Significant and impactful research has been completed in recent years in the combat against cognitive decline which includes vascular dementia and Alzheimer’s disease. Doctors and researchers are discovering new ways to help prevent and even reverse these diseases. EVND physicians have created a unique program of prevention and treatment based on the knowledge from many prominent researchers which include Dale E. Bredesen M.D. and Dr. Dayan Goodenowe. The most promising research has developed from the idea that Alzheimer’s disease is too complex for any single drug or therapy to significantly prevent or reverse dementia and Alzheimer’s. Dr. Bredesen’s and Dr. Goodenowe’s research has shown that there are multiple root causes of Alzheimer’s disease which can include:
- Low plasmalogen production leading to diminished nerve maintenance and regeneration
- Excessive inflammation resulting in poor oxygen saturation and nerve cell damage
- Insufficient nutrients and hormones necessary for healthy brain function
- Toxic exposures such as mold, metals, and environmental toxicants leading to inflammation, nerve damage, and reduction in neural plasticity
- Suboptimal nitric oxide activity resulting in loss of nerve cells and optimal nerve velocity.
Through extensive testing, we are able to determine the root causes for each patient, and develop an extremely personal and unique plan for the treatment of dementia and prevention of Alzheimer’s disease. This program, known as the Brain Regeneration Program, is designed to help all known areas of research for optimal brain function. Any single treatment will not be as effective as a combination of targeted therapies based on individualized labs and assessments. Described below are the significant portion of labs we run to help determine metabolic activity, hormone pathways, toxicities, and the specific root causes in order to best help prevent or reverse cognitive decline.
QEEG Brain Mapping
Our brains consist of about 20 billion neurons which generate electrical impulses registered by medical EEG equipment. The first step to assessing a true baseline of cognitive function requires mapping out the electric patterns of the brain in a procedure called “brain mapping”. Brain mapping is the measurement of electrical EEG patterns at the surface of the scalp which reflect cortical activity, or “brainwave” activity. This noninvasive assessment tool is used to evaluate current brainwaves and create an individualized report. The procedure takes approximately one hour and consists of placing small sensors on the scalp using a snug cloth cap, as well as a dry cap, which measures electrical patterns. The dry cap can provide data that is predictive of cognitive decline associated with dementia and Alzheimer’s decades before it presents clinically.
The brain mapping done in the clinic is used to evaluate the manner in which a particular person’s brain functions. It is widely recognized as being comparable to fMRI, SPECT or CT scan. Using the QEEG we gather information on brainwave patterns, relationships and interactions between different parts of the brain, and the efficiency of communication between different sides of the brain. This information is then put into a normative database to determine in a scientific and objective manner, whether there are abnormalities in brain function. The QEEG can identify patterns associated with metabolic dysfunction, cellular degeneration, addiction, stress, worry, anxiety, insomnia, adrenal fatigue, neurotransmitter irregularity, inflammation, depression, memory deficits, attention deficits, brain injury, cognitive decline, and cortical perfusion. This advanced cognitive assessment is only available for patients who are greater than 50 years of age.
After determining a functional cognitive baseline and assessing future risk of cognitive decline, the next step is to do precision testing to discover root and potential causes of cognitive dysfunction and create a program of prevention and restoration.
One of the most valuable discoveries from research of Alzheimer’s and dementia, is the discovery of depletion of critical membrane lipids called plasmalogens. Plasmalogens are naturally occurring lipids incorporated within all cell membranes of our bodies, playing a particularly important role in the brain, heart, lungs, kidneys, and eyes. A significant body of research indicates that brain plasmalogen levels decline decades before the development of Alzheimer’s, dementia, and Parkinson’s, and are also correlated with the progression of these age-related neurodegenerative diseases. Prodrome labs now offer reliable measurements to evaluate an individual’s plasmalogen levels with a simple blood draw to be completed at the offices of EVND.
