Posts Tagged concussion

[BLOG POST] Study: Transcranial e-stim beneficial in mild traumatic brain injury

Researchers from the University of California San Diego and from the Veterans Affairs San Diego Healthcare System have improved neural function in a group of people with mild traumatic brain injury using low-impulse electrical stimulation to the brain, according to a study published in Brain Injury.

Although little is understood about the pathology of mild TBI, the team of researchers noted that previous work has shown that passive neuro-feedback, low-intensity pulses applied to the brain through transcranial electrical stimulation, has promise as a potential treatment.

The team’s pilot study enrolled six people with mild TBI who were experiencing post-concussion symptoms. Researchers used a form of LIP-tES combined with concurrent electroencephalography monitoring and assessed the treatment’s effect using a non-invasive functional imaging technique, magnetoencephalography, before and after treatment.

“Our previous publications have shown that MEG detection of abnormal brain slow-waves is one of the most sensitive biomarkers for mild traumatic brain injury (concussions), with about 85 percent sensitivity in detecting concussions and, essentially, no false-positives in normal patients,” senior author Dr. Roland Lee said in prepared remarks. “This makes it an ideal technique to monitor the effects of concussion treatments such as LIP-tES.”

Researchers reported that the brains in all six patients had abnormal slow-waves at the time of initial scans. After treatment, MEG scans showed reduced abnormal slow-waves and the study participants reported a significant reduction in post-concussion scores.

“For the first time, we’ve been able to document with neuroimaging the effects of LIP-tES treatment on brain functioning in mild TBI,” first author Ming-Xiong Huang added. “It’s a small study, which certainly must be expanded, but it suggests new potential for effectively speeding the healing process in mild traumatic brain injuries.”

Source: Study: Transcranial e-stim beneficial in mild traumatic brain injury – MassDevice

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[WEB SITE] TBI Basics – BrainLine

A TBI can happen to anyone, whether it happens while playing sports, at work, or just slipping on an icy sidewalk. Injuries can range from “mild” to “severe”, with a majority of cases being concussions or mild TBI. The good news is that most cases are treatable and there are several ways to help prevent injury.

What You’ll Find Here

You Are Not Alone

You Are Not Alone

See how others are navigating their post-TBI lives. Check out personal stories and “life after TBI” blogs, or join the conversation with our Facebook community.

Source: TBI Basics | BrainLine

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[WEB SITE] 9 1/2 Need-to-Know Facts About Traumatic Brain Injury

9 1/2 Need-to-Know Things About Traumatic Brian InjuryAn estimated 5.3 million Americans — about 2 percent of the U.S. population — currently have a long-term or lifelong need for help with everyday activities due to traumatic brain injury (TBI). (1) Many believe this number to be low as it only takes into account the number of reported injuries to hospital emergency rooms and by health care professionals. We’ve compiled the top 9 1/2 things to know about traumatic brain injury, it would have been 10 but the last 1/2 was left off because memory is often affected by traumatic brain injury.

Multimedia

  1. A traumatic brain injury is a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. You do not need to lose consciousness to sustain a concussion.
  2. 1.7 million people sustain a TBI each year in the United States. By the numbers, every American has more than a 1:300 chance of sustaining a traumatic brain injury each year. (2)

  3. The three groups at highest risk for traumatic brain injury are children (0-4 year olds), teenagers (15-19 year olds), and adults (65 and older). (2)

  4. Estimates peg the number of sports-related traumatic brain injuries as high as 3.8 million per year. (2)

  5. Using a seatbelt and wearing a helmet are the best ways to prevent a TBI.

  6. Males are almost twice as likely as females to sustain a TBI.

  7. A concussion is a mild brain injury. The consequences of multiple concussions can be far more dangerous than those of a first TBI. (3)

  8. The area most often injured are the frontal lobes that control thinking and emotional regulation.

  9. A blow to one part of the brain can cause damage throughout.

9 1/2. Most people do make a good recovery from TBI.

If you found this useful, please share with family and friends or leave a comment below if you think we’ve left something off.

References:

  1. Centers for Disease Control. http://www.cdc.gov/traumaticbraininjury/pdf/BlueBook_factsheet-a.pdf
  2. Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2006.
  3. Cifu, David, MD. eMedicine.com. www.emedicine.com/sports/TOPIC113.HTM.

