Brain Mapping and Cognitive Recovery with Dr. Michael Bagnell | E13 - Life After Impact: The Concussion Recovery Podcast

Episode Transcript
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Speaker 1 (00:00):
And we look at two factors in your brain map how
much power in every brain wave,every bandwidth?
How much power Do you have?
Too much power or too littlepower, or a normal amount of
power, normative range.
And then we look at coherence,like the communicating signal.
So an example of coherencewould be you and I are talking,
we can hear each other.

(00:20):
We have normal coherence.
If I turn off, if I mute myselfand I'm talking, hypo coherence
it's too low, you can't hear me.
And if I turn up your volumeand turn up my volume and we're
yelling at each other, that'shyper coherence.
So think about the brain kindof screaming at different places
inside or racing thoughts.
Hypo coherence is supersluggish.

(00:42):
Another way to think about itis like too much gas and too
much brake in the car.
And so we're looking at thesemeasures coherence and power.

Speaker 2 (00:51):
Welcome to Life After Impact the concussion recovery
podcast.
I'm Dr Ayla Wolf and I'll behosting today's episode, where
we help you navigate the oftenconfusing, frustrating and
overwhelming journey ofconcussion and brain injury
recovery.
This podcast is your go-toresource for actionable
information, whether you'redealing with a recent concussion

(01:12):
, struggling withpost-concussion syndrome or just
feeling stuck in your healingprocess.
In each episode, we dive deepinto the symptoms, testing,
treatments and neurologicalinsights that can help you move
forward with clarity andconfidence.
We bring you leading experts inthe world of brain health,
functional neurology andrehabilitation to share their

(01:34):
wisdom and strategies.
So if you're feeling lost,hopeless or like no one
understands what you're goingthrough, know that you are not
alone.
This podcast can be your guideand partner in recovery, helping
you build a better life afterimpact.
All right, dr Bagnell, thank youso much for being on the show

(01:55):
today.
I am so excited to talk to you.
You have been a functionalneurologist, and in private
practice, for over 30 years inSouth Florida, and one of the
things that I absolutely love isthat you call yourself a health
detective, and I love, love,love that.
I think we need more healthdetectives in the world, so why
don't you start by giving us alittle bit about your background

(02:18):
, how you became interested inneurological disorders
specifically, and then we can gofrom there.

Speaker 1 (02:29):
Very good.
Yeah, thanks for having me.
I'm excited to be on.
So it's always nice to be ableto share with another colleague
and for people, lay people oreven professionals, really what
it is we do in the differentworlds of neurology and oriental
medicine oriental medicine,excuse me.
So this is kind of fascinatingfor me.
This is a first.
I love it.
So, yes, I, when I graduatedchiropractic university many
years ago, I was very interestedin the brain, right out of the

(02:50):
doors basically, and so Istarted with program with Dr
Carrick, who we both know, kindof the patriarch of functional
neurology, and at that point itwas a postgraduate program for
doctors to really start tounderstand more of the
neurologic basis of physicalmedicine, chiropractic.
And so that began and I waslike, so intrigued and

(03:11):
fascinated.
So this is going back to 89 and90.
And, as life would have it, Iwas always interested.
But we got married and childrenand said, okay, time to work,
pause the studying for a whilein a way, and so I had to put
that a little bit on the backburner.
But I was always interested inthe brain, the nervous system

(03:32):
and the understanding of thedifferent aspects of how it
really works, which, of coursethat many years ago wasn't
neuroscience so much, it wasmore neurology.
So as the years went forward,my wife gave me the green light,
many years later, as our kidswere older and grandkids were
already on the way and alreadyhere she said you really love
that, you might want to jumpback into that.

(03:53):
So I did get back intofunctional neurology, which was
much more advanced at that point, and completed the fellowship
and brain injury rehabilitation.
So that gave me a beautifulwindow into what we could do
with people who have thedifficult cases like we were
talking about previously, thereally challenging ones that

(04:14):
don't seem to respond to othertypes of approaches, or no one
was able to help them or no oneeven in a way believed, because
it's really the invisible injury, isn't it?
People that continue to suffer.
They say you have that minorthing, how could that still be
bothering you?
So our work in functionalneurology yours and mine has
really opened up a window, maybeeven a door, we might say maybe

(04:37):
even sliding doors, big doorsinto what's really going on in
the brain and how can we helppeople to not only recover but
optimize really their brainfunction right, to get back all
of these functions and maybeeven improve to a way that they
didn't even anticipate.
So that's been my healthdetective journey, and I did
write a book like no, you're onthe path to that and I can't

(05:00):
wait to see that and read that.
But that was about detectives,because I feel that good
medicine is looking into manythings, not just what I like to
call it fast and slow medicine.
Right, like fast food.
I'm not into fast food, neverhave been and I'm not into fast
medicine like oh yes, this, this, this here, take this, do that,

(05:21):
you're done.
Let's really spend time I knowyou do, so this is at your heart
too and get into what is goingon with the person and keep
asking myself the question whyis that and why is that and why
do they have this and why,rather than just defaulting to
something that might beseemingly simple but yet not get

(05:43):
the quality of results.
So we're really into one-to-onepatient care, very focused,
highly specific, high touch mywife likes to say high touch and
high level quality.
And so that's being a detectiveis looking for the clues, as I
know you do looking for theclues and getting underneath the
hood to help people get back tothe things they want and love

(06:05):
to do.

Speaker 2 (06:06):
I love that.
I love that concept of fastversus slow medicine and
especially when it comes to thebrain and people that have had
brain injuries, they need peopleto put the time in to ask the
questions and do theinvestigation, and so I just I
love that kind ofdifferentiation there between
fast and slow.

Speaker 1 (06:25):
It's great yes, agree 100% with you.

Speaker 2 (06:29):
Yeah well, today I wanted to explore the topic of
cognitive symptoms and cognitivedysfunction, because that is
one of the things that so manypeople do experience, and a lot
of the you know the researchsays, oh, maybe% to 30% of
people go on to have lingering,persistent symptoms, but then
when they started looking atactual cognitive symptoms, they

(06:51):
started to recognize, ooh, maybethat number's closer to like
40% to 50% of people actuallyexperience lasting cognitive
symptoms, and so I think thatnow that the research has gotten
a little bit better at payingattention to the cognitive
aspect, we're recognizing that'sreally important.

Speaker 1 (07:10):
Yeah, I agree.
Yeah, the cognitive aspect.
Actually, this is a perfectdiscussion because we just
completed a two-week immersive.
Many of our clients come fromdifferent locations, as I'm sure
yours do, around the country,even some from outside the
country for shorter periods oftime, called immersives, and
this one young man who's incollege, he was dealing with
let's just call it brain fogthat's the way he positioned it

(07:33):
which affected his ability tofunction in college, so his
cognitive abilities, and so whenwe looked at him, we had to get
under the hood as a healthdetective and determine what
could be causing this experienceof a cognitive impairment we
could say in some officiallanguage, or brain fog in his

(07:54):
language.
And so he had been to the MayoClinic with his family.
He had been to numerous otherpractitioners in different
disciplines looking atimmunology, which of course
could be a very importantcomponent, gastrointestinal,
another very important componentthat should be considered, mayo
Clinic, looking at things likechronic fatigue syndrome.

(08:15):
When we looked at everything,all the information, and
re-evaluate everythingneurologically, really from a
hierarchy, you know, we startwith what I call brain-based
healthcare.
So here's another nugget wethink about brain-based
healthcare, so we're looking atthe brain to determine is it
primarily involved with whatyou're dealing with, or
secondarily involved or notinvolved.

