Traumatic brain injury (TBI) is an extremely challenging condition for many patients to face. According to the Centers for Disease Control and Prevention (CDC), from 2006 to 2014, the number of TBI-related emergency department visits, hospitalizations, and deaths increased by 53%. Those who survive after a TBI may experience irreversible neurological symptoms that can sustain for the rest of their lives. However, there is some evidence that suggests that stem cell therapy may help in the treatment of TBI. There are many benefits of Stem Cells.
How Stem Cells May Benefit A Patient With A Traumatic Brain Injury
Mesenchymal stem cells have the ability to differentiate into any type of cell and tissue. They can become any type of cell in the body, including ones that do not normally replicate. For instance, you often hear that you have the same number of nerve cells since birth. Recent evidence suggests that neurons can regenerate in certain cases, but, the rate of regeneration is not sufficient to restore some lost functions after irreversible damage (e.g., TBI, stroke).
For this reason, scientists are studying stem cells since they have the potential to differentiate, regenerate, and repair, to help patients with neurological conditions, such as multiple sclerosis, strokes, and traumatic brain injuries.
What Does Science Say About Stem Cells And TBI?
In recent decades, mesenchymal stem cells obtained from the bone marrow, umbilical cord, and adipose tissues demonstrated impressive potential in the management of TBI. There have been clinical studies that describe the administration of stem cells via a lumbar puncture and/or intravenous (IV) methods to patients with TBI. After the evaluation of these patients using imaging techniques (i.e., MRI, fMRI), lesions in the brain showed improvements after each treatment session.
Today, dozens of clinical trials are still being conducted to get a deeper understanding of the effects of stem cell therapy on patients with TBI. With that said, and based on the available results, patients with TBI conditions may find this treatment method as an encouraging option. Research will continue as scientists keep studying this new advancement in regenerative medicine.
Stem cells have an incredible ability to divide into any type of tissue, opening the door for endless therapeutic options in not only neurodegenerative conditions, such as TBI but for autoimmune and orthopedic conditions as well. If you would like to learn more then contact a care coordinator today!
According to the CDC, in 2019, traumatic brain injury (TBI) contributed to nearly 61,000 deaths in the United States alone[1]. While there are several clinical treatments designed to address the neurological dysfunction after sustaining a TBI, including hyperbaric oxygen, brain stimulation, and behavioral therapy, none appear to produce satisfactory or lasting results.
In recent years, several studies have demonstrated the therapeutic potential of various stem cells, including mesenchymal stem cells (MSCs), neural stem cells (NSCs), Multipotent adult progenitor cells (MAPCs), and endothelial progenitor cells (EPCs) in the treatment of neurological impairment resulting from TBI. Specific benefits of these stem cells observed throughout these studies demonstrate that exogenous stem cells have the ability to migrate to the site of damaged brain tissue, help to repair damaged tissue, and significantly improve neurological function.
In this article, Zhou et al. review recent findings on the role, effects, deficiencies, and related mechanisms of the various stem cells being used as therapeutic agents in the treatment of TBI.
Examining numerous studies occurring between 2010-17 and exploring various TBI models and the roles of different stem cells in animal models, the author’s general summary is that the use of stem cells demonstrated some form of measurable improvement in every study reviewed. As a reference, specific observed benefits included improved integrity of the blood-brain barrier; improved neurological function, social interaction, and motor performance; enhanced neurovascular repair and recovery; and enhanced cognitive and spatial learning, information retention, and memory retrieval.
The authors point out that although there appears to be a large amount of research exploring the complexity of pathophysiology and the application of stem cell therapy for treating TBI, many problems still exist and must be addressed before the best method for TBI recovery can be determined.
Specifically, while there have been several clinical studies exploring the role of stem cells in the role of TBI treatment and recovery, and while most demonstrate promising results, the studies have almost universally been completed on mice and/or rats, contained human sample sizes that are not large enough, or failed to include a control group. As a result, Zhou et al. call for further study, including multi-center long term follow-up and randomized prospective trials that examine the safety of stem cells, route of injection, the time of injection, and the specific mechanisms as a way to identify the appropriate and effective stem-cell-based therapeutic treatment options for those suffering from various types of TBI.
In neurodegenerative conditions and cases of brain damage such as traumatic brain injury (TBI), the goal of treatment is usually to manage symptoms and prevent or slow the rate of further damage. Yet, ongoing research suggests stem cells could play an important role in creating new neurons, potentially resulting in repair of central nervous system damage and potentially regrow brain tissue. While the science is still in its infancy, there is evidence to suggest stem cell therapy could help to potentially restore lost brain function.
