Friday, January 17, 2020

Blue Light May Help Heal Mild Traumatic Brain Injury

Early morning blue light exposure therapy may aid the healing process of people impacted by mild traumatic brain injury, according to a study. Mild traumatic brain injuries, or concussions, are often the result of falls, car accidents and sports participation. Among other threats, military personnel can also experience mTBI from exposure to explosive blasts.

"Daily exposure to blue wavelength light each morning helps to re-entrain the circadian rhythm so that people get better, more regular sleep," said William D. Killgore, a psychiatry professor at the University of Arizona in the US. "This is likely true for everybody, but we recently demonstrated it in people recovering from mild traumatic brain injury, or mTBI.

"That improvement in sleep was translated into improvements in cognitive function, reduced daytime sleepiness and actual brain repair," Killgore said. Shockwaves strike the soft tissue of the gut, and push a burst of pressure into the brain, causing microscopic damage to blood vessels and brain tissue, Killgore said.

Those with a concussion or mTBI might momentarily become disoriented, or even briefly lose consciousness following the injury. However, loss of consciousness doesn't always happen and many people who sustain a concussion are able to walk it off without realising they have a mild brain injury, according to Killgore.

Few effective treatments for mTBI exist, according to the study published in the journal Neurobiology of Disease. "About 50 per cent of people with mTBI also complain that they have sleep problems after an injury," Killgore said.

Recent research has shown that the brain repairs itself during sleep, so Killgore and his co-authors sought to determine if improved sleep led to a faster recovery. In a randomised clinical trial, adults with mTBI used a cube-like device that shines bright blue light -- with a peak wavelength of 469 nanometre -- at participants from their desk or tables for 30 minutes early each morning for six weeks.

Control groups were exposed to bright amber light, the researchers said. "Blue light suppresses brain production of a chemical called melatonin," Killgore said.

"You don't want melatonin in the morning because it makes you drowsy and prepares the brain to sleep. When you are exposed to blue light in the morning, it shifts your brain's biological clock so that in the evening, your melatonin will kick in earlier and help you to fall asleep and stay asleep," Killgore said. People get the most restorative sleep when it aligns with their natural circadian rhythm of melatonin -- the body's sleep-wake cycle associated with night and day.

"If we can get you sleeping regularly, at the same time each day, that's much better because the body and the brain can more effectively coordinate all these repair processes," he said. As a result of the blue light treatment, participants fell asleep and woke an average of one hour earlier than before the trial and were less sleepy during the daytime, researchers said.

Participants improved their speed and efficiency in brain processing, and showed an increase in volume in the pulvinar nucleus, an area of the brain responsible for visual attention. Neural connections and communication flow between the pulvinar nucleus and other parts of the brain that drive alertness and cognition were also strengthened, the researchers said.

"We think we're facilitating brain healing by promoting better sleep and circadian alignment, and as these systems heal, these brain areas are communicating with each other more effectively. "That could be what's translating into improvements in cognition and less daytime sleepiness," Killgore said.


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Monday, November 25, 2019

Concussions in high school athletes may increase depression and suicide risk

One of the most common forms of traumatic brain injury, a concussion, could lead to an increased risk of depression and suicide in adults, says a recent study.

Research published suggests high school students with a history of sports-related concussions might be at an increased risk for suicide.


The research examined the link between self-reported history of concussion and risk factors for suicide completion.


It was the 1st study to include a nationally representative sample of high school students.
It's important to remember that when it comes to concussions, there's no visual test to confirm them. Unfortunately, you can't take your child to have a lab test done to diagnose one, said a researcher.


Common symptoms of a concussion include loss of consciousness, headache, confusion and change in mood.


Researchers discovered that teenagers who reported having a concussion in the last year were more likely to report feelings of depression, suicidal ideations and planned or previous suicide attempts.
Of the portion of students who reported a history of concussions, approximately 36 % reported they had felt sad ot hopeless ( compared to 31.1 % of all teens) and around 21 % had thoughts of suicide ( compared to 17%).


Male participants with a reported concussion in the last year were twice as likely to report having attempted suicide and 3 times more likely to report a history of receiving medical treatment for attempted suicide than those who did not have a recent concussion.


The study also revealed female students with a history of concussions had greater odds to report all risk factors of suicide.


They were more likely to have reported feeling sad or hopeless, having suicidal ideations, a planned suicide attempt, having attempted suicide, and were twice as likely to indicate a history of receiving medical treatment for an attempted suicide compared to female who did not report a concussion in the last year.