Source: 9 1/2 Need-to-Know Facts About Traumatic Brain Injury

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[ARTICLE] Role of Interleukin-10 in Acute Brain Injuries – Full Text

 

Interleukin-10 (IL-10) is an important anti-inflammatory cytokine expressed in response to brain injury, where it facilitates the resolution of inflammatory cascades, which if prolonged causes secondary brain damage. Here, we comprehensively review the current knowledge regarding the role of IL-10 in modulating outcomes following acute brain injury, including traumatic brain injury (TBI) and the various stroke subtypes. The vascular endothelium is closely tied to the pathophysiology of these neurological disorders and research has demonstrated clear vascular endothelial protective properties for IL-10. In vitro and in vivo models of ischemic stroke have convincingly directly and indirectly shown IL-10-mediated neuroprotection; although clinically, the role of IL-10 in predicting risk and outcomes is less clear. Comparatively, conclusive studies investigating the contribution of IL-10 in subarachnoid hemorrhage are lacking. Weak indirect evidence supporting the protective role of IL-10 in preclinical models of intracerebral hemorrhage exists; however, in the limited number of clinical studies, higher IL-10 levels seen post-ictus have been associated with worse outcomes. Similarly, preclinical TBI models have suggested a neuroprotective role for IL-10; although, controversy exists among the several clinical studies. In summary, while IL-10 is consistently elevated following acute brain injury, the effect of IL-10 appears to be pathology dependent, and preclinical and clinical studies often paradoxically yield opposite results. The pronounced and potent effects of IL-10 in the resolution of inflammation and inconsistency in the literature regarding the contribution of IL-10 in the setting of acute brain injury warrant further rigorously controlled and targeted investigation.

Introduction

Stroke and traumatic brain injury (TBI) are devastating acute neurological disorders that can result in high mortality rates or long-lasting disability. Approximately 87% of strokes are ischemic and 13% are hemorrhagic, with 10 and 3% of the latter representing intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), respectively (1). Stroke is the fourth most common cause of death in the United States, and ischemic stroke (IS) in particular is the seventh most frequent emergency department presentation (2, 3). TBI and concussions have over twice the incidence of all strokes combined (4), with more than three million people in the United States alone living with long-term disability as a result of TBI (5). Collectively, stroke and TBI have very few treatments, and despite advances in clinical management of these disorders, they are still associated with significant disability and mortality (6, 7).

Inflammation plays a central role in the pathophysiology of stroke and TBI and can have both protective and harmful effects on brain tissue (815). Although there are some distinct differences in the inflammatory cascades following the various types of acute brain injury, there are also numerous commonalities. Acute neuroinflammation is characterized by the activation of resident central nervous system (CNS) immune surveillance glial cells that release cytokines, chemokines, and other immunologic mediators, which facilitate the recruitment of peripheral cells such as monocytes, neutrophils, and lymphocytes (8, 9, 12, 15). Collectively, this initial response is helpful in the clearance of toxic entities and the restoration and repair of damaged tissue. However, during the resolution phase, with an uncontrolled and prolonged inflammatory response, secondary damage results from overactivation of this inflammatory surge and release of additional factors that led to breakdown of the blood–brain barrier (BBB), cerebral edema, cerebral hypertension, and ischemia.

Interleukin-10 is generally known as an anti-inflammatory cytokine that exerts a plethora of immunomodulatory functions during an inflammatory response and is particularly important during the resolution phase. Expression of IL-10 in the brain increases with CNS pathology, promoting neuronal and glial cell survival, and dampening of inflammatory responses via a number of signaling pathways (16). IL-10 was originally described as cytokine synthesis inhibitory factor and in addition to attenuating the synthesis of proinflammatory cytokines, IL-10 also limits inflammation by reducing cytokine receptor expression and inhibiting receptor activation (16). Furthermore, IL-10 has potent and diverse effects on essentially all hematopoetic cells that infiltrate the brain following injury. For example, IL-10 reduces the activation and effector functions of T cells, monocytes, and macrophages, ultimately ending the inflammatory response to injury (17). The structure, function, and regulation of IL-10 have been extensively reviewed elsewhere, including a review of IL-10 in the brain (1620), although not in the context of the various forms of acute brain injury. Please refer to the aforementioned reviews for additional details, including the potential cellular sources, target cells, signal transduction, and mode of action of IL-10.