Just until a couple decades ago, scientists were under the impression that the brain and spinal cord could not rebuild themselves once cells were lost. Yet, in the mid-1990s, neuroscientists discovered that the brain could create new neurons in certain circumstances, which arise from neural stem cells. As undifferentiated cells, the stem cells could give rise to many different brain cell types, including neurons, which carry messages throughout the nervous system.
Further research has supported the idea that neurons can regenerate. For instance, in 2003, research was published which showed improvements in paralyzed rats who were exposed to a virus which caused symptoms similar to that of amyotrophic lateral sclerosis (ALS). Mice that had been previously paralyzed were able to regain some mobility after receiving stem cell injections, and the stem cells took on the characteristics of mature motor neurons.
Researchers have also been exploring stem cell therapies to help treat Parkinson’s disease. The goal is to rebuild the central nervous system through stem cell implantation. While levodopa is the go-to treatment to help regulate dopamine levels which are affected in PD, the drug’s efficacy tends to wear off over time, and its side effects increase. Some researchers have investigated the use of fetal stem cell tissue for PD patients, but lack of standardization and challenges in acquiring donor tissue have been barriers to ongoing research efforts.
With that said, stem cells from umbilical cord blood and adult adipose (fat) or bone marrow can also be coaxed to display many protein markers similar to those found in nervous system cells. It’s unclear whether these cells will ultimately be able to give rise to functioning neurons, but researchers continue to make progress.
Ultimately, there is much left to discover when it comes to the potential role of being able to regrow brain tissue and regenerative therapies such as stem cells in neurodegenerative conditions and brain injury. What we’ve already seen is promising, however. As experts continue to develop a deeper understanding of how stem cells and neurons can work together, patients with these challenging conditions will likely continue to benefit from evolving treatment options. If you would like to learn more then contact a care coordinator today!
With nearly 1.5 million traumatic brain injuries (TBI) occurring each year in the United States and over 69 million more cases of TBI[1] occurring worldwide, TBI continues to be one of the leading annual causes of mortality and morbidity. Carrying with it an annual estimated cost exceeding $56 billion, there has yet to be a viable, effective treatment option for TBI.
As researchers continue to search for an effective pharmacological-based treatment for TBI, recent preclinical studies have found endogenous neurorestoration occurring after TBI. Treatments developed in an effort to improve and/or promote the post-TBI neurorestorative recovery process have also shown to be promising.
Of the potential regenerative peptides identified as part of the TBI recovery efforts, thymosin beta 4 (Tβ4) has been found to exhibit several interesting and promising benefits, including pro-survival and pro-angiogenic properties, protecting tissue against damage, and promoting tissue regeneration.
In addition, previous studies exploring Tβ4 as a potential TBI-treatment option have demonstrated reduced inflammation, improved remyelination, and improved recovery in animal models studying such effects. As a result, the authors of this brief conclude that these observed benefits indicate Tβ4 to hold tremendous potential as a treatment option for TBI.
Since there isn’t one established animal model that can clinically reproduce the significant and multi-layered deficits in cognitive and motor performance experienced as a result of TBI in humans, most TBI studies rely on the controlled cortical impact, or CCI, model to evaluate the efficacy of potential TBI treatments.
Early Tβ4 Treatment May Reduce Cortical lesion Volume and Improve Functional Recovery After TBI
Using the CCI model to evaluate the efficacy of early Tβ4 treatment on spatial learning and sensorimotor functional recovery in rats, the authors demonstrated that rats receiving (Tβ4) treatments 6, 24, and 48-hours after TBI demonstrated significant improvements, especially when compared to rats treated with a vehicle control (in this case, saline). Rats in the Tβ4-treated group also demonstrated reduced hippocampal cell loss and reduced cortical lesion volume at a rate of up to 30%.
As a result of these findings, the authors suggest Tβ4 may encourage neuroprotection even when treatment is provided up to 6-hours after the occurrence of a TBI.
Tβ4 Treatment Provided 24-Hours After TBI Injury May Improve Functional Recovery, But Not Alter Cortical Lesion Volume
The primary intent of any neuroprotective TBI treatment is to reduce the size of established lesion(s). Researchers note that a major, but recurring, limitation of TBI-based treatments is the short timeframe between injury and need for treatment. As such, researchers point out that most preclinical TBI studies found the treatment to be effective only when administered within several hours after experiencing a TBI.
However, when using the CCI model, researchers noted the ability to improve neurological recovery without altering cortical lesion volume; these improvements were observed even when administering Tβ4 treatment more than 24-hours after injury.
