What is a Mild Brain Injury?

Posted on Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Michael Howard, Ph.D.

The Mild Traumatic Brain Injury (MTBI) Working Group of the CDC (Center for Disease Control) in Atlanta has defined MTBI as an injury to the head resulting from blunt trauma or acceleration or deceleration forces with one or more of the following conditions:

  • transient confusion, disorientation, or impaired consciousness.
  • dysfunction of memory around the time of injury.
  • loss of consciousness lasting less than 30 minutes.

Mild traumatic brain injury is also called concussion.  Traumatic brain injury results when the neurons inside the brain are damaged from acceleration-deceleration forces during impact.  When the head is struck or moved violently, the gel-like brain is rapidly displaced or concussed back and forth within the skull.  The brain is distorted in shape and the fragile, thread-like neuron cells inside the brain can be stretched, torn, or traumatized by the mechanical forces.

Typically, the long axon of the neuron is most susceptible to injury.  The phenomenon is called axonal shearing.  This type of traumatic injury can result in the neuron’s death or temporary loss of function.  When, by head trauma, a number of neurons is disabled in such a manner, disruption or alteration of brain functions can occur.  This is the major mechanism behind MTBI.

Traumatic brain injury can result in the skull being broken or fractured (penetrating head injury) or the skull remaining intact (closed head injury).  In MTBI, closed-head injuries are by far the most common.  It is not necessary for the head to be physically struck to result in mild traumatic brain injury.  Violent back-and-forth movement of the head, called whiplash, can also result in neuronal damage.  The MTBI that is due to proximity to a blast explosion that many soldiers and others in Iraq have sustained is another example of an MTBI occurring without the head being physically struck.

WHAT ARE THE SYMPTOMS OF A MILD BRAIN INJURY?

It is common for individuals to have immediate symptoms of brain impairment after a mild traumatic brain injury.  These symptoms can be physical, cognitive, and behavioral in nature and can occur in any combination. They typically last up to a few weeks.  Although there is no “typical” MTBI patient, headaches, dizziness, insomnia, and intermittent confusion are commonly seen in the first days or weeks after the injury.  These symptoms are most severe immediately after the injury.

Over the few days or weeks following the injury, the symptoms should diminish in number and intensity.  Whether or not an individual will have symptoms persisting beyond the first few weeks or months is very difficult to predict and may depend on a number of factors, including the presence of co-existing conditions like depression, anxiety, chronic pain, prior head traumas, or involvement in personal-injury litigation.

Sleep: Crucial for Good Health

Posted on Posted in Continuing Education, Homestudy, Psychology, Seminars, Webinars

baby-22194_640By Michael Howard, PhD

Regular and restful sleep helps keep immune systems strong.  Such sleep also helps keep blood pressure and blood sugar at low levels.

This kind of sleep can help resist weight gain and obesity, assist in emotional stability and forming new memories, and reduce pain perception.

Many older people in their 70s and 80s get only about six hours of sleep per night. Centenarians typically have regular sleep patterns and get plenty of restful, restorative sleep—usually seven to eight hours.

One of the major characteristics of 100-year-olds in an area of Costa Rica is sleeping about eight hours per day on a regular basis. While sleep times can vary from person to person, getting regular rest is the key.  Centenarians have established sleep routines, tending to go to bed and wake up at the same time each day. In general, they go to sleep when the sun goes down and wake up when it comes up. In the Japanese Centenarian Study, spontaneously waking up at regular times in the morning was a major characteristic of those who were living independently.

Taking a nap during the day may be a healthy sleeping pattern for older people. While sleeping continuously throughout the night is often touted as the most recommended way to sleep, midday napping appears to be a common characteristic of the healthiest older people. In the MEDIS study of long-lived people in the Mediterranean islands, all of the people in the study older than 90 years were found to engage in naps around noontime.

Unfortunately, as many as 40 percent of the elderly have some type of sleep disorder that can result in physical and cognitive problems. “Short-sleepers” getting less than six hours of sleep a night have been found to have poor insulin control of blood sugar, more diabetes and obesity, stronger appetites, more heart attacks, and shorter life spans. These risks are even more pronounced for those getting five or fewer hours of sleep per night.  Obesity and sleep deprivation are strongly connected. Studies show that, compared with those getting about eight hours of sleep per night, those who sleep only five hours have a 50 percent higher chance of becoming obese. Those who sleep only four hours have a 73 percent higher chance of obesity. It also appears that getting too much sleep—hypersomnia—of nine or more hours nightly may be even worse for health and longevity than sleep deprivation.

Increasing age increases the chance of developing several sleep disorders. Sleep disorders are associated with many health problems and are major risk factors for heart disease, stroke, depression, and even Alzheimer’s disease.

