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Baker CE, Yu X, Lovell B, Tan R, Patel S, Ghajari M. How Well Do Popular Bicycle Helmets Protect from Different Types of Head Injury? Ann Biomed Eng 2024:10.1007/s10439-024-03589-8. [PMID: 39294466 DOI: 10.1007/s10439-024-03589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/25/2024] [Indexed: 09/20/2024]
Abstract
Bicycle helmets are designed to protect against skull fractures and associated focal brain injuries, driven by helmet standards. Another type of head injury seen in injured cyclists is diffuse brain injuries, but little is known about the protection provided by bicycle helmets against these injuries. Here, we examine the performance of modern bicycle helmets in preventing diffuse injuries and skull fractures under impact conditions that represent a range of real-world incidents. We also investigate the effects of helmet technology, price, and mass on protection against these pathologies. 30 most popular helmets among UK cyclists were purchased within 9.99-135.00 GBP price range. Helmets were tested under oblique impacts onto a 45° anvil at 6.5 m/s impact speed and four locations, front, rear, side, and front-side. A new headform, which better represents the average human head's mass, moments of inertia and coefficient of friction than any other available headforms, was used. We determined peak linear acceleration (PLA), peak rotational acceleration (PRA), peak rotational velocity (PRV), and BrIC. We also determined the risk of skull fractures based on PLA (linear risk), risk of diffuse brain injuries based on BrIC (rotational risk), and their mean (overall risk). Our results show large variation in head kinematics: PLA (80-213 g), PRV (8.5-29.9 rad/s), PRA (1.6-9.7 krad/s2), and BrIC (0.17-0.65). The overall risk varied considerably with a 2.25 ratio between the least and most protective helmet. This ratio was 1.76 for the linear and 4.21 for the rotational risk. Nine best performing helmets were equipped with the rotation management technology MIPS, but not all helmets equipped with MIPS were among the best performing helmets. Our comparison of three tested helmets which have MIPS and no-MIPS versions showed that MIPS reduced rotational kinematics, but not linear kinematics. We found no significant effect of helmet price on exposure-adjusted injury risks. We found that larger helmet mass was associated with higher linear risk. This study highlights the need for a holistic approach, including both rotational and linear head injury metrics and risks, in helmet design and testing. It also highlights the need for providing information about helmet safety to consumers to help them make an informed choice.
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Affiliation(s)
- C E Baker
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, UK.
| | - X Yu
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, UK
- Department of Mechanical Engineering, University of Sheffield, Sheffield, S10 2TN, UK
| | - B Lovell
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, UK
| | - R Tan
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, UK
| | - S Patel
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, UK
| | - M Ghajari
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, UK
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Zhang N, Zhang S, Dong X. Plant-derived bioactive compounds and their novel role in central nervous system disorder treatment via ATF4 targeting: A systematic literature review. Biomed Pharmacother 2024; 176:116811. [PMID: 38795641 DOI: 10.1016/j.biopha.2024.116811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
Central nervous system (CNS) disorders exhibit exceedingly intricate pathogenic mechanisms. Pragmatic and effective solutions remain elusive, significantly compromising human life and health. Activating transcription factor 4 (ATF4) participates in the regulation of multiple pathophysiological processes, including CNS disorders. Considering the widespread involvement of ATF4 in the pathological process of CNS disorders, the targeted regulation of ATF4 by plant-derived bioactive compounds (PDBCs) may become a viable strategy for the treatment of CNS disorders. However, the regulatory relationship between PDBCs and ATF4 remains incompletely understood. Here, we aimed to comprehensively review the studies on PDBCs targeting ATF4 to ameliorate CNS disorders, thereby offering novel directions and insights for the treatment of CNS disorders. A computerized search was conducted on PubMed, Embase, Web of Science, and Google Scholar databases to identify preclinical experiments related to PDBCs targeting ATF4 for the treatment of CNS disorders. The search timeframe was from the inception of the databases to December 2023. Two assessors conducted searches using the keywords "ATF4," "Central Nervous System," "Neurological," "Alzheimer's disease," "Parkinson's Disease," "Stroke," "Spinal Cord Injury," "Glioblastoma," "Traumatic Brain Injury," and "Spinal Cord Injury." Overall, 31 studies were included, encompassing assessments of 27 PDBCs. Combining results from in vivo and in vitro studies, we observed that these PDBCs, via ATF4 modulation, prevent the deposition of amyloid-like fibers such as Aβ, tau, and α-synuclein. They regulate ERS, reduce the release of inflammatory factors, restore mitochondrial membrane integrity to prevent oxidative stress, regulate synaptic plasticity, modulate autophagy, and engage anti-apoptotic mechanisms. Consequently, they exert neuroprotective effects in CNS disorders. Numerous PDBCs targeting ATF4 have shown potential in facilitating the restoration of CNS functionality, thereby presenting expansive prospects for the treatment of such disorders. However, future endeavors necessitate high-quality, large-scale, and comprehensive preclinical and clinical studies to further validate this therapeutic potential.
