Probing brain's recovery mechanisms after traumatic injury

Whether it's caused by a car crash, a fall or some other incident, traumatic brain injury can be debilitating. Cognitive functions such as memory and language are often impaired. So are motor skills like coordination and balance. Dr. Robin Green is trying to better understand how cognitive and motor functions recover after traumatic brain injury.

A Scientist at Toronto Rehab, Dr. Green has developed an intriguing theory, which she has so far investigated in a pilot study. Her research suggests there is 'competition' between recovery of cognitive and motor functions after traumatic brain injury. In other words, the more one of these areas recovers, the less the other one does.

This may be because injured parts of the brain must "compete" for the limited neural resources that support recovery following injury.

"If that's true, it's extremely important because it suggests that during rehab, clinicians and patients might have to choose which functions to try and rehabilitate first," says Dr. Green. "Also, if there really is competition, this will provide an opportunity to enhance recovery by looking for interventions that diminish competition."

At the moment, Dr. Green and her team are trying to replicate their preliminary findings. "We want to make sure what we're seeing is authentic before taking the findings to the clinical arena," she says.

"We know that many of these patients have difficulty interacting with other people socially. This might have something to do with their inability to read emotions on people's faces, which we are learning is a very common problem. We now have some evidence about what is causing these problems. This may pave the way for effective therapy."

Dr. Green has always been interested in how the brain works. After her clinical training in neuropsychology, she became fascinated by the extent to which the brain spontaneously recovers following an injury. " We know the brain changes a lot after injury, and those changes support recovery. I'm interested in how we can augment those changes to improve recovery."

To Dr. Green, the way the brain recovers after injury, when it does, is intriguing and awe-inspiring. "I will sometimes see a patient one month after injury who is completely debilitated. He can barely walk, talk or remember anything from one minute to the next. A year later he's walking, talking and back at work. How did his brain repair itself? It's wonderful and fascinating."

Dr. Green serves on the Research Ethics Board at Toronto Rehab and is co-founder and co-chair of Toronto Rehab's Researchers' Network.

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