(08:37):
And so if we can go throughthat hierarchy, we can determine
is this someone we can help oris this someone that really
needs to be referred to theappropriate type of caretaker?
So with him, his brain fog, hiscognitive issues would be in
this category dysautonomia.
His blood pressure when hestood up would drop and his

(08:58):
heart rate would soar.
So you can imagine if yourheart rate went up to as if you
were jogging 120, let's say,well, maybe, if most people
might be in that area, 120 with30.
But his blood pressure wentdown to 90 over 60.
And if you're 6'3" and yourblood pressure drops down and
you're a 20-year-old male whowas a high school state champion

(09:19):
volleyball player, that's not agood feeling player, that's not
a good feeling.
And so we realized, throughautonomic testing on a tilt
table, we ran the tests, we ranevaluations for what's going on
in his brainstem, which isreally that autonomic hub.
We could say we're looking at ablood flow issue, a brain to
cardiovascular blood flow issueto his brain.

(09:41):
Is that the source for everyonewith cognitive issues?
No, it's not.
But with him that's theunderlying cause.
And so we worked the whole week.
We got him a percentageimprovement and actually I was
on a Zoom call with himyesterday.
We follow our patients afterthat for weeks each week to
determine are the things weprescribed for them helping them

(10:03):
to trend in a still continuedimprovement direction?
So yesterday we tweaked some ofhis exercises, so to speak.
We improve those, we got rid ofsome things that were not
seeming to help and keep movingthe needle forward for clarity
with his cognitive function byimproving his dysautonomia.

Speaker 2 (10:23):
I love that and I think that that speaks volumes
to the health detective thatsaid okay, we've got a case of
brain fog, this could be comingfrom a gut dysbiosis, it could
be coming from other issues, andso that autonomic testing is
such an important foundation ofthe work that we do, because the
autonomic nervous systemcontrols so many things, and I

(10:48):
think that one of the thingsthat we often talk about,
especially in the world ofChinese medicine and acupuncture
, is blood flow right, Bloodflow to the brain, and I think
also, people can maybe get alittle confused between global
blood flow versus regional bloodflow and this idea that you can
have kind of maybe in somecases, normal overall global
blood flow versus regional bloodflow, and this idea that you
can have kind of maybe in somecases, normal overall global

(11:09):
blood flow, but when you'retrying to activate certain parts
of your brain, it's yourautonomic nervous system that is
supposed to say, ooh, I need tosend more blood flow to that
prefrontal cortex so that peoplecan be thinking and
strategizing, and that thatactually might not be working so
well either.
Can you speak a little bit tohow you are kind of assessing
these maybe regional aspects ofblood flow and activation?

Speaker 1 (11:33):
Yeah, very good.
I love the way you're kind oftaking what I'm saying and then
kind of putting in a better.
I, like you, tie a bow on it.
That's very good.
So let's throw out aterminology for your listeners
neurovascular coupling.
Neurovascular coupling and I'mputting my fingers together we
can see on the video like thesethings are bound together.
So my nervous system, my nerves,neurology, is bound to my blood

(11:56):
vessels to allow them to get asignal to function in that
moment.
As you're saying, even insidethe brain, where we're
delivering blood flow indifferent directions.
So, as we need things in thebody, if I'm going to run, I
need to shunt blood to my legsand my lungs and, of course, my
head.
If I'm going to do bicep curls,I better shunt blood to my

(12:16):
biceps.
If I'm going to be working in acognitive capacity, working in
some problem solving, I betterbe shunting blood to that
frontal lobe.
And when someone has an injury,that system can become uncoupled
.
So it may not shunt blood at amoment right, in the right
moment that you need it.
It may be a little delayed,which we call a latency, it may

(12:39):
be a little slower, so I don'tfeel quite good.
Oh, a very good example of this, for most people have
experienced it.
You're laying down, you standup really quick and you might
feel a little bit of like, oh,I'm a little light-headed.
I mean, most of us have feltthat to some small degree.
Well, someone with dysautonomiamight stand up, as you know,
and might feel horrible for fiveminutes and that would be

(13:02):
difficult, right, but theneventually, oh, I'm starting to
feel okay now.
So there's a latency, it's tooslow.
These things arephysiologically linked in time.
So things happen soautomatically, right, so in
milliseconds, these things areall operating because your brain
is really good and it's tightlywired to the blood vascular
system and the heart, regulatingthe heart.

(13:23):
Actually, most people don'trealize right, you and I do that
the brain regulates the heartfunction.
Right, you know, we have oneelectrical system causing
another electrical and pumpingsystem, more of kind of like a
plumbing system, to move.
So I love that languageneurovascular coupling, that is

(13:43):
language that is in theliterature that gets somewhat
uncoupled when we have an injury.
It could happen in our brain,it could happen in our limbs, it
could happen in one leg or inone arm, you know.
So we want to evaluate.
So your question was how do weevaluate that?
So when we run a tilt table,which is really in the past, has
been considered the goldstandard for evaluating that.
So when we run a tilt table,which is really in the past, has

(14:05):
been considered the goldstandard for evaluating that.
Now we know there's another test, the hand grip test, which
gives you a very good windowinto the same type of function
or dysfunction of the autonomicsystem.
But we'll focus on the tilttable test where we hook up
pulse oximeters to the feet andthe hands.

(14:26):
So we're watching the oximetry,the oxygenation of tissues in
the extremities, blood pressure,cuffs on the ankles and the arm
, and EKG.
So we're monitoring heart,we're monitoring things in the
extremities, we're monitoringall these parameters of the
sympathetic, the parasympatheticsystem and how they react.

(14:48):
When we have someone dodifferent types of parameters,
like deep breathing, maybe we'llhave them do a breath hold,
which is called a Valsalva, youknow.
We'll have them do a hand gripduring the test and we'll bring
the table up into an uprightposition, which really is not a

(15:08):
stress for the person whosenervous system is working right,
but it's a pretty big stress ifyour autonomic system has been
injured through a concussion.

Speaker 2 (15:16):
Absolutely, and in Chinese medicine we have the
saying that's been there forthousands of years where qi goes
, blood flows, and that wastheir way thousands of years ago
of saying we don't have enoughblood to be perfusing everywhere
, at every point.
And, like you said, if we'reeating, our blood needs to go to
our stomach to help digest.

(15:37):
If we're using our brain, weneed to send blood up to our
frontal lobe and our cortex.
If we're exercising, we need tosend to our muscles, and so you
know this idea of uncoupling.
It's the same concept Like ifwe're trying to do cognitive
work, we're trying to use ourenergy, our chi, and then all of
a sudden it's not coupled withblood flow.
Well then that manifestation ofbrain fog kicks in, and often I

(16:00):
hear people describe it as mybrain just doesn't want to work,
which is a very frustratingexperience for people,
especially when they are at workor at school.

Speaker 1 (16:11):
Yeah, when you need to step on the gas, so to speak,
for your brain, you need it torespond right now, just like
you're on the highway or you'regetting on the highway.
You can't have a sluggish car,that's kind of sputtering
because it's dangerous.
So it may not be as dangerousin the cognitive realm, but it's
very frustrating, it's verylimiting and it can create even
mood changes for people becauseyou're not the person you used

(16:33):
to be.
And so it's important for us toconsider how do we analyze it?
As you're saying and I reallylike that language, I never
heard that before where chi goes, blood flows.
That's very good, something newfor me to put on my tool belt
that I can speak.
Yeah, I enjoy that.
Yeah, but how to analyze itproperly?
Because, as we talked aboutbefore we started, a lot of

(16:56):
people are not it's notacknowledged by a clinician or
physician.
I mean, we're in a very largemetropolitan area.
I know you're in Minnesota, Iknow how large it is, but Miami
is very large and I can't tellyou the number of patients who
have come to us and said my, Iwon't even say names, but this
kind of physician, this kind ofphysician, this kind of

(17:16):
therapist said I don't reallyhave that.
Here's an antidepressant.
You don't really have that,here's an antidepressant.
You don't really have that, youjust need to exercise more.
You don't really have that, youneed this.
And I thought, my goodness,because we know people with
brain injuries.
It's very hard for them to getand longer term symptoms.
It's very hard for them to getthe proper type of analysis.
We even had a 10 yearold boyfrom out of town who found out

(17:41):
about us.
The parents brought him to usand he had had a concussion.
He was a very high-levelbaseball player.
As a kid got hit in the facewith a fly ball, suffered a
concussion and weeks after thatwas suffering with various
symptoms, anxiety and apediatric neurologist said kids
don't get concussions.
Are you serious?
Are you kidding me?

