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Traumatic brain injury

Alicia A Swan, Jeremy T Nelson, Terri K Pogoda, Megan E Amuan, Faith W Akin, Mary Jo Pugh
OBJECTIVES: To describe the prevalence of sensory dysfunction (i.e. auditory, visual, vestibular, chemosensory and multiple sensory problems) and explore associations with traumatic brain injury (TBI) severity and injury mechanism among deployed Post-9/11 Veterans. METHODS: This retrospective cohort analysis used Departments of Defense and Veterans Affairs diagnostic codes and administrative data. RESULTS: Among the 570,248 Veterans in this cohort, almost 23% had at least one diagnosis of sensory dysfunction...
July 19, 2018: Brain Injury: [BI]
Konrad Oppelt, Doreen Hähnlein, Jürgen Boschert, Maike Küffer, Paul Alfred Grützner, Matthias Münzberg, Michael Kreinest
PRIMARY OBJECTIVE: We evaluated the neurologic, psychological and vegetative outcome, the health status and changes of the personal and occupational status of patients after traumatic brain injuries (TBIs). Correlations between outcome parameters and basic demographic factors and initial clinical status parameters of the patients were assessed. RESEARCH DESIGN: Monocentric, retrospective follow-up analysis. METHODS AND PROCEDURES: We evaluated the neurologic, psychological and vegetative outcome and health status of patients, who survived TBI with a mean follow-up time of 54 months...
July 19, 2018: Brain Injury: [BI]
Radhika Madhavan, Suresh E Joel, Rakesh Mullick, Taylor Cogsil, Sumit Niogi, Apostolos John Tsiouris, Pratik Mukherjee, Joseph C Masdeu, Luca Marinelli, Teena Shetty
Mild traumatic brain injury (mTBI) affects about 42 million people worldwide. It is often associated with headache, cognitive deficits and balance difficulties but rarely shows any abnormalities on conventional CT or MR imaging. While in most mTBI patients the symptoms resolve within 3 months, 10-15% of patients continue to exhibit symptoms beyond a year. Also, it is known that there exists a vulnerable period post-injury, when a second injury may exacerbate clinical prognosis. Identifying this vulnerable period may be critical for patient outcome, but very little is known about the neural underpinnings of mTBI and its recovery...
July 19, 2018: Journal of Neurotrauma
Bryan G Beutel, Bryan J Marascalchi, Eitan Melamed
BACKGROUND: Spasticity resulting from traumatic brain injury (TBI) or stroke can lead to debilitating sequelae, including deformities from joint subluxation and spasticity, causing a loss of functional independence. Despite the effectiveness of surgery to address these issues, it is unclear how often these procedures are performed. The objective of the study was to determine the rate of, and trends associated with, reconstructive upper extremity surgery in patients following TBI or stroke...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Shari L Wade, Gary Bedell, Jessica A King, Michele Jacquin, Lyn S Turkstra, Juliet Haarbauer-Krupa, Jeremy Johnson, Ralph Salloum, Megan E Narad
PURPOSE/OBJECTIVE: Our goal was to examine the feasibility and preliminary efficacy of an app-based coaching intervention (Social Participation and Navigation; SPAN) to help survivors of acquired brain injury attain social participation goals. Research Method/Design: This is a nonrandomized pilot trial of SPAN, including 15 adolescents (9 with traumatic brain injury, 6 with brain tumor) between the ages of 14-22. The SPAN intervention consisted of a mobile app to support the development and implementation of social participation goals, weekly video-conference coaching sessions to identify goals and step-by-step action plans, and online didactic materials...
July 19, 2018: Rehabilitation Psychology
Erica Weber, Angela Spirou, Nancy Chiaravalloti, Jeannie Lengenfelder
OBJECTIVE: To explore the contribution of frontal systems behavioral dysfunction on employment outcomes in individuals with traumatic brain injury (TBI), in the context of relevant predictors of work status. METHOD: Forty-two participants with history of moderate-to-severe TBI were classified as either "Employed" or "Unemployed." Groups did not differ on most demographic or injury variables, although the Unemployed sample reported greater symptoms of depression, pain, and fatigue ( p s < 0...
July 19, 2018: Rehabilitation Psychology
Matthew L Cohen, James A Holdnack, Pamela A Kisala, David S Tulsky
PURPOSE/OBJECTIVE: To compare and contrast how individuals with traumatic brain injury (TBI) are classified (positive or negative screen) by different cut-offs on two self-report measures of depressive symptoms: the PHQ-9, which assesses somatic symptoms, and the TBI-QOL Depression item bank, which does not. Research Method/Design: Three hundred eighty-five individuals with TBI were recruited from six rehabilitation hospitals in the U.S. as part of the calibration data collection for the TBI-QOL patient-reported outcome measurement system...
