Dr Kristin Willeumier PhD: IFV-TV Panel Discussion on Concussion

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Today Rebecca and I watched an amazing video presentation by Dr. Kristin Willeumier, Ph.D, a neurobiologist and Director of Research at the Dr. Daniel Amen Clinics. Dr. Willeumier and Dr. Amen bring a very uplifting message: people CAN rehabilitate brain function IF they follow a regimented recovery plan… even if the brain injury occurred many years ago. Please get the word out by tweeting and sharing both the video and slide share. Many thanks!

[youtube http://www.youtube.com/watch?v=jNeHYx4B9fY&w=420&h=315]
Slide Share

SUMMARY: DR DANIEL AMEN BRAIN REHAB PROGRAM PROTOCOL FOR CONCUSSION

BRAIN RECOVERY PLAN: PART A STOP HURTING YOUR BRAIN
Avoid:
Brain injuries, High blood pressure, Drugs, Diabetes, Alcohol, High sugar diets, Obesity, Environmental toxins, Sleep apnea, Chronic stress, Smoking, Lack of exercise.

BRAIN RECOVERY PLAN: PART B START HELPING THE BRAIN
Enhance:
Social connections, Green tea, New learning, Exercise, Great diet (whole foods nothing processed), Coordination exercises, Calorie restriction, Gratitude (strengthens cerebellum and frontal cortex areas), Omega 3s, Meditation, Supplements, Vitamin D 3, Healthy sleep (deep REM sleep, 7-8 hours a night).

NUTRIENTS:
• High potency multi-vitamin daily
• Omega 3 – 5.6 grams High Potency Pure Fish oil per day. Reduces inflammation in body, expands blood vessels, and improves blood flow to the brain. Lowered inflammation in body means improved weight loss.
• Dr Amen’s Brain Boost Formula – vinpoticine, ginko biloba (both to improve blood flow to brain), Phosphatidylserine (helps rebuild cell membranes), huperzine A (boosts memory), Acetyl-l-carnitine, N-acetylcysteine , alpha-lipoic acid (both are potent antioxidants which protect neurons).
• Additional notes on nutrients: vitamin D3 (responsible for many metabolic actions in body), green tea extract helps protect the ends of your DNA.

LIFESTYLE:
Address individual player needs, such as treating depression, anxiety, alcoholism, ADD, dementia or using Hyperbaric Oxygen (HBOT).

Weight loss for obese players – If you are overweight, get lean as this is extremely important for recovery. A large body equals a small brain (dinosaur syndrome). Carrying extra fat puts stress on your body coordination, as well as raises your level of inflammation.

Healthy Diet – nothing packaged. Whole foods diet only. Low-glycemic diet is in line with keeping inflammation in the body low and preventing metabolic syndrome.

Calorie Restriction – Aim for a nutrient dense, low calorie diet of 1800 to 2000 calories a day. Low calorie intake also means less free radical damage from metabolizing food, and this translates into longevity for you.

Sleep – if you have sleep apnea, have it addressed with an oxygen device, or through some other method (i.e., weight loss). Sleep apnea is very common with concussion.

AVOID:

High blood sugar and Diabetes – Sugar is inflammatory and damages your brain and tissues. Make smart choices around food, diet and lifestyle. Alcohol is processed into sugar in your body.

High blood pressure – high pressure in your vein means less oxygen to your brain. It also means damage to your veins (including the ones in your brain).

Exposure to environmental toxins or molds – these toxins create neurotoxins and stress in your body, leading to accelerated brain degeneration.

Chronic stress – stress hormones such as cortisol raise your levels of inflammation and help you to put weight on. If you are experiencing personal, marital or family stress, address it through counselling and support early on.

THINGS TO DO TO SUPPORT BRAIN RECOVERY:

Exercise – Daily exercise boosts the feel-good hormone ‘serotonin’, which addresses prevention of depression. Exercise also improves blood flow to the brain.

Coordination Exercises – The cerebellum at the back of the brain houses 50% of the brain’s neurons yet makes important connections to the frontal lobes (executive area responsible for judgement, focus, and impulse control). Exercising the back of the brain actually helps to strengthen the front of the brain. Tips: play tennis, table-tennis, Tai Chi, yoga, juggling, so gym exercises. (Can also dance and swim).

Brain Learning Games/New Learning – enhances the ability of your brain to make new neural connections.

Hyperbaric Oxygen – increases vasculature in the brain. This is especially good for people who have experienced significant brain injury.

