This post explores Better Brain & Body’s proactive approach to post-concussion and TBI recovery, using advanced therapies and technologies that complement traditional recommendations. Hopefully, you’ll be empowered to make more informed decisions about your healthcare for yourself or a loved one. We'll explore our cutting-edge diagnostic testing technology and its role in giving Dr. Brown the information she needs to customize a patient’s treatment plan for their recovery. We’ll also talk about the advanced therapies at Better Brain & Body and how each plays a role in proactive post-concussion and TBI treatment. It's important to remember that healthcare approaches vary. Not all providers offer the same options, so finding the right fit for you is crucial.
Before getting into the proactive treatment of Concussion and TBI at Charlotte's Better Brain & Body, let’s review some basics.
Table of Contents:
What is a Traumatic Brain Injury (TBI)?
TBI stands for Traumatic Brain Injury. According to the CDC, there are three different types of TBI.
Mild TBI
Moderate TBI
Severe TBI1
A mild TBI, also called a concussion, usually does not end with loss of consciousness but can sometimes be reported. A moderate TBI may involve someone losing consciousness for 30 minutes, and a severe TBI may involve someone losing consciousness up to 6-24 hours2. Both moderate and severe TBI are often used interchangeably. Please check out this link for a detailed report on the differences between mild, moderate, and severe TBI.
What are the Causes of TBI and Concussion?
There are a variety of possible causes for these conditions. Falling, explosions, assaults, vehicle crashes, sports like football, hockey, rugby, lacrosse, soccer, and more can cause head injuries. Any event that causes the brain to rock violently against the skull can cause a concussion or TBI. Unfortunately, many incidents of TBI or concussion are out of your control at the moment. Being informed about concussion and TBI care in Charlotte empowers you to make informed decisions before or after a head injury occurs.
Types of Head Injuries We See
Post-Concussion Syndrome (also known as Persistent Post-Concussion Symptoms)
Mild TBI (Concussion)
Whiplash injury
Cervical Concussion
Moderate/Severe TBI
Better Brain & Body specializes in treating head injuries, from recent traumas to those with long-term effects. Whether you've sustained a mild TBI/concussion or a severe TBI (traumatic brain injury), we can help at the clinic here in Charlotte, NC. During a consultation, Dr. Brown will discuss factors like injury severity, recovery potential, and time elapsed since the injury to determine the best course of action. For severe TBIs, Dr. Brown may work closely with your emergency doctor to establish the ideal amount of cognitive rest before starting a personalized treatment plan. Ultimately, our goal is to help all patients find lasting relief from head injury symptoms.
What is Post-Concussion Syndrome (PCS)?
Many times, patients can present with post-concussion syndrome (also known as persistent post-concussive symptoms), where symptoms of the initial head injury persist for many weeks, months, and even years following the initial head injury. Unfortunately, PCS is quite common, with 15% of patients experiencing it out of the millions of concussions occurring in this country per year alone3. The current on-label treatment protocols for post-concussion syndrome are also very passive and simply involve lifestyle modifications, behavioral changes, medications, and rest. Symptoms can be mild to debilitating, resulting from any type of head injury, especially those resulting in persistent symptoms.
Prevalence of Traumatic Brain Injury
In the United States, 1.5 to 3 million Americans suffer some form of TBI per year; the exact number varies across online sources. Similarly, recent estimates suggest that Americans, in general, withstand 3.8 million concussions per year from sports alone, with up to 50% of head injuries going unreported4.
What are the Symptoms of TBI & Concussion?
TBI & Concussion symptoms vary depending on the type of head injury. A moderate or severe TBI can include all the symptoms of mild TBI but are often more severe and persistent.
