A recent systemic review of the literature, just published in the Journal of Athletic Training, 2024; 59(1): 49-64, concludes that “vestibular and oculomotor screening are prognostic of time to recovery” from concussion.
Positive findings on these assessments “consistently predict longer recovery.” The authors therefore recommend that vestibular and ocular motor screening be part of the standard of care for assessment of concussion patients. Read the full study.Read More
A large TRACK-TBI cohort study published in JAMA Network Open finds incomplete recovery at 5 years in 53% of mild traumatic brain injury (mTBI) patients, dictating need for longer term rehabilitation.
A multi-center transforming research and clinical knowledge in TBI (TRACK-TBI) cohort study published March 20, 2023 in JAMA Network Open followed 1196 patients at 18 level 1.0 trauma care centers in the US over five years, including patient with mTBI, patients with moderate-severe brain injury (msTBI) and orthopedic controls. It found persistently elevated rates of incomplete functional outcomes in 53% of mild traumatic brain injury patients and 83% of msTBI patients compared to controls, supporting a need for longer term monitoring and rehabilitation.
As highlighted in prior posts in this blog, TBI research increasingly highlights the importance of providing follow-up care to patients discharged from the ER with a diagnosis of TBI. Put simply, patients with follow up care have better outcomes.
One of the most frequent questions I get from TBI clients in my Vermont law practice is: “Are there alternative therapies I can explore to help support my recovery from a traumatic brain injury without risking further harm?” Physicians practicing “integrative oncology” offer a multi-disciplinary approach to patient care for cancer that implements complementary therapies in collaboration with conventional treatment. Although TBI medicine is not as well organized, the peer reviewed TBI literature does support similar evidence-based complementary therapies for the treatment of TBI. Several have been featured in prior posts in this blog, including yoga and other mindfulness based therapies, exercise therapies, dietary therapies (especially foods rich in ‘polyphenols” found in many fruits and vegetables) and promising supplements including melatonin and curcumin (found in tumeric, curcumin reduces the levels of two enzymes in the body that cause inflammation.)
Another supplement receiving increasing attention in the literature is resveratrol, a “phytoalexin” produced by plants such as the red grape in response to various stresses, which promotes disease resistance. Read More
Victims of mild traumatic brain injury (“mTBI”) commonly report psychological distress, which is not surprising given the impact the injury can have on every aspect of everyday life including but not limited to balance, vision, sleeping, physical discomfort including headaches, and perhaps most significantly thinking clearly. Patients often report that they are not the same person and fear that person will never return.
Among the chronic symptoms seen in these children were forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems. Sadly, many of these children had been misdiagnosed as suffering from unrelated ADHD, sleep disorders, depression, etc. This misdiagnosis, the researchers noted, leads to treatment that is not suited to the problem, thus causing the children prolonged suffering. Read More
A new study published February 16, 2022 by the American Academy of Neurology in the Journal “Neurology” finds that the frequency of clinically meaningful poor cognitive outcomes one year after a concussion are more common than previously thought. The results, says study author Raquel Gardner, MD, of the University of California San Francisco, “highlight the need to better understand the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery.” Read More
So called “mild” traumatic brain injury (“mTBI”) can have long-term, disabling consequences (in both civilian and military populations);
that this injury is heterogeneous in both presentation and clinical outcome (in other words, every injury is different); and
that interventions targeted to the individual presentation of the injury (whether it is predominantly vestibular, cognitive, oculomotor, headache, sleep or mood related, or some combination) can reduce symptoms in otherwise intractable patients.
The message is that ignoring the symptoms and hoping that they will ultimately disappear – the approach often taken in the past – is not wise for either the individual or for society as a whole. Read More
For those not familiar with the term, a “meta-analysis” is a quantitative, formal, epidemiological study design used to systematically assess the results of previous research to derive conclusions about that body of research. Dr. Rebecca Acabchuk and her team at UConn’s Institute for Collaboration on Health, Intervention and Policy (InCHIP) have just published the first ever systematic review and meta-analysis on the “Therapeutic Effects of Meditation, Yoga and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury,” in Applied Psychology: Health and Well-Being, the journal of the International Association of Applied Psychology.