Common age-related sleep disorders include insomnia, obstructive sleep disorder, restless legs, periodic limb movement disorder, and REM (rapid eye movement) behavior disorder. Insomnia is the biggest culprit, because it is the most common sleep disorder. Other less-common sleep disorders may be even more dangerous. Obstructive sleep apnea, for example, dramatically raises the risk of heart attack and stroke. According to a study in the American Journal of Respiratory and Critical Care, even mild obstructive sleep apnea raises cardiovascular disease risk because of increased arterial stiffness. It seems clear that getting a good night’s sleep is crucial to health and longevity.

If there are problems sleeping, there are techniques you can try at home to help, called “sleep hygiene.”  Techniques of improving sleep with easily-implemented sleep hygiene strategies can be found on the internet, and many people can help themselves to a better night’s sleep by using them. Centenarians practice many of these techniques. If sleep hygiene techniques do not work and sleep problems continue, the best recommendation is to see a sleep disorders specialist or go to a sleep disorders clinic for thorough evaluation, diagnosis, and treatment.  Bottom line: to live long, sleep well.

webinarsSeminars-CTA

Why Do We Forget? Where Do Memories Go?

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

dream-catcher-902508_640By Michael Howard, Ph.D.

How do memories get lost? The reasons can be found in any stage of the memory process: encoding, storage (consolidation), and/or retrieval. In the encoding stage, forgetting usually occurs because of inadequate attention to the material when it was acquired. In the storage or consolidation stage, several problems can develop. For instance, inadequate associations may not develop between new memories being formed and old memories already stored in the brain. There appears to be a natural time-linked decay of the information if it is not recalled occasionally.

Retrieval failure of memories can occur, especially when relevant cues are not present. Sometimes we can remember something and, other times we can’t. Certain situations may cue memories when others do not. For example, it may be easier to retrieve the memory of an event when you are in the same emotional state or same physical place you were in when the event occurred.

Forgetting is a normal process that aids in our ability to select out important information. Typically, we forget memories that are not meaningful to us. If you held onto memories for irrelevant facts, your brain would become quite cluttered and important information would be obscured. Forgetting unwanted or unneeded material obviously has evolutionary importance and helps in our adaptation and survival. For non-meaningful information, the greatest amount of forgetting occurs just after the information is put into long-term memory. This is called a “forgetting curve.” The forgetting curve is not nearly as steep for information that is important to us. We retain meaningful memories much longer.

Memory can also vary depending on how motivated we are to remember the event. We tend to forget things that we do not want to remember, such as traumatic events or very unpleasant information. This can be done in a conscious or unconscious manner. Some very traumatic events are thought to be unconsciously forgotten and are known as repressed memories. Methods for recovering these repressed memories in psychotherapy have created controversy concerning their validity.

INR-Bookstore-CTA

The Mystery of Pain: Acute vs Chronic Pain

Posted on Posted in Brain Science, Continuing Education, Pain, Psychology, Seminars, Webinars

By Michael Howard, Ph.D.

Early humans explained the mystery of pain by associating it with evil, magic, or demons. Relief was the responsibility of sorcerers, shamans, priests, and priestesses, who treated their clients with herbs and rituals.

Ancient civilizations recorded on stone tablets accounts of pain and the treatments used, including pressure, heat, water, and sun. The Greeks and Romans were the first to advance a theory of sensation, the idea that the brain and nervous system were involved in the perception of pain.pain

During the Middle Ages and into the Renaissance, evidence began to accumulate supporting these theories. Leonardo da Vinci and his contemporaries came to see the brain as the central organ responsible for sensation, with the spinal cord transmitting sensations to the brain.

In the 19th century, pain came to dwell under a new domain—science—which paved the way for advances in pain therapy. Physician-scientists discovered that opium, morphine, codeine, and cocaine could be used to treat pain. In the late 1800s, research led to the development of aspirin, to this day the most commonly-used pain reliever. Before long, anesthesia—both general and regional—was refined and applied during surgery.

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. There are two basic categories of pain, acute and chronic, and they differ greatly.

Acute pain usually results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly—for example, after trauma or surgery—and may be accompanied by anxiety or emotional distress. The cause of acute pain can generally be diagnosed and treated, and the pain is self-limiting—confined to a given period of time and severity. In some instances, it can become chronic.

Chronic pain is widely believed to represent a disease in and of itself. It persists over a longer period of time than acute pain and is resistant to most medical treatments. Chronic pain often persists longer than three months, or longer than expected for normal healing. It can be made much worse by environmental and psychological factors. It can—and often does—cause severe problems for patients, as pain signals keep firing in the nervous system for weeks, months, or years. There may have been an initial mishap such as a sprained back or serious infection, or there may be an ongoing cause of pain such as arthritis, cancer, or infection. However, some people suffer chronic pain in the absence of any past injury or evidence of illness.

Bookstore-Large-CTA-2