#E63 Unlocking The Full Potential of Our Brains, With Reza Hosseini Ghomi

Read the HYPERSCALE transcript

[00:00] Briar: Hey everybody, it's Briar Prestige and welcome to another episode of Hyperscale. Today I've got Reza Hosseini Ghomi and he's going to be talking about all things brain health, neuroscience, potentially merging with a brain computer interface and the future of humanity. Welcome to the show, Reza.

[00:21] Reza: Thank you for having me.

[00:23] Briar: So you have a very fascinating background, and I was reading through your accolades and your story. You're a cancer survivor. Tell me a little bit about how you got to where you are today.

[00:38] Reza: Absolutely. Growing up I was always, I think just naturally inclined towards technology. I was growing up in the eighties and nineties, and so a lot was coming out, a lot was happening. A lot of video games and that kind of thing. But I pretty quickly, I think around age 10, 11, 12, I started building computers and I was just so fascinated that you could design a machine to basically improve your efficiency to like, kind of carry out, things that you desired to have something you imagined come to life. And so I did that all through kind of high school. I went off to college and pursued engineering, thought that was a logical choice. And then I actually ended up being diagnosed with Hodgkin's lymphoma, a form of blood cancer right out of college.

[01:28] Reza: And that experience is kind of what really shifted my view. I still liked engineering, but I really sat in the hospital getting chemotherapy and thinking, wow, this is really not working well. This is very inefficient. it was an obviously difficult couple years for many reasons, but not least of which was just the cost, the inefficiency, just the unneeded administrative pain. So that's what put me on the medical track. So I went on and did some more training by medical engineering and then medical school and so on. But I later became really fascinated with the brain.

[02:04] Briar: What fascinated you so much about the brain?

[02:08] Reza: Probably similar type of fascination from when I was a kid. The brain, as I was making my way through school, seemed sort of like the final frontier. There's certainly more to be achieved in other areas of medicine, but the brain was such a mystery. There was so much we didn't know yet. So I thought, okay, that's something I know I can spend a career on, and I'm sure there'll still be questions, when I'm done. And I just love, again, so it's almost like the brain is our computer and our body is sort of a machine and your brain controls so much. And so it was similar type of fascination. I think that led me to, as I specialize, part of what I love is I love the hands-on with patients. I love doing the physical exam and cognitive or physical exam, but the interaction and being able to pinpoint where something might be going awry in the brain based on the physical manifestation. So I think I see some common themes in there, but yeah, I loved just problem solving that came with it.

[03:11] Briar: How much do we actually know about the brain? Like, it's a very complicated thing, right?

[03:19] Reza: Absolutely. I would guess, I thought about this before, I think we probably know still, like single digits, percent, if you like thought about a hundred percent. Still we have a long way to go, that's my best guess. 

[03:36] Briar: Wow. Isn't that incredible to think that we do all of this stuff and here you are telling me that we know like mere percentage of our brain, right? And what could we achieve if we were doing like, full usage of it?

[03:51] Reza: I'm one of those people. I think like you, I was attracted to your work is, I think there's just incredible potential. I mean, I love reading science fiction and watching it, but, it is not hard to imagine. I think that some of those things are not very farfetched. I think if we were using our full brain, and now I know we'll get into kind of the interface of with computers and advancing AI, but the brain I think can do, I mean incredible. I mean, AI as we know it today, is modeled on the human brain and the closer it's modeling, I mean, look how powerful it is. So you almost wonder, is AI kind of outpacing, because it's using the full potential of how we're designed versus us realizing our full potential. So I think the sky's the limit. I really do.

[04:41] Briar: Oh, yeah. I love deep diving into this discussion. And I often am thinking like, oh God, what do I need to do in order to keep up with the pace of AI. Here we are all sitting here or worried about it, like, ah, AI is going to kill us all. Like, the world is going to get destroyed. But it's like, come on, people, it's like a race almost it feels like. Let's work into tapping into ourselves and seeing what power we can create within us.

[05:08] Reza: Exactly. I mean, the important thing is I take the same position as well. Even if you have a doomsday approach, well, do you want to participate, and help guide it? Or do you want to sit back and be a spectator? I certainly want to be a participant. I want to make sure I have a voice in what's developing. So it's even more motivating, seeing things moving so quickly motivates me to participate.

[05:32] Briar: So you're a neuropsychiatrist and work with a lot of people with dementia. Tell me about this field of work.

[05:40] Reza: Absolutely. Dementia is fascinating because I think in the process of our brains breaking down in various ways and various places, you start to be able to put some of the pieces together. So, although it's a terrible thing, it does teach us a lot about the brain. Personally, I think what drew me to treating patients with dementia is, I love the hope and power it gives them to diagnose as early as possible and ideally intervene as early as possible. And sometimes I'm talking intervening for their children where they might feel they have a higher risk factor. So let's intervene earlier and earlier in life. Seeing how empowering that is, where it gives them hope that it's not inevitable, that they're going to get dementia and waste away. And so that's what really is rewarding.

[06:29] Reza: And it's amazing because of how our healthcare system works. And this is really agnostic to country. I think no matter where you are, the best you'll get is late diagnosis right now on average. And so when you hand someone an earlier diagnosis, the amount of reward that gives me, but also how appreciative they are, is a little counterintuitive. A lot of people will say, don't you get tired of giving people, like these terrible diagnoses. Well actually they usually are thanking me because I'm giving them choice. I'm giving them power and autonomy because now they know what's going on and they can choose what they want to do. So that's just one of the things I really love about it.

 [07:08] Briar: And so what to you is counted as an early diagnosis and like, what kind of  symptoms are we seeing in people 

[07:17] Reza: Absolutely. So, in my world, I think early diagnosis would be in what we call mild cognitive impairment stage. And so this is before you have official dementia, meaning you're still functioning, you might be still working, you're living your life. But something's starting to change. And that's the window right now where the focus has been on intervention. Of course we talked about earlier intervention, but that's where I think generally speaking, people accept as early intervention. So if I maybe do a really hard test with you, I could start to detect something that's predicated on me knowing, well, Briar, when you were, at your peak, at your prime, this is how fast you could do this exercise, with your brain. And now it's like slightly lower. So it's assuming I know the background, but it's when you start to see that change, that's what we call early.

