Nurture Integrative Health

Neurometabolic Cascade: An Introduction

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Neurometabolic Cascade: An Introduction

March is Brain Injury Awareness Month. 

So we are focusing our attention on an important brain health event, Neurometabolic Cascade. 

Have you heard of it? Probably not. Unless you, or someone you love, have been treated for a Brain Injury even then maybe not. Neurometabolic Cascade is pathophysiology, or the disordered physiological processes, associated with mild to severe traumatic brain injury.

Today I’ll map out the Cascade with brief descriptions of what is happening following a head injury or traumatic event, such as a car accident. Over the next few weeks, we will come back and dive deeper into each step of the Neurometabolic Cascade and offer some tips and treatments for managing them.

The cascade that occurs:

  1. An energy crisis occurs. The brain’s mitochondria lose the ability to produce ATP (or energy). This can last up to 7-10 days.
  2. Cytoskeletal damage occurs because of the force neurons and glial cells, and can damage surrounding structures. This can lead to persistent symptoms.
  3. Axonal Dysfunction occurs. Axons (a part of the neuron) are vulnerable to mechanical force. After a TBI these axons can shorten impacting neurotransmission and cognition.
  4. Altered Neurotransmission occurs. This can lead to heightened anxiety states, depression, impaired cognition because of the disruption in glutamate and GABA production.
  5. Inflammation During inflammation, the brain’s microglia become activated. These microglial create a more inflammatory environment that can lead to long-term symptoms.
  6. Oxidative Stress occurs along with the altered neurotransmission, energy crisis, and cell death. It is important to address this as it can lead to long-term damage and symptoms.
  7. Cell Death: Depending on the severity and location of the injuries can range in magnitude and can lead to severe complications like Dementia and Parkinson’s.

Photo and research credit: Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014 Oct;75 Suppl 4(0 4):S24-33. doi: 10.1227/NEU.0000000000000505. PMID: 25232881; PMCID: PMC4479139.