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Recent Brain Injury News Summaries 
Provided by David L. Goldin
http://headlaw.com


Brains of Stroke Patients Retrained

A new type of rehabilitation may help stroke victims regain nearly full use of paralyzed limbs. By immobilizing the good arm of a stroke victim and forcing the patient to use his or her "bad" arm, it may be possible to renew muscle activity in the paralyzed limb. A study reported in "Stroke: Journal of the American Heart Association" supports this finding which seems to vindicate the theory the brain can be actively rewired and is not static or fixed.

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Internet Headache Test Effective

The Headache Impact Test (HIT) is an Internet-based amIhealthy.com questionnaire measuring the severity and impact of headaches and shows how it limits the patient's ability to function. New research suggests this test can improve diagnosis and treatment of headaches.

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Stroke Warnings Ignored By Primary Care Physicians 

In a study presented at the American Stroke Association meeting in February, the cases of 176 patients who contacted their primary care physicians due to symptoms of a TIA (transient ischemic attack) or stroke were reviewed. The results of the study show that these patients are not likely to be admitted to a hospiital, undergo special scans to assess their stroke risk or be referred to a specialist. TIAs are temporary stroke-like symptoms, such as sudden weakness of the face, arm or leg; loss of vision; dizziness; or trouble speaking. Patients fully recover, but must take these symptoms seriously because they are important danger signs of stroke. Unfortunately, primary care physicians often do not recognize this risk to their patients

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New Drug May Halt Brain Damage After Head Injury

An antioxidant drug, called LY341122, which inhibits free radical molecules that are thought to contribute to brain damage after a head injury, may be effective if administered in the immediate aftermath of the injury. Rats which were given the drug up to 30 minutes after a head injury had less bruising and fewer damaged brain cells. If the drug were give three hours after injury, it did not reduce the damage. The research is reported in the September issue of the journal Neurosurgery.

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Moral Behavior Traced to Specific Brain Area

Damage to an area at the front of the brain called the prefrontal cortex causes severe behavior problems, including stealing, lying, physical and verbal aggression, poor parenting, and an inability to consider the consequences of actions. When this brain trauma occurs to infants, they may never be able to overcome this pathological behavior even though they can otherwise develop normal mental abilities as adults. This study is reported in the November issue of Nature Neuroscience.

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Molecular Treatment To Relieve Chronic Pain

As reported in the November 19th issue of the journal Science, a new treatment to destroy nerve cells responsible for long-term pain has been successfully tested on rats. Chronic pain is believed to occur when neurons in the spinal cord send faulty signals. The study done at the University of Minnesota uses a substance toxic to neurons injected into the spinal cord. Fine-tuning of the approach is required to temporarily shut down neurons without destroying them because the treatment in its current form also destroys nerve cells that are needed by the body.
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Teens and Brain Power
Researchers at the National Institute of Mental Health and UCLA have found that the last areas of the brain to mature in humans appear to be those responsible for reasoning, problem solving and other sophisticated functions. This maturation happens sometime between the ages of 18 and 21. The brain area involved is known as the pre-frontal cortex and integrates information registered by the senses and controls reasoning and decision making.
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Brain Area Responsible for Compulsion To Clutter
40% of the seven to eight million Americans with OCD (obsessive compulsive disorder) engage in pathological hoarding. A recent study at UCLA found that these compulsive hoarders have decreased activity in both the anterior cingulate, a brain structure involved in decision making and problem solving, and in the posterior cingulate gyrus, an area involved in spatial orientation, memory and processing of emotional stimuli.

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Estrogen Boosts Memory in Men With Prostate Cancer
According to a study conducted by Oregon Health & Science University Institute, high doses of estrogen improve long term memory and decrease feelings of confusion in men whose testosterone levels have been lowered to treat advanced prostate cancer. Long term or verbal memory is a function of the brain’s hippocampus whereas short term or working memory is a function of the brain’s pre-frontal cortex. Estrogen replacement improves verbal memory but not working memory.
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First Reliable Measure of Neurobehavioral Functioning During Coma from Severe Brain Injury (March 2005)
A Northwestern University researcher, Theresa Louise-Bender Pape, has developed a measure of neurobehavioral functioning during coma from severe brain injury that predicts recovery of consciousness up to one year after injury, with up to 86 percent certainty. Called the Disorders of Consciousness Scale (DOCS), it tests stimuli organized into eight subscales, including social knowledge; taste and swallowing; olfactory; proprioceptive (perception of one's body in space); vestibular (balance); auditory; visual; tactile; and testing-readiness. DOCS accurately detected improvements, declines and plateaus in neurobehavioral functioning in unconscious patients. The study also showed how repeated measures using DOCS improved medical and rehabilitation management during coma recovery.
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Blood Test Gives Early Warning of Brain Injury (November, 2005)

