Grain Brain: Perlmutter

Dr. David Perlmutter, MD, is a board-certified neurologist and a Fellow of the American College of Nutrition, as well as a leader on the use of alternative treatments to neurological disorders according to Dr. Mehmet Oz. Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar -- Your Brain's Silent Killers pretty much sums up what the book is about! Dr. Perlmutter's appreciation for the value of restricted grain diets came through success in treating his patients, despite the conventional wisdom of the "value" of whole grains to dietary health.

Here are some questions Dr. Permutter's began to ask himself as he came to the above realizations:

• Why did his patients get sicker when he recommended the "healthy" diet of carbohydrates and polyunsaturated vegetable oils?
• If a (small) percentage of the population found wheat, barley, and rye to be catastrophic to their digestive systems (i.e., celiac sufferers), what might be the impact on the rest of us?
• What is the link that often ties disorders of the brain to diabetes?
• Why do recent studies link increased longevity to high (i.e., "unhealthy") cholesterol levels?

Clearly, many of the dietary recommendations that we've been getting from the medical establishment are, at best, incomplete. Dr. Perlmutter presents his perspective from his medical practice and a host of supporting clinical studies.

Here are some factoids to whet your appetite:

• To a large extent, neurological conditions of the brain are dietary in nature. Dr. Perlmutter describes Alzheimers as "Type 3 Diabetes."
• Although there are genetic components to both Type 1 and Type 2 diabetes, it is becoming increasingly clear that the environmental factors are more important than previously thought. Type 2 diabetes (previously referred to as "adult-onset diabetes" until it became epidemic in young people as well) is considered completely controllable and reversible if caught early enough through dietary and lifestyle changes. 
• As with coronary artery disorders, many if not most neurological disorders are strongly influenced by high levels of circulating glucose in the blood stream over prolonged periods of time.

We know that Type 2 diabetes is caused by insulin resistance -- the inability of our cells to respond to the overproduction of insulin in response to the over consumption of carbohydrates over time. This insulin resistance produces an upward spiral of poor blood sugar regulation, damage to the pancreas (that produces insulin), and eventually, cardiovascular events, stroke, and/or neurodegenerative diseases such as Alzheimers.

So what does this have to do with grains, especially "healthy" whole grains -- in particular wheat? There's a host of evidence contradicting the idea that whole grains are good for most of us, but the following two facts are the most compelling:

Fact 1 The wheat we eat today (Borlaug dwarf wheat) is NOT the wheat eaten by our grandparents nor the wheat discussed in the Bible (einkorn and emmer wheats). Although it can be argued that 10,000 years of human agriculture has not been enough time to adapt our genome (i.e., DNA) to grains, it's largely irrelevant since the wheat we eat today was created in the 1950's in a research project in Mexico, sponsored by the U.S. government. The goal to eradicate world hunger through developing a more highly productive, more disease resistant strain of wheat was largely realized, but without studying the long-term impact on our overall health. Borlaug dwarf wheat, with 42 chromosomes vs. 28 for emmer vs. 14 for einkorn, is as different as pigs to humans -- even more so!

Fact 2 The key issue with insulin resistance is glycemic index -- the level of glucose response in our blood caused by various foods. GI's are referenced against pure glucose with a GI of "100" -- the lower the better. Although we are led to believe that "healthy" whole-grained wheat would have a "good" GI, it is just the opposite. While table sugar has a GI of 68, a Snickers candy bar a GI of 55 and a banana a GI of 54, whole wheat bread tops the charts at a GI of 71. If you track the rise of wheat as a percentage of the Standard American Diet ("SAD") as Dr. Perlmutter reports in Grain Brain, it strongly suggests that wheat is the cause of the majority of our modern dietary and health problems -- especially the obesity epidemic.

