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Neurocognitive Evaluations: What They Are and How They Work

Neurocognitive Evaluations and Their Functions

Our brain is capable of performing so many different functions such as remembering things, solving problems, making decisions, understanding instructions, and appreciating art. 

Sometimes these brain functions can decline due to a concussion, a stroke, or conditions such as sleep apnea or depression. When this happens, you can not keep up with your responsibilities at home or at work.

Neurocognitive Testing VS MRI

You know something is wrong, but you yourself can’t quantify which of your brain functions have been affected, and by how much.

Diagnosing brain problems can be a tricky business. Brain MRIs’ can give us nice pictures of the brain, but most of the time, they cannot explain why a person is slow in getting things done or why a person with concussion cannot drive. 

Fortunately, neurocognitive testing can help. This testing can unravel the strengths and weaknesses of your brain so that your spouse, your employer, or your disability insurance can understand what is going on inside your head – and provide you with the accommodations and services you may need. 

In short, neurocognitive evaluation is a great way to check in with your brain without having to undergo expensive and complex medical procedures. Read on to learn more about this testing and how it works.

What Is Neurocognitive Testing?

Neurocognitive testing is the best non-invasive way to test your brain’s level of functioning as compared to people with your age and education. 

A brain MRI can only give pictures of your brain’s anatomical structure. These images are not that helpful in most patients with neurological symptoms, as such symptoms are a result of abnormalities in the level of activity in different brain regions, not their size or appearance.

For example, patients concussion, depression, memory loss, or migraine all have normal brain MRI. They suffer from a great deal of “cognitive deficits,” but their brain MRI does not show anything abnormal on the outside. 

Neurocognitive testing uses objective pencil-and-paper or computerized tests to determine your cognitive function. Think of it as a vision test for your brain. Rather than examining the physical structure of your brain (which can be done with a MRI), neurocognitive function measures your brain’s functions and level of performance compared to other people with your age and level of education.

Why Use This Method

Neurocognitive testing shows the outcome of whatever’s happening in the brain, which can unravel your strength and weaknesses.

Neurocognitive testing shows the outcome of whatever’s happening in the brain, which can unravel your strength and weaknesses.

No other test, including expensive brain MRIs (which give information about the cold anatomy of your brain) or new brain PET scans (which give information about the metabolic activity of your brain), can reveal a true picture of what is really happening inside your brain with regards to the things that matter to you in a day-to-day life.

Neurocognitive testing can answer the following questions: Are you capable of solving problems quickly? Are you able to memorize things at a level appropriate for your age? Can you do multitasking? Can you pay attention and maintain focus for a long period of time?

Neurocognitive testing is commonly used for assessment of patients with concussions, which we’ll discuss more in-depth later. But this testing can also help diagnose everything from childhood ADHD to early dementia.

Neurocognitive testing can help catch your level of functioning in different medical or neurological conditions such as anxiety, depression, OCD, migraine, and bipolar disorder. Neurocognitive testing can pick up on subtle changes in the brain; it also can be useful to measure how a person improves with rehabilitation and when he/she can return to work or playing sports.

Catch Problems Early

One of the big advantages of neurocognitive testing is the time it can save in coming to a diagnosis. Within 2-3 hours of testing, results can reveal if a patient’s memory, attention, concentration, problem solving, processing speed, “executive function,” or language ability are within the normal range or not. 

For a patient who suffers from mild traumatic brain injury, results of neurocognitive testing can establish how much brain rehabilitation they need and estimate when they can return to their normal self. 

No other test can provide such practical information; often patients go from one doctor to another and undergo a large number of tests (brain MRI, head CT, EEG, or vision testing) – none of which unveil what the patient is suffering from.

So the sooner this testing gets done, the sooner a patient (and his family, coach, or employer) can decide what needs to be done right away and what can be expected in the coming weeks or months.

What’s Involved

In many cases, a test administrator gives you a series of computer-based brain tests (similar to brain games) to measure your memory, attention, ability to process information quickly, do multi-tasking, or solve problems.

