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Journal of Neurotrauma

Stephanie M Wolahan, Elliott Lebby, Howard C Mao, David McArthur, Courtney Real, Paul M Vespa, Daniel Braas, Thomas C Glenn
Treatment of severe traumatic brain injury (TBI) in the intensive care unit focuses on controlling intracranial pressure, ensuring sufficient cerebral perfusion, and monitoring for secondary injuries. Yet there are limited prognostic tools and no biomarkers or tests of the evolving neuropathology. Metabolomics has the potential to be a powerful tool to indirectly monitor evolving dysfunctional metabolism. We compared metabolite levels in simultaneously collected arterial and jugular venous samples in acute TBI patients undergoing intensive care as well as in healthy control volunteers...
June 14, 2018: Journal of Neurotrauma
Hiroyuki Toi, Yukihiko Fujii, Toru Iwama, Hiroyuki Kinouchi, Hiroyuki Nakase, Kazuhiko Nozaki, Hiroki Ohkuma, Hajime Ohta, Hideo Takeshima, Hironobu Tokumasu, Yuhei Yoshimoto, Masaaki Uno
BACKGROUND Over the decades, postoperative recurrence of chronic subdural hematoma (CSDH) has not been resolved. OBJECT The objective of our study was to investigate whether the recurrence rate of CSDH is decreased when artificial cerebrospinal fluid (ACF) is used as irrigation solution for CSDH surgery. METHODS The present study was a multi-center, prospective, randomized, open parallel group comparison test of patients enrolled from 10 hospitals in Japan. Eligible patients with CSDH were randomly assigned to undergo burr hole drainage with either normal saline (NS) or ACF irrigation...
June 14, 2018: Journal of Neurotrauma
Tsutomu Oshigiri, Toru Sasaki, Masanori Sasaki, Yuko Kataoka-Sasaki, Masahito Nakazaki, Shinichi Oka, Tomonori Morita, Ryosuke Hirota, Mitsunori Yoshimoto, Toshihiko Yamashita, Kazue Hashimoto-Torii, Osamu Honmou
Recent evidence has demonstrated that remote responses in the brain can be induced after spinal cord injury (SCI), as well as local responses in the injured spinal cord. Intravenous infusion of mesenchymal stem cells (MSCs) has been shown to provide functional improvements in SCI through local therapeutic mechanisms that provide neuroprotection, stabilization of the blood-spinal cord barrier, remyelination, and axonal sprouting. In the present study, we examined the brain response that might be associated with the functional improvements induced by the infused MSCs after SCI...
June 14, 2018: Journal of Neurotrauma
Christine L MacDonald, Jason Barber, Jason Wright, David Coppel, Nina De Lacy, Steve Ottinger, Suzanne Peck, Chris Panks, Samantha Sun, Kody Zalewski, Nancy Temkin
This study longitudinally assessed 10-14-year-old patients with sports and recreational concussion (n=22) who remained symptomatic 3-4 weeks post-injury compared to typically developing controls (n=24). Examination by multimodal MRI and multidomain clinical outcome measures was completed at 1-month and 6-months post-injury. Concussion patients showed evidence of improvement by 6-month follow up in domains of cognitive function while measures of psychological health were less resolved with patients exhibiting sustained symptoms of depression, behavior impairment, and concussion symptoms...
June 14, 2018: Journal of Neurotrauma
Karen Barlow, Michael M J Esser, Myra Veidt, Roslyn Boyd
Traumatic brain injury is common and yet effective treatments of the secondary brain injury are scarce. Melatonin is a potent, non-selective neuroprotective and anti-inflammatory agent that is showing promising results in neonatal brain injury. The aim of this study was to systematically evaluate the pre-clinical and clinical literature for the effectiveness of Melatonin to improve outcome after TBI. Using the systematic review protocol for animal intervention studies (SYRCLE) and Cochrane methodology for clinical studies, a search of English articles was performed...
June 14, 2018: Journal of Neurotrauma
Xin Lin Tan, Mujun Sun, Rhys D Brady, Shijie J Liu, Roxana Llanos, Steve Cheung, David K Wright, Pablo M Casillas-Espinosa, Maithili Sashindranath, Stuart John McDonald, Bradley J Turner, Terence John O'Brien, Sandy Richard Shultz
Initial studies have found some evidence for transactive response DNA-binding protein 43 (TDP-43) abnormalities after traumatic brain injury (TBI), and the presence of protein inclusions consisting of TDP-43 are a pathological hallmark of amyotrophic lateral sclerosis, a condition associated with TBI. However, no study has characterized changes in TDP-43 phosphorylation, mislocalization, and fragmentation (i.e., abnormalities linked to hallmark TDP-43 pathology) after TBI, and how these relate to functional outcomes...
