Inducing Different Brain Injury Levels Using Shock Wave Lithotripsy

Divani, Afshin A.; Salazar, Pascal; Monga, Manoj; Beilman, Gregory J.; SantaCruz, Karen S.

doi:10.1002/jum.14656

Cited by 5 publications

(6 citation statements)

References 41 publications

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“…Recently, Divani et al . used the same device to show the feasibility of inducing different degrees of ESW-induced TBI 26 . Their rats were divided into two groups receiving different numbers of ESW iterations to the cortex.…”

Section: Discussionmentioning

confidence: 99%

Cavitation-induced traumatic cerebral contusion and intracerebral hemorrhage in the rat brain by using an off-the-shelf clinical shockwave device

Huang

Lai

Hsu

et al. 2019

Sci Rep

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Traumatic cerebral contusion and intracerebral hemorrhages (ICH) commonly result from traumatic brain injury and are associated with high morbidity and mortality rates. Current animal models require craniotomy and provide less control over injury severity. This study proposes a highly reproducible and controllable traumatic contusion and ICH model using non-invasive extracorporeal shockwaves (ESWs). Rat heads were exposed to ESWs generated by an off-the-shelf clinical device plus intravenous injection of microbubbles to enhance the cavitation effect for non-invasive induction of injury. Results indicate that injury severity can be effectively adjusted by using different ESW parameters. Moreover, the location or depth of injury can be purposefully determined by changing the focus of the concave ESW probe. Traumatic contusion and ICH were confirmed by H&E staining. Interestingly, the numbers of TUNEL-positive cells (apoptotic cell death) peaked one day after ESW exposure, while Iba1-positive cells (reactive microglia) and GFAP-positive cells (astrogliosis) respectively peaked seven and fourteen days after exposure. Cytokine assay showed significantly increased expressions of IL-1β, IL-6, and TNF-α. The extent of brain edema was characterized with magnetic resonance imaging. Conclusively, the proposed non-invasive and highly reproducible preclinical model effectively simulates the mechanism of closed head injury and provides focused traumatic contusion and ICH.

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Section: Discussionmentioning

confidence: 99%

Cavitation-induced traumatic cerebral contusion and intracerebral hemorrhage in the rat brain by using an off-the-shelf clinical shockwave device

Huang

Lai

Hsu

et al. 2019

Sci Rep

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“…Experiments by Divani et al (53) used 5 or 15 shock wave exposures, also at 1 Hz, with peak negative pressures of −10 MPa. These ESW did lead to graded cognitive symptoms in the animals, but the repeated, short duration, high pressure shock waves may not lead to the same types of diffuse neuronal injury expected from a blast wave (53). In studies by both (53) and (31), shock waves were able to generate characteristic bTBI histopathologies, like tissue shearing and parenchymal lesions.…”

Section: Lessons From Other Instances Of Biological Cavitationmentioning

confidence: 92%

“…These ESW did lead to graded cognitive symptoms in the animals, but the repeated, short duration, high pressure shock waves may not lead to the same types of diffuse neuronal injury expected from a blast wave (53). In studies by both (53) and (31), shock waves were able to generate characteristic bTBI histopathologies, like tissue shearing and parenchymal lesions. Although, it is unclear how the magnitude of the bTBI histopathologies would be different if a real blast wave was used to induce cavitation.…”

Section: Lessons From Other Instances Of Biological Cavitationmentioning

confidence: 92%

“…Extracorporeal shock waves (ESW), similar to those used for lithotripsy, have also been used in more than one instance to generate bTBI due to cavitation (31,53). In one of those instances, bubbles were artificially injected to increase cavitation effects, suggesting likely bTBI due to bubble collapse (31).…”

Section: Lessons From Other Instances Of Biological Cavitationmentioning

confidence: 99%

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Cerebrospinal Fluid Cavitation as a Mechanism of Blast-Induced Traumatic Brain Injury: A Review of Current Debates, Methods, and Findings

Marsh

Bentil

2021

Front. Neurol.

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Cavitation has gained popularity in recent years as a potential mechanism of blast-induced traumatic brain injury (bTBI). This review presents the most prominent debates on cavitation; how bubbles can form or exist within the cerebrospinal fluid (CSF) and brain vasculature, potential mechanisms of cellular, and tissue level damage following the collapse of bubbles in response to local pressure fluctuations, and a survey of experimental and computational models used to address cavitation research questions. Due to the broad and varied nature of cavitation research, this review attempts to provide a necessary synthesis of cavitation findings relevant to bTBI, and identifies key areas where additional work is required. Fundamental questions about the viability and likelihood of CSF cavitation during blast remain, despite a variety of research regarding potential injury pathways. Much of the existing literature on bTBI evaluates cavitation based off its prima facie plausibility, while more rigorous evaluation of its likelihood becomes increasingly necessary. This review assesses the validity of some of the common assumptions in cavitation research, as well as highlighting outstanding questions that are essential in future work.

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“…Extracorporeal shockwave therapy (ESWT) is a new type of therapy that is exploding in demand as the clinical effect is confirmed for diseases in the field of degenerative osteoarthritis, which is difficult to treat [1]. Shock waves generated in vitro can be focused on specific parts of the human body to treat not only neurological diseases but also orthopedic musculoskeletal diseases [2]. In addition, ESWT has received much attention as an alternative therapy for musculoskeletal disorders and pain treatments, as clinical trial and medical reports indicate that it is effective for the treatment of pain that was incurable with previous conservative treatment methods or surgery.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Shock Wave Therapy as Therapeutic Intervention: a Narrative Review

Park¹,

Lee²

2019

World Journal of Research and Review

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Extracorporeal shock wave therapy has since been developed and used steadily in medical advanced countries. Shock waves have features such as reflection, transmission, and diffraction, as do sound and light waves. Compared to sound waves, they are faster and more powerful pressure waves. ESWT is classified into focus type and radial type, according to the principle of wave generation. Extracorporeal shock wave therapy has been used for a variety of musculoskeletal disorders. Extracorporeal shockwave therapy is a non-surgical and non-invasive treatment. Also, it is applied relatively easily to musculoskeletal patients and it has less impact on daily life since the recovery time after treatment is short.

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Inducing Different Brain Injury Levels Using Shock Wave Lithotripsy

Abstract: We have successfully established different SW-induced TBI severities in our SW-induced TBI model by delivering different numbers of SW pulses to brain tissue.

Cited by 5 publications

References 41 publications

Cavitation-induced traumatic cerebral contusion and intracerebral hemorrhage in the rat brain by using an off-the-shelf clinical shockwave device

Cavitation-induced traumatic cerebral contusion and intracerebral hemorrhage in the rat brain by using an off-the-shelf clinical shockwave device

Cerebrospinal Fluid Cavitation as a Mechanism of Blast-Induced Traumatic Brain Injury: A Review of Current Debates, Methods, and Findings

Extracorporeal Shock Wave Therapy as Therapeutic Intervention: a Narrative Review

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