TBI's Symptoms | Mild TBI/Concussion | Moderate/Severe TBI | M/S TBI Continued |
Physical Symptoms | Headache, dizziness, nausea or vomiting, fatigue, light and sound sensitivity. Tinnitus, blurred vision, sleep disturbances (sleeping too much or little). | Loss of consciousness, seizures, speech problems, paralysis or weakness, vision problems including, blurred or double vision or loss of vision. | Balance and coordination problems, fatigue, increased intracranial pressure, and sleep disturbances. |
Emotional Symptoms | Irritability, anxiety, nervousness. | Increased confusion and agitation. May be unable to follow commands or instructions and may get easily frustrated or aggressive. Changes in personality or behavior including, being withdrawn, impulsive, or having difficulty controlling emotions. | May experience depression, anxiety, or PTSD. Difficulty with processing emotions, understanding emotions, or empathizing with others. |
Cognitive Symptoms | Confusion, disorientation, memory problems, difficulty concentrating, brain fog, and sluggishness. | May have trouble forming new memories or remembering old ones. May have difficulty concentrating and focusing, which may have slowed thinking. | Learning difficulties, and executive function problems, such as, planning, organizing, and prioritizing. Also may have problems communicating. |
Passive TBI & Concussion Treatment
Traditionally, treatment for traumatic brain injury (TBI), including concussions (mild TBI,) has focused on a passive yet “on-label” approach. On-label use refers to the modality being used as intended. The current on-label prescription for mild TBI/concussion is primarily rest in traditional healthcare. This also holds for moderate and severe TBI. Here, patients may be prescribed rest to minimize the brain's energy expenditure, allowing it to heal without the added stress of work, school, or other activities. Medications like over-the-counter pain relievers, prescription painkillers, diuretics, or anti-seizure drugs may be prescribed. In severe cases, surgery might be necessary following the injury. Overall, this is passive recovery treatment for TBIs and concussions and does not involve proactive rehabilitation strategies that are implemented at Better Brain & Body.
It's important to remember: Better Brain & Body supports patients in their rehabilitation and recovery journey after they've received emergency care for their head injury. If you have a head injury emergency, call 911 or proceed to your nearest emergency room.
Beyond Rest: Proactive TBI and Concussion Treatment
While rest is crucial following a TBI or concussion, Dr. Alicia Brown of Better Brain & Body in Charlotte emphasizes the importance of combining rest with additional interventions and innovative rehabilitation strategies to promote brain healing. In fact, prolonged rest with no activity after a concussion may even do more harm than good5. It is essential to discuss the appropriate timeline for initiating proactive TBI and concussion treatment with your healthcare provider and Dr. Alicia Brown for a smooth and successful recovery after a head injury.
Typically, Dr. Brown advises that patients or family members contact her clinic as soon as possible after a head injury. After a head injury, the brain is very “plastic,” meaning there is neuroplasticity (the brain’s ability to heal or change in response to its environment or an event). When the brain is most receptive to change, proactive concussion and TBI treatments can significantly boost healing by capitalizing on this neuroplasticity.
What is Proactive TBI and Concussion Treatment?
Better Brain & Body utilizes a proactive approach to TBI and Concussion recovery. Our treatments go beyond traditional rest-based recovery protocols with “off-label” tools and therapies (treatments not directly approved for their intended use). Now, "off-label" doesn't mean ineffective, in fact, Dr. Brown believes these treatments should be the new gold standard for treating concussions. Many evidence-based treatments used by doctors and patients fall into this category. It’s important to remember that treatments vary depending on the healthcare provider you choose.
At Better Brain & Body, our team utilizes cutting-edge diagnostic testing tools alongside advanced rehabilitation therapies and technologies to promote healing and improve patient outcomes. Dr. Brown believes that solely relying on rest is outdated for TBI and concussion recovery. Instead, we combine rest with proactive techniques like Hyperbaric Oxygen Therapy (HBOT), which can help the brain heal and rewire after a head injury. In essence, passive care focuses on rest and medication, while our proactive approach leverages rehabilitation technologies and therapies to manage symptoms and promote brain healing actively.
Diagnostic Testing for TBI & Concussions
Our advanced diagnostic testing is a primary example of the proactive approach to post-head injury care. Better Brain & Body performs a full neurological exam and physical. We look at the whole person, brain, and body. We analyze the brain and nervous system with diagnostic equipment that measures brain processing speeds, eye movement patterns (concussion can be identified with eye movements), changes in balance down to a 100th of an inch, brainwaves, and brain activity. We also assess the brain's timing, coordination, and rhythm down to the millisecond. Lastly, we perform an autonomic nervous system exam. You can find the details of our diagnostic testing here. With many different diagnostic testing capabilities and technologies, Dr. Alicia Brown can gain a comprehensive inside view of the functionality of the brain and body. She then will create a personalized treatment plan based on diagnostic test results and patients' needs, wants, and goals to aid their treatment outcomes.
Therapies for TBI & Concussion Treatment:
Check out the full list of therapies at Better Brain & Body.
