

• Dataanalysiscomputer

3. Collimator

• Thefirstobjectemittedgammaphotonencountersafterexitingthebodyis

thecollimator.

• Pattern of holes through gamma ray absorbing material, usually lead or

tungsten, that allows the projection of the gamma ray image onto the

detectorcrystal.

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4. DetectorCrystal

• Sodiumiodide[NaI]detectorcrystaloptimal

• Typically3/8”thick

• Photon interactswithcrystal causing the releaseofelectronswhich in turn

interactwiththecrystallatticetoproducelight

• Processknownasscintillation

5. PhotomultiplierTubes(PMT)

• Onlyverysmallamountsoflightaregivenofffromthescintillationdetector,

sothePMTtubesareattachedtothebackofthecrystal

• PMT tubes detect and amplify the electrons and convert them into an

electricalpulse

• Each gamma camera has several photomultiplier tubes arranged in a

geometricalarray.Thetypicalcamerahas37to91PMT’s.

6. PositionLogicCircuit

• ImmediatelyfollowthePMTtubearray

• Receivetheelectricalimpulsesfromthetubes

• Allows the position circuits to determine where each scintillation event

occurredinthedetectorcrystal

7. DataAnalysisComputer

• Finally, to dealwith incomingdata andprocess it into a readable image, a

processingcomputerisused

• Computermayusevariousdifferentmethodstoreconstructanimage

8. Images

• Imagesacquiredaredigitalconsistingofpictureelementscalledpixels

• TypicalSPECTacquisitionconsistsof60to120projections

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• Eachprojectionwillhaveapproximately100,000counts,andtakeabout20

seconds

• Eachscanismadeupofabout10millioncountsortimesthephotonshitthe

crystals

J. TimeinCamera

1. DataacquisitiontimesforacompleteSPECTscan:

• Singleheadedcamera:46-60minutes

• Dualheadedcamera:30minutes

• Tripleheadedcamera:15minutes

2. DualheadSPECTsystem

• Most commonly used in a hospital setting and enjoys the largest installed

base

• Performs all types of nuclear medicine studies; excellent general purpose

system

3. TripleheadSPECTsystem

• Specializedsystem,optimizedforbrainandcardiacimaging

• Smalldetectorsallowfor“closein”positioningofdetectors

• Threeyearsmeansshortacquisition/scanningtimes

• LargestinstalledbaseofanybrainSPECTsystem

VIII. PerformingBrainSPECT

A. Pre-Arrival

1. Patientsinstructedondayofexamtoavoidcaffeineandalcohol

2. Stopstimulants4dayspriortothescan

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3. Checkwiththeirdoctoraboutotherprescriptionmedications

4. Anumberofpsychiatricmedicationshavelongbiologicalhalf-lives

B. ScanningOnorOffMedication

1. Dr.Amenprefersbrainsoffmedication,butitdependsonthequestionbeingasked

2. Ifsomeonestableonmedswantsadditionalhelp,scanthemontheirmedications

3. Ifmedsarenothelpful,takethemoffuntiltheyarewashedoutofthebody,then

scan

C. InformedConsent

1. Enclosedinhandoutmaterial

2. Sendaheadoftime

3. Ensurepatientsknowaboutinjectionandradiationexposure

4. Insurancereimbursementvariesbyplans.Havepatientscheckwith theircompany

toseeifitisacoveredbenefit

5. Risks?

• Studydoesnotinvolveadye

• Peopledonothaveallergicreactionstothestudy

• Possibility exists, although very small, of a mild rash, facial redness and

edema,fever,andatransientincreaseinbloodpressure

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• AmountofradiationexposurefromonebrainSPECTstudyisapproximately

sameasheadCTscan

• Rarely,patientshavegreenurineforadayortwo

D. Pre-Injection

1. Stepstoachieveconsistentscanenvironment

• Seatpatientinaquiet,dimly-litroom,eyesandearsopen

• Nogumorcandytominimizeextra-axialtraceruptake

• Place intravenous access at least 5-10minutes prior to injection to permit

accommodation

• Instructthepatientnottospeak

• Minimize interaction with the patient during and up to 15 minutes post-

injection

• Closelymonitordementedpatientsandthosewithneurologicormovement

disorders

2. Whytwoscans?

• Bestinformationobtainedwithtwoscans

• Variousbraindisordersaffectthesameregionsofthebrainindifferentways

dependingonrestorconcentration

• To minimize residual activity interfering with the second study, the

interveningtimebetweentwostudiesshouldbenolessthan24hours

• ACIusuallydoesconcentrationscanfirst

E. BaselineStudy

1. Patientsitsquietlyforabout10minutesbeforeinjectionoftheradiopharmaceutical

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2. Patientinstructednottotalkandtojustallowhisorhermindtowander

3. Aftertheinjectionpatientshouldremainquietforaminimumof10minutes

F. Scan

1. Imageacquisitionmaybegin20-30minutesaftertherestingorconcentrationphase

2. Patientneedstoholdverystill

3. Ifdesired,givepatientablanket,asroomisoftencoldforhealthofcameras

4. Goalis10,000,000countsperstud

5. WithHMPAO,imagingshouldbecompletedwithin4hourpostinjectionifpossible

G. Sedation

1. Afterinjection

2. IVVersed(midazolam),needstobemonitored

3. Shortacting

4. Amnestic

5. Consultwithananesthesiologistornurseanesthetist

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H. InformationPertinentReadingtheScan

1. Patienthistory(includinganypastdruguseortrauma)

2. Age,gender

3. Reasonforthestudy

4. Currentmedicationandwhenlasttaken

5. Timeofstartoflastmenstrualcycle

6. Anyrecentmorphologicimagingstudies(E.g.CT,MRI)

IX. BrainSPECTProcessing

A. ProcessingRawData

1. Oncethecameracapturestherawdataitneedstobeprocessedsoitcanbeeasily

read.

2. ACIprocessesallofthescansinthesamewaytoensureconsistencyandreliability.

B. TheSteps

1. Checkformotion

• Nomotion

• Thiscanbeachallenge

• Donottrustmotioncorrectionsoftware

• BeautyofSPECT,youcanscanpatientsforupto6hoursifneeded

• Youcansedatethem,aftertheinjection,ifneeded,andnotaffectthescan

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2. Transversereconstruction

3. Filterdata

• Lowpassfilter

• Order5.0

• Cutoff0.25

• Smoothsimagesmakingthemeasiertoread

4. Attenuationcorrection

• Helpsdeepertissuehavesimilarlooktosurface

• Changmethod,0.110setting

5. Maskdata

• Toeliminateartifact

• 0.000setting

6. Obliquereformat

• Spatialorientationforslice

C. rCBF–RegionalCerebralBloodFlow

1. SPECTmeasuresrelativebloodflow

2. Mostintensepixelsinbrain=100%

3. Leastintensepixelsinbrain=0%

4. Allelseisscaledbetweenthese2poles

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5. Mostintensepixelsusuallyincerebellum

6. BecarefulwithinterpretationwhenthecerebellumisnotactivewithHMPAO

D. WhatisNormal?HowDoWeKnow?

1. Full,even,symmetricalactivity

2. WithHMPAOcerebellummostactive

3. Oftensomebasalgangliaorthalamicactivity

4. Childrenmostactive

5. Femalesmoreactivethanmales

6. 59normalSPECTstudiesforchildrenandadults

E. ResearchSample–Normal

1. Chiron,1992,42children

• By age 2 childrenhave same relative perfusionpattern as adults, although

theirbrainsaremoreactive

2. Catafu,1996,68normaladults

• SymmetricalrCBFdistributioncanbeassumedbetweenhomologousregions,

independentofage

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3. Yang,1996,52adults

• Significant negative correlation found between rCBF and advancing age,

particularlyinmales

4. Barthel,1997,23children

• Systematic differences between 4 to 15-year-old children and adults with

regardtonormalrCBF

• Normalrangesshouldbedeterminedseparatelytheagegroups4-10and11-

15years

5. Slosman,2001,187adults

• Significant differences between the sexes and a significant decline as a

functionofage

F. ACIHealthyBrainStudy

1. Nopsychiatricillness

2. Nofirstdegreerelativewithpsychiatricillness

3. Noheadinjury

4. Noorverylimitedsubstanceabuse

5. Notonanymedication

6. Scanned99healthyadults

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G. NormalClinicalPearls

1. Brainsarelikefaces.

2. Ageandsexmatters.

3. SeeproblemsonSPECTyearsbeforetheydevelop,suchasAlzheimer’s

4. Someonemightreportbeingnormal,buttheirscanmayshowtheyareheadedfor

trouble.

H. NormalScans–AgeandGenderMatched

1. Surfacescansshowfull,even,symmetricalperfusion.

2. Activescansvaryoverageandgender.

3. ExamplesthatfollowarefromACI’snormaldatabaseforadults.

4. Fromhealthiest179childrenandteensfromaclinicalsample

I. SPECTRendering/Reading

1. Allscansrenderedandreadexactlythesame

2. Eachscanisreadin5-8views

3. Slicesreadinlinearcolorscaleand/orstep20colorscales

• Horizontalortransaxialview–toptobottom

• Coronalview–fronttoback

• Sagittalview–sidetoside

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4. 3Drenderingintwoways,thatcorrelatewithotherreadings

• Surfaceview,cutoff55%,helpsseeunderactiveareas

• Activeview,blue=55%,red=85%,white=92%,helpsevaluateoveractive

areas

• Active,yellow=55%,white=85%(printsnicelyinblackandwhite)

J. SPECTReading–Step20Scale

1. SPECT is a study of relative blood flow. It takes the hottest part in the brain and

makesit100,andthecoldestspotinthebrainandmakesit0.

2. Colorschangeevery5degrees

• 95-100=4+white

• 90-95=3+gold

• 85-90=2+lightbrown

• 80-85=1+darkbrown

• 60-80=0

• 55-60=-1lightpurple

• 50-55=-2purple

• 45-50=-3brightred

• <45=-4darkred

3. SPECT Reading Tip: In reading the slices, allow your eyes to systematically make

circlesaroundeachofthebrainslices,lookingfor:

• Symmetry

• Hotspots

• Coldspots

• Patterns

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K. RatedAreas

1. PFCPoleL/R(Fronttipofthebrain)

2. PFCAnteriorLateralL/R

3. PosteriorFrontalL/R

4. PFCInferiorOrbitalL/R(Bestseenonsagittalview)

5. InsularCortex/AnteriorandPosteriorL/R(JustlateraltoBG)

6. AnteriorCingulate

• Dorsal

• Genu

• Ventral

7. MiddleCingulate

8. PosteriorCingulate(bestseenonsagittalview)

9. BasalgangliaL/R

• Caudate

• Putamen

10. Thalamo-limbic

• Diffuse

• FocalL/C/R

11. CerebellumL/R/vermis

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12. ParietallobesL/R(bestseenoncoronalview)

13. LateraltemporallobesL/R(bestseenoncoronalview)

14. MedialtemporallobesL/R(bestseenoncoronalview)

15. OccipitallobesL/R(bestseenonsagittalview)

L. RepresentativeCases

1. Stroke

2. BrainInjury

3. Dementia

4. Epilepsy

5. Toxicity/Infection

6. OCDSpectrum

7. PTSD

8. Anxiety

9. BipolarDisorder

10. Tumor

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11. ADHD

12. Depression

M. HowScansCanFoolYouIfYouAreNotCareful

1. Artifact

• Tearductorscalpuptake

• Limbicsink

• Movement

2. B-12deficiencies,anemia,hypothyroidism

3. Dehydration

4. Dayofmenstrualcycle

X. ChangeYourBrain,ChangeYourLife

A. 10WaysSPECTWillChangeEverythingYouDo

1. Youwilldevelopbrainenvy

2. Youwillbemorecarefulwithpsychotropicmedications

3. Youwon’tletyourkidsplaytacklefootball

4. Iftheydoplay,youwillworkhardtorehabilitatetheirbrains

5. Youwilltakesleepapneaseriously

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6. Youwilltakeyourweightmoreseriously–don’tbeadinosaur!

7. StopthinkinginDSMtermsonlyandmoreinbrainsystempathology

8. ThinkabouttheearlydetectionandpreventionofAlzheimer’sdisease

9. Youwillbemorecautionsinhandingoutpersonalitydisorderdiagnoses

10. You’llstartthinkingoutside-the-box!

• HBOT

• Supplements

• Weightcontrol

• rTMS

• Etc.

B. Seeing50Scans

1. Scan1:M48

• LeftMCAstroke

• Notecrossedcerebellardiaschesis

2. Scan2:M79

• RightParietal/TemporalStroke

• Notevasculardiseasewithdiffusedecreases

3. Scan3:M21

• Lefttemporallobecyst

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4. Scan4:M9

• Prefrontaltrauma

• Notefocalrightprefrontaloveractivearea(seizurefocus?)

5. Scan5:F30

• Birthstroke,lefthemisphere

• Notecrossedcerebellardiaschesis

• Notehyperfrontalpatternonright

6. Scan6:F62

• LeftMCAstroke

• Mildcrossedcerebellardiaschesis

7. Scan7:F68

• Frontaltemporallobedementia

8. Scan8:M54

• Medicationinducedcognitivedecline

9. Scan9:73M

• Ventricularenlargement

• Normalpressurehydrocephalus

• Lobsterpattern#11,12

10. Scan10:M8

• Arachnoidcyst

11. Scan11:M72

• Ventricularenlargement

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12. Scan12/13:M67

• Globaldecreasesorartifact?

• Artifact–meningioma

13. Scan14:M11

• Normaloutsidesurface

• Autism

14. Scan15:M62

• Alzheimer’s

15. Scan16:M35

• Toxic

• Xanaxabuse

16. Scan17:M19

• Lefttemporallobedamage

• Depression/suicide

17. Scan18:M20

• Braintrauma

• Stroke

• Tennisracketattack

• Alsohyperfrontal

18. Scan19:F19

• Normaloutsidesurface

• OCD,bipolar,anddepressed

• Reallyactivebasalganglia,cingulate,insularcortex

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19. Scan20/21:M28

• LimbicADD

20. Scan22:M45

• Hypothyroidism

21. Scan23/24:M26

• Bipolar

• Outsidesurfacelooksfine,butreallybusyinternally

22. Scan25/26:F63

• TemporallobeADD

• BeforeandafterAdderall

23. Scan27:M40

• Cerebellarabnormality

• Hyperfrontalandcerebellarabnormality

24. Scan28:F59

• Toxic–drugabuse

25. Scan29:M57

• ADD+DID

26. Scan30:M76

• Alcoholicdementia

27. Scan31/32:M14

• ADD+Violence

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28. Scan33/34:F22

• Over-focusedADD

• BeforeandaftertreatmentwithProzac

29. Scan37:M22

• Autism–obviouslytoxic

• Hypercingulate

30. Scan38/39:M45

• Dehydration

• Healthymealandexercise

31. Scan40/41:F36

• Meditationbeforeandafter

32. Scan42/43:M14/17

• Viralencephalitis

• Beforeandaftertreatment

33. Scan44:F46

• Frontaltemporallobedementia

34. Scan45:M54

• NFLTBI

35. Scan46:M12

• Autism

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36. Scan47:F23

• Herpesencephalitis

37. Scan48/49:M15

• Violenceandtorture

38. Scan50:M71

• Alcoholicdementia

C. SitesUsingSPECTTodayinPsychiatry

1. SixAmenClinics

2. HanleyCenter,Florida

3. MindMatters,Dallas

4. Pavel/Best,Chicago

5. Uszler,SantaMonica

6. Harch,NewOrleans

7. Stevens,OHSU

8. Newberg,Philadelphia

9. FortCampbell,KY

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10. NeuroSPECT,FL

11. Maxfield,DelRey,FL

12. Cerescan,CO

13. TedHenderson,CO

14. Cohen+,Vancouver,BC

15. Thornton+,Toronto

16. Mena,Chile

17. Cheung,HongKing

18. SouthAfrica

Endnotes1Insel,T:DisruptiveInsightsinPsychiatry:TransformingaClinicalDiscipline.JournalofClinicalInvestigation.2009.

