Could Omega-3 Fatty Acids Help Reduce Sports-Related Mild Traumatic Brain Injury?
Yearly, around 1.4 million mild traumatic brain injuries, such as concussion, occur that are serious enough to require hospitalization or an emergency department visit. While some causes are related to falls and motor vehicle accidents, an estimated 2 to 3 million traumatic brain injuries are due to sports, the majority of which are not treated in a hospital or emergency department (information from the CDC). Many concussion injuries in sports cause only temporary and short-lived problems such as confusion, dizziness or nausea, and difficulty answering questions. In many cases, people may be able to return to the game after a short break, or at least return to the next game. Other mild traumatic brain injuries can be more serious and require weeks or months of rehabilitation for people to return to normal life. Despite recent growing awareness of sport-related traumatic brain injury, it seems that there are few options available at the moment to help people recover from concussion apart from plenty of rest and avoidance of physical or mental exertion.
A recent article by Cernkovich Barrett and colleagues looked at how brain-friendly omega-3 fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), could be important in reducing damage from injuries to the head in sports. These omega-3 fatty acids are part of the membrane structure of brain cells, and also play functional roles such as improving brain cell membranes fluidity and the function of molecules involved in sending signals between brain cells.
As DHA is a structural component of the brain, and as the DHA content of the brain is reduced after head injury (see Wu et al.), there may be an increased need for DHA in the brain to recover from injury. Several animal models, including the publication by Bailes and Mills, support the idea that supplemental DHA can reduce structural injury to the brain.
Another consequence of head injury is an increase in oxidative stress, which is related to damage to the brain cells disrupting cells’ normal metabolism, and causes further cell damage. Another publication by Wu and co-workers reports that DHA supplementation helps brain cells to normalize metabolic processes after injury, and prevents injury-related declines in levels of enzymes that clear away pro-oxidative molecules in the brain. Some researchers, such as Mills and associates, report that DHA supplementation can improve functional outcomes such as memory after traumatic head injury in animal models.
Although these results in animals are promising, further work is needed before we can recommend that sports players who show signs of concussion, or are likely to have concussion, take omega-3 supplements. Some carefully designed clinical studies are planned to see if omega-3 fatty acid is also effective in humans, for example in upcoming clinical trials NCT01814527 in younger adults, and NCT01903525 in adolescents. If these trials are successful, omega-3 supplements could be an important way to reduce brain injury in people unlucky enough to have received head trauma when playing sports.
Erin Cernkovich Barrett, Michael I. McBurney, and Eric D. Ciappio. ω-3 Fatty Acid Supplementation as a Potential Therapeutic Aid for the Recovery from Mild Traumatic Brain Injury/Concussion. Adv Nutr May 2014 5 3): 268-277; doi:10.3945/an.113.005280
Bailes JE, Mills JD. Docosahexaenoic acid reduces traumatic axonal injury in a rodent head injury model. J Neurotrauma. 2010 Sep;27(9):1617-24. doi: 10.1089/neu.2009.1239. http://www.ncbi.nlm.nih.gov/pubmed/20597639
CDC. Heads Up: Facts for Physicians About Mild Traumatic Brain Injury (MTBI). CS109152. 2009. http://www.cdc.gov/concussion/headsup/pdf/Facts_for_Physicians_booklet-a.pdf
Maron, Dina Fine. A Generation Loses Consciousness, and Grows More Conscious of Headbanging. May 13, 2014. Scientific American. http://www.scientificamerican.com/article/a-generation-loses-consciousness-and-grows-more-conscious-of-headbanging/
Mills JD, Hadley K, Bailes JE. Dietary supplementation with the omega-3 fatty acid docosahexaenoic acid in traumatic brain injury. Neurosurgery. 2011 Feb;68(2):474-81; discussion 481. doi: 10.1227/NEU.0b013e3181ff692b. http://www.ncbi.nlm.nih.gov/pubmed/21135750
Salem N Jr, Litman B, Kim HY, Gawrisch K. Mechanisms of action of docosahexaenoic acid in the nervous system. Lipids. 2001 Sep;36(9):945-59. http://www.ncbi.nlm.nih.gov/pubmed/11724467
Wu A, Ying Z, Gomez-Pinilla F. Dietary strategy to repair plasma membrane after brain trauma: implications for plasticity and cognition. Neurorehabil Neural Repair. 2014 Jan;28(1):75-84. doi: 10.1177/1545968313498650. Epub 2013 Aug 1. http://www.ncbi.nlm.nih.gov/pubmed/23911971
Wu A, Ying Z, Gomez-Pinilla F. Exercise facilitates the action of dietary DHA on functional recovery after brain trauma. Neuroscience. 2013 Sep 17;248:655-63. doi: 10.1016/j.neuroscience.2013.06.041. Epub 2013 Jun 28. http://www.ncbi.nlm.nih.gov/pubmed/23811071