Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury
Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (...
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| Veröffentlicht in: | Journal of neurotrauma 2020-01, Vol.37 (2), p.347-356 |
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| creator | O'Keeffe, Eoin Kelly, Eoin Liu, Yuzhe Giordano, Chiara Wallace, Eugene Hynes, Mark Tiernan, Stephen Meagher, Aidan Greene, Chris Hughes, Stephanie Burke, Tom Kealy, John Doyle, Niamh Hay, Alison Farrell, Michael Grant, Gerald A Friedman, Alon Veksler, Ronel Molloy, Michael G Meaney, James F Pender, Niall Camarillo, David Doherty, Colin P Campbell, Matthew |
| description | Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (mTBI), especially concussion which, by definition, is characterized by a normal CT. To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast extravasation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on MRI and multiple biomechanical parameters indicating the severity of impacts recorded using instrumented mouthguards in professional MMA fighters. MMA fighters were examined pre-fight for a baseline and again within 120 h post-competitive fight, whereas rugby players were examined pre-season and again post-season or post-match in a subset of cases. DCE-MRI, serological analysis of BBB biomarkers, and an analysis of instrumented mouthguard data, was performed. Here, we provide pilot data that demonstrate disruption of the BBB in both professional MMA fighters and rugby players, dependent on the level of exposure. Our data suggest that biomechanical forces in professional MMA and adolescent rugby can lead to BBB disruption. These changes on imaging may serve as a biomarker of exposure of the brain to repetitive subconcussive forces and mTBI. |
| doi_str_mv | 10.1089/neu.2019.6483 |
| format | Article |
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To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast extravasation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on MRI and multiple biomechanical parameters indicating the severity of impacts recorded using instrumented mouthguards in professional MMA fighters. MMA fighters were examined pre-fight for a baseline and again within 120 h post-competitive fight, whereas rugby players were examined pre-season and again post-season or post-match in a subset of cases. DCE-MRI, serological analysis of BBB biomarkers, and an analysis of instrumented mouthguard data, was performed. Here, we provide pilot data that demonstrate disruption of the BBB in both professional MMA fighters and rugby players, dependent on the level of exposure. Our data suggest that biomechanical forces in professional MMA and adolescent rugby can lead to BBB disruption. These changes on imaging may serve as a biomarker of exposure of the brain to repetitive subconcussive forces and mTBI.</description><identifier>ISSN: 0897-7151</identifier><identifier>ISSN: 1557-9042</identifier><identifier>EISSN: 1557-9042</identifier><identifier>DOI: 10.1089/neu.2019.6483</identifier><identifier>PMID: 31702476</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Adolescent ; Adult ; Athletes ; Biomarkers ; Blood-brain barrier ; Blood-Brain Barrier - diagnostic imaging ; Blood-Brain Barrier - pathology ; Brain - diagnostic imaging ; Brain - pathology ; Brain Concussion - diagnostic imaging ; Brain Concussion - pathology ; Brain damage ; Chronic traumatic encephalopathy ; Computed tomography ; Concussion ; Consciousness ; Deformation ; Diagnosis ; Extravasation ; Football ; Football - injuries ; Gadolinium ; Human subjects ; Humans ; Kinematics ; Magnetic Resonance Imaging ; Male ; Martial Arts - injuries ; Neuroimaging ; NMR ; Nuclear magnetic resonance ; Original ; Population studies ; Regression analysis ; Rugby ; Traumatic brain injury ; Young Adult ; Young adults</subject><ispartof>Journal of neurotrauma, 2020-01, Vol.37 (2), p.347-356</ispartof><rights>Copyright Mary Ann Liebert, Inc. Jan 2020</rights><rights>Copyright 2020, Mary Ann Liebert, Inc., publishers 2020 Mary Ann Liebert, Inc., publishers</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-506f185aa216e302bcf2880fe89582bf3c8fb9d1ecd2786da8ef70e021f85ae93</citedby><cites>FETCH-LOGICAL-c482t-506f185aa216e302bcf2880fe89582bf3c8fb9d1ecd2786da8ef70e021f85ae93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31702476$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Keeffe, Eoin</creatorcontrib><creatorcontrib>Kelly, Eoin</creatorcontrib><creatorcontrib>Liu, Yuzhe</creatorcontrib><creatorcontrib>Giordano, Chiara</creatorcontrib><creatorcontrib>Wallace, Eugene</creatorcontrib><creatorcontrib>Hynes, Mark</creatorcontrib><creatorcontrib>Tiernan, Stephen</creatorcontrib><creatorcontrib>Meagher, Aidan</creatorcontrib><creatorcontrib>Greene, Chris</creatorcontrib><creatorcontrib>Hughes, Stephanie</creatorcontrib><creatorcontrib>Burke, Tom</creatorcontrib><creatorcontrib>Kealy, John</creatorcontrib><creatorcontrib>Doyle, Niamh</creatorcontrib><creatorcontrib>Hay, Alison</creatorcontrib><creatorcontrib>Farrell, Michael</creatorcontrib><creatorcontrib>Grant, Gerald A</creatorcontrib><creatorcontrib>Friedman, Alon</creatorcontrib><creatorcontrib>Veksler, Ronel</creatorcontrib><creatorcontrib>Molloy, Michael G</creatorcontrib><creatorcontrib>Meaney, James F</creatorcontrib><creatorcontrib>Pender, Niall</creatorcontrib><creatorcontrib>Camarillo, David</creatorcontrib><creatorcontrib>Doherty, Colin P</creatorcontrib><creatorcontrib>Campbell, Matthew</creatorcontrib><title>Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury</title><title>Journal