Journal of neurotrauma
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Journal of neurotrauma · Jan 2023
Randomized Controlled TrialMilnacipran ameliorates executive function impairments following frontal lobe traumatic brain injury in male rats: a multimodal behavioral assessment.
Traumatic brain injuries (TBIs) affect more than 10 million patients annually worldwide, causing long-term cognitive and psychosocial impairments. Frontal lobe TBIs commonly impair executive function, but laboratory models typically focus primarily on spatial learning and declarative memory. We implemented a multi-modal approach for clinically relevant cognitive-behavioral assessments of frontal lobe function in rats with TBI and assessed treatment benefits of the serotonin-norepinephrine reuptake inhibitor, milnacipran (MLN). ⋯ Both AST tests revealed significant deficits in TBI+VEH rats, seen as elevated total trials and errors (p < 0.05), which generally normalized in MLN-treated rats (p < 0.05). This first simultaneous dual AST assessment demonstrates oAST and dAST are sufficiently sensitive and robust to detect subtle attentional and cognitive flexibility executive impairments after frontal lobe TBI in rats. Chronic MLN administration shows promise for attenuation of post-TBI executive function deficits, thus meriting further investigation.
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Journal of neurotrauma · Jan 2023
Randomized Controlled TrialUse of olanzapine to treat agitation in traumatic brain injury: a series of n-of-one trials.
Agitation is common during post-traumatic amnesia (PTA) following traumatic brain injury (TBI) and is associated with risk of harm to patients and caregivers. Antipsychotics are frequently used to manage agitation in early TBI recovery despite limited evidence to support their efficacy, safety, and impact upon patient outcomes. The sedating and cognitive side effects of these agents are theorized to exacerbate confusion during PTA, leading to prolonged PTA duration and increased agitation. ⋯ Importantly, administration of olanzapine during PTA may lead to increased patient confusion, possibly prolonging PTA. When utilizing olanzapine, physicians must therefore balance the possible advantages of agitation management with the possibility that the patient may never respond to the medication and may experience increased confusion, longer PTA and potentially poorer outcomes. Further high-quality research is required to support these findings and the efficacy and outcomes associated with the use of any pharmacological agent for the management of agitation during the PTA period.
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Journal of neurotrauma · Jan 2023
Clinical and blood biomarker trajectories after concussion: New insights from a longitudinal pilot study of professional flat-track jockeys.
There is a recognized need for objective tools for detecting and tracking clinical and neuropathological recovery after sports-related concussion (SRC). Although computerized neurocognitive testing has been shown to be sensitive to cognitive deficits after SRC, and some blood biomarkers have shown promise as indicators of axonal and glial damage, the potential utility of these measures in isolation and combination for assisting SRC diagnosis and tracking recovery is not well understood. To provide new insights, we conducted a prospective study of 64 male and female professional flat-track jockeys (49 non-SRC, 15 SRC), with each jockey undergoing symptom evaluation, cognitive testing using the CogSport battery, and serum biomarker quantification of glial fibrillary acidic protein (GFAP), tau, and neurofilament light (NfL) using a Simoa HD-X Analyzer. ⋯ Relatively prolonged changes in serum NfL were observed, with elevated levels and classification utility persisting beyond the resolution of SRC symptoms and cognitive deficits. Finally, SRC classification performance throughout the 1st month after SRC was optimized through the combination of cognitive testing and serum biomarkers. Considered together, these findings provide further evidence for a role of computerized cognitive testing and fluid biomarkers of neuropathology as objective measures to assist in the identification of SRC and the monitoring of clinical and neuropathological recovery.
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Journal of neurotrauma · Jan 2023
Telling the Whole Story: Bibliometric Network Analysis to Evaluate Impact of Media Attention on Chronic Traumatic Encephalopathy Research.
There is a national debate regarding the existence of a relationship between contact sport participation and future risk of neurodegenerative disease. We employed bibliometrics and altmetrics to quantify the academic, popular, and social media impact of published scientific articles that report an association between contact sports or military service with chronic traumatic encephalopathy (CTE+), and compare with those scientific articles that report null or no association of contact sports or military service with CTE (CTE-). In this cross-sectional study, we extracted number of citations, total link strength, altmetric score, number of news stories, media outlets, and Twitter interaction from published CTE articles. ⋯ CTE- publications had an average of 29 citations per article, Altmetric score of 39, two news stories and media outlets, and upper-bound of Twitter users of 91,070. Top 10 CTE+ publications had, on average, 94% more citations (p < 0.001), 95% higher altmetric scores (p = 0.01), 99% higher number of news stories (p = 0.01), 98% higher number of media outlets (p = 0.01), and reached 95% more Twitter users than top 10 CTE- publications (p = 0.11). The bibliometric analysis indicates a significant inequality in media dissemination and popular consumption of scientific findings that do not support a relationship between contact sports or military service and future neurodegeneration.
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Journal of neurotrauma · Jan 2023
A Study of 309 Patients and at One Year Follow-up for Depression Following Traumatic Brain Injury.
Traumatic brain injury (TBI) is one the major causes of death and morbidity in developing countries, where depression is a common psychiatric condition among individuals with TBI. The objectives were to investigate the occurrence and severity of depression one-year post-TBI; the association between radiological findings and depression; and the risk factors. We report a cross-sectional study among adult patients who were hospitalized because of TBI in the past one year. ⋯ The risk factors for depression at one-year post-TBI are moderate-severe TBI (odds ratio [OR]: 3.75, 95% confidence interval [CI] 2.03-6.90, p < 0.00), being unmarried (OR: 2.67, 95% CI 1.51-4.72, p = 0.001), female gender (OR: 2.62, 95% CI 1.25-5.46, p = 0.011), alcohol consumption (OR: 2.38, 95% CI 1.12-5.06, p = 0.024) and frontal lobe injury (OR: 1.96, 95% CI 1.05-3.68, p = 0.035). Increasing severity of TBI is associated with worsening levels of depression. Patients with frontal lobe injury have the highest risk of depression, while diffuse injury is associated with occurrence of moderate and moderately severe depression.