Journal of neurotrauma
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Journal of neurotrauma · Jan 2016
Multicenter StudyCirculating Brain Derived Neurotrophic Factor (BDNF) Has Diagnostic and Prognostic Value in Traumatic Brain Injury.
Brain-derived neurotrophic factor (BDNF) is important for neuronal survival and regeneration. We investigated the diagnostic and prognostic values of serum BDNF in traumatic brain injury (TBI). We examined serum BDNF in two independent cohorts of TBI cases presenting to the emergency departments (EDs) of the Johns Hopkins Hospital (JHH; n = 76) and San Francisco General Hospital (SFGH, n = 80), and a control group of JHH ED patients without TBI (n = 150). ⋯ The addition of GFAP/UCH-L1 to BDNF did not improve outcome prediction significantly. Day-of-injury serum BDNF is associated with TBI diagnosis and also provides 6-month prognostic information regarding recovery from TBI. Thus, day-of-injury BDNF values may aid in TBI risk stratification.
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Journal of neurotrauma · Jan 2016
ReviewThe Role of Thalamic Damage in Mild Traumatic Brain Injury.
There is growing alarm in the United States about an epidemiologically large occurrence of mild traumatic brain injury with serious long lasting consequences. Although conventional imaging has been unable to identify damage capable of explaining its organic origin or discerning patients at risk of developing long-term or permanently disabling neurological impairment, most disease models assume that diffuse axonal injury in white matter must be present but is difficult to resolve. ⋯ This review examines recent proposals that in addition to white matter, the thalamus may be another important further site of injury. Although its possible role still remains largely under-investigated, evidence from experimental human and animal models, as well as simulational and analytical representations of mild head injury and other related conditions, suggest that this strategically vital region of the brain, which has reciprocal projections to the entire cerebral cortex, could feasibly play an important role in understanding pathology and predicting outcome.
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Journal of neurotrauma · Jan 2016
First- and second-order stimuli reaction time measures are highly sensitive to mild traumatic brain injuries.
Mild traumatic brain injury (mTBI) has subtle effects on several brain functions that can be difficult to assess and follow up. We investigated the impact of mTBI on the perception of sine-wave gratings defined by first- and second-order characteristics. Fifteen adults diagnosed with mTBI were assessed at 15 days, 3 months, and 12 months postinjury. ⋯ All these observations were made over the three sessions. The level of symptoms observed in mTBI was higher than that of control participants, and this difference did also persist up to 1 year after the brain injury, despite an improvement. The combination of RT measures with particular stimulus properties is a highly sensitive method for measuring mTBI-induced visuomotor anomalies and provides a fine probe of the underlying mechanisms when the brain is exposed to mild trauma.
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Journal of neurotrauma · Jan 2016
Who Gets Head Trauma or Recruited in Mild Traumatic Brain Injury Research?
Mild traumatic brain injury (mTBI) is a public health problem. Outcome from mTBI is heterogeneous in part due to pre-injury individual differences that typically are not well described or understood. Pre-injury health characteristics of all consecutive patients (n=3023) who underwent head computed tomography due to acute head trauma in the emergency department of Tampere University Hospital, Finland, between August 2010 and July 2012 were examined. ⋯ Age, neurological conditions, and psychiatric problems were the most common reasons for exclusion. Most of the patients sustaining an mTBI have some pre-injury diseases or conditions that could affect clinical outcome. By excluding patients with pre-existing conditions, the patients with known risk factors for poor outcome remain poorly studied.
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Journal of neurotrauma · Jan 2016
Microparticles Impair Hypotensive Cerebrovasodilation and Cause Hippocampal Neuronal Cell Injury after Traumatic Brain Injury.
Endothelin-1 (ET-1), tissue plasminogen activator (tPA), and extracellular signal-regulated kinases-mitogen activated protein kinase (ERK-MAPK) are mediators of impaired cerebral hemodynamics after fluid percussion brain injury (FPI) in piglets. Microparticles (MPs) are released into the circulation from a variety of cells during stress, are pro-thrombotic and pro-inflammatory, and may be lysed with polyethylene glycol telomere B (PEG-TB). We hypothesized that MPs released after traumatic brain injury impair hypotensive cerebrovasodilation and that PEG-TB protects the vascular response via MP lysis, and we investigated the relationship between MPs, tPA, ET-1, and ERK-MAPK in that process. ⋯ PEG-TB-treated animals also showed reduction in neuronal injury in CA1 and CA3 hippocampus, compared with control animals. These results show that serum MP levels are elevated after FPI and lead to impaired hypotensive cerebrovasodilation via over-expression of tPA, ET-1, and ERK-MAPK. Treatment with PEG-TB after injury reduces MP levels and protects hypotensive cerebrovasodilation and limits hippocampal neuronal cell injury.