[08:09] Briar: Okay. So like for instance, I went to get brain training and one of my tests that I did was how quickly could I press something. So I was going there pressing and how many times I screwed it up as well was something that they judge. So having that kind of data from me, for instance, would be helpful at a later date. Like if something started to decline, then you would be like, haha, but what happens if we don't have that data? Because I'm sure there are a lot of people in the world who aren't really going out there getting tested. Like, is this covered under insurance? Is this even something that people keep on on their radar?

 [08:50] Reza: Very good question. Excellent question. That's something I get all the time. In your case, it's extremely helpful because depending on all kinds of factors, education, what you're born with, everyone's abilities are different. So what represents a decline for someone might not for another person. So in your case, in five years, if we test you and something changed, we know and we can jump right in. If let's say you didn't get that test and you came in 20 years later, you come in and we know, okay, well Briar is extremely intelligent, she's educated, we're guessing. So what we do is we do a lot of guessing, we guess, what is your premorbid condition, we call it? So, okay, I think she would've done about this, but that's leaving a lot of room for error when we're guessing.

[09:32] Reza: And so we're kind of robbing people of having that information. And right now insurance, I mean at least in the US does not cover early screening. You have to have some kind of, again, we're a disease oriented system, so you have to have a disease to get paid for something. But the tools like you use, I'm hoping to see in part of the work I've done is expanding access so that everyone can get at least some baselines and it makes it easier to access. You can do it from home, just get the best you can. There's obviously levels of it, but that would give you that baseline that'd be extremely valuable. 

[10:10] Briar: You're in Boston. Have you met the guys from Neurable, the non-invasive brain computer interfaces?

[10:16] Reza: Not yet.

[10:17] Briar: Oh, I'm going to introduce you. They're amazing. Yeah. The work that they're doing and they use like headphones to measure brain activity and things like this. So I think you guys have a lot of areas of synergy and yeah, you're both in Boston, so that'll be cool.

[10:34] Reza: Absolutely. I'm always looking for people like, how can we combine? Because this is a major team effort. I think there are lots of topics, but the traditional like sort of smaller academic based research is not going to move the needle here. We all have to work together.

[10:52] Briar: So getting these tests, like what age should people start testing would you say, to sort of be on the lookout for dementia? Are you seeing this diagnosed in younger people these days than historically before?

[11:06] Reza: Absolutely. So, because of my specialty, the earliest I've diagnosed somebody is about 30 years old. But that's someone with genetic, I mean, just absolutely heartbreaking, very, very young, very young mother actually at the time. But these were well-known families with very clear genetic drivers where you look at their family tree and 50% of folks all have it. So it's somewhat predictable and it occurs early in life. And that was a genetic Alzheimer's, so that's rare. So I have diagnosed it very early but I'm bullish. I want people to be tested in their twenties and thirties because that's ideally when, you kind of, in certain ways are at your prime, that's when your processing speed is the highest. Not everything, verbal ability does peak in your fifties and sixties, but in terms of how fast you can think, how fast you can switch I want to know what you are at your best. So I think we should be testing as part of annual physicals early in life, twenties and thirties.

[12:06] Briar: So a big part of dementia is genetic, as you mentioned, but how much of it is due to our lifestyle?

[12:14] Reza: Absolutely. All the studies that we've seen to date suggest approximately 40%. So a pretty gigantic portion, almost half are due to what we call modifiable or adjustable risk factors, which primarily are lifestyle. So if we optimize the lifestyle, we would actually 40% of dementia, which means 3 to 4 million people in the US wouldn't have dementia. So I mean, it's a massive amount of, morbidity that would be eliminated. So that's about the number and a lot of things contribute to that. Certainly genetics is part of it. What became popular a little bit with 23 and me and similar tests was the APOE4 testing that got a lot of people talking. I remember Thor, he kind of did the testing and announced him. 

[13:03] Reza: So I think it brought a lot of attention to it. That one does increase your risk, but believe it or not, if you have both of the genes that APOE4, if you're homozygous they call it, that means give the highest risk factor possible out of that combination. That's still not as much risk as if you have hearing loss and you don't correct it. So just to put it in perspective, so those things that you have control over still add up to a lot. Of course, if you have one of those rare genetic clear variants, that's, that's a much harder thing to treat.

[13:37] Briar: So when we're talking about lifestyle factors impacting this, what are we speaking about specifically? Like processed food or toxins? Like plastics, like I hear we're all like 50% plastic these days. I'm just kidding, but it does seem a little bit like that. Microplastics are everywhere,

[13:57] Reza: When you look at what's in our water supply, every time I read something they say, oh, this is on the water supply. You think, okay. 

[14:01] Briar: It's just everywhere, isn't it?

[14:03] Reza: Absolutely. So you can think of it at different stages of life, like what are the things you can do when you're younger? Younger education level is highly protective. So obviously for those of us that are sort of later in life, you can still always learn. But that early years education, making sure our kids have good education, very protective. As you move into more midlife, it's things like uncorrected hearing loss. It's heavily the nutrition and diet and those things. Controlling cholesterol, blood pressure, those are all things that are nicking away little by little over years. Because by the time, if you have Alzheimer's when you're 65, that means I could have looked back when you were 40 and seen the disease starting. So it's starting that far in advance. And we know that because we do actually have the tools to test for the things, for Alzheimer's 20 plus years in advance, we don't, because we don't know what to do with it so that's not recommended, but those tools will show it. 

[14:59] Reza: So that means, well, if I'm 65 and I'm getting Alzheimer's when I was 40, I probably should have been looking at a lot of these things, exercise, diet. And, diet is something I go deep with patients. I just customize it depending on the patient, but there's so much you can do there and optimize, how is your blood flowing? It's flowing clean and smooth. It's not damaging your blood vessels. All these things add up and go on. And then later in life. So that's midlife. And then later in life, it's things like, not just obesity and smoking, but sleep, is massive. 

