Immune Response in Traumatic Brain Injury

Current Neurology and Neuroscience Reports, Journal Year: 2024, Volume and Issue: 24(12), P. 593 - 609

Published: Oct. 29, 2024

Abstract Purpose of Review This review aims to comprehensively examine the immune response following traumatic brain injury (TBI) and how its disruption can impact healing recovery. Recent Findings The is now considered a key element in pathophysiology TBI, with consequences far beyond acute phase after injury. A delicate equilibrium crucial for healthy When this disrupted, chronic inflammation imbalance lead detrimental effects on survival disability. Summary Globally, imposes substantial burden terms both years life lost lived Although epidemiology exhibits dynamic trends over time across regions, TBI disproportionally affects younger populations, posing psychosocial financial challenge communities families. Following initial trauma, primary succeeded by an inflammatory response, primarily orchestrated innate system. inflammasome plays pivotal role during stage, catalyzing programmed cell death pathways up-regulation cytokines transcription factors. These events trigger activation differentiation microglia, thereby intensifying systemic level facilitating migration cells edema. initially originated brain, monitored our autonomic nervous Through vagus nerve adrenergic cholinergic receptors various peripheral lymphoid organs cells, bidirectional communication regulation between systems established.

Language: Английский

---

Vagus Nerve Suppression in Ischemic Stroke by Carotid Artery Occlusion: Implications for Metabolic Regulation, Cognitive Function, and Gut Microbiome in a Gerbil Model

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(14), P. 7831 - 7831

Published: July 17, 2024

The vagus nerve regulates metabolic homeostasis and mediates gut–brain communication. We hypothesized that dysfunction, induced by truncated vagotomy (VGX) or carotid artery occlusion (AO), would disrupt communication exacerbate dysregulation, neuroinflammation, cognitive impairment. This study aimed to test the hypothesis in gerbils fed a high-fat diet. were divided into four groups: AO with VGX (AO_VGX), without (AO_NVGX), no (NAO_VGX), (NAO_NVGX). After 5 weeks on diet, neuronal cell death, neurological severity, hippocampal lipids inflammation, energy/glucose metabolism, intestinal morphology, fecal microbiome composition assessed. increased death severity scores associated lipid profiles peroxidation, as well changes inflammatory cytokine expression brain-derived neurotrophic factor (BDNF) levels. also body weight, visceral fat mass, insulin resistance decreased skeletal muscle mass. morphology altered, an increase abundance of Bifidobacterium decrease Akkermansia Ruminococcus. Microbial metagenome functions impacted, including glutamatergic synaptic activity, glycogen synthesis, amino acid biosynthesis. Interestingly, effects not significantly additive AO, suggesting inhibited partly offsetting VGX. In conclusion, exacerbated dysregulation energy, glucose, memory deficits, potentially through modulation axis. Targeting axis inhibiting suppression represents potential therapeutic strategy for ischemic stroke.

Language: Английский

---

Vagus nerve stimulation for stroke rehabilitation: Neural substrates, neuromodulatory effects and therapeutic implications

The Journal of Physiology, Journal Year: 2024, Volume and Issue: 603(3), P. 723 - 735

Published: Sept. 7, 2024

Paired vagus nerve stimulation (VNS) has emerged as a promising strategy to potentiate recovery after neurological injury. This approach, which combines short bursts of electrical the with rehabilitation exercises, received approval from US Food and Drug Aministration in 2021 first neuromodulation-based therapy for chronic stroke. Because this treatment is increasingly implemented clinical practice, there need take stock what we know about approach have yet learn. Here, provide survey on foundational basis VNS stroke offer insight into mechanisms that underlie potentiated recovery, focusing principles neuromodulatory reinforcement. We discuss current state observations regarding synaptic reorganization motor networks are enhanced by VNS, propose other prospective loci neuromodulation should be evaluated future. Finally, highlight future opportunities challenges faced translated use. Collectively, clearer understanding mechanistic may reveal ways maximize its benefits.

Language: Английский

---

Effect of transcutaneous vagus nerve stimulation in hemodialysis patients: A randomized controlled trial

Therapeutic Apheresis and Dialysis, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 4, 2025

Abstract Introduction Transcutaneous auricular vagus nerve stimulation (tVNS) has shown potential in neurological, autoimmune, and cardiovascular disorders, but its effects on HD patients remain unclear. This study aimed to evaluate the efficacy safety of tVNS patients. Methods We conducted a randomized controlled clinical trial receiving ≥6 months. The group received for 1 h during first 2 sessions, three times weekly 8 weeks, while control standard care. primary outcomes were dialysis efficiency (Single‐pool Kt/V, Sp Kt/V) dialysis‐related symptoms (Dialysis Symptom Index, DSI), assessed every 4 weeks. Secondary included pain fatigue scores, physical performance, Hemodialysis Comfort Scale, hemoglobin levels, Mini‐Mental State Examination, anxiety depression measured at baseline weeks after intervention. Results A total 63 enrolled study, with 32 assigned 31 group. At showed significant improvements Kt/V (1.31 ± 0.11 vs. 1.25 0.10, p = 0.02), DSI (12.09 5.84 16.26 5.27, 0.004), as well reductions fatigue, increases function, comfort, hemoglobin. However, there no statistically changes observed cognitive anxiety, or depression. Conclusions could improve efficiency, symptoms, function patients, indicating it may have role complementary therapy.

