TBI/PTSD5, Adolescence/Teens10 Larry Minikes TBI/PTSD5, Adolescence/Teens10 Larry Minikes

Youth tackle football participation linked to earlier onset of cognitive and emotional symptoms

April 30, 2018

Science Daily/Boston University School of Medicine

Starting to play tackle football before age 12 could lead to earlier onset of cognitive and emotional symptoms among athletes who were diagnosed with CTE and other brain diseases postmortem, according to a new study.

 

The findings, from researchers at VA Boston Healthcare System (VABHS) and Boston University (BU) School of Medicine, found that among 211 football players who were diagnosed with the neurodegenerative disease CTE after death, those who began tackle football before age 12 had an earlier onset of cognitive, behavior, and mood symptoms by an average of 13 years.

 

Every one year younger that the individuals began to play tackle football predicted earlier onset of cognitive problems by 2.4 years and behavioral and mood problems by 2.5 years. This study included 246 deceased football players who were part of the UNITE (Understanding Neurologic Injury and Traumatic Encephalopathy) study and who had donated their brains for neuropathological examination to the VA-BU-CLF (Concussion Legacy Foundation) Brain Bank. Of those 246, 211 were diagnosed with CTE (with several having evidence of additional brain diseases, such as Alzheimer's) and 35 had no evidence of CTE, though several had evidence of other neuropathology. Of the 211 with CTE, 76 were amateur football players and 135 played at the professional level.

 

"Youth exposure to repetitive head impacts in tackle football may reduce one's resiliency to brain diseases later in life, including, but not limited to CTE," said corresponding author Ann McKee, MD, chief of Neuropathology at Boston VA Healthcare System, and Director of BU's CTE Center. "It makes common sense that children, whose brains are rapidly developing, should not be hitting their heads hundreds of times per season."

 

It is noteworthy that, although age of first exposure to tackle football was associated with early onset of cognitive and emotional problems, it was not associated with worse overall severity of CTE pathology, Alzheimer's disease pathology or other pathology. In addition, earlier symptom onset was not restricted to those diagnosed with CTE. The relationship was similar for the former football players without CTE who had cognitive or behavioral and mood changes that may have been related to other diseases.

 

"Younger age of first exposure to tackle football appears to increase vulnerability to the effects of CTE and other brain diseases or conditions. That is, it influences when cognitive, behavioral, and mood symptoms begin. It is comparable to research showing that children exposed to neurotoxins (e.g., lead) during critical periods of neurodevelopment can have earlier onset and more severe long-term neurological effects. While participation in sports has important health and social benefits, it is important to consider contact and collision sports separately and balance those benefits against potential later life neurological risks," said Michael Alosco, PhD, an assistant professor of Neurology at BU School of Medicine and an investigator at the BU Alzheimer's Disease Center and the BU CTE Center.

 

The study extends research from the BU CTE Center that previously linked youth tackle football with worse later-life cognitive, emotional, and behavioral disturbances in living former amateur and professional tackle football players, as well as changes in brain structures (determined by MRI scans) in former NFL players.

 

Data were collected by conducting telephone interviews with family members and/or friends to determine the absence or presence, and age of onset, of cognitive, behavior and mood symptoms. The interviewers did not know the neuropathological findings and the neuropathologists did not know the individuals' histories.

 

Although this study supports the idea that there may be long-term consequences associated with experiencing repeated hits to the head during childhood, the researchers stress that it is unclear if their findings generalize to the broader tackle football population and that much more research, particularly prospective longitudinal studies, is needed to understand the association between youth football and long-term consequences. The findings appear online in the journal Annals of Neurology.

https://www.sciencedaily.com/releases/2018/04/180430131950.htm

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Pregnant women with PTSD have higher levels of stress hormone cortisol

December 5, 2017

Science Daily/University of Michigan

A woman's emotional and physical health during pregnancy impacts a developing fetus, research shows. However, less is known about the effect of past stressors and posttraumatic stress disorder on an expectant woman.

 

To that end, researchers at the University of Michigan measured the stress hormone cortisol in pregnant women from early pregnancy to when their baby was 6 weeks old. They found that those with a dissociative type of PTSD that's often related to childhood abuse or trauma had levels up to 10 times higher than their peers.

 

These toxic levels of cortisol may contribute to health problems in the next generation, said Julia Seng, professor of nursing and lead author on the study.