But GI is just the beginning! The other major issues discussed in detail in Grain Brain are:

• Gluten allergies Gluten is Latin for "glue." Gluten is a set of sticky proteins in wheat that give it the desirable properties valued by bakers and processed food manufacturers, used to hold processed foods together. Unfortunately, many of us (estimates from 50% to over 90%) have allergic reactions to ingesting the gluten proteins -- glutenins and gliadins. Daily consumption of wheat results in a chronic immune system reaction to those proteins, resulting in auto-immune diseases such as arthritis, celiac, MS, and many more where the over-stimulated immune system attacks and destroys healthy body tissues such as ligaments and cartillage, bone tissues, organ tissues, skin, etc. Modern wheat has forty times the gluten of grains cultivated just a few decades ago.
• Glycation Glycation is a chemical process whereby sugars bind to other metabolic substances such as proteins and fats, potentially reducing their biologic value -- or worse. Glycation is the cause of the widely publicized plaques that are the principal problem in Alzeimer's and similar diseases of the brain. Although the body has the capacity to "unglycate" proteins under normal circumstances, the accumulated stress caused by years of uncontrolled blood sugar levels overwhelms its ability to do so.
• Chronic inflammation Although an important metabolic process, inflammation that is chronic and systemic places undo stress on the body, forcing the our organs to mediate the resulting stress levels. Chronic inflammation can result in organ failure and contributes to auto-immune problems.
• Leaky gut syndrome Gluten has been shown to be the cause of the leaky gut problem that characterizes celiac disease. Leaky gut allows toxins normally blocked by a healthy gut to "leak" into the bloodstream, resulting in serious immune system responses. It has been shown that many individuals with leaky gut do not exhibit celiac antibodies, but still suffer similar metabolic abnormalities. 
• Cholesterol There's not enough space here to review the details behind our misguidance on cholesterol; you'll need to read Grain Brain to fully appreciate them! Cholesterol is the basis for all hormonal systems in our bodies and insufficient hormonal levels results in sub-optimal health. LDL cholesterol, in particular, is not bad but is good. The "issue" with LDL and VLDL cholesterol is around oxidized and/or glycated cholesterol -- issues avoided with healthy blood sugar levels, promoted by low glycemic index diets. Current studies indicate that people live longer with higher cholesterol levels when dangerous statin drugs such as Lipitor are avoided. 
• Dietary Fats Like cholesterol, our understanding of the value and impact of dietary fats has been almost 100% wrong for several decades. Scientific hubris in thinking we were smarter than nature without a complete understanding of the complexities involved is notable. Now that we are just beginning to understand, some key take-aways are: (1) serum fat levels are primarily caused by dietary carbohydrates -- not dietary fat -- since the liver produces 4 times the amount of fat we ingest on a daily basis; (2) much maligned saturated fats comprise 50% of the cell walls in every cell in our bodies and are critical to proper cell protective mechanisms; and (3) polyunsaturated fats in cooking oils from vegetable sources (i.e., corn oil, etc.) are unhealthy and should be replace with coconut or palm oil.
• Excess Body Fat Any discussion of health issue would be negligent without consideration of the obesity epidemic in the developed nations. Despite the efforts of many people that watch what they eat and exercise (often excessively), they cannot shed excess body fat -- especially the more dangerous visceral body fat. Recent evidence shows that fat cells are not just store-rooms for fatty acids and triglycerides, but active organs that generate hormones affecting the entire system. Excessive body fat contributes to insulin resistance and the production of inflammatory chemicals linked to cancer, autoimmune disorders, and brain disease. Excess body fat is shed naturally with a ketogenic or paleo diet -- see below.
• Neurogenesis We were taught that brains cells do not regenerate, but that myth has been dispelled in the past decade. As a neurologist, Dr. Perlmutter was particularly interested in a recent finding based on brain-derived neurotrophic factor, or BDNF. BDNF is a protein expressed by a gene on chromosome 11 -- a key to "neural plasticity" -- which when activated, can reverse memory decline in the elderly. Several things can cause the BDNF gene to activate: (1) exercise; (2) following a ketogenic (i.e., fat-based) diet; (3) calorie restriction; and (4) certain nutrients such as curcumin and the omega-3 fat DHA.
• Anti-Oxidants Everyone is aware of the importance of anti-oxidants. The simple act of living involves production of incomplete chemical reactions that produce free-radicals -- highly reactive, unstable molecules that if left unresolved, will damage body tissues and DNA. We know that ingesting adequate "anti-oxidants" helps us to resolve these issues -- issues that occur in the mitochondria in every one of the trillions of cells in our bodies. The exciting new-news is the discovery of the nrf2 protein, which turns on anti-oxidant and detoxification pathways in the cell nuclei. Activation can be triggered by oxidation of DHA/EPA, calorie restriction, and dietary sources of curcumin (turmeric), green tea, silymarin, bacopoa extract, DHA, sulforaphane (from broccoli) and ashwagandha.

