Neuro Quantitative MRI: Know Your Brain Age

So I talked to you about something really exciting that's available in Michigan. If you're not from Michigan, there's other states you can do this in. But it's about detecting the possibility of developing brain disease down the road, decades in advance. So we know that there's three causes of death that are probably preventable in most people. Cardiovascular disease, cancer, and neurodegeneration, also known as dementia. And one of the common ones is Alzheimer's. And an inherent problem is we don't really intervene on Alzheimer's until people have symptoms. We call that mild cognitive impairment, where somebody's showing signs of dementia and then eventually they have Alzheimer's. And we really don't have effective drugs for that right now. But in the early preventative stage, when you somebody is getting before they're at the neurocognitive decline symptoms, they don't have mild cognitive impairment. The brain is plastic, meaning that it can grow back, what's called neuroplasticity. And the brain can spring back. But we don't really know who needs to do the interventions or when interventions are needed unless we identify the people that have risk for neurocognitive decline. Now, there's certain genes. There's a gene called the APOE gene. And just in a brief summary, APOE is a 2, 3 or 4, and 2 is protective, 3 is neutral, and 4 is risk for Alzheimer's. And there's even different things called homozygous and heterozygous. I don't want to get into that, but that's worth testing. It's probably a $25 test. If you're a higher risk, I would definitely do the do the imaging for neurocognitive decline. But let's talk about neuro quantitative imaging. We're using a local radiology called Bipartisan Bionic mri, and they're using a company called Neuroquant. And I've been following them for a while, and they really have some pretty good testing for brain age. So what we're going to look at is the amount of brain mass ratio to the amount of liquid in the brain. So when we're very young, our brain has a lot of brain mass and very little liquid, or what we call cerebral spinal fluid. And as we age, the brain shrinks and cerebral spinal fluid liquid takes up the space. And then when I was in, say, medical school and some of you have seen CT scans of brain, you see that the brain is shrunken down, looks more like cauliflower. And when it's A younger brain. It looks like broccoli. It's got real smooth edges where the cauliflower rough edges is more the age brain. And now with imaging, we can determine the age of the brain relative to same age and gender of other people. With brain scans, you want to have a high amount of brain mass and a lower amount of brain volume to assure you're not going to get neurocognitive declines where that means your brain is not shrinking and they give you a percentile. So the percentile could be, you know, 99 percentile for your age or it can be, you know, the one percentile for your age, which would be bad. There's something called the hippocampal occupancy index that we're looking at and that's how much volume the hippocampus takes up. That's a part of the brain that's, that's largely involved in Alzheimer's. There's just really the amount of volume in each of the lobes of the brain. So I'm going to talk about how this works and what we can do. So I've scanned my brain periodically since 2018 and in 2018 my brain was at the 88 percentile for my age, which would be good now being the top 12% of brains, my ventricles were smaller. And I did a one year intervention, an 18 to 19 where I did some very specific tasks, very specific things and took some very specific supplements to cause neuroplasticity. And at the end of one year, 2019, my brain had gone to the 95 percentile for a 20 year old and over off the charts for my own age. And that stayed that way. It stayed at a, you know, I'm not going to get Alzheimer's and I'm going to make sure I don't because I'm going to, I'm going to scan this. It's an MRI that you do. You lay there for about, about 45 minutes to an hour and then you get a report in a. And what does this mean for, for us in general? Well, Alzheimer's is going to be growing in our society. As we live longer, we're going to have less cancers, less heart disease, or we're going to have delayed heart disease, which as we get older, the risk of Alzheimer's goes up significantly. And if you intervene at an earlier point, you can change the outcome of your brain age. And there's a lot of things that are very simple, like social interactions, learning new things, learning new tasks, periodic fasting, certain supplements that may be beneficial, but really sometimes people don't want to do those specific efforts if they're already in good shape. So if I was at 88%, I might say, well, I'm pretty happy with that. If I'm above the 50 percentile, you know, the chance of me getting Alzheimer's in the next 20 years is pretty slim. That's good. I wanted to be at the 99 percentile, so I did some particular efforts. And I'm going to just briefly talk about some of the things that are being done to cause neuroplasticity and help the brain. But there's going to be more in the future. Right now there are some simple things and some complex things, but I think the first step is to do the measurement. So you go get an mri. You can't just do the this at a hospital. They're not going to give you the answer. In fact, the Neuroquant study was to tell whether or not you do have Alzheimer's more or less, versus are you going to get it in 10, 20 years from now? But now we can actually extrapolate that very accurately based on populations. So we know a certain percentage of population at every age is going to get Alzheimer's disease and they're going to have the most shrunken brains and the most presence of cerebral spinal fluid. And if you get your MRI done when you're say 50 and you're at the 70 percentile, yeah, you're in pretty good shape. You're not going to get Alzheimer's in the next 20, 20 years. If you're 60 and now you're in a 50 