Journal of neurotrauma
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Journal of neurotrauma · Jun 2022
History of Mild Traumatic Brain Injury Affects Static Balance Under Complex Multisensory Manipulations.
A recent study in active-duty military in the Coast Guard suggested that lifetime experience with mild traumatic brain injury (mTBI) was associated with subtle deficits in postural control when exposed to multi-sensory discordance (i.e., rotating visual stimulation). The present study extended postural assessments to veterans recruited from the community. Service veterans completed the Defense Veteran Brain Injury Center TBI Screening Tool, Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), and Neurobehavioral Symptom Inventory (NSI). ⋯ Increased postural sway was not related to PTSD, NSI, or balance-specific symptom expression. In summary, veterans who experienced mTBI over their lifetime exhibited dysfunction in balance control as revealed by challenging conditions with multi-sensory discordance. These balance-related signs were independent of self-reported balance-related symptoms or other symptom domains measured by the NSI, which can provide a method for exposing otherwise covert dysfunction long after the experience of mTBI.
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Journal of neurotrauma · Jun 2022
Improving the Precision of the Glasgow Outcome Scale-Extended Using Item Response Theory: A TRACK-TBI Study.
The Glasgow Outcome Scale-Extended (GOSE) is a functional outcome measure intended to place individuals with traumatic brain injury (TBI) into one of eight broad levels of injury-related disability. This simplicity is not always optimal, particularly when more granular assessment of individuals' injury recovery is desired. The GOSE, however, is customarily assessed using a multi-question interview that contains richer information than is reflected in the GOSE score. ⋯ Moreover, GOSE-IRT scores were significantly more strongly associated with measures of TBI-related symptoms, psychological symptoms, and quality of life. Our findings demonstrate that rescoring the GOSE interview using IRT yields more granular, meaningful measurement of injury-related functional limitations, while adding no additional respondent or examiner burden. This technique may have utility for many applications, such as clinical trials aiming to detect small treatment effects, and small-scale studies that need to maximize statistical efficiency.
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Journal of neurotrauma · Jun 2022
ASSOCIATION BETWEEN ALTERED CORTISOL PROFILES AND NEUROBEHAVIORAL IMPAIRMENT FOLLOWING mTBI IN COLLEGE STUDENTS.
Mild traumatic brain injury (mTBI) is the most common form of TBI, with more than 2.5 million TBI cases in the United States annually. Identification of easily obtainable biomarkers that track strongly with mTBI symptoms may improve our understanding of biological factors that contribute to mTBI symptom profiles and long-term outcomes. Notably, some individuals with mTBI exhibit circadian disruptions and elevated stress sensitivity, which in other clinical groups often correlate with disrupted secretion of cortisol, a glucocorticoid hormone that coordinates circadian and stress physiology. ⋯ Further, female mTBI subjects exhibited diminished neurobehavioral function compared with males. Regardless of sex, decreased amplitude of diurnal cortisol and a blunted cortisol awakening response were associated with mTBI symptom severity and neurobehavioral impairment. Taken together, these findings suggest that salivary cortisol profiles may be a sensitive biomarker for studying underlying biological factors that impact mTBI symptoms and outcomes.