Article Review
Armstrong RC, Meirzwa AJ, Marion CM, Sullivan GM. White matter involvement after TBI: Clues to axon and myelin repair capacity. Experimental Neurology. 2016; 275:328–333.
Introduction: This descriptive review discussed the changes in white matter after a traumatic brain injury (TBI). Researchers understand that the white matter is susceptible to injury because of the physical force to the head, but now researchers want to examine all levels of the brain to enhance future diagnostic and therapeutic approaches.
Hypothesis/Purpose: The purpose of this study to understand the changes in white matter at all levels in the brain after a traumatic brain injury because it has been examined that changes occur, but researchers have not examined this on a deeper molecular and cellular level. By understanding all these levels, it will help future TBI patients for recovery.
Method: The methods of this analysis is that researchers looked at the axons’ and myelin’s condition after a TBI and examined how the axons and myelin could recover after this impact in the white matter.
Results: The researchers first observed the most crucial concern resulting from a TBI and that is traumatic axonal injury (TAI). These axons are damaged in a pattern within the white matter. Researchers are using neuroimaging of hemorrhages to gain a deeper understanding of the damage of the axons within the white matter. From TBIs, axons are more prone to vulnerability than blood vessels. The results show that future technology such as diffusion tensor imaging (DTI) and MRIs help researchers examine on another level to examine anisotropy. This is detrimental because researchers can look at the highly myelinated nerve fibers that are within the white matter. The severity of the TBI is important with examining the different cellular and ultrastructural levels. Researchers cannot just look at the axons without looking deeper into the myelin’s role. As discussed, myelinated axons will go through Wallerian degeneration if they are disconnected from damage. The article stated that TAI caused myelin to shed debris and this could restrain axons and myelin from regenerating. This could also spread chronic neuroinflammation. Discussion: All the results prove we need to examine more into depth all the levels that axons and myelin play in white matter. DTI is a crucial technique for future researchers to examine the white matter of a TBI patient. Future researchers need to examine different kinds of TBIs and all severities to fully grasp the overall understanding. By the researchers observing the Wallerian degeneration, it will allow them in the future to develop techniques to stop it and more axonal loss. The researchers’ observation will allow them to look more into neuroinflammation focal axon degeneration. These are keys to advancing future therapy approaches for TBI patients.
Personal statement: I think this study should be repeated and it is crucial for the recovery process for TBI patients. I think it can be improved by using more animal studies so researchers can understand more into depth with neuroimaging and electron microscopy.
Additional Question: A person’s age alters the prognosis because it has to do with principles of neuroplasticity. The younger an individual is they are more susceptible to improvement with training. The older the person is the less likely they are going respond to therapy.
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