Department of Neuroscience, Monash University, Melbourne, VIC, Australia.
Department of Neuroscience, Monash University, Melbourne, VIC, Australia; Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia.
J Pain. 2023 Aug;24(8):1383-1395. doi: 10.1016/j.jpain.2023.03.009. Epub 2023 Mar 22.
Traumatic brain injury (TBI) survivors often experience debilitating consequences. Due to the high impact nature of TBI, patients often experience concomitant peripheral injuries (ie, polytrauma). A common, yet often overlooked, comorbidity of TBI is chronic pain. Therefore, this study investigated how common concomitant peripheral injuries (ie, femoral fracture and muscle crush) can affect long-term behavioral and structural TBI outcomes with a particular focus on nociception. Rats were randomly assigned to 1 of 4 groups: polytrauma (POLY; ie, fracture + muscle crush + TBI), peripheral injury (PERI; ie, fracture + muscle crush + sham TBI), TBI (ie, sham fracture + sham muscle crush + TBI), and sham-injured (SHAM; ie, sham fracture + sham muscle crush + sham TBI). Rats underwent behavioral testing at 3-, 6-, and 11-weeks postinjury, and were then euthanized for postmortem magnetic resonance imaging (MRI). POLY rats had a persisting increase in pain sensitivity compared to all groups on the von Frey test. MRI revealed that POLY rats also had abnormalities in the cortical and subcortical brain structures involved in nociceptive processing. These findings have important implications and provide a foundation for future studies to determine the underlying mechanisms and potential treatment strategies for chronic pain in TBI survivors. PERSPECTIVE: Rats with TBI and concomitant peripheral trauma displayed chronic nociceptive pain and MRI images also revealed damaged brain structures/pathways that are involved in chronic pain development. This study highlights the importance of polytrauma and the affected brain regions for developing chronic pain.
创伤性脑损伤 (TBI) 幸存者常经历使人衰弱的后果。由于 TBI 的高冲击力性质，患者常伴有外周损伤（即多发伤）。TBI 的一种常见但常被忽视的合并症是慢性疼痛。因此，本研究调查了常见的并发外周损伤（即股骨骨折和肌肉挤压伤）如何影响 TBI 的长期行为和结构结果，特别关注痛觉过敏。大鼠被随机分为 4 组之一：多发伤（POLY；即骨折+肌肉挤压伤+TBI）、外周损伤（PERI；即骨折+肌肉挤压伤+假 TBI）、TBI（即假骨折+假肌肉挤压伤+TBI）和假损伤（SHAM；即假骨折+假肌肉挤压伤+假 TBI）。大鼠在受伤后 3、6 和 11 周进行行为测试，然后进行死后磁共振成像 (MRI)。von Frey 测试显示，POLY 大鼠的疼痛敏感性持续增加，与所有组相比均有增加。MRI 显示，POLY 大鼠在参与痛觉处理的皮质和皮质下脑结构中也存在异常。这些发现具有重要意义，并为未来研究确定 TBI 幸存者慢性疼痛的潜在机制和治疗策略提供了基础。观点：TBI 合并外周创伤的大鼠表现出慢性痛觉过敏，MRI 图像还显示了参与慢性疼痛发展的受损大脑结构/通路。本研究强调了多发伤和受影响的大脑区域在慢性疼痛发展中的重要性。
