Brain Injury Treatment

Deep transcranial magnetic stimulation is a way of non-invasively stimulating the brain. The deep TMS device shown above appears to be similar to a hair dryer. It actually uses electromagnetism to generate an electric current in a targeted brain region. Doing this allows scientists to selectively increase or decrease brain activity in specific areas of the mind. In a variety of brain disorders, regions of the brain may be overactive or under active in comparison to a normal brain. Deep TMS allows researchers to target centimeter sized brain regions that are located deep within the brain. It can selectively reach almost any brain area for non-invasive stimulation. This can be done without the need for brain surgery and the procedure itself is extremely mild and fairly painless. Transcranial magnetic stimulation can be performed on a person when they are fully awake and conscious.

Researchers have been tested the deep TMS on stroke patients. People with stroke often have damage to their brains. After a stroke, brain cells may die off. This can lead to a significant reduction in functioning, depending on the brain area affected. Researchers have found that deep TMS can improve stroke recovery. Neuroplasticity refers to the brain's ability to reshape itself, especially after a traumatic brain insult. Transcranial magnetic stimulation has the ability to alter brain chemistry and utilize this neuroplasticity for beneficial effect. It can help many with brain injuries regain some functioning that may have been previously lost.

Transcranial magnetic stimulation has recently been used to help awaken a coma patient. Doctors targeted a specific regions of the brain called the right dorsolateral prefrontal cortex for activation with TMS. The doctors did a total of 15 TMS treatment sessions on the patient. They found that the coma victim was eventually able to use a few choice words and regained the ability to move his eyelids.

Transcranial magnetic stimulation is a very powerful tool that can shape the brain for beneficial effect. Transcranial magnetic stimulation may even allow researchers to increase neurogenesis (the creation of new brain cells) when targeted to specific brain regions. It should find increasing use for all sorts of brain disorders as scientists continue to refine this brain stimulation technique.

Scientists have created virtual reality programs that can be used to improve cognitive deficits among those who have had a brain injury. Virtual reality enables scientists to control that sensory inputs that enter into someone's brain. The virtual reality sessions can be automatically monitored and adjusted according to specific patient's need. The virtual reality program represents real life situations where a person can get extra practice. Doing this allows a certain amount of rehabilitation for their injuries. Through repeated practice the brain can be changed merely though the process of the repetition of simple tasks.

Recently, researchers from Japan have published a new paper detailing how they constructed some brain tissue from stem cells. Stem cells are cells that have the capacity to differentiate into any cell in the body, including brain cells. The researchers were able to create brain tissue that is similar to that of the cerebral cortex, the brain's outer layer. In this recent paper they described how they coaxed the growth of the brain cells into four distinct layers. They then found that the brain tissue actually showed some signs of neural activity. This means that the tissue acted in a manner similar to actual brain matter.

Aggregating neurons into a 3-dimensional pattern is a large step up from previous research. In the past researchers were mostly able to implant single brain cells for beneficial effect. This new type of tissue engineering, however, may eventually allow the replacement of almost any type of brain region. This would go a long way in helping those who have lost brain tissue due to damage or other types of brain disorders. Scientists will likely continue to get better at synthesizing a variety of different types of brain tissue from different brain regions.

Scientists may be able to get stem cells from a person's teeth. This would be a much less controversial way of obtaining stem cells. It would overcome many of the ethical hurdles that now cloud the use of embryonic stem cells.

Sometimes people with certain types of brain injuries may have trouble moving their limbs or other body parts. People who have a so called "locked in" syndrome are unable to move any of their appendages. This can be quite distressing for the affected person. Scientists are now increasingly using brain-computer interfaces to help these types of people. The general idea behind a brain-computer interface is that a device such as an EEG or a brain implant records brain activity. The brain patterns/activity that are recorded are usually related to movement, speech or something of that nature. The brain waves are then read by a computer and the computer translates that information into either movement of a robotic arm or making speech with a computer voice synthesizer.

Many of these brain-computer interface devices are brain implants that take brain recordings from a brain area called the motor cortex. The motor cortex is located near to a person's scalp and it is involved with the movement of parts of the body (mouth, lips, hands, feet etc.). So by taking readings from here, a person would be able to move an artificial appendage in much the same manner as they do a real one. They would just think about moving their appendage and that brain implant would record their brain signals, translating them into movement.

