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Vita SM, Cruise SC, Gilpin NW, Molina PE. HISTOLOGICAL COMPARISON OF REPEATED MILD WEIGHT DROP AND LATERAL FLUID PERCUSSION INJURY MODELS OF TRAUMATIC BRAIN INJURY IN FEMALE AND MALE RATS. Shock 2024; 62:398-409. [PMID: 38813916 DOI: 10.1097/shk.0000000000002395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
ABSTRACT In preclinical traumatic brain injury (TBI) research, the animal model should be selected based on the research question and outcome measures of interest. Direct side-by-side comparisons of different injury models are essential for informing such decisions. Here, we used immunohistochemistry to compare the outcomes from two common models of TBI, lateral fluid percussion (LFP) and repeated mild weight drop (rmWD) in adult female and male Wistar rats. Specifically, we measured the effects of LFP and rmWD on markers of cerebrovascular and tight junction disruption, neuroinflammation, mature neurons, and perineuronal nets in the cortical site of injury, cortex adjacent to injury, dentate gyrus, and the CA 2/3 area of the hippocampus. Animals were randomized into the LFP or rmWD group. On day 1, the LFP group received a craniotomy, and on day 4, injury (or sham procedure; randomly assigned). The rmWD animals underwent either injury or isoflurane only (randomly assigned) on each of those 4 days. Seven days after injury, brains were harvested for analysis. Overall, our observations revealed that the most significant disruptions were evident in response to LFP, followed by craniotomy only, whereas rmWD animals showed the least residual changes compared with isoflurane-only controls, supporting consideration of rmWD as a mild injury. LFP led to longer-lasting disruptions, perhaps more representative of moderate TBI. We also report that craniotomy and LFP produced greater disruptions in females relative to males. These findings will assist the field in the selection of animal models based on target severity of postinjury outcomes and support the inclusion of both sexes and appropriate control groups.
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Affiliation(s)
| | - Shealan C Cruise
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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Singh A, Gong S, Vu A, Li S, Obenaus A. Social deficits mirror delayed cerebrovascular dysfunction after traumatic brain injury. Acta Neuropathol Commun 2024; 12:126. [PMID: 39107831 PMCID: PMC11304659 DOI: 10.1186/s40478-024-01840-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024] Open
Abstract
Traumatic brain injury (TBI) survivors face debilitating long-term psychosocial consequences, including social isolation and depression. TBI modifies neurovascular physiology and behavior but the chronic physiological implications of altered brain perfusion on social interactions are unknown. Adult C57/BL6 male mice received a moderate cortical TBI, and social behaviors were assessed at baseline, 3-, 7-, 14-, 30-, and 60-days post injury (dpi). Magnetic resonance imaging (MRI, 9.4T) using dynamic susceptibility contrast perfusion weighted MRI were acquired. At 60dpi mice underwent histological angioarchitectural mapping. Analysis utilized standardized protocols followed by cross-correlation metrics. Social behavior deficits at 60dpi emerged as reduced interactions with a familiar cage-mate (partner) that mirrored significant reductions in cerebral blood flow (CBF) at 60dpi. CBF perturbations were dynamic temporally and across brain regions including regions known to regulate social behavior such as hippocampus, hypothalamus, and rhinal cortex. Social isolation in TBI-mice emerged with a significant decline in preference to spend time with a cage mate. Cortical vascular density was also reduced corroborating the decline in brain perfusion and social interactions. Thus, the late emergence of social interaction deficits mirrored the reduced vascular density and CBF in regions known to be involved in social behaviors. Vascular morphology and function improved prior to the late decrements in social function and our correlations strongly implicate a linkage between vascular density, cerebral perfusion, and social interactions. Our study provides a clinically relevant timeline of alterations in social deficits alongside functional vascular recovery that can guide future therapeutics.
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Affiliation(s)
- Aditya Singh
- Department of Pediatrics, School of Medicine, University of California Irvine, Hewitt Hall Rm. 2066, Irvine, CA, 92697, USA
- Department of Neurology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA, 120 Walter P Martin Research Center, Torrance, California, 90502, USA
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, 90095, USA
| | - Steven Gong
- Department of Pediatrics, School of Medicine, University of California Irvine, Hewitt Hall Rm. 2066, Irvine, CA, 92697, USA
| | - Anh Vu
- Department of Pediatrics, School of Medicine, University of California Irvine, Hewitt Hall Rm. 2066, Irvine, CA, 92697, USA
| | - Scott Li
- Department of Pediatrics, School of Medicine, University of California Irvine, Hewitt Hall Rm. 2066, Irvine, CA, 92697, USA
| | - Andre Obenaus
- Department of Pediatrics, School of Medicine, University of California Irvine, Hewitt Hall Rm. 2066, Irvine, CA, 92697, USA.
- Division of Biomedical Sciences, 206 SOM Research Bldg, University of California Riverside, Riverside, CA, 92521, USA.
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Özen I, Clausen F, Flygt J, Marklund N, Paul G. Neutralization of Interleukin 1-beta is associated with preservation of thalamic capillaries after experimental traumatic brain injury. Front Neurol 2024; 15:1378203. [PMID: 38765267 PMCID: PMC11100426 DOI: 10.3389/fneur.2024.1378203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/11/2024] [Indexed: 05/21/2024] Open
Abstract
Introduction Traumatic brain injury to thalamo-cortical pathways is associated with posttraumatic morbidity. Diffuse mechanical forces to white matter tracts and deep grey matter regions induce an inflammatory response and vascular damage resulting in progressive neurodegeneration. Pro-inflammatory cytokines, including interleukin-1β (IL-1β), may contribute to the link between inflammation and the injured capillary network after TBI. This study investigates whether IL-1β is a key contributor to capillary alterations and changes in pericyte coverage in the thalamus and cortex after TBI. Methods Animals were subjected to central fluid percussion injury (cFPI), a model of TBI causing widespread axonal and vascular pathology, or sham injury and randomized to receive a neutralizing anti-IL-1β or a control, anti-cyclosporin A antibody, at 30 min post-injury. Capillary length and pericyte coverage of cortex and thalamus were analyzed by immunohistochemistry at 2- and 7-days post-injury. Results and Conclusion Our results show that early post-injury attenuation of IL-1β dependent inflammatory signaling prevents capillary damage by increasing pericyte coverage in the thalamus.
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Affiliation(s)
- Ilknur Özen
- Lund Brain Injury Laboratory for Neurosurgical Research, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Fredrik Clausen
- Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Johanna Flygt
- Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Niklas Marklund
- Lund Brain Injury Laboratory for Neurosurgical Research, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Gesine Paul
- Translational Neurology Group, Department of Clinical Science, Wallenberg Neuroscience Center and Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Neurology, Scania University Hospital, Lund, Sweden
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Ali HT, Sula I, AbuHamdia A, Elejla SA, Elrefaey A, Hamdar H, Elfil M. Nervous System Response to Neurotrauma: A Narrative Review of Cerebrovascular and Cellular Changes After Neurotrauma. J Mol Neurosci 2024; 74:22. [PMID: 38367075 PMCID: PMC10874332 DOI: 10.1007/s12031-024-02193-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/22/2024] [Indexed: 02/19/2024]
Abstract
Neurotrauma is a significant cause of morbidity and mortality worldwide. For instance, traumatic brain injury (TBI) causes more than 30% of all injury-related deaths in the USA annually. The underlying cause and clinical sequela vary among cases. Patients are liable to both acute and chronic changes in the nervous system after such a type of injury. Cerebrovascular disruption has the most common and serious effect in such cases because cerebrovascular autoregulation, which is one of the main determinants of cerebral perfusion pressure, can be effaced in brain injuries even in the absence of evident vascular injury. Disruption of the blood-brain barrier regulatory function may also ensue whether due to direct injury to its structure or metabolic changes. Furthermore, the autonomic nervous system (ANS) can be affected leading to sympathetic hyperactivity in many patients. On a cellular scale, the neuroinflammatory cascade medicated by the glial cells gets triggered in response to TBI. Nevertheless, cellular and molecular reactions involved in cerebrovascular repair are not fully understood yet. Most studies were done on animals with many drawbacks in interpreting results. Therefore, future studies including human subjects are necessarily needed. This review will be of relevance to clinicians and researchers interested in understanding the underlying mechanisms in neurotrauma cases and the development of proper therapies as well as those with a general interest in the neurotrauma field.
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Affiliation(s)
| | - Idris Sula
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Al Qassim, Saudi Arabia
| | - Abrar AbuHamdia
- Department of Medical Laboratory Science, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | | | - Hiba Hamdar
- Medical Learning Skills Academy, Beirut, Lebanon
- Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Mohamed Elfil
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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5
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Vita SM, Cruise SC, Gilpin NW, Molina PE. Histological comparison of repeated mild weight drop and lateral fluid percussion injury models of traumatic brain injury (TBI) in female and male rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.31.578177. [PMID: 38352449 PMCID: PMC10862833 DOI: 10.1101/2024.01.31.578177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Traumatic brain injury (TBI) heterogeneity has led to the development of several preclinical models, each modeling a distinct subset of outcomes. Selection of an injury model should be guided by the research question and the specific outcome measures of interest. Consequently, there is a need for conducting direct comparisons of different TBI models. Here, we used immunohistochemistry to directly compare the outcomes from two common models, lateral fluid percussion (LFP) and repeat mild weight drop (rmWD), on neuropathology in adult female and male Wistar rats. Specifically, we used immunohistochemistry to measure the effects of LFP and rmWD on cerebrovascular and tight junction disruption, inflammatory markers, mature neurons and perineuronal nets in the cortical site of injury, cortex adjacent to injury, dentate gyrus, and the CA2/3 area of the hippocampus. Animals were randomized into either LFP or rmWD groups. The LFP group received a craniotomy prior to LFP (or corresponding sham procedure) three days later, while rmWD animals underwent either weight drop or sham (isoflurane only) on each of those four days. After a recovery period of 7 days, animals were euthanized, and brains were harvested for analysis of RECA-1, claudin-5, GFAP, Iba-1, CD-68, NeuN, and wisteria floribunda lectin. Overall, our observations revealed that the most significant disruptions were evident in response to LFP, followed by craniotomy-only, while rmWD animals showed the least residual changes compared to isoflurane-only controls. These findings support consideration of rmWD as a mild, transient injury. LFP leads to longer-lasting disruptions that are more closely associated with a moderate TBI. We further show that both craniotomy and LFP produced greater disruptions in females relative to males at 7 days post-injury. These findings support the inclusion of a time-matched experimentally-naïve or anesthesia-only control group in preclinical TBI research to enhance the validity of data interpretation and conclusions.
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Kalyani P, Lippa SM, Werner JK, Amyot F, Moore CB, Kenney K, Diaz-Arrastia R. Phosphodiesterase-5 (PDE-5) Inhibitors as Therapy for Cerebrovascular Dysfunction in Chronic Traumatic Brain Injury. Neurotherapeutics 2023; 20:1629-1640. [PMID: 37697134 PMCID: PMC10684467 DOI: 10.1007/s13311-023-01430-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/13/2023] Open
Abstract
Multiple phase III randomized controlled trials (RCTs) for pharmacologic interventions in traumatic brain injury (TBI) have failed despite promising results in experimental models. The heterogeneity of TBI, in terms of pathomechanisms and impacted brain structures, likely contributes to these failures. Biomarkers have been recommended to identify patients with relevant pathology (predictive biomarkers) and confirm target engagement and monitor therapy response (pharmacodynamic biomarkers). Our group focuses on traumatic cerebrovascular injury as an understudied endophenotype of TBI and is validating a predictive and pharmacodynamic imaging biomarker (cerebrovascular reactivity; CVR) in moderate-severe TBI. We aim to extend these studies to milder forms of TBI to determine the optimal dose of sildenafil for maximal improvement in CVR. We will conduct a phase II dose-finding study involving 160 chronic TBI patients (mostly mild) using three doses of sildenafil, a phosphodiesterase-5 (PDE-5) inhibitor. The study measures baseline CVR and evaluates the effect of escalating sildenafil doses on CVR improvement. A 4-week trial of thrice daily sildenafil will assess safety, tolerability, and clinical efficacy. This dual-site 4-year study, funded by the Department of Defense and registered in ClinicalTrials.gov (NCT05782244), plans to launch in June 2023. Biomarker-informed RCTs are essential for developing effective TBI interventions, relying on an understanding of underlying pathomechanisms. Traumatic microvascular injury (TMVI) is an attractive mechanism which can be targeted by vaso-active drugs such as PDE-5 inhibitors. CVR is a potential predictive and pharmacodynamic biomarker for targeted interventions aimed at TMVI. (Trial registration: NCT05782244, ClinicalTrials.gov ).
