Traumatic Brain Injury Centers

By Amy Price PhD

Music Changes The Brain (image from meditate on it)

Neuroscience reports successful outcomes with specially engineered music therapy programs. Reports of music making a difference abound in science and classical literature. In Bible days musicians were sent ahead of Warriors to maintain morale and to set the climate of victory for battle. Recently there has been much emphasis given to the Mozart effect. In some studies music has been emphasized as being able to even enhance mathematical ability.

There is little doubt that music plays an important role in clinical recovery for many clients. One program I have used personally and clinically with great success is The Listening Program. We find The Listening Program improves many clients’ abilities to hear in noisy environments. Additionally we see improvements in auditory processing speed and attention. 

The Listening Program has matched spectral bands with somato-sensory cortex patterns and taken out some of these frequency bands. Participants enjoy the music in a classical format. The brain then attempts to match the missing frequencies to strengthen synaptic connections in the new pattern. The program employs dichotic listening in order to restore the balance in the way sound is perceived by the ears and translated by the brain.

Impaired auditory processing skills can be seen with imaging techniques as an abnormally enlarged auditory cortex is with the neurons responding over a greater area producing increased sensitivity as a compensatory measure. Unfortunately this also produces a greater signal to noise ratio in the brain. This may translate to reduced auditory accuracy in noisy environments. The ability to filter extraneous interference and to accurately discriminate sound is compromised. This same process takes place in chronic pain patients who are slower to feel the initial sensation of pain but are found to have increased sensitivity to pain, less tolerance and this pain is spread over a wider area.

One logical way to solve this problem would be to help the brain create a new path, making it less reactive to all stimuli and more sensitive to discriminating important stimuli. The Listening Program is effective as a tool to train the brain in this way. The orderly cadence of classical music in its mathematical formation can act as a filing cabinet for the auditory cortex. The frequency filtering allows the brain to come out of an automatic mode and learn a new way of hearing. The stereophonic listening gives the brain an opportunity to generalize where and how it will process new sound.

Song is often used to awaken dormant skills in comatose or stroke patient’s, evoking auditory response and initiating corrective response. Individuals may be unable to say words but they can repeat them when they are sung to them by a participating therapist. After singing, they then say the same words that were impossible for them just moments before. It may be that when people cycle between speaking and singing the contour and spacing of musical sounds may be decoded by additional areas in the brain which can then act as a conduit to the language centres of the brain. This may be because language uses motor, auditory and visual skills.

Singing may engage other brain areas and then cue brain neurons to act as a construction crew to make a detour around the damaged area or to enlist nearby neurons to build a strong new path. Recently neuro imaging tools have advanced so that changes caused by this kind of learning can be demonstrated by an increase in white and gray matter cells in the brain. The Listening Program also serves as a relaxing way to restore cognitive reserve and reduce the fight or flight response created by learning anxiety.

Many brain therapy patients spend hours in occupational, speech pathology, and physical therapy every day. This concentration is required to build new paths in the brain, however in early stages of recovery the brain is vulnerable and becomes tired. The Listening Program can provide a restful interlude in the midst of these other therapies. Clients report that using The Listening Program between other therapies refreshes them and allows them to be more productive.

Brain and Pain Diet Help

By Amy Price PhD

Brain injury and chronic pain survivors often ask me why they are getting so fat inspite of  low fat eating. Many people blame it on the meds but patients in increasing numbers are stating they get overwhelming cravings for sweet and fatty foods. This makes sense as it is one way the body tries to bring the reward system into balance since being brain damaged and in chronic pain sucks out the feel good neurotransmitters like dopamine, oxytocin and opiod receptors which the body then tries to take short cuts to get back to acceptable levels by over indulging on sweets and fats. Sadly over time this makes things worse and the system requires more and more fats and sweets just to find a balance. Getting your thyroid levels checked after a spine injury is important too thyroid dysfunction due to injury can show up years later and thwart efforts to have clear thinking and a slim body.

