Trump’s Apparent Arm Weakness, Slurred Speech, and Odd Circular Gait.
Trump's 'Mental Acuity' Challenge Gets Exactly The Response You'd Expect.
“Yes, the first few questions are easy, but I'll bet you couldn't even answer the last five questions,” the president continued. “I'll bet you couldn't. They get very hard, the last five questions.”
TRUMP HAS OFTEN BRAGGED OF PASSING THE ASSESSMENT, AND INSISTED THAT IT WAS HARD. BUT IT’S NOT SUPPOSED TO BE. “IT IS SUPPOSED TO BE EASY FOR SOMEONE WHO HAS NO COGNITIVE IMPAIRMENT,” DR. ZIAD NASREDDINE, WHO INVENTED THE TEST, TOLD MARKETWATCH IN 2020.
We Are Entitled to Ask Former President Trump for His Brain Scan
Instead of Twitter speculation, the public craves a scan and honest answers.
Trump’s pre-COVID halting gait, bent posture, and jerking right arm have caused much speculation on social media. Armchair critics, without any apparent medical background, have freely diagnosed him as having a series of mini-strokes, frontotemporal dementia, or other neurological illness such as the Lewy Body dementia that afflicted comedian and actor Robin Williams.
This speculation is problematic and unwise. And yet the American public deserves an accurate account of our president’s health.
As a textbook author and professor of neurology at George Washington University, I know something about political figures and observable signs of illness from afar. (I once wrote a Pulitzer Prize-nominated New York Times Magazine cover story about James Brady, President Reagan’s Press Secretary, who was shot in the head.)
Neurologists by profession rely on direct observation more than other clinical skills. Like Sherlock Holmes, we are attuned to the odd remark, the unexpected detail or action that doesn’t fit. We are trained to probe past face value because superficial appearances often turn out to hide the actual problem. Here then are my observations about the social media buzz surrounding the president.
Trump’s Tilting Posture and Jerking Limbs.
Trump’s forward-listing posture—illustrated by nearly every political cartoonist—was initially attributed to the high-heeled elevator shoes readily observed in photographs. But his torso leans so markedly off-center that it suggests the possibility of a neurological problem rather than vanity. In medical terms, the Bent Spine Syndrome is called camptocormia, first documented in the 17th century by Francisco de Zurbaran, a Spanish painter. The mean age of onset is 65 years (Trump is 78).
Bent spine syndrome causes:
Usually, the bent spine is caused by dysfunctioning extensor spinal muscles with a neurological cause. Neurological origin BSS may also result from damage to the basal ganglia nuclei that are a part of the cerebral cortex, which play a major role in bodily positioning.
Head injuries, especially concussions and traumatic brain injuries, can damage the basal ganglia and other parts of your brain. In some cases, that damage is severe and/or permanent.
DAMAGE TO THE BASAL GANGLIA CELLS MAY CAUSE PROBLEMS CONTROLLING SPEECH, MOVEMENT, AND POSTURE. THIS COMBINATION OF SYMPTOMS IS CALLED PARKINSONISM. A PERSON WITH BASAL GANGLIA DYSFUNCTION MAY HAVE TROUBLE STARTING, STOPPING, OR SUSTAINING MOVEMENT.
https://www.psychologytoday.com/ca/blog/the-fallible-mind/202010/we-are-entitled-ask-president-trump-his-brain-scan
Frontotemporal dementia (FTD), a common cause of dementia, is a group of disorders that occur when nerve cells in the frontal and temporal lobes of the brain are lost. This causes the lobes to shrink. FTD can affect behavior, personality, language, and movement.
These disorders are among the most common dementias that strike at younger ages. Symptoms typically start between the ages of 40 and 65, but FTD can strike young adults and those who are older. FTD affects men and women equally.
PEOPLE LIVING WITH FTD MAY HAVE DIFFICULTY WITH BASIC WORK SKILLS, SUCH AS ORGANIZING, PLANNING, AND FOLLOWING THROUGH ON TASKS. ACTIVITIES THAT WERE EASY BEFORE MIGHT TAKE MUCH LONGER OR BECOME IMPOSSIBLE.