(18:02):
Wow, are you kidding me?
It reminds me of a movie whereMatt Damon Martian the movie
Martian.

Speaker 2 (18:10):
I don't know if maybe your listeners?
Yeah, love the book, love themovie.

Speaker 1 (18:14):
Yeah, yeah, you like the books.
Yeah, I need to read more.
But all these are the thingsI'm reading, all that how the
brain's working.
But he says they say to him,when he says we're gonna have to
come and get you, it's a delay,and he says Are you serious?
Are you really serious?
So I mean, that's what I wantedto say.
Of course I didn't say that,but I thought this is a problem.
But not everyone has thetraining.

(18:34):
So I'm going to say that noteveryone has the training, but
at least don't diminish the factthat and I will say this often
because I think I've made manyerrors over the years is that
it's possible.
I'll say to a patient askingwhat do you think about this or
that or this?
I say, well, I guess it'spossible.
It is possible.
Instead of shooting somethingdown.

(18:55):
We really want to supportpatients.
We want to give them agency torecover their health.
Even if it's not in mywheelhouse, someone might ask me
something about a medication.
I said, well, it might be ahelp.
I'm not really certain, butit's possible.
So I think, giving openpossibilities as a person that
people come to like yourself andmyself, being careful with

(19:18):
taking care of them empathy andconcern and not thinking I know
everything, because I certainlydon't, you know, I don't want to
close the door on thepossibility of hope for them and
we want to look at thingsprudently and rationally and
with data and with information.

Speaker 2 (19:33):
Absolutely.
And I think too, you know, whenyou talk about doing the tilt
table testing and you'reobserving that somebody's blood
pressure is dropping and thentheir heart rate goes up, the
conventional approach is to say,well, let's just try to
artificially control this withpharmaceuticals.
And so you do get a lot ofpeople that are just given a
beta blocker to try to lower theheart rate.

(19:56):
And I think it's reallyimportant to recognize the error
in the system is the originalerror is not necessarily the
elevated heart rate.
And I think it's reallyimportant to recognize, you know
, the error in the system is theoriginal error is not
necessarily the elevated heartrate, that's just a reaction to
everything else that's notfunctioning right.
And so you're kind of coming inand trying to just squash a
response to an error, and so Ithink it's really important for
people to recognize that.

(20:16):
That's one of the reasons whythe outcomes of just trying to
artificially control theautonomic nervous system
typically don't have goodoutcomes.

Speaker 1 (20:27):
It's oh, that is very well said the error in the
system.
I like that a lot because thatis very accurate.
Everyone does what is in theirwheelhouse, right?
So whether you're achiropractic physician, whether
you're an oriental medicinephysician, whether you're a you
know, a traditional neurologist,we might say, or cardiologist,

(20:48):
you're going to work with what'sin your wheelhouse.
What I think is beautiful aboutthe area that we have been had
the opportunity to work in isthat we have the opportunity to
think outside the box.
That's not necessarilysomething that they can do.
I'm trying to be morealtruistic, right, they're
trying to do the best that theycan, but they're working within
a limited range.
Like, if you do not prescribethose things, there's five other

(21:10):
doctors that will testifyagainst you that you should have
prescribed them.
So that's a problem, becausethe modeling for what's really
going on, as you said, where'sthe error in the system is not
being addressed.
It's symptomatic, even if itdoes give symptomatic relief.
And how much more?
If you get an ablation and youdidn't need it, that's even more
intense, right?

(21:31):
So I agree with you Havingpeople that are working outside
of the traditional quote areaand thinking a little
differently can be verybeautiful.
We see that all over thecountry.
Right, If we can thinkdifferently and talk, maybe we
can help people more.
So it's really wonderful toknow that.
Yeah, drugs are reallysuppressive in one area and

(21:52):
they're not going to actuallystrengthen.
So when people say, yeah,there's no cure for dysautonomia
, I say, well, what do you meanby that?
Because if you can strengthenit and resolve the imbalance in
that dysautonomic function,isn't that a cure?
If a person doesn't have thesymptoms anymore and they can
function to the capacity theydid?
So I wouldn't say that lightly,like oh, we cure everyone.

(22:12):
That's foolishness.
But I would say let's look atwhat's a resolution rather than
just a compensation withmedication or salt intake or
stockings or an abdominal beltor something that's compensating
you.
Let's get in there and see ifwe can understand it, untangle

(22:32):
it and then fix it if possible,for the long-term health that
you might be able to enjoy.

Speaker 2 (22:38):
Yeah, absolutely.
And if the point of theautonomic nervous system is to
be responsive to what'shappening in the moment, taking
a medication that takes awaythat responsiveness is also not
a great long term solution.

Speaker 1 (22:51):
Yeah, totally, that's very well said.
You know, when we talkautonomics, you know we're
talking about heart rate andblood pressure and blood flow
and it's probably good tomention all the other end organs
that can be affected becausepeople may go in that direction.
So we mentioned gut.
I think there's two things Iwant to mention, but this one
will be the first one.

(23:12):
So someone, let's say theirdisautonomic function affects
their gut much more.
They may go off to the GIspecialist.
If someone else is saying, youknow, I'm in my fifties, I think
my hormones are probably thesource of this problem.
Now they're off to theendocrinologist or the
gynecologist or to someone inanti-aging medicine Could be a
help.
Or if they say I'm havingproblems with, you know, dry

(23:34):
eyes.
So these end organs of theautonomic system can cause
someone to go off into thatdirection not inappropriate, but
not the whole picture maybe.
And so we've tried to look backat what other symptoms they're
having.
And there's a very good surveythat someone can do a compass 31

(23:54):
, to give you an overview oftheir autonomic system.
I'm sure you can probably linkthat into the podcast so people
can do it on their own andunderstand.
Am I having issues like this,because this might be part of
all of my other issues as theunderlying cause.
I think that's really critical.
I'll stop there because I keephaving very long answers.
I'll give you a chance to jumpin.

Speaker 2 (24:15):
That's great.
To take it back to ancientChinese medicine, which really
did have a reference frame fordysautonomia, they talked about
disharmonies, and they talkedabout disharmonies between the
circadian rhythm and the abilityto actually have a proper
immune response, and thesedisharmonies between how the
kidneys and the heart arefunctioning and disharmonies

(24:37):
between the liver and the spleen, or that really manifests as
these digestive problems, and sothey were really looking at
this from a functionalperspective a long time ago to
say where is the disharmony?
And again like how can weharmonize the system which, when
it comes to dysautonomia, youknow, that's really what we're
trying to do too, as functionalneurologists is we're like how

(24:58):
do we bring harmony back to asystem that controls so many
different things in the body?

Speaker 1 (25:05):
Yeah, I mean so far ahead of its time, oriental
medicine, right Even medicineback then, as you're saying that
it's like, yeah, they wereright on the money and you're
talking about blood flow.
We don't really talk about thatin.
We'll call it Western medicineor more modern medicine in terms
of the whole body.
It's rather that you have acirculatory issue you go to, you
know, but not in terms of thewhole body, like global or local

(25:27):
or regional, but yet you allwere doing it thousands of years
ago, at least considering it.
Now we just have differentlanguage, but it actually was
already a thing.
I've often thought of that whenit comes to the chakras, and for
my thought is just and this isa little off topic is what would
be the kind of possibleequivalent of that?