[15:34] Briar: Oh no, I'm terrible at my sleep. 

[15:37] Reza: Yeah. And we all are, right? So this is the hard part, is we live in a modern society makes it hard to do some of these things. But depending on the priorities, you got to think, well I'm just going to be super strict. And so for me, I've got the blackout. If I'm traveling, I've got my eye mask, I've got my white noise machine. I find a way to try to cool down the room wherever I am. All those things add up to a much better sleep.

[16:05] Briar: And food wise, nutrition, you've just mentioned, this is a big thing that we need to be mindful of. Like what should we be eating? Are walnuts? I hear walnuts are like, because they look like mini brains, they're meant to be quite good for our brain. I remember hearing this

[16:20] Reza: I think that's a good rule of thumb. I think walnuts are good. Definitely a good thing. I started at a high level, I've done a lot of, unfortunately in medicine, we do not get trained for nutrition. So the average doctor has about zero training in nutrition, so they're not able to comment.

[16:36] Briar: That's ridiculous.

[16:37] Reza: Which is pretty, pretty ridiculous. And that's why I think a lot of patients will leave doctor's offices frustrated. But I remind them they had no training in this. So that's why they say, well, go see a dietician or a nutritionist or someone else. So I actually took a number of courses. I traveled to conferences, cooking classes, I participated in studies. So I did a lot of nutrition in my own just teaching. So I dove pretty deep, partially from my own selfish reasons because I had cancer and I thought, man, I really don't want this to come back. But also now I'm thinking of it through the brain interface. And so high level things are thinking about, just asking questions like, where's this food coming from and how many ingredients are in it? And like, how natural is it?

[17:18] Reza: So I try to find my local butcher and I buy meats that I trust. I don't say don't eat something specific. I just say, well, where's it coming from? I like grass fed meats, I love eggs, but I like them to be pastured, those chickens to have access to a lot of natural ground. We know if we test those foods, the ones that are grass fed or pastured, whether it's meat or eggs, they have much higher Omega-3 and less Omega-6. And so they drive inflammation a lot less. In fact, they can be healing, versus what we find a lot in American grocery stores is highly, highly kind of pro-inflammatory. And so it's really quite a big difference. In fact, I mean, there was a time when I was researching, I was calling all the companies on the shelves at the grocery store, and I was asking them for their chemical, like kind of rundowns.

[18:06] Reza: And it's fascinating, I mean, the, the difference it makes. So I start at that level. I don't eat things that typically come in boxes like cereals and stuff like that with just too many ingredients. So I think honesty is a good rule of thumb. That's a great place to start. And another big thing is just because it creeps in, just get rid of any added sugar in your diet. Don't eat anything, no fluids with sugar in it, drink water flavored if you want with some lemon. Don't flavored yogurts. There are just so many sugar additives everywhere. And I think when you think about your blood running through your brain and those blood vessels, all that sugar is nicking away at those blood vessels. It's causing some breakdown. And over 20 years, what's going to happen, that those vessels, walls are going to be kind of destroyed.

[18:52] Briar: And what happens if we're all living longer, right? Like, we've got an older population. Does this mean that we're seeing more dementia, Alzheimer's brain diseases among people?

[19:05] Reza: So you bring up a really good point. We have this field of longevity that's making big strides and I've seen, estimates that people born today, without doing anything special, just sort of average life expectancy is expected to far exceed 100. I've heard 120, 130 and so on. Well, another thing we say that's kind of concerning is in clinics, when I'm working with my colleagues, any movement disorder, Parkinson's type of doctor, neurodegenerative specialist, dementia doctor, will say if we all live to 120, we'll all have Parkinson's. And that's a concerning thing because yeah, our brains are not designed necessarily to make it that far. So those areas that make the dopamine, we need that without them we have Parkinson's. Those do tend to, I mean your risk just skyrocket with age. So as you approach 100 or go past, the percentage is going up.

[19:56] Reza: So all this work we're doing, we have to find ways. And I think the brain computer interface is going to be probably one of the biggest ways to replace some of those things to keep us going. So those dopamine neurons have to stay healthy. In the case of Alzheimer's, it's what are all these bad proteins doing? Why are they building up and why are they killing my brain cells? So I think we've figured out what the pathways are, a lot of them, and we know we just need to intervene.

[20:25] Briar: This is what I've been hearing from the community, so even if I do find a way, which I'm pretty determined to do, so to live to 130, 150, 300 years old, everyone said, Briar, that's all well and good. Say your arm starts failing you, you can replace it with a robotic limb, or say you are not able to walk, you could do like an exoskeleton or you can replace all these failing organs or you could get a pacemaker sort of thing. But everyone's saying the one thing that you can't replace is your brain. And that your brain does sort of expire perhaps around the 120, 130 mark, is that what you are saying and thinking as well? How do we push past this brain thing, like we can keep our body living forever?

[21:18] Reza: You're absolutely right. That is very much in line I think with what modern medicine would say, like all these, by the time you get to 120, your risk of many of these diseases is, 80, 90%. So how are you going to get past it? But that doesn't tell me that there's nothing to do about it. That just means we have to find ways to simulate brain structures.

[21:39] Briar: Yeah.

 [21:40] Reza: I don't see any reason it's not, we've come up with livers and kidneys and all this others, with growing other organs that the challenge there is, yeah, how do you maintain your consciousness, your memories, all of those things. Again, these problems to me I think are solvable, not today, but I think they're all things that can be solved. So yeah, is it more complicated than a mechanical arm? Sure, of course. But we're learning a lot, and I can see that there are ways, just like Parkinson is a great example. We're getting better and better and better. We have deep brain stimulators. I put a little tiny wire down deep into your brain through a brain surgery and walla you're moving better. So clearly there are ways to keep pushing the brain further.

[22:23] Briar: Do you think that big pharma will be able to cure things like dementia, Alzheimer's, Parkinson's? Or do you think there might be some other piece of technology? Like what's the most promising things that you're seeing in your field in terms of cures?

