Traumatic brain injury (TBI) is one of the most common causes of disability in the United States, affecting over 13 million citizens. Traumatic brain injury is responsible for over 2 million emergency department visits, over a quarter of 1 million hospitalizations, and nearly 60,000 deaths each year.
Traumatic brain injury harms brain tissue in two phases. The first phase of injury occurs at the time of the traumatic incident. This initial injury may cause small or large areas of the brain to bleed. It may also shear (stretch/tear) nerve cells, making them dysfunctional. The second phase occurs hours or days after the initial injury. The brain is subjected to ongoing damage because of inflammation, cell death, and injury to blood vessels. Many people with TBI are left with lifelong problems with thinking, memory, and behavior.
In both of these phases of injury, one major way to help prevent long-term brain damage is by maintaining adequate blood flow to brain tissue. Unfortunately, once the damage has occurred, it can be a challenge to reverse the damage. Patients usually must endure months or years of physical and occupational therapy to regain what was lost. Moreover, patients often need substantial amounts of psychiatric and psychological support to treat mental health problems.
Fortunately, researchers are using hyperbaric oxygen therapy (HBOT) to improve blood flow to the brain in patients with traumatic brain injury. Hyperbaric oxygen therapy provides patients with pure oxygen (100%) at slightly higher pressures than they would experience normally. It is been used for hundreds of years to treat scuba divers who suffered “the bends” or decompression sickness; however, researchers are finding that hyperbaric oxygen therapy is a “coveted neurotherapeutic method for brain repair.”
To study the effects of hyperbaric oxygen therapy, researchers selected 10 people who had suffered mild traumatic brain injury in the previous 7 to 13 years. Patients all had brain damage that interfered with attention, memory, and thinking abilities.
Even though patients had sustained traumatic brain injury and brain damage a decade earlier, hyperbaric oxygen therapy was able to improve blood flow in the brain. Likewise, the amount of blood detected within the brain significantly increased, suggesting that hyperbaric oxygen therapy actually caused blood vessels in the brain to grow and multiply. Just as impressively, patients with chronic brain damage performed better on tests of cognition (i.e. thinking). They were able to process information more quickly, they had better motor function, and they were able to take in and process information about the world around them more efficiently.
Because people with traumatic brain damage have limited treatment options to improve their situations, these results are incredibly exciting. This was a study on 10 patients and more studies on larger numbers are still needed to build on these findings. Nonetheless, these results are quite encouraging for people with traumatic brain injury and their loved ones.
A technique called hyperbaric oxygen therapy (HBOT) has been shown to help patients with traumatic brain injury (TBI) who are suffering from a chronic neurological injury. HBOT appears to confer its benefits to these patients by increasing the neuroplasticity in the brain – or, in other words, by making it easier for the brain to re-wire itself. When the brain has a higher degree of neuroplasticity, it is easier to recover from neurological injuries because the brain can find ways to re-wire and restore functions that were lost due to damage to brain tissue.
A new study, published in Frontiers in Human Neuroscience, investigated the effects of HBOT on prolonged post-concussion syndrome (PPCS) that occurs as a result of TBI. The researchers used imaging strategies to monitor the brains of 15 patients with PPCS and evaluated the patients with tests of cognition. The researchers gave each patient 60 treatments with HBOT. The treatments were initiated anywhere from 6 months to 27 years after the patients had sustained their injuries.
Using imaging techniques called Dynamic Susceptibility Contrast-Enhanced and Diffusion Tensor Imaging (DTI) MR sequences, the researchers observed that HBOT increased blood flow and volume in the brain and that it led to the generation of new blood vessels. Using various cognitive tests, the researchers also found that HBOT improved memory, information processing speed, and executive functions.
Based on these findings, the researchers concluded that HBOT is beneficial for patients with TBI by inducing neuroplasticity in the brain, improving the integrity of microstructures of both white and gray matter within the brain, and allowing for the regeneration of nerve fibers. Future research will help clarify further benefits of HBOT and how the brain responds to this treatment.
In their article, Neurogenic differentiation of murine and human adipose-derived stromal cells, Kristine Safford and colleagues provide evidence for a new candidate for brain therapies. Much of our body’s tissue is able to regenerate to repair itself following injury. However, brain tissue, or neural tissue, does not have this capacity. It has therefore been a priority for medical researchers to identify strategies for repairing damaged brain tissue.
Certain cells, such as embryonic stem cells, can be treated so that they turn into brain cells. However, because it is difficult to access these types of cells, there has been an ongoing search for other ways to create neural tissue for therapeutic purposes. In this publication, the researchers share their finding that fat tissue, or adipose tissue, from adults, may be able to serve this function. Here, the researchers demonstrate that they were able to induce adipose-derived stem cells to undergo alterations that resulted in cells resembling brain cells, or neurons. The researchers were able to change both the shape and chemical features of adipose-derived stem cells so that these aspects of the cells were consistent with those of normal neurons.
This study provides a new therapeutic candidate for brain injury. Ongoing research that aims to determine whether adipose-derived stem cells can be used to develop mature neurons that function appropriately as neurons will clarify whether adipose-derived stem cells will indeed eventually be able to be used to treat specific brain injuries or abnormalities.
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