Abstract

Approximately 2 million individuals experience a traumatic brain injury (TBI) every year in the United States. Secondary injury begins within minutes after TBI, with alterations in cellular function and chemical signaling that contribute to excitotoxicity. Post-traumatic seizures (PTS) are experienced in an increasing number of TBI individuals that also display resistance to traditional anti-seizure medications (ASMs). Sonic hedgehog (Shh) is a signaling pathway that is upregulated following central nervous system damage in zebrafish and aids injury-induced regeneration. Using a modified Marmarou weight drop on adult zebrafish, we examined PTS following TBI and Shh modulation. We found that inhibiting Shh signaling by cyclopamine significantly increased PTS in TBI fish, prolonged the timeframe PTS was observed, and decreased survival across all TBI severities. Shh-inhibited TBI fish failed to respond to traditional ASMs, but were attenuated when treated with CNQX, which blocks ionotropic glutamate receptors. We found that the Smoothened agonist, purmorphamine, increased Eaat2a expression in undamaged brains compared to untreated controls, and purmorphamine treatment reduced glutamate excitotoxicity following TBI. Similarly, purmorphamine reduced PTS, edema, and cognitive deficits in TBI fish, while these pathologies were increased and/or prolonged in cyclopamine-treated TBI fish. However, the increased severity of TBI phenotypes with cyclopamine was reduced by cotreating fish with ceftriaxone, which induces Eaat2a expression. Collectively, these data suggest that Shh signaling induces Eaat2a expression and plays a role in regulating TBI-induced glutamate excitotoxicity and TBI sequelae.

Highlights

  • IntroductionTraumatic brain injuries (TBIs) have tremendous and lasting impacts because they can result in various sequelae and are one of the leading causes of disease burden in the United States [1,2,3]

  • Sonic hedgehog (Shh) was identified as a key pathway that is activated following damage to the central nervous system (CNS) in the adult zebrafish and is required for injury-induced regeneration [17,34,35]

  • No Post-traumatic seizures (PTS) was observed within 1 hpi following a mild traumatic brain injury (TBI), while moderate TBI induced PTS in a significant percentage of fish immediately following injury (10.66% ± 1.37%, Figure 2B) and this was further elevated following severe TBI

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Summary

Introduction

Traumatic brain injuries (TBIs) have tremendous and lasting impacts because they can result in various sequelae and are one of the leading causes of disease burden in the United States [1,2,3]. Post-traumatic seizures (PTS) are a common consequence following TBI [3,4]. Development of PTS is influenced by age at time of injury, type of TBI (blunt vs penetrating), and injury severity [4,5,6]. The incidence rate varies greatly, PTS has been reported as high as 30% in military veterans with TBI, while civilians displayed a 20–50% increased risk of TBI-induced PTS compared to the development of non-acquired epilepsy [7,8]. PTS can result in a cyclic injury pattern in which

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