Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA.
Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
Acta Neuropathol Commun. 2016 Nov 24;4(1):124. doi: 10.1186/s40478-016-0395-3.
Mild traumatic brain injury (mTBI) is the signature injury in warfighters exposed to explosive blasts. The pathology underlying mTBI is poorly understood, as this condition is rarely fatal and thus postmortem brains are difficult to obtain for neuropathological studies. Here we report on studies of an experimental model with a gyrencephalic brain that is exposed to single and multiple explosive blast pressure waves. To determine injuries to the brain resulting from the primary blast, experimental conditions were controlled to eliminate any secondary or tertiary injury from blasts. We found small but significant levels of neuronal loss in the hippocampus, a brain area that is important for cognitive functions. Furthermore, neuronal loss increased with multiple blasts and the degree of neuronal injury worsened with time post-blast. This is consistent with our findings in the blast-exposed human brain based on magnetic resonance spectroscopic imaging. The studies on this experimental model thus confirm what has been presumed to be the case with the warfighter, namely that exposure to multiple blasts causes increased brain injury. Additionally, as in other studies of both explosive blast as well as closed head mTBI, we found astrocyte activation. Activated microglia were also prominent in white matter tracts, particularly in animals exposed to multiple blasts and at long post-blast intervals, even though injured axons (i.e. β-APP positive) were not found in these areas. Microglial activation appears to be a delayed response, though whether they may contribute to inflammation related injury mechanism at even longer post-blast times than we tested here, remains to be explored. Petechial hemorrhages or other gross signs of vascular injury were not observed in our study. These findings confirm the development of neuropathological changes due to blast exposure. The activation of astrocytes and microglia, cell types potentially involved in inflammatory processes, suggest an important area for future study.
轻度创伤性脑损伤(mTBI)是暴露于爆炸冲击波的作战人员的标志性损伤。mTBI 的发病机制尚不清楚,因为这种情况很少致命,因此很难获得用于神经病理学研究的死后大脑。在这里,我们报告了一种具有脑回的实验模型的研究,该模型暴露于单次和多次爆炸压力波下。为了确定原发性爆炸对大脑造成的损伤,实验条件得到了控制,以消除爆炸引起的任何继发性或三级损伤。我们发现,海马体中的神经元损失很小,但有统计学意义,海马体是认知功能的重要区域。此外,随着多次爆炸,神经元损失增加,并且神经元损伤程度随着爆炸后时间的延长而恶化。这与我们基于磁共振波谱成像对暴露于爆炸的人脑的研究结果一致。因此,该实验模型的研究证实了作战人员的情况,即暴露于多次爆炸会导致大脑损伤增加。此外,与爆炸和闭合性头部 mTBI 的其他研究一样,我们发现星形胶质细胞激活。在白质束中,尤其是在暴露于多次爆炸和长时间后爆炸的动物中,激活的小胶质细胞也很明显,尽管在这些区域中没有发现受伤的轴突(即β-APP 阳性)。小胶质细胞的激活似乎是一种延迟反应,尽管它们是否可能在比我们在此处测试的更长的时间后,对与炎症相关的损伤机制做出贡献,仍有待探索。在我们的研究中没有观察到瘀点样出血或其他血管损伤的明显迹象。这些发现证实了由于爆炸暴露而导致的神经病理学变化的发展。星形胶质细胞和小胶质细胞的激活,这些细胞类型可能涉及炎症过程,表明这是未来研究的一个重要领域。