Concussion Recovery Program
Dr. Majid Fotuhi, MD, PhD, is the medical director of NeuroGrow Brain Fitness Center. Dr. Fotuhi is a neurologist as well as a research neuroscientist, with expertise in the field of brain rehabilitation. Dr. Fotuhi developed NeuroGrow’s 12-week Concussion Recovery Program based on the results of research studies conducted at NeuroGrow, and on those performed at external institutions. The Concussion Recovery Program is designed for patients with post-concussive syndrome, a condition that affects between 10 and 15% of individuals who suffer a concussion. In post-concussive syndrome, the symptoms following the concussion (described below) do not resolve on their own, and instead persist for at least 3 months following the initial injury. The comprehensive Concussion Recovery Program begins with a thorough evaluation of each patient’s medical history, medication use, and post-concussive symptoms (neurological, psychological, and physical). Additionally, patients are evaluated with a medical and neurological exam before the program begins, to establish their baseline condition. This is followed by an integrated and personalized 12-week treatment program that is designed to address each patient’s symptoms, and to help them achieve peak brain performance. The vast majority of our patients report remarkable improvements in their concussion symptoms, and return to full time school or work activities.
What to Expect at Neurogrow
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.
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.
Concussion and Post-Concussive Syndrome
Mild Traumatic Brain Injury (mTBI), commonly referred to as concussion, can damage or alter the function of neurons and blood vessels in the brain. Patients may experience dizziness, vertigo, headache, neck pain, sensitivity to light, sensitivity to noise, insomnia, irritability, memory loss, and an inability to get things done (among other possible symptoms). Most patients who enroll in the Concussion Recovery Program feel they are functioning at 20% to 80% of their usual baseline as a result of their concussion. Sometimes, these nagging symptoms can last for weeks, months, or even years. If symptoms persist for at least 3 months following the initial injury, the patient may be suffering from post-concussive syndrome.
Patients with 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, patients will first meet with Dr. Fotuhi. He has many years of experience with taking care of patients with headaches, sensitivity to light/sound, irritability, insomnia, memory loss, vertigo, and fatigue, having cared for over 5,000 such patients during his career. These patients have often suffered from these symptoms for months to years, and feel frustrated by their failure to return to their baseline (pre-concussion) level of function. Dr. Fotuhi, with the help of his multi-disciplinary Concussion Recovery Program, gets patients on their way to a full recovery.
Format of Concussion Recovery Program
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. 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 helps us measure the level of electrical activity in different regions of your brain. It uses small sensors similar to the ones used for a heart EKG to reveal whether parts of your brain are running too fast, or too slowly. You may also undergo a brain MRI, blood tests, or fitness testing, depending on your particular clinical issues.
Once you complete your thorough assessment, you will meet again with Dr. Fotuhi to discuss the results. At this point, it will become clear which parts of your brain need the most training, and which aspects of your life need the most improvement and coaching. Dr. Fotuhi will discuss the personalized Concussion Recovery Program treatment plan designed for you, and answer any questions you may have.
The treatment component of your program begins with a meeting with your brain coach. He or she will explain 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, improved exercise regimen, 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. Dr. Fotuhi and 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. At this point, you will take 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 for 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 asleep, 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, Jennifer had on dark sunglasses inside the office, and wore large noise-cancelling headphones. She was clearly in pain as her husband explained her many 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.
Before starting the Concussion Recovery Program, Jennifer’s cognitive test scores (depicted by the tan bars in the graph below) were all below average for adults in her age range. Her attention was at 5th percentile, meaning that 95% of adults in Jennifer’s age range performed better than she did on the attention test. Similarly, her working memory was at 9th percentile, and her verbal memory was at 3rd percentile. Her ability to be organized and perform tasks in sequence (executive function) was at 12th percentile.
As she started the program, Dr. Fotuhi reduced some of the medications that were making Jennifer 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-cancelling headphones were gone. Jennifer was smiling more often than she had in a long time, and her husband was thrilled. Her mid-program cognitive test results (depicted by the blue bars in the graph below) showed remarkable improvements in almost all of her cognitive domains, except for her executive function. Therefore, 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-week program, Jennifer was feeling great. She felt she was 90% of her usual self. Her executive function had increased to the 87th percentile for her age range (depicted in green bars in the graph below). Her attention had increased from 14th to 65th percentile, and her processing speed had increased from 9th to 73rd percentile.
Jennifer’s brain fitness score reflected her progress:
Jennifer’s 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):