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[BLOG POST] Gist reasoning – The most invisible loss of mild TBI

Broken Brain - Brilliant Mind

catching-up-6I am thinking a lot about losses, these days. Loss of friends, loss of doctors, loss of family, loss of jobs, loss of money, loss of hope.

I’ve been actively working on my brain injury recovery since 2007 — nearly 10 years. I got hurt at the end of 2004, so it’s been over 11 years since my last TBI. And my expectations and hopes have varied, during that time.

I always expected to be able to build back my abilities to at least some extent. I expected to be able to be able to retrain my brain to build back my memory, to address my distractability, to handle my fatigue, and basically all-round get myself back to where I wanted to be.

But that hasn’t happened. The one area where I have significantly improved, is in my gist reasoning, which is really the biggest “functional” deficit I had. Not…

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[WEB SITE] Brain Injury News – September 2017 – CNS

09/29/2017 Early predictors of outcome after mild traumatic brain injury
09/29/2017 Scientists say fluids study could aid traumatic brain injury research
09/28/2017 Risk of hospitalization with neurodegenerative disease after moderate-to-severe traumatic brain injury in the working-age population
09/28/2017 Girl soccer players are five times more likely to return to the game after a concussion than boys
09/27/2017 Neuropsychological predictors of outcome following traumatic brain injury in adults
09/27/2017 Many people thought to be in ‘vegetative’ conditions may still be conscious
09/26/2017 Accelerated cognitive aging following severe traumatic brain injury
09/26/2017 Study shows modified blood thinner reduces the impact of traumatic brain injury
09/25/2017 Expression of masculine identity in individuals with a traumatic brain injury
09/25/2017 Memory decline after head injury may be prevented by slowing brain cell growth
09/21/2017 Risk factors and outcomes associated with post-traumatic headache after mild traumatic brain injury
09/21/2017 Seaweed may help heal injured brain tissue
09/20/2017 Provider perceptions of the assessment and rehabilitation of sexual functioning after traumatic brain injury
09/20/2017 New treatment option discovered for brain injury patients suffering from aggression
09/19/2017 Risk factors for myocardial dysfunction after traumatic brain injury
09/19/2017 Concussion drug could reverse brain damage by ‘releasing’ damaged cells
09/18/2017 Who among patients with acquired brain injury returned to work after occupational rehabilitation?
09/15/2017 Home environment as a predictor of long-term executive functioning following early childhood traumatic brain injury
09/15/2017 Concussion in teenagers increases the risk of multiple sclerosis in later life
09/14/2017 ndividual- and population-level impacts of traumatic brain injury and maternal characteristics on subsequent offending behavior
09/14/2017 Concussions in women: Rates, symptoms and recovery are different than men
09/13/2017 The association of cognitive reserve in chronic-phase functional and neuropsychological outcomes following traumatic brain injury
09/13/2017 Science Says: How repeated head blows affect the brain
09/12/2017 Online family problem solving for pediatric traumatic brain injury
09/12/2017 Smartphones could someday assess brain injuries
09/11/2017 Resilience after traumatic brain injury
09/08/2017 Brain biomarkers and pre-injury cognition are associated with long-term cognitive outcome in children with traumatic brain injury
09/07/2017 Remediation of social communication impairments following traumatic brain injury using metacognitive strategy intervention
09/07/2017 Lab-grown brain balls are starting to look more lifelike
09/06/2017 Citicoline in severe traumatic brain injury: indications for improved outcome
09/06/2017 Researchers testing theory that you can diagnose a concussion through saliva
09/05/2017 Work productivity loss after mild traumatic brain injury
09/01/2017 Non-invasive vagal nerve stimulation effects on hyperarousal and autonomic state in patients with posttraumatic stress disorder and history of mild traumatic brain injury
09/01/2017 Brain Glue’ repairs traumatic brain injuries

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[Proceedings] Proceedings of the Third Neurological Disorders Summit (NDS-2017) – Journal of Neurology & Experimental Neuroscience – PDF file

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How to reduce holiday stress and depression post-ABI

Brain Injury Society of Toronto


Now that we’re well into December, the holiday season has officially arrived and its many celebrations have begun. While retailers have been entrancing us with benchmark images of the perfect Hallmark Christmas for years, the advancement of technology and social media apps such as Instagram, Twitter, Facebook, filled with photos of happy people celebrating, can leave us feeling like we are ‘failing’ at Christmas and all the holiday cheer.