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Affiliation(s)
- Priyanka Kalyani
- Department of Neurology, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA.
| | - Sara M Lippa
- Walter Reed National Military Medical Center, The National Intrepid Center of Excellence, Palmer Rd S, Bethesda, MD, 20814, USA
- Department of Neuroscience, Uniformed Services University Health Sciences, 4301, Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - J Kent Werner
- Walter Reed National Military Medical Center, The National Intrepid Center of Excellence, Palmer Rd S, Bethesda, MD, 20814, USA
- Department of Neuroscience, Uniformed Services University Health Sciences, 4301, Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Franck Amyot
- Walter Reed National Military Medical Center, The National Intrepid Center of Excellence, Palmer Rd S, Bethesda, MD, 20814, USA
| | - Carol B Moore
- Department of Neuroscience, Uniformed Services University Health Sciences, 4301, Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Kimbra Kenney
- Department of Neuroscience, Uniformed Services University Health Sciences, 4301, Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
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Zhao ZA, Yan L, Wen J, Satyanarayanan SK, Yu F, Lu J, Liu YU, Su H. Cellular and molecular mechanisms in vascular repair after traumatic brain injury: a narrative review. BURNS & TRAUMA 2023; 11:tkad033. [PMID: 37675267 PMCID: PMC10478165 DOI: 10.1093/burnst/tkad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/01/2023] [Accepted: 05/26/2023] [Indexed: 09/08/2023]
Abstract
Traumatic brain injury (TBI) disrupts normal brain function and is associated with high morbidity and fatality rates. TBI is characterized as mild, moderate or severe depending on its severity. The damage may be transient and limited to the dura matter, with only subtle changes in cerebral parenchyma, or life-threatening with obvious focal contusions, hematomas and edema. Blood vessels are often injured in TBI. Even in mild TBI, dysfunctional cerebral vascular repair may result in prolonged symptoms and poor outcomes. Various distinct types of cells participate in vascular repair after TBI. A better understanding of the cellular response and function in vascular repair can facilitate the development of new therapeutic strategies. In this review, we analyzed the mechanism of cerebrovascular impairment and the repercussions following various forms of TBI. We then discussed the role of distinct cell types in the repair of meningeal and parenchyma vasculature following TBI, including endothelial cells, endothelial progenitor cells, pericytes, glial cells (astrocytes and microglia), neurons, myeloid cells (macrophages and monocytes) and meningeal lymphatic endothelial cells. Finally, possible treatment techniques targeting these unique cell types for vascular repair after TBI are discussed.
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Affiliation(s)
- Zi-Ai Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
- Department of Neurology, General Hospital of Northern Theater Command, 83# Wen-Hua Road, Shenyang 110840, China
| | - Lingli Yan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
| | - Jing Wen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
| | - Senthil Kumaran Satyanarayanan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
| | - Feng Yu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
| | - Jiahong Lu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
| | - Yong U Liu
- Laboratory of Neuroimmunology in Health and Disease Institute, Guangzhou First People’s Hospital School of Medicine, South China University of Technology, Guangzhou Higher Education Mega Center, Panyu District, Guangzhou 511400, China
| | - Huanxing Su
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China
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Anderson ED, Talukdar T, Goodwin G, Di Pietro V, Yakoub KM, Zwilling CE, Davies D, Belli A, Barbey AK. Assessing blood oxygen level-dependent signal variability as a biomarker of brain injury in sport-related concussion. Brain Commun 2023; 5:fcad215. [PMID: 37649639 PMCID: PMC10465085 DOI: 10.1093/braincomms/fcad215] [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: 04/07/2022] [Revised: 07/02/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
Mild traumatic brain injury is a complex neurological disorder of significant concern among athletes who play contact sports. Athletes who sustain sport-related concussion typically undergo physical examination and neurocognitive evaluation to determine injury severity and return-to-play status. However, traumatic disruption to neurometabolic processes can occur with minimal detectable anatomic pathology or neurocognitive alteration, increasing the risk that athletes may be cleared for return-to-play during a vulnerable period and receive a repetitive injury. This underscores the need for sensitive functional neuroimaging methods to detect altered cerebral physiology in concussed athletes. The present study compared the efficacy of Immediate Post-concussion Assessment and Cognitive Testing composite scores and whole-brain measures of blood oxygen level-dependent signal variability for classifying concussion status and predicting concussion symptomatology in healthy, concussed and repetitively concussed athletes, assessing blood oxygen level-dependent signal variability as a potential diagnostic tool for characterizing functional alterations to cerebral physiology and assisting in the detection of sport-related concussion. We observed significant differences in regional blood oxygen level-dependent signal variability measures for concussed athletes but did not observe significant differences in Immediate Post-concussion Assessment and Cognitive Testing scores of concussed athletes. We further demonstrate that incorporating measures of functional brain alteration alongside Immediate Post-concussion Assessment and Cognitive Testing scores enhances the sensitivity and specificity of supervised random forest machine learning methods when classifying and predicting concussion status and post-concussion symptoms, suggesting that alterations to cerebrovascular status characterize unique variance that may aid in the detection of sport-related concussion and repetitive mild traumatic brain injury. These results indicate that altered blood oxygen level-dependent variability holds promise as a novel neurobiological marker for detecting alterations in cerebral perfusion and neuronal functioning in sport-related concussion, motivating future research to establish and validate clinical assessment protocols that can incorporate advanced neuroimaging methods to characterize altered cerebral physiology following mild traumatic brain injury.
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Affiliation(s)
- Evan D Anderson
- Decision Neuroscience Laboratory, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Air Force Research Laboratory, Wright-Patterson AFB, OH 45433, USA
| | - Tanveer Talukdar
- Decision Neuroscience Laboratory, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Grace Goodwin
- Decision Neuroscience Laboratory, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Department of Psychology, University of Nevada, Las Vegas, NV 89557, USA
| | - Valentina Di Pietro
- Decision Neuroscience Laboratory, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
| | - Kamal M Yakoub
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
| | - Christopher E Zwilling
- Decision Neuroscience Laboratory, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - David Davies
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
| | - Antonio Belli
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
| | - Aron K Barbey
- Decision Neuroscience Laboratory, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Department of Psychology, University of Illinois, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois, Urbana, IL 61801, USA
- Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
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9
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Poon C, Teikari P, Rachmadi MF, Skibbe H, Hynynen K. A dataset of rodent cerebrovasculature from in vivo multiphoton fluorescence microscopy imaging. Sci Data 2023; 10:141. [PMID: 36932084 PMCID: PMC10023658 DOI: 10.1038/s41597-023-02048-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
We present MiniVess, the first annotated dataset of rodent cerebrovasculature, acquired using two-photon fluorescence microscopy. MiniVess consists of 70 3D image volumes with segmented ground truths. Segmentations were created using traditional image processing operations, a U-Net, and manual proofreading. Code for image preprocessing steps and the U-Net are provided. Supervised machine learning methods have been widely used for automated image processing of biomedical images. While much emphasis has been placed on the development of new network architectures and loss functions, there has been an increased emphasis on the need for publicly available annotated, or segmented, datasets. Annotated datasets are necessary during model training and validation. In particular, datasets that are collected from different labs are necessary to test the generalizability of models. We hope this dataset will be helpful in testing the reliability of machine learning tools for analyzing biomedical images.
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Affiliation(s)
- Charissa Poon
- Sunnybrook Research Institute, Physical Sciences Platform, Toronto, M4N 3M5, Canada.
- RIKEN Center for Brain Science, Brain Image Analysis Unit, Wako-shi, 351-0198, Japan.
| | - Petteri Teikari
- High-Dimensional Neurology Group, University College London Queen Square Institute of Neurology, London, WC1N 3BG, United Kingdom
| | | | - Henrik Skibbe
- RIKEN Center for Brain Science, Brain Image Analysis Unit, Wako-shi, 351-0198, Japan
| | - Kullervo Hynynen
- Sunnybrook Research Institute, Physical Sciences Platform, Toronto, M4N 3M5, Canada
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10
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Meyer S, Hummel R, Neulen A, Hirnet T, Thal SC. Influence of traumatic brain injury on ipsilateral and contralateral cortical perfusion in mice. Neurosci Lett 2023; 795:137047. [PMID: 36603737 DOI: 10.1016/j.neulet.2023.137047] [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: 09/20/2022] [Revised: 11/28/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
Traumatic brain injury (TBI) is one of the most important causes of death in young adults. After brain injury cortical perfusion is impaired by cortical spreading depression, cerebral microvasospasm or microvascular thrombosis and contributes to secondary expansion of lesion into surrounding healthy brain tissue. The present study was designed to determine the regional cortical perfusion pattern after experimental TBI induced by controlled cortical impact (CCI) in male C57/BL6N mice. We performed a longitudinal time series analysis by Laser speckle contrast imaging (LSCI). Measurements were carried out before, immediately and 24 h after trauma. Immediately after CCI cortical perfusion in the lesion core dropped to 10 % of before injury (baseline; %BL) and to 21-24 %BL in the cortical area surrounding the core. Interestingly, cortical perfusion was also significantly reduced in the contralateral non-injured hemisphere (41-58 %BL) matching the corresponding brain region of the injured hemisphere. 24 h after CCI perfusion of the contralateral hemisphere returned to baseline level in the area corresponding to the lesion core, whereas the lateral area of the parietal cortex was hyperperfused (125 %BL). The lesion core region itself remained severely hypoperfused (18 to 26 %BL) during the observation period. TBI causes a maldistribution of both ipsi- and contralateral cerebral perfusion immediately after trauma, which persist for at least 24 h. Higher perfusion levels in the lesion core 24 h after trauma were associated with increased tissue damage, which supports the role of reperfusion injury for secondary brain damage after TBI.
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Affiliation(s)
- Simon Meyer
- Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Regina Hummel
- Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Axel Neulen
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Tobias Hirnet
- Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Serge C Thal
- Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz, Germany; Department of Anesthesiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Heusnerstraße 40, 42283 Wuppertal, Germany.
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11
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Luo P, Li L, Huang J, Mao D, Lou S, Ruan J, Chen J, Tang R, Shi Y, Zhou S, Yang H. The role of SUMOylation in the neurovascular dysfunction after acquired brain injury. Front Pharmacol 2023; 14:1125662. [PMID: 37033632 PMCID: PMC10073463 DOI: 10.3389/fphar.2023.1125662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
Acquired brain injury (ABI) is the most common disease of the nervous system, involving complex pathological processes, which often leads to a series of nervous system disorders. The structural destruction and dysfunction of the Neurovascular Unit (NVU) are prominent features of ABI. Therefore, understanding the molecular mechanism underlying NVU destruction and its reconstruction is the key to the treatment of ABI. SUMOylation is a protein post-translational modification (PTM), which can degrade and stabilize the substrate dynamically, thus playing an important role in regulating protein expression and biological signal transduction. Understanding the regulatory mechanism of SUMOylation can clarify the molecular mechanism of the occurrence and development of neurovascular dysfunction after ABI and is expected to provide a theoretical basis for the development of potential treatment strategies. This article reviews the role of SUMOylation in vascular events related to ABI, including NVU dysfunction and vascular remodeling, and puts forward therapeutic prospects.
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Affiliation(s)
- Pengren Luo
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Lin Li
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Jiashang Huang
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Deqiang Mao
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Silong Lou
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Jian Ruan
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Jie Chen
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Ronghua Tang
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - You Shi
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Shuai Zhou
- Department of Neurosurgery, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- *Correspondence: Shuai Zhou, ; Haifeng Yang,
| | - Haifeng Yang
- Department of Neuro-Oncology, Chongqing University Cancer Hospital, Chongqing, China
- *Correspondence: Shuai Zhou, ; Haifeng Yang,
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12
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Lin X, Chen L, Jullienne A, Zhang H, Salehi A, Hamer M, C. Holmes T, Obenaus A, Xu X. Longitudinal dynamics of microvascular recovery after acquired cortical injury. Acta Neuropathol Commun 2022; 10:59. [PMID: 35468870 PMCID: PMC9036719 DOI: 10.1186/s40478-022-01361-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/05/2022] [Indexed: 01/04/2023] Open
Abstract
Acquired brain injuries due to trauma damage the cortical vasculature, which in turn impairs blood flow to injured tissues. There are reports of vascular morphological recovery following traumatic brain injury, but the remodeling process has not been examined longitudinally in detail after injury in vivo. Understanding the dynamic processes that influence recovery is thus critically important. We evaluated the longitudinal and dynamic microvascular recovery and remodeling up to 2 months post injury using live brain miniscope and 2-photon microscopic imaging. The new imaging approaches captured dynamic morphological and functional recovery processes at high spatial and temporal resolution in vivo. Vessel painting documented the initial loss and subsequent temporal morphological vascular recovery at the injury site. Miniscopes were used to longitudinally image the temporal dynamics of vascular repair in vivo after brain injury in individual mice across each cohort. We observe near-immediate nascent growth of new vessels in and adjacent to the injury site that peaks between 14 and 21 days post injury. 2-photon microscopy confirms new vascular growth and further demonstrates differences between cortical layers after cortical injury: large vessels persist in deeper cortical layers (> 200 μm), while superficial layers exhibit a dense plexus of fine (and often non-perfused) vessels displaying regrowth. Functionally, blood flow increases mirror increasing vascular density. Filopodia development and endothelial sprouting is measurable within 3 days post injury that rapidly transforms regions devoid of vessels to dense vascular plexus in which new vessels become increasingly perfused. Within 7 days post injury, blood flow is observed in these nascent vessels. Behavioral analysis reveals improved vascular modulation after 9 days post injury, consistent with vascular regrowth. We conclude that morphological recovery events are closely linked to functional recovery of blood flow to the compromised tissues, which subsequently leads to improved behavioral outcomes.
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Wu N, Cheng CJ, Zhong JJ, He JC, Zhang ZS, Wang ZG, Sun XC, Liu H. Essential role of MALAT1 in reducing traumatic brain injury. Neural Regen Res 2022; 17:1776-1784. [PMID: 35017438 PMCID: PMC8820691 DOI: 10.4103/1673-5374.332156] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
As a highly evolutionary conserved long non-coding RNA, metastasis associated lung adenocarcinoma transcript 1 (MALAT1) was first demonstrated to be related to lung tumor metastasis by promoting angiogenesis. To investigate the role of MALAT1 in traumatic brain injury, we established mouse models of controlled cortical impact and cell models of oxygen-glucose deprivation to mimic traumatic brain injury in vitro and in vivo. The results revealed that MALAT1 silencing in vitro inhibited endothelial cell viability and tube formation but increased migration. In MALAT1-deficient mice, endothelial cell proliferation in the injured cortex, functional vessel density and cerebral blood flow were reduced. Bioinformatic analyses and RNA pull-down assays validated enhancer of zeste homolog 2 (EZH2) as a downstream factor of MALAT1 in endothelial cells. Jagged-1, the Notch homolog 1 (NOTCH1) agonist, reversed the MALAT1 deficiency-mediated impairment of angiogenesis. Taken together, our results suggest that MALAT1 controls the key processes of angiogenesis following traumatic brain injury in an EZH2/NOTCH1-dependent manner.
