Cited by 43Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchAutomotive and Human Injury Biomechanics

Neurogliovascular dysfunction in a model of repeated traumatic brain injury

Open access
Adams, Conner, Bazzigaluppi, Paolo, Beckett, Tina L., Bishay, Jossana, Weisspapir, Iliya, Dorr, Adrienne, Mester, James R., Steinman, Joe +6 more·2018·Theranostics

Abstract

Traumatic brain injury (TBI) research has focused on moderate to severe injuries as their outcomes are significantly worse than those of a mild TBI (mTBI).However, recent epidemiological evidence has indicated that a series of even mild TBIs greatly increases the risk of neurodegenerative and psychiatric disorders.Neuropathological studies of repeated TBI have identified changes in neuronal ionic concentrations, axonal injury, and cytoskeletal damage as important determinants of later life neurological and mood compromise; yet, there is a paucity of data on the contribution of neurogliovascular dysfunction to the progression of repeated TBI and alterations of brain function in the intervening period.Methods: Here, we established a mouse model of repeated TBI induced via three electromagnetically actuated impacts delivered to the intact skull at three-day intervals and determined the long-term deficits in neurogliovascular functioning in Thy1-ChR2 mice.Two weeks post the third impact, cerebral blood flow and cerebrovascular reactivity were measured with arterial spin labelling magnetic resonance imaging.Neuronal function was investigated through bilateral intracranial electrophysiological responses to optogenetic photostimulation.Vascular density of the site of impacts was measured with in vivo two photon fluorescence microscopy.Pathological analysis of neuronal survival and astrogliosis was performed via NeuN and GFAP immunofluorescence.Results: Cerebral blood flow and cerebrovascular reactivity were decreased by 50±16% and 70±20%, respectively, in the TBI cohort relative to sham-treated animals.Concomitantly, electrophysiological recordings revealed a 97±1% attenuation in peri-contusional neuronal reactivity relative to sham.Peri-contusional vascular volume was increased by 33±2% relative to sham-treated mice.Pathological analysis of the peri-contusional cortex demonstrated astrogliosis, but no changes in neuronal survival.Conclusion: This work provides the first in-situ characterization of the long-term deficits of the neurogliovascular unit following repeated TBI.The findings will help guide the development of diagnostic markers as well as therapeutics targeting neurogliovascular dysfunction.

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Written from the paper’s full text.

TL;DR

Repeated mild closed-head impacts in Thy1-ChR2 mice produced persistent peri-contusional and some bilateral neurogliovascular dysfunction two weeks after the third impact, including reduced CBF/CVR, prolonged ATT, reduced optogenetic-evoked neuronal responses, increased vascular volume, and astrogliosis without neuronal loss. The authors conclude that serial individually mild impacts can cause pathology comparable to moderate TBI.

Key findings

  • Peri-contusional resting CBF was 140±30 vs. 280±30 mL/min/100 mL in sham (p=0.001), and ATT was 260±50 vs. 120±6 ms (p=0.01); contralateral CBF and ATT were not significantly different.
  • CVR to 10% CO2 was reduced peri-contusionally (50±10% vs. 250±30%, p=0.003) and contralaterally (45±7% vs. 250±40%, p=0.02).
  • Evoked neuronal response amplitude to optogenetic photostimulation was reduced peri-contusionally (0.02±0.01 mV vs. 0.7±0.2 mV, p=0.02) and contralaterally (0.2±0.1 mV vs. 0.6±0.1 mV, p=0.04).
  • Peri-contusional vascular volume increased (3.2±0.4% vs. 2.4±0.6%, p=0.02) and GFAP immunoreactivity increased (29±1% vs. 1.5±0.2%, p=0.009), with no significant changes in NeuN, MAP2, or neurofilament.