July 19, 2018: Rehabilitation Psychology
Brad G Kurowski, Terry Stancin, H Gerry Taylor, Kelly A McNally, Michael W Kirkwood, Amy Cassedy, Eileen King, McKenna Sklut, Megan E Narad, Shari L Wade
Introduction: The objective of this manuscript is to describe the methodology that will be used to test the comparative effectiveness, feasibility, and acceptability of three formats of family problem solving therapy (F-PST) for improving functional outcomes of complicated mild to severe adolescent TBI. Methods: Three-arm comparative effectiveness, randomized clinical trial (RCT) design. We describe the protocol of a three-arm RCT comparing the effectiveness of three modalities of F-PST to reduce executive dysfunction and behavior problems following TBI in adolescence...
June 2018: Contemporary Clinical Trials Communications
Carolyn M Hendrickson, Stuart L Gibb, Byron Y Miyazawa, Sheila M Keating, Erin Ross, Amanda S Conroy, Carolyn S Calfee, Shibani Pati, Mitchell J Cohen
Background: Complications after injury, such as acute respiratory distress syndrome (ARDS), are common after traumatic brain injury (TBI) and associated with poor clinical outcomes. The mechanisms driving non-neurologic organ dysfunction after TBI are not well understood. Tissue inhibitor of matrix metalloproteinase-3 (TIMP-3) is a regulator of matrix metalloproteinase activity, inflammation, and vascular permeability, and hence has plausibility as a biomarker for the systemic response to TBI...
2018: Trauma surgery & acute care open
Sean Wilkes, Erin McCormack, Kimbra Kenney, Brian Stephens, Ross Passo, Leah Harburg, Erika Silverman, Carol Moore, Tanya Bogoslovsky, Dzung Pham, Ramon Diaz-Arrastia
This study seeks to quantitatively assess evolution of traumatic ICHs over the first 24 h and investigate its relationship with functional outcome. Early expansion of traumatic intracranial hematoma (ICH) is common, but previous studies have focused on the high density (blood) component. Hemostatic therapies may increase the risk of peri-hematoma infarction and associated increased cytotoxic edema. Assessing the magnitude and evolution of ICH and edema represented by high and low density components on computerized tomography (CT) may be informative for designing therapies targeted at traumatic ICH...
2018: Frontiers in Neurology
Kristen E DeDominicis, Hye Hwang, Casandra M Cartagena, Deborah A Shear, Angela M Boutté
Treatments to improve outcomes following severe traumatic brain injury (TBI) are limited but may benefit from understanding subacute-chronic brain protein profiles and identifying biomarkers suitable for use in this time. Acute alterations in the well-known TBI biomarkers glial fibrillary acidic protein (GFAP), αII-spectrin, and their breakdown products (BDPs) have been well established, but little is known about the subacute-chronic post-injury profiles of these biomarkers. Thus, the current study was designed to determine the extended profile of these TBI-specific biomarkers both in brain tissue and cerebral spinal fluid (CSF)...
2018: Frontiers in Neurology
Anne Sebastiani, Frederik Greve, Christina Gölz, Carola Y Förster, Hermann Koepsell, Serge C Thal
Acute cerebral lesions are associated with dysregulation of brain glucose homeostasis. Previous studies showed that knockdown of Na+ -D-glucose cotransporter SGLT1 impaired outcome after middle cerebral artery occlusion and that widely expressed intracellular RS1 (RSC1A1) is involved in transcriptional and posttranslational downregulation of SGLT1. In the present study, we investigated whether SGLT1 is upregulated during traumatic brain injury (TBI) and whether removal of RS1 in mice (RS1-KO) influences SGLT1 expression and outcome...
July 19, 2018: Journal of Neurochemistry
Max J Hilz, Mao Liu, Sankanika Roy, Ruihao Wang
Autonomic dysfunction is common in neuro-critical care patients and may compromise the function of various organs. Among the many diseases causing or being associated with autonomic dysfunction are traumatic brain injury, cerebrovascular diseases, epilepsy, Guillain-Barré syndrome (GBS), alcohol withdrawal syndrome, botulism and tetanus, among many others. Autonomic dysfunction may afflict various organs and may involve hyper- or hypo-activity of the sympathetic or parasympathetic system. In this short overview, we address only a small number of neuro-intensive care diseases with autonomic dysfunction...
July 18, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Devang K Thakor, Lei Wang, Darcy Benedict, Serdar Kabatas, Ross D Zafonte, Yang D Teng
Human mesenchymal stromal stem cells (hMSCs) hold regenerative medicine potential due to their availability, in vitro expansion readiness, and autologous feasibility. For neural repair, hMSCs show translational value in research on stroke, spinal cord injury (SCI), and traumatic brain injury. It is pivotal to establish multimodal in vitro systems to investigate molecular mechanisms underlying neural actions of hMSCs. Here, we describe a platform protocol on how to set up organotypic co-cultures of hMSCs (alone or polymer-scaffolded) with explanted adult rat dorsal root ganglia (DRGs) to determine neural injury and recovery events for designing implants to counteract neurotrauma sequelae...