Vol119,#4,pgs.700-7052Kirsch: Review benefits of antidepressants over placebo limited except in very severe depression. Evid. Based

MentHealth2010May:13(2):493CommunicationswithLTCDanielJohnston4Amen,DG:HighResolutionBrainSPECTImaginginaClinicalSubstanceAbusePractice.2010JPsychoactiveDrugs.

Volume42(2),June2010

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BHC106:

AmenClinicsMethod:Healinginthe4Circles

DanielAmen,M.D.

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Summary

Healing is a multi-faceted process that takes place in four different ways: biological,

psychological,social,andspiritual.TheAmenClinicsMethodutilizesallfourofthese“circles”in

helping people recover from brain injuries. Dr. Amen discusses the importance of taking a

thoroughexaminationofaclient’shistorythroughavarietyofquestionnairesandintakeforms.

These help make the correct diagnosis and properly interpret the brain scans. Brain SPECT

imaging improves results and outcomes for clients and is extremely valuable in confirming

diagnoses.

LearningObjectives

1. Participantswillidentifyanddescribeeachofthefourcircle

2. ParticipantswillexploretheAmenClinicsMethodandthevarietyofquestionnairesthat

theyuse

3. Participants will compare the outcomes of clients who received brain scans to those

whodidnot

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I. AmenClinicsMethod:TheFourCircles

A. TheAmenClinicsMethod

1. DetailedClinicalAssessments:Bio/Psycho/Social/Spiritual

2. BrainSPECTImaging

3. TargetedLabStudies

• All lead to more specific, personalized diagnoses and targeted treatment

plans

• Youcannotchangewhatyoudonotmeasure

4. Plus,weaddbrainhealthyhabittoboostbrainreserveandresilience

5. Leadstomarkedlyimprovedoutcomes

B. AmenClinicsFullEvaluation

1. MeticulousBackgroundInformation

• Review of history, previous treatment, medical, drug, legal, school, and

familyhistory

• BeckDepressionInventory

• BriefSymptomInventory

• QualityofLifeInventory

2. NeuropsychologicalAssessment

• Webneuro/Conner’sCPT

3. Twohourswithhistorianreviewinghistoricaldata

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4. TwobrainSPECTscans(restingandconcentration)

5. Final evaluation with psychiatrist (to synthesize and present the data and

recommendationsforongoingtreatment)

6. Scanpicturesandreport(includingcopiesforreferringclinician(s))

7. Firstfollowupvisit

8. Callsatsixweeks,threemonths,sixmonthsforfollowupandoutcomedata

II. 4CircleEvaluation

A. Biological

1. Brainhealth

2. Physicalhealth

3. Nutrition

4. Exercise

5. Sleep

6. Hydration

7. Hormones

8. Bloodsugarlevel

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9. Supplements

10. Genetics(familyhistory)

11. Toxins(environment,mold,drugs,excessivecaffeine,alcohol,smoking)

12. Infections

13. Physicalillness

14. Medication

15. Trauma/injuries

16. Allergies

B. Psychological

1. Self-talk

2. Self-concept

3. Bodyimage

4. Upbringing

5. Development

6. Postemotionaltrauma

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7. Pastsuccesses

8. Pastfailures

9. Grief/loss

10. Hope

11. Generationalhistoriesand issues (i.e., immigrants,survivorsof trauma,childrenor

grandchildrenofalcoholics)

12. Senseofworth

13. Senseofpowerorcontrol

C. Social

1. Qualityofcurrentenvironment

2. Senseofconnectiontofamily,friends,andcommunity

3. Healthhabitsoffriendsandfamily

4. Relationships

5. Stresses

6. Health

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7. Finances

8. Work,school

9. Currentsuccessesorfailures

10. Information

D. Spiritual

1. Senseofmeaningandpurpose

2. Whydoesmylifematter

3. Connectiontohigherpower?

4. WhoamIaccountableto?

5. Connectiontopastgenerations

6. Connectiontofuturegenerations

7. Connectiontoplanet

8. Morality

9. Values

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E. AmenClinicIntakeQuestionnaire

1. Printedquestionnaire

2. Generalsymptomchecklist

• Filledoutbypatient

• Filledoutbypersonwhoknowsthepatientwell

3. Brainsystemquestionnaire

4. Learningdisabilityquestionnaire

5. Hormonequestionnaire

• Male

• Female

6. Parentbrainsystemscheck

F. WebNeuro

1. BrainResources

2. Computerized

3. ~30minutes

4. Normed6-90

5. Self-regulation

• Negativitybias

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• Emotionalresilience

• Socialskills

6. Feeling

• Depressed

• Anxious

• Stressed

7. Emotions

• EmotionID

• Emotionalbias

8. Thinking

• Responsespeed

• Impulsivity

• Attention

• Informationprocessing

• Memory

• Executivefunction

III. BrainSPECTImaging

A. SPECTChangesClinicalPractice

AmenDG,etal.JPsychoactiveDrugs2012

1. Sevenpsychiatristsevaluated109consecutivechartswithoutandthenwithscans

2. SPECTchangeddiagnosisand/ortreatment79%

3. 22%unexpectedbraininjury

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4. 22%unexpectedtoxicity

5. 10%needforstructuralimaging

6. 60%newtargetsformedication/supplements

B. BrainSPECTChangesClinicalPsychiatricManagement

1. Borghesanietal.JAmGeriatrSoc2010

2. SPECTconfirmed,clarified,orcontradictedinitialdiagnosisin>80%ofpatients

“Neuroimagingwasusefuleven if itonlyconfirmedasuspecteddiagnosis. ‘Seeing’the

disease process increased diagnostic confidence and the clinician’s ability to explain

cognitive symptoms to patients and families. Visual images seem to have special

resonance for patients and families, grounding clinical symptoms in observable brain

changes.”

C. KnowYourImportantNumbers

1. Youcan’tchangewhatyoudon’tmeasure.

2. BMI

3. Waist-to-Heightratio

4. Hoursofsleep

5. Bloodpressure

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6. CBC

7. Generalchemistrypanel

• Fastingbloodsugar

• Lipidpanel(particlesize)

8. HgA1C

9. 25(OH)VitaminDlevel

10. Thyroidpanel(TSH,T3,T4,antibodies)

11. CRP,homocysteine

12. Ferritin

13. Free/Totaltestosterone

14. Cortisol

15. DHEA

16. AA/EPAratio

D. AA/EPARatio–Omega6:3FattyAcidLevels

1. Normal<3

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2. >3associatedwithinflammationandhigherlevelsassociatedwithdepression1

3. Dr.Amen=1.66

4. Pregnantniece=43.4

E. AmenClinicsTreatmentAlgorithm

SPECTFindings

SystemClusters

TreatmentMeds

TreatmentSupplements

ACI BrandedSupplements OtherRx

LowPFC ADHD Stimulants Stimulatingsupplements

Focus andEnergy

Exercise,diet,NFB

Depression Wellbutrin SAMe SAMe TMSstimulating

Psychosis Abilify

High AC (orhyperfrontal)

Anxious,depressed,obsessive,autistic

SSRIs

SerotoninBoosters(5HTP,saffron,inositol,etc.)

SerotoninMoodSupport

TMScalming

Psychosis Risperdal/Zyprexa

Low PFC,HighAC

ADHD, andOverfocusedanxiety anddepression

SSRI+Stimulant Boost DA andSerotonin

Focus/Energy+SerotoninMood

TemporalLobe(increasedordecreased)

Moodinstability,irritability

Anticonvulsant BoostGABA GABAcalmingKetogenicdiet,NFB

Memory orlearning ACEI

Memoryboostingsupplements

BMPB

BasalGanglia Anxiety Anticonvulsant BoostGABA EverydayStressRelief

Meditationhypnosis

Thalamo-Limbic Depressed Wellbutrin SAMe SAMe

Thalamo-Limbic+AC Depressed SNRI SAMe+5HTP

SAMe +SerotoninMoodSupport

Pain Cymbalta,Lyrica SAMe SAMe

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IV. TargetedLabStudies

A. BoostingBrainReserveRequiresThreeStrategies

1. BrainEnvy

2. Avoidanythingthathurtsyourbrain

3. Engageinregularhealthyhabits

B. AmenClinicsMethodImprovesResults

1. AmenClinicsongoing6monthoutcomestudy

2. Eachpatienthasadetailedclinicalhistory,SCID,BDI,BSI,QOLI

3. RestandconcentrationbrainSPECTscan

4. Followedat6weeks,3and6months

5. 6 months quality of life inventory, beck depression inventory, brief symptom

inventoryrepeatedwithaself-reportofimprovementandcompliance

C. AmenClinicsMethodImprovesOutcomes

1. 500consecutivepatients

2. Onaverage,ourpatientshave4.2diagnoses.

3. Failed3.3priorprovidersand6medications

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4. 75%significantlyimprovedacrossallmeasures

5. QOLIsignificantlyincreasedin85%

6. ClevelandClinicQOLIin<50%

D. ConsistentwithStudyfromCreighton,PresentedatAPA1993

1. Drs. Jaeger andMehr from Creighton presented study of 100 hospitalized bipolar

teens.

2. 50scanneddayofadmission,50neverscanned

3. Averagelengthofstayin“neverscanned”groupwas44days.

4. Averagelengthofstayin“SPECT”groupwas17days.

5. Averagecostsavingsof~$15,000perpatient

Endnotes1Adam, P.B., Lawson, S., Sanigorski, A., & Sinclair, A.J. (1996). AA/EPA ratio in blood correlates positively with

clinicalsymptomsofdepression.LipidsSuppl:S157-61.

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BHC107:

BrainHealthySupplements

DanielAmen,M.D.

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Summary

You can jump-start your way to a healthy brain without prescription medications that will

impact your health insurance and land you with complicated side effects! Supplements are

natural ways to improve your brain health with significantly decreased side effects.

Multivitamins,omega3fattyacids,andVitaminDsupplementsarejustafewofthewaysthat

Dr. Amen suggests improving your health. This presentation will describe the benefits and

problemswithsupplementsandprovidedetailed informationaboutthedifferentsupplement

optionsthatareavailableandhowtheyareused.

LearningObjectives

1. Participantswillanalyzetheprosandconsofsupplements

2. Participantswill explore theways that different supplements can help different brain

types

3. Participantswillidentifytheevidencebehinddifferentnutraceuticalsanddescribehow

theycanbeusedtohelpwithspecificproblems

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I. BrainHealthySupplements

A. MedicationEffectsandNutrientDepletions

1. Antacids:decreaseHCL,CA2+,phosphorus,folicacid,K+

2. FemaleHormones:FA,Mg,Bvitamins,C,Zn,Se,CoQ10

3. Antidiabetics:CoQ10,B12

4. Antihypertensives:B6,CoQ10,Mg,K,Zn

5. Anti-inflammatory:Ca,K,Zn,Fe,B6,C,D,FA,K

6. Cholesterol–lowering:CoQ10,Omega3fattyacids,carnitine

7. Antibiotics:Bvitamins,vitaminK

8. Oral Contraceptives: B vitamins, Mg, FA, Se, Zn, Tyrosine, SEROTONIN, elevated

homocysteine

B. SupplementBenefits

1. Neverhavetorevealtoinsurancecompany

2. Lessexpensive

3. Generallysignificantlyfewersideeffects,butnotNOsideeffects

4. Someeffectiveformildtomoderateproblems

5. Generally,haveincreasedcompliance

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C. SupplementProblems

1. Maybemoreexpensivebecausetheyarenotusuallycoveredbyinsurance

2. Manyarenotawareofpotentialsideeffects

3. Qualitycontrol/standardizationissues

4. Consultantmaybeclerkatthegrocerystore

5. Fewerstudiesasitishardtomaintainpatentsontheseproducts

D. RecommendationsforAll

1. Multiplevitamin

2. Morefishoromega3fattyacidsupplement

3. TestandoptimizeVitaminDlevel

4. Then,issuespecificstrategies

E. MultipleVitamin

1. Mostpeopledonoteatfiveservingsoffruitsandvegetablesaday

2. 1998NEJM,“Eatrightandtakeamultiplevitamin”

3. 2002 JAMA, “IT appears prudent for all adults to take vitamin supplements for

preventionofchronicdiseases.”

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4. MV – Placebo controlled trial of 215men – significant improvement in perceived

stress,generalhealth,vigorafter33days

F. NeuroVitePlus

1. 50brainsupportingnutrients

• IncludingALC,ALA,PS,CoQ10

2. CompleteMV/mineralcomplex

3. HighBvitamins,B6,B12,5MTHF

4. 2,000IUsVitaminD

5. Phytonutrients – blueberries, spinach, tomato, apple, broccoli, 2 glasses of wine

(withoutalcohol)

6. Digestiveenzymes

G. Omega3s

1. LowLevels

• HeartDisease

• Strokes

• Depression

• Suicidalbehavior

• ADHD

• Dementia

• Obesity

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2. Benefits

• Heart

• Skin

• Eyes

• Joints

• Brain

• Decreaseappetiteandcravings

• 2-3gramsaday

3. Sample/Omega3Studies–HigherEPAforADHDandDepression

• Stevens1995,Burgess2000,lowinADD

• Stoll1999,longerremissionsintreatedBP

• Nemets2002,1-4gpositiveaddoneffect

• Peet2002,1gEPAhelpfulindepression

• Zanarini2003,helpinBorderlinePD

• Su,2003,addonMDDimprovedresponse

• Frangou2006,1gEPAhelpfulinbipolar

• Su2008,helpfulindepression+pregnancy

• Jazaveri2008,1gEPA=fluoxetine,bothbettertogether

• Amminger2010,1.2gdecreasedpsychosisinvulnerable

• Mossabeh2014,1.2gdecreaseriskofpsychosisonvulnerablepatientsby12

weeks

• Amminger2007,1.5ghelpfulforautism

4. Omega3Power

• Highlypurified

• Independentlytested

• 2.8gfishoilin2capsules

• 60/40EPAtoDHAratio

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• Nofishburps

• Onlytwoplantsintheworldwiththispurity

H. VitaminD

1. LowLevelsofVitaminD

• 2/3ofAmericans

• Depression–depletesserotonin

• Alzheimer’sdisease

• MS–replacementhelpspreventrelapse

• Heartdisease

• Diabetes

• Cancer

• Obesity

• Interfereswithsenseoffullness

2. GivingVitaminD

• 25hydroxy-vitaminD

• Normalbetween30-100ng/dl

• Optimalbetween50-90ng/dl

• GiveVitaminD3 if levels low and retest level so you optimize it and don’t

overdoit.

