Ethos Health Group

Discoveries Unveiled: Loss of Smell Post Traumatic Brain Injury Can Severely Impact Quality of Life.

Close your eyes and picture what Thanksgiving dinner cooking smells like in your home. Or think of what it was like to smell the head of your newborn child as you hold them close. Have you ever been walking by a store and all of a sudden had memories flood back because they were selling the same perfume your grandmother wore?

Or even worse, have you ever been dumb enough to indulge one of your children saying, "Hey Dad, smell my finger?" I'm proud to say I've only fallen for this ruse once (my youngest son caught me off guard when he was 5, and let's just say his finger did not smell like Thanksgiving dinner or Grandma's perfume), and it's seared in my brain never to repeat the mistake!

Smells provide some of the most powerful stimulation to the brain, and has a profound impact on our memory and how we perceive the world. If you'd like a great overview of the phenomenon, I highly suggest this recent article from the Harvard Gazette titled "The Nose Knows".

Read it here:
https://news.harvard.edu/gazette/story/2020/02/how-scent-emotion-and-memory-are-intertwined-and-exploited/

It is well established that traumatic brain injury can lead to decrease or loss of smell. Studies have shown roughly 20% of TBI patients suffer with temporary or permanent olfactory dysfunction. This can be measured using standardized testing like the University of Pennsylvania Smell Identification Test (UPSIT) which we routinely utilize with our TBI patients.

A recent study helped to quantify an often overlooked element related to loss of smell: decreased quality of life.

Published in the January 2020 issue of the European Archives of Oto-Rhino-Laryngology, the study compared qualify of life in TBI patients with and without olfactory dysfunction. Previous studies had evaluated the impact of olfactory dysfunction on quality of life in areas like food enjoyment, hazard avoidance, personal hygiene, and social isolation; but very few had ever looked at this in the context of post TBI olfactory problems.

The study found that when TBI patients with olfactory issues were compared with TBI patients whose smell/taste was unaffected, those in the former group were 5 times as likely to feel more anxious, 3.4 times more likely to have weight problems, 5.5 times more likely to avoid groups of people, and 6 times as likely to feel isolated.

Remember, this isn't even comparing them to the general public, but to patients who have TBI but have their olfactory function intact.

This is why a detailed assessment of numerous aspects of brain function is critical. Too often cognitive performance and perhaps an MRI are the only tests that are performed, and it's no wonder that patients and their attorneys alike are often left with more questions than answers when it comes to objective evidence of TBI.

At Ethos, we understand that preventing olfactory issues may not be possible, but we have an extensive range of testing options available. Our cutting-edge technologies, such as VNG, EEG with ERP, oculomotor tracking, and balance testing, provide us with a wealth of valuable data for review.

Rest assured, we have a plethora of therapies that greatly improve the quality of life for our patients. Whether you or someone you know requires TBI diagnostics, TBI rehab or therapy, or a neurology evaluation, our Florida locations are here to help. Feel free to contact us via email at [email protected] or give us a call directly at 904-616-1284. We look forward to assisting you!

Unbelievable Resilience: How a Headless Chicken Defied the Odds and Survived the Most Severe TBI for 18 Months.

In September 1945, farmer Lloyd Olsen tried to kill a chicken named Mike to eat for dinner. His ax missed the chicken's jugular vein and most of its brain stem, so Mike remained alive. For 18 months the farmer fed it a mixture of milk and water using an eyedropper and toured with the chicken across the United States.

Beyond a sideshow oddity, Mike the chicken illustrates an important concept of the neuroarchitecture of the brain known as neural circuit function redundancy. This refers to the fact that vastly different synaptic connections can enable the same neurologic function. It's a design mechanism to ensure that if damage is sustained in a specific area of the brain there are other regions that can still pick up the slack.

Given that none of you will likely find a niche representing wrongfully beheaded chickens, why is this of relevance to your practice?

I have found that many attorneys want to grab onto imaging findings like white matter lesions in a particular part of the brain on MRI and make the easy link of "There's a lesion on this part of the brain, and the patient reports symptoms associated with injury to that part of the brain, so this is a slam dunk."

The challenge with this way of thinking lies in the redundancy concept I mentioned earlier. There are virtually no bodily functions that are exclusively controlled by just a single area of the brain. So rather than pin your case on one particular diagnostic study or one specific brain region it may be more prudent to evaluate as many domains of brain function as possible with as many tools available.

For example, damage to the cerebellum could be assessed by performing oculomotor tracking (such as the images attached to this post), videonystagmography (VNG), and computerized balance testing.

Other tests can then be layered on top of these to assess other regions of the brain like EEG with ERPs, quantitative pupillometry, autonomic testing, neurocognitive testing, olfactory testing, and more. While I don't know that any of these tests would have been needed to diagnose the source of Mike the headless chicken's problems they can be quite impactful for your injured clients.

If you or someone you know would benefit from TBI diagnostics or therapy at any of our locations across Florida, please reach out via email at [email protected] or you can call directly at 904-616-1284.