Neurological Disorders Arising from Cortical Lesions

A brain lesion is an abnormality in part of the brain tissue, often resulting from a stroke, from a traumatic brain injury, or from a tumor or other disease process. Cortical lesions are lesions occurring in the brain’s cortex--- the part of the human brain responsible for higher functions like cognition, as well as for sensory and motor functions. Depending on the location of the lesion, neurological disorders can arise after a stroke or injury in Boston, with the type of problems dependent on the location of the lesion. Different types of neurological disorders arise from lesions in different areas of the brain, with injuries to the frontal lobes, parietal lobes, temporal lobes, or occipital lobes producing different effects that correspond to the functions of the damaged area.

Neurological Disorders from Frontal Lobe Lesions

The brain’s frontal lobes are most strongly associated with what is called “executive function”. This refers to the ability to plan future actions, to contemplate the consequences of possible alternate courses of action, to modulate one’s responses based on what is socially acceptable, and to recognize patterns in systems or events. When a lesion in Boston occurs in the frontal lobes, executive function can become compromised as a result. Various behavioral changes can arise as a result. Sometimes a frontal lobe lesion will decrease a person’s volition and motivation, functions which are largely handled in the frontal lobes. The person can also become less socially inhibited and display inappropriate behaviors, or otherwise become more impulsive than they were before the injury occurred.

Neurological Disorders from Parietal Lobe Lesions

The parietal lobes play an important role in integrating sensory information, as well as in mathematical and spatial reasoning processes. The neurological disorders that result from parietal lobe lesions in Boston often correspond to which hemisphere is affected. Right parietal lesions often compromise mental imagery and the ability to visualize spatial relationships. Sometimes a right parietal lesion can also lead to a neurological condition called “left hemispheric neglect”, in which the person is no longer aware of, or in control of, the left side of their body. Left parietal lobe lesions often cause neurological disorders involving a loss of mathematical, reading, and symbolic reasoning abilities. Other neurological disorders associated with parietal lobe lesions in Boston involve ataxia, a loss of motor coordination ability; amorphosynthesis, a loss of perception of one side of the body, generally the side opposite the side on which the lesion occurred; and Gerstmann syndrome. Gerstmann syndrome is a neurological disorder characterized by loss of the ability to write, loss of the ability to perform mathematical calculations, left-right disorientation, and finger agnosia.

Neurological Disorders from Temporal Lobe Lesions

Among the primary functions of the temporal lobes, which contain a brain structure called the “hippocampus”, is the formation of long-term memories. The temporal lobes are also involved in processing auditory sensory information; establishing object recognition and interpreting the meaning and importance of visual input; and recognizing and processing language. These functions can become impaired in Boston when lesions result from injury or stroke. One common result of temporal lobe lesions is the loss of the ability to remember visual stimuli, called visual agnosia. Another of the neurological disorders associated with temporal lobe lesions in Boston is prosopagnosia, a disorder in which a person loses the ability to recognize faces.

Neurological Disorders from Occipital Lobe Lesions

The occipital lobes, located at the back of the brain, are best known for containing the areas that process various aspects of visual information. Occipital lobe lesions in Boston most often lead to some form of vision loss. Often this take the form of homonymous hemianopsia, in which one side of the visual field is “cut off” in both eyes. Damage to the primary visual cortex in the occipital lobes can cause total cortical blindness. When areas of the occipital lobes adjacent to the temporal or parietal lobes are damaged, phenomena like color agnosia--- a loss of the ability to recognize color--- and movement agnosia--- a loss of the ability to recognize motion--- can occur.

