Traumatic Brain Injury Blog

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March 1, 2022

Study published by the American Academy of Neurology Finds that Poor Cognitive Outcomes Following Concussion are more Common than Previously Thought

A new study published February 16, 2022 by the American Academy of Neurology in the Journal “Neurology” finds that the frequency of clinically meaningful poor cognitive outcomes one year after a concussion are more common than previously thought.  The results, says study author Raquel Gardner, MD, of the University of California San Francisco, “highlight the need to better understand the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery.” Read More

December 21, 2021

New Research Offers Hope for Restoration of Memory Function after TBI

A small region of the brain called the anterior thalamus could hold the key for restoring memory function after a traumatic brain injury. Researchers in New Zealand and the University of Oxford in the UK have shown that targeted electrical stimulation of the anterior thalamus could help with memory restoration in patients with brain injury.

Given how complex the brain is, scientists do not fully understand the extent to which memory impairments following TBI or stroke are caused by irreversible tissue loss and are therefore not treatable or by treatable dysfunctions in the wider brain networks. The hypothesis tested in this study is that lost memory function may be in part due to network dysfunction that can be improved with targeted stimulation. The results of this study support this thesis and could ultimately revolutionize therapies for memory defects. Read More

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October 5, 2021

TBI and COVID: A Dangerous Combination

Earlier this year the Brain Injury Association of America (BIAA) issued an open letter encouraging all individuals with brain injury to get a COVID vaccine. The letter cites evidence from the American Academy of Neurology that anyone with a neurologic disorder such a brain injury is particularly vulnerable to diseases like influenza and COVID:

“When one is infected with COVID-19, the virus attacks the “weakest link” it finds in the body, which is why individuals with longstanding chronic medical conditions are at the greatest risk for infection, complications and even death,” explained BIAA National Medical Director Brent E. Masel, M.D. “Studies have shown that traumatic brain injury triggers an inflammatory process in the brain that causes an individual to experience chronic issues. This process places those individuals at far greater risk of developing complications from COVID-19, which itself is well known to cause chronic neuroinflammatory issues.”

Read More

July 2, 2021

Article debunks defense myth that the risk of injury in a “minor impact” collision is not greater than activities of daily living

Most personal injury lawyers have represented clients suffering from the chronic consequences of concussion and musculoskeletal injuries following a rear end collision that caused minimal damage to the vehicles involved. This blog has reported on countless scientific studies showing that in some patients concussions can have long-term, chronic consequences. The standard defense employed by insurers in minimal damage rear end collisions (which they call “MIST” cases) is to argue that any injury is improbable in these accidents because the forces involved are similar to the forces involved in many activities of daily living (ADLs) where injuries rarely occur (like sitting down in a chair or sneezing.

The insurers and their defense counsel typically have an “accident reconstruction” expert they routinely use (often retired police officers) who calculate the speed change in the crash (the “delta V”) and then compare it to the delta V involved in everyday activities. (The delta V calculations by these so-called experts is often inaccurate, but that is a different issue.) Experience shows that this testimony can be very compelling to a jury, faced with judging the credibility of an injury victim whose injury is not immediately apparent. Read More

June 29, 2021

Defense Department Study Finds that Targeted Treatment Improves Chronic Symptoms Following Mild Traumatic Brain Injury

A recent Defense Department/University of Pittsburgh study confirms three important points made in prior posts:

  1. So called “mild” traumatic brain injury (“mTBI”) can have long-term, disabling consequences (in both civilian and military populations);
  2. that this injury is heterogeneous in both presentation and clinical outcome (in other words, every injury is different); and
  3. that interventions targeted to the individual presentation of the injury (whether it is predominantly vestibular, cognitive, oculomotor, headache, sleep or mood related, or some combination) can reduce symptoms in otherwise intractable patients.

The message is that ignoring the symptoms and hoping that they will ultimately disappear – the approach often taken in the past – is not wise for either the individual or for society as a whole. Read More

June 10, 2021

Evidence supports DTI imaging as a reliable biomarker predicting the severity of cognitive decline following concussion

A research report from the University of Texas Medical School, just published in Frontiers in Neurology, finds a correlation between Diffusion Tensor Imaging (DTI) findings and cognitive assessments in patients with chronic complaints after concussion, providing evidence that DTI imaging may be a reliable biomarker predicting the severity of cognitive decline following concussion. (DTI is an MRI technique that detects microstructural changes in white matter such as the changes that can occur as a result of “diffuse axonal injury” in brain injuries including concussion.) Read More

June 1, 2021

Emerging Evidence indicates that the Composition of the Gut Microbiome is Altered after a Traumatic Brain Injury

In the first systematic review on this topic, researchers at the University of Texas report on growing consistent evidence that traumatic brain injury (TBI) changes the gut microbiome. Evaluating these changes, they conclude, will be a fertile ground for new therapeutic interventions. Read More

June 1, 2021

Alzheimer’s Researchers Find “Compelling” Evidence that Mild Traumatic Brain Injuries Increase the Risk of Dementia as much as Diabetes, Hypertension and Obesity

In a peer-reviewed article published in the Journal of Alzheimer’s Disease, 2020;78(2):757-775. doi: 10.3233/JAD-200662, Canadian researcher found that a history of mild traumatic brain injury (mTBI) almost doubled the risk of being diagnosed with dementia and that mTBI was the strongest environmental risk factor for dementia, comparable to health risk factors such as diabetes, hypertension and obesity. Read More

April 8, 2021

Montreal Study Finds Subtle Long-Term Cognitive Effects of a Single Mild Traumatic Brain Injury

Adding to a growing volume of literature on this topic, Montreal researchers published a study in January, 2021 demonstrating that a single mild traumatic brain injury involving late adulthood patients (ages 50-70) leads to subtle, long-term cognitive consequences.

The article, authored by Camille Larson-Dupuis et. al., entitled Subtle long-term cognitive effects of a single mild traumatic brain injury and the impact of a three-month aerobic exercise intervention, was published in The Journal of Sports Medicine and Physical Fitness (2021 January: 61(1): 87-95).  What makes these findings particularly significant is that all participants in the study were exempt from confounding factors sometimes associated with long-term consequences. All participants:

  • had negative scans
  • were symptom-free within three months of their accident (including depression and anxiety)
  • did not present with chronic conditions known as risk factors for cognitive decline (uncontrolled diabetes, uncontrolled high blood pressure or cardiovascular disease)
  • were all well-educated

Read More

March 11, 2021

Danish Study Shows that Concussions Have a Large and Long-lasting impact on Salary and Employment

Studies in several countries, including Denmark, have found that between 10 and 30% of patients diagnosed with Concussion suffer from long-term symptoms. These long term consequences were recognized by the American Academy of Neurology in an important study published in July, 2020 and featured in this blog (“a single mild to moderate TBI may cause long-term neuroaxonal degeneration and astrogliosis/ activation.”)

Having recognized the potential for serious long-term consequences, researchers have begun to assess the economic impact of concussion. A Danish study recently published in BMJ Open concluded that concussions have a large and long-lasting impact on the salary and employment of working class adults on a national scale. Read More