# World-Renowned Neuroscientist shares tips on preventing dementia & boosting brain health

An episode of [Project 100 with Mark Bouris](https://invisiblenetwork.ai/podcast/1767053714), 24 Nov 2024, 1 h 24 min.

Audio: https://p.podderapp.com/2544644999/traffic.omny.fm/d/clips/2fb3740d-3436-44af-8cc0-a91900716aa5/05ac4e52-79fb-46b8-849c-b305000bd6d0/87ea492e-93f9-4bca-a988-b305000c226b/audio.mp3?utm_source=Podcast&in_playlist=ef13e652-7a19-41fd-9d0f-b305000bd6dc

All content and media by Project 100 is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. *** Professor Matthew Kiernan is a world-renowned clinical academic and scientist, serving as the Chief Executive Officer and Institute Director at Neuroscience Research Australia (NeuRA). His research primarily focuses on neurodegenerative diseases, including motor neurone disease (MND) and frontotemporal dementia. Matthew is also a practicing neurologist, and both my mother and I have had the privilege of being his patients. In this Project 100 episode we delved into the fascinating world of neuroscience, exploring the complexities of the brain, the definitions and risks associated with dementia, motor neuron disease (MND), and Parkinson’s. Our conversation covered available treatments, the impact of lifestyle factors, prevention strategies, tips on improving brain health and much more. Follow Project 100 on Instagram. Follow Mark Bouris on Instagram, LinkedIn, Twitter & YouTube. See omnystudio.com/listener for privacy information.

## Transcript

[0:00] Speaker 1: Professor Matthew Kinnan, Hey mate, Well Mark, how are you good?
[0:05] Speaker 2: Mate?
[0:05] Speaker 1: Well, you tell me, we'll get to that ive your patient. Well,
[0:11] Speaker 1: welcome to probably one undred Maine.
[0:12] Speaker 2: Thanks for doing so.
[0:15] Speaker 1: Uh, maybe just tell us a little bit about your
[0:21] Speaker 1: medical qualifications. So what's the deal. I know you're neuroscientists.
[0:25] Speaker 1: I know you're neurologists, but just tell me a little
[0:27] Speaker 1: bit about what that all means, because a lot of
[0:28] Speaker 1: people don't know you know what that means.
[0:30] Speaker 3: So I did medicine at university, and then after medicine
[0:34] Speaker 3: you do general training intern resident registrar and you choose
[0:37] Speaker 3: a stream, whether it's surgery, physician training, obstetrics and gynecology, psychiatry.
[0:43] Speaker 3: I chose medical training, so physician training and that's general training.
[0:47] Speaker 3: You cover all of the subspecialties cardiology, hematology. Then you
[0:51] Speaker 3: choose your own subspecialty, which for me was neurology. So
[0:55] Speaker 3: you do three years of neurology and usually that means
[0:59] Speaker 3: later operating research. So I did a PhD at the
[1:02] Speaker 3: University of New South Wales and luckily for me, Australia
[1:06] Speaker 3: has a training position in London at the National Hospital
[1:09] Speaker 3: for Neurology, in Eurosurgery, which is at University College London,
[1:12] Speaker 3: so that that's awarded in Australia and I was fortunate
[1:15] Speaker 3: to get that role, went over to London and then
[1:18] Speaker 3: stayed there for five years before coming back to Sydney.
[1:22] Speaker 3: And most recently I was the what's called the Bushel
[1:25] Speaker 3: Chair of Neurology at Royal Prince Alfred Hospital, so it
[1:27] Speaker 3: was for a decade that was the first professorship in
[1:30] Speaker 3: neurology around Australia. And then more recently there was a
[1:35] Speaker 3: position became vacant, the Chief Executive Officer at Neurosciences Research Australia.
[1:40] Speaker 2: And I took up that role.
[1:41] Speaker 3: That's where I am now at the Randwick Precinct, also
[1:44] Speaker 3: at the University of New South Wales and a neurologist
[1:48] Speaker 3: at Prince of Wales Hospital, Southeastern Sydney Local Health District.
[1:52] Speaker 1: And are you still a clinician.
[1:54] Speaker 3: Yeah, so I'm working as a neurologist about half my
[1:57] Speaker 3: week seeing patients, are trying to involve patients in clinical
[2:01] Speaker 3: trials nationally and internationally. The other half of my week
[2:05] Speaker 3: is looking after the research institute and that has about
[2:08] Speaker 3: five hundred and fifty neuroscientists divided into thirty groups, covering
[2:13] Speaker 3: I think the three themes that we're working on neurodigeneration
[2:16] Speaker 3: and dementia that incorporates a brain bank which is a
[2:20] Speaker 3: national and international facility. We have mental health, so particularly
[2:24] Speaker 3: the neuroscience of mental health, the underlying mechanisms. And the
[2:28] Speaker 3: third theme is translational neuroscience, so using all of the
[2:32] Speaker 3: strengths of the university engineering and psychology to look at
[2:37] Speaker 3: problems such as spinal cord injury, pain, trying to bring
[2:40] Speaker 3: in technology as an alignment with neuroscience research.
[2:44] Speaker 1: So you might just explain what neuroscience is, because neurology
[2:48] Speaker 1: is different in neuroscience, and you are a neuroscientist, I
[2:51] Speaker 1: presume your PhD is in neuroscience. And is it sort
[2:56] Speaker 1: of relatively speaking, a new stream, relatively speaking in that
[3:00] Speaker 1: more people are doing it these days than ever before.
[3:02] Speaker 1: What is neuroscience?
[3:04] Speaker 2: Very good question.
[3:06] Speaker 3: So I think it's really the science of anything to
[3:08] Speaker 3: do with nerves and brain. It's a brain tissue. But
[3:11] Speaker 3: for neurology that's a clinical discipline and it can be both.
[3:15] Speaker 3: But a neuroscientist might just focus on purely the science.
[3:18] Speaker 3: It might be molecular that might be genetics, might be
[3:21] Speaker 3: looking at a cell type, could be electrical. It could
[3:23] Speaker 3: be electrical, totally electrical, and it could be artificial intelligence.
[3:27] Speaker 3: It could be purely on structural imaging like MRI. So
[3:31] Speaker 3: that's just a focus of science. Neurology makes it a
[3:35] Speaker 3: clinical discipline and you know, working with patients.
[3:39] Speaker 1: Out of those two fit in together, though maybe in
[3:42] Speaker 1: the context of neuro where you're the CEO, which is
[3:45] Speaker 1: a joint vito as honestadto a new and s w
[3:47] Speaker 1: University of South Wales and the Prince Wales Hospital. And
[3:51] Speaker 1: it's by the way, it's a big deal for anybody
[3:53] Speaker 1: who hasn't seen it, Like there's a massive building out there.
[3:56] Speaker 1: It looks like pretty new to me. It looks like
[3:58] Speaker 1: a big investment by somebody I know, with the state government,
[4:00] Speaker 1: federal government, university, whatever, doesn't matter, it's a big deal.
[4:04] Speaker 1: How do those two interact. Neurology and neuroscience is one
[4:08] Speaker 1: more about doing research. Is science about more understanding the
[4:12] Speaker 1: science of the brain, because there is an actually manage
[4:15] Speaker 1: because there's a lot of doctors around, okay, and they
[4:19] Speaker 1: are very good at diagnosing and perhaps giving you something
[4:23] Speaker 1: to take for whatever it is they're diagnosed, But I
[4:26] Speaker 1: find I'm not knocking them. It's just an observation. They're
[4:30] Speaker 1: so damn busy they don't always have the opportunity to
[4:33] Speaker 1: keep up with the science. And neuroscience seems to be
[4:37] Speaker 1: not so much involved in the clinic, but is about
[4:40] Speaker 1: within its various silos. But it's about keeping up with
[4:43] Speaker 1: the science and or maybe making the science. Is that?
[4:46] Speaker 1: Am I right?
[4:47] Speaker 2: Yeah?
[4:48] Speaker 3: So neuroscience would be very much discovery and neurology would
[4:52] Speaker 3: be translation. In other words, how does that get into
[4:55] Speaker 3: the clinic looking after patients? So you're right, they should
[4:58] Speaker 3: be aligned and that's where the move movement is nationally
[5:00] Speaker 3: and internationally. So governments want neuroscientists working on problems that
[5:05] Speaker 3: society wants to deal with, whether it's psychosis, whether it's dementia.
[5:10] Speaker 3: So you have to use the strengths of a science
[5:13] Speaker 3: background to look at mechanisms, to look at new treatments, discovery,
[5:18] Speaker 3: and then once that discovery is made, can it translate
[5:21] Speaker 3: through and ultimately be prescribed, as you mentioned, from your
[5:24] Speaker 3: doctor to the patient. And that's that is that's the
[5:27] Speaker 3: final outcome, and that is such a you know, amazing
[5:30] Speaker 3: outcome for society, but for individual patients.
[5:34] Speaker 1: We see a lot of you know, you would see
[5:37] Speaker 1: it all the time, but there's a there's a lot
[5:40] Speaker 1: of stuff going on overseas. It looks like, you know,
[5:42] Speaker 1: the place to be is in the United States or
[5:44] Speaker 1: some other place around the world. How does Australia rank.
[5:47] Speaker 1: I mean you would see you read all the journals,
[5:50] Speaker 1: you would see all the research, particularly in your current role.
[5:54] Speaker 1: How do we rank as a country relative to the
[5:58] Speaker 1: rest of the world when it comes to science around
[6:00] Speaker 1: the brain?
[6:01] Speaker 3: Well, we really are way ahead in Australia. Wow, and
[6:05] Speaker 3: we punch well above our weight. And probably you know,
[6:08] Speaker 3: discovery wise, ten to fifteen twenty percent is linked to
[6:12] Speaker 3: Australia in some form. Probably one of the issues that
[6:16] Speaker 3: we've had as a country is once the discovery is made,
[6:19] Speaker 3: we often sell it off. And whether we sell it off,
[6:21] Speaker 3: particularly to North America or Western Europe, that's usually the outcome.
[6:26] Speaker 3: So what we need to do now is try and
[6:28] Speaker 3: harness those discoveries and keep them in Australia and try
[6:31] Speaker 3: and develop them through for the benefit of not just
[6:34] Speaker 3: Australia but worldwide, and that would then bring the income
[6:37] Speaker 3: back into Australia, so we tend to sell off too
[6:40] Speaker 3: early and we need visionaries like you and investors to
[6:44] Speaker 3: try and keep those discoveries in Australia and bring them through.
[6:48] Speaker 3: Part of the problem is that, you know, international farmer
[6:50] Speaker 3: companies are particularly North American based, like Boston is the
[6:54] Speaker 3: mecca you know, Western Europe, Germany, UK, France, that's where
[6:57] Speaker 3: they all are. There's really only one made international farmer
[7:01] Speaker 3: company in Australia see USL. And even then they have
[7:04] Speaker 3: to have their major outlet through America, North America, King
[7:07] Speaker 3: of Prussia, so see USSEL Bearing. And I think that's
[7:10] Speaker 3: probably related to our population. But if we had a
[7:13] Speaker 3: few more international players here, Australia would really take off.
[7:18] Speaker 1: Okay, So we first met through the Brain of Mind Center,
[7:24] Speaker 1: where you were when my mother was first diagnosed with
[7:28] Speaker 1: M and D through a neurologist just down the radio.
[7:30] Speaker 1: It's in Vincent's. They said the best place to go
[7:33] Speaker 1: is Brain and Mind Center, which is where you were
[7:34] Speaker 1: at the time and mode in your own disease, which,
[7:38] Speaker 1: by the way, I have to tell you I had
[7:39] Speaker 1: no sense of whatsoever of neurodegenerated diseases. And what was
[7:45] Speaker 1: interesting is that. I don't know if I ever told you,
[7:47] Speaker 1: but I used to ring my mum. By the way,
[7:50] Speaker 1: my mother's a Irish background, and I do want to
[7:52] Speaker 1: touch on this in a moment, and i'd say, your
[7:54] Speaker 1: surname is the same. But I used to dream my
[7:58] Speaker 1: mother on my way home, probably every night, if not
[8:01] Speaker 1: every night, definitely every second night. Didn't just talked to
[8:03] Speaker 1: her during that period because I knew that my between
[8:05] Speaker 1: my office and my home was about twenty five minutes,
[8:07] Speaker 1: and my mother, being Irish, could talk, and I knew
[8:10] Speaker 1: that I could say, Mum, I'm home. I got to
[8:12] Speaker 1: go and side for my dinner and that would be
[8:14] Speaker 1: the end of my tid. I'd have a nice fixed
[8:16] Speaker 1: period and I did it for many, many years, like
[8:19] Speaker 1: all my working career, whilst I've had a mobile phone.
[8:22] Speaker 1: And I remember one night I was talking to my
[8:23] Speaker 1: mother and my mother didn't drink. And I talked to
[8:26] Speaker 1: my mother and she soundly she'd been drinking, and my
[8:29] Speaker 1: dad did mind a scotch every now and then I
[8:31] Speaker 1: said to mom, he mum, you had a drink my
[8:34] Speaker 1: dad and she said, no, dear, no, dear, no, no,
[8:36] Speaker 1: I haven't had a drink and I said, you're sure,
[8:38] Speaker 1: I said, you go, you're soundly. You're slurring your words anyway,
[8:44] Speaker 1: short story a long story becoming a short story. I
[8:48] Speaker 1: got nervous. I didn't know what to do. I never
[8:50] Speaker 1: met a neurologist in my life. I bumped into my
[8:53] Speaker 1: friend Phil Streeker ad here was a urologist, and he
[8:56] Speaker 1: quickly got me referred to somebody at Saint Vincent's, like
[8:58] Speaker 1: literally two days later. They did a series of tests
[9:02] Speaker 1: which we may quickly touch on, but they weren't blood
[9:06] Speaker 1: test ringing like that. They were sort of sensory tests.
[9:12] Speaker 1: Then she was sent to you guys. Within six months
[9:15] Speaker 1: she passed away. One of the things I found out
[9:19] Speaker 1: I was told is that people with Irish genetics have
[9:24] Speaker 1: a or Celtic genetics is probably better way putting it,
[9:27] Speaker 1: have a statistically more likely to get this as a
[9:31] Speaker 1: genetic disease than other people. Is that the truth? Or
[9:36] Speaker 1: am I just amaging.
[9:36] Speaker 2: That it's the truth.