Methods

  • Thirty-six 9-week-old Thy1-ChR2 mice underwent repeated CHI (n=19; 10 male, 9 female) or sham preparation (n=17; 9 male, 8 female); repeated TBI used three electromagnetically actuated impacts at 3-day intervals to the intact skull over S1FL (2 m/s, 1000 μm depth, 200 ms dwell, 1.5 mm tip).
  • Two weeks after the third impact, mice underwent pCASL MRI for resting CBF, ATT, and CVR to 10% CO2; bilateral electrophysiology with 450 nm optogenetic photostimulation; in vivo two-photon fluorescence microscopy for vascular occupancy; and histopathology for NeuN, GFAP, MAP2, and neurofilament.
  • Analysis used a logistic regression classifier to identify peri-contusional voxels, then linear mixed effects models or Kruskal-Wallis tests depending on normality and variance, with subject as a random effect for imaging.

Limitations

  • Stated: cohort sizes precluded analysis of sex effects, and future larger cohorts are required; future work is also needed for 3D cerebrovascular segmentation, and rodent and human ages should not be conflated.
  • Evident: final assay cohorts were small (MRI n=5–6, two-photon n=4, electrophysiology n=4), limiting power and subgroup analyses; assessments were at a single chronic time point two weeks after the final impact, so temporal progression is not captured; no behavioral outcomes are reported.

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Integrity signals

Registry

Crossref · 10.7150/thno.24747

Cites

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Claims the paper makes

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  • Findingown data

    In mice with repeated traumatic brain injury, GFAP immunoreactivity in the peri-contusional cortex is increased compared to sham-treated mice.

    “Increased peri-contusional vascular density was accompanied by an increase in GFAP immunoreactivity (29±1% for TBI mice, 1.5±0.2% for sham-treated mice, p = 0.009)”
    Quote in the paperSubstantial claim
  • Findingown data

    In mice with repeated traumatic brain injury, cerebrovascular reactivity to CO2 in impacted tissue is reduced compared to sham-treated mice.

    “In TBI mice (n=6), the CO2-induced change in CBF of impacted tissue was 50±10%, compared to 250±30% in that of sham-treated mice (n=5) (χ2= 9.0, p=0.003)”
    Quote in the paperSubstantial claim
  • Findingown data

    In mice with repeated traumatic brain injury, cerebral blood flow in the contralateral hemisphere is not reduced relative to sham-treated mice.

    “CBF of the contralateral hemisphere (240±20 mL/min/100 mL, n=5) was not reduced relative to that of sham-treated mice (210±20 mL/min/100 mL, n=5, χ2= 2.75, p=0.1)”
    Quote in the paperNot a substantial claim
  • Findingown data

    T2-weighted anatomical images acquired 24 h after a single CHI in a subset of mice confirmed an absence of significant structural damage following a single insult.

    “T2-weighted anatomical images of the site of the impact acquired at 24 h after a single CHI in a subset of mice confirmed an absence of significant structural damage following a single insult (Figure 1)”
    Quote in the paperSubstantial claim
  • Findingown data

    In mice with repeated traumatic brain injury, there is no significant change in neuronal survival in the peri-contusional cortex compared to sham-treated mice.

    “Pathological analysis of the peri-contusional cortex demonstrated astrogliosis, but no changes in neuronal survival.”
    • Also stated in: § Introduction · plain
      “despite no significant changes in neuronal density on NeuN, neurofilament, and MAP2 immunofluorescence.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 22
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 17
  • May combine two claims.

    Findingown data

    Two weeks post final impact, resting cerebral blood flow was reduced at the site of the impacts, but not contralaterally or in sham-treated animals.

    “Two weeks post final impact, we observed a reduction of resting cerebral blood flow at the site of the impacts that was not present either contralaterally or in sham-treated animals.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    No differences in NeuN, MAP2, or neurofilament immunofluorescence were observed in the contralateral cortex of TBI mice compared with sham-treated mice.

