Posts from ‘Latest Research’
Study results published recently in the online journal Nature Medicine reveal the discovery of the specific mechanism responsible for the death of brain cells in stroke victims. Researchers had already known that brain cells continue to die even after blood flow had been returned to the brain due to a complex cascade of chemical reactions flows through the brain. What they didn’t know was exactly how and why the brain cells continued to die.
The study¾conducted by researchers at the Brain Research Center of British Columbia¾revealed in animal models that the over-activation of NMDA receptors on the surface of brain cells activates a protein known as SREBP-1, the main culprit responsible for the death of the cells. SREBP-1 is normally found throughout the brain, but is kept in check by another protein, Insig-1.
In the aftermath of a stroke, NMDA receptors become over activated, which leads to a fast breakdown of Insig-1 proteins. The decrease in the mediating presence of Insig-1 forces an increase and activation of SREBP-1, which was shown to be instrumental in the post-stroke death of brain cells. By inhibiting SREBP-1, the scientists involved in the study were able to halt further brain cell death in the animal models.
Dr. Max Cyander, the co-lead of the study, said of the study results, “We developed a drug that can stabilize Insig-1, which in turn inhibits the activity of SREBP-1,” … “By doing so, we were able to prevent cell death,” a EurekAlert article reported.
Previous research focused on blocking the NMDA receptors but yielded limited results. The current study demonstrated in animal models that the new drug led to a decrease in the rate and quantity of brain cell death after one month when compared to the levels exhibited in a control group.
The research¾funded by the Heart and Stroke Foundation of BC and Yukon, the Canadian Institutes of Health Research, and the Cure Huntington’s Disease Initiative Foundation¾will be further explored to determine exactly how SREBP-1 leads to cell death, to identify other roles the protein may play in disorders such as Lou Gehrig’s disease, and to develop highly effective treatments for human stroke victims based on the results.
The NFL and high school football have come into focus in the traumatic brain injury world lately, as studies pile up demonstrating the serious risk of degenerative brain disease to players who suffer multiple concussions. The Boston Globe reported that the NFL’s own study showed that retired football players from age 30 to 49 had dementia rates 19 times greater than normal, and that retirees 50 and older had 5 times more incidence of memory-related disorders.
The Boston Globe also mentioned a University of North Carolina study saying that players who had suffered multiple concussions had “several times more prevalence of cognitive impairment” than those players who had never suffered brain injuries. The Boston Globe reported that 1.14 million kids play high school football and 3.2 million more play in youth leagues. New studies continue to be released revealing the serious danger inherent to the violent crashes between players in the sport.
Since it seems that football is not going to stop being a hugely popular sport, parents of young athletes are faced with the task of making the sport somehow safer for their young boys, or removing them from the sport altogether. After all, no matter how glorious it may feel to win games and make fantastic plays, living with degenerative brain disorder with a failing memory in a wheelchair is not glorious at all.
One solution some coaches and parents agree on is to not let boys continue playing after a concussion or head injury occurs until the child’s brain has had time to heal. The Globe article reported on a study from the journal Brain Injury that said 16% of student players in high school were returned to play after losing consciousness during a game. They added that most high school games do not have a certified athletic trainer in attendance on the sidelines.
A Harvard epidemiologist said to the Globe that the NFL should use footage of plays when injuries occur to make rule changes to ensure the safety of all players. Scientists at Boston University’s Center for the Study of Traumatic Encephalopathy told the Globe of incidents of degenerative brain disease in 18-year-old football players. They added that the brain continues to mature and develop well into the 20s and that football will have to change to make it safer for the youth.
60 Minutes reported that the impacts between football players, who can run at up to 20 miles per hour, are akin to a car hitting a brick wall at 40 miles per hour. Unfortunately, human heads are much more delicate than car bumpers. As the studies pile up that prove how dangerous football can be to the brains of the players, one must wonder what changes, if any, will be made to the sport to protect its players from serious injury.