[9:38] Speaker 3: So I remember your mother well, and she's a lovely lady,
[9:42] Speaker 3: and as you say, she had some slurring of speech,
[9:45] Speaker 3: and it turned out that she had made in your
[9:46] Speaker 3: own disease Als says. It was called yeah, Als and
[9:49] Speaker 3: we call it bulber onsets, so bulber it means the
[9:52] Speaker 3: tongue in mouth region. And one of the more common
[9:55] Speaker 3: genes of genetic processes is called C nine open reading
[9:59] Speaker 3: frame seventy tw to sina on and off, and that
[10:01] Speaker 3: can be traced back to one individual in Finland a
[10:04] Speaker 3: thousand years ago.
[10:05] Speaker 2: Wow.
[10:06] Speaker 3: And then we've seen the movement of this one person
[10:09] Speaker 3: and extended family through Western Europe and then migration from
[10:13] Speaker 3: Western Europe to Australia and North America. So every time
[10:17] Speaker 3: we find this gene, we find the original Finnish haplotype,
[10:20] Speaker 3: the founder, so it's all related to one person a
[10:23] Speaker 3: thousand years ago. Interestingly, there's none of this gene representation
[10:28] Speaker 3: in Asia, for instance, so none of it, none of
[10:30] Speaker 3: the vikings never made it to Asia, but it's interesting. So, right,
[10:34] Speaker 3: a very high proportion of Western Europeans and particularly Ireland
[10:39] Speaker 3: and Great Britain, United Kingdom.
[10:41] Speaker 1: And I was also told of the time, and then
[10:44] Speaker 1: I think this is important for people in terms of
[10:47] Speaker 1: their habits and behaviors. I was also told at the
[10:49] Speaker 1: time that you might have the mutation or the gene
[10:52] Speaker 1: mutation gene mutated gene which goes back thousand years, but
[10:59] Speaker 1: my mother never got into a she's eighty six years
[11:00] Speaker 1: of age. And I was also told that it needs
[11:04] Speaker 1: another element to sort of excite that gene into turning
[11:11] Speaker 1: into als. And at the time this is many years,
[11:16] Speaker 1: is like seven eight years ago now. But they said
[11:19] Speaker 1: either exposure to chemicals, heavy chemicals, alcoholism, which is a
[11:25] Speaker 1: problem an island as we know, and severe respiratory infections.
[11:34] Speaker 1: Should we maybe not eveone's going to run and get
[11:38] Speaker 1: a genetic test. But is that sort of quite straight
[11:41] Speaker 1: up informing us that we've got to be careful about
[11:43] Speaker 1: our behaviors, what we get exposed to, and is there
[11:47] Speaker 1: any expansion on that? Am I correct what I just said?
[11:50] Speaker 2: Absolutely correct? I suppose.
[11:52] Speaker 3: The interesting thing is we're born with these genetic changes,
[11:55] Speaker 3: so that's our makeup. Why is it then that some
[11:58] Speaker 3: people manifest disease some people don't. So let's say, you know,
[12:02] Speaker 3: an individual has this gene. There's no guarantee that they're
[12:05] Speaker 3: going to get the disease, so they could die from
[12:08] Speaker 3: something totally unrelated at the age of ninety five and
[12:11] Speaker 3: that gene will never have any play in their life.
[12:13] Speaker 3: Presumably there are compensations going on in the brain and
[12:17] Speaker 3: the nervous tissues. Those compensations can keep things under control,
[12:21] Speaker 3: and then ultimately a stress triggers the process of the
[12:25] Speaker 3: original cell death, and then there's a sort of a
[12:28] Speaker 3: cascade that spreads through the brain or the spinal cord.
[12:32] Speaker 3: And we know that if we look at we've looked
[12:34] Speaker 3: at cancer modeling and we've taken that now into neurology,
[12:38] Speaker 3: and if we look at the onset of a disease
[12:40] Speaker 3: and the incidents, it's a straight line and the slope
[12:43] Speaker 3: of that straight line is six, So six things have
[12:46] Speaker 3: to happen for you to manifest the disease. If you
[12:50] Speaker 3: have a gene, that's three of the steps. So there's
[12:53] Speaker 3: another three steps. And as you mentioned, it's a severe stress,
[12:57] Speaker 3: so we know it a very extreme case is someone
[12:59] Speaker 3: who gets hit by lightning or they have to get
[13:01] Speaker 3: a severe electrical injury. You've got an entry and exit
[13:04] Speaker 3: where moder in your own disease begins in that region. Wow,
[13:07] Speaker 3: so that's the stress. And you mentioned and you know,
[13:10] Speaker 3: severe respiratory infection or you know, severe alcohol, any of
[13:14] Speaker 3: those things could be sufficient to trigger the process. Unfortunately,
[13:19] Speaker 3: we don't know exactly how that happens that's the problem,
[13:22] Speaker 3: but it could.
[13:23] Speaker 1: Be, but it could inform us about because you know,
[13:26] Speaker 1: it's actually healthy not to be an alcoholic, it's actually
[13:29] Speaker 1: healthy not to be exposed as poisons of any type,
[13:34] Speaker 1: and it's actually healthy to say, to stay healthy enough
[13:36] Speaker 1: not to get a severe respiratory disease. And I recall
[13:40] Speaker 1: that my mother actually had a severe flu, the worst
[13:43] Speaker 1: chest affection she'd ever had. She lost ten kilos during
[13:45] Speaker 1: the period prior to getting the diagnosis, and I often
[13:50] Speaker 1: wonder whether that was the very thing that actually catalyzed
[13:53] Speaker 1: the whole process. But I guess, you know, because this
[13:58] Speaker 1: project that I'm taking and you're well aware of, because
[14:01] Speaker 1: I've actually consulted you in relation to myself, it's about
[14:07] Speaker 1: not really avoiding things that you're never going to be
[14:09] Speaker 1: able to avoid. There are some things we're just going
[14:11] Speaker 1: to be unavoidable. Eventually, something's going to kill us. You know,
[14:15] Speaker 1: it's going to be heartenerative, neurologic, neurodegenerative disease, you know,
[14:22] Speaker 1: cancer or something like that. Because you're not going to
[14:24] Speaker 1: you know, just don't die, you die of something, something fails.
[14:29] Speaker 1: The question here is about how do I extend my
[14:32] Speaker 1: period of not sort of bringing on myself, and that
[14:36] Speaker 1: sort of then talks to me to be about behavior.
[14:39] Speaker 1: You know, what I get exposed to, or more importantly,
[14:42] Speaker 1: what I expose myself to or knowingly as opposed to
[14:45] Speaker 1: being unwittingly exposed to something. The more I become aware
[14:50] Speaker 1: of things, which is what this whole program is about,
[14:52] Speaker 1: which I got you here today. If I become aware
[14:55] Speaker 1: of things, then I might become much more a lot
[14:58] Speaker 1: more likely than not to have avoid something that might
[15:01] Speaker 1: actually cause me a problem. And there's simple things. Don't
[15:03] Speaker 1: drink too much mark, don't go around getting exposed to
[15:09] Speaker 1: some monsanto poison. It's simple. Try to live a healthy
[15:15] Speaker 1: life so you don't get severe COVID or you know,
[15:18] Speaker 1: you might be seventy. Maybe you should get vaccinated. I
[15:22] Speaker 1: know all the end VAXs is not going to send
[15:23] Speaker 1: me a text, but it doesn't matter. But you may.
[15:26] Speaker 1: Maybe it's something you decided because it's your call, and
[15:29] Speaker 1: you must take People must take more control of their outcomes.
[15:33] Speaker 1: You're a doctor and various other things, but you're a
[15:37] Speaker 1: doctor at first hand. How important do you think it
[15:40] Speaker 1: is for? And that's what this program is all about.
[15:43] Speaker 1: But how an important is it for patients actually to
[15:45] Speaker 1: start to take a bit more control of their outcomes
[15:47] Speaker 1: and when they come to you say hey, Matthew, which
[15:50] Speaker 1: is what I do because I've got my trustee file
[15:52] Speaker 1: here which I take every with me. Sooner or light,
[15:54] Speaker 1: I'm going to turn this into some sort of dashboard
[15:56] Speaker 1: with all my stuff and there I haven't done that.
[15:57] Speaker 1: I'm going to get something to build me a software,
[16:00] Speaker 1: a bit of software to put it all in the dashboard.
[16:01] Speaker 1: But how important do you think it is for someone
[16:04] Speaker 1: to come and say, Matthew, I've had Lea's tests done.
[16:07] Speaker 1: What do you reckon?
[16:09] Speaker 2: Well?
[16:09] Speaker 3: I think you're absolutely correct, And that's where the focus
[16:12] Speaker 3: of medicine is.
[16:13] Speaker 2: Now.
[16:13] Speaker 3: Can you prevent conditions or can you manage conditions as
[16:17] Speaker 3: well as possible? And to do that you have to
[16:19] Speaker 3: have an understanding, but also then you have to be
[16:22] Speaker 3: willing to take that message on board and control it.
[16:26] Speaker 3: And I think a lot of these things are in
[16:28] Speaker 3: an individual control, so that I think the message that
[16:31] Speaker 3: you're bringing across is critically important. We have to understand
[16:35] Speaker 3: processes and if we can manage lifestyle factors, we can
[16:39] Speaker 3: actually control a lot of these conditions, including neurodegeneration and dementia.
[16:44] Speaker 1: So what okay, let's talk about neurodegeneration, because so here
[16:48] Speaker 1: we are, we've got to a highly qualified, well positioned,
[16:56] Speaker 1: you know, access to the best research in the country,
[17:00] Speaker 1: experience with all sorts of patients. What are the neurodegenerative
[17:05] Speaker 1: diseases that we need to even be aware of? Because
[17:09] Speaker 1: we've all heard of someone's got Parkinson's and maybe the
[17:11] Speaker 1: men do. But what are we talking about here? Will
[17:13] Speaker 1: give me? Is there four big ones or five big ones?
[17:16] Speaker 2: Yeah?
[17:16] Speaker 3: Well, I think the biggest one is dementia, and dementia
[17:19] Speaker 3: forms different parts of the most common one is Alzheimer's disease, right,
[17:23] Speaker 3: You've mentioned Parkinson's disease, also mode of neurine disease, fronto
[17:27] Speaker 3: temporal dementia. They'd be probably the key neurodegenerative dementia conditions
[17:32] Speaker 3: that we're considering.
[17:34] Speaker 1: Are they sort of covering like ninety percent of the
[17:35] Speaker 1: population to get near degenerative diseases easily? So okay, let's
[17:41] Speaker 1: talk about those four Like maybe there's startup for Parkinson's.
[17:46] Speaker 1: It just for places like what are we talking about there?
[17:48] Speaker 2: What is that?
[17:49] Speaker 3: So Parkinson's was originally thought to be a clinical diagnosis,
[17:53] Speaker 3: so particularly everyone would understand there's a tremor usually associated
[17:57] Speaker 3: with shaking. Then there's also what we call a kin
[18:01] Speaker 3: easier kinesia is movement a is no movement, so reduced movement,
[18:05] Speaker 3: and that includes facial expression, reduced blink rate, reduce facial reactivity, smiling,
[18:11] Speaker 3: and also reduce movement in general, so walking. And the
[18:15] Speaker 3: third thing is rigidity, so stiffness, and so when you
[18:19] Speaker 3: test someone's limbs, there's stiff and it's particularly what we
[18:22] Speaker 3: call cog wheeling. So that was a clinical diagnosis. If
[18:25] Speaker 3: you had those three features, it was Parkinson's disease. But
[18:29] Speaker 3: now with time, and this is really through the strengths
[18:32] Speaker 3: of the community donating brains for research and through brain banks,
[18:36] Speaker 3: we know that Parkinson's disease is particularly related to a
[18:40] Speaker 3: protein change alpha SIN nucleon, and that particular protein is
[18:45] Speaker 3: involved in the coordination of movement and link to that
[18:48] Speaker 3: is a neurotransmitter called dopamine. So now we understand the
[18:52] Speaker 3: mechanisms of Parkinson's disease. There's a reduction in dopamine, which
[18:56] Speaker 3: is the neurotransmitter the signal, and we also know that
[18:59] Speaker 3: if alphas nuclear starts appearing and spreading. Then you get
[19:02] Speaker 3: a dementia associated with Parkinson's. It could be Louis body
[19:06] Speaker 3: dementia or Parkinson's dementia. So we've understood now the mechanism.
[19:10] Speaker 2: So that's that's parkins.
[19:11] Speaker 1: I'll just ask you that you might so what produces
[19:14] Speaker 1: the protein that reduces the dopamine.
[19:19] Speaker 3: Well, that's the brain. That's a Nobel prize waiting to happen.
[19:22] Speaker 3: There are some unusual instances.
[19:24] Speaker 1: We're rele We're going to sort of share now.
[19:28] Speaker 3: I would love to know that one. But there are
[19:30] Speaker 3: some unusual instances. So, for instance, there's a group of
[19:32] Speaker 3: intravenous drug users in New York and they started injecting
[19:35] Speaker 3: a compound which they thought was speed or heroin, and
[19:38] Speaker 3: there was another compound in there and that caused a
[19:42] Speaker 3: depletion of all the dopamine cells and they obviously developed
[19:45] Speaker 3: a Parkinsonian syndrome. We also know from the work from
[19:49] Speaker 3: Oliver Sacks Awakenings in the movie with Robin Williams that
[19:55] Speaker 3: in kephalitis lethargica. So the Spanish flu in nineteen eighteen
[20:00] Speaker 3: again depleted dopamine and so patients were basically locked in
[20:04] Speaker 3: they were asleep and then they were given dopamine, they
[20:07] Speaker 3: reactivated for a period of time. So there are things
[20:10] Speaker 3: that can deplete dopamine, but the actual form that it
[20:14] Speaker 3: happens in Parkinson's, we don't know necessarily how it happens.
[20:18] Speaker 3: I suppose it's one of the key diseases that's linked
[20:21] Speaker 3: to the gut brain axis, and so people are thinking
[20:24] Speaker 3: that maybe it's something that is ingested that is taken
[20:27] Speaker 3: through either the lymph nodes or cells of the stomach,
[20:31] Speaker 3: transferred up the vagus nerve and into the brain, and
[20:34] Speaker 3: that's These are current theories of Parkinson's, but to be honest,
[20:38] Speaker 3: the mechanisms aren't established.
[20:41] Speaker 1: Well given what you just said, and that's very interesting
[20:45] Speaker 1: in the gut brain axis, I mean, by the way,
[20:48] Speaker 1: maybe you could explain there, because most people think the
[20:50] Speaker 1: gut is something separate to the brain, but they have
[20:52] Speaker 1: a connection. So what are we talking about here, gut
[20:54] Speaker 1: brain access.
