Samatra Dewa Putu Gede Purwa, Pratiwi Ni Made Dwita, Widyadharma I Putu Eka
Department of Neurology, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia.
Open Access Maced J Med Sci. 2018 Sep 24;6(9):1674-1677. doi: 10.3889/oamjms.2018.390. eCollection 2018 Sep 25.
Traumatic brain injury (TBI) exerts a significant impact on society with regards to physical, affective, and cognitive impairment. The consequent cognitive sequelae include a problem in memory, attention, concentration, and processing speed. Following traumatic brain injury, inflammatory response developed, characterised by increased interleukin 1-β (IL-1β) levels in the blood. IL 1-β at pathophysiological concentration has been reported to cause an inhibition of the expression of long-term potentiation (LTP) in the areas CA1, CA3, and dentate gyrus of the hippocampus.
This study aims to determine whether high IL-1β serum is a predictor of decreased cognitive function in mild TBI.
This is a prospective cohort study conducted at the emergency room, surgical and neurologic ward at Sanglah Hospital from November 2017 until January 2018. As many as thirty-five mild TBI with normal IL-1β serum (< 0.0565 pg/ml) and thirty-five of those with high IL-1β serum (≥ 0.0565 pg/ml) subjects were included within the corresponding period. The decrease of cognition after trauma was measured seven days later.
This study demonstrated that group with high IL-1β serum levels were at higher risk of suffering from cognitive impairment after TBI when compared with the group with normal IL-1β serum levels (RR = 2.6; 95% CI 1.49-4.55, p < 0.001).
Mild TBI with high serum IL-1β levels were more than twice likely to experience decreased cognitive function than those with normal IL-1β levels.
创伤性脑损伤(TBI)在身体、情感和认知障碍方面对社会产生重大影响。随之而来的认知后遗症包括记忆、注意力、专注力和处理速度方面的问题。创伤性脑损伤后会引发炎症反应,其特征是血液中白细胞介素1-β(IL-1β)水平升高。据报道,病理生理浓度的IL-1β会抑制海马体CA1、CA3和齿状回区域的长时程增强(LTP)表达。
本研究旨在确定高血清IL-1β是否是轻度TBI患者认知功能下降的预测指标。
这是一项前瞻性队列研究,于2017年11月至2018年1月在桑格拉医院的急诊室、外科和神经科病房进行。在相应时间段内纳入了35名血清IL-1β正常(<0.0565 pg/ml)的轻度TBI患者和35名血清IL-1β高(≥0.0565 pg/ml)的患者。7天后测量创伤后认知功能的下降情况。
本研究表明,与血清IL-1β正常的组相比,血清IL-1β水平高的组在TBI后发生认知障碍的风险更高(RR = 2.6;95%CI 1.49 - 4.55,p < 0.001)。
血清IL-1β水平高的轻度TBI患者出现认知功能下降的可能性是血清IL-1β水平正常患者的两倍多。