Changing your diet can help as can safe effective forms of exercise not only because you will look better but because your body will operate more effectively and the brain fog will lessen.

In the spinal patient community patients have been unofficially using bio-active magnesium and benfotiamine  (along with a multi B and C supplement) for relief of CNS nerve pain along with piracetam or aniricetam to assist cognitive functioning. There is also considerable discussion on the merits of a heart healthy diet inclusive of lots of green vegetables, whole grains and lean proteins for improving cognitive function, cell repair and pain levels after spine and head injuries. Some of us have found supplementing glucosamine chondritin along with vitamin C, E and fish oil to be helpful as well, for the vegetarians flax seed oil seems to do the trick. The diet rich in magnesium may seem counterintuitive due to the brain’s demand for glycogen and sweets cravings induced by chronic unremitting pain and brain fog but many have found good results with a change in diet and supplementation. In light of  this, the following  information about research on magnesium  was an interesting find.

Here is a link to a doable diet, for recipes there are some good ones at this  South Beach Diet site. You can download free apps to your cell phone  or use this program from your desktop that will total not only calories but nutrients so you can track your progress

Injury Consequences Can't Wait, Drive Safe Now!

By Amy Price PhD

MTBI survivors and families want to know if and when it is safe to drive again. There is computer software and professional treatment that can help many with driving, processing and memory skills. It is important to know if the treatment is effective before going back on the road. Email for more information on what is available. The AMA has released guidelines for physicians on how to test for safe driving and in addition many universities with memory clinics have road testing clinics where driving skills can be practised and tested before heading back on the road.

Abilities like picking out an object against a contrasting background can diminish in TBI in addition to visual processing speed and acuity as well as balance. Attention is important as many accident are caused by Brain fog and this can often be rehabililitated.  The ability to find your way around or handle the stress of adverse driving conditions such as weather, traffic, headaches or bad drivers is critical for safe driving. Often fear can influence driving skills and it is common for those who have sustained a TBI as a driver or a passenger are justifiably concerned. The AMA and Highway Safety comission have partnered to creat a great guide for physicians to test driving ability. You may want to take this to your doctor. It is also a good barometer for you and your loved ones to assess when you are safe for the road!

Save Your neck and the Necks of others rehabilitate driving skills…see you at the Dashboard!

Brain Training You Can do Together

By Amy Price PhD 

    Do you need to get your life back and restore relationships after trauma? It is not only truama survivors that can benefit from training but also family and caregivers who deal with the unexpected pressure of caring for a critically injured loved one. Brain neurons that fire together wire together, families that play together, stay together! Extensive research indicates our brain needs to overcome the negativity bias ingrained through the fight/flight response produced by trauma or social rejection to operate at maximum potential. It is more than positive thinking as the mind has a specific ratio of positive to negative input it accepts plus the input must be genuine to release the feel good chemicals that promote brain learning and healing.  Many people involved in an auto crash must fight for insurance rights and social acceptance during an era of limited capacity and chronic pain. All these aspects take a critical toll on the brain and promote inflammation cascades that lead to long term functional loss. The great news is that with targeted brain training in small manageable steps you can get back the edge taken from you though trauma, bad relationships, or serious illness. Your brain wants to work for you! 

Clicking on Train Your Brain , Save Your Mind here will take you to a fascinating short video on the power of personal brain optimization and contains a clinically validated assessment tool. This video is presented by Dr Evian Gordon of Brain Resource Company  and speaks about the highly acclaimed wellness program My Brain Solutions. It is well worth investigating, in less than 15 days I showed improvement on several measures of cognition. If you would like to sign-up for MyBrainSolutions please email me ….read on for why training your brain matters. 

