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Can Exercise Treat Hidden Traumatic Brain Injury Symptoms?

Brain

Each year, more than 2 million people in the United States suffer traumatic brain injury (TBI). Most cases are mild to moderate, the individuals recover, and they resume their normal lives.

But do they really?

Mild head injury sufferers may appear normal. However, many cope with long-lasting TBI symptoms, including memory loss, trouble focusing, mood swings, disturbed sleep, and depression — symptoms that may affect their quality of life, but can’t be detected on a CT scan or MRI.

My colleagues and I are in the midst of a preliminary study funded by the Texas Institute for Brain Injury and Repair, which is part of the UT Southwestern Peter O’Donnell Jr. Brain Institute, to discover ways to treat these hidden symptoms of TBI.

We believe mild brain injury accelerates the brain’s aging process, but exercise may counteract it.

We believe mild brain injury accelerates the brain’s aging process, but exercise may counteract it.

Over the past 10 years, researchers have studied how exercise affects brain aging in older adults.

But for TBI patients, the work is just beginning. Researchers have tried to develop medications for mild brain injury for nearly two decades, to no avail. There must be some way to help these patients, and we believe exercise is the key.

Most TBI cases are due to motor vehicle crashes and household accidents, such as falls. The brain is shaken about the skull, causing brain damage.

Many TBI patients give up exercise for fear of worsening symptoms or because of developing depression after injury. Consequently, they may gain weight, develop vascular issues, and miss out on activities they enjoy. These difficulties reduce their quality of life and further impact brain health.

Our hypothesis is that for mild brain injury, patients should be prescribed exercise, not just medications which provide some temporary relief. More than 90 percent of patients with mild TBI are physically able to exercise, and research suggests that exercise may potentially allow patients to regain lost cognitive abilities.

Our hypothesis is that for mild brain injury, patients should be prescribed exercise, not just medications which provide some temporary relief.

Participants often appear well when they visit our lab, but reveal limitations during cognitive and health-related quality of life testing.

Their memory and mood are affected by TBI. Patients can’t function effectively and feel frustrated at home and at work.

But how can we measure how a person feels? Neuropsychological measurement of quality of life is an emerging field, and we’re taking it to a new level.

After baseline fitness testing, we use patient-recorded outcome measures to assess participants’ emotional status. Then we use blood biomarkers and advanced imaging equipment to monitor physical changes in their brains.

We have three goals:
1. To transform TBI patients’ quality of life.
2. To disprove the myth that mild TBI patients shouldn’t exercise.
3. To determine how TBI patients’ brains change with exercise.

Our Advanced Imaging Research Center in Dallas is uniquely positioned to house this study because we’re surrounded by a community of specialists.

Kathleen Bell, M.D., is our TBI expert. She has conducted extensive research nationwide on head injuries and cognition.

My research partner is Chris Madden, M.D., from the O’Donnell Brain Institute. We work with my co-investigator, Kan Ding, M.D., and our UT Southwestern neurology faculty colleagues who maintain the Parkland Health & Hospital System comprehensive brain trauma registry.

This registry, along with our prime location, allows us access to thousands of potential participants for our next phase of research, which we hope will be a national, multicenter study.

With TBI, there are two treatment outcomes to consider: how the patient feels physically, and how the patient feels emotionally.

We’re optimistic that this study will open the door for improved cognitive outcomes for TBI patients.

For more information about this study, health care innovations, and ongoing research, contact Justin Repshas at 214-345-4734, or visit our Stories and Insights blog.


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Rong Zhang, Ph.D. is an Associate Professor in the UT Southwestern Department of Internal Medicine.

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