[22:38] Reza: That's a great question. I'm most reassured right now by whether it's big pharma or other government or academia moving higher in the pathway, so to speak. So when we're looking at Alzheimer's and these proteins are already there, to me that's too late. Like, looking at amyloid or tau, great, we need to know how they work, but that's like 20 years too late. So what I like is we are getting better at going, oh, this is now something that happened five years ago. This is what happened 10 years ago, and so on. So we're getting really good at detecting what's changing 20 years ago. So that right there, that gives us targets. And I think incentives are getting better aligned. I think part of the challenge, and this is big picture sort of government level things that I'm not an expert with, but when big pharma is making such a big investment, they have a lot of inertia.

[23:29] Reza: They feel that they have to, even if 10 years ago they realized this probably isn't going to be super helpful, they have so much momentum and pressure to continue the next 10 years and get it to market. So just like anything in life, right? With science, we need to AB test quickly. So if you see something that's not working, I want them to have the system support them to say, okay, we're going to switch gears. So we have to find a way where revenue and incentives can align with that. I don't have a great answer for that, but I think that's part of the problem that's kept things slow, is we don't have aligned incentives. So that's one big area, but I absolutely don't see any reason why we can't see major improvement in these areas.

[24:10] Briar: So I've got one more question before I start diving a little bit deeper into this immortal mind upload consciousness, brain computer interfaces, some of my most favorite topics that I'm really keen to pick your brain about. But, for me and keeping my brain at optimal health, is there any kind of activities I should be doing on a daily basis to be like training it? You know how I go to the gym for weightlifting, for instance? I'm doing that like every single day. Like, I'm so big on Pilates and like taking care of my health and I definitely think it's very good for my, as you said, brain health as well. I see a huge difference in my mental health, but yeah what kind of like weightlifting should I be doing for my brain?

[24:53]] Reza: That's a great question. What we know works, we use the term moderate exercise. So what I tell people is weightlifting doesn't really, whatever activity you're doing, as long as your heart rate is elevated to the point where it's kind of hard to talk, you're feeling out of breath, you're building up a sweat, that's that level. So walking in more casual activities, people often tell me, oh, I walk, 10,000 steps a day. Great but that's not quite linked to the brain health. When you get into that moderate stage, your body starts to release a lot of chemicals that are healing to the brain and neurotrophic kind of chemicals. So they're helping build brain connections. So that's where you want to be. So those activities you just listed are all great 

[25:37] Reza: And it's just having to write a level of intensity, I tell people, is kind of the key. Not necessarily exactly what you do. On top of it, I would say just for longevity in general, we want to maintain muscle mass, for men and women, much after the 30, late thirties, early forties, we see a precipitous drop in muscle mass. And so doing the things to offset that will dramatically improve your longevity, because how do we predict, how do I predict if one of my 80 year olds is going to survive the next year? Some of the strongest risk factors are what's their VO2 max, what's their grip strength? What's their standing and seating. It's like, what are their big muscles capable of? And what's their kind of heart and lung capacity? And those are all things we can improve.

[26:22] Briar: Yep. And that's really interesting. And what about things like neurofeedback training or I don't know, doing puzzles or creativity or friendships? Like what kind of impact do these things have on our brain as well?

[26:37] Reza: Absolutely. So part of when I do a cognitive care plan with patients, one of the areas is the social interaction. That's another muscle, that's another lever to pull. Especially with older guys, typically they're a little more stubborn. They tend to isolate a lot. It's natural. It's kind of scary when you look at the graphs of how much social time people get with life. For both men and women, it goes down, but for men it really goes down. So I really work with people to combat that, signing up for a lot of volunteering, usually, especially both men, but guys particular, they do better if there's a sense of responsibility. So often I'm kind of saying, Hey, why don't you go volunteer at your local church or the soup kitchen or whatever it might be because then that'll force the social interaction without them realizing that's the point. So social interaction is huge. Without it you will decline much faster. So I think that's a significant thing. So I think anything you can do there and just realize no matter what you do, it's going to get harder as you get older. I mean, we just tend to get isolated.

[27:41] Briar: Okay. So we have to be a bit more intentional as we get older with our friendships. 

[27:46] Reza: Exactly.

[27:47] Briar: I can see that happening. Now I've got like three friends, whereas back in the day I used to have like 3 billion.

[27:52] Reza: Absolutely. That's exactly right. And you get busy, right? Yeah. Life gets busier, but yeah, you got to kind of just force it, even if it's a small gesture.

 [28:01] Briar: Yeah. So brain computer interfaces, I have interviewed Noland Arbor. He's the world's first recipient of the neural link. And following that, about three weeks ago I interviewed Bradford Smith and he has late stage ALS so he could only move his eyes. So he was using the brain computer interface to communicate somewhat telepathically, which was fascinating. It was so fascinating to see how much hope and autonomy that this BCI had brought these gentlemen in their everyday lives. Where do you see the future of technology and the brain?

[28:38] Reza: Absolutely. So I think these are probably low hanging fruit, is not quite the right term, but yeah, I think these are areas where it's great to get started because I think you can see real results immediately. Can they use their brains to do things that their bodies can't do anymore? I've been interested in that in a long time. We used to do little coding competitions and see, could we use, with electrodes or something, get some feedback into the computer and control something on the screen with your, thoughts. And so, this has been going on a long time. Definitely been following neural link and similar projects. Making huge strides. Honestly, I'm impressed with how fast the field is moving.

[29:21] Reza: It might not feel fast to everybody, but it's actually moving pretty quickly. So I'm extremely optimistic. I don't think we're far from having at least control of a lot of our external kind of body movements with simply the brain interface and obviously someone you met, someone obviously with late stage ALS, it's completely earth shattering. I mean to empathize with that is almost impossible and to be sort of trapped in your own body. So I think these are, I mean, just wonderful ways to start, but then the next level. What else can we do? That's where we get into like even more human potential. Sure, we can move my arm, but now if I'm interfaced with AI, now all of a sudden, am I expanding my reach now? Am 10 xing, 1000 xing my potential? You can kind of think about so many scenarios here.

