Articles: traumatic-brain-injuries.
-
Journal of neurotrauma · Aug 2024
Evidence for Altered White Matter Organisation After Mild Traumatic Brain Injury: A Scoping Review on the Use of Diffusion MRI and Blood-Based Biomarkers to Investigate Acute Pathology and Relationship to Persistent Post-Concussion Symptoms.
Mild traumatic brain injury (mTBI) is the most common form of traumatic brain injury. Post-concussive symptoms typically resolve after a few weeks although up to 20% of people experience these symptoms for >3 months, termed persistent post-concussive symptoms (PPCS). Subtle white matter (WM) microstructural damage is thought to underlie neurological and cognitive deficits experienced post-mTBI. ⋯ Significant biomarker alterations were frequently associated with heightened symptom burden and prolonged recovery time post-injury. These data suggest that dMRI and blood-based biomarkers may be useful proxies of WM organization, although few studies assessed these complementary measures in parallel, and the relationship between modalities remains unclear. Further studies are warranted to assess the benefit of a combined biomarker approach in evaluating alterations to WM organization after mTBI.
-
Journal of neurotrauma · Aug 2024
Molecular pathway changes associated with different post-conditioning exercise interventions after experimental TBI.
Traumatic brain injury (TBI) causes complex, time-dependent molecular and cellular responses, which include adaptive changes that promote repair and recovery, as well as maladaptive processes such as chronic inflammation that contribute to chronic neurodegeneration and neurological dysfunction. Hormesis is a well-established biological phenomenon in which exposure to low-dose toxins or stressors results in protective responses to subsequent higher-level stressors or insults. Hormetic stimuli show a characteristic U-shaped or inverted J-shaped dose-response curve, as well as being time and exposure-frequency dependent, similar to pre-conditioning and post-conditioning actions. ⋯ Exercise initiated at a more delayed timepoint of 6 weeks after injury and continuing for 4 weeks was more effective than that during the acute phase. The delayed paradigm was also more effective than exercise initiated at 10 weeks after injury and continuing for 8 weeks, consistent with hormetic responses in other models and species. Overall, our study delineates regional and interventional parameters, as well as related molecular pathway changes, associated with post-conditioning exercise treatment, which may help inform future translational interventional strategies.
-
Traumatic brain injury (TBI) can impact language processing, necessitating language-tailored approaches. Telehealth may expand rural Veterans' access but has unknown feasibility for language preferences. This study explored telehealth/Veterans Video Connect satisfaction for Spanish/English TBI screening. ⋯ Patients conveyed positive experiences, but qualitative data revealed actionable targets for optimization like infrastructure and coordination improvements. Key limitations include small samples and lack of comparison to in-person care. Still, high satisfaction coupled with specific user feedback highlights telehealth's potential while directing enhancements. The results found high Veteran satisfaction with Spanish/English TBI telehealth, but mixed methods illuminated salient domains for better accommodating user needs, particularly regarding logistics and technology. Rigorously integrating experiences with metrics over expanded diverse samples and modalities can further guide refinements to enhance telehealth with a language-tailored approach.
-
Emerg Med Australas · Aug 2024
Can rotational thromboelastometry rapidly identify theragnostic targets in isolated traumatic brain injury?
Coagulation assessment in traumatic brain injury (TBI) typically relies upon laboratory-based standard coagulation tests (SCTs), including the activated partial thromboplastin time (aPTT), INR and platelet count. Rotational thromboelastometry (ROTEM) sigma is an alternative point-of-care assay; however, its role in isolated TBI is under-evaluated. The present study aims to assess the prognostic utility of ROTEM sigma in isolated TBI. ⋯ ROTEM sigma expedites the detection of clinically significant coagulopathy in isolated TBI. EXTEM and FIBTEM CT values are more rapidly attainable than INR and comparable in predicting head injury-related death.
-
Computational head injury models are promising tools for understanding and predicting traumatic brain injuries. However, most available head injury models are "average" models that employ a single set of head geometry (e.g., 50th-percentile U.S. male) without considering variability in these parameters across the human population. A significant variability of head shapes exists in U.S. Army soldiers, evident from the Anthropometric Survey of U.S. Army Personnel (ANSUR II). The objective of this study is to elucidate the effects of head shape on the predicted risk of traumatic brain injury from computational head injury models. ⋯ Head shape has a considerable influence on the injury predictions of computational head injury models. Available "average" head injury models based on a 50th-percentile U.S. male are likely associated with considerable uncertainty. In general, larger head sizes correspond to greater BIPV magnitudes, which point to potentially a greater injury risk under rapid neck rotation for people with larger heads.