Brain Injury Lawyer - New York

Mapping the Human Brain

The New York Times reports this morning that the Obama admiration will announce a plan latter today for the investment of $100 million starting in 2014 focused on research to understand how the human brain functions. “Obama to Unveil Initiative to Map the Human Brain”

The plan is to develop new technology that will enable scientists to map and understand the complex circuits that comprise the human brain.  According to the Times story, “The effort will require the development of new tools not yet available to neuroscientists and, eventually, perhaps lead to progress in treating diseases
like Alzheimer’s and epilepsy and traumatic brain injury. It will involve both government agencies and private institutions”.

The plan has been named the Brain Research Through Advancing Innovative Neurotechnologies, or Brain for short. Government agencies to be involved in the project are: the National Institutes of Health, the Defense Advanced
Research Projects Agency and the National Science Foundation.

More proof that “mild” traumatic brain injury is anything but mild

Scientific evidence is being to accumulate to establish the permanent consequences of mild traumatic brain damage, long referred to as the “invisible injury”.

In research sponsored by the National Institutes of Health at the Human Brain Lab located at the Medical College of Gerogia, scientists have been able to capture in real time, the damage to brain cells that takes place following a concussion. 

The research, published in the journal Brain reports proof of the swelling of blood vessels resulting in reduced flow of blood and resulting nourishment to nerve cells following mild brain trauma.  The secondary damage to the nerve cell takes place in the hours following initial injury.

The neuroscientists say they watched as the astrocytes, the small cells that supply neurons with nutrients and help maintain normal electrical activity and blood flow, swell and smoother the neurons.  Sergei Kirov, lab director is quoted as saying, “we saw every branch, every small wire and how it gets cut. We saw how it destroys networks.  It really goes downhill. It’s the first time we know of that someone has watched this type of minor injury play out over the course of 24 hours.”   

Hopefully this work will lead to better treatment in the immediate hours following the initial brain trauma and ways to protect nerve cells and brain function.

Simple blood test may detect brain damage in athletes even from subconcussive blows to the head

New research from The Cleveland Clinic and the University of Rochester suggests that even sub concussive blows to the brain may cause long term brain injury and can be detected by a simple blood test.

The researchers found that cumulative trauma to the head cause a brain protein to leak into the blood stream following a head injury.  The study conducted among college found that even though none of the players suffered a concussion during the season, four of them showed signs of an autoimmune response that has been associated with brain disorders.

The study was published March 6, 2013, in the online journal PLOS ONE and was sponsored by the National Institute of Neurological Disorders and Stroke (NINDS). 

The protein, known as S100B is found only in the brain; finding S100B in the blood indicates damage to the blood-brain barrier and is widely used as a marker of traumatic brain damage when other typical signs or symptoms are absent. The researchers studying the release of this protein found that once in the bloodstream, S100B is seen by the immune system as a foreign invader, triggering an autoimmune response that releases auto-antibodies against S100B. Those antibodies then seep back into the brain through the damaged blood-brain barrier, attacking brain tissue and leading to long-term brain damage.

It has been suggested that utilizing this blood test may prove to be an effective, quick and cost effective means of detecting traumatic brain injury in athletes.A blood test will be much less expensive (about $40) and could be performed anywhere, such as locker rooms or doctors' offices. More importantly, though, the blood test could offer a yes-or-no determination of whether an athlete requires medical intervention as a result of in-game collisions.

 

Distinguishing Traumatic Brain Injury from Post Traumatic Stress Disorder

Attempts are being made at the New York University School of Medicine to distinguish Traumatic Brain Injury and Post Traumatic Stress Disorder.

Frequently there is overlap between the symptoms caused by both of these conditions and clinicians often must rely on self-reports from patients.

The New York Times reports that one of the largest studies of its kind is being undertaken by a team of researchers based out of New York University’s medical school have begun a five-year study to find biological signals, known as biomarkers, that could provide reliable, objective evidence of those so-called invisible injuries of war.

The NYU project is significant both because of its size — researchers hope to recruit 1,500 subjects and because much of its financing is already guaranteed through a $17 million grant from the Steven A. and Alexandra M. Cohen Foundation, founded by the billionaire hedge-fund manager.

The Times reports that biomarkers are physiological road signs that can tell doctors whether a person has a disease or injury, or is likely to contract a particular ailment. Tissue damaged by a heart attack releases chemicals into the blood that can be detected. Abnormal levels of the proteins amyloid and tau, as well as shrinkage of certain areas of the brain, are considered markers of Alzheimer’s disease.

The lack of reliable markers for PTSD and mild T.B.I. has had significant consequences, experts say. Without clear-cut tests to spot them early, the disorders can go undetected until symptoms become disabling. Misdiagnoses readily occur, leading to ineffective or even damaging treatments. Beyond confirming or debunking diagnoses, dependable biomarkers could also be used to determine whether treatments for PTSD or T.B.I. are effective.

The subjects will undergo a diverse battery of tests to analyze hormone levels, blood chemistry, genetic makeup, brain structure and even voices. One team will use magnetic resonance imaging to compare the brain structures of healthy people with those of people with PTSD. Another team will use brain imaging to test a theory that abnormalities in the thalamus, a part of the central brain that acts as a switchboard for nerve signals, are an indication of head trauma. Other researchers will look for biomarkers in genes, blood and hormones. One group will even analyze audio recordings of speech to see whether evidence of PTSD can be found in the pitch, timber and tone of voices.