[30:18] Briar: Well, especially since earlier on in our discussion, you say, we're only tapping into such a small portion of our brain. Do you think that through artificial intelligence, that might even like open us up? 

[30:31] Reza: I think so. It is sort of like, imagine the analogy of just in my average day, if I had a coach next to me that was aware of my thoughts and said, Hey, you're being mean to yourself right now. Don't say that. Don't beat yourself up or on the other side of it. Like, ah, you're a little too full of yourself. Imagine having that coach helping throughout, I mean, how much more productive you would be. I get caught up all the time. Like, something makes me put something off or I'm procrastinating. This is just, I'm talking at the like, easy for me to understand levels, but then there's so much more. And so if AI is really in there, I mean, how much it can enhance our day to day. I don't even know if I can comprehend it.

[31:17] Briar: Yeah, it's incredible to think, I sometimes like to imagine that maybe in the future we might all be connected via like a hive mind through our BCIs and that we'll be connected to artificial intelligence and then through that we could yeah, have like our thoughts uploaded to the cloud or quantum processing power, combining our creativity, perhaps mixed with the data and the accuracy and speed of artificial intelligence.

[31:46] Reza: I think that is absolutely like reasonable to think those ways. I've thought about that too. I think we can see this interface, not that far away, and now as we're all just using GPT, our LLMs, it's getting easier and easier to see. Well, it's not a huge leap then to have a little more directly, interface with us.

[32:09] Briar: So, you know that the neural link engineers, what are you kind of seeing in terms of the development of this tech? Like you mentioned, it's not very far away. Like how far are we talking, to the point that maybe healthy patients might be having brain computer interfaces?

[32:27] Reza: Right. That's a good question. From what I've seen, I mean, there's a mix, at places like Neuralink they have focused on hardware engineering. If initially there is some hardware involved, like what is that going to be? Because in some cases, they're testing people with handheld devices or just something where they can make some small movement. And then obviously a lot of the research is, well what kind of lead or, device do I put in the brain and where can it plug in, where it can actually, almost like if I was going to plug into a computer, so it's attached to the highway, so I know everything that's going on? The biggest challenge is where can I plug in, like at the thalamus, like deep basal ganglia structures, where there is like with less surface area, I can access more content of the brain, if you will.

[33:18] Reza: But pretty soon we're probably not far from being able to, with better materials, better metals, like covering the entire brain. I think that's the hardest part is, where do I put the device so that I'm detecting what's coming from your brain? So if you have the thought, I want to move my finger, it might be in this one spot, but what if you have other more abstract thoughts? what if it's not just moving my finger? What if, I'm having more complex thoughts, where does that arise? That I think and from what I understand, is kind of, one of the biggest issues to solve. But where they're making progress is with movement because we do know at least where they localized it to a large degree. And so I think those are easy places to get started.

 [34:02] Briar: So here's a question for you. Do you think you would get a brain computer interface?

[34:09] Reza: It's a good question. It's funny, if you look at my life, typically, I love researching and testing, but in terms of my day to day, I tend to be a little bit of a later adopter in general. But I'm not sure exactly what drives that, other than I'm probably, honestly the biggest driver is probably when I do dive into something I'm all in, and I adjust. My whole lifestyle and I want to do it, take it head on. So it's probably more of that than anything else. But I do, I see myself, I mean, I see the potential, like I'm automating so much in my day-to-day, both professionally and personally. I'm using AI day-to-day. I'm honestly less concerned about privacy than I think the average person. I certainly respect the concern, I support it and want to think through it. But yeah, I'm typically a bit less concerned. And I think privacy standards are there. They help us, need to be in place in some ways. But I do think in healthcare in particular, they tend to hold back innovation. I think it's a little not as well characterized or just like, kind of well implemented.

[35:21] Reza: So in the US when I'm doing research, it's really hard to make progress because of privacy standard, which a lot of people don't really have the concern, but, because you have, the way it's implemented, you have to chase them down with all complex paperwork and get signatures that's really hard to get. So I'm less concerned about that. Certainly, it's on the radar, but I know that's a topic that comes up anytime there's a new technology, someone says, oh my God, what about like 23 and me, bringing them up again. Everyone is so concerned about the privacy. But then, time goes on and, oh, wow, this is great. We have this database of genetic information. So I think I see that happening. I think there's probably like a big bolus of privacy concerns and then things settle down. A long answer. But yeah, I would absolutely be open to it.

[36:10] Briar: Yeah. You might be the thousandth million.

[36:12] Reza: I might honestly. Yeah. And I've participated in research studies. I believe in giving back. I've been the recipient of information from others, so I've participated in numerous research studies. I've let people poke and prod me and do all kinds of things.

[36:28] Briar: And so you mentioned that you're using artificial intelligence to automate a lot in your daily life. How have you implemented AI? Are you using it for your health and data tracking for instance?

[36:40] Reza: I am at the level of training some like LLMs on my data. So I have like, fed all of my personal medical data to get insights to it. I'm not, I know people are concerned, but I'm not concerned about privacy. So it was my choice, my data. And so I fed all that in and that has given me insights. I've made several pretty, I would think, significant changes in the last year, year and a half, two years with the use of this technology. And I think it's probably making a big difference on my longevity. It's helped me identify insights into like a high cholesterol that runs in my family, and I've been able to intervene in a way now where it's dramatically lowered 

[37:28] Reza: It's helped me intervene in a number of other areas. For example, even it took probably this kind of insight, but finally, I'm one of those people, like, I think pretty average. I don't have a substance use issue, but I also realized, I'm like, I think any amount of alcohol is probably not great. No judgment to anyone that chooses, but I cut alcohol to almost zero, which is dramatically lower. So basically, my goal is to drink less than one drink per month. So I've been able to do that for about a year now. And again, I think this, for me personally, it adds up. I'm more prone. My friend's grandmother has a martini every night, and she's like 99. Some people, but yeah, for me, I just realized with the help of doing this bigger analysis with my medical data, it pointed out, I think you might be more prone to certain things. 

