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.

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.

Bicycle helmet studies - how seriously can you take them? We are aware that there are contradictory studies that benefit both those for and those against the use of helmets, and each one states that its conclusions are the right ones. Knowing of these biases, how can you determine whether wearing a helmet will benefit you or not?

Ignoring case-control studies, where those with head injuries are compared to cyclists without, and anecdotal evidence, we are left with the actual hard research regarding a helmet’s ability to protect your head in a crash.

Helmets are designed to handle crash energy - when your helmet sustains an impact, the foam crushes decreasing the energy and extending the time in which your head stops moving forward. This reduces the impact force to your brain. A good helmet won’t shatter or break, and a great one will be made with foam that can stiffen or yield depending on the degree of impact.

The goal is for the foam to be thick enough that it won’t bottom out on impact, but not so thick that it contributes to neck strain. The rounded shape isn’t just to fit to your head, its to help reduce impact even more by easily skidding when it comes into contact with the pavement.

Helmet safety standards have been created to make sure that your helmet can be used as the manufacturer intends. The American Society for Testing Materials (ASTM) is the most commonly referred to standards organization today and publishes on a variety of sport helmets. They have impact tests, strap tests, coverage requirements, as well as performance standards for different temperatures and weather conditions. Check out the Snell Memorial Foundation site for detailed bicycle helmet standards or the US CPSC.

These standards include most of the following tests. Impact testing drops a headform wearing a helmet onto an anvil…the anvil will be in a variety of shapes, each one fit the particular test. The amount of shock that the headform sustains is measured and these measurements determine how well the helmet protected it. Some impact tests drop weights onto the helmet or an attempt is made to penetrate the helmet with a sharp, heavy object.

These same tests, among others, are carried out when the helmet is wet, hot, cold, dry, etc. The strap is tested as well, by being yanked either by a machine or by the attachment of a weight. This is done to measure how much it stretches or if it breaks.

Now, short of donning a helmet and riding your bike into a deliberate crash scenario, you will have to take this research along with the countless studies both advocating for and against helmet use and make up your own mind.

Helmets have been created to lower your risk of brain damage, not prevent it, not guarantee a complete recovery after a crash. They can help you to enjoy your time riding, knowing that in addition to taking careful stock of your surroundings and using safe riding habits, you are doing everything in your power to help prevent a traumatic brain injury.

It is of course, your choice.

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.

This week’s resource is the Northeast Center for Special Care’s Brain Injury Conference, Symposium and Event Listing page.

If you are interested in knowing what brain injury related workshops, conferences and meetings are available near you, or what topics are being explored right now, then this page will be a great resource. They have listings that cover the entire year and span the whole world.

You can also sign up for updates and reminders if you want to easily keep on top of things. To check out this resource, click here.

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.

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!

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.

ClinicalTrials.gov is this week’s spotlight.

This Website is dedicated to providing information on a variety of traumatic brain injury (TBI) trials. If you are interested in participating in cutting edge research regarding various aspects of TBI, this is a good place to start looking for information.

Clinical trials are essential to TBI research as they determine which drugs and treatments are approved for human use. While tests on lab animals are what initially decides whether or not a drug is effective, they need human test subjects to figure out if they will really work or if they are ineffective.

Researchers often face the problem of not being able to find enough trial participants. This holds up the process of publishing a potentially beneficial drug. Some trials offer compensation, and all offer high levels of medical care while you are participating in the study