Rewriting Life

The Brain Injury Epidemic

There are still no treatments for traumatic brain injury, though Barclay Morrison offers cause for hope.

Every year traumatic brain injury (TBI) causes 50,000 deaths and 80,000 cases of long-term disability in the United States, according to the Centers for Disease Control and Prevention. An estimated 5.3 million Americans (some 2 percent of the population) live with long-term disabilities due to brain injury.

Yet much about brain injuries remains unknown. Despite decades of research, no treatments yet target the underlying pathophysio­logical cause of progressive brain damage. For patients so severely injured that they are in a minimally conscious state, medical knowledge is particularly lacking; in such cases, we are just beginning to understand the damage and the possibility of treatment (see “Raising Consciousness”).

This story is part of our January/February 2007 Issue
See the rest of the issue
Subscribe

Preventing brain injuries is enormously important. Prevention strategies include such commonsense devices as air bags in cars, protective helmets, and cushioned playground materials. Detailed knowledge of TBI biomechanics at both the whole-body and single-cell levels can make prevention even more successful. Equipped with this information, computational models can predict how likely an event is to cause injury and how effective a protective device is likely to be.

Finding treatments for those injuries that do occur will depend on better understanding the complex cellular events triggered by a brain injury. In TBI, a rapid mechanical deformation of the brain both physically disrupts and mechanically stimulates cells. Some cell damage is immediate, but most of the damage develops over days, weeks, and even months. The delayed and progressive nature of the neurodegenerative cascade represents a critical therapeutic opportunity: targeted intervention could halt the progression of cell damage and death. However, no therapeutic strategies yet exist that target the degeneration mechanisms.

One approach, which my research group is working on, is to develop experimental TBI models that simulate the neurodegenerative sequence. With the molecular understanding that such models offer, promising therapeutic targets can be identified and treatments rationally developed with the intent of breaking the progression from mechanical event to delayed cell death. Boosting the brain’s own protective mechanisms is another possible tactic. Finally, therapeutic strategies to encourage sprouting of new brain tissue or regeneration of damaged tissue could also hold promise for those living with long-term disability.

Our understanding of TBI is greater today than it has ever been. But TBI must continue to be studied so that effective treatments can be found for the approximately 230,000 people each year who suffer head injuries that require hospitalization.

Barclay Morrison is an assistant professor of biomedical engineering at Columbia University and the principal investigator in its Neuro­trauma and Repair Laboratory.

Become an MIT Technology Review Insider for in-depth analysis and unparalleled perspective.
Subscribe today

Uh oh–you've read all five of your free articles for this month.

Insider Premium

$179.95/yr US PRICE

More from Rewriting Life

Reprogramming our bodies to make us healthier.

Want more award-winning journalism? Subscribe to Insider Basic.

  • Insider Basic {! insider.prices.basic !}*

    {! insider.display.menuOptionsLabel !}

    Six issues of our award winning magazine and daily delivery of The Download, our newsletter of what’s important in technology and innovation.

    See details+

    What's Included

    Bimonthly home delivery and unlimited 24/7 access to MIT Technology Review’s website.

    The Download. Our daily newsletter of what's important in technology and innovation.

You've read of free articles this month.