MAGNETIC RESONANCE SPECTROSCOPY (MRS)
MRS is a new diagnostic tool to detect brain injury by looking at the levels of common brain chemicals after injury. If these metabolites are at certain levels as to each other, an injury is likely. MRS can be done as part of a standard MRI and is available in most cities in the U.S. A recent review of almost 1000 studies on MRS shows that it is effective on all TBIs, except for mild TBI and acute injuries.
CURE FOR RINGING EARS (Tinnitus)
The intrusive and sometimes severe symptom commonly following TBI – tinnitus, a loud constant ringing in the ears, has long evaded a cure. Now, however, tinnitus retaining therapy (TRT) seems to work in up to 80% of patients. The treatment now can show improvements in one month instead of one year. Hopefully TRT will soon be covered by heath insurance, if not already.
NEUROINFLAMMATION: A COMMON CAUSE OF DISEASE
Depression seems to be associated with disruptions in the body caused by neuro-inflammation such as TBI, stroke, chronic pain, diabetes and other illnesses. Inflammatory reactions in the brains microglia (immune cells) as well as brain blood barrier (BBB) disruption seem to be the cause. Depression occurs in the presence of a high brain inflammatory load. Researchers are racing to learn more about these causes and cures. (Benattin, C et al. 2016).
STRESS AND MICROGLIA ILLNESS
The microglia of the brain, which were ignored by scientists for 70 years until recently, appear to have a great deal to do with our health. Microglia are activated after TBI and often do not shut down after their immune response should be over. This causes chronic neuro-inflammation, which can lead to dementia, depression, anxiety, Parkinson’s and more. Stress has been found to create microglia activation – yet another strike against stress in our stressful lives.
In fact, stress caused by “repeated social defeat” failure at dating or work, for example, actually activates microglial and harms the immune system, leading to widespread susceptibility to a variety of illnesses. (Ramirez, K. et al. 2016)
IGF-1: GROWTH HORMONES AND ALZHEIMER
Insulin-like growth factor (IGF-1) is involved in both growth hormones and diabetes and is produced by the pituitary gland. Commonly in TBI we see damage to the pituitary/hypothalamic axis which results in lowered IGF-1/growth hormone levels (although do not rely on IGF-1 testing alone after a TBI, the levels can be normal; do only a Glucagon tolerance test). IGF-1 is now thought to be involved in regulation of the human body’s “homeostasis” – or normal metabolic levels. Disruption can lead to Alzheimers and diabetes. IGF-1 itself shows promise as a possible therapy. (Zheng P. 2017).
LIGHT THERAPY FOR FATIGUE AFTER TBI
Fatigue, after a headache, is the most common symptom of TBI. An injured brain consumes far more fuel (glucose) than a normal brain, leading to such fatigue. When an injured brain goes around injured areas, thus consuming more fuel.
With this new therapy of using short blue wavelength light (blue), after four weeks most patients showed lessened fatigue and increased attention. Yellow lights and no lights showed no improvement. Better yet, no pills needed! (Sinclair, KL et al 2014)
NEURONS GET NEW BATTERIES
Injured brain cells, neurons, can have damage to the energy producing component to the cell – the mitochondria. These essential parts of any cell are needed for a cells very survival. Now researchers have discovered that one of the brain’s immune cells called an astrocyte, actually donates its own mitochondria to the wounded cell. The cell signals “help me” and the signal is picked up by an enzyme called CD38. Efforts are underway to see if CD38 itself can aid recovery in TBI and mouse data seems to say “yes,” as mice with CD38 faired twice as well post TBI. (Lo E. 2016)
VITAMIN D DOWN AFTER TBI
Studies have shown that 80% of TBI patients show mild to moderate Vitamin D deficiency. Further, these patients showed lower cognitive ability and depression. It is thought that Vitamin D aids in neuro-protection of the brain. Eat you salmon, milk, sardines and get some sunlight.
PROPRANOLOL LOWERS TBI MORTALITY
Beta blockers, especially propranolol (Inderal), administered early after moderate to severe TBI, showed shorter time for ventilation, hospital stay and higher rates of survival. (Ko A. 2016)
MTBI CAN BE CHRONIC
While most doctors treating MTBI continue to opine that it cannot be the cause of chronic impairments, with three months being the cut off, they are being shown to be wrong. A total of 45 studies, many on returning Veterans, were reviewed. Half of the patients in these studies showed symptoms for far longer than three months from a single MTBI (McInnes K et al. 2017).
MTBI AND THALAMUS IN NEW MRI
A new type of MRI scan, know as fast mean kurtosis tensor (MKT or diffusion kurtosis imaging – DKI) is showing promise in viewing structural damage in MTBI, as well as in cancer detection. They found micro-structural changes in the thalamus and corpus callosum 14 days to three months after MTBI. MKI promises to be more sensitive than even DTI in the future. (Naess-Schmidt ES et al. 2017).