Research has revealed certain genes can increase the risk of developing dementia, including Alzheimer’s disease. The most significant genetic risk factor of discovery, is a form of the apolipoprotein E gene called APOE4. About 25% of people carry one copy of APOE4, and 2 to 3% of individuals carry two copies. Though APOE4 is the strongest risk factor gene for Alzheimer’s disease, it is not absolute a person will develop the disease.
Because the APOE protein helps carry cholesterol and other fats in the bloodstream, studies suggest that problems with brain cells’ ability to process fats may play a key role in Alzheimer’s Disease. The APOE gene comes in several different forms, or alleles. APOE3 is the most common and not believed to affect Alzheimer’s risk. APOE2 is relatively rare and may provide some protection against Alzheimer’s disease.
Testing for APOE4 allows patients to be more proactive. Because we have been able to discover root causes and know because we know how to support many of the pathways which result in Alzheimer’s Disease even decades before its onset, we embrace knowing and are allowed to prevent or reverse AD.
Elevated levels of homocysteine can indicate inflammation and problems in optimal methylation and nutritional support. Homocysteine buildup in the brain can also damage blood vessels. Healthy levels of vitamins B12 and B6, folate, and betaine can insure that homocysteine is recycled and does not build up causing damage to the circulation.
High insulin and high glucose are known contributors to Alzheimer’s. Insulin supports neuronal survival but high levels of insulin blunt its ability to send survival signals. The other issue is that IDE (Insulin Degrading Enzyme) also degrades amyloid-beta plaques. High levels of insulin mean that IDE is too busy degrading insulin that it can’t help control the amyloid-beta plaques. They begin to slowly build up contributing to Alzheimer’s. Glucose can also alter proteins and create free radicals. These altered proteins and free radicals can damage neuro supporting molecules, DNA, and blood vessels which all contribute to the disease.
Inflammation is important in the body’s defense against harmful substances or infections. However, chronic infections, food allergies, toxic exposures, and a host of other things, can chronically activate the body’s inflammatory responses. Chronic inflammation can then lead to the body damaging its own tissues and cells and slowing the natural turn over of dying cells leading to premature or accelerated aging. Inflammation in the brain can damage neurons and leads to Alzheimer’s. Here are a few important markers that can tell us if the body’s inflammatory responses are activated.
- C-Reactive Protein (CRP): a protein made by the liver that is sent into the bloodstream in response to inflammation.
- Albumin/globulin ratio: high levels of albumin to globulin can be signs of infection or an inflammatory response
- Omega-6/Omega-3 ratio: both fatty acids are important for health, however omega-3s are anti-inflammatory while omega-6s are pro-inflammatory
- Interleukin-6 (IL-6) and Tumor Necrosis Factor alpha (TNF𝜶): elevated levels of these cytokines can also indicate inflammation
- Hormones can contribute to cognitive function by supporting synapse formation and maintenance. We perform several tests to determine hormone status within the patient.
- Thyroid function: The thyroid controls the body’s metabolic processes. Suboptimal thyroid levels bring slower reflexes and lowered mental sharpness. Many people who suffer from dementia and cognitive issues also have lowered thyroid function.
- Estrogens and progesterone: There is strong evidence of the role
estrogens play in the prevention of dementia. The ratio between estrogen and progesterone is also associated with brain fog and memory problems.
- Testosterone: Present in both men and women, testosterone is important for neuronal survival.
- Cortisol, Pregnenolone, Dehydroepiandrosterone (DHEA): Cortisol is a hormone released by the adrenal glands in response to stress. This hormone, in high levels, can damage neurons, especially those associated with memory. Pregnenolone is converted into all other hormones. During periods of high stress, pregnenolone is converted into stress hormones instead of sex hormones (testosterone, estrogen, etc.). This leads to decreased levels of sex hormones which are important for brain health and cognition. DHEA is a “neurosteroid” that supports brain health and the body’s response to stress. Low levels of DHEA can hurt cognition.