A new test that detects fragments of broken brain cells that leak into the blood stream may help doctors quickly detect and treat people with severe head injuries or severe diseases. This test allows easy monitoring of the release of an axonal protein into serum indicating that axonal injury must have occurred. This could lead to diagnoses of ailments with just a few drops of blood, bypassing more cumbersome, time consuming and expensive tests, such as brain scans.

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Chilling Newborns May Prevent Brain Damage (October, 2005)

Infants whose brains are starved of oxygen at birth stand a better chance of surviving without damage if their body temperatures are chilled by six degrees Fahrenheit for three days. When the brain lacks enough oxygen, it sparks a cascade of harmful chemical reactions that can inflict further damage even after oxygen has been restored. Cooling the brain actually decreases the production of these substances and gives the brain time to recover. Of the 106 babies in this study, the rate of disabling cerebral palsy was 63% lower with cooling, the rate of blindness was 50% lower, and the death rate was 32% lower. It is uncertain if the treatment will help babies born prematurely who have many other problems related to prematurity, such as disorders of lung development (a lower body temperature can have an adverse effect on the lungs).

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Improving Brain Cell Survival After Brain Injury (July, 2006)

Scientists in Melbourne have found a protein in the brain that can save neurons from dying after experiencing traumatic brain injury. This naturally occurring protein, called BP5, is produced more than usual in brain cells after they have experienced traumatic injury. BP5 works by using the cell’s waste disposal system to flush away toxic and damaged proteins produced after injury, which appears to tip the balance toward nerve cell survival, instead of death. The challenge is to develop drugs that can do the same thing, limiting damage to the brain after injury, as well as in the subsequent few days when injured nerves release “suicide factors” that cause surrounding, healthy neurons to die en masse. This study is published in the Journal of Neuroscience.

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Exercise Keeps the Brain Fit (August, 2006)

Exercise may keep the mind healthy, as well as the body, and fight the effects of aging on brain function. The review of research on exercise and aging suggests that exercise and physical activity can improve brain function and reduce neurological diseases such as Alzheimer’s and dementia. A further group of studies suggest an increased level of exercise or aerobic fitness training may improve mental processes even more than moderate activity. Aerobically trained older adults showed increased neural activities in certain parts of the brain that involve attention and reduced activity in other parts of the brain that are sensitive to behavioral conflict. On a molecular level, the studies showed that aerobic exercise and physical activity may work by moderating age-related changes in brain structure on a cellular level, in effect, maintaining a younger-looking and younger-performing brain well into old age. This also helps the brain maintain its elasticity, the ability to
cover one function if another starts failing
.

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Gene Map of Mouse Brain May Provide Human Benefits (September, 2006)

A private laboratory backed by Microsoft co-founder Paul G. Allen unveiled the complete genetic map of the mouse brain, an advance researchers say could shave years off the time required to develop the next generation of gene-targeted drugs. The map details the location of more than 21,000 genes in a male mouse’s brain. Researches have placed the complete three dimensional map on the internet and opened it up to scientists and the public free of charge. The map will let scientists immediately locate genes they suspect of playing a role in disease to determine how they actually operate at a particular brain region (at least in the mouse). This means genes can now be ruled in or out in a matter of minutes or hours. About 90% of the genes in a mouse’s brain have a human counterpart. More than 80% of the genes in a mouse’s DNA are expressed in the brain and almost no genes are found at only one brain region.

