Traumatic Brain Injury treated by Vitamin D - many studies

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Vitamin D Protects against Traumatic Brain Injury via Modulating TLR4/MyD88/NF- κ B Pathway-Mediated Microglial Polarization and Neuroinflammation - July 2022

Biomed Res Int. 2022 Jul 15;2022:3363036. doi: 10.1155/2022/3363036. eCollection 2022.
Hongsheng Jiang 1, Xinyu Yang 2, Yanzhou Wang 1, Caifeng Zhou 1

Vitamin D (VD) deficiency is associated with neuroinflammation and neurocognitive deficits in patients with traumatic brain injury (TBI). The present study was aimed at investigating the therapeutic effects of VD and the molecular mechanisms after TBI. After the intraperitoneal injection of VD (1 µg/kg), sensorimotor and cognitive function was assessed via a series of behavioral tests in TBI rats. Traumatic outcomes were investigated by brain edema, blood-brain barrier (BBB) disruption, and morphologic staining. In vitro, cellular viability and cytotoxicity in primary hippocampal neurons were detected via the MTT method and LDH release. Hippocampal oxidative stress-related enzymes and proinflammatory mediators and the serum concentration of VD were analyzed by ELISA. The expression of VDR, TLR4, MyD88, and NF-κ B p65 was measured by Western blot. Furthermore, the levels of M1/M2 microglial markers were quantified using real-time PCR and Western blot. VD treatment significantly increased the serum level of VD and the hippocampal expression of VDR.

VD not only effectively alleviated neurocognitive deficits, brain edema, and BBB disruption but also promoted hippocampal neuronal survival in vivo and in vitro. Moreover, VD therapy prevented excessive neuroinflammation and oxidative stress caused by TBI. Mechanically, the hippocampal expression of TLR4, MyD88, and nuclear NF-κ B p65 was elevated in the TBI group but robustly restrained by VD treatment. Taken together, VD provides an important neuroprotection through modulating hippocampal microglial M2 polarization and neuroinflammation via the TLR4/MyD88/NF-κ B pathway.
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13% of those average age 75 recently had a TBI - April 2024

Incidence of Traumatic Brain Injury in a Longitudinal Cohort of Older Adults
JAMA Netw Open. 2024;7(5):e2414223. doi:10.1001/jamanetworkopen.2024.14223
Erica Kornblith, PhD1,2; L. Grisell Diaz-Ramirez, MS1,3; Kristine Yaffe, MD1,2,4,5,6; et alW. John Boscardin, PhD1,3,6; Raquel C. Gardner, MD7

Key Points

• Question How common is traumatic brain injury (TBI) among older adults in the US?
• Findings Over an 18-year study period, this cohort study found that 12.9% of 9239 study respondents experienced TBI. Race and ethnicity, sex, cognition, educational level, and medical conditions were associated with TBI status.
• Meaning Findings of this study suggest that incident TBI is common among older adults and may be associated with demographic or social factors.

Importance Traumatic brain injury (TBI) occurs at the highest rate in older adulthood and increases risk for cognitive impairment and dementia.

Objectives To update existing TBI surveillance data to capture nonhospital settings and to explore how social determinants of health (SDOH) are associated with TBI incidence among older adults.

Design, Setting, and Participants This nationally representative longitudinal cohort study assessed participants for 18 years, from August 2000 through December 2018, using data from the Health and Retirement Study (HRS) and linked Medicare claims dates. Analyses were completed August 9 through December 12, 2022. Participants were 65 years of age or older in the HRS with survey data linked to Medicare without a TBI prior to HRS enrollment. They were community dwelling at enrollment but were retained in HRS if they were later institutionalized.

Exposures Baseline demographic, cognitive, medical, and SDOH information from HRS.

Main Outcomes and Measures Incident TBI was defined using inpatient and outpatient International Classification of Diseases, Ninth or Tenth Revision, diagnosis codes received the same day or within 1 day as the emergency department (ED) visit code and the computed tomography (CT) or magnetic resonance imaging (MRI) code, after baseline HRS interview. A cohort with TBI codes but no ED visit or CT or MRI scan was derived to capture diagnoses in nonhospital settings. Descriptive statistics and bivariate associations of TBI with demographic and SDOH characteristics used sample weights. Fine-Gray regression models estimated associations between covariates and TBI, with death as a competing risk. Imputation considering outcome and complex survey design was performed by race and ethnicity, sex, education level, and Area Deprivation Index percentiles 1, 50, and 100. Other exposure variables were fixed at their weighted means.