Hyperbaric Treatment for TBI (HBOT):
One therapy mentioned earlier in this blog post is hyperbaric oxygen therapy (HBOT). While this is considered an “off-label” treatment for TBI and concussion, there are hundreds of clinics operating around the USA that use HBOT with their patients to treat a variety of conditions, including concussion and TBI. Numerous studies show the promising benefits of HBOT in a clinical setting. Hyperbaric oxygen therapy (HBOT) is a treatment that creates an oxygen-rich environment to accelerate the body's natural healing process. This is achieved by increasing pressure to help the blood directly carry oxygen to tissues in need, such as the brain.
Anti-inflammatory Effects: Inflammation is a natural part of the healing process, but excessive inflammation can damage brain tissue after TBI. Some studies suggest HBOT might have anti-inflammatory properties, potentially helping to reduce brain damage.
Angiogenesis Boost: HBOT may stimulate the growth of new blood vessels (angiogenesis) in the injured area. A lack of blood flow and oxygen to the brain after a TBI or concussion may contribute to symptoms. These new blood vessels can improve blood flow and oxygen delivery to the brain tissue, further aiding recovery.
Cognitive Function Boost: HBOT has shown promising results in improving information processing, attention and focus, and executive functioning.
Stem Cell Stimulation: While fascinating research, scientists are still actively studying this. More research to come!
Improved Mitochondrial Function
GyroStim Therapy:
The FDA approved this rotational device for treating vestibular rehabilitation and balance disorders. However, it has several off-label uses, including treating head injuries. Athletes also use it for athletic performance training, which can be tailored to each patient’s treatment and needs. Patients with a head injury can suffer from vestibular dysfunction. GyroStim is an excellent tool for managing the resulting symptoms caused by a head injury.
Vestibular symptoms from a TBI or concussion can arise, like headaches, dizziness, or vertigo. The GyroStim is a specialized, computer-driven, rotational chair/device that improves the vestibular and balance systems of the brain and body. Our qualified team carefully monitors a patient’s GyroStim session. Patients can expect comfortable and controlled movement during their session that does not involve fast rotations. The sensory challenges the GyroStim offers stimulate cognitive processes, enhancing attention, focus, problem-solving skills, and decision-making. It also improves motor skill development, reduces dizziness, improves balance and coordination, and promotes neuroplasticity (the brain’s ability to heal and positively change).
Virtual Reality Therapy:
Virtualis Motion VR enhances our patient’s treatment experience by opening up new physical and cognitive therapy possibilities. Imagine strapping on a high-tech headset and then stepping into a world that isn't real but feels like it could be. Virtual reality (VR) creates immersive 3D environments you can explore and interact with using your senses. You can climb mountains, walk in a forest, or visit ancient Rome. Virtualis Motion VR has a variety of virtual applications for post-TBI and concussion treatment that patients can discuss with Dr. Alicia Brown during a complimentary consultation.
Neurofeedback for TBI
Neurofeedback or biofeedback is the process of training brainwaves into healthy patterns using modern computer technology. This non-invasive and drug-free therapy uses brain imaging technology to record brainwave activity and thus identify unhealthy brainwave patterns. Once irregular patterns have been identified, they can be corrected using guided audio and visual feedback to help individuals self-regulate and optimize their brain function. Neurofeedback cannot heal a concussion or head injury, but it can optimize specific brain areas (including those affected,) thus improving symptoms. While the scientific evidence surrounding neurofeedback is mixed, many patients who use neurofeedback find significant benefits in their recovery journeys.
Red Light Therapy For Concussions & TBI:
Also known as transcranial photobiomodulation (tPBM), Vielight is a headset that shines red and infrared light through the skull and onto the brain to aid healing. In our blog post about red light therapy (RLT), we covered in detail how light plays a role in various forms of healing, also called photobiomodulation. The Vielight has even shown promising results in scientific studies for the treatment of suspected CTE, a disease of the brain that affects people who have suffered multiple concussions. The Vielight has an intranasal clip that shines light through the nose and into the brain.
Improved cognitive function: Studies have shown that tPBM can improve memory, attention, and focus.
Reduced pain: tPBM can help reduce pain, both chronic and acute.
Faster healing: tPBM can accelerate healing times for wounds, sports injuries, and even concussions.
