See BI Series: Sleep Disruption, TBI, and Long-Term Effects with Olga (Niki) Kokiko Cochran, Ph. D., The Ohio State University’s CBI Program

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Have you ever wondered what the long term effects of your brain injury will be? We know that brain injury is a risk factor to developing types of dementia like Alzheimer’s. BUT not all who have brain injury get dementia. Today in our See BI segment, we are joined by The Ohio State University’s CBI researcher Olga (Niki) Kokiko Cochran to discuss TBI + what = Alzheimer’s. Could sleep disruption in TBI have chronic effects that lead to long term neurodegenerative consequences? Listen to learn more about the emerging research on this topic.

We are super excited to announce our series: SEE BI! in partnership with The Ohio State’s CBI Program. The Ohio State Chronic Brain Injury program (CBI) works on improving our understanding, detection, and treatment of brain injuries through research and community partnership. Over the next few months, we’ll be chatting with brain injury researchers about their work and findings in the brain injury field. We are honored to be joining with them to bring you this educational series!!!

Covered in this episode:

  • Chronic outcomes after brain injury
  • How does the experience of traumatic injury set the stage for neurodegenerative disease?
  • If you experience traumatic brain injury your risk of developing dementia or Alzheimer’s is higher
  • BUT traumatic brain injury doesn’t cause brain injury
  • In Nikki’s lab they wonder, Brain injury + what= Alzheimer’s
  • Mouse models used for her research
  • Models used mimic different types traumatic brain injury
  • Trauma is induced on mouse brains several different ways which allows researchers to study and explore
  • They need to carefully select which type of mouse model to use to most closely mimic the population they hope to study
  • Niki’s Research
  • Niki’s initial research focused on giving mice who have a genetic predisposition to Alzheimer’s disease a traumatic brain injury. Her hypothesis was that brain injured mice would have a worse pathology (worse Alzheimer’s). This was not true at all. The brain injured mice did not do worse and in some cases did better.
  • What they did see was that the inflammatory response to traumatic brain injury was different in mice genetically predisposed to Alzheimer's. That suggested that the presence of pathological proteins that predispose you to Alzheimer’s (which causes inflammation) was changing the inflammatory response from the traumatic brain injury.
  • This got Niki thinking about brain injury + what= Alzheimer’s
  • Niki started thinking about common symptoms seen in TBI and Alzheimer’s--sleep disruption is present in both.
  • Could sleep disruption be the stressor that predisposes brain injured people to Alzheimer’s?
  • Brain injury alone can cause sleep disruption. Then you have other life stressors (positive or negative) that disrupt sleep. How does this combination impact your brain function?
  • Sleep disruption is a common symptom of any type of stress. In Niki’s lab, they look at how sleep disruption, which is a common physiological consequence to stress, complicates recovery after brain injury.
  • To research the connections, the researchers disrupt the brain injured mice’s sleep. Their models mimic humans who have trouble falling asleep and staying asleep. The mice are only disrupted for four hours at a time. After the 4 hours, they are no longer disrupted and can sleep as much as they need to. They are not sleep deprived, only disrupted.
  • They study the effects of this sleep fragmentation through:
  • Behavioral testing:They test the mice to see how the stress of sleep disruption affects their cognitive performance--their tests look at the mouse’s spatial memory, information processing, motor function, and aspects of anxiety.
  • Tissue analysis: looking for inflammatory changes and hallmarks of Alzheimer’s disease and other neurodegenerative diseases (axonal damage, cell loss, microglial activity)
  • Measuring the quality and type of sleep
  • Early findings of sleep disruption with brain injury
  • REM sleep seems to be vulnerable to sleep disruption
  • Cognitive deficits occur especially on days that the animals get sleep fragmentation
  • When animals are allowed to recover for 7 days after 7 days of sleep disruption; they see that the animals have positive changes (i.e. they are able to recover from the effects of sleep disruption)
  • Neuronal activity is compromised in the hypothalamus and other areas of the brain that are susceptible to stress
  • The hippocampus is affected which means that the animal’s spatial awareness and memory are affected
  • The brain’s inflammatory response is changed but doesn’t necessarily exaggerate what the brain injury alone has done
  • The light at the end of the tunnel is that our brain’s do have the ability to recover
  • We need to consider the effect of chronic stress and chronic sleep disruption--chronic stress leads to poorer outcomes
  • They have work to do with figuring out where the line is that causes permanent consequences. Where is the boundary between acute and recoverable and long term consequences of stress?
  • Summary-sleep disruption does alter stress pathways, results in behavioral changes, and alters inflammation. We still need more information to know what that means long term.
  • They do not see a complete loss of REM sleep in their brain injured mouse models. Their mice only represent certain types of injury so they cannot make sweeping statements about REM sleep and all brain injuries.
  • Early takeaways
  • The timing of sleep disruption matters
  • There is an ability to recover
  • Sleep disruption is a stressor to the brain
  • Sleep disruption changes inflammatory response and has cognitive and behavioral effects
  • Brain injury and development of Alzheimer’s
  • In the lab they can ask questions and test what it takes for a genetic predisposition to turn into Alzheimer’s disease. This is a field of ongoing study.
  • Protect your sleep. Strategies to help:
  • CBD oil to help calm
  • Meditation
  • Yoga nidra
  • No screens before bed
  • Reading
  • Stress management
  • Acknowledge the stressors in your life--it can be positive and negative experiences that cause stress and influence your sleep
  • Identify what works for you
  • Find support from others
  • Examine what the root causes of your stress are
  • Prioritize--is it worth it? Can it go? Does it make you happy? Does it add value to my life?
  • Are you adding more pressure to yourself than is needed?
  • The lab exists to elevate the quality of life that brain injury survivors have.

Links to any resources mentioned:

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