Chronic traumatic encephalopathy in blast-exposed military veterans and a blast neurotrauma mouse model

Sci Transl Med. 2012 May 16;4(134):134ra60. doi: 10.1126/scitranslmed.3003716.

Abstract

Blast exposure is associated with traumatic brain injury (TBI), neuropsychiatric symptoms, and long-term cognitive disability. We examined a case series of postmortem brains from U.S. military veterans exposed to blast and/or concussive injury. We found evidence of chronic traumatic encephalopathy (CTE), a tau protein-linked neurodegenerative disease, that was similar to the CTE neuropathology observed in young amateur American football players and a professional wrestler with histories of concussive injuries. We developed a blast neurotrauma mouse model that recapitulated CTE-linked neuropathology in wild-type C57BL/6 mice 2 weeks after exposure to a single blast. Blast-exposed mice demonstrated phosphorylated tauopathy, myelinated axonopathy, microvasculopathy, chronic neuroinflammation, and neurodegeneration in the absence of macroscopic tissue damage or hemorrhage. Blast exposure induced persistent hippocampal-dependent learning and memory deficits that persisted for at least 1 month and correlated with impaired axonal conduction and defective activity-dependent long-term potentiation of synaptic transmission. Intracerebral pressure recordings demonstrated that shock waves traversed the mouse brain with minimal change and without thoracic contributions. Kinematic analysis revealed blast-induced head oscillation at accelerations sufficient to cause brain injury. Head immobilization during blast exposure prevented blast-induced learning and memory deficits. The contribution of blast wind to injurious head acceleration may be a primary injury mechanism leading to blast-related TBI and CTE. These results identify common pathogenic determinants leading to CTE in blast-exposed military veterans and head-injured athletes and additionally provide mechanistic evidence linking blast exposure to persistent impairments in neurophysiological function, learning, and memory.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acceleration
  • Adolescent
  • Adult
  • Animals
  • Athletes
  • Axons / pathology
  • Behavior, Animal
  • Blast Injuries / complications*
  • Blast Injuries / pathology*
  • Blast Injuries / physiopathology
  • Brain Concussion / complications
  • Brain Concussion / pathology
  • Brain Concussion / physiopathology
  • Brain Injury, Chronic / complications*
  • Brain Injury, Chronic / pathology*
  • Brain Injury, Chronic / physiopathology
  • Disease Models, Animal
  • Head / pathology
  • Head / physiopathology
  • Hippocampus / pathology
  • Hippocampus / physiopathology
  • Hippocampus / ultrastructure
  • Humans
  • Intracranial Pressure
  • Long-Term Potentiation
  • Male
  • Mice
  • Middle Aged
  • Military Personnel / psychology*
  • Phosphorylation
  • Postmortem Changes
  • Synaptic Transmission
  • Veterans / psychology*
  • Young Adult
  • tau Proteins / metabolism

Substances

  • tau Proteins