For those who are dealing with PTSD, ABI and/or difficult times – this feeling of not doing or being enough during the the holidays can lead to a cocktail of increased anxiety, stress, and depression with a side appetizer of isolation.


Common triggers to holiday stress and depression are:


Even in healthy families, holiday gatherings can stir up a whirlwind of emotions, especially if you have gone through significant changes in your life. Perhaps you have lost touch…

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[SLIDE SHOW] The Invisible Effects of Stroke – PDF File

The Invisible Effects of Stroke

By Nicole Walmsley


The objective is to:
1. identify four common invisible effects of a stroke
2. demonstrate how nursing staff can identify these on an
acute stroke unit

Download the PDF File

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[WEB SITE] Virtual reality simulator for the rehabilitation of hemianopsia




The Red Cross in Lugo, Spain had already been using VirtualRehab, Virtualware’s CE certified rehabilitation gaming platform, experiencing first-hand how new technologies could help improve  rehabilitation outcomes for many of their patients suffering from some sort of neurological condition.  They proposed to Virtualware the idea of developing a digital format for assisting in the rehabilitation of their patients with brain damage who were undergoing treatment for homonymous hemianopsia.Homonymous hemianopsia is a condition in which a person sees only one side―right or left―of the visual world of each eye. It occurs often in stroke and traumatic brain injuries due to the way vision is represented in the brain.


The development of the project was based on a close collaboration between Virtualware and an experienced team of clinicians and IT engineers from the Red Cross clinic. Based on the Red Cross’ briefing, Virtualware developed an immersive Virtual Reality driving application that uses the Oculus Rift CV1 VR headset and a joystick or gaming steering wheel.

The virtual rehabilitation app incorporates 6 different 3D environments the patient will ‘drive’ through. Each one can be configured using a simple therapy editor, allowing the treatment to be tailored to each patient’s requirements. Once the environment is chosen, the therapist can program the objects that will appear along the border of the intact and damaged visual field. In some cases, these stimuli will remain along the sides of the street, while in other cases they may move into the road (like a child crossing the streets suddenly) which requires the patient to either brake or swerve to avoid the object.

This therapy technique stimulates the patient through the use of visual cues promoting an organized visual search with the healthy eye, to assist them in learning oculomotor compensation.  Once the session is completed, the data is saved for the therapist to analyse and used to measure the patient’s progress.


This collaborative project has proven to be a fruitful one from the Red Cross’ point of view.  Already having developed various projects using Virtual Reality in the United Kingdom to help assess mental health problems, David Fried, Director of International Business in Virtualware explains how this application for the Red Cross serves to show how VR technologies can also be used as a means for clinicians to improve how the rehabilitate their patients.

This pioneering work is expected to make an important impact in the treatment of hemianopsia at the clinic. A clinical trial of the application is slated to begin in the next few months with 20 patients who suffer from Hemianopsia.

Source: Virtual reality simulator for the rehabilitation of hemianopsia

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[WEB SITE] Driving after Stroke: What You Must Know

Sometimes the side effects of a stroke can impair your ability to drive. The good news is that 80% of stroke survivors will work their way back to driving safely again. Here’s a comprehensive guide on how to get there.

Warning Signs

First, evaluate your warning signs. This will help you determine if you can drive safely right now or if you need to do some training first. Here are some warning signs of unsafe driving:

  • Driving too fast or too slow for road conditions or posted speed
  • Needing help or instructions from passengers
  • Making slow or poor distance decisions
  • Becoming easily frustrated or confused
  • Getting lost frequently in familiar areas
  • Having accidents or close calls
  • Drifting unintentionally across lane markings

If you’ve experienced any of these signs while driving after stroke, then you aren’t ready to drive yet. And if you can’t attempt driving but want to know if you’ll be able to do so safely, you can ask friends and family members if they’ve seen a change in your communication, thinking, judgement, or behavior. Those who observe you frequently can provide a good outside opinion.

Driving Evaluations

To properly determine if you’re able to drive again, you need to participate in a driver evaluation. During this evaluation, a trained professional can help you determine your readiness and, if you’re not ready, help train you to do so.

A driver’s evaluation will usually include:

  • Assessment of functional availability
  • Reaction time testing
  • Visual testing
  • Perceptual testing
  • In-car testing

To find a qualified driver education training program, ask your doctor or occupational therapist for a recommendation; or you can search for a driver specialist on the AOTA website.

