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Pan X, Hu Y, Lei G, Wei Y, Li J, Luan T, Zhang Y, Chu Y, Feng Y, Zhan W, Zhao C, Meunier FA, Liu Y, Li Y, Wang T. Actomyosin-II protects axons from degeneration induced by mild mechanical stress. J Cell Biol 2024; 223:e202206046. [PMID: 38713825 PMCID: PMC11076810 DOI: 10.1083/jcb.202206046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 06/16/2023] [Accepted: 04/09/2024] [Indexed: 05/09/2024] Open
Abstract
Whether, to what extent, and how the axons in the central nervous system (CNS) can withstand sudden mechanical impacts remain unclear. By using a microfluidic device to apply controlled transverse mechanical stress to axons, we determined the stress levels that most axons can withstand and explored their instant responses at nanoscale resolution. We found mild stress triggers a highly reversible, rapid axon beading response, driven by actomyosin-II-dependent dynamic diameter modulations. This mechanism contributes to hindering the long-range spread of stress-induced Ca2+ elevations into non-stressed neuronal regions. Through pharmacological and molecular manipulations in vitro, we found that actomyosin-II inactivation diminishes the reversible beading process, fostering progressive Ca2+ spreading and thereby increasing acute axonal degeneration in stressed axons. Conversely, upregulating actomyosin-II activity prevents the progression of initial injury, protecting stressed axons from acute degeneration both in vitro and in vivo. Our study unveils the periodic actomyosin-II in axon shafts cortex as a novel protective mechanism, shielding neurons from detrimental effects caused by mechanical stress.
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Affiliation(s)
- Xiaorong Pan
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | - Yiqing Hu
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | - Gaowei Lei
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences China, Shanghai, China
| | - Yaxuan Wei
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences China, Shanghai, China
| | - Jie Li
- Division of Chemistry and Physical Biology, School of Physical Science and Technology, ShanghaiTech University, Shanghai, China
- Shanghai Clinical Research and Trial Center, Shanghai, China
| | - Tongshu Luan
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | - Yunfan Zhang
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences China, Shanghai, China
| | - Yuanyuan Chu
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | - Yu Feng
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | - Wenrong Zhan
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | - Chunxia Zhao
- School of Chemical Engineering, The University of Adelaide, Adelaide, Australia
| | - Frédéric A. Meunier
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland, Brisbane, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Yifan Liu
- Division of Chemistry and Physical Biology, School of Physical Science and Technology, ShanghaiTech University, Shanghai, China
- Shanghai Clinical Research and Trial Center, Shanghai, China
| | - Yi Li
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences China, Shanghai, China
| | - Tong Wang
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, China
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Richard SA. Elucidating the pivotal molecular mechanisms, therapeutic and neuroprotective effects of lithium in traumatic brain injury. Brain Behav 2024; 14:e3595. [PMID: 38874089 PMCID: PMC11177180 DOI: 10.1002/brb3.3595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/17/2024] [Accepted: 05/26/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) refers to damage to brain tissue by mechanical or blunt force via trauma. TBI is often associated with impaired cognitive abilities, like difficulties in memory, learning, attention, and other higher brain functions, that typically remain for years after the injury. Lithium is an elementary light metal that is only utilized in salt form due to its high intrinsic reactivity. This current review discusses the molecular mechanisms and therapeutic and neuroprotective effects of lithium in TBI. METHOD The "Boolean logic" was used to search for articles on the subject matter in PubMed and PubMed Central, as well as Google Scholar. RESULTS Lithium's therapeutic action is extremely complex, involving multiple effects on gene secretion, neurotransmitter or receptor-mediated signaling, signal transduction processes, circadian modulation, as well as ion transport. Lithium is able to normalize multiple short- as well as long-term modifications in neuronal circuits that ultimately result in disparity in cortical excitation and inhibition activated by TBI. Also, lithium levels are more distinct in the hippocampus, thalamus, neo-cortex, olfactory bulb, amygdala as well as the gray matter of the cerebellum following treatment of TBI. CONCLUSION Lithium attenuates neuroinflammation and neuronal toxicity as well as protects the brain from edema, hippocampal neurodegeneration, loss of hemispheric tissues, and enhanced memory as well as spatial learning after TBI.
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Affiliation(s)
- Seidu A Richard
- Department of Medicine, Princefield University, Ho, Ghana
- Institute of Neuroscience, Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
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Nwakamma MC, Stillman AM, Gabard-Durnam LJ, Cavanagh JF, Hillman CH, Morris TP. Slowing of Parameterized Resting-State Electroencephalography After Mild Traumatic Brain Injury. Neurotrauma Rep 2024; 5:448-461. [PMID: 38666007 PMCID: PMC11044859 DOI: 10.1089/neur.2024.0004] [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] [Indexed: 04/28/2024] Open
Abstract
Reported changes in electroencephalography (EEG)-derived spectral power after mild traumatic brain injury (mTBI) remains inconsistent across existing literature. However, this may be a result of previous analyses depending solely on observing spectral power within traditional canonical frequency bands rather than accounting for the aperiodic activity within the collected neural signal. Therefore, the aim of this study was to test for differences in rhythmic and arrhythmic time series across the brain, and in the cognitively relevant frontoparietal (FP) network, and observe whether those differences were associated with cognitive recovery post-mTBI. Resting-state electroencephalography (rs-EEG) was collected from 88 participants (56 mTBI and 32 age- and sex-matched healthy controls) within 14 days of injury for the mTBI participants. A battery of executive function (EF) tests was collected at the first session with follow-up metrics collected approximately 2 and 4 months after the initial visit. After spectral parameterization, a significant between-group difference in aperiodic-adjusted alpha center peak frequency within the FP network was observed, where a slowing of alpha peak frequency was found in the mTBI group in comparison to the healthy controls. This slowing of week 2 (collected within 2 weeks of injury) aperiodic-adjusted alpha center peak frequency within the FP network was associated with increased EF over time (evaluated using executive composite scores) post-mTBI. These findings suggest alpha center peak frequency within the FP network as a candidate prognostic marker of EF recovery and may inform clinical rehabilitative methods post-mTBI.
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Affiliation(s)
- Mark C. Nwakamma
- Department of Physical Therapy Human Movement Sciences, Northeastern University, Boston, Massachusetts, USA
- Center for Cognitive and Brain Health, Northeastern University, Boston, Massachusetts, USA
| | - Alexandra M. Stillman
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Laurel J. Gabard-Durnam
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Center for Cognitive and Brain Health, Northeastern University, Boston, Massachusetts, USA
| | - James F. Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Charles H. Hillman
- Department of Physical Therapy Human Movement Sciences, Northeastern University, Boston, Massachusetts, USA
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Center for Cognitive and Brain Health, Northeastern University, Boston, Massachusetts, USA
| | - Timothy P. Morris
- Department of Physical Therapy Human Movement Sciences, Northeastern University, Boston, Massachusetts, USA
- Center for Cognitive and Brain Health, Northeastern University, Boston, Massachusetts, USA
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
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Fesharaki-Zadeh A, Datta D. An overview of preclinical models of traumatic brain injury (TBI): relevance to pathophysiological mechanisms. Front Cell Neurosci 2024; 18:1371213. [PMID: 38682091 PMCID: PMC11045909 DOI: 10.3389/fncel.2024.1371213] [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: 01/16/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
Background Traumatic brain injury (TBI) is a major cause of morbidity and mortality, affecting millions annually worldwide. Although the majority of TBI patients return to premorbid baseline, a subset of patient can develop persistent and often debilitating neurocognitive and behavioral changes. The etiology of TBI within the clinical setting is inherently heterogenous, ranging from sport related injuries, fall related injuries and motor vehicle accidents in the civilian setting, to blast injuries in the military setting. Objective Animal models of TBI, offer the distinct advantage of controlling for injury modality, duration and severity. Furthermore, preclinical models of TBI have provided the necessary temporal opportunity to study the chronic neuropathological sequelae of TBI, including neurodegenerative sequelae such as tauopathy and neuroinflammation within the finite experimental timeline. Despite the high prevalence of TBI, there are currently no disease modifying regimen for TBI, and the current clinical treatments remain largely symptom based. The preclinical models have provided the necessary biological substrate to examine the disease modifying effect of various pharmacological agents and have imperative translational value. Methods The current review will include a comprehensive survey of well-established preclinical models, including classic preclinical models including weight drop, blast injury, fluid percussion injury, controlled cortical impact injury, as well as more novel injury models including closed-head impact model of engineered rotational acceleration (CHIMERA) models and closed-head projectile concussive impact model (PCI). In addition to rodent preclinical models, the review will include an overview of other species including large animal models and Drosophila. Results There are major neuropathological perturbations post TBI captured in various preclinical models, which include neuroinflammation, calcium dysregulation, tauopathy, mitochondrial dysfunction and oxidative stress, axonopathy, as well as glymphatic system disruption. Conclusion The preclinical models of TBI continue to offer valuable translational insight, as well as essential neurobiological basis to examine specific disease modifying therapeutic regimen.
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Affiliation(s)
- Arman Fesharaki-Zadeh
- Department of Neurology and Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Dibyadeep Datta
- Division of Aging and Geriatric Psychiatry, Alzheimer’s Disease Research Unit, Department of Psychiatry, New Haven, CT, United States
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Tian Y, Oh JH, Rhee HY, Park S, Ryu CW, Cho AR, Jahng GH. Gray-white matter boundary Z-score and volume as imaging biomarkers of Alzheimer's disease. Front Aging Neurosci 2023; 15:1291376. [PMID: 38161586 PMCID: PMC10755914 DOI: 10.3389/fnagi.2023.1291376] [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: 09/09/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Alzheimer's disease (AD) presents typically gray matter atrophy and white matter abnormalities in neuroimaging, suggesting that the gray-white matter boundary could be altered in individuals with AD. The purpose of this study was to explore differences of gray-white matter boundary Z-score (gwBZ) and its tissue volume (gwBTV) between patients with AD, amnestic mild cognitive impairment (MCI), and cognitively normal (CN) elderly participants. Methods Three-dimensional T1-weight images of a total of 227 participants were prospectively obtained from our institute from 2006 to 2022 to map gwBZ and gwBTV on images. Statistical analyses of gwBZ and gwBTV were performed to compare the three groups (AD, MCI, CN), to assess their correlations with age and Korean version of the Mini-Mental State Examination (K-MMSE), and to evaluate their effects on AD classification in the hippocampus. Results This study included 62 CN participants (71.8 ± 4.8 years, 20 males, 42 females), 72 MCI participants (72.6 ± 5.1 years, 23 males, 49 females), and 93 AD participants (73.6 ± 7.7 years, 22 males, 71 females). The AD group had lower gwBZ and gwBTV than CN and MCI groups. K-MMSE showed positive correlations with gwBZ and gwBTV whereas age showed negative correlations with gwBZ and gwBTV. The combination of gwBZ or gwBTV with K-MMSE had a high accuracy in classifying AD from CN in the hippocampus with an area under curve (AUC) value of 0.972 for both. Conclusion gwBZ and gwBTV were reduced in AD. They were correlated with cognitive function and age. Moreover, gwBZ or gwBTV combined with K-MMSE had a high accuracy in differentiating AD from CN in the hippocampus. These findings suggest that evaluating gwBZ and gwBTV in AD brain could be a useful tool for monitoring AD progression and diagnosis.
