Sunday, February 21, 2010

Brain Injury Is Changeable?

Brain injury has many causes and comes in all levels of severity.  It can occur during the 9 months of pregnancy from genetics, alcohol or drug use (over-the-counter, RX or street).  It can occur shortly before, during or slightly after birth (the most likely time for it to occur).  It can also occur anytime after birth from illness, high fever, accident, trauma or abuse/neglect.  However, regardless of the cause, the severity or when it occurred, all brain injury has one thing in common… brain injury prevents you from reaching your potential.  A brain injury does not lower or take away your potential; it just prevents you from accessing, demonstrating or using the full potential you have.
Since brain injury does not interfere with ones true potential there is every reason we should do as much as possible to help overcome the problems that are caused from the brain injury.  The potential is there, you just don’t have access to it.  You know you can move your arm, say a word, or perform a function; but, due to a brain injury your body won’t cooperate… the potential is there just not the ability.
Even though potential can not be properly measured, when someone suffers from a brain injury their potential is always significantly higher than they are able to show or communicate.  CAN LEARN is proud of the results achieved by the courageous children and their families we work with.
CAN LEARN programs achieves results by providing individualize home programs that are administered by family members.  After evaluations, the family is empowered and enabled to actually work in their own home successfully. For those families that can provide what is needed, our programs offer exciting results regardless of age or degree of disability. In fact, the programs used at the CAN LEARN often get good results even when other programs fail. 
How does it work?
Our programs work on the “root” cause of the problem, not the symptoms.  The human brain is responsible for virtually every thing we do.  Every movement we make, every word we say, every thought, reaction, response and expression.  The list of functions of the brain is infinite.  However, we can place all those millions of functions into three categories.  Our brain must receive information from its environment, process it (filter, prioritize, interpret and categorize) and do something with the information.  The brain develops in an orderly, sequential manner; one level building upon the next.  If the foundation is shaky or dysorganized so will the upper levels. The only way our brain receives information is through our 6 senses (eyes, ears, nose, mouth, touch and balance).  Here is where problems begin.  If information isn’t received properly by one (or more) senses the brain is unable to process it properly which affects how well it is able to use or store information.  Function is a mirror….
If the brain received information well it will process well and store (learn and recall) information in highly skilled, organized and consistent ways.  It puts out information such as walking, talking, writing or riding a bike by a complex series of commands that must occur at the right time and in the right order.  Brain injured individuals aren’t receiving proper information therefore unable to process or store the information well.
CAN LEARN provides specialized exercises and activities that are designed to help the brain perform better in these three areas.  Sensory systems are stimulated and trained to work in better and healthier way.  The consistency of our stimulation program’s help the brain process in a more organized and consistent ways.  As the brain’s dysorganization is eliminated performance is increased and enhanced by building onto existing skills in a developmental way and by strengthening fundamental skills. By increasing the efficiency of the brain's functional ability there is less need for the brain to demonstrate symptoms. Therefore, virtually all symptoms of brain injury can be helped.

Female sex hormone involved in pregnancy can fix brain damage

A break through research indicates that Progesterone, a female sex hormone involved in pregnancy can fix brain damage in human beings. A large scale clinical trial ProTECT III in this regard involving over 1000 patients, over the next three to six years in 17 trauma centers across US would be commenced in March. This was announced at the annual meeting of the American association for the Advancement of Science (AAAS) , San Diego

The trial would be led by Dr David Wright, associate professor of emergency medicine at Emory University in Atlanta. Atlanta's Grady Memorial Hospital will serve as lead center .The study is being funded by The National Institute of Neurological Diseases and Stroke, a division of the National Institutes of Health (NIH).  "This could transform the way we care for head injury patients. It could be a dramatic improvement. There has been no treatment in 30 years … and now we're on the brink of having something.” Wright said in a statement.

Previous studies had predicted that Progesterone, a C-21 hormone involved in female menstrual cycle and pregnancy can bring the mortality rate as a result of Traumatic Brain Injury (TBI)  to half. This finding is a part of the earlier 3 year trial, ProTECT I (Progesterone for Traumatic brain injury - Experimental Clinical Treatment conducted on 100 patients.

