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Cited by 62Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchAutomotive and Human Injury Biomechanics

Influence of apoptosis on neurological outcome following traumatic cerebral contusion

Nathoo, Narendra, Narotam, Pradeep K., Agrawal, Devendra K., Connolly, Catherine A., van Dellen, James R., Barnett, Gene H., Chetty, Runjan·2004·Journal of Neurosurgery
DOI 10.3171/jns.2004.101.2.0233
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Abstract

OBJECT: Apoptosis has increasingly been implicated in the pathobiology of traumatic brain injury (TBI). The present study was undertaken to confirm the presence of apoptosis in the periischemic zone (PIZ) of traumatic cerebral contusions and to determine the role of apoptosis, if any, in neurological outcome. METHODS: Brain tissue harvested at Wentworth Hospital from the PIZ in 29 patients with traumatic supratentorial contusions was compared with brain tissue resected in patients with epilepsy. Immunohistochemical analyses were performed on the tissues to see if they contained the apoptosis-related proteins p53, bcl-2, bax, and caspase-3. The findings were then correlated to demographic, clinical, surgical, neuroimaging, and outcome data. In the PIZ significant increases of bax (18-fold; p < 0.005) and caspase-3 (20-fold; p < 0.005) were recorded, whereas bcl-2 was upregulated in only 14 patients (48.3%; 2.9-fold increase) compared with control tissue. Patients in the bcl-2-positive group exhibited improved outcomes at the 18-month follow-up examination despite an older mean age and lower mean admission Glasgow Coma Scale score (p < 0.03). Caspase-3 immunostaining was increased in those patients who died (Glasgow Outcome Scale [GOS] Score 1, 12 patients) when compared with those who experienced a good outcome (GOS Score 4 or 5, 17 patients) (p < 0.005). Regression analysis identified bcl-2-negative status (p < 0.04, odds ratio [OR] 5.5; 95% confidence interval [CI] 1.1-28.4) and caspase-3-positive status (p < 0.01, OR 1.4, 95% CI 1.1-1.8) as independent predictors of poor outcome. No immunostaining for p53 was recorded in the TBI specimens. CONCLUSIONS: The present findings confirm apoptosis in the PIZ of traumatic cerebral contusions and indicate that this form of cell death can influence neurological outcome following a TBI.

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  • The above-mentioned events lead to membrane degradation of cellular and vascular structures and eventually to necrosis or apoptosis of neurons.

    “Furthermore, the above-mentioned events lead to membrane degradation of the cellular and vascular structures and eventually to necrosis or apoptosis of neurons (97,129,130).”

    From Pituitary Dysfunction After Traumatic Brain Injury: A Clinical and Pathophysiological Approach (2015) · cites this paper as [129]

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Authors
Nathoo, N., Narotam, P. K., Agrawal, D. K., Connolly, C. A., van Dellen, J. R., Barnett, G. H., & Chetty, R.
Affiliations
  • Cleveland Clinic (US)
  • Creighton University (US)
ORCID
Venue
Journal of Neurosurgery
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Published
2004-08
Volume
101
Issue
2
Pages
233-240
ISSN
0022-3085 (ISSN-L)
DOI
10.3171/jns.2004.101.2.0233
OpenAlex
W2030417422
Cited by
62
References
38
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 6 · 2016: 2 · 2015: 3 · 2013: 3 · 2012: 1
FWCI
3.58
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
Keywords
apoptosis, traumatic brain injury, cerebral contusion, neurological outcome, Bcl-2, Bax, caspase-3, p53, prognostic factors, Glasgow Outcome Scale
MeSH terms
Adolescent, Adult, Aged, Brain, Brain Injuries, Child, Emergency Medical Services, Female, Follow-Up Studies, Humans, Male, Middle Aged, Proto-Oncogene Proteins, Glasgow Coma Scale, Tumor Suppressor Protein p53, Apoptosis, Proto-Oncogene Proteins c-bcl-2, Caspases, bcl-2-Associated X Protein, Caspase 3

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