Anaemia worsens early functional outcome after traumatic brain injury: a preliminary study

ABSTRACT

Objective: To determine early effects on outcome from traumatic brain injury (TBI) induced by controlled cortical impact (CCI) associated with anaemia in mice.

Hypothesis: Outcome from TBI with concomitant anaemia would be worse than TBI without anaemia.

Methods: CCI was induced with electromagnetic impaction in four groups of C57BL/6J mice: sham, sham+anaemia; TBI; and TBI+anaemia. Anaemia was created by withdrawal of 30% of calculated intravascular blood volume and saline replacement of equal volume. Functional outcome was assessed by beam-walking test and open field test (after pre-injury training) on post-injury days 3 and 7. After functional assessment, brains removed from sacrificed animals were pathological reviewed with haematoxylin and eosin, cresyl violet, Luxol Fast Blue, and IBA-1 immunostains.

Results: Beam-walking was similar between animals with TBI and TBI+anaemia (p = 0.9). In open field test, animals with TBI+anaemia walked less distance than TBI alone or sham animals on days 3 (p < 0.001) and 7 (p < 0.05), indicating less exploratory and locomotion behaviours. No specific pathologic differences could be identified.

Conclusions: Anaemia associated with TBI from CCI is associated with worse outcome as measured by less distance travelled in the open field test at three days than if anaemia is not present.

KEYWORDS:

• Anaemia
• haemoglobin
• traumatic brain injury
• outcome
• mouse
• electromagnetic impactor

Acknowledgments

The authors would like to thank University of Missouri undergraduate students Maria R. Juarez and Catherine L. Seidu who assisted with tissue sectioning.

Additional information

Funding

This work was supported by an internal grant from the Department of Surgery, University of Missouri School of Medicine in 2013-2014 and research funds from the Division of Neurological Surgery, University of Missouri School of Medicine. Additional support was provided in part from the NFL Charity Foundation and MIZZOU Advantage (ZG) and research funds from the Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine (JC and ZG).