Concussions and Traumatic Brain Injury (TBI)
Concussions and Traumatic Brain Injury (TBI) can have long lasting effects on our mental, emotional, and physical health. You know that being on top of your game is crucial. Clarity of thought is the gift that keeps on giving. Who can afford that that brain fog feeling? Did you know that acupuncture can speed and enhance the recovery time after a concussion? Symptoms of a concussion include erratic and unexplained emotions, fatigue, and brain fog. It’s important to remember that very cell in our body is electrically charged and that capacity for charge is the first step toward rebuilding those damaged tissues. Traumatic brain injuries (or TBI) alters the
electrical charge in the damaged tissues. Acupuncture helps balance and enhance the electrical circulation in the injured tissues and can increase recovery times after traumatic brain injuries.
[12][13][14][15][16]
Traumatic brain injuries (TBI) and concussions have been gaining public and clinical attention in recent years. The Centers for Disease Control and Prevention
(CDC) reports that
between 2006 and 2014, the number of hospitalizations and deaths resulting from TBI’s jumped a staggering 53%! This dramatic increase is undoubtedly related to increasing public awareness around the immediate and long-term consequences of head traumas, but even with increasing collective cognizance, the problem persists. In 2014 alone, some 2.87 million people were hospitalized, 837,000 of which were children, and sadly, with fatal outcomes in 56,800 and 2,529 respectively.
The leading causes of TBI’s are falling and landing on the head, car accidents, and external trauma to the head as is common in sports injuries or workplace injuries. You can read further and ‘get-the-facts’ from the CDC
[1].
Equally concerning are the potential long term consequences of brain injuries. As time passes, and the brain continues to heal, it’s important to be aware of symptoms that may persist.
Months to years after a brain injury, people may still experience:
Chronic Headaches: More than half of those who suffer a brain injury experience long-term headaches or migraines.
[2]
Depression, anxiety, and behavior changes: There is no one specific psychological, behavioral, or personality change that is predictable after TBI. Know that behavior and mood changes are common for several months afterward.
[3],
[4],
[5] Don’t shrug this off. Seek medical evaluation and establish a supportive care network.
Visual sensitivities: Regions of the brain that process near field of vision are often disrupted. This can impact balance and cause light sensitivity. Screen time likely aggravate this.
[6]
Fatigue: When healthy, the brain consumes up to 25% of our total energy. After a TBI, cells are damaged, blood flow is reduced, thus reducing oxygen, and the mitochondria in our brain cells require significantly more energy.
[7],[8]
Sleep problems: After brain injury, up to 70% of people suffer from significant sleep problems.
[9],
[10]
Epilepsy and seizures: Research indicates a wide variation among TBI and patients who develop seizures or epilepsy.
[11]
Higher risk of developing Alzheimer’s, Stroke, or other neurodegenerative disease
In light of these statistics, unfortunately it’s likely that someone you know has experienced a traumatic brain injury. It is our intention to carry on the conversation and provide education on what we see in the clinic and how we treat brain injuries at The WellBridge Clinic (You can check out our recent post highlighting the efficacy of acupuncture in treating TBI and concussions
here). To state the obvious disclaimer, if you or someone you know has suffered a traumatic brain injury, get a comprehensive medical evaluation. The information that we are providing here is all based on brain injury research and has shown clinical efficacy in reducing symptoms and severity while reducing the duration of recovery.
1: Get Acupuncture!: Using specific electrical frequencies at acupuncture points along the head can significantly increase blood flow to the brain for hours to days after treatment. Increasing blood flow to damaged nerve cells is critical in the acute phase to prevent the impacted brain cells from dying.
Electro-acupuncture reduces the amount of inflammation around the brain cells, thereby protecting them from long-term damage. Further, a large-scale study of nearly 30,000 TBI patients followed over an 8 year period after brain injury, showed that those who received acupuncture treatments after their brain injury were significantly less likely to suffer a stroke years later.
Acupuncture improves quality of sleep and reduces stress and anxiety often experienced following brain injury. Acupuncture is a crucial treatment to add in immediately after a traumatic brain injury and can help prevent long-term cognitive problems and neurodegenerative diseases such as stroke and Alzheimer’s.