(25:48):
And I'm thinking about theendocrine system, all these
midline glandular functions thatare energetic in a way.
Anyway, that's just a littleside note, but there's so many
things that are, I don't evenwant to say confirmed in Western
medicine, but as science hasidentified things or as
technology has been able toidentify things, we go oh, that
was right on the money.
In Oriental medicine, that wasright on the money, and so this

(26:11):
is really beautiful that youhave the marriage in your own
practice of those two things.
I really appreciate that.

Speaker 2 (26:19):
Thank you.
For me, I look at it as maps.
You know, if you're hiking inthe woods, you need a trail map
or a topographical map.
If you're driving in a car, youwant a roadmap, and so all
these different forms ofmedicine and all these different
ways of looking at the brainand the body are just.
They're just maps that we canuse interchangeably to say what
is the appropriate map I want touse right now to kind of look

(26:40):
at this particular problem.
So you know, no attachment toany map, just what's the what's
a good map right now forapproaching the problem.

Speaker 1 (26:49):
Yeah, but you got to have a few maps in your backpack
so you can decide which oneright?
Yeah, that's right.
Topographical is it more rivermap?
Is it more, you know,atmospheric map?
You better have a couple ofmaps and you do.
That's the beauty of that.

Speaker 2 (27:03):
Yeah, talk to me a little bit about the QEEG that
you use, because that also givesyou a whole nother level of
analysis to say where is thebrainwave activity happening.
That's maybe a little bitdepressed or too active, and I
would love if you could kind oftie that into patterns that you
see in maybe people that arecoming in with brain fog or

(27:24):
cognitive symptoms versus, say,I know you do a lot of work with
kids with ADHD and I'd becurious if you could speak to
maybe any kind of differentpatterns that you see with
somebody that has ADHD versussomebody that's coming in with
post-concussion syndrome andcognitive symptoms.

Speaker 1 (27:42):
Yeah, it's very good.
So one of the analysis tools weuse is a brain map, an EEG,
known to us as a QEEG, as youmentioned, which is a
quantitative EEG.
So the difference if someonesays, yeah, I already did that,
I went to the hospital, I hadthat after my concussion and
they didn't find anything.
I said no problem, so that'sgood.

(28:03):
What they're primarily lookingfor, I would say, is any type of
seizure activity,post-concussion, so epileptiform
, to use the right language.
But in the absence of that,you're good to go.
When we do the analysis, wetake the data and we compare it
to normative databases oneEuropean model, one American

(28:23):
model and we look at two factorsin your brain map how much
power in every brain wave, everybandwidth, how much power?
Do you have?
Too much power or too littlepower?
Or a normal amount of power,normative range, normal amount
of power, normative range.
And then we look at coherence,like the communicating signal.
So an example of coherencewould be you and I are talking,

(28:44):
we can hear each other, we havenormal coherence.
If I turn off, if I mute myselfand I'm talking, hypo coherence
, it's too low, you can't hearme.
And if I turn up your volumeand turn up my volume, we're
yelling at each other.
That's hypercoherence.
So think about the brain kindof screaming at different places
inside or racing thoughts.
Hypocoherence is super sluggish.

(29:07):
Another way to think about itis like too much gas and too
much brake in the car.
And so we're looking at thesemeasures, coherence and power,
and we compare them to anormative database.
So we have people withpost-concussion or concussion.
We have people with cognitiveissues, maybe from the
concussion or not, and we havepeople with ADHD.
Actually, as you know, someonecould have a post-concussion

(29:30):
effect and not have a classicADHD diagnosed, maybe early in
their life, but could developattentional problems because of
the injury right.
So there may be moreself-diagnosed, but there are
signatures.
There are signatures when youlook at a brain map.
So it's not really ethical todiagnose from a brain map.

(29:52):
That's known across neuroethicswhen we're looking at EEG.
But what we can do is say thereis a signature pattern here.
There's a pattern and thatpattern is common with people
who have brain injuries and thatpattern would be too much delta
and too much high beta.
So a quick class on thebrainwaves right, very short,

(30:13):
probably good for listeners.
Five brainwaves we'll just talkabout that.
Delta is very slow, deep sleep,theta is a little bit faster.
That's your REM sleep.
Very important.
Alpha is a beautiful brainwave,the first one ever identified,
considered very flow state, verymuch where people want to train

(30:34):
to be in their athletic best.
So they're kind of relaxed butthey're still sharp and crisp
and ready.
I always say it's kind of likefor us waking still sharp and
crisp and ready.
I always say it's kind of likefor us waking up in Asheville on
a fall morning and having anice coffee on the deck and just
being.
I'm ready to go but I'm chill.
That's my thought of alpha.
Or maybe a summer in Minnesotasummer, but not winter.

(30:55):
It can't be winter, unless youlove that then it would be your
alpha.

Speaker 2 (30:59):
I mean, going snowshoeing during a snowfall is
pretty relaxing no, that's true.

Speaker 1 (31:04):
I haven't experienced it, but that sounds like yeah,
I think that would be a goodthing.
So alpha is this very flexiblebrain wave.
It increases when we close oureyes, when you're visualizing
something.
If you're that type of person,your alpha goes high.
If you're artistic, you have alot of alpha.
Then you go into beta.
Beta is a higher brainwave.
So if you're exercising alittle bit, you're in a beta

(31:26):
state, probably a low beta.
High beta is complex problemsolving Very good if you're a
complex problem solving, but canalso be agitation, could also
be anxiety if it's too much.
Then we rise up into gamma.
Gamma is a very high frequencyand I'm trying to make these
just simple for people becausethere's a lot of detail that can

(31:47):
be overlaid.
But you know just this was asimple takeaway.
Gamma is your memory, bindinginto deep memory the gestalt,
understanding the bigger pictureand being able to process that
deep in the memory.
So delta, theta, alpha, beta,high beta, gamma Great.
So when we look at someone witha brain map that has a lot of

(32:07):
delta in one region and they'renot asleep during the taking the
brain map and they have a lotof high beta, a question I would
ask is have you ever had abrain injury?
Have you ever had a concussion?
I ask it in different waysbecause some people say no, no
brain injury.
Did you ever hit your head kindof hard and you kind of knew it
for a while?
Oh yeah, that happened when Iwas 10 or 11.
Because there's a lot ofdefinitions.

(32:28):
That's part of the problem, asyou know, with concussion or
MTBI it's got this very andthey're trying to bring all that
into one alignment in theconsensus documents.
But to this point I thinkthere's over 50 different
definitions, which is a problem.
So we look at that signature doyou have that?
And if they have that, we startconsidering and looking into

(32:51):
that history very carefully.
And then we want to re-regulatethat brain, help that brain to
self-regulate better, and that'sthrough neurofeedback, training
and, which is a passive form oftherapy, very effective and
functional neurology, which isthe active form of therapy
layered together and I'm verymuch a fan of the passive and

(33:14):
the active together.
In my experience, which islimited, my own personal
experience, in my experience,which is limited, my own
personal experience people'sresponses are faster than what
you say, than previous historyof only doing passive types of
therapies.
So passive types of therapiesmight be CBT, as you know, or

(33:35):
audiovisual entrainment withsound and light, or
neurofeedback.
Those would be consideredpassive, but they're very
valuable to people recovering.
I like them layered togetherwith oriental medicine,
functional neurology, anotherapproach that complements it as
well.
So I'll pause there for aminute.

(33:56):
Did I answer the first part ofthat?