[20:55] Speaker 3: So anything that happens in the gut in the stomach
[20:59] Speaker 3: can influence the general environment. But we also know another
[21:03] Speaker 3: classic disease that helped us understand this was mad cow
[21:06] Speaker 3: disease or variant CJD, and the way that was diagnosed
[21:11] Speaker 3: is through a tonsilla biopsy. So when people ate the
[21:14] Speaker 3: bad beef, it was absorbed through the stomach into the
[21:18] Speaker 3: lymph nodes, which are the tonsils, and then it got
[21:20] Speaker 3: up into the brain and spread through the brain and
[21:22] Speaker 3: patients died. And they worked out then that it was
[21:25] Speaker 3: a prion protein, a protein that couldn't be broken down
[21:28] Speaker 3: that came from the beef the food practices in the
[21:31] Speaker 3: United Kingdom. But then it turned out you had to
[21:34] Speaker 3: have a genetic mutation. So some people could eat as
[21:36] Speaker 3: much bad beef as they wanted to and they'll never
[21:39] Speaker 3: get CJD or mad cow disease. But if you had
[21:42] Speaker 3: a genetic variant that you were born with that predisposed
[21:46] Speaker 3: you to developing mad cow disease. So it's a combination
[21:49] Speaker 3: of genes and environment. Back to what you were suggesting.
[21:52] Speaker 1: Like sort of like behavior and environment. That's interesting, so
[21:57] Speaker 1: in order for us to produce domain and if we
[22:00] Speaker 1: just go back to Parkinson's for a moment, maybe you
[22:04] Speaker 1: could explain how that happens. You know, how receptors in
[22:09] Speaker 1: various parts of the brain actually received things and push
[22:12] Speaker 1: out the dopmine and are the receptors being blocked for
[22:16] Speaker 1: some reason and not doing their job. Is that why
[22:18] Speaker 1: we're not getting the dopain? Is there something stopping the
[22:20] Speaker 1: receptors from doing the job.
[22:21] Speaker 3: It's a reduction in manufacture. So the brain isn't producing
[22:24] Speaker 3: dopamine and the dopamine cells have died, they've degenerated, so
[22:28] Speaker 3: it's a neurodegenerative condition, no dopamine being secreted or released. Interestingly,
[22:34] Speaker 3: then there was an idea that maybe if we put
[22:36] Speaker 3: in a whole lot of stem cells with also you know,
[22:39] Speaker 3: brain cells that had dopamine, we could actually treat this.
[22:42] Speaker 3: So that was a form of treatment. Unfortunately, what would
[22:46] Speaker 3: happen is the cells were put in, but they weren't
[22:49] Speaker 3: controlled in any mechanism. So then what would happen is
[22:51] Speaker 3: the cells actually produced too many they went out of control,
[22:54] Speaker 3: They produced too much dopamine, so people had too much
[22:56] Speaker 3: excessive movement and that caused degeneration in it. So sometimes
[23:01] Speaker 3: you have a scientific theory and then you follow it
[23:04] Speaker 3: through with a clinical trial and the outcome is whatever
[23:06] Speaker 3: the outcome is. Unfortunately, so far we haven't been able
[23:10] Speaker 3: to get over the reduction in dopamine producing cells in Parkinson's.
[23:14] Speaker 3: We can treat the symptoms. So if you take tablets
[23:17] Speaker 3: which are dopamine to the cinemat matter PA, that's dopamine
[23:21] Speaker 3: which you swallow, goes into the stomach, goes up into
[23:24] Speaker 3: the brain, and it puts dopamine back in. But that's
[23:27] Speaker 3: symptomatic therapy. It doesn't alter the cause of the disease.
[23:31] Speaker 3: So your Parkinson's will have the same outcome whether we
[23:34] Speaker 3: treat you with dopamine or not. However, it's far more
[23:37] Speaker 3: pleasant and you behave normally and you know your movement
[23:41] Speaker 3: is normal if you.
[23:42] Speaker 2: Take the tablets to a degree.
[23:44] Speaker 3: The other way that we've been looking at as well
[23:47] Speaker 3: is deep brain stimulation, and you'll see that Michael J.
[23:49] Speaker 3: Fox had that done. So by putting electrodes into cells,
[23:53] Speaker 3: we can artificially alter the environment such that the motor
[23:57] Speaker 3: system is working, the coordination is working a lot better.
[24:01] Speaker 1: Because my friend John Cornell, who he had it done,
[24:05] Speaker 1: Corney told me he went and what actually worked a
[24:07] Speaker 1: couple of years. He ended up passing ways you probably know.
[24:09] Speaker 1: But and he had Parkers for a long long time,
[24:14] Speaker 1: like a long time as I can recall, and maybe
[24:16] Speaker 1: fifteen years or in recall that it was actually dreadful.
[24:19] Speaker 1: What are the sort of things that like, do we
[24:22] Speaker 1: look to our parents or our cousins? I mean, is
[24:24] Speaker 1: there something very early stage we should think about or
[24:26] Speaker 1: be aware of relative to maybe go going off to
[24:32] Speaker 1: our GP then and say, look, look, I've got a
[24:34] Speaker 1: bit of a thing going on here. What are the
[24:36] Speaker 1: very very early signs.
[24:37] Speaker 3: Perhaps one of the first thing is we've got to
[24:40] Speaker 3: choose our parents. Unfortunately we can't do that, but I
[24:43] Speaker 3: think then we have to look after general health. And
[24:46] Speaker 3: what I would do. I think everyone should see their
[24:48] Speaker 3: general practitioner. And obviously you need to see them more
[24:50] Speaker 3: commonly as you get older, but probably in the ages
[24:53] Speaker 3: of you know, thirty to forty, it's worthwhile just getting
[24:55] Speaker 3: a health check. And what would that consist of? Blood
[24:57] Speaker 3: pressure and cholesterol particular, just a routine blood screen.
[25:02] Speaker 1: So cholesterols has some relationship to Parkinson's.
[25:05] Speaker 3: It has to all neurodegenerative diseases. So regardless of the diagnosis,
[25:10] Speaker 3: if you can treat vascular risk factors, people do better.
[25:14] Speaker 3: So at an individual and at a population level, looking
[25:18] Speaker 3: after vascular res factors, and that means blood pressure, cholesterol,
[25:22] Speaker 3: looking after your body mass index, keeping your sugar levels down,
[25:27] Speaker 3: not smoking, they're the key things that you can control
[25:31] Speaker 3: which will help outcomes regardless. I mean, obviously we're hoping
[25:33] Speaker 3: that no one gets anything. Yeah, but and it gets
[25:36] Speaker 3: well into their hundreds and then dies of something in
[25:38] Speaker 3: their sleep. But in general, you can manage these neurodegenerative
[25:42] Speaker 3: conditions through vascular risk factors very successfully.
[25:46] Speaker 1: Well, you once told me what's good for the heart
[25:48] Speaker 1: is good for the brain, and I'd never really connected
[25:52] Speaker 1: the two because I've always thought of them as sort
[25:54] Speaker 1: of individual silos. So let's just talk about what's good
[25:57] Speaker 1: for the heart. I know you're not a cardiologist, and
[25:59] Speaker 1: by the way, I know not here giving advice on
[26:01] Speaker 1: this matter. And this is just a discussion between two mates.
[26:05] Speaker 1: But you know people who listen to this and then
[26:07] Speaker 1: go and see the GP or whoever it is that
[26:09] Speaker 1: they see advice from and get their own advice. But
[26:12] Speaker 1: when you say vascular health, which is obviously starts with
[26:17] Speaker 1: the heart, but vascular health relates to how blood gets
[26:23] Speaker 1: pumped in and out of your brain, because is that
[26:26] Speaker 1: because the brain needs blood and needs to also get
[26:29] Speaker 1: rid of whatever blood it has used. Is that what
[26:31] Speaker 1: we taught me, like in other words, needs to go
[26:33] Speaker 1: when the artery come back in the veins exactly if
[26:35] Speaker 1: we need good veins exactly.
[26:37] Speaker 3: So the heart is pumping usually against gravity because we're
[26:40] Speaker 3: standing up or sitting up like we're doing now, as
[26:43] Speaker 3: you say, that's through the crotid artery into the brain.
[26:45] Speaker 3: The brain then has a whole vascular system of its own,
[26:49] Speaker 3: which incorporates capillaries and so all of the messages, the
[26:52] Speaker 3: signaling that's going on through the brain needs the blood
[26:55] Speaker 3: flow to basically it's the energy factory of the brain.
[26:59] Speaker 3: And so the more that you can look after that,
[27:01] Speaker 3: the better things go. And so similar to a heart
[27:06] Speaker 3: management we do the same thing. We're into vascular health
[27:10] Speaker 3: critically important, right.
[27:12] Speaker 1: So therefore one of the tests we should be getting
[27:14] Speaker 1: is apart from getting it just a general blood test,
[27:18] Speaker 1: but we should be asking our GP to make sure
[27:21] Speaker 1: that they look at our our lipids in our blood.
[27:26] Speaker 1: In other words, you know LDL, hd L cholesterol, and
[27:32] Speaker 1: if you saw somebody with real high LDL levels, and
[27:36] Speaker 1: let's call it even low HDL levels, they might be
[27:40] Speaker 1: I don't know what the word is, hypercholesteremia, whatever the
[27:42] Speaker 1: word is. Someone word like that is that a bit
[27:47] Speaker 1: of a marker for maybe potential problems with the brain
[27:50] Speaker 1: later in their life.
[27:52] Speaker 3: It is a potential marker and it's also then you
[27:56] Speaker 3: understand that cholesterol reading in the setting of everything else
[28:00] Speaker 3: that's going on. So you would want to just look
[28:01] Speaker 3: at HDL and LDL. But that is an important marker
[28:05] Speaker 3: and then you combine it with other blood markers, but
[28:08] Speaker 3: also vascular health in general. And I suppose as well
[28:11] Speaker 3: as I mean, as you get older, there are probably
[28:14] Speaker 3: more things that you can do to look at this.
[28:16] Speaker 3: So once you're into your fifties, sixties, etc. Probably a
[28:20] Speaker 3: coronary ct angiogram is something that most doctors would advise
[28:25] Speaker 3: and a calcium score, So that's a way of looking
[28:28] Speaker 3: at vascular disease and we would say in a non
[28:30] Speaker 3: invasive way, so it's not a lot of pain or
[28:33] Speaker 3: issues for an individual to have this. That's done. They're
[28:36] Speaker 3: done in radiology practices all across Australia. That gives you
[28:40] Speaker 3: a marker of whether vascular disease is an important issue,
[28:44] Speaker 3: but it also is a marker to treat against. So
[28:46] Speaker 3: you can use those scores and now comes to help
[28:49] Speaker 3: predict your own health but also manage yourself.
[28:53] Speaker 1: I always say if you can't measure it, you can't
[28:55] Speaker 1: manage it. And I guess one of the good things
[28:58] Speaker 1: about what do those say, the calcium score, And it's
[29:01] Speaker 1: not a big deal. I've had it done and you know,
[29:03] Speaker 1: they injective with something and they sort of put you
[29:06] Speaker 1: in a CT machine and they watch the die go
[29:11] Speaker 1: through your bloodstream and they just see if there's any blockages,
[29:14] Speaker 1: et cetera. And they look at whether there's any calcification
[29:16] Speaker 1: in your arteries around your heart, et cetera, and they
[29:19] Speaker 1: give you a score. What's important are these things, though,
[29:22] Speaker 1: is if you get it done again, say a couple
[29:24] Speaker 1: of years down the track, is seeing if there's change.
[29:27] Speaker 1: How important is delta when it comes to managing your.
[29:30] Speaker 3: Health critically important. So the first thing is just the
[29:34] Speaker 3: cross sectional idea. So once you do get that calcium score,
[29:37] Speaker 3: you can interpret that in the setting of all of
[29:40] Speaker 3: your other vascular res factors. But then if you can
[29:43] Speaker 3: do another test in five to ten years time, that
[29:46] Speaker 3: informs that first test. And you mentioned the high LDL
[29:51] Speaker 3: and a low HDL. So if I had that and
[29:53] Speaker 3: then I had a calcium score of zero, there'd be
[29:55] Speaker 3: no need to intervene. It would be a matter of
[29:57] Speaker 3: watching that. Yes, but if I have add a low HDL,
[30:02] Speaker 3: a very high LDL and had a calcium score of
[30:05] Speaker 3: twenty five, that's going to be an issue. So can
[30:07] Speaker 3: we treat the cholesterol like that informs when you treat
[30:11] Speaker 3: and how you treat.
[30:12] Speaker 1: Yeah, that's very interesting. So the whole cholesterol thing, too,
[30:14] Speaker 1: by the way, is a little bit more complicated then
[30:20] Speaker 1: you and I talking about. Obviously much more complicated, and
[30:22] Speaker 1: I actually do I will take you up. And you
[30:25] Speaker 1: offered for me to talk to the best lipids guy
[30:29] Speaker 1: cholestero guy in the country in your view, and I
[30:32] Speaker 1: will take that individual up on that in some stage
[30:34] Speaker 1: because I've been reading a lot about It's like it's
[30:36] Speaker 1: quite dense. It's quite fascinating too at the same time.
[30:39] Speaker 1: But before I get onto to mention, because I have
[30:41] Speaker 1: a particular question, I want to talk to you about
[30:42] Speaker 1: dimension Alzheimer's but as being one of the new degenerative
[30:46] Speaker 1: diseases outside of Parkinson's, and I think we'll leave MND out.
[30:51] Speaker 1: We've probably spoken enough about him and du even though
[30:53] Speaker 1: I know it's one of your one of your specialties.
[30:55] Speaker 1: But we keep hearing other commentators who are quite famous
[31:04] Speaker 1: around the world talk about a line of I think
[31:08] Speaker 1: they're proteins that sit on ldal and hdal that sit
[31:11] Speaker 1: on top of the cholesterol. What are we talking about here,
[31:15] Speaker 1: these apolipo proteins. I mean, we've got the cholesterol molecule
[31:19] Speaker 1: and there's something sits on top of it. Is that
[31:22] Speaker 1: And what is this protein?
[31:24] Speaker 3: Well, it's a protein that's linked to cholesterol. But there's
[31:27] Speaker 3: also triglycerides. So these are all the fat con constituents
[31:31] Speaker 3: in our body, right, and that's again another mix. So
[31:34] Speaker 3: we can interpret all of these together too. But there
[31:37] Speaker 3: are conditions and there are neurological conditions that are associated
[31:40] Speaker 3: with different apoprotein epolipoproteins too, And I suppose what we
[31:45] Speaker 3: also then understand is the body is a metabolic factory
[31:48] Speaker 3: and we're working through huge metabolism all day every day,
[31:51] Speaker 3: whether it's the food we're eating, all of these structures
[31:54] Speaker 3: come into it. But also cholesterol is part of the
[31:57] Speaker 3: lining of brain cells, so it's it's a critical part
[32:01] Speaker 3: of brain function, so you need it, but there's levels
[32:06] Speaker 3: that you.
