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1. TBI THERAPY WEBINAR: OVERVIEW OF TBI THERAPY By Dr. John Hughes January 3, 2018 2. WHO I AM • Dr. John Hughes, DO • Practice osteopathic, integrative, and regenerative medicine • Graduated from Arizona College of Osteopathic Medicine in 2007 • Opened Aspen Integrative Medicine in 2009 • Opened TBI Therapy in 2014 3. LEARNING OBJECTIVE Learn about the individual mechanisms and benefits of each regenerative modality offered at TBI Therapy to treat TBI. 4. MAINSTREAM TREATMENTS • Occupational and physical rehabilitation • Speech therapy • Pharmaceutical drugs • Cognitive maintenance exercises • Do not regenerate the damaged brain • Do not combine regenerative treatments • Can be prohibitive for patients and their families, both in cost and time = Simply cope with the condition 5. TBI THERAPY PROTOCOL Hyperbaric Oxygen Therapy Intranasal Therapies IV Nutrition Cranial Osteopathy Ketogenic Diet and MCT Oil 6. HYPERBARIC OXYGEN THERAPY (HBOT) • Allows the body to absorb about 10-15 times its normal supply of oxygen • Stimulates the growth of tissue, bone and blood vessels, reduce inflammation, and mobilizes stem cells • 2 hours of HBOT triples the patients own circulating stem cells • 20 sessions of HBOT increases circulating stem cells to 8 fold (800%) 7. INTRANASAL PRP/INSULIN • Improves brain ATP production • Decreases CSF cortisol • Improves neuronal viability in the hippocampus • Increases the expression of anti- inflammatory microglia • Reduces beta-amyloid and tau protein deposition • Autologous plasma contains growth factors and cytokines to aid the injured brain 8. INTRANASAL STEM CELLS • Peripheral blood derived pluripotent stem cells • Plasma contains hundreds of thousands of these cells per mL • Have regenerative and reparative properties • Have been used to treat ischemic brain damage by reducing gray and white matter loss • Downregulate neuroinflammatory cytokines 9. IV NUTRITION • Includes PRP, stem cells, NAD+, Myer’s cocktail with potassium, magnesium, calcium, B-complex, B5, B6, and B12, ascorbate followed by a glutathione push • Vitamin D deficiency has been found in over 65% of TBI patients • B vitamin supplementation improves memory, mood, and energy levels 10. CRANIAL OSTEOPATHY • Manual manipulation of the cranial bones and membranes to allow the cerebral spinal fluid to flow properly • The central nervous system, including the brain and spinal cord, has a subtle, rhythmic pulsation • This rhythmic pulsation can be blocked in brain injuries – impedes CSF and blood flow • Effective at treating vertigo and headaches associated with TBIs 11. KETOGENIC DIET • Proven treatment for patients suffering from epileptic seizures • Produce cortical sparing and less apoptotic neuro-degeneration • Overall improvements in cognitive and motor functioning • Increase the available calming neurotransmitter GABA • With less glutamate, there is less oxidative stress and improved neuroprotection • MCT oils are a rich source of ketone bodies 12. 2 DAY PROTOCOL 60 Minute Physician Consultation Cranial Osteopathy Ketogenic Diet Hyperbaric Oxygen Therapy (2 sessions) Intranasal PRP (Platelet Rich Plasma) Intravenous PRP (Platelet Rich Plasma) + Nutrition Intranasal PRP-PDSC (Plasma and Platelet Derived Stem Cells) Intravenous PRP-PDSC (Plasma and Platelet Derived Stem Cells) + NAD Take home supplements: Brain Octane MCT Oil by Bulletproof, Elk Antler by High Wire Ranch, BrainOn by E3 Live, Stem XCell, and Fat for Fuel by Dr. Mercola Take home drugs and devices: insulin for personal administration and brainwave training player 13. CLINICAL RESULTS • More mental clarity • Improved memory • Improved executive function/decision making • More stable emotions and less stress • Better ability to cope with pain • More physical and mental energy 14. CASE REPORT 46 YEAR-OLD MALE FROM BOULDER, CO • Presented with: • Light and sound sensitivity • Could not drive • Emotionally unstable • Headaches daily • Inability to carry on conversation • Inability to do math or read • Loss of libido • Depression and anxiety • Insomnia • Memory loss • After Treatment: • “Memory download” • “An awakening” • Mood and personality improvements • Improvements intellectually, physiologically, and psychologically • Improved ability to read • Able to turn on lights and get on computer / TV • Able to drive • Sleep normalized 15. CASE REPORT 46 YEAR-OLD MALE FROM BOULDER, CO “Dr. Hughes then administered the plasma into