Driving Adaptations

Some physical impairments can be temporarily solved with the use of assistive devices or car adaptations. For example, if you can only use one hand, a spinner knob can be attached to the steering wheel to enable steering with one hand. Also, if your right side is impaired, then a left gas pedal and spinner knob can be installed on your car.


There are also adaptive solutions for stroke survivors in wheelchairs. The National Mobility Equipment Dealers Association is a great resource for adaptive transportation that can help you reclaim independence behind the wheel. Choosing a modified vehicle is a big decision, so be sure to do extensive research before investing.

With the help of trained specialists and adaptive equipment, driving after stroke is a possibility that many stroke survivors can successfully work towards.

Source: Driving after Stroke: What You Must Know – Flint Rehab

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[ARTICLE] Reorganization of finger coordination patterns through motor exploration in individuals after stroke – Full Text




Impairment of hand and finger function after stroke is common and affects the ability to perform activities of daily living. Even though many of these coordination deficits such as finger individuation have been well characterized, it is critical to understand how stroke survivors learn to explore and reorganize their finger coordination patterns for optimizing rehabilitation. In this study, I examine the use of a body-machine interface to assess how participants explore their movement repertoire, and how this changes with continued practice.


Ten participants with chronic stroke wore a data glove and the finger joint angles were mapped on to the position of a cursor on a screen. The task of the participants was to move the cursor back and forth between two specified targets on a screen. Critically, the map between the finger movements and cursor motion was altered so that participants sometimes had to generate coordination patterns that required finger individuation. There were two phases to the experiment – an initial assessment phase on day 1, followed by a learning phase (days 2–5) where participants trained to reorganize their coordination patterns.


Participants showed difficulty in performing tasks which had maps that required finger individuation, and the degree to which they explored their movement repertoire was directly related to clinical tests of hand function. However, over four sessions of practice, participants were able to learn to reorganize their finger movement coordination pattern and improve their performance. Moreover, training also resulted in improvements in movement repertoire outside of the context of the specific task during free exploration.


Stroke survivors show deficits in movement repertoire in their paretic hand, but facilitating movement exploration during training can increase the movement repertoire. This suggests that exploration may be an important element of rehabilitation to regain optimal function.


Stroke often results in impairments of upper extremity, including hand and finger function, with 75% of stroke survivors facing difficulties performing activities of daily living [12]. Critically, impairments after stroke not only include muscle- and joint-specific deficits such as weakness, and changes in the kinetic and kinematic workspace of the fingers [34], but also coordination deficits such as reduced independent joint control [5] and impairments in finger individuation and enslaving [6789]. Therefore, understanding how to address these coordination deficits is critical for improving hand rehabilitation.

Typical approaches to hand rehabilitation emphasize repetition [10] and functional practice based on evidence that such experience can cause reorganization in the brain [11]. Although this has proven to be reasonably successful, functional practice (such as repetitive grasping of objects) does not specify the coordination pattern to be used when performing the tasks. As a result, because of the redundancy in the human body, there is a risk that stroke survivors may adopt atypical compensatory movements to perform tasks [12]. These compensatory movements have been mainly identified during reaching [1314], but there is evidence that they are also present in finger coordination patterns during grasping [15]. Although there is still debate over the role of compensatory movements in rehabilitation [16], there is at least some evidence both in animal and humans that continued use of these compensatory patterns may be detrimental to true recovery [171819].

To address this issue, there has been a greater focus on directly facilitating the learning of new coordination patterns. Specifically, in hand rehabilitation, virtual tasks (such as playing a virtual piano) have been examined as a way to train finger individuation [2021]. In these protocols, individuation is encouraged by asking participants to press a particular key with a finger, while keeping other fingers stationary. A similar approach to improve hand dexterity was also adopted by developing a glove that could be used as a controller for a popular guitar-playing video game [22]. However, directly instructing desired coordination patterns to be produced becomes challenging as the number of degrees of freedom involved in the coordination pattern increase. For example, the hand has approximately 20 kinematic degrees of freedom, and providing verbal, visual or auditory feedback for simultaneously controlling all these degrees of freedom would be a major challenge. A potential solution that has been suggested is not to directly instruct the coordination pattern itself, but rather let participants explore different coordination patterns [23]. This idea of motor exploration is based on dynamical systems theory that suggests that variability and exploration may help participants escape sub-optimal pre-existing coordination patterns and potentially settle in more optimal coordination patterns [24252627]. Such exploration has been shown to be important in adapting existing movement repertoire [28], and has also been shown to be associated with faster rates of learning [29].