You will also complete a series of questionnaires about your mood, sleep, diet, exercise, or level of stress in your life.  

Sometimes your test administrator may start by asking you to repeat lists of words or numbers as a memory test. They might ask you to explain how two things, such as coffee and tea, are alike. You may be asked to name items as your administrator points at them or list words that start with a certain letter of the alphabet.

The testing process itself can help you better appreciate what things you are good at and what things you struggle with. 

Knowing When You Need It

So how do you know when you need to get a neurocognitive test done? If you feel you are not quite as sharp as you used to be or if you find that you need to put more effort to complete your routine tasks at work or at home, you may have had a decline in your brain function.

This can be due to a car accident, due to adult attention deficit disorder, due to mild depression, or due to lyme’s disease or exposure to mold.  

It’s not a bad idea to get a neurocognitive test done every now and then even if you don’t think there’s anything wrong.

This can help establish a baseline for your normal cognitive function. That way, if there ever is a problem, you can catch it more quickly.

Neurocognitive Testing and Concussions

We’ve all seen the scene in action movies where the hero gets knocked unconscious and when he wakes up is asked “Who’s the president of the United States?”

This is a form of neurocognitive testing. The person who asks that question is trying to determine without complicated medical tests if the hero has a concussion.

Neurocognitive testing can be a very effective way to test for concussion. Often, a person with a concussion will be disoriented, have slower reaction times, and have trouble focusing.

Sometimes they may have subtle problems such as difficulty understanding instructions, difficulty doing calculations in their head, or being able to follow the steps in cooking.  These are all things that can show up on a neurocognitive test.

Get Neurocognitive Testing Done

Neurocognitive evaluations are a great way to keep a finger on the pulse of your brain’s level of performance.

It can pick up on subtle changes in your mental function, alerting you to problems before you may even notice it yourself. This can help you get the right treatment more quickly, getting you back to your normal life.

If you’d like to set up a neurocognitive test, get in touch with us at NeuroGrow Brain Fitness Center. We offer testing services, as well as brain coaching to strengthen any weak areas your test may find.

Contact us today to start improving your brain performance and get back on track. These tests are often covered, at least in part, by most private insurance companies. 

Neurofeedback: Your Complete Guide to What It Is and How It Works

How Neurofeedback Works

Do you struggle to maintain your attention when you read?  Do you have a hard time falling asleep or staying sleep at night?

Maybe you have difficulty finding the right words in conversations. Or you might be struggling with your performance at school, home or work. Even worse, you might be suffering from anxiety.

If you have any of these issues and would like to overcome them without medications, there is a new treatment protocol that may be just perfect for you: Neurofeedback.

This drug-free program of improving your brain waves has been shown – through hundreds of published studies – to help patients with insomnia, anxiety, concussion, memory loss with aging, addiction, and ADHD symptoms. 

The Origins of Neurofeedback

Neurofeedback first began in the late 1950s and 1960s. Dr. Joe Kamiya conducted studies using electroencephalogram (EEG) to look at consciousness. He found that by using a simple reward system, his subjects could change their brain activity.

The Cat Study

Dr. Barry Sterman later worked with cats to alter their brain activity by giving them treats when they responded in the right way. His work aimed at teaching the cats to increase their sensory motor rhythm (SMR). The cats learned to change their brain patterns to get the treat.

Years later, Dr. Sterman worked with NASA to test the effects of lunar landing fuel exposure. Once again, he used cats in this experiment.

When the cats were exposed to the fuel, their brains experienced instability. First, they became drowsy and then developed headaches, hallucinations, and seizures. The cats finally died from the exposure.

Amazingly, the cats from Dr. Sterman’s previous experiment did not experience these deadly effects. Their previous training seemed to have made their brains ultra-resistant to the toxic fuel.

Using these findings, Dr. Sterman began training patients with epilepsy in SMR to decrease their seizures. Sixty percent of his patients experienced lasting reduction of their seizures by 20 to 100%.

