Berkeley
Pharma Tech
Journal of Medicine
Traumatic Brain Injury-Induced
Parkinson's Disease:
An Analysis of the Potential Correlation
ΡॸǦƺΚƺǿƺ^ȖǓǓȒƺǏॹEƺǹǩǦƺ?Ǧƺǿॹ[ȅljǦǓǹǹǓ^ǦȠȣȠǩǿॹ^ȅЙƺXǩǓǏȖƺЙȠƺেKȖȠǩΦॹ
Tejaswini Govindaraman, Neha Ramachandran, Danielle McMillion,
Ariana Samimi and Diego Sandoval
Correspondence:
bhavana.sreepad@gmail.com
Keywords:
Parkinson’s Disease
Traumatic Brain Injury
Alpha-synuclein
Tyrosine hydroxylase
Dopamine
Image Credits: N/C
Abstract
Submitted July 7, 2021
Accepted August 28, 2021
Published December 17, 2021
Full Open Access
Creative Commons
Attribution License 4.0
Research findings on the correlation between Traumatic Brain Injury (TBI)
and the onset of Parkinson’s Disease (PD) are inconclusive. With PD affecting
thousands of individuals, it is imperative to determine a potential causal link.
The purpose of this literature review is to under-stand the validity and extent of
the relationship between TBI and PD by examining population demographics,
biological, sociological, and cognitive factors, as well as therapeutic treatments.
Previous research has found that the incidence of TBI can occur during the
prodromal period of PD, which is the period when symptoms of the disease begin to
show, though the directionality of the correlation between TBI and the onset of
PD requires a more in-depth investigation. Other findings include the overaccumulation of alpha-synuclein in the substantia nigra—a protein that
regulates vesicle trafficking—which is prominent in both patients with TBI and
those with PD. The presence of Tyrosine Hydroxylase from TBI has also been
proven to contribute to the decrease in dopamine seen in PD. Hippocampal
damage is present in patients who experience either PD or TBI, which leads to
cognitive decline. These findings indicate a positive correlation between TBI and
the subsequent onset of PD, and confirm the need for additional research to
develop new therapies for PD.
Introd ction
Pa
d ea e PD a ec
e e a d
e ec d
c
g e e e dege e a e d de af e A e e d ea e S
c de
e e
gd
g ga
a
ab
a d
ba a ce
T
e
a
ba a ce f
ed b
e dege e a
f
d a
e e
e b a a g a f e ba a ga g a
e
e
b a a d e de e
e
f Le
b de
c
e fe e
ba
ac
PD a
de c bed b Ja e Pa
T e
ca e f e dege e a
a c a ed
PD a
bee c e
ca
e a d
a
a e ce age f PD d ag e a e a b ed
ge e c fac
H e e PD a bee e
ed
a ca
ge e c
fac
c a a a c ba
Ta a c b a
TBI
ca
e
f
b
e e a f ce
e
c
a e
c g
e a d be a
a d
a c d ead b a
a
ge
C e e ea c e a d ded ega d g e e g
f
e c ea
be ee TBI a d e
e f PD A
c
e e
a a e
a
de g a c b g ca a d c g
e fac
e c da e e a e f
c ea
St dies on the Risk Factors for TBI and Parkinson s
Disease
TBI
ad
a
ga ed
c ca ca eg e
a d
g
e
e e f e e
a d eac ca eg
e a
ead
e dege e a
Ye
e ea c e e
a a e e
ac
e e e TBI
I
ce
e ea c a bee c d c ed
a e
de a e TBI
g be a c a e ge f e ea c e
H e e
g e ea c f
d a d e e e TBI
a bee de e
ed a e a
f TBI ca e
e U ed S a e e
f
fa a d
e c e acc de
Re ea c e a a ed de g a
da a f
e Na
a Ta
f
a e
e e age
fa a d
e c e e a ed
ca e
e ec e
F
e
de
a ed a ad
f d c ea ed
e
c ea ed
f e e e c g
c e a
a
a
c
ec
a a a
c d c
c a d e ca e f
g eg
a Da a Ba
NTDB be ee
f
d TBI I a de e
ed a
e acc
ed f
a d
f TBI
e a e g TBI
c e e e e
e
ea age a ge ad ab
a
e e
ea
d ad ea a e f d
c e Re ea c e de ed
ce a d
g e ca e S
a a
ed b Ma da e a de
ed
Berkeley Pharma Tech Journal of Medicine | 27
TBI e a ed
a d c a ge a d f
d e
TBI be fa a d a c c de
I ece
bee a f f
a c acc de
fa a e
e a e ca e f
ea
e e
ee a
f e e ca e f TBI
O
e
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fac
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f PD
e f
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A ge
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age
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ed
e
e f PD T e e ea c e
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ge
e de a a
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g
d
a
e a ce T e de
ed ge e a e a a ed a d c
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a e ee a e a
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PD
Q ad e a . de
ed a
a
LRP
c
e
be
ed
e
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ed
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ad a fa
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LRP
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e DNA f
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gge
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e e a e ed a
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d a e g e
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e
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ce f a g a
ea
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PD a e c
a ed
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ca c
a e a e ce a
PD
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c
Re ea c e a e f
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a
a e
f c ea ed e a e
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a e
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PD a d
TBI
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ed
d
e ea c ed e e ec
fb
TBI a d a a a e
e
c ca e
da age
e d ge e
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ga
a e
PD Re ea c e
e
a ed a
f d c ea e
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f de e
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a e
e e e ced TBI f
e
g e c ea
be ee
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d ea e I c
a
e e a
