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Adult traumatic brain injury

Johanna Flygt, Fredrik Clausen, Niklas Marklund
BACKGROUND: Injury to the white matter may lead to impaired neuronal signaling and is commonly observed following traumatic brain injury (TBI). Although endogenous repair of TBI-induced white matter pathology is limited, oligodendrocyte progenitor cells (OPCs) may be stimulated to proliferate and regenerate functionally myelinating oligodendrocytes. Even though OPCs are present throughout the adult brain, little is known about their proliferative activity following axonal injury caused by TBI...
October 17, 2016: Restorative Neurology and Neuroscience
(no author information available yet)
The American Occupational Therapy Association (AOTA) Evidence-Based Practice Project has developed a table summarizing the research opportunities in the area of adults with traumatic brain injury. The table provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice and is based on the systematic reviews from the AOTA Practice Guidelines Series. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the occupational therapy field...
November 2016: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Olga Calcagnile, Anders Anell, Johan Undén
BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study...
October 20, 2016: BMC Neurology
Stephanie M Wolahan, Mayumi L Prins, David L McArthur, Courtney R Real, David A Hovda, Neil A Martin, Paul M Vespa, Thomas C Glenn
BACKGROUND: The objective was to investigate the impact of targeting tight glycemic control (4.4-6.1 mM) on endogenous ketogenesis in severely head-injured adults. METHODS: The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7-8.3 mM. Blood was collected periodically during both tight and loose glycemic control epochs. Post hoc analysis of insulin dose and total nutritional provision was performed...
October 19, 2016: Neurocritical Care
Chung-Ching Chio, Mao-Tsun Lin, Ching-Ping Chang, Hung-Jung Lin
BACKGROUND: Transforming growth factor-beta 1 (TGF-β1) regulates many processes after traumatic brain injury (TBI). Both Neuro AiD(™) (MLC601) and Astragaloside (AST) attenuate microglia activation in rats with TBI. The purpose of this study was to investigate whether MLC601 or AST improves output of TBI by affecting microglial expression of TGF-β1. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (120 in number) were used to investigate the contribution of TGF-β1-containing microglia in the MLC601-mediated or the AST-mediated neuroprotection in the brain trauma condition using lateral fluid-percussion injury...
October 19, 2016: European Journal of Clinical Investigation
James Q Truong, Kenneth J Ciuffreda
OBJECTIVE: No objective vision biomarker for photosensitivity currently exists. The present study sought to uncover potential biomarkers for photosensitivity within the pupillary light reflex. METHODS: The pupillary light reflex was evaluated in those with mild traumatic brain injury (mTBI) and in normal individuals, with and without photosensitivity, under a range of test conditions. The Neuroptics DP-2000, infrared, binocular pupillometer was used for both binocular stimulation and recording...
October 2016: Military Medicine
Abigail Livny, Anat Biegon, Tammar Kushnir, Sagi Harnof, Chen Hoffmann, Eyal Fruchter, Mark Weiser
Traumatic brain injury (TBI) is known to have a substantial, though highly variable, impact on cognitive abilities. Due to the wide range of cognitive abilities among healthy individuals, an objective assessment of TBI-related cognitive loss requires an accurate measurement of premorbid cognitive performance. To address this problem, we recruited 50 adults who sustained a TBI and had performed a cognitive baseline assessment in adolescence as part of the aptitude tests mandated by the Israeli Defense Forces...
October 18, 2016: Journal of Neurotrauma
William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
Shannon B Juengst, Galen Switzer, Byung Mo Oh, Patricia M Arenth, Amy K Wagner
INTRODUCTION: Behavioral changes often occur after moderate-to-severe traumatic brain injury (TBI) and can lead to poor health, psychosocial functioning, and quality of life. Challenges in evaluating these behaviors often result from the complexity and variability in the way they are conceptualized and defined. We propose and test a conceptual model that is specific to behavioral symptoms after TBI, to serve as a basis for better assessment and treatment. We hypothesized that clusters of individuals, with unique emotional, cognitive, and behavioral characteristics, would emerge that would illustrate this conceptual model...
