Posts Tagged TBI

[VIDEO] Cognitive and Psychological Consequences of Traumatic Brain Injury (TBI) – YouTube

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[WEB SITE] Nutritional Therapies for Traumatic Brain Injury

A change in diet might alleviate some of the long term symptoms of TBI.

Posted Dec 22, 2017

 

You have just experienced a traumatic injury to your head; a series of changes are about to occur in your brain that will have short and long term negative consequences.  You just joined the ranks of 1.7 million other people living in the U.S. who experience a traumatic brain injury (TBI) every year.  TBI is an alteration of brain function caused by external forces leading to loss of consciousness, temporary memory loss and alterations in mental state at the time of the injury.  

 

A study by the Mayo Clinic found that one-third of patients’ brains showing pathology and evidence of chronic degenerative diseases had participated in contact sports. The popular press has carried numerous stories about retired players of the National Football League who have a threefold increase in their risk of developing depression as well as a variety of worsening cognitive impairments.  Indeed, all athletes, especially young adults, exposed to repetitive concussions are at increased risk of developing cognitive deficits.

In the hours, days and weeks following initial accident a series of secondary biochemical changes develop that lead to a progressive degeneration within vulnerable brain regions. Many of these changes are also commonly seen associated with advanced normal aging and are thus rather well studied.  One of the initial changes involves a dysfunction of the mitochondria inside of the neurons of the brain.  Mitochondrial are responsible for energy production and are critical to the survival of neurons, which use a lot of energy. The injury to the mitochondria leads to a condition called oxidative stress where individual atoms of oxygen that we inhale become very toxic to the brain. Next, the oxidative stress induces brain inflammation which leads to an assortment of degenerative diseases, particularly during the years following the TBI event.  These three critical events following the TBI, i.e. loss of normal energy production, oxidative stress and long term brain inflammation, underlies the development of seizures, sleep disruption, fatigue, depression, impulsivity, irritability and cognitive decline. Although no effective treatments are available to alleviate these biochemical events in the brain, research has advanced sufficiently to understand how specific chemicals in the diet can target the negative effects of oxidative stress and inflammation.

A series of recent studies (Nutritional Neuroscience 2018, 21:79), conducted primarily using animal models, have discovered that adding certain vitamins and minerals to the diet might alleviate some of the long term consequences of TBI. I would never recommend taking mega-doses of any supplement, thus I have listed the dietary sources of these nutrients.  It is always most effective, and considerably cheaper, to obtain nutrients via their natural sources.  Supplementation with Vitamins B3 (found in white meat from turkey, chicken and tuna), D (most dairy products, fatty fish such as salmon, tuna, and mackerel) & E (nuts and seeds, spinach, sweet potatoes) improved cognitive function following repetitive concussive brain injury.

Magnesium and zinc are both depleted following TBI.  Zinc supplementation for four weeks reduced inflammation and neuronal cell death and decreased the symptoms of depression and anxiety in rats following TBI.  Both zing and magnesium can be obtained by eating nuts, seeds, tofu, wheat germ and chocolate. The omega-3 fatty acids DHA and α-linolenic acid were also shown to be neuroprotective in animal studies whether taken prior to, or after, the injury.  Thus, people who participate in contact sports might want to add these fats to their regular diet.  However, don’t waste your money on α-linolenic acid or DHA supplements; adequate amounts are easily obtained via a diet containing fatty fish, flaxseeds, canola oil, soybeans, pumpkin seeds, tofu and walnuts.

Sulforaphane was shown to improve blood–brain barrier integrity, reduce cerebral edema and improve cognition in a rodent model of TBI.  Sulforaphane can be obtained via a diet containing brussels sprouts, broccoli, cabbage, cauliflower, kale, broccoli sprouts, turnips and radish. Finally, enzogenol improved cognition when administered to TBI patients in a randomized, controlled study. Enzogenol is a water extract of the bark from Pinus radiate that contains high levels of proanthocyanidins. Once again, do not waste your money, proanthocyanidins are easily obtained by consuming grapes (seeds and skins), apples, unsweetened baking chocolate, red wines, blueberries, cranberries, bilberries, black currants, hazelnuts, pecans and pistachios.

Interventional studies with natural anti-oxidants and anti-inflammatories via the diet are becoming attractive options for patients with TBI.  Unfortunately, very few clinical trials to treat this neurological condition have been performed. Finally, because I have written so often about this topic in other blogs, I must also recommend a daily puff of marijuana which will reduce the consequences of oxidative stress and brain inflammation following TBI.

