Every year, some 1.7 million Americans suffer a traumatic brain injury (TBI).
And that statistic makes TBI the leading cause of traumatic death and disability in the U.S.
Anything that can help TBI victims’ prognoses and families – and save billions in rehab and long-term care costs – should be pursued aggressively.
Omega-3s from fish – especially DHA – hold real promise. The justification for urgent clinical testing of DHA in brain injuries just increased.
Fish oil may have rescued a teenager’s brain
Last month, CNN reported the case of Virginia teenager Bobby Ghassemi, who, in 2010, suffered a very serious brain injury in a car crash.
His mother paraphrased what Bobby’s doctors told her, “It is a miracle that he lived, that he made it. If he comes out of the coma … I don’t know if he’s going to be a vegetable for the rest of his life or whether he’ll remember anybody.” (CNN 2012)
As Bobby lay comatose, his parents were desperate for anything that might improve his condition and grim prognosis.
Ten days later his father, Peter Ghassemi, called a series of friends and ultimately found U.S. Army Colonel Michael Lewis, M.D., who’s been researching omega-3s’ effects on suicide in soldiers.
Dr. Lewis surprised Bobby’s father with his proposal…convince the doctors to feed the 17-year-old intravenous (IV) fish oil.
He later advised the family, and as he told CNN, “I’m looking at the [hospital’s] reports, and they report a Glasgow Coma Score of 3. A brick or a piece of wood has a Glasgow Coma Score of 3. It’s dead.” (CNN 2012)
Yet, after receiving IV fish oil, Bobby enjoyed a remarkably strong, rapid recovery…one presaged by a more famous case.
Last August, Drs. Hibbeln and Lewis published a paper about Bobby’s case, in The American Journal of Emergency Medicine.
And these excerpts from its summary make a strong, succinct case for both expedited clinical research and for the FDA to permit safe, “compassionate” use of fish oil in TBI patients (Lewis M et al. 2012):
- “Here, we present a case that was intentionally treated with substantial amounts of omega-3 fatty acids to provide the nutritional foundation for the brain to begin the healing process following severe TBI.”
- “Recent animal research supports the use of omega-3 fatty acids, and clinical experience suggests that benefits may be possible from substantially and aggressively adding omega-3 fatty acids to optimize the nutritional foundation of severe TBI patients and must be in place if the brain is to be given the opportunity to repair itself to the best possible extent.”
- “Administration early in the course of treatment, in the emergency department or sooner, has the potential to improve outcomes from this potentially devastating public health problem.”
Teen’s case and miner’s “miracle” share scientific support
This Virginia teenager’s unusually robust, rapid recovery echoes a story that made headlines five years ago.
Back in 2007, doctors were desperate to help Randal McCloy, the sole survivor of the Sago Coal Mine disaster in West Virginia, who suffered serious brain damage from carbon monoxide exposure.
McCloy’s neurosurgeon – Julian Bailes, M.D., of West Virginia University – decided to throw a “Hail Mary pass,” in the form of hyperbaric oxygen treatment and intravenous fish oil.
The stricken miner had almost no measurable brain activity until Bailes’ team started giving him fish oil through a tube in order to deliver large doses of omega-3 fatty acids.
Dr. Barnes said that he believes the miner’s brain function was spared and restored only by his doctors’ unprecedented decision.
As he told Men’s Health magazine, “The omega-3s helped rebuild the damaged gray and white matter of his brain. I would say he should be on it for a lifetime. But then, I think everybody should.”
Of the two omega-3s essential to human life and health – DHA and EPA – DHA is by far the most critical to brain function.
This explains why brain cell membranes are rich in DHA…so much so that this omega-3 fat constitutes the biggest single component of the human brain, by weight.
Dr. Barnes’ belief in DHA’s importance to people’s diets is reflected in a series of related studies conducted in recent years.
Omega-3s’ potential to help humans has support from basic research
The idea that omega-3s can help protect and heal the human brain enjoys substantial support from a growing body of lab evidence.
Last June, we were privileged to see Queen Mary University scientist Adina Michael-Titus, D.Sc., present the amazing results of her team’s research into the ability of omega-3 DHA to reduce the effects of spinal injuries and enhance recovery.
