The BRAIN Center offers unique, specialized brain-based neurological and musculoskeletal rehabilitation therapies to treat a wide-variety of conditions. We’re very different than other healthcare clinics you may have been to. Therefore, we deliver very different results.
Concussions and traumatic brain injuries can be debilitating injuries with lifelong consequences. Most concussions resolve on their own in a short period of time. When symptoms do not fully resolve, those that remain are classified as post-concussion syndrome.
These individuals may experience severe headaches, dizziness, light-headedness and vertigo, crippling chronic fatigue, painful light and sound sensitivity, and incapacitating brain fog. They may suffer from memory loss, and even struggle to find the words to communicate. Multi-tasking becomes impossible, and even the completion of a simple task may become challenging. Often these symptoms never resolve, despite extensive therapy from numerous physicians and therapists.
While there are many ways the brain may be damaged, often many of the symptoms seen in post-concussion syndrome and traumatic brain injuries derive from a failure of integration within the brain. The primary function of your brain is to make sense of where you are in the environment, so that you can adapt to the world appropriately. Your brain does this with visual, vestibular (inner ear), and proprioceptive (muscle and joint) pathways. It needs to use all of these pathways simultaneously to create a coherent unconscious picture of where the world is, and where you are in relation to gravity and the environment.
These pathways include long, thin, and fragile fibers that project from all over the brain down into the brainstem. This is unfortunately the area that takes the most torque and stress from the multivectorial shearing forces that develop with rapid acceleration and rotation of the head. This disrupts these pathways and damages their integration. They may then have difficulty knowing where their body is in relation to the world, and the brain must struggle to resolve the mismatch between the senses. This can be profoundly fatiguing, as it robs resources from cognitive pathways, and provokes the majority of post-concussive symptoms.
The BRAIN Center works to find solutions to these complex neurological problems using cutting-edge diagnostics and examination procedures to find the root of your dysfunction. We utilize various neurodiagnostic technologies to quantify all of the relevant aspects of your visual, vestibular, and proprioceptive systems. More importantly, we analyze how they work together, in order to determine what circumstances provoke their failure and devise strategies to make them work in unison again. Lastly, we determine the precise fatigue thresholds of these pathways, and create programs to rebuild your functional endurance.
BALANCE & DIZZINESS DISORDERS
Vertigo is a sensation that can make you feel as though you are spinning, tilting, swaying back and forth, being pulled in one or several directions, or generally unstable. Dizziness is a sensation of light-headedness that can make one feel as if they might faint and lose consciousness. Both these conditions may cause nausea, headaches, heart palpitations, ringing in your ears, inability to hold your eyes still, vomiting, and a feeling of being unable to sit up or stand without passing out. Together they can range from a mild annoyance to a severely debilitating problem.
Vertigo is often caused by a problem with the vestibular system. This includes the inner ear and vestibular nerves. The problem can also involve any of the brainstem, cerebellar, and brain regions that receive inner ear input. Sometimes the mechanism might even be visually-induced. When the input from the vestibular system does not match the input from the eyes or the muscles, this sensory mismatch creates the inappropriate perception of motion.
Orthostatic hypotension is a form of dizziness that develops when people shift their position towards being more vertical. People often feel like they are about to pass out during sit-to-stand transitions. This can involve poor coordination between the vestibular system and the brainstem mechanisms that regulate blood flow to the brain.
Postural Orthostatic Tachycardia Syndrome (POTS) is a more severe orthostatic issue, wherein people lose the ability to properly regulate heart rate appropriately. This is a common consequence of traumatic brain injuries, but can also be the result of viral infections, mold exposure, chemical sensitivities, and other types of autoimmune conditions.
Traumatic Brain Injuries frequently result in vertigo and dizziness. Vertigo is one of the most common symptoms of an injured brain. Vertigo can also be the result of neck injuries. The forces that create TBI also commonly damage the vestibular system and the neck muscles and joints. This can create severe sensory mismatches. This can affect some or all of these systems simultaneously.
Mal De Debarquement Syndrome is a type of vertigo that creates a rocking sensation, as if the individual is constantly on a boat. This is the result of a mismatch between the two types of vestibular receptors, the Otoliths and the Vestibular Canals, along with dysfunction in the brain and brainstem systems that make these receptors work together.
Vertigo can also be the result of migraine headaches, or more insidious brain problems such as tumor or stroke. In some cases, dizziness and vertigo can be a consequence of prescription medications and their interactions, or even from certain dietary supplements.
At The BRAIN Center our goal is to rehabilitate the brain and receptor mechanisms that may be creating the mismatch, and make them integrate properly with other systems. In other cases, our goal is to teach the brain to adapt to the impaired reflexes, and teach it to rely on other mechanisms to maintain balance and decrease the vertigo sensations.
Treatment starts with a comprehensive neurological examination, followed by cutting-edge neurodiagnostic testing. We use several advanced technologies to map and graph the function of every system involved in your vertigo, including important visual reflexes, vestibular function, and the feedback from your muscles and joints. We assess how these systems integrate in several different balance conditions. This allows us to precisely identify and quantify which systems are creating the mismatch, how they integrate, and the exact circumstances under which their integration fails.
We then create a neurorehabilitation program that is unique to your condition, and specific to your individual pattern of dysfunction and fatigability.