    “No differences were observed in the contralateral cortex either (NeuN: 22±1% for TBI vs. 19±1% for sham-treated mice, p = 0.1; MAP2: 63±7% for TBI vs. 46±3% for sham-treated mice, p = 0.2; and neurofilament: 25±3% for TBI vs. 28±2% for sham-treated mice, p = 0.8).”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim.

    Findingown data

    The average lesion volume in the repeated traumatic brain injury cohort estimated from NeuN staining was 100 ± 10 μm3.

    “The average lesion volume in the TBI cohort estimated from NeuN staining was 100 ± 10 μm3.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The observed increases in cerebrovascular density and GFAP immunoreactivity were limited to the peri-contusional cortex, while impairments of cerebrovascular and neuronal reactivity were observed bilaterally, although peri-contusional effects were much stronger than contralateral ones.

    “While the observed increases in cerebrovascular density and GFAP immunoreactivity were limited to the peri-contusional cortex, impairments of cerebrovascular and neuronal reactivity were observed bilaterally, although the peri-contusional effects were much stronger than the contralateral ones.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Repeated head trauma amplifies the risk of chronic traumatic encephalopathy and neuropsychiatric conditions including depression and suicidal tendencies.

    “This risk is amplified in the case of repeated head trauma, which may lead to chronic traumatic encephalopathy—a progressive neurodegenerative disease involving cognitive decline—as well as neuropsychiatric conditions including depression and suicidal tendencies 5,6.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [5] McKee AC Cantu RC Nowinski CJ Hedley-Whyte ET Gavett BE Budson AE Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury J Neuropathol Exp Neurol 2009 68 709 735 19535999 PMC2945234

      Not checked in the free run.

    • cites [6] McKee AC Stern RA Nowinski CJ Stein TD Alvarez VE Daneshvar DH The spectrum of disease in chronic traumatic encephalopathy Brain 2013 136 43 64 23208308 PMC3624697

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Rodent and human ages should not be conflated due to different time scales of important complex biological processes.

    “rodent and human ages should not be conflated due to the different time scales of important complex biological processes 18,29.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] Agoston DV How to translate time? The temporal aspect of human and rodent biology Front Neurol 2017 8 92 28367138 PMC5355425

      Not checked in the free run.

    • cites [29] Scopaz KA Hatzenbuehler JR Risk modifiers for concussion and prolonged recovery Sports Health 2013 5 537 541 24427429 PMC3806172

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Chronically reduced resting cerebral blood flow may lead to irreversible selective neuronal loss.

    “Chronically reduced resting CBF may lead to irreversible selective neuronal loss 28.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Baron J-C Yamauchi H Fujioka M Endres M Selective neuronal loss in ischemic stroke and cerebrovascular disease J Cereb Blood Flow Metab 2014 34 2 18 24192635 PMC3887360

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Similar "windows of vulnerability" have been observed in the clinic; in the most extreme cases, a second impact can be fatal.

    “Similar “windows of vulnerability” have been observed in the clinic as well: in the most extreme cases, a second impact can be fatal 35.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Bey T Ostick B Second impact syndrome West J Emerg Med 2009 10 6 10 19561758 PMC2672291

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the human population, young adults suffer a disproportionate number of mild head injuries through participation in athletics and military service.

    “in the human population, young adults suffer a disproportionate number of mild head injuries through participation in athletics and military service 18,29.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] Agoston DV How to translate time? The temporal aspect of human and rodent biology Front Neurol 2017 8 92 28367138 PMC5355425

      Not checked in the free run.

    • cites [29] Scopaz KA Hatzenbuehler JR Risk modifiers for concussion and prolonged recovery Sports Health 2013 5 537 541 24427429 PMC3806172

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    An increase of cerebral blood volume concomitant to decreased cerebral blood flow may have produced a decrease of blood velocity and a decreased efficiency of metabolite delivery by the circulation, as seen in moderate to severe TBI.

