Dennis B. Kottler, MD

Westlake Village, CA

Appointments:   818-991-8376 


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The BRAIN is the most forgotten organ in the body.  While we "hear" from most of our other organs--a pain, a cramp, an ache--the BRAIN, lacking pain receptors, is essentially silent.  In fact, once the BRAIN is exposed, doctors can perform surgery, insert electrodes, and otherwise invade it, without anesthetic!  Nonetheless, to insure years of trouble-free use of the BRAIN, please read the following:




1   LIGHT  -   Light has a powerful influence on the brain in establishing the normal "sleep/wake" cycle.  The natural alternation of day and night entrains the brain, keeping the biological clock running on a diurnal schedule, causing us to fall asleep at night and awaken in the morning.  However, the advent of good artificial light, including glaring TV and computer screens, has probably done more harm than anything to disrupt this natural cycle and cause SLEEP DISORDERS.

Suggestion: To keep the brain running "like a clock" and to reset it when it gets "out of sync," treat it to early morning daylight by taking a short walk outdoors or having breakfast near a window.  If this is impossible, use bright artificial light to help the brain "awaken."  This morning light is especially important if susceptible to the mood disorder known as “seasonal affective disorder.”  In the evening, avoid the temptation to extend the day with artificial light into the late hours.  Turn all lights off and go to a consistent and reasonable hour to ensure 7 to 9 hours of good sleep.

****Technical Sidebar #1:  The current scientific explanation for the above advice involves melatonin and a tiny organ known as the pineal gland, deep inside the brain.  When light, especially bright light, enters through the eyes, a train of neurological sequences INHIBITS the pineal gland from secreting a compound known as melatonin.  This DROP in melatonin level is one factor allowing the brain to "wake-up" and smell the coffee.  At night, in the absense of light-triggered melatonin inhibition, the pineal enters its default mode and melatonin secretion resumes, effectively putting the brain back to sleep.  (Melatonin, the store-bought kind, has been touted as a sleep aid.  However, its effectiveness has recently been questioned.  The problem with external sources of endogenous substances is bioavailibility where it counts.  After passing through the digestive system and the liver and then struggling to gain passage through the blood/brain barrier, it is questionable how much melatonin survives in any therapeutic quantity).

****Technical Sidebar #2:  Staying up later and later into the night is known as “delaying” the sleep cycle.  Sometimes it becomes very difficult to reverse this process.  The sleep cycle behaves like a clock that is much easier to set ahead than back.  In fact, when the sleep cycle is delayed by many hours, it is sometimes easier to keep delaying it by a couple of hours a day until it is set again to a reasonable bedtime.  This assumes one has the luxury of taking several days off work or school.  Good light hygiene can help prevent this problem.  To help advance the sleep cycle, use regular exposure to early morning light; to delay the sleep cycle use exposure to evening light.  


2.  SOUND  -  Sound has been less studied than light as it impacts brain function.  In susceptible people, loud sounds can induce migraines and/or tension headaches.  Sound certainly can interfere with concentration.  On the positive side, “white noise” can help the brain enter into a relaxing alpha wave state.    Rhythmic, harmonious sound, such as some music, can induce a state of relaxation.  Strident sounds, such as a baby crying, can induce maximum awareness, if not outright irritation, and most likely evolved as such to ensure that vulnerable infants got maximum attention from their parents.

****Technical Sidebar:  The power of sound is showcased by an emerging technology known as "HSS," hypersonic sound system.  Using "HSS," focused sound of high amplitude can have devastating effects on the brain, causing individuals to be “stopped in their tracks” and disoriented for hours.  This may have military and police applications.


3. SCENT There is much conjecture about the effects of scents on the brain.  Perfumes and pheromones, come to mind, literally, as they penetrate the nasal mucosa and exert powerful effects on mood and arousal, including sexual arousal.  Noxious scents lead to irritation and avoidance, a technique honed to perfection by the skunk and probably other animals as well.

