Disclaimer: This is transcribed using AI. Expect (funny) errors.
Mindy Peterson: [00:00:00] I’m Mindy Peterson, and this is Enhance Life with Music, where we explore the practical ways music transforms everyday life – health, happiness and beyond. I think that all of us at some point have worried about memory issues, forgetting names, or maybe why we walked into a room. Maybe we’ve seen loved ones slip away into a fog of dementia. That’s true for me and wonder if that will be our destiny. Other common brain concerns are trouble focusing. Maybe you worry, or know that you have ADHD, or you’ve suffered from a concussion and are wondering if your brain will ever fully recover, or you simply want to know how to stay mentally sharp as you age. My guest today is convinced that Alzheimer’s and dementia can be delayed, prevented, and in some cases reversed, and that your brain can become sharper, more focused, and more resilient with time. Doctor Majid Fatuhi is a world renowned neurologist and medical doctor who is redefining how we think about aging, intelligence and brain health. He teaches at Johns Hopkins University, George Washington University, and Harvard Medical School. He is the author of multiple books, the latest of which just released. It’s called The Invincible Brain: The Clinically Proven Plan to Age-Proof your Brain and Stay Sharp for Life. He’s here today to discuss this brand new book, and how music can play a role in enhancing brain vitality and cognitive performance at any age. Welcome to Enhance Life with Music, Dr. Fotuhi.
Majid Fotuhi: [00:01:44] Thank you very much for having me on your podcast. I really appreciate it.
Mindy Peterson: [00:01:48] I’m really looking forward to our conversation. I loved your book and as a healthy lifestyle junkie, there’s so much that I’d love to talk about, but I’m going to discipline myself and try to stick to the aspects that are relevant to music, since that’s the scope of this podcast. But first of all, before we get into anything musical related, I’m wondering if you can just explain to listeners why you wrote this book, because I found the reason so compelling. It sounds like it started with concerns that you had during your residency about Alzheimer’s being overdiagnosed and being presented as an incurable disease. And that concern was followed up by your own experiences in clinical practice, where you saw dramatic results in just 12 weeks with your own patient. So tell us a little bit more about these experiences that you had and how they led to this book.
Majid Fotuhi: [00:02:43] Yes, that was exactly right. You know, when I was in medical school at Harvard, I became interested in the brain particularly, and I decided that I wanted to become a neurologist. And when I started my neurology residency at Johns Hopkins, I saw a lot of patients who were diagnosed with Alzheimer’s disease, but they had many treatable conditions at the same time. For example, let’s say a 78 year old who has significant diabetes, some degree of depression, takes a lot of medications, is depressed, and is home alone. All of those factors can cause memory loss. And yet these patients were diagnosed with Alzheimer disease. And I thought, wait a minute, we shouldn’t really labeling them as having Alzheimer’s disease. They have a super problem in their brains due to vascular problems, inflammation and poor rinsing and cleaning of the brain, and some degree of what we call Alzheimer disease, which is accumulation of these proteins in the brain called amyloid and tau. So we have a series of reversible things depression, diabetes, sleep apnea, obesity, sedentary lifestyle, isolation, all that things. And then we have these stubborn little proteins that for some reason aggregate. And when they aggregate, they become like a gum and they become insoluble and they cause inflammation in the brain and cause brain shrinkage. So a group of things that are reversible cause brain shrinkage. And these two proteins, which we call neurodegenerative disease, cause problems.
Majid Fotuhi: [00:04:21] And yet most people had a combination of these things in their brain. They may have been like 80% vascular metabolic things and 20% plaques and tangles. And they were patients who had like 70% plaques and tangles and 30% other things. But it was never the case, never the case that 85 year old had only plaques and tangles and nothing else. This was very rare, if at all. So I felt, well, why aren’t we treating the treatable components. These are the stubborn proteins are difficult, and we’ll have to figure out a way to handle them. But why? We just tell people they have Alzheimer’s disease, and we park them in a nursing home and let them have a miserable end to their life? Why don’t we try, and even more importantly, why don’t we educate people to treat these treatable things in midlife? Sure, because the damage they cause, the shrinkage they cause in the brain is cumulative over decades. So if you’re 45 years old and you have high blood pressure and you have poor sleep and you snore at night and you don’t exercise, all of those are going to shrink your brain just a little, tiny bit every day. But over 30 years, that becomes significant shrinkage. And that’s why I wrote my first book in 2002 called The Memory Cure, where I talk about just what I just told you.