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Affiliation(s)
- Yunan Tian
- Department of Medicine, Graduate School, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jang-Hoon Oh
- Department of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Soonchan Park
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Chang-Woo Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Ah Rang Cho
- Department of Psychiatry, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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Zhao X, Zeng W, Xu H, Sun Z, Hu Y, Peng B, McBride JD, Duan J, Deng J, Zhang B, Kim SJ, Zoll B, Saito T, Sasaguri H, Saido TC, Ballatore C, Yao H, Wang Z, Trojanowski JQ, Brunden KR, Lee VMY, He Z. A microtubule stabilizer ameliorates protein pathogenesis and neurodegeneration in mouse models of repetitive traumatic brain injury. Sci Transl Med 2023; 15:eabo6889. [PMID: 37703352 PMCID: PMC10787216 DOI: 10.1126/scitranslmed.abo6889] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/24/2023] [Indexed: 09/15/2023]
Abstract
Tau pathogenesis is a hallmark of many neurodegenerative diseases, including Alzheimer's disease (AD). Although the events leading to initial tau misfolding and subsequent tau spreading in patient brains are largely unknown, traumatic brain injury (TBI) may be a risk factor for tau-mediated neurodegeneration. Using a repetitive TBI (rTBI) paradigm, we report that rTBI induced somatic accumulation of phosphorylated and misfolded tau, as well as neurodegeneration across multiple brain areas in 7-month-old tau transgenic PS19 mice but not wild-type (WT) mice. rTBI accelerated somatic tau pathology in younger PS19 mice and WT mice only after inoculation with tau preformed fibrils and AD brain-derived pathological tau (AD-tau), respectively, suggesting that tau seeds are needed for rTBI-induced somatic tau pathology. rTBI further disrupted axonal microtubules and induced punctate tau and TAR DNA binding protein 43 (TDP-43) pathology in the optic tracts of WT mice. These changes in the optic tract were associated with a decline of visual function. Treatment with a brain-penetrant microtubule-stabilizing molecule reduced rTBI-induced tau, TDP-43 pathogenesis, and neurodegeneration in the optic tract as well as visual dysfunction. Treatment with the microtubule stabilizer also alleviated rTBI-induced tau pathology in the cortices of AD-tau-inoculated WT mice. These results indicate that rTBI facilitates abnormal microtubule organization, pathological tau formation, and neurodegeneration and suggest microtubule stabilization as a potential therapeutic avenue for TBI-induced neurodegeneration.
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Affiliation(s)
- Xinyi Zhao
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Wen Zeng
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Hong Xu
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Zihan Sun
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Yingxin Hu
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Beibei Peng
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
| | - Jennifer D McBride
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Jiangtao Duan
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
| | - Juan Deng
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
| | - Bin Zhang
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Soo-Jung Kim
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Bryan Zoll
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Takashi Saito
- Laboratory of Proteolytic Neuroscience, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
- Department of Neurocognitive Science, Institute of Brain Science, Nagoya City University Graduate School of Medical Science, Nagoya, Aichi 467-8601, Japan
| | - Hiroki Sasaguri
- Laboratory of Proteolytic Neuroscience, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Takaomi C Saido
- Laboratory of Proteolytic Neuroscience, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Carlo Ballatore
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Haishan Yao
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
| | - Zhaoyin Wang
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Kurt R Brunden
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Virginia M-Y Lee
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Zhuohao He
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
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Harris JP, Mietus CJ, Browne KD, Wofford KL, Keating CE, Brown DP, Johnson BN, Wolf JA, Smith DH, Cohen AS, Duda JE, Cullen DK. Neuronal somatic plasmalemmal permeability and dendritic beading caused by head rotational traumatic brain injury in pigs-An exploratory study. Front Cell Neurosci 2023; 17:1055455. [PMID: 37519631 PMCID: PMC10381956 DOI: 10.3389/fncel.2023.1055455] [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: 09/27/2022] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
Closed-head traumatic brain injury (TBI) is induced by rapid motion of the head, resulting in diffuse strain fields throughout the brain. The injury mechanism(s), loading thresholds, and neuroanatomical distribution of affected cells remain poorly understood, especially in the gyrencephalic brain. We utilized a porcine model to explore the relationships between rapid head rotational acceleration-deceleration loading and immediate alterations in plasmalemmal permeability within cerebral cortex, sub-cortical white matter, and hippocampus. To assess plasmalemmal compromise, Lucifer yellow (LY), a small cell-impermeant dye, was delivered intraventricularly and diffused throughout the parenchyma prior to injury in animals euthanized at 15-min post-injury; other animals (not receiving LY) were survived to 8-h or 7-days. Plasmalemmal permeability preferentially occurred in neuronal somata and dendrites, but rarely in white matter axons. The burden of LY+ neurons increased based on head rotational kinematics, specifically maximum angular velocity, and was exacerbated by repeated TBI. In the cortex, LY+ cells were prominent in both the medial and lateral gyri. Neuronal membrane permeability was observed within the hippocampus and entorhinal cortex, including morphological changes such as beading in dendrites. These changes correlated with reduced fiber volleys and synaptic current alterations at later timepoints in the hippocampus. Further histological observations found decreased NeuN immunoreactivity, increased mitochondrial fission, and caspase pathway activation in both LY+ and LY- cells, suggesting the presence of multiple injury phenotypes. This exploratory study suggests relationships between plasmalemmal disruptions in neuronal somata and dendrites within cortical and hippocampal gray matter as a primary response in closed-head rotational TBI and sets the stage for future, traditional hypothesis-testing experiments.
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Affiliation(s)
- James P. Harris
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Constance J. Mietus
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kevin D. Browne
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Kathryn L. Wofford
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Carolyn E. Keating
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Daniel P. Brown
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Brian N. Johnson
- Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Research Institute, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - John A. Wolf
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Douglas H. Smith
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Akiva S. Cohen
- Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Research Institute, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - John E. Duda
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - D. Kacy Cullen
- Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States
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8
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Du Z, Wang P, Luo P, Fei Z, Zhuang Z, Liu Z. Mechanical mechanism and indicator of diffuse axonal injury under blast-type acceleration. J Biomech 2023; 156:111674. [PMID: 37300977 DOI: 10.1016/j.jbiomech.2023.111674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
Diffuse axonal injury (DAI) caused by acceleration is one of the most prominent forms of blast-induced Traumatic Brain Injury. However, the mechanical mechanism and indicator of axonal deformation-induced injury under blast-type acceleration with high peak and short duration are unclear. This study constructed a multilayer head model that can reflect the response characteristics of translational and rotational acceleration (the peak time of which is within 0.5 ms). Based on von Mises stress, axonal strain and axonal strain rate indicators, the physical process of axonal injury is studied, and the vulnerable area under blast-type acceleration load is given. In the short term (within 1.75 ms), dominated by sagittal rotational acceleration peaks, the constraint of falx and tentorium rapidly imposes the inertial load on the brain tissue, resulting in a high-rate deformation of axons (axonal strain rate of which exceed 100 s-1). For a long term (after 1.75 ms), fixed-point rotation of the brain following the head causes excessive distortion of brain tissue (von Mises stress of which exceeds 15 kPa), resulting in a large axonal stretch strain where the main axonal orientation coincides with the principal strain direction. It is found that the axonal strain rate can better indicate the pathological axonal injury area and coincides with external inertial loading in the risk areas, which suggests that DAI under blast-type acceleration overload is mainly caused by the rapid axonal deformation instead of by the excessive axonal strain. The research in this paper helps understand and diagnose blast-induced DAI.
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Affiliation(s)
- Zhibo Du
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, PR China
| | - Peng Wang
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, PR China; School of Aerospace Engineering and Applied Mechanics, Tongji University, Shanghai 200092, PR China
| | - Peng Luo
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, PR China
| | - Zhou Fei
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, PR China
| | - Zhuo Zhuang
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, PR China
| | - Zhanli Liu
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, PR China.
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9
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Pavlichenko M, Lafrenaye AD. The Central Fluid Percussion Brain Injury in a Gyrencephalic Pig Brain: Scalable Diffuse Injury and Tissue Viability for Glial Cell Immunolabeling following Long-Term Refrigerated Storage. Biomedicines 2023; 11:1682. [PMID: 37371777 PMCID: PMC10295711 DOI: 10.3390/biomedicines11061682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Traumatic brain injury (TBI) affects millions of people annually; however, our knowledge of the diffuse pathologies associated with TBI is limited. As diffuse pathologies, including axonal injury and neuroinflammatory changes, are difficult to visualize in the clinical population, animal models are used. In the current study, we used the central fluid percussion injury (CFPI) model in a micro pig to study the potential scalability of these diffuse pathologies in a gyrencephalic brain of a species with inflammatory systems very similar to humans. We found that both axonal injury and microglia activation within the thalamus and corpus callosum are positively correlated with the weight-normalized pressure pulse, while subtle changes in blood gas and mean arterial blood pressure are not. We also found that the majority of tissue generated up to 10 years previously is viable for immunofluorescent labeling after long-term refrigeration storage. This study indicates that a micro pig CFPI model could allow for specific investigations of various degrees of diffuse pathological burdens following TBI.
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Affiliation(s)
- Mark Pavlichenko
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA 23298-0709, USA
| | - Audrey D. Lafrenaye
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA 23298-0709, USA
- Richmond Veterans Affairs Medical Center, Richmond, VA 23249-4915, USA
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10
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Hanna M, Ali A, Klienberger M, Pfister BJ. A Method for Evaluating Brain Deformation Under Sagittal Blunt Impacts Using a Half-Skull Human-Scale Surrogate. J Biomech Eng 2023; 145:1155772. [PMID: 36562120 DOI: 10.1115/1.4056547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022]
Abstract
Trauma to the brain is a biomechanical problem where the initiating event is a dynamic loading (blunt, inertial, blast) to the head. To understand the relationship between the mechanical parameters of the injury and the spatial and temporal deformation patterns in the brain, there is a need to develop a reusable and adaptable experimental traumatic brain injury (TBI) model that can measure brain motion under varying parameters. In this effort, we aim to directly measure brain deformation (strain and strain rates) in different brain regions in a human head model using a drop tower. METHODS Physical head models consisting of a half, sagittal plane skull, brain, and neck were constructed and subjected to crown and frontal impacts at two impact speeds. All tests were recorded with a high-speed camera at 1000 frames per second. Motion of visual markers within brain surrogates were used to track deformations and calculate spatial strain histories in 6 brain regions of interest. Principal strains, strain rates and strain impulses were calculated and reported. RESULTS Higher impact velocities corresponded to higher strain values across all impact scenarios. Crown impacts were characterized by high, long duration strains distributed across the parietal, frontal and hippocampal regions whereas frontal impacts were characterized by sharply rising and falling strains primarily found in the parietal, frontal, hippocampal and occipital regions. High strain rates were associated with short durations and impulses indicating fast but short-lived strains. 2.23 m/s (5 mph) crown impacts resulted in 53% of the brain with shear strains higher than 0.15 verses 32% for frontal impacts. CONCLUSIONS The results reveal large differences in the spatial and temporal strain responses between crown and forehead impacts. Overall, the results suggest that for the same speed, crown impact leads to higher magnitude strain patterns than a frontal impact. The data provided by this model provides unique insight into the spatial and temporal deformation patterns that have not been provided by alternate surrogate models. The model can be used to investigate how anatomical, material and loading features and parameters can affect deformation patterns in specific regions of interest in the brain.
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Affiliation(s)
- Michael Hanna
- Department of Biomedical Engineering, Center for Injury Biomechanics, Materials and Medicine, New Jersey Institute of Technology, Newark, NJ 07102
| | - Abdus Ali
- Department of Biomedical Engineering, Center for Injury Biomechanics, Materials and Medicine, New Jersey Institute of Technology, Newark, NJ 07102
| | | | - Bryan J Pfister
- Department of Biomedical Engineering, Center for Injury Biomechanics, Materials and Medicine, New Jersey Institute of Technology, Newark, NJ 07102
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11
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Boiczyk GM, Pearson N, Kote VB, Sundaramurthy A, Subramaniam DR, Rubio JE, Unnikrishnan G, Reifman J, Monson KL. Rate- and Region-Dependent Mechanical Properties of Göttingen Minipig Brain Tissue in Simple Shear and Unconfined Compression. J Biomech Eng 2023; 145:1154461. [PMID: 36524865 DOI: 10.1115/1.4056480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Traumatic brain injury (TBI), particularly from explosive blasts, is a major cause of casualties in modern military conflicts. Computational models are an important tool in understanding the underlying biomechanics of TBI but are highly dependent on the mechanical properties of soft tissue to produce accurate results. Reported material properties of brain tissue can vary by several orders of magnitude between studies, and no published set of material parameters exists for porcine brain tissue at strain rates relevant to blast. In this work, brain tissue from the brainstem, cerebellum, and cerebrum of freshly euthanized adolescent male Göttingen minipigs was tested in simple shear and unconfined compression at strain rates ranging from quasi-static (QS) to 300 s-1. Brain tissue showed significant strain rate stiffening in both shear and compression. Minimal differences were seen between different regions of the brain. Both hyperelastic and hyper-viscoelastic constitutive models were fit to experimental stress, considering data from either a single loading mode (unidirectional) or two loading modes together (bidirectional). The unidirectional hyper-viscoelastic models with an Ogden hyperelastic representation and a one-term Prony series best captured the response of brain tissue in all regions and rates. The bidirectional models were generally able to capture the response of the tissue in high-rate shear and all compression modes, but not the QS shear. Our constitutive models describe the first set of material parameters for porcine brain tissue relevant to loading modes and rates seen in blast injury.
