Brain damage continues to develop and evolve for months after a traumatic brain injury (TBI), revealing a potential target for treatments to improve brain trauma, new research led by the University of Melbourne, Australia has found.
The study funded by the Victorian Neurotrauma Initiative is published in the latest issue of The Journal of Nuclear Medicine (JNM).
Around 400,000 Australians have a disability related to traumatic brain injury with cognitive, psychiatric and epileptic problems the most common symptoms. The major cause of TBI is motor vehicle accidents. Other causes include falls, sports injuries and violent crime.
Professor Terry O'Brien, Head of the University of Melbourne's Department of Medicine at the Royal Melbourne Hospital and a senior author on the paper said the results provided new insights into the progressive nature of how the brain changes following injury.
"Patients who suffer brain injury commonly experience long-term neurological and psychiatric problems, including memory and thinking difficulties, anxiety and depression, and epilepsy. Currently there are no effective interventions to reduce the incidence or severity of these problems," Professor O'Brien said.
"We have demonstrated that changes in brain structure and function after traumatic brain injury are dynamic and continue to progress and evolve for many months. This opens up a window of opportunity to give treatments to halt this damage, and therefore reduce the long term neurological and psychiatric complications that many patients experience," he said.
Using powerful imaging techniques--positron emission tomography (PET) fused with magnetic resonance imaging (MRI)-- on animal models researchers have been able to better understand the long-term functional and structural changes that take place after traumatic brain injury.
The study revealed widespread decreases in brain functioning in specific regions of the brain, many of which are remote from the site of the direct trauma and showed no signs of initial injury on the MRI. The hippocampus, a brain structure critical to memory and emotion, is the key area of these changes.
This study has also provided a platform for testing the biological effectiveness of potential new therapies before embarking on expensive and lengthy clinical trials.
"Our discovery could also be applicable to the study of other neurological diseases, such as stroke, dementia, multiple sclerosis brain infections and epilepsy, which are associated with long-term progressive degenerative changes in the brain," Professor O'Brien said.
Traumatic brain injury is a leading cause of death and disability in children and young adults around the world. Long-term disabilities following TBI include: cognitive disabilities such as disorders in attention, memory, learning and executive functioning; psychiatric and behavioral problems including depression, anxiety, aggression, agitation and social inappropriateness; and epilepsy.
The study was done in collaboration with the Department of Neurology, Washington University, St. Louis, Missouri and the Department of Neurophysiology and Epilepsy, APHP, CHU Bicêtre, Paris, France