Complexity of our Brain

Our brain is the most complex machine that ever existed. With over 7.146 billion models it is also the most ubiquitous.   Despite this, we are unsure of its complexity. We still do not yet understand how it works. By defining the functionality of certain areas of the brain, and by understanding some of the mechanics at the neural chemcial level, we still remain ignorant of how the brain coordinates all of its activities and develops language, thought and a sense of self.

This three point three-pound wet mass—greyish on the outside, and whitish pink on the inside—controls every single thing you will ever do. Ever. Each one of us needs these complex structures because each one of us needs it to reflect the totality of the world we live in and how we function within it. Our brain constructs a representation of the world and how we function within it.  Other animals do this as well, but what is important in their world is different from what our brain determines is important for us.

In the past we took a different attitude to studying the brain. Most of the scientific writing on the brain was focused on establishing the superiority of human intelligence. But there is not one single factor that we can apply to distinguish our brains from those of other animals. We cannot just use size, because some mammals (eg whales) have bigger brains. Perhaps it is the size of the brain in proportion to the body. When we try that by measuring the Encephalization Quotient (EQ) ratio, small birds beat us. Perhaps it is size, EQ and something else. The correct question is to ask what aspects of the world are we, as humans, trying to represent in our brain? And how complex is the brain really?

In 2009, the Brazilian scientist Suzana Herculano-Houzel performed a review of what we know about the physical structure of the brain. The adult human male brain has 86 billion neurons--more than any other primate. Each neuron has between 1,000 to 10,000 synapses that result in 125 trillion synapses in the cerebral cortex alone. That is at least 1,000 times the number of stars in our galaxy. Stephen Smith from Stanford University reported that one synapse might contain some 1,000 molecular-scale switches. That is over 125,000 trillion switches in a single human brain.

With such a lean mean machine then it is a surprise to learn that the brain is obese. It is composed of 60 percent fat, with over 25 percent of that being cholesterol. Cholesterol is in every cell in our body and becomes concentrated in our brain. Most of the cholesterol in the brain is produced in the hypothalamus itself, establishing cholesterol as an integral part of our brain. Cholesterol is used by a specific type of glial cells in the brain to form myelination—sheathing which enhances neuron speed and integrity of signal. Glial cells outnumber neurons ten times over with 860 billion cells. It was only in 2010 that glial cells were found to assist neurons in forming synaptic connections between each other. Once thought to be simply support cells, cleaning up and helping with myelination, they are now known to also promote dendrite growth, and to be as important as neurons in forming the neural network that make up cognitive activity. Glial cells can also reproduce—if neurons reproduce they do it slower—and similarly release transmitters and control neural activity just like neurons. All of this activity is monitored by microglia cells that not only clean up damaged cells but they also prune dendrites, forming part of the learning process.

Comparing mapping the brain to mapping the human genome is like comparing the artistry of the Mona Lisa to Sponge Bath Bob. The total length of the human genome is over 3 billion base pairs, the brain has nearly 30 times more neurons. And whereas the genome base pairs has an on and off arrangement, each neuron might have a thousand switches. Mapping the brain will mean that if every switch in every synaptic end at every neuron is identified by a second of time then it will take 4,000,000,000 years to complete. The brain is that complex.

In the cortex alone, there are 100,000 miles of myelin-covered—insulted—nerve fibers. Leaving the brain to the outer reaches of our skin, we have a neural network that is incomparable. We have millions of nerve endings in the outermost layer of our body that sense minute variations of light, sounds, vibrations, touch, smell, pressure, temperature; all extremely sensitive in most cases more sensitive than any computer on earth. The marvel of the brain is not just the capacity but the sensitivity to stimuli.

There is a galaxy of neural networks active in our bodies designed to get information from the outside. All this information is travelling from the outer reaches of the body to the brain sometimes at speeds of 268 miles per hour. The brain is structured in such a way that information is processed both linear and parallel. And here is the beauty of the brain. It creates a kind of a dance, it orchestrates the flow of information in a way that we still do not fully understand.

We filter out most of the sensory information. Information travelling from our peripheral senses to the brain, making a vibrating, electrical symphony. Constantly on and constantly playing and the brain makes music from trillions of individual notes every second throughout our lives. And the musical composition has to do with the world outside and how it affects us. The brain teaches the body to survive. We represent the dynamics of the outside world inside our brain. There we can predict and therefore control the outcome. This is learning. Through learning and some innate ability we identify what is important and what is not so important. That “so” is crucial. Information as differing levels of importance, and also times when we are more prone to learn than at other times.

