Cobbers on the Brain – Page 83 – Student Commentary on the Neurological Sciences

Clearing the Haze on the Science of Marijuana

Posted on December 1, 2018 by / 0 Comment

What comes to mind when you think of the word marijuana? Gateway drug? Euphoria? Weed? Illegal? Schedule I drug? It is important to realize that there has been a dramatic increase in using marijuana for medicinal purposes in order to help relieve pain, help reduce anxiety and migraines, and other diseases such as cancer, Parkinson’s, and Epilepsy. So you may be asking yourself, “how can marijuana be beneficial?” and in order to answer this question we look to the endocannabinoid system in the body.

What is the Endocannabinoid system and why is it important?

In essence, endocannabinoids are lipid molecules that are produced in the body that interact with the cannabinoid system in order to help maintain stable conditions physiologically and act as neurotransmitters when needed. The two cannabinoid receptors that are involved in this story are CB1 and CB2 receptors and act as G-protein coupled receptors (GPCR). The CB1 receptors are more common and are mainly found in the central nervous system (brain), peripheral nervous system and other organs. The CB2 receptors, however, are less common and mainly found in the immune and gastrointestinal systems.

Common Endocannabinoid molecules

Anandamide (AEA) and 2-AG are both molecules derived from arachidonic acid and are known as retrograde neurotransmitters that essentially act backward from the post-synaptic neuron to the pre-synaptic neuron and decrease the amount of communication between neurons. This is what leads to the positive effects of pain relief, helping with anxiety, seizures, and even muscle spasms. When one of these endocannabinoids (made from body) or cannabinoids (from marijuana) binds to the receptor, the pathway that would otherwise be activated is now inhibited and cAMP is also inactive. This could lead to multiple cellular changes, including apoptosis, or cell death. This aspect of the endocannabinoids is extremely beneficial in cancer. Apoptosis happens due to the binding of the cannabinoid and an increase in ceramide synthesis, which leads to a stress response and causes cell death.

To legalize marijuana or not: that is the question.

In today’s society, we are constantly talking about whether to legalize marijuana, whether it is for recreational or medical purposes. Some states have decided to legalize the drug for recreational use while others have not. However, it is still illegal under the federal government. But do the benefits outweigh the risks? Should marijuana be legalized for recreational use or solely for medical purposes? Is it really a schedule I drug? Why is it SO HARD to study marijuana? I personally would like to see more research done with marijuana and the contents that come with the drug, especially as an aspiring physician. However, as the FDA classifies marijuana as a schedule I drug, it makes research on cannabis nearly impossible. This continues to frustrate me because it means that it is extremely difficult to learn more about the potential benefits from this drug from a research perspective. Research labs and scientists want to conduct research studies on cannabis, yet cant have easy access in order to do this. This seems to be the bigger problem that needs to be fixed and maybe one day, hopefully soon, more research on cannabis can become a reality.

Image 1: https://www.youtube.com/watch?v=MqxJ7tsBt0s

Image 2: https://musclemx.com/2018/03/24/11-mind-blowing-facts-about-your-bodys-endocannabinoid-system/

Image 3: https://www.sclabs.com/the-endocannabinoid-system-and-stress-related-psychiatric-illness/

Image 4: https://medium.com/ucsf-magazine/why-is-it-so-hard-to-study-marijuana-d7a17c206fe1

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The Benefits and Drawbacks of Medical Marijuana

Posted on December 1, 2018 by / 0 Comment

Over half of the states in the United States have legalized marijuana for medical uses, however so far, the FDA has only approved the treatment by medical marijuana for two specific types of epilepsy and some effects of chemotherapy. There is a lack of research on the effects of marijuana for medical uses as the FDA classifies marijuana as an abusive drug, therefore making it extremely dangerous to be a prescribed drug. This causes researchers to go through extensive testing and licensing just to be given permission to research medical marijuana and its effects.

