Better management of traumatic brain injury

New treatments to lessen the severity of the more than 21,000 Traumatic Brain Injury (TBI) cases that occur in Australia each year are on the horizon.

Published today in the leading neurology journal, Brain, a study led by researchers from Monash University's Australian Centre for (ACBD) revealed how inhibiting certain enzymes decreased the severity of TBI, providing a target for future treatments.

Caused by a blow to the head, often suffered during falls or road crashes, severe TBI can result in long-term disability or death. Effects can include impairments to cognitive and motor function, vision, hearing and . Additionally, the post-injury disruption to blood flow, and around the brain has been linked to debilitating diseases including Alzheimer's disease and post-traumatic epilepsy.

The study was led by Professor Robert Medcalf and Dr Maithili Sashindranath of the ACBD, who collaborated for five years with scientists at the University of Geneva in Switzerland and the University of Michigan in the United States.

Professor Medcalf said the researchers identified two enzymes, known as t-PA and MMP-3, that act together to promote following TBI.

"The enzyme t-PA, well known for its ability to remove blood clots, also has a healthy and very important role in supporting learning and in everyday life. However, previous research has shown that in TBI cases, its presence makes the injury much worse," Professor Medcalf said.

Initially, the researchers thought t-PA itself exacerbated the injury. However, a surprising finding of the study was that t-PA is not the culprit - its inhibition triggers the activation of MMP-3, the enzyme which does the damage.

"The activity of naturally occurring enyzmes is controlled by specific enzyme inhibitors," Professor Medcalf said.

"Unexpectedly, we found that the process of t-PA inactivation by one of its natural inhibitors actually contributed to brain injury, because it leads to the activation of MMP-3.

"Now we know that if we block MMP-3 with an inhibitor, we can protect the brain following TBI," Professor Medcalf said.

Co-author and international expert on TBI, Professor Jeffrey Rosenfeld, from Monash University's Department of Surgery said the results were exciting.

"We now have a new and promising therapeutic target for the treatment of human TBI, which has not, so far, been significantly improved by pharmacological intervention," Professor Rosenfeld said.

Research is continuing with the aim of bringing this finding to a point where clinical trials can evaluate this novel approach in patients with TBI.

Related Stories

What happens after traumatic brain injury occurs?

Nov 01, 2010

Results from a study published in the November issue of The Journal of Nuclear Medicine (JNM) show that powerful imaging techniques––positron emission tomography (PET) fused with magnetic resonance imaging (MRI)& ...

Recommended for you

New ALS associated gene identified using innovative strategy

13 hours ago

Using an innovative exome sequencing strategy, a team of international scientists led by John Landers, PhD, at the University of Massachusetts Medical School has shown that TUBA4A, the gene encoding the Tubulin Alpha 4A protein, ...

Can bariatric surgery lead to severe headache?

13 hours ago

Bariatric surgery may be a risk factor for a condition that causes severe headaches, according to a study published in the October 22, 2014, online issue of Neurology, the medical journal of the American Academy of Neurol ...

Bipolar disorder discovery at the nano level

13 hours ago

A nano-sized discovery by Northwestern Medicine scientists helps explain how bipolar disorder affects the brain and could one day lead to new drug therapies to treat the mental illness.

Brain simulation raises questions

17 hours ago

What does it mean to simulate the human brain? Why is it important to do so? And is it even possible to simulate the brain separately from the body it exists in? These questions are discussed in a new paper ...

Human skin cells reprogrammed directly into brain cells

17 hours ago

Scientists have described a way to convert human skin cells directly into a specific type of brain cell affected by Huntington's disease, an ultimately fatal neurodegenerative disorder. Unlike other techniques ...

User comments