低强度爆炸对神经血管健康和脑血流的影响:神经影像学中的当前发现和未来机遇。

Effects of Low-Level Blast on Neurovascular Health and Cerebral Blood Flow: Current Findings and Future Opportunities in Neuroimaging.

机构信息

Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY 40536, USA.

Department of Physiology, University of Kentucky, Lexington, KY 40536, USA.

出版信息

Int J Mol Sci. 2024 Jan 4;25(1):642. doi: 10.3390/ijms25010642.

Abstract

Low-level blast (LLB) exposure can lead to alterations in neurological health, cerebral vasculature, and cerebral blood flow (CBF). The development of cognitive issues and behavioral abnormalities after LLB, or subconcussive blast exposure, is insidious due to the lack of acute symptoms. One major hallmark of LLB exposure is the initiation of neurovascular damage followed by the development of neurovascular dysfunction. Preclinical studies of LLB exposure demonstrate impairment to cerebral vasculature and the blood-brain barrier (BBB) at both early and long-term stages following LLB. Neuroimaging techniques, such as arterial spin labeling (ASL) using magnetic resonance imaging (MRI), have been utilized in clinical investigations to understand brain perfusion and CBF changes in response to cumulative LLB exposure. In this review, we summarize neuroimaging techniques that can further our understanding of the underlying mechanisms of blast-related neurotrauma, specifically after LLB. Neuroimaging related to cerebrovascular function can contribute to improved diagnostic and therapeutic strategies for LLB. As these same imaging modalities can capture the effects of LLB exposure in animal models, neuroimaging can serve as a gap-bridging diagnostic tool that permits a more extensive exploration of potential relationships between blast-induced changes in CBF and neurovascular health. Future research directions are suggested, including investigating chronic LLB effects on cerebral perfusion, exploring mechanisms of dysautoregulation after LLB, and measuring cerebrovascular reactivity (CVR) in preclinical LLB models.

摘要

低强度爆炸(LLB)暴露可导致神经健康、脑血管和脑血流(CBF)改变。由于缺乏急性症状,LLB 或亚脑震荡性爆炸暴露后认知问题和行为异常的发展是隐匿的。LLB 暴露的一个主要标志是神经血管损伤的开始,随后是神经血管功能障碍的发展。LLB 暴露的临床前研究表明,在 LLB 后早期和长期阶段,脑血管和血脑屏障(BBB)都受到损害。神经影像学技术,如磁共振成像(MRI)中的动脉自旋标记(ASL),已在临床研究中用于了解脑灌注和 CBF 变化对累积 LLB 暴露的反应。在这篇综述中,我们总结了神经影像学技术,这些技术可以进一步了解与爆炸相关的神经创伤的潜在机制,特别是在 LLB 之后。与脑血管功能相关的神经影像学可以为改善 LLB 的诊断和治疗策略做出贡献。由于这些相同的成像方式可以捕捉到动物模型中 LLB 暴露的影响,神经影像学可以作为一种弥合差距的诊断工具,更广泛地探索 CBF 和神经血管健康之间的潜在关系。提出了未来的研究方向,包括研究慢性 LLB 对脑灌注的影响、探索 LLB 后自主调节失调的机制以及测量临床前 LLB 模型中的脑血管反应性(CVR)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ec/10779081/cde5924eb814/ijms-25-00642-g001.jpg

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