Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

Worried about whether your favorite desert will taste the same in years to come?  New research out of Milan, Italy reveals a possible link between flavor and abnormal eating behavior in patients with Alzheimer's Disease.  And words put to music assist those same patients memory of the words sung as opposed to spoken.  But not so for healthy adults.

Forget Flavor?

The Journal Cortex  published "Flavour processing in semantic dementia" by Katherine E. Piwnica-Worms, Rohani Omar, Julia C. Hailstone, and Jason D. Warren, and appears in Cortex, Volume 46, Issue 6 (June 2010).

The researchers tested patients' flavour processing using jelly beans: a convenient and widely available stimulus covering a broad spectrum of flavours. The abilities of patients to discriminate and identify flavours and to assess flavour combinations according to their appropriateness and pleasantness were compared with healthy people of the same age and cultural background. Patients were able to discriminate different flavours normally and to indicate whether they found certain combinations pleasant or not, but they had difficulty identifying individual flavours or assessing the appropriateness of particular flavour combinations (for example, vanilla and pickle).

These findings provide the first evidence that the meaning of flavours, like other things in the world, becomes affected in semantic dementia: this is a truly 'pan-modal' deficiency of knowledge. The research gives clues to the brain basis for the abnormal eating behaviours and the altered valuation of foods shown by many patients with dementia. More broadly, the results offer a perspective on how the brain organises and evaluates those commonplace flavours that enrich our daily lives.

So if you ever hear an elderly person announce, after trying frog legs, "tastes like chicken," consider these findings.

Remember Music

The National Institute on Aging supports Research from Boston University School of Medicine. That research shows that patients with Alzheimer's disease (AD) are better able to remember new verbal information when it is provided in the context of music even when compared to healthy, older adults. The findings, which currently appear on-line in Neuropsychologia, offer possible applications in treating and caring for patients with AD.

Watching Grandma kick it to her genre of music explains these findings, or the other way around. So in the end, the last things I may remember are the lyrics to some old Led Zeppelin or Jethro Tull songs.  "Whole Lotta...Aqualung!"

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Brain and Spine Injury Law Blog is about to celebrate a birthday. Over the past few years we have covered important issues to Brain and Spine Injury Advocates, victims and much, much more.

We are proud to say that our readers include board members, caregivers, prominent community leaders, governmental officials, industry professionals, local and national media representatives as well as licensed community association managers in Nevada and elsewhere.

Please Note: The host of this site is making some technological improvements, but that means you will need to re-subscribe to receive future updates. You will receive an email inviting you to re-subscribe. Subscribing is as easy as typing your email address on the link provided in the email.

Don't miss out - we have a lot more information to share with our readers. In fact, we are expanding the scope of our coverage in 2010 to include even more information about the brain and spine, its processes and much more.   Be on the lookout for additional authors, videos, newsfeeds and more. Of course, we will provide a detailed analysis of legislative activities and will include posts direct from the capital as items are considered.

Stay up-to-date by re-subscribing! Subscribing is as easy as typing your email address on the link provided in the email.
 

• Email This
• Print
• Comments
• Trackbacks
• Share Link

This is the latest as reported by the Brain Injury Association of America:

Federal TBI Program Update

On June 15, 2010, BIAA and other TBI stakeholders met with Mary Wakefield, the Administrator of Health and Human Service’s (HHS) Health Resources and Services Administration (HRSA) to discuss the future of the federal TBI program, one of the programs funded through the TBI Act. The federal TBI program provides grants to states to improve access to care for people with brain injury. 

The meeting was very positive and both the TBI stakeholders and HRSA are committed to working together to bring the attention needed to the program in order to grow the program and receive more funding for the TBI population in each state. HRSA has committed to working with stakeholders going forward to craft a strategic plan for the program and solicit public comment from appropriate entities such as BIAA state affiliates and state lead agencies in order to ensure that elevation of the program is successful.

