Journal of neurotrauma
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Journal of neurotrauma · Feb 2009
Glucocorticoids aggravate retrograde memory deficiency associated with traumatic brain injury in rats.
Administration of glucocorticoid to patients with head injury has previously been demonstrated to impair memory. We hypothesize that glucocorticoids promote post-traumatic hippocampal apoptosis, resulting in retrograde memory deficiency associated with traumatic brain injury (TBI). In the present study, we tested this hypothesis by measuring spatial memory deficiency in rats subjected to fluid percussion injury (FPI) and receiving dexamethasone (DXM at 0.5-10 mg/kg) or methylprednisolone (MP at 5-30 mg/kg); we also examined neuronal apoptosis in hippocampus. ⋯ TUNEL-positive cells in hippocampus were first detected 24 h post-injury, plateauing at 48h. The number of TUNEL-positive cells was significantly higher in injured rats treated with either DXM or MP. The data suggest that glucocorticoid therapy for TBI may increase neuronal apoptosis in hippocampus and, as a result, aggravate retrograde memory deficits induced by TBI.
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Journal of neurotrauma · Feb 2009
Nonlinear pressure-flow relationship is able to detect asymmetry of brain blood circulation associated with midline shift.
Reliable and noninvasive assessment of cerebral blood flow regulation is a major challenge in acute care monitoring. This study assessed dynamics of flow regulation and its relationship to asymmetry of initial computed tomography (CT) scan using multimodal pressure flow (MMPF) analysis. Data of 27 patients (38 +/- 15 years old) with traumatic brain injury (TBI) were analyzed. ⋯ The difference in phase shift between CPP and BFV in the left and right side was strongly correlated to the midline shift (R = 0.78; p < 0.0001). These findings indicate that the MMPF method allows reliable assessment of alterations in pressure and flow relationship after TBI. Moreover, mean pressure-flow phase shift is sensitive to the displacement of midline of the brain, and may potentially serve as a marker of asymmetry of cerebral autoregulation.
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Journal of neurotrauma · Feb 2009
Attitudes toward the elderly with CNS trauma: a cross-sectional study of neuroscientists, clinicians, and allied-health professionals.
Despite the potential impact of ageist attitudes on outcomes of central nervous system (CNS)-injured patients, little has been reported on this issue. Given this, we sought to conduct a questionnaire-based survey to assess the attitudes toward the elderly among basic and clinical neuroscientists, clinicians, and allied-health professionals whose research or medical practice is focused on neurotrauma. We also reviewed all abstracts presented in the National Neurotrauma Symposia from 1984 to 2007 and identified previous studies on the potential effects of age/aging on outcomes. ⋯ These findings may reflect a lack of knowledge and misconceptions regarding the impact of aging and old age on outcomes after CNS trauma. Further research on the impact of aging on outcomes after neurotrauma is required. Moreover, knowledge translation and mobilization appears required to positively influence attitudes among neuroscience research and clinical professionals regarding the issues of neurotrauma and the elderly.
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Journal of neurotrauma · Feb 2009
Effect of post-traumatic mild hypothermia on hippocampal cell death after traumatic brain injury in rats.
In this investigation, we evaluated the effect of post-traumatic mild hypothermia on cell death in the hippocampus after fluid percussion traumatic brain injury (TBI) in rats. Adult male Sprague-Dawley rats were randomly divided into three groups (n = 40/group): TBI with hypothermia treatment (32 degrees C), TBI with normothermia (37 degrees C), and sham injury. The TBI model was induced by a fluid percussion TBI device. ⋯ Based on RT-PCR and Western blotting results, the expression of caspase-3 was 186.20 +/- 6.20% and 142.30 +/- 5.10% in the normothermic TBI group, versus only 152.10 +/- 3.60% and 120.60 +/- 3.90% in the hypothermic TBI group (p < 0.05). Based on our findings, we conclude that post-traumatic hypothermia significantly attenuates cell death within the hippocampus following fluid percussion injury. Taken together with other studies, these observations support the premise that post-traumatic mild hypothermia can provide cerebral protection for patients with TBI.
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Journal of neurotrauma · Feb 2009
Pharyngeal selective brain cooling improves neurofunctional and neurocognitive outcome after fluid percussion brain injury in rats.
Therapeutic hypothermia (TH) after cardiac arrest reduces mortality and improves neurological outcome. Experimental TH after traumatic brain injury (TBI) indicated similar effects, but benefits were not reproducible in large clinical trials. Therefore, a novel approach of pharyngeal selective brain cooling (pSBC) was tested in respect to neurological outcome in a model of experimental TBI. ⋯ In the time course of the experiment, pSBC-animals showed superior neurofunctional recovery on DPI 7 (p = 0.03) and 14 (p = 0.002). Similarly, distance, time, and maximum speed on the Rota-Rod were significantly increased in pSBC-animals on DPI 7 (p < 0.01) and 14 (p < 0.01), as well as latency, distance, and mean number of errors in the BCM on DPI 14 (p < 0.01). The novel approach of pSBC was associated with improved neuromotor, sensormotor, and neurocognitive outcome after experimental TBI.