Category: News

2021 Neurodiagnostic Week

Neurodiagnostic Week 2021 takes place from April 18-24. At DENT Neurologic Institute, this is one of many ways we can honor and celebrate our Neurodiagnostic professionals for their contributions by demonstrating their value to quality healthcare.

The purpose of the week is to acknowledge the year-round efforts of the Neurodiagnostic professionals around the world. It is an opportunity to educate others, recruit new students into the profession, and to promote Neurodiagnostic awareness in the community. It is also a great time to celebrate the individual accomplishments of Neurodiagnostic technologists everywhere.


What do Neurodiagnostic technologists do?

Neurodiagnostic Techs record and study the electrical activity of the brain and nervous system in a variety of ways. They work with patients who have diagnoses of epilepsy, coma, sleep disorders, tumors, strokes, and countless more diseases, injuries, and conditions of the central and peripheral nervous systems.

Procedures performed include electroencephalography, evoked potentials, intraoperative neuromonitoring, long-term monitoring, nerve conduction studies and polysomnography or sleep studies.


Electroencephalogram (EEG)

An EEG, the most common test performed, detects electrical activity in the brain. This non-invasive procedure is used to help diagnose a wide array of disorders, including seizure disorders, head injuries, brain tumors, infections, degenerative diseases and metabolic disturbances.

The test involves recording and evaluating electrical activity of the brain, detected through electrodes attached to your scalp that are connected by wires to a computer. The computer will record your brain’s electrical activity represented as wavy lines. During the test, you will lie in a prone position in a relaxed and quiet atmosphere. While in the recording phase of your test, you may be asked to complete simple tasks, such as opening and closing your eyes.


Polysomnography (Sleep Study)

Your head is measured so that all electrodes fit comfortably and securely. Removable marks are made on your scalp where electrodes will be placed. Several others are placed on your chest and legs. Special jelly is applied to each electrode, which is then glued to your scalp and skin with an air blower. To measure your breathing, a plastic belt is placed around your chest. Wires are placed by your nose and mouth to monitor air flow during breathing, and a probe to measure the oxygen saturation of your blood is taped to your finger. Set-up may take 30 minutes or more.


Neurodiagnostic & COVID-19

As the ongoing COVID-19 pandemic evolves, healthcare providers and research experts are learning more about how this virus impacts us. Initially thought to primarily affect the respiratory system, it is now known to be linked to several neurological conditions and is given little media attention. According to a survey ASET conducted in December 2020, Neurodiagnostic technologists witnessed a range of neurological symptoms amongst patients who tested positive or were under investigation for COVID-19.


Neurodiagnostic Week is sponsored by the ASET – The Neurodiagnostic Society and is celebrated annually during the third week of April.

How aging can change your cannabis routine

Read the full article here on


When I first started consuming cannabis, I was a 21-year-old college student. My cannabis routine consisted primarily of shared bowls, bongs, and blunts packed with THC-dominant cannabis flower, and I typically only consumed on nights and weekends.

Just as it does now, cannabis helped me relieve stress, anxiety, pain, and depressive symptoms back then. It helped me fall asleep faster and sleep better as well. But in the near-decade that’s passed since my first toke, aging has changed my cannabis routine in so many ways. Everything from my preferred method of cannabis consumption to my dosing preferences to my THC tolerance is completely different now.

Just as it does now, cannabis helped me relieve stress, anxiety, pain, and depressive symptoms back then. It helped me fall asleep faster and sleep better as well. But in the near-decade that’s passed since my first toke, aging has changed my cannabis routine in so many ways. Everything from my preferred method of cannabis consumption to my dosing preferences to my THC tolerance is completely different now…… more on the original article


Vaccines and Pain/Fever Medicines

Dr. Gengo shares information from a recent article. The use of Motrin and Tylenol when getting a vaccine possibly may have a negative impact on the immune response to the vaccine.

The recommendations:

  1. Use those medications only if needed.
  2. Using the medications before the vaccine to prevent side effects seems to have the most noticeable impact.
  3. Tylenol use a few hours after injection does not seem to have a negative impact on immune response.

Important notes:

  • Do NOT interrupt daily aspirin therapy.
  • If you take daily aspirin for cardiovascular or cerebrovascular protection do not skip your aspirin because of your COVID vaccine
  • If you are taking aspirin 81 mg daily this is not a high enough dose to produce an antipyretic or anti-inflammatory effect and should not compromise your vaccine
  • If you are taking aspirin 325 mg daily , take your last dose of aspirin the MORNING before your vaccine and then take your aspirin at least 4 -6 hours after your vaccine on the day of inoculation


In summary, do not shy away from using Tylenol after vaccine administration if need and try to avoid Motrin and Tylenol as prophylactic treatment before the vaccine. The full article can be found here.

Covid-19 Vaccine Myths & Facts

By: Bennett Myers, MD, Director of DENT Multiple Sclerosis & Immunology Center and the DENT Spasticity Clinic.

The following information is from the Mayo Clinic in Rochester, Minnesota. It is considered by many to be the top health care center in the world.

The 2 vaccines available have already been given to over 10 million Americans. Outside of very rare serious allergic reactions, no dangerous side effects have been found.  Some side effects experienced were: sore arms, flu like symptoms (usually mild after first shot, mild to moderate after second) lasting from one to several days frequently occur.

Over 400,000 Americans have died of COVID-19 since February 2020, even if you are young, healthy, and low risk, you interact with people who are not (at home, at work, and in the community). COVID-19 may not kill you, but it can kill people you come in contact with. Only if enough of us get vaccinated will this pandemic end.


