The next part of the module on the social realm, is about neuroplasticity and chronic pain. Now there's a new brain paradigm that has been developed over the past decade or so and that's that the brain really is very resilient and open to change. And the paradigm really is to make your own brain. And, the old paradigm is that you are born with X number of brain cells and as you live and age you lose them and, of course, they are not replaced. But, the new paradigm is that the brain is a constantly changing structure. Changing its structure and synapses, efficiency due to environmental, social and lifestyle factors. And this can enhance your intelligence throughout the course of your lifetime as well as insight, happiness and of course, comfort in reducing pain. So with regard to this new brain paradigm, there are three important concepts. One is neuroplasticity, neurogenesis and cognitive reserve, and let's discuss each one of those. Neuroplasticity is really a process by which the brain produces more morphological synapse changes in response to external stimuli. So in this case, external stimuli may be positive or negative. And may have a positive influence on the brain, or a negative, whereas brain changes may also be then, positive and negative. Changes occur to the brain throughout our lifetime, and we can take advantage of this. So the process of Neurogenesis can occur. Like a tree, the human brain can grow new neurons and replace old neurons with new ones. So, the adult brain continues to produce stem cells called neuronal progenitive cells that generate new neurons throughout our lifetimes. This can enhance our memory and improve a host of other cognitive functions, but it also can either amplify pain or reduce pain. So the next concept is cognitive reserve. Now this is the mind's resistance to damage of the brain. So brain damage can come from a host of different factors, poor health, dementia, Alzheimer's, chronic pain, depression and many other conditions. And we can either have a very strong or a weak cushion to protect us against this brain damage. So cognitive reserve can be either built up or lost during our lifetime, with cognitive, behavioral, emotional, physical and many social strategies, many of which we're discussing as part of this course. And thus, dementia can then ebb and flow according to the same risk and protective factors, that are involved in chronic pain. That's quite an interesting concept that dementia and chronic pain are connected by these phenomena. So what we need to do is make sure we either use our brain, use it or lose it. Now this applies to the brain as well as the musculoskeletal system. So protective factors that increase this cognitive reserve include for example, high levels of education and continued education. Performing complex cognitive tasks like learning a new language is a good example, social interaction really enhances, cognitive reserve. Creative pursuits like art, music, we've all known that was true but that has been demonstrated to be the case. And there is many other cognitive lifestyle and social factors that can play a role in boosting our cognitive reserve. So there is a concept called positive neuroplasticity then. Now this enhances cognitive and emotional functioning and reduces the risk of dementia as well as chronic pain. And you can look at the different 7 realms and different factors in each realm with regard to things that will improve neuroplasticity and cognitive reserve. So the body, for instance, physical exercise, such as yoga and conditioning. Life style factors such as good sleep and diet help our brain adapt and change. Social factors, social ties that protect us against impaired cognition after a stroke for example. Emotional factors, creative pursuits, art, musical training, learning to juggle all kinds of different emotions, things that generate positive emotions. Spiritual factors including mindfulness meditation, relaxation strategies play a significant role as well as things that improve your mind. Maintaining an intellectually challenging vocation, education over the lifetime, playing thinking games are all things that develop your mind. And then finally creating an environment that is stimulating and non-threatening and safe is real critical. And you can think of some of these activities as a brain treadmill. Here are some examples that you can do on a daily basis that will enhance. Cognitive reserve and neuroplasticity, such as using both hands to do things daily, like in typing, or using a computer mouse, or playing games that require thinking. Crossword puzzles Sudo, Sudoku, create art, cooking, music, gardens, literature, businesses, so creativity is really critical. Learning a new language, as I mentioned, or even practicing remembering things such as presidents, events, dates, and of course people's names. So all of these will enhance cognitive reserve. But there's also the concept called negative neuroplasticity. Now this increases the risk of cognitive decline and dementia, as well as chronic pain, and increases with risk in the seven realms. So, within the guards of the body other comorbid conditions such as diabetes, high blood pressure, and other conditions do play a role in decreasing neuroplasticity. Lifestyle factors such as repeatedly poor sleep, substance abuse including alcohol, nicotine, opioids, methamphetamines and cocaine can play a role in reducing neuroplasticity. Emotional problems that are sustained, depression, anxiety, anger. Social factors, chronic social stressors, abuse, violence and socioeconomic status. Spirituality, burn-out and, and loss of hope and, in the future. And in the mind avoiding learning and educational pursuits and developing your mind further. And then the environment improvise or monotonous environments are something that creates negative neuroplasticity. So the take home with regard to this particular part is that we need to understand the concepts of neuroplasticity and neurogenesis and cognitive reserve. It means that anyone can change their mind and subsequently their attitudes, lifestyles, and social situations that can cause both dementia as well as chronic pain. And there are many strategies in each realm to achieve a positive neuroplasticity. Do them on a daily basis, and it will protect you from dementia as well as chronic pain. There are also many circumstances in which negative neuroplasticity can result. And we need to be cautious about those things and avoid them. Change our lives if they exist. And so this module is really about the circumstances in the social realm that lead to negative neuroplasticity, and end up with how to reverse this. So thank you.