The Modern Paleo Diet

So, operationally, what can we do with the above information? I think the easiest way to summarize is by understanding the concept of the modern, paleo diet. Paleo diets are not new, having formed the basis for the Atkins diet popularized (and daemonized!) in the 1970's. What's new is our improved understanding of why the paleo diet has been successful for many people and why it is in fact, a healthy diet! Some paleo advocates resist the "diet" label, insisting that paleo is a template for proper eating. "Diet" seems to imply a prescription, while "eating paleo" can be and should be personalized.

The simple idea behind paleo is to think about what foods our ancestors had access to prior to the advent of modern agriculture -- a recent event occurring just 10,000 years ago! Since it takes about 40,000 years for our genome (DNA) to adapt to changes, many modern, man-induced dietary changes are incompatible with our genome. The introduction of grains in the last 10,000 years has not given us time to adapt -- especially the addition of massive amounts of gluten into the Standard American Diet at levels not seen until recently.

For two million years, animal products dominated our "paleo" dietary intake with fats and proteins comprising 60-100% of our calories, depending on the season of the year. Vegetables were often not available in the colder seasons and fruits were used to "fatten up" at the end of the growing season in preparation for winter. The "modern paleo diet" is based on 60% good fats (no man-made transfatty acids like hydrogenated vegetable oils or oils corrupted by frying), 20% good protein sources (preferably grass-fed animals and mercury-free fish!), and lots of fresh (and fresh frozen) vegetables. Although whole fruits (not juices) are healthy, the impact of high fructose levels places a demand on the liver that should be minimized; hence, one apple a day keeps the doctor away -- not a lot more! High-fructose corn syrup is a manufactured toxin that should always be avoided.

Thanks to modern medicine, we are living longer, more productive lives. We are on the cusp of major improvements to the quality of life based on our new understanding of the genome and proteome. The most recent breakthroughs have been occurring in our proper understanding of diet and its impact on health. I do not believe it is an overstatement to say that improper diet and health-style is the cause of the major diseases/conditions affecting life in the developed nations today. The major causes of death -- heart disease, stroke, and diabetes -- are preventable -- a case well-documented in Grain Brain. 

Hopefully, the summary presented above will catch your attention. If you've weary of being innundated with yet another trendy idea on how to eat, please do not stop here. I've been on a quest to understand the impact of nutrition and diet on our health for two decades -- as confused as everyone else -- and I believe firmly that we are now beginning to make true progress. Grain Brain is one very good example of an excellent blend of science that we can understand with common-sense advice on how to work our way to a dramatic improvement in our quality of life. I personally have been practicing some of these ideas for years with very beneficial effects, but without understanding the science behind them. I am now more motiviated to continue based on this new understanding of our species! If you are intrigued, I would highly recommend that you read Grain Brain.

Another key book published in 2013 on the topic of wheat auto-immune issues was Wheat Belly, written by a cardiologist with similar experiences to Dr. Perlmutter in his practice. Click here to compare notes!

3 Minutes to a Pain Free Life: Weisberg

Many if not most of us experience chronic pain at least some of the time. But what is chronic pain? What causes it and what can we do to overcome or prevent it? Providing a solution to chronic pain is the purpose of 3 Minutes to a Pain Free Life.

Dr. Joseph Weisberg, P.T., Ph.D., runs a private practice for treating chronic pain -- back pain, headaches, joint stiffness, or arthritis. Contrary to the natural inclination to think that joint pain is from the joint itself, in the vast majority of cases, it is from strain induced in the soft tissue: the ligaments and tendons in the joints.

Acute pain is usually relatively short-lived and the result of trauma, while chronic pain is recurring pain that is the result of the accumulation of the stresses brought on by micro trauma. Dr. Weisberg provides checklists to help you distinguish acute pain from chronic pain. For acute pain you should contact a medical practitioner; don't attempt to resolve acute pain issues on your own.

When you compare chronic pain to more stealthy medical conditions such as coronary artery disease or cancer, you realize that chronic pain has an up-side: it makes you aware that something is wrong. Unfortunately, we generally believe that we need to "baby" the body part that is the source of the pain -- which is advisable for acute pain -- but for chronic pain, that's exactly the wrong approach! Movement is needed to treat chronic pain, but it requires the correct movements to effect healing over time.

