Monthly Archives: September 2018

KO the KD? Results of Keto Diet for TBI Inconclusive

“Dinner today is going to be a big steak and, for dessert, a huge bowl of ice cream.”

The above meal may seem like a recipe for weight gain, but it is also a meal in tune with the ketogenic diet.  A diet trend for about the past decade, the ketogenic diet (KD) seeks to, “mimic biochemical changes associated with starvation.”  The basic idea of this diet is to limit the carbohydrates one consumes, and eat a diet of 80 – 90% fat, in order to put the body into a starvation state.  This extreme limitation of foods that are turned into glucose means that the metabolic source used for energy production must be changed by the body, so that it goes into a ketonic state.

People with chronic diseases/conditions have said that KD promotes their overall health, reduces their symptoms, slows their diseases progression and even may be a treatment for it.  In a 2008 study, entitled Diet, Ketones and Neurotrauma, scientists noted, “This altered dietary approach may have tremendous therapeutic potential for both the pediatric and adult head injured populations.”  Since that time, over 20 studies have been done that show that KD both helps you lose weight and improves your health.  This year, in fact, the NIH reviewed past studies and performed new animal studies that showed, “The KD is an effective treatment for TBI recovery in rats and shows potential in humans… [however] the human trials did not establish much evidence with respect to the KD as a treatment for TBI.”  Again, the NIH concluded that further research is needed.

What has been determined is that the ketogenic diet is beneficial for some people who have particular neurological disorders – specifically children with epilepsy.  As far back as 1921, the KD diet was used as a treatment for epilepsy in children with positive results.  Since the diet is very strict it may be the last option, but it is still an option, especially for epilepsy – a disorder that can be caused or exasperated by traumatic brain injury.  Additionally, it seems that the ketogenic diet may be beneficial for treatment of diabetes, as it lowers blood sugar.  Diabetes has been shown both to be a possible consequence of brain injury or a possible cause of brain injury.  Even if a brain injury is not involved, the symptoms of hyperglycemia, the identifying mark of diabetes and other disorders, mimic those of TBI.  In fact, “Among the secondary complications, hyperglycemia (both peak glucose and persistent hyperglycemia) in TBI patients is one of the most common and correlates with the severity of the injury and clinical outcome.”  (However, the Cleveland Clinic notes that, “Eating a lot of sugar can lead to tooth decay, but it does not cause diabetes.”)

In reality, most people will embark on a diet at some point in their lives.  Even with all this inconsistent evidence, the ketogenic diet is still on trend, largely because of celebrity endorsements by such people as Kim and Kourtney Kardashian, Halle Berry, Gwyneth Paltrow and LeBron James.  Be aware though, that whenever you intake a greater amount of calories than your body needs, you will gain weight.  And even if you intake the correct number of calories, but not the right nutrients, your body will suffer.  This is even more true for those with severe and/or ongoing disorders/diseases, such as brain injury.

Investigating the Zombies in the Brain

This summer, a film, entitled Tau, was released to movie theaters and explored the human trappings of implantation of artificial intelligence.  In August, UT Health San Antonio, formerly The University of Texas Health San Antonio, reported the human trappings of human intelligence, specifically in the brain: “Tau protein accumulation is the most common pathology among degenerative brain diseases, including… traumatic brain injury (TBI) and over twenty others.”

Simply explained, tau proteins are, “proteins that stabilize microtubules [and]… are abundant in neurons of the central nervous system.”  Related to brain injury, a high level of tau proteins results in poor recovery and, therefore, can possibly result in an ongoing cognitive decline.  The title of a 2012 NIH study further explains, Tau elevators in the brain extracellular space correlate with reduced amyloid-B levels and predict adverse clinical outcomes after severe traumatic brain injury.  This study notes that it was only the second study that was done on the subject, at the time.  However, since then, tau protein studies have become much more common, as can be seen by the above-mentioned quote.

