Effects Of Traumatic Brain Injury Research Articles

Effect of Aqueous Extract of Lettuce on the Outcome of Patients With Traumatic Brain Injury in the Intensive Cares: A Randomized Clinical Trial

Objective Traumatic Brain Injury (TBI) is one of the leading causes of death in younger people. It activates neuroinflammatory responses that play an important role in breaking the blood-brain barrier and resulting in brain edema. Various studies have indicated the anti-inflammatory effect and the ability of lettuce extract to reduce oxygen free radicals. Therefore, it is expected to improve the consequences of TBI. Therefore, this study aims to investigate the anti-inflammatory effect of lettuce extract on the outcomes of patients with TBI admitted to the Intensive Care Units (ICUs). Methods This is a randomized clinical trial. Patients were divided into two groups of intervention (n=15) and control (n= 15). In the intervention group, patients received 250 g of lettuce aqueous extract twice a day for 7 days. In the control group, a placebo was administered. For all patients, the levels of inflammatory markers and variables related to the patient outcome were recorded. The data were analyzed in SPSS v.18 software using t-test, Mann-Whitney U test, repeated measures ANOVA, and chi-square test. Results There was no significant difference between the study groups in any study variables (P>0.05). Conclusion Lettuce aqueous extract is not effective in improving the outcomes of patients with TBI in ICUs, which can be due to the small sample size, short study duration, the illness of patients, the influence of confounding factors such as acidosis, and use of different lettuce cultivation method.

Use of Anti-epileptic Drugs for Post Traumatic Seizure: A Global Survey.

Post traumatic seizures (PTS) and post traumatic epilepsy (PTE) are potential consequences of traumatic brain injury (TBI). There is no consensus regarding its management among treating doctors. We have undertaken a global survey to assess the variability of management practices of PTS and PTE and highlight the pressing need to formulate uniform practice guidelines. A questionnaire consisting of sixteen questions were developed with the help of Google survey and sent through e-mail, or social media platforms like WhatsApp, Facebook messenger or Telegram, to practicing Neurologists and Neurosurgeons round the world. There were a total of 220 responses. Majority of our responders (n = 202; 91.8%) would start an anti-epileptic (AED) prophylaxis to prevent PTS; 18 people (8.18%) told that they would not start AED prophylaxis for TBI. Phenytoin (n = 98; 48.5%) followed by Levetiracetam (n = 78; 38.6%) was the preferred drug, although the latter was significantly preferred by high and upper middle-income countries (p<.001). Majority (n = 99; 49%) would not use it beyond two weeks. Most clinicians would manage PTE with a single drug (n = 160; 72.7%) either Phenytoin (n = 69; 31.3%) or levetiracetam (n = 67; 30.4%). Most of them (n = 174; 86%) would treat for less than one year. Practices in the management of PTS and PTE vary widely among clinicians. Our study point towards the need for the development of a more robust and comprehensive practice guidelines for the management of the same.

Piperine attenuates the inflammation, oxidative stress, and pyroptosis to facilitate recovery from spinal cord injury via autophagy enhancement.

Spinal cord injury (SCI) is a serious injury that can lead to irreversible motor dysfunction. Due to its complicated pathogenic mechanism, there are no effective drug treatments. Piperine, a natural active alkaloid extracted from black pepper, has been reported to influence neurogenesis and exert a neuroprotective effect in traumatic brain injury. The aim of this study was to investigate the therapeutic effect of piperine in an SCI model. SCI was induced in mice by clamping the spinal cord with a vascular clip for 1 min. Before SCI and every 2 days post-SCI, evaluations using the Basso mouse scale and inclined plane tests were performed. On day 28 after SCI, footprint analyses, and HE/Masson staining of tissues were performed. On a postoperative Day 3, the spinal cord was harvested to assess the levels of pyroptosis, reactive oxygen species (ROS), inflammation, and autophagy. Piperine enhanced functional recovery after SCI. Additionally, piperine reduced inflammation, oxidative stress, pyroptosis, and activated autophagy. However, the effects of piperine on functional recovery after SCI were reversed by autophagy inhibition. The study demonstrated that piperine facilitated functional recovery after SCI by inhibiting inflammatory, oxidative stress, and pyroptosis, mediated by the activation of autophagy.