Specifically, rats receiving Tβ4 treatment initiated 24 hours post-injury demonstrated significantly reduced cell loss as well as improvement in spatial learning and sensorimotor functional recovery when compared to TBI rats receiving saline treatments.
Tβ4 Treatment Provided 24-Hours After TBI Injury May Promote Neurogenesis
Substantial evidence has repeatedly indicated that all mammals, including humans, have the ability to generate new neurons. Specifically, these neurons originate from neural stem cells in the adult brain and appear to replace neurons that die regularly and in specific areas of the brain.
Considering this information, scientists introduced bromodeoxyuridine (BrdU), a thymidine analogue, into the DNA of dividing cells with the goal of improving neurogenesis. When compared to sham controls, this process demonstrated a significant increase in the presence of BrdU-positive cells 35 days after TBI.
Additionally, Tβ4 treatment appeared to further increase the number of BrdU-positive cells when compared to saline controls. These findings were further supported by the authors’ data confirming neurogenesis increases in TBI rats receiving Tβ4 treatment. The authors suggest that these findings indicate Tβ4 treatment promotes new cells to differentiate into brain-specific neurons.
Tβ4 Treatment Provided 24-Hours After TBI Injury May Promote Angiogenesis
Research demonstrates normal adult brains contain a stable vascular system; however, the vascular system becomes active in response to several pathological conditions, one of them being TBI. Findings indicate that Tβ4 treatment applied to specific areas of the brain associated with TBI, including the cortex, demonstrate significant increases in the observed vascular density of these specific areas, especially when compared to a control group receiving a saline treatment.
The presence of increased vascular density in these areas of the brain is thought to be closely related to improved recovery from TBI and specifically enhanced neurogenesis and synaptogenesis. As a result, the authors of this brief suggest further study to attain a better understanding of neurovascular molecular mechanisms with a specific focus on developing angiogenic and neurogenic therapies for TBIs.
Considering the above findings pertaining to the potential benefits of Tβ4 treatment for TBI and the fact that administration of Tβ4 has proven safe and well-tolerated in both animals and humans, the authors call for further investigation of molecular mechanisms that contribute to enhanced Tβ4-mediated neuroprotection and neurorestoration.
Traumatic brain injuries (TBI) occur from an outside force, and are commonly caused by sports injuries and car accidents. In many cases, symptoms can improve over time with the help of therapy. In some cases, however, it’s possible for symptoms to worsen over time. Here’s a closer look at why some cases improve and others appear to decline.
Secondary Brain Injury: In certain patients, complications develop after the initial injury, such as an infection or hematoma. The injury may also cut off blood to the brain, causing brain cells to die. The effects of these secondary brain injuries may not appear right away, which is why some patients’ symptoms seem to worsen over time.
Chemical Events: A brain injury can also trigger chemical changes which lead to worsening symptoms. For instance, the patient may develop an abundance of neurotransmitters, causing brain cells to become overstimulated and eventually die off.
Failure to Receive Treatment: Lastly, if a patient fails to receive proper treatment to facilitate healing following their brain injury, their symptoms are likely to worsen.
How to Minimize the Risk of Worsening Symptoms
Experts don’t know why symptoms worsen in some TBI cases and not others, but there are still factors within your control that can promote optimal outcomes. Here are a few options to consider.
Attend Therapy
Many people recovering from TBI need a combination of physical, speech, and occupational therapy. These rehabilitative programs help you rebuild physical strength, support blood flow to the brain, sharpen your mental skills, and reestablish your daily routine. Most importantly, they keep the brain and body active and can help prevent worsening symptoms.
Keep Your Brain Stimulated
Your brain is a muscle that can benefit from regular exercise. If there’s a type of puzzle you enjoy, such as sudoku or crosswords, try doing some during your downtime. You might also consider music or art therapy to engage your brain. Stimulating your brain encourages it to produce neuropathic growth factors, which kickstart the development of brain cells. Of course, you’ll want to follow your practitioners’ recommendations and avoid overstimulation during early recovery.
Engage Your Neuroplasticity
Neuroplasticity is the mechanism the brain uses to create neural pathways which allow healthy brain tissue to take on functions the damaged portions can no longer accommodate. Repetition is one of the simplest yet most effective ways to engage neuroplasticity. Thus, if there’s a skill you want to remaster, you’ll need to practice it often. Over time, it will start to become easier.