In 2006, her team reported that competing omega-6 fats actually worsen outcomes of spinal injuries:
“This report shows a striking difference in efficacy between the effects of treatment with omega-3 and omega-6 PUFAs [fatty acids] on the outcome of SCI [spinal cord injury], with omega-3 PUFAs being neuroprotective and omega-6 PUFAs having a damaging effect.” (King VR et al. 2006)
Her team also found that the sooner injured animals got DHA, the stronger the protection, and that continued feeding of DHA enhanced long-term recovery. (See “Curry Spice + Omega-3 Curbed Spine Injuries in Rats”.)
We also saw a presentation by Professor Nicolas Bazan, M.D., Ph.D., of Harvard University, whose lab reported that omega-3s protect rats against stroke damage.
Now, Bobby Ghassemi’s story adds weight to the notion that omega-3s protect our noggins.
Because lab research renders its remarkable outcome – like that of miner McCloy’s case – biologically plausible, it should prompt urgent research by the U.S. National Institutes of Health (NIH) and Department of Defense.
These two cases should also prompt the FDA to grant a “compassionate use” permit to administer omega-3 DHA to brain-injured patients as the agency has partially, slowly done for premature babies living on IV nutrition (see “Preemies Saved by Omega-3s, FDA Drags Feet”).
Sources
•Akbar M, Calderon F, Wen Z, Kim HY. Docosahexaenoic acid: a positive modulator of Akt signaling in neuronal survival. Proc Natl Acad Sci U S A. 2005 Aug 2;102(31):10858-63. Epub 2005 Jul 22. Erratum in: Proc Natl Acad Sci U S A. 2005 Sep 6;102(36):12997.
•Barringer N, Conkright W. Omega-3 Fatty Acid Ingestion as a TBI Prophylactic. J Spec Oper Med. 2012 Fall;12(3):5-7.
•Bazan NG. Neuroprotectin D1 (NPD1): a DHA-derived mediator that protects brain and retina against cell injury-induced oxidative stress. Brain Pathol. 2005 Apr;15(2):159-66. Review.
•Calderon F, Kim HY. Docosahexaenoic acid promotes neurite growth in hippocampal neurons. J Neurochem. 2004 Aug;90(4):979-88. Erratum in: J Neurochem. 2004 Sep;90(6):1540.
•Cao D, Kevala K, Kim J, Moon HS, Jun SB, Lovinger D, Kim HY. Docosahexaenoic acid promotes hippocampal neuronal development and synaptic function. J Neurochem. 2009 Oct;111(2):510-21. Epub 2009 Aug 13.
•Dyall SC, Michael-Titus AT. Neurological benefits of omega-3 fatty acids. Neuromolecular Med. 2008;10(4):219-35. Epub 2008 Jun 10. Review.
•Florent S, Malaplate-Armand C, Youssef I, Kriem B, Koziel V, Escanyé MC, Fifre A, Sponne I, Leininger-Muller B, Olivier JL, Pillot T, Oster T. Docosahexaenoic acid prevents neuronal apoptosis induced by soluble amyloid-beta oligomers. J Neurochem. 2006 Jan;96(2):385-95. Epub 2005 Nov 21.
•Gladman SJ, Huang W, Lim SN, Dyall SC, Boddy S, Kang JX, Knight MM, Priestley JV, Michael-Titus AT. Improved outcome after peripheral nerve injury in mice with increased levels of endogenous ω-3 polyunsaturated fatty acids. J Neurosci. 2012 Jan 11;32(2):563-71.
•Hall JC, Priestley JV, Perry VH, Michael-Titus AT. Docosahexaenoic acid, but not eicosapentaenoic acid, reduces the early inflammatory response following compression spinal cord injury in the rat. J Neurochem. 2012 Jun;121(5):738-50. doi: 10.1111/j.1471-4159.2012.07726.x. Epub 2012 Apr 12.
•He C, Qu X, Cui L, Wang J, Kang JX. Improved spatial learning performance of fat-1 mice is associated with enhanced neurogenesis and neuritogenesis by docosahexaenoic acid. Proc Natl Acad Sci U S A. 2009 Jul 7;106(27):11370-5. Epub 2009 Jun 22.
•Högyes E, Nyakas C, Kiliaan A, Farkas T, Penke B, Luiten PG. Neuroprotective effect of developmental docosahexaenoic acid supplement against excitotoxic brain damage in infant rats. Neuroscience. 2003;119(4):999-1012.