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Affiliation(s)
- Gregory M Boiczyk
- Department of Biomedical Engineering, The University of Utah, 36 S. Wasatch Drive, Salt Lake City, UT 84112
| | - Noah Pearson
- Department of Mechanical Engineering, The University of Utah, 1495 E 100 S, Salt Lake City, UT 84112
| | - Vivek Bhaskar Kote
- Department of Defense Biotechnology, High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, 2405 Whittier Drive, Suite 200, Frederick, MD 21702; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD 20817
| | - Aravind Sundaramurthy
- Department of Defense Biotechnology, High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, 2405 Whittier Drive, Suite 200, Frederick, MD 21702; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD 20817
| | - Dhananjay Radhakrishnan Subramaniam
- Department of Defense Biotechnology, High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, 2405 Whittier Drive, Suite 200, Frederick, MD 21702; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD 20817
| | - Jose E Rubio
- Department of Defense Biotechnology, High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, 2405 Whittier Drive, Suite 200, Frederick, MD 21702; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD 20817
| | - Ginu Unnikrishnan
- Department of Defense Biotechnology, High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, 2405 Whittier Drive, Suite 200, Frederick, MD 21702; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD 20817
| | - Jaques Reifman
- Department of Defense Biotechnology, High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, 2405 Whittier Drive, Suite 200, Frederick, MD 21702
| | - Kenneth L Monson
- Department of Mechanical Engineering, The University of Utah, 1495 E 100 S, Salt Lake City, UT 84112; Department of Biomedical Engineering, The University of Utah, 36 S. Wasatch Drive, Salt Lake City, UT 84112
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12
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Martínez-Tapia R, Estrada-Rojo F, López-Aceves T, García-Velasco S, Rodríguez-Mata V, Pulido-Camarillo E, Pérez-Torres A, López-Flores E, Ugalde-Muñiz P, Noriega-Navarro R, Navarro L. A model of traumatic brain injury in rats is influenced by neuroprotection of diurnal variation which improves motor behavior and histopathology in white matter myelin. Heliyon 2023; 9:e16088. [PMID: 37215868 PMCID: PMC10196591 DOI: 10.1016/j.heliyon.2023.e16088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 04/07/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
Traumatic brain injury (TBI) represents a significant public health concern and has been associated with high rates of morbidity and mortality. TBI generates two types of brain damage: primary and secondary. Secondary damage originates a series of pathophysiological processes, which include metabolic crisis, excitotoxicity, and neuroinflammation, which have deleterious consequences for neuronal function. However, neuroprotective mechanisms are also activated. The balance among these tissue responses, and its variations throughout the day determines the fate of the damage tissue. We have demonstrated less behavioral and morphological damage when a rat model of TBI was induced during the light hours of the day. Moreover, here we show that rats subjected to TBI in the dark lost less body weight than those subjected to TBI in the light, despite no change in food intake. Besides, the rats subjected to TBI in the dark had better performance in the beam walking test and presented less histological damage in the corpus callosum and the cingulum bundle, as shown by the Klüver-Barrera staining. Our results suggest that the time of day when the injury occurs is important. Thus, this data should be used to evaluate the pathophysiological processes of TBI events and develop better therapies.
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Affiliation(s)
- R.J. Martínez-Tapia
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - F. Estrada-Rojo
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - T.G. López-Aceves
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
- Programa Regional de Posgrado en Biotecnología, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, Mexico
| | - S. García-Velasco
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - V. Rodríguez-Mata
- Departamento de Biología Celular y Tisular, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - E. Pulido-Camarillo
- Departamento de Biología Celular y Tisular, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - A. Pérez-Torres
- Departamento de Biología Celular y Tisular, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - E.Y. López-Flores
- Residente de Anatomía Patológica, CMN “20 de Noviembre”, ISSSTE, Ciudad de México, Mexico
| | - P. Ugalde-Muñiz
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - R. Noriega-Navarro
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - L. Navarro
- Laboratory of Neuroendocrinology, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
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13
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Adams AA, Li Y, Kim HA, Pfister BJ. Dorsal root ganglion neurons recapitulate the traumatic axonal injury of CNS neurons in response to a rapid stretch in vitro. Front Cell Neurosci 2023; 17:1111403. [PMID: 37066078 PMCID: PMC10090399 DOI: 10.3389/fncel.2023.1111403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/28/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction: In vitro models of traumatic brain injury (TBI) commonly use neurons isolated from the central nervous system. Limitations with primary cortical cultures, however, can pose challenges to replicating some aspects of neuronal injury associated with closed head TBI. The known mechanisms of axonal degeneration from mechanical injury in TBI are in many ways similar to degenerative disease, ischemia, and spinal cord injury. It is therefore possible that the mechanisms that result in axonal degeneration in isolated cortical axons after in vitro stretch injury are shared with injured axons from different neuronal types. Dorsal root ganglia neurons (DRGN) are another neuronal source that may overcome some current limitations including remaining healthy in culture for long periods of time, ability to be isolated from adult sources, and myelinated in vitro. Methods: The current study sought to characterize the differential responses between cortical and DRGN axons to mechanical stretch injury associated with TBI. Using an in vitro model of traumatic axonal stretch injury, cortical and DRGN neurons were injured at a moderate (40% strain) and severe stretch (60% strain) and acute alterations in axonal morphology and calcium homeostasis were measured. Results: DRGN and cortical axons immediately form undulations in response to severe injury, experience similar elongation and recovery within 20 min after the initial injury, and had a similar pattern of degeneration over the first 24 h after injury. Additionally, both types of axons experienced comparable degrees of calcium influx after both moderate and severe injury that was prevented through pre-treatment with tetrodotoxin in cortical neurons and lidocaine in DRGNs. Similar to cortical axons, stretch injury also causes calcium activated proteolysis of sodium channel in DRGN axons that is prevented by treatment with lidocaine or protease inhibitors. Discussion: These findings suggest that DRGN axons share the early response of cortical neurons to a rapid stretch injury and the associated secondary injury mechanisms. The utility of a DRGN in vitro TBI model may allow future studies to explore TBI injury progression in myelinated and adult neurons.
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Affiliation(s)
- Alexandra A. Adams
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
- Department of Biological Sciences, Rutgers University Newark, Newark, NJ, United States
| | - Ying Li
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Haesun A. Kim
- Department of Biological Sciences, Rutgers University Newark, Newark, NJ, United States
| | - Bryan J. Pfister
- Center for Injury Biomechanics, Materials and Medicine, Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
- Department of Biological Sciences, Rutgers University Newark, Newark, NJ, United States
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14
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Raizman R, Itzhaki N, Sirkin J, Meningher I, Tsarfaty G, Keren O, Zibli Z, Silberg T, Pick CG, Livny A. Decreased homotopic functional connectivity in traumatic brain injury. Cereb Cortex 2023; 33:1207-1216. [PMID: 35353131 DOI: 10.1093/cercor/bhac130] [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: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Homotopic functional connectivity (HoFC), the synchrony in activity patterns between homologous brain regions, is a fundamental characteristic of resting-state functional connectivity (RsFC). METHODS We examined the difference in HoFC, computed as the correlation between atlas-based regions and their counterpart on the opposite hemisphere, in 16 moderate-severe traumatic brain injury patients (msTBI) and 36 healthy controls. Regions of decreased HoFC in msTBI patients were further used as seeds for examining differences between groups in correlations with other brain regions. Finally, we computed logistic regression models of regional HoFC and fractional anisotropy (FA) of the corpus callosum (CC). RESULTS TBI patients exhibited decreased HoFC in the middle and posterior cingulate cortex, thalamus, superior temporal pole, and cerebellum III. Furthermore, decreased RsFC was found between left cerebellum III and right parahippocampal cortex and vermis, between superior temporal pole and left caudate and medial left and right frontal orbital gyri. Thalamic HoFC and FA of the CC discriminate patients as msTBI with a high accuracy of 96%. CONCLUSION TBI is associated with regionally decreased HoFC. Moreover, a multimodality model of interhemispheric connectivity allowed for a high degree of accuracy in disease discrimination and enabled a deeper understanding of TBI effects on brain interhemispheric reorganization post-TBI.
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Affiliation(s)
- Reut Raizman
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel
| | - Nofar Itzhaki
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Johanna Sirkin
- Department of Psychology, Reichman University, Herzelia, Israel
| | - Inbar Meningher
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Galia Tsarfaty
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of imaging, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel
| | - Ofer Keren
- Department of Brain Injury Rehabilitation, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Zion Zibli
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, 69979 Ramat Gan, Israel
| | - Tamar Silberg
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Department of Psychology, Bar Ilan University, 5290002 Ramat Gan, Israel
| | - Chaim G Pick
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69979 Tel Aviv, Israel.,The Dr. Miriam and Sheldon G. Adelson, Chair and Center for the Biology of Addictive Diseases, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, 69979 Tel Aviv, Israel
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of imaging, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69979 Tel Aviv, Israel
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15
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A model for estimating the brainstem volume in normal healthy individuals and its application to diffuse axonal injury patients. Sci Rep 2023; 13:33. [PMID: 36593347 PMCID: PMC9807567 DOI: 10.1038/s41598-022-27202-x] [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: 09/08/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Diffuse axonal injury (DAI) is a subtype of traumatic brain injury that causes acute-phase consciousness disorders and widespread chronic-phase brain atrophy. Considering the importance of brainstem damage in DAI, a valid method for evaluating brainstem volume is required. We obtained volume measurements from 182 healthy adults by analyzing T1-weighted magnetic resonance images, and created an age-/sex-/intracranial volume-based quantitative model to estimate the normal healthy volume of the brainstem and cerebrum. We then applied this model to the volume measurements of 22 DAI patients, most of whom were in the long-term chronic phase and had no gross focal injury, to estimate the percentage difference in volume from the expected normal healthy volume in different brain regions, and investigated its association with the duration of posttraumatic amnesia (which is an early marker of injury severity). The average loss of the whole brainstem was 13.9%. Moreover, the percentage loss of the whole brainstem, and particularly of the pons and midbrain, was significantly negatively correlated with the duration of posttraumatic amnesia. Our findings suggest that injury severity, as denoted by the duration of posttraumatic amnesia, is among the factors affecting the chronic-phase brainstem volume in patients with DAI.
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16
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Snapper DM, Reginauld B, Liaudanskaya V, Fitzpatrick V, Kim Y, Georgakoudi I, Kaplan DL, Symes AJ. Development of a novel bioengineered 3D brain-like tissue for studying primary blast-induced traumatic brain injury. J Neurosci Res 2023; 101:3-19. [PMID: 36200530 DOI: 10.1002/jnr.25123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/04/2022] [Accepted: 08/29/2022] [Indexed: 11/08/2022]
Abstract
Primary blast injury is caused by the direct impact of an overpressurization wave on the body. Due to limitations of current models, we have developed a novel approach to study primary blast-induced traumatic brain injury. Specifically, we employ a bioengineered 3D brain-like human tissue culture system composed of collagen-infused silk protein donut-like hydrogels embedded with human IPSC-derived neurons, human astrocytes, and a human microglial cell line. We have utilized this system within an advanced blast simulator (ABS) to expose the 3D brain cultures to a blast wave that can be precisely controlled. These 3D cultures are enclosed in a 3D-printed surrogate skull-like material containing media which are then placed in a holder apparatus inside the ABS. This allows for exposure to the blast wave alone without any secondary injury occurring. We show that blast induces an increase in lactate dehydrogenase activity and glutamate release from the cultures, indicating cellular injury. Additionally, we observe a significant increase in axonal varicosities after blast. These varicosities can be stained with antibodies recognizing amyloid precursor protein. The presence of amyloid precursor protein deposits may indicate a blast-induced axonal transport deficit. After blast injury, we find a transient release of the known TBI biomarkers, UCHL1 and NF-H at 6 h and a delayed increase in S100B at 24 and 48 h. This in vitro model will enable us to gain a better understanding of clinically relevant pathological changes that occur following primary blast and can also be utilized for discovery and characterization of biomarkers.
