Brain Injury Forces of Moderate Magnitude Elicit the Fencing Response
Brain Injury Forces of Moderate Magnitude Elicit the Fencing Response
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DOI：
10.1249/mss.0b013e31819fcd1b
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发表时间：
2009-09-01
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影响因子：
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通讯作者：
Lifshitz, Jonathan
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文献类型：
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作者：
Hosseini, Ario H.;Lifshitz, Jonathan
侯赛尼H、和J·利夫希茨中等强度的脑损伤力引起击剑反应。医学科学体育锻炼：Vol. 41，No. 9，pp. 1687-1697，2009年。引言：创伤性脑损伤是异质性的，无论是在其诱导和随后的神经系统后遗症。这样，医疗保健就依赖于准确识别与伤害相关的力量的严重程度。临床上，损伤的严重程度由格拉斯哥昏迷评分、无意识时间、创伤后遗忘和神经系统后遗症的持续性共同决定。在实验室中，损伤的严重程度是通过生物力学力量和神经反射的急性抑制来衡量的。目前的通信描述和验证的“击剑反应”作为一个明显的指标，伤害力的大小和中脑定位，以帮助损伤识别和分类。研究方法：使用YouTube（TM），互联网视频数据库，视频被筛选为头部受伤导致无意识和记录的击剑反应。成年雄性大鼠遭受两种严重程度的中线液压冲击脑损伤，观察急性神经反射和中脑组织病理学评价。结果如下：已观察到强直性姿势（击剑反应）在运动损伤的抽搐之前，在冲击的时刻，无论身体位置或重力如何，对侧手臂都会伸展和弯曲。在35个通过头部撞击和无意识期识别的视频中，66%在撞击时显示出击剑反应，无论撞击的侧面如何，没有随后的抽搐。同样，弥漫性脑损伤大鼠在中度（1.9 atm，39/44只动物）但非轻度（1.1 atm，0/19只动物）损伤后表现出击剑反应。前庭外侧核与小脑脚的接近使其容易受到机械力的影响，机械力会引发神经化学风暴，引发神经运动反应，破坏血脑屏障并改变核体积。结论：因此，击剑反应可能表明与施加在中脑上的中等大小的机械力相关的惊厥所特有的神经障碍，并且可以帮助指导受伤后的医疗护理。
HOSSEINI, A. H., and J. LIFSHITZ. Brain Injury Forces of Moderate Magnitude Elicit the Fencing Response. Med Sci. Sports Exerc., Vol. 41, No. 9, pp. 1687-1697, 2009. Introduction: Traumatic brain injury is heterogeneous, both in its induction and ensuing neurological sequelae. In this way, medical care depends on accurately identifying the severity of injury-related forces. Clinically, injury severity is determined by a combination of the Glasgow Coma Scale, length of unconsciousness, posttraumatic amnesia, and persistence of neurological sequelae. In the laboratory, injury severity is gauged by the biomechanical forces and the acute suppression of neurological reflexes. The present communication describes and validates the "fencing response" as an overt indicator of injury force magnitude and midbrain localization to aid in injury identification and classification. Methods: Using YouTube (TM), the Internet video database, videos were screened for head injury resulting in unconsciousness and documented for the fencing response. Adult male rats were subjected to midline fluid percussion brain injury at two severities, observed for acute neurological reflexes and the midbrain evaluated histopathologically. Results: Tonic posturing (fencing response) has been observed to precede convulsions in sports injuries at the moment of impact, where extension and flexion of opposite arms occurs despite body position or gravity. Of the 35 videos identified by an impact to the head and period of unconsciousness, 66% showed a fencing response at the moment of impact, regardless of the side of impact, without ensuing convulsion. Similarly, diffuse brain-injured rats demonstrate a fencing response upon injury at moderate (1.9 atm, 39/44 animals) but not mild severity (1.1 atm, 0/19 animals). The proximity of the lateral vestibular nucleus to the cerebellar peduncles makes it vulnerable to mechanical forces that initiate a neurochemical storm to elicit the neuromotor response, disrupt the blood-brain barrier, and alter the nuclear volume. Conclusions: Therefore, the fencing response likely indicates neurological disturbance unique from convulsion associated with mechanical forces of moderate magnitude imparted on the midbrain and can assist in guiding medical care after injury.