Nina Koons

The Blood-Brain Barrier and Its Role in Concussion Recovery

The brain is a highly sensitive organ that requires a protective barrier to shield it from harmful substances in the bloodstream. This barrier, known as the blood-brain barrier (BBB), is essential for maintaining the brain's stable environment and preventing the entry of pathogens, toxins, and other damaging agents. However, when a concussion occurs, the integrity of the BBB can be compromised. This disruption can lead to a multitude of problems that affect both the immediate and long-term recovery process, potentially contributing to conditions such as Post-Concussion Syndrome (PCS).

Understanding the Blood-Brain Barrier  

The blood-brain barrier is a highly selective, semi-permeable membrane composed of tightly packed endothelial cells lining the blood vessels in the brain. Its primary function is to regulate the movement of molecules between the bloodstream and the brain, allowing essential nutrients like glucose and oxygen to pass through while blocking harmful substances, such as toxins and inflammatory agents.

The BBB's selective permeability is crucial for maintaining the brain's delicate balance and protecting it from fluctuations in blood composition that could interfere with neuronal function. It also plays an essential role in preventing immune cells and other potentially harmful agents from entering the brain's extracellular space, which is particularly important in preventing inflammation and damage to neural tissue.

However, when the brain experiences a traumatic event like a concussion, the force of the impact can cause the BBB to become "leaky," allowing substances that are normally kept out of the brain to pass through. This breach in the BBB can lead to neuroinflammation, oxidative stress, and increased vulnerability to additional injuries.

How a Concussion Disrupts the Blood-Brain Barrier  

The mechanical forces involved in a concussion can physically damage the endothelial cells that make up the blood-brain barrier. This disruption results in increased permeability, allowing proteins, immune cells, and other molecules that would typically be blocked to enter the brain. One of the most damaging effects of BBB disruption is the entry of pro-inflammatory cytokines, which can trigger widespread inflammation in the brain.

Inflammation is a normal part of the body’s response to injury, but in the brain, excessive or prolonged inflammation can cause further damage to neurons and glial cells. This can contribute to the long-term cognitive and emotional symptoms seen in PCS. Additionally, a leaky BBB allows harmful oxidative agents to accumulate in the brain, leading to oxidative stress. Oxidative stress damages cellular components such as DNA, proteins, and lipids, further impeding the brain’s ability to heal.

A study published in Frontiers in Neuroscience demonstrated that BBB disruption following a traumatic brain injury is closely linked to both acute and chronic neuroinflammation, which can impair cognitive function and lead to long-term brain health issues. The study highlighted that even subtle changes in BBB integrity can have significant consequences for brain recovery, emphasizing the need for strategies to restore and protect the BBB after a concussion.

Consequences of a Compromised Blood-Brain Barrier in Concussion Recovery  

When the blood-brain barrier is compromised, the brain becomes vulnerable to a wide range of detrimental processes. The increased permeability of the BBB allows harmful substances, including blood-borne toxins, immune cells, and inflammatory mediators, to infiltrate the brain. This infiltration can lead to several adverse effects that complicate concussion recovery.

1. Neuroinflammation  

As mentioned earlier, the breakdown of the BBB allows pro-inflammatory molecules to enter the brain, leading to an exaggerated inflammatory response. Chronic neuroinflammation is a significant factor in the persistence of symptoms seen in PCS, such as headaches, mood disturbances, and cognitive impairments. If neuroinflammation is not addressed, it can lead to neuronal damage and contribute to neurodegenerative processes.

2. Oxidative Stress  

BBB disruption also leads to increased oxidative stress in the brain, as harmful free radicals and reactive oxygen species (ROS) are allowed to accumulate. Oxidative stress can damage neuronal structures, including cell membranes and mitochondrial DNA, further impairing brain function. This process is associated with cognitive decline, memory problems, and other long-term effects of concussions.

3. Neurovascular Dysfunction  

The BBB is critical for maintaining proper blood flow and nutrient delivery to the brain. When the BBB is compromised, neurovascular dysfunction can occur, leading to reduced cerebral blood flow and impairing the brain's ability to receive adequate oxygen and glucose. This further contributes to the energy crisis that occurs after a concussion and can prolong recovery by limiting the brain's ability to repair itself.

4. Increased Risk of Secondary Injury  

A leaky BBB increases the risk of secondary injuries following a concussion. Without the protective barrier intact, the brain is more vulnerable to further trauma and may be less resilient to future concussions or even mild head impacts. This is particularly concerning for athletes or individuals in professions where repeated head injuries are common, as it increases the likelihood of developing chronic traumatic encephalopathy (CTE) or other long-term neurological conditions.

Strategies to Restore and Protect the Blood-Brain Barrier  

Given the critical role that the BBB plays in maintaining brain health and facilitating recovery, it is essential to prioritize strategies that restore its integrity and protect it from further damage. Several interventions have shown promise in supporting the BBB and promoting recovery after a concussion.

1. Nutritional Support for BBB Repair  

Certain nutrients have been shown to support the integrity of the blood-brain barrier. For example, omega-3 fatty acids, particularly docosahexaenoic acid (DHA), are essential for maintaining the structure of endothelial cells and reducing inflammation. Studies have demonstrated that omega-3 supplementation can help reduce BBB permeability and promote brain recovery following traumatic brain injuries.

In addition to omega-3s, antioxidants such as vitamins C and E play a crucial role in reducing oxidative stress and protecting the BBB from free radical damage. These nutrients help neutralize ROS, reducing the oxidative damage that can further compromise the BBB after a concussion.

2. Non-invasive Therapies  

Therapies such as hyperbaric oxygen ketone therapy (HBOKT) and low-level laser therapy (LLLT) have also been shown to enhance the repair of the blood-brain barrier. HBOT increases oxygen delivery to the brain, which supports cellular repair processes and helps reduce inflammation. LLLT stimulates cellular activity and promotes the production of growth factors that aid in the repair of endothelial cells, helping to restore BBB integrity.

3. Physical Exercise  

Moderate physical exercise has been shown to improve cerebral blood flow and support BBB health. Regular aerobic exercise can enhance the delivery of oxygen and nutrients to the brain, promoting repair processes and improving overall brain function. However, it is important that exercise be carefully managed following a concussion to avoid exacerbating symptoms.

The Importance of Early Intervention with Carolina Brain Center

As with other aspects of concussion recovery, early intervention is critical when it comes to protecting and repairing the blood-brain barrier. The sooner that strategies to reduce inflammation, oxidative stress, and neurovascular dysfunction are implemented, the better the chances of preventing long-term cognitive and emotional impairments. Healthcare providers should assess BBB integrity as part of the initial concussion evaluation and tailor treatment plans accordingly.

At Carolina Brain Center in Raleigh, NC, we recognize the importance of maintaining and repairing the blood-brain barrier in concussion recovery. Our comprehensive approach includes therapies designed to reduce inflammation, enhance blood flow, and support the brain's natural healing processes. By addressing BBB disruption early, we can help patients recover more effectively and prevent the long-term complications associated with concussions.

If you’re experiencing prolonged concussion symptoms or are concerned about the impact of a recent head injury, contact Carolina Brain Center today. Our personalized treatment plans are designed to promote faster, more complete recovery. Start your journey to healing today—because the right care can make all the difference.

 

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by Nina Koons

Excitotoxicity and Its Role in Concussion-Induced Neurodegeneration

Concussions are more than just a temporary disruption of brain function. They set off a series of complex biochemical events that can lead to long-term brain damage, especially if left untreated. One of the most significant processes triggered by a concussion is excitotoxicity, a condition where neurons are overstimulated to the point of damage or death. This overstimulation is primarily caused by the excessive release of the neurotransmitter glutamate, which, under normal conditions, helps facilitate communication between neurons.

However, in the aftermath of a concussion, this process goes awry. The brain's inability to regulate glutamate leads to a cascade of events that can result in cell death, contributing to neurodegeneration and long-term cognitive impairment. Excitotoxicity in concussion-induced neurodegeneration has many implications on brain health, but there are strategies to mitigate its damaging effects during recovery.

Understanding Excitotoxicity: The Role of Glutamate  

Glutamate is the primary excitatory neurotransmitter in the brain, responsible for sending signals between neurons. Under normal circumstances, the release of glutamate is carefully regulated to ensure that neurons are appropriately stimulated without becoming overexcited. However, after a concussion, the brain experiences a surge in glutamate release. This surge, coupled with the impaired function of glutamate transporters (which normally help remove excess glutamate from the synapses), leads to the accumulation of glutamate in the extracellular space.

This accumulation of glutamate overstimulates neurons by activating glutamate receptors, such as NMDA (N-methyl-D-aspartate) and AMPA receptors. These receptors allow calcium ions (Ca2+) to enter the neurons, leading to a dangerous influx of calcium. While calcium plays an essential role in many cellular processes, excessive calcium within neurons can trigger a chain reaction that damages cell membranes, disrupts mitochondrial function, and activates enzymes that break down proteins and DNA. This process is what ultimately leads to neuronal death—a hallmark of excitotoxicity.

The Consequences of Excitotoxicity in Concussion  

In the context of a concussion, excitotoxicity plays a central role in the neurometabolic cascade of concussion that follows the initial mechanical injury. The excessive stimulation of neurons caused by glutamate leads to the production of reactive oxygen species (ROS), which cause oxidative stress. This oxidative stress damages cellular components, including membranes, proteins, and mitochondria, further impairing the brain's ability to recover from the injury.