 

"We know from research on the developmental origins of health and disease that the baby's first environment in its mother's body has implications for health across the lifespan," Seng said. "Higher exposure to cortisol may signal the fetus to adapt in ways that help survival, but don't help health and longevity. This finding is very useful because it helps us know which women are most likely to exhibit the highest level of stress and stress hormones during pregnancy and postpartum."

 

Cortisol is sometimes called the stress hormone because it's released in stressful situations as part of the flight-or-fight response. Cortisol levels that stay high are linked to serious health problems such as heart disease and high blood pressure, and can fuel weight gain, depression and anxiety plus a host of other problems. The effect of elevated cortisol on a developing fetus isn't well understood, but high cortisol and stress also contribute to preterm birth

 

In the study, 395 women expecting their first child were divided into four groups: those without trauma, those with a trauma but no PTSD, those with classic PTSD and those with dissociative PTSD.

 

Researchers measured salivary cortisol at different times during the day. Then 111 of those women gave saliva specimens until postpartum. The difference in cortisol was greatest in early pregnancy, when levels were eight times higher in the afternoon and 10 times higher at bedtime for the dissociative group than for other women.

 

About 8 percent of pregnant women in the study had PTSD, a disorder that results when symptoms of anxiety and fear persist well after exposure to stressful events. About 14 percent of that group had the more complex dissociative PTSD, which was associated with higher cortisol.

 

"It's been a mystery in our field why cortisol is sometimes high with PTSD and sometimes not," Seng said. "This finding that in pregnancy it's only the dissociative subgroup that has high cortisol gives us more to go on for future research."

 

Seng was surprised at how high the cortisol was in the dissociative group. She also said researchers expected women with classic PTSD to experience elevated cortisol as well, and the fact that they didn't is good news.

 

"We can do something for the 1-to-2 out of 100 pregnant women who have this dissociative PTSD," Seng said. "We can work with them to make pregnancy, maternity care, labor, breastfeeding and early parenting less likely to trigger stress reactions. And we can connect them to mental health services when they are ready to treat their PTSD."

 

Seng and collaborator Mickey Sperlich have developed a PTSD-specific education program for pregnant woman with a childhood trauma called the Survivor Moms' Companion, which has been piloted in Michigan and is currently being piloted in England.

https://www.sciencedaily.com/releases/2017/12/171205130121.htm

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The late effects of stress: New insights into how the brain responds to trauma

December 28, 2016

Science Daily/National Centre for Biological Sciences

A new study has shown how a single instance of severe stress can lead to delayed trauma. A stressful incident can lead to increased electrical activity in a brain region known as the amygdala. This activity is delayed and is dependent on a molecule known as the N-Methyl-D-Aspartate Receptor (NMDA-R), a protein on nerve cells known to be crucial for memory functions.

Mrs. M would never forget that day. She was walking along a busy road next to the vegetable market when two goons zipped past on a bike. One man's hand shot out and grabbed the chain around her neck. The next instant, she had stumbled to her knees, and was dragged along in the wake of the bike. Thankfully, the chain snapped, and she got away with a mildly bruised neck. Though dazed by the incident, Mrs. M was fine until a week after the incident.

 

Then, the nightmares began.

She would struggle and yell and fight in her sleep every night with phantom chain snatchers. Every bout left her charged with anger and often left her depressed. The episodes continued for several months until they finally stopped. How could a single stressful event have such extended consequences?

 

A new study by Indian scientists has gained insights into how a single instance of severe stress can lead to delayed and long-term psychological trauma. The work pinpoints key molecular and physiological processes that could be driving changes in brain architecture.

 

The team, led by Sumantra Chattarji from the National Centre for Biological Sciences (NCBS) and the Institute for Stem Cell Biology and Regenerative Medicine (inStem), Bangalore, have shown that a single stressful incident can lead to increased electrical activity in a brain region known as the amygdala. This activity sets in late, occurring ten days after a single stressful episode, and is dependent on a molecule known as the N-Methyl-D-Aspartate Receptor (NMDA-R), an ion channel protein on nerve cells known to be crucial for memory functions.