percentile, you might want to take some action because your risk of Alzheimer's at 80 years old is now going up. You're having an average rate risk of Alzheimer's. And if you're 60 years old and you're in the bottom 20%, well then now you have a very high risk of getting Alzheimer's in the next 20 years. My friend Mark is a, who's a contractor for us for a long time and advisor of mine. He had risk of Alzheimer's because his mother's risk, she got it in her 60s. He was really concerned about that. And we did the neuro quantitative imaging. It was a difference he did down in Florida. Different, a different company and his percentage was a little bit on the lower side. And he was cognitively, I mean, extremely sharp. This guy is on the mark because you don't really have mild cognitive impairment until you get lower. You know, 1 to 5 percentile. So he didn't have any symptoms whatsoever, but his brain was aged. So he did intervention. First off, we treated his sleep apnea, his sleep apnea, we treat him with night lays that went away. He made major changes in his diet, did hyperbaric oxygen therapy, did a lot of things very specifically to salvage his brain and actually went up more than triple where he started out at. From a percentage standpoint, he's not in the top percentile yet, but he's way over the 50 percentile. So he really effectively pushed off Alzheimer's should he get it at least a decade. And this is of course a presumption. I don't know if it's really a decade or not, but some period of time and ideally we're going to make it so that he would never get Alzheimer's. So that is the goal, regardless of how long he lives, because we want to live longer. I told you my story where I went from 88 percentile to high percentile for younger person. And that's where I kind of want to stay. Mark wants to get up there too, and he will. He's got, he's got incredible self discipline. We're looking at right now, society wise, the way we manage Alzheimer's. We sort of wait till you get it and then we put people on drugs that really don't work as of now and we just kind of, you know, put them in, put people in assisted care facilities and eventually nursing home and then, you know, you do die from Alzheimer's. Time to diagnosis of death is relatively short. So this is something that we can intervene early on, but I think the first step is to get yourself tested. We're using bionic MRI at Southfield and here in Michigan. There's other places that have this throughout the country, but you want a going to go to a place. They'll measure your brain and give you a percentage relative to your own population. There's several full body MRI centers throughout the country. One's called Pronovo and I'm assuming they do the brain aging. There's the Fountain Life, that's a company with Peter Diamandis and Tony Robbins and others that are working on something similar. So go to one places, get your brain tested and see where you're at. If you're up in the upper 20, 30%, you really, you know, you're in good shape. What you're doing is working. If you're in the middle range, I'd probably making some intervention because the risk of getting Alzheimer's just basically is an aging thing. So you want to have your brain, you know, maybe in the 70, 80, 90 percentile. And if you're below 50 percentile, you know, take some action. Now. Some simple things that we could do. If we have a brain age older than our age, there's some very simple things we can do. So if your brain age is in the 50% tower below, the first thing to do is get a sleep study. Get a home sleep study. I use the watch pat W a T C h like watch pat P a T pulse amplitude technology. And if you have Alzheimer's, I'm sorry, if you have sleep apnea, your risk of Alzheimer's goes up about threefold and it comes on about 10 years sooner. So you can treat that and obviously reduce the risk of Alzheimer's. Reduce the risk of sooner Alzheimer's. So sleep apnea present at probably about 60% of men over 50 and probably 30, 30% of women over 50. So don't assume you don't have it. Just get tested. The watchpad test is relatively cheap. We sell them for $106. That's our cost. You can go online. If you're not in Michigan or state that we practice in, you can go online. You usually get the doctor's visit and the watch pad $200 or so. Or you can go to your doctor and get one order where you go into a sleep lab. That's probably a couple thousand dollars. Your insurance may cover it. I don't really like those because it's in an environment that's kind of foreign. These watchpad devices are just as good for the majority of people. You can do them at home and you can pay cash for your ins. Recover in some situations. So that's the first step, treat the sleep apnea. Second thing is the brain seems to be most plastic during times of fasting. And we've heard about periodic fasting. My protocol was. I mean, it was a rough one, but for one year, I ate five days a week. On Monday and Tuesday, I fasted and I did Dave Asprey's bulletproof diet at first because it was easier for me. And that's where you take. I use his bulletproof coffee and his brain octane oil, which is basically a real high quality coconut oil, and ghee, which is a modified butter. And you mix it in the coffee, you heat it up, mix it and blend it. And if you blend the ghee and the coconut oil, it emulsifies it, makes you ketotic right away. And when you do that, you're really not that hungry. I thought I could go fasting for days without, without much trouble. And your brain is more plastic when it's fasting, so when it's eating ketones rather than sugar. So that's something I did. I'm not really necessarily recommending that, but I did that. I was actually doing it with my son, wanted to lose some weight and we did this five day on two day off diet. For a while I wasn't trying to lose weight, I was trying to just get healthier. And I took some specific supplements. I'm not going to talk about those because they really should be tailored to you. Talk to your functional medicine doctor about which you might