One of the most concerning consequences of excitotoxicity is its contribution to neurodegeneration. When neurons are damaged or die due to excitotoxicity, the brain's capacity for communication and plasticity is compromised. This can lead to long-term cognitive impairments, such as difficulties with memory, attention, and executive function. In severe cases, excitotoxicity may also contribute to the development of neurodegenerative disorders, such as Alzheimer's and Parkinson's disease, by accelerating the loss of neurons and promoting the accumulation of toxic proteins like beta-amyloid.

Calcium Overload and Mitochondrial Dysfunction  

One of the primary mechanisms through which excitotoxicity causes neuronal death is calcium overload. When glutamate receptors are overstimulated, they allow large amounts of calcium to enter neurons. This calcium overload overwhelms the mitochondria, the energy-producing centers of the cell, impairing their ability to produce ATP (adenosine triphosphate). Without sufficient ATP, neurons cannot maintain their normal functions, leading to energy failure and eventual cell death.

Mitochondrial dysfunction caused by calcium overload also contributes to the generation of reactive oxygen species (ROS), which exacerbate oxidative stress and damage cellular components. This creates a vicious cycle where mitochondrial dysfunction and oxidative stress feed into one another, further amplifying the damage caused by excitotoxicity.

Additionally, calcium overload activates enzymes such as calpains and caspases, which break down cellular proteins and contribute to cell death through a process called apoptosis. Apoptosis, or programmed cell death, is a natural process that helps eliminate damaged cells. However, in the case of excitotoxicity, apoptosis is triggered excessively, leading to the loss of healthy neurons.

How Excitotoxicity Contributes to Neurodegeneration  

Excitotoxicity doesn't just affect neurons in the immediate aftermath of a concussion. It sets the stage for long-term neurodegeneration, particularly in patients who experience multiple concussions or suffer from Post-Concussion Syndrome (PCS). The chronic effects of excitotoxicity can lead to the accumulation of damaged proteins, the loss of synaptic connections, and the eventual death of neurons, all of which contribute to the progressive decline in brain function.

In some cases, excitotoxicity has been linked to the development of neurodegenerative diseases. For example, research has shown that chronic excitotoxicity can promote the accumulation of beta-amyloid, a protein associated with Alzheimer's disease. Excessive calcium influx and mitochondrial dysfunction also play a role in the development of neurofibrillary tangles, another hallmark of Alzheimer's. Similarly, excitotoxicity has been implicated in the degeneration of dopaminergic neurons in Parkinson's disease.

For patients recovering from concussions, the long-term effects of excitotoxicity may manifest as cognitive decline, memory problems, and difficulty with concentration and decision-making. These symptoms can persist for months or even years, particularly if the excitotoxic cascade is not properly managed during the early stages of recovery.

Strategies to Mitigate Excitotoxicity in Concussion Recovery  

Given the significant role that excitotoxicity plays in concussion-induced neurodegeneration, managing this process is critical for improving recovery outcomes and preventing long-term cognitive decline. Several strategies have emerged that focus on reducing glutamate release, protecting neurons from calcium overload, and supporting mitochondrial function.

1. Glutamate Modulation  

One of the most effective ways to mitigate excitotoxicity is to reduce the release of glutamate or block its interaction with receptors. Certain nutritional interventions, such as the ketogenic diet, can help regulate glutamate levels in the brain. The ketogenic diet shifts the brain's energy source from glucose to ketones, which have been shown to reduce glutamate release and enhance the production of GABA, a calming neurotransmitter that counteracts the excitatory effects of glutamate.

2. Antioxidant Therapy  

Since excitotoxicity generates reactive oxygen species (ROS) that contribute to oxidative stress, antioxidant therapy is a valuable tool for reducing neuronal damage. Antioxidants such as coenzyme Q10 (CoQ10), N-acetylcysteine (NAC), and vitamins C and E can help neutralize ROS and protect neurons from oxidative damage. These supplements support mitochondrial function and reduce the impact of excitotoxicity on long-term brain health.

3. Hyperbaric Oxygen Ketone Therapy (HBOKT)  

Hyperbaric Oxygen Ketone Therapy (HBOKT) has been shown to reduce excitotoxicity by increasing oxygen delivery to damaged brain tissues. This therapy enhances mitochondrial function, reduces oxidative stress, and promotes the repair of damaged neurons. HBOT is particularly useful for patients with Post-Concussion Syndrome, as it helps address both the acute and chronic effects of excitotoxicity.

The Importance of Early Intervention  

Excitotoxicity begins immediately after a concussion, making early intervention critical for preventing long-term neurodegeneration. The sooner that strategies to mitigate excitotoxicity are implemented, the greater the chances of reducing neuronal damage and improving recovery outcomes. For patients with a history of multiple concussions or those experiencing prolonged symptoms, proactive management of excitotoxicity is especially important for preventing cognitive decline and neurodegenerative diseases.

Have You Experienced a Concussion?

At Carolina Brain Center in Raleigh, NC, we recognize the importance of addressing excitotoxicity in concussion recovery. Our personalized approach integrates therapies such as glutamate modulation, antioxidant support, and hyperbaric oxygen therapy to reduce the effects of excitotoxicity and promote faster recovery.

If you've recently experienced a concussion, don't wait to seek treatment. By addressing excitotoxicity early, we can help prevent long-term cognitive decline and neurodegeneration. Start your recovery journey by filling out our phone consultation request form today. The knowledge and care you receive will set you on the path to healing.

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by Nina Koons

The Potential of Low-Level Laser Therapy (LLLT) in Treating Concussions

Concussions are increasingly recognized as complex injuries that extend beyond immediate symptoms like headaches and dizziness. At the cellular level, a concussion triggers a cascade of biochemical processes, including inflammation, oxidative stress, and mitochondrial dysfunction. These processes not only contribute to the acute phase of injury but can also prolong symptoms, leading to conditions like Post-Concussion Syndrome (PCS). As research progresses, new therapeutic approaches are emerging that target the underlying cellular damage caused by concussions. One such therapy is Low-Level Laser Therapy (LLLT), a non-invasive treatment that uses light energy to stimulate cellular repair and promote healing.

Let’s explore how LLLT works to treat concussions, its potential benefits in accelerating recovery, and the evidence supporting its use. By addressing the root causes of concussion symptoms, LLLT offers a promising option for patients seeking relief from both acute and prolonged symptoms.

How LLLT Works: Mechanisms of Action  

LLLT, also known as photobiomodulation, uses light in the near-infrared spectrum to penetrate the scalp and interact with cellular structures in the brain. The therapy specifically targets mitochondria, the energy-producing centers of the cell. Mitochondria contain a protein called cytochrome c oxidase, which absorbs light and uses the energy to increase ATP (adenosine triphosphate) production. ATP is essential for powering cellular functions, and its production is often impaired after a concussion due to mitochondrial dysfunction.

By boosting ATP production, LLLT helps restore the energy balance in neurons, enabling them to function more effectively and repair damage. In addition to increasing energy production, LLLT also has anti-inflammatory effects. It reduces the release of pro-inflammatory cytokines, molecules that contribute to the chronic inflammation often seen in patients with PCS. Furthermore, LLLT stimulates the release of antioxidants, which neutralize harmful reactive oxygen species (ROS) produced during the injury, reducing oxidative stress and preventing further cellular damage.

One of the most significant advantages of LLLT is its ability to promote neuroplasticity—the brain’s ability to adapt and reorganize itself. LLLT has been shown to enhance synaptogenesis (the formation of new synapses between neurons) and neurogenesis (the growth of new neurons), both of which are critical for cognitive recovery following a concussion.

The Benefits of LLLT for Concussion Recovery  

1. Reducing Inflammation  

Inflammation is a natural response to brain injury, but when it becomes chronic, it can impede recovery and contribute to long-term symptoms. Patients with PCS often experience neuroinflammation, which can manifest as cognitive deficits, mood disturbances, and physical symptoms like headaches and fatigue. LLLT helps reduce this inflammation by downregulating pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6).

By reducing inflammation, LLLT alleviates many of the persistent symptoms associated with PCS. Research has shown that patients treated with LLLT experience faster resolution of symptoms and an improved ability to return to normal activities. This is particularly important for patients who suffer from prolonged symptoms and have been unable to find relief through conventional treatments.

2. Enhancing Mitochondrial Function  

Mitochondrial dysfunction is a hallmark of the neurometabolic cascade triggered by a concussion. When mitochondria are damaged, they cannot produce sufficient ATP to meet the brain’s energy demands, leading to cognitive fatigue, memory problems, and difficulty concentrating. LLLT directly targets mitochondria, increasing their ability to produce ATP and repair damage.

Enhanced mitochondrial function allows neurons to recover more effectively and regain their normal function. This improvement in cellular energy production is key to reducing cognitive symptoms and improving overall brain health. For patients with PCS, LLLT offers a way to restore energy balance in the brain, which can accelerate recovery and prevent the progression of long-term neurological issues.

3. Stimulating Neuroplasticity  

One of the most exciting aspects of LLLT is its ability to promote neuroplasticity. After a concussion, the brain often struggles to form new connections and repair damaged neural pathways. This can lead to persistent cognitive deficits and impairments in memory, attention, and problem-solving skills. LLLT stimulates the release of growth factors, such as brain-derived neurotrophic factor (BDNF), which support the growth of new neurons and the formation of new synapses.