The 7 Stages of Frontotemporal Dementia.Stage 1: Early Symptoms. ... Stage 2: Language Impairment. ... Stage 3: Executive Function Impairment. ... Stage 4: Movement Disorders. ... Stage 5: Severe Behavioral Changes. ... Stage 6: Severe Language Impairment. ... Stage 7: End-Stage FTD.https://www.hopkinsmedicine.org/health/conditions-and-diseases/dementia/frontotemporal-dementiaWhat causes frontotemporal dementia?The cause of FTD is unknown. Researchers have linked certain subtypes of FTD to mutations on several genes. Some people with FTD have tiny structures, called Pick bodies, in their brain cells. Pick bodies contain an abnormal amount or type of protein.https://taylorandfrancis.com/knowledge/medicine-and-healthcare/frontotemporal-dementia/Frontotemporal dementiaFrontotemporal dementia (FTD) is an umbrella term for a group of brain diseases that mainly affect the frontal and temporal lobes of the brain. These areas of the brain are associated with personality, behavior and language. In frontotemporal dementia, parts of these lobes shrink, known as atrophy. Symptoms depend on which part of the brain is affected. Some people with frontotemporal dementia have changes in their personalities. They become socially inappropriate and may be impulsive or emotionally indifferent. Others lose the ability to properly use language.https://www.mayoclinic.org/diseases-conditions/frontotemporal-dementia/symptoms-causes/syc-20354737Detecting frontotemporal dementia syndromes using MRI biomarkersDiagnosing frontotemporal dementia may be challenging. New methods for analysis of regional brain atrophy patterns on magnetic resonance imaging (MRI) could add to the diagnostic assessment. Therefore, we aimed to develop automated imaging biomarkers for differentiating frontotemporal dementia subtypes from other diagnostic groups, and from one another. Methods In this retrospective multicenter cohort study, we included 1213 patients (age 67 ± 9, 48% females) from two memory clinic cohorts: 116 frontotemporal dementia, 341 Alzheimer's disease, 66 Dementia with Lewy bodies, 40 vascular dementia, 104 other dementias, 229 mild cognitive impairment, and 317 subjective cognitive decline. Three MRI atrophy biomarkers were derived from the normalized volumes of automatically segmented cortical regions: 1) the anterior vs. posterior index, 2) the asymmetry index, and 3) the temporal pole left index. We used the following performance metrics: area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. To account for the low prevalence of frontotemporal dementia we pursued a high specificity of 95%. Cross-validation was used in assessing the performance. The generalizability was assessed in an independent cohort (n = 200). Results The anterior vs. posterior index performed with an AUC of 83% for differentiation of frontotemporal dementia from all other diagnostic groups (Sensitivity = 59%, Specificity = 95%, positive likelihood ratio = 11.8, negative likelihood ratio = 0.4). The asymmetry index showed highest performance for separation of primary progressive aphasia and behavioral variant frontotemporal dementia (AUC = 85%, Sensitivity = 79%, Specificity = 92%, positive likelihood ratio = 9.9, negative likelihood ratio = 0.2), whereas the temporal pole left index was specific for detection of semantic variant primary progressive aphasia (AUC = 85%, Sensitivity = 82%, Specificity = 80%, positive likelihood ratio = 4.1, negative likelihood ratio = 0.2). The validation cohort provided corresponding results for the anterior vs. posterior index and temporal pole left index. Conclusion This study presents three quantitative MRI biomarkers, which could provide additional information to the diagnostic assessment and assist clinicians in diagnosing frontotemporal dementia. Keywords: Dementia, Frontotemporal lobar degeneration, Differential diagnosis, Behavioral variant frontotemporal dementia, Primary progressive aphasia, MRIhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369219/An MRI-based strategy for differentiation of frontotemporal dementia and Alzheimer’s diseasehttps://alzres.biomedcentral.com/articles/10.1186/s13195-020-00757-5Structural brain imaging in frontotemporal dementiahttps://www.sciencedirect.com/science/article/pii/S0925443911001670https://onlinelibrary.wiley.com/doi/full/10.1111/jnc.13656The use of neuroimaging techniques in the early and differential diagnosis of dementiaDementia is a leading cause of disability and death worldwide. At present there is no disease modifying treatment for any of the most common types of dementia such as Alzheimer’s disease (AD), Vascular dementia, Lewy Body Dementia (LBD) and Frontotemporal dementia (FTD). Early and accurate diagnosis of dementia subtype is critical to improving clinical care and developing better treatments. Structural and molecular imaging has contributed to a better understanding of the pathophysiology of neurodegenerative dementias and is increasingly being adopted into clinical practice for early and accurate diagnosis. In this review we summarise the contribution imaging has made with particular focus on multimodal magnetic resonance imaging (MRI) and positron emission tomography imaging (PET). Structural MRI is widely used in clinical practice and can help exclude reversible causes of memory problems but has relatively low sensitivity for the early and differential diagnosis of dementia subtypes. 