© Gary L. Wenk, Ph.D. is the author of The Brain: What Everyone Needs to Know (2017) and Your Brain on Food, 2nd Edition, 2015 (Oxford University Press).

 

via Nutritional Therapies for Traumatic Brain Injury | Psychology Today

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[VIDEO] Living With A Stranger: My Husband’s Brain Injury

Why We Created This Video

 

Traumatic or acquired brain injury as discussed by the media and the medical profession often fails to accurately portray the devastating and lifelong consequences brain damage can also have on a spouse and the entire family.

We created this video to offer a different perspective on the lifelong aftermath of brain injury, focusing on a person who has not actually sustained the injury but suffers from its consequences. Spouses and people close to brain injury victims may feel overwhelmed and find it difficult to explain their emotional roller coaster. We hope this video will assist in communicating the difficulties they themselves face. The impact on the spouse, family, and loved ones of someone who has sustained a brain injury are often neglected and overlooked. Their needs must be examined and addressed.

Although families are aware of the importance of the brain, very few families know of the consequences of a brain injury. Often, family members observation of physical improvement leads them to unrealistic expectations regarding cognitive, emotional, and behavioral recovery. Recovery and rehabilitation of these functions may take a long and uneven path, particularly when there is damage to frontal and temporal lobes of the brain, most vulnerable in auto crashes and falls. Those suffering the tragic consequences of a concussion, may have no visible physical symptoms, creating a false assumption that the injury was insignificant.

A once generous, articulate, cheerful, and socially appropriate person, however, may be transformed into a self-centered, verbose, depressed, and unpleasant person shunned by members of his or her own family. These more subtle changes in a person with a brain injury unfortunately envelope and affects a spouse, left alone to cope with the tragic aftermath.

A spouse or significant other may be constantly fearful of upsetting his or her loved one and may become isolated from others. One person’s brain injury has devastating effects on the entire family constellation, with a spouse or significant other functioning as both caretaker and liaison to the world. Spouses require support as well to learn to cope with the long-term consequences of brain injury.

Possible Consequences of Brain Injury to a Spouse, Significant Other:

  • Isolation
  • Clinical Depression
  • Divorce
  • Substance abuse
  • Domestic violence
  • Neglected healthcare

New responsibilities assumed by a spouse following a traumatic brain injury:

  • Household Responsibility
  • Parenting Responsibility
  • Income Responsibility
  • Decision Making
  • Caring for The Injured Spouse

Support Services for Spouses to Consider:

  • Brain Injury Spouse Support Groups
  • In Home Assistance: Home Health Aides and Personal Care Assistance
  • Respite Care

Problems Your Spouse May Have:

  • Change in Sleep Patters
  • Decreased Ambition and Initiation
  • Dependency
  • Depression
  • Impatience
  • Impaired Self-Control
  • Inflexibility
  • Inappropriate Public Behavior
  • Irritability
  • Memory Impairment
  • Self-Centered Behavior
  • Sexual Disinterest or Sexual Preoccupation
  • Sleep Disturbance
  • Temper Outbursts

Important Resources for Spouses, Significant Others and Family Members:

Organizations

Important Information

Publications

About Shana & Michael

Shana De Caro and Michael V. Kaplen.

Shana De Caro and Michael V. Kaplen are personal injury attorneys dedicated to assisting brain injury survivors navigate the road after traumatic brain injury. With extensive experience in representing victims of brain trauma, they are prepared to guide brain injury victims through the legal obstacles they will confront and recover full and fair compensation for the harms and losses their clients have suffered as a result of someone’s careless or negligent conduct.

De Caro & Kaplen, LLP is a New York personal injury law firm focused on representing victims of brain injury. Our attorneys have the knowledge and skill to make a crucial difference in the lives of brain injury victims. Specialized brain injury cases require a law firm with the experience and proficiency to assist brain injury victims through the most difficult legal challenges in their lives following a traumatic brain injury.

Shana and Michael are nationally recognized for their advocacy on behalf of brain injury victims. Shana is in her second term as an officer, and a member of the board of directors of the Brain Injury Association of America . Michael is a three-term past president of the Brain Injury Association of New York State and current Chair of the New York State Traumatic Brain Injury Services Coordinating Council. They have been designated Preferred Attorneys for the Brain Injury Association of America.