Get Support
TBI recovery can be frustrating, especially if you’ve reached a plateau. Support groups are available to encourage you to overcome plateaus and discuss the ups and downs with first-hand knowledge. Whether you choose to join an online community or meet with a group in person, you may find that sharing your experiences in a supportive setting is a great outlet for the emotional and mental challenges that come with recovery.
Although it’s impossible to say for sure whether someone’s TBI symptoms will worsen or improve with time, the steps above won’t hurt in either case. By staying mentally and physically active and pursuing treatments such as therapy, individuals who have experienced brain injuries can support the best possible outcomes in their recovery. Patients are discovering the alternative option of stem cell therapy to help manage symptoms and assist in the healing process. In particular, stem cells can slow or halt further brain damage and promote healing by reducing inflammation and achieving a tissue-protective effect. If you would like to learn more then contact us today to speak with a care coordinator.
The brain controls everything we do, including our emotions, behaviors, the way we move our bodies, how we process information, and how we interact with others. As such, a traumatic brain injury can have life-altering effects, not only for the person who sustains it but also for their loved ones.
Every brain injury is different, and the precise circumstances that unfold afterward will depend on several unique factors, including the location and severity of the injury. Some impairments are primary, which means they are directly related to the injury itself and are usually physical and cognitive in nature. Others, such as emotional and behavioral changes, can be both primary and secondary impairments.
Nearly all brain injury survivors report feeling fatigued, especially soon after the event. An injured brain has to work much harder to perform normal functions, so long stretches of sleep are common in people as they’re healing, sometimes even indefinitely.
Other physical changes could include muscle weakness, headaches, partial paralysis, persistent pain, sleep disturbances, spasticity, seizures, speech and swallowing differences, and appetite changes to name a few. Some physical changes are permanent, while others can be addressed through physical therapy, medications, and if needed, surgeries.
Cognitive Changes
The cognitive impairments a survivor sustains are often among the most disabling of all the effects. They are most intense immediately after the injury, and while they may improve significantly, it’s rare that they disappear fully. With that being said, recovery can be an effort that span’s a person’s entire life, with improvements being made all the time.
Memory impairments are particularly common in brain injuries. Both the short- and long-term memory may be affected, as well as retrograde (events before the injury) and anterograde (events after the injury). A person may also face challenges in certain areas such as learning new material and processing information, comprehending language, safety awareness, spatial orientation, judgment and decision-making, comprehension, attention, and concentration.
A person’s executive functioning, including activities surrounding planning, organizing, multi-tasking, evaluating, and problem-solving, can also be affected.
Communication Changes
The communication changes a person may experience can span far and wide. For instance, they might struggle with speech as well as the ability to understand and process words. Reading impairments, difficulty finding the right word, and a limited listening attention span may also develop.
Emotional Changes
Emotional impairments can occur from the brain injury itself, or as a result of a primary impairment. For instance, someone might experience depression as a reaction to the physical or cognitive challenges they’re facing. A few emotions people can have after a brain injury are anger, apathy, anxiety, paranoia, frustration, confusion, restlessness, post-traumatic stress, and mood swings. Oftentimes, emotional challenges can be addressed through therapy.
Behavioral Changes
Like emotional changes, behavioral differences can be directly or indirectly caused by brain injury. They can range from mildly irritating to dangerous. Some behavioral changes that could emerge are withdrawal, verbal or physical aggression, intolerance, over-or under-reactions, rebelliousness, defensiveness, and excessive crying.
Behavioral changes call for patience and understanding from an individual’s support system, but those with potentially dangerous consequences should be addressed in an inpatient environment.
Social Changes
Many people experience feelings of loneliness following a brain injury. The largest population of survivors is young men, whose friends may not understand the wide range of changes they’re experiencing. Oftentimes, survivors’ friendships, and romantic relationships suffer. Issues like behavioral and emotional changes, difficulties with conversations and understanding social cues, and fatigue, can impact social lives. Nonetheless, many survivors get tremendous support from their families and are ultimately able to enjoy loving relationships and fulfilling friendships.
Family Support
Survivors’ family members will face stress and their own range of emotions after their loved one experiences a brain injury. Everyone handles the event and recovery in their own ways, and the challenges they face will depend on a number of independent factors.
Children, in particular, should be encouraged to openly discuss their feelings. If emotions among family members seem particularly intense, counseling could help.
Parents should consider how they’ll divide time between caring for the family, the survivor, and managing other responsibilities, such as work and household management. While there will be a lot to juggle, resources are available for support, such as BrainLine.org and the Brain Injury Association of America.
If you are interested in regenerative medicine also know as stem cell therapy for brain injuries then contact a care coordinator today for a free assessment!
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