[ARTICLE] Functional Medicine Approach to Traumatic Brain Injury – Full Text

Abstract

Background: The U.S. military has seen dramatic increases in traumatic brain injuries (TBIs) among military personnel due to the nature of modern-day conflicts. Conventional TBI treatment for secondary brain injuries has suboptimal success rates, and patients, families, and healthcare professionals are increasingly turning to alternative medicine treatments.

Objective: Effective treatments for the secondary injury cascades that occur after an initial brain trauma are unclear at this time. The goal of successful treatment options for secondary TBI injuries is to reduce oxidative stress, excitotoxicity, and inflammation while supporting mitochondrial functions and repair of membranes, synapses, and axons.

Intervention: A new paradigm of medical care, known as functional medicine, is increasing in popularity and acceptance. Functional medicine combines conventional treatment methods with complementary, genetic, holistic, and nutritional therapies. The approach is to assess the patient as a whole person, taking into account the interconnectedness of the body and its unique reaction to disease, injury, and illness while working to restore balance and optimal health. Functional medicine treatment recommendations often include the use of acupuncture, Ayurveda, chiropractic manipulation, detoxification programs, herbal and homeopathic supplements, specialized diets, massage, meditation and mindfulness practices, neurobiofeedback, nutritional supplements, t’ai chi, and yoga. At present, some of these alternative treatments appear to be beneficial, but more research is needed to validate reported outcomes.

Conclusions: Few clinical studies validate the effectiveness of alternative therapies for TBIs. However, further clinical trials and empirical studies warrant further investigation based on some reported positive results from research studies, case histories, anecdotal evidence, and widespread popularity of some approaches. To date, only nutritional therapies and hyperbaric oxygen therapy have shown the most promise and potential for improved outcomes for the treatment of secondary TBI injuries.

Introduction

The u.s. military has seen a dramatic increase in traumatic brain injuries (TBIs) among military personnel during conflicts in recent years. According to estimates by the Department of Defense (DoD) and the Defense and Veteran’s Brain Injury Center, the majority of military TBIs are sustained during motor vehicle accidents, gunshot wounds, blasts, or a combination of these. An estimated 22% of all combat casualties are thought to be caused directly by TBIs.¹ Compared to civilian populations, veterans are disabled for longer periods of time with symptoms of cognitive and behavioral impairments. Veterans frequently experience additional symptoms of post-traumatic stress disorder (PTSD) and chronic pain, and are at increased risk for suicide and substance abuse.

When the brain is injured, brain metabolism is altered and neurons are highly susceptible to damage from free radicals and mitochondrial dysfunction. Thus begins a pathologic process that can sometimes take years to repair. Conventional TBI treatment for these secondary brain injuries has had suboptimal success rates. Because of this, TBI victims, their families, and some healthcare professionals are increasingly exploring new treatment options that are perceived to be less injurious to health, more beneficial, and sometimes their only hope. As Joel Goldstein—whose son sustained a severe TBI in an automobile accident—the founder of the Bart Foundation, and author of No Stone Unturned: A Father’s Memoir of His Son’s Encounter with Traumatic Brain Injury—states: “Unconventional therapies are not merely a reasonable option, they are a necessity.”² These “new” treatments include cell-based, genetic, holistic, integrative, nutritional, and hyperbaric oxygen therapies. Emerging treatment options for the treatment of secondary brain injuries is the focus of this article.

A literature review of alternative treatment options for patients with TBI was completed for this article with a focus on research reported between the years 1980 and 2017. Search criteria included TBI in the military; alternative and functional medicine therapies for brain injury; blogs and foundations for patients with TBI; and supplements, nutrition, and alternative therapies for the treatment of TBI. Because there are few clinical studies validating the effectiveness of alternative treatments for TBIs to date, promising therapies were selected for discussion based on reported objective evidence found in research settings, subjective therapies reported by patients with TBI and their families, and subjective clinician case reports.

Numerous clinical studies involving individual nutrients for brain injury treatment in animal models was found and 10 articles summarizing the most prominent of these studies were focused on. The Institute of Medicine (IOM) book about nutrition and TBI³ was also relied upon for a summary of research in this area. Three specific case reports are highlighted in this article because they represent the most successful alternative treatment approaches for patients with TBI to date. The Brain Trauma Foundation, Brain Health Education and Research Institute, Brainline.org, TraumaticBrainInjuryatoz.org, the National Center for PTSD [post-traumatic stress disorder], and Harch Hyperbarics also supplied information about therapies and treatments that patients with TBI and their families are finding helpful for recovery.

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