[32:06] Speaker 2: Have to be in between.
[32:08] Speaker 1: Well, this is bring is this probably bringing us to dementia?
[32:11] Speaker 1: I think maybe can we just start off, you're defining
[32:15] Speaker 1: what is Alzheimer's dash dementia. I mean, are they different
[32:19] Speaker 1: things or they one leads to the other. What are they?
[32:22] Speaker 3: So everyone puts the field of anything to do with
[32:24] Speaker 3: memory or in eurol dues of a cognition into this
[32:28] Speaker 3: term dementia. Dementia is just an overarching term that incorporates everything.
[32:34] Speaker 3: Now it turns out that there are different forms of dementia.
[32:37] Speaker 3: Probably the most common from a sort of a protein
[32:40] Speaker 3: based is Alzheimer's disease, which is related to amyloid and
[32:43] Speaker 3: TAUL protein which are abnormal in the brain. In the
[32:48] Speaker 3: general population, vascular dementia would be the most common form,
[32:52] Speaker 3: so the blood vessels in the brain have become harder,
[32:54] Speaker 3: people having like small strokes microstrokes throughout the brain such
[32:59] Speaker 3: the parts of the brain working and that spreads okues.
[33:02] Speaker 3: A Vascular dementia is a second type. We've already touched
[33:05] Speaker 3: on Parkinson's dementia alphasin nuclear we've mentioned frontier temporal dementia,
[33:10] Speaker 3: which is another protein TDP forty three. So dementia is
[33:13] Speaker 3: the overarching term, but there are specific families within that.
[33:17] Speaker 1: Within that definition, so the most common one, as I
[33:22] Speaker 1: understand is vascular dementia. Which is one of the things
[33:25] Speaker 1: you got me to do is to get a an
[33:29] Speaker 1: ultrasound of my carotid arteries, which are the both sides
[33:32] Speaker 1: of my neck, just to see if they were clogged,
[33:36] Speaker 1: and luckily they weren't. The objective, I presume is what
[33:41] Speaker 1: you're trying to work at, is am I getting enough
[33:43] Speaker 1: blood flow from my heart to my brain? But let's
[33:47] Speaker 1: say I wasn't, So what could be an outcome? Does
[33:50] Speaker 1: your brain die because it doesn't have blood? Is it
[33:53] Speaker 1: brain cells die off? Is that what we're talking about?
[33:55] Speaker 2: Yep?
[33:55] Speaker 3: And the carotid scan is a marker of blood vessels,
[33:59] Speaker 3: more generally vessel that we can see. It's very hard
[34:01] Speaker 3: to look at the small vessels in the head, although
[34:04] Speaker 3: with some directed ultrasound you can so with the credit artery.
[34:09] Speaker 3: The manifestation of a problem might be what's called a
[34:12] Speaker 3: transient a scheme meek attack. So someone might be sitting
[34:15] Speaker 3: at the dinner table and they can't speak, and you
[34:18] Speaker 3: asked them a question. They just can't speak, and then
[34:19] Speaker 3: a few minutes later speeches come back and say what
[34:22] Speaker 3: was that due to? And then we might do an
[34:24] Speaker 3: ultrasound of the credit and show that there's a blockage there.
[34:27] Speaker 3: So instead of one hundred percent normal normal volume, it
[34:32] Speaker 3: might be down to the you know, thirty percent, so
[34:34] Speaker 3: seventy percent inclusion. So if someone had a seventy percent
[34:38] Speaker 3: or higher occlusion and it presented with a transient a
[34:40] Speaker 3: schemeek attack, that's an indicator that that blockage should be
[34:45] Speaker 3: taken out, most likely through an operation, so neurosurgery. In
[34:49] Speaker 3: some cases it could be stenting, so putting a stent
[34:52] Speaker 3: up into the credit artery and opening it up. If
[34:55] Speaker 3: it's less than seventy percent, generally we wouldn't do anything.
[34:58] Speaker 3: It's medical manager. So again back to looking after cholesterol, sugars,
[35:03] Speaker 3: body mass index, blood pressure and following it.
[35:06] Speaker 1: And perhaps some medication like statins.
[35:09] Speaker 2: Statins and a blood thinner.
[35:12] Speaker 1: Right, and just so we can get clear on let's
[35:17] Speaker 1: call it the ultrasound it is. I remember when you
[35:19] Speaker 1: gave me refer it was referred to as a doppler.
[35:22] Speaker 1: So anybody who does have to get this, they could
[35:24] Speaker 1: see a doppler is the same as ul Basically you're
[35:27] Speaker 1: using the Doppler effect, which we will learn at school
[35:29] Speaker 1: and science science physics. We all did that and it's
[35:35] Speaker 1: it's basically sending a sound in there, and because it's
[35:39] Speaker 1: water in there, it sort of refracts the sound back
[35:42] Speaker 1: and you can actually measure the distance and the thickness
[35:45] Speaker 1: and the wall all that sort of stuff.
[35:46] Speaker 2: So that that's seriphysicist.
[35:48] Speaker 1: That's exactly what I remember from school.
[35:49] Speaker 2: Its science.
[35:50] Speaker 1: But that's sort of what the Doppler dash ultrasound means.
[35:54] Speaker 1: But what you were trying to do when You've got
[35:56] Speaker 1: me to get this done, and I'm going to talk
[35:58] Speaker 1: about the prenew tests I had done before, but I mean,
[36:02] Speaker 1: I'll talk and I will talk while I went to
[36:04] Speaker 1: see you. But you were getting me to do that
[36:07] Speaker 1: to make sure that I was getting because I have
[36:10] Speaker 1: an uncle, and so we did a familial analysis and
[36:14] Speaker 1: my uncle, my dad's youngest brother, actually has had a
[36:18] Speaker 1: series of mini strokes and a larger stroke. Admittedly he
[36:22] Speaker 1: was a heavy smoke and drinker, not now, but then
[36:26] Speaker 1: I've never done either. So but you wanted to see
[36:30] Speaker 1: whether or not this vascular dementia which he now has
[36:35] Speaker 1: was something that could potentially be of something I need
[36:38] Speaker 1: to be concerned about or start to manage better. Give
[36:41] Speaker 1: my age turned out no problem. But you ordered this
[36:46] Speaker 1: thing because you wanted to see I guess crept if
[36:48] Speaker 1: I'm wrong, is my my neurons in my brain getting
[36:52] Speaker 1: enough blood and enough oxygen, enough nutrients not to die off?
[36:56] Speaker 1: Is that what happens if they die off? What happens
[36:58] Speaker 1: if they don't get enough?
[36:59] Speaker 2: They do die off?
[37:00] Speaker 1: They die off.
[37:01] Speaker 3: So it is a plumbing approach for similar to the heart.
[37:04] Speaker 3: So it's a plumbing approach. And then presuming that all
[37:07] Speaker 3: of the blood flow is normal, the energy is appropriate,
[37:11] Speaker 3: then it's looking at the molecular level, which might be
[37:14] Speaker 3: then you know, scans and also neurotransmitters.
[37:19] Speaker 1: So what started is off was me talking to you
[37:22] Speaker 1: about you know, vascular dementia. Dementia generally it's a big
[37:27] Speaker 1: topic now everybody's talking about it. The concussion it's even
[37:31] Speaker 1: a bigger topic. Is the fact that I had boxed
[37:34] Speaker 1: for many, many years, and I've had many many concussions,
[37:37] Speaker 1: So I got nervous about it. So I thought it
[37:39] Speaker 1: bitter talk to you. But the could you just touch
[37:43] Speaker 1: on what do you see? How do you see the
[37:47] Speaker 1: connection between concussions and let's call it what everyone refers
[37:54] Speaker 1: to as dementia. I don't want to touch on CTE
[37:56] Speaker 1: because there's just out there. Okay, let's leave ct alone.
[38:00] Speaker 1: That's more for the pathologist who look at a brain
[38:06] Speaker 1: once someone's passed away. I think, as I understand it.
[38:09] Speaker 1: But let's just talk quickly about how concussions might somehow
[38:15] Speaker 1: add to my opportunity to suffer from Alzheimer's end or
[38:19] Speaker 1: dementia or end or anything else of that matter.
[38:22] Speaker 2: Yeah.
[38:22] Speaker 3: Well, so, I think it's been well known in boxing,
[38:25] Speaker 3: probably over the last one hundred years that if you
[38:27] Speaker 3: get too many hits to the brain, there's a risk
[38:29] Speaker 3: that you start to lose your Muhammad Ali is that
[38:33] Speaker 3: is the classic example, and so pugilistic us. So it's
[38:37] Speaker 3: in kephalitis pugilistic usa thing, is it, Yes, And it's
[38:41] Speaker 3: usually related to the volume of hits. Yes, So it
[38:44] Speaker 3: builds up. And that's what they used to say about
[38:46] Speaker 3: Muhammad Ali that he did so much spa work and
[38:50] Speaker 3: training he used to let himself get hit a lot.
[38:52] Speaker 3: That was his strength. Tickend withstand it. But then you
[38:55] Speaker 3: see the other side of this is a potential neurodegenerative condition.
[39:00] Speaker 3: And as usually as said, it's the number of hits
[39:02] Speaker 3: that's that's the general understanding from.
[39:04] Speaker 1: The cushions or something. Yeah, not necessarily being knocked out once.
[39:09] Speaker 1: So if someone some somehow has been in a car
[39:11] Speaker 1: accional falling over the head, that might be a problem.
[39:13] Speaker 1: But what you're talking about here in terms of sport
[39:14] Speaker 1: at least, is lots and lots and lots of this,
[39:17] Speaker 1: Like it could be a football player just getting hit
[39:19] Speaker 1: every week, week after week after week. It doesn't, But
[39:23] Speaker 1: it doesn't necessarily follow that someone who has had that
[39:27] Speaker 1: studying it. Why does then some people get dementia as
[39:31] Speaker 1: looks like as it is as a result of it,
[39:33] Speaker 1: and some people have the same many hits, but they
[39:34] Speaker 1: don't get dementia.
[39:36] Speaker 3: You're asking all of these, you know, Nobel prize winning questions.
[39:40] Speaker 3: Unfortunately we don't know. So there must be a predisposition,
[39:43] Speaker 3: because you're right, some people have played you know, rugby,
[39:46] Speaker 3: done boxing all their lives and been hit so many
[39:49] Speaker 3: times and their bank completely normal. So there are obviously
[39:53] Speaker 3: there must be protective factors. And there's your constitution. So
[39:58] Speaker 3: it's again back to who your pair and were and
[40:01] Speaker 3: choosing your parents. Well, but we don't understand why some
[40:03] Speaker 3: people get it and others don't.
[40:05] Speaker 1: Yeah, so let's talk about parents. Let's talk about So
[40:13] Speaker 1: when I had a blood test, I asked for not
[40:20] Speaker 1: only the APO LiPo protein or let's call it LiPo
[40:24] Speaker 1: A and LiPo B, cholesterol blah blah blah, and a
[40:27] Speaker 1: very whole lot of other stuff, but I asked for
[40:29] Speaker 1: to see whether or not I had a a POE
[40:34] Speaker 1: And it came out that I have this APOE three
[40:39] Speaker 1: and four gene. They didn't say I had a POE.
[40:44] Speaker 1: Proteins they're different, as understand it. But what is a
[40:48] Speaker 1: POE three four to two? What are we talking about here?
[40:52] Speaker 3: So these the understanding this field comes from epidemiology, so
[40:56] Speaker 3: looking at huge populations and looking at blood tests for
[40:59] Speaker 3: you know, tens of thousands, hundreds of thousands of people.
[41:03] Speaker 3: And they've realized now that APO E four is linked
[41:06] Speaker 3: to dementia, particularly Alzheimer's disease, so a higher incidence. Also,
[41:11] Speaker 3: if you have APO E four, it tends to lead
[41:15] Speaker 3: to a more rapid progression, So it's a marker that
[41:18] Speaker 3: can be used to inform So Chris Hemsworth in that
[41:22] Speaker 3: show actually bravely got up and told the world that
[41:25] Speaker 3: he has that gene.
[41:27] Speaker 1: I'm here to say I also have it. But I
[41:32] Speaker 1: don't know. Maybe you can explain this part to me,
[41:35] Speaker 1: because I don't know. There's two terms which confuse me
[41:39] Speaker 1: a little bit. One's heterozygous and the other one's home
[41:43] Speaker 1: zigus apo E four. Does that mean like one parent
[41:47] Speaker 1: or two parents? What are we talking?
[41:48] Speaker 3: Maybe that's it one one or two. So you get
[41:51] Speaker 3: a gene from both, you get one from your mother,
[41:53] Speaker 3: one from your father. Yeah, and homozygous is you've got
[41:58] Speaker 3: both the same. Heterozygous is you've got one of each,
[42:00] Speaker 3: and that depends. So if we're looking at an abnormality,
[42:05] Speaker 3: you probably don't want to have the homozygous form because
[42:08] Speaker 3: you've got the both both risk factors. Yes, But obviously
[42:11] Speaker 3: this interpretation, like the discussion, is different for every single
[42:16] Speaker 3: type of condition that may be linked to genes. So
[42:18] Speaker 3: I don't want to lead anyone astray. But that's just
[42:21] Speaker 3: the general understanding of homozygous and heterozygous and from what.
[42:25] Speaker 1: I read that patients and this is epidemium epidemium myologically
[42:33] Speaker 1: epedemological the word is, but it's based on on a
[42:36] Speaker 1: broad population of people who had Alzheimer's disease, and according
[42:45] Speaker 1: to that of those people who had Alzheimer's had this ephour.
[42:51] Speaker 1: But it went on to say, just because you got it,
[42:54] Speaker 1: there's obviously sty percent of the people we didn't have EVO.
[42:57] Speaker 1: So it's not causal. It's just correlation. It correlates statistically.
[43:02] Speaker 3: Exactly, and that's that's the interpretation. It's an association. Yeah,
[43:05] Speaker 3: it's not cause and effect.
[43:07] Speaker 1: Yeah. So but do you think people men, I'm a
[43:10] Speaker 1: bit weird about it, but do you think people should
[43:13] Speaker 1: seek that answer to that question?
[43:15] Speaker 2: Do they?
[43:15] Speaker 1: Do you think it's something one should ask the GP
[43:18] Speaker 1: to get tested. Does it does it inform you as
[43:22] Speaker 1: and neurologists in any way relative to your patient? Does
[43:24] Speaker 1: it help you with anything?
[43:25] Speaker 2: It does?
