Neuroinflammation as a likely cause of persistent symptoms following traumatic brain injury (TBI), as well as increased risk of neurodegenerative complications, is leading to increased attention on anti-inflammatory strategies with diet, exercise, lifestyle and medication
Our May 28, 2015 blog post discussed the evidence offered by McMasters University researchers in support of their conclusion that the body’s immune response following injury can lead to unchecked, ultimately destructive neuroinflammation and that this likely underlies persistent symptoms following TBI as well as increased risk of neurodegenerative conditions such as chronic traumatic encephalopathy (CTE) and Alzheimers. The authors observed similar neuroinflammatory processes in patients without a history of head injury, such as patients with serious infections, PTSD and Depression. They also noted that subtle genetic differences may explain differences in inflammatory responses between patients, leading to different long term outcomes. The October 2015 issue of Trends in Neuroscience includes a review by Ohio State neuroscientists with further support for this new paradigm for understanding the brain’s response to injury. See “Priming the Inflammatory Pump of the CNS after Traumatic Brain Injury.” Read More
Sony Pictures has made a movie about the devastating long term effects of concussion in professional football players, and the NFL’s efforts to cover this up. Will Smith stars as Nigerian doctor Bennet Omalu, the pathologist who first discovered the prevalence in players of a degenerative disease known as chronic traumatic encephalopathy (CTE). A trailer for the movie has just been released and can be seen here.
This movie promises to bring even greater public attention to the growing body of evidence, discussed in many past posts in this blog, demonstrating that concussion can in some cases trigger a chronic degenerative process with permanent consequences. Read More
Research from the National Institute of Health, published in the August 3, 2015 issue of JAMA Neurology, shows that a protein that was until recently linked only to acute symptoms following traumatic brain injury, may also be responsible for chronic neurological symptoms, such as headache and dizziness, found in patients diagnosed with persistent post-concussion syndrome.
Tau is a protein known to play a significant role in the development of Alzheimer’s disease and Parkinson’s disease. Using ultra-sensitive technology, the researchers measured levels of tau in the blood months and years after injury. These levels correlated with the severity of post-concussive symptoms. If these findings are further confirmed, this could be the first biomarker that is sensitive and specific to ongoing TBI symptoms. Read More
The Radiology Society of North America has published a new study that identifies particular white matter brain injury patterns in patients with persistent depression and anxiety following mild traumatic brain injury (concussion or mTBI.) Read More
The April, 2015 issue of The American Surgeonreports on a retrospective study of 395 patients admitted to the ER following concussions (MTBI, or mild traumatic brain injury). The patients had “normal” Glascow Coma scores of 15 and normal CT scans and therefore met discharge criteria. The study found that a surprisingly high percentage of these patients (27%) had persistent deficits after neurocognitive testing and benefitted from referral for ongoing therapy. The study is authored by Hartwell et. al. and entitled “You Cannot Go Home: Routine Concussion Evaluation is Not Enough.” Read More
In a study published in April 2015 in the medical journal Brain Behavior and Immunity, a team of Canadian researchers at McMaster University presents a new understanding of the cause of the wide-array of symptoms experienced by some patients following concussion, such as headaches, dizziness, sleep disturbance, fatigue, cognitive impairment and neuropsychiatric symptoms.
This new paradigm helps to explain why the same pattern of symptoms can be found in some non-head injury patients, such a patient who has experienced infections or a patient diagnosed with post-traumatic stress disorder. It also helps to explain why some patients recover and others do not and why pre-accident experience can influence the course of post-accident recovery. Read More
The latest issue of the Journal of Neuroscience (April 22, 2015) reports on animal research from the University of Kentucky which “adds to an increasing body of knowledge strongly indicating that traumatic brain injury is a contributor to increased susceptibility to Alzheimer’s Disease-relevant pathologies, including cognitive dysfunction.”
The authors begin by noting that “epidemiological studies have associated increased risk of Alzheimer’s disease-related clinical symptoms with a medical history of head injury,” but that “little is known about the pathophysiological mechanisms linked to this association.” Prior studies, as well as this study, did find that persistent neuroinflammation is one outcome observed in patients after a single head injury. Read More
A new study published in the Annals of Neurology – the official journal of the American Neurological Association – adds further evidence in support of our growing understanding that TBI, especially moderate/severe TBI or repetitive mild TBI, often triggers a “progressive neurodegenerative process” that accelerates over time. As discussed in prior posts, TBI is now conceptualized as potentially a chronic disease triggered by injury, not as an isolated event. Hopefully this understanding will lead in the future to interventions designed to halt or slow the disease process.
The recent study, published in the April 2015 issue, reports on the results of research at the Imperial College London, where brain scans of over 1500 healthy people were analyzed to develop a computer program that could predict a person’s age from their brain scan. The program was then used to estimate the “brain age” of 113 more healthy people and 99 people who had suffered TBIs. The brains of the TBI patients were on average five years older than their real age would predict. Read More
The New England Journal of Medicine has published the most exhaustive analysis to date of brain injury in children and adolescents. The results reinforce the critical importance of safety helmets for children under 12 and the importance of safety helmets and seatbelts for adolescents.
The data analyzed in the study was from over 40,000 pediatric brain injuries. The most common cause of trauma in children under 12 was falls, often from bicycles. Motor vehicle accidents, sports injuries and assaults were the most frequent mechanisms of injury among adolescents. Read More
The weight of scientific evidence demonstrates that “diffusion tensor imaging” is an effective tool for demonstrating damage to the white matter of the brain associated with mild traumatic brain injury.
The damage typically associated with mild traumatic brain injury (mTBI) is in the axons, the microscopic fiber tracts in the white matter of the brain too small to be seen by conventional tools such as MRI and CT. In fact an individual with a perfectly normal MRI and CT could even be in a coma due to a brain injury. Treatment providers have been left to infer injury from clinical symptoms. However, even the most commonly used clinical tools, such as neuropsychological assessment, are generally seen as insensitive to the subtle, but sometimes life altering, effects of mTBIs. Read More