Articles: traumatic-brain-injuries.
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Journal of neurotrauma · Jan 2024
Concussive head trauma deranges axon initial segment function in axotomized and intact layer 5 pyramidal neurons.
The axon initial segment (AIS) is a critical locus of control of action potential (AP) generation and neuronal information synthesis. Concussive traumatic brain injury gives rise to diffuse axotomy, and the majority of neocortical axonal injury arises at the AIS. Consequently, concussive traumatic brain injury might profoundly disrupt the functional specialization of this region. ⋯ In contrast, within injured mice, we discovered a subset of axotomized layer 5 pyramidal neurons in which the AIS-regional 2o peak was abolished, a functional perturbation associated with diminished excitability, axonal sprouting and distention of the AIS as assessed by staining for ankyrin-G. Our analysis revealed an additional subpopulation of both axotomized and intact layer 5 pyramidal neurons that manifested a melding together of the AIS- and soma-regional 2o peaks, suggesting a more subtle aberration of sodium channel function and/or translocation of the AIS initiation zone closer to the soma. When these experiments were repeated in animals in which cyclophilin-D was knocked out, these effects were ameliorated, suggesting that trauma-induced AIS functional perturbation is associated with mitochondrial calcium dysregulation.
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Journal of neurotrauma · Jan 2024
Prognosis at your fingertips: a machine learning-based web application for outcome prediction in acute traumatic epidural hematoma.
Traumatic brain injury (TBI) affects 69 million people worldwide each year, and acute traumatic epidural hematoma (atEDH) is a frequent and severe consequence of TBI. The aim of the study is to use machine learning (ML) algorithms to predict in-hospital death, non-home discharges, prolonged length of stay (LOS), prolonged length of intensive care unit stay (ICU-LOS), and major complications in patients with atEDH and incorporate the resulting ML models into a user-friendly web application for use in the clinical settings. The American College of Surgeons (ACS) Trauma Quality Program (TQP) database was used to identify patients with atEDH. ⋯ This study aimed to improve the prognostication of patients with atEDH using ML algorithms and developed a web application for easy integration in clinical practice. It found that ML algorithms can aid in risk stratification and have significant potential for predicting in-hospital outcomes. Results demonstrated excellent performance for predicting in-hospital death and fair performance for non-home discharges, prolonged LOS and ICU-LOS, and poor performance for major complications.
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Patients 65 years and older account for an increasing proportion of traumatic brain injury (TBI) patients. Aged TBI patients experience increased morbidity and mortality compared with young TBI patients. We previously demonstrated a marked accumulation of CD8 + T-cells within the brains of aged TBI mice compared with young TBI mice. ⋯ Contrastingly, no difference was detected in young mice after aCD49d Ab treatment. Collectively, aCD49 Ab treatment reduced T-cells in the injured brain, improved survival, and attenuated neurocognitive and gait deficits. Hence, aCD49d Ab may be a promising therapeutic intervention in aged TBI subjects-a population often excluded in TBI clinical trials.