BIAA is encouraged by the partnership forged between TBI stakeholders and HRSA and will continue to pass on important information as efforts progress.

FMAP Update

Last week, Senate Democrats came four votes short of invoking cloture on the tax extenders bill that includes the extension of increased federal Medicaid monies through June, 2011. After passing a Medicare physicians’ payment bill on its own instead of as a part of the larger extender package, Senator Max Baucus is encouraged that the larger bill still has the support and momentum needed for approval. The bill is expected to be considered in the Senate this week. 

BIAA will continue to monitor the situation closely. If you haven’t taken action on this alert, it’s not too late!

Health Care Reform Update

Last week, the Health and Human Services (HHS) department asked for public comments regarding their draft strategic framework on multiple chronic conditions (MCC). The framework addresses approaches to improving the health of individuals with concurrent MCC by providing options for HHS to strengthen coordination of its efforts internally and collaboration with stakeholders externally.

BIAA submitted a document detailing the concern that the draft framework does not include TBI in the list of conditions that constitute concurrent multiple chronic conditions. BIAA argued that because brain injury has been linked to epilepsy, Parkinson’s and Alzheimer’s disease and that individuals with brain injury manifest neurologic, neuroendocrine and psychiatric disorders as well as cardiovascular, musculoskeletal, gastrointestinal, urologic and sexual dysfunction it absolutely should be addressed in the framework.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

• Email This
• Print
• Comments
• Trackbacks
• Share Link

TheAmerican Medical Association study links depression and traumatic brain injury. Survivors of concussions are almost eight times more likely to become clinically depressed, researchers report.

In the year following a traumatic brain injury, roughly half of survivors likely experience a bout of clinical depression -- a rate almost eight times higher than that found in the general population, says a study published  in the Journal of the American Medical Association. And those whose head trauma was followed by depression reported significantly more pain, greater mobility problems and more difficulty carrying out their usual responsibilities than those who were not plagued by post-injury depression.

Traumatic brain injury, or TBI, is sometimes called concussion. Often called the "silent epidemic," it affects some 1.5 million Americans yearly. Its symptoms are often subtle -- including personality changes, problems of memory and concentration, headaches and mood disturbances. While for most, the effects of a head trauma will clear within a year, many have more lasting effects. For at least 80,000 people a year, major disability will follow.  

The 559 participants in this study had all come to a trauma center in the Seattle area with a head injury, signs of brain trauma that could be detected by a CT scan, and at least a few complications -- including loss of consciousness, disorientation or other factors that qualified them as scoring at most a 13 on the 15-point Glasgow Coma scale. Over the next six months, and then again at eight, 10 and 12 months after the participant's injury, researchers conducted a detailed telephone interview to gauge his or her mood state and ability to function. The result, said the researchers, was likely to yield a conservative picture of how many suffered from depression.

LA Times reporter Melissa Healy interviewed Dr. Hovda, a UCLA biologist who said, "the study made clear what clinicians had long suspected: "Major depressive disorder can have severe consequences for recovery from TBI."

But the study didn't explore some important distinctions, said Hovda, who was not involved in the research. Among those are whether repeated concussions — like those suffered by some U.S. troops and athletes — might make depression more likely than a single, severe brain trauma.

Other factors were also correlated with depression after Traumatic Brain injury including being African-Amreican, being involved in litigation, not completing high school, or when the injury was caused by violence (as opposed to a vehicular crash, fall or recreational injury).

It is still questionable whether depression is related to organicity of the injury or psyhological affects of the injury.  The latter being more susceptible to treatment.  But the myth that depression is "all in your head" (seriously - no pun intended) continues to dispelled.  It a serious consequence of traumatic brain injury that can severly affect a persons ability to function.

To learn more about TBI and its sometimes-persistent effects, this comprehensive website can't be beat. To learn about local support groups and national and state efforts to improve life for those with TBI, check this website out.  