To this day, NASA’s astronaut training program incorporates SMR and neurofeedback training. Outcomes include increased focus and brain resiliency as well as decreased stress.

How Neurofeedback Can Benefit You

Electrical impulses, or brain waves, move through the brain and account for your ability for all the things you do such as walking, typing, cooking, or driving as well as eating, going to the bathroom, sweating, or getting scared.

Brain waves determine how we feel, how we interact with others, how well we sleep, and how organized we are. 

When our brain waves are too slow or too fast, we may feel too sluggish or too nervous. Harmonized brain waves are essential for feeling good and functioning in the optimal range. 

Neurofeedback is a type of biofeedback that helps you harmonize your brain waves, naturally (without medications). During the neurofeedback sessions, your brain “learns” how to bring abnormally fast or slow waves into the normal range.  You sit back and watch a movie while we monitor your brain waves.

When your brain waves are good (i.e. they are in the optimal range), you are rewarded by watching the movie without interruptions.

But when you get distracted and your brain waves slip into the abnormal range, the screen in front of you fades; this negative experience tips your brain to move its oscillations toward the optimal range.

As soon as this happens, you (i.e. your brain) is rewarded by having the movie continue without any pauses or fading.

Much like a dog “learns” to catch a ball in order to receive a reward, your brain “learns” to optimize the brain waves that are associated with being calm and focused. In other words, your brain gets rewarded when your brain waves (based on the EEG feedback) are harmonized. 

Problems That Can Improve with Neurofeedback

Traumatic brain injury (TBI) has become a hot topic as long-term effects in athletes have come to light. Common consequences of concussions include migraines, general anxiety, sleep disorders, and cognitive problems. Neurofeedback training has helped 68.2% of TBI patients improve in 5 of 15 areas of their brain functions.

There are several other conditions that improve with neurofeedback training. 

Individuals living with attention deficit hyperactivity disorder (ADHD), strokes, post-traumatic stress disorder (PTSD), anxiety, seizures, age-related memory loss, and sleep disorders have shown improvement in different aspects of their cognitive abilities and their daily functions. 

Neurofeedback programs may also be helpful for individuals with:

  • addictions
  • anger management
  • chronic fatigue syndrome
  • eating disorders
  • headaches/migraines
  • learning disorders
  • obsessive compulsive disorder (OCD)
  • oppositional defiant disorder (ODD)
  • pain management
  • insomnia

Athletes are also using neurofeedback to enhance focus, decrease stress, and to boost their performance.

How Is Neurofeedback Done?

Let’s assume you have some difficulty with attention, anxiety, or sleep and you want to improve your brain waves. To begin, we arrange for you to complete a qEEG (also known as brain mapping). 

Our EEG technician first places a cap on your head that has 20 holes in certain places. Gel, which usually feels cool on your scalp, is placed in each of the holes. Sensors are embedded into each of these holes and can record your brain’s electrical impulses.

We obtain recordings of your brain’s electrical impulses both when you are fully awake and when you are relaxed with your eyes closed.  

Your unique brain waves are then compared with a “normative database” and a map is generated to show which parts of your brain are too fast and which parts are too sluggish, or if your brain waves are not operating in a harmonious way.

Dr. Fotuhi reviews your brain map, and in a combination of his knowledge of the specific brain symptoms you have, he orders a specific neurofeedback protocol for you; this protocol will help you move your brain waves toward the normal range in order for you to feel calmer and more focused.  

Our EEG technician follows Dr. Fotuhi’s protocol recommendation and sets you up for your first neurofeedback session. 

During the training, you sit in a comfortable chair and watch a movie on a computer screen. The screen fades when your brain waves are too fast or too slow, but the screen becomes bright instantly when your brain waves are normalized. 

As you watch the movie, you see that the screen fades in and out. Each fading reflects how your brain waves were outside the optimal range for a few seconds, and each correction of this fading reflects how your brain figured out to correct itself.

