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Landvater J, Kim S, Caswell K, Kwon C, Odafe E, Roe G, Tripathi A, Vukovics C, Wang J, Ryan K, Cocozza V, Brock M, Tchopev Z, Tonkin B, Capaldi V, Collen J, Creamer J, Irfan M, Wickwire E, Williams S, Werner JK. Traumatic brain injury and sleep in military and veteran populations: A literature review. NeuroRehabilitation 2024:NRE230380. [PMID: 39121144 DOI: 10.3233/nre-230380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a hallmark of wartime injury and is related to numerous sleep wake disorders (SWD), which persist long term in veterans. Current knowledge gaps in pathophysiology have hindered advances in diagnosis and treatment. OBJECTIVE We reviewed TBI SWD pathophysiology, comorbidities, diagnosis and treatment that have emerged over the past two decades. METHODS We conducted a literature review of English language publications evaluating sleep disorders (obstructive sleep apnea, insomnia, hypersomnia, parasomnias, restless legs syndrome and periodic limb movement disorder) and TBI published since 2000. We excluded studies that were not specifically evaluating TBI populations. RESULTS Highlighted areas of interest and knowledge gaps were identified in TBI pathophysiology and mechanisms of sleep disruption, a comparison of TBI SWD and post-traumatic stress disorder SWD. The role of TBI and glymphatic biomarkers and management strategies for TBI SWD will also be discussed. CONCLUSION Our understanding of the pathophysiologic underpinnings of TBI and sleep health, particularly at the basic science level, is limited. Developing an understanding of biomarkers, neuroimaging, and mixed-methods research in comorbid TBI SWD holds the greatest promise to advance our ability to diagnose and monitor response to therapy in this vulnerable population.
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Affiliation(s)
- Jeremy Landvater
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Sharon Kim
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Keenan Caswell
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Caroline Kwon
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Emamoke Odafe
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Grace Roe
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Ananya Tripathi
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Johnathan Wang
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Keith Ryan
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Victoria Cocozza
- Wilford Hall Ambulatory Surgical Center Center, San Antonio, TX, USA
| | - Matthew Brock
- Wilford Hall Ambulatory Surgical Center Center, San Antonio, TX, USA
| | - Zahari Tchopev
- Wilford Hall Ambulatory Surgical Center Center, San Antonio, TX, USA
| | - Brionn Tonkin
- University of Minnesota, Minneapolis, MN, USA
- Minneapolis Veterans Administration Medical Center, Minneapolis, MN, USA
| | - Vincent Capaldi
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jacob Collen
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Muna Irfan
- University of Minnesota, Minneapolis, MN, USA
- Minneapolis Veterans Administration Medical Center, Minneapolis, MN, USA
| | - Emerson Wickwire
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Scott Williams
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Defense Health Headquarters, Falls Church, VA, USA
| | - J Kent Werner
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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2
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Kuo LT, Lu HY, Chen YH. Traumatic brain injury-induced disruption of the circadian clock. J Mol Med (Berl) 2024; 102:403-414. [PMID: 38285094 PMCID: PMC10879350 DOI: 10.1007/s00109-024-02416-w] [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: 02/22/2023] [Revised: 12/16/2023] [Accepted: 01/03/2024] [Indexed: 01/30/2024]
Abstract
Disturbances in the circadian rhythm have been reported in patients following traumatic brain injury (TBI). However, the rhythmic expression of circadian genes in peripheral blood leukocytes (PBL) following TBI has not yet been studied. The messenger ribonucleic acid (mRNA) expression of period 1 (Per1), Per2, Per3, cryptochrome 1 (Cry1), Cry2, brain and muscle aryl hydrocarbon receptor nuclear translocator-like 1 (Bmal1), and circadian locomotor output cycles kaput (Clock) was quantified in PBLs from sham-operated rats and rats with acute subdural hematoma (ASDH) over a 48-h period. The rectal temperature of the animals was measured every 4 h over 2 days. The mesor, rhythm, amplitude, and acrophase were estimated using cosinor analysis. Cosinor analysis revealed that Per2, Cry1, and Bmal1 mRNAs were rhythmically expressed in the PBLs of sham-operated rats. In contrast, fluctuations in rhythmic expression were not observed following ASDH. The rectal temperature of sham-operated rats also exhibited rhythmicity. ASDH rats had a disrupted rectal temperature rhythm, a diminished amplitude, and an acrophase shift. TBI with ASDH results in dysregulated expression of some circadian genes and changes in body temperature rhythm. Further research is required to understand the pathophysiology of altered circadian networks following TBI. KEY MESSAGES: First to investigate the mRNA expression of circadian genes in PBLs of ASDH rats. ASDH rats had disrupted rhythmicity of Per2, Cry1, and Bmal1 mRNA expression. Cosinor analysis showed that ASDH rats had a disrupted rectal temperature rhythm.
