Sports play a uniting role in our current society. Kids,
young adults, and adults alike join sports teams or feel a sense of community
when cheering for their favorite team. A common injury in contact sports is a
concussion. I am sure many of you either have had or know of someone who has
had a concussion before. Each year there are 3.5 million new cases of traumatic
brain injuries (1). A traumatic brain injury (TBI) occurs when the brain
undergoes a rapid movement within the skull causing dysfunction. After a TBI, it
has been shown that metabolic changes occur. Initially, ionic disequlibrium
causes a 9% to 12% increase in cerebral glucose metabolism through the pentose
phosphate pathway, an increase in free radical production, and decrease in
glyceraldehyde-3-pohsphate dehydrogenase. These changes combined decrease the
importance of glucose as an energy source (1).
With glucose as a less favorable energy source, researchers
have found that dietary changes and nutritional supplements may limit tissue
damage and increase positive TBI patient outcome. A ketogenic diet, which produces
ketone bodies, was shown to have neuroprotective effects, since metabolism of
ketone bodies decreases reactive oxygen species and has antioxidant,
anti-inflammatory, and anti-apoptotic effects in the brain (1). Also, magnesium,
zinc, and branched-chain amino acids provide neuroprotection and increased
cognitive function. Further, omega-3 and docosahexaenoic acid supplementation
in rats after a TBI revealed a reduction in axonal damage and increased
cognitive performance. On the other hand, high fat and high sucrose diets have
shown to reduce spatial learning in TBI rats (1). These results show that correcting
the cerebral homeostatic dysfunction through diet may allow for better outcomes
in patients with TBI.
As medicine starts to integrate personalized medicine,
dietary and nutritional supplementation may allow for a cheap and easy way to
limit neuronal and cognitive damage caused by a TBI. Understanding how cerebral
metabolism and ionic balances change allows for a way to reverse ionic
imbalances and promote metabolism of specific molecules. Supplementing TBI
patients with magnesium or zinc or providing a ketogenic diet may alter the
neuronal damage seen in TBI patients. With the potential benefits outlined
above, I think dietary and supplemental treatments may compliment current
treatment options for patients with TBIs.
Reference:
1. Greco T, Prins ML. Traumatic brain injury and diet. Journal
of Child Neurology 28(2): 983-988, 2013.
Jamie, this is a very interesting and very prevalent topic to explore. More and more athletic teams worry about concussions and are trying to take measures to prevent the amount of concussions received. If scientists know the exact pathway that is being affected after a TBI (pentose phosphate pathway), could a supplement of some sort after the TBI be used to restore this pathway, rather than implement other agents such as ketones, magnesium, and omega-3? Of course, if these agents are proving to be affective in preventing the amount of damage received from a TBI when taken ahead of time, it would be wise to just take these supplements or change your diet if you know you may be prone to TBI's. The final question to explore would be the negative of affects, if any of these supplemental/dietary changes. If a large amount of any of these agents may be detrimental to the body it would be a difficult situation for the pro-boxer for example to decide what to do. Do they take the supplements preventing a TBI but risking other affects, or hope to be a lucky one that walks away injury free?
ReplyDeleteWith the proposed negative effects of glucose metabolism in TBIs, I would guess physicians would opt for a different fuel source than glucose along with supplementation. Also, I do not think taking the proposed supplements ahead of time would be beneficial, because it would disrupt homeostasis and the supplements would also be eliminated without use. You, therefore, would be wasting money on the supplements. As with all medical issues/treatments, you are right, there are most likely negative side effects that need to be explore.
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