Falls Supplanting MVA’s as Leading Cause of Fatal TBI’s

The July 2011 issue of the American Journal of Preventive Medicine reviews statistics on fatal TBIs from 2003-2008. During those years the percentage of fatal TBIs from motor vehicle accidents (MVAs) continued to decline while those from falls continued to rise. As of 2008 fatal TBIs from MVAs accounted for 31% of all fatal TBIs, while falls came in second at 29% and acts of criminal and non-criminal violence came in at 20%. Men suffered fatality rates 15 times higher than women, and workers 65 and over had the highest TBI fatality rates of all workers (2.5 per 100,000 per year). Experts say that falls have increased significantly as a cause of fatal TBI because more of our aging population is over age 65, while vigorous enforcement of seatbelt laws and improved safety features of automobiles (including side airbags and computerized sensing of imminent collisions) have lowered fatalities from head injuries in MVAs.

The occupation with the highest number of fatal TBIs was construction. The highest rate of fatal TBIs was associated with the transportation, agriculture, forestry, and fishing industries, recording nearly half of all work-related TBI fatalities.

Faith in Higher Power Helps TBI Survivors in Rehab

Brigid Waldron-Perrine, Ph.D., a recent graduate from Wayne State University, and her mentor, Lisa J. Rapport, Ph.D., professor of psychology at Wayne State University’s College of Liberal Arts and Sciences, reported in June 2011 that personal faith in a higher power improves the emotional and physical outcome of rehabilitation for TBI patients. Their conclusion was based on a study involving neuropsychological testing of 88 individuals diagnosed with TBI, most of whom were male, African American Christians. The improved outcome was associated with the feeling of a personal connection with a higher power, not with belonging to a religious group or participating in public worship activities. Most likely the feeling of connection helped by reducing stress, negativity, and loneliness, and by increasing positive emotions including trust and optimism.

TMS Therapy May Wake Up Comatose TBI Patients

In July 2011 Dr. Theresa Pape announced that by using a series of TMS treatments she had significantly increased alertness in Josh Villa, a father of 3 children left in a deep coma after an auto accident 6 years before. TMS or transcranial magnetic stimulation uses a coil to send harmless magnetic pulses into the brain, and it has been used effectively to reduce depression. Thanks to TMS Mr. Villa is now able to raise his head, look at other people and utter a few simple words (“Mom,” “Help me,” and “Pain”). Dr. Pape theorizes that TMS activated dormant neurons in his brain, causing them to send their axons into the brainstem and rebuild the damaged RAS (reticular activating system) required for conscious alertness. She will try the therapy on three other patients in the coming years.

MEG Scanner Can Detect Mild/Moderate TBI

While MRI can detect brain swelling/compression and CT can detect brain bleeding, neither type of scanner can find small traumatic brain lesions involving torn axons. So many mild and some moderate traumatic brain injuries remain invisible. However, a team of researchers at UC San Diego is making use of a new high tech scanner called MEG (magneto-encephalography) that makes these invisible brain injuries visible. MEG pinpoints damaged areas of the brain by showing sites with low frequency brainwaves.

The researcher in charge of the ongoing research project is Mingxiong Huang, associate director of UC San Diego’s MEG Radiology Imaging Laboratory. In a June 1, 2011, interview he said MEG can also be used to diagnose PTSD.

Brain Gym Program Helps Mild TBI

Soliders coming back from Iraq and Afghanistan with concussive brain injuries from explosions show problems with concentration, working memory, and multi-tasking. Dr. David Twillie, director of the Fort Campbell Traumatic Brain Injury Clinic, has developed a new method of treating these “mild” brain injuries with an 80% success rate.

The method involves identifying the part(s) of the brain which were damaged along with the functions that have been impaired, and then coming up with cognitive challenges tailored to stimulating the injured areas. Pushing the soldiers to use the damaged parts of their brains stimulates their brains to regrow brain cells, thicken synapses, and restore some of the lost brain function. Some of the soldiers helped by this therapy elected to return to the war zone for duty. Dr. Twillie believes the technique can be successfully applied to civilians with mild TBI.