Our minds and brains become so starved for approval and acceptance that we accept input and relationships that are harmful and not genuine. Your own brain even when it is damaged can pick up emotional cues in 1/20 of a second  which will determine how we respond to others.  I worked for the medical director of an organization for several years following a TBI…it was not until I was past that situation and had embarked on an adventure training positive emotions that I realised that in four years I had never been given a genuine smile. How can you tell? For a smile ask your self if the eyes crinkle slightly and the pupils enlarge, smiling with only the mouth is not genuine expression. Interestingly this insight has been validated by multiple behavioral, FMRI, GSR and QEEG studies, yet like many insights it is rooted in wisdom passed down from successful individuals who are at peace with themselves. Dr David Whitehouse, an eminent Harvard trained Psychiatrist put is this way  ”PEOPLE NOT ONLY SEEK AN EMPOWERING MIND, BUT ONE THAT IS AT PEACE WITH ITSELF”.  My Brain Solutions can help you learn to discern emotion and train your brain from a negative to a positive bias and offers a clinically validated personal assessment with a presonalized prescription to increase your brain function. Dr Evian Gordon states in his book ‘The Brain Revolution’ that  “THE DIFFERENCE BETWEEN AND EXPERT AND A NOVICE LEARNER IS A MODEL” One critical component of cognitive skill is one’s ability to speedily reframe or re-appraise the circumstances that surround you. People that successfully reframe have better life satisfaction and long term survival rates than those who are fixated on negative events, this ability can be trained. 

Research on cognition that shows transfer of training and increase in quality of life is dependent on carefully assessing individual differences with  clinically accepted tools which provide personalized training to meet these perimeters[1,2,3,4,] 

Learning and novelty are partners yet many brain fitness programs offer rote repetition of weak areas without variation in task or content in a bid to target learning, However research shows us this is not the way meaningful learning occurs. Tasks must be individually challenging to hold engagement and yet structured enough to be doable. Ideally tasks will adapt to changing learning curves to build neuroplasticity. The best learning capitalizes on emotional and intellectual strengths already present while strengthening areas of weakness in a positive atmosphere. For example, teaching a university student mnemonics and concept mapping may make the memory more efficient however teaching an individual with organic damage or early dementia how to remember names and faces with a mnemonic is an exercise in futility. 

Specific training alone can lead to plastic changes in the brain as demonstrated by expert Braille readers who show an enlarged hand area and smearing of finger representations in the somatosensory cortex. This result was observed in expert, but not in novice Braille readers suggesting that the training and not the blindness which leads to the changes in cortical representation [5]Similar domain specific results were noted in London taxi drivers and expert violinists. Kramer et al [6] states recruitment of additional brain regions helps performance only if the recruited area complements processing of the task in question. This is likely why rote memorization fails to increase working memory whereas training that targets attentional networks and processing speed increases working memory limits. We are incapable of processing in depth what we have not attended to and our capacity for material attended to is limited by the speed at which we process stimuli. 

References: 

1. Posner, M., & Rothbart M. Educating the human brain. Washington, DC US: American Psychological Association.; 2007:189-208. doi:10.1037/11519-009 

2. Jaeggi SM, Buschkuehl M, Jonides J, Perrig WJ. Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences of the United States of America. 2008;105(19):6829-33. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18443283 

3. Willis SL, Tennstedt SL, Marsiske M, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA : the journal of the American Medical Association. 2006;296(23):2805-14. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17179457 

4. Gordon E, Arns M, Paul RH. Research Report THE INTEGRATE MODEL OF EMOTION, THINKING AND SELF REGULATION: AN APPLICATION TO THE “PARADOX OF AGING”. Thinking. 2008;7(3):367-404. 

