I have been an anesthesiologist for 20 years. I had a back-pain practice, I had a simultaneous overlapping software career in scalable software. And about a year ago I opened a pain practice locally focusing only on laser treatment of pain.
So, what’s inside of your head? We all know there’s a conceptual model of the head which looks like this and there are various lobes, but the actual of what’s inside of our head, the brain, is actually pretty gnarly-looking. It’s just a lot nicer looking. So the brain is divided into lobes – there’s the frontal lobe, you may have heard about. The frontal love is our executive function. As someone said, the CEO of our brain. The back of our brain is responsible for vision. And people, scientists are looking at the areas of the brain as functional areas. So we know one area’s responsible for speech and one area is responsible for vision, and people talk about all the functional areas of the brain.
There are only two types of brain cells, only two. There’s the thinking cell. You may have heard of that, that’s the neuron. Watch the movie Concussion, they probably talk about it. And then the other type of cell is what I call the good vibe cell. And the good vibe cells are actually key – these are technically called glial cells. And these ensure that there’s a good vibe, a good environment within the brain.
Actually one of the things I wanted to point out earlier – this is a schematic of a brain cell. This thing is really gnarly-looking. And the takeaway here is that the brain is a great unknown to both scientists as well as everyone else in this room, everyone around. It’s impossible to know everything that’s going on in the brain.
So there are 80 billion thinking cells. The same number of cells that we have in our brain, it’s the same number that are stars in the Milky Way. It’s a huge number. And what that means is that we can have a concussion, where you have a brain injury, with a brain injury that a few cells, a few hundred, a few thousand cells might be injured. But we have billions of spares. It’s only when you get millions or potentially billions of cells, neurons damaged that we start to see the effects. But as somebody said back in Washington DC, a billion here, a billion there and pretty soon you’re talking about real brain power.
There are also 80 billion good vibe cells. And these good vibe cells are not just support cells. These are not just things like tables and chairs. The good vibe cells are as essential as the thinking cells. Without a good vibe cell, we would just not be able to exist.
The brain is lightweight. So if we take it out of the skull, the brain only weighs about 3 pounds. About the same amount of weight as two women’s feet. Two petite feet weigh about the same as our brain. But the brain is power-hungry. The brain uses 20% – this little thing up here that weighs the same as two feet, takes 20% of all of our energy. Brain damage can occur when any of those 160 billion cells are damaged. It may not necessarily be a billion or two billion – it might just be a few thousand cells that are damaged. Damage can be temporary or permanent, or it can just be – we think it’s permanent until we find the cure.
The body is designed to pump energy into the brain. Now, if you’re a brain scientist, you think the world revolves around the brain. And it’s really true. Other people think that our body performs other functions, but it’s really just there to support our brain. So it all starts off a turkey dinner. Turkey is converted into a type of sugar called glucose and the heart pumps that glucose into the brain. At the same time, oxygen that we’re breathing turns red blood cells, gives them their oxygen and then the heart pumps that into the brain. So you can already see the entire purpose of our entire body is to pump food and energy into our brain. The brain then takes that energy and passes it through the good vibe cells – these are not again, these are not passive cells. They’ve very, very active and these good vibe cells pass it to the actual thinking cells, where we can then perform a maneuver like this. This football player is firing on all cylinders – their brain is going wild. It is using all 160 billion of their brain cells and their muscles to do this. None of this happens without all of these things, all this food energy pumping into the brain.
There’s one universal energy source in our entire body, and our brain, and it’s a chemical called ATP. ATP doesn’t get its due force, because most people haven’t heard about it – but it’s very important. We wouldn’t be here, we wouldn’t be able to think, we wouldn’t be able to actually get those fantastic plays on the field without ATP. Outside the body, energy is taken in the form of turkey dinner. Inside of the body, we convert that turkey dinner into a sugar called glucose, and inside of the cell, energy is always in the form of ATP. It’s a magic chemical. Without ATP we couldn’t do anything here. We couldn’t think about it, we couldn’t figure it out, we couldn’t sign the contract the lead gave us, we couldn’t do anything without ATP.
And where does ATP come from? ATP comes from a powerhouse within our cells called the mitochondria. Mitochondria do a bunch of things, but their primary job is to take turkey and oxygen and turn it into ATP so we can do our daily living, so we can perform plays on the field, so we can think. ATP is the center of the universe as far as the brain is concerned.
