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Haarbauer-Krupa J, Wray AP, Lebrun-Harris LA, Cree RA, Womack LS. Prevalence and Correlates of Suspected and Diagnosed Traumatic Brain Injuries among US School-Aged Children. JOURNAL OF PEDIATRICS. CLINICAL PRACTICE 2024; 14:200117. [PMID: 39100506 PMCID: PMC11292372 DOI: 10.1016/j.jpedcp.2024.200117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 08/06/2024]
Abstract
Objective To (1) estimate the lifetime prevalence of suspected and diagnosed traumatic brain injury (TBI) based on parent report overall and select sociodemographic characteristics; and (2) describe differences in prevalence of health conditions and health-related risk factors by whether a child had a lifetime history of diagnosed TBI. Study design We analyzed data from the 2020 National Survey of Children's Health, a cross-sectional address-based survey of US households. A categorical variable was created on the basis of parent responses to 3 questions inquiring about their suspicion of their child having a brain injury, if they sought medical care, and if the health care provider provided a diagnosis. Parents also were asked to report on their child's additional health conditions, functional indicators, school and social factors, and health care access and service use. Results The prevalence of lifetime diagnosed TBI was 4.2% (95% CI 3.8-4.5). Children with a parent-reported lifetime history of diagnosed TBI were more likely to have a variety of health conditions, special health care needs, disabilities, activity limitations, missed days of school, and unmet care coordination needs, compared with those without a history. However, they were more likely to have a usual source of sick care and to receive more health-related services. Conclusions For school-aged children, a history of TBI is associated with parent-reported health needs and conditions, as well as missed days from school. It is particularly important for parents to seek care when they suspect their child has experienced a TBI to receive a diagnosis and monitor the impacts of the TBI.
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Affiliation(s)
- Juliet Haarbauer-Krupa
- US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA
| | - Allison P. Wray
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA
| | - Lydie A. Lebrun-Harris
- US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Rockville, MD
| | - Robyn A. Cree
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA
| | - Lindsay S. Womack
- US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA
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Tan W, Hang Y, Wang A, Wang J, Wigginton JG, Muehlschlegel S, Wu N. Development and Analytical Validation of a Surface-Enhanced Raman Scattering Paper Lateral Flow Immunoassay for Detection of the Ubiquitin C-Terminal Hydrolase-L1 Traumatic Brain Injury Biomarker. ACS OMEGA 2024; 9:37965-37972. [PMID: 39281897 PMCID: PMC11391534 DOI: 10.1021/acsomega.4c04685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/22/2024] [Accepted: 08/16/2024] [Indexed: 09/18/2024]
Abstract
Paper lateral flow immunoassays combined with surface-enhanced Raman scattering (SERS) technology have gained increasing attention due to their high sensitivity characteristics resulting from the amplified SERS signals of the plasmon-enhanced optical probes. In contrast to conventional colorimetric lateral flow strips, SERS paper lateral flow strips (SERS-PLFSs) are currently not commercially available for widespread use. Analytical validation is the key step for commercialization. In this work, we have developed a PLFS with a hierarchical SERS probe (gold-silver nanoparticle@Raman reporter@silica) for detection of the US Food and Drug Administration (FDA)-approved traumatic brain injury (TBI) protein biomarker, ubiquitin C-terminal hydrolase-L1 (UCH-L1), in blood plasma samples. Analytical validation has been performed on this SERS-PLFS in terms of the limit of detection (LOD), limit of quantification (LOQ), accuracy, precision, selectivity, and stability. The SERS-PLFS exhibits a reportable range of 0.2-100 ng/mL with a LOD of 0.08 ng/mL toward measurement of UCH-L1 in blood plasma. The SERS-PLFS has been applied to clinical TBI samples. The test results were compared with those from enzyme-linked immunosorbent assay (ELISA), demonstrating a strong correlation between the two analytical methods. This study has important implications in the commercialization of SERS-PLFSs for rapid TBI detection in clinical practice.
