How to Recover from a Concussion – Athletes Take Note

July 29, 2011 | Byron J. Richards, Board Certified Clinical Nutritionist

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 How to Recover from a Concussion – Athletes Take Note
New, advanced brain imaging shows that the thalamus region of the brain is significantly disturbed by a concussion, potentially resulting in excessive formation of abnormal circuits in the thalamus. Subsequently, this may alter perception, memory, mood, sleep, and coordination. In this article, I offer my theory that these alterations are driven by excitotoxic damage caused by excessive substance P and can be prevented by both reducing substance P and boosting BDNF (brain-derived neurotrophic factor). Both of these results can be achieved with good nutrition and exercise, offering the first science-based strategy, of which I am aware, to actually fix the adverse effects of concussion.

Anyone can have an accident or impact to the brain resulting in concussion or another type of brain injury. There are over 1 million such injuries per year in the U.S. This issue is reaching a higher level of public awareness due to observing injuries sustained by children in competitive sports, injuries sustained by our troops, professional athletes having trouble recovering from concussions, and the long-term adverse effects of concussions on brain health that have been observed in professional football players.

It is very interesting to note that the thalamus is not usually directly injured during the concussion; rather, it is a key region in the brain that is processing the pain of the injury, and the failure to do so correctly is what results in long-term injury from the concussion. The specific area of the brain that was injured must obviously heal, but once that has happened, the lasting adverse impacts from the concussion have more to do with the subconscious brain’s pain response to the injury than to the injury itself.

This explains why multiple concussions dramatically increase potential risk for brain damage. Once the thalamus gets injured in this way, subsequent injuries can induce magnified damage to the thalamus. In other words, each thalamus brain injury is not like 1 + 1 + 1, it is more like 1 + 10 + 100.

Concussion researchers have been using the most advanced diagnostic imaging they can but typically do not see any lasting damage in individuals with persisting symptoms. This is not because damage does not exist; rather, the tools they have been using cannot see it. A new type of brain imaging1 is, for the first time, able to see what type of damage has occurred in individuals with persisting problems following concussion. This specialized imaging has found that the amount of damage to the thalamus is directly proportionate to the number and severity of symptoms that persist following a concussion. Furthermore, the type of damage to the thalamus has been clearly indentified. The resulting damage is chaotically-organized new brain circuits that form after the injury which significantly impede normal function.

This information is also highly relevant to any person with post-traumatic stress disorder (PTSD) or significant fibromyalgia. The traumas that led to these consequences induce similar damage to the thalamus as does a concussion.

Thalamus 101

Your thalamus sits atop your much smaller hypothalamus gland, which is your subconscious brain’s command and control center. Beneath these structures is your brain stem, and all of these structures process very core survival information such as pain.

Only until very recently, scientists believed that your thalamus acted primarily as a passive sensory relay station. All sensory input except smell is processed by your thalamus and relayed to various other regions of higher intelligence for interpretation. Its data is also required for proper perception of sensation, spatial awareness, motor signals, coordination, alertness, consciousness and sleep.

The perception that the thalamus was nothing more than a giant switchboard and relay station is now changing. New science indicates that it is a dynamic processor of information2. It integrates memory information with sensory information and then modifies the information based on experience, before ultimately, passing the information on. This is a dynamic process that appears vital to the optimal function of multiple brain circuits. In this emerging view, it is obvious that the thalamus is a key subconscious region of the brain and is a foundation for both optimal cognitive function and optimal physical ability (such as being highly coordinated in a sport).

This data indicates that, in the case of sports injuries, it is not surprising that lingering effects of concussions could reduce a player’s physical ability from that of a professional elite athlete to that of a mediocre player.

In addition to a reduction in physical talent, many other adverse effects can result. Some of the typical persisting issues include headaches, dizziness, memory loss, attention deficit, depression, and anxiety. It is not uncommon for individuals to experience even more significant mental health issues involving obsessive-compulsive, impulsive, or even psychotic types of behavior.

