Progesterone and Vitamin D Hormone as a Biologic Treatment of Traumatic Brain Injury in the Aged

• Type of Material: Article
• Authors: Donald G Stein, Emory University; Milos Cekic, Emory University
• Language: English
• Date: 2011-06
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pmrj.2011.03.010
• Title of Journal or Parent Work: PM&R
• ISSN: 1934-1482
• Volume: 3
• Issue: 6 0 1
• Start Page: S100
• End Page: S110
• Grant/Funding Information: Research described in this paper was supported by NIH grant no. 5R01HD61971 to DGS and a gift in support of research from H. Allen and company.; Dr. Donald Stein may receive research funding from BHR, which is developing products related to this research
• Keywords: Traumatic brain injury; aging; vitamin D; progesterone; recovery of function
• Research Categories: Health Sciences, Rehabilitation and Therapy; Health Sciences, Medicine and Surgery

Abstract

There is growing recognition that traumatic brain injury (TBI) is a highly variable and complex systemic disorder that is refractory to therapies that target individual mechanisms. It is even more complex in the elderly, in whom frailty, prior comorbidities, altered metabolism, and a long history of medication use are likely to complicate the secondary effects of brain trauma. Progesterone, one of the few neuroprotective agents that has shown promise for the treatment of acute brain injury, is now in national and international Phase III multi-center trial. New findings show that vitamin D hormone (VDH) and vitamin D deficiency in aging (and across the developmental spectrum) may interact with progesterone and TBI treatment. This paper reviews the use of progesterone and VDH as biologics based therapies and recent studies showing that the combination of progesterone and VDH may promote better functional outcomes than either treatment independently.