Cited by 1,273Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchAutomotive and Human Injury Biomechanics

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Axonal pathology in traumatic brain injury

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Johnson, Victoria E., Stewart, William, Smith, Douglas H.·2013·Experimental Neurology

DOI 10.1016/j.expneurol.2012.01.013PMC PMC3979341

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Abstract

Over the past 70 years, diffuse axonal injury (DAI) has emerged as one of the most common and important pathological features of traumatic brain injury (TBI). Axons in the white matter appear to be especially vulnerable to injury due to the mechanical loading of the brain during TBI. As such, DAI has been found in all severities of TBI and may represent a key pathologic substrate of mild TBI (concussion). Pathologically, DAI encompasses a spectrum of effects from primary mechanical breaking of the axonal cytoskeleton, to transport interruption, swelling and proteolysis, through secondary physiological changes. Depending on the severity and extent of injury, these changes can manifest acutely as immediate loss of consciousness or confusion and persist as coma and/or cognitive dysfunction. In addition, recent evidence suggests that TBI may induce long-term neurodegenerative processes, such as insidiously progressive axonal pathology. Indeed, axonal degeneration has been found to continue even years after injury in humans, and appears to play a role in the development of Alzheimer’s disease-like pathological changes. Here we review the current understanding of DAI as a uniquely mechanical injury, its histopathological identification, and its acute and chronic pathogenesis following TBI.

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Authors: Johnson, V. E., Stewart, W., & Smith, D. H.
Affiliations: University of Pennsylvania (US)
Corresponding author: Smith, Douglas H.
ORCID: Johnson, Victoria E.
Smith, Douglas H.
Venue: Experimental Neurology
Publisher: Elsevier BV
Published: 2013-08
Volume: 246
Pages: 35-43
ISSN: 0014-4886 (ISSN-L)
DOI: 10.1016/j.expneurol.2012.01.013
PMC: PMC3979341
OpenAlex: W2170921124
Semantic Scholar: 6fdff07fcccb6429453f06a8aae43cdaad508837
Cited by: 1,273
References: 162
Citations by year: 2026: 82 · 2025: 88 · 2024: 86 · 2023: 106 · 2022: 105 · 2021: 123 · 2020: 102 · 2019: 98 · 2018: 93 · 2017: 113 · 2016: 92 · 2015: 89 · 2014: 37 · 2013: 44
FWCI: 8.26
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Experimental Neurology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
Funders: National Institutes of Health
National Institute on Aging (R03AG038911)
National Institute of Neurological Disorders and Stroke (NS-038104, R01NS038104, P01NS056202, NS 056202)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Physical Sciences › Engineering › Biomedical Engineering › Automotive and Human Injury Biomechanics
Keywords: diffuse axonal injury, traumatic brain injury, axonal pathology, white matter, mild traumatic brain injury, concussion, axonal cytoskeleton, axonal transport, axonal swellings, proteolysis, secondary injury, Alzheimer's disease, histopathology, pathogenesis
MeSH terms: Animals, Axons, Brain Injuries, Coma, Humans, Nerve Degeneration, Nerve Fibers, Myelinated, Diffuse Axonal Injury

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