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Perivascular Space Burden and Cerebrospinal Fluid Biomarkers in US Veterans With Blast-Related Mild Traumatic Brain

Erin A Yamamoto1, Seiji Koike2, Madison Luther3

  • 1Department of Neurological Surgery, Division of Child Neurology, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon, USA.

Journal of Neurotrauma
|January 8, 2024
PubMed

Insights

Mild traumatic brain injury from blasts is linked to inflammation and changes in brain fluid pathways. Neuroinflammation, not peripheral inflammation, is associated with these changes in Veterans with blast-related mild traumatic brain injury.

Area of Science:

  • Neuroscience
  • Radiology
  • Military Medicine

Background:

  • Blast-related mild traumatic brain injury (mTBI) is a signature injury from recent conflicts.
  • Sleep disruption, mTBI, and neuroinflammation are linked to dilated perivascular spaces (PVS).
  • Dilated PVS may indicate impaired brain fluid exchange and waste clearance.

Purpose of the Study:

  • To investigate associations between inflammatory biomarkers and MRI-visible PVS (MV-PVS) burden.
  • To compare these associations in Veterans with blast-mTBI and control groups.

Main Methods:

  • Cross-sectional, retrospective study design.
  • Comparison of CSF and plasma inflammatory biomarker concentrations between blast-mTBI and control groups.
  • Correlation of biomarker concentrations with MV-PVS volume and number; multiple regression analyses performed.

Main Results:

  • No significant group differences in MV-PVS burden were observed.
  • Greater MV-PVS burden correlated with higher CSF pro-inflammatory biomarkers (eotaxin, MCP-1, IL-6, IL-8) and plasma biomarkers (MCP-4, IL-13) in the blast-mTBI group only.
  • This association persisted after controlling for sleep and PTSD symptoms, implicating central neuroinflammation.

Conclusions:

  • Central neuroinflammation, not peripheral, is associated with MV-PVS burden in Veterans with blast-mTBI.
  • Findings suggest a link between neuroinflammation and impaired CSF/interstitial fluid exchange post-blast-mTBI.
  • Further research is needed to explore the role of neuroinflammation in MV-PVS development and subclinical exposures.
Keywords:
MRIbrain traumaglymphaticneuroinflammationperivascular spaces

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