Treating the Secondary Effects of TBI

The initial effects of a traumatic brain injury (TBI) could be physical symptoms. A person may struggle to walk or move, if the injury affects that part of the brain. The secondary effects of a TBI may soon follow, and can include symptoms such as sleep disruption or inflammation. Researchers are now working to better understand how these secondary effects come to pass, and may have identified a method to mitigate their impact. 

Through a study conducted using mice with brain injuries, a research team was able to monitor their subjects wirelessly and get a full picture of them at sleep, awake and in between. Often, the primary site of brain injuries is what’s called the cerebral cortex. This is the outer part of the brain that best resembles what we think of when we think of the brain’s appearance. However, researchers have found that another part of the brain, located deep beneath the surface, was often even more affected than the cerebral cortex.

The thalamus is located in the center of the brain, far from where any physical impact could make contact. However, the thalamus seems to be disproportionately affected. During the study, researchers noticed that a molecule known as C1q was present in the thalamus at much higher than normal levels. At high levels, this molecule can be associated with brain circuits that no longer function, the death of neurons (which are responsible for transmitting information from the brain), and inflammation. 

C1q isn’t all bad though, it’s just a problem in the thalamus at these levels. C1q also helps the brain clear out old memories to make room for new ones and protects the central nervous system from infection. Since it plays a critical role, this makes treatment a challenge, because simply removing it from the brain could cause catastrophic results. 

As researchers dig deeper, they have learned that C1q also didn’t need to be completely absent from the thalamus as soon as possible. It was actually more helpful to allow the C1q to be present, because it does help keep the brain safe and prevent cell death. However, as time goes on the C1q starts to overcompensate and does more harm than good. 

With that in mind, researchers have developed an antibody treatment which could help block activity from C1q. That antibody also showed notable impacts on other brain injury effects, such as sleep difficulties. When we sleep, most of us experience normal brain rhythms which are known as sleep spindles. These occur in part because of activity in the thalamus. Sleep issues are, of course, common and debilitating after brain injuries. It’s unsurprising to learn that researchers noticed that sleep spindles were disrupted after a brain injury. What was surprising, is that this new antibody treatment not only helped restore the sleep spindles, but also helped to prevent the development of epileptic activities. 

As the study’s author Stephanie Holden, PhD put it, “targeting the C1q molecule after injury could avoid some of the most devastating, long-term consequences of traumatic brain injury.” The hope is that this study and treatment “could eventually lead to the development of treatments for traumatic brain injury.” A host of treatments for TBI do currently exist, and are implemented at the Intrepid Spirit Centers constructed by the Intrepid Fallen Heroes Fund. These treatments range from physical and occupational therapies to sleep therapy and music therapy. Because of the complexity of brain injuries, there is still no one cure-all, but these treatments are transforming the lives of our service members every day. 


Posted on September 20 2021 in Blog

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