Majid Fotuhi: [00:05:44] Yeah. And in 2009, I realized that there are many things that actually grow the brain. So first I was talking about stop doing things that shrink your brain. But then new evidence started coming up in the literature that showed that regular exercise increases the volume of the brain areas that are important for memory. For example, an area called hippocampus, which is the size of your thumb, there’s one on the right, one on the left. And this brain, this part of the brain is critically important for learning new things. So for example, if you learn how to play the piano, the learning part happens in the hippocampus. So then I said, wait a minute. That’s so interesting. So if somebody didn’t have any negative risk factors but wanted to increase their brain capacity, to increase their brain resilience so that there will be more resilient at age 80, if some plaques and tangles appear out of nowhere, the brain is stronger to fight back. That was incredible. So I wrote two articles in a very prestigious journal called nature. And I talk about these things. And it was to me a breakthrough. But, you know, people usually want a drug. And so the emphasis always was, let’s try to find a drug for these two proteins, and these other things will somehow resolve themselves.
Mindy Peterson: [00:07:07] Well, it was so interesting in your book how you talk about the proteins, the presence of the proteins doesn’t necessarily.
Majid Fotuhi: [00:07:14] Exactly.
Mindy Peterson: [00:07:14] Result in dementia. Like. Yeah, I won’t go into that. But that was really interesting.
Majid Fotuhi: [00:07:19] For example, a study called a nun study showed that if you look at elderly women, sisters who live in monasteries, they teach, they pray, they do community work, they drive, they do things they don’t stress usually that much. These people’s brains were functioning much better than expected. Many of these sisters had significant load of pathology, of Alzheimer’s pathology. These plaques and tangles in the brain, yet they had no symptoms. Their brains were very resilient to the effects of Alzheimer’s in the brain. So as a neurologist, I figured, well, if all these things are true, what if we made a program and put all these good things together and work with patients to reduce their bad habits and give them new habits, then we should see results. If it’s all true, then if I had a neurology center and I did all this things, I should be able to see a result in nine months. So I started.
Mindy Peterson: [00:08:18] So reduce the things that are shrinking the brain and increase the things that we know will grow the brain or increase that brain capital or brain reserves.
Majid Fotuhi: [00:08:27] Right. So up to that point in 2010, 2011, all the studies had described how people were exercise, for example, grow their brain or how people who reduce stress can improve their brain, how meditation grows the brain, how obesity shrinks the brain, but nobody, to my knowledge, had put all of them into one program. This is an academic centers, and people have done research on them. But I argued, well, if I have an office and I have coaches who help people address these things, then we should see the results technically, right? I mean, it should work. And then I started a program in 2012, and the program was nine months. And as I did these things with this elderly who were usually 60s, 70s and early 80s, we saw results much faster. So I decided nine months is too much, six months is enough. And then I realized, no, even three months seems to be good. So then I made three months. I said, how about six weeks? Six weeks.
Mindy Peterson: [00:09:26] Okay, so 12 weeks. Is the magic the minimum amount necessary for the maximum results?
Majid Fotuhi: [00:09:33] Anyways, people come to our center twice a week, 90 minutes each time, and we do brain training and life coaching. And so within 12 weeks. That seemed to be the optimal time for most people. And so I had several patients who came in really convinced they have Alzheimer’s disease. They were not talking much. They were repeating themselves. The family was convinced that this is it, and they wanted to just confirm the diagnosis. And I thought, wait a minute. Let’s let’s give him a chance. And many of them improved. So then I started doing MRIs on their brains to see if all these things we do that seem to be improving their symptoms, does it actually grow their brain? So much so that we can see on MRI? Keep in mind that we’re not. When we talk about things at the brain level, we’re talking about the microscopic level. Neurons are born. Blood vessels are generated. Synapses are formed. It’s all microscopic. But could it be enough that we can see on an MRI with naked eye? And this is what happened. About half our patients had grown their hippocampus by about 1 to 3%. Keep in mind that hippocampus usually shrinks about 1% per year after age 50. So they have a campus by 3% in three months is equivalent of making someone’s brain younger in equivalent of three years younger in brain age. Just 12 weeks.
