When you talk to someone who shows the same ease at Harvard as on El Hormiguero and explains neuroscience by quoting Machado, you might suspect you're dealing with a genius. But when you discover that he is helping thousands of people of all ages improve their brain health, the suspicion turns into conviction: Álvaro Pascual-Leone is making the world a better place through his work at the Barcelona Brain Health Initiative (BBHI), a project of the Institut Guttmann with the support of Obra Social "la Caixa", and that makes him a scientist everyone should know, even if he doesn't care for the "usted" (formal 'you') or even the recognition of his positions.
Professor of neurology at Harvard Medical School and scientific director of the BBHI. Anything else? No, that's long enough.
Why did you become a neurologist? I was fascinated by figuring out why humans are the way we are, why we fall in love, why we are passionate about a job... Those kinds of things. I thought the best thing then was to study philosophy, but my parents told me: "Maybe studying medicine will also help you make a living."
And you became a scientist. A humanist scientist. Exactly. Helping people fills me with satisfaction.
What led you to create the BBHI? Neurologists need a change of focus. Until now, we have developed tools to diagnose and treat neurological diseases, but we have forgotten about prevention! The motivation of the BBHI is to achieve an approach based on health, not on disease. And to discover what the markers are that characterize a healthy brain.
One of the project's great discoveries is that having a purpose in life is key to maintaining brain health. Yes, and the important thing is that your purpose transcends. That it's not "I want to get rich," but "I want to get rich to give it to my children" or "to give it to the poor so there are fewer."
Okay, without a purpose, the brain atrophies. But if after a blank period you find a vital goal again, does the brain damage reverse? We know that the brain is intrinsically plastic and that we can guide that plasticity, so it's never too late. If, for example, a person who has just had grandchildren has "reconnected" to life, that will improve their brain function and, consequently, their general health.
Mens sana in corpore sano. And vice versa! But let me clarify three things. One, Machado was right, "the end is not the goal, but the path"; we are not talking about making the purpose a reality, but about having it. Two, the vital purpose can vary, because life changes and so does the brain. And three, keeping the brain healthy is not about preventing it from aging, but about making it function in the best possible way at whatever age you are.
What changes occur in the brain as it ages and should we accept? The connections between neurons become more distant. The bad part is that it's harder for you to remember concrete things, like that this is called a clip. The good part is that you are now able to think that you can give that clip a different use than in the office, or that it can lead you to remember something that happened to you once with a clip. That is, you lose "proximal" learning but gain what Americans call "seeing the big picture."
To maintain brain health, on the website you give a list of bad habits: smoking, sleeping little, overdoing it with sugar or salt… Why don't you talk about alcohol? Because there is data suggesting that in small doses it can be good for the heart and coronary arteries and, therefore, for cerebral blood flow. We want to study it because it is not yet clear.
But you do make it clear that routine is bad. To maintain a plastic, vibrant and healthy brain, you have to give it new challenges. For example, for me reading or talking to people is not a brain challenge. For me a challenge is… learning to dance tango. That activates my brain.
You also advise cultivating interpersonal relationships. Do social networks work? Yes. Thanks to the work of many people like Barabási we have learned that they cause a real impact on the brain. Furthermore, the brain will be healthier if we surround ourselves with healthy people, with optimistic people we become more optimistic… But in Spain we already knew that: "Tell me who you walk with, and I will tell you who you are."
And can we know if our brain is well, without having to put all those cables on the BBHI volunteers? Honestly, I don't think so. People can tell you "You look good," but that's like saying your car is fine because it goes 120 on the highway, when it might be losing oil and water and is about to stop. There are disabling brain diseases that begin to develop 15 years before having symptoms. That's why you have to look "under the hood," to see how your brain is doing to allow itself to function like that.
Returning to the volunteers. You asked for 3,000 and 4,500 came! Do you still accept more? It has been a spectacular response. These things usually take six or seven years, and thanks to the people, we have been able to obtain results in a year and a half! But yes, we continue to accept volunteers, who, by the way, learn a lot of things about their brain that are very beneficial to them.
Do you think that, based on your discoveries, you are already managing to keep our brain healthy with age? Yes, that is already happening. Our initiative contemplates that studies become interventions. Because, once you know what to do to be healthy, the challenge is to do it. To repeat it individual by individual. And although we cannot have a brain health coach per person, which would be ideal, we can reach everyone using technology guided by the knowledge of a team of professionals. That is feasible and is now our goal.
Interview: Ana Portolés Illustration: David de las Heras
You can read more stories like these in ALMA, the social social network, a digital space dedicated to the social sphere that provides a new perspective on the present and future of society, from an optimistic and diverse voice, and all the initiatives promoted by "la Caixa" Social Project.