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Affiliation(s)
- Weirui Tan
- Department of Chemical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01002, United States
| | - Yingjie Hang
- Department of Chemical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01002, United States
| | - Anyang Wang
- Department of Chemical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01002, United States
| | - Jiacheng Wang
- Department of Chemical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01002, United States
| | - Jane G Wigginton
- Center for BrainHealth and Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, Texas 75080, United States
| | - Susanne Muehlschlegel
- Departments of Neurology and Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, Massachusetts 02655, United States
| | - Nianqiang Wu
- Department of Chemical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01002, United States
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Mitchell JT, Edwards M, Walsh K, Brown-Schmidt S, Duff MC. Comprehension of Miranda warnings in adults with chronic, moderate-severe traumatic brain injury. JOURNAL OF COMMUNICATION DISORDERS 2024; 111:106452. [PMID: 39029420 DOI: 10.1016/j.jcomdis.2024.106452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 05/15/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
INTRODUCTION To compare comprehension of Miranda rights in adults with traumatic brain injury (TBI) versus adults without TBI as measured by response accuracy on the Miranda Right Comprehension Instruments. METHODS Data were collected virtually via teleconferencing from July 2022 to February 2023. Participants included 25 adults with moderate-severe TBI (12 females, 13 males) and 25 adults without TBI (12 females, 13 males), ages 20-55 years. In this observational study, both groups (with and without TBI) completed the Miranda Right Comprehension Instruments (MRCI), which includes four instruments including Comprehension of Miranda Rights, Comprehension of Miranda Rights-Recognition, Function of Rights in Interrogation, Comprehension of Miranda Vocabulary instruments. Response accuracy on the MRCI was compared across groups. RESULTS The TBI group was significantly less accurate when responding to questions on the MRCI compared to the NC group. CONCLUSION Individuals with chronic moderate-severe TBI underperform their non-injured peers on the Miranda Rights Comprehension Instruments, a tool used in legal settings when there is doubt about an individual's understanding of their Miranda rights. TBI is a risk factor for disruptions in comprehension of language in legal contexts that may, in part, contribute to the increased interaction with the criminal justice system and incarceration for individuals with TBI. Implications for policy, advocating, and intervention are discussed.
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Affiliation(s)
- Jade T Mitchell
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center.
| | | | - Kimberly Walsh
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
| | | | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
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Balleste AF, Sangadi A, Titus DJ, Johnstone T, Hogenkamp D, Gee KW, Atkins CM. Enhancing cognitive recovery in chronic traumatic brain injury through simultaneous allosteric modulation of α7 nicotinic acetylcholine and α5 GABA A receptors. Exp Neurol 2024; 379:114879. [PMID: 38942266 PMCID: PMC11283977 DOI: 10.1016/j.expneurol.2024.114879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/20/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
Traumatic brain injury (TBI) leads to changes in the neural circuitry of the hippocampus that result in chronic learning and memory deficits. However, effective therapeutic strategies to ameliorate these chronic learning and memory impairments after TBI are limited. Two pharmacological targets for enhancing cognition are nicotinic acetylcholine receptors (nAChRs) and GABAA receptors (GABAARs), both of which regulate hippocampal network activity to form declarative memories. A promising compound, 522-054, both allosterically enhances α7 nAChRs and inhibits α5 subunit-containing GABAARs. Administration of 522-054 enhances long-term potentiation (LTP) and cognitive functioning in non-injured animals. In this study, we assessed the effects of 522-054 on hippocampal synaptic plasticity and learning and memory deficits in the chronic post-TBI recovery period. Adult male Sprague Dawley rats received moderate parasagittal fluid-percussion brain injury or sham surgery. At 12 wk after injury, we assessed basal synaptic transmission and LTP at the Schaffer collateral-CA1 synapse of the hippocampus. Bath application of 522-054 to hippocampal slices reduced deficits in basal synaptic transmission and recovered TBI-induced impairments in LTP. Moreover, treatment of animals with 522-054 at 12 wk post-TBI improved cue and contextual fear memory and water maze acquisition and retention without a measurable effect on cortical or hippocampal atrophy. These results suggest that dual allosteric modulation of α7 nAChR and α5 GABAAR signaling may be a potential therapy for treating cognitive deficits during chronic recovery from TBI.
