Posts tagged brain tissue
Articles and news from the latest research reports.
Leading researchers report on the elusive search for biomarkers in Huntington’s disease
While Huntington’s disease (HD) is currently incurable, the HD research community anticipates that new disease-modifying therapies in development may slow or minimize disease progression. The success of HD research depends upon the identification of reliable and sensitive biomarkers to track disease and evaluate therapies, and these biomarkers may eventually be used as outcome measures in clinical trials. Biomarkers could be especially helpful to monitor changes during the time prior to diagnosis and appearance of overt symptomatology. Three reports in the current issue of the Journal of Huntington’s Disease explore the potential of neuroimaging, proteomic analysis of brain tissue, and plasma inflammatory markers as biomarkers for Huntington’s disease.
"Characteristics of an ideal biomarker include quantification which is reliable, reproducible across sites, minimally invasive and widely available. The biomarker should show low variability in the normal population and change linearly with disease progression, ideally over short time intervals. Finally, the biomarker should respond predictably to an intervention which modifies the disease," says Elin Rees, researcher at UCL Institute of Neurology, London.
In the first report, Rees and colleagues explore the use of neuroimaging biomarkers. She says they are strong candidates as outcome measures in future clinical trials because of their clear relevance to the neuropathology of disease and their increased precision and sensitivity compared with some standard functional measures. This review looks at results from longitudinal imaging studies, focusing on the most widely available imaging modalities: structural MRI (volumetric and diffusion), functional MRI, and PET.
"All imaging modalities are logistically complicated and expensive compared with standard clinical or cognitive end-points and their sensitivity is generally reduced in individuals with later stage HD due to movement," says Rees. "Nevertheless, imaging has several advantages including the ability to track progression in the pre-manifest stage before any detectable clinical or cognitive change."
Current evidence suggests that the best neuroimaging biomarkers are structural MRI and PET using [11C] raclopride (RACLO-PET) as the tracer, in order to assess changes in the basal ganglia, especially the caudate.
A study led by Garth J.S. Cooper, PhD, professor of Biochemistry and Clinical Biochemistry at the School of Biological Sciences and the Department of Medicine at the University of Auckland, used comparative proteome analysis to identify how protein expression might correlate with Huntington’s neurodegeneration in two regions of human brain: the middle frontal gyrus (MFG) and the visual cortex (VC). The investigators studied post mortem human brain tissue from seven HD brains and eight matched controls. They found that the MFG of HD brains differentially expressed 22 proteins compared to controls, while only seven were different in the VC. Several of these proteins had not been linked to HD previous. Investigators categorized these proteins into six general functional categories: stress response, apoptosis, glycolysis, vesicular trafficking, and endocytosis. They determined that there is a common thread in the degenerative processes associated with HD, Alzheimer’s disease, and diabetes.
The third report explores the possibility that inflammatory markers in plasma can be used to track HD, noting that immune changes are apparent even during the preclinical stage. “The innate immune system orchestrates an inflammatory response involving complex interactions between cytokines, chemokines and acute phase proteins and is thus a rich source of potential biomarkers,” says Maria Björkqvist, PhD, head of the Brain Disease Biomarker Unit, Department of Experimental Science of Lund University, Sweden.
The authors compare plasma levels of several markers involved in inflammation and innate immunity of healthy controls and HD patients at different stages of disease. Two methods were used to analyze plasma: antibody-based technologies and multiple reaction monitoring (MRM).
None of the measures were significantly altered in both HD cohorts tested and none correlated with HD disease stage. Only one substance, C-reactive protein (CRP), was decreased in early HD – but this was found in only one of the two cohorts, so the finding may not be reliable. The investigators were unable to confirm other studies that had found HD-related changes in other inflammatory markers, including components of the complement system.
Some markers correlated with clinical measures. For instance, ApoE was positively correlated with depression and irritability scores, suggesting an association between ApoE and mood changes.
Even though recent data suggest that the immune system is likely to be a modifier of HD disease, inflammatory proteins do not seem to be likely candidates to be biomarkers for HD. “Many proteomic studies designed to provide potential biomarkers of disease have generated significant findings, however, often these biomarkers fail to replicate during the validation process,” says Björkqvist.
