Meditation: The Missing Link In Post Concussion Syndrome Treatment?

June 25, 2018

A concussion causes direct damage to the emotional centre of the brain, the amygdala, increasing the likelihood of mental health disorders. Fortunately, meditation can help rewire this part of the brain.

Most of us are familiar with a concussion, the most common form of mild traumatic brain injury (TBI). However, we’re not as aware of the 30 percent of patients that continue to struggle with serious symptoms well after the recovery period for a concussion, known as post-concussion syndrome disorder (PCS).

This is a serious disorder that disrupts the ability to lead a normal family, social and professional life, and can take a big toll on mental health; patients often have to restructure their entire life in order to simply avoid triggering symptoms.

Fortunately, there is hope for PCS patients that are struggling with their mental health. Research has shown that mindfulness-based stress reduction training (MBSR) can improve mood, memory, attention and overall quality of life for PCS patients. [1]

What Is Post Concussion Syndrome?

Typically, the major symptoms following a concussion last up to two weeks, and full recovery takes place within a month. [2]

In the case of PCS, symptoms persist beyond the normal two week period and can last for months, or even years.

Lingering symptoms that indicate PCS are: [2]

Headaches
Dizziness
Fatigue
Irritability
Insomnia
Reduce tolerance to noise and light
Problems with memory and concentration

If you have any of these symptoms following two weeks after a concussion, speak with your doctor about post-concussion syndrome.

Certain risk factors also increase the likelihood of PCS: [2]

Age
Being female
History of previous concussions
History of mental health disorders, such as anxiety or depression
History of migraines
History of seizures
The severity of impact
Major visual symptoms soon after injury
The duration of initial symptoms

Post Concussion Syndrome Treatment

Managing PCS is often a matter of allowing the brain time to rest and recover, by avoiding both physical and cognitive triggers, such as work, looking at a screen or being in social settings.

However, depending on the severity and duration of an individual’s symptoms, specialized therapies are sometimes prescribed.

These are tailored based on the individual and include: [3]

Vision therapy
Vestibular (balance) therapy
Physical therapy
Exertional (light aerobic exercise) therapy
Cognitive behavioural therapy
Psychotherapy or antidepressants for mood problems

It’s also important for patients to take extra care with their diet and lifestyle:

A healthy diet ensures that the brain receives the right micro and macro-nutrients to function; essential fatty acids from flax, hemp, chia, walnuts and fish are especially important for cognitive function. [4]
Aerobic exercise under clinical supervision helps rewire brain circuitry and restore normal blood flow to the brain.
Restorative sleep is crucial, as this is when the brain processes information and changes from the day, repairs and heals itself overnight.

Post Concussion Syndrome and Mental Health

Not only do concussions trigger mental health problems due to the disruption of a normal lifestyle, but they also impact mental health at a physiological level.

A concussion can physically damage the emotional centre of the brain known as the amygdala. [5]

The amygdala plays an important role in storing memories and is responsible for the perception and regulation of primal emotions such as fear, anger and sadness. When the amygdala is damaged, emotional self-control becomes much more difficult, and it puts someone with PCS at a much higher risk for anxiety disorders, such as generalized anxiety disorder (GAD) and post-traumatic stress syndrome (PTSD). [5] [6]

Given that PCS has a direct impact on the amygdala, it is necessary for a PCS patient to undertake treatment that is specific to emotional regulation; while medication can help improve mood, it is a short-term solution that does not consider rewiring brain circuitry for better emotional control.

Improving Mental Health with Mindfulness

Scientists have found that mindfulness-based stress reduction training (MBSR), a combination of mindfulness meditation, body awareness and yoga, is an effective tool for rewiring the emotional centre of the brain.

For example, a 2013 study published in the Journal of Head Trauma Rehabilitation found that people with PCS showed significant improvements in quality of life, self-efficacy, working memory and attention after a 10-week MBSR program. [7]

Another study published in NeuroImage: Clinical revealed that an 8-week MBSR program for patients with GAD resulted in less amygdala activation and an improvement in the frontal-limbic cortex, which is another area that is crucial for the regulation of emotions. [8]

Mindfulness Meditation: The Key To MBSR

The most important element within an MBSR training program – and one that is both accessible and affordable to patients on a regular basis – is mindfulness meditation.