Many times, athletes and their coaches and families are unaware that their brains have suffered serious injuries. Since degenerative brain disease eats away at brain cells slowly over time, it is easy to mistake the symptoms for psychological disorders or other issues. It is not until after a person dies and an autopsy is done on their brain that traumatic brain injuries and subsequent degeneration are revealed. Some scientists are working to improve diagnostic tools to better identify serious brain injuries in living patients while successful treatment remains possible.
It seems that football’s popularity will continue to remain high, but with 60 Minutes reporting that “sports related concussions are an epidemic in this country,” one can only hope that parents take the lead in keeping their children’s developing brains safe from traumatic brain injuries, and that NFL players and coaches will take the hint and stop putting players with concussions back in the game.
Each player has to ask himself, “Is it worth losing my brain functions later in life to continue playing now?” If the answer is no, changes to the game and how concussions are dealt with will have to be made.
(pic from flickr.com/photos/aheram)
A senior at Troy High School in Detroit, Gayathri Kollipara, is the recipient of an immensely powerful and educational gift from assistant professor Christian Kreipke. Kreipke is employed as a cell biologist at Wayne State University’s medical school. In March, Kreipke began conducting a study on a new drug that may prove useful in the treatment of traumatic brain injuries (TBI). He invited Kollipara, whose long time dream has been to become a brain surgeon, to shadow him throughout the duration of his drug study.
The drug Kreipke was testing in animal trials is Clazosentan. It proved successful in the animal studies at preventing vasospasms blood vessel constrictions in the brain, which occur when the head has been impacted in an accident or other trauma.
Kollipara was extremely excited to have such a unique opportunity to observe up close the kinds of work she is looking forward to after another decade or so of schooling. She told the Chicago Tribune that her father’s death of lung cancer two years ago cemented her lifelong wish to become a brain surgeon. She said it has always been her dream to go into the medical field, but she knew for certain she would pursue it after her father died.
Over the course of Kreipke’s Clazosentan study, Kollipara was able to observe the surgeries the scientist performed on lab animals. She was also enlisted to assist Kreipke in the behavioral study portion of the research to measure the effectiveness of the novel drug.
Kreipke reported to the Tribune that he had a lot of trouble choosing a major and a career path – he changed his major seven times before completing his studies – so he was more than happy to grant Kollipara the chance to witness his research, since she knew exactly what career path she wanted to pursue, even at such a young age.
While other high schoolers go out partying or searching for minimum wage jobs, Kollipara was granted the opportunity to get a head start on her way to her dream career as a neurosurgeon.
(pic from ucdmc.ucdavis.edu)
Researchers at University College London (UCL), London, UK, published new brain wave research findings online October,1 in Current Biology, a Cell Press publication. The scientists were astounded to discover the powerful influence that brain waves exert on voluntary human motor functions. The EurekAlert report quoted Peter Brown of the Sobell Department of Motor Neuroscience and Movement Disorders in the Institute of Neurology, UCL, as saying, “At last we have some direct experimental proof that brain waves influence behavior in humans, in this case how fast a movement is performed,” … “The implication is that it is not just how active brain cells are that is important, but also how they couple their activity into patterns like beta activity.”
The team of scientists at UCL used an injection of a tiny electrical current through the scalps and into the brains of 14 study participants while the subjects moved a spot around a computer screen. The subjects were instructed to move the spot around the screen with a joystick as fast as they could.
The specific current employed by the scientists increased the normal beta brainwave activity in the subjects’ brains. Beta brainwaves have been linked in previous studies to prolonged muscle activities, such as holding up a book, the article reported.
The new study differed from similar studies in the past in that the scientists used an oscillating current similar to the currents in operation in normal brain activity. In earlier studies, constant brain stimulation current has been employed. Although the participants were unable to sense the tiny electrical current, the effects is produced were profound. The participants’ fastest times recorded on the computer and joystick task were 10% slower when the electrical current was administered.
Earlier studies have also shown that altered brain waves have an effect on memory, but not until this groundbreaking study has it been demonstrated conclusively that a causal link between and increase in beta waves and the slowing of voluntary movement in all study participants. The researchers hope their findings will lead to possible treatments for conditions that involve slowed or uncontrolled movements., perhaps even those caused by traumatic brain injuries.