 

The amygdala is a small, almond-shaped groups of nerve cells that is located deep within the temporal lobe of the brain. This region of the brain is known to play key roles in emotional reactions, memory and making decisions. Changes in the amygdala are linked to the development of Post-Traumatic Stress Disorder (PTSD), a mental condition that develops in a delayed fashion after a harrowing experience.

 

Previously, Chattarji's group had shown that a single instance of acute stress had no immediate effects on the amygdala of rats. But ten days later, these animals began to show increased anxiety, and delayed changes in the architecture of their brains, especially the amygdala. "We showed that our study system is applicable to PTSD. This delayed effect after a single episode of stress was reminiscent of what happens in PTSD patients," says Chattarji. "We know that the amygdala is hyperactive in PTSD patients. But no one knows as of now, what is going on in there," he adds.

 

Investigations revealed major changes in the microscopic structure of the nerve cells in the amygdala. Stress seems to have caused the formation of new nerve connections called synapses in this region of the brain. However, until now, the physiological effects of these new connections were unknown.

 

In their recent study, Chattarji's team has established that the new nerve connections in the amygdala lead to heightened electrical activity in this region of the brain.

 

"Most studies on stress are done on a chronic stress paradigm with repeated stress, or with a single stress episode where changes are looked at immediately afterwards -- like a day after the stress," says Farhana Yasmin, one of the Chattarji's students. "So, our work is unique in that we show a reaction to a single instance of stress, but at a delayed time point," she adds.

 

Furthermore, a well-known protein involved in memory and learning, called NMDA-R has been recognised as one of the agents that bring about these changes. Blocking the NMDA-R during the stressful period not only stopped the formation of new synapses, it also blocked the increase in electrical activity at these synapses. "So we have for the first time, a molecular mechanism that shows what is required for the culmination of events ten days after a single stress," says Chattarji. "In this study, we have blocked the NMDA Receptor during stress. But we would like to know if blocking the molecule after stress can also block the delayed effects of the stress. And if so, how long after the stress can we block the receptor to define a window for therapy," he adds.

 

Chattarji's group first began their investigations into how stress affects the amygdala and other regions of the brain around ten years ago. The work has required the team to employ an array of highly specialised and diverse procedures that range from observing behaviour to recording electrical signals from single brain cells and using an assortment of microscopy techniques. "To do this, we have needed to use a variety of techniques, for which we required collaborations with people who have expertise in such techniques," says Chattarji. "And the glue for such collaborations especially in terms of training is vital. We are very grateful to the Wadhwani Foundation that supports our collaborative efforts and to the DBT and DAE for funding this work," he adds.

https://www.sciencedaily.com/releases/2016/12/161228102418.htm

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Recovery from brain injury, better sleep go hand in hand

December 22, 2016

Science Daily/American Academy of Neurology (AAN)

After a traumatic brain injury (TBI), people also experience major sleep problems, including changes in their sleep-wake cycle. A new study shows that recovering from these two conditions occurs in parallel.

 

"These results suggest that monitoring a person's sleep-wake cycle may be a useful tool for assessing their recovery after TBI," said study author Nadia Gosselin, PhD, of the University of Montréal in Québec, Canada. "We found that when someone sustained a brain injury and had not recovered a certain level of consciousness to keep them awake and aware of their surroundings, they were not able to generate a good sleep-wake cycle. But as they recovered, their quality of sleep improved."

 

A good sleep-wake cycle was defined as being alert and active during the day and getting uninterrupted sleep at night.

 

The study involved 30 people, ages 17 to 58, who had been hospitalized for moderate to severe TBI. Most of the patients were in a coma when they were admitted to the hospital and all initially received care in an intensive care unit. The injuries were caused by motor vehicle accidents for 20 people, falls for seven people, recreational or sports injuries for two people and a blow to the head for one person. They were hospitalized for an average of 45 days with monitoring for the study beginning an average of 21 days into a person's stay.

 

Each person was monitored daily for an average of 11 days for level of consciousness and thinking abilities using the Rancho Los Amigos scale, which ranges from 1 to 8. Each person also wore an activity monitor on their wrist so researchers could measure their sleep.

 

Researchers found that consciousness and thinking abilities improved hand-in-hand with measures of quality of sleep, showing a linear relationship.

 

One measure, the daytime activity ratio, shows percentage of activity that occurs during the day. Immediately after the injury, activity occurs throughout the day and night. The study showed that participants reached an acceptable sleep-wake cycle, with a daytime activity ratio of at least 80 percent, at the same point when they emerged from a minimally conscious state.

