Triggering Receptor Expressed on Myeloid Cell 2-Mediated Microglial Phagocytosis in the Subacute Phase of Traumatic Brain Injury Exacerbates Impaired Memory

髓系细胞触发受体2介导的小胶质细胞吞噬作用在创伤性脑损伤亚急性期加剧记忆障碍

Traumatic brain injury (TBI) induces severe neuropsychiatric complications. Triggering receptor expressed on myeloid cells 2 (TREM2) is essential for microglial-mediated synaptic engulfment. This study aimed to clarify the unique role played by microglial TREM2 in memory dysfunction during the subacute phase of TBI. Our findings suggest that upregulation of TREM2 exacerbated TBI-induced memory dysfunction by promoting excessive microglial phagocytosis and synaptic loss in the subacute phase.

创伤性脑损伤（TBI）可引发严重的神经精神并发症。髓系细胞触发受体2（TREM2）对小胶质细胞介导的突触吞噬至关重要。本研究旨在阐明小胶质细胞TREM2在创伤性脑损伤亚急性期记忆功能障碍中所发挥的独特作用。研究结果表明，TREM2表达上调会在亚急性期促进小胶质细胞过度吞噬及突触丢失，从而加重创伤性脑损伤所致的记忆功能障碍。

[REF: Xia J, Sun CY, Su T, Xia SY, Zhao SZ, Zhang YM. Triggering Receptor Expressed on Myeloid Cell 2-Mediated Microglial Phagocytosis in the Subacute Phase of Traumatic Brain Injury Exacerbates Impaired Memory. J Neurotrauma. 2026;43(3-4):317-340. doi:10.1177/08977151251388041 PMID: 41700019]

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Neuroprotective Effects of Salvia Miltiorrhiza-Derived Extracellular Nanovesicles in Traumatic Brain Injury

丹参来源的细胞外纳米囊泡在创伤性脑损伤中的神经保护作用

Traumatic brain injury (TBI) initiates a series of pathogenic processes, including neuroinflammation, oxidative stress, and metabolic failure, that ultimately result in neurological damage. Plant-derived bioactive compounds have demonstrated promise as treatments to reduce TBI-associated neurodegeneration. However, most previous studies have investigated the efficacy of a single active ingredient, and many such compounds have poor permeability across the blood–brain barrier (BBB), limiting their therapeutic potential. Cells release vesicles containing various signaling factors, ions, and nutrients that are subsequently taken up by adjacent cells via endocytosis. The present study explored the therapeutic effects of extracellular vesicles derived from Salvia miltiorrhiza-derived extracellular vesicles (SalEVs) for the treatment of TBI in mice model via biochemical, histological, microfluorometric, behavioral, and omics analyses. Systemic SalEV administration may be an effective therapeutic strategy for TBI by simultaneously targeting multiple pathogenic pathways.

创伤性脑损伤（TBI）会启动一系列病理过程，包括神经炎症、氧化应激和代谢功能障碍，最终导致神经损伤。植物来源的生物活性化合物在减轻创伤性脑损伤相关神经退行性变方面展现出良好的治疗前景。然而，以往大多数研究仅考察单一活性成分的疗效，且许多此类化合物的血脑屏障（BBB）通透性较差，限制了其治疗潜力。细胞会释放包含多种信号因子、离子和营养物质的囊泡，这些囊泡随后通过内吞作用被邻近细胞摄取。本研究通过生化、组织学、显微荧光、行为学和组学分析，探讨了丹参来源的细胞外囊泡（SalEVs）对小鼠创伤性脑损伤模型的治疗作用。系统性给予丹参细胞外囊泡，有望通过同时靶向多条病理通路，成为一种有效的创伤性脑损伤治疗策略。

[REF: Chen BB, Wang Y, Li YN, et al. Neuroprotective Effects of Salvia Miltiorrhiza-Derived Extracellular Nanovesicles in Traumatic Brain Injury. J Neurotrauma. 2026;43(3-4):295-316. doi:10.1177/08977151251383549 PMID: 41052963]

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Age-Stratified Treatment Variations in Acute Intracranial Surgery for Traumatic Brain Injury in Europe: A Prospective Observational Study Within CENTER-TBI

欧洲创伤性脑损伤急性颅内手术的年龄分层治疗差异：一项基于CENTERTBI的前瞻性观察性研究

High-quality evidence to guide the practice of acute cranial surgery across age groups in traumatic brain injury (TBI) remains sparse. Current surgical guidelines generally do not consider age in their recommendations. The aim of the study is to evaluate acute cranial surgery rates and center treatment differences across age in TBI. Older patients with TBI were less likely to receive acute cranial evacuation surgery, independent from other (comorbidity) factors. Higher age was associated with more surgical treatment variation between centers. Neurosurgery for TBI can be improved by age-personalized treatment algorithms.

