Autonomic Dysfunction After Brain Injury - An Interview with Dr. John McClaren - Part 1 | E11

March 24, 202547m 17s

Autonomic FunctionFunctional Neurology

About This Episode

Dr. John McClaren shares his journey into specializing in brain injury rehabilitation and explains how autonomic nervous system dysfunction affects many TBI patients, often going undiagnosed despite causing significant symptoms.

• Personal connection to TBI after his father's severe train accident which inspired his specialization
• Conventional autonomic testing (QSART, tilt table) often has 6-month waiting lists, delaying treatment
• Autonomic nervous system functioning requires responsiveness - like a high-performance sports car - needing both acceleration and braking capabilities
• Simple bedside assessments can reveal autonomic dysfunction without lengthy waits
• Pupillary light reflex testing using smartphone apps provides millisecond-precision measurements
• Blood pressure differences between sides and positions offer valuable diagnostic information
• Heart examination with position changes can detect subtle autonomic abnormalities
• White matter connections between brain regions drive proper autonomic function
• Current focus on vagus nerve may miss the bigger picture of central autonomic network dysfunction
• New imaging techniques like DTI now allowing visualization of damaged neural connections

Dr. McClaren can be contacted at Advanced Chiropractic & Neurology in Omaha Nebraska.

Advanced Chiropractic & Neurology Facebook page

Topics Covered

Autonomic FunctionFunctional Neurology

Full Transcript

Dr. John McClaren: 00:00 What you're looking at for people who are getting these reflex tests done. Those are the things they're going to do the QSART testing and the tilt table test, which you know we're going to orthostatically challenge you and see what happens to your blood pressure and your heart rate over time. And do the responses occur normally, or do I get, you know, a huge rise in my heart rate and a drop in my blood pressure when I become upright, which is not, you know, the response that you want to have, and it's got to meet a certain criteria which they change. You know they move the goalposts all the time on this stuff too. You know, used to be 30 beats a minute, now some people are saying 40, you know, because it's like one. Dr. John McClaren: 00:35 Do we have so many people, especially in this post COVID era, that have autonomic nervous system dysfunction? You know, and you know again what we know not function, you know, and you, you know again, we, you know, not to get ahead of ourselves on topic there, but you combine some of these things, which is the human experience, you know, oh boy Dr. John McClaren: 00:58 right. Sophia Bouwens: 00:58 Welcome to the Li…

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