Monthly Archives: May 2009

Traumatic Brain Injury and Recovery

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I am often asked clinical questions pertaining to traumatic brain injury (TBI). There are two major types of TBI that include closed head injury (CHI) in which the skull is struck and does not fracture. The second type is known as open head injury in which the skull is struck and fractures (split the head open). Sometimes an open head injury is advantageous as it permits room for the predictable swelling or edema that occurs with head injuries. The problem with an open head injury is high risk for infection.

Closed head injuries are caused by a blow to the head from a motor vehicle accident, sports such as football, hockey, and even soccer, falls, and being hit by an instrument or other object. The brain sits in a liquid medium called cerebral spinal fluid and it will move inside the skull with an accelerating and then decelerating force. The brain can be injured at the site of the trauma (coup) and also on the opposite side of the brain as it moves in the liquid medium and hits against the skull (contracoup). As the skull is most rugged in the front and temporal skull regions with a smoother surface in the rear of the skull, it is common to experience cognitive and behavioral changes related to damage in the fronto-temporal region.

Such changes in cognition from a closed head injury typically involve memory, attention, and personality change. It is difficult to predict behavioral and cognitive changes related to open head injuries until the site of the damage is clearly known. Other factors such as loss and duration of loss of consciousness and memory loss that predates the time of the injury (retrograde amnesia) and post-dates the injury (anterograde amnesia) relate to extent and severity of the brain injury.

Treatment for TBI includes medication, surgery, speech, occupational, and physical therapy, and time. Improved function and cognition occurs primarily in the first year post injury, but improvement can continue to occur into the third year. Little is known about the effects of a proactive brain health lifestyle and or the consistent use of cognitive-based mental exercise software on recovery. This is an empirical question that is generating interest and attention.

The brain will heal to some degree, hopefully to a complete recovery, and one should not discount lifestyle for brain health and use of cognitive exercises to help in the process.

Implications of Poverty on the Brain

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Most advanced nations spend a significant amount of time, money, and energy dealing with poverty and the short and long term consequences for those who live in poverty. Policy statements are drafted and then implemented with varying degrees of success. One thing is certain, no policy has removed poverty suggesting that we either have not implemented the correct policy or poverty is a reality of life.

One aspect of poverty that probably does not receive enough attention is the negative health outcomes that result from such an environment. Studies many years ago demonstrated the negative effects of an un-enriched environment on rats. Interestingly, the brain was significantly affected both structurally and functionally. For humans, poverty really represents an unenriched environment in which poor nutrition, lack of love and attention, crime, drugs, insecurity, and lack of proper mental stimulation exist.

A nation enlightened to development of our youth and to creation of a policy that understands the impact of poverty will confront this reality. Research has demonstrated a correlation between poverty in childhood and increased risk for Alzheimer’s disease later in life. While there are short term consequences of poverty, there are also long term effects particularly when one understands that poverty limits proper development of the human brain.

Perhaps a first step in creating a policy on poverty is to educate the public on the importance of environmental input early in life upon later development of the human brain. Most families will work to follow such educational guidelines if they understand what to do with regard to promoting brain health for their own children. For those who are vulnerable and without resources or adults to provide the enriched environment policies can address what is needed and appropriate resources to help developing children thrive.

Baby boomers can eat their way to better health

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A healthy lifestyle is key to reducing the risk of illness and chronic disease. By reducing excess intake of calories, saturated fat, sodium and simple sugars and increasing intake of whole grains, fruits, vegetables, low-fat dairy and lean meats, baby boomers may help reduce their risk of developing heart disease, certain cancers, type 2 diabetes and osteoporosis.

A diet low in saturated fat is among the top recommendations from health professionals to promote heart health and reduce the risk of cancer. Registered dietitian and baby boomer Susie Langley recognizes the challenge of keeping active and eating well, but argues that with just a little more effort boomers could be better off in the long run.

Read More:Baby Boomers can eat their way to better health

Take the Fit Brains Brain Lifestyle Quiz

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The Brain Lifestyle Quiz is designed to help you learn more about your own brain health! The quiz uses research-based information to propose a healthy brain lifestyle relevant to your life. We recommend you repeat this survey every three months to see your progress.

