ABSTRACT
Approximately 2.8 million people sustain a traumatic brain injury (TBI) yearly in the United States, with over
500,000 emergency room visits being attributed to childhood-acquired brain trauma (<14 years of age).
Survivors often endure long-term cognitive and emotional disabilities that reduce quality of life and the ability to
return to school/workforce. Current and past research has largely overlooked complex attention impairments
post-TBI, especially in conjunction with overlapping clinical comorbidities, which may exacerbate injury effects.
We aim to remedy the paucity of studies examining comorbidities of TBI by exploring how hypertension/high
blood pressure, a common underlying condition, can affect TBI-related neurological, physiological, and
cognitive impairments. An estimated 50% of the adult population is diagnosed with hypertension, which can
lead to heart attacks, blocked or damaged arteries, reduced blood flow to the muscles, strokes, and premature
death. Thus, there is a critical need to investigate preclinical models of TBI that are also affected by
hypertension (i.e., hypertensive rats) to better characterize neurological, physiological, and cognitive
impairments, in an effort to enhance bench-to-bedside translatability by more closely reflecting the existing
clinical landscape. This study explores the effects of TBI on Spontaneously Hypertensive Rats (SHR), a widely
used animal model of hypertension, by administering a battery of behavioral assays across different modalities,
such as motor coordination/balance, higher-order sustained and flexible attention, and anxiety-like symptoms.
Moreover, it is important to determine whether being subjected to TBI during pediatric (i.e., prior to
developing stable hypertension at 16 weeks of age) or adult age (i.e., after hypertension onset) alters
physiological, emotional, and cognitive outcomes long term. The aims are designed to 1) determine
interactions of moderate parietal TBI and age-at-impact (pediatric versus adulthood) on motor function (rotarod
test), sustained attention and impulsivity (3-choice serial reaction time task), cognitive flexibility (attentional set-
shifting test), and anxiety-like responses (elevated plus-maze test, shock-probe defensive burying) in SHR
versus normotensive male and female adult rats, and 2) evaluate TBI-induced and sex-related differences in
histological assessments of lesion volumes, neuronal survival, and neuroinflammation markers in SHR versus
normotensive rats. Studies will be conducted in both male and normal cycling female rats, an approach that is
clinically relevant. Women represent up to 45% of the TBI cases, thus evaluating normal cycling female rats
parallels the real world, where injuries occur independent of menstrual cycles. The findings from this R21
Exploratory/Developmental Research Grant will serve as proof-of-concept for significant future funding support
from the National Institutes of Health, the American Heart Association, or the US Department of Veterans
Affairs, as dissecting the impact that underlying conditions such as hypertension may have on TBI preclinically
is critical to further developing clinically-relevant therapies.