Their opinions on traumatic brain injury are frequently sought by The New York Times, USA Today, The Daily News, Fox News Network, and others. They are widely respected throughout the legal, medical, and judicial communities. The two regularly lecture lawyers, medical professionals, and judges, across the nation on how traumatic brain injury clients and cases should be evaluated and handled in and out of the courthouse.

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[WEB SITE] Family Caregiver Guide: Introduction to Traumatic Brain Injury (Module 1) – BrainLine

The Defense Health Board, The Defense and Veterans Brain Injury Center and The Department of Veterans Affairs
Family Caregiver Guide: Introduction to Traumatic Brain Injury (Module 1)

Module 1 Summary

In this section, you can find basic information about:

  •  the parts of the brain and what they do
  •  the causes of traumatic brain injury (TBI)
  •  how the brain changes after TBI
  •  how the brain begins to recover.

You can use this information to understand:

  •  how the brain works
  •  what you might see during recovery
  •  why you might see changes in how your service member/veteran
  •  thinks and acts due to a TBI.

TBIs are classified by how severe or serious they are at the time of injury. TBIs range from mild (concussion) to moderate to severe.

This module provides information on moderate to severe TBI. Doctors, nurses, and other health care providers who work with TBI guided
content.

As you read through this document, ask your health care providers to explain what you don’t understand.

Some key points are:

  •  The brain is the body’s control center.
  •  The parts of the brain work together to help us think, feel, move, and talk.
  •  A TBI is caused by a penetrating injury or by blunt force trauma to the head.
  •  TBI is very common in both civilian and military populations.
  •  Many different health care providers will help diagnose and treat your service member/veteran with TBI.
  •  It is the goal of health care providers to minimize complications, the things that can go wrong after the injury.
  •  Many service members/veterans with TBI go through common stages of recovery. Each person, however, progresses at his or her own pace.
  •  Recovery from a TBI may be measured in weeks, months, or years.
  •  Promising new research is showing the brain’s capacity for healing.
  •  There are many ways you can support your service member/veteran with TBI throughout his or her recovery.

Be hopeful. The brain is very good at repairing itself.

Read some of the chapters in this module:

Posted on BrainLine July 5, 2012.

 

via Family Caregiver Guide: Introduction to Traumatic Brain Injury (Module 1) | BrainLine

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[WEB PAGE] Treatment of Traumatic Brain Injury With Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is defined as the use of oxygen at higher than atmospheric pressure for the treatment of underlying disease processes and the diseases they produce. Modern HBOT in which 100% O2 is breathed in a pressurized chamber dates back to the 1930s, when it was first used for treatment of decompression illness in divers. There are currently 13 FDA-approved uses for HBOT, including decompression illness, gas gangrene, air embolism, osteomyelitis, radiation necrosis, and the most recent addition—diabetic ulcers.

Just as practicing physicians routinely identify off-label uses for medications, over the years HBOT physicians have identified many other conditions that respond to HBOT. A number of chronic neurological conditions including traumatic brain injury (TBI) have been shown to respond particularly well. There is published literature supporting HBOT’s efficacy for TBI, including human trials and animal research, but due to the impossibility of arranging sham pressure there are no rigorous double-blind placebo-controlled trials.1 As a result, HBOT is not FDA-approved for TBI, and insurance will generally not pay for it.

HBOT can dramatically and permanently improve symptoms of chronic TBI months or even many years after the original head injury. This assertion is generally met with skepticism within the medical establishment because we have been taught for generations that any post-concussion symptoms persisting more than 6 months or so after a head injury are due to permanent brain damage that cannot be repaired. Therefore, treatment has been limited to symptom management and rehabilitative services, and any claim suggesting that fundamental healing is possible is suspect. The combination of entrenched skepticism and lack of insurance coverage has made it very difficult for patients to access treatment.

Another source of skepticism has been the large number of disparate conditions that are claimed to be helped by HBOT. A brief review of the mechanisms through which HBOT triggers healing responses, with particular reference to the modern understanding of the pathophysiology of TBI, provides a theoretical framework to explain these claims.

