Sarah Allen, PCOM – Concussion Recovery

We’ve previously discussed the frequency of concussions, but today we’re looking at recovery.

Sarah Allen, a psychologist at the Philadelphia College of Osteopathic Medicine, is studying how best to bounce back from one of these very common brain injuries.

Sarah Levin Allen, PhD, CBIS is assistant professor of psychology at the Philadelphia College of Osteopathic Medicine and executive director of Neuropsychology at Brain Behavior Bridge. She received her PhD in clinical psychology with a concentration in pediatric neuropsychology from the APA-accredited program at Drexel University, where she worked with biomedical engineering on functional imaging tools such as the functional near infared spectroscopy as well as new software for assessing navigation abilities in men and women. Throughout her doctoral experiences, Dr. Allen trained at the Children’s Hospital of Philadelphia, St. Christopher’s Hospital for Children, Bancroft NeuroHealth, and other outpatient neurology clinics. In addition, her post-doctoral education working in schools has enabled her to apply her neuropsychological assessment and intervention skills to a school setting.

Prior to PCOM, Dr. Allen held an administrative and clinical position directing the Medford, Mansfield, and Northern Burlington campuses at the Y.A.L.E. School, which serves children who learn differently than their peers due to brain injuries, learning disabilities or other social or executive deficits. In addition, she has established programs to promote the academic, social, and emotional development of students. As a member of the Child and Adolescence Committee of the Brain Injury Alliance of NJ as well as through her clinical work, she has also worked closely with medical and school professionals to design and implement “return to school” programming for students with concussions as well as other brain injuries.

Dr. Allen is currently a New Jersey licensed psychologist, a certified Brain Injury Specialist, and a New Jersey Certified School Psychologist. She specializes in the area of evidence-based interventions for schools as well as in school-wide concussion management and recovery programming. Her work focuses on translating medical and neuropsychological intervention to schools, specifically promoting and integrating brain based learning approaches into the classroom. She has a primary interest and expertise in building executive functioning skills through interventions that combine neuropsychology with behavioral approaches. In her practice and scholarly work, Dr. Allen focuses on bridging the gap between neuropsychology and behavioral sciences by promoting research into neuropsychological recommendations in the school setting.

Collaborators involved in the neuro-Behavioral Prevention and Intervention (n-BIP) Lab:

• Denah Appelt PhD – Professor of Neuroscience, Dept of Bio-Medical Sciences and Director of Biomedical Imaging at PCOM.
• Brian Balin, PhD – Professor, Dept of Bio-Medical Sciences and Director, Center for Chronic Disorders of Aging at PCOM
• Hasan Ayaz, PhD – Assistant Research Professor in the School of Biomedical Engineering, Science and Health Systems at Drexel University
• Prithvi Narayan, MD – Chief, Section of Pediatric Neurosurgery at St. Christopher’s Hospital for Children

Concussion Recovery

We’ve come far in our understanding of the human brain, but much of it remains a mystery. The clinical management of concussions is one such mystery. It’s a relatively new area of research, so the evidence-based data hasn’t caught up yet with what we know clinically.

Our lab seeks to learn more about concussions from both a biological and clinical standpoint. We do this by exploring myriad factors including certain forms of RNA; sense of smell; images of the brain that track activity; as well as psychological and neuropsychological outcomes.

Clinically, we’ve seen that symptoms can be used as a determinate for when to return to school. This is similar to returning to play: after immediate symptoms reduce, patients should go back to cognitive activity gradually, while monitoring their symptoms. Those who do, seem to improve faster. When symptoms increase, it means there is too much activity. When they remain at bay, it’s a sign the cognitive load is more appropriate and can be gradually increased. This pattern should continue until the patient is able to function as before, say, by returning to a full day of school.

From the research side, we know that students with concussions also face increased risk of anxiety and depression. What we don’t know is why. It’s likely they feel stressed by mounting work and reduced cognitive functioning, but by studying the brain, we can see there may be a disruption in normal communication between nerve cells as well. It’s very possible there’s a critical period during which the brain can re-organize and heal, the same way the body does after injury.

During this period, it’s possible that by building cognitive activity, the brain possibly rids itself of chemical waste and reroutes connections that may have been lost during a concussion.

By looking at the interplay of all these factors, we can begin to fill in the gaps, in order to develop better treatments and improve outcomes.