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Affiliation(s)
- Nan Zhang
- Department of Neurology, the Seventh Clinical College of China Medical University, No. 24 Central Street, Xinfu District, Fushun, Liaoning 113000, China
| | - Shun Zhang
- Department of Neurology, Shengjing Hospital of China Medical University, No. 36 Sanhao street, Heping District, Shenyang, Liaoning 110000, China
| | - Xiaoyu Dong
- Department of Neurology, Shengjing Hospital of China Medical University, No. 36 Sanhao street, Heping District, Shenyang, Liaoning 110000, China.
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Murase M, Yasuda S, Sawano M. Prediction for the prognosis of diffuse axonal injury using automated pupillometry. Clin Neurol Neurosurg 2024; 240:108244. [PMID: 38520767 DOI: 10.1016/j.clineuro.2024.108244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE Previous studies have reported various predictive indicators of diffuse axonal injury (DAI), but no consensus has not been reached. Although the efficiency of automated pupillometry in patients with consciousness disorder has been widely reported, there are few reports of its use in patients with DAI. This study aimed to investigate the significance of pupillary findings in predicting the prognosis of DAI. PATIENTS AND METHODS We included patients admitted to our center with a diagnosis of DAI from June 1, 2021 to June 30, 2022. Pupillary findings in both eyes were quantitatively measured by automated pupillometry every 2 hours after admission. We statistically examined the correlations between automated pupillometry parameters, the patients' characteristics, and outcomes such as the Glasgow Outcome Scale Extended (GOSE) after 6 months from injury, the time to follow command, and so on. RESULTS Among 22 patients included in this study, five had oculomotor nerve palsy. Oculomotor nerve palsy was correlated with all outcomes, whereas Marshall computed tomography (CT) classification, Injury severity score (ISS) and DAI grade were correlated with few outcomes. Some of the automated pupillometry parameters were significantly correlated with GOSE at 6 months after injury, and many during the first 24 hours of measurement were correlated with the time to follow command. Most of these results were not affected by adjustment using sedation period, ISS or Marshall CT classification. A subgroup analysis of patients without oculomotor nerve palsy revealed that many of the automated pupillometry parameters during the first 24 hours of measurement were significantly correlated with most of the outcomes. The cutoff values that differentiated a good prognosis (GOSE 5-8) from a poor prognosis (GOSE 1-4) were constriction velocity (CV) 1.43 (AUC = 0.81(0.62-1), p = 0.037) and maximum constriction velocity (MCV) 2.345 (AUC = 0.78 (0.58-0.98), p = 0.04). The cutoff values that differentiated the time to follow command into within 7 days and over 8 days were percentage of constriction 8 (AUC = 0.89 (0.68-1), p = 0.011), CV 0.63 (AUC = 0.92 (0.78-1), p = 0.013), MCV 0.855 (AUC = 0.9 (0.74-1), p = 0.017) and average dilation velocity 0.175 (AUC = 0.95 (0.86-1), p = 0.018). CONCLUSIONS The present results indicate that pupillary findings in DAI are a strong predictive indicator of the prognosis, and that quantitative measurement of them using automated pupillometry could facilitate enhanced prediction for the prognosis of DAI.
