Below are just a couple of symptoms that we can help with:
Preventing Stroke with Nutrition
Between 1970 and 2008, the risk of stroke in high income countries fell by 42%. This time period coincided with increased public awareness of the health dangers of high cholesterol, high blood pressure, and cigarette smoking. Further understanding of the role of nutrition in the incidence of stroke is crucial to developing strategies to minimize this risk.
A recent review examined the evidence linking poor nutrition, over-nutrition, obesity, and diet to the risk of stroke by examining the results of studies examining nutrition and stroke risk.
The findings of this review are diverse. Among the most important findings are: Dietary supplementation with antioxidants, calcium, and B vitamins does not reduce the risk of stroke, while diets that are low in salt and sugar while high in potassium could reduce the risk of stroke. The overall quality of the diet, and balance between energy intake and expenditure (avoiding over-nutrition or malnutrition) seem to be more important determinants of stroke risk than individual foods or nutrients.
Further research is needed to add to the evidence relating to the association of nutrients, foods, and dietary patterns with stroke risk. A doctor of chiropractic trained in nutrition can advise you on making healthy lifestyle choices to prevent stroke and other conditions associated with aging.
Hankey GJ. Nutrition and the risk of stroke. Lancet Neurology 2012; 11: 661-81.
Photo by Pixabay on Pexels.com
MTBI and Working Memory
It is common for researchers and practitioners to see mild traumatic brain injury (MTBI) patients with normal CT or MRI scans, but who have a number of post-concussive complaints and cognitive deficits. The authors of this study deal with the concepts of “working memory” and “processing load.” They define working memory as, “the ‘online’ storage of information necessary for performing cognitive operation,” and processing load as, “the amount of information that must be held online to solve a particular problem.”
The authors hypothesize that there is a physiologic basis for MTBI complaints, and that if a functional MRI (fMRI) were performed within one month following injury, it would show changes in both the working memory and processing load.
12 MTBI patients and 11 healthy controls had their brains scanned while performing memory tasks. Eleven of the patients had a normal CT and regular MRI scan. Both groups took a symptom checklist, and the MTBI patients reported more symptoms. Included symptoms were poor memory of recent events, difficulty in doing their job, and trouble with concentration.
Controls showed no decline in performance when moving from the low processing demand tasks to the high processing demand tasks. Both the controls and the patients had similar areas of brain activation and similar task performance. But, there were differences in how the memory worked in the patients and in the controls- patients showed increased activity in the right lateral parietal regions and the right dorsolateral frontal regions. The authors claim that it is unlikely that the differences in activation are related attentional difference or to distress or depression since both groups scored similarly on the symptom checklist; it is also not possible that the patients suffered neural loss since they showed performance similar to the controls in memory tasks. They conclude, “The ability to activate, modulate, or allocate processing resources in response to gradations of processing load may be impaired in the postacute period after MTBI.” Which means that MTBI patients do not have decreases in brain resources (the information is all there) but have difficulty in the circuitry—they have difficulty moving, timing, and regulating access to the information. To explain all these incongruities between the patient’s experience of difficulties and what test results imply, the authors write:
“One possible explanation is that the MTBI patients perceive the change in their ability to engage working memory easily and efficiently, and experience this change as ‘having to work harder’ to maintain accurate task performance. Perhaps this is then labeled as ‘problems with memory.’ If true, this might account for the discrepancy between the severity of complaints voiced by many MTBI patients and the relatively minor performance deficits often found in these individuals.”
The MTBI patient then, is not malingering or experiencing depression or anxiety—which are common conclusions researchers come to when grappling with the chasm between test results and patients. This study makes headway, and suggests that cognitive complaints of MTBI patients are related to differences in brain activation and the condition of brain circuitry. The authors also point out that, “patterns of activation differences are likely to be more important than the overall level of activation.”
McAlister TW, Saykin AJ, LA Flashman, et al. Brain activation during working memory 1 month after mild traumatic brain injury. Neurology 1999;53:1300-1308.
Mild Traumatic Brain Injury and Reversible Neuropsychological Deficits
The objective of this Swiss study was to determine the impact of motivation on the performance of mild traumatic brain injury (MTBI) patients in a divided attention test. Three groups of subjects participated in the study. Twelve (average age of 40.3 years) were MTBI patients recruited from an inpatient rehabilitation program, injury was sustained 10 to 70 months prior to testing, and none had exhibited signs of traumatic brain damage on CT or MRI exams. Ten subjects (with an average age of 53.6 years) with injuries classified as severe brain injury (SBI) were from the same rehabilitation program, had received brain injury one and a half to seventeen months before testing, and had abnormal CT/MRI results. The control group was made up of eleven healthy subjects (average age 37 years) with no history of brain injury or neurological disease.
A computer-supported, divided attention test (The Wiener D test) was selected for the study because it is short, well accepted by patients, easy to perform, and is used broadly in the region. For the test, subjects are required to respond to 180 visual or auditory stimuli by pressing a specific button within an allotted time. The computer produces reports on the number of incorrect responses, on time responses, delayed responses, and omitted responses as independent variables. The possibilities of error analysis are limited because certain responses are counted twice, for instance, a correct but delayed response. Each participant took the test twice, with the second testing within twelve hours of the first. The first test (T1) established baseline data; the second test (T2) yielded the study results. The second test occurred after verbal motivation. Verbal motivation consisted of each patient hearing the comment, “This test is important for safe driving of your car. Could you do better?”
T1 showed the controls achieved statistically significant better results than the other two groups on all measures, except for the number of wrong responses. The difference between the T1 wrong response scores for the control and the MTBI group were not statistically significant. Results for T2, after verbal motivation, showed that the SBI and control groups did not achieve a significant change in their performance. The MTBI group showed significant improvement in performance between T1 and T2 in on time responses, delayed, and omitted responses. The improved T2 responses of the MTBI group did not differ statistically from the T1 results of the control group. The following graph illustrates the results of T1 and T2:
The authors comment on the results:
“Only a tentative explanation may be offered for the striking improvement of the performance of patients with MTBI. The MTBI group may have taken the comment after the initial testing as a threat to their independence and mobility. Hence the possibility of an additional loss of quality of life may have allowed them to mobilize latent mental resources. It is also possible that months and in many cases years of self perceived disability generates expectation of failure and poor motivation to perform even when capacity to perform is retained. Concern about loss of driving may have induced the motivation to produce full effort.”
“Although the motivating intervention may have improved the performance of both MTBI and the controls at both levels of test difficulty, the net improvement of the controls was less (presumably because they performed closer to their maximum at T1) than that of the MTBI and the mean test results of the patients with MTBI at T2 remained lower than those of the controls. This may indicate that insufficient motivation acted in concert with other factors such as chronic cervical musculoskeletal pain, headache, sleep disorder, and depressed mood or inadequate coping with the consequences of the accident, each of which might contribute to poor attention.”
The researchers suggest that in order to develop therapeutic strategies to aid in returning patients to work, and to activate patient performance potential additional studies are needed to assess how premorbid personality, pain, emotional disorders and motivational factors affect neuropsychological performance.
Keller M, Hiltbrunner B, Dill C, Kesserling J. Reversible Neuropsychological Deficits after Mild Traumatic Brain Injury. Journal of Neurology, Neurosurgery and Psychiatry 2000;68:761-764.
Click the links below to read about some of the techniques we use to help with symptoms relating to neurology: