DEAR MAYO CLINIC: My mother gets headaches from time to time, but recently she's been reading that some headaches can be signs of serious medical problems. What's the difference between a headache that's just a nuisance and one that needs immediate medical attention? 

ANSWER: Most headaches aren't a symptom of a life-threatening condition. Common headaches, including tension headaches and migraines, can be painful and disruptive, but they usually aren't medical emergencies. However, certain headache symptoms shouldn't be ignored because they can signal a serious underlying condition, such as a stroke, bleeding in the brain, meningitis or, less commonly, a brain tumor. Knowing the warning signs can help you decide when to seek emergency care. 

You should contact your healthcare team if you experience: 

• Headaches that wake you from sleep or are present when you wake up. 

• Headaches that become more frequent or progressively more severe. 

• Headaches that don't improve with over-the-counter medications such as acetaminophen or ibuprofen. 

A severe headache can be described as the "worst headache of your life" — one that develops suddenly and reaches maximum intensity within seconds or minutes. This can be a sign of a medical emergency. 

Go to the emergency department or call 911, especially if your headache is accompanied by: 

• Weakness or numbness. 

• Slurred speech. 

• Confusion. 

• Loss of consciousness. 

• Double or blurred vision. 

• Severe dizziness or difficulty walking. 

• Fever and a stiff neck. 

While serious causes of headaches are uncommon, they do occur. For example, headaches can be associated with brain aneurysms, although these headaches are typically sudden and severe, and they may be accompanied by loss of consciousness. 

Brain tumors are rare, but about half of the people who are diagnosed with one experience headaches. These headaches often become progressively worse over time, and may occur in the morning or wake someone from sleep. They're frequently accompanied by nausea or neurological symptoms, such as weakness, numbness or vision changes. 

Headaches with vision changes can have several causes. Some people with migraines experience visual disturbances. In other cases, vision changes and headaches may be related to inflammatory conditions such as giant cell arteritis, which is an immune disease that causes swelling and narrowing of medium- and large-sized arteries, and it can cause blindness.  

If you're over the age of 50, you should always discuss new headaches with your healthcare professional. Most primary headache disorders, including migraines and tension headaches, begin much earlier in adulthood. 

You also should seek medical evaluation if headaches consistently occur with coughing, sneezing or straining, or if they're triggered by exercise and continue to recur. Although these headaches are often benign, they sometimes can signal an underlying structural condition. 

After a head injury, it's common to develop headaches. Many go away with rest and over-the-counter pain relievers. However, seek medical care after a head injury if you lose consciousness, have memory loss or repeated vomiting, take blood thinners, are age 65 or older, have obvious head trauma, or were injured in a significant fall or by a direct blow to the head. 

If you're being evaluated for headaches, be prepared to describe: 

• How severe the headache is. 

• When it started and how long it lasted. 

• Whether it wakes you from sleep. 

• Whether it's different from your usual headaches. 

• Any associated symptoms, such as fever, weakness, numbness or vision changes. 

• What treatments you've tried and whether they helped. 

Depending on your symptoms, your healthcare team may recommend imaging, such as a CT scan or MRI, to help identify the cause. 

The bottom line is that most headaches aren't dangerous, but some require immediate attention. Remember the key warning signs. And when in doubt, it's always safest to seek medical evaluation. 

Grant Mallory, M.D., Spine Care, Neurosurgery, Mayo Clinic Health System, La Crosse, Wisconsin

The post Mayo Clinic Q&A: Headaches that should never be ignored appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My spouse will tell me occasionally that their hands and feet "fall asleep," and they experience numbness, tingling and a pins-and-needles sensation. Is this normal, or does it require medical attention?  

ANSWER: Most people experience numbness or the familiar pins-and-needles sensation from time to time. Often, it's harmless and happens because you've been sitting, standing or sleeping in a position that puts temporary pressure on a nerve. Once you change positions, the sensation usually goes away within a few minutes. 

However, these symptoms can sometimes signal an underlying medical condition. They can occur when a nerve is damaged, compressed or irritated. The nerve itself may not be functioning properly, a condition called neuropathy. In other cases, pressure on a nerve, such as in the spine or somewhere along its path through the arms or legs, can cause numbness and tingling. 