Mindy Peterson: [00:10:56] Yeah. I just want to say that again. So listeners hear this. So the MRI results showed that more than half of your patients had grown the size of their hippocampus by 3%, or 1 to 3%. And that meant that their brains had become about three years younger. And that 12 week time when typically they would be losing size and mass as they age.
Majid Fotuhi: [00:11:19] Absolutely.
Mindy Peterson: [00:11:20] Pretty amazing.
Majid Fotuhi: [00:11:20] It was amazing to me. So I thought maybe I just got lucky. You know, this is actually the first patient I saw. It was the best case we saw and was the first case. One of the first patients I saw had many problems, and we really give her intensive training. And she had 8%, which was the best. Usually it’s about 1 to 3% anyway. So I thought maybe just, oh, this is too good to be true. I remember one day I went to work and like, I used to go to work at 4 a.m. just getting ready for my day, and I did a radiology report came and this person’s brain had grown and I couldn’t believe it. So I provided this program for more patients, and we saw 129 patients with a diagnosis of MCI. Mci stands for mild cognitive impairment is a condition between normal and Alzheimer disease. These are people who are very forgetful, get confused sometimes, but they’re still driving and doing things, but they really are not normal. So stage one Alzheimer’s. And so we saw that 84% of our patients had objective improvements in their cognitive tests. It wasn’t just that told me they felt better when we did computerized cognitive testing on them, independent content, cognitive testing on them, 84% of them had improved their cognitive functions. That was amazing. These are patients who were one step away from Alzheimer’s disease, and yet we made them normal again. Wow. And it was. Wow. Exactly. I sent that article to the Journal of Alzheimer’s Disease was accepted, and we had a picture of the patients. And you can see MRI before and after. It’s actually on my website. People want to look at it. Those papers. So then I was so excited. 2015 I started the brand new office here in Northern Virginia near Washington, D.C., and, um, we made the program more structured. I hired, uh, brain coaches, who usually had a bachelor’s degree or master’s degree in psychology or social work, and I trained them based on my publications and my books and papers, how to encourage patients to change their behavior.
Mindy Peterson: [00:13:26] And I’ll just point, jump in and point out, too, that, like you said, this was the same results with people, whether they had more advanced dementia or if it was mild cognitive impairment. But you also had these same dramatic results with patients that had ADHD and patients that had post-concussion syndrome. Yes. Right. This is all ages. It wasn’t just elderly.
Majid Fotuhi: [00:13:52] This was not the case for people with advanced dementia. This was only for people who had mild cognitive impairment or mild disease.
Mindy Peterson: [00:14:01] Not okay. Okay. So you had these dramatic results with mild cognitive impairment and also ADHD and post-concussion syndrome Alzheimer’s disease.
Majid Fotuhi: [00:14:10] So you know, there’s a cognitive testing called Moca, which is from 1 to 30. And usually 24 is considered a borderline when people if they’re around 24 are called mild cognitive impairment. If there are 28 is considered okay normal. If it’s considered 19, that’s dementia. So we had patients who were like 20 to 29 at that range. If somebody. Okay, know what year it was or didn’t recognize family members, unfortunately, that was too late. Okay, so.
Mindy Peterson: [00:14:39] Then, just for time’s sake, I’m just going to fast forward a little bit and say that for 12 years you had patients flying in from across the country to your clinic. You were booked solid seven days a week, 12 hours a day, and you came to the conclusion that people could take advantage of these tools and these resources right from their own home. Tell us a little bit about that, how you decided to retire from this practice and write this book as a result of the success you were seeing in your clinic?
Majid Fotuhi: [00:15:12] Yeah, well, our office was open from 8 a.m. to 8 p.m. every day, and it was solid books. We had 25 coaches, and managing this was becoming quite a job of seven days a week, 8 a.m. to 8 p.m. like Sunday night, Saturday night, the office was full and thanks to my wife, we were able to manage and keep everything organized. And I realized there’s a need for this. And so I decided, you know, I can’t just keep repeating myself to 100 or so patients every week in my office and tell them the same thing over and over again. I really need to bring this up to a national level, and the best way to do that would be through writing a book, putting together an app, an online course, and do public health education through giving lectures. And I’m so glad I did that because I love doing it. Now I am I’m a professor at Johns Hopkins University and I teach a whole course about these things.