Your brain “keeps learning” with each fading and its correction. Each neurofeedback session usually lasts 45 minutes. You will receive neurofeedback twice a week for 12 weeks.

By the time you finish your neurofeedback treatment protocol in three months, you become calmer and more focused. You feel sharper and faster.

How Do You Prepare for a Neurofeedback Session?

Planning and preparing for your neurofeedback session can improve progress toward treatment goals. Here are several suggestions that you may wish to consider before you sit on your comfortable neurofeedback chair:

  • get plenty of rest the night before
  • turn off your mobile phone and other electronic devices
  • avoid or decrease caffeine intake that day
  • wash your hair so that it is clean and dry

What Questions Should I Ask My Healthcare Provider?

It is prudent to create a list of questions when seeing a healthcare provider or starting a new treatment program. Here are some questions you may have before you start a 12-week neurofeedback program:

  • How long are the treatment sessions?
  • How often are treatment sessions scheduled?
  • Will I be able to return to work immediately after a session?
  • What do I have to do to before each session?
  • Are there things I will need to do between sessions?
  • How soon will I know if the treatment is working?
  • How much will the treatment cost?
  • Does insurance cover this treatment?
  • Can I take my regular medications during my treatment program?

 Is Neurofeedback for You?

Do you struggle to get through your daily life? Have you always had this problem, or do you know what caused it? Neurofeedback can greatly improve your quality of life.

People who receive neurofeedback treatment usually describe their experience as an interesting and absorbing experience. They also say that it feels euphoric and very relaxing.

Consider exploring neurofeedback to  improve your mood, your sleep, and your ability to function better on a daily life. 

qEEG Testing 101: What Is It and How Does It Work?

The Functions of qEEG Testing

Do you have a concern about your brain functions such as memory, attention, sleep, or anxiety? Do you know someone with a brain condition? Chances are that you answered Yes to one or both questions.

Though brain-related conditions are widespread, most of them are treatable. 

New diagnostic modalities, including qEEG, provide healthcare professionals with needed information for effective treatment interventions. You may not be familiar with qEEG, but this technique was first developed more than 70 years

Let’s take a closer look at our brain and how modern medicine is improving lives.

How the Brain Works

Many people do not realize that our brain is powered by electrical processes. In healthy brains, electrical impulses account for every single brain function, from blinking an eye or solving complex puzzles.

Problems result when interruptions occur in the movement of the electrical impulses.

When parts of the brain are overactive or underactive, or if the neurons do not fire in harmony, a wide variety of neurological condition will ensue.

Changes in the level of brain wave oscillation can result from many different causes such as:

  • Stressful environment
  • Medications
  • Recreational drugs
  • Strokes
  • Alzheimer’s Disease
  • Seizure disorders
  • Fetal alcohol syndrome
  • Decreased oxygen to the brain
  • Too much or too little thyroid
  • Vitamin deficiency
  • Anemia
  • Genes you inherit from your parents

What Is a Standard EEG?

A standard EEG measures the brain wave pattern and looks for interruptions or abnormal movement of electrical impulses in the brain. During the test, the EEG technician records your brain’s bursts of electrical activity. They also provide different stimulus, such as shining a light, and measure corresponding electrical activity in the brain.

EEGs assist in diagnosing conditions such as epilepsy, sleep disorders, and finding the causes for confusion or coma. 

How Is qEEG Testing Different?

A quantitative electroencephalogram or qEEG also looks at these electrical activities in multiple parts of the brain. qEEGs are also called “Brain Mapping” or topographic EEG.

This test allows healthcare providers to make interpretations about what is happening in the brain and to look for areas in the brain that show too little or too much activity. 

The qEEG adds the use of modern computers and statistical analysis to the standard EEG and helps with the diagnosis and treatment of ADHD, anxiety, depression, OCD, and insomnia. The FDA has currently approved six qEEG systems for clinical use by qualified healthcare providers.

How Is the qEEG Test Performed?