Given the intriguing multifactorial role of IL-10 in the resolution of inflammatory cascades that are important for promoting neurologic recovery from acute brain injury, here we present a comprehensive literature review of preclinical and clinical studies in this area. We focus on the contribution of IL-10 in modulating various important parameters and pathophysiologic processes important for IS, SAH, ICH, and TBI outcomes, and whether IL-10 has therapeutic or biomarker potential. A better understanding of the many functions of IL-10 in the brain after injury, particularly in the resolution phase of inflammatory processes, will promote our knowledge of the pathophysiology of these debilitating disorders and guide future development of novel therapeutic approaches.[…]

Continue —> Frontiers | Role of Interleukin-10 in Acute Brain Injuries | Neurology

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[WEB SITE] Cannabidiol shows promise to reduce seizures for people with difficult-to-treat epilepsy

Taking cannabidiol may cut seizures in half for some children and adults with Lennox-Gastaut syndrome (LGS), a severe form of epilepsy, according to new information released today from a large scale controlled clinical study that will be presented at the American Academy of Neurology’s 69th Annual Meeting in Boston, April 22 to 28, 2017. Cannabidiol is a molecule from the cannabis plant that does not have the psychoactive properties that create a “high.”

Nearly 40 percent of people with LGS, which starts in childhood, had at least a 50 percent reduction in drop seizures when taking a liquid form of cannabidiol compared to 15 percent taking a placebo.

When someone has a drop seizure, their muscle tone changes, causing them to collapse. Children and adults with LGS have multiple kinds of seizures, including drop seizures and tonic-clonic seizures, which involve loss of consciousness and full-body convulsions. The seizures are hard to control and usually do not respond well to medications. Intellectual development is usually impaired in people with LGS.

Although the drop seizures of LGS are often very brief, they frequently lead to injury and trips to the hospital emergency room, so any reduction in drop seizure frequency is a benefit.

“Our study found that cannabidiol shows great promise in that it may reduce seizures that are otherwise difficult to control,” said study author Anup Patel, MD, of Nationwide Children’s Hospital and The Ohio State University College of Medicine in Columbus and a member of the American Academy of Neurology.

For the randomized, double-blind, placebo-controlled study, researchers followed 225 people with an average age of 16 for 14 weeks. The participants had an average of 85 drop seizures per month, had already tried an average of six epilepsy drugs that did not work for them and were taking an average of three epilepsy drugs during the study.

Participants were given either a higher dose of 20 mg/kg daily cannabidiol, a lower dose of 10 mg/kg daily cannabidiol or placebo as an add-on to their current medications for 14 weeks.

Those taking the higher dose had a 42 percent reduction in drop seizures overall, and for 40 percent, their seizures were reduced by half or more.

Those taking the lower dose had a 37 percent reduction in drop seizures overall, and for 36 percent, seizures were reduced by half or more.

Those taking the placebo had a 17 percent reduction in drop seizures, and for 15 percent, seizures were reduced by half or more.

There were side effects for 94 percent of those taking the higher dose, 84 percent of those taking the lower dose and 72 percent of those taking placebo, but most side effects were reported as mild to moderate. The two most common were decreased appetite and sleepiness.

Those receiving cannabidiol were up to 2.6 times more likely to say their overall condition had improved than those receiving the placebo, with up to 66 percent reporting improvement compared to 44 percent of those receiving the placebo.

“Our results suggest that cannabidiol may be effective for those with Lennox-Gastaut syndrome in treating drop seizures,” said Patel. “This is important because this kind of epilepsy is incredibly difficult to treat. While there were more side effects for those taking cannabidiol, they were mostly well-tolerated. I believe that it may become an important new treatment option for these patients.”

There is currently a plan to submit a New Drug Application to the FDA later this year.

Source: Cannabidiol shows promise to reduce seizures for people with difficult-to-treat epilepsy

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[BLOG  POST] An Integrative Brain Injury Treatment Approach! 

Integrative Brain Injury Treatment plan helps The moment you hear the doctor say you have a brain injury your life stops, no different than if you were told that you have Cancer. Your first reaction is numbness, and then fear sets in. I know personally, for I was diagnosed with both!

Prognosis after Concussion (mild traumatic brain injury)

The first question that you ask is, “Am I going to get better?’ And most PCPs, neurologists and rehabilitation clinicians will say, “Wait and see.” The usual prescription for a concussion is to go home and rest, limit your activity, especially TV, electronics and sports. Nothing is said about changing your diet, or treatments such as water therapy which can actually help you heal your brain. Since this advice is typically not given, most people who sustain a Concussion, a mild traumatic brain injury, are sent home. Without proper treatment, these symptoms not only don’t go away, they worsen, leading to Post-Concussion Syndrome (PCS).

