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Sánchez-Martín T, Costa-Miserachs D, Coll-Andreu M, Portell-Cortés I, García-Brito S, Torras-Garcia M. Treating Traumatic Brain Injury with Exercise: Onset Delay and Previous Training as Key Factors Determining its Efficacy. Neurorehabil Neural Repair 2024:15459683241270023. [PMID: 39143847 DOI: 10.1177/15459683241270023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
PURPOSE Exercise reduces cognitive deficits in traumatic brain injury (TBI), but early post-trauma exercise is often discouraged due to potential harm. The purpose was to evaluate the interaction between pre- and post-injury physical exercise on cognition, neuronal survival and inflammation. METHODS Rats were either sham-operated and kept sedentary (Sham) or subjected to controlled cortical impact injury and then distributed into sedentary (Tbi), pre-injury exercise (Pre-Tbi), post-injury exercise with early (24 hours, Tbi-early) or late (6 days, Tbi-late) onset, and a combination of pre- and post-injury exercise with early (Pre-Tbi-early) or late (Pre-Tbi-late) onset. Object recognition memory, hippocampal volume, neuronal survival (NeuN+) in the hippocampus and perirhinal cortex, and microglial activity (Iba-1) in the hippocampus were evaluated. RESULTS All exercise conditions, except TBI-early, attenuated the significant memory impairment at 24-hour retention caused by TBI. Additionally, Pre-TBI-early treatment led to memory improvement at 3-hour retention. Pre-TBI reduced neuronal death and microglial activation in the hippocampus. TBI-late, but not TBI-early, mitigated hippocampal volume loss, loss of mature neurons in the hippocampus, and inflammation. Combining pre-injury and early-onset exercise reduced memory deficits but did not affect neuronal death or microglial activation. Combining pre-injury and late-onset exercise had a similar memory-enhancing effect than late post-injury treatment alone, albeit with reduced effects on neuronal density and neuroinflammation. CONCLUSIONS Pre-TBI physical exercise reduces the necessary onset delay of post-TBI exercise to obtain cognitive benefits, yet the exact mechanisms underlying this reduction require further research.
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Affiliation(s)
- Tanit Sánchez-Martín
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Costa-Miserachs
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Margalida Coll-Andreu
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Isabel Portell-Cortés
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Soleil García-Brito
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Meritxell Torras-Garcia
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Cordingley DM, Marquez I, Buchwald SCL, Zeiler FA. Response of Central Nervous System Biomolecules and Systemic Biomarkers to Aerobic Exercise Following Concussion: A Scoping Review of Human and Animal Research. Neurotrauma Rep 2024; 5:708-720. [PMID: 39114375 PMCID: PMC11301856 DOI: 10.1089/neur.2024.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
The purpose of this study was to identify the response of biomolecules and biomarkers that are associated with the central nervous system to aerobic exercise in human and pre-clinical models of concussion or mild traumatic brain injury (TBI), and to highlight the knowledge gaps in the literature. A systematic scoping review was conducted following a search of EMBASE, MEDLINE, SCOPUS, BIOSIS, and Cochrane Libraries performed on September 8, 2023 (from data base inception). The scoping review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Duplicates were removed and article screening was performed using an online systematic review management system. The search resulted in a total of 2,449 articles being identified, with 14 articles meeting the inclusion/exclusion criteria and having their data extracted. One study was conducted in humans, while the remainder of identified studies utilized murine models. The current literature is limited and evaluated many different biomolecules and biomarkers with brain-derived neurotrophic factor being the most researched. Further studies on this topic are needed to better understand the biomarker response to exercise after concussion and mild TBI, especially in the human population.
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Affiliation(s)
- Dean M. Cordingley
- Pan Am Clinic Foundation, Winnipeg, Canada
- Applied Health Sciences Program, Faculty of Graduate Studies, University of Manitoba, Winnipeg, Canada
| | - Izabella Marquez
- Department of Biosystems Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada
| | | | - Frederick A. Zeiler
- Pan Am Clinic Foundation, Winnipeg, Canada
- Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada
- Department of Surgery, Section of Neurosurgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Centre on Aging, University of Manitoba, Winnipeg, Canada
- Division of Anaesthesia, Department of Medicine, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
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Yang J, Alshaikh E, Asa N, VonDeylen O, Desai N, Taylor HG, Pommering T, MacDonald JP, Cohen DM, Yeates KO. Exploring the association between cognitive activity and symptom resolution following concussion in adolescents aged 11-17 years. Br J Sports Med 2024; 58:328-333. [PMID: 38346776 DOI: 10.1136/bjsports-2023-107601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 03/16/2024]
Abstract
OBJECTIVE As opposed to postconcussion physical activity, the potential influence of cognitive activity on concussion recovery is not well characterised. This study evaluated the intensity and duration of daily cognitive activity reported by adolescents following concussion and examined the associations between these daily cognitive activities and postconcussion symptom duration. METHODS This study prospectively enrolled adolescents aged 11-17 years with a physician-confirmed concussion diagnosis within 72 hours of injury from the emergency department and affiliated concussion clinics. Participants were followed daily until symptom resolution or a maximum of 45 days postinjury to record their daily cognitive activity (intensity and duration) and postconcussion symptom scores. RESULTS Participants (n=83) sustained their concussion mostly during sports (84%), had a mean age of 14.2 years, and were primarily male (65%) and white (72%). Participants reported an average of 191 (SD=148), 166 (SD=151) and 38 (SD=61) minutes of low-intensity, moderate-intensity and high-intensity daily cognitive activity postconcussion while still being symptomatic. Every 10 standardised minutes per hour increase in moderate-intensity or high-intensity cognitive activities postconcussion was associated with a 22% greater rate of symptom resolution (adjusted hazard ratio (aHR) 1.22, 95% CI 1.01 to 1.47). Additionally, each extra day's delay in returning to school postconcussion was associated with an 8% lower rate of symptom resolution (aHR 0.92, 95% CI 0.85 to 0.99). CONCLUSION In adolescents with concussion, more moderate-high intensity cognitive activity is associated with faster symptom resolution, and a delayed return to school is associated with slower symptom resolution. However, these relationships may be bidirectional and do not necessarily imply causality. Randomised controlled trials are needed to determine if exposure to early cognitive activity can promote concussion recovery in adolescents.
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Affiliation(s)
- Jingzhen Yang
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
| | - Enas Alshaikh
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Nichole Asa
- University of Washington, Seattle, Washington, USA
| | - Olivia VonDeylen
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Nikhil Desai
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Hudson Gerry Taylor
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
| | - Thomas Pommering
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
- Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - James P MacDonald
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
- Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Daniel M Cohen
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
- Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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Treble-Barna A, Petersen BA, Stec Z, Conley YP, Fink EL, Kochanek PM. Brain-Derived Neurotrophic Factor in Pediatric Acquired Brain Injury and Recovery. Biomolecules 2024; 14:191. [PMID: 38397427 PMCID: PMC10886547 DOI: 10.3390/biom14020191] [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: 12/20/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
We review emerging preclinical and clinical evidence regarding brain-derived neurotrophic factor (BDNF) protein, genotype, and DNA methylation (DNAm) as biomarkers of outcomes in three important etiologies of pediatric acquired brain injury (ABI), traumatic brain injury, global cerebral ischemia, and stroke. We also summarize evidence suggesting that BDNF is (1) involved in the biological embedding of the psychosocial environment, (2) responsive to rehabilitative therapies, and (3) potentially modifiable. BDNF's unique potential as a biomarker of neuroplasticity and neural repair that is reflective of and responsive to both pre- and post-injury environmental influences separates it from traditional protein biomarkers of structural brain injury with exciting potential to advance pediatric ABI management by increasing the accuracy of prognostic tools and informing clinical decision making through the monitoring of therapeutic effects.
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Affiliation(s)
- Amery Treble-Barna
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (B.A.P.); (Z.S.)
- Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (E.L.F.); (P.M.K.)
| | - Bailey A. Petersen
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (B.A.P.); (Z.S.)
- Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (E.L.F.); (P.M.K.)
| | - Zachary Stec
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (B.A.P.); (Z.S.)
| | - Yvette P. Conley
- Department of Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, PA 15213, USA;
| | - Ericka L. Fink
- Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (E.L.F.); (P.M.K.)
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Patrick M. Kochanek
- Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (E.L.F.); (P.M.K.)
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Adams JA, Uryash A, Lopez JR. Harnessing Passive Pulsatile Shear Stress for Alzheimer's Disease Prevention and Intervention. J Alzheimers Dis 2024; 98:387-401. [PMID: 38393906 DOI: 10.3233/jad-231010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Alzheimer's disease (AD) affects more than 40 million people worldwide and is the leading cause of dementia. This disease is a challenge for both patients and caregivers and puts a significant strain on the global healthcare system. To address this issue, the Lancet Commission recommends focusing on reducing modifiable lifestyle risk factors such as hypertension, diabetes, and physical inactivity. Passive pulsatile shear stress (PPSS) interventions, which use devices like whole-body periodic acceleration, periodic acceleration along the Z-axis (pGz), and the Jogging Device, have shown significant systemic and cellular effects in preclinical and clinical models which address these modifiable risks factors. Based on this, we propose that PPSS could be a potential non-pharmacological and non-invasive preventive or therapeutic strategy for AD. We perform a comprehensive review of the biological basis based on all publications of PPSS using these devices and demonstrate their effects on the various aspects of AD. We draw from this comprehensive analysis to support our hypothesis. We then delve into the possible application of PPSS as an innovative intervention. We discuss how PPSS holds promise in ameliorating hypertension and diabetes while mitigating physical inactivity, potentially offering a holistic approach to AD prevention and management.
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Affiliation(s)
- Jose A Adams
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Arkady Uryash
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Jose R Lopez
- Department of Research, Mount Sinai Medical Center, Miami Beach, FL, USA
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Weil ZM, Ivey JT, Karelina K. Putting the Mind to Rest: A Historical Foundation for Rest as a Treatment for Traumatic Brain Injury. J Neurotrauma 2023; 40:1286-1296. [PMID: 36310426 PMCID: PMC10294563 DOI: 10.1089/neu.2022.0363] [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] [Indexed: 12/14/2022] Open
Abstract
Rest after traumatic brain injury (TBI) has been a part of clinical practice for more than a century but the use of rest as a treatment has ancient roots. In contemporary practice, rest recommendations have been significantly reduced but are still present. This advice to brain injured patients, on the face of it makes some logical sense but was not historically anchored in either theory or empirical data. The definition and parameters of rest have evolved over time but have encompassed recommendations including avoiding physical exercise, sensory stimulation, social contact, and even cognitive exertion. The goals and theoretical explanations for this approach have evolved and in modern conception include avoiding reinjury and reducing the metabolic demands on injured tissue. Moreover, as cellular and molecular understanding of the physiology of TBI developed, scientists and clinicians sometimes retroactively cited these new data in support of rest recommendations. Here, we trace the history of this approach and how it has been shaped by new understanding of the underlying pathology associated with brain injury.
