April 4, 2019 Newsletter

Welcome to Concussion Alliance’s inaugural Weekly Update Newsletter! If you like this newsletter, forward it to a friend and suggest they subscribe.

You can help people find ways to recover from a concussion by becoming a Concussion Alliance Patreon member. See our perks for being a sponsor on our Patreon account.

Education


Take a free online course "Concussion: Prevention, Management, and Treatment" through the University of Calgary. The course starts on April 8 and runs for seven weeks.

The annual Brain Health Online Summit, produced by Amy Zellmer (Faces of TBI) and Dr. Jeremey Schmoe (Minnesota Functional Neurology) is over, but you can purchase recordings of all the video presentations for $29. A portion of the proceeds goes to support the nonprofit LoveYourBrain.

Dr. Robert Hyman, medical director of the Cleveland Clinic’s Center for Functional Medicine, and #1 New York Times bestselling author is hosting an 8-part documentary Broken Brain 2 premiering on April 3. The program is not specifically about concussions, although Episode 7 looks at vision therapy, functional neurology, and hyperbaric oxygen. Each episode is free for 24 hours after it is posted. The April 3 edition is available today until 5:59 pm EST.

Finding Providers


Find a concussion healthcare provider with our new Find Providers page on the Concussion Alliance website. We provide search tools to find medical and alternative healthcare providers who work with people with concussions and persistent post-concussion symptoms.

Concussion Alliance has listings for concussion specialists in Maryland, New York, Utah, Virginia, and Washington State. Contact us to recommend a specialist or request the next state or province specialists page.

Rehab Therapies


Our blog post Finding a Functional Neurologist has an updated list of referrals for Functional Neurologists in the United States and Canada. The Concussion Alliance article on Functional Neurology is the first comprehensive review of this rehabilitation modality for concussions.

A recent episode of the Concussion Corner podcast with guests Lenore Herger, PT, DPT, MEd, and Caralyn Baxter, DPT, goes into depth about physical therapy for concussions from the perspective of professionals who treat collegial, pro, and Olympic athletes. 

Exercise


The medical understanding of when to start exercising after a concussion is rapidly evolving. Drs. Ellis and Leddy (et al.) have published research indicating that collegiate and elite athletes recover from a concussion more rapidly if they begin a monitored, individualized exercise routine 24 to 48 hours after a concussion.

A recent clinical trial with 103 teenage athletes (starting within ten days of sport-related concussion) concluded that "moderate levels of physical activity, including prescribed sub-symptom threshold aerobic exercise, after the first 48 hours following sport-related concussion can safely and significantly speed recovery," 

Dr. Cameron Marshall DC, FRCCSS (C), in his Ask A Concussion Doc podcast, gives his exercise recommendations on a day-by-day post-concussion timeline, based on current medical understanding. Episode 31, Rest and Physical Activity After Concussion (1/9/2019). SoundCloud, iTunes, YouTube

Cannabis


A new study supports the use of medical cannabis (medical marijuana) as a treatment for concussion-related chronic pain (such as headaches) and other concussion symptoms. The study also specifies the type of medical cannabis that provided the optimal benefit, in terms of the THC to CBD ratio, and oral ingestion or vapor pen.

What of the legal status of CBD from hemp, often called CBD oil? The 2018 Farm Bill passed by Congress made industrial hemp and its derivatives legal, but it could take years for the FDA to enact CBD regulations

Because CBD products are unregulated, there are many unsafe and ineffective products for sale, see our page on CBD product from hemp to find safe products.

A study published in Journal of Chemical Neuroanatomy, 2019, reports "Emerging evidence for the antidepressant effect of cannabidiol and potential underlying molecular mechanisms."

Mental Health


We are deeply saddened by the suicide of Olympic silver medalist, cyclist Kelly Catlin. "Family members this week recalled Catlin as a fierce competitor, but also expressed concern about whether several crashes and a concussion she suffered in December were related to the apparent mental and physical decline that preceded her death." After her concussion, Kelly developed headaches, light sensitivity, racing thoughts, including thoughts of suicide.

A recent study found that experiencing a concussion (or mild TBI) was associated with a 2-fold higher risk of suicide.

The outdated (but still often given) advice to concussion patients to "cocoon," to stay in a dark room and avoid the use of screens (including cell phones), may contribute to the development of depression. This lack of physical movement, disruption of routine, lack of connection to friends, and anxiety about schoolwork or work can lead to depression "which may be wrongly attributed to head trauma."

Research is showing that depression can make someone more vulnerable to concussion. Children who have been previously diagnosed with depression had a five-fold increased risk of suffering a concussion while playing football compared to those who did not have a depression diagnosis.

Health Devices


Although not specifically for concussions, the FDA just approved an electrical brain stimulator, for the treatment of anxiety, depression, and insomnia, which are common concussion symptoms. Cervella delivers micro-pulses of electrical current to the brain via headphones and is available by prescription. Clinical trials showed the device led to a reduction in anxiety levels, insomnia, and depressed mood.

Diagnostics


The FDA granted Breakthrough Device Designation to EYE-SYNC as an aid for concussion assessment. The device has already been in use by clinicians and some sports organizations to evaluate visual impairments and monitor recovery. The EYE-SYNC measures specific eye movements via a "modified VR headset with infrared cameras that connect wirelessly and securely to a tablet where results are viewable to the clinician within 60 seconds."

Malayka GormallyComment