The fragile brain : the strange, hopeful science of dementia

Neurodegenerative diseases, such as a stroke, Alzheimer's and dementia, are now tragically commonplace within the western world. Our brains are a strange and complex organ, and there is much to be discovered about what causes them to fail in such devastating ways. In this book Kathleen Taylor presents the ever-developing research into the cause and cure of these life-changing conditions, focusing on insights arising from the relatively new field of neuroimmunology - the increasing recognition of the important role of the immune system in the brain. Interweaving the latest scientific ideas on neurodegenerative diseases with accounts of the devastation which illnesses affecting the brain can cause to sufferers and to anyone who cares about them, __Fragile Brains__ is not only an important account of current research in this field, but a very personal study. As instances of dementia rise in our ageing populations, many harbour anxieties concerning the future.This book is about knowing the enemy. Cover 1 the Fragile Brain: The Strange, Hopeful Science of Dementia 4 Copyright 5 CONTENTS 6 List of Figures 8 LIST OF TABLES 10 ACKNOWLEDGEMENTS 11 ORGANIZATIONS 12 UK 12 US 12 Europe 12 Australia 12 Other countries 12 Chapter 1: Fragile Brains 14 Part 1: The Problem 20 Chapter 2: Living Well and Growing Old 22 The Links to Lifestyle 23 Barriers to Change 23 Chapter 3: Counting the Costs 27 Dementia Expenses 27 Dementia Spending 29 Global Costs 30 Is Prevention Better than Cure? 31 Chapter 4: Brain Disorders Affect All of Us 33 The Hope 34 A Roadmap 35 Chapter 5: Discovering Dementia 37 The Dying Brain 40 Symptoms 41 Brain Changes 42 Ventricles 43 Neurotransmitters and Ion Channels 45 The Marvel of Fat 46 Glutamate and the Power of Calcium 49 GABA 50 Deep Brain Transmitters 50 Synapses 52 Myelin 53 Wiring Damage 55 From Birth to Death in the Brain 56 Dementia: A Problem of Association? 58 Brain and Mind 60 Chapter 6: Protein Problems 63 The Amyloid Cascade 64 A Brief Guide to Protein Production 65 Location, Location, Location 66 The Vital Start 67 APP’s Butchers 68 Which Amyloid? 71 Protein not Wanted 73 Chapter 7: Too Much Amyloid? 74 A Dip into Physics 74 ‘Protein Function is Governed by Shape and Charge’ 76 Gene Control 76 Amyloid Production 79 Chapter 8: Transfers In? 80 Travelling Blood 81 Where Blood Meets Brain 81 Endothelial Cells 83 Amyloid Entry 83 9: How to Clean Your Brain 85 Blood 85 Cerebrospinal Fluid 87 Windows on the Brain 88 Interstitial Fluid 89 Lymph 90 Flushing out Amyloid 92 Deportation 93 Destruction 93 Internal Waste Disposal 94 Outside the Cell 95 Part 2: Risk Factors 98 10: Interpreting Risk Factors 100 Too Much to Study 101 From Quality to Quantity 103 Dissecting the Numbers 103 11: The Inescapables—Age, Gender, and Genes 105 Getting Old 105 Hope You Die Before You Get Old? 105 DNA Damage and Repair 109 Growth and Ageing 110 Failing Power Supplies 112 Oxidative Stress 113 Being Female 115 Having Certain Gene Variants 117 ApoE and cholesterol 118 ApoE and disease 120 12: Injury and Surgery 124 Traumatic Brain Injury 125 Surgery and General Anaesthesia 127 Chapter 13: Infection and Inflammation 128 Three Functions of the Immune System 128 The Enemies 130 The Detectives 132 Signs of Danger 133 Cells and Chemicals 133 The Naming of Names 134 Go Forth and Multiply 135 The Counter-attack 136 Innate Immune Cells 136 Adaptive Immune Cells 137 Fluid Defences 140 Cytokines 141 The Signs of Inflammation 142 Reaching the Brain 143 Context is Everything 145 Microglia 146 Neuroinflammation 147 Weakened Before You Were Born? 149 Chapter 14: Big Killers 151 The Heart and the Blood 151 The Vulnerable Border 152 Diabetes 154 The Glucose Trap 154 The Dangers of High Blood Sugar 155 Your Energetic Brain 157 Insulin and the Brain 157 Needier Cells Die Younger? 159 Cancer 160 Stem Cells 161 Troubled Bodies, Troubled Minds 162 Depression 163 Schizophrenia 164 Stress 165 Chapter 15: Consumerism, Literally 168 Diet and Obesity 169 Food Quality and Food Habits 170 Passing on the Problems 171 Foods versus Diets 172 Low Levels of Micronutrients 172 Red Meat and Dairy 173 Processed Foods 174 Quick Fix or Slow Change? 