A recently published article revealed female high school athletes have higher concussion rates than their make counterparts.


The researchers noted that while the study did control for commonly associated suicide risk factors like sexual orientation and a history of being bullied, it did not account for other risk factors like drug or alcohol use.


There were no measures of per-concussion mental health for survey participants.


Concussions are a traumatic brain injury and they are even worse for young people with developing brains, said one of the authors. These injuries can have long term effects such as memory issues and sleep disturbances.


According to the National Suicide Prevention Lifeline, warning signs of suicide can include talking about feeling hopeless, withdrawing or social isolation, extreme mood swings and reckless or anxious behaviour.


Everyone needs to be aware of the warning signs of the risks that come with concussion- parents, teachers, coaches, but also the students themselves, the researcher said.


If there is any concern that a child may have suffered a concussion, it is critical to seek medical attention. If a child is diagnosed with a concussion, everyone in their support network should look for changes in mood or behaviour that may be warning signs of reduced mental well-being, added the researcher.


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Saturday, February 09, 2019

Breathing Pure Oxygen Could Repair Brain Damage Years After a Concussion

Researchers have revisited hyperbaric oxygen sessions as a possible treatment for brain damage sustained after a concussion. According to a report compiled for experts, in a single year, approximately 2.2 million emergency room visits were for traumatic brain injuries (TBI). The majority of these injuries are considered mild and are commonly called concussions. These injuries are common in contact sports and in soldiers.

Most individuals who suffer a concussion are able to heal back to normal brain activity, yet up to five percent of sufferers can experience long-term symptoms. This is called post-concussion syndrome and it can manifest with headaches, mood changes, and other cognitive problems. The symptoms are caused by damage to blood vessels in the brain, making it more difficult for the organ to receive adequate oxygen.

A study published in 2013 showed that treating post-concussion syndrome patients with pure oxygen significantly improved cognitive function and quality of life for participants. Research  shows exactly how this treatment heals the brain. The lead researcher explained that “Once the extra oxygen diffuses into damaged areas, it supplies energy and the regenerative process can happen.” The extra oxygen helped to regrow blood vessels and nerve fibers.

This treatment was previously tested in 2015 by researchers. They concluded that the treatment was not effective. However, their conclusions were based on a faulty interpretation of their supposed “sham” treatment. The researchers subjected a group of participants to a pressurized chamber with normal levels of oxygen. These patients also showed improved cognitive function, so the researchers concluded that the treatment was no more effective than breathing normally.

However, the researchers did not account for the higher pressure actually allowing more oxygen to enter the brain, thus performing along the same lines as the patients who were actually receiving the active treatment. “It was meant to be a sham treatment, but it was actually an active treatment,” says the researcher.

Using hyperbaric oxygen treatments for post-concussion syndrome still needs to be approved by the FDA. More research is needed to confirm its safety and efficacy. However, should the treatment prevail, it will be the first to tackle the underlying causes of the syndrome, as opposed to treating individual symptoms.

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Sunday, November 18, 2018

Head injuries lead to serious brain diseases- Here's all you need to know

 In a recent study, biologists discovered how head injuries adversely affect individual cells and genes that can lead to serious brain disorders. The researchers studied more than 6,000 cells in 15 hippocampal cell types -- the first study of individual cell types subject to brain trauma. Each cell has the same DNA, but which genes are activated varies among different cell types. Among the 15 cell types are two that were previously unknown, each with a unique set of active genes.
The life scientists provide the first cell 'atlas' of the hippocampus -- the part of the brain that helps regulate learning and memory -- when it is affected by traumatic brain injury. The team also proposed gene candidates for treating brain diseases associated with traumatic brain injuries, such as Alzheimer's disease and post-traumatic stress disorder.
"Every cell type is different," said  co-senior author of the study.  The biologists found that hundreds of genes are adversely affected by mild traumatic brain injury, such as a concussion. These altered genes can later lead to Alzheimer's, Parkinson's and other diseases.
The researchers reproduced a concussion-like brain injury in mice and studied other mice that did not receive a brain injury. The researchers analysed thousands of cells in the hippocampus of both groups of mice.
The mice without an injury had very low levels in 14 of the 15 cell types of a gene called TTR that regulates metabolism, controls thyroid hormones and performs other functions. Brain trauma increased the level of Ttr in essentially all of the cell types, the researchers found.
They concluded TTR is important to brain health and may function to bring more thyroid hormone to the brain to maintain metabolism. A thyroid hormone called T4 was injected in mice. T4 improved traumatic brain injury-induced learning deficits and reversed changes in 93 genes that affect learning and memory.
This reversal in damage caused by traumatic brain injury is a major new finding. After brain injury, metabolism is substantially reduced. The biologists think T4 may "reboot" metabolism.
Researchers found evidence that at least 12 of 15 cell types are negatively affected by brain trauma, some more strongly than others. They were able to see how genes that have been linked to Alzheimer's disease acted within different cell types, providing new details about where these genes act when they are affected by brain trauma.
"We are learning which cell types we may want to target in future research," said  a senior author of the study. "Maybe Alzheimer's disease-related genes do not have to be active in all different cell types."
For the first time, the biologists found several genes that are affected by traumatic brain injury, which has recently been linked to neurotic behaviour in humans. Traumatic brain injury has been associated with depression, anxiety, and schizophrenia. This research could lead to new treatments for these conditions. 

