Study reveals no benefit to costly and risky brain cooling after brain injury

The study, published today, in the Journal of the American Medical Association and presented at the same time at the Congress of European Society of Intensive Care Medicine in Paris by lead authors, Professors Jamie Cooper and Alistair Nichol, looked at the outcomes for 511 patients across six countries who had traumatic brain injury (TBI).

An estimated 50-60 million people, worldwide, will suffer a TBI this year and more than half of the world’s population will suffer at least one TBI during their lifetime. There has long been controversy around the benefits of brain cooling in the Intensive Care Unit following a TBI, in the belief the cooling or hypothermia reduces brain inflammation and consequent brain damage.

Professors Cooper, and Nichol, together with Lisa Higgins, and Tony Trapani, Dr. Dashiell Gantner, Profs Michael Bailey, Stephen Bernard, Peter Cameron Jeffrey Rosenfeld and Andrew Forbes all from Monash, together with colleagues in Queensland, Western Australia, New Zealand, France, Qatar, and Saudi Arabia, divided the TBI patients into two groups: those that received hypothermia treatment as soon as possible post-injury, often in the ambulance on the way to an emergency department, and half who did not receive the therapy. The study, called POLAR (Prophylactic hypothermia to lessen traumatic brain injury) ran from seven years from 2010.

Full story at Medical Xpress

‘Concussion pill’ shows promise in pre-clinical pilot study

In 2016, funded by a $16 million grant from Scythian, the multidisciplinary Miller School team embarked on a five-year study to examine the effects of combining CBD (a cannabinoid derivative of hemp) with an NMDA antagonist (an anesthetic used in animals and humans) for the treatment of traumatic brain injury and concussion. The researchers believed the combination could reduce post-injury brain cell inflammation, headache, pain and other symptoms associated with concussion.

The findings of a pre-clinical pilot study were recently released, and they show that the combination therapy improved the cognitive functions of animals, compared with those treated with a single vehicle. In addition, there were no adverse effects from either the combination therapy or the individual components.

“There needs to be more systematic research in this field in order to study the neuroprotective properties of CBD, and to improve treatment for those sustaining mild-to-moderate TBI (traumatic brain injury) and concussion,” said Gillian A. Hotz, Ph.D., professor of neurological surgery, and director of the KiDZ Neuroscience Center at The Miami Project and the University of Miami Sports Medicine Institute concussion program.

Full story at Medical Xpress

Prior TBI Diagnosis Increases Risk of Parkinson’s Disease

Recently, there has been attention on the association of traumatic brain injury (TBI) with progressive neurodegenerative diseases; such as, Parkinson’s disease. However, the association between mild TBI and Parkinson’s remains unclear. Therefore, the authors used 3 nationwide Veterans Health Administration databases (Comprehensive TBI Evaluation, National Patient Care Databases, Vital Status File Database) of inpatients and outpatients seen between 2002-2014 to determine the risk of developing Parkinson’s disease following a TBI. Authors age-matched 162,935 patients (~48 years of age) with TBI diagnosis without dementia, Parkinson’s disease, or secondary parkinsonism at baseline to a random sample of patients without any of the aforementioned conditions. The authors defined TBI exposure as a diagnosis of TBI after a comprehensive neurological assessment or by at least one inpatient or outpatient TBI diagnosis from a list of ICD-9 codes. Parkinson’s disease was defined as any inpatient or outpatient diagnosis of ICD-9 332.0 at least 1 year after TBI. The average follow-up was ~5 years. The authors found that a veteran with a prior TBI (0.6%) is >56% more likely to develop Parkinson’s disease than a veteran without a prior TBI (0.3%). This finding was consistent even after accounting for factors such as medical comorbidities (diabetes, hypertension, cerebrovascular disease) and psychiatric disorders (anxiety, post-traumatic stress, drug/alcohol use). Furthermore, this finding was consistent among people with mild or moderate-severe TBI.

Full story at Sports Medicine Research

TBI Reauthorization Now Approved by Both Houses of Congress

Government-sponsored research and data collection on traumatic brain injury (TBI) has support from both houses of Congress, now that the US Senate has approved the TBI Reauthorization Act. The House passed its version of the legislation earlier this summer. APTA was among the organizations advocating for the bills.

The measure passed in the Senate is substantially similar to the House version, with some differences in funding amounts and a Senate request that the US Centers for Disease Control and Prevention (CDC) review evidence on management of TBI in children. If the bills are reconciled and signed into law, the act will provide funding to the CDC, the National Institutes of Health, and the Health Resources and Services Administration for programs supporting TBI research and individuals with brain injury.

Full story of TBI Reauthorization at APTA

PT’s Movie Review on ESPN Also Educates on Consecutive TBI

An APTA member’s review of a new documentary on traumatic brain injury (TBI) has been featured on ESPN. Stephania Bell, PT, CSCS, OCS, senior writer for ESPN, gave a strong, positive review for the new documentary “The Crash Reel,” but perhaps just as important, seized the opportunity to provide readers with valuable education on consecutive TBI and its impact on developing brains.

“The Crash Reel” follows the rise, devastating injury, and recovery of elite snowboarder Kevin Pearce, who at age 22 suffered a head injury during training for the 2010 Vancouver Olympics. Pearce’s recovery continues, and he is now a motivational speaker and sports equipment consultant. Earlier this month he carried the torch at the opening ceremonies of the Winter Olympics in Sochi.

