Traumatic Brain Injury Blog

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September 12, 2022

Resveratrol: Another Promising Research Based Alternative Therapy To Supplement TBI Treatment

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

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July 7, 2022

Early Mental Health Intervention Improves TBI Outcomes

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.

We often recommend counseling support, but this has been based more on instinct and anecdotal information than on data. In prior posts we have reported on studies showing that depression is a common sequelae of mTBI that should be treated before it becomes disabling.  Read More

April 20, 2022

One in Four Children with Mild Traumatic Brain Injury Suffer from Post-Concussive Symptoms

Israeli study finds that one in four children with mild traumatic brain injury (mTBI) suffer from persistent post-concussive symptoms

In a large multi-center retrospective matched cohort study, Israeli scientists recently found that one in four children (25.3%) who have been discharged from the emergency room after a mild head injury suffered from persistent post- concussive symptoms.

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

March 1, 2022

Study published by the American Academy of Neurology Finds that Poor Cognitive Outcomes Following Concussion are more Common than Previously Thought

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

June 29, 2021

Defense Department Study Finds that Targeted Treatment Improves Chronic Symptoms Following Mild Traumatic Brain Injury

A recent Defense Department/University of Pittsburgh study confirms three important points made in prior posts:

  1. So called “mild” traumatic brain injury (“mTBI”) can have long-term, disabling consequences (in both civilian and military populations);
  2. that this injury is heterogeneous in both presentation and clinical outcome (in other words, every injury is different); and
  3. 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

February 4, 2021

Psychotherapy for PTSD offers a potential “biosignature” for effective treatment

Functional MRI studies suggest that psychotherapy for PTSD improves symptoms by changing the way brain networks communicate with each other, offering a potential “biosignature” for effective treatment

In prior blog posts we have reviewed literature demonstrating that TBI and PTSD may not be separable but may, in fact, be intimately related not just at the level of symptoms and etiology, but also as the level of pathophysiology. Both can impact the interactions between the body’s immune, endocrine and neuromodulatory neurotransmitter systems. Read More

December 15, 2020

First Ever Meta-Analysis Supports the Effectiveness of Mindfulness-Based Interventions for Chronic Concussion Symptoms

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.

This topic was first introduced in this blog in 2014  and touched on more recently in our review of a Dartmouth study documenting the effectiveness of the “Love your Brain” Yoga program started by Vermont’s snowboarding celebrity Kevin Peace (who was recently featured as the key-note speaker at the annual Vermont Brain Association conference.) Read More

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September 17, 2020

Damage to the Brain’s Lymphatic System May Explain Why Some Patients Suffer More Serious Consequences from TBI

Studies over the last several years have shown that the lymphatic system serving the brain, located in the membranes covering the brain (the “meninges”) plays an important role in brain injury recovery.

As most people know, the lymphatic system helps to rid the body of toxins and waste, including the byproducts of the body’s immune response to injury. For brain injury this is sometimes described as “damage/danger-associated molecular patterns” – “DAMPs” – such as protein aggregates, necrotic cells, and cellular debris.

Researchers at the University of Virginia, at the Center for Brain Immunology and Glia, have released an important study furthering our understanding of the role meningeal lymphatic dysfunction plays in causing some patients to suffer severe and long-lasting impairments following even a “mild” traumatic brain injury (TBI) and helps to explain why these injuries increase the risk for neurodegenerative problems such as Alzheimer’s, ALS and dementia. Read More

July 21, 2020

Study Shows Consistent Evidence of Axonal Injury Following A Single TBI For Years After Injury

American Academy of Neurology publishes an important study showing consistent evidence of axonal injury following a single TBI for years after injury using multiple measures, including a blood biomarker, MRI/DTI and volumetric analysis, and functional tests

On July 8, 2020 the American Academy of Neurology published an important study advancing our understanding of, and ability to diagnose, traumatic brain injury (TBI). The study, Shahim P, Politis A, van der Merwe A, et al. Time course and diagnostic utility of NfL, tau, GFAp, and UCH-L1 in subacute and chronic TBI was published online ahead of print, 2020 Jul 8 in Neurology. Funding for the study was provided by the National Institutes of Health and the Department of Defense (Center for Neuroscience and Regenerative Medicine.)

The authors of the study conclude as follows:

“ In summary, these findings suggest that a single mild to moderate TBI may cause long-term neuroaxonal degeneration and astrogliosis/activation.”

Read More

April 7, 2020

Neck Injury as Potential Contributor to Concussion Symptoms

In 2015, Dr. John Leddy and his groundbreaking concussion team at the University of Buffalo published a peer reviewed article cautioning that symptoms after head injury, including cognitive symptoms, that have traditionally been ascribed to brain injury can originate, at least in part, from injury to the neck, He counseled that the cervical spine should be examined and, if injured, should be treated to address these symptoms. “Brain or strain? Symptoms alone do not distinguish physiologic concussion from cervical/vestibular injury.

A review of the literature published not long after the Leddy article, in the Journal of Sports Medicine, sounded a similar theme. “Cervical Spine Involvement in Mild Traumatic Brain Injury: A Review.” It noted that many post-concussion symptoms can be explained by injuries to structures near or in the head, other than the brain itself. “For example,” the authors note, “following a trauma, structures such as the cervical spine, the vestibular ocular system and the temporomandibular joint can be injured.” They note, for example, that “neck pain, headaches, dizziness and balance dysfunction are common symptoms associated with both mTBI and WAD” (cervical spine injury.) Addressing neck injuries, they suggest, may lead to better concussion recovery. A randomized controlled trial testing this hypothesis is currently in process. Read More