Posts Tagged memory

[WEB SITE] TBI and PTSD: Navigating the Perfect Storm – BrainLine

Marilyn Lash, MSW, Brain Injury Journey magazine
TBI and PTSD: Navigating the Perfect Storm

So often people talk about the effects of traumatic brain injury or the consequences of post-traumatic stress disorder as separate conditions — which they are. But for the person who is living with the dual diagnosis of TBI and PTSD, it can be hard to separate them.

Just as meteorologists predict “the perfect storm” when unusual and unprecedented conditions move in to create catastrophic atmospheric events, so can the combination of PTSD and TBI be overpowering and destructive for all in its path. The person with TBI and PTSD is living in a state unlike anything previously experienced. For the family, home is no longer the safe haven but an unfamiliar front with unpredictable and sometimes frightening currents and events.

While awareness of PTSD has greatly increased with recently returning service members and veterans, it is not new and nor limited to combat. Anyone — children, adolescents, adults, elderly — who is exposed to a life-threatening trauma can develop PTSD. Car crashes, shootings, floods, fires, assaults, or kidnapping can happen to anyone anywhere. But the rate of PTSD after brain injury is much higher in veterans than civilians due to their multiple and prolonged exposure to combat. According to O’Connor and Drebing, it is estimated that up to 35% of returning veterans with mild brain injury also have PTSD.

What’s unique about PTSD?

Symptoms of PTSD include:

  • Unwanted and repeated memories of the life-threatening event
  • Flashbacks where the event is relived and person temporarily loses touch with reality
  • Avoidance of people, places, sights, or sounds that are reminders
  • Feelings of detachment from people, even family, and emotional numbness
  • Shame about what happened and was done
  • Survivor guilt with loss of friends or comrades
  • Hypervigilance or constant alertness for threats.

Individuals with PTSD are at increased risk for depression, physical injuries, substance abuse, and sleep problems, which in turn can affect thoughts and actions. These risk factors also occur with brain injury.

PTSD is a mental disorder, but the associated stress can cause physical damage. TBI is a neurological disorder caused by trauma to the brain. It can cause a wide range of impairments and changes in physical abilities, thinking and learning, vision, hearing, smell, taste, social skills, behaviors, and communication. The brain is so complex, the possible effects of a traumatic injury are extensive and different for each person.

When PTSD and TBI coexist, it’s often difficult to sort out what’s going on. Changes in cognition such as memory and concentration, depression, anxiety, insomnia, and fatigue are common with both diagnoses. One basically feeds and reinforces the other, so it’s a complicated mix — it’s the perfect storm. It may help to consider and compare changes commonly seen with TBI and PTSD.

Memory

TBI: A period of amnesia for what went on just before (retrograde amnesia) or after (anterograde amnesia) the injury occurred is common. The length of time (minutes, hours, days, or weeks) of amnesia is an indicator of the severity of the brain injury. For example, the person may have no memory of what happened just before or after the car crash or IED explosion.

PTSD: In contrast, the person with PTSD is plagued and often haunted by unwanted and continuing intrusive thoughts and memories of what happened. The memories keep coming at any time of day or night in such excruciating detail that the person relives the trauma over and over again.

Sleep

TBI: Sleep disorders are very common after brain injury. Whether it is trouble falling asleep, staying asleep, or waking early, normal sleep patterns are disrupted, making it hard to get the restorative rest of sleep so badly needed.

PTSD: The mental state of hypervigilance interferes with slowing the body and mind down for sleep. Nightmares are so common with PTSD that many individuals dread going to bed and spend long nights watching TV or lying on the couch to avoid the night’s terrors. Waking up with night sweats so drenching that sheets and clothing are soaked. Flashbacks so powerful that bed partners have been struck or strangled while sleep battles waged.

Isolation

TBI: Many survivors of TBI recall the early support and visits of friends, relatives, and coworkers who gradually visited or called less often over time. Loss of friends and coworkers leads to social isolation, one of the most common long-term consequences of TBI.

PTSD: The isolation with PTSD is different as it is self-imposed. For many it is simply too hard to interact with people. The feeling of exposure outside the safe confines of the house is simply too great. The person may avoid leaving the house as a way of containing stimuli and limiting exposure to possible triggers of memories. As a result, the individual’s world becomes smaller and smaller.

Emotions

TBI: When the areas of the brain that control emotions are damaged, the survivor of a TBI may have what is called “emotional lability.” This means that emotions are unpredictable and swing from one extreme to the other. The person may unexpectedly burst into tears or laughter for no apparent reason. This can give the mistaken impression that the person is mentally ill or unstable.

PTSD: Emotional numbness and deadened feelings are a major symptom of PTSD. It’s hard for the person to feel emotions or to find any joy in life. This emotional shutdown creates distance and conflicts with spouses, partners and children. It is a major cause of loss of intimacy with spouses.

Fatigue

TBI: Cognitive fatigue is a hallmark of brain injury. Thinking and learning are simply harder. This cognitive fatigue feels “like hitting the wall,” and everything becomes more challenging. Building rest periods or naps into a daily routine helps prevent cognitive fatigue and restore alertness.

PTSD: The cascading effects of PTSD symptoms make it so difficult to get a decent night’s sleep that fatigue often becomes a constant companion spilling over into many areas. The fatigue is physical, cognitive, and emotional. Feeling wrung out, tempers shorten, frustration mounts, concentration lessens, and behaviors escalate.

Depression

TBI: Depression is the most common psychiatric diagnosis after brain injury; the rate is close to 50%. Depression can affect every aspect of life. While people with more severe brain injuries have higher rates of depression, those with mild brain injuries have higher rates of depression than persons without brain injuries.

PTSD: Depression is the second most common diagnosis after PTSD in OEF and OIF veterans. It is very treatable with mental health therapy and/or medication, but veterans in particular often avoid or delay treatment due to the stigma of mental health care.