Main takeaway points: Boost acetylcholine to the brain, use brain-enhancing nutrients (see below), boost coordination exercises, achieve and remain normal weight, avoid inflammatory toxins, substances (no more than 2 servings of alcohol per week, no sugar, avoid marijuana and recreational drugs, get at 7-8 hours of sleep, exercise daily, limit daily calories to between 1700 and 2000 a day to help keep free-radical formation low, and to enhance longevity).

Finally,
Practice Gratitude and Meditation: performing these activities help to keep your brain from shrinking and help strengthen the cerebellum and frontal lobes.

DR WILLEUMIER’S SLIDE SHARE NOTES:
• 1. Amen Clinic NFL Brain Imaging Brain Rehab Study.
• 2. Our NFL Story Started in 1991. In 1991, brain SPECT imaging work. Brain injuries greater part of psychiatric problems than most people knew. Saw many high school and college football players with brain injuries on scans who had troubled behavior.
• 3. Middle Linebacker UC, Berkeley Arrested for Domestic Violence Healthy College Player.
• 4. ESPN Highlights and Arrests. As a fan I watched highlights. Then who was arrested that day. Thought there must be serious brain damage among many active and retired players.
• 5. Just imagine someone like Ron Yary hitting you 30 -50 times a game.
• 6. NFL Position On Brain Trauma Started Committee on MTBI in 1994, “Said they didn’t know if football caused long term brain damage, more studies needed.” Curiously, had the same position in 2009?? NFL acting like many employers with worker’s compensation claims – delay, deny, and blame the employee … steroids, alcohol, laziness.
• 7. The Problem with the NFL Position. IF YOU DON’T ADMIT YOU HAVE A PROBLEM, YOU CANNOT DO ANYTHING TO SOLVE IT. Many, many brain damaged retired players are currently left without help or hope.
• 8. 2000 Brent Boyd Minnesota Vikings Offensive Guard 6 Seasons.
• 9. Brent Came to see us for: Headaches, Depression, Fatigue, Memory Problems, Dizziness. He was also overweight.
• 10. Clear Evidence of Serious Brain Trauma Healthy BB.
• 11. NFL Hired Doctor’s. Scans mean nothing. They say his problems not work-related. Deny his claim. Brent gets traumatized twice: once by his brain injuries, and again by being called a liar or a faker.
• 12. 2007 Anthony Davis College Football Hall of Fame Running Back from USC and NFL Player.
• 13. Healthy At age 54, brain looked 85.
• 14. Before Treatment After Treatment.
• 15. Los Angeles Chapter NFLPA• AD Invites me to speak February 2009• Meet many players who clearly needed help• Someone has to answer question, “Does playing football in the NFL cause brain damage?”• Team up with Reggie Berry, Marvin Smith and Dr. Joe Wu to design our study• LA Chapter helps us recruit our first players.
• 16. Where To Get The Money?• First arm of study paid for by me (Dr Amen) personally to insure independence• Total cost is about $5,000 a player• Most of researchers who helped volunteered their time.
• 17. Study Design• Brain SPECT imaging (blood flow)• Conners’ CPT (Continuous Performance Test)• QEEG (Quantitative Electroencephalography)• MCIS (Mild Cognitive Impairment Screen)• Microcog (Measures 9 different cognitive scales).
• 18. Current Status of Our Study• 115 Active and Retired Players• From 27 teams• All positions• Ages 25 – 85.
• 19. Reported Number of Concussions• 0 = 14%• 1-2 = 24%• 3-5 = 19%• > 5 = 43%.
• 20. Important Numbers• Obese = 48% • Microcog = below• Sleep apnea = 30% average in all• Depression = 28% categories except• Dementia = 19% spatial processing and reaction time• CPT = 81% abnormal.
• 21. Outcomes• > 90% had brain trauma pattern on brain SPECT and QEEGs• Severe decreased activity … across whole brain• Results are HIGHLY STATISTICALLY SIGNIFICANT!
• 22. Damage Seen Across Whole Brain.
• 23. •Confirmation Number: 82635741 Damage Seen Across Whole Brain.
• 24. 20 Year Player Damage across whole brain.
• 25. Offensive Lineman 12 yr NFL.
• 26. Running Back 4 yr NFL.
• 27. Defensive Back 3 yr NFL.
• 28. Linebacker 10 yr NFL.
• 29. Wide Receiver 8 yr NFL
• 30. Tight End 8 yr NFL.
• 31. Quarterback 18 yr NFL.
• 32. Damage Seen Especially In Prefrontal, Temporal and Cerebellar Regions – judgment, focus, and impulse control memory, learning, emotion & moods physical coordination and thought coordination
