Ethos Health Group

At Ethos Health Group, we supply normal images to compare with injured clients, as in the picture below. We have learned that this can greatly assist in painting the picture and helps explain our patients' injuries and symptoms.

Why A Rare Medical Condition Would've Caused David Bowie To Flunk TBI Testing

David Bowie was renowned for his other worldly artistry and creativity that was way ahead of his time. Part of his stage persona revolved not just around his vivid makeup and incredible gift for music, but also for his magnetic, almost eerie pair of eyes: one clear blue, the other a moody black.

What gave Bowie’s eyes their hypnotic dual colors, and why is this important for your clients with TBI?

Many people mistakenly assume it was caused by heterochromia, a condition in which a person has two different iris colors. It’s hereditary and usually harmless, and the condition is in fact much more common in dogs, cats, and horses.

But Bowie’s case was different. His eyes were the product not of genes but a teenage fistfight that resulted in anisocoria, a condition in which a person’s eyes have different-size pupils.

In the spring of 1962, Bowie got into a fight with his school pal — and, later, lifetime artistic partner — George Underwood. Both of the boys were fond for the same girl, and as the story goes, Underwood wasn’t exactly pleased. In a fit of passion reportedly punched Bowie in his left eye, and Underwood’s fingernail scratched the surface of Bowie’s eyeball, paralyzing the muscles that contract the iris.

When a person with typical, uninjured eyes stumbles into light their pupils contract and become smaller, showing more of their iris. In darkness, the pupils expand and do the opposite to allow as much light in as possible so you can get into bed without tripping over an errant object on the floor. In Bowie’s case, his left pupil remained permanently expanded, leading to his famous pair of blue and black eyes. And despite the fistfight, the boys’ relationship healed: The two became lifelong friends and artistic collaborators, so apparently they were able to move past their teenage scuffle.

The ability to monitor the constriction and dilation of the pupils has been utilized for years by medical professionals in the assessment of patients with brain injury. You've all seen a doctor shine a penlight into a patient's eye and watch to see if the pupil constricts in response to light and then dilates back to normal.

While this is a useful part of a neurologic examination it can be somewhat subjective and also doesn't detect much of the very subtle changes in pupil function that are too fast to be seen by the naked eye.

A technology first developed about 20 years ago called quantitative pupillometry uses high speed cameras to measure the speed at which the pupils constrict, any delay in response, how much they constrict, and how long it takes before the pupils dilate back to normal. As many of these functions take place in a matter of milliseconds this testing gives far more detailed and objective data than what could be seen on a neurologic examination by a doctor.

This is highly relevant to brain injury as we know that dysfunction in the autonomic, or unconscious portion of the nervous system is what can impact pupillary function. Normative data exists that we can compare our patients to, and this test not only helps us confirm the diagnosis of TBI but also can help guide and monitor progress of the treatment we are providing.

As you can see, David Bowie's eyes would have completely thrown this testing for a loop, but fortunately aniscoria is a fairly rare condition that is easily observed on an initial examination of the patient!

If you have a TBI client you feel would benefit from this testing, TBI rehab, or neurology eval, please reach out to Dr. Walker directly at 904-616-1284 or by email at [email protected].

Our goat at Ethos is the raise the standard of care across the country for patients suffering with concussions and increase the treatment options made available to them.

The Ancient Greek Astronomy Computer That Has Changed How TBI Is Diagnosed And Treated

In 1900, a deep sea diver named Elias Stadiatis emerged from the eastern Mediterranean sea visibly shaken and mumbling about a "heap of dead naked people". He was part of a sponge diving expedition, so it's understandable that what he saw threw him for a loop!

It turns out that his crew had uncovered an ancient shipwreck, and the "dead naked people" were marble statues that had been strewn across the sea floor. This discovery prompted what would become the first major underwater archaeological dig in history that would yield artifacts far more interesting than just ancient sculptures.

One object recovered from the site was roughly the size of a dictionary and was thought at first to be a mass of coins that had fused together. However, months later at the National Archaeological Museum in Athens the lump began to fall apart revealing precision bronze gearwheels that were not thought to have existed for many centuries after the date of the wreck.

It turns out that the sponge divers had accidentally uncovered what became known as the Antikythera mechanism, essentially the earliest analog computer known to man. It contains over 80 individual moving parts intricately engineered together to help track the movements of the planets and stars.

Scientists remain to this day baffled that a device of such high complexity was created in the ancient world, but this amazing technology remains utterly primitive when compared to even the simplest computer we use on a daily basis today.