    “An increase of cerebral blood volume concomitant to decreased cerebral blood flow may have produced a decrease of blood velocity and a decreased efficiency of metabolite delivery by the circulation, as seen in moderate to severe TBI 40,43.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [40] Meaney DF Smith DH Biomechanics of concussion Clin Sports Med 2011 30 19 31 21074079 PMC3979340

      Not checked in the free run.

    • cites [43] Giza CC Hovda DA The new neurometabolic cascade of concussion Neurosurgery 2014 75 Suppl 4 S24 33 25232881 PMC4479139

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Increased peri-contusional vascular volume may have resulted either from angiogenesis with partial pruning and/or from dilation of immature vessels due to the lack of vascular smooth muscle cells in their walls.

    “This may have resulted either from angiogenesis with partial pruning and/or from dilation of immature vessels due to the lack of vascular smooth muscle cells in their walls 42.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Carmeliet P Angiogenesis in health and disease Nat Med 2003 9 653 660 12778163

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Thy1-ChR2 mice express channelrhodopsin in cortical pyramidal neurons, enabling optical control of neuronal activation.

    “These mice have been bred to express channelrhodopsin-, a light-gated cation channel that is non-selective towards H+, Na+, K+, and CA2+, in cortical pyramidal neurons, enabling optical control of neuronal activation 19,20.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] Nagel G Szellas T Huhn W Kateriya S Adeishvili N Berthold P Channelrhodopsin-2, a directly light-gated cation-selective membrane channel Proceedings of the National Academy of Sciences 2003 100 13940 13945 PMC283525 14615590

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    • cites [20] Arenkiel BR Peca J Davison IG Feliciano C Deisseroth K Augustine GJ In vivo light-induced activation of neural circuitry in transgenic mice expressing channelrhodopsin-2 Neuron 2007 54 205 218 17442243 PMC3634585

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The age of 9-week-old mice is considered equivalent to puberty/young adulthood in humans.

    “This age is considered equivalent to puberty/young adulthood in humans 18.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Agoston DV How to translate time? The temporal aspect of human and rodent biology Front Neurol 2017 8 92 28367138 PMC5355425

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Impairments of cerebrovascular circulation and altered neuronal function may have produced an imbalance between the metabolic demands of the tissue and the brain's ability to deliver metabolites.

    “Impairments of the cerebrovascular circulation as well as altered neuronal function may have produced an imbalance between the metabolic demands of the tissue and the brain's ability to deliver these metabolites.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Recent work from Tucker et al. suggests that behavioural outcomes between female and male C57BL/6J mice post TBI are equivalent.

    “recent work from Tucker et al. suggests that behavioural outcomes between female and male C57BL/6J mice post TBI are equivalent 33.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Tucker LB Fu AH McCabe JT Performance of male and female C57BL/6J mice on motor and cognitive tasks commonly used in pre-clinical traumatic brain injury research J Neurotrauma 2016 33 880 894 25951234 PMC4860656

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The reduction in amplitude of evoked responses suggests fewer viable neurons and/or impaired functioning of the surviving neurons.

    “The signals detected with these extracellular recordings are an integration of neuronal depolarizations that occur proximal to the electrodes; reduction in the amplitude of evoked responses suggests fewer viable neurons and/or impaired functioning of the surviving neurons.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Rodents may reach sexual maturity around 50 days of age but do not enter adulthood until 210 days; hence, the mice in this study are sexually mature but not yet adults.

    “They suggest that rodents may reach sexual maturity around 50 days of age, but do not enter adulthood until 210 days; hence, the mice in this study are sexually mature but not yet adults.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] Agoston DV How to translate time? The temporal aspect of human and rodent biology Front Neurol 2017 8 92 28367138 PMC5355425

      Not checked in the free run.

    • cites [29] Scopaz KA Hatzenbuehler JR Risk modifiers for concussion and prolonged recovery Sports Health 2013 5 537 541 24427429 PMC3806172

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Both traumatic brain injury and sham mice were maintained in a stable physiological state during imaging procedures, with no significant differences between groups for any physiological parameters.