 

The participants still had inadequate sleep-wake cycles at a score of 5 on the Rancho Los Amigos scale, where people are confused and give inappropriate responses to stimuli but are able to follow simple commands. Sleep-wake cycles reached adequate levels at the same time that people reached a score of 6 on the Rancho Los Amigos scale, which is when people can give appropriate responses while still depending on outside input for direction. At that level, they can remember relearned tasks, but cannot remember new tasks.

 

The results were the same when researchers adjusted for the amount of time that had passed since the injury and the amount of medications they had received while they were in the ICU.

 

"It's possible that there are common underlying brain mechanisms involved in both recovery from TBI and improvement in sleep," said Gosselin. "Still, more study needs to be done and future research may want to examine how hospital lighting and noise also affect quality of sleep for those with TBI."

https://www.sciencedaily.com/releases/2016/12/161222095319.htm

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Heading a soccer ball causes instant changes to the brain

October 23, 2016

Science Daily/University of Stirling

Researchers have explored the true impact of heading a soccer ball, identifying small but significant changes in brain function immediately after routine heading practice.

The study from Scotland's University for Sporting Excellence published in EBioMedicine is the first to detect direct changes in the brain after players are exposed to everyday head impacts, as opposed to clinical brain injuries like concussion.

 

A group of soccer ball players headed a ball 20 times, fired from a machine designed to simulate the pace and power of a corner kick. Before and after the heading sessions, scientists tested players' brain function and memory.

 

Increased inhibition in the brain was detected after just a single session of heading. Memory test performance was also reduced by between 41 and 67 per cent, with effects normalising within 24 hours.

 

Whether the changes to the brain remain temporary after repeated exposure to a soccer ball and the long-term consequences of heading on brain health, are yet to be investigated.

 

Played by more than 250 million people worldwide, the 'beautiful game' often involves intentional and repeated bursts of heading a ball. In recent years the possible link between brain injury in sport and increased risk of dementia has focussed attention on whether soccer ball heading might lead to long term consequences for brain health.

 

Cognitive neuroscientist Dr Magdalena Ietswaart from Psychology at the University of Stirling, said: "In light of growing concern about the effects of contact sport on brain health, we wanted to see if our brain reacts instantly to heading a soccer ball. Using a drill most amateur and professional teams would be familiar with, we found there was infact increased inhibition in the brain immediately after heading and that performance on memory tests was reduced significantly.

 

"Although the changes were temporary, we believe they are significant to brain health, particularly if they happen over and over again as they do in soccer ball heading. With large numbers of people around the world participating in this sport, it is important that they are aware of what is happening inside the brain and the lasting effect this may have."

 

Dr Angus Hunter, Reader in Exercise Physiology in the Faculty of Health Sciences and Sport, added: "For the first time, sporting bodies and members of the public can see clear evidence of the risks associated with repetitive impact caused by heading a soccer ball.

 

"We hope these findings will open up new approaches for detecting, monitoring and preventing cumulative brain injuries in sport. We need to safeguard the long term health of soccer ball players at all levels, as well as individuals involved in other contact sports."

 

Dr Ietswaart and Dr Hunter were supported in the research by Stirling neuropsychologist Professor Lindsay Wilson and PhD student Tom Di Virgilio, consulting with leading Glasgow University Medical School Neuropathologist Dr Willie Stewart and a wider multi-disciplinary team.

 

In the study, scientists measured levels of brain function using a basic neuroscience technique called Transcranial Magnetic Stimulation (TMS). The findings from this study, funded by the NIHR Brain Injury Healthcare Technology Cooperative (HTC) are the first to show the TMS technique can be used to detect changes to brain function after small, routine impacts.

https://www.sciencedaily.com/releases/2016/10/161023154804.htm

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What's really going on in PTSD brains? Experts suggest new theory

October 7, 2016

Science Daily/University of Michigan Health System

PTSD experts agree that the condition has its roots in very real, physical processes within the brain – and not some sort of psychological “weakness”. But no clear consensus has emerged about what exactly has gone “wrong” in the brain. A new theory that integrates decades of research focuses on a key function called context processing.

 

For decades, neuroscientists and physicians have tried to get to the bottom of the age-old mystery of post-traumatic stress disorder, to explain why only some people are vulnerable and why they experience so many symptoms and so much disability.

