Page 13 - The Memory Program How to Prevent Memory Loss and Enhance Memory Power

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insistent that his lapses had begun abruptly. I put him through a battery of tests, which included a
complete medical, neurological, and psychiatric evaluation, several blood tests to look for nutritional
and hormonal causes of memory loss, an MRI (magnetic resonance imaging) scan to evaluate brain
structure, and a SPECT (single photon emission computerized tomography) scan to assess blood
flow in different brain regions. This extensive workup revealed an abnormality on the SPECT scan: a
small decrease in blood flow in the left temporal lobe, the critical region that includes the
hippocampus, the main seat of memory in the brain. Detailed neuropsychological testing, which
involved a variety of paper and pencil tests, confirmed a deficit in memory for names. Otherwise, his
memory and intellectual performance were in the normal range.

A history of an abrupt onset of memory loss often points to a stroke that is caused by decreased
blood supply. The neuropsychological test results and SPECT findings seemed to confirm this
possibility. I concluded that a localized deficit in blood flow, probably a “ministroke” had affected a
small part of the temporal lobe that controls memory for names. A ministroke means that the cutoff
in blood supply affects such a small portion of brain tissue that usually no symptoms are reported
when the stroke occurs, as was the case with David Finestone. Only later had he begun to notice
memory loss. The radiologist had read his MRI scan as normal, but MRI technology was not, and
still is not, capable of picking up very small strokes less than 2 mm (one-tenth of an inch) in size.
While I couldn't absolutely rule out very early Alzheimer's disease— a condition in which memory
deficits are widespread and not restricted to forgetting names— this diagnosis seemed very unlikely. I
discussed the results in detail with David, and told him that he was lucky he hadn't yet had a clinical
stroke, the cause of his father's untimely death. I reassured him that there was a high probability his
symptom could indeed be prevented from worsening, if not fully reversed. He let out an audible sigh
of relief and listened carefully to my advice.

I suggested that he change his lifestyle, both for general health reasons and to prevent the risk of
stroke and further memory loss. He followed through on my instruction to decrease the intake of
saturated fats in his diet, which in his case included red meat and milk products, especially pizza,
which he had two to three times a week. He started eating more fresh fruit and green vegetables, and
began a regular exercise regimen. He also acted on my recommendation to take an aspirin a day to
reduce the risk of future strokes, and 800 units daily of vitamin E for its antioxidant properties,
which can delay both