g e c b ed e ec
f b
aa a e
e a d TBI e ea c e
ced a
ee f d
c ea e
A d
a f
e b a a ed e e d g b de
a g
a TBI a d a a a e
e ed a
d a
e gc e
a d
Berkeley Pharma Tech Journal of Medicine | 28
c
c e
eb a
c ea ed a
c a ec
a
c e acc
c a ac e c
a
f PD
a d
a
a
Demographics
Age a d ge de a e
e
be g ca fac
e c de ce f TBI
a d
e de e
e
f PD
W e e ea c g e de g a c
da a e a g
e e d ea e
d e a e bee gea ed
a d e ea c g
e de g a c f TBI a d PD d d a
a e
a
e
ea
eac
e A d a a
g e c a ac e c f a e
PD f
d a e age ad ed c de ce a e f PD a g e
e
a
e a
e
e
a d
e
e
e ec e I c de ce a e a d e a e fe a e a
c ea ed
a d af e
ea f age T e ea age f d ag
a
ea f
b
e a d
e
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e e d ag ed e a a ge age a ge
ea
a
e
ea F
e a a
f
d c de ce
ae f
e
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a d
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f be g
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gge g a
d ag ed
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age Re ea c e a
g
d
g
e e a e ce f d a c PD a
g d ee
ac a
g
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d be d ag ed
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de age a H a c a d A a Pac c I a de a d a g
de
age a Af ca A e ca W e ad
g f age a d ge de
c de ce
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g H a c f
ed b
H a c
W e A a Pac c I a de
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e
c
a
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be
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e b ed c de ce a e
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a d
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Re ea c e a
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a
e e g
be de e A a Pac c I a de c
e c de ce
f PD a g e
e
a
e b
f d
Re ea c e
a e f
d c ea
a fac
e de e
d c d c ed b Haa a e a
e a
e age f
e ec e
A
f PD
efe e
a
e
g e de ce
g
ge de a a
e a d e e
f PD
. A ca e
f
d
e
be
ea
de a
e
e ea age be g
a d
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a
a d
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Berkeley Pharma Tech Journal of Medicine | 29
e H e e
e
ee
a e age
ea
de a
a ge de ba ed d e e ce
e ded
be de a
a
a d e
d
a
ge
c
a ed
e
d ag ed
PD e d
b
ae e d
a e a
c
a ed
e f
e
d e e ce be ee
ae a d
de g a c fac
ea g
e age a d ge de f a e
A c
ec
a
A b a
Med ca
de g a c c a
e U ed S a e T
ea f age
fe a e
g
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a
e age f
e ee
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e ea c
a c c ded
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e e g ca
W e
e
e e ed g e
aa d a
e
a d e e e ced
e d ea e
O e
de a e
a
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e be g
e
c
c ea ed
f ea e c
ca
g
e b g ca a d
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c
fe a e a e
PD
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TBI e ea
a e d ega d g da a
d a a ed da a f
e Na
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Ca e S e NHAMCS a d c ec ed
ac e c f de a e
a ed
e a e age age f a e d ag ed
f
eeW e a d
f
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a
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a
d TBI
d TBI a
ee
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eea
b e ed
c ea e
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d e ae a
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de ad a
c de ce a e f
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e
S ce e a e f
e
a d de
e e ae f
e be ee
ea
f age TBI a bee f
d
be
e
e
de age g
Re ea c e f
d a
e
ed e
ED f TBI a a a e f
e
e
e e
ed a a a e
f
e
e
A
e c a ac e c a e ea c e
e ga ed a ge g a c eg
d g a
e a ed d ag ed
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e c
a
e a ed
be
d TBI
e
ea e a d e e
eg
f e U ed S a e T e d ag
f
TBI a
e e ae
e e c a a d e
e ae
e
a dMd e c
a ed
e
ea eg
f e U ed S a e T
da a
e e
d be e e ed
ca
a
e a e gge ed
a e CDC c de f de ec g
d TBI a e
e
a d
d
TBI ca be de d ag ed
A e
ec e c
d a a ed
da a
de ad
f
e O a A ca
fC
Ca e
Acce Ce e
OACCAC
e ca e da aba e I
e e e
c de ce f TBI a
g a e
f a
g ed ca
e e
a a a
e ace a d age g
e e b e ed e a e ea e d f
Berkeley Pharma Tech Journal of Medicine | 30
I e ga
f
d a
e
ad
a ed a TBI
e d b
O ea
e a ca
ee f
a
g TBI a d e e a g
c d g ae a e
g
c ea g age ed ca
e e be g d ed a d a
I a
e
d
e ed ca da a f Ca f
a a e
de
e e d ag ed
TBI b
PD a e
g
de
e e
be a e a e g e
c e
e e
c e
e c
a ed
a e
TBI a
ad a e a
d be ee
f ab g a
g PD
ea
TBI e e
a d g e
a NTT
M e e a e
TBI e e
e e
be d ag ed
e
PD a a e
NTT T e a e age
e
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a
ea f TBI a e
e
ea f NTT a e
a d
f e
a af b
e TBI a d NTT g
a ca ed b fa Pa e
PD ad a a e age age f
ea
d
be g fe a e a d
be g
e Da a
ed a c de ce a e f TBI a
g ac a g
a
g e a
g W e f
ed b H a c A a a d Af ca
A e ca Ca e f TBI e e f
d
c ea e
ea
ee ee
c de
f TBI
e
e
a e
e ee ee
ca e f TBI
e g e
ea e
a e Re ea c e a
ed a
TBI a a c a ed
a
c ea ed
f PD d ag
af e a g
ad ed f de g a c a ab e age e ace c e e c T da a
gge ed a
c ea ed
f PD a c a ed
TBI c
a ed NTT
S
a
e ea c e f
d a
e
f be g d ag ed
PD
c ea e
e e e
a d f e e c f TBI
d g
a
e ca a a c a
Pre alence of TBI in patients ith PD
C
ad c g e de ce e
ega d g e a ca g ca ce f e
a ca
be ee TBI a d e
f de e
g PD
TBI e a ed
e e ge c
a e c ea ed
ece
ea
e U ed S a e
age ad ed a e
g c ea e f
e
e
e
e
Sa ca e a
a c e
a
c ea e PD c de ce
ece decade W
e e c ea g a e
bec e e e
e e e
a e
e e
ee
a c ea
be ee PD a d TBI
Rece
de e
