Medical applications · investigational

Autologous biologic therapies for TBI & CTE.

An investigational, patient-derived procedure for selected adults with a history of traumatic brain injury and persistent post-traumatic symptoms, or symptom patterns consistent with chronic traumatic encephalopathy (CTE). 

Post-concussion syndrome Repetitive head trauma Suspected CTE Cognitive symptoms Autonomic / sleep symptoms

This procedure is investigational. No stem cell or cellular therapy is approved by the FDA for TBI, CTE, or post-traumatic neurodegeneration. CTE is a neuropathological diagnosis that cannot be definitively confirmed during life. Read the full regulatory disclosure ↓

What it is

Investigational biologic procedures for TBI and CTE.

Boulder Biologics offers investigational autologous biologic procedures for selected individuals with a history of traumatic brain injury (TBI) and persistent post-traumatic symptoms. These procedures are also explored in patients with symptom patterns consistent with chronic traumatic encephalopathy (CTE), recognizing that CTE is a neuropathological diagnosis that cannot be definitively confirmed during life.

The approaches described on this page are experimental, based on evolving scientific evidence, and offered only after a comprehensive informed-consent process, consistent with our approach to Long COVID and intranasal biologic therapies.

Shared biological features

Ongoing injury after the first impact.

As with Long COVID, lasting symptoms after TBI and repeated head injury are now thought to come partly from processes that continue after the injury (secondary injury), and not only from the first blow.

01 · Neuroinflammation

Persistent neuroinflammation.

The brain's immune cells (microglia and astrocytes) can stay switched on long after an injury, which keeps nerve cells under stress. This immune dysregulation parallels inflammatory mechanisms described in Long COVID-associated cognitive impairment.

Refs. 7, 8
02 · Neurovascular

Neurovascular & BBB dysfunction.

Disruption of the blood–brain barrier and cerebral microvasculature impairs nutrient delivery, waste clearance, and neurovascular coupling, mechanisms now recognized in both post-traumatic and post-infectious neurological syndromes.

Refs. 2, 10
03 · Cumulative

Progressive or cumulative injury.

In individuals with repetitive head impacts, chronic inflammation, axonal injury, and abnormal protein accumulation may drive progressive cognitive, behavioral, and motor symptoms over time.

Refs. 1, 7, 11

About the biology

Paracrine signaling, not neuronal replacement.

Mesenchymal stromal cells (MSCs) are cells found in bone marrow and other tissues that are not blood-forming cells. In the body, they appear to act mainly by releasing signals that adjust the immune system. They don't turn into new nerve cells or replace brain tissue.

As with our Long COVID program, we describe any possible benefit in terms of signaling: adjusting the immune response without suppressing it, supporting the body's own repair, and signals to blood vessels and support cells in the brain. None of these replaces or regrows lost nerve cells.

Claims of routine differentiation into functional brain cells are not supported in human clinical data and are intentionally avoided.

Proposed mechanismParacrine · immunomodulatory
Studied immune effectMay modulate microglia & peripheral signaling
Studied blood-vessel effectMay support endothelial cells & the blood-brain barrier
Studied tissue effectMay provide growth-factor signaling in the repair environment
What it is notNeuron replacement · neuroregeneration

Rationale

Why investigators are studying MSC-containing biologics.

Immune system modulation.

Preclinical and early clinical studies suggest MSC-associated biologics may reduce pro-inflammatory cytokines and influence immune cell behavior after TBI, similar to mechanisms hypothesized in Long COVID.

Refs. 6–8

Neurovascular & tissue-support signaling.

Animal models demonstrate increased expression of growth factors involved in angiogenesis and neurovascular support following administration of marrow-derived stromal cells. These effects are thought to improve the biologic environment for recovery, rather than replacing damaged neurons.

Refs. 5, 6

Secondary injury in animal studies.

In animal studies, signals from these cells affected inflammation, cell death, and small blood vessels after brain injury (refs 5, 6). Whether this changes symptoms or the course of neurodegeneration in people is not known.

What to expect

How the procedure works.

This investigational approach mirrors the framework used in our Long COVID program. No donor cells, no culture expansion, no genetic modification, no manufactured cellular products.

Step 01

Consultation

Full medical history, imaging review, and case conference. Symptom timeline and prior care are reviewed before any procedure is scheduled.

Pre-treatment
Step 02

Bone marrow aspiration

From the posterior superior iliac spine (PSIS) under local anesthesia and image guidance.

~20–30 min
Step 03

Filtration & minimal processing

Bone marrow aspirate is filtered and minimally processed in our on-site lab; cellular components may be concentrated.

~1–2 hrs
Step 04

Autologous administration

Intravenous (IV) delivery and, in selected cases, intranasal delivery for CNS access via olfactory / trigeminal pathways. Intranasal delivery remains investigational.

Same-visit
Step 05

Longitudinal follow-up

Structured neurocognitive measures and symptom tracking over time.

Long-term

Safety

What we tell patients about safety.