(Source: eurekalert.org)
Researchers discover a missing link in signals contributing to neurodegeneration
In many neurodegenerative diseases the neurons of the brain are over-stimulated and this leads to their destruction. After many failed attempts and much scepticism this process was finally shown last year to be a possible basis for treatment in some patients with stroke. But very few targets for drugs to block this process are known.
In a new highly detailed study, researchers have discovered a previously missing link between over-stimulation and destruction of brain tissue, and shown that this might be a target for future drugs. This research, led by the A. I. Virtanen Institute at the University of Eastern Finland in collaboration with scientists from Lausanne University Hospital, University of Lausanne and the company Xigen Pharma AG, was published in the Journal of Neuroscience. Research was funded mainly by the Academy of Finland.
What is this missing link? We have known for years that over-stimulated neurons produce nitric oxide molecules. Although this can activate a signal for destruction of cells, the small amount of nitric oxide produced cannot alone explain the damage to the brain. The team now show that a protein called NOS1AP links the nitric oxide that is produced to the damage that results. NOS1AP binds an initiator of cell destruction called MKK3 and also moves within the cell to the source of nitric oxide when cells are over-activated. The location of these proteins in cells causes them to convert the over-stimulation signal into a cell destruction response. The team designed a chemical that prevents NOS1AP from binding the source of nitric oxide. This reduces the cell destruction response in cells of the brain and as a result it limits brain lesions in rodents.
Other funders are the European Union and the University of Eastern Finland. Researchers used the recently developed high-throughput imaging facilities at the A. I. Virtanen Institute. The researchers hope that continuation of their work could lead to improved treatments for diseases such as stroke, epilepsy and chronic conditions like Alzheimer’s disease. As NOS1AP is associated with schizophrenia, diabetes and sudden cardiac death, future research in this area may assist the treatment of a wider range of diseases.
(Source: aka.fi)
Turning human stem cells into brain cells sheds light on neural development
Medical researchers have manipulated human stem cells into producing types of brain cells known to play important roles in neurodevelopmental disorders such as epilepsy, schizophrenia and autism. The new model cell system allows neuroscientists to investigate normal brain development, as well as to identify specific disruptions in biological signals that may contribute to neuropsychiatric diseases.
Scientists from The Children’s Hospital of Philadelphia and the Sloan-Kettering Institute for Cancer Research led a study team that described their research in the journal Cell Stem Cell, published online today.
The research harnesses human embryonic stem cells (hESCs), which differentiate into a broad range of different cell types. In the current study, the scientists directed the stem cells into becoming cortical interneurons—a class of brain cells that, by releasing the neurotransmitter GABA, controls electrical firing in brain circuits.
"Interneurons act like an orchestra conductor, directing other excitatory brain cells to fire in synchrony," said study co-leader Stewart A. Anderson, M.D., a research psychiatrist at The Children’s Hospital of Philadelphia. "However, when interneurons malfunction, the synchrony is disrupted, and seizures or mental disorders can result."
Anderson and study co-leader Lorenz Studer, M.D., of the Center for Stem Cell Biology at Sloan-Kettering, derived interneurons in a laboratory model that simulates how neurons normally develop in the human forebrain.
"Unlike, say, liver diseases, in which researchers can biopsy a section of a patient’s liver, neuroscientists cannot biopsy a living patient’s brain tissue," said Anderson. Hence it is important to produce a cell culture model of brain tissue for studying neurological diseases. Significantly, the human-derived cells in the current study also "wire up" in circuits with other types of brain cells taken from mice, when cultured together. Those interactions, Anderson added, allowed the study team to observe cell-to-cell signaling that occurs during forebrain development.
In ongoing studies, Anderson explained, he and colleagues are using their cell model to better define molecular events that occur during brain development. By selectively manipulating genes in the interneurons, the researchers seek to better understand how gene abnormalities may disrupt brain circuitry and give rise to particular diseases. Ultimately, those studies could help inform drug development by identifying molecules that could offer therapeutic targets for more effective treatments of neuropsychiatric diseases.