Physiological effects of HBOT

About 97% of the total oxygen in blood is tightly bound to hemoglobin when breathing room air (21% O2) at sea level (1 atmosphere, or 1 ATM; 3% of the oxygen is dissolved in blood serum. This amounts to about 0.3 mL of oxygen dissolved in 100 mL of serum. By the time oxygen diffuses out of the circulatory system and ultimately reaches the mitochondria, there is just a trace amount present. HBOT’s primary mechanism is to temporarily hyper-oxygenate body tissues. HBOT delivered at 1.3 ATM increases dissolved oxygen in serum by a factor of 7. HBOT delivered in hard chambers at 2.5 to 3.0 ATM increases dissolved oxygen by a factor of 15 or more. Oxygen levels in body tissues outside the circulatory system will be increased commensurately.

If a hyper-oxygenated state is maintained for long periods it will cause significant oxidative damage, but when it is “pulsed” for an hour it triggers a variety of healing processes without overwhelming the body’s anti-oxidant system. The currently known mechanisms include a powerful anti-inflammatory effect, reduction of edema, increased blood perfusion, angiogenesis, stimulation of the immune system, stimulation of endogenous antioxidant systems, mobilization of stem cells from bone marrow, axonal regrowth, and modulation of the expression of thousands of genes involved in the inflammatory response and various healing responses.2,3

[…]

Continue —>  Treatment of Traumatic Brain Injury With Hyperbaric Oxygen Therapy | Psychiatric Times

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[ARTICLE] Pharmacological management of long-term aggression secondary to traumatic brain injuries – Full Text

Abstract

Aggression is common after traumatic brain injuries (TBI) in acute and chronic settings. However, there is limited guidance regarding its assessment and effective management. Whilst a number of pharmacological options are available for long term treatment, the evidence base is not of an adequate strength to support a unified practice. This article will explore the currently available guidelines and recommendations for treating chronic aggression after TBIs and evaluate the evidence for its pharmacological management.


Introduction

Aggression is a long term neurobehavioural sequelae of TBIs with incidences quoted from 11.5-33.7%.1 In TBI patients, aggressive behaviour tends to be impulsive rather than premeditated and can manifest as episodic dyscontrol syndrome, disinhibition or exacerbated premorbid antisocial traits.2 The underlying mechanisms of aggression are complex allowing numerous and diverse interventions targeting various pathways.

In acute settings, Lombard and Zafonte (2005) describe non-pharmacological measures to manage aggression including environmental alterations and ensuring minimal or non-contact restraints. Screening for systemic causes, optimising pain control and patients’ sleep-wake cycle are also advocated. In the event of failed non-pharmacological treatment, Lombard and Zafonte (2005) recommend that medication choice should be tailored to individuals; with side effect profiles taken into consideration.3

For chronic aggression, psychological therapies are used as a first line with pharmacological interventions trialled in later stages.4 Psychological therapy options include cognitive behavioural therapy (CBT), behavioural management utilising operant learning theory and contingency management. However, a review by Alderman (2013) concluded that further evidence using scientific methods is needed to analyse these approaches.5  Comparatively, there is a diverse body of literature addressing long term pharmacological treatment although quality among studies are varied. This article will focus on the aetiology for chronic post TBI aggression, current management guidelines and the evidence for long term pharmacological interventions.[…]

via Pharmacological management of long-term aggression secondary to traumatic brain injuries | ACNR | Online Neurology Journal

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[QUOTATION] Brain Injury is …

Η εικόνα ίσως περιέχει: φαγητό

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[BLOG POST] 10 Things My Doctor Didn’t Tell Me About Traumatic Brain Injury Recovery

10 Things My Doctor Didn’t Tell Me About Traumatic Brain Injury Recovery 

After my traumatic brain injury (TBI), a trauma doctor, a neurologist, and a brain surgeon watched over me while I was in the ICU and trauma wing of the hospital. I am extremely grateful for their help during that fragile and scary experience. However, when I left the hospital, they largely left me in the dark regarding traumatic brain injury recovery.

With help from others (mostly my mom) I was able to connect with resources to help me face the challenges I was having. Lo and behold my challenges were very common for TBI survivors. I had no idea that other people were facing the same thing.

I wish my doctors would have prepped me better for what life is like after a TBI. If you are new to the journey of at TBI survivor (or still trying to figure things out), here are 10 things I wish the doctors would have told me about traumatic brain injury recovery before I left the hospital.

1. No Two TBI’s Are the Same

Even when people have similar challenges as a result of their injury, the speed of a recovery, how much a person recovers (50%, 70%, or 90%), which medication can help resolve symptoms (if it works at all), and many other factors vary widely from person to person. You can’t see a person who recovered 100% and say “that will be me”. You also can’t see someone who faces significant challenges after a long period of time and think that you will not make any improvement.

