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Neurofeedback for Mild and Chronic Concussions

Neurofeedback can treat mild traumatic brain injury (mTBI), Post-Concussive Syndrome, and Chronic Traumatic Encephalopathy (CTE).

ConcussionRecent events regarding the long-term repercussions of traumatic brain injury have raised both our awareness and interest in applying effective restorative treatments. With symptoms of acute and chronic brain trauma including problems with attention, impulse and emotional control, seizures, memory, anxiety, insomnia, depression, and physical balance. Symptoms arising from brain trauma are debilitating enough in some patients to affect work, school, and tasks of daily living. Mood disorders often rise straining relationships and reducing focus and executive functioning. It can quickly bring a normal life to a complete standstill.

Current guidelines still rely predominantly on watching and waiting. Following TBI there are a few strategies that have been historically applied to help with cognitive restoration and functioning. Results are modest at best and leave some only partially recovered even after 18 months.

Fortunately, studies utilizing Neurofeedback have shown significant impact in just weeks with regard to restoration of brain processes toward “normal” or “historical” functioning. Reported benefits of neurofeedback treatment include improvement in short and long term memory, better attention and focus, sleep onset and quality, and improved mood. Neurofeedback has also been applied for the treatment of brain fog or cognitive changes following chemotherapy and radiation treatment, stroke, whiplash injuries and chronic illness or infections.

Brain Trauma in the News

Recent studies are beginning to elucidate the depth and width of brain trauma associated with impact resulting in concussive injuries or mTBI. A recent article in the NY Times describes how brains react to impact and why stretching damage occurs deep in the brain. VIEW NOW

Benefit of Neurofeedback and Post-Concussion Symptoms

In a recent pilot study, through the University of California at San Diego School of Medicine’s, retired military, who suffer from PTSD and TBI, are part of research showing the efficacy of Microcurrent Neurofeedback(IASIS). According to Dr. Mingxiong Huang, “In a veteran with mild traumatic brain injury(mTBI), substantial post-concussion symptoms(PCS) reductions were found after Micro Current Neurofeedback, as measured by the Rivermead PCS questionnaire. In one patient, total symptom score decreased from 46 (pretreatment) to 25 (post-treatment), with marked symptom decreases in headaches, forgetfulness, feeling frustrated or impatient, and sleep disturbance. Pretreatment showed abnormal Magnetoencephalography(MEG) slow-waves. Compared with pretreatment MEG,  post-treatment MEG showed decreases in abnormal slow waves in the frontal pole, posterior cingulate cortex, right insular, and right hippocampus. MEG findings are consistent with the improvement of PCS for a headache (insular and PCC), memory function (hippocampus), and feeling frustrated or impatient (frontal pole).”

Mingxiong Huang Ph.D. who was the principal investigator of the Micro Current neurofeedback UCSD Pilot Study noted, “I was skeptical of the Micro Current Neurofeedback intervention; now I believe in this technology as an effective tool to reduce symptoms such as PTSD, mTBI, migraine, and headache, diminishing impulsivity and anxiety, and potentially helping with numerous other conditions such as addiction to smoking and nicotine, improving memory and sleep.”

Leading Alternative Medicines Opinion of IASIS Neurofeedback

Dr. Frank Shallenberger a leading alternative medicine doctor reported recently on his experience with IASIS(Microcurrent neurofeedback). “We hear a lot of talk these days about helping veterans, especially those who have suffered permanent injuries in the line of duty.  But guess what is the leading cause of sustained impairments among our veterans.  If you guessed mild traumatic brain injury (mTBI) you would be right.  And here’s the really depressing thing.  The treatments for mTBI are pathetically ineffective.  To a large extent that is because they are focused on using either drugs to decrease the symptoms or talk therapy to decrease the effect of the symptoms.  There are no treatments out actually focusing on fixing the problem.  That is until now.

First of all, understand this.  “Mild” TBI is not really mild.  It just means that the loss of consciousness, confusion, or disorientation after the initial head trauma did not last longer than 30 minutes.  The most common symptoms of mTBI are unexplained fatigue, headaches, visual disturbances, memory loss, poor attention and/or concentration, sleep disturbances, dizziness, decreased balance, irritability, emotional disturbances, feelings of depression, and seizures.  Other less common symptoms can include nausea, loss of smell, sensitivity to light and sounds, and getting lost or confused.  Most cases of mTBI resolve on their own in a few weeks to months.  But not all do.  Many cases never resolve.  And here’s the problem.

In cases of unresolved or chronic mTBI the symptoms may not be present or noticed at the time of injury.  They may be delayed days or weeks before they appear.  The symptoms are often subtle and are can easily be missed by the injured person, family, and doctors.  The person looks normal and often moves normally in spite of not feeling or thinking normally.  This makes the diagnosis easy to miss.  And it is important to understand that this is not a psychological disorder.  It comes about from a brain injury that won’t heal.  And the only way to fix it is to fix the injury.  And that is exactly why what I am about to tell you is so important.

About a year ago I reported to you on the marvelous effects we are seeing in our clinic for all kinds of brain-associated neurological problems including mTBI using a passive neurofeedback treatment system called IASIS.  Now I have the results of an amazing study that has been submitted for publication using IASIS to treat veterans and other patients with mTBI.  I can’t give you the reference until the study is published but this is just too important to wait for that.

