About this Research Topic
Brain injuries, whether due to trauma, cardiac arrest, ischemia-reperfusion, or other etiological factors, remain one of the unresolved challenges not only for neurology but for the entire medical science.
Regardless of the causal event of the lesion, the progression and outcomes of brain lesions are based on specific pathophysiological mechanisms of the nervous system, which generate neuropathological features and clinical symptoms common not only to brain injury but also to the most widespread neurodegenerative diseases.
Neither the management of patients in the acute phase nor the therapeutic strategies currently available in the outcome and/or rehabilitation phase, guarantee that the often-ominous development and evolution of brain damage can be arrested, if not even reversed.
This leads, in a large percentage of patients, to develop lifelong functional deficits and disabilities affecting both sensory-motor and cognitive functions.
Ultimately, the fate of a person who suffers the medium- and long-term consequences of a severe brain injury may be the reliance, for survival and daily life, on the care of relatives and/or specialized personnel, having no prospects for functional improvement and generating significant social burden as well as personal and indirect suffering.
The development of innovative therapies, both pharmacological and non-pharmacological, should purpose at limiting the consequences described above and eventually at recovering lost functions.
This presupposes that therapeutic approaches must aim both at the protection of the components of the central nervous system, be they neurons, glial cells or vascular networks, and at the reactivation/replacement of the cellular functions and neural networks possibly lost following brain injury.
The pursuit of neuroprotection can be achieved through interventions that improve, among others, perfusion and oxygenation and favor mitochondrial function, dampening oxidative stress, which limits the development of neuroinflammation and prevents the deleterious consequences of its chronicization, which contrast the adaptive mechanism that leads to the accumulation of aggregates proteins, such as those generated from amyloid or tau protein, which allow for less production and accumulation and greater elimination of toxic byproducts.
On the other hand, neuro-repair strategies should be based on synergic interventions aimed at restoring interrupted neuro-circuits or replacing them by exploiting the redundancy and plasticity of the nervous system.
With these very clear goals in mind, neurologists, neuroscientists, pharmacologists, and bioinformaticians are producing a remarkable and promising amount of knowledge, concerning the action of new possible pharmacological principles, the efficacy of unconventional drug delivery to the brain, the development of bio-engineering technologies for stimulating the functions and plasticity of the nervous system, the creation of computational tools supporting the clinical-prognostic needs and boosting the development of effective therapies.
In this Research Topic, we welcome contributions on the following themes related to brain injury:
- Epidemiology, the actual standard of care, and research on biomarkers.
- Preclinical Pharmacology: animal models, validation of novel drug targets, the mechanism(s) of drug action, innovative methods for drug delivery to the brain.
- Computational research: modeling of diffusion/propagation of brain damage, network-based analysis to dissect brain injury proteomics/genomics, development of PD/PK models for brain pharmacology.
- Non-pharmacological therapies: research on and application of neuroprosthetics, transcranial direct or pulsed current stimulation, transcranial magnetic stimulation, neurofeedback, and the possible combinatorial approaches with pharmacological interventions.
- Clinical Trials.
Regardless of the causal event of the lesion, the progression and outcomes of brain lesions are based on specific pathophysiological mechanisms of the nervous system, which generate neuropathological features and clinical symptoms common not only to brain injury but also to the most widespread neurodegenerative diseases.
Neither the management of patients in the acute phase nor the therapeutic strategies currently available in the outcome and/or rehabilitation phase, guarantee that the often-ominous development and evolution of brain damage can be arrested, if not even reversed.
This leads, in a large percentage of patients, to develop lifelong functional deficits and disabilities affecting both sensory-motor and cognitive functions.
Ultimately, the fate of a person who suffers the medium- and long-term consequences of a severe brain injury may be the reliance, for survival and daily life, on the care of relatives and/or specialized personnel, having no prospects for functional improvement and generating significant social burden as well as personal and indirect suffering.
The development of innovative therapies, both pharmacological and non-pharmacological, should purpose at limiting the consequences described above and eventually at recovering lost functions.
This presupposes that therapeutic approaches must aim both at the protection of the components of the central nervous system, be they neurons, glial cells or vascular networks, and at the reactivation/replacement of the cellular functions and neural networks possibly lost following brain injury.
The pursuit of neuroprotection can be achieved through interventions that improve, among others, perfusion and oxygenation and favor mitochondrial function, dampening oxidative stress, which limits the development of neuroinflammation and prevents the deleterious consequences of its chronicization, which contrast the adaptive mechanism that leads to the accumulation of aggregates proteins, such as those generated from amyloid or tau protein, which allow for less production and accumulation and greater elimination of toxic byproducts.
On the other hand, neuro-repair strategies should be based on synergic interventions aimed at restoring interrupted neuro-circuits or replacing them by exploiting the redundancy and plasticity of the nervous system.
With these very clear goals in mind, neurologists, neuroscientists, pharmacologists, and bioinformaticians are producing a remarkable and promising amount of knowledge, concerning the action of new possible pharmacological principles, the efficacy of unconventional drug delivery to the brain, the development of bio-engineering technologies for stimulating the functions and plasticity of the nervous system, the creation of computational tools supporting the clinical-prognostic needs and boosting the development of effective therapies.
In this Research Topic, we welcome contributions on the following themes related to brain injury:
- Epidemiology, the actual standard of care, and research on biomarkers.
- Preclinical Pharmacology: animal models, validation of novel drug targets, the mechanism(s) of drug action, innovative methods for drug delivery to the brain.
- Computational research: modeling of diffusion/propagation of brain damage, network-based analysis to dissect brain injury proteomics/genomics, development of PD/PK models for brain pharmacology.
- Non-pharmacological therapies: research on and application of neuroprosthetics, transcranial direct or pulsed current stimulation, transcranial magnetic stimulation, neurofeedback, and the possible combinatorial approaches with pharmacological interventions.
- Clinical Trials.
Keywords: Brain injury, Neuropharmacology, Neuro-rehabilitation, Brain Plasticity, Neuromodulation
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