• Universal risk factor for multifactorial diseases, such as diabetes, heart

disease,strokes,canceranddementia

II. BrainTypeHelp

A. Impulsive

1. Focusandenergy

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2. Boostdopamine

• Greentea

• Ashwagandha

• Rhodiola

• Ginseng

B. Compulsive

1. SerotoninMoodSupport

2. Boostserotonin

• 5HTP

• Saffron

• Inositol

• B6

C. ImpulsiveandCompulsive

1. FocusandEnergy

2. SerotoninMoodSupport

III. Nutraceuticals

A. Nutraceuticals–DepressionwithEvidence

1. ALevel–St.John’sWort,SAMe,Sage(musictherapy)

2. BLevel–5HTP,omega3s,saffron,DHEA

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• Folate,folinicacid,5MTHF

• N-acetyl-cysteine(NAC)

• Hypnosis,yoga,psychotherapy,aromatherapy

3. 5HTP

• Depression,cerebellarataxia,fibromyalgia,obesity,headaches

• BLevel

• Dose50–150mgtwiceadaywithmeals

• Insomniadose100-300mgabedtime

• 15 studies have evaluated the clinical effects of 5-HTP on depression –

285/511patientsimproved

• Oraladminassociatedwith30%in5HIAAinCSF

4. SAMe–s-adenosyl-methionine

• Depressionandpainsyndromes

• BLevel,movingclosertoA

• Dose400-800mgtwiceaday

• 26studiesfordepression,11RDBC>1050pts

• Watchbipolarpatientscarefully

• SEmorestimulating(insomnia,anxiety)

• Equallyeffectivetotricyclics,fewersideeffects

• AJP2010enhancedtreatmentinresistantpatientsonSSRIandwelltolerated

5. Folate(B9),FolinicAcid,5-MTHF

• BLevel

• CheckMTHFRgene

• If present add 800mcg folate, 7.5mg 5-MTHF, 15-30mg folinic acid (avoid

highdosefolate,maydecreasenaturalkillercells)asaugmentationstrategy

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• Strongerresponseinwomen

• Folate depletion caused by anticonvulsants, birth control pills, metformin,

lithium,methotrexate,smoking,alcoholism,poordiet

6. Saffron(Crocussativus)

• Spice,traditionalPersianremedyfordepression

• C/Blevel–encouragingresultsindiverseareas

• Dose30mg/d

• Twodoubleblind randomizedplacebo controlled studies positive (n=80); 3

DBRC(fluoxetine20mg,imipramine100mg)studiesshowedequalefficacy)

• PositivestudyforPMS(DBPC)andageassociatedmemoryproblem

• CounteractssexualsideeffectsofSSRIs(DBPC)

• Reducessnacking(DBPC)

• Helpsinsulinsensitivity

B. Nutraceuticals–AnxietywithEvidence

1. Elevateddaytimecortisol–Relora1capTID

2. Elevatedeveningcortisol–PS300-1,000mgHS

3. ALevel–Kavakava–avoidduetosafetyconcerns(musictherapy)

4. BLevel

• St. John’s Wort (somatoform disorder), 5HTP, Inositol (panic disorder and

OCD)

• Meditation,hypnosis,acupressure,yoga,aromatherapy)

5. Consider–L-Theanine,Relora,HolyBasil

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6. Anxious:EverydayStressRelief

7. Neurolink:GABA,5HTP,L-tyrosine

8. NAC–n-acetyl-cysteine

• Oxidativestressandabnormalglutathioneseeninmanypsychiatricillnesses

(depression,bipolar,schizophrenia)

• Lithiumandvalproatebufferoxidativedefenses

• NACshowntoincreaseglutathionelevels

• Showntoimprovepositiveandnegativesymptomsinschizophrenia

• Betterthanfluoxetinefortrichotillomania

• Decreasecravingsforcocaine,alcohol,gambling,marijuana

• Reduceddepressioninbipolardepressed

• Dose1,200–2,400mgaday

9. CravingControl:NotjustforFoodCravings

C. Nutraceuticals–SleepwithEvidence

1. ALevel–Melatonin–jetlag,initialinsomnia

2. BLevel–Musictherapy,taichi

3. Alsoconsider:Magnesiumglycinate

4. Restfulsleep:TheHammer

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D. Nutraceuticals–MemoryEnhancement

1. ALevel–Gingko,Sage

2. BLevel–HuperzineA

• VInpocitine

• Acetyl-l-carnitine

• Phophatidylserine

• Omega3s

3. BrainandMemoryPowerBoost:Mindthegapofyourmind

E. BrainPowerBasics

1. NeuroVitePlus

2. Omega3Power2.8g

3. BrainandMemoryPowerBoost–4

4. 2Highqualitystudies(Doubleblind,placebocontrolledtrials)

• Significantimprovement

• Overallcognitivefunction

• Memory

• Reasoning

• Processingspeed/accuracy

• Executivefunction

• Mood

• Emotionalidentification

• Lowerhostility

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• Lowersomatization

• Lossobsessiveness

F. AdditionalSupplements

1. BrainPowerMax

• NeuroVitePlus

• Omega3Power5.6g

• BrainandMemoryPowerBoost–6

• NFLstudy

2. BrainHealthyChocolate

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BHC108:

BoostingBrainReserve

DanielAmen,M.D.

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Summary

Forthosewhowanttohaveahealthybrain,therearemanythingsthatcanbedonetoboost

brainreserves,startingwithbrainenvy.Inordertoachieveahealthybrain,youhavetowanta

healthybrain. Inthispresentation,Dr.Amenwilldiscussthingstoavoidandthingstopursue

whenworking to improveyourbrainhealth.Ultimately,brainhealth is achievableas longas

you focuson the goal, avoid the things thatwill hurt yourbrain, andworkonmaintaining a

healthydietandexercise.

LearningObjectives

1. Participantswillrecognizetheimportanceofbrainenvy

2. Participantswillidentifywhattoavoidwhenseekingtomaintainbrainhealth

3. Participantswillexplorenaturalwaystoboosthormones

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I. BrainEnvy

A. BrainExcellence

1. SPECT

2. Braintypequestionnaire

3. qEEG

4. WebNeuro

5. Microcog

B. Motivation

1. Whydoyouwanttobehealthy?

2. Whydoyouwantagreatbrain?Writeitdownandlookatiteveryday

• Havegreatenergy

• Befocused

• Getreallyhealthy

• Makegreatdecisions

• BemybestforthoseIlove

3. AnchorImages

• Thebrainis50%visual.

• Findtheimagethatimmediatelyremindsyouwhyyouneedtobehealthy.

C. PracticalNeuroscience

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II. AvoidBad

A. AvoidAnythingThatHurtsYourBrain

1. Braininjuries

2. Drugs&alcohol

3. Obesity

4. Toxins

5. AGEs

6. Insomnia/sleepapnea

7. Nicotine/highcaffeine

8. Diabetes,highbloodpressure

9. Lowhormones

10. Infections

11. Cancerchemotherapy

12. Processeddiet/sugarSAD

13. Chronicstress

14. Untreateddepression,ADD,PTSD,anxiety,OCD,bipolardisorder

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15. Lackofexercise

16. Poordecisions

17. Unhealthypeergroup

18. Notknowingyourownbrain’svulnerability

B. Alcohol

1. Carbohydratewithoutanynutritionalvalue

2. Sevencalories/gram(asopposedtomostat4/gram)

3. Fattyliver

4. Damagesneurons,cerebellum

5. InterfereswithabsorptionofB1

6. Peripheralneuropathy

7. Disinhibition

8. Sleepdisturbance

9. Predispositiontosugarabuse

10. Simulatesappetite,prolongsmealduration,continuedeatingevenwhenfull

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11. Alcohol exerts substantial influence on pancreatic microcirculation by evoking a

massiveredistributionofpancreaticbloodflowfromtheexocrineintotheendocrine

(insulin –producing) part via mechanisms mediated by nitric oxide and the vagal

nerve,augmentinglatephaseinsulinsecretion,andtherebyevokinghypoglycemia1

C. Caffeine

1. Constrictsbloodflowtothebrain

2. Increasescortisol

3. Interfereswithsleep

4. Addictive

5. Decreasesadenosine

6. Increaseswhitematterhyperintensities2,3

7. Decreasesriskofdiabetes

D. EnvironmentalToxins

1. Pollution

2. Aluminum

3. Arsenic

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4. Cadmium

5. Lead

6. Mercury

7. Carbonmonoxide

8. Bismuth

9. Organophosphates

10. Pesticides,AgentOrange

11. PCBs

12. Phthalates

13. BPAs

14. Volatilesolvents

15. Mother’ssmokingordrinking,drugabuse

E. Infections

1. Meningitis

2. Encephalitis

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3. HIV/AIDS

4. Syphilis

5. Herpes

6. Lyme,Borreliosis

7. H.Pylori

8. EpsteinBarr

9. Rubella,measles,mumps

10. Mold–aspergillus

11. Fungal–candida

12. Parasites–toxoplasmosisgondii(increasesuiciderisk)4

13. Chronicfatigue

III. DoGood

A. BrainHealthyHabits

1. Gooddecisions

2. Positivepeergroup

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3. Cleanenvironment

4. Physicalhealth

5. Healthyweight

6. 7-8hoursofsleep

7. Newlearning

8. Greatdiet

9. ANTkilling

10. Stressmanagement

11. Exercise

12. Simplesupplements,suchasmultiplevitamin,omega3,vitaminD

B. Hormones

1. Estrogen

• Toomuch–feelanxiousandirritable

• Toolittle–depressedandconfused

2. Progesterone

• Brain’snaturaltranquilizer

• Lowlevelsassociatedwithanxietyandinsomnia

• Drops~10yearsbeforemenopause

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3. Testosterone

• Libido,moods,andmemory

• Toolow–depressed,foggyheaded,lowlibido

• Toohigh–facialhair,lessempathy,andalwaysthinkingofsex

4. Thyroid

• Involvedwithmetabolism

• Toolittle–feellikeaslug

• Toomuch–anxiousandfrazzled

• 1/3ofalldepressionsrelatedtothyroidimbalance

5. Insulin

• Bloodsugarregulation

• Lowbloodsugar–foggyandslow

• Highbloodsugar–causesbloodvesselstobecomebrittleandbreak

6. Cortisol

• Stresshormone

• Needitforacutestress

• High levelsover timedamageyourbrain,put faton yourbelly, andmakeyou

sick

IV. NaturalWaystoBoostYourHormones

A. GetYourNutritionRight

1. Increasefiber

2. Eliminatesugarandfoodsthatquicklyturntosugar

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3. Avoidmeatsraisedwithhormonesandantibiotics

B. MakeSureYourBodyisCleanofToxins

1. Eatorganic

2. Limitexposuretoplastics

C. LosetheExcessWeight

1. Fatstorestoxins

2. Transformshealthytestosteroneintounhealthyestrogens

3. Disruptsfertility,makesmenopauseharder

4. Increasedweightdecreasesbrainsize

D. ExerciseisCritical

1. Balancesinsulin,testosterone,andcortisol

2. Helpsdepression

3. Coordinationexercisessuchasdancingandtabletennis

4. Strengthtraining

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E. TargetedBrainSmartSupplements

1. PMS–B6,magnesium,andcalcium

2. Hotflashes–fishoil

3. Zinccanhelpraisetestosteronelevels

4. Chromiumandcinnamoncanhelpstabilizebloodsugarlevels,and

5. L-theaninefromgreenteacanhelplowerstresshormones

Endnotes1ZhenHuangandAkeSjoholm.Ethanolacutelystimulatesisletbloodflow,amplifiesinsulinsecretion,andinduces

hypoglycemiaviaNOandvagallymediatedmechanisms.Endocrinology(2008);149:232-2362DagerSR,Friedman,SD.Brainimagingandtheeffectsofcaffeineandnicotine.AmMed2000Dec;32(9):592-9.3NehligA,ArmspachJP,NamerIJ.(2010).SPECTassessmentofbrainactivationinducedbycaffeine:noeffecton

areasinvolvedindependence.DialoguesClinNeurosci.;12(2):255-634PedersenMG,MortensenP,Norgaard-PedersenB,PostolacheTT. (2012)Toxoplasmagondii InfectionandSelf-

directedViolenceinMothers.ArchGenPsychiatry69(11):1123-1130.doi:10.1001/archgenpsychiatry.2012.668.

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BHC109:

PhysicalExercise

DanielAmen,M.D.

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Summary

Today’sworld isaworldofobesityandapathy.Thesedentary lifestyleofmanyAmericans is

incrediblydamagingtothebrain.Physicalexerciseiscrucialtoahealthylifestyle,andahealthy

brain. There are many benefits of exercise, cognitively, physically, and emotionally. In this

module,Dr.Amendescribes thepositive effects of energyonmental health and the various

otherbenefitsthatregularexercisecanhaveonthebodyandbrain.Likemostthings,exercise

is best in moderation. Dr. Amen provides guidelines as to what forms of exercise aremost

beneficialandhowpeoplecangetthebestresultsforoptimumhealth.