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Affiliation(s)
- Na Wu
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chong-Jie Cheng
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian-Jun Zhong
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun-Chi He
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhao-Si Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhi-Gang Wang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Chuan Sun
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Han Liu
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing; Department of Neurosurgery, Qilu Hospital of Shandong University (Qingdao Campus), Qingdao, Shandong Province, China
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Thomas BP, Tarumi T, Wang C, Zhu DC, Tomoto T, Munro Cullum C, Dieppa M, Diaz-Arrastia R, Bell K, Madden C, Zhang R, Ding K. Hippocampal and rostral anterior cingulate blood flow is associated with affective symptoms in chronic traumatic brain injury. Brain Res 2021; 1771:147631. [PMID: 34464600 DOI: 10.1016/j.brainres.2021.147631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/02/2021] [Accepted: 08/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to assess cerebral blood flow (CBF) and its association with self-reported symptoms in chronic traumatic brain injury (TBI). PARTICIPANTS Sixteen participants with mild to severe TBI and persistent self-reported neurological symptoms, 6 to 72 months post-injury were included. For comparison, 16 age- and gender-matched healthy normal control participants were also included. MAIN MEASURES Regional CBF and brain volume were assessed using pseudo-continuous Arterial Spin Labeling (PCASL) and T1-weighted data respectively. Cognitive function and self-reported symptoms were assessed in TBI participants using the national institutes of health (NIH) Toolbox Cognition Battery and Patient-Reported Outcome Measurement Information System respectively. Associations between CBF and cognitive function, symptoms were assessed. RESULTS Global CBF and regional brain volumes were similar between groups, but region of interest (ROI) analysis revealed lower CBF bilaterally in the thalamus, hippocampus, left caudate, and left amygdala in the TBI group. Voxel-wise analysis revealed that CBF in the hippocampus, parahippocampus, rostral anterior cingulate, inferior frontal gyrus, and other temporal regions were negatively associated with self-reported anger, anxiety, and depression symptoms. Furthermore, region of interest (ROI) analysis revealed that hippocampal and rostral anterior cingulate CBF were negatively associated with symptoms of fatigue, anxiety, depression, and sleep issues. CONCLUSION Regional CBF deficit was observed in the group with chronic TBI compared to the normal control (NC) group despite similar volume of cerebral structures. The observed negative correlation between regional CBF and affective symptoms suggests that CBF-targeted intervention may potentially improve affective symptoms and quality of life after TBI, which needs to be assessed in future studies.
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Affiliation(s)
- Binu P Thomas
- Advanced Imaging Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA.
| | - Takashi Tarumi
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA.
| | - Ciwen Wang
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - David C Zhu
- Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA
| | - Tsubasa Tomoto
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - C Munro Cullum
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Neurological Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - Marisara Dieppa
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 51 North 39(th) St, Philadelphia, PA 19104, USA
| | - Kathleen Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - Christopher Madden
- Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA
| | - Rong Zhang
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - Kan Ding
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
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Barretto TA, Park E, Telliyan T, Liu E, Gallagher D, Librach C, Baker A. Vascular Dysfunction after Modeled Traumatic Brain Injury Is Preserved with Administration of Umbilical Cord Derived Mesenchymal Stromal Cells and Is Associated with Modulation of the Angiogenic Response. J Neurotrauma 2021; 38:2747-2762. [PMID: 33899499 DOI: 10.1089/neu.2021.0158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Vascular dysfunction arising from blood-brain barrier (BBB) breakdown after traumatic brain injury (TBI) can adversely affect neuronal health and behavioral outcome. Pericytes and endothelial cells of the neurovascular unit (NVU) function collectively to maintain strict regulation of the BBB through tight junctions. Secondary injury mechanisms, such as pro-angiogenic signals that contribute to pericyte loss, can prolong and exacerbate primary vascular injury. Human umbilical cord perivascular cells (HUCPVCs) are a source of mesenchymal stromal cells (MSCs) that have been shown to reduce vascular dysfunction after neurotrauma. We hypothesized that the perivascular properties of HUCPVCs can reduce vascular dysfunction after modeled TBI by preserving the pericyte-endothelial interactions. Rats were subjected to a moderate fluid percussion injury (FPI) and intravenously infused with 1,500,000 HUCPVCs post-injury. At acute time points (24 h and 48 h) quantitative polymerase chain reaction (qPCR) analysis demonstrated that the gene expression of angiopoietin-2 was increased with FPI and reduced with HUCPVCs. Immunofluorescent assessment of RECA-1 (endothelial cells) and platelet-derived growth factor receptors (PDGFR-β) (pericytes) revealed that capillary and pericyte densities as well as the co-localization of the two cells were decreased with FPI and preserved with HUCPVC administration. These acute HUCPVC-mediated protective effects were associated with less permeability to Evan's blue dye and increased expression of the tight junction occludin, suggesting less vascular leakage. Further, at 4 weeks post-injury, HUCPVC administration was associated with reduced anxiety and decreased β-amyloid precursor protein (β-APP) accumulation. In summary, HUCPVCs promoted pericyte-endothelial barrier function that was associated with improved long-term outcome.
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Affiliation(s)
- Tanya A Barretto
- Keenan Research Centre, St. Michaels's Hospital, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Eugene Park
- Keenan Research Centre, St. Michaels's Hospital, Toronto, Ontario, Canada
| | - Tamar Telliyan
- Keenan Research Centre, St. Michaels's Hospital, Toronto, Ontario, Canada
| | - Elaine Liu
- Keenan Research Centre, St. Michaels's Hospital, Toronto, Ontario, Canada
| | | | - Clifford Librach
- CReATe Fertility Centre, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Baker
- Keenan Research Centre, St. Michaels's Hospital, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Critical Care, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
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16
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Barlow KM, Iyer K, Yan T, Scurfield A, Carlson H, Wang Y. Cerebral Blood Flow Predicts Recovery in Children with Persistent Post-Concussion Symptoms after Mild Traumatic Brain Injury. J Neurotrauma 2021; 38:2275-2283. [PMID: 33430707 PMCID: PMC9009764 DOI: 10.1089/neu.2020.7566] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Persistent post-concussion symptoms (PPCS) following pediatric mild traumatic brain injury (mTBI) are associated with differential changes in cerebral blood flow (CBF). Given its potential as a therapeutic target, we examined CBF changes during recovery in children with PPCS. We hypothesized that CBF would decrease and that such decreases would mirror clinical recovery. In a prospective cohort study, 61 children and adolescents (mean age 14 [standard deviation = 2.6] years; 41% male) with PPCS were imaged with three-dimensional (3D) pseudo-continuous arterial spin-labelled (pCASL) magnetic resonance imaging (MRI) at 4-6 and 8-10 weeks post-injury. Exclusion criteria included any significant past medical history and/or previous concussion within the past 3 months. Twenty-three participants had clinically recovered at the time of the second scan. We found that relative and mean absolute CBF were higher in participants with poor recovery, 44.0 (95% confidence interval [CI]: 43.32, 44.67) than in those with good recovery, 42.19 (95% CI: 41.77, 42.60) mL/min/100 g gray tissue and decreased over time (β = -1.75; p < 0.001). The decrease was greater in those with good recovery (β = 2.29; p < 0.001) and predicted outcome in 77% of children with PPCS (odds ratio [OR] 0.54, 95% CI: 0.36, 0.80; p = 0.002). Future studies are warranted to validate the utility of CBF as a useful predictive biomarker of outcome in PPCS.
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Affiliation(s)
- Karen M. Barlow
- Children's Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Queensland, Australia
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kartik Iyer
- Children's Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Tingting Yan
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alex Scurfield
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Helen Carlson
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Haber M, Amyot F, Lynch CE, Sandsmark DK, Kenney K, Werner JK, Moore C, Flesher K, Woodson S, Silverman E, Chou Y, Pham D, Diaz-Arrastia R. Imaging biomarkers of vascular and axonal injury are spatially distinct in chronic traumatic brain injury. J Cereb Blood Flow Metab 2021; 41:1924-1938. [PMID: 33444092 PMCID: PMC8327117 DOI: 10.1177/0271678x20985156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/07/2020] [Accepted: 12/06/2020] [Indexed: 11/17/2022]
Abstract
Traumatic Brain Injury (TBI) is associated with both diffuse axonal injury (DAI) and diffuse vascular injury (DVI), which result from inertial shearing forces. These terms are often used interchangeably, but the spatial relationships between DAI and DVI have not been carefully studied. Multimodal magnetic resonance imaging (MRI) can help distinguish these injury mechanisms: diffusion tensor imaging (DTI) provides information about axonal integrity, while arterial spin labeling (ASL) can be used to measure cerebral blood flow (CBF), and the reactivity of the Blood Oxygen Level Dependent (BOLD) signal to a hypercapnia challenge reflects cerebrovascular reactivity (CVR). Subjects with chronic TBI (n = 27) and healthy controls (n = 14) were studied with multimodal MRI. Mean values of mean diffusivity (MD), fractional anisotropy (FA), CBF, and CVR were extracted for pre-determined regions of interest (ROIs). Normalized z-score maps were generated from the pool of healthy controls. Abnormal ROIs in one modality were not predictive of abnormalities in another. Approximately 9-10% of abnormal voxels for CVR and CBF also showed an abnormal voxel value for MD, while only 1% of abnormal CVR and CBF voxels show a concomitant abnormal FA value. These data indicate that DAI and DVI represent two distinct TBI endophenotypes that are spatially independent.
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Affiliation(s)
- Margalit Haber
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Franck Amyot
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Cillian E Lynch
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Danielle K Sandsmark
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Kimbra Kenney
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - John K Werner
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Carol Moore
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kelley Flesher
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Sarah Woodson
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Erika Silverman
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Yiyu Chou
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Dzung Pham
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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18
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Zhang M, Hamblin MH, Yin KJ. Long non-coding RNAs mediate cerebral vascular pathologies after CNS injuries. Neurochem Int 2021; 148:105102. [PMID: 34153353 DOI: 10.1016/j.neuint.2021.105102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/12/2021] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
Central nervous system (CNS) injuries are one of the leading causes of morbidity and mortality worldwide, accompanied with high medical costs and a decreased quality of life. Brain vascular disorders are involved in the pathological processes of CNS injuries and might play key roles for their recovery and prognosis. Recently, increasing evidence has shown that long non-coding RNAs (lncRNAs), which comprise a very heterogeneous group of non-protein-coding RNAs greater than 200 nucleotides, have emerged as functional mediators in the regulation of vascular homeostasis under pathophysiological conditions. Remarkably, lncRNAs can regulate gene transcription and translation, thus interfering with gene expression and signaling pathways by different mechanisms. Hence, a deeper insight into the function and regulatory mechanisms of lncRNAs following CNS injury, especially cerebrovascular-related lncRNAs, could help in establishing potential therapeutic strategies to improve or inhibit neurological disorders. In this review, we highlight recent advancements in understanding of the role of lncRNAs and their application in mediating cerebrovascular pathologies after CNS injury.
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Affiliation(s)
- Mengqi Zhang
- Pittsburgh Institute of Brain Disorders & Recovery, Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Milton H Hamblin
- Department of Pharmacology, Tulane University School of Medicine, 1430 Tulane Avenue SL-83, New Orleans, LA, 70112, USA
| | - Ke-Jie Yin
- Pittsburgh Institute of Brain Disorders & Recovery, Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA; Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, 15261, USA.
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Lynch CE, Eisenbaum M, Algamal M, Balbi M, Ferguson S, Mouzon B, Saltiel N, Ojo J, Diaz-Arrastia R, Mullan M, Crawford F, Bachmeier C. Impairment of cerebrovascular reactivity in response to hypercapnic challenge in a mouse model of repetitive mild traumatic brain injury. J Cereb Blood Flow Metab 2021; 41:1362-1378. [PMID: 33050825 PMCID: PMC8142124 DOI: 10.1177/0271678x20954015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Incidences of repetitive mild TBI (r-mTBI), like those sustained by contact sports athletes and military personnel, are thought to be a risk factor for development of neurodegenerative disorders. Those suffering from chronic TBI-related illness demonstrate deficits in cerebrovascular reactivity (CVR), the ability of the cerebral vasculature to respond to a vasoactive stimulus. CVR is thus an important measure of traumatic cerebral vascular injury (TCVI), and a possible in vivo endophenotype of TBI-related neuropathogenesis. We combined laser speckle imaging of CVR in response to hypercapnic challenge with neurobehavioral assessment of learning and memory, to investigate if decreased cerebrovascular responsiveness underlies impaired cognitive function in our mouse model of chronic r-mTBI. We demonstrate a profile of blunted hypercapnia-evoked CVR in the cortices of r-mTBI mice like that of human TBI, alongside sustained memory and learning impairment, without biochemical or immunohistopathological signs of cerebral vessel laminar or endothelium constituent loss. Transient decreased expression of alpha smooth muscle actin and platelet-derived growth factor receptor β, indicative of TCVI, is obvious only at the time of the most pronounced CVR deficit. These findings implicate CVR as a valid preclinical measure of TCVI, perhaps useful for developing therapies targeting TCVI after recurrent mild head trauma.
