Traumatic brain injury (TBI) accounts for significant global health burden. Effects of TBI can become chronic even following mild injury. There is a need to develop effective therapies to attenuate the damaging effects of TBI and improve recovery outcomes. This literature review using a priori criteria (PROSPERO; CRD42018100623) summarized 43 studies between January 1998 and July 2019 that investigated nutritional interventions (NUT) delivered with the objective of altering neurophysiological (NP) outcomes following TBI. Risk of bias was assessed for included studies, and NP outcomes recorded. The systematic search resulted in 43 of 3,748 identified studies met inclusion criteria. No studies evaluated the effect of a NUT on NP outcomes of TBI in humans. Biomarkers of morphological changes and apoptosis, oxidative stress, and plasticity, neurogenesis, and neurotransmission were the most evaluated NP outcomes across the 43 studies that used 2,897 animals. The risk of bias was unclear in all reviewed studies due to poorly detailed methodology sections. Taking these limitations into account, anti‐oxidants, branched chain amino acids, and ω‐3 polyunsaturated fatty acids have shown the most promising pre‐clinical results for altering NP outcomes following TBI. Refinement of pre‐clinical methodologies used to evaluate effects of interventions on secondary damage of TBI would improve the likelihood of translation to clinical populations.

中文翻译：

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改善创伤性脑损伤后神经生理损伤的营养干预：系统评价

创伤性脑损伤 (TBI) 是全球重大的健康负担。即使在轻度损伤后，TBI 的影响也会变成慢性。需要开发有效的疗法来减轻 TBI 的破坏性影响并改善康复结果。这篇使用先验标准 (PROSPERO; CRD42018100623) 的文献综述总结了 1998 年 1 月至 2019 年 7 月期间的 43 项研究，这些研究调查了旨在改变 TBI 后神经生理学 (NP) 结果的营养干预 (NUT)。对纳入研究的偏倚风险进行了评估，并记录了 NP 结果。系统搜索导致 3,748 项确定的研究中有 43 项符合纳入标准。没有研究评估 NUT 对人类 TBI NP 结果的影响。形态变化和细胞凋亡、氧化应激和可塑性的生物标志物，在使用 2,897 只动物的 43 项研究中，神经发生和神经传递是评估最多的 NP 结果。由于方法学部分不够详细，所有审查的研究中的偏倚风险都不清楚。考虑到这些局限性，抗氧化剂、支链氨基酸和 ω-3 多不饱和脂肪酸已显示出最有希望改变 TBI 后 NP 结果的临床前结果。改进用于评估干预措施对 TBI 继发性损伤的影响的临床前方法将提高转化为临床人群的可能性。抗氧化剂、支链氨基酸和 ω-3 多不饱和脂肪酸已显示出最有希望改变 TBI 后 NP 结果的临床前结果。改进用于评估干预措施对 TBI 继发性损伤的影响的临床前方法将提高转化为临床人群的可能性。抗氧化剂、支链氨基酸和 ω-3 多不饱和脂肪酸已显示出最有希望改变 TBI 后 NP 结果的临床前结果。改进用于评估干预措施对 TBI 继发性损伤的影响的临床前方法将提高转化为临床人群的可能性。