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Tate DF, Wade BSC, Velez CS, Bigler ED, Davenport ND, Dennis EL, Esopenko C, Hinds SR, Kean J, Kennedy E, Kenney K, Mayer AR, Newsome MR, Philippi CL, Pugh MJ, Scheibel RS, Taylor BA, Troyanskaya M, Werner JK, York GE, Walker W, Wilde EA. Persistent MRI Findings Unique to Blast and Repetitive Mild TBI: Analysis of the CENC/LIMBIC Cohort Injury Characteristics. Mil Med 2024; 189:e1938-e1946. [PMID: 38401164 PMCID: PMC11363162 DOI: 10.1093/milmed/usae031] [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: 04/21/2023] [Revised: 08/04/2023] [Accepted: 02/02/2024] [Indexed: 02/26/2024] Open
Abstract
INTRODUCTION MRI represents one of the clinical tools at the forefront of research efforts aimed at identifying diagnostic and prognostic biomarkers following traumatic brain injury (TBI). Both volumetric and diffusion MRI findings in mild TBI (mTBI) are mixed, making the findings difficult to interpret. As such, additional research is needed to continue to elucidate the relationship between the clinical features of mTBI and quantitative MRI measurements. MATERIAL AND METHODS Volumetric and diffusion imaging data in a sample of 976 veterans and service members from the Chronic Effects of Neurotrauma Consortium and now the Long-Term Impact of Military-Relevant Brain Injury Consortium observational study of the late effects of mTBI in combat with and without a history of mTBI were examined. A series of regression models with link functions appropriate for the model outcome were used to evaluate the relationships among imaging measures and clinical features of mTBI. Each model included acquisition site, participant sex, and age as covariates. Separate regression models were fit for each region of interest where said region was a predictor. RESULTS After controlling for multiple comparisons, no significant main effect was noted for comparisons between veterans and service members with and without a history of mTBI. However, blast-related mTBI were associated with volumetric reductions of several subregions of the corpus callosum compared to non-blast-related mTBI. Several volumetric (i.e., hippocampal subfields, etc.) and diffusion (i.e., corona radiata, superior longitudinal fasciculus, etc.) MRI findings were noted to be associated with an increased number of repetitive mTBIs versus. CONCLUSIONS In deployment-related mTBI, significant findings in this cohort were only observed when considering mTBI sub-groups (blast mechanism and total number/dose). Simply comparing healthy controls and those with a positive mTBI history is likely an oversimplification that may lead to non-significant findings, even in consortium analyses.
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Affiliation(s)
- David F Tate
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA
- George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA
- Department of Psychology, Brigham Young University, Provo, UT 84604, USA
| | - Benjamin S C Wade
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Carmen S Velez
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA
- George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA
| | - Erin D Bigler
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA
- Department of Psychology, Brigham Young University, Provo, UT 84604, USA
- Departments of Neuroscience, Brigham Young University, Provo, UT 84604, USA
| | - Nicholas D Davenport
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN 55417, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA
| | - Emily L Dennis
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA
- George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sidney R Hinds
- Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Jacob Kean
- George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Eamonn Kennedy
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Andrew R Mayer
- The Mind Research Network, University of New Mexico Health Science Center, Albuquerque, NM 87106, USA
| | - Mary R Newsome
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO 63121, St. Louis
| | - Mary J Pugh
- George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Randall S Scheibel
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Brian A Taylor
- Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Maya Troyanskaya
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - John K Werner
- Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Gerald E York
- Imaging Associates of Alaska, Anchorage, AK 99508, USA
| | - William Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Elisabeth A Wilde
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA
- George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
