Last week, I was delighted to attend TEDMED in Palm Springs, CA. TEDMED assembled an amazing group of speakers to give insights on a wide range of topics related to medicine, health, and society. The theme of this year’s conference was Limitless—how to use “what is” to imagine and explore “what if” and how to get there.
One of my favorite talks was delivered by Dr. Betty Diamond, a prominent autoimmune researcher from The Feinstein Institute Medical Research. Diamond’s talk was about the paradox of autoimmune disorders and posed the question that is the basis for autoimmune disorders:
“What protects the body from its army?”
Our immune system’s primary function is to protect our bodies from harmful bacteria, viruses, and other pathogens that threaten to wreak havoc. But sometimes our immune system acts like a zealous bodyguard, overreacting to any perceived threat. A prime example is hay fever where the body interprets pollen as an irritation and launches an unnecessary siege against it. People with pollen allergies are rewarded with itchy eyes, runny noses, and sore throats for this antibody overcorrection.
The consequences of an excitable immune system are much more serious than the discomforts of a pollen allergy. Autoimmune disease is caused by the immune system attacking healthy parts of the body. Lupus (Diamond’s area of focus), celiac disease, Type 1 diabetes, IBS, rheumatoid arthritis, psoriasis, and multiple sclerosis are all cases of the immune system going rogue and assaulting the body it is supposed to protect. The effects of these autoimmune disorders can lead to major reductions in quality of life. With lupus, common symptoms are fever, chest pain, hair loss, joint stiffness, fatigue, and rashes to name a few.
At the TEDMED Foundation we discussed autoimmune diseases and the cognitive issues that often accompany these disorders. Attendees at the dinner were experts in their fields of research, clinical practice, immunology, or entrepreneurship. For my part, I shared the current understanding of the relationship between cognition and autoimmune diseases. The organizers didn’t know it when they invited me, but as well as being an expert on cognition, I also suffer from the autoimmune disorder celiac disease. This dinner was really powerful for me as an intersection between my personal and professional lives.
Autoimmune diseases have a cognitive component to them that is often misdiagnosed as a psychiatric illness instead of as part of the overall syndrome. There is scientific literaturedating back to 1922 that notes that type 1 diabetes is often paired with poor memory, information processing, and attention. The medical community is also focusing on more awareness around the impact of lupus on cognition. Many patients with lupus note issues with memory and overall executive function, also known as lupus fog. For instance, in her TED talk, Diamond referenced a patient with lupus who couldn’t recognize her block from the street one to lupus fog.
We need further research conducted on this topic and greater awareness of the role cognition and our brains play in the course of many diseases from cardiovascular disease to Lupus. Both patients and their doctors can benefit from better information about the possible cognitive concerns that come with autoantibodies breaching the blood-brain barrier. I’m thankful for TEDMED and its Foundation Dinner for starting the conversation, and I look forward to doing my part to continue the conversation and work towards a cognitively healthy future.