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Cited by 1,353Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesAutomotive and Human Injury Biomechanics

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The New Neurometabolic Cascade of Concussion

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Giza, Christopher C., Hovda, David A.·2014·Neurosurgery
DOI 10.1227/neu.0000000000000505PMC PMC4479139
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Abstract

Since the original descriptions of postconcussive pathophysiology, there has been a significant increase in interest and ongoing research to study the biological underpinnings of concussion. The initial ionic flux and glutamate release result in significant energy demands and a period of metabolic crisis for the injured brain. These physiological perturbations can now be linked to clinical characteristics of concussion, including migrainous symptoms, vulnerability to repeat injury, and cognitive impairment. Furthermore, advanced neuroimaging now allows a research window to monitor postconcussion pathophysiology in humans noninvasively. There is also increasing concern about the risk for chronic or even progressive neurobehavioral impairment after concussion/mild traumatic brain injury. Critical studies are underway to better link the acute pathobiology of concussion with potential mechanisms of chronic cell death, dysfunction, and neurodegeneration. This “new and improved” article summarizes in a translational fashion and updates what is known about the acute neurometabolic changes after concussive brain injury. Furthermore, new connections are proposed between this neurobiology and early clinical symptoms as well as to cellular processes that may underlie long-term impairment. ABBREVIATIONS: APP, amyloid precursor protein BOLD, blood oxygen level-dependent DTI, diffusion tensor imaging FA, fractional anisotropy fMRI, functional magnetic resonance imaging FPI, fluid percussion injury GABA, γ-aminobutyric acid mTBI, mild traumatic brain injury NAA,N-acetylaspartate NMDAR,N-methyl-D-aspartate receptor TBI, traumatic brain injury

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Metadata

Authors
Giza, C. C., & Hovda, D. A.
Affiliations
University of California, Los Angeles (US)
Corresponding author
Giza, Christopher C.
ORCID
Giza, Christopher C.
Venue
Neurosurgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-10
Volume
75
Issue
Supplement 4
Pages
S24-S33
ISSN
0148-396X (ISSN-L)
DOI
10.1227/neu.0000000000000505
PMC
PMC4479139
OpenAlex
W2088800239
Cited by
1,353
References
210
Citations by year
2026: 105 · 2025: 114 · 2024: 130 · 2023: 117 · 2022: 108 · 2021: 150 · 2020: 157 · 2019: 139 · 2018: 106 · 2017: 102 · 2016: 71 · 2015: 41 · 2014: 5
FWCI
9.75
Type
journal article
Language
en
Open access
Locations
  • Neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institute of Neurological Disorders and Stroke (R01NS027544, P01NS058489)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Physical Sciences › Engineering › Biomedical Engineering › Automotive and Human Injury Biomechanics
Keywords
concussion, mild traumatic brain injury, ion flux, glutamate release, brain energy metabolism, metabolic crisis, cognitive impairment, neurodegeneration, fluid percussion injury
MeSH terms
Athletic Injuries, Brain Concussion, Female, Humans, Male, Neuroimaging

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