Speaker 2 (33:58):
You did yes, and I love that you are also
differentiating things betweenpassive and active, because in
my book I use the same languageto say here are passive
therapies that have shown to behelpful, here are the active
therapies.
It's important that you do both, and I've heard you speak
before about I think somebodyhad asked you a question of you

(34:20):
know well what is what's adevice I can try or what's a
therapy I can use.
And you gave such a greatanswer because you said it's not
just about let me go out andtry one thing, let me just do
vagal nerve stimulation or letme just do acupuncture.
It's about creating thisorchestra of therapies that
really help to bring integrityback to the body.

(34:41):
That is often a combination ofthese passive and active and
utilized in the appropriate dose, in the appropriate order, at
the right time, and so I lovethat.
That's kind of how you speak toit.

Speaker 1 (34:54):
Yeah, I agree with that.
They kind of it's helpful forthem to have a coach or kind of
a quarterback to help themfigure out what is their
personal brain formula.
That's helpful for them to havea coach or kind of a
quarterback to help them figureout what is their personal brain
formula.
That's the language we use here.
We help people determine theirpersonal brain formula, whether
you're a teenager, and if it's ayounger child, then we help the
parents determine their child'spersonal brain formula.

(35:14):
What does that mean?
What combination of thingstherapies, exercises, diet might
be the best based on the datawe have for their family member?

Speaker 2 (35:25):
Yeah, I like to tell people think of me like a
personal trainer for your brain.

Speaker 1 (35:32):
I like it.
I don't do one exercise in mygym, I don't just do pushups.
I have such a variety of thingsbands and ropes and box jumps,
and running and jogging and yoga.
So I do a variety of thingsbecause it affects my body in so
many different ways.
And so why not the same thingwith the brain?
Aren't we going to get a betterresponse because the brain is

(35:54):
doing so much all the time?
How about if we come at it fromdifferent directions and
different angles and differenttypes of demands on it to cause
it to increase its bandwidth,literally when we're talking
about brainwaves?
So another thought aboutbrainwaves is with attentional
issues.
So we have some areas that arevery important for attention the

(36:15):
midline I read the other dayactually, in a book the lady
discusses it as the Mohawk area.
So the midline, the cingulate,the limbic area very important
attention.
And then we have the frontalcortex, which most of us know.
And so here's one thing peopleshould start to think about that
your brain works in networks.

(36:36):
This is really helpful.
So it's not just this region orjust that region, it's how they
network together and this isimportant.
I talked with a father yesterday.
Came from out of the countrywith his daughter, the central
executive network carrying outyour activities, like we're
there right now, but later wemight drop our brain back into
the default mode network andkind of step back, consider our

(36:59):
future, consider things that arehopeful, consider, you know,
stepping back out of theactivity of the day, and so
these networks have to shiftback and forth and they do very
well, beautifully, as a matterof fact, until there's an injury
or there's a trauma or there is, etc.
An immune problem that canaffect the brain, like a

(37:20):
chemical concussion.
Almost right, we talk aboutthat.
You didn't have a physicalinjury, but you had so much
chemistry, maybe from an immuneoverload or Lyme or mold these
things happen a lot down herethat it overwhelmed the brain
chemically and caused the sametype of dysfunction as if there

(37:41):
was a physical injury.
So it's an inflammatory cascade.
So, attentional issues we workto train those areas of the
brain that are involved toimprove function, whether you
have diagnosed ADHD or whetheryou're dealing with attentional
problems as a result of aninjury later, whether you're

(38:01):
dealing with attentionalproblems as a result of an
injury later.
And that really touchescognition, because when you talk
about cognition, attention,focus and concentration are the
three main components.
Someone might say no, no memory.
I say yes, I agree 100%.
So I'm just using these topthree in this discussion
Concentration, attention andfocus and so we will do things

(38:22):
to drive activity into thoseareas, as long as there's good
blood flow, adequate blood flow,in an appropriate manner, like
you mentioned just a few minutesago, dose specific.
So we don't want to drivesomeone into complete fatigue.
We want to kind of exercisethat area of the brain as it's
getting good blood flow, becausewe actually fix that first, and

(38:43):
now that area is starting tobecome stronger, almost like a
muscle from a brain coach likeyou.

Speaker 2 (38:50):
And sorry to put you on the spot, but focus,
concentration and attention allsound like adjectives describing
the same thing.
Are you differentiating thosethree terms?

Speaker 1 (39:02):
They're a little bit different.
Yeah, because there's differentregions that come into play,
not completely different, likeif you drew three over, what is
it a Venn diagram?
And you had overlapping focus,concentration, attention.
There are some areas that areconsistent among all three in
the middle, but they also haveareas that are a bit different
and you can actually see theseon a platform where you don't

(39:23):
see the diagram, but you can.
You can read them on a platformthat you and I are both
familiar with, that is out ofCanada actually, that we use for
a lot of our cognitiveassessment, but we actually use
it in the office as well.
I can mention it's Crayos, itused to be Cambridge brain
science and so we'll use thatwith people where we'll do an
act, an active therapy, and thenthey'll come to the laptop and

(39:44):
I'll say, okay, I'll load it andthey'll do one that is focusing
on the right prefrontal cortexfor attention, and they'll do
that task.
Go back and do the activetherapy, come back and do the
task and I'll work them back andforth just as an example.
And it's pretty marvelous tosee are.
I'll work them back and forthjust as an example, and it's
pretty marvelous to see are theytrending up, are they staying
level, are they trending down?

(40:05):
And then I may send that homethrough their email and have
them do it every single day fora week until I'm seeing them
again, or things like that.
So I keep working the area thatI feel is the most needed to
bring up the other three,because if they're all
overlapping to some degree, ifyou strengthen one, you may have
an effect on the others, and infact that's what we see.
We see that yeah, excellent.

Speaker 2 (40:27):
I love that idea of you know, pairing different
exercises together and saying,okay, let's go activate this and
then come back and test that,and then go back and and
exercise this activity and thenretest, and I think that that is
, you know, like you said, beinga health detective, you're
being a detective in the middleof the therapy as well, to say

(40:47):
is this the right therapy?

Speaker 1 (40:50):
Yeah, I mean, as an example, we do, as you mentioned
, that you're going to have inyour book a chapter on
oculomotor and eye movements.
So how could they do a score?
Let's say they score, I'm justgoing to pick an arbitrary
number, an 80 percentile.
Then they do some oculomotorexercise, they come back and
they're at 82.
Then they go back and do theoculomotor exercises again that
are specified to them.

(41:11):
They come back and now they'reat 92.
Wow, that jumped up.
Now they go back and do themagain, they come back and
they're at 60.
I said, oh, we hit a fatiguelevel.
We're done so by activating andretesting the actual thing they
want to improve, becausethey're saying, doc, I'm not
that concerned, my eyes arebetter, I believe you, and those
are brain networks that arerunning my eyes, but I'm

(41:33):
concerned about my attention.
I said, look at your attentionjust improved.
Look at your score just went up.
And that's what we're going towork on, but not excessively so.
Especially with people withpost-concussion, we have to be
cautious and I know you are towatch their metabolic capacity
not to push them too far,because I have found well, I
think it's pretty classic youhave a group of people that

(41:53):
don't push themselves hardenough.
And then you have a lot ofpeople that really just push
themselves way too hard and theydo too many things I'm talking
about in post-concussion and soour job is to help them.
I'll say this word shepherdthem a little bit more here or a
little bit less here, kind ofguide them, walk with them, help
them through that and kind oftaper them down if they're going
too much, or get them going alittle bit more, maybe just to

(42:16):
the next level if they're notkind of doing enough.

