Researchers at the University of Maryland School of Medicine are challenging widespread misperceptions about the true nature of the chronic degenerative problems caused by traumatic brain injury (TBI).
David Loane, PhD, an assistant professor of anesthesiology and Alan Faden, MD, a neurologist and professor of anesthesiology, propose that the neuropsychiatric problems and chronic brain damage that occur after traumatic brain injury are mostly caused by long-term inflammation in the brain. This inflammation can be associated with many symptoms of both traumatic and mild traumatic brain surgery such as cognitive decline, depression, and brain atrophy.
The scientists say that medical professionals place too much emphasis on a condition known as chronic traumatic encephalopathy (CTE), a condition that has been found in some former professional football players. Dr. Loane and Dr. Faden say that this focus distracts attention from more important and treatable symptoms. CTE is a serious condition, but few people have this diagnosis. Instead, they say that journalists and researchers should focus more on the effects of mild traumatic injury or repeated concussions – conditions that may trigger chronic, long-term brain inflammation that can cause lasting damage for years.
“Brain inflammation is a key issue, and it has been under-emphasized,” says Dr. Faden. “Recent brain imaging studies, including those in former professional football players, indicate that persistent brain inflammation after a single moderate head injury or repeated milder traumatic brain injury may be very common, and may contribute to cognitive problems. In addition, larger studies indicate that brain inflammation persists for many months or years in many people with traumatic brain injury.”
The doctors say that past research demonstrates that chronic brain inflammation may be treatable with experimental drugs and by carefully monitored exercise programs. They say that these treatment options should be vigorously pursued. Dr. Faden has published several papers that look at animal models of TBI and discussed how even mild brain injuries can cause psychiatric and cognitive problems. They appeared in the Journal of Cerebral Blood Flow and Metabolism1 and the Journal of Neuroscience.
“These studies show how repeated mild injuries can lead to the same kinds of injuries that occur after a single moderate or severe traumatic brain injury,” said Dr. Faden. “The brain inflammation and loss of brain cells look remarkably similar in both cases. Now that we understand more about the mechanism behind the damage, we can develop strategies to prevent or minimize the problems.”