e de
g ca
d e a e c ed a ac f c e a
be ee
e
e
f PD a d e e e ead
O e d a a ed e ed ca
Berkeley Pharma Tech Journal of Medicine | 31
ec d f e Da
a
ea a d de
ee
a ed
f
ead a a f
Of e
ca e e
g
a a
a e de e ed PD
c
f
e ca e e e
aea d
ca e e e fe a e T e ea age
a
e
a
f
ae a d
f fe a e
Rega d g e e e
f TBI Ra e
a f
d a
e ea age f
a
g
de a e
e e e TBI
ea
a e
a
a f a e
d ag ed
d TBI
ea
I a
d b S a ge be g e a
e e ec ed
be
f
a c a
de e ed PD
a
g a e e e ead
a
e
e
D e
ee e
e
d c c ded a
ee a
c ea
be ee PD
a d
e e e ead
a
g ad
S
a
Ra e a f
d
g ca
a e
fc ea
be ee TBI
a d PD
e ad F
a
C e e
e
d e a e b e ed a c e a
be ee PD
a d
TBI A ca e c
d c
g f
f
d a ead
e ee
a c a ed
a ee f d c ea e PD
e ead
e
a e a
a d
fc c
e
ee
e
g a c a ed
e
e f
PD T e e e
gge
a
d
de a e c ed ead
a
c ea e PD
I a a
b e ed a e
f PD c ea ed
e
fe e c a d e e
f e ead
S
a a d b B e
e a c
b a ed
a
e e ea c e f
d a
de a e e e e
d ag e f TBI e e c e a ed
a
c ea ed PD
S
a
W ee a f
da
f da d
f d c ea e PD
Ve e a
A a
ea ca e fac e
a e
d ag ed
d TBI a d
de a e TBI e ec e
d ca g a c e a
be ee
c ea ed
c de ce a e a d e e e
f TBI
B e e a a dW ee
a a
b e ed a
be a ca
be ee PD
a d TBI
e
de
D
g
e a e e e ega d g e e a e ce a d de g a c
f PD a d TBI
e de
ed e
b
fa a
g TBI d e
PD I a d c d c ed De a
a e
e ef
d
a ea
g e
f de e
g PD f e
a ed a ead
e
a
ea bef e e d ag
a da e e
g e
f e TBI a
a ed
ee
PD d ag
D e
ac f c e a
e
e
ea
d R gb e g e a c c ded a e e a
c ea
be ee
ead
a d PD I fac R gb e g e a
e
ed e
b
f PD d ced TBI d e
PD a e
e de c
a e a
e eac
e
De a ed eac
e a e d c f PD
Berkeley Pharma Tech Journal of Medicine | 32
a e
b ea
e fa
e a
e
g a
e e ee
c c d ead
TBI I
b e a ead
e
eced g PD
a ca e f d ag
b a e a c e e ce d e
dec ea ed c
f
f c
T
c d e e a a a be
e a a
f
e b e ed a c a
be ee TBI a d e b e e
PD d ag
e e
d T
e e e ea
c d be
a e f a a ca
be ee TBI a d c ea ed PD
a d
d be e ea c ed f
e
a e
e a e a d d ec
a
f
a ca
Cognition
PD a d TBI ca g ea
a ca
be ee
e
b
ca a d b g ca
a ec a
gge
a d
a e
c g
e f c
T e
a c g
ca be a ec ed f
Cogniti e d sf nction in PD and in TBI
C g
e d f c
a ea a a c
a
g
e
d ag ed
PD a d
e
de a e e a
ed e e e
c c g
a ec ed b PD I
e
d
a c a
e
d ag ed
PD a d
ea
c
a c a
ee g e a
e
c
g ca a e e
c
c ded e
f
c
eed
e
a g age a e
a d e ec
e a d
a a
f c
PD a e
ef
ed g ca
e a ea
c
f
f ec g
e ea e T e e
d ca ed a PD a e
ee c g
e
a ed d e
e d f c
a ef
a ce
a
ea
ee e
c
g ca e
f PD a e
e e de e
ed
be c g
e
a ed
e ea
f ea
c
ee
c g
e
a ed T e de c
PD a e a ea ed
e
a d
e ec
ef c
A a e de c
a be
e e e ed b e
e f
e g e a
e e
a a e fa ed a e e
f
ed a e e
a e
a c g
e d f c
a a
e
F
e a a
a a ed
d ce
fac
c a TBI a d fa
a
a
a e
c
b ed
ef
a ce
A
c g
e
d c
ed f a
a
ba ed ca e c
ef c
ea PD a e
T e d c
ee
ea
de
a
e e ed PD
a e
e ee
ed
e Ne
g ca D de
e a
ed f
e ea
a
f
a e
A
ee
Berkeley Pharma Tech Journal of Medicine | 33
Ce a S a NEDICES a d a c ed
c
f c
a
T e M Me a S a e E a
a
ac g
e ab
e a
a
f e
e de
a ad
e ed a d PD a e
ef
ed
e
a
c
S b ec e e
c
a
e e b e ed
f PD
a e
c
a ed
c
Re
d ca ed a
PD a e
e e d ag ed
e a
e ea d d
ef
e
g ba c g
e
e ba
e c e
a d e
e
Add
a
f e
PD a e
ea PD e e e
d ag ed
I add
a
d f
g c g
e c
d ag ed a e
a d e e
e ee
PD a e
A e
ee a d e ea
a da a
e f ea
c
a e e
c
c g
ed a
e ce
e a e e
f a e
a e
dec e a
e ea
c
e
a e
ed a g ea e dec e
c g
c g
e
a e
a
g e e f
a
g PD a e
e
a d
c
a ec ed
S
a
a e
TBI
a e
F
e
e
a ge f
e ea
e
e
fc g
ed f c
a a
e f PD a e
e eg e e
c
g ca
e e e ed I a
ed a
PD
ed a g ea e
e I d d a
f PD
a c
O ea
e e
ee
be e a e
eed be g e
c
e b c g
e
de
a e e ea c ed a ea f e b a
c c g
e
a e
cc
a e
PD O e
d a e ed e a ea
c ba a
cc ed PD a e
a
ad M d C g
e
I a e
MCI a c g
e
a e
a d e
e fe e
da
ac
e I c
a
PD a e
c g
e
a e
PD a e
c g
e
a e
ad
ca a
a
a
e a b
a e f
a c g
e dec e
a e
PD
A
PD c g
e d f c
a e
a ea
be a
c
c a ac e c a
g a e
TBI T be e
de a d e
a ca
be ee c g
ed f c
a d TBI a d a c d c ed
e ga e c g
e
a e
e ea af e a c a
e e e ced TBI
e a ge f
a
a
ed
e ea
f
a d
TBI a c a
e e ga e ed a d c
a ed
a
g
f
de g a ca
a a c a
T e eg
de e
a e e f e
a ea ed f c
c a a e
ce g eed
e
a d e ec
ef c
Re
ed a e g
f a e
ad a TBI
ea
c ed g ca
e a
ec
Berkeley Pharma Tech Journal of Medicine | 34
g
eS
be
e
g e
b
g
c g
b
D g M da e Te a d e D g S b C d g
f
c
ea ed f
a
ce g eed T e e
gge
a a e
e ed a TBI a e e e ce
ed f c
I add
g e e ec
e e a ea
be a
e e ec
c g
ef c
TBI a e a e A d f
eU e
f
Te a a Da a
e a
ed e e a
f TBI a a c a ed
a
c ea ed
f ea e
e f dc g
e
a e MCI
b ec
MCI a d
a c g
b ec
e e e ec ed
f
e Na
a A e e
C d a g Ce e da aba e a d
ca eg ed ba ed
e e
a d de g a c T e e
de
a ed
a a e
MCI e e d ag ed
ea ea e
e TBI
e
g
a
e b ec
TBI
g TBI a a
e a
fac
f MCI L
a
ae a a
a ca
c d be d e
e
fac
c a ge de
e a ae H e e
e
ed
f
f
e
de
d c e
e e TBI a d MCI ca be a c a ed
a
c ea ed
f e dege e a e d ea e c a PD
TBI and PD Cognition St dies
C g
e
a e
a a ed c a ac e
a d PD F
e e
a
fc g
e
a e e a be g ea e c g
e
e e e ced TBI c
a ed PD a e
He ce e e a g ea eed
e ga e
e ace ba g PD
ca
g a e
TBI
a e
ece
de a
a e
PD a e
a e
e e e ced TBI
e e f TBI
d c g
A e ea c ea a UCSF c d c ed a d
e ga e e e a
be ee ead
a d PD e
e Da a c ec ed f
a e
e Pa
P ge
Ma e I a e PPMI
a f
d
a
d d a
e e e ced ead
be g d ag ed
PD ad g e
PD a e
a
e
f
ead
ece ed a ea c e f
e M e e D de
S c e U ed Pa
D ea e Ra g Sca e
ee
e c e
d ca e
de
B c
a
PD a e
f
ead
ad a ea c e f
e a e ca e
T e
e e e ead
ad c e f
a d
e
a ead
e
ad a c e f
Add
a
ee
Berkeley Pharma Tech Journal of Medicine | 35
g e
a e e
e
e ea
ad a e e e ead
a e
a ead
1: PD
e e e ead
a
e g e
S c e -U f ed Pa
D ea e Ra g Sca e.