Increased Fear Generalization and Amygdala AMPA Receptor Proteins in Chronic Traumatic Brain Injury.

Cognitive impairments and emotional lability are common long-term consequences of traumatic brain injury (TBI). How TBI affects interactions between sensory, cognitive, and emotional systems may reveal mechanisms that underlie chronic mental health comorbidities. Previously, we reported changes in auditory-emotional network activity and enhanced fear learning early after TBI. In the current study, we asked whether TBI has long-term effects on fear learning and responses to novel stimuli. Four weeks following lateral fluid percussion injury (FPI) or sham surgery, adult male rats were fear conditioned to either white noise-shock or tone-shock pairing, or shock-only control and subsequently were tested for freezing to context and to the trained or novel auditory cues in a new context. FPI groups showed greater freezing to their trained auditory cue, indicating long-term TBI enhanced fear. Interestingly, FPI-Noise Shock animals displayed robust fear to the novel, untrained tone compared with Sham-Noise Shock across both experiments. Shock Only groups did not differ in freezing to either auditory stimulus. These findings suggest that TBI precipitates maladaptive associative fear generalization rather than non-associative sensitization. Basolateral amygdala (BLA) α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAr) subunits GluA1 and GluA2 levels were analyzed and the FPI-Noise Shock group had increased GluA1 (but not GluA2) levels that correlated with the level of tone fear generalization. This study illustrates a unique chronic TBI phenotype with both a cognitive impairment and increased fear and possibly altered synaptic transmission in the amygdala long after TBI, where stimulus generalization may underlie maladaptive fear and hyperarousal.

The effect of Riluzole on neurological outcomes, blood-brain barrier, brain water and neuroinflammation in traumatic brain injury

BackgroundRiluzole (RLZ) is a potent anticonvulsant drug that reveals neuroprotective effects on neurological disease by inhibiting the release of glutamate and increasing its uptake. This study aims to investigate the potential neuroprotective effects of Riluzole in a rat model with acute severe traumatic brain injury (TBI). Materials and MethodsIn this study, seven groups of male Wistar rats were investigated including Sham, Intact, TBI, Saline (TBI + intraperitoneal (i.p) injection of normal saline), TBI + i.p injection of Riluzole in 2,4 and 8 mg/kg doses (RLZ 2, RLZ 4 and RLZ 8 groups), induction of severe diffuse TBI performed by weight dropping Marmarou model, and evaluation of short-term neurological deficits by using veterinary coma scale (VCS), beam-balance and beam-walk tasks. Histopathological changes in neural tissue were evaluated by using hematoxylin and eosin staining and light microscopy. Evaluation of blood-brain barrier (BBB) permeability was performed by using the Evans Blue method 6 h after traumatization. Brain water content assessment was performed by using the wet-dry method and the level of IL-1β and IL-10 was determined by using an enzyme-linked immunosorbent assay (ELISA). ResultsTreatment with Riluzole improves neurological function, VCS score, and vestibulomotor function, reduces pathological changes of neural tissue, brain edema, and level of IL-1β, and increases IL-10 concentration in CSF compared to the saline group (p < 0.0001). Treatment with 4 and 8 mg/kg of Riluzole reveals a significant therapeutic effect on consequences of TBI. This effect was enhanced by an increase in the dose of Riluzole from 4 to 8 mg/kg, but no significant changes were seen after administration of 2 mg/kg of Riluzole. ConclusionRiluzole can reduce the first and second phase of TBI damage by lowering inflammation, brain edema, histopathological destruction, BBB permeability, level of IL- 1β, and increasing IL-10 in CSF; it is highly suggested to use Riluzole in further studies and human trials, and also to consider it as a therapeutic compound in the treatment of traumatic brain injury.