The endocannabinoid system produces chemicals called cannabinoids and is a system that works to maintain homeostasis in the nervous system. Endocannabinoids are inhibitory and are made when needed to reduce a reaction and counteract overstimulation. The endocannabinoid system is responsible for maintaining:

reproduction and fertility
digestion and appetite
sleep
motor control
pain
pleasure
immune function
memory
mood
temperature

The two most common cannabinoids are THC and cannabidiol. Both bind to the endocannabinoid receptors, which are CB1 and CB2. These receptors are moderated by GPCRs and when activated, are responsible for the symptoms caused by cannabinoids. The receptors were created for the endocannabinoid system, but they can also be activated by the chemicals in cannabis.

CB1:

located in brain and nervous system, as well as some other specific organs
bind with THC and endocannabinoids
aid in pain relief

CB2:

located in immune system
bind CBD and specific endocannabinoids, such as 2-AG
aid with appetite, inflammation, and immunity

The two most common endocannabinoids are anandamide and 2-AG. Endocannabinoids act like the body’s natural THC, with a much shorter and less extreme effect. THC is the psychoactive component of marijuana and is known for causing many changes in the brain, including:

Increased blood flow in areas of cognition, emotion, and awareness
Decreased blood flow in areas of sensory
Altered brain activity in areas of reward, emotion, coordination, and speech

THC is responsible for the “high” feeling of marijuana. Cannabidiol, or CBD, is legal in all states and is naturally occurring. It is used to relieve symptoms of many diseases, including pain, inflammation, anxiety, depression, epilepsy, and chronic conditions.

As medical marijuana contains both THC and CBD, there are varying effects that this treatment could have on an individual. In some cases, this could cause pain relief, a reduction in inflammation, or a feeling of relaxation and calmness. However, in other situations, it could cause panic, paranoia, or a worsening of symptoms. Similar to other prescription drugs, the reactions to the drug would have to be closely monitored. Some negative side effects of medical marijuana include:

depression
dizziness
hallucinations
low blood pressure
judgement and coordination issues
mental function deficits

However, the main conflict with the legalization of medical marijuana is the claim of it being a gateway drug. As the levels of THC increase, the addictive levels increase and cause an individual to become dependent on the drug for the symptom relief and “high” feeling. Another main issue is the regulation of medical marijuana and how it is administered to patients. As medical marijuana does not go through a pharmacy, it is argued that is could be easily abused and the marijuana will be different in every place it is received based on THC and CBD concentrations.

Despite the negative effects and controversy behind medical marijuana, it could potentially have positive effects and aid in the treatment of many diseases. Some of these include:

Alzheimer’s Disease
appetite loss/eating disorders
cancer
chronic diseases
epilepsy
mental health disorders
pain
nausea
muscle spasms
glaucoma

The fight for the legalization of medical marijuana in all states and for many types of conditions will continue, however it seems that there may need to be more regulations and research done in order to truly understand the effects of medical marijuana, how to prescribe it and regulate its use, and in what ways medical marijuana can be beneficial for the population.

https://www.greenrelief.ca/blog/cannabinoid-receptors/

https://www.webmd.com/a-to-z-guides/medical-marijuana-faq

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Love Hurts: The Collision of Sports and Concussions

Posted on November 29, 2018 by / 0 Comment

“You look up and see stars. The sun shining down on you seems extra bright. You’re not really sure what is going on, so you look around for clues around you. You look at the scoreboard, ‘Okay I’m at school.’ You look down at your body and see your padded body, ‘Okay I was playing football.’ You look at the trainer, ‘What the heck just happened?’ She answers, ‘You got hit in the head pretty hard, you might have a concussion.’ That is the first thing that makes sense because your head feels like it is splitting in two.”

This is a real story from an individual who suffered a concussion during a football game. He told me about the confusion he felt, how dizzy he was, and how blinding the light was to look at right after. There are many stories that are just like this one told by many athletes around the world, but not only athletes suffer concussions. The Brain Injury Research Institute (BIRI) says that in the United States there are around 2-4 million concussions every year.

But what is a concussion?

