Investigating the Memory Maze

Merriam-Webster defines dementia as a “condition (such as Alzheimer’s disease) marked by the development of multiple cognitive deficits (such as memory impairment, aphasia, and the inability to plan and initiate complex behavior).”  Though dementia is typically a progressive disease, the effects of it largely mirror those of traumatic brain injury, which can also cause long-term cognitive impairments.  Though many brain injury survivors are fortunate enough to get progressively better, it is not a surprise that scientists have found a link between the two conditions.

The written report of the results of a 2012 NIH-funded study found this link, and specifically notes that, “the recognition that certain members of society… are at particular risk of TBI-related dementia should stimulate research on preventive strategies focused on these individuals.”  It has stimulated research on the topic and presently, “The U.S. Department of Defense has awarded a team of scientists and physicians from leading health care institutions across Phoenix a $1.3 million grant over three years to study traumatic brain injury and its relationship to dementia.”

Led by Dr. Jonathan Lifshitz and Dr. Raymond Migrino, the study is a cooperative effort between the University of Arizona College of Medicine – Phoenix, the Phoenix Veterans Affairs Health Care System, Phoenix Children’s Hospital, Barrow Neurological Institute and Arizona State University.  These institutions will work together to identify the negative effects of the damage to blood vessel function that is caused by traumatic brain injuries, dementia, and, surprisingly, diabetes.  The mission is to discover specifically why those who had a brain injury, particularly during their youth, are at a 4.5 times greater risk of developing dementia.


Rep. Cicilline Donates His Brain

We need to understand what happens in the brain when it’s hit, and how many hits trigger these neurological effects,” said ranking member of the House Energy and Commerce Committee Frank Pallone (D-NJ) in the opening remarks of the House Democrats meeting about brain injury in football and other contact sports on October 13, 2017.  Held at the Rayburn House Office Building in Washington D.C., the forum focused on CTE and what the government can do to prevent it.  It was a meeting of the Energy and Commerce Committee and the Judiciary Committee and featured 7 panelists – players, widows and researchers.  It was a reaction to the recent release of a study with astonishing results.  (Not only were 110 of 111 deceased NFL players found to have CTE, but so were 48 of 53 deceased college players and 3 deceased high school players.)

Those attending the forum were understandably shocked with these findings.  Many asked what they could do to help.  As Rep. David Cicilline (D-R.I. – 1st District) said, “Just listening to the testimony and listening to what a serious issue this is and what the implications are for players, both young people and players who play in high school.  If we can help in some way… then I am happy to do it.”  True to his word, Cicilline, who played Pop Warner football as a youth, pledged to donate his brain for concussion research upon his death.  (As his personal motto states, Cicilline “never quits“.)

Note: In the Washington Post article about this forum, Former player: Parents should be warned of football’s risks, the newspaper notes, “Republicans had no interest in convening a formal hearing on the subject.”  This forum, however, was designed as a meeting of the House Democrats committee, therefore Republican attendance was not intended or desired.  It is also noteworthy that, although they were invited, the NFL declined to participate.

Cold War Tactics in Cuba

The Associated Press has released audio of mysterious sounds that some US diplomats and their families , as well as Canadian diplomats and families, were unknowingly subjected to in Cuba before suffering a variety of neurological problems, reports various sources.  “Some can no longer remember words, while others have hearing loss, speech problems, balance issues, nervous-system damage, headaches, ringing in the ears, and nausea. Some have shown signs of brain swelling or concussions — mild traumatic brain injuries.”  News in North America since last year, it wasn’t until a few weeks ago that the US State Department determined that it was most likely that these problems were “specific attacks”.  (Most likely from the Cuban government, but environmental issues or simply human error could cause such problems, too.)  Though it is known that audible attacks can be a weapon, the exact weapon used in this instance is still not known or understood.

There have been some studies showing that sound can cause brain injuries.  A study conducted by the University of Texas in 2014, for example, showed that, “prolonged exposure to loud noise alters how the brain processes speech, potentially increasing the difficulty in distinguishing speech sounds.”  Such a conclusion goes way beyond the general thought that prolonged exposure to loud noise results in hearing loss.  Additionally, there already words to describe some of the problems people have with sound.  Misophonia, literally “hatred of sound”, was proposed in 2000 as a condition in which negative emotions, thoughts, and physical reactions are triggered by specific sounds.  The more likely culprit is hyperacusis, a “debilitating hearing disorder characterized by an increased sensitivity to certain frequencies and volume ranges of sound (a collapsed tolerance to usual environmental sound).”  Causes of hyperacusis include, but are not limited to, post-traumatic stress disorder and traumatic brain injury.

However, the United States government is not wholly confident that sound caused these brain injuries.  Since there is very little way to determine if such sound came at the direction of the Cuban government or by it, it is important not to draw final conclusions.  Still, the United States has severely shrunk its embassy staff in Cuba.  Earlier this month, President Trump expelled 15 Cuban diplomats from the United States.  Additionally, since September 29, 2017, “The Department of State warns U.S. citizens not to travel to Cuba.”