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Affiliation(s)
- Zachary M. Weil
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Julia T. Ivey
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Kate Karelina
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
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Kopczynski A, Carteri RB, Rodolphi MS, Oses JP, Portela LO, Geller CA, de Oliveira VG, De Bastiani MA, Strogulski NR, Smith DH, Portela LV. Lower and higher volumes of physical exercise build up brain reserves against memory deficits triggered by a head injury in mice. Exp Neurol 2023; 363:114352. [PMID: 36813223 PMCID: PMC10103909 DOI: 10.1016/j.expneurol.2023.114352] [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: 10/01/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
Decreasing neurotrophic support and impaired mitochondrial bioenergetics are key mechanisms for long-term neurodegeneration and cognitive decline after traumatic brain injury (TBI). We hypothesize that preconditioning with lower and higher volumes of physical exercise upregulates the CREB-BDNF axis and bioenergetic capability, which might serve as neural reserves against cognitive impairment after severe TBI. Using a running wheel mounted in the home cage, mice were engaged in lower (LV, 48 h free access, and 48 h locked) and higher (HV, daily free access) exercise volumes for thirty days. Subsequently, LV and HV mice remained for additional thirty days in the home cage with the running wheel locked and were euthanized. The sedentary group had the running wheel always locked. For the same type of exercise stimulus in a given time, daily workout presents higher volume than alternate days workout. The total distance ran in the wheel was the reference parameter to confirm distinct exercise volumes. On average, LV exercise ran 27.522 m and HV exercise ran 52.076 m. Primarily, we investigate whether LV and HV protocols increase neurotrophic and bioenergetic support in the hippocampus thirty days after exercise ceased. Regardless of volume, exercise increased hippocampal pCREBSer133-CREB-proBDNF-BDNF signaling and mitochondrial coupling efficiency, excess capacity, and leak control, that may compose the neurobiological basis for neural reserves. Further, we challenge these neural reserves against secondary memory deficits triggered by a severe TBI. After thirty days of exercise LV and HV, and sedentary (SED) mice were submitted to the CCI model. Mice remained for additional thirty days in the home cage with the running wheel locked. The mortality after severe TBI was approximately 20% in LV and HV, while in the SED was 40%. Also, LV and HV exercise sustained hippocampal pCREBSer133-CREB-proBDNF-BDNF signaling, mitochondrial coupling efficiency, excess capacity, and leak control for thirty days after severe TBI. Corroborating these benefits, the mitochondrial H2O2 production linked to complexes I and II was attenuated by exercise regardless of the volume. These adaptations attenuated spatial learning and memory deficits caused by TBI. In summary, preconditioning with LV and HV exercise builds up long-lasting CREB-BDNF and bioenergetic neural reserves that preserve memory fitness after severe TBI.
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Affiliation(s)
- Afonso Kopczynski
- Laboratório de Neurotrauma e Biomarcadores, Departamento de Bioquímica, Programa de Pós-Graduação em Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Randhall B Carteri
- Laboratório de Neurotrauma e Biomarcadores, Departamento de Bioquímica, Programa de Pós-Graduação em Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil; Centro Universitário Metodista, Departamento de Nutrição, Instituto Porto Alegre, IPA, Porto Alegre, Brazil; CESUCA Centro Universitário, Departamento de Nutrição, Cachoeirinha, RS, Brazil
| | - Marcelo S Rodolphi
- Laboratório de Neurotrauma e Biomarcadores, Departamento de Bioquímica, Programa de Pós-Graduação em Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Jean P Oses
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Luiz O Portela
- Laboratório de Performance em Ambiente Simulado (LAPAS), Centro de Educação Física, Universidade Federal de Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - Cesar A Geller
- Laboratório de Performance em Ambiente Simulado (LAPAS), Centro de Educação Física, Universidade Federal de Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - Vitória G de Oliveira
- Laboratório de Neurotrauma e Biomarcadores, Departamento de Bioquímica, Programa de Pós-Graduação em Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Marco Antonio De Bastiani
- Zimmer Neuroimaging Lab, Departamento de Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nathan R Strogulski
- Laboratório de Neurotrauma e Biomarcadores, Departamento de Bioquímica, Programa de Pós-Graduação em Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil; School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.
| | - Douglas H Smith
- Penn Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Luis V Portela
- Laboratório de Neurotrauma e Biomarcadores, Departamento de Bioquímica, Programa de Pós-Graduação em Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil.
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Law LM, Griffiths DR, Lifshitz J. Peg Forest Rehabilitation - A novel spatial navigation based cognitive rehabilitation paradigm for experimental neurotrauma. Behav Brain Res 2023; 443:114355. [PMID: 36801425 PMCID: PMC10883691 DOI: 10.1016/j.bbr.2023.114355] [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: 09/13/2022] [Revised: 01/18/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Traumatic brain injury (TBI) results from mechanical forces applied to the head. Ensuing cascades of complex pathophysiology transition the injury event into a disease process. The enduring constellation of emotional, somatic, and cognitive impairments degrade quality of life for the millions of TBI survivors suffering from long-term neurological symptoms. Rehabilitation strategies have reported mixed results, as most have not focused on specific symptomatology or explored cellular processes. The current experiments evaluated a novel cognitive rehabilitation paradigm for brain-injured and uninjured rats. The arena is a plastic floor with a cartesian grid of holes for plastic dowels to create new environments with the rearrangement of threaded pegs. Rats received either two weeks of Peg Forest rehabilitation (PFR) or open field exposure starting at 7 days post-injury; or one week starting at either day 7 or 14 post-injury; or served as caged controls. Cognitive performance was assessed on a battery of novel object tasks at 28 days post-injury. The results revealed that two weeks of PFR was required to prevent the onset of cognitive impairments, while one week of PFR was insufficient regardless of when rehabilitation was initiated after injury. Further assessment of the task showed that novel daily arrangements of the environment were required to impart the cognitive performance benefits, as exposure to a static arrangement of pegs for PFR each day did not improve cognitive performance. The results indicate that PFR prevents the onset of cognitive disorders following acquired a mild to moderate brain injury, and potentially other neurological conditions.
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Affiliation(s)
- L Matthew Law
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States; University of Arizona College of Medicine, Phoenix, AZ, United States; BARROW Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States.
| | - Daniel R Griffiths
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States; University of Arizona College of Medicine, Phoenix, AZ, United States; BARROW Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Jonathan Lifshitz
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States; University of Arizona College of Medicine, Phoenix, AZ, United States; BARROW Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
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Tseitlin L, Richmond-Hacham B, Vita A, Schreiber S, Pick CG, Bikovski L. Measuring anxiety-like behavior in a mouse model of mTBI: Assessment in standard and home cage assays. Front Behav Neurosci 2023; 17:1140724. [PMID: 37035620 PMCID: PMC10073456 DOI: 10.3389/fnbeh.2023.1140724] [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: 01/09/2023] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
Traumatic brain injury (TBI) is a primary global health concern and one of the most common causes of neurological impairments in people under 50. Mild TBI (mTBI) accounts for the majority of TBI cases. Anxiety is the most common complaint after mTBI in humans. This study aims to evaluate behavioral tests designed to assess anxiety-like phenotypes in a mice model of mTBI. ICR mice underwent mTBI using the weight-drop model. Seven days post-injury, mice were subjected to one of five different behavioral tests: Elevated Plus Maze (EPM), Open Field apparatus (OF), Marble Burying test (MBT), Light Dark Box (LDB), and the Light Spot test within the PhenoTyper home cage (LS). In the EPM and OF tests, there were no significant differences between the groups. During the 30-min test period of the MBT, mTBI mice buried significantly more marbles than control mice. In the LDB, mTBI mice spent significantly less time on the far side of the arena than control mice. In addition, the time it took for mTBI mice to get to the far side of the arena was significantly longer compared to controls. Results of LS show significant within-group mean differences for total distance traveled for mTBI mice but not for the control. Furthermore, injured mice moved significantly more than control mice. According to the results, the anxiety traits exhibited by mTBI mice depend upon the time of exposure to the aversive stimulus, the apparatus, and the properties of the stressors used. Therefore, the characterization of anxiety-like behavior in mTBI mice is more complicated than was initially suggested. Based on our findings, we recommend incorporating a variety of stressors and test session lengths when assessing anxiety-like behavior in experimental models of mTBI.
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Affiliation(s)
- Liron Tseitlin
- Department of Anatomy and Anthropology, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Bar Richmond-Hacham
- Department of Anatomy and Anthropology, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Adi Vita
- Department of Anatomy and Anthropology, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Shaul Schreiber
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Chaim G. Pick
- Department of Anatomy and Anthropology, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
- Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel
- Dr. Miriam and Sheldon G. Adelson Chair and Center for the Biology of Addictive Diseases, Tel-Aviv University, Tel-Aviv, Israel
| | - Lior Bikovski
- Myers Neuro-Behavioral Core Facility, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- School of Behavioral Sciences, Netanya Academic College, Netanya, Israel
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Role of Running-Activated Neural Stem Cells in the Anatomical and Functional Recovery after Traumatic Brain Injury in p21 Knock-Out Mice. Int J Mol Sci 2023; 24:ijms24032911. [PMID: 36769236 PMCID: PMC9918280 DOI: 10.3390/ijms24032911] [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: 12/08/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Traumatic brain injury (TBI) represents one of the most common worldwide causes of death and disability. Clinical and animal model studies have evidenced that TBI is characterized by the loss of both gray and white matter, resulting in brain atrophy and in a decrease in neurological function. Nowadays, no effective treatments to counteract TBI-induced neurological damage are available. Due to its complex and multifactorial pathophysiology (neuro-inflammation, cytotoxicity and astroglial scar formation), cell regeneration and survival in injured brain areas are strongly hampered. Recently, it has been proposed that adult neurogenesis may represent a new approach to counteract the post-traumatic neurodegeneration. In our laboratory, we have recently shown that physical exercise induces the long-lasting enhancement of subventricular (SVZ) adult neurogenesis in a p21 (negative regulator of neural progenitor proliferation)-null mice model, with a concomitant improvement of olfactory behavioral paradigms that are strictly dependent on SVZ neurogenesis. On the basis of this evidence, we have investigated the effect of running on SVZ neurogenesis and neurorepair processes in p21 knock-out mice that were subject to TBI at the end of a 12-day session of running. Our data indicate that runner p21 ko mice show an improvement in numerous post-trauma neuro-regenerative processes, including the following: (i) an increase in neuroblasts in the SVZ; (ii) an increase in the migration stream of new neurons from the SVZ to the damaged cortical region; (iii) an enhancement of new differentiating neurons in the peri-lesioned area; (iv) an improvement in functional recovery at various times following TBI. All together, these results suggest that a running-dependent increase in subventricular neural stem cells could represent a promising tool to improve the endogenous neuro-regenerative responses following brain trauma.
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Wang Y, Luo H, Liu Y, Yang C, Yin Y, Tan B. Multimodal rehabilitation promotes axonal sprouting and functional recovery in a murine model of spinal cord injury (SCI). Neurosci Lett 2023; 795:137029. [PMID: 36566832 DOI: 10.1016/j.neulet.2022.137029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/09/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Spinal cord injury (SCI) is a devastating neurological disorder affecting millions of people worldwide, resulting in severe and permanent disabilities that significantly impact the individual's life. Rehabilitation is a commonly accepted and effective clinical treatment modality for neurological disabilities. A single form of rehabilitation training is, however, limited. Indeed, recent studies have reported that a combination of various training strategies may be more promising in promoting functional recovery. However, few studies have focused on combining different forms of rehabilitative training. Here, we investigated the effect of combining treadmill training and single pellet grasping in a well-established model of murine SCI to assess whether combining rehabilitation approaches improve outcomes. In brief, one week following crush SCI, mice were subjected to the treadmill and single pellet grasping training (SPG) for a period of six weeks. Biotinylated dextran amine (BDA) was used to anterogradely trace corticospinal tract axons to assess functionally relevant axonal sprouting. Our results revealed that the combined training upregulated p-S6 expression, facilitated axonal sprouting, increased the formation of functional synaptic connections, and promoted functional recovery of the upper limb. Our study provides experimental evidence for the benefit of combining multiple modalities of rehabilitative strategies.