c e f
c e (8.29)
e MDS
ad a c e f
eM e e
D
de
A e aae
g d a
d
ace e
ea a d c
ed f
c g
e e g
PD a e
a d
a
f TBI T e
d f
d a a e
a
f TBI faced
e g ca
c g
e dec e e
e
ea Af e a g e Ma
De e a
Ra g Sca e e
c
ea e a e
a
e e ea
c
c
e
a d c ce a a
PD a e
TBI
ad
ed c e af e
ea
e ea PD a e
TBI ad a
dec e
c e H e e b
faced a
a dec ea e
f c
a da
a c ea e de e e
T e PD g
a
f TBI fa e
e
b
e
a d
a
ee a
b ca e
T
d de
a ed a
e a c ea
be ee TBI a d PD
A
e c
ec
a c
d
a c d c ed
e ga e e e a a e
f TBI c d be a c a ed
PD
a d c g
e
a d e
c a c
a e
be ee
e age f
e e a e ed f de g a c da a
e
c
g ca
e
e a a
e
c a c
e
a e a d a ba
c ee g
e
a e Of e
a e
ad PD a d
e e ea
c
Re
f
d
c c ded e e a a g ca
ega e c e a
be ee
e
be
f TBI
PD a e
a d ea
c e f g ba c g
Berkeley Pharma Tech Journal of Medicine | 36
Ne rodegeneration in PD and TBI and its E ects on
Cognition
T e e ec
f TBI
e ba
a
c ea e e e e
f c g
e
a e
b e ace ba g
e e dege e a
ee
PD
We a b e a
c d c ed a
d
a e eg
c ba
a
cc ed
a e
PD
a c g
PD
d c g
e
a e a d de e a e e c g
e dec e
PD
a e
PD
a c g
PD
dc g
e
a ed a d
de e a e e c g
e
a ed a d
ea
c
e e a e ed
g ag e c e a ce
ag g f e b a Re
d ca ed a
d d a
ad PD a d
a c g
dd
a e g ca
ba a
c
a ed
e ea
c
W e c
a g e PD
a e
a c g
a d a e
d c g
e
a e
PD a e
d c g
e
a e de
a ed
ca a a
P
a d PD a e
de e a ad
ca a
P
a d ed a e
a be
a
P
PD a e
d c g
e
a e
ad a
a a e
e a e
b
de e a a d
PD A c e a
be ee
e
e c d g
ef
a ce a d
ca a
e a f
d
e PD g
e b g de e a
F
d
a c c ded a
ca a a
a e ea a
b
a e f
a c g
e dec e PD
PD a e
dc g
e
a e a
ed a fa e a e f
c ca
g Acc d g
e M
ea C g
e A e e
g ca
g f e e
a a d ed a cc a
be a
c e a ed
a dec e
c g
e f c
T
de a d e
ge e c a e f c g
e
a e
e ea c e f
N
C a
U e
c d c ed a e e e
a a e e d eg a ed e e
f c RNA
RNA a d
e
e a ge e
f TBI a a
de TBI Acc d g
e e ea c e
R
ee e
a a
c
c a ac e c f e
g ca d ea e a M R
c d a e
ge e e e
e
ca
Af e a a
g e R
ge e
TBI a e a d TBI
a
a d
e ea c e f
d a e
b
f e ge e ed a be e e
g ca
c e af e TBI
a d
ed c g
e de c
T e e ea c e a
f
d
a
ee e
f e R
ge e ed a
b
f e ADAM
e e
c ca
d a e be a a
d f
a
a c
Berkeley Pharma Tech Journal of Medicine | 37
e
ed
de
ae e
a d ge e e e
c a PD
e de e
e a ea
eba
e
fc g
e de c
T ee e
be ee c g
e de c
TBI
c c d ead
e
g ca d ea e
Pe
e ea c
a
e ga ed a ea f e b a
e
be f
c g
e d f c
c
b e ed
TBI PD de e
a d
de e a Af e a a
g ag e c e a ce ag g MRI da a f
a c a
e ea c e f
df
a e a a df
cc a e
a d e
a ea
fe
f
a c ce e e e
a
e
e
bef
f
a
ce g eed a d
d e a e
f eb a
2: T e
ed a e
a
be,
g
g
g
e
ca
a a ea affec ed b TBI a d
PD.
Biological Factors
C
c
a
e
c
a
e
ea e a
a a a
ce
c g f
a c
e
c a
a
da e e
c
b e
e
a ge f c ed
e e f b g ca
ec e
a e a c e
a
e
a eg a e e
e c e a d e e ea e f e
a
e a d
e d
a e Add
a b g ca
e
e a
a d e
a
a
ae
bec d
a
fd a
e gc e
Berkeley Pharma Tech Journal of Medicine | 38
Alpha S n clein
T e e
be
a
f
a
d
dege e a e e ec ca ed b TBI a d PD a e bee c e a
ec c
e
eba T
de a d a
g ca c e a
ee PD d ea e a d TBI
e
c e a d g ca ce
a
ce
be d c ed A d
a
a
g ca c a ac e
PD
e ab
a f d g a d acc
a
f a a
ce
e de
a Le b d e Agg ega
a d ee e
a
ce
a e bee
d
e ce
e ba e
a
e gc e
ca
g e
a da age
ed
f
c
f
f
A a
ce
a d ee
c a f
c a
e g e a d
b a f
c
a e a
g e ec
PD a
g A
d
c d c ed b F
ae a
e ga ed e ab e a
d ee
g e
f
ec da
e
c e f e a a
ce
e
c
a
e b a f
de f
e a
g ab e
d ce
c a ac e c f PD
T e a
e de ed f
f a a
ce
e e ec ed
e a
f ce
a
e ca a
ce
ec
e
g a
e c
f
e e e e
Ne
a
g ca
c e
ee
ed b
ef
g
c e
g a
a b d
f
a a
ce
a ed a e e
Re
ed a
c
a
e
e
ec ed ce b
ce a c
e
a
de ab
d ced
f d a
e gc e
e b a a ga
c
ac a a d
fd a
e e
a
e a
I ec
f b
a a
ce a
e ded a g e c ce a
f a a
ce
e c
I c
a
ec
f e
ee
g e e ed
a a e
fd a
e e
e b a a gac
ac a b
ed
g
f c
f
a
I add
e b a f
f
a a
c e ed
ab e
defec
e g e
ec ed ce
dd
e b a dec e
be a
I a c c ded a
e
b a f
fa a
ce
ad a
e g ca
c
ac a
e
ee
g e d e
e b a
e
ab
ec
a a
ce
e a d ead
e
c
O ea
e ea c
c c ded a e b a f
fa a
ce
a a
a
e
e d c
f PD e a ed
e
e a d
ee g a a
ce a
e
be a c a ac e c f TBI
I a
a e TBI
d b Ac a e a
ae a
S
da af e TBI
ge
de
e c
eba
ca
e
ac
f ee
Berkeley Pharma Tech Journal of Medicine | 39
a
e e a e ed f
e g C a ac e a
f a a
ce
TBI d ced b a
a
d ed
g
e ce
a
g f
ec
f e b a a g a Pe f
g
e e e
ed a
ba
e e
ed
TBI ad a
c ea ed acc
a
f
a a
ce
e
aea
b a a ga a c
ac a TBI
e ed a ee f d
eg a
fa a
c e de
a
d e
aa d e e fd a
e gc e
c
gge ed d a
e gc
ce dea Re ea c e c c ded a e a a
ce
ee e
TBI e
ed b a
ed a
fd a
e gc e
a d e ed a a
c
ec