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Affiliation(s)
- Makoto Murase
- Department of Emergency Medicine and Critical Care, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Shinichi Yasuda
- Department of Emergency Medicine and Critical Care, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Makoto Sawano
- Department of Emergency Medicine and Critical Care, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
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Hazwani T, Khalifa AM, Azzubi M, Alhammad A, Aloboudi A, Jorya A, Alkhuraiji A, Alhelabi S, Shaheen N. Diffuse axonal injury on magnetic resonance imaging and its relation to neurological outcomes in pediatric traumatic brain injury. Clin Neurol Neurosurg 2024; 237:108166. [PMID: 38364490 DOI: 10.1016/j.clineuro.2024.108166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Diffuse axonal injury (DAI), a frequent consequence of pediatric traumatic brain injury (TBI), presents challenges in predicting long-term recovery. This study investigates the relationship between the severity of DAI and neurological outcomes in children. METHODS We conducted a retrospective analysis of 51 pediatric TBI patients diagnosed with DAI using Adam's classification. Neurological function was assessed at 2, 3, and 6 weeks, and 12 months post-injury using the Pediatric Glasgow Outcome Scale-Extended (PGOSE). RESULTS PGOSE scores significantly improved over time across all DAI grades, suggesting substantial recovery potential even in initially severe cases. Despite indicating extensive injury, patients with DAI grades II and III demonstrated significant improvement, achieving a good recovery by 12 months. Although the initial Glasgow Coma Scale (GCS) score did not show a statistically significant association with long-term outcomes in our limited sample, these findings suggest that the severity of DAI alone may not fully predict eventual recovery. CONCLUSIONS Our study highlights the potential for significant neurological recovery in pediatric patients with DAI, emphasizing the importance of long-term follow-up and individualized rehabilitation programs. Further research with larger cohorts and extended follow-up periods is crucial to refine our understanding of the complex relationships between DAI severity, injury mechanisms, and long-term neurological outcomes in children.
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Affiliation(s)
- Tarek Hazwani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Pediatrics, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed M Khalifa
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Pediatrics, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
| | - Moutasem Azzubi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Division of Neurosurgery, Department of Pediatric Surgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah Alhammad
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah Aloboudi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ahmad Jorya
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Pediatrics, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Arwa Alkhuraiji
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sarah Alhelabi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Naila Shaheen
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Vieira RDCA, Pipek LZ, de Oliveira DV, Paiva WS, de Sousa RMC. The Relationship between Injury Characteristics and Post-Traumatic Recovery after Diffuse Axonal Injury. Biomedicines 2024; 12:311. [PMID: 38397913 PMCID: PMC10886783 DOI: 10.3390/biomedicines12020311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The diagnosis and prognosis of diffuse axonal injury (DAI) remain challenging. This research aimed to analyze the impact on activities of daily living (ADL), functional outcomes, quality of life (QoL), and the association between lesion severity and DAI location identified through imaging exams. METHODS This prospective cohort study included 95 patients diagnosed with DAI. Data were collected at admission, three, six, and twelve months post-injury. The associations between variables were evaluated using a mixed-effects model. RESULTS Functional recovery and QoL improved between three and twelve months after DAI. An interaction was observed between independence in performing ADL and subarachnoid hemorrhage (p = 0.043) and intraventricular hemorrhage (p = 0.012). Additionally, an interaction over time was observed between the Glasgow Outcome Scale (GOS) and DAI severity (p < 0.001), brain lesions (p = 0.014), and the Disability Rating Scale (DRS) with injury in brain hemispheres (p = 0.026) and Adams classification (p = 0.013). Interaction effects over time were observed with the general health perceptions and energy/vitality domains with intraventricular hemorrhage, and the social functioning domain with the obliteration of basal cisterns and Gentry's classification. CONCLUSION The use of CT in the acute phase of DAI is important for predicting outcomes. The severity and location of DAI are associated with functional outcomes, ADL, and QoL.