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Affiliation(s)
- Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, 7 Chun-Shan South Road, Taipei, 100, Taiwan.
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin Branch, Douliu, Yunlin, 640, Taiwan.
| | - Hsueh-Yi Lu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Douliu, Yunlin, 640, Taiwan
| | - Yi-Hsing Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, 7 Chun-Shan South Road, Taipei, 100, Taiwan
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Kimura A, Ishida Y, Nosaka M, Ishigami A, Yamamoto H, Kuninaka Y, Hata S, Ozaki M, Kondo T. Application and limitation of a biological clock-based method for estimating time of death in forensic practices. Sci Rep 2023; 13:6093. [PMID: 37055510 PMCID: PMC10102023 DOI: 10.1038/s41598-023-33328-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/11/2023] [Indexed: 04/15/2023] Open
Abstract
Estimating time of death is one of the most important problems in forensics. Here, we evaluated the applicability, limitations and reliability of the developed biological clock-based method. We analyzed the expression of the clock genes, BMAL1 and NR1D1, in 318 dead hearts with defined time of death by real-time RT-PCR. For estimating the time of death, we chose two parameters, the NR1D1/BMAL1 ratio and BMAL1/NR1D1 ratio for morning and evening deaths, respectively. The NR1D1/BMAL1 ratio was significantly higher in morning deaths and the BMAL1/NR1D1 ratio was significantly higher in evening deaths. Sex, age, postmortem interval, and most causes of death had no significant effect on the two parameters, except for infants and the elderly, and severe brain injury. Although our method may not work in all cases, our method is useful for forensic practice in that it complements classical methods that are strongly influenced by the environment in which the corpse is placed. However, this method should be applied with caution in infants, the elderly, and patients with severe brain injury.
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Affiliation(s)
- Akihiko Kimura
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Yuko Ishida
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Mizuho Nosaka
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Akiko Ishigami
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Hiroki Yamamoto
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Yumi Kuninaka
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Satoshi Hata
- Department of Cardiovascular Medicine, Kinan Hospital, Wakayama, Japan
| | - Mitsunori Ozaki
- Department of Neurological Surgery, National Hospital Organization Minami Wakayama Medical Center, Wakayama, Japan
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan.
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Boots R, Xue G, Tromp D, Rawashdeh O, Bellapart J, Townsend S, Rudd M, Winter C, Mitchell G, Garner N, Clement P, Karamujic N, Zappala C. Circadian Rhythmicity of Vital Signs at Intensive Care Unit Discharge and Outcome of Traumatic Brain Injury. Am J Crit Care 2022; 31:472-482. [PMID: 36316179 DOI: 10.4037/ajcc2022821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Physiological functions with circadian rhythmicity are often disrupted during illness. OBJECTIVE To assess the utility of circadian rhythmicity of vital signs in predicting outcome of traumatic brain injury (TBI). METHODS A retrospective single-center cohort study of adult intensive care unit (ICU) patients with largely isolated TBI to explore the relationship between the circadian rhythmicity of vital signs during the last 24 hours before ICU discharge and clinical markers of TBI severity and score on the Glasgow Outcome Scale 6 months after injury (GOS-6). RESULTS The 130 study participants had a median age of 39.0 years (IQR, 23.0-59.0 years), a median Glasgow Coma Scale score at the scene of 8.0 (IQR, 3.0-13.0), and a median Rotterdam score on computed tomography of the head of 3 (IQR, 3-3), with 105 patients (80.8%) surviving to hospital discharge. Rhythmicity was present for heart rate (30.8% of patients), systolic blood pressure (26.2%), diastolic blood pressure (20.0%), and body temperature (26.9%). Independent predictors of a dichotomized GOS-6 ≥4 were the Rotterdam score (odds ratio [OR], 0.38 [95% CI, 0.18-0.81]; P = .01), Glasgow Coma Scale score at the scene (OR, 1.22 [95% CI, 1.05-1.41]; P = .008), age (OR, 0.95 [95% CI, 0.92-0.98]; P = .003), oxygen saturation <90% in the first 24 hours (OR, 0.19 [95% CI, 0.05-0.73]; P = .02), serum sodium level <130 mmol/L (OR, 0.20 [95% CI, 0.05-0.70]; P = .01), and active intracranial pressure management (OR, 0.16 [95% CI, 0.04-0.62]; P = .008), but not rhythmicity of any vital sign. CONCLUSION Circadian rhythmicity of vital signs at ICU discharge is not predictive of GOS-6 in patients with TBI.