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Brain Injury Association Partnership with Bob Woodruff (February, 2007)

The Brain Injury Association of America (BIAA) has entered into a partnership with ABC Anchor Bob Woodruff and his family to raise awareness of brain injury and to administer the newly created Bob Woodruff Family Fund for TBI to assist servicemen and women and their families affected by the war in Iraq and Afghanistan. Mr. Woodruff sustained a serious brain injury as a result of an improvised explosive device while on assignment for ABC News in Iraq in January 2006. Although he received superior care, Bob, his wife, Lee, and their extended family recognize that many individuals with brain injury do not receive the services and supports needed to regain their independence. They also understand the lack of funding in the public, private and military sectors, and best of all, they want to help. In an effort to “give back” to the people who saved Bob’s life, the family has established the Bob Woodruff Family Fund for TBI. The Fund will raise money through events and other activities. Donations will be used to make grants to nonprofit organizations serving members of the military who have sustained a TBI. In some circumstances, funds may be used to provide direct financial assistance to military personnel and their families and/or grants for medical research, public education, awareness and prevention of TBI. Bob Woodruff will file a series of reports for World News, Good Morning America and Nightline throughout the month of March. The reports will cover various aspects of brain injury and will include some of the individuals featured in BIAA’s Brain Injury Awareness Month campaign, “Living with Brain Injury, As Diverse as We Are.” Bob Woodruff and members of his family will serve as honorary spokespersons for BIAA by testifying before Congress and recording public service announcements. It is hoped the family’s willingness to partner with BIAA and discuss Bob’s injuries will encourage other public figures to do so as well. Susan H. Connors, President/CEO Brain Injury Association of America 8201 Greensboro Drive, Suite 611 McLean, VA 22102 703.761.0750 ext 627 (Main) 703.761.0755 (Fax) 703.584.8627 (Direct) shconnors@biausa.org 

 

Football Concussions Not Properly Appreciated

As reported in the September-October issue of the American Journal of Sports Medicine, high school football players who sustain concussions often return to play prematurely because the significance of their injuries is not appreciated. Return-to-play guidelines are not inclusive of some of the most common signs and symptoms such as concentration deficits, blurred vision (sensitivity to light), amnesia, dizziness and balance deficits.

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Brain Development in 4-D

Sophisticated imaging techniques can be used to visualize changes in brain structure during childhood. A report published in the March 9, 2000 issue of the journal Nature describes "the creation of spatially complex, four-dimensional quantitative maps of growth patterns in the developing human brain." The authors of the report believe that their form of dynamic mapping "may . . . offer advantages in tracking fine-scale effects of therapeutic interventions in dementia (and other diseases)."

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Stroke Damage May Be Reversible

A study from the University of California, Los Angeles Stroke Unit, has shown that the early use of clot-busters may reverse stroke injury. Time is critical: clot-busting drugs generally must be used within 3 hours of symptom onset. Therefore, it is particularly important for patients to be aware of the warning signs of a stroke. Stroke symptoms include sudden onset of weakness or numbness, difficulty speaking, severe headache and vision problems, among others.

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Brain Trauma Linked To Alzheimer’s

Findings to be published in the September issue of the Journal of Neuropathology and Experimental Neurology support earlier studies saying brain trauma can raise the risk of Alzheimer’s disease. In experiments performed on anesthetized pigs, a research team at the University of Pennsylvania School of Medicine found that even moderate brain trauma can set off a biochemical process that leads to development of amyloid plaques in the brain tissues. This is the same kind of brain deterioration seen in patients with Alzheimer’s disease.

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Human Neurons Establish Connections in Rats With Severe Spinal Cord Injuries

As reported (in the July, 2002 Journal of Neurosurgery: Spine), human neurons grown as cells cloned from a tumor help restore some function in severely injured spinal cords of rats.  All seven rats in the delayed (two weeks after injury) transplant group recovered electrical activity in spinal cord neurons that control muscle movement.  The cells sprouted fibers, or axons, that grew into the undamaged, intact portions of the spinal cord above and below the injured area.

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Protein Helps Injured Nerve Cells Regenerate

Researchers at Boston's Children's Hospital and Harvard University report that the protein, inosine, switches on a number of genes involved in the growth of nerve cells.  Inosine caused nerve cells in rats to sprout new axons and when those axons meet, they form new synapses through which messages can be sent.  Also inosine and related molecules may help prevent damage from brain injury and stroke, as well as the progression of Alzheimer's and Parkinson's, by shutting off the mechanism that signals healthy brain cells to die.