Some metals are necessary for metabolic processes and cellular function within the body. Other metals can cause inflammation and damage to tissues and cells. We can run tests to determine if a patient is deficient in beneficial metals or determine if they need to “detox” themselves from any harmful ones.
- Copper/zinc ratio: Levels of copper and zinc in the body are inversely related. High levels of copper mean low levels of zinc and vice versa. Higher levels of copper and lower levels of zinc are associated with dementia and other neurological issues. Copper can produce free radicals which can damage brain tissue. Zinc deficiency has been linked to increased autoantibodies and oxidative damage, reduced hormonal and neurotransmitter signaling, and enhanced sensitivity to toxins. These symptoms of zinc deficiency can all contribute to cognitive decline and dementia.
- Magnesium: an important micronutrient in brain function and health
- Selenium: This metal is critical in regenerating the peptide glutathione. Glutathione is needed to fight free radicals and inflammation. Low levels of either leads to inflammation, toxicity, and loss of neuronal support.
- Vitamin D: This vitamin is crucial for activating genes that affect a host of important things including creating and maintaining brain synapses. Suboptimal levels can be a hindrance for improving cognition and brain health in Alzheimer’s patients.
- Vitamin E: This vitamin is an important antioxidant that protects cells from free radicals. It is one of the few monotherapies, in clinical trials, to have shown any effect on cognitive decline.
- Vitamin B1: This vitamin has been linked to healthy memory formation. Sufficient levels are required to support healthy cognition.
Cholesterol and lipid particles
Low cholesterol is associated with cognitive decline. Cholesterol is an important part of cell membranes and lowered cholesterol can lead to brain shrinkage. We’ll test for lipid particles from damaged cholesterol molecules to determine if there are any issues.
Metals such as mercury, lead, aluminum, and cadmium are extremely harmful to the body. Along with being neurotoxic, they have been linked to a host of other health problems, including cancer. Tests can be run to determine heavy metal exposure and their levels within the body. Lead in particular is associated with cognitive decline in all ages, but most often presents in patients over the age of fifty.
Testing is completed with gathering non provoked baselines and often followed by a provoked test by adding a chelating agent to grab or “bind” toxic metals. A test result provides graphical and numerical values of the 20 most common toxic metals. Toxic metal evaluation is a must for any patient with any degree of cognitive decline.
Mycotoxins are metabolites produced by mold. Mold can be found in water damaged buildings as commonly occurring in the workplace or home environments. Mold reactivity is very likely to be a major detriment to health when HLA positive immune responses are present. This heightened reactivity to mold is known as Chronic Inflammatory Response Syndrome or CIRS. Mold can also be found in certain foods like coffee, grapes, spices, and corn for example. Specific genetics result in a greater struggle eliminating toxins from the body. HLA specific immune testing along with a urine Mycotoxin Panel are able to determine personal risk as well as recent and historical exposures that result in chronic inflammation.
Alzheimer’s LINX™ – Alzheimer’s-Associated Immune Reactivity
Decades of research has demonstrated that a particular set of cross-reactive antibodies are present in elevated levels in patients with Alzheimer’s disease. The purpose of Alzheimer’s LINX™ test is to provide an analysis of various associated risk factors for AD by testing for these antibodies. Alzheimer’s LINX™ test results are intended to identify the presence of elevated levels of antibodies to certain environmental triggers (foods, chemicals, and pathogens) that are known to be cross reactive with brain-related proteins and factors and are associated in the development of AD. Reducing these environmental triggers, calming the immune system’s production of these antibodies, and maintaining the health of the blood-brain barrier can reduce the risk of autoimmune reactivity, neuro-autoimmunity, and the development of Alzheimer’s disease.
