Journal of neurotrauma
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Journal of neurotrauma · Dec 2016
ReviewInhibition of glycogen synthase kinase-3: an emerging target in the treatment of traumatic brain injury.
Although traumatic brain injury (TBI) has been a major public health concern for decades, the pathophysiological mechanism of TBI is not clearly understood, and an effective medical treatment of TBI is not available at present. Of particular concern is sustained TBI, which has a strong tendency to take a deteriorating neurodegenerative course into chronic traumatic encephalopathy (CTE) and dementia, including Alzheimer's disease. Tauopathy and beta amyloid (Aβ) plaques are known to be the key pathological markers of TBI, which contribute to the progressive deterioration associated with TBI such as CTE and Alzheimer's disease. ⋯ GSK-3 inhibition studies using rodent TBI models demonstrate that GSK-3 inhibition produces diverse neuroprotective actions such as reducing the size of the traumatic injury, tauopathy, Aβ accumulation, and neuronal death, by releasing and activating neuroprotective substrates from GSK-3 inhibition. These effects are correlated with reduced TBI-induced behavioral and cognitive symptoms. Here, we review studies on the therapeutic effects of GSK-3 inhibition in TBI rodent models, and critically discuss the issues that these studies address.
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Journal of neurotrauma · Dec 2016
Concussion History in Adolescent Athletes with Attention-Deficit Hyperactivity Disorder.
Little is known about the rate of concussions in adolescents with attention-deficit hyperactivity disorder (ADHD). We hypothesized that high school athletes with ADHD would report a greater history of concussion than students without ADHD. A total of 6529 adolescent and young adult student athletes, between the ages of 13 and 19 years (mean, 15.9; standard deviation, 1.3), completed a preseason health survey in 2010. ⋯ Stratified by gender, 10.0% of boys with ADHD reported a history of two or more concussions, compared to 6.7% of boys without ADHD (p<0.033; OR, 1.54), and 9.1% of girls with ADHD reported a history of two or more concussions, compared to 3.8% of girls without ADHD (p<0.006; OR, 2.51). In this large-scale, retrospective survey study, boys and girls with ADHD were significantly more likely to report a history of concussion. Additional research is needed to determine whether students with ADHD are more susceptible to injury (i.e., have a lower threshold) or have different recovery trajectories.
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Journal of neurotrauma · Dec 2016
Test or rest? Computerized cognitive testing in the emergency department after pediatric mild traumatic brain injury does not delay symptom recovery.
Rest is commonly prescribed following a mild traumatic brain injury (mTBI). There is concern that cognitive exertion by an acutely or sub-acutely injured brain may negatively alter outcome. The objective of this study was to determine if computerized cognitive testing in the emergency department alters symptom outcome from mTBI. ⋯ There also was no difference in symptom outcome for those who underwent a shortened (four subtests, mean time = 16 min) or full-length (seven subtests, mean time = 28 min) version of the computerized test. Brief cognitive exertion using a computerized cognitive assessment after mTBI in youth does not result in worse symptoms at these follow-up periods, does not prolong symptom recovery, should not be considered contraindicated to recovery, and could be considered as another tool to aid in the management of these injuries. Further research with different samples is warranted.
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Journal of neurotrauma · Dec 2016
Long-term effects of concussion on electrophysiological indices of attention in varsity college athletes: An ERP and sLORETA approach.
This study investigated the effects of a past concussion on electrophysiological indices of attention in college athletes. Forty-four varsity football athletes (22 with at least one past concussion) participated in three neuropsychological tests and a two-tone auditory oddball task while undergoing high-density event-related potential (ERP) recording. Athletes previously diagnosed with a concussion experienced their most recent injury approximately 4 years before testing. ⋯ Source localization using standardized low-resolution brain electromagnetic tomography indicated that athletes with a history of concussion generated larger electrical current density in the left inferior parietal gyrus compared to control athletes. These findings support the hypothesis that individuals with a past concussion recruit compensatory neural resources in order to meet executive functioning demands. High-density ERP measures combined with source localization provide an important method to detect long-term neural consequences of concussion in the absence of impaired neuropsychological performance.
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Few studies have investigated the influence of traumatic brain injury (TBI) on bone homeostasis; however, pathophysiological mechanisms involved in TBI have potential to be detrimental to bone. The current study assessed the effect of experimental TBI in rats on the quantity and quality of two different weight-bearing bones, the femur and humerus. Rats were randomly assigned into either sham or lateral fluid percussion injury (FPI) groups. ⋯ There were no differences in bone quantity and mechanical properties of the femoral midshaft between sham and TBI animals. There were no differences in locomotor outcomes, which suggested that post-TBI changes in bone were not attributed to immobility. Taken together, these findings indicate that this rat model of TBI was detrimental to bone and suggests a link between TBI and altered bone remodeling.