of neurotrauma</title><addtitle>J Neurotrauma</addtitle><description>Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (mTBI), especially concussion which, by definition, is characterized by a normal CT. To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast extravasation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on MRI and multiple biomechanical parameters indicating the severity of impacts recorded using instrumented mouthguards in professional MMA fighters. MMA fighters were examined pre-fight for a baseline and again within 120 h post-competitive fight, whereas rugby players were examined pre-season and again post-season or post-match in a subset of cases. DCE-MRI, serological analysis of BBB biomarkers, and an analysis of instrumented mouthguard data, was performed. Here, we provide pilot data that demonstrate disruption of the BBB in both professional MMA fighters and rugby players, dependent on the level of exposure. Our data suggest that biomechanical forces in professional MMA and adolescent rugby can lead to BBB disruption. These changes on imaging may serve as a biomarker of exposure of the brain to repetitive subconcussive forces and mTBI.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Athletes</subject><subject>Biomarkers</subject><subject>Blood-brain barrier</subject><subject>Blood-Brain Barrier - diagnostic imaging</subject><subject>Blood-Brain Barrier - pathology</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - pathology</subject><subject>Brain Concussion - diagnostic imaging</subject><subject>Brain Concussion - pathology</subject><subject>Brain damage</subject><subject>Chronic traumatic encephalopathy</subject><subject>Computed tomography</subject><subject>Concussion</subject><subject>Consciousness</subject><subject>Deformation</subject><subject>Diagnosis</subject><subject>Extravasation</subject><subject>Football</subject><subject>Football - injuries</subject><subject>Gadolinium</subject><subject>Human subjects</subject><subject>Humans</subject><subject>Kinematics</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Martial Arts - injuries</subject><subject>Neuroimaging</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Original</subject><subject>Population studies</subject><subject>Regression analysis</subject><subject>Rugby</subject><subject>Traumatic brain injury</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>0897-7151</issn><issn>1557-9042</issn><issn>1557-9042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkd9LwzAQx4Mobv549FUKvvjSmUvaJn0SN6cOJoLM55C1ycxok5m2wv57MzeH-nRw97kvd3wQugA8AMzzG6u6AcGQD7KE0wPUhzRlcY4Tcoj6Yc5iBin00EnTLDEGmhF2jHoUGCYJy_pofL-2sjZFNKycK-Ohl8ZGQ-m9UT56VYuukq1xNgrdZ1OV0czLrg6tsPCNTuyy8-szdKRl1ajzXT1Fbw_j2egpnr48TkZ307hIOGnjFGcaeColgUxRTOaFJpxjrXiecjLXtOB6npegipIwnpWSK82wwgR02FI5PUW329xVN69VWSjbelmJlTe19GvhpBF_J9a8i4X7FIApBchISLjeJXj30ammFbVpClVV0irXNYJQoJSxlGcBvfqHLl3nbfgvUBQSRimHQMVbqvCuabzS-2sAi40hEQyJjSGxMRT4y98v7OkfJfQLvs-MFw</recordid><startdate>20200115</startdate><enddate>20200115</enddate><creator>O'Keeffe, Eoin</creator><creator>Kelly, Eoin</creator><creator>Liu, Yuzhe</creator><creator>Giordano, Chiara</creator><creator>Wallace, Eugene</creator><creator>Hynes, Mark</creator><creator>Tiernan, Stephen</creator><creator>Meagher, Aidan</creator><creator>Greene, Chris</creator><creator>Hughes, Stephanie</creator><creator>Burke, Tom</creator><creator>Kealy, John</creator><creator>Doyle, Niamh</creator><creator>Hay, Alison</creator><creator>Farrell, Michael</creator><creator>Grant, Gerald A</creator><creator>Friedman, Alon</creator><creator>Veksler, Ronel</creator><creator>Molloy, Michael G</creator><creator>Meaney, James F</creator><creator>Pender, Niall</creator><creator>Camarillo, David</creator><creator>Doherty, Colin P</creator><creator>Campbell, Matthew</creator><general>Mary Ann Liebert, Inc</general><general>Mary Ann Liebert, Inc., publishers</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200115</creationdate><title>Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury</title><author>O'Keeffe, Eoin ; Kelly, Eoin ; Liu, Yuzhe ; Giordano, Chiara ; Wallace, Eugene ; Hynes, Mark ; Tiernan, Stephen ; Meagher, Aidan ; Greene, Chris ; Hughes, Stephanie ; Burke, Tom ; Kealy, John ; Doyle, Niamh ; Hay, Alison ; Farrell, Michael ; Grant, Gerald A ; Friedman, Alon ; Veksler, Ronel ; Molloy, Michael G ; Meaney, James F ; Pender, Niall ; Camarillo, David ; Doherty, Colin P ; Campbell, Matthew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-506f185aa216e302bcf2880fe89582bf3c8fb9d1ecd2786da8ef70e021f85ae93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Athletes</topic><topic>Biomarkers</topic><topic>Blood-brain barrier</topic><topic>Blood-Brain Barrier - 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| subjects | Adolescent Adult Athletes Biomarkers Blood-brain barrier Blood-Brain Barrier - diagnostic imaging Blood-Brain Barrier - pathology Brain - diagnostic imaging Brain - pathology Brain Concussion - diagnostic imaging Brain Concussion - pathology Brain damage Chronic traumatic encephalopathy Computed tomography Concussion Consciousness Deformation Diagnosis Extravasation Football Football - injuries Gadolinium Human subjects Humans Kinematics Magnetic Resonance Imaging Male Martial Arts - injuries Neuroimaging NMR Nuclear magnetic resonance Original Population studies Regression analysis Rugby Traumatic brain injury Young Adult Young adults |
| title | Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury |
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