Tag: mental

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The neurochemical reality of placebos

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As of September 2017, new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)

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The New Yorker had a great look at the placebo effect last month (unfortunately the full text isn’t available online), focusing on the work of Harvard’s Ted Kaptchuk. He’s the guy who did the study last year that found that placebos can be effective even when patients are aware that they’re receiving a placebo instead of “real medicine.” His hope is that doctors will learn to harness the placebo effect more effectively, and understand that it’s a real physical effect, not just in your head.

To that end, one of the most interesting nuggets in the article was a description of one of the classic placebo studies, from UCSF back in 1978. People recovering from dental surgery were given either morphine or a saline placebo; as expected, some patients responded to the placebo (their pain diminished) while others didn’t (their pain got worse).

What happened next, however, fundamentally reshaped the field. The researchers dismissed the subjects who had received morphine and then divided the remaining participants into those who responded to the placebo and those who didn’t. Then they introduced Naloxone into patients’ I.V. drips. Naloxone was developed to counteract overdoses of heroin and morphine. It works essentially by latching onto, and thus locking up, key opioid receptors in the central nervous system. The endorphins that we secrete attach themselves to the same receptors in the same way, so Naloxone blocks them, too. The researchers theorized that, if endorphins had caused the placebo effect, Naloxone would negate their impact, and it did. The Naloxone caused those who responded positively to the placebos to experience a sharp increase in pain; the drug had no effect on the people who did not respond to the placebo. The study was the first to provide solid evidence that the chemistry behind the placebo effect could be understood — and altered.

In other words, placebo responders were dulling their pain via exactly the same route as morphine recipients. It was a “real” effect. In the realm of sports science, that’s something to bear in mind when we read yet another report showing that some supposedly performance-enhancing substance doesn’t outperform placebos in a controlled trial.

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Mental effort increases physical fatigue, reduces HR variability

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As of September 2017, new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)

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A pretty neat study just appeared online at European Journal of Applied Physiology, looking at the links between mental effort and physical fatigue. This is a topic I’ve touched on previously, and find really interesting. The new study, from researchers at Michigan Technological University and Virginia Tech, adds some new wrinkles.

The protocol is quite complex, but basically a bunch of volunteers did fatiguing shoulder exercises while doing mental arithmetic (“Here’s a number, multiply it by three… now multiply it by three again…” etc.). The researchers measured how quickly the subjects’ shoulders fatigued, and how quickly they recovered and returned to full strength in the 15 minutes after the exercise bout. As you can probably guess, the subjects doing mental arithmetic lost strength and reached failure more quickly than the controls.

Why does this happen? Well, the researchers discuss some previous work suggesting that mental activity triggers stress which triggers low-level muscular contractions, which can lead to premature fatigue. But I actually find another explanation more convincing:

It has been shown that fatiguing contractions require high attentional demands due to changes in the excitability of motor cortex. As such, it could be argued that additional mental demand in the current study may have reduced available attentional resources needed to increase the drive to motor neurons to maintain the required force levels, resulting in early task failure (i.e., shorter endurance times).

In other words, it takes focus and mental effort to push to your limits, and those are finite quantities that can be squandered thinking about other things. That seems like the simplest explanation to me, and it would fit with the research by Samuele Marcora that I mentioned above.

A neat additional observation: the mental arithmetic resulted in lower “heart rate variability” (HRV). Basically, you measure the time between successive heart beats — if that time is always identical, you have low HRV; if it fluctuates, you have higher HRV. This tells you something about the balance between sympathetic and parasympathetic nervous systems; when you’re under stress, the sympathetic system ramps up and release norepinephrine (aka noradrenaline), which elevates your heart rate but reduces heart rate variability. The result: it takes longer for your heart rate to settle back to normal — which is exactly what the researchers observed in the subjects doing the mental arithmetic.

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Which childhood activities predict healthy adulthood?

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As of September 2017, new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)

***

Encouraging kids to be more active is one of those motherhood-and-apple-pie goals that pretty much everyone sees as an excellent idea. Still, it’s worth asking: do the kids who are most active grow up to be the adults who are most active? And perhaps more importantly, which types of childhood activity (school phys ed? sports? unstructured play? walking or biking to school?) are most effective at establishing lifelong habits of physical activity?

Researchers in Australia just published a big study on the British Journal of Sports Medicine that followed up on 2,201 kids who had completed a detailed physical activity questionnaire way back in 1985, when they were between the ages of 9 and 15. The goal was to figure out whether and how “frequency and duration of discretionary sport and exercise (leisure activity), transport activity, school sport and physical education (PE) in the past week and number of sports played in the past year” when they were kids influenced their activity patterns as adults between the ages of 26 and 36.

Depending on how you look at it, the results are either very simple or very complicated. You can delve into all the nitty-gritty details of which childhood factors seem linked to which adulthood factors — and find puzzling and seemingly contradictory trends like this:

Higher levels of school sport among older males were associated with a 40% increase in the likelihood of being in the top third of total weekly activity in adulthood, but with a 40% lower likelihood among younger males.

