Remember the Hippocampus! You Can Protect the Brain's 'Regeneration Center': Stress Management, Physical and Mental Exercise, and Some Medications Can Keep the Hippocampus Active, Allow Neurogenesis

Article excerpt

What part of the brain incorporates our moment-to-moment experiences, weaves them into coherent and interconnected verbal, spatial, and emotional memories, and enables us to be aware of our entire 'life story'?

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It's the hippocampus, of course. Damage to this portion of the brain--as in seriously mentally ill individuals--severely impairs the ability to form new memories, with subsequent social and vocational impairment.

Interestingly, the hippocampus also is the "regeneration center" of the brain, continuously producing progenitor cells that can differentiate into neurons and glia that migrate to brain regions that need replenishment.

What does that have to do with psychiatry? A lot. It is now well established that the hippocampus is structurally and functionally impaired in several severe neuropsychiatric disorders. The hippocampus:

* fails to develop adequately in schizophrenia

* shows progressive atrophy in persons with recurrent unipolar or bipolar depression

* shrivels in severe stress disorders such as posttraumatic stress disorder (PTSD)

* is damaged by the toxicity of alcohol addiction

* is rapidly devastated in Alzheimer's dementia.

It's no wonder that cognitive functions--especially memory and learning--are seriously impaired in persons suffering from these disorders.

Regeneration and repair

What can psychiatrists do about our patients' hippocampal dysfunction? There is good news on that front.

Abstinence from alcohol will reverse hippocampal damage within 6 to 12 months. Antidepressants have been found to stimulate production of new brain cells (neurogenesis) and to gradually rebuild the structure of the hippocampus in depressed individuals. Ditto for atypical (but not conventional) antipsychotics, which induce neurotrophic growth factors such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). …