Evidence-based articles written by a neurologist
Stress is not only an emotion. It is a psychological and physiological response that occurs when the brain and body perceive a situation as difficult or threatening.
Feeling briefly dizzy with a faster heartbeat after standing may reflect the body's response to a change in posture, but dehydration, anemia, medications, poor sleep, and abnormal heart rhythms may cause similar symptoms.
Palpitations, dizziness, and indigestion may occur together because autonomic pathways influence cardiovascular and digestive function—but symptoms alone are not enough to diagnose an autonomic disorder.
What the evidence says about diet, omega-3s, vitamin B12, B vitamins, vitamin D, iron, thiamine, choline, and the limits of supplement claims.
Memory changes do not always mean dementia. Learn the differences among normal aging, subjective cognitive decline, mild cognitive impairment, and dementia—and when to seek care.
Learn how the autonomic nervous system helps regulate heart rate, blood pressure, digestion, body temperature and sweating, pupil responses, and bladder function.
Brain fog is not a formal diagnosis. Learn how sleep, stress, mood, long COVID, menopause, medications, and other factors may contribute—and when symptoms need medical care.
Difficulty concentrating is not always a dopamine problem. Learn how sleep, stress, smartphones, mood, pain, medications, and adult ADHD can affect focus—and when to seek care.
Sleep loss produces same-day sleepiness and impaired attention, and repeated sleep restriction can affect memory formation and executive function. A synthesis of the current evidence.
Elevated homocysteine is an independent, measurable risk factor for cognitive decline and brain atrophy. This article reviews the VITACOG trial evidence for targeted B vitamin supplementation.
The Lancet Commission estimated that 12 modifiable risk factors account for approximately 40% of dementia cases worldwide. This article examines seven of the most clinically actionable factors.
The clinical presentation of Alzheimer's disease is the endpoint of a process that begins silently, one to two decades before the first symptom. This article examines that preclinical trajectory.
Omega-3 fatty acids have one of the most extensive evidence bases in nutritional medicine, but molecular form determines whether EPA and DHA actually reach target tissues. This article compares three delivery forms.
Phosphatidylserine is among the few non-pharmaceutical compounds with FDA-recognized qualified health claim language regarding cognitive function. This article examines its rationale and trial evidence.
The autonomic nervous system governs involuntary processes essential to homeostasis. This article provides a clinical framework for recognizing dysautonomia and its evidence-based management.
Brain fog reflects measurable dysfunction across interconnected neural systems rather than a purely psychological state. This article examines four neurobiological mechanisms and relevant nutrients.
Progressive increases in levodopa dosing are often mistaken for pharmacological tolerance. This article clarifies the three biological mechanisms actually responsible for rising dose requirements.
Atypical parkinsonian syndromes account for 15-25% of parkinsonism cases in specialist clinics. This article provides a framework for differentiating them from Parkinson's disease.
Despite five decades as the most effective Parkinson's treatment, levodopa remains subject to persistent misconceptions. This article addresses common myths and reviews the evidence on treatment timing.
This article provides an evidence-based framework for the genetic architecture of Parkinson's disease — prevalence of monogenic forms, key genes, incomplete penetrance, and testing indications.
Parkinsonism describes a clinical syndrome that includes Parkinson's disease alongside a heterogeneous group of mimicking conditions. This article reviews four major non-PD categories and their features.
Gastrointestinal symptoms in Parkinson's disease reflect pathological involvement of the enteric nervous system, a network of roughly 500 million neurons vulnerable to alpha-synuclein pathology.
In early Parkinson's disease, the nigrostriatal system buffers levodopa doses, producing a stable therapeutic response. This article explains how and why this changes with long-term treatment.
Parkinson's disease imposes one of the highest caregiver burdens among chronic neurological conditions, correlating more strongly with non-motor symptoms than motor severity.
Glutathione is an antioxidant tripeptide synthesized intracellularly, functioning as a free radical scavenger and detoxification cofactor relevant to Parkinson's disease pathophysiology.
REM sleep behavior disorder disrupts the brainstem circuit that normally prevents the body from acting out dreams. This article examines its neurological mechanisms and link to Parkinson's disease.
Structured exercise functions as a neurobiologically active intervention in Parkinson's disease, not merely an adjunct wellness activity. This article reviews its mechanisms and evidence base.
Pain affects 40-85% of individuals with Parkinson's disease yet remains underrecognized relative to motor symptoms. This article reviews its neurobiological basis and management strategies.
Parkinson's disease pharmacological management has evolved since levodopa's introduction in the 1960s. This article reviews the principal drug classes and the evidence informing prescribing decisions.
Parkinson's disease involves selective degeneration of dopaminergic neurons in the substantia nigra. This article examines alpha-synuclein aggregation and neuroinflammation in disease progression.
Parkinson's disease is widely recognized by tremor, bradykinesia, and rigidity, but non-motor prodromal symptoms may precede motor onset by a decade or more. This article examines five early signs.
Postherpetic neuralgia — persistent neuropathic pain after herpes zoster — affects 10-15% of patients overall, up to 40% in those over 60. This article examines the neuroplastic mechanisms behind its chronicity.
Vitamin B12 is indispensable for myelin synthesis and axonal maintenance. This article examines B12's neurological roles, deficiency consequences, and the difference between its two supplemental forms.
Alpha-lipoic acid is both a mitochondrial cofactor and antioxidant relevant to peripheral nerve dysfunction. This article reviews its biochemical rationale and key clinical data.
Nerve symptoms that worsen at night reflect the intersection of circadian biology, attentional pain modulation, and postural changes in peripheral blood flow — not a psychological pattern.
Specific dietary patterns and food constituents exert measurable effects on peripheral nerve biology. This article reviews dietary risk factors and neuroprotective constituents relevant to nerve health.
Peripheral neuropathy arises from damage or dysfunction of the nerves outside the brain and spinal cord. This article reviews the pathophysiology, symptoms, causes, and nutritional considerations.
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