Let’s set the record straight on some of the myths circulating about COVID-19 vaccines.


Myth: The COVID-19 vaccine is not safe because it was rapidly developed and tested.
Fact: Many pharmaceutical companies invested significant resources into quickly developing a vaccine for COVID-19 because of the world-wide impact of the pandemic. The emergency situation warranted an emergency response, but that does not mean that companies bypassed safety protocols or didn’t perform adequate testing.

Doctors will recommend the use of those vaccines that we are confident are safe. The Pfizer and Moderna vaccines were created using a novel technology based on the molecular structure of the virus. The novel methodology to develop a COVID-19 vaccine allows it to be free from materials of animal origin and synthesized by an efficient, cell-free process without preservatives. The vaccines developed by Pfizer/BioNTecH has been studied in over 43,000 people.

To receive emergency use authorization, the vaccines must be proven safe and effective. The FDA and an Advisory Committee on Immunization made up of a panel of vaccine safety experts independently evaluated the safety data from the clinical trials. The safety of COVID-19 vaccines continues to be closely monitored by the Centers for Disease Control and Prevention (CDC) and the FDA.


Myth: I already had COVID-19 and I have recovered, so I don’t need to get a COVID-19 vaccine.
Fact: There is not enough information currently available to say if or for how long after infection someone is protected from getting COVID-19 again. This is called natural immunity. Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this. The CDC recommends getting the COVID-19 vaccine, even if you’ve had COVID-19 previously. However, those that had COVID-19 should delay vaccination until about 90 days from diagnosis. People should not get vaccinated if in quarantine after exposure or if they have COVID-19 symptoms.


Myth: There are severe side effects of the COVID-19 vaccines.
Fact: There are short-term mild or moderate vaccine reactions that resolve without complication or injury. About 15% of people developed short lived symptoms at the site of the injection. 50% developed systemic reactions primarily headache, chills, fatigue or muscle pain or fever lasting for a day or two. Keep in mind that these side effects are indicators that your immune system is responding to the vaccine and are common when receiving vaccines.


Myth: I won’t need to wear a mask after I get vaccinated for COVID-19.
Fact: It will take time for everyone who wants a COVID-19 vaccination to get one. Also, while the vaccine may prevent you from getting sick, it is unknown at this time if you can still carry and transmit the virus to others. Until more is understood about how well the vaccine works, continuing with precautions such as mask-wearing and physical distancing will be important.


Myth: More people will die as a result of a negative side effect to the COVID-19 vaccine than would actually die from the virus.
Fact: Circulating on social media is the claim that COVID-19’s mortality rate is 1%-2% and that people should not be vaccinated against a virus with a high survival rate. However, a 1% mortality rate is 10 times more lethal than the seasonal flu. In addition, the mortality rate can vary widely and is influenced by age, sex and underlying health condition.
While some people that receive the vaccine may develop symptoms as their immune system responds, remember that this is common when receiving any vaccine and not considered serious or life-threatening. You cannot get COVID-19 infection from the COVID-19 vaccines; they are not live viruses.
It’s important to recognize that getting the vaccine is not just about survival from COVID-19. It’s about preventing spread of the virus to others and preventing infection that can lead to long-term negative health effects. While no vaccine is 100% effective, they are far better than not getting a vaccine. The benefits certainly outweigh the risks, even in healthy people.

Myth: The COVID-19 vaccine was developed to control the general population either through microchip tracking or “nanotransducers” in our brains.
Fact: There is no vaccine microchip, and the vaccine will not track people or gather personal information into a database.

This myth started after comments made by Bill Gates from The Gates Foundation about a digital certificate of vaccine records. The technology he was referencing is not a microchip, has not been implemented in any manner and is not tied to the development, testing or distribution of COVID-19 vaccines.


Myth: COVID-19 vaccines will alter my DNA.
Fact: The first COVID-19 vaccines to reach the market are messenger RNA (mRNA) vaccines. According to the CDC, mRNA vaccines work by instructing cells in the body how to make a protein that triggers an immune response. Injecting mRNA into your body will not interact or do anything to the DNA of your cells. Human cells break down and get rid of the mRNA soon after they have finished using the instructions.


Myth: COVID-19 vaccines were developed using fetal tissue.
Fact: Neither the Pfizer/BioNTech COVID-19 vaccine nor the Moderna COVID-19 vaccines contain fetal cells, nor were fetal cells used the development or production of either vaccine.


Myth: COVID-10 vaccines cause infertility or miscarriage.
Fact: No, COVID-19 vaccines have not been linked to infertility or miscarriage.

A sophisticated disinformation campaign has been circulating online, claiming that antibodies to the spike protein of COVID-19 produced from these vaccines will bind to placental proteins and prevent pregnancy. This disinformation is thought to originate from internet postings by a former scientist known to hold anti-vaccine views. A similar lie has spread previously about other vaccines, including the polio, measles, and ebola vaccines.

These postings are not scientifically plausible, as COVID-19 infection has not been linked to infertility. Also, no other viral infection or vaccination-inducing immunity by similar mechanisms has been shown to cause infertility. Antibodies to the spike protein have not been linked to infertility after COVID-19 infection. There is no scientific reason to believe this will change after vaccination for COVID-19.
While there are no formal studies, the best evidence comes from women who got sick with COVID-19 while pregnant. While data clearly indicate pregnant women are at higher risk of hospitalization due to COVID-19 infection, there is no evidence of increased miscarriage rates.
During natural infection, the immune system generates the same antibodies to the spike protein that COVID-19 vaccines would. Thus, if COVID-19 affected fertility, there already would be an increase in miscarriage rates in women infected with COVID-19. This has not happened.


