Journal of neurotrauma
-
Journal of neurotrauma · Feb 2014
Review Meta AnalysisOlfactory dysfunction in pediatric traumatic brain injury: A systematic review.
The neuropsychological outcomes of pediatric traumatic brain injury (TBI) have received increasing study over the past 20 years and are currently well delineated in the research literature. One outcome that has received little attention is that of olfactory dysfunction after pediatric TBI. This is despite literature indicating that anosmia and olfactory dysfunction are common after adult TBI and are likely to be linked to severity of injury, neuropathology, and executive dysfunction. ⋯ The studies found were limited by methodological weaknesses, variability in measures, small sample size, and difficulty of comparison across cohorts studied. Despite this, they reported consistent findings of anosmia and olfactory dysfunction in their TBI cohorts and identified a dose-response relationship between severity of injury and olfactory dysfunction. The results of the studies are discussed in terms of relevant findings, limitations, and areas requiring further exploration.
-
Journal of neurotrauma · Feb 2014
ReviewThe Presence and Role of Iron in Mild Traumatic Brain Injury: An Imaging Perspective.
Mild traumatic brain injury (mTBI), although often presenting without the gross structural abnormalities seen in more severe forms of brain trauma, can nonetheless result in lingering cognitive and behavioral problems along with subtle alterations in brain structure and function. Repeated injuries are associated with brain atrophy and dementia in the form of chronic traumatic encephalopathy (CTE). The mechanisms underlying these dysfunctions are poorly understood. ⋯ In addition, there is evidence that iron may contribute to pathology after mTBI through a number of mechanisms, including generation of reactive oxygen species (ROS), exacerbation of oxidative stress from other sources, and encouragement of tau phosphorylation and the formation of neurofibrillary tangles. Finally, recent animal studies suggest that iron may serve as a therapeutic target in mitigating the effects of mTBI. However, research on the presence and role of iron in mTBI and CTE is still relatively sparse, and further work is necessary to elucidate issues such as the sources of increased iron and the chain of secondary injury.
-
Journal of neurotrauma · Feb 2014
ReviewSpinal cord injury: How can we improve the classification and quantification of its severity and prognosis?
The preservation of functional neural tissue after spinal cord injury (SCI) is the basis for spontaneous neurological recovery. Some injured patients in the acute phase have more potential for recovery than others. This fact is problematic for the construction of clinical trials because enrollment of subjects with variable recovery potential makes it difficult to detect effects, requires large sample sizes, and risks Type II errors. ⋯ New imaging techniques to assess tract injury and demyelination and methods to quantify tissue injury, inflammatory markers, and neuroglial biochemical changes may improve the evaluation of injury severity, and the correlation with neurological outcome, and measure the effects of treatment more robustly than is currently possible. The ability to test such a multimodality approach will require a high degree of collaboration between clinical and research centers and government research support. When the most informative of these assessments is determined, it may be possible to identify patients with substantial recovery potential, improve selection criteria and conduct more efficient clinical trials.