Journal of neurotrauma
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Journal of neurotrauma · Dec 2021
Three-Month Psychiatric Outcome of Pediatric Mild Traumatic Brain Injury: A Controlled Study.
The objective was to clarify occurrence, phenomenology, and risk factors for novel psychiatric disorder (NPD) in the first 3 months after mild traumatic brain injury (mTBI) and orthopedic injury (OI). Children aged 8-15 years with mTBI (n = 220) and with OI but no TBI (n = 110) from consecutive admissions to an emergency department were followed prospectively at baseline and 3 months post-injury with semi-structured psychiatric interviews to document the number of NPDs that developed in each participant. Pre-injury child variables (adaptive, cognitive, and academic function, and psychiatric disorder), pre-injury family variables (socioeconomic status, family psychiatric history, and family function), and injury severity were assessed and analyzed as potential confounders and predictors of NPD. ⋯ In multi-predictor analyses, the factors besides mTBI that were significantly associated with higher NPD frequency after adjustment for each other were pre-injury lifetime psychiatric disorder [MR = 2.284, CI95 (1.026, 5.305), p = 0.043]; high versus low family psychiatric history [MR = 2.748, CI95 (1.201, 6.839), p = 0.016], and worse socio-economic status [MR = 0.618 per additional unit, CI95 (0.383, 0.973), p = 0.037]. These findings demonstrate that mild injury to the brain compared with an OI had a significantly greater deleterious effect on psychiatric outcome in the first 3 months post-injury. This effect was present even after accounting for specific child and family variables, which were themselves independently related to the adverse psychiatric outcome.
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Journal of neurotrauma · Dec 2021
Altered attention network in paratroopers exposed to repetitive subconcussion: evidence based on behavioral and ERP results.
Cognitive impairment caused by repetitive subconcussion has received increasing attention in recent years. Although the dysfunction of attention has been confirmed by neuropsychological research using scales, there is no event-related potentials (ERPs) research. The Attention Network Test (ANT) has been widely used to evaluate the three separate components of attention processing (alerting, orienting, and executive control). ⋯ Moreover, there was a reduced P3 amplitude in the executive control network in the subconcussion group compared with the HCs group, suggesting a dysfunction of attentional resource allocation and inhibition control in the former group. This study is, to our knowledge, the first analysis of the altered attention network caused by repetitive subconcussion from the perspectives of behavioral and neuropsychology levels. These preliminary results revealed the possible damage of the alerting and executive control networks and provided a reference for further research on subconcussion cognitive impairment.
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Journal of neurotrauma · Dec 2021
Arcuate Fasciculus Subsegment Impairments Distinctly Associated with Memory and Language Deficits in Acute Mild Traumatic Brain Injury Patients.
In acute mild traumatic brain injury (mTBI), the injury-related axonal swelling leads to white matter fiber bundle impairments, closely related to the memory and language deficits commonly shown in the patients. The arcuate fasciculus (AF) plays a central role in verbal learning and language function but could be functionally heterogeneous along the fiber tract. In this study, 25 patients with acute mTBI (<48 h after trauma) and 33 age- and sex-matched healthy controls (HCs) were included. ⋯ On the other hand, the correlation between the FA in the right AF frontal subsegment and the language function in HCs diminished in the patient group. Moreover, the functional connectivity between the inferior frontal gyrus and the middle occipital gyrus decreased, and its correlation with language function in HCs was absent in the patients with mTBI. Our work provides new insights into the understanding of the structural and functional heterogeneity of the AF tracts as well as the distinct associations of its subsegment impairments with verbal memory and language function deficits in patients with acute mTBI.
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Journal of neurotrauma · Dec 2021
Fetal and perinatal expression profiles of proinflammatory cytokines in the neuroplacodes of rats with myelomeningoceles: A contribution to the understanding of secondary spinal cord injury in open spinal dysraphism.
The cellular and molecular mechanisms that presumably underlie the progressive functional decline of the myelomeningocele (MMC) placode are not well understood. We previously identified key players in post-traumatic spinal cord injury cascades in human MMC tissues obtained during postnatal repair. In this study, we conducted experiments to further investigate these mediators in the prenatal time course under standardized conditions in a retinoic acid-induced MMC rat model. ⋯ C-X3-C motif ligand 1 mRNA was lower in MMC tissues than in control tissues on E16. The presented findings contribute to the concept that pathophysiological mechanisms, such as cytokine induction in the neuroplacode, in addition to the "first hit," promote secondary spinal cord injury with functional loss in the late fetal time course. Further, these mediators should be taken into consideration in the development of new therapeutic approaches for open spinal dysraphism.