Journal of neurotrauma
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Journal of neurotrauma · Feb 2008
Identification of serum biomarkers in brain-injured adults: potential for predicting elevated intracranial pressure.
Brain injury biomarkers may have clinical utility in stratifying injury severity level, predicting adverse secondary events or outcomes, and monitoring the effectiveness of therapeutic interventions. As a biomarker source, serum offers several advantages over cerebrospinal fluid (CSF), including ease of accessibility and reduced risk to the patient. We screened pooled serum samples obtained from 11 severely injured traumatic brain injury (TBI) patients (Glasgow Coma Scale [GCS]
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Journal of neurotrauma · Feb 2008
Nicotinamide treatment provides acute neuroprotection and GFAP regulation following fluid percussion injury.
Previous studies in our laboratory have demonstrated the preclinical efficacy of nicotinamide (NAM; vitamin B3) treatment following fluid percussion injury (FPI). At a dose of 500 or 50 mg/kg, NAM significantly facilitated recovery of function on a variety of motor and sensorimotor tasks in rodents, and the 500 mg/kg dose improved cognitive performance. The purpose of the present study was to examine the acute neuroprotective ability of NAM following FPI. ⋯ However, the inverse was observed at 7 days where NAM treatment significantly increased the number of GFAP(+) astrocytes. Both doses of NAM also significantly reduced FJ expression at the 24-h and 7-day time intervals. The results of this study suggest that NAM has strong neuroprotective abilities in the injured brain and may have therapeutic potential for brain injury.
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Journal of neurotrauma · Feb 2008
Differential neuroprotective properties of endogenous and exogenous erythropoietin in a mouse model of traumatic brain injury.
Both heat acclimation (HA) and post-injury treatment with recombinant human erythropoietin (Epo, rhEpo, exogenous Epo) are neuroprotective against traumatic brain injury (TBI). Our previous data demonstrated that HA-induced neuroprotection includes improved functional recovery and reduced cerebral edema formation. Additionally, in earlier Western-blot analyses, we found that HA mice display increased expression of the specific erythropoietin receptor (EpoR) and of hypoxia-inducible factor-1 alpha (HIF-1 alpha), the inducible subunit of the transcription factor, which regulates Epo gene expression, but not of Epo itself. ⋯ Treatment with anti-Epo antibody given to NT mice increased edema formation, whereas rhEpo induced no beneficial effect. Cognitive performance testing and immunohistochemical findings reinforced HA and rhEpo as separate protective interventions but showed no advantage to combining the two strategies. We therefore suggest that HA-induced neuroprotection is shaped by pre-existing mediators but cannot be modified by post-injury treatment aimed at increasing the levels of neuroprotective agents.
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Journal of neurotrauma · Jan 2008
Review Meta AnalysisHypothermia treatment for traumatic brain injury: a systematic review and meta-analysis.
In this study, we conducted an updated meta-analysis of the effects of hypothermia therapy on mortality, favorable neurologic outcome, and associated adverse effects in adults with traumatic brain injury (TBI) for use by Brain Trauma Foundation (BTF)/American Association of Neurological Surgeons (AANS) task force to develop evidence-based treatment guidelines. Our data sources relied on handsearches of four previous good-quality systematic reviews, which all conducted electronic searches of primarily MEDLINE (OVID), EMBASE, and Cochrane Library. An independent, supplemental electronic search of MEDLINE was undertaken as well (last searched June 2007). ⋯ However, this evidence comes with the suggestion that the potential benefits of hypothermia may likely be offset by a significant increase in risk of pneumonia (RR 2.37; 95% CI 1.37, 4.10). In sum, the present study's updated meta-analysis supports previous findings that hypothermic therapy constitutes a beneficial treatment of TBI in specific circumstances. Accordingly, the BTF/AANS guidelines task force has issued a Level III recommendation for optional and cautious use of hypothermia for adults with TBI.
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Journal of neurotrauma · Jan 2008
Comparative StudyLongitudinal comparison of two severities of unilateral cervical spinal cord injury using magnetic resonance imaging in rats.
Magnetic resonance imaging (MRI) should be a powerful tool for characterization of spinal cord pathology in animal models. We evaluated the utility of medium-field MRI for the longitudinal assessment of progression of spinal cord injury (SCI) in a rat model. Thirteen adult rats were subjected to a 6.25 or 25 g-cm unilateral cervical SCI, and underwent MRI and behavioral tests during a 3-week study period. ⋯ Significant correlation was also found between parameters determined by MRI: swelling, hypointense signal, hyperintense signal, and lesion length. MRI is a valuable imaging modality to assess the temporal evolution of SCI and to distinguish different severities of cervical SCI in rats. In future, MRI could be applied as a screening tool to either administer goal-directed therapies, or enable even group distribution, prior to therapeutic intervention for example through quantification and matching of swelling and edema.