5. Greenwood PM. Functional plasticity in cognitive aging: review and hypothesis. Neuropsychology. 2007;21(6):657-73. http://www.ncbi.nlm.nih.gov/pubmed/17983277 

6. Kramer AF, Bherer L, Colcombe SJ, Dong W, Greenough WT. Environmental influences on cognitive and brain plasticity during aging. The journals of gerontology. Series A, Biological sciences and medical sciences. 2004;59(9):M940-57.: http://www.ncbi.nlm.nih.gov/pubmed/15472160

  National Event Stresses the Importance of Proper Detection and Treatment

Free Memory Screenings for Brain Optimization

 Boca Raton, FL— Consumers who want a status check on their memory can take advantage of free, confidential screenings on November 17 as part of National Memory Screening Day, an annual initiative of the Alzheimer’s Foundation of America (AFA) designed to promote proper detection of memory problems and strategies for successful aging.

 Memory screenings are a significant first step toward finding out if a person may have a memory problem. Memory problems could be caused by Alzheimer’s disease or other medical conditions.   

 Now in its seventh year, AFA’s National Memory Screening Day coincides with National Alzheimer’s Disease Awareness Month, which takes place during November.

    On November 17,  Sparks of Genius Brain Optimization Center will hold memory screenings at 7777 Glades Road, Boca Raton, from 10 am – 3 pm. Please call 561-859-4060 for more information or to make an appointment. You are also welcome to stop by.  Refreshments will be provided.

    At Sparks of Genius we offer cognitive training program which can slow down the progression of memory loss or delay it’s onset.

    AFA suggests memory screenings for adults concerned about memory loss or experiencing warning signs of dementia; whose family and friends have noticed changes in them; or who believe they are at risk due to a family history of Alzheimer’s disease or a related illness. Screenings also are appropriate for those who do not have a concern right now, but who want to see how their memory is now and for future comparisons.

    The event features a face-to-face screening, which takes only about five to ten minutes, and consists of a series of questions and tasks. Screenings will be conducted by Dr. Rohn Kessler, Dr. Amy Price and Ninah Kessler, LCSW. The results do not represent a diagnosis, and AFA advises those individuals with below-normal scores or those who have normal scores but are still concerned to follow up with a qualified healthcare professional.

     Eric J. Hall, AFA’s president and CEO, is urging consumers “to be proactive about brain health.”

    ”We pay so much attention to the health of our bodies, but we should be equally concerned about the health of our brains,” he said. “National Memory Screening Day offers the opportunity to find out how your memory is now and to learn how to protect it in the future.”

        For more information about National Memory Screening Day, visit www.nationalmemoryscreening.org or call 866-AFA-8484.

Medical Specialist Appointment and You

By Amy Price PhD
You have been sent to a specialist…what next? First of all sort out what you expect to happen as a result of this visit. What are your goals? Make sure they are realistic. If this was easy your primary care doctor could probably fix it.

Before your visit explain what records you have and ask which of these they would like you to copy and pre-send. Usually you can get copies of MRIs or other diagnostic tests on CD. They are easier to carry with you or send than bulky films. If you choose to send your diagnostic results and films call and confirm they arrived. Get a cost for a cash price unless you have medical insurance which will cover your visit so that you will know your costs and if you can absorb them.

If you are making a distance appointment insist on a phone consultation so you will know if your expectations are viable. If the staff you speak with don’t have information about a certain area make arrangements to call back when it is available. This way all the preliminary material is out of the way and your appt can focus on what is most important. Explain you are travelling from out of town and are in pain and request the best time of day to be seen promptly. Emergencies or office back ups can still happen but this step minimizes the possibility.

Write down what you consider to be the most important things you want covered in your visit. The reason you may want to do this is because chronic pain and injury can cause us to be sidetracked by emotion. You may get a compassionate response but it may eat away at the time available.

This is the place to get your MRI and other diagnostic tests explained. The doctor that ordered the test is the one who needs to explain it. Get an advance copy of the report and ask about what you don’t understand. We get emails every day from people who want us to translate the MRI or other diagnostics. We cannot do this because the MRI is only part of the equipment needed for a diagnosis. It is your job to make sure you understand your diagnosis before you leave the doctor’s office.