Chronic pain is largely the result of bio mechanical dysfunction from tight, stiff or short muscles, weak and imbalanced musculature, lack of lubrication in the joints, misalignment of joints, and/or poor posture. These dysfunctions cause stress on the body mechanics that cause the body to get out of balance, resulting in the continual micro traumas that eventually lead to chronic pain.

Possibly the biggest cause of chronic pain, much to my surprise is the chair! Chapter Two, cleverly titled "The Chair is the Seat of all Evil" explains the history and bio mechanical problems caused by the chair, ergonomic or not! Exposed is the myth that our evolution from quadrupedal to bipedal is the cause of back pain, Dr. Weisberg explains the marvel of the back's S-curve and what an amazing engineering design it is, resisting both gravity and shock that might otherwise damage it. Prolonged sitting has the effect of working counter to the design of our entire musculoskeletal system. [Hint: get up and walk around at least once every hour.] Conversely, moving, standing and squatting are naturally beneficial to the system, relieving tension and lubricating the joints. Although devised several thousand years ago, the chair did not come into common usage until the last 150 years -- not enough time for the evolutionary changes needed for the body to adapt to it. The archaeological evidence is presented that supports this premise!

3 Minutes to a Pain Free Life consists of three parts, each section with a hundred pages of information. The first part is an anatomy lesson in how the body is designed to work, while parts two and three provide exercises along with how, why, and when to perform them. I've been exposed to many exercise programs in the past, but was left without a firm knowledge of why they were important, and without immediate results, tended to stop performing them at some point. Dr. Weisberg's in depth explanations of the importance of this program to your overall well-being provides the science behind the program that helps you to persevere.

The main program consists of six exercises that are performed for 30 seconds each and done at least once a day. The exercises are designed to stretch, lengthen and strengthen the muscles that otherwise get out of alignment and cause the microtraumas that are the source of the pain. Rather than "No pain no gain", the catch phrase is "Work to the pain, not through the pain," allowing the muscles to relax and return to their normal length. Stretching for more than a few seconds is required because the muscles resist this stretching in the same way that they continuously stress to produce the chronic condition. The key to the physiology of overcoming this reaction is that the muscles cannot maintain that tension in a stretched state for more than a few seconds, so the 30 second exercises teach them to relax and return to a normal state.

I have several sources of chronic pain: my knees, back, and right shoulder. I have a bone condition in my right knee (osteochondritis dessicans) which has had open and microsurgery performed over the past forty years. I tore an ACL and MCL ligament (one in each knee) and have osteoarthritis in both knees. These accumulated conditions can made walking difficult, especially on stairs, and prevent me from running anymore. But as it turns out, my knee pain was the result of two factors: the unavoidable mechanical problems in the knees (only correctable through knee replacement) and the chronic soft-tissue micro traumas. I noticed immediate improvements through the 3-minute exercises in a few days and continuous improvements over several months. I am far from pain-free (due to the mechanical problems) but have resumed normal functioning. I'd like to say my tennis game is great now, but let's be reasonable, this is not a miracle program!

I rarely have back episodes anymore, the one exception being long automobile rides in my BMW M3 -- not the most ergonomic experience. The right shoulder pain due to improper weight-lifting in my younger days and exacerbated by my tennis serve has largely subsided -- enough to allow sleeping on that side at night. Overall, I have to enthusiastically endorse The Weisberg Way and the overall improvement in quality of life that it has provided. It's available on Amazon for under $15. If you try the program, please post your experience here to benefit others!

Blink: Gladwell

blink, The Power of Thinking Without Thinking, is about intuition, how it works, and how to refine this capability by an improved understanding of the brain's decision-making process. As a master story-teller, Malcolm Gladwell makes his case through a series of extremely interesting, inter-related examples of successes and failures of this process.

Gladwell refers to our brain's ability to make these impromptu decision as thin slicing, a term from psychologist John Gottman at the University of Washington, who has done extensive research on married couples by studying their facial expressions. Gottman relies on the work of Drs. Tomkins and Ekman, who discovered that our personal interactions are laced with microexpressions that expose our true feelings. They painstakingly codified the basic microexpressions and their combinations while divining their true meaning. Microexpressions are just one portal into thin slicing and helps us to understand our unconscious analytics machinery.

