VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA 98108, USA.
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA.
Brain. 2024 Jun 3;147(6):2214-2229. doi: 10.1093/brain/awae065.
Mild traumatic brain injury (mTBI) has emerged as a potential risk factor for the development of neurodegenerative conditions such as Alzheimer's disease and chronic traumatic encephalopathy. Blast mTBI, caused by exposure to a pressure wave from an explosion, is predominantly experienced by military personnel and has increased in prevalence and severity in recent decades. Yet the underlying pathology of blast mTBI is largely unknown. We examined the expression and localization of AQP4 in human post-mortem frontal cortex and observed distinct laminar differences in AQP4 expression following blast exposure. We also observed similar laminar changes in AQP4 expression and localization and delayed impairment of glymphatic function that emerged 28 days following blast injury in a mouse model of repetitive blast mTBI. In a cohort of veterans with blast mTBI, we observed that blast exposure was associated with an increased burden of frontal cortical MRI-visible perivascular spaces, a putative neuroimaging marker of glymphatic perivascular dysfunction. These findings suggest that changes in AQP4 and delayed glymphatic impairment following blast injury may render the post-traumatic brain vulnerable to post-concussive symptoms and chronic neurodegeneration.
轻度创伤性脑损伤(mTBI)已成为阿尔茨海默病和慢性创伤性脑病等神经退行性疾病发展的潜在风险因素。爆炸引起的压力波导致的爆震性 mTBI 主要发生在军事人员中,在最近几十年中其患病率和严重程度都有所增加。然而,爆震性 mTBI 的潜在病理机制在很大程度上尚不清楚。我们研究了 AQP4 在人类死后额皮质中的表达和定位,并观察到在爆震暴露后 AQP4 表达存在明显的分层差异。我们还观察到在重复爆震性 mTBI 小鼠模型中,AQP4 表达和定位出现类似的分层变化以及糖质淋系统功能延迟损伤,这是在爆震损伤后 28 天出现的。在一组患有爆震性 mTBI 的退伍军人中,我们观察到爆震暴露与额皮质 MRI 可见的血管周围空间负担增加有关,这是糖质淋系统血管周围功能障碍的一个潜在神经影像学标志物。这些发现表明,爆震伤后 AQP4 的变化和糖质淋系统功能的延迟损伤可能使创伤后的大脑容易受到脑震荡后症状和慢性神经退行性变的影响。
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