高质量证据仍较为缺乏，无法指导不同年龄段创伤性脑损伤（TBI）患者的急性颅脑外科临床实践。现行外科指南的推荐意见通常未考虑年龄因素。本研究旨在评估不同年龄段TBI患者的急性颅脑手术率及各治疗中心的差异。在排除合并症等其他因素后，高龄TBI患者接受急性颅内清除手术的可能性更低。年龄越高，各中心间的外科治疗差异越大。通过年龄个体化治疗流程，可改善TBI的神经外科诊疗水平。

[REF: Vreeburg RJG, Singh RD, van Dijck JTJM, et al. Age-Stratified Treatment Variations in Acute Intracranial Surgery for Traumatic Brain Injury in Europe: A Prospective Observational Study Within CENTER-TBI. J Neurotrauma. 2026;43(3-4):280-294. doi:10.1177/08977151251379454 PMID: 40988619]

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Brain Injury Within Intimate Partner Violence: What Are the Cognitive Effects?

亲密伴侣暴力中的脑损伤：认知影响有哪些？

Intimate partner violence (IPV) is a worldwide health concern with devastating implications for physical, mental, and cognitive health. IPV-associated brain injuries (IPV-BIs) induced through impacts to the head (e.g., mild traumatic brain injury [mTBI]) and non-fatal strangulation (NFS; i.e., a hypoxic-ischemic injury) have long been overlooked among IPV victim-survivors. Identifying their presence and consequences is vital to inform interventions. The findings highlight the need for IPV-BI screening, neuropsychological assessment, and targeted education and therapy for this underserved population.

亲密伴侣暴力（IPV）是一个全球性的公共卫生问题，对躯体、心理及认知健康会造成毁灭性影响。在亲密伴侣暴力受害幸存者中，由头部撞击（如轻型创伤性脑损伤[mTBI]）和非致命性窒息（NFS，即缺氧缺血性损伤）所导致的亲密伴侣暴力相关脑损伤（IPVBI）长期以来一直被忽视。识别这类损伤的存在及其后果，对于制定干预措施至关重要。研究结果强调，需要对这一服务不足的人群开展亲密伴侣暴力相关脑损伤筛查、神经心理学评估，以及针对性的宣教与治疗。

[REF: Makovec Knight J, Hannon O, Spitz G, et al. Brain Injury Within Intimate Partner Violence: What Are the Cognitive Effects?. J Neurotrauma. 2026;43(3-4):269-279. doi:10.1177/08977151251388070 PMID: 41164911]

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Adverse Childhood Experiences Exacerbate Neurobehavioral and Post-Traumatic Stress Disorder Symptoms Among Survivors of Intimate Partner Violence-Related Head Trauma

不良童年经历加剧亲密伴侣暴力相关头部创伤幸存者的神经行为及创伤后应激障碍症状

At least 27% of women who report a history of intimate partner violence (IPV) also report experiencing IPV-related head trauma (IPV-HT) or probable brain injury (IPV-BI). Prior studies of non-IPV-related traumatic BI and IPV-BI suggest that adverse childhood experiences (ACEs) may be associated with the severity of common neurobehavioral symptoms after the injury, potentially due to their association with elevated post-traumatic stress disorder (PTSD) symptoms. This study sought to examine PTSD symptom severity as an intermediary of the relationship between ACEs and measures of symptoms commonly reported after HT among 121 women with exposure to IPV-HT. The findings suggest that ACEs are associated with worse symptoms after IPV-HT, potentially by way of the association between ACEs and heightened PTSD symptom severity. Longitudinal studies are needed to determine the causality of these relationships. However, our findings suggest that ACEs and elevated PTSD symptoms may be important considerations for individuals reporting symptoms associated with IPV-HT. As such, providers of these individuals may want to consider whether childhood adversity may be impacting current symptom burden in conjunction with IPV, PTSD, and associated HT/BI.