A concussion is described as a biomechanical force to the brain. This causes a potassium efflux, and a sodium and calcium influx. This increase of calcium can lead to neurofilaments collapsing and axons losing their structural integrity leading to axonal dysfunction. There is also glutamate release at times when it is not meant to release, causing excitotoxicity inside of cells. With everything going wacky, ATP is required to bring everything back to normal. This calls for an increased consumption of glucose to provide ATP. This causes your energy stores of glucose to be low after a concussion and you can feel very exhausted from small activities.

Why Don’t We Eliminate Concussions?

http://a1.espncdn.com/combiner/i?img=%2Fphoto%2F2017%2F1026%2Fr280294_1296x729_16%2D9.jpg

Joe Flacco sustained a concussion on this hit from Kiko Alonso in a football game last year.

Since concussions are so prevalent and they can cause lasting and worsening effects of the brain and people’s lives, why don’t we just eliminate them? I believe that the main reason for this is: people care so much about their activities and the possibility of suffering a brain injury is worth it to participate in something they love doing. Just look at sports, according to BIRI 10% of all college football players and 20% of all high school players sustain brain injuries, 87% of professional boxers have sustained a brain injury, 5% of soccer players have sustained brain injuries, and an athlete who sustains a concussion is 4-6 times more likely to sustain a second concussion. In my personal opinion, we need to start looking at concussions more as a serious injury and I believe we have as a society. We need to get more information out there to those who are at risk for suffering concussions and for those who have already suffered concussions. We should be taught that the sport could end up costing you a normal life and that if you need to give it up, you should. Sometimes you need to sacrifice things you love for other things you love, whether that is not playing your sport after sustaining an injury; or a healthy brain. Sometimes love hurts.

Sources:

http://www.protectthebrain.org/Brain-Injury-Research/What-is-a-Concussion-.aspx

https://moodle.cord.edu/pluginfile.php/708078/mod_resource/content/3/2014%20The_New_Neurometabolic_Cascade_of_Concussion.3.pdf

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Are Concussions a Cultural Issue?

Posted on November 26, 2018 by / 0 Comment

Concussions are a very prevalent injury in today’s society affecting one in four adults, according to a 2016 Truven Health Analytics Health Poll. Many people are familiar with the term and symptoms, especially after the movie “Concussions” and the discovery of CTE in professional football players. However, a majority of the population is very uneducated about concussion’s neurological effects and long-term impairments, so let’s cover the basics.

Science

A concussion is described as a biomechanical force applied to the head. This results in stretching, pulling and tugging on our intricate web of brain cells. The disruption causes microtears in cell membranes and dismembers cell-cell communication. The tears also destroy the cell of its natural barrier from outside molecules and ion concentrations. Ions are then free to rush into or out of the cell with no regulatory mechanisms. The disturbed cell will then try to regain homeostasis by using energy to pump ions back in and out of the existing membrane. This futile effort of the cell only increases its consumption of energy, placing more stress on the entire organism resulting in sleepiness, foggy memory, migraines, and inability to concentrate.

Fig 1. Microtears of a cell membrane after mechanical force disrupts the natural balance of ions inside and outside of the cell.

Other effects of concussions include the production of harmful free radicals and oxidative stress which can lead to an inability to degrade old or malfunctioning proteins. The build-up of these ineffective proteins can lead to some serious consequences including an increased chance of developing neurodegenerative diseases. These diseases can include ALS, Alzheimer’s, and Huntington’s disease and would not appear until later in life. You also have a greater chance of developing other diseases like depression and anxiety after multiple concussive events.

After learning all of the immediate and delayed outcomes of concussions, what can we do to prevent these injuries from occurring? Majority of the time, the brain can heal itself if given enough time to recover. Most of the long-term effects on cognitive processing, learning, and memory do not occur unless a person has sustained multiple concussive injuries and have not allowed their brain to heal fully before returning to everyday activities. So why doesn’t everybody take the necessary time to recover? Well with lack of education and our current cultural norms, most people find it very difficult to properly treat a concussion.