By promoting neuroplasticity, LLLT helps the brain adapt and recover from the damage caused by a concussion. Patients treated with LLLT often report improvements in cognitive function, including better memory retention, faster processing speeds, and enhanced attention. These benefits make LLLT a valuable tool for both short-term recovery and long-term brain health.

Scientific Evidence Supporting LLLT in Concussion Treatment  

In clinical trials, patients treated with LLLT reported a reduction in headaches, improved cognitive function, and better overall quality of life compared to those who received standard treatments. These findings are particularly encouraging for patients with PCS, who often experience lingering symptoms that are difficult to treat with conventional therapies.

A study published in Photomedicine and Laser Surgery explored the effects of LLLT on patients with mild traumatic brain injuries, including concussions. The researchers found that LLLT reduced inflammation and oxidative stress, while also improving cognitive performance and mood. The study emphasized the importance of early intervention with LLLT to prevent the progression of long-term symptoms.

Combining LLLT with Other Therapies  

While LLLT is a powerful tool in concussion recovery, its benefits are often maximized when combined with other therapeutic interventions. For example, Hyperbaric Oxygen Keotne  Therapy (HBOT) can be used alongside LLLT to enhance oxygen delivery to the brain, further improving mitochondrial function and reducing inflammation. Nutritional interventions, such as the ketogenic diet, can also support mitochondrial health by providing the brain with an alternative energy source (ketones), which may improve the overall effectiveness of LLLT.

Physical therapy and cognitive rehabilitation are also important components of a comprehensive treatment plan for concussion recovery. LLLT can accelerate the brain’s ability to form new neural connections, making it easier for patients to benefit from cognitive training and physical therapy exercises. By combining these therapies, healthcare providers can offer a holistic approach that addresses the full spectrum of concussion symptoms.

Safety and Accessibility of LLLT  

One of the most attractive features of LLLT is its safety profile. Unlike invasive treatments or medications, LLLT is non-invasive and has few, if any, side effects. Patients typically tolerate the therapy well, and the sessions are painless. LLLT can be performed in an outpatient setting, making it accessible to patients who may not require hospitalization but still need targeted therapy for concussion recovery.

While more research is needed to fully understand the long-term effects of LLLT, the current evidence suggests that it is a safe and effective option for managing both acute and prolonged concussion symptoms. Its ability to target the underlying causes of these symptoms makes it a valuable addition to any concussion treatment plan.

Carolina Brain Center Can Help In Your Recovery Process  

At Carolina Brain Center in Raleigh, NC, we believe in using cutting-edge therapies like Low-Level Laser Therapy (LLLT) to help patients recover from concussions more quickly and effectively. LLLT addresses the root causes of concussion symptoms by improving mitochondrial function, reducing inflammation, and promoting neuroplasticity. Whether you're dealing with acute symptoms or long-term effects like Post-Concussion Syndrome, LLLT administered by Dr. Dane at Carolina Brain Center can help accelerate your recovery and restore your quality of life.

If you've experienced a concussion and are looking for innovative, non-invasive treatments, Carolina Brain Center can help. Start your recovery journey today by filling out our consultation request form. The vast knowledge and care you receive in our clinic will set you on the path to healing.

 

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by Nina Koons

Ketogenic Diet as a Therapeutic Strategy for Concussion Recovery

Traumatic brain injuries (TBIs), including concussions, are becoming increasingly recognized for their long-term effects on cognitive function, mood, and overall brain health. When a person experiences a concussion, the immediate focus is often on physical symptoms such as headaches, dizziness, and confusion. However, the underlying biochemical changes in the brain—the neurometabolic cascade of concussion—can persist well after the initial injury, leading to prolonged symptoms. Recent research has explored alternative therapeutic strategies to support brain recovery, and one of the most promising interventions is the ketogenic diet. By providing an alternative energy source to glucose, which is often impaired after a brain injury, the ketogenic diet may help resolve the energy crisis and oxidative stress triggered by the neurometabolic cascade of concussion. 

Understanding the Neurometabolic Cascade of Concussion  

When a concussion occurs, the brain undergoes a complex set of biochemical reactions known as the neurometabolic cascade of concussion (NMCC). This cascade is triggered by the initial mechanical forces that disrupt neuronal function, leading to excitotoxicity (excessive neuronal firing), oxidative stress, and impaired glucose metabolism. These changes result in a brain-wide energy crisis where neurons struggle to maintain homeostasis, leading to cognitive, emotional, and physical impairments.

The cascade begins with the release of excitatory neurotransmitters such as glutamate, leads to a massive efflux of potassium out of the cells creating a higher demand for ATP (the cells’ energy currency) within a disrupted supply chain. Because the NMCC also leads to calcium influx into cells, the mitochondrial—the powerhouse of the cell—struggles to keep up with the supply needed to meet the new higher demand. Mitochondrial dysfunction is one of the critical drivers of the brain's energy crisis post-concussion.

In 2001, Giza and Hovda introduced the concept of the neurometabolic cascade, emphasizing that the secondary injuries following the initial trauma, such as oxidative stress and inflammation, contribute to long-term neurological deficits. These secondary injuries can persist for weeks, months, or even years, highlighting the importance of addressing the cascade early on to prevent chronic symptoms.

Ketones as an Alternative Energy Source for the Brain  

The ketogenic diet, which involves drastically reducing carbohydrate intake and increasing fat consumption, forces the body to switch from using glucose as its primary fuel source to using ketones. Ketones, such as beta-hydroxybutyrate (BHB) and acetoacetate (AcAc), are produced by the liver during periods of fasting or carbohydrate restriction. These ketones serve as an alternative energy source for the brain, bypassing the glucose metabolism pathways that are often impaired after a concussion.

Research published by the NIH has shown that ketone bodies provide a more efficient and stable source of energy for the brain compared to glucose. In a concussed brain, where glucose metabolism is impaired due to mitochondrial dysfunction and reduced cerebral blood flow, ketones offer a critical alternative fuel that can help restore energy balance and support recovery. Ketones are readily used by neurons and other brain cells, enhancing mitochondrial function and reducing oxidative stress.

In a 2021 review, NIH researchers highlighted the neuroprotective properties of ketones in conditions of traumatic brain injury. They found that ketones not only provide an alternative source of ATP but also reduce the production of reactive oxygen species (ROS), molecules that contribute to cellular damage and inflammation after a concussion.  By reducing oxidative stress, ketones can help protect the brain from further injury and promote cellular repair.

The Role of Ketones in Reducing Excitotoxicity and Inflammation

Excitotoxicity, which occurs when neurons are overstimulated by excessive amounts of glutamate, is one of the main contributors to neuronal damage after a concussion. Glutamate, an excitatory neurotransmitter, is released in large quantities following brain trauma and overstimulates neurons, leading to calcium influx into cells. This calcium overload damages mitochondria, resulting in further energy deficits and ultimately, cell death. The ketogenic diet has been shown to modulate this process by increasing the production of gamma-aminobutyric acid (GABA), a calming neurotransmitter that counteracts the effects of glutamate.

According to a study published in Frontiers in Neurology, ketone bodies can reduce excitotoxicity by enhancing GABA activity and limiting glutamate release. This reduction in neuronal firing prevents further neuronal damage and allows the brain to recover from the excitotoxic effects of the neurometabolic cascade. Additionally, ketones have been shown to stabilize neuronal membranes and improve the function of ion channels, which are critical for maintaining cellular homeostasis in the aftermath of a concussion.

Inflammation is another key factor in the progression of post-concussion symptoms. Chronic inflammation in the brain, driven by the release of pro-inflammatory cytokines, contributes to the development of conditions such as post-concussion syndrome (PCS), characterized by persistent symptoms like headaches, dizziness, and cognitive impairments. The ketogenic diet, through its anti-inflammatory effects, has been shown to reduce the levels of these cytokines, including tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), which are elevated after a traumatic brain injury.

A review conducted by the NIH in 2022 highlighted that ketone bodies can downregulate inflammatory pathways in the brain, thereby reducing the risk of developing chronic neuroinflammation. This reduction in inflammation not only accelerates recovery but also decreases the risk of long-term complications such as depression, anxiety, and even neurodegenerative diseases like Alzheimer's.

Clinical Evidence Supporting the Ketogenic Diet in Concussion Recovery  

While most of the research on the ketogenic diet has focused on epilepsy, its potential benefits for brain injury recovery are gaining increasing attention. Clinical studies have begun to explore the effects of ketosis on cognitive function, inflammation, and energy metabolism in individuals recovering from concussions. The NIH has supported several studies that suggest ketones can enhance recovery following brain injury by providing the brain with an alternative fuel source and protecting against further damage.

A study published in Journal of Neurotrauma, researchers examined the effects of a ketogenic diet on cognitive function in patients with mild traumatic brain injury. The results showed that patients who followed a ketogenic diet demonstrated significant improvements in memory, attention, and overall cognitive performance compared to those who consumed a standard diet. The study also found that ketogenic patients had lower levels of oxidative stress and inflammation, indicating that the diet had a protective effect on the brain.

Additionally, a study published in Frontiers in Nutrition highlighted the ability of ketones to reduce brain edema (swelling) and improve mitochondrial function following brain trauma. These findings provide further support for the use of the ketogenic diet in concussion recovery, as brain swelling and mitochondrial dysfunction are common issues that hinder recovery. The researchers concluded that the ketogenic diet not only provides neuroprotection but also enhances the brain’s capacity for healing by supporting cellular repair mechanisms.