在自述有亲密伴侣暴力（IPV）史的女性中，至少有27%同时报告曾遭受亲密伴侣暴力相关头部创伤（IPVHT）或疑似脑损伤（IPVBI）。既往针对非亲密伴侣暴力相关创伤性脑损伤及亲密伴侣暴力相关脑损伤的研究表明，不良童年经历（ACEs）可能与损伤后常见神经行为症状的严重程度相关，其潜在机制与不良童年经历会加重创伤后应激障碍（PTSD）症状有关。本研究纳入121名遭受亲密伴侣暴力相关头部创伤的女性，旨在探讨PTSD症状严重程度是否在不良童年经历与头部创伤后常见症状之间起中介作用。结果显示，不良童年经历与IPVHT后更严重的症状相关，其潜在途径是通过ACEs加重PTSD症状。仍需开展纵向研究以明确这些关联的因果关系。然而，本研究结果提示，对于报告IPVHT相关症状的个体，不良童年经历与加重的PTSD症状可能是重要的考量因素。因此，临床医护人员应考虑童年期不良经历是否与IPV、PTSD及相关头部创伤/脑损伤共同影响患者当前的症状负担。

[REF: Jain D, Carlsson E, Baird CL, et al. Adverse Childhood Experiences Exacerbate Neurobehavioral and Post-Traumatic Stress Disorder Symptoms Among Survivors of Intimate Partner Violence-Related Head Trauma. J Neurotrauma. 2026;43(3-4):259-268. doi:10.1177/08977151251385572 PMID: 41626812]

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IL6 in Combination with Either NfL, NTproBNP, or GFAP to Safely Discharge Children with Mild Traumatic Brain Injury

IL6联合NfL、NTproBNP或GFAP用于轻型创伤性脑损伤患儿的安全出院评估

Mild traumatic brain injury (mTBI) in children is a public health concern resulting in one of the main causes of pediatric emergency department (PED) visits. However, the acute care of mTBI patients remains challenging due to the limited use of specific and safe diagnostic tools. The objective of the study was to evaluate the performance of combined blood biomarkers in distinguishing between children with mTBI who had intracranial injuries (ICI) visible on CT scans and required hospitalization and those who did not. IL6 in combination with either NfL, NTproBNP, or GFAP could safely rule out 61% of children without ICI (corresponding to 33/79 unnecessary CT scans and 212/322 observation stays at PED). Blood panels incorporating IL6 show promise as decision-making tools for the acute management of children with mTBI. However, further external studies are required to validate these findings.

儿童轻型创伤性脑损伤（mTBI）是一个公共卫生问题，也是导致患儿前往儿科急诊室（PED）就诊的主要原因之一。然而，由于特异性、安全性良好的诊断工具应用有限，轻型创伤性脑损伤患儿的急性期诊疗仍面临挑战。本研究旨在评估联合血液生物标志物在区分轻型创伤性脑损伤患儿中存在CT可见颅内损伤（ICI）并需住院治疗与无需住院者的诊断效能。IL6联合NfL、NTproBNP或GFAP可安全排除61%无颅内损伤的患儿（相当于减少33/79次不必要的CT检查与212/322次儿科急诊留观）。包含IL6的血液检测组合有望成为儿童轻型创伤性脑损伤急性期管理的决策工具。但仍需开展进一步外部研究来验证这些结果。

[REF: Chiollaz AC, Pouillard V, Seiler M, et al. IL6 in Combination with Either NfL, NTproBNP, or GFAP to Safely Discharge Children with Mild Traumatic Brain Injury. J Neurotrauma. 2026;43(3-4):248-258. doi:10.1177/08977151251385576 PMID: 41054843]

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Cystatin C as a Predictor of Severe Hospital-Acquired Pneumonia in Traumatic Brain Injury Patients: A Cohort Study

胱抑素C作为创伤性脑损伤患者重症医院获得性肺炎的预测指标：一项队列研究

This study aimed to identify core differential proteins associated with severe hospital-acquired pneumonia (sHAP) complicating the hospitalization of traumatic brain injury (TBI) patients through proteomic analysis. Our findings suggest that serum CysC levels may not only indicate renal function but also reflect systemic inflammation and other pathological states. Elevated CysC levels at 24 h post-admission were significantly linked to an increased risk of sHAP, with this association persisting after adjusting for relevant factors. Notably, CysC demonstrated superior accuracy in predicting sHAP compared with traditional inflammatory markers such as WBC and Neu#. Thus, CysC holds potential as a novel indicator for assessing sHAP risk in TBI patients post-admission. Further studies are needed to validate its clinical utility and broaden its application.

