We recently checked in with one of our partners, the Department of Neuroscience at Tufts University School of Medicine. A portion of all funds that Sail For Epilepsy raises flows through to our partners, supporting community activities and research. We spoke with one of the scientists who heads a research lab which investigates the mechanisms underlying various forms of epilepsy.
Dr. Chris Dulla is a tenured Associate Professor of Neuroscience and runs a very active research laboratory that focuses on epilepsy and its causes. His long-term goal is to identify new mechanisms that cause with the hope that these discoveries will lead to new therapies for epilepsy.
In our conversation with Dr. Dulla we were intrigued by his research and his laboratory setting. His laboratory trains Ph.D. students enrolled in the Neuroscience graduate program, postdoctoral fellows (they have already received their Ph.D.), laboratory technicians, and students who are at University studying for their bachelors degree. Chris is an excellent mentor for these trainees and has been awarded the Story Landis mentorship award from the National Institutes of Neurological Disorders and Stroke.
Funds that Sail For Epilpesy has provided to Dr. Dulla are supporting research into how traumatic brain injury (TBI) causes post-traumatic epilepsy. This is a question that is close to my own heart since, when I was 15, it was a head injury that caused my epilepsy. And still today, there are no treatments that a physician can provide in the emergency room that will reduce the probability that someone with a head injury may develop epilepsy. Head injuries result from many causes including car accidents, falls, or wounds obtained during combat and the probability of developing post-traumatic epilepsy is greatest with more severe injuries.
An excellent overview of TBI and epilepsy is provided here including discussions of treatment options, and the link between the severity of the head injury and likelihood of developed post-traumatic epilepsy
Dr. Dulla is particularly excited by this work because he and his lab colleagues have made new discoveries about how TBI leads to changes in the various cell types of the brain. “We are working with new therapeutic strategies that would change brain metabolism and how the brain uses energy to prevent epilepsy after TBI.” By delivering alternative energy sources it may be possible to prevent the development of post-traumatic epilepsy.
Such a result would be so exciting because 50% of those who develop epilepsy from a severe head injury do so in the first year post injury. The Centers for Disease Control (CDC) has estimated that about 1.5 million Americans survive a traumatic brain injury every year. Just imagine if changing their brain metabolism could positively affect their prognosis!
A little known but staggering fact about TBI and the development of post-traumatic epilepsy is that even though one has by all appearances made a full recovery from the initial injury, slow changes in the brain can lead to the onset of seizures after a significant latent period of 2 or more years after the head injury for 20% of those who develop post traumatic epilepsy.
Continued research into the mechanisms underlying the different causes of epilepsy is essential so that we can develop new drugs that could be used to treat people with epilepsy who do not respond to current medications. Better still, just imagine if the TBI research leads to a method to prevent the development of epilepsy in those who suffer a head injury!
Symptoms of TBI and Concussion
There are a range of Traumatic Brain Injuries (TBI) from mild, which occur following a concussion, to severe, for example, after a penetrating head injury (gunshot). TBI can result from a bump or a blow to the head, even if it is does not cause an overtly observable injury. Indeed, even a rapid change in speed that accompanies deceleration during a car crash can cause the brain to move in the skull much like Jello would move in a pan if the pan were tapped on the exterior, resulting in a mild TBI.
Severe TBI’s can lead to seizures within an hour, as occurred with my penetrating head injury, but there may be a significant delay in the onset of a resulting seizure. In some cases, this can be delayed for years after the accident.
Mild TBI or concussion can lead to a variety of symptoms that may last for weeks and that may change during recovery. For example, initially one might have headaches or dizziness, but later have sleep problems. The table beneath, obtained from the CDC, list some symptoms. Importantly, TBI does not necessarily cause subsequent seizures, but the risk of developing a seizure disorder and epilepsy increases with the severity of the TBI.
| Physical | Thinking and Remembering | Social or Emotional | Sleep |
|---|---|---|---|
| Bothered by light or noise | Attention or concentration problems | Anxiety or nervousness | Sleeping less than usual |
| Dizziness or balance problems | Feeling slowed down | Irritability or easily angered | Sleeping more than usual |
| Feeling tired, no energy | Foggy or groggy | Feeling more emotional | Trouble falling asleep |
| Heachaches | Problems with short- or long-term memory | Sadness | |
| Nausea or vomiting (early on) | Trouble thinking clearly | ||
| Vision problems |