TBI occurs when the brain is traumatically injured by an outside force as a result of vehicle crashes, violence, assaults etc.The severity of TBI may range from “ mild” ( temporary unconsciousness ) to sever ( extended unconsciousness or Amnesia).

TBI is a major cause of death and disability worldwide. As per statistics provided by Centers for Disease Control and Prevention – Of the 1.4 million who suffer from TBI each year , 50000 patients die while 235,000 are hospitalized and 1.1 million are treated and released from an emergency department.

As a part of ProTECT III, TBI patients in addition to the standard treatment would be administered either a placebo or Progesterone for a period of 4 days. Nina Gentile, a professor of emergency medicine at the School of Medicine head of the study’s regional efforts declared, “If this study proves that using progesterone in traumatic brain injury cases works, this would be the most promising breakthrough in improving outcomes for traumatic brain injury patients. It is awesome to me that it is the naturally produced hormone progesterone that might rescue brain cells.”

Singing 'rewires' damaged brain

Mouth (file image)
Singing words made it easier for stroke patients to communicate
Teaching stroke patients to sing "rewires" their brains, helping them recover their speech, say scientists.
By singing, patients use a different area of the brain from the area involved in speech.
If a person's "speech centre" is damaged by a stroke, they can learn to use their "singing centre" instead.
Researchers presented these findings at the annual meeting of the American Association for the Advancement of Science (AAAS) in San Diego.
An ongoing clinical trial, they said, has shown how the brain responds to this "melodic intonation therapy".
Gottfried Schlaug, a neurology professor at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, US, led the trial.
The therapy is already established as a medical technique. Researchers first used it when it was discovered that stroke patients with brain damage that left them unable to speak were still able to sing.
Professor Schlaug explained that his was the first study to combine this therapy with brain imaging - "to show what is actually going on in the brain" as patients learn to sing their words.
Making connections
Most of the connections between brain areas that control movement and those that control hearing are on the left side of the brain.
"But there's a sort of corresponding hole on the right side," said Professor Schlaug.

Music engages huge swathes of the brain - it's not just lighting up a spot in the auditory cortex

Dr Aniruddh Patel, neuroscientist

"For some reason, it's not as endowed with these connections, so the left side is used much more in speech.
"If you damage the left side, the right side has trouble [fulfilling that role]."
But as patients learn to put their words to melodies, the crucial connections form on the right side of their brains.
Previous brain imaging studies have shown that this "singing centre" is overdeveloped in the brains of professional singers.
During the therapy sessions, patients are taught to put their words to simple melodies.
Professor Schlaug said that after a single session, a stroke patients who was are not able to form any intelligible words learned to say the phrase "I am thirsty" by combining each syllable with the note of a melody.
The patients are also encouraged to tap out each syllable with their hands. Professor Schlaug said that this seemed to act as an "internal pace-maker" which made the therapy even more effective.
"Music might be an alternative medium to engage parts of the brain that are otherwise not engaged," he said.
Brain sounds
Dr Aniruddh Patel from the Neurosciences Institute in San Diego, said the study was an example of the "explosion in research into music and the brain" over the last decade.
"People sometimes ask where in the brain music is processed and the answer is everywhere above the neck," said Dr Patel.
"Music engages huge swathes of the brain - it's not just lighting up a spot in the auditory cortex."
Dr Nina Kraus, a neuroscientist from Northwestern University in Chicago, also studies the effects of music on the brain.
In her research, she records the brain's response to music using electrodes on the scalp.
This work has enabled her to "play back" electrical activity from brain cells as they pick up sounds.
"Neurons work with electricity - so if you record the electricity from the brain you can play that back through speakers and hear how the brain deals with sounds," she explained.
Dr Kraus has also discovered that musical training seems to enhance the ability to perform other tasks, such as reading.
She said that the insights into how the brain responds to music provided evidence that musical training was an important part of children's education.

