Q: Is there any recent research that supports the idea of brain plasticity?

A: There have been a handful of studies over the last decade that can be considered to support the idea of brain plasticity, the brain’s ability reorganize in response to input, a very useful growth mechanism that can benefit traumatic brain injury (TBI) recovery. Here is one of the most recent areas of research:

A study from the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center (BIDMC) has shown through tests on the effects of blindness that the brain possesses more reorganization ability than originally assumed.

How does vision and brain plasticity mesh? The studies’ senior author Alvaro Pascual-Leone, the director of the Berenson-Allen Center, used blindfolded subjects to demonstrate how the area of the brain that controls vision quickly switches to touch when the use of the eyes are no longer available.

Pascual-Leone believes that this indicates an ability that was dormant while sight was intact. It’s not that our brain is creating new connections, according to the author, but that they already exist. In this study, the blindfolded participants were better at learning Braille than those without.

According to the Newswise article, “as predicted, the researchers found that the subjects who were blindfolded were superior at learning Braille than their non-blindfolded counterparts. Furthermore, the brain scans of the blindfolded subjects showed that the brain’s visual cortex had become extremely active in response to touch (in contrast to the initial scan in which there was little or no activity).”

We can all most likely recall times that we closed our eyes to better hear or taste something, and because of these automatic impulses, we have already experienced the brain’s ability to compensate with the other senses. Studies like this one bring our brain’s amazing potential into relief.

Those with brain injuries experience everything from a slightly impaired ability to recall things to a loss of all conscious awareness. It will be interesting to see how these discoveries can be applied to TBI patients and whether or not there is the potential to stimulate non responsive areas of the brain with these methods.

This week’s resource is the Website America’s Heroes at Work.

The United States Department of Labor (DOL) created this site in order to address the “employment challenges of returning service members living with Traumatic Brain Injury (TBI) and/or Post-Traumatic Stress Disorder (PTSD).”

America’s Heroes gives employers tools that can help our military men and women affected by TBI and PTSD better succeed in the civilian workplace. To accomplish this they are collaborating with the Veterans’ Employment and Training Service (VETS) and the Office of Disability Employment Policy (ODEP).

For more information, visit their site here.

The Federal Motor Vehicle Safety Standard (FMVSS) 207 “specifies strength requirements for automotive seats and their attachment assemblies, so as to minimize the possibility of their failure by forces acting on them as a result of vehicle impact.”

While this standard helps to regulate how well a seat structure performs in an accident, it has failed to significantly decrease injuries and fatalities due to seatback failure. Alyssa’s story is one of many such devastating tales.

The Insurance Institute for Highway Safety lists 2006 as their most recent year of fatality statistics. There were 1,327 deaths caused by rear impact motor vehicle accidents. The majority of fatalities were under the age of 25, with crashes causing one of every three injury-related deaths among children under 13.

Of these numbers, it is unclear exactly how many death were a result of seatback failures, but what is clear is that auto crashes are a significant cause of life ending or altering injuries in children. What is tragic is the lack of governmental oversight, or seemingly interest, in how often seats fail with catastrophic results.

We have numerous reports on air bag related injuries, but no hard data on seat failures and the resulting injuries. A study for The Los Angeles Times by Keith Friedman, an auto safety researcher, analyzed 72 rear-end collisions using a government database of tow-away crashes, found that from 1988 to 1997 1,800 backseat passengers were injured or killed by seat failures.

What we need are more researchers willing to invest the time into this important subject. Data on which cars have a history of seat collapse and which ones are best known to withstand a rear impact needs to be better available to the public. This topic isn’t a new one - auto safety engineers have been issuing warnings on this subject since the 1950s.

The FMVSS 207 was adopted back in 1968 and other than adding vans, trucks and buses in 1972, there hasn’t been an update in its standards since. FMVSS 207 requires that a seat back be capable of handling an impact of 270 foot/lbs. Now compare that number to the 6,000 lbs. of force that seat belts are required to withstand before failure. Why would the seat only need to be four or five percent as strong as the seat belt?

