Traumatic Brain Injury Blog

head

Rehabilitation

April 16, 2019

Dartmouth Study Recognizes LoveYourBrain Yoga as an Effective Tool for Community Based Rehabilitation For People with Traumatic Brain Injury

Funded by the Brain Injury Association of New Hampshire, a group of researchers at Dartmouth assessed the effectiveness of the program by conducting semi-structured interviews of 13 participants with traumatic brain injury and 3 caregivers who had completed the 6 week, 6 session program.  The results are published in the February, 2019 issue of Disability Rehabilitation.

Kevin Pearce, a Vermont resident and world leading professional snowboarder, suffered a near fatal traumatic brain injury while training for the 2010 winter Olympics. Kevin’s remarkable resilience since his injury has inspired millions through the award-winning HBO documentary, The Crash Reel. Using the visibility generated by his success as a professional snowboarder and the international acclaim achieved by The Crash Reel, Kevin and his brother Adam created the LoveYourBrain Foundation, a non-profit organization that is working to connect, educate and empower people with Traumatic Brain Injury and to promote prevention programs. Building on Kevin’s own experience, the LoveYourBrain Yoga program has become central to the Foundation’s mission.  The program incorporates group-based breathing exercises, yoga, meditation and psychoeducation. The first six weekly sessions of the program are open only to the TBI community. Participants who complete the program can remain in the yoga community by taking gentle classes at studios throughout the country taught by yoga teachers with specialized training through the Foundation (at a discounted rate.)

As most yoga teachers recognize (including the author of this blog) one of the important benefits of the yoga program was building, through this shared experience, a sustained sense of community connection. This is particularly important to a TBI survivor isolated by her injury and impaired in the ability to make those connections. About half of the participants in the program sustained relationships built during the program and felt more capable of accessing other activities in the community. Most participants also reported physical benefits including improvements in strength, balance and flexibility and cognitive benefits, particularly the ability to control attention. Participants also reported ongoing use of tools such as breathing exercises to cope with negative emotions and stress.

Yoga practice has become increasingly popular in the general population, which is also challenged by community disconnection, stress and physical deconditioning. The LoveYourBrain yoga program customizes yoga for the TBI community and intentionally encourages connections among participants to make these recognized benefits more accessible to that community. As the Dartmouth researchers conclude, the LoveYourBrain Yoga program appears to be an effective model for community-based rehabilitation, with diverse and meaningful physical, psychological and social health benefits.

October 4, 2018

Use of Melatonin for Treatment of TBI and Sleep Disturbance Following TBI

There’s promising research on the use of melatonin for acute treatment of traumatic brain injury (TBI) and for treatment of sleep disturbance following TBI coming from two recent peer-reviewed papers. One, published in the Journal of Neurotrauma, reviews the literature and performs meta-analyses of the data in studies examining the use of melatonin shortly after injury.

The other, published in the journal BMC Med, reports on a randomized controlled trial examining the efficacy of melatonin in treating sleep disturbance following TBI.

Melatonin is an important hormone made by the pineal gland that helps control a person’s sleep and wake cycles. Read More

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

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