Mindy Peterson: [00:16:10] It’s called wonderful because that’s another great way to extend the the ripple effect of all of this teaching is to teach the next generation of physicians.
Majid Fotuhi: [00:16:19] Exactly, exactly. So I’m loving it these days, and I’m very excited about the book being available for public and going around giving lectures. I’m doing a lot of podcasts and I find that I’m in my element. You know, I need to find a sense of purpose. What drives them? What excites them. And I feel so excited that I can share the good news that, listen, every person can grow to their 60s, 70s and early 80s and remain sharp and independent. Only a small percentage of people, maybe 5%, maybe 7%, have genes that determine whether they stay sharp no matter what they do or unfortunately, they decline despite doing everything right. Genes play a small role for late life Alzheimer’s disease. It’s different from early onset Alzheimer’s disease, where genes do play an important role for a 50 year old or 40 year old, or a 55 year old. Genes are primarily cause of Alzheimer’s disease, but that early onset Alzheimer’s disease accounts for less than 2 to 3% of all Alzheimer’s disease cases in the world, 97% 95% have a mixed pathologies in the brain, and most of those things are treatable and genes play a very small role.
Mindy Peterson: [00:17:33] Hmm. Well, it’s so encouraging to hear that we have agency. We have control over a lot of what’s happening with our brain size, our brain health, our brain reserves. And I’m so excited that you’ve written this book. And I’ll point out to listeners that this book, part three of the book, takes your brain fitness program that you were so booked with in your clinic and puts it into this book so listeners can access that for themselves. And the the third part of your book. So let’s there’s so much you talk about in the, in the book, including Pillars of Brain Health, you talk about all those different factors that feed into this Alzheimer’s soup, as you called it, and you reference that in your book, which I think is such a helpful metaphor to think about where you talk about diabetes and obesity can play a factor, a factor in this. In fact, I’ve heard multiple times that diabetes is considered now like a type three. Um, uh, Alzheimer’s, I think is or Alzheimer’s is considered a type three diabetes, I guess is how it’s termed. But there’s so many of these different factors and elements that feed into the Alzheimer’s soup. And I love that you’ve broken out those different factors and talked about the ones that can be addressed that we have agency over. So you talk about the pillars of brain health, but steering toward the topic of music and the scope of our discussion and the topic of this podcast. You said that prevention of cognitive decline is not only possible, but realistic. Talk to us about what role music can play in each proofing the brain, preventing dementia, and enhancing brain vitality at any age.
Majid Fotuhi: [00:19:12] I think music is one of the best ways to keep your brain young. And, uh, I strongly recommend, uh, playing music, listening to music, and doing things like singing, dancing and so forth. Just to put things in perspective, there are five pillars of brain health exercise, sleep, nutrition, stress reduction, and brain training. So musical training, when you learn to play a musical instrument, really activates multiple networks in your brain. Your brain is like a muscle. The more you use it, the stronger it gets. Now, the good thing about music is that often you have to use multiple parts of your brain to learn a new musical instrument, and that really challenges the brain and pushes the brain to create new neurons, new synapses, new connections. You know, when you go to a gym and you exercise, they say, no pain, no gain. And when you play an instrument, a musical instrument, you get frustrated because you want to hold, for example, the guitar. You just changing a note and it keeps the wrong one. It’s just, you know, you’re hitting the wrong one and it gets frustrating. Well, that frustration is the same as the pain and the discomfort. An athlete would experience when they bench press £200.
Mindy Peterson: [00:20:32] Oh, it’s interesting to hear it put that way. I haven’t heard it explained that way, but that makes sense.
Majid Fotuhi: [00:20:36] Yeah. So it’s frustrating because, you know, you just want to move on and it just doesn’t seem to go. And so your brain is like a muscle. The more you stimulate, the stronger it gets. And the beauty of music is that it activates multiple brain networks. Let’s say you learn a new language. When you learn a new language, you’re focusing your brain on areas of the brain that are important for language, which is like 3 or 4 patches of the brain and a network that includes eight nodes. So you really are working those eight nodes and you’re also working attention part. But if you’re learning to play the guitar, you have to keep track of your fingers. You have to be listening to music, you’re reading music and you’re sequencing your fingers. Whether it’s a piano or the guitar, the flute or you’re learning to sing. All of those things activate multiple brain areas at once. And that’s where the beauty of music is. And that’s why I recommend learning a new instrument. And, you know, also, I like dancing. My interaction music is through dancing. I love to dance. I do tango, cha cha, waltz, and I love to just immerse myself in the music and let the music move my body. I love that, and I know for a fact that the music not only is challenging my brain, not only is pushing me to create new synapses, new pathways in the brain, but it also has a calming effect.
