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When Presidential Brains Go Awry: Neuro Disorders In The Oval Office

Ronald Reagan’s family is still arguing about whether he had signs of Alzheimer’s during his time in the Oval Office. Here's the official portrait of the Reagans on the White House grounds in 1988. (Wikimedia Commons)

Ronald Reagan’s family is still arguing about whether he had signs of Alzheimer’s during his time in the Oval Office. Here’s the official portrait of the Reagans on the White House grounds in 1988. (Wikimedia Commons)

By Richard Knox

Thomas Jefferson probably suffered from migraines. Woodrow Wilson had a devastating stroke while in office. FDR was known to have seizure-like blank-outs. And Ronald Reagan’s own family is still arguing about whether he had signs of Alzheimer’s during his time in the Oval Office.

The health of presidents is a perennially intriguing subject. But this Presidents Day weekend, a New York neurologist is focusing new attention on the presidential disorders that arguably matter most: those of the brain and central nervous system.

“Do we really know about the health status of our leaders and should we?” asks Dr. Nicholas Silvestri. “I think in the case of neurologic illness, we should.”

Dr. Nicholas J. Silvestri

Dr. Nicholas J. Silvestri (Sandra Kicman, University at Buffalo)

Silvestri, a history buff on the faculty of the University at Buffalo School of Medicine and Biomedical Sciences, thinks commanders-in-chief ought to undergo neuropsychological testing just as regular recruits do.

And he wonders if the 48-year-old 25th Amendment, which provides for presidential succession if a president becomes unfit to govern, is really suited to determine cognitive or mental fitness. That’s a touchy matter the Constitution currently leaves entirely in political hands.

Now, of course, too rigorous a screen could deprive the nation of a truly great (if mentally flawed) president. Abraham Lincoln, for example, famously suffered from depression.

We’ll come back to the issue of how presidential brain unfitness should be determined. But first, let’s take a journey through the surprising twists and turns of the neurological history of U.S. presidents, guided by Silvestri. He pulled that history together for a Lincoln’s Birthday seminar in Buffalo, and described its high points in an interview.

Migraine, Seizures, Strokes

First stop: migraine headache. It’s a common ailment that doesn’t disqualify anyone from a highly responsible job. But still, migraines are “an extremely debilitating collection of neurological symptoms,” as the Migraine Research Foundation puts it — possibly a matter of concern in a president who needs to function at the top of his game during a crisis.

Silvestri says there’s evidence that John Adams, Jefferson, Lincoln, Dwight Eisenhower and John F. Kennedy suffered from migraines.

James Madison and FDR probably had seizure disorders, Silvestri says. From his college years, Madison was known to have spells that temporarily paralyzed him. “He would stare off, become immobile, and not react to his surroundings,” Silvestri says. It may be a reason Madison didn’t fight in the Revolution.

Silvestri thinks Madison’s spells were probably psychogenic seizures — a reaction to stress. “It’s what Freud describes as hysteria,” he says.

Whatever it was, Madison evidently grew out of it. The disorder didn’t prevent him from coauthoring the Constitution or the Federalist Papers, nor hinder him as president. “He was the last president to lead a field army in battle, during the War of 1812,” Silvestri notes.

FDR Didn’t Have Polio? 

FDR probably didn’t suffer from polio -- the disease he has long been associated with. Instead, many researchers think the evidence points to a different cause of FDR’s paralysis -- a rarer disease called Guillain-Barre syndrome. Here he is in 1943. (George R. Skadding/AP)

FDR probably didn’t suffer from polio — the disease he has long been associated with. Instead, many researchers think the evidence points to a different cause of FDR’s paralysis — a rarer disease called Guillain-Barre syndrome. Here he is in 1943. (George R. Skadding/AP)

FDR’s health problems are well known. They include the polio he supposedly suffered at the age of 39, his subsequent lifelong leg paralysis, and the soaring blood pressure that led to a fatal brain bleed two months after the Yalta Conference that carved up post-war Europe.

Less known are the seizures he had throughout his presidency. Continue reading

The Migraine-Body Clock Connection: New Genetic Clues

migraine

Wikimedia Commons

If you’re one of the 36 million Americans who suffer from migraine headaches, you probably already know that if your sleep routine is thrown off, you’re asking for head-whanging trouble.

New research suggests that the migraine-sleep connection goes far deeper than that, and revolves around the brain’s hypothalamus, which helps control our body clocks among other functions.

The Dana Foundation, which supports brain research, has just posted an intriguing scientific yarn about how insights gained from a family of extreme “morning larks” — as in, up at 4:30 every morning, asleep by 7:30 at night — may help point to a better understanding of migraine that could lead to better treatments. Read the full story here. The crux:

The spark of insight that brought the two fields together occurred recently when migraine researcher Robert Shapiro realized that his patient, who was seeing him for migraine with aura, was a member of an extended Vermont family of extreme morning larks. Continue reading

Exploring The Link Between Exercise And Migraine

By Judy Foreman
Guest Contributor

A few weeks ago, on an otherwise uneventful Sunday afternoon, I got an urgent call on my cell phone from my daughter-in-law, Robin, a vigorous 42-year-old. She was calling from her health club, barely “10 minutes into a decent run” on the treadmill

Suddenly, she told me, she had gotten a “hole” in her vision in her right eye, and zig-zaggy lines like lightening when she closed her eye, a predictable sign, she knew from past experience, that a migraine headache was about to start.

(miss_rogue/flickr)

(miss_rogue/flickr)

An exercise-induced migraine was not a total surprise for Robin, who has had about a dozen such episodes over the years. “It does make me scared to exercise for a few days,” she told me later. “But then I just get on with my life. I only get four or five migraines a year, so it’s not as scary for me as for some people.”

For years, exercise has been believed to be a significant “trigger” for migraines, along with other triggers, or premonitory symptoms, such as food cravings, being very tired, mood changes, increased urges to urinate, muscle aches, stuffy noses – all part of what Dr. Carolyn Bernstein, a neurologist and migraine specialist at Beth Israel Deaconess Medical Center calls the “build up of what’s changing in the brain before migraine pain gets going.”

But in a recent study in the journal Neurology, researchers explored the exercise-migraine link in a novel way. Continue reading