Scientists now refer to tau proteins as zombie cells, as they, “can’t die but are equally unable to perform the functions of a normal cell.”  Unfortunately, they live as stressed, toxic senescent cells in the extracellular space of the brain, which means that while they are interesting to investigate, they are difficult to access.  However, just as scientists have discovered that eating protein-filled food like sushi is beneficial to the brain, scientists have developed a new means of brain study, referred to as SUSHI (super-resolution shadow imaging) that can access the extracellular space.  With the use of SUSHI, UT Health is currently attempting to develop a drug that clears tau tangles and zombie cells to improve brain function and structure following a traumatic brain injury and other brain diseases.  To this point, “The scientists at UT Health used senolytic drugs… to clear the senescent cells and tau tangles in [neurologically damaged] mice.”

* Also, this summer, across the ocean, Mario Negri Institute for Pharmacological Research of Milan and the University of Glasgow published the results of a study in which they determined a single brain trauma could result in widespread tau deposition.  According to the study, this is, “the first evidence for how a mechanical brain injury might evolve into chronic degenerative brain disease, including CTE.”  CTE is, of course, associated with American football, though this conclusion seems to indicate that the concern may be even greater.

Yoga Stretches Your Legs to Strengthen Your Mind

It is widely known that, as remarked on by the NIH, “Exercise-based therapies can promote recovery of function and are easily implemented in the clinical rehabilitation setting.”  Since at least the turn of this century, the government has been studying the benefits of a certain type of exercise, yoga, within various segments of the population.  In September, federally-sanctioned National Yoga Awareness Month, one should look at the specific benefits of yoga for those who have suffered a brain injury.

Though there are benefits from the practice of yoga for all individuals, the above-quote comes from a current NIH study regarding the energizing effects of exercise for those with brain injuries.  That study is not set to end until 2022, however the researchers have already discovered, “Very early [post-brain injury] exercise seems to exacerbate brain injury, while later exercise seems to be beneficial.”  (The NIH does not state how one is to determine the appropriate time in one’s recovery to restart it.) Further governmental information is limited as, in a 2012 article titled The therapeutic value of yoga in neurological disorder, the NIH stated that the benefits of exercise for those with many neurological disorders is a “largely unexamined treatment”.

In the meantime, there are known benefits of yoga for the general population, including enhancing one’s quality of life and wellbeing, and benefits specifically for the brain injured/disabled population, such benefits as: strengthening muscle, increasing flexibility, increasing endurance, coping with setbacks, calming an active mind.  Previously-mentioned Former Rep. Gabby Giffords has remarked that her recovery from brain injury has been though, “Speech therapy. Physical therapy.  And YOGA, too.”

As the government states, “The purpose of this month is to promote the health and benefits of yoga and inspire a healthy lifestyle.”  In celebration, many yoga studios and gyms are offering free yoga classes this month.  Yoga can also be accessed through your television, computer and smart phone.

(However, if you do not begin to exercise or do not continue with your exercise/yoga schedule, do not fret.  Few people, with a TBI or not, adhere entirely to their workout schedules.  Additionally, the NIH found that, “Injury severity, age and pre-injury exercise history predict adherence to a home-based exercise program in adults with traumatic brain injury.”)

New Study Walks Fast to Prove Benefit of Exercise after TBI

Rebecca M.

The National Institute of Health recently completed a study on the role of exercise in memory and cognitive skills for those with a traumatic brain injury.  Specifically, the goal of this study was to look at the benefits of exercise in 18-45 year old individuals with a TBI, at least 2 months after their injury and otherwise healthy.  Completed this summer at the main NIH Clinical Research site, this study was an exploration of previous findings that exercise after exposure to images enhances the participant’s subsequent recall and extended the study to include recall of words and logical cognition.  Notably, this study also looked at new ways to measure progress after a brain injury by examining the mechanism of the effect of using exercise biomarkers and the relatively new technology of fMRI.  In a parallel fMRI experiment, intended to explore the brain basis of the effect of exercise on memory, healthy volunteers viewed pictures, exercised at a high or low intensity, and then performed a recall task while in the scanner.

As of yet, the NIH has not published the study’s results.  However, this new study may well have similar findings to past ones.  Additionally, the use of newer biological tools will make an even stronger case that exercise, even walking fast, is well worth the time for adults living with a TBI to enhance their cognitive skills.