Pinched nerves can occur in several places. Nerves can become compressed in the spinal canal, a condition known as spinal stenosis, or further along their path, such as carpal tunnel syndrome. 

Other health conditions also can damage nerves. Diabetes is one of the most common causes. Diabetic neuropathy often begins in the feet, causing numbness, tingling or burning sensations that usually affect both sides of the body equally. Symptoms often spread in a pattern similar to wearing socks or gloves. 

Vitamin deficiencies, kidney disease, heavy alcohol use, exposure to certain toxins and some medications, particularly chemotherapy drugs, also can contribute to numbness and tingling. 

Anxiety and stress can trigger numbness or tingling, as well. During periods of stress, some people breathe more rapidly than usual, which can lead to tingling around the mouth or in the hands. Panic attacks also may cause these sensations. 

You should schedule an appointment with your healthcare team if numbness or tingling: 

• Becomes constant. 

• Gets worse over time. 

• Interferes with your daily activities. 

• Occurs along with pain, weakness, balance problems or difficulty walking. 

While many causes aren't emergencies, persistent symptoms should be evaluated to identify and treat any underlying conditions. Some symptoms require immediate medical attention. 

Sudden numbness affecting one side of the face, arm or leg, especially when accompanied by weakness, can be a sign of a stroke. If this occurs, call 911 or seek emergency medical care immediately. 

You also should seek emergency care if you develop numbness in the groin or genital area, particularly if it occurs along with difficulty controlling your bladder or bowels, trouble urinating or weakness in your legs. These symptoms can indicate a serious problem, such as a spinal cord injury, that requires prompt treatment. 

When numbness or tingling needs further evaluation, your healthcare professional will begin by asking detailed questions about your symptoms, including when they started, what makes them better or worse, and whether you have other symptoms such as pain or weakness. 

A physical examination helps evaluate how your nerves and muscles are functioning. Depending on the findings, additional testing may be recommended. This could include imaging tests, such as X-rays, ultrasound or MRI, to look for structural problems around the nerves. Nerve studies, including electromyography, can help determine how well your nerves are sending and receiving signals. 

For mild episodes related to body position, simply changing positions, improving your posture or gently moving the affected arm or leg may be enough. When symptoms are more persistent, physical therapy can help improve strength, mobility and function. 

Other treatments may include medications to manage nerve pain, injections to reduce inflammation around pinched nerves, or surgery when nerve compression is severe. Some nerve problems, such as those caused by spinal stenosis, may improve with treatment. Others, including diabetic neuropathy, are often permanent, so treatment focuses on managing symptoms and preventing further nerve damage. 

The most important step is talking with your healthcare team. Identifying the cause early allows you to begin the right treatment and, in many cases, prevent symptoms from getting worse. 

Occasional numbness and tingling that go away quickly after you change positions are usually nothing to worry about. But if symptoms persist, worsen, interfere with your daily life or occur with weakness or other concerning symptoms, don't ignore them. Early evaluation can help identify the cause and guide the most appropriate treatment. 

Megan Everson, M.D., Neurosurgery, Spine Care, Mayo Clinic Health System, Eau Claire, Wisconsin 

The post Mayo Clinic Q&A: When to worry about numbness and tingling appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — An international study led by Mayo Clinic researchers has identified interleukin-6 (IL-6) receptor blockers as a promising option for preventing relapses in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). MOGAD is a rare autoimmune neurological disorder that can cause vision loss, paralysis and other serious neurological complications.

The study, published in JAMA Neurology, provides one of the largest real-world evaluations to date of IL-6 receptor blockade in patients with MOGAD and offers new evidence to help guide treatment decisions while randomized clinical trials are underway.

MOGAD occurs when the immune system mistakenly attacks myelin, the protective coating surrounding nerve fibers in the brain, spinal cord and optic nerves. In some patients, the disease causes repeated inflammatory attacks, or relapses, that can lead to accumulating neurological disability. Although several therapies are used off-label, there are currently no treatments approved specifically for preventing relapses in MOGAD.