Full story on the movie review and TBI at APTA

New Report on Blast Injuries Cites Research Gaps

Despite the prevalence of blast-related injuries among returning war veterans there are still big gaps in research into long-term effects, according to a newly released study by the National Academy of Science’s Institutes of Medicine (IOM). These gaps exist not only in research into specific injury types, but also in understanding the ways in which blast injuries can involve multiple systems and create “cross system interactions” such as mild traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).

The new publication, Long Term Effects of Blast Exposure, is the ninth volume in a series of congressionally mandated studies focusing on the health effects of military service. The newest report focuses on blast injury effects present after 6 months, and is based on reviews of nearly 13,000 titles and abstracts and approximately 400 full peer-reviewed journal articles. The report estimates that between 2001and 2011, more than 31,000 soldiers were injured by explosive devices in the Iraq and Afghanistan wars.

Full story of blast injuries at APTA

A traumatic brain injury can instantly impact a person’s life

Traumatic brain injuries often occur when a victim suffers a violent blow to the head or when a foreign object penetrates his or her skull. For instance, TBIs are commonly suffered during severe car accidents as victims are flung about the wreckage.

According to the Centers for Disease Control and Prevention (CDC), an estimated 1.7 million people sustain traumatic brain injuries every year in the United States.

Otherwise known as TBIs, traumatic brain injuries are a factor in almost one-third of all injury-related fatalities in the U.S. In fact, the CDC reports that from 2002 through 2006, there were 52,000 deaths each year, on average, attributed to TBIs. However, even in instances in which TBIs do not lead to death, many victims face a lifetime of TBI-related disabilities – including roughly 5.3 million people in the U.S. alone.

Dangers associated with brain injuries

TBIs often occur when a victim suffers a violent blow to the head or when a foreign object penetrates his or her skull. For instance, TBIs are commonly suffered during severe car accidents as victims are flung about the wreckage. However, a traumatic brain injury can be caused during any type of serious accident.

Full story of traumatic brain injury at the Digital Journal

A Silent Epidemic: Minor Traumatic Brain Injury

In the United States, approximately 1.4 million people suffer a traumatic brain injury (TBI) each year. Of those injuries, three out of four are minor TBI (mTBI) — a head injury that causes a temporary change in mental status including confusion, an altered level of consciousness, or perceptual or behavioral impairments.

According to a literature review appearing in the October 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), falls and motor vehicle accidents are responsible for most cases of mTBI and also are a common cause of bone and joint injuries. “Musculoskeletal injuries are often seen concurrently with some studies estimating that 50 percent of patients with orthopaedic injuries also sustain a mTBI,” says lead study author Richard L. Uhl, MD, an orthopaedic surgeon at Albany Medical Center in Albany, N.Y.

Approximately 80 percent of patients who sustain a mTBI can be safely discharged from the emergency department and will fully recover and return to their baseline mental status. However, mTBI often goes undiagnosed initially because symptoms do not appear until the patient resumes everyday life. Advanced imaging of the head such as CT scans is often of little use as the majority of patients with a mTBI will initially have a normal examination.

A Silent Epidemic: mTBI by the Numbers

  • The Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control declared mTBI a major public health issue and a silent epidemic.

Full story of minor TBI at Science Daily

Behavior Changes Show Up Early in Traumatic Brain Injury

Patients with chronic trauma-related brain disease may develop in two distinct ways, one involving mood and behavioral disorders and the other by cognitive impairment, according to a study that combined prospective and postmortem data.

Behavior Changes Show Early in TBIAlmost all of the 36 patients with chronic traumatic encephalopathy (CTE) had a combination of cognitive, mood, and behavioral disorders, and cognitive impairment was almost universal.

However, almost two-thirds of the patients developed mood and behavioral disturbances at a younger age and died at a younger age. The rest of the patients had predominately cognitive impairment, which had later onset and was associated with death at an older age, Robert A. Stern, PhD, of Boston University, and co-authors reported online in Neurology.

“At this point, CTE can be diagnosed only when someone passes away, postmortem,” Stern told MedPage Today. “Because of that we can’t begin to evaluate treatments or potential cures for the disease. What we’re trying to do is establish what someone looks like when someone is alive.”

Full story of behavior change in TBI at MedPageToday

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Pregnancy hormone could help traumatic brain injury patients

Pregnancy Hormone Could Help TBIIt can happen in an instant and change lives forever. Close to two million people are affected by traumatic brain injury every year. Worldwide, it’s a major cause of death and disability. Now, researchers are hoping something that our body produces naturally can help bring the first ever TBI treatment to those who need it.

“As I was driving, I blacked out behind the wheel and the car went into the back of a parked 18 wheeler,” explained Lester Talley.

Health issues lead to Lester’s near fatal accident. The husband and father of two suffered a serious traumatic brain injury.

“My brain had started swelling,” he said.

“There really is no definitive therapy for the treatment of acute brain injury,” explained Daniel Laskowitz, MD, MHS, Professor Medicine (Neurology), Neurobiology, & Anesthesiology, and Director, Neurovascular Laboratories at Duke University Medical Center.

Lester’s wife Ashley feared the worst.

“Seemed like my world was coming to an end,” she said.

While in a coma, Lester was enrolled in a phase three trial called SyNAPSe. The study is testing if progesterone could help treat TBI.  It’s a natural hormone produced in men and women, that’s most often associated with pregnancy.

Full story of pregnancy hormone helping TBI at News 4 Jax

Photos courtesy of and copyright PhotoPin, http://photopin.com/