Prophylactic and Post-acute use of Progesterone and its Enantiomer to Improve Outcomes Associated with Concussion
The essential elements of this invention include: 1) nasal delivery of progesterone or its enantiomer for prophylactic use to improve outcomes associated with concussion, 2) the use of both compounds as molecular neuroprotectants and effective treatments post-acutely.
An estimated 300,000 sports-related cases of Traumatic Brain Injury's (TBI), of mild (MTBI) to moderate severity, most of which can be classified as concussions, occur each year in the United States. The proportion of these concussions that are repeat injuries is unknown; however, there is an increased risk for subsequent TBI among persons who have had at least one previous TBI. Brain injury causes Lesions that appear and change over time in the prefrontal cortex and its pathways to the older regions of the brain. This can result in the wide spectrum of complex neurobehavioral complaints following MTBI: compulsive and explosive behavior, sensory anomalies, memory loss, as well as behavioral dis-inhibition, domestic violence, and alcohol intolerance. Worse, repetitive head injuries, even minor ones, can have serious repercussions including permanent brain damage or death.
Due to the lack of a consistent definition, the economic costs of MTBI are not known, but they are estimated to be very high ($5 billion). These high costs are due in part to the large percentage of hospital admissions for head injury that are due to mild head trauma, however, indirect costs such as lost work time and early retirement account for the bulk of the costs. These direct and indirect costs cause the expense of mild brain trauma to rival that of moderate and severe head injuries.
A 1999 study of college football players found that their learning disorders and reduced neuropsychological performance were independently associated with multiple concussions. Verbal learning and memory appeared to be the most sensitive components in athletes with concussions. A survey of retired professional football players found that 60% had suffered at least one concussion during their careers, and 26% reported three or more concussions. Significantly fewer neurological symptoms were reported from players who had no concussions.
A growing body of data suggests that those who suffer repetitive head injuries in sports may be at a greater risk for neurodegenerative diseases later in life. The cumulative damage from successive concussions can increase the risk of premature senility, Alzheimer's disease, and Parkinson's disease.