Majid Fotuhi: [00:22:06] I feel calmer when I dance. I feel relaxed because while I’m dancing, while I’m keeping track of the steps like I’m doing this, this, this, and the next step is going to be this, and after that, it’s going to be that. But while I’m thinking of what it will be, meanwhile, I need to pay attention to what I’m doing now so I am really cross-training my brain. And while I’m doing these things, I can’t be worrying about the politics or the mortgage or the kids, or whether I’m so consumed with all these things that are my brain being challenged with. And that’s so refreshing. And our dancing is really, uh, refreshing. And the third element, uh, of dancing for me is the element of socializing. You know, when you go to dance parties or you go to ballroom dancing classes, it’s a social event. So music can improve brain functions in three ways. It challenges the brain, it relaxes the brain, and it has the reward associated with the social aspect of it when there is a social component. And for all these reasons, I think that that’s a no brainer.
Mindy Peterson: [00:23:20] Nice pun there.
Majid Fotuhi: [00:23:22] I think I think, you know, passive listening to music obviously is the bottom of the list. If you’re just having some music on while you’re driving, that’s really the least interaction can have with music. Some relaxation component maybe. So I think if that’s what you’re doing, you could perhaps make a playlist for yourself. You use the brain areas for music and sort of categorize different songs, you know, and put them in an album and a playlist for yourself so that you have like three playlists.
Mindy Peterson: [00:23:55] In your book. You quote a very widely cited study from 2024, in The Lancet that highlighted the importance of prevention for dementia. And in the study, they talk about how not to get Alzheimer’s. And they had, I think, 14 different lifestyle factors. And you kind of translate those into a list of actions. So instead of don’t do this, let’s do this. And the number one thing I don’t know if this was by design, by priority or not, but the number one thing was keep learning new things, which obviously we’ve been talking about and has high relevance to playing a musical instrument or making music. Another one was make social Connections and as you pointed out, music is highly social, whether it’s involved in dance or whether it’s involved in singing in a choir or playing in an orchestra or a band, um, even just listening to music can be so beneficial. Like there’s been studies about why do we love listening to sad music? It seems counterintuitive, but when we hear somebody singing a sad song and we’re sad, it makes us feel less alone. We know that the person who wrote these lyrics, they’ve experienced similar situations to what we’re experiencing. So there is such a social aspect of music. In fact, it’s been called social glue before. And you mentioned music can relax the brain. And definitely stress can be a component too, that can feed into that Alzheimer’s soup that you mentioned.
Majid Fotuhi: [00:25:26] Yes. And these are not hypothetical. These are facts. And these have clinical applications. Several studies have shown that if you take a group of older adults, even people who have, for example, Parkinson’s disease, and provide them with musical training, their brain improves and their function improves, they can function better after three months of learning a musical instrument.
Mindy Peterson: [00:25:48] You say in your book, too, that neurologists tend to say, and you say this, that practice makes cortex. And I found that interesting because I taught piano lessons for years and piano teachers, and you’ve probably heard this before. We like to say practice makes perfect. And you talk in the book about how practice grows the brain and increases the thickness of the cortex. And that’s why you say practice makes cortex. So all of you music teachers who are listening to this, in addition to saying practice makes perfect, I want you to talk to your students and their parents about how practice makes cortex.
Majid Fotuhi: [00:26:26] So cortex is the outer layer of the brain, which is important for all our higher cognitive functions. Things like reading, writing, typing, cooking, doing your taxes. You know, everything we do, all our higher cognitive functions emerge from cortex and hippocampus. So the cortex and hippocampus together are the seat of consciousness. They are the place where cognitive functions emerge and different parts of the cortex are different. Are nodes in networks that do different functions. For example, I talk about the language network. So we need to understand language, and we need to make sense of language and articulate our response. Not all of the brain is involved in doing that. You know, like eight, ten, 12 nodes form networks and the network of connections between these handles you understanding the language and responding appropriately. Now, if you learn how to play golf, then you’re going to use parts of your cortex and hippocampus that are important for learning correct posture, hand-eye coordination to hit the ball. And when you learn to play the piano, you really use like 70% of your brain more. I mean, you really maximize using a lot of parts of your brain because you’re listening to music, you’re reading your notes, your sequence, your hand movements, you’re planning your movements, you’re paying attention. That’s why music is extra good when it comes to brain training. And any of those things you do grow, literally grow the parts of the cortex and hippocampus that correspond to those functions.