Brown was further quoted in the article as saying, “If we know what patterns of brain activity slow voluntary movement, then we can try and boost these patterns in conditions like chorea and dystonia, where there is excessive and uncontrolled movement,” … “Conversely, we can try and suppress beta activity in conditions like Parkinson’s disease typified by slow movement.”
(pic from zatma.org)
In early September of 2009, The Department of Defense (DOD) Congressionally Directed Medical Research Programs (CDMRP) hosted the Military Health Research Forum (MHRF) in Kansas City, MO. The forum was dedicated to exploring new research on traumatic brain injury (TBI).
Military interest in brain injury research has increased dramatically over the past few years due to an alarming rate of servicemen and women who have suffered from TBI due to close range, non-impact exposure to explosive blasts and other combat-related injuries. The CDMRP estimates that about 20% of combat soldiers suffer from TBI.
Two programs of the CDMRP, the Psychological Health and Traumatic Brain Injury Research Program (PH/TBIRP) and the Peer Reviewed Medical Research Program (PRMRP), funded studies on various issues surrounding TBI in combat soldiers, such as prevention, diagnosis, and treatment of the condition. The researchers and funding agencies also hope the research will lead to improved care for civilians with TBI.
What follows is a summary of the research presented at the MHRF.
The US Army Aeromedical Research Laboratory presented research that demonstrated the value of new Advanced Combat Helmets. Their research revealed that paratroopers wearing the older Personnel Armor System for Ground Troops Helmet were 2.3 times more likely to suffer brain injuries than those wearing the Advanced Combat Helmets. The researchers said further research to improve helmets and armor systems is underway.
Clemson University researchers presented data on their development of an injectable hydrogel to promote brain tissue regeneration at lesion cavity sites in rats given TBIs. Researchers funded by CDMRP also performed neural stem cell transplantation into the injury sites and used the hydrogel, which mimics native brain tissue, as a carrier. They reported that functional recovery was significant after eight weeks of treatment.
Finally, researchers at Duke University presented research on their testing of three different biomarkers used to better evaluate the severity of and diagnose mild traumatic brain injury (mTBI). Many patients with mTBI show no external signs of brain injury, thus a new method is needed to better diagnose the presence of brain injury in these cases. The researchers found that two of the three biomarkers, brain natriuretic peptide (BNP) and D-Dimer, showed a 92% sensitivity rate in determining the presence of intracranial abnormalities in diagnostic CT scans.
The vast and expansive collaboration of research and funding that went into all of the data presented at the MHRF will likely provide demonstrable advances toward the prevention, diagnosis, and treatment of TBI not only in military personnel, but in civilian populations as well.
Admiral Michael Mullen, the chairman of the Joint Chiefs of Staff, is promoting a new Army policy that would limit the number of mild traumatic brain injuries an Army combat soldier can suffer before being relieved of combat duty. The new policy would limit soldiers’ exposure to three mild brain injuries, after which they would be reassigned to non-combat positions on Army bases.
Mullen is motivated partially by a disturbing story of a soldier who was exposed to 30 explosions at close range before being removed from combat duty. USA Today reported that if the policy were enacted, it is estimated that only about 400 soldiers, out of the 20,000 troops deployed in Afghanistan, would be removed from combat and put to work on bases for the duration of their tour of duty.
Admiral Mullen is motivated also by data published in recent studies on multiple concussions and traumatic brain injuries experienced by football players. The studies, reported on here, demonstrated that people whose brains had suffered multiple concussions would heal more slowly from future injuries and would be more likely to have more serious future concussions. The same studies also showed that multiple brain injury sufferers have also been shown to be at a higher risk for long-term brain dysfunction and complications.
We have explored some of the recent research on the physiological effects on the brain of repeated exposure of military personnel to explosive blasts. While the injuries are similar to those experienced by football players, the exposure to bomb blasts has a distinctly different and less understood effect on the brain.
The USA Today article reported that, “up to 300,000 service members may have suffered a mild TBI in the Iraq and Afghanistan wars.” It is data like this that has spurred Admiral Mullen to take action to prevent soldiers from suffering serious long-term brain damage that could be prevented by a simple change in policy.