In addition, Anderson’s laboratory is studying interneurons derived from stem cells made from skin samples of patients with chromosome 22q.11.2 deletion syndrome, a genetic disease which has long been studied at The Children’s Hospital of Philadelphia. In this multisystem disorder, about one third of patients have autistic spectrum disorders, and a partially overlapping third of patients develop schizophrenia. Investigating the roles of genes and signaling pathways in their model cells may reveal specific genes that are crucial in those patients with this syndrome who have neurodevelopmental problems.
(Source: eurekalert.org)
Mild Blast Injury Causes Molecular Changes in Brain Akin to Alzheimer’s Disease
A multicenter study led by scientists at the University of Pittsburgh School of Medicine shows that mild traumatic brain injury after blast exposure produces inflammation, oxidative stress and gene activation patterns akin to disorders of memory processing such as Alzheimer’s disease. Their findings were recently reported in the online version of the Journal of Neurotrauma.
Blast-induced traumatic brain injury (TBI) has become an important issue in combat casualty care, said senior investigator Patrick Kochanek, M.D., professor and vice chair of critical care medicine and director of the Safar Center for Resuscitation Research at Pitt. In many cases of mild TBI, MRI scans and other conventional imaging technology do not show overt damage to the brain.
“Our research reveals that despite the lack of a lot of obvious neuronal death, there is a lot of molecular madness going on in the brain after a blast exposure,” Dr. Kochanek said. “Even subtle injuries resulted in significant alterations of brain chemistry.”
The research team developed a rat model to examine whether mild blast exposure in a device called a shock tube caused any changes in the brain even if there was no indication of direct cell death, such as bleeding. Brain tissues of rats exposed to blast and to a sham procedure were tested two and 24 hours after the injury.
Gene activity patterns, which shifted over time, resembled patterns seen in neurodegenerative diseases, particularly Alzheimer’s, Dr. Kochanek noted. Markers of inflammation and oxidative stress, which reflects disruptions of cell signaling, were elevated, but there was no indication of energy failure that would be seen with poor tissue oxygenation.
“It appears that although the neurons don’t die after a mild injury, they do sustain damage,” he said. “It remains to be seen what multiple exposures, meaning repeat concussions, do to the brain over the long term.”
(Source: upmc.com)
Bat and Rat Brain Rhythms Differ When on the Move
To get a clear picture of how humans and other mammals form memories and find their way through their surroundings, neuroscientists must pay more attention to a broad range of animals rather than focus on a single model species, say two University of Maryland researchers, Katrina MacLeod and Cynthia Moss. Their new comparative study of bats and rats reports differences between the species that suggest the need to revise models of spatial navigation.
In a paper appearing in the April 19, 2013 issue of Science, the UMD researchers and two colleagues at Boston University reported significant differences between rats’ and bats’ brain rhythms when certain cells were active in a part of the brain used in memory and navigation.
These cells behaved as expected in rats, which mostly move along surfaces. But in bats, which fly, the continuous brain rhythm did not appear, said Moss, a professor in Psychology and Biology and the Institute for Systems Research.
The finding suggests that even though rats, bats, humans and other mammals share a common neural representation of space in a part of the brain that has been linked to spatial information and memory, they may have different cellular mechanisms to create or interpret those maps, said MacLeod, an assistant research scientist in Biology.
“To understand brains, including ours, we really must study neural activity in a variety of animals,” MacLeod said. “Common features across multiple species tell us ‘Aha, this is important,’ but differences can occur because of variances in the animals’ ecology, behavior, or evolutionary history.”
The research team focused on a brain region that contains specialized “grid cells,” so named because they form a hexagonal grid of activity related to the animal’s location as it navigates through space. This brain region, the medial entorhinal cortex, sits next to the hippocampus, the place that, in humans, forms memories of events such as where a car is parked. The medial entorhinal cortex acts as a hub of neural networks for memory and navigation.
