Journal of neurotrauma
-
Journal of neurotrauma · Feb 2023
Functional Connectivity in the Mouse Brainstem Represents Signs of Recovery from Concussion.
Mild traumatic brain injury (mTBI) is one of the most frequent neurological disorders. Diagnostic criteria for mTBI are based on cognitive or neurological symptoms without fully understanding the neuropathological basis for explaining behaviors. From the neuropathological perspective of mTBI, recent neuroimaging studies have focused on structural or functional differences in motor-related cortical regions but did not compare topological network properties between the post-concussion days in the brainstem. ⋯ Functional connectivity and local network properties on post-concussion day 2 were also significantly decreased compared with those on post-concussion day 14, but there were no significant group differences in global network properties between days 2 and 14. We also observed that the local efficiency and clustering coefficient of the brainstem network were significantly correlated with anxiety-like behaviors on post-concussion days 7 and 14. This study suggests that functional connectivity in the mouse brainstem provides vital recovery signs from concussion through functional reorganization.
-
Journal of neurotrauma · Feb 2023
ReviewCognitive and behavioural digital health interventions for people with traumatic brain injury and their caregivers: a systematic review.
Traumatic brain injury (TBI) leads to cognitive linguistic deficits that significantly impact on quality of life and well-being. Digital health offers timely access to specialized services; however, there are few synthesized reviews in this field. This review evaluates and synthesizes reports of digital health interventions in TBI rehabilitation and caregiver education. ⋯ Digital health interventions for people with TBI and their caregivers are feasible and all studies reported positive outcomes; however, few included blind assessors. Improved methodological rigor, clearly described intervention characteristics and consistent outcome measurement is recommended. Further research is needed regarding multi-modal digital health interventions.
-
Journal of neurotrauma · Feb 2023
ReviewMicrodialysis-based classifications of abnormal metabolic states following traumatic brain injury: a systematic review of the literature.
After traumatic brain injury (TBI), cerebral metabolism can become deranged, contributing to secondary injury. Cerebral microdialysis (CMD) allows cerebral metabolism assessment and is often used with other neuro-monitoring modalities. CMD-derived parameters such as the lactate/pyruvate ratio (LPR) show a failure of oxidative energy generation. ⋯ This is the first systematic review summarizing the published literature on microdialysis-based abnormal metabolic states following TBI. Although variability exists among individual classifications, there is broad agreement about broad definitions of metabolic crisis, ischemia, and mitochondrial dysfunction. Identifying the etiology of deranged cerebral metabolism after TBI is important for targeting therapeutic interventions.
-
Journal of neurotrauma · Feb 2023
Randomized Controlled TrialChange in hematoma size after dexamethasone therapy in chronic subdural hematoma subtypes: A prospective study in symptomatic patients.
The main treatment strategy for chronic subdural hematoma is surgical intervention. When a conservative pharmacological approach is considered in symptomatic patients, mainly dexamethasone therapy is applied. Recent trials revealed dexamethasone therapy to be an ineffective treatment in symptomatic patients with chronic subdural hematoma. ⋯ Additional surgery was performed in 57% of patients with the highest observed rate (81%) in separated hematoma. Largest hematoma reduction and better clinical improvement was observed in chronic subdural hematoma without hyperdense components after dexamethasone therapy. Evaluation of these parameters can be part of an individualized treatment strategy.