BOSTON: NEUROFEEDBACK FOR NEUROLOGICAL DISORDERS

Three Things That Might Be Worsening Your Anxiety

Three Things That Might Be Worsening Your Anxiety

Many people in Foxborough suffer from anxiety. For some people, it’s a normal emotional response to life stressors and will subside over time; for others, it’s a chronic state and is part of a full-blown anxiety disorder. If you are diagnosed with an anxiety disorder, or even if you’re just acutely stressed out from work, school, or relationship problems, you may be making your anxiety worse. There are three common things that can increase your anxiety: caffeine, nicotine, and alcohol. These can be particularly problematic if you have generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), or panic disorder. Fortunately, by reducing your use of these three items, you may be able to improve your symptoms.

#1: Caffeine

Almost all adults in Foxborough consume some amount of caffeine on a daily basis, often without thinking about it. Some of us can’t get our day started without that morning cup of coffee; others prefer tea or energy drinks. Even if you’re not a caffeine junkie and don’t care for coffee, you may still be caffeinating without even realizing it. Many sodas, including colas, Dr. Pepper, Mountain Dew, and even Sunkist, contain a significant amount of caffeine. If you’ve ever had one too many shots of espresso, than you know firsthand that caffeine can make you jittery and on-edge. Caffeine is a central nervous system stimulant, and too much of it can worsen anxiety symptoms. You may be able to keep your anxiety and tension at bay by being mindful of how much caffeine you’re ingesting. A cup of coffee has an average of 80 mg of caffeine per 8 ounces. Sodas generally have 30-40 mg, and green tea has about 60 mg. Keeping it under 200 mg per day is a good rule of thumb, if you really feel like you need caffeine.

#2: Nicotine

Like caffeine, nicotine is a central nervous system stimulant. If you smoke, chew tobacco, or use other tobacco products, which contain nicotine, it’s probably a habit and you may not realize its stimulant effects. Some studies have shown that nicotine increases the risk of someone developing an anxiety disorder, as well as worsening the symptoms of anxiety. Quitting smoking is quite difficult, but reducing how much you smoke (or chew) per day can be a step in the right direction and can help calm your nerves and prevent anxiety symptoms from flaring up. You may also want to talk to a doctor in Foxborough to see about getting help to quit smoking for good.

#3: Alcohol

Alcohol is a central nervous system depressant that produces feelings of ease and mild euphoria. Alcohol in moderate amounts, consumed relatively infrequently, may appear to ease anxiety; however, this effect is largely illusory. In the longer term, alcohol exacerbates anxiety. If you have an anxiety disorder, you may want to be careful with your alcohol consumption. There is a high correlation between alcohol abuse and anxiety disorder, which may be due to underlying genetic factors that predispose an individual to both conditions. Because alcohol can temporarily relieve anxiety, a person may fall into the habit of using alcohol as a coping mechanism. This is neither healthy nor effective. This isn’t to say that you can never drink at all, but moderation is a must. According to the National Institute on Alcohol Abuse and Alcoholism, “at-risk drinking” can be defined as a woman who drinks more than seven drinks in a week or more than three drinks on one occasion; for men, the numbers are 14 drinks per week or more than four drinks on one occasion. Having a glass of wine or a cocktail every once in a while is generally okay, and may even have positive effects on cardiovascular health. However, excessive drinking can cause heightened anxiety and increasingly negative emotional states. If you suffer from anxiety, remain mindful of how much and how often you’re drinking. Also, it may be wise to pay attention to your reasons for drinking. A drink or two as a “social lubricant” is one thing, but if you drink for the purpose of relieving your anxiety, you may be at risk for developing alcohol abuse or dependency.

 If you have anxiety in Foxborough, or even if you’re just suffering from normal levels of stress, you could inadvertently be making it worse by excessive caffeine, nicotine, and alcohol consumption. Taking care to reduce your caffeine and nicotine usage, as well as avoiding excessive alcohol, may help reduce your anxiety symptoms.