Your brain health profile is comprised of five major areas:

  1. Nutrition
  2. Mental Stimulation
  3. Spirituality
  4. Physical Activity
  5. Socialization

Take the Brain LifeStyle Quiz

Exercise is not only good for the heart and lungs, it can keep the brain healthy.

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Studies show that those who exercise the most have bigger brain volumes in key areas than those who do not. Keeping fit may also slow the rate of age-related decline in the brain.

In the trial, 52 healthy men and women had their brains scanned, were interviewed and had their exercise data collected.

Brain volume in key areas  -  including the temporal lobe which is involved in language, memory and emotion  -  were significantly lower in those who did the least exercise, say the American researchers.

It’s thought exercise boosts the growth and development of brain cells.

Read more about Excercise and Brain Health

Games and Fun

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Stress is an outcome of a diverse and complex interface physiology and psychology that results in increased cortisol, anxiety, depression, cognitive dysfunction, and adverse bodily functions.

Research indicates a relationship between increased cortisol, increased depression, and increased risk of heart disease. Factors that promote stress and lead to this reaction need to be recognized, confronted, and changed. How does one reduce stress?

This is the million dollar question, but the answer does not need to be complicated. One simple remedy for stress reduction is to increase the amount of fun in your life. While this sounds great and even easy, Americans and others may actually find this difficult. Humans tend to fill up all the minutes in their day with tasks and forget to secure free time and fun time in their life.

Games are a good example of fun and stress reduction. Fitbrains.com provides online brain games for mental exercise and to promote cognitive functioning. These brain games are also fun and personal. Consumers indicate that two primary reasons they play online games (like the ones at Fitbrains.com) are for stress reduction and mental stimulation.

If you are experiencing stress in your life and need to try something new to help generate some fun in your life, I suggest you take a few moments and play a brain game or two at Fitbrains.com.

Have some Fun!

Nutrition – it does make a difference

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There are 5 major roles in determining how your body can react and handle stress:

1. Immune System
2. Diet
3. Weight
4. Mineral and Vitamin balance
5. Metabolism
According to the Fibro and Fatigue Inc (2008), a baseline analysis is a critical component to understanding your body’s metabolic balance. Research shows that nutritional imbalances may manifest themselves with a number of symptoms, exacerbate existing conditions or led to chronic conditions/disease.

…..Nutrition – it does make a difference

More Americans taking drugs for Mental Illness

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Significantly more Americans are taking prescription drugs for mental illness since 1996 according to a new study. Researchers believe the increase is due in part to expanded insurance coverage and a greater familiarity with the drugs among primary care doctors.

The findings indicate 73% more adults and 50% more children are using drugs to treat mental illness than in 1986. Among those over the age of 65, use of psychotropic medication has doubled between 1996 and 2006. Similarly, children diagnosed and treated for mental health conditions by their primary care physician have doubled between 1996 and 2006.

Mental health has become more of a mainstream issue within overall health and access to such care has improved. One problem the researches underscore is the lack of access to mental health services by the severely mentally ill. Lack of treatment can lead to these individuals ending up in the criminal justice system according to the researchers.

While the researchers point out that access to mental health services has increased significantly and that this is a positive outcome, it is also reasonable to question if something else besides access accounts for increased utilization of psychotropic medication. In particular, why are so many children being treated for mental health problems and being treated with medication?

It is important for the United States and all nations to provide appropriate diagnostic and treatment interventions. This includes medication and non-medication treatments and certainly a greater reliance on proactive rather than reactive approaches to care.

What is Dementia?

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Dementia is a clinical term that describes a loss of general intelligence from a previous level. There also needs to be a memory deficit and other cognitive problems such as language or visuospatial prolems. Personality is changed and there is functional decline.

It is important to note that there are approximately 100 different causes of dementia with Alzheimer’s Disease (AD) being the number one cause. AD accounts for nearly 50-70% of all dementias and 95% of all dementias are irreversible. Examples of reversible dementias include B12 deficiency, thyroid disorder and depression.

It is important to seek a comprehensive dementia workup if there is any question that a loved one may be demonstrating signs of a dementia.

To Learn more about Brain Plasticity & Cognitive Reserve