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President Reagan's Death Renews Search for Alzheimer Cure
In the ten years between President Regan's poignant letter to the American people disclosing his diagnosis of Alzheimer disease, much research has been undertaken but few of the findings have made their way into clinical practice. With the aging of the baby boomer population, there will be an explosion of Alzheimer cases which will burgeon into a major public health problem. Research into Alzheimer includes study of brain cell regeneration, diagnosis, drugs, genes and stem cells
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Damage to Left Side of Brain Raises Infection Risk
As reported in the May, 2004, issue of Annals of Neurology, damage to the dominant side of the brain, which is the left side in most people, seems to suppress the immune system. This effect could make a person more susceptible to infection. The immune and nervous systems are interlinked, influencing each other in complex ways that are just beginning to be understood.
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Use of Anti-Inflammatory Steroids for TBI May Increase Risk of Death (January 2005)
Published by the British-based Cochran Library, this study of corticosteroid treatment for brain injury, including coma and concussion, included 10,008 patients, more than all similar studies combined. It is thought that some of the damage after a brain injury results from inflammation following initial injury and that reducing inflammation might reduce this secondary injury. A 2000 survey of brain trauma treatment centers in the United States found that one-third of those centers still use corticosteroids routinely. However, the study found that patients receiving corticosteroids were 18 percent more likely to die from their brain injury that those who did not take the drugs.
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Researchers Pinpoint Circuit in the Brain Responsible for Encoding Decision-Making (May 2005)
Researchers at John Hopkins University have pinpointed the orbital frontal cortex, located right behind the eyes, as the site in the brain which controls normal decision making. Damage to this area explains why people who may still have the ability to learn normally are sluggish and inflexible in their behavior, trapping them in a prison of habit. 
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Pure Brain Stem Cells Cultured in Lab by British Scientists (August, 2005)

Scottish researchers have converted embryonic stem cells into nerve stem cells through the use of chemicals. Before this, scientists who managed to grow stem cells had not been able to obtain pure brain stem cells. This will help in understanding how stem cells work, that is, in explaining the difference between an embryonic stem cell which can make anything, and a brain stem cell which can just make brain. This has positive connotations for those working towards the treatment of Alzheimer's disease and Parkinson's.

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Caffeine Can Improve Short Term Memory (December, 2005)

For the first time, researches have been able to watch distinct areas of the brain, the ones that relate to short term memory, fire up after volunteers ingested the equivalent of two cups of coffee. The studies show that caffeine modulates a higher brain function through its effect on distinct areas of the brain. Researchers at the Medical University of Innsbruck used functional magnetic resonance imaging to determine the effect of caffeine consumption on parts of the brain network associated with short term, or working, memory; that is, the kind of brain activity required to remember things for a short period of time, like looking up a telephone number in the phone book and storing the number until it is dialed. The researchers found significant increases in activity in a brain region in the frontal lobe, where a part of the working network is located, and in the interior cingulate cortex, a part of the brain that controls attention. 

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Brains “God Spot” Hard to Pin Down (August, 2006)

A new study shows that mystical experiences may engage several areas of the brain, not just one “God spot.” Published in Neuroscience Letters, based on work done at Canada’s University of Montreal, the researchers tested 15 Carmelite Nuns. The nuns were asked to recall their most intense mystical experience, defined as a sense of union with God, as their brains were being scanned. The nuns’ brain scans did not show any particular “God spot” of brain activity.

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Drugs May Quickly Lift Depression (August, 2006)

Ketamine, an anesthetic also used illegally as the club drug Special K, has the power to lift stubborn depression within hours, instead of weeks it typically takes prescription antidepressants to kick in. Researchers and drug companies have been working for years to develop faster-acting antidepressants but none has made it to market yet. In a new federal study, patients given a single intravenous infusion of Ketamine began to feel their depression lift within two hours and after a single day, 71% reported a major improvement in mood. There were no serious side effects. A week after the single injection, 35% were still feeling better. Published in the Archives of General Psychiatry, this Ketamine study adds to mounting evidence that a brain chemical called glutamate is involved in depression and can be targeted for treatment. Researchers emphasize that people should not experiment with the drug on themselves.

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Progesterone Shows Promise as Treatment for Brain Injuries (October, 2006)

Progesterone given to trauma victims shortly after brain injuries appears to be safe and may reduce the risk of death and degree of disability. Researchers at Emory University conducted a three year pilot study with one hundred participants, finding encouraging evidence that progesterone is safe in a tbi setting and that there was a 50% reduction in the rate of death. Further, the study found significant improvement in the functional outcome and level of disability among patients with moderate brain injury. The research team is now planning a large clinical trial to test the effectiveness of progesterone in 1,000 patients with tbi.

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