How Is Our Prefrontal Cortex Faring in this Toxic Era?

Arnold R. Eiser, MD, MACP
Arnold R. Eiser, MD, MACP
10 Min Read

Eiser is an expert in environmental toxicology.

In the postmodern age, the assaults on our prefrontal cortices abound. From the continued influence of violent digital media to environmental neurotoxins to stress and diet, the offenses proliferate. Here I will review the factors wreaking havoc on this essential component of higher thinking, and encourage the creation of a less toxic future.

The Prefrontal Cortex and the Postmodern Stress Disorder

In a medical journal article several years ago, I described the post-modern stress disorder (PMSD) as distinct from the better known post-traumatic stress disorder (PTSD). In both disorders the prefrontal cortex (PFC) — the brain component that inhibits compulsive behavior, maintains civility, and makes complex plans — is fundamentally damaged, while the amygdala — the brain component responsible for fearful anger responses — is heightened. In the PMSD the confluence of repetitive violent digital media experience through violent video games, violent cinema, and other media instill brain dysfunction involving the PFC and amygdala such that when connected with a perceived slight may result in a violent act or other anti-social behavior such as substance abuse. Some of those violent acts are mass shootings, but many more are more personal acts of violence, including suicide and intimate partner violence.

A Legal System Not Protecting

The confluence of capitalism, politics, and the American legal system assures that little will change significantly on this front. The seminal Supreme Court decision in 2011 concerned a California law that prohibited the sale or rental of violent video games to minors without parental consent. They struck down the law in a 7-2 vote with justices Ruth Bader Ginsburg, Sonia Sotomayor, and Elena Kagan joining the Republican majority. Only justices Clarence Thomas and Stephen Breyer dissented from voiding this legislation that had been signed into law by then-governor Arnold Schwarzenegger (R.-Calif.). Ironically the “Terminator” himself understood the importance of such a restriction, while Supreme Court justices of both parties only managed to show their obeisance to an ancient writ.

So, if U.S. laws are not going to protect the youth of America, could a cultural change help? People in authority are so uncomfortable with this connection that they avoid discussing it at all costs. We read and hear of the negative consequences of this denial every single day.

Gaming Disorder and a Positive Note

The American Psychiatric Association recognized an Internet Gaming Disorder in their DSM5-TR. It is considered an addiction disorder that is desensitizing in its effect.

On a positive note, non-violent video games actually have a salutary impact on brain health, as do non-violent exercise (sans CTE [chronic traumatic encephalopathy]), forest walks, non-violent music, art, religious services, and volunteer and communal activities. Who is going to guide today’s youth in the proper direction in these matters?

Environmental Neurotoxins and the PFC

As the years progressed, I began studying and researching the impact of environmental neurotoxins and diet on brain health — this had relevance for adversely impacting the PFC. The best known neurotoxicant is lead, which has done much damage to youth in America and elsewhere. It damages cognitive function in many ways, including damage to the PFC, therefore reducing the ability to pay attention, make complex decisions, and comport oneself properly. The impact of this neurological damage may last a lifetime.

Arsenic, which is found in drinking water in several parts of the country and in certain foods and beverages, may also negatively impact the PFC, as supported by animal studies. Low-dose mixtures of lead, mercury, and cadmium have been shown experimentally to negatively impact the PFC. The neuronal damage is through an increase in oxidative stress, excitatory damage to neurons, and activation of neuroglial cells that are designed to protect against infection but can be turned against the brain when activated by toxicants.

Pesticides and Herbicides

Toxic metals aren’t the only neurotoxicants out there. A study of farm workers found organophosphate insecticides reduce prefrontal activity by use of functional near-infrared spectroscopy. These agents, like chlorpyrifos, were commonly used on crops until a ban was issued by the Environmental Protection Agency (EPA) in the summer of 2021. Glyphosate, the commonly used herbicide, also displays neurotoxic aspects in rodent studies, promoting behavioral and cognitive impairment and impacting the PFC. Human epidemiological studies have shown a relationship to autism. One might be safer to stick to organic foods.

Looming large among neurotoxicants are the endocrine-disrupting chemicals in the PFAS and phthalate family. Experimental studies have shown that phthalates reduce the number of neurons and synapses in the PFC of rats, and decrease their ability to adapt.

Stress Itself Harms

Besides toxins, excessive stress appears to impair PFC functioning. Excessive noradrenaline or dopamine impair its activity. Good thing we don’t have any excessive stress these days!

Certainly, electronic overload of various types, as well as economic stressors, can be contributory. Out of a population ages 12 or over (about 270 million), 169 million consume some alcohol, illicit drugs, or tobacco, while nearly 49 million have a substance abuse disorder. How much of this consumption is borne out of the stress of living in the 21st century? Alcohol consumption, which is found in virtually all cultures across the world, has notable impact on the PFC.

Intoxicants Are Toxic Too

Both animal and human studies document decreased PFC activity from the acute and chronic effects of alcohol — this may account in part for the increase in reprehensible conduct when under the influence. Methamphetamine is highly toxic to the PFC — it’s accompanied by inflammation and neuronal death as well as damage to other parts of the brain. Addiction to this chemical results in a serious brain affliction.

Contemplating Social Ills, the EPA, and Diet

The next time you are contemplating American social ills, you may reflect on all of the many assaults on the PFC and their impact on our patients’ and society’s well-being. Certainly efforts to reduce the many toxicants out there would be helpful. The need for a robust and effective EPA has never been greater. Better mental health care, including preventive measures, would also be an improvement.

Diet too plays a huge role as well, for many obscure micronutrients not abundant in the Western diet are needed to defend the brain against toxicants. These include vitamins and trace amounts of zinc and selenium, two essential metals that are components of protective enzymes. Yet, even these metals can become toxic if present in too large an amount.

Strengthening the PFC

Much can be done to strengthen our individual and hence our collective PFC, and thus create a more responsible and effective future. Let’s begin addressing the important risk factors I’ve identified, and help improve the health and well-being of human society.

A less toxic future would be a saner choice. Physicians and scientists have to raise awareness of these negative influences among their colleagues and the public at large. Political leaders need to consult physicians and scientists more often and with greater understanding of these immense influences on brain health.

Arnold R. Eiser, MD, MACP, is an adjunct member of the Center for Excellence in Environmental Toxicology and a senior scholar at the Penn Center for Public Health at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. He is the author of Preserving Brain Health in a Toxic Age: New Insights from Neuroscience, Integrative Medicine, and Public Health.

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