Brain-computer interfaces are increasingly becoming more and more sophisticated as time goes on. They may find use for those who have currently devastating disablements from brain disorders.

There are a variety of brain imaging techniques that are helpful to diagnose brain injuries. Magnetic resonance imaging uses a magnetic field to image the brain, while CT scans uses X-rays. The main problem with these types of brain imaging techniques is that they often cannot detect mild brain injury. Mild brain injury can often damage the so called "white matter" of the brain. "White matter" consists of the axons of neurons (connections) in the brain. This is much harder to visualize with existing types of brain imaging.

Now researchers have created several new imaging techniques that may better detect more milder injuries. One is named diffusion tensor imaging (DTI). DTI has the ability to track the water molecules that are located in the brain's white matter. Another imaging variant is called magnetic resonance spectroscopic imaging (MRSI). This type can analyze specific spectral frequencies of various chemicals that are found within the brain. A third type of new imaging technique is named magnetoencephalography (MEG). This imaging can measure magnetic fields that are made by the activity of neurons. MEG can detect brain waves that are associated with damage to "white matter". All of these new imaging techniques are more sophisticated and can better determine if a person actually has certain types of brain trauma.

Researchers have also begun using real time functional magnetic resonance imaging (rtfMRI) for brain injured patients. fMRI tracks the blood flow responses in the brain. It can detect the activation/deactivation patterns of specific brain regions when doing certain tasks. Real time fMRI allows a person to view an imaging of their brain and immediately see the resulting effects of self manipulating their mind. Real time fMRI could enable a patient to alter the functioning of their brain through practice. This would basically be analogous to neurofeedback. So real time fMRI may become a useful tool for brain injury rehabilitation. It would allow a person to retrain their brain after a damaging insult. Researchers have used fMRI for many studies to track the brain changes that are induced from rehabilitation therapy. It enables the visualization of the brain's neuroplasticity at work.

Deep brain stimulation involves implanting a pacemaker sized electrode deep within the brain. The electrode delivers electricity to the brain tissue that surrounds the implant. The DBS implant is connected to a battery that is placed inside a person's chest. Researchers believe that the deep brain stimulation device quells brain activity in the region around the implant. So in a way it is almost like doing tissue lesioning as it selectively deactivates brain regions. However, in this case no tissue is destroyed and the stimulation intensity can be adjusted by the doctor. This allows for a more refined treatment method that can equalize brain activity to a greater degree. Deep brain stimulation requires a person to undergo brain surgery, so it does have some risks. Deep brain stimulation has already been used as a treatment for a variety of brain disorders like Parkinson's disease. In the future it may be also used for those who have brain injuries. It could enable the stimulation of deep brain regions for beneficial effect.

Recently researchers who are from the University of British Columbia have found the reason as to why the brain loses the capacity to repair itself and also to regrow new connections. The scientists discovered a new set of proteins that are named calpain and cortactin. These proteins regulate the growth and sprouting of neurons. The growth of brain cells is referred to as neural plasticity.

Neurons send messages along their axons by the use of electrochemical signaling. When the brain begins to develop, neurons are often fairly plastic and can easily sprout new connections. However, as the brain develops this process reduces a significant degree. The brain does this so as to regulate the growth of the brain. To much growth could have negative consequences for the organism. So neurons lose much of their capacity to reorganize.

The fact that the brain cannot reorganize well means that after an injury brain repair is often limited. This new research indicated that brain cells have not really lost their capacity to regrow. What has happened is that the two different proteins stop the new growth of neural connections. So researchers think that by reducing the functioning of these proteins, they may enable the brain to repair itself after an insult.

Researchers have recently found that ultrasound has the ability to non-invasively stimulate brain regions. Ultrasound can penetrate across a person's skull and touch practically any brain area with a high selectivity. This is similar in effect to transcranial magnetic stimulation, but uses a different property of physics. The benefits to using ultrasound is that it has a much higher targeting accuracy when compared to transcranial magnetic stimulation. It can excite brain areas that are 1mm in diameter. In comparison, transcranial magnetic stimulation stimulates brain regions 1 cm or greater. So ultrasound could be beneficial for many brain disorders. It could shape the mind in powerful ways and enable rehabilitation for many brain disorders.