Multi-Mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Despite extensive research efforts, the majority of trialed monotherapies to date have failed to demonstrate significant benefit. It has been suggested that this is due to the complex pathophysiology of TBI, which may...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-03, Vol.12 (6), p.2179
Main Authors: Lynch, Daniel G, Narayan, Raj K, Li, Chunyan
Format: Article
Language:English
Subjects:
Antioxidants
Brain
Brain research
Clinical medicine
Clinical trials
Combined modality therapy
Edema
Enzymes
Evolution
Free radicals
Hypotension
Hypoxia
Injuries
Ischemia
Nervous system agents
Oxidative stress
Pathophysiology
Review
Therapeutics, Experimental
Traumatic brain injury
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Summary:Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Despite extensive research efforts, the majority of trialed monotherapies to date have failed to demonstrate significant benefit. It has been suggested that this is due to the complex pathophysiology of TBI, which may possibly be addressed by a combination of therapeutic interventions. In this article, we have reviewed combinations of different pharmacologic treatments, combinations of non-pharmacologic interventions, and combined pharmacologic and non-pharmacologic interventions for TBI. Both preclinical and clinical studies have been included. While promising results have been found in animal models, clinical trials of combination therapies have not yet shown clear benefit. This may possibly be due to their application without consideration of the evolving pathophysiology of TBI. Improvements of this paradigm may come from novel interventions guided by multimodal neuromonitoring and multimodal imaging techniques, as well as the application of multi-targeted non-pharmacologic and endogenous therapies. There also needs to be a greater representation of female subjects in preclinical and clinical studies.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12062179