Results Among 9239 eligible respondents, 5258 (57.7%) were female and 1210 (9.1%) were Black, 574 (4.7%) were Hispanic, and 7297 (84.4%) were White. Mean (SD) baseline age was 75.2 (8.0) years. During follow-up (18 years), 797 (8.9%) of respondents received an incident TBI diagnosis with an ED visit and a CT code within 1 day, 964 (10.2%) received an incident TBI diagnosis and an ED code, and 1148 (12.9%) received a TBI code with or without an ED visit and CT scan code.
Compared with respondents without incident TBI, respondents with TBI were

• more likely to be female (absolute difference, 7.0 [95% CI, 3.3-10.8]; P < .001) and
• White (absolute difference, 5.1 [95% CI, 2.8-7.4]; P < .001),
• have normal cognition (vs cognitive impairment or dementia; absolute difference, 6.1 [95% CI, 2.8-9.3]; P = .001),
• higher education (absolute difference, 3.8 [95% CI, 0.9-6.7]; P < .001), and
• wealth (absolute difference, 6.5 [95% CI, 2.3-10.7]; P = .01), and
• be without baseline lung disease (absolute difference, 5.1 [95% CI, 3.0-7.2]; P < .001)
• (n)or functional impairment (absolute difference, 3.3 [95% CI, 0.4-6.1]; P = .03).

In adjusted multivariate models, lower education (subdistribution hazard ratio [SHR], 0.73 [95% CI, 0.57-0.94]; P = .01), Black race (SHR, 0.61 [95% CI, 0.46-0.80]; P < .001), area deprivation index national rank (SHR 1.00 [95% CI 0.99-1.00]; P = .009), and male sex (SHR, 0.73 [95% CI, 0.56-0.94]; P = .02) were associated with membership in the group without TBI. Sensitivity analyses using a broader definition of TBI yielded similar results.

Conclusions and Relevance In this longitudinal cohort study of older adults, almost 13% experienced incident TBI during the 18-year study period. For older adults who seek care for TBI, race and ethnicity, sex, and SDOH factors may be associated with incidence of TBI, seeking medical attention for TBI in older adulthood, or both.
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The word VITAMIN does not occure once in the PDF

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21+ VitaminDWiki pages with "Traumatic Brain Injury OR TBI" in the title

This list is automatcially updated

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TBI while in ICU: a single dose of 120,000 IU helped a lot - RCT March 2020

• Neuroprotective Role of Oral Vitamin D Supplementation on Consciousness and Inflammatory Biomarkers in Determining Severity Outcome in Acute Traumatic Brain Injury Patients: A Double-Blind Randomized Clinical Trial

- https://doi.org/10.1007/s40261-020-00896-5  PDF

GCS = Glasgow outcome scale
GOSE = Glasgow Outcome Scale Extended

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17,200 Google Scholar hits for search of "Traumatic brain injury" ("Vitamin D" OR Omega-3)

