Articles: traumatic-brain-injuries.
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Journal of neurotrauma · Jan 2017
Clinical TrialIncreases of Plasma Levels of Glial Fibrillary Acidic Protein, Tau and Amyloid Beta 42 up to 90 Days Following Traumatic Brain Injury.
Glial fibrillary acidic protein (GFAP), microtubule-associated protein tau, and amyloid β peptide (Aβ42) have been proposed as diagnostic and prognostic biomarkers in traumatic brain injury (TBI). Single molecule array (Simoa) is a novel technology that employs highly sensitive immunoassays for accurate measurements of candidate biomarkers found at low concentration in biological fluids. Our objective was to trace the trajectory of tau, GFAP, and Aβ42 levels in plasma from the acute through subacute stages after TBI, compared with controls. ⋯ Total tau levels correlated with clinical and radiological variables of TBI severity. Plasma Aβ42 correlated with clinical outcome. Combination of all three biomarkers at Days 0 and 30 can be used to differentiate controls from cmTBI populations, and may be useful as biomarkers of TBI in both acute and subacute phases.
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NeuroRehabilitation · Jan 2017
Meta AnalysisPrevalence of persistent vegetative state in patients with severe traumatic brain injury and its trend during the past four decades: A meta-analysis.
Estimating the prevalence of persistent vegetative state (PVS) following severe traumatic brain injury (sTBI) and its change over time is important for the study of the disease. ⋯ Prevalence of PVS at six months after sTBI has no significant change over the past four decades. Age and gender do not seem to have a significant effect on the prevalence.
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Brain injury : [BI] · Jan 2017
ReviewNeuroimaging of deployment-associated traumatic brain injury (TBI) with a focus on mild TBI (mTBI) since 2009.
A substantial body of recent research has aimed to better understand the clinical sequelae of military trauma through the application of advanced brain imaging procedures in Veteran populations. The primary objective of this review was to highlight a portion of these recent studies to demonstrate how imaging tools can be used to understand military-associated brain injury. ⋯ This information must be considered in the larger context of research into mTBI, including the potentially unique nature of blast exposure and the long-term consequences of mTBI.
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Journal of neurotrauma · Jan 2017
Randomized Controlled TrialVery Early Administration of Progesterone Does Not Improve Neuropsychological Outcomes in Subjects with Moderate to Severe TBI.
A Phase III, double-blind, placebo-controlled trial (ProTECT III) found that administration of progesterone did not reduce mortality or improve functional outcome as measured by the Glasgow Outcome Scale Extended (GOSE) in subjects with moderate to severe traumatic brain injury. We conducted a secondary analysis of neuropsychological outcomes to evaluate whether progesterone is associated with improved recovery of cognitive and motor functioning. ProTECT III was conducted at 49 level I trauma centers in the United States. ⋯ Analyses of covariance did not reveal significant treatment effects for memory (Buschke immediate recall, p = 0.53; delayed recall, p = 0.94), attention (Trails A speed, p = 0.81 and errors, p = 0.22; Digit Span Forward length, p = 0.66), executive functioning (Trails B speed, p = 0.97 and errors, p = 0.93; Digit Span Backward length, p = 0.60), language (timed phonemic fluency, p = 0.05), and fine motor coordination/dexterity (Grooved Pegboard dominant hand time, p = 0.75 and peg drops, p = 0.59; nondominant hand time, p = 0.74 and peg drops, p = 0.61). Pearson Product Moment Correlations demonstrated significant (p < 0.001) associations between better neuropsychological performance and higher GOSE scores. Similar to the ProTECT III trial's results of the primary outcome, the secondary outcomes do not provide evidence of a neuroprotective effect of progesterone.
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There have been many recent advances in the management of traumatic brain injury (TBI). Research regarding established and novel therapies is ongoing. ⋯ In addition, the impact of these advances on varying severities of brain injury must not be ignored. It is hoped that future research strategies in TBI will prioritize large-scale trials using common data elements to develop large registries and databases, and leverage international collaborations.