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Affiliation(s)
- Rita de Cássia Almeida Vieira
- Department of Nursing, University of Sergipe, Lagarto 49400-000, Brazil;
- Nursing School, University of Sao Paulo, Sao Paulo 05508-010, Brazil;
| | - Leonardo Zumerkorn Pipek
- Department of Neurology, Clinical Hospital of the University of Sao Paulo, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil
| | | | - Wellingson Silva Paiva
- Division of Neurosurgery, Clinical Hospital of the University of Sao Paulo, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil;
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Sharma M, Prakash S, Mathur P, Suri V, Subramanian A, Agrawal D, Pandey RM, Raina A, Malhotra R, Lalwani S. Alterations of oligodendrocyte progenitor cells (OPCs) with survival time in humans following high impact brain trauma. J Forensic Leg Med 2023; 97:102557. [PMID: 37413907 DOI: 10.1016/j.jflm.2023.102557] [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: 04/06/2023] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND As there is a lack of comprehensive literature regarding the molecular environment of the human brain emphasizing on oligodendrocyte progenitor cells (OPCs) following high impact brain trauma. The protagonist of OPCs post severe traumatic brain injury (sTBI) provides a significant thrust towards estimating time elapsed since trauma as well as developing novel therapeutic approaches. The present study was carried out to study post trauma alterations pertaining to myelin sheath and oligodendrocyte response with survival time. MATERIALS AND METHODS In the present study, victims (both male and female) of sTBI (n = 64) were recruited and contrasted with age and gender matched controls (n = 12). Post mortem brain samples from corpus callosum and grey white matter interface were collected during autopsy examination. Extent of myelin degradation and response of OPC markers Olig-2 and PDGFR-α were evaluated using immunohistochemistry and qRT-PCR. STATA 14.0 statistical software was used for data analysis with P-value<0.05 considered statistically significant. RESULTS Timewise qualitative correlation with extent of demyelination performed using LFB-PAS/IHC-MBP, IHC Olig-2 and mRNA expression revealed tendency towards remyelination in both corpus callosum and grey white matter interface. Number of Olig-2 positive cells was significantly higher in sTBI group as compared to control group (P-value: 0.0001). Moreover, mRNA expression studies of Olig-2 showed significant upregulation in sTBI patients. mRNA expression of Olig-2 and PDGFR-α in sTBI patients showed significant variation with respect to survival time (p value:0.0001). CONCLUSION Detailed assessment of post TBI changes implementing various immunohistochemical and molecular techniques shall potentially reveal intriguing and important inferences in medicolegal practices and neurotherapeutics.
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Affiliation(s)
- Meenakshi Sharma
- Division of Forensic Pathology and Molecular DNA Laboratory, Jai Prakash Narayan Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi, 110029, India.
| | - Shyam Prakash
- Department of Laboratory Medicine, All ındia ınstitute of Medical Sciences, New Delhi- 110029, India.
| | - Purva Mathur
- Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi-1100029, India.
| | - Vaishali Suri
- Neuropathology Laboratory, All ındia ınstitute of Medical Sciences, New Delhi-110029, India.
| | - Arulselvi Subramanian
- Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi-1100029, India.
| | - Deepak Agrawal
- Department of Neurosurgery, Jai Prakash Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi-110029, India.
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All ındia ınstitute of Medical Sciences, New Delhi-110029, India.
| | - Anupuma Raina
- Division of Forensic Pathology and Molecular DNA Laboratory, Jai Prakash Narayan Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi, 110029, India.
| | - Rajesh Malhotra
- Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi-110029, India.
| | - Sanjeev Lalwani
- Division of Forensic Pathology and Molecular DNA Laboratory, Jai Prakash Narayan Apex Trauma Centre, All ındia ınstitute of Medical Sciences, Raj Nagar, New Delhi, 110029, India.
