Department of Biology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada.
Cell and Systems Biology, University of Toronto, Toronto, ON M5S 3G5, Canada.
Biomolecules. 2024 Jul 15;14(7):853. doi: 10.3390/biom14070853.
Finding an effective treatment for traumatic brain injury is challenging for multiple reasons. There are innumerable different causes and resulting levels of damage for both penetrating and non-penetrating traumatic brain injury each of which shows diverse pathophysiological progressions. More concerning is that disease progression can take decades before neurological symptoms become obvious. Currently, the primary treatment for non-penetrating mild traumatic brain injury, also called concussion, is bed rest despite the fact the majority of emergency room visits for traumatic brain injury are due to this mild form. Furthermore, one-third of mild traumatic brain injury cases progress to long-term serious symptoms. This argues for the earliest therapeutic intervention for all mild traumatic brain injury cases which is the focus of this review. Calcium levels are greatly increased in damaged brain regions as a result of the initial impact due to tissue damage as well as disrupted ion channels. The dysregulated calcium level feedback is a diversity of ways to further augment calcium neurotoxicity. This suggests that targeting calcium levels and function would be a strong therapeutic approach. An effective calcium-based traumatic brain injury therapy could best be developed through therapeutic programs organized in professional team sports where mild traumatic brain injury events are common, large numbers of subjects are involved and professional personnel are available to oversee treatment and documentation. This review concludes with a proposal with that focus.
寻找有效的创伤性脑损伤治疗方法具有挑战性,原因有很多。无论是穿透性还是非穿透性创伤性脑损伤,其原因和损伤程度都有无数种,每种损伤都表现出不同的病理生理进展。更令人担忧的是,疾病进展可能需要数十年的时间,直到神经症状变得明显。目前,非穿透性轻度创伤性脑损伤(也称为脑震荡)的主要治疗方法是卧床休息,尽管创伤性脑损伤的大多数急诊就诊都是由于这种轻度损伤。此外,三分之一的轻度创伤性脑损伤病例会发展为长期严重症状。这就要求对所有轻度创伤性脑损伤病例进行最早的治疗干预,这也是本次综述的重点。由于组织损伤和离子通道中断,初始冲击会导致受损大脑区域的钙水平大幅升高。失调的钙水平反馈以多种方式进一步增强钙神经毒性。这表明靶向钙水平和功能将是一种强有力的治疗方法。通过在职业运动队中组织的治疗方案,可以最好地开发出有效的基于钙的创伤性脑损伤治疗方法,在这些方案中,轻度创伤性脑损伤事件很常见,涉及大量的参与者,并且有专业人员负责监督治疗和记录。本综述以该重点提出了一个建议。