Myth: I am allergic to eggs so I shouldn’t get the COVID-19 vaccine
Fact: Neither the Pfizer/BioNTech COVID-19 vaccine nor the Moderna COVID-19 vaccines contain egg nor were eggs used the development or production of either vaccine. However, those with severe allergic reactions to eggs or any other substance (i.e., anaphylaxis) are encouraged to remain after vaccination for 30 minutes for observation.


Myth: COVID-19 vaccines must be stored at extremely low temperatures because of preservatives in the vaccines.
Fact: Pfizer/BioNTech and Moderna have reported that their vaccines contain no preservatives.

Different vaccines have different storage requirements. For instance, the Pfizer/BioNTech vaccine must be stored at minus 94 degrees Fahrenheit (minus 70 degrees Celsius), while Moderna has said that its vaccine needs to be stored at minus 4 degrees Fahrenheit (minus 20 degrees Celsius). Both of these vaccines use messenger RNA, or mRNA, to teach your cells how to make a protein that will trigger an immune response to COVID-19. However, messenger RNA is fragile and can break down easily. Storing messenger RNA vaccines, like these COVID-19 vaccines, in an ultracold environment keeps them stable and safe.


UB partners with CW Labs to advance cannabinoid science

UB partners with CW Labs to advance cannabinoid science

The original article can be found here.

UB’s Center for Integrated Global Biomedical Sciences (CIGBS) will partner with Charlotte’s Web Labs (CW Labs) on a research initiative to advance understanding of the therapeutic uses of cannabinoids.

The multidisciplinary research program will bring together researchers from UB, University of the West Indies and University of Zimbabwe to develop safe and optimized approaches to cannabinoid therapy. CW Labs is a subsidiary of Charlotte’s Web, a manufacturer of hemp-derived cannabinoid products.

The initiative builds on the research of Gene Morse, SUNY Distinguished Professor in the School of Pharmacy and Pharmaceutical Sciences and CIGBS director.

The CIGBS is an international hub that addresses global health challenges through pharmacological research, education and training, and drug and vaccine development.

“These scientists will contribute to a global understanding of cannabinoid replacement therapy approaches,” Morse explains. “They bring global expertise in areas such as cellular transport mechanisms that influence cannabinoid distribution throughout the body, clinical pharmacology mechanisms that contribute to different responses among individuals, and drug interactions between cannabinoids and commonly used medications.”

The collaboration will be co-lead by Morse and Jeffrey Lombardo, research assistant professor of pharmacy practice and CIGBS project coordinator for cannabinoid sciences.

Additional UB investigators include Laszlo Mechtler, clinical professor of oncology and neurology in the Jacobs School of Medicine and Biomedical Sciences at UB, and Jason Sprowl, assistant professor in the School of Pharmacy and Pharmaceutical Sciences. Researchers from the University of the West Indies at Mona, Jamaica, include Marvin Reid, director of the Tropical Metabolism Research Unit; Thejani Delgoda, professor and director of the Natural Products Institute; and Wendel Abel, professor and head of community health and psychiatry. Charles Maponga, director of the School of Pharmacy at the University of Zimbabwe, is also an investigator.

Dementia, COVID & the Holidays | Alzheimer’s Association

Navigating the Holidays and Alzheimer’s in the COVID-19 Era

Information via the Alzheimer’s Association

With COVID-19 surging across the country, families are struggling with decisions about the upcoming holiday season—weighing concerns about the safety of traveling and gathering with the desire to spend time with friends and relatives. For families who have a loved one with Alzheimer’s or another dementia, these decisions are even harder, especially since many families have forgone visits with grandparents, parents, and older relatives since COVID-19 began. The emotional pull to see and spend time with these loved ones during the holiday season is felt very keenly. To help families in their decision-making, a team of Alzheimer’s Association care consultants created this guide of tips and things to consider. We hope you will find it useful.


Start Now to Plan and Prepare for the Holidays

Discuss. Schedule a family Zoom or FaceTime to talk about upcoming holiday celebrations and visiting a loved one with dementia. If there is a family member serving as the primary caregiver for the loved one, be sure to include them in the discussion.

Consult. Check the CDC website——for COVID19 guidelines on visits with individuals deemed higher risk/vulnerable.

Consider. Think about what is best for the person with dementia and assess the risks of various options for family gatherings and in-person visits.

Decide. Reach a consensus among family members and make a decision for the holidays that everyone supports. Plan Map out how you’ll celebrate the season and divide up responsibilities and assignments to make it happen


Planning for virtual holiday celebrations

Start right away to create an enjoyable and meaningful holiday season by utilizing technology and Zoom/Facebook offerings to bring the family together. Find out the current device being used by the person with the disease and their caregiver.

It may be necessary for the family to consider purchasing a new, updated device to make viewing and participation in virtual activities more enjoyable. (Note this could be a joint family holiday gift for the loved one.) To ensure the person with the disease and their caregiver are able to participate in virtual events, arrange for training.

For instance, is a nonprofit that offers free videos and classes for seniors to learn technology. Identify one or two family members who can serve as the point persons to coordinate the details and logistics of the various virtual offerings.

