Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky.
Department of Basic Medicine, Caucasus International University, Tbilisi, Georgia.
Eur J Neurosci. 2019 Sep;50(5):2860-2876. doi: 10.1111/ejn.14390. Epub 2019 Mar 12.
Traumatic brain injury (TBI) is an increasing health problem. It is a complex, progressive disease that consists of many factors affecting memory. Studies have shown that increased blood-brain barrier (BBB) permeability initiates pathological changes in neuro-vascular network but the role of cerebrovascular dysfunction and its mediated mechanisms associated with memory reduction during TBI are still not well understood. Changes in BBB, inflammation, extravasation of blood plasma components, activation of neuroglia lead to neurodegeneration. Extravasated proteins such as amyloid-beta, fibrinogen, and cellular prion protein may form degradation resistant complexes that can lead to neuronal dysfunction and degeneration. They also have the ability to activate astrocytes, and thus, can be involved in memory impairment. Understanding the triggering mechanisms and the places they originate in vasculature or in extravascular tissue may help to identify potential therapeutic targets to ameliorate memory reduction during TBI. The goal of this review is to discuss conceptual mechanisms that lead to short-term memory reduction during non-severe TBI considering distinction between vascular and non-vascular effects on neurons. Some aspects of these mechanisms need to be confirmed further. Therefore, we hope that the discussion presented bellow may lead to experiments that may clarify the triggering mechanisms of memory reduction after head trauma.
创伤性脑损伤(TBI)是一个日益严重的健康问题。它是一种复杂的、进行性的疾病,由许多影响记忆的因素组成。研究表明,血脑屏障(BBB)通透性的增加会引发神经血管网络的病理变化,但脑血管功能障碍及其介导的机制与 TBI 期间记忆减少的关系仍不清楚。BBB 的变化、炎症、血浆成分的渗出、神经胶质的激活导致神经退行性变。渗出的蛋白质,如淀粉样β、纤维蛋白原和细胞朊病毒蛋白,可能形成降解抗性复合物,导致神经元功能障碍和退化。它们还具有激活星形胶质细胞的能力,因此可能参与记忆障碍。了解触发机制及其在血管内或血管外组织中的起源部位,可能有助于确定潜在的治疗靶点,以改善 TBI 期间的记忆减退。本综述的目的是讨论导致非严重 TBI 期间短期记忆减退的概念机制,同时考虑血管和非血管对神经元的影响之间的区别。这些机制的某些方面需要进一步证实。因此,我们希望下面的讨论能引导进一步的实验,以阐明头部创伤后记忆减退的触发机制。