Anxiety

TBI: Rather than appearing anxious, the person acts as if nothing matters. Passive behavior can look like laziness or “doing nothing all day,” but in fact it is an initiation problem, not an attitude. Brain injury can affect the ability to initiate or start an activity; the person needs cues, prompts, and structure to get started.

PTSD: Anxiety can rise to such levels that the person cannot contain it and becomes overwhelmed by feelings of panic and stress. It may be prompted by a specific event, such as being left alone, or it can occur for no apparent reason, but the enveloping wave of anxiety makes it difficult to think, reason or act clearly.

Talking about the Trauma

TBI: The person may retell an experience repetitively in excruciating detail to anyone who will listen. Such repetition may be symptomatic of a cognitive communication disorder, but it may also be due to a memory impairment. Events and stories are repeated endlessly to the frustration and exasperation of caregivers, friends, and families who have heard it all before.

PTSD: Avoidance and reluctance to talk about the trauma of what was seen and done is a classic symptom of PTSD, especially among combat veterans.

Anger

TBI: Damage to the frontal lobes of the brain can cause more volatile behavior. The person may be more irritable and anger more easily, especially when overloaded or frustrated. Arguments can escalate quickly, and attempts to reason or calm the person are often not effective.

PTSD: Domestic violence is a pattern of controlling abusive behavior. PTSD does not cause domestic violence, but it can increase physical aggression against partners. Weapons or guns in the home increase the risks for family members. Any spouse or partner who feels fearful or threatened should have an emergency safety plan for protection.

Substance Abuse

TBI: The effects of alcohol are magnified after a brain injury. Drinking alcohol increases the risks of seizures, slows reactions, affects cognition, alters judgment, interacts with medications, and increases the risk for another brain injury. The only safe amount of alcohol after a brain injury is none.

PTSD: Using alcohol and drugs to self-medicate is dangerous. Military veterans drink more heavily and binge drink more often than civilian peers. Alcohol and drugs are being used often by veterans to cope with and dull symptoms of PTSD and depression, but in fact create further problems with memory, thinking, and behavior.

Suicide

TBI: Suicide is unusual in civilians with TBI.

PTSD: Rates of suicide have risen among veterans of OEF and OIF. Contributing factors include difficult and dangerous nature of operations; long deployments and multiple redeployments; combat exposure; and diagnoses of traumatic brain injury, chronic pain, post-traumatic stress disorder, and depression; poor continuity of mental health care; and strain on marital and family relationships. Veterans use guns to commit suicide more frequently than civilians.

Summary

There is no easy “either/or” when it comes to describing the impact of TBI and PTSD. While each diagnosis has distinguishing characteristics, there is an enormous overlap and interplay among the symptoms. Navigating this “perfect storm” is challenging for the survivors, the family, the caregivers, and the treatment team. By pursuing the quest for effective treatment by experienced clinicians, gathering accurate information, and enlisting the support of peers and family, it is possible to chart a course through the troubled waters to a safe haven.

References:

O’Connor, M. & Drebing, C. (2011). Veterans and Brain Injury. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Ehde, D. & Fann, J. (2011). Managing Depression, Anxiety, and Emotional Challenges. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Posted on BrainLine March 7, 2013. Reviewed July 26, 2018.

 

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[VIDEO] RehaCom introduction – YouTube

RehaCom is a modular software used for cognitive therapy. It assists therapist in the rehabilitation of cognitive disorders that affect specific aspects of attention, concentration, memory, perception, activities of daily living and much more.

 

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[WEB PAGE] 8 techniques to improve memory

Most people have occasional lapses in memory, such as forgetting a new acquaintance’s name or misplacing the car keys.

Most of the time, this is simply a sign that a person is a bit too busy or is preoccupied. On the other hand, having a consistently poor memory can be problematic for someone.

Many factors play a role in memory loss, including genetics, age, and medical conditions that affect the brain. There are also some manageable risk factors for memory loss, such as diet and lifestyle.

While not all memory loss is preventable, people may be able to take measures to protect the brain against cognitive decline as they age.

In this article, learn about eight techniques to try to help improve your memory.

1. Do brain training

a man improving his memory with a brain training exercise on an iPad

There are many brain training activities online that may help improve a person’s memory.

A large trial from the journal PLoS One found that people who did just 15 minutes of brain training activities at least 5 days a week had improvements in brain function.

The participants’ working memory, short term memory, and problem solving skills all significantly improved when researchers compared them to a control group doing crossword puzzles.

The researchers used brain training activities from the website Lumosity. The challenges work on a person’s ability to recall details and quickly memorize patterns.

2. Exercise

Physical exercise has a direct impact on brain health. As the author of research in the Journal of Exercise Rehabilitation notes, regular exercise reduces the risk of cognitive decline with age and protects the brain against degeneration.

The results of a 2017 study suggest that aerobic exercise can improve memory function in people with early Alzheimer’s disease. The control group did nonaerobic stretching and toning.

Aerobic exercise increases a person’s heart rate and can include any of these activities:

3. Meditate

meditation class

Research suggests that meditation may cause long term changes in the brain that improve memory.

Mindfulness meditation may help improve memory. The authors of a 2018 research paper note that many studies show meditation improves brain function, reduces markers of brain degeneration, and improves both working memory and long term memory.

The researchers observed the brains of people who regularly practiced meditation and those who did not.

Their results indicated that making a habit of meditating may cause long term changes in the brain, including increasing brain plasticity, which helps keep it healthy.

Learn about a variety of different meditation types and how to do them in this article.

4. Get enough sleep

Sleep is vital for overall brain health. Disrupting the body’s natural sleep cycle can lead to cognitive impairments, as this interrupts the processes the brain uses to create memories.

Getting a full night’s rest, typically about 7–9 hours a night for an adult, helps the brain create and store long term memories.

5. Reduce sugar intake

Sugary foods can taste delicious and feel rewarding at first, but they may play a role in memory loss. Research from 2017 in animal models noted that a diet high in sugary drinks has a link to Alzheimer’s disease.