As noted in On Intelligence, one of the principal functions of our brain is to identify patterns in the stream of information fed to it from our primary sensory organs -- sight, sound, taste, touch, and smell -- and our secondary senses -- balance, acceleration, temperature, kinestheics, pain, time, and more! This pattern-matching capability operates in fractions of a second, below the conscious level. We form opinions on matters and often are unable to understand how we arrived at them. blink helps us become better at figuring that out!

Some examples of thin slicing from blink:

• A kouros statue from the 6th century B.C. was sold to the Getty museum in New York for $10M over the objections of several art experts that the statue was a  fake. Fourteen months of investigation and scientific research on the statue preceded the sale, but some time afterward, it was confirmed that the kouros was indeed the result of an elaborate hoax. It just didn't "look right" to the experts -- but why?

• Vic Braden, one of the world's top tennis coaches,  inadvertently realized that he could predict when a professional tennis player was about to double fault in a match, male or female, live or on TV, known or unknown to him! His accuracy was uncanny: typically 19/20 or 20/20 correct predictions. For years he tried to uncover the source of his uncanny ability, but was unable to understand how he did it. It was driving him crazy, literally keeping him up at night! Through the use of high-speed video analysis, he was able to uncover his brain's ability to thin slice the visual input.

• Warren Harding was discovered by Harry Dougherty, a brilliant political analyst, in 1899 and shepherded him to the White House as the 29th President of the United States. By all accounts, Harding was the perfect candidate: tall, handsome, athletic, and confident. Harding died in office and by all acounts, may have been the worst candidate to ever hold that high office. Experts and non-experts alike failed to make the right decision! This was a case of thin slicing gone wrong!

• Paul Van Riper retired from a very successful career as an officer in the Marine Corps. Van Riper was chosen by JFCOM to lead the opposition forces in a war gaming exercise known as the Millennium Challenge. Millennium Challenge was designed to provide the Pentagon with experience in fighting wars in the new millennium -- the unconventional warfare of the future, driven by technology and information, modeling and simulation of every conceivable military, economic, political, societal, cultural, and institutional possibility. Acronyms for new techniques were rampant. Hundreds of military personnel participated in the exercise over several weeks, pitting the new technology against a battle-hardened field commander who relied on instinct and training for the split second decisions needed in combat. In the end, sixteen U.S. ships lay at the bottom of the Persian Gulf; had this been a real war, 20,000 American troops would have died before firing a shot. Van Riper's seasoned decision-making process allowed his intuition or right brain to function unimpeded in the heat of battle while the overly analytical approach adopted by the Pentagon obstructed this process.

Gladwell studied a number of experts of various stripes, all of which were very interesting. One of my favorites sets of experts were Gail Civille and Judy Heylmun -- professional tasters for the food industry. They could not only identify the ingredients in packaged food, but could often identify the particular factory in which it was manufactured! They used a fifteen point scale to identify over ninety attributes of appearance, flavor, and texture. What's commercially interesting, and interesting to the premise of this book, is the Degree of Difference (DOD) ten-point scale that indicates how different one product is from another, even within the same category of food such as potato chips. The significance is that the buying public will not be able to discern the difference between products if their DOD is low; hence buying decisions will be driven by packaging and brand -- don't bother trying to improve the taste! The key to their blink-ability is that they can understand the conscious basis for their impressions, and recognize the difference between those formed by someone of their expertise vs. those of ordinary people -- very important to the advertising industry.

Overall, the book is outstanding, both entertaining and exceptionally informative. You may need to reread it to get the full benefit, focusing on the meaning behind the cryptic chapter titles, which help to uncover several sub-themes that recur through the book. You will be rewarded with a better understanding of how the majority of our opinions are formed and the basis for most of our actions -- decisions we reach in a blink. You will hopefully learn to question those reactions that need further investigation and better understand the importance of honing your experiences to blink better in the future. Advertising executive, political hopeful, or just an average Joe, you need to read blink!

On Intelligence: Hawkins

What is intelligence? How do we know things? What is creativity? What is consciousness? These are ideas that philosophers have pondered for centuries, with earliest records from the Greeks.