175 Caveat Lector—Reader Beware 177 Chapter 16: Exercise 179 Moving is Good for You 179 The Killer Sloth 180 What the Experts Think You Should be Doing 181 Chapter 17: Traditional Vices 183 The Many Trials of Meta-analysis 183 Smoking and Dementia 184 Drinking and Dementia 185 Minor Vices: Coffee, Tea, and Dark Chocolate 187 Chapter 18: Unhealthy Environments 189 Chemical Poisoning 189 Electromagnetic Poisoning 190 Being Poor 191 Sleep Debt 192 Chapter 19: Use It or Lose It 195 Boredom and Loneliness 196 Complacency 197 Those Covariates, Again 198 Building Up Reserves 198 What is Reserve? 199 Chapter 20: What are Your Chances? 201 What Can We Do about Dementia? 206 Part 3: Mechanisms 208 Chapter 21: The Puzzle of Amyloid 210 Amyloid Hypotheses 211 The Hole at the Heart of the Hypothesis 216 Expectations 0, Reality 1 218 Methods 219 Facts 222 Timing and Tau 222 Other Suspects 223 Chapter 22: The Promise of Amyloid 227 Inflammation and Oxidative Stress 228 Metals 229 Insulin 229 Vascular Therapies 229 Neurotransmitters 230 Cholesterol 230 DNA and the Cell Cycle 231 Calcium, Cytoskeletal, and Endoplasmic Reticulum Stress 231 Chapter 23: Probing the Frontiers 232 Chapter 24: This End is Only a Beginning 235 Nothing in the Body is Ever Simple 237 Beyond the Science 238 ENDNOTES 242 Chapter 1 242 Part 1 242 Chapter 2 242 Chapter 3 243 Chapter 4 245 Chapter 5 245 Chapter 6 255 Chapter 7 260 Chapter 8 262 Chapter 9 264 Part 2 269 Chapter 10 269 Chapter 11 271 Chapter 12 277 Chapter 13 278 Chapter 14 290 Chapter 15 296 Chapter 16 300 Chapter 17 301 Chapter 18 303 Chapter 19 306 Chapter 20 310 Part 3 312 Chapter 21 312 Chapter 22 319 Chapter 23 320 Chapter 24 320 Further Reading 322 ABBREVIATIONS 324 PUBLISHER’S ACKNOWLEDGEMENTS 326 Index 328 SOCIAL : WHY OUR BRAINS ARE WIRED TO CONNECT 334 THE BRAIN SUPREMACY: NOTES FROM THE FRONTIERS OF NEUROSCIENCE 335 THE BRAIN: A VERY SHORT INTRODUCTION 336 In This Sensitive And Informative Account Of Dementia Science, Focusing On Alzheimer's, The Neuroscientist And Writer Kathleen Taylor Explains What We Have Learnt In Recent Years About The Condition. She Looks At The Strengths And Weaknesses Of The Currently Dominant View Of The Disease-- The Amyloid Cascade Hypothesis-- And At The Identified Risk Factors.--jacket. Fragile Brains -- Part 1 The Problem -- Living Well And Growing Old -- Counting The Costs -- Brain Disorders Affect All Of Us -- Discovering Dementia -- Protein Problems -- Too Much Amyloid? -- Transfers In? -- How To Clean Your Brain -- Part 2 Risk Factors -- Interpreting Risk Factors -- The Inescapables -- Age, Gender, And Genes -- Injury And Surgery -- Infection And Inflammation -- Big Killers -- Consurmerism, Literally -- Exercise -- Traditional Vices -- Unhealthy Environments -- Use It Or Lose It -- What Are Your Chances? -- Part 3 Mechanism -- The Puzzle Ofamyloid -- The Promise Of Amyloid -- Probing The Frontiers -- This End Is Only A Beginning. Kathleen Taylor. Includes Bibliographical References (pages 229-310) And Index. Text In English. Neurodegenerative diseases, such as a stroke, Alzheimer's and dementia, are now tragically commonplace within the western world. Our brains are a strange and complex organ, and there is much to be discovered about what causes them to fail in such devastating ways. In this book Kathleen Taylor presents the ever-developing research into the cause and cure of these life-changing conditions, focusing on insights arising from the relatively new field of neuroimmunology - the increasing recognition of the important role of the immune system in the brain. Interweaving the latest scientific ideas on neurodegenerative diseases with accounts of the devastation which illnesses affecting the brain can cause to sufferers and to anyone who cares about them, The Fragile Brain is not only an important account of current research in this field, but a very personal study. As instances of dementia rise in our ageing populations, many harbour anxieties concerning the future.This book is about knowing the enemy.