Dr. Michael Hoffmann obtained his medical degree at the University of Witwatersrand, Johannesburg, South Africa and neurological subspecialty fellowship training in stroke from Columbia University. This was followed by two senior doctorates, one in cerebrovascular medicine (MD) and one in behavioral health (PhD). Dr. Hoffman’s main areas of research have concerned cognitive disorders after stroke and how to improve brain health and fitness based on scientific principles and evolutionary insights.
Dr. Hoffmann is currently a Professor of Neurology with the University of Central Florida and has recently served in a number of administrative leadership positions, such as Associate Dean of Academic Assessment and Chief of Neurology Services and Director of the Stroke Center at the Orlando VA Medical Center. He is the founding director of comprehensive and primary stroke centers in 5 tertiary medical centers to date in the USA and South Africa and has current licenses in Florida and Kentucky and previously in Canada, Germany and South Africa. Dr. Hoffman is also a cognitive neurology consultant at the Roskamp Neuroscience Institute in Sarasota, Florida where he focuses on frontotemporal disorders, traumatic brain illness and neuro-toxicological syndromes such as Gulf War Illness.
summerizer
Clinical brain energy failure model
- Brain and mental illness as brain-energy failure with mitochondria at the center.
- Metabolic syndrome, insulin resistance, and obesity drive neurologic and psychiatric decline; Alzheimer’s as “type 3 diabetes”.
- Stress and environmental load trigger migraine and other brain symptoms.
Clinical observation and clinical blind spots
- Subtle changes in mood, outlook, and behavior can precede recognized neurologic or psychiatric syndromes.
- “Clinical simultanagnosia”: item-by-item medicine misses the whole-person metabolic pattern.
Ketogenic / low-carb as a main lever
- Dozens of large weight-loss cases with rapid functional improvement; goal is brain-function recovery.
- Ketogenic metabolism overlaps with mitochondrial resilience, inflammation control, and neuroplastic support.
- Target conditions include epilepsy, headache disorders, cerebrovascular disease, multiple sclerosis, depression, and other psychiatric disorders.
Evidence and examples named in the talk
- JAMA 2018 risk-factor data: diet among the leading contributors to mortality and disability burden.
- Mild cognitive impairment: a blinded randomized controlled trial of a ketogenic medium-triglyceride diet improves Trail Making, verbal fluency, and naming, with higher cerebral metabolic rates.
- Multiple sclerosis: a positive pilot study is already available.
Comorbidity and system wiring
- Psychiatric diagnoses cluster; a “P factor” concept and multi-million-person data show strong cross-disorder risk links.
- Vagus-nerve pathways and noninvasive vagus nerve stimulation converge with metabolic approaches across headache and psychiatric domains.
Historical and anthropological notes
- Banting’s “Letter on Corpulence” anchors an early low-carbohydrate precedent.
- The Horus mummy findings include coronary-artery calcification; atherosclerosis is not exclusively modern.
Information growth and data reliability
- Medical knowledge growth outpaces clinician bandwidth; research reliability concerns remain.
- Clinical practice uses structured handouts, reading lists, and performance criteria to drive adherence.
References
- [00:04] Brain on Fire (10th Anniversary Edition): My Month of Madness — https://www.simonandschuster.com/books/Brain-on-Fire-%2810th-Anniversary-Edition%29/Susannah-Cahalan/9781451621389
- [00:07] The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States — https://doi.org/10.1001/jama.2018.0158
- [00:07] Letter on Corpulence, Addressed to the Public — https://www.gutenberg.org/files/57545/57545-h/57545-h.htm
- [00:07] Brain Energy — https://www.simonandschuster.com/books/Brain-Energy/Christopher-M-Palmer/9781637741580
- [00:32] Atherosclerosis in Ancient Egyptian Mummies: The Horus Study — https://doi.org/10.1016/j.jcmg.2011.02.002