Episode 34: Neuroplasticity: Hope for the Hopeless with Dr. Angela Gabella, Functional Neurologist
Our brains are truly remarkable organs!! They are what make us unique! It provides the connections needed to support all our body functions, thoughts, personality, and well-being. Their complexity and highly individualized nature are what make it the most misunderstood organ. There is no medicine or one size fits all approach to treatment which makes it a poor fit for traditional medicine. Today, we learn all about functional neurology, a field that truly explores each individual’s unique neuronal responses to provide personalized treatment. Dr. Angela Gabella DC, DACNB, FABBIR gives us an introduction to the field and how it can help you. She gives us hope by reminding us that symptoms like anxiety, depression, confusion, inattention, insomnia, and more are treatable; even if it was something you struggled with pre-injury!! You cannot miss this one!!!! It is one of our most fascinating episodes yet!
Topics covered in this episode:
What is Functional Neurology (FN)?
A treatment of the whole person
A functional neurologists goes in depth doing a complete physical exam to see how your neurons were affected by your brain injury
They dig to find what the symptoms are and where they originate from
So many of us have scans that look normal but still have symptoms. They look beyond the scans
Neuroplasticity: concept has been around but not commonly accepted until recently and remains controversial
Early 1900s: Santiago Ramon y Cajal, the father of neuroscience-coined the neuron doctrine, Nobel Prize winner, his ideas weren’t accepted
2016: Michael Merzenich, a neuroscientist out University of California San Francisco won a prize related to neuroplasticity which made the idea of the brain being able to change more commonly accepted
This is a new field with many clinical applications yet to be found
The field of neuroplasticity gives hope to those of us with brain injury
Why is neuroplasticity hard for the science community to accept?
The brain is still a highly unknown organ with many complexities.
The science is ongoing. It’s behind other organ systems. Clinical applications are still being developed
It is really difficult to be specific with medication. There is no easy fix.
POTS: Postural orthostatic tachycardia syndrome
Increased heart rate with standing up that causes you to pass out
People get stuck in bed with this not being treated. Greatly limits mobility
Seen in some brain injury patients.
Covid is correlated with an increased risk of POTS
Dr. Gabella explains a normal autonomic response to position changes
More common in young healthy females.
It can be idiopathic meaning there is no easy answer for what caused it
Need to consider what is going on in the blood and crossing the blood brain barrier. For example when you are sick, is something crossing into the brain that shouldn’t be?
What is treatment like?
Tilt table: diagnostic test but can also be used as therapy
Throughout the different degrees of tilt, the FN measures your BP and heart rate responses and either activates your parasympathetic or sympathetic nervous system to get the correct response. Once you respond appropriately, they change the position of the tilt
Can take a few to many treatments. The longer you have have had the dysautonomic response, the longer it takes to treat.
Females are more susceptible as they have more neuronal connections with a more complex hormonal system. Also females’ necks are less stable with different vasculature and muscular structures.
FN= individualized care
Traditional medicine operates on gold standards, protocols, and expected responses
With neuronal injury, we all respond differently meaning we need a practitioner who has the time and knowledge to make a personalized treatment plan
FN looks for what modality will work best based on which areas are damaged and which areas are still good. They create neuroplasticity pathways to create positive connections.
Even if the 2 people have a stroke or brain injury in the exact same spot, the 2 people will respond differently. Recovery relies on activating surrounding neurons to build new connections.
How do you know you need FN? Look at the symptoms:
Headaches
Migraines
Pressure in the head
I don’t feel right
Difficulty concentrating or remembering
Fatigue
Sleep and insomnia
Confusion
Brain fog
Feeling slowed down
Sensitivity to noise, sound, light
Dizziness: lightheaded, feeling like you’re rocking or swaying
Nausea, vomiting
Depression: if you have been treated by medication and it hasn’t gotten better, see FN. FN can test if depression is from a brain abnormality or psych. Some people absolutely need psych and medications but others need brain treatment
If you have brain dysfunction that causes depression you will see gait, arm swing, trouble walking and concentrating on a task
Concussion survivors have a high likelihood of depression
Anxiety
Cognitive slips, losing your train of thought
You could have these symptoms prior to brain injury but the brain injury was the thing that pushed you over the edge making your normal compensatory measures ineffective--FN can help!
What does FN treatment look like?
It’s noninvasive
Eye movement measures
Vestibular stimulation provided by a clinician
Electric stimulation
Finding the right sensory system and activating or calming it down to address the symptoms
Brain health tips
Brain cells need glucose and oxygen.
Brain cells do not store glucose, need to snack on high quality food sources frequently.
Take 5 minute rests: use a breathing app or meditation app. Your brain needs those moments of rest.
Cannot just push through!!
The question many of us grapple with: Is this just your baseline and who you are now? Most likely it is not and you can be treated!!
You don’t need to feel helpless or hopeless
Finding a FN
Dr. Carrick, founder of the field of functional neurology. Clinicians trained at the Carrick Institute received top-notch education
Fellow of the American College of Functional Neurology (FACFN), a generalist
Fellow of the American Board of Brain Injury and Rehabilitation (FABIR), more specified to to brain injuries
Dr. Gabella: Precision Brain Center Raleigh, NC--many resources on what FN can treat
Links to any resources mentioned:
Brain HQ is a great app to strengthen your brain!! Check it out!!
Finding a functional neurologist: https://acfn.org/directory/
Dr. Gabella: Precision Brain Center Raleigh, NC--many resources on what FN can treat
Email Dr. Gabella at: dr.gabella@precisionbraincenter.com
Links to any research or studies mentioned
Learn more about the work of:
Michael Merzenich: Dr. Merzenich is the brain behind BrainHQ, an online brain training program. More than 100 published studies show that BrainHQ brain training technologies benefit the brain. Learn more.
Learn more from Dr. Gabella on Functional Neurology through this slide show
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