Supplements may offer neuroprotection after traumatic brain injury

Writing in the journal Nutrients​, researchers from Australia and the United States reviewed a body of literature that pointed to biochemical compounds and their use as potential therapeutic benefits post-TBI.

“As clinical evidence in this research field is rapidly emerging, a comprehensive approach including appropriate nutritional interventions has the potential to mitigate some of the physical, neurological and emotional damage inflicted by TBIs, promote timely and effective recovery, and inform policymakers in the development of prevention strategies,” they wrote.

A TBI increase​

Although there is an underreporting of head trauma, the Centers for Disease Control and Prevention indicate that in 2014 alone there were approximately 2.87 million emergency department visits, hospitalizations and deaths in the United States related to traumatic brain injuries, a nearly 53% increase since the previous decade. About a half a million U.S. military personnel have suffered from TBIs during the last 20 years.

TBIs occur when a bump, blow or jolt to the head or a penetrating head injury disrupts how the brain typically functions. The researchers noted that TBIs “comprise excitotoxicity, ionic disturbances, decreased cerebral blood flow, edema, oxidative stress, inflammation and damage to and death of brain cells that may occur during acute (i.e., within minutes) and subacute phases (i.e., within 24 hours)” and can continue for “months or decades after the injury.”

Headaches, confusion, dizziness, nausea, vomiting, slurred speech, drowsiness and difficulty concentrating are among the common symptoms of TBI though TBIs can result in a loss of consciousness and amnesia lasting more than a week for some people. These symptoms have significant effects on the health and well-being of TBI sufferers.  

Investigators suggest that prevention strategies and neuroprotective therapies could minimize the incidence of TBIs and indicate that TBI-specific supplementation and dietary regimens can have “beneficial effects both before and after the occurrence of TBI and concussion by targeting specific neuropathological mechanisms such as inflammation and oxidative stress,” the researchers noted.

Creatine monohydrate, omega-3 fatty acids (Docosahexaenoic acid, DHA, and Eicosapentaenoic acid, EPA), branched-chain amino acids (BCAAs), riboflavin, choline, magnesium, berry anthocyanins, Boswellia serrata​, enzogenol, N-Acetylcysteine (NAC) and melatonin are all supplements under clinical investigation to address TBIs.

Study details​

The researchers explored MEDLINE (PubMed) and Cochrane online databases to identify journal articles for the review and included key search terms for nutrients, foods and biochemical compounds of interest and broader terms for interventions after TBI occurrence.

“Perhaps not surprisingly, the current body of literature points to biochemical compounds such as omega-3 fatty acids, magnesium and anthocyanins as potential neuroprotective agents against the brain’s excitotoxic and inflammatory response post-TBI,” the researchers wrote. “Similarly, evidence suggests that creatine monohydrate allows for maintaining adequate ATP levels to address the brain’s high energy demands [after injury], while choline attenuates brain edema and helps preserve the integrity of the blood–brain barrier and cellular membranes.”

Other studies indicate that BCAA supplementation can correct imbalances in the release of GAMA and glutamate which occurs from the result of brain injuries. The investigators also found that Boswellia serrata​ downregulates the production of inflammatory cytokines, and that Enzogenol and NAC support cognitive function and decrease markers of oxidative stress and neuroinflammation after concussion.

In one study, melatonin was useful for individuals suffering from post-TBI sleep disturbances.

“Our understanding of the pathophysiology of TBI has seen dramatic improvements in recent years," the researchers wrote. "Accordingly, there is an increasing appreciation for the link between TBI and later neurodegenerative conditions and cognitive decline.

“These debilitating, often irreversible, conditions arguably constitute one of the major healthcare issues of the current generation and, while public awareness continues to rise, concerted efforts must be made to reduce the risk and incidence of both TBIs of all degrees of severity and subsequent neurodegenerative disorders.”

Source: Nutrients​
doi: doi.org/10.3390/nu16152430​
“Mitigating Traumatic Brain Injury: A Narrative Review of Supplementation and Dietary Protocols”
Authors: Federica Conti et al.