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Affiliation(s)
- Cillian E Lynch
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK.,James A. Haley Veteran's Administration, Tampa, FL, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Maxwell Eisenbaum
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK
| | - Moustafa Algamal
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK
| | - Matilde Balbi
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Ferguson
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK
| | - Benoit Mouzon
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK.,James A. Haley Veteran's Administration, Tampa, FL, USA
| | | | - Joseph Ojo
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK.,James A. Haley Veteran's Administration, Tampa, FL, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mike Mullan
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK
| | - Fiona Crawford
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK.,James A. Haley Veteran's Administration, Tampa, FL, USA
| | - Corbin Bachmeier
- The Roskamp Institute, Sarasota, FL, USA.,Department of Life Sciences, The Open University, Milton Keynes, UK.,Bay Pines VA Healthcare System, Bay Pines, FL, USA
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20
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Baker TL, Agoston DV, Brady RD, Major B, McDonald SJ, Mychasiuk R, Wright DK, Yamakawa GR, Sun M, Shultz SR. Targeting the Cerebrovascular System: Next-Generation Biomarkers and Treatment for Mild Traumatic Brain Injury. Neuroscientist 2021; 28:594-612. [PMID: 33966527 DOI: 10.1177/10738584211012264] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The diagnosis, prognosis, and treatment of mild traumatic brain injuries (mTBIs), such as concussions, are significant unmet medical issues. The kinetic forces that occur in mTBI adversely affect the cerebral vasculature, making cerebrovascular injury (CVI) a pathophysiological hallmark of mTBI. Given the importance of a healthy cerebrovascular system in overall brain function, CVI is likely to contribute to neurological dysfunction after mTBI. As such, CVI and related pathomechanisms may provide objective biomarkers and therapeutic targets to improve the clinical management and outcomes of mTBI. Despite this potential, until recently, few studies have focused on the cerebral vasculature in this context. This article will begin by providing a brief overview of the cerebrovascular system followed by a review of the literature regarding how mTBI can affect the integrity and function of the cerebrovascular system, and how this may ultimately contribute to neurological dysfunction and neurodegenerative conditions. We then discuss promising avenues of research related to mTBI biomarkers and interventions that target CVI, and conclude that a clinical approach that takes CVI into account could result in substantial improvements in the care and outcomes of patients with mTBI.
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Affiliation(s)
- Tamara L Baker
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Denes V Agoston
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University, Bethesda, MD, USA
| | - Rhys D Brady
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Brendan Major
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Stuart J McDonald
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.,Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - David K Wright
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Glenn R Yamakawa
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Mujun Sun
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Sandy R Shultz
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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21
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Ma Y, Liu Y, Ruan X, Liu X, Zheng J, Teng H, Shao L, Yang C, Wang D, Xue Y. Gene Expression Signature of Traumatic Brain Injury. Front Genet 2021; 12:646436. [PMID: 33859672 PMCID: PMC8042258 DOI: 10.3389/fgene.2021.646436] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/12/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Traumatic brain injury (TBI) is a brain function change caused by external forces, which is one of the main causes of death and disability worldwide. The aim of this study was to identify early diagnostic markers and potential therapeutic targets for TBI. Methods: Differences between TBI and controls in GSE89866 and GSE104687 were analyzed. The two groups of differentially expressed genes (DEGs) were combined for coexpression analysis, and the modules of interest were performed using enrichment analysis. Hub genes were identified by calculating area under curve (AUC) values of module genes, PPI network analysis, and functional similarity. Finally, the difference in immune cell infiltration between TBI and control was calculated by ssGSEA. Results: A total of 4,817 DEGs were identified in GSE89866 and 1,329 DEGs in GSE104687. They were clustered into nine modules. The genes of modules 1, 4, and 7 had the most crosstalk and were identified as important modules. Enrichment analysis revealed that they were mainly associated with neurodevelopment and immune inflammation. In the PPI network constructed by genes with top 50 AUC values in module genes, we identified the top 10 genes with the greatest connectivity. Among them, down-regulated RPL27, RPS4X, RPL23A, RPS15A, and RPL7A had similar functions and were identified as hub genes. In addition, DC and Tem were significantly up-regulated and down-regulated between TBI and control, respectively. Conclusion: We found that hub genes may have a diagnostic role for TBI. Molecular dysregulation mechanisms of TBI are associated with neurological and immune inflammation. These results may provide new ideas for the diagnosis and treatment of TBI.
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Affiliation(s)
- Yawen Ma
- Department of Neurobiology, School of Life Sciences, China Medical University, Shenyang, China.,Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Yunhui Liu
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Xuelei Ruan
- Department of Neurobiology, School of Life Sciences, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Xiaobai Liu
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Jian Zheng
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Hao Teng
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Lianqi Shao
- Department of Neurobiology, School of Life Sciences, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Chunqing Yang
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Di Wang
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
| | - Yixue Xue
- Department of Neurobiology, School of Life Sciences, China Medical University, Shenyang, China.,Key Laboratory of Neuro-Oncology in Liaoning Province, Shenyang, China
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22
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Wang J, Deng X, Xie Y, Tang J, Zhou Z, Yang F, He Q, Cao Q, Zhang L, He L. An Integrated Transcriptome Analysis Reveals IGFBP7 Upregulation in Vasculature in Traumatic Brain Injury. Front Genet 2021; 11:599834. [PMID: 33505428 PMCID: PMC7831608 DOI: 10.3389/fgene.2020.599834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/30/2020] [Indexed: 01/08/2023] Open
Abstract
Vasculature plays critical roles in the pathogenesis and neurological repair of traumatic brain injury (TBI). However, how vascular endothelial cells respond to TBI at the molecular level has not been systematically reviewed. Here, by integrating three transcriptome datasets including whole cortex of mouse brain, FACS-sorted mouse brain endothelial cells, and single cell sequencing of mouse brain hippocampus, we revealed the key molecular alteration of endothelial cells characterized by increased Myc targets and Epithelial-Mesenchymal Transition signatures. In addition, immunofluorescence staining of patients’ samples confirmed that IGFBP7 was up-regulated in vasculature in response to TBI. TGFβ1, mainly derived from microglia and endothelial cells, sufficiently induces IGFBP7 expression in cultured endothelial cells, and is significantly upregulated in response to TBI. Our results identified IGFBP7 as a potential biomarker of vasculature in response to TBI, and indicate that TGFβ signaling may contribute to the upregulation of IGFBP7 in the vasculature.
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Affiliation(s)
- Jianhao Wang
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
| | - Xiangyi Deng
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
| | - Yuan Xie
- Key Laboratory of Ministry of Education for Medicinal Plant Resource and Natural Pharmaceutical Chemistry, National Engineering Laboratory for Resource Developing of Endangered Chinese Crude Drugs in Northwest of China, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Jiefu Tang
- Trauma Center, First Affiliated Hospital of Hunan University of Medicine, Huaihua, China
| | - Ziwei Zhou
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
| | - Fan Yang
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
| | - Qiyuan He
- Key Laboratory of Ministry of Education for Medicinal Plant Resource and Natural Pharmaceutical Chemistry, National Engineering Laboratory for Resource Developing of Endangered Chinese Crude Drugs in Northwest of China, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Qingze Cao
- Key Laboratory of Ministry of Education for Medicinal Plant Resource and Natural Pharmaceutical Chemistry, National Engineering Laboratory for Resource Developing of Endangered Chinese Crude Drugs in Northwest of China, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Lei Zhang
- Key Laboratory of Ministry of Education for Medicinal Plant Resource and Natural Pharmaceutical Chemistry, National Engineering Laboratory for Resource Developing of Endangered Chinese Crude Drugs in Northwest of China, College of Life Sciences, Shaanxi Normal University, Xi'an, China.,Precision Medicine Center, The Second People's Hospital of Huaihua, Huaihua, China
| | - Liqun He
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China.,Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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23
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Contrast enhanced magnetic resonance imaging highlights neurovasculature changes following experimental traumatic brain injury in the rat. Sci Rep 2020; 10:21252. [PMID: 33277513 PMCID: PMC7718275 DOI: 10.1038/s41598-020-77975-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 11/10/2020] [Indexed: 11/08/2022] Open
Abstract
Neurovascular injury has been proposed as a universal pathological hallmark of traumatic brain injury (TBI) with molecular markers of angiogenesis and endothelial function associated with injury severity and morbidity. Sex differences in the neurovasculature response post-TBI may contribute to the differences seen in how males and females respond to injury. Steady-state contrast enhanced magnetic resonance imaging (SSCE-MRI) can be used to non-invasively assess the neurovasculature and may be a useful tool in understanding and predicting outcomes post-TBI. Here we used SSCE-MRI to investigate the neurovasculature of male and female rats at 48 h after an experimental TBI, and how these changes related to neuromotor function at 1-week post-TBI. In addition to TBI induced changes, we found that female rats had greater vessel density, greater cerebral blood volumes and performed better on a neuromotor task than their male counterparts. These results suggest that acute post-TBI cerebrovascular function is worse in males, and that this may contribute to the greater functional deficits observed post-injury. Furthermore, these results highlight the potential of SSCE-MRI to provide insights into the cerebral microvasculature post-TBI. Future studies, incorporating both males and females, are warranted to investigate the evolution of these changes and the underlying mechanisms.
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24
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Wilde EA, Merkley TL, Lindsey HM, Bigler ED, Hunter JV, Ewing-Cobbs L, Aitken ME, MacLeod MC, Hanten G, Chu ZD, Abildskov TJ, Noble-Haeusslein LJ, Levin HS. Developmental Alterations in Cortical Organization and Socialization in Adolescents Who Sustained a Traumatic Brain Injury in Early Childhood. J Neurotrauma 2020; 38:133-143. [PMID: 32503385 DOI: 10.1089/neu.2019.6698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated patterns of cortical organization in adolescents who had sustained a traumatic brain injury (TBI) during early childhood to determine ways in which early head injury may alter typical brain development. Increased gyrification in other patient populations is associated with polymicrogyria and aberrant development, but this has not been investigated in TBI. Seventeen adolescents (mean age = 14.1 ± 2.4) who sustained a TBI between 1-8 years of age, and 17 demographically-matched typically developing children (TDC) underwent a high-resolution, T1-weighted 3-Tesla magnetic resonance imaging (MRI) at 6-15 years post-injury. Cortical white matter volume and organization was measured using FreeSurfer's Local Gyrification Index (LGI). Despite a lack of significant difference in white matter volume, participants with TBI demonstrated significantly increased LGI in several cortical regions that are among those latest to mature in normal development, including left parietal association areas, bilateral dorsolateral and medial frontal areas, and the right posterior temporal gyrus, relative to the TDC group. Additionally, there was no evidence of increased surface area in the regions that demonstrated increased LGI. Higher Vineland-II Socialization scores were associated with decreased LGI in right frontal and temporal regions. The present results suggest an altered pattern of expected development in cortical gyrification in the TBI group, with changes in late-developing frontal and parietal association areas. Such changes in brain structure may underlie cognitive and behavioral deficits associated with pediatric TBI. Alternatively, increased gyrification following TBI may represent a compensatory mechanism that allows for typical development of cortical surface area, despite reduced brain volume.
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Affiliation(s)
- Elisabeth A Wilde
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.,Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.,Department of Radiology, Baylor College of Medicine, Houston, Texas, USA
| | - Tricia L Merkley
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.,Department of Psychology, Brigham Young University, Provo, Utah, USA.,Department of Clinical Neuropsychology, Barrow Neurological Institute, Phoenix, Arizona, USA.,Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Hannah M Lindsey
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.,Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Erin D Bigler
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.,Department of Psychology, Brigham Young University, Provo, Utah, USA.,Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Jill V Hunter
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.,Department of Radiology, Baylor College of Medicine, Houston, Texas, USA.,Department of Pediatric Radiology, Texas Children's Hospital, Houston, Texas, USA
| | - Linda Ewing-Cobbs
- Department of Pediatrics, Children's Learning Institute, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mary E Aitken
- Arkansas Children's Research Institute and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arizona, USA
| | - Marianne C MacLeod
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Gerri Hanten
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Zili D Chu
- Department of Radiology, Baylor College of Medicine, Houston, Texas, USA.,Department of Pediatric Radiology, Texas Children's Hospital, Houston, Texas, USA
| | - Tracy J Abildskov
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.,Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Linda J Noble-Haeusslein
- Departments of Neurology and Psychology and the Institute of Neuroscience, University of Texas at Austin, Austin, Texas, USA
| | - Harvey S Levin
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.,Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
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25
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Menet R, Lecordier S, ElAli A. Wnt Pathway: An Emerging Player in Vascular and Traumatic Mediated Brain Injuries. Front Physiol 2020; 11:565667. [PMID: 33071819 PMCID: PMC7530281 DOI: 10.3389/fphys.2020.565667] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/18/2020] [Indexed: 12/13/2022] Open
Abstract
The Wnt pathway, which comprises the canonical and non-canonical pathways, is an evolutionarily conserved mechanism that regulates crucial biological aspects throughout the development and adulthood. Emergence and patterning of the nervous and vascular systems are intimately coordinated, a process in which Wnt pathway plays particularly important roles. In the brain, Wnt ligands activate a cell-specific surface receptor complex to induce intracellular signaling cascades regulating neurogenesis, synaptogenesis, neuronal plasticity, synaptic plasticity, angiogenesis, vascular stabilization, and inflammation. The Wnt pathway is tightly regulated in the adult brain to maintain neurovascular functions. Historically, research in neuroscience has emphasized essentially on investigating the pathway in neurodegenerative disorders. Nonetheless, emerging findings have demonstrated that the pathway is deregulated in vascular- and traumatic-mediated brain injuries. These findings are suggesting that the pathway constitutes a promising target for the development of novel therapeutic protective and restorative interventions. Yet, targeting a complex multifunctional signal transduction pathway remains a major challenge. The review aims to summarize the current knowledge regarding the implication of Wnt pathway in the pathobiology of ischemic and hemorrhagic stroke, as well as traumatic brain injury (TBI). Furthermore, the review will present the strategies used so far to manipulate the pathway for therapeutic purposes as to highlight potential future directions.