Science continues to show that meditation strengthens the assessment center of the brain (the lateral prefrontal cortex), which engages in logical reasoning and rational thought, and weakens the fear centre of the brain (the amygdala) that responds with fear and anger. [9]

Getting Started with Mindfulness Meditation

Mindfulness meditation can be learned through an instructor, group class, or – perhaps ideally for PCS patients – guided meditation sessions at home.

If you are a PCS patient, adding neurofeedback to your meditation session is highly recommended. This is a specific treatment that has been studied for use in traumatic brain injury (TBI), where ‘patients are able to see or hear representations of data related to their own physiologic responses to triggers, such as stress or distraction, in real time and, with practice, learn to alter these responses in order to reduce symptoms and/or improve performance’. [10]

According to a 2017 study in Medical Acupuncture, the use of at-home neurofeedback devices for TBI patients helped improve motivation for treatment, attention and mood.

Fortunately, this combination of guided meditation and neurofeedback can be found in the Muse app and brain-sensing headband; it tracks your brainwaves as you meditate, whether it’s with the assistance of a guided session or simply the sounds of nature. Feedback is communicated to PCS patients in the form of gentle guiding sounds and visuals e.g. the sound of ocean waves picks up when the mind is distracted, and the waves quiet down when the mind is calm and focused.

To learn more about Muse, visit http://www.choosemuse.com/how-does-muse-work/

SOURCES

[1] Azulay, J., Smart, C., Mott, T. and Cicerone, K. (2013). A Pilot Study Examining the Effect of Mindfulness-Based Stress Reduction on Symptoms of Chronic Mild Traumatic Brain Injury/Postconcussive Syndrome. Journal of Head Trauma Rehabilitation, 28(4), pp.323-331.

[2] Concussion Legacy Foundation. (2018). What is PCS?. [online] Available at: https://concussionfoundation.org/PCS-resources/what-is-PCS [Accessed 4 Jul. 2018].

[3] Concussion Legacy Foundation. (2018). What is PCS?. [online] Available at: https://concussionfoundation.org/PCS-resources/what-is-PCS [Accessed 4 Jul. 2018].

[4] Gomez-Pinilla, F. and Kostenkova, K. (2008). The influence of diet and physical activity on brain repair and neurosurgical outcome. Surgical Neurology, 70(4), pp.333-335.

[5] Reger, M., Poulos, A., Buen, F., Giza, C., Hovda, D. and Fanselow, M. (2012). Concussive Brain Injury Enhances Fear Learning and Excitatory Processes in the Amygdala. Biological Psychiatry, 71(4), pp.335-343.

[6] Stein, M. and McAllister, T. (2009). Exploring the Convergence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury. American Journal of Psychiatry, 166(7), pp.768-776.

[7] Azulay, J., Smart, C., Mott, T. and Cicerone, K. (2013). A Pilot Study Examining the Effect of Mindfulness-Based Stress Reduction on Symptoms of Chronic Mild Traumatic Brain Injury/Postconcussive Syndrome. Journal of Head Trauma Rehabilitation, 28(4), pp.323-331.

[8] Hölzel, B., Hoge, E., Greve, D., Gard, T., Creswell, J., Brown, K., Barrett, L., Schwartz, C., Vaitl, D. and Lazar, S. (2013). Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training. NeuroImage: Clinical, 2, pp.448-458.

[9] Gladding, R. (2018). This Is Your Brain on Meditation. [online] Psychology Today. Available at: https://www.psychologytoday.com/us/blog/use-your-mind-change-your-brain/201305/is-your-brain-meditation [Accessed 4 Jul. 2018].

[10] Gray, S. (2017). An Overview of the Use of Neurofeedback Biofeedback for the Treatment of Symptoms of Traumatic Brain Injury in Military and Civilian Populations. Medical Acupuncture, 29(4), pp.215-219.