The Preliminary Research On The Characteristics Of The Cognitive Function And Its Aβ-related Mechanism In Patients With Acute Traumatic Brain Injury

Objective:Firstly, To analysis the characteristics of cognitive function with the multi-dimensional neuropsychological scales that general used in the international in patients who suffered severe traumatic brain injury(sTBI)at 3 months after treatment.Secondly, To investigate the expression ofβamyloid precursor protein,βamyloid42,βamyloid40 in local cerebral tissues of the patients with severe traumatic brain injury and its possible role in the pathogenesis of cognitive disfunction after injury.Thirdly, Combined with modern medical model (ie, biological, psychological, social medical model) to investigate the correlation between the level of cognitive disfunction and the facters of patients'age,gender,injury site,amyloid at 3 months after treatment in patients with severe traumatic brain injury Methods:Firstly, Loewenstein Occupational Therapy Cognitive Assessment(LOCTA),Montreal Cognitive Assessment(MoCA),MMSE scales was used to evaluate cognitive function in 21 patients who suffered decompression craniectomy and partial tissue removed for decompression and in 30 normal contrals.Secondly, The immunohistochemistry was used to investigate the expression of Aβ42,Aβ40,β-APP in local cerebral tissues from 21 patients with sTBI,which was obtained for decompression to relieve intractable cerebral swelling,and from normal brain tissue in 3 patients with malignant brain tumors, the image analysis software was used for analysis and Statistics.Results:Firstly, All the scored of cognitive function assessment in sTBI group was significantly lower than control group, The ability of computing, repetition and fluency of language, logical thinking, attention, delayed Memories, abstraction in patients with left hemisphere injury was significantly lower, while the ability of visuospatial and watch test, spatial perception, organization in patients with right hemisphere injury was significantly lower.Secondly, there were 7 patients had the images of Aβ42 aggregation which similar to the plaque, including 3 patients with left cerebral hemisphere injury and 4 patients with right cerebral hemisphere injury, in 21 patients with sTBI; the expression of Aβ42 andβ-APP (MOD values) in patients with sTBI was significantly higher than normal cerebral cortex (P <0.01), However, the typical image of AD-like Aβplaques were not found in any cases.Thirdly, Multivariate statistics showed that age, injury parts, Aβ42 plaque and the level of education have significant impact on the overall cognitive function.Conclusions:Firstly, The patients have cognitive disfunction with different forms and degrees after severe traumatic brain injury.Secondly, the expression of Aβ42 showed a strong positive and high specificity and the images of Aβ42 plaque-like aggregation in frontal and temporal cortex after severe traumatic brain injury provided a reliable pathological evidence for the early onset of AD and cognitive dysfunction.Thirdly, Cognitive dysfunction after severe traumatic brain injury was closely related with age, injury parts, Aβ42 plaque and the level of education.