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CAROLINA BRAIN CENTER

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CAROLINA BRAIN CENTER

Darcy Dane, DC,
Dana Brindisi, DC 

6404 Falls of Neuse Rd., #201

Raleigh, NC 27615

Telephone: (919) 703-0207

info@carolinabraincenter.com

www.carolinabraincenter.com

Understanding the Potential
of Functional Neurology

Whether you step into the office of Carolina Brain Centeror onto their website, you will find yourself entering the relatively new and creative world of functional neurology. Your hosts will be Dr. Darcy Dane and Dr. Dana Brindisi. Both are deeply trained and engaged in this new and creative approach to health and healing.

Darcy Dane, MDiv, DC, DACNB Dr. Dane is the founder and owner of the Carolina Brain Center. She is a Diplomate of the American Chiropractic Neurology Board and has extensively studied childhood developmental disorders, traumatic brain injuries, and vestibular disorders. She is a charter member of the International Association of Functional Neurology and Rehabilitation.

The office space offers cues to the nature of this unique neurology practice. One might be greeted by Ollie or Doc, the practice’s two certified therapy dogs, and the open, inviting therapy room is lined with the “brain training” tools and equipment used to treat neurological disorders.

In a conversation with Health&Healing, Dr. Dane and Dr. Brindisi explain the healing approach of functional neurology.

Health&Healing: How do you define “functional neurology” and how is it distinguished from more conventional approaches to treating neurological disorders?

DR. DANE: Functional neurology—which is also called chiropractic neurology—is a new concept for many people. It is the clinical evaluation and treatment method for the central and peripheral nervous system.

The word “functional” is the key to understanding the difference between this approach and a more conventional neurology practice. When evaluating the central nervous system, we are evaluating a complex and integrated network of systems for level of function. This allows us to identify specifically what systems of the brain and brainstem are working normally and abnormally versus just grouping symptoms into a categorical diagnosis, like concussion, Parkinson’s, or ADD. If the goal is to restore or establish proper function of a failing or struggling system, the devil is in the details not in the “label.”

Dana Brindisi, DC, DACNB, CFMP
Dr. Brindisi has done extensive post-graduate work in functional neurology and functional medicine with a focus on concussions, auto-immune disorders, movement disorders and migraines. She obtained her Diplomate in Neurology from the American Chiropractic Neurology Board after training with the Carrick Institute. She is a Certified Functional Medicine Practitioner through Functional Medicine University, working towards her Diplomate in Clinical Nutrition.

We work with medical doctors in the area because some people need medication. However, the patient who takes charge of their own health and decides to do more than just drug therapy may be able to prolong a lower dose of a drug, as in the case of Parkinson’s, or may be able to eventually stop using a medication, as in the case of migraine headaches.

DR. BRINDISI: Our focus is on brain function; we are able to identify areas of the brain that are functioning poorly, causing symptomatology, as well as areas of the brain that are working well. And, using that information, we design a therapy plan that will improve function in those weak areas of the brain to work better; to make the brain stronger and more efficient.

It’s an approach based on “neuroplasticity.”

H&H: What do you mean by “neuroplasticity”

DR. BRINDISI: Making the brain stronger means improving the functionality of the brain. This can be achieved by creating positive neuroplastic changes. “Neuroplasticity” is the term that describes the brain’s ability to make new connections and formulate new pathways in order to achieve a new function or improve existing function. Think about how a developing child learns to walk or talk or write. It takes practice, but once the task is learned, it is hard-wired.

However, because of trauma, degeneration, or a developmental obstacle, the brain may not be “wired” correctly or it may have a weak or broken wire. A functional neurological treatment is one that promotes rewiring and/or strengthening a connection that is already in place.

That’s why we describe functional neurology as “brain training.” Smell, taste, sound, balance, vision, movement, and touch are all utilized in specific ways to promote “rewiring”—neuroplastic change.  Making a positive neuroplastic change requires specificity. Treatment needs to be specific for the part of the brain requiring change, and then the treatment intensity needs to be done within the brain’s metabolic capacity. When working with fragile or broken “wires”—neuronal pathways—the treatment and its outcomes need to be closely monitored, which is why we provide one-on-one therapy for our patients.

Doc and Ollie

DR. DANE: And it is important to understand that these therapies are layered. One of the ironies is that people tend to think that a neurological problem affects one specific area of the brain, and we are just going to be able to treat that. However, the brain is so much more integrated. Therefore, everything we do here is extremely integrated. I think that is one reason why we get such good results with functional therapy—because we are looking at how all parts of the brain function, and how they function together.

H&H: How do you change the brain?

DR. DANE: Changing the brain—neuroplasticity—requires an appropriate intensity and frequency of treatment. Most of our patients begin treatment with an Intensive Week, that we call “Brain Camp.” During an Intensive, a patient receives three hours a day of treatment, over a four-hour period, for five days. Outcome assessments are performed throughout the week to ensure each patient is receiving the best treatment.

The power of this intensive model is extraordinary; with this approach, we get the same results in 15 hours that it used to take us 3 months to achieve. Remember: to change the brain the exercises require both frequency and specificity. You also need to work within a patient’s metabolic capacity. This takes a lot of one-on-one time because we are observing the minutia of the nervous system—such as heart rate or pupil size—and assessing the patient’s progress and metabolic capacity. The process is very demanding, but also incredibly rewarding.

DR. BRINDISI: And that intensive one-on-one time means that we can push patients up to the limit of what they can handle—but without exceeding that limit. Not pushing enough will reduce the effectiveness of therapy, but pushing too far or too fast is not good either. We monitor that constantly throughout the treatment to find the right balance for each patient.