be ee TBI a d e de e
e
f PD a
g
F
e
e a
d f
I e e e a c
ed
d g T
d a a ed a a
ce e e
a e ce b a
da af e e
ce e e e
ed
d ced TBI T
g d a
e a
e a d
a a
ce
a
g g ca
c ea e
a a
ce e e
a d g ca dec ea e
d a
e a
e
e e b e ed
c
a
c
I e e e a a
f
d a ed c
e
c fac
af e
da
c a eb
ec e a
e
g
a d de e
e
f e
O ea
d g f
ee
d e gge
a a a
ce
a e ea a
ab e a
g ca
be ee TBI a d Pa
d ea e
T rosine H dro lase
I add
a a
ce
e d
ae a e
e a a a
e
e
e
e
f d a
e a bee e ea c ed a a
e
b g ca
a e
TBI a d PD S
e a
e ga ed
e
d
ae e e
a ba
e de e
e
e
e e ec
d a
e g c ac
F
d a e f a
a
e
ed TBI
gac
ed c ca
ac
T
da af e e
e TBI e
ba
e f ee a
e e a e ed f
e g We e b
g
ec
e
ee
ed
de ec
e
a
f
e
d
a e Be ee
ea df
ee af e e
e TBI
e
d
a e e e dec ea ed g ca
a e e e
e I add
a a
f e
aa
e e ea ed a dec ea e
a
e ed
d a
e e ea e I a c c ded a
e
e d
ae e e
af e TBI ega e
ac d a
e c ce a
e ba
gge g a c e a
be ee TBI a d e de e
e
f PD
a
g
Berkeley Pharma Tech Journal of Medicine | 40
Figure 3: Location of the Substantia Nigra--the site of the dopamine-producing neurons. A
decrease in these neurons is implicated in the development of Parkinson's Disease.
O idati e Stress
O da e e
a e
e
c
e e
d c
a d acc
a
ca
be ead de
ed
eac e
ge
ec e ROS a a e
ad ca
T
a be beca e b a
a
f
ge C e
ea e
e c e
f TBI a d PD de e de
b
gge
a
e b g ca
a c
Se e a
de a e
a e
f ec a
c ea e
ROS
ac e a d
d
I add
H e
T e e e ec
c
a ed
e
A
e
d
a
e
a
e
a da age ca cc d e
f eac e c e ca ec e a
T ca
e e c e ca a e
ef
f
ge c a
g
ce
e
e a d ece e a ge
a d c ed
da e e
a d e
a a
g f
a ec
a
a
ee
ca ed da e e
TBI
H e a b e ed
c
a d e acc
a
e a
c a e d ca e
b e ed
a e
fC
e
e
ced
e
ee
a c
a
f
f
e
a
g
f
eac e a de
da e da
I a d II ac
c
c
g a
a
de
age
d a
d
f c ed
g
e
e g c e ec
f
ec a ca
a
d ced TBI a d a a a
e c de e
e
Re ea c
a bee ca ed
g a
de
f
d e e a ed SH SY Y ce
c ae fe
ed
de
e
e ac
e e e
Ce
a
de e a
de a e
deg ee f
a e e e ced g ea e a d
ge a g
c
d a
e b a e de a a
a d
c ea ed ROS
c
d a
Berkeley Pharma Tech Journal of Medicine | 41
d c
T e e e ec
T ge
e
f
e e
e
c
d
ae e
g
e dea
fd a
eea
ed
e c b ed
e
e
ee
de
gge
a
da e e
e
aga g e
a da age f
TBI
b
e fe g
e ce a e a
a
e gc e
e
aa
a a
a
e ce
ce e
a
e
a
e
Ge e eg a ed e e
a a
a a e
da e e Wa g e
a e a
ed e e f
e d
de
e a e a c a ed PDIA
eg a ed
da e e
a g e
g TBI da age
T
g
d f c e
e e e
f ROS a d a
da e
e a a
e c f ga g g e e e f da e e a e a
c
d a
ac
a ea
c
e
d g f H e a W e
c
d a d f c
a d
e fe e ce
e
a f c
a ea
be
f g e e c
ec g TBI a d da e e
ee
de
f
e e ea c
e
ed e c da e e e ac
ec a
de e
e a ca a e a
Add
a e ea c a
g
c a ac e e e
e a
e f
da e
e
e
de e
e
f PD
e ec ca
ac
e dec e f
d a
e gc e
Pa e a a ed
e a a e e e cac f
ea
a a a
da ca ab e f
d g e
ec e be e
ga e e de e
e
f PD Re ea c e
ed a a
e e e c g
da e e a e e
fa
c e e ec
e ba
e b ed a dec ea e
e
be
f f c
g
d a
e gc e
e b a a g a eg
T e
d
c c ded a e a
a a e ec e a
da a d c d
e
g a a ea e O da e e a d e e e e
fa a
ce
ge e a e bee f
d
b ca e a e g c e ec
b g e f c
f c
e gc e
e ag
e e
T
d
e e
ed a
a c
e gc e
e
ba
e e a ec ed b
da e e
gge g a ec c eg
f
eba a d e
e
a be a ec ed d e e
A
a a e
a bee b e ed f d a
e gc e
e b a a ga
a d
a
be g e a eg
ff c
A ca a e
ea
a
be ade ca
be ee
da e e a d PD
d e
ed f
a
If e af e e
g ca
ea
ca a e a
ed b e a
g
da e e a e a
ac
d a
e gc e
e
e e a be a
be ee TBI a d PD Re ea c e f
P d e
Berkeley Pharma Tech Journal of Medicine | 42
U e
ed a
d TBI a
de
e ce ce a
g a d
We e
B
a a
de
a e ac e
e
d c g
agg ega
a d
d ca
f a a
ce f
e c
b a g
e
d g f
H e a
T
d
e f e fe
a
d c e
e
e f
da e e
e
e a a
g ca
be ee TBI a d PD H e e add
a e ea c
eeded
e
e ec f
da e e a d
a ca
TBI ca
e ce
e de e
e
f PD S ec ca
e ec a
f
c
d a
d f c
a d e acc
a
f a de de b
d c
ea
e ac
a a
ce e
e f
e e ea c
de e
e
ea
e de e
e
f PD e a ed
4: General Trends Associated with Oxidative Stress and its Potential Role in PD
Ne roin ammation
Ne
a
a
be ee PD a d TBI
a
a
e
c a ac e c f PD
a a
g e
a
a bee e ea c ed a a
e b g ca
A d a
e gc e
a e ea
ce b e
a
a
a bee f
d
be a
a
I e e e a c d c ed a
d
a
ce e
eba
f a e ce
Berkeley Pharma Tech Journal of Medicine | 43
d ced TBI We e b a a
a
ed a a e db a
e
f ce
da af e e
e
TBI
g I B a d NF B ec c
a b d e Pe f
g
a a
ed a g ca ed c
I B
e e
a da
c ea e NF B a
ca
ce e
ed TBI
N c ea B a
ca
a a c ca
e
e a c
a
a
f
a
a
a ge ge e c a d c b e
c de
a e NOS a d c c
ge a e
COX
NOS a d COX a e
b
e
c
a e
a ca da age d a
e gc e
E a a g NOS e e
e ea ed a e e a a
e
c ea e
NOS
e TBI d ced b a
c
a
ec
ba
I
add