Majid Fotuhi: [00:28:12] So you can have your cortex like a blanket, or you can think of it as a mosaic of nodes. And every ten, 12, 14 nodes from local networks. And sometimes when you do one thing, you’re using one network. For example, I can ask you to sit down and take a deep breath, and I want you to pay attention to the air going to your nostrils and just focus on that. So when you do that, you’re using your brain because you’re using the attention network to maintain your attention on the sound of the air going through your nostrils. So you’re using one or particularly the front of the brain. You’re not using all your brain. But in contrast, when you’re learning a musical instrument, you’re using so parts of the brain and every time you use a brain networks of the brain. And the more connectivity they have, they grow like a muscle that when you stimulate it, it grows. Those parts of the brain grow first at a microscopic level. You can’t see with the naked eye. But many hundreds of studies have shown that different types of brain training corresponds to increasing the volume of cortex and hippocampus. So whatever you do that challenges different parts of the cortex and hippocampus grows them so much so that we can see them on a brain MRI before and after interventions.
Mindy Peterson: [00:29:33] Well, I love in the book how you talk about the different types of memory and the different memory networks, short term memory, working memory, long term memory, procedural memory, which is probably like when you talked about dancing. You don’t have to consciously think about every single move you’re making because of that procedural memory that your, your body has. And so that was really interesting. And then you talked about cognition and cognitive skills. Like we talk about cognition. What actually is cognition, and you say it consists of mental processes that help you acquire knowledge, make sense of the world through your experiences and senses. And when you talked about the abilities that we gain with cognition, the ability to focus, control impulses, switch back and forth between different tasks, pay attention to certain things and not others. Spot patterns solve problems. You know all of those things that you mentioned. I just was thinking all of those higher brain functions are exercised in learning a musical instrument.
Majid Fotuhi: [00:30:38] Absolutely. And that’s why I’m a fan myself. I’m a fan because I’ve seen the literature that supports the profound benefits of music, from stimulating the brain, relaxing the brain and the social element. And like I said, it’s a no brainer.
Mindy Peterson: [00:30:59] One, I’m really curious to get your input on this question that I have for you. So I know someone who had a concussion about six months ago is working. Um, his physician sent him to a therapist to deal with some post-concussive symptoms. Um, it’s actually a speech therapist that he was sent to, which kind of surprised me a little because he’s not having any problems with speech. But apparently this person has training in post-concussive, uh, treatment. So this therapist has him doing a lot of brain exercises. And when he was describing the exercises. Okay, so it was things like, you’re at a restaurant with four other people, this is what everybody ordered. This is what the cost of each meal was in your brain. Calculate the tax and tip on each of these individual orders. Add them together. Figure out which what each person ordered, you know, things like that. And I, I thought, well, okay, that probably is challenging your brain, but there’s no relevance to real life in this exercise because we all have smartphones that will do that for us. And it also does not sound nearly as interesting as picking up that instrument that you learned when you were a kid. I’m wondering, would it be just as effective for a patient like this to do something that is interesting that he wants to do, like take up a musical instrument rather than something that in my life, in my mind is sort of pointless because once he finishes working with his therapist, he’s not going to have to use those exercises anymore. What are your thoughts on that?
Majid Fotuhi: [00:32:42] I recommend that people engage in exercises that they find interesting and fun. If the exercise is not interesting, people are not going to continue with it. And there are so many ways to stimulate your brain. You might as well pick one you like. It’s not like the choices that are probably 50 choices in my book. As you see at the end of the chapter for Brain Training, I have a list of at least 20 or 30 things that people can try. You can learn a new hobby. You can play video games. You can go to the nature and learn about different plants. You can go fishing. You can, you know, there’s so many things people can do. And I recommend that people pick something they like when it comes to concussion, brain needs rehabilitation, but rehabilitation needs to be guided. And it should not be frustrating because if it’s frustrating, it adds to, you know, the problems patients have. It needs to be very carefully selected and patients need to enjoy it. So I think musical instruments are great because you learn something that’s useful. I mean, you can do it in the future. It’s not like some Sudoku you do that’s good for you. But at the end of it, you just done Sudoku. But if you learn a good piano, the guitar or dancing, you actually learn something useful you can do.