It is helpful to plan a nice dinner out or a treat for yourself for afterwards and if you can, take someone with you who will remember what the Doctor says. The reason for this is it will be difficult for you to reconcile yourself to a 40 minute appt when the injury has taken over your life 24/7. Even though your appointment time may be quite generous, logic and rational thought cannot always be counted on, when you just want it fixed.

Now relax and trust the specialist you have chosen!

Dr and TBI

How you communicate with your doctor will often determine the quality of care you recieve and that your legal rights are protected. Here is a practical guide from Michael Kaplen a lawyer at BrainLaw. For other survival skills to help you through a doctor’s appointment this post is good reading

1. When you schedule your first appointment, tell your doctor that you will require extra time. Tell him that you need at least an additional 20 minutes (or more if you need it) for your appointment. The challenge here is to not feel rushed, as when you are stressed your cognition erodes.
2. If distractions bother you, arrange with the doctor’s office (when you make the appointment) for a quiet place to wait, such as a quiet exam room. If this is not possible, ask for somebody to come and get you in the foyer or your car.
3. Get to your appointment at least 15 minutes ahead of time, so you can collect your thoughts, become settled and unwind from the drive.
4. Write down everything you want to tell or ask your doctor. Cross each item off the list after you have covered it. Write down instructions that your doctor gives. Recap at the end of each issue, to make sure you understand.
5. Ask your doctor to write down your diagnosis. Ask for a written explanation in layman’s language. Ask for a written description of the preferred treatment and goals, with an estimate of the costs and the expected time frame.
6. Trust your instincts. If you don’t think that a diagnosis is valid, or if you think it minimizes your problems, remember this: YOU ARE PROBABLY RIGHT. Remember, you are the “expert” about you.
7. Always ask your doctor about the contraindications when he prescribes new medications. Additionally, have the doctor provide you with a written list. Take charge of knowing everything about the drugs you take.
8. Ask your doctor to make a notation in your file stating that you should receive a copy of all reports and tests as soon as they are received by the office.
9. Never sign a blank release form. Make sure all authorization forms are completely filled out. Read what you’re signing. Make sure the release has ONLY the names on it that YOU want. Get a copy of each and every release form/letter you sign.

TBI Math Help Online

By Amy Price PhD

If you are having a tough time with math after an injury or just never understood it. This is a great link. The material is free online and you can download explanations and practice questions. If you learn best by hearing and seeing there are I-Phone apps by Math tutor that you can down load.  There are also math  apps for othe 3g phones  although the I-Pod selection is better. Most people have trouble with math because it is sequential so if you missed steps or the brain injury knocked them out you need to relearn them. Simple things like what to do with brackets and in which order to do the equations help a lot. There is also a free class for basic math at open university and one on visualizing maths. This is an important step for really getting it as if when you can see it in your mind it is easier to work the equations. Remember if you are using a scientificor graphing  calculator the vendor will generally have tutorials on the web site.  Be patient with yourself and give it time. You can do this!

Change Ethnic Poverty

Students of African American and Hispanic background were recently part of a pilot project using a novel system of cognitive assessment to assess children’s learning potential. It was developed by Professor Reuven Feuerstein. The assessment consists of a battery of six to eight tests which measure abstract thinking, analogies, and qualitative thinking and are not culturally-biased.

“Nationally, African American students are identified as educationally mentally retarded twice as often as their white peers; and African Americans are identified as emotionally/behaviorally disordered one and a half times as often as their white peers. The actual number of these “BD” (Behavioral Disorder) diagnoses has increased by 500% between 1974 and 1998.”

Dr. Eric Cooper, President of the National Urban Alliance notes how unfortunate it is that “misdiagnosis of special education status has been used to place a significant number of children of color into programs that doom them to a life of low expectations and low achievement.”

