Feb 21 2013

Epilepsy and Exercise Study and Epilepsy at the Olympics – ‘Exercise is good for the brain and the heart, and everything else’ Dr. Elinor Ben-Menachem from Göteborg University.

This week I was listening to the ETP (1) blog cast and was really inspired by the post on the work of DR Elinor Ben-Menachem on her project on exercise and epilepsy as discussed with Dr Joseph Sirven.(2)

Topics discussed:

Raising seizure threshold by exercising more. Low cardiovascular fitness related to 79% higher risk of developing epilepsy after age 18.

Exploring the importance of exercise before the age of 18 in the importance of prevention of health problems in later life, including epilepsy. The possibility that exercise may be an inexpensive way of managing seizures is also mentioned.

Her message is that exercise is ‘good for the brain and the heart, and everything else’.

Full transcript (3)

Also of interest Dr Ben-Menachem’s Hot Topics Symposium Modulators of Epilepsy: The Influence of Lifestyle and Environmental Factors (4)

This research presentation is interesting because it covers neuroplasticity, the hippocampus, the role of exercise in preventing central nervous system diseases, cardiovascular fitness and the future risk of epilepsy. Hormones are also discussed. The Hypothalamic Pituitary Testes and Ovarian axis is covered, together with progesterone treatment trial.

The hypothesis is: cardiovascular fitness could modulate brain plasticity by increasing amounts of circulating growth factors or beta endorphins or some other neuroactive molecule.

Dr Ben-Menachem discusses the Olympic silver medallist cyclist Marion Clignet (5) who was not allowed to race for America at the Olympics so she cycled for France instead. Marion has written a book called ‘Tenacious’ with a fellow sportsman yachtsman Benjamin Hovey who also has epilepsy see here (6) (7)

Further athletes with epilepsy at the Olympics can be found at (8) The Epilepsy Institute of North Carolina blog. Worthy of note in this blog post:

‘Dai Greene played football (soccer for us since he’s British) when he was a teenager. He had to quit playing soccer in his late teens due to a growing spurt that causes knee pain. It is called Osgood Schlatter Disease. He now runs the 400m hurdler for Welsh and Great Britain. Dai had his first seizure at seventeen. He doesn’t take any medication; instead he doesn’t drink any alcohol and makes sure he gets the right amount of sleep needed. Several medals have been won and he will be Captain for the Great British Athletics Team.’

This is very promising from the point of view of the possibilities of using alternative means to control seizures and giving people options beyond medication.

Dr Ben-Menachem has also written a book called Case Studies in Epilepsy (Case Studies in Neurology) [Kindle Edition] (9) This book looks very interesting and although it is out of my price range the initial ‘look inside’ was very promising so if you can find it at a library resource it may be very useful.

Dr Ben-Menachem covers barriers that prevent people with epilepsy from exercising such as; over protection, social isolation, low self-esteem, anxiety and depression. She mentions that weight can be a problem.

I would add one other problem area facing people with epilepsy and exercise which is ‘stigma’; either because of society, weather it is because of lack of understanding of epilepsy or ignorance of what epilepsy is and that it is important to exercise no matter what the health problem.

Exercising in groups is recommended.

Some useful strategies for safely exercising with epilepsy are covered in this blog post from Rosewinelover epilepsy action media volunteer;

http://rosewinelover.com/2013/01/04/epilepsy-and-fitness-resolutions-for-2013/

For myself I can say that without exercise my personal seizure management is extremely challenging because I experience so many positive benefits from exercising. (10)

Happy Exercising Everybody!

1)http://www.epilepsy.com/epilepsy/hallway_2013_podcasts?utm_source=Epilepsy+Therapy+Project&utm_campaign=535342f2b3-Epilepsy_News_2_20_13&utm_medium=email

Epilepsy Therapy Project

2) http://www.gu.se/english/about_the_university/staff/?languageId=100001&userId=6850

3) http://professionals.epilepsy.com/pdfs/Exercise%20and%20Epilepsy%20-%20HC%20-%201_9_13.pdf Epilepsy Therapy Project Blogcast Transcript

4) http://www.hope4harper.com/wp-content/uploads/2012/12/The-Influence-of-Lifestyle-and-Environmental-Factors.pdf

5) http://en.wikipedia.org/wiki/Marion_Clignet

6) http://marionclignet.com/

7)http://marionclignet.com/tenacious

8) http://epilepsyinstitute.blogspot.co.uk/2012/07/epilepsy-and-olympics.html

9) http://www.amazon.co.uk/Case-Studies-Epilepsy-Neurology-ebook/dp/B00A8GYWBO

Case Studies in Epilepsy (Case Studies in Neurology) [Kindle Edition] Hermann Stefan (Author, Editor), Elinor Ben-Menachem (Author, Editor),Patrick Chauvel (Author, Editor), Renzo Guerrini (Editor)

10) https://epilepsymeandneurology.wordpress.com/2012/12/26/what-do-epilepsy-autism-hormones-sleep-music-meditation-exercise-have-in-common-the-hippocampus-and-neurogenesis/

Dec 26 2012

What do Epilepsy, Autism, Hormones, Sleep, Music, Meditation, Exercise have in common? The Hippocampus and Neurogenesis.

This was my first full year of blogging and it has been an enormous learning curve.

Blogging has been an amazing way to connect with other people, read about life experiences, thoughts, emotions and ideas. Thank you to all the bloggers whose work I have read this year. It has been very enriching.

For me, I have been able to express myself in writing, and to say what I am thinking about – which is quite liberating.

Most of all blogging has helped me to make sense of epilepsy.

So, when I was looking back at all the subjects that came up in the last year, I was struck by how although very different subject areas were covered, a number of these topics could all be knitted together in a ‘holistic’ kind of way via one area of the brain.

