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创伤性脑损伤相关视神经损伤。

Traumatic Brain Injury-Related Optic Nerve Damage.

机构信息

From the Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Neuropathol Exp Neurol. 2022 Apr 27;81(5):344-355. doi: 10.1093/jnen/nlac018.

Abstract

Vision disorders are associated with traumatic brain injury (TBI) in 20%-40% of clinical cases and involve a diverse set of potential symptoms that can present acutely or chronically. Due to its structure and position, the optic nerve is vulnerable to multiple forms of primary injury, which can result in traumatic optic neuropathy (TON). Multiple studies have shown that the optic tract may also be injured during TBI, though data regarding the temporospatial resolution of injury to the optic nerve are sparse. We evaluated the time course of optic nerve injury and visual impairments in our closed head impact acceleration mouse model of mild TBI (mTBI) designed to mimic repetitive injuries experienced in the context of sport. Our results show that inflammation and gliosis occur acutely in response to injury. Additionally, indications of optic nerve degeneration and functional loss of vision beginning at 1-month postinjury, and retinal ganglion cell loss at 7 months, revealed that the degeneration is continuous and permanent. Together, this study demonstrated that the optic nerve is vulnerable to damage during mTBI, which can cause TON and vision loss. These findings will be important for clinicians to consider to determine whether optic nerve is injured in the TBI patients with vision problems.

摘要

视觉障碍与创伤性脑损伤(TBI)在 20%-40%的临床病例中有关,涉及一系列潜在的症状,这些症状可能急性或慢性出现。由于视神经的结构和位置,它容易受到多种形式的原发性损伤,从而导致外伤性视神经病变(TON)。多项研究表明,在 TBI 期间,视束也可能受到损伤,尽管关于视神经损伤的时空分辨率的数据很少。我们评估了我们设计的轻度创伤性脑损伤(mTBI)闭合性头部撞击加速小鼠模型中视神经损伤和视力障碍的时间过程,该模型旨在模拟运动背景下反复发生的损伤。我们的结果表明,炎症和神经胶质增生在损伤后急性发生。此外,视神经退行性变和损伤后 1 个月开始的视力丧失以及 7 个月时视网膜神经节细胞丢失的迹象表明,退行性变是连续和永久性的。综上所述,这项研究表明,视神经在 mTBI 中容易受到损伤,从而导致 TON 和视力丧失。这些发现对于临床医生来说很重要,需要考虑是否在有视力问题的 TBI 患者中视神经受伤。

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