  • Autologous biologics reduce immune rejection risks seen with donor-derived products.
  • Published studies suggest acceptable short-term safety, but long-term efficacy is unknown.
  • Not all patients improve; response cannot be predicted.
  • Patients are screened carefully. 

Current evidence

Clinical outcomes: current state.

Evidence for MSC-based biologics in TBI and suspected CTE is preliminary, derived largely from animal models, small human studies, and early-phase clinical investigations. This treatment is experimental supportive care. It does not change the course of the disease.

However:

  • Results are inconsistent.
  • Controlled trials specific to CTE are lacking.
  • No therapy is proven to prevent, halt, or reverse CTE.

Talking it through

A consultation is how we figure that out.

We work out together, case by case, whether this makes sense for you. That usually takes a few visits, including a review of your imaging and, where relevant, a case conference.

What we look at together

  • Persistent post-concussion symptoms for 6 months or more
  • History of repetitive head trauma in sport or service
  • Records of your injury history, imaging, and prior care, if available
  • Open to a multi-visit workup before any procedure
  • You understand this is investigational territory
  • Realistic expectations: investigational supportive care, not a cure or disease-modifying therapy

WE WANT TO BE CLEAR

FDA Regulatory Disclosure

Regulatory status

  • No stem cell or cellular therapy is FDA-approved for TBI, CTE, or Long COVID.
  • The procedures described are investigational.
  • No claims are made regarding cure, neuroregeneration, or disease modification.
  • Outcomes vary; no benefit is guaranteed.

We describe these treatments only as far as the published evidence goes.

Terminology and scientific accuracy

Consistent with FDA guidance and current scientific consensus, we avoid claims that mesenchymal stromal cells differentiate into functional brain cells in vivo. Any potential benefit is described as paracrine signaling, immune modulation, and support for endogenous repair, consistent with the prevailing literature.

References to "stem cells" on this page reflect cellular populations contained within autologous bone marrow–derived biologic material, not manufactured or expanded stem cell products.

Autologous vs donor-derived cells

The FDA has raised particular concern regarding allogeneic (donor-derived) stem cell products, including umbilical cord, placental, and amniotic products, marketed outside of approved clinical trials.

At Boulder Biologics:

  • Only autologous (patient-derived) cellular material is used
  • No donor cells are administered
  • No culture expansion, genetic modification, or manufacturing of cells occurs

Investigational nature and informed consent

  • Patients are informed that this approach is experimental.
  • Clinical response is variable and unpredictable.
  • Some patients may experience no benefit.
  • Long-term efficacy data for TBI and suspected CTE are not yet established.

Participation is voluntary, and treatment is undertaken only after a comprehensive informed-consent process.

Intranasal delivery, investigational

As with Long COVID-associated cognitive dysfunction, intranasal delivery is explored as a route to allow biologic signaling molecules to access the central nervous system via olfactory and trigeminal pathways.

References

Selected literature.

  1. Schepici G, Silvestro S, Bramanti P, Mazzon E. Traumatic brain injury and stem cells: an overview of clinical trials, the current treatments and future therapeutic approaches. Medicina (Kaunas). 2020;56(3):137.
  2. Greene C, Connolly R, Brennan D, et al. Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment. Nat Neurosci. 2024;27(3):421–432.
  3. Wislet-Gendebien S, Laudet E, Neirinckx V, Rogister B. Adult bone marrow: which stem cells for cellular therapy protocols in neurodegenerative disorders? J Biomed Biotechnol. 2012;2012:601560.
  4. Sekiya I, Larson BL, Smith JR, et al. Expansion of human adult stem cells from bone marrow stroma: conditions that maximize the yields of early progenitors and evaluate their quality. Stem Cells. 2002;20(6):530–541.
  5. Mahmood A, Lu D, Qu C, et al. Human marrow stromal cell treatment provides long-lasting benefit after traumatic brain injury in rats. Neurosurgery. 2005;57(5):1026–1031.
  6. Mahmood A, Lu D, Chopp M. Intravenous administration of marrow stromal cells (MSCs) increases the expression of growth factors in rat brain after traumatic brain injury. J Neurotrauma. 2004;21(1):33–39.
  7. McKee CA, Lukens JR. Emerging roles for the immune system in traumatic brain injury. Front Immunol. 2016;7:556.
  8. Hasan A, Deeb G, Rahal R, et al. Mesenchymal stem cells in the treatment of traumatic brain injury. Front Neurol. 2017;8:28.
  9. Galeano C, Qiu Z, Mishra A, et al. The route by which intranasally delivered stem cells enter the central nervous system. Cell Transplant. 2018;27(3):501–514.
  10. Cash A, Theus MH. Mechanisms of blood-brain barrier dysfunction in traumatic brain injury. Int J Mol Sci. 2020;21(9):3344.
  11. McKee AC, Stern RA, Nowinski CJ, et al. The spectrum of disease in chronic traumatic encephalopathy. Brain. 2013;136(Pt 1):43–64.

Schedule a TBI / CTE consultation

Tell us about your case.

Our team will review your injury history, imaging, and current symptoms, and tell you honestly whether this investigational approach fits your case or whether another path makes more sense.

720-550-6175
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