In order to test the hypothesis that exploration of novel coordination patterns can improve overall movement repertoire, I used a body-machine interface [3031] to examine how stroke survivors explore and reorganize finger coordination patterns with practice. A body-machine interface maps body movements (in this case finger movements) to the control of a real or virtual object (in this case a screen cursor), which can provide a way to elicit different coordination patterns in the context of an intuitive task. Specifically I examined: (i) how stroke survivors reorganize their finger coordination patterns, (ii) how training to explore novel coordination patterns affects their ability to reorganize their coordination pattern, and (iii) if training to explore novel coordination patterns has an effect on their overall movement repertoire. In this context, I use the term “novel” to indicate coordination patterns that require finger individuation. This assumption is motivated by the finding that stroke survivors have difficulty producing finger individuation even under explicit instruction [69], and therefore it is highly likely that they would not use coordination patterns requiring finger individuation frequently in activities of daily living.[…]

Continue —>  Reorganization of finger coordination patterns through motor exploration in individuals after stroke | Journal of NeuroEngineering and Rehabilitation | Full Text

Fig. 1 a Experimental setup – participants wore a data glove and moved their fingers to control a screen cursor b Schematic of task – participants moved a cursor between two targets using movements of four fingers (thumb excluded). c Experimental protocol. Participants came in for 5 total sessions – an initial assessment phase, followed by a learning phase. d Weighting coefficients of the index and middle (blue), and ring and little (red) fingers during the initial assessment phase, and e weighting coefficients during the learning phase

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[BLOG POST] The Best Apps to Help With Stroke Recovery – Saebo

Recovering after a stroke requires hard work from the survivor and their caretakers. Though this can be intimidating, there is good news: with new technology in apps, patients have more help than ever regaining abilities after their stroke.

The great thing about apps is that they can level the playing field for people recovering from stroke by boosting their chances of success during the recovery period. An app on your own smartphone or tablet can now help you regain your ability to speak, keep track of your medications and appointments, and even help manage diabetes. Plus, apps are becoming more and more accessible, so it’s not hard to find one you like. You can basically pick and choose which ones work best for you to customize your “app rehab.”

 Best Apps for Stroke Recovery

Speech Therapy Apps/Aphasia

Tactus Therapy

Tactus Therapy has a variety of speech therapy apps that can help stroke survivors with aphasia, dysphagia, cognition, and more. Whatever your speech-related impairment is, Tactus Therapy likely has an app for you.


Constant Therapy

The Constant Therapy app has a library of more than 100,000 exercises to help stroke survivors with cognition, language, and communication. The app provides instant feedback on tasks and creates a map of the each individual’s strengths and weaknesses, allowing for personalized therapy.



The SmallTalk™ Family of Communication apps from Lingraphica is a collection of 14 different free apps for individuals suffering from aphasia or dysphasia. There are apps that can help with practicing speech and apps that help people with aphasia or dysphasia communicate.



Proloquo2Go is a communication solution for people with limited speech or those who have lost the ability to speak altogether. This app uses symbol-supported communication to help stroke survivors with aphasia communicate.


Hand Recovery Apps

Balloon Frenzy

With Balloon Frenzy, you can pop balloons without the mess or noise! This game starts out simple with only a few balloons to pop, then gradually increases in difficulty as more balloons are added. Challenge your motor skills as you try to keep up with popping the virtual balloons.



Dexteria turns your iOS device into a therapeutic tool that helps you improve your motor control, coordination, and dexterity. With engaging repeatable exercises and a tracking and reporting feature, it is easier than ever to add hand exercises to your recovery program.


iOT Session

iOT Session was created by an award winning occupational therapist. The app is designed to improve deficits in visual tracking, bilateral coordination, visual perception, fine motor/dexterity, visual scanning, and handwriting/correct letter formation. The game like format helps keep the patient’s attention.


Hit It!

Improve your dexterity with the Hit It! app. This game is all about quick fingers. Touch and move as quickly as you can to beat all the levels.


Apps for Cognitive Deficits


What’s the Difference?

Look at and analyze the difference between two different photos with the What’s the Difference? App. As you progress the challenges get harder helping you challenge your perception skills.


Thinking Time Pro

Thinking Time Pro was designed with Harvard and UC Berkeley neuroscientists. This app trains memory, attention, reasoning and key cognitive skills through 4 scientific games.The dynamic skills levels make it easy to match to any skill level.


