Journal of neurotrauma
-
Journal of neurotrauma · Oct 2015
ReviewSleep-wake disturbances and fatigue following pediatric traumatic brain injury: a systematic review of the literature.
Sleep-wake disturbances (SWD) after traumatic brain injury (TBI) are frequently reported and can persist several years post-injury. The adult literature covering this topic is exhaustive; numerous robust studies using objective measures of sleep and advanced methodologies support the presence of SWD post-TBI. Despite being the leading cause of morbidity in children and adolescents, however, relatively few studies exist investigating SWD and symptoms of fatigue after pediatric TBI. ⋯ Moreover, no study targeted preschool children despite the fact that there is evidence regarding the critical importance of sleep for appropriate cognitive development, especially in high-order cognitive functioning. In sum, the results of the studies analyzed were consistent with the presence of SWD and fatigue after pediatric TBI, but there is a lack of information concerning this relationship in younger children. The use of more objective measures, such as actigraphy, could bring better insight to the impact of TBI on the quality of children's sleep.
-
Journal of neurotrauma · Oct 2015
ReviewAlterations in Cholinergic Pathways and Therapeutic Strategies Targeting Cholinergic System after Traumatic Brain Injury.
Traumatic brain injury (TBI) results in varying degrees of disability in a significant number of persons annually. The mechanisms of cognitive dysfunction after TBI have been explored in both animal models and human clinical studies for decades. Dopaminergic, serotonergic, and noradrenergic dysfunction has been described in many previous reports. ⋯ Although pharmacological agents that modulate cholinergic neurotransmission have been used with varying degrees of success in previous studies, improving their function and maximizing cognitive recovery is an ongoing process. In this article, we review the previous findings on the biological mechanism of cholinergic dysfunction after TBI. In addition, we describe studies that use both older agents and newly developed agents as candidates for targeting cholinergic neurotransmission in future studies.