18F-fluorodeoxyglucose PET has high sensitivity and specificity for AD and FTD, while PET with ligands for amyloid and tau can improve the differential diagnosis of AD and non-AD dementias, including recognition at prodromal stages. Dopaminergic imaging can assist with the diagnosis of LBD. The lack of a validated tracer for α-synuclein or TAR DNA-binding protein 43 (TDP-43) imaging remain notable gaps, though work is ongoing. Emerging PET tracers such as 11C-UCB-J for synaptic imaging may be sensitive early markers but overall larger longitudinal multi-centre cross diagnostic imaging studies are needed.https://www.nature.com/articles/s41380-023-02215-8DRINKING SODA TIED TO POOR BRAIN HEALTH AND ALZHEIMER’S RISK."Trump reportedly drinks 12 cans of Diet Coke each day."Daily Consumption of Sodas, Fruit Juices and Artificially Sweetened Sodas Affect Brain. “We also found that people drinking diet soda daily were almost three times as likely to develop stroke and dementia. This included a higher risk of ischemic stroke, where blood vessels in the brain become obstructed and Alzheimer’s disease dementia, the most common form of dementia,” he said.https://www.bumc.bu.edu/camed/2017/04/20/daily-consumption-of-sodas-fruit-juices-and-artificially-sweetened-sodas-affect-brain/https://www.alzdiscovery.org/cognitive-vitality/blog/is-diet-soda-harming-your-brain-healthThose keeping tabs on Donald Trump’s diet know that Wendy’s and McDonald’s are staples. While campaigning, Trump inhaled Filets-o-Fish and Big Macs, savored bacon, eggs and sausage and snacked on Oreos.He’d then wash it all down with a Diet Coke. Just how much diet soda the president consumes, though, was revealed Saturday by the New York Times, which reported that Trump has a button to summon household staff for one of the 12 Diet Cokes he drinks each day. It’s a lot of soda to consume in one day, and - were it regular soda - most research suggests the potential consequences would be alarming. A 12-ounce can of regular Coke has 140 calories and 39 grams of sugar. By drinking Diet Coke instead, which has no calories or sugar, Trump has avoided consuming 1,680 calories and 468 grams of sugar daily.https://www.jacksonville.com/story/news/nation-world/2017/12/12/trump-reportedly-drinks-12-cans-diet-coke-each-day/16286277007/Sugar- and artificially-sweetened beverages in relation to stroke and dementia - Are soft drinks hard on the brain?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468791/Two new studies link soda consumption to early signs of Alzheimer’s disease and poor brain health. Although the studies do not prove cause and effect, they suggest that drinking sodas — whether they are sugar sweetened or diet — may be linked to accelerated brain aging and an increased risk of Alzheimer’s or other forms of dementia.One study, in the journal Alzheimer’s and Dementia, looked at more than 4,000 middle-aged adults. They were given brain scans and memory tests and filled out detailed questionnaires about what they ate and drank. The researchers, from Boston University and other research centers, found that the more sugary sodas someone regularly drank, the worse they tended to do on memory tests.Those who drank the most sugary drinks also tended to have more shrinkage of the brain. In other studies, reduced brain volume has been tied to an increased risk of developing Alzheimer’s disease years later. Those who drank one or two sugary sodas a day had shrinkage of the brain that corresponded to one to two years of aging compared with those who didn’t drink sugary sodas or other sugar-sweetened beverages. They also tended to do worse on memory tests, scoring about the same as someone five or six years older. A typical can of sugar-sweetened soda or similarly sweetened beverage contains up to 10 teaspoons of sugar, or about 150 calories. Those who regularly drank more than two sugary drinks daily performed even worse on memory tests, scoring the equivalent of someone more than a decade older. The researchers considered variables like diabetes and high blood pressure, which have also been linked to an increased risk of Alzheimer’s. But even after controlling for these risk factors, increased sugar consumption was tied to accelerated brain aging and brain shrinkage. And for those concerned about sugar intake, turning to diet sodas may not be the answer. The second study, in the American Heart Association’s journal Stroke, found that drinking diet sodas was also tied to an increased risk of dementia and increased stroke was another risk associated. That study analyzed data from the Framingham Heart Study, which followed a large