2. There Are Groups with Resources to Help TBI Survivors and Caregivers

Lots of them. In the US, the Brain Injury Association of America is a great resource with branches in many states. The branch in California put me in touch with a doctor that really helped me. Another good resource are hospitals. They often host support groups for TBI survivors and their families. If not, they will be aware of the groups that do meet in your area.

Please take advantage of these groups! Everything changes so much for everyone involved, especially the relationships between them. The support groups give you a place to vent your frustrations and get support from other people walking the TBI road.

For some help with exploring the new relationships, I’ve written two articles, one for survivors, and one for family & friends that highlight some of the big changes and give ideas for addressing them.

3. There Are Some Very Common Deficits after a TBI

Since a TBI affects your brain, it can ripple into every part of your life. Some of it also depends on the part of the brain that is affected. Nevertheless, here are some common ways that at TBI shows up:

  • Memory problems, especially short term memory
  • Bad temper/mood swings
  • Balance
  • Visual processing
  • Motor control
  • Depression
  • Anxiety

If you are experiencing any (or several of) these effects after your TBI, know that it’s completely normal for TBI survivors. If you have any doubt about that, go to a TBI support group. You WILL find survivors there who will offer you encouragement because they dealt (or are dealing) with the same thing.

4. There is No Time Threshold for Recovery

The medical opinion used to say that said your recovery will happen within two years. It also said that whatever abilities haven’t returned by then will never come back. Some doctors who don’t specialize in traumatic brain injury recovery, continue perpetuating that myth. Over the last several years, doctors have found that our brains are capable of learning indefinitely after a brain injury.

I can tell you from my own experience that this seems to be true. My accident was nearly 6 years ago. Although my recovery was the fastest in the first two years, I still feel and observe occasional improvements in different things. Another example is of a woman I met recently at TBI support who is starting to learn to walk again. Her injury happened 13 years ago and has been confined to a wheelchair since then. It’s a long road. Don’t give up. Keep working at it.

5. Spend Some Time Investigating Alternative Approaches to Dealing with Your Symptoms

Medication did provide the biggest breakthrough to controlling my temper after my injury. However, I wanted to explore additional options to cope with it. I found exercising to be very helpful. Mindfulness meditation also provided some help. I still use both of these strategies on a regular basis. I haven’t used it myself, but some people in support groups mention that aromatherapy helps them. Explore the different options and listen to your mind and body to see what works best for you.

6. BEWARE of Overstimulation

Yes, I put beware in all caps. This is a big deal. I can’t believe that no one mentioned this to me when I left the hospital after my injury. Many TBI challenges are made worse once your brain is maxed out. An injured brain’s tolerance for stimulation is much lower than a brain that is not injured. Remember any outside input is stimulation.

For me, by biggest challenges were on my phone. Too much social media, YouTube, and too many games. I also watched to much TV. The stimulation from those activities accelerated me reaching my threshold. Once I maxed out, I became more irritable, had a harder time focusing on important tasks, and had a harder time remembering stuff. Give your brain the down time it needs to recover. Over time you will likely be able to tolerate more outside stimuli. But at the beginning, take it easy.

7. Balance Pushing Yourself and Allowing Down Time

I firmly believe that getting back to work quickly helped me recover as much as I did. However, in retrospect, I might have done it differently. For the first 6 months I didn’t know I needed to beware of overstimulation, so I would work like I was operating at 100%. But by 1pm everyday, I was maxed out, irritable, and extremely angry. Some down time during the work day, or taking on fewer projects would have helped me avoid that anger. Listen to your brain, your body, and those closest to you. Push yourself as much as you can, but back-off when necessary.

8. Physical Fatigue

Rebuilding a brain must take a lot of energy, because it can leave you very tired. During the first few weeks after my injury, I slept for 12-16 hours a day. I needed 10 hours of sleep per night until about 3 months after my injury. It’s normal, and it’s giving your brain the time it needs to heal itself.

9. You Will Be Living with an Invisible Injury

It’s quite likely that you have some physical injuries associated with whatever caused your TBI. Most of them will heal 6-12 weeks after your accident. Once the casts, splints, and braces are removed, people will stop asking what happened and assume that you are doing well. It’s hard to blame them, because there aren’t any visual cues telling them something is wrong. Any of us might do the same thing.