Create a line-up of fun, entertaining, and emotional video programs throughout the season: Cook favorite dishes together virtually in the days leading up to the holiday. Share the holiday meal by having the loved one and their caregiver join your family virtually. Recreate family rituals in the new virtual space by saying a special blessing or having everyone around the virtual table say what they are grateful for this year.

Organize a series of musical performances where children play a musical instrument or sing holiday songs. These performances can be live or recorded as a video and shared with the loved one. Schedule virtual baking sessions with the loved one during the holiday season. Introduce new holiday traditions virtually, such as Couch Caroling, Gingerbread House Construction Competition, etc.

Play a family favorite game or find a new one to try over Zoom or FaceTime. Synchronize a virtual watch party of a cherished holiday movie via an online streaming service


Planning for a safe visit

Check the CDC website——for the latest COVID-19 guidelines on visits with individuals deemed higher risk/vulnerable. Avoid or minimize any type of travel for the person with dementia during this busy travel season.

Even car trips present risks, such as rest stops and restaurants. Restrict the number of individuals who will visit during the holidays.

Visitors must fully commit to adhering to the guidelines—pre-visit and during the visit—such as quarantining for the appropriate time period prior to the visit, wearing a mask and maintaining safe social distancing during the visit, etc. Make sure your loved one with dementia wears a mask when visitors are in the home.

If they refuse or are unable to wear a mask, maintain social distance in a well-ventilated area and ensure everyone else is wearing a mask. Consider having one family member be the official holiday helper for your loved one with dementia.

This should be someone who practices social distancing on a regular basis and is able to commit fully to the necessary safety precautions. If another relative serves as the loved one’s primary caregiver, the official holiday helper could provide much-needed assistance and respite for them.


Communicating about holiday plans

Involve the loved one with dementia in the planning as much as possible and as appropriate to the stage of dementia.

If the person has early-stage dementia, inform them of changes early and repeat as necessary to help them adjust.

If the person is in the middle to late stages, it may be more appropriate to address the new plans as they happen to avoid unnecessary confusion and stress.

Keep in mind that for someone with advanced dementia, it is not necessary to talk about the pandemic. Instead, simply remind them that there is a flu bug going around. Therefore, masks will be worn, or some visitors will not be coming as in previous years.


How to support a caregiver you won’t be seeing over the holidays

Be in touch with the caregiver on a regular basis—at a time that works best for them and allows enough time to talk.

Talk with a caregiver about what they need and how you can support them; and even help to develop a specific list. Share the list with others in the family.

Depending on how far away you live, consider going to the home for a day, and doing outside tasks—yard work, home repairs, putting up outside holiday decorations.

Find out if there are specific tasks that can be taken off their plate—gift buying, Christmas cards, etc.


Making the holidays meaningful for a loved one in a long-term care community

Check into the policies for visiting on the specific holidays.

If you need to sign up for visits on the holidays, be sure to do that as soon as possible.

Inquire about the community’s plans for the holiday season, such as festive activities and decorations.

Ask if presents or food items can be sent to residents.

Find out whether there are audio-visual capabilities in your loved one’s room or whether they have access to community equipment. Then consider sending them a mobile tablet and/or small CD player and also holiday song lists or classic movies. (Either digitally or on CD/DVD.)


Gift ideas for a loved one with dementia and a family caregiver

  1. Make a holiday scrapbook full of photos from holidays past and send that to the person with dementia prior to the holidays. This will help them to feel love and connected.
  2. Ask the caregiver for a gift list for the person with dementia and arrange for the items to be sent to the house. Ask the caregiver for their own gift list and then arrange to have gifts sent to the house.
  3. Create a family video montage. Ask the family to record short clips and ask a tech-savvy family member to put it together.
  4. Encourage family/friends to give different gifts this year, such as a weekly phone call for the entire year or a monthly card.
  5. Consider sending a monthly delivery of a home-cooked or restaurant-purchased meal. Look into gift cards for household or yard work services. Think ahead to what might be helpful for the rest of the year.
  6. Have someone in the family design a family mask and give one to all family members.



You can view the article here.

DENT’s Family/Caregiver Policy during COVID

The Dent’s Family/Caregiver Policy during COVID is that we are limiting access to patients only unless absolutely necessary due to the size of our examination rooms and the need to remain as socially distant as possible for the health and safety of our patients and staff.

Exceptions to this rule are patient’s that are under the age of 18 and must have a parent present for their appointment or for patients that have a medical condition that requires them to have a caregiver with them for their appointment. In these instances one visitor will be permitted in the office with the patient, additional guests will be asked to wait in their vehicle.

If you have any questions or concerns related to this policy, feel free to reach out to your provider team via the MyDentChart patient portal.

MIND Clinic Lecture Series

The MIND clinic is pleased to able to announce the establishment of a neuroscience lecture series that will be held every other Friday. This will be a webinar based lecture series by esteemed colleagues from United States, Hungary and Europe.

The one hour lecture will be held on Friday’s at 8 AM (ET). This would be 2 PM (Hungary time). The lecture itself will be 45 minutes long with 15 minutes for questions via chat. A list of topics and lectures will be forwarded in the upcoming weeks. The official language will be English.

This lecture series is supported by MIND clinic, Hungarian American Society of America (HMAA), DENT Neurologic Institute and PADME. The logistics of the meeting will be forwarded in upcoming correspondence.

The purpose of this lecture series is to allow neurologists, neuroscientists and interested colleagues the opportunity to meet the greatest minds of today in the field of neurology. Presenters will include internationally known thought leaders.

