In a 2022 survey of more than two million veterans, seventeen percent or about 400,000 had experienced mild traumatic brain injury and three and a half percent or about 75,000 experienced severe traumatic brain injury. In the US civilian population there are about a million and half traumatic brain injuries a year and between eighty and ninety thousand of these people experience lifelong consequences. A new form of treatment may be helpful for those with long term problems. There are implants for traumatic brain injuries.
Traumatic Brain Injury
Traumatic brain injury is a result of sudden external force to the head. Damage can be confined to a single area, two areas on opposite sides of the brain (coup contrecoup injury) or be diffuse. Injuries range from mild and limited in scope to severe with brain injury causing many deaths and lifelong disability. Some injuries involve penetration of the skull and others are closed head injuries with or without a skull fracture. A prominent feature of long term severe brain injury is diffuse axonal injury or shearing of connecting nerve fibers. These injuries are microscopic and not diagnosable by modern brain scans.
What Are Brain Implants for Traumatic Brain Injuries?
The New York Times published an informative article understandable by a lay person regarding brain injury and brain implants.
More than five million Americans are permanently disabled as a result of traumatic brain injuries. The severity of their conditions range from being totally unable to function to having trouble focusing on basic tasks and being unable to complete their education or hold a simple job. Neurologists say that the ability to focus on basic tasks depends on the integrity of nerves that connect adjacent parts of the brain. The feedback loops for which these nerves are the backbone do not function normally when the connecting nerves are damaged or lost.
An almond-sized sheet of neurons called the central lateral nucleus plays an important role in how brain interconnectivity works. There are two of these, one in each brain hemisphere. These structures help the brain settle down during sleep at night and ramp up during hours when a person is awake. The rationale for a brain implant came from the belief that by stimulating these regions of the brain people with traumatic brain injuries might regain attention and focus. There is a precedent for this approach in patients with Parkinson’s disease where implants restore some brain functions.
The results in five traumatic brain injury patients were encouraging with basic skill test scores going up from 15 to 52% in those so treated.
As Other See Patients With Traumatic Brain Injuries
During follow up interviews the patient who had the best score increases after an implant gave a lukewarm report. He said that it could not hurt and maybe it would help. However, his family and families and friends of others who got implants said the differences were like night and day. A common appraisal by family was that the person was more like their old self. Neurosurgeons are looking at other regions of the brain where an implant could possibly help those with traumatic brain injuries. They admit that this form of treatment on a broad scale would be very expensive. However, they note that the cost that society bears in terms of a person’s disability, support payments, lack of taxes paid, and lack of healthy people in the workforce is significant and should be added to the equation when deciding if this approach is viable on a large scale.
Traumatic Brain Injury and Suicide Risk
Individuals with sequelae of traumatic brain injuries have a host of issues to deal with during their lives. The sum total of these issues may lead to depression and suicidal thoughts. In the general population it appears that a traumatic brain injury roughly double the risk of suicide. A problem for trying to reduce suicide risk in these patients is that while therapies like psychedelic-assisted psychotherapy can help depression it does nothing to reconnect the long nerve fibers in the brain. Traumatic brain injury is the root cause of so many problems in a person’s life. The best way to reduce suicide risk will be to find ways like brain implants that hold the promise of improving the root cause.