**Author details**

*Advancement and New Understanding in Brain Injury*

epilepsy) are important [59, 62].

**6. Conclusions**

**Conflict of interest**

cerebral diseases, including consequences of TBI.

The authors declare no conflict of interest.

basis for potential optimization of neuroplasticity.

radical balance and prevention of excessive inflammatory processes, which is the

effect of the drug on the energy supply of brain tissue becomes clear [61].

Cortexin was demonstrated to be effective in the treatment of neurological, cognitive consequences of TBI and PTH in both pediatric and adult patients [56, 58]. Taking into account the risk of post-traumatic epilepsy in the long-term period of TBI, data on the dose-dependent antiepileptic activity of cortexin obtained in experiments in animals when modeling chronic convulsive activity (model of temporal

The potential multicomponent nature of cortexin, containing a multitude of different neuropeptides, may be favorable for simultaneous actions on multiple targets [58, 59]. The brain tissue specificity of these molecular mechanisms is important, as to a significant extent it determines the efficacy of the formulation in

Childhood and adolescence are periods of rapid physical and psychological growth, endocrine adjustment, and, at the same time, high risk of injuries. TBI is the most common and potentially the most deleterious type of injury in pediatric population. The consequences of TBI in children and adolescents can be represented in cognitive, behavioral, and paroxysmal disorders. These disorders may have a long-term and significantly negative impact on the success of school education and social adaptation in pediatric patients. Meanwhile, high levels of neuroplasticity in

children and adolescents may determine favorable outcomes of TBI.

Another study identified four brain proteins that interact with cortexin peptides [61]. The identified molecular partners of cortexin peptides are the cytoskeletal proteins actin and the brain-specific isoform of tubulin, the brain-specific adaptive protein 14-3-3 and creatine kinase—the first potential primary targets of the drug. All these proteins are involved in fundamentally important processes. The actin cytoskeleton is known to regulate important cellular processes in the brain, including division and proliferation, cell migration, cytokinesis, and differentiation. The neuronspecific protein tubulin β5, a component of the cytoskeleton microtubules, is critical for the emergence and maturation of neurons, their migration, differentiation, and integration into neural networks. Protein 14-3-3 (alpha/beta) is the important adaptive protein of the brain that interacts with a large number of proteins, determining their localization and function in the cell, and thereby affecting a variety of cellular and physiological processes. Regulating the activity of enzymes, protection from dephosphorylation of proteins, the formation of triple complexes and sequestration processes, protein 14-3-3 participates in pathogenesis and performs neuroprotective functions in neurodegenerative diseases and other neurological and mental disorders. If we assume that binding to cortexin peptides modulates the activity of creatine kinase type B, another molecular partner identified in this study, then the positive

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Nikolay Zavadenko\*, Yuriy Nesterovskiy, Alexey Kholin and Irina Vorobyeva Neurology, Neurosurgery and Medical Genetics Department Named After Academician L.O. Badalian, Faculty of Pediatrics, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation

\*Address all correspondence to: zavadenko@mail.ru

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
