Scientists Explore the Potential of Biperiden Through Minimally Invasive Analyses 

A study published in Molecular Neurobiology investigates the relationship between brain injuries, epilepsy, and the therapeutic potential of biomarkers found in extracellular vesicles. The research was funded by FAPESP and conducted in collaboration with the D’Or Institute for Research and Education (IDOR) and the Federal University of São Paulo (UNIFESP). 

Traumatic Brain Injury in Brazil 

Traumatic brain injury (TBI) is a major global public health concern, with estimates ranging from 27 to 69 million cases annually worldwide. The leading causes vary depending on cultural contexts. In Brazil, approximately 150,000 new cases occur each year, with traffic accidents being the primary cause, especially among men. 

TBI can severely impact a person’s quality of life, affecting social and professional activities. Additionally, complications may lead to post-traumatic epilepsy (PTE), increasing the challenges survivors face due to recurrent seizures. 

The progression to PTE follows a complex process that begins with trauma and includes a latency phase that can last from weeks to years. During this period, molecular and cellular events—such as neuronal death, neuroinflammation, and changes in gene transcription—increase brain cell excitability, promoting epileptic seizures. This timeframe represents a therapeutic window for interventions, yet one of the biggest challenges in neurological research is the difficulty of directly accessing brain tissue in living patients. 

Within this context, researchers investigated PTE caused by TBI using extracellular vesicles found in the bloodstream. These tiny structures, released by cells, can cross the blood-brain barrier and transport microRNAs (miRNAs), regulatory molecules that act both in the brain and other tissues. In the case of TBI, miRNAs present in blood vesicles help identify biomarkers associated with trauma and PTE development, offering new diagnostic and therapeutic perspectives through less invasive methods. 

The Study: miRNAs, Biperiden, and PTE 

In this study, blood samples from 37 patients were analyzed ten days after trauma. Participants were divided into two groups: 18 received the experimental drug, biperiden, while 19 received a placebo, allowing for comparison of effects. Over the 24-month follow-up, three patients treated with biperiden developed PTE, compared to two in the control group. 

Biperiden is traditionally used to treat neurological disorders such as Parkinson’s disease. It works by blocking acetylcholine, a neurotransmitter that, in excess, can cause tremors and muscle rigidity, as well as contribute to imbalances in the central nervous system. This study examined its potential to influence cellular mechanisms related to epilepsy development, a hypothesis suggested by previous studies in animal models. 

Biomarkers Offer Clues for Further Research 

Analysis of extracellular vesicles revealed differential expression of miR-9-5p, an miRNA associated with neurogenesis, neurodegeneration, and stress responses. Patients treated with biperiden showed a significant reduction in miR-9-5p levels, suggesting a possible effect of the drug on epilepsy-related processes. 

This study was the first to investigate biperiden use in TBI patients. However, while the drug altered biomarkers, it did not significantly reduce seizure incidence during the monitored period. This underscores the need for further studies to better understand its therapeutic potential for PTE. 

A Window for Diagnostic and Therapeutic Advances 

Identifying biomarkers such as miR-9-5p is an essential step in expanding knowledge about TBI and PTE. Moreover, using extracellular vesicles as an investigative tool highlights a promising approach, enabling access to brain-related information through minimally invasive methods. 

This methodological advancement not only opens new diagnostic perspectives but also paves the way for early interventions, offering hope to TBI patients and those at risk of developing post-traumatic epilepsy.