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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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Role of integrin and its potential as a novel postmortem biomarker in traumatic axonal injury. Int J Legal Med 2022; 137:843-849. [PMID: 36562807 DOI: 10.1007/s00414-022-02938-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Traumatic axonal injury (TAI) accounts for a large proportion of the mortality of traumatic brain injury (TBI). The diagnosis of TAI is currently of limited use for medicolegal purposes. It is known that axons in TAI are diffusely damaged by secondary processes other than direct head injury. However, the physiopathological mechanism of TAI is still elusive. The present study used RGD peptide, an antagonist of the mechanotransduction protein integrin, to explore the role of integrin-transmitted mechanical signalling in the pathogenesis of rat TAI. The rats were subjected to a linearly accelerating load, and changes in beta-amyloid precursor protein (β-APP) expression, skeleton ultrastructure, skeleton protein neurofilament light (NF-L), and α-tubulin in the brainstem were observed, indicating that RGD could relieve the severity of axonal injury in TAI rats. In addition, the expression of β-integrin was stronger and centralized in the brainstem of the deceased died from TAI compared to other nonviolent causes. This study examined the pathophysiology and biomechanics of TAI and assessed the role of integrin in the injury of microtubules and neurofilaments in TAI. Thus, we propose that integrin-mediated cytoskeletal injury plays an important role in TAI and that integrin has the potential as a biomarker for TAI.
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Hershkovitz Y, Kessel B, Dubose JJ, Peleg K, Zilbermints V, Jeroukhimov I, Givon A, Dudkiewicz M, Aranovich D. Is Diffuse Axonal Injury Different in Adults and Children? An Analysis of National Trauma Database. Pediatr Emerg Care 2022; 38:62-64. [PMID: 35100742 DOI: 10.1097/pec.0000000000002626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Diffuse axonal injury (DAI) is typically associated with significant mechanisms of injury and the effects of acceleration-deceleration forces on brain tissues. The prognosis of DAI remains a matter of active investigation, but little is known about outcome differences between adult and pediatric populations with DAI. METHODS We performed a retrospective cohort study involving blunt trauma patients with DAI between the years 1997 and 2018 from the Israeli National Trauma Registry. The patients were divided to pediatric (age <15 years) and adult (age >15 years) groups, with subsequent comparison of demographics and outcomes. RESULTS Diffuse axonal injury was identified in 1983 patients, including 469 pediatric victims (23.6%) and 1514 adults (76.4%). Adults had higher Injury Severity Score (20.5% vs 13.2%, P = 0.0004), increased mortality (17.7% vs 13.4%, P < 0.0001), longer hospitalizations (58.4% vs 44.4%, P < 0.001), and higher rehabilitation need rates (56.4% vs 41.8%, P < 0.0001). Associated extracranial injuries were also more common in adults, particularly to the chest. CONCLUSIONS Pediatric patients with DAI have improved outcomes and fewer associated injuries than adult counterparts.
