title: Temporal window of metabolic brain vulnerability to concussions: mitochondrial-related impairment--part I.
abstract: OBJECTIVE
  In the present study, we investigate the existence of a temporal window of brain vulnerability in rats undergoing repeat mild traumatic brain injury (mTBI) delivered at increasing time intervals.
  
  
  METHODS
  Rats were subjected to two diffuse mTBIs (450 g/1 m height) with the second mTBI delivered after 1 (n = 6), 2 (n = 6), 3 (n = 6), 4 (n = 6), and 5 days (n = 6) and sacrificed 48 hours after the last impact. Sham-operated animals were used as controls (n = 6). Two further groups of six rats each received a second mTBI after 3 days and were sacrificed at 120 and 168 hours postinjury. Concentrations of adenine nucleotides, N-acetylated amino acids, oxypurines, nucleosides, free coenzyme A, acetyl CoA, and oxidized and reduced nicotinamide adenine dinucleotides, oxidized nicotinamide adenine dinucleotide phosphate, and reduced nicotinamide adenine dinucleotide, reduced nicotinamide adenine dinucleotide phosphate nicotinic coenzymes were measured in deproteinized cerebral tissue extracts (three right and three left hemispheres), whereas the gene expression of N-acetylaspartate acylase, the enzyme responsible for N-acetylaspartate (NAA) degradation, was evaluated in extracts of three left and three right hemispheres.
  
  
  RESULTS
  A decrease of adenosine triphosphate, adenosine triphosphate/adenosine diphosphate ratio, NAA, N-acetylaspartylglutamate, oxidized and reduced nicotinamide adenine dinucleotide, reduced nicotinamide adenine dinucleotide, and acetyl CoA and increase of N-acetylaspartate acylase expression were related to the interval between impacts with maximal changes recorded when mTBIs were spaced by 3 days. In these animals, protracting the time of sacrifice after the second mTBI up to 1 week failed to show cerebral metabolic recovery, indicating that this type of damage is difficult to reverse. A metabolic pattern similar to controls was observed only in animals receiving mTBIs 5 days apart.
  
  
  CONCLUSIONS
  This study shows the existence of a temporal window of brain vulnerability after mTBI. A second concussive event falling within this time range had profound consequences on mitochondrial-related metabolism. Furthermore, because NAA recovery coincided with normalization of all other metabolites, it is conceivable to hypothesize that NAA measurement by 1H-NMR spectroscopy might be a valid tool in assessing full cerebral metabolic recovery in the clinical setting and with particular reference to sports medicine in establishing when to return mTBI-affected athletes to play. This study also shows, for the first time, the influence of TBI on acetyl-CoA, N-acetylaspartate acylase gene expression, and N-acetylaspartylglutamate, thus providing novel data on cerebral biochemical changes occurring in head injury.
authors.affiliation: Department of Neurosciences, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vagnozzi
authors.forename: Barbara
authors.initials: B
authors.lastname: Tavazzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Signoretti
authors.forename: Angela M
authors.initials: AM
authors.lastname: Amorini
authors.forename: Antonio
authors.initials: A
authors.lastname: Belli
authors.forename: Marco
authors.initials: M
authors.lastname: Cimatti
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
authors.forename: Valentina
authors.initials: V
authors.lastname: Di Pietro
authors.forename: Antonino
authors.initials: A
authors.lastname: Finocchiaro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lazzarino
mesh_terms: D000107:Acetylation; D000227:Adenine Nucleotides / Q000378:metabolism; D000596:Amino Acids / Q000378:metabolism; D000818:Animals; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D001924:Brain Concussion / Q000378:metabolism*; D003067:Coenzymes / Q000378:metabolism; D004195:Disease Models, Animal; D004734:Energy Metabolism / Q000502:physiology*; D043425:Glutamate Carboxypeptidase II / Q000235:genetics; D008297:Male; D008928:Mitochondria / Q000378:metabolism*; D009249:NADP / Q000378:metabolism; D009539:Nicotinic Acids / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000227:Adenine Nucleotides; D000596:Amino Acids; D003067:Coenzymes; D009539:Nicotinic Acids; D012333:RNA, Messenger; D001224:Aspartic Acid; D009249:NADP; C000179:N-acetylaspartate; D043425:Glutamate Carboxypeptidase II