Quality of life, vestibular discoordination and violation of the walking pattern of amateur athletes with long-term consequences of traumatic brain injury

Among the participants in the hostilities in the East of Ukraine, military personnel receive a brain contusion three times more often than other injuries. The main problem of closed craniocerebral injury is that complications appear after some time. The aim of the work was to investigate the consequences of traumatic brain injury accompanied by brain contusion in amateur athletes. All the tested athletes had the main neurological syndromes that limited their vital activity: vegetative disorders and discoordination of the vestibular genesis. Under observation were 12 men aged 25-42 years with long-term consequences of a closed craniocerebral injury in the late long-term period. The duration of the post-traumatic period is from six months. The cause of disability was wounds and contusions associated with military operations. In all patients, complications after TBI were a decrease in muscle strength in the lower extremities, impaired coordination and balance, and a walking pattern. According to the International Classification of Functioning, limitation of vital activity and health in subjects in the domain "Structure and functions of the body" was observed mono- or hemiparesis of the lower extremities. In the activity and participation domain, patients complained about being able to return to amateur sports. When assessing the quality of life on the VAS scale, a low level of quality of life was revealed. According to the Lovett manual muscle test, it was found that in the subjects in the late long-term period after injury, there is a decrease in muscle strength of both the anterior and posterior thigh and lower back muscle groups. The results of the Bohannon test showed an increased risk of falling due to imbalance. «Timed Up and Go» testing indicated a statistically significant decrease in vestibular coordination and gait pattern compared to the norm.

Advancing care and research for traumatic brain injury: a roadmap.

Across all segments of society in the United States, millions of adults and children experience a traumatic brain injury (TBI) each year, which may pose lifetime health and financial burdens in the billions of dollars. Efforts have been made to advance research and care with goals to improve awareness of the causes and consequences of TBI, but gaps still remain in understanding TBI and delivering high-quality care to everyone who needs it both in military and civilian life. At the request of the Department of Defense, the National Academies of Sciences, Engineering and Medicine recently convened experts to address existing gaps in brain injury science and systems of care. Although many people who experience a TBI recover fully, others experience long-term physical, emotional, and often financial consequences to the patient and family system, and require ongoing accommodations to support their return to the communities in which they live, learn, and work. A holistic approach within the context of osteopathic medicine may be helpful and enhance contributions within the field. This article will discuss the roadmap to help guide the field, including key conclusions and recommendations for actions to advance progress over the next decade while embracing a comprehensive bio-psycho-socio-ecological model of TBI care bringing in the distinctive osteopathic approach not only to improve care and outcomes, but also to understand patient and family experiences on their TBI journey.

Glutamate Neurotoxicity and Destruction of the Blood-Brain Barrier: Key Pathways for the Development of Neuropsychiatric Consequences of TBI and Their Potential Treatment Strategies.

Traumatic brain injury (TBI) is associated with significant cognitive and psychiatric conditions. Neuropsychiatric symptoms can persist for years following brain injury, causing major disruptions in patients’ lives. In this review, we examine the role of glutamate as an aftereffect of TBI that contributes to the development of neuropsychiatric conditions. We hypothesize that TBI causes long-term blood–brain barrier (BBB) dysfunction lasting many years and even decades. We propose that dysfunction in the BBB is the central factor that modulates increased glutamate after TBI and ultimately leads to neurodegenerative processes and subsequent manifestation of neuropsychiatric conditions. Here, we have identified factors that determine the upper and lower levels of glutamate concentration in the brain after TBI. Furthermore, we consider treatments of disruptions to BBB integrity, including repairing the BBB and controlling excess glutamate, as potential therapeutic modalities for the treatment of acute and chronic neuropsychiatric conditions and symptoms. By specifically focusing on the BBB, we hypothesize that restoring BBB integrity will alleviate neurotoxicity and related neurological sequelae.