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Affiliation(s)
- Dustin M Snapper
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University, Bethesda, Maryland, USA
| | - Bianca Reginauld
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University, Bethesda, Maryland, USA
| | - Volha Liaudanskaya
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - Vincent Fitzpatrick
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - Yeonho Kim
- Preclinical Behavior and Modeling Core, Uniformed Services University, Bethesda, Maryland, USA
| | - Irene Georgakoudi
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - Aviva J Symes
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University, Bethesda, Maryland, USA
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17
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Role of integrin and its potential as a novel postmortem biomarker in traumatic axonal injury. Int J Legal Med 2022; 137:843-849. [PMID: 36562807 DOI: 10.1007/s00414-022-02938-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Traumatic axonal injury (TAI) accounts for a large proportion of the mortality of traumatic brain injury (TBI). The diagnosis of TAI is currently of limited use for medicolegal purposes. It is known that axons in TAI are diffusely damaged by secondary processes other than direct head injury. However, the physiopathological mechanism of TAI is still elusive. The present study used RGD peptide, an antagonist of the mechanotransduction protein integrin, to explore the role of integrin-transmitted mechanical signalling in the pathogenesis of rat TAI. The rats were subjected to a linearly accelerating load, and changes in beta-amyloid precursor protein (β-APP) expression, skeleton ultrastructure, skeleton protein neurofilament light (NF-L), and α-tubulin in the brainstem were observed, indicating that RGD could relieve the severity of axonal injury in TAI rats. In addition, the expression of β-integrin was stronger and centralized in the brainstem of the deceased died from TAI compared to other nonviolent causes. This study examined the pathophysiology and biomechanics of TAI and assessed the role of integrin in the injury of microtubules and neurofilaments in TAI. Thus, we propose that integrin-mediated cytoskeletal injury plays an important role in TAI and that integrin has the potential as a biomarker for TAI.
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18
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Pan X, Li J, Li W, Wang H, Durisic N, Li Z, Feng Y, Liu Y, Zhao CX, Wang T. Axons-on-a-chip for mimicking non-disruptive diffuse axonal injury underlying traumatic brain injury. LAB ON A CHIP 2022; 22:4541-4555. [PMID: 36318066 DOI: 10.1039/d2lc00730d] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Diffuse axonal injury (DAI) is the most severe pathological feature of traumatic brain injury (TBI). However, how primary axonal injury is induced by transient mechanical impacts remains unknown, mainly due to the low temporal and spatial resolution of medical imaging approaches. Here we established an axon-on-a-chip (AoC) model for mimicking DAI and monitoring instant cellular responses. Integrating computational fluid dynamics and microfluidic techniques, DAI was induced by injecting a precisely controlled micro-flux in the transverse direction. The clear correlation between the flow speed of injecting flux and the severity of DAI was elucidated. We next used the AoC to investigate the instant intracellular responses underlying DAI and found that the dynamic formation of focal axonal swellings (FAS) accompanied by Ca2+ surge occurs during the flux. Surprisingly, periodic axonal cytoskeleton disruption also occurs rapidly after the flux. These instant injury responses are spatially restricted to the fluxed axon, not affecting the overall viability of the neuron in the acute stage. Compatible with high-resolution live microscopy, the AoC provides a versatile system to identify early mechanisms underlying DAI, offering a platform for screening effective treatments to alleviate TBI.
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Affiliation(s)
- Xiaorong Pan
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
| | - Jie Li
- Division of Chemistry and Physical Biology, School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Wei Li
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Haofei Wang
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Nela Durisic
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Zhenyu Li
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
| | - Yu Feng
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
| | - Yifan Liu
- Division of Chemistry and Physical Biology, School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Chun-Xia Zhao
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Chemical Engineering and Advanced Materials, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Tong Wang
- The Brain Center, School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
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19
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Abdullah AN, Ahmad AH, Zakaria R, Tamam S, Abd Hamid AI, Chai WJ, Omar H, Abdul Rahman MR, Fitzrol DN, Idris Z, Ghani ARI, Wan Mohamad WNA, Mustafar F, Hanafi MH, Reza MF, Umar H, Mohd Zulkifly MF, Ang SY, Zakaria Z, Musa KI, Othman A, Embong Z, Sapiai NA, Kandasamy R, Ibrahim H, Abdullah MZ, Amaruchkul K, Valdes-Sosa PA, Bringas Vega ML, Biswal B, Songsiri J, Yaacob HS, Sumari P, Noh NA, Azman A, Jamir Singh PS, Abdullah JM. Disruption of white matter integrity and its relationship with cognitive function in non-severe traumatic brain injury. Front Neurol 2022; 13:1011304. [PMID: 36303559 PMCID: PMC9592834 DOI: 10.3389/fneur.2022.1011304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background Impairment in cognitive function is a recognized outcome of traumatic brain injury (TBI). However, the degree of impairment has variable relationship with TBI severity and time post injury. The underlying pathology is often due to diffuse axonal injury that has been found even in mild TBI. In this study, we examine the state of white matter putative connectivity in patients with non-severe TBI in the subacute phase, i.e., within 10 weeks of injury and determine its relationship with neuropsychological scores. Methods We conducted a case-control prospective study involving 11 male adult patients with non-severe TBI and an age-matched control group of 11 adult male volunteers. Diffusion MRI scanning and neuropsychological tests were administered within 10 weeks post injury. The difference in fractional anisotropy (FA) values between the patient and control groups was examined using tract-based spatial statistics. The FA values that were significantly different between patients and controls were then correlated with neuropsychological tests in the patient group. Results Several clusters with peak voxels of significant FA reductions (p < 0.05) in the white matter skeleton were seen in patients compared to the control group. These clusters were located in the superior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, and cingulum, as well as white matter fibers in the area of genu of corpus callosum, anterior corona radiata, superior corona radiata, anterior thalamic radiation and part of inferior frontal gyrus. Mean global FA magnitude correlated significantly with MAVLT immediate recall scores while matrix reasoning scores correlated positively with FA values in the area of right superior fronto-occipital fasciculus and left anterior corona radiata. Conclusion The non-severe TBI patients had abnormally reduced FA values in multiple regions compared to controls that correlated with several measures of executive function during the sub-acute phase of TBI.
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Affiliation(s)
- Aimi Nadhiah Abdullah
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Asma Hayati Ahmad
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- *Correspondence: Asma Hayati Ahmad
| | - Rahimah Zakaria
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Sofina Tamam
- Faculty of Science and Technology, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Aini Ismafairus Abd Hamid
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wen Jia Chai
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hazim Omar
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Riddha Abdul Rahman
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Diana Noma Fitzrol
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zamzuri Idris
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Abdul Rahman Izaini Ghani
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wan Nor Azlen Wan Mohamad
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Faiz Mustafar
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Hafiz Hanafi
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohamed Faruque Reza
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hafidah Umar
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohd Faizal Mohd Zulkifly
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Song Yee Ang
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zaitun Zakaria
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azizah Othman
- Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zunaina Embong
- Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nur Asma Sapiai
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | | | - Haidi Ibrahim
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Mohd Zaid Abdullah
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Kannapha Amaruchkul
- Graduate School of Applied Statistics, National Institute of Development Administration (NIDA), Bangkok, Thailand
| | - Pedro Antonio Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- The Cuban Neurosciences Center, La Habana, Cuba
| | - Maria Luisa Bringas Vega
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- The Cuban Neurosciences Center, La Habana, Cuba
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Jitkomut Songsiri
- EE410 Control Systems Laboratory, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Hamwira Sakti Yaacob
- Department of Computer Science, Kulliyah of Information and Communication Technology, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Putra Sumari
- School of Computer Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Nor Azila Noh
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Azlinda Azman
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Jafri Malin Abdullah
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
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20
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Hasan F, Mahmud KAHA, Khan MI, Adnan A. Viscoelastic damage evaluation of the axon. Front Bioeng Biotechnol 2022; 10:904818. [PMID: 36277388 PMCID: PMC9583024 DOI: 10.3389/fbioe.2022.904818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
In this manuscript, we have studied the microstructure of the axonal cytoskeleton and adopted a bottom-up approach to evaluate the mechanical responses of axons. The cytoskeleton of the axon includes the microtubules (MT), Tau proteins (Tau), neurofilaments (NF), and microfilaments (MF). Although most of the rigidity of the axons is due to the MT, the viscoelastic response of axons comes from the Tau. Early studies have shown that NF and MF do not provide significant elasticity to the overall response of axons. Therefore, the most critical aspect of the mechanical response of axons is the microstructural topology of how MT and Tau are connected and construct the cross-linked network. Using a scanning electron microscope (SEM), the cross-sectional view of the axons revealed that the MTs are organized in a hexagonal array and cross-linked by Tau. Therefore, we have developed a hexagonal Representative Volume Element (RVE) of the axonal microstructure with MT and Tau as fibers. The matrix of the RVE is modeled by considering a combined effect of NF and MF. A parametric study is done by varying fiber geometric and mechanical properties. The Young’s modulus and spacing of MT are varied between 1.5 and 1.9 GPa and 20–38 nm, respectively. Tau is modeled as a 3-parameter General Maxwell viscoelastic material. The failure strains for MT and Tau are taken to be 50 and 40%, respectively. A total of 4 RVEs are prepared for finite element analysis, and six loading cases are inspected to quantify the three-dimensional (3D) viscoelastic relaxation response. The volume-averaged stress and strain are then used to fit the relaxation Prony series. Next, we imposed varying strain rates (between 10/sec to 50/sec) on the RVE and analyzed the axonal failure process. We have observed that the 40% failure strain of Tau is achieved in all strain rates before the MT reaches its failure strain of 50%. The corresponding axonal failure strain and stress vary between 6 and 11% and 5–19.8 MPa, respectively. This study can be used to model macroscale axonal aggregate typical of the white matter region of the brain tissue.
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Affiliation(s)
- Fuad Hasan
- Department of Mechanical and Aerospace Engineering, The University of Texas at Arlington, Arlington, TX, United States
| | - KAH Al Mahmud
- Department of Mechanical and Aerospace Engineering, The University of Texas at Arlington, Arlington, TX, United States
| | - Md. Ishak Khan
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ashfaq Adnan
- Department of Mechanical and Aerospace Engineering, The University of Texas at Arlington, Arlington, TX, United States
- *Correspondence: Ashfaq Adnan,
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21
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Song H, Chen C, Kelley B, Tomasevich A, Lee H, Dolle JP, Cheng J, Garcia B, Meaney DF, Smith DH. Traumatic brain injury recapitulates developmental changes of axons. Prog Neurobiol 2022; 217:102332. [PMID: 35870679 PMCID: PMC9454890 DOI: 10.1016/j.pneurobio.2022.102332] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022]
Abstract
During development, half of brain white matter axons are maintained for growth, while the remainder undergo developmental axon degeneration. After traumatic brain injury (TBI), injured axons also appear to follow pathways leading to either degeneration or repair. These observations raise the intriguing, but unexamined possibility that TBI recapitulates developmental axonal programs. Here, we examined axonal changes in the developing brain in young rats and after TBI in adult rat. Multiple shared changes in axonal microtubule (MT) through tubulin post-translational modifications and MT associated proteins (MAPs), tau and MAP6, were found in both development and TBI. Specifically, degenerating axons in both development and TBI underwent phosphorylation of tau and excessive tubulin tyrosination, suggesting MT instability and depolyermization. Conversely, nearby axons without degenerating morphologies, had increased MAP6 expression and maintenance of tubulin acetylation, suggesting enhanced MT stabilization, thereby supporting survival or repair. Quantitative proteomics revealed similar signaling pathways of axon degeneration and growth/repair, including protein clusters and networks. This comparison approach demonstrates how focused evaluation of developmental processes may provide insight into pathways initiated by TBI. In particular, the data suggest that TBI may reawaken dormant axonal programs that direct axons towards either degeneration or growth/repair, supporting further study in this area.