The researchers also found that drinking too many sugary drinks, including fruit juice, may have a connection a lower total brain volume, which is an early sign of Alzheimer’s disease.

Avoiding extra sugar may help combat this risk. While naturally sweet foods, such as fruits, are a good addition to a healthful diet, people can avoid drinks sweetened with sugar and foods with added, processed sugars.

6. Avoid high calorie diets

Along with cutting out sources of excess sugar, reducing overall caloric intake may also help protect the brain.

Researchers note that high calorie diets can impair memory and lead to obesity. The effects on memory may be due to how high calorie diets lead to inflammation in particular parts of the brain.

While most research in this area has been with animals, a study from 2009 looked at whether restricting calories in humans could improve memory.

Female participants with an average age of 60.5 years reduced their calorie intake by 30%. The researchers found that they had a significant improvement in verbal memory scores and that the benefit was most significant in those who stuck to the diet best.

7. Increase caffeine intake

Caffeine from sources such as coffee or green tea may be helpful for the memory.

The authors of a 2014 study found that consuming caffeine after a memory test boosted how well participants’ brain stored memories long term.

People who took 200 milligrams of caffeine scored better on recall tests after 24 hours than people who did not take caffeine.

Caffeine may also boost memory in the short term. A study in Frontiers in Psychology found that young adults who took caffeine in the morning had improved short term memory.

This insight might be useful for individuals who have to take tests or recall information during a time of day when they may otherwise be tired.

8. Eat dark chocolate

Eating dark chocolate sounds like an indulgence, but it may also improve a person’s memory. The results of a 2011 study suggest that cocoa flavonoids, which are the active compounds in chocolate, help boost brain function.

People who ate dark chocolate performed better on spatial memory tests than those who did not. The researchers noted that cocoa flavonoids improved the blood flow to the brain.

With that said, it is important not to add more sugar to the diet, and so people should aim for at least 72% cacao content in dark chocolate and avoid chocolate with added sugar.

Risk factors for memory impairment

woman using bcaas supplement running on racing track

Exercising regularly may help keep the mind sharp.

There are risk factors a person has no control over, such as genetics. Some people may be more predisposed to conditions, such as Alzheimer’s, which greatly affect the brain and memory.

In other cases, a person may be able to reduce the risk of memory impairment. Eating a diet high in refined sugar and fats and leading a sedentary lifestyle may increase the risk of memory loss.

Eating a rounded, healthful diet and exercising regularly may contribute to keeping the mind sharp and reduce memory loss.

Summary

Many techniques for improving memory can be beneficial for a person’s overall health and well-being. For example, practicing mindfulness meditation may not only make a person less forgetful but can also reduce stress.

Even adding one or two memory boosting practices to a person’s daily routine may help them keep their brain healthy and protect it from memory loss.

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[WEB PAGE] The Most Effective Methods to Improve Your Memory

SPONSORED BY: Leslie Sherman

If there is one thing that everyone would like to improve, it would undoubtedly be memory. This is true for students and professionals alike. After all, you are expected to remember a wide array of information throughout your lifetime. Unfortunately, few people are capable of actually doing this.
Well, the good news is that there are evidence-backed ways to improve your memory. While it may take some dedication and effort, following these methods is sure to help you retain information more effectively. Here are the top strategies that you need to know in this regard:

Practice Mindfulness

Most people associate mindfulness with mental and emotional wellbeing. However, there is research to suggest that mindfulness can also help boost your memory as well. The logic behind this is startlingly simple.
You may have noticed that when you are not paying attention, your memory worsens quite a bit. This is because you aren’t focusing on a situation long enough for your brain to be able to capture it in its working memory. Thus, that information is quickly lost.
Mindfulness, however, overcomes this problem. By its definition, mindfulness is all about focusing on the present and being aware of the environment around you. In addition, it also deals with bringing your mind back to the present when it begins to wonder.
Naturally, this ensures that you are able to notice and remember a great deal more. It should be noted that mindfulness can take some time to master. However, as long as you are determined and make an attempt to pay attention, this habit will quickly become automatic.

Use the Method of Loci

Now, in many cases, you are expected to remember larger chunks of information in one go. This is especially true for students or working professionals who are introduced to a new concept. Due to this, you are going to need a more effective method of remembering all these details.
Well, this is where the method of loci comes in. It is a mnemonic strategy that helps you recall information by connecting it to a particular location in a mental image. In many instances, the mental image is often a room or large building. Here, you will “place” certain details in specific spots such as in a drawer or on a table.
Then, when you need to recall this information, you simply mentally walk past that room. After this, it is a matter of focusing on what you left in a particular spot and then remembering the rest of the information attached to that.
While this strategy may sound a little farfetched, there is evidence to suggest that it does work. It has been utilized by professional memory athletes, college students, and everyone in between. Therefore, it can undoubtedly work for you as well.

Train Your Brain

Think of your brain as a muscle: if you exercise it and use it well, it is unlikely to get rusty from disuse. This is precisely why it is important for you to flex your brain on a regular basis. Of course, it isn’t quite as simple as completing a crossword puzzle each day. No, you really need to push your brain to its limits.
This is especially important when you are trying to remember specific information for a certain reason. For instance, if you are trying to retain details for an exam, make sure to try an exercise related to the exam you will be taking. Thus, you will be forcing your brain to utilize – and remember – information in more meaningful ways.

Get More Sleep

Believe it or not, sleep is integral to your memory. It is during your sleep that your memories are consolidated. As a result, they are strengthened and often passed onto long-term storage during this stage. Scientists have determined that this process takes place during every stage of sleep.
To ensure that you are reaping the benefits of these findings, you need to get around seven to eight hours of sleep a day. If you get any less, you could increase the risk of forgetting what you learned during the day.
You may also want to start taking naps when you need to remember certain information, perhaps after a study session. So, go ahead and learn the new information and once you are done, take a nap for around an hour. This will help to consolidate what you have learned previously.

