Traumatic Brain Injuries (TBIs) are recognized as epigenetic risk factors in the DSM-5, causing significant alterations to the human psyche and potential neurodegenerative conditions (Chauhan). TBIs effect around 1.7 million individuals in the U.S. and 235 per 100,000 in Europe annually (Hemphill). They are the leading cause of death for those under 45, with an estimated annual economic cost of $76.5 billion (Nelson). Clearly, TBIs are a prevalent issue in today's world.
With the guidance and help of research studies, we continue to grow closer to solutions and better rehabilitation methods. Post-injury, neuropsychiatrists examine the potential long-term effects of the given TBI, prescribe medications, and draft a rehabilitation plan. Possible medications include anti-anxiety, anticoagulants, anticonvulsants, antidepressants, muscle relaxants, and stimulants. Anti-anxiety medication will help with nervousness and fear, anticoagulants to avert blood clots, anticonvulsants to avert seizures, antidepressants to help with depression and mood swings, muscle relaxants to avert muscle spasms, and stimulants to aid with alertness (National Institutes of Child Health and Human Development). Just like medical prescriptions, rehabilitation techniques differ per individual. Types of therapy include but are not limited to physical, occupational, speech, psychological, vocational, and cognitive therapy. Despite these therapeutic measures, research labs continue to find a solution to the root problem underlying more severe Traumatic Brain Injuries, which frequently damage neuronal circuitry and subsequent neuronal and glial cell death.
In the research paper titled Neuromodulatory Interventions for Traumatic Brain Injury, Theresa L. Bender Pape et al. discuss the prospective usage of neuromodulatory interventions like transcranial magnetic stimulation (TMS) to aid in Traumatic Brain Injury rehabilitation. In previous studies, transcranial magnetic stimulation has improved motor function and mood regulation, especially in patients diagnosed with Major Depressive Disorder. As indicated previously, Traumatic Brain Injuries frequently result in neuronal and glial cell death, damage, or disruption, thus giving rise to the question, can stimulating network-level reorganization and neuroplasticity following a brain injury allow for more intact neuronal pathways to form? Theresa L. Bender Pape et al. examine just this by proposing that since neuromodulatory interventions like TMS allow for targeted stimuli delivery to modulate neural pathway behaviors to support network-level reorganization and promote neuroplasticity, allowing for the compensation of dysfunctional or damaged neural pathways, they can be employed to promote the same benefits for patients suffering with TBIs. Traumatic Brain Injuries are a chain reaction beginning in the neuronal microenvironment, with decreased quality of life being the denouement, implying that to better the physical and mental well-being of these patients, we must work at the neuronal microenvironment to better the effects that that microenvironment produces. Thus, by directly stimulating neuronal pathways through neuromodulation, we can promote increased plasticity to regain the mental and physical well-being that was lost following the brain injury (Bender Pape).
Promoting neuroplasticity is one of the preferred mechanisms for TBI rehabilitation. As such, many other research laboratories have worked on other mechanisms to induce neuroplasticity, such as psychedelics. In a research paper titled Psychedelics and Neuroplasticity: A Systematic Review Unraveling the Biological Underpinnings of Psychedelics, de Vos CMH et al. analyze at a molecular level how the use of psychedelics such as DMT, LSD, psilocybin, and ayahuasca can be employed to promote neuroplasticity. Their review indicated that studies primarily pictured that a single dose of one of the psychedelics, as mentioned earlier, produced instantaneous changes in promoting neuronal and dendritic plasticity, allowing the expression of genes and plasticity implicated in plasticity like Brain-Derived Neurotrophic Factor (BDNF). Further, these changes in neuronal plasticity seemed to outlast the acute effects of psychedelics, promoting the theory that psychedelics are a powerful tool to induce neuroplasticity (De Vos).
As such, the question arises: can psychedelics aid patients suffering from TBIs to stimulate network-level reorganization and neuroplasticity following a TBI similar to the mechanism that Theresa L. Bender Pape et al. proposed? The multifaceted usages of neuromodulatory interventions and psychedelics shine a light on potential rehabilitation mechanisms for patients following Traumatic Brain Injuries by promoting neuroplasticity. The future looks bright for those whose family, friends, or themselves have been directly impacted by Traumatic Brain Disorders as more mechanisms of triggering neuroplasticity in brain-injured patients emerge and using TMS and psychedelics solidifies for rehabilitation.
Bender Pape, T. L., Herrold, A. A., Guernon, A., Aaronson, A., & Rosenow, J. M. (2020). Neuromodulatory interventions for traumatic brain injury. Journal of Head Trauma Rehabilitation, 35(6), 365–370. https://doi.org/10.1097/htr.0000000000000643
Chauhan, Neelima B. “Chronic Neurodegenerative Consequences of Traumatic Brain Injury.” Restorative Neurology and Neuroscience, U.S. National Library of Medicine, 2014, pubmed.ncbi.nlm.nih.gov/24398724/.
De Vos, Cato M., et al. “Psychedelics and Neuroplasticity: A Systematic Review Unraveling the Biological Underpinnings of Psychedelics.” Frontiers in Psychiatry, vol. 12, 2021, https://doi.org/10.3389/fpsyt.2021.724606.
Hemphill, Matthew A, et al. “Traumatic Brain Injury and the Neuronal Microenvironment: A Potential Role for Neuropathological Mechanotransduction.” Neuron Review, Wyss Institute for Biologically Inspired Engineering, 18 Mar. 2015, www.cell.com/neuron/pdf/S0896-6273(15)00156-7.pdf.
National Institutes of Child Health and Human Development. “What Are the Treatments for TBI?” Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. Department of Health and Human Services, 2016, www.nichd.nih.gov/health/topics/tbi/conditioninfo/treatment.
Nelson, Clinton G, et al. “Severe Traumatic Brain Injury: A Case Report.” The American Journal of Case Reports, International Scientific Literature, Inc., 23 Mar. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4807741/.
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