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
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
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. These hormone deficiencies can produce many of the persistent symptoms seen following a TBI, such as fatigue, poor memory, depression, anxiety, emotional lability, exercise intolerance, lack of concentration and attention difficulties. (Although not always the case, these deficiencies can also produce physical symptoms, such as increased fat mass – especially in the abdominal area – and increased cholesterol.) We also noted findings showing that pituitary dysfunction can worsen over the five year period following an injury – in other words, that this is an issue that deserves to be monitored on an ongoing basis. Read More
Neuroinflammation as a likely cause of persistent symptoms following traumatic brain injury (TBI), as well as increased risk of neurodegenerative complications, is leading to increased attention on anti-inflammatory strategies with diet, exercise, lifestyle and medication
Our May 28, 2015 blog post discussed the evidence offered by McMasters University researchers in support of their conclusion that the body’s immune response following injury can lead to unchecked, ultimately destructive neuroinflammation and that this likely underlies persistent symptoms following TBI as well as increased risk of neurodegenerative conditions such as chronic traumatic encephalopathy (CTE) and Alzheimers. The authors observed similar neuroinflammatory processes in patients without a history of head injury, such as patients with serious infections, PTSD and Depression. They also noted that subtle genetic differences may explain differences in inflammatory responses between patients, leading to different long term outcomes. The October 2015 issue of Trends in Neuroscience includes a review by Ohio State neuroscientists with further support for this new paradigm for understanding the brain’s response to injury. See “Priming the Inflammatory Pump of the CNS after Traumatic Brain Injury.” Read More
The Radiology Society of North America has published a new study that identifies particular white matter brain injury patterns in patients with persistent depression and anxiety following mild traumatic brain injury (concussion or mTBI.) Read More
In a study published in April 2015 in the medical journal Brain Behavior and Immunity, a team of Canadian researchers at McMaster University presents a new understanding of the cause of the wide-array of symptoms experienced by some patients following concussion, such as headaches, dizziness, sleep disturbance, fatigue, cognitive impairment and neuropsychiatric symptoms.
This new paradigm helps to explain why the same pattern of symptoms can be found in some non-head injury patients, such a patient who has experienced infections or a patient diagnosed with post-traumatic stress disorder. It also helps to explain why some patients recover and others do not and why pre-accident experience can influence the course of post-accident recovery. Read More
Recent research has shown that traumatic brain injury, (TBI) including mild traumatic brain injury (mTBI), can damage and cause dysfunction in the pituitary gland, a pea-sized gland located in the center of the skull that releases several essential hormones affecting such functions as growth and metabolism (part of the neuroendocrine system). Researchers have found that a surprisingly high percentage of patients with persistent symptoms following a TBI show evidence of neuroendocrine dysfunction.
It turns out that the anatomy of this gland makes it particularly susceptible to the sheering injuries seen in TBI. The most common dysfunction found after TBI is deficiency in the Growth Hormone (GH), one of the key hormones released by the pituitary gland. The symptoms of GH deficiency overlap with many persistent TBI symptoms including fatigue, poor memory, depression, emotional lability, lack of concentration and attention difficulties. Read More
I travel between two worlds that may appear far apart – by day I am a trial lawyer with a focus on traumatic brain injury; nights and weekends I am a yoga teacher. I increasingly find that these worlds are very close together.
As a brain injury lawyer I work with people struggling to recover from the loss of sense of self so often caused by brain injury as well as associated depression and chronic pain. Many of my clients have reported meaningful increases in the quality of their lives following injury through “mindfulness” practices such as yoga and meditation. Practices such as yoga are designed to increase awareness of the present moment, to increase awareness of our thoughts, emotions and physical sensations without filtering them through past experience or fears of the future – to recapture our sense of ourselves. Read More
The American Academy of Sleep Medicine has announced the results of a recent study showing that bright light therapy following Mild TBI (concussion) may improve sleep, cognitive and brain function. The study results were presented at the June 3, 2013 meeting of the Associated Professional Sleep Societies LLC and published in an online supplement to the journal Sleep. Read More