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Campos-Pires R, Ong BE, Koziakova M, Ujvari E, Fuller I, Boyles C, Sun V, Ko A, Pap D, Lee M, Gomes L, Gallagher K, Mahoney PF, Dickinson R. Repetitive, but Not Single, Mild Blast TBI Causes Persistent Neurological Impairments and Selective Cortical Neuronal Loss in Rats. Brain Sci 2023; 13:1298. [PMID: 37759899 PMCID: PMC10526452 DOI: 10.3390/brainsci13091298] [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: 07/31/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Exposure to repeated mild blast traumatic brain injury (mbTBI) is common in combat soldiers and the training of Special Forces. Evidence suggests that repeated exposure to a mild or subthreshold blast can cause serious and long-lasting impairments, but the mechanisms causing these symptoms are unclear. In this study, we characterise the effects of single and tightly coupled repeated mbTBI in Sprague-Dawley rats exposed to shockwaves generated using a shock tube. The primary outcomes are functional neurologic function (unconsciousness, neuroscore, weight loss, and RotaRod performance) and neuronal density in brain regions associated with sensorimotor function. Exposure to a single shockwave does not result in functional impairments or histologic injury, which is consistent with a mild or subthreshold injury. In contrast, exposure to three tightly coupled shockwaves results in unconsciousness, along with persistent neurologic impairments. Significant neuronal loss following repeated blast was observed in the motor cortex, somatosensory cortex, auditory cortex, and amygdala. Neuronal loss was not accompanied by changes in astrocyte reactivity. Our study identifies specific brain regions particularly sensitive to repeated mbTBI. The reasons for this sensitivity may include exposure to less attenuated shockwaves or proximity to tissue density transitions, and this merits further investigation. Our novel model will be useful in elucidating the mechanisms of sensitisation to injury, the temporal window of sensitivity and the evaluation of new treatments.
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Affiliation(s)
- Rita Campos-Pires
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London SW7 2AZ, UK
| | - Bee Eng Ong
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Mariia Koziakova
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Eszter Ujvari
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Isobel Fuller
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Charlotte Boyles
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Valerie Sun
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Andy Ko
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Daniel Pap
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Matthew Lee
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Lauren Gomes
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Kate Gallagher
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Peter F. Mahoney
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London SW7 2AZ, UK
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Robert Dickinson
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London SW7 2AZ, UK
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3
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Hu R, Tan F, Chen W, Wu Y, Jiang Y, Du W, Zuo Y, Gao B, Song Q, Miao Y. Microstructure abnormalities of the diffusion quantities in children with attention-deficit/hyperactivity disorder: an AFQ and TBSS study. Front Psychiatry 2023; 14:1237113. [PMID: 37674550 PMCID: PMC10477457 DOI: 10.3389/fpsyt.2023.1237113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
Abstract
Objective To explore the specific alterations of white matter microstructure in children with attention-deficit/hyperactivity disorder (ADHD) by automated fiber quantification (AFQ) and tract-based spatial statistics (TBSS), and to analyze the correlation between white matter abnormality and impairment of executive function. Methods In this prospective study, a total of twenty-seven patients diagnosed with ADHD (20 males, 7 females; mean age of 8.89 ± 1.67 years) and twenty-two healthy control (HC) individuals (11 males, 11 females, mean age of 9.82 ± 2.13 years) were included. All participants were scanned with diffusion kurtosis imaging (DKI) and assessed for executive functions. AFQ and TBSS analysis methods were used to investigate the white matter fiber impairment of ADHD patients, respectively. Axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD) and fractional anisotropy (FA) of 17 fiber properties were calculated using the AFQ. The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), mean diffusivity (MDDKI), axial diffusivity (ADDKI), radial diffusivity (RDDKI) and fractional anisotropy (FADKI) of DKI and AD, RD, MD, and FA of diffusion tensor imaging (DTI) assessed the integrity of the white matter based on TBSS. Partial correlation analyses were conducted to evaluate the correlation between white matter abnormalities and clinical test scores in ADHD while taking age, gender, and education years into account. The analyses were all family-wise error rate (FWE) corrected. Results ADHD patients performed worse on the Behavior Rating Inventory of Executive Function (BRIEF) test (p < 0.05). Minor variances existed in gender and age between ADHD and HC, but these variances did not yield statistically significant distinctions. There were no significant differences in TBSS for DKI and DTI parameters (p > 0.05, TFCE-corrected). Compared to HC volunteers, the mean AD value of right cingulum bundle (CB_R) fiber tract showed a significantly higher level in ADHD patients following the correction of FWE. As a result of the point-wise comparison between groups, significant alterations (FWE correction, p < 0.05) were mainly located in AD (nodes 36-38, nodes 83-97) and MD (nodes 92-95) of CB_R. There was no significant correlation between white matter diffusion parameters and clinical test scores in ADHD while taking age, gender, and education years into account. Conclusion The AFQ method can detect ADHD white matter abnormalities in a specific location with greater sensitivity, and the CB_R played a critical role. Our findings may be helpful in further studying the relationship between focal white matter abnormalities and ADHD.