Singing helps stroke victims regain speech

SAN DIEGO, California — US scientists have restored speech to stroke victims by getting them to sing words instead of speaking them, a leading neurologist said.
Gottfried Schlaug, an associate professor of neurology at Beth Israel Deaconess Medical Center and Harvard Medical School, showed a video of a patient with a stroke lesion on the left side of the brain who was asked to recite the words of a birthday song.
The patient could not comply, and merely repeated the letters N and O.
But when Schlaug asked him to sing the song while someone held the patient's left hand and tapped it rhythmically, the words "happy birthday to you" came out clear as day.
"This patient has meaningless utterances when we ask him to say the words but as soon as we asked him to sing, he was able to speak the words," Schlaug told reporters at the annual meeting of the American Association for the Advancement of Science (AAAS).
Another patient was taught to say, "I am thirsty" by singing, while another who suffered a large lesion on the left side of the brain and had tried various, ultimately unsuccessful therapies for several years to try to regain the power of speech was taught to say his address.
Images of the brains of patients with stroke lesions on the left side of the brain -- which is typically used more for speech -- show "functional and structural changes" on the right side of the brain after they have undergone this form of therapy through song, called Music Intonation Therapy (MIT).
Although medical literature has documented the phenomenon of people who are unable to speak being able to utter words when singing, Schlaug was the first to run a randomized clinical trial of MIT, with a view to gaining acceptance of the therapy in the medical field.
"You don't need to be a trained singer to do this. We want to teach caregivers to do MIT because the treatment is very long and expensive," said Schlaug.
MIT treatment can last for 14-16 years, and involves sessions of an hour and a half a day, five days a week.
But the benefits of the therapy are usually permanent, and two thirds of patients who have undergone MIT with Schlaug added more words to their spoken vocabulary after their therapy had ended than the 100 words they were "taught" to say in therapy.
Exactly how MIT works is not clear, but another study presented at the AAAS meeting by Aniruddh Patel of the Neurosciences Institute showed that grammatical processing of language and music overlaps in the brain.
Schlaug said music helps parts of the brain that usually do not engage with each other when a person speaks, to do so.
"Music-making is a multisensory experience that simultaneously activates several systems in the brain and links and loops them together. It engages many regions of the brain," he said.
Tapping the patient's hand gently on the table "might serve as a pacemaker for the motor articulatory system in the brain," said Schlaug.
"Combining motor activity with sound might facilitate speech."
In the United States, MIT could potentially help up to 70,000 nonverbal stroke victims to retrieve the ability to speak, according to the neurologist.

Sex Hormone Now In Phase III Trials As Treatment For Traumatic Brain Injury

Traumatic Brain Injury (TBI), generally results from a severe blow to the head, brought on by hitting, being hit, or falling on one's head.  Many soldiers, particularly in the Iraq and Afghanistan wars, are victims of TBI, as a result of being struck by projectiles in battle.  When such a blow occurs, the brain is literally rattled for a time by the force of the impact. 

Traumatic Head Injuries: USA Today via The Utah VeteranTraumatic Head Injuries: USA Today via The Utah Veteran

Short-term, the disruption can affect thinking, language, learning, vision, hearing, motor skills, emotions, and can even bring on additional disorders of the brain, such as epilepsy. But these disturbances may become long-term and even worsen, if the patient is not treated immediately.
Several drugs are currently used to minimize the impact of TBI; the precise one(s) prescribed often depend on the symptoms expressed.  But 25 years of research on a biologically available hormone, progesterone, is finally in Phase III trials, having shown promise for early-identified and early-treated TBI patients, regardless of the specific symptoms.
Progesterone, often called the "pregnancy hormone," plays a big role in menstruation, pregnancy, and the development of the fetus right through birth.  But progesterone has other roles as well, including nurturing of the brain. 
It was Emory University's Dr. Asa G. Candler, Professor of Emergency Medicine and Donald G. Stein, PhD, who first discovered the neuro-protective role of progesterone 25 years ago.  Dr. David Wright, Associate Professor of  Emergency Medicine, is also at Emory, and he and his team have continued research on progesterone, infusing it into the brains of TBI animal models and in a small sample of human TBI subjects.
In the latter study (ProTECT I) researchers found evidence that the form of progesterone injected was a safe and effective treatment for patients with TBI.  It reduced patient mortality by 50 percent and reduced disabilities and functional outcomes for patients with moderate brain injury, something no other drug had done before.
Phase III, aka ProTECT III, will begin in March, 2010 at 17 medical centers across the country.   Phase III clinical trials will be a randomized, double-blind study, involving approximately 1,140 patients over a three-to-six year period using the hormone progesterone to treat TBI.  The National Institutes of Health (NIH) is funding the grant, which was awarded to Emory University.