Why is Grandpa or Grandma Acting That Way?

Older people often have poor balance. If they fall forward they can strike their head on the ground and sustain a concussion, but may not remember the event. Afterwards they can exhibit cognitive slowing, poor memory, difficulties with word retrieval and other problems that family may wrongly attribute to Alzheimer’s. How frequent are falls among the elderly causing TBI? Very. According to a research paper published in October 2013 in the Journal of the Canadian Medical Association by Stephen Robinovitch of Simon Fraser University in Canada, some 60% of the hospital admissions of long-term care elderly patients were due to traumatic brain injury. Fraser found that sideways falls into the wall or furniture were the least common and that falling forward to the ground was the most common. He also said, “We were actually surprised that falling forwards is much more risky. You’re three times more likely to impact your head if you fall forward.”

Top Ten Signs of TBI in a Child

Ajit A. Sarnaik, MD, a critical care medicine physician on staff at Children’s Hospital of Michigan, says parents should look for the following ten warning signs after a bump on the head to determine if their child requires medical attention for a possible concussion:

• Child is not alert or responsive after injury
• A headache that gets worse over time
• Slurred speech, dizziness, blurred vision or confusion
• Difficulty recognizing people
• Vomiting more than two or three times
• Stumbling or weakness of arms or legs
• Child has blood or watery fluid from the nose or ears
• Difficulty waking up or excessive sleepiness
• Unequal size of the pupils (the dark center part of the eyes)
• Convulsions (seizures)

Self-Healing Language Disorder After TBI

Survivors of TBI with left-sided brain damage often experience problems with language such as difficulty making intelligible speech sounds and difficulty forming proper words from those sounds. Depending on insurance coverage it may be possible to accelerate recovery through visits to a speech therapist. Is there anything you can do on your own to activate your speech center and prompt it to rewire in a healthy way? The answer is yes.

Having heard many success stories I can say that a quirky and creative trial-and-error technique is useful. Some people who can barely form a sentence find they can sing along to music from their teen years. Some people who can barely form a sentence find they can speak with complete intelligibility when they use a foreign accent. Others make progress through making funny sounds like a frog, an owl, a fog horn or an explosion. Keep experimenting. The more you play with sounds and language the easier speaking will become.

American Legion Criticizes the DoD and the VA for Deficient Care of Vets with TBI

The American Legion has completed an investigation of the quality of care that veterans receive for TBI and PTSD by the Department of Defense and the VA. The seven-member committee that drafted the report includes a retired Army colonel who served on the Joint Staff Wounded Warrior Integration Team and a public health researcher at Columbia University, but no medical personnel.

The committee members visited military, VA and private medical facilities, read previous reports and studies, and interviewed many patients, caregivers and doctors to develop the findings. The committee called the care “limited and inadequate.” It found that current treatment emphasizes opioid painkillers and had little in the way of alternative treatments such as biofeedback, yoga or acupuncture. It recommended that the DoD and VA accelerate research and ensure that the departments work with private-sector researchers to discover new treatments. It also recommends Congress provide additional funds for research and calls for better oversight within VA and DoD of patients’ medications.

Virtual Reality Therapy Improves Coordination in Young TBI Patients

In early October 2013 Ksenia Ustinova, PT, PhD, an associate professor of physical therapy in the School of Rehabilitation and Medical Sciences at Central Michigan University in Mount Pleasant, told the World Congress of Neurology about her success with virtual reality (VR) therapy with young TBI patients. Dr. Ustinova used VR therapy over a computer to teach six different exercises to patients in their homes or at a clinic. The simple Microsfot Xbox Kinect system was able to measure their movements. Each session took 55 minutes and showed how to improve coordination, sitting balance, and eye-head coordination. After 5-6 weeks the test subjects showed definite improvement in all of these areas.

The major limitation of the study was the lack of a control group to demonstrate how much of these improvements were due to the VR therapy rather than natural healing over time. Dr. Ustinova’s next step will be to do a larger study with a broader age range and an age-matched control group. However, the preliminary results are promising.

How Stem Cells Repair Cellular Damage from a TBI

Stem cells harvested from adult bone marrow can be cued to grow into brain cells and then transplanted into the brain of a mammal in hopes of repairing brain damage from TBI or stroke.

In the past there were two theories regarding how the repair was done. One theory was that the transplanted stem cells grew new brain cells which replaced the dead or dying brain cells at the site of injury. The second theory was that the stem cells secreted a neural growth factor that helped the damaged cells heal.

In early October 2013 researchers led by Cesar Borlongan, PhD. at the University of South Florida published a paper in the online journal PLOS ONE setting out a third theory based on an experiment with rats. In the experiment they used two groups of rats with a TBI which displayed problems with movement and neurological function. One group received a stem cell transplant near the site of injured brain tissue, while the other received no treatment. The treated group showed good recovery of movement and neurological function, while the untreated group showed minimal recovery.

On autopsy the researchers found that the transplanted stem cells in the treated group had cued enhanced activity in the sub-ventricular zone of the rats’ brains, which pumped out new neurons, and the stem cells had also acted as a kind of “bio-bridge” to guide the movement of these freshly made brain cells to the site of brain injury. Based in part on this data the FDA recently approved a limited clinical trial to transplant SanBio Inc’s SB632 cells (an adult stem cell therapy) in patients with traumatic brain injury.

Stanford Professors Translate Seizure Activity Into Music

People who sustain a severe TBI sometimes develop epileptic seizures – either temporarily or permanently. Have you ever wondered what a seizure sounds like? To do that you have to find a way to listen to the patient’s neuronal circuitry when it fires normally in synchronous rhythm and when it fires abnormally in asynchronous rhythm. Well, this has now been done. Josef Parvizi, a neurologist at Stanford Medical Center, teamed up with Chris Chafe, a professor of music research at Stanford who is one of the world’s foremost experts in “musification,” the process of converting natural signals into music.Together they were able to convert EEG signals from a seizure patient’s brain into music resembling a human voice. When you listen to the music it is truly astounding how well you can grasp what is happening in the brain and how much empathy you feel for the patient. This is an amazing breakthrough.

To listen to the musical representation of a real seizure on Youtube follow this link http://youtu.be/n0T2uB-GLc8

New Device to Predict Severe TBI Outcome Almost Ready for FDA

On October 1, 2013, Luoxis Diagnostics (a subsidiary of Ampio Pharmaceuticals, Inc) announced the results of its five year multi-center study on the use of a device at bedside to predict the outcome of severe TBI.

The results confirmed that measurement of ORP is an accurate gauge to outcome. ORP stands for oxidation-reduction-potential. When ORP is high it means the patient’s brain is highly inflammed and undergoing severe oxidative stress along with severe depletion of anti-oxidants to combat inflammation. When the device shows very high ORP the patient is likely to die or come out with severe disability. At this point the device is nearly ready to submit to the FDA for regulatory approval.



Preventing Alzheimer’s Dementia From a TBI

Research on older U.S. veterans with a TBI shows a doubling of the risk of Alzheimer’s dementia over people of like age without a TBI. How can someone with a TBI cut their risk of Alzheimer’s? New research by Dr. George Bartzokis, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA shows that excess iron in the brain is an earlier contributor to the development of Alzheimer’s than the development of beta-amyloid plaques in brain cells.

The excess iron damages the hippocampus (the brain’s memory center first) and only after this damage occurs do the beta-amyloid plaques appear. Dr. Bartzoki recommends cutting back on dietary sources such as red meat and iron supplements unless you have anemia. This is something that could help. Dr. Bartzokis’ research was published in the August 2013 issue of the Journal of Alzheimer’s Disease.