LearningObjectives

1. Participantswilldescribethephysicalbenefitsofexercise

2. Participantswillunderstandhowexercisebenefitsthebrain

3. Participantswillcompareandcontrastdifferentformsofexercise

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I. PhysicalExercise

A. ChangeYourExercise,ChangeYourBrain

1. Cognitiveabilitiesarebestinthosewhoexercise

2. Itimprovesbrainbloodflow

3. Itimprovesoxygenandglucosesupply

4. IncreasesinDNAcellrepair

5. Protectbrainagainstthingsthathurtit,suchasfreeradicals,highglucoselevels,and

highglutamatelevels

B. Exercise

1. Afterage70,memoryandothercognitiveabilitiesarelesslikelytobeimpaired

2. Improvesbrainmetabolismofcholesterolandotherlipids

3. Improvesinsulinabilitytoregulateglucose

4. Neuronresponsetostressisimproved(especiallyinthehippocampus)

5. ToneinbloodvesselsisimprovedbecauseNitricOxideisenhanced

6. Lowersbloodsugar

7. Increasesinsulinsensitivity

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8. Helpsreverseinsulinresistance

9. One study found that 40%ofwomenwere no longer insulin resistant after just a

weekofmoderateexerciseofwalkingorcyclingforanhoureachday

10. Increases:

• Brainhealth

• Metabolism

• Vitality

• Agility

• Bonedensity

• Senseofwell-being

• Longevity

• Sexiness

11. Decreases:

• Newfatcells

• Inflammation

• Weight

C. PositiveEffectsonMentalHealth

1. Improvescognitivefunction

2. Enhancepsychologicalwell-being

3. DecreaserisksofAlzheimer’s(AD)&dementia

4. Promoteseffectsofantidepressantsandanxiolytics

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5. Increaseneurotransmittersafferenttohippocampus,includingNE,S,Ach,GABA

6. Up-regulatesBDNFandneurogenesis1

7. Exercise increases average longevity of female rats despite increased food intake

andnogrowthretardation.

• Results show exercise improves average longevity of rats independent of

decreasedavailabilityofenergyforcellproliferationandgrowth.

• Also provide evidence that an increase in food intake is not harmfulwhen

balancedbyanincreaseinenergyexpenditure.2

D. ButNotTooMuch

1. What’sreallyimportantwithexerciseisnottoomuch.Youcanoverdoit.

2. DNAdamageafterexhaustivetreadmillrunningintrainedanduntrainedmen

3. DNAdamageinwhitebloodcellsfollowingexhaustiveexercise3

4. Inducedbyoxidativestress?

II. TypesofExercise

A. Tabletennis

1. World’s2ndmostpopularsport

2. Aerobicchess

3. Lowbraininjuries

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4. Upperandlowerbodycoordination

5. Cerebellaractivities

B. SevenReasonstoPlayTableTennis

C. Walking

1. AstudycomparedZoloftandwalkingfoundthatwalkinglikeyouarelate45minutes

fourtimesaweekhadanantidepressanteffect.Attheendof12weeks,theywere

equallyeffective.Attheendof10months,exerciseasmoreeffective.

2. Walklikeyouarelate45minutesfourtimesaweek.

3. Liftweightstwiceaweek.

4. Addcoordinationexercisesonceortwiceaweek.

D. ExerciseCanSaveYourLife

Endnotes1Ma,Q.(2008).Beneficialeffectsofmoderatevoluntaryphysicalexerciseanditsbiologicalmechanismsonbrain

health.NeurosciBull,24(4):265-70.2Holloszy, J.O. (1993). Exercise increases average longevity of female rats despite increased food intake and no

growthretardation.JGerontol.,48(3):B97-100.3Niess,A.M.,Hartmann,A.,Grunert-Fuchs,M,Poch,B,&Speit,G.(1996).DNAdamageafterexhaustivetreadmill

runningintrainedanduntrainedmen.IntJSportsMed.,17(6):397-403.

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BHC110:

BrainHealthyNutritionPrinciples

DanielAmen,M.D.

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Summary

Foodismedicine–orfoodispoison.Yourgutisessentiallyasecondbrain,andwhatyoufeed

yourself impacts yourbody. If yourbody is right, yourbrain is right. In thispresentation,Dr.

Amenprovideshelpfulwaystounderstandnutritionandtakecareofyourbodythroughwhat

youfeed it.Food isessential for life,butwhenpeopleeatthewrongkindsof food, itcanbe

damaging to the body and the brain. Dr. Amen focuses on high quality calories, smart

carbohydrates,“clean foods,”andprovidesanoverviewofhowguthealth impacts thebody.

Propernutritionisfoundationaltoahealthybrain,andthispresentation

LearningObjectives

1. Participantswilldifferentiatebetweenhealthyandunhealthyfoods

2. Participantswillanalyzetheproblemswithsugarandexplorealternatives

3. Participantswillexploretheimportanceofahealthygut

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I. OverviewofBrainHealthyNutrition

A. 12Principles1. Highqualitycalories

2. Water

3. Healthy,cleanprotein

4. Smartcarbohydrates

5. Healthyfat

6. Eatfromtherainbow

7. Brainhealthyherbs/spices

8. Onlycleanfood

9. Checkoutfoodallergies

10. Usingfoodtohealyourmind

11. Typespecific

12. Tips

B. TypicalWesternDiet

1. Badfat,saltandsugar…thinkcheeseburgers,friesandsodas

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2. Associatedwith depression, dementia, ADHD, heart disease, cancer, diabetes and

obesity

3. Promotesinflammation

4. ADHD1

5. Consistsofonly15foods

6. Thinkcheeseburger,fries,andacoke

• Beefpatty

• Lettuce

• Tomato

• Cheese

• Pickles

• Onionsona

• Sesameseedbun

• Sesameseeds

• Mustard

• Mayonnaise

• Ketchup

• Frenchfries

• GiantsizeCola

• You’vegot13andformanyafullday’ssupplyoffat,salt,ANDcalories

7. Wouldyoufeeda$1,000,000racehorsejunkfood?

C. EatingWellisaboutAbundance,notDeprivation

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II. Principle1:ThinkHighQualityCaloriesInVersusHighQualityEnergyOut

A. CaloriesCount

1. Besmartwithyourcalories

2. Calorierichvs.Caloriepoor

B. CalorieRestrictionandLongevity

1. Moststudiedwaytoextendlife

2. Worksbycontrollingtheseprocesses:

• Inflammation(majorcauseofaginganddisease)

• Glucosecontrol

• Glycation(bondingofsugartoprotein)

• Oxidativestress

• Methylation-Detoxification

• DNArepair

3. Goforhighqualitycalories.

4. Makefoodwithyourchildren.

5. Epigenetics:Yourgenesareturnedonorturnedoffbythehabitsthatyouengagein.

6. Weighandmeasureyourcalories.

7. Theaverage50-yearoldmeanneeds2,200caloriesaday.

8. Theaverage50-yearoldwomanneeds1800caloriesaday.

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9. Toloseapoundaweek,eat500caloriesadaylessthanyouneed.

III. Principle2:Water

A. DrinkWaterandNOTTooManyCalories

1. Brainis80%water.

2. Stayawayfromthingsthatdehydrateyou.

• Toomuchcaffeine

• Much alcohol (decreases production of anti-diuretic hormone and increases

urination. Hard liquor is worse than beer [95% water], more concentrated.

Vomiting)

• Diuretics

IV. Principle3:HighQualityProtein

A. HighQualityProtein

1. Proteinstabilizesyourbloodsugar.

2. MakeitCLEAN(hormonefree,antibioticfree,freerange,grassfed)

3. Fishandlambforomega3s

4. Turkeyandchicken

5. Beans

6. Rawnuts

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7. Highproteinveggies

8. Broccoliandspinach

V. Principle4:SmartCarbohydrates

A. SmartCarbohydrates

1. Lowglycemic,highfiber

2. Carbsthatdonotraiseyourbloodsugar

3. Highinfiber(vegetablesandfruits,suchasblueberriesandapples)

B. Fiber

1. Fiberdecreasesghrelin

2. Feelfullfasterandlonger

3. Slowsabsorptionoffood

4. Reducescholesterol

5. Keepsyourdigestivetractmoving

6. Reduceshighbloodpressure

7. Reducestheriskofcancer

8. 25-35gramsaday

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C. SugarisNOTYourFriend

1. Americanseatanaverageof150poundsofsugarperyear

2. 14typesofsugarinone“healthbar”

• Sugar

• Molasses

• Carmelcolor

• Barleymalt

• Cornsyrup

• Cornsyrupsolids

• Highfructosecornsyrup

• Honey

• Sorbitol

• Fructose

• Canejuicecrystals

• Maltose

• Fruitjuiceconcentrate

• Maltodextrin

3. Refinedsugaris99.4to99.7%purecalories–novitamins,minerals,orproteins,just

carbohydrates2

4. Voidofmineralsneededforenzymes

5. Causeachromiumandcopperdeficiency3

6. Interfereswithcalciumandmagnesium

7. Increasesinflammation

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8. Increaseserraticbraincellfiring

9. Implicatedinaggression

10. AssociatedwithADHDandhyperactivity4

11. Increasedtriglycerides,lowerHDL,raiseLDL5

12. Feedcancercells

13. Increase“slowbrainwaves”

14. Depression

15. Makes you dumb – alters learning and memory, but adding omega-3s can help

minimizethedamage6

D. HiddenSugar

1. Alcoholicbeverages

2. Almosthalfofcaloriesinketchups

3. Inmostluncheonmeats

4. Breadingonmanyproducts

5. Moststoreboughtbreads

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6. Saladdressingsfrequentlycontainsugar

7. Oftenaddedtohamburgerstopreventshrinkage

8. Infastfoodgrilledchicken

E. Top20CarbohydratesintheU.S.

AccordingtotheHarvardNurses’HealthStudy

1. Potatoes

2. Whitebread

3. Breakfastcereal

4. Darkbread

5. Orangejuice

6. Banana

7. Whiterice

8. Pizza

9. Pasta

10. Muffins

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11. Cookies,pastries

12. Otherfruitjuices

13. Coca-Cola

14. Apple

15. Skimmilk

16. Pancake

17. Tablesugar

18. Jam

19. Frenchfries

20. Candy

F. Hypoglycemia

1. Presentinviolentoffenders,arsonists7,8,9

2. Alcoholic, impulsive offenders with intermittent explosive disorder had lowmean

CSF5-HIAAconcentrationandbloodglucosenadirafterglucosechallenge10

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3. Symptomsofhypoglycemia

• Feelingsleepy/drugged

• Mentalconfusion

• Inabilitytoconcentrate

• Impairedmemory

• Dizzy,light-headed

• Nervousness

• Depression

• Irritability

• Blurredvision

• Anxiety/panicattacks

• Palpitations

• Shakyhands

• “Butterfliesinstomach”

• Flushing/sweating

• Faintness/fainting

• Frontalheadache

• Insomnia

• Abdominalpain/diarrhea

G. KillMostSugar

1. RobertLustig,MD,UCSFPediatricEndocrinology

2. Sugarisaddictive

3. It is PRIMARY cause of obesity, hypertension, heart disease, cholesterol problems

anddiabetes,allofwhichcausebraindamage

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4. AverageAmericaneats141lbs.ofsugarayear

5. Fructoseprocessedinliverlikealcohol

6. 90minuteYouTubevideoworthwatching:Sugar,theBitterTruth

H. SugarSubstitutes

1. Aspartame

• Phenylalanine+asparticacid

• PKUcannotuse

• Destroyedbyheat

• 200xsweeterthansugar

• Associatedwithdizziness

• Disorientation

• Elevatedliverenzymes

• Arthritis/muscleaches

• Lossofbalance

• Numbness

• Highbloodpressure

• ADD/ADHD

• Hives

• Memoryloss

• Headaches

• Seizures

2. Sucralose

• Startedoutasapesticide

• ClosertoDDTthansugar

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• Splendaisnotnatural.

• 600xsweeterthansugar

• Starts as a sugarmolecule and has three of its components removed and

replacedwithchloride.

• Providesnocaloriesbecausethebodydoesnotrecognizeitasfood.

3. Honey

• Containssmallamountsofvitaminsandminerals

• Glycemic indexofabout73 (slightlyhigher thansucrosebecausesucrose is

halffructoseandhoneyisabout40%fructose).

• 20-60%sweeterthansugar

4. Saccharin

• Hasbeenusedforover100years

• Studiesaremixedonwhetheritisacarcinogen

• 200xsweeterthansugar

• In 2000, determined that the link between bladder cancer in ratswas not

associatedtohumans

• Therearebetteroptions

5. Stevia

• Steviaisextractedfromaleaf

• Noknownsideeffects

• Doesnotraiseglucoseorinsulinlevels

6. Xylitol

• Naturallyoccurringsweetcompound,fruits/veggies

• Supplementsmadefromfiberofthebirchtree

• Maydecreasedentalcariesandbuildupofplaque

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• Increasessatiety

• 40%lesscaloriesthansugar,2.4calories/gram

• 7glycemicindex,littleeffectonbloodsugar/insulin

• Bodyproducesupto15gramsofxylitolperday

• Sugar alcohols incompletely absorbed in the intestines, so it may have a

laxativeeffect,especiallyinlargequantities

7. Othersugaralcohols:erythritol,sorbitol,mannitol,isomalt

VI. Principle5:HealthyFats

A. EliminateBadFats

1. Alltrans-fats(readthefoodlabels)

2. Uncleananimalfat

B. FocusonHealthyFats

1. EspeciallyOmega3s

2. Salmon,avocados,walnuts,andgreenleafyvegetables

C. Cholesterol

1. Highcholesterolisnotgoodforyourbrain

2. Verylowfatdietsarenotgoodforyourbraineither

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3. Lowcholesterolassociatedwith:

• Antisocialpersonalitydisorder

• Violence

• Suicide

• Childhoodonsetconductdisorder

• 250Finnishoffenders–8xmorelikelytodieofunnaturalcauses11

D. DoesFishMakeYouSmarter?

1. C.Raji,2011,n260

2. Askedpeoplehowmuchfishtheyate

3. 10yearslater,MRIsandcognitivetesting

4. Peoplewhoatebakedfishatleastonceaweek

5. Greater amounts of gray matter in three key areas: hippocampus, posterior

cingulate,orbitalfrontalcortex,performedbetterontests

6. 5xreducedriskofAlzheimer’sdiseaseorMCI12

E. Seafoodwatch.orgFishChoices

1. Bestfishchoices:

• Abalone(USf=farmed)

• ArcticChar(f)

• Barramundi(USf)

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• Catfish(USf)

• Clams,Mussels,Oysters(f)

• Cod:Pacific(USnon-trawled)

• Crab:Dungeness

• Halibut:Pacific(US)

• Lobster:CaliforniaSpiny(US)

• Rockfish:Black(CA,OR,WA,hook&line)

• Sablefish/BlackCod(Alaska&Canada)

• Salmon(Alaskawild)

• Sardines:Pacific(US)

• Scallops(f)

• Shrimp:Pink(OR)

• SpotPrawn(Canada)

• Stripedbass(f&wild*)

• Tilapia(USf)

• Trout:Rainbow(USf)

• Tuna:Albacore(Canada&USPacific,troll/pole)

• Tuna:Skipjack,Yellowfin(UStroll/pole)

• WhiteSeabass(hook/line)

2. Goodfishchoices*Nottoomuchduetomercuryconcerns

• Caviar,Sturgeon(USf)

• Clams,Oysters(wild)

• Cod:Pacific(UStrawled)

• Crab:King(US),Snow

• Flounders,Soles(Pacific)

• Halibut:California*

• Lingcod*

• Lobster:American/Maine

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• MahiMahi(US)

• Pollock:Alaska(US)