A-188 The Effect of Traumatic Experiences on Identity Among People With Expressive Language Disorders

Abstract Objective: To examine the effects of traumatic brain injury (TBI) on identity functioning. Method: TBI survivors’ recollections of their sense of identity before and after they acquired a TBI were compared. Participants (N = 15, Mage = 52.67) recruited from rehabilitation and support groups completed two clinical interviews, as well as the Trauma Impacts of Identity Functioning Scales (Waterman, 2020) and Identity Distress Scale (Berman et al., 2004). They were mostly stroke survivors with aphasia. The majority of the participants were White (53.3%). The time since they acquired an expressive language disorder ranged from 2 to 21 years ago (M = 7.33). Results: A paired samples t-test revealed a significant increase in identity distress from pre- to post-brain injury (t(14) = -3.11, p = .008, 95% CI). A ONEWAY ANOVA revealed that ratings of how important their career is to their sense of identity significantly decreased post-TBI (F(1, 13) = 17.47, p = .001, λ = .427, 95% CI). During the clinical interviews, many TBI survivors reflected that they lost a large part of themselves because they could no longer pursue their careers, and they experienced drastic changes in their relationships and life roles. Participants had identity development delays, trauma-centered identity, identity loss, identity threat, and identity affirmation. Conclusion: Identity changes post-TBI varied greatly from one survivor to another, and time since trauma was not significantly correlated with identity functioning nor identity distress, suggesting the need for future research to determine which factors influence why TBI survivors’ experience post traumatic identity disruption and/or post-traumatic growth.

Animal welfare assessment after severe traumatic brain injury in rats.

Severe traumatic brain injury (TBI) is a multifactorial injury process involving respiratory, cardiovascular and immune functions in addition to the brain. Thus, live animal models are needed to study the molecular, cellular and systemic mechanisms of TBI. The ethical use of laboratory animals requires that the benefits of approaches be carefully weighed against potential harm to animals. Welfare assessments adapted to severe TBI research are lacking. Here, we introduce a scoresheet to describe and monitor potential distress in animals, which includes general welfare (body weight, general appearance and spontaneous behaviour) and TBI-specific indices (respiratory function, pain, locomotor impairment, wound healing). Implementation of this scoresheet in Sprague-Dawley rats subjected to severe lateral fluid percussion TBI revealed a period of suffering limited to four days, followed by a recovery to normal welfare scores within 10-15 days, with females showing a worse impact than males. The scores indicate that animal suffering in this model is transitory compared with TBI consequences in humans. The scoresheet allows for the implementation of refinement measures including (1) analgesia during the initial period following TBI and (2) humane endpoints set (30% weight loss, score ≥90 and/or respiratory problems). This animal scoresheet tailored to TBI research provides a basis for further refinement of animal research paradigms aimed at understanding or treating the sequelae of severe TBI.

Psychosocial Consequences of Spinal Cord Injury: A Narrative Review.

Consequences of a spinal cord injury (SCI) entail much more than damage to the spinal cord. The lives of people with SCI, along with those around them, experience profound long-lasting changes in nearly every life domain. SCI is a physical (biological) injury that is inextricably combined with various psychological and social consequences. The objective of this review is to present psychosocial challenges following SCI through the biopsychosocial model, beginning with acknowledgement of the larger societal effects of ableism and stigma before addressing the many unique psychosocial aspects of living with SCI. Included in this review are qualitative studies and systematic reviews on current psychosocial outcomes and consequences. This paper attempts to structure this information by dividing it into the following sections: relationships and family; changes in finances and employment; issues related to the person’s living situation; community reintegration; factors associated with mood and coping (e.g., depression, anxiety, substance use, and PTSD); self-harm behaviors (ranging from nonadherence to suicide); effects of traumatic brain injury; considerations regarding sexual health; aging with SCI; and concludes with a brief discussion about post-traumatic growth. Cultivating an understanding of the unique and interrelated psychosocial consequences of people living with SCI may help mitigate the psychosocial aftermath and serve as a reminder to providers to maintain a person-centered approach to care.