The U.S. Marines already operate under a policy that limits marines to three mild traumatic brain injuries before removal from combat, and the Army is currently designing a policy that will likely follow suit. Although further research is ongoing, the workings of the brain and how it reacts to injuries remain mysterious and not fully understood. Yet, as more and more studies are published, it’s inspiring to see military leaders using current scientific data in the design of their policies and protocols.
(pic from ameddcsdl.org)
Blanchette Rockefeller Neurosciences Institute (BRNI) announced an agreement of collaboration with the neuroscience specialists of the Brain Injury Group. The groups of scientists and researchers plan to compare their data on brain injuries, including strokes, head trauma, and other areas of research. They also plan to determine any links between brain injuries and later developments of other neurological dysfunctions, disorders, and diseases such as Alzheimer’s disease.
BRNI is a nonprofit institute dedicated to the study of memory and diseases of memory. It is the only nonprofit institute of its kind. Of the recent agreement between BRNI and the Brain Injury Group, Dr. Daniel Alkon of BRNI was reported as saying, “Together, we will uncover the potential links between brain injury and diseases and disorders of human memory, including Alzheimer’s disease.”
A huge area of focus for the two groups will be chronic traumatic encephalopathy (CTE), which is a repeated chronic swelling of the brain suffered commonly by boxers, football players, and soldiers who experience brain injuries as a result of being near explosions in combat zones. Some scientists believe that the high rate of traumatic brain injury among U.S. soldiers returning from Iraq could lead to an equally increasing rate of CTE cases in the injured soldiers.
BRNI and the Brain Injury Group plan have set high aims at understanding all there is to know about the functioning of the brain and human memory. Their collaboration holds much promise for patients suffering with brain injuries and CTE. The groups plan to study the mechanisms by which CTE arises following traumatic brain injuries.
Future research and collaboration such as this may allow radical new developments in the treatment, diagnosis, rehabilitation, and prevention of traumatic brain injury.
Soldiers returning home from Afghanistan and Iraq suffering from a high rate of traumatic brain injury due to exposure to explosive blasts have prompted research projects to determine exactly how brain injury occurs during an explosion in which direct impact to the head does not occur.
Researchers from the Defense and Veterans Brain Injury Center in Washington D.C. recently conducted research in which they ran DTI scans on soldiers ranging from completely healthy to those who suffered direct head impacts, acceleration brain injuries, and finally, nonlethal explosive blasts.
Previously, MRI and CT scans were proven ineffective at revealing and diagnosing concussions. However, researchers have recently made use of DTI scans to detect neurological damage on the level of the neural networks connecting brain cells, which scientists call the brain’s “white matter.”
The recent research using DTI scans showed “a more diffuse pattern of damage to the white matter,” in those soldiers who had experienced non-impact brain injury from close proximity to explosions. This research demonstrates conclusively that soldiers near an explosion can indeed suffer brain damage even without any physical impact.
Common concussions arise from direct impact to the skull and from acceleration injuries as in automobile accidents. Brain injuries from explosions can cause impact and acceleration injuries, as well as a wave of rapid pressure that puts even more sudden, but invisible, impact on the brain itself.
Scientists also discovered signs of inflammation in brains exposed to explosive blast shockwaves, many months after the initial injury occurred. Another team of researchers at the Defense Advanced Research Projects Agency found signs of brain injury in the blood, even when no other signs of injury showed up.
DTI scans, while promising in brain research, still has limits. Soldiers with shrapnel in their body are unable to undergo MRI and DTI scans due to the powerful magnetic fields inherent to the scans. Researchers hope to vastly expand the available tools for more effective and efficient diagnosis, treatment, and rehabilitation of patients suffering from traumatic brain injuries, especially those due to close proximity to explosive blasts.
The U.S. military is increasingly interested in understanding and more efficiently treating blast-induced brain injuries, as between 10-20% of the soldiers returning home from Iraq and Afghanistan return with concussions from explosive blasts. Military and health officials hope to see further expansion of research and treatment built upon the foundation of current research and knowledge of traumatic brain injury.
