Following repeated head traumas to Miami Dolphins quarterback Tua Tagovailoa in back-to-back NFL games, the subject of concussions and head injuries is back in the news.
While it is certainly not my place to comment on his specific case or the NFL’s concussion protocol since I don’t have all the facts, I’d like to share what might be some medically appropriate methods of ameliorating the effects of a head injury in general once it occurs.
My goal is to discuss methods that may speed up the recovery from a concussion without cutting any corners.
There are a number of causes of Traumatic Brain Injuries (TBI) but they all have essentially one thing in common: they result from a sudden trauma, which causes an injury to the brain.
There are a broad range of injuries that qualify as TBI, from relatively mild cases that cause little in the way of symptoms, to those that are devastating and life threatening.
What Happens in the Body Immediately Following Head Trauma?
First, there is an energy crunch in the brain immediately after a traumatic brain injury. This energy crisis is caused by impaired blood supply, which can lead to a cascade of devastating consequences. Namely, the brain requires more energy to repair itself at the exact same time that there may be decreased blood flow due to the injury.
In addition, limited energy stores may create a metabolic mismatch.
Remember, when blood flow is impaired the cells ultimately have difficulty producing energy, the main form of which is ATP.
Obviously, the manifestation of the symptoms depends upon the individual and on the extent of the injury.
When all is said and done the main problems resulting from traumatic brain injuries are decreased blood flow, decreased energy production, the overproduction of reactive oxygen species (ROS) also known as free radicals, mitochondrial dysfunction and ultimately cell death.
Interestingly, these are very reminiscent of the process of aging, as aging typically occurs with these mismatches. With that in mind, here are …
6 Potential Regenerative Medicine Treatments for Brain Injuries
1) Hyperbaric Oxygen Therapy
In our new clinic, we have some powerful tools that can help a patient recover from a traumatic brain injury very expeditiously.
When we look at the results of TBI, we look at these aspects individually and come up with a unique treatment protocol.
One modality that seems to be taking on increasing importance in the treatment of TBI is hard chamber Hyperbaric Oxygen Therapy (HBOT). This is not to be confused with the canvas hyperbaric chambers, which do not seem to have the efficiency of the hard-shell chambers.
On the matter of HBT’s effectiveness in healing brain trauma, an article published this year (2022) from Louisiana State University Health Science Center came to this conclusion, “In multiple randomized and randomized controlled studies HBOT at 1.5 ATA oxygen demonstrated statistically significant symptomatic and cognitive or cognitive improvements alone in patients with mild traumatic brain injury Persistent Post-concussion Syndrome. Positive and negative results occurred at lower and higher doses of oxygen and pressure. Increased pressure within a narrow range appears to be the more important effect than increased oxygen which is effective over a broad range”
I am proud to say we will have two brand new hard shell Sechrist Hyperbaric Chambers at our new PUR-FORM facility in Boca Raton. These chambers are considered the best of the best.
Typically, the air we breathe at sea level is 21% oxygen. The atmospheric pressure at sea level is one atmosphere. At sea level 97% of oxygen is bound to hemoglobin and 3 percent dissolved in the blood plasma.
By the time the oxygen diffuses through the tissues, into the cells, and reaches the mitochondria (energy-producing organelles inside the cells), only trace amounts of oxygen are available. Remember, in TBI there is even further diminished blood supply so oxygen availability to the mitochondria is even scarier.
The beauty of Hyperbaric Oxygen Therapy (HBOT) is that HBOT’s main function is to super-saturate the organs and cells with oxygen. Typically, with our hyperbaric chambers we will use 1.3 atmosphere pressure which can increase oxygen concentration by at least seven times.
Body tissues outside the circulation will thereby experience a commensurate increase in oxygen concentration.
Further information about the use of Hyperbaric Oxygen Therapy can be discovered by reading my blog on this subject.
Certainly, we are not the only clinic which possesses the state-of-the-art hard shell Serachrist Hyperbaric Chambers, however, most clinics utilizing these chambers limit their concussion protocol only to the hyperbaric chambers. That is where we leave these clinics behind.
Our concussion regimen utilizes a number of other cutting-edge modalities to deal with TBI, including the following:
2) Intermittent Hypoxia Therapy
This sounds almost contradictory to Hyperbaric Oxygen Therapy, yet Intermittent Hypoxia Therapy (IHT) has been found to be very beneficial in the treatment of a variety of neurological problems.
Actually, Intermittent Hypoxia Therapy and Hyperbaric Oxygen Therapy go hand and hand with each other and I’ll explain why in a moment.
Intermittent Hypoxia Therapy is done with a specialized machine over a number of sessions. We will typically combine it with Hyperbaric Oxygen Therapy for the following reasons:
Hypoxia is a natural trigger of mitogenesis and mitochondrial metabolic changes through the induction of hypoxia-inducible factor (HIF), vascular endothelial growth factor (VEGF), other relevant molecular cascades, stem cell proliferation and more.
Essentially, IHT stimulates a number of pathways in the body that are instrumental in stimulating healing, especially in the brain. These are all important in the treatment of TBI and when combined with the benefits of HBOT, they complement each other and can be highly beneficial.
3) NAD+ and Other Compounds
NAD+ is one form of the coenzyme nicotinamide adenine dinucleotide (NAD+). Coenzymes are organic compounds or molecules used in the body to help enzymes initiate reactions or functions. NAD+ is used to make the body’s energy currency, which, as we mentioned, is called ATP. ATP is produced in the mitochondria.
