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
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
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. Read More
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.
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
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
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 Neuropsychopharmacology. Read More
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
University of Toronto researchers have just published an important longitudinal study in the peer-reviewed Journal of Neurotrauma following patients with Post-Concussion Syndrome (PCS) based on a diagnosis of concussion in conformity with the international sport concussion criteria. This was the first longitudinal study that specifically excluded patients with contusions and hemorrhages identified by imaging (so-called “complicated” concussions), patients who tested positive on so-called “malingering” tests (the TOMM) and patients involved in litigation. Read More
There’s new evidence supporting immediate removal of athletes from play following concussion.
A new study published in the September, 2016 issue of Pediatrics provides evidence that returning to play immediately following a sports related concussion, even without a “second impact” nearly doubles, on average, the length of time required to recover and exposes athletes to a greater risk of protracted symptoms. As the authors point out in their report, the Institute of Medicine and National Research Council stated in 2013 that
“the culture of sports negatively influences SRC [sports related concussion] reporting and that athletes, coaches, and parents do not fully acknowledge the risks of playing while injured.”