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Affiliation(s)
- Romain Menet
- Neuroscience Axis, Research Center of CHU de Québec - Université Laval, Quebec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Sarah Lecordier
- Neuroscience Axis, Research Center of CHU de Québec - Université Laval, Quebec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Ayman ElAli
- Neuroscience Axis, Research Center of CHU de Québec - Université Laval, Quebec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
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26
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Liu ZH, Chen NY, Tu PH, Wu CT, Chiu SC, Huang YC, Lim SN, Yip PK. DHA Attenuates Cerebral Edema Following Traumatic Brain Injury via the Reduction in Blood-Brain Barrier Permeability. Int J Mol Sci 2020; 21:ijms21176291. [PMID: 32878052 PMCID: PMC7503959 DOI: 10.3390/ijms21176291] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
Traumatic brain injury (TBI) could result in edema and cause an increase in intracranial pressure of the brain resulting in mortality and morbidity. Although there is hyperosmolarity therapy available for this pathophysiological event, it remains controversial. Recently, several groups have shown docosahexaenoic acid (DHA) to improve functional and histological outcomes following brain injury based on reduction of neuroinflammation and apoptosis. However, the effect of DHA on blood-brain barrier (BBB) dysfunction after brain injury has not been fully studied. Here, a controlled cortical impact rat model was used to test the effect of a single dose of DHA administered 30 min post injury. Modified neurological severity score (mNSS) and forelimb asymmetry were used to determine the functional outcomes. Neuroimaging and histology were used to characterize the edema and BBB dysfunction. The study showed that DHA-treated TBI rats had better mNSS and forelimb asymmetry score than vehicle-treated TBI rats. Temporal analysis of edema using MRI revealed a significant reduction in edema level with DHA treatment compared to vehicle in TBI rats. Histological analysis using immunoglobulin G (IgG) extravasation showed that there was less extravasation, which corresponded with a reduction in aquaporin 4 and astrocytic metalloprotease 9 expression, and greater endothelial occludin expression in the peri-contusional site of the TBI rat brain treated with DHA in comparison to vehicle treatment. In conclusion, the study shows that DHA can exert its functional improvement by prevention of the edema formation via prevention of BBB dysfunction after TBI.
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Affiliation(s)
- Zhuo-Hao Liu
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan County 333, Taiwan; (P.-h.T.); (Y.-C.H.)
- Correspondence: (Z.-H.L.); (P.K.Y.)
| | - Nan-Yu Chen
- Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan County 333, Taiwan;
| | - Po-hsun Tu
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan County 333, Taiwan; (P.-h.T.); (Y.-C.H.)
| | - Chen-Te Wu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan County 333, Taiwan;
| | - Shao-Chieh Chiu
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital at Linkou, Taoyuan County 333, Taiwan;
| | - Ying-Cheng Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan County 333, Taiwan; (P.-h.T.); (Y.-C.H.)
| | - Siew-Na Lim
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan County 333, Taiwan;
| | - Ping K. Yip
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Blizard Institute, Centre for Neuroscience, Surgery & Trauma, London E1 2AT, UK
- Correspondence: (Z.-H.L.); (P.K.Y.)
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27
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Glucose transporters in brain in health and disease. Pflugers Arch 2020; 472:1299-1343. [PMID: 32789766 PMCID: PMC7462931 DOI: 10.1007/s00424-020-02441-x] [Citation(s) in RCA: 219] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 12/15/2022]
Abstract
Energy demand of neurons in brain that is covered by glucose supply from the blood is ensured by glucose transporters in capillaries and brain cells. In brain, the facilitative diffusion glucose transporters GLUT1-6 and GLUT8, and the Na+-d-glucose cotransporters SGLT1 are expressed. The glucose transporters mediate uptake of d-glucose across the blood-brain barrier and delivery of d-glucose to astrocytes and neurons. They are critically involved in regulatory adaptations to varying energy demands in response to differing neuronal activities and glucose supply. In this review, a comprehensive overview about verified and proposed roles of cerebral glucose transporters during health and diseases is presented. Our current knowledge is mainly based on experiments performed in rodents. First, the functional properties of human glucose transporters expressed in brain and their cerebral locations are described. Thereafter, proposed physiological functions of GLUT1, GLUT2, GLUT3, GLUT4, and SGLT1 for energy supply to neurons, glucose sensing, central regulation of glucohomeostasis, and feeding behavior are compiled, and their roles in learning and memory formation are discussed. In addition, diseases are described in which functional changes of cerebral glucose transporters are relevant. These are GLUT1 deficiency syndrome (GLUT1-SD), diabetes mellitus, Alzheimer’s disease (AD), stroke, and traumatic brain injury (TBI). GLUT1-SD is caused by defect mutations in GLUT1. Diabetes and AD are associated with changed expression of glucose transporters in brain, and transporter-related energy deficiency of neurons may contribute to pathogenesis of AD. Stroke and TBI are associated with changes of glucose transporter expression that influence clinical outcome.
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28
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Steinman J, Cahill LS, Stortz G, Macgowan CK, Stefanovic B, Sled JG. Non-Invasive Ultrasound Detection of Cerebrovascular Changes in a Mouse Model of Traumatic Brain Injury. J Neurotrauma 2020; 37:2157-2168. [PMID: 32326817 DOI: 10.1089/neu.2019.6872] [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] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) can induce changes in vascular architecture. Although ultrasound metrics such as pulsatility index (PI) are sensitive to changes in hemodynamic resistance downstream from major arteries, these metrics depend on features unrelated to vessel architecture, such as blood pressure and heart rate. In contrast, input impedance and reflection coefficient that are derived from wave reflection theory seek to minimize the effects of altered cardiac output or heart rate. In this article, we investigate the use of ultrasound to assess changes in vascular impedance and wave reflection in the common carotid arteries of mice exposed to a controlled cortical impact. Focusing on the first harmonics of the reflected waves, the impedance phase was increased ipsilaterally in impacted mice compared with shams, whereas the magnitude of the impedance was unchanged. In contrast, PI was reduced bilaterally. Interestingly, PI and the first harmonic magnitude of input impedance in the carotid artery were correlated on the contralateral but not ipsilateral side. We investigated the use of these metrics to classify mice as sham or TBI, finding an area under the receiver operating characteristic curve ipsilaterally of 0.792 (confidence interval [CI]: 0.648-0.936) for correct classification with first harmonic impedance magnitude and phase as predictors and 0.716 (CI: 0.553-0.879) using carotid artery PI and diameter as predictors. Overall, the findings support the use of wave reflection analysis as a more specific measure of vascular changes following TBI and motivate the translation of this approach for monitoring vascular changes in humans affected by TBI.
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Affiliation(s)
- Joe Steinman
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay S Cahill
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Chemistry, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Greg Stortz
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christopher K Macgowan
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Bojana Stefanovic
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - John G Sled
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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29
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Mastorakos P, McGavern D. The anatomy and immunology of vasculature in the central nervous system. Sci Immunol 2020; 4:4/37/eaav0492. [PMID: 31300479 DOI: 10.1126/sciimmunol.aav0492] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/13/2019] [Indexed: 12/21/2022]
Abstract
Barriers between circulation and the central nervous system (CNS) play a key role in the development and modulation of CNS immune responses. Structural variations in the vasculature traversing different anatomical regions within the CNS strongly influence where and how CNS immune responses first develop. Here, we provide an overview of cerebrovascular anatomy, focusing on the blood-CNS interface and how anatomical variations influence steady-state immunology in the compartment. We then discuss how CNS vasculature is affected by and influences the development of different pathophysiological states, such as CNS autoimmune disease, cerebrovascular injury, cerebral ischemia, and infection.
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Affiliation(s)
- Panagiotis Mastorakos
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Dorian McGavern
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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30
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Ichkova A, Rodriguez-Grande B, Zub E, Saudi A, Fournier ML, Aussudre J, Sicard P, Obenaus A, Marchi N, Badaut J. Early cerebrovascular and long-term neurological modifications ensue following juvenile mild traumatic brain injury in male mice. Neurobiol Dis 2020; 141:104952. [PMID: 32442681 DOI: 10.1016/j.nbd.2020.104952] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/05/2020] [Accepted: 05/17/2020] [Indexed: 12/15/2022] Open
Abstract
Clinical evidence suggests that a mild traumatic brain injury occurring at a juvenile age (jmTBI) may be sufficient to elicit pathophysiological modifications. However, clinical reports are not adequately integrated with experimental studies examining brain changes occurring post-jmTBI. We monitored the cerebrovascular modifications and assessed the long-term behavioral and electrographic changes resulting from experimental jmTBI. In vivo photoacoustic imaging demonstrated a decrease of cerebrovascular oxygen saturation levels in the impacted area hours post-jmTBI. Three days post-jmTBI oxygenation returned to pre-jmTBI levels, stabilizing at 7 and 30 days after the injury. At the functional level, cortical arterioles displayed no NMDA vasodilation response, while vasoconstriction induced by thromboxane receptor agonist was enhanced at 1 day post-jmTBI. Arterioles showed abnormal NMDA vasodilation at 3 days post-jmTBI, returning to normality at 7 days post injury. Histology showed changes in vessel diameters from 1 to 30 days post-jmTBI. Neurological evaluation indicated signs of anxiety-like behavior up to 30 days post-jmTBI. EEG recordings performed at the cortical site of impact 30 days post-jmTBI did not indicate seizures activity, although it revealed a reduction of gamma waves as compared to age matched sham. Histology showed decrease of neuronal filament staining. In conclusion, experimental jmTBI triggers an early cerebrovascular hypo‑oxygenation in vivo and faulty vascular reactivity. The exact topographical coherence and the direct casualty between early cerebrovascular changes and the observed long-term neurological modifications remain to be investigated. A potential translational value for cerebro-vascular oxygen monitoring in jmTBI is discussed.
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Affiliation(s)
| | | | - Emma Zub
- Cerebrovascular and Glia Research Laboratory, Department of Neuroscience, Institute of Functional Genomics (UMR 5203 CNRS-U1191 INSERM, University of Montpellier), Montpellier, France
| | - Amel Saudi
- Cerebrovascular and Glia Research Laboratory, Department of Neuroscience, Institute of Functional Genomics (UMR 5203 CNRS-U1191 INSERM, University of Montpellier), Montpellier, France
| | | | | | - Pierre Sicard
- INSERM, CNRS, Université de Montpellier, PhyMedExp, IPAM, Montpellier, France
| | - André Obenaus
- CNRS UMR5287, University of Bordeaux, Bordeaux, France; Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA; Basic Science Department, Loma Linda University School of Medicine, Loma Linda, CA, USA; Center for Glial-Neuronal Interactions, Division of Biomedical Sciences, UC Riverside, Riverside, CA, USA; Department of Pediatrics, University of California, Irvine, Irvine, CA, USA
| | - Nicola Marchi
- Cerebrovascular and Glia Research Laboratory, Department of Neuroscience, Institute of Functional Genomics (UMR 5203 CNRS-U1191 INSERM, University of Montpellier), Montpellier, France.
| | - Jerome Badaut
- CNRS UMR5287, University of Bordeaux, Bordeaux, France; Basic Science Department, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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Mayer AR, Stephenson DD, Wertz CJ, Dodd AB, Shaff NA, Ling JM, Park G, Oglesbee SJ, Wasserott BC, Meier TB, Witkiewitz K, Campbell RA, Yeo RA, Phillips JP, Quinn DK, Pottenger A. Proactive inhibition deficits with normal perfusion after pediatric mild traumatic brain injury. Hum Brain Mapp 2019; 40:5370-5381. [PMID: 31456319 PMCID: PMC6864901 DOI: 10.1002/hbm.24778] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/11/2019] [Accepted: 08/16/2019] [Indexed: 12/14/2022] Open
Abstract
Although much attention has been generated in popular media regarding the deleterious effects of pediatric mild traumatic brain injury (pmTBI), a paucity of empirical evidence exists regarding the natural course of biological recovery. Fifty pmTBI patients (12-18 years old) were consecutively recruited from Emergency Departments and seen approximately 1 week and 4 months post-injury in this prospective cohort study. Data from 53 sex- and age-matched healthy controls (HC) were also collected. Functional magnetic resonance imaging was obtained during proactive response inhibition and at rest, in conjunction with independent measures of resting cerebral blood flow. High temporal resolution imaging enabled separate modeling of neural responses for preparation and execution of proactive response inhibition. A priori predictions of failed inhibitory responses (i.e., hyperactivation) were observed in motor circuitry (pmTBI>HC) and sensory areas sub-acutely and at 4 months post-injury. Paradoxically, pmTBI demonstrated hypoactivation (HC>pmTBI) during target processing, along with decreased activation within prefrontal cognitive control areas. Functional connectivity within motor circuitry at rest suggested that deficits were limited to engagement during the inhibitory task, whereas normal resting cerebral perfusion ruled out deficits in basal perfusion. In conclusion, current results suggest blood oxygen-level dependent deficits during inhibitory control may exceed commonly held beliefs about physiological recovery following pmTBI, potentially lasting up to 4 months post-injury.