NEUROFEEDBACK FOR ANXIETY

St. John’s Wort: An Herbal Remedy for Milder Forms of Depression

Depression

Although Major Depressive Disorder can be very severe and debilitating, there are also milder forms of depression. “Dysthymia” is a disorder related to depression, but with a milder degree of emotional disturbance; “minor depressive disorder” is another label sometimes used for individuals whose depression is to a less extreme extent, or who meet some but not all of the criteria for being diagnosed with Major Depressive Disorder. Clinical depression is usually treated with a combination of psychotherapy and antidepressant medications. Although antidepressants can be quite effective for treating the symptoms of depression, they also have a range of potentially negative side-effects. For less intense cases of depression, some evidence suggests that St. John’s Wort may be effective in lieu of prescription antidepressants like Zoloft or Lexapro. 

What is St. John’s Wort? 

St. John’s Wort, also known as Hypericum perforatum, is a flowering plant native to Europe. Historically, it has been used as a medicinal herb. Modern research supports the hypothesis that St. John’s Wort may be quite effective for depression. In some studies, it has been shown not only to be superior to a placebo, but to be equally as effective as standard SSRIs like Zoloft. Like SSRIs, which work by inhibiting reuptake of the neurotransmitter serotonin, St. John’s Wort is thought to have its effects by inhibiting serotonin reuptake. Reuptake inhibition increases the available amount of serotonin, a neurotransmitter used in communication between brain cells that is strongly involved in processes involving mood regulation. 

What Makes St. John’s Wort Effective for Depression? 

St. John’s Wort contains numerous chemical compounds. There are two main chemicals that are thought to be tied to the herb’s effect on mood regulation.

·         Hyperforin is a chemical that acts as a reuptake inhibitor for a class of neuro-chemically important compounds called “monoamines”, including serotonin, norepinephrine, dopamine, GABA, and glutamate.

·         Hypericin is another active component found in St. Jon’s Wort that is implicated in its efficacy for treating depression. Along with hyperforin, it helps to give the plant effects similar to MAOI inhibitors, an older form of antidepressant medication.

  

Are Any Risks and Side Effects Associated with St. John’s Wort? 

St. John’s Wort has relatively few side effects, although you should always consult with your physician before beginning any medicine, herb, or supplement. Studies have found it to be less problematic than commercial SSRIs such as Zoloft and Prozac in terms of negative side effects, although the following effects can occur when taking St. John’s Wort:

·         Difficulty sleeping

·         Unusually vivid dreams

·         Stomach upset

·         Fatigue

·         Skin rash

·         Heightened sensitivity to light

Although it has fewer side effects than most depression medications, chemicals contained in St. John’s Wort can interact with other drugs. You should NOT take St. John’s Wort if you are taking one of the following medications:

·         Alprazolam (Xanax). St. John’s Wort can cause the body to excrete the active components of Xanax more quickly, possibly decreasing its effectiveness.

·         Aminolevulinic acid. Both this medicine and St. John’s Wort can increase your sensitivity to sunlight and increase your risk of sunburn.

·         Amitryptaline (Elavil). As with Xanax, St. John’s Wort can cause the body to break this medicine down more quickly, decreasing its effectiveness.

·         Birth control pills. These pills usually contain estrogen; St. John’s Wort can make the body break the estrogen down more quickly.

·         Cyclosporine may have reduced effectiveness when combined with St. John’s Wort.

·         Digoxin may be less effective with St. John’s Wort.

·         Fenfluramine works on serotonin, so if it is taken with St. John’s Wort it can cause there to be too much serotonin, which causes anxiety and nausea.

·         Many antidepressants, especially SSRIs like Celexa, Zoloft, Prozac, and Lexapro, should not be combined with St John’s Wort, in order to avoid too much serotonin.

This is only a partial list of drugs that St. John’s Wort can interact with. If you are considering trying Saint John’s Wort for mild to moderate depression, you should talk to your doctor beforehand to assess the risks of interactions with other medications.

St. John’s Wort is very safe overall, and produces few side effects. Clinical studies have indicated that for mild to moderate depression, it may be as effective as many antidepressants--- without the negative side effects. 