 

All experts in the field now agree that PTSD indeed has its roots in very real, physical processes within the brain -- and not in some sort of psychological "weakness." But no clear consensus has emerged about what exactly has gone "wrong" in the brain.

 

In a Perspective article published this week in Neuron, a pair of University of Michigan Medical School professors -- who have studied PTSD from many angles for many years -- put forth a theory of PTSD that draws from and integrates decades of prior research. They hope to stimulate interest in the theory and invite others in the field to test it.

 

The bottom line, they say, is that people with PTSD appear to suffer from disrupted context processing. That's a core brain function that allows people and animals to recognize that a particular stimulus may require different responses depending on the context in which it is encountered. It's what allows us to call upon the "right" emotional or physical response to the current encounter.

 

A simple example, they write, is recognizing that a mountain lion seen in the zoo does not require a fear or "flight" response, while the same lion unexpectedly encountered in the backyard probably does.

 

For someone with PTSD, a stimulus associated with the trauma they previously experienced -- such as a loud noise or a particular smell -- triggers a fear response even when the context is very safe. That's why they react even if the noise came from the front door being slammed, or the smell comes from dinner being accidentally burned on the stove.

 

Context processing involves a brain region called the hippocampus, and its connections to two other regions called the prefrontal cortex and the amygdala. Research has shown that activity in these brain areas is disrupted in PTSD patients. The U-M team thinks their theory can unify wide-ranging evidence by showing how a disruption in this circuit can interfere with context processing and can explain most of the symptoms and much of the biology of PTSD.

 

"We hope to put some order to all the information that's been gathered about PTSD from studies of human patients, and of animal models of the condition," says Israel Liberzon, M.D., a professor of psychiatry at U-M and a researcher at the VA Ann Arbor Healthcare System who also treats veterans with PTSD. "We hope to create a testable hypothesis, which isn't as common in mental health research as it should be. If this hypothesis proves true, maybe we can unravel some of the underlying pathophysiological processes, and offer better treatments."

 

Liberzon and his colleague, James Abelson, M.D., Ph.D., describe in their piece models of PTSD that have emerged in recent years, and lay out the evidence for each. The problem, they say, is that none of these models sufficiently explains the various symptoms seen in patients, nor all of the complex neurobiological changes seen in PTSD and in animal models of this disorder.

 

The first model, abnormal fear learning, is rooted in the amygdala -- the brain's 'fight or flight' center that focuses on response to threats or safe environments. This model emerged from work on fear conditioning, fear extinction and fear generalization.

 

The second, exaggerated threat detection, is rooted in the brain regions that figure out what signals from the environment are "salient," or important to take note of and react to. This model focuses on vigilance and disproportionate responses to perceived threats.

 

The third, involving executive function and regulation of emotions, is mainly rooted in the prefrontal cortex -- the brain's center for keeping emotions in check and planning or switching between tasks.

 

By focusing only on the evidence bolstering one of these theories, researchers may be "searching under the streetlight," says Liberzon. "But if we look at all of it in the light of context processing disruption, we can explain why different teams have seen different things. They're not mutually exclusive."

 

The main thing, says Liberzon, is that "context is not only information about your surroundings -- it's pulling out the correct emotion and memories for the context you are in."

 

A deficit in context processing would lead PTSD patients to feel "unmoored" from the world around them, unable to shape their responses to fit their current contexts. Instead, their brains would impose an "internalized context" -- one that always expects danger -- on every situation.

 

This type of deficit, arising in the brain from a combination of genetics and life experiences, may create vulnerability to PTSD in the first place, they say. After trauma, this would generate symptoms of hypervigilance, sleeplessness, intrusive thoughts and dreams, and inappropriate emotional and physical outbursts.

 

Liberzon and Abelson think that testing the context processing theory will enhance understanding of PTSD, even if all of its details are not verified. They hope the PTSD community will help them pursue the needed research, in PTSD patients and in animal models. They put forth specific ideas in the Neuron paper to encourage that, and are embarking on such research themselves.

 

The U-M/VA team is currently recruiting people with PTSD -- whether veterans or not -- for studies involving brain imaging and other tests.

