In recent years a great deal of research has been done to identify an objective “biomarker” of concussion. As reported in this blog, some promise has been found in blood biomarkers (measuring plasma tau protein levels) and neuroimaging, such as the DTI MRI sequence. Unfortunately, these approaches are invasive and/or expensive and are not always a reliable indicator of concussion and concussion recovery. As reported in our November 27, 2016 blog post, until now, one of the most promising concussion screening tools was a series of vision tests endorsed by the Department of Defense.
Scientists at Northwestern University have now found a related, and what appears to be an even more precise and accurate tool, a measure of the brain’s electrophysiological response to sound. 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
Several recent developments demonstrate increasing recognition of the serious potential consequences of concussion, and commitment to minimize those consequences through appropriate treatment of concussion:
Physicians have an ethical obligation to become knowledgeable about concussion.
On June 9, 2014 the American Academy of Neurology, the largest professional association of neurologists, released a position paper stating that doctors have an ethical obligationto educate and protect athletes from sports concussion and clear them to play only when the athlete is medically ready, standing firm against objections from players, athletes and coaches. The statement declares that sports concussion “is a major issue in the world of health care” and requires more attention from physicians. 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
On January 23, 2014 the Defense and Veterans Brain Injury Center released new clinical recommendations with a standardized approach for concussion recovery. Included in the recommendations for managing concussion symptoms is a first of its kind five-stage approach for return to activity following a concussion. Detailed “do”s and “do not”s are specified for each stage. Movement from stage to stage is determined by scores on a simple twenty-two item “neurobehavioral symptom inventory” included in the recommendations. Read More
On June 4, 2013, Vermont’s Governor Peter Shumlin signed a bill that imposes greater requirements on schools to protect student athletes from the potentially serious consequences of concussions in sports, especially from multiple concussions.
Under prior law, coaches were required to keep athletes who they had “reason to believe” had sustained a concussion out of play until cleared to return by a qualified health professional. The new law imposes a similar requirement on a coach or health care provider who “knows or should know” that the athlete has sustained a concussion. Read More
The topic of sexual dysfunction after a traumatic brain injury shouldn’t be taboo. Millions of people in the United States live with the physical, cognitive and emotional consequences traumatic brain injury (TBI). Sexuality is often impacted, but not often discussed or addressed. Failure to address this issue can compound the adverse effect of TBI symptoms on important relationships and self-esteem. NeuroRehabilitation: An International Journal recently published a critical review of fourteen studies on this topic. Read More
The human brain is complex. Every brain injury is unique. But nearly every person who suffers a brain injury experiences that frightening feeling of “I am not myself anymore.” In mild traumatic brain injury (MTBI) cases, specifically, this feeling may recede over a period of weeks or months. But for others, it does not.
Whether the symptoms are permanent, improve, or get worse, the reasons for these differences are constantly researched—looking for ways to explain, prevent, and/or heal traumatic brain injuries. Several new studies on mild brain injury are examining factors ranging from genetic differences to differences in emotional make-up in order to understand why these differences exist. New research is leading to new approaches in treatment and rehabilitation, as well as prevention.
The “BRAIN” initiative, which stands for Brain Research through Advancing Innovative Neurotechnologies, is already underway at the National Institute of Health (NIH). And, on April 2, 2013 President Obama announced that his 2014 budget will include $110 million in funding to advance the initiative, which supports human brain research that could be used to treat a range of neurological conditions, including traumatic brain injury (TBI).
I expect the additional funds to elevate the project’s urgency, as it would be a joint effort of the National Institutes of Health, the Defense Advanced Research Projects Agency (DARPA) and the National Science Foundation along with other private and public entities. If this initiative goes forward, it also promises to augment work already underway at other research centers throughout the country.