You can read the full New York Times article by clicking here.

New technology to decrease seizures

Can cooling the brain limit the severity of seizures?

A new study reported in the Annals of Neurology: Mild passive focal cooling prevents epileptic seizures after head injury in rats suggests that cooling the brain can limit the severity of seizures.

Traumatic brain injury is a leading cause of traumatic epilepsy and seizure disorder.  The study suggests that chronic seizures which are often resistant to medication can be effectively treated by cooling of the brain.  The authors even believe that this therapy may prevent further seizures from taking place.

While cooling the human brain is not easy to accomplish, success has been reported with even a two degree Celsius drop in temperature. The physician researchers at Washington University in St. Louis have begun developing technology to cool the brain circuits in humans. 

New project proposed to map the human brain

A new initiative to map the human brain has been proposed by President Obama according to a story in today’s New York Times.

The Times reports that the project is designed "to do for the brain what the Human Genome Project did for genetics."

According to today’s article, “The project, which the administration has been looking to unveil as early as March, will include federal agencies, private foundations and teams of neuroscientists and nanoscientists in a concerted effort to advance the knowledge of the brain's billions of neurons and gain greater insights into perception, actions and, ultimately, consciousness.”

"Scientists with the highest hopes for the project also see it as a way to develop the technology essential to understanding diseases like Alzheimer's and Parkinson's, as well as to find new therapies for a variety of mental illnesses.”

Mild brain injury in children may cause structural changes to the brain

A brain injury in a child, even what physicians call a “mild traumatic brain injury”, may have lifetime affects according to according to a study published in the December 12 issue of The Journal of Neuroscience.

The researchers studied the brains of children who sustained a mild traumatic brain injury or a concussion using an advanced MRI imaging technique known as diffusion tensor imaging (DTI). Using this sophisticated imaging technology, the study found that even following a mild tbi, children exhibit structural changes to the white matter of the brain which can lead to permanent disability. The white matter nerve tracks in the brain carry nerve signals from one region of the brain to another.

Importantly, the study found these changes remain within the brain even though the child may seem symptom free of the typical post- concussion symptoms of headache, nausea, dizziness, sensitivity to light or sound and ringing in the ears.

Seizure disorders, Parkinson's Disease, Dementia and Hormone Deficience Accepted by Veterans Administration As Being Caused by a Traumatic Brain Injury

In recognition of the link between traumatic brain injury and the following medical conditions: seizures, Parkinson’s disease, dementia, depression and some hormonal deficiencies, the Department of Veterans Affairs have proposed new regulations to compensate veterans with these conditions.

The regulations are scheduled for publication in today’s edition of the Federal Register and list Parkinsonism, unprovoked seizures, certain dementias, depression and hormone deficiency diseases related to the hypothalamus, pituitary or adrenal glands as eligible for the expanded benefits.

The benefits are not limited to veterans injured in Afghanistan or Iraq.  Brain injury victims from prior conflicts can also claim these benefits if they can show their traumatic brain injury was service related.

Under the proposed rule, once a veteran can establish he or she was a victim of traumatic brain injury then these five conditions will be deemed connected to the brain injury with no further proof.

But, the proposed regulations do not go far enough.  The proposal only links these conditions to a traumatic brain injury if the TBI was originally classified as being “moderate” or “severe” 

There are also significant time restrictions requiring the illnesses become manifest following the brain injury within short periods of time. For hormonal deficiencies the time is one year, depression carriers a three year period for moderate or severe brain injury and a one year restriction for mild TBI. Dementia has a 15 year window.   

Children who suffer traumatic brain injury more likely to engage in criminal conduct in adulthood

A news report from New Zealand reports research showing that individuals who suffer a traumatic brain injury as a child are more likely to commit offenses as adults.

According to the article, Professor Randolph Grace of the University of Canterbury, and Dr Audrey McKinlay from Melbourne's Monash University, studied Canterbury children who had experienced a brain injury as a child from birth to 17 years old.

The participants were now 18 years or older and more than five years had passed since their injury.

Dr Grace said there is "increasing evidence" childhood TPI can have negative impacts during adulthood.

"We found traumatic brain injury (TBI)  was significantly associated with an increased risk of offending behaviour. Our analysis revealed that for people with moderate to severe TBI the strongest predictors of offending behaviour was the TBI status - higher levels of malevolent aggression and lower levels of social anxiety” according to Dr. Grace.

Read the full story by clicking here.

Brain injury increases the risk of developing Parkinson Disease

Additional evidence further confirms the link between head injury and developing Parkinson disease according to a new study published in the Journal, Neurology, November, 2012. 

The study examined individuals who suffered brain trauma and also were exposed to a pesticide known as “paraquat”   

The study reported that Traumatic Brain Injury and exposure to paraquat each increased the risk for developing Parkinson Disease, but when the two risk factors were combined in the same individual, the risk of developing Parkinson disease tripled.

In the late 1980’s I successfully handled a law suit in New York City proving a link between my client’s development of Parkinson’s disease and the head trauma she sustained when the taxi cab she was a passenger is was struck by a New York City bus.  This is one of the few  jury verdicts establishing  that  Parkinson disease can be caused by brain trauma.   My summarion resulting in a 2 million dollar jury verdict was published in the Summation volumne of the Art of Advocacy Seried published by Matthew Bender.

The study is reported in Neurology, 2012, Volume 79 at pages 2061-2066 entitled, “Traumatic brain injury, paraquat exposure and their relationship to Parkinson disease"