Take Up Spaced Rehearsal

Few people can remember something right away. You often have to go over the information a couple of times before it becomes cemented in your memory. It is for this reason that you should engage in spaced rehearsal when you want to remember new details.
Spaced rehearsal is when you revise a chunk of information at regular intervals. This way, the content continues to remain fresh in your brain, reducing the risk of you forgetting it. Such a technique should be utilized from the moment you learn new information for the best results.

Improve Your Diet

Last but not least, take steps to improve your diet as well. To begin with, increase your intake of omega-3 fatty acids. These have been proven to boost brain health. They can be found in fatty fish, walnuts, flaxseed, kidney beans, pinto beans, seaweed, and more.
You should also start eating fruits and vegetables that are rich in antioxidants. These will help to protect your brain from damage and keep your cells in better condition for longer. Finally, cut down on foods that are rich in saturated fats as they can increase your risk of dementia.
If you really want to improve your memory, then it is important to follow every one of these guidelines. Sure, it may take some time and effort but it will be well worth it in the end when you are able to boost your recall capabilities considerably. So, don’t wait any longer – go ahead and put these tips and tricks to good use today. You will soon reap the benefits.

 

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[WEB SITE] Nootropics: Types, safety, and risks of smart drugs

Last reviewed 

Nootropics, or “smart drugs,” are a class of substances that can boost brain performance. They are sometimes called cognition enhancers or memory enhancing substances.

Prescription nootropics are medications that have stimulant effects. They can counteract the symptoms of medical conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, or Alzheimer’s disease.

Nonprescription substances that can enhance brain performance or focus — such as caffeine and creatine — are also considered nootropics. They do not treat diseases but may have some effects on thinking, memory, or other mental functions.

This article looks at prescription and nonprescription smart drugs, including their uses, side effects, and safety warnings.

Prescription nootropics

a woman taking nootropics at her desk.

A person may take a nootropic to treat ADHD, narcolepsy, or dementia.

Prescription nootropics include:

  • modafinil (Provigil), a stimulant that addresses the sudden drowsiness of narcolepsy
  • Adderall, which contains amphetamines to treat ADHD
  • methylphenidate (Ritalin), a stimulant that can manage symptoms of narcolepsy and ADHD
  • memantine (Axura), which treats symptoms of Alzheimer’s disease

While these can be effective in treating specific medical conditions, a person should not take them without a prescription.

Like any prescription medications, they carry risks of side effects and interactions, and a person should only take them under a doctor’s care.

Common side effects of prescription nootropics include:

Some evidence suggests that people who use prescription nootropics to improve brain function have a higher risk of impulsive behaviors, such as risky sexual practices.

Healthcare providers should work closely with people taking prescription nootropics to manage any side effects and monitor their condition.

Over-the-counter nootropics

The term “nootropic” can also refer to natural or synthetic supplements that boost mental performance. The following sections discuss nootropics that do not require a prescription.

Caffeine

Many people consume beverages that contain caffeine, such as coffee or tea, because of their stimulant effects. Studies suggest that caffeine is safe for most people in moderate amounts.

Having a regular cup of coffee or tea may be a good way to boost mental focus. However, extreme amounts of caffeine may not be safe.

The Food and Drug Administration (FDA) recommend that people consume no more than 400 milligrams (mg) of caffeine a day. This is the amount in 4–5 cups of coffee.

Caffeine pills and powders can contain extremely high amounts of the stimulant. Taking them can lead to a caffeine overdose and even death, in rare cases.

Women who are pregnant or may become pregnant may need to limit or avoid caffeine intake. Studies have found that consuming 4 or more servings of caffeine a day is linked to a higher risk of pregnancy loss.

L-theanine

L-theanine is an amino acid that occurs in black and green teas. People can also take l-theanine supplements.

A 2016 review reported that l-theanine may increase alpha waves in the brain. Alpha waves may contribute to a relaxed yet alert mental state.

L-theanine may work well when paired with caffeine. Some evidence suggests that this combination helps boost cognitive performance and alertness. Anyone looking to consume l-theanine in tea should keep the FDA’s caffeine guidelines in mind.

There are no dosage guidelines for l-theanine, but many supplements recommend taking 100–400 mg per day.

Omega-3 fatty acids

person at desk holding omega 3 supplements in palm

Studies have shown that omega-3 fatty acids are important to fight against brain aging.

These polyunsaturated fats are found in fatty fish and fish oil supplements. This type of fat is important for brain health, and a person must get it from their diet.

Omega-3s help build membranes around the body’s cells, including the neurons. These fats are important for repairing and renewing brain cells.

A 2015 review found that omega-3 fatty acids protect against brain aging. Other research has concluded that omega-3s are important for brain and nervous system function.

However, a large analysis found “no benefit for cognitive function with omega‐3 [polyunsaturated fatty acids] supplementation among cognitively healthy older people.” The authors recommend further long term studies.

A person can get omega-3 supplements in various forms, including fish oil, krill oil, and algal oil.

These supplements carry a low risk of side effects when a person takes them as directed, but they may interact with medications that affect blood clotting. Ask a doctor before taking them.

Racetams

Racetams are synthetic compounds that can affect neurotransmitters in the brain. Some nootropic racetams include:

  • piracetam
  • pramiracetam
  • phenylpiracetam
  • aniracetam

A study conducted in rats suggests that piracetam may have neuroprotective effects.

One review states that “Some of the studies suggested there may be some benefit from piracetam, but, overall, the evidence is not consistent or positive enough to support its use for dementia or cognitive impairment.” Confirming this will require more research.

There is no set dosage for racetams, so a person should follow instructions and consult a healthcare provider. Overall, studies have no found adverse effects of taking racetams as directed.

Ginkgo biloba

Ginkgo biloba is a tree native to China, Japan, and Korea. Its leaves are available as an herbal supplement.

2016 study found that gingko biloba is “potentially beneficial” for improving brain function, but confirming this will require more research.