本研究旨在通过蛋白质组学分析，筛选与创伤性脑损伤（TBI）患者住院期间并发重症医院获得性肺炎（sHAP）相关的核心差异蛋白。研究结果提示，血清胱抑素C（CysC）水平不仅可反映肾功能，还能提示全身炎症及其他病理状态。入院后24小时CysC升高与sHAP风险增加显著相关，且在校正相关混杂因素后该关联依然存在。值得注意的是，与白细胞（WBC）、中性粒细胞计数（Neu#）等传统炎症标志物相比，CysC对sHAP的预测准确性更高。因此，CysC有望作为评估TBI患者入院后sHAP风险的新型指标。未来仍需进一步研究验证其临床价值并拓展应用。

[REF: Wang Y, Zhou W, Wen D, et al. Cystatin C as a Predictor of Severe Hospital-Acquired Pneumonia in Traumatic Brain Injury Patients: A Cohort Study. J Neurotrauma. 2026;43(3-4):236-247. doi:10.1177/08977151251381354 PMID: 41020721]

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Diffusion Alterations at the Gray Matter/White Matter Boundary in Traumatic Encephalopathy Syndrome

创伤性脑病综合征中灰白质交界区的弥散改变

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with exposure to repetitive head impacts (RHI). In CTE, hyperphosphorylated tau (p-tau) aggregates are found in neurons at the depth of cortical sulci close to the gray matter/white matter (GM/WM) boundary. To date, CTE can only be diagnosed postmortem by neuropathological examination. Traumatic encephalopathy syndrome (TES) is the clinical syndrome purported to be associated with CTE pathology. The aim of this study is to investigate microstructural properties at the GM/WM boundary in individuals with a history of exposure to RHI and clinical features of CTE (i.e., TES). Taken together, these findings suggest that dMRI at the GM/WM boundary could be used to investigate microstructural alterations suggestive of tau pathology-associated neurodegeneration in individuals with TES, the clinical presentation of CTE. Future studies are needed to validate this approach and to identify clinically useful cutoff values for dMRI metrics.

慢性创伤性脑病（CTE）是一种与重复性头部撞击（RHI）暴露相关的神经退行性疾病。在CTE患者中，过度磷酸化tau蛋白（ptau）聚集物出现在靠近灰白质（GM/WM）交界的脑沟深处神经元内。迄今为止，CTE仅能通过死后神经病理学检查确诊。创伤性脑病综合征（TES）被认为是与CTE病理改变相关的临床综合征。本研究旨在探讨有重复性头部撞击暴露史且具备CTE临床特征（即TES）的个体，其灰白质交界区的微观结构特征。综上所述，这些结果表明，对灰白质交界区进行弥散磁共振成像（dMRI）检查，可用于检测TES患者（即CTE临床表现患者）中提示tau蛋白相关神经退行性变的微观结构改变。未来需要开展研究验证该方法，并确定dMRI指标具有临床应用价值的临界值。

[REF: Wiegand TLT, Pankatz L, Arciniega H, et al. Diffusion Alterations at the Gray Matter/White Matter Boundary in Traumatic Encephalopathy Syndrome. J Neurotrauma. 2026;43(3-4):224-235. doi:10.1177/08977151251393966 PMID: 41218808]

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Regionally Specific Resting-State Beta Neural Power Predicts Brain Injury and Symptom Recovery in Adolescents with Concussion: A Longitudinal Study

脑区特异性静息态β神经功率可预测青少年脑震荡的脑损伤与症状恢复：一项纵向研究

Mild traumatic brain injury (mTBI) is common in adolescents. Magnetoencephalography (MEG) studies (primarily reporting on adult males) have demonstrated abnormal resting-state (RS) brain activity in mTBI. The present study sought to identify RS abnormalities in male and female adolescents with mTBI (no previous Diagnostic and Statistical Manual of Mental Disorders – 5th Edition diagnosis) identified from an outpatient specialty care concussion program setting as a basis for evaluating potential clinical utility. Of clinical significance in the mTBI group, a decrease in mTBI symptoms from Visit 1 to 2 was associated with an increase in beta power in 4 other brain regions. Present findings suggest that RS beta power has potential as a measure and perhaps as a mechanism of clinical recovery in adolescents with mTBI.

轻型创伤性脑损伤（mTBI）在青少年中较为常见。脑磁图（MEG）研究（主要以成年男性为研究对象）已证实，mTBI患者存在异常的静息态（RS）脑活动。本研究从门诊专项脑震荡诊疗项目中纳入无《精神疾病诊断与统计手册（第五版）》诊断史的男性及女性青少年mTBI患者，旨在明确其静息态异常表现，以此为基础评估其潜在临床应用价值。在mTBI组中具有临床意义的发现是：从第1次就诊到第2次就诊，mTBI症状减轻与另外4个脑区的β波段功率升高相关。本研究结果提示，静息态β波段功率有望作为评估青少年mTBI患者临床恢复情况的指标，甚至可作为其临床恢复的潜在机制指标。

[REF: Edgar JC, Blaskey L, Chen Y, et al. Regionally Specific Resting-State Beta Neural Power Predicts Brain Injury and Symptom Recovery in Adolescents with Concussion: A Longitudinal Study. J Neurotrauma. 2026;43(3-4):209-223. doi:10.1177/08977151251383542 PMID: 41048046]

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