We're continuing our multi-part conversation about our responses to the recent NY Times piece called "A Father's Search for a Drug for Down Syndrome." Today's guest post is different in a couple of ways. All previous guest-posters have been parents of kids with Down syndrome. Today's guest poster is an uncle of a kid with Down syndrome. It's my brother Aaron!
Also, he is a Ph.D. student who is perfectly comfortable using "doo doo" as a category of analysis.
So I read/skimmed a few of the studies that Costa and his colleagues did. My main observation is that these are scientists interested in how drugs can be used to increase the cognitive performance of those with DS. Drugs are their thing. So, they're looking at their questions through this lens.
In the same regard I'm looking at all of my questions through the lens of exercise. This is what I have to say after reading the literature (To be fair, I only read the 3 articles specifically mentioned in the NYT - these guys have published loads of stuff).
MEDICINE has been found to increase the number of brain cells in the dentate gyrus of the hippocampus (Prozac), as well as increase cognitive performance (Memantine) in rats.
EXERCISE has been found to do the same thing. What's interesting is that Costa actually cites one of the foundational pieces of literature that shows how exercise increases neurogenesis (new brain cell growth), but he doesn't mention how his results match up (better, worse, same). I pulled up both articles to compare their findings and the metrics were off. Just lead me to a bunch of questions regarding the experimental design of the study that I don't think you'd be very interested in.
Additionally, Costa's justification for testing the effectiveness of Memantine comes from an exploration into a potential mechanism of the early onset Alzheimer's-like symptoms that a lot of people with DS get. It's been seen that exercise helps with symptoms of Alzheimer's - especially in those with certain genetic predispositions for early onset.
The NYT article goes on to mention other studies that have shown that learning is enhanced by increasing norepinephrine and decreasing beta amyloid deposits. Exercise does this too.
Here's what we need to know: Which helps more; exercise or meds? Is there an interaction? Meaning, is it even better to do both? Past studies have shown that some antidepressants increase the expression of BDNF (like miracle grow for brain cells) in the dentate gyrus. However, exercise been found to do the same thing. And, when combined with drugs, it does even better.
Obviously, I look to exercise for answers. However, there are several reasons why it's important that we know if exercise is a viable option for increasing cognitive performance, quality of life, and physical health (regardless of your net chromosome count). Exercise is free for everyone! It helps with our entire self (mind and body). And the side effects include: looking awesome, feeling great, having better doo doo's, sleeping better, increased insulin sensitivity (bye bye diabetes), etc...
So, we don't know how well this magic pill stacks up against the exercise studies that are out there. And, actually, I haven't seen any studies that have looked at these exercise questions with mice or people with DS. However, based on what is out there, I see a lot of parallels. And, I'm 100% sure that most parents of kids with DS would agree that making sure that their kids get enough physical activity is a good thing. No guilty Matrix-like dilemmas (should I take the blue pill?)- just moving your body.
I'm all for increasing cognitive performance. But, when dealing with meds, there are a lot of questions that need to be answered first (especially with kids!). The little I've read about the experiences kids with ADHD have while trying to adjust to their meds has been heart breaking. Sometimes meds can really help someone out, but sometimes they can cause more problems than they solve (medical, social, etc).