The study focused on two medications, tocilizumab and satralizumab, that belong to a class of drugs known as IL-6 receptor blockers. Researchers believe the immune signaling protein IL-6 plays an important role in the inflammation that damages myelin in people diagnosed with MOGAD. By blocking that immune signaling pathway, these medications are designed to reduce inflammation and help prevent future relapses.

"Interleukin-6 receptor blockers appear to be a promising treatment option for people living with MOGAD," says Eoin Flanagan, M.B., B.Ch., a neurologist at Mayo Clinic and senior author of the study. "While we await results from randomized clinical trials, these findings provide additional evidence that these medications may help limit the neurological disability that can accumulate with repeated attacks.”

Researchers evaluated 116 patients treated with IL-6 receptor blockers across multiple centers in North and South America, making it the largest observational study of its kind. Most participants received tocilizumab, which is widely available around the world, while a smaller number received satralizumab. The study found that patients had substantially fewer relapses after starting treatment and that the medications had a generally favorable safety profile, though infections remain an important consideration for clinicians.

Because MOGAD is uncommon, individual medical centers often care for relatively small numbers of patients, making it difficult to study new treatments. This multinational collaboration allowed researchers to evaluate outcomes across various patient populations while expanding the evidence for IL-6 receptor blockade in MOGAD.

"Rare diseases require collaboration," says Andreu Vilaseca Jolonch, M.D., first author of the study and a neurology fellow at Mayo Clinic. "By bringing together patients and researchers across multiple countries, we were able to generate stronger evidence than any single center could produce alone. That collaboration not only strengthened this study but also created a foundation for future research."

Multiple clinical trials evaluating treatments for MOGAD are underway, and observational studies such as this one help provide important evidence while physicians await those results.

"There is growing optimism for patients with MOGAD," Dr. Flanagan says. "New treatments are emerging, and we're trying to bring the best treatment options to patients while continuing to learn which therapies work best."

This research was supported by the National Institutes of Health (R01NS113828). One patient included in the study was supported by National Institutes of Health grant R01AI170863-01A1.

 For a complete list of authors, disclosures and funding, review the JAMA Neurology article.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post International study identifies promising therapy to prevent relapses in rare neurological disease appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A visit from a therapy animal may do more than lift spirits. A new study in Mayo Clinic Proceedings highlights how animal-assisted treatment can support inpatient stroke rehabilitation. Patients who interacted with therapy animals showed greater engagement in their treatment, increased physical activity and longer mobility compared with those who did not.

The findings suggest a promising approach to addressing common barriers patients face with stroke recovery, including limited motivation, reduced energy, lack of companionship and decreased interest in therapy activities. By incorporating trained therapy dog-handler teams into rehabilitation care, patients can do a variety of activities including walking, playing fetch, and petting or brushing the dog.

"The presence of a therapy dog can change the entire dynamic of a rehabilitation session," says Whitney Romine, manager of animal-assisted services at Mayo Clinic. "Patients often share that they feel more grounded, safe and empowered to engage in therapy activities, which can make a meaningful difference in their recovery experience."

The paper, "The Impact of Animal-Assisted Treatment on Inpatient Stroke Rehabilitation," shows how patient care could be improved using a clinical care delivery model that includes qualified animal handler teams. The study also explores how these changes could be applied across a variety of medical specialties and patient populations.

"Stroke recovery can be challenging, particularly when patients face barriers such as low motivation or limited energy," says Brent Bauer, M.D., a physician in internal medicine at Mayo Clinic. "This research demonstrates that animal-assisted treatment may offer a practical and effective way to enhance engagement and support better rehabilitation outcomes."

Watch: Dr. Brent Bauer discusses the benefits of therapy dogs

Journalists: Sound bites and broll with Dr. Bauer are in the downloads at the end of the post. Please courtesy: "Brent Bauer, M.D./General Internal Medicine/Mayo Clinic."

This research was conducted in collaboration with Nestlé Purina PetCare. For a complete list of authors, disclosures and funding, review the study.

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a peer-reviewed medical journal that publishes original research and reviews across clinical and translational science.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study highlights benefits of animal-assisted treatment in stroke rehabilitation (VIDEO) appeared first on Mayo Clinic News Network.