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Affiliation(s)
- Rui Hu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fan Tan
- Department of Nuclear Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Wen Chen
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yong Wu
- Department of Paediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yuhan Jiang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wei Du
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yuchen Zuo
- Department of Paediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Bingbing Gao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yanwei Miao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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4
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Yeh PH, Lippa SM, Brickell TA, Ollinger J, French LM, Lange RT. Longitudinal changes of white matter microstructure following traumatic brain injury in U.S. military service members. Brain Commun 2022; 4:fcac132. [PMID: 35702733 PMCID: PMC9185378 DOI: 10.1093/braincomms/fcac132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/01/2022] [Accepted: 05/24/2022] [Indexed: 09/02/2023] Open
Abstract
The purpose of this study was to analyze quantitative diffusion tensor imaging measures across the spectrum of traumatic brain injury severity and evaluate their trajectories in military service members. Participants were 96 U.S. military service members and veterans who had sustained a mild traumatic brain injury [including complicated mild traumatic brain injury (n = 16) and uncomplicated mild traumatic brain injury (n = 68)], moderate-severe traumatic brain injury (n = 12), and controls (with or without orthopaedic injury, n = 39). All participants had been scanned at least twice, with some receiving up to five scans. Both whole brain voxel-wise analysis and tract-of-interest analysis were applied to assess the group differences of diffusion tensor imaging metrics, and their trajectories between time points of scans and days since injury. Linear mixed modelling was applied to evaluate cross-sectional and longitudinal diffusion tensor imaging metrics changes within and between groups using both tract-of-interest and voxel-wise analyses. Participants with moderate to severe traumatic brain injury had larger white matter disruption both in superficial subcortical and deep white matter, mainly over the anterior part of cerebrum, than those with mild traumatic brain injury, both complicated and uncomplicated, and there was no evidence of recovery over the period of follow-ups in moderate-severe traumatic brain injury, but deterioration was possible. Participants with mild traumatic brain injury had white matter microstructural changes, mainly in deep central white matter over the posterior part of cerebrum, with more spatial involvement in complicated mild traumatic brain injury than in uncomplicated mild traumatic brain injury and possible brain repair through neuroplasticity, e.g. astrocytosis with glial processes and glial scaring. Our results did not replicate 'V-shaped' trajectories in diffusion tensor imaging metrics, which were revealed in a previous study assessing the sub-acute stage of brain injury in service members and veterans following military combat concussion. In addition, non-traumatic brain injury controls, though not demonstrating any evidence of sustaining a traumatic brain injury, might have transient white matter changes with recovery afterward. Our results suggest that white matter integrity following a remote traumatic brain injury may change as a result of different underlying mechanisms at the microstructural level, which can have a significant consequence on the long-term well beings of service members and veterans. In conclusion, longitudinal diffusion tensor imaging improves our understanding of the mechanisms of white matter microstructural changes across the spectrum of traumatic brain injury severity. The quantitative metrics can be useful as guidelines in monitoring the long-term recovery.