This is a non-invasive test. You sit in a comfortable chair during the procedure. A sensor cap is placed on your head that captures the pattern of electrical activity throughout your brain; it fits like a swim cap on your head and contains 19 EEG electrodes. There is no risk of any harm during this procedure; these sensors only listen (record) your brain’s electrical impulses; they do not emit any electrical activity on their own.

The brain’s electrical activity is measured on multiple places on the scalp, from above your eyebrows to the back of your head – once with your eyes open and once with your eyes closed. The multiple electrodes allow for the evaluation of many areas of the brain at the same time. The procedure lasts between 30 and 45 minutes including preparation time. 

Once you finish with the test, your results are compared to a database containing brain maps of healthy, normal people of the same age. The information obtained by qEEG help your healthcare provider develop a targeted and effective plan of care for you.

Neurofeedback Treatment Using EEG

One method of treatment includes a form of biofeedback called neurofeedback.

During neurofeedback, you are connected to an EEG that monitors your brain wave patterns. You watch a movie or TV show on a TV or computer monitor.

The machine monitors your brain waves while you watch the movie or TV show and will alter the image in response to your brain activity.

The image may dim or flicker. Your brain is rewarded when the activity is within the normal range.

The theory behind all types of neurofeedback is to allow your brain to learn new patterns of electrical activity that is associated with being calm and focused; your brain “learns” to work in a way that will improve your day-to-day function.

Neurofeedback works (https://www.youtube.com/watch?v=P36y7Iralfw&t=5s) for helping patients with a variety of conditions such as:

  • ADD/ADHD
  • Anger management
  • Anxiety
  • Chronic Fatigue Syndrome
  • Chronic pain
  • Depression
  • Drug, Tobacco, and Alcohol Addictions
  • Eating disorders
  • Headaches and Migraines
  • Learning Disorders
  • Obsessive Compulsive Disorder (OCD)
  • Oppositional Defiant Disorder (ODD)
  • Pain management
  • Seizure Disorders
  • Sleep Disorders
  • Stroke
  • Traumatic Brain Injuries

There is a great deal of scientific evidence for the effectiveness of neurofeedback in improving your memory, attention, mood, sleep, and many other brain-related problems. (https://www.youtube.com/watch?v=FFHg9jO8fCc&t=6s

Improving these health problems can greatly increase your quality of life and day-to-day productivity. 

What Questions Should You Ask Your Doctor About qEEG and Neurofeedback?

It is often helpful to write a list of questions down to take to your doctor’s appointment. Many people are not familiar with qEEG testing. 

Here are some questions to get you started:

  • Do I need to stop taking any of my routine medications?
  • How long can I expect the test to take?
  • What do I do If I am sick?
  • What do I need to do to prepare for the test?
  • Do I need to shampoo my hair before the test?
  • Can I eat and drink after midnight before the test?
  • Do hair products such as dyes or styling products affect the results?

Do not hesitate to ask your health care provider questions. The test results are more accurate when the patient is relaxed and properly prepared for the test.

Visit our page for more information on qEEG testing and neurofeedback (https://www.youtube.com/watch?v=FFHg9jO8fCc&t=6s).

The Terrible Teens: How Our Brains Change

Does our brain go through a remodeling during teenage years? Yes. Absolutely.

Our brain keeps making new cells and remodel pathways for balance, memory, and emotional control during early childhood. The last set of pruning, updating, and renovation of these neuronal pathways happen during teenage years.

These substantial changes in the brain structure account for why teenagers may experience turmoil in their behavior and do things that don’t always make sense. Once these changes our completed, our brains are in top notch condition in our 20s.

Beyond that, our brain maintains its ability for plasticity and repair; it changes for better or for worse, but not to the same degree that happens in our teenage years. 

Given that anatomical changes happen to the brains of teenagers, we (as parents) need to be patient with them. We need to allow them to find their new pathways in life and guide them to make good decisions.

Also, we need to help them eat well, sleep well, and exercise a lot. And of course, we should help them avoid concussions or drug abuse.

