Nutritional interventions to improve neurophysiological impairments following traumatic brain injury: A systematic review

McGeown, Joshua P.; Hume, Patria A.; Theadom, Alice; Quarrie, Kenneth L; Borotkanics, Robert

doi:10.1002/jnr.24746

Cited by 13 publications

(10 citation statements)

References 136 publications

(419 reference statements)

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“…(positive) effect, vs. only 19% reported a negative interaction (6). Nutrition interventions for both prevention and treatment of TBI symptomatologies have been reported (24)(25)(26). While several therapies, including vitamins (B 2 , B 3 , B 6 , B 9 , C, D, and E) and nutrients (arginine, carnitine, magnesium, omega-3 fatty acids, resveratrol, selenium, and zinc) have demonstrated efficacy in preclinical studies, using rats and mice, but investigations of polytherapy treatments have not been conducted.…”

Section: Introductionmentioning

confidence: 99%

Omega-3 Fatty Acids and Vitamin D Decrease Plasma T-Tau, GFAP, and UCH-L1 in Experimental Traumatic Brain Injury

et al. 2021

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Traumatic brain injury (TBI) results in neuronal, axonal and glial damage. Interventions targeting neuroinflammation to enhance recovery from TBI are needed. Exercise is known to improve cognitive function in TBI patients. Omega-3 fatty acids and vitamin D reportedly reduce inflammation, and in combination, might improve TBI outcomes. This study examined how an anti-inflammatory diet affected plasma TBI biomarkers, voluntary exercise and behaviors following exposure to mild TBI (mTBI). Adult, male rats were individually housed in cages fitted with running wheels and daily running distance was recorded throughout the study. A modified weight drop method induced mTBI, and during 30 days post-injury, rats were fed diets supplemented with omega-3 fatty acids and vitamin D3 (AIDM diet), or non-supplemented AIN-76A diets (CON diet). Behavioral tests were periodically conducted to assess functional deficits. Plasma levels of Total tau (T-tau), glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase L1 (UCH-L1) and neurofilament light chain (NF-L) were measured at 48 h, 14 days, and 30 days post-injury. Fatty acid composition of food, plasma, and brain tissues was determined. In rats exposed to mTBI, NF-L levels were significantly elevated at 48 h post-injury (P < 0.005), and decreased to levels seen in uninjured rats by 14 days post-injury. T-tau, GFAP, and UCH-L1 plasma levels did not change at 48 h or 14 days post-injury. However, at 30 days post-injury, T-tau, GFAP and UCH-L1 all significantly increased in rats exposed to mTBI and fed CON diets (P < 0.005), but not in rats fed AIDM diets. Behavioral tests conducted post-injury showed that exercise counteracted cognitive deficits associated with mTBI. The AIDM diets significantly increased docosahexaenoic acid levels in plasma and brain tissue (P < 0.05), and in serum levels of vitamin D (P < 0.05). The temporal response of the four injury biomarkers examined is consistent with studies by others demonstrating acute and chronic neural tissue damage following exposure to TBI. The anti-inflammatory diet significantly altered the temporal profiles of plasma T-tau, GFAP, and UCH-L1 following mTBI. Voluntary exercise protected against mTBI-induced cognitive deficits, but had no impact on plasma levels of neurotrauma biomarkers. Thus, the prophylactic effect of exercise, when combined with an anti-inflammatory diet, may facilitate recovery in patients with mTBI.

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Section: Introductionmentioning

confidence: 99%

Omega-3 Fatty Acids and Vitamin D Decrease Plasma T-Tau, GFAP, and UCH-L1 in Experimental Traumatic Brain Injury

et al. 2021

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“…Diets rich in red meat, saturated and trans fats, refined sugars, and carbohydrates are associated with neuroinflammation, while neuroprotective and anti-inflammatory effects are linked to diets high in unsaturated, polyunsaturated, and monounsaturated fats, as well as ketogenic and Mediterranean diets, and intermittent fasting [139]. The effects on anti-neuroinflammatory (ANI) diets on TBI outcomes are being worked out in both preclinical [140] and clinical studies [108,141]. Specific supplements have been extensive studied, most notably the use of omega oils [142][143][144].…”

Section: Dietary Changesmentioning

confidence: 99%

Conservative Management of Acute Sports-Related Concussions: A Narrative Review

Kureshi,

Mendizabal,

Francis

et al. 2024

Healthcare

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This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management.