A-22 Neurorehabilitation Improves Emotional Domain Symptoms in Active and Retired NHL Players

Abstract Purpose: The prevalence of concussions in the National Hockey League (NHL) has been identified as approximately 1 concussion per 16.67 games, and the long-term effects of traumatic brain injuries are being highlighted in recent research. These long-term consequences may be due to chronic symptoms, especially neuropsychological symptoms, from unaddressed neurological dysfunction. Methods: A neuro-rehabilitation clinic treated 14 active or retired NHL players with symptoms relating to head injury an average of 2.47 years after their most recent head injury. A 5-day, multi-modal neurorehabilitation program was administered in 10 one-hour treatment sessions. Each session consisted of a combination of photobiomodulation, repetitive peripheral somatosensory stimuli, neuromuscular reeducation, vestibular rehabilitation, orthoptic exercises, cognitive exercises, and/or off-vertical axis rotation utilizing a multi-axis rotational chair. Results: On intake, the average overall symptom severity score of the SCAT5 graded symptom checklist was 31.42, and the average severity of emotional domain symptoms (Nervousness/Anxiety, Irritability, Sadness, More Emotional) was 5.86. Of the 14 players, 12 players reported symptoms in the emotional domain on intake while only 6 players reported emotional domain symptoms on exit. On average, emotional domain symptom severity score decreased by 81.71% compared to the 72.27% decrease in total symptom severity.: Conclusions: This neurorehabilitation program has shown to be beneficial at decreasing overall symptom severity in NHL players with symptoms post-head injury, especially symptoms that may be described as neuropsychological. The authors suggest further research be performed with a larger sample size and a follow-up study be performed to assess progression/regression.

Effects of Computerized Biofeedback-based Balance Intervention on the Muscle Coactivation Patterns during Dynamic Postural Control in Traumatic Brain Injury.

Balance Dysfunction (BDF) is a severe conse-quence of Traumatic Brain Injury (TBI) that significantly increases the falls risk. However, the neuromuscular mecha-nisms of the BDF are not adequately researched. Therefore, in this study, our objective was to investigate the effects of a Computerized Biofeedback-based Balance Intervention (CBBI) on the muscle coactivation patterns in a group of TBI participants. This study presents the findings from 13 TBI individuals randomized into the Intervention group (TBI - INT, N=6) and Control group (TBI-CTL, N=7). Using a computerized posturography platform (Neurocom Balance Master) during baseline and follow-up assessment visits, the participant's pos-tural response to anterior-posterior balance perturbations were recorded in a multimodal setup including electroencephalogra-phy (EEG), electromyography (EMG), and the platform sway in terms of center of pressure (COP). The muscle responses were recorded from lower-limb muscles, including tibialis an-terior (TA) and gastrocnemius (GAST), whose coactivation was computed using a metric called Co-Contraction Index (CCI). Clinical outcome measures such as Berg Balance Scale (BBS), 10 Meter Walk Test (10MWT), and Timed Up-and-Go (TUG) tests were used to evaluate functional balance and mobility. The comparison of CCI values across time points (baseline and follow-up) revealed a significant decrease (p<0.01) in the TBI-INT group but not TBI-CTL. The intervention-related changes in CCI correlated with the changes in BBS score (from baseline to follow-up). These preliminary findings demonstrate that the CBBI training may help postural stability by facilitating the coactivation between muscles involved in postural control. Clinical relevance- The current knowledge of changes in the neuromuscular response to balance perturbation in TBI is limited. Our study opens the possibility of using the muscle CCI metric to evaluate the muscle response in individuals with impaired balance.

The Effect of Traumatic Brain Injury on Sleep Architecture and Circadian Rhythms in Mice-A Comparison of High-Frequency Head Impact and Controlled Cortical Injury.