Brain Proteins: Amyloid And Alzheimer’s

Is the simplistic concept that too much amyloid causes late-life Alzheimer’s correct? No. Absolutely not. In the 1960s some researchers proposed the hypothesis that too much accumulation of a protein called Amyloid can cause shrinkage in the brain which then leads to dementia (called Amyloid Cascade Hypothesis).  Initially, it looked like we were finally going to cure Alzheimer’s disease once and for all. But more and more research failed to show that amyloid plaques “cause” brain shrinkage.

Pharmaceutical companies spent billions of dollars on finding drugs that reduce levels of amyloid in the brain. They were successful in doing this, but the patients who took the drug did not improve. Many pharmaceutical companies finally realized that amyloid may not be the key target for prevention or treatment of Alzheimer’s disease, but the research community in this field keeps pushing the cascade hypothesis. 

I think Amyloid is likely a marker for damage to the brain, more so than being the culprit itself; it is the smoke, not the fire. Lack of sleep, concussion, and vascular risk factors have all been associated with too much amyloid in the brain. We need to focus on factors that have been shown to improve brain health, such as exercise, diet, and quality sleep for ways we can prevent late-life cognitive decline. 

Does Alcohol Shrink Your Brain?

Can Drinking Too Much Cause Your Brain to Shrink?

Can too much alcohol prime your brain for getting Alzheimer’s disease? Yes. Absolutely. Too much alcohol can shrink your brain. 

It can also impair your brain’s ability to clear the accumulation of toxic Alzheimer’s protein called amyloid, which will put you at risk of getting Dementia.

But let’s dig into this a bit deeper. How much alcohol is too much, and what kind of impact will alcohol have on your brain? 

These are some questions I like to explore because neuroscience is my passion, and I hope that everyone takes hold of the ability to grow their brains. 

It is the steps that you chose to take in your daily life that impact the longevity of your brain’s health and prevent disease later on in life. So let’s dive in together and figure out the factors that affect how much alcohol is too much. 

How much alcohol is healthy to drink?

There are some things which you should consider on a personal level before deciding how much alcohol is too much. And we will go over these things, but first let’s talk about drinking in moderation standards in the US.

According to the US Department of Health and Human Services, and the US Department of Agriculture, moderate drinking is defined as “1 drink per day for women and two drinks per day for men.”

Drinking one or two glasses of alcoholic beverages (maximum of one per day for women and two per day for men)  can have some anti-inflammatory benefits for the brain and the heart. But this suggested amount relies on several factors. 

You should only consider drinking 1-2 glasses daily if you already exercise at least 45 minutes 4 times a week. Another factor is sleep; you need to have 8 hours a night.

How are your stress and anxiety levels?

Drinking regularly combined with a low-stress lifestyle, and proactive desire to continually challenge your brain daily is a must. 

If you are not doing these things, then you should limit your drinking to social occasions on weekends only. 

If you already have memory problems, you should not drink even one drop of alcohol. It will expedite the rate of your memory loss with aging. 

Pathological Changes in the Brain

While these are the drinking in moderation standards in America, it is essential to recognize the scientific-based data on drinking in moderation and its impact on the brain. 

According to a study done by the British Medical Journal, moderate drinking may not be so good for your brain. 

Researchers from the University of Oxford and University College London studied 550 men and women over 30 years. Researchers followed and measured the brain function and structure of participants. They did this to determine how moderate alcohol consumption affects the mind over time. 

Participants in the study periodically underwent tests that challenged their thinking skills. At the end of the study, all participants had MRI scans taken of their brains. 

The results came in and suggest that drinking just over seven drinks or less a week did not hurt or enhance brain health. However, drinking over seven alcoholic beverages per week did impact brain health. 

Studies proved that eight or more drinks per week directly correlates with shrinkage of the hippocampus, which is a part of your brain that is very important for memory. But the results found more.

Drinking more than eight drinks per week was found to cause deterioration of white matter in the brain which deals with your brain’s internal wiring. Both of these parts of your brain are associated with a decline in thinking skills. 