October 17, 2016: Journal of Clinical and Experimental Neuropsychology
Kathleen Brewer-Smyth, Monica Cornelius, Ryan T Pohlig
The staggering prevalence of obesity and obesity-related health conditions takes exorbitant tolls on health care resources. This cross-sectional study with private evaluations of 636 adult inmates in a southern state prison was conducted with regressions comparing obese (body mass index [BMI] ≥ 30) to nonobese individuals to define obesity risk factors. Obese individuals more likely were female, were victims of childhood sexual abuse, suffered greater severity of childhood sexual abuse, attempted suicide, reported drug dependency, were non-Caucasian, and were older than nonobese...
October 2016: Journal of Correctional Health Care
Stephen S Humble, Laura D Wilson, John W McKenna, Taylor C Leath, Yanna Song, Mario A Davidson, Jesse M Ehrenfeld, Oscar D Guillamondegui, Pratik P Pandharipande, Mayur B Patel
OBJECTIVE: To determine risk factors associated with tracheostomy placement after severe traumatic brain injury (TBI) and subsequent outcomes among those who did and did not receive a tracheostomy. METHODS: This retrospective cohort study compared adult trauma patients with severe TBI (n = 583) who did and did not receive tracheostomy. A multivariable logistic regression model assessed the associations between age, sex, race, insurance status, admission GCS, AIS (Head, Face, Chest) and tracheostomy placement...
October 14, 2016: Brain Injury: [BI]
Alexandra L Clark, Lisa Delano-Wood, Scott F Sorg, Madeleine L Werhane, Karen L Hanson, Dawn M Schiehser
No known studies have directly examined white matter microstructural correlates of cognitive fatigue post-TBI in a Veteran sample. We therefore investigated the relationship between cognitive fatigue and white matter integrity in Veterans with history of mild to moderate TBI (mmTBI). 59 Veterans (TBI = 34, Veteran Controls [VCs] = 25]) with and without history of mmTBI underwent structural 3T DTI scans and completed questionnaires related to cognitive fatigue and psychiatric symptoms. Tractography was employed on six regions of interest, including the anterior and posterior limbs of the internal capsule; genu; body and splenium of the corpus callosum; and cingulum bundle...
October 6, 2016: Brain Imaging and Behavior
Stephen W Scheff, Kelly N Roberts
We have previously shown that pycnogenol (PYC) increases antioxidants, decreases oxidative stress, suppresses neuroinflammation and enhances synaptic plasticity following traumatic brain injury (TBI). Here, we investigate the effects of PYC on cognitive function following a controlled cortical impact (CCI). Adult Sprague-Dawley rats received a CCI injury followed by an intraperitoneal injection of PYC (50 or 100mg/kg). Seven days post trauma, subjects were evaluated in a Morris water maze (MWM) and evaluated for changes in lesion volume...
October 11, 2016: Neuroscience Letters
Nolan B Skop, Frances Calderon, Cheul H Cho, Chirag D Gandhi, Steven W Levison
Tissue engineering using stem cells is widely used to repair damaged tissues in diverse biological systems; however, this approach has met with less success in regenerating the central nervous system (CNS). In this study we optimized and characterized the surface chemistry of chitosan-based scaffolds for CNS repair. To maintain radial glial cell (RGC) character of primitive neural precursors, fibronectin was adsorbed to chitosan. The chitosan was further modified by covalently linking heparin using genipin, which then served as a linker to immobilize fibroblast growth factor-2 (FGF-2), creating a multifunctional film...
