Edlow Brian L, Tseng Chieh-En J, Gilmore Natalie, McKinney Isabella R, Tromly Samantha L, Deary Katryna B, Hu Collin G, Healy Brian C, Priemer David S, Mac Donald Christine L, Dams-O'Connor Kristen, Greve Douglas N, Bodien Yelena G, Perl Daniel P, Hooker Jacob M, Zürcher Nicole R
Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Neurotrauma Rep. 2024 Dec 16;5(1):1205-1211. doi: 10.1089/neur.2024.0116. eCollection 2024.
Emerging evidence from autopsy studies indicates that interface astroglial scarring (IAS) at the gray-white matter junction is a pathological signature of repeated blast brain injury in military personnel. However, there is currently no neuroimaging test that detects IAS, which is a major barrier to diagnosis, prevention, and treatment. In 27 active-duty U.S. Special Operations Forces personnel with high levels of cumulative blast exposure, we performed translocator protein (TSPO) positron emission tomography (PET) using [C]PBR28 to detect neuroinflammation at the cortical gray-white matter interface, a neuroanatomic location where IAS has been reported in autopsy studies. TSPO signal in individual Operators was compared with the mean TSPO signal in a control group of nine healthy civilian volunteers. We identified five Operators (18.5%) with TSPO signal at the cortical gray-white matter interface that was more than 2 standard deviations above the control mean. Cumulative blast exposure, as measured by the generalized blast exposure value, did not differ between the five Operators with elevated TSPO signal and the 22 Operators without elevated TSPO signal. While the pathophysiologic link between neuroinflammation and IAS remains uncertain, these preliminary observations provide the basis for further investigation into TSPO PET as a potential biomarker of repeated blast brain injury.
尸检研究的新证据表明，灰白质交界处的界面星形胶质瘢痕形成（IAS）是军事人员反复爆炸脑损伤的病理特征。然而，目前尚无检测IAS的神经影像学检查方法，这是诊断、预防和治疗的主要障碍。在27名累积爆炸暴露水平较高的美国现役特种作战部队人员中，我们使用[C]PBR28进行了转运体蛋白（TSPO）正电子发射断层扫描（PET），以检测皮质灰白质界面的神经炎症，尸检研究已报道IAS存在于该神经解剖位置。将个体操作人员的TSPO信号与9名健康平民志愿者对照组的平均TSPO信号进行比较。我们确定了5名操作人员（18.5%），其皮质灰白质界面的TSPO信号比对照平均值高出2个标准差以上。通过广义爆炸暴露值测量的累积爆炸暴露，在TSPO信号升高的5名操作人员和TSPO信号未升高的22名操作人员之间没有差异。虽然神经炎症与IAS之间的病理生理联系仍不确定，但这些初步观察结果为进一步研究TSPO PET作为反复爆炸脑损伤潜在生物标志物提供了基础。
