Military traumatic brain injury [Neurosurgery Wiki]

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====== Military traumatic brain injury ======

[[Contact sport]]s athletes and [[military]] personnel who suffered a repetitive [[mild traumatic brain injury]] (rmTBI) are at high risk of [[neurodegenerative disease]]s such as advanced [[dementia]] and [[chronic traumatic encephalopathy]] (CTE). However, due to the lack of specific biological indicators in clinical practice, the diagnosis and treatment of repetitive [[mild traumatic brain injury]]  are quite limited.

Zhang et al. used 2-methacryloyloxyethyl phosphorylcholine (MPC)-nanocapsules to deliver [[immunoglobulin]]s (IgG), which can increase the delivery efficiency and specific target of [[IgG]] while reducing the effective therapeutic dose of the [[drug]].

The results demonstrated that MPC-capsuled immunoglobulins (MPC-n (IgG)) significantly alleviated [[cognitive impairment]], hippocampal atrophy, p-Tau deposition, and [[myelin]] injury in rmTBI mice compared with free IgG. Furthermore, MPC-n (IgG) can also effectively inhibit the activation of microglia and the release of inflammatory factors.

In the present study, Zhang et al. put forward an efficient [[strategy]] for the repetitive [[mild traumatic brain injury treatment]] of related [[cognitive impairment]] and provide evidence for the administration of low-dose [[IgG]]
((Zhang C, Wei C, Huang X, Hou C, Liu C, Zhang S, Zhao Z, Liu Y, Zhang R, Zhou L, Li Y, Yuan X, Zhang J. MPC-n ([[IgG]]) improves long-term cognitive impairment in the [[mouse model]] of repetitive [[mild traumatic brain injury]]. BMC Med. 2023 May 30;21(1):199. doi: 10.1186/s12916-023-02895-7. PMID: 37254196.))

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[[Mild Traumatic brain injury]] (mTBI) is a signature wound in [[military]] personnel, and repetitive mTBI has been linked to age-related [[neurodegenerative disease]]s that affect [[white matter]] (WM) in the [[brain]]. However, findings of [[injury]] to specific [[white matter tract]]s have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, [[etiology]], and comorbid disorders related to mTBI. [[Non-negative matrix factorization]] (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. Bouchard et al. applied NMF to [[Diffusion-weighted magnetic resonance imaging]] data from military [[Veteran]]s with and without a self-reported TBI history. NMF identified 12 independent components derived from [[fractional anisotropy]] (FA) in a large [[dataset]] (n = 1,475) gathered through the ENIGMA (Enhancing Neuroimaging Genetics through Meta-Analysis) Military Brain Injury working group. Regressions were used to examine TBI- and mTBI-related associations in NMF-derived components while adjusting for age, sex, post-traumatic stress disorder, depression, and data acquisition site/scanner. They found significantly stronger age-dependent effects of lower FA in Veterans with TBI than Veterans without in four components (q < 0.05), which are spatially unconstrained by traditionally defined WM tracts. One component, occupying the most peripheral location, exhibited significantly stronger age-dependent differences in Veterans with mTBI. They found NMF to be powerful and effective in detecting covarying patterns of FA associated with mTBI by applying standard parametric regression modeling. The results highlight patterns of WM alteration that are differentially affected by TBI and mTBI in younger compared to older military Veterans
((Bouchard HC, Sun D, Dennis EL, Newsome MR, Disner SG, Elman J, Silva A, Velez C, Irimia A, Davenport ND, Sponheim SR, Franz CE, Kremen WS, Coleman MJ, Williams MW, Geuze E, Koerte IK, Shenton ME, Adamson MM, Coimbra R, Grant G, Shutter L, George MS, Zafonte RD, McAllister TW, Stein MB, Thompson PM, Wilde EA, Tate DF, Sotiras A, Morey RA. [[Age]]-dependent [[white matter disruption]]s after [[military traumatic brain injury]]: [[Multivariate]] [[analysis]] results from [[ENIGMA brain injury]]. Hum Brain Mapp. 2022 Mar 15. doi: 10.1002/hbm.25811. Epub ahead of print. PMID: 35289463.)).