학술논문

Glucose administration after traumatic brain injury improves cerebral metabolism and reduces secondary neuronal injury
Document Type
article
Source
Subject
Traumatic Head and Spine Injury
Traumatic Brain Injury (TBI)
Diabetes
Brain Disorders
Physical Injury - Accidents and Adverse Effects
Neurosciences
Neurological
Mental health
Animals
Brain
Brain Injuries
Glucose
Male
Neurons
Neuroprotective Agents
Rats
Rats
Sprague-Dawley
C-14-2DG
Controlled cortical impact
Fluoro-Jade B
Hyperglycemia
Rat
(14)C-2DG
4′
6-diamidino-2-phenylindol dihydrochloride
5% dextrose in 0.9% saline
ANLS
ANOVA
ATP
CCI
CMRGlc
CMRO(2)
D5NS
DAPI
FJB
FPI
GLC
Mg(++)
PBS
ROS
SAL
SEM
TBI
adenosine triphosphate
analysis of variance
astrocyte-neuron lactate shuttle
cerebral metabolic rates of glucose
cerebral metabolic rates of oxygen
controlled cortical impact
fluid percussion injury
glucose
magnesium
phosphate buffered saline
reactive oxygen species
saline
standard error of the mean
traumatic brain injury
Psychology
Cognitive Sciences
Neurology & Neurosurgery
Language
Abstract
Clinical studies have indicated an association between acute hyperglycemia and poor outcomes in patients with traumatic brain injury (TBI), although optimal blood glucose levels needed to maximize outcomes for these patients' remain under investigation. Previous results from experimental animal models suggest that post-TBI hyperglycemia may be harmful, neutral, or beneficial. The current studies determined the effects of single or multiple episodes of acute hyperglycemia on cerebral glucose metabolism and neuronal injury in a rodent model of unilateral controlled cortical impact (CCI) injury. In Experiment 1, a single episode of hyperglycemia (50% glucose at 2 g/kg, i.p.) initiated immediately after CCI was found to significantly attenuate a TBI-induced depression of glucose metabolism in cerebral cortex (4 of 6 regions) and subcortical regions (2 of 7) as well as to significantly reduce the number of dead/dying neurons in cortex and hippocampus at 24 h post-CCI. Experiment 2 examined effects of more prolonged and intermittent hyperglycemia induced by glucose administrations (2 g/kg, i.p.) at 0, 1, 3 and 6h post-CCI. The latter study also found significantly improved cerebral metabolism (in 3 of 6 cortical and 3 of 7 subcortical regions) and significant neuroprotection in cortex and hippocampus 1 day after CCI and glucose administration. These results indicate that acute episodes of post-TBI hyperglycemia can be beneficial and are consistent with other recent studies showing benefits of providing exogenous energy substrates during periods of increased cerebral metabolic demand.