The hippocampus.(1)

Architecturally the hippocampus sits within the limbic system (2) fairly centrally inside the brain (towards the brainstem).

This area of the brain is implicated in; mood, memory, learning and spatial awareness. Because of these factors the study of the hippocampus has been important in diseases such as Alzheimer’s and depression.

Relatively recently scientists identified the hippocampus as one of a number of areas in the brain that is capable of neurogenesis into adulthood. (3) Neurogenesis is the ability of the brain to create new neurons.

For this reason the hippocampus crops up in lots of neurological studies.

Within epilepsy for example, some of the factors that aggravate seizure symptoms generally are sleep deprivation and stress. Sleep deprivation and stress negatively affect neurogenesis and there are a number of studies around the relationship with epilepsy and the hippocampus. One study in particular shows; abnormal neurogenesis in the hippocampus of people with epilepsy, increased neurogenesis in people with epilepsy and inhibited neurogenesis in the hippocampus, in particular a study relating to temporal lobe epilepsy (4). All of these problems can impact on mood, depression, memory and learning in epilepsy.

Having found information that epilepsy and autism can be linked I started exploring this area more and even found people advocating for both such as Epilepsy Action’s Advocate blog (5).

Within autism, the hippocampus is mentioned in studies relating to the importance of autism and working memory. (6) The reason I was looking at this relationship is because one of my friends who is on the autistic spectrum benefits highly from martial arts training. I read an article ages ago in ‘Martial Arts Illustrated’ magazine about ‘Sandra Jane Beale Ellis’(7) who has autism and has spent her life helping people with autism to train in Karate (8). Recently someone posted a blog about how kung fu and tai chi training help people with autism. (9) These studies reminded me how much tai chi training helped me with seizures and how much my memory, concentration, co-ordination and overall health was improved by tai chi and karate training. Some studies of autism indicate that an enriched learning environment from a young age in autism can be beneficial to promote neurogeneisis (10).

Hormones such as cortisol negatively effects neurogenesis within the hippocampus (11) cortisol is elevated by stress. Studies relating to oestrogen show there may be some impact of this hormone within the hippocampus and co-ordination (12) I found this research interesting because of problems I have around oestrogen and progesterone and seizure control. Melatonin (13) studies within the hippocampus indicate that melatonin may have neuroprotective qualities and indeed other bloggers with epilepsy have said that they find melatonin supplementation to be beneficial (14).

This leads onto Sleep deprivation negatively influences or reduces neurogenesis within the hippocampus (15). I am quite interested in the importance of sleep in relation to this area of the brain, because it crops up a lot in my personal experience of managing seizures. Reading about Jill Taylor Bolt stroke insight caused me to think about how sleep influences the brain and why. The asdresearchinitiative also shows a study of how sleep pattern problems impact on autism. (16) During sleep the brain goes through a process of ‘pruning’ neurons, this process also happens at different times in life. (17) (18)

Music came up more recently in relation to the ‘Mozart effect ’ in classical music (19). Studies of the hippocampus in music show how the hippocampus is implicated in long term memory and stringing together music in the brain. The music of Mozart in particular has been used to train mice to carry out spatial tasks in mazes, and one theory is that music may activate the same pathways as spatial awareness in the brain. (20) Music can cause emotional responses and I was interested how the hippocampus is located in the emotional brain or limbic system.

Within meditation, Studies into meditation have shown that meditation influences neuroplasticity and neurogenesis positively within the hippocampus. (21)

Exercise studies show that exercise promotes neurogenesis within the hippocampus. (22) In relation to exercise and mental health exercise has been shown to have a positive influence on mental health and some studies show that this positively influences the hippocampus. (23) This could explain why life systems such as yoga or tai chi which incorporate meditation as well as exercise are very good for the mind and body, because they support growth in the hippocampus.

In the context of Traditional Chinese Medicine, the Kidney energy (24), is an area that I felt conceptually could be linked to neurogenesis by ‘pre natal chi’ (25) or Jing. This is because of the involvement of the Central Nervous System and stem cells in neurogenesis (26). I also thought that this could be carried across into ‘sexual energy’ or ‘kundalini’ in yoga.

Of course the hippocampus is only one small area of the brain and only one small part of the ‘whole body’, but I am interested that there are so many links with so many corresponding or similar impacting factors such as stress and sleep. The hippocampus is a bit like the ‘spaghetti junction’ of the brain! It is quite important how it fits into the whole body and mind because when it goes wrong or without it (such as was the case for poor Henry Molaison who had his hippocampus removed!)(26) things could get really messy!

The hippocampus is not the be all and end all of epilepsy and autism, or brain function; but I thought it was a good area to take a ‘big picture’ ‘small area’ snapshot into holistic mind body connections.

Normally I talk about one thing at a time, but it occurred to me that it can all fit together if you cross reference all these areas to help understand mind body health!

Happy Christmas and New Year! Wishing you all the best for 2013!

1) http://en.wikipedia.org/wiki/Hippocampus

2) http://en.wikipedia.org/wiki/Limbic_system limbic system

3) http://en.wikipedia.org/wiki/Neurogenesis

4) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654382/ epilepsy

5) http://rosewinelover.com/ Epilepsy Action Advocate Blog

6) http://en.wikipedia.org/wiki/Autism_and_working_memory

7) http://challengeautism.wordpress.com/ Sandra Beale Ellis blog

8) http://www.challengeautism.co.uk/#/autism-me/4543515032 autism and karate

9) http://doctordilday.wordpress.com/2012/12/21/just-another-form-of-exercise/ tai chi and autism

10) http://brain.oxfordjournals.org/content/124/7/1317.full#ref-29 enriched learning and autism

11) http://en.wikipedia.org/wiki/Neurogenesis cortisol