Google Scholar Feb 2024

• Omega-3 polyunsaturated fatty acids alleviate early brain injury after traumatic brain injury by inhibiting neuroinflammation and necroptosis - March 2023 https://doi.org/10.1515/tnsci-2022-0277 FREE PDF
• Optimal vitamin D level ameliorates neurological outcome and quality of life after traumatic brain injury: a clinical perspective - Sep 2021 https://doi.org/10.1080/00207454.2021.1924706 Behind paywall
• The More, the Better: High-Dose Omega-3 Fatty Acids Improve Behavioural and Molecular Outcomes in Preclinical Models in Mild Brain Injury - July 2021 https://doi.org/10.1007/s11910-021-01132-z FREE PDF
• Chapter 10 - Vitamin D level and the outcome after traumatic brain injury - 2023 https://doi.org/10.1016/B978-0-323-89835-5.00009-0 PDF is behind a paywall
  • Paucity of vitamin D significantly affects the consequences of a brain injury. Deficiency of vitamin D along with traumatic brain injury (TBI) elevates the risk of severity of the injury. This possibly affects the therapeutic regimen prescribed for TBI which may have a negative effect on its outcome. Pre-clinical trials suggested that the levels of vitamin D influence the recovery and outcome after a TBI. Vitamin D deficiency has been found to cause more deterioration in patients with severe TBI than in the ones with mild TBI. This clearly validates the necessity of screening the levels of vitamin D in neural deficit in order to reduce the risk of morbidity, neurocognitive disorders, osteomalacia, and cardiovascular disease. This review focuses on the incidence of vitamin D deficiency in TBI and how it affects the recovery and subsequent quality of life of the patient.
• The Effect of Omega-3 Fatty Acids on Recovery from Traumatic Brain Injury - Dec 2019 PHD Dissertation

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VitaminDWiki founder has kept emergency vitamin D in all of his vehicles since 2017

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351 items in – Trauma and surgery category:

Trauma and Surgery category has 351 articles

Large dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
Sepsis is both prevented and treated by Vitamin D - many studies
Thyroidectomy and Vitamin D - many studies
Orthopaedic surgeries need Vitamin D – many studies
Cancer - After diagnosis   chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Superbug (Clostridium difficile) Infections strongly associated with low vitamin D - many studies
Glutamine and Omega-3 have also been proven to help several traumas/surgeries
   Note: Vitamin D also prevents the need for various surgeries and Omega-3 prevents many concussions/TBI
Trauma and Surgery is associated with 22 other VitaminDWiki categories
  Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022

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TBI ==> 7X more Substance Abuse in US soldiers - Aug 2023

MDEdge

• "But the sharpest difference was the increase in substance use disorder among those with TBI, which rose 100% compared with a 14.5% increase in solders with no history of TBI."

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The Standard Advice for Concussions Is Wrong (therapy does actually help) - Oct 2023

6 month to recover after falling off of a horse, The Atlantic

• "The statistic of 3.8 million Americans a year gets bandied about, sometimes linked to mild head injuries from sports and other times to brain injuries of all kinds. Falls, recreational activities, car crashes, and domestic violence all can cause head trauma."
• "Six months after falling off the horse, my final, lingering symptom—the feeling of pressure in my head when I’d been working for too long—went away. I recovered but was left wondering why it had taken so much time for me to be routed to the care that I needed. I’ll never know if I would have gotten better without it, but I suspect recovery would have, at the very least, taken much longer. Why had I—a patient with a brain injury—been the one sifting through scientific papers and online support groups rather than getting these referrals from my doctor? In our American health-care system, many patients are expected to be their own advocates, but in this case, when a better, clearer path to recovery is so well established, it seems like that should have been unnecessary."
  • Consensus statement on concussion in sport - June 2023 https://doi.org/10.1136/bjsports-2023-106898 FREE PDF

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$500,000 study to reduce use of Opioids for TBI Headache (igoring Vitamin D, etc.) Aug 2023

NFL & Players Association Award $500K to Investigators Studying Alternatives to Opioids for Post-Traumatic Headache TrialSiteNews

• Update on Non-Pharmacological Interventions for Treatment of Post-Traumatic Headache - Oct 2022 https://doi.org/10.3390/brainsci12101357 FREE PDF
• Evaluation of current post-concussion protocols - Sept 2020 https://doi.org/10.1016/j.biopha.2020.110406 FREE PDF
  • ...Antioxidants, certain B vitamins, omega-3 fatty acids, vitamin D, progesterone,...
• Racial Differences in Head Pain and Other Pain-Related Outcomes After Mild Traumatic Brain Injury Aug 2023 https://doi.org/10.1089/neu.2022.0415
  • more pain in A-A (dark skin is associated with lower vitamin D)

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NFL has required extra-padded helmets during practice since 2022 (cut TBI in half)

In 2024 The NFL is "allowing" use of the helmets during actual games Wired Magazine
One can hope that the NFL in the future will notice that taking vitamin d and/or omega-3 reduces TBI severity and recovery time
Suspect that they also prevent TBI.

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