Articles: traumatic-brain-injuries.
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Journal of neurotrauma · Jan 2015
Altered regulation of protein kinase A activity in the medial prefrontal cortex of normal and brain injured animals actively engaged in a working memory task.
Cyclic adenosine monophosphate (cAMP)-dependent protein kinase A (PKA) signaling is required for short- and long-term memory. In contrast, enhanced PKA activity has been shown to impair working memory, a prefrontal cortex (PFC)-dependent, transient form of memory critical for cognition and goal-directed behaviors. Working memory can be impaired after traumatic brain injury (TBI) in the absence of overt damage to the PFC. ⋯ Inhibition of PKA activity by intra-mPFC administration of Rp-cAMPS into TBI animals had no influence on working memory performance 30 min postinfusion, but significantly improved working memory when tested 24 h later. This improvement was associated with reduced glutamic acid decarboxylase 67 messenger RNA levels. Taken together, these results suggest that TBI-associated working memory dysfunction may result, in part, from enhanced PKA activity, possibly leading to altered expression of plasticity-related genes in the mPFC.
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The nonspecific and variable presentation of traumatic brain injury (TBI) has motivated an intense search for blood-based biomarkers that can objectively predict the severity of injury. However, it is not known how cytosolic proteins released from traumatized brain tissue reach the peripheral blood. ⋯ Clinically relevant manipulation of glymphatic activity, including sleep deprivation and cisternotomy, suppressed or eliminated TBI-induced increases in serum S100β, GFAP, and neuron specific enolase. We conclude that routine TBI patient management may limit the clinical utility of blood-based biomarkers because their brain-to-blood transport depends on glymphatic activity.
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This study examined the clinical utility of the Wechsler Adult Intelligence Scales-Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate or severe TBI. One hundred individuals with TBI (n = 35 complicated mild or moderate TBI; n = 65 severe TBI) and 100 control participants matched on key demographic variables from the WAIS-IV normative dataset completed the WAIS-IV. Univariate analyses indicated that participants with severe TBI had poorer performance than matched controls on all index scores and subtests (except Matrix Reasoning). ⋯ Effect sizes for index and subtest scores were generally small-to-moderate for the group with complicated mild/moderate and moderate-to-large for the group with severe TBI. PSI also showed good sensitivity and specificity for classifying individuals with severe TBI versus controls. Findings provide support for the clinical utility of the WAIS-IV in individuals with complicated mild, moderate, and severe TBI.
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Brain injury : [BI] · Jan 2015
Review Historical ArticleChronic traumatic encephalopathy in professional sports: retrospective and prospective views.
The purposes of this paper are to review: (1) the history of chronic traumatic encephalopathy (CTE) in sports, (2) the similarities and differences between historic and current definitions of CTE, (3) recent epidemiology and cohort studies of CTE and (4) controversies regarding the current CTE positions. ⋯ There are multiple causes of abnormal tau protein deposition in the human brain and the pathogenesis of CTE may not be related solely to concussion and/or sub-concussive injury. In all likelihood, the causes of CTE are a multivariate, as opposed to a univariate, phenomenon.
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Stud Health Technol Inform · Jan 2015
The Prognostic Scale CRASH in the Treatment of Children with Severe Traumatic Brain Injury.
The aim of the present study was to assess the effectiveness and validity of prognostic scale CRASH which is calculated using on-line resources and which may serve as a decision support for physicians in treating severe traumatic brain injury (TBI) in children. This retrospective study was conducted using clinical and physiological data of 168 hospitalized pediatric patients with severe traumatic brain injury (GCS score less than or equal to 8). CRASH scale was used for calculating the severity of patients' state and for prognosing death outcomes at 14 days and at 6 months using the on-line resource. ⋯ The study has also shown that the scale has a satisfactory calibration ability in the option of 14 days with CT (χ2 equal 8.7 and p-value equal to 0.368). Calibration ability for other options was unsatisfactory. Thus, CRASH scale with CT scan has turned to be useful for assessing death outcomes at 14 days in children with severe TBI.