Our brain is an organic reflection of the environment that we face day-in-day-out. Our conscious attention is drawn to specific aspects of all sensory information monitored by the brain. We are monitoring many other peripheral events at a subconscious level. The more we learn the less we need the brain, unless we challenge it all the time. That constant state of unease, the novelty is what keeps the brain functioning as it is meant to function. Once it can predict then it no longer needs to learn new things.

All of this complexity allows the brain to continuously receive feedback from the outside to modify its construct of the world and then to determine what is important for us. Its aim is to be able to predict the environment we live in and to do that is has developed one of the most complex structures known to humans. By mapping the brain we will be holding a mirror to another mirror.

© USA Copyrighted 2014 Mario D. Garrett

Dementia and Gambling

In 2013 the gambling industry reported that more than half of its customers are 50 years and older. David Oslin at the University of Pennsylvania reports that 70 percent of the older adults 65 years and older had gambled in the previous year and that one in 11 had bet more than he or she could comfortably afford to lose. Using this percentage—despite older adults having the lowest rate of pathological gambling—in 2013, there were potentially more than four million older adults with a gambling problem.

Although there is very little independent research—that which is not sponsored by the gambling industry—on pathological gambling older adults, what we know is that they are likely to have poor mental and physical health and have less income. Although these are not the cases that make the news, these are the gamblers that fuel the profit margins of the gambling industry.

Most older adults are hesitant talking about their addiction—as Oslin found when half refused to participate. Most will not come out of the closet since it involves money-secrets at both ends. How you obtain money to gamble and what you do with the losses or the wins. For addicted gamblers both the winning and losing are highs, either way, casinos always profit. Casinos will not make a profit if they do not have compulsive gamblers.  The Wall Street Journal reports how Harrah's Entertainment Inc. in 2007 derived 5.6% of its Las Vegas gambling revenue from just one man, Mr. Terry Watanabe—despite their competitor Steve Wynn barring Mr. Watanabe because he was a compulsive gambler and alcoholic. 

Pathological gambling, or Gambling Disorder (GD)—as the DSM-V defines it now—is characterized by consistent, repetitive gambling and unsuccessful attempts at quitting. GD is seen an impulse control disorder and has been reported in patients with Parkinson's disease, frontotemporal dementia, and amyotrophic lateral sclerosis.   

However, there is no comprehensive study of how many patients with dementia gamble. Studies that show the benefits of gambling among nursing home patients do not report control studies or the amount of money being gambled and lost. There are also inconclusive results about the effect of dementia or Parkinson’s medication. One outcome is certain however. Gambling disorder responds to medication—either positive or negative. While 30-50 percent of adults with gambling disorders also have substance abuse—medication (such as opioid antagonists) used to treat drug and alcohol dependence also seems to work for gambling addiction. 

Gambling Disorder (GD) is argued to be different from recreational gambling.  However with an increasing aging population that exhibit more and more cognitive decline and impairment, the lines are becoming blurred. But this is not a no-cost venture. Older adults are unlikely to recover lost savings, while their families are usually the ones left without any resources. In the award winning and highly readable 2013 book “Addiction by Design”, anthropologist Natasha Dow Schüll from Massachusetts Institute of Technology defines exactly how slot machines, and the casinos that contain them, are designed specifically to create addiction and encourage their users to 'play to extinction'. 

© USA Copyrighted 2014 Mario D. Garrett

Casinos Preying on Older Adults

After it was revealed in February 2013 that San Diego’s former mayor, 67 year old Maureen O’Connor, lost more than a billion dollars at casinos, the gaming industry shed its disguise and became the gambling industry again. This was definitely not entertainment.

Maureen O’Connor reported that she was suffering from a brain tumor that might have impaired her judgment. A vulnerability that was not moderated by Las Vegas casinos sending private jets to fetch Ms O’Connor from San Diego. A trend that was also seen with Terry Watanabe who risked more than $825 million in 2007 at two casinos owned by Harrah's where it is alleged Harrah's senior management made a conscious decision to exploit his well-known addiction with alcohol and prescription drugs. No lawsuit has ever won. But what they do is expose the human tragedy fueled by the industry’s predatory use of complimentary services called “comps” against the increasing vulnerability of some older adults.