[12],
[13],
[14],
[15]
2: Creatine Supplementation: That molecule so frequently associated with the body-building community, is crucial in providing energy for the brain. Athletes who have been taking creatine before a TBI seem to recover more quickly, with less long-term symptoms. Taking creatine after a TBI will still provide energy to the brain’s mitochondria and protect against oxidative damage. [16],[17]
3: Ketones supplementation and ketogenic diet: Glucose is the primary energy source for the brain but our cells are well adapted to convert to using fat as fuel. When utilizing fats as energy sources, the ketone bodies generated by fat metabolism not only provide a quality fuel source for mitochondria in brain cells, the ketones also exert a neuroprotective effect, and reduce the prolonged brain cell death caused by leakage of glutamate out of damaged brain cells, and circulating reactive oxygen species resulting from trauma. [18],[19],[20]
4: Omega-3 oil supplementation: Omega-3 oils have been well established for reducing the risk of heart attacks and strokes, but they are a crucial addition after any brain injury. Days to weeks after brain trauma, the damaged brain cells either repair or are signalled to die. If left untreated, neuroinflammation will result in greater brain cell loss. Omega-3 oils exert a protective function that reduce brain cell death and have also been shown to increase neural communication after damage to brain cells. [21],[22],[23]
5: Lion’s Mane mushroom: Hericium erinaceus, aka Lion’s Mane mushroom, is rich in several types of compounds called erinacines. Clinical studies are showing that erinacines stimulate nerve-growth-factor (NGF) and can protect brain cells not only in TBI patients, but Alzheimer’s, Parkinson’s, and Stroke patients as well. [24],[25]
6: Reduce screen time: Blue light emitted from phones, computers, and fluorescent lights often aggravate headaches and can worsen an already fatigued brain. Avoid unnecessary visual stimulation from
7: Get quality sleep and take more naps: When we are in deep sleep, our cells do most of their repair. After a TBI, it is very common that sleep patterns are disrupted due to disturbed neural activity. Those that don’t prioritize sleep after a brain injury are very likely to have significant and prolonged impaired cognitive function months after injury. [26]
The Bottom Line: Traumatic brain injuries are serious and can be fatal. It has been common in our culture to ignore or “shake off” a blow to the head but please take it seriously. Though the headache may resolve within a few days, the long term consequences of brain cell damage can cause life-long problems and pose a risk for developing diseases like Alzheimers, ALS or stroke.
Acupuncture, nutrition, and specific supplementation play a key role in recovering from any traumatic brain injury.
Citations:
[1] Centers for Disease Control and Prevention: Traumatic Brain Injury: Get the Facts
[2] “Prevalence of Chronic Pain After Traumatic Brain Injury” JAMA. 2008;300(6):711-719 (doi:10.1001/jama.300.6.711)
[3] “Axis II psychopathology in individuals with traumatic brain injury” Mary. R. Hibbard, Jennifer Bogdany, Suzan Uysal, Karen Kepler, Jonathan M. Silver, Wayne A. Gordon & Lisa Haddad (2000); 14:1, 45-61, DOI: 10.1080/0269905001209161
[4] “Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury”; Charles H. Bombardier, PhD; Jesse R. Fann, MD, MPH; Nancy R. Temkin, PhD; et alPeter C. Esselman, MD; Jason Barber, MS; Sureyya S. Dikmen, PhD; JAMA. 2010;303(19):1938-1945. doi:10.1001/jama.2010.599
[5] “What Impact Will Moderate or Severe TBI Have on a Person’s Life?”; Center of Excellence for Medical Multimedia. (n.d.). Moderate to Severe TBI: Long-Term Effects. Retrieved March 28, 2019, from https://tbi.cemmlibrary.org/Moderate-to-Severe-TBI/Long-Term-Effects
[6] “Convergence insufficiency in brain-injured patients”; M. Cohen,Z. Groswasser,R. Barchadski &A. Appel, Journal Brain Injury, Volume 3, 1989 – Issue 2
[7] “Neurometabolic indicators of mitochondrial dysfunction in repetitive mild traumatic brain injury”; Susan Kim, Steve C Han, Alexander J Gallan & Jasmeet P Hayes; Future Medicine, Concussion, Vol. 2. No. 3.
[8] “Impaired cerebral mitochondrial function after traumatic brain injury in humans”; Bon H. Verweij M.D., J. Paul Muizelaar M.D., Ph.D., Federico C. Vinas M.D., Patti L. Peterson M.D., Ye Xiong M.D., Ph.D. and Chuan P. Lee Ph.D.; Journal of Neurosurgery; https://doi.org/10.3171/jns.2000.93.5.0815
[9] “Traumatic Brain Injury and Sleep Disorders”; Mari Viola-Saltzman, D.O. and Nathaniel F. Watson, M.D., M.Sc.; Neurol Clin. 2012 Nov; 30(4): 1299–1312.; doi: 10.1016/j.ncl.2012.08.008
[10] “Insomnia following traumatic brain injury: a review.”; Ouellet MC1, Savard J, Morin CM.; Neurorehabil Neural Repair. 2004 Dec;18(4):187-98.