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Affiliation(s)
- Alyssa F Balleste
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Akhila Sangadi
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David J Titus
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | | | - Derk Hogenkamp
- Department of Pharmaceutical Sciences, University of California Irvine, Irvine, USA
| | - Kelvin W Gee
- Department of Pharmaceutical Sciences, University of California Irvine, Irvine, USA
| | - Coleen M Atkins
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
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Krch D, Lequerica AH, Arango-Lasprilla JC, Corrigan JD. Neurobehavioral Symptoms in Spanish-Speaking Individuals With Subconcussive Injuries. J Head Trauma Rehabil 2024; 39:E399-E406. [PMID: 38456793 DOI: 10.1097/htr.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To examine whether exposure to high-risk events causing injury to the head or neck has an effect on neurobehavioral symptoms in the absence of an alteration of consciousness in Spanish-speakers. SETTING Web-based survey. PARTICIPANTS Seven hundred forty-eight individuals from Spain and Latin America, aged 18 to 65 years, with 10 years or more of education. Thirty-nine participants failed quality checks and were excluded. Seven hundred nine participants were included in the analyses. DESIGN Cross-sectional study. Subconcussive exposure was defined as endorsing exposure to one or more high-risk scenarios in the absence of any alteration of consciousness. Three injury groups were derived: No Head Injury, Subconcussive Exposure, and traumatic brain injury (TBI). The Subconcussive Exposure group was further divided into Single and Multiple Exposures. Two analyses were conducted: the effect of lifetime exposure to injury (No Head Injury, Subconcussive Exposure, TBI) on neurobehavioral symptoms; the effect of Subconcussive Exposure Frequency (No Head Injury, Single Exposure, Multiple Exposures) on neurobehavioral symptoms. MAIN MEASURES Spanish Ohio State University Traumatic Brain Injury Identification Method Self-Administered-Brief (OSU TBI-ID SAB); Neurobehavioral Symptom Inventory (NSI). RESULTS There was a significant effect for Injury group on the NSI partial eta-squared (η p2 = 0.053) and a significant effect of Exposure Frequency group on the NSI (η p2 = 0.40). Individuals with subconcussive exposures reported significantly more neurobehavioral symptoms than those with no history of head injury and significantly less symptoms than those with TBI. Individuals with multiple subconcussive exposures reported significantly more neurobehavioral symptoms than those with single and no exposure. CONCLUSION This research expands the utility of the OSU-TBI-ID SAB as a lifetime TBI history assessment tool to one capable of evaluating subconcussive exposure dosing effects in Spanish-speakers. Such an index may facilitate establishment of subconcussive exposure prevalence rates worldwide, leading to improved understanding of the chronic effects of high-risk exposures.
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Affiliation(s)
- Denise Krch
- Author Affiliations: Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, and Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey (Drs Krch and Lequerica); Department of Psychology, Virginia Commonwealth University, Richmond, Virginia (Dr Arango-Lasprilla); and Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio (Dr Corrigan)
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Karamian A, Seifi A, Lucke-Wold B. Comparing the effects of mannitol and hypertonic saline in severe traumatic brain injury patients with elevated intracranial pressure: a systematic review and meta-analysis. Neurol Res 2024; 46:883-892. [PMID: 38825027 DOI: 10.1080/01616412.2024.2360862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVES Controlling elevated intracranial pressure following brain injury with hyperosmolar agents is one of the mainstay treatments in traumatic brain injury patients. In this study, we compared the effects of hypertonic saline (HS) and mannitol in reducing increased intracranial pressure. METHODS A total of 637 patients from 15 studies were included in our meta-analysis. The primary outcomes were mortality, the length of stay in the hospital and ICU, and the Glasgow Outcome Scale at follow-up. RESULTS The mortality in the mannitol group was not statistically different compared to the HS group (RR = 1.55; 95% CI = [0.98, 2.47], p = 0.06). The length of stay in the ICU was significantly shorter in the HS group (MD = 1.18, 95% CI = [0.44, 1.92], p < 0.01). In terms of favorable neurological outcomes, there was no significant difference between the two agents (RR = 0.92, 95% CI = [0.11, 7.96], p = 0.94). The duration of the effect was shorter in the mannitol group than in the HS group (MD = -0.67, 95% CI = [-1.00, -0.33], p < 0.01). DISCUSSION The results showed that HS and mannitol had similar effects in reducing ICP. Although the HS was associated with a longer duration of effect and shorter ICU stay, other secondary outcomes including mortality rate and favorable neurological outcomes were similar between the two drugs. In conclusion, considering the condition of each patient individually, HS could be a reasonable option than mannitol to reduce ICP in TBI patients.
