Whether you’re concentrating on your golf swing, enjoying a cup of coffee or daydreaming about a favorite vacation spot, your brain is hard at work, timing everything to the milliseconds, to make the experience a smooth narrative and register the important bullet points in your memory banks. And it does this seamlessly throughout different stages of life, as we create our signature thoughts, stylistic movements, and degrees of athletic performance. The key components here are timing and energy management.

As a neurosurgeon, I have come across many miraculous stories of patients recovering from insults to the brain or spine. Recovery is always challenging, and regaining control and function even from the most seemingly minor injury, such as a bulging disc, requires diligent rehabilitation, incredible patience, and optimal mental focus. Our nervous system’s ability to energize and direct our body into action or stillness is a key ingredient in this healing process. Our brain’s ability to modulate and manage this narrative can enhance (or sabotage) our recovery, everyday performance, relationships, and ultimately, life experience.

I have personally seen successful outcomes from brain or spine surgeries, depending as much on each patient’s nervous system’s ability to heal as on the precision and technical proficiency of the surgeon. I have also witnessed neurologic devastation in the setting of irreversible trauma, tumor or dementia. As the individual expression of “self” unravels from within, our nervous system loses its grip and directional ‘timing’ on this narrative.
 

In the very near future, increased cognitive reserve through therapeutic stimulation and immersive VR assisted mindful practices will enhance brain performance including memory, reasoning, and even processing speed as we age.

The brain, our unique window to the world, is finally giving up some of its longest held secrets, the map of its networks which control our thoughts and time our actions, as well as our energy expenditure which is specifically targeted in conditions such as chronic stress and trauma. Repair mechanisms within our nervous system which decay with chronic insults are being elucidated, including inflammatory signaling between the gut, the hormonal balance, and the supporting brain cells called the glia. The brain processes information at incredible speeds (1016 Hz. processing power), filtering energy delivered by the bloodstream and other “cognitive” means to produce the cohesive narrative we call reality with impeccable timing, all while spending less than the voltage of an extremely weak light bulb and weighing only around 3 pounds! We are enthralled that we can finally look deeper at our internal map and devote some effort to the health of this marvelous organ. But the brain is not just another organ, you may say; its structure evolves and grows to become the literal and unique expression of OURSELVES, and so brain health is not simply akin to hearth health or kidney health! And you would be correct. But unless we can gain better insight into the physiologic and molecular workings of a healthy brain, we will not be able to gain perspective on this complex timing and energy expense to optimize its performance. A few discoveries on the horizon that make our understanding of the inner workings of the brain much deeper are:
 

1. Precise sequencing of circulating miRNA levels in the bloodstream
2. Hormonal and other physiological influences of the gut microbiome on brain inflammation and even emotions
3. Cognitive training and enhancement using immersive technology and meditation

Major epidemics that concern brain health are already impacting every one of us: Post-traumatic stress, depression, addiction, and dementia are plaguing our society increasingly. These unique conditions target the brain specifically, leading to perceptual abnormalities and cognitive and memory impairment. Since reasoning can also be impaired, there is a significant loss of hope associated with these conditions which leads to additional stress and ultimately depression. One in six Americans above 65 years of age will be afflicted by AD by 2020. One in five veterans suffers from Post Traumatic Stress Disorder and this may be under-reported. Epidemiology of non-combatant traumatic brain injury is also staggering, with one death every five minutes attributed to brain trauma.

It took almost 100 years for us to be con­vinced of the value of exercise physiology and physical fitness. Hopefully it won’t take another century to see the value of cognitive fitness. In the hyperconnected world of the internet of all things, the most critical paradigm shift will be in the way we recondition our brains to adapt (and evolve). Optimal brain function in the modern world requires a balanced nutrition and exercise program but also a dedicated restorative practice in a sustained habitual way. Many people are conditioned to use harmful chemicals or other stimuli to gain relaxation and increase their social connection. In fact, use of chemical means of enhancing or deepening the conscious experience and connection is a pervasive and ancient practice, but it may cause more harm than good as evidenced by the social epidemic of drugs and alcohol abuse. Through immersive cognitive training with better technology as well as deep meditative experiences, we will be able to overcome long-term effects of trauma or ‘suboptimal’ or harmful cognitive conditioning.

Reaching deeper levels of conscious experience is possible by making the cognitive exercises part of our daily habits, making us more purposeful and connected while expanding the possibilities within the hidden abilities of the nervous system. These types of exercises can help us feel happier and more connected. Of course, this is a skill that needs practice just like any form of physical exercise. Indeed there are direct neural stimulation methods that are targeting athletes to enhance their exercises reward by Neural Priming through direct electrical stimulation, a technique called tCDS. Just like sleep hygiene is so important to our health and overall body function, neural priming and restorative practices can increase our ability to reach beyond our immediate limits and preconditioning. Exploring these deeper connections has traditionally been the realm of religion and spirituality. Real-time neuroscience is, however, closing in fast as the only measurable way we can reproduce and sustain our results and remain free of the past dogma, diving even deeper into the universe of possibilities.

Different practices of mindfulness meditation, breathing methods, immersive VR, AR, and even direct electrical and magnetic stimulation are undergoing rigorous testing and fine tuning. Indeed many physicians—such as myself and others at a few major universities such as UCSF, UCLA, and USC—have created brain mapping and treatment centers using a variety of immersion and stimulation methods.
 

I believe the future of neurosurgery will be transformative and through innovative neuroscientific research into the realm of cognitive immersion, we will overcome the societal epidemics that are plaguing humanity.

In the very near future, increased cognitive reserve through therapeutic stimulation and immersive VR or AR assisted mindful practices will enhance brain performance including memory, reasoning, and even processing speed as we age. To create a balanced lifestyle around this concept, we need the right amount of cognitive immersion and stimulation. The speed at which we process information has changed drastically through technology, and this causes stress leading to cognitive fatigue. Indeed our physiological coping mechanisms (the hormones required for the fight or flight response) and our ‘cognitive reserve’ will continue to be challenged by the exponential rise in computational processing and artificial intelligence. Curation of mental and emotional stimuli through the explosion of neuro-technology will allow us to pierce better into the elusive nature of our brains and nervous system as a whole. In a way the same technology that has caused our “brain problems” has also brought complex diagnostic and therapeutic tools for brain health at the consumer level. I believe the future of neurosurgery will be transformative and through innovative neuroscientific research into the realm of cognitive immersion, we will overcome the societal epidemics that are plaguing humanity.