The National Highway Traffic Safety Administration (NHTSA) is well aware of the problem and in 1996 actually admitted that the current standard was inadequate…this didn’t lead to any changes, only further recognition of the problem in 1997 and 1998. One of the reasons they are dragging their heels is over the concern that stiffer seatbacks will lead to more incidents of whiplash.

Compare a whiplash injury with a traumatic brain injury (TBI) that leads to permanent disability or death - which one would you chose?

For now, research into the car you own or are looking to buy is the best offensive you can take to keep you and your passengers safe. One Website with some information, though not nearly enough regarding seat failures, is Safecar.gov. Until we see higher seatback safety standards, we will continue to hear of tragic stories such as Alyssa’s. We need to write to NHTSA, to our local government and to our automobile manufacturers. These issues need to be resolved for the safety of all vehicle occupants.

The importance of the vehicle seat’s role in automobile accidents shouldn’t be overlooked, yet it often is. If you run an Internet search, you will find numerous stories on collapsed seat backs, faulty restraint systems and inadequate load bearing ability - all manufacturer-related issues that have contributed to injury or death in automobile crashes.

One area of concern that is overlooked more than most is that of wheelchairs used in lieu of standard seats in vehicles. For those with disabilities, the act of transferring from a wheelchair to a car seat is often difficult and thus prohibitive. Instead, they often choose to purchase a van or other vehicle with the capacity to hold a wheelchair. Either the back seats are removed or the front passenger seat is in order to create a space for the wheelchair.

Vehicles can be modified to allow room for the wheelchair and the addition of special restraints to offer protection in an accident. While these restraints are tested for strength and comfort, they don’t give the wheelchair the same protective properties as originally equipped manufactured seats would.

Keeping in mind that a stock seat is still no guarantee that the person riding in or near it will be safe in an accident, the idea of a wheelchair providing the same degree of protection is faulty. They simply aren’t built to act as car seats. They haven’t been created to withstand the load placed on them and the occupant during a wreck nor to optimize the protective abilities of the restraints.

A common cause of injury during an accident is seat back failure - when the seat is unable to bear the increased load from the force of the impact added to the weight of the occupant, causing it to collapse. The two most common types are either a failure of the seat to maintain an upright position and the deformation of the actual structure. This usually happens after a rear impact that propels the vehicle forward the person backwards, creating strain on the back of the seat. There have been thousands of life-altering traumatic brain injury (TBI) or spinal cord injury (SCI) cases from these failures.

Properly manufactured seats should be able to bear this additional load as well as prevent the occupant from coming into contact with the vehicle’s interior, but too often they don’t measure up.

Now picture a wheelchair encountering those same circumstances. This chair is designed for comfort, ease of transportation and maneuverability - not impact resistance. The Subcommittee on Wheelchairs and Transportation (SOWHAT) has been pushing for better wheelchair standards, ones that will protect a passenger during motor vehicle transportation. They call for an emphasis on “design requirements, test procedures, and performance criteria” that will provide the necessary stability, restraint and strength.

SOWHAT’s earlier efforts in the 1990s to have ANSI, the American National Standards Institute, approve WC-19-Wheelchairs Used as Seats in Motor Vehicles has been approved, but it does not address every issue or concern posed, most notably it does not cover protection from rear impacts or rollovers.

To find out how you can better protect yourself or the wheelchair user in your life, check out the Ride Safe online brochure. They provide step by step instructions on how to best secure a wheelchair and its occupant while in a motor vehicle. They also list tips for selecting a wheelchair and tiedown equipment.

This week’s spotlight is on The Prince Synergy, a worldwide organization focused on maximizing human capitol.