For years, some patients diagnosed with multiple sclerosis (MS) weren't getting better despite receiving the right treatments. The problem wasn't the therapy. It was the diagnosis. 

A new episode of "Tomorrow's Cure" podcast explores how the discovery of myelin oligodendrocyte glycoprotein antibody-associated disease, or MOGAD, transformed the understanding of autoimmune neurologic disease. Once mistaken for MS, MOGAD is now recognized as a distinct condition with its own diagnostic criteria, treatment approaches and emerging therapies. 

The episode features Eoin Flanagan, M.B., B.Ch., an autoimmune neurologist at Mayo Clinic whose research has helped shape how MOGAD is diagnosed and treated, and Brenda Banwell, M.D., a pediatric neurologist at Johns Hopkins Children's Center who led the international effort to develop the first diagnostic criteria for the disease. Together, they discuss how decades of collaboration among researchers, clinicians and patients helped redefine the disease and improve care for people who had spent years searching for answers. 

"It was life-changing for them to have an actual diagnosis and an identity," says Dr. Flanagan, describing patients who spent decades seeking answers before MOGAD was recognized as a distinct disease. 

The conversation also explains why distinguishing MOGAD from multiple sclerosis is critical. Although the conditions can present similar symptoms, including vision loss and spinal cord inflammation, they follow different disease courses and require different treatment strategies. Advances in antibody testing and internationally accepted diagnostic criteria help physicians identify MOGAD earlier and begin more targeted care. 

Researchers are also making progress toward more precise therapies. Clinical trials targeting the immune pathway known as interleukin-6 have reported encouraging early results, although treatments for MOGAD are still emerging.  

"Diagnosis matters," says Dr. Banwell. "Prompt treatment of an acute attack matters because your recovery from that first attack really dictates how you're doing." 

Listen to the latest episode of "Tomorrow's Cure" to learn how one discovery reshaped the diagnosis of autoimmune neurologic disease and how ongoing research is opening the door to more personalized treatment for people with MOGAD. You can also explore the show's full library of episodes and guests on the show's playlist.  

The post When it’s not MS: Inside the discovery of MOGAD appeared first on Mayo Clinic News Network.

The brain relies on carefully coordinated electrical signals to control everything from movement and memory to thought and emotion. When those signals become too active or poorly regulated, they can contribute to neurological disorders such as epilepsy. Researchers are working to better understand these abnormal patterns of brain activity and develop new ways to measure and safely influence them without surgery. 

Brian Lundstrom, M.D., Ph.D., is a Mayo Clinic neurologist and physician-scientist whose research focuses on cortical excitability — how active or responsive the brain is — and how noninvasive brain stimulation may help improve the diagnosis and treatment of epilepsy and related neurological disorders.  

As a member of Mayo Clinic's BIONIC (Bioelectronic Neuromodulation with Innovation to Cure) initiative, Dr. Lundstrom shares how advances in bioelectronic medicine are shaping the future of personalized neurological care. 

Watch: BIONIC: AI, Brain Stimulation, and the Future of Neurotechnology

Journalists: Sound bites and with Dr. Brian Lundstrom are in the downloads at the end of the post. Please courtesy: "Brian Lundstrom, M.D., Ph.D./Neurology/Mayo Clinic."

Q: What does it mean when the brain is "hyperexcitable" or has abnormal cortical excitability? 

A: Cortical excitability is one way to describe how responsive the brain is to activity. The cortex is the outer layer of the brain, and neurons — the brain's fundamental cells — communicate with each other through electrical signals. 

In some neurological diseases, the brain can become too excitable. Epilepsy is one example. During a seizure, the brain's electrical activity becomes abnormally high. Many neurological conditions may involve brain activity that is either too high, too low or not properly regulated. 

Q: Your research explores ways to stimulate the brain without surgery. How do these technologies work, and how could they help people with conditions like epilepsy? 

A: Because the brain communicates through electricity, we can also use electrical or magnetic stimulation to try to better understand brain activity. One way is through transcranial magnetic stimulation (TMS). TMS uses magnetic pulses delivered outside the head to stimulate targeted brain regions.  

