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Kline AE, Moschonas EH, Bondi CO. Music as medicine for traumatic brain injury: a perspective on future research directions. Neural Regen Res 2024; 19:2105-2106. [PMID: 38488540 PMCID: PMC11034591 DOI: 10.4103/1673-5374.392862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 03/19/2024] Open
Affiliation(s)
- Anthony E. Kline
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eleni H. Moschonas
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Corina O. Bondi
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA, USA
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Davis CK, Arruri V, Joshi P, Vemuganti R. Non-pharmacological interventions for traumatic brain injury. J Cereb Blood Flow Metab 2024; 44:641-659. [PMID: 38388365 PMCID: PMC11197135 DOI: 10.1177/0271678x241234770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
Heterogeneity and variability of symptoms due to the type, site, age, sex, and severity of injury make each case of traumatic brain injury (TBI) unique. Considering this, a universal treatment strategy may not be fruitful in managing outcomes after TBI. Most of the pharmacological therapies for TBI aim at modifying a particular pathway or molecular process in the sequelae of secondary injury rather than a holistic approach. On the other hand, non-pharmacological interventions such as hypothermia, hyperbaric oxygen, preconditioning with dietary adaptations, exercise, environmental enrichment, deep brain stimulation, decompressive craniectomy, probiotic use, gene therapy, music therapy, and stem cell therapy can promote healing by modulating multiple neuroprotective mechanisms. In this review, we discussed the major non-pharmacological interventions that are being tested in animal models of TBI as well as in clinical trials. We evaluated the functional outcomes of various interventions with an emphasis on the links between molecular mechanisms and outcomes after TBI.
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Affiliation(s)
- Charles K Davis
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
| | - Vijay Arruri
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
| | - Pallavi Joshi
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
- Neuroscience Training Program, University of Wisconsin, Madison, WI, USA
| | - Raghu Vemuganti
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
- Neuroscience Training Program, University of Wisconsin, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
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Vozzella VJ, Bittner RA, Ranellone TS, Grimm KM, Palmer KN, Carpio AN, Abel QC, Moschonas EH, Bondi CO, Kline AE. A bridge to recovery: Acute amantadine prior to environmental enrichment after brain trauma augments cognitive benefit. Exp Neurol 2024; 373:114648. [PMID: 38081352 DOI: 10.1016/j.expneurol.2023.114648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 12/22/2023]
Abstract
Environmental enrichment (EE) facilitates motor and cognitive recovery after traumatic brain injury (TBI). Historically, EE has been provided immediately and continuously after TBI, but this paradigm does not model the clinic where rehabilitation is typically not initiated until after critical care. Yet, treating TBI early may facilitate recovery. Hence, we sought to provide amantadine (AMT) as a bridge therapy before commencing EE. It was hypothesized that bridging EE with AMT would augment motor and cognitive benefits. Anesthetized adult male rats received a cortical impact (2.8 mm deformation at 4 m/s) or sham surgery and then were housed in standard (STD) conditions where they received intraperitoneal AMT (10 mg/kg or 20 mg/kg) or saline vehicle (VEH; 1 mL/kg) beginning 24 h after surgery and once daily during the 6-day bridge phase or once daily for 19 days for the non-bridge groups (i.e., continuously STD-housed) to compare the effects of acute AMT plus EE vs. chronic AMT alone. Abbreviated EE, which was presented to closer emulate clinical rehabilitation (e.g., 6 h/day), began on day 7 for the AMT bridge and chronic EE groups. Motor (beam-walking) and cognition (acquisition of spatial learning and memory) were assessed on days 7-11 and 14-19, respectively. Cortical lesion volume and hippocampal cell survival were quantified on day 21. EE, whether provided in combination with VEH or AMT, and AMT (20 mg/kg) + STD, benefitted motor and cognition vs. the STD-housed VEH and AMT (10 mg/kg) groups (p < 0.05). The AMT (20 mg/kg) + EE group performed better than the VEH + EE, AMT (10 mg/kg) + EE, and AMT (20 mg/kg) + STD groups in the acquisition of spatial learning (p < 0.05) but did not differ in motor function (p > 0.05). All groups receiving EE exhibited decreased cortical lesion volumes and increased CA3 neuron survival relative to the STD-housed groups (p < 0.05) but did not differ from one another (p > 0.05). The added cognitive benefit achieved by bridging EE with AMT (20 mg/kg) supports the hypothesis that the temporal separation of combinational therapies is more effective after TBI.
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Affiliation(s)
- Vincent J Vozzella
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Rachel A Bittner
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Tyler S Ranellone
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Kelsey M Grimm
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Kelsey N Palmer
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Anna N Carpio
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Quinn C Abel
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Eleni H Moschonas
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Psychology, University of Pittsburgh, Pittsburgh, PA 15213, United States of America.
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