Does this mean that school sport is bad for 9- to 12-year-olds and good for 13- to 15-year-olds? Probably not. As discussed earlier this week, when you search for links between large numbers of variables in a big collection of data, you’ll always find some relationships that appear statistically significant but in fact have little or no meaning. When you look at this data as a whole, there are a few “significant” associations, but there’s no overall trend, as the researchers acknowledge:

[F]ew associations were evident, most were relatively weak in magnitude and, for some activities, inconsistent in direction.

In other words, if you take a group of 12-year-olds and look at how active they are, you’ll have very little ability to predict which of those kids will have healthy, active lifestyles 20 years later. This is a bit of a bummer, because it makes it harder to decide exactly what types of physical activity are most useful for forming lifelong activity patterns. But don’t make the mistake of thinking that this implies that school phys ed (and other childhood physical activity) isn’t useful! Phys ed for 12-year-olds may not produce healthy 30-year-olds, but it sure as heck produces healthy 12-year-olds — and that’s a worthwhile goal on its own.

And hey, there’s also the fact that (as Gretchen Reynolds wrote about in the New York Times last week), a little bit of physical activity makes you perform better on tests. What kid wouldn’t want a boost of brain-derived neurotrophic factor coursing through his veins and boosting his memory as he heads back to math class?

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Exercise -> serotonin -> antidepressant

THANK YOU FOR VISITING SWEATSCIENCE.COM!

As of September 2017, new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)

***

It’s well-established that exercise can be a powerful tool against depression (as Gretchen Reynolds wrote about in the New York Times a few months ago). What’s less clear is how and why it might help. A new study in  Medicine & Science in Sports & Exercise, from researchers at the University of Sherbrooke, offers some evidence for the theory that exercise can boost serotonin levels in the brain. This, of course, is pretty much the same as what the most common antidepressants (SSRIs: selective serotonin reuptake inhibitors) do.

The study was pretty straightforward. They had 19 men with an average age of 64 perform a 60-minute bout of exercise at moderate intensity (average HR 129 beats per minute, 68% VO2max). Then they measured several proxies of serotonin production, since it’s very difficult to directly measure neurotransmitters in the brain. The result: levels of tryptophan — the key precursor which is converted into serotonin — roughly doubled.

Is this a surprise? There was previous evidence in studies of rodents and younger humans that exercise boosted tryptophan availability, but it wasn’t clear whether the same effect would occur in older adults. This is particularly important because we become increasingly susceptible to depression as we age, suggesting that some of the mechanisms that help us ward off depression stop working quite as well.

Of course, one of the problems with “prescribing” exercise as a depression treatment (as Reynolds notes) is that once you’re depressed, it can be extremely difficult to summon the motivation needed to maintain a regular exercise program. Still, this study suggests that exercise might help to prevent depression in the first place, particularly as you get older.

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The incredible shrinking hippocampus (and how to stop it)

THANK YOU FOR VISITING SWEATSCIENCE.COM!

As of September 2017, new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)

***

Over the last few years, a bunch of studies have built the case that aerobic exercise does something to keep your brain in good working order as you age — or perhaps more accurately, it does several good things for your brain. Last week, I blogged about a study showing that exercise stimulates the growth of new mitochondria in the brain. In the comments of that post, Seth Leon pointed out another new study — this one in the September issue of Neuropsychology — that links exercise to greater volume of the hippocampus, which in turn improves memory.

I’ve been particularly interested in the hippocampus ever since I wrote this article in The Walrus back in 2009, looking at suggestions that increased use of GPS navigation would lead to decreased volume of the hippocampus, where our direction-finding skills reside. And smaller hippocampi are associated with increased risk of age-related cognitive impairment. One of the researchers I spoke to worried that this is part of larger shift:

But Bohbot sees the decline in spatial thinking as part of a broader shift toward stimulus-response, reward-linked behaviour. The demand for instant gratification, for efficiency at all costs and productivity as the only measure of value — these sound like the laments of the nostalgist in the Age of the Caudate Nucleus. But here, they’re based on neuroscience. “Society is geared in many ways toward shrinking the hippocampus,” she says. “In the next twenty years, I think we’re going to see dementia occurring earlier and earlier.”

I can’t count the number of times I’ve taken wrong turns since writing that article because of my stubborn refusal to use GPS unless absolutely necessary! But I digress…

Anyway, this new study, by researchers at the University of Illinois, looked at a group of 158 sedentary adults between 60 and 80 years old, to look for evidence for the following model:

The basic gist is straightforward: they hypothesize that fitness (as measured by a graded exercise test to exhaustion) predicts hippocampus size, which in turn predicts working memory, which in turn predicts how frequently you forget things. What’s new about this study is that they separately consider age, BMI, sex, physical activity, and education to see if any of them are skewing the results. Here’s what they find:

By and large, the data supports their hypothesis. There are a few wrinkles: for example, age, in addition to affecting fitness, also has a direct effect on hippocampus size. That means no matter how fit you are, your hippocampus is still getting smaller. Also, physical activity (that’s the PASE box) didn’t directly contribute to fitness — but that’s not surprising, because the volunteers had to be sedentary in order to be admitted to the study, so they all had roughly the same (lack of) physical activity.

Bottom line: aerobic fitness is good for the brain — and in particular, it’s good for the hippocampus. So maybe if I get enough exercise, I’ll start letting myself use that GPS navigation system.