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Affiliation(s)
- Andrew R. Mayer
- The Mind Research Network/LBERIAlbuquerqueNew Mexico
- Department of PsychologyUniversity of New MexicoAlbuquerqueNew Mexico
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew Mexico
- Department of PsychiatryUniversity of New MexicoAlbuquerqueNew Mexico
| | | | | | | | | | - Josef M. Ling
- The Mind Research Network/LBERIAlbuquerqueNew Mexico
| | - Grace Park
- Emergency MedicineUniversity of New MexicoAlbuquerqueNew Mexico
| | | | | | - Timothy B. Meier
- Department of NeurosurgeryMedical College of WisconsinMilwaukeeWisconsin
- Department of Cell BiologyNeurobiology and Anatomy, Medical College of WisconsinMilwaukeeWisconsin
| | - Katie Witkiewitz
- Department of PsychologyUniversity of New MexicoAlbuquerqueNew Mexico
| | | | - Ronald A. Yeo
- Department of PsychologyUniversity of New MexicoAlbuquerqueNew Mexico
| | - John P. Phillips
- The Mind Research Network/LBERIAlbuquerqueNew Mexico
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew Mexico
| | - Davin K. Quinn
- Department of PsychiatryUniversity of New MexicoAlbuquerqueNew Mexico
| | - Amy Pottenger
- Emergency MedicineUniversity of New MexicoAlbuquerqueNew Mexico
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Acute and chronic stage adaptations of vascular architecture and cerebral blood flow in a mouse model of TBI. Neuroimage 2019; 202:116101. [DOI: 10.1016/j.neuroimage.2019.116101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 11/18/2022] Open
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Mayer AR, Cohen DM, Wertz CJ, Dodd AB, Shoemaker J, Pluto C, Zumberge NA, Park G, Bangert BA, Lin C, Minich NM, Bacevice AM, Bigler ED, Campbell RA, Hanlon FM, Meier TB, Oglesbee SJ, Phillips JP, Pottenger A, Shaff NA, Taylor HG, Yeo RA, Arbogast KB, Leddy JJ, Master CL, Mannix R, Zemek RL, Yeates KO. Radiologic common data elements rates in pediatric mild traumatic brain injury. Neurology 2019; 94:e241-e253. [PMID: 31645467 DOI: 10.1212/wnl.0000000000008488] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/18/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The nosology for classifying structural MRI findings following pediatric mild traumatic brain injury (pmTBI) remains actively debated. Radiologic common data elements (rCDE) were developed to standardize reporting in research settings. However, some rCDE are more specific to trauma (probable rCDE). Other more recently proposed rCDE have multiple etiologies (possible rCDE), and may therefore be more common in all children. Independent cohorts of patients with pmTBI and controls were therefore recruited from multiple sites (New Mexico and Ohio) to test the dual hypothesis of a higher incidence of probable rCDE (pmTBI > controls) vs similar rates of possible rCDE on structural MRI. METHODS Patients with subacute pmTBI (n = 287), matched healthy controls (HC; n = 106), and orthopedically injured (OI; n = 71) patients underwent imaging approximately 1 week postinjury and were followed for 3-4 months. RESULTS Probable rCDE were specific to pmTBI, occurring in 4%-5% of each sample, rates consistent with previous large-scale CT studies. In contrast, prevalence rates for incidental findings and possible rCDE were similar across groups (pmTBI vs OI vs HC). The prevalence of possible rCDE was also the only finding that varied as a function of site. Possible rCDE and incidental findings were not associated with postconcussive symptomatology or quality of life 3-4 months postinjury. CONCLUSION Collectively, current findings question the trauma-related specificity of certain rCDE, as well how these rCDE are radiologically interpreted. Refinement of rCDE in the context of pmTBI may be warranted, especially as diagnostic schema are evolving to stratify patients with structural MRI abnormalities as having a moderate injury.
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Affiliation(s)
- Andrew R Mayer
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada.
| | - Daniel M Cohen
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Christopher J Wertz
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Andrew B Dodd
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Jody Shoemaker
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Charles Pluto
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Nicholas A Zumberge
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Grace Park
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Barbara A Bangert
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Cindy Lin
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Nori M Minich
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Ann M Bacevice
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Erin D Bigler
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Richard A Campbell
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Faith M Hanlon
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Timothy B Meier
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Scott J Oglesbee
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - John P Phillips
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Amy Pottenger
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Nicholas A Shaff
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - H Gerry Taylor
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Ronald A Yeo
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Kristy B Arbogast
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - John J Leddy
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Christina L Master
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Rebekah Mannix
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Roger L Zemek
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
| | - Keith Owen Yeates
- From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada
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Uddin O, Studlack PE, Parihar S, Keledjian K, Cruz A, Farooq T, Shin N, Gerzanich V, Simard JM, Keller A. Chronic pain after blast-induced traumatic brain injury in awake rats. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2019; 6:100030. [PMID: 31223145 PMCID: PMC6565615 DOI: 10.1016/j.ynpai.2019.100030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/14/2019] [Accepted: 04/01/2019] [Indexed: 12/14/2022]
Abstract
Explosive blast-induced traumatic brain injury (blast-TBI) in military personnel is a leading cause of injury and persistent neurological abnormalities, including chronic pain. We previously demonstrated that chronic pain after spinal cord injury results from central sensitization in the posterior thalamus (PO). The presence of persistent headaches and back pain in veterans with blast-TBI suggests a similar involvement of thalamic sensitization. Here, we tested the hypothesis that pain after blast-TBI is associated with abnormal increases in activity of neurons in PO thalamus. We developed a novel model with two unique features: (1) blast-TBI was performed in awake, un-anesthetized rats, to simulate the human experience and to eliminate confounds of anesthesia and surgery inherent in other models; (2) only the cranium, rather than the entire body, was exposed to a collimated blast wave, with the blast wave striking the posterior cranium in the region of the occipital crest and foramen magnum. Three weeks after blast-TBI, rats developed persistent, ongoing spontaneous pain. Contrary to our hypothesis, we found no significant differences in the activity of PO neurons, or of neurons in the spinal trigeminal nucleus. There were also no significant changes in gliosis in either of these structures. This novel model will allow future studies on the pathophysiology of chronic pain after blast-TBI.
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Affiliation(s)
- Olivia Uddin
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
| | - Paige E. Studlack
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
| | - Saitu Parihar
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
| | - Kaspar Keledjian
- Department of Neurosurgery, University of Maryland School of Medicine, 10 S Pine St, MSTF 634B, Baltimore, MD, USA
| | - Alexis Cruz
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
| | - Tayyiaba Farooq
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
| | - Naomi Shin
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
| | - Volodymyr Gerzanich
- Department of Neurosurgery, University of Maryland School of Medicine, 10 S Pine St, MSTF 634B, Baltimore, MD, USA
| | - J. Marc Simard
- Department of Neurosurgery, University of Maryland School of Medicine, 10 S Pine St, MSTF 634B, Baltimore, MD, USA
- Department of Pathology, University of Maryland School of Medicine, 10 S Pine St, MSTF, Room 634B, Baltimore, MD, USA
- Department of Physiology, University of Maryland School of Medicine, 10 S Pine St, MSTF, Room 634B, Baltimore, MD, USA
| | - Asaf Keller
- Department of Anatomy and Neurobiology and Program in Neuroscience, University of Maryland School of Medicine, 20 Penn St, HSF-II S251, Baltimore, MD, USA
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Bogorad MI, DeStefano JG, Linville RM, Wong AD, Searson PC. Cerebrovascular plasticity: Processes that lead to changes in the architecture of brain microvessels. J Cereb Blood Flow Metab 2019; 39:1413-1432. [PMID: 31208241 PMCID: PMC6681538 DOI: 10.1177/0271678x19855875] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The metabolic demands of the brain are met by oxygen and glucose, supplied by a complex hierarchical network of microvessels (arterioles, capillaries, and venules). Transient changes in neural activity are accommodated by local dilation of arterioles or capillaries to increase cerebral blood flow and hence nutrient availability. Transport and communication between the circulation and the brain is regulated by the brain microvascular endothelial cells that form the blood-brain barrier. Under homeostatic conditions, there is very little turnover in brain microvascular endothelial cells, and the cerebrovascular architecture is largely static. However, changes in the brain microenvironment, due to environmental factors, disease, or trauma, can result in additive or subtractive changes in cerebrovascular architecture. Additions occur by angiogenesis or vasculogenesis, whereas subtractions occur by vascular pruning, injury, or endothelial cell death. Here we review the various processes that lead to changes in the cerebrovascular architecture, including sustained changes in the brain microenvironment, development and aging, and injury, disease, and repair.
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Affiliation(s)
- Max I Bogorad
- 1 Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.,2 Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jackson G DeStefano
- 1 Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.,2 Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Raleigh M Linville
- 1 Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.,3 Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Andrew D Wong
- 1 Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.,2 Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Peter C Searson
- 1 Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.,2 Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA.,3 Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
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36
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Zhou Z, Austin GL, Young LEA, Johnson LA, Sun R. Mitochondrial Metabolism in Major Neurological Diseases. Cells 2018; 7:E229. [PMID: 30477120 PMCID: PMC6316877 DOI: 10.3390/cells7120229] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 01/18/2023] Open
Abstract
Mitochondria are bilayer sub-cellular organelles that are an integral part of normal cellular physiology. They are responsible for producing the majority of a cell's ATP, thus supplying energy for a variety of key cellular processes, especially in the brain. Although energy production is a key aspect of mitochondrial metabolism, its role extends far beyond energy production to cell signaling and epigenetic regulation⁻functions that contribute to cellular proliferation, differentiation, apoptosis, migration, and autophagy. Recent research on neurological disorders suggest a major metabolic component in disease pathophysiology, and mitochondria have been shown to be in the center of metabolic dysregulation and possibly disease manifestation. This review will discuss the basic functions of mitochondria and how alterations in mitochondrial activity lead to neurological disease progression.
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Affiliation(s)
- Zhengqiu Zhou
- Molecular & Cellular Biochemistry Department, University of Kentucky, Lexington, KY 40536, USA.
| | - Grant L Austin
- Molecular & Cellular Biochemistry Department, University of Kentucky, Lexington, KY 40536, USA.
| | - Lyndsay E A Young
- Molecular & Cellular Biochemistry Department, University of Kentucky, Lexington, KY 40536, USA.
| | - Lance A Johnson
- Department of Physiology, University of Kentucky, Lexington, KY 40536, USA.
| | - Ramon Sun
- Molecular & Cellular Biochemistry Department, University of Kentucky, Lexington, KY 40536, USA.
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Mayer AR, Kaushal M, Dodd AB, Hanlon FM, Shaff NA, Mannix R, Master CL, Leddy JJ, Stephenson D, Wertz CJ, Suelzer EM, Arbogast KB, Meier TB. Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils. Neurosci Biobehav Rev 2018; 94:149-165. [PMID: 30098989 DOI: 10.1016/j.neubiorev.2018.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 12/20/2022]
Abstract
There is growing public concern about neurodegenerative changes (e.g., Chronic Traumatic Encephalopathy) that may occur chronically following clinically apparent and clinically silent (i.e., sub-concussive blows) pediatric mild traumatic brain injury (pmTBI). However, there are currently no biomarkers that clinicians can use to objectively diagnose patients or predict those who may struggle to recover. Non-invasive neuroimaging, electrophysiological and neuromodulation biomarkers have promise for providing evidence of the so-called "invisible wounds" of pmTBI. Our systematic review, however, belies that notion, identifying a relative paucity of high-quality, clinically impactful, diagnostic or prognostic biomarker studies in the sub-acute injury phase (36 studies on unique samples in 28 years), with the majority focusing on adolescent pmTBI. Ultimately, well-powered longitudinal studies with appropriate control groups, as well as standardized and clearly-defined inclusion criteria (time post-injury, injury severity and past history) are needed to truly understand the complex pathophysiology that is hypothesized (i.e., still needs to be determined) to exist during the acute and sub-acute stages of pmTBI and may underlie post-concussive symptoms.
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Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States; Neurology Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychiatry Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychology Department, University of New Mexico, Albuquerque, NM, 87131, United States.
| | - Mayank Kaushal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Christina L Master
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States; Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - John J Leddy
- UBMD Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, NY, 14214, United States
| | - David Stephenson
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Christopher J Wertz
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Elizabeth M Suelzer
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
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Jullienne A, Salehi A, Affeldt B, Baghchechi M, Haddad E, Avitua A, Walsworth M, Enjalric I, Hamer M, Bhakta S, Tang J, Zhang JH, Pearce WJ, Obenaus A. Male and Female Mice Exhibit Divergent Responses of the Cortical Vasculature to Traumatic Brain Injury. J Neurotrauma 2018; 35:1646-1658. [PMID: 29648973 DOI: 10.1089/neu.2017.5547] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
We previously reported that traumatic brain injuries (TBI) alter the cerebrovasculature near the injury site in rats, followed by revascularization over a 2-week period. Here, we tested our hypothesis that male and female adult mice have differential cerebrovascular responses following a moderate controlled cortical impact (CCI). Using in vivo magnetic resonance imaging (MRI), a new technique called vessel painting, and immunohistochemistry, we found no differences between males and females in lesion volume, neurodegeneration, blood-brain barrier (BBB) alteration, and microglia activation. However, females exhibited more astrocytic hypertrophy and heme-oxygenase-1 (HO-1) induction at 1 day post-injury (dpi), whereas males presented with increased endothelial activation and expression of β-catenin, shown to be involved in angiogenesis. At 7 dpi, we observed an increase in the number of vessels and an enhancement in vessel complexity in the injured cortex of males compared with females. Cerebrovasculature recovers differently after CCI, suggesting biological sex should be considered when designing new therapeutic agents.