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Affiliation(s)
- Yunhang Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
| | - Haodong Luo
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Yuan Liu
- State Key Laboratory of Trauma, Burns and Combined Injury, Department of Special War Wound, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Ce Yang
- State Key Laboratory of Trauma, Burns and Combined Injury, Department of Special War Wound, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Ying Yin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
| | - Botao Tan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
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12
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Kim CK, Park JS, Kim E, Oh MK, Lee YT, Yoon KJ, Joo KM, Lee K, Park YS. The effects of early exercise in traumatic brain-injured rats with changes in motor ability, brain tissue, and biomarkers. BMB Rep 2022; 55:512-517. [PMID: 36104258 PMCID: PMC9623238 DOI: 10.5483/bmbrep.2022.55.10.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/06/2022] [Accepted: 08/17/2022] [Indexed: 09/19/2023] Open
Abstract
Traumatic brain injury (TBI) is brain damage which is caused by the impact of external mechanical forces. TBI can lead to the temporary or permanent impairment of physical and cognitive abilities, resulting in abnormal behavior. We recently observed that a single session of early exercise in animals with TBI improved their behavioral performance in the absence of other cognitive abnormalities. In the present study, we investigated the therapeutic effects of continuous exercise during the early stages of TBI in rats. We found that continuous low-intensity exercise in early-stage improves the locomotion recovery in the TBI of animal models; however, it does not significantly enhance short-term memory capabilities. Moreover, continuous early exercise not only reduces the protein expression of cerebral damage-related markers, such as Glial Fibrillary Acid Protein (GFAP), Neuron-Specific Enolase (NSE), S100β, Protein Gene Products 9.5 (PGP9.5), and Heat Shock Protein 70 (HSP70), but it also decreases the expression of apoptosis-related protein BAX and cleaved caspase 3. Furthermore, exercise training in animals with TBI decreases the microglia activation and the expression of inflammatory cytokines in the serum, such as CCL20, IL-13, IL-1α, and IL-1β. These findings thus demonstrate that early exercise therapy for TBI may be an effective strategy in improving physiological function, and that serum protein levels are useful biomarkers for the predicition of the effectiveness of early exercise therapy.[BMB Reports 2022; 55(10): 506-511].
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Affiliation(s)
- Chung Kwon Kim
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea
- Single Cell Network Research Center, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
- Medical Innovation Technology Inc. (MEDINNO Inc.), Seoul 08517, Korea
| | - Jee Soo Park
- Single Cell Network Research Center, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
| | - Eunji Kim
- Medical Innovation Technology Inc. (MEDINNO Inc.), Seoul 08517, Korea
| | - Min-Kyun Oh
- Department of Rehabilitation Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University Graduate School of Medicine, Jinju 52727, Korea
| | - Yong-Taek Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Kyung Jae Yoon
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Kyeung Min Joo
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea
- Single Cell Network Research Center, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
- Medical Innovation Technology Inc. (MEDINNO Inc.), Seoul 08517, Korea
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
| | - Kyunghoon Lee
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
| | - Young Sook Park
- Department of Physical & Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea
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13
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Gomez-Pinilla F, Mercado NM. How to boost the effects of exercise to favor traumatic brain injury outcome. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:147-151. [PMID: 36090919 PMCID: PMC9453688 DOI: 10.1016/j.smhs.2022.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 10/25/2022] Open
Abstract
Physical rehabilitation is an effective therapy to normalize weaknesses encountered with neurological disorders such as traumatic brain injury (TBI). However, the efficacy of exercise is limited during the acute period of TBI because of metabolic dysfunction, and this may further compromise neuronal function. Here we discuss the possibility to normalize brain metabolism during the early post-injury convalescence period to support functional plasticity and prevent long-term functional deficits. Although BDNF possesses the unique ability to support molecular events involved with the transmission of information across nerve cells through activation of its TrkB receptor, the poor pharmacokinetic profile of BDNF has limited its therapeutic applicability. The flavonoid derivative, 7,8-dihydroxyflavone (7,8-DHF), signals through the same TrkB receptors and results in the activation of BDNF signaling pathways. We discuss how the pharmacokinetic limitations of BDNF may be avoided by the use of 7,8-DHF, which makes it a promising pharmacological agent for supporting activity-based rehabilitation during the acute post-injury period after TBI. In turn, docosahexaenoic acid (C22:6n-3; DHA) is abundant in the phospholipid composition of plasma membranes in the brain and its action is important for brain development and plasticity. DHA is a major modulator of synaptic membrane fluidity and function, which is fundamental for supporting cell signaling and synaptic plasticity. Exercise influences DHA function by normalizing DHA content in the brain, such that the collaborative action of exercise and DHA can be instrumental to boost BDNF function with strong therapeutic potential for reducing the deleterious effects of TBI on synaptic plasticity and cognition.
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Affiliation(s)
- Fernando Gomez-Pinilla
- Department of Integrative Biology & Physiology, University of California at Los Angeles (UCLA), Los Angeles, CA, 90095, USA
- Department of Neurosurgery, UCLA Brain Injury Research Center, University of California at Los Angeles, Los Angeles, CA, 90095, USA
| | - Natosha M. Mercado
- Department of Integrative Biology & Physiology, University of California at Los Angeles (UCLA), Los Angeles, CA, 90095, USA
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14
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Lin PH, Kuo LT, Luh HT. The Roles of Neurotrophins in Traumatic Brain Injury. LIFE (BASEL, SWITZERLAND) 2021; 12:life12010026. [PMID: 35054419 PMCID: PMC8780368 DOI: 10.3390/life12010026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
Neurotrophins are a collection of structurally and functionally related proteins. They play important roles in many aspects of neural development, survival, and plasticity. Traumatic brain injury (TBI) leads to different levels of central nervous tissue destruction and cellular repair through various compensatory mechanisms promoted by the injured brain. Many studies have shown that neurotrophins are key modulators of neuroinflammation, apoptosis, blood–brain barrier permeability, memory capacity, and neurite regeneration. The expression of neurotrophins following TBI is affected by the severity of injury, genetic polymorphism, and different post-traumatic time points. Emerging research is focused on the potential therapeutic applications of neurotrophins in managing TBI. We conducted a comprehensive review by organizing the studies that demonstrate the role of neurotrophins in the management of TBI.
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Affiliation(s)
- Ping-Hung Lin
- Department of Medical Education, School of Medicine, National Taiwan University, Taipei 100, Taiwan;
| | - Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan;
| | - Hui-Tzung Luh
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-956279587
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15
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Dhote VV, Raja MKMM, Samundre P, Sharma S, Anwikar S, Upaganlawar AB. Sports Related Brain Injury and Neurodegeneration in Athletes. Curr Mol Pharmacol 2021; 15:51-76. [PMID: 34515018 DOI: 10.2174/1874467214666210910114324] [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: 11/20/2020] [Revised: 03/03/2021] [Accepted: 06/03/2021] [Indexed: 11/22/2022]
Abstract
Sports deserve a special place in human life to impart healthy and refreshing wellbeing. However, sports activities, especially contact sports, renders athlete vulnerable to brain injuries. Athletes participating in a contact sport like boxing, rugby, American football, wrestling, and basketball are exposed to traumatic brain injuries (TBI) or concussions. The acute and chronic nature of these heterogeneous injuries provides a spectrum of dysfunctions that alters the neuronal, musculoskeletal, and behavioral responses of an athlete. Many sports-related brain injuries go unreported, but these head impacts trigger neurometabolic disruptions that contribute to long-term neuronal impairment. The pathophysiology of post-concussion and its underlying mechanisms are undergoing intense research. It also shed light on chronic disorders like Parkinson's disease, Alzheimer's disease, and dementia. In this review, we examined post-concussion neurobehavioral changes, tools for early detection of signs, and their impact on the athlete. Further, we discussed the role of nutritional supplements in ameliorating neuropsychiatric diseases in athletes.
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Affiliation(s)
- Vipin V Dhote
- Faculty of Pharmacy, VNS Group of Institutions, Bhopal, MP,462044. India
| | | | - Prem Samundre
- Faculty of Pharmacy, VNS Group of Institutions, Bhopal, MP,462044. India
| | - Supriya Sharma
- Faculty of Pharmacy, VNS Group of Institutions, Bhopal, MP,462044. India
| | - Shraddha Anwikar
- Faculty of Pharmacy, VNS Group of Institutions, Bhopal, MP,462044. India
| | - Aman B Upaganlawar
- Faculty of Pharmacy, VNS Group of Institutions, Bhopal, MP,462044. India
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16
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Karelina K, Schneiderman K, Shah S, Fitzgerald J, Cruz RV, Oliverio R, Whitehead B, Yang J, Weil ZM. Moderate Intensity Treadmill Exercise Increases Survival of Newborn Hippocampal Neurons and Improves Neurobehavioral Outcomes after Traumatic Brain Injury. J Neurotrauma 2021; 38:1858-1869. [PMID: 33470170 PMCID: PMC8219196 DOI: 10.1089/neu.2020.7389] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Physician-prescribed rest after traumatic brain injury (TBI) is both commonplace and an increasingly scrutinized approach to TBI treatment. Although this practice remains a standard of patient care for TBI, research of patient outcomes reveals little to no benefit of prescribed rest after TBI, and in some cases prolonged rest has been shown to interfere with patient well-being. In direct contrast to the clinical advice regarding physical activity after TBI, animal models of brain injury consistently indicate that exercise is neuroprotective and promotes recovery. Here, we assessed the effect of low and moderate intensity treadmill exercise on functional outcome and hippocampal neural proliferation after brain injury. Using the controlled cortical impact (CCI) mouse model of TBI, we show that 10 days of moderate intensity treadmill exercise initiated after CCI reduces anxiety-like behavior, improves hippocampus-dependent spatial memory, and promotes hippocampal proliferation and newborn neuronal survival. Pathophysiological measures including lesion volume and axon degeneration were not altered by exercise. Taken together, these data reveal that carefully titrated physical activity may be a safe and effective approach to promoting recovery after brain injury.
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Affiliation(s)
- Kate Karelina
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Katarina Schneiderman
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Sarthak Shah
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Julie Fitzgerald
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ruth Velazquez Cruz
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Robin Oliverio
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Bailey Whitehead
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Jingzhen Yang
- Nationwide Children's Hospital, Center for Injury Research and Policy, Columbus, Ohio, USA
| | - Zachary M. Weil
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
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17
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The Role of BDNF in Experimental and Clinical Traumatic Brain Injury. Int J Mol Sci 2021; 22:ijms22073582. [PMID: 33808272 PMCID: PMC8037220 DOI: 10.3390/ijms22073582] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 02/07/2023] Open
Abstract
Traumatic brain injury is one of the leading causes of mortality and morbidity in the world with no current pharmacological treatment. The role of BDNF in neural repair and regeneration is well established and has also been the focus of TBI research. Here, we review experimental animal models assessing BDNF expression following injury as well as clinical studies in humans including the role of BDNF polymorphism in TBI. There is a large heterogeneity in experimental setups and hence the results with different regional and temporal changes in BDNF expression. Several studies have also assessed different interventions to affect the BDNF expression following injury. Clinical studies highlight the importance of BDNF polymorphism in the outcome and indicate a protective role of BDNF polymorphism following injury. Considering the possibility of affecting the BDNF pathway with available substances, we discuss future studies using transgenic mice as well as iPSC in order to understand the underlying mechanism of BDNF polymorphism in TBI and develop a possible pharmacological treatment.
