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Genetic drivers of cerebral blood flow dysfunction in TBI: a speculative synthesis

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Zeiler, FA 
Stevens, A 

Abstract

Cerebral autoregulatory dysfunction after traumatic brain injury (TBI) is strongly linked to poor global outcome in patients at 6 months after injury. However, our understanding of what drives this dysfunction is limited. Genetic variation among individuals within a population gives rise to single nucleotide polymorphisms (SNPs) that have the potential to influence a given patient’s cerebrovascular response to an injury. Associations have been reported between a variety of genetic polymorphisms and global outcome in patients with TBI, but few studies have explored the association between genetics and cerebrovascular function after injury. In this Review, we explore polymorphisms that might play an important part in cerebral autoregulatory capacity after TBI. We outline a variety of SNPs, their biological substrates and their potential role in mediating cerebrovascular reactivity. A number of candidate polymorphisms exist in genes that are involved in myogenic, endothelial, metabolic and neurogenic vascular responses to injury. Furthermore, polymorphisms in genes involved in inflammation, the central autonomic response and spreading cortical depression might drive cerebrovascular reactivity. Identification of candidate genes involved in cerebral autoregulation after TBI provides a platform and rationale for further prospective investigation of the link between genetic polymorphisms and autoregulatory function.

Description

Keywords

Brain Injuries, Traumatic, Cerebrovascular Circulation, Genetic Variation, Humans, Nitric Oxide Synthase, Polymorphism, Single Nucleotide

Journal Title

Nature Reviews Neurology

Conference Name

Journal ISSN

1759-4766
1759-4766

Volume Title

15

Publisher

Springer Nature
Sponsorship
Medical Research Council (G0601025)
Medical Research Council (G1002277)
Medical Research Council (G0600986)
Medical Research Council (G9439390)
NETSCC (None)
NETSCC (None)
TCC (None)
Medical Research Council (G0600986/1)
Medical Research Council (G1002277/1)