The Risk Goes Beyond Gambling: Brain Injury and the 2017 Vegas Massacre

On October 1, 2017, Las Vegas was home to what is the worst domestic mass shooting in history, when Stephen Paddock took aim at the crowd at the Harvest Music Festival on the Las Vegas Strip – 58 people dead and 489 injured – and subsequently took his own life.  (Note the current gun laws in the United States by state.)  Since Paddock had no history of violence and no criminal record, the police and public were and are quite confused.  Even his own brother simply says, “something went wrong in his head.”  Some sort of mental issue seems to be the most likely culprit.  This CNN article documents the possible problems Paddock may have had, writing that, “It is important to note that a tumor isn’t the only thing that can cause such changes in behavior: strokes or a traumatic brain injury can do the same.”  The article then mentions one neurodegenerative disorder, FTLD, that makes decision-making and emotional control difficult.  Brain injury, of course, also makes these tasks difficult, though through rehabilitation and support from family and friends, those with brain injuries are typically able to maintain decent control of these mental faculties.

As for his victims, I find it relatively fortunate that, at this time, I can only find articles about one living individual who acquired a brain injury from the shooting, though knowing that there are any victims with brain injuries is horrible – Maryland native Tina Frost, a concert attendee who was shot in the right eye.  “When they have to move her, she sits up on her own, rolls herself and pushes the nurses away,” Rich Frost [her father] wrote. “She calms down when we say ‘easy Tina.’ Her eye is swollen shut and she is on the ventilator and still in her coma, but it is encouraging.”  I hope for the best for her, and for the other 488 injured, and pray with the families of all those injured and of the 58 people who lost their lives.

A New Model Joins the System

Earlier this week, I reported on last week’s designation of an Indiana medical facility as the 15th TBI Model System, by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) and it’s funding therein.  This week, a facility has been designated the 16th TBI Model System and received research funds, in kind – the Southeastern Michigan Traumatic Brain Injury System (SEMTBIS).  Specifically, the Wayne State University’s Department of Physical Medicine and Rehabilitation (WSU) and the DMC Rehabilitation Institute of Michigan (RIM) were awarded a five-year grant of $2.23 million to fund SEMTBIS.

Unlike some awarded Systems, SEMTBIS does not have a specific research focus.  Instead SEMTBIS is, “a program of research that studies a variety of topics related to traumatic brain injury.”  According to their website, RIM is currently host to a variety of “local and collaborative projects”: The Menopause Transition in Women with Traumatic Brain Injury, Prevention of Long-Term Consequences of Mild Traumatic Brain Injury, Visual Gaze and Validity of Cognitive Evaluations, TBI Care QOL.  There is little more to report on about SEMTBIS at this moment, as their designation is so new that the Center’s webpage is still listed as, “UNDER CONSTRUCTION.”

* A school of about 27,000 students in Michigan, “Wayne State University (WSU) has the longest history of TBI research in the nation and a long history of clinical trials… [Their] interdisciplinary Program for Traumatic Brain Injury Research (PTBIR) is dedicated to campus-wide research, education and treatment of TBI.”

IU Awarded Funding to Decrease the Anger Effect

Last week, Indiana University (IU) School of Medicine, in partnership with the Rehabilitation Hospital of Indiana, was granted $2.1 million from a division of the U.S. Department of Health and Human Services to conduct a five-year study to research a particularly negative, life-long possible effect of a traumatic brain injury: an increase of negative thoughts and generalized anger.  “Our… projects will study emotional self-awareness and the ability to reduce irritability and aggression through treatment,” said Dr. Hammond, who is the Chair of the IU School of Medicine Department of Physical Medicine and Rehabilitation, a Professor of Physical Medicine and Rehabilitation, and also the chief of medical affairs at the Rehabilitation Hospital of Indiana.  Ultimately, the purpose of this study goes beyond the determination of a link.  “We hope to help patients and families better manage the effects of brain injury,” she continued.

With this funding, IU joins 15 other facilities, as part of the National Institute on Disability Independent Living and Rehabilitation Research’s (NIDILRR) Traumatic Brain Injury Model Systems.  Located in every section of the United States, “these centers serve as platforms for collaborative, multi-site research, including research on interventions using randomized controlled approaches.”

Beyond research, though, NIDILRR systems also focus on treatment.  For example, “the objectives of the New York Traumatic Brain Injury Model System focus on improving the quality of life of persons with TBI through: 1] state-of-the-art clinical care, 2] innovative research and 3] multi-platform, extensive dissemination of research results and other information on TBI to consumers and professionals.”  Specifically related to the most recent funding mentioned above, IU’s BRAIN (Brain Research in Aggression and Irritability Network) is, “a comprehensive model service delivery and research system serving individuals with TBI.”