Extreme Weather Has Traumatic Results in Carolinas

Though severe weather affects all of America, in the continental United States hurricane season (June – November) comes with specific concern for the coastal states from Virginia to Texas.  During the past few days, the Carolina’s have been dealing with the wind, water, power outages and trauma caused by Hurricane Florence.  Because of the extreme weather, head injuries are more common.  However, because extreme weather limits one’s ability to exit the house and get access to medical facilities, the exact amount of trauma caused by a sudden-onset disaster like a hurricane is not known.  (As the NIH notes, “Injury patterns during storms are not much studied and lack uniformity.”)

Online, brain injury experts have presented lists of what safety precautions should be taken for those who live with a brain injury or who get a brain injury during the storm.  The Center for Disease Control briefed medical experts and hospitals on what injuries they are likely to face because of Florence and how to deal with them.  The Federal Department of Health and Human Services online provides a list of resources specific to Emergency/Crisis and Disaster Settings.  In preparation for Florence, the CDC set up a small temporary medical facility in Atlanta.  They also have a webpage detailing emergency wound care after a natural disaster and a pamphlet online providing tips for safety, though these tips don’t seem to address prevention of head trauma beyond DON’T DRIVE.  The states provide information online regarding what those with disabilities and their caregivers should do in the event of a natural disaster, with 10 states offering brochures, booklets, guides and other material.

No matter how much people and hospitals prepare for the negative effects of natural disasters, or how much natural disasters bring out the more considerate side of people, there will always be injuries and possible deaths.  For Florence, the death toll is now 23.  Often, “outside assistance arrives later, and transportation to functional hospitals is too long to save lives of the most critically injured.”  The public is horrified by the news that a mother and her infant were crushed and killed by a tree on Friday, September 14, the first known fatalities from the storm.

The NIH notes the challenges of diagnosis, treatment and prevention of a brain injury during a sudden-onset disaster: immediate emergency medical response, long-term care, and prevention of post-event increases in pediatric TBIs because of abuse when rapid-onset natural disasters occur.  With such a natural disaster, though, trauma is all too common and hospitals are limited due to weather, which presents an ethical quandary for medical professionals – immediate action is necessary for brain injury, but should a hospital first care for someone who may not survive?  (The development of telemedicine for those who do not need or do not have access to immediate care may help answer this question for doctors.)

A medical professional, however, notes about such emergency circumstances, “this is what we train for.”  For example, a North Carolina deputy got a head injury while responding to calls for service.  A North Carolina teen and his father were transported to the hospital with a fractured skull/bleeding on the brain and an injury that required 12 staples in his head, respectively, after a tree fell on them while they were removing debris from the road.

Today, September 17, the extreme weather has subsided in the Carolinas.  However, according to the National Hurricane Center, the flooding, power outages and road closures continue.  Those that evaluated due to the storm, including those with brain injuries and their caregivers, will soon return.  Some hospitals have reopened in the past few days.  Now, though, the residents of the Carolinas are coping with extreme flooding.  Medical care is not yet easily accessible and it is still difficult to communicate with medical professionals.  Also, “evacuees have [now] been exposed to potentially contaminated flood waters and crowded living conditions and have had many opportunities for traumatic injury.”  Among the mentioned injuries is traumatic brain injury.

 

Preventing Pesticides from Killing Bugs and Brain Cells

A pesticide is “any substance used to kill, repel, or control certain forms of plant or animal life that are considered to be pests.”  No one denies the harm in ingestion of a pesticide.  However, the legality of using certain chemicals in pesticides has been long debated – at present, the chemical chlorpyrifos is of particular concern.

An active ingredient in some pesticides since 1965, chlorpyrifos is “used primarily to control foliage and soil-borne insect pests on a variety of food and feed crops.”  A Google search shows that it is sold under a variety of brand names.  In the past few years, chlorpyrifos has been a focus of concern because of a government-supported study conducted by the Columbia Center for Children’s Environmental Health at Columbia University.  One of the findings of this study confirms, “Children with high pesticide exposure cluster together to form a distinct behavioral phenotype… Cognitive and behavioral deficits associated with this phenotype may be mapped to alterations in brain regions and function.”