In The Prince Synergy’s own words, “Traumatic Brain Injury takes away victims’ freedom and opportunities internally.” With the unique obstacles faced by traumatic brain injury (TBI) patients in mind, this business works to help companies and their employees work with the limitations created by this injury and others.

The Prince Synergy provides teaching and consulting in the areas of health and stress management, leadership and innovation at “times of unexpected change, stress, illness and injury.”

If you or someone you know has sustained a TBI that is interfering with productivity, this company may be just what you are looking for. To find out more, click here.

Top Three Things to Know for New Brain Injury Patients

The time following a brain injury can be confusing, overwhelming, and emotional. There are three things that new brain injury patients should be aware of to help them through this difficult time.

1. You Are Not Alone

Every year 1.4 million people in the United States seek medical care for traumatic brain injury. Survivors should be willing to ask for—and receive—help from family, friends, and other loved ones when needed. Support groups, resources, and the survivor’s medical team are all there to help the patient navigate the time following traumatic brain injury. If the patient is not able to advocate for himself or herself, caregivers should be willing to call on the medical team, support groups, and other resources for help.

2. There are Different Types of Treatment and Rehabilitation

Survivors should be aware that there are a variety of types of treatments and rehabilitation available, depending upon individual needs, as well as where they are in the recovery process. No two treatment and rehabilitation programs are the same. Instead, they are individualized based on the location and severity of the injury. The goal of treatment and rehabilitation is to restore as much function to the survivor as possible. The plan should be to focus on the particular issues the survivor faces, and to structure therapies accordingly.

3. Recovery Will Be a Challenge

There’s nothing easy about recovery, and the new brain injury patient should realize this. As a matter of fact, without the many “challenges” that go hand-in-hand with recovery, the brain can’t rewire itself. While recovery can be extremely frustrating—with the gains offset by steps backward—perseverance, patience, and celebrating all forward progress, no matter how small, can keep the survivor in a positive frame of mind.

Have you felt like you or someone else you know with a disability has been the victim of a hate crime? We will admit that this isn’t a subject that we knew much about before coming across a BBC article discussing the issue.

“Last year, Christine Lakinski - a woman in her 50s with learning and physical disabilities - had collapsed in the street near her home in Harlepool when she was set upon by a neighbour. She was covered in shaving foam, urinated upon and filmed on a mobile phone as she lay dying.”

This horrendous account started us thinking about the issue - if there is actually an issue with disabled hate crimes.

According to the same BBC article, there have been multiple deaths where the assailed was either physically or mentally disabled, or a combination of the two. The question asked seems to be - where does the title “hate crime” come into play?

If you are picking on someone who is different from you, is it a matter of “hate” or is it just a form of bullying? When someone is either physically or mentally hurt from the actions of another, does it matter what the label is? According to the law, there is a significant difference.

The Federal Bureau of Investigation defines a hate crime as “a traditional offense like murder, arson, or vandalism with an added element of bias. For the purposes of collecting statistics, Congress has defined a hate crime as a “criminal offense against a person or property motivated in whole or in part by an offender’s bias against a race, religion, disability, ethnic origin or sexual orientation.” Hate itself is not a crime—and the FBI is mindful of protecting freedom of speech and other civil liberties.”

Interestingly enough, “federal statutes prevent the FBI from investigating crimes of bias motivated solely by … disability” as this is primarily the domain of the local law enforcement. Because hate crimes are often a blurry area, they tend to get prosecuted as arson, murder or intimidation. For disability specifically, the majority of crimes usually fall under Title 42 - Criminal Interference with Right to Fair Housing. This statute focuses on preventing intimidation, interference or injury in regards to a person’s housing rights.

This makes sense when you consider the amount of disabled people who are unable to care for themselves physically and are dependent on either paid or non-paid companions to assert their rights. But what about those who are harassed outside of a housing situation?

