Semple Bridgette D, Raghupathi Ramesh
Department of Neuroscience, Monash University, Prahran, VIC, Australia.
Department of Neurology, Alfred Health, Prahran, VIC, Australia.
Front Neurol. 2021 Aug 19;12:714253. doi: 10.3389/fneur.2021.714253. eCollection 2021.
Traumatic brain injury (TBI) is a leading cause of injury-induced disability in young children worldwide, and social behavior impairments in this population are a significant challenge for affected patients and their families. The protracted trajectory of secondary injury processes triggered by a TBI during early life-alongside ongoing developmental maturation-offers an extended time window when therapeutic interventions may yield functional benefits. This mini-review explores the scarce but promising pre-clinical literature to date demonstrating that social behavior impairments after early life brain injuries can be modified by drug therapies. Compounds that provide broad neuroprotection, such as those targeting neuroinflammation, oxidative stress, axonal injury and/or myelination, may prevent social behavior impairments by reducing secondary neuropathology. Alternatively, targeted treatments that promote affiliative behaviors, exemplified by the neuropeptide oxytocin, may reduce the impact of social dysfunction after pediatric TBI. Complementary literature from other early life neurodevelopmental conditions such as hypoxic ischemic encephalopathy also provides avenues for future research in neurotrauma. Knowledge gaps in this emerging field are highlighted throughout, toward the goal of accelerating translational research to support optimal social functioning after a TBI during early childhood.
创伤性脑损伤（TBI）是全球幼儿因伤致残的主要原因，该人群的社会行为障碍对受影响的患者及其家庭构成了重大挑战。在生命早期，TBI引发的继发性损伤过程持续时间较长，再加上持续的发育成熟过程，这为治疗干预可能产生功能益处提供了一个较长的时间窗口。这篇综述探讨了迄今为止稀少但有前景的临床前文献，这些文献表明，生命早期脑损伤后的社会行为障碍可以通过药物治疗得到改善。提供广泛神经保护作用的化合物，如那些针对神经炎症、氧化应激、轴突损伤和/或髓鞘形成的化合物，可能通过减少继发性神经病理学来预防社会行为障碍。或者，以神经肽催产素为例的促进亲和行为的靶向治疗，可能会减轻小儿TBI后社会功能障碍的影响。来自其他生命早期神经发育疾病（如缺氧缺血性脑病）的补充文献也为神经创伤的未来研究提供了途径。本文自始至终强调了这一新兴领域的知识空白，旨在加速转化研究，以支持幼儿TBI后实现最佳社会功能。
