Cell therapy attempted as a novel approach for chronic traumatic brain injury - a pilot study

Alok Sharma, Hemangi Sane, Pooja Kulkarni, Jayanti Yadav, Nandini Gokulchandran, Hema Biju, Prerna Badhe, Alok Sharma, Hemangi Sane, Pooja Kulkarni, Jayanti Yadav, Nandini Gokulchandran, Hema Biju, Prerna Badhe

Abstract

Traumatic brain injury is an injury to the brain parenchyma resulting from external factors such as vehicular accidents, falls, or sports injuries. Its outcome involves primary insult followed by a cascade of secondary insult, resulting in diffuse axonal injury further causing white matter damage. Surgical intervention targets the primary damage, whereas only few treatment alternatives are available to treat the secondary damage. Cellular therapy could be one of the prospective therapeutic options, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. We conducted a pilot study on 14 cases who were administered with autologous bone marrow mononuclear cells, intrathecally. The follow up was done at 1 week, 3 months and 6 months after the intervention. The Functional Independence Measure scale, the SF-8 Health Survey Scoring and the disability rating scale were used as outcome measures. These scales showed a positive shift in scores at the end of 6 months. Improvements were observed in various symptoms, along with activities of daily living. Improvement in PET CT scan performed before and 6 months after the intervention in 3 patients corresponded to the clinical and functional improvements observed in these patients. The results of this study suggest that cell therapy may promote functional recovery leading to an improved quality of life in chronic TBI. Although the results are positive, the improvements after cell therapy are not optimal. Hence, additional multicenter, controlled studies are required to establish cell therapy as a standard therapeutic approach.

Keywords: Autologous; Bone marrow; Cellular therapy; Intrathecal; Mononuclear cells; PET CT scan; Traumatic brain injury.

Figures

Figure 1
Figure 1
Graph representing symptomatic improvements in traumatic brain injury after cell therapy.
Figure 2
Figure 2
Graph representing the mean values of pre and post physical components and mental components of SF8 health survey scoring.

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