Another method is transcranial direct current stimulation (tDCS), which uses low levels of electrical current applied through the scalp. These approaches are considered noninvasive because they do not require surgery or implanted devices. 

The goal is to use these targeted, noninvasive stimulations to influence brain activity, helping us better understand brain activity and, ultimately, correct abnormal patterns that contribute to conditions like epilepsy. 

Q: What makes noninvasive stimulation especially appealing compared with traditional approaches for epilepsy, such as medication, surgery or implanted devices? 

A: While medications are highly effective for many people, they don't work for everyone, and some patients experience side effects that affect their daily lives. Our goal is to move beyond that trial-and-error approach by using measurable changes in brain activity to guide treatment decisions earlier and more precisely. 

Surgery and implanted devices can also be very effective, but they're not the right option for every patient.  

That's where noninvasive brain stimulation, like TMS or tDCS, is especially promising. Because these approaches target specific areas of the brain without surgery, they generally don't produce the same whole-body side effects that medications can.  

While additional research is needed, I've also seen patients whose seizures were significantly reduced or eliminated entirely through noninvasive brain stimulation after other treatments hadn't worked. Our hope is to continue refining these approaches so more patients can benefit from safe, personalized therapies. 

Q: What are biomarkers, and why are they important in understanding the brain? 

A: One of the biggest modern challenges in using brain stimulation therapies is that we still don't have simple, precise ways to measure how the brain is working in real time. Before treatments like TMS or tDCS can be used most effectively, we first need to understand how the brain is functioning. 

Biomarkers are measurements that help us understand what's happening inside the brain and help us identify abnormalities. We gather this information using tools such as electroencephalography (EEG), which records the brain's electrical activity, and magnetoencephalography (MEG), which measures the magnetic fields produced by that activity.  

Q: Why is Mayo Clinic the right environment for this kind of research? 

A: Understanding how the brain works is incredibly complex, and solving these challenges requires expertise from many different fields. Neurologists, engineers, imaging specialists, computational neuroscientists, data scientists and many others all play an important role in developing new ways to diagnose and treat neurological disorders. 

One of Mayo Clinic's greatest strengths is that this kind of collaboration is part of how we work every day. Researchers and clinicians from different specialties work side by side, combining discoveries about how the brain functions with technologies that can measure and influence brain activity.  

Many institutions recognize the value of multidisciplinary research, but Mayo Clinic's integrated model makes collaboration especially seamless. Rather than working in separate silos, experts across departments are united by a shared goal of improving patient care.  

Q: How are new technologies, including noninvasive stimulation, advanced monitoring or computational modeling, being used or envisioned within BIONIC research? 

The BIONIC initiative is centered on advancing bioelectronic medicine, which uses technology to better understand, diagnose and treat disease. Traditionally, medicine has relied on medications and surgery, but bioelectronic medicine offers another way to care for patients by measuring and influencing the brain's electrical activity. 

In my research, we're using advanced brain monitoring tools, noninvasive brain stimulation and computational approaches with the goal of combining these technologies so we can develop more personalized treatments and, ultimately, help more patients become seizure-free with fewer side effects. 

Looking ahead, I'm especially excited about the role artificial intelligence (AI) can play. AI can help us bring together information from many different sources to better understand brain activity and guide more precise treatments.  

There are certainly challenges ahead, but I think the potential is extraordinary. By combining these new technologies with the collaborative environment fostered by BIONIC, we have an important opportunity to improve how we diagnose, monitor, and treat epilepsy and many other neurological disorders. 

The post How noninvasive brain stimulation could transform epilepsy care (VIDEO) appeared first on Mayo Clinic News Network.

Glioblastoma begins in glial cells, the brain's support cells. When these cells become cancerous, they can grow rapidly into surrounding tissue, damaging the healthy brain they were meant to protect. 

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:05) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script. 

"It tends to be a tumor that also tends to grow and invade the brain," says Dr. Alfredo Quinones-Hinojosa, Mayo Clinic neurosurgeon. "Sometimes it can be slow and steady, but it tends to grow very fast." 