• Rockfish(Pacifichook/line)

• Sablefish/BlackCod(CA,OR,WA)

• Salmon(CA,OR,WA*,wild)

• Sanddabs(Pacific)

• Scallops(wild)

• Shrimp(US,Canada)

• SpotPrawn(US)

• Squid

• Swordfish(US)*

• Tilapia(Central&SouthAmericaf)

• Tuna:Bigeye,Tongol,Yellowfin(troll/pole)

• Yellowtail:California(US,wild)

3. Avoidfishchoices*Nottoomuchduetomercuryconcerns

• Caviar,Sturgeon*(imported)

• ChileanSeabass/Toothfish*

• Cod:Atlantic(Canada&US)

• Cod:Pacific(imported)

• Cobia(f)

• Crab:King(imported)

• Dogfish(US)*

• Grenadier

• Lobster:Spiny(Brazil)

• MahiMahi(imported)

• Marlin:Blue,Striped(Pacific)*

• Monkfish

• OrangeRoughy*

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• Rockfish/“PacificSnapper”(trawled)

• Salmon(f,includingAtlantic)*

• Sharks*

• Shrimp(imported)

• Swordfish(imported)*

• Tilapia(Asiafarmed)

• Tuna:Albacore*,Bigeye*,Skipjack,Tongol,Yellowfin(excepttroll/pole)

• Tuna:Bluefin*

• Tuna:Canned(excepttroll/polecaught)

VII. Principle6:EatFromtheRainbow

A. EatFromtheRainbow

1. Foodsofmanydifferentcolors

2. Boostantioxidantlevels

3. Helpkeepbrainyoungandhealthy

4. Antioxidantstatusassociatedwithdepression13

B. AntioxidantsandMentalHealth

1. Oxidativestressplaysaroleinmajorpsychiatricdisorders,includingdepression14

2. ReactiveoxygenspeciesmodulateneurotransmittersNE,S,DA,glutamate

3. Depressionassociatedwithlowerantioxidants,suchascompounds,suchasvitamin

E,zinc,andCoQ10

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4. NAChelpsdepressioninRPCstudies

5. Curcuminantidepressantactivityinanimalmodels

6. Antioxidantrichfoods(ORAC:OxygenRadicalAbsorbanceCapacity)

• Cloves:290,000

• Oregano:175,000

• Rosemary:165,000

• Thyme:157,000

• Cinnamon:131,000

• Turmeric:125,000

• Sage:120,000

• Acaifruit:02,000

• Parsley:73,000

• Cocoapowder:55,000

• Raspberries:19,000

• Walnuts:13,000

• Blueberries:9,600

• Artichokes:9,400

• Cranberries:9,000

• Kidneybeans:8,600

• Blackberries:5,900

• Pomegranates:4,400

VIII. Principle7:BrainHealthyHerbsandSpices

A. CookingwithBrainHealthyHerbsandSpices

1. Garlicandoreganoboostbrainbloodflow

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2. Saffronhasantidepressanteffects

3. Curcumindecreasesbetaamyloidplaques

4. Rosemary,thyme,sageenhancememory

5. Cinnamonboostsattention,aphrodisiacformen

6. Ginger, cayenne, blackpepper – hot/spicy fromgingerols, capsaicin, andpiperine,

compoundsthatboostmetabolismandaphrodisiaceffect

IX. Principle8:MakeSureFoodisClean

A. CleanFoods

1. Avoidtoxicfoodsasmuchaspossible.

2. Artificial colors and sodium benzoate increased ADHD symptoms (2007

SouthamptonUniversityStudy).15

3. Meta-analysisof15double-blindclinicaltrialsthatevaluatedartificialfoodcoloring

inchildrenalreadyconsideredtobehyperactiveshowedanincreaseinhyperactive

behavior.16

B. PesticideResidues

1. 14foodswiththehighestlevelsofpesticideresidues(buyorganic)

• Celery

• Peaches

• Strawberries

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• Apples

• Blueberries

• Nectarines

• Cucumbers

• SweetBellPeppers

• Cherries

• CollardGreens/Kale

• Potatoes

• Grapes

• GreenBeans

2. 17foodswiththelowestlevelsofpesticideresidues(don’tnecessarilyneedorganic)

• Onions

• Avocado

• SweetCorn(Frozen)

• Pineapples

• Mango

• Asparagus

• SweetPeas(frozen)

• KiwiFruit

• Bananas

• Cabbage

• Broccoli

• Papaya

• Mushrooms

• Watermelon

• Grapefruit

• Eggplant

• Cantaloupe

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X. Principle9:CheckOutFoodAllergies

A. GlutenSensitivity

1. Cancauseloweroverallperfusioninthebrainandschizophrenicsymptoms

2. Drasticreduction,ifnotfullremission,ofschizophrenicsymptomsafterinitiationof

glutenwithdrawalhasbeennotedinavarietyofstudiesinasubsetofschizophrenic

patients17

3. ImprovedADHDsymptomsinasubsetofpatients18

4. Associatedwithcerebellarabnormalities

5. 40%ofidiopathicsporadicataxia19

6. Intractableseizuresandhippocampalatrophy20

B. SchizophreniaandGIInflammation

1. Immune factors (pathogensand foodantigens) cross gutbarrier and implicated in

braindisorders

2. GIinflammationassociatedwithschizophrenia21

3. Milk,glutenexorphins

4. IgG antibodies to Saccharomyces cerevisiae (ASCA, a marker of intestinal

inflammation)

5. Casein,gluten,6infectionsagentsassayed

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6. 264schizophrenicsvs.207non-psychiatriccontrols

7. ASCAmarkerssignificantlyelevatedinpatients(p<0.0001–0.004)

8. Anti-food antigen antibodies correlated to antibodies against Toxoplasma gondii,

particularlyinmaleswithrecentonsetschizophrenia(p<0.002)

9. GIinflammationrelevantinschiphrenia22

C. CaseofGlutenSensitivity

1. A33-year-old“schizophrenicpatient”

2. Diarrheaandweightloss

3. SPECTHypoperfusionleftfrontalarea

4. Glutensensitivitydiagnosed

5. Gluten-freedieteliminatedpsychiatricsymptoms23

D. BreadismyCrack!GlutenandAddiction

1. Glutenandcaseinexposedtopepsin&HCLdegradetopolypeptides(exorphins)and

crossthebloodbrainbarrier24

2. Bindtoendorphinreceptors,mildeuphoria

3. Effectblockedbynaltrexone25,26

4. Withdrawalsymptoms

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XI. Principle10:UsingFoodtoHealYourMind

A. FoodasMedicine

1. EliminationdietfoundhelpfulforADHD

2. 73%improvedvs.0%incontrolledgroup27

3. Ketogenicdietinepilepsy

4. Helpfulformanychildrenandadultswithmanydifferentseizuretypes,including:28

• Infantilespasms

• Myoclonicepilepsy

• Febrileinfectionsepilepsy

• 2/3withseizurereductionatsixmonths

• Alzheimer’s,ALS,autismbeingstudied

5. Mediterraneandiet<depressionanddementia

6. Healthydietassociatedwithlowerriskofdepression29

7. Dietandphysicalactivityassociatedwithlowerriskofdementia30

B. PowerfulAnti-InflammatoryPlantChemicals

1. SulforaphanesfromBroccoli

2. CurcuminfromCurry

3. CarsonolinRosemary

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4. Garlic

5. GreenTea

6. KahewolinCoffee

7. Pomegranate

8. SuperFoods:Maca,Cocao,GogiBerries

C. Serotonin

1. Mood stability, sleep regulation, appetite, social engagement, “don’t worry be

happy”

2. Carbohydraterichfoodsthatincreaseinsulin

3. Supplements:5HTP,inositol,saffron,SaintJohn’sWort

4. Foodstoboostmood/serotonin=Carbs

5. TroubledCarbs

• Crackers

• Pancakes/Waffles

• Sweetcereals

• Muffins

• Bagels

• Pasta

• Whiterice

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• Potatoes

• Fruitjuice/sodas

6. SmartCarbs

• Sweetpotatoes

• Brownrice

• Steelcutoatmealw/berries/stevia

• Apples

• Cherries

• Redbellpeppers

• Sweetcorn

• Cantaloupe

D. Dopamine

1. Motivation,emotionalsignificance,relevance, pain and pleasure, “Let’s get it

done”

2. Foundinproteinrichfoodsthatdecreaseinsulin

3. Supplements:DLPA,L-tyrosine,SAMe,Bcomplex,rhodiola,gingkobalboa,ascorbic

acid

4. Foodstoboostfocus/dopamine=Protein

5. Goodsources:

• Beans–lima,lentils

• Meat–fish,lamb,chicken,turkey,beef

• Eggs

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• Cheese

• Nuts

• Seeds(pumpkinandsesame)

• Highproteinveggies–broccoli,spinach

• Proteinpowders

E. Acetylcholine

1. Learning,memory,association,“factpeople”

2. Foundinliver,eggs,lecithin,milk,salmon,shrimp

3. Supplements:cholinesalts,phosphatidylcholine,lecithin

F. GABA

1. Inhibitory,calming,stabilizing,grounding,“listpeople”

2. Foundinwholegrains,bananas,broccoli,nuts,lentils,greentea

3. Supplements:L-theanine,GABA

G. Glutamate/Aspartate

1. Excitability,memory,painperception

2. Foundindietsoda,dairy(cheese),soy,wheat,barley,peanuts

3. Meat(lambandeggsarelowest)

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XII. BrainGutConnection

A. GutisSecondBrain1. Gutisloadedwithnervoustissue

2. Indirectcommunicationwithourbigbrain

3. Whywegetbutterflieswhenexcitedorloosebowelswhenupset

4. Anxiety,depression,stress,andgriefallexpressthemselveswithemotionalpain(the

brain)andquiteoftengastrointestinal(GI)distress

B. TheGut

1. Singleepitheliallayer(likethebrain,largestmucosalsurfaceinbody)31

2. Interfacebetweenexternalworldandhost

3. Initialmetabolism&transformationoffood

4. Structuraldefense(troublewhenthisbreaksdown)

C. MucosalLiningoftheGut

1. Provideslayerofprotectiontoendothelium

2. Madeofglycoproteins–mucin

3. Mucinproductionupregulatedbyprobiotics

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4. Canbe compromised by stress, drug use, diet, environmental chemicals, gut flora

balance,geneticpredisposition

D. YourGutSupportsBrainHealth

1. 100trillionmicro-organisms(bacteria,yeast,andothers)

2. 10xtotalnumberofcellsinthehumanbody

3. Tobehealthy, relationshipof good/badbugsneeds tobe lopsided in thepositive

direction

4. Ahealthyguthas85%goodbugsand15%badbugs

5. Outofbalancebadformentalhealth32

E. GutHealth33

1. Friendlybacteriadetertroublemakers,suchasE-coli,andhelpuswithstandstress

2. If deficient, frompoor diet that feeds yeast overgrowth (think sugar) or excessive

useofantibiotics(eveninchildhood),morelikelytofeelstressed

3. ADD, autism, depression, mental fogginess connected to intestinal bacteria

imbalances

F. GutFlora34

1. Inhabitthesmallandlargeintestines

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2. Anaerobicbacteriaarethemostabundant

3. Probiotic–beneficialbacteriathatservemanyfunctionsinthegut

4. Yeast – candida albicans are also part of normal flora, but should be kept under

controlbygoodbacteria

G. FunctionsofBeneficialFlora

1. MakesvitaminKandbiotin

2. Helpswithdigestion

3. Detoxification(probioticshavebeenfoundtodecreasecoloncancerrisk)

4. Carriersforestrogenoutofthebody

5. Immunemodulation

6. Populationcontrolofpathogens

7. Nutrientabsorptionandmetabolism

H. BeneficialFloraProtection

1. Allergies/Intolerances

2. Hormonalregulation

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3. Probiotic organisms help to synthesize butyrate, a short chain fatty acid that

protectstheGIlining

4. Dysbiotic organisms contribute to the deterioration of the intestinal lining

Yeast/Bacteria/Parasites

5. Butyrateprotectsthecellsoftheintestinefromabnormalgrowth,andmayprotect

againstcoloncancer

I. WhatDecreasesHealthyGutBacteria?

1. Medications

• Antibiotics

• Oralcontraceptives

• Protonpumpinhibitors

• Steroids

• NSAIDS

2. Stress

• Physiological

• Emotional

• Environmental

3. Sugarintake,artificialsweeteners

4. Allergies

5. Toxins–bactericidalchemicalsinH20,pesticides,heavymetals,alcohol

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6. Infections–H.Pylori,parasites

7. Radiation/chemo

8. Highintensityexercise

J. FoodistheGreatestDangertoGutBacteria

1. Thegreatestdangerisnotfromtheantibioticsprescribedbyyourdoctor,butrather

fromthefoodsyoueat

2. Prevalenceofantibioticsfoundinconventionallyraisedmeatsandvegetableshave

potentialtothrowoffthebalanceofgoodtobadbacteria

3. 70%oftotalantibioticuseinU.S.forlivestock

4. Criticaltofocusoneatingantibioticfree,hormonefree,grassfed,freerangemeats

K. AFewGermsCanBeGoodForYou

1. Animals raised in a germ-free environment show exaggerated responses to

psychologicalstress35

2. NeedgoodGIbugstoboostimmunesystem

3. Don’tkeepkidsawayfromdirt

4. Whenresearchersgaveanimalsprobiotics,stresslevelsnormalized

5. Stress,allbyitself,decreaseshealthygutflora

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L. BoostGutFloraEarly?