Legislation related to pesticide control was first introduced in Congress over a century ago in the Federal Insecticide, Fungicide, and Rodenticide Act.  Since its enactment in 1910, this legislation has been amended and new legislation regulating pesticide use has passed, such as the Food Quality Protection Act in 1996.  In November 2015, the EPA, with former head Gina McCarthy, proposed a ban on the use of neurotoxic chemical chlorpyifos on all food crops.  What then happened to this proposal is unclear.

During the tumultuous tenure of former EPA head Scott Pruitt, in 2017 and 2018, chlorpyrifos came to the pesticide forefront.  In 2017, Pruitt refused to sign off on a ban of the use of chlorpyrifos as a pesticide on food crops.  This decision, many say, is a sign of Pruitt siding with the “Pesticide Lobby”.  Groups such as the Environmental Working Group (EWG) have denounced and fought against Pruitt’s action, noting that, “The evidence is overwhelming that even small doses of chlorpyrifos can damage parts of the brain that control language, memory, behavior and emotion.”  Finally, last month, Pruitt’s decision was reversed by the United States Court of Appeals for the Ninth Circuit – the EPA now bans the use of chlorpyrifos on food crops.

While the above decision is a victory for food safety, the results of this legislation are not immediate.  Additionally, fruits and vegetables must still be washed before eaten both to eliminate any residual pesticide and to better the taste.  On the positive note, though, the EWG notes that, “the agency [has] put children’s health, strong science and the letter of the law above corporate interests.”

U.S. Diplomats Ailments Possibly Explained

Almost a year ago, I reported on the search for the culprit of mysterious ailments on American diplomats in Cuba; this year, I reported that diplomats in China were experiencing the same symptoms and that a cause had not yet been determined.  Last Saturday, September 1, the New York Times published the results of various studies that searched for the cause of brain damage in so many diplomats and their families: Microwave Weapons Are Prime Suspect in Ills of U.S. Embassy Workers.  Of course, microwave weapons do not refer to the most common “microwave”, the microwave oven, but “[any] electromagnetic wave with wavelength between that of  infrared light and radio waves.”  (Microwave weapons are not a new phenomenon.  As these ailments show, other countries use this method of attack and, for over a decade, the American military has been searching for ways to use it in battle.)  However, even after a year of study, as to what caused so many to experience the so-called Frey Effect, nothing is conclusive.

McCain’s Posthumous Charitable Hopes

In 2002, Senator John McCain was instrumental in establishing the Arizona-based nonprofit Translational Genomics Research Institute (TGen),  “a one-of-a-kind genomics research institute.” Unfortunately, the research focus of this institute later became all too important for McCain, as his diagnosis of brain cancer was announced last year.  After losing this year-long battle with glioblastoma*, Senator McCain was laid to rest near the US Naval Academy in Annapolis, Maryland on Sunday, September 2, 2018.  However, his service to America has not ended.

A visit to the memorial webpage of the late Senator provides not only a history of the man and synopses of the moments of honor that have occurred since his death on August 25, 2018, but also gives the visitor an opportunity to donate to two nonprofits specifically selected by McCain: The McCain Institute Foundation and the Translational Genomics Research Institute (TGen).

*According to the NIH, glioblastoma is, “the most common and aggressive malignant brain tumor in adults.”  As previously reported on this site, symptoms of brain malignancy, a.k.a. brain cancer, include headaches, seizures, speech difficulty, weakness and double vision – symptoms that can also be found following a traumatic brain injury.  The question as to whether there is a link between brain injury and brain cancer has been “long-debated”, as was remarked on in a 1979 NIH report.  Today the NIH continues this investigation.  Two years ago, they reported, “Epidemiological studies are equivocal on the possible link between trauma and increased risk of malignant glioblastoma… We propose a putative pathogenesis model that connects post-traumatic inflammation, stem and progenitor cell transformation, and glioblastoma.”