[43:26] Speaker 3: So I think all knowledge is power, and I'm a scientist,
[43:31] Speaker 3: so I want to know the knowledge. And I can
[43:34] Speaker 3: understand if someone doesn't want to know the knowledge, and
[43:36] Speaker 3: this is an individual decision. But I think then putting
[43:39] Speaker 3: on the other hat as a clinician, as a doctor,
[43:42] Speaker 3: you want to know risk factors. So if you want
[43:44] Speaker 3: to know these associations, because then you can manage your patient.
[43:47] Speaker 3: So again, when we talked about the credit and looking
[43:49] Speaker 3: at volumes, et cetera, we want to see what risk
[43:52] Speaker 3: factors are present, because these risks are cumulative. So if
[43:56] Speaker 3: I had an abnormal cholesterol and apo lipoprotein E for
[44:00] Speaker 3: and I had a father who died at the age
[44:02] Speaker 3: of fifty two from a heart attack, that person needs
[44:04] Speaker 3: aggressive treatment.
[44:05] Speaker 2: That's the message, right.
[44:07] Speaker 3: Whereas if I had apoprotein E four and I have
[44:10] Speaker 3: no other risk factors and my parents lived to you know,
[44:12] Speaker 3: one hundred and we don't even know what happened to them,
[44:15] Speaker 3: then it's less of a I know that person, I
[44:18] Speaker 3: can be more conservative and that helps to inform how
[44:22] Speaker 3: to manage a condition. So there's lots of ways to
[44:24] Speaker 3: manage patients or individuals and preventative help them. Where it
[44:28] Speaker 3: looked looking at healthy individuals and you have to work
[44:31] Speaker 3: out how aggressive you need to be, and the risk
[44:34] Speaker 3: factors informed that treatment algorithm.
[44:36] Speaker 1: So when I saw you, I had gone often prior
[44:41] Speaker 1: to that, about three or four months before that, i'd been.
[44:43] Speaker 1: I got to be carried away and I went and
[44:45] Speaker 1: got a test called a preneuvo test, which is basically
[44:50] Speaker 1: an AMRI of my whole body. And you can't get
[44:54] Speaker 1: it here in Australia. Maybe you can now, but you
[44:55] Speaker 1: couldn't at the time. It was quite expensive I did
[44:57] Speaker 1: as part of an experiment relative to this program. You know,
[45:01] Speaker 1: I probably would not ordinarily have had it done. And
[45:04] Speaker 1: pretty much it's an hour and a quarter hour and
[45:06] Speaker 1: twenty minutes in an MRI machine, which is not pleasant.
[45:10] Speaker 1: But I got it done. And they looked at every
[45:13] Speaker 1: organ and part of my body looking for mass, and
[45:16] Speaker 1: they gat they give a report and they said, look,
[45:18] Speaker 1: you know, look at something when your livers. I had
[45:20] Speaker 1: that checked and they said the something. I had that checked.
[45:23] Speaker 1: And then when I showed you on my brain there
[45:25] Speaker 1: was a small vein or something like that I showed
[45:28] Speaker 1: to you, and then they said, that's worth noting. But
[45:32] Speaker 1: they didn't think it was anything of it. But you
[45:34] Speaker 1: saw something on there which they never saidnything about. And
[45:37] Speaker 1: you notice plaque in my brain. Now no one said
[45:42] Speaker 1: they didn't say anything about the plaque. But because I
[45:45] Speaker 1: showed you the image or a copy of the image,
[45:49] Speaker 1: what does that mean plaque in someone's brain, Because do
[45:51] Speaker 1: our brains get plucked like our heart does archeries, I
[45:53] Speaker 1: should say.
[45:54] Speaker 3: Yeah, it's the same thing. So plark is usually built
[45:57] Speaker 3: up of material either in the wall or beside the
[46:00] Speaker 3: wall of a blood vessel and happens in all organs
[46:03] Speaker 3: of the body, and that's a marker of potentially reduced
[46:07] Speaker 3: blood flow. So back to the plumbing concept of the brain.
[46:10] Speaker 3: So that's an important piece of information to have. It's
[46:14] Speaker 3: probably inevitable as we get older, we start accumulating plaque
[46:19] Speaker 3: and we start accumulating blockages.
[46:21] Speaker 1: Right. That's interesting because because then you said to me,
[46:25] Speaker 1: then you went through my family history, et cetera, and
[46:27] Speaker 1: then you ordered the Crotta thing. But something that was
[46:32] Speaker 1: really interesting to me is I happen to mention that
[46:36] Speaker 1: I had.
[46:38] Speaker 2: What's this thing here called Jupiter's contracture? Yeah?
[46:42] Speaker 1: Is there? Is it got another name? Do they give
[46:44] Speaker 1: it some other? So they sort of called the Viking
[46:47] Speaker 1: gene sometimes?
[46:47] Speaker 3: Yeah, well Jupatrid was a I think to do with Vikings.
[46:52] Speaker 1: People in northern Europe. And then I have it in
[46:56] Speaker 1: both hands.
[46:56] Speaker 2: Yeah.
[46:57] Speaker 1: And then I was reading about you mentioned earlier about
[47:02] Speaker 1: amyloid not getting cleared out of your brain. Everyone's brain's
[47:06] Speaker 1: got emloid and and by the way, got emloid and
[47:08] Speaker 1: all throughout our body. And I think there's a condition
[47:11] Speaker 1: called Emba lloyd osis or something like that, and emeroid
[47:15] Speaker 1: osis as I understand, it can sit on tendons, and
[47:22] Speaker 1: that there is potentially an example of Amma lloyd osis
[47:26] Speaker 1: on those tendons, which thickens the tendons. It's the amyloids
[47:31] Speaker 1: sort of sitting on there. They're not being removed. And
[47:34] Speaker 1: I thought of myself, and I'm glad I was meeting
[47:36] Speaker 1: each day because I only researched this every more recently.
[47:40] Speaker 1: And I thought to myself, well, if I can see
[47:43] Speaker 1: it in my hands, and I actually have torn tendons
[47:46] Speaker 1: in both my bicep to my tricep over the past
[47:50] Speaker 1: a couple of years, just randomly. I'm not taking steroids,
[47:54] Speaker 1: I'm not particularly muscular. No, I'm not doing crazy shit.
[47:57] Speaker 1: But you know, I know how it happened. I know
[48:00] Speaker 1: the impact of it. But it was a bit unusual
[48:02] Speaker 1: that it actually snapped off. That the a's a tendon.
[48:05] Speaker 1: Wasn't the muscle coming off, the tenner was a tendon
[48:06] Speaker 1: snapping the weakness, And I was wondering whether or not
[48:12] Speaker 1: if someone, say, has more some of these indicators. Can
[48:19] Speaker 1: you check the emoid level in someone's brain to see
[48:22] Speaker 1: whether or not they're accumulating too much amyloid in their brain,
[48:26] Speaker 1: which could lead to Alzheimer's.
[48:29] Speaker 3: So we can now we can look at the amyloid
[48:31] Speaker 3: in the brain using what's called a PET scan, and
[48:33] Speaker 3: we can put in an amyloid marker, so we put
[48:35] Speaker 3: ameloid a nuclear scan, take a picture of the brain
[48:39] Speaker 3: and it shows you the load or the volume of
[48:41] Speaker 3: amyloid in the brain.
[48:42] Speaker 1: So that's an injection with some sort of radio nuclears.
[48:45] Speaker 2: Okay, a color.
[48:46] Speaker 3: So it's coming from Leucas Heights comes in every day,
[48:49] Speaker 3: for instance, to Prince Alfred, Prince of Wales's hospital and
[48:52] Speaker 3: they inject that is it dangerous not dangerous?
[48:55] Speaker 1: So and that thing will sit on the amyloid and
[48:59] Speaker 1: you'll see it through the right yep.
[49:00] Speaker 3: And you can do a volume then as well, you
[49:02] Speaker 3: can say like this, you know severe let's say you
[49:05] Speaker 3: know forty percent amyloid volume load in the brain right,
[49:08] Speaker 3: And that also then can be used to treat against.
[49:11] Speaker 3: So now we have what are called monoclonal antibodies directed
[49:15] Speaker 3: against amyloid. So monoclonal antibodies are activating the immune system
[49:20] Speaker 3: and the best example currently is melanoma. So you can
[49:23] Speaker 3: have a monoclonal antibody against melanoma. So it dissolves the
[49:26] Speaker 3: melanoma and for people who had stage three or stage
[49:29] Speaker 3: four melanoma, it's usually a death sentence. Are now going
[49:32] Speaker 3: into emission because the immune system is clearing the melanoma itself. Yes,
[49:38] Speaker 3: So what we're doing now is adapting that approach for
[49:42] Speaker 3: Alzheimer's disease. And two medications are currently under review through
[49:46] Speaker 3: the TGA here in Australia. They are approved in America
[49:49] Speaker 3: through the FDA. And this is an intravenous therapy that's
[49:52] Speaker 3: given say every month, and it comes in and it
[49:55] Speaker 3: basically starts dissolving the amyloid in the brain. Now at
[49:59] Speaker 3: the moment, we can show that on a PET scan,
[50:01] Speaker 3: so we see the amyloid getting less and going away
[50:04] Speaker 3: at the moment. That doesn't necessarily transmit into memory coming back,
[50:08] Speaker 3: but what it does slows the progression. But this is
[50:11] Speaker 3: the first generation of therapy, a targeted therapy.
[50:15] Speaker 2: To a mechanism.
[50:16] Speaker 3: And like with melanoma and multiple sclerosis and you know
[50:20] Speaker 3: inflammatory bil disease, we're going to get better and better treatments,
[50:23] Speaker 3: but this is the first treatment.
[50:25] Speaker 1: So that's very interesting. So if let's say someone that
[50:30] Speaker 1: are you know, this is probably not going to happen
[50:31] Speaker 1: to someone in their thirties or forties. But you know,
[50:33] Speaker 1: as you get older. I guess what this informs people
[50:39] Speaker 1: is that, particularly people like me, who generally speaking think
[50:43] Speaker 1: have thought up until more recently than on bulletproof, like
[50:46] Speaker 1: I never really got sick. I had injuries, but I
[50:48] Speaker 1: never really got sick. Mostly they were self inflicted injuries,
[50:51] Speaker 1: so to speak. But as we get older, we've got
[50:54] Speaker 1: to start thinking about, oh, hang on a minute, like
[50:57] Speaker 1: you know, we've got another twenty years to go or more,
[51:02] Speaker 1: what are the things that I need to get checked outs?
[51:04] Speaker 1: That will be just ignoring stuff. So if we're looking
[51:07] Speaker 1: at just generally apart from I want to talk about maintenance,
[51:12] Speaker 1: after that led to sorts of things how we should
[51:14] Speaker 1: be living our lives perhaps, and I don't mean in
[51:18] Speaker 1: a like a demanding way, but just well just talk
[51:21] Speaker 1: about the perhaps the ways you can live your life.
[51:23] Speaker 1: But what are the things that from neurodegenitive point of view,
[51:27] Speaker 1: like cognition and things like that, what should we be
[51:31] Speaker 1: sort of becoming aware of without getting paranoid about it.
[51:35] Speaker 3: Well, I think you're the perfect model of what should happen.
[51:38] Speaker 3: So I think if you have an interest, and you
[51:40] Speaker 3: want to look after yourself. What are the things that
[51:42] Speaker 3: are reversible that I could take control of, And that
[51:45] Speaker 3: would start with a review with your general practitioner, and
[51:48] Speaker 3: that would be screening vascular approaches. If there was some
[51:51] Speaker 3: worry about a family history, you could go and be
[51:54] Speaker 3: referred to a neurologist and that would incorporate a clinical
[51:58] Speaker 3: examination also then looking at neuropsychometry, so in other words,
[52:02] Speaker 3: testing your memory. So as we go on for about
[52:04] Speaker 3: an hour, and I know that you had that in
[52:05] Speaker 3: the United States, and again that would inform So let's
[52:09] Speaker 3: say you score right across the board completely normally. Well,
[52:12] Speaker 3: that's the baseline that's important to know. If there was
[52:15] Speaker 3: some unusual changes there, that might then inform to go
[52:18] Speaker 3: onto the next step, which could be for instance, a
[52:20] Speaker 3: brain scan like an MRI, or they might be if
[52:23] Speaker 3: you had a family history of particular things, you might
[52:25] Speaker 3: go and have a PET scan and you might have
[52:27] Speaker 3: an amyloid pet scan looking for these conditions. At the moment,
[52:32] Speaker 3: we don't know when to treat, so in neurology we're
[52:35] Speaker 3: treating patients when they're manifesting the conditions. So when they
[52:38] Speaker 3: have some memory issues and they have minor changes but
[52:42] Speaker 3: actually functioning pretty normally, and they have evidence of amyloid
[52:45] Speaker 3: either on the pet scan or a lumber puncher, So
[52:48] Speaker 3: taking some fluid out from the spine and testing it
[52:51] Speaker 3: for amyloid. But one of the next questions is what
[52:54] Speaker 3: happens if you came from a family and you knew
[52:56] Speaker 3: there was Alzheimer's in the family, when should we start treatment?
[52:59] Speaker 3: And that's research. So what we need to do is
[53:01] Speaker 3: try and work out when do we start treatment. What
[53:04] Speaker 3: we really need is a buyer marker of a change
[53:08] Speaker 3: and one of those and this is this is where
[53:10] Speaker 3: the field is at the moment. Can we take blood
[53:12] Speaker 3: tests on individuals to try and work out where they are?
[53:15] Speaker 3: And we know one of those markers is called neurofilament,
[53:18] Speaker 3: which is a blood test, and that's a marker of
[53:21] Speaker 3: a brain cell being distressed and neurofilament goes up. So
[53:25] Speaker 3: if I had a family history of dementia and I
[53:27] Speaker 3: knew that there was at risk of Alzheim's disease, and
[53:30] Speaker 3: if I had a blood test and my amyloid and
[53:32] Speaker 3: my neurofilaments going up, I'm pretty sure I'm going to
[53:36] Speaker 3: be starting to manifest the condition. So I should start treatment.
[53:39] Speaker 3: And that's where the field is.
[53:40] Speaker 1: You can ask your doctor for that.
[53:42] Speaker 2: You can ask your doctor for that, or at.
[53:44] Speaker 1: Least discuss it with your doctor. Discus advise because it's interesting.
[53:48] Speaker 1: You should say that because and I don't know what
[53:50] Speaker 1: the reason for this is, but I remember twenty five
[53:53] Speaker 1: years ago I had a friend who one of the
[53:57] Speaker 1: original people who set up the the colonosc colonoscopy department
[54:04] Speaker 1: at St. Vincent's very like twenty five year thirty years ago.
[54:08] Speaker 1: He's passed away now, but he's when he's a gastronologist.
[54:12] Speaker 1: When I spoke to him, his name is Steves still Iss,
[54:14] Speaker 1: doctor steph Manstillas, and I said, Steve, in my consutation.