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Affiliation(s)
- Rob Boots
- Rob Boots is an associate professor, Thoracic Medicine, Royal Brisbane and Women's Hospital, a senior specialist, Intensive Care, Bundaberg Hospital, Faculty of Medicine, The University of Queensland, Herston, and a professsor, Faculty of Medicine and Dentistry, Griffith University, Queensland, Australia
| | - George Xue
- George Xue is the medical registrar, Royal Brisbane and Women's Hospital
| | - Dirk Tromp
- Dirk Tromp is the senior radiology registrar, Royal Brisbane and Women's Hospital
| | - Oliver Rawashdeh
- Oliver Rawashdeh is director, Chronobiology and Sleep Research, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Judith Bellapart
- Judith Bellapart is a senior specialist, Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, and Burns, Trauma, and Critical Care, The University of Queensland
| | - Shane Townsend
- Shane Townsend is director, Intensive Care Services, Royal Brisbane and Women's Hospital
| | - Michael Rudd
- Michael Rudd is acting director, Trauma, Royal Brisbane and Women's Hospital
| | - Craig Winter
- Craig Winter is a staff specialist neurosurgeon, Royal Brisbane and Women's Hospital
| | - Gary Mitchell
- Gary Mitchell is a staff specialist, Emergency Medicine, Royal Brisbane and Women's Hospital
| | - Nicholas Garner
- Nicholas Garner is a PhD student, Chronobiology and Sleep Research Lab, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Pierre Clement
- Pierre Clement is a clinical information systems manager, Intensive Care Services, Royal Brisbane and Women's Hospital
| | - Nermin Karamujic
- Nermin Karamujic is a data manager and clinical information systems manager, Intensive Care Services, Royal Brisbane and Women's Hospital
| | - Christopher Zappala
- Christopher Zappala is a senior staff specialist, Thoracic Medicine, Royal Brisbane and Women's Hospital
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5
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Zhanfeng N, Liang W, Jing K, Jinbo B, Yanjun C, Hechun X. Regulation of sleep disorders in patients with traumatic brain injury by intestinal flora based on the background of brain-gut axis. Front Neurosci 2022; 16:934822. [PMID: 36303945 PMCID: PMC9594989 DOI: 10.3389/fnins.2022.934822] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE This study investigates whether people with sleep disorders following traumatic brain injury exhibit altered intestinal flora. The changes may allow us to gain a better understanding of the role of intestinal flora in patients with sleep disorders after traumatic brain injury, which may give us insights into curing the sleep disorder after traumatic brain injury (TBI). METHOD We analyzed the intestinal microbial colony structure in the feces of the 28 patients in the normal sleep group and the sleep disorder group by 16SrDNAsequencing technology. The bioinformatics method was used to analyze the intestinal flora change in the v3-v4 region of patients with biorhythm disorder and to observe the difference between the two groups. RESULTS Group grouping comparison and analysis of the evolutionary cladistic map showed the intestinal flora of patients with normal sleep after TBI was mainly Bacilli and Lactobacillales, while that of patients with sleep disorders was mainly Lachnospiraceae and Bacteroidales. The histogram of group value distribution by grouping comparison and analysis showed that Lachnospiraceae, Bacteroidales, Bacteroidia, and Bacteroidetes were dominant in the sleep disorder group. A relative abundance map of species with significant differences by group grouping comparison showed the main manifestations of intestinal flora are Firmicutes, Bacilli, Lactobacillales, Streptococcaceae, and Bacteroidetes. The normal sleep group was dominated by Bacilli, Lactobacillales, Streptococcus, and Veillonella, while in the sleep disorder group, Lachnospiraceae, Bacteroidales, Bacteroidia, and Bacteroidetes were the main species. It was found that there were also significant differences in intestinal flora abundance between the two groups after TBI. After statistics processing, it was compared with the normal sleep group, Lactobacillus, Streptococcus, Oribacterium and Rothia, Actinomyces, Streptophyta, TM7-3 bacteria, and Serratia, showing a significant reduction in the sleep disorder group (P < 0.05). However, Odoribacter, Lachnospiraceae, and Bilophila increased significantly (P < 0.05). CONCLUSION The sleep disorders of patients after TBI can be closely related to intestinal flora disturbance, and its internal mechanism needs further study. Intestinal flora has the potential to be a new therapeutic target.
