Department of Neurology, University Hospital of Zurich, University of Zurich , Zurich, Switzerland .
J Neurotrauma. 2018 Jan 1;35(1):85-93. doi: 10.1089/neu.2017.5067. Epub 2017 Oct 27.
Although sleep-wake disturbances are prevalent and well described after traumatic brain injury, their pathophysiology remains unclear, most likely because human traumatic brain injury is a highly heterogeneous entity that makes the systematic study of sleep-wake disturbances in relation to trauma-induced histological changes a challenging task. Despite increasing interest, specific and effective treatment strategies for post-traumatic sleep-wake disturbances are still missing. With the present work, therefore, we aimed at studying acute and chronic sleep-wake disturbances by electrophysiological means, and at assessing their histological correlates after closed diffuse traumatic brain injury in rats with the ultimate goal of generating a model of post-traumatic sleep-wake disturbances and associated histopathological findings that accurately represents the human condition. We assessed sleep-wake behavior by means of standard electrophysiological recordings before and 1, 7, and 28 days after sham or traumatic brain injury procedures. Sleep-wake findings were then correlated to immunohistochemically labeled and stereologically quantified neuronal arousal systems. Compared with control animals, we found that closed diffuse traumatic brain injury caused increased sleep need one month after trauma, and sleep was more consolidated. As histological correlate, we found a reduced number of histamine immunoreactive cells in the tuberomammillary nucleus, potentially related to increased neuroinflammation. Monoaminergic and hypocretinergic neurotransmitter systems in the hypothalamus and rostral brainstem were not affected, however. These results suggest that our rat traumatic brain injury model reflects human post-traumatic sleep-wake disturbances and associated histopathological findings very accurately, thus providing a study platform for novel treatment strategies for affected patients.
尽管创伤性脑损伤后普遍存在且充分描述了睡眠-觉醒障碍,但它们的病理生理学仍然不清楚,这很可能是因为人类创伤性脑损伤是一种高度异质的实体,使得系统性研究与创伤引起的组织学变化相关的睡眠-觉醒障碍成为一项具有挑战性的任务。尽管人们越来越感兴趣,但针对创伤后睡眠-觉醒障碍的具体和有效的治疗策略仍然缺失。因此,通过使用电生理手段,我们旨在研究急性和慢性睡眠-觉醒障碍,并评估其在闭合性弥漫性创伤性脑损伤大鼠中的组织学相关性,最终目标是生成一种与创伤后睡眠-觉醒障碍和相关组织病理学发现相关的模型,该模型准确地代表了人类的情况。我们通过在假手术或创伤性脑损伤程序之前和之后的 1、7 和 28 天进行标准的电生理记录来评估睡眠-觉醒行为。然后将睡眠-觉醒发现与免疫组织化学标记和立体定量神经元觉醒系统相关联。与对照动物相比,我们发现闭合性弥漫性创伤性脑损伤导致创伤后一个月睡眠需求增加,并且睡眠更加巩固。作为组织学相关性,我们发现丘脑海马核中的组胺免疫反应细胞数量减少,这可能与神经炎症增加有关。然而,下丘脑和脑桥前部的单胺能和下丘脑分泌素能神经递质系统没有受到影响。这些结果表明,我们的大鼠创伤性脑损伤模型非常准确地反映了人类创伤后睡眠-觉醒障碍和相关的组织病理学发现,从而为受影响患者的新型治疗策略提供了一个研究平台。