Traumatic injuries to the spinal cord or the brain have serious medical consequences and lead to long-term disability. The epidemiology, medical complications, and prognosis of isolated spinal cord injury (SCI) and traumatic brain injury (TBI) have been well described. However, there are limited data on patients suffering from concurrent SCI and TBI, even if a large proportion of SCI patients have concomitant TBI. The complications associated with this "dual-diagnosis", such as cognitive or behavioral dysfunction, are well known in the rehabilitation setting, but evidence-based and standardized approaches for diagnosis and treatment are lacking. Our goal was to develop and characterize a preclinical animal model of concurrent SCI and TBI to help identifying "dual-diagnosis" tools. Female rats received a unilateral contusive SCI at the thoracic level alone (SCI group) or combined to a TBI centered on the contralateral sensorimotor cortex (SCI-TBI group). We first validated that the SCI extent was comparable between SCI-TBI and SCI groups, and that hindlimb function was impaired. We characterized various neurological outcomes, including locomotion, sleep architecture, brain activity during sleep, depressive- and anxiety-like behaviors, and working memory. We report that SCI-TBI and SCI groups show similar impairments in global locomotor function. While wake/sleep amount and distribution, anxiety- and depression-like symptoms were not affected in SCI-TBI and SCI groups in comparison to the control group (laminectomy and craniotomy only), working memory was impaired only in SCI-TBI rats. This preclinical model of concomitant SCI and TBI, including more severe variations of it, shows a translational value for the identification of biomarkers to refine the "dual-diagnosis" of neurotrauma in humans.

中文翻译：

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脊髓和创伤性脑损伤的新大鼠模型中睡眠、情绪和认知功能的表征。

脊髓或大脑的创伤会造成严重的医疗后果并导致长期残疾。孤立性脊髓损伤 (SCI) 和创伤性脑损伤 (TBI) 的流行病学、医疗并发症和预后已有详细描述。然而，尽管大部分 SCI 患者同时患有 TBI，但关于同时患有 SCI 和 TBI 的患者的数据有限。与这种“双重诊断”相关的并发症，例如认知或行为功能障碍，在康复环境中是众所周知的，但缺乏基于证据和标准化的诊断和治疗方法。我们的目标是开发并表征同时发生 SCI 和 TBI 的临床前动物模型，以帮助识别“双重诊断”工具。雌性大鼠仅接受胸部水平的单侧挫伤性 SCI（SCI 组）或联合以对侧感觉运动皮层为中心的 TBI（SCI-TBI 组）。我们首先验证了 SCI-TBI 组和 SCI 组之间的 SCI 程度相当，并且后肢功能受损。我们描述了各种神经学结果，包括运动、睡眠结构、睡眠期间的大脑活动、抑郁和焦虑样行为以及工作记忆。我们报告 SCI-TBI 和 SCI 组在整体运动功能方面表现出类似的损伤。与对照组（仅椎板切除术和开颅手术）相比，SCI-TBI 组和 SCI 组的觉醒/睡眠时间和分布、焦虑和抑郁样症状未受影响，但仅 SCI-TBI 大鼠的工作记忆受损。这种同时发生 SCI 和 TBI 的临床前模型（包括其更严重的变异）显示出生物标志物鉴定的转化价值，以完善人类神经创伤的“双重诊断”。