The Invisibility of Mild Traumatic Brain Injury: Impaired Cognitive Performance as a Silent Symptom

Leore R. Heim, Miaad Bader, Shahaf Edut, Lital Rachmany, Renana Baratz-Goldstein, Ran Lin, Aviya Elpaz, Doaa Qubty, Lior Bikovski, Vardit Rubovitch, Shaul Schreiber, Chaim G. Pick

Research output: Contribution to journalArticlepeer-review


The present study was designed to tackle two notorious features of mild traumatic brain injury (mTBI)-heterogeneity and invisibility-by characterizing the full scope of mTBI symptoms. Mice were exposed to brain injuries of different intensities utilizing a weight-drop model (10, 30, 50, and 70 g) and subsequently subjected to a comprehensive battery of behavioral tests at different time points and immunohistochemical examination of cortical slices. Whereas the physiological, neurological, emotional, and motor function of mTBI mice (i.e., their well-being) remained largely intact, cognitive deficits were identified by the y-maze and novel object recognition. Results from these two cognitive tests were combined and a dose-response relationship was established between injury intensity and cognitive impairment, ranging from an 85% decline after a 70-g impact (p < 0.001) to a 20% decline after a 10-g impact (essentially no effect). In addition, higher intensities of injury were accompanied by decreased expression of axonal and synaptic markers. Thus, our mTBI mice showed a clear discrepancy between performance (poor cognitive function) and appearance (healthy demeanor). This is of major concern given that diagnosis of mTBI is established on the presence of clinical symptoms and emphasizes the need for an alternative diagnostic modality.

Original languageEnglish
Pages (from-to)2518-2528
Number of pages11
JournalJournal of Neurotrauma
Issue number17
StatePublished - 1 Sep 2017


  • animal studies
  • behavioral assessment
  • cognitive function
  • head trauma
  • traumatic brain injury


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