Grid cells were first noticed in rats navigating their environment, but recent work by Nachum Ulanovsky (Moss’s former postdoctoral researcher at UMD) and his research team at the Weizmann Institute in Rehovot, Israel, has shown these cells exist in bats as well.
In rats, grid cells fire in a pattern called a theta wave when the animals spatially navigate. Theta waves are fairly low-frequency electrical oscillations that also have been observed at the cellular level in the medial entorhinal cortex. The prominence of theta waves in rats suggested they were important. As a result, neuroscientists, trying to understand the relationship between theta waves and grid cells, have developed models of the brain based on the assumption that theta waves are key to spatial navigation in mammals.
However, Moss said, “recordings from the brains of bats navigating in space contain a surprise, because the expected theta rhythms aren’t continuously present as they are in the rodent.”
The new Science study doubles down on the lack of theta in bats by reporting that theta rhythms also are not present at the cellular level. “The bat neurons don’t ‘ring’ the way the rat neurons do,” says MacLeod. “This raises a lots of questions as to whether theta rhythms are actually doing what the spatial navigation theory proposes in rats or even humans.”
Do drugs for bipolar disorder “normalize” brain gene function?
Every day, millions of people with bipolar disorder take medicines that help keep them from swinging into manic or depressed moods. But just how these drugs produce their effects is still a mystery.
Now, a new University of Michigan Medical School study of brain tissue helps reveal what might actually be happening. And further research using stem cells programmed to act like brain cells is already underway.
Using genetic analysis, the new study suggests that certain medications may help “normalize” the activity of a number of genes involved in communication between brain cells. It is published in the current issue of Bipolar Disorders.
The study involved brain tissue from deceased people with and without bipolar disorder, which the U-M team analyzed to see how often certain genes were activated, or expressed. Funding support came from the National Institutes of Health and the Heinz C. Prechter Bipolar Research Fund.
“We found there are hundreds of genes whose activity is adjusted in individuals taking medication – consistent with the fact that there are a number of genes that are potentially amiss in people with bipolar,” says senior author Melvin McInnis, M.D., the U-M psychiatrist, U-M Depression Center member and principal investigator of the Prechter Fund Projects who helped lead the study. “Taking the medications, specifically ones in a class called antipsychotics, seemed to normalize the gene expression pattern in these individuals so that it approached that of a person without bipolar.”
Digging deeper into bipolar genetics
Scientists already know that bipolar disorder’s roots lie in genetic differences in the brain — though they are still searching for the specific gene combinations involved.
McInnis and his colleagues have now embarked on research developing several a lines of induced pluripotent stem cells derived (iPSC) from volunteers with and without bipolar disorder, which will allow even more in-depth study of the development and genetics of bipolar disorder.
The newly published study looked at the expression, or activity levels, of 2,191 different genes in the brains of 14 people with bipolar disorder, and 12 with no mental health conditions. The brains were all part of a privately funded nonprofit brain bank that collected and stored donated brains, and recorded what medications the individuals were taking at the time of death.
Seven of the brains were from people with bipolar disorder who had been taking one or more antipsychotics when they died. These drugs include clozapine, risperidone, and haloperidol, and are often used to treat bipolar disorder. Most of the 14 brain donors with bipolar disorder were also taking other medications, such as antidepressants, at the time of death.
When the researchers compared the gene activity patterns among the brains of bipolar disorder patients who had been exposed to antipsychotics with patterns among those who weren’t, they saw striking differences.
Then, when they compared the activity patterns of patients who had been taking antipsychotics with those of people without bipolar disorder, they found similar patterns.
The similarities were strongest in the expression of genes involved in the transmission of signals across synapses – the gaps between brain cells that allow cells to ‘talk’ to one another. There were also similarities in the organization of nodes of Ranvier – locations along nerve cells where signals can travel faster.
McInnis, who is the Thomas B. and Nancy Upjohn Woodworth Professor of Bipolar Disorder and Depression in the U-M Department of Psychiatry, worked with U-M scientists Haiming Chen, M.D. and K. Sue O’Shea, Ph.D., of the U-M Department of Cell and Developmental Biology. They also teamed with Johns Hopkins University researcher Christopher Ross, M.D., Ph.D. on the new research; U-M and Johns Hopkins have a long history of collaboration on bipolar disorder research.