How Much is too Much?

So how much is too much? More than seven drinks a week is most likely too much. You need a healthy brain to live a long and happy life. 

The most important takeaway is that your lifestyle is what is going to impact your brain health more than anything else. 

If you are coming home every day and looking forward to a glass of wine instead of a good read or run around the block, health issues will arise.

If you find that you forget things very often, and you still use alcohol on a daily basis, your ability to remember things will decrease faster over time. 

So take a look at your lifestyle. Are you are active, passionate, and engaging? Do you participate in regular brain-stimulating activities like meditation, memorization, and exercise?  If so, go ahead and follow the rules suggested for moderate consumption. 

It is essential to be mindful about your specific situation and take the healthiest steps possible. 

Grow Your Brain

Your brain actually has the ability to grow. Participation in activities that could cause some of the most important functions in your brain to demise overtime is not what’s best for your body.  

Drinking can be a nice way to relax, and these are just the facts behind how alcohol can impact your brain’s health. It is really up to you to decide what to do with them in your daily life. 

If you would like to work on your brain health and cognition, our 12-week brain fitness program might be the right fit for you!

Risky Business: Contact Sports

Is there a link between frequent violent hits in hockey and the risk of dementia late in life? Yes. Absolutely. To say there is no link between severe concussions in hockey and risk of dementia late in life (CTE) is like saying there is no link between smoking and lung cancer. We need new rules to stop the violent hits in hockey.  Thousands of hit to the brain, in any sport, can lead to dementia later in life. I respectfully disagree with the NHL commissioner, Mr. Bettman.

All About Concussion Follow-Up Care

Do patients with concussion, also known as mild TBI, receive adequate follow-up care? No. Absolutely not. About 3 million Americans have some symptoms due to a concussion.

Fewer than half of these patients are scheduled to receive follow up care. Even patients with multiple concussion do not receive adequate care, in part because the name “mild Traumatic Brain Injury” is misleading; there is nothing “mild” about having daily headaches, dizziness, nausea, difficulty doing simple tasks such as typing, cooking, or driving as well as not being able to read, understand, or manage your daily affairs.  But why is this?

Unfortunately, there are no guidelines on “standard of care” for concussion the same way we have standards on how to care for patients with diabetes, heart failure, multiple sclerosis, or hypertension.

Moreover, physicians do not have any instructions on how to care for patients who often have multiple interacting symptoms such as irritability, insomnia, poor attention, and inability to organize their daily tasks.

Those patients who do show up for regular follow-up care often get fragmented treatment by specialists who focus only one aspect of their symptoms (such as insomnia or attention – not taking full responsibility for all of their problems). 

Until we have standard guidelines and multi-disciplinary centers (such as our brain center) throughout the country, patients need to take an active role in caring for themselves.

They need to appreciate that their lingering symptoms can be treated and should insist on getting effective interventions that will end their misery – even if this means seeing multiple specialists and multiple treatment programs.  They should not accept their symptoms as their new “norm.” They should fight to get back to their usual self.

Does Running Help Your Brain?

Can running 30 minutes a day improve your mood, sleep, focus, and memory? Yes. Absolutely. Many recent studies have shown that running, by increasing blood flow and boosting levels of growth factors in your brain, can improve your mood, sleep, focus, and memory.  Running is the only way we know of to increase the number of your brain cells (neurogenesis) in the memory center of your brain (hippocampus). Even walking one mile a day can reduce your risk of Alzheimer’s disease by 48%.

Can You Grow New Neurons?