Simple SummaryTraumatic brain injury (TBI) is a significant risk factor for the development of sleep and circadian rhythm impairments. In order to understand if TBI models with different injury mechanism, severity and pathology have different sleep and circadian rhythm disruptions, we performed a detailed sleep and circadian analysis of the high-frequency head impact TBI model (a mouse model that mimics sports-related head impacts) and the controlled cortical impact TBI model (a mouse model that mimics severe brain trauma). We found that both TBI models disrupt the ability of brain cells to maintain circadian rhythms; however, both injury groups could still maintain circadian behavior patterns. Both the mild head impact model and the severe brain injury model had normal amount of sleep at 7 d after injury; however, the severe brain injury mice had disrupted brain wave patterns during sleep. We conclude that different types of TBI have different patterns of sleep disruptions.Traumatic brain injury (TBI) is a significant risk factor for the development of sleep and circadian rhythm impairments. In this study we compare the circadian rhythms and sleep patterns in the high-frequency head impact (HFHI) and controlled cortical impact (CCI) mouse models of TBI. These mouse models have different injury mechanisms key differences of pathology in brain regions controlling circadian rhythms and EEG wave generation. We found that both HFHI and CCI caused dysregulation in the diurnal expression of core circadian genes (Bmal1, Clock, Per1,2, Cry1,2) at 24 h post-TBI. CCI mice had reduced locomotor activity on running wheels in the first 7 d post-TBI; however, both CCI and HFHI mice were able to maintain circadian behavior cycles even in the absence of light cues. We used implantable EEG to measure sleep cycles and brain activity and found that there were no differences in the time spent awake, in NREM or REM sleep in either TBI model. However, in the sleep states, CCI mice have reduced delta power in NREM sleep and reduced theta power in REM sleep at 7 d post-TBI. Our data reveal that different types of brain trauma can result in distinct patterns of circadian and sleep disruptions and can be used to better understand the etiology of sleep disorders after TBI.

Risk factors and consequences of traumatic brain injury in a Swiss male population cohort

ObjectiveTo investigate the risk factors for and the consequences (ie, substance use disorders (SUD), depression, personality traits) of traumatic brain injury (TBI) in young Swiss men.DesignThis is a three-wave cohort...

Tooth for a tooth: Does fighting serve as a deterrent to greater violence in the modern NHL

Fighting has been part of the fabric of the NHL for nearly a century. Recent sharp declines in the frequency of fighting and increased understanding of the long-term consequences of traumatic brain injuries have led many to question whether fighting still has a place in the modern NHL. League commissioner Gary Bettman as recently as 2019 testified before Canadian Parliament that fighting has a deterrent effect, reducing the overall level of violent and dangerous plays within the game. This study empirically examines this claim and tests whether fighting indeed serves as a deterrent to undesirable behaviors in the NHL. I examine data on all regular season penalties from 2010-2019 to determine whether fighting and the threat of fighting is empirically related the level of violence in NHL games. Using a mix of descriptive and quasi-experimental approaches, I find no quantifiable evidence that fighting serves as a deterrent to undesirable violent behaviors in the NHL. To the contrary, I find that teams and players who fight are responsible for a disproportionate amount of the violent penalties that happen across the league. These results have implications for player safety in the many professional-and especially junior-hockey leagues around the world that sanction in-game fighting.

Application of Space Technologies Aimed at Proprioceptive Correction in Terrestrial Medicine in Russia.

Space technologies greatly contributed not only to space medicine but also to terrestrial medicine, which actively involves these technologies in everyday practice. Based on the existing countermeasures, and due to similarities of sensorimotor alterations provoked by the weightlessness with various neurological disorders, a lot of work has been dedicated to adaptation and introduction of these countermeasures for rehabilitation of patients. Axial loading suit and mechanical stimulation of the soles’ support zones are used in mitigation of stroke and traumatic brain injury consequences. They are also applied for rehabilitation of children with cerebral palsy. Complex application of these proprioceptive correction methods in neurorehabilitation programs makes it possible to effectively treat neurological patients with severe motor disturbances and significant brain damage.

Brain Trauma, Glucocorticoids and Neuroinflammation: Dangerous Liaisons for the Hippocampus.

