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Moderate traumatic brain injury

Peter C Fino, Lucy Parrington, Will Pitt, Douglas N Martini, James C Chesnutt, Li-Shan Chou, Laurie A King
BACKGROUND: While a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear. RESEARCH QUESTION: This review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion...
March 8, 2018: Gait & Posture
Samuel Enumah, Elizabeth J Lilley, Stephanie Nitzschke, Adil H Haider, Ali Salim, Zara Cooper
BACKGROUND: Hospice improves quality and value of end of life care (EOLC), and enrollment has increased for older patients dying from chronic medical conditions. It remains unknown if the same is true for older patients who die after moderate to severe traumatic brain injury (msTBI). METHODS: Subjects included Medicare beneficiaries (≥65 years) who were hospitalized for msTBI from 2005 to 2011. Outcomes included intensity and quality of EOLC for decedents within 30 days of admission, and 30-day mortality for the entire cohort...
March 1, 2018: American Journal of Surgery
Helena Verhelst, Catharine Vander Linden, Toon De Pauw, Guy Vingerhoets, Karen Caeyenberghs
Recent evidence has shown the presence of a "rich club" in the brain, which constitutes a core network of highly interconnected and spatially distributed brain regions, important for high-order cognitive processes. This study aimed to map the rich club organization in 17 young patients with moderate to severe TBI (15.71 ± 1.75 years) in the chronic stage of recovery and 17 age- and gender-matched controls. Probabilistic tractography was performed on diffusion weighted imaging data to construct the edges of the structural connectomes using number of streamlines as edge weight...
March 12, 2018: Human Brain Mapping
Hailong Song, Landry M Konan, Jiankun Cui, Catherine E Johnson, Martin Langenderfer, DeAna Grant, Tina Ndam, Agnes Simonyi, Tommi White, Utkan Demirci, David R Mott, Doug Schwer, Graham K Hubler, Ibolja Cernak, Ralph G DePalma, Zezong Gu
Explosive blast-induced mild traumatic brain injury (mTBI), a "signature wound" of recent military conflicts, commonly affects service members. While past blast injury studies have provided insights into TBI with moderate- to high-intensity explosions, the impact of primary low-intensity blast (LIB)-mediated pathobiology on neurological deficits requires further investigation. Our prior considerations of blast physics predicted ultrastructural injuries at nanoscale levels. Here, we provide quantitative data using a primary LIB injury murine model exposed to open field detonation of 350 grams of high-energy explosive C4...
March 8, 2018: Behavioural Brain Research
Marie Hexeberg Tollefsen, Anne Vik, Toril Skandsen, Oddrun Sandrød, Susan Frances Deane, Vidar Rao, Kent Gøran Moen
OBJECT: We aimed to examine the effect of preinjury antithrombotic medication on clinical and radiological neuroworsening in TBI and study the effect on outcome. METHODS: 184 consecutive patients ≥50 years old with moderate and severe TBI admitted to a level 1 trauma center were included. Neuroworsening was assessed clinically by using Glasgow Coma Scale (GCS) score and radiologically by using Rotterdam CT score on repeated time points. Functional outcome was assessed with the Glasgow Outcome Scale Extended (GOSE) at 6 months postinjury...
March 7, 2018: World Neurosurgery
Lenore Hawley, Jessica M Ketchum, Clare Morey, Kathleen Collins Pharm D, Susan Charlifue
OBJECTIVE: To describe the prevalence of cannabis use in an adult sample with spinal cord injury (SCI) or traumatic brain injury (TBI) in Colorado, and to describe the self-reported reasons and side effects of cannabis use in this sample. DESIGN: Mixed methods observational study, using focus group data and telephone survey SETTING: Community PARTICIPANTS: Colorado adults who have sustained SCI or moderate to severe TBI and have received services through the rehabilitation hospital conducting the study...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
Tracey A Brickell, Louis M French, Sara M Lippa, Rael T Lange
OBJECTIVES: To (a) characterize a sample of post-9/11 caregivers providing help to service members and veterans (SMV) following traumatic brain injury (TBI), (b) examine the level of support provided, and (c) determine caregiver health and well-being outcomes. SETTING: Military treatment facility. PARTICIPANTS: Caregivers (N = 278) of SMVs who sustained a mild, moderate, severe, or penetrating TBI (96.0% female; 86.0% spouse/partner; age: M = 38...