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Affiliation(s)
- Amandine Jullienne
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Arjang Salehi
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Bethann Affeldt
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Mohsen Baghchechi
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Elizabeth Haddad
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Angela Avitua
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Mark Walsworth
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Isabelle Enjalric
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Mary Hamer
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Sonali Bhakta
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California
| | - Jiping Tang
- 2 Department of Physiology and Pharmacology, University of California Irvine , Irvine, California
| | - John H Zhang
- 2 Department of Physiology and Pharmacology, University of California Irvine , Irvine, California.,3 Department of Anesthesiology, University of California Irvine , Irvine, California.,4 Department of Neurosurgery, University of California Irvine , Irvine, California
| | - William J Pearce
- 2 Department of Physiology and Pharmacology, University of California Irvine , Irvine, California.,5 Center for Perinatal Biology, Loma Linda University , Loma Linda, California
| | - André Obenaus
- 1 Department of Basic Sciences, University of California Irvine , Irvine, California.,6 Department of Pediatrics, University of California Irvine , Irvine, California
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39
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Russo MV, Latour LL, McGavern DB. Distinct myeloid cell subsets promote meningeal remodeling and vascular repair after mild traumatic brain injury. Nat Immunol 2018; 19:442-452. [PMID: 29662169 DOI: 10.1038/s41590-018-0086-2] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/15/2018] [Indexed: 12/14/2022]
Abstract
Mild traumatic brain injury (mTBI) can cause meningeal vascular injury and cell death that spreads into the brain parenchyma and triggers local inflammation and recruitment of peripheral immune cells. The factors that dictate meningeal recovery after mTBI are unknown at present. Here we demonstrated that most patients who had experienced mTBI resolved meningeal vascular damage within 2-3 weeks, although injury persisted for months in a subset of patients. To understand the recovery process, we studied a mouse model of mTBI and found extensive meningeal remodeling that was temporally reliant on infiltrating myeloid cells with divergent functions. Inflammatory myelomonocytic cells scavenged dead cells in the lesion core, whereas wound-healing macrophages proliferated along the lesion perimeter and promoted angiogenesis through the clearance of fibrin and production of the matrix metalloproteinase MMP-2. Notably, a secondary injury experienced during the acute inflammatory phase aborted this repair program and enhanced inflammation, but a secondary injury experienced during the wound-healing phase did not. Our findings demonstrate that meningeal vasculature can undergo regeneration after mTBI that is dependent on distinct myeloid cell subsets.
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Affiliation(s)
- Matthew V Russo
- Viral Immunology & Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.,Johns Hopkins University Graduate Partnership Program, Baltimore, MD, USA
| | - Lawrence L Latour
- Acute Cerebrovascular Diagnostics Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Dorian B McGavern
- Viral Immunology & Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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40
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Main BS, Villapol S, Sloley SS, Barton DJ, Parsadanian M, Agbaegbu C, Stefos K, McCann MS, Washington PM, Rodriguez OC, Burns MP. Apolipoprotein E4 impairs spontaneous blood brain barrier repair following traumatic brain injury. Mol Neurodegener 2018; 13:17. [PMID: 29618365 PMCID: PMC5885297 DOI: 10.1186/s13024-018-0249-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 03/21/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Traumatic Brain Injury (TBI) is a major cause of disability and mortality, to which there is currently no comprehensive treatment. Blood Brain Barrier (BBB) dysfunction is well documented in human TBI patients, yet the molecular mechanisms that underlie this neurovascular unit (NVU) pathology remains unclear. The apolipoprotein-E (apoE) protein has been implicated in controlling BBB integrity in an isoform dependent manner, via suppression of Cyclophilin A (CypA)-Matrix metallopeptidase-9 (MMP-9) signaling cascades, however the contribution of this pathway in TBI-induced BBB permeability is not fully investigated. METHODS We exposed C57Bl/6 mice to controlled cortical impact and assessed NVU and BBB permeability responses up to 21 days post-injury. We pharmacologically probed the role of the CypA-MMP-9 pathway in BBB permeability after TBI using Cyclosporin A (CsA, 20 mg/kg). Finally, as the apoE4 protein is known to be functionally deficient compared to the apoE3 protein, we used humanized APOE mice as a clinically relevant model to study the role of apoE on BBB injury and repair after TBI. RESULTS In C57Bl/6 mice there was an inverse relationship between soluble apoE and BBB permeability, such that damaged BBB stabilizes as apoE levels increase in the days following TBI. TBI mice displayed acute pericyte loss, increased MMP-9 production and activity, and reduced tight-junction expression. Treatment with the CypA antagonist CsA in C57Bl/6 mice attenuates MMP-9 responses and enhances BBB repair after injury, demonstrating that MMP-9 plays an important role in the timing of spontaneous BBB repair after TBI. We also show that apoe mRNA is present in both astrocytes and pericytes after TBI. We report that APOE3 and APOE4 mice have similar acute BBB responses to TBI, but APOE3 mice display faster spontaneous BBB repair than APOE4 mice. Isolated microvessel analysis reveals delayed pericyte repopulation, augmented and sustained MMP-9 expression at the NVU, and impaired stabilization of Zonula Occludens-1, Occludin and Claudin-5 expression at tight junctions in APOE4 mice after TBI compared to APOE3 mice. CONCLUSIONS These data confirm apoE as an important modulator of spontaneous BBB stabilization following TBI, and highlights the APOE4 allele as a risk factor for poor outcome after TBI.
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Affiliation(s)
- Bevan S Main
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Sonia Villapol
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Stephanie S Sloley
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - David J Barton
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Maia Parsadanian
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Chinyere Agbaegbu
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Kathryn Stefos
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Mondona S McCann
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Patricia M Washington
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Olga C Rodriguez
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Mark P Burns
- Laboratory for Brain Injury and Dementia, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 20057, USA. .,Department of Neuroscience, Georgetown University Medical Center, New Research Building-EG11, 3970 Reservoir Rd, NW, Washington, D.C, 20057, USA.
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41
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Kenney K, Amyot F, Moore C, Haber M, Turtzo LC, Shenouda C, Silverman E, Gong Y, Qu BX, Harburg L, Wassermann EM, Lu H, Diaz‐Arrastia R. Phosphodiesterase-5 inhibition potentiates cerebrovascular reactivity in chronic traumatic brain injury. Ann Clin Transl Neurol 2018; 5:418-428. [PMID: 29687019 PMCID: PMC5899908 DOI: 10.1002/acn3.541] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 12/12/2017] [Accepted: 12/26/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Traumatic cerebrovascular injury (TCVI), a common consequence of traumatic brain injury (TBI), presents an attractive therapeutic target. Because phosphodiesterase-5 (PDE5) inhibitors potentiate the action of nitric oxide (NO) produced by endothelial cells, they are candidate therapies for TCVI. This study aims to: (1) measure cerebral blood flow (CBF), cerebrovascular reactivity (CVR), and change in CVR after a single dose of sildenafil (ΔCVR) in chronic TBI compared to uninjured controls; (2) examine the safety and tolerability of 8-week sildenafil administration in chronic symptomatic moderate/severe TBI patients; and as an exploratory aim, (3) assess the effect of an 8-week course of sildenafil on chronic TBI symptoms. METHODS Forty-six subjects (31 chronic TBI, 15 matched healthy volunteers) were enrolled. Baseline CBF and CVR before and after administration of sildenafil were measured. Symptomatic TBI subjects then completed an 8-week double-blind, placebo-controlled, crossover trial of sildenafil. A neuropsychological battery and neurobehavioral symptom questionnaires were administered at each study visit. RESULTS After a single dose of sildenafil, TBI subjects showed a significant increase in global CVR compared to healthy controls (P < 0.001, d = 0.9). Post-sildenafil CVR maps showed near-normalization of CVR in many regions where baseline CVR was low, predominantly within areas without structural abnormalities. Sildenafil was well tolerated. Clinical Global Impression (CGI) scale showed a trend toward clinical improvement while on sildenafil treatment. FINDINGS Single-dose sildenafil improves regional CVR deficits in chronic TBI patients. CVR and ΔCVR are potential predictive and pharmacodynamic biomarkers of PDE5 inhibitor therapy for TCVI. Sildenafil is a potential therapy for TCVI.
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Affiliation(s)
- Kimbra Kenney
- Department of NeurologyUniformed Services University of the Health SciencesBethesdaMaryland
| | - Franck Amyot
- Department of NeurologyUniformed Services University of the Health SciencesBethesdaMaryland
| | - Carol Moore
- Department of NeurologyUniformed Services University of the Health SciencesBethesdaMaryland
| | - Margalit Haber
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania
| | | | - Christian Shenouda
- Department of Physical Medicine and RehabilitationNational Institutes of Health Clinical CenterBethesdaMaryland
| | - Erika Silverman
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania
| | - Yunhua Gong
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania
| | - Bao‐ Xi Qu
- Department of NeurologyUniformed Services University of the Health SciencesBethesdaMaryland
| | - Leah Harburg
- Department of NeurologyUniformed Services University of the Health SciencesBethesdaMaryland
| | - Eric M. Wassermann
- Behavioral Neurology UnitNational Institute of Neurological Diseases and StrokeNational Institutes of HealthBethesdaMaryland
| | | | - Ramon Diaz‐Arrastia
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania
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Wright AD, Smirl JD, Bryk K, Fraser S, Jakovac M, van Donkelaar P. Sport-Related Concussion Alters Indices of Dynamic Cerebral Autoregulation. Front Neurol 2018; 9:196. [PMID: 29636724 PMCID: PMC5880892 DOI: 10.3389/fneur.2018.00196] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
Sport-related concussion is known to affect a variety of brain functions. However, the impact of this brain injury on cerebral autoregulation (CA) is poorly understood. Thus, the goal of the current study was to determine the acute and cumulative effects of sport-related concussion on indices of dynamic CA. Toward this end, 179 elite, junior-level (age 19.6 ± 1.5 years) contact sport (ice hockey, American football) athletes were recruited for preseason testing, 42 with zero prior concussions and 31 with three or more previous concussions. Eighteen athletes sustained a concussion during that competitive season and completed follow-up testing at 72 h, 2 weeks, and 1 month post injury. Beat-by-beat arterial blood pressure (BP) and middle cerebral artery blood velocity (MCAv) were recorded using finger photoplethysmography and transcranial Doppler ultrasound, respectively. Five minutes of repetitive squat-stand maneuvers induced BP oscillations at 0.05 and 0.10 Hz (20- and 10-s cycles, respectively). The BP-MCAv relationship was quantified using transfer function analysis to estimate Coherence (correlation), Gain (amplitude ratio), and Phase (timing offset). At a group level, repeated-measures ANOVA indicated that 0.10 Hz Phase was significantly reduced following an acute concussion, compared to preseason, by 23% (-0.136 ± 0.033 rads) at 72 h and by 18% (-0.105 ± 0.029 rads) at 2 weeks post injury, indicating impaired autoregulatory functioning; recovery to preseason values occurred by 1 month. Athletes were cleared to return to competition after a median of 14 days (range 7-35), implying that physiologic dysfunction persisted beyond clinical recovery in many cases. When comparing dynamic pressure buffering between athletes with zero prior concussions and those with three or more, no differences were observed. Sustaining an acute sport-related concussion induces transient impairments in the capabilities of the cerebrovascular pressure-buffering system that may persist beyond 2 weeks and may be due to a period of autonomic dysregulation. Athletes with a history of three or more concussions did not exhibit impairments relative to those with zero prior concussions, suggesting recovery of function over time. Findings from this study support the potential need to consider physiological recovery in deciding when patients should return to play following a concussion.
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Affiliation(s)
- Alexander D Wright
- MD/PhD Program, University of British Columbia, Vancouver, BC, Canada.,Southern Medical Program, Reichwald Health Sciences Centre, University of British Columbia Okanagan, Kelowna, BC, Canada.,Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jonathan D Smirl
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Kelsey Bryk
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Sarah Fraser
- Southern Medical Program, Reichwald Health Sciences Centre, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Michael Jakovac
- Southern Medical Program, Reichwald Health Sciences Centre, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
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43
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Amyot F, Kenney K, Moore C, Haber M, Turtzo LC, Shenouda C, Silverman E, Gong Y, Qu BX, Harburg L, Lu HY, Wassermann EM, Diaz-Arrastia R. Imaging of Cerebrovascular Function in Chronic Traumatic Brain Injury. J Neurotrauma 2018; 35:1116-1123. [PMID: 29065769 DOI: 10.1089/neu.2017.5114] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Traumatic cerebrovascular injury (TCVI) is a common pathologic mechanism of traumatic brain injury (TBI) and presents an attractive target for intervention. The aims of this study were to assess cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) using magnetic resonance imaging (MRI) to assess their value as biomarkers of TCVI in chronic TBI, characterize the spatial distribution of TCVI, and assess the relationships between each biomarker and neuropsychological and clinical assessments. Forty-two subjects (27 chronic TBI, 15 age- and gender-matched healthy volunteers) were studied cross-sectionally. CBF was measured by arterial spin labeling and CVR by assessing the MRI-blood oxygen level-dependent signal with hypercapnia challenge. A focused neuropsychological battery adapted from the TBI Common Data Elements and neurobehavioral symptom questionnaires were administered at the time of the imaging session. Chronic TBI subjects showed a significant reduction in mean global, gray matter (GM), and white matter (WM) CVR, compared with healthy volunteers (p < 0.001). Mean GM CVR had the greatest effect size (Cohen's d = 0.9). CVR maps in chronic TBI subjects showed patchy, multifocal CVR deficits. CBF discriminated poorly between TBI subjects and healthy volunteers and did not correlate with CVR. Mean global CVR correlated best with chronic neurobehavioral symptoms among TBI subjects. Global, GM, and WM CVR are reliable and potentially useful biomarkers of TCVI in the chronic stage after moderate-to-severe TBI. CBF is less useful as biomarker of TCVI. CVR correlates best with chronic TBI symptoms. CVR has potential as a predictive and pharmacodynamic biomarker for interventions targeting TCVI.
