This is a longer post. If you have a brain injury, I recommend reading this in segments and taking breaks.

If you or your loved one have explored the standard initial treatment options for brain injury (as I discussed in my Brain Injury Guide), but are still experiencing symptoms, it might be time to look into alternative treatment options. My advice to you before reading this post is to understand that all these treatments are very expensive, are not covered by insurance, and although they may help improve symptoms, none of them are guaranteed to help, and they certainly are not a “cure”. If there was one single thing that “cured” brain injury, everyone would be doing it, and I would only need one post on this entire blog. Be skeptical of any treatment provider promising a cure. Remember, most people cannot afford even one of these treatments, much less all of them, and they continue to improve regardless. These treatments are something more you can try, but they are not the only way to get better.

1. Hyperbaric Oxygen therapy
2. Near-infrared light therapy
3. Stem Cell Therapy
4. Neurofeedback
5. Botox, Cefaly, and drug therapy for migraines
6. Supplements – because there are so many options, this will be a separate post

1) Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy refers to sessions of exposure to below sea level atmospheric pressures while breathing increased levels of oxygen.  It is thought that under normal conditions, the brain receives enough oxygen to function, but not to heal. The theory is this treatment will allow higher levels of oxygen to reach the brain, which promotes healing.

There are two main options for hyperbaric oxygen therapy. The first is supervised treatment at a hyperbaric facility. Typically this involves 40 (or more) sessions in a row, 6-7 days a week. Having undergone this treatment myself, you can read more about my experience, as well as links to scientific studies, in this blog post. Personally, I believe this treatment helped significantly. The cost was roughly $5,000, and there are limited facilities around the country. I’m fortunate to live a mile away from Rocky Mountain Hyperbaric Institute.

The second option for hyperbaric is to purchase or rent a home unit. The pros are that you can use it whenever you want, don’t have to travel to the treatment center, and can continue beyond 40 sessions. The cons are that you will be using an oxygen concentrator instead of 100% oxygen, and the atmospheric pressure in these units cannot be set as high. Breathing 100% oxygen at the treatment facilities is what makes it so expensive. Using a concentrator, you get a higher level of oxygen than room air, but it is nowhere near 100%. All of the existing scientific research on the benefits of hyperbaric oxygen for brain injury are using treatment facilities. So although I can’t say that a home unit doesn’t help as much, I also can’t say that it does.

2) Near Infrared Light Therapy

In basic terms, is thought that light energy can penetrate through the skull and through a complex cellular pathway, help with neuroregeneration and repair. Conducting a clinical trial, Boston Children’s Hospital has a great summary of the theory behind this treatment:

“Concussion, also known as mild traumatic brain injury (mTBI), results from a rotational acceleration of the brain. The biomechanical forces which cause concussion lead to the opening of ion channels within the neuronal cell membranes, allowing for a massive influx of sodium and efflux of potassium. This results in a spreading depression type of phenomenon, leading to the depolarization of neurons diffusely throughout the brain. In order to restore the homeostatic ion gradients across the membrane, the sodium-potassium pumps require increasing amounts of adenosine triphosphate (ATP). Thus, there is an increased need for ATP after concussion. ATP is supplied by the glycolysis of glucose from the blood stream. Both experimental models of concussion and human studies, however, show decreased cerebral blood flow after the initial response to injury. Thus, there is an increased demand for ATP after concussion; but a diminished supply of glucose to meet the demand.

The absorption of light in the red/near infrared wavelength spectrum by cytochrome C oxidase increases ATP synthesis. Thus, by increasing ATP synthesis, red/near infrared LEDs can treat the underlying pathophysiological cause of concussion symptoms.”

This treatment modality is available for use at home. At the time of posting this article, the Vielight Neuro Alpha (the unit recommended for TBI) is available for purchase at $1,749, so while not cheap, it is much less expensive than many other alternative therapies.

