The essay I published last Saturday titled, “Errors, Oversights, and the Profit Motive: The Frustrating Evolution of Alzheimer’s Research,” ignited an energetic and fascinating discussion in the Alzheimer’s Reddit community. Anytime Alzheimer’s patients and caregivers discuss lecanemab and donanemab there will be differences of opinion.
Just as Alzheimer’s affects patients differently, so do the two monoclonal antibody drugs. Lecanemab and donanemab are controversial Alzheimer’s therapies. During the discussion, someone (u/AntiqAndroi7) commented to me, “What you have been doing is one of the best ways to slow down the progress. It works in many patients that I've worked with. Better than any drugs or treatments.” The Redditor was referring to my advocacy, research, and writing. The comment included this famous quote: "keep the neurons sparking, that keeps the plaques from accumulating".
The quote is famously delivered by Chloë Grace Moretz's character, Flynne Fisher, in the sci-fi television series The Peripheral. In the show, she uses this phrase to describe how keeping her mother's brain active helps fight off the progression of her Alzheimer's disease.
Something about the quote seemed off or incorrect to me. As someone who studies the brain and Alzheimer’s with zero medical training, I could easily be confused. Or, my Alzheimer’s brain could be messing with me. I decided to dig a bit and see if the quote is neurologically correct.
In the May 1, 2011 edition of Nature Neuroscience, there is an article titled “Neuronal activity regulates the regional vulnerability to amyloid-β deposition". This article points out that in a healthy brain, mental stimulation does clear plaques, but the physiological act of neurons "sparking" actually increases the production of the raw material that makes those plaques. I suppose the Flynne Fisher quote is actually a paradox.
The science behind this complex relationship breaks down into three key mechanics:
1. The Paradox of the “Spark”: Activity Drives Production
When neurons fire (or "spark"), they communicate across synapses. This synaptic activity naturally triggers the release of amyloid-beta (Aβ) peptides into the surrounding interstitial fluid.
Research has demonstrated that hyperactive brain regions like the default mode network (DMN), which is highly active during idle thought, accumulate the highest concentrations of amyloid plaques over time. This process can happen years before an Alzheimer’s diagnosis.
Conversely, studies blocking sensory input drastically reduce the formation of plaques in that area.
2. The Power of “Sparking”: Cognitive Reserve and Glial Cleanup
If neuronal activity creates the building blocks of plaques, why do doctors recommend puzzle-solving, learning, and mental engagement? The answer lies in how the brain clears waste and builds resilience:
Upregulating Microglia and Astrocytes: Mental engagement increases blood flow and metabolic demands in the brain. This activates support cells like astrocytes and microglia, which act as the brain’s internal cleanup crew, physically engulfing and destroying toxic amyloid aggregates before they can clump into rigid plaques.
Cognitive Reserve: While keeping the brain active might not entirely halt the accumulation of plaques, it builds denser neural networks. This “cognitive reserve” allows a patient to maintain normal cognitive function and keep processing thoughts smoothly even if some plaque accumulation is present.
3. The Ultimate Neural Wave: Gamma Entrainment
In recent years, neuroscientists have discovered that a specific kind of unified “sparking”, specifically gamma frequency brain waves (40 Hz) - is incredibly powerful at clearing plaques.
When large networks of neurons sync up and pulse together at 40 Hz (which can be triggered naturally through intense cognitive tasks, or artificially using specialized light and sound stimulation), it acts like a physical pump for the brain’s waste system.
This rhythmic firing dramatically recruits microglia to clear out existing amyloid plaques and improves the brain’s glymphatic clearance system, flushing the toxins out of the brain tissue.
I appreciate u/AntiqAndroi7 encouraging me to keep up the hard work. I spend between four and six hours every day studying and writing. I bet the combination of mental engagement, walking at least a mile every day, and eating salmon frequently will keep my own plaques at bay. And that daily mental engagement is precisely why I pour myself into this keyboard, even as navigating the financial realities of this disease becomes a distinct uphill battle.
The Financial Realities
I absolutely despise asking for financial help. I much prefer to roll up my sleeves and create something of value that customers purchase. That is what I did my entire life as an entrepreneur.
Unfortunately, my Alzheimer’s disease limits the work I can do now. Surprisingly, the work I can do is using my brain to conduct scientific research and write.
For as long as I have been writing this blog, I have not been able to successfully monetize it. It certainly is not for a lack of trying!
Linda and I kicked around a few ideas over the weekend. We continue to believe $5/month is a fair price for the value the blog delivers. If we add a paid option, there has to be an added benefit. Of course, the basic blog will always be free. We have not settled on the extra benefit for paid subscribers. Maybe, Big Bit and I can produce a storytelling video each month. We can discuss salmon recipes, favorite cat treats, and ice cream reviews.
The easier path forward is voluntary donations. There are several subscribers who donate generously once per year as opposed to a monthly $5 donation. Stripe is set up for recurring monthly donations.
I know the economy is in the toilet for most Americans. Groceries, fuel, and ice cream prices have skyrocketed since the Iran War began. If you can, please donate a minimum of $5/month to support my writing.
Linda, the cats (Big Bit, Lola, and Bella), and I appreciate any support you can provide.
Thank you.