Blueprint for recovery

At least twice a month Putzier voluntarily visits his version of hell. Beads of sweat dot his forehead as he slowly makes his way inside the windowless room in the office of Dr. Shane Steadman, a chiropractic neurologist with Integrated Health Systems in Englewood. There is no wall art, and the only furniture is an outsize barber’s chair that beckons Putzier with its soft black leather and plush armrests.

“I hate this,” he says as a wave of anxiety and nausea rushes over him. “I hate this so much.”

As Putzier eases into the chair, Steadman straps a pair of infrared goggles around his head. Putzier’s enlarged pupils, bouncing side to side, are projected onto a nearby laptop computer. Faster and faster they bob as the sweat drips down his face and his fingers dig into the leather.

CereScan joins quest for research, answers Extensive news coverage of the dangers of concussions in recent years has led some NFL players to retire early to avoid the possibility of further brain damage. And many retired players have taken steps to not only alleviate their postfootball pain but to try to fight the onset of additional complications. But the science behind traumatic brain injury (TBI), and especially chronic traumatic encephalopathy (CTE), is still in its infancy. CereScan, a functional brain imaging and data analytics company in Littleton, is working to change that. Using quantitative single-photon emission computed tomography (qSPECT) imaging to measure blood flow in up to 160 regions of the brain, CereScan’s technology, combined with clinical assessments and previous imaging, can offer a more complete picture of a patient’s brain function than structural images, like MRIs and CT scans, alone can provide. Blood flow in the brain, which indicates how cells are working, is diagnosed and displayed on a color spectrum. Blues and greens show areas with less blood flow, and oranges and reds indicate normal or above-average blood flow. The diagnostic report and imaging, which can cost $2,400 to $4,200 per patient, provide a starting point in recommending treatments that can include infrared light therapy, functional neurology, hyperbaric oxygen therapy, neurofeedback or even yoga. CereScan stores and catalogues all information in its database, CereMetrix, without using patient identification. CereMatrix now includes about 7,000 scans from patients in 40 states and four countries. In that database are records of dozens of current and former NFL players, Broncos included. CereScan hopes the extensive database will aid practitioners and also advance research of brain injuries and diseases. The company, with funding from the Tug McGraw Foundation and in partnership with the Colorado Neurological Institute, is nearing completion of a study called The Invisible Brain Injury Project on the effectiveness of near-infrared light therapy as treatment for TBI in military veterans and former NFL players. “There are some positive indications emerging from various therapies, and we’re as anxious as anyone to help in verifying which offer the most promising results,” says John Kelley, CereScan’s chairman and CEO. “Hyperbaric chamber, yoga, dietary changes, all sorts of things. Sometimes they show good things, sometimes not. But how do you know? We can provide measurements and precise locations of those functional changes.” Locally, word has gotten out about CereScan’s research. The next step? Getting the NFL and NFL Players Association to buy in. CereScan has had multiple meetings with league and union officials about offering its technology to help active and retired players. But the conversations — much like the research of TBI — are just getting started. “The NFL is appropriately skeptical of people bearing gifts,” Kelley says. “Over time, we’re gaining credibility with them. We don’t want anything. We’re not asking for anything. We’re saying look, we’re providing technology you guys should be familiar with or take advantage of.”

Putzier says he was diagnosed in April with postconcussion syndrome, attaching a label to myriad symptoms he has dealt with since he retired. Steadman, an expert in functional neurology, is one of many specialists Putzier and other former players see to try to find peace.

“The goal is to try to understand the function or, in many of our patients’ cases, we’re trying to understand their dysfunction,” says Steadman, who also does full blood and hormonal evaluations to connect the physical symptoms with the neurological causes. “(We’re) trying to figure out how areas of the brain integrate with other areas of the brain and also how it integrates with the body.”

With interactive technologies such as a Neuro Sensorimotor Integrator, Steadman tests Putzier’s balance and motor skills. The videonystagmography (VNG) goggles Putzier hate so much record his drifting eyes, offering signs of how his brain is working. Coordinated head-and-eye movements target certain areas of the brain that are underperforming.

The process seems simple, but within minutes Putzier’s long hair is drenched, his face is pale and the energy he entered the office with has disappeared. The light-and-sound stimulation is overwhelming, and recovery can sometimes take as many as 18 hours of rest, he says.

“Because we’re using measuring tools, we’re able to see improvements within a short period of time,” Steadman says. “It doesn’t mean that they’re 100 percent resolved. But we’re able to see improvements within a few weeks.”

Progress for Putzier has been slow and unsteady, but noticeable in terms of his emotional stability, mental endurance and thought processing. But the incremental and often invisible changes in his mind are laid bare in specialized images taken at CereScan, a functional brain imaging and data analytics company in Littleton.

CereScan uses quantitative single-photon emission computed tomography (qSPECT) imaging to show how the brain is functioning. (Putzier began working with the company in 2011 and is now both a patient and a consultant.) Unlike magnetic resonance images (MRI) or computed tomography (CT) scans that show the structure of the brain, qSPECT scans measure blood flow, which can reveal how cells are working in the brain.

For Putzier and the dozens of other NFL players and military veterans CereScan has worked with, the images and medical assessments provide not only proof of their cognitive limitations but baselines for treatment, be it near-infrared light therapy (NIR), hyperbaric oxygen therapy, neurofeedback, dietary changes or even yoga.