consider to get your brain growing. I took some things that were helping lengthen my telomeres and things that were helping reverse my aging in general. So I did it. Mark did it. This can be done. We know that when somebody does have mild cognitive decline, it's a little late because they're not really super good at following instructions. We would want somebody who stay older and does have cognitive decline and their brain age is a little older than it should be for their age. We're going to want them to start socially interacting with other people. Sitting there at home by yourself does lead to faster neurocognitive decline, whereas activity and social community improves the brain doing. In my case, when I did the two days of fasting for, in 2018, for a year on my fasting days I did. I learned subjects I was not particularly interested in. I read about things that were new and novel to me. I tried different activities that were novel to me. And all these things lead to neuroplasticity. There's even a study showing just simple. Something simple is learning to dance when you're elderly causes neuroplasticity. Neuroplasticity, the growth of the brain. So I think this is very exciting. We were struggling because we couldn't find a company that would do the neuro quantitative imaging in Michigan for sending people out of state. And now you can do it right here. This bionic MRI has got a letter there including it in the price of the full body MRI cancer screening. So it's less than $3,000. I'm not sure exactly what it is, but this is a great value, something you don't need to do repeatedly. Your insurance will not cover this. Your insurance is not designed to pick up Alzheimer's before now. If you get Alzheimer's, they'll pay for the drugs that work. So if you get Alzheimer's, the drugs that don't work will be paid for. When I say don't work, they don't work much, they don't do much. Very expensive, they don't do much. But if you don't have Alzheimer's, they won't pay for screening, they won't pay for prevention. It is something you have to do on your own or for your family. And I think all of us. You know, I'm in my 60s and I want to live a long life, healthy life, and I want to be healthy when I'm 80. I want to be a badass when I'm 100. So I'm trying to make sure I'm there now. And part of that is having a really sharp brain, which is measured quantitatively. Let me tell you one more thing that I'm thinking about with brain aging. There's two experiences that I've had with other people not doing it myself, people I know. So one is called plasma apheresis. And my friend David Hassi is with the Maxwell Clinic in Nashville, Tennessee. He does plasmapheresis, which was studied in a big study called the Apgar trial, I'm sorry, Ambar trial, where they did, they took people with mild cognitive plan degree of Alzheimer's, like mild to moderate Alzheimer's, and they did plasma phoresis where they extracted all their plasma out to pull these tau and beta amyloid proteins out. And they threw the plasma away and restored them with saline and albumin. They did this a few times over a couple months and then they did it periodically. And they found that the people's Alzheimer's seemed to get better. A problem with the study was it wasn't powered to meet FDA approval. So it's not FDA approved yet. But you can go ahead and do it because the procedure itself is FDA approved. It's just not approved for Alzheimer's. This seems to improve Alzheimer's related disease and mild cognitive impairment and something that your insurance won't cover. I don't know how much it costs. I think it's relatively expensive. But it's a procedure where you go in as it takes a couple hours, they take blood out, put it through a machine and give your blood back. So it's not uncomplicated, it's not cheap. But if your loved one has mild cognitive impairment, you might want to see David Hassey with the Maxwell Clinic. You might not see David Hassey, Dr. Hassey, but you'll see one of his clinicians. And that's what I refer people to when they're having a loved One that has mild cognitive impairment. Then a friend of mine went to buenos Aries with Dr. Molia. Dr. Mogil is based in, in Wake Forest in North Carolina at university and he's got a clinic in Buenos Aries where he's doing something very novel. I'm not recommending this. I'm just telling you what, what I'm seeing happening. And he's doing some T cell programming. T cells are styles of our s thymus gland right behind our breastbone with fat derived stem cells to cause neuro plasticity. He's getting the brains to grow back. So he's really passionate about, he's really passionate about spinal cord injury, but he's also working on brain. And I know people have gone there, I know a couple people have gone there and have had improvements in their brain function after getting this brain stem cell therapy. And again, I'm not recommending that. I am recommending David Max, I'm sorry. Maxwell clinic with David Hassi, David Hasi's group for plasmapheresis. Should you have Alzheimer's. I think the stem cell, T cell stem cell programming is a little, little new yet that I really haven't vetted. I'm gon visit them. I get a better understanding what's going on. Let me do a treatment myself. And there's steps you can do before that, but the first thing is get tested. There's no reason not to get tested other than the financial risk. And the question is, you know, do you love yourself more than your money or possessions? If you do, then this is maybe a reasonable way to spend a couple thousand dollars. Might even be cheaper just to do the brain imaging. I'm not, I'm not sure. So neuro quantitative imaging, they're using neuroquant and hippocampus occupancy score and a hippocampus volume and a ventricle volume to tell people what the status of their brain is. And if again you want to be, you know, over 50 percentile for your brain and below the 50 percentile for your ventricles. So there's, there's liquid and there's brain. We want brain mass up, liquid mass down. So thank you very much.