Brain Damage and Spinal Cord Injury

Introduction of Brain Damage and Spinal Cord Injury

Brain damage and spinal cord injury are central nervous system (CNS) traumatic injury which has been a leading cause of disability and morbidity in the world, as well as a significant economic burden for society.

Brain damage also knows as traumatic brain injury, is an injury that causes the destruction or deterioration of brain cells. There are two types of brain damage, which include traumatic brain injury (TBI) and acquired brain injury (ABI). In addition, brain damage caused by genetic, or birth injury is called congenital brain damage.

A spinal cord injury refers to damage to a part of the spinal cord or the nerve (cauda equina) at the end of the spinal canal, which usually results in permanent changes in the strength, sensation, and other body functions below the injury site. Based on the location of the spinal cord injury and the severity of the spinal cord injury, the spinal cord injury can be divided into complete and incomplete. In addition, paralysis caused by spinal cord injury can be divided into tetraplegia and paraplegia. The complications would include bladder control, bowel control, skin sensation, circulatory control, respiratory system, as well as depression.

Fig.1 Time course and dual roles of innate and adaptive immune responses after CNS injury. (Putatunda, 2018)

Mechanisms Underlying the Secondary Injury

• Excitotoxicity caused by impaired glutamate homeostasis
• Free radicals/oxidative stress/lipid peroxidation
• Calcium overload
• Sterile neuroinflammation
• Autophagy

Symptoms of Brain Damage and Spinal Cord Injury

• Loss of movement
• Exaggerated reflex activities or spasms
• Loss or altered sensation
• Pain or strong tingling
• Difficulty breathing and coughing
• Loss of bladder or bowel control

Treatments for Brain Damage and Spinal Cord Injury

Both brain damage and spinal cord injury affect all individuals and result in significant morbidity and mortality. In recent years, a series of treatments against brain damage and spinal cord injury have been developed, such as early neuroprotective therapies, neuroprotective interventions, and immunomodulatory strategies.

Intravenous immunoglobulin G (IVIG) has always been the first-line therapy and presents great efficacy against immunodeficiency and autoimmune diseases. Some studies showed that IVIG significantly improves neural functional recovery and has a neuroprotective effect. IVIG can inhibit the excessive immune response by inhibiting the production of inflammatory cytokines in the central nervous system, and it can also reverse the immune suppression of invading pathogens following the injury of the central nervous system. In this case, IVIG has been served as a potential candidate for clinical trials against brain damage and spinal cord injury. What’s more, the adaptive immune responses may also help neuro repair after CNS injury.

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Reference

1. Putatunda, R.; et al. Potential immunotherapies for traumatic brain and spinal cord injury. Chinese Journal of Traumatology. 2018, 21(3): 125-136.