Research on near infrared light therapy for brain injury

More information regarding light therapy for brain injury

3) Stem Cell Therapy

The theory behind this therapy is that stem cells may lead to regeneration of damaged brain cells. Stem cell therapy has a few different categories, depending on how the stem cells are harvested (from blood or fat), and how they are delivered (intranasal, venous injection, CSF injection). Cost varies greatly depending on the methods utilized. This treatment is not widely available, and there are limited facilities performing this treatment. I have no personal experience with this treatment, other than knowing some facilities combine stem cell treatment with hyperbaric, and other treatments/supplements, so it may be difficult to determine what is actually helping.  Additionally, many facilities recommend early intervention (prior to 6 months) for the best outcomes. My concern with this recommendation is that most people spontaneously improve prior to 6 months. As with all brain injury treatment modalities, this makes clinical research difficult, because recovery may occur without any treatment. I am not discounting the potential benefits of stem cell therapy, and research suggests it may be beneficial.

Here is a good scientific summary article on stem cell therapy for brain injury.

Here is a rather lengthy review article on stem cell therapy for brain injury.

4) Neurofeedback

Neurofeedback is also known as EEG biofeedback. Unlike some of the other modalities presented here, it is not aimed at healing damaged brain tissue, but at improving function. It may help with the cognitive dysfunction and emotional disturbances that can be present after brain injury. This includes cognitive deficits, depression, PTSD, anxiety, and more. It is essentially retraining the brain and developing conscious control of brain waves. More information can be found on the Neuroworks website.

Sensors are placed all over the head, and brain waves are measured. Sessions may involve watching videos, playing games all while the brain waves are being monitored. Recommendations may vary, but generally 30-40 treatment sessions may be necessary, and the cost may be $100-150 per session. This treatment is not covered by insurance.

You can find a board certified neurofeedback practitioner in your area at this link.

5) Botox, Cefaly, and migraine therapy

First off I will say that migraines may be helped by many of the above treatment modalities, and some of the supplements I’ll be sharing in a later post. However, if you aren’t able to pursue these, or they haven’t helped, here are a few more suggestions:

Sumatriptan or Imitrex – this is not for daily use, however myself, and many people I know, have used it almost daily for a long time.  The problem with frequent usage is that the more you take this medication, the more likely you are to have rebound migraines. I am now thankfully, mostly off this medication taking it once or twice a month, and rely on CBD to control the migraines. If you happen to use this medication frequently, I have found that the Costco pharmacy is the best option, as I can purchase a box for $20 cash pay, whenever I need it. Insurance only covers 1 box (9 pills) per month, and if you go through insurance, you will not be allowed to refill this medication more than once a month.

Botox is commonly used for wrinkles. Botulinum toxin is injected and causes temporary paralysis of facial muscles by slowing conduction at nerve fibers, thus softening the fine lines. It also blocks the transmission of pain signals along the nerve fibers, and this is why is helps with migraines. Injections can be performed across the forehead, scalp, temples, jaw, neck and shoulders, depending on where pain is typically centered on an individual basis. I have had this performed twice. The first time was amazing, and the second time didn’t seem to help at all. However, I did look about 10 years younger, and perhaps I should consider trying again if only for that reason. As with every treatment, nothing works for everyone, but it worked so well the first time I have considered trying again. Some insurance plans cover treatment if you have tried multiple medications first. Here is more information from the American Migraine Foundation.

Cefaly is an external trigeminal nerve stimulation (eTNS) unit. It was approved by the FDA for use in treating migraines. It is not an instant fix, but is used on a daily basis to desensitize the nerve fibers. The unit is available only by prescription, and is typically not covered by insurance. They are available for roughly $300. Here is more information about Cefaly.

Aimovig is a new drug available for migraine prevention. This is a prescription treatment that is available to people who have tried several other migraine medications first.  It is an injection that is given once a month at home. It comes in an auto-injector, similar to an insulin pen. As a preventative medication, it is not used to treat active migraines, but to decrease the frequency. Here is more information about Aimovig.

 

Which treatment is right for me?

This is not an exhaustive list of treatment options, but these are the most commonly pursued treatments. As I stated previously, there are many treatment options, but nothing is guaranteed. Unfortunately, there is no way for anyone to tell you what treatment is your best option. I recommend looking at the financial side of these treatments, proximity to where you live and convenience, and then maybe flip a coin. Honestly, if you ask 10 different treatment providers you will get 10 different answers on what you should pursue. Remember that treatment providers tend to think the treatment they are providing is the best one. This is understandable, as it is what they have the most knowledge and experience with. Hopefully with the links I’ve provided you can read a bit more about the options. Try what you can, and if you can’t afford any of them time, rest, and continuing to push your boundaries will help more than anything.

Stay tuned for a post about brain injury supplements.