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18
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Yang J, Yeates KO, Shi J, Sullivan L, Xun P, Taylor HG, Tiso M, Pommering T, MacDonald J, Cohen DM, Hautmann A, Asa N, Singichetti B, Bailey M, Lu ZL. Association of Self-Paced Physical and Cognitive Activities Across the First Week Postconcussion With Symptom Resolution in Youth. J Head Trauma Rehabil 2021; 36:E71-E78. [PMID: 33661813 DOI: 10.1097/htr.0000000000000642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the association of objectively measured, self-paced physical and cognitive activities across the first week postconcussion with symptom resolution in youth. SETTING Emergency department or concussion clinics. PARTICIPANTS Youth aged 11 to 17 years with physician-confirmed concussion. DESIGN Prospective cohort with repeated measures. MAIN MEASURES Days from injury to symptom resolution, based on daily ratings by youth on the Post-Concussive Symptom Scale. Physical and cognitive activities were assessed using an ActiGraph and a Narrative Clip, respectively. RESULTS A total of 83 youth participants were included (n = 54 [65%] males; mean age = 14.2 years, SD = 1.9). While self-paced daily physical and cognitive activities increased across the first week postinjury, daily postconcussion symptoms decreased. Increased daily step count was associated with an increased likelihood of early symptom resolution (hazard ratio [HR] = 1.17; 95% confidence interval [CI], 1.02-1.34). However, this association was not statistically significant after adjusting for acute postconcussion symptoms and other covariates. Greater school attendance time was associated with earlier symptom resolution (adjusted HR = 1.14; 95% CI, 1.02-1.27). CONCLUSION Self-paced physical and cognitive activities across the first week postinjury alone neither hastened nor prolonged concussion recovery. Youth with concussion may have some latitude to determine their activity levels.
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Affiliation(s)
- Jingzhen Yang
- Center for Injury Research and Policy (Drs Yang and Sullivan and Mss Hautmann and Asa), Biobehavioral Health Center (Dr Taylor), Biostatistics Resource (Dr Shi), and Research Information Solution and Innovation (Mr Bailey), The Abigail Wexner Research Institute, at Nationwide Children's Hospital, Columbus, Ohio; Departments of Pediatrics (Drs Yang, Taylor, Pommering, MacDonald, and Cohen) and Sport and Internal Medicine (Dr Tiso), The Ohio State University College of Medicine, Columbus; Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (Dr Yeates); Divisions of Sports Medicine (Drs Pommering and MacDonald) and Emergency Medicine (Dr Cohen), Nationwide Children's Hospital, Columbus, Ohio; Discipline of Children's Studies, National University of Ireland, Galway (Dr Sullivan); Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington (Dr Xun); Injury Prevention Research Center and Department of Epidemiology, University of North Carolina at Chapel Hill (Ms Singichetti); Department of Psychology, New York University, New York (Dr Lu); and Division of Arts and Sciences, NYU Shanghai, Shanghai, China (Dr Lu)
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19
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TBI as a Risk Factor for Substance Use Behaviors: A Meta-analysis. Arch Phys Med Rehabil 2020; 102:1198-1209. [PMID: 33152264 DOI: 10.1016/j.apmr.2020.10.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To quantify the relationship between substance use behaviors before and after traumatic brain injury (TBI), to identify populations that may benefit more from targeted interventions to reduce the effect of substance use on TBI recovery, and to establish areas for further study. DATA SOURCES Studies were identified via literature searches using MEDLINE, PsychInfo, PsychArticles, PubMed, and GoogleScholar (published before January 2019), as well as reference section reviews and forward searches. Searches were conducted using search terms for TBI and substance use behaviors. STUDY SELECTION Studies were included if they (1) contained both a measure of TBI and a measure of substance use behaviors; (2) reported an effect size representing the relationship between substance use behaviors before and after TBI, compared TBI vs non-TBI groups on substance use behaviors controlling for pre-TBI substance use, or compared groups with differing TBI severity on subsequent substance use behaviors controlling for pre-TBI substance use; (3) were written in English; and (4) were human subjects research. Studies examining effects of substance use intervention for people sustaining TBI were excluded from this study. DATA EXTRACTION Study variables included substance use behaviors, TBI severity, time since TBI, military status, age, race, and sex. DATA SYNTHESIS Substance use behaviors had a small but statistically significant decrease after moderate-severe TBI. After moderate-severe TBI, there was a statistically significant decline in both substance use (d=-0.29, P<.01) and negative substance use consequences (d=-0.67, P=.01). There was no significant change in substance use behaviors after mild TBI. CONCLUSIONS Substance use behaviors had a small decrease after moderate to severe TBI and no significant change after mild TBI. Study findings suggest the need for accurate assessment to identify those at greatest risk for problematic substance use behaviors after TBI.
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20
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Aravind A, Kosty J, Chandra N, Pfister BJ. Blast exposure predisposes the brain to increased neurological deficits in a model of blast plus blunt traumatic brain injury. Exp Neurol 2020; 332:113378. [PMID: 32553593 DOI: 10.1016/j.expneurol.2020.113378] [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: 12/30/2019] [Revised: 05/20/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
Soldiers are often exposed to more than one traumatic brain injury (TBI) over the course of their service. In recent years, more attention has been drawn to the increased risk of neurological deficits caused by the 'blast plus' polytrauma, which typically is a blast trauma combined with other forms of TBI. In this study, we investigated the behavioral and neuronal deficits resulting from a blast plus injury involving a mild-moderate blast followed by a mild blunt trauma using the fluid percussion injury model. We identified that the blast injury predisposed the brain to increased cognitive deficits, chronic ventricular enlargement, increased neurodegeneration at acute time points and chronic neuronal loss. Interestingly, a single blast and single blunt injury differed in their onset and manifestation of cognitive and regional neuronal loss. We also identified the presence of cleaved RIP1 from caspase 8 mediated apoptosis in the blunt injury while the blast injury did not activate immediate apoptosis but led to decreased hilar neuronal survival over time.
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Affiliation(s)
- Aswati Aravind
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr M.L.K. Jr. Blvd, Newark, NJ 07102, USA
| | - Julianna Kosty
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr M.L.K. Jr. Blvd, Newark, NJ 07102, USA
| | - Namas Chandra
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr M.L.K. Jr. Blvd, Newark, NJ 07102, USA
| | - Bryan J Pfister
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr M.L.K. Jr. Blvd, Newark, NJ 07102, USA.
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21
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Treble-Barna A, Patronick J, Uchani S, Marousis NC, Zigler CK, Fink EL, Kochanek PM, Conley YP, Yeates KO. Epigenetic Effects on Pediatric Traumatic Brain Injury Recovery (EETR): An Observational, Prospective, Longitudinal Concurrent Cohort Study Protocol. Front Neurol 2020; 11:460. [PMID: 32595586 PMCID: PMC7303323 DOI: 10.3389/fneur.2020.00460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 04/29/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction: Unexplained heterogeneity in outcomes following pediatric traumatic brain injury (TBI) is one of the most critical barriers to the development of effective prognostic tools and therapeutics. The addition of personal biological factors to our prediction models may account for a significant portion of unexplained variance and advance the field toward precision rehabilitation medicine. The overarching goal of the Epigenetic Effects on Pediatric Traumatic Brain Injury Recovery (EETR) study is to investigate an epigenetic biomarker involved in both childhood adversity and postinjury neuroplasticity to better understand heterogeneity in neurobehavioral outcomes following pediatric TBI. Our primary hypothesis is that childhood adversity will be associated with worse neurobehavioral recovery in part through an epigenetically mediated reduction in brain-derived neurotrophic factor (BDNF) expression in response to TBI. Methods and analysis: EETR is an observational, prospective, longitudinal concurrent cohort study of children aged 3-18 years with either TBI (n = 200) or orthopedic injury (n = 100), recruited from the UPMC Children's Hospital of Pittsburgh. Participants complete study visits acutely and at 6 and 12 months postinjury. Blood and saliva biosamples are collected at all time points-and cerebrospinal fluid (CSF) when available acutely-for epigenetic and proteomic analysis of BDNF. Additional measures assess injury characteristics, pre- and postinjury child neurobehavioral functioning, childhood adversity, and potential covariates/confounders. Recruitment began in July 2017 and will occur for ~6 years, with data collection complete by mid-2023. Analyses will characterize BDNF DNA methylation and protein levels over the recovery period and investigate this novel biomarker as a potential biological mechanism underlying the known association between childhood adversity and worse neurobehavioral outcomes following pediatric TBI. Ethics and dissemination: The study received ethics approval from the University of Pittsburgh Institutional Review Board. Participants and their parents provide informed consent/assent. Research findings will be disseminated via local and international conference presentations and manuscripts submitted to peer-reviewed journals. Trial Registration: The study is registered with clinicaltrials.org (ClinicalTrials.gov Identifier: NCT04186429).
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Affiliation(s)
- Amery Treble-Barna
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jamie Patronick
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Srivatsan Uchani
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Noelle C. Marousis
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Christina K. Zigler
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Ericka L. Fink
- Safar Center for Resuscitation Research, Division of Pediatric Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Department of Critical Care and Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Patrick M. Kochanek
- Safar Center for Resuscitation Research, Division of Pediatric Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Department of Critical Care and Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Yvette P. Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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22
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Avcu P, Fortress AM, Fragale JE, Spiegler KM, Pang KCH. Anhedonia following mild traumatic brain injury in rats: A behavioral economic analysis of positive and negative reinforcement. Behav Brain Res 2019; 368:111913. [PMID: 30998994 DOI: 10.1016/j.bbr.2019.111913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 02/07/2023]
Abstract
Psychiatric disorders affect nearly 50% of individuals who have experienced a traumatic brain injury (TBI). Anhedonia is a major symptom of numerous psychiatric disorders and is a diagnostic criterion for depression. It has recently been appreciated that reinforcement may be separated into consummatory (hedonic), motivational and decisional components, all of which may be affected differently in disease. Although anhedonia is typically assessed using positive reinforcement, the importance of stress in psychopathology suggests the study of negative reinforcement (removal or avoidance of aversive events) may be equally important. The present study investigated positive and negative reinforcement following a rat model of mild TBI (mTBI) using lateral fluid percussion. Hedonic value and motivation for reinforcement was determined by behavioral economic analyses. Following mTBI, the hedonic value of avoiding foot shock was reduced. In contrast, the hedonic value of escaping foot shock or obtaining a sucrose pellet was not altered by mTBI. Moreover, motivation to avoid or escape foot shock or to acquire sucrose was not altered by mTBI. Our results suggest that individuals experiencing mTBI find avoidance of aversive events less reinforcing, and therefore are less apt to utilize proactive control of stress.
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Affiliation(s)
- Pelin Avcu
- NeuroBehavioral Research Lab, Department of Veteran Affairs Medical Center, New Jersey Health Care System, East Orange, New Jersey, USA; Graduate School of Biomedical Sciences, New Jersey Medical School-Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Ashley M Fortress
- NeuroBehavioral Research Lab, Department of Veteran Affairs Medical Center, New Jersey Health Care System, East Orange, New Jersey, USA
| | - Jennifer E Fragale
- NeuroBehavioral Research Lab, Department of Veteran Affairs Medical Center, New Jersey Health Care System, East Orange, New Jersey, USA; Graduate School of Biomedical Sciences, New Jersey Medical School-Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Kevin M Spiegler
- NeuroBehavioral Research Lab, Department of Veteran Affairs Medical Center, New Jersey Health Care System, East Orange, New Jersey, USA; Graduate School of Biomedical Sciences, New Jersey Medical School-Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Kevin C H Pang
- NeuroBehavioral Research Lab, Department of Veteran Affairs Medical Center, New Jersey Health Care System, East Orange, New Jersey, USA; Department of Pharmacology, Physiology and Neurosciences, New Jersey Medical School - Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA; Graduate School of Biomedical Sciences, New Jersey Medical School-Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA.