Cultural impacts

Our society has been hardwired to go-go-go with fast food restaurants, the abuse of over the counter medicine and working 40+ hours per week. We are conditioned to never take breaks because they are a sign of weakness and we are taught that anything less than being the best is not good enough. Also with sports becoming increasingly competitive at younger ages, kids will not sit out for the appropriate amount of time to recover. Every day we praise this behavior by bragging about our abilities to push our bodies past their limits with phrases like, “Ya I once played in a game the day after I fractured my ankle” or “Ya I woke up at 3 am this morning so that I could get all of my homework done, go for a run, and make a balanced breakfast all before 7am.” We are taught to value physical and emotional toughness even when completely unnecessary and possibly harmful to our future health. This nationwide mindset is preventing people from letting their bodies heal naturally. Unless we start to place a bigger emphasis on mental health and a balanced lifestyle, our population will always suffer from the lasting impacts of concussions.

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Feed Your Brain After a Brain Injury

Posted on November 24, 2018 by / 0 Comment

What is a Concussion?

A concussion is a traumatic injury that is characterized by a negative effect in brain function. Affects are normally temporary, but can sometimes be long-term, especially in the case of multiple concussions. Symptoms can include headaches, loss of concentration and memory, and loss of balance and coordination. Concussions are usually caused by blows to the head, especially in people who play contact sports such as football and boxing, but they can also be caused by violent shaking to the head or upper body.

The brain is protected by cerebrospinal fluid in the skull from minor bumps and sudden movements. A heavy blow to the head, neck, or upper body can result in the brain sliding back and forth against the inner walls of the skull. With that being said, it’s easy to see that a concussion can be caused by a sudden acceleration or deceleration of the head, especially in a car accident. If severe enough, internal bleeding can occur inside the skull, which can be fatal.

Concussions and traumatic brain injuries are incredibly unpredictable, so it’s important to take steps that are neuroprotective for your brain. One of the most overlooked, but most helpful ways to improve brain health after a traumatic brain injury is healing digestion through improving nutrition.

Brain Injuries Affect Your Gut?

Remarkably, after a traumatic brain injury, there is an increase in intestinal permeability. The exact mechanism for increased intestinal permeability after traumatic brain injury is unknown, but hyperglycemia is found to degrade intestinal membrane proteins, and hyperglycemia is characteristic of brain injury.

What is “Leaky Gut?”

Increased intestinal permeability is commonly referred to as “leaky gut.” In a healthy gut, food is completely broken down into the simplest components of glucose and individual amino acids, which can then cross the gut lining into the bloodstream. In a leaky gut, undigested food particles can cross the gut lining into the bloodstream.

These particles are recognized as foreign in the bloodstream by antibodies, which then trigger the release of inflammatory cytokines, which cause inflammation throughout the body, and are also small enough to cross the blood-brain barrier, causing inflammation in the brain. When there is inflammation in the brain, communication with the gut is reduced, and the gut becomes more permeable, and the cycle repeats itself.

Feed Your Brain

To heal a leaky gut, the simplest way is to go on an elimination diet. This is accomplished by eliminating all grains, dairy, legumes, nightshades, and all processed sugar and foods. After doing this for several weeks, some of these foods can be added in every once in a while.

Another way to feed the brain after a traumatic brain injury is to eat a high fat, low carb diet. Glucose metabolism in the brain is depressed after a brain injury, and the brain can’t effectively use all of the glucose introduced from the diet. To combat this, a diet of mostly fats and low carbs can be used. When the body doesn’t have access to glucose, it converts fats to ketone bodies for fuel. This alternative fuel source releases less free radicals in the body, and is more neuroprotective.

Traumatic brain injuries are always a scary, unexpected experience. Because there is little you can do to prevent an injury from occurring, it is important to know how to feed your brain in the event one does happen.

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A Discussion about Concussion Repercussion

Posted on November 21, 2018 by / 0 Comment

Football is America’s game. It is a game that families and friends gather to watch three days out of the week- Sunday, Monday and Thursday. At the end of the season, the entire world watches on Super Bowl Sunday in anticipation to witness the greatest football team in the world. I, personally, do not believe there is any other spectacle in America similar to football. However, over the last 10-15 years, the National Football League has been under scrutiny.