    “Both TBI and sham mice were maintained in a stable physiological state during imaging procedures, as summarized in Table 3. There were no significant differences between groups for any physiological parameters.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Iron depositions result in T2 tashortening, potentially explaining the hypointensities seen on T2-weighted imaging here.

    “Iron depositions result in T2 tashortening, potentially explaining the hypointensities seen on T2-weighted imaging here 38.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Wu G Xi G Hua Y Sagher O T2* magnetic resonance imaging sequences reflect brain tissue iron deposition following intracerebral hemorrhage Transl Stroke Res 2010 1 31 34 20811505 PMC2930789

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    As the neuronal and cerebrovascular networks are closely coupled functionally, impairments of one could affect the other, and vice versa.

    “As the neuronal and cerebrovascular networks are closely coupled functionally, impairments of one could affect the other, and vice versa.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neuronal and cerebrovascular networks are closely coupled functionally.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The aforementioned blood velocity decrease surrounding the site of the injury could have also contributed to the observed elongation of arterial transit time.

    “The aforementioned blood velocity decrease surrounding the site of the injury could have also contributed to the observed elongation of arterial transit time.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Global reduction of cerebrovascular reactivity could result from increased intracranial pressure or be secondary to global decreases in neuronal activity and thus their signaling to the vessels.

    “Global reduction of cerebrovascular reactivity could result from increased intracranial pressure or be secondary to global decreases in neuronal activity and thus their signaling to the vessels.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    This is the first study to employ optogenetic photostimulation as a readout of neuronal function following TBI.

    “To our knowledge, ours is the first study to employ optogenetic photostimulation as a readout of neuronal function following TBI.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Clinical repeated TBI is known to impair cerebrovascular reactivity, but this had not previously been observed in experimental repeated TBI.

    “While clinical repeated TBI is known to impair cerebrovascular reactivity, this had not previously been observed in experimental repeated TBI 49,50.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [49] Mutch WAC Ellis MJ Ryner LN Ruth Graham M Dufault B Gregson B Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome J Neurosurg 2016 125 648 660 26684777

      Not checked in the free run.

    • cites [50] Ellis MJ Ryner LN Sobczyk O Fierstra J Mikulis DJ Fisher JA Neuroimaging assessment of cerebrovascular reactivity in concussion: Current concepts, methodological considerations, and review of the literature Front Neurol 2016 7 61 27199885 PMC4850165

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Elevated peri-contusional vascular density and altered topology of the vessel network have also been seen in animal models of moderate to severe TBI; this remodelling has been suggested to underlie changes in the neurovascular unit functioning.

    “an elevated peri-contusional vascular density and altered topology of the vessel network have also been seen in animal models of moderate to severe TBI 44,46: this remodelling has been suggested to underlie changes in the neurovascular unit functioning 53.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [44] Hayward NMEA Tuunanen PI Immonen R Ndode-Ekane XE Pitkänen A Gröhn O Magnetic resonance imaging of regional hemodynamic and cerebrovascular recovery after lateral fluid-percussion brain injury in rats J Cereb Blood Flow Metab 2011 31 166 177 20485295 PMC3049481

      Not checked in the free run.

    • cites [46] Obenaus A Ng M Orantes AM Kinney-Lang E Rashid F Hamer M Traumatic brain injury results in acute rarefication of the vascular network Sci Rep 2017 7 239 28331228 PMC5427893

      Not checked in the free run.

    • cites [53] Jullienne A Obenaus A Ichkova A Savona-Baron C Pearce WJ Badaut J Chronic cerebrovascular dysfunction after traumatic brain injury J Neurosci Res 2016 94 609 622 27117494 PMC5415378

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Ostergaard et al. proposed that moderate TBI could lead to an increase in heterogeneity of capillary transit times.

