Journal of neurotrauma
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Journal of neurotrauma · Apr 2014
Clinical TrialSport Concussion Assessment Tool 2 in a Civilian Trauma Sample with Mild Traumatic Brain Injury.
The aim of the study was to evaluate the validity of the Sport Concussion Assessment Tool-Second Edition (SCAT2) in patients with acute mild traumatic brain injuries (mTBIs) in a civilian trauma setting. In addition, the SCAT2 was compared to the Military Acute Concussion Evaluation (MACE). All the participants of the study were prospectively recruited from the emergency department of Tampere University Hospital (Tampere, Finland). ⋯ Symptom scores differentiated patients with mTBIs from controls, and elevated initial symptom scores in patients with mTBI were associated with a greater risk of persistent postconcussion symptoms. The SCAT2 was superior to the MACE. The SCAT2 appears useful for detecting acute mTBI-related symptoms and cognitive impairment, refining prognosis, and monitoring recovery.
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Journal of neurotrauma · Apr 2014
Post-acute Brain Injury Urinary Signature: A New Resource for Molecular Diagnostics.
Heterogeneity within brain injury presents a challenge to the development of informative molecular diagnostics. Recent studies show progress, particularly in cerebrospinal fluid, with biomarker assays targeting one or a few structural proteins. Protein-based assays in peripheral fluids, however, have been more challenging to develop, in part because of restricted and intermittent barrier access. ⋯ Identified peptide constituents were enriched for outgrowth and guidance, extracellular matrix, and post-synaptic density proteins, which were reflective of ongoing post-acute neuroplastic processes demonstrating pathobiological relevance. Taken together, these findings support further development of diagnostics based on brain injury urinary signatures using either combinatorial quantitative models or pattern-recognition methods. Particularly, these findings espouse assay development to address unmet diagnostic and theragnostic needs in brain injury rehabilitative medicine.
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Journal of neurotrauma · Apr 2014
Prevalence of and risk factors for poor functioning after isolated mild traumatic brain injury in children.
This study aimed to determine the prevalence and predictors of poor 3 and 12 month quality of life outcomes in a cohort of pediatric patients with isolated mild TBI. We conducted a prospective cohort study of children and adolescents <18 years of age treated for an isolated mild TBI, defined as "no radiographically apparent intracranial injury" or "an isolated skull fracture, and no other clinically significant non-brain injuries." The main outcome measure was the change in quality of life from baseline at 3 and 12 months following injury, as measured by the Pediatric Quality of Life index (PedsQL). ⋯ Significant predictors of poor functioning included less parental education, Hispanic ethnicity (at 3 months following injury, but not at 12 months); low household income (at 3 and 12 months), and Medicaid insurance (at 12 months only). Children and adolescents sustaining a mild TBI who are socioeconomically disadvantaged may require additional intervention to mitigate the effects of mild TBI on their functioning.
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Journal of neurotrauma · Apr 2014
Attentional control 10 years post childhood traumatic brain injury: the impact of lesion presence, location and severity in adolescence and early adulthood.
The relationship between brain injury and attentional control (AC) long after a childhood traumatic brain injury (TBI) has received limited investigation. The aim of this article was to investigate the impact that lesion presence, location, and severity has on AC in a group of young persons who had sustained a moderate to severe TBI 10 years earlier during childhood. The participants in this study were a subset of a larger 10-year, follow-up assessment comprised of 31 persons in late adolescence and early adulthood (21 males), with a mean age at testing of 15.4 years (standard error 0.6; range 10.7-21.2 years). ⋯ When using standardized testing with subtests of the TEA-ch, no differences in performance between those with and those without a lesion at 10 years post-TBI were found. On standardized behavioral measures such as parental reports of perceived AC (Behavior Rating Inventory of Executive Function), however, the presence of a lesion was found to have a detrimental effect on the ability to self-regulate and monitor behavior in late adolescence and the early stages of adulthood. We discuss these results and propose that there is a network of brain regions associated with AC, and generalized lesions have the greatest influence on such abilities.
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Journal of neurotrauma · Apr 2014
Traumatic brain injury in vivo and in vitro contributes to cerebral vascular dysfunction through impaired gap junction communication between vascular smooth muscle cells.
Gap junctions (GJs) contribute to cerebral vasodilation, vasoconstriction, and, perhaps, to vascular compensatory mechanisms, such as autoregulation. To explore the effects of traumatic brain injury (TBI) on vascular GJ communication, we assessed GJ coupling in A7r5 vascular smooth muscle (VSM) cells subjected to rapid stretch injury (RSI) in vitro and VSM in middle cerebral arteries (MCAs) harvested from rats subjected to fluid percussion TBI in vivo. Intercellular communication was evaluated by measuring fluorescence recovery after photobleaching (FRAP). ⋯ In isolated MCAs from rats treated with the ONOO(-) scavenger, penicillamine, GJ coupling was not impaired by fluid percussion TBI. In addition, penicillamine treatment improved vasodilatory responses to reduced intravascular pressure in MCAs harvested from rats subjected to moderate fluid percussion TBI. These results indicate that TBI reduced GJ coupling in VSM cells in vitro and in vivo through mechanisms related to generation of the potent oxidant, ONOO(-).