A new drug under development at James Cook University intended to treat badly wounded soldiers could also be used to treat brain injuries in rural and remote environments, sports concussions, and victims of one-punch assaults.
JCU’s Professor Geoffrey Dobson and Dr Hayley Letson have reported in the Journal of Trauma and Acute Care Surgery that a drug they are developing to treat hemorrhagic shock can also treat traumatic brain injuries.
A traumatic brain injury (TBI) is defined as a blow or jolt to the head or a penetrating or blast injury that disrupts the function of the brain.
The scientists reported their drug led to increased survival, a three-fold increase in brain blood flow, a 70% reduction in inflammation, and a 70% reduction in brain injury markers released into the blood after a TBI in an experimental model.
Dr Dobson said many people assume they do not have a concussion if they have not lost consciousness.
“A TBI can lead to headache, dizziness, fatigue, balance problems, memory loss or loss of consciousness. They can be caused by contact sports, one-punch assaults, falls, and car crashes, not just by military action,” he said.
He said everyone is at risk and that repeated head impacts like those we see in rugby league, rugby union and Australian Rules football and other contact sports are a major concern as they can damage critical areas of the brain involved in memory and executive functions.
“A recent study of Australian Rules football players reported that each player receives nearly 20 concussions per 1000 player match hours. This equates to one concussion every 25 matches, or one concussion every two games per team. These estimates are likely too low for rugby league and union given the increased level of head contact, and possibly under reporting among the players to medical staff,” Dr Dobson said.
Repeated concussions from early years to mid-30s can lead to late-life disability, including dementia-like symptoms, post-traumatic stress disorder (PTSD), and other cognitive and neurological diseases, such as Alzheimer’s disease.
“PTSD affects up to 30% of veterans from military-related TBI, and early-onset dementia is becoming the new ‘silent epidemic’ for many returned service people,” Dr Dobson said.
“You can’t treat the primary blow, but you can treat the secondary progression of injury that begins immediately after a concussion. In the first few hours to days is when most of the damage occurs,” said Dr Dobson.
Dr Letson said the primary and secondary injury is analogous to throwing a pebble into a lake.
“The point of impact is the focal injury, and the secondary progression is the 'ripple effect' that radiates outward and downward. Our drug reduces the 'ripple effect', by reducing local bleeding, local inflammation and local nerve damage. This helps to explain why we saw a 70% reduction in injury biomarkers released into the blood,” she said.
The next stage of testing will be in collaboration with the US military, with the goal to translate the research into field operations and civilian pre-hospital medicine.