Mechanisms underlying vulnerabilities after repeat mild traumatic brain injuries

Greco, Tiffany; Ferguson, Lindsay; Giza, Christopher C.; Prins, Mayumi L.

doi:10.1016/j.expneurol.2019.01.012

Cited by 39 publications

(38 citation statements)

References 83 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Determination of the rate of glycolysis after injury has been suggested to be a valuable diagnostic tool for patients with TBI [10,35]. The temporal changes of injury-induced depression of glucose utilization represent a period in which the brain is particularly susceptible to further damage and the severity of glucose depression is associated with functional deficits and outcomes [4,15]. Several preclinical and clinical studies have shown worsened outcomes with repeat concussions [10,12,15].…”

Section: Discussionmentioning

confidence: 99%

“…The temporal changes of injury-induced depression of glucose utilization represent a period in which the brain is particularly susceptible to further damage and the severity of glucose depression is associated with functional deficits and outcomes [4,15]. Several preclinical and clinical studies have shown worsened outcomes with repeat concussions [10,12,15]. However, the degree to which elevated temperature contributes to glucose metabolic deficits is less known.…”

Section: Discussionmentioning

confidence: 99%

“…Guskiewicz and colleagues [12] showed that collegiate football players with a history of concussion are 3.4 times more likely to sustain a second concussion within the same season. This potential for a second impact is important because several studies have shown that sustaining an additional injury when the brain is particularly susceptible can significantly exacerbate physiological damage and functional deficits [4,10,[15][16][17]. Giza and DiFiori [4] reported that if the brain is injured during this "window", there exists a cumulative effect of injurious processes and worsened neurological outcomes; however, when there is a greater interval between the mTBIs, cumulative deficits are not observed [18].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mild Hyperthermia Aggravates Glucose Metabolic Consequences in Repetitive Concussion

Blaya

Truettner

Zhao

et al. 2020

IJMS

View full text Add to dashboard Cite

Traumatic brain injury (TBI) is one of the leading causes of mortality and disability around the world. Mild TBI (mTBI) makes up approximately 80% of reported cases and often results in transient psychological abnormalities and cognitive disruption. At-risk populations for mTBI include athletes and other active individuals who may sustain repetitive concussive injury during periods of exercise and exertion when core temperatures are elevated. Previous studies have emphasized the impact that increased brain temperature has on adverse neurological outcomes. A lack of diagnostic tools to assess concussive mTBI limits the ability to effectively identify the post-concussive period during which the brain is uniquely susceptible to damage upon sustaining additional injury. Studies have suggested that a temporal window of increased vulnerability that exists corresponds to a period of injury-induced depression of cerebral glucose metabolism. In the current study, we sought to evaluate the relationship between repetitive concussion, local cerebral glucose metabolism, and brain temperature using the Marmarou weight drop model to generate mTBI. Animals were injured three consecutive times over a period of 7 days while exposed to either normothermic or hyperthermic temperatures for 15 min prior to and 1 h post each injury. A 14C-2-deoxy-d-glucose (2DG) autoradiography was used to measure local cerebral metabolic rate of glucose (lCMRGlc) in 10 diverse brain regions across nine bregma levels 8 days after the initial insult. We found that repetitive mTBI significantly decreased glucose utilization bilaterally in several cortical areas, such as the cingulate, visual, motor, and retrosplenial cortices, as well as in subcortical areas, including the caudate putamen and striatum, compared to sham control animals. lCMRGlc was significant in both normothermic and hyperthermic repetitive mTBI animals relative to the sham group, but to a greater degree when exposed to hyperthermic conditions. Taken together, we report significant injury-induced glucose hypometabolism after repetitive concussion in the brain, and additionally highlight the importance of temperature management in the acute period after brain injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mild Hyperthermia Aggravates Glucose Metabolic Consequences in Repetitive Concussion

Blaya

Truettner

Zhao

et al. 2020

IJMS

View full text Add to dashboard Cite

show abstract

“…Recent estimates suggest that 6-36% of high school and collegiate athletes in the USA have experienced more than one concussion [72], potentially predisposing them to long-term neurodegenerative diseases [72] and an increased risk of suicide [64]. Concussion is a distinct form of mild traumatic brain injury (TBI) in which a biomechanical force temporarily disrupts normal brain functioning causing neurological-cognitive-behavioural signs and symptoms [97].…”

