Abstract

A significant proportion of the military personnel returning from Iraq and Afghanistan conflicts have suffered from both mild traumatic brain injury (mTBI) and post-traumatic stress disorder. The mechanisms are unknown. We used a rat model of repeated stress and mTBI to examine brain activity and behavioral function. Adult male Sprague-Dawley rats were divided into four groups: Naïve; 3 days repeated tail-shock stress; lateral fluid percussion mTBI; and repeated stress followed by mTBI (S-mTBI). Open field activity, sensorimotor responses, and acoustic startle responses (ASRs) were measured at various time points after mTBI. The protein expression of mitochondrial electron transport chain (ETC) complex subunits (CI-V) and pyruvate dehydrogenase (PDHE1α1) were determined in four brain regions at day 7-post mTBI. Compared to Naïves, repeated stress decreased horizontal activity; repeated stress and mTBI both decreased vertical activity; and the mTBI and S-mTBI groups were impaired in sensorimotor and ASRs. Repeated stress significantly increased CI, CII, and CIII protein levels in the prefrontal cortex (PFC), but decreased PDHE1α1 protein in the PFC and cerebellum, and decreased CIV protein in the hippocampus. The mTBI treatment decreased CV protein levels in the ipsilateral hippocampus. The S-mTBI treatment resulted in increased CII, CIII, CIV, and CV protein levels in the PFC, increased CI level in the cerebellum, and increased CIII and CV levels in the cerebral cortex, but decreased CI, CII, CIV, and PDHE1α1 protein levels in the hippocampus. Thus, repeated stress or mTBI alone differentially altered ETC expression in heterogeneous brain regions. Repeated stress followed by mTBI had synergistic effects on brain ETC expression, and resulted in more severe behavioral deficits. These results suggest that repeated stress could have contributed to the high incidence of long-term neurologic and neuropsychiatric morbidity in military personnel with or without mTBI.

Highlights

  • Estimates as high as 24% of U.S military personnel returning from Iraq and Afghanistan battlefields have suffered from a mild traumatic brain injury and/or post-traumatic stress disorder (PTSD) [1,2,3,4,5]

  • There was a main effect for Group, F [3,40] = 6.46, p < 0.001, η2 = 0.32, such that Naïve animals had significantly more vertical activity (VA) than did S-mild traumatic brain injury (mTBI) animals and Stress animals

  • Summary The behavioral and brain protein data support a greater impact of combined stress plus brain injury than mTBI or stress alone on neurobehavioral function and brain mitochondrial electron transport chain (ETC) expression

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Summary

Introduction

Estimates as high as 24% of U.S military personnel returning from Iraq and Afghanistan battlefields have suffered from a mild traumatic brain injury (mTBI) and/or post-traumatic stress disorder (PTSD) [1,2,3,4,5]. Comorbidity of mTBI and PTSD are high among this sub-population [3]. The brain is the organ of glucose metabolism and adenosine triphosphate (ATP) utilization, which expresses our essence, our nature, and is solely responsible for our behavioral and psychological functions to help define who we are. Pyruvate dehydrogenase (PDH) is the rate-limiting enzyme that irreversibly transfers the glycolysis product pyruvate into acetyl-coenzyme A (CoA) for efficient production of nicotinamide adenine dinucleotide (NADH) and ATP through mitochondrial tricarboxylic acid (TCA) cycle and oxidative phosphorylation pathway (OXPHOS). OXPHOS is mediated by mitochondrial electron transport chain (ETC) complex subunits (CI, CII, CIII, CIV, and CV)

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