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.

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.

Science Daily has released an article regarding a study on brain plasticity from neuroscientists at Children’s Hospital Boston that has the potential to help patients heal from a brain injury.

Otx2, a protein that is manufactured in the retina, has been found to initiate a state of “heightened brain plasticity” in mice. This state of plasticity allows the brain to make new neural connections, leading to an increased ability to learn new things.

Imagine your brain being able to re-connect the portions that control memory, learning and physical stability with the application of eye drops…it’s not a reality for humans yet, but with the continued research into this area, it may be in the near future.

Takao Hensch from the Neurobiology Program and Department of Neurology at Children’s Hospital Boston has suggested that auditory and olfactory senses, along with others, may play a part in turning this critical period of the brain on.

It’s interesting to think that the eyes tell the brain when to begin learning. It’s as though when the eyes are fully prepared to document what is going on around us, they then send a signal to the brain telling it to begin “maturing”. The researchers involved with this study injected Otx2 directly into the brain’s cortex, and found that it had the same plasticity reaction that was produced in a natural setting.

These results are what leads us to hope for a convenient method of activating this protein transmission, such as the eye drops mentioned in the Science Daily article. Time will tell!

Due to the U.S.’s continued military presence in Iraq, we have seen a lot of attention paid to the increasing numbers of soldiers returning with head injuries from bomb blasts. These injuries are often hard to detect and too many times go unreported.

Luckily, both for the soldiers and for civilians who have sustained brain injuries, there has been a correlating increase in research into preventing and curing traumatic brain injuries (TBI).

The latest study that has caught our attention is focused on the use of crystals to detect and report a TBI. Shu Yang, one of the researchers who developed the device, says that the amount of damage sustained from an impact such as a soldier would get from an explosion, can be registered by crystals.

The crystal structure changes depending on the level of shock it experiences, changing its color. Scientists are working on developing a method that will allow doctors to translate a particular color into a level of neurological damage.

According to a NewScientist article, the blast waves from large roadside bombs “stretch and shear the brain, damaging the long nerve cells connecting the different regions of the brain”. The damage can only be detected with a specialized MRI scan, until now. With these crystal stickers, the hope is that the degree of damage will be apparent with a quick visual check, allowing the necessary level of care to be ascertained immediately.

When attached to a uniform or helmet in the form of a think sticker strip, these crystals can potentially be incredibly useful on the battlefield, helping to bring more of our soldiers home after receiving proper and beneficial TBI care.

Researchers at Johns Hopkins University are helping U.S. soldiers with early detection and timely treatment of traumatic brain injuries.

A prototype software has been designed to “integrate in real time data provided by medics on the battlefield with information from the patient’s electronic medical record, filter them through a template and present a visualization over a network to a physician in a remote location who could then diagnose TBI and direct treatment.”

This means that a soldier who is injured in some remote location like Iraq can have the needed brain injury information ready and waiting to put into play once the patient arrives.

This system uses data such as the injured soldier’s heart rate, respiration rate and blood pressure that is added to the patient’s medical history to determine the degree of the injury and the next needed step.

As traumatic brain injuries need to be treated as soon as possible, this software’s ability to “visually transfer the physician to the battle” will greatly increase a soldier’s chance of survival and recovery after sustaining a TBI.

How far will $1.7 million go when applied towards research on traumatic brain injuries (TBI)? Far enough to help progress ground breaking research in the areas of neuropsychology, rehabilitation psychology and physical medicine and rehabilitation at the Southeastern Michigan Traumatic Brain Injury System (SEMTBIS).

The DMC Rehabilitation Institute of Michigan and the Department of Physical Medicine and Rehabilitation at Wayne State University was awarded a 5-year grant totaling $1.7 million from the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research (NIDRR).

SEMTBIS will be able to apply this funding towards cutting-edge research focused on the clinical care of patients with TBI. Specifically, they are concentrating on “Full Access to Community Life”, a project that looks at priority areas such as employment of people with disabilities and the community integration of TBI survivors and their family members.

For more information on SEMTBIS, visit their Website.

We’ve talked about nutrition and how researchers are finding correlations between ingesting optimal amounts of vitamins and minerals and decreased brain damage after an injury. For this post we are going to explore one of the oft times touted supplements, fish oil.