After completing an intensive period, patients are provided with therapies to do at home, up to several times a day, and will return for a follow-up appointment, to assess progress and decide upon appropriate treatment protocols moving forward. Our goal is to have patients do as much therapy as possible at home after their intensive week once we ensure that they are neurologically ready to do so. For our pediatric patients, parent participation during the intensive week and at home is key to ensure that all home therapies are done confidently and correctly.

H&H: During such an Intensive Week, what are the rehabilitation exercises like?

Functional Neurology/Functional Health Care: What Holistic Really Means

“Carolina Brain Center is a holistic practice,” say Drs. Dane and Brindisi, explaining that “the goal of holistic health care is to get the best results possible by taking a multi-disciplinary approach to treating the whole person. By utilizing a fusion of functional medicine and functional neurology, each of our patients is evaluated in six different categories:

  • Neuro-physiologic imbalance
  • Neuro-endocrine imbalance
  • Anatomical imbalance
  • Immune imbalance
  • Mood imbalance
  • G.I. imbalance

“Using this unique holistic approach allows us to evaluate and prioritize each category. Treatments are then based upon the individual’s unique presentation, and the highest priority imbalances are addressed first, which helps us achieve the best results possible.

“It is important for our patients to understand that our goal is to correct problems that are correctable, and to help them achieve optimal function in those areas that cannot be restored 100 percent. While we are working toward optimal function for each patient, we are also modeling effective ways to manage an individual’s health. We are here to teach and guide our patients how to maintain their new and healthier lifestyle.”

DR. DANE: They vary from patient to patient and are customized to the patient based on the exam findings as well as ongoing assessments during therapy. They might include head and eye exercises, vestibular training, balance training, cognitive training, dual task training, or core stability training.

We cannot underestimate the importance of the customized therapy plan. Each patient not only presents a unique problem, but a unique context for dealing with that problem—affected by other health issues, their age, the nature of their injury, and so on. We do a lot of work with autistic children, for example, and if you lined up 25 of those children, you would have 25 different therapy programs. This is also true in concussion cases, for Parkinson’s patients—or for any neurological problem. The diagnosis—the “label”—does not determine the treatment. Remember the devil is in the details. Treatment plans are designed based on the comprehensive neurological evaluation.

H&H: Describe the process.

DR. BRINDISI: Step one is the functional neurology exam. These evaluations take approximately two hours and include a complete health history, observations, a clinical neurological examination, and a series of diagnostic tests. From this information, we develop a proposed therapy program. We have found that intensive treatment periods are best to increase function quickly and effectively, but not every patient will need an intensive program.

H&H: What conditions are treated with functional neurology?

DR. DANE: It’s a long list. Functional neurology can address any problem or injury to the central or peripheral nervous system. These include ADD/ADHD, Alzheimer’s autism, balance problems, brain injury, concussions, learning disabilities, memory loss, Parkinson’s, and sensory processing disorders; a complete list can be found on our website. We have a special interest in dealing with concussion and traumatic brain injury and childhood development disorders.

Recovering from Concussion:
The Power of Neuroplasticity

In an auto accident that occurred on May 12 of this past year, Sonya Morales, 40, sustained a severe blow to her right temple that rapidly turned into a life-changing event.

“I went to a hospital emergency room, in very shaky condition, and was told that for a couple of days I was going to feel like I was hit by a truck. They were right. Almost immediately I was having trouble with peripheral vision—I couldn’t see to one side. I was told to wait a couple of days to see if this condition cleared up. But the opposite happened: the symptoms got worse. It soon became clear that I had a concussion. I checked with other providers and got the same advice: get a lot of rest and ease the condition with pain medicine.

“But, 10 days go by, and I’m simply not getting out of bed. I can’t tolerate sound. I can’t tolerate light. I can’t tolerate anything. My husband and I continued our search for relief, and it was a blessing that we found Carolina Brain Center. We made the call, and I was seen the next day. Intensive brain therapy, over an extended period of time, led to a complete healing for me, in all parts of my life.”

The Path to Recovery

“When Sonya first arrived for evaluation and treatment,” recalls Dr. Dane, “she was clearly suffering from a concussion; if she simply tilted her head a bit and looked up, she would vomit. Now she is released from care, and she and we agree that she is completely recovered and well.”

The path to her recovery was shaped by functional neurology—a powerful approach for treating concussion and other traumatic brain injury.
“Concussions account for roughly 75 percent of all traumatic brain injuries each year—according to the Centers for Disease Control,” notes Dr. Dana Brindisi. “And recovering from a traumatic brain injury—such as Sonya Morales suffered—is sometimes a long road.

“Further, it is the consensus view that concussions have been poorly managed in years past. However, new technology and research are driving better treatment options, and these advances in science mean that physicians must continue to learn. Dr. Dane and I consistently continue our training concentrated in the diagnosis and treatment of concussions, under the oversight of Dr. Frederick Carrick—who is generally acknowledged as ‘the father of functional neurology.’ That training has helped in developing more effective treatments for concussion.”

“Effective treatments,” explains Dr. Dane, “require an accurate diagnosis of which part of the central nervous system is being affected. After the level of the lesion has been determined, it is important to know how the site, pathway, or neural integrator is being affected.

“Examining a patient with a concussion includes comparing subjective findings (the patient’s answers concerning their health and symptoms) with Videonystagmography findings (gaze, fixation, pursuit, saccade, optokinetic, pupillometry, and consensual light reflect), and with neurological exam findings (cerebellar, cranial nerve, cortical). All of these assessments are important pieces of the puzzle that allow us to build more effective treatment protocols for the concussed patient.”