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Damage to Arousal-Promoting Brainstem Neurons with Traumatic Brain Injury


Valko, P O; Gavrilov, Y V; Yamamoto, M; Noaín, D; Reddy, H; Haybaeck, J; Weis, S; Baumann, C R; Scammell, T E (2016). Damage to Arousal-Promoting Brainstem Neurons with Traumatic Brain Injury. Sleep, 39(6):1249-1252.

Abstract

STUDY OBJECTIVES Coma and chronic sleepiness are common after traumatic brain injury (TBI). Here, we explored whether injury to arousal-promoting brainstem neurons occurs in patients with fatal TBI. METHODS Postmortem examination of 8 TBI patients and 10 controls. RESULTS Compared to controls, TBI patients had 17% fewer serotonergic neurons in the dorsal raphe nucleus (effect size: 1.25), but the number of serotonergic neurons did not differ in the median raphe nucleus. TBI patients also had 29% fewer noradrenergic neurons in the locus coeruleus (effect size: 0.96). The number of cholinergic neurons in the pedunculopontine and laterodorsal tegmental nuclei (PPT/LDT) was similar in TBI patients and controls. CONCLUSIONS TBI injures arousal-promoting neurons of the mesopontine tegmentum, but this injury is less severe than previously observed in hypothalamic arousal-promoting neurons. Most likely, posttraumatic arousal disturbances are not primarily caused by damage to these brainstem neurons, but arise from an aggregate of injuries, including damage to hypothalamic arousal nuclei and disruption of other arousal-related circuitries.

Abstract

STUDY OBJECTIVES Coma and chronic sleepiness are common after traumatic brain injury (TBI). Here, we explored whether injury to arousal-promoting brainstem neurons occurs in patients with fatal TBI. METHODS Postmortem examination of 8 TBI patients and 10 controls. RESULTS Compared to controls, TBI patients had 17% fewer serotonergic neurons in the dorsal raphe nucleus (effect size: 1.25), but the number of serotonergic neurons did not differ in the median raphe nucleus. TBI patients also had 29% fewer noradrenergic neurons in the locus coeruleus (effect size: 0.96). The number of cholinergic neurons in the pedunculopontine and laterodorsal tegmental nuclei (PPT/LDT) was similar in TBI patients and controls. CONCLUSIONS TBI injures arousal-promoting neurons of the mesopontine tegmentum, but this injury is less severe than previously observed in hypothalamic arousal-promoting neurons. Most likely, posttraumatic arousal disturbances are not primarily caused by damage to these brainstem neurons, but arise from an aggregate of injuries, including damage to hypothalamic arousal nuclei and disruption of other arousal-related circuitries.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 June 2016
Deposited On:29 Dec 2016 08:13
Last Modified:01 Jan 2017 06:29
Publisher:American Academy of Sleep Medicine
ISSN:0161-8105
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.5665/sleep.5844
PubMed ID:27091531

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