[54:18] Speaker 1: The first thing he asked me is about my family,
[54:21] Speaker 1: and he built up a probability chart, a statistical probability chart,
[54:26] Speaker 1: and off the back of that he said, I let's
[54:29] Speaker 1: say it was forty at the time. He said, you
[54:30] Speaker 1: need to have a colonoscopy, and then we need to
[54:33] Speaker 1: do one every couple of years, and we can, you know,
[54:36] Speaker 1: we can measure and manage you know, market up, et cetera.
[54:39] Speaker 1: And fortunate for me, I didn't have any issues. But
[54:43] Speaker 1: but he did build a probability algorithm. Why has that
[54:49] Speaker 1: not been the case for neurology. Why haven't we had
[54:52] Speaker 1: that same sort of discipline when it comes neurology. We've
[54:55] Speaker 1: had it with hearts as well. Why we have not
[54:57] Speaker 1: had that with brains?
[54:58] Speaker 2: Very good question.
[54:59] Speaker 3: I think we're a bit slow on the uptake, but
[55:01] Speaker 3: we are. That's an important part of the history now.
[55:04] Speaker 3: I suppose also we're realizing that brain and mind conditions
[55:08] Speaker 3: are linked. So we know in these genes that are
[55:11] Speaker 3: connected to neuroady, generation and dementia, families have higher incidents
[55:15] Speaker 3: of autism, spectrum disease, of schizophrenia, of bipolar, of mania.
[55:21] Speaker 3: So we've been probably focusing on the one disease. So
[55:26] Speaker 3: someone comes in and you're worried about Alzheimer's disease. We're
[55:28] Speaker 3: asking about Alzheimer's disease. We're not taking a fuller history
[55:32] Speaker 3: of the family. And this is now incredibly important and
[55:36] Speaker 3: we've realized this. But you have to put to a
[55:38] Speaker 3: very intricate family history, and I think that's an interesting
[55:42] Speaker 3: voyage for everyone to do. Regardless family history, well, you
[55:46] Speaker 3: want to go through all of the conditions that affect
[55:49] Speaker 3: each individual and there's usually a family historian. There's someone
[55:52] Speaker 3: who likes doing this, and then what you have to
[55:54] Speaker 3: do is you have to get them involved because people say,
[55:56] Speaker 3: you say, if you've got any family history, No, no, no, don't.
[55:59] Speaker 3: But then when you start giving them certain conditions, anyone
[56:01] Speaker 3: have you know, bipoloiticis, oh, yeah, you know uncle Joe
[56:05] Speaker 3: and you know my cousin, and it starts filling out.
[56:08] Speaker 3: But you've got to be. You've got to be. It's
[56:10] Speaker 3: like Sherlock Holmes. You've really got to start probing in depth.
[56:14] Speaker 3: Clinicians have to do that.
[56:16] Speaker 1: The problem is that we all get interested in stuff,
[56:19] Speaker 1: and I see this in the economy. We get interested
[56:22] Speaker 1: in stuff, then we get caught back up in our
[56:24] Speaker 1: day to day stuff the next day and we pretty
[56:26] Speaker 1: much park everything that we've just been told or read
[56:29] Speaker 1: or thought about, we've discussed, and then we get caught
[56:32] Speaker 1: up in a day to day stuff and then we
[56:34] Speaker 1: don't attend to the most important thing. Someone asked me
[56:37] Speaker 1: the other day. I was still in a Larry Emda
[56:40] Speaker 1: on Channel seven, and he was fascinated about pro To
[56:43] Speaker 1: one hundred right because he follows me, and he said, mate,
[56:47] Speaker 1: that sounds like a full time job. And I said, Larry,
[56:50] Speaker 1: living is a full time job, and you've got to
[56:53] Speaker 1: think of it that way, because we spend more time
[56:56] Speaker 1: full time on things that have are not as important
[57:01] Speaker 1: as a thing we should be thinking about full top.
[57:03] Speaker 1: That's our life and our families lives. Yeah, I mean
[57:06] Speaker 1: as a clinician, as a scientist, and what do you
[57:14] Speaker 1: think about that? I mean as a concept you do
[57:16] Speaker 1: people only come to you when they're really crooked?
[57:19] Speaker 2: Yeah?
[57:19] Speaker 3: Well, and that's why I was keen to do this
[57:20] Speaker 3: show with you, because I think this is the important message.
[57:23] Speaker 3: As a clinician. Patients come to see me and there's
[57:26] Speaker 3: only two outcomes that get well and they never see
[57:29] Speaker 3: me again, or they continue on and they won't see
[57:31] Speaker 3: me after that either. So it's and I think we've
[57:35] Speaker 3: got to take your message on board and don't don't
[57:38] Speaker 3: sweat the small stuff, but focus on ourselves. You've got
[57:41] Speaker 3: to be able to look after yourself. That's a critical part.
[57:44] Speaker 3: You can't achieve anything unless you start to do that.
[57:47] Speaker 1: So can I just talk about alcohol? Drugs? Alcohol? Let's
[57:51] Speaker 1: call it that. It's called life style? Where does its
[58:00] Speaker 1: sounds pretty basic, but it's pretty fundamental and fundamentally important.
[58:04] Speaker 1: Where does sleep And I don't know if you guys
[58:08] Speaker 1: do any about sleep at your institution, Sleep, nutrition and exercise.
[58:14] Speaker 1: And when I say nutrition, I include what you shouldn't
[58:16] Speaker 1: have and what you should have like alcohol, drugs, what
[58:20] Speaker 1: you shouldn't have perhaps and also but you know what
[58:23] Speaker 1: you should have two in terms of proper nutrition. Where
[58:25] Speaker 1: do those three things fit in what you guys do?
[58:29] Speaker 3: Yeah, well, they're critically important in terms of management in
[58:32] Speaker 3: a general sense. So we know there's a system that
[58:36] Speaker 3: is activated when we sleep, only in the deepest sleep
[58:38] Speaker 3: rem sleep, rapid eye movement sleep, where filters come on
[58:43] Speaker 3: in the brain and filter out all of the proteins
[58:46] Speaker 3: and chemicals in the brain that you've accumulated in that
[58:48] Speaker 3: twenty four hours.
[58:50] Speaker 2: And unless you.
[58:51] Speaker 3: Have that deep sleep, you can't clear these toxins.
[58:54] Speaker 2: From the brain.
[58:55] Speaker 1: So my mother never slept, you know that.
[58:57] Speaker 3: And that's an important part. Whether it's cause or effect.
[59:01] Speaker 3: Was it the underlying process causing the sleep disturbance, or
[59:04] Speaker 3: is a sleep problem causing the underlying degeneration?
[59:08] Speaker 1: That's interesting.
[59:09] Speaker 3: Yeah, I think sleep, now we recognize is a critical
[59:13] Speaker 3: part of this jigsaw.
[59:15] Speaker 1: So let's just quickly talk about sleep. So how would
[59:19] Speaker 1: I know, well, how would someone know if they're not
[59:22] Speaker 1: getting a proper sleep? I mean, are there's like you
[59:26] Speaker 1: should you should not wake up at once? You should
[59:29] Speaker 1: wake up feeling fresh? I mean what is it?
[59:31] Speaker 2: Well?
[59:32] Speaker 3: I mean symptoms wake up feeling fresh. You can get headaches,
[59:36] Speaker 3: high blood pressure. They're often features of not getting enough
[59:39] Speaker 3: sleep and particularly sleep app near and then the quickest
[59:42] Speaker 3: way to resolve that is to have a sleep study.
[59:45] Speaker 3: Most slip studies. Now it can be organized through your GP,
[59:48] Speaker 3: done at home and then reported by More often than not,
[59:52] Speaker 3: now people don't want to go into sleep laboratories. But
[59:55] Speaker 3: also you don't sleep as well in an artificial bed,
[59:59] Speaker 3: in an artificial room and a place you haven't been
[1:00:01] Speaker 3: to before as you do in your own bed. So
[1:00:03] Speaker 3: sleep studies can be done at home and then reported
[1:00:06] Speaker 3: by the sleep physician or neurologist is in charge.
[1:00:10] Speaker 1: And is that something that NERO does.
[1:00:12] Speaker 3: So we've got sleep labora trees, but most hospitals around
[1:00:16] Speaker 3: Australia will have a sleep expert or sleep physician.
[1:00:19] Speaker 1: And then more about let's talking about nutrition before we
[1:00:23] Speaker 1: talk about exercise, like what you shouldn't and what you
[1:00:25] Speaker 1: should take Yeah. I mean, I'm not here to be
[1:00:29] Speaker 1: a moralist. But the more I read it about alcohol,
[1:00:34] Speaker 1: basically no alcohol, I mean is unfortunate, but it doesn't
[1:00:38] Speaker 1: mean you don't have it. To have any alco doesn't
[1:00:40] Speaker 1: necessarily follow if you have a drink. But I guess
[1:00:42] Speaker 1: it's about excess. But what do you think about alcohol
[1:00:45] Speaker 1: and drugs?
[1:00:46] Speaker 2: Well, you're right.
[1:00:47] Speaker 3: If you want to be really healthy, there's no alcohol,
[1:00:50] Speaker 3: and you have to work out a lifestyle.
[1:00:52] Speaker 2: That's a lifestyle decision.
[1:00:55] Speaker 3: The current idea is that two to three standard drinks
[1:01:00] Speaker 3: to four times a week four a male and one
[1:01:03] Speaker 3: to two for a female is inverticoma is healthy drinking.
[1:01:06] Speaker 3: But in a way, the recommendation is no drinking. So
[1:01:10] Speaker 3: doctors would say no drinking, and we're looking at levels
[1:01:14] Speaker 3: that are called healthy, but there's no such thing as
[1:01:17] Speaker 3: healthy levels. Yeah, so you have to just take that
[1:01:19] Speaker 3: on board. So you are taking a risk when you drink,
[1:01:22] Speaker 3: no matter what.
[1:01:22] Speaker 1: Absolutely, because alcohol itself is okay, but it's this high
[1:01:26] Speaker 1: that gets produced, which is the poison.
[1:01:28] Speaker 2: Yes, and your brain doesn't like it, and it's toxic
[1:01:30] Speaker 2: to the brain.
[1:01:31] Speaker 1: It's toxic.
[1:01:31] Speaker 3: Yeah, And a bit like we're talking about the you know,
[1:01:33] Speaker 3: punctures to the head. It's a cumulative effects and it's
[1:01:37] Speaker 3: not healthy.
[1:01:38] Speaker 1: Yeah, and drugs like let's call let's call a recreation
[1:01:42] Speaker 1: of drugs because it just better. Every kid in Australia
[1:01:44] Speaker 1: these days taste cocaine if they're under thirty, they don't
[1:01:47] Speaker 1: even drink, they just take cocaine. It's out of control. Cocaine, marijuana,
[1:01:54] Speaker 1: very unhealthy, unhealthy.
[1:01:56] Speaker 3: Again, dangerous and unfortunately it can be just like a
[1:01:59] Speaker 3: first episode of cocaine can lead to a spasm of
[1:02:03] Speaker 3: a blood vessel that can lead to brain hemorrhages. Plus
[1:02:06] Speaker 3: we don't even know what's in the cocaine, where's it
[1:02:09] Speaker 3: come from, what's being mixed in with it?
[1:02:10] Speaker 2: So very unhealthy.
[1:02:12] Speaker 1: What about food generally? You know, people keep Someone asked
[1:02:17] Speaker 1: me this morning about neotropics.
[1:02:20] Speaker 2: Are there?
[1:02:21] Speaker 1: What do you think about those sorts of things neutropics?
[1:02:23] Speaker 1: I mean, it's a big broad perspectrum things. I mean
[1:02:26] Speaker 1: people say, for example, right now, five milligrams of creatine
[1:02:29] Speaker 1: a day is quite healthy for us. It's a big thing.
[1:02:31] Speaker 1: Now everyone's talking about it. What do you about think
[1:02:34] Speaker 1: about it? I don't know if that is a neotropic
[1:02:36] Speaker 1: it's not a plant based thing. But what do you
[1:02:38] Speaker 1: think about neutropics generally.
[1:02:39] Speaker 3: Well, look, I think we're getting a much better understanding
[1:02:41] Speaker 3: of diet now and the importance of diet and brain
[1:02:44] Speaker 3: health and protein is incredibly important and as you're right,
[1:02:48] Speaker 3: like creatine now it turns out is beneficial for brain function.
[1:02:53] Speaker 3: We also know that protein is very important and not.
[1:02:56] Speaker 1: A lot of creta. We're just a little bit of cretea.
[1:02:58] Speaker 2: That's it, yep.
[1:03:00] Speaker 3: And same with protein, not too much, and it needs
[1:03:03] Speaker 3: to be spread across protein sources. But we know, for
[1:03:06] Speaker 3: instance that if you have a protein diet and you
[1:03:10] Speaker 3: do resistance exercise, that promotes brain function and brain health.
[1:03:16] Speaker 3: And there's a whole industry now an understanding of frailty
[1:03:19] Speaker 3: and how do you prevent frailty? Well, frailty is part
[1:03:22] Speaker 3: of the whole neurodegenerative process and you can manage it
[1:03:26] Speaker 3: by regular exercise, resistance training, protein intake. So that's a
[1:03:31] Speaker 3: critical message for all of us.
[1:03:34] Speaker 1: It's funny. Many years ago there was a well known
[1:03:38] Speaker 1: professor sin Vince's name, Professor Ron Penny, professor immunology. His
[1:03:43] Speaker 1: son Mark is a kidney specialist, and Ron was a
[1:03:46] Speaker 1: klinomne and when I was in a law firm and
[1:03:50] Speaker 1: also a good friend of mine, and Ron of course
[1:03:53] Speaker 1: died adventure like crazy, like the fittest go no weight
[1:03:57] Speaker 1: on him, used to walk up and down to level
[1:03:59] Speaker 1: six where it was every day up in the stairs.
[1:04:01] Speaker 1: Vinces league didn't drink like and like a super smart
[1:04:05] Speaker 1: guy super broke. It would have been like eighty, I'd
[1:04:08] Speaker 1: say when he passed away. Anyway, I said to Mark,
[1:04:11] Speaker 1: are you going to get a genetic test for this?
[1:04:14] Speaker 1: And Mark is also professor submits, and he said the
[1:04:18] Speaker 1: to me, he said no, he said, because even if
[1:04:21] Speaker 1: I find out, I'm going to get anxious if I
[1:04:23] Speaker 1: find out I have got it, So there's no point
[1:04:26] Speaker 1: in that.
[1:04:27] Speaker 2: He said.