The MIND clinic has been established to promote educational and scientific values among residents, fellows and medical colleagues. This is especially important in today’s world of social distancing and the inability to hold academic meetings.

The first lecture will be held on October 16, 2020 and the subject will be:

“The Role of CGRP in the Treatment of Migraine”,
Laszlo Mechtler MD, FAAN, FAHS, FASN, FEAN.
Professor of Neurology and Oncology
Medical Director of MIND and DENT
Past President of HMAA and ASN

DENT Neurologic Institute and BryLin Behavioral Health System to Enhance Mental Health Services in Western New York

July 12, 2020

DENT Neurologic Institute and BryLin Behavioral Health System, Inc. have coordinated a
Memorandum of Understanding to strengthen the support to patients in our community
especially as many individuals are suffering from severe depression during these most difficult

“This is a partnership that WNY deserves with the top private neurology and psychiatry
practices combining resources and building relationships that will benefit the Buffalo community
and beyond” Dr. Laszlo Mechtler, Medical Director Dent Neurologic Institute.

The DENT Institute has been a leading provider of comprehensive neurological care in the
Western New York region for over fifty years. Our goal at the DENT Neurologic Institute is to
expand psychiatric services and to improve psychiatric care in Western New York including
Buffalo, Amherst, and Orchard Park. We treat adult patients for a wide range of mental illnesses
and addiction disorders, including depression, anxiety, schizophrenia, bipolar disorder, and
more. Over the years, our psychiatric team has continued to grow, which has allowed for
increased access to care as well as the expansion of Interventional Psychiatry services such as
TMS, Ketamine Infusion Services, esketamine, and psychotherapy.

“The current global health crisis has truly underscored the necessity of collaboration to preserve
and maximize our valuable medical resources. Dent Neurologic Institute and BryLin have
provided a prime example of our best instincts that we can be proud off. It is through such
progressive thought and action that we can overcome even the greatest challenge,” states
Horacio A. Capote, MD, Director, Division of Neuropsychiatry Dent Neurologic Institute
BryLin Behavioral Health System, with its two comprehensive treatment locations, is recognized
as an industry leader in behavioral health care throughout Upstate New York. At BryLin
Hospital, in downtown Buffalo, inpatient mental health care is provided for children, adolescents,
adults and older adults in crisis, struggling with various mental illnesses.


The Hospital is also home to the only ambulatory center for both inpatient and outpatient Electroconvulsive Therapy
(ECT) in Western New York, considered to be the most effective and rapidly acting treatment
today for major depression and other mental illnesses. At BryLin’s Behavioral Health Center, in
Williamsville, both outpatient mental health and substance use disorder care are offered using
evidence-based practices and specific treatment models, interventions, and technique.
Individuals of all ages, from child and adolescent to adults, heal from the impact of traumatic
stress. In this ever-changing field of behavioral health, BryLin continues to monitor the needs of
the community with an eye on future expansion of services and collaboration.

“Our dedicated staff, through the compassionate care they provide to our patients, are the
foundation to BryLin’s success as we strive to be the premier mental health provider in the
region”, says Eric D. Pleskow, BryLin President & CEO and founder’s son. “We have had a
long-term collegial relationship with the DENT Neurologic Institute through our collaboration.
Our energies are focused on having patient-centered care that brings respect and dignity to the
patients and families we care for who are affected by mental health issues.”

Dr. Sanjay Gupta comments, “This partnership will ultimately benefit our patients in Western
New York improving access to psychiatric care bringing novel and effective treatments providing
new hope.”

For more information, please contact:

Maria Caserta, Director of Marketing and Community Outreach, Dent Neurologic Institute at
716.310.1684 or

Mark Nowak, Director of Marketing, BryLin Behavioral Health System, at 716.604.2893 or

Coping With Stress and the Unknown | Livestream Recap

In light of current events, Dr. Horatio Capote opened discussion on how to deal with anxiety and stress, and how working together, as a community, can benefit all of us.




Anxiety is a “perfectly normal emotion…it’s how we’re built, it’s probably a signal to our brains that something is up, something may need to be adjusted, or we may need to be careful about something.” Anxiety is an important and, given the circumstances, appropriate emotion to be having. Everyone experiences anxiety at some point in their lives. However, anxiety is not only an emotional response but a disorder. According to Dr. Capote, one may be suffering from an anxiety disorder if the anxiety persists for “about two weeks…not just a blip, but an ongoing issue…that it affects our function in some kind of way.” These may include interpersonal, occupational, and/or physiological functions. If you believe you have an anxiety disorder, it is essential to contact your doctor so they can help you.

The unknown is “extremely stressful…when we don’t know, we can’t predict, we’re figuring it out…that is tough on us.” A study conducted at Sloan Kettering Cancer Center in New York City and “what they discovered is that it was much more stressful to await the results of, say, a biopsy…await the results of some testing than to hear “Yes, you have cancer.” …because once you know, now you have a game plan…now you’re not up in the air trying to figure it out.” In this current situation, medical professionals are learning about the behavior of the virus and, and the unknown adds to the communal stress.


Community & Credible Sources


Dr. Capote builds off of his statement about communal stress, stating that community and connectedness are incredibly important during this pandemic. It is more than just physical connectedness; it is emotional and spiritual connectedness, a feeling that we are all in this together. “Our brains, our neocortex, our limbic systems, are built that way..different parts of our brain are built to respond to each other. So, we’re all connected…even if we’re not physically as connected lately as we would often like to be.” We must remember that we are all part of the human race, and we are all learning as much as possible to help each other.