June 14, 2018: Journal of Neurotrauma
Xiangbing Wu, Wenrui Qu, Adewale Bakare, Yi-Ping Zhang, Collin M Fry, Lisa Shields, Christopher B Shields, Xiao-Ming Xu
Mouse models are unique for studying molecular mechanisms of neurotrauma due to the availability of various genetic modified mouse lines. For spinal cord injury (SCI) research, producing an accurate injury is essential but is challenging due to the small size of the mouse cord and inconsistency of injury production. The Louisville Injury System Apparatus (LISA) impactor has been shown to produce precise contusive SCI in adult rats. Here we examined whether the LISA impactor could be used to create accurate and graded contusive SCIs in mice...
June 12, 2018: Journal of Neurotrauma
Jetan H Badhiwala, Jefferson R Wilson, Brian K Kwon, Steve Casha, Michael G Fehlings
Acute traumatic spinal cord injury (SCI) entered the arena of prospective randomized clinical trials almost 40 years ago, with the undertaking of the National Acute Spinal Cord Study (NASCIS) I trial. Since then, a number of clinical trials have been conducted in the field, spurred by the devastating physical, social, and economic consequences of acute SCI for patients, families, and society at large. Many of these have been controversial and attracted criticism. The current review provides a critical summary of select past and current clinical trials in SCI, focusing in particular on the findings of prospective randomized controlled trials (RCTs), the challenges and barriers encountered, and the valuable lessons learned that can be applied to future trials...
June 11, 2018: Journal of Neurotrauma
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose Pineda, Ross C Brownson, David Limbrick
While most children with mild TBI (mTBI) without intracranial injury (ICI) can be safely discharged home from the emergency department, many are admitted to the hospital. To support evidence-based practice, we developed a decision tool to help guide hospital admission decisions. This study was a secondary analysis of a prospective study conducted in 25 emergency departments. We included children under 18 years who had Glasgow Coma Scale score 13-15 head injuries and normal CT scans or skull fractures without significant depression...
June 8, 2018: Journal of Neurotrauma
Nadine A Kerr, Juan Pablo de Rivero Vaccari, Sam Abbassi, Harmanpreet Kaur, Ronald Zambrano, Shu Wu, W Dalton Dietrich, Robert W Keane
Approximately 20-25% of traumatic brain injury (TBI) subjects develop acute lung injury (ALI), but the pathomechanisms of TBI-induced ALI remain poorly defined. Our previous work has shown that the inflammasome plays a critical role in TBI-induced secondary pathophysiology and that inflammasome proteins are released in extracellular vesicles (EV) after TBI. Here we investigated whether EV-mediated inflammasome signaling contributed to the etiology of TBI-induced ALI. C57/BL6 male mice were subjected to controlled cortical impact (CCI), and the brains and lungs were examined for inflammasome activation and ALI at 4 and 24 h after TBI...
June 8, 2018: Journal of Neurotrauma
Malihe-Sadat Poormasjedi-Meibod, Maral Mansouri, Mary Fossey, Jordan W Squair, Jie Liu, John H McNeill, Christopher R West
Spinal cord injury (SCI) causes autonomic dysfunction, altered neurohumoral control, profound hemodynamic changes, and an increased risk of heart disease. In this prospective study we investigated the cardiac consequences of chronic experimental SCI in rats by combining cutting edge in vivo techniques (magnetic resonance imaging (MRI) and left-ventricular (LV) pressure-volume catheterization) with histological and molecular assessments. 12 weeks post-SCI, MRI-derived structural indices and in vivo LV catheterization derived functional indices indicated the presence of LV atrophy (LV mass in Control vs...
June 7, 2018: Journal of Neurotrauma
Georgios A Maragkos, Efstathios Papavassiliou, Martina Stippler, Aristotelis S Filippidis
Civilian gunshot wounds to the head (cGSWH) are devastating, but there is no consensus regarding prognosis and management. Therefore, we conducted a meta-analysis to identify prognostic factors associated with mortality. PubMed, EMBASE, Scopus, Web of Science and Cochrane Library were queried for retrospective cohort studies of isolated cGSWH reporting mortality prognostic factors. MOOSE guidelines were followed. Study quality was assessed using the Newcastle-Ottawa scale. Primary outcome was mortality. Pooled estimates of odds ratios and 95% confidence intervals were derived using random-effects models...
June 7, 2018: Journal of Neurotrauma
David James Davies, Michael Clancy, Hamid Dehghani, Samuel John Edwin Lucas, Mario Forcione, Kamal Makram Yakoub, Antonio Belli
The cost and highly invasive nature of brain monitoring modality in traumatic brain injury patients currently restrict its utility to specialist neurological intensive care settings. We aim to test the abilities of a frequency domain near-infrared spectroscopy (FD-NIRS) device in predicting changes in invasively measured brain tissue oxygen tension. Individuals admitted to a United Kingdom specialist major trauma centre were contemporaneously monitored with an FD-NIRS device and invasively measured brain tissue oxygen tension probe...
June 7, 2018: Journal of Neurotrauma
Emerson Wickwire, David M Schnyer, Anne Germain, Scott Williams, Christopher Lettieri, Ashlee McKeon, Steven Scharf, Ryan Stocker, Jennifer S Albrecht, Neeraj Badjatia, Amy Markowitz, Geoffrey Manley
A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). Although many questions remain unanswered, the preponderance of evidence suggests that sleep and circadian disorders can result from mTBI. Among those with mTBI, sleep disturbances and clinical sleep and circadian disorders contribute to the morbidity and long-term sequelae across domains of functional outcomes and quality of life. Specifically, along with deterioration of neurocognitive performance, insufficient and disturbed sleep can precede, exacerbate, or perpetuate many of the other common sequelae of mTBI, including depression, post-traumatic stress disorder, and chronic pain...
