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Semin Neurol 2015; 35(01): 083-100
DOI: 10.1055/s-0035-1544237
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Emerging Therapies in Traumatic Brain Injury

Patrick M. Kochanek
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
6   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Travis C. Jackson
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Nikki Miller Ferguson
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
6   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Shaun W. Carlson
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
3   Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Dennis W. Simon
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
6   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Erik C. Brockman
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
6   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Jing Ji
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Hülya Bayır
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
6   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
7   Department of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
,
Samuel M. Poloyac
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
8   University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania
,
Amy K. Wagner
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
4   Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Anthony E. Kline
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
4   Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Philip E. Empey
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
8   University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania
,
Robert S.B. Clark
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2   Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
6   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Edwin K. Jackson
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
5   Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
C. Edward Dixon
1   Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
3   Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
25 February 2015 (online)

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Abstract

Despite decades of basic and clinical research, treatments to improve outcomes after traumatic brain injury (TBI) are limited. However, based on the recent recognition of the prevalence of mild TBI, and its potential link to neurodegenerative disease, many new and exciting secondary injury mechanisms have been identified and several new therapies are being evaluated targeting both classic and novel paradigms. This includes a robust increase in both preclinical and clinical investigations. Using a mechanism-based approach the authors define the targets and emerging therapies for TBI. They address putative new therapies for TBI across both the spectrum of injury severity and the continuum of care, from the field to rehabilitation. They discussTBI therapy using 11 categories, namely, (1) excitotoxicity and neuronal death, (2) brain edema, (3) mitochondria and oxidative stress, (4) axonal injury, (5) inflammation, (6) ischemia and cerebral blood flow dysregulation, (7) cognitive enhancement, (8) augmentation of endogenous neuroprotection, (9) cellular therapies, (10) combination therapy, and (11) TBI resuscitation. The current golden age of TBI research represents a special opportunity for the development of breakthroughs in the field.

Keywords

head injury - concussion - neurocritical care - treatment - drugs - excitotoxicity - inflammation - oxidative stress - regeneration - rehabilitation - secondary injury
 

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