Psychedelic and nutraceutical interventions as therapeutic strategies for military-related mild traumatic brain injuries

Concussion is a type of acquired brain injury that is common in the military, as well as among civilians and contact sport athletes, and is defined by a transient impairment in mental function. Nevertheless, concussion presents a considerable health burden, and a small minority of people suffer from continued impairment. Repetitive sub-concussive head injury is a known risk factor for neurodegenerative disease, including dementias. Concussions are difficult to treat because symptom profiles vary, but psychedelic therapies may help address some of the neurological issues that occur after brain injury. Classic psychedelics show promise as an emerging pharmacological intervention because they appear to help the brain to rewire, and they have anti-inflammatory effects. Nutraceutical interventions are widely available, cost-effective, and well tolerated, and they could also support recovery when combined with psychedelic compounds. Here, studies presenting classical psychedelics and nutraceuticals that may be combined with psychedelics as therapeutic strategies for the treatment of concussions and persistent symptoms are discussed. Mild traumatic brain injury (mTBI), also referred to as concussion, is an acquired brain injury that is common in the military. mTBI results in alterations to brain function that are underpinned by a cascade of neuropathological and neurometabolic events that can result in excitotoxicity, oxidative stress, edema, neuroinflammation, and cell death. To date, traditional pharmaceutical therapies have been used with limited success to treat mTBI, leading to interest in the potential for psychedelic and nutraceutical therapies to alleviate the deleterious pathological sequelae that follow neurotrauma. An accumulating body of evidence supports research into the use of classic psychedelics and nutraceutical interventions for treating mTBI and concussion. This article highlights pre-clinical and clinical studies that show classic psychedelics are promising pharmacological interventions for mTBI because of their potent neuroplastic properties - including synaptogenesis and large-scale re-wiring, anti-inflammatory effects, and modulatory properties - on neural excitation and inhibition. The addition of nutraceutical interventions could also hasten recovery and improve general functioning along the spectrum from mild acute injury to long-term chronic issues (e.g., persistent post-concussive symptoms) and, potentially, to other forms of neurodegenerative disorders after neurotrauma and repetitive head injury. Le traumatisme craniocerebral leger (TCCL), egalement appele commotion cerebrale, est une lesion cerebrale acquise, frequemment observee chez les militaires. Le TCCL entraine des modifications de la fonction cerebrale qui sont renforcees par une cascade d'evenements neuropathologiques et neurometaboliques pouvant entrainer une excitotoxicite, un stress oxydatif, un oe deme, une neuroinflammation et la mort cellulaire. A ce jour, le succes des therapies pharmaceutiques classiques a traiter les TCCL demeure limite, ce qui suscite de l'interet pour le potentiel des therapies psychotropes et nutraceutiques a soulager les sequelles pathologiques deleteres qui suivent un neurotraumatisme. Des donnees toujours plus nombreuses encouragent la recherche sur l'utilisation des psychotropes et des interventions nutraceutiques dans le traitement des traumatismes craniocerebraux legers et des commotions cerebrales. Cet article signale des etudes precliniques et cliniques qui montrent que les psychotropes constituent des interventions pharmacologiques prometteuses pour les TCCL, en raison de leurs puissantes proprietes neuroplastiques - synaptogenese et recablage a grande echelle, effets antiinflammatoires et proprietes modulatrices, entre autres - agissant sur l'excitation et l'inhibition neuronales. Des interventions nutraceutiques complementaires pourraient egalement accelerer le retablissement et ameliorer le fonctionnement general, dans le spectre allant des blessures aigues legeres aux problemes chroniques a long terme (p. ex. les symptomes postcommotionnels persistants) et, potentiellement, pour d'autres formes de troubles neurodegeneratifs suivant un neurotraumatisme ou un traumatisme cranien repete.