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Affiliation(s)
- Niu Zhanfeng
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Wu Liang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Kang Jing
- ENT & HN Surgery Department, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Bai Jinbo
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Chen Yanjun
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xia Hechun
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
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6
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Li T, Liu Z, Wang Y, Zuo D, Wang S, Ju H, Wang S, Xing Y, Ling Y, Liu C, Zhang Y, Zhou H, Yin J, Cao J, Gao J. Multiplexed Visualization Method to Explore Complete Targeting Regulatory Relationships Among Circadian Genes for Insomnia Treatment. Front Neurosci 2022; 16:877802. [PMID: 35844237 PMCID: PMC9285005 DOI: 10.3389/fnins.2022.877802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Understanding the complete map of melatonin synthesis, the information transfer network among circadian genes in pineal gland, promises to resolve outstanding issues in endocrine systems and improve the clinical diagnosis and treatment level of insomnia, immune disease and hysterical depression. Currently, some landmark studies have revealed some genes that regulate circadian rhythm associated with melatonin synthesis. However, these studies don't give a complete map of melatonin synthesis, as transfer information among circadian genes in pineal gland is lost. New biotechnology, integrates dynamic sequential omics and multiplexed imaging method, has been used to visualize the complete process of melatonin synthesis. It is found that there are two extremely significant information transfer processes involved in melatonin synthesis. In the first stage, as the light intensity decreased, melatonin synthesis mechanism has started, which is embodied in circadian genes, Rel, Polr2A, Mafk, and Srbf1 become active. In the second stage, circadian genes Hif1a, Bach1, Clock, E2f6, and Per2 are regulated simultaneously by four genes, Rel, Polr2A, Mafk, and Srbf1 and contribute genetic information to Aanat. The expeditious growth in this technique offer reference for an overall understanding of gene-to-gene regulatory relationship among circadian genes in pineal gland. In the study, dynamic sequential omics and the analysis process well provide the current state and future perspectives to better diagnose and cure diseases associated with melatonin synthesis disorder.
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Affiliation(s)
- Tao Li
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
- *Correspondence: Tao Li
| | - Zhenyu Liu
- Inner Mongolia Autonomous Region Key Laboratory of Big Data Research and Application of Agriculture and Animal Husbandry, College of Computer and Information Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Yitong Wang
- Department of Neurosurgery, Beijing Hospital, Beijing, China
| | - Dongshi Zuo
- Inner Mongolia Autonomous Region Key Laboratory of Big Data Research and Application of Agriculture and Animal Husbandry, College of Computer and Information Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Shenyuan Wang
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Haitao Ju
- Department of Neurosurgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Shichao Wang
- Clinical Genetic Laboratory, First Hospital of Hohhot, Hohhot, China
| | - Yanping Xing
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Yu Ling
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Chunxia Liu
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Yanru Zhang
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Huanmin Zhou
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Jun Yin
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
| | - Junwei Cao
- Inner Mongolia Key Laboratory of Bio-manufacture, College of Life Sciences, Inner Mongolia Agricultural University, Hohhot, China
- Junwei Cao
| | - Jing Gao
- Inner Mongolia Autonomous Region Key Laboratory of Big Data Research and Application of Agriculture and Animal Husbandry, College of Computer and Information Engineering, Inner Mongolia Agricultural University, Hohhot, China
- Jing Gao
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7
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Melatonin attenuates repeated mild traumatic brain injury-induced cognitive deficits by inhibiting astrocyte reactivation. Biochem Biophys Res Commun 2021; 580:20-27. [PMID: 34607259 DOI: 10.1016/j.bbrc.2021.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/10/2021] [Indexed: 12/25/2022]
Abstract
Melatonin has been well documented for its neuroprotective role through inhibiting oxidative stress against traumatic brain injury (TBI). However, the specific role of melatonin and the exact effects on cell responses (neurons, astrocytes, and microglia) in different brain regions are unclear. Here, we subjected mice to closed head injury, to establish a repeated mild TBI model and detect neuronal activity and glial responses in cognition-related brain regions after melatonin administration. Melatonin only showed cognitive enhancement if administered during early pathological stages, but not in late (chronic) stages. Additionally, we observed a significant increase in neuronal activity and inhibition of astrocyte reactivation in medial prefrontal cortex and hippocampus, but not in other cognitive deficit related brain regions. Furthermore, by activating astrocytes in these brain regions, we found neuronal activity upregulation and cognitive improvement following melatonin treatment. Therefore, we concluded that melatonin administration during the early stages of TBI is necessary to inhibit astrocyte reactivation and to promote cognitive function. Our results provide evidence for use of melatonin for cognitive improvement after TBIs.
