Concussion Recovery Program
Dr. Fotuhi is an expert in the field of brain rehabilitation and gives lectures about effective treatment strategies for concussion at national conferences. His Concussion Recovery Program involves a comprehensive evaluation of all his patients’ symptoms followed by an integrated treatment program that addresses neurocognitive and neurobehavioral symptoms. Most of his patients get back to their work or school in a timely fashion.
Concussions can cause a wide variety of symptoms that affect your ability to function on a daily basis. As such, Dr. Fotuhi spends a great deal of time with you to learn about ALL of your concerns. He reviews your medical records, examines you, and orders tests that include cognitive evaluation and brain mapping qEEG.
Neurological Evaluation: Dr. Fotuhi will learn about your concerns and then review your medications, past medical history, and your previous evaluations.
Neurocognitive Testing: We will perform a battery of cognitive tests to establish your baseline.
Brain Mapping (qEEG): We use state-of-the-art EEG technology to establish your brain’s pattern of electrical activity and determine areas that can be improved with neurofeedback therapy. We then tailor a neurofeedback protocol (see below) to help put you become more calm and focused.
The most important factor in recovery is integrated and coordinated care. The Concussion Recovery Program includes a set of diagnostic evaluations followed by a series of therapeutic interventions, and emphasizes areas of the brain specifically affected by the concussion. We use brain coaching and neurofeedback to target all the symptoms of your concussion and address each in a way that is tailored to meet your specific needs.
Brain coaching: One of our enthusiastic brain coaches will work with you every week, for 12 weeks. These one-on-one training sessions will be personalized just for you. Based on the results of your cognitive evaluation and qEEG as well as your specific needs and concerns, you may receive training about meditation and stress reduction or training for memorizing a list of 20-100 items. Your brain coach will use effective, fun, and targeted brain games to help you improve your memory, attention, and executive function.
Neurofeedback: This cutting-edge EEG-based biofeedback therapy is designed to enhance and optimize your brain wave activity. It is a science-based and drug-free intervention to help you become calm and focused. For more information about neurofeedback, click here.
Mild Traumatic Brain Injury (mTBIs), commonly referred to as concussion, can cause dizziness, vertigo, headache, neck pain, sensitivity to light, sensitivity to noise, insomnia, irritability, memory loss, and an inability to get things done. Most patients feel they are functioning at 20% to 80% of their usual baseline. Sometimes, these nagging symptoms can last for weeks, months, or even years.
Patients with this condition, called post-concussive syndrome, often receive fragmented treatment for their individual symptoms from different experts, and as a result, they fail to achieve full recovery. At our brain center, you will first meet with Dr. Fotuhi. He has a great deal of experience in taking care of patients with headaches, sensitivity to light/sound, irritability, insomnia, memory loss, vertigo, and fatigue. Having taken care of more than 5,000 patients with variety of such symptoms, he is experienced in caring for patients who have post-concussive syndrome. These patients often have the above symptoms for months to years and feel frustrated by their failure to return to their baseline. Dr. Fotuhi, with the help of his multi-disciplinary program, gets patients on their way to full a recovery.
After your initial visit with Dr. Fotuhi, you will be scheduled to undergo a thorough neurocognitive assessment. We determine which of your brain functions are above average for your age, and which ones are below average for your age. We also use questionnaires to gauge your level of insomnia, daytime sleepiness, anxiety, depression, headache, irritability, dizziness, and sensitivity to motion, sound, and/or light. A Brain Mapping qEEG will help us measure the level of electrical activity in different corners of your brain. It uses small sensors similar to the ones used for a heart EKG to reveal if parts of your brain are running too fast, or if other parts are running too slow. You may also undergo a brain MRI, blood tests, or fitness testing, depending on your particular clinical issues.
Once you complete your thorough assessment, it becomes clear which parts of your brain need the most amount of training, and which aspects of your life need to most amount of improvement and coaching.
The treatment component of your program begins with your meeting with your brain coach. He or she will explain to you the specific components of your 12-week training with us, and answer all of your questions. During your subsequent brain coaching sessions, you may receive training and instructions for meditation, memory improvement, better organizational skills, exercising more, a brain healthy diet, and stress reduction. You will be assigned specific brain games that are tailored to boost your attention, concentration, processing speed, and recall.
At mid-program, after six weeks, you will repeat the cognitive evaluation and brain mapping qEEG. It will show you how you have improved and which areas of your brain function need further training. Your brain coach will review these results with you and help you become more confident and competent in your cognitive functioning.
At the end of the program, you will most likely have formed healthier lifestyle habits such as a better exercise regimen, better diet, better sleep pattern, and better organizational skills. When have your final cognitive evaluation and qEEG to capture your progress with objective testing. Dr. Fotuhi will review these results with you and answer any questions you may have.
The vast majority of our patients report remarkable improvements in their concussion symptoms and return to full time school or work activities.
Click here to see a PDF copy of Dr. Fotuhi’s lecture at a national conference in Williamsburg in May 2017. It outlines the main features of our 12-week program.
Jennifer was a 25-year-old soccer player who had a concussion two years ago. She recovered fairly well in a few weeks, but was never quite the same. Last year, she had two more concussions and had to stop playing in her team. As she put it, she could not think straight, was unusually moody, and everything took forever to get done. She was frustrated that she was always tired, had difficulty falling and staying sleep, and was not as sharp as she used to be. Loud noise, sensitivity to moving her head, almost daily headaches, and not being able to finish her college courses were aggravating her even more.
The first day she came to see Dr. Fotuhi she was wearing dark sunglasses inside the office and had large noise-cancelling headphones. She was clearly in pain as her husband explained her dozen different symptoms. She felt hopeless, especially since another neurologist had told her “this is your new you; get used to it.” She felt she was at about 20% of her usual self, as compared to how she was before her first concussion.
Her initial scores were all below average for her age. Her attention was at 5 percent level, compared to people her age. Her working memory was at 9 percentile. Her verbal memory was at 3 percentile. Her ability to be organized and perform tasks in sequence (executive function) was 12 percentile.
As she started the program, Dr. Fotuhi reduced some of the medications which were making her feel groggy. He recommended that she follow a migraine diet and reduce exposure to environments with loud noises or busy places for one month. She learned to meditate and perform breathing exercises. She received neurofeedback treatment and bonded with her brain coach who monitored her progress week by week. After six weeks, she was feeling much better. The dark sunglasses and bulky noise canceling headphones were gone. For the first time in a long time, she was smiling more often and her husband was thrilled. Her mid-term cognitive testing showed remarkable improvements in almost all of her cognitive domains, except for her executive function (the blue column on the right side of the graph below). For the second half of her program, she received more focused training to improve these specific brain functions. She received “homework” to do brain games that were selected for boosting her executive function.
By the end of the 12-weeks she was feeling great. She felt she was 90% of her usual self. Her executive function increased to the 87th percentile. Her attention had increased from 14 to 65 percentile. Her processing speed had increased from 9 to 73 percentile.
Her brain fitness score reflected her progress:
Her brain mapping qEEG also provided objective evidence that her brain waves had improved significantly (less abnormal “red” in the panel on the right, compared to the panel on left):