    “Ostergaard et al. proposed that moderate TBI could lead to an increase in heterogeneity of capillary transit times 45.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Østergaard L Engedal TS Aamand R Mikkelsen R Iversen NK Anzabi M Capillary transit time heterogeneity and flow-metabolism coupling after traumatic brain injury J Cereb Blood Flow Metab 2014 34 1585 1598 25052556 PMC4269727

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Hayward et al. observed acute reduction of vessel density followed by a chronic stage increase in vessel density on rat endothelial cell antibody-1 immunohistochemistry in a lateral fluid percussive model of moderate TBI in rats.

    “Hayward et al., observed acute reduction of vessel density followed by a chronic stage increase in vessel density on rat endothelial cell antibody-1 immunohistochemistry in a lateral fluid percussive model of moderate TBI in rats 44.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Hayward NMEA Tuunanen PI Immonen R Ndode-Ekane XE Pitkänen A Gröhn O Magnetic resonance imaging of regional hemodynamic and cerebrovascular recovery after lateral fluid-percussion brain injury in rats J Cereb Blood Flow Metab 2011 31 166 177 20485295 PMC3049481

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Cerebrovascular reactivity impairment was due to the newly sprouted vessels seen on in vivo two-photon fluorescence microscopy that were not yet functionally mature, hence having thin vessel walls and limited endothelium-associated smooth muscle cells.

    “we postulate that cerebrovascular reactivity impairment was due to the newly sprouted vessels seen on in vivo two-photon fluorescence microscopy that were not yet functionally mature, hence having thin vessel walls 52 and limited endothelium-associated smooth muscle cells 42.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [52] Pries AR Reglin B Secomb TW Remodeling of blood vessels: responses of diameter and wall thickness to hemodynamic and metabolic stimuli Hypertension 2005 46 725 731 16172421

      Not checked in the free run.

    • cites [42] Carmeliet P Angiogenesis in health and disease Nat Med 2003 9 653 660 12778163

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    An earlier study in a model of moderate TBI reported decreased electrophysiological responses to contralateral forepaw stimulation two weeks following a single controlled cortical impact.

    “an earlier study in a model of moderate TBI reported decreased electrophysiological responses to contralateral forepaw stimulation two weeks following a single controlled cortical impact 58.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Li N Yang Y Glover DP Zhang J Saraswati M Robertson C Evidence for impaired plasticity after traumatic brain injury in the developing brain J Neurotrauma 2014 31 395 403 24050267 PMC3922417

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    Photostimulation of opsin-expressing cells affords two important advantages over peripheral stimulation: finer spatial targeting of the neuronal perturbation in relation to the site of the injury and cell-type specific activation.

    “Photostimulation of opsin-expressing cells affords two important advantages over peripheral stimulation in that it enables finer spatial targeting of the neuronal perturbation in relation to the site of the injury as well as cell-type specific activation.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation

    Mild impact may cause subtle dendritic and axonal damage, thus altering connections between cortical neurons; fewer recruited neurons following photostimulation could thus also have contributed to the observed decrease in evoked response amplitude.

    “Mild impact may cause subtle dendritic and axonal damage, thus altering connections between cortical neurons: fewer recruited neurons following photostimulation could thus also have contributed to the observed decrease in evoked response amplitude 59.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Sword J Masuda T Croom D Kirov SA Evolution of neuronal and astroglial disruption in the peri-contusional cortex of mice revealed by in vivo two-photon imaging Brain 2013 136 1446 1461 23466395 PMC3634194

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Given that there was no statistically significant effect of the serial impacts on neuronal survival, the reduction of evoked response amplitude may be a result of impaired responses on the individual unit level.

    “Given that there was no statistically significant effect of the serial impacts on neuronal survival (on NeuN, MAP2, and neurofilament immunofluorescence), the reduction of evoked response amplitude may be a result of impaired responses on the individual unit level.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    A dearth of available metabolites may also lead to neuronal dysfunction and loss.