Despite significant advances in surgery, chemotherapy, immunotherapy and radiation therapy, glioblastoma remains one of the most challenging cancers to treat. Long-term survival is uncommon. 

"The median survival of patients with the best therapies tends to be between 12 and 14 months," says Dr. Quinones-Hinojosa. 

Although there is no cure for glioblastoma, treatment can help slow tumor growth, manage symptoms and maintain quality of life. Ongoing research continues to advance understanding of the disease and create new possibilities for patients. 

"Research is crucial to finding hope and healing in every corner of our operating room, in every corner of our laboratory," says Dr. Quinones-Hinojosa. "We are connecting research and hope, ultimately, through our patients." 

The post Mayo Clinic Minute: Treatment and research of glioblastoma (VIDEO) appeared first on Mayo Clinic News Network.

World Brain Day is July 22

SCOTTSDALE, Ariz. — The same lifestyle choices that reduce your risk of heart disease, diabetes and cancer also can reduce your risk of cognitive decline. Bryan Woodruff, M.D., a cognitive neurologist at Mayo Clinic in Arizona, explains the brain-body connection, lifestyle changes to foster brain health and why work to make earlier detection of Alzheimer's disease and other dementias is important.

“What’s good for your overall health is good for your brain too,” Dr. Woodruff says.

You may have heard that Alzheimer’s disease is caused, in part, by the buildup of beta-amyloid plaques and twisted tau proteins in the brain. While true, other brain changes also are likely involved, Dr. Woodruff says.

“When scientists look at the brains of people with Alzheimer’s disease after they’ve died, they find more than just plaques and tangles,” he adds.

They often find a buildup of fats, cholesterol and other substances in the vessels that supply blood to the brain. They also discover evidence of microscopic strokes — also called microinfarctions.

Unlike major strokes with noticeable symptoms such as facial drooping, physical numbness, a severe headache and trouble speaking, microscopic strokes are silent. As more occur, they can starve brain tissue of oxygen and nutrition. If enough microvascular changes occur, there may be symptoms like slowed thinking and trouble concentrating.

“Your brain, as with every other organ in your body, depends on your cardiovascular system,” Dr. Woodruff says: This is why it’s so important to care for your heart and blood vessels.

Lifestyle choices help reduce risk

Thanks to this connection, what benefits your heart also protects your brain. To get these benefits:

• Manage heart disease risk factors. Treat elevated blood sugar, high blood pressure and undesirable cholesterol levels. Don’t use tobacco products. Keep your weight in the healthy range. “The earlier you address these, the better the benefit is for your brain,” Dr. Woodruff says.

• Follow a heart-healthy diet. The Mediterranean diet's emphasis on minimally processed whole foods and fruits and vegetables may improve brain health by helping to keep body fat and chronic inflammation in check. The Mayo Clinic Diet takes a similar approach to establishing a healthy-eating lifestyle.

• Get enough sleep. Research has linked insomnia to cognitive decline. And poor sleep can also increase your risk of other diseases that can impact cognition, such as high blood pressure and diabetes.

• Maintain social connections. Social connections are thought to benefit the brain in many ways. Research suggests that social engagement triggers the release of chemicals such as serotonin and dopamine, which improve mood and outlook. Social connections may help to spur the growth of new connections between nerve cells.

• Treat hearing and vision loss. If you can’t see and hear what’s going on around you, you’ll find it more difficult to communicate and remain social. “Those sensory functions are integral to how we think and interact with the world,” Dr. Woodruff says. “If you don’t see or hear it, then you can’t encode and remember it.”

• Avoid chronic use of sedating medications. Some medicines used to treat pain, insomnia and other conditions can dull thinking, slow reaction time and make you feel sleepy. If you’re not sure of the side effects of the medications you take regularly, talk with your healthcare professional, who can look at what is on your medication list and suggest alternatives, Dr. Woodruff advises.

• Exercise. Physical and mental exercise can benefit brain health. A large study found rates of cognitive decline were twice as common in sedentary people.

Keeping your mind active through activities you find enjoyable, particularly trying new things, can also exercise your brain. When you have difficulty learning something new, your brain builds new connections between nerve cells. If you continually learn new skills and information over time, experts believe that these networks of nerve cell connections create a cognitive reserve, sort of like savings in a bank account.