To help ourselves and one another, we, as a community, must rely on credible sources for our information. Dr. Capote strongly recommends, for example, gathering information from the Centers for Disease Control. It is a trustworthy, scientific source that is more reliable than the “unusual information out there on the internet.”


How to Help Ourselves


Pandemics have existed throughout humanity, but now “we have technology that we all find out about things instantly. In the past, a pandemic could wipe out a country and then go on to the next country, and maybe take ten years to circle the globe. Everything is accelerated as a result of our new technologies.” So what do we do in the face of the unknown and compounding stress? First, we remember that we are all human beings connected. We must be kind, understanding, polite to each other. Secondly, we must take care of our bodies by getting adequate sleep and fueling our bodies with proper nutrition and exercise. “These things that keep our bodies intact and keep us going are important. We should not…skimp on this,” says Dr. Capote. Lastly, he also mentions that we should treat ourselves “within reason, within the bounds of normalcy…whatever it is for you.” All of these points are basic ideas of things that we can do to keep ourselves level-headed in the face of the current environment.


Q&A with Doctor Capote


Q: There’s a lot of parents who are homeschooling for the first time, and this can be very stressful for them. Are there any tips that you would give those parents on how to deal with this new routine they’re going through?

A: It is a challenge. I think it always pays to be honest and not make-believe you know stuff when you don’t. You can teach a lot to your kids by modeling…like “Hey, that’s a good question. I don’t know. Let’s learn together; let’s figure this out together. Let me show you how I’ve learned to seek out information,” and do some joint problem-solving. Make it a bit of an adventure. It is an opportunity to strengthen those ties with your kids. You know, you see them more frequently. Mind you, you know, everybody in close proximity for prolonged periods of time can get on each other’s nerves. So, you know, that’s understandable. But I think, you know, being honest, remembering that you are the parent, do not give the impression that you’re the buddy. You are the parent, and you have some leadership to exert and some delineation of what is right and wrong and things like that. But turn it into an adventure where both of you are sort of co-learners, and you’re still the guider and the leader because you have more experience on how to get questions answered, and of course, you do have a higher body of knowledge than the student. Then on top of it, it’s likely that after some amount of time, you’ll start kicking up memories of the information that you do know, and you start being able to retrieve that more easily. Like anything, it’s a, you know, it’s like a muscle; the more you use it, the better you get at it. So it’s a challenge, but I would invite you to reframe it as an adventure cognitively. By the way, it should give us great empathy for our teachers in the community. Teachers are out there. Some say probably not being rewarded as well as they ought or at least appreciated as much as they should be. So, you know, the next time you see a teacher just like we do with our veterans and thank them for their service. I think this will give us a much greater appreciation for that as well. I know I have a lot to owe to my teachers back from elementary school, but yes, my high school teachers. Shoutout to Christopher Columbus High School at Miami, Florida! They were terrific and have taught me great things that I remember to this day.


Q: Are there any tips that you have on how to discuss what’s going on with children?

A: Sure, sure. Again, you know, some honesty, some information. Try not to editorialize too much, you know, “Oh, this is because this that.” It’s just like, “Well, there’s this virus that has arisen and viruses, you know, they tend to change and mutate over time.” You see, it as an opportunity, right? And what’s a virus? Is it a bacteria? Is it more of a biochemical structure? Does it have life? What is it? So all those exciting opportunities to learn science are there depending on the age of the child, of course. But it’s something that’s out there. It can make people sick, and we’re dealing with it. We’re learning about it as we’re dealing with it at the same time, and we’re trying our best. Honestly, we are probably better equipped than we ever have been in the history of humanity. We have a lot of very bright people thinking about this thing. We have a lot of excellent technology, and so we’re putting all of these things to bear to answer these essential questions.


Q: Can CBD help with your anxiety?

A: Yes. And this is from someone…I was initially a little bit skeptical, but it does turn out that CBD, which by the way, is extractable from both hemp as well as from cannabis, right, so it turns out that it has a beneficial effect on anxiety and probably sleep as well. We are proposing some studies on that soon. It’s just waiting for some FDA issues with the federal government to be able to do that. But, as you know, you can pretty much pick up CBD nowadays, I guess, at the corner store or the gas station or whatever. Mind you; there are products out there that our uber medical director, Director Laszlo Mutchler, actually went about purchasing CBDs from all these different places and had them laboratory analyzed. I found out that some of them only had 1% CBD in it, but they’re still calling it CBD and selling it out there. So that Latin phrase “caveat emptor” right “buyer beware,” that there’s different products thereof different qualities and, consequently, you would like to have something that is laboratory tested and certified actual CBD. I think over time we’ll see a lot more studies showing the efficacy of it. So double-blind placebo-controlled studies that will begin to show us its benefits on the, say, the sleep architecture and on the overall issue of curbing anxiety.


Q: Do you have any tips on how to talk to the elderly, whether it’s your parents, your grandparents, to make sure that they’re taking everything seriously without them feeling like you’re talking down to them or like they’re a child?