Section: Neuroprotection-concussion and Subconcussionmentioning

confidence: 99%

Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research

et al. 2020

View full text Add to dashboard Cite

Cannabidiol (CBD) is a non-intoxicating cannabinoid derived from Cannabis sativa. CBD initially drew scientific interest due to its anticonvulsant properties but increasing evidence of other therapeutic effects has attracted the attention of additional clinical and non-clinical populations, including athletes. Unlike the intoxicating cannabinoid, Δ 9-tetrahydrocannabinol (Δ 9-THC), CBD is no longer prohibited by the World Anti-Doping Agency and appears to be safe and well-tolerated in humans. It has also become readily available in many countries with the introduction of over-the-counter "nutraceutical" products. The aim of this narrative review was to explore various physiological and psychological effects of CBD that may be relevant to the sport and/ or exercise context and to identify key areas for future research. As direct studies of CBD and sports performance are is currently lacking, evidence for this narrative review was sourced from preclinical studies and a limited number of clinical trials in non-athlete populations. Preclinical studies have observed robust anti-inflammatory, neuroprotective and analgesic effects of CBD in animal models. Preliminary preclinical evidence also suggests that CBD may protect against gastrointestinal damage associated with inflammation and promote healing of traumatic skeletal injuries. However, further research is required to confirm these observations. Early stage clinical studies suggest that CBD may be anxiolytic in "stress-inducing" situations and in individuals with anxiety disorders. While some case reports indicate that CBD improves sleep, robust evidence is currently lacking. Cognitive function and thermoregulation appear to be unaffected by CBD while effects on food intake, metabolic function, cardiovascular function, and infection require further study. CBD may exert a number of physiological, biochemical, and psychological effects with the potential to benefit athletes. However, well controlled, studies in athlete populations are required before definitive conclusions can be reached regarding the utility of CBD in supporting athletic performance.

show abstract

“…In addition, the underreporting of concussions and concussion-like symptoms continues to be a serious medical concern, especially with athletes [8]. ose who continue to participate in sports after failing to report symptoms of a suspected concussion remain vulnerable to worsened symptomology if they return to play prior to full recovery [9].…”

Section: Introductionmentioning

confidence: 99%

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Lariviere

Bureau

Marshall³

et al. 2019

Journal of Sports Medicine

View full text Add to dashboard Cite

Concussions are among the most common neurological conditions, with emergency departments and sports injury clinics seeing hundreds of patients each year. The consideration of risk factors such as age, sex, and comorbid conditions are very important when looking at individual physiological and psychological outcomes after a concussion. The purpose of this study was to look at four comorbid conditions (depression, anxiety, behavioural disorder, or learning disability) and identify any interactions with age and sex in symptom presentation after suffering a concussion. A total of 4,865 participants from the CCMI (Complete Concussion Management Inc.) dataset were used with 1,577 self-identified with a diagnosis of anxiety, depression, a behavioural disorder, or a learning disability. Fixed-factor analyses of variance were used with age and sex as fixed, grouping factors and symptom total and severity as dependent measures. For the individuals who did not have one of the 4 mental health conditions (3,288 control participants), symptom total and symptom severity increased with age (p<0.05), and females showed more symptoms and a higher symptom severity than males across all ages (p<0.05). A diagnosis of anxiety or depression exacerbated total symptoms and symptom severity from 25–50% above control levels in the 19 and under age groups, while depression or anxiety exacerbated total symptoms and severity by 10–15% in males more than females over 20. A diagnosis of a behavioural disorder or a learning disability exacerbated symptom severity by approximately 50% above control levels in 13–19–year-old females and in males of 30 years and older. This study highlights how the presence of a mental health condition may alter concussion symptom presentation dependent on age and sex. The identification of risk factors and how they may interact can be of great value to health care providers who manage concussion symptoms and recovery.

show abstract

Mechanisms underlying vulnerabilities after repeat mild traumatic brain injuries

Cited by 39 publications

References 83 publications

Mild Hyperthermia Aggravates Glucose Metabolic Consequences in Repetitive Concussion

Mild Hyperthermia Aggravates Glucose Metabolic Consequences in Repetitive Concussion

Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Contact Info

Product

Resources

About