Traumatic Brain Injury Blog

August 2, 2018

Pituitary Dysfunction Following TBI: Update on the Importance of Stimulation Testing

In our May, 2014 post, we reported on research showing that traumatic brain injury, including mild traumatic brain injury (mTBI), can damage and cause dysfunction in the pituitary gland resulting in deficiencies in key hormones released by the pituitary gland, such as Growth Hormone (GH). As we explained in that post, the anatomy of the pituitary gland makes it particularly susceptible to the sheering injuries seen in TBI. The pituitary gland, which is housed in a bony structure at the base of the skull, controls the function of most other endocrine glands and is therefore sometimes called the “master gland.” Read More

May 31, 2018

Cognitive Training Reduces Depression and Changes Brain Structure in Individuals with Chronic TBI Symptoms

Research scientists at the Center for Brain Health at the University of Texas at Dallas have just published a study, funded by the US Department of Defense, supporting the effectiveness of “strategy-based” cognitive training at reducing symptoms of depression commonly found in patients with chronic (greater than 6 months) traumatic brain injury (TBI) symptoms.

The training was an integrative program designed to improve cognitive control by exerting more efficient thinking strategies for selective attention and abstract reasoning. The training did not directly target psychiatric symptoms such as depression, but was nonetheless effective at reducing those symptoms. Read More

May 16, 2018

Large Study Finds Increased Risk of Dementia Diagnosis in Veterans with Mild Traumatic Brain Injury

In a propensity-matched cohort study of more than 350,000 veterans with and without traumatic brain injuries (TBI), mild traumatic brain injury (mTBI) without loss of consciousness was associated with more than a twofold increase in the risk of a dementia diagnosis, even after adjusting for medical and psychiatric co-morbidities. This large epidemiological study was recently published in JAMA Neurology.  Approximately 2.8 million TBIs occur each year in the United States; approximately 80% are in the “mild” category.

Although prior studies of the association between mTBI and dementia have been mixed, this study, among the largest epidemiological studies to date, adds to the weight of evidence suggesting that even mild TBI is associated with an increased dementia diagnosis risk. Read More

May 2, 2018

Differences in Axonal Structure Likely Contributing to Increased Vulnerability of Women to Concussions

Although males represent a majority of emergency department visits for sports and recreation-related concussion, researchers have recently found that female athletes have a higher rate of concussion and appear to have worse outcomes than their male counterparts participating in the same sport. University of Pennsylvania researchers have recently identified anatomical differences between male and female axons that may explain this increased vulnerability. Read More

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