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23
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Is There an Optimal Time to Initiate an Active Rehabilitation Protocol for Concussion Management in Children? A Case Series. J Head Trauma Rehabil 2019; 33:E11-E17. [PMID: 28926482 DOI: 10.1097/htr.0000000000000339] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To estimate the time frame during which initiating an active rehabilitation intervention (aerobic exercise, balance, and sport specific skills) after concussion contributed to improvement in symptoms at follow-up in children and adolescents who are slow to recover (symptoms persisting beyond 2 weeks) from concussion. SETTING Concussion clinic at a tertiary care pediatric teaching hospital. PARTICIPANTS A total of 677 children and adolescents with concussion aged 7 to 18 years. DESIGN Case series of participants starting active rehabilitation less than 2, 2, 3, 4, 5, or 6 or more weeks postconcussion. MAIN MEASURE Symptom severity measured by the 22-item Post-Concussion Scale (PCS)-revised. RESULTS All patients experienced significant improvement of symptoms while participating in active rehabilitation, irrespective of the start time postonset. Patients initiating active rehabilitation at 2 (P < .001) or 3 (P = .039) weeks postinjury demonstrated lower symptom severity at follow-up than those starting at 6 weeks or later. Patients starting at 2 weeks had lower symptom severity than patients starting less than 2 (P = .02), 4 (P = .20), or 5 weeks postinjury (P = .04). Lastly, patients starting less than 2 and 6 weeks or more postinjury yielded equivalent outcomes. CONCLUSIONS The findings support the use of active rehabilitation in children and adolescents who are slow to recover from concussion. Participants starting active rehabilitation less than 2 weeks and up to 6 or more weeks postconcussion demonstrated significant symptom improvements, but improvement was observed in all groups, regardless of the time to start active rehabilitation.
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Yang J, Yeates K, Sullivan L, Singichetti B, Newton A, Xun P, Taylor HG, MacDonald J, Pommering T, Tiso M, Cohen D, Huang Y, Patterson J, Lu ZL. Rest Evaluation for Active Concussion Treatment (ReAct) Protocol: a prospective cohort study of levels of physical and cognitive rest after youth sports-related concussion. BMJ Open 2019; 9:e028386. [PMID: 31015276 PMCID: PMC6501995 DOI: 10.1136/bmjopen-2018-028386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Although current guidelines for the early clinical management of sports-related concussion (SRC) call for a gradual return-to-activity, the optimal level of rest needed to promote recovery remains unknown. This paper describes the protocol of the Rest Evaluation for Active Concussion Treatment (ReAct) study which objectively measures physical and cognitive rest following SRC and its relation to recovery among youth athletes. METHODS AND ANALYSIS Youth athletes aged 11-17 years are recruited preinjury and enrolled within 72 hours following a physician-diagnosed concussion. Injury information and acute clinical presentation are assessed at the time of injury. Youth participants are prospectively followed to objectively monitor daily physical and cognitive rest using two electronic devices: ActiGraph (to measure physical rest and sleep) and Narrative Clip (to measure cognitive rest), along with self-reported postconcussive symptoms using daily surveys. Other concussion outcomes, including functional outcomes, are assessed by surveying youth and their parents at three time points: (1) within 72 hours of injury, (2) at day 7 postenrolment and (3) at symptom resolution (or a maximum of 45 days postconcussion). ETHICS AND DISSEMINATION This study has received ethical approval from the Institutional Review Board (IRB) at the participating institution (IRB at Nationwide Children's Hospital, IRB16-00613). The results of the study will be presented at national and international scientific conferences and published in peer-reviewed journals.
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Affiliation(s)
- Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Keith Yeates
- Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lindsay Sullivan
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Bhavna Singichetti
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Alison Newton
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana, USA
| | - H Gerry Taylor
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - James MacDonald
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Sports Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Thomas Pommering
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Sports Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Michael Tiso
- Sport and Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Daniel Cohen
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Emergency Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Yungui Huang
- Research Information Solution and Innovation, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Jeremy Patterson
- Research Information Solution and Innovation, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Zhong-lin Lu
- Psychology, The Ohio State University, Columbus, Ohio, USA
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25
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Sullivan KA, Hills AP, Iverson GL. Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome. Curr Neurol Neurosci Rep 2018; 18:75. [DOI: 10.1007/s11910-018-0884-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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26
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Chronic Electrical Stimulation Promotes the Excitability and Plasticity of ESC-derived Neurons following Glutamate-induced Inhibition In vitro. Sci Rep 2018; 8:10957. [PMID: 30026496 PMCID: PMC6053382 DOI: 10.1038/s41598-018-29069-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/02/2018] [Indexed: 01/07/2023] Open
Abstract
Functional electrical stimulation (FES) is rapidly gaining traction as a therapeutic tool for mediating the repair and recovery of the injured central nervous system (CNS). However, the underlying mechanisms and impact of these stimulation paradigms at a molecular, cellular and network level remain largely unknown. In this study, we used embryonic stem cell (ESC)-derived neuron and glial co-cultures to investigate network maturation following acute administration of L-glutamate, which is a known mediator of excitotoxicity following CNS injury. We then modulated network maturation using chronic low frequency stimulation (LFS) and direct current stimulation (DCS) protocols. We demonstrated that L-glutamate impaired the rate of maturation of ESC-derived neurons and glia immediately and over a week following acute treatment. The administration of chronic LFS and DCS protocols individually following L-glutamate infusion significantly promoted the excitability of neurons as well as network synchrony, while the combination of LFS/DCS did not. qRT-PCR analysis revealed that LFS and DCS alone significantly up-regulated the expression of excitability and plasticity-related transcripts encoding N-methyl-D-aspartate (NMDA) receptor subunit (NR2A), brain-derived neurotrophic factor (BDNF) and Ras-related protein (RAB3A). In contrast, the simultaneous administration of LFS/DCS down-regulated BDNF and RAB3A expression. Our results demonstrate that LFS and DCS stimulation can modulate network maturation excitability and synchrony following the acute administration of an inhibitory dose of L-glutamate, and upregulate NR2A, BDNF and RAB3A gene expression. Our study also provides a novel framework for investigating the effects of electrical stimulation on neuronal responses and network formation and repair after traumatic brain injury.
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27
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Thomas TC, Stockhausen EM, Law LM, Khodadad A, Lifshitz J. Rehabilitation modality and onset differentially influence whisker sensory hypersensitivity after diffuse traumatic brain injury in the rat. Restor Neurol Neurosci 2018; 35:611-629. [PMID: 29036852 DOI: 10.3233/rnn-170753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND As rehabilitation strategies advance as therapeutic interventions, the modality and onset of rehabilitation after traumatic brain injury (TBI) are critical to optimize treatment. Our laboratory has detected and characterized a late-onset, long-lasting sensory hypersensitivity to whisker stimulation in diffuse brain-injured rats; a deficit that is comparable to visual or auditory sensory hypersensitivity in humans with an acquired brain injury. OBJECTIVE We hypothesize that the modality and onset of rehabilitation therapies will differentially influence sensory hypersensitivity in response to the Whisker Nuisance Task (WNT) as well as WNT-induced corticosterone (CORT) stress response in diffuse brain-injured rats and shams. METHODS After midline fluid percussion brain injury (FPI) or sham surgery, rats were assigned to one of four rehabilitative interventions: (1) whisker sensory deprivation during week one or (2) week two or (3) whisker stimulation during week one or (4) week two. At 28 days following FPI and sham procedures, sensory hypersensitivity was assessed using the WNT. Plasma CORT was evaluated immediately following the WNT (aggravated levels) and prior to the pre-determined endpoint 24 hours later (non-aggravated levels). RESULTS Deprivation therapy during week two elicited significantly greater sensory hypersensitivity to the WNT compared to week one (p < 0.05), and aggravated CORT levels in FPI rats were significantly lower than sham levels. Stimulation therapy during week one resulted in low levels of sensory hypersensitivity to the WNT, similar to deprivation therapy and naïve controls, however, non-aggravated CORT levels in FPI rats were significantly higher than sham. CONCLUSION These data indicate that modality and onset of sensory rehabilitation can differentially influence FPI and sham rats, having a lasting impact on behavioral and stress responses to the WNT, emphasizing the necessity for continued evaluation of modality and onset of rehabilitation after TBI.
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Affiliation(s)
- Theresa Currier Thomas
- Barrow Neurological Institute at Phoenix Children's Hospital - Phoenix, AZ, USA.,Department of Child Health, University of Arizona College of Medicine - Phoenix, AZ, USA.,Phoenix VA Healthcare System - Phoenix, AZ, USA.,Spinal Cord and Brain Injury Research Center, University of Kentucky Chandler Medical Center - Lexington, KY, USA
| | - Ellen Magee Stockhausen
- Core Medical Group, Manchester, NH, USA.,Spinal Cord and Brain Injury Research Center, University of Kentucky Chandler Medical Center - Lexington, KY, USA
| | - L Matthew Law
- Barrow Neurological Institute at Phoenix Children's Hospital - Phoenix, AZ, USA.,Department of Child Health, University of Arizona College of Medicine - Phoenix, AZ, USA
| | - Aida Khodadad
- Barrow Neurological Institute at Phoenix Children's Hospital - Phoenix, AZ, USA.,Department of Child Health, University of Arizona College of Medicine - Phoenix, AZ, USA
| | - Jonathan Lifshitz
- Barrow Neurological Institute at Phoenix Children's Hospital - Phoenix, AZ, USA.,Department of Child Health, University of Arizona College of Medicine - Phoenix, AZ, USA.,Phoenix VA Healthcare System - Phoenix, AZ, USA.,Neuroscience Program, Arizona State University - Tempe, AZ, USA.,Spinal Cord and Brain Injury Research Center, University of Kentucky Chandler Medical Center - Lexington, KY, USA
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28
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Faw TD, Lerch JK, Thaxton TT, Deibert RJ, Fisher LC, Basso DM. Unique Sensory and Motor Behavior in Thy1-GFP-M Mice before and after Spinal Cord Injury. J Neurotrauma 2018; 35:2167-2182. [PMID: 29385890 DOI: 10.1089/neu.2017.5395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sensorimotor recovery after spinal cord injury (SCI) is of utmost importance to injured individuals and will rely on improved understanding of SCI pathology and recovery. Novel transgenic mouse lines facilitate discovery, but must be understood to be effective. The purpose of this study was to characterize the sensory and motor behavior of a common transgenic mouse line (Thy1-GFP-M) before and after SCI. Thy1-GFP-M positive (TG+) mice and their transgene negative littermates (TG-) were acquired from two sources (in-house colony, n = 32, Jackson Laboratories, n = 4). C57BL/6J wild-type (WT) mice (Jackson Laboratories, n = 10) were strain controls. Moderate-severe T9 contusion (SCI) or transection (TX) occurred in TG+ (SCI, n = 25, TX, n = 5), TG- (SCI, n = 5), and WT (SCI, n = 10) mice. To determine responsiveness to rehabilitation, a cohort of TG+ mice with SCI (n = 4) had flat treadmill (TM) training 42-49 days post-injury (dpi). To characterize recovery, we performed Basso Mouse Scale, Grid Walk, von Frey Hair, and Plantar Heat Testing before and out to day 42 post-SCI. Open field locomotion was significantly better in the Thy1 SCI groups (TG+ and TG-) compared with WT by 7 dpi (p < 0.01) and was maintained through 42 dpi (p < 0.01). These unexpected locomotor gains were not apparent during grid walking, indicating severe impairment of precise motor control. Thy1 derived mice were hypersensitive to mechanical stimuli at baseline (p < 0.05). After SCI, mechanical hyposensitivity emerged in Thy1 derived groups (p < 0.001), while thermal hyperalgesia occurred in all groups (p < 0.001). Importantly, consistent findings across TG+ and TG- groups suggest that the effects are mediated by the genetic background rather than transgene manipulation itself. Surprisingly, TM training restored mechanical and thermal sensation to baseline levels in TG+ mice with SCI. This behavioral profile and responsiveness to chronic training will be important to consider when choosing models to study the mechanisms underlying sensorimotor recovery after SCI.
