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Mechanisms and Implications of Traumatic Brain Injury and Neuroinflammation

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Neurobiology".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 2615

Special Issue Editor

Department of Psychiatry, F. E. Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
Interests: post-traumatic stress disorder; substance use disorders; traumatic brain injury; major depression; opioids; ketamine; psychostimulants; neuroinflammation; synaptic plasticity; hypothalamic-pituitary-adrenal (HPA) axis
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Special Issue Information

Dear Colleagues,

Traumatic brain injury (TBI) is a leading cause of death and disability in the world. Although certain individuals recover from TBI, a significant portion of individuals will suffer from long-lasting adverse effects such as physical, cognitive, emotional, social, and behavioural deficits. The TBI consists of primary injury (effects directly tied to the mechanical forces at the moment of impact) and secondary injury (biochemical processes occurring in the hours or days following primary injury). The consequences of primary injury are generally regarded as irreversible, but secondary injury, such as increased neuroinflammation, may provide a target for TBI treatment. Neuroinflammation involves the activation of glial cells (e.g., microglia and astrocytes), the release of inflammatory cytokines and chemokines in the brain, and the subsequent recruitment of peripheral immune cells. Microglia, the primary immune cells in the brain, are critically important in neuroinflammation and serve various roles such as initiating neuroimmune responses, clearing cellular debris, and releasing numerous substances. Microglia can be activated into either a pro-damage state with harmful effects such as the release of neurotoxic and pro-inflammatory substances or a pro-repair state with beneficial effects such as the clearing of cellular debris and the release of neurotrophic factors and anti-inflammatory cytokines, depending on the injury severity and neuroenvironmental factors.

We therefore invite academic, non-profit, and industrial investigators working in the fields of TBI to submit original research articles or reviews describing and discussing the mechanisms and implications of TBI and neuroinflammation to progress basic and clinical sciences related to TBI.

Potential topics include, but are not limited to:

  • The molecular and biological mechanisms of TBI and neuroinflammation;
  • Biomarkers, including advanced neuroimaging, biosensors, and high-throughput approaches;
  • Novel pharmacological and cognitive/behavioural interventions and treatment strategies;
  • Translational research to bridge the gap between preclinical and clinical studies;
  • The comorbidity of TBI, neuroinflammation, and psychiatric disorders;
  • Novel, automated, and unbiased data analysis strategy using machine learning and artificial intelligence technology.

Dr. Kwang Choi
Guest Editor

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Keywords

  • traumatic brain injury
  • head trauma
  • neuroinflammation
  • secondary injury
  • microglia

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Published Papers (3 papers)