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Affiliation(s)
- Yehuda Hershkovitz
- From the Department of Surgery, Shamir Medical Center, Zeriffin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Boris Kessel
- Surgical Division, Hillel Yaffe Medical Center, Hadera, affiliated with Rappoport Medical School, Technion, Haifa
| | - J J Dubose
- National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - Kobi Peleg
- University of Maryland School of Medicine, Baltimore, MD
| | - Viacheslav Zilbermints
- Surgical Division, Hillel Yaffe Medical Center, Hadera, affiliated with Rappoport Medical School, Technion, Haifa
| | - Igor Jeroukhimov
- From the Department of Surgery, Shamir Medical Center, Zeriffin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Adi Givon
- National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | | | - David Aranovich
- Surgical Division, Hillel Yaffe Medical Center, Hadera, affiliated with Rappoport Medical School, Technion, Haifa
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Andreone BJ, Larhammar M, Lewcock JW. Cell Death and Neurodegeneration. Cold Spring Harb Perspect Biol 2020; 12:cshperspect.a036434. [PMID: 31451511 DOI: 10.1101/cshperspect.a036434] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Neurodegenerative disease is characterized by the progressive deterioration of neuronal function caused by the degeneration of synapses, axons, and ultimately the death of nerve cells. An increased understanding of the mechanisms underlying altered cellular homeostasis and neurodegeneration is critical to the development of effective treatments for disease. Here, we review what is known about neuronal cell death and how it relates to our understanding of neurodegenerative disease pathology. First, we discuss prominent molecular signaling pathways that drive neuronal loss, and highlight the upstream cell biology underlying their activation. We then address how neuronal death may occur during disease in response to neuron intrinsic and extrinsic stressors. An improved understanding of the molecular mechanisms underlying neuronal dysfunction and cell death will open up avenues for clinical intervention in a field lacking disease-modifying treatments.
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Abstract
PURPOSE OF REVIEW The current review analyzes recent findings that suggest that axon degeneration is a druggable process in the treatment of neurodegenerative disorders and a subset of traumas. RECENT FINDINGS Emerging evidence reveals that axon degeneration is an active and regulated process in the early progression of some neurodegenerative diseases and acute traumas, which is orchestrated through a combination of axon-intrinsic and somatically derived signaling events. The identification of these pathways has presented appealing drug targets whose specificity for the nervous system and phenotypes in mouse models offers significant clinical opportunity. SUMMARY As the biology of axon degeneration becomes clear, so too has the realization that the pathways driving axon degeneration overlap in part with those that drive neuronal apoptosis and, importantly, axon regeneration. Axon-specific disorders like those seen in CIPN, where injury signaling to the nucleus is not a prominent feature, have been shown to benefit from disruption of Sarm1. In injury and disease contexts, where involvement of somatic events is prominent, inhibition of the MAP Kinase DLK exhibits promise for neuroprotection. Here, however, interfering with somatic signaling may preclude the ability of an axon or a circuit to regenerate or functionally adapt following acute injuries.
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Wang F, Yang T, Li J, Zhou X, Liu L. Histopathology mapping of biochemical changes in diffuse axonal injury by FTIR micro-spectroscopy. Leg Med (Tokyo) 2019; 37:76-82. [PMID: 30772767 DOI: 10.1016/j.legalmed.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/05/2018] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
The diagnosis of diffuse axonal injury (DAI) is an important task in forensic pathology and clinical medicine. This study aimed to explore the use of Fourier transform infrared spectroscopy (FTIR) to detect DAI. The DAI area of the rat model was detected point by point by the FTIR-mapping system. Infrared spectral data of DAI were obtained by selecting the amide A band, CH3 symmetric stretching, collagen triple-helix structure and asymmetric stretching vibrational frequency of nucleic acid and phospholipid PO2 as the target peak positions. The system can automatically draw infrared spectral color pathological images. In the DAI group, the amide A protein secondary amine N-H stretching vibration and the collagen triple-helix structure of the high-absorption area were consistent with the DAI area confirmed by the silver and β-APP staining. The CH3 symmetric stretching, nucleic acid and phospholipid PO2 symmetric stretching vibration absorption spectra showed no significant differences between the experimental and verification groups. The FTIR-mapping technique can visually express the molecular characteristics of DAI, which is expected to be applied to the pathological diagnosis of DAI.
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Affiliation(s)
- Fulei Wang
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Tiantong Yang
- Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 West Tucheng Road, Haidian District, Beijing 100088, China
| | - Jian Li
- Beijing People's Police College, 11 Nanjian Road, Changping District, Beijing 102202, China
| | - Xiaowei Zhou
- Chongxin Judicial Expertise Center (Hubei), F1-2, Zone B, Huazhong International Industrial Park, Yangluo Development Zone, Xinzhou District, Wuhan, Hubei 430415, China
| | - Liang Liu
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei, China.
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