Head & Brain Injury Advice and Resources


New Hope for TBI Survivors with Extreme Day Time Fatigue

A significant majority of people with TBI suffer from night-time insomnia and day-time fatigue. New research published in December 2013 by a group led by Akiva S. Cohen, Ph.D., a neuroscientist at The Children’s Hospital of Philadelphia (CHOP), may point the way to treatment. Dr. Cohen, in collaboration with other experts, induced TBI in mice which developed sleep disruption and day-time fatigue. The team fed these mice with selected branched chain amino acids (BCAA) which are precursors of the neurotransmitters glutamate and GABA. These neurotransmitters maintain a normal balance in brain excitation (wakefulness) and inhibition (sleep).

The researchers found that the new diet restored more normal patterns of sleep and wakefulness. On the BCAA diet the mice with TBI not only slept better at night but were much more active during the day. Their day-time EEG recordings showed marked improvement in activity level. Apparently the diet stimulated activity in the orexin neurons that keep the mice (and other mammals like humans) awake. After sustaining the TBI the mice showed decreased orexin levels in their spinal fluid, but these levels went up after eating the BCAA diet. Dr. Cohen cautioned Cohen cautioned that current evidence does not support TBI patients medicating themselves with commercially available amino acids from health food stores.

To help my readers understand the context of this research, the sleeping pill Ambien helps people get to sleep by activating the flow of GABA in the brain. Given the strange side effects reported by some Ambien users safety concerns exist regarding this drug even though it is currently the top seller in the sleeping pill market. The December 9, 2013 issue of the The New Yorker reported that Merck has developed a new sleeping drug called Suvorexant which works by inhibiting the orexin neurons which maintain wakefulness. This drug may be marketed in a year or so after further negotiations with the FDA. The BCAA diet Dr. Akiva’s team fed to mice activated the orexin neuron system in hopes of increasing day-time activity. TBI survivors with extreme day-time fatigue may wish to follow the progress of Dr. Cohen’s research.