Neuroprotection by acrolein sequestration through exogenously applied scavengers and endogenous enzymatic enabling strategies in mouse EAE model

We have previously shown that the pro-oxidative aldehyde acrolein is a critical factor in MS pathology. In this study, we found that the acrolein scavenger hydralazine (HZ), when applied from the day of induction, can suppress acrolein and alleviate motor and sensory deficits in a mouse experimental autoimmune encephalomyelitis (EAE) model. Furthermore, we also demonstrated that HZ can alleviate motor deficits when applied after the emergence of MS symptoms, making potential anti-acrolein treatment a more clinically relevant strategy. In addition, HZ can reduce both acrolein and MPO, suggesting a connection between acrolein and inflammation. We also found that in addition to HZ, phenelzine (PZ), a structurally distinct acrolein scavenger, can mitigate motor deficits in EAE when applied from the day of induction. This suggests that the likely chief factor of neuroprotection offered by these two structurally distinct acrolein scavengers in EAE is their common feature of acrolein neutralization. Finally, up-and-down regulation of the function of aldehyde dehydrogenase 2 (ALDH2) in EAE mice using either a pharmacological or genetic strategy led to correspondent motor and sensory changes. This data indicates a potential key role of ALDH2 in influencing acrolein levels, oxidative stress, inflammation, and behavior in EAE. These findings further consolidate the critical role of aldehydes in the pathology of EAE and its mechanisms of regulation. This is expected to reinforce and expand the possible therapeutic targets of anti-aldehyde treatment to achieve neuroprotection through both endogenous and exogenous manners.

Bridging the humanities and health care with theatre: Theory and outcomes of a theatre-based model for enhancing psychiatric care via stigma reduction

OBJECTIVE

This article describes the rational, methods, implementation, and effectiveness of Identity Development Evolution and Sharing (IDEAS), an evidence-supported, narrative theater-based training that reduces stigma among health care providers to increase health care equity in psychiatric rehabilitation.

METHOD

The IDEAS model has been used to reduce provider bias toward patients. From May 2017 to January 2020, we interviewed people from three patient groups who have been harmed by stigma, including Black women, transgender, and gender-diverse people, and people with substance use disorders. These interviews informed the creation of three theatrical scripts that were performed by professional actors for audiences of health care providers from January 2020 to May 2022. The performances aimed to raise conscious awareness of implicit provider biases and to provide a reflective opportunity to ameliorate these biases. The purpose of IDEAS is to improve experiences in health care settings such as psychiatric rehabilitation of patients from groups who have been harmed by stigma. We used paired-samples t tests to compare pre/postprovider stigma, measured via the Acceptance and Action Questionnaire-Stigma (AAQ-S).

RESULTS

Sociodemographic factors for providers who viewed IDEAS were similar across all three performances. IDEAS significantly decreased AAQ-S scores (t = 11.32, df = 50, M = 13.65, 95% confidence limit: [11.32, 15.97], p < .0001).

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

IDEAS reduces provider stigma to support positive clinical encounters with diverse patient populations. These findings are relevant for psychiatric rehabilitation settings, which seek to establish positive rapport between providers and patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differential susceptibility of retinal ganglion cell subtypes in acute and chronic models of injury and disease

Retinal ganglion cells (RGCs) are a heterogeneous population of neurons, comprised of numerous subtypes that work synchronously to transmit visual information to the brain. In blinding disorders such as glaucoma, RGCs are the main cell type to degenerate and lead to loss of vision. Previous studies have identified and characterized a variety of RGC subtypes in animal models, although only a handful of studies demonstrate the differential loss of these RGC subtypes in response to disease or injury. Thus, efforts of the current study utilized both chronic (bead occlusion) and acute (optic nerve crush, ONC) rat models to characterize disease response and differential loss of RGC subtypes. Bead occlusion and ONC retinas demonstrated significant RGC loss, glial reactivity and apoptosis compared to control retinas. Importantly, bead occlusion and ONC retinas resulted in differential subtype-specific loss of RGCs, with a high susceptibility for alpha- and direction selective-RGCs and preferential survival of ipRGCs. Results of this study serve as an important foundation for future experiments focused on the mechanisms resulting in the loss of RGCs in optic neuropathies, as well as the development of targeted therapeutics for RGC subtype-specific neuroprotection.