Ginkgo biloba may help with dementia symptoms, according to one review, which reported the effects occurring in people who took more than 200 mg per day for at least 5 months.

However, the review’s authors note that more research is needed. Also, with prescription nootropics available, ginkgo biloba may not be the most safe or effective option.

Panax ginseng

Panax ginseng is a perennial shrub that grows in China and parts of Siberia. People use its roots for medicinal purposes.

People should not confuse Panax ginseng with other types of ginseng, such as Siberian or American varieties. These are different plants with different uses.

2018 review reports that Panax ginseng may help prevent certain brain diseases, including Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease. It also may help with brain recovery after a stroke.

Panax ginseng interacts with many medications, so consult a doctor before taking it. A typical dosage for mental function is 100–600 mg once or twice a day.

Rhodiola

Some evidence suggests that Rhodiola rosea L., also known as rhodiola or roseroot, can help with cognitive ability.

One review reported that rhodiola may have neuroprotective effects and may help treat neurodegenerative diseases.

Another review found that rhodiola helped regulate neurotransmitters in the brain, having a positive effect on mood.

Rhodiola capsules have varying strengths. Usually, a person takes a capsule once or twice daily.

Creatine

Creatine is an amino acid, which is a building block of protein. This supplement is popular among athletes because it may help improve exercise performance. It may also have some effects on mental ability.

A 2018 review found that taking creatine appears to help with short term memory and reasoning. Whether it helps the brain in other ways is unclear.

The International Society of Sports Nutrition report that creatine supplementation of up to 30 grams per day is safe for healthy people to take for 5 years.

Another 2018 review notes that there has been limited research into whether this supplement is safe and effective for adolescent athletes.

Do nootropics work?

Some small studies show that some nootropic supplements can affect the brain. But there is a lack of evidence from large, controlled studies to show that some of these supplements consistently work and are completely safe.

Because of the lack of research, experts cannot say with certainty that over-the-counter nootropics improve thinking or brain function — or that everyone can safely use them.

For example, one report on cognitive enhancers found that there is not enough evidence to indicate that they are safe and effective for healthy people. The researchers also point to ethical concerns.

However, there is evidence that omega-3 fatty acids can benefit the brain and overall health. In addition, caffeine can improve mental focus in the short term.

Notes on the safety of nootropics

doctor and patient in office discussing adrenal cancer

A person should talk to a doctor about any interactions supplements may have with existing medications.

Also, some supplements may not contain what their labels say. A study of rhodiola products, for example, found that some contain contaminants or other ingredients not listed on the label.

For this reason, it is important to only purchase supplements from reputable companies that undergo independent testing.

BUYING NOOTROPICSA prescription is necessary for some nootropics, such as Provigil and Adderall. Over-the-counter nootropics are available in some supermarkets and drug stores, or people can choose between brands online:

Not all of these supplements are recommended by healthcare providers and some may interact with medications. Always speak to a doctor before trying a supplement.

Summary

Many doctors agree that the best way to boost brain function is to get adequate sleep, exercise regularly, eat a healthy diet, and manage stress.

For people who want to boost their cognitive function, nootropic supplements may help, in some cases. Anyone interested in trying a nootropic should consult a healthcare professional about the best options.

 

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[BOOK Chapter] Assessment and Rehabilitation Using Virtual Reality after Stroke: A Literature Review – Abstract + References

Abstract

This chapter presents the studies that have used virtual reality as an assessment or rehabilitation tool of cognitive functions following a stroke. To be part of this review, publications must have made a collection of data from individuals who have suffered a stroke and must have been published between 1980 and 2017. A total of 50 publications were selected out of a possible 143 that were identified in the following databases: Academic Search Complete, CINAHL, MEDLINE, PsychINFO, Psychological and Behavioural Sciences Collection. Overall, we find that most of the studies that have used virtual reality with stroke patients focused on attention, spatial neglect, and executive functions/multitasking. Some studies have focused on route representation, episodic memory, and prospective memory. Virtual reality has been used for training of cognitive functions with stroke patients, but also for their assessment. Overall, the studies support the value and relevance of virtual reality as an assessment and rehabilitation tool with people who have suffered a stroke. Virtual reality seems indeed an interesting way to better describe the functioning of the person in everyday life. Virtual reality also sometimes seems to be more sensitive than traditional approaches for detecting deficits in stroke people. However, it is important to pursue work in this emergent field in clinical neuropsychology.

References

  1. Ansuini, C., Pierno, A. C., Lusher, D., & Castiello, U. (2006). Virtual reality applications for the remapping of space in neglect patients. Restorative Neurology and Neuroscience, 24(4–6), 431–441.PubMedGoogle Scholar
  2. Baheux, K., Yoshikawa, M., Tanaka, A., Seki, K., & Handa, Y. (2004). Diagnosis and rehabilitation of patients with hemispatial neglect using virtual reality technology. Conference proceedings: Annual international conference of the IEEE engineering in medicine and biology society, 7, 4908–4911.Google Scholar
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[BLOG POST] 7 Common Behavioral Effects of Brain Injury and How to Deal With Them – Jumbledbrain

A brain injury can have various physical, cognitive, medical, emotional, and behavioral effects on head injury survivors. Of these changes, behavioral changes can be one of the most challenging for survivors to overcome to live happier and more independently. To help survivors with traumatic brain injury (TBI), families and caregivers should learn to understand their behavior and develop practical ways to address those challenges.

Why Does Brain Injury Affect Emotions?

Behavioral problems following TBI are often the result of damage to the frontal lobe, the area of the brain that controls “executive functions.” Executive functions refer to the set of skills a person uses to plan, create, evaluate, organize, evaluate, reason, communicate, and solve problems. These impairments have a significant impact on how a person behaves.