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Affiliation(s)
- Hailong Song
- Department of Neurosurgery, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Chen Chen
- Department of Computer Sciences, University of Missouri, Columbia, MO 65211, United States
| | - Brian Kelley
- Department of Neurosurgery, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Alexandra Tomasevich
- Department of Neurosurgery, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Hyoungjoo Lee
- Department of Biochemistry and Biophysics, Quantitative Proteomics Resource Core, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Jean-Pierre Dolle
- Department of Neurosurgery, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Jianlin Cheng
- Department of Computer Sciences, University of Missouri, Columbia, MO 65211, United States
| | - Benjamin Garcia
- Department of Biochemistry and Biophysics, Quantitative Proteomics Resource Core, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - David F Meaney
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Douglas H Smith
- Department of Neurosurgery, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA 19104, United States.
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22
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Effect of orbital volume in unilateral orbital fracture on indirect traumatic optic neuropathy. Int Ophthalmol 2022; 43:1121-1126. [PMID: 36153431 DOI: 10.1007/s10792-022-02509-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/03/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE This retrospective study aimed to analyze the relationship between the volume of the fractured and the normal orbit in patients with unilateral orbital fractures with and without indirect traumatic optic neuropathy (TON). SUBJECTS Data of 25 patients with unilateral orbital fractures who underwent computer tomography between January 2016 and December 2020 were investigated. Emergency imaging was performed within 2 hours of arrival at the emergency room. The subjects were categorized into two groups: unilateral orbital fractures with and without TON. METHODS AND MEASURES The assessment of TON was performed during a comprehensive ophthalmologic examination by an ophthalmologist. The stereographic orbit was reconstructed, and the volume was calculated. Other variables examined included age, sex, and cause of orbital trauma. The variables were compared using paired t-tests. Statistical significance was set at p < 0.05. RESULTS The orbital volume of the non-fractured orbit was 27.50 ± 2.26 and 27.48 ± 2.64 cm3 in the groups with and without TON, respectively. The average volume of the fractured orbit in the TON group was 27.78 ± 2.56 cm3, and there was no significant volumetric difference between the fractured and non-fractured sides in this group. However, the average volume of the fractured orbit without TON was 28.76 ± 3.18 cm3, larger than that of the non-fractured orbit (p = 0.016). CONCLUSIONS Non-expansion of the fractured orbit was a risk factor for indirect TON in patients with unilateral orbital fractures. Volumetric analysis from primary imaging would expedite the diagnosis and treatment of TON, resulting in optimal outcomes.
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23
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Wu T, Rifkin JA, Rayfield AC, Anderson ED, Panzer MB, Meaney DF. Concussion Prone Scenarios: A Multi-Dimensional Exploration in Impact Directions, Brain Morphology, and Network Architectures Using Computational Models. Ann Biomed Eng 2022; 50:1423-1436. [PMID: 36125606 DOI: 10.1007/s10439-022-03085-x] [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: 07/13/2022] [Accepted: 09/11/2022] [Indexed: 11/30/2022]
Abstract
While individual susceptibility to traumatic brain injury (TBI) has been speculated, past work does not provide an analysis considering how physical features of an individual's brain (e.g., brain size, shape), impact direction, and brain network features can holistically contribute to the risk of suffering a TBI from an impact. This work investigated each of these features simultaneously using computational modeling and analyses of simulated functional connectivity. Unlike the past studies that assess the severity of TBI based on the quantification of brain tissue damage (e.g., principal strain), we approached the brain as a complex network in which neuronal oscillations orchestrate to produce normal brain function (estimated by functional connectivity) and, to this end, both the anatomical damage location and its topological characteristics within the brain network contribute to the severity of brain function disruption and injury. To represent the variations in the population, we analyzed a publicly available database of brain imaging data and selected five distinct network architectures, seven different brain sizes, and three uniaxial head rotational conditions to study the consequences of 74 virtual impact scenarios. Results show impact direction produces the most significant change in connections across brain areas (structural connectome) and the functional coupling of activity across these brain areas (functional connectivity). Axial rotations were more injurious than those with sagittal and coronal rotations when the head kinematics were the same for each condition. When the impact direction was held constant, brain network architecture showed a significantly different vulnerability across axial and sagittal, but not coronal rotations. As expected, brain size significantly affected the expected change in structural and functional connectivity after impact. Together, these results provided groupings of predicted vulnerability to impact-a subgroup of male brain architectures exposed to axial impacts were most vulnerable, while a subgroup of female brain architectures was the most tolerant to the sagittal impacts studied. These findings lay essential groundwork for subject-specific analyses of concussion and provide invaluable guidance for designing personalized protection equipment.
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Affiliation(s)
- Taotao Wu
- Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 S 33rd St, Philadelphia, PA, 19104, USA
| | - Jared A Rifkin
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
| | - Adam C Rayfield
- Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 S 33rd St, Philadelphia, PA, 19104, USA
| | - Erin D Anderson
- Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 S 33rd St, Philadelphia, PA, 19104, USA
| | - Matthew B Panzer
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA.,Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - David F Meaney
- Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 S 33rd St, Philadelphia, PA, 19104, USA. .,Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
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24
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Lindsey A, Ellison RL, Herrold AA, Aaronson AL, Kletzel SL, Stika MM, Guernon A, Bender Pape T. rTMS/iTBS and Cognitive Rehabilitation for Deficits Associated With TBI and PTSD: A Theoretical Framework and Review. J Neuropsychiatry Clin Neurosci 2022; 35:28-38. [PMID: 35872613 DOI: 10.1176/appi.neuropsych.21090227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Rehabilitation of cognitive and psychosocial deficits resulting from traumatic brain injury (TBI) continues to be an area of concern in health care. Commonly co-occurring psychiatric disorders, such as major depressive disorder and posttraumatic stress disorder, create additional hurdles when attempting to remediate cognitive sequelae. There is increased need for procedures that will yield consistent gains indicative of recovery of function. Intermittent theta-burst stimulation (iTBS), a form of repetitive transcranial magnetic stimulation, has potential as an instrument that can be tailored to aid cognitive processes and support functional gains. The use of iTBS enables direct stimulation of desired neural systems. iTBS, performed in conjunction with behavioral interventions (e.g., cognitive rehabilitation, psychotherapy), may result in additive success in facilitating cognitive restoration and adaptation. The purpose of this theoretical review is to illustrate how the technical and physiological aspects of iTBS may enhance other forms of neurorehabilitation for individuals with TBI. Future research on combinatorial iTBS interventions has the potential to translate to other complex neuropsychiatric conditions.
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Affiliation(s)
- André Lindsey
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Rachael L Ellison
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Amy A Herrold
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Alexandra L Aaronson
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Sandra L Kletzel
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Monica M Stika
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Ann Guernon
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
| | - Theresa Bender Pape
- Research Service (Lindsey, Ellison, Herrold, Kletzel, Guernon, Pape), Center for Innovation for Complex Chronic Healthcare (Herrold, aronson, Kletzel, Pape), and Spinal Cord Injury/Disorder Service (Stika), Edward Hines, Jr., Veterans Affairs (VA) Hospital, Hines, IL; School of Education, Nevada State College, Henderson (Lindsey); Department of Psychology, Illinois Institute of Technology, Chicago (Ellison); Departments of Psychiatry and Behavioral Medicine (Herrold, Aaronson) and Physical Medicine and Rehabilitation (Pape), Feinberg School of Medicine, Northwestern University, Chicago; Speech-Language Pathology Program, College of Nursing and Health Sciences, Lewis University, Romeoville, IL (Guernon)
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25
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Head Impact Kinematics and Brain Deformation in Paired Opposing Youth Football Players. J Appl Biomech 2022; 38:136-147. [PMID: 35483702 DOI: 10.1123/jab.2021-0098] [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: 03/18/2021] [Revised: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022]
Abstract
Head impact exposure is often quantified using peak resultant kinematics. While kinematics describes the inertial response of the brain to impact, they do not fully capture the dynamic brain response. Strain, a measure of the tissue-level response of the brain, may be a better predictor of injury. In this study, kinematic and strain metrics were compared to contact characteristics in youth football. Players on 2 opposing teams were instrumented with head impact sensors to record impact kinematics. Video was collected to identify contact scenarios involving opposing instrumented players (ie, paired contact scenarios) and code contact characteristics (eg, player role, impact location). A previously validated, high-resolution brain finite element model, the atlas-based brain model, was used to simulate head impacts and calculate strain metrics. Fifty-two paired contact scenarios (n = 105 impacts) were evaluated. Lighter players tended to have greater biomechanical metrics compared to heavier players. Impacts to the top of the helmet were associated with lower strain metrics. Overall, strain was better correlated with rotational kinematics, suggesting these metrics may be better predictors of the tissue-level brain response than linear kinematics. Understanding the effect of contact characteristics on brain strain will inform future efforts to improve sport safety.
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Buccino AP, Yuan X, Emmenegger V, Xue X, Gänswein T, Hierlemann A. An automated method for precise axon reconstruction from recordings of high-density micro-electrode arrays. J Neural Eng 2022; 19. [PMID: 35234667 PMCID: PMC7612575 DOI: 10.1088/1741-2552/ac59a2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022]
Abstract
Objective Neurons communicate with each other by sending action potentials through their axons. The velocity of axonal signal propagation describes how fast electrical action potentials can travel. This velocity can be affected in a human brain by several pathologies, including multiple sclerosis, traumatic brain injury and channelopathies. High-density microelectrode arrays (HD-MEAs) provide unprecedented spatio-temporal resolution to extracellularly record neural electrical activity. The high density of the recording electrodes enables to image the activity of individual neurons down to subcellular resolution, which includes the propagation of axonal signals. However, axon reconstruction, to date, mainly relies on manual approaches to select the electrodes and channels that seemingly record the signals along a specific axon, while an automated approach to track multiple axonal branches in extracellular action-potential recordings is still missing. Approach In this article, we propose a fully automated approach to reconstruct axons from extracellular electrical-potential landscapes, so-called “electrical footprints” of neurons. After an initial electrode and channel selection, the proposed method first constructs a graph based on the voltage signal amplitudes and latencies. Then, the graph is interrogated to extract possible axonal branches. Finally, the axonal branches are pruned, and axonal action-potential propagation velocities are computed. Main results We first validate our method using simulated data from detailed reconstructions of neurons, showing that our approach is capable of accurately reconstructing axonal branches. We then apply the reconstruction algorithm to experimental recordings of HD-MEAs and show that it can be used to determine axonal morphologies and signal-propagation velocities at high throughput. Significance We introduce a fully automated method to reconstruct axonal branches and estimate axonal action-potential propagation velocities using HD-MEA recordings. Our method yields highly reliable and reproducible velocity estimations, which constitute an important electrophysiological feature of neuronal preparations.
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Affiliation(s)
| | - Xinyue Yuan
- D-BSSE, ETH Zürich, Basel, Zurich, 8092, SWITZERLAND
| | | | - Xiaohan Xue
- D-BSSE, ETH Zürich, Basel, Zurich, 8092, SWITZERLAND
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An interdisciplinary computational model for predicting traumatic brain injury: Linking biomechanics and functional neural networks. Neuroimage 2022; 251:119002. [PMID: 35176490 DOI: 10.1016/j.neuroimage.2022.119002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 01/19/2022] [Accepted: 02/12/2022] [Indexed: 11/22/2022] Open
Abstract
The brain is a complex network consisting of neuron cell bodies in the gray matter and their axonal projections, forming the white matter tracts. These neurons are supported by an equally complex vascular network as well as glial cells. Traumatic brain injury (TBI) can lead to the disruption of the structural and functional brain networks due to disruption of both neuronal cell bodies in the gray matter as well as their projections and supporting cells. To explore how an impact can alter the function of brain networks, we integrated a finite element (FE) brain mechanics model with linked models of brain dynamics (Kuramoto oscillator) and vascular perfusion (Balloon-Windkessel) in this study. We used empirical resting-state functional magnetic resonance imaging (MRI) data to optimize the fit of our brain dynamics and perfusion models to clinical data. Results from the FE model were used to mimic injury in these optimized brain dynamics models: injury to the nodes (gray matter) led to a decrease in the nodal oscillation frequency, while damage to the edges (axonal connections/white matter) progressively decreased coupling among connected nodes. A total of 53 cases, including 33 non-injurious and 20 concussive head impacts experienced by professional American football players were simulated using this integrated model. We examined the correlation of injury outcomes with global measures of structural connectivity, neural dynamics, and functional connectivity of the brain networks when using different lesion methods. Results show that injurious head impacts cause significant alterations in global network topology regardless of lesion methods. Changes between the disrupted and healthy functional connectivity (measured by Pearson correlation) consistently correlated well with injury outcomes (AUC≥0.75), although the predictive performance is not significantly different (p>0.05) to that of traditional kinematic measures (angular acceleration). Intriguingly, our lesion model for gray matter damage predicted increases in global efficiency and clustering coefficient with increases in injury risk, while disrupting axonal connections led to lower network efficiency and clustering. When both injury mechanisms were combined into a single injury prediction model, the injury prediction performance depended on the thresholds used to determine neurodegeneration and mechanical tolerance for axonal injury. Together, these results point towards complex effects of mechanical trauma to the brain and provide a new framework for understanding brain injury at a causal mechanistic level and developing more effective diagnostic methods and therapeutic interventions.