Football has a hard hitting culture; but, these hard hits come with a price. Concussions are sometimes the consequence of hard hits to one’s head that cause the brain to hit the skull. A concussion is a traumatic brain injury that affects your brain function¹. The effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Concussions have emerged as a serious and deadly injury that once shrugged off. Coaches used to tell players to suck it up and get back out there. Many injuries can be weathered; concussions are not one of them.

Repercussions of a Concussion:

Once someone sustains a concussion, their brain becomes over excited. The biomechanical impact of the brain causes excitatory neurotransmitters, such as glutamate, to randomly be released into the synapse². This disrupts the brain’s environment because the brain is sending lots and lots of random action potentials. As glutamate is being released during a concussion, your brain’s ion channels are also getting disrupted². These channels are responsible for maintaining ion levels to the correct concentrations. However, after a concussion, too many positive ions flow out into the cell, creating a better likelihood of the cell sending signals². In turn, the brain is sending too many signals. The brain becomes unable to focus on the important signals and block out the unnecessary ones. Common symptoms described above stem from this issue.

So what can one do after they sustain a concussion?

The answer is rest to allow your body’s natural restoration mechanisms to occur!

However, this restoration costs a lot of energy. Energy, in the form of ATP, is required for powering the pumps that will work to restore the ion imbalance². In order to produce enough ATP to power the pumps, the brain will gointo a metabolic frenzy by recruiting any available energy stores². Moreover, this frenzy will overwhelm the brain. The brain soon uses all this energy, leading to the production of lactic acid. The mitochondria will then start to decrease in production of ATP needed to restore the brain’s proper environment². As a result, neurons start to die as they are unable to perform regular functions that require ATP.

Therefore, concussions, should not be taken lightly. It is understandable the the NFL is under fire for their concussion protocol. The NFL says they are trying to take necessary actions to prevent concussions. It is not just a problem within football, every sport must be cautious with head injuries. It is not like any other injury. You cannot physically see the damage, but it is there. Concussions must be taken seriously.

https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594
https://moodle.cord.edu/pluginfile.php/708078/mod_resource/content/3/2014%20The_New_Neurometabolic_Cascade_of_Concussion.3.pdf
Image from http://www.slma.cc/caution-on-concussions/

Health/Uncategorized

“Just Part of the Game”

Posted on November 21, 2018 by / 0 Comment

An Injury You Can’t See

A concussion can affect anyone anywhere at any time. One can walk from their house to their car, slip, and hit their head on the ground. A football player can go into the game winning tackle with a hit that went wrong. A concussion alters the most important thing in one’s body, the brain.

A concussion occurs when the brain is moved rapidly causing the brain issue to change. This damage can cause chemical and metabolic changes in the brain cells. An ionic flux and glutamate release during this energy demands. This can cause a voltage- or ligand-gated ion channels to create a “depression-like” state. This change is the reason for post concussive impairments. The proper function of these gates are crucial for proper communication between cells.

A Love that Can Break the Heart

Children grow up finding a hobby to fall in love with. Even if people don’t continue to play them after high school, college or semi-professional they can always watch. In a study of a high school football team over a length of a season, a reduction of white matter in the brain was present. The white matter of the brain is vital for having a high abundance of neuron fibers. These neuron fibers are important for sending signals in the brain. Unfortunately, even at the young age of 14-18 there is an alteration in the brain. Around 300,000 concussions are diagnosed yearly in high school athletes from girls soccer to boys lacrosse.

One sport, football is a beloved sport of the United States. This loved sport is seen to have a high risk of chronic, long-lasting effects on the athlete. CTE, chronic traumatic encephalopathy, is a degenerative disease due to repetitive brain trauma. This long-term brain injury seen in hundreds of NFL players is due to hundreds of blows to the head. Symptoms such as: cognitive impairment, depression, emotional instability, and memory loss may appear a few years after hits. Post-mortem, Boston University found 110 of 111 brains donated by NFL families had CTE. Oxidative damage to these proteasomes can occur just hours after a single hit causing the accumulation of tau protein clumps in an organized formation in the patient’s brain. These tau proteins are found in high abundance in the NFL brains studied by Boston University.

