4.5 Review

Targeting the Cerebrovascular System: Next-Generation Biomarkers and Treatment for Mild Traumatic Brain Injury

Journal

NEUROSCIENTIST
Volume 28, Issue 6, Pages 594-612

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/10738584211012264

Keywords

concussion; blood-brain barrier; neurovascular unit; MRI; VEGF; angiogenesis; exercise; chronic traumatic encephalopathy; neurodegeneration; intervention

Funding

  1. Australian National Health and Medical Research Council

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The impact of mTBI on the cerebral vasculature and the potential of CVI as a therapeutic target for improving clinical outcomes are highlighted in this article. Despite limited research in this area, focusing on the cerebrovascular system could lead to substantial improvements in patient care for mTBI.
The diagnosis, prognosis, and treatment of mild traumatic brain injuries (mTBIs), such as concussions, are significant unmet medical issues. The kinetic forces that occur in mTBI adversely affect the cerebral vasculature, making cerebrovascular injury (CVI) a pathophysiological hallmark of mTBI. Given the importance of a healthy cerebrovascular system in overall brain function, CVI is likely to contribute to neurological dysfunction after mTBI. As such, CVI and related pathomechanisms may provide objective biomarkers and therapeutic targets to improve the clinical management and outcomes of mTBI. Despite this potential, until recently, few studies have focused on the cerebral vasculature in this context. This article will begin by providing a brief overview of the cerebrovascular system followed by a review of the literature regarding how mTBI can affect the integrity and function of the cerebrovascular system, and how this may ultimately contribute to neurological dysfunction and neurodegenerative conditions. We then discuss promising avenues of research related to mTBI biomarkers and interventions that target CVI, and conclude that a clinical approach that takes CVI into account could result in substantial improvements in the care and outcomes of patients with mTBI.

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