 

In the meantime, they note that there is a growing set of therapeutic tools that can help patients with PTSD, such as cognitive behavioral therapy mindfulness training and pharmacological approaches. These may work by helping to anchor PTSD patients in their current environment, and may prove more effective as researchers learn how to specifically strengthen context processing capacities in the brain.

https://www.sciencedaily.com/releases/2016/10/161007123407.htm

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Fish oil may help improve mood in veterans

September 22, 2016

Science Daily/Texas A&M University

Low concentration of fish oil in the blood and lack of physical activity may contribute to the high levels of depressed mood among soldiers returning from combat, according to researchers.

 

In a study titled "Fatty Acid Blood Levels, Vitamin D Status, Physical Performance, Activity and Resiliency: A Novel Potential Screening Tool for Depressed Mood in Active Duty Soldiers," researchers worked with 100 soldiers at Fort Hood to identify which factors affected moods in returning soldiers.

 

The research was conducted by Major Nicholas Barringer when he was a Texas A&M doctoral student under the direction of Health & Kinesiology Professor and Department Head Richard Kreider, in collaboration with several current and former members of the U.S. Army, and colleagues at Texas A&M.

 

"We looked at how physical activity levels and performance measures were related to mood state and resiliency," Kreider says. "What we found was the decrease in physical activity and the concentration of fish oil and Omega-3s in the blood were all associated with resiliency and mood."

 

Kreider says fish oil contains Omega-3 fatty acids that help to boost brain function. He says studies also show that fish oil acts as an anti-inflammatory within the body -- helping athletes and soldiers manage intense training better. Fish oil content is especially important for soldiers due to the consistent training and physical regiments performed in and out of combat and risk to traumatic brain injury.

 

The study originated from research conducted by Colonel Mike Lewis, M.D. who examined Omega-3 fatty acid levels of soldiers who committed suicide compared to non-suicide control and found lower Omega-3 levels in the blood were associated with increased risk of being in the suicide group.

 

Barringer says he believes these findings to be significant toward addressing some of the issues many soldiers face.

 

"The mental health of our service members is a serious concern and it is exciting to consider that appropriate diet and exercise might have a direct impact on improving resiliency," Barringer notes.

 

In order to properly measure soldiers physically, Kreider and Barringer developed a formula they say has the potential to assist in effectively screening soldiers with potential PTSD ahead of time. The formula measures a number of factors including: fitness and psychometric assessments, physical activity, and additional analysis.

 

"By improving resiliency in service members, we can potentially decrease the risk of mental health issues," Barringer says. "Early identification can potentially decrease the risk of negative outcomes for our active service members as well as our separated and retired military veterans."

 

"The military is using some of our exercise, nutrition, and performance-related work and the findings may help identify soldiers at risk for depression when they return from combat tours," Kreider notes. He says that by working to identify such high-risk issues faced by soldiers, it can set a precedent that will benefit not only military leadership, but also the general public.

 

"The public must realize that our soldiers need support before, during, and after their service," Kreider explains. "There needs to be a time for soldiers to transition, become re-engaged within a community, and stay engaged in that community."

https://www.sciencedaily.com/releases/2016/09/160922104406.htm

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Using light to image and potentially to treat PTSD

September 6, 2016

Science Daily/University of Texas at Arlington

After years of studying the effects of near-infrared light on veterans with post-traumatic stress disorder or traumatic brain injuries, a team of bioengineers has published research that could result in an effective, long-term treatment for brain disorders.

 

Professor Hanli Liu was the primary investigator on the project. Her team of graduate students and a research associate, Fenghua Tian, worked with co-investigators Alexa Smith-Osborne, a UTA social work associate professor; Francisco Gonzalez-Lima, a psychology professor at UT Austin; and Fu Lye Martin Woon, a former assistant professor of psychiatry at UT Southwestern; to show potential intervention using light in brain disorders including post-traumatic stress disorder.

 

Their research is funded in part by a UT System BRAIN or Brain Research through Advancing Innovative Neurotechnologies seed grant titled, "Transcranial light therapy and imaging of prefrontal cognition in PTSD."

 

With the UT System's support, Liu's interdisciplinary collaborative team has not only investigated the brain imaging capability of light but also revealed the therapeutic rationale for potentially improving cognitive functions of patients with PTSD. The first paper resulting from the seed funding is published online and titled, "Interplay between up-regulation of cytochrome-c-oxidase and hemoglobin oxygenation induced by near-infrared laser."

