In the latest consensus statement from the Concussion in Sport Group (CISG), a committee made up of governing bodies in various contact sports, it defines a sport-related concussion (SRC) as "a traumatic brain injury induced by biomechanical forces." It is usually caused by a direct blow to the head, face, or neck, and it can result in anywhere from a short-term disruption of brain function to neuropathological changes in the long run.
In some cases, concussions are also referred to as mild traumatic brain injuries (mTBIs). A defining difference in mTBIs and more severe forms of TBI is that the effects of the latter can be easily detected. To note, the Centers for Disease and Prevention define the severity of a brain injury using a tool to evaluate coma and impaired consciousness.
Mild traumatic brain injuries, however, are not as easily detected as that of a severe TBI. The authors noted that while sports-related concussive and sub-concussive impacts start out as mild, the brain's inflammatory response to an injury may aggravate it, especially in repeated and prolonged exposures. This may develop into long-term neurological impairment in the long run, according to recent studies. In some cases, this could even lead to an increased risk of having neurodegenerative diseases. (Related: Brain trauma, at any point in life, increases risk of later dementia by 600%.)
The researchers also noted that there are multiple processes needed to address mTBIs and other forms of sports-related injury. Sub-concussive impacts, for example, lead to measurable changes in the body's pathophysiology. mTBIs can also adversely affect not only the structure and function of the brain but also its metabolic organization.
In the study, the researchers talked about how specific nutrients and nutraceuticals can affect a wider number of pathways than conventional drugs, offering a broader treatment approach for mTBIs. They pointed out that while pharmaceutical therapies target a single mechanism in treating an injury, nutritional supplementation utilizes multiple mechanisms of the injury. This allows it to relieve damage caused by both sub-concussive and non-concussive impacts.
The team reviewed some well-known nutrients, such as:
- Curcumin – Studies have shown that the bioactive component of the turmeric herb contains antioxidant properties which can stop lipid peroxidation in the brain on rodent models with mTBI.
- Creatine – The body has a natural source of creatine. In the brain, it is used to provide the energy needed for various functions. Experts have noted that in an SRC, the levels of creatine dip days following the injury. Using supplements may be an effective strategy to boost levels of creatine in the brain.
- Omega-3 fatty acids – A known consequence of TBI is the loss of DHA (docosahexaenoic acid) in the body. This may lead to slower recovery of motor function, anxiety-like behaviors, and even cognitive deficiency. Various animal studies have shown that omega-3 fatty acids help minimize brain damage and protect against it.
A limitation revealed in the study is the lack of human studies on the role of supplementation in protecting the brain. So far, only murine models have been used to conduct studies on mTBI and TBI. In the study, researchers only identified one human case – that which studied the effects of DHA (docosahexaenoic acid) on head trauma injuries. While that study revealed that DHA reduced head trauma damage, as measured by the serum neurofilament light biomarker, the results cannot be fully inferred because of constraints.
The researchers deduced that there is a potential for nutritional supplementation to be used to treat TBI.
"Nutritional supplementation has emerged as a potential strategy to prevent and/or reduce the deleterious effects of sports-related concussion and sub-concussive impacts," they wrote. "In contrast to pharmaceutical treatment, nutrients (creatine and omega-3 FAs) and nutraceuticals (curcumin) have the potential to act on multiple mechanisms within the complex neurochemical and neurometabolic sequelae that occur subsequent to concussive and sub-concussive impacts."
However, they recommended further exploration to understand its safety risks and efficacy fully.
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