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Stitt D, Kabaliuk N, Alexander K, Draper N. Potential of Soft-Shell Rugby Headgear to Mitigate Linear and Rotational Peak Accelerations. Ann Biomed Eng 2022; 50:1546-1564. [DOI: 10.1007/s10439-022-02912-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/01/2022] [Indexed: 11/30/2022]
Abstract
AbstractRugby union is a popular sport played across the world. The physical contact inherent in the game means that players are at increased risk of concussive injury. In 2019, World Rugby created a new category of permitted headgear under Law 4 as a medical device. This established a pathway for headgear designed to reduce peak accelerations to be worn in matches. Investigations of the potential of soft-shelled protective headgear to reduce head impact accelerations have been mostly limited to the analysis of linear kinematics. However rotational head impact accelerations have long been implicated as far more injurious. The aim of this study, therefore, was to assess the linear and rotational acceleration reduction brought about by soft-shelled rugby headgear. A Hybrid III headform and neck were dropped onto a modular elastomer programmer impact surface, impacting at four different velocities (1.7–3.4 m/s) in five different impact orientations. Impact surface angles were 0°, 30°, and 45°. Peak linear and rotational accelerations, PLA and PRA respectively, were recorded. All headgear significantly reduced PLAs and PRAs when compared to a no headgear scenario. The new generation, headgear reduced all measures significantly more than the older generation of headgear. Impact locations offset from the center of mass of the headform resulted in the highest PRAs measured. As the impact surface angle increased, both PLAs and PRAs decreased. The study demonstrated that headgear tested lowered PLAs by up to 50%, and PRAs by up to 60% compared to the bare headform. Our data suggest that new generation headgear could make a difference on the field in reducing injurious impact accelerations in a collision.
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Abdelrahman HAF, Ubukata S, Ueda K, Fujimoto G, Oishi N, Aso T, Murai T. Combining Multiple Indices of Diffusion Tensor Imaging Can Better Differentiate Patients with Traumatic Brain Injury from Healthy Subjects. Neuropsychiatr Dis Treat 2022; 18:1801-1814. [PMID: 36039160 PMCID: PMC9419894 DOI: 10.2147/ndt.s354265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
AIM Diffuse axonal injury (DAI) is one of the most common pathological features of traumatic brain injury (TBI). Diffusion tensor imaging (DTI) indices can be used to identify and quantify white matter microstructural changes following DAI. Recently, many studies have used DTI with various machine learning approaches to predict white matter microstructural changes following TBI. The current study sought to examine whether our classification approach using multiple DTI indices in conjunction with machine learning is a useful tool for diagnosing/classifying TBI patients and healthy controls. METHODS Participants were adult patients with chronic TBI (n = 26) with DAI pathology, and age- and sex-matched healthy controls (n = 26). DTI images were obtained from all participants. Tract-based spatial statistics analyses were applied to DTI images. Classification models were built using principal component analysis and support vector machines. Receiver operator characteristic curve analysis and area under the curve were used to assess the classification performance of the different classifiers. RESULTS Tract-based spatial statistics revealed significantly decreased fractional anisotropy, as well as increased mean diffusivity, axial diffusivity, and radial diffusivity in patients with TBI compared with healthy controls (all p-values < 0.01). The principal component analysis and support vector machine-based machine learning classification using combined DTI indices classified patients with TBI and healthy controls with an accuracy of 90.5% with an area under the curve of 93 ± 0.09. CONCLUSION These results highlight the potential of our approach combining multiple DTI measures to identify patients with TBI.
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Affiliation(s)
| | - Shiho Ubukata
- Kyoto University Graduate School of Medicine-Medical Innovation Center, Kyoto, 606-8507, Japan
| | - Keita Ueda
- Kyoto University Graduate School of Medicine-Department of Psychiatry, Kyoto, 606-8507, Japan
| | - Gaku Fujimoto
- Kyoto University Graduate School of Medicine-Department of Psychiatry, Kyoto, 606-8507, Japan
| | - Naoya Oishi
- Kyoto University Graduate School of Medicine-Medical Innovation Center, Kyoto, 606-8507, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Kobe, 650-0047, Japan
| | - Toshiya Murai
- Kyoto University Graduate School of Medicine-Department of Psychiatry, Kyoto, 606-8507, Japan
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Mitoquinone supplementation alleviates oxidative stress and pathologic outcomes following repetitive mild traumatic brain injury at a chronic time point. Exp Neurol 2022; 351:113987. [DOI: 10.1016/j.expneurol.2022.113987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/23/2021] [Accepted: 01/13/2022] [Indexed: 11/17/2022]
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Korn P, Gellrich NC, Spalthoff S, Jehn P, Eysel UT, Zerfowski M. Evaluation of the neuroprotective effects of methylprednisolone and surgical decompression in a rodent model of traumatic optic neuropathy. Curr Eye Res 2021; 47:461-467. [PMID: 34696640 DOI: 10.1080/02713683.2021.1998544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF THE STUDY Traumatic optic neuropathy (TON) is a rare but serious consequence of head injuries. The optimal therapy for TON remains controversial, and standardized recommendations are lacking. The most common therapies used are steroid administration and surgical decompression procedures. The aim of the present study was to compare two common conservative and surgical therapies in a rodent model with a standardized traumatic optic nerve lesion. MATERIALS AND METHODS This study employed 59 male Wistar rats. After exposing the optic nerve, defined trauma was exerted on the optic nerve using a micromanipulator to trigger TON. Rats received either "megadose" methylprednisolone applied perioperatively or decompression via nerve sheath fenestration. The number of neurons was histologically evaluated in retinae explanted as whole mounts. Neuronal size was determined histomorphometrically. RESULTS Neuronal loss was significantly lower following perioperative "megadose" steroid therapy (p = 0.017), especially in the central retinal area (p = 0.025). Compared to the control group without therapy, on average more than 400 neurons/mm2 were saved. In the central retinal area, more than 600 neurons/mm2 were rescued. In contrast, neuronal loss was not significantly affected by surgical decompression; however, this procedure was associated with a reduction in neuron size (p = 0.003). CONCLUSIONS The present model revealed significant neuroprotective effects following administration of methylprednisolone for TON treatment. Mitigation of neuronal loss may result in functional benefits. Neuroprotective effects were not observed following surgical therapy, suggesting that this approach should be reserved for individual cases such as hematomas in the area of nerve envelopes.
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Affiliation(s)
- Philippe Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Ulf T Eysel
- Department of Neurophysiology, Ruhr University, Bochum, Germany
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Zhou Z, Li X, Liu Y, Fahlstedt M, Georgiadis M, Zhan X, Raymond SJ, Grant G, Kleiven S, Camarillo D, Zeineh M. Toward a Comprehensive Delineation of White Matter Tract-Related Deformation. J Neurotrauma 2021; 38:3260-3278. [PMID: 34617451 DOI: 10.1089/neu.2021.0195] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Finite element (FE) models of the human head are valuable instruments to explore the mechanobiological pathway from external loading, localized brain response, and resultant injury risks. The injury predictability of these models depends on the use of effective criteria as injury predictors. The FE-derived normal deformation along white matter (WM) fiber tracts (i.e., tract-oriented strain) recently has been suggested as an appropriate predictor for axonal injury. However, the tract-oriented strain only represents a partial depiction of the WM fiber tract deformation. A comprehensive delineation of tract-related deformation may improve the injury predictability of the FE head model by delivering new tract-related criteria as injury predictors. Thus, the present study performed a theoretical strain analysis to comprehensively characterize the WM fiber tract deformation by relating the strain tensor of the WM element to its embedded fiber tract. Three new tract-related strains with exact analytical solutions were proposed, measuring the normal deformation perpendicular to the fiber tracts (i.e., tract-perpendicular strain), and shear deformation along and perpendicular to the fiber tracts (i.e., axial-shear strain and lateral-shear strain, respectively). The injury predictability of these three newly proposed strain peaks along with the previously used tract-oriented strain peak and maximum principal strain (MPS) were evaluated by simulating 151 impacts with known outcome (concussion or non-concussion). The results preliminarily showed that four tract-related strain peaks exhibited superior performance than MPS in discriminating concussion and non-concussion cases. This study presents a comprehensive quantification of WM tract-related deformation and advocates the use of orientation-dependent strains as criteria for injury prediction, which may ultimately contribute to an advanced mechanobiological understanding and enhanced computational predictability of brain injury.
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Affiliation(s)
- Zhou Zhou
- Department of Bioengineering, Stanford University, Stanford, California, USA.,Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Xiaogai Li
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Yuzhe Liu
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Madelen Fahlstedt
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Marios Georgiadis
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Xianghao Zhan
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Samuel J Raymond
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Gerald Grant
- Department of Neurosurgery, Stanford University, Stanford, California, USA.,Department of Neurology, Stanford University, Stanford, California, USA
| | - Svein Kleiven
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - David Camarillo
- Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Neurology, Stanford University, Stanford, California, USA.,Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Michael Zeineh
- Department of Radiology, Stanford University, Stanford, California, USA
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Wu YH, Rosset S, Lee TR, Dragunow M, Park T, Shim V. In Vitro Models of Traumatic Brain Injury: A Systematic Review. J Neurotrauma 2021; 38:2336-2372. [PMID: 33563092 DOI: 10.1089/neu.2020.7402] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Traumatic brain injury (TBI) is a major public health challenge that is also the third leading cause of death worldwide. It is also the leading cause of long-term disability in children and young adults worldwide. Despite a large body of research using predominantly in vivo and in vitro rodent models of brain injury, there is no medication that can reduce brain damage or promote brain repair mainly due to our lack of understanding in the mechanisms and pathophysiology of the TBI. The aim of this review is to examine in vitro TBI studies conducted from 2008-2018 to better understand the TBI in vitro model available in the literature. Specifically, our focus was to perform a detailed analysis of the in vitro experimental protocols used and their subsequent biological findings. Our review showed that the uniaxial stretch is the most frequently used way of load application, accounting for more than two-thirds of the studies reviewed. The rate and magnitude of the loading were varied significantly from study to study but can generally be categorized into mild, moderate, and severe injuries. The in vitro studies reviewed here examined key processes in TBI pathophysiology such as membrane disruptions leading to ionic dysregulation, inflammation, and the subsequent damages to the microtubules and axons, as well as cell death. Overall, the studies examined in this review contributed to the betterment of our understanding of TBI as a disease process. Yet, our review also revealed the areas where more work needs to be done such as: 1) diversification of load application methods that will include complex loading that mimics in vivo head impacts; 2) more widespread use of human brain cells, especially patient-matched human cells in the experimental set-up; and 3) need for building a more high-throughput system to be able to discover effective therapeutic targets for TBI.