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Affiliation(s)
- Timothy D Faw
- 1 Neuroscience Graduate Program, The Ohio State University , Columbus, Ohio.,2 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio.,3 Center for Brain and Spinal Cord Repair, The Ohio State University , Columbus, Ohio
| | - Jessica K Lerch
- 3 Center for Brain and Spinal Cord Repair, The Ohio State University , Columbus, Ohio.,4 Department of Neuroscience, The Ohio State University , Columbus, Ohio
| | - Tyler T Thaxton
- 2 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio.,3 Center for Brain and Spinal Cord Repair, The Ohio State University , Columbus, Ohio
| | - Rochelle J Deibert
- 2 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio.,3 Center for Brain and Spinal Cord Repair, The Ohio State University , Columbus, Ohio
| | - Lesley C Fisher
- 2 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio.,3 Center for Brain and Spinal Cord Repair, The Ohio State University , Columbus, Ohio
| | - D Michele Basso
- 2 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio.,3 Center for Brain and Spinal Cord Repair, The Ohio State University , Columbus, Ohio
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29
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Commentary on: "An Exploration of the Impact of Initial Timing of Physical Therapy on Safety and Outcomes After Concussion". J Neurol Phys Ther 2018; 42:132-133. [PMID: 29864100 DOI: 10.1097/npt.0000000000000233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Exercise Rehabilitation Attenuates Cognitive Deficits in Rats with Traumatic Brain Injury by Stimulating the Cerebral HSP20/BDNF/TrkB Signalling Axis. Mol Neurobiol 2018; 55:8602-8611. [PMID: 29574629 DOI: 10.1007/s12035-018-1011-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/16/2018] [Indexed: 10/17/2022]
Abstract
Physical exercise (PE) is an effective method for improving cognitive function among patients with traumatic brain injury (TBI). We previously demonstrated that PE with an infrared-sensing running wheel (ISRW) system provides strong neuroprotection in an experimental animal model of stroke. In this study, we used fluid percussion injury in rats to simulate mild TBI. For rats, we used both passive avoidance learning and the Y-maze tests to evaluate cognitive function. We investigated whether PE rehabilitation attenuated cognitive deficits in rats with TBI and determined the contribution of hippocampal and cortical expression of heat shock protein 20 (HSP20) to PE-mediated cognitive recovery. In addition to increasing hippocampal and cortical expression of HSP20, brain-derived neurotrophic factor (BDNF), and the tropomyosin receptor kinase B (TrkB) ratio, PE rehabilitation significantly attenuated brain contusion and improved cognitive deficits in the rat model. Furthermore, reducing hippocampal and cortical expression of HSP20 with an intracerebral injection of pSUPER hsp20 small interfering RNA significantly diminished the PE-induced overexpression of hippocampal and cortical BDNF and the TrkB ratio and also reversed the beneficial effect of PE in reducing neurotrauma and the cognitive deficits. A positive Pearson correlation was found between HSP20 and BDNF, as well as between HSP20 and TrkB, in the hippocampal and cortical tissues. We thus conclude that post-ischaemic ISRW exercise rehabilitation attenuates cognitive deficits, as well as brain contusions, in TBI rats by stimulating the cerebral HSP20/BDNF/TrkB signalling axis.
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31
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Alshehri MM, Sparto PJ, Furman JM, Fedor S, Mucha A, Henry LC, Whitney SL. The usefulness of the video head impulse test in children and adults post-concussion. J Vestib Res 2018; 26:439-446. [PMID: 28262647 DOI: 10.3233/ves-160598] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Dizziness after concussion have been reported in both youths and adults. It is not clear if the dizziness experienced post-concussion is from peripheral or central etiology. New technology has been developed to quickly and easily quantify the magnitude of peripheral vestibular disorders that is non-invasive and acceptable to youths and adults. The purpose of this study was to determine if youths and adults' post-concussion have evidence of decreased horizontal semicircular canal vestibulo-ocular reflex (VOR) gains as measured with the video head impulse test (vHIT), which would indicate a peripheral vestibular disorder. An additional purpose was to determine if VOR gain scores correlate with functional performance measures. DESIGN Descriptive cross sectional. SETTING Large medical center out-patient concussion program. PARTICIPANTS Fifty-six subjects with concussion. MAIN OUTCOMES/MEASURES Subjects completed the vHIT testing, the Dizziness Handicap Inventory (DHI), the Vestibular Activities and Participation (VAP) scale, the Pediatric Vestibular Symptom Questionnaire, gait speed assessment, the Dynamic Gait Index (DGI) and a verbal analog scale of symptom provocation before and after the vHIT testing. RESULTS There were no abnormal vHIT findings in any subject. Headaches, dizziness and nausea were significantly worse post vHIT testing (p < 0.05). Youths had better DGI and DHI scores than subjects older than 20 (p < 0.05). CONCLUSION The vHIT did not detect horizontal semicircular canal weakness in any of the subjects tested. In addition, older adults reported more activity and participation limitations than the younger subjects with concussion.
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Affiliation(s)
| | - Patrick J Sparto
- Departments of Physical Therapy and Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph M Furman
- Departments of Otolaryngology, Neurology, and Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sheri Fedor
- Centers for Rehab Services, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anne Mucha
- Centers for Rehab Services, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Luke C Henry
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Susan L Whitney
- Departments of Physical Therapy and Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
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32
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de la Tremblaye PB, O'Neil DA, LaPorte MJ, Cheng JP, Beitchman JA, Thomas TC, Bondi CO, Kline AE. Elucidating opportunities and pitfalls in the treatment of experimental traumatic brain injury to optimize and facilitate clinical translation. Neurosci Biobehav Rev 2018; 85:160-175. [PMID: 28576511 PMCID: PMC5709241 DOI: 10.1016/j.neubiorev.2017.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/12/2017] [Indexed: 12/19/2022]
Abstract
The aim of this review is to discuss the research presented in a symposium entitled "Current progress in characterizing therapeutic strategies and challenges in experimental CNS injury" which was presented at the 2016 International Behavioral Neuroscience Society annual meeting. Herein we discuss diffuse and focal traumatic brain injury (TBI) and ensuing chronic behavioral deficits as well as potential rehabilitative approaches. We also discuss the effects of stress on executive function after TBI as well as the response of the endocrine system and regulatory feedback mechanisms. The role of the endocannabinoids after CNS injury is also discussed. Finally, we conclude with a discussion of antipsychotic and antiepileptic drugs, which are provided to control TBI-induced agitation and seizures, respectively. The review consists predominantly of published data.
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Affiliation(s)
- Patricia B de la Tremblaye
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Darik A O'Neil
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Megan J LaPorte
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jeffrey P Cheng
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joshua A Beitchman
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States; Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, United States; Midwestern University, Glendale, AZ, United States
| | - Theresa Currier Thomas
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States; Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, United States; Phoenix VA Healthcare System, Phoenix, AZ, United States
| | - Corina O Bondi
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anthony E Kline
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States.
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33
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Zafonte RD, Shih SL, Iaccarino MA, Tan CO. Neurologic benefits of sports and exercise. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:463-471. [PMID: 30482373 DOI: 10.1016/b978-0-444-63954-7.00042-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Traumatic brain injury (TBI) is associated with several pathophysiologic changes, including: neurostructural alterations; molecular changes with shifts in circulating neurotrophins; impaired neural metabolism; changes in cerebrovascular autoregulation, vasoreactivity, and neurovascular coupling; and alterations in functional brain connectivity. In animal models of TBI, aerobic exercise reduces neuronal injury, promotes neuronal survival, and enhances the production of neuroprotective trophic factors. However, the timing of exercise initiation is an important consideration as early exercise in the acute postinjury period may impede recovery mechanisms, although evidence for this in humans is lacking. Though human clinical studies are limited, aerobic exercise post-TBI engages cerebrovascular mechanisms and may impart neurophysiologic benefits to mitigate post-TBI pathophysiologic changes. Additionally, subsymptom threshold exercise in humans has been demonstrated to be safe, feasible, and effective in decreasing symptom burden in individuals with mild TBI, and to counteract the detrimental effects of prolonged inactivity, subsequent physical deconditioning, and its negative emotional sequelae. This chapter will explore the potential role of aerobic exercise in neurorecovery after TBI.
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Affiliation(s)
- Ross D Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
| | - Shirley L Shih
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Mary Alexis Iaccarino
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Can Ozan Tan
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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Segat H, Barcelos R, Metz V, Rosa H, Roversi K, Antoniazzi C, Vey L, Kronbauer M, Veit J, Piccolo J, Emanuelli T, Burger M. Influence of physical activity on addiction parameters of rats exposed to amphetamine which were previously supplemented with hydrogenated vegetable fat. Brain Res Bull 2017; 135:69-76. [DOI: 10.1016/j.brainresbull.2017.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 08/30/2017] [Accepted: 09/25/2017] [Indexed: 02/08/2023]
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35
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Nicola FC, Rodrigues LP, Crestani T, Quintiliano K, Sanches EF, Willborn S, Aristimunha D, Boisserand L, Pranke P, Netto CA. Human dental pulp stem cells transplantation combined with treadmill training in rats after traumatic spinal cord injury. ACTA ACUST UNITED AC 2017; 49:e5319. [PMID: 27509306 PMCID: PMC4988478 DOI: 10.1590/1414-431x20165319] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/13/2016] [Indexed: 01/09/2023]
Abstract
Spinal cord injury (SCI) is a disabling condition resulting in deficits of sensory and motor functions, and has no effective treatment. Considering that protocols with stem cell transplantation and treadmill training have shown promising results, the present study evaluated the effectiveness of stem cells from human exfoliated deciduous teeth (SHEDs) transplantation combined with treadmill training in rats with experimental spinal cord injury. Fifty-four Wistar rats were spinalized using NYU impactor. The rats were randomly distributed into 5 groups: Sham (laminectomy with no SCI, n=10); SCI (laminectomy followed by SCI, n=12); SHEDs (SCI treated with SHEDs, n=11); TT (SCI treated with treadmill training, n=11); SHEDs+TT (SCI treated with SHEDs and treadmill training; n=10). Treatment with SHEDs alone or in combination with treadmill training promoted functional recovery, reaching scores of 15 and 14, respectively, in the BBB scale, being different from the SCI group, which reached 11. SHEDs treatment was able to reduce the cystic cavity area and glial scar, increase neurofilament. Treadmill training alone had no functional effectiveness or tissue effects. In a second experiment, the SHEDs transplantation reduced the TNF-α levels in the cord tissue measured 6 h after the injury. Contrary to our hypothesis, treadmill training either alone or in combination, caused no functional improvement. However, SHEDs showed to be neuroprotective, by the reduction of TNF-α levels, the cystic cavity and the glial scar associated with the improvement of motor function after SCI. These results provide evidence that grafted SHEDs might be an effective therapy to spinal cord lesions, with possible anti-inflammatory action.