COX e e
c ea ed
e
db a
f
ce a
e ed TBI
I ee g
c ea ed COX e e
a a
de ec ed
e
e b a a g a f Pa
a e
Ba ed
ee
d g e ea c e c c ded a e
a
a
ce e e
gf
TBI ca ead
e de e
e
f PD a
g
e db a
I a
d Y e a e a
ed e e a
e e e
f e
a c
a fac
ea g
e
e
Eg
a ed
d c g
e
a
a
a d e dege e a
e
de f PD
M ce e e
ec ed
e
e
e a d
d e
MPTP d ced e e
a d
eg a
f Eg
e b a a
ga a c
ac a U
Eg
ac a
e ea c e a
ed a
c ea e
e e
be a IL b a d
ec
fac a a
TNF a
c ae c
e
ed
a
a
e
e
C e e
g Eg
c
ce
de e ea c e
ed a e
e e
f e
a
a
e
ea dd a
e gc e
a dea
a
e
a
c
de
gge g a Eg c d a a e
g e
a
a
PD a
g T e e ea c e c
ed
ee
d g b ad
e g
a c A a a b c
d ace a c
fac
c a Eg f
e b d g e Y e a
a
ed a e
ec e e ec f Eg
c
a a ge
ed
e b a a ga a d a
ec e e ec a
b e ed
e
a
T
f
e
e ga
eeded
e ec c
ec a
a
a
e b a a g aa d e a
O e
d e a e f c ed
e e e ce f
a
a
c
e a ec PD a e
Ka e
e a
a
ed e e a e ce f
d ee c
e
ee
b d a
e f
PD a e g
a
a
d ea e age
g
be a a
I
a c a
e
Berkeley Pharma Tech Journal of Medicine | 44
e ea c e e a
ed a
e f
eb d e
a d ce eb
a
d
de e
e f e e e ce f TNF a a d e e
IL
ec
e
c e a ed
e e e
a d
ge
f PD
Re ea c e f
d
a g e e e f IL b
e e
a d TNF a
e ce eb
a
d e e c e a ed
c ea ed e e
a d a d d ea e
ge
b
e c ea
be ee
e c
e
c a IL a d PD a
c ea
A
e
d
c d c ed b L e a e
ed
a e d
e a a e ec ea
be ee c
e
eb d
a a a d PD e a ed a f
d c ea ed e e f IL
eb d
e
f PD a e
Beca e IL b c a ed
e IL
fa
e e d g a ea
c
b a e e d g f Ka e
e a
f
e
gge g a
a
a
fac
a
a a e
PD
ge
g
e e ac
e e a
c ea
W e
ee
e de ce
a
e
a
a
da e
e
a a
ce a d
e d
ae a
de a
be ee TBI
a d PD e e d g a e ec a e a d e
ef
e e ea c
e
a ca a e a
S c e ea c c d
e ef
e de e
e
f e
a ace ca ea e
Treatment and Therape tic Targets
Med ca
ea e
fc
c d ea e c
g d ea e a age e
a d
f c e
ec
d g a d
a age e
f PD
a a c a c
c a ac f ba a ce
e
d
c e c a ge
e a fa a e
ea TBI ega d e
f e e e
c
ca
a a ef
e
g a
a
e e a e
Medication
P a ace
c ba g
e a e ce
a d be a
e
e
ca d g e
e de
e
f de e ec
a ea
a
ga e a
ca
a e
g g fe
a e
ce a
Pa
PD
a e e
e e
gf
e be g
a g
C e
e ea c
ea e
f
e
e e g
a ga
c
a
Med ca
ed
g a f ab
g
e
a d
ea a
ef
cce f
ea e
a eg
a e ec
f TBI a d PD de e e g
U e
a e ea e
c a e ec e
ec
d g
b g ca
gge b d
d e e
e
ge
f
Berkeley Pharma Tech Journal of Medicine | 45
Ra c e a d c
ed ca
a a e bee
e
e ec e
e e
e
e g f PD
S e ea e
c de
Le d a
c b a
Ca b d a Pe g de P a
e e
R
e a d Se eg e
Le d a
e
ge a d
e ec e
ea e
ed
a e
de a d ea e
ge
e e e
e a d
g e
de e ec a d
e e be g Le d a a
a
a ag g ac e
f PD e a g
b d
e e
c a
e
e
a d
e
f
T e de e
e
f ee
e f
e ac f d a
e ce a b a a ea f
a e
PD Le d a ac a a d a
e e ace e age
a age
e
a e
C e e
a
a e ec a ed
a Le d a ca
e a be a f a d d ec
e
c
ca
S de a e
a Le d a ca be
d a
e gc e
gge g e ad a ce e
f e
deg ada
e b a a ga
H e e
e e a e bee fe
de
a
ee d g
PD a e
N e ee
e be e
f
Le d a
ga g PD
a
eg
e ega e
c
e e a a e a e ega d g e cac M c
e
e
g
a ace ca d g
e a e
ee ae
e
de e ec
f
Le d a
c d g d
e
a ea a d a c a
H e e
Ga d a d Saadabad d c
a e e
ad
e g Le d a
Pa
a e
eg a e
a deca b
ae
b
e
Ca b d a
Ca b d a c
e c bed
Le d a a
e
a ea a d b c Le d a f
be g a f
ed
d a
e
g
eba
e e
g de e ec
c a
g
F
e
e Pe g de P a
e e R
e a d Se eg e a e
d a
e ag
a f c
b e
a g e ac
fd a
e
S de
a e
a d a
e ag
a e e cac
a b
e a e a d ad c
ea e
ea g
ab
a e
a d d
e a
a
a
c e d de
H e e
ee
ce
e ea c
e ef
a ce f e e d a
e
ag
Le d a a e a e
a d a ac f e ca
a
ee
e e
ec e ec a
Ra c e a d c
a f
a
a e
d a
e ag
e a Le d a a e
e
be
e
e ec e H e e a
Ca b d a c
ec b gd a
e ag
a
ed
g ca
ga e
c
a ed
ea e
e Le d a a e
I
e
d Ra c e a
e a
ed e e cac f b
Le d a a d R
e a e a g PD
Berkeley Pharma Tech Journal of Medicine | 46
A a e
a
ee
e
e
Le d a a e R
e ec e ed ced e e
f de e
g d
e a a f
d
be
e a g R
e a e a
ed
e a d Le d a a e
ge e
e
d f
e g PD
N
e
a ace ca ed ca
e e
ea e e a
f a e
a e e e e ced TBI U e PD
c
c a ac e ed b a ec c
e f de e ec c
eac a e TBI
a e d ag ed
a ca e b ca e ba
T e ef e d ag
c
ced e d e
eac
a e a d ec
d age d ec c e a e
e e e
f e TBI
F
de f
f TBI c a b a da age a a e b a e a ed
ca ed b a
e
e c a ge f ca ca ed b c ac d
ed ca ed
b f ce
f
c c
e
ce f d ag
e e a
g
e
e
f e c de a d d ec ca e f
H e e
f ac e b a
e
c a
f ac e b
g f ba
e
a ce eb a c
e a
a
g
de e
ed a
a a
f ag g e a d a a e
c ca e e a
I
d
ca e ec
e ded ed ca
c de e e c
e a e ef d g
c a Na
e a d Ace a
e
O e
ec
ed ca
d ec
a ge ed
ed ce b
ca
a
a d e
a
a a e e e ced b TBI a e
c de
a c
a
a de e a
a
c
c a d ed ca
e e g
c
ca
A c
a
ed ca
ed
a e
e e e ce e e c e
de d e