I have been fascinated with these topics for many years and have searched unsuccessfully for answers. Philosophy books on the topic were too... well, philosophical... and unsatisfying. Books on brain functioning more than ten years old were very interesting, with most of our knowledge coming from brain dysfunction, where direct knowledge of damage to specific brain areas produced consistently serious problems. Neuroanatomy books were helpful in learning about the parts of the physical brain and the associated high-level notions on the role of specific brain parts.

Recent advances in neurophysiology were more encouraging. There is a tremendous body of knowledge around chemical and electrical signaling mechanisms in the axons, dendrites, and synapses of neuron cells. The known details around these mechanisms begin to peel back the layers of how this all fits together. But the very massive detail and complexity of the mechanisms is a barrier to understanding how and why intelligence results from this amazing system. Having read several books on the biochemistry and neurophysiology encouraged my belief that we could answer the questions on intelligence, knowledge, and creativity, but neuroscientists were still unable to provide those insights.

Jeff Hawkins seems to have shared my interests and similar experience, but has applied his insight and resources to posit a theory which he calls the memory prediction framework. To understand how the brain works, you must begin with how and why it evolved -- the biological value of the brain:

• For millions of years, the animal brain evolved as a mechanism to control behavior in order to increase survivability.
• The brain accepts input from the senses -- vision, hearing, sensory, olfactory -- in order to drive action through the motor systems. Lion -- RUN!
• The brain consists logically of two parts: the primitive brain parts that are shared by reptiles, birds, and mammals, and the neocortex, which is exclusive to mammals. Knowledge and memory in insects seems to be stored and persisted in DNA, while higher level animals store information in the neuronal structures in the brain. The neocortex evolved to provide higher level functions on top of the primitive brain, organized in a multi-level hierarchy.
• Memory allows animals to store experiences perceived from their environment. Learning improves survivability by improving the value of the accumulated memories. Darwinian logic drives this process -- adaptations that improve survivability perpetuate the gene pool.

To understand how this works, some other key ideas are as follows:

• Sensory inputs are at an extremely low-level. Vision consists of about one million nerve fibers of information while hearing has thirty thousand.
• In addition to spatial content, all senses (and everything in the brain) has a time dimension -- quite different from modern computer architectures. Vision, which we perceive as static spatial content, always has a time component; in fact, the eyes move in a process called saccades about three times per second to focus on specific aspects of the visual field. We actually cannot discern objects using our sense of touch without moving our hands or feet on or in the object; i.e., our object recognition through our sense of touch comes through a temporal comparison of sensory inputs. The temporal input is used to constantly modify our working model of our environment.
• Actual cognition occurs at higher levels in the neocortex hierarchy, where concepts are formed. For visual level V1 (which does some pre-processing from the optic nerves), we begin to see lines and edges. At level IT (an intermediate level), we perceive objects such as lions. At higher levels, we develop strategies to deal with our perceptions.
• The main purpose of the brain is to form a model of our environment, mostly to deal with now but in our evolved state, to also plan for the future. Note that at any point in time, our senses are only aware of a small subset of our environment (e.g., the visual field in front of us) and that our memory model of the overall environment (and our history of related situations) allows us to respond to it in a comprehensive manner. If, for example, you are sitting alone at home and hear a certain pattern of footsteps and associated sounds, you realize that your child has arrived at home without actually seeing him or her, and if you have more than one, which one!

We can now begin to talk about the actual functioning of the brain:

• As sensory information moves up the cortical hierarchy, it gets refined into generalized, invariant representations. So we can recognize a song in any key even though the input from the auditory tract is totally different. We can recognize a face from close up, far away, tilted, or from the side, even though the pixel representations are totally different. Invariant representations allow one copy of the Gettysburg Address to be used to recite it orally, write it down by hand, or type it on a computer -- even though the mechanics of reproducing it are totally different.
• As we learn new behaviors and concepts, they get pushed down in the memory hierarchy, allowing higher levels the freedom to cogitate on how we might deal with the object(s) of focus. Note that at birth, we start with a blank slate; i.e., we know nothing. As sensory inputs are received, we store them as raw temporal images until we begin to associate them with our prior experiences and generalize what we perceive.
• The human brain has about 10 billion neurons with somewhere between 1,000 and 10,000 synapses or connections to each one: roughly 100 trillion synapses. Everything we know and do, including our intelligence, knowledge, creativity, and consciousness is contained in these synaptic connections. 