This same acceleration of technology has changed the way TBI is confirmed and treated. While the initial diagnosis of mTBI (aka concussion) is still made clinically, technology like video nystagmography (VNG), oculomotor tracking, QEEG with event related potentials, quantitative pupillometry, and many other devices serve two purposes:

To confirm the established diagnosis of TBI

To guide and inform treatment for the patient

This is a very important distinction, particularly as it relates to Daubert challenges, in that TBI is not diagnosed off of any single test in isolation, but rather it's a clinical diagnosis made by a healthcare provider that technology allows for much more objective confirmation and fine tuned guidance of treatment.

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.

How Target Predicted A Teen Girl Was Pregnant....Will Your iPhone Do The Same For TBI?

The amount of data that is being collected on a given day in our lives is quite frankly staggering. Retailers have perfected the science of data mining to predict purchasing patterns, trends, and apparently even pregnancy.

Target is one of the most sophisticated retailers when it comes to the analysis of consumer shopping habits, largely because of the reams of data generated by it's app many shoppers use. One of the predictions Target data scientists learned to make was pregnancy, as this is a very lucrative stage of life for retailers given that there are loads of purchases that are now a necessity, and price sensitivity is typically lower than normal.

For example, lots of people buy lotion, but Target noticed that women on the baby registry were buying larger quantities of unscented lotion around the beginning of their second trimester. They also noted that sometime in the first 20 weeks, pregnant women loaded up on supplements like calcium, magnesium and zinc. Many shoppers purchase soap and cotton balls, but when someone suddenly starts buying lots of scent-free soap and extra-big bags of cotton balls, in addition to hand sanitizers and washcloths, it signals they could be getting close to their delivery date.

All of came to a head a few years ago for Target when a store manager in Minneapolis was confronted by an angry father.

“My daughter got this in the mail!” he said. “She’s still in high school, and you’re sending her coupons for baby clothes and cribs? Are you trying to encourage her to get pregnant?”

The manager didn’t have any idea what the man was talking about. He looked at the mailer. Sure enough, it was addressed to the man’s daughter and contained advertisements for maternity clothing, nursery furniture and pictures of smiling infants. The manager apologized and then called a few days later to apologize again.

On the phone, though, the father was somewhat abashed. “I had a talk with my daughter,” he said. “It turns out there’s been some activities in my house I haven’t been completely aware of. She’s due in August. I owe you an apology.”

This brings me to a study I read that was recently published in the journal, Nature. The study discovered that the results of neuropsychological testing could be predicted by analyzing 7 days of smartphone usage (you can check out the study by clicking the link below). The authors claim that, "preliminary results suggest that passive measures from smartphone use could be a continuous ecological surrogate for laboratory-based neuropsychological assessment."

While I don't think this will replace neuropsych testing anytime soon, it is fascinating to see that how a smart phone is used gives equivalent data to measuring executive function, dexterity, trail making, and cognitive function with sophisticated testing. There are also software programs in the works that can assess cognitive function via analyzing typing and speech patterns, so this is just the tip of the iceberg for the biomarkers we'll soon be able to assess.

With the array of testing available at Ethos we can't predict pregnancy, but we do have a robust amount of data that can be reviewed with VNG, EEG with ERP, oculomotor tracking, balance testing, and much more. If you or someone you know would benefit from TBI diagnostics, TBI rehab or therapy, or neurology evaluation at any of our locations across Florida, please reach out via email at [email protected] or you can call directly at 904-616-1284.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550173/

A Weird Recipe for Squishy Brains by A Leading Neurologist

If you're like most people you've never had the opportunity (if you want to look at it this way) to touch a human brain. You probably envision it as having a firm, rubbery type of texture, but in reality, the brain has a much softer texture that feels more like tofu or butter. When you add to that the numerous sharp edges and protuberances inside the skull, it's easy to see how the brain can be injured in events that might not seem particularly violent, like a low speed car crash.

If you're ever wanted to feel the consistency of the brain first hand, but are a bit squeamish about how this could be achieved then world-renowned neurologist Daniel Amen has a solution for you.

Watch the video below to see how you can recreate the squish feel of the human brain:

https://www.youtube.com/watch?v=eA9kJGqHX4A

I haven't cooked this up in my kitchen yet, so drop me a line if you actually recreate Dr. Amen's brain recipe and tell me what you think.

If you'd like to see a more realistic video showing the soft, pliable nature of brain tissue, this if from the University of Utah's Neurosurgery Department (warning, don't watch if you are disturbed by blood as this is a much more clinical video than the first one).

https://www.youtube.com/watch?v=jHxyP-nUhUY

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.