Reduced symptoms of depression: Some studies have shown that tPBM can help improve mood and reduce symptoms of depression.
Neuroprotection: tPBM may offer neuroprotective benefits, potentially helping to protect brain cells from damage caused by stroke, Alzheimer's disease, TBI, concussion, and other neurological conditions.
Neurosensorimotor Integration (NSI) Therapy:
Neurosensorimotor Integration (NSI) is an interactive therapy on a touch-screen TV that patients engage with through cognitive games and tasks. NSI helps address some of the symptoms or deficits associated with head injuries. It can strengthen learning and attention, hand-eye coordination, visual reaction timing, oculomotor, visual motor, and neurocognitive skills. Similarly, NSI can engage with the brain's visual and auditory memory systems.
Interactive Metronome (IM) Therapy:
Interactive Metronome (IM) is another interactive therapy that helps enhance the brain’s timing and coordination. Timing is responsible for a person being able to walk without falling or speaking without stuttering. Timing allows us to focus, process language, keep balance and a smooth gait, play sports, and even read. Timing is responsible for the synchronous communication of the brains’ network system that connects cognitive processes and physical movement.
Neuromodulation Therapy:
Neuromodulation technology works with the nerves and the nervous system. Various devices and areas of treatment fall under neuromodulation, including vagus nerve stimulation, peripheral nerve stimulation, and cranial nerve stimulation. At Better Brain & Body, we use the gammaCore, a vagus nerve stimulator device for concussion headache treatment. The Pulsetto is another vagus nerve stimulator device used for stress, anxiety, depression, and insomnia. The Alpha-Stim is a cranial electrotherapy stimulator that treats anxiety, PTSD, insomnia, depression, and pain. Some studies suggest the Alpha-Stim can provide relief for fibromyalgia and neuropathic pain. All neuromodulation devices are non-invasive and are comfortable and safe treatments. Lastly, the regular neuromodulation device provides targeted treatment of specific nerves, delivered by Dr. Alicia Brown. Cranial and peripheral nerve stimulation activates under active neural pathways in the brain, helping aid recovery from head injury. The ultimate goal of neuromodulation is to modify neural activity in the nervous system to restore or normalize the functioning of neural circuits involved in specific conditions or symptoms.
Conclusion
And there you have it–Better Brain & Body’s unique approach to proactive post-concussion and TBI treatment. As you have now learned, Better Brain & Body is a holistic clinic focused on brain-to-body rehabilitation. We are a functional neurology clinic and human optimization center. Dr. Alicia Brown owns and leads the efforts at Better Brain & Body and is a well-known doctor in Charlotte for her personalized treatment plans and state-of-the-art performance-based therapies. If you or a loved one are seeking proactive post-concussion and TBI rehabilitation and care, give us a call at 704-752-8100 or fill out our contact form. We'll schedule you a complimentary 15-minute phone consultation with Dr. Brown to discuss how our treatment plans may help you.
Better Brain & Body is not an emergency care clinic. We see head injury patients after they have been discharged from the emergency room, urgent care, or primary doctor for their head injury. Our treatments are considered “off-label” uses, as the only approved “on-label” care for TBI and concussions are rest, medications, and surgeries.
Reviewed by Dr. Alicia Brown, DC, DACNB.
Sources:
1 Eastman, A., & Chang, D. G. (2015). Return to Learn: A review of cognitive rest versus rehabilitation after sports concussion. NeuroRehabilitation, 37(2), 235–244. https://doi.org/10.3233/NRE-151256
2 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Report to Congress on traumatic brain injury in the United States: Epidemiology and rehabilitation Atlanta (GA): Centers for Disease Control and Prevention; 2015.
3 Cleveland Clinic (n.d.). Traumatic Brain Injury. Retrieved April 4, 2024, from https://my.clevelandclinic.org/health/diseases/8874-traumatic-brain-injury
4 Cleveland Clinic (n.d.). Post-Concussion Syndrome. Retrieved April 9, 2024, from https://my.clevelandclinic.org/health/diseases/24900-post-concussion-syndrome
5 Hallock, H., Mantwill, M., Vajkoczy, P., Wolfarth, B., Reinsberger, C., Lampit, A., & Finke, C. (2023). Sport-Related Concussion: A Cognitive Perspective. Neurology. Clinical practice, 13(2), e200123. https://doi.org/10.1212/CPJ.0000000000200123