Most Effective Interventions for Enhancing Neural Plasticity for Functional Recovery in Patients with Traumatic Brain Injury

Author(s): Ambria Pogue and Devendra K. Agrawal

Traumatic brain injury (TBI) is a major global health concern and one of the leading causes of disability worldwide. Outcomes of this injury range from full recovery to lifelong cognitive, physical, and psychological impairments. Management of TBI remains challenging due to the variety of symptoms and severity, as well as the complexity of the underlying cellular mechanisms. In addition, the lack of standardized treatment protocols contributes to the uncertainty of recovery. This article explores current evidence of the most effective interventions in improving function in patients with TBI. Acute management focuses on patient stabilization, tight control of intracranial pressure, and seizure prophylaxis. Long-term recovery, however, is dependent on a multidisciplinary approach including compensatory cognitive training with supported employment and social communication therapy, which have been shown to accelerate return to work and social reintegration. In addition, structured exercise, dietary modifications, and environmental enrichment have proven to be helpful. Novel therapeutic therapies including neuromodulation techniques and regenerative medicine strategies show promise in enhancing neuroplasticity and repairing injured neural tissue. Although encouraging, these treatments remain experimental, and no FDA approved disease modifying agents exist currently. Future progress will likely center around advancing these novel interventions as well as developing reliable biomarkers to help assess injury severity, predict prognosis, and guide individualized treatment planning.