Expression and distribution of β amyloid precursor protein immunomarkers in the detection of diffuse axonal injury

Abstract

Introduction/Objective The diffuse axonal injury has a very important place in clinical and forensic aspects of neurotraumatology. A special challenge is proving it in situations of short survival (less than two hours) after a craniocerebral injury. The aim of this study was to determine the efficacy of beta-amyloid precursor protein (βAPP) immunohistochemical staining in postmortem diagnosis of axonal injuries in head injury survival shorter than two hours, its expression, and distribution through the brain tissue of the deceased. Methods 36 adult fatalities, both sexes, injured by acceleration-deceleration mechanisms were divided into two groups: died up to two hours and died more than two hours after the injury. Immunostaining of brain tissue samples (frontal parasagittal white mass, genu and splenium of the corpus callosum and rostral pons) was used to register βAPP positivity. Data were processed by methods of descriptive and inferential nonparametric statistics, and p two hours group). βAPP expression was enhanced towards the posterior structures of the brain. The shortest survival period with detected βAPP immunopositivity was 20–25 minutes, in three cases. There was an association of βAPP expression in the brainstem and interhemispheric/perimesencephalic subarachnoid hemorrhage (p = 0.035). Conclusion βAPP immunohistochemical staining is effective in proving diffuse axonal injury in casualties that survived less than half an hour. Interhemispheric/perimesencephalic subarachnoid hemorrhage may indicate a more severe form of axonal injury.

Keywords

• craniocerebral trauma
• diffuse axonal injury
• fatal outcome
• amyloid beta-peptides