Diabetes drug may fight traumatic brain injury
Health Scan: Promising discovery can help researchers find best combination of meds to minimize the lasting impact.
Scientists in a laboratory Photo: iStockphoto
Although the death toll in people who suffer from traumatic brain injury (TBI)
is relatively low, it can have severe, lifelong consequences for brain
TBI can impair a patient’s mental abilities, impact memory and
behavior and lead to dramatic personality changes. In addition, the long-term
medical treatment carries a high financial cost.
In research commissioned
by the US Air Force, Prof.
Chaim Pick of Tel Aviv University’s Sackler
Faculty of Medicine and Dr. Nigel Greig of the US National Institute of Aging
have discovered that Exendin-4 – an FDA-approved diabetes drug – significantly
minimizes damage in TBI animal models when administered shortly after the
Originally designed to control sugar levels in the
body, the drug has recently been found effective in protecting neurons in
disorders such as Alzheimer’s disease.
Pick’s collaborators include his
TAU colleagues Dr. Vardit Rubovitch, Lital Rachmany-Raber and Prof. Shaul
Schreiber, and Dr. David Tweedie of the US institute.
in the journal Experimental Neurology, this “breakthrough” is the first step
toward developing a cocktail of medications to prevent as much brain damage as
possible following injury, the team said.
Pick has been researching TBI
for many years, beginning with the effects of everyday injuries such as hitting
the windshield in a car accident. As a result of his work for the US military,
he has expanded his research to include trauma sustained when someone is exposed
to an explosion, such as during a terrorist attack.
TBI causes long-term
damage by changing the chemistry of the brain. During an explosion, increased
pressure followed by an intense vacuum shakes the fluid inside the brain and
damages the brain’s structure. This damage can’t be reversed, but mapping the
injury through behavioral and physical tests is crucial to understanding and
quantifying the damage and forming a therapy- or medication- based treatment
The TAU team designed a pre-clinical experiment that exposed mice
to controlled explosions from eight and 11 meters away and then analyzed the
resulting injuries. They also studied the effect of Exendin-4 as an additional
parameter in minimizing brain damage. They divided the mice into four groups: a
control group; a second group that was exposed to the blast without medication;
a third group that received the medication but was not exposed to the blast; and
a fourth group, exposed to the explosion and given the medication within an hour
after the blast and continuing for seven days afterwards. (The mice were placed
under anesthesia before the explosion so they would not suffer.) Behavioral and
physical tests showed that the mice that were exposed to the blast had severely
impaired brain function compared to the control group. However, the mice that
had also received the Exendin-4 treatment were almost on a par with the control
group in terms of brain function, proving that Exendin-4 significantly reduced
the long-term damage done by an explosion. In separate experiments, the drug was
also associated with an improved outcome in mice who sustained TBI by blunt
Pick says this promising discovery can help researchers find the
ideal combination of medications to minimize the lasting impact of TBI. “We are
moving in the right direction.
Now we need to find the right dosage and
delivery system, then build a cocktail of drugs that will increase the
therapeutic value of this concept,” he explains. He adds that in treating such
traumatic injuries, one drug is unlikely to be sufficient.
With numerous Israeli medical centers around the country building new
wings and even whole new buildings, it would be worthwhile for administrators to
take into account research on how courtyard gardens and other aesthetic touches
– including the inclusion of animals – are important to the well-being and
recovery of patients. The Israeli Hebrew-language edition of Scientific American
reported in its latest issue that scientific research has proven such elements
are beneficial to patients (and probably also to hospital staffers). San
Francisco medical writer Deborah Franklin, whose article was translated by the
magazine, said that the greener such hospital facilities are, the
Bushes, trees that provide shade and flowers that gladden the eye
have shown to be desirable, especially if they attract birds. Realistic statues
are also loved by patients, as are wide and meandering paths that are made of
dark materials (so they don’t blind patients in the sun). Plants and trees that
emit pleasant scents and can be safely touched are preferable, and doors to the
courtyards should not be so heavy that it’s difficult for people to open
Having such places within the hospital grounds where patients can
“escape” to speeds up recovery from surgery, infection and disease in general.
The research proving these statements were randomized, controlled studies. If
such touches cannot be added to old buildings, even hanging large photos of
nature spots such as a running stream or a shady forest speeds up recovery of
heart surgery patients, the article reported, and were much more effective than
abstract paintings or drawings.
FOLLOW YOUR DREAMS
How often do you
encourage others to pursue their dreams? How often do you feel caught up in
daily hassles that keep you from following your own dreams? Dr. Rachel Barkan of
Ben-Gurion University of the Negev and Prof.
Shai Danziger of Tel Aviv
University have been trying to understand why it is always easier said than
done. Their research, funded by the Israel Science Foundation, examines the
differences between choice and advice in a wide variety of situations. In a new
research paper Danziger, Barkan and their student, Ronit Montal, demonstrate
that advisers tend to promote idealistic options while choosers tend to opt for
pragmatic options. The paper was recently published in the prestigious Journal
of Personality and Social Psychology.
“It’s a matter of seeing the forest
for the trees,” Barkan explains. “The advice we give is not anchored in the
choice we would make. When we give advice, we don’t consider what we would have
done in the same situation. Instead, our role as adviser distances us from the
dilemma at hand.
From afar, we see the forest. We consider long-term
goals that are worthy and desirable. As advisers, we overlook the trees and
discount obstacles and impediments on the way to this goal. As choosers,
however, we can’t avoid seeing the trees – sometimes to the extent of losing the
forest. As choosers, our mindset is oriented toward implementation and we give
more weight to concrete details of feasibility and pragmatism.
conducted a series of six studies showing that – compared with choosers –
advisers weigh idealistic considerations more heavily than pragmatic ones, place
greater emphasis on goals (“why?” questions) than on means to achieve the goals
(“how?” questions) and generate more reasons in favor of acting idealistically.
Advisers do not put themselves in the chooser’s position before offering advice
(unless specifically asked to). Finally, studies confirmed that choice-advice
difference was present in consequential reallife decisions.
between the idealistic desire to follow our dreams and the pragmatic
considerations that hold us back resembles the experience you go through looking
at the famous picture of the young/old woman. You see the young woman for a
moment, but then the old lady jumps in,” says Barkan. “You can’t keep a steady
image of one of them for very long, and you can’t see both of them at the same
Then how can people follow their dreams? One answer lies in the
findings, Barkan says: “It takes two. Not one person juggling two hats, but
actually two people – a believer and a doer. They may fight throughout the
journey, but if they share a dream they have a better chance of making it a
reality together than apart.”