Mindy Peterson: [00:33:59] Right? Is there any chance that those in my mind, sort of arbitrary and random brain exercises, would exercise a part of the brain that wouldn’t be exercised in one of those other options, whether it’s playing a musical instrument or something else. Is that possible that this therapist had those exercises designed for a certain purpose?
Majid Fotuhi: [00:34:19] Yes. So when somebody has a concussion, they will have problems with different parts of the cortex. A person may have had a concussion in the frontal lobe, which make it more challenging for things like executive functions maintaining attention. Or it could be a side of the brain where it can affect a difficult orientation and find navigation, or it can affect this part of the brain that may affect a problem, you know, cause problems with calculation and numbers or affect memory or vision. So, you know, I told you that cortex like a mosaic of nodes that form networks, and so it’s possible that a whole bunch of nodes related to attention get affected. In that case, the person needs physical therapy for attention, so to speak. And then so they need to pick up exercises that challenge the attention capacity of a patient, whereas another person may have difficulty with executive function. And, you know, sequencing movements. And they need a different type of training another person with language. So that person may benefit from language training. Another person may have difficulty with memory. And they will have problem that will benefit from memory training. That’s why it really needs to be tailored to specific patient’s needs.
Mindy Peterson: [00:35:39] Okay, but playing a musical instrument does address most of those areas of the brain, right?
Majid Fotuhi: [00:35:46] I think the advantage of, for example, learning to play the guitar is that it affects all of them. I told you how playing instrument musical instrument is. Learning to play musical instruments really challenges so many parts of the brain at the same time. So many brain networks get activated simultaneously and that’s why they’re powerful.
Mindy Peterson: [00:36:07] So if this person doesn’t really like doing these random arbitrary again in my mind exercises, brain exercises, would it make sense that a person in a situation could ask the therapist what exact part of the brain, or what brain network are you wanting to strengthen? And are there other, more enjoyable ways that I can do that? Would that be?
Majid Fotuhi: [00:36:34] I think speech therapists would be familiar with cognitive testing, and cognitive tests usually take an hour to hour, sometimes six hours, depending on who does it really map out a person’s strengths and weaknesses. So, for example, if you do cognitive testing, your memory may be 80%, your executive function may be 90%, your verbal fluency may be 60. I’m just any person has variables, sure weaknesses. And so if someone has concussion, their memory may be 20%, executive 10%, but the processing speed may be 80%. So then that person needs to work on the areas where cognitive function has been affected.
Mindy Peterson: [00:37:16] Sir. So really they could even take your book with that list of all the activities that you list out as options and take that to their therapists and say which of these that I find more interesting would work the same part of my brain that you’re trying to work, right?
Majid Fotuhi: [00:37:31] Important that they enjoy it. See, when we had in office, the brain coaches would play, you know, chess with someone because chess is great for maintaining your attention. Yeah, good for executive function. Or, you know, they’ll play card games with them or they play monopoly. They would play something that is fun and engaging and it doesn’t feel like a chore.
Mindy Peterson: [00:37:52] Yeah, well, and related to that, you talk quite a bit about in the in the book too, about happiness and purpose and how that translates to brain health. Thoughts and emotions have a direct correlation to brain chemistry, and brain chemistry goes back to thoughts and emotions. So it’s like this two way street. And happiness and purpose really can have a direct impact on depression and cognitive function or dysfunction. So that was really interesting. So that also makes sense that if you’re doing an exercise that you enjoy and makes you happy and brings you purpose because you’ll be able to use this in your life like playing a musical instrument, that that would definitely make more sense than doing something that you feel is irrelevant to your future life.
Majid Fotuhi: [00:38:40] Absolutely, yeah. Now, people don’t always appreciate that the thought and emotion parts of their brain are tightly intermingled and your thoughts can make you happy and happiness can bring you good thoughts. So you can always start by controlling your good thoughts and think positive. And that brings better feelings. And better feelings are going to help you have more positive thoughts. And so you can have some control over the link between thoughts and emotions in your brain. You’re not just passive, you can have an active role on how you feel every day.