In my previous blog, I mentioned both a patient who fell off a horse and her symptoms were dismissed, and the Customer Service Representative, who has had symptoms for 8 years, without any help or relief. Because concussions are generally misdiagnosed, undiagnosed, and misunderstood, there are unfortunately many more people out there with experiences like theirs who are living with PCS.

Help and Hope! – There is a Way!

Long before my brain injury on March 5, 1990, I opened the first integrative health team in New England in 1979. The practice was called Lafayette Counseling, Inc. We had three locations and over 256 patients at the time of my accident. Our integrative team was unique because it included conventional, complementary and alternative approaches to treatment for trauma, educational, health issues and sports. We treated many issues were from chronic pain, chronic illness, including Cancer, Irritable Bowel Syndrome (IBS), learning disabilities, ADD, ADHD, incest, rape, abuse, and Post Traumatic Stress Disorder (PTSD).  Also, we did hypnosis for Pain Control during Childbirth, which I’m published in the field, and for work in Cancer, along with methods for Peak Performance Training.

The team worked seamlessly together, promoting the welfare of each person who came to the practice the team. We consulted each other and conducted team meetings for every one of the 256 patients we served. We had a psychiatrist, neuropsychologist, psychologist, neurologist, gastroenterologist, endocrinologist, physical therapist, speech and language pathologist, polarity therapist, massage therapist, acupuncturist and homeopathic practitioner as well as psychiatric nurses and social workers. It was during this time I developed Dr. Diane®’s 5 Prong Approach to treatment. It was a thriving practice… until my accident occurred.

After My Brain Injury

During the four years following my accident, I was not offered any services or treatments to help me progress in my rehabilitation and to help me regain my life. In 1991, I had to close my practice since I could no longer manage it. In 1994, I was told by one of the neurologists that I needed to see a psychiatrist to help me deal with the fact I was permanently brain damaged and that I would never walk or talk properly every again. I remember initially wishing I had died in the accident. I even contemplated suicide.  I was no longer the wife or mother I wanted to be.  I had 3 young children at home, and I could not function. It was a dark and lonely place. Then after a period of grieving, I decided, “Doc, you are going to heal yourself”. It was then I realized the amazing professionals that once made up the integrative team at my practice. I contacted the various team members and engaged them in my own rehabilitation, starting with polarity and acupuncture. Prior to my brain injury I had gone on a 6-month elimination diet to deal with food allergies. From this information, I realized after my brain injury that if I ate certain foods that my symptoms would get worse. I realized that changing my diet was improving my symptoms. Yet, no doctor could have given me that advice. I followed those same guidelines from the earlier elimination diet.  I started with one food and noted, along with the family members, who were living with all my symptoms, if that food made my symptoms better or worse. After 6 months, it was extremely clear that certain foods only made my symptoms worse, while others truly did help.  With this knowledge, I developed my brain food diet, which to this day has helped every single patient.

During this period, I was introduced to Dr. Igor Burdenko, Ph.D., the founder and chairman of the Burdenko Water and Sports Therapy Institute. Dr. Burdenko developed The Burdenko Method, a practical application of water and land exercises based on holistic approach to rehabilitation, conditioning, and training. The Burdenko Method changed my life, as did being on my brain health diet and being introduced to neurofeedback.

I learned about neurofeedback through a presentation given at a brain injury support group by Janet Bloom, who trained with Dr. Margaret Ayers. I had been trained in hypnosis and biofeedback, yet I had never heard of neurofeedback.  I am so grateful I attended that brain injury support group and discovered neurofeedback.  These three methods were the vital forces integral to regaining my life.

With all the information I acquired from these methods and with the help of my previous integrative team, I set out to write a book to help other like myself to regain their life again.  I co-authored, Coping with Mild Head Injury that was later changed to Coping with Mild Traumatic Brain Injury. The entire focus of this book was and is about the integrative approach that helped me rebuild my life. The book contains Conventional, Complementary and Alternative approaches to taking back your life after brain injury.  The book was released in 1997, the same year I was able to resume my practice, as a solo practitioner. I still was not ready cognitively to resume all of the responsibilities of having an integrative team of experts working with me.

From 1997 until 2007, I worked alone, yet was gradually meeting and working different practitioners developing a new integrative team with the current brain health experts.

