Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Researchers urge reclassification of traumatic brain injury as chronic disease

27.08.2010
Study shows brain trauma associated with lifelong conditions that affect quality of life and mortality

Traumatic brain injury, currently considered a singular event by the insurance industry and many health care providers, is instead the beginning of an ongoing process that impacts multiple organ systems and may cause or accelerate other diseases and disorders that can reduce life expectancy, according to research from the University of Texas Medical Branch at Galveston.

As such, traumatic brain injury should be defined and managed as a chronic disease to ensure that patients receive appropriate care and that future research is directed at discovering therapies that may interrupt the disease processes months or even years after the initiating injury, say co-authors Dr. Brent Masel, a clinical associate professor in UTMB's department of neurology and Dr. Douglas DeWitt, director of the Moody Center for Traumatic Brain & Spinal Cord Injury Research/Mission Connect and professor in the department of anesthesiology. Masel also serves as president and director of the Transitional Learning Center in Galveston, which for more than 25 years has provided survivors of brain injury with the special rehabilitation services they need to re-enter the community.

The literature review, which appears in the current issue of The Journal of Neurotrauma, examines 25 years of research on the effects of brain injury, including its impact on the central nervous system and on cognitive and motor functions.

Traumatic brain injury occurs when a sudden trauma causes damage to the brain and can be classified as mild, moderate or severe, depending on the extent of the damage. While many patients recover completely, more than 90,000 become disabled each year in the U.S. alone. It is estimated that more than 3.5 million Americans are presently disabled by brain injuries – suffering lifelong conditions as a result.

"Traumatic brain injury fits the World Health Organization's definition of a chronic disease, yet the U.S. health care system generally views it as a one-time injury that heals the way a broken bone does," says Masel. "Only by reimbursing and managing brain injuries on par with other chronic diseases will patients get the long-term treatment and support they need and deserve."

The researchers add that re-classifying traumatic brain injury as a chronic disease may help to provide brain injury researchers with the additional funding required to investigate a potential cure.

Masel and DeWitt's review compiled extensive evidence that brain trauma initiates a disease process that severely affects cognitive function, physiological processes and quality of life. These effects can prevent patients from fully reentering society post-injury and may ultimately contribute to death months or years later. Specifically, traumatic brain injury is strongly associated with:

Neurological disorders that reduces life expectancy, including epilepsy – for which traumatic brain injury is the leading cause in young adults – and obstructive sleep apnea, which is associated with reduced cognition and severe cardiac arrhythmias during sleep.

Neurodegenerative disorders that lead to gradual declines in cognitive function after injury, including Alzheimer's dementia, Parkinson's disease and chronic traumatic encephalopathy (also known as "punch drunk" and characterized by disturbed coordination, gait, slurred speech and tremors). However, research shows that those who receive more therapy in the early post-injury months, irrespective of severity of injury and level of neuropsychological impairment, were less likely to show decline over the long-term. Age is also a factor in cognitive outcome after brain injury, with older patients showing greater decline.

A host of neuroendocrine disorders, possibly caused by complex hormonal responses in the hypothalamic-pituitary system that ultimately lead to acute and/or chronic post-traumatic hypopituitarism – the decreased secretion of hormones normally produced by the pituitary gland, which can result in several related conditions, including growth hormone deficiency and hypothyroidism.

Psychiatric and psychological diseases, which are among the most disabling consequences of traumatic brain injury. Many individuals with mild brain trauma and the majority of those who survive moderate-to-severe brain injury are left with significant long-term neurobehavioral conditions. These range from aggression, confusion and agitation to obsessive-compulsive disorders, anxiety/mood/ psychotic disorders, major depression and substance abuse. It is also associated with high rates of suicide.

Non-neurologic disorders, including sexual dysfunction, which affects 40-60 percent of patients; incontinence; musculoskeletal dysfunction, or spasticity that results in abnormal motor patterns that may limit mobility and independence; and metabolic dysfunction, as brain injury appears to impact the way the body absorbs, utilizes and converts amino acids, which play a critical role in brain function.

According to Masel and DeWitt, research suggests that the progression of symptoms seen in chronic traumatic brain injury patients may be due, in part, to defective apoptotic cell death – a natural process in which cells die because they are genetically programmed to do so or because of injury or disease. It is possible that the abnormal apoptotic cell death is triggered by brain trauma, leading to an accelerated decline in cognitive function and development of disease.

"Media coverage of traumatic brain injury among soldiers and athletes, especially football players, has highlighted the serious health problems resulting from brain injury that are experienced later in life and helped raise awareness among the general public," says DeWitt. "But until traumatic brain injury is recognized as a chronic disease, research funding won't be adequate for the work that is needed to help patients minimize or avoid these outcomes."

ABOUT UTMB

Established in 1891, Texas' first academic health center comprises four health sciences schools, three institutes for advanced study, a research enterprise that includes one of only two national laboratories dedicated to the safe study of infectious threats to human health, and a health system offering a full range of primary and specialized medical services throughout Galveston County and the Texas Gulf Coast region. UTMB is a component of the University of Texas System.

ABOUT THE TRANSITIONAL LEARNING CENTER

The Transitional Learning Center at Galveston and in Lubbock Texas (TLC) is a pioneer in the field of brain injury rehabilitation. Since 1982, TLC has been providing survivors of brain injury with the special rehabilitation services they need to re-enter the community. TLC's approach encompasses the trifold mission of treatment, research and education.

Jim Kelly | EurekAlert!
Further information:
http://www.utmb.edu

More articles from Studies and Analyses:

nachricht Researchers simplify tiny structures' construction drip by drip
12.11.2018 | Princeton University, Engineering School

nachricht Mandibular movement monitoring may help improve oral sleep apnea devices
06.11.2018 | Elsevier

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First diode for magnetic fields

Innsbruck quantum physicists have constructed a diode for magnetic fields and then tested it in the laboratory. The device, developed by the research groups led by the theorist Oriol Romero-Isart and the experimental physicist Gerhard Kirchmair, could open up a number of new applications.

Electric diodes are essential electronic components that conduct electricity in one direction but prevent conduction in the opposite one. They are found at the...

Im Focus: Nonstop Tranport of Cargo in Nanomachines

Max Planck researchers revel the nano-structure of molecular trains and the reason for smooth transport in cellular antennas.

Moving around, sensing the extracellular environment, and signaling to other cells are important for a cell to function properly. Responsible for those tasks...

Im Focus: UNH scientists help provide first-ever views of elusive energy explosion

Researchers at the University of New Hampshire have captured a difficult-to-view singular event involving "magnetic reconnection"--the process by which sparse particles and energy around Earth collide producing a quick but mighty explosion--in the Earth's magnetotail, the magnetic environment that trails behind the planet.

Magnetic reconnection has remained a bit of a mystery to scientists. They know it exists and have documented the effects that the energy explosions can...

Im Focus: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Optical Coherence Tomography: German-Japanese Research Alliance hosted Medical Imaging Conference

19.11.2018 | Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

 
Latest News

Removing toxic mercury from contaminated water

21.11.2018 | Life Sciences

New China and US studies back use of pulse oximeters for assessing blood pressure

21.11.2018 | Medical Engineering

Exoplanet stepping stones

21.11.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>