This week’s technology spotlight is on an interesting assistive device called a cerebral interface or brain-computer interface (BCI).

The BCI enables users to augment their ability to communicate. Created by Carmen Vidaurre Arbizu, the BCI interfaces with the user’s computer and electroencephalograms (EEG) to generate signals used for communication.

In only four hours of of training, the typical user was able to control the interface. If you are interested in using your mind to control your computer, this device is worth checking out! Perhaps a peek into the future of assistive technology, the BCI brings us a big step closer to easy communication.

The Christopher & Dana Reeve Paralysis Act, S.3297 (CDRPA) has passed the House and is now awaiting the Senate vote. The Christopher Reeve Foundation is asking for your help in passing this important package.

According to the foundation’s Website, the CDRPA “has three components that support and enhance paralysis research, rehabilitation an quality of life programs.”

In detail:

“Title I. Paralysis Research
The bill expands research on paralysis at the National Institutes of Health (NIH) by establishing the Christopher Reeve Paralysis Consortia. This style of research promotes collaboration - connecting scientists doing similar work in multiple fields to enrich understanding and speed discovery of better treatments and cures.

Title II. Paralysis Rehabilitation and Care
The bill calls for rehabilitation research to advance daily function for people with paralysis including intensive, activity-based research to measure the effectiveness of certain rehabilitative tactics that aim to improve mobility, prevent secondary complications, and develop improved assistive technology.

Title III. Improving Quality of Life for Persons with Paralysis and Other Physical Disabilities
The bill will develop unique programs at the Centers for Disease Control & Prevention (CDC) to better the quality of life and long-term health status of persons with paralysis and other physical disabilities. Programs include providing grants to non-profit health and disability organizations to educate the public about paralysis, improve access to services, and integrate life with paralysis into society, as well as coordinate services within each state to assist persons living with paralysis.”

For more information on how you can help support this bill, visit the Christopher Reeve Foundation’s Website.

In a recent article on PhysOrg.com, MIT researchers are spotlighted for finding stem cells in the spinal cord that may be able to be pushed to turn into healing cells instead of scarring cells. This would help with the development of non-surgical treatments for spinal cord injuries (SCI).

The stem cells under consideration are called ependymal cells. On their own they are slow to proliferate and promote regeneration on their own, but when grown in a lab they have been found to restore some degree of function in paralyzed rodents and primates.

According to the article, the ependymal cells migrate to the injured area of the spine, producing a mass of scar-forming cells along with beneficial healing cells called oligodendrocytes. The oligodendrocytes produce myelin, a nerve coating of sorts that helps to insulate nerves, helping their function to improve.

If you want to read the original study, check out the July issue of PLoS Biology. The article is by Konstantinos Meletis.

This week’s resource is the Traumatic Brain Injury Model System. We have been talking about ways to increase your brain’s ability to recall and process information after a TBI, and this site has some good data that can help with the process.

Run by the University of Alabama, this Website provides activities that are created to enhance cognitive function in people with brain injuries. According to their introduction page, “Each activity provides a group of tasks listed by their level of difficulty…you can select activities you feel might be appropriate and increase the level of difficulty by selecting appropriate task as progress warrants.”

They include 48 activities, a skill index that organizes the tasks according to which thinking skills are used and an appendices that has additional resources. You can choose to practice your Fine Motor Control, Attention/Concentration Skills, Memory-Oriented Skills, Reasoning/Problem Solving Skills, Visual Spatial Skills and Language Skills.

We found this site to be both helpful and easy to use. Let us know what you think!

An unusual path to brain damage:

In the news these last few days have been versions of a story about a woman who suffered brain damage from a detox diet she was on. The British woman, Dawn Page, was taking a nutritionist’s advice and ingesting large amounts of water while cutting back on salt intake.

The resulting sodium deficiency caused an epileptic fit that lead to permanent brain damage. Page was given a settlement by the nutritionist’s insurance company, but that didn’t exactly make up for the memory damage, speech difficulties and loss of concentration that Page now lives with.

This story is a good example of how important it is to make sure you are taking advice from a registered and thoroughly trained professional. Not only that, but following up someone’s advice with research of your own to make sure that there is some validity to the information is equally important.

It’s easy for people to assume that because someone lables themselves a nutritionist or doctor or herbalist, etc., that they are automatically trustworthy. In our culture we tend to take “professionals” on faith, figuring that they wouldn’t lie to us as they are in the health profession.