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Research

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14 pages, 1158 KB  
Article
Neuroinflammatory Signature of Post-Traumatic Confusional State: The Role of Cytokines in Moderate-to-Severe Traumatic Brain Injury
by Federica Piancone, Francesca La Rosa, Ambra Hernis, Ivana Marventano, Pietro Arcuri, Marco Rabuffetti, Jorge Navarro, Marina Saresella, Mario Clerici and Angela Comanducci
Int. J. Mol. Sci. 2025, 26(17), 8593; https://doi.org/10.3390/ijms26178593 - 4 Sep 2025
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Abstract
Traumatic brain injury (TBI), a leading cause of mortality and disability, recognizes a primary, immediate injury due to external forces, and a secondary phase that includes inflammation that can lead to complications such as the post-traumatic confusional state (PTCS), potentially impacting long-term neurological [...] Read more.
Traumatic brain injury (TBI), a leading cause of mortality and disability, recognizes a primary, immediate injury due to external forces, and a secondary phase that includes inflammation that can lead to complications such as the post-traumatic confusional state (PTCS), potentially impacting long-term neurological recovery. An earlier identification of these complications, including PTCS, upon admission to intensive rehabilitation units (IRU) could possibly allow the design of personalized rehabilitation protocols in the immediate post-acute phase of moderate-to-severe TBI. The present study aims to identify potential biomarkers to distinguish between TBI patients with and without PTCS. We analyzed cellular and molecular mechanisms involved in neuroinflammation (IL-6, IL-1β, IL-10 cytokines), neuroendocrine function (norepinephrine, NE, epinephrine, E, dopamine), and neurogenesis (glial cell line-derived neurotrophic factor, GDNF, insuline-like growth factor 1, IGF-1, nerve growth factor, NGF, brain-derived growth factor, BDNF) using enzyme-linked immunosorbent assay (ELISA), comparing results between 29 TBI patients (17 with PTCS and 12 non-confused) and 34 healthy controls (HC), and correlating results with an actigraphy-derived sleep efficiency parameter. In TBI patients compared to HC, serum concentration of (1) pro-inflammatory IL-1β cytokine was significantly increased while that of anti-inflammatory IL-10 cytokine was significantly decreased; (2) NE, E and DA were significantly increased; (3) GDNF, NGF and IGF-1 were significantly increased while that of BDNF was significantly decreased. Importantly, IL-10 serum concentration was significantly lower in PTCS than in non-confused patients, correlating positively with an improved actigraphy-derived sleep efficiency parameter. An anti-inflammatory environment may be associated with better prognosis after TBI. Full article
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17 pages, 17043 KB  
Article
A Semi-Automated and Unbiased Microglia Morphology Analysis Following Mild Traumatic Brain Injury in Rats
by Luke Sumberg, Rina Berman, Antoni Pazgier, Joaquin Torres, Jennifer Qiu, Bodhi Tran, Shannen Greene, Rose Atwood, Martin Boese and Kwang Choi
Int. J. Mol. Sci. 2025, 26(17), 8149; https://doi.org/10.3390/ijms26178149 - 22 Aug 2025
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Abstract
Mild traumatic brain injury (mTBI) affects over 40 million people every year. One of its features includes the activation of microglia, the resident immune cells of the brain. Microglia assume different morphological states depending on their level of activation, such as surveilling ramified [...] Read more.
Mild traumatic brain injury (mTBI) affects over 40 million people every year. One of its features includes the activation of microglia, the resident immune cells of the brain. Microglia assume different morphological states depending on their level of activation, such as surveilling ramified and activated hypertrophic, ameboid, and rod-like microglia. These states can be distinguished by multiple features, including the shape, span, and branching of microglia. Male Sprague–Dawley rats sustained mTBI using the Closed-Head Impact Model of Engineered Rotational Acceleration (CHIMERA) (3 times, 1.5 J per impact) or sham treatment. Four days after the injury, brains were collected and stained for microglia using the ionized calcium-binding adapter molecule-1 (Iba-1) antibody. Cortical injury sites were identified in a subset of CHIMERA animals. Using the MicrogliaMorphology ImageJ plugin and the MicrogliaMorphologyR package, 27 morphological features were quantified from individual microglia, and k-means clustering was used to classify microglia as ramified, rod-like, ameboid, and hypertrophic states. The CHIMERA injury altered microglia morphology features, which contributed to increased hypertrophic (activated) and decreased ramified (inactive) microglia compared to the sham controls. Combined with the clinically relevant mTBI paradigm and semi-automated/unbiased approach, the current findings may contribute to microglia morphology classification. Full article
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Review

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27 pages, 1095 KB  
Review
The Relationship Between Inflammation and the Development of Cerebral Ischaemia and Hypoxia in Traumatic Brain Injury—A Narrative Review
by Alan Nimmo and Alexander Younsi
Int. J. Mol. Sci. 2025, 26(16), 8066; https://doi.org/10.3390/ijms26168066 - 20 Aug 2025
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Abstract
Traumatic brain injuries (TBI) represent a leading cause of morbidity and mortality globally. Whilst clinical care has significantly improved in recent years, there is still significant scope to improve patient outcomes, particularly in relation to quality of life. However, there is a window [...] Read more.
Traumatic brain injuries (TBI) represent a leading cause of morbidity and mortality globally. Whilst clinical care has significantly improved in recent years, there is still significant scope to improve patient outcomes, particularly in relation to quality of life. However, there is a window of opportunity for clinical intervention, since most of the mortality and morbidity is associated with secondary injury processes that arise after the initial trauma. In the brain, as with any tissue, inflammation plays an important role in the response to injury. However, particularly with severe injuries, an excessive inflammatory response can have detrimental effects. Following TBI, inflammation can lead to the development of cerebral oedema and a rise in intracranial pressure. Without effective control, these processes can rapidly lead to patient deterioration. This narrative review focusses on the role of inflammation in TBI in order to examine the strategies that may help improve patient outcomes. Whilst there is clearly a relationship between the development of cerebral oedema, rising intracranial pressure (ICP), and poor patient prognosis, there are also discrepancies in terms of their impact on patient outcomes. In addition to causing a rise in ICP, this review examines in what other ways inflammation and the development of cerebral oedema may contribute to the injury process. The potential for these factors to impact upon microvascular function and reduce cerebral tissue perfusion and oxygenation is explored. In addition, the impact of TBI on glymphatic function is discussed. Following an evaluation of the potential injury processes, the scope for intervention and the development of novel therapeutic approaches is explored. Full article
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