NEUROFEEDBACK FOR DEPRESSION

Massachusetts Services for Brain Injury

What You Need to Know 

The Massachusetts State Division of Health and Human Services offers disability services for people who have sustained an externally caused traumatic brain injury. According to online information provided by the department, “externally caused traumatic brain injury” is damage to the brain caused by an external injury. For example, if you suffer a concussion or open head injury in a car accident because you slammed against the windshield in an impact, that is an externally caused brain injury; however, injury due to a stroke, drug overdose, viral or bacterial disease, or other internal event, would not qualify. 

The Massachusetts Statewide Head Injury Program, or “SHIP”, offers state residents a number of services for brain injury due to external injury. Brain injuries can be truly debilitating, resulting in loss of vision, hearing, memory, impulse control, cognition, language capacity, and countless other abilities controlled within the brain. 

What Kinds of Services for Brain Injury Are Available to SHIP Applicants? 

The SHIP program offers several services for brain injury to qualifying applicants, including:

·         Assistive Technology. SHIP offers assistance in obtaining devices that may be necessary for people who have suffered traumatic brain injury. This includes equipment such as medication dispensers, reach extenders, grab bars and shower chairs, and communication devices. A traumatic brain injury can inhibit a person’s ability to speak or coordinate motor movements effectively, depending on what part or parts of the brain sustained damage.

·         Community-Based Support Services. These types of services are important for helping with rehabilitation and general quality of life for individuals with brain damage. This may include the assignment of a case manager to assess the person’s needs and coordinate services; community support workers to help the person learn and use daily living skills or to assist with day-to-day tasks like grocery shopping or driving to doctor’s appointments that the injured person may no longer be able to do on their own; individual aides to provide support and companionship; and residential services for injured persons needing “around-the-clock” care and support as a result of their injuries.

·         Regional Service Centers. The SHIP program operates four community-based service centers for eligible individuals. These service centers provide support and opportunities that help brain injury victims regain independence and daily living skills. The centers are located in Boston, Cape Cod, Western Massachusetts, and Southeastern Massachusetts.

·         Respite Services exist to provide relief for full-time caregivers of individuals who have been disabled by a brain injury. This includes in-home respite, as well as up to two weeks of out-of-home respite in a 24-hour treatment facility.

·         Family Assistance Programs. SHIP can provide clinical consultants to help brain-damaged individuals and their families develop in-home strategies to address changes in capabilities resulting from traumatic brain injury, as well as assistance in identifying and addressing clinical treatment needs.

·         Social and Recreation Programs are also among SHIP’s services for brain damage. Each program has an activities coordinator; recreational activities include museums, sporting events, bowling, trips to amusement parks, and craft nights, to name only a few of the recreational options.

·         Substance Abuse Treatment is also available through SHIP for individuals with TBI who are also recovering from addiction. 

How Do I Find Out If I Qualify for SHIP? 

To be eligible for SHIP services, you must be a resident of the state of Massachusetts and have documented externally caused brain injury. You must also, as a result of your injury, have impaired behavioral, cognitive, social, motor, or other functioning. After you apply for SHIP, your medical documentation will be reviewed to confirm your eligibility. People of all ages and income levels are eligible. 

If you or a loved one are a Massachusetts resident who has sustained externally caused brain damage, and have suffered impairments in mental or physical functioning as a result, you may be eligible for SHIP. To find out more about what SHIP has to offer and whether you qualify for assistance with services for brain injury, you can visit the following website: http://www.mass.gov/eohhs/consumer/disability-services/services-by-type/head-injury/. Or, you can call for information at (617)-204-3852 OR toll-free at (800)-223-2559. You can also request information by emailing SHIPU@MRC.state.ma.us. If you or someone close to you has been mentally or physically compromised by an externally caused brain injury, SHIP can help you find and coordinate the treatment and rehabilitation services you need.

NEUROFEEDBACK FOR BRAIN INJURY SUFFERERS