“Cognitive reserve doesn’t mean you’re immune,” Dr. Woodruff says. “But it buys you some cushion against a neurodegenerative problem.”

The importance of early detection

Dr. Woodruff is among Mayo Clinic researchers working to make earlier diagnosis of dementia and its precursor mild cognitive impairment possible, to allow for earlier treatment. This will be essential if therapeutic advances eventually make it possible to slow or even halt progression, he says.

It is never too late to make lifestyle changes to protect and improve brain health, he adds: “I tell all my patients, regardless of the severity of their cognitive decline, to take care of their overall health."

For more information about brain health, visit Mayo Clinic Press and the Mayo Clinic News Network.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Brain-body connection: Expert shares tips to reduce risk of cognitive decline, Alzheimer’s disease appeared first on Mayo Clinic News Network.

Despite treatment close to home, the Indiana teenager continued to experience relapses from myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), a rare autoimmune neurological disorder that can affect the brain, spinal cord and optic nerves. 

The disease disrupted school, affected his ability to walk and left his family worried about the future. 

"I just felt like we were one relapse away from permanent damage," says his mother, Jennifer. 

A diagnosis but not a solution 

At 10 years old, Brody's medical journey began in 2020 after a serious illness led to neurological symptoms and multiple hospitalizations. Months of testing eventually led his neurologist to order a specialized antibody test for myelin oligodendrocyte glycoprotein (MOG), a test developed by Mayo Clinic researchers. 

The result confirmed MOGAD, finally giving Brody's family an explanation for what he had been experiencing. 

The diagnosis brought answers, but managing the disease remained an ongoing challenge. 

Finding the right expertise 

As relapses continued, Jennifer wanted her son to see physicians whose careers were dedicated to treating patients with MOGAD. 

"Having somebody that knows about the disease versus somebody that's a specialist in the disease is two totally different things," she says. 

That search eventually brought the family to Mayo Clinic in Rochester, Minnesota, and to Dr. Eoin Flanagan, a neurologist specializing in autoimmune neurological disorders, including MOGAD. 

Mayo Clinic has helped shape the understanding of MOGAD through research, diagnostics and specialized care. Its contributions include launching the world's first multidisciplinary MOGAD clinic, which provides specialized care across Mayo Clinic's campuses in Rochester, Florida and Arizona. Mayo researchers also helped establish international diagnostic criteria that defined MOGAD as a distinct disease and have evaluated hundreds of patients with MOGAD, helping physicians and researchers better understand the disease and its long-term impact. 

Before Brody's first appointment, Mayo Clinic physicians had already reviewed years of his medical records, imaging studies and treatment history. 

"I was amazed at how thoughtful everybody at Mayo Clinic was," Brody says. "You weren't just another patient. They made you feel like you were their priority." 

Patients benefit from Mayo Clinic's team-based approach, which brings together specialists in neurology, neuro-ophthalmology, neuroradiology, rehabilitation medicine, neuropsychology, urology, pharmacy and laboratory medicine across Mayo Clinic's campuses in Rochester, Florida and Arizona. 

"We like to work as a team," Dr. Flanagan says. "Many heads are better than one, and a team approach really gets you further ahead than you do on your own." 

Among the opportunities available was a clinical trial for patients living with MOGAD, reflecting Mayo Clinic's ongoing efforts to advance research into the disease. Brody chose to participate. The trial is evaluating satralizumab, an investigational treatment that targets a specific immune pathway involved in inflammation. Researchers are continuing to evaluate its potential role in treating MOGAD. 

Helping others navigate MOGAD  

In 2025, Brody attended MOGAD Patient Day, the first event of its kind hosted by Mayo Clinic. Led by Mayo Clinic physicians and researchers, the gathering brought together patients, families and experts from across the country to learn more about the disease and connect with others facing similar challenges.  

By that point, Brody had spent years navigating MOGAD. At Patient Day, he found himself in a different role, helping other families who were just beginning their journeys. 

He even participated in a patient panel discussion, answering questions and sharing his experiences. 