Protecting the Head with Modernized Technology

With a better understanding [of] how traumatic brain injuries occur, a Brown-led research team hopes to develop new standards for head protection and next-generation helmets,” reads a news story from Brown University.  In July, the Office of Naval Research granted the university $4.75 million to study brain injury, specifically as it relates to helmet use in the military and in athletics.

Currently, helmets must essentially follow standards that were set in the late 1970’s (there have been changes in sizing since that time), with the technology that was available 40 years ago when computers were still an anomaly.  “[Brown University associate professor Christian Frank’s lab] has developed a novel technique for measuring for effects of traumatic forces on individual neurons…  a custom-built device that can apply compressive forces to neurons inside three-dimensional cell cultures [not a 2D petri dish, as is presently used].”  With these updated and more stringent standards, Brown University and their associates hope to first develop a helmet that can gather all the data about the brain during the action that resulted in its injury.  Ultimately, because they are now learning about the effects of injury on a cellular level, researchers hope to develop a helmet prototype to completely prevent such injuries.

Giffords Shows Support for McCain

Gabby Giffords may be a Democrat, but she also is an Arizonian and brain injury survivor.  Her husband, Mark Kelly, is a former astronaut who presumptively knows many fellow astronauts who have had a brain injury from their travel.  Politically, they differ from Senator McCain.  However, as fellow Arizonians, his friend and his former colleague, she and her husband have expressed their hope for McCain’s recovery.

Kelly expressed the importance of maintaining a positive outlook, just as McCain did during his 5+ years detained as a prison-of-war during the Vietnam War.  Giffords tweeted, “You’re tough! You can beat this. Fight, fight, fight! I am proud to call you my friend.”

Prayers for Senator McCain

As has been widely reported, Senator John McCain was diagnosed with brain cancer on Friday of last week.  As if having to undergo brain surgery to remove what were thought to be benign brain tumors wasn’t enough, now that they are known to be malignant, McCain can look forward to a host of symptoms.  These symptoms can include vision problems, seizures, difficulties with concentration and thinking, difficulties with speech, etc.  In essence, the symptoms of brain cancer largely mirror those of brain injury.  In fact, the National Institute of Health has published the results of a study that shows that there is an, “association between traumatic brain injury and the subsequent risk of brain cancer.”

Despite his medical issue though, McCain has chosen not to stay idle: “Just hours after news broke of McCain’s brain cancer diagnosis, the Arizona senator blasted President Trump amid a report that the administration decided to halt a CIA training program for moderate Syrian rebels fighting Bashar al-Assad’s regime.”  Additionally, his diagnosis has produced an almost unheard-of-now bipartisan show of support, which could perhaps open the door for further cooperation.

Trauma on Trumpcare

Update: Today, “President Donald Trump asked Republican senators not to leave town for their August recess without passing a health care reform plan that makes good on seven years of promises to repeal and replace President Barack Obama’s Affordable Care Act.”


Since 2010, health care has been a top talking point for both general Americans and the American government.  Then, Obamacare, the Affordable Care Act, was enacted without a single Republican vote.  Now, the current iteration of Trumpcare, H.R. 1628, has passed the House and seeks to pass the Senate without the support of a single Democrat Senator.  Increasingly though, it is losing Republican support*, as Senators wrangle with the idea on Medicaid cuts and other issues.  (According to a recent report, the bill would cut Medicaid funding for children by at least $43 billion over 10 years.)

Throughout the country, articles continue to show the need for Medicaid for many Americans, often showcasing the needs of the brain injured.  The website (part of the USA Today network) highlights a 22-year-old and his mother who spoke to members of Congress about the ongoing trauma that the family deals with, caused by an accident that occurred when the boy was 18.  “Many families… will face major health care challenges.  It is important to protect Medicaid to allow these families to focus on their child’s care and recovery,” said the mother.  An article published on highlights the care of a severely brain injured man who lives in a nursing home, but whose family worries he won’t be able to stay at the facility with the proposed Medicaid cut.  A New York-based newspaper notes a 9-year-old girl who survived a horse-back riding accident with the financial support of Medicaid.

Yesterday, Trump expressed his frustration on Twitter with passing this bill.  “Most Republicans were loyal…,” he wrote, as a criticism of those Republicans who did not express support for the law.  However, this statement appears to show that Trump is looking for support to him and party, when he should be seeking support and loyalty towards the American people.

(Notably, Arizona Senator John McCain just underwent surgery yesterday to rid his head or his left eye, both have been reported, from blood clots.  While the specifics of his initial condition and the exact surgical procedure he underwent remains vague, it is concerning.  Because of McCain, the vote on this health care bill has been delayed.  It will be interesting, though, to see if McCain’s ordeal affects his views. )

* Yesterday, “Sens. Mike Lee (Utah) [a staunch conservative] and Jerry Moran (Kan.) issued statements declaring that they would not vote for the revamped measure.  They joined Sens. Rand Paul (Ky.) and Susan Collins (Maine), who also oppose it.”  A significant amount of other Republicans have also not declared their support.