The research used brain tissue samples from the Stanley Brain Collection of the Stanley Medical Research Institute in Maryland.
Using “gene chip” analysis to measure the presence of messenger RNA molecules that indicate gene activity, and sophisticated data analysis, they were able to map the expression patterns from the brains and break the results down by bipolar status and medication use. The bipolar and control (non-bipolar) brains were matched by age, gender and other factors.
“In bipolar disorder, it’s not just one gene that’s involved – it’s a whole symphony of them,” says McInnis, who has helped lead U-M’s bipolar genetics research for nearly a decade. “Medications appear to nudge them in a direction that aligns more with the normal expression pattern.”
Among those that were “nudged” were genes that have already been shown to be linked to bipolar disorder, including glycogen synthase kinase 3 beta (GSK3β), FK506 binding protein 5 (FKBP5), and Ankyrin 3 (ANK3).
Going forward, says McInnis, cell culture studies will be critical to studying how medications for bipolar disorder work, and to screen new molecules as potential new medications.
Legal high Benzo Fury may be dangerous due to stimulant and hallucinogenic effects
The ‘legal high’ known as Benzo Fury may have stimulant as well as hallucinogenic effects according to new research presented at the British Neuroscience Association Festival of Neuroscience today (Tuesday 9 April 2013).
In a poster presentation at the meeting, Dr Jolanta Opacka-Juffry and Dr Colin Davidson reported that one of the main ingredients of Benzo Fury (also known as 5-APB) acts on brain tissue like both a stimulant and a hallucinogen – a combination of properties that is often found in illegal drugs and which can make them dangerous to users. The researchers believe this information should be disseminated to let potential users know the possible dangers of the drug.
Dr Opacka-Juffry, who is a principal lecturer in neuroscience and director of the health sciences research centre at the University of Roehampton, and Dr Davidson, senior lecturer in neuropharmacology and expert in drugs of addiction at St George’s, University of London, studied the effect of 5-APB samples from the brains of rats. In particular, they looked at the effect it had on serotonin receptors, which are affected by hallucinogenic drugs, and on a protein called the dopamine transporter (DAT), which pumps a neurotransmitter, dopamine, back in to nerve cells, terminating its activity, and which is involved in addiction. They compared the effects of 5-APB with those caused by cocaine and amphetamine.
“We have found that 5-APB behaves a little like amphetamine – that is, like a stimulant with addictive potential – and a bit like a hallucinogen, acting via serotonin receptors. This kind of mixed properties can be found in some illegal ‘designer’ drugs,” the presenting author, Dr Opacka-Juffry said.
“This finding is significant because it demonstrates that some ‘legal highs’ may have addictive properties, which are unlikely to be well-known amongst the users of these drugs. In addition, its effects on the serotonin receptors – known as 5-HT2A receptors – would suggest that it may lead to high blood pressure by causing constriction of the blood vessels, which would make the drug more dangerous. It is possible that the reason these drugs are so popular is because they are seen as safer than their illegal counterparts. It is important to challenge these assumptions.”
The researchers also found that 5-APB caused “reverse transport of dopamine”.
Dr Davidson said: “In theory, drugs which cause reverse transport could cause damage to the dopamine nerve cells. Other drugs such as amphetamines can also cause reverse transport, where dopamine is displaced from the nerve rather than mopped up by the dopamine transporter.”
Dr Opacka-Juffry said: “It is in the combination of these stimulant and hallucinogenic properties that the greatest danger lies. Pure hallucinogens are not addictive as such because they do not cause an increase in dopamine release, unlike amphetamine or cocaine. They are attractive to many people who enjoy the ‘mind altering’ properties of hallucinogens. But Benzo Fury with its mixed properties is a trap as its repetitive use for the hallucinogenic effects could lead to dependence, which the user may not expect.”