[1:04:27] Speaker 1: And by the way, if I did have it, if
[1:04:28] Speaker 1: I did have the gene for it, it doesn't necessarily mean
[1:04:30] Speaker 1: I'm going to get it. And he went on to say,
[1:04:32] Speaker 1: then if and if I did have it, did if
[1:04:36] Speaker 1: I did get dementia? He said, the first thing they're
[1:04:38] Speaker 1: going to tell me is exercise, high intensity exercise. What
[1:04:42] Speaker 1: is high intense? Is it about blood flow? What are
[1:04:44] Speaker 1: we talking about? Why is high intensity exercise important?
[1:04:47] Speaker 3: Well, we know it's important again from epidemiology, Why is
[1:04:50] Speaker 3: it important? Definitely part of it is the blood flow,
[1:04:53] Speaker 3: but are there other processes that are as yet unknown. Yeah,
[1:04:57] Speaker 3: it must be similar to your discussion about neurotransmitter et cetera.
[1:05:00] Speaker 3: Though there are things going on in the brain that
[1:05:02] Speaker 3: we don't understand, but it's established.
[1:05:04] Speaker 2: It's a fact.
[1:05:05] Speaker 1: Yeah, it's it's because I guess that. Then brings me
[1:05:10] Speaker 1: over to my final question to you in terms of
[1:05:13] Speaker 1: lifestyle is about obesity. And because one of the things
[1:05:18] Speaker 1: you asked me to do is because my grandfather was
[1:05:21] Speaker 1: a diabetic type two so in otherwise acquired diabetic, but
[1:05:26] Speaker 1: diabetes from lack of whatever these on my dad's side.
[1:05:29] Speaker 1: And when I reveal that to you, and this is
[1:05:31] Speaker 1: when we're doing the family stuff, you said you better
[1:05:34] Speaker 1: go get a glucose test, which is not a very
[1:05:36] Speaker 1: pleasant test, but I put it up on my Instagram actually,
[1:05:38] Speaker 1: but it's it's like they sort of take your blood
[1:05:43] Speaker 1: before you do the test, test your sugar levels and
[1:05:45] Speaker 1: your incinent levels. Then they hit you with this massive
[1:05:48] Speaker 1: amount of glucose and over a three hour period they
[1:05:50] Speaker 1: test your glucose and inchinent levels to see whether you're insulent.
[1:05:54] Speaker 1: Resistant resistance or your insilance, not just or you just
[1:05:57] Speaker 1: don't have enough and you can't clear the gluct to
[1:06:00] Speaker 1: get back to the mistakes like a normal level. Why
[1:06:05] Speaker 1: is And of course diabetes too has relationship to weight.
[1:06:12] Speaker 1: What is the deal with being into the lifestyle? What's
[1:06:16] Speaker 1: the deal with being overweight and not necessarily a bees
[1:06:20] Speaker 1: but just overweight, unhealthy? Overweight and diabetes relative to neurological disease.
[1:06:26] Speaker 3: Well, I think you've covered the whole territory very well yourself,
[1:06:29] Speaker 3: and I think.
[1:06:30] Speaker 1: Because you told me, you are very thoughtful.
[1:06:32] Speaker 3: But you're exactly right. So the first thing is we
[1:06:35] Speaker 3: look at a fasting blood sugar level, So it is
[1:06:37] Speaker 3: the blood sugar level high? And in other words, is
[1:06:39] Speaker 3: someone diabetic or not? And we know that diabetes is
[1:06:42] Speaker 3: a controllable, manageable risk factor for dementia and memory.
[1:06:46] Speaker 1: Is that right?
[1:06:47] Speaker 3: Yes, So you would intervene if I was a diabetic.
[1:06:50] Speaker 3: Very aggressive therapy sugars is in the low normal range
[1:06:54] Speaker 3: best outcomes for long term memory function. Now we're starting
[1:06:59] Speaker 3: to understand it's not it's not a binary decision.
[1:07:01] Speaker 2: Either you're diabetic or not. There's a whole middle.
[1:07:04] Speaker 3: Territory which what you've said inchulin resistance and insulin resistance
[1:07:09] Speaker 3: is promoted, for instance, by being overweight or obesity, so
[1:07:14] Speaker 3: they're linked and can we can we try and manage
[1:07:17] Speaker 3: this insulin resistance by losing weight. And that's why now
[1:07:20] Speaker 3: governments are taking this on by for instance, doing you know,
[1:07:24] Speaker 3: interventions for weight loss, surgery for weight loss. And that's
[1:07:29] Speaker 3: because we know that if weight is managed, it helps
[1:07:34] Speaker 3: all the other sort of complications, particularly insulin resistance, which
[1:07:38] Speaker 3: is also linked to cognitive dysfunction, you know, memory problems, dementia,
[1:07:43] Speaker 3: also proofer on europathy. But I'm focusing on neurology, but
[1:07:47] Speaker 3: that all of the systems in the body are connected.
[1:07:49] Speaker 1: So and so I think what you're sort of saying
[1:07:52] Speaker 1: what's coming from this then, is that all of those
[1:07:55] Speaker 1: things we discussed into the lifestyle food, nutrition, exercise, is sleep,
[1:08:03] Speaker 1: you know, and or where you don't do those things,
[1:08:05] Speaker 1: you get your obs, you've got you know, your type
[1:08:08] Speaker 1: two diabetic or you have diabetes. Generally, all of these
[1:08:13] Speaker 1: things relate to the heart as well. All of these
[1:08:15] Speaker 1: relate probably every organ in your body. You know, like
[1:08:18] Speaker 1: if you're not in good shape, your liver, it could
[1:08:20] Speaker 1: have a problem, or your kidneys could have a problem.
[1:08:23] Speaker 1: You're saying, well, yeah, the brain can have a problem too,
[1:08:26] Speaker 1: as neurologist, and pretty much it comes back back to
[1:08:29] Speaker 1: this very same point. Live healthy, get the three strategies right, sleep, diet,
[1:08:38] Speaker 1: and exercise. That's a big start. That's a huge start.
[1:08:43] Speaker 2: Massive.
[1:08:43] Speaker 1: Are there any exercises that you know you would recommend
[1:08:46] Speaker 1: that we should do just to sort of maybe get
[1:08:48] Speaker 1: our brain fit.
[1:08:50] Speaker 2: Yeah.
[1:08:50] Speaker 3: The brain loves being challenged. So anything new helps the brain.
[1:08:54] Speaker 3: And whether that's for instance, learning a new language, having
[1:08:57] Speaker 3: a new hobby, doing dancing, get a new interest in
[1:09:02] Speaker 3: life that grows the brain.
[1:09:03] Speaker 2: How can you.
[1:09:04] Speaker 3: Challenge the brain do things differently each day? So, for instance,
[1:09:07] Speaker 3: don't just do the same drive home every day. Oftentimes
[1:09:10] Speaker 3: you get home and you think, I can't even remember
[1:09:12] Speaker 3: the trip home. Looks like you're unconscious, and you think,
[1:09:14] Speaker 3: have I got a memory problem? No, your brain switches off.
[1:09:17] Speaker 3: So what you want to do is keep on challenging
[1:09:19] Speaker 3: the brain and driving new function. So we also know
[1:09:23] Speaker 3: that cells that fire together wire together, and that's the
[1:09:26] Speaker 3: basis of plasticity. So we know that if you can
[1:09:29] Speaker 3: try and increase different approaches, you'll strengthen the connections across
[1:09:34] Speaker 3: brain networks, which is important for brain health. The brain
[1:09:37] Speaker 3: does get bored.
[1:09:39] Speaker 1: Oh really, so that's one of the reasons. Maybe I
[1:09:42] Speaker 1: can't remember why who told me this, but I change
[1:09:44] Speaker 1: hands with toothbrushes. Like some mornings, I'll do left, some
[1:09:46] Speaker 1: wanted to do right. Someone as I'll start on the right,
[1:09:49] Speaker 1: or in other ones that's on the left. So you're
[1:09:51] Speaker 1: saying that stuff is actually like a brain exercise.
[1:09:55] Speaker 3: It's an important brain exercise. And I think, deep down
[1:09:57] Speaker 3: you're a brain enthusiast, So I think you've got you
[1:10:00] Speaker 3: love this challenge, and I think we all have to
[1:10:02] Speaker 3: do these things. The challenge is incredibly important for brain health.
[1:10:06] Speaker 1: Could that be a reason why people when they do
[1:10:12] Speaker 1: something they don't want to do. For example, let's say
[1:10:14] Speaker 1: it's middle winter and I'm all nice and cozy, warm,
[1:10:19] Speaker 1: and I jump in one of those ice baths and
[1:10:22] Speaker 1: I feel great after it, but I don't want to
[1:10:25] Speaker 1: get in it. Exactly after, I think I'm glad I
[1:10:27] Speaker 1: did that.
[1:10:28] Speaker 3: Yeah, And the brain releases sort of pleasure hormones because
[1:10:34] Speaker 3: of that, So you feel good afterwards because you know
[1:10:37] Speaker 3: you've done something. The brain likes it. It's a release.
[1:10:39] Speaker 1: But I didn't want to do in the first place.
[1:10:41] Speaker 1: So but once I did it, I feel good exactly. Okay,
[1:10:45] Speaker 1: that's interesting, So sort of you got to keep It's
[1:10:47] Speaker 1: a bit like going to the gym. If you go
[1:10:49] Speaker 1: to the gym to do the same expo, same way
[1:10:50] Speaker 1: every day for the rest of your life, you want
[1:10:53] Speaker 1: nothing changes, So you've got to keep tricking your body.
[1:10:56] Speaker 1: So you've got to keep tricking your brain too.
[1:10:58] Speaker 3: Yeah, and I think you know, learning new tasks, learning
[1:11:01] Speaker 3: new languages. I mean, the brain is always ready to
[1:11:04] Speaker 3: be activated.
[1:11:06] Speaker 1: Is there any point in time in your age when
[1:11:07] Speaker 1: you should stop that or just keep doing it? Got
[1:11:10] Speaker 1: to keep doing it, so, and you know, maybe that's
[1:11:14] Speaker 1: one of the reasons why retirement's not a great idea,
[1:11:16] Speaker 1: because it's sort of put you in a position where
[1:11:20] Speaker 1: you're pretty much no longer challenging anything, and you're you know,
[1:11:23] Speaker 1: as we got it on, it's funny you should say,
[1:11:24] Speaker 1: because there's anything about the other day. You know, as
[1:11:28] Speaker 1: you get older, you've accumulated more, you've got less stress
[1:11:33] Speaker 1: in your life. You tend to get into this rhythm
[1:11:36] Speaker 1: of doing exactly the same thing every day, and you're comfortable,
[1:11:40] Speaker 1: and I often wondered to myself, is that a reason
[1:11:43] Speaker 1: why we age because we're no longer challenged?
[1:11:48] Speaker 3: It is, and that's also recently been brought out by
[1:11:51] Speaker 3: the Lancet Commission. Social engagement and new experience is a
[1:11:55] Speaker 3: part of the modifiable approaches to preventing new heady generation
[1:12:00] Speaker 3: and managing it. So it's incredibly important to be part
[1:12:03] Speaker 3: of your community, to be doing different things, to stay involved.
[1:12:06] Speaker 3: And as you say, detaching yourself and retiring, pulling yourself
[1:12:10] Speaker 3: out and doing your own thing is not good for
[1:12:13] Speaker 3: the brain.
[1:12:14] Speaker 1: Well, mate, I am not going to retire.
[1:12:16] Speaker 2: Whatever happens, we're all happy.
[1:12:20] Speaker 1: I have one more question for you, and it's like,
[1:12:22] Speaker 1: I don't know if it's right or wrong, but what
[1:12:26] Speaker 1: do you think about people using mobile phones? Well, look
[1:12:30] Speaker 1: to be on relatives the brain I'm talking about.
[1:12:32] Speaker 3: Yeah, yeah, the jury is out and at the moment,
[1:12:37] Speaker 3: all of the epidemiology hasn't shown an increase in a
[1:12:40] Speaker 3: particular type.
[1:12:41] Speaker 1: Of emology means, yes, study of the universe of people
[1:12:45] Speaker 1: who use phones relative to those people who get neurological disease.
[1:12:48] Speaker 3: Yeah, yeah, So I think we've got to keep an
[1:12:50] Speaker 3: open mind. And then ultimately we'll come down to lifestyle.
[1:12:53] Speaker 3: But I couldn't give any I don't have any insight
[1:12:56] Speaker 3: into anything more than is available in the pupper?
[1:13:00] Speaker 1: What is Matthew Kinn and doctor Matthew Kinnon? Does he
[1:13:02] Speaker 1: put things in his ear what he call his ear buds?
[1:13:08] Speaker 1: Or does he get on the mobile phone or was
[1:13:10] Speaker 1: he just put it on speaker? What do you do?
[1:13:11] Speaker 2: I get on the mobile phone, you.
[1:13:12] Speaker 1: Actually put up to your ear?
[1:13:14] Speaker 2: What do you do?
[1:13:15] Speaker 1: I got the earbuds, but like someone told me the
[1:13:17] Speaker 1: other day, the earbuds are bad for me. So like
[1:13:19] Speaker 1: I don't know, but mostly though I put it on loudspeaker.
[1:13:24] Speaker 2: Okay, I'm going to do that for now.
[1:13:26] Speaker 3: I'm going to tell everyone that you told me to
[1:13:28] Speaker 3: do that.
[1:13:29] Speaker 1: It's funny because I spoke to the treasurer recently and
[1:13:31] Speaker 1: I said to him, mate, you got to change the
[1:13:33] Speaker 1: capital the GST. Instead of putting interest rates up, just
[1:13:37] Speaker 1: put the GST up and then when the you know,
[1:13:39] Speaker 1: when the economy recovers the inflation gets better, put the
[1:13:42] Speaker 1: GST down. And he said, I'm going to tell everybody,
[1:13:45] Speaker 1: but it was but he was being quite cynical. He'll
[1:13:48] Speaker 1: being funny, but he was being cynical towards me, and
[1:13:50] Speaker 1: I appreciate that we covered dementia, Alzheimer's dementia and all
[1:13:57] Speaker 1: of some of the other parts of dementia. We've covered Parkinson's.
[1:14:01] Speaker 1: We did talk briefly about M and D. To me,
[1:14:06] Speaker 1: one of the great and you're you know, I have
[1:14:10] Speaker 1: so much respect and actually totally jealous of people like.
[1:14:13] Speaker 2: You vice versa.
[1:14:15] Speaker 1: Envious now, man, but I am envious. I'll be honest,
[1:14:18] Speaker 1: I am so envious because I think, apart from out
[1:14:22] Speaker 1: of space, the brain is the great in a space
[1:14:28] Speaker 1: like we keep getting I want to send rockets to
[1:14:31] Speaker 1: Mars and stuff like that, but there's an inner space
[1:14:35] Speaker 1: that is just totally undiscovered, and that's what you guys
[1:14:39] Speaker 1: are doing. Yeah, so what are the initiatives in Europe?