And finally, the Hawkins memory prediction model:

• The many levels of the memory hierarchy communicate up and down and left and right.
• The idea of context is very important. Concurrent neuronal firings determine the context of the situation and how we react, so a loud noise on the 4th of July is normal, but a loud noise in a library would be a cause for concern. 
• The key to understanding the memory prediction model is the prediction part: the current context causes specific levels within the memory hierarchy to pass predictions down the hierarchy in anticipation of what we expect to have happen next. The feeling we get from surprise (like missing the last step when walking up or down a staircase) is when the predictions do not mesh with the subsequent sensory inputs. Predictions are the essence of understanding -- we do not understand something that we simple observe without having an associated knowledge base that automatically forms predictions.
• These predictions are crucial to understanding how we function because the predictions make it possible for us to anticipate what is going to happen so that we can automatically adapt. So in driving down the highway, we ease off the gas pedal as we sense that the driver to our right is about to change lanes unexpectedly.

So how does this relate to intelligence? The memory model is constantly updated based on sensory inputs. In the case of action (say, in sports), it is concurrently sending action commands through the motor cortex to adapt to this changing environment. The memory predictions driven down the memory hierarchy (including the motor cortex) are based on invariant representations of similar past experiences. These invariant representations are what we might also call analogies. Depending on how they are applied, they might also be called biases or prejudices. These predictions run smoothly as long as they measure up to the incoming signals; when they do not, something like an interrupt occurs that focuses attention to address the mis-prediction and learning occurs.

An interesting thing to think about is whether we know anything! What we "know" are neuronal associations, largely in our neocortex. These associations are formed based on relationships to past experiences. When we drill down in our knowledge to a lower level -- peeling back the onion -- our knowledge becomes deeper, but I would question whether there are any absolute truths -- only our current memories related to a topic. An example of this is our initial model of the atom based on electrons circulating around a nucleus and how we are still discovering subatomic particulars such as new mesons that peel back the onion even further. Ask yourself what you actually know about electrons, protons, and neutrons, let alone quarks, leptons, bosons, mesons, or fermions!

Jeff Hawkins is an accomplished computer scientist, and many of his insights come from analogies from his original field. It would appear that many concepts from computer science apply to how the brain functions as well.

• Objects Neurophysiologists have identified a mechanism for objects in the brain. One research study identified the "Bill Clinton" neuron (possibly a series of neurons) in a set of test subjects. Any topic related to Bill Clinton caused the same set of firings in the brain, whether events related to his presidency or Monica Lewinsky. Within a time period in which Bill Clinton is the topic of attention, a series of neuronal firings maintain the context of Bill Clinton.
• Ontologies Although On Intelligence predates the popularity of topics such as RDF, the semantic web, and ontologies, the memory prediction framework seems to map nicely to the concept of an ontology; i.e., a set of objects and concepts (sets of neurons) that are interrelated through synaptic connections. For an ontology, we map subjects to objects using predicates. 
• Attributes Based on experience, objects stored in the brain have relationships to many other objects, including "objects" such as colors, textures, belief systems, etc. otherwise known as attributes. Related synaptic connections that are not currently firing, may fire later when some other aspect of the context increases the action potential of the appropriate synapse(s) to exceed the firing threshold . 
• Algorithms Although there are many differences in brain cell types, there are also great similarities. Essentially, the process that the brain uses to grow and wire neurons is driven by our DNA and is the same process for all brain cells. There are no unique "hearing" cells vs. "vision" cells or language cells vs. motor cells. The fetal brain evolves from a single bud that grows in packages around something called columns. The cells that grow out of a single "column cell" have long-term relationships to each other through synaptic connections in addition to the extended connections they have to other parts of the brain. The mechanism of growth -- how axons can grow long distances (as much as a meter) to connect to other parts of the body is all handled by the same DNA-driven algorithm. 

There is insufficient space in this review to include the many excellent examples from On Intelligence that help to illuminate Hawkins' ideas. For those of you that may have studied neurophysiology, you'll get hints and references to the research that will make you comfortable that this theory is indeed based on the hard science that we currently understand as well as understanding where he takes leaps of faith in developing his theory. I would highly recommend reading the book in order to fully appreciate the magnitude and impact of these ideas.