Levy Dan, Edut Shahaf, Baraz-Goldstein Renana, Rubovitch Vardit, Defrin Ruth, Bree Dara, Gariepy Helaine, Zhao Jun, Pick Chaim G
Department of Anesthesia Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, USA Harvard Medical School, USA
Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Cephalalgia. 2016 Sep;36(10):915-23. doi: 10.1177/0333102415617412. Epub 2015 Nov 12.
Chronic post-traumatic headache (PTH) is one of the most common symptoms of mild traumatic brain injury (mTBI) but its underlying mechanisms remain unknown. Inflammatory degranulation of dural mast cells (MCs) is thought to promote headache, and may play a role in PTH. Whether mTBI is associated with persistent degranulation of dural MCs is yet to be determined.
Histochemistry was used to evaluate time course changes in dural MC density and degranulation level in concussive head trauma and blast mouse models of mTBI. The effects of sumatriptan and the MC stabilizer cromolyn sodium on concussion-evoked dural MC degranulation were also investigated.
Concussive head injury evoked persistent MC degranulation for at least 30 days. Blast trauma gave rise to a delayed MC degranulation response commencing at seven days that also persisted for at least 30 days. Neither sumatriptan nor cromolyn treatment reduced concussion-evoked persistent MC degranulation.
mTBI evoked by closed head injury or blast exposure is associated with persistent dural MC degranulation. Such a response in mTBI patients may contribute to PTH. Amelioration of PTH by sumatriptan may not involve inhibition of dural MC degranulation. If persistent dural MC degranulation contributes to PTH, then cromolyn treatment may not be effective.
慢性创伤后头痛(PTH)是轻度创伤性脑损伤(mTBI)最常见的症状之一,但其潜在机制尚不清楚。硬脑膜肥大细胞(MCs)的炎性脱颗粒被认为会引发头痛,并且可能在PTH中起作用。mTBI是否与硬脑膜MCs的持续性脱颗粒有关尚待确定。
采用组织化学方法评估mTBI的震荡性头部创伤和爆炸小鼠模型中硬脑膜MC密度和脱颗粒水平的时间进程变化。还研究了舒马曲坦和MC稳定剂色甘酸钠对震荡诱发的硬脑膜MC脱颗粒的影响。
震荡性头部损伤诱发了至少持续30天的持续性MC脱颗粒。爆炸伤引起了延迟的MC脱颗粒反应,从第7天开始,也持续了至少30天。舒马曲坦和色甘酸钠治疗均未降低震荡诱发的持续性MC脱颗粒。
闭合性头部损伤或爆炸暴露诱发的mTBI与硬脑膜MC的持续性脱颗粒有关。mTBI患者的这种反应可能导致PTH。舒马曲坦对PTH的改善可能不涉及抑制硬脑膜MC脱颗粒。如果硬脑膜MC的持续性脱颗粒导致PTH,那么色甘酸钠治疗可能无效。