MMA Fighter Trainer with long standing issues related to Traumatic Brain Injury.

1. The Career Pugilist
Case of Traumatic Brain Injury: MMA Fighter/Trainer

2. 2
CONFIDENTIAL

3. What Is Traumatic Brain Injury (TBI)?
TBI and mTBI is an acronym for (mild) Traumatic Brain Injury, also known as a concussion. The injury
occurs when the brain impacts the skull’s inside, causing the brain to shift and move violently. Moreover,
traumatic brain injuries occur when the skull rapidly decelerates or strikes another object. The injured
areas of the brain determine what types of deficits someone might suffer. mTBI can occur at any age and
is more common in athletes and military personnel. Numerous studies have demonstrated that mTBI
associates with early-onset dementia even thirty years after the incident.
What is CTE (Chronic Traumatic Encephalopathy)?
CTE is not the same as mTBI. CTE is a chronic progressive disorder that occurs after multiple
concussions. CTE was formerly known as Dementia Pugillistica or Punch-Drunk Syndrome. CTE was first
noticed in people who engaged in hand-to-hand combat and received blows to the head. In CTE, an
autoimmune process is triggered in the brain that causes “neurofibrillary tangles.” These tangles become
calcified and cause significant and severe problems. Under current guidelines, CTE may only be
diagnosed via post-mortem examination of cerebral tissue.

4. Where does mTBI appear in the brain?
In mTBI, the area of injury depends on the location in which the brain was struck. Using QEEG, it is possible to locate the
areas of an mTBI. In addition to specific brain regions affected, forces cause diffuse axonal injury by stretching and tearing
the microscopic junctions between neurons in the brain. There are slowing areas in a typical mTBI representing penumbras
of hyperpolarized cells oscillating in the frequency of delta or theta. Think of these areas as being a sleeping part of the
brain that will not wake up.
This creates an area of dysfunction that is related to the area affected. For example, suppose the brain impacts the inside of
the skull on the left front behind the eye. In that case, the prefrontal cortex might be injured, causing executive functioning,
impulsivity, and attention problems. The brain would then shift back and impact the skull’s right rear interior, causing injury in
the visual system on the right.
Unfortunately, the underside of the skull is not smooth. It is somewhat rocky and bumpy like the Grand Canyon. When the
brain subluxates from the greater wing of the sphenoid bone, the anterior temporal horns rest inside and scrape across the
middle cranial fossa. When the brain moves over this ridge on the skull’s internal underside, the temporal lobes get injured,
causing an “ear-muff” type pattern on QEEG that is pathognomonic for mTBI. The example above would appear on a QEEG
as slow waves in the left front and right back of the brain with decreased coherence and two circular spots over the ears
where the brain shifted.

5. Individual Case- Fighter/Trainer
Identifying Information about Subject
● Male
● Mid- Fifties
● Competed in Judo and DIV I Wrestling in high school and college
● Top Student - studied Exercise Physiology and Biochemistry
● Left college to pursue career as a professional fighter between 2nd and 3rd
semester of junior year
● Moved to Bangkok, Thailand - lived there for three years as Muay Thai fighter
● Tained/Spared daily - sometimes more than once per day
● Broken jaw and was concussed at age 22 during fight
● Continued to compete in MMA with an active and successful career for years
● Opened gym and worked as fight trainer after retirement
● Currently trains fighters at elite and hobby levels

6. Symptoms and Interpersonal Issues:
Emerged over the course of a few decades, not at time of incident
● Insomnia
● Anger/Rage
● Attention Problems
● Memory Problems
● Alcoholism
● Migraine
● Tinnitus
● Slowed Reaction Time
● Coordination Problems
● Weight Gain = 40 pounds

7. Conventional Treatment Was Attempted
● Subject saw Psychiatrist - Diagnosed with Depression
○ After his medication failed, subject was re-diagnosed with Bipolar Disorder
○ Subject placed on Depakote (Mood Stabilizer), Effexor (Antidepressant), Seroquel
(Sleep and Anger), Ambien (Sleep), Klonopin (Anxiety)
This form of clinical diagnosis and treatment results in Subject’s poor controlled of
symptoms leading to the consumption of large amounts of alcohol for self
medication and weight gain of up to 40lbs.

8. Subject’s QEEG Showing Head Injury
Many individuals have undiagnosed head injury and are inappropriately treated for a psychiatric disorder.
Quantitative electroencephalography (qEEG or QEEG) is a field concerned with the numerical analysis of
electroencephalography (EEG) data and associated behavioral correlates. Using QEEG a brainscan of a
subject’s brain is compared to a certified normative databases of other scans to determine what major
structural issue might be present. The z-score is the number of standard deviations a data point is from
the population mean.
Case Example
Treatment recommendations based on z-score variance
40 Myneurva Remoted Guided QEEG Neurofeedback Sessions as
an protocol to teach self-regulation of brain function
● Each Session = 1 hour
● Best Results = Training 3 or more sessions per week

9. Subject’s Pre Neurofeedback Treatment QEEG

10. Can Neurofeedback help mTBI?
There is no cure for mTBI. It is a chronic condition and may affect an individual through the course of their
lives. When administered properly, neurofeedback may assist with some of the complaints associated with
mTBI, such as memory problems, brain fog, inattention, anxiety, sleep problems, and irritability.
How does Neurofeedback help mTBI?
Neurofeedback helps mTBI by retraining the brain to move back towards a regular electrical pattern. This
may take several sessions as mTBI impairs the brain’s ability to learn new information. By targeting the
areas of injury and assisting the “sleepy” areas in waking up, NF can improve some complaints associated
with mTBI.
How many Neurofeedback sessions are needed for TBI?
This is not easily answered without a QEEG. Generally, our clients require 20 sessions to reach a
significant improvement in their daily functioning. However, in mTBI, the brain may have multiple
dysregulated sites and areas of connectivity unbalanced. Although 20 sessions may improve some
symptoms associated with mTBI, additional booster sessions may be required after the first set of twenty
sessions.

11. Subject’s Post Treatment QEEG Scan

12. Subject’s Results After Neurofeedback Treatment
● Under direction of the primary care physician, subject was able to gradually
lower his medication over the course of six months to become medication free
● Migraines decreased from 1x per week to 1x per year
● Tinnitus has decreased significantly
● Subject abstained from alcohol - currently for the past four years
● Sleep and mood has significantly improved
● Anger has decreased
● There has been a >30 pound weight loss back to healthy weight with blood
pressure and heart rate improvement

13. Can Traumatic Brain Injury Be Cured?
Unfortunately like most neurological disorders, mTBI is not curable. Although rehabilitation and time can
assist with complaints associated with the injury, effects may be lifelong. Using Neurofeedback as a tool to
keep the neural pathways strong and the organ that is the brain sharp is a key component to overall
Mental Health later in life. If one participates in an active and or contact sport as an enthusiasts or a
professional it is of the utmost importance they adopt a wellness protocol for their Brain Functions.
“I struggled for years with rage and a foggy mind. I
was never happy with what my Doctors were telling
me. After working with Dr. Starr and MYNEURVA on
Neurofeedback I feel I have a whole new leash on life”
- A . Pullini
Resolution