A: Sure. You know, as always, you speak genuinely to people. You start probably by saying, “Hey, the reason I’m having this conversation with you is because, you know, I love you, and I want you to do well. So whatever information I’m about to share with you is not it’s not coming from a bad place. It’s coming from a good place.” It’s my guess without knowing the particular situations. It’s hard to give specific advice. It may be hard to put things into context for some people. Some people have never experienced anything like this, and they’ve been around for a while. It may also be that older people, you know, they hear this information that they’re at a much higher risk and they’re anxious. They’re exceedingly concerned. I spoke to someone yesterday in a long-term care facility, and one of her neighbors had just passed away about four days ago. I don’t suspect anything, not from the virus. I think it was just her time. But yes, what happens, you know, another of your cohorts is gone, and you’re faced with your mortality. That’s scary, you know? When is it going to be my turn? And then on top of it, there’s this other new danger which threatens your life expectancy for sure, which is the coronavirus. So I can see it being very hard for people, you know, beyond their 60’s and 70’s to deal with things. But as always, we give honest information. We express our caring and our love, which is why we’re sharing knowledge, and we take it from them. So I think if you’re coming from the right place, if you’re not looking to be manipulative that, you know, shines through.


Q: Would you give that same advice to someone who is not following the guidelines that are in place? Is that kind of the same way you would talk to them? How would you reach out to someone who is not social distancing, not following the recommendations that are out there? How would you bring up that topic?

A: Well, I tend to try to use humor, so I would probably say something like, “Hey, I know you’re Superman and invincible, but listen. I’m worried about you. I mean, people are dying, and it’s best to take this thing seriously. I am! I am for myself and my family, and guess what? You’re part of my family, either immediate or the greater family of humanity. And for whatever reason, it just doesn’t look to me like you’re taking this as seriously as you should.”

There could be so many reasons for people who could be having some cognitive problems. People could be engaging in a lot of denial. I mean, we call these things “denial rationalization” we call these “defense mechanisms.”There’s a reason for that. We defend ourselves by utilizing these techniques. Now, there turns out to be a hierarchy of defense mechanisms. So, the most primitive defense mechanisms are denial. Even more primitive than that is the loss of contact with reality as hallucinations and things like. But the most sophisticated defense mechanisms are altruism and humor. So, people that are altruistic, they look out for others, they engage in philanthropy and caring for others and people that are funny. Those are the more sophisticated ego-coping mechanisms that we have.

And in the middle, there’s different ones, and interestingly enough, if you look at the development of the human being, you actually see that we tend to go through these different defense mechanisms as we mature. So little kids could probably spend a whole lot of time in denial and anger, and all kinds of stuff and then that comes that magical time in adolescence when everything seems funny and people just laughing up a storm no matter what. I know for me as a kid, I discovered Monty Python, and I thought that was hilarious. So you know you just see people going through all these stages. Unfortunately, some people seem to get stuck in a stage, or you have to help them move a little across those borders. Well, again, that’s the whole idea of connectedness in one way or another. So certainly, there are a lot of online communities that occur. There our faith communities that are meeting online.

I heard yesterday about a church that is basically operating almost like a drive-in theater. People are pulling up in their cars and listening to the sermon on a screen, and sometimes they honk the horn instead of “Amen,” but they’re connected. They’re connected even though they’re not that physically connected. There turns out to be online AA meetings and NA meetings, so people are engaging in the fellowship of sobriety that way. So I think we’ll see a lot more of that happening and, honestly, there can be great benefit to that as well. You can get a different sort of experience, but a connection on another level as well. We adopted telemedicine very quickly and, interestingly enough, I’ve noticed that and, you know, not to brag on myself, but I consider myself observant, and I think I listen to people and hear them out. But now, with telemedicine, I listen more attentively. I also have noticed that the people I’m connecting with, they’re better at describing things. They’re paying more attention to these details and telling me about it. So it may make us better communicators in the long run. It’s very interesting.

They say there are silver linings to everything. I see families get more connected, spending more time together, and I think it may enhance our communication skills because we’ve been so accustomed to texting a few words here and there or throwing out a…some message on Twitter and stuff like that. So this is an opportunity to engage in some of these uniquely human capabilities that we have. By the way, this is a little bit of an aside, but what the heck I’m the one talking so I could say whatever I want! One of my favorite things to remark on is a statement, you know, it’s not an exact quote, but basically, Sigmund Freud, the of the fathers of psychiatry was trained as a neurologist, so it’s always been part of the neurosciences. So, Dr. Freud just ran across this group of patients that were difficult to understand with the neurology he had been taught. So he developed this sort of, what he called the sort of artificial language of psychoanalysis to help describe what he was seeing. But he predicted one day we’ll know enough neuroanatomy, neurophysiology, and neuroscience in general, and my language will disappear. We won’t need these words that I’ve created. We will understand how it’s happening in the brain. So sure enough, the ventral tegmental area and the nucleus accumbens is kind of the reward center of the brain. That’s actually where, so to speak, sex, drugs, and rock and roll happen. So that would probably be the seat of the id of all of these impulses, of all of these urges. That would be where the id flows from. We know the anatomical location of that in the brain. And then the super-ego, that part that sort of holds down the id, the inhibitory part that he talked about turns out to be the prefrontal cortex. So in the prefrontal cortex, where the executive functions of the brain reside, we actually see these fibers that reach down into the ventral tegmental area and inhibit.