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8
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Köhli P, Otto E, Jahn D, Reisener MJ, Appelt J, Rahmani A, Taheri N, Keller J, Pumberger M, Tsitsilonis S. Future Perspectives in Spinal Cord Repair: Brain as Saviour? TSCI with Concurrent TBI: Pathophysiological Interaction and Impact on MSC Treatment. Cells 2021; 10:2955. [PMID: 34831179 PMCID: PMC8616497 DOI: 10.3390/cells10112955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/08/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022] Open
Abstract
Traumatic spinal cord injury (TSCI), commonly caused by high energy trauma in young active patients, is frequently accompanied by traumatic brain injury (TBI). Although combined trauma results in inferior clinical outcomes and a higher mortality rate, the understanding of the pathophysiological interaction of co-occurring TSCI and TBI remains limited. This review provides a detailed overview of the local and systemic alterations due to TSCI and TBI, which severely affect the autonomic and sensory nervous system, immune response, the blood-brain and spinal cord barrier, local perfusion, endocrine homeostasis, posttraumatic metabolism, and circadian rhythm. Because currently developed mesenchymal stem cell (MSC)-based therapeutic strategies for TSCI provide only mild benefit, this review raises awareness of the impact of TSCI-TBI interaction on TSCI pathophysiology and MSC treatment. Therefore, we propose that unravelling the underlying pathophysiology of TSCI with concomitant TBI will reveal promising pharmacological targets and therapeutic strategies for regenerative therapies, further improving MSC therapy.
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Affiliation(s)
- Paul Köhli
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ellen Otto
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Denise Jahn
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Marie-Jacqueline Reisener
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
| | - Jessika Appelt
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Adibeh Rahmani
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Nima Taheri
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
| | - Johannes Keller
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;
- University Hospital Hamburg-Eppendorf, Department of Trauma Surgery and Orthopaedics, Martinistraße 52, 20246 Hamburg, Germany
| | - Matthias Pumberger
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;
| | - Serafeim Tsitsilonis
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;
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Daneva E, Makris K, Korompeli A, Muurlink O, Kaklamanos I, Fildissis G, Vlachos K, Myrianthefs P. Saliva cortisol levels and physiological parameter fluctuations in mild traumatic brain injury patients compared to controls. Int J Neurosci 2021; 133:612-620. [PMID: 34228947 DOI: 10.1080/00207454.2021.1951264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Evidence suggests that fluctuations of cortisol and physiological parameters can emerge during the course of mild Traumatic Brain Injury (mTBI). OBJECTIVE To investigate fluctuations of cortisol and physiological parametersduring the acute phase of mTBI in hospitalized patients. METHODS 30 participants (19 patients with mTBI and 11 controls) were examined for saliva cortisol dynamics, heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and body temperature (BT) fluctuations for four consecutive days. Also, the participants completed the Athens Insomnia Scale and Epworth Sleepiness Scales, in order to check for sleep problems. RESULTS Patients showed elevated levels of cortisol relative to controls (peak at 8 am and lowest levels at 12 am), as well as for most physiological parameters. MAP was significantly higher for patients throughout the measurement period, and BT was elevated for patients relative to controls at almost all measurements of the first and second day. Mean HR tended to track at non-significantly higher levels for the mTBI group. Patients' sleepiness and insomnia values (ESS and AIS) were initially significantly higher relative to controls but the difference dissipated by day 4. CONCLUSION The increase in absolute values of cortisol and physiological parameters measurements, indicates that in the acute phase of mTBI, a stressful process is activated which may affect sleep quality as well.Supplemental data for this article is available online at at doi: 10.1080/00207454.2021.1951264.