Studies have shown that oxidative stress after a concussion depletes levels of NAD+ in the mitochondria of neurons leading to cell death. This damage can occur in the acute, subacute and chronic stages of a head injury.
NAD+ has been shown to reduce oxidative stress, prevent damage to brain cells and reduce the risk of neuronal cell death by correcting mitochondrial metabolism. When the brain is depleted of NAD+, the cells rely on alternative, more oxidative forms of energy production. By increasing the brain’s levels of NAD+, the mitochondrial energy pathways are forced back into functional metabolism. These are all key factors that need correcting when considering post-concussion treatment.
The goal behind NAD+ therapy is to restore mitochondrial metabolism and decrease oxidative stress in the brain. By using higher doses of NAD+, we can alter the brain’s energy metabolism to restore proper function after a traumatic brain injury. A very important portion of our protocol will utilize very high doses of intravenous NAD+.
Also, in the TBI protocol we will utilize intranasal sprays of NAD+ in addition to the intravenous route.
There are also a few other peptide therapies and proprietary compounds that have shown to be successful in reducing inflammation that we use. One of them is Neo-40, which is produced by the company HumanN. Neo-40 is a beet derivative, which may increase stem cell output from the bone marrow and therefore increase blood circulation. This will have a positive effect in healing TBI.
4) EBO2
EBO2 is the abbreviation for a treatment called Extracorporeal Blood Oxygenation and Ozonation. We are leaders in using this unique technology and are the experts who train other facilities how to use it properly. We are very high on this treatment for a variety of conditions, but it has a special application when it comes to treating traumatic brain injuries.
One of the dire consequences of TBI is that it causes an increase in inflammation in the brain and as you know, it is difficult to heal tissue in the face of inflammation.
One of the major bonuses of EBO2 therapy is its ability to stimulate the NRF2 pathway. The NRF2 pathway is a major pathway in the body that can significantly reduce inflammation. This is where EBO2 comes in.
EBO2 can help reduce the production of reactive oxygen species (ROS). The levels of reactive oxygen species (ROS) in cells are determined by two opposing mechanisms: the one that produces free radicals and the cellular antioxidant system that eliminates ROS.
We know that the cellular antioxidant system is stimulated by the NRF2 pathway. Thus, the balance between the rate of ROS production and the efficiency of the cellular detoxification process determines the levels of harmful reactive oxygen species.
This is why EBO2 is a very significant contributor in the TBI protocol.
In addition to reducing inflammation and the production of ROS, EBO2 will also increase blood oxygenation, NAD+ production, and mitochondrial health, all of which are important in recovering from Traumatic Brain Injury.
5) Infrared Sauna Therapy & Photobiomodulation
Our new facility is equipped with the two main types of light sauna therapy: infrared sauna panels and an LED red light therapy (photobiomodulation) bed. Both of these treatments contribute to healing the effects of Traumatic Brain Injury. This is how:
Photobiomodulation (PBM) employs red or near-infrared (NIR) light to stimulate healing, protect tissue from dying, increase mitochondrial function, improve blood flow and tissue oxygenation, all of which are needed to improve TBI.
PBM can also act to reduce swelling, increase antioxidants, decrease inflammation, protect against apoptosis (cell death), and modulate microglial activation state.
All these mechanisms of action strongly suggest that PBM delivered to the head should be beneficial in cases of both acute and chronic TBI.
Many studies in small animal models of acute TBI have found positive effects on neurological function, learning and memory, and reduced inflammation and cell death in the brain as well.
There is additional evidence that PBM can help the brain repair itself by stimulating neurogenesis, upregulating BDNF (a very important brain growth factor) synthesis, and encouraging synaptogenesis.
In healthy human volunteers (including students and healthy elderly women), PBM has been shown to increase regional cerebral blood flow, tissue oxygenation, and improve memory, mood, and cognitive function.
6) Xenon Therapy
Another therapy which holds promise for treating TBI is the use of xenon gas.
Xenon is a rare noble gas and its structure is exceptionally simple compared with the molecular complexity we see with most anesthetic drugs. Xenon also has neuro-protective properties.
A recent study published in the British Journal of Anesthesia in which 72 mice were treated with either xenon (75% Xe: 25% O2) or control gas (75% N2: 25% O2) after controlled traumatic brain damage, showed real promise.
The mice that received the xenon therapy shortly after TBI showed reduced neuronal cell loss and chronic brain inflammation, while improving survival and clinically relevant outcomes, such as long-term cognitive function.
It is still very early in the discovery process of what xenon therapy is capable of, but in the future xenon therapy may be a significant step in the treatment of TBI.
Final Thoughts
As you’ve seen, the treatment of TBI touches on many aspects of regenerative medicine and our protocol calls for some sophisticated treatments involving a number of different pathways in the body, ranging from lack of energy production to an inadequate blood supply, with inflammation also rearing its ugly head.
With that in mind, we are confident that we have a solid foundation when it comes to treating TBI with Hyperbaric Oxygen, Intermittent Hypoxia Therapy, EBO2, and NAD+ and its related compounds, along with red-light sauna therapy. Xenon may be the icing on the cake.
I am not aware of any other clinics that can offer the combinations of the modalities that have been mentioned in this article.
In addition, our world-class clinic, PUR-FORM, offers all of these treatments under one roof, in a first-class setting.
Remember, we don’t just practice regenerative medicine – we define it!