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Friday, April 27, 2018

Brain Scan Can Tell PTSD Apart from Traumatic Brain Injury

In 2008, a marine Capt. was deployed in Afghanistan.

The combat engineer’s goal was to detect and remove mines, improvised explosive devices (IEDs), and other hazards from roads, clearing the way for troops and supplies to move through.

By the time he left Afghanistan, he had survived three explosive blasts that caused concussions.
These weren’t the first concussions in his life. He’d already had five or six such head injuries from playing sports and from other incidents.

Still, when he first got home, he felt fine. Not just fine, but fortunate that he’d survived Afghanistan unscathed. Or so he thought.

Over the weeks and months following his return, he began to deteriorate. He began experiencing headaches and difficulty sleeping, as well as problems concentrating, focusing, and remembering. He had frequent angry outbursts, which he’d never experienced before.

“I was rude and nasty to people, and the worst part was that I didn't really know just how much I had changed,” he said.

But when he sought medical help, his diagnosis was unclear. A history of surviving explosive attacks, coupled with his symptoms, pointed to two different possible conditions: traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). So which was it?

A Look Into the Brain

A new study published  has found a way to tell TBI and PTSD apart by using brain scans.

The researchers gathered more than 20,000 people with TBI, PTSD, both conditions, or neither. They scanned participants using single-photon emission computer tomography (SPECT), an imaging technique that can measure blood flow to highly specific regions of the brain.

In a smaller group with about 100 patients of each type, they also strictly controlled for demographics and co-occurring conditions.

Although PTSD and TBI can have similar symptoms, in a brain scan, they look nothing alike, the researchers found.

Patients with TBI showed decreased activity in the prefrontal cortex, temporal lobes, and cerebellum. These brain regions govern self-control of mood and behavior, memory formation, and coordinated movement.

Meanwhile, patients with PTSD showed increased activity in the limbic system, basal ganglia, prefrontal cortex, cerebellum, and temporal, occipital, and parietal lobes. Brain regions that are involved in fear processing and emotional regulation, sensory processing, and integration of information are also affected.

Using a computer-driven analysis, in the smaller controlled group, the scientists were able to determine who had PTSD or TBI with 100 percent accuracy. Visual readings performed by humans were only 89 percent accurate, stressing the need to have such analysis performed by computers. In the larger group, accuracy did not exceed 82 percent, even with computer analysis.

“Diagnosis and treatment for PTSD and TBI [are] often based on symptom clusters, and difficulties in differentiating between these brain disorders often arise due to the symptom overlap,” said a primary investigator on the study. “Functional neuroimaging with SPECT may hold the key to differentiating these disorders effectively, eliminating the reliance on self-report data, diagnosis based on symptom clusters, and challenges to diagnosis.”

Tricky Treatment

The Capt. eventually found his way to the clinic, where a brain scan revealed that he was living with both PTSD and TBI. 

“Boy, did I underestimate the value of actually looking at the brain when you have a brain problem,” he said.

With the problem uncovered, his doctors were able to tailor his treatment.

“I felt a dramatic difference right away,” he added. “I felt more mentally sharp and focused than ever.”

When it comes to treating TBI and PTSD, it’s important to be able to tell the two apart. The treatments for one can be harmful for people with the other.

For example, the tranquilizers (benzodiazepines) that people with PTSD use to soothe an overactive brain could pack a dangerous double-punch to the already-underactive TBI brain.

Meanwhile, the regular therapies required to treat TBI could be triggering for someone with PTSD.

Not a Small Problem

Since 2000, more than 300,000 veterans have been diagnosed with TBI and more than 125,000 with PTSD — with no small amount of overlap among them. One study found that 73%  of veterans with TBI also had PTSD.