October 2016: Journal of Tissue Engineering and Regenerative Medicine
Ana Luiza Zaninotto, Jessica Elias Vicentini, Davi Jorge Fontoura Solla, Tatiana Tateishi Silva, Vinicius Monteiro de Paula Guirado, Fabrício Feltrin, Mara Cristina Souza de Lucia, Manoel Jacobsen Teixeira, Wellingson Silva Paiva
OBJECTIVE: Diffuse axonal injury (DAI) is prevalent in traumatic brain injury (TBI), and is often associated with poor outcomes and cognitive impairment, including memory deficits. Few studies have explored visual memory after TBI and its relationship to executive functioning. Executive functioning is crucial for remembering an object's location, operating devices, driving, and route finding. We compared visual memory performance via the Rey-Osterrieth Complex Figure (ROCF) test 6 and 12 months after DAI...
October 11, 2016: Acta Neuropsychiatrica
Matthew E Peters
Approximately 39 million older adults (age >65) were evaluated for traumatic brain injury (TBI) in United States emergency departments during the 2-year period from 2009 to 2010, representing a 61% increase in estimates from prior years (Albrecht et al., 2015a). Across the lifespan, an estimated 5.3 million Americans are living with a TBI-related disability (Centers for Disease Control and Prevention (CDC), 2003). With improved recognition and management, more individuals experiencing TBI are surviving to die of other causes later in life (Flanagan et al...
October 11, 2016: International Psychogeriatrics
Tony Rosen, Sunday Clark, Elizabeth M Bloemen, Mary R Mulcare, Michael E Stern, Jeffrey E Hall, Neal E Flomenbaum, Mark S Lachs, Soumitra R Eachempati
INTRODUCTION: While geriatric trauma patients have begun to receive increased attention, little research has investigated assault-related injuries among older adults. Our goal was to describe characteristics, treatment, and outcomes of geriatric assault victims and compare them both to geriatric victims of accidental injury and younger assault victims. PATIENTS AND METHODS: We conducted a retrospective analysis of the 2008-2012 National Trauma Data Bank. We identified cases of assault-related injury admitted to trauma centers in patients aged ≥60 using the variable "intent of injury...
September 3, 2016: Injury
W Geoffrey Wright, Jane McDevitt, Ryan Tierney, F Jay Haran, Kwadwo Osei Appiah-Kubi, Alex Dumont
PURPOSE: Balance impairment is a common sensorimotor symptom in mild traumatic brain injury (mTBI). We designed an affordable, portable virtual reality (VR)-based balance screening device (Virtual Environment TBI Screen [VETS]), which will be validated relative to the Neurocom Sensory Organization Test (SOT) to determine if it can replace commonly used postural assessments. METHODS: This preliminary study examines healthy adults (n = 56) and adults with mTBI (n = 11)...
October 10, 2016: Disability and Rehabilitation
Anne Moessner, James F Malec, Scott Beveridge, Cara Camiolo Reddy, Tracy Huffman, Julia Marton, Audrey J Schmerzler
PRIMARY OBJECTIVE: To develop and provide initial validation of a measure for accurately determining the need for Constant Visual Observation (CVO) in patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation. RESEARCH DESIGN: Rating scale development and evaluation through Rasch analysis and assessment of concurrent validity. METHODS AND PROCEDURES: One hundred and thirty-four individuals with moderate-severe TBI were studied in seven inpatient brain rehabilitation units associated with the National Institute for Disability, Independent Living and Rehabilitation Research (NIDILRR) TBI Model System...
August 11, 2016: Brain Injury: [BI]
James Q Truong, Kenneth J Ciuffreda
INTRODUCTION: Little is known about human inter-ocular pupillary asymmetry (IOPA). Thus, the purpose of the present investigation was to assess objectively static and dynamic IOPA in normals and in individuals with mild traumatic brain injury (mTBI). METHODS: The pupillary light reflex (PLR) was assessed in an adult population of normals and in those with mTBI using the Neuroptics DP-2000 binocular pupillometer. Four stimulus conditions were used to optimize the assessment...
August 11, 2016: Brain Injury: [BI]
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