IntellxxDNA Genetic Testing
IntellxxDNA labs offers the most comprehensive genetic evaluation for optimal brain function and the prevention and treatment of cognitive decline. The Optimal Brain Report provides unprecedented insight into your unique genetic make-up to assist your clinician in developing true, personalized care. This is accomplished by evaluating your DNA for variants or SNPs (single nucleotide polymorphisms) that may signal potential benefits and risks that lie within your DNA. The genetic report examines the complex interplay between these variants and how they can affect your quality of life. IntellexxDNA genetic reports also provide evidence-based intervention strategies which encompass potential environmental, lifestyle, nutrition, supplements, and medication recommendations. Genetic testing applied alongside traditional labs builds a more precise foundation for sustaining and restoring optimal cognitive performance.
Following an appropriate medical assessment to include comprehensive lab testing and the baseline brain mapping completed, your physician can now develop a focused and very individualized treatment plan for optimal cognitive function.
Brain Regeneration Therapies
Upon completing all labs and developing a plan to support the metabolic, endocrine, and detox pathways, therapies that support brain regeneration can be introduced. Support of the specific hormone, metabolic, immune, and detoxification pathways, with the proper supplements and diet, places the brain in a place to heal and increase neuronal connections and velocity. HBOT, Brain Photobiomodulation, and Neurofeedback therapies stand supreme in improving blood flow and neural connections in the presence of cognitive decline.
Hyperbaric Oxygen Therapy (HBOT)
The leading root causes of neuron loss in the brain includes chronic diffuse inflammation and poor circulation of oxygen resulting in low oxygen states. Because nerves need oxygen to survive and thrive, both conditions result in chronic nerve damage and loss, as a result of low oxygen in the brain. HBOT has the ability to push oxygen deep into the brain, improving oxygen levels in damaged or oxygen-poor regions. HBOT also helps to rehabilitate those individuals where symptoms are caused by vascular dementia and damage from past strokes. In a recent study, HBOT was also shown to activate the neuroplasticity of the brain tissue. Neuroplasticity refers to the brain’s ability to form and reorganize synaptic connections, especially in response to learning or experience. This brain healing capability means that healing can occur in poststroke patients. The addition of Neurofeedback therapy can enhance HBOT by stimulating the brain to both heal and rewire to regain optimal function.
Benefits of HBOT
- Stimulates Blood Vessel Growth to Improve Blood Flow
- Improves Cerebral Oxygenation
- Enhances Memory and Mental Performance
- Reduces Brain Swelling
- Decreases Intracranial Pressure
- Increases Blood Flow to the Brain
- Reduces Blood-Brain Barrier Breakdown
- Minimizes Oxidative Stress
- Stimulates Brain Tissue Regeneration
- Promotes Proliferation and Mobilization of Neural Stem Cells
- Facilitates Neuroplasticity
- Recovers & Repairs Damaged Brain Tissue
- Develops & Regains Cognitive/Motor Functions
Scientific research supports positive benefits of Photobiomodulation (PBM) on mitochondria with light exposure in the NIR spectrum (810nm) providing the deepest penetration into brain tissues. Besides safely increasing ATP it produces as a consequence of energy production, mild oxidants (ROS) which lead to gene transcription which is followed by cellular repair and healing. And lastly, it liberates trapped nitric oxide (NO), improving circulation and cellular communication to all body cells. Collectively, brain Photobiomodulation with visible red and NIR light photon energy heals damaged brain cells, improves cerebral blood circulation, reduces inflammation and toxicity, and regenerates damaged brain cells. These benefits lead to improved communication between neurons positively benefiting cognition, cognitive efficiency, and brain performance. The literature on brain Photobiomodulation is growing rapidly. Currently (Oct 2023), there are over 220 published studies on brain Photobiomodulation.
As already mentioned, Alzheimer’s Disease is often the result of factors common to aging that cause inflammation, toxicity, and poor oxygen supply. Once the body and brain are being supported with the proper nutrients, diet, and Plasmalogens, it is able to regenerate even brain neurons and create new connections. Following HBOT, the application of neurofeedback can also be helpful in restoring additional brain function by enhancing connections and promoting neuroplasticity.