Mindy Peterson: [00:39:12] Yeah, well, we touched just briefly on some of the different types of memory. You talk about a lot in your book about memory networks. One thing that I want to bring out in this conversation, too, is that you talk about how memory is emotional and music is the sound of emotions, or it’s been called the sound of emotions. And it’s it’s really interesting in the book about how you talk about almost all the memories from our distant past involve strong emotions. When you think about your first kiss or the first time you held a brand new baby, or, you know, something like that. There’s strong emotions that are associated with those. Talk to us just briefly about the role that music plays in this emotional memory component.
Majid Fotuhi: [00:39:57] Yes. The part of the brain for emotions is very close to the part of brain for memory. In fact, hippocampus, a part of brain for learning and memory, is also a part of the network for emotions. Remember I told you that there were networks in the brain? Well, there’s also a network for emotions, and things that are emotional are remembered better, in fact. Can you think of any memory you have from your life that was not emotional? The reason you remember it is because it was emotional. Otherwise you wouldn’t have remembered it. I mean, you’ve had so many breakfasts in your life, so many lunches and dinners, but all the things, there’s probably 1 or 2 dinners that you still remember. And there was something emotional that happened. It was perhaps where you met your spouse or a Or dinner where somebody offered you a job, or a dinner where you had a ha moment about the business. So emotions really strongly impact what we remember. And one of the things that are good about music is that really plays with emotions. When I see a violinist go into it oh my God. They’re like they’re they’re they’re like they’re become one with their instruments. They’re like so into it emotionally. And I think that’s how you can train the emotional network, the brain, while you’re also training these other networks in the brain.
Mindy Peterson: [00:41:17] Love that. Well, as you can tell, I’m a huge fan of your book. I definitely recommend that listeners go out and get their hands on it and find out all the many ways that you can address this soup of factors that contribute to either brain reserves or and brain growth, or shrinking the brain. And you make it clear in your book that no matter where you are on the brain spectrum right now, no matter what age you are right now, there are many things that you can do to either progress or decline the choices yours and you give so many practical resources in the book. One favorite quote of mine that I’ll mention in close as we wrap up here is this in your book, you say, suppose you want to age gracefully. Not just avoid Alzheimer’s disease, but remain sharp, mobile, energetic, and able to pursue your passions and purpose. In that case, there is a straightforward formula. Keep growing your brain. The more neurons, synapses, and fiber bundles you have, the greater your brain reserve will be. That translates into more efficient and harmonious connections between your brain networks, and your brain will be better able to resist aging effects. You can begin doing this at any age, whether you are 18 or 81. It is never too late to build more reserves and slow the aging process. Love that quote and really does a good job. I think of summarizing the content of your book. Well, as you know, I ask all my guests to close out our conversation with a musical ending a coda by sharing a musical tool you wish more people knew about. It could be a book or a blog, an app, a therapeutic tool, or anything that enables you to enhance your life with music. Do you have a tool that you can share with us today in closing?
Majid Fotuhi: [00:43:06] Yes. Well, the musical tool that I recommend and I do myself is dancing. Ah, I really recommend dancing. Whether it’s Zumba class in a gym or waltz classes in a ballroom class. Uh, I really recommend music dancing because in addition to, uh, stimulating multiple networks for emotions, for executive function, for connections, it also moves your body. So when you’re playing the piano or the guitar or the flute. You’re sitting. And the music, when it’s in the context of dancing, also moves your body. And personally, that’s what gives me the oh my God, I love this. And when I do this turns and swings and do things with my wife, I love it. And I also realized that, you know, for an hour I’ve been moving, I’ve been dancing. And, you know, it’s probably 2 or 3000 steps that I’ve done. So that’s my favorite recommendation is to learn dancing, whether it’s Zumba class or Chacha or modern dancing, and learn new steps and you will really have a full package. I can’t think of any part of the brain that’s not engaged when you’re dancing. I can’t think of any part of the brain. Maybe. Maybe the language. I’m not talking unless, you know, I think that’s the only part that’s probably not as active. But all all your brain is active when you’re dancing.
Transcribed by Sonix.ai