Journal of neurotrauma
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Journal of neurotrauma · Jan 2018
Changes in [18F]Fluorodeoxyglucose Activities in a Shockwave-Induced Traumatic Brain Injury Model Using Lithotripsy.
We present a longitudinal study of cerebral metabolism using [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in a rat model of shockwave-induced traumatic brain injury (SW-TBI). Anesthetized rats received 5 or 10 SW pulses to the right anterior lateral or dorsal frontal regions using SW lithotripsy. Animals were scanned for FDG uptake at baseline, 3 h post-injury, and 3 days post-injury, using a small animal PET/computed tomography (CT) scanner. ⋯ Our data suggest that SW-TBI causes hypermetabolism on the impact side of the rat brain at 3 h post-injury compared with the baseline measurements. However, the increase in FDG uptake by day 3 post-injury was not significant. Further studies on post-TBI metabolic changes are needed to understand better the pathophysiology of the injury.
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Journal of neurotrauma · Jan 2018
Increased sleep need and reduction of tuberomammillary histamine neurons after rodent traumatic brain injury.
Although sleep-wake disturbances are prevalent and well described after traumatic brain injury, their pathophysiology remains unclear, most likely because human traumatic brain injury is a highly heterogeneous entity that makes the systematic study of sleep-wake disturbances in relation to trauma-induced histological changes a challenging task. Despite increasing interest, specific and effective treatment strategies for post-traumatic sleep-wake disturbances are still missing. With the present work, therefore, we aimed at studying acute and chronic sleep-wake disturbances by electrophysiological means, and at assessing their histological correlates after closed diffuse traumatic brain injury in rats with the ultimate goal of generating a model of post-traumatic sleep-wake disturbances and associated histopathological findings that accurately represents the human condition. ⋯ As histological correlate, we found a reduced number of histamine immunoreactive cells in the tuberomammillary nucleus, potentially related to increased neuroinflammation. Monoaminergic and hypocretinergic neurotransmitter systems in the hypothalamus and rostral brainstem were not affected, however. These results suggest that our rat traumatic brain injury model reflects human post-traumatic sleep-wake disturbances and associated histopathological findings very accurately, thus providing a study platform for novel treatment strategies for affected patients.
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Journal of neurotrauma · Dec 2017
Multicenter StudyFunctional outcomes in very early (<5 hours) and early (5-24 hours) surgical decompression in traumatic cervical spinal cord injury. Analysis of Neurological Improvement from the Austrian Spinal Cord Injury Study (ASCIS).
Our study aim was to assess the neurological outcomes of surgical decompression and stabilization within 5 and 24 h after injury. We performed a multi-center, retrospective cohort study in adolescents and adults 15-85 years of age presenting cervical spinal cord injury (CSCI) at one of 6 Austrian trauma centers participating in the Austrian Spinal Cord Injury Study (ASCIS). Neurological outcomes were measured using the American Spinal Injury Association Impairment Scale (AIS) grade according to the International Standards For Neurological Classification Of Spinal Cord Injury (ISNCSCI) form after at least 6 months of follow-up (FU). ⋯ Improvement by three AIS grades was observed in 6% and 3% of patients in the early and very early groups, respectively (p = 1.0). Decompression of the spinal cord within 24 h after SCI was associated with an improved neurological outcome. No additional neurological benefit was observed in patients who underwent decompression within 5 h of injury.
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Individuals with cervical spinal cord injury (SCI) have impaired thermoregulatory mechanisms attributed to interruption of motor, sensory, and autonomic neuropathways. To determine the effects of heat exposure on core body temperature (Tcore) and cognitive performance in persons with tetraplegia, 8 individuals with chronic tetraplegia (C3-C7, American Spinal Cord Injury Association Impairment Scale A-B) and 9 able-bodied controls were acclimated to 27°C at baseline (BL) before being exposed to 35°C for up to 120 min (Heat Challenge). Rectal temperature (Tcore), distal skin temperatures (Tskavg), sweat rate (QSavg), microvascular skin perfusion (LDFavg), and plasma norepinephrine (NE) were measured. ⋯ Stroop Color, Interference, and WAIS-IV Sequence scores increased only in tetraplegics (19.4 ± 17.2%; p < 0.05, 8.3 ± 5.9%; p < 0.05, 29.1 ± 27.4%; p < 0.05, respectively). Dysfunctional thermoregulatory mechanisms in the tetraplegic group allowed Tcore to rise from subnormal levels to normothermia during heat exposure. Normothermia was associated with improvements in attention, working memory, and executive function.