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Affiliation(s)
| | - Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece
| | - Anna Korompeli
- National and Kapodistrian University of Athens, School of Health Sciences, Department of Nursing, "AgioiAnargyroi" General Hospital, Athens, Greece, Noufaron & Timiou Stavrou, Kaliftaki, Nea Kifissia, Athens, Greece
| | - Olav Muurlink
- Central Queensland University, Brisbane, Griffith Institute of Educational Research, Brisbane, Australia
| | - Ioannis Kaklamanos
- National and Kapodistrian University of Athens, School of Health Sciences, Department of Nursing, "AgioiAnargyroi" General Hospital, Athens, Greece, Noufaron & Timiou Stavrou, Kaliftaki, Nea Kifissia, Athens, Greece
| | - George Fildissis
- National and Kapodistrian University of Athens, School of Health Sciences, Department of Nursing, "AgioiAnargyroi" General Hospital, Athens, Greece, Noufaron & Timiou Stavrou, Kaliftaki, Nea Kifissia, Athens, Greece
| | | | - Pavlos Myrianthefs
- National and Kapodistrian University of Athens, School of Health Sciences, Department of Nursing, "AgioiAnargyroi" General Hospital, Athens, Greece, Noufaron & Timiou Stavrou, Kaliftaki, Nea Kifissia, Athens, Greece
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Zhang H, Dahlén T, Khan A, Edgren G, Rzhetsky A. Measurable health effects associated with the daylight saving time shift. PLoS Comput Biol 2020; 16:e1007927. [PMID: 32511231 PMCID: PMC7302868 DOI: 10.1371/journal.pcbi.1007927] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/18/2020] [Accepted: 05/06/2020] [Indexed: 12/26/2022] Open
Abstract
The transition to daylight saving time (DST) is beneficial for energy conservation but at the same time it has been reported to increase the risk of cerebrovascular and cardiovascular problems. Here, we evaluate the effect of the DST shift on a whole spectrum of diseases-an analysis we hope will be helpful in weighing the risks and benefits of DST shifts. Our study relied on a population-based, cross-sectional analysis of the IBM Watson Health MarketScan insurance claim dataset, which incorporates over 150 million unique patients in the US, and the Swedish national inpatient register, which incorporates more than nine million unique Swedes. For hundreds of sex- and age-specific diseases, we assessed effects of the DST shifts forward and backward by one hour in spring and autumn by comparing the observed and expected diagnosis rates after DST shift exposure. We found four prominent, elevated risk clusters, including cardiovascular diseases (such as heart attacks), injuries, mental and behavioral disorders, and immune-related diseases such as noninfective enteritis and colitis to be significantly associated with DST shifts in the United States and Sweden. While the majority of disease risk elevations are modest (a few percent), a considerable number of diseases exhibit an approximately ten percent relative risk increase. We estimate that each spring DST shift is associated with negative health effects-with 150,000 incidences in the US, and 880,000 globally. We also identify for the first time a collection of diseases with relative risks that appear to decrease immediately after the spring DST shift, enriched with infections and immune system-related maladies. These diseases' decreasing relative risks might be driven by the documented boosting effect of a short-term stress (such as that experienced around the spring DST shift) on the immune system.
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Affiliation(s)
- Hanxin Zhang
- Committee on Genetics, Genomics and Systems Biology, The University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, and Institute of Genomics and Systems Biology, The University of Chicago, Chicago, Illinois, United States of America
| | - Torsten Dahlén
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Atif Khan
- Department of Medicine, and Institute of Genomics and Systems Biology, The University of Chicago, Chicago, Illinois, United States of America
| | - Gustaf Edgren
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Södersjukhuset Hospital, Stockholm, Sweden
| | - Andrey Rzhetsky
- Committee on Genetics, Genomics and Systems Biology, The University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, and Institute of Genomics and Systems Biology, The University of Chicago, Chicago, Illinois, United States of America
- Department of Human Genetics and Committee on Quantitative Methods in Social, Behavioral, and Health Sciences, The University of Chicago, Chicago, Illinois, United States of America
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