Major Difference with Integrative Brain Injury Team

Just as the previous integrative team prior to my brain injury, this new team of brain health experts works seamlessly together, in true integrative fashion. One of my biggest complaints own with medical team treating my brain injury was they never spoke to one another. I can’t tell you how many times I was informing a specific doctor on what the other doctor had said or was doing.  They did NOT communicate with one another.  There was NO joint documentation of my files.  And often there was disagreement of methods of medication or procedures.

Having had this awful experience, I vowed that this would never happen to any patient we consult with or treat in our practice.  The Dr. Diane Brain Health team each has their own private practice, and are throughout the US.  Also, I’m extremely fortunate that since 1997, I met and personally know a network of national and international practitioners that we work with.  Hence, where ever you are located in the world, we can either refer you to a specialist in your area or we can provide remote, virtual, now called (tele-health) services.

COPING WITH CONCUSSION AND MILD TRAUMATIC BRAIN INJURY

In 2011, Penguin Publishing asked me to write another book. I agreed if the book’s focus was on the integrative treatment approach that was working so well in my practice. They agreed. Thus, Barbara Albers Hill and I set out to write a book with the main focus of an integrative approach of treatment for brain injury. The book came out in 2013.

Susan Connors, the president and CEO of the Brain Injury Association wrote the following review which appears on the back cover of the book:  “Coping with Concussion and Mild Traumatic Brain Injury” is a long-awaited prescription for the millions who experience a so-called mild TBI and for their families and care providers.  Incorporating detailed information, practical suggestions and personal insight, Dr. Stoler, has compiled a must-have encyclopedia for managing life after a Concussion.”

DR. DIANE®’S 5 PRONG APPROACH TO TREATMENT

My 5 Prong Approach evolved as part of my own journey in regaining my life after my brain injury, and with working with the brain injury patients and consult clients upon my return to active practice. What I realized is that even though there are common symptoms related to injury to the brain, each person is unique. Because of this, each treatment program for similar symptoms has to be different in order to achieve an excellent outcome. I believe the key to healing is to view and treat each person from the five distinct views that make up our approach: physical, psychological, emotional, spiritual and energy while looking for the core issue. Often these areas are connected and each needs to be addressed to ultimately reach your goal, Each integrative team member brings their own specialty and together we develop customized treatment programs based on the individual’s unique needs and goals and symptoms, using a wide-range of traditional, alternative, and complementary methods.

LIST OF INTEGRATIVE SERVICES

  • Neurofeedback, Biofeedback, and QEEG
  • Nutrition Education and Nutrition Response Testing
  • Physical Therapy/CranioSacral Therapy
  • Water Therapy/Burdenko Method
  • Speech-Language Pathology
  • Cognitive Remediation Therapy
  • Energy Psychology
  • Energy Healing
  • Reiki
  • Acupuncture
  • Other Energy Healing Treatments- Tom Tam, Evan Pantazi
  • Hypnosis and Relaxation Techniques
  • Massage and Muscular Therapy
  • Psychiatry and Psychopharmacology
  • Psychotherapy
  • Cognitive Behavioral Therapy
  • Aromatherapy
  • Bach Flower Essence
  • BAUD
  • Brainspotting
  • Chiropractic
  • Homeopathy
  • iListen Therapy™
  • Interactive Metronome
  • Irlen Method
  • Light Therapy + Photonic Modulation
  • The Tomatis Method®
  • Care Management

MEET THE DR. DIANE INTEGRATIVE TEAM OF BRAIN HEALTH EXPERTS

In the following weeks, my blogs will be focused on introducing you to the various individual team members, their background, beliefs and philosophy about specific treatment and the importance of being a part of an integrative team.  Here is a brief introduction of the team members. For more detailed information about each member and the services they offer, please click on the links.

Dr. Diane Roberts Stoler, Ed.D.

Dr. Diane® is a Neuropsychologist, Board Certified Health Psychologist,  and Board Certified Sports Psychologist with a focus on brain fitness and brain rehabilitation.  She has worked with amateur, professional and Olympic athletes to help them achieve Peak Performance and be in “The Zone”.

Amy Karas MS, CCC-SLP Speech-Language Pathologist

Certified Speech-Language Pathologist with over 19 years’ experience working with acquired brain injuries, learning disabilities and other social and communication disorders. Amy’s approach emphasizes understanding what someone needs to improve quality of life, task efficiency and effectiveness and maximizing independence.