group of residents from Framingham, Mass., over many years. The researchers, some of whom were involved in the first study, found that among almost 1,500 people over 60, those who drank at least one diet beverage daily had nearly three times the risk of developing Alzheimer’s or other forms of dementia over the next 10 years compared to those who drank diet sodas less than once a week. The authors note that as in the earlier study, they cannot prove cause and effect. Many of those in the study may have been drinking diet soda because they had diabetes or been overweight, which are known to raise the risk of dementia. “We recommend that people drink water on a regular basis instead of sugary or artificially sweetened beverages,” the authors advise. Increasingly, research shows that what we eat and drink can have an impact on the long-term health of our brain. Sugary sodas and other drinks can lead to weight gain, and obesity in midlife has been tied to an increased risk of Alzheimer’s in old age. Diabetes, also tied to obesity and poor diets, can severely impact blood vessel health, including the health of blood vessels in the brain. “Real” foods that are not artificially modified or industrially processed and as fresh as possible, including a heart-healthy diet rich in fruits and vegetables and whole grains, on the other hand, has been tied to a lower risk of Alzheimer’s in old age. By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University. Sources: Matthew P. Pase, Jayandra J. Himali, Paul F. Jacques, et al: “Sugary beverage intake and pre-clinical Alzheimer’s disease in the community.” Alzheimer’s and Dementia, April 2017. Matthew P. Pase, et al: “Sugar and artificially sweetened beverages and the risks of incident stroke and dementia: a prospective cohort study.” Stroke, April 20, 2017.https://www.alzinfo.org/articles/prevention/drinking-sodas-tied-to-poor-brain-health-and-alzheimers-risk/Link Between Diet Soda and Dementia.Jan 16, 2020 | Dementia Some call it soda, others “pop”, but scientists call it something else: a cause for concern.https://dolancare.com/link-between-diet-soda-and-dementia/The artificial sweeteners in diet sodas have been shown to be a risk for many health concerns, including heart conditions, metabolic issues and obesity. In 2017, research from the American Heart Association added a risk for dementia to that list of risks. For ten years, researchers followed nearly 4,500 adults to track their eating and drinking habits in addition to recording which participants suffered a stroke or developed a dementia. The participants who consumed at least one artificially-sweetened beverage a day were almost three times as likely to either have a dementia or a stroke compared to their counterparts who drank less than one of those beverages a week. To ensure the strokes and dementia diagnoses were correlated to the consumption of diet beverages and not other factors, researchers adjusted the findings for genetic risk, exercise, caloric intake, healthy eating habits, gender and age. The findings were the same: regardless of these factors, study subjects were still three times more likely to have the stroke or dementia diagnoses. The lead researcher, Matthew Pase, emphasized several points important to note. First, the strong correlation between these beverages and stroke and dementia is just that-a correlation, not a causation. He also highlighted the fact that there are many different types of artificial sweeteners used in diet sodas and other beverages; this study did not distinguish between the different types. All this to say: the study findings supports evidence that diet beverages are not as healthy of an alternative to sugary drinks and many people would like to believe. Pase says “We recommend that people drink water on a regular basis instead of sugary or artificially-sweetened beverages”. To bolster your health against your risk for a dementia diagnoses or stroke, among many other serious conditions, consider incorporating more water to your daily eating and drinking habits in addition to the multitude of other protective factors proven to reduce your risk. Dolan Memory Care Homes strives to provide the community with resources to educate regarding dementia prevention. At Dolan Memory Care Homes, we encourage diets that honor individual’s wishes and preferences.https://www.aarp.org/health/healthy-living/info-2017/diet-soda-high-risk-dementia-stroke.htmlProviding Care for a Person With a Frontotemporal DisorderPeople living with frontotemporal disorders, sometimes called frontotemporal dementia, can have a range of symptoms, including unusual behaviors, emotional problems, trouble communicating, and difficulty walking. Caring for someone with a frontotemporal disorder (FTD) can be hard, both physically and emotionally. Caregivers may face challenges with managing the medical and day-to-day care, as well as changing family and social relationships, loss of work, poor health, stress, decisions about long-term care, and end-of-life