Effects of traumatic brain injury on intestinal contractility

Olsen, Alex; Hetz, Robert A.; Xue, Hasen; Aroom, Kevin R.; Bhattarai, Deepa; Johnson, Elizabeth O.; Bedi, Supinder S.; Cox, Charles S.; Uray, Karen

doi:10.1111/nmo.12121

Cited by 72 publications

(58 citation statements)

References 44 publications

(54 reference statements)

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“…Functionally, decreased contractility of the smooth muscle within the GI tract results in delayed transit times following TBI 108,109 . Pre-clinical data suggests that this functional impairment is correlated with both increased systemic inflammation in the gut and brain atrophy 108 .…”

Section: Top-down: Brain-to-gutmentioning

confidence: 99%

The bidirectional gut-brain-microbiota axis as a potential nexus between traumatic brain injury, inflammation, and disease

Sundman

Chen

Subbian

et al. 2017

Brain, Behavior, and Immunity

150

103

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The bidirectional gut-brain-microbiota axis as a potential nexus between traumatic brain injury, inflammation, and disease. AbstractAs head injuries and their sequelae have become an increasingly salient matter of public health, experts in the field have made great progress elucidating the biological processes occurring within the brain at the moment of injury and throughout the recovery thereafter. Given the extraordinary rate at which our collective knowledge of neurotrauma has grown, new insights may be revealed by examining the existing literature across disciplines with a new perspective. This article will aim to expand the scope of this rapidly evolving field of research beyond the confines of the central nervous system (CNS). Specifically, we will examine the extent to which the bidirectional influence of the gut-brain axis modulates the complex biological processes occurring at the time of traumatic brain injury (TBI) and over the days, months, and years that follow. In addition to local enteric signals originating in the gut, it is well accepted that gastrointestinal (GI) physiology is highly regulated by innervation from the CNS. Conversely, emerging data suggests that the function and health of the CNS is modulated by the interaction between 1) neurotransmitters, immune signaling, hormones, and neuropeptides produced in the gut, 2) the composition of the gut microbiota, and 3) integrity of the intestinal wall serving as a barrier to the external environment. Specific to TBI, existing pre-clinical data indicates that head injuries can cause structural and functional damage to the GI tract, but research directly investigating the neuronal consequences of this intestinal damage is lacking. Despite this void, the proposed mechanisms emanating from a damaged gut are closely implicated in the inflammatory processes known to promote neuropathology in the brain following TBI, which suggests the gut-brain axis may be a therapeutic target to reduce the risk of Chronic Traumatic Encephalopathy and other neurodegenerative diseases following TBI. To better appreciate how various peripheral influences are implicated in the health of the CNS following TBI, this paper will also review the secondary biological injury mechanisms and the dynamic pathophysiological response to neurotrauma. Together, this review article will attempt to connect the dots to reveal novel insights into the bidirectional influence of the gut-brain axis and propose a conceptual model relevant to the recovery from TBI and subsequent risk for future neurological conditions.

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Section: Top-down: Brain-to-gutmentioning

confidence: 99%

The bidirectional gut-brain-microbiota axis as a potential nexus between traumatic brain injury, inflammation, and disease

Sundman

Chen

Subbian

et al. 2017

Brain, Behavior, and Immunity

150

103

View full text Add to dashboard Cite

show abstract

“…Some studies showed that moderate TBI with no substantial mucosal damage causes a delayed significant decrease in intestinal contractile activity that occurs primarily in the ileum due to decreased contraction amplitude. In addition, intestinal transit was decreased after TBI [33]. Also, studies demonstrated that TBI induces a decrease in both intestinal contractility and transit and an increase in inflammation in the intestinal smooth muscle suggesting that motility is inhibited in the small intes- tine due to inflammatory damage secondary to the brain injury.…”

Section: Tbi and Gi Problemsmentioning

confidence: 91%

“…Altered contractile activity and motility in the small intestine were associated with increased inflammation in the intestinal smooth muscle [33].…”

Section: Tbi and Gi Problemsmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic Brain Injury and the Gastrointestinal Tract: The Role of Female Sexual Hormones

et al. 2017

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Traumatic brain injury (TBI) is an important public health problem which can lead to several complications like gastrointestinal dysfunction. Patients with TBI often suffer from gastrointestinal dysfunctions such as enteral feeding intolerance. Gastric ulceration is induced by various forms of stress like surgery, ischemia and trauma. TBI causes a delayed but significant decrease in intestinal contractile activity in the ileum leading to delayed transport. The association between severity of brain injury and enteral feeding intolerance suggests a strong link between the central nervous system and the non-functional gut. The results of recent basic and clinical studies revealed the beneficial effects of estrogen and progesterone hormones in the treatment of gastrointestinal dysfunction. Females have more resistance to stress and fewer gastrointestinal lesions occur in females as compared to males. Sex steroid hormones have sparked interest as possible neuroprotective agents after traumatic injury and many studies have been done on this subject. This article reviews the literature related to some possible physiological effects of female sexual hormones on the gastrointestinal tract following TBI.

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“…These findings are supported by Spodniewska et al (12) who considered their patients were constipated if they failed to open their bowels for 3 continuous days. While, Olsen et al (13) commented that traumatic patients usually have gastrointestinal dysfunction especially enteral feeding intolerance. Moreover, Nassar et al (1) stated that constipation is occurred in the majority of their studied patients with no significance in terms of age, sex and admission diagnosis.…”

Section: Discussionmentioning

confidence: 99%