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

Alcohol abuse by teenagers is similar to drug abuse on brain development.  There are two major periods of mental development: The first three years of life and adolescence.  Hopefully by the early 20s the brain is fully developed.

During adolescence the brain has difficulty handling emotions, seeks high excitement/low effort activities, and has poor planning and judgment skills. You can either think back to your own teenage angst or look at your kids or grandkids.  That combination leads to a cycle in which impulsive decisions to consume reduce inhibitions more and lead to increased impulsiveness and risk taking.

It’s also attractive to teens because consumption begins a short period of feeling good with no effort expended.  Unfortunately this many times sets the stage for adult behavior as well.

The AMA reports, additionly, adolescent females who drink alcohol have a greater risk of benign breast disease than do their non-drinking counterparts, according to new research.

The 2010 statement indicates that the brain's frontal lobes, essential for functions such as emotional regulation, planning and organization, continue to develop through adolescence and young adulthood. At this stage, the brain is more vulnerable to the toxic and addictive actions of alcohol and other drugs.  The developmental interruption is the concern.

Alcohol is the most commonly used and abused drug among youth in the U.S., according to the Centers for Disease Control and Prevention.

Nearly three-quarters of students (72%) consumed alcohol by the end of high school, according to the 2008 Monitoring the Future study, which is funded by the National Institute on Drug Abuse. Each year, the study surveys a total of about 50,000 students in eighth, 10th, and 12th grades. In 2008, 55% of 12th graders and 18% of eighth-graders reported having been drunk at least once.

 The American Academy of Pediatrics has published an updated policy statement on alcohol use by youth and adolescents. The AAP recommends that physicians take the following steps to help prevent and reduce underage drinking:

• Become knowledgeable about adolescent alcohol, tobacco and other substance use through training programs or continuing medical education.
• Obtain a complete family medical and social history at prenatal and child wellness visits to explore potential genetic and family influences regarding alcohol and other substance use.
• Recognize risk factors for adolescent alcohol use and be aware of mental health problems that might occur in this age group.
• Use validated methods to screen regularly for alcohol and other drug use.
• Assess patients whose screening results are positive for alcohol use to determine the appropriate level of intervention.
• Use brief intervention and motivational interviewing techniques to work with patients who use alcohol but do not meet criteria for immediate referral.
• Discuss the hazards of alcohol and other substance use with patients.
• Strongly advise teen patients against the use of alcohol, tobacco and other illicit drugs.
• Encourage parents to be good role models for healthy life choices.
• Be familiar with local resources to which young patients can be referred for treatment.
• Support continuation of 21 as the minimum legal drinking age.
• Support further research into prevention, evidence-based screening and identification, brief intervention, and management and treatment of alcohol and other substance use by adolescents.

Source: American Academy of Pediatrics, "Policy Statement Alcohol Use by Youth and Adolescents: A Pediatric Concern," Pediatrics, published online April 12 .

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Pediatric traumatic brain injury (TBI) is a major public health concern and challenge to critical care practitioners. The prevention of secondary injury is key to improving morbidity and mortality outcomes. Interventions are targeted at maintaining adequate cerebral blood flow and minimizing oxygen consumption by the brain. The anticipation and prevention of systemic complications are also of vital importance.

A new book focuses on evaluating what is currently known about childhood TBI and the challenges faced by researchers and clinicians in this arena. The book is entitled "Pediatric Traumatic Brain Injury: New Frontiers in Clinical and Translational Research," edited by Vicki Anderson and Keith Owen Yeates and published by Cambridge University Press. 

The following is an Introduction I ran across:

Traumatic brain injury (TBI) is a major public health problem among children and
adolescents. Surveillance data reveal that 1 in every 20 emergency department presentations at pediatric hospitals is for a TBI, making TBI more common than burns or
poisonings. For children, such injuries represent a common interruption to normal
development, with population estimates ranging from 200 to over 500 per 100 000 a year,
and with well-established variations across age and gender (Crowe et al., in press; Langlois et al., 2006).

