TBI link to NDD

Question 1

Define TBI

Answer 1

Closed or open injury that disrupts the function of the brain.

1. Open (penetrating) injuries (breach skull and dura with direct damage to parenchyma)
2. Closed- head injuries (skull and dura are intact)

Question 2

Non-traumatic injury

Answer 2

a non-traumatic brain injury causes damage to the brain by internal factors, such as a lack of oxygen, exposure to toxins, pressure from a tumor, etc

Question 3

What scale is used to measure severity of TBI

Answer 3

Glasgow coma scale
lower score-worse

Question 4

mild TBI features

Answer 4

0-30mins loss of consciousness
13-15 GCS
Normal structural brain imaging

Question 5

Types of symptoms for mTBI?

Answer 5

Physical, sensory, cognitive, emotional, Behavioural

Question 6

Sex differences to mTBI

Answer 6

men have more mTBI

Question 7

Biophysical mechanism for TBI

Answer 7

-Intracranial pressure gradient shift
-Shearing and strain forces stretch and damage axons
-Diffuse axonal injury or focal strains, but how?

Question 8

Axonal injury of TBI Effects:

Answer 8

-Microtubule disruption
-Impairs axonal transport
-membrane leakage - ion permeability selectivity
-Impairs synapse function
-Increase to Ca2+ influx

Question 9

CSF biomarkers for TBI

Answer 9

T-tau (higher t-tau = higher disease severity)
NF-L for long axons

Question 10

astrocyte function marker

Answer 10

(S100 calcium-binding protein B (S100B)

glial fibrillary acidic protein (GFAP)

Question 11

Blood Biomarkers of TBI

and the issue with it

Answer 11

astroglia protein S100B
has poor specificity to predict intracranial pathology that can be observed with CT, with many false-positive results

Question 12

What is CTE and the hallmark feature of it

Answer 12

Chronic traumatic encephalopathy

an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern

Question 13

What accumulates in CTE

Answer 13

p-tau
TDP-43
Ab

Question 14

Link to Parkinson’s

Answer 14

Repeated mild TBI ‘punch drunk’ or ‘dementia pugilistica’

Military evidence: not typical of idiopathic PD but may be overlapping. earlier diagnosis by 2 years for PD if you have mTBI.

Question 15

What is the ‘window of vulnerability’

Answer 15

After mild traumatic brain injury (TBI), the brain has increased susceptibility for a new injury during the recovery phase

Question 16

Issue with identifying CTE

Answer 16

No biomarkers for CTE identity