 

As in the first study, the team used a human forearm as a biological model instead of the human brain to avoid confounding factors due to such anatomical structures as the scalp and skull. The paper outlines their discovery that shining near-infrared light on the subject's forearm increases production of cytochrome-c-oxydase, a protein inside the neurons that stimulates blood flow. This discovery shows great potential that NIR or infrared light also will work within the brain.

 

"This is the first time that effects of light stimulation have been quantified on living human tissue," Liu said. "The next challenge is to apply what was learned in a simpler system to the brain, where the light must pass through the scalp and the skull, as well as the brain. In the past several years, we have used the knowledge gained in the NIR field to detect, monitor and understand certain brain disorders, such as PTSD. But we have never utilized NIR light for treatment."

 

Now the team is moving to report and publish its findings of transcranial NIR stimulation on the human brain by quantifying production of cytochrome-c-oxydase and increase of blood flow. It would support a novel, non-invasive treatment with imaging ability, especially for memory, which could really help veterans who suffer from PTSD.

 

The UT BRAIN initiative was approved by the UT System Board of Regents in 2014 and supports a virtual UT System Neuroscience and Neurotechnology Research Institute that promotes trans-disciplinary, multi-institutional research projects focused on neuroscience and neurotechnology. It has provided a total of $5 million with a $100,000 per grant in a 2-year period of Sept.1, 2015 to Aug. 31, 2017.

 

Eight days prior to that paper, Liu and her team published another paper in Scientific Reports, titled, "Prefrontal responses to Stroop tasks in subjects with post-traumatic stress disorder assessed by functional near infrared spectroscopy." That paper outlined Liu's work to understand how the brains of people suffering from PTSD are different from a healthy group of non-PTSD sufferers using a Stroop test.

 

Stroop tests are attention tests that are commonly used in psychology.

 

Liu measured blood flow in the left side of the dorsal lateral prefrontal cortex of subjects' brains and found that those suffering from PTSD don't have the ability to pay attention and also have insufficient blood flow in that area of the brain. Michael Cho, chair of UTA's Bioengineering Department, says that Liu's continuing focus on using NIR light to detect, monitor and potentially treat brain injuries underscores the UTA's focus on health and the human condition contained within the Strategic Plan 2020: Bold Solutions | Global Impact.

 

"Dr. Liu and her collaborators have made incredible strides in identifying how the brain is affected by trauma, as well as how to treat disorders such as PTSD noninvasively with light," Cho said. "This is truly innovative, groundbreaking research, and the results are a testament to Hanli and the input of her collaborators."

 

Liu, a Fellow of the American Institute for Medical and Biological Engineering and a member of the UTA Academy of Distinguished Scholars, joined UTA's College of Engineering in 1996 and has secured more than $11 million as principal investigator or co-PI in research funding during her career. Her work is focused on medical instrumentation and imaging, minimally invasive and noninvasive spectroscopy and imaging of tissue, optical diffuse imaging for cancer prognosis, and brain activities.

 

She has studied PTSD extensively with Smith-Osborne and Tian, and they have applied a portable brain-mapping device that allows them to "see" where memory fails student veterans with PTSD. That research led the team to connect with Gonzalez-Limam and further discovered that shining low-level light on the brain by placing the light source on the forehead can stimulate and energize neurons to function more effectively. When cells are stimulated with light, they remain stimulated for a lengthy period of time even after the light is removed. The approach differs from other therapies that use magnets or electric shocks and has the potential to yield effective, longer-lasting treatments.

https://www.sciencedaily.com/releases/2016/09/160906213622.htm

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Concussions and brain injury: Can omega-3 intake aid in brain health recovery?

August 24, 2016

Science Daily/Taylor & Francis

The treatment of concussions and traumatic brain injury (TBI) is a clinical challenge. Clinical studies thus far have failed to identify an effective treatment strategy when a combination of targets controlling aspects of neuroprotection, neuroinflammation, and neuroregeneration is needed. According to emerging science and clinical experience, aggressive intake of omega-3 fatty acids (n-3FA) seems to be beneficial to TBI, concussion, and post-concussion syndrome patients.