• 33. Brain Rehab Program• Damage so high, we added a “pragmatic” rehab component• Brain healthy strategies • weight loss for obese players • coordination exercises • healthy diet • recommended sleep apnea evaluations • avoid toxic substances (drugs, much alcohol).
• 34. Brain Rehab Program• High potency multiple vitamin• Omega 3 supplement, 5.6 grams a day• Brain and Memory Power Boost Formula – vinpocitine, gingko, PS, huperzine A, acetyl-l- carnitine, n-acetylcysteine, alpha lipoic acid• Other recommendations for individual player needs, such as treating depression, anxiety, alcoholism, ADD, dementia or using HBOT.
• 35. Preliminary Results• 30 players with follow up scans/cognitive tests• 25 showed improvement• Especially in: • Memory (69%) • Attention (53%) • Mood (38%) • Motivation (38%) • Sleep (25%).
• 36. MicroCog Before After p value #> 50% betterGeneral cognitive 31.8 (24.1) 43.4 (25.7) <0.000 14 functioningGeneral cognitive 24.7 (20.1) 35.2 (23.5) 100%+• Attention 21 25 2%• Reasoning 3 13 > 400%+• Memory 14 66 > 470%+.
• 39. “Little” Ed White.
• 40. John Hauser (74) Before After %• General Cognitive Fun. 19 42 121%+• Information Processing 55 90 64%+• Attention 12 58 383%+• Reasoning 39 50 28%+• Memory 23 39 70%+.
• 41. Gern Nagler (77) Before After %• General Cognitive Fun. 63 77 22%+• Information Processing 42 70 66%+• Attention 45 73 62%+• Reasoning 75 75 0%• Memory 50 86 72%+.
• 42. Tight End 8 yr NFL Before After 8 mos.
• 43. Tight End 10 yr NFL Before After 18 months.
• 44. Offensive Tackle 12 yr NFL Before After 18 months.
• 45. Defensive Tackle 2 yr NFL Our interventions plus 40 Sessions of HBOT.
• 46. Conclusions• Based on our sample, playing football in the NFL puts players at risk for brain damage & long-term cognitive and mood problems• Preliminarily: The brain has potential to improve with a comprehensive rehab program• More studies immediately needed to evaluate components of our study and other interventions such as HBOT, neurofeedback, and meds such as memantine and modafinil.
• 47. Conclusions• General brain health principles should be taught to all active and former players• More intense brain rehab offered to current and former players• Targeted supplements, such as omega 3s and the ones we used• Start using brain imaging tools, like SPECT and QEEG on any player with a concussion.
• 48. Conclusions• Implications go beyond NFL to: • High school and college athletes • Military personnel (15% of soldiers returning from Iraq and Afghanistan have brain injuries) • 2 million people each year who acquire brain injuries.
• 49. NFL/Amen Clinics Collaboration?• We have a great cohort for a long term study• We have a waiting list of dozens of players and could easily recruit hundreds more, players trust us• We could add DTI and genetic markers• Help us on design better studies• Help us find funding to continue our work.
• 50. If I Was The Commissioner• Be an advocate and a leader for brain health among football players, stop the bad press with genuine care and concern• Invest in unbiased studies, with researchers who have a sense of urgency• Evaluate all players coming into the league to establish baseline level of brain function.
• 51. If I Was The Commissioner• Treat concussions early and effectively• Work to identify retired players who are troubled and get them the help they need• It will be less expensive in the long run• Lawyers and legal battles are very expensive.
• 52. BRAIN RECOVERY PLAN: PART A STOP HURTING YOUR BRAIN Brain injuries  High blood pressure Drugs  Diabetes Alcohol  High sugar diets Obesity  Environmental toxins Sleep apnea  Chronic stress Smoking  Lack of exercise.
• 53. BRAIN RECOVERY PLAN: PART B START HELPING THE BRAIN Social connections  Green tea New learning  Exercise Great diet  Coordination Calorie restriction  Gratitude Omega 3s  Meditation Supplements, Vit D  Healthy sleep.
• 54. With Gratitude to all of our players, Los Angeles Chapter of the Retired NFLPA, especially Reggie Berry and Marvin Smith, Independent Football Veterans Conference, with special thanks to Dave Pear and Robert Lee.
• 55. With Gratitude to Our Research Team Most Have Donated Their Time, Kristen Willeumier, PhD, Amen Clinics, Joe Wu, MD, UC, Irvine Andrew Newberg, MD, Univ of Pennsylvania, Robert Thatcher, PhD, Applied Neuroscience, Yi Jin, MD, NeoSync Technologies Jim Fallon, PhD, UC, Irvine.
• 56. Daniel G. Amen, MDdocamen@amenclinics.com 949-266-3749
• 57. Fred McNeill on the cover of GQ