concerns.https://www.nia.nih.gov/health/frontotemporal-disorders/providing-care-person-frontotemporal-disorderThe Fascinating Reason Why Liars Keep On Lying: Lying Changes the Brain.The Fascinating Reason Why Liars Keep On Lying.Most of us will squirm a little, but may also lie a little, if someone asks us a difficult question such as how they look in a new outfit. No one really wants to honestly say the outfit is a disaster, or it makes the person look huge. So, some glib comment like, “It’s just your color” comes to the rescue in what we might call a “white lie.” But what happens if we find ourselves telling a real lie about something? All sorts of circumstances may have happened to cause us to lie, but we are still stuck with the reality of it, and the guilty feelings.Lying Changes the BrainNow, Scientific American is telling us what else happens when we lie. They say a new study has found lying gets easier for humans the more they lie, because lying changes the brain! Nature Neuroscience reported a study of the amygdala, the part of the brain dealing with emotional responses. The researchers said the amygdala shows up less and less, as we lie more and more. Essentially, our guilt feelings tend to weaken and shrink. Also lies that helped the person telling the lie may draw even less response from the amygdala. Other researchers point out how much we dislike thinking of ourselves as liars. I have seen people do this, inventing elaborate justifications explaining why lying was the only way to handle a difficult situation. In the long run, it would have been better to just avoid lying in the first place.Pitfalls of LyingThe fact that there seems to be less emotional response with repeat lies reinforces the statement, “once a liar always a liar.” If you think about it, the people you know who lie often fit that pattern. In work situations, it often becomes quickly known who can be counted on to tell it as it is, and who will waffle or outright lie when push comes to shove. But the real issue of what lies do to relationships may be the reason we should all understand the process and make every effort to not lie. Essentially, lies can turn a relationship into quicksand very quickly. If someone cannot believe you, why would they want to invest time and effort in building a relationship only to have it sabotaged by lying? So if you are tempted to lie, consider what you might be doing to relationships that you value. Or, if you realize someone is lying to you, you may want to question how much that relationship is really worth. It’s also important to carry this over into our dealings with our kids, making the point early that lies never work.https://www.thejoint.com/california/chula-vista/eastlake-31125/202872-what-happens-to-brain-when-we-liehttps://ethicalleadership.nd.edu/news/what-dishonesty-does-to-your-brain-why-lying-becomes-easier-and-easier/https://www.snexplores.org/article/lying-brain-power-prefrontal-cortex-truth-tellinghttps://www.ucl.ac.uk/news/2016/oct/how-lying-takes-our-brains-down-slippery-slopeNeuroscientist Uses Brain Scan to See Lies Form.Daniel Langleben, a psychiatrist and neuroscientist at the University of Pennsylvania, might go down in history as the man who revolutionized lie detection. Instead of wiring someone up to a machine like the polygraph, which measures the anxiety thought to accompany deception, Langleben has skipped a step: He is looking right into the brain to track a lie while it is taking shape. Langleben, an Israeli immigrant with ceaseless energy, had never intended to build a modern-day lie-detection machine. His interest in deception came from work he had done with children suffering from attention deficit disorder (ADD). All the research indicated that children with ADD were terrible liars because they couldn't help but blurt out the truth. https://www.npr.org/templates/story/story.php?storyId=15744871The Brain Adapts to Dishonesty.Dishonesty is an integral part of our social world, influencing domains ranging from finance and politics to personal relationships. Anecdotally, digressions from a moral code are often described as a series of small breaches that grow over time. Here, we provide empirical evidence for a gradual escalation of self-serving dishonesty and reveal a neural mechanism supporting it. Behaviorally, we show that the extent to which participants engage in self-serving dishonesty increases with repetition. Using fMRI we show that signal reduction in the amygdala is sensitive to the history of dishonest behavior, consistent with adaptation. Critically, the extent of amygdala BOLD reduction to dishonesty on a present decision relative to the last, predicts the magnitude of escalation of self-serving dishonesty on the next decision. The findings uncover a biological mechanism that supports a “slippery slope”: what begins as small acts of dishonesty can escalate into larger instances.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5238933/
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