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Affiliation(s)
- Ping-Hong Yeh
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, RM1128, Bldg 51, Bethesda, MD, USA
| | - Sara. M. Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, RM1128, Bldg 51, Bethesda, MD, USA
| | - Tracey A. Brickell
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, RM1128, Bldg 51, Bethesda, MD, USA
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Contractor, General Dynamics Information Technology, Silver Spring, MD, USA
- Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, RM1128, Bldg 51, Bethesda, MD, USA
| | - Louis M. French
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, RM1128, Bldg 51, Bethesda, MD, USA
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rael T. Lange
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, RM1128, Bldg 51, Bethesda, MD, USA
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Contractor, General Dynamics Information Technology, Silver Spring, MD, USA
- Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada
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5
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Zhong Y, Liang B, Meng H, Ye R, Li Z, Du J, Wang B, Zhang B, Huang Y, Lin X, Hu M, Rong W, Wu Q, Yang X, Huang Z. 1,2-Dichloroethane induces cortex demyelination by depressing myelin basic protein via inhibiting aquaporin 4 in mice. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 231:113180. [PMID: 35026584 DOI: 10.1016/j.ecoenv.2022.113180] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
1,2-Dichloroethane (1,2-DCE) is a pervasive environmental pollutant, and overexposure to this hazardous material causes brain edema and demyelination in humans. We found that 1,2-DCE inhibits aquaporin 4 (AQP4) and is a primary pathogenic effector of 1,2-DCE-induced brain edema in animals. However, AQP4 down-regulation's link with cortex demyelination after 1,2-DCE exposure remains unclear. Thus, we exposed wild-type (WT) CD-1 mice and AQP4 knockout (AQP4-KO) mice to 0, 100, 350 and 700 mg/m3 1,2-DCE by inhalation for 28 days. We applied label-free proteomics and a cell co-culture system to elucidate the role of AQP4 inhibition in 1,2-DCE-induced demyelination. The results showed that 1,2-DCE down-regulated AQP4 in the WT mouse cortexes. Both 1,2-DCE exposure and AQP4 deletion induced neurotoxicity in mice, including increased brain water content, abnormal pathological vacuolations, and neurobehavioral damage. Tests for interaction of multiple regression analysis highlighted different effects of 1,2-DCE exposure level depending on the genotype, indicating the core role of AQP4 in regulation on 1,2-DCE-caused neurotoxicity. We used label-free quantitative proteomics to detect differentially expressed proteins associated with 1,2-DCE exposure and AQP4 inhibition, and identified down-regulation in myelin basic protein (MBP) and tyrosine-protein kinase Fyn (FYN) in a dose-dependent manner in WT mice but not in AQP4-KO mice. 1,2-DCE and AQP4 deletion separately resulted in demyelination, as detected by Luxol fast blue staining, and manifested as disordered nerve fibers and cavitation in the cortexes. Western blot and immunofluorescence confirmed the decreased AQP4 in the astrocytes and the down-regulated MBP in the oligodendrocytes by 1,2-DCE exposure and AQP4 inhibition, respectively. Finally, the co-culture results of SVG p12 and MO3.13 cells showed that 1,2-DCE-induced AQP4 down-regulation in the astrocytes was responsible for demyelination, by decreasing MBP in the oligodendrocytes. In conclusion, 1,2-DCE induced cortex demyelination by depressing MBP via AQP4 inhibition in the mice.