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Affiliation(s)
- F C Nicola
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - L P Rodrigues
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - T Crestani
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Laboratório de Hematologia e Célula Tronco, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - K Quintiliano
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Laboratório de Hematologia e Célula Tronco, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - E F Sanches
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - S Willborn
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - D Aristimunha
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - L Boisserand
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - P Pranke
- Laboratório de Hematologia e Célula Tronco, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Instituto de Pesquisas com Células Tronco, Porto Alegre, RS, Brasil
| | - C A Netto
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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36
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Hylin MJ, Kerr AL, Holden R. Understanding the Mechanisms of Recovery and/or Compensation following Injury. Neural Plast 2017; 2017:7125057. [PMID: 28512585 PMCID: PMC5415868 DOI: 10.1155/2017/7125057] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/24/2017] [Accepted: 03/26/2017] [Indexed: 11/30/2022] Open
Abstract
Injury due to stroke and traumatic brain injury result in significant long-term effects upon behavioral functioning. One central question to rehabilitation research is whether the nature of behavioral improvement observed is due to recovery or the development of compensatory mechanisms. The nature of functional improvement can be viewed from the perspective of behavioral changes or changes in neuroanatomical plasticity that follows. Research suggests that these changes correspond to each other in a bidirectional manner. Mechanisms surrounding phenomena like neural plasticity may offer an opportunity to explain how variables such as experience can impact improvement and influence the definition of recovery. What is more, the intensity of the rehabilitative experiences may influence the ability to recover function and support functional improvement of behavior. All of this impacts how researchers, clinicians, and medical professionals utilize rehabilitation.
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Affiliation(s)
- Michael J. Hylin
- Neurotrauma and Rehabilitation Laboratory, Department of Psychology, Southern Illinois University, Carbondale, IL, USA
| | - Abigail L. Kerr
- Department of Psychology, Illinois Wesleyan University, Bloomington, IL, USA
| | - Ryan Holden
- Neurotrauma and Rehabilitation Laboratory, Department of Psychology, Southern Illinois University, Carbondale, IL, USA
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Haefeli J, Ferguson AR, Bingham D, Orr A, Won SJ, Lam TI, Shi J, Hawley S, Liu J, Swanson RA, Massa SM. A data-driven approach for evaluating multi-modal therapy in traumatic brain injury. Sci Rep 2017; 7:42474. [PMID: 28205533 PMCID: PMC5311970 DOI: 10.1038/srep42474] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/11/2017] [Indexed: 01/22/2023] Open
Abstract
Combination therapies targeting multiple recovery mechanisms have the potential for additive or synergistic effects, but experimental design and analyses of multimodal therapeutic trials are challenging. To address this problem, we developed a data-driven approach to integrate and analyze raw source data from separate pre-clinical studies and evaluated interactions between four treatments following traumatic brain injury. Histologic and behavioral outcomes were measured in 202 rats treated with combinations of an anti-inflammatory agent (minocycline), a neurotrophic agent (LM11A-31), and physical therapy consisting of assisted exercise with or without botulinum toxin-induced limb constraint. Data was curated and analyzed in a linked workflow involving non-linear principal component analysis followed by hypothesis testing with a linear mixed model. Results revealed significant benefits of the neurotrophic agent LM11A-31 on learning and memory outcomes after traumatic brain injury. In addition, modulations of LM11A-31 effects by co-administration of minocycline and by the type of physical therapy applied reached statistical significance. These results suggest a combinatorial effect of drug and physical therapy interventions that was not evident by univariate analysis. The study designs and analytic techniques applied here form a structured, unbiased, internally validated workflow that may be applied to other combinatorial studies, both in animals and humans.
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Affiliation(s)
- Jenny Haefeli
- Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco, CA, United States
| | - Adam R. Ferguson
- Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco, CA, United States
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Deborah Bingham
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Adrienne Orr
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Seok Joon Won
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Tina I. Lam
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Jian Shi
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Sarah Hawley
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Jialing Liu
- Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco, CA, United States
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Raymond A. Swanson
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Stephen M. Massa
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
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38
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Huie JR, Morioka K, Haefeli J, Ferguson AR. What Is Being Trained? How Divergent Forms of Plasticity Compete To Shape Locomotor Recovery after Spinal Cord Injury. J Neurotrauma 2017; 34:1831-1840. [PMID: 27875927 DOI: 10.1089/neu.2016.4562] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Spinal cord injury (SCI) is a devastating syndrome that produces dysfunction in motor and sensory systems, manifesting as chronic paralysis, sensory changes, and pain disorders. The multi-faceted and heterogeneous nature of SCI has made effective rehabilitative strategies challenging. Work over the last 40 years has aimed to overcome these obstacles by harnessing the intrinsic plasticity of the spinal cord to improve functional locomotor recovery. Intensive training after SCI facilitates lower extremity function and has shown promise as a tool for retraining the spinal cord by engaging innate locomotor circuitry in the lumbar cord. As new training paradigms evolve, the importance of appropriate afferent input has emerged as a requirement for adaptive plasticity. The integration of kinematic, sensory, and loading force information must be closely monitored and carefully manipulated to optimize training outcomes. Inappropriate peripheral input may produce lasting maladaptive sensory and motor effects, such as central pain and spasticity. Thus, it is important to closely consider the type of afferent input the injured spinal cord receives. Here we review preclinical and clinical input parameters fostering adaptive plasticity, as well as those producing maladaptive plasticity that may undermine neurorehabilitative efforts. We differentiate between passive (hindlimb unloading [HU], limb immobilization) and active (peripheral nociception) forms of aberrant input. Furthermore, we discuss the timing of initiating exposure to afferent input after SCI for promoting functional locomotor recovery. We conclude by presenting a candidate rapid synaptic mechanism for maladaptive plasticity after SCI, offering a pharmacological target for restoring the capacity for adaptive spinal plasticity in real time.
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Affiliation(s)
- J Russell Huie
- 1 Department of Neurological Surgery, Brain and Spinal Injury Center, University of California , San Francisco, California
| | - Kazuhito Morioka
- 1 Department of Neurological Surgery, Brain and Spinal Injury Center, University of California , San Francisco, California
| | - Jenny Haefeli
- 1 Department of Neurological Surgery, Brain and Spinal Injury Center, University of California , San Francisco, California
| | - Adam R Ferguson
- 1 Department of Neurological Surgery, Brain and Spinal Injury Center, University of California , San Francisco, California.,2 San Francisco Veterans Affairs Medical Center , San Francisco, California
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39
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Morris T, Gomes Osman J, Tormos Muñoz JM, Costa Miserachs D, Pascual Leone A. The role of physical exercise in cognitive recovery after traumatic brain injury: A systematic review. Restor Neurol Neurosci 2016; 34:977-988. [DOI: 10.3233/rnn-160687] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Timothy Morris
- The Guttmann University Institute for Neurorehabilitation, Universitat Autónoma de Barcelona, Badalona, Spain
- Departament de Psicobiologia i Ciéncies de la Salut, Institut de Neurociéncies, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Joyce Gomes Osman
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Physical Therapy, University of Miami, Miller School of Medicine, Miami, USA
| | - Jose Maria Tormos Muñoz
- The Guttmann University Institute for Neurorehabilitation, Universitat Autónoma de Barcelona, Badalona, Spain
| | - David Costa Miserachs
- Departament de Psicobiologia i Ciéncies de la Salut, Institut de Neurociéncies, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Alvaro Pascual Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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40
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Elbin R, Sufrinko A, Schatz P, French J, Henry L, Burkhart S, Collins MW, Kontos AP. Removal From Play After Concussion and Recovery Time. Pediatrics 2016; 138:peds.2016-0910. [PMID: 27573089 PMCID: PMC5005026 DOI: 10.1542/peds.2016-0910] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Despite increases in education and awareness, many athletes continue to play with signs and symptoms of a sport-related concussion (SRC). The impact that continuing to play has on recovery is unknown. This study compared recovery time and related outcomes between athletes who were immediately removed from play and athletes who continued to play with an SRC. METHODS A prospective, repeated measures design was used to compare neurocognitive performance, symptoms, and recovery time between 35 athletes (mean ± SD age, 15.61 ± 1.65 years) immediately removed after an SRC (REMOVED group) compared with 34 athletes (mean ± SD age, 15.35 ± 1.73 years) who continued to play (PLAYED group) with SRC. Neurocognitive and symptom data were obtained at baseline and at 1 to 7 days and 8 to 30 days after an SRC. RESULTS The PLAYED group took longer to recover than the REMOVED group (44.4 ± 36.0 vs 22.0 ± 18.7 days; P = .003) and were 8.80 times more likely to demonstrate protracted recovery (≥21 days) (P < .001). Removal from play status was associated with the greatest risk of protracted recovery (adjusted odds ratio, 14.27; P = .001) compared with other predictors (eg, sex). The PLAYED group exhibited significantly worse neurocognitive and greater symptoms than the REMOVED group. CONCLUSIONS SRC recovery time may be reduced if athletes are removed from participation. Immediate removal from play is the first step in mitigating prolonged SRC recovery, and these data support current consensus statements and management guidelines.
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Affiliation(s)
- R.J. Elbin
- Department of Health, Human Performance and Recreation/Office for Sport Concussion Research, University of Arkansas, Fayetteville, Arkansas
| | - Alicia Sufrinko
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Philip Schatz
- Department of Psychology, Saint Joseph’s University, Philadelphia, Pennsylvania; and
| | - Jon French
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Luke Henry
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Scott Burkhart
- Department of Human Sciences/Tallahassee Orthopedic Clinic, Florida State University, Tallahassee, Florida
| | - Michael W. Collins
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anthony P. Kontos
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
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41
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Mychasiuk R, Hehar H, Ma I, Candy S, Esser MJ. Reducing the time interval between concussion and voluntary exercise restores motor impairment, short-term memory, and alterations to gene expression. Eur J Neurosci 2016; 44:2407-2417. [DOI: 10.1111/ejn.13360] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Richelle Mychasiuk
- Alberta Children's Hospital Research Institute; Department of Psychology; University of Calgary; Heritage Medical Research Building, 3330 Hospital Drive NW Calgary AB T2N 1N4 Canada
| | - Harleen Hehar
- Alberta Children's Hospital Research Institute; Department of Psychology; University of Calgary; Heritage Medical Research Building, 3330 Hospital Drive NW Calgary AB T2N 1N4 Canada
| | - Irene Ma
- Alberta Children's Hospital Research Institute; Department of Psychology; University of Calgary; Heritage Medical Research Building, 3330 Hospital Drive NW Calgary AB T2N 1N4 Canada
| | - Sydney Candy
- Alberta Children's Hospital Research Institute; Faculty of Medicine; University of Calgary; Calgary AB Canada
| | - Michael J. Esser
- Alberta Children's Hospital Research Institute; Faculty of Medicine; University of Calgary; Calgary AB Canada
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42
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Gram MG, Wogensen E, Moseholm K, Mogensen J, Malá H. Exercise-induced improvement in cognitive performance after fimbria-fornix transection depends on the timing of exercise administration. Brain Res Bull 2016; 125:117-26. [DOI: 10.1016/j.brainresbull.2016.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 06/15/2016] [Accepted: 06/21/2016] [Indexed: 01/29/2023]
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43
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The interplay between neuropathology and activity based rehabilitation after traumatic brain injury. Brain Res 2016; 1640:152-163. [DOI: 10.1016/j.brainres.2016.01.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 02/07/2023]
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44
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Stam D, Fernandez J. Robotic gait assistive technology as means to aggressive mobilization strategy in acute rehabilitation following severe diffuse axonal injury: a case study. Disabil Rehabil Assist Technol 2016; 12:543-549. [PMID: 27049732 DOI: 10.3109/17483107.2016.1139633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Diffuse axonal injury is a prominent cause of disablement post-traumatic brain injury. Utilization of the rapid expansion of our current scientific knowledge base combined with greater access to neurological and assistive technology as adjuncts to providing sensorimotor experience may yield innovative new approaches to rehabilitation based upon a dynamic model of brain response following injury. CASE DESCRIPTION A 24-year-old female who sustained a traumatic brain injury, bilateral subdural hemorrhage, subarachnoid hemorrhage and severe diffuse axonal injury secondary to a motor vehicle collision. DISCUSSION AND CONCLUSIONS Evidence-based appraisal of present literature suggests a link between graded intensity of aerobic activity to facilitation of neuro-plastic change and up-regulation of neurotrophins essential to functional recovery post-diffuse axonal injury. Following resolution of paroxysmal autonomic instability with dystonia, aggressive early mobilization techniques were progressed utilizing robotic assistive gait technology in combination with conventional therapy. This approach allowed for arguably greater repetition and cardiovascular demands across a six-month inpatient rehabilitation stay. Outcomes in this case suggest that the use of assistive technology to adjunct higher level and intensity rehabilitation strategies may be a safe and effective means towards reduction of disablement following severe traumatic brain and neurological injury. Implications for Rehabilitation Functional recovery and neuroplasticity following diffuse neurological injury involves a complex process determined by the sensorimotor experience provided by rehabilitation clinicians. This process is in part modulated by intrinsic brain biochemical processes correlated to cardiovascular intensity of the activity provided. It is important that rehabilitation professionals monitor physiological response to higher intensity activities to provide an adaptive versus maladaptive response of central nervous system plasticity with activity. Identification of early mobilization parameters and skill acquisition may assist selection of gait assistive technology adjunct in progressing early optimal physical rehabilitation outcomes in the acute inpatient setting.