Further work needs to be carried out to find out more. “Rat data are quite informative as the brain addiction pathway is similar in rodents and humans. Long-term effects should be tested in rodents to investigate the potential toxic effects on the nervous system and the cardiovascular system, in addition to its liability for abuse due to addiction. We also need to collate data from human users. Taken together we can determine how dangerous this drug is,” she said.
Benzo Fury is currently one of the most popular legal highs in the UK and is also sold in the USA. It appears to be fairly easy to buy via the internet, at music festivals and clubs, and its street price is around £10 a pill or £25 for three. “However, tragedies such as the death of 19-year-old Alex Heriot at a music festival in June 2012 after taking Benzo Fury demonstrate the importance of making as much information available as possible about the potential adverse effects of these ‘highs’ as quickly as possible,” said Dr Opacka-Juffry.
Drs Opacka-Juffry and Davidson report that the approach they used to study Benzo Fury could be applied to other drugs as well, so that as new legal high drugs emerge, they can be tested quickly against the “gold standard” drugs such as cocaine and amphetamines to establish their relative danger.
Dr Davidson said: ”Over the last few years 40 or more new legal highs have appeared each year. Given the speed with which legal highs are developed and reach the market, it is important to be able to respond quickly to assess their potential dangers, and disseminate this information accordingly.”
Human brain research made easier by database
Researchers will be able to access samples from more than 7,000 donated human brains to help study major brain diseases, thanks to a new on-line database, launched by the Medical Research Council (MRC) today.
The UK Brain Banks Network database speeds up access to donated brain samples held across 10 brain banks in the UK and allows researchers studying Multiple Sclerosis, Alzheimer’s, Parkinson’s and a range of other neurodegenerative and developmental diseases to track down human tissue samples for their work.
Thanks to a unique collaboration between the MRC and five leading charities, the database will help scientists from academia and industry investigate the underlying causes of major brain diseases and understand how they take hold in our bodies.
Although scientists can model diseases in the lab, to fully understand dementia and other brain-related disorders they need to study human brain tissue. A lot of research relies on donated brain tissue stored in brain banks across the UK. Until today, researchers had to apply to each brain bank in turn to find out if they held the samples they needed and find the ‘control’ samples (donated brains free from disease) for comparison – a long and drawn out process. Now samples can be found with the click of a button from one source.
Professor James Ironside, Director of the MRC UK Brain Banks Network, said:
“The database is the result of four years of painstaking planning and data analysis by very dedicated people. It will enable quick and easy access for researchers who are already working on neurological or psychiatric disease (perhaps in animal models or cells) and would like to translate their findings into human tissue and is very useful for those who are planning a grant application. The brain banks have already been given ethical approval, cutting out the need for researchers to go through a separate ethics application.
We must remember that vital research would not be possible without the generosity of those individuals who donate their brains to medical research. We’re working hard to make sure that the access for researchers studying brain samples is much easier. The next step is to improve the systems for those wishing to donate their brain to medical research.”
Five leading charities helped to supply data for the database; the MS Society, Parkinson’s UK, Alzheimer’s Society, Alzheimer’s Research UK and Autistica.
For more information about the database visit: http://www.mrc.ac.uk/brainbanksnetwork
Brain tumour cells killed by anti-nausea drug
New research from the University of Adelaide has shown for the first time that the growth of brain tumours can be halted by a drug currently being used to help patients recover from the side effects of chemotherapy.
The discovery has been made during a study looking at the relationship between brain tumours and a peptide associated with inflammation in the brain, called “substance P”.
Substance P is commonly released throughout the body by the nervous system, and contributes to tissue swelling following injury. In the brain, levels of substance P greatly increase after traumatic brain injury and stroke.
"Researchers have known for some time that levels of substance P are also greatly increased in different tumour types around the body," says Dr Elizabeth Harford-Wright, a postdoctoral fellow in the University’s Adelaide Centre for Neuroscience Research.
"We wanted to know if these elevated levels of the peptide were also present in brain tumour cells, and if so, whether or not they were affecting tumour growth. Importantly, we wanted to see if we could stop tumour growth by blocking substance P."
Dr Harford-Wright found that levels of substance P were greatly increased in brain tumour tissue.
