NEUROPSYCHOLOGY IN AN UPHEAVAL
Since 2014 Neuropsychologist in the United States have been engaged in a bitter battle over the proper way to address the part of their test batteries which try to determine if the patientis giving full effort or is faking it. (“malingering”) Effort testing is often used by the defense in particularly mild TBI cases. However while more and more “effort tests” are piled into the test, the chances of being mistakenly identified as a malingerer, who fails one or more of these tests,is much higher. However, the false-positive rate of most of these tests (percentage of people whoare mistakenly diagnosed as being malingerers) if the false-positive rate was 30%, would mean that three out of ten people. We are working to clean this up.
TBI AND SUBSEQUENT DISEASE
Reviewing over 20 years of TBI research, the study found a significant association ofprior TBI with subsequent neurologic and psychiatric diagnosis. They found higher rates of Alzheimer’s, Parkinson’s, mild impairment, depression and bipolar disorder in individuals with a previous TBI compared to those without TBI. Analysis of mild TBI found no evidence that multiple TBI’s were associated with higher odds of disease than a single TBI.
BRAIN BLOOD BARRIER INJURY IN MILD TBI
In a study of martial art and boxing athletes, who sustained repeated sub-concussive blows, it was found that the brain blood barrier, a protective highly regulated gateway into the central nervous system (the spine in the brain) was found to be damaged by trauma. The brain does not like large molecules. You may have heard that certain compounds can make their way to the brain. With a tear or leak in the protective system during trauma or MS, the brain becomes inflamed when large molecules enter the system that should not be in the system. New technology regarding MRI will enable patients to determine if the BBB is torn or not, in the near future.
INSOMNIA AFTER MILD TRAUMATIC BRAIN INJURY
Sleep disturbance after TBI is extremely common, yet it has been relatively ignored by researchers. In a 2008 study it showed that insomnia, largely goes undiagnosed. Sleep problems and deprivation can severely compromise the recovery process and lead to worse outcomes. Those suffering from sleep problems after TBI should go to the local hospital and sign up for a sleep study, which can identify the particular problem. Sleep apnea, if caused by TBI, can lead to cognitive problems and a shortened life.
THE EMERGENCY ROOM MISSES MOST MILD TBIs
Studies from Australia, as well as British medical journals have shown what most of us have long suspected. That is, that ER personnel are not keen on wading into a diagnosis of mild TBI. This is a major concern for those headed into TBI litigation because the EMT and ER records form the foundation for the presence or absence of TBI, according to the insurance companies. A recent article in the Journal of Neurotrauma from 2019 shows that the diagnosis of mild TBI is difficult because the symptoms are vague and not specific. After looking at the records of 1600 patients, they found that less than half of those with a confirmed TBI were actually diagnosed with a mild TBI.
MORE RESEARCH ON PITUITARY DYSFUNCTION AFTER TBI
This study found that presence of at least one or two pituitary hormone dysfunction was 32%. While most pituitary dysfunction’s resolve within 12 to 24 monoths, a third of those with TBI might have ongoing problems, especially with the hormone known as human growth hormone. The diagnosis of this condition is not a blood test as commonly believed. It is a four hour, rather difficult test, which involves drinking glucose and taking blood samples over that period of time. Only a few centers in the country are currently doing this type of testing. In our experience, 10 out of 20 of our clients, so tested, have been found to be HGH deficient. All ofthem have shown a great deal of recovery in energy, motivation and initiative after receiving their daily shots of growth hormone. Insurance companies are terrible to work with regarding human growth hormone shots, so if coverage is cut off on someone properly diagnosed an attorney must be called.