Cognitive Rehab for Traumatic Brain Injury

The current issue of PARADE magazine contains an interesting article titled Can Brains Be Saved? In the United States alone, 1.4 billion people sustain traumatic brain injuries (TBI) each year. Nine percent of those people end up with lifelong impairments. Common causes of TBI include car accidents, tractor trailer accidents, playground or sports accidents, falls, and domestic violence. According to the U.S. centers for Disease Control and Prevention, 3.2 million Americans have long-term disabilities as a result of TBI.

The symptoms of a TBI may be obvious or subtle. Erin Patrice O’Brien, author of the article, points out, “You may think you don’t know anyone with a brain injury, but they’re all around you. One could be the person you see lose his temper with the store clerk because sports-induced concussions left him short-fused. Another could be your neighbor who keeps locking her keys in the car or the man who looks healthy but needs a few tries to push a revolving door.”

In 2006, O’Brien’s husband Bob was injured by a roadside bomb in Iraq while working as a journalist for ABC News. Shrapnel shattered his skull, and doctors didn’t know if he would ever walk again or regain mental function. Bob was in a coma for 36 days. When he woke up, he couldn’t think of simply words like “scissors.” Today Bob has resumed his roles as husband, father, and journalist. Advancements in cognitive rehabilitation helped Bob to recover. Twenty years ago, he may not have made such a recovery.

“One of the advancements in rehabilitation is to make the therapy person-centered,” said Dr. Lori Terryberry-Spohr, brain-injury program manager at Madonna Rehabilitation Hospital in Lincoln, Neb. “We can tailor it to the individual’s goals, strengths, hobbies, interests, and occupations.”

For example, a cognitive rehab specialist might use dog-walking as part of the therapy for an animal-lover. This would improve the patient’s mobility, sense of direction, and interaction with normal life.

A TBI may damage the connections between nerve cells, or neurons. Neuronal signals control memory, thought, speech, and movement, among other functions. A TBI may temporarily or permanently disconnect these signals.

“One helpful analogy is to think of the brain’s neural pathways as highways,” explains O‘Brien. “A brain injury is like a jackknifed tractor-trailer stopping traffic. With proper medical attention and therapy, the brain repairs itself. Neurons that ran from point A to point B can grow back in different ways and make new roads, and the brain rebuilds new paths to functions like speech and memory. They might not be exactly the same as before, but they’re still effective.”

“The more sophisticated the function, like complex thought or writing, the longer it takes,” said Dr. Col. Rocco Armonda, senior Army neurosurgeon at Walter Reed Army Medical Center in Washington and at Bethesda Naval Hospital in Maryland. “But over 70 percent of our patients with the most severe injuries are now approaching functional independence after treatment, and that was unheard-of previously . . . Research points to the amazing regenerative powers locked in our brains. The proper therapies can help with the unlocking.”

Cognitive rehab helps TBI patients relearn their own abilities using specific strategies to make up for injury-related deficits. For example, someone who has trouble recalling words might learn to remember them by associating them with a familiar object. In this way, they build new neural pathways.

Traumatic brain injuries often cause changes in personality as well as executive functions like memory and reading. Cognitive therapy helps TBI patients address personality changes, too. Patients learn to recognize negative thought patterns. The solution may be as simple as taking a mental “time-out” and breathing deeply for 10 seconds.

Last year researchers at the Defense and Veterans Brain Injury Center in Washington found that cognitive rehab - learning how to think through tasks - enhances cognitive recovery and helps patients return to work or school at a higher rate than those whose treatments focus on the physical aspects of tasks. The earlier the patient begins cognitive therapy, the better the outcome.

Unfortunately, most health insurance plans do not cover cognitive therapy!

“You’d never have a problem getting insurance to cover a broken bone or injured shoulder, but it is routinely denied for therapies that help brains heal,” said Susan H. Connors, president and CEO of the nonprofit Brain Injury Association of America. “Brain injury is often invisible since changes are on the inside. Because of this, help and awareness are not as widespread as they should be.”

O’Brien reminds families of people with TBI that the recovery will be a marathon and not sprint. If you or a loved one has suffered a traumatic brain injury, you need an experienced attorney who can get you the monetary settlement you need to make a full recovery. Call MLN Law at 404-531-9700 to schedule your free consultation.