Pocket Neurology (Pocket Notebook Series)

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Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA.

Scarmeas N, Stern Y. Cognitive reserve and lifestyle. J Clin Exp Neuropsychol. 2003; 25(5):625–633. [ PMC free article] [ PubMed] [ Google Scholar]

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Jamain S, Quach H, Betancur C, Råstam M, Colineaux C, Gillberg IC, Soderstrom H, Giros B, Leboyer M, Gillberg C, Bourgeron T. Mutations of the X-linked genes encoding neuroligins NLGN3 and NLGN4 are associated with autism. Nat Genet. 2003; 34(1):27–29. [ PMC free article] [ PubMed] [ Google Scholar] Voss MW, Nagamatsu LS, Liu-Ambrose T, Kramer AF. Exercise, brain, and cognition across the lifespan. J Appl Physiol. 2011 Epub ahead of print. [ PMC free article] [ PubMed] [ Google Scholar]

Kaplan, L. & Bailey, H. Bispectral index (BIS) monitoring of ICU patients on continuous infusion of sedatives and paralytics reduces sedative drug utilization and cost. Crit. Care 4, P190 (BioMed Central 2000). Animal studies building on pioneering work from Barnes in the late 1970s ( Barnes 1979) have demonstrated an age-associated decline in synaptic plasticity that correlates with neurocognitive impairments ( Rosenzweig and Barnes 2003). For example, once induced, hippocampal long-term potentiation (LTP) decays faster in older rats, and this appears to be associated with a greater degree of forgetfulness ( Barnes and McNaughton 1980; Kelly et al. 2006). Moreover, deficits in the balance between LTP and longterm depression (LTD) result in impaired learning and memory ( Larson et al. 1986; Roman et al. 1987; Bliss et al. 2003).Ramsay, M., Savege, T., Simpson, B. & Goodwin, R. Controlled sedation with alphaxalone-alphadolone. Br. Med. J. 2, 656 (1974). Ely, E. W. et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit. Care Med. 29, 1370–1379 (2001).

Stern Y. Cognitive reserve. Neuropsychologia. 2009; 47(10):2015–2028. [ PMC free article] [ PubMed] [ Google Scholar]Direct evidence of brain plasticity changes in humans throughout the lifespan in health and disease can be measured via real-time combination of TMS with EMG, EEG, and/or fMRI ( Fig. 4). Moreover, measures of TMS before and serially following cTBS or iTBS can provide measurements of LTP- or LTD-like plasticity. Carmeli E, Patish H, Coleman R. The aging hand. J Gerontol A Biol Sci Med Sci. 2003; 58(2):146–152. [ PubMed] [ Google Scholar] The use of TMS in animal studies has been met with some difficulty. Namely, conventional TMS coils, designed for human application, generate relatively broad volumes of electrical current which may activate multiple cortical and subcortical regions when applied to the rat. As such, the focality of TMS in animals is brought into question and obscures the origin and interpretation of resultant TMS metrics. Furthermore, TMS animal studies require anesthesia to both minimize animal discomfort and suppress spontaneous muscle activation. The presence of neuro-chemically-active anesthetics may further obscure TMS findings ( Luft et al. 2001; Rotenberg et al. 2010).