June 7, 2018: Journal of Neurotrauma
Harun Najib Noristani, Guillaume Patrick Saint-Martin, Maida Cardoso, Rahima Sidiboulenouar, Mathias Catteau, Christophe Coillot, Christophe Goze-Bac, Florence Evelyne Perrin
Spinal cord injuries (SCI) are disastrous neuropathologies causing permanent disabilities. The availability of different strains of mice is valuable for studying the pathophysiological mechanisms involved in SCI. However, strain differences have a profound effect on spontaneous functional recovery after SCI. CX3CR1+/eGFP and Aldh1l1-EGFP mice that express green fluorescent protein in microglia/monocytes and astrocytes respectively are particularly useful to study glial reactivity. Whereas CX3CR1+/eGFP mice have C57BL/6 background, Aldh1l1-EGFP are in Swiss Webster background...
June 7, 2018: Journal of Neurotrauma
Yu-Jun Chang, Wen-Miin Liang, Wen-Yu Yu, Mau-Roung Lin
This study compared psychometric properties of the Taiwanese version of the Quality of Life after Brain Injury (QOLIBRI) between patients with mild and those with moderate/severe traumatic brain injury (TBI). Of 683 participants, 548 had sustained a mild injury with Glasgow coma scale (GCS) scores of 13~15, and 135 had a moderate/severe injury with GCS scores of 3~12. The QOLIBRI comprises six domains of Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, and Physical Problems. Results of the Rasch analysis showed that two items of "Problems with seeing/hearing" and "Finding one's way about" were underfitting in the mild TBI group while the item "Problems with seeing/hearing" was underfitting and the item "TBI effects" was overfitting in the moderate/severe TBI group...
June 7, 2018: Journal of Neurotrauma
Jefferson R Wilson, Blessing N R Jaja, Brian E Kwon, James D Guest, James S Harrop, Bizhan Aarabi, Christopher I Shaffrey, Jetan H Badhiwala, Elizabeth G Toups, Robert G Grossman, Michael G Fehlings
The course, treatment response, and recovery potential after acute traumatic spinal cord injury (SCI) have been shown to differ depending on the neurological level of injury. There are limited data focused on thoracic-level injuries, however. A cohort of 86 patients from the prospectively maintained North American Clinical Trials Network SCI registry were identified and studied to characterize the patterns of neurological recovery and to determine rates of acute hospital death and pulmonary complications. Regression analyses were used to examine the relationship between timing of surgery and administration of methylprednisolone on neurologic and clinical outcomes...
June 7, 2018: Journal of Neurotrauma
Hefan He, Yingying Zhou, Yilin Zhou, Jiayuan Zhuang, Xu He, Siyuan Wang, Wenping Lin
Excessive neuroinflammation aggravates neurological damage after spinal cord injury (SCI). Controlling neuroinflammation might favor neuroregeneration and tissue repair. Dexmedetomidine is reported to inhibit post-SCI neuroinflammation in previous research. In the current study, to determine the mechanisms by which dexmedetomidine inhibits neuroinflammation, we tested the effect of dexmedetomidine hydrochloride on microglia in vitro and in a rat SCI model. We found that dexmedetomidine hydrochloride up-regulated programmed cell death protein 1 (PD-1), an immunoregulatory molecule, in activated microglia but not in resting microglia...
June 7, 2018: Journal of Neurotrauma
Liang Wen, Wendong You, Hao Wang, Yuanyuan Meng, Junfeng Feng, Xiaofeng Yang
Increasing evidence indicates that activated microglia play an important role in the inflammatory response following traumatic brain injury (TBI). Inhibiting M1 and stimulating M2 activated microglia have demonstrated protective effects in several animal models of central nervous system diseases. However, it is not clear whether the polarization of microglia to M2 attenuates axonal injury following TBI. In this study, we used a lateral fluid percussion injury device to induce axonal injury in mice. Mice were randomly assigned to the sham, TBI, TBI + rosiglitazone (peroxisome proliferator-activated receptor gamma [PPAR-γ] agonist), and TBI + GW9662 (PPAR-γ antagonist) groups...
June 7, 2018: Journal of Neurotrauma
Lindsay Horton, Jonathan Rhodes, Lindsay Wilson
As part of efforts to improve study design, the use of outcome measures in randomized controlled trials (RCTs) in traumatic brain injury (TBI) is receiving increasing attention. This review aimed to assess how clinical outcome assessments (COAs) have been used and reported in RCTs in adult TBI. Systematic literature searches were conducted to identify medium to large (n ≥ 100) acute and post-acute TBI trials published since 2000. Data were extracted independently by two reviewers using a set of structured templates...
June 7, 2018: Journal of Neurotrauma
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