Category: TBI

The tongue is connected to the brain by thousands of cranial nerve fibers. There are motor fibers running from the brain to the tonue that activate the muscles of the tongue and there are sensory fibers (in the facial and glossopharyngeal nerves) that bring sensations from the tongue to the brain. Very recently researchers at the U.S. Army Medical Research and Materiel Command have collaborated with researchers at the University of Wisconsin-Madison and NeuroHabilitation Corporation to use the sensory nerves of the tongue as a pathway to stimulate the brain and regenerate damaged brain tissue following TBI, stroke or MS.

They have created an experimental device they call the PoNS (a battery operated appliance covered with electrodes) that gets placed upon the tongue and sends specially-patterned nerve impulses to a patient’s brain. The electro-stimulation of the tongue is done in tandem with a custom set of physical, occupational, and cognitive exercises, based on the patient’s deficits.

The idea is to improve the brain’s organizational ability and allow the patient to regain neural control. The PoNS prototype and associated therapy were developed by University of Wisconsin-Madison scientists Yuri Danilov, Ph.D., Mitchell Tyler, M.S., P.E., and Kurt Kaczmarek, Ph.D. Their research is driven by the principle that brain function is not hardwired or fixed, but can be reorganized in response to new experiences, sensory input and functional demands. If the ongoing research shows the PoNS device to be safe and effective, the collaborators will apply for FDA approval.

According to the National Institutes of Healh a traumatic brain injury (TBI) is “an injury from a blow, jolt, or penetrating object that disrupts normal functioning of the brain. Causes of TBI include falls, car accidents, sports-related impacts, and penetrating injuries. A TBI can be mild, some​times called a concussion; serious, causing long-term problems; or any level in between.”

Is the brain of a child more vulnerable to mild traumatic brain injury (MTBI) than an adult? In the December 12, 2012 issue of the Journal of Neuroscience researchers published a study showing that damage to the white matter of the brain first detected 2 weeks after MTBI in children (ages 10-17) was still visible 3 months post-injury on DTI brain scanning. The damage was present even though the children had stopped reporting symptoms. This study contradicts the assumption that the brains of children heal rapidly and completely from MTBI. The white matter of the brain consists of long nerve fibers (axons) that carry messages from one part of the brain to another. Thus the persistence of visible white matter damage 3 months after MTBI is a concern that warrants further investigation.

The APOE-e4 allele is a gene mutation associated with incresed risk of Alzheimer’s disease. Does possession of this gene mutation contribute to worse outcome following TBI? In the Journal of Neurotrauma 25:279–290 (April 2008) Zhou and colleges carried out a comprehensive survey and meta-analysis of cohort studies of sufficient rigor to determine whether the presence of the APOE4 allele contributes to poor outcome following traumatic brain injury (TBI). They 100 identified studies between 1993 and 2007 they selected 14 cohort studies for analysis based on comprehensive quality assessment. These studies included a total of 2527 participants, 736 with and 1791 without the APOE4 allele. The studies showed that possession of the APOE-e4 allele was not associated with initial injury severity of TBI.

However, the APOE4 allele was significantly associated with a poor outcome of TBI at 6 months after injury. While knowing that a victim of TBI has the gene mutation does not create any new or improved treatment options, it can explain in litigation why a mild or moderate TBI has more severe consequences than ordinarily anticipated.

The most common cause of acquired epilepsy in teens and young adults is traumatic brain injury resulting from head contact. This year Associate Prof. of Neurosurgery Raimondo D’Ambrosia at the University of Washington performed an experment to test the cooling hypothesis. He gave a contusive brain injury to a group of rats. Half the rats received mock cooling for 5 weeks while the other half received head cooling within (but not exceeding) 2 degrees Celsius for 5 weeks. The sham-cooled rats showed a high degree of post-traumatic epilepsy, while the rats who had their heads cooled showed almost none. Dr. D’Ambrosia will seek permission to try the cooling treatment on humans to see if he gets the same highly protective effect.

The Notre Dame team Athletic Dept. has developed a tablet-based testing system that captures the voice of an individual and analyzes the speech for signs of a potential concussion anytime, anywhere, in real time. The benefit of this technology is that nearly 90 percent of concussions go unrecognized when they occur. The way it works is that an athelete speaks into a tablet equipped with the Notre Dame program before and after an event.

The two samples are then compared for TBI indicators, which include distorted vowels, hyper nasality and imprecise consonants. The systems has been validated independently by physicians in football and boxing matches. The testing was done in cooperation with James Moriarity, the University’s chief sports medicine physician, who has developed a series of innovative concussion testing studies.