They hold that thing down, and that would be the seat of the super-ego. Now interestingly enough, what I’ve just described is a little bit of a yin and yang. These opposing forces so in that counterbalance between the id and the super-ego arises, the ego, the self. One person might be a little bit heavier on the super-ego and that the personality arises a lot more on the regimented sort of obsessive side, and some person might be on the other side of that spectrum. So it’s that balance and friction and, I guess, yin and yang between those two things out of which can arise the personality. Another interesting thing, people’s sense of empathy, the seat of empathy turns out to be the amygdala. People, by the way, that get infectious yawning, turn out to be exceedingly empathic. But you can actually take pictures of people grimacing in pain and show them to someone under PET scanner, and you see the amygdala light right up. So we’re showing this deep that empathic connection, “Oh my God, that person is experiencing pain. It must be awful for them.” By the way, if you go to some maximum-security prison somewhere in America where people with antisocial personality disorder reside, you will see that that amygdala does not light up. That is how you could be a cold-blooded killer. You don’t have that. You don’t experience it, and nothing lights up in your brain, alright, I could kill you. So that’s another interesting phenomenon as well as we gain our knowledge of the brain and how it functions and how it makes us who we are. We’re figuring out a lot. I think that there are things beyond the physicality of the brain as well, you know, the whole spiritual perspective as well. So we’re not, at least in my estimation… we’re much more than just an interesting machine with lots of interesting parts that work together. We have sort of this ability to transcend all of that as well.


Q: Another question we have is for people who might be having, like you were saying, they obsess over something, or they’re empaths, they might be having panic attacks during this time. Whether it’s someone they know was going through something or if they find themselves obsessing over the news or if they have a cold and are obsessing over it themselves. So what are any tips you can give for someone who might be mid-panic attack?

A: Well, it’s important to understand that no one has ever died of a panic attack, although it feels that way. By the way, if you have frequent panic attacks, I would say more than two or three a week, it sort of, it may certainly be worthwhile to seek out some help with that. Now the panic attack and the whole sort of anxiety response is an important evolutionary phenomenon. We tend to focus sometimes on the emotional perspective of these things, but in fact, it’s very physical. There’s a part of the brain called the locus coeruleus, the little place that looks like a prune… ciruela coeruleus means prune. Anyway, the little place that looks like a prune secretes adrenaline, so in the face of a threat in the environment…boom! Adrenaline comes out. And what does adrenaline do? Well, it can make us hyperventilate, so we get lots of oxygen on board in case we need to fight or flee, in case we need to put them up or run away.


Because of this hyperventilation, that tends to make your ph in your blood change, you blow off CO2, and so your blood becomes more basic, and you can get tingly sensations in your fingertips and throughout. It cuts down circulation in the limbs, so if you get slashed, you won’t bleed out, and it shunts the blood to the major organs in the torso. It opens up your peripheral vision so you can spot danger coming at you from the sides more easily. It really prepares you for an emergency. If there were a bus coming at you down the street, you would want to have that system intact because it would prepare you to save yourself. The unfortunate thing is if this thing is happening all the time and for no reason at all, then it can become taxing. It can begin to have negative consequences on your body and your brain, and that’s when you would want to seek out some professional help with that. There are many ways to help, not only just medications, but certainly cognitive behavioral therapy is quite good, and oftentimes the simultaneous use of these different things can be synergistic. So one plus one equals three when you do things together like that. You may get much greater effects as well.



Q: So those are all the questions that we have. Is there anything else you want to add in? Maybe mention how people can call and make an appointment?

A: Absolutely. You are certainly welcome to seek us out. We are glad to help and to be of service. We have a great many different technologies that we utilize to help people, not just medications. We also have techniques like transcranial magnetic stimulation that turns out to be very good for treatment-resistant depression. We have electro-convulsive therapy. We have other medication treatments that are not exactly like taking a pill. We have a very, very good intravenous ketamine program. That one is actually quite impressive in that if you are a responder, you can see impressive and very rapid results from it. I’ve been impressed by it. I know I’ve said the same word like ten times. I’d be an awful author, but it’s been really exciting to see that happen. There are other treatments as well on the horizon. We are involved in a lot of research at the DENT. I believe I’m the principal investigator, I think in 27 different trials right now.

The DENT, in general, probably has close to 100 trials going on. We are America’s largest Neuroscience group. People come to us for help with researching new things, so we often have our ear to the ground for what’s up and coming. We may be able to get you into a trial for something new if you’ve tried all these different things, and nothing’s worked so far. We may be able to get you onboard for a new trial. So, a lot of aspects to the kind of work that we do at the DENT. We’re always glad to help in any way that we possibly can. If there’s something we don’t do quite often, our different providers, the doctors, and staff can reach out to other thought leaders throughout the country and find out more details. We’re proud to be from Buffalo. We love our community. We’re glad to help any way that we can. We’ve been here since 1963—some of the very first work that we did actually involved Parkinson’s disease.

We welcome the opportunity to help people in our community, and now with the espousal of telemedicine, we have actually been able to reach out. We do have people that come in from other regions and travel and come here to be seen, but now I think we will have the opportunity to expand our reach to different parts of the state and perhaps other states and help people without them having to be physically present all the time. So that’s maybe one of the silver linings of this whole thing. We’re really espousing the different new technologies and figuring out more ways that we can help people. So give us a call. We will try to help any way that we can, and hopefully we’ll all get through things together as part of the overall community, the sisterhood, and brotherhood of humanity


Q: And if someone’s provider is closed right now, they can always come to us, right? If someone’s doctor’s office is closed, but they really need to see, they can always come DENT?

A: Oh yeah. Sure, sure


Q: Do you have anything else you want to add in?

A: No. Listen, I wish you all well. Stay safe, take care of yourselves, and thanks for taking some of your valuable time and listening to me. I think together we’ll get through all of this and come out the better for it.





The content of this post is intended for general educational and informational purposes only; it does not constitute medical advice. Readers should always consult with a licensed healthcare professional for diagnosis and treatment.


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