BRAIN SIGNALS: Dr Elizabeth Harris spoke at Gisborne Cosmopolitan Club yesterday evening. Picture by Paul Rickard
Emerging studies around the treatment of symptoms for post-concussion syndrome was the topic of discussion at Gisborne Cosmopolitan Club yesterday evening.
In a “conversation” hosted by Mātai Medical Research Institute, Dr Elizabeth Harris talked about the “untapped science around the syndrome” and the exciting opportunities it presented for both clinicians and patients.
Persistent post-concussive symptoms, also called post-concussion syndrome, occur when concussion symptoms last beyond the expected recovery period after the initial injury.
The usual recovery period may range from weeks to months and include symptoms such as headaches, dizziness and problems with concentration and memory.
Dr Harris covered two key points — the need to address the inflammation in the brain, and the other to “drill down” on specific methods a clinician could use to reduce such inflammation in the brain using “already established but untapped science”.
“When someone has a head injury, many other systems in the body such as the autonomic nervous system, gut and hormones get thrown out of balance,” she said.
“So fixing or healing these other systems could eventually help in the healing of brain. In medical science we refer to this method of healing as bottom-up approach to head injury.”
Dr Harris focused on the use of an antioxidant called N-acetyl cysteine for treating head injuries.
The antioxidant is used in hospitals to treat paracetamol poisoning.
But a research paper published in 2013 suggested the positive impacts of the drug, after all 81 symptomatic US service members exposed to significant blasts in Iraq volunteered for the study.
“Barring a few side effects, it has been researched that the use of the drug reduces the number of people who go on to have post-concussion syndrome by 44 percent.”
The study used the randomised double blind placebo controlled method which was the “gold standard approach”, Dr Harris said.
She said the antioxidant presented an exciting opportunity for clinicians to use in the future, because it helped in the regulation of glutathione which reduces spontaneous remote inflammation in the brain, after a head injury.
As well as the drug, looking at symptoms such as breathing issues, hormone imbalance and nutrient insufficiency were also important to monitor.
“Retained primitive reflex is another significant symptom to look out for.”
She gave an example of a six- year-old boy playing cricket and catching the ball in the palm of his hand.
The brain sends a signal to tell them to catch it, but if the child doesn’t let go after catching, it could mean a few different messages are ringing in the nervous system, “and that’s called the retained primitive reflex”.
Dr Harris said such reflexes were more predominantly found in infants but disappeared with maturity.
“But if someone had a head injury they might experience a drop of maturation and their primitive reflexes return. That’s one way to know you are suffering from concussion or its after-effects and it can cause a problem.
“Sometimes understanding and solving such affected areas can make the healing process faster,” she said.
At her clinic in Dunedin, Dr Harris utilises the “systems biology” approach — a way of thinking and approaching something that doesn’t just look at one parameter or data point but overall factors.
Standard practice for post-concussion syndrome would involve the patient seeing either an occupational therapist or a physiotherapist, she said.
An occupational therapist would put the patients through some tests to identify which areas in their thinking or memory have been affected. They would then be provided with techniques and tools to help.
A physiotherapist on the other hand would often check a patient’s neck since it was quite common for people suffering a head injury to have sustained it from, for example, whiplash.
Other check-ups in physiotherapy would involve checking the balance system in the brain called the vestibular system.
“While current practice methods and concussion services are useful for many people, the idea is to add to the existing system and make it even better,” Dr Harris said.
“It’s much like in the old days we could just do plain chest X-rays. But then computed tomography scans (CT scans) came along, followed by MRI. So while we still use X-ray, additional methods mean more ways to detect and solve a problem or problems.”
Dr Harris hopes pharmacies will one day be able to give out concussion kits to patients.
Speaking after yesterday’s session, Dr Harris said, “It was really wonderful to see people come and raise questions on the issue.
“It just shows that there actually is a need, that there are people with ongoing symptoms and who are looking for solution. I do believe that there are solutions both in the immediate sense and longer term as well.”