Common Behavioral Changes Experienced by TBI Survivors

Human behavior is complex and multi-faceted. This means it can be difficult to isolate which behavior is a result of TBI. A TBI patient’s behavior is, after all, influenced by many different factors, like the nature of the injury, their pre- and post-injury experience, their cognitive abilities, or the behavior of other people. But some of the most common behavior changes encountered by TBI survivors include:

1. Memory Problems

Most people diagnosed with a brain disorder may experience memory problems, but they are more common among TBI survivors as a result of an injury from the bony protrusions inside the skull. Typical situations include forgetting a person’s name, losing a train of thought, and difficulty learning new things.

2. Temper Outbursts

Family members of people with TBI often describe their loved one as someone with a quick temper. They may use bad language, throw objects, or slam doors. Drastic changes like the loss of independence and inability to follow a conversation, in particular, can make a person with TBI more prone to these temper outbursts.

3. Depression

Depression among people with TBI can arise because of the struggle to adjust to disabilities and the changes to one’s role in the family and society. Symptoms of depression include feelings of worthlessness, suicidal thoughts, changes in sleep and appetite, and withdrawal from peers.

4. Poor Concentration

TBI affects a person’s attention and concentration abilities, posing a challenge to work, study, and everyday living. Poor concentration manifests itself in difficulty multitasking, following conversations, and processing information. This happens when the lateral intraparietal cortex—the region of the brain responsible for controlling attention—suffers damage.

5. Self-Centered Attitude

It’s common for TBI survivors to show signs of egocentrism. In turn, this could hamper their ability to see things from another person’s point of view which severely impact their relationship with family members, especially if they used to be a caring person. And although it is often taken for granted, the ability to understand another’s perspective is a complex cognitive skill.

6. Aggressive Behavior

Aggressive behavior following a TBI is often impulsive. A person with TBI can easily grow agitated over trivial disagreements. Experts explain that aggression that happens directly after the TBI is the result of delirium and other post-injury medications. Aggression up to three months after TBI, on the other hand, happens as a result of depression, chronic pain, and post-traumatic stress disorder.

7. Lower Sex Drive

A decreased desire or interest in sex is more common among TBI survivors than heightened libido. Disinhibited sexual behavior can be a possible effect of poor awareness and impulsivity. Changes in sexual functioning following TBI can be due to hormonal changes, medication side effects, fatigue, and movement problems.

Coping with a Loved One with Head Injury

People with TBI showing signs of these behavior problems should be evaluated by a doctor so they can receive proper treatment. On top of medical intervention, friends and family of survivors should also actively participate in rehabilitation, recovery, and advocacy.

1. Set Realistic Expectations

Brain injury has lifelong effects. It pays to understand that a person with TBI might already be trying his or her best. Every member of the family can have different abilities, skills, comfort levels, and limitations, so set small goals and acknowledge that every day is an achievement.

2. Get Involved

Behavioral problems are often hard to deal with. But try to resist the temptation of avoiding difficult situations. People with TBI could end up feeling more confused and isolated if left alone. Instead, get involved and familiarize yourself with their day-to-day routine.

3. Encourage Independence

Learning how to comfort a loved one with TBI is a must. But tread carefully: there is a fine line between caring for people and smothering them with affection. Try to instill independence and study their behavior to know the right time to provide comfort.

4. Reinforce Positive Behavior

What used to come easy to a TBI survivor may now feel extremely difficult. Reinforce positive behavior by focusing on the patient’s strengths, rather than pointing fingers or directing behavior.

5. Rediscover Preferences

Stay alert and pay attention to the wants and needs of a person with TBI. Discover new ways they can engage in activities and establish a balance between easy and difficult tasks. And always encourage them to participate, instead of assuming that their injury makes them unable to.

6. Confide with Loved Ones

Honesty is the best policy, and confiding in friends and family members can help alleviate the burden. Enlisting others for support can provide a fresh perspective and make it easier to identify triggers and how to avoid them.

7. Bounce Back Quickly

Accept that encountering behavioral problems is a part of life. Avoid getting stuck by teaching

new skills while a person is upset. Bounce back quickly from these obstacles then revisit them again later since people aren’t receptive to learning new things when they’re upset.

Other articles you may like:

Have you or a brain injury survivor you know struggled with these behavioural issues? What advice would you give to others?


Today’s article is written by Hazel Ann Westco.

Hazel Ann Westco is a start-up freelance writer. She is interested in writing blogs and articles related to legal cases mainly in personal injury and employment.  Whenever she has free time she rides her bicycle or motorcycle for a road trip. You can follow her on Twitter using her handle @AnnWestco.

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[ARTICLE] Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial – Full Text HTML

Abstract

Objectives: Memory deficits are common after stroke, yet remain a high unmet need within the community. The aim of this phase II randomized controlled trial was to determine whether group compensatory or computerized cognitive training approaches were effective in rehabilitating memory following stroke.

Methods: A parallel, 3-group, single-blind, randomized controlled trial was used to compare the effectiveness of a compensatory memory skills group with restorative computerized training on functional goal attainment. Secondary outcomes explored change in neuropsychological measures of memory, subjective ratings of prospective and everyday memory failures and ratings of internal and external strategy use.

Results: A total of 65 community dwelling survivors of stroke were randomized (24: memory group, 22: computerized cognitive training, and 19: wait-list control). Participants allocated to the memory group reported significantly greater attainment of memory goals and internal strategy use at 6-week follow-up relative to participants in computerized training and wait-list control conditions. However, groups did not differ significantly on any subjective or objective secondary outcomes.

Conclusion: Preliminary evidence shows that memory skills groups, but not computerized training, may facilitate achievement of functional memory goals for community dwelling survivors of stroke. These findings require further replication, given the modest sample size, subjective nature of the outcomes and the absence of objective eligibility for inclusion.

 

Lay Abstract

Memory problems are commonly reported following stroke but receiving help for these difficulties remains a high unmet need among survivors. Two different approaches to memory rehabilitation are available: memory skills group training and computerised cognitive training; however, it is unclear which approach is more effective. This study compared these two approaches in 65 stroke survivors who all reported memory difficulties. We found that participants who received memory group training were more likely to achieve their memory improvement goals than those who received computerised cognitive training. It was concluded that memory skills group training may be a more effective approach to improve memory function in daily life following stroke, but more research is required.

