These disruptions and subsequent progressive neurodegeneration adversely affect normal progression of age-dependent behaviors, such as social cognition, social play, social interaction, working memory, and skill acquisition. Moreover, injury to the developing brain disrupts normal developmental processes, including myelination, synaptogenesis, synaptic pruning, and gliogenesis, each of which contribute to long-term brain function. With low antioxidant reserves, the developing brain is rendered more vulnerable to these adverse secondary events ( 4– 7). TBI results from both a primary insult, due to the direct tearing and shearing of brain structures, and a secondary cascade of adverse events that begins within minutes post injury and includes disruption of the blood-brain barrier, vasogenic and cytotoxic edema, excitotoxicity, neuroinflammation, dysregulation of metabolism, and cell death. Here we focus on the young brain, due to the high prevalence of TBIs in this age group and address how early life stress (ELS) may alter recovery after an early brain injury. Lastly, we identify a common mechanistic trend namely, early life stress worsens outcomes independent of its temporal proximity to a brain injury.Īccording to the Centers for Disease Control ( 1), children (age 0–17) are more likely to sustain a traumatic brain injury (TBI), with those 4 years and under at highest risk. While the focus of this review is on early age traumatic brain injuries, there is also a consideration of preclinical models of neonatal hypoxia and stroke, as each further speaks to the vulnerability of the brain and reinforces those characteristics that are common across each of these injuries. This review outlines how early life stress primes the immune cells of the brain and periphery to elicit a heightened response to injury. We consider the interacting pathologies imposed by early life stress and subsequent brain injuries during early brain development as well as at adulthood. Studies of early life stress alone reveal persistent structural and functional impairments at adulthood. Here we consider how early life stress may influence recovery after an early age brain injury. 2Department of Psychology, Behavioral Neuroscience, College of Liberal Arts, University of Texas at Austin, Austin, TX, United Statesĭespite the high incidence of brain injuries in children, we have yet to fully understand the unique vulnerability of a young brain to an injury and key determinants of long-term recovery. 1Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States.
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