For more information: https://www.bu.edu/research/articles/cte-former-nfl-players/

A Hope for Future Technology

When conducting for the presence of a concussion, the lack of concrete detection available is concerning. Unfortunately, there is not a rapid test to help answer this but a new possible blood test is emerging. Blood tests look for ubiquitin carboxy-terminal hydrolase-L1 and glial fibrillary acidic protein that are present during the first twelve hours after a traumatic brain injury was just FDA approved in February 2018. Until this becomes readily available, the continuation of the IMPACT test will be the first test after a thought to be concussion.

Preventative technology is being produced quickly. New helmets for football players detecting the force, direction, and number of hits are making their way onto college and NFL players heads. The hope it to make the game safer for everyone and reduce the long-term effects.

Mouth guards with sensors in them to calculate the force are also making their way onto the field. Not only is there research and preventative care going on the soccer, football, lacrosse, etc. but also in the battle field. New patches that detect the force an individual experiences near an explosion are becoming more popular.

While, the best remedy for a concussion is still rest, reduction in stimuli, and sleep, there is hope for a more effective and faster elimination of the damage to one’s brain.

References:

https://www.sporttechie.com/q-collar-bauer-neuroshield-concussion-prevention-canada-brad-keselowski/ ▲
https://www.aafp.org/news/health-of-the-public/20180223concussiontest.html
http://prevacus.com/concussions-101/statistics/

Community/Health/Hot topics

The Top 5 Things You Need to Know About a Concussion

Posted on November 20, 2018 by / 0 Comment

1. It’s more than just a “simple hit” to the head

A concussion can occur from a traumatic brain injury that ultimately affects brain function. These effects are usually temporary but can include headaches, problems with concentration, memory loss, nausea, fatigue, and loss of coordination. What most people don’t understand is that while a concussion is usually caused by a hit to the head, the effects are extremely detrimental. You could even lose consciousness. A concussion is essentially causing injury to neural tissue and axons that are responsible for these symptoms. Moreover, concussions can impair higher-order brain functions through energy malfunction, inflammation, and even altered recycling, or degradation of proteins. So the next time you play football and get tackled to the ground or play a game of soccer and use your head to score the game-winning goal, think about the implications that this may have on your brain.

2. CTE

Chronic traumatic encephalopathy (CTE) is a serious brain disease that is characterized among individuals who have experienced a lot of trauma to their brain. Symptoms may not occur for CTE until years after the blow to the head, but can affect one’s mood, behavior, memory, and judgment. In essence, a protein, namely tau (also found in AD) is clumped and spread throughout brain tissue and destroys brain cells, as well. What is important to note in CTE is that it isn’t necessarily defined by a certain number of concussions, but rather a series of impacts to the head over a long period of time (even years) that could also likely not even be diagnosed as a concussion, but just a hard enough blow to the head.

3. Second impact syndrome

Second impact syndrome (SIS) is characterized by when an individual has recently had a head injury and another hit to the head is taken before the symptoms from the first hit have receded. SIS is often times deadly or can result in severe disability. This condition is extremely rare, but there exists very little research and data behind the condition because it is often hard to exactly define. Everyone’s mind is different and unique, and a concussion may affect people slightly different. This second hit to the head significantly decreases the brain’s ability to regulate itself due to cellular changes and increased ion fluxes, glutamate release, and other metabolic changes from the first concussion. This leads into the next point about athletes and returning to the game after a concussion.

4. Return to the game

Imagine you are the star player for your team and you just got taken out of the game because of a concussion. You feel a mix of emotions as you, yourself want to return to the game so badly-you have colleges coming to watch you play and need a scholarship to further your education. Your parents, friends, teammates, coaches all pressure you into a speedy recovery to get you back on the field. However, this could be extremely detrimental to your brain and a concussion should not be taken lightly. It is important to receive plenty of rest before returning to the game (however, avoid falling asleep immediately after a concussion as this could lead to death-discuss with your doctor), no matter how badly you might want to play, be honest about the symptoms you are having to the coach and healthcare professionals, and give your brain some time to heal.