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Affiliation(s)
- Yizhou Zhong
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Boxuan Liang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Hao Meng
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Rongyi Ye
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Zhiming Li
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jiaxin Du
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Bo Wang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Bingli Zhang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yuji Huang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xi Lin
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Manjiang Hu
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Weifeng Rong
- Department of Hygiene Monitor, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou 510300, China
| | - Qinghong Wu
- Laboratory Animal Management Center, Southern Medical University, Guangzhou 510515, China
| | - Xingfen Yang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Zhenlie Huang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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6
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Li Y, Liu K, Li C, Guo Y, Fang J, Tong H, Tang Y, Zhang J, Sun J, Jiao F, Zhang Q, Jin R, Xiong K, Chen X. 18F-FDG PET Combined With MR Spectroscopy Elucidates the Progressive Metabolic Cerebral Alterations After Blast-Induced Mild Traumatic Brain Injury in Rats. Front Neurosci 2021; 15:593723. [PMID: 33815036 PMCID: PMC8012735 DOI: 10.3389/fnins.2021.593723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
A majority of blast-induced mild traumatic brain injury (mTBI) patients experience persistent neurological dysfunction with no findings on conventional structural MR imaging. It is urgent to develop advanced imaging modalities to detect and understand the pathophysiology of blast-induced mTBI. Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) could detect neuronal function and activity of the injured brain, while MR spectroscopy provides complementary information and assesses metabolic irregularities following injury. This study aims to investigate the effectiveness of combining 18F-FDG PET with MR spectroscopy to evaluate acute and subacute metabolic cerebral alterations caused by blast-induced mTBI. Thirty-two adult male Sprague–Dawley rats were exposed to a single blast (mTBI group) and 32 rats were not exposed to the blast (sham group), followed by 18F-FDG PET, MRI, and histological evaluation at baseline, 1–3 h, 1 day, and 7 days post-injury in three separate cohorts. 18F-FDG uptake showed a transient increase in the amygdala and somatosensory cortex, followed by a gradual return to baseline from day 1 to 7 days post-injury and a continuous rise in the motor cortex. In contrast, decreased 18F-FDG uptake was seen in the midbrain structures (inferior and superior colliculus). Analysis of MR spectroscopy showed that inflammation marker myo-inositol (Ins), oxidative stress marker glutamine + glutamate (Glx), and hypoxia marker lactate (Lac) levels markedly elevated over time in the somatosensory cortex, while the major osmolyte taurine (Tau) level immediately increased at 1–3 h and 1 day, and then returned to sham level on 7 days post-injury, which could be due to the disruption of the blood–brain barrier. Increased 18F-FDG uptake and elevated Ins and Glx levels over time were confirmed by histology analysis which showed increased microglial activation and gliosis in the frontal cortex. These results suggest that 18F-FDG PET and MR spectroscopy can be used together to reflect more comprehensive neuropathological alterations in vivo, which could improve our understanding of the complex alterations in the brain after blast-induced mTBI.
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Affiliation(s)
- Yang Li
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Department of Medical Imaging, Air Force Hospital of Western Theater Command, Chengdu, China
| | - Kaijun Liu
- Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing, China
| | - Chang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jingqin Fang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Haipeng Tong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yi Tang
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Junfeng Zhang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jinju Sun
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Fangyang Jiao
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Qianhui Zhang
- Department of Foreign Language, Army Medical University, Chongqing, China
| | - Rongbing Jin
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Kunlin Xiong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Xiao Chen
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
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Emerging Utility of Applied Magnetic Resonance Imaging in the Management of Traumatic Brain Injury. Med Sci (Basel) 2021; 9:medsci9010010. [PMID: 33673012 PMCID: PMC7930990 DOI: 10.3390/medsci9010010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022] Open
Abstract
Traumatic brain injury (TBI) is a widespread and expensive problem globally. The standard diagnostic workup for new TBI includes obtaining a noncontrast computed tomography image of the head, which provides quick information on operative pathologies. However, given the limited sensitivity of computed tomography for identifying subtle but meaningful changes in the brain, magnetic resonance imaging (MRI) has shown better utility for ongoing management and prognostication after TBI. In recent years, advanced applications of MRI have been further studied and are being implemented as clinical tools to help guide care. These include functional MRI, diffusion tensor imaging, MR perfusion, and MR spectroscopy. In this review, we discuss the scientific basis of each of the above techniques, the literature supporting their use in TBI, and how they may be clinically implemented to improve the care of TBI patients.
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