Subconcussive head impact exposure between drill intensities in U.S. high school football

USA Football established five levels-of-contact to guide the intensity of high school football practices. The objective of this study was to examine head impact frequency and magnitude by levels-of-contact to determine which drills had the greatest head impact exposure. Our primary hypothesis was that there would be an incremental increase in season-long head impact exposure between levels-of-contact: air<bags<control<thud<live. This observational study included 24 high-school football players during all 46 practices, 1 scrimmage, 9 junior varsity and 10 varsity games in the 2019 season. Players wore a sensor-installed mouthguard that monitored head impact frequency, peak linear acceleration (PLA), and rotational acceleration (PRA). Practice/game drills were filmed and categorized into five levels-of-contact (air, bags, control, thud, live), and head impact data were assigned into one of five levels-of-contact. Player position was categorized into lineman, hybrid, and skill. A total of 6016 head impacts were recorded during 5 levels-of-contact throughout the season. In the overall sample, total number of impacts, sum of PLA, and PRA per player increased in a near incremental manner (air<bags<control = thud<live), where live drills had significantly higher cumulative frequency (113.7±17.8 hits/player) and magnitude [2,657.6±432.0 g (PLA), and 233.9 ± 40.1 krad/s² (PRA)] than any other levels-of-contact, whereas air drills showed the lowest cumulative frequency (7.7±1.9 hits/player) and magnitude [176.9±42.5 g (PLA), PRA 16.7±4.2 krad/s² (PRA)]. There was no significant position group difference in cumulative head impact frequency and magnitude in a season. Although there was no difference in average head impact magnitude across five levels-of-contact and by position group PLA (18.2–23.2g) and PRA (1.6–2.3krad/s²) per impact], high magnitude (60-100g and >100g) head impacts were more frequently observed during live and thud drills. Level-of-contact influences cumulative head impact frequency and magnitude in high-school football, with players incurring frequent, high magnitude head impacts during live, thud, and control. It is important to consider level-of-contact to refine clinical exposure guidelines to minimize head impact burden in high-school football.

Automated Detection of Symptomatic Autonomic Dysreflexia Through Multimodal Sensing

OBJECTIVE

Autonomic Dysreflexia (AD) is a potentially life-threatening syndrome which occurs in individuals with higher level spinal cord injuries (SCI). AD is caused by triggers which can lead to rapid escalation of pathophysiological responses and if the trigger is not removed, AD can be fatal. There is currently no objective, non-invasive and accurate monitoring system available to automatically detect the onset of AD symptoms in real time in a non-clinical setting. Technology or Method: We developed a user-independent method of symptomatic AD detection in real time with a wearable physiological telemetry system (PTS) and a machine learning model using data from eleven participants with SCI.

RESULTS

The PTS could detect onset of AD symptoms with an average accuracy of 94.10% and a false negative rate of 4.89%.

CONCLUSIONS

The PTS can detect the onset of the symptoms AD with high sensitivity and specificity to assist people with SCIs in preventing the occurrence of AD. It would enable persons with high level SCIs to be more independent and pursue vocational activities while granting continuous medical oversight. Clinical Impact: The PTS could serve as a supplementary tool to current solutions to detect the onset of AD and prepare individuals who are newly injured to be better prepared for AD episodes. Moreover, it could be translated into a system to encourage individuals to practice better healthcare management to prevent future occurrences.

RhoA/Rho Kinase Mediates Neuronal Death Through Regulating cPLA2 Activation

Activation of RhoA/Rho kinase leads to growth cone collapse and neurite retraction. Although RhoA/Rho kinase inhibition has been shown to improve axon regeneration, remyelination and functional recovery, its role in neuronal cell death remains unclear. To determine whether RhoA/Rho kinase played a role in neuronal death after injury, we investigated the relationship between RhoA/Rho kinase and cytosolic phospholipase A₂ (cPLA₂), a lipase that mediates inflammation and cell death, using an in vitro neuronal death model and an in vivo contusive spinal cord injury model performed at the 10th thoracic (T10) vertebral level. We found that co-administration of TNF-α and glutamate induced spinal neuron death, and activation of RhoA, Rho kinase and cPLA₂. Inhibition of RhoA, Rho kinase and cPLA₂ significantly reduced TNF-α/glutamate-induced cell death by 33, 52 and 43 %, respectively (p < 0.001). Inhibition of RhoA and Rho kinase also significantly downregulated cPLA₂ activation by 66 and 60 %, respectively (p < 0.01). Furthermore, inhibition of RhoA and Rho kinase reduced the release of arachidonic acid, a downstream substrate of cPLA₂. The immunofluorescence staining showed that ROCK₁ or ROCK₂, two isoforms of Rho kinase, was co-localized with cPLA₂ in neuronal cytoplasm. Interestingly, co-immunoprecipitation (Co-IP) assay showed that ROCK₁ or ROCK₂ bonded directly with cPLA₂ and phospho-cPLA₂. When the Rho kinase inhibitor Y27632 was applied in mice with T10 contusion injury, it significantly decreased cPLA₂ activation and expression and reduced injury-induced apoptosis at and close to the lesion site. Taken together, our results reveal a novel mechanism of RhoA/Rho kinase-mediated neuronal death through regulating cPLA₂ activation.