Speaker 2 (42:19):
Well, and that touches upon that really
important concept of cognitivereserve.
And I think that's where some ofthe maybe traditional
neurocognitive testing is notcapturing the point at which
somebody gets fatigued and sosomebody that is coming in with
a really high level of cognitivereserve and cognitive capacity,
they get a concussion.

(42:40):
Maybe they can do aneurocognitive test and perform
just fine on it the first timearound, but if you ask them to
sit there and keep repeatingthat test over and over again,
all of a sudden you'd see theirscores tank.
And for me, I rememberobviously I've had a number of
concussions and there was a timewhere if I had to drive my car

(43:03):
for more than an hour and a half, my brain would get so tired I
would have to pull over and takea 20 minute nap and then it was
like I had.
You know, years later I candrive for 13 hours in one day
and be listening to podcasts andI'm completely fine, you know,
and it's that difference betweenI couldn't hold my attention

(43:23):
and focus and concentration formore than 90 minutes to now I
can do it for 13 hours.

Speaker 1 (43:29):
Wow, because that's substantial difference.
So there's so much that we haveon our tool belt that can
really help people not onlywith-concussion but especially
that are kind of strugglingstill to improve and get back
functionality, whether it bethrough these different active
or passive therapies, especiallywhen it comes to the cognitive

(43:50):
issues, like you're saying is,you know, getting the right fuel
.
I know you had that in theemail there.
I love the way you put thatgetting the blood flow
appropriately going.
If that's happening, then we'retraining those areas in a
systematic way based on whattheir needs are, where they may
have brainwave imbalances,increasing bandwidth and
brainwave bandwidth improvingcoherence.

(44:11):
I didn't talk too much aboutthat, but that's a whole, nother
animal, but just really havinggood, clean phone lines, so to
speak, inside their head so thatthe signaling is fast when it
needs to be fast and it's calmwhen it needs to be calm.
Yeah, these are reallywonderful things that we have
and we get to share them withpeople and through this podcast
I'm glad we're able to do this.

Speaker 2 (44:32):
I love that, and so you have this cognitive testing
platform, the KREOS that you canthen also send home to people,
and are you using that purely asa testing platform or also as a
therapy?

Speaker 1 (44:47):
Yeah, therapy and testing, yeah, and it also has
outcome assessments.
So we do a lot of outcomeassessment testing.
So, for instance, peopledealing with anxiety, people
dealing with depression, peopledealing with possible bipolar,
people dealing with PTSD, we cando an analysis on outcome
assessments that arestandardized in mental health

(45:07):
and I can keep following up withthem.
So, as we have someone thatleaves our care for an immersive
, I can follow up with themmonth by month to see are they
trending still well in theirimproved level of anxiety and
depression that was caused byPTSD, and so we can keep
watching those trends withpeople.
And which is what we like to do.

(45:27):
Because people often ask, right,I'm sure they ask you, how long
will this last if we do thisbrain training?
And I say, well, it's based onfactors, but we're looking for
long-term potentiation, we'relooking for long-term
improvements with people, and sothat's always the goal, that's
my bullseye Can we get you backto what you love and want to do
and can we keep it for a longterm?

(45:48):
Those are the goals and we haveto see what we have to put in
place to bring that to fruition.

Speaker 2 (45:54):
Yeah Well, and we don't get to just exercise our
bodies for six weeks and thensay, okay, now my muscles are
toned and I'm strong and I don'thave to exercise anymore.
And so I think, for people whodo ask those questions of, well,
how long do I have to do theseexercises?

Speaker 1 (46:21):
It's to everybody's benefit to see their brain as a
complicated series of musclesthat also need activation and
training for their lifespan.
Yeah, our brain.
As you're saying that, whatcomes to my mind is that our
brain is an afterthought.
Until we have an injury, we'renot even thinking about it.
I know I wasn't.
I've had, I estimate, five toeight concussions.
I know you've had a history ofthose.
We've both done very well,thankfully, and it's just an

(46:41):
afterthought.
It's like people like well, Ididn't do things before, why
should I have to do them now?
But we wouldn't think that withour body that's already been
drilled into us or with ourteeth, right, oh no, I need
regular dental work and even so,much to nutrition.
No, I have to take in the rightnutrients.
I have to eat a particular way.
That's very good for me.
A lot of people, not everyone.
But with the brain, I think wejust have to develop that with

(47:03):
people like a culture of that.
I like what Dale Bredesen saysout of UCLA, that every year
maybe people should have acognoscopy instead of just
having a normal physical like weused to have.
But now having their brainevaluated would be beautiful.
I always think that an EE brainevaluated would be beautiful.
I always think that an EEGyearly would be fantastic, would

(47:24):
be a great way to get anon-invasive baseline of how
your brainwave activity is andyou go from there.
Everyone would be different,but I think that's a very good
non-invasive, low-cost way to atleast get some analysis on your
brain.

Speaker 2 (47:37):
Absolutely.
There was a study that came outthat was estimating that
millions and millions ofAmericans that are developing
mild cognitive impairment, thatthat's going missed, it's not
being caught.
And I do think within the worldof fast medicine there's almost
an acceptance of, well, you'regetting older and so there's a
certain amount of cognitivedecline that we're just going to

(47:58):
call normal, and I think thatthat attitude, you know is it
takes quality of life away frompeople.

Speaker 1 (48:06):
Yeah, I agree with you.
Yeah, it's an uphill battle.
It's an uphill battle becauseit's just.
I think the way I think aboutit is one to one.
I'm going to help the next oneand I'm going to help the next
one or the next family, and I'mgoing to help educate them,
because my wife and I feel thatone of our primary roles is
educators.
We are educators for people andwe try to bring forth, you know

(48:33):
, information and data that isactionable, that they can decide
to do something with.
You know, that's really kind oflanguage that we enjoy.
Give people agency, give themactionable data about themselves
, about their environment, abouttheir internal health that they
can move forward on, whetherit's gut health, metabolic
health, but of course, it'sunder the umbrella of
brain-based health care when itcomes to our office.

Speaker 2 (48:51):
Yeah, absolutely Switching gears.
I wanted to talk a little bitabout spatial awareness, because
this is one of the things where, when people get a concussion,
the thing that I hear frequentlyis that they then start hitting
their head all the time, and Ithink that that's something I'd
love to talk about, becauseobviously we're talking about
cognition, which is not just ourability to focus and attention,

(49:14):
but also these higher corticalareas in our brain is also where
we have our maps of our body,our concept of spatial awareness
, and one of the things that canoften be affected is that idea
of where am I in space.
Once we lose that or it becomesdistorted, it becomes much
easier to then hit your head onthe cabinet or on the doorframe

(49:37):
of the car when you're gettingout of it, and so I would love
for you to speak a little bit tomaybe how you're looking at
testing that and what you see inyour practice and then some of
these kind of body remappingtherapies.

Speaker 1 (49:50):
Very good, because you mentioned earlier in the
podcast maps.
We're talking about having amap to analyze the person
overall.
But I was immediately thinkingwhen you said that the maps in
our head.
We have maps in our brain and aperson's probably saying what
are you talking about?
And I would tell anyone of thelisteners right now, if you're a
listener to this, you touchyour right hand with your left
hand.
You just touch your top of yourhand.

(50:12):
You're not looking at it.
Your brain knows I just touchedthe top, something touched the
top of my hand, which I'm doingright now.
So how does it know that?
Because your brain has a map ofyour body on the inside.
Actually, it has more than onemap.
It has many maps, not only tothe physical structure, but it
has sensory maps to know, oh,that's like something is on my

(50:33):
left hand, maybe it's a fly,maybe it's a mosquito, ouch, or
maybe it's something dangerous.
So we have all kinds of mapsthat help us function in the
world, navigate our body, moveour body, know where our body is
in space, know where space isin relation to our body,
tonotopic maps for sounds.
We don't really have smell mapsor olfactory maps, but we have

(50:54):
tons of information stored inthere based on things we've
smelled before that are linkedto memory.
Right, we do that actually witha lot of our memory work with
people.
Talk to them about somefavorite smell that they might
have.
I'll just use like lavender, itmight be peppermint, and then
they'll smell that.
What does that remind you?
Oh, that reminds me of mygrandmother's kitchen, when we
used to have lavender in Franceon the windowsill.

