Jul 292017

I got my brain assessment results back. There are a lot of them! I'll talk about them in the order I did them until I peter out then finish another time.

The first ones were the usual questionnaires. Can't stand them as I did a bazillion the same or like them for too many insurance experts. Nothing new. It's really me self-reporting.

The IVA and TOVA are tests of attention conducted on the computer by a computer after someone has set you up and watched you do the practice to ensure you know how to do the test. Then it's just you and the computer in a quiet room. The IVA tests both visual and auditory attention. The TOVA I had tests visual attention only. Both test results blew the ADD Centre staff away. I began my odyssey with them with poor attention and extreme hyperactivity (I'll be showing before and after results in my book Concussion Is Brain Injury since visuals really show how much and quickly I began to improve back in 2005. Makes me realize how severe and through my whole brain my injury was that I still need treatment. It being delayed years made it harder to treat too. People who start treatment quickly are way better off than me.)

Now I have excellent attention.

The tests measure various aspects of attention, too many to cover here. Attention isn't only about focus, it's also about speed, accuracy, vigilance, consistency, stamina, etc. The Response Control Quotient measures how consistent and how much stamina I have as I attend to the most boring task in the world — except for the TOVA. That's deadlier boring. When I began in 2005, my score was 93. It's gone up at each reassessment. By 2013, after gamma training, it was 122. This month, it was 134. I could feel the difference when I did the test this year. I felt more solid, and I wasn't screaming in my mind, when will this be ooooovvvvveeeerrrr. Instead, I just attended to the numbers, knowing it really would come to an end. My Total Attention Quotient, measuring speed and accuracy, was not as high, with my visual attention significantly lower than auditory as my brain is still rewiring my visual system after eye surgery. But both scores were still freaking amazing. The TOVA was at 5.86, dramatically up from last time. I'm not sure why. Since it's a test of visual attention, perhaps the eye surgery along with the gruelling Cogmed, which requires intense visual attention, upped it. I'm sure all the other things I do, like the gamma brainwave training, also influenced it.

In any case, these scores are proof that treatment works, that one can heal an injured brain. You don't need drugs to prop up attention or convince people with brain injury a diminished life of day programs, movies, and feel-good outings is all there is. You can actually fix it.

The next test was CNS — an online test the computer conducts on you that's a combination of self-reporting and testing your verbal, motor, visual, attention, discriminant skills. The part that surprised me and pleased the ADD staff was the increase in my reaction time. Brain injury slows you down so much, a snail is speedier. Things drop from your hands and hit the floor, and a few seconds later, you think, I should catch that and try to react. So for me to be speedier in IVA, TOVA, and this test is quite remarkable. It means my neurons and neural networks are speaking to each other again and in real time. I can feel the difference because I can hear, comprehend, think, and respond in real time even to unexpected questions. Fatigue still impedes me, and group attention is still not great and so I'm slow to react in those conditions. But to be able to hold a normal conversation with one or two people is huge.

The single electrode EEG shows the brainwave frequencies in relation to each other. Dr. Lynda Thompson explained it this way. Think of a car with its windows rolled up and music blasting. You can hear the thump of the bass easily through the glass but not so much the trebles of the singers. Similarly when listening to brainwaves with EEG, the lower brainwave frequencies can push through the dura and skull easier than the higher frequencies. So as you go up from the lower to the higher, the amplitudes of each frequency shrink like an angled line. Any frequency that dips off that line or rises above tells her something. It could be a good abnormality that reflects a talent or skill or it could be a bad one. She determines that by asking you about symptoms.

The first dip in me was at 6 Hz. That's hippocampal theta or central midline theta. It reflects long-term memory. The surgery did a number on my memory, which had been gradually recovering. But even before that, my long-term memories developed black holes then the holes shrank then appeared elsewhere. It could be reflecting an encoding issue. That wouldn't be true for events before my injury though. I encoded memories both naturally and deliberately. I had one hell of a memory. But since the injury, that could be true. I also think retrieval is a bit short circuited. So I told my brain trainer we have to add 2 minutes long-term recall, testing how well I remember what I read the previous weeks, before reading for 5 minutes and doing immediate recall. I'm trying to do that with my reading practice the rest of the week, but so far a bit tough as I have to have enough initiation to make it happen. Not always a given.

Anyway, the next blip was a rise at 8-9 Hz. This could be daydreaming, but in me, Lynda said it reflected creativity and brilliance. I do feel my daydreaming is returning. But for me, it was never a bad thing. It's the source of stories and ideas. And now it helps me see what I'm really feeling.

The next blip was at 23-25 Hz. Busy brain. Not good. But given my busy brain used to go from something like 20-30+ Hz, this is a huge improvement. Since it's not gone, we still have to inhibit it during brain biofeedback.

The last rise is a subtle but significant one. Gamma. It begins at 39 Hz and increases more and more up to 42 Hz, exactly the frequencies we’re training. Also, some of the gamma frequencies above that also show a rise rather than the expected amplitude drop off. Awesome!

The big 19-point qEEG test showed a ton of stuff. The big one for me is that even though my HRV SDNN remains stubbornly half of the minimum for good heart health, my heart rate has decreased steadily at each reassessment. It began at 100. It’s down to 85! I also noticed my heart rhythm is stronger (higher amplitude). My heart’s getting stronger! All those cardiologists couldn't understand how brain injury injures heart health and so couldn't help improve my cardiac health, only give me fatiguing drugs that didn't control my heart rate all that well. This biofeedback way takes forever, but I don't need drugs, and I don't need to worry if my prescription runs out or there’s a shortage or side effects or losing the battle to additional life-sucking fatigue. Also, drugs don't make you feel stronger inside, and they didn't take away my shortness of breath nor did they increase my exercise tolerance. They couldn't because they were only sticking a band-aid on my symptoms, not healing the brain injury causing the problem.

It is worrying my SDNN is still so low. But cardiac care after brain injury is such a nascent area and so few are treating it appropriately that it doesn't surprise me we haven't been able to budge that marker. There’s still so much to learn. At least people like the ADD Centre are trying to learn and tackle it. More than most cardiologists or brain injury specialists are whose bailiwick this should be. More later!