 [38:22] Briar: Interesting. I also stopped drinking as well. But I also had a great grandma who, when you asked her how she lived to 105 years old, she dedicated her longevity to working hard on the farm and a glass of sherry every night.

 [38:38] Reza: Exactly. A part of why I like treating dementias. I love the stories from the older folks I see. Yep. I've heard that many times.

[38:48] Briar: What will happen in the future when we've all got an older population? So maybe we all are living to 120, 130, as you sort of mentioned earlier, like, what will that mean on things like our brain? Like, are we all going to have things like dementia, our Alzheimer's? Like what kind of impact do you believe that have on society?

[39:11] Reza: I think and part of the urgency I feel in my work that is a significant concern are the population that's aging now, we're going to have to carry a larger burden, right now with no changes, much larger burden of dementias and other neurodegenerative diseases. So I feel like I'm rushing. I'm rushing to find these solutions because our baby boomers are now the oldest baby boomers are hitting their eighties. I mean, there's a big wave coming. So those numbers are going to go up, and we are really under prepared for it in the US at least I can say, extremely under prepared. I tell people, imagine all of a sudden 2, 3 million people showed up with a certain cancer and just all of a sudden, all on the same day, they said, oh, we've got this cancer we're going to treat. I mean, our systems would buckle. We would really, it would be huge issues. I don't see why though, over the next, 10 to 30, 40, 50 years, we can't get to the point of having technology, these interfaces to give to people and detecting it earlier, intervening earlier, but also then giving them these interfaces to extend longevity. The combination has to happen. But yeah, I spend a lot of my time worrying about what's happening right now and watching how many people are getting dementia. 

[40:27] Briar: Like how many people are getting dementia right now?

 [40:30] Reza: So, in the US we say at least 7 million people have it, but more than half of them don't even have a diagnosis. Don't even know. And that's an old number, so that's before these kind of, the baby boomer, the larger older population in the US is really getting to that age. And so it's on the order of millions, your risk factor goes up, it's in the single digit percentages when you're in your sixties, but as you go into your seventies and eighties, it's going up 10, 15, 20%. So that's a significant portion when you're talking about a population that's tens of millions. 

[41:04] Briar: And what kind of impact do you think that artificial intelligence is going to have either on like the diagnosis or perhaps the cures of these sorts of brain diseases?

[41:16] Reza: Absolutely. I mean right away, I think diagnosis today, if we had artificial intelligence live, I think we could be diagnosing much earlier across the board very accurately. I don't think that even needs to wait. I think we have the technology. If you let AI have access to things like your mobile phone data, some of your medical data, I think it could very accurately tell you, okay, I think this is early stages of Alzheimer's disease, or there's something happening. We need to do more testing. We have new blood tests now for Alzheimer's and other dementias. We have skin biopsies. It's getting easier to detect it, and those can detect it again many, many years before you actually show the symptoms. So I think today, yeah, it's a big opportunity. And I'm hopefully seeing a faster adoption than in the past with other technology. So we're seeing AI coming in. In my work, I use AI to take in health data and try to build these automations and take interventions earlier. So that's today, I mean, yeah, I don't think we need to, like there's nothing we're waiting for at this point. We just need to implement it.

[42:24] Briar: So these automations that you're talking about on like a day to day, so are you using, so you mentioned LLMs, but chatGPT, or say someone's listening to this and they're like, oh my God, I'm really into longevity. I want decent brain health. I want to start automating my data. Like, how could they start doing this?

[42:42] Reza: So I think on a personal level, I mean, things that I've done, I think that anyone can do today, is gather up, so much has to do with data. So gather up your data. Luckily they're good at reading PDFs and all kinds of formats, so get what you can. I feed it in and I explain to it. You have to do a lot of teaching. We call it prompt engineering, but you have to explain, Hey, I want to look at this. This to the lens that I care about, in my case, it was, Hey, let's start with like peer reviewed literature. Let me look in medical journals. Don't give me stuff that people are chatting about necessarily on like a chat board, but you can, but just customize it for you. And then I give it all the data I can. So I've downloaded all my health records, I've gotten a lot of lab tests myself, testing like you mentioned, like cognitive testing. I feed it all in. And it's remarkably good. And I found it to be very accurate in assessing where I'm at. And honestly, in some ways it's kind of fun. I've given it test scores, like my SAT scores when I was in high school, and things like that to say, where am I? Like am I trending a certain way 20, 25 years later? Sky's the limit. So if you have that data, I've taken, like, I've scanned in all kinds of stuff. So that's on a personal level, just feed it data, give it guidance and like see what it can do.

[44:02] Reza: But the models now can take in quite a bit of information so you can feed it. I mean, I think for most people, you can feed it as much as you can and you won't run out of space. In terms of, on the professional side, the way I use it in many ways, but in terms of directly impacting health and like our brains, I'm using it to automate cognitive testing for clinics, for other providers because I think to myself, okay, here's my strong opinion about early testing and what we should be doing, but then how do I get all my colleagues to do it? Because I get it, they're busy, they're not thinking about this. And so I'm building tools that help automate it for them so that all those people I mentioned, those 7 million people, they can all get screened every year quickly, early, and then opens a door to intervention.

[44:47] Briar: That sounds like an amazing thing. Let me know when you're releasing it, I'd love to get my hands on it as well. I'm sure there are lots of people who would be interested.

[44:57] Reza: Absolutely. Right now we're working directly with kind of health organizations. And the key is also, we work behind the scenes because we know healthcare providers are burned out. We're not trying to give them something new to learn or anything. It's really meant to be behind the scenes. And I think that's a lot of this. And getting back to the brain computer interface, so much of it is helping us on the subconscious level. Like asking someone to pay more attention to more things is maybe not as realistic. But if I had a coach right next to me that was helping guide me, that's the key. And so professionally with the tool we're working on, I mean, it's essentially a coach for providers, but it's not taking their attention away. And just like in my personal life, I need a coach to just stand next to me and remind me, it's time to take a break. Go for your run. That kind of thing.