1. Ifdeficientearlyinlife,causesdecreasedserotonin,maybefortherestofaperson’s

life

2. Atleastinanimalmodels36

M. EarlyAbandonmentIssues

1. Early abandonment issues can cause increased stress, decreased healthy bacteria,

andincreasedgutpermeability

2. Whenyoungratsseparatedfrommothers,celllayersthatlinethegutbecomemore

permeable,allowingbacteriafromtheintestinetopassthroughthebowelwalland

stimulateimmunecellstostartattackingotherorgans.37

3. “In rats, it’s an adaptive response… if born into a stressful, hostile environment,

natureprogramsthemtobevigilantandstressresponsiveinfuturelife.”38,39

4. Upto70%ofpatientstreatedforchronicgutdisordersexperiencedearlychildhood

traumaslikeparents’divorces,chronicillnesses,orparents’death

5. “Whathappensinearlylife,alongwithanindividual’sgeneticbackground,programs

howapersonwillrespondtostressfortherestofhisorherlife.”39

N. CaseT

1. T,grewupinasingleparenthomefilledwithstress

2. Atfour,hermotherwasmurdered

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3. Then,mombringingherinforGIcomplaints

4. Lotsofantibiotics

5. Atnine,startedhavingpanicattacks,especiallywhenmothercamehomelatefrom

work

6. Developedbulimiaasateenwithbadintestinalissues

7. Probioticsandstressreductionhelpfulphysicallyandemotionally

O. Chronic,Fatigue,Gut,andMind

1. Roa(2009)39CFSpatients

2. Threeprobioticdoses/dayorplacebofor2months

3. 73%probioticgrouphadincreasedgoodgutbacteria

4. Correspondedwithsignificantdecreasedanxiety

5. Nochangeinplacebogroup

6. Researchers believed probiotics “crowded out” more toxic gut bacteria linked to

depression

7. “Subjectsfeltlessanxious,calmer,betterabletocope,sleepingbetter,fewerheart

palpitations.”40

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P. FixtheGut

1. Improvediet,nutrientdensity,essentialfattyacids,fiberphytonutrients

2. Eliminatemostsimplesugarsthatfeedbadbugs

3. Supportdigestion:enzymesandHCL

4. Supportnormalflora:preandprobiotics

5. Becarefulwithantibiotics

6. Removeinfectionsandtoxins

Endnotes1Howard,A.L.,Robinson,M.,Smith,G.J.,AmbrosiniG.L.,Piek,J.P.,&Oddy,W.H.(2011)ADHDisassociatedwith

a “Western” dietary pattern in adolescents. Journal of Attention Disorders, 15(5). 403-411. doi:

10.1177/10870547103659902UnitedStatesSugarPolicy:AnAnalysis.(1989).WashingtonDC:USPrintingOffice,43Kozlovsky,A.S.,Moser,P.B.,Reiser,S.,&Anderson,R.A.(1986).Effectsofdietshighinsimplesugarsonurinary

chromiumloses.Metabolism,35(6).515-518.4Goldman,J.A.,Lerman,R.H.,Contois, J.H.,&Udall Jr., J.N. (1986).Behavioraleffectsofsucroseonpreschool

children.JournalofAbnormalChildPsychology,14.565-577.doi:10.1007/BF012605245Scanto,S.,&Yudkin,J.(1969).Theeffectofdietarysucroseonbloodlipids,seruminsulin,plateletadhesiveness

andbodyweightinhumanvolunteers.PostgradMedicalJournal,45(527).602-607.6Agrawal, R., & Gomez-Pinilla, F. (2012). Metabolic syndrome in the brain: Deficiency in omega-3 fatty acid

exacerbates dysfunctions in insulin receptor signaling and cognition. The Journal of Physiology, 590(10). 2485-

2499.doi:10.1113/jphysiol.2012.2300787Virkkunen,M. (1984).Reactivehypoglycemic tendencyamongarsonists.ActaPsychiatricaScandinavica,69(5).

445-52.

BrainHealthCoaching

LightUniversity213

8 Virkkunen,M.,&Huttunen,M.O.(1982).Evidenceforabnormalglucosetolerancetestamongviolentoffenders.

Neuropsychobiology,8(1).30-34.9Virkkunen,M.,Rissanen,A.,Franssila-Kallunki,A.,&Tiihonen,J. (2009).Lownon-oxidativeglucosemetabolism

andviolentoffending:An8-yearprospectivefollow-upstudy.PsychiatryResearch,128(1).26-31.10 Virkkunen, M., Rawlings, R., Tokola, R., Poland, R.E., Guidotti, A., Nemeroff, C., Bissette, G., Kalogeras, K.,

Karonen, S.L., & Linnoila, M. (1994). CSF biochemistries, glucose metabolism, and diurnal activity rhythms in

alcoholic,violentoffenders,firesetters,andhealthyvolunteers.ArchiveofGeneralPsychiatry,51(1).20-27.11Repo-Tiihonen, E., Halonen, P., Tiihonen, J., & Virkkunen, M. (2002). Total serum cholesterol level, violent

criminal offenses, suicidal behavior,mortality and the appearance of conduct disorder in Finnishmale criminal

offenderswithantisocialpersonalitydisorder.EuropeanArchivesofPsychiatryandClinicalNeuroscience,252(1),8-

1112Raji,C.FishMakesYouSmarter.Presented11/2011meetingofRadiologicalSocietyoftheNorthAmerica.13Cumurcu,B.E.,Ozyurt,H.,Etikan,I.,Demir,S.,&Karlidag,R.(2009).Totalantioxidantcapacityandtotaloxidant

statusinpatientswithmajordepression:Impactofantidepressanttreatment.PsychiatryandClinicalNeuroscience,

63(5).639-45.doi:10.1111/j.1440-1819.2009.02004.x14 Scapagnini,G.,Davinelli,S.,Drago,F.,DeLorenzo,A.,&Oriani,G.(2012).Antioxidantsasantidepressants:Fact

orfiction?CNSDrugs26(6).477-490.doi:10.2165/11633190-000000000-00000.15McCann,D.,Barrett,A.,Cooper,A.,Crumpler,D.,Dalen,L.,Grimshaw,D.,Kitchin,E.,Lok,K,.Porteous,L.,Prince,

E.,Sonuga-Barke,E.,Warner, J.O.,&Stevenson, J. (2007).Foodadditivesandhyperactivebehavior in3-year-old

and 8/9-year-old children in the community: A randomized, double-blind, placebo-controlled trial. Lancet

370(9598),1560-67.16Artificialfoodcoloringandhyperactivitysymptomsinchildren.2009.PrescrireInternational,18(103),21517Kalaydjian,A.E., Eaton,W.,Cascella,N.,&Fasano,A. (2006). Thegluten connection: TheAssociationbetween

schizophreniaandceliacdisease.ActaPsychiatricaScandinavica,113(2).82-90.18Niederhofer,H.,&Pittschieler,K. (2006).Apreliminary investigationofADHDsymptomsinpersonswithceliac

disease.JournalofAttentionDisorders,10(2),200-204.19Hadjivassiliou,M., Sanders, D.S.,Woodroofe,N.,Williamson, C.,&Grunewald, R.A. (2008).Gluten ataxia.The

Cerebellum,7(3),494-498.20Peltola,M.,Kaukinen,K.,Dastidar,P.,Haimila,K.,Partanen,J.,Haapala,A.M.,Maki,M.,Keranen,T.,&PeltolaJ.

(2009).Hippocampalsclerosisinrefractorytemporallobeepilepsyisassociatedwithglutensensitivity.Journalof

Neurology,Neurosurgery,andPsychiatry,80(6),626-630.21Severance, E.G., Alaedini, A., Yang, S., Halling, M., Gressitt, K.L., Stallings, C.R., Origoni, A.E., Vaughan, C.,

Khushalani,S.,Leweke,F.M.,Dickerson,F.B.,&Yolken,R.H.(2012).Gastrointestinalinflammationandassociated

immuneactivationinschizophrenia.SchizophreniaResearch,138(1),48-53.22Ibid

BrainHealthCoaching

LightUniversity214

23DeSantis, A., Addolorato, G., Romito, A., Caputo, S., Giordano, A., Gambassi, G., Taranto, C., Manna, R., &

Gasbarrini, G. (1997). Schizophrenic symptoms and SPECT abnormalities in a celiac patient: Regression after a

gluten-freediet.JournalofInternationalMedicine,242(5),421-423.24Zioudrou, C., Streaty, R.A., & Klee, W.A. (1979). Opioid peptides derived from food proteins. The exorphins.

JournalofBiologyandChemistry,254(7),2446-2449.25Cohen, M.R., Cohen, R.M., Pickar, D., Murphy, & D.L. (1985). Naloxone reduces food intake in humans.

PsychosomaticMedicine,27(2)132-138.26Drewnowski, A., Krahn, D.D., Demitrack,M.A., Nairn, K., & Gosnell, B.A. (1995). Naloxone, an opiate blocker,

reduces the consumption of sweet high-fat foods in obese and lean female binge eaters.American Journal of

ClinicalNutrition,61(6),1206-1212.27Pelsser,L.M.,Frankena,K.,Toorman,J.,Savelkoul,H.F.,Pereira,R.R.Buitelaar,J.K.(2009).Arandomizedcontrol

trialintotheeffectsoffoodonADHD.EuropeanChild&AdolescentPsychiatry,18(1),12-19.doi:10.1007/s00787-

008-0695-728Kossoff, E.H.,&Hartman,A.L. (2012).Ketogenicdiets:Newadvances formetabolism-based therapies.Current

OpinioninNeurology,25(2),173-178.29 Sanchez-Villegas Delgado-Rodriguez,M., Alonso, A., Schlatter, J., Lahortiga, F., SerraMajem, L., &Martinez-

Gonzalez,M.A.(2009).AssociationofMediterraneandietanddepression.ArchivesofGeneralPsychiatry,66(10),

1090-1098.doi:10.1001/archgenpsychiatry.2009.129.30Scarmeas,N.,Luchsinger,J.A.,Schupf,N.,Brickman,A.M.,Cosentino,S.,Tang,M.X.,&Stern,Y.(2009).Physical

activity, diet, and risk of Alzheimer Disease. Journal of the American Medical Association, 302(6), 627-637,

doi:10.1001/jama.2009.1144.31 LaValle,J(2012).MetabolicTraidModule28,A4M32Logan,A.C.,&Katzman,M.(2005).Majordepressivedisorder:Probioticsmaybeanadjuvanttherapy.Medical

Hypotheses,64(3),533-538.33Ibid34 LaValle,J(2012).MetabolicTraidModule28,A4M35Dinan, T.G., & Cryan, J.F. (2012). Regulation of the stress response by the gut microbiota: Implications for

psychoneuroendocrinology.Psychoneuroendocrinology.[Epubaheadofprint]36Clarke,G.,Grenham,S.,Scully,P.,Fitzgerald,P,Moloney,R.D.,Shanahan,F.,Dinan,T.G.,&Cryan,J.F.(2012).The

microbiome-gut-brain axis during early life regulates the hippocampal serotonergic system in a sex-dependent

manner.MolecularPsychiatry,18(6),666-73.doi:10.1038/mp.2012.7737Desbonnet, L., Garrett, L., Clarke, G., Kiely, B., Cryan, J.F., & Dinan, T.G. (2010). Effects of the probiotic

Bifidobacteriuminfantisinthematernalseparationmodelofdepression.Neuroscience,170(4),1179-1188.38Brown, H. (August 25, 2005). A brain in the head, and one in the gut. New York Times. Retrieved from

http://www.nytimes.com/2005/08/24/health/24iht-snbrain.html?pagewanted=1&_r=1

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39Brown, H. (August 23, 2005). The other brain also deals with many woes.New York Times. Retrieved from

http://www.nytimes.com/2005/08/23/health/the-other-brain-also-deals-with-many-woes.html40Roa,A.V.,Bested,A.C.,Beulne,T.M.,Katzman,M.A.,Iorio,C.,Berardi,J.M.,&Logan,A.C.(2009).Arandomized,

double-blind, placebo-controlledpilot studyof a probiotic in emotional symptomsof chronic fatigue syndrome.

GutPathogens,1(1).6.

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BHC111:

ScienceofChangeandSelf-Control

DanielAmen,M.D.

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Summary

Youarenotstuckwiththebrainyouhave–youcanmakeitbetter,butyouhavetocareandbe

willing to put the effort into making the necessary changes. In this presentation, Dr. Amen

describestheimportanceofmotivation.Inordertogetwell,youhavetounderstandwhyyou

wanttogetwell.Then,oncethedecisionismade,stepsneedtobetakentostayonthecorrect

path.Friendsplananimportantrole,asdothequalityofthedecisionsthatyoumake.Dr.Amen

alsoprovidessuggestionsandguidanceforgettingcravingsundercontrol.Withmotivationand

willpower,youcanchangeyourbrainandyourlife.

LearningObjectives

1. Participantswillidentifytheimportanceoffindingthepropermotivationforchange

2. Participantswillanalyzethepurposeofaccomplicesandfriends

3. Participantswilldiscernwaystocontrolandeliminatecravings

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I. ScienceofChangeandSelf-Control

A. Overview

1. Brainenvy

2. Avoidbad

3. Dogood

4. Motivation

5. Stickingtoachangeplan

6. Improvethequalityofdecisions

7. Killtheliesthatdrivefailure

8. Breakemotionalconnectiontotoxicpatterns

9. HALT+

B. KeepYourPrefrontalCortexandAnteriorCingulateHealthy

1. AC–letsyouknowwhensomethingisnotright,whenthereisatemptation

2. DL-PFChelpsyoumakegooddecisions

3. DL-PFCbecomesdepletedwhenchallengedtoomanytimes1,2

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C. Motivation:WhyDoYouCare?

1. Knowwhyyoucare

2. Changeoftenrequirespain

3. Writeitdownandseeiteveryday

4. Seeafutureofsuccessandfailure

5. Onepagemiracle

• WhatdoIwant?

• WhatdoIwantinrelationships?

• WhatdoIwantatwork?

• WhatdoIwantwithyourmoney?

• WhatdoIwantwithmyself?

• IsmybehaviorgettingmewhatIwant?

D. ForkintheRoad

1. TroubledPath–Vivid,detailed,believablefutureofpain:

• Decreasedmentalcapacity

• Illhealth,smallerbrain

• Olderappearance

• Lowerincome

• Strainedrelationship

• Alwaystired

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2. BrainSmartPath-Vivid,detailed,believablefutureofhealth:

• Increasedmentalcapacity

• Makemoreofadifference

• Optimalhealth,vitality,longevity

• Youngerappearance

• Moreincome

• Improvedrelationships

E. TemptationsareEverywhere

1. Mostofusareblindandoutnumbered

2. Constantstreamofnegativeinfluences

3. Slick,effectiveadvertising

• Vegas

• Disneyland

• Fastfoodrestaurants

• Airportvendors

• Grocerystorecheckoutcounters

4. Turnbaddaysintogooddata

II. HowtoSticktoaChangePlan

A. Steps:

1. Decidewhatyoutrulywant(motivation)

2. Identifyyourvulnerablemoments(journaling)

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3. Knowwhatyouneedtodo(vitalbehaviors)

4. Turnaccomplicesintofriends

B. TurnAccomplicesintoFriends

1. Bad(andgood)habitsareateamsport

2. Needlotsofaccomplicestostartandsustain

3. Friends,mentorsorcoachessupportyourpositivebehaviors…askfortheirhelp

4. Accomplices encourage your negative behaviors… or are complicit with your

negativebehavior

5. Adding friends improves your chances for success up to 40%, especially true for

addiction

6. NutritionalgatekeeperMUSTbecomeafriend

7. If youwant to change, you need to change your friends or turn accomplices into

friendsorpeoplewithwhomyouspendlittleornotime

8. Many accomplices can change into friends if you have crucial conversations with

them

9. Explainwhattheycanstartdoing,stopdoing,orcontinuedoingtohelp

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III. ImprovetheQualityofYourDecisions

A. ThenWhat?

1. Jose

2. ChrisandSammie

3. Neverletgriefbeyourexcusetohurtyourself

B. AlwaysProtectYourDecision-MakingAbility

1. “Thebestwaytoreducestressinyourlifeistostopscrewingup.”–RoyBaumeister,

Ph.D.