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Affiliation(s)
- Yi-Han Wu
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Center for Brain Research, The University of Auckland, Auckland, New Zealand
| | - Samuel Rosset
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Tae-Rin Lee
- Advanced Institute of Convergence Technology, Seoul National University, Seoul, Korea
| | - Mike Dragunow
- Center for Brain Research, The University of Auckland, Auckland, New Zealand
- Department of Pharmacology, The University of Auckland, Auckland, New Zealand
| | - Thomas Park
- Center for Brain Research, The University of Auckland, Auckland, New Zealand
- Department of Pharmacology, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
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Smith DH, Kochanek PM, Rosi S, Meyer R, Ferland-Beckham C, Prager EM, Ahlers ST, Crawford F. Roadmap for Advancing Pre-Clinical Science in Traumatic Brain Injury. J Neurotrauma 2021; 38:3204-3221. [PMID: 34210174 PMCID: PMC8820284 DOI: 10.1089/neu.2021.0094] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Pre-clinical models of disease have long played important roles in the advancement of new treatments. However, in traumatic brain injury (TBI), despite the availability of numerous model systems, translation from bench to bedside remains elusive. Integrating clinical relevance into pre-clinical model development is a critical step toward advancing therapies for TBI patients across the spectrum of injury severity. Pre-clinical models include in vivo and ex vivo animal work-both small and large-and in vitro modeling. The wide range of pre-clinical models reflect substantial attempts to replicate multiple aspects of TBI sequelae in humans. Although these models reveal multiple putative mechanisms underlying TBI pathophysiology, failures to translate these findings into successful clinical trials call into question the clinical relevance and applicability of the models. Here, we address the promises and pitfalls of pre-clinical models with the goal of evolving frameworks that will advance translational TBI research across models, injury types, and the heterogenous etiology of pathology.
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Affiliation(s)
- Douglas H Smith
- Center for Brain Injury and Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Patrick M Kochanek
- Department of Critical Care Medicine; Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh of UPMC, Rangos Research Center, Pittsburgh, Pennsylvania, USA
| | - Susanna Rosi
- Departments of Physical Therapy Rehabilitation Science, Neurological Surgery, Weill Institute for Neuroscience, University of California San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Retsina Meyer
- Cohen Veterans Bioscience, New York, New York, USA.,Delix Therapeutics, Inc, Boston, Massachusetts, USA
| | | | | | - Stephen T Ahlers
- Department of Neurotrauma, Operational and Undersea Medicine Directorate Naval Medical Research Center, Silver Spring, Maryland, USA
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Fourier Transform Infrared Imaging-A Novel Approach to Monitor Bio Molecular Changes in Subacute Mild Traumatic Brain Injury. Brain Sci 2021; 11:brainsci11070918. [PMID: 34356152 PMCID: PMC8307811 DOI: 10.3390/brainsci11070918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022] Open
Abstract
Traumatic brain injury (TBI) can be defined as a disorder in the function of the brain after a bump, blow, or jolt to the head, or penetrating head injury. Mild traumatic brain injury (mTBI) can cause devastating effects, such as the initiation of long-term neurodegeneration in brain tissue. In the current study, the effects of mTBI were investigated on rat brain regions; cortex (Co) and corpus callosum (CC) after 24 h (subacute trauma) by Fourier transform infrared (FTIR) imaging and immunohistochemistry (IHC). IHC studies showed the formation of amyloid-β (Aβ) plaques in the cortex brain region of mTBI rats. Moreover, staining of myelin basic protein presented the shearing of axons in CC region in the same group of animals. According to FTIR imaging results, total protein and lipid content significantly decreased in both Co and CC regions in mTBI group compared to the control. Due to this significant decrease in both lipid and protein content, remarkable consistency in lipid/protein band ratio in mTBI and control group, was observed. Significant decrease in methyl content and a significant increase in olefinic content were observed in Co and CC regions of mTBI rat brain tissues. Classification amongst distinguishable groups was performed using principal component analysis (PCA) and hierarchical clustering (HCA). This study established the prospective of FTIR imaging for assessing biochemical changes due to mTBI with high sensitivity, precision and high-resolution.
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Pharmacotherapy for Treatment of Cognitive and Neuropsychiatric Symptoms After mTBI. J Head Trauma Rehabil 2021; 35:76-83. [PMID: 31834058 DOI: 10.1097/htr.0000000000000537] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Cognitive and neuropsychiatric symptoms are extremely common following mild traumatic brain injury (TBI), also known as concussion. Although most patients will recovery rapidly, a significant minority go on to experience persistent symptoms. There are currently no FDA-approved medications for treatment of cognitive and neuropsychiatric problems in the context of mild TBI, yet a number of agents are prescribed "off-label" for these complaints. Rigorous trials are lacking, but there are a number of open-label studies, and some small randomized controlled trials that support the safety and possible efficacy of pharmacotherapies in this population. Clinical trials conducted in samples with more severe brain injuries can also serve as a guide. METHODS Review of the literature. RESULTS & CONCLUSIONS There is the most support in the literature for the neurostimulant methylphenidate for treatment of mild TBI-related cognitive dysfunction, and the selective serotonin reuptake inhibitor, sertraline, for the treatment of postinjury depression. There is clearly a need for more well-designed studies to guide clinicians in selecting the appropriate medication and dose. Without clear guidance from the literature, a cautious approach of starting low and titrating slowly is recommended.
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Hoursan H, Farahmand F, Ahmadian MT. Effect of axonal fiber architecture on mechanical heterogeneity of the white matter-a statistical micromechanical model. Comput Methods Biomech Biomed Engin 2021; 25:27-39. [PMID: 33998911 DOI: 10.1080/10255842.2021.1927000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A diffusion tensor imaging (DTI) -based statistical micromechanical model was developed to study the effect of axonal fiber architecture on the inter- and intra-regional mechanical heterogeneity of the white matter. Three characteristic regions within the white matter, i.e., corpus callosum, brain stem, and corona radiata, were studied considering the previous observations of locations of diffuse axonal injury. The embedded element technique was used to create a fiber-reinforced model, where the fiber was characterized by a Holzapfel hyperelastic material model with variable dispersion of axonal orientations. A relationship between the fractional anisotropy and the dispersion parameter of the hyperelastic model was used to introduce the statistical DTI data into the representative volume element. The FA-informed statistical micromechanical models of three characteristic regions of white matter were developed by deriving the corresponding probabilistic measures of FA variations. Comparison of the model predictions and experimental data indicated a good agreement, suggesting that the model could reasonably capture the inter-regional heterogeneity of white matter. Moreover, the standard deviations of experimental results correlated well with the model predictions, suggesting that the model could capture the intra-regional mechanical heterogeneity for different regions of white matter.
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Affiliation(s)
- Hesam Hoursan
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
| | - Farzam Farahmand
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
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38
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Alisafaei F, Gong Z, Johnson VE, Dollé JP, Smith DH, Shenoy VB. Mechanisms of Local Stress Amplification in Axons near the Gray-White Matter Interface. Biophys J 2021; 119:1290-1300. [PMID: 33027609 DOI: 10.1016/j.bpj.2020.08.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/11/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022] Open
Abstract
Diffuse axonal injury is a primary neuropathological feature of concussion and is thought to greatly contribute to the classical symptoms of decreased processing speed and memory dysfunction. Although previous studies have investigated the injury biomechanics at the micro- and mesoscale of concussion, few have addressed the multiscale transmission of mechanical loading at thresholds that can induce diffuse axonal injury. Because it has been recognized that axonal pathology is commonly found at anatomic interfaces across all severities of traumatic brain injury, we combined computational, analytical, and experimental approaches to investigate the potential mechanical vulnerability of axons that span the gray-white tissue interface. Our computational models predict that material heterogeneities at the gray-white interface lead to a highly nonuniform distribution of stress in axons, which was most amplified in axonal regions near the interface. This mechanism was confirmed using an analytical model of an individual fiber in a strained bimaterial interface. Comparisons of these collective data with histopathological evaluation of a swine model of concussion demonstrated a notably similar pattern of axonal damage adjacent to the gray-white interface. The results suggest that the tissue property mismatch at the gray-white matter interface places axons crossing this region at greater risk of mechanical damage during brain tissue deformation from traumatic brain injury.
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Affiliation(s)
- Farid Alisafaei
- Department of Materials Science and Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Engineering Mechanobiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ze Gong
- Department of Materials Science and Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Engineering Mechanobiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Victoria E Johnson
- Penn Center for Brain Injury and Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jean-Pierre Dollé
- Penn Center for Brain Injury and Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Douglas H Smith
- Penn Center for Brain Injury and Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Vivek B Shenoy
- Department of Materials Science and Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Engineering Mechanobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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39
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Spatial calcium kinetics after a traumatic brain injury. Biomech Model Mechanobiol 2021; 20:1413-1430. [PMID: 33772677 DOI: 10.1007/s10237-021-01453-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Accurate modelling of intracellular calcium ion ([Formula: see text]) concentration evolution is valuable as it is known to rapidly increase during a Traumatic Brain Injury. In the work presented here, our older non-spatial model dealing with the effect of mechanical stress upon the [Formula: see text] transportation in a neuron is spatialized by considering the brain tissue as a solid continuum with the [Formula: see text] activity occurring at every material point. Starting with one-dimensional representation, the brain tissue geometry is progressively made realistic and under the action of pressure or kinematic impulses, the effect of dimensionality and material behaviour on the correlation between the stress and concomitant [Formula: see text] concentration is investigated. The spatial calcium kinetics model faithfully captures the experimental observations concerning the [Formula: see text] concentration, load rate, magnitude and duration and most importantly shows that the critical location for primary injury may not be the most important location as far as secondary injury is concerned.
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Miller LE, Urban JE, Davenport EM, Powers AK, Whitlow CT, Maldjian JA, Stitzel JD. Brain Strain: Computational Model-Based Metrics for Head Impact Exposure and Injury Correlation. Ann Biomed Eng 2021; 49:1083-1096. [PMID: 33258089 PMCID: PMC10032321 DOI: 10.1007/s10439-020-02685-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/20/2020] [Indexed: 12/20/2022]
Abstract
Athletes participating in contact sports are exposed to repetitive subconcussive head impacts that may have long-term neurological consequences. To better understand these impacts and their effects, head impacts are often measured during football to characterize head impact exposure and estimate injury risk. Despite widespread use of kinematic-based metrics, it remains unclear whether any single metric derived from head kinematics is well-correlated with measurable changes in the brain. This shortcoming has motivated the increasing use of finite element (FE)-based metrics, which quantify local brain deformations. Additionally, quantifying cumulative exposure is of increased interest to examine the relationship to brain changes over time. The current study uses the atlas-based brain model (ABM) to predict the strain response to impacts sustained by 116 youth football athletes and proposes 36 new, or derivative, cumulative strain-based metrics that quantify the combined burden of head impacts over the course of a season. The strain-based metrics developed and evaluated for FE modeling and presented in the current study present potential for improved analytics over existing kinematically-based and cumulative metrics. Additionally, the findings highlight the importance of accounting for directional dependence and expand the techniques to explore spatial distribution of the strain response throughout the brain.
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Affiliation(s)
- Logan E Miller
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA.
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA.
| | - Jillian E Urban
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
| | - Elizabeth M Davenport
- Department of Radiology, Southwestern Medical School, University of Texas, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA
| | - Alexander K Powers
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- Department of Neurosurgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Christopher T Whitlow
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Joseph A Maldjian
- Department of Radiology, Southwestern Medical School, University of Texas, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
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A Systematic Literature Review on Traumatic Optic Neuropathy. J Ophthalmol 2021; 2021:5553885. [PMID: 33728056 PMCID: PMC7935564 DOI: 10.1155/2021/5553885] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 01/01/2023] Open
Abstract
Traumatic optic neuropathy (TON) is an uncommon vision-threatening disorder that can be caused by ocular or head trauma and is categorized into direct and indirect TON. The overall incidence of TON is 0.7–2.5%, and indirect TON has a higher prevalence than direct TON. Detection of an afferent pupillary defect in the presence of an intact globe in a patient with ocular or head trauma with decreased visual acuity strongly suggests TON. However, afferent pupillary defects may be difficult to detect in patients who have received narcotics that cause pupillary constriction and in those with bilateral TON. Mechanical shearing of the optic nerve axons and contusion necrosis due to immediate ischemia from damage to the optic nerve microcirculation and apoptosis of neurons is a probable mechanism. The proper management of TON is controversial. High-dose corticosteroid therapy and decompression of the optic nerve provide no additional benefit over observation alone. Intravenous erythropoietin may be a safe and efficient treatment for patients with TON.
