Subclinical brain manifestations of repeated mild traumatic brain injury are changed by chronic exposure to sleep loss, caffeine, and sleep aids.

Exp Neurol

Neuroscience Research, Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address:

Published: November 2024

AI Article Synopsis

  • The study examines how common activities like caffeine consumption, sleep deprivation, and sleep aids affect the brain after mild traumatic brain injury (mTBI), suggesting these exposures can change brain function and structure during recovery.
  • Using an animal model, researchers analyzed brain changes through advanced imaging techniques after administering these treatments for 70 days following repeated mTBIs.
  • Results indicate that each treatment uniquely impacted brain regions, with sleep aids showing the most significant alterations, highlighting the importance of understanding everyday habits during recovery from mTBI.

Article Abstract

Introduction: After mild traumatic brain injury (mTBI), the brain is labile for weeks and months and vulnerable to repeated concussions. During this time, patients are exposed to everyday circumstances that, in themselves, affect brain metabolism and blood flow and neural processing. How commonplace activities interact with the injured brain is unknown. The present study in an animal model investigated the extent to which three commonly experienced exposures-daily caffeine usage, chronic sleep loss, and chronic sleep aid medication-affect the injured brain in the chronic phase.

Methods: Subclinical trauma by repeated mTBIs was produced by our head rotational acceleration injury model, which causes brain injury consistent with the mechanism of concussion in humans. Forty-eight hours after a third mTBI, chronic administrations of caffeine, sleep restriction, or zolpidem (sedative hypnotic) began and were continued for 70 days. On Days 30 and 60 post injury, resting state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) were performed.

Results: Chronic caffeine, sleep restriction, and zolpidem each changed the subclinical brain characteristics of mTBI at both 30 and 60 days post injury, detected by different MRI modalities. Each treatment caused microstructural alterations in DTI metrics in the insular cortex and retrosplenial cortex compared with mTBI, but also uniquely affected other gray and white matter regions. Zolpidem administration affected the largest number of individual structures in mTBI at both 30 and 60 days, and not necessarily toward normalization (sham treatment). Chronic sleep restriction changed local functional connectivity at 30 days in diametrical opposition to chronic caffeine ingestion, and both treatment outcomes were different from sham, mTBI-only and zolpidem comparisons. The results indicate that commonly encountered exposures modify subclinical brain activity and structure long after healing is expected to be complete.

Conclusions: Changes in activity and structure detected by fMRI are widely understood to reflect changes in the functions of the affected region which conceivably underlie mTBI neuropathology and symptomatology in the chronic phase after injury.

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Source
http://dx.doi.org/10.1016/j.expneurol.2024.114928DOI Listing

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