e TBI a d
e e
e
cc e ce f e e
A e e cd g
c a Gaba e
a d
T a ae
b e ce e e
a e c ab
a d
e e
e
e ca a
fe
g e e U ed
ea a f
f e
g ca a d
e a
e e a de e a a d a
c
c a ec
ea e
f
a e
e f
b
PD a d TBI A b
PD a d TBI
d ec
e ce e e e
f e
a
e g a g
e ba
a de e a a d a
c
c e e c ba a
c a c d de
a a a e c a de e
a d a c a
A a ad e a a
a ed ca
a a
e c bed c ba e
I
e a A
a
c ea g bee
e
g ca
ed ce
e ae
f PD c a
e
e
a d
e
f
e e
a b ad
e a
A a ad e a a bee
ae e f c
a ec e
f
e
e f
d f c
e a ed TBI F
e
e C a g a d Ra
Berkeley Pharma Tech Journal of Medicine | 47
a
e
a ad a age f A a ad e
de e ec
e
c a
e f c
e ce e a
T
g
A a ad e a bee
e c bed
a e
e g f
PD a d
a e
e g f
TBI fe
de a e e a
ed e e ec f
A a ad e
ea g PD a d TBI
a e
T
f
e
e ea c
eeded
de e
e e d g e cac
a e
b
d de
Ac a e a de
ae e
b
f a
ec a
ec a
a c d be a e ed c ea e e
ed ca
f PD
Ne e a d
e ad a ced ed ca
ca a ge ac e
eb d
ede a d
de a e
da e e W
e e
g e ea c
e
e ec e e
f ec
ed ca
a c a e f d g ca be
ed
a ge
f PD a d TBI b
d d a
a d
a e
5: Mec a
be
d Le d
a, a PD d
a age
Non in asi e treatment Cogniti eTherapies/E ercising
N
a e
a
de
e ab a
PD a d TBI
a ea a ce f
A ab
a ec
e ab
g e
a ea a ce f
c a ac e ed b
ea e
f PD a d TBI a e de
a ed e cac
S c
ea e
ce e
ca a d c g
e
a e ae a
f ec
f
d b
c d g
ea e a d ab
A c
ea e
PD a d TBI a e
a ab
a ga
a ga
c a ac e ed b a a
e c
a
f e a e
a e ec e a d ca
a fe a
ga
a
fa e
f ee g f ga
A
e
ea e
a ac
f ba a ce
c ca be
a
a
c ea ed
be f fa
Ma
de
Berkeley Pharma Tech Journal of Medicine | 48
a e bee
cce f
e f c
g ga ba a ce
b
a d
Pa
d ea e
F
e
a ed
ed
e e
c a da ce a d ga
e
de a ec
ed e e c e
e ec ea a
be e d f
ea
f a e
e ba c ead
e ec e a e
c
a
e f
f
T a
e e a e c be e
e f
f
a
A e
d f
d a c b
g
ca d
a
RAS
a d ead
a
g g ea
ed e e a ga e f
a ce f e
a c a
RAS a
e e ed
d
g
e e f
c
ca
e e
ae
e a
g
ce a d
e e ga
aa ee A a c a
e a e
ed
de e ec d
g e
e e
f e e ab a
ce O e a
a c c ded a
e
add
f R
c A d
S
a
ead
e ec e e
c
e e a ad a age
PD a e
ba a ce
de c
a d
e a ga e f
a ce
D e
e
f
c
e e
a
c a ac e e ga
PD a e
ca d
a
de
c
e a
f
A fe
de a ea
e ea c ed e
f
e
e e
f
a e
PD a d c e a
e a ea a ce f ab
a ga
A
d c d c ed
f c ed
e e ec f
ca d
a
e ga e c a d cade ce f PD a e
T e
d
f
d a a fa e RAS e ed
a g ca
e e
ga
e c a d cade ce d ca g a
ca d
fac a
c d be
a
cce f
ec
e
ga
e ab a
A
e
d
c
a ed
ca d
c e fa e
e bea
a a e e
e a e ec PD a e
ef
a ce
gea dd a
a
N
g ca c a ge ga e f
a ce a b e ed e
e e
e
bea a
e e ed a a a da e
e e g ca
e e
a b e ed
a e
e e e ced a c b a
fa
c
a d
c e a d a a e
a c e eg e
g a e
f c
a gbg e
T
d c
b a e eca
a
e
e f
c
a
f
c a d
a
ca
a e a g ca
e c a ge ga e f
a ce f Pa
d ea e Ne e e e
e
c f RAS a d ead
a
g a a e a e c a eg
e
ga a ea a ce ac ece e ea c a d e
e f
e
e ga
O e f
f e ec e
c
e a e c be e
PD a e
a a a c e ec e
A a d
ed c
a a
ed a
de
d ed
Berkeley Pharma Tech Journal of Medicine | 49
e e ec f a a c e e c e e a
e
e e
f Pa
a
ga T e e e e a g
ef
ed a
e ec e
ac
e gf
e e
e ee f a a f
ee
e ea
e c
g
ece ed e
a ea e
c
c
ed f ed ca
B
e e e e a a d c
g
de
a ed a
e e
ga
ed g c c
e e de ce f
e be e
f a a ce ec ea a
e a e a e c ec
e
A
e
d
g
c
a e e e ec e e
f b
a d ga
a
g a d a a c ga
a
g
ga e e
ea e
a e a
c
cc e ce f PD a e
T e
d c c ded a
e
e e
f
e c
f a a c ba ed ga
a
g
c
c
ad
a
a d ga
a
g ee
a
e
e e
f ec
g
a dd
de g a a a c ba ed
ga
a
g
De e g a
ae
a a a c ba ed e a e
d
de be e
PD a e
c e
e ea c d e
de
d ab e
f
ca
A
PD c g
e a d
ca e a
a e ece ed a e
a a
e a e a e c a e e A be E e a e a f c ed
ec c
e d
f c
ea
a a ge ed
e ga
e c
a d
a e
a
e
f TBI a e
Re ea c e e ed e e ec f
a e d e ec
b a b ce
ee
a d ead
a
g
a a
a
ed
a a b d
eg
L
a
T e
L
a
a
g e d c ded a a e a d a b c
c
ee
ed
a ead
T e a a b d
eg
ed
ead
a
g e d ed a L eGa b d e g
e
a de
a
ead
E e a
e a
f
d
g ca
e e
e a c a
e f e ec ed e c
a
ee
e d f e e
a e a a g ca
e e
a a
e c
ee c
f eg
a
ed a e d e ec
b
O ea
e e
ga
eed ga
e
a d a g
e d a ce e e b e ed S
a
Pe e e a e ea c ed e
ac f
e
e
b
a
g
ba a ce a d ga
eed f c
c TBI
a e
T
g a
b ec e
ed fa g e a d a
g
e e e e
e e ea c e
ed g ca
e e
e
ee
f e a T
Pe e e a c c ded a e g
c
e c
e e a a d fa g e e
e e
b
f
g e
e
b
a
g c
e be a
be e a e c
ec
e f
e TBI a e
W e e af e e
ed
de
a a ed a a e
f d ee
ec
e b
f
d a g ca
Berkeley Pharma Tech Journal of Medicine | 50
a a
e e
ea e
ga e f
c e e
a ce
f
a e
6: Be g Ba a ce Sca e c
a g e f
Pa a - B d We g -S
ed T ead
, L
e
g a e d effec
b (G-EO) T a
g
e
TBI
g L c
a , a d ga
g
a e
b e e ec e e
T ea I e e
e c
a d a e
TBI.