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Zhou Z, Domel AG, Li X, Grant G, Kleiven S, Camarillo D, Zeineh M. White Matter Tract-Oriented Deformation Is Dependent on Real-Time Axonal Fiber Orientation. J Neurotrauma 2021; 38:1730-1745. [PMID: 33446060 DOI: 10.1089/neu.2020.7412] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Traumatic axonal injury (TAI) is a critical public health issue with its pathogenesis remaining largely elusive. Finite element (FE) head models are promising tools to bridge the gap between mechanical insult, localized brain response, and resultant injury. In particular, the FE-derived deformation along the direction of white matter (WM) tracts (i.e., tract-oriented strain) has been shown to be an appropriate predictor for TAI. The evolution of fiber orientation in time during the impact and its potential influence on the tract-oriented strain remains unknown, however. To address this question, the present study leveraged an embedded element approach to track real-time fiber orientation during impacts. A new scheme to calculate the tract-oriented strain was proposed by projecting the strain tensors from pre-computed simulations along the temporal fiber direction instead of its static counterpart directly obtained from diffuse tensor imaging. The results revealed that incorporating the real-time fiber orientation not only altered the direction but also amplified the magnitude of the tract-oriented strain, resulting in a generally more extended distribution and a larger volume ratio of WM exposed to high deformation along fiber tracts. These effects were exacerbated with the impact severities characterized by the acceleration magnitudes. Results of this study provide insights into how best to incorporate fiber orientation in head injury models and derive the WM tract-oriented deformation from computational simulations, which is important for furthering our understanding of the underlying mechanisms of TAI.
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Affiliation(s)
- Zhou Zhou
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - August G Domel
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Xiaogai Li
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Gerald Grant
- Department of Neurosurgery, Stanford University, Stanford, California, USA.,Department of Neurology, Stanford University, Stanford, California, USA
| | - Svein Kleiven
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - David Camarillo
- Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Neurosurgery, Stanford University, Stanford, California, USA.,Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Michael Zeineh
- Department of Radiology, Stanford University, Stanford, California, USA
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Gu C. Rapid and Reversible Development of Axonal Varicosities: A New Form of Neural Plasticity. Front Mol Neurosci 2021; 14:610857. [PMID: 33613192 PMCID: PMC7886671 DOI: 10.3389/fnmol.2021.610857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Axonal varicosities are enlarged, heterogeneous structures along axonal shafts, profoundly affecting axonal conduction and synaptic transmission. They represent a key pathological feature believed to develop via slow accumulation of axonal damage that occurs during irreversible degeneration, for example in mild traumatic brain injury (mTBI), Alzheimer's and Parkinson's diseases, and multiple sclerosis. Here this review first discusses recent in vitro results showing that axonal varicosities can be rapidly and reversibly induced by mechanical stress in cultured primary neurons from the central nervous system (CNS). This notion is further supported by in vivo studies revealing the induction of axonal varicosities across various brain regions in different mTBI mouse models, as a prominent feature of axonal pathology. Limited progress in understanding intrinsic and extrinsic regulatory mechanisms of axonal varicosity induction and development is further highlighted. Rapid and reversible formation of axonal varicosities likely plays a key role in CNS neuron mechanosensation and is a new form of neural plasticity. Future investigation in this emerging research field may reveal how to reverse axonal injury, contributing to the development of new strategies for treating brain injuries and related neurodegenerative diseases.
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Affiliation(s)
- Chen Gu
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH, United States
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Carlsen RW, Fawzi AL, Wan Y, Kesari H, Franck C. A quantitative relationship between rotational head kinematics and brain tissue strain from a 2-D parametric finite element analysis. BRAIN MULTIPHYSICS 2021. [DOI: 10.1016/j.brain.2021.100024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Bruggeman GF, Haitsma IK, Dirven CMF, Volovici V. Traumatic axonal injury (TAI): definitions, pathophysiology and imaging-a narrative review. Acta Neurochir (Wien) 2021; 163:31-44. [PMID: 33006648 PMCID: PMC7778615 DOI: 10.1007/s00701-020-04594-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Abstract
Introduction Traumatic axonal injury (TAI) is a condition defined as multiple, scattered, small hemorrhagic, and/or non-hemorrhagic lesions, alongside brain swelling, in a more confined white matter distribution on imaging studies, together with impaired axoplasmic transport, axonal swelling, and disconnection after traumatic brain injury (TBI). Ever since its description in the 1980s and the grading system by Adams et al., our understanding of the processes behind this entity has increased. Methods We performed a scoping systematic, narrative review by interrogating Ovid MEDLINE, Embase, and Google Scholar on the pathophysiology, biomarkers, and diagnostic tools of TAI patients until July 2020. Results We underline the misuse of the Adams classification on MRI without proper validation studies, and highlight the hiatus in the scientific literature and areas needing more research. In the past, the theory behind the pathophysiology relied on the inertial force exerted on the brain matter after severe TBI inducing a primary axotomy. This theory has now been partially abandoned in favor of a more refined theory involving biochemical processes such as protein cleavage and DNA breakdown, ultimately leading to an inflammation cascade and cell apoptosis, a process now described as secondary axotomy. Conclusion The difference in TAI definitions makes the comparison of studies that report outcomes, treatments, and prognostic factors a daunting task. An even more difficult task is isolating the outcomes of isolated TAI from the outcomes of severe TBI in general. Targeted bench-to-bedside studies are required in order to uncover further pathways involved in the pathophysiology of TAI and, ideally, new treatments.
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Affiliation(s)
- Gavin F Bruggeman
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Iain K Haitsma
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Clemens M F Dirven
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Victor Volovici
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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Mechanical threshold for concussion based on computation of axonal strain using a finite element rat brain model. BRAIN MULTIPHYSICS 2021. [DOI: 10.1016/j.brain.2021.100032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Fleck DE, Ernest N, Asch R, Adler CM, Cohen K, Yuan W, Kunkel B, Krikorian R, Wade SL, Babcock L. Predicting Post-Concussion Symptom Recovery in Adolescents Using a Novel Artificial Intelligence. J Neurotrauma 2020; 38:830-836. [PMID: 33115345 DOI: 10.1089/neu.2020.7018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This pilot study explores the possibility of predicting post-concussion symptom recovery at one week post-injury using only objective diffusion tensor imaging (DTI) data inputs to a novel artificial intelligence (AI) system composed of Genetic Fuzzy Trees (GFT). Forty-three adolescents age 11 to 16 years with either mild traumatic brain injury or traumatic orthopedic injury were enrolled on presentation to the emergency department. Participants received a DTI scan three days post-injury, and their symptoms were assessed by the Post-Concussion Symptom Scale (PCSS) at 6 h and one week post-injury. The GFT system was trained using one-week total PCSS scores, 48 volumetric magnetic resonance imaging inputs, and 192 DTI inputs per participant over 225 training runs. Each training run contained a randomly selected 80% of the total sample followed by a 20% validation run. Over a different randomly selected sample distribution, GFT was also compared with six common classification methods. The cascading GFT structure controlled an effectively infinite solution space that classified participants as recovered or not recovered significantly better than chance. It demonstrated 100% and 62% classification accuracy in training and validation, respectively, better than any of the six comparison methods. Recovery sensitivity and specificity were 59% and 65% in the GFT validation set, respectively. These results provide initial evidence for the effectiveness of a GFT system to make clinical predictions of trauma symptom recovery using objective brain measures. Although clinical and research applications will necessitate additional optimization of the system, these results highlight the future promise of AI in acute care.
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Affiliation(s)
- David E Fleck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | - Ruth Asch
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kelly Cohen
- Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati College of Engineering and Applied Science, Cincinnati, Ohio, USA
| | - Weihong Yuan
- Imaging Research Center, Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Robert Krikorian
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Shari L Wade
- Divisions of Emergency Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lynn Babcock
- Divisions of Physical Medicine and Rehabilitation, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Keating CE, Cullen DK. Mechanosensation in traumatic brain injury. Neurobiol Dis 2020; 148:105210. [PMID: 33259894 DOI: 10.1016/j.nbd.2020.105210] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/10/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) is distinct from other neurological disorders because it is induced by a discrete event that applies extreme mechanical forces to the brain. This review describes how the brain senses, integrates, and responds to forces under both normal conditions and during injury. The response to forces is influenced by the unique mechanical properties of brain tissue, which differ by region, cell type, and sub-cellular structure. Elements such as the extracellular matrix, plasma membrane, transmembrane receptors, and cytoskeleton influence its properties. These same components also act as force-sensors, allowing neurons and glia to respond to their physical environment and maintain homeostasis. However, when applied forces become too large, as in TBI, these components may respond in an aberrant manner or structurally fail, resulting in unique pathological sequelae. This so-called "pathological mechanosensation" represents a spectrum of cellular responses, which vary depending on the overall biomechanical parameters of the injury and may be compounded by repetitive injuries. Such aberrant physical responses and/or damage to cells along with the resulting secondary injury cascades can ultimately lead to long-term cellular dysfunction and degeneration, often resulting in persistent deficits. Indeed, pathological mechanosensation not only directly initiates secondary injury cascades, but this post-physical damage environment provides the context in which these cascades unfold. Collectively, these points underscore the need to use experimental models that accurately replicate the biomechanics of TBI in humans. Understanding cellular responses in context with injury biomechanics may uncover therapeutic targets addressing various facets of trauma-specific sequelae.
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Affiliation(s)
- Carolyn E Keating
- Department of Neurosurgery, Center for Brain Injury and Repair, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz VA Medical Center, USA
| | - D Kacy Cullen
- Department of Neurosurgery, Center for Brain Injury and Repair, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA; Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz VA Medical Center, USA.
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Shakiba D, Zhao W, Ji S. Multiscale Mechanobiology of Brain Injury: Axonal Strain Redistribution. Biophys J 2020; 119:1273-1274. [PMID: 32919494 DOI: 10.1016/j.bpj.2020.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- Delaram Shakiba
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, Missouri
| | - Wei Zhao
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts
| | - Songbai Ji
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts.
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Bartnik-Olson B, Holshouser B, Ghosh N, Oyoyo UE, Nichols JG, Pivonka-Jones J, Tong K, Ashwal S. Evolving White Matter Injury following Pediatric Traumatic Brain Injury. J Neurotrauma 2020; 38:111-121. [PMID: 32515269 DOI: 10.1089/neu.2019.6574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study is unique in that it examines the evolution of white matter injury very early and at 12 months post-injury in pediatric patients following traumatic brain injury (TBI). Diffusion tensor imaging (DTI) was acquired at two time-points: acutely at 6-17 days and 12 months following a complicated mild (cMild)/moderate (mod) or severe TBI. Regional measures of anisotropy and diffusivity were compared between TBI groups and against a group of age-matched healthy controls and used to predict performance on measures of attention, memory, and intellectual functioning at 12-months post-injury. Analysis of the acute DTI data using tract based spatial statistics revealed a small number of regional decreases in fractional anisotropy (FA) in both the cMild/mod and severe TBI groups compared with controls. These changes were observed in the occipital white matter, anterior limb of the internal capsule (ALIC)/basal ganglia, and corpus callosum. The severe TBI group showed regional differences in axial diffusivity (AD) in the brainstem and corpus callosum that were not seen in the cMild/mod TBI group. By 12-months, widespread decreases in FA and increases in apparent diffusion coefficient (ADC) and radial diffusivity (RD) were observed in both TBI groups compared with controls, with the overall number of regions with abnormal DTI metrics increasing over time. The early changes in regional DTI metrics were associated with 12-month performance IQ scores. These findings suggest that there may be regional differences in the brain's reparative processes or that mechanisms associated with the brain's plasticity to recover may also be region based.
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Affiliation(s)
- Brenda Bartnik-Olson
- Department of Radiology, Loma Linda University Health, Loma Linda, California, USA
| | - Barbara Holshouser
- Department of Radiology, Loma Linda University Health, Loma Linda, California, USA
| | - Nirmalya Ghosh
- Department of Pediatrics, Loma Linda University Health, Loma Linda, California, USA
| | - Udochukwu E Oyoyo
- Department of Radiology, Loma Linda University Health, Loma Linda, California, USA
| | - Joy G Nichols
- Department of Pediatrics, Loma Linda University Health, Loma Linda, California, USA
| | - Jamie Pivonka-Jones
- Department of Pediatrics, Loma Linda University Health, Loma Linda, California, USA
| | - Karen Tong
- Department of Radiology, Loma Linda University Health, Loma Linda, California, USA
| | - Stephen Ashwal
- Department of Pediatrics, Loma Linda University Health, Loma Linda, California, USA
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