Kedar N. Prasad - Treat Concussion, TBI, and PTSD with Vitamins and Antioxidants

ACKNOWLEDGMENTS

I would like to thank my family for their support and encouragement. I also am very thankful to Anne Dillon and Chanc VanWinkle Orzell for their superb editing of this book.

Foreword

Physical injury to the brain is widespread and can have many causes. Vehicular accidents, domestic violence, and sports injuries can lead to serious brain injury in otherwise healthy young people. In combat zones, concussive brain injuries can lead to prolonged post-traumatic stress disorder. In addition to any acute injury to the brain, extended adverse consequences are a common feature.

The novel concept that Kedar Prasad has originated and presents in this book is that this long period of disruption of brain function following physical trauma also gives the opportunity for therapeutic intervention. He has developed a logical regimen incorporating many recent findings relevant to effecting restoration of optimal functioning by the brain. His approach is essentially nutritional and is inexpensive, non-invasive, and devoid of adverse toxic side effects. The plan that Prasad has designed has been found of broad applicability in several other disease states. This volume assembles the reasons validating each component of his design and explains the advantages of dietary supplementation with of a mixture of several kinds of probiotic agents.

This book is designed to be useful to a broad range of readers, and the material within it is readily accessible to non-scientists. The book will be especially valuable to physicians and other health care workers engaged in the care and treatment of victims of traumatic brain injury.

Modern medicine has allowed an increasing number of victims to survive the immediate consequences of brain injury, making the material in this report particularly relevant and an especially important contribution to current medical issues.

STEPHEN BONDY, PH.D.

Stephen Bondy, Ph.D., is a Professor of Neuroscience in the Center for Occupational and Environmental Health, University of California, Irvine. He obtained an M.A. from Cambridge University and a Ph.D. in Biochemistry from the University of Birmingham, UK. He has held positions at Columbia University, UCLA, University of Colorado, and the National Institute for Environmental Health Sciences. He is the author of over 300 articles and reviews. His earlier work included contributions to the relation between sensory input and brain energy metabolism, the factors influencing neurotransmitter receptor density, and the role of free radicals in neurotoxic damage.

PREFACE

Why Should You Read This Book?

Although many neurological diseases exist to plague mankind, this book discusses only concussive injury, penetrating traumatic brain injury (penetrating TBI), and post-traumatic stress disorder (PTSD). These neurological abnormalities are induced by external agents, such as contact sports (concussive injury without fracture of the skull), accidents in which objects penetrate the skull (penetrating TBI), or explosive blasts or other extreme events that later lead to post-traumatic stress disorder (PTSD).

Among veterans of foreign wars, the incidence of PTSD and other mental disorders is being diagnosed at increased rates, which has become a major concern for the U.S. military. Among the veterans of Iraq and Afghanistan, the incidence of PTSD is about 1820 percent; however, among the Vietnam veterans, the incidence of PTSD is about 31 percent in men and 27 percent in women. This suggests that the incidence rate among veterans of recent conflicts may increase in future. The incidence of TBI among American soldiers has risen from about 20 percent in the previous wars to 60 percent in the Iraq and Afghanistan conflicts.

Increasing numbers of high school, college, and professional athletes are participating in contact sports such as football, soccer, and ice hockey, and concussive injuries of the brain are being diagnosed on a more frequent basis among these individuals. It has been estimated that concussive injuries increased 4-fold between the years 1998 and 2008. Treatment of PTSD and TBI remain unsatisfactory and although physical protection against concussive injury and TBI exists, there is no adequate biological protection.

In this book, I propose a unified hypothesis: increased oxidative stress, chronic inflammation, and glutamate release are primarily responsible for the initiation and progression of concussive injury, penetrating TBI, and PTSD, because all of them are toxic to nerve cells. Additionally, I contend that imbalances between the action of excitatory neurotransmitter glutamate, and the inhibitory neurotransmitter gama-aminobutyric acid (GABA) result in increased activity of glutamate in the brain, which contributes to the progression of concussive injuries, penetrating TBI, and PTSD. Therefore, reducing oxidative stress, chronic inflammation, and glutamate release would appear to be one of the best choices for reducing the progression of the above-referenced neurological diseases.

This proposed micronutrient strategy in combination with standard therapy may improve the management of these neurological abnormalities more than that produced by standard therapy alone. In order to reduce oxidative stress, chronic inflammation, and glutamate release, its essential to simultaneously increase the levels of all antioxidant enzymes and all dietary and endogenous antioxidants. (Endogenous antioxidants are those that are made by the body.) This goal cannot be achieved by the use of only one or two antioxidants. Therefore, I have proposed a preparation of micronutrients containing multiple dietary and endogenous antioxidants, vitamin D, selenium, B vitamins, and certain polyphenolic compounds (curcumin and resveratrol) and omega-3 fatty acids, for reducing the risk of the progression of the neurodegenerative conditions discussed in this book. These micronutrients are efficacious because they increase the levels of all antioxidant enzymes by activating a nuclear transcriptional factor-2/antioxidant response element (Nrf2/ARE) pathway, as well as enhancing the levels of dietary and endogenous antioxidant chemicals.

Even though some laboratory data exists to suggest that even the genetic basis of neurological disease can be prevented or delayed by micronutrient supplements, the increase in the amount of micronutrients that I propose flies in the face of conventional theory, for most neurologists believe that antioxidants and vitamins have no significant role in the prevention or improved management of neurodegenerative diseases. These beliefs are primarily based on a few clinical studies in which supplementation with a single antioxidant, such as vitamin E in Alzheimers disease or coenzyme Q10 in Parkinsons disease, produced only modest beneficial effects in the study group. Another study demonstrated that vitamin E alone was ineffective in reducing the progression of Parkinsons disease.

Although some books on neurodegenerative diseases and their causes and symptoms are available, none of them have critically analyzed the published data on antioxidant and neurodegenerative diseases, and have never questioned whether the experimental designs of the study on which the conclusions were based were scientifically valid, whether the results obtained from the use of a single antioxidant in high-risk population can be extrapolated to the effect of the same antioxidant in a multiple antioxidant preparation for the same population, and whether the results of studies obtained on high-risk populations can be extrapolated to normal populations.

The fact of the matter is that patients with neurodegenerative diseases may have a high oxidative environment in the brain, thus the administration of a single antioxidant