the right nostril. After this it was like a stream of information had been let loose like a dam that had busted. I saw clips of memories such as faces, numbers, and letters. After 5 minutes the stream of thoughts slowed down. I needed sugar during the process due to slight hypoglycemia. Upon completing the second treatment for the day I had the same reaction and results except the stream of information slowed down and I could recognize images and conversations I had with people. It was almost like a computer file had been opened full of letters, numbers, and words. I started having expanded thought. I felt for the first time in a year that I had some clarity. The initial feeling of bubbly effervescent seemed to give me life. The light was on in the back of a dark warehouse. I was excited to read more than 2-3 sentences without triggering a migraine. I found that I was able to get back on the computer and learn more about my trauma and recent treatment. Within the following days it was like an awakening. I could turn on lights for a few minutes and keep the TV on. It seemed like a light switch was turned back on inside my head even though it was dim. There was new activity occurring.” 16. Q&A Learn more at or call 303-447-1257 17. Boussi-Gross, R., Golan, H., Fishlev, G., Bechor, Y., Volkov, O., et al. (2013) Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury – Randomized Prospective Trial. PLoS ONE 8(11): e79995. doi: 10.1371/journal.pone.0079995. Brabazon, F. P., Khayrullina, G. I., Frey, W. H., & Byrnes, K. R. (2014, June). INTRANASAL INSULIN TREATMENT OF TRAUMATIC BRAIN INJURY. In JOURNAL OF NEUROTRAUMA (Vol. 31, No. 12, pp. A106-A106). 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA: MARY ANN LIEBERT, INC. Danielyan, L., Beer-Hammer, S., Stolzing, A., Schäfer, R., Siegel, G., Fabian, C., … & Novakovic, A. (2014). Intranasal delivery of bone marrow-derived mesenchymal stem cells, macrophages, and microglia to the brain in mouse models of Alzheimer’s and Parkinson’s disease. Cell transplantation,23(1), S123-S139. European Society of Endocrinology. (2010). Vitamin D deficiency associated with chronic fatigue in brain injured patients. ScienceDaily. Retrieved August 15, 2016 from Gladstone Institutes. (2008). Collagen May Help Protect Brain Against Alzheimer’s Disease. ScienceDaily. Retrieved August 15, 2016 from Gunther, N. & Queen, E. (2013). What Physical and Cognitive Rest Really Mean After a Concussion. Brainline. Retrieved from Haller, H., Cramer, H., Werner, M., & Dobos, G. (2015). Treating the sequelae of postoperative meningioma and traumatic brain injury: a case of implementation of craniosacral therapy in integrative inpatient care. The Journal of Alternative and Complementary Medicine, 21(2), 110-112. Huskisson, E., Maggini, S., & Ruf, M. (2007). The role of vitamins and minerals in energy metabolism and well-being. Journal of international medical research, 35(3), 277-289. Kurtz, S. (2008). U.S. Patent Application No. 12/077,296. Retrieved August 15, 2016 from McNally, M. A., & Hartman, A. L. (2012). Ketone bodies in epilepsy. Journal of neurochemistry, 121(1), 28-35. Mischley, L. K., Conley, K. E., Shankland, E. G., Kavanagh, T. J., Rosenfeld, M. E., Duda, J. E., … & Padowski, J. M. (2016). Central nervous system uptake of intranasal glutathione in Parkinson’s disease. npj Parkinson’s Disease, 2, 16002. Moskalenko, Y., Frymann, V., Kravchenko, T., & Weinstein, G. (2003). Physiological background of the Cranial Rhythmic Impulse and the Primary respiratory Mechanism. Am Acad Osteopath J, 13(2), 21- 33. Rho, J. M., & Stafstrom, C. E. (2012). The ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in pharmacology, 3, 59. Sun, D. (2014). The potential of endogenous neurogenesis for brain repair and regeneration following traumatic brain injury. Neural regeneration research, 9(7), 688.). Thom, S. R., Bhopale, V. M., Velazquez, O. C., Goldstein, L. J., Thom, L. H., & Buerk, D. G. (2006). Stem cell mobilization by hyperbaric oxygen. American Journal of Physiology-Heart and Circulatory Physiology, 290(4), H1378-H1386. Tithon Biotech (n.d.). Retrieved from UHN Staff. (2015). Vitamins for Memory Loss and Stroke Prevention – These 3 Are Critical. University Health News Daily. Retrieved August 15, 2016 from Van Velthoven, C. T., Kavelaars, A., van Bel, F., & Heijnen, C. J. (2010). Nasal administration of stem cells: a promising novel route to treat neonatal ischemic brain damage. Pediatric research, 68, 419- 422.