Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury
Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury
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DOI：
10.1089/neu.2019.6483
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发表时间：
2019-11-08
影响因子：
4.2
通讯作者：
Campbell, Matthew
中科院分区：
文献类型：
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作者：
O'Keeffe, Eoin;Kelly, Eoin;Campbell, Matthew
中度和重度创伤性脑损伤（TBI）的诊断在当前的医学成像范式（磁共振成像（MRI）和计算机断层扫描（CT））上很容易看到，但与轻度创伤性脑损伤（mTBI）的诊断和后续治疗相关的挑战要大得多，尤其是脑震荡，根据定义，其特征是正常的CT。为了研究血脑屏障完整性（BBB）是否在脑震荡高危人群中发生改变，我们研究了专业综合格斗（MMA）运动员和青少年橄榄球运动员。此外，我们对动态对比增强磁共振成像（DCE-MRI）上钆造影剂外溢所定义的血脑屏障破坏与专业MMA运动员使用器械护齿所记录的多种生物力学参数之间进行了线性回归。综合格斗运动员在比赛前进行基线检查，在比赛后120小时内再次进行检查，而橄榄球运动员在赛季前和赛季后或比赛后再次进行检查。进行DCE-MRI、血脑屏障生物标志物血清学分析和仪器护齿数据分析。在这里，我们提供了试验数据，证明了职业综合格斗运动员和橄榄球运动员的血脑屏障的破坏，这取决于暴露水平。我们的数据表明，职业综合格斗和青少年橄榄球比赛中的生物力学力量会导致BBB的破坏。这些影像学上的变化可以作为大脑暴露于重复性次震荡力和mTBI的生物标志物。
Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (mTBI), especially concussion which, by definition, is characterized by a normal CT. To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast extravasation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on MRI and multiple biomechanical parameters indicating the severity of impacts recorded using instrumented mouthguards in professional MMA fighters. MMA fighters were examined pre-fight for a baseline and again within 120 h post-competitive fight, whereas rugby players were examined pre-season and again post-season or post-match in a subset of cases. DCE-MRI, serological analysis of BBB biomarkers, and an analysis of instrumented mouthguard data, was performed. Here, we provide pilot data that demonstrate disruption of the BBB in both professional MMA fighters and rugby players, dependent on the level of exposure. Our data suggest that biomechanical forces in professional MMA and adolescent rugby can lead to BBB disruption. These changes on imaging may serve as a biomarker of exposure of the brain to repetitive subconcussive forces and mTBI.