Glucocorticoid-dependent mechanisms of inflammation-mediated distant hippocampal damage are discussed with a focus on the consequences of traumatic brain injury. The effects of glucocorticoids on specific neuronal populations in the hippocampus depend on their concentration, duration of exposure and cell type. Previous stress and elevated level of glucocorticoids prior to pro-inflammatory impact, as well as long-term though moderate elevation of glucocorticoids, may inflate pro-inflammatory effects. Glucocorticoid-mediated long-lasting neuronal circuit changes in the hippocampus after brain trauma are involved in late post-traumatic pathology development, such as epilepsy, depression and cognitive impairment. Complex and diverse actions of the hypothalamic–pituitary–adrenal axis on neuroinflammation may be essential for late post-traumatic pathology. These mechanisms are applicable to remote hippocampal damage occurring after other types of focal brain damage (stroke, epilepsy) or central nervous system diseases without obvious focal injury. Thus, the liaisons of excessive glucocorticoids/dysfunctional hypothalamic–pituitary–adrenal axis with neuroinflammation, dangerous to the hippocampus, may be crucial to distant hippocampal damage in many brain diseases. Taking into account that the hippocampus controls both the cognitive functions and the emotional state, further research on potential links between glucocorticoid signaling and inflammatory processes in the brain and respective mechanisms is vital.

Effects of Traumatic Brain Injury on the Gut Microbiota Composition and Serum Amino Acid Profile in Rats.

Traumatic brain injury (TBI) heavily impacts the body: it damages the brain tissue and the peripheral nervous system and shifts homeostasis in many types of tissue. An acute brain injury compromises the “brain–gut-microbiome axis”, a well-balanced network formed by the brain, gastrointestinal tract, and gut microbiome, which has a complex effect: damage to the brain alters the composition of the microbiome; the altered microbiome affects TBI severity, neuroplasticity, and metabolic pathways through various bacterial metabolites. We modeled TBI in rats. Using a bioinformatics approach, we sought to identify correlations between the gut microbiome composition, TBI severity, the rate of neurological function recovery, and blood metabolome. We found that the TBI caused changes in the abundance of 26 bacterial genera. The most dramatic change was observed in the abundance of Agathobacter species. The TBI also altered concentrations of several metabolites, specifically citrulline and tryptophan. We found no significant correlations between TBI severity and the pre-existing gut microbiota composition or blood metabolites. However, we discovered some differences between the two groups of subjects that showed high and low rates of neurological function recovery, respectively. The present study highlights the role of the brain–gut-microbiome axis in TBI.

Role of Bevacizumab on Vascular Endothelial Growth Factor in Apolipoprotein E Deficient Mice after Traumatic Brain Injury.

Traumatic brain injury (TBI) disrupts the blood–brain barrier (BBB). Vascular endothelial growth factor (VEGF) is believed to play a key role in TBI and to be overexpressed in the absence of apolipoprotein E (ApoE). Bevacizumab, a VEGF inhibitor, demonstrated neuroprotective activity in several models of TBI. However, the effects of bevacizumab on Apo-E deficient mice are not well studied. The present study aimed to evaluate VEGF expression and the effects of bevacizumab on BBB and neuroinflammation in ApoE−/− mice undergoing TBI. Furthermore, for the first time, this study evaluates the effects of bevacizumab on the long-term consequences of TBI, such as atherosclerosis. The results showed that motor deficits induced by controlled cortical impact (CCI) were accompanied by increased brain edema and VEGF expression. Treatment with bevacizumab significantly improved motor deficits and significantly decreased VEGF levels, as well as brain edema compared to the control group. Furthermore, the results showed that bevacizumab preserves the integrity of the BBB and reduces the neuroinflammation induced by TBI. Regarding the effects of bevacizumab on atherosclerosis, it was observed for the first time that its ability to modulate VEGF in the acute phase of head injury prevents the acceleration of atherosclerosis. Therefore, the present study demonstrates not only the neuroprotective activity of bevacizumab but also its action on the vascular consequences related to TBI.