Among U.S. civilians, about 3.5% of adults experience PTSD — that’s about 8.5 million people. In 2010 alone, there were about 2.3 million emergency department visits for suspected TBI.

The author cautioned in his paper that seemingly mild head impacts that happen during sports can cumulate over a lifetime into repetitive TBI with long-term symptoms.

Amen hopes his work will lead to diagnosis of PTSD and TBI based off biomarkers like the SPECT analysis, rather than symptom-based diagnosis.

“The results of this work offers help to vulnerable populations who suffer from PTSD and TBI — such as veterans — demonstrating that functional neuroimaging offers targeted care and the potential for improved outcomes,” he said.

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Sunday, April 22, 2018

Easier detection of concussions!

According to a study some specific small molecules in blood plasma may be useful in determining whether someone has sustained a mild traumatic brain injury (mTBI), commonly known as a concussion.

Six specific small molecules from blood plasma were discovered in a group of college athletes who had been diagnosed with concussions. When these molecules were assessed, their combined presence accurately predicted whether teammates had sustained an mTBI or not.

This suggests that these small molecules, and possibly others, might be clinically relevant biomarkers of mTBI.

The same six biomarkers were then tested in a separate group of individuals, without and with mTBI, and the results replicated the athlete findings.

Although the results are encouraging, the authors reported limitations to their study and recommended additional investigations related to these and other mTBI biomarkers in blood that will further clarify their utility in clinical management.

“Such blood tests are important in determining not only whether someone has sustained a concussion, which is not currently an easy task, but may eventually prove useful in defining when injured individuals may be eligible to safely return to regular activities,” said  the paper’s first author.

Researchers are helping advance technologies and therapeutic approaches that may benefit all societies, but are directly relevant to their local populations.

The estimated 40 million individuals worldwide diagnosed with mTBI likely represent a gross underestimation of those actually sustaining such injuries.

Clinical practitioners require a relevant and reliable, minimally invasive, objective diagnostic test to determine high versus low probability of mTBI in a timely manner.

The author said there is a clear need to improve diagnostic capabilities, which could reduce under-reporting of mTBI and allow more appropriate care to be delivered to concussed individuals.

Although current technologies for defining the discovered small molecules in today’s publication lack the rapid, point-of-care platforms being developed for other measures, the study authors anticipated a growing technological momentum to develop such novel platforms resulting from this and similar investigations.

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Tuesday, November 08, 2016

Novel blood test to identify concussions

Scientists have developed a new blood test that identifies with over 90 per cent accuracy whether an adolescent athlete has suffered a concussion or not.

Diagnosis of a clinically significant concussion, or a mild traumatic brain injury, can be difficult as it currently relies on a combination of patient symptom assessment and clinician judgement.

Equally problematic are the decisions to stop play or activities, or when patients who have suffered a concussion can safely return to normal activities without risking further injury.

Researchers from Children's Health Research Institute and Western University in Canada, have demonstrated that a blood test can now accurately diagnose a concussion using a form of blood profiling known as metabolomics.
 
In the relatively inexpensive test, blood is drawn from an individual that may have suffered a concussion as the result of a sudden blow to the head (or from transmitted forces from a sudden blow to the body) within 72 hours of the incident.

The scientists measure a panel of metabolites — small molecules that are the products of the body's metabolism  — in the blood to search for distinct patterns that indicate a concussion has occurred.

"This novel approach, to use blood testing of metabolites as a diagnostic tool for concussions, was exploratory and we were extremely pleased with the robustness of our initial results," said Douglas Fraser from Children's Hospital, who led the study with his co-investigator Mark Daley, a professor at Western University.

"We looked at a host of patterns and it appears that those who suffered a concussion have a very different pattern than those who have not had a concussion," Fraser said.

In this latest successful attempt, the researchers took a different approach and investigated a full spectrum of 174 metabolites.

"We looked at all of these metabolites in concussed male adolescent patients and in non-concussed male adolescent patients and it turns out that the spectrum is really different," said Daley.

"There is no one metabolite that we can put a finger on but when we looked at all of them, those profiles are different enough that we could easily distinguish concussed patients from non-concussed," said Daley.

In fact, with fine tuning we can now look at sets of as few as 20-40 specific metabolites and maintain the diagnostic accuracy level of the test over 90 per cent," said Daley.

Concussion is a major public health concern, often resulting in significant acute symptoms and in some individuals, long-term neurological dysfunction.

The study was published in the journal Metabolomics.

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