Amino Acid Supplementation in Recovery From Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of death and disability in young people. It
has been called the "signature wound" of the Iraq war because of its frequency among troops.
TBI is associated with many chronic disabilities. Physical alterations include reduced
exercise tolerance and profound muscle weakness, whereas psychological alterations include
diminished sense of well-being, depression, fatigue and anxiety. Muscle and brain tissues
rely upon circulating blood amino acids as precursors for metabolic functions. The
investigators have shown that even one year after injury, plasma valine, an essential amino
acid (EAA), was markedly reduced in patients with TBI compared to healthy controls. The
investigators speculate that low plasma valine concentration contributes to chronic fatigue
after TBI, since valine and tryptophan compete for the same transporter into the brain, and
a low plasma valine concentration will allow more tryptophan to be transported. As a
consequence, increased brain tryptophan will increase serotonin production, which may
significantly contribute to the development of fatigue. Thus, the investigators will test if
restoring valine concentration in persons with TBI may reduce fatigue perception and improve
physical and neuropsychological function. Further, the investigators have previously shown
that EAA intake has an anabolic effect in healthy young and elderly individuals. However, no
data are currently available in persons recovering from TBI. Thus,the investigators will
also test if EAA and/or valine can improve muscle mass in patients with TBI.