One thing to remember is that sometimes they aren’t lying, such as seemed to be the case with Page’s nutritionist, Barbara Nash. From all accounts, Nash believed what she was selling and most likely it was ignorance on her part that caused her to prescribe a detox program that was so dangerous. This is why doing your own research to back up what you have been told is so important.

It’s impossible for those who have never experienced a life altering and debilitating injury to imagine what it’s like to go through the grief of losing your ability to walk, stand or even utilize the hands that you never gave a thought to before. For the thousands who sustain a paralyzing injury every year, this reality is one that is all too real.

Making it through this trying period can often seem like a insurmountable challenge, but with time and support, those with paralysids are able to reorganize and readjust to their changed lives. Jobs, relationships and everyday activities now require new maps to be drawn in order to navigate what used to be familiar territory.

The steps immediately following are familiar to anyone who has experienced a significant loss in their lives: denial, isolation, anger, bargaining, depression and finally acceptance. Often the person who is newly injured will try to ignore what has happened and try to pretend that their paralysis isn’t now a fact of life. They will attempt to isolate themselves in order to keep their injury from being brought to their attention. Then, when there is no choice but to acknowledge the paralysis, anger sets in.

The loss of one’s limbs often seems unfair, creating a sense of injustice and anger. This is then followed by bargaining with doctors and with an individual’s representation of God, with depression close on its heels. Finally comes acceptance. At this point, the person finally accepts the reality of their loss.

This pattern varies depending on the individual, but becoming familiar with these stages will help either you realize that these feelings are normal and others have not only dealt with them but gotten through to the other side intact.

Regaining control of your life is important, and through self-education you can find a means to do it. Find out all you can about the injury and the options that are available to help make your environment more conducive to your needs. There are modifications that can be made to your car, your house and everything within it that will make things a great deal more accessible.

With time, you will adjust to your disability and gain a thorough understanding of how to educate others about it, what to ask for to have your needs met and how to properly take care of yourself physically and emotionally.

This is not an easy condition to get used to, but in time, you will be able to have a life as full and engrossing in a way that you never imagined before becoming paralyzed - and with the constant advances being made in science, the chance for a treatment grows with every day that passes.

Q: Since my brain injury, I have memory loss and difficulty concentrating. Is there anything I can do to improve this?

A: There was a time when doctors assumed that the brain, once damaged, couldn’t regain any of it’s previous functions, but thankfully we have progressed beyond that limited evaluation.

We now know that there are things we can do to improve brain functioning after a traumatic brain injury (TBI). In addition to the rehabilitation that the doctor will recommend after an injury, there are a variety of exercises that you can do on your own that will help to boost brain power.

Some researchers claim that music incites increased brain function by creating connections between the right and left brain hemisphere. The interplay that allows you to learn music utilizes both your creativity and your reasoning, strengthening cognitive capacities and developing better organization skills. By learning a new musical skill, you potentially improve your mind’s flexibility.

Others stress the importance of physical exercise, especially aerobic activities. While this area still needs more study in order to clarify what specific processes are happening to cause improved memory and general mental function, there have been a handful of seemingly conclusive tests creating a definite link between the two. Some speculate that it’s the increased blood flow bringing oxygen to the brain that promotes these beneficial effects. This doesn’t mean that you need to run for hours a day. Find an activity that you enjoy, be it running or biking, hiking or swimming, and try to increase the time spent doing it.

Besides learning a new musical skill or upping your aerobic activity, you can also practice brain exercises that will help you to increase your capacity to process information with speed and efficiency. There are a wide assortment of books and Websites that not only detail different activities, but walk you through them. Here are a few to get you started:

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Workbook for Cognitive Skills

The Brain Injury Workbook

Whichever steps you decide to take to improve and even regain your cognitive capabilities, keep in mind that scientists are just starting to discover the brain’s recuperative abilities. Don’t give up hope!

Choosing the right rehabilitation facility is one of the most important decisions a survivor of a brain or spinal cord injury will make. That’s because the type and quality of care will have a significant impact on the patient’s long-term outcome.

A good rehabilitation center should offer the survivor of a brain or spinal cord injury a combination of specialized medical care needed to return to the highest level of function, as well as the inspiration and strength needed to cope with difficult injuries.