    “A dearth of available metabolites may also lead to neuronal dysfunction and loss 28”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Baron J-C Yamauchi H Fujioka M Endres M Selective neuronal loss in ischemic stroke and cerebrovascular disease J Cereb Blood Flow Metab 2014 34 2 18 24192635 PMC3887360

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Enhanced GFAP fluorescence is sometimes also associated with astrocytic swelling, which has been observed to reduce capillary lumen and in turn reduce cerebral blood flow and microvascular hematocrit.

    “Enhanced GFAP fluorescence is sometimes also associated with astrocytic swelling, which has been observed to reduce capillary lumen and in turn reduce cerebral blood flow and microvascular hematocrit 56.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] Bouzat P Millet A Boue Y Pernet-Gallay K Trouve-Buisson T Gaide-Chevronnay L Changes in brain tissue oxygenation after treatment of diffuse traumatic brain injury by erythropoietin Crit Care Med 2013 41 1316 1324 23591210

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Enhancement of GFAP has been previously reported in the acute phase of repeated TBI as part of the neuroinflammatory cascade.

    “Enhancement of GFAP has been previously reported in the acute phase of repeated TBI as part of the neuroinflammatory cascade 54.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Bolton AN Saatman KE Regional neurodegeneration and gliosis are amplified by mild traumatic brain injury repeated at 24-hour intervals J Neuropathol Exp Neurol 2014 73 933 947 25232942 PMC4170569

      Not checked in the free run.

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  • The paper relies on this without support.

    A mismatch between metabolic demands and the brain's ability to deliver metabolites is key in the pathological progression of moderate to severe traumatic brain injury.

    “This mismatch has been identified as key in the pathological progression of moderate to severe TBI.”
  • The paper relies on this without support.

    Impairment of cerebrovascular reactivity leads to cognitive dysfunction and can contribute to functional deficits in repeated traumatic brain injury patients.

    “Impairment of CVR is known to lead to cognitive dysfunction and hence could contribute to the functional deficits seen in repeated TBI patients.”
  • The paper relies on this without support.

    Cerebrovascular reactivity is a critical aspect of healthy brain function because the brain depends on tuning of blood flow to local tissue metabolic needs.

    “Cerebrovascular reactivity is a critical aspect of healthy brain function as the brain depends on tuning of blood flow to the local tissue metabolic needs.”
  • The paper relies on this without support.

    Transcallosal connections between homologous regions of the cortex are dense.

    “Given the density of transcallosal connections between homologous regions of the cortex”
  • The paper relies on this without support.

    The neuronal and cerebrovascular networks are closely coupled functionally.

    “As the neuronal and cerebrovascular networks are closely coupled functionally”
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Authors
Adams, C., Bazzigaluppi, P., Beckett, T. L., Bishay, J., Weisspapir, I., Dorr, A., Mester, J. R., Steinman, J., Hirschler, L., Warnking, J. M., Barbier, E. L., McLaurin, J., Sled, J. G., & Stefanovic, B.
Affiliations
  • University of Toronto (CA)
  • University Health Network (CA)
  • Sunnybrook Hospital (CA)
  • Inserm (FR)
Corresponding author
Adams, Conner
Venue
Theranostics
Published
2018
Volume
8
Issue
17
Pages
4824-4836
ISSN
1838-7640 (ISSN-L)
OpenAlex
W2889661896
Cited by
42
References
62
Citations by year
2026: 3 · 2025: 4 · 2024: 10 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 5 · 2016: 1
FWCI
2.89
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Theranostics (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by-nc)
Funders
Canadian Institutes of Health Research (148521_1)
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
mild traumatic brain injury, cerebral blood flow, cerebrovascular reactivity, neuronal excitability, optogenetic stimulation, vessel density, astrocyte activation, neuronal survival
MeSH terms
Brain Injuries, Traumatic, Animals, Cerebrovascular Disorders, Disease Models, Animal, Magnetic Resonance Imaging, Microscopy, Fluorescence, Neuroglia, Neurons, Recurrence, Mice, Optogenetics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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