 

Introduction

Memory impairment is one of the most commonly reported cognitive consequences of stroke (1) and can compromise rehabilitation engagement (2). Despite this, support for memory problems remains a high unmet need within the community (3) and has been identified by patients, researchers and clinicians as a high-priority research area (4).

Memory skills group (MSG) training and computerized cognitive training (CCT) are commonly used approaches to rehabilitate memory. Although both share the fundamental goal of improving everyday memory outcomes (5), there are a number of key differences between these interventions. CCT adopts a restorative approach to rehabilitation, with the theoretical goal of restoring underlying impairment through cognitive exercises (6). Repetitive drill and practice style activities are purported to result in everyday functional gains, although there remains no robust evidence of this transfer (6). By contrast, MSG interventions take a compensatory approach to rehabilitation with a theoretical aim of lessening the disabling impact of impairment (7). In addition, the format of delivery differs. CCT training tasks are generally completed individually, with associated well-recognized advantages of low cost, wide availability and potential for at personalized use at home (8). MSG intervention is facilitated by a trained clinician and is delivered face-to-face in a group format, due, in part, to increased recognition of the multifaceted nature of memory dysfunction and limited economic resources (9).

While a number of comprehensive reviews have explored best-practice recommendations for cognitive impairment following acquired brain injury (10, 11), only a minority of studies included in these reviews were conducted in stroke-only samples. Consequently, the long-held view that MSG training is the treatment of choice in rehabilitating memory has been largely speculative post-stroke and appears to have been based on an absence of evidence, rather than evidence of absence for the effectiveness of CCT (5). The aim of this study was to compare the effectiveness of CCT and MSG training in community dwelling survivors of stroke in achieving individualized, functional memory goals. A further aim was to explore the effect of training on secondary measures of objective, neuropsychological memory tasks and subjective memory ratings. In addressing these aims, we intended to maintain ecological validity by evaluating the interventions as they are clinically implemented (rather than transforming them to be experimentally matched with each other on characteristics such as group vs individual format), with the goal of facilitating clinical translation. We hypothesized that intervention participants (i.e. CCT and MSG) would show greater improvement in performance on outcome measures than waitlist control participants (WC). Given the proposed mechanism of action of each approach, we also hypothesized participants in the CCT group would show greater improvement on neuropsychological tests of memory, while participants in the MSG would show greater improvement on functional measures of memory and strategy use.[…]

 

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[WEB SITE] The Benefits of Playing Music Help Your Brain More Than Any Other Activity

Learning an instrument has showed an increase resilience to any age-related decline in hearing.

The brain-training is big business. For companies like BrainHQ, Luminosity, and Cogmed, it’s actually a multimillion dollar business that is expected to surpass $3 billion by 2020. But, do the actually benefit your brain?

 

Research doesn’t believe so. In fact, the the University of Illinois determined that there’s little or no evidence that these games improve anything more than the specific tasks being trained. Luminosity was even fined $2 million for false claims.

So, if these brain games don’t work, then what will keep your brain sharp? The answer? Learning to play a musical instrument.

Why Being a Musician Is Good For Your Brain

Science has shown that musical training can change brain structure and function for the better. It can also improve long-term memory and lead to better brain development for those who start at a young age.

Furthermore, musicians tend to be more mentally alert, according to new research from a University of Montreal study.

 

“The more we know about the impact of music on really basic sensory processes, the more we can apply musical training to individuals who might have slower reaction times,” said lead researcher Simon Landry.

 

“As people get older, for example, we know their reaction times get slower. So if we know that playing a musical instrument increases reaction times, then maybe playing an instrument will be helpful for them.”

 

Previously, Landry found that musicians have faster auditory, tactile, and audio-tactile reaction times. Musicians also have an altered statistical use of multi-sensory information. This means that they’re better at integrating the inputs from various senses.

 

“Music probably does something unique,” explains neuropsychologist Catherine Loveday of the University of Westminster. “It stimulates the brain in a very powerful way, because of our emotional connection with it.”

 

Unlike brain-games, playing an instrument is a rich and complex experience. This is because it’s integrating information from senses like vision, hearing, and touch, along with fine movements. This can result long-lasting changes in the brain. This can also be applicable in the business world.

Changes in the Brain

Brains scans have been able to identify the difference in brain structure between musicians and non-musicians. Most notably, the corpus callosum, a massive bundle of nerve fibres connecting the two sides of the brain, is larger in musicians. Also, the areas involving movement, hearing, and visuospatial abilities appear to be larger in professional keyboard players.

 

Initially, these studies couldn’t determine if these differences were caused by musical training of if anatomical differences predispose some to become musicians. Ultimately, longitudinal studies showed that children who do 14 months of musical training displayed more powerful structural and functional brain changes.

 

These studies prove that learning a musical instrument increases grey matter volume in various brain regions, It also strengthens the long-range connections between them. Additional research shows that musical training can enhance verbal memory, spatial reasoning, and literacy skills.

Long Lasting Benefits For Musicians

Brain scanning studies have found that the anatomical change in musicians’ brains is related to the age when training began. It shouldn’t be surprising, but learning at a younger age causes the most drastic changes.

 

Interestingly, even brief periods of musical training can have long-lasting benefits. A 2013 study found that even those with moderate musical training preserved sharp processing of speech sounds. It was also able to increase resilience to any age-related decline in hearing.

 

Researchers also believe that playing music helps speech processing and learning in children with dyslexia. Furthermore, learning to play an instrument as a child can protect the brain against dementia.

“Music reaches parts of the brain that other things can’t,” says Loveday. “It’s a strong cognitive stimulus that grows the brain in a way that nothing else does, and the evidence that musical training enhances things like working memory and language is very robust.”