Implementing the Ketogenic Diet in Clinical Practice  

While the ketogenic diet holds promise as a therapeutic tool for concussion recovery, it is essential to approach its implementation with care. Transitioning to a state of ketosis requires strict dietary modifications that involve reducing carbohydrate intake to less than 10% of daily calories and increasing fat intake to 70-80%. This shift can be challenging for some patients, especially those unfamiliar with low-carbohydrate diets.

In clinical practice, the ketogenic diet should be implemented under the guidance of healthcare professionals who can monitor patients for potential side effects such as fatigue, dehydration, or electrolyte imbalances. It is important to ensure that patients remain well-hydrated and consume adequate amounts of electrolytes (such as sodium, potassium, and magnesium) to prevent complications. Additionally, exogenous ketones, which are ketone supplements, may be used to help patients achieve ketosis more quickly, especially in the acute phase of concussion recovery.

Healthcare providers should also consider combining the ketogenic diet with other therapeutic interventions, such as hyperbaric oxygen therapy (HBOT) or transcranial low-level laser therapy (LLLT), to maximize recovery outcomes. By addressing both the neurometabolic and physical aspects of concussion recovery, a comprehensive approach can be developed that supports the patient’s overall well-being.

Addressing Post-Concussion Syndrome (PCS) with Ketosis  

For individuals suffering from post-concussion syndrome (PCS), where symptoms persist beyond the typical recovery period, the ketogenic diet may offer an additional benefit. Chronic inflammation and ongoing oxidative stress are significant contributors to PCS, and ketones can help reduce these processes. 

Because ketones provide a stable source of energy for the brain, they help alleviate the "brain fog" and cognitive fatigue often reported by PCS patients. This improvement in mental clarity is likely due to the reduction in neuroinflammation and oxidative damage, allowing the brain to heal more effectively.

How We Can Help

At Carolina Brain Center in Raleigh, NC, we believe that understanding the neurometabolic cascade and using innovative treatments can accelerate concussion recovery. Our personalized approach from both in-office treatments and at-home work incorporates therapies like the ketogenic diet, hyperbaric oxygen therapy, and transcranial low-level laser therapy to help patients heal efficiently.

If you’ve recently experienced a concussion and feel too unwell to start treatment, we offer strategies that allow you to begin healing even while resting. For acute concussions, we use a combination of hyperbaric oxygen ketone therapy and laser therapy to reduce the effects of the neurometabolic cascade. For patients with prolonged symptoms, we develop customized rehabilitation programs that combine at-home and in-office treatments.

Take the first step towards recovery by filling out our phone consultation request form today. The knowledge and care you'll receive at Carolina Brain Center will set you on the path to healing.

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by Nina Koons

The Role of Mitochondrial Dysfunction in Post-Concussion Syndrome

Concussions are often thought of as temporary injuries, with symptoms that resolve within days or weeks. However, for many individuals, concussions can have lingering effects that last for months or even years, a condition known as Post-Concussion Syndrome (PCS). One of the key mechanisms driving the long-term effects of PCS is mitochondrial dysfunction. Mitochondria, often referred to as the "powerhouses" of the cell, are responsible for producing energy in the form of ATP (adenosine triphosphate). When a concussion occurs, the delicate balance within mitochondria is disrupted, leading to a cascade of problems that contribute to the persistent symptoms of PCS. 

This article explores the critical role that mitochondrial dysfunction plays in PCS, examining the scientific evidence behind this phenomenon and the potential strategies for addressing it during recovery. A comprehensive understanding of mitochondrial health can offer new pathways for treatment, both in the acute phase of injury and in long-term care.

Understanding Mitochondrial Dysfunction After a Concussion

When the brain experiences trauma, such as a concussion, neurons undergo significant metabolic stress. The initial mechanical damage leads to a surge in calcium ions within neurons, which overwhelms the mitochondria. Mitochondria are tasked with regulating calcium levels within the cell, but this sudden influx impairs their function. As a result, mitochondria cannot produce ATP as efficiently, and they generate higher levels of reactive oxygen species (ROS), molecules that cause oxidative damage to cells.

This combination of reduced energy production and increased oxidative stress leads to further cellular damage and dysfunction. The mitochondria, which are critical for sustaining cellular activity, become a source of cellular stress and inflammation. This dysfunction is not limited to the acute phase of the injury. Long after the initial impact, mitochondrial damage can persist, contributing to chronic symptoms such as cognitive difficulties, fatigue, headaches, and mood disturbances—all hallmark signs of PCS.

A study published by the National Institutes of Health (NIH) supports this understanding, showing that mitochondrial dysfunction plays a central role in the neurometabolic cascade of concussion. The research highlights that disruptions in mitochondrial function not only impair energy production but also contribute to long-term neuroinflammation, which underpins many of the symptoms seen in PCS.

The Neurometabolic Cascade and Its Impact on Mitochondria  

Following a concussion, the brain undergoes a series of biochemical changes referred to as the neurometabolic cascade of concussion. This cascade begins with the release of excitatory neurotransmitters like glutamate, which creates a massive efflux of potassium out of the cells. This creates a larger demand for ATP, the cells energy currency, and ultimately leads to an energy crisis. Moreover, there is a massive influx of calcium into the cells. Mitochondria, responsible for buffering calcium within cells, are quickly overwhelmed by this surge. In a healthy state, mitochondria produce ATP through oxidative phosphorylation, a process that requires tight regulation of calcium levels. However, in the concussed brain, mitochondrial membranes are disrupted, leading to a loss of control over calcium homeostasis and ultimately cannot keep up with the new demand for energy, ATP, and the energy crisis becomes an even bigger problem. 

This mitochondrial stress results in the production of reactive oxygen species (ROS), which cause oxidative damage to both the mitochondria and surrounding cellular structures. Over time, these oxidative damage compounds further impair mitochondrial function and exacerbate the energy crisis within neurons. Without sufficient energy, neurons struggle to carry out their essential functions, leading to symptoms such as cognitive impairment, mood disturbances, and fatigue, which are often observed in patients with PCS.

The persistent nature of mitochondrial dysfunction is what makes PCS so challenging to treat. While many symptoms of concussion resolve within a few weeks, mitochondrial damage can linger, creating a cycle of ongoing cellular stress and neuroinflammation that prolongs recovery.

How Mitochondrial Dysfunction Contributes to Post-Concussion Symptoms  

One of the most significant ways mitochondrial dysfunction affects patients with PCS is through its impact on energy metabolism. The brain is an energy-intensive organ, and when it cannot produce enough ATP, cognitive function, memory, and mood regulation are all affected. Patients with PCS often report "brain fog," difficulty concentrating, and memory lapses—all of which are likely tied to the brain's reduced ability to meet its energy demands.

In addition to cognitive symptoms, mitochondrial dysfunction also contributes to physical symptoms such as headaches and fatigue. This is because mitochondria are also involved in regulating the function of blood vessels and the autonomic nervous system, which controls involuntary processes such as heart rate and blood pressure. When mitochondrial function is impaired, blood flow to the brain can be disrupted, leading to symptoms such as headaches, dizziness, and light sensitivity, which are commonly seen in PCS patients.

Furthermore, mitochondrial dysfunction plays a critical role in maintaining the balance of neurotransmitters, the chemicals that transmit signals between neurons. When mitochondria are damaged, they are unable to efficiently recycle neurotransmitters, leading to imbalances that can affect mood and emotional regulation. Many patients with PCS experience symptoms of anxiety, depression, and irritability, which are thought to be related to these neurotransmitter imbalances.

Addressing Mitochondrial Dysfunction in Post-Concussion Care  

Given the central role that mitochondrial dysfunction plays in PCS, addressing this issue is key to effective treatment. Several strategies have emerged that focus on restoring mitochondrial health and improving energy production in the brain. One of the most promising approaches is the use of antioxidant therapy. Antioxidants help neutralize the reactive oxygen species that are produced by damaged mitochondria, reducing oxidative stress and preventing further damage.

A study published in the Journal of Neurotrauma explored the use of antioxidants such as coenzyme Q10 (CoQ10) and N-acetylcysteine (NAC) in patients with brain injuries. The findings showed that these compounds could improve mitochondrial function, reduce oxidative stress, and accelerate recovery in patients with PCS. These antioxidants work by supporting the mitochondria's ability to produce ATP and by preventing the accumulation of oxidative damage that impairs cellular function.

Another approach to addressing mitochondrial dysfunction involves optimizing energy production through nutritional interventions. The ketogenic diet, which shifts the brain's energy source from glucose to ketones, has shown promise in improving mitochondrial function. Ketones are a more efficient fuel source for the brain and can bypass some of the metabolic impairments caused by mitochondrial damage. Research suggests that the ketogenic diet may help reduce symptoms of PCS by providing the brain with an alternative energy source and supporting mitochondrial recovery.

Physical therapies, such as hyperbaric oxygen ketone therapy (HBOKT) and transcranial low-level laser therapy (LLLT), have also been explored as methods for improving mitochondrial function. HBOKT increases the availability of oxygen in the brain, which enhances mitochondrial respiration and supports ATP production. TLLLT, on the other hand, uses light energy to stimulate mitochondrial activity and reduce inflammation. Both therapies have been studied for their potential to accelerate recovery in patients with PCS, with promising results.