Bill Kearney—a staunch advocate for effective regulations of casinos—defines the world of comping in his excellent 2001 book “Comped”. Comping might start off with a free room, meals, free drinks and then, like Ms. O’Connor, ends up with to limos, helicopter and Lear Jet flights, interest-free loans, and lavish penthouse suites that the casinos provide as they cultivate their profits. These comps are in addition to exemptions that the gambling industry has gained, including no-limit ATM machines, sales tax exemptions, smoking exemptions, and many others. All these exemptions and comps transform the industry from one of entertainment—where you pay a predefined cost for a service—to predation.

Predation involves monitoring older adults’ gambling behavior and promoting both the frequency—through comping—or the amount—through interest-free loans, cashless gambling, free alcohol and medication pills. When you have older adults with obvious cognitive impairment then you need to question if such predatory behavior constitutes financial elder abuse under state laws.

In California, financial elder abuse has both criminal and civil definitions that apply to anyone 65 or older regardless of whether they have any diminished physical or mental capacity. Financial elder abuse occurs when any person or entity—takes, secrets, appropriates, obtains or retains real or personal property of an elder for a wrongful use or with intent to defraud—including assisting. “Wrongful use” is when a person “knew or should have known that this conduct is likely to be harmful to the elder.” Cal. Welfare & Institutions Code §15610.30.
This definition makes for a perfect storm. With increasing penetration of the gambling industry into nearly all States, increasing prevalence of older adults with cognitive and physical frailty, and an increasing awareness by families of the signs of financial elder abuse we might see our first test case of financial elder abuse laws against casinos. When Harrah’s comps $1.1 million to AARP we have to question what AARP is gambling with, and what are we likely to lose. Thom Reilly, executive director of the Harrah’s Foundation explained that “This relationship with the AARP Foundation allows us to extend our reach into that community and help them address caregiving issues.”

© USA Copyrighted 2014 Mario D. Garrett

Cholesterol and our Aging Brains

Cholesterol is in every cell in our body and becomes concentrated in our brain. Our brain is 60% fat, with over 25% of that being cholesterol. Most of the cholesterol in the brain is produced in the hypothalamus itself, establishing cholesterol as an integral part of our brain.

One of the most dramatic difference between young and old brains is the reduced myelination—fat sheathing—around nerves, which might explain why aging brains shrink at 1% a year. Myelin is a sheet of lipid, or fat, with the highest cholesterol content of any brain tissue. Even neurotransmitters, the chemical words used in the language that the brain communicates in, are made of cholesterol. George Bartzokis, with UCLA, and his colleagues, found a correlation between diminishing speed of performing tasks and diminishing level of myelination. The older we get, the less myelination we have. And in older age we can destroy this protective layer much faster through excessive alcohol intake and some non-/prescription drugs.

Myelination seems to be important in how we learn. Although grey matter—on the outside of the cortex made up of neurons—carry messages and does the “thinking”—white matter—the myelinated part of the brain—controls the strength of signals. Myelination is how we learn, strengthening some signals above others. Myelination also occurs in at different ages. Starting from the back of the brain as children, and finishing off at the front of the brain in adulthood. This explains why certain tasks are easier when you are a child then at older ages (learning to speak without an accent.)

And the role of cholesterol seems crucial to this process of myelination. In 2008 Rebecca West and her colleagues from Mount Sinai School of Medicine, New York, unexpectedly found that among normal—no expression of dementia and not having the genes that predispose you to get dementia—older adults aged 85 years and older, high total cholesterol and high LDL (bad) cholesterol were associated with higher memory scores.

Other evidence is mounting. Elizabeth Johnson and Ernst Schaefer with Tufts University, Boston, MA conjectured that one commercially available fish oil capsule per week—180 mg dietary DHA/d—might reduce the risk of dementia by half.  On the negative side, two small trials published in 2000 and 2004 by Matthew Muldoon from the University of Pittsburgh, suggest that prescription medication we use to lower cholesterol—statins—might bring about cognitive decline. He reported that participants taking placebo pills improved on repeated tests of attention and reaction while those on statins did not.  This was further confirmed by anecdotal evidence published in an article in 2003 in Reviews of Therapeutics which reported  that among 60 statin users who had reported memory problems to MedWatch, when they stopped taking the medication more than half reported  improved memory.

Science is not truer than religion. Science is being able to challenge the accepted reality of today. Science is a method rather than a body of truths. The method is to question beliefs, to test expectations. The problem with science in large U.S. institutions is that it has become a religion.

© USA Copyrighted 2014 Mario D. Garrett