[1:14:42] Speaker 1: What are you guys doing there? Like, tell me some
[1:14:44] Speaker 1: of the stuff. Is any cool stuff happening? I'm sure there.
[1:14:47] Speaker 3: Well, for a start, as you say, it's the most
[1:14:49] Speaker 3: interesting thing I think in the world.
[1:14:51] Speaker 2: I mean, I'm biased.
[1:14:52] Speaker 1: Totally, but you are biased, but I'm not. And I
[1:14:55] Speaker 1: actually think if I at my age and where what
[1:14:58] Speaker 1: I've sort of done a lot of things, and I think, well,
[1:15:00] Speaker 1: what's really interesting to me, what's really cool Ela Musk
[1:15:03] Speaker 1: is the same thing neurally.
[1:15:04] Speaker 2: Yeah.
[1:15:05] Speaker 1: El Musk is trying to work out how to insert
[1:15:08] Speaker 1: things to make you use limbs that you couldn't ordinarily
[1:15:11] Speaker 1: use by somehow stimulating the brain or whatever he does
[1:15:13] Speaker 1: with the neuralink. And I know other people we're doing
[1:15:17] Speaker 1: these sorts of things here in Australia too. You know,
[1:15:20] Speaker 1: we had Nicholas Opi on this show, not this Project
[1:15:24] Speaker 1: one hundred, but we had nicobiy on The Mental Show.
[1:15:28] Speaker 1: And I think his business called synchron which is one
[1:15:31] Speaker 1: of the big businesses equivalent to Elon Musker's show. And
[1:15:36] Speaker 1: Nicholas is a biomedical engineer, but they they're also doing
[1:15:39] Speaker 1: they're in the US, but they're putting implants in the
[1:15:42] Speaker 1: people's brain so try and help them live better lives.
[1:15:44] Speaker 1: But the brain really is the inner space. Do you
[1:15:49] Speaker 1: realize how cool that is? Or you're just so busy
[1:15:52] Speaker 1: doing your stuff?
[1:15:53] Speaker 2: Absolutely?
[1:15:53] Speaker 3: And I think you're right, you've got to take a
[1:15:55] Speaker 3: step back and think about it. But everything we've done
[1:15:57] Speaker 3: here today is all brain related. You're talking, you listen,
[1:16:00] Speaker 3: you're thinking, I mean, how are you thinking? What's going
[1:16:02] Speaker 3: on there? And you know later on tonight you'll have
[1:16:05] Speaker 3: dinner and then you'll go to bed and you'll fall asleep,
[1:16:08] Speaker 3: and the system will be unconsciously. Your heart's going to
[1:16:11] Speaker 3: be beating at fifty to sixty beats per minute. You're
[1:16:14] Speaker 3: going to be breathing fourteen to fifteen breaths a minute
[1:16:17] Speaker 3: all the way through. While they're unconscious. Your brain's doing
[1:16:19] Speaker 3: all of this, and it's going to clear all of
[1:16:21] Speaker 3: the toxins from the day, and it's going to wake
[1:16:23] Speaker 3: up the next morning. You're going to feel refreshed and
[1:16:25] Speaker 3: bang its. But we just take all of this for granted.
[1:16:28] Speaker 3: But it's the unconscious brain that is just working all
[1:16:31] Speaker 3: the time. I mean, it's an amazing thing. It's an
[1:16:35] Speaker 3: amazing thing to think about. And then we're starting to
[1:16:38] Speaker 3: now try and work out thoughts people thinking, and then
[1:16:41] Speaker 3: consciousness consciousness. We haven't worked out what consciousness is. Do
[1:16:45] Speaker 3: you think this is chemical? Isn't it weird that you
[1:16:47] Speaker 3: can go for an operation and the niecess can put
[1:16:49] Speaker 3: you to sleep and you've got no memory. Yeah, and
[1:16:52] Speaker 3: you wake up and it's all gone. It's like it's
[1:16:54] Speaker 3: all happened. That's just amazing. But we don't know what
[1:16:57] Speaker 3: consciousness is. We don't know how to control other than
[1:17:00] Speaker 3: through deep sedation and anesthetic agents. But that's something that
[1:17:04] Speaker 3: people are very interested in. Similarly thinking and that has
[1:17:10] Speaker 3: lots of implications, and for instance, our defense forces. Everyone
[1:17:14] Speaker 3: is interested in thinking. And also can we invert a commace?
[1:17:19] Speaker 3: This is sounding science fiction? Can we read people's minds?
[1:17:23] Speaker 3: Can we tell whether people are lying? This is where
[1:17:26] Speaker 3: the future is going. And we're starting to see that
[1:17:30] Speaker 3: through our very rudimentary techniques through MRI functional imaging, and
[1:17:34] Speaker 3: we're getting very simple parts of this JIGXAW, but you
[1:17:37] Speaker 3: can imagine that probably in five to ten years time. Yes,
[1:17:40] Speaker 3: we will be able to see thoughts. Can we see
[1:17:43] Speaker 3: an individual thought? Can we see release of dopamine for pleasure?
[1:17:48] Speaker 3: It's amazing where this is going to go. We're right
[1:17:50] Speaker 3: at the beginning.
[1:17:51] Speaker 1: I saw a very interesting piece on the Conversation the
[1:17:54] Speaker 1: ABC's show and where they were talking about some experiments
[1:18:02] Speaker 1: and or discoveries, but not in a sense that those
[1:18:06] Speaker 1: discovery discoveries you are going to change any in the future.
[1:18:09] Speaker 1: But there's things are working on whereby they put individuals
[1:18:12] Speaker 1: in MRI machines for quite a long period of time,
[1:18:15] Speaker 1: and they played porn to them and they saw which
[1:18:18] Speaker 1: parts of their brain lit up, and then they are
[1:18:21] Speaker 1: able to then put them back in a machine and
[1:18:26] Speaker 1: suggest certain things to them, and they are able to
[1:18:31] Speaker 1: read effectively. The machine was able to read their mind
[1:18:34] Speaker 1: by reading what actually lit up in their brain. And
[1:18:36] Speaker 1: one of the obviously we can extend anything we want,
[1:18:40] Speaker 1: but one of the extensions of that is in time
[1:18:43] Speaker 1: where we have MRI machines at an airport, but ones
[1:18:48] Speaker 1: that's not one you have to lay in for thirty
[1:18:50] Speaker 1: minutes whatever, when you just as you walk through the
[1:18:53] Speaker 1: software so fast and the equipment so good that it
[1:18:55] Speaker 1: actually can read your mind whether or not perhaps you're
[1:18:57] Speaker 1: going to be you're intending to commit terrorists terrorism.
[1:19:01] Speaker 3: That's exactly where the field is. That's amazing, that's amazing.
[1:19:06] Speaker 1: Yeah, And when you talk about consciousness, you know, when
[1:19:10] Speaker 1: we talk about living and I don't talk about this,
[1:19:13] Speaker 1: but some people do talk about living forever or never dying,
[1:19:17] Speaker 1: and you know, Brian Johnson's one of those people. But
[1:19:19] Speaker 1: in order to achieve that, maybe what's going to happen
[1:19:23] Speaker 1: is they're going to get your consciousness and they're going
[1:19:26] Speaker 1: to transport it into a machine. So your body biologically
[1:19:30] Speaker 1: you will fall apart, your body will die, but your
[1:19:32] Speaker 1: consciousness Matthew Kington's consciousness will exist in something in here
[1:19:37] Speaker 1: and somehow they're going to transfer your consciousness, which means
[1:19:39] Speaker 1: you will live forever. You're another way of saying it
[1:19:42] Speaker 1: is your consciousness will live forever. And by the way, Schroading,
[1:19:46] Speaker 1: whilst you did the cat experiment or the cat thought experiment,
[1:19:50] Speaker 1: Schrodinger sorta wrote a book on consciousness and he called
[1:19:54] Speaker 1: the universal consciousness, and as a physics professor, he talked
[1:20:00] Speaker 1: about there is a universal consciousness and that I mean,
[1:20:03] Speaker 1: I'm getting a bit weird now, but when you die,
[1:20:06] Speaker 1: all our consciousness go to one place and they actually
[1:20:10] Speaker 1: never never leave us because energy, the conservation of energy principle,
[1:20:14] Speaker 1: energy never dies, It just changes. For yeah, exactly, the
[1:20:18] Speaker 1: question is where does it go?
[1:20:20] Speaker 3: Got us go in there? But brain computer interfaces are
[1:20:23] Speaker 3: occurring now and one of the ideas is that, yes,
[1:20:26] Speaker 3: you would download your whole memory function and that's that's
[1:20:30] Speaker 3: that'll be a question for society. But the other issue
[1:20:33] Speaker 3: is do you want to go through an experiential life?
[1:20:35] Speaker 3: Like do you want to have these experiences and learns
[1:20:38] Speaker 3: from those experiences, or I just want to inherit Mark
[1:20:40] Speaker 3: Burris's brain, plug it in and that's version two point
[1:20:43] Speaker 3: zero and go from that.
[1:20:44] Speaker 2: At the moment I think we.
[1:20:45] Speaker 1: Can get wealthy. Is for that you can someone lots
[1:20:49] Speaker 1: of people who buy it, don't buy.
[1:20:50] Speaker 3: It, and it's going to turn over very rapidly. And
[1:20:54] Speaker 3: the other thing is people mathematically model all of this,
[1:20:57] Speaker 3: So Alan Turing that's how he got into and that
[1:21:00] Speaker 3: that developed the whole idea of a computer and artificial intelligence.
[1:21:03] Speaker 3: People are trying to mathematically model consciousness and that's possible,
[1:21:08] Speaker 3: but it still doesn't let us know where consciousness is.
[1:21:11] Speaker 3: But this is this is where you know, there are
[1:21:13] Speaker 3: so many things going on that are just very very
[1:21:16] Speaker 3: inspiring and amazing.
[1:21:18] Speaker 1: As CEO and neuro though, do you maybe just get
[1:21:22] Speaker 1: into the sort of the weeds are a little bit
[1:21:26] Speaker 1: as not as doctor Mathewkain and or professor mathink In,
[1:21:30] Speaker 1: but as CEO of Newer do you the business that is,
[1:21:35] Speaker 1: do you sit down and say to you know, your team,
[1:21:38] Speaker 1: have a strategy session and say, okay, these are the
[1:21:40] Speaker 1: areas we're going to go for Apart from the clinical
[1:21:43] Speaker 1: stuff that you do in terms of helping people get better,
[1:21:46] Speaker 1: et cetera, diagnosing stuff. Do you actually go into these
[1:21:49] Speaker 1: really crazy places.
[1:21:50] Speaker 3: We do, and in fact, what we need to do more.
[1:21:53] Speaker 3: We have to do more of that and we have
[1:21:54] Speaker 3: to engage more with industry.
[1:21:57] Speaker 2: We know that and we.
[1:21:58] Speaker 3: Have to get out more. So that's the message to
[1:22:00] Speaker 3: get out more, interact with people like yourself in financial markets,
[1:22:04] Speaker 3: all industry, and that includes then imaging, you know, repositories,
[1:22:09] Speaker 3: financial that there's there's neurosciences everywhere. There's neuroscience down in
[1:22:14] Speaker 3: the local Woolworths. Why do you think that certain you know,
[1:22:18] Speaker 3: sales are at certain levels of eyesight? This is all neuroscience,
[1:22:21] Speaker 3: it's applied neuroscience, it's all informed. So people have done
[1:22:24] Speaker 3: that research and we want to see more and more
[1:22:27] Speaker 3: of that as well as society wants us to tackle
[1:22:30] Speaker 3: the real problems of our day, and the real problem
[1:22:33] Speaker 3: of our day at the moment is dementia. So the
[1:22:35] Speaker 3: society is putting a big focus. The governments are saying
[1:22:39] Speaker 3: we need to manage this and we need to understand it.
[1:22:41] Speaker 3: So that's that's the big ticket item at the moment.
[1:22:44] Speaker 1: Where are you guys at with dementia at neuroworld, like
[1:22:46] Speaker 1: what's going on now.
[1:22:48] Speaker 3: Well, for a start, we've been very lucky that the
[1:22:51] Speaker 3: community has been engaged with neuro over thirty years and
[1:22:54] Speaker 3: we've and patients who have come there have donated very
[1:22:57] Speaker 3: kindly their brains and their histories and buying markers. We're
[1:23:01] Speaker 3: now trying to understand mechanistic inputs for neuroaded generation and dementia,
[1:23:05] Speaker 3: discover new therapies we're incorporating now at the moment. To
[1:23:09] Speaker 3: look at a brain, a person might do a PhD
[1:23:11] Speaker 3: and count every single cell in one part of the
[1:23:14] Speaker 3: brain for Parkinson's disease. We know that's not efficient. We
[1:23:18] Speaker 3: need to get AI. So we're trying to bring all
[1:23:20] Speaker 3: of the strengths of the university's AI systems to help
[1:23:23] Speaker 3: us tackle neurological problems. See work with engineers engineers. So
[1:23:28] Speaker 3: the Faculty of engineering at university in your South Wales
[1:23:31] Speaker 3: is a thousand PhD students want, they want impact and translation,
[1:23:36] Speaker 3: they want to be involved in the brain, they want
[1:23:38] Speaker 3: to be involved with neuros. This is a great synergy,
[1:23:40] Speaker 3: great bridge.
[1:23:41] Speaker 1: And you said earlier on the brain bank, so neuro
[1:23:46] Speaker 1: has its own brain bank, or there's a brain bank
[1:23:48] Speaker 1: attached to neuro.
[1:23:49] Speaker 3: Neuro has its own brain bank, and we are supplying
[1:23:51] Speaker 3: tissue nationally and internationally. So actually, just yesterday Emmerie University
[1:23:56] Speaker 3: wanted a large number of samples with a particular new,
[1:24:00] Speaker 3: already generative condition. So provided it's got ethics approval and
[1:24:04] Speaker 3: it's all scientifically valid, we supply those tissues and samples
[1:24:09] Speaker 3: from Australian patients to drive international research and outcomes. We're
[1:24:14] Speaker 3: trying to improve outcomes globally.
[1:24:16] Speaker 1: I don't want to come work for you.
[1:24:19] Speaker 3: Please, well I'll run your enterprise and you can.
[1:24:21] Speaker 2: Have my.
[1:24:23] Speaker 1: Professor, Professor Matthew Kinnon.
[1:24:25] Speaker 2: Thanks for much, Thanks, thanks, thanks for your support.
[1:24:28] Speaker 1: You're welcome me

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