Looking ahead 

Today, Brody is preparing for his junior year of high school. He's looking forward to earning his driver's license, spending time with friends and planning for the future. 

If he could offer advice to another young person facing a rare disease, it would be simple. 

"Keep an open mind," he says. "There are always other options. Listen to your doctors, but advocate for yourself too." 

Dr. Flanagan hopes stories like Brody's remind families that progress continues to be made for patients with complex neurological diseases. 

"There is a lot of hope," Dr. Flanagan says. "We can make diagnoses that we couldn't make many years ago, and with clinical trials of multiple novel targeted treatments underway, the future is really bright for those with MOGAD." 

The post Following years of relapses, family turns to Mayo Clinic for MOGAD expertise  appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers have created a detailed map of the pulvinar, a deep brain region that could help doctors more precisely target brain stimulation therapies for people with drug-resistant epilepsy.

The findings, published in the Journal of Neuroscience, reveal that brain regions separated by only a few millimeters connect to entirely different brain networks. The discovery provides a blueprint for placing electrodes more precisely during deep brain stimulation, an emerging treatment for epilepsy.

The researchers studied people with drug-resistant epilepsy who already had temporary electrodes implanted as part of their clinical care. By delivering small electrical pulses to different parts of the pulvinar and measuring the brain's responses, the team created a map showing how this largely unexplored region communicates with the rest of the brain.

The pulvinar is part of the thalamus, a deep brain structure that relays and coordinates information from sight, sound, touch and other senses. Because it lies deep within the brain, scientists have had limited opportunities to study how its different regions connect to other brain networks.

"We were surprised by how large, detailed and complex this deep brain structure is, and by its potential role in guiding epilepsy treatments," says Dora Hermes Miller, Ph.D., a biomedical engineer at Mayo Clinic and senior author of the study.

The findings have immediate relevance for clinical care and build upon ongoing research to develop personalized treatment for people with drug-resistant epilepsy. "We are already using the pulvinar maps to help individualize pulvinar deep brain stimulation targeting in patients with drug-resistant epilepsy, while continuing to study how these maps relate to long-term outcomes," says co-author Nick Gregg, M.D., a neurologist at Mayo Clinic.

Why researchers studied the pulvinar

Researchers recognized the pulvinar's therapeutic potential when they were caring for patients with drug-resistant epilepsy. As part of their clinical care, patients had electrodes placed in several brain regions, including the pulvinar, to evaluate whether stimulation could reduce seizures.

"When we stimulated the pulvinar, we expected to see the same brain networks respond each time," Dr. Hermes says. "Instead, some patients showed activation of visual brain areas while others didn't. That unexpected finding led us to ask why."

By studying 30 patients, the researchers discovered that the pulvinar is not a single, uniform structure. Instead, it contains specialized regions connected to different brain networks involved in vision, memory, language and attention.

The distances between these pulvinar subregions were remarkably small. Brain regions separated by as little as 3 millimeters connected to completely different brain networks.

"That level of detail means that if neurologists want to suppress the seizures coming from those areas, they have to place electrodes in the precise right spot. And these findings provide a guide towards that spot," Dr. Hermes says.

What the study means for personalized epilepsy treatments

Epilepsy affects more than 50 million people worldwide. About one-third continue to have seizures despite medication. For many of these patients, neuromodulation — a treatment that uses electrical stimulation to regulate brain activity — can help reduce seizures.

"These findings provide data that enables exploration of tailoring neuromodulation therapies in a more personalized way, targeting each patient's specific epilepsy networks," says Gregory Worrell, M.D., Ph.D., a study co-author and neurologist at Mayo Clinic.

Researchers are now investigating which parts of the pulvinar should be stimulated — and at what frequencies — to better control seizures while minimizing side effects.

"Our aim is to make therapy more precise, more consistent and ultimately more effective," Dr. Gregg says.

The study highlights the collaborative mission of Mayo Clinic's Bioelectronic Neuromodulation Innovation to Cure (BIONIC) initiative, which unites clinicians, scientists and engineers to translate advances in brain science into personalized neuromodulation therapies.

For a complete list of authors, disclosures and funding, review the study.

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Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

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