Neural Mechanism of Cerebrocardiac Syndrome Following Traumatic Brain Injury

Lesion-Network Mapping Analysis With Brain Connectomics to Reveal the Neural Mechanisms of Cerebrocardiac Syndrome Following Traumatic Brain Injury

Cerebrocardiac syndrome (CCS), including myocardial injury, arrhythmia or heart failure is one of serious complications of traumatic brain injury (TBI), mostly occurs within seven days after TBI, which directly aggravates the brain damage and affects the prognosis of TBI patients. Accumulative evidences suggest that autonomic nervous system disorder is a key initiation point for CCS, but how TBI affects the specific action patterns is not yet clear. Therefore, elucidating the neural mechanisms of TBI-induced CCS, maintaining the central sympathetic-parasympathetic balance through novel interventions such as noninvasive brain stimulation, may fundamentally block the downstream peripheral mechanism, thus achieving effective prevention and treatment for CCS. Based on the current emerging research in brain connectomics and lesion-symptom mapping, we speculate that cerebral contusions can cause structural or functional disconnection of key nodes in the central autonomic nervous system regulatory network, thereby mediating the occurrence of TBI-induced CCS.

In this study, magnetic resonance imaging (MRI) or functional MRI (fMRI) examinations were performed in patients with mild or moderate TBI with aim to explore the association between structural and functional disconnection caused by cerebral contusion and TBI-induced CCS, and to screen out the neural anatomical structures to predict CCS following TBI, providing therapy targets for prevention and treatment of CCS.

Inclusion Criteria:

• Patients with isolated closed head trauma
• Age 18-80 years old
• Admitted to hospital within 24 hours of injury
• Mild or moderate TBI (Glasgow Coma Scale score of 9-15)
• Signed consent form

Exclusion Criteria:

• Severe TBI (Glasgow Coma Scale score of 3-8)
• A history of stroke, TBI, intracranial tumor or surgery in the past 1 year
• A history of coronary heart disease, structural heart disease and other primary heart diseases or suspected cardiac symptoms prior to injury
• Causes of abnormal cardiac biomarkers such as renal insufficiency, severe anemia, sepsis, cardiotoxic drugs and so on
• Not suitable for MRI examinations, such as pregnant women and those with metal implants in the body
• Undergo surgery prior to MRI examinations or cardiac testing