Clara Diebold, Energy Healing Practitioner, Reiki Master

Clara practices several forms of energy healing, including Reiki, HBLU, and techniques for emotional processing. She is a Reiki Master trained in the Usui Shiki Ryoho tradition by John and Lourdes Gray.

Paul Soper, M.M., RCTC

Specializing in Biofeedback, Brain Training, Listening Training, and Neurofeedback, Paul earned his certification in the first authorized Tomatis training in the US at Spectrum Center in Bethesda, MD, and was trained in neurofeedback and neuroscience at ESII and BrainMaster Institute.

Martha Lindsay, MS, CNE, certified in Nutrition Response Testing℠, GAPS certified practitioner

Offering a muscle testing technique is used to choose the most appropriate specific nutrition products for each person. The specific nutritional program thus chosen enhances that individual’s immune system function which then helps the brain to function more efficiently.

Joan Flynn, Craniosacral, Physical Therapist

Joan is certified in CranioSacral Therapy from the Upledger Institute. She has an intuitive and insightful approach to her work.  She treats chronic pain, stroke, alignment disorders, and most orthopedic problems.

Wendy Keiver-Hewett, NCTMB, LMT, Massage Therapist, Muscle-Release Therapist

Wendy is a Nationally Licensed Massage Therapist and Muscle Release Therapist.  Muscle release technique can break down scar tissue, lengthen a muscle, restore muscle memory and relieve pain.

Jennifer Stanley, LMT Massage Therapist

With over ten years’ experience, Jennifer specializes in Deep Tissue, Swedish Eflurage and Sports Massage. Using Reflexology and Shiatsu in addition to traditional massage, she intuitively combines these techniques to release muscle tension and promote relaxation and wellness.

Karen Campbell, CMC – Certified Care Manager

Care management can increase the quality of life for the senior or disabled adult, improve the quality of care, and to reduce caregiver stress. Karen specializes in care management working with seniors, adults with disabilities, and the families that love them.

Dr. Igor Burdenko, Ph.D., Sports Therapist, Water Therapist

Dr. Burdenko, founder and chairman of the Burdenko Water and Sports Therapy Institute, is one of the world’s leading authorities on the use of water for rehabilitation, conditioning, and training.

William Mogan, L.Ac. Acupuncturist, Chinese Herbal Medicine

William specializes in TBI, Headaches/Migraines, chronic pain, chronic illness, sleep and insomnia issues. He is nationally board certified by the National Association of Acupuncture and Oriental Medicine (NCCAOM) and licensed in Massachusetts.

David Sollars, MAc., LAc. Acupuncturist, Chinese Herbal Medicine, Homeopathic

David founded a series of Integrative Medical clinics that pioneered the then uncommon practice of a combined conventional and integrative medical staff. Focus areas include: Breaking the Wellness Barrier with solutions for stress, anxiety and depression, Developing Patient Medical Leadership Skills, Healthy Aging at Home, Successful Engagement with Wellness at Work and Ancient Solutions for Modern Problems.

Dr. Paul Schoonman, DC, Chiropractor

Paul obtained his undergraduate training in Biology at the University of Connecticut followed by graduate education at the National College of Chiropractic in Lombard, Illinois. He graduated cum laude, with a doctorate in Chiropractic in 1992. He complements his chiropractic education with an extensive postgraduate program in rehabilitation, which help patients manage some of the most complicated and/or chronic cases of musculo-skeletal pain.

Dr. Jorge Gonzalez, MD Neurologist

Primary area of interest centers on head injuries, migraines, seizures, movement disorders, neuropathies, and the injection of botulinum toxin (botox) in the treatment of migraines, headaches, and similar forms of pain, muscle contractions and movement disorders, as well as Alzheimer’s disease, stroke, and epilepsy. One of the many qualities that set Dr. Gonzales apart from the rest is his acceptance of alternative approaches to migraine treatment and palliation.

Dr. Sharon Barrett, MD, Psychopharmacologist, Psychiatrist

Board Certified adult psychiatrist with over 25 years’ experience treating people with Brain Injury, Fibromyalgia and Chronic Fatigue Syndrome. She is a graduate of Emory University School of Medicine, and completed her residency at the Beth Israel Deaconess in Boston, Massachusetts.

Dr Kathleen O’Neil-Smith, MD Endocrinologist, FAARM

Dr.O’Neil-Smith is a magna cum laude graduate of Boston University Medical School. She completed an internship in pathology at Massachusetts General Hospital followed by an internship and residency in internal medicine at the Brigham and Women’s Hospital in Boston. Dr. O’Neil-Smith has an extensive background in nutrition, applied physiology and sports medicine.

