Concussion and mild brain injury: neuropsychological and immunopathogenetic aspects

RESUME. Brain damage is a significant medical and social problem. At the same time, the main share in its overall structure is occupied by the so-called “light” traumatic brain injury — concussion and bruising of the brain of mild severity.

OBJECTIVE: to study the features of the neuropsychological status and the state of T-cell immunity in the acute period of mild concussion and brain injury.

MATERIALS AND METHODS: 55 patients with mild traumatic brain injury aged 18 to 55 years. A neuropsychological examination was conducted. The content of T-lymphocyte subpopulations was determined in venous blood, the level of cytokines and chemokines was determined in cerebrospinal fluid.

RESULTS: it was found that the basis of cognitive disorders are neurodynamic and regulatory disorders. The most significant indicators of violations in immune status are changes in the absolute values of “naive” Th, Th CM, Th EM cells, absolute and relative TEMRA content in blood serum, as well as pro-inflammatory cytokines IL‑6, IL‑15, IL‑1 RA, G-CSF, sCD40L, and CCL2/MCP‑1, CXCL9/MIG, CXCL10/IP‑10 chemokines in liquor.

CONCLUSION: In the acute period of mild traumatic brain injury, the development of cognitive disorders associated with the defeat of the first and third functional blocks dominates. The “pro-inflammatory” profile of cytokines and chemokines prevails in peripheral blood, which indicates the essential role of immune inflammation in the pathogenesis of injury.

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