Brain trauma is an abrupt, unpredictable event. Here, we describe the animal model that reproduces a spectrum of pathological changes observed in human patients after brain injury such as neurodegeneration, elimination of dendrites, brain edema, glial scar, hemorrhages in the cerebral cortex coupled with focal subarachnoid hemorrhaging and increased permeability of the blood–brain barrier. To study primary and secondary pathogenesis, as well as recovery after trauma, this injury model was combined with longitudinal in vivo visualization of fine neuronal and glial structures. Transgenic mouse lines were used that express fluorescent proteins in neurons (Thy1-YFP-H)7, astrocytes (GFAP-EGFP)8, or microglia (CX3CR1-EGFP)9. Additionally, we used second harmonic generation (SHG) imaging and astrocyte loading with Sulfarhodamine 10110.
The model described here recapitulates penetrating type of brain injury. Therefore a limitation of the present model is that it does not provide information about mechanisms of closed head injury. Recently Sword and coauthors reported multiphoton imaging results on cell behavior in pericontusional cortex6. Taking into account that closed head injury is a more frequent medical case, the methodological approach reported by the authors is highly promising to complement traditional research methods in the field of impact brain trauma11.
We used both the chronic cranial window12 and the skull thinning13 preparations to study cell behavior under posttraumatic conditions in living brain. Both methods have certain advantages and limitations. Thus, the chronic cranial window provides better resolution, deeper optical penetration into the brain tissue and convenience for multiple imaging sessions. Conversely, skull thinning is less likely to induce inflammation at the imaging site, and, perhaps more importantly, it allows repetitive applications of drugs and dyes. A few examples of pharmacological agents to be applied in this type of experiments are given in Table 1.
| Agent type | Injected agent | Areas of biology/pharmacy research |
| Anti-inflammatory | Cyclosporin A | Traumatic brain injury, secondary damage, neurodegeneration |
| Toxins | Tetrodotoxin | TBI – secondary damage, excytotoxicity |
| Bicuculline | TBI – secondary damage, chloride homeostasis |
| Inhibitors of signaling pathways | PD98059 (MAPKK inhibitor) | signaling mechanisms of inflammation, secondary damage, posttraumatic cell death, neurodegeneration and regeneration |
| SU6656 (Src family kinase inhibitor) |
| Neurotrophic factors | Brain-derived neurotrophic factor, BDNF | TBI – neuronal survival after injury, neuroprotection in secondary posttraumatic brain damage |
| Glial cell line-derived neurotrophic factor, GDNF |
| Viruses | lentiviral vectors for protein expression | molecular mechanisms of posttraumatic neurodegeneration and regeneration, differential labelling of cell types in damaged brain for in vivo imaging |
| adenoviral vectors for protein expression |
| Ca2+ fluorescent indicators | Fluo-2,4 | signaling mechanisms of posttraumatic inflammation, cell death, cell migration, axonal/dendritic regeneration |
| Oregon Green BAPTA |
Table 1. Pharmacological agents and dyes for cortical injection in prick injury model.
A wide range of biochemical events that are highly important under physiological and pathological conditions can be probed with chemical inhibitors, fluorescent indicators and mutant protein introduced via viral constructs. Advantages for choosing particular time window provided by the skull thinning preparation may be highly relevant for those studies.
In the present study, we used second harmonic generation signal to delineate the injury site. Alternatively, the injury site borders could be indicated by a weakly diffusing fluorescent dye, for instance a high molecular weight dextran fluorescent conjugate (2 million Dalton).
Recently, Schaffer and colleagues14 have used a chronic preparation with reopenable cranial window for repetitive delivery of fluorescent dyes to mouse cortex. It is likely that cranial window reopening may adversely affect the brain tissue transparency. Moreover, it is difficult to predict the time course of the reopening-induced inflammation, which may affect the connective tissue regrowth.
One major advantage of the thinned skull preparation is the possibility to deliver therapeutic compounds (and other materials requiring topical injection into brain tissue) multiple times during progression of the trauma, without complicating artifacts (e.g. without cranial window reopening).
If repetitive compound delivery directly to the injury site is desired, one should consider special means to prevent skull dry-out and bacterial infection. Thus, keeping the operated head region under sterile conditions and application of antibiotics (such as enrofloxacin) is recommended. To preserve the thinned skull region from drying, fill the metal holder with 1.5% agarose and cover it with round glass coverslip. In most cases this will allow maintaining the same transparency or thinned skull over the period of up to 10 days. Some additional should be taken if multiple imaging sessions in the thinned skull preparation are planned over a prolonged period of time. Immediately before each imaging session, gently remove the newly formed connective tissue from the thinned region using a microsurgical blade. Use the TPEM imaging of SHG to verify image quality and measure bone thickness. Tissue regrowth may compromise the penetration depth and cause image blurring accompanied by an increase in the background fluorescence. Refresh the skull thinning gently with a microsurgical blade to regain high imaging quality.
In those cases that do not require direct access to the injury site, we highly recommend covering the thinned region of the skull with a glass coverslip as described in the paper on polished and reinforced thinned skull preparation by Kleinfeld and colleagues15. This could be done by using the following optional procedure. Place a small drop of agarose (1.5%) on the thinned skull region, wait until it becomes a gel, remove all unnecessary agarose, i.e. leave it only on the injury site. Agarose should protect the injury site from external effects. Dry the thinned skull region using compressed air. Drop a small amount of polyacrylic glue on a small piece of #0 coverglass and place it on the thinned skull region. The polyacrylic glue prevents bone and connective tissue regrowth, thus keeping the thinned skull under the window preserved.
A combination of these procedures allows studying acute and chronic posttraumatic processes, delivering drugs topically or systemically and directly monitoring the treatment effects. Use of dual or triple transgenic mouse lines can also be beneficial, particularly for simultaneous imaging of multiple posttraumatic processes, such as glial scar formation and neuronal branch regrowth. We expect our models of acute brain injury studied with intravital two-photon microscopy to prove fruitful for drug candidate testing.