Fit Brains Trainer

Fit Brains Trainer is a free brain training app that is designed to stimulate your cognitive & emotional intelligence. The system has 60+ fun games, 500+ workout sessions, and in-depth performance reports to help track your progress.

Having trouble with your memory after your stroke? Eidetic uses a technique called spaced repetition to help you memorize anything from important phone numbers to interesting words or facts.


Apps for Vision Loss

Captain Lazy Eye

Captain Lazy Eye was designed in cooperation with ophthalmologists with experience in successful amblyopic treatment, and it is the first iPad App designed to assist in keeping visual acuity and assisting in amblyopic correction.


Vision Tap

Vision Tap was designed to assist with vision problems including eye-hand coordination, reaction time, as well as reading and learning issues.


BigMagnify Free

Turn your iOS device into a magnifying glass using BigMagnify Free. This advanced magnifying glass offers cutting-edge features while being simple to use. You can use the entire screen as a magnifying glass, and even freeze and share the magnified image.

TapTapSee is designed to help the blind and visually impaired identify objects they encounter in their daily lives. Simply double tap the screen to take a photo of anything, at any angle, and hear the app speak the identification back to you.


Lifestyle Apps


The Cozi app is an organizer designed for families to keep multiple schedules in sync. Cozi is the perfect app for caregivers to manage their schedules, especially if a stroke survivor has multiple caregivers. It can also help track important medical appointments.


The Medisafe Pill Reminder & Medication Tracker helps make sure you never miss a dose of your medication. Get reminded when it is time to take your medication and when you need to renew your prescription.



Lumosity is a brain-training app that claims to measure and challenge your cognitive ability. The games can help improve things like memory and focus, which can be weakened by stroke.



Stress and strokes do not get along, which is why stress-relieving apps like Breathe2Relax can help. Breathe2Relax is a deep-breathing app that coaches you through deep-breathing exercises with the goal of improving mood, controlling anger and anxiety, and reducing stress.


Health Apps

<30 Days

<30 Days is an app from the Heart and Stroke Foundation of Canada designed to promote heart health and help individuals prevent stroke. The app helps you find out what unhealthy habits you have, and then it challenges you to break them in 30 days or less.



Diabetes:M helps individuals with diabetes manage their condition. Some of the features include a logbook to keep track of glucose and insulin levels, a reminder system to help you remember to check, and a graph to let you see blood sugar changes over time. Diabetes increases your stroke risk, so managing it carefully is important.


Blood Pressure (BP) Watch

Lowering high blood pressure is important for preventing a second stroke. Blood Pressure (BP) Watch helps you keep track of your blood pressure, pulse, and weight all in one convenient app.


7 Minute Workout Challenge

Exercising can help prevent a recurrent stroke, but it can be hard to know how to get started. The 7 Minute Workout Challenge challenges you to complete 12 high-intensity exercises in 7 minutes that can all be done with no equipment. Not having time is no longer an excuse. You can fit this workout in anytime and anywhere.


New Resources

Apps are becoming an important resource in the stroke survivor’s rehab repertoire. Caretakers and patients alike have easy access to programs that make communication and organization easier, and trying out deep breathing and fitness activities simpler. By trying one of these apps or combining them, patients may add more structure to their routines, track their progress, and have fun.

Disclaimer: Our company is not endorsing these apps. We list them with the intention of providing stroke survivors and their caretakers with additional resources.

Source: The Best Apps to Help With Stroke Recovery | Saebo

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[REBLOG] Keppra — What People Are Saying

Epilepsy Talk

To say the word “Keppra,” is to invite instant controversy.  For some people it works, for some it doesn’t and for others, it’s a living nightmare.

Yet two different studies found that clinically significant behavioral consequences of Keppra were eight percent, no higher, and maybe even lower, than those reported for other new antiepileptic drugs.

John Gates, M.D., lead investigator of the adult study, neurologist at Minnesota Epilepsy Group and clinical professor of neurology at the University of Minnesota said: “The efficacy of Keppra in treating seizures, coupled with our findings of its low side-effect profile, makes it an option that should be considered, especially for those who have struggled with other treatments.”

Interestingly, both studies evaluated patients with epilepsy who were proven to be drug resistant to other medications.

When Keppra was approved as an add-on medicine for partial seizures, including partial seizures with secondary generalization, at the time, it…

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