July 18, 2018: Current Protocols in Stem Cell Biology
Valentin A Schriever, Janine Gellrich, Maja von der Hagen, Thomas Hummel
Olfactory function can be influenced by many factors and olfactory dysfunction is associated with several diseases. But even considering this, the causes of acquired olfactory dysfunction in children are not well understood. This review was conducted to gain an overview of the etiologies of acquired olfactory dysfunction in a pediatric population. Studies were identified using a predefined literature search including studies if patients were ≤18 years of age and results of psychophysical olfactory testing were reported...
July 18, 2018: Chemical Senses
Heather T Keenan, Angela P Presson, Amy E Clark, Charles S Cox, Linda Ewing-Cobbs
Children under 4 years of age have the highest incidence of traumatic brain injury (TBI) among the non-elderly and may be at high risk of poor developmental outcomes. We prospectively enrolled a cohort of children injured before 31 months old with TBI or orthopaedic injury (OI), from 2013 to 2015 at two pediatric level 1 trauma centers to study very young children's developmental outcomes after injury. We used Ages & Stages-3 (ASQ-3) and Ages & Stages: Social-Emotional (ASQ:SE) screening tools to measure children's development at pre-injury, 3 and 12 months post-injury...
July 18, 2018: Journal of Neurotrauma
Zhi Zhang, Lindsey Rasmussen, Manda Saraswati, Raymond Koehler, Courtney L Robertson, Sujatha Kannan
Neuroinflammation following traumatic brain injury (TBI) contributes to widespread cell death and tissue loss. Here we evaluated the sequential inflammatory response in the brain, as well as inflammation-induced changes in brain tryptophan metabolism over time in a rabbit pediatric TBI model. On postnatal day 5-7 (P5-7), New Zealand white rabbit littermates were randomized into three groups, naïve (no injury), sham (craniotomy alone) and TBI (controlled cortical impact). Animals were sacrificed at 6 h, 1, 3, 7 and 21 days post-injury for evaluating levels of pro- and anti-inflammatory cytokines, as well as the major components in the tryptophan-kynurenine pathway...
July 18, 2018: Journal of Neurotrauma
Naomi Ketharanathan, Yumi Yamamoto, Ursula Karin Rohlwink, Enno Wildschut, Ron A A Mathôt, Elizabeth C M de Lange, Saskia N de Wildt, Andrew C Argent, Dick Tibboel, Anthony Figaji
Evidence-based analgosedation in severe pediatric traumatic brain injury (pTBI) management is lacking and improved pharmacological understanding is needed. This starts with increased knowledge of factors controlling the pharmacokinetics (PK) of unbound drug at the target site (brain) and related drug effect(s). This prospective descriptive study tested a pediatric physiology-based pharmacokinetic software model by comparing actual plasma and brain extracellular fluid (brainECF) morphine concentrations with predicted concentration time profiles in severe pTBI patients (Glasgow Coma Scale ≤ 8)...
July 18, 2018: Journal of Neurotrauma
Joanna K Huttunen, Antti M Airaksinen, Carmen Barba, Gabriella Colicchio, Juha-Pekka Niskanen, Artem Shatillo, Alejandra Sierra Lopez, Xavier Ekolle Ndode-Ekane, Asla Pitkanen, Olli Gröhn
Diagnosis of ongoing epileptogenesis and associated hyperexcitability after brain injury is a major challenge. As increased neuronal activity in the brain triggers a blood oxygenation level-dependent (BOLD) response in functional magnetic resonance imaging (fMRI), we hypothesized that fMRI could be used to identify the brain area(s) with hyperexcitability during post-injury epileptogenesis. We applied fMRI to detect the onset and spread of BOLD activation after pentylenetetrazol (PTZ)-induced seizures (PTZ, 30 mg/kg, i...
July 18, 2018: Journal of Neurotrauma
Il-Gyu Ko, Sung-Eun Kim, Lakkyong Hwang, Jun-Jang Jin, Chang-Ju Kim, Bo-Kyun Kim, Hong Kim
Traumatic brain injury (TBI) causes deficit in spatial learning and memory function. Physical activity ameliorates neurological dysfunction after TBI. We investigated the effect of late starting treadmill exercise on spatial learning ability in relation with cAMP-response element binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway using TBI rats. For this study, radial 8-arm maze test, TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) staining, caspase-3 immunohistochemistry, and western blot for Bax, Bcl-2, BDNF, tyrosine kinase B (TrkB), CREB, and phosphorylated CREP (p-CREB) were performed...
June 2018: Journal of Exercise Rehabilitation
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