Traumatic Brain Injury Blog

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July 2, 2021

Article debunks defense myth that the risk of injury in a “minor impact” collision is not greater than activities of daily living

Most personal injury lawyers have represented clients suffering from the chronic consequences of concussion and musculoskeletal injuries following a rear end collision that caused minimal damage to the vehicles involved. This blog has reported on countless scientific studies showing that in some patients concussions can have long-term, chronic consequences. The standard defense employed by insurers in minimal damage rear end collisions (which they call “MIST” cases) is to argue that any injury is improbable in these accidents because the forces involved are similar to the forces involved in many activities of daily living (ADLs) where injuries rarely occur (like sitting down in a chair or sneezing.

The insurers and their defense counsel typically have an “accident reconstruction” expert they routinely use (often retired police officers) who calculate the speed change in the crash (the “delta V”) and then compare it to the delta V involved in everyday activities. (The delta V calculations by these so-called experts is often inaccurate, but that is a different issue.) Experience shows that this testimony can be very compelling to a jury, faced with judging the credibility of an injury victim whose injury is not immediately apparent. 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

June 10, 2021

Evidence supports DTI imaging as a reliable biomarker predicting the severity of cognitive decline following concussion

A research report from the University of Texas Medical School, just published in Frontiers in Neurology, finds a correlation between Diffusion Tensor Imaging (DTI) findings and cognitive assessments in patients with chronic complaints after concussion, providing evidence that DTI imaging may be a reliable biomarker predicting the severity of cognitive decline following concussion. (DTI is an MRI technique that detects microstructural changes in white matter such as the changes that can occur as a result of “diffuse axonal injury” in brain injuries including concussion.) Read More

June 1, 2021

Emerging Evidence indicates that the Composition of the Gut Microbiome is Altered after a Traumatic Brain Injury

In the first systematic review on this topic, researchers at the University of Texas report on growing consistent evidence that traumatic brain injury (TBI) changes the gut microbiome. Evaluating these changes, they conclude, will be a fertile ground for new therapeutic interventions. Read More

June 1, 2021

Alzheimer’s Researchers Find “Compelling” Evidence that Mild Traumatic Brain Injuries Increase the Risk of Dementia as much as Diabetes, Hypertension and Obesity

In a peer-reviewed article published in the Journal of Alzheimer’s Disease, 2020;78(2):757-775. doi: 10.3233/JAD-200662, Canadian researcher found that a history of mild traumatic brain injury (mTBI) almost doubled the risk of being diagnosed with dementia and that mTBI was the strongest environmental risk factor for dementia, comparable to health risk factors such as diabetes, hypertension and obesity. Read More

April 8, 2021

Montreal Study Finds Subtle Long-Term Cognitive Effects of a Single Mild Traumatic Brain Injury

Adding to a growing volume of literature on this topic, Montreal researchers published a study in January, 2021 demonstrating that a single mild traumatic brain injury involving late adulthood patients (ages 50-70) leads to subtle, long-term cognitive consequences.

The article, authored by Camille Larson-Dupuis et. al., entitled Subtle long-term cognitive effects of a single mild traumatic brain injury and the impact of a three-month aerobic exercise intervention, was published in The Journal of Sports Medicine and Physical Fitness (2021 January: 61(1): 87-95).  What makes these findings particularly significant is that all participants in the study were exempt from confounding factors sometimes associated with long-term consequences. All participants:

  • had negative scans
  • were symptom-free within three months of their accident (including depression and anxiety)
  • did not present with chronic conditions known as risk factors for cognitive decline (uncontrolled diabetes, uncontrolled high blood pressure or cardiovascular disease)
  • were all well-educated

Read More

March 11, 2021

Danish Study Shows that Concussions Have a Large and Long-lasting impact on Salary and Employment

Studies in several countries, including Denmark, have found that between 10 and 30% of patients diagnosed with Concussion suffer from long-term symptoms. These long term consequences were recognized by the American Academy of Neurology in an important study published in July, 2020 and featured in this blog (“a single mild to moderate TBI may cause long-term neuroaxonal degeneration and astrogliosis/ activation.”)

Having recognized the potential for serious long-term consequences, researchers have begun to assess the economic impact of concussion. A Danish study recently published in BMJ Open concluded that concussions have a large and long-lasting impact on the salary and employment of working class adults on a national scale. 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