Traumatic Brain Injury

Background

Mild traumatic brain injury (mTBI) includes concussion, subconcussion, and most exposures to explosive blast from improvised explosive devices. mTBI is the most common traumatic brain injury affecting military personnel.

Military-Related Traumatic Brain Injury and Neruodegeneration

Pentagon Data Shows High Suicide Rates Among Troops Exposed to Blasts

Repeated blast exposure, particularly from firing weapons during training and combat, has been linked to brain damage in Navy SEALs and other elite military personnel. This damage, often resulting from low-level blast overpressure, can lead to cognitive and psychological issues, including depression, paranoia, and even suicide. Studies have identified a pattern of brain damage in deceased SEALs, with the damage correlating with repeated blast exposure. 

View the Study: https://www.nytimes.com/2024/07/31/us/military-suicide-rates-report.html

Overview

A single traumatic brain injury can produce long-term gray and white matter atrophy, precipitate or accelerate age-related neurodegeneration, and increase the risk of developing Alzheimer’s disease, Parkinson’s disease, and motor neuron disease.

Miami Dolphins quarterback Tua Tagovailoa sustained two head injuries within a week.  A neurologist who was part of the process that allowed him to return to the field was removed.

Military-Related Traumatic Brain Injury and Neurodegeneration

Increasing evidence suggests that a single traumatic brain injury can produce long-term gray and white matter atrophy, precipitate or accelerate age-related neurodegeneration, and increase the risk of developing Alzheimer’s disease, Parkinson’s disease, and motor neuron disease. In addition, repetitive mTBIs can provoke the development of a tauopathy, chronic traumatic encephalopathy. We found early changes of chronic traumatic encephalopathy in four young veterans of the Iraq and Afghanistan conflict who were exposed to explosive blast and in another young veteran who was repetitively concussed. Four of the five veterans with early-stage chronic traumatic encephalopathy were also diagnosed with posttraumatic stress disorder. Advanced chronic traumatic encephalopathy has been found in veterans who experienced repetitive neurotrauma while in service and in others who were accomplished athletes. Clinically, chronic traumatic encephalopathy is associated with behavioral changes, executive dysfunction, memory loss, and cognitive impairments that begin insidiously and progress slowly over decades.

View the Study: https://pubmed.ncbi.nlm.nih.gov/24924675/

A High-Consequence Threat

Nearly 500,000 U.S. troops worldwide experienced a TBI resulting from military training, deployment, or day-to-day activities—such as sporting events—between 2000 and 2023

TBI Diagnostics

TriCelX

Abbott and the U.S. Army Medical Materiel Development Activity (USAMMDA) collaborated to develop a blood test for traumatic brain injury (TBI).

The i-STAT TBI cartridge provides objective data to help assess patients with suspected mild traumatic brain injury (mTBI) and provides lab-quality results in 15 minutes.

“Given the large numbers of expected casualties with all severities of traumatic brain injury in future large-scale combat operations, this test can help maintain combat power far forward by helping to eliminate unnecessary evacuations.” 

https://usammda.health.mil/index.cfm/public_affairs/news_releases/2024/fda_clears_whole_blood_rapid_test

Supporting Science: TBI | MSCs

In summary, the results of experimental and clinical studies demonstrate that transplantation of MSCs in TBI recipients enhances neural tissue modulation of the inflammatory processes in the injured brain. It improves cognitive and motor function repair by stimulation of neurogenesis, angiogenesis, maturation of newborn neurons and their neuroprotection, and al recovery and reduces brain tissue damage in TBI disorders.

View the Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024997/

Stem cell therapy leads to neurological improvement in patients with traumatic brain injuries and is perhaps the most promising treatment to this type of injury to date.

View the Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024997/

Clinical Research

Mesenchymal Stem Cell Therapy Alleviates the Neuroinflammation Associated with Acquired Brain Injury

Ischemic stroke and traumatic brain injury (TBI) comprise two particularly prevalent and costly examples of acquired brain injury (ABI). Following stroke or TBI, primary cell death and secondary cell death closely model disease progression and worsen outcomes. Mounting evidence indicates that long‐term neuroinflammation extensively exacerbates the secondary deterioration of brain structure and function. Due to their immunomodulatory and regenerative properties, mesenchymal stem cell transplants have emerged as a promising approach to treating this facet of stroke and TBI pathology. In this review, we summarize the classification of cell death in ABI and discuss the prominent role of inflammation. We then consider the efficacy of bone marrow–derived mesenchymal stem/stromal cell (BM‐MSC) transplantation as a therapy for these injuries. Finally, we examine recent laboratory and clinical studies utilizing transplanted BM‐MSCs as antiinflammatory and neurorestorative treatments for stroke and TBI. Clinical trials of BM‐MSC transplants for stroke and TBI support their promising protective and regenerative properties. Future research is needed to allow for better comparison among trials and to elaborate on the emerging area of cell‐based combination treatments.

View the Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC7248547/

Mesenchymal Stem Cells in the Treatment of Traumatic Brain Injury

Traumatic brain injury (TBI) is characterized by a disruption in the normal function of the brain due to an injury following a trauma, which can potentially cause severe physical, cognitive, and emotional impairment. The primary insult to the brain initiates secondary injury cascades consisting of multiple complex biochemical responses of the brain that significantly influence the overall severity of the brain damage and clinical sequelae. The use of mesenchymal stem cells (MSCs) offers huge potential for application in the treatment of TBI. MSCs have immunosuppressive properties that reduce inflammation in injured tissue. As such, they could be used to modulate the secondary mechanisms of injury and halt the progression of the secondary insult in the brain after injury. Particularly, MSCs are capable of secreting growth factors that facilitate the regrowth of neurons in the brain. The relative abundance of harvest sources of MSCs also makes them particularly appealing. Recently, numerous studies have investigated the effects of infusion of MSCs into animal models of TBI. The results have shown significant improvement in the motor function of the damaged brain tissues. In this review, we summarize the recent advances in the application of MSCs in the treatment of TBI. The review starts with a brief introduction of the pathophysiology of TBI, followed by the biology of MSCs, and the application of MSCs in TBI treatment. The challenges associated with the application of MSCs in the treatment of TBI and strategies to address those challenges in the future have also been discussed..

View the Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC5316525/