health & wellness Brain Aging Weizmann researchers find evidence of "link" to slow or reverse cognitive decline. H ow the brain ages is still largely an open question — in part because this organ is mostly insulated from direct contact with other systems in the body, including the blood and immune systems. In research recently published in Science magazine, Rehovot, Israel-based Weizmann Institute of Science researchers Professor Michal Schwartz of the Neurobiology Department and Dr. Ido Amit of the Immunology Department found evidence of a unique "signature" that may be the "missing link' between cognitive decline and aging. The scientists believe this discovery may lead, in the future, to treatments that can slow or reverse cognitive decline in older people. Until a decade ago, scientific dogma held that the blood-brain barrier prevents the blood-borne immune cells from attacking and destroying brain tissue. Yet in a long series of studies, Schwartz's group had shown that the immune system actually plays an important role both in healing the brain after injury and in maintaining the brain's normal functioning. They have found that this brain-immune interaction occurs across a barrier that is actually a unique interface within the brain's territory. This interface, known as the choroid plexus, is found in each of the brain's four ventricles, and it separates the blood from the cerebrospinal fluid. "The choroid plexus acts as a 'remote control' for the immune system to affect brain activity:' Schwartz said. "Biochemical `danger' signals released from the brain are sensed through this interface; in turn, blood-borne immune cells assist by com- municating with the choroid plexus. This cross-talk is important for preserving cog- nitive abilities and promoting the genera- tion of new brain cells:' This finding led Schwartz and her group to suggest that cognitive decline over the years may be connected not only to one's "chronological age" but also to one's "immunological age:' that is, changes in immune function over time might con- tribute to changes in brain function — not necessarily in step with the count of one's years. To test this theory, Schwartz and research students Kuti Baruch and Aleksandra Deczkowska teamed with Amit and his research group in the Immunology Department. The researchers used next- generation sequencing technology to map changes in gene expression in 11 different organs, including the choroid plexus, in both young and aged mice, to identify and compare pathways involved in the aging process. That is how they identified a strikingly unique "signature of aging" that exists solely in the choroid plexus — not in the other organs. They discovered that one of the main elements of this signature was interferon beta, a protein the body nor- mally produces to fight viral infection. This protein appears to have a negative effect on the brain: When the researchers injected an antibody that blocks interferon beta activ- Ask Dr. Vieder • Er The choroid plexus in the brain acts as an interface. ity into the cerebrospinal fluid of the older mice, their cognitive abilities were restored, as was their ability to form new brain cells. The scientists were also able to identify this unique signature in elderly human brains. The scientists hope that this finding may, in the future, help prevent or reverse cognitive decline in old age, by finding ways to rejuvenate the "immunological age" of the brain. ❑ LAKES URGENT CARE When your health concerns can't wait. Every year, we rake up a ton of leaves from our yard. What's the best way to prevent injury from all the strenuous activity? Like any new seasonal activity, raking leaves will stress muscles which most of us do not use on a regular basis. Making sure to stretch will help. Try to divide the task into smaller sessions with breaks, rather than a "marathon" day to get it all complete. Also, make sure the rake has an appropriate length handle for your height. Lastly, make sure to wear gloves to avoid generating painful blisters on your hands in the cold dry air. Is there a good way to determine if something is a break or just a strain? A painful extremity can be very misleading! Generally, without obtaining an x-ray of the area, it will not be possible to ascertain if the pain is due to a strain or fracture (break). The old advice of "if I can move it, it's not broken," generally is false. Quite often we discover a fracture even though someone can move a painful finger, wrist, foot or ankle. If it's just a strain, do I need to see a doctor? If you have injured a joint and are not experiencing severe pain or marked limitation of motion, you may consider applying the basics of "RICE" (Rest, Ice, Compression, Elevation) for a period of 24-48 hours. If pain remains persistent beyond a few days or prevents you from near normal mobility in a joint, especially the ankle or foot with weight bearing, it is best to have the injury evaluated by your primary care physician or a certified urgent care. If I suspect that it's a break, should I go to my doctor, the emergency room, or urgent care? We always suggest you check with your primary care physician to help navigate and obtain the most appropriate care for any health condition. Some primary care offices are comfortable taking care of minor fractures, some are not. A certified urgent care facility can competently take care of fractures, providing initial x-rays, diagnosis and casting. At Lakes Urgent Care, we provide all of these services and also work closely with several orthopedic specialists to provide excellent continuity of care for more complex fractures. For more info, visit the Ask Dr. Vieder page at LakesUrgentCare.com Dr. Sanford Vieder, DO, FACOEP, Medical Director at Lakes Urgent Care, West Bloomfield 58 October 30 • 2014