Professor Feuerstein agrees and writes that “Too often we give up on children who are labeled with learning disabilities, but my work has found that using more creative techniques to teach these children will lead them to the same successes that life offers the other children in the classroom. Poverty is not destiny and we can reverse major depression in a child’s cognitive development and realize impressive results.”

Feuerstein’s theory of Structural Cognitive Modifiability “views the human organism as open, adaptive and amenable for change. The aim of this approach is to modify the individual, emphasizing autonomous and self-regulated change. Intelligence is viewed as a propensity of the organism to modify itself when confronted with the need to do so. Intelligence is defined as a changeable state rather than an immutable trait.”

Feuerstein’s claim that “poverty is not destiny” and that we can improve a child’s cognitive development and realize impressive results is profoundly important. He asserts that the benefits to all of society cannot be overstated.

Let me give one example. It has been proposed by Dr. Paul Nussbaum that learning may act as a potential vaccine again Alzheimer’s Disease and other age-related neurodegenerative diseases of the brain.

If we begin to think of learning as a process that improves health, like nutrition and exercise, then all students need to maximize their cognitive development. If tens and hundreds of thousands of poor children are placed in programs that doom them to a life of low expectations and low achievement and learning does act as a vaccine against age-related neurodegenerative diseases of the brain, we are accelerating the rate of dementias.

Childhood poverty has already been linked to dementia. Author of the research, Dr Moceri, said that “a poor quality childhood environment could prevent the brain from reaching a complete level of maturation.” The areas of the brain that show the earliest signs of Alzheimer’s are the one that take the longest time to mature during childhood and adolescence.

There are more than 5 million people in the United States living with Alzheimer’s. This means that every 72 seconds, someone develops Alzheimer’s. The indirect costs of Alzheimer’s and other dementias amount to more than $148 billion annually. Feuerstein’s International Center for the Enhancement of Learning works with children throughout the world. Plans are underway to start implementing the partnership in 20 U.S. cities. Educators, policy makers and journalists should follow the story carefully.

–Dr. Rohn Kessler

CEO and Founder Sparks Of Genius

By Amy Price PhD            An alternate title is “What you see on the inside produces consequences on the outside”. Scriptures state this a couple of other ways “As an individual thinks in his/her heart so is their destiny” The prophets explained the Israelites initial inability to enter the land of promise by saying “They were like grasshoppers in their own sight and so they were the same in the eyes of others”.

Science bears this out. According to integrative neuroscientist Evian Gordon (2001, 2008) minimizing danger and maximizing reward is a significant principle in how the brain organizes and in so doing impacts our lives. If a situation leads to a reward response such as positive emotions, words, or activities the brain engages and approaches or engages. When a situation brings up negative emotions or punishment the brain sends out an avoid response and detaches.

Can you see where this principle would lead in marriages, the work place or learning? In one research study participants completed a paper maze that featured a mouse in the middle trying to reach a picture on the outside. Half of the group saw a piece of the cheese as the picture to reach while others saw a predator.

The effect on learning the maze was astounding those that had the cheese picture solved more problems more creatively than those with the predator picture. (Friedman and Foster, 2001). Other studies relate how people who specifically visualize and mentally practice winning have significant advantages over people who did not practice and in fact what they ‘thought” gave them a similar advantage to actually practicing (Logie and Denis ,1991)

Transferring this concept to the real we can ask these questions. How likely is someone who senses their credibility is undermined to be able to produce answers to complex problems or initiate creative solutions?

Performance reviews, constructive criticism, even unasked for advice can threaten status and cloud thinking. You can even threaten your own status by seeing yourself as hanging by your fingernails over a cliff or rehearsing failure. There are a series of steps you can take to change your mind and get it working for you from the inside out.

As an employer, parent, friend or marriage partner are you unknowingly causing threats to an individual’s status or is someone threatening yours? Watch this space for ways of enhancing status and changing your place in the workspace!

For ways to put these principles in action see this article http://empower2go.wordpress.com/