5. New technology

As we live in the 21^st century, there are some new, yet expensive, technologies that can help athletes out on the field. A Q-collar is a device that can be worn around the neck and works by compressing the jugular blood vessels in the neck for an increase of blood volume to the skull and brain. The ZERO1 helmet, now worn by some professional NFL players and college athletes will compress and twist in any direction from the angle of impact. Finally, new mouth guards have been invented to help with the concussion issue in sports. This mouth guard does not necessarily prevent a concussion from happening, but can send information such as the number, direction, and force of impact by sensors that are placed inside the device. This will hopefully provide a safer environment out on the field for athletes and allow the coaches to be notified when a diagnostic test for concussion should be ran.

Read more about ZERO1 helmet here: https://vicis.com/products/zero1

Read more about new mouth guards here: https://www.fitguard.me

Now hopefully you know a few more tid-bits of information on concussions and whether you are an athlete or not, you likely know someone who has been impacted about a concussion. Go ahead and ask them: how long did you let your brain rest? Did you feel it was a long enough time? Have you had any other concussions since? These questions are vital to learning more about concussions!

Image 1: http://www.vereencenter.com/concussions-prevention-diagnosis-treatment/

Image 2: https://www.medbridgeeducation.com/blog/2016/04/concussions-and-symptom-variability/

Image 3: https://www.dogonews.com/2016/4/3/simple-blood-test-may-be-able-to-diagnose-concussions-for-up-to-seven-days-after-injury

Image 4: https://hilpischchiro.com/post-concussion-syndrome-natural-treatment-for-athletes-twin-cities/

Image 5: https://www.cdc.gov/headsup/basics/return_to_sports.html

Community

More than a Brain Bruise: Understanding Concussions

Posted on November 20, 2018 by / 0 Comment

You’ve hit your head, so what? Now you have a little headache, no big deal right? Wrong. Chances are if you experience a headache along with symptoms such as sensitivity to light and sound, along with issues concentrating after hitting your head, you have a concussion.

What is a concussion?

Most people, refer to a concussion as a brain bruise. This trauma to the brain is more than a little bruise. When a person’s head is hit, their brain sloshes around in their skull. Depending on the angle, and the force of the hit the concussion can range from mild, to severe or traumatic. The initial sloshing of the brain leads to an influx of ions in between different neurons. This abnormal activity between neurons leads to the activation to an immune response, and as a result histamine is released. This release of histamine results in inflammation, which in turn results in oxidative stress. This stress on the brain leads to the build up of toxic proteins which leads to cell death.

When a concussion happens, the membrane of the brain stretches there is an efflux of potassium, and an influx of calcium in the neurons. The rapid influx of calcium ions leads to excitotoxicity. At the same time there is an increase of glucose metabolism, and an increase in ATPase activity as the brain tries to get back to homeostasis. This hypermetabolism leads to increased protease activation. As the cascade of a concussion continues to happen the cell begins to run low on energy trying to fix all the problems that are simultaneously occurring. This leads to an energy crisis, and the neurofilament side-arms can now be phosphorylated which leads to the collapse of the axons. This collapse of the axons causes microtubule disruption, which in turn diminishes the normal signaling between neurons and the rest of the body.

Classification of TBIs and Recovery

Like people, no two concussions are the same. Depending on the force of the hit, and the location and area of the hit the class of the concussion changes. There are two main classes of traumatic brain injuries or TBIs.

Mild
Severe

Mild, have a faster recovery time than severe, and the symptoms displayed are less.

Studies have shown, that it takes adults 10-14 days to recover from a mild TBI, and children 18 and under take about 4 weeks to recovery. Of course, recovery time depends on the person and the severity of the concussion. There are five steps to recovery from a concussion.