Language: Английский

---

Remodeling and Characterization Analysis of Corticospinal Tract in Patients with Intracerebral Hemorrhage in the Basal Ganglia

Translational Stroke Research, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 9, 2025

Language: Английский

---

Noninvasive Vagus Nerve Stimulation Protects Neurons in the Perihematomal Region and Improves the Outcomes in a Rat Model of Intracerebral Hemorrhage

Neurocritical Care, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 15, 2025

Language: Английский

---

Advancements in the investigation of gut microbiota-based strategies for stroke prevention and treatment

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 4, 2025

Stroke represents a predominant cause of mortality and disability on global scale, impacting millions annually exerting considerable strain healthcare systems. The incidence stroke exhibits regional variability, with ischemic accounting for the majority occurrences. Post-stroke complications, such as cognitive impairment, motor dysfunction, recurrent stroke, profoundly affect patients’ quality life. Recent advancements have elucidated microbiota-gut-brain axis (MGBA), underscoring complex interplay between gut health brain function. Dysbiosis, characterized by an imbalance in microbiota, is significantly linked to elevated risk unfavorable outcomes. MGBA plays crucial role modulating immune function, neurotransmitter levels, metabolic byproducts, which may intensify neuroinflammation impair cerebral health. This review elucidates pathophysiology explores potential gut-targeted therapeutic strategies reduce promote recovery, including probiotics, prebiotics, pharmacological interventions, dietary modifications. However, current prevention treatment based intestinal flora still face many problems, large difference individual flora, stability efficacy, long-term safety need be considered. Further research needs strengthened its better application clinical practice.

Language: Английский

---

TRanscutaneous lImb reCovEry Post-Stroke (TRICEPS): study protocol for a randomised, controlled, multiarm, multistage adaptive design trial

BMJ Open, Journal Year: 2025, Volume and Issue: 15(3), P. e092520 - e092520

Published: March 1, 2025

Introduction Arm weakness after stroke is one of the leading causes adult-onset disability. Invasive vagus nerve stimulation (VNS) paired with rehabilitation has been shown to improve arm recovery in chronic stroke. Small studies non-invasive or transcutaneous VNS (tVNS) suggest it safe and tolerable. However, not known whether tVNS effective promoting what mechanisms action are. Methods analysis TRICEPS a UK multicentre, double-blinded, superiority, parallel-group, three-arm two-stage an option select promising arm(s) at 50% accrual, individually randomised, sham-controlled trial. Up 243 participants will be randomised (1:1:1) using minimisation via restricted, web-based centralised system. delivered by movement-activated system (TVNS Technologies), which delivers during repetitive task practice. Rehabilitation consist training for 1 hour day, 5 days per week 12 weeks. Participants adults anterior circulation ischaemic between 6 months 10 years prior moderate-severe weakness. The primary outcome measure change Upper Limb Fugl-Meyer total motor score 91 start treatment. Secondary measures include Wolf Motor Function Test, Modified Ashworth Scale assess spasticity affected Stroke-Specific Quality Life Scale. A mechanistic substudy including 40 explore active versus sham multimodal MRI serum inflammatory cytokine levels. Participant recruitment started on 30 November 2023. Ethics dissemination study received ethical approval from Cambridge Central Research Committee (REC reference: 22/NI/0134). Dissemination results publications scientific journals, meetings, written reports articles stakeholder publications. Trial registration number NCT20221867 .

Language: Английский

---

Vagus Nerve Stimulation in Stroke Management: Brief Review of Evolution and Present Applications Paired with Rehabilitation

Brain Sciences, Journal Year: 2025, Volume and Issue: 15(4), P. 346 - 346

Published: March 27, 2025

Cerebrovascular accident (CVA) or stroke is a devastating neurological condition with dismal prognosis associated recurrent episodes that further damage the neuronal networks, thus disabling plasticity. Vagus nerve stimulation (VNS) has been used in clinical practice to treat epilepsy for several decades and well accepted as safe procedure devoid of serious adverse events. Bailey Bremer demonstrated VNS capabilities stimulate pathways enhance recovery damaged cerebral function. Further studies have strengthened these observations, while technology improved tolerability implants, resulting applications epilepsy. Several animal models on neural plasticity our understanding its ability provide neuromodulation improve patients. The closed-loop vagus individualized parameters combined physical therapy appears be an attractive option today. also being tested noninvasive trans-cutaneous modality patient acceptance tolerability. However, implantation yielding desirable outcomes more reliable treatment rehabilitation trials.

Language: Английский

---

Splenectomy Improves Outcome of Intracerebral Hemorrhage

The FASEB Journal, Journal Year: 2025, Volume and Issue: 39(8)

Published: April 18, 2025

ABSTRACT The acute splenic response triggers a surge of immune cells and pro‐inflammatory mediators, exacerbating secondary brain injury worsening the outcome after intracerebral hemorrhage (ICH). Splenectomy confers benefits in experimental ischaemic stroke, but its effects on ICH are not known. We conducted proof‐of‐concept study to test hypothesis that prior splenectomy would improve behavioral outcomes ICH. Adult C57BL/6N mice with collagenase‐induced had undergone two weeks were compared those intact spleens. Motor function, haematoma size, cerebral oedema, peripheral blood neutrophil counts evaluated. Splenectomised lower peri‐haematoma regions brain. They performed better modified Neurological Severity Score during first week post‐ICH for shorter duration rotarod cylinder tests. Haematomas non‐splenectomised animals showed expansion initial larger than splenectomised animals, more severe surrounding oedema greater mass effect. This is report beneficial Further studies optimal timing mode ablation justified assess translational potential.

Language: Английский

---