March 2018: Journal of Head Trauma Rehabilitation
Jennifer M Flaherty, Robert J Spencer, Lauren L Drag, Percival H Pangilinan, Linas A Bieliauskas
OBJECTIVES: This study examined how depression, anxiety, and sleep items from the Neurobehavioral Symptom Inventory (NSI) predict results from longer inventories. METHOD: This was a retrospective review from 484, predominantly male (96.1%) Veterans, mean age 29.7 years, who underwent brief neuropsychological screening during a comprehensive, multidisciplinary evaluation for mild traumatic brain injury (TBI). Participants completed the NSI, insomnia severity index (ISI), and hospital anxiety and depression scale (HADS)...
March 6, 2018: Journal of Clinical Psychology
Silvia D Vaca, Benjamin J Kuo, Joao Ricardo Nickenig Vissoci, Catherine A Staton, Linda W Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E Rice, Gerald A Grant, Michael M Haglund
BACKGROUND: Significant care continuum delays between acute traumatic brain injury (TBI) and definitive surgery are associated with poor outcomes. Use of the "3 delays" model to evaluate TBI outcomes in low- and middle-income countries has not been performed. OBJECTIVE: To describe the care continuum, using the 3 delays framework, and its association with TBI patient outcomes in Kampala, Uganda. METHODS: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June to 30 November 2016...
February 26, 2018: Neurosurgery
Emily L Dennis, Talin Babikian, Christopher C Giza, Paul M Thompson, Robert F Asarnow
Traumatic brain injury (TBI) is a significant public health problem in the United States, especially for children and adolescents. Current epidemiological data estimate over 600,000 patients younger than 20 years are treated for TBI in emergency rooms annually. While many patients experience a full recovery, for others there can be long-lasting cognitive, neurological, psychological, and behavioral disruptions. TBI in youth can disrupt ongoing brain development and create added family stress during a formative period...
February 1, 2018: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
Andrew R Mayer, Faith M Hanlon, Eric D Claus, Andrew B Dodd, Brittny Miller, Jessica Mickey, Davin K Quinn, Sarah L Hagerty, Brandi Seaman, Kent E Hutchison
BACKGROUND: Chronic alcohol use disorders (AUDs) and traumatic brain injury (TBI) are highly comorbid and share commonly affected neuronal substrates (i.e., prefrontal cortex, limbic system, and cerebellum). However, no studies have examined how combined physical trauma and heavy drinking affect neurocircuitry relative to heavy drinking alone. METHODS: The current study investigated whether comorbid AUDs and mild or moderate TBI (AUDs+TBI) would negatively affect maladaptive drinking behaviors (n = 90 AUDs+TBI; n = 62 AUDs) as well as brain structure (i...
March 2018: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Vida Motamedi, Rebekah Kanefsky, Panagiotis Matsangas, Sara Mithani, Andreas Jeromin, Matthew S Brock, Vincent Mysliwiec, Jessica Gill
Obstructive sleep apnea (OSA) is characterized by apneas and hypopneas that result in hypoxia, cerebral hypoperfusion, endothelial dysfunction, inflammation, and oxidative stress. These pathophysiologic processes likely contribute to neuronal damage. Tau is a protein that stabilizes microtubules and, along with amyloid beta (Aβ), is associated with neurodegenerative processes. We sought to determine if tau and other biomarkers of inflammation were related to OSA severity. Concentrations of tau, Aβ40, Aβ42, c-reactive protein (CRP), TNF-α, interleukin (IL)-6, and IL-10 were measured in blood and compared between participants with moderate-severe OSA (n = 28), those with mild OSA (n = 22), and healthy controls (n = 24)...
March 2018: Sleep Medicine
Shahan Waheed, Muhammad Akbar Baig, Emaduddin Siddiqui, Danyal Jamil, Masharib Bashar, Asher Feroze
Optic nerve sheath diameter measurement (ONSD) has been associated with identifying the prognosis of traumatic brain injury (TBI) patients. The study was planned to evaluate the prognostic value of ONSD measured on the initial brain computed tomography (CT) scan performed on patients with blunt TBI in the emergency department(ED). This retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of moderate and severe TBI patients from January to December 2014...
February 2018: JPMA. the Journal of the Pakistan Medical Association
Dubravko Tršinski, Meri Tadinac, Žarko Bakran, Ivana Klepo
PURPOSE: To examine the utility of the Community Integration Questionnaire-Revised, translated into Croatian, in a sample of adults with moderate to severe traumatic brain injury. METHOD: The Community Integration Questionnaire-Revised was administered to a sample of 88 adults with traumatic brain injury and to a control sample matched by gender, age and education. Participants with traumatic brain injury were divided into four subgroups according to injury severity...
