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A meta-analysis published in the January issue of Neuropyschology provides evidence that cognitive rehabilitation after a serious brain injury or stroke can help the mind in much the same way that physical therapy helps the body. new meta-analysis. Because the data suggest that treatment may work best when tailored to age, injury, symptoms, and time since injury, the findings may help establish evidence-based treatment guidelines.

Researchers at the University of South Alabama and the University of North Carolina at Charlotte analyzed and updated the data found in systematic reviews of several hundred studies of cognitive rehabilitation. The researchers took those studies whose samples and methods were most amenable to rigorous statistical techniques and documented the extent to which various treatments improve the language, attention, memory and other cognitive problems that appear after acquired brain injury.

The meta-analysis examined 97 articles, comprising 115 studied treatment samples and 45 control samples. These samples collectively included 2,014 individuals who underwent cognitive rehabilitation after brain injury and 870 individuals in a variety of control conditions. The authors of the initial reviews had concluded there was enough evidence to generally support the use of a variety of rehabilitative treatments. To develop specific treatment guidelines, this new analysis documented the extent to which treatment type and timing, origin of the injury, recovery level, and participant age affected the odds of success.

Given the patterns they found, the authors offered initial treatment guidelines:

Generally, it is better to start treating patients as early as possible, rather than waiting for a more complete neurological recovery.
Even older patients (age 55 and up) may benefit from cognitive rehabilitation, particularly if the brain injury is due to stroke.
Clinicians should focus their efforts on direct cognitive skills training in specific cognitive domains (such as attention or visuospatial processing). More holistic, non-targeted interventions appear to be less effective.

Especially if they were treated soon after the event, language training helped older people after stroke with aphasia, problems producing and/or comprehending language. However, language training was still effective, just not as much, when it started more than a year after the stroke.

Attention training helped people with acquired brain injury and seemed to work best with younger patients less than a year after injury. It was the most specific treatment, improving nothing but attention.

Visuospatial training helped stroke patients with visuospatial neglect, the inability to respond or orient to something shown on the side opposite to the site of the injury. Visuospatial training also tended to improve performance in other cognitive domains.

Memory treatment did not produce clear results. Nor did comprehensive treatments that attempted to treat cognitive problems holistically.

The authors also found that patients treated less than a year after injury did better than those treated more than a year later.

There are some very talented experts in acquired brain damage and cognitive rehabilitation in Virginia. The challenge is to get the physicians who first treat victims of acquired brain damage (e.g., ER doctors, family doctors, and neurologists) to recogize the symptoms of TBI and timely refer the patient for cognitive rehabilitation.

Labels: Acquired brain injury Acquired head injury Brain damage Brain injury Brain injury attorney Brain injury lawyer Brain injury litigation Traumatic brain damage Traumatic brain injury Traumatic head injury Virginia brain injury attorney Virginia brain injury lawyer

12/8/2008
Michael G. Phelan
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Think Twice About Holding Your Cell Phone to Your Ear

Are we going to have to go back to the days of mounted car phones? A new study concludes that radiation from cell phones can affect the memory. At the Division of Neurosurgery, Lund University, in Sweden. Henrietta Nittby, researchers studied rats that were exposed to mobile phone radiation for two hours a week for more than a year. These rats had poorer results on a memory test than rats that had not been exposed to radiation.

The lead researchers believe that the findings indicate that microwave radiation from cell phones can affect the so-called blood-brain barrier. This is a barrier that protects the brain by preventing substances circulating in the blood from penetrating into the brain tissue and damaging nerve cells. The bottom line is the rats in the experiments suffered brain damage from the microwave radiation, and the brain damage caused memory problems.

The research team also found certain nerve damage in the form of damaged nerve cells in the cerebral cortex and in the hippocampus, the memory center of the brain. Moreover, they have discovered alterations in the activity of a large number of genes, not in individual genes but in groups that are functionally related.

Henrietta Nittby, one of the researchers, has cell phone herself, but never holds it to her ear, using hands-free equipment instead.

Labels: Acquired brain injury Brain damage Brain injury Brain injury attorney Brain injury lawyer Brain injury litigation Traumatic brain damage Traumatic brain injury Virginia brain injury attorney Virginia brain injury lawyer

11/26/2008
Michael G. Phelan
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Brain Injury Association of America Teams Up With Journal of Head Trauma Rehabilitation

The Brain Injury Association of America (BIAA) entered an agreement that designates the Journal of Head Trauma Rehabilitation (JHTR) as BIAA's official scholarly journal beginning January 1, 2009.

"As the nationwide voice of brain injury, our goal is to put timely, relevant research findings into the hands of brain injury clinicians and business leaders as well as policy makers and the media," said Susan Connors, BIAA President and CEO.

The partnership with LWW ensures that each new member of BIAA's Academy of Certified Brain Injury Specialists will receive a one-year subscription to the leading, peer-reviewed publication in brain injury. Renewing certificants will have an opportunity to subscribe to JHTR at discounted rates.

"JHTR has led the way in brain injury treatment research and practice for nearly 25 years," noted Sandra Kasko, JHTR Publisher. "JHTR is ranked #1 in rehabilitation by the Institute for Scientific Information's 2007 Journal Citation Report. LWW is pleased to partner with BIAA to provide this essential resource."

In concert with BIAA's adoption of JHTR, the Association will introduce the Mitch Rosenthal Memorial Lecture Series in 2009. The Rosenthal Lectures, delivered via teleconference and webinars, will be drawn from each issue's content.

John D. Corrigan, PhD, an editor of JHTR noted, "BIAA and JHTR are two of the nation's oldest, most respected names in the brain injury field. This partnership will extend the good work both organizations do to improve care for individuals with brain injury.

Founded in 1980, the Brain Injury Association of America is the premier source of information for victims of brain injury. BIAA and its nationwide network of state affiliates provide help, hope and healing to the millions of Americans who live with a lifelong disability as a result of brain injury, as well as their families and the researchers, clinicians and professionals who provide treatment and long-term care. For more information about brain injury or the BIAA, visit www.biausa.org.

Our local chapter, The Brain Injury Association of Virginia, Inc. (BIAV) can be contacted at www.biav.net or (804) 355-5748. For additional information concerning the medico-legal aspects of brain injury, visit www.injuryboard.com and click on the brain injury section.