Is it possible to grow new neurons in your brain even if you are old? Yes. Absolutely. Here are some of the ways that you can increase the size of your brain, in part by growing new neurons and in part by growing new blood vessels, new connections, and new synapses:

  • Get fit — people who walk at least one mile a day reduce the risk of getting Alzheimer’s by 48 percent simply by increasing the amount of oxygen to their brain.
  • Eat a Mediterranean diet — rich in vegetables, fruits, whole grains, beans, nuts, olive oil and fish and low in red meat, processed foods, poultry, and dairy, eating a Mediterranean diet will make your mind sharper in six months and less susceptible to Alzheimer’s.
  • Have a purpose in life; follow your passion — studies show that people who have a sense of purpose in life can harbor significant amounts of Alzheimer’s pathology in their brain without showing the symptoms.
  • Take omega-3 supplements — omega-3fatty acids are highly concentrated in the brain and are important for healthy cognitive and behavioral functions.
  • Learn new things — the process of learning and acquiring new information and experiences can stimulate new brain cell growth.
  • Sleep well — poor sleep is a risk factor for cognitive
  • Meditate — a general consensus concerning cognitive decline has led many scientists to search for new preventive strategies, with growing evidence that meditation can serve as a potential tool.

How Concussions Affect The Brain

Can concussion injure the lining of blood vessels in the brain? Yes. Recent studies show that trauma to the brain can damage the lining of the blood vessels and make them leaky. Usually, the content of the blood cannot reach inside the brain because the blood vessels in the brain have three protective layers; this is called the Blood Brain Barrier. With TBI, it appears that the BBB becomes leaky so that molecules that do not belong to the inside milieu of the brain enter this protected environment and damage the brain cells.

This is similar to the way when your sink pipe breaks the water floods your carpets and wood floors.  Also, some of the content of the brain leaks out into the blood flow, and we can actually use this process to measure if someone has had significant TBI.  All of these happen in parallel to the direct damage that a concussion poses on the extensions of the neurons and causing small tears in them. These “micro-tears” cannot be seen on MRIs but cause severe symptoms in patients, such as not being able to think straight, being slow in processing information, and feeling sad or tired. 

Effective treatment of patients with a concussion should include interventions that would reduce leakage of blood into the brain and repair of the tears in neuronal extensions (axons). There are no specific medications to address these issues.

So, at this time, the best interventions include taking omega-3 fatty acids to protect the lining of the blood vessels and repair the tears in axons, to perform brain exercises that would help grow neurons and their extensions, to exercise in order to improve blood flow to the brain, and to do neurofeedback in order to harmonize and optimize brain waves and neuronal pathways.

These non-pharmaceutical interventions appear to be working well for our patients with concussion. More than 80% of them gain significant recovery of their symptoms.

Treating ADHD: Do Children Need Medication?

Is it possible to treat kids with ADHD without medication and see remarkable results?

YES! Neurofeedback, especially when combined with brain coaching, helps children with ADHD gain remarkable improvements in their attention, concentration, memory, and “executive function.”

Here is an example of one of the patients (9 years old) whose objective cognitive testing shows jaw-dropping results.

He keeps improving with continued treatment since his baseline testing last October (blue graphs). 

His April testing (green bars) demonstrate how his attention performance has improved from 8th percentile to 66th percentile and his overall brain performance (neurocognition index) has improved from 14th percentile to 63rd percentile. 

We did not give him any medications.

He only received brain coaching and neurofeedback. 

Traumatic Brain Injury: Can You Fully Recover?

Children (and adults) with traumatic brain injury often do not always receive adequate treatment for their symptoms

This is in part due to the fact that we do not have nationally accepted protocols for long-term treatment for patients with concussion. Most patients just get a lot of testing.

Get The Help You Need

At our NeuroGrow brain center, we do offer a 12-week “Concussion Recovery Program” and more than 80% of our patients gain remarkable improvements in their symptoms.

Majid Fotuhi, MD PhD

Reference: https://www.reuters.com/article/us-health-tbi-rehab/many-u-s-kids-with-brain-injuries-not-getting-needed-rehab-idUSKBN1HR2WG

Dr. Majid Fotuhi NeuroGrow Brain Fitness Center

If you have any questions or would like to request an appointment, please call us or complete the information below. If you are already a patient with us, you can contact us using your patient portal.

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Phone: 703.462.9296

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