Power of the human brain

While many organs are critical for our survival, the brain is what makes us human. Like the rest of our organs, the brain is not impervious to damages of life.

Rehabilitation medicine consultant of the Brunei Neuroscience, Stroke and Rehabilitation Centre (BNSRC) of Pantai Jerudong Specialist Centre (PJSC) Dr Lee Chooi Lynn noted in an article on Brain Health and Disability.

Commemorated annually on July 22, World Brain Day this year follows a ‘Brain Health and Disability: Leave No One Behind’ theme highlighting efforts to drive awareness for brain health, and to align with the World Health Organization (WHO) efforts to emphasise the importance of prioritising efforts to make the world more accessible and equitable for everyone.

Dr Lee said the responsibilities of the brain that encompasses personality and consciousness that differentiates humans from other species, exerting control over the rest of the body and regulates many of our core body functions, including those of the cardiovascular, respiratory, endocrine and immune systems.

It also interprets information from senses that allow us to hear, see, touch, taste and smell, as well as gives emotions from happiness and fear to jealousy and love.

Certain issues related to the brain, said Dr Lee, emerge as early as the preconception phase, encompassing diverse congenital defects related to the brain, while others may arise at any point in life. This may include conditions like seizures, strokes, brain tumours, mental disorders, infections, Alzheimer’s disease, Parkinson’s disease and traumatic brain injuries (TBI).

Brain health can be defined as the state of the brain functioning across cognitive, sensory, social-emotional, behavioural and motor domains. By optimising brain health, we can reduce the prevalence and burden of neurological disorders, improve mental and physical health overall, create positive social and economic impacts, and contribute to greater well-being and help advance society, irrespective of the presence or absence of disorders.

A state of disability arises from the interplay between individuals dealing with a health condition and various personal and environmental elements. The elements encompass adverse attitudes, inaccessible transportation and public structures, as well as a lack of sufficient social assistance.

“Disability is part of being human. Almost everyone will temporarily or permanently experience disability at some point in their life,” said Dr Lee.

She highlighted the five key aims of this year’s World Brain Day – prevention, awareness, access, education and advocacy.

PREVENTION

Dr Lee said that maternal well-being holds a pivotal role in the intricate journey of intrauterine development. The impact of various factors on both the expectant mother and the developing foetus is profound, underlining the significance of prevention strategies.

Stress, malnutrition, and physical inactivity cast a shadow over the immune and central nervous system functions of both the mother and the foetus.

To bolster the growth of the brain and spinal cord, pregnant women must ensure a sufficient intake of at least 600 milligrames (mg) of folate (folic acid) during the initial trimester, followed by 400mg in later stages of pregnancy. Prenatal vitamins, tailored to cater to the unique demands of pregnancy, often provide an additional dose of folate.

In cases where dietary sources fall short, consultation with a healthcare provider is advisable.
In mitigating non-communicable diseases, its proactive management of hypertension, diabetes, obesity, depression and high cholesterol necessitates a multi-faceted approach.

Vigilance against TBI is paramount. Simple practices such as seatbelt usage during every ride and abstaining from driving under the influence of substances can drastically mitigate the incidence of TBIs.

Protective headgear while engaging in activities like motorcycling, cycling, high-impact sports, and horse riding further fortifies this defence.

Prioritising fall preventions for different age groups is also needed.

Ensuring regular eye examinations, creating safe home environments, choosing appropriate footwear, and partaking in strength and balance exercises form a robust strategy against falls in older adults.

Similarly, safeguarding play areas, using safety gates, and installing window guards are vital steps in averting falls among young children.

Swift diagnosis and treatment are important for certain brain disorders. Meningitis, if detected promptly, can be managed with antibiotics or antivirals, forestalling irreversible brain damage.

Early intervention also holds promise for certain brain tumours, which may be treated through surgery, chemotherapy, or radiotherapy, potentially achieving control or remission.

Advances in stroke treatment underscore the importance of timely medical attention, as clot-busting medications and clot retrieval procedures can significantly enhance outcomes.

In the realm of health and well-being, prevention emerges as a cornerstone.

By cultivating a holistic approach that encompasses maternal care, lifestyle adjustments, safety measures, and early intervention, we empower ourselves and our communities to steer clear of avoidable health challenges. Informed, and proactive choices pave the way for healthier lives and brighter futures.

AWARENESS

In any aspects of life, regular exercise is important. Dr Lee said studies have shown people who exercise regularly have a lower risk of developing Alzheimer’s disease.

It also improves blood flow and memory by stimulating chemical changes in the brain that enhance learning, mood and thinking, she added.

“The recommended amount of exercises for children and adolescents aged five to 17 years old should accumulate 60 minutes of moderate to vigorous exercise daily,” said Dr Lee, further adding that adults aged above 17 years should have 150 moderate intensity aerobic exercise a week or 75 minutes of high intensity aerobic exercise a week. There’s also the need for adequate rest and sleep, as well as mental fitness.

ACCESS

Despite best efforts to minimise risk factors, many people still develop conditions that affect the CNS at some point in their lifetime.

There is a need for universal access to quality health and social services to manage the many risk factors of brain health; universal access to rehabilitation therapy for brain injuries and brain disorders helps people relearn lost functions.

These might include daily activities such as eating, dressing, walking or speech; and universal access to assistive technology that helps to level the playing field for people with brain injury by providing them with a way to engage in life’s activities more fully.

EDUCATION

“Education increases equity for those living with brain disabilities. In all countries of the world, people with disabilities have lower literacy rates than people without disabilities,” said the consultant.

She added there is a difference based on the nature of the disability for example illiteracy is higher in children with visual impairments, multiple or mental disorders compared to children with motor disabilities.

“Inclusive education means including students with disabilities in a mainstream school environment.”

Moving towards a more inclusive model, said Dr Lee, is a long-term process and there are many obstacles to overcome and this includes identifying pupils with disabilities, lack of trained teachers, poorly adapted school facilities and learning materials, lack of resources and assessments of students with disabilities.

ADVOCACY

“Brain health is a human right that applies to everyone, everywhere,” Dr Lee said.

Health and social care for neurological disorders require multi-sectoral and interdisciplinary collaborations with a holistic person-centred approach focused on promotion, prevention, treatment, care and rehabilitation and the active engagement of persons with lived experience, their families, and caregivers.

The BNSRC at PJSC was established in 2010 as a stroke centre that has grown to a specialised facility for neurology, neurosurgery, and rehabilitation with a comprehensive array of infrastructure and expertise for patients requiring medical, surgical and rehabilitation care with specialised investigations, treatments, and therapies.

This year for World Brain Day 2023, PJSC has organised activities via social media, radio, and newspaper to expand public awareness regarding the importance of brain health. – Izah Azahari