The Importance of Early Intervention  

Mitochondrial dysfunction begins immediately after a concussion, making early intervention critical to preventing long-term damage. The sooner therapies targeting mitochondrial health are implemented, the greater the chances of preventing the development of PCS. For example, initiating antioxidant therapy or hyperbaric oxygen ketone therapy shortly after the injury can help stabilize mitochondrial function and prevent the cascade of oxidative stress and inflammation that contributes to prolonged symptoms.

Early intervention is also important for patients who are at higher risk of developing PCS, such as those with a history of multiple concussions or individuals with pre-existing neurological conditions. In these cases, proactive management of mitochondrial dysfunction may help reduce the severity of symptoms and shorten recovery times.

Carolina Brain Center Can Help  

At Carolina Brain Center in Raleigh, NC, we understand the importance of addressing mitochondrial dysfunction in patients recovering from concussions. Our approach combines innovative therapies like hyperbaric oxygen ketone therapy, antioxidant treatments, and personalized rehabilitation programs to help patients recover faster and more effectively.

If you've recently experienced a concussion, don't wait to seek treatment. Our therapies can help address the underlying causes of your symptoms, including mitochondrial dysfunction. For patients dealing with prolonged symptoms, we offer individualized treatment plans that combine in-office therapies with at-home strategies to optimize recovery.

Start your journey to recovery today, with Dr. Dane and the Carolina Brain Center. Complete our phone consultation request form today and let us show you how to start living a pain free life again.

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by Nina Koons

The Importance of Early Intervention in Preventing Long-Term Cognitive Deficits After Concussion

Concussions, often referred to as mild traumatic brain injuries (mTBIs), are commonly seen in contact sports, motor vehicle accidents, and falls. While they are labeled "mild" due to the absence of structural damage visible on standard brain imaging, concussions can have long-term consequences if not properly addressed. The neurometabolic cascade triggered by the concussion results in complex biochemical changes that, if left untreated, can lead to cognitive deficits, mood disorders, and other lasting impairments. Early intervention following a concussion is critical to preventing these long-term issues.

This article explores the significance of early intervention in managing concussions, emphasizing how prompt and proactive treatment strategies can mitigate the risk of developing long-term cognitive impairments. It also highlights key research supporting the efficacy of early interventions.

The Neurometabolic Cascade and Cognitive Impairments  

The brain is particularly vulnerable to the effects of a concussion due to the biochemical changes that occur immediately after impact. The neurometabolic cascade, a process characterized by the release of excitatory neurotransmitters, mitochondrial dysfunction, and oxidative stress, sets the stage for both short- and long-term damage. This cascade results in an energy crisis in the brain, where neurons struggle to generate sufficient ATP (adenosine triphosphate) to function properly. The energy crisis is exacerbated by calcium influx into cells, further damaging mitochondria and impairing cellular function.

In the days following a concussion, the brain remains in a state of heightened vulnerability, particularly to secondary injuries. During this time, the risk of developing long-term cognitive deficits, such as memory problems, reduced attention span, and difficulties with executive function, increases significantly. Research has shown that individuals who do not receive proper intervention in the acute phase of injury are more likely to experience persistent cognitive impairments months or even years later.

The effects of these impairments can range from subtle to profound. Many patients with Post-Concussion Syndrome (PCS) report difficulties with concentration, memory, and problem-solving, all of which can significantly impact daily life and occupational performance. Early intervention aims to disrupt this cascade of damage and provide the brain with the support it needs to heal before long-term effects take hold.

Why Early Intervention is Critical  

The first 24 to 72 hours after a concussion are crucial for preventing long-term cognitive deficits. This window represents a period when the brain is most vulnerable but also most responsive to therapeutic interventions. The goal of early intervention is to address the neurometabolic cascade before the brain sustains lasting damage. Without treatment, the inflammatory and oxidative processes initiated by the cascade can cause irreversible harm to neuronal structures, leading to persistent cognitive and emotional impairments.

A study published by the National Institutes of Health (NIH) in 2021 emphasizes the importance of initiating treatment as soon as possible following a concussion. The study found that patients who received early intervention within the first 48 hours of injury had significantly better cognitive outcomes compared to those who delayed treatment. Early intervention was shown to reduce the duration and severity of symptoms, improve cognitive function, and lower the risk of developing chronic neuroinflammation.

Therapeutic Approaches to Early Intervention  

1. Rest and Gradual Resumption of Activity  

One of the earliest interventions recommended for concussions is cognitive and physical rest. This allows the brain time to recover from the initial injury without added strain. Patients are typically advised to avoid activities that require intense mental effort, such as studying, reading, or screen time, as well as strenuous physical activities. However, prolonged rest beyond 48 hours may delay recovery, so it is crucial to gradually reintroduce light physical and cognitive activities under the guidance of a healthcare professional.

Research has shown that controlled reintroduction of light aerobic exercise can improve cerebral blood flow and help regulate the autonomic nervous system, both of which are disrupted by concussion. This gradual increase in activity promotes neuroplasticity, the brain's ability to reorganize and form new neural connections, which is essential for cognitive recovery.

2. Nutritional Interventions  

Nutritional strategies can also play a significant role in early intervention for concussion recovery. Proper nutrition supports mitochondrial function, reduces inflammation, and provides the brain with the nutrients necessary for cellular repair. Omega-3 fatty acids, for example, have been shown to reduce neuroinflammation and improve synaptic plasticity, both of which are critical for cognitive recovery.

Researchers found that supplementation with omega-3 fatty acids in the acute phase of a concussion resulted in improved cognitive function and reduced symptoms of depression and anxiety. Similarly, the ketogenic diet, which shifts the brain's energy source from glucose to ketones, may offer neuroprotective benefits by providing an alternative energy source to support mitochondrial health.

3. Hyperbaric Oxygen Ketone Therapy (HBOKT)  

Hyperbaric Oxygen Ketone Therapy (HBOKT) is another intervention that has shown promise in early concussion treatment. By delivering high concentrations of oxygen to the brain, HBOT promotes healing by increasing oxygen availability in areas affected by reduced cerebral blood flow and mitochondrial dysfunction. The NIH has published several studies supporting the use of HBOT to reduce inflammation and enhance cognitive function in patients with mTBI.

HBOT has been shown to improve cognitive recovery by promoting mitochondrial function and reducing oxidative stress. It also accelerates the repair of damaged neuronal pathways, which is critical for restoring cognitive function after a concussion.

4. Low-Level Laser Therapy (LLLT)  

Low-Level Laser Therapy (LLLT), also known as photobiomodulation, uses light energy to stimulate cellular repair and improve mitochondrial function. LLLT has been shown to reduce neuroinflammation, enhance synaptic plasticity, and promote the growth of new neurons (neurogenesis). These effects are particularly beneficial for patients with concussions, as they address both the acute and long-term aspects of brain recovery.

LLLT can significantly improve cognitive performance and reduce the duration of symptoms in patients who receive treatment in the acute phase of injury. The light energy penetrates the scalp and is absorbed by mitochondria in brain cells, stimulating ATP production and reducing oxidative stress, which accelerates recovery.

At Carolina Brain Center, we specialize in using the Erchonia Laser to treat our patients. The Erchonia laser promotes science-backed healing in concussion patients.  This non-invasive treatment not only enhances mitochondrial function, but improves cerebral blood flow, and accelerates recovery from concussion-related symptoms such as headaches, cognitive impairment, and dizziness.This laser is one of the many ways that we implement a multipoint approach to concussion care. 

The Role of Education in Early Intervention  

In addition to medical interventions, education is a key component of early concussion management. Patients and their families should be informed about the risks associated with concussions and the importance of seeking early treatment. Many individuals are unaware of the long-term cognitive risks associated with concussions and may not seek medical attention unless symptoms become severe. Educating patients about the neurometabolic cascade and the potential for long-term damage can encourage them to pursue early interventions that may prevent lasting cognitive deficits.

Healthcare providers should also emphasize the importance of follow-up care. Concussions are dynamic injuries, and symptoms can evolve over time. Regular follow-up appointments allow healthcare professionals to monitor recovery, adjust treatment plans, and address any emerging cognitive or emotional issues.

Our Approach in Early Intervention of Concussion Injury  

At Carolina Brain Center in Raleigh, NC, we understand the importance of early intervention in concussion recovery. By addressing the neurometabolic cascade and preventing long-term damage, we help patients recover faster and with fewer lasting effects. Our personalized approach integrates therapies such as low-level laser therapy, hyperbaric oxygen ketone therapy, and nutritional interventions to provide a comprehensive recovery plan.

If you’ve recently suffered a concussion, don’t wait to seek treatment. Early intervention is key to preventing long-term cognitive deficits. At Carolina Brain Center, we are committed to helping you recover fully and efficiently. To start the conversation, contact us today. The knowledge and care you receive will put you on the path to a faster, healthier recovery.

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by Nina Koons

Inflammation and the Brain: How Neuroinflammation Contributes to Prolonged Concussion Symptoms

Concussions, often described as mild traumatic brain injuries (mTBIs), are far more complex than they appear. Beyond the immediate physical symptoms like headaches, dizziness, and confusion, concussions initiate a series of biochemical processes that can have long-lasting effects on brain health. One of the most significant of these processes is neuroinflammation. This inflammatory response, triggered by the initial injury, is a key driver of the prolonged symptoms seen in conditions like Post-Concussion Syndrome (PCS). 

Neuroinflammation plays a crucial role in determining how well, or how poorly, a patient recovers from a concussion. When the inflammatory response becomes chronic, it can impair cognitive function, contribute to mood disorders, and exacerbate physical symptoms. 

What Happens During Neuroinflammation?  

When a concussion occurs, the brain experiences a mechanical force that damages neurons and disrupts the blood-brain barrier. This initial trauma sets off an immune response involving the activation of microglia, the brain’s resident immune cells. These microglia release pro-inflammatory cytokines, which are signaling molecules that trigger inflammation. While inflammation is a necessary part of the healing process, it can become problematic when it continues long after the initial injury.

In a healthy response, inflammation helps to clear damaged cells and promote tissue repair. However, in the case of concussions, this process can spiral out of control, leading to a state of chronic inflammation. Microglial cells remain activated for extended periods, continually releasing pro-inflammatory cytokines that contribute to ongoing brain dysfunction. This chronic state of inflammation can impair neuronal communication, disrupt synaptic plasticity (the brain’s ability to adapt and reorganize), and create an environment where cognitive deficits, mood disturbances, and physical symptoms persist.

A study by the National Institutes of Health (NIH) highlights the importance of understanding this prolonged inflammatory response. Researchers have identified that individuals with elevated levels of cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), are more likely to experience prolonged symptoms after a concussion.

The Role of Inflammatory Cytokines in Post-Concussion Syndrome (PCS)  

Cytokines are critical players in the body’s immune response, acting as messengers that regulate inflammation and immune function. Following a concussion, the release of pro-inflammatory cytokines is intended to initiate healing. However, when these cytokines remain elevated for too long, they contribute to ongoing neuroinflammation, which can manifest as cognitive impairment, emotional instability, and persistent physical symptoms.

One of the key cytokines involved in neuroinflammation is IL-6. This cytokine is responsible for both promoting and regulating the inflammatory response. In the context of a concussion, elevated IL-6 levels have been linked to prolonged cognitive deficits, such as difficulties with memory, attention, and executive function. Additionally, increased IL-6 levels can contribute to mood disturbances, including anxiety and depression, both of which are common in patients with PCS.

TNF-alpha is another critical cytokine involved in neuroinflammation. It plays a central role in regulating the immune response and can exacerbate neuronal damage if left unchecked. Elevated TNF-alpha levels following a concussion have been associated with persistent headaches, cognitive decline, and neurodegenerative processes. Chronic elevation of TNF-alpha can also lead to a breakdown of the blood-brain barrier, allowing harmful substances to enter the brain and further contribute to neuroinflammation.

How Neuroinflammation Affects Cognitive Function  

Neuroinflammation has a profound impact on cognitive function. The brain’s ability to process information, store memories, and regulate attention is highly dependent on the health of its neurons and synaptic connections. Chronic inflammation disrupts these processes by damaging neurons and impairing synaptic plasticity. This means that the brain is less able to adapt, learn, and repair itself following injury.

Studies have shown that patients with PCS often experience "brain fog," which is characterized by difficulty concentrating, slower processing speeds, and impaired memory. These cognitive deficits can persist for months or even years if the underlying neuroinflammation is not addressed. Inflammation in the hippocampus, a brain region essential for memory formation, has been particularly implicated in the cognitive decline seen in PCS patients. Additionally, neuroinflammation can interfere with neurotransmitter systems, such as the balance between glutamate and GABA, further impairing cognitive function and contributing to mood disorders.

Managing and Reducing Neuroinflammation Post-Concussion  

Given the significant role that neuroinflammation plays in prolonging concussion symptoms, addressing inflammation is a key component of effective treatment. Several strategies have emerged to help manage and reduce inflammation, promoting faster recovery and reducing the risk of long-term complications.

1. Nutritional Interventions  

Dietary interventions can play a significant role in reducing neuroinflammation. Omega-3 fatty acids, commonly found in fish oil, have been shown to reduce the production of pro-inflammatory cytokines and support neuronal health. A recent study found that patients with brain injuries who supplemented with omega-3 fatty acids experienced reduced neuroinflammation and improved cognitive outcome.

Additionally, antioxidants, such as vitamins C and E, can help neutralize the reactive oxygen species (ROS) produced during the inflammatory response. These antioxidants support mitochondrial function and reduce oxidative stress, both of which are important for maintaining cognitive function post-concussion.

2. Non-invasive Therapies: Low-Level Laser Therapy (LLLT) and Hyperbaric Oxygen Ketone Therapy (HBOKT)  

Non-invasive therapies like Low-Level Laser Therapy (LLLT) and Hyperbaric Oxygen Ketone Therapy (HBOKT) have also been shown to reduce neuroinflammation and promote brain healing. LLLT uses light energy to stimulate cellular repair and reduce inflammation in damaged tissues, while HBOT increases oxygen delivery to the brain, enhancing the brain’s ability to heal and reducing oxidative stress.

Research has demonstrated that both therapies can help alleviate symptoms of PCS by targeting the underlying inflammatory processes that contribute to cognitive decline and mood disorders. These therapies are particularly effective when combined with other interventions, such as nutritional support and cognitive rehabilitation.

3. Lifestyle Changes  

In addition to non-invasive therapies and nutritional interventions, lifestyle changes can also play a role in managing neuroinflammation. Regular physical activity has been shown to reduce inflammatory markers and improve cognitive function. Engaging in light aerobic exercise, such as walking or swimming, can promote neuroplasticity and reduce the duration of PCS symptoms. Additionally, stress management techniques, such as meditation and mindfulness, can help regulate the body’s immune response and reduce the production of pro-inflammatory cytokines.

Carolina Brain Center Can Help

  At Carolina Brain Center in Raleigh, NC, we understand the importance of managing neuroinflammation to support concussion recovery. Our approach integrates therapies like hyperbaric oxygen ketone therapy, low-level laser therapy, and nutritional interventions to reduce inflammation and promote faster healing. If you’re experiencing prolonged concussion symptoms, don’t wait to seek treatment. By addressing neuroinflammation early, we can help you recover more effectively and prevent long-term complications.

Take the first step toward recovery by filling out our phone consultation request form today. The knowledge and care you receive at Carolina Brain Center will put you on the path to healing.

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by Nina Koons

Managing Calcium Dysregulation in Concussion Recovery

Concussions are often underestimated in terms of the complex biochemical changes they cause within the brain. While immediate symptoms such as headaches and dizziness are more obvious, the underlying cellular disturbances are far more intricate. One of the key processes disrupted after a concussion is calcium homeostasis. Calcium ions (Ca2+) play a critical role in many cellular functions, including signal transmission, muscle contraction, and energy production. However, after a concussion, calcium regulation becomes dysfunctional, contributing to a cascade of problems that can delay recovery and exacerbate symptoms.

Keep reading, as we will begin to explore the impact of calcium dysregulation on brain health following a concussion as well as discuss strategies to manage and mitigate its effects during recovery. By understanding how calcium contributes to both immediate and prolonged symptoms, healthcare professionals and patients can better tailor treatment plans for optimal recovery outcomes.

The Role of Calcium in Neuronal Function  

Calcium is essential for neuronal function and signaling. It acts as a messenger that helps transmit signals between neurons by facilitating the release of neurotransmitters across synapses. Calcium also plays a vital role in maintaining the balance of excitatory and inhibitory signals in the brain, helping regulate brain activity. Under normal conditions, neurons tightly regulate calcium levels to ensure proper functioning. Mitochondria and the endoplasmic reticulum act as reservoirs for calcium, releasing it when needed and sequestering it when its levels become too high.

However, when a concussion occurs, the mechanical impact disrupts the cell membranes and leads to a massive influx of calcium into neurons. This excess calcium can overwhelm the cells, triggering a chain reaction that impairs cellular processes, damages mitochondria, and disrupts energy production. The result is an energy crisis in the brain, which contributes to the neurometabolic cascade of concussion.

Calcium Dysregulation and the Neurometabolic Cascade  

The neurometabolic cascade that follows a concussion is a series of biochemical reactions that disrupt normal brain function. One of the central components of this cascade is calcium dysregulation. After a concussion, neurons experience a surge in calcium influx, which impairs their ability to function properly. Excess calcium in the cells activates harmful enzymes, such as calpains, which break down proteins and other cellular components, leading to cell death.

This influx of calcium also overwhelms the mitochondria, the energy-producing centers of the cells. Mitochondria are responsible for generating ATP (adenosine triphosphate), the energy currency of cells. However, when overloaded with calcium, mitochondria become dysfunctional and unable to produce sufficient ATP. This contributes to the brain’s energy crisis following a concussion, further impairing cognitive function and prolonging symptoms.

Moreover, calcium dysregulation can trigger oxidative stress, a condition where harmful reactive oxygen species (ROS) are produced in excessive amounts. These ROS cause damage to cellular structures, including membranes, proteins, and DNA. The combination of oxidative stress and impaired energy production creates an environment where the brain cannot heal effectively, leading to persistent symptoms such as headaches, cognitive impairments, and mood disturbances.

The Long-Term Impact of Calcium Dysregulation  

If calcium dysregulation is not addressed early in the concussion recovery process, it can lead to long-term consequences. Persistent calcium overload in neurons has been linked to the development of neurodegenerative disorders, such as Alzheimer’s and Parkinson’s disease. Research has shown that chronic calcium dysregulation contributes to the buildup of toxic proteins, such as beta-amyloid, which are associated with neurodegenerative conditions. 