[45:43] Briar: Yeah, no, of course. And I think especially with social media as well. It's like so many people just find themselves scrolling for like an hour, two hours, watching Netflix. Like, what kind of impact is this cheap dopamine having on our brain? Because obviously we're getting all these little dopamine hits, but we're doing jackal to really earn it when we think about it.

[46:07] Reza: Yeah, that's a really good point. I've fallen prey at time, so I have to like, even have like block certain websites or delete apps because I'm human I will fall into the trap.

 [46:17] Briar: Same. I had to delete Reddit recently. I was reading some stupid stuff about Meghan Marco all the time. I was like, I don't even care. Why am I here? 

[46:25] Reza: Exactly. How did I get here? Yeah, an hour goes by. I do think unfortunately, it is absolutely fracturing and destroying the average human's attention span. And I think that has the downstream impacts on dementia because it's taking away our ability to do the things that are helpful and certainly destroying our attention in terms of like paying attention to important things. So with having like a shorter attention span, I've noticed it daily. I mean, with my colleagues, my friends, children around me, Hey, like, let's pay attention to this. So I'm constantly fighting it. It's like you have to work hard to fight it, but I will bet that it will be found over time if it's unchecked to accelerate dementia, to kind of correlate with it. Not necessarily pause it per se. But I can definitely see it being like a correlation in terms of trajectory, how fast someone would decline to shorter their attention span. I definitely think so.

[47:27] Briar: So focus, sustaining our focus is a superpower these days. So reading books and timing ourselves maybe like really kind of pushing through that. Here I am over here, here I am doing this, jotting around this attention deficit disorder we almost seem to have.

 [47:47] Reza: Yes. Yeah. Basically do what you have to do to be able to focus on one task at a time, turn off notification. We just have way too many alarms in our life. So when I'm working, everything's off. And my phone has actually, except for phone calls, it doesn't have any notifications because I'm one of those people, I get sucked in, if I see I got to respond. So turn that off, learn to focus. And this is why all these research studies, how many research studies have we seen for how many decades about how meditation's good for you. It's like, okay, I get it. We keep seeing study after study, but that's the reason. It's because it's bringing you back into self-awareness, aware of your body, aware of where you are and focusing on one thing. And I think that's why meditation is protective. It helps in just about anything. So I mean, it just made it so difficult to pursue that.

[48:38] Briar: When are we going to find out like more about our brain? Like obviously things like meditation, maybe psychedelics. Things like this help us perhaps tap into something a bit deeper. I'm so curious as to why do we know so little? Like how can we tap into more?

[49:00] Reza: That's a really good question.

[49:04] Briar: Are they researching this at the moment? Or like, is there much research happening in this space, or is it just something that we've kind of given up on a little bit?

[49:13] Reza: It's a good question. I don't know that we've given up on it in that sense, but certainly research seems to be somewhat fractured. Part of what I've done a lot of thinking about is just the modern research style, like these sort of clinical trials or standardized or controlled trials. There are lots of terms. Those to me, I wonder if they're losing their utility, like that's not the way to study things. Because what it does is it focuses you on isolating a variable. And what we're talking about now is considering lots of variables together. And that style of research, I think makes it difficult to come to more than one conclusion in a very focused way. And part of what I don't like is a lot of trials I'll look at, but they've controlled it to the point where it's not really helpful for my average patient 

[50:03] Reza: Like, oh, we took out anyone over this age or under this age, oh, that smokes, that does this. I mean, by the time you look at inclusion exclusion criteria, you're like, well, who is this applied to? So I think there are a lot of flaws with research. I think it has time in place. But I do think we're in an era now where we have to work together and do much larger scale, huge data trials. So I need access to millions of patients of data, doing trials with 30 patients and then making a conclusion like exercise help with this. I'm not as excited about that, but I think that's part of it. I think systems don't support it. So I think it is making it hard and people's motivation is going down. You do see some progress in the UK, in other countries where there's like larger, broader networks of data that are coming together. And there's more synergy. But I think that just needs to become the standard. Like if I want to do a study and I have an idea and I want to research something about brain computer interface, it shouldn't be so hard to recruit patients, or to get data. I should have access to millions of points of data if I need it. But I think to me that's one of the biggest issues.

[51:18] Briar: What do you think that people listening to this podcast, like what would you say are your top three take home messages when they're thinking about preparing for a future? And obviously we're going through a period of exponential change. We've got the media constantly, like fear mongering us, and social media. Like there's a lot of things wrong with today's society, but yeah when we're thinking of becoming this future human, what do you think we should keep in mind?

[51:48] Reza: So I think number one, I would say in terms of like what that's going to look like in the future, I would say for people to maybe move forward, just err on the side more of, I think optimism and hope and a little more openness. I think it's tempting. Whenever we've lived in history, it probably seems like, oh man, there's a lot to be worried about and things are not going well. I think that's kind of how we've always felt, when you look back hundreds of years.

[52:17] Briar: When we were living like in sewage and with the rats. Life was hard.

[52:21] Reza: There's always something we worry about. So I think, as these technologies come out, I think just being open to participating and like being optimistic that it can help and just like moving forward with that earnestness, I think number one for me, that would really help us come together more. I know it can be hard. I know there are lots of reasons to be concerned, but I do think that would help speed things up. So when people are asking for my data, again, I'm more open to it. I'm a little less concerned. I think number two, I would say pick one thing. I mean just start with implementing one change in your life. I always tell people don't try to do it all. We talked about a lot of things, but just pick one thing, one area.

[53:05] Reza: Something resonated. For everyone that listens, something will resonate. They'll think, oh, okay, oh yeah, that's an area I'm having trouble with. Just spend the next six months and just dive deep. See if you can make an improvement, whether it's your sleep, whether it's your exercise, your nutrition, whatever it might be. Maybe you're like, oh, no, my friends have been telling me, like I keep talking louder and I'm like, not hearing things, get that checked out. So I think just pick one thing and I think that will give you a really tremendous sense of power and just reward too and can kind of become a domino effect to do other things. And I think those are the big two. I'm trying to think like what would be my third biggest thing.