Thalamus Injury, Substance P, and Pain

Many of the nerves within the thalamus naturally release substance P. In normal conditions of brain function, substance P helps regulate routine function. Under conditions of traumatic pain felt anywhere in the body, including emotional pain, substance P is released in high amounts by the thalamus. This is a key part of how the pain signal is registered in the subconscious brain. Substance P is also released at the site of injury, provoking an inflammatory response to seal up the injured area so germs cannot enter the body.

In general terms, an optimal healing response includes going through the following phases: 1) going through this initial inflammatory phase, 2) going through a remodeling phase of the injured area, and 3) taking down the scaffolding that was erected during healing and cleaning up the job site.

If the injury is fairly significant and/or the individual lacks nutrients to assist healing, then ongoing pain signals are sent to the thalamus, provoking the release of higher-than-desired levels of substance P in the thalamus. In essence, the thalamus is like a cat on a hot tin roof—a problem driven by excessive substance P release. This is often accompanied by a wound-up and anxious, uncomfortable feeling. Normal sleep is almost always disrupted by excess substance P, making it harder for a person to fall asleep, sleep through the night, and/or wake up feeling well-rested.

The newest science shows that substance P surges3 in the thalamus can induce excess glutamate release. Now that we understand that the thalamus is a dynamic brain region that relies on plasticity of nerve networks to coordinate information, it can readily be understood that excitotoxic glutamate activation from prolonged exposure to substance P would cause the formation of new brain circuits that are chaotically structured—paralleling what was discovered in the study I reference earlier pertaining to new brain imaging technology. Unfortunately, these new brain circuits are inferior in terms of their ability to coordinate information, which leads to reduced physical ability, worsened cognitive performance, and a variety of potential mental health issues.

The bad news for individuals with lingering symptoms following a concussion is that actual malfunctioning brain circuits now exist—not just a nutrient deficiency of some sort. The good news is that prudent nutrient support following an injury can likely prevent them from forming. And fortunately, it is also well within the realm of nutrition to help remove existing problem circuits, although that will likely take a number of months.

New research also shows that increasing the amount of stem cell activity in the brain via increasing levels of BDNF4 can help the thalamus build healthy new circuits.

Nutrition to the Rescue

It is a good thing that nutrition happens to excel at supporting the healing process. During evolution, injury was common and there needed to be a way to repair injury for humans to survive. Nutrients were obviously a key part of the solution, just as 2x4s and plywood are needed to build or repair a home.

If all goes well, the healing response will complete itself in a timely manner (two to four weeks for a mild concussion) and there will be no lingering effects, which implies that the thalamus was not injured by the process.

Walking and aerobics, especially, also help build BDNF. If able to, a person should therefore exercise and progressively build their aerobic capacity, along with consuming nutrients that help build BDNF.

Using nutrition during healing is going to enhance the healing response and prevent adverse changes in the thalamus. If a person already has problems from past concussions or PTSD, based on my experience, the same nutritional approach is likely to be helpful but will take three to six months in conjunction with aerobic exercise to help facilitate significant improvement.

Referenced Studies

  1. ^ Thalamus Damage and Persisting Concussion Symptoms  Radiology.   Tang L, Ge Y, Sodickson DK, Miles L, Zhou Y, Reaume J, Grossman RI.
  2. ^ Plasticity and Dynamic Activity of the Thalamus  Hippocampus.  Tsanov M, Vann SD, Erichsen JT, Wright N, Aggleton JP, O'Mara SM.
  3. ^ Substance P is an Exciter of Glutamate Nerve Transmission  J Neurophysiol.  Masterson SP, Li J, Bickford ME.
  4. ^ BDNF Needed for Recovery from Traumatic Brain Injury  J Neural Transm.  Johanson C, Stopa E, Baird A, Sharma H.

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