Additionally, prolonged calcium imbalances can disrupt the brain’s ability to form new connections, a process known as synaptic plasticity. Synaptic plasticity is critical for learning, memory, and cognitive flexibility. Without proper calcium regulation, the brain becomes less capable of adapting and recovering from the initial injury. This is one reason why some patients experience Post-Concussion Syndrome (PCS), where symptoms such as memory problems, concentration difficulties, and mood disorders persist for months or even years after the initial concussion.

Strategies to Manage Calcium Dysregulation in Concussion Recovery  

Given the critical role that calcium plays in both the acute and long-term phases of concussion recovery, managing calcium dysregulation is essential for improving outcomes. Several strategies have emerged that focus on restoring calcium balance and protecting neurons from the damaging effects of calcium overload.

1. Magnesium Supplementation  

Magnesium is a natural antagonist to calcium and plays a crucial role in maintaining calcium balance within neurons. After a concussion, magnesium levels often drop, which exacerbates calcium dysregulation. Supplementing with magnesium can help restore this balance by preventing excessive calcium influx and supporting mitochondrial function.

Research has shown that magnesium supplementation can reduce the severity of concussion symptoms and improve recovery outcomes. By stabilizing calcium levels, magnesium helps protect neurons from damage and supports the brain’s ability to generate energy. In addition to magnesium supplementation, maintaining adequate hydration is important, as dehydration can exacerbate electrolyte imbalances, including calcium dysregulation.

2. Mitochondrial Support  

Since calcium dysregulation primarily affects mitochondria, supporting mitochondrial function is a key strategy for managing calcium imbalances. Nutritional interventions can help protect mitochondria from oxidative damage and improve their ability to produce ATP. These supplements act as antioxidants, neutralizing reactive oxygen species and reducing oxidative stress.

Hyperbaric oxygen ketone therapy (HBOKT) is another approach that has been shown to enhance mitochondrial function by increasing oxygen delivery to damaged brain tissues. HBOKT can improve energy production and reduce the effects of calcium dysregulation by supporting cellular repair mechanisms. Research suggests that combining HBOKT with other treatments, such as nutritional support and light therapy, may offer synergistic benefits in concussion recovery.

3. Low-Level Laser Therapy (LLLT)  

Low-Level Laser Therapy (LLLT) has shown promise in addressing calcium dysregulation by stimulating cellular repair and reducing inflammation. LLLT uses light energy to penetrate the scalp and reach brain cells, where it interacts with mitochondria to enhance ATP production and improve calcium homeostasis. Studies have found that LLLT can reduce oxidative stress and inflammation, both of which are exacerbated by calcium overload in the brain.

By improving mitochondrial function and reducing calcium imbalances, LLLT can help accelerate recovery and alleviate symptoms such as headaches, cognitive impairments, and mood disturbances. This non-invasive therapy is particularly useful for patients with persistent symptoms of Post-Concussion Syndrome.

The Importance of Early Intervention  

Calcium dysregulation begins immediately after a concussion, making early intervention critical to preventing long-term damage. The sooner that therapies targeting calcium balance are implemented, the greater the chances of preventing prolonged symptoms and cognitive decline. For patients with a history of multiple concussions or those who experience persistent symptoms, proactive management of calcium dysregulation is especially important for preventing chronic neurological issues.

Healthcare providers should assess calcium regulation as part of the initial evaluation following a concussion and implement strategic support. Early intervention can make a significant difference in the recovery trajectory, reducing the risk of long-term complications and improving overall brain health.

How We Can Help 

At Carolina Brain Center, we understand the importance of managing calcium dysregulation in patients recovering from concussions. Our approach integrates innovative therapies such as hyperbaric oxygen therapy, low-level laser therapy, and nutritional interventions to restore calcium balance and support mitochondrial function. By addressing calcium dysregulation early, we help patients recover more quickly and prevent long-term complications.

If you've recently experienced a concussion, don't wait to seek treatment. Early intervention is key to preventing prolonged symptoms and ensuring a full recovery. Take the first step by filling out our phone consultation request form today. The knowledge and care you receive at Carolina Brain Center will set you on the path to healing.

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by Nina Koons

Help For Those Suffering With Chronic Lyme Disease

Living with chronic Lyme disease can be an exhausting and challenging journey. The persistent symptoms, ranging from fatigue to joint pain, can severely impact one's quality of life. If you're seeking help and live in Raleigh, NC, a chiropractic neurologist like myself can offer effective and holistic solutions. At Carolina Brain Center, we specialize in providing comprehensive care tailored to your needs. Let’s explore how we can help you manage and alleviate the symptoms of chronic Lyme disease.

Understanding Chronic Lyme Disease

Lyme disease is an infection caused by the bacteria Borrelia burgdorferi, transmitted through tick bites. While early-stage Lyme disease can often be treated successfully with antibiotics, some people develop chronic Lyme disease, experiencing long-term symptoms even after treatment. These symptoms can include:

- Persistent fatigue

- Muscle and joint pain

- Cognitive difficulties

- Headaches

- Sleep disturbances

Dealing with these symptoms can be incredibly frustrating and debilitating, but there is hope. Seeking care from a chronic Lyme disease specialist in Raleigh, NC, can make a significant difference.

The Role of a Chiropractic Neurologist

A chiropractic neurologist is a healthcare professional specializing in functional neurology, focusing on the health of the nervous system. At Carolina Brain Center, we combine chiropractic care with neurological expertise to provide a unique and effective approach to managing chronic Lyme disease. Here’s how we can help:

 

1. Personalized Care Plans

    - Each patient is unique, and so is their experience with chronic Lyme disease. We develop personalized care plans tailored to your specific symptoms and needs. This personalized approach ensures you receive the most effective treatment possible.

 

2. Holistic Healthcare Services

    - We offer a range of holistic healthcare services that go beyond traditional treatments. Our services include chiropractic adjustments, neurological rehabilitation, nutritional counseling, and lifestyle recommendations. This comprehensive approach addresses the root causes of your symptoms, promoting overall health and well-being.

 

3. Pain Management

    - Chronic pain is one of the most common and challenging symptoms of Lyme disease. Through targeted chiropractic adjustments and other therapies, we can help alleviate pain and improve your quality of life. Our goal is to reduce your reliance on pain medications and help you achieve long-term relief.

 

4. Neurological Rehabilitation

    - Lyme disease can affect cognitive functions, leading to memory issues, difficulty concentrating, and brain fog. Our functional neurology center specializes in neurological rehabilitation to improve cognitive function. We use techniques like brain exercises, sensory stimulation, and other therapies to enhance brain health.

 

5. Nutritional Support

    - Nutrition plays a crucial role in managing chronic Lyme disease. We provide nutritional counseling to help you adopt a diet that supports your recovery. Proper nutrition can boost your immune system, reduce inflammation, and enhance your overall health.

 

6. Stress Management

    - Living with chronic Lyme disease can be stressful, which can exacerbate symptoms. We offer stress management techniques, including relaxation exercises, mindfulness, and other strategies to help you cope with stress and improve your mental well-being.

What to Expect at Carolina Brain Center

When you visit Carolina Brain Center, you can expect a compassionate and comprehensive approach to your care. Here’s a glimpse of what your journey with a Lyme Disease specialist in NC might look like:

 

1. Initial Consultation

    - During your first visit, we will conduct a thorough evaluation to understand your medical history, symptoms, and concerns. This evaluation helps us create a personalized care plan tailored to your needs.

 

2. Diagnostic Assessments

    - We use various diagnostic tools and assessments to get a complete picture of your health. These may include neurological exams, cognitive tests, and other evaluations to identify areas that need attention.

 

3. Treatment Plan

    - Based on our findings, we will develop a customized treatment plan. This plan may include chiropractic adjustments, neurological rehabilitation, nutritional counseling, and other therapies designed to address your specific symptoms.

 

4. Ongoing Support

    - Managing chronic Lyme disease is an ongoing process. We provide continuous support and adjustments to your treatment plan as needed. Our goal is to help you achieve and maintain optimal health and well-being.

The Benefits of Choosing a Functional Neurology Center

Choosing a functional neurology center like Carolina Brain Center for your chronic Lyme disease care offers several benefits:

 

1. Comprehensive Care

    - We address all aspects of your health, from physical symptoms to cognitive function and emotional well-being. Our holistic approach ensures you receive well-rounded care.

 

2. Expertise

    - As a chiropractic neurologist, I have specialized training in both chiropractic care and neurology. This unique combination allows us to provide effective treatments for complex conditions like chronic Lyme disease.

 

3. Patient-Centered Approach

    - We prioritize your needs and preferences, ensuring you are an active participant in your care. Your input is valuable in creating a treatment plan that works for you.

 

4. Natural and Non-Invasive Treatments

    - Our treatments focus on natural and non-invasive methods, reducing the need for medications and invasive procedures. We aim to support your body’s natural healing processes.

Why Holistic Healthcare Services Matter

Holistic healthcare services are essential in managing chronic conditions like Lyme disease. By addressing the whole person – mind, body, and spirit – we can achieve better health outcomes. Here’s why holistic care is so effective:

 

1. Root Cause Focus

    - Rather than just treating symptoms, holistic care aims to identify and address the underlying causes of your health issues. This approach leads to more sustainable and long-lasting results.

