Traumatic Brain Injury Blog

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April 18, 2018

Depression following Concussion is Highly Prevalent and Needs to Be Monitored and Treated

A new study published in the Journal of Neurotrauma highlights the importance of monitoring TBI patients for the presence of depression symptoms and providing clinical support to prevent minor depression from converting into major depression.

Canadian researchers assessed 236 individuals diagnosed with traumatic brain injury at 4, 8 and 12 months following injury. The results confirm prior studies showing that depression in very prevalent following TBI. Read More

March 7, 2018

Concussions Can Impair Emotional Processing During Sleep Contributing to Chronic Mood Disturbance

As discussed in prior posts on this blog, sleep alterations are commonly found after a concussion or other traumatic brain injury, both short term and in some cases long term. One of the most well documented impacts of concussion, also discussed in prior posts, is an increased risk of mood disturbances, including depression, increased anxiety and increased risk of suicide. In recent years researchers have turned to sleep studies to explore the connection between these symptoms.

There is substantial evidence in the literature of the role healthy sleep plays in the “consolidation” of emotional memories. At first blush, this research is counter-intuitive. If sleep “consolidates” emotional memories, doesn’t this have the potential to increase rather than decrease mood disturbance? The answer appears to be that, although sleep preserves memory of events associated with emotional experience, at the same time it weakens the emotional “charge” coating the experience (referred to in the literature as “valence”) in a process called “habituation.” As one researcher hypothesized, “we sleep to forget the emotional tone, yet sleep to remember the tagged information.” Read More

January 23, 2018

TBI can trigger Pathology in the Gut-Brain Axis and Increase Infections

Several of my traumatic brain injury (TBI) clients have been treated for gut issues – issues that were not present prior to their TBI. Insurers, of course, insist that this treatment cannot be related to the brain injury. The scientific literature indicates otherwise. Researchers at the University of Maryland School of Medicine recently found a two-way link between TBI and intestinal changes.

The findings indicate that this two way interaction may contribute to increased infections in TBI patients and may also worsen chronic brain damage. Read More

January 10, 2018

Combining Ritalin and Cognitive Behavioral Rehabilitation Shows Promise Following TBI

A treatment protocol combining Ritalin, a stimulant commonly used for ADHD, and a form of Cognitive Behavioral Rehabilitation known as “Memory and Attention Adaptation Training” (MAAT) shows great promise for improving persistent traumatic brain injury (TBI) symptoms, including attention, episodic and working memory and executive function. The research supporting this finding, led by Thomas McAllister and Brenna McDonald at the Indiana School of Medicine, was published in 2017 in the journal of the American College of NeuropsychopharmacologyRead More

January 2, 2018

Exercise as Key Component of Treatment for “Chemobrain”

Although the primary focus of this blog is on “traumatic” brain injury, the literature increasingly demonstrates that the physiological causes of cognitive impairment overlap between a range of conditions having neurodegenerative consequences, including TBI, PTSD, Alzheimer’s disease and “Chemobrain”. (Chronic inflammation appears to be one of the common variables, as discussed in prior posts.) Read More

November 6, 2017

The Challenges of Concussion Diagnosis, Prognosis and Treatment: The Most Complicated Disease of the Most Complex Organ of the Body

A review published in the September 2017 issue of Frontiers in Neurology proposes use of “systems science” to better understand concussion diagnosis and prognosis.  This is a discipline that analyzes complex problems as whole systems and integrates research findings from different disciplines. In explaining the need for a systems approach, the reviewers note one description of concussion that is uniformly recognized – that it is a highly heterogeneous phenomenon, with numerous factors interacting dynamically to influence an individual’s recovery trajectory. (This concept is highlighted in the title of one of the Concussion WebCasts made available by the American Association of Family Physicians : “If you have seen one concussion, you have seen one concussion.”) Read More

August 17, 2017

Concussion Can Cause Abnormalities in Organ Systems Through Autonomic Nervous System Dysfunction

The open source journal Brain Science has just published a survey of literature demonstrating that a mild traumatic brain injury (mTBI) , otherwise known as concussion, is a complex pathophysiological process that can have a systemic effect on the body aside from solely impairing cognitive function. According to the article, “dysfunction in the autonomic nervous system (ANS) has been found to be a major factor in the symptomatology in TBI, including in mTBI” and can “induce abnormalities in organ systems throughout the body.” Read More

July 31, 2017

New Information on Photophobia following TBI

One of the most common symptoms following TBI is photophobia, an intense intolerance to light that can cause significant discomfort, interfere with activities of daily living, and contribute to post traumatic headaches. It can impact the ability to work at computer screens and in well-lit offices and can cause a great deal of fatigue for patients who try to return to usual activities. Avoiding light can be very limiting. Read More

June 8, 2017

New Study Highlights Importance of Vision Testing following Concussion (mTBI)

The May 16, 2017 issue of The American Journal of Sports Medicine highlights the significance of subtle changes in vision following concussion in predicting more prolonged recovery.   The study found that a diagnosis of  “convergence insufficiency” increased the odds of prolonged recovery by 12.3 fold. Read More

February 6, 2017

New Studies Identify Imaging Findings Associated with Persistent Post-Concussion Syndrome

A topic frequently addressed in this blog is the building body of evidence showing that the minority of patients who have long term, sometimes permanent, symptoms following concussion typically experience those symptoms because of injury to the brain, not to achieve some “secondary gain.” Although scientists do not have a clear understanding about why some people are more vulnerable to these injuries, we know as discussed in prior posts, that certain factors can play a role, such as genetics, prior head injuries and a history of migraines. Two recently published studies contribute to our understanding that real pathology likely underlies most persistent symptoms and that this pathology can be identified with advanced neuroimaging techniques. Read More