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“…It no longer seems so clear that sTBI‐induced damage can only be treated within a few hours after the trauma, and the possibility of a longer therapeutic window of time for pharmacological intervention is in discussion 7 . For reduction of secondary damage, anti‐oxidants, branched‐chain amino acids, and ω‐3 polyunsaturated fatty acids have shown promising pre‐clinical results 8 . However, pharmacological research has not yet identified a “gold standard” to prevent secondary brain damage.…”

Section: Introductionmentioning

confidence: 99%

“… 7 For reduction of secondary damage, anti‐oxidants, branched‐chain amino acids, and ω‐3 polyunsaturated fatty acids have shown promising pre‐clinical results. 8 However, pharmacological research has not yet identified a “gold standard” to prevent secondary brain damage. Although there are promising data from animal studies, the only positive findings in retrospective 9 , 10 and prospective “real life” clinical trials 11 , 12 were achieved with Citicoline and Cerebrolysin.…”

Section: Introductionmentioning

confidence: 99%

A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury—Two case reports

Trimmel

Herzer

Derdak

et al. 2022

Clinical Case Reports

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Severe traumatic brain injury (sTBI) is a major cause of death and disability worldwide, resulting in a significant individual and socioeconomic burden. Current treatment guidelines do not include any recommendations for neuroprotective or neuoregenerative drugs. Here, we present a combined treatment with Cerebrolysin and Citicoline in two cases. Both drugs are experimentally better than clinically proven in their own effectiveness, but there is almost no clinical data on the combination of the two. Our case study hints at a promising approach that may improve neurological outcome after sTBI. The first patient was a 29 years male motorcyclist suffered polytrauma in a high-speed accident. He had severe bilateral chest trauma and fractures in both thighs and an sTBI. In addition to surgical and standard neurocritical care according to the evidence-based guidelines, he was given neuroprotective therapy with Cerebrolysin (50 ml/day) and Citicoline (3 g/day), by continuous intravenous infusion (IV), for 21 days.The second patient was a 30 years male ski mountaineer who had suffered a fall over 300 m in open terrain. In addition to the sTBI, he had fractures in the cervical spine, ribs, pelvis, and lower extremities, as well as lung contusions and massive soft tissue trauma. After initial treatment in a local hospital, he was transferred to our department and received the same neuroprotective drugs, like all of our patients with sTBI. Considering the severity of the injuries (Injury Severity Score[ISS]: 43/50, Revised Trauma Score [RTS: 5.0304, 2.7794]) and the unfavorable outcome probability (Hukkelhoven Score) of 93.1% and 82.6%, the outcomes of both patients are surprisingly encouraging 1 year after the accident. They achieved a Glasgow Outcome Score of 6 and 5 and grades 2 and 4 on the modified Rankin Scale, respectively. Currently, both are able to take care of themselves in activities of daily life to a large extent. Neuroprotective drugs may improve the regeneration of cell membranes, improve blood brain barrier integrity, and reduce neuroinflammation leading to secondary damage to the injured brain.How to cite this article: Trimmel H, Herzer G, Derdak C, Kettenbach J, Grgac I. A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury-Two case reports.

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Nutritional interventions to improve neurophysiological impairments following traumatic brain injury: A systematic review

Cited by 13 publications

References 136 publications

Omega-3 Fatty Acids and Vitamin D Decrease Plasma T-Tau, GFAP, and UCH-L1 in Experimental Traumatic Brain Injury

Omega-3 Fatty Acids and Vitamin D Decrease Plasma T-Tau, GFAP, and UCH-L1 in Experimental Traumatic Brain Injury

Conservative Management of Acute Sports-Related Concussions: A Narrative Review

A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury—Two case reports

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