The good vibe is essential to brain health. With 80 billion thinking cells, we have 80 billion cells totally responsible for creating a good vibe within the body. If you’re a scientist, you might already have recognized that the good vibe is generally referred to homeostasis and back in the, about 150 years ago a friend guy really coined the term, called it the internal milieu. But the concept is that our brain is in a constant state of trying to basically maintain a good vibe. You may not feel well, but the brain is always feeling at a state of homeostasis. And of those support cells, half of the cells, they use up one third of the energy just to maintain our brain state, even if we’re sleeping – one third of the energy goes to supporting their functions.
So we’re going to talk about brain injuries next. And we’re talking about 3 types of brain injuries – CTE, a football disease that we’re all familiar with; TBI which is traumatic brain injury – again, it’s a type of concussion, being knocked out, however you want to call it, it’s a brain injury that’s caused by trauma, and a related disease called PTSD which is a stress disease. Some people think of it as a mental issue, that our troops get, civilians can get that is not a result of physical trauma, but a result often of mental trauma. These 3 diseases overlap considerably both in how you can potentially treat them and what causes them. So I’m not going to go through all of this, but some of the more interesting ones, between CTE, TBI and PTSD, all 3 cause depression. We heard about depression, it’s a big factor and it’s impossible to know whether when somebody has had a lifetime of football, whether that’s from a concussion, from traumatic brain injury, from CTE, perhaps it’s even PTSD. One of the differences over here in suicide, primarily goes to – I’m not actually sure I drew the slide right, but CTE should have suicide and PTSD has suicide. Nightmares and sleeplessness are more related to PTSD and TBI. But there’s overall a huge overlap between these 3 huge diseases.
If you know anything about CTE or you watched the movie Concussion, you may have heard about a chemical in the body, a protein in the body called Tau. And you may actually come under the impression that Tau is bad. It turns out that Tau is a normal protein found in all of our brains. It’s essential, Tau is essential. Not as important as ATP, but it’s essential for brain functioning. It’s when Tau gets to, goes to actually being a Tau Tangle that it represents a problem. What’s unknown is when that’s the chicken or the egg. Tau tangles are not specific to CTE, they’re present in many, many brain diseases. And nobody yet knows whether the Tau tangle causes the problem or whether it represents the problem.
So, we’re going to talk now about ATP and how they generate a good vibe, and why that’s so important. So, when you get an injury, the injury can be a concussion, be bobbed brain or lightness, it could be traumatic brain injury – it could be virtually be anything. PTSD. The injury causes trauma to the thinking cells, so you heard me talk about somebody, a football player who was post-concussion, they had trauma to their thinking cells. They asked the same questions over and over again. Very common. That’s what we think about a person that’s knocked out, semi-permanent, permanent brain damage. We all think about damage to the thinking cells. That’s actually not where the money is. That’s not where the money is. The money is in the damage to the good vibe cells. Because left to their own devices, the good vibe cells would help the thinking cells heal. So that’s why, if you ever – most of us are old enough to have suffered some minor concussion in our life where we saw stars. You run into the wall, you hit your head on the table, the cabinet bangs you, if you have a football player obviously, you have many bruises for this – all those are concussions. They’re traumatic brain injuries that most of us have healed from and the way we heal was our good vibe cells fix our thinking cells. Nothing good happens in the brain to correct an injury, to fix an injury if the good vibe cells don’t do their work. And all the work requires ATP. Thinking cells can’t think without ATP and good vibe cells cannot repair and keep a good vibe without ATP. So what happens in these cells, once they’ve been damaged, they only have two choices in life. Most of the time they end up being repaired. They go back to being a thinking cell. Obviously, some of the time in CTE, TBI and PTSD, they end up dying. This is the injured state, but eventually they either go to recover or die. It’s when they die that we end up with this CTE. And you can already see you don’t have to be a brain scientist – if you’re 20-years-old and you’re suffering a concussion or a multiple sub-concussive as a football player here, 30 years later, when you get CTE is because those cells have failed to heal. It’s because those thinking cells have not gotten the support of the good vibe cells to make them heal.
So, next we’re going to talk about TLT. TLT stands for transcranial laser therapy. It’s a promising new way to treat brain injuries – CTE, TBI and PTSD. Here’s a picture of what TLT looks like. It’s a hand-held laser that’s a couple of inches across. It’s painless, it’s not a pinpoint laser. The laser does not zap or melt anything. The laser is given in the front of the head and this is also referred to the head, the way it works, these both ways to get the frontal cortex, one of the lobes of the head, and the laser penetrates about 2 inches.