The study used a very special brain mapping technique called magnetoencephalography (MEG).  MEG does not simply look at an image of the brain.  Better yet.  Using highly sensitive devices called magnetometers MEG can monitor brain activity.  MEG has been used to research brain processes such as thinking and perception, determine the function of different areas in the brain, measure brain activity, and to identify abnormal areas of the brain before brain surgery.  With MEG, it is possible to literally see the injured areas of the brain in patients with mTBI.  So with this in mind, here’s what the researchers did.

They gave six patients with symptomatic chronic mTBI two IASIS sessions a week for six weeks.  A symptom questionnaire (PCS score) was completed and a MEG exam was performed before the first treatment and after the last one.  The results showed that at the first MEG exam, all six patients had abnormal slow-wave signals. In the MEG exam following the IASIS treatment, the patients all showed a significant reduction in the abnormal slow waves in approximately the same brain areas as in the first exam.  And that’s not even the best part.

The reductions in abnormal MEG slow-wave generation strongly correlated with significant reductions in the symptom scores.  The greater the reduction in the abnormal MEG findings the greater the reduction in the patient’s’ symptoms.  This remarkable experiment tends to prove two things.

First, the abnormal MEG signaling is an actual measurement of the brain damage that happened in these patients.  And second, IASIS treatments actually treated the cause of the mTBI by successfully repairing the damage.  In essence, this might be the first time that we can not only see the cause of mTBI but can also treat that cause directly.  This is fantastic news not only for veterans but also for the many other patients out there who suffer from mTBI symptoms from accidents or athletic injuries.  So, if you have had an mTBI and still have symptoms let me strongly urge you to find an IASIS practitioner and treat the cause instead of just drugging up or living with the symptoms.”

Research Supporting Neurofeedback for TBI and Post-Concussive Syndrome

Quantitative EEG Neurometric Analysis-Guided Neurofeedback Treatment in Postconcussion Syndrome (PCS): Forty Cases. How Is Neurometric Analysis Important for the Treatment of PCS and as a Biomarker?

Clin EEG Neurosci. 2016 Jun 27. pii: 1550059416654849. [Epub ahead of print]

Surmeli T1, Eralp E2, Mustafazade I3, Kos IH3, Özer GE2, Surmeli OH2.

Postconcussion syndrome (PCS) has been used to describe a range of residual symptoms that persist 12 months or more after the injury, often despite a lack of evidence of brain abnormalities on magnetic resonance imaging and computed tomography scans. In this clinical case series, the efficacy of quantitative EEG-guided neurofeedback in 40 subjects diagnosed with PCS was investigated. Overall improvement was seen in all the primary (Symptom Assessment-45 Questionnaire, Clinical Global Impressions Scale, Hamilton Depression Scale) and secondary measures (Minnesota Multiphasic Personality Inventory, Test of Variables for Attention). The Neuroguide Traumatic Brain Index for the group also showed a decrease. Thirty-nine subjects were followed up long term with an average follow-up length of 3.1 years (CI = 2.7-3.3). All but 2 subjects were stable and were off medication. Overall neurofeedback treatment was shown to be effective in this group of subjects studied.
The role of early posttraumatic neuropsychological outcomes in the appearance of latter psychiatric disorders in adults with brain trauma.

Asian J Neurosurg. 2015 Jul-Sep;10(3):173-80. doi: 10.4103/1793-5482.161165.

DISCUSSION: Post resuscitationThe objective was to determine the predictors of posttraumatic psychiatric disorders (PTPD) during the first 6 months following traumatic brain injury (TBI) focusing on neuroimaging, clinical and neuropsychological appraisements during acute and discharge phase of TBI.

MATERIALS AND METHODS: We designed a prospective, longitudinal study in which 150 eligible TBI patiePost-resuscitation brain injury severity and discharged functional outcome were evaluated by standard clinical scales. First Neuroimaging was done at a maximum of 24 h after head trauma. Early post-traumatic (PT) neuropsychological outcomes were assessed using Persian neuropsychological tasks at discharge. The standardized psychiatric assessments were carefully implemented 6 months postinjury. A total of 133 patients returned for follow-up assessment at 6 months. They were divided into two groups according to the presence of PTPD.

RESULTS: Apparently, aggression was the most prevalent type of PTPD (31.48%). There was no significant difference between groups regarding functional outcome at discharge. Diffuse axonal injury (12.96%) and hemorrhages (40.74%) within the cortex (42.59%) and sub-cortex (33.33) significantly occurred more prevalent in PTPD group than non-PTPD ones. Primary post resuscitation TBI severity, early PT lingual deficit and subcortical lesion on the first scan were able to predict PTPD at 6 months follow-up.

CONCLUSION: Almost certainly, the expansive dissociation risk of cortical and subcortical pathways related to linguistic deficits due to severe intracranial lesions over a period of time can augment possibility of subsequent conscious cognitive-emotional processing deficit, which probably contributes to later PTPD. Hence, early combined therapeutic supplies including neuroprotective pharmacotherapy and neurofeedback for neural function reorganization can dampen the lesion expansion and later PTPD.