Cyclosporine Effectively Treats Severe TBI

NeuroVive Pharmaceutical, AB is a Swedish drug development company. Working with NeuroStat it has developed a mechanism for delivering drugs directly to the brain through the blood-brain-barrier which normally screens out large molecules. In recent tests NeuroVive has shown that cyclosporine A, a drug used to help organ transplant recipients avoid immune rejection, helps victims of severe traumatic brain injury by revving up the shocked mitochondria in their brain cells. Mitochondria are the part of cells that produce the vital energy needed for all cellular processes including cellular respiration, repair, and reproduction. NeuroVive continues to work on this new treatment, and it has just received a large grant from the Swedish government to use cyclosporine to treat acute stroke.

Seizures and Migraine Following TBI – Is There a Common Cause and a Common Method of Prevention?

Some of the soldiers returning from Iraq and Afghanistan with TBI are displaying the dual problem of seizures and migraine. Two University of Utah researchers (K.C. Brennan, M.D., assistant professor of Neurology, and Edward Dudek, Ph.D., professor and chair of the Department of Physiology) are teaming up with the Department of Defense to investigate this phenomenon. They suspect that seizures and migraine both arise from over-excitation of the brain due to TBI, and they are collaborating on a study to see if there is a common mechanism and a common method of preventing these very serious, long-term consequences of TBI.

traumatic brain injury in sports

Brain Inflammation Secondary To TBI Can Be Limited

Benjamin Cravatt, Ph.D., at the Scripps Research Institute and Daniel Nomura, Ph.D., at UC Berkeley have made an important discovery about how to block brain inflammation, something which can severely compound the initial damage done by a TBI. They learned that in the brain the production of arachidonic acid (which gets converted into the pro-inflammatory substances called prostaglandins) is controlled chiefly by the enzyme MAGL(monoacylglycerol lipase). MAGL uses the enzyme 2-AG to make arachidonic acid. 2-AG is a cannabinoid associated with pain reduction and pleasure production which mimics the effects of marijuana.

The research scientists showed that by blocking the activity of MAGL they could shrink of the pool of arachidonic acid and prostaglandins in mouse brains and effectively limit the amount of brain inflammation in mice. Brain inflammation (which occurs in Alzheimer’s and Parkinson’s diseases) is also a major problem following TBI, and limiting brain inflammation following TBI would prevent secondary damage. The researchers will continue studying the most effective ways to eliminate MAGL from the brain or to block its actions.

Lithium Shows Promise as Treatment for Acute TBI

Lithium has been used for decades to treat mania. Psychiatrists believe that lithium controls mania in part by decreasing the activity of the excitatory neurotransmitter glutamate. Following TBI some brain cells release excessive quantities of glutamate which damages or kills other brain cells. Fengshan Yu and colleagues at NIH and the University of Health Sciences have explored the effect of lithium on acute TBI in mice. They devised an experiment in which some of the mice given a TBI under anesthesia were treated with lithium for 3 days and the others were treated with a placebo.

The key results of the study include: lithium chloride at 1.5 to 3.0 mEq/kg reduced brain lesion volume compared to control; lithium chloride reduced post-trauma related anxiety behavior during the outcome monitoring; lithium chloride reduced breakdown of the blood-brain barrier; and short-term and long-term motor coordination was better in the lithium group of mice. The researchers would like to try out lithium in a clinical study on human beings with TBI in the future. Their results were published in the Journal of Neurotrauma.

Treating TBI as a Chronic Disease

Steven Flanagan, M.D., Chairman of the Department of Rehabilitation Medicine at the NYU’s Rusk Medical Institute is an expert on rehabilitation of adult and child traumatic brain injuries. In December 2011 he will give a talk in Orlando, Florida, offering a rationale for treating TBI as a chronic disease with long-lasting medical problems requiring lifelong follow-up. Patients who suffer a TBI often exhaust the limited health care resources in the period soon after the initial injury – resulting in inadequate long-term care.