From before, there are different lobes in the head, and those different lobes, the different functional areas are associated with different things, different ways of thinking. Many of the problems associated with traumatic brain injury, TBI and CTE area associated with the front of the head. And that includes problem solving, concentration, memory; it includes core sleeplessness, but personality, we’ve heard about all these things many times today that all of these problems rearing their head in both traumatic brain injury and in…
So, how does transcranial laser therapy work? The reason I’m so excited about laser therapy is that it increases one of the keys to the brain, which is the ATP. Transcranial laser therapy increases ATP in all the cells that absorb it. So, what happens when you give TLT? Transcranial laser therapy, it’s absorbed by the mitochondria. The mitochondria are the powerhouses that brew ATP so they of course produce more ATP. From ATP you can get more – so if it’s a good vibe cell, they’re going to do more repair work. More anti-inflammatory are going to come out, so inflammation is going to be reduced. Nerve cells will actually regrow when they’re exposed to laser, by the function of increasing ATP. Everything stems from the increased ATP. Once you have more ATP, the good vibe cells can repair themselves and they can help repair the thinking cells. Outside of the brain it’s very similar.
This is just a picture showing how the laser gets absorbed by the mitochondria. Sort of the universal signal for mitochondria. And that produces more ATP. So going back to our brain injury, what happens is that when there’s transcranial laser therapy, there’s more ATP so the thinking cells can repair themselves and the good vibe cells have an easier job of doing their job in life which is repairing the thinking cells. And the goal of transcranial laser therapy is to get more of the thinking cells to go back to living a healthy cell life, and fewer of them to die.
The results of TLT are potentially phenomenal. There has only been one study of TLT in brain disease. That was a study done in Denver, it was done on 10 patients with traumatic brain injury and they used a very small, relatively small laser but have phenomenal results. So the quick way of looking at this is that red’s bad and green is good. It’s very simple. So for instance, if you look at depression, they measure depression two ways and after laser therapy, the depression went down by 30-50%. But if you look at something else, so if you look at suicide which is a big problem in this PTSD, PTI and CTE, 5 of the 10 patients had suicidal thoughts before treatment. Now, to most of you, other than those of you who’ve had direct contact with patients who have CTE, this seems hypothetical. But I’ve got to tell you – these people not only think about suicide, they commit suicide. This is a real problem and it just goes to show how deranged these diseases made people. After laser treatment, zero of the 5 had suicidal thoughts. This is a phenomenal result. Sleeplessness, which was present in 10 of the 10 patients, went after treatment to zero. So there’s some phenomenal results – sleeplessness, one of the views is employment. Employment, you might think to yourself is not such a big deal, but employment represents how we function, how a person with CTE, TBI and PTSD functions in society, how they deal with relationships inside of the house and outside of the house. Because when you have these diseases, you don’t feel right, you don’t act right. You don’t have the emotional stability. So if somebody comes – when Reggie says we’re running a little behind, all of us kind of groan. But we don’t want to come up and punch him. But when you have PTSD and TBI and CTE, sometimes you don’t have that control. Reggie says ‘Hey, your function’s delayed by an hour’, blam! When a family member says something innocuous, they lose control, it’s not their fault. They’ve lost potentially billions of neurons and transcranial laser therapy may be one of the solutions.
One of the most exciting parts, this paper was published and one of the most exciting parts of the research for me, my background as an anesthesiologist is that we’re a little different than most other doctors, which is we give a little bit of drug when you come in to go to sleep, and if it doesn’t work, we give more and more drug and we’ll give you as much drug as it takes. We’re anesthesiologist, are the only people who love to give more drugs than anybody else. So in locker room, the NFL locker room, they have a certain talk; in the anesthesia locker room we have a different kind of talk and people will talk about how much drug it took the last patient to get to sleep. Somebody will say, I had one patient who took me one bucket. And somebody will say I had a patient who took me 5 buckets to get them to sleep. We don’t actually use buckets, but you get the idea. And to us, to anesthesiologists, that’s a sign the more drug we give and the more effect it has, that’s a real drug.
… relief of depression they got. And this is the most exciting thing about the study. So what I’m involved with now is taking the results of this study and getting research of at least 10, but hopefully 40 patients with TBI, PTSD and CTE but using much higher doses of laser, two times and up to 10 times the laser does and accelerate the treatment, the previous…