Journal of neurotrauma
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Journal of neurotrauma · Jul 2017
Applying systems biology methodology to identify genetic factors possibly associated with recovery after traumatic brain injury.
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality worldwide. It is linked with a number of medical, neurological, cognitive, and behavioral sequelae. The influence of genetic factors on the biology and related recovery after TBI is poorly understood. ⋯ Overall, this study demonstrates the use of a systems biology-based approach to identify unique/novel genes or sets of genes important to the recovery process. Findings from this systems biology-based approach provide additional insight into the potential impact of genetic variants on the underlying complex biological processes important to TBI recovery and may inform the development of empirical genetic-related studies for TBI. Future studies that combine systems biology methodology and genomic, proteomic, and epigenetic approaches are needed in TBI.
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Journal of neurotrauma · Jul 2017
Directions for use of intracranial pressure monitoring in treatment of severe traumatic brain injury using data from the Japan Neurotrauma Data Bank.
Neuromonitoring can be used to observe intracranial pathological conditions in neurointensive care; however, use of intracranial pressure (ICP) monitoring is low in Japan. In this study, we retrospectively investigated the effects of ICP monitoring in the treatment of severe traumatic brain injury (TBI), using data from the Japan Neurotrauma Data Bank (JNTDB). The study was conducted in 1091 subjects enrolled in the JNTDB (Project 2009) from July 2009 to June 2011. ⋯ In multivariate analysis, age, GCS, pupillary abnormalities, perimesencephalic cistern disappearance or compression, and ICP were associated with a favorable outcome, but the therapeutic method did not affect outcome. We conclude that ICP monitoring and management of ICP are both important for management and care of severe TBI. However, current therapies do not control ICP sufficiently, and more effective therapies are needed.
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Journal of neurotrauma · Jul 2017
Subconcussive impact -dependent increase in plasma S100β levels in collegiate football players.
The current study investigates whether repetitive subconcussive impacts cause changes in plasma S100β levels, and also tests the associations between S100β changes and frequency/magnitude of impacts sustained. This prospective study of 22 Division-I collegiate football players included baseline and pre-season practices (one helmet-only and four full-gear). Blood samples were obtained and assessed for S100β levels at baseline and pre- to post-practices; symptom scores were assessed at each time-point. ⋯ Players in the higher impact group showed consistently greater increases in plasma S100β levels, but not symptom scores, at each post-practice than the lower impact group. Collectively, these data suggest that although players continued to play without noticeable change in symptoms, a brain-enriched serological factor suggests an acute burden from head impacts. Assessing the effects of repetitive subconcussive head impacts on acute changes in S100β levels may be a clinically useful blood biomarker in tracking real-time acute brain damage in collegiate football players.
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Journal of neurotrauma · Jul 2017
ReviewThe effect of concussion or mild traumatic brain injury on academic outcomes: A systematic review.
Concussion often results in symptoms, including difficulty concentrating, focusing, and remembering, that are typically managed with cognitive and physical rest. Often, the school environment is not conducive to cognitive rest and may lead to worsening or prolonged symptoms that can contribute to impaired academic performance. The objective of the review was to identify and summarize literature concerning the effects of concussion or mild traumatic brain injury (mTBI) on academic outcomes. ⋯ Four examined school absenteeism and found that students who developed post-concussion syndrome missed significantly more school days and took longer to return to school than students with extremity injuries. Although mTBI or concussion is associated with missed school, the results demonstrate minimal impact on school grades and national examination scores at a group level. Further research is needed to identify risk factors for impaired school functioning following mTBI and concussion in individual patients.
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Journal of neurotrauma · Jul 2017
Inter-Subject Variability of Axonal Injury in Diffuse Traumatic Brain Injury.
Traumatic brain injury (TBI) is a leading cause of cognitive morbidity worldwide for which reliable biomarkers are needed. Diffusion tensor imaging (DTI) is a promising biomarker of traumatic axonal injury (TAI); however, existing studies have been limited by a primary reliance on group-level analytic methods not well suited to account for inter-subject variability. In this study, 42 adults with TBI of at least moderate severity were examined 3 months following injury and compared with 35 healthy controls. ⋯ In moderate-to-severe TBI, there is substantial inter-subject variation in TAI, with extent strongly correlated to post-traumatic deficits in processing speed. Significant group-level effects do not necessarily represent consistent effects at the individual level. Better accounting for inter-subject variability in neurobiological manifestations of TBI may substantially improve the ability to detect and classify patterns of injury.