According to a handful of studies, to be listed in the end, fish oil’s mega-3s (DHA) from sources such as tuna or salmon have the ability to reduce the risk of stroke, dementia and cognitive as well as brain abnormalities. In addition to this, it may also help with brain recovery after a traumatic injury.

Omega-3 fatty acids are essential nutrients that are obtained from food. There are three omega-3s, ALA, DHA and EPA. Of those, DHA is the form most usable by the body. Fatty acids are needed for normal growth and they benefit kidney function and support skin integrity as well as regulate inflammation and control hormones and cell growth.

The recommended dose varies depending on age and whether or not you are taking other supplements or medications. If you are in good health, taking 1,000 mg once a day should provide an adequate amount.

There have been some concerns regarding mercury in fish, as an increase in mercury levels can lead to brain damage, the very thing we are trying to counteract. To avoid this you can either stick to the fish oil capsules which have had the impurities taken out, or eat fish with lower amounts such as Alaskan cod or sockeye salmon (tuna contains the highest level of mercury).

Of course, as in all studies, there are possible variables such as the age of those who tend to use fish oil, so keep in mind that while it may have been shown to improve cognitive functioning, it may not work for you. Research into supplements such as omega-3s are still in the early stages, but the potential benefits make them worth watching.

Studies: One, two, three, and some good information on Wikipedia. For more on the dangers of mercury, click here.

Four men are “wheeling” across Canada with the use of hand cycles in order to bring awareness and generate donations to research for conditions such as concussive head injury and Alzheimer’s. They believe that a donation of 30 cents by each Canadian citizen for “breakthrough” research will allow them to walk again.

This research comes from a Canadian research team at McMaster University in Hamilton. Dr. Michel Rathbone and Dr. Shucui Jiang successfully regenerated nerves in the chronically damaged spinal cords of rats with the use of adult enteric glia cells. These cells are abundant in human and animal intestines and have been found to support the nervous system.

The enteric glia cells were grown in cell cultures and then transplanted into the rat’s spinal cords where they stimulated nerves to grow, reducing the damage in the spinal cord. These cells are not only stable, they have bypassed the problem of tissue rejection by the host. In addition, this team of scientists found that a naturally occurring molecule in the body, guanosine, stimulates stem cells already present in the spinal cord to grow and develop into cells that insulate the nerve processes.

Even more interesting, this medical approach and application can be used on other diseases as well, including those of the brain.

To progress beyond animal testing, the researchers need support. You don’t have to be Canadian to pitch it - visit Wheel to Walk for more information!

It’s has to be incredibly difficult to be faced with the choice of ending the life of a non-responsive brain injury patient. As a parent, spouse, sibling or child, this choice can’t get any easier.

Now, with new information on the brain activity in patients who have been diagnosed as being vegetative, this decision has gotten even harder.

Niels Birbaumer, a neurobiologist at the University of Tubingen in Germany, found surprising levels of cortical activity after studying EEG recordings of the brain activity in vegetative patients. The cerebral cortex is the area of the brain associated with memory, attention, awareness, thought and language.

Since the vegetative state was first labeled and defined, there has been a great deal of argument among everyone from scientists to lawyers and family members over the point where it’s OK to finally make the decision to end a life. This has been so difficult due to the varying concepts of what determines that someone is “alive”.

If they are breathing and the body is able to sustain itself on IV-fed nutrition, does this mean the person is still living? If they have no response to verbal communication or physical stimulation, does this mean they are no longer conscious and hence no longer “with us”? Because of this blurry line, scientists have been working to find a definite way to determine “true” brain death.

Birbaumer’s EEG recordings are an example of the recent studies to clarify this difficult matter. In one, Birbaumer and colleagues looked for patterns in the brain’s electrical activity as patients with severe brain damage had sentences read to them. The patients ranged from completely vegetative to those who could still control their gaze or other physical abilities.

Of the 38 participants that were labeled persistently vegetative, a state that is usually considered irreversible, 22 percent responded to errors that were deliberately mixed in with the sentences. This suggests that these patients are able to process more than was previously assumed and creates further questions on what a person who is in a vegetative state is aware of internally, if unable to respond externally.

Hopefully studies such as this one will help doctors to determine if someone is truly non-functioning and unable to have any awareness of their surroundings. This would make it easier for those whose trial it is to make and end-of-life decision.