(pic from military.com)
BHR Pharma has recently announced plans for a study to begin in early 2010. The study will be a multi-clinic trial to test the power and effectiveness of BHR-100, an intravenous progesterone infusion product, as an outcome-enhancing treatment option for patients with severe traumatic brain injury.
Currently, there are no FDA approved medications for use in improving the outcome for those suffering with traumatic brain injuries. The BHR Pharma study, if successful, will lead to the production and dissemination of the BHR-100 progesterone product as a neuroprotective substance for treating traumatic brain injury.
The study will span over 100 clinics in the U.S., Europe, Israel, and elsewhere about the globe, and will treat over 1200 traumatic brain injury patients. BHR-100 will be administered for 5 days to randomly selected patients with “severe closed head trauma” type traumatic brain injuries. BHR-100, unlike previous progesterone infusions, has been tailored to meet all U.S. Food and Drug Administration requirements for approval for use in humans.
BHR Pharma is cooperating with the American Brain Injury Consortium (ABIC) and the European Brain Injury Consortium (EBIC) to locate trial clinics and to help with the final design of the study. BHR has hired PRA International as a Contract Research Organization to assist in conducting the massive trial.
A Reuters article on the study described traumatic brain injury as, “a non-degenerative, non-congenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairments of cognitive, physical and psychosocial functions with an associated diminished or altered state of consciousness.”
Most traumatic brain injuries happen during sporting and automobile accidents. Over 1.5 million Americans per year suffer from traumatic brain injuries. Over 50,000 of them lead to fatalities, while the vast majority of survivors suffer a wide spectrum of short and long-term symptoms, from loss of cognitive function to paralysis and coma.
Previous progesterone studies conducted by BHR Pharma showed promising results in the form of lower mortality rates and improved brain functionality following progesterone treatment. The company hopes that the new study will show even more exciting results and will lead to the release of BHR-100 for use in treating traumatic brain injuries around the world.
BHR Pharma holds the exclusive rights to patents on the use of progesterone-based drugs for use in treatment of traumatic brain injuries.
(pic from itech.dickinson.edu)
Doctors and researchers at the Albert Einstein College of Medicine of Yeshiva University recently made novel use of diffusion tensor imaging (DTI) in order to scan the brains of 20 concussion patients to determine once and for all whether or not concussions involve traumatic injury to the brain. The DTI scans revealed subtle brain damage in 15 of the 20 patients. The team of researchers reported their results in the August 26, 2009 issue of the journal Radiology.
The results of the DTI study hold much promise for the over 1 million Americans who get concussions each year. Most concussion patients experience a full recovery and return to full mental functioning over time, but upwards of 30% of concussion patients suffer long term symptoms such as personality change and inability to perform complex planning and organizational tasks.
Doctors currently diagnose concussions by examining patients’ accident histories and checking for the most common symptoms, which include headaches, shifts in behavior and personality, and dizziness. This approach has proven ineffective since it does not allow doctors to distinguish between which patients will recover fully, and which patients will exhibit long-term symptoms.
DTI scanning may now provide more objective diagnosis of concussion and allow doctors to more accurately diagnose actual brain injury following a concussion. The DTI scans may also give doctors the ability to predict whether or not concussion patients will suffer from a loss of the ability to make decisions, organize complex tasks, and efficient management of their time. In the Radiology study, the 15 patients whose brains showed actual damage also performed more poorly than the control group and the 5 non-brain-damaged patients on executive function tests.
Researchers hope that DTI diagnosis will allow doctors to begin treating more severe concussion-based brain injuries immediately following the injury, which could decrease the chances of long term loss of executive functioning. By initiating cognitive rehabilitation therapy early in the brain injury treatment process, doctors may be able to reduce the amount of sustained long-term damage.
Doctors have long suspected, but have never before been able to objectively demonstrate, a link between concussions and actual brain tissue damage. Now that this link has been clearly demonstrated and understood, researchers can focus on developing more efficient and useful treatments for serious concussions.