At The BRAIN Center, we perform comprehensive evaluations which include advanced technology to assess the functionality of different areas of the brain and how each area of the brain communicates with one another.
As a consequence of the evaluation, a customized management plan is created with the goal of increasing the strength and efficiency of specific connections in the brain which may be underdeveloped and/or not working optimally.
NEURO-DEGENERATIVE / NEURO-INFECTIOUS DISEASE
Neurodegenerative disease is an umbrella term for a range of conditions which primarily affect the neurons in the human brain and spinal cord. Some examples of neurodegenerative conditions are Alzheimer’s disease and other dementias, Parkinson’s disease and other Parkinson’s related disorders, prion disease and other neuro-infectious disorders, motor neuron diseases, Huntington disease, spinocerebellar ataxia (SCA), and spinal muscular atrophy. Currently, many neurodegenerative disorders are incurable and debilitating conditions that continue to progress over time.
At The BRAIN Center, we assess the functionality of different areas of the brain. This allows us to understand which areas of the brain are still viable and functioning versus other areas which may have been damaged.
A customized management plan is then implemented to help strengthen the available brain circuits with the hope of increasing function and slowing progression.
Commonly, we co-manage patients with their medical providers, and we focus on improving functions such as balance/fall prevention, walking/gait, coordination, memory, speech, dizziness, visual problems, digestion, fatigue, pain and a variety of movement disorders.
When conventional pain management interventions fail, patients are often left without direction where to turn next. While in some cases these offer relief, there are still a large number of pain syndromes that persist without relief.
So, where do you turn if you’re one of the many individuals with chronic pain syndromes which have not responded to conventional pain management therapy?
Regardless of the location or cause of chronic pain, many patients will develop altered patterns of brain activity, which may result in occupational disabilities, insomnia, cognitive deficits, depression, anxiety, and ultimately a diminished quality of life.
The BRAIN Center utilizes a combination of neuroscience, physical modalities, biotechnology and pain management approaches to effectively treat a wide range of common orthopedic conditions.
By treating the body and brain simultaneously, clients often experience unusually rapid reductions in pain and improvements in function, even after a long-history of chronic pain and multiple, prior surgeries.
Understand the Cause of Migraine, and You’ll Understand the Solution
Migraines can seem complicated, but they often can be very simple. There is only one main cause for migraines: Neurological Dysfunction. However, there are 3 main triggers: Dietary, Musculoskeletal and/or Hormonal. To treat migraines effectively, you need to address both the cause and all 3 triggers at the same time.
Hormonal: The hormonal correlation with migraine is well known, but how to address hormones is still an ongoing area of debate. Many of our patients are prescribed birth control or hormone replacement therapies (HRT) which can be helpful in some cases. Unfortunately, there is also research concerning the long-term effects of these treatments which may lead to other health complications. Many female patients report flares in symptoms around the beginning of their cycle, which is why estrogen is frequently prescribed.
However, we often find low estrogen to be associated with a bigger problem. Often migraine patients have an increased response to stress. This causes resources required for estrogen production to instead be converted to stress hormones. Therefore, The BRAIN Center utilizes a ‘top down’ approach when assessing hormones by performing comprehensive hormonal panels to identify the underlying cause.
Dietary: Healthy diet and removal of common ‘triggers’ is essential for migraine treatment. However, many patients often report having tried every type of dietary modification without results. It’s important to understand that nutritional changes are often just a piece of the puzzle. For some, this may produce profound outcomes. For others, there are additional underlying factors which must be addressed. So, if you’re one of the many migraine sufferers who have not responded to dietary modification there is still hope.
Musculoskeletal: Increased musculoskeletal stress on the body will make a person more likely to experience migraine. Therefore, research shows positive outcomes for migraine with almost any type of manual therapy. An important consideration, however, is that different types of manual therapy can have a very different impact of the neurological structures central to the onset your migraines. No two patients are the same, therefore, treatment recommendations must be individually tailored. This is why a thorough functional examination is important to understanding which treatment interventions will be most beneficial.
Neurological: Individuals with migraine have a known genetic predisposition. It has been outlined that migraineurs have an altered brain state different from individuals who do not experience migraine, even when they are not having symptoms. Groups of cells in the brain are more predisposed to fatigue or fail in these circumstances, leading to various symptoms associated with migraine. For example, if your genetic predisposition is in the area associated with sight, you’ll have visual symptoms. If this is an area associated with balance, you can experience dizziness. The underlying pathology is basically the same, however it impacts different parts of the brain and brainstem.
To fix migraines it's essential to identify the areas of the brain that are functionally not as healthy as others and stimulate that part of the brain at an appropriate level. Too much stimulation can actually lead to a migraine, and too little won’t make much of an impact. This is why The BRAIN Center uses a graduated approach in which some people will be given a great amount of stimulation right away, and some get very little.
The key is to continually strengthen these parts of the brain. The other aspect of the brain has to do with injury and general neurological dysfunction. It is very common, for example, to see someone who gets in a car accident or has had a concussion to have a noticeable increase in migraines. It’s not that these injuries caused migraine, but the stress on the brain and nervous system makes them more likely to have migraine. This can also happen with vestibular imbalances, difficulty with eye or head movements, or difficulty with motion. Improving these aspects will help move you down the spectrum of migraine to have less and less.