Alternative, Nontraditional, and Supplemental Treatment Methods for Traumatic Brain Injuries Are Necessary for A Multifaceted Approach to Chronic TBI Treatment

I fondly remember the day I visited the Neuro ICU at a big hospital in my city. It was the summer before the 12th grade and I had the opportunity to meet the director of the department. He imparted some bleak truth upon me, that of all the places you can end up in the hospital, the Neuro ICU is the one place you pray to never end up in. As we were talking, he took me into the room of a patient who had just suffered a horrible car accident. “He’s fully conscious,” the doctor told me. “He can see and hear us, but he can’t move a single muscle in his body.” He was ‘locked in’.

He had suffered a Traumatic Brain Injury (often shortened to TBI), a type of brain injury resulting from external, physical trauma. TBIs encompass a variety of deficits that can result from many types of physical trauma. A benign, inconsequential concussion would fall under the broad classification of TBIs as well as someone who falls out of a third-story window and becomes vegetative or paralyzed. In this manner, the primary damage is done to the brain, and due to how intricately complex the brain is, damage to areas even one centimeter apart can yield different symptoms and complications. This makes it a disease process that is especially hard to study and even treat. Oftentimes, traditional pharmacological treatment isn’t enough.

Due to this difficult reality, clinicians and researchers are forced to think outside the box. This is an issue that Dr. Theresa Pape, Research Professor of Physical Medicine and Rehabilitation at Northwestern who spoke to us at Loyola a couple of weeks ago, aims to help remedy by treating with innovative treatments such as through TMS and deep brain stimulation. Another article titled “Supplements, nutrition, and alternative therapies for the treatment of traumatic brain injury” discusses some more nontraditional treatment options for the secondary effects of mild TBI.

While the trauma itself causes the primary injury and is what Dr. Pape researchers, secondary cascades of diseases and disorders arise after and as a result of the primary injury and can include “seizures, sleep disruption, depression, impulsivity, and cognitive decline, which can manifest months to years after the initial injury” among many other deficits. Less severe complaints include “headache, fatigue, and irritability.” It is a chronic disability for many, and a nuisance to say the least for all. Due to the complicated nature of primary injuries, they are essentially untreatable, so clinicians oftentimes work to address secondary injuries more so than primary injuries. It is in this arena that non-traditional treatment options are especially beneficial.

The good thing is that most patients who suffer from TBIs do not experience it in as severe a capacity as the patient I saw in the hospital bed that day. For many patients, it is the chronic impairments to everyday function and behavior that appear to be the most prevalent issues. If not to resolve, a lot of TBI treatment sees improvement and prevention of degradation as victories of themselves, and these can have great impacts on patients’ outlook and ability to live a functional and peaceful life.

In this article, researchers discussed some of these supplemental treatments and therapies. None of these are meant to replace traditional treatment options and are really only beneficial when used in conjunction and as a supplement. In this manner, to attempt to remedy the secondary injuries, the researchers discuss the importance of individualized treatments, and tailoring treatments to the unique nature of the primary injury, all the while acknowledging that certain combinations are more useful for certain types of TBI than others.

In this pursuit, researchers have identified a couple of useful supplementary treatments. Among these are antioxidants useful to fight reactive oxidative species (which can cause a lot of damage to the brain), certain vitamins and minerals, nutritional supplements, and alternative therapy methods such as acupuncture, meditation, and music therapy. In addition to all this, but not discussed in this article, are methods treating primary injuries such as through TMS and deep brain stimulation.

It is necessary to be upfront that for many, these may not lead to immense changes and improvements. However, it is entirely possible that even small improvements may be life-changing for individuals and families who struggle with chronic deficits from TBIs. This article also emphasizes the necessity and advantage of looking outside of the box for treatment options and realizing that there are multiple ways to address a problem to find a solution.


References


Bender Pape, Theresa L. DrPH, MA, CCC-SLP/L, FACRM; Editor; Herrold, Amy A. PhD; Guernon, Ann PhD, MS, CCC-SLP/L; Aaronson, Alexandra MD; Rosenow, Joshua M. MD, FACS; Co-editors. Neuromodulatory Interventions for Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 35(6):p 365-370, November/December 2020. | DOI: 10.1097/HTR.0000000000000643


Lucke-Wold BP, Logsdon AF, Nguyen L, Eltanahay A, Turner RC, Bonasso P, Knotts C, Moeck A, Maroon JC, Bailes JE, Rosen CL. Supplements, nutrition, and alternative therapies for the treatment of traumatic brain injury. Nutr Neurosci. 2018 Feb;21(2):79-91. doi: 10.1080/1028415X.2016.1236174. Epub 2016 Oct 5. PMID: 27705610; PMCID: PMC5491366.