Brain Injury – special reader contribution

A reader “J.S.” asked to do a guest post — something that I am very fine with. CFS/ME often can be accurately described as  infection caused brain injury for many patients. I usually avoid the term trauma — because it implies someone being hit over the head with a physical bat.

Coping With Brain Trauma: Understanding The Long-Term Effects

Nearly 1.7milion traumatic brain injuries occur in the United States every year, according to CDC. TBI is the leading cause of death and disability, resulting in 1.5 times more deaths than AIDS. Yet, no head injury case is alike. Traumatic brain injury is the leading cause of disability in adults under forty.

Head injuries are worrisome for a number of reasons as they can lead to brain damage but also learn to devastating long-term effects. However, it is important to highlight that there are no “typical” effects of TBI but rather require an understanding of how to cope.

Long-term effects of brain injury

Depending on the severity and location of the brain affected, the consequences will vary. Survivors can be affected in a variety of issues, including:

  • Cognitive Impact – This may include short-term memory loss, poor motivation, impaired reasoning, slowed responses, and difficulty in problem-solving abilities.
  • Physical Changes – Excessive tiredness and fatigue as a common effect for most individuals who sustain brain trauma, including minor accidents. This can lead to reduced balance, coordination, sensory and mobility perceptions. Thus, the individual may need to rely on aids for mobility to walk.
  • Behavioral Effects – The individual’s personality can change after sustaining a head trauma. They will experience sudden emotional outburst and mood swings. In fact, depression, frustration, and anxiety are also quite common and might become difficult to control.

Managing fatigue after brain trauma

In the general population, fatigue is involved with 10% of incidences. But for people with TBI, it is one of the most common complains post-trauma. Consider how a car needs gas to run properly. If your tank is low, your car will start running down, reaching the end of your fuel reserve. This works the same way with fatigue after a traumatic brain injury. Chronic fatigue is caused by a decrease in physiological reserve. When the brain is low on energy, your body becomes exhausted.

Understanding sensory impairment

After a head injury, individuals may feel a loss, reduction, or exaggerated sense of touch. This can also be difficult for those with odd postures in addition to poor eyesight and the sense of smell. If the person has lost the sensation of smell or taste, they might find food unappetizing. Instead, try to present meals that look appealing.

Difficulty with speech

Rapid, slow, or indistinct speech is highly common after a brain injury. It can be hard to understand their initial speech, but listeners will slowly learn to “tune in” instinctively. While some may lose the ability to speak, it is important to remember that their disability does not mean that they have lost their intelligence. If you cannot understand their gestures, ask to repeat the statement or rephrase in another way.

Coping in the longer term is a journey – for the survivor and their loved ones. Constant monitoring is vital as you may end up missing the small, yet vital feats which are the true marks of progress.

Ken’s Notes on Microbiome Changes

There have been a few more studies since my last post in this area.

  • “Experimental stroke altered the composition of caecal microbiota, with specific changes in Peptococcaceae and Prevotellaceae  correlating with the extent of injury” [2016]
  • ” Here we show that antibiotic-induced alterations in the intestinal flora reduce ischemic brain injury in mice, an effect transmissible by fecal transplants.” [2016]
  • Microbiota Dysbiosis Controls the Neuroinflammatory Response after Stroke.[2016]
    • “Reduced species diversity and bacterial overgrowth of bacteroidetes were identified as hallmarks of poststroke dysbiosis, which was associated with intestinal barrier dysfunction and reduced intestinal motility as determined by in vivo intestinal bolus tracking. “
  • Clostridium butyricum attenuates cerebral ischemia/reperfusion injury in diabetic mice via modulation of gut microbiota [2016].
  • Clostridium butyricum exerts a neuroprotective effect in a mouse model of traumatic brain injuryvia the gut-brain axis. [2018]
  • Moderate Traumatic Brain Injury Alters the Gastrointestinal Microbiome in a Time-Dependent Manner.[2018]
  • “In regards to traumatic injury, Hayakawa and colleagues found that the intestinal microbiota becomes fundamentally disrupted within hours of injury and sudden physiologic insult including cardiac arrest and stroke [49]. Similarly, a recent study in severely injured patients demonstrated significant changes in phylogenetic composition and relative abundance in the first 72 h following injury [50]. Critically ill patients admitted with the systemic inflammatory response (SIRS), including those with traumatic injury, have also been shown to have alterations in the gut microbiome, and these disturbances are predictive of sepsis-associated mortality in their patient population. Another instance of surgical injury altering the gut microbiome was described by Shogan et al., in their study revealing that intestinal anastomotic injury can provoke changes in the gut microbiome [51]. Furthermore, amongst critically ill patients with a prolonged hospitalization, the composition of the gut microbiome dramatically changes such that pathogen communities of extremely low diversity emerge and trigger further virulence in the host [52]. Similarly, critical illness can also cause a shift in the microbiome in such a way that dysbiosis occurs in which beneficial microbes are lost and pathogenic bacteria begin to monopolize the gut [53].” [2018]

Bottom Line

There are two aspects of treatment:

  • reducing stress on the person with brain injury
  • altering the microbiome — one probiotic appears to be effective in improving brain injury, see this post on Clostridium butyricum