:
a
W
e e ec
be ee ec
g a d ed c e add
a
de
a e f c ed
e e fd ee f
f
a ea
a
e e ba a ce a d
ea
f a e
Pa
d ea e W e c
a g
a ea
e ab a
c e
a
ca e a Ha Fe g e a c c ded a e e f
a ea
b a e
PD e ed
a g ea e
e e
e ba a ce a d ga T e
d c
ed f a
ee e ab a
ga
c
ee e e a g
ece ed ba a ce a d ga a
g
g
a ea
VR ec
g W e e e e e de
a ed
a ba a ce a d ga g ca
c ea ed
VR e a
e d dd
Berkeley Pharma Tech Journal of Medicine | 51
c
e VR
a e
f a ab e c a age
e f
e a d e e f ee
ea e c
da
De e
e
d de
a ed
c
f e e c e a e VR ec
g
a
be e a
e Pa
ba a ce a d
b
A
e
d e ea c ed
VR ba ed ba a ce e ab a
TBI a e
T
g a a d
ed
c
ed a
a ea
ea
a c
a ed
e ad
a
e ba ed e e c e
ga
c e
ed
e
e e
ba a ce
TBI a e
T ee ee
ee
ee a d
ee
f
eeb
ee e e a g
a d ec
g
a
g ca
e e
ba a ce
De e e
e e
e
ba a ce f TBI a e
a c a ed VR ba ed e ab a
e e dd
e ceed a f e
e ba ed e e c e
ga
T e
c c
fb
de
gge
a
a ea
a be a a b e
e a e c ec
e a
e ba a ce f b
PD a e a d TBI
a e
A
g
a
f e de e
ed ab e e f c ed e e PD
TBI e e
a e ea e
a d ea e
c de a c b ed
e e
f
f b
PD a d TBI Add
a
e
ea e a d e a e a a
be ec ca
a e ed
a d PD
TBI b
c de a
e e
e
a
e A
e
e
ed
a
ec
ed ca
a a e ed
c ba
f PD a d TBI c de e a ea d g
c a
a
c
c a d a de e a
Ta ge ed
a e ae
e a
c
g ca d de
e e c a e f ed ca
ad
g e
e a a a d
e g a cc a a acc
a
e
e
g ca
d de
c a TBI a d PD
S
f b
fe
c de
c
de e
a e
a d
e
a
d de
F
e
e a ece
d f
dac ea
be ee de e
a d
e
c a c
a d c ea ed
e e
Re ea c d e b C ad e a
a e a e a ea a ce
f de e
a e a d a
e
a
e a ed d de
a e bee
a ca
e
be
e e ae
e
a e PD a d TBI
Ma
e f ea e b
a ea d
ef
f ec
ed ca
c
a
c
ea
a de e a
d g
a d
e
d a
ae
ed
e e e ec
f de e
a d
a e
a a ea
b
PD a e a d TBI a e
Ma Ta a a
a d c eag e c d c ed a
ce e a d
ed
d
c
e
a a ed
e e ec e e
f a g d
e e a e
a d
Berkeley Pharma Tech Journal of Medicine | 52
e e
e e a
ec a
a
c ae
e de e e
d c c ded a
b
e f ee g f e
H e e
e
d dd
a a
e a c a
c b ed
e e
c
e de e a d
Concl sion
e
b
SNRI
a e e a d
e ec e e
e a e
b
SSRI
a a
a d ga f ee g PD a e
T e
e c b a
f SNRI
SSRI
ed
ga a d e de e e
PD a e
d ca e a
g ca c a ge fee g f
Ne e e e
ea e
a
de a
f b
PD a e
a d TBI a e
e
W e e c de ce f T a a c B a
c ea
e
e f Pa
e
ed
de e
e e b g ca
a ca
T e
c de ce f TBI
d
a e a ec ce a age
e ae
e
a
e
ge
a d de age a
I
a de
a ed a
e
d ea e f
e e ea c
a d c g
e ec a
f
a d
PD
a f
d
a d ge de g
be g
e
e e e e c g
e d ea e
e
S d e ega d g e
e ce f ge de a d e a e
c
ad c
e
g
e
a ce f f
d g a e
b
PD a d TBI e ea c e
de e
g PD a d
ead
c ea e g ea
ce f TBI
ed
e e ea c W e
f
d e
f
age
Re ea c a c e a ed PD
ge e c a d e
e a
fac
aa a e
e a g a
ea
a
ca c
a a d c ea ed
da
c
F
e e ea c
e
ed
de a d e
ac f TBI
e
e f PD
g ea e de
F
e
e PD a e
ae
e e
e e e ce TBI d
g e
d
a e d f e d ea e T e e e
c d d ca e a
a
dec e
f c
d e
ag g d d a a e
e e
e e e ce TBI f
fa g
c c d c ea e e c a ce f
de e
g PD W e e c de ce f TBI ca ead
a
c ea ed
c a ce f de e
g PD
e
d
a e d f PD ca
c ea e a
d d a c a ce f e e e c g a TBI f
c de
c a fa
T e ef e e d ec
f e c ea
c ea a d f
e e ea c
e
ed
Berkeley Pharma Tech Journal of Medicine | 53
W e
de a d g e b g ca c e a
be ee TBI a d e
e
f PD
ca be c c ded a TBI ead
e acc
a
f
a a
ce
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