(51:16):
Now they're getting memory,they're getting visualization,
they're getting olfactory intothe frontal lobe.
That's just another.
That's a free one for people.
You can link olfactory tomemory restoration and music.
It's fantastic when you canfigure out those things as a
detective.
So we're talking about the mapsin the brain.
How do we remap?
One of the best ways to analyzethe maps is with eye tracking,

(51:42):
eye tracking, testing.
So when the eyes are inaccuratein their tracking or their
testing, then more than likelythe maps of where our body is in
space are also what we callskewed.
They're not accurate.
So we can remap some of thosethings by using the eyes and the
brain.
Connection number one, numbertwo, body movements and knowing.

(52:03):
We use things like a headapplied laser on some glasses
and people will use that torecognize areas of the body and
to move that laser slowly onthat body part.
We might use vibrationaltherapy at the same time, so
it's causing the brain to have agreater recognition of a body
part, visually, vibrationally.

(52:25):
So we're getting two sensoryinputs there, so we use many
different ways.
The key, I think, isunderstanding is there map
skewed or isn't it?
And yeah, there's so manythings to properly evaluate
there.
But we also think about theircerebellum and their parietal
lobe, physically right, not onlythe maps but also the areas of

(52:47):
the brain that are involved withmoving and knowing where.
And then, if you go to the qeg,that default mode network is
very important towards the backof the brain and in figuring out
where you are in the world andyour place in the world and your
spatial awareness.
And it's located right backthere in that parietal area
primarily.

(53:08):
And then we have to talk aboutthe vestibular system, which we
won't talk about now becauseit's too much which gives you a
self-reference.
And so I actually spent theweekend in Pittsburgh and we
were looking at some very novelvestibular testing equipment.
That is just.
It's really on the cutting edgeof being helping people to
rehabilitate a brain injury veryquickly, faster than, I think,

(53:32):
anything we've seen before.
So that's really coming up inthe next year or two.
That's really remarkable Usingthe vestibular system.
Year or two that's reallyremarkable using the vestibular
system.
So all these different systemsdefault mode, network,
vestibular system, parietallobes, cerebellum, eye movements
all can tell us how good areyour maps and can we improve
them.
And we can use those samesystems not only to test but to

(53:53):
treat them and improve them.
I think that's the end of thatstatement.

Speaker 2 (53:56):
Yeah, love it, I love it.
And do you use transcranialmagnetic stimulation in your
practice, or do you refer outfor that, or what are your
thoughts on that, because a lotof the research coming out is
just so positive on it.

Speaker 1 (54:11):
Yeah, we do not use it.
So first state that I've alwayswanted it, many years ago.
That was one of the firstthings I looked into, but we put
it on the back burner and Ithink it has dramatic
applications.
It's being used primarily now,as I think we could say I think
this is a generalization, but wecould say it in psychiatry and
it's being used with it has beenapproved with depression.

(54:33):
You know non-responsive typesof depression, but there's so
many other applications for itand so you have to be able to
use it outside of that.
I know one of our colleaguesuses it in Texas with a lot of
former military PTSD.
Great results.
She's brilliant with that, andso I think it's got great
applications.
It should be considered.
Lately there's been a trend herein South Florida where they're

(54:56):
doing it with children.
I mean little children, three,four, five.
I don't know enough about it,but I'm a little hesitant about
that.
So I guess knowing more aboutit might open my eyes, but I'm a
little hesitant about that.
I did see some of the pre andpost data on one of the children
that did that and it caused alittle bit of a pause in me.

(55:17):
So I think it's got greatapplications.
I think it's worthy of lookinginto and finding out who can do
it, because it's also, just foryou know, listeners to be
educated.
Caveat emptor it's amoney-making thing and it's been
brought into a lot of practiceslike that.
It wouldn't be that way infunctional neurology because
many of our colleagues areworking outside the box to

(55:39):
improve OCD and other brainfunctionality.
So you have to be cautiousabout what's being recommended
and is it the right application.
But it is a brilliant therapyand I would highly recommend
people look into it as apotential for them.

Speaker 2 (55:55):
Yeah, I had a patient who, through the VA hospital,
actually they were covering itand she was doing it, you know,
every, every day and it was veryhelpful and so I love that even
the VA is now utilizing thesenon-pharmaceutical options to
address depression.

Speaker 1 (56:14):
Couldn't agree more.
I mean vagal stimulation.
I know they're using and nowusing this.
Tms is brilliant.
I'm wonderfully happy thatthose are in that space for
people.

Speaker 2 (56:23):
And on the topic of depression, I think it would be
worthwhile to also explore thisconcept of again, when we talk
about depression, the age-oldapproach has been oh, it's a
neurotransmitter imbalance,let's just give people some
pharmaceuticals to modulate theneurotransmitters.
I think it's really importantfor people to recognize that the

(56:44):
brain producesneurotransmitters and different
neurotransmitters in differentparts of the brain, and that a
lot of the brain activation workthat we do in functional
neurology has the ability toactually create better integrity
and bring function back tothese areas that actually
produce neurotransmitters, andso maybe speak a little bit to

(57:04):
this concept of you knowneurotransmitters in the brain
and the difference between justtrying to pharmaceutically come
in and kind of push pathwaysversus this idea of engaging
different networks andactivating different parts of
the brain.

Speaker 1 (57:27):
Right, I mean wonderfully stated.
The previous model inpsychiatry has been
pharmaceuticals.
It's a chemical imbalance.
I think most people canacknowledge that.
At least if you're over 40years of age, you've heard that
before.
It's a chemical imbalance andso could there be a chemistry
imbalance.
Certainly there could be.
It's absolutely possible.
Very hard to measure thosethings.
There's some different schoolsof thought of measuring it,

(57:47):
through urinary excretion orthrough this or that, but anyway
it's difficult to measureneurotransmitters.
So most of it has been used,diagnosed on symptoms, how you
feel.
Dr Daniel Amen would say whyhave we been the one profession
not using imaging to understandwhat's going on in the organ
we're treating, when everyoneelse has been?

(58:07):
So that's from Dr Daniel Amen,one of the top psychiatrists in
the world.
And so with that we can say that, yes, dopamine is produced in
the brainstem.
Serotonin is produced in thebrainstem.
Norepinephrine is produced inthe brainstem.
Serotonin is produced in thebrainstem.
Norepinephrine is produced inthe brainstem.
These are three of the majorchemistries that our brain uses.
Yes, there's serotonin producedin the gut, but sometimes it

(58:30):
gets a little too much attentionmaybe.
So it doesn't mean that youshouldn't have a healthier diet.
It does not mean that.
What I'm saying is it's not allthe serotonin in your gut is
going to your brain.
Your brain is making much ofwhat it needs right there, very
close to it.
So, yes, this brainstem which wetalked about earlier is the
autonomic hub, you could say, ofthe brain.

(58:51):
This brainstem is actuallycreating chemistry by firing.
So we go from the ancientChinese thought, where qi goes,
blood flows, to Sherringtonright, I think it was
Sherrington.
If it fires together, it wirestogether.
And now we're going to.
Firing creates chemistry.
Oh wait a minute.
Firing creates chemistry ofneurons.
Yes, that's how they talk toeach other.