One of the most common features discovered from research of Alzheimer’s and dementia is the depletion of critical membrane lipids called plasmalogens. Plasmalogens are naturally occurring lipids incorporated within all cell membranes of our bodies and brain. Research indicates that brain plasmalogen levels begin to decline decades before the development of Alzheimer’s and Dementia. That means we can predict Azlheimer’s even 20-40 years before its onset. In addition, observed deficiencies in both serum and brain Plasmalogen levels are correlated with the progression of Alzheimer’s and Dementia. As the depletion of plasmalogen in Alzheimer’s and dementia is believed to occur as a result of reduced biosynthesis associated with aging, supplementation becomes a real necessity and established option to prevent and reverse Alzheimer’s and Dementia. An increase in Plasmalogens can help rebalance the neural system reducing observed depletion, inflammation, mitochondrial deficiency, and restoring optimal myelin production.
In December of 2021, a team of researchers were able to publish their results which had identified numerous medications that might be helpful in treatment or reversal of Alzheimer’s Disease. The research began by identifying a network of specific genes associated with the onset of Alzheimer’s and compared that to known the responses or actions of 1,600 medications. The researchers were able to identify 66 drugs with the closest relationships to AD-associated genes. One of the most prominent medications to be discovered was Sildenafil which is currently used in medicine for treatment of erectile dysfunction and pulmonary hypertension.
After discovering the connection between Alzheimer’s genes and the prescription medication sildenafil, the researchers analyzed the insurance claims from more than 7 million Americans. They discovered that those individuals (mostly men) who took sildenafil were 69% less likely to develop AD over 6 years than those who did not take the drug.
Continuing research in the benefit of sildenafil on the brain of AD, demonstrated increased growth of neurites, which helps connect neurons to each other. Additionally the researchers observed a decline in a leading biomarker for tau phosphorylation which is associated with the progression of Alzheimer’s Disease. Future research will hopefully validate the association between sildenafil and AD and help us understand how it works, and the best dosing strength and frequency.
Detoxification and Chelation Therapy
A leading cause of aging and cognitive decline is generally rooted in environmental exposures and a persisting body toxin load. Toxic metal testing and results from the Alzhiemer’s LINX test are able to expose the toxins, metals, and immune reactions associated with environmental factors linked to cognitive decline. Based on the lab results, individualized detox protocols will be recommended. Detox therapies could include recommendations for chelation and toxic metal detox, infrared sauna therapy, detox footbaths, glutathione injections, and detox IV therapies. Toxins are most often the cause of chronic inflammation and result in neuronal damage and the associated loss of optimal cognition.
The Brain Regeneration Program
The Brain Regeneration Program is for patients who desire to prevent or reverse the early stages of Alzheimer’s Disease and dementia. The program combines two of the most valuable therapies (Hyperbaric Oxygen and Neurofeedback) into one program to both evaluate and treat, in the most thorough and efficient manner, the risk or effects of cognitive decline. You start with a baseline QEEG(brain map) using 2 different databases (this may already have been completed and reviewed with your physician to develop a baseline and appropriate treatment plan). Then you begin with 40 sessions of Hyperbaric Oxygen Therapy over 8-16 weeks, followed by 20 sessions of Neurofeedback Therapy over 10 weeks. Repeat brain maps, which offer comparisons overtime and can help monitor progress, are scheduled after 40 sessions of HBOT and also after every 10 sessions of Neurofeedback Therapy. We monitor the regeneration program with the comparison brain maps and follow up visits with the physician as needed to review appropriate labs at 4-8 week intervals based on the initial lab testing. This package provides an additional discount when compared to standard pricing for individual sessions or treatment based packages. Discounted packages are non-refundable and non-transferable to other services provided at EVND.