ABSTRACT
Traumatic brain injury (TBI) includes mild TBI (concussion) and penetrating TBI (pTBI). Concussion occurs when the brain violently rocks back and forth within the skull following a blow to the head or neck, whereas pTBI occurs when an object penetrates the skull. Despite newer head protective devices and improved management of pTBI, concussion remains a major health concern, and morbidity and mortality remain high among pTBI. Role of microRNAs in pathogenesis and diagnosis of TBI is discussed. Increased oxidative stress, inflammation, and glutamate are common cellular abnormalities in TBI. Therefore attenuation of these cellular defects may be useful in prevention and improved management of TBI. To reduce oxidative stress and inflammation, elevation of the levels of antioxidant enzymes, and dietary and endogenous antioxidants is essential. Antioxidant levels are increased by supplementation; however, increasing the levels of antioxidant enzymes requires an activation of Nrf2. A mixture of micronutrients that would activate the Nrf2/ARE pathway, enhance the levels of antioxidants, and reduce the release and toxicity of glutamate is proposed. This micronutrient mixture when consumed before exposure to concussion might reduce acute and long-term brain damage. The same mixture in combination of standard therapy may improve the management of TBI in humans.