 

Research suggests that early and optimal doses of omega-3 fatty acids (n-3FA) have the potential to improve outcomes from traumatic brain injury. The article reviews preclinical research and cites three brain injury case studies that resulted from a mining accident, a motor vehicle accident, and a drowning accident. Each instance showcased evidence of safety and tolerability, wherein the patients who sustained life-threatening brain injuries recovered brain health with the aid of omega-3 fatty acids (n-3FA).

 

Growing clinical experience by numerous providers is that the brain needs to be saturated with high doses of n-3FA in order for the brain to have the opportunity to heal. Without an optimal supply of omegas, healing is less likely to happen. It is well recognized that n-3FAs are not a drug and not a cure and every situation is different. Clinically, some patients respond better than others. However, there is no downside to providing optimal levels of nutrition in order to give a patient the best opportunity to regain as much function as possible following a TBI.

https://www.sciencedaily.com/releases/2016/08/160824140113.htm

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TBI/PTSD5 Larry Minikes TBI/PTSD5 Larry Minikes

Combat exposure may jeopardize the behavioral health of women in the military

August 2, 2016

Wiley

In a recent study, combat exposure among Army enlisted women was associated with an increased likelihood of developing behavioral health problems post-deployment, including post-traumatic stress disorder (PTSD), depression, and at-risk drinking.

 

In the study, which was funded by the National Institute on Drug Abuse, 42,397 Army enlisted women who returned from Afghanistan or Iraq were assigned combat exposure scores of 0, 1, 2, or 3+ based on their self-reported experiences. Importantly, any report of combat exposure among Army women was associated with an increased likelihood of each post-deployment behavioral health problem (PTSD, depression, and at-risk drinking), suggesting that the impact of even one exposure event should not be overlooked.

 

The magnitude of the association between combat exposure and PTSD was most striking. Active duty and National Guard/Reserve women with combat exposure scores of 3+ had at least a 20 times higher likelihood of screening positive for PTSD compared with women with no combat exposure.

 

"Our findings suggest that injuries, assaults, and combat exposures experienced by women during deployment may have an additive, negative effect on their post-deployment behavioral health," said Dr. Rachel Sayko Adams, lead author of the Journal of Traumatic Stress study. "Ongoing force-wide screening for behavioral health problems should be coupled with development and evaluation of programs to improve the psychological wellbeing of the Armed Forces."

https://www.sciencedaily.com/releases/2016/08/160802130109.htm

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Light Therapy Improves Sleep and Promote Recovery in Patients With Mild TBI

May 31, 2013

Science Daily/American Academy of Sleep Medicine

A new study suggests that bright light therapy may improve sleep, cognition, emotion and brain function following mild traumatic brain injury (TBI).

Results show that six weeks of morning bright light therapy resulted in a marked decrease in subjective daytime sleepiness. This improvement was further associated with improvements in the propensity to fall asleep and nighttime sleep quality. Bright light therapy also affected depressive symptoms.

"Our preliminary data suggests that morning bright light therapy might be helpful to reduce subjective daytime sleepiness and to improve nighttime sleep," said investigator Mareen Weber, PhD, instructor in psychiatry at McLean Hospital/Harvard Medical School in Belmont, Mass. "Importantly, the research also shows changes in brain activation during a demanding cognitive task, suggesting that bright light treatment might yield changes in brain functioning."

The research abstract was published recently in an online supplement of the journal SLEEP, and Weber will present the findings Monday, June 3, in Baltimore, Md., at SLEEP 2013, the 27th annual meeting of the Associated Professional Sleep Societies LLC.

The study group comprised 18 individuals with a documented history of at least one mild TBI and sleep disturbance that either emerged or was aggravated with the most recent injury. Data were gathered using Multiple Sleep Latency Tests (MSLT), actigraphy and sleep diaries, and all participants underwent magnetic resonance imaging (MRI) and comprehensive psychiatric and neuropsychological assessments before and after the intervention.

According to the authors, it has been estimated that at least 50 percent of individuals with TBI experience some kind of sleep disturbance at some point following their injury, and sleep has been demonstrated to be essential for brain plasticity and may be important for recovery.

"Improving sleep following mild traumatic brain injury could prove critical to maximizing recovery from the injury," said Weber. "Furthermore, bright light therapy is easy and minimally invasive, requiring no medication, and has no known serious side effects."

http://www.sciencedaily.com/releases/2013/05/130531105518.htm

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