Ranking the Facilities

Each year, US News & World Report ranks nearly 200 hospitals in 17 specialties. Included in this list is the top ten rehabilitation hospitals in the USA for the year 2007. Rankings are obtained through a nationwide survey of board-certified physicians. In order, this year’s top ten rehabilitation facilities are:
The Rehabilitation Center of Chicago in Illinois.
The Kessler Institute of Rehabilitation, with three locations throughout New Jersey.
The University of Washington Medical Center, Seattle, Washington.
Memorial Hermann-TIRR, Houston, Texas.
The Mayo Clinic’s Physical Medicine and Rehabilitation Center, Rochester, Minnesota.
Craig Hospital, Denver, Colorado
Rusk Institute, NYU Medical Center, New York, New York
Spaulding Rehabilitation Hospital, Boston, Massachusetts
National Rehabilitation Hospital, Washington, D.C.
Ohio State University Hospital, Columbus, Ohio.

Choosing a rehabilitation facility with an excellent track record of success, such as the ones listed above, will contribute to the success of the patient’s long-term outlook.

We’ve mentioned brain plasticity in a couple of our post regarding brain injury and brain repair, so this post is going to delve into exactly what this term means and why it’s so important.

Brain plasticity, also called neuroplasticity, cortical plasticity and cortical re-mapping, is a term used to describe the way the brain organizes itself in response to experience. More specifically, “neuro” stands for neuron, the nerve cells in our brains and nervous centers, and “plasticity” for changeable or malleable. Since scientists began to study the brain, the idea was fairly set in stone that it was hardwired to respond in certain ways, and much like a computer, when one drive failed, that drive and all of it’s information was gone for good. The knowledge (read synaptic connections) contained in that portion of the brain would be wiped out if damaged, to never be regained.

Looking back now, it seems surprising that people who could easily grasp that the brain grows both in physical size and knowledge from childhood to adulthood, would assume that such an amazing organ was as unchanging as a machine. When scientists in the late 60s and early 70s began to discover that the brain was able to change what parts it used for different activities, switching over to other areas as the previously used portions stopped working or were utilized for different functions, the idea of brain plasticity was born.

Now decades of research have given credence to the idea that the brain changes in reaction to new situations or in counterbalance to brain injury. Thinking, learning and even acting change not only the brain’s organization but its actual physical structure. Called “maps”, the way the sensory system in the brain is organized changes with stimulus, often moving from one part of the brain to the other. Picture a map overlaying the brain, then move it from one area to another and you have an idea of how it works.

No longer are we limited by the idea of a never changing mind… we can now work on various aspects that are poorly formed or badly damaged with the hope of creating the necessary connections in some other part of the brain - a part capable of the needed responses. For a great book on this process and how to help your own brain function better, visit Norman Doidge’s Website or order his book, The Brain that Changes Itself.

A recent article in BioWorld Today by Donna Young discuses the difficulties that traumatic brain injury (TBI) research faces when looking for potential investors.

It would seem that financial backers are turned off by past drug failures that are brain injury specific - strokes, brain illnesses and brain trauma. Harry Tracy who runs NI Research, a neurological focused consulting firm, cites 50 stroke drugs that failed over the past 10 years. Tracy says that this is because of the difficulty in conducting clinical trials as there are a variety of reactions to not only the drugs but the injuries themselves.

This lack of ready progress, high cost and level of complexity discourages potential investors from TBI research, which detrimentally effects millions every year. Larry Glass, CEO of Neuren Pharmaceuticals Ltd. says that TBI is second only to hemorrhage as a cause of death for soldiers serving in Iraq and Afghanistan.

Glass believes that while there are initial complications and expenses involved, “the potential for returns are phenomenal” which is why his company is partnering with the U.S. Army to develop the drug NNZ-2566. This drug will hopefully work to prevent secondary damage to brain cells, reducing the degree of damage sustained by the initial TBI.

There is hope - in May lawmakers introduced a bill intended to add $75 million to the annual amount of federal TBI research funding. Not a significant amount when compared to the need, this money will still benefit some areas of vital development and research, perhaps providing the little bit extra needed for some lab to come up with the next wonder drug.

Young points out another potential avenue that companies can explore to advance their pharmaceuticals, “to exploit the crossover between orphan disorders.” By doing this, firms are able to work on two or more diseases at once, using their common elements to hopefully find potential cures for both. An example of this is Huntington’s disease and Alzheimer’s disease. Both diseases share a common pathological hallmark that can potentially be treated with the same drug.

It’s frustrating to see pharmaceutical companies pursuing drugs that target the wealthy such as those for erectile dysfunction and longevity, while ignoring research into topics that affect millions who don’t have bottomless pockets. We can keep our fingers crossed that something with a significant profit potential is developed that can also benefit TBIs.