Tom Tam, Acupuncturist

Tom is a licensed Acupuncturist who has also practiced Tai Chi and Chi Gong since 1975, specializing in Acupuncture, Qui Gong. Tom formed his own healing system, and wrote the Tom Tam Healing System (1995). Also, he wrote a Chinese healing book, An Zhen – The Palpation diagnose (2005). This book combined the west and east medical knowledge and formed a new theory for the understanding and healing the difficulty disease.

Evan Pantazi, Oriental Body Work and Nerve Trauma Instructor

Evan has formulated a new and highly advanced method of Kyusho (Vital Point) for use in Health, Martial, Intimacy Enhancement and Law Enforcement. Based on the ancient understanding of acupuncture and pressure point massage methods, but adapted with modern science… the vital point is that all of us can easily rid the body of common ailments.

Integrative Brain Injury Consult

There are many practices that call themselves “integrative”.  However, if you call and ask you will typically find the integrative team keep does not keep the same notes or meet to discuss your individual needs or treatment. This is norm at Dr. Diane Brain Health, not the exception.

Whether you are looking for help restoring your Brain Health and regain your life again……There is a Way! ®

GET HELP TODAY!

With over 30 years of experience as a Neuropsychologist, Board Certified Health Psychologist, Board Certified Sports Psychologist and brain injury survivor Dr. Diane can help you!

SCHEDULE A CONSULT

Schedule a personal consult today with Dr. Diane®

please call us at 800-500-9971 or submit a contact form.

Source: Dr. Diane Brain Health | An Integrative Brain Injury Treatment Approach! | Dr. Diane Brain Health

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[WEB SITE] Omega-3 intake may aid in recovery of concussions and brain injury

The treatment of concussions and traumatic brain injury (TBI) is a clinical challenge. Clinical studies thus far have failed to identify an effective treatment strategy.

According to emerging science and clinical experience, aggressive intake of omega-3 fatty acids (n-3FA) seems to be beneficial to TBI, concussion, and post-concussion syndrome patients.

This research is presented in Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s, a review article from the Journal of the American College of Nutrition, official publication of the American College of Nutrition.

Research suggests that early and optimal doses of omega-3 fatty acids (n-3FA) have the potential to improve outcomes from traumatic brain injury.

The article reviews preclinical research and cites three brain injury case studies that resulted from a mining accident, a motor vehicle accident, and a drowning accident.

Each instance showcased evidence of safety and tolerability, wherein the patients who sustained life-threatening brain injuries recovered brain health with the aid of omega-3 fatty acids (n-3FA).

Growing clinical experience by numerous providers is that the brain needs to be saturated with high doses of n-3FA in order for the brain to have the opportunity to heal.

Without an optimal supply of omegas, healing is less likely to happen. It is well recognized that n-3FAs are not a drug and not a cure and every situation is different.

Clinically, some patients respond better than others. However, there is no downside to providing optimal levels of nutrition in order to give a patient the best opportunity to regain as much function as possible following a TBI.

Source: Omega-3 intake may aid in recovery of concussions and brain injury | Knowridge Science Report

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[Press Announcements] FDA allows marketing of first-of-kind computerized cognitive tests to help assess cognitive skills after a head injury.

August 22, 2016

Release

The U.S. Food and Drug Administration today permitted marketing of two new devices to assess a patient’s cognitive function immediately after a suspected brain injury or concussion. The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and ImPACT Pediatric are the first medical devices permitted for marketing that are intended to assess cognitive function following a possible concussion. They are intended as part of the medical evaluation that doctors perform to assess signs and symptoms of a head injury.

ImPACT and ImPACT Pediatric are not intended to diagnose concussions or determine appropriate treatments. Instead the devices are meant to test cognitive skills such as word memory, reaction time and word recognition, all of which could be affected by a head injury. The results are compared to an age-matched control database or to a patient’s pre-injury baseline scores, if available.

“These devices provide a useful new tool to aid in the evaluation of patients experiencing possible signs of a concussion, but clinicians should not rely on these tests alone to rule out a concussion or determine whether an injured player should return to a game,” said Carlos Peña, Ph.D., M.S., director of the division of neurological and physical medicine devices at the FDA’s Center for Devices and Radiological Health.