The Criminal Justice Act of 2003 labels a hate crime as an “offense motived by hatred or prejudice towards a person because of their actual or perceived disability. It is also a criminal offense in which immediately before, after or during the offense the perpetrator demonstrates hostility towards a person because of their actual or perceived disability.”

So what does all this mean? People with a disability are protected from hate crimes or anything that can be construed as a hate crime by our legal system. The difficulty is not just in the justice system’s definition, but in what the person who encountered the situation considers the harassment, intimidation or abuse to be.

In our research we found multiple accounts of those who both supported the idea of a disabled hate crime and those who thought it was too strong or too general of a term. Where this becomes important is when the definition is imperative to categorizing acts against the disabled as hate crimes in order to better protect them from abuse.

In the UK, surveyors found that the 68 recorded cases of disability hate crimes prosecuted between April and September 2007 fell far short of the number those surveyed had directly experienced. When it’s a matter of protecting and denouncing this sort of crime, it becomes vitally important to have them not only clearly defined, but to have a precedent to follow that will help prevent future occurrences.

Call it “harassment” or call it a hate crime; any degree of abuse towards a disabled person should be confronted immediately for what it is. And hopefully, with a greater awareness of this issue, more people will be willing to protect those who are physically or mentally unable to protect themselves.

This week’s technology report isn’t on something you can use - yet. ScienceDaily reports that a team at the University of Reading has created a robot that is controlled by an actual biological brain. This has a great deal of potential applications as it continues to develop and become more complex.

Using cultured neurons, the scientists developed this brain in a move to determine how memories manifest and how the brain “stores specific pieces of data”. The neurons are placed into a dish called a multi-electrode array (MEA) that has 60 electrodes which pick up the electrical signals sent by the cells. These signals are what determine how the robot moves.

As researchers figure out how to get the robot to learn, they hope to be able to watch the actual process of how memories manifest themselves when the robot travels over known territory.

Knowing more about how memory forms will help researchers understand how memory is damaged in a traumatic brain injury (TBI) and eventually, how to repair it!

To keep an eye on this research, visit the University of Reading.

This week’s resource is the Center for Disease Control and Prevention’s (CDC) teen driver fact sheet.

The CDC says that motor vehicle accidents are the leading U.S. cause of teen deaths, accounting for more than one in three deaths. This site has some valuable information such as the size of this problem, who is at risk, risk factors and how to prevent these accidents.

They include a section specifically for traumatic brain injury (TBI), citing 1.4 million cases a year in the U.S. alone.

For more information and additional resources, visit the CDC fact sheet.

Remember that feeling of invincibility that you had as a teenager? For most of us, that feeling is almost unrecognizable now that life has caught up with us and we are aware of just how delicate life can be.

Dr. Najma Ahmed, the assistant director of trauma at St. Michael’s Hospital in Toronto, Canada, says that this feeling of invincibility is preventable. “Teenage drivers have the highest rate of injury and death from motor vehicle crashes of any demographic group in Canada,” says the Canadian Press, and most of these teens are oblivious to their danger.

Dr. Ahmed says “It’s my job, our job to save them.” With a new program at St. Michael’s, she is hoping to do just that. A study of 260 adolescents found that when teens met with their peers who had sustained paralysis or another such life altering injury, they were most likely to alter their attitude and behavior in regards to taking the risk of damage or death seriously.

Dr. Ahmed is promoting the ThinkFirst Injury Prevention Strategy for Youth (TIPSY) at St. Michael’s, a program that takes teens to see first hand what can happen to them. Some of the situations included visiting young victims of accidents in the ICU unit, a situation that worked to bring the intended point home.

Researchers are hoping that programs such as this will spread as parents begin to realize the importance of prevention. Traumatic brain injuries (TBI) or spinal cord injuries (SCI) are just some of the life changing results of a teen driving too fast and losing control of their car.

With early education, such as is given through TIPSY, the researchers at St. Michael’s hope to greatly minimize these traumatic situations as more youth leave behind the idea that “it can’t happen to me”.