A new study carried out by military veterans suggested that sound sleep plays a critical role in healing traumatic brain injury.

The study, published in the Journal of Neurotrauma, employed a new method involving magnetic resonance imaging developed at Oregon Health & Science University.

For the study, the authors used MRI to examine the enlargement of perivascular spaces that surround blood vessels in the brain. Enlargement of these spaces happens during aging and is linked to the development of dementia.

The findings of the study indicated that those who slept poorly had more evidence of these enlarged spaces and more post-concussive symptoms.

"This has huge implications for the armed forces as well as civilians," said lead author Juan Piantino, M.D., MCR, assistant professor of pediatrics (neurology) in the OHSU School of Medicine and Doernbecher Children's Hospital.

Piantino added: "This study suggests sleep may play an important role in clearing waste from the brain after traumatic brain injury—and if you don't sleep very well, you might not clean your brain as efficiently."

The researchers noted that their novel technique measures changes in the brain's perivascular spaces, which are part of the brain's waste clearance system known as the glymphatic system.

"We were able to very precisely measure this structure and count the number, location, and diameter of channels," Piantino said.

The researchers revealed that, during sleep, this brain-wide network clears away metabolic proteins that would otherwise build up in the brain.

The study used data collected from a group of 56 veterans enrolled by co-authors Elaine Peskind, M.D., and Murray Raskind, M.D., at the Mental Illness Research, Education and Clinical Center at the VA Puget Sound between 2011 and 2019.

"Imagine your brain is generating all this waste and everything is working fine. Now you get a concussion. The brain generates much more waste that it has to remove, but the system becomes plugged," Piantinio elaborated further.

Piantino said the new study suggests the technique could be useful for older adults. "Longer term, we can start thinking about using this method to predict who is going to be at higher risk for cognitive problems including dementia," he said.

Improving sleep is a modifiable habit that can be improved through a variety of methods. This includes better sleep hygiene habits such as reducing screen time before bed, Piantino added.

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