Of course, we know that we have an injury and we are healing. Since our injury is invisible to others, there will be times when we seem “off”. Maybe it’s a word that we can’t seem to find, or we are unusually forgetful or irritable. People will make a judgment, because they don’t have the whole picture. It’s tough to be on the receiving end of those judgments.

10. Accepting the new normal

After a TBI, we can’t hit an undo button. This is who we are now. I spent a lot of time worrying at the beginning of my TBI journey because I didn’t want to accept this. Once I accepted what was, it made it easier to look at what was in my control and start working with that. My post-TBI life became a re-start opportunity. Reframing the situation didn’t make my problems go away, but it did make it easier to face them.

Bonus: Give Yourself Time to Grieve

I nearly forgot to include this. The transition from the “pre-TBI you” to the “new-TBI you” is very real, and it’s a lot like mourning your own death. Sounds odd, I admit. However there is a real loss that happens after a TBI. Some of what we might experience includes the loss of cognitive function, the loss of your old personality, of your memories, the loss of physical abilities, the loss of relationships, the loss of employment, to name a few.

Note to the wives, mothers, girlfriends, etc of men who have experienced a TBI. Grieving does not equal crying. Crying can be part of the grieving process, but it doesn’t have to be. There are lots of ways to grieve. If your man grieves one way, and you grieve another, that’s perfectly normal. What’s important is that you support each other in the process, so you can prepare for the journey that is to come.

Note to men: Guys, we’re not always great about feelings. We’re tough, want to be independent, and have a hard time admitting when something is wrong with us. But this grieving process is important. It helps you process the changes that have happened, face what is, and prepare for the new journey into the future. And I am not telling you to cry. Crying might be part of your grieving (it was for me), but it doesn’t have to be. Find what works for you. If you’ve had a TBI, take the time to grieve what’s happened. It will do worlds of good to help you through the recovery process.

The grieving process also applies to those around us: spouses, children, parents, friends, and employers. You can check out this great article from Brainline about about the grieving process after at TBI.

Traumatic brain injury recovery is HARD, and it takes more grit that I thought I had. If someone had shared this information with me at the beginning, it would have really helped me regroup sooner, work smarter, and be more patient with myself.

Is there anything else you would have included on this list? Leave it in the comments below.

If you found this guide useful you can sign up here to get get ideas and support to help with your recovery from TBI. Starting tomorrow, you will receive my 4 part email series where I cover several techniques to help you (or your loved one) with the TBI recovery journey.

 

via Traumatic Brain Injury Recovery | 10 Things My Doctor Didn’t Tell Me

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[Infographic] What NOT to say to someone with a brain injury

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[NEWS] Finding innovative treatments to help patients with traumatic brain injury

To treat a traumatic brain injury, researchers are thinking outside the box.

A traumatic brain injury can range from mild to severe, but is usually caused by a harsh bump or blow to the head. A patient may experience a moment of dysfunction on the mild end, to unconsciousness and loss in brain function on the severe end of injury.”

Kevin Ward, M.D., a professor of emergency medicine and biomedical engineering at Michigan Medicine and director of the Michigan Center for Integrative Research in Critical Care (MCIRCC)

According to the Centers for Disease Control and Prevention, TBI is a serious public health problem in the United States. In 2014, there were approximately 2.87 million TBI-related emergency department visits, hospitalizations and deaths throughout the nation.

“Unfortunately, the current diagnosis, monitoring and treatment strategies for TBI have not significantly progressed over the last 30 years and have been ineffective at reducing the extent of the injury,” Ward says.

Massey TBI Grand Challenge

Thanks to funding from the Joyce and Don Massey Family Foundation, MCIRCC hopes to improve treatment and survival rates for patients that experience a TBI. The Massey family had their own experience with TBI after a car accident injured mother and wife, Joyce Massey.

“Funding from the Massey Family Foundation has allowed us to institute the Massey TBI Grand Challenge,” Ward says.

“The Grand Challenge aims to bring interdisciplinary teams together to create high-risk, high-impact, milestone-driven solutions that address the golden hours of care, or the treatment administered during the initial hours after injury, plus the 24 to 48 hours of care after a severe traumatic brain injury.”

The funding also allows MCIRCC to host the Joyce Massey TBI Summit each fall. The conference brings together the nation’s leading experts and researchers to discuss the most pressing challenges facing TBI care and how to work together to find innovative solutions.