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45
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Leddy J, Hinds A, Sirica D, Willer B. The Role of Controlled Exercise in Concussion Management. PM R 2016; 8:S91-S100. [PMID: 26972272 DOI: 10.1016/j.pmrj.2015.10.017] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/06/2015] [Accepted: 10/08/2015] [Indexed: 11/30/2022]
Affiliation(s)
- John Leddy
- UBMD Orthopaedics and Sports Medicine, SUNY Buffalo, 160 Farber Hall, Buffalo, NY 14214
| | - Andrea Hinds
- Department of Psychiatry, SUNY Buffalo, Buffalo, NY
| | - Dan Sirica
- University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY
| | - Barry Willer
- Department of Psychiatry, SUNY Buffalo, Buffalo, NY
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46
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Yoon KJ, Lee YT, Chae SW, Park CR, Kim DY. Effects of anodal transcranial direct current stimulation (tDCS) on behavioral and spatial memory during the early stage of traumatic brain injury in the rats. J Neurol Sci 2016; 362:314-20. [PMID: 26944170 DOI: 10.1016/j.jns.2016.02.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 01/10/2016] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive technique to modulate the neural membrane potential. Its effects in the early stage of traumatic brain injury (TBI) have rarely been investigated. This study assessed the effects of anodal tDCS on behavioral and spatial memory in a rat model of traumatic brain injury. Thirty six rats underwent lateral fluid percussion and were then randomly assigned to one of three groups: control (n=12), five-day tDCS over peri-lesional cortex at one (1W, n=12), or two (2W, n=12) weeks post-injury. The Barnes maze (BM) and Rotarod (RR) tests were evaluated in a blind manner on day 1, week 3 and week 5 post-injury. After three weeks, both the 1W and 2W groups showed significant improvements in the BM ratio (P<0.05), whereas only group 2W obtained a significant improvement in the RR ratio compared with the control group (P<0.05). However, there were no significant differences between any of the groups at five weeks after TBI. Immunohistochemistry revealed that only group 2W had a significantly higher brain-derived neurotrophic factor (BDNF) expression in the peri-lesional cortex, which was significantly correlated with the improvement of the Rotarod test at 3-week post-injury. However, BDNF expression in the ipsi-lesional hippocampus was not significantly different among the three groups. Group 1W tended to have increased choline/creatine ratios, as measured by magnetic resonance spectroscopy in the peri-lesional cortex, than the control group (P=0.051). Neither regimen aggravated the lesion volume or brain edema measured by MRI. These beneficial effects were not observed with either regimen at five weeks post-injury. In conclusions, anodal tDCS ameliorated behavioral and spatial memory function in the early phase after TBI when it is delivered two weeks post-injury. Earlier stimulation (one week post-injury) improves spatial memory only. However, the beneficial effects did not persist after cessation of the anodal stimulation.
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Affiliation(s)
- Kyung Jae Yoon
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Republic of Korea; Medical Research Institute, Regenerative & Neuroscience Lab, Kangbuk Samsung Hospital, Sungkyunkwan University, Republic of Korea
| | - Yong-Taek Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Republic of Korea; Medical Research Institute, Regenerative & Neuroscience Lab, Kangbuk Samsung Hospital, Sungkyunkwan University, Republic of Korea
| | - Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Republic of Korea
| | - Chae Ri Park
- Asan Institute for Life Science, University of Ulsan College of Medicine, Republic of Korea
| | - Dae Yul Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
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Wells EM, Goodkin HP, Griesbach GS. Challenges in Determining the Role of Rest and Exercise in the Management of Mild Traumatic Brain Injury. J Child Neurol 2016; 31:86-92. [PMID: 25688071 DOI: 10.1177/0883073815570152] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 03/21/2014] [Indexed: 12/31/2022]
Abstract
Current consensus guidelines recommending physical and cognitive rest until a patient is asymptomatic after a sports concussion (ie, a mild traumatic brain injury) are being called into question, particularly for patients who are slower to recover and in light of preclinical and clinical research demonstrating that exercise aids neurorehabilitation. The pathophysiological response to mild traumatic brain injury includes a complex neurometabolic cascade of events resulting in a neurologic energy deficit. It has been proposed that this energy deficit leads to a period of vulnerability during which the brain is at risk for additional injury, explains why early postconcussive symptoms are exacerbated by cognitive and physical exertion, and is used to rationalize absolute rest until all symptoms have resolved. However, at some point, rest might no longer be beneficial and exercise might need to be introduced. At both extremes, excessive exertion and prolonged avoidance of exercise (physical and mental) have negative consequences. Individuals who have experienced a concussion need guidance for avoidance of triggers of severe symptoms and a plan for graduated exercise to promote recovery as well as optimal functioning (physical, educational, and social) during the postconcussion period.
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Affiliation(s)
- Elizabeth M Wells
- Department of Neurology, Children's National Medical Center, George Washington School of Medicine, Washington, DC, USA
| | - Howard P Goodkin
- Departments of Neurology and Pediatrics, UVA Healthsystem, Charlottesville, VA, USA
| | - Grace S Griesbach
- Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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48
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Combs HL, Jones TA, Kozlowski DA, Adkins DL. Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats. J Neurotrauma 2015; 33:741-7. [PMID: 26421759 DOI: 10.1089/neu.2015.4136] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI.
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Affiliation(s)
- Hannah L Combs
- 1 Department of Psychology, University of Texas at Austin , Austin, Texas
| | - Theresa A Jones
- 1 Department of Psychology, University of Texas at Austin , Austin, Texas.,2 Institute for Neuroscience, University of Texas at Austin , Austin, Texas
| | | | - DeAnna L Adkins
- 4 Department of Neuroscience, Department of Health Sciences and Research, and Center for Biomedical Imaging, Medical University of South Carolina , Charleston, South Carolina
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49
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Detloff MR, Quiros-Molina D, Javia AS, Daggubati L, Nehlsen AD, Naqvi A, Ninan V, Vannix KN, McMullen MK, Amin S, Ganzer PD, Houlé JD. Delayed Exercise Is Ineffective at Reversing Aberrant Nociceptive Afferent Plasticity or Neuropathic Pain After Spinal Cord Injury in Rats. Neurorehabil Neural Repair 2015; 30:685-700. [PMID: 26671215 DOI: 10.1177/1545968315619698] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Neuropathic pain is a debilitating consequence of spinal cord injury (SCI) that correlates with sensory fiber sprouting. Recent data indicate that exercise initiated early after SCI prevents the development of allodynia and modulated nociceptive afferent plasticity. This study determined if delaying exercise intervention until pain is detected would similarly ameliorate established SCI-induced pain. Adult, female Sprague-Dawley rats with a C5 unilateral contusion were separated into SCI allodynic and SCI non-allodynic cohorts at 14 or 28 days postinjury when half of each group began exercising on automated running wheels. Allodynia, assessed by von Frey testing, was not ameliorated by exercise. Furthermore, rats that began exercise with no allodynia developed paw hypersensitivity within 2 weeks. At the initiation of exercise, the SCI Allodynia group displayed marked overlap of peptidergic and non-peptidergic nociceptive afferents in the C7 and L5 dorsal horn, while the SCI No Allodynia group had scant overlap. At the end of 5 weeks of exercise both the SCI Allodynia and SCI No Allodynia groups had extensive overlap of the 2 c-fiber types. Our findings show that exercise therapy initiated at early stages of allodynia is ineffective at attenuating neuropathic pain, but rather that it induces allodynia-aberrant afferent plasticity in previously pain-free rats. These data, combined with our previous results, suggest that there is a critical therapeutic window when exercise therapy may be effective at treating SCI-induced allodynia and that there are postinjury periods when exercise can be deleterious.
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Affiliation(s)
| | | | - Amy S Javia
- Drexel University College of Medicine, Philadelphia, PA, USA
| | | | | | - Ali Naqvi
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Vinu Ninan
- Drexel University College of Medicine, Philadelphia, PA, USA
| | | | | | - Sheena Amin
- Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - John D Houlé
- Drexel University College of Medicine, Philadelphia, PA, USA
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Gram MG, Wogensen E, Wörtwein G, Mogensen J, Malá H. Delayed restraint procedure enhances cognitive recovery of spatial function after fimbria-fornix transection. Restor Neurol Neurosci 2015; 34:1-17. [PMID: 26518669 DOI: 10.3233/rnn-140396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To i) evaluate the effect of a restraint procedure (7 days, 2 h/day) on place learning after fimbria-fornix transection (FF), ii) investigate effects of early vs. late administration of restraint, and iii) establish effects of the restraint procedure on expression of brain derived neurotrophic factor (BDNF) in prefrontal cortex and hippocampus. METHODS Fifty rats subjected to FF or sham surgery and divided into groups exposed to restraint immediately (early restraint) or 21 days (late restraint) after surgery were trained to acquire an allocentric place learning task. In parallel, 29 animals were subjected to FF or sham surgery and an identical restraint procedure in order to measure concentrations of BDNF and corticosterone. RESULTS The performance of the sham operated rats was positively affected by the late restraint. In FF-lesioned animals, the late restraint significantly improved task performance compared to the lesioned group with no restraint, while the early restraint was associated with a negative impact on task acquisition. Biochemical analysis after restraint procedure revealed a lesion-induced upregulation of BDNF in FF animals. CONCLUSIONS The improved task performance of lesioned animals suggests a therapeutic effect of this manipulation, independent of BDNF. This effect is sensitive to the temporal administration of treatment.
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Affiliation(s)
- Marie Gajhede Gram
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Elise Wogensen
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Gitta Wörtwein
- Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Mogensen
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Hana Malá
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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