Neurosteroids and Traumatic Brain Injury: Translating Biomarkers to Therapeutics; Overview and Pilot Investigations in Iraq and Afghanistan Era Veterans

In: Translational Research in Traumatic Brain Injury. Boca Raton (FL): CRC Press/Taylor and Francis Group; 2016. Chapter 7.


Neurosteroids are endogenous molecules that are enriched in the brain (where they can be synthesized de novo from cholesterol) and also produced in the adrenals, gonads, and other peripheral tissues. Many neurosteroids demonstrate pleiotropic actions that are potentially relevant to traumatic brain injury (TBI) and its therapeutics. This chapter will provide an overview of preclinical data supporting a role for neurosteroids in TBI, followed by a summary of clinical studies to date involving neurosteroids and TBI. Next, the development of neurosteroids as both biomarker candidates and treatment interventions will be discussed. Initial data examining neurosteroid alterations in Iraq and Afghanistan era veterans with a history of blast-related TBI will be presented, and a theoretical framework for the translation of these biomarker efforts to clinical endeavors will be provided. Results from a pilot proof-of-concept neurosteroid intervention in mild TBI will be presented as an example of a potential biomarker-informed translational model, followed by a synopsis of this area and discussion of future directions.

Publication types

  • Review