ImPACT software runs on a desktop or laptop and is intended for those ages 12 to 59, while the ImPACT Pediatric runs on an iPad and is designed for children ages 5 to 11. Only licensed health care professionals should perform the test analysis and interpret the results.

Traumatic brain injuries account for more than 2 million emergency room visits in the United States each year, according to the U.S. Centers for Disease Control and Prevention, and contribute to the deaths of more than 50,000 Americans. A significant percentage of these injuries are considered to be mild. A concussion is considered to be a mild traumatic brain injury.

The manufacturer submitted over 250 peer-reviewed articles, of which half were independently conducted clinical research studies. The research publications analyzed the scientific value of the ImPACT devices including the devices’ validity, reliability and ability to detect evidence of cognitive dysfunction that might be associated with a concussive head injury. The FDA concluded that these studies provide valid scientific evidence to support the safety and effectiveness of the ImPACT and ImPACT Pediatric devices.

The FDA reviewed the ImPACT device through its de novo classification process, a regulatory pathway for novel, low- to-moderate-risk medical devices that are first-of-a-kind, for which special controls can be developed, in addition to general controls, to provide a reasonable assurance of safety and effectiveness of the devices. The device is manufactured by ImPACT Applications, located in Pittsburgh, Pennsylvania.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Source: Press Announcements > FDA allows marketing of first-of-kind computerized cognitive tests to help assess cognitive skills after a head injury

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[Poster] Gender Differences in Neuropsychological Functioning Following Mild Traumatic Brain Injury: Implications for Assessment and Rehabilitation.

Women generally experience higher incidence of concussions, different and more severe postconcussive symptoms (PCS), and slower recovery. Nonetheless, the literature does not unanimously support sex-related differences in neuropsychological (NP) deficits, arguably due to a lack of consistency in objective NP measures used. The present study aims to elucidate gender differences in NP functioning, using an evidence-based test battery incorporating measures recommended by the Federal Interagency TBI Outcomes Common Data Elements (CDE) Work Group.

Source: Gender Differences in Neuropsychological Functioning Following Mild Traumatic Brain Injury: Implications for Assessment and Rehabilitation – Archives of Physical Medicine and Rehabilitation

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[ARTICLE] Pharmacotherapy in rehabilitation of post-acute traumatic brain injury

Available online 20 January 2016

Highlights

  • Post-acute TBI has numerous symptoms that require pharmacological management.
  • Beta-blockers work well in reducing hyper-arousal in TBI.
  • Donepezil can be used to improve cognition and memory after a TBI.
  • Melatonin and trazodone can be used to improve sleep after a TBI.
  • Sertraline and citalopram can be used to treat depression after a TBI.

Abstract

There are nearly 1.8 million annual emergency room visits and over 289,000 annual hospitalizations related to traumatic brain injury (TBI).

The goal of this review article is to highlight pharmacotherapies that we often use in the clinic that have been shown to benefit various sequelae of TBI.

We have decided to focus on sequelae that we commonly encounter in our practice in the post-acute phase after a TBI. These symptoms are hyper-arousal, agitation, hypo-arousal, inattention, slow processing speed, memory impairment, sleep disturbance, depression, headaches, spasticity, and paroxysmal sympathetic hyperactivity.

In this review article, the current literature for the pharmacological management of these symptoms are mentioned, including medications that have not had success and some ongoing trials. It is clear that the pharmacological management specific to those with TBI is often based on small studies and that often treatment is based on assumptions of how similar conditions are managed when not relating to TBI. As the body of the literature expands and targeted treatments start to emerge for TBI, the function of pharmacological management will need to be further defined.

This article is part of a Special Issue entitled SI:Brain injury and recovery.

Abbreviations

  • TBI, traumatic brain injury;
  • CDC, Centers for Disease Control and Prevention;
  • ED,emergency department;
  • AHRQ, US Agency for Healthcare Research and Quality;
  • NMDA, N-methyl-D-aspartate;
  • DRS, disability rating scale;
  • CSM, cerebral state monitoring;
  • PTSD, post-traumatic stress disorder;
  • GABA, gamma aminobutyric acid;
  • CCI, controlled cortical impact;
  • TCA, tricyclic antidepressant;
  • MAS, Modified Ashworth Score;
  • SCI, spinal cord injury;
  • MS, multiple sclerosis;
  • BoNT, Botulinum toxin;
  • ITB,intrathecal baclofen

Source: Pharmacotherapy in rehabilitation of post-acute traumatic brain injury

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