February 23, 2018: Disability and Rehabilitation
Robert J Kanser, Lisa J Rapport, Jesse R Bashem, Robin A Hanks
OBJECTIVE: The present study examined the incremental utility of item-level response time (RT) variables on a traditional performance validity test in distinguishing adults with verified TBI from adults coached to feign neurocognitive impairment. METHOD: Participants were 45 adults with moderate to severe TBI, 45 healthy adults coached to feign neurocognitive impairment (SIM), and 61 healthy adult comparisons providing full effort (HC). All participants completed a computerized version of the Test of Memory Malingering (TOMM-C) in the context of a larger test battery...
February 22, 2018: Clinical Neuropsychologist
Himakarnika Alluri, Chinchusha Anasooya Shaji, Matthew L Davis, Binu Tharakan
Traumatic brain injury (TBI) is one of the leading causes of death and disability worldwide. It is a silently growing epidemic with multifaceted pathogenesis, and current standards of treatments aim to target only the symptoms of the primary injury, while there is a tremendous need to explore interventions that can halt the progression of the secondary injuries. The use of a reliable animal model to study and understand the various aspects the pathobiology of TBI is extremely important in therapeutic drug development against TBI-associated complications...
2018: Methods in Molecular Biology
Paige S Katz, Patricia E Molina
Traumatic brain injury (TBI) diagnoses have increased in frequency during the past decade, becoming a silent epidemic. The pathophysiology of TBI involves pathophysiological processes affecting the brain, induced by traumatic biomechanical forces resulting in temporary impairment of neurological function. Preclinical models have been generated to recapitulate the mechanical, neuroinflammatory, and behavioral outcomes observed in the clinical setting. The lateral fluid percussion (LFP) model is the most extensively used and well-characterized model of nonpenetrating and nonischemic TBI...
2018: Methods in Molecular Biology
Juan Lu, Cecilie Roe, Solrun Sigurdardottir, Nada Andelic, Marit Vindal Forslund
A better understanding of long-term functional recovery process for patients with traumatic brain injury (TBI) facilitates effective rehabilitations. The objective of this study was to classify and characterize patients with moderate-to-severe TBI based on their functional trajectories up to 5-years following injury. The study included 121 patients with moderate-to-severe TBIs (ICD-10: S06.0-S06.9), aged 16-55 years and admitted at Trauma Referral Hospital within 24-hours of injury between 2005 and 2007. Demographics and injury characteristics were documented at the admission, and functional status was recorded at 3 months, 1 and 5 years post injury using Functional Independence Measure motor (FIM-M) and cognitive (FIM-C) subscales...
February 21, 2018: Journal of Neurotrauma
Philip Foerstner, Rida Rehman, Sofia Anastasiadou, Melanie Haffner-Luntzer, Daniela Sinske, Anita Ignatius, Francesco Roselli, Bernd Knoell
Traumatic brain injury (TBI) induces a neuroinflammatory response resulting in astrocyte and microglia activation at the lesion site. This involves up-regulation of neuroinflammatory genes including chemokines and interleukins. However, so far there is lack of knowledge on transcription factors (TFs) modulating this TBI associated gene expression response. Herein we analyzed activating transcription factor 3 (ATF3), a TF encoding a regeneration-associated gene (RAG) predominantly studied in peripheral nervous system (PNS) injury...
February 20, 2018: Journal of Neurotrauma
Victoria C Merritt, Alexandra L Clark, Scott F Sorg, Nicole D Evangelista, Madeleine Werhane, Mark W Bondi, Dawn M Schiehser, Lisa Delano-Wood
Since few studies have examined the relationship between the APOE gene and clinical outcomes following military-related traumatic brain injury (TBI), we aimed to determine whether the ε4 allele of the APOE gene influences neuropsychiatric symptoms in Veterans with a history of mild to moderate TBI. Participants included 133 Veterans (TBI=79, military controls [MC]=54) who underwent APOE genotyping and were divided into ε4+ (TBI=18, MC=15) and ε4- (TBI=61, MC=39) groups. All participants underwent evaluation of psychological distress using the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and PTSD Checklist-Military Version (PCL-M)...
February 20, 2018: Journal of Neurotrauma
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