The majority of TBI in children and adolescents are mild, typically with few
long-term consequences; however, a significant proportion of children will suffer more
serious injuries and will experience a range of residual physical, cognitive, educational,
functional, and social and emotional consequences, requiring the lifelong involvement of
health professionals across a range of disciplines and leading to a significant social
and economic burden for the children’s families and for the community more broadly
(Cassidy et al., 2004).

This book, New Frontiers in Pediatric Traumatic Brain Injury, aims to evaluate what we
have learned about TBI in childhood to date and, perhaps more importantly, to articulate
the challenges we face and how we should go forward in the future. Over the past two or
three decades, researchers and clinicians working with children with TBI have become
aware that injuries to the developing brain cannot be understood or treated in exactly the
same manner as those occurring in adulthood. Although we may be guided by science and
practice in adult TBI, unique developmental and contextual issues need to be taken into
account at all stages of recovery and treatment in children. Thus, a separate knowledge base is needed for pediatric TBI. As a consequence, until recently our understanding of recovery and outcomes in pediatric TBI has lagged behind that for adults. This is changing. Research in pediatric TBI now has more solid foundations. A number of principles have been established, some consistent with the adult literature, such as the predictive value of injury severity (Anderson et al., 2004; Taylor et al., 2008).

Others are specific to early brain injury, such as the unique mechanics and characteristic pathology of inflicted injury in children (Coats & Margulies, 2006; Prange & Margulies, 2002), or reflect the importance of developmental and contextual factors, such as the age at injury, developmental stage of brain development, and functional maturation (Anderson et al., 2005; Taylor & Alden, 1997), the key role of the family, and implications of life tasks specific to children (Yeates et al., 1997). 

• Email This
• Print
• Comments
• Trackbacks
• Share Link

A new classification of depressive subtypes of depression has been proposed in the current issue of Psychotherapy and Psychosomatics.  In keeping current on the new DSM being revised, as I have been writing about in previous posts, certain authors are recommending a revamping of depression subtypes to effect treatment. 

Lichtenberg and Belmaker argue that a simple diagnosis is no longer sufficient to guide treatment.  They propose the following subtypes:

Type A: Depression with Anxiety

Type B: Acute Depression

Type C: Adult Depression after Childhood Trauma

Type D: Depressive Reaction to Separation Stress

Type E: Postpartum Depression

Type F: Late-Life Depression

Type G: Psychotic Depression

Type H: Atypical Depression

Type I: Bipolar Depression

Type J: Depression Secondary to Substance Abuse or to a Medical Condition.

 One of the major challenges in treatment of depression seems to be the heterogeneity of the disorder. It is not uncommon to see significant differences in symptomatic presentation of depress patients.  Besides there are differences in age of onset, severity of course, treatment response and comorbid conditions. One assumption is that the heterogeneity is simply because there are different subtypes of depression,

says Tanvir Singh, MD and Alina Rais, MD, Dept. Psychiatry, University of Toledo Medical Center in their article entitled Subtypes of Depression.

I will anxiously await more information on the revised DSM.  For more information visit www.depression.com.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Brain Injury Association of America posts the following update:

Tell your Senators to Extend Extra Medicaid Funding Through June 2011!

It is important that all grassroots advocates unite to support the extension of the current elevated Federal Medicaid Assistance Percentage (FMAP) that is currently being debated in the Senate and will be very important to states come the end of this year!

Originally, both the House and the Senate acted to extend the extra match through June 2011, the end of the fiscal year for states. However, the offsets that were supposed to pay for this extension went instead to help pay for the health care reform legislation. Without an extension, the money will run out Dec. 31, 2010, and many states will be forced to make drastic cuts to the federal-state program. The 2009 federal stimulus package provided $87 billion to increase the federal share of the program through December (it included a 6.2% increase of the federal medical assistance percentage (FMAP) under Medicaid).