Knowing that substance P binds to a receptor called NK1, Dr Harford-Wright used an antagonist drug called Emend® to stop substance P binding to the receptor. Emend® is already used in cancer clinics to help patients with chemotherapy-induced nausea.
The results were startling.
"We were successful in blocking substance P from binding to the NK1 receptor, which resulted in a reduction in brain tumour growth - and it also caused cell death in the tumour cells," Dr Harford-Wright says.
"So preventing the actions of substance P from carrying out its role in brain tumours actually halted the growth of brain cancer.
"This is a very exciting result, and it offers further opportunities to study possible brain tumour treatments over the coming years."
Even mild traumatic brain injuries can kill brain tissue
Scientists have watched a mild traumatic brain injury play out in the living brain, prompting swelling that reduces blood flow and connections between neurons to die.
“Even with a mild trauma, we found we still have these ischemic blood vessels and, if blood flow is not returned to normal, synapses start to die,” said Dr. Sergei Kirov, neuroscientist and Director of the Human Brain Lab at the Medical College of Georgia at Georgia Regents University.
They also found that subsequent waves of depolarization – when brain cells lose their normal positive and negative charge – quickly and dramatically increase the losses.
Researchers hope the increased understanding of this secondary damage in the hours following an injury will point toward better therapy for the 1.7 million Americans annually experiencing traumatic brain injuries from falls, automobile accidents, sports, combat and the like. While strategies can minimize impact, no true neuroprotective drugs exist, likely because of inadequate understanding about how damage unfolds after the immediate impact.
Kirov is corresponding author of a study in the journal Brain describing the use of two-photon laser scanning microscopy to provide real-time viewing of submicroscopic neurons, their branches and more at the time of impact and in the following hours.
Scientists watched as astrocytes – smaller cells that supply neurons with nutrients and help maintain normal electrical activity and blood flow – in the vicinity of the injury swelled quickly and significantly. Each neuron is surrounded by several astrocytes that ballooned up about 25 percent, smothering the neurons and connective branches they once supported.
“We saw every branch, every small wire and how it gets cut,” Kirov said. “We saw how it destroys networks. It really goes downhill. It’s the first time we know of that someone has watched this type of minor injury play out over the course of 24 hours.”
Stressed neurons ran out of energy and became silent but could still survive for hours, potentially giving physicians time to intervene, unless depolarization follows. Without sufficient oxygen and energy, internal pumps that ensure proper polarity by removing sodium and pulling potassium into neurons, can stop working and dramatically accelerate brain-cell death.
“Like the plus and minus ends of a battery, neurons must have a negative charge inside and a positive charge outside to fire,” Kirov said. Firing enables communication, including the release of chemical messengers called neurotransmitters.
“If you have six hours to save tissue when you have just lost part of your blood flow, with this spreading depolarization, you lose tissue within minutes,” he said.
While common in head trauma, spreading depolarization would not typically occur in less-traumatic injuries, like his model. His model was chemically induced to reveal more about how this collateral damage occurs and whether neurons could still be saved. Interestingly, researchers found that without the initial injury, brain cells completely recovered after re-polarization but only partially recovered in the injury model.
While very brief episodes of depolarization occur as part of the healthy firing of neurons, spreading depolarization exacerbates the initial traumatic brain injury in more than half of patients and results in poor prognosis, previous research has shown. However, a 2011 review in the journal Nature Medicine indicated that short-lived waves can actually protect surrounding brain tissue. Kirov and his colleagues wrote that more study is needed to determine when to intervene.
One of Kirov’s many next steps is exploring the controversy about whether astrocytes’ swelling in response to physical trauma is a protective response or puts the cells in destruct mode. He also wants to explore better ways to protect the brain from the growing damage that can follow even a slight head injury.
Currently, drugs such as diuretics and anti-seizure medication may be used to help reduce secondary damage of traumatic brain injury. Astrocytes can survive without neurons but the opposite is not true, Kirov said. The ratio of astrocytes to neurons is higher in humans and human astrocytes are more complex, Kirov said.