(59:13):
So we can approach it from thechemistry or approach it from
getting it to fire properlybecause it may have been
suppressed.
So, yes, we have seen dramaticmood changes in many individuals
with functional neurologyapplications by treating things
in a region that increaseschemistry activation.

(59:34):
And many times we have to addby subtraction and say what does
that mean?
We have to take away too manythings they're putting in so
that their brain can startworking properly.
And we do that, whether itmight be maybe there's too many
supplements they're taking,maybe there's too many
medications that they're takingand many people don't want to do
that they just don't know whatis the other option.
They need another healthdetective or coach to kind of

(59:58):
present some other maps to themto think about how they might be
able to do this.
And we've been, I would say,pretty successful in that and
helping people navigate awayfrom some of those things,
because they got the improvementthat they needed and now
they're more functional.

Speaker 2 (01:00:12):
Yeah, I love that and I think that's so important for
people to recognize is that youknow, like you said, there's a
lot of focus on the gutsproduction of serotonin, but a
lot of that serotonin does stayin the gut and it really is the
brain that is producing its ownneurotransmitters that can at
times be suppressed because ofan injury and we can bring
activation back to these regions.

(01:00:33):
That then it's kind of likejumpstarting a car All of a
sudden the areas are firingagain, they can produce their
own neurotransmitters and youstart to actually very naturally
get the brain'sneurotransmitter balance back in
play simply by providing theright activation.

Speaker 1 (01:00:50):
Totally, and that's such a key component, especially
with people with ADHD, whenwe're working with them, and
that brainstem function forproper dopamine levels, I would
say, and more appropriate levels, it would be the better word of
serotonin, so now, and theirepinephrine, norepinephrine, so
their attentional issues canimprove from a chemistry side,

(01:01:10):
as well as strengthening brainnetworks and so forth.

Speaker 2 (01:01:13):
Before we wrap up, I would love for you to talk about
your work with dolphins,because it's so, so unique and
it sounds absolutely phenomenal,so share a little bit about
this very special thing thatyou're doing.

Speaker 1 (01:01:26):
Who would have thunk it that it would be such an
incredible thing?
Yeah, everyone would.
Because for me it was like oh,the holy grail kind of thing.
When I was a kid, I wanted tobe working with Jacques Cousteau
I don't know if you rememberthat name so my mom even helped
me write a letter because Iwanted to go and visit the
Calypso.
That was what I wanted to do.
So, many years later, thisopportunity comes up with some

(01:01:47):
of our patients who areco-owners in habitats, dolphin
habitats around the world.
Well, they happen to be veryclose to us here in South
Florida, in the Keys.
And so they said you know,there are some occupational
therapists and physicaltherapists that work in another
facility down there withchildren with disabilities.
Would you consider doingsomething in neuroscience with

(01:02:09):
the dolphins and with clients?
And I said, oh, wow, this is aninteresting opportunity.
So we spent the better part ofsix months going down there
almost every weekend, workingwith the marine mammal
specialists in the water anddetermining what types of
movements the dolphins could dothat our clients could do.
That would actually integratethings in the brain.
And so that was the beginningof it.

(01:02:32):
And then we ran a number ofcamps with larger family groups.
We had two different familiesone time and another family
another time.
So we had about six to eightpeople and they would do on land
.
First we evaluated everyoneright, evaluated their brain
function, brain maps, eyetracking, everything.
And then we designed therapiesfor each individual person on

(01:02:52):
land and then in the water.
So they would train on land foran hour and a half, then they'd
be in the water for an hour,then they'd have lunch, then
they train on land and theytrain in the water.
We did that for a week and sowe did that over two camps.
Since then, of course, thepandemic, there was a big change
in the environment and so wehave gone back and periodically
worked with one client at a timeand it's been similar.

(01:03:16):
So now we work out of ourfacility where they do on land
dry training, so to speak, basedon what they need.
Then we'll go down to the Keysand they'll do sessions in the
water with the dolphins based onthe exercise we developed
together, which have a lot to dowith the vestibular system is

(01:03:41):
very much life changing.
I would totally do that everyweek.
I love this so much becausethey're like giant puppies,
these things.
They say the marine mammalspecialists say, when you come
here, the dolphins will takeyour heart and they will keep it
.
And it's true, they really do.
They're incredibly intuitiveanimals.
We had one lady who is the wifeof a doctor and he brought her
down with a seizure disorder.
And so we do this one componentwhere it's.

(01:04:04):
We call it a dolphin meditation.
So you'll lay on your back,floating with a device under
your feet and under yourshoulders, you have a vest on
and you're in the lagoon andthis marine mammal specialist
will bring the dolphin aroundand they are echolocating around
you and and this, and shedoesn't force the dolphin around
, and they are echolocatingaround you.
And she doesn't force thedolphin any way, just allows the
dolphin to go wherever shewants, he or she.

(01:04:26):
And in this case the dolphinwould not leave this woman's
head, and we saw with otherpeople around the back, the legs
, the feet, the head thisdolphin would here, and then
she's trying to move.
Nope, the dolphin came backhere.
Nope, came back here.
And we've heard stories likethat, where dolphins recognize
that some women are pregnantprior to them, even knowing when
they go into the water there,and then they'll say yeah, and

(01:04:47):
they find out later.
So the intuitiveness anddolphin brains are marvelous.
I've done quite a bit ofreading after that to find out.
Let me understand thesecreatures even more.
And they are in echolocating.
They're providing a very highfrequency exposure, a
biologically healthy frequency,to the individual.

(01:05:07):
And we actually recorded thatwith microphones that go into
the water, which are calledhydrophones, and we recorded
that over time so we could knowwith each client what was the
profile, what was going on there.
Because we did a little bit ofwhat was the profile, what was
going on there, because we did alittle bit of research on the
front end of those camps.
So the results were reallywonderful.
People had improvement in manydifferent symptoms.

(01:05:28):
There was PTSD, there wasautism, there were previous
concussion cases in there.
People love it, they enjoy itand it's very novel, as you said
, and it's a life-changing event.
So we still have it available.
We just do it on a one-to-onebasis, as people might find
interest in that, and so it's ablended approach to functional
neurology and a dolphinexperience that will radically

(01:05:51):
alter your life.

Speaker 2 (01:05:52):
Oh my gosh, I just love that.
I love it Well, thank you so?
Much for being so generous withyour time.
I know you have to run Well.
Thank you so much for being sogenerous with your time.
I know you have to run.
Where can people find you,Maybe?

Speaker 1 (01:06:04):
give us some of your information there.
Yeah, we're on all the socialmedia.
We're on Instagram and Facebookand so forth.
I think even they have a TikTokplace for us there.
We have someone who handlesthat for us very well.
She's an excellent young ladyand she takes care of those
things, as we film videos.
And we also have a website,bagnellbraincentercom
bagnellbraincentercom, andthere's extensive information

(01:06:26):
there.
There's links to our podcast aswell, and I love that you
invited me to yours, so Iappreciate it so much.
So, yeah, we have a neurocollective podcast on Spotify
that people can listen to.

Speaker 2 (01:06:37):
Excellent, awesome.
I will put all of that in theshow notes so people can click
on all those links.
And thank you so much.
This has been a wonderfulconversation.

Speaker 1 (01:06:46):
I appreciate it.
Thank you so much.

Speaker 2 (01:06:52):
Medical disclaimer.
This video or podcast is forgeneral informational purposes
only and does not constitute thepractice of medicine or other
professional health careservices, including the giving
of medical advice.
No doctor-patient relationshipis formed.
The use of this information andmaterials included is at the

(01:07:12):
user's own risk.
The content of this video orpodcast is not intended to be a
substitute for medical advice,diagnosis or treatment, and
consumers of this informationshould seek the advice of a
medical professional for any andall health-related issues.
A link to our full medicaldisclaimer is available in the
notes.

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