Loss of Synapses is the Engine that Drives Cognitive Decline

May 01, 2022

Yale Can Image Your Brain and Define Your Cognitive Function

The long-standing sign of Alzheimer's is a shrunken brain. In fact, brain shrinkage is so common in all of us, that radiologists will often make offhand comments that an older person has mild shrinkage, but within normal limits. We have presumed that loss of linkages between neurons, called synapses, is what is happening but hard proof has been difficult to come up with. That means we are all on the path to getting Alzheimer/s, just with some getting it sooner and some later. Hmm.

A little bit of basic science. The estimate is that you have about 4 quadrillion synapses in your brain with each active neuron connected to some 3500-10,000 other neurons. You have so much redundancy and resilience that it is thought that you have lost at least 50% of your synapses before you demonstrate cognitive decline. You can function at 50%.  You have just lost the ability to immediately remember where your car keys ended up.

Therein lies the dilemma. This has all been "presumed" but not proven. What is called "mild cognitive impairment" (MCI) or otherwise shrugged off as "senior moments" is actually part of the same process, just earlier in the journey. Treating the disease called Alzheimer's is fruitless. It's too late. You can't bring back the lost neural connections. Preventing it depends on knowing early and reversing the conditions that are setting it off while your brain can still tap into the biological process of rebuilding redundancy. And preventing depends on having some means of quantifying early disease in a credible fashion.

And that is what Yale just proved.  Researchers at Yale have now measured early cognitive decline. A PET scan using a new glycoprotein called SV2A gave the researchers a measurement of metabolic activity in brain synapses of 45 people diagnosed with mild to moderate Alzheimer's disease. Each person was then tested in five key areas: verbal memory, language skills, executive function, processing speed, and visual-spatial ability. The loss of synapses or connections between brain cells was found to be strongly associated with poor performance on cognitive tests. There you have it. It's not widely available yet, but it will be coming. The loss of synapses correlates directly with loss of cognitive function. It makes perfect sense.

And this correlates exactly with the plasmalogen evidence that effectively says the same thing, but at the molecular level. Let me repeat that metabolic explanation!  Our synapse membranes are 70% plasmalogen content. Plasmalogens are using choline as part of their structure. For our brain to function, it must have acetyl-choline to communicate across the synaptic cleft. If your synapse gets a little short on acetyl-choline, it can make some more by borrowing choline from its own plasmalogen membranes, in effect self-cannibalizing. That's the problem. You can't borrow from Peter to pay Paul forever. The ultimate Ponzi scheme. Enough "borrowing" and the synapse collapses. Now, you only have 3 quadrillion, 999 trillion, 999 billion......you get the point. This process is going on for decades.  Lose a synapse here and there and you lose the neural network that retrieved where your keys were.

And that, my friend, is how we will conquer this cognitive decline epidemic. If we measure and quantify your plasmalogens, which we can do, and we repair your methylation system, your inflammation system, and your mitochondrial health, all in the same package, which we also can do, we can give your brain the tools to repair itself. Fundamental to all biology, cells will repair themselves if given the right tools and building blocks and removed from the environment of reductive deficiency. Likewise, your brain will rebuild redundancy and resilience if it has the proper building blocks. And now we have a PET scan coming that will provide the precise details to assure you that you are making progress. Cool, Huh?!

You have time. This is a long, persistent issue. But don't discount that "senior" moment. Take it as a warning that you have lost some function you used to have and you want it back.

www.What will Work for me. Having now measured plasmalogens for over 18 months and seen folks come back and say they feel improvement, I'm sure we are on the right path. The issue is whether we can prove it and quantify it. That should be the goal. I want hard data. Someone in a memory unit with severe dementia has lost so much function that rebuilding redundancy and resilience is a much higher burden. I take my plasmalogens every day.

References: Alzheimer's Dementia, Yale News, Apple News, Science Daily, NeuroSci Letters, Science Daily

Pop Quiz

1. What was the imaging technique they used at Yale? Answer: PET scan

2. For cancer, a PET scan uses high glucose use to indicate unusual activity. In this scenario of cognitive decline, the imaging compound was what? Answer: Glycoprotein SV2A

3. Did the research report say much about amyloid plaque or tangles, some of the old criteria for Alzheimer's? Answer: Nope

4. What is the key engine driving cognitive decline? Answer: loss of synapses, or links between neurons.

5. And what is the key nutrient missing that makes you lose a synapse? Answer: choline plasmalogens.

This column written by Dr. John E. Whitcomb, MD, Brookfield Longevity, Brookfield, WI 53045