[11] “A Population-Based Study of Seizures after Traumatic Brain Injuries”; John F. Annegers, Ph.D., W. Allen Hauser, M.D., Sharon P. Coan, M.S., and Walter A. Rocca, M.D., M.P.H.; January 1, 1998; N Engl J Med 1998; 338:20-24; DOI: 10.1056/NEJM199801013380104
[12] “Cerebral Blood Flow and Apoptosis-Associated Factor with Electroacupuncture in a Traumatic Brain Injury Rat Model”; Chih Hsiang Chuang, Yao Chin Hsu, Che Chuan Wang, ChoYa Hu, Jinn Rung Kuo; Acupuncture in Medicine; Volume: 31 issue: 4, page(s): 395-403; https://doi.org/10.1136/acupmed-2013-010406
[13] “Early electroacupuncture treatment ameliorates neuroinflammation in rats with traumatic brain injury”; Wei-Chen Tang, Yao-Chin Hsu, Che-Chuan Wang, Chiao-Ya Hu, Chung-Ching Chio & Jinn-Rung Kuo; BMC Complementary and Alternative Medicine volume 16, Article number: 470 (2016)
[14] “Decreased Risk of Stroke in Patients with Traumatic Brain Injury Receiving Acupuncture Treatment: A Population-Based Retrospective Cohort Study”; Shih C-C, Hsu Y-T, Wang H-H, Chen T-L, Tsai C-C, Lane H-L, et al. (2014) Decreased Risk of Stroke in Patients with Traumatic Brain Injury Receiving Acupuncture Treatment: A Population-Based Retrospective Cohort Study. PLoS ONE 9(2): e89208.; https://doi.org/10.1371/journal.pone.0089208
[15] “Reduced Use of Emergency Care and Hospitalization in Patients with Traumatic Brain Injury Receiving Acupuncture Treatment”; Evidence-Based Complementary and Alternative Medicine; Volume 2013, Article ID 262039, http://dx.doi.org/10.1155/2013/262039
[16] “Dietary supplement creatine protects against traumatic brain injury”; Sullivan, P. G., Geiger, J. D., Mattson, M. P. and Scheff, S. W. (2000); Ann Neurol., 48: 723-729. doi:10.1002/1531-8249(200011)48:5<723::AID-ANA5>3.0.CO;2-W
[17] “Potential for use of creatine supplementation following mild traumatic brain injury”; Philip John Ainsley Dean, Gozdem Arikan, Bertram Opitz, Annette Sterr; Concussion. 2017 Jun; 2(2): CNC34. Published 2017 Mar 21. doi:10.2217/cnc-2016-0016
[18] “Clinical review: Ketones and brain injury”; Hayden White, Balasubramanian Venkatesh; Crit Care. 2011; 15(2): 219. Published 2011 Apr 6. doi: 10.1186/cc10020
[19] “Ketone Bodies, Potential Therapeutic Uses”; Richard L. Veech, Britton Chance, Yoshihiro Kashiwaya, Henry A. Lardy, George F. Cahill, Jr.; IUBMBLife, 51: 241–247, Copyright 2001 IUBMB1521-6543/01
[20] “The collective therapeutic potential of cerebral ketone metabolism in traumatic brain injury”; Mayumi L. Prins, and Joyce H. Matsumoto; Department of Neurosurgery, Brain Injury Research Center and Department of Pediatrics, Division of Pediatric Neurology, University of California, Los Angeles; Journal of Lipid Research Volume 55, 2014[
21] “Omega-3 polyunsaturated fatty acid attenuates traumatic brain injury-induced neuronal apoptosis by inducing autophagy through the upregulation of SIRT1-mediated deacetylation of Beclin-1”; Chen, X., Pan, Z., Fang, Z. et al. Omega-3 polyunsaturated fatty acid attenuates traumatic brain injury-induced neuronal apoptosis by inducing autophagy through the upregulation of SIRT1-mediated deacetylation of Beclin-1. J Neuroinflammation 15, 310 (2018) doi:10.1186/s12974-018-1345-8
[22] “Concussions and brain injury: Can omega-3 intake aid in brain health recovery?”; ScienceDailyNews; Date:August 24, 2016; Source:Taylor & Francis
[23] “Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s”; Lewis MD; J Am Coll Nutr. 2016 Jul;35(5):469-75. doi: 10.1080/07315724.2016.1150796.
[24] “Neurohealth Properties of Hericium erinaceus Mycelia Enriched with Erinacines”; I-Chen Li, Li-Ya Lee, Tsai-Teng Tzeng, Wan-Ping Chen, Yen-Po Chen, Young-Ju Shiao, Chin-Chu Chen; Behav Neurol. 2018; 2018: 5802634. Published 2018 May 21. doi: 10.1155/2018/5802634
[25] “Protective Effects of Hericium erinaceus Mycelium and Its Isolated Erinacine A against Ischemia-Injury-Induced Neuronal Cell Death via the Inhibition of iNOS/p38 MAPK and Nitrotyrosine”; Kam-Fai Lee, Jiann-Hwa Chen, Chih-Chuan Teng; Int. J. Mol. Sci. 2014, 15(9), 15073-15089; https://doi.org/10.3390/ijms150915073
[26] “A review of sleep disturbances following traumatic brain injury”; Zuzuárregui, J.R.P., Bickart, K. & Kutscher, S.J. A review of sleep disturbances following traumatic brain injury. Sleep Science Practice 2, 2 (2018) doi:10.1186/s41606-018-0020-4