2. Betterdecisionswhen:3

• “Thenwhat?”

• Bloodsugarisstable

• 7-8hoursofsleep

• Littletonoalcohol

• Eliminatetheliesthatdrivefailure

• Why?Youknowyourmotivation

C. TheLittleLiesthatDriveFailure

1. Howyouthinkdramaticallyaffectshowyoufeelandeverydecisionyoumake

2. Theliesyoutellyourselfareoneofthebiggestfactorsthatdriveillness

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3. “Idon’twanttodeprivemyself”

• Doesn’t eating bad food deprive you of your health, your most previous

resource?

• What isworthmore?Energy,a trimwaistline,health; or, themountainof

fries, sodas, cakes, cookies, and the like you have consumed over the last

decade?

4. “Ican’teathealthybecauseItravel.”

• Yesyoucan!

• Itjusttakesforesightandplanning

5. “Mywholefamilyisoverweight;itisinmygenes.”

• Oneofthebiggestlies.Genesaccountforonlyabout20-30%ofyourhealth

• Thevastmajorityofhealthproblemsaredrivenbythebaddecisionspeople

make

• Genessayyou’re likely tobefat,butyoudon’thavetomakethedecisions

thatmakeitlikelytohappen

6. “Ican’taffordtogethealthy.”

• Beingsickisalwaysmoreexpensivethangettinghealthy

7. “Ican’tfindthetimetoworkout.”

• Withasharpermind,youwillactuallysavetimeifyouworkout

8. “It’s Easter, Memorial Day, July 4th, Labor Day, Thanksgiving, Christmas,Monday,

Tuesday,Wednesday,Thursday,Friday,SaturdayorSunday.”

• Thereisalwaysanexcusetohurtyourself

• When you stop believing every thought you have, the quality of your

decisionsandyourhealthwillgowayup

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D. BreakEmotionalConnectionstoToxicPast

1. Patterns from thepastandnegative thinking can try tohijackyourbrainand ruin

yourprogress

2. Peopleoftensaythesmartestthings–youjusthavetoasktherightquestions

3. Observethepatternsfromyourpastthatyouarehavingtroublelettinggo

4. Yourpatternscanhurtnotonlyyou,butalsothosewhoyoulovemost

IV. OvercomeBarriers

A. Overview

1. HALT+

2. Cravings

3. Foodpushers

4. Unhealthyfriends

5. Environmentalstresses

6. Plateaus

7. Shiftwork

8. Traveling

9. Medications

10. Unhealthytreatmentproviders(youhavetolivethemessage)

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B. HALT+Don’tGetToo

1. HUNGRY – eat frequent, small, high-quality meals, nutritional supplements to

balanceyourbloodsugar.

2. ANGRY–maintaincontroloveremotionsandautomaticnegativethoughts.

3. LONELY–socialskillsandapositivesocialnetworkarecriticaltosuccess.

4. TIRED –make sleep a priority to boost brain function and improve judgment and

self-control.

5. +=brainhealth

C. GetYourCravingsUnderControl

1. Keepyourbloodsugarbalanced.

• Lowbloodsugarlevelsmeanloweroverallbrainflowtothebrain

• Morebaddecisions

• Poorimpulsecontrol

• Breakfast skipping associated with smoking, alcohol use, and being

sedentary4

2. Maintainahealthybloodsugarlevel.

• Chromiumandalphalipoicacid

• Eatinganutritiousbreakfast

• Smallermealsthroughouttheday

• Stayingawayfromsimplesugars

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3. KnowandoptimizeyourVitaminDlevel.

• 25-hydroxy-VitaminDlevel

4. Boostyouromega3s.

5. Eliminaterefinedsugars,sodas,fruitjuices,andartificialsweeteners.

6. Decreaseartificialsweeteners

• Upto600timessweeterthansugar

• Maytriggercravings

• Steviaisagoodnaturalsubstitute.

7. Stresstriggerscravings

• Hypnosisandmeditationcanhelp.

8. Managefoodtriggers

• Knowyourvulnerablespotsandplanahead.

9. Hiddenfoodallergiescantriggercravings.

• Wheatgluten

• Milk

• Canlowerbrainbloodflow

10. Sugarandfatactonthebrain’saddictioncenters.

11. ButIlovedonutsandcan’tgivethemup!

• Chronichyperglycemialeadstodiabetesmellitus.

• Hyperglycemiaindiabeticsleadstoskinulcerationsandneuropathy.

• Diabeticamputationresultingfromuncontrolledbloodsugar.

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• Diabetesleadstoblindness.

• Alzheimer’sdisease:Type3diabetes

• Depressionisoneofthemostcommonsideeffectsofobesity.

• Sugarfeedscancercells.

• Hyper-insulinemiaisassociatedwithmanyformsofcancer.

• Sugarandtransfatsleadtoelevatedcholesterol,vascular,andheartdisease.

• Sugarandtransfatsleadtocoronaryarterydiseaseandstroke.

• Sugarcausesrapidagingandwrinkles.

• Fructoseistoxictotheliverandleadstonon-alcoholicfattyliver.

• Excessivefructoseleadstohypertensionandgout.

D. TheDinosaurSyndrome

Endnotes1Hedgecock, W.H., Vohs, K.D., & Rao, A.R.. (2012). Reducing self-control depletion effects through enhanced

sensitivitytoimplementation:EvidencefromfMRIandbehavioralstudies.JournalofConsumerPsychology,22(4),

486-495.doi:10.1016/j.jcps.2012.05.0082Baumeister, R.F., Bratslavsky, E.,Muraven,M.,& Tice, D.M. (1998). Ego depletion: Is the active self a limited

resource?JournalofPersonalandSocialPsychology,74(5),1252-653Baumeister,R.,&Tierney,R.(2011).Willpower.Penguin:NewYork,NY4Keski-Rahkonen, A., Kaprio, J., Rissanen, A., Virkkunen,M., & Rose, R.J. (2003). Breakfast skipping and health-

compromisingbehaviorsinadolescentsandadults.EuropeanJournalofClinicalNutrition,57(7),842-853.

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BHC112:

KillingtheANTs:DirectingYourThoughts

DanielAmen,M.D.

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Summary

Automaticnegativethoughts,orANTs,canbepervasiveandpainful,andwithoutinterventions,

they can significantly hinder attempts to change your brain. In this presentation, Dr. Daniel

Amen describes the different types of ANTs and how to go about defeating them.Multiple

techniquesarecoveredtochallengeanddefeattheautomaticnegativethoughts.Focusingon

gratitudeandenthusiasmforliferatherthanonthenegativescanmakeasignificantdifference

inthebrain.Totrulyhaveahealthybrain,itisimportanttocontrolyourthoughtsratherthan

lettingyourthoughtscontrolyou.

LearningObjectives

1. ParticipantswilldefineanddescribethetypesofANTs

2. ParticipantswillidentifythefourquestionsthatcanbeusedtoturntargetANTs

3. ParticipantswillexploredifferentmethodsandtechniquesthatcaneliminateANTs

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I. KillingtheANTS

A. Psychotherapy

1. Whenpsychotherapycausesnewlearning:

2. Enhancesnewneuronalpathways

3. Encourageslong-termpotentiation

4. Calmskindling(over-firinginthebrain)

5. Changes, remodels the brain (spring cleaning or remodeling an old bathroom or

kitchen)

B. BehaviorTherapy

1. LewisBaxteratUCLA

2. OCDPatients

3. Increased caudate and cingulate – subcortical circuit that acts as a kind of filter,

siftingoutextraneousthoughtsandimpulses

4. BehaviorTherapyvs.Prozac

5. Bothcalmedcaudate

6. Psychologicalinterventionscanhavebiologicaleffects

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C. InterpersonalPsychotherapy(ITP)

1. TwostudieswithMajorDepression

2. Brody(12weeksatUCLA)ITPvsPaxil

• Bothcalmedhyperactiveprefrontallobes

3. Martin(sixweeksinEngland)ITPvsEffexor

• Bothincreasedbasalgangliaactivity

4. Interpersonalpsychotherapyiseffectiveandhelpschangethebrain

D. CognitiveTherapyHelpsWeightLoss1

1. Swedishstudyof107obesepeople

2. CBTfor10weekslost17pounds

3. Thosewithnointerventionsgainedweight

4. 18monthslater,CBTgrouplostanother5lbs,controlgroupstillgaining

5. Anotherstudy thatusedbrain-scanning technology foundthatCBTactuallycauses

changeinthebrainstemandcortexareas

II. StressBusters

A. KilltheANTsThatStealYourHappinessandMakeYouFat

1. ANTs=AutomaticNegativeThoughts

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2. Everytimeyouhaveathoughtyourbrainreleaseschemicals.

3. Everybadthoughtreleaseschemicalsthatmakeyoufeelbad.

4. Everygoodthoughtreleaseschemicalsthatmakeyoufeelgood.

5. Thoughtsareautomatic.

6. Nineantspecies

• Alwaysthinking

• Mindreading

• Blame

• Focusonnegative

• Fortunetelling

• Thinkingwithfeelings

• Guiltbeating

• Labeling

• Allornone

7. Youneedaninternalanteater.

8. ANTKillingexercise:

• Wheneveryoufeelsad,mad,nervous,oroutofcontrol

• WritedownyourANTS

• Labelthem

• Talkbacktothem

• Don’tbelieveeverystupidthoughtyouhave!

• ANTKillingisabigpartofgettingwell

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9. FeedYourAnteater

• ANT:Thispatientwillbedifficult

• SPECIES:Fortunetelling

• ANTEATER:Thismaybeagreatexperience

B. FourQuestions

1. Isittrue?

2. CanIabsolutelyknowthatitistrue?

3. HowdoIfeelwhenIhavethisthought?

4. WhowouldIbewithoutthethought?

5. Turn the thought around. Is the turnaround true or even truer than the original

thought?

6. Examples:

• Icanneverlosetheweight.

• Doctorkilledgrandpa.

• Idon’twanttofiretheemployee.

• Imissmyex.

• Mysontreatsmebadlyallthetime.

7. Thegoalisneverpositivethinking–itisaccuratethinking.

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C. Happiness:NewResearch

1. Geneticpredisposition

• Genesonlyaccountfor30%ofhappiness.

2. Engagementinlife

3. Meaningfullife

4. Thequalityofyourthoughts

D. GratitudeTherapy

1. Studyofgratitudeandfear

2. Fearcausedmarkeddeactivationofcerebellum

3. Fearincreasesconfusion

4. Athleticslumporemotionalslump

E. BestWaystoDe-StressYourLife

1. Prayer

2. Gratitude

3. ANTtherapy

4. Exercise

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5. Fishoil

6. Deepbreathing

7. Sharingyourchallengesinasmallgroup

F. GainingSelfControl:BreathingandBiofeedback

1. Stresskillsbraincells.

2. Relaxationtrainingkeytohealth

3. Handwarmingimages

4. Diaphragmaticbreathing

5. Meditation,prayerexercises

6. Heartratevariability

G. CognitiveTherapy(ANTTherapy)

1. Furmark,Sweden2

• 18patientsinCelexavs.“Group”CBTvswaitgroupforsocialphobia

• Afternineweeks,equaleffectivenessforCBTandCelexa,notinwaitgroup

• DecreasedR>L,inamygdalaandhippocampusinrespondersinbothgroups

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2. Paquette,Canada3

• 12patients“spiderphobias”

• fMRI

• FearactivatedrightlateralPFC

• AfterCBT,noactivationofrightlateralPFC

H. SPECT,MeditationandPrayer

1. AndrewNewberg2001&2003study

• TibetanBuddhistsandFranciscanNunsprayerandmeditation

• IncreasedPFCanddecreasedleftparietallobe

• Book:WhyWon’tGodGoAway

2. AmenClinic2009study

• 11subjects,10experiencedmeditators

• Baselineversusmeditation(12minutes)

• KriyaKirtanForm,SaaTaaNaaMaa

• Results–downleftparietallobe,upleftandrightPFCanduprighttemporal

lobe

I. PsychotherapyHypnosis

1. Maquet,Belgium,PET,increasedlefthemisphere

2. Rainville,Canada,PET,increasedbrain’sattentionalsystem

3. Faymonville,Belgium,PET,decreasedpainandareaofthebrainthatfeelspain

4. Componentsofhypnosis

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• Natural,allinhypnoticstates

• Focusedrelaxation

• Focuseyes

• Deepbreathing

• Progressiverelaxation

• Deepening

• Imagery

• Individualtechniques

J. EMDR

1. Eyemovementdesensitizationandreprocessingtherapy

2. DevelopedbyFrancineShapiro

3. Systematictherapeuticsystem

4. PositivebeforeandafterSPECTstudies

5. PTSD,anxiety,performanceanxiety

• PTSDDiamondPattern

• IncreasedAC

• IncreasedBG

• Increasedthalamus

• Increasedrightlateraltemporallobe

6. AmenClinic2001-2003study

• SixpoliceofferswithPTSDbyDSM-IV

• ThreeStates–concentration,firstEMDRsession,aftertreatment

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K. ImagingandQiGong

1. Chinesemeditation

2. Litscher2001

• rCBFonQiGongmaster

• Increasedcerebralbloodflow

Endnotes1Stahre,L.,Tarnell,B.,Hakanson,C.E.,&Hallstrom,T.(2007).Arandomizedcontrolledtrialoftwoweight-reducing

short-termgrouptreatmentprogramsforobesitywithan18-monthfollow-up.InternationalJournalofBehavioral

Medicine,14(1).48-55.2Furmark, T., Tillfors, M., Marteinsdottir, I., Fischer, H., Pissiota, A., Langstrom, B., & Fredrikson, M. (2002).

Common changes in cerebral blood flow in patients with social phobia treated with citalopram or cognitive-

behavioraltherapy.ArchivesofGeneralPsychiatry,59(5).425-433.3Paquette, V., Levesque, J., Mensour, B., Leroux, J.M., Beaudoin, G., Bourgouin, P., & Beauregard, M. (2003)

“Changethemindandyouchangethebrain”:Effectsofcognitive-behavioraltherapyontheneuralcorrelatesof

spiderphobia.Neuroimage,18(2).401-409.

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BHC113:

InnovativeTreatments

DanielAmen,M.D.

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Summary

There aremultipleways to improvebrain functions.Whilemedicines canoftenhelppeople,

thereareotheralternativesthatcanhaveequalorgreaterresults.Thispresentationdescribes

someofthemanyinnovativetreatmentoptionsthatareavailableforpeoplewithbrainissues.

Dr. Amen describes the seven categories of innovative treatment and goes into detail on

severaloftheoneshehasfoundparticularlyeffective.