 

2. Integrated Care

    - Holistic healthcare integrates various treatments and therapies, providing a comprehensive approach to your health. This integration ensures all aspects of your well-being are considered and addressed.

 

3. Patient Empowerment

    - Holistic care empowers patients to take an active role in their health. By providing education and support, we help you make informed decisions and adopt healthier lifestyles.

 

4. Improved Quality of Life

    - By addressing all dimensions of health, holistic care can significantly improve your quality of life. You’ll experience not only relief from symptoms but also enhanced overall well-being.

Contact Us Today

If you’re struggling with chronic Lyme disease, know that you don’t have to face it alone. At Carolina Brain Center, we are dedicated to providing compassionate and comprehensive care to help you manage and alleviate your symptoms. As a chronic Lyme disease specialist in Raleigh, NC, Dr Dane and her team are here to support you every step of the way. Our functional neurology center offers a holistic approach that addresses your unique needs, helping you achieve better health and a better quality of life.

Take the first step towards relief and recovery by reaching out to us today. Let’s work together to create a personalized plan that helps you reclaim your life from chronic Lyme disease.

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by Nina Koons

Dealing With Concussions as a Young Adult

Concussions are a serious issue, especially for young adults. At Carolina Brain Center, we see firsthand how important it is to take brain health seriously, especially when it comes to concussions. In this article, we’ll dive into what concussions are, the differences between getting a concussion as a child versus as a young adult, and why it’s so important to focus on brain health.

Understanding Concussions

A concussion is a type of brain injury caused by a bump, blow, or jolt to the head. This sudden movement can make the brain bounce around or twist in the skull, creating chemical changes and sometimes damaging brain cells. Concussions can affect memory, judgment, reflexes, speech, balance, and coordination. The symptoms might show up right after the injury or not until days later. Common signs include headaches, confusion, dizziness, nausea, and sometimes loss of consciousness.

Concussions can happen to anyone at any time. Whether you’re playing sports, involved in a car accident, or even just taking a hard fall, the risk is there. The brain is a sensitive organ, and even a seemingly minor hit can have significant consequences. This is why it’s crucial to recognize the signs and symptoms of a concussion and take immediate action if you suspect you have one.

Concussions in Children vs. Young Adults

Children:

When children get concussions, their brains are still developing. This means they might recover more quickly in some cases, but they also face unique risks. Their brain tissues are more pliable, which can sometimes result in less immediate damage but can cause more long-term issues. Children might have trouble explaining how they feel, making it harder for parents and doctors to understand the severity of the injury. It's also essential to consider their academic and social development. Missing school and activities due to concussion symptoms can significantly impact their growth and learning.

Additionally, children’s brains are more susceptible to the effects of a second concussion if they haven’t fully recovered from the first one. This condition, known as second impact syndrome, can lead to severe complications, including brain swelling and even death. Therefore, it’s crucial for parents and caregivers to ensure children fully recover before returning to any activities that might put them at risk for another head injury.

Young Adults:

For young adults, the situation is different. While their brains have mostly developed, they are more likely to experience lasting effects from concussions. This age group is often involved in high-risk activities like sports, driving, and physically demanding jobs. The pressure to perform academically and socially can also lead to pushing through symptoms rather than resting, which is crucial for recovery. Additionally, young adults are at a stage where they’re making significant life decisions, and a concussion can disrupt plans, career paths, and overall life goals.

Young adults may also face challenges in recognizing the severity of their injury. There’s a tendency to downplay symptoms or attribute them to other causes like stress or lack of sleep. This can delay seeking proper treatment and prolong recovery. Moreover, the demands of higher education or early career responsibilities can make it difficult to take the necessary time off for proper healing.

The Importance of Focusing on Brain Health

Brain health is crucial at any age, but young adults need to pay special attention. Here’s why:

1. Academic Performance: Young adults are often in college or starting their careers. A concussion can disrupt studies, lead to missed classes, and lower grades. It's important to recognize that rest and recovery are essential to getting back on track.
   Academic pressure can be intense, and trying to keep up with coursework while dealing with concussion symptoms can be overwhelming. It’s essential to communicate with professors and academic advisors about your condition. Many educational institutions have accommodations in place for students recovering from concussions, such as extended deadlines and adjusted workloads.
2. Long-term Impact: Ignoring concussion symptoms can lead to long-term problems. Chronic headaches, memory issues, and mood changes can significantly affect one's quality of life. It’s vital to address concussions properly to avoid these long-term consequences.
   Long-term impacts aren’t just physical. Persistent concussion symptoms can lead to feelings of frustration, anxiety, and depression. It’s important to seek support not only for the physical aspects of recovery but also for the emotional and psychological challenges that may arise.
3. Mental Health: Concussions can lead to anxiety, depression, and other mental health issues. Young adults already face significant stress from their responsibilities, and a concussion can exacerbate these problems.
   Mental health is just as important as physical health. If you’re experiencing mood changes, difficulty sleeping, or feelings of sadness or anxiety following a concussion, don’t hesitate to seek help from a mental health professional. Addressing these issues early can prevent them from becoming more severe over time.
4. Holistic Healthcare: At Carolina Brain Center, we emphasize the importance of holistic healthcare services. Treating a concussion isn’t just about addressing the immediate symptoms but also about supporting overall health. This includes physical therapy, nutritional counseling, and stress management.
   Holistic care involves looking at the whole person, not just the injury. By supporting the body’s natural healing processes and addressing all aspects of health, we can help you recover more fully and prevent future issues. This approach can include chiropractic care, massage therapy, acupuncture, and other complementary treatments that support the body’s healing.

How to Handle a Concussion

If you suspect you have a concussion, here’s what to do:

1. Seek Medical Attention: Visit a healthcare professional who specializes in concussions. If you're in the area, consider a visit to a concussion clinic in Raleigh, NC. They can perform a thorough evaluation and recommend the best course of treatment.
2. Rest and Recovery: Give your brain time to heal. Avoid physical activities and get plenty of sleep. It might be frustrating, but it's crucial for recovery.
   Rest doesn’t just mean avoiding physical exertion. It also means giving your brain a break from cognitive activities that can strain it, such as reading, screen time, and problem-solving tasks. Take it easy and allow yourself the time to heal.
3. Follow Up: Keep up with follow-up appointments to monitor your progress. Sometimes symptoms can change or new ones can appear later on.
   Regular check-ins with your healthcare provider can help ensure you’re on the right track and allow for adjustments to your treatment plan as needed. Don’t skip these appointments, even if you’re feeling better.
4. Holistic Approach: Look into holistic healthcare services to support your recovery. At Carolina Brain Center, we offer a range of services to help with concussion recovery, from chiropractic care to nutritional advice.
   Incorporating holistic treatments can enhance your recovery process. Nutritional counseling, for example, can ensure you’re getting the nutrients needed to support brain health and healing. Stress management techniques like mindfulness and relaxation exercises can help reduce stress and promote overall well-being.

Why Choose a Chiropractic Neurologist?

Dealing with a concussion is not just about immediate treatment; it’s about long-term care. Visiting a neurologist specializing in post concussion syndrome can make a significant difference. Specialists understand the complexities of brain injuries and can provide personalized care plans. They can help manage symptoms, offer rehabilitation options, and provide support for mental health issues that might arise.

Choosing a specialist means you’re getting care from someone who has extensive experience and knowledge in treating concussions and their aftermath. They can offer advanced diagnostic tools and treatment options that general practitioners might not have access to.

Prevention Tips

Preventing concussions is as important as treating them. Here are some tips:

1. Wear Protective Gear: Whether you're playing sports or working in a risky environment, always wear appropriate protective gear.
   Helmets, pads, and other protective equipment are designed to absorb impact and reduce the risk of injury. Make sure your gear fits properly and is in good condition.
2. Follow Safety Guidelines: Adhere to safety rules in sports, driving, and other activities.
   Safety rules are there for a reason. Following them can significantly reduce your risk of injury. Be aware of your surroundings and take precautions to protect yourself.
3. Educate Yourself: Learn about the symptoms of concussions and take them seriously. Educate friends and family, too, so they understand the importance of brain health.
   The more you know about concussions, the better prepared you’ll be to recognize and respond to them. Share this knowledge with others to help create a safer environment for everyone.
4. Stay Fit: Physical fitness can help improve balance and coordination, reducing the risk of falls and injuries.
   Regular exercise strengthens your muscles and improves your balance, making you less likely to fall or sustain an injury. Activities like yoga and tai chi can be particularly beneficial for enhancing balance and coordination.

The Role of Carolina Brain Center

At Carolina Brain Center, we are committed to helping young adults navigate the challenges of concussions. Our team offers comprehensive care tailored to each individual. We believe in treating the whole person, not just the symptoms. From initial assessment to long-term recovery plans, we are here to support you every step of the way.

Concussions are a serious issue, especially for young adults. Understanding the differences between concussions in children and young adults, focusing on brain health, and seeking proper care are all crucial steps in dealing with this injury. If you or someone you know is dealing with a concussion, don't hesitate to reach out to a concussion clinic in Raleigh, NC, or find a neurologist specializing in post concussion syndrome near me. Remember, taking care of your brain is taking care of your future.

For more information or to schedule an appointment with chiropractic neurologist Dr. Dane, please head to CarolinaBrainCenter.com. We're here to help you on your journey to recovery and overall brain health.

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by Nina Koons