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Sugar as a therapeutic target for the cognitive restoration following traumatic brain injury

Kumar, Amita,b,c

doi: 10.1097/WCO.0000000000000752
TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida
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Purpose of review This review aims to discuss examples of changes in glucose (sugar) metabolism after traumatic brain injury (TBI). It will attempt to provide an understanding of what changes in glucose metabolism mean for the injured brain. It will further identify potential therapeutic target(s) emanating from our growing understanding of glucose pathways and their roles in TBI.

Recent findings Although a significant fraction of glucose is utilized for the energy production in the brain, a small fraction is utilized in other, often ignored pathways. Recent studies have unraveled unexpected biological effects of glucose through these pathways, including redox regulation, genetic and epigenetic regulation, glycation of proteins, nucleotide synthesis and amino acid synthesis.

Summary A number of regulatory players in minor glucose metabolic pathways, such as folate and chondroitin sulfate proteoglycans, have recently been identified as potential targets to restore cognitive functions. Targeting of these players should be combined with the supplementation of alternative energy substrates to achieve the maximal cognitive restoration after TBI. This multimodal therapeutic strategy deserves testing in various models of TBI.

Video abstract: Supplemental digital video content 1: Video that demonstrates an effective therapeutic strategy for the cognitive restoration after TBI. http://links.lww.com/CONR/A46.

aBurke Neurological Institute

bBrain and Mind Research Institute

cDepartment of Neurology, Weill Cornell Medicine, New York, New York, USA

Correspondence to Amit Kumar, PhD, Burke Neurological Institute, 785 Mamaroneck Avenue, White Plains, New York, NY 10605, USA. Tel: +1 914 368 3120; e-mail: amk3001@med.cornell.edu

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-neurology.com).

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