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Chen Q, Li L, Xu L, Yang B, Huang Y, Qiao D, Yue X. Proteomic analysis discovers potential biomarkers of early traumatic axonal injury in the brainstem. Int J Legal Med 2024; 138:207-227. [PMID: 37338605 DOI: 10.1007/s00414-023-03039-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Application of Tandem Mass Tags (TMT)-based LC-MS/MS analysis to screen for differentially expressed proteins (DEPs) in traumatic axonal injury (TAI) of the brainstem and to predict potential biomarkers and key molecular mechanisms of brainstem TAI. METHODS A modified impact acceleration injury model was used to establish a brainstem TAI model in Sprague-Dawley rats, and the model was evaluated in terms of both functional changes (vital sign measurements) andstructural changes (HE staining, silver-plating staining and β-APP immunohistochemical staining). TMT combined with LC-MS/MS was used to analyse the DEPs in brainstem tissues from TAI and Sham groups. The biological functions of DEPs and potential molecular mechanisms in the hyperacute phase of TAI were analysed by bioinformatics techniques, and candidate biomarkers were validated using western blotting and immunohistochemistry on brainstem tissues from animal models and humans. RESULTS Based on the successful establishment of the brainstem TAI model in rats, TMT-based proteomics identified 65 DEPs, and bioinformatics analysis indicated that the hyperacute phase of TAI involves multiple stages of biological processes including inflammation, oxidative stress, energy metabolism, neuronal excitotoxicity and apoptosis. Three DEPs, CBR1, EPHX2 and CYP2U1, were selected as candidate biomarkers and all three proteins were found to be significantly expressed in brainstem tissue 30 min-7 days after TAI in both animal models and humans. CONCLUSION Using TMT combined with LC-MS/MS analysis for proteomic study of early TAI in rat brainstem, we report for the first time that CBR1, EPHX2 and CYP2U1 can be used as biomarkers of early TAI in brainstem by means of western blotting and immunohistochemical staining, compensating for the limitations of silver-plating staining and β-APP immunohistochemical staining, especially in the case of very short survival time after TAI (shorter than 30 min). A number of other proteins that also have a potential marker role are also presented, providing new insights into the molecular mechanisms, therapeutic targets and forensic identification of early TAI in brainstem.
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Affiliation(s)
- Qianling Chen
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Lingyue Li
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Luyao Xu
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Bin Yang
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Yuebing Huang
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Dongfang Qiao
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Xia Yue
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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Rauchman SH, Pinkhasov A, Gulkarov S, Placantonakis DG, De Leon J, Reiss AB. Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury. Diagnostics (Basel) 2023; 13:3330. [PMID: 37958226 PMCID: PMC10650880 DOI: 10.3390/diagnostics13213330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions occur yearly, and a substantial number result in lingering symptoms, loss of productivity, and lower quality of life. The diagnosis may not be made for multiple reasons, including due to patient hesitancy to undergo neuroimaging and inability of imaging to detect minimal damage. Biomarkers could fill this gap, but the time needed to send blood to a laboratory for analysis made this impractical until point-of-care measurement became available. A handheld blood test is now on the market for diagnosis of concussion based on the specific blood biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl terminal hydrolase L1 (UCH-L1). This paper discusses rapid blood biomarker assessment for mild TBI and its implications in improving prediction of TBI course, avoiding repeated head trauma, and its potential role in assessing new therapeutic options. Although we focus on the Abbott i-STAT TBI plasma test because it is the first to be FDA-cleared, our discussion applies to any comparable test systems that may become available in the future. The difficulties in changing emergency department protocols to include new technology are addressed.
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Affiliation(s)
| | - Aaron Pinkhasov
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (A.P.); (S.G.); (J.D.L.)
| | - Shelly Gulkarov
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (A.P.); (S.G.); (J.D.L.)
| | | | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (A.P.); (S.G.); (J.D.L.)
| | - Allison B. Reiss
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (A.P.); (S.G.); (J.D.L.)
