Abstract

Traumatic brain injury (TBI) is a frequent cause of chronic headache, fatigue, insomnia, hyperactivity, memory deficits, irritability and posttraumatic stress disorder. Recent evidence suggests beneficial effects of pro-cannabinoid treatments. We assessed in mice levels of endocannabinoids in association with the occurrence and persistence of comparable sequelae after controlled cortical impact in mice using a set of long-term behavioral observations in IntelliCages, motor and nociception tests in two sequential cohorts of TBI/sham mice. TBI mice maintained lower body weights, and they had persistent low levels of brain ethanolamide endocannabinoids (eCBs: AEA, OEA, PEA) in perilesional and subcortical ipsilateral brain tissue (6 months), but rapidly recovered motor functions (within days), and average nociceptive responses were within normal limits, albeit with high variability, ranging from loss of thermal sensation to hypersensitivity. TBI mice showed persistent non-goal directed nighttime hyperactivity, i.e. they visited rewarding and non-rewarding operant corners with high frequency and random success. On successful visits, they made more licks than sham mice resulting in net over-licking. The lower the eCBs the stronger was the hyperactivity. In reward-based learning and reversal learning tasks, TBI mice were not inferior to sham mice, but avoidance memory was less stable. Hence, the major late behavioral TBI phenotype was non-goal directed nighttime hyperactivity and "over-licking" in association with low ipsilateral brain eCBs. The behavioral phenotype would agree with a "post-TBI hyperactivity disorder". The association with persistently low eCBs in perilesional and subcortical regions suggests that eCB deficiency contribute to the post-TBI psychopathology.

Highlights

  • Traumatic brain injury (TBI) is a frequent cause of chronic headache, fatigue, insomnia, hyperactivity, memory deficits, irritability and posttraumatic stress disorder

  • We found previously in the controlled cortical impact model (CCI) that TBI mice have persistent anxiety-like behavior up to 7 months after T­ BI17, which is reminiscent of the malprocessing of threat signals in human ­PTSD32

  • Asterisks indicate significant differences between groups (2-way analysis of variance (ANOVA) for time courses, factor "group", 2-sided independent T test for comparison of final body weights, ***< 0.001; P adjusted according to Šidák for comparison of individual time points). (C) Plasma concentrations of endocannabinoids: anandamide AEA, oleoylethanolamide, OEA, palmitoylethanolamide, PEA and 1-arachidonoylglycerol, 1-AG in TBI/sham mice of cohort-1 at the end of the observation 101 days after surgery

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Summary

Introduction

Traumatic brain injury (TBI) is a frequent cause of chronic headache, fatigue, insomnia, hyperactivity, memory deficits, irritability and posttraumatic stress disorder. TBI mice showed persistent non-goal directed nighttime hyperactivity, i.e. they visited rewarding and non-rewarding operant corners with high frequency and random success On successful visits, they made more licks than sham mice resulting in net overlicking. Even mild traumatic brain injuries often lead to persistent fatigue, unstable mood and poor concentration, insomnia, memory deficits, depression or hyperactivity and chronic p­ ain[3,4]. These symptoms resolve, but they persist in some patients over months regardless of the injury severity. Early predictors of unfavorable outcomes were identified such as emotional distress and a­ ge[5], there are no established preventive strategies, and chronic post TBI pain, partially co-incident with depression or PTSD, is mostly not sufficiently responsive to psychosocial interventions or typical a­ nalgesics[6]

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