In the future, treating a concussion could be as simple as cooling the
brain.
That’s according
to research conducted by University of Wisconsin-Madison engineers, whose
findings support the treatment approach at the cellular level.
“There are
currently no effective medical treatments for concussions and other types of
traumatic brain injuries,” says Christian Franck, the UW-Madison associate
professor of mechanical engineering who led the study. “We’re very excited
about our findings because they could potentially pave the way for treatments
we can offer patients.”
The process is a
bit more finicky than just applying an ice pack to the head.
Conducting
experiments on brain cells in a dish, Franck and his team discovered several
key parameters that determined the effectiveness of therapeutic cooling for
mitigating damage to the injured cells.
“We found that,
for this treatment to be successful, there’s a sweet spot,” he says. “You can’t
cool too little; you can’t cool too much; and you can’t wait too long following
an injury to start treatment.”
And when the
researchers identified that sweet spot, the results were striking.
“I was amazed at
how well the cooling worked,” Franck says. “We actually went back and repeated
the experiments multiple times because I didn’t believe it at first.”
The researchers published their findings in the journal PLOS
ONE.
The high
occurrence of concussions underscores the pressing need for treatments. Every
year in the United States, there are an estimated 1.7 million new cases of
traumatic brain injury assessed in emergency rooms, and the incidence of sports-related
concussions may approach 3.8 million annually.
A traumatic
impact to the brain can turn on biochemical pathways that lead to
neurodegeneration, the progressive deterioration and loss of function in brain
cells. Neurodegeneration causes long-lasting and potentially devastating health
issues for patients.
“These pathways
are like flipping on a bad molecular switch in your brain,” says Franck.
In their
experiments, the researchers looked at two of those biochemical pathways.
First, they
created a network of neurons in a dish and delivered a mechanical stimulus that
simulates the kind of injury and cell damage that people experience with a
concussion.
Then they cooled
the injured cells separately to four different temperatures. They found that 33
degrees Celsius (91.4 degrees Fahrenheit) provided the most protective benefit
for the cells after 24 and 48 hours post-injury. Notably, cooling to 31 degrees
Celsius had a detrimental effect.
“So there’s such
a thing as cooling too much,” Franck says.
Time also is a
factor. For the best outcome, the team determined that cooling needed to begin
within four hours of the injury and continue for at least six hours, although
Franck says cooling for even 30 minutes still showed some benefits.
When they
adhered to those parameters, the researchers discovered they could keep the
cells’ damaging biochemical pathways switched off. In other words, the cells
remained healthy and functioning normally — even though they had just suffered
a traumatic injury.
After six hours
of cooling, the researchers brought the concussed brain cells back up to normal
body temperature, curious about whether warming would cause the damaging
biochemical pathways to turn on.
“The biggest
surprise was that the molecular switches actually stayed off — permanently —
through the duration of the lab experiment,” Franck says. “That was huge.”
He and his
students compared their results with previous animal studies and randomized
human trials that investigated cooling as a treatment for traumatic brain injuries.
“We found really
good agreement between the studies when we dialed in to those specific
parameters, so that’s a very encouraging sign,” Franck says. “But this isn’t
the end of the story. We think this warrants further investigation in animal
studies.”
Franck says
there’s more to learn before cooling the brain could be a practical treatment
for patients at a clinic. For example, it’s not as easy as simply lowering the
temperature of a person’s whole body, which taxes the heart and can have a
strong negative effect on the immune system.
Rather,
isolating cooling to the brain is crucial. “We hope our paper will spawn
renewed motivation and interest in solving the technical challenges for getting
this type of treatment to patients in the future,” Franck says. “For a long
time, the scientific literature was inconclusive on whether this would be a
successful treatment. What we showed in our study was that, yes, as far as the
cell biology is concerned, this is effective. And so now it’s really worth
thinking about how we might implement this in practice.”
Source: https://myfusimotors.com/2020/04/06/chilling-concussed-cells-shows-promise-for-full-recovery/
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