****Technical Sidebar:  A recent study (2003) was conducted at the University of Pennsylvania involving the effects of male sweat.  Sweat was pooled from men's underarms (the men had refrained from deodorant for four weeks) and applied to the upper lips of 18 women, aged 25 to 45.   Over a period of 6 hours several beneficial effects were noted by the women, who were unaware of what had been applied to their upper lips.  The women noted improvement in mood and level of stress.  Furthermore, hormonal changes were noted in the women's blood, specifically an increase in LH (luteinizing Hormone) which is important in triggering ovulation.  This study suggests a role for the olfactory effects of human sweat in both mood regulation and reproductive synchronization.   An interesting speculation:  Some individuals (men?) have been known to sniff their own scents.  Perhaps this has some self-regulatory effect on mood?  Animals, of course, are well known to be sniffers.


4. TOUCH -  This is a largely unexplored area, although we do know that gentle human touch as well as more vigorous massage can have various salutary effects on both mood and physical well-being.  Another interesting subject is the sexually arousing effects of touch in certain interpersonal contexts.


5. TEMPERATURE Aside from the obvious discomfort and irritability resulting from a too hot room, there is also the oxygen factor.  As temperature rises, air becomes less dense and the partial pressure of oxygen falls.  This is the equivalent of the altitude effect.  Less oxygen to the brain results in tiredness, slowed thinking, and difficulty concentrating.  

Suggestion:  If temperature cannot be controlled, do more demanding tasks earlier or later when it will probably be cooler.  This is probably the origin of the siesta in warm climates.


6. MECHANICAL, CHEMICAL and MICROBIAL ASSAULT - Although the brain is happily ensconced in the cranial fortress and further protected by a sophisticated blood-brain barrier, it is nonetheless vulnerable to mechanical trauma and chemical and microbial assault.   

Suggestion:  Wear helmets when on skateboards, bicycles, motorcycles, skies, snowboards, etc.   Use seatbelts when riding in enclosed vehicles.  Practice discretion when around sources of infection.  Keep informed of the latest environmental hazards in your community, e.g. lead, mercury, pesticides, and other hazardous chemicals.  Recently attention has been focused on the toxic chemicals found in building materials and furniture, such as fire retardants.  Since it is thought these chemicals may degrade brain function, it is best to keep informed about the latest research and act accordingly.

Finally, the same people who would not think of pouring caustic chemicals into their television sets or computers, snort and smoke, inhale, ingest, and otherwise contrive to get into their brains a multitude of noxious chemicals.  No comment.


7.  INFORMATION  -  In very simplistic terms, G-I-G-O....or "garbage in, garbage out" they used to say in the computer programming lab.  

                A - DO NOT input faulty information:  misconceptions, distortions, prejudices, and logical fallacies.

                B - DO learn and practice Critical Thinking through which  information can be appropriately assessed.

                C - DO develop an appreciation of one's talents and achievements, which reinforces perception of positive self-worth.  

                D - Do learn and practice strategies for dealing with failures and mistakes, which adds resiliency, encourages perseverance, and further improves self-esteem.


8. THE IN UTERO BRAIN  -  Poor nutrition, smoking and chemical abuse, as well as exposure to certain viruses, probably have detrimental developmental effects on the brain and possibly contribute to such problems as ADHD (?) and schizophrenia (?)...although this is unproven.

Childbirth is another vulnerable time, during which the infant brain is susceptible to hypoxia (oxygen deprivation) and pathogens which may infect the birth canal.  Good prenatal care helps detect and plan for these potential problems.


9.  THE AGING BRAIN  -  The ultimate dread of aging is a body that outlives the brain.   Alzheimer's disease is the bane of an aging brain.  Several strategies have been suggested to help forestall this ultimate deterioration:

                A - Maintain good cardiovascular health, including blood pressure control.    This will help prevent strokes (brain infarcts) and cognitive decline.

                B - NSAID's (non-steroidal, anti-inflammatory drugs such as ibuprofen-Advil) may help delay or prevent Alzheimer's disease.  Possibly aspirin may help(?).

                C -  Vitamin E - This OTC, antioxidant supplement may also help delay or prevent Alzheimer's disease.

                D -  Crossword Puzzles - There is some evidence that ongoing mental exercise is  beneficial in maintaining cognitive function.

                E -  Exercise - This may benefit the brain by improving the overall health of the cardiopulmonary system and by improving mood.

                F -  All the "Care and Repair" factors listed above also apply to the aging brain.


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Appointments:   818-991-8376