Acute Injury: This is the first 72 hours after a concussion. There may be some testing done at this step like the ImPACT test. During this time symptoms may evolve and change during this time.
Initial Rest and Recovery: Initial testing such as the ImPACT test, a balance test, and a neuropsychology test, may be done at this time, and if necessary a care plan is created.
“Hunker Down”: During this phase some days are worse than others, but in order to recovery in a healthy manner, you should take recovery a day at a time.
Mountaintop: At this stage symptoms are mostly resolved, however, you should still take care to not go back to full exertion
Transition: In this stage symptoms are gone. You can now resume all activities, and no longer worry about the TBI.

More than a bruise

If someone you know has experienced a concussion, and is slow to return back to “normal” remember….

A concussion is more than a bruise. Every time a concussion occurs the normal functions of the brain are disrupted. Additionally, each subsequent concussive event causes more damage than the previous one. Studies have shown that suffering from multiple concussions can leave you at a higher risk for, anxiety, depression, and Alzheimer’s Disease.

Images:

Image 1: https://crls.cpsd.us/athletics/sports_related_head_injury_and_concussions

Image 2: https://www.headsmart.me/

Image 3: https://concussionu.wordpress.com/concussion-management/

Uncategorized

Concussions: The Invisible Injury

Posted on November 20, 2018 by / 0 Comment

In recent years and with developing research, the severity of concussions has started to become more identified and recognized. Concussions are caused by some bio-mechanical force to the head. This could be due to a collision in sports, a car accident, a fall or any circumstance where the heat experiences a great force. Most people are Image result for concussion picture familiar with the initial symptoms associated with concussions like headaches, memory issues and sensitivity to light; however, there are chemical changes happening in the brain to cause these symptoms and can explain long term changes that happen to one’s brain after a concussion.

What’s your brain doing?

These are the main events that occur in the brain after incurring a concussion.

The membranes of the neurons stretch as a result of the force or jolt to the head. This causes increased potassium efflux and calcium influx as well as glutamate release. The excess of glutamate release impairs learning and memory because the excitatory inhibitory balance is off and these processes are glutamate dependent.
There is an increased activity of ATPase (an enzyme that cleaves ATP to ADP) which causes more ATP to be consumed. This leads the body to go into hyperglycolysis in order to restore the energy that was used by trying to restore the ion balance.
Calcium becomes sequestered in the mitochondria which leads to impairment of glucose metabolism. This is associated with deficits in spatial learning and behavioral impairments.
Due to these conditions, there is more anaerobic metabolism occurring which leads to a build-up of lactate which could eventually lead to acidosis.

Long term risks

Effects of a concussion can last much longer than just a few weeks after the event occurs. It is possible to have symptoms that last years or even throughout one’s lifetime. It has been shown that having multiple concussions and not allowing enough recovery time can increase symptoms of depression in athletes. Additionally, the prevalence of anxiety was in collegiate athletes with multiple concussions. There is also an increased risk of development of Alzheimer’s Disease, Parkinson’s Disease and ALS with history of a traumatic brain injury.

Chronic Traumatic Encephalopathy (CTE) is a degenerative disease commonly found in those with a history of repetitive brain trauma. This does not necessarily mean having multiple concussions but rather hundreds of small, hard hits on the head that impact the brain over the timeframe of multiple years. CTE consists of a build-up of tau proteins that spreads throughout the brain and kill the brain cells which results in the degeneration. Symptoms usually affect one’s mood and behavior and can include aggression, depression and paranoia. When the disease is more advanced, symptoms can include difficulty with memory and thinking, confusion, dementia and loss of good judgement.

Recovery

It is extremely important that enough recovery time is allowed before returning to regular daily activities and sports after experiencing a concussion. The treatment of concussions depends on the severity of the symptoms that are experienced. In general, Image result for concussion picture rest is the best way for one’s brain to recover from a concussion. This entails resting both physically and mentally which may include eliminating screens, reading, working and driving for a certain amount of time.

It is crucial to the brain’s health to allow sufficient time to recover, because repeat concussion events can cause cumulative effects on the brain. This is often difficult for many people to understand as concussions are an injury that is not visible to outsiders. When looking at someone, we may assume they seem able to play or return to their daily activities when in reality they are still suffering from symptoms that are not visible. These injuries to the brain are very serious and should be treated as such even though there may not be any physical impairment to someone’s body.