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Affiliation(s)
- Franck Amyot
- 1 Department of Neurology, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Kimbra Kenney
- 1 Department of Neurology, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Carol Moore
- 1 Department of Neurology, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Margalit Haber
- 2 Department of Neurology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - L Christine Turtzo
- 3 Center for Neuroscience and Regenerative Medicine, National Institute of Neurological Disorder and Stroke, National Institutes of Health , Bethesda, Maryland
| | - Christian Shenouda
- 3 Center for Neuroscience and Regenerative Medicine, National Institute of Neurological Disorder and Stroke, National Institutes of Health , Bethesda, Maryland
| | - Erika Silverman
- 2 Department of Neurology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Yunhua Gong
- 2 Department of Neurology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Bao-Xi Qu
- 1 Department of Neurology, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Leah Harburg
- 1 Department of Neurology, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Hanzhang Y Lu
- 4 Department of Radiology and Radiological Science, Johns Hopkins University Baltimore , Maryland
| | - Eric M Wassermann
- 5 National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, Maryland
| | - Ramon Diaz-Arrastia
- 2 Department of Neurology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
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44
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Salehi A, Jullienne A, Baghchechi M, Hamer M, Walsworth M, Donovan V, Tang J, Zhang JH, Pearce WJ, Obenaus A. Up-regulation of Wnt/β-catenin expression is accompanied with vascular repair after traumatic brain injury. J Cereb Blood Flow Metab 2018; 38:274-289. [PMID: 29160735 PMCID: PMC5951019 DOI: 10.1177/0271678x17744124] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Recent data suggest that repairing the cerebral vasculature after traumatic brain injury (TBI) may help to improve functional recovery. The Wnt/β-catenin signaling pathway promotes blood vessel formation during vascular development, but its role in vascular repair after TBI remains elusive. In this study, we examined how the cerebral vasculature responds to TBI and the role of Wnt/β-catenin signaling in vascular repair. We induced a moderate controlled cortical impact in adult mice and performed vessel painting to visualize the vascular alterations in the brain. Brain tissue around the injury site was assessed for β-catenin and vascular markers. A Wnt transgenic mouse line was utilized to evaluate Wnt gene expression. We report that TBI results in vascular loss followed by increases in vascular structure at seven days post injury (dpi). Immature, non-perfusing vessels were evident in the tissue around the injury site. β-catenin protein expression was significantly reduced in the injury site at 7 dpi. However, there was an increase in β-catenin expression in perilesional vessels at 1 and 7 dpi. Similarly, we found increased number of Wnt-GFP-positive vessels after TBI. Our findings suggest that Wnt/β-catenin expression contributes to the vascular repair process after TBI.
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Affiliation(s)
- Arjang Salehi
- 1 Cell, Molecular and Developmental Biology Program, 8790 University of California, Riverside , CA, USA.,2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Amandine Jullienne
- 2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Mohsen Baghchechi
- 2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Mary Hamer
- 2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Mark Walsworth
- 2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Virginia Donovan
- 2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Jiping Tang
- 4 Department of Physiology and Pharmacology, School of Medicine, 4608 Loma Linda University , Loma Linda, CA, USA
| | - John H Zhang
- 4 Department of Physiology and Pharmacology, School of Medicine, 4608 Loma Linda University , Loma Linda, CA, USA.,5 Department of Anesthesiology, School of Medicine, 4608 Loma Linda University , Loma Linda, CA, USA.,6 Department of Neurosurgery, School of Medicine, 4608 Loma Linda University , Loma Linda, CA, USA
| | - William J Pearce
- 4 Department of Physiology and Pharmacology, School of Medicine, 4608 Loma Linda University , Loma Linda, CA, USA.,7 Center for Perinatal Biology, 4608 Loma Linda University , Loma Linda, CA, USA
| | - Andre Obenaus
- 1 Cell, Molecular and Developmental Biology Program, 8790 University of California, Riverside , CA, USA.,2 Department of Pediatrics, 4608 Loma Linda University , Loma Linda, CA, USA.,3 Department of Pediatrics, 12219 University of California, Irvine , CA, USA
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45
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Wright AD, Smirl JD, Bryk K, van Donkelaar P. A Prospective Transcranial Doppler Ultrasound-Based Evaluation of the Acute and Cumulative Effects of Sport-Related Concussion on Neurovascular Coupling Response Dynamics. J Neurotrauma 2017. [DOI: 10.1089/neu.2017.5020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Alexander D. Wright
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jonathan D. Smirl
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kelsey Bryk
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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46
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3D morphological analysis of the mouse cerebral vasculature: Comparison of in vivo and ex vivo methods. PLoS One 2017; 12:e0186676. [PMID: 29053753 PMCID: PMC5650181 DOI: 10.1371/journal.pone.0186676] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 10/05/2017] [Indexed: 02/06/2023] Open
Abstract
Ex vivo 2-photon fluorescence microscopy (2PFM) with optical clearing enables vascular imaging deep into tissue. However, optical clearing may also produce spherical aberrations if the objective lens is not index-matched to the clearing material, while the perfusion, clearing, and fixation procedure may alter vascular morphology. We compared in vivo and ex vivo 2PFM in mice, focusing on apparent differences in microvascular signal and morphology. Following in vivo imaging, the mice (four total) were perfused with a fluorescent gel and their brains fructose-cleared. The brain regions imaged in vivo were imaged ex vivo. Vessels were segmented in both images using an automated tracing algorithm that accounts for the spatially varying PSF in the ex vivo images. This spatial variance is induced by spherical aberrations caused by imaging fructose-cleared tissue with a water-immersion objective. Alignment of the ex vivo image to the in vivo image through a non-linear warping algorithm enabled comparison of apparent vessel diameter, as well as differences in signal. Shrinkage varied as a function of diameter, with capillaries rendered smaller ex vivo by 13%, while penetrating vessels shrunk by 34%. The pial vasculature attenuated in vivo microvascular signal by 40% 300 μm below the tissue surface, but this effect was absent ex vivo. On the whole, ex vivo imaging was found to be valuable for studying deep cortical vasculature.
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47
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Park E, Park K, Liu E, Jiang R, Zhang J, Baker AJ. Bone-Marrow–Derived Endothelial Progenitor Cell Treatment in a Model of Lateral Fluid Percussion Injury in Rats: Evaluation of Acute and Subacute Outcome Measures. J Neurotrauma 2017; 34:2801-2811. [DOI: 10.1089/neu.2016.4560] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Eugene Park
- Keenan Research Center in the Li Ka Shing Knowledge Institute at St. Michael's Hospital, Toronto, Ontario, Canada
| | - Katya Park
- Keenan Research Center in the Li Ka Shing Knowledge Institute at St. Michael's Hospital, Toronto, Ontario, Canada
| | - Elaine Liu
- Keenan Research Center in the Li Ka Shing Knowledge Institute at St. Michael's Hospital, Toronto, Ontario, Canada
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Medical University, Tianjin Neurological Institute, Tianjin, China
| | - Jianning Zhang
- Department of Neurosurgery, Tianjin Medical University, Tianjin Neurological Institute, Tianjin, China
| | - Andrew J. Baker
- Keenan Research Center in the Li Ka Shing Knowledge Institute at St. Michael's Hospital, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Departments of Anesthesia & Surgery, University of Toronto, Toronto, Ontario, Canada
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48
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Li L, Chopp M, Ding G, Li Q, Mahmood A, Jiang Q. Chronic global analysis of vascular permeability and cerebral blood flow after bone marrow stromal cell treatment of traumatic brain injury in the rat: A long-term MRI study. Brain Res 2017; 1675:61-70. [PMID: 28899758 DOI: 10.1016/j.brainres.2017.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/29/2017] [Accepted: 09/04/2017] [Indexed: 12/11/2022]
Abstract
Vascular permeability and hemodynamic alteration in response to the transplantation of human bone marrow stromal cells (hMSCs) after traumatic brain injury (TBI) were longitudinally investigated in non directly injured and normal-appearing cerebral tissue using magnetic resonance imaging (MRI). Male Wistar rats (300-350g, n=30) subjected to controlled cortical impact TBI were intravenously injected with 1ml of saline (at 6-h or 1-week post-injury, n=5/group) or with hMSCs in suspension (∼3×106 hMSCs, at 6-h or 1-week post-injury, n=10/group). MRI measurements of T2-weighted imaging, cerebral blood flow (CBF) and blood-to-brain transfer constant (Ki) of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA), and neurological behavioral estimates were performed on all animals at multiple time points up to 3-months post-injury. Our long-term imaging data show that blood-brain barrier (BBB) breakdown and hemodynamic disruption after TBI, as revealed by Ki and CBF, respectively, affect both hemispheres of the brain in a diffuse manner. Our data reveal a sensitive vascular permeability and hemodynamic reaction in response to the time-dependent transplantation of hMSCs. A more rapid reduction of Ki following cell treatment is associated with a higher level of CBF in the injured brain, and acute (6h) cell administration leads to enhanced therapeutic effects on both the recovery of vascular integrity and stabilization of cerebral perfusion compared to delayed (1w) cell engraftment. Our results indicate that cell-enhanced BBB reconstitution plays an important role in underlying the restoration of CBF in the injured brain, which in turn, contributes to the improvement of functional outcome.
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Affiliation(s)
- Lian Li
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202, USA.
| | - Michael Chopp
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202, USA; Department of Physics, Oakland University, Rochester, MI 48309, USA.
| | - Guangliang Ding
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202, USA.
| | - Qingjiang Li
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202, USA.
| | - Asim Mahmood
- Department of Neurosurgery, Henry Ford Health System, Detroit, MI 48208, USA.
| | - Quan Jiang
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202, USA.
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49
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Medaglia JD. Functional Neuroimaging in Traumatic Brain Injury: From Nodes to Networks. Front Neurol 2017; 8:407. [PMID: 28883806 PMCID: PMC5574370 DOI: 10.3389/fneur.2017.00407] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/28/2017] [Indexed: 12/16/2022] Open
Abstract
Since the invention of functional magnetic resonance imaging (fMRI), thousands of studies in healthy and clinical samples have enlightened our understanding of the organization of cognition in the human brain and neuroplastic changes following brain disease and injury. Increasingly, studies involve analyses rooted in complex systems theory and analysis applied to clinical samples. Given the complexity in available approaches, concise descriptions of the theoretical motivation of network techniques and their relationship to traditional approaches and theory are necessary. To this end, this review concerns the use of fMRI to understand basic cognitive function and dysfunction in the human brain scaling from emphasis on basic units (or "nodes") in the brain to interactions within and between brain networks. First, major themes and theoretical issues in the scientific study of the injured brain are introduced to contextualize these analyses, particularly concerning functional "brain reorganization." Then, analytic approaches ranging from the voxel level to the systems level using graph theory and related approaches are reviewed as complementary approaches to examine neurocognitive processes following TBI. Next, some major findings relevant to functional reorganization hypotheses are discussed. Finally, major open issues in functional network analyses in neurotrauma are discussed in theoretical, analytic, and translational terms.
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Affiliation(s)
- John D Medaglia
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
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50
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Salehi A, Zhang JH, Obenaus A. Response of the cerebral vasculature following traumatic brain injury. J Cereb Blood Flow Metab 2017; 37:2320-2339. [PMID: 28378621 PMCID: PMC5531360 DOI: 10.1177/0271678x17701460] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The critical role of the vasculature and its repair in neurological disease states is beginning to emerge particularly for stroke, dementia, epilepsy, Parkinson's disease, tumors and others. However, little attention has been focused on how the cerebral vasculature responds following traumatic brain injury (TBI). TBI often results in significant injury to the vasculature in the brain with subsequent cerebral hypoperfusion, ischemia, hypoxia, hemorrhage, blood-brain barrier disruption and edema. The sequalae that follow TBI result in neurological dysfunction across a host of physiological and psychological domains. Given the importance of restoring vascular function after injury, emerging research has focused on understanding the vascular response after TBI and the key cellular and molecular components of vascular repair. A more complete understanding of vascular repair mechanisms are needed and could lead to development of new vasculogenic therapies, not only for TBI but potentially vascular-related brain injuries. In this review, we delineate the vascular effects of TBI, its temporal response to injury and putative biomarkers for arterial and venous repair in TBI. We highlight several molecular pathways that may play a significant role in vascular repair after brain injury.
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Affiliation(s)
- Arjang Salehi
- 1 Cell, Molecular and Developmental Biology Program, University of California, Riverside, CA, USA.,2 Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA
| | - John H Zhang
- 3 Department of Physiology and Pharmacology Loma Linda University School of Medicine, CA, USA.,4 Department of Anesthesiology Loma Linda University School of Medicine, CA, USA.,5 Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Andre Obenaus
- 1 Cell, Molecular and Developmental Biology Program, University of California, Riverside, CA, USA.,2 Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA.,6 Department of Pediatrics, University of California, Irvine, Irvine, CA, USA
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