Trigeminal Nerve Stimulation to Augment Cerebrospinal Fluid Flow Following Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Cerebral edema (i.e., brain tissue swelling) is a common complication that follows TBI and increases the risk of death tenfold. Recently, acute post-TBI edema has been linked to suppression of fluid transport through the glymphatic system (a cerebrospinal fluid (CSF) flow pathway). Hence, restoring glymphatic flow may provide an effective treatment of cerebral edema for TBI patients to limit further brain injury. Recent studies have shown that performing trigeminal nerve stimulation (TNS) immediately following TBI leads to improved cognitive outcomes, which they attribute to increased cerebral blood flow. We hypothesize that TNS also increases CSF flow by enhancing arterial pulsation. In this talk, we present preliminary data from in vivo imaging in mice in which we inject fluorescent tracers into the CSF following a TBI. Our results characterize alterations to glymphatic flow in response to varying trigeminal nerve stimulation parameters.

*This work is supported by the Minnesota OHE SCI-TBI Research Grant Program and the University of Minnesota DSI-MnDRIVE Graduate Assistantship.