MICHAEL D. LEWIS*
*Corresponding author
Brain Health Education and Research Institute, 10004 Weatherwood Court, Potomac, Maryland, 20854, USA

Abstract

Traumatic brain injury and concussions (TBI), with its diverse heterogeneity and prolonged secondary pathogenesis, remains a clinical challenge. Current medical management of brain injured patients lacks clinically proven effective management with neuroprotective and neuroregenerative agents. Clinical studies thus far have failed to identify an effective treatment strategy as they typically have targeted single enzymatic factors in an attempt to identify a pharmacologic target rather than considering multiple mechanisms of injury with a more holistic approach. A combination of targets controlling aspects of neuroprotection, neuroinflammation, and regeneration is needed. Omega-3 fatty acids (n-3FA) offer the advantage of a poly-target approach. Although further clinical trial research is needed to establish the true advantage of using n-3FA, there is a growing body of strong preclinical evidence and clinical experience suggests that benefits may be possible from aggressively adding substantial amounts of n-3FA to optimize the nutritional foundation of TBI patients. With evidence of unsurpassed safety and tolerability, administration of substantial and optimal doses of n-3FA early in the course of TBI has the potential to improve outcomes from this potentially devastating public health problem.

INTRODUCTION

Omega-3 polyunsaturated fatty acids (n-3FA), particularly decosahexanoic acid (DHA), are structural components of cell membranes, most concentrated in the brain and retina. Emerging science on the ability of n-3FA to be beneficial to the nervous system during and after acute traumatic brain injury (TBI) is acknowledged, mainly in preclinical studies, but now in clinical experience and case reports. TBI has long been recognized as a leading cause of traumatic death and disability. TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Over 3.5 million known TBI’s occur annually, approximately 52,000 deaths, and more than 300,000 hospitalizations in the United States alone. TBI is often classified using mild, moderate, and severe categories. It is believed that 80-95 percent of all TBI are mild, often labeled as a “concussion” and are not seen in hospital settings (1). TBI, most often from falls, vehicle accidents, and violence, is a major healthcare concern, constituting a major cause of death and disability not just in the United States, but throughout the world. M ...