Last week, House Democrats debated HR 4213, the vehicle for this extension and chose to remove the provision extending extra federal Medicaid funding. With states in fiscal peril due to the recession and unemployment, it is vital that the extra federal funding continues in order to keep health care accessible for many brain injury patients and caregivers!
 

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Young people who exercise are building not only muscles and strength now, but stronger bones in the future.  Although exercising becomes more of a chore as we age some of us can take some small comfort in knowing we are still benefiting from out younger years.

The positive effects of exercise while growing up seem to last longer than previously believed. New findings suggest that physical activity when young increases bone density and size, which may mean a reduced risk of osteoporosis later in life.  All men and women face the risk and dangers of osteoporosis in their lifetime. These pages help make osteoporosis understandable.
http://www.endocrineweb.com/osteoporosis/index.html.

The researchers also looked at bone density and structure in the lower leg in around 360 19-year-old men who had previously done sports but had now stopped training. They found that men who had stopped training more than six years ago still had larger and thicker bones in the lower leg than those who had never done sports.  Running was also found to benefit middle aged men.

Bones tend to adapt to the muscles around them; puny muscles can mean puny bones.   Scientists in Minnesota, using a new machine that examines bone in three dimensions and measuring the runners’ leg muscles, found that, surprisingly,  injured runners’ bones were as strong, in relation to their muscle size as the bones in the uninjured runners. But the injured runners had significantly smaller calf muscles and therefore also slighter bones.

Thicker bones are good since they are more resistant to fractures.  Since falling becomes more prevalent in older people, so do fracture causing events.  Hence the benefit.  If you are young, be SURE to exercise.  Play a sport, lift weights, and do cardiovascular work outs.   If you are not "young," you are not off the hook.  Exercising at all stages of life is beneficial.  And as we age, the circulatory system depends on cardiovascular exercise.

The researchers have established that there is a positive link between exercise while young and bone density and size. The connection is even stronger if account is taken of the type of sports done.    Running appears to be the sport of choice when it comes to fewer injuries and arthritis. 

 

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

New Evidence that prevention will not cure Alzheimer's.  Here is some news that will turn your head around.  Just when you thought you might be doing everything right, you find out you might be wrong.  This reminds me of how much cigarette smoking is condoned Europe.  If you have ever been on an elevator in Italy or France you can not help but notice (and ingest) second hand smoke from the habitual smokers.  Now why is that?  Did Woody Allen's prediction in Sleeper come true?  Are cigarettes really good for you!?  And now the following.

An independent panel of experts meeting in the US concluded there is no evidence that you can prevent or slow down Alzheimer's, a progressive and fatal brain disease, even if you keep yourself active with exercise, social interaction, brain puzzles, or take fish oil, other supplements, or medication.  That is exactly the opposite of what we have been told.

The National Institutes of Health determined that the value of these strategies for delaying the onset and/or reducing the severity of decline or disease hasn't been demonstrated in rigorous studies.  Interestingly, the panel's assessment of the available evidence revealed that progress to understand how the onset of these conditions might be delayed or prevented is limited by inconsistent definitions of what constitutes Alzheimer's disease and cognitive decline. Other factors include incomplete understanding of the natural history of the disease and limited understanding of the aging process in general. The panel recommended that the research community and clinicians collaborate to develop, test, and uniformly adopt objective measures of baseline cognitive function and changes over time.
 

Alzheimer's Disease and Cognitive Decline, Structured Abstract. April 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/alzcogtp.htm actually concludes:

The current research on the list of putative risk or protective factors is largely inadequate to confidently assess their association with AD or cognitive decline. Further research that addresses the limitations of existing studies is needed prior to be able to make recommendations on interventions.

 But the initial ramifications may make us all rethink taking up smoking!  If you have not seen it, watch Woody Allen explain it in this short video.

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link