Mark Allen and Alina Fong
Cognitive FX, USA
Posters & Accepted Abstracts: J Neurol Disord 2020
Post-concussion syndrome (PCS) occurs in a significant percentage of concussion patients and is defined as having a history of traumatic brain injury with persistence of three or more symptoms. Standard structural clinical neuroimaging studies show no abnormal findings for the majority of PCS patients as opposed to functional MRI, which often reveals irregularities in the Blood-Oxygen Level Dependent (BOLD) signal. This suggests that dysregulation of Neurovascular Coupling (NVC), which causes abnormal BOLD signals, plays a significant role in PCS pathology. Compared to the pathophysiologic mechanisms occurring in acute concussion, the underlying neuropathophysiology of chronic concussive sequelaeor PCS is less understood, though becoming clearer with emerging research. We present a treatment approach grounded in the physiological theory presented here called Enhanced Performance in Cognition (EPIC), which has shown strong clinical success. Dysregulation of neurovascular coupling (NVC), along with disruptions in Cerebrovascular Reactivity (CVR) and Autonomic Nervous System (ANS) dysregulation are the targets of EPIC treatment. Success of the approach tentatively supports the hypothesis that these features figure prominently in the neuropathophysiology of PCS. The aim is to provide a theory of the underlying mechanisms of PCS pathology and its treatment that is in accord with the current corpus of research and explains the recent therapeutic success seen in PCS patient using the EPIC treatment. We propose a theory by which NVC dysregulation is normalized through focused, intense and repetitive neurocognitive challenges during post-exercise cognitive boost and the avoidance of intracerebral steal in the setting of restored and re-regulated CVR and ANS.
Neurological Disorders received 1343 citations as per Google Scholar report
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