LearningObjectives

1. Participantswillidentifytherationalebehindusingtreatmentsotherthanmedications

2. Participantswillexplorethesevencategoriesofinnovativetreatments

3. ParticipantswillgaininformationaboutIrlenlensesandotherbiologicaltreatments

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I. InnovativeTreatments

A. ManyWaystoOptimizetheBrain

1. Supplements

2. Acupuncture

3. Sleepdeprivation(Chronotherapy)

4. HBOT

5. Vagalnervestimulation

6. rTMS

7. Lighttherapy

8. IrlenLenses

9. Neurofeedback

10. CES/AVS

11. BrainGames

B. 7TypesofInnovativeTreatments

1. Mind-bodyinterventions

• Biofeedback

• Relaxationtherapies

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• Meditation

• Body-orientedexercises(yoga,t’aichi)

• Hypnosis

• Imagery

2. Bioelectromagnetictherapies

• ECT

• rTMS

• Vagalnervestimulation

3. Alternativesystemsofmedicalpractice

• Acupuncture

• Homeopathy

4. Manualhealingmethods

• Osteopathy

• Chiropractic

• Physicaltherapy

• Massage

5. Pharmacologicandbiologictreatments

• Lighttherapy

• Sleepdeprivation

• Irlenlenses

• HBOT

6. Herbalmedicine

• Plants

• Extracts

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7. Dietandnutrition

• VitaminEforbloodclotandstrokeprevention

• Folicacidforneuraltubedefectprevention

• Ketogenicdietforepilepsy

II. Bio-Electro-MagneticTherapies

A. CranialElectrotherapyStimulation(CES)

1. Depression,anxiety,pain,insomnia

2. Modern devices use <1mA low-frequency (0.5Hz) bi-phasic currents appliedwith

electrodesattachtoheadorearlobes.

3. Averagetreatmentis20-60minutes.

4. Dailytreatmentsarerecommendedduringthefirst1-3weeksofCEStherapy.

B. rTMS

1. Repetitivetranscranialmagneticstimulation(rTMS)

2. Helpfulinresistantdepression

3. Helpfulinpoststrokedepression

4. FDAapproved

5. WhatisrTMSusedfor?

• Depression–onlyFDAapprovedindication

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• Alcohol,marijuana,cocaineaddiction

• OCD

• Migraines

• Pain

• Insomnia

• Parkinson’sDisease

• Tinnitus

• Stroke

III. PharmacologicalandBiologicalTreatments

A. SleepDeprivationandDepression

1. Ebert,1994,n=20,responderswithincreasedanteriorcingulateactivity

2. Goodwin, 1993, n=28, responders with higher anterior cingulate perfusion,

normalizedaftersleepdeprivation

3. Wu, 1999, PET, n=36, high pretreatment activity and decreases in activity after

treatmentinmedialprefrontalcortex

B. LightsandSeasonalAffectiveDisorder

1. Vasile,1997,n=10,increasedoverallactivityinrespondersbutnotinnonresponders

2. Seasonal AffectiveDisorder is growingmore commonbecause people are indoors

more

C. IrlenSyndrome:ScotopicSensitivitySyndrome

1. Lightsensitive,botheredbyglare,sunlight,headlightsorstreetlights

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2. Withbrightorfluorescent lightsbecometired,headaches,moodchanges,restless,

unfocused

3. Troublereadingwordsthatareonwhite,glossypaper

4. Words/letters shift, shake,blur,move, run together,disappearorbecomedifficult

toperceivewhenreading

5. Feelstense,tired,sleepy,orevengetheadacheswhenreading

6. Problemsjudgingdistanceandhavedifficultywithsuchthingsasescalators,stairs,

ballsports,ordriving

D. HyperbaricOxygenTreatment(HBOT)

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BHC114:

DecreasingtheRiskforBrainAging,

Alzheimer’s,andOtherFormsofDementia

DanielAmen,M.D.

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Summary

ThememorylossandbrainproblemsthatcomewithdementiaandAlzheimer’sdiseasearenot

inevitable.Althoughtherearegeneticpredispositionstowardstheseissues,thereareanumber

ofstepsthatcanbetakentopreventage-relatedmemoryproblems.Thispresentationdetails

the prevalence and types of dementia and Alzheimer’s disease, and then presents practical

steps that people can do to preventmemory loss.With early detection and treatment, the

onsetofdementiaorAlzheimer’sdiseasecanbesignificantlydelayed.

LearningObjectives

1. Participantswill explore the scopeandnatureof the issueofAlzheimer’sdiseaseand

dementia

2. Participantswilldistinguishthedifferentformsofdementiaandthecausesofeachtype

3. Participants will list practical steps that people can take to prevent the onset of

Alzheimer’sordementia

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I. TheScopeoftheProblem

A. Age-RelatedMemoryProblemsEscalateafterAge45

1. Theworkingpopulationisaging

2. Alzheimer’sisexpectedtotripleinthenext25years

3. Thereisnocureonthehorizon

4. ThereareverysmartstrategiestodecreaseyourriskforAlzheimer’sdisease

B. YouMayBeatRiskforAlzheimer’sDisease(AD)If:

1. Youhaveafamilymemberwithit

2. Youhaveapersonalhistoryofheadinjury,heartdisease,strokes,diabetes,cancer,

ADD,ordepression

3. Youexerciselessthantwiceaweek

4. Youdonotengageinregularlearning

C. AgeRelatedMemoryProblems

1. Alzheimer’sDisease

2. FrontalTemporalDementia

3. VascularDementia

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4. LewyBodyDementia

5. AlcoholicRelatedDementia

6. ChronicFatigueSyndrome

7. MildCognitiveImpairment

8. BrainTrauma

D. DementiaDefined

1. Damage to nerve cells that results in a progressive difficulty with remembering,

thinking,ordoingyourusualactivities

2. Theimportanttermhereisthatitisprogressive.

E. Alzheimer’sDisease

1. CTE:ChronicTraumaticEncephalopathy

2. Betaamyloidplaquesandneurofibrillarytangles

3. Tauproteinabnormalities

4. Tauproteinsformtheskeletonorbuildingblocksforneurons.

5. Itisthephosphorylatedtauproteinthatacceleratestheagingprocess.

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II. StepstoPreventingAlzheimer’sDisease

A. KnowtheSteps

1. Keepyourbodyandbrainactive.

2. Antioxidants

3. Betaamyloidreducingagents

4. Modulateglutamate

5. Enhanceacetylcholine

B. KnowYourRisk

1. Geneticrisks–ApoE4gene

2. Braininjury

3. Alcoholabuse

• Nomorethantwoglassesaweek

4. Obesity,MetabolicSyndrome

5. CVdisease,includinghighBP,lipidproblems

6. Cerebralvasculardisease

7. Exerciselessthantwiceaweek

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8. Lessformaleducation

9. Diabetes

10. Smoking

11. Parkinson’sdisease

12. Untreateddepression

13. UntreatedADD

14. Lowestrogenfromhysterectomies

15. Lowtestosteronelevels

16. Sleepapnea

17. Cancertreatment

18. Highhomocysteinelevels

19. Gettinghairornailsdonetoooften

C. PreventionStrategies

1. Knowandchangeyourrisk

2. KnowApoEstatusearly,inchildhoodifdesiringtoplaycontactsports

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3. Exercise

4. Brainexercise,newlearning

5. CurcuminandVitaminD (reducebetaamyloid), asmay10wdoes ibuprofen (100-

200mg).

6. Restricteddiet,highinantioxidants

7. Omega3fattyacids

8. B6,B12,folate

9. Tightbloodsugarregulation,chromium?1

D. EarlyDetection

1. Treatmentworksearly,notlate

2. 95%notdiagnoseduntillate

3. Smellidentificationtest

• Strawberry

• Pineapple

• Lemon

• Naturalgas

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E. EarlyTreatmentStrategies

1. Workupforothercausesofmemoryloss

2. Preventionstrategies

3. Gingko,vinpocetine,huperzineA,acetyl-l-carnitine

4. Acetylcholineenhancingagents(Aricept,ReminylandExelon)

5. Glutamatemodulator(memantine)

Endnotes1Krokorian, J., Eliassen, J.C., Boespflug, E.F., Nash, T.A., & Shidler, M.D. (2010). Improved cognitive-cerebral

function in older adults with chromium supplementation. Nutritional Neuroscience, 13(3), 116-122. doi:

10.1179/147683010X12611460764084.

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BHC115:

CreatingBrainHealthyCommunities

DanielAmen,M.D.

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Summary

Lifeislivedincommunity,andhealthylivingshouldbedoneincommunityaswell.Therearea

numberofpracticalwaysthatpeoplecanencourageotherstojointhemintakingcareoftheir

brains. Groups have power, and through effective leadership, lives can be changed

dramatically.Churchesareagreatplacetostart,sincetheytendtofeedthesoulbutharmthe

body with the type of food they offer to their members. In this presentation, Dr. Amen

describespracticalwaystocreateahealthybrainprogramandencourageyourfriends,family,

coworkers,andclientstoliveoutabrain-healthylife.

LearningObjectives

1. Participants will explore the power of the group dynamic in maintaining a healthy

lifestyle

2. Participantswilldescribethebenefitsofimplementingbrain-healthyprogramsinoffice

andchurchsettings

3. Participantswill furtherunderstand theprocessof changing theway theworld thinks

aboutfoodandthebrain

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I. It’sNotJustAboutYou–It’sAboutGenerationsofYou

A. Epigenetics

1. Habitsturnonandoffgenes

2. Makeillnessesmoreorlesslikely

3. Choiceaffectgenerations

“OrdoyounotknowthatyourbodyisatempleoftheHolySpirit,whoisinyou,whom

youhavereceivedfromGod.Youarenotyourown;youwereboughtataprice.”–

1Corinthians6:19-20a

B. TheDanielPlan

1. Churchhealthcareinitiative

2. 52-weekprogram

3. Contentdeliveredweeklythroughweb

4. Meetinsmallgroups

5. 15,000peopleintheproject

6. Spectacularresults

7. After12months,churchhadlost260,000lbs.

8. Peoplereportedimprovedenergy,focus,creativity,sleep,andmood

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9. Reductions in stress, blood pressure, blood sugar, sexual dysfunction, and many

medications

C. TheFivePillars

1. Faith–whydoyoucare?

2. Food

3. Fitness

4. Focus

5. Friends

D. ThePowerofGroups

1. Aristotle–manisasocialanimal

2. “JointheClub”–peerpressureleadstoactsofgreatcourageorgreatharm

3. Peerpressurecanbeusedasasocialcuretosmoking,AIDSprevention,etc.

4. Peerrelationsaredominatedby thesearch forstatus, identity,andacceptanceby

others

5. Mostpowerfulofhumanmotivations:ourlongingforconnectionwithoneanother.1

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II. CreateaBrainHealthyProgram

A. ForStaff

1. Brain health education for all medical and office staff (brain envy, avoid bad, do

good)

2. Medicalandofficestaffneedtolivethemessage(ifyoudon’tlivethemessage,you

areabadmessenger,plus,youwillsaveoninsurancecosts).

3. Helpyourteam’shealthwithdiscountsonsupplements,gymmemberships,etc.

4. Encouragesleep,exercise,newlearning

5. Stepsforsuccess

• Theheadoftheorganizationhastobecommitted

• Theleadersoftheorganizationhavetomodelit

• Everyonehastohaveuniversalaccesstotheinformation

• Thereneedstoberegularreinforcementandmutualaccountability

6. Onlyhavebrainhealthyfoodoutatwork(nocandyondesk,drugrepsnotallowed

tobringbadfood).

7. Makesureenvironmentisnon-toxic.

8. Befirmwiththosewhoareresistant,allhavetolivethemessagetobesuccessful(if

theyquit,yourinsuranceratesmaygodown).

9. Staffcamaraderieiscriticaltosuccess.

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B. ForPatients

1. Bio/psycho/social/spiritualevaluations

2. Braintypequestionnaire

3. SPECTscansincomplexcases

4. Brainhealtheducation(brainenvy,avoidbad,dogood)

5. Knowyourmotivation(onepagemiracleandotherstrategies)

6. Knowyourimportantnumbers(waist-to-heightratio,bloodpressure,labs).

7. Journaling

8. Brainhealthynutrition

9. Brainhealthyexercise

10. Brainhealthysupplements(MV,O3,VitD,typespecific)

11. Get your mind right (Boost decision making skills, Kill the ANTs, 4 Questions,

hypnosis,medication).

12. Overcomebarriers.

13. Influenceothers.

14. Dogroups,eitheryoudoitorhireacoach.

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15. Lotsoftips

16. Createsupportbuddies.

17. Onlineprograms

• Brainfitlife

C. TheProcessofChangingtheWorld

1. Firstyouhavetogetit(learntheinformation)

2. Thenyouhavetogiveitaway(teachothers)

3. Thatway,youcankeepit(fortherestofyourlife)

Endnotes1Rosenburg, T. (2008). Join the club: How peer pressure can transform the world. W.W. Norton & Co:

NewYork,NY

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IndexofAcronymsandAbbreviations

AC:AnteriorCingulate

ADD:AttentionDeficitDisorder

ALA:AlphaLipoicAcid

ALC:Acetyl-L-Carnitine

BBB:BloodBrainBarrier

BCP:BirthControlPills

BDI:BeckDepressionInventory

BG:BasalGanglia

BPD:BipolarDisorder

Bq:Bequerel

BSI:BriefSymptomsInventory

CES:CranialElectricStimulation

Ci:Curie

CRP:C-ReactiveProtein

DB:DoubleBlind

DBPC:DoubleBlindPlaceboControlled

DID:DissociativeIdentityDisorder

DL-PFC:DorsalLateralPrefrontalCortex

Dx:Diagnosis

FA:FolicAcid

fMRI: Functional Magnetic Resonance

Imaging

HBOT:HypobaricOxygenTreatment

HCL:HydrochloricAcid

LTP:LongTermPotentiation

MCA:MiddleCerebralArtery

MCI:MildCognitiveImpairment

MEG:Magnetoencephalography

Mg:Magnesium

MPD:MultiplePersonalityDisorder

MS:MultipleSclerosis

MV:Multivitamin

NAC:N-Acetyl-Cysteine

OCD:ObsessiveCompulsiveDisorder

ORAC:OxygenRadicalAbsorbanceCapacity

PET:PositronEmissionTomography

PFC:PrefrontalCortex

PS:Phosphatidylserine

qEEG:QuantitativeElectroencephalography

QOLI:QualityofLifeInventory

rCBF:RegionalCerebralBloodflow

RDBC:RandomizedDoubleBlindControlled

RPBC/RPC:RandomizedPlaceboControlled

rTMS: Repetitive Transcranial Magnetic

Stimulation

SAMe:S-Adenosyl-Methionine

Se:Selenium

SJW:SaintJohn’sWort

SPECT: Single Photon Emission Computed

Tomography

SSRI:SelectiveSerotoninReuptakeInhibitor

Sxs:Symptoms

TBI:TraumaticBrainInjury

Tx:Treatment

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