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Pankatz L, Rojczyk P, Seitz-Holland J, Bouix S, Jung LB, Wiegand TLT, Bonke EM, Sollmann N, Kaufmann E, Carrington H, Puri T, Rathi Y, Coleman MJ, Pasternak O, George MS, McAllister TW, Zafonte R, Stein MB, Marx CE, Shenton ME, Koerte IK. Adverse Outcome Following Mild Traumatic Brain Injury Is Associated with Microstructure Alterations at the Gray and White Matter Boundary. J Clin Med 2023; 12:5415. [PMID: 37629457 PMCID: PMC10455493 DOI: 10.3390/jcm12165415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
The gray matter/white matter (GM/WM) boundary of the brain is vulnerable to shear strain associated with mild traumatic brain injury (mTBI). It is, however, unknown whether GM/WM microstructure is associated with long-term outcomes following mTBI. The diffusion and structural MRI data of 278 participants between 18 and 65 years of age with and without military background from the Department of Defense INTRuST study were analyzed. Fractional anisotropy (FA) was extracted at the GM/WM boundary across the brain and for each lobe. Additionally, two conventional analytic approaches were used: whole-brain deep WM FA (TBSS) and whole-brain cortical thickness (FreeSurfer). ANCOVAs were applied to assess differences between the mTBI cohort (n = 147) and the comparison cohort (n = 131). Associations between imaging features and post-concussive symptom severity, and functional and cognitive impairment were investigated using partial correlations while controlling for mental health comorbidities that are particularly common among military cohorts and were present in both the mTBI and comparison group. Findings revealed significantly lower whole-brain and lobe-specific GM/WM boundary FA (p < 0.011), and deep WM FA (p = 0.001) in the mTBI cohort. Whole-brain and lobe-specific GM/WM boundary FA was significantly negatively correlated with post-concussive symptoms (p < 0.039), functional (p < 0.016), and cognitive impairment (p < 0.049). Deep WM FA was associated with functional impairment (p = 0.002). Finally, no significant difference was observed in cortical thickness, nor between cortical thickness and outcome (p > 0.05). Findings from this study suggest that microstructural alterations at the GM/WM boundary may be sensitive markers of adverse long-term outcomes following mTBI.
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Affiliation(s)
- Lara Pankatz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- Département de génie logiciel et TI, École de Technologie Supérieure, Université du Québec, Montreal, QC H3C 1K3, Canada
| | - Leonard B. Jung
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Tim L. T. Wiegand
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Elena M. Bonke
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, 82152 Planegg, Germany
| | - Nico Sollmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Department of Neurology, University Hospital, LMU, 81377 Munich, Germany
| | - Holly Carrington
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Twishi Puri
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
| | - Michael J. Coleman
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Mark S. George
- Psychiatry Department, Medical University of South Carolina, Charleston, SC 29425, USA;
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
| | - Thomas W. McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA 02129, USA;
- Department of Physical Medicine and Rehabilitation, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA;
- School of Public Health, University of California San Diego, La Jolla, CA 92093, USA
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Christine E. Marx
- VA Mid-Atlantic Mental Illness Research and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC 27705, USA;
- Department of Psychiatry and Behavior Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Inga K. Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, 82152 Planegg, Germany
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Wang Y, Chen Q, Dang X, Lu W, Zhang X, Yan H, Niu S, Yan X, Yan J. A bibliometric analysis on traumatic brain injury in forensic medicine of a half-century (1972-2021). Front Neurol 2023; 14:913855. [PMID: 36816552 PMCID: PMC9932540 DOI: 10.3389/fneur.2023.913855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Traumatic brain injury (TBI) is among the most common injuries in forensic medicine, the identification of which is of particular importance in forensic practice. To reveal the circumstances and trends of TBI in the forensic field, we used the Web of Science (WoS) database for comprehensive retrieval. We made a metrological analysis of 1,089 papers in the past 50 years (1972-2021). The United States and Germany have the most forensic research on TBI. Diffuse axonal injury (DAI) has been the focus of attention for many years, and much effort has been devoted to its diagnosis in forensic pathology. Infants and children are the subgroups of most concern, especially in infant and child abuse cases. Research on identifying shaken baby syndrome has received increasing attention in recent years. Overall, our study provides a comprehensive list and analysis of the articles regarding TBI in legal medicine, which may shed light on recognizing the trends and research hotspots in this field.
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Affiliation(s)
- Yufang Wang
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Qianqian Chen
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Xingxing Dang
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Wanqing Lu
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Xinran Zhang
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - He Yan
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Shuliang Niu
- School of Basic Medical Science, Xinjiang Medical University, Urumqi, China
| | - Xisheng Yan
- Department of Cardiovascular Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jie Yan
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, Hunan, China,School of Basic Medical Science, Xinjiang Medical University, Urumqi, China,*Correspondence: Jie Yan ✉
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