Journal of neurotrauma
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Journal of neurotrauma · May 2018
Neuroimmunology of Traumatic Brain Injury: A Longitudinal Study of Interdependency of Inflammatory Markers and Heart Rate Variability in Severe Traumatic Brain Injury.
The aim of the present study is to evaluate the interdependency between heart rate variability (HRV) and inflammatory markers in patients with severe traumatic brain injury (TBI). A prospective exploratory study was done with a sample size of 89 patients. HRV of these patients was recorded using a telemetric device. ⋯ An increase in IL-10 levels correlated with the unfavorable outcome. This study highlights the association between the HRV parameters and immune response. The timely management of both autonomic and immune dysfunction in patients with severe TBI may have an impact in preventing the secondary injury process.
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Journal of neurotrauma · May 2018
Functional Status Examination in Patients with Moderate-to-Severe Traumatic Brain Injuries.
The assessment of functional status after traumatic brain injury (TBI) is important. The Glasgow Outcome Scale (GOS) and its revised version, the Glasgow Outcome Scale Extended (GOSE), have been used most frequently in TBI research, but there are concerns about the sensitivity of these measures. ⋯ In addition, there was a significant agreement (r = 0.817, p < 0.001) between the patient and significant other's assessment of functional status on the FSE at 6 months post-injury. The FSE may be a valuable measure of functional status after TBI given its strong psychometric properties, including validity, sensitivity to brain injury severity, and recovery over time.
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Journal of neurotrauma · May 2018
Abnormal turning and its association with self-reported symptoms in chronic mTBI.
Turning is common in daily activity and requires rapid, coordinated reorientation of the head, trunk, and pelvis toward the new direction of travel. Yet, turning gait has not been well explored in populations with mild traumatic brain injury (mTBI) who may alter their turning behavior according to self-perceived symptoms or motor dysfunction. The purpose of this study was to examine turning velocities and coordination in adults with chronic mTBI (>3 months post-injury and still reporting balance complaints) during a task simulating everyday ambulation. ⋯ Within the chronic mTBI group, somatosensory symptoms were associated with slower angular velocities of the head and pelvis (p = 0.03) and increased PVT variability (p < 0.01). The results suggest individuals with chronic mTBI with worse somatic symptoms have impaired head stabilization during turning in situations similar to everyday life. These results encourage future research on turning gait to examine the causal relationship between symptoms and daily locomotor function in adults with chronic mTBI.
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Journal of neurotrauma · May 2018
Imaging of Cerebrovascular Function in Chronic Traumatic Brain Injury.
Traumatic cerebrovascular injury (TCVI) is a common pathologic mechanism of traumatic brain injury (TBI) and presents an attractive target for intervention. The aims of this study were to assess cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) using magnetic resonance imaging (MRI) to assess their value as biomarkers of TCVI in chronic TBI, characterize the spatial distribution of TCVI, and assess the relationships between each biomarker and neuropsychological and clinical assessments. Forty-two subjects (27 chronic TBI, 15 age- and gender-matched healthy volunteers) were studied cross-sectionally. ⋯ CBF is less useful as biomarker of TCVI. CVR correlates best with chronic TBI symptoms. CVR has potential as a predictive and pharmacodynamic biomarker for interventions targeting TCVI.
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Journal of neurotrauma · May 2018
Perceived Injustice and Its Correlates after Mild Traumatic Brain Injury.
Perceived injustice is a belief that one has been treated unfairly and disrespectfully, and is suffering unnecessarily as a result of another person's actions. Perceived injustice predicts chronic disability after musculoskeletal injury but to our knowledge has not been empirically studied in people with mild traumatic brain injuries (mTBIs). We examined perceived injustice and its correlates in patients who were slow to recover from mTBI. ⋯ Patients who failed performance validity testing (Cohen's d = 0.48) or were seeking/receiving compensation (d = 0.92) reported greater perceived injustice. Greater perceived injustice was associated with greater post-concussion symptoms (r = 0.48), traumatic stress (r = 0.69), depression (r = 0.60), bodily pain (r = 0.32), and negative expectations for recovery (r = 0.40; all p < 0.01). Given that perceived injustice is a belief system that can influence health behaviors, it might be a viable target for psychological treatment.