Pharmacological treatments for brain-injury repair: Progress and prognosis

It has been only within the last 10 years that research on treatment for central nervous system (CNS) recovery after injury has become more focused on the complexities involved in promoting recovery from brain injury when the CNS is viewed as an integrated and dynamic system. There have been major advances in research in recovery over the last decade, including new information on the mechanics and genetics of metabolism and chemical activity, including the definition of excitotoxic effects and the discovery that the brain secretes complex proteins, peptides, and hormones that are capable of directly stimulating the repair of damaged neurons or blocking some of the degenerative processes caused by the injury cascade. Many of these agents, plus other non-toxic, naturally occurring substances, are being tested as treatment for brain injury. Further work is needed to determine appropriate combinations of treatments and optimum times of administration with respect to the time course of the CNS disorder. Understanding the mechanisms underlying traumatic brain injury and repair must eventually come from a merging of the findings of neurochemical alterations in the whole brain with data from intensive behavioural testing, which will determine the meaning of these findings. For optimum treatment strategies, we also need testing procedures and definitions used in connection with treatment for brain injury.