[53:48] Reza: I mean, maybe I would say then on the side of how we spend our time, maybe a little bit on the kind of how we consume media and social media. What I love is people like you giving access to information in a really clean, direct way, without the sort of like misinformation and obviously lots of other influences I think has just dominated other sources of media. So I think fracturing other people's attention, like if someone can sit down and listen to your show and pay attention, that's a big win. That's good for. Just sit down, listen, like don't check your phone. You're listening right now. Don't check your phone. Get rid of the other distractions. Just practice and see how it feels. It's hard. Like it's become really hard, but the more you do it, it does get easier. Maybe if you have to take a copy of this podcast and go sit by a lake somewhere in the woods. And just listen and just see what that's like. So I would say the third thing is really more about attention. Yeah. Like how do you restore your attention?

[54:58] Briar: Well, lots of take home messages for everybody listening today. So thank you so much for sharing all your thoughts and opinions and advice and I'm very keen to improve my brain health because I did my true diagnostics test and I came back younger than before, so I was overjoyed. So my biological age is 27, I'm 33 chronologically. So I was very happy by that. But there was one thing, a couple of things, but one thing that really stood out to me, my brain age is 38. So this is something that either I'm extremely wise, which I know I am, but I was thinking like, oh, like I think this needs to come down a little bit. Maybe it's the impact from technology. I obviously exercise very well. I eat very healthy, but I'm like, oh, 38, like how do we make this 27? What's your thoughts?

 [55:57] Reza: And I wonder, and I actually need to do, I'm always evaluating these kinds of tests and seeing what they look at. So you wonder too, because obviously you are doing a lot of the right things, in terms of what they look at and I haven't looked yet, so I don't know exactly, but in terms of what I would guess is maybe sleep or stress or certain other angles that are contributing that. And that's a good message that you can make progress in lots of areas, but we got to do one thing at a time, but we do got to cover all the areas. We can't leave out, for example, sleep, like great, doing everything else, right. But obviously sleep is a time when our glymphatic system is just really cleaning the brain during sleep and it doesn't happen other times a day. Again, I don't know, that's just one general comment. But I can see lots of other things and stress too. I mean like, are we really dealing with stress? That's a big one for me. I'll do all these other things, but sometimes I think I'm sure stress would impact my performance on that test.

 [56:57] Briar: What other tests do you think I should maybe as part of my journey go out and get as a next phase? Because this true diagnostic one, you're right, like maybe it stays this one little thing and then I go get tested by something else and it'll be like, ah, you've got the brain health of an 18-year-old.

[57:10] Reza: Right. Absolutely. So I think the true diagnostic included a neurocognitive test, which you mentioned, in terms of like how fast you were clicking and thinking through things. I think that kind of test, so that's great. Again, I have the exact contents of it, but I think if you have that and you have that repeated every so often, that's super helpful. The fact that they're looking at inflammatory markers, I mean, I'm just looking right now, but it looks like they cover a lot of bases. I mean in general, I think that these are really good. I would also just higher level inflammatory, like the things like deep dive into cholesterol, like the specific types of cholesterol blood pressure. Like we want it lower than I think traditionally we've tolerated for a lot of people. We want like nice calm, blood flow. Those are a couple of other things, I mean, it looks like they are pretty comprehensive from what I can see.

[58:08] Briar: Okay. Amazing. That sounds positive for me. 

[58:11] Reza: Absolutely. No, you're clearly on the right track and I mean, yeah, the good thing is you're doing it at the right time. So you're doing it. Yeah. You're not doing this when you're in your sixties, you're doing this much earlier. So yeah, you'll see results. 

[58:23] Briar: It kind of gamifies the experience a little bit as well. Like the first test that I got, I was horrified with the result that came back. I did the GlycanAge test about a year ago. And it came back saying that I was, yeah, like 38. And then my real age was like 31 at the time. And I was just like, what the hell? Like, I've been trying so hard with my longevity journey. The person that I was speaking to Sebastian, he's like, well, this is your first time testing. How do you know you weren't even worse before? So further to what you said at the start of the discussion, this is why it's so important that we are testing our data. We at least do have a baseline measure so that we can try and improve it from there and feed it to AI. I love all of your advice that you've shared about this autonomous doctor AI that you've been using. Very interesting. I'm going to do a similar thing because I don't really care about my data either.  

[59:21] Reza: That's excellent. Yeah. Good for you. Doing all of this and encouraging others. Everyone that's listening, take one step, but I mean, there's so much we can do to improve our longevity, improve our brain health. So yeah, that's a big message. 

[59:36] Briar: Amazing. Well thank you so much for coming on the show. This was so interesting and thank you for sharing all of your insights with us.

[59:43] Reza: You're very welcome, thanks for having me. 

About Reza Hosseini Ghomi

Boston-based neuropsychiatrist-engineer Reza Hosseini Ghomi is the clinical brain behind MedFlow’s automation platform, blending frontline dementia care with full-stack product chops.

He designed and deployed his first EHR in medical school after seeing clinicians drown in paperwork, foreshadowing MedFlow’s workflow mission. Over the past decade he has launched four health-tech start-ups, notably NeuroLex, a voice-biomarker company acquired by Sonde Health in 2020, creating a 500 K-sample vocal data biobank. He built and scaled BrainCheck’s R&D pipeline. He also co-founded Frontier Psychiatry, a virtual behavioral-health network now exceeding ~$12 M in annual revenue, proving he can scale care models.

Clinically, Reza has diagnosed over 1,000 dementia families, giving him unmatched insight into care-gap pain points and real-world ROI triggers. He has worked on projects across enterprise health systems, SMB, pharma, and government, cementing his credibility with health-system partners. A cancer survivor at 22, he pivoted from naval engineering to medicine—an early test of resilience that now fuels MedFlow’s mission to catch conditions before crisis.