•Huang WL, King VR, Curran OE, Dyall SC, Ward RE, Lal N, Priestley JV, Michael-Titus AT. A combination of intravenous and dietary docosahexaenoic acid significantly improves outcome after spinal cord injury. Brain. 2007 Nov;130(Pt 11):3004-19. Epub 2007 Sep 27.
•Kim HY, Akbar M, Kim KY. Inhibition of neuronal apoptosis by polyunsaturated fatty acids. J Mol Neurosci. 2001 Apr-Jun;16(2-3):223-7; discussion 279-84. Review.
•Kim HY, Akbar M, Kim YS. Phosphatidylserine-dependent neuroprotective signaling promoted by docosahexaenoic acid. Prostaglandins Leukot Essent Fatty Acids. 2010 Apr-Jun;82(4-6):165-72. Epub 2010 Mar 5.
•Kim HY, Akbar M, Lau A, Edsall L. Inhibition of neuronal apoptosis by docosahexaenoic acid (22:6n-3). Role of phosphatidylserine in antiapoptotic effect. J Biol Chem. 2000 Nov 10;275(45):35215-23. Kim HY, Akbar M, Lau A. Effects of docosapentaenoic acid on neuronal apoptosis. Lipids. 2003 Apr;38(4):453-7.
•Kim HY, Moon HS, Cao D, Lee J, Kevala K, Jun SB, Lovinger DM, Akbar M, Huang BX. N-Docosahexaenoylethanolamide promotes development of hippocampal neurons. Biochem J. 2011 Apr 15;435(2):327-36.
•Kim HY. Biochemical and biological functions of docosahexaenoic acid in the nervous system: modulation by ethanol. Chem Phys Lipids. 2008 May;153(1):34-46. Epub 2008 Mar 2. Review.
•King VR, Huang WL, Dyall SC, Curran OE, Priestley JV, Michael-Titus AT. Omega-3 fatty acids improve recovery, whereas omega-6 fatty acids worsen outcome, after spinal cord injury in the adult rat. J Neurosci. 2006 Apr 26;26(17):4672-80.
•Lewis M, Ghassemi P, Hibbeln J. Therapeutic use of omega-3 fatty acids in severe head trauma. Am J Emerg Med. 2012 Aug 3. [Epub ahead of print]
•Lewis MD, Hibbeln JR, et al. Suicide Deaths of Active-Duty US Military and Omega-3 Fatty-Acid Status: A Case-Control Comparison. Journal of Clinical Psychiatry. 2011 August 23. [Epub ahead of print]
•Lim SN, Huang W, Hall JC, Michael-Titus AT, Priestley JV. Improved outcome after spinal cord compression injury in mice treated with docosahexaenoic acid. Exp Neurol. 2012 Sep 28. pii: S0014-4886(12)00377-9. doi: 10.1016/j.expneurol.2012.09.015. [Epub ahead of print]
•Lim SN, Huang W, Hall JC, Ward RE, Priestley JV, Michael-Titus AT. The acute administration of eicosapentaenoic acid is neuroprotective after spinal cord compression injury in rats. Prostaglandins Leukot Essent Fatty Acids. 2010 Oct-Dec;83(4-6):193-201. Epub 2010 Sep 15.
•Michael-Titus AT. Omega-3 fatty acids and neurological injury. Prostaglandins Leukot Essent Fatty Acids. 2007 Nov-Dec;77(5-6):295-300. Epub 2007 Nov 26. Review.
•Robson LG, Dyall S, Sidloff D, Michael-Titus AT. Omega-3 polyunsaturated fatty acids increase the neurite outgrowth of rat sensory neurones throughout development and in aged animals. Neurobiol Aging. 2010 Apr;31(4):678-87. Epub 2008 Jul 14.
•Walczewska A, Stępień T, Bewicz-Binkowska D, Zgórzyńska E. [The role of docosahexaenoic acid in neuronal function]. Postepy Hig Med Dosw (Online). 2011 Jun 2;65:314-27. Review. Polish.
•Ward RE, Huang W, Curran OE, Priestley JV, Michael-Titus AT. Docosahexaenoic acid prevents white matter damage after spinal cord injury. J Neurotrauma. 2010 Oct;27(10):1769-80. Epub 2010 Oct 6.
