Two million Americans suffer a moderate to severe traumatic brain injury (TBI) each year. In addition, current military action is resulting in a large spike in the number of additional TBI cases. These injuries produce enduring disabilities that include cognitive, sensory, motor and emotional impairments. The associated health care costs from these injuries can be staggering. Confounding this major public health issue is the fact that currently there are no pharmacological treatment options for patients who have suffered a TBI. One potential cause of these failures is the lack of preclinical assessment of dosing factors (e.g., treatment windows, dose responses, and mechanism studies);in addition, preclinical studies are rarely performed in animals over 4-5 months of age. We have recently demonstrated that administration of nicotinamide, vitamin B3 (B3), following cortical contusion injury (CCI) and fluid percussion injury (FPI) resulted in a significant improvement in the recovery of sensorimotor and cognitive function, as well as in a reduction of many of the secondary pathophysiological changes that occur following injury (e.g., neurodegeneration, edema formation and reactive gliosis). However, when B3 was investigated in middle-aged (14 month old) rats following CCI, we found that the preclinical effectiveness observed in the young rats did not occur in the middle-aged rats. This is a unique and troubling finding because few studies, if any, have addressed the potential preclinical efficacy of novel therapies in the middle-age or aged rodent populations. This age range would account for a large number of TBI patients in the clinical setting. If the treatment looses efficacy in the aged population, then the clinical trial might be more likely to fail. Thus, the primary objectives of this proposal are aimed at the continued examination of B3 in aged rats following TBI.
The specific aims of this study are to: 1) Determine the age window at which B3 treatment looses efficacy following TBI in rats;2) Determine the effect of B3 treatment on NAD/NADH metabolism following TBI at different age points.;3) Evaluate the preclinical efficacy of sustained infusion of B3 in middle-aged rats (14-month old);4) Compare B3 treatment following bilateral frontal CCI to treatment with progesterone (Prog) (currently in Phase II trials and has been shown to be effective in aged rats) and to the combination of both in middle-aged rats. By examining many of these clinically relevant factors (e.g., dosing regimens, long-term behavioral outcomes, and potential mechanisms) in aged subjects, we hope to build a strong case for the potential translation of B3 into clinical trials. It is also hoped that these investigations will shed light on our initial findings demonstrating reduced efficacy with B3 therapy in middle- aged rodents.

Public Health Relevance

Two million Americans suffer a moderate to severe traumatic brain injury (TBI) each year which can produce enduring disabilities that include cognitive, sensory, motor and emotional impairments. The associated health care costs from these injuries are staggering for the families and the general public. It is hoped that the research included in this proposal will help offset this major public health crisis by helping to identify a potential therapy for TBI.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Academic Research Enhancement Awards (AREA) (R15)
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Brain Injury and Neurovascular Pathologies Study Section (BINP)
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Hicks, Ramona R
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Southern Illinois University Carbondale
Schools of Arts and Sciences
United States
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Vonder Haar, Cole; Peterson, Todd C; Martens, Kris M et al. (2016) Vitamins and nutrients as primary treatments in experimental brain injury: Clinical implications for nutraceutical therapies. Brain Res 1640:114-129
Vonder Haar, Cole; Smith, Travis R; French, Eric J et al. (2014) Simple tone discriminations are disrupted following experimental frontal traumatic brain injury in rats. Brain Inj 28:235-43
Martens, Kris M; Vonder Haar, Cole; Hutsell, Blake A et al. (2013) The dig task: a simple scent discrimination reveals deficits following frontal brain damage. J Vis Exp :
Vonder Haar, Cole; Emery, Michael A; Hoane, Michael R (2012) Chronic folic acid administration confers no treatment effects in either a high or low dose following unilateral controlled cortical impact injury in the rat. Restor Neurol Neurosci 30:291-302
Hoane, Michael R; Swan, Alicia A; Heck, Sarah E (2011) The effects of a high-fat sucrose diet on functional outcome following cortical contusion injury in the rat. Behav Brain Res 223:119-24
Swan, Alicia A; Chandrashekar, Rupa; Beare, Jason et al. (2011) Preclinical efficacy testing in middle-aged rats: nicotinamide, a novel neuroprotectant, demonstrates diminished preclinical efficacy after controlled cortical impact. J Neurotrauma 28:431-40
Vonder Haar, Cole; Anderson, Gail D; Hoane, Michael R (2011) Continuous nicotinamide administration improves behavioral recovery and reduces lesion size following bilateral frontal controlled cortical impact injury. Behav Brain Res 224:311-7
Goffus, Andrea M; Anderson, Gail D; Hoane, Michael (2010) Sustained delivery of nicotinamide limits cortical injury and improves functional recovery following traumatic brain injury. Oxid Med Cell Longev 3:145-52
Kuypers, Nicholas J; Hoane, Michael R (2010) Pyridoxine administration improves behavioral and anatomical outcome after unilateral contusion injury in the rat. J Neurotrauma 27:1275-82
Quigley, Andrea; Tan, Arlene A; Hoane, Michael R (2009) The effects of hypertonic saline and nicotinamide on sensorimotor and cognitive function following cortical contusion injury in the rat. Brain Res 1304:138-48

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