Other Ways Learning an Instrument Strengthens Your Brain

Guess what? We’re still not done. Here are eight additional ways that learning an instrument strengthens your brain.

 

1. Strengthens bonds with others. This shouldn’t be surprising. Think about your favorite band. They can only make a record when they have contact, coordination, and cooperation with each other.

 

2. Strengthens memory and reading skills. The Auditory Neuroscience Laboratory at Northwestern University states that this is because music and reading are related via common neural and cognitive mechanisms.

 

3. Playing music makes you happy. McMaster University discovered that babies who took interactive music classes displayed better early communication skills. They also smiled more.

 

4. Musicians can process multiple things at once. As mentioned above, this is because playing music forces you to process multiple senses at once. This can lead superior multisensory skills.

 

5. Musical increases blood flow in your brain. Studies have found that short bursts of musical training increase the blood flow to the left hemisphere of the brain. That can be helpful when you need a burst of energy. Skip the energy drink and jam for 30 minutes.

6. Music helps the brain recover. Motor control improved in everyday activities with stroke patients.

7. Music reduces stress and depression. A study of cancer patients found that listening and playing music reduced anxiety. Another study revealed that music therapy lowered levels of depression and anxiety.

 

8. Musical training strengthens the brain’s’ executive function. Executive function covers critical tasks like processing and retaining information, controlling behavior, making, and problem-solving. If strengthened, you can boost your ability to live. Musical training can improve and strengthen executive functioning in both children and adults.

 

And, wrap-up, check out this awesome short animation from TED-Ed on how playing an instrument benefits your brain.

 

via The Benefits of Playing Music Help Your Brain More Than Any Other Activity | Inc.com

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[BLOG POST] 7 principles of neuroscience every coach and therapist should know – Your Brain Health

What does neuroscience have to do with coaching and therapy?

Short answer: EVERYTHING!

If you’re a coach or therapist, your job is to facilitate change in your client’s

  • thinking (beliefs and attitudes)
  • emotions (more mindfulness and resilience)
  • behaviour (new healthy habits).

Coaching builds the mental skills needed to support lasting change. Skills such as:

  • mindfulness
  • self-awareness
  • motivation
  • resilience
  • optimism
  • critical thinking
  • stress management

Health and wellness coaching, in particular, are emerging as powerful interventions to help people initiate and maintain sustainable change.

And we have academic research to support this claim: check out a list of RCTs in table 2 of this paper).

How can neuroscience more deeply inform coaching and therapy?

Back in the mid-1990s when I was an undergrad, the core text of my neuroscience curriculum was ‘Principles of Neural Science’ by Eric Kandel, James Schwartz and Thomas Jessell. Kandel won the 2000 Nobel Prize in Physiology or Medicine for his research on memory storage in neurons.

A few years before his Nobel, Kandel wrote a paper A new intellectual framework for psychiatry’. The paper explained how neuroscience can provide a new view of mental health and wellbeing.

Based on Kandel’s paper, researchers at the Yale School of Medicine proposed seven principles of brain-based therapy for psychiatrists, psychologists and therapists. The principles have been translated intopractical applications for health & wellness, business, and life coaches. 

One fundamental principle is,

“All mental processes, even the most complex psychological processes, derive from the operation of the brain.”

And another is:

“Insofar as psychotherapy or counseling is effective . . . it presumably does so through learning, by producing changes in gene expression that alter the strength of synaptic connections.”

That is, human interactions and experience influence how the brain works.

This concept of brain change is now well established in neuroscience and is often referred to as neuroplasticity. Ample neuroscience research supports the idea that our brains remain adaptable (or plastic) throughout our lifespan.

Here is a summary of Kandel, Cappas and colleagues thoughts on how neuroscience can be applied to therapy and coaching…

Seven principles of neuroscience every coach should know.

1. Both nature and nurture win.

Both genetics and the environment interact in the brain to shape our brains and influence behaviour.

Therapy or coaching can be thought of as a strategic and purposeful ‘environmental tool’ to facilitate change and may be an effective means of shaping neural pathways.

2.  Experiences transform the brain.

The areas of our brain associated with emotions and memories such as the pre-frontal cortex, the amygdala, and the hippocampus are not hard-wired (they are ‘plastic’).

Research suggests each of us constructs emotions from a diversity of sources: our physiological state, by our reactions to the ‘outside’ environment, experiences and learning, and our culture and upbringing.

3.  Memories are imperfect.

Our memories are never a perfect account of what happened. Memories are re-written each time when we recall them depending on how, when and where we retrieve the memory.

For example, a question, photograph or a particular scent can interact with a memory resulting in it being modified as it is recalled.

With increasing life experience we weave narratives into their memories.  Autobiographical memories that tell the story of our lives are always undergoing revision precisely because our sense of self is too.

Consciously or not, we use imagination to reinvent our past, and with it, our present and future.

4. Emotion underlies memory formation.

Memories and emotions are interconnected neural processes.

The amygdala, which plays a role in emotional arousal, mediate neurotransmitters essential for memory consolidation. Emotional arousal has the capacity to activate the amygdala, which in turn modulates the storage of memory.

 

5. Relationships are the foundation for change 

Relationships in childhood AND adulthood have the power to elicit positive change.

Sometimes it takes the love, care or attention of just one person to help another change for the better.

The therapeutic relationship has the capacity to help clients modify neural systems and enhance emotional regulation.

6. Imagining and doing are the same to the brain.

Mental imagery or visualisation not only activates the same brain regions as the actual behaviour but also can speed up the learning of a new skill.

Envisioning a different life may as successfully invoke change as the actual experience.

7. We don’t always know what our brain is ‘thinking’.

Unconscious processes exert great influence on our thoughts, feelings, and actions.

The brain can process nonverbal and unconscious information, and information processed unconsciously can still influence therapeutic and other relationships. It’s possible to react to unconscious perceptions without consciously understanding the reaction.

 

via 7 principles of neuroscience every coach and therapist should know – Your Brain Health

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