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Neurogenic organ dysfunction syndrome after acute brain injury

摘要Systemic complications are common after acute brain injury(ABI)and may trigger coagulation cascades,systemic inflammation,as well as dysfunction of the cardiovascular,respiratory,and gastrointestinal systems,etc.The pathogenesis of these systemic manifestations is multifactorial but not yet fully elucidated.This paper introduces the novel term neurogenic organ dysfunction syndrome(NODS)to characterize systemic instability arising from internal and external perturbations of the neuronal center following ABI.Elucidating the central neurogenic mechanisms of NODS is critical for early detection and prevention of complications,thereby reducing mortality and improving patient outcomes following ABI.In this paper,we explore the potential central neurogenic mechanisms of NODS from the perspective of complex brain network theory,focusing on the structural network of the central autonomic system(CAS)that maintains systemic stability,and the functional network governed by the central stress system(CSS).The CAS can be divided into the cortical autonomic network,which involves higher cortical regions,and the subcortical autonomic network,which is relatively conserved,with its main connections located in deep brain structures.The CSS is a large-scale complex network characterized by hierarchy,hubs,and modularity,which together enable the competitive optimization of functional segregation and integration.Under physiological conditions,modules(mediating functional segregation)and hubs(functional integration)within the CSS dynamically trade-off with each other to maintain the overall homeostasis.However,this balance is disrupted following pathological insults or injury,resulting in weakened functional integrity of the CSS following ABI,impaired module activity,and disturbed hub integration.This paper also demonstrates the distinct pathological manifestations arising from disturbances at different levels of the homeostatic system.Finally,this study proposes potential clinical interventions,including analgesia and sedation,neuromodulation,and receptor regulation,for early interventions and potential treatment of NODS,aiming to improve patient outcomes.

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作者单位 Department of Neurosurgery,the First Hospital of China Medical University,Shenyang 110001,China [1] Department of Neurosurgery,Neuroscience ICU,Xuanwu Hospital Capital Medical University,Beijing 100032,China [2] Department of Critical Care Medicine,the First Hospital of Tsinghua University,Beijing 100016,China [3] State Key Laboratory of Advanced Medical Materials and Devices,School of Medicine,Tianjin University,Tianjin 300072,China [4] IRCCS for Oncology and Neuroscience,San Martino Policlinico Hospital,16132 Genoa,Italy [5] Department of Clinical Neurosciences,University of Cambridge,Cambridge CB1 0QQ,UK [6] Department of Critical Care Medicine,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China [7] Nell Hodgson Woodruff School of Nursing,Emory University,Atlanta,GA 30322,USA [8] Ministry of Education Key Laboratory for Neuroinformation,School of Life Science and Technology,University of Electronic Science and Technology,Chengdu 611731,China [9] Department of Critical Care Medicine,West China Hospital,Sichuan University,Chengdu 610041,China [10] Department of Critical Care Medicine,the First Affiliated Hospital of USTC,Division of Life Science and Medicine,University of Science and Technology of China,Hefei 230001,China [11] Department of Critical Care Medicine,the First Hospital of China Medical University,Shenyang 110001,China [12] State Key Laboratory of Advanced Medical Materials and Devices,School of Medicine,Tianjin University,Tianjin 300072,China;Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration,Tianjin 300380,China;School of Pharmaceutical Science and Technology,Tianjin University,Tianjin 300072,China [13] State Key Laboratory of Advanced Medical Materials and Devices,School of Medicine,Tianjin University,Tianjin 300072,China;Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration,Tianjin 300380,China [14]
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DOI 10.1186/s40779-025-00662-8
发布时间 2026-05-27(万方平台首次上网日期,不代表论文的发表时间)
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军事医学研究(英文版)

军事医学研究(英文版)

2026年13卷4期

542-558页

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