The Massey TBI Grand Challenge encourages researchers to come up with “innovative and disruptive” TBI solutions and pitch them to an independent panel of clinicians, innovation and commercialization experts, national TBI experts and Department of Defense representatives.

“All of these great minds come together to push past the borders of typical TBI care,” Ward says. “What starts as an idea, evolves and starts to take shape. Then the team participates in our Wolverine Den, or a U-M version of Shark Tank,pitching day with research behind their idea and support that it should be funded, as it could help potentially guide future treatments.”

Five projects were selected for funding this year:

Using light wavelengths to target cells

Thomas Sanderson, Ph.D., an associate professor of emergency medicine and molecular and integrative physiology at Michigan Medicine, says that while the molecular events happening in the body during a TBI are complex and can vary, mitochondria, or the organelles in cells that help them stay energized, appear to be a common contributor to brain injury.

The research team proposed a non-invasive therapy that uses light wavelengths to target mitochondria and alter the molecular events happening inside cells during a brain injury.

Project and researcher: Evaluating Non-Invasive Mitochondrial Modulation in a Translational Model of TBI; Thomas Sanderson, Ph.D.

Valproic acid in TBI patients

Valproic acid is a type of medication generally used to treat patients with epilepsy and psychiatric disorders. Now, researchers hope it could be used to treat TBI.

The funded project will further investigate if valproic acid can successfully be used to treat patients with TBI and if so, the funds will help support an Investigational New Drug application.

Project and researchers: Valproic Acid Treatment for Varying Severities of Traumatic Brain Injury; Ben Biesterveld, M.D., Hasan Alam, M.D., Manjunath Pai, PharmD, Jason Fawley, M.D., Aaron Williams, M.D., George Velmahos, M.D., Martin Sillesen, M.D., Glenn Wakam, M.D., and Michael Kemp, M.D.

Point-of-care device to monitor and measure biomarkers in real-time

Cerebrospinal fluid, the fluid found in the brain and spinal cord that protects them from trauma, and blood contain biomarkers that researchers say could play a role in how a TBI is diagnosed and monitoring the progression of the injury.

Mark Burns, Ph.D., and Frederick Korley, M.D., Ph.D., proposed a portable, point-of-care device that could measure biomarkers in the fluid and blood and display the results on a handheld device, such as a smartphone, within 15 minutes.

Project and researchers: Device for High Frequency and Real-Time Measurement of Biofluid Biomarkers; Mark Burns, Ph.D., Frederick Korley, M.D., Ph.D.

Intranasal insulin therapy to protect the brain

Intranasal insulin, or insulin nasal spray, is already in clinical trials for Alzheimer’s disease and stroke, but researchers hope to prove it can successfully protect the brain when a high-dose is given to a TBI patient soon after injury.

The nasal spray speeds up the ability for the hormone to get to the brain through small blood vessels in the nose, instead of waiting for it to enter and go through the bloodstream when administered in the arm or stomach.

The research team will study the neuroprotective effects of an early dose and a treatment strategy where non-medical providers could administer the dose to a TBI patient right after the injury takes place.

Project and researcher: Neuroprotection with Intranasal Insulin after Traumatic Brain Injury; Tulasi Ram Jinka, DVM, Ph.D., and Robert Neumar, M.D., Ph.D.

Device to measure and monitor systolic blood pressure

Systolic blood pressure indicates the amount of pressure in the arteries when the heart pushes blood through the arteries to the rest of the body. A drop of systolic blood pressure below certain levels can dramatically worsen TBI. Unfortunately, monitoring critical levels of systolic blood pressure is very difficult.

The research team previously developed a device that provides automated, targeted systolic blood pressure monitoring. In this project, the group will refine and test the next iteration of their device to ensure it can provide continuous readings of a patient with TBI’s systolic blood pressure and keep it at a level needed for optimal TBI management.

Project and researchers: STAT: Systolic Target Assessment Tool; David Hackenson, M.D., Hakam Tiba, M.D., and Kevin Ward, M.D.

Future care

MCIRCC encourages researchers, clinicians and stakeholders to attend its future TBI events.

“By working collaboratively, we can pioneer a new path to transform TBI care,” Ward says.

“We hope the innovations our MCIRCC members are researching now, will result in improved care in the near future.”

 

via Finding innovative treatments to help patients with traumatic brain injury

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