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Affiliation(s)
- Armin Karamian
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Seifi
- Department of Neurosurgery, University of Texas Health, San Antonio, TX, USA
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7
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Cheng KY, Robinson N, Ploner A, Kuja-Halkola R, Molero Y, Lichtenstein P, Bergen SE. Impact of traumatic brain injury on risk for schizophrenia and bipolar disorder. Psychiatry Res 2024; 339:115990. [PMID: 38896929 PMCID: PMC11321911 DOI: 10.1016/j.psychres.2024.115990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024]
Abstract
The impact of traumatic brain injury (TBI) on subsequent risk of schizophrenia (SCZ) or bipolar disorder (BD) remains contested. Possible genetic and environmental confounding effects have also been understudied. Therefore, we aim to investigate the impact of TBI on the risk of SCZ and BD and whether the effect varies by injury severity, age at injury, and sex. We identified 4,184 SCZ and 18,681 BD cases born between 1973 and 1998 in the Swedish National Registers. Case-control samples matched (1:5) on birth year, sex, and birthplace were created along with a family design study, with cases matched to non-case full siblings. TBI was associated with higher risk of SCZ and BD (IRR=1.33 for SCZ, IRR=1.78 for BD). The association remained significant in the sibling comparison study. Moderate or severe TBI was associated with higher risk for both SCZ and BD compared to mild TBI. Older age at injury was associated with higher risk of SCZ and BD, and the effect of TBI was stronger in women than men. Findings indicate that TBI is a risk factor for both SCZ and BD with differential impact by age, severity and sex and that this association cannot be explained by familial confounding alone.
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Affiliation(s)
- Kai-Yuan Cheng
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden
| | - Natassia Robinson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden
| | - Yasmina Molero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden; Centre for Psychiatric Research, Karolinska Institutet, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden.
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El-Menyar A, Asim M, Khan N, Rizoli S, Mahmood I, Al-Ani M, Kanbar A, Alaieb A, Hakim S, Younis B, Taha I, Jogol H, Siddiqui T, Hammo AA, Abdurraheim N, Alabdallat M, Bahey AAA, Ahmed K, Atique S, Chaudry IH, Prabhu KS, Uddin S, Al-Thani H. Systemic and cerebro-cardiac biomarkers following traumatic brain injury: an interim analysis of randomized controlled clinical trial of early administration of beta blockers. Sci Rep 2024; 14:19574. [PMID: 39179700 PMCID: PMC11343837 DOI: 10.1038/s41598-024-70470-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/16/2024] [Indexed: 08/26/2024] Open
Abstract
This is an interim analysis of the Beta-blocker (Propranolol) use in traumatic brain injury (TBI) based on the high-sensitive troponin status (BBTBBT) study. The BBTBBT is an ongoing double-blind placebo-controlled randomized clinical trial with a target sample size of 771 patients with TBI. We sought, after attaining 50% of the sample size, to explore the impact of early administration of beta-blockers (BBs) on the adrenergic surge, pro-inflammatory cytokines, and the TBI biomarkers linked to the status of high-sensitivity troponin T (HsTnT). Patients were stratified based on the severity of TBI using the Glasgow coma scale (GCS) and HsTnT status (positive vs negative) before randomization. Patients with positive HsTnT (non-randomized) received propranolol (Group-1; n = 110), and those with negative test were randomized to receive propranolol (Group-2; n = 129) or placebo (Group-3; n = 111). Propranolol was administered within 24 h of injury for 6 days, guided by the heart rate (> 60 bpm), systolic blood pressure (≥ 100 mmHg), or mean arterial pressure (> 70 mmHg). Luminex and ELISA-based immunoassays were used to quantify the serum levels of pro-inflammatory cytokines (Interleukin (IL)-1β, IL-6, IL-8, and IL-18), TBI biomarkers [S100B, Neuron-Specific Enolase (NSE), and epinephrine]. Three hundred and fifty patients with comparable age (mean 34.8 ± 9.9 years) and gender were enrolled in the interim analysis. Group 1 had significantly higher baseline levels of IL-6, IL-1B, S100B, lactate, and base deficit than the randomized groups (p = 0.001). Group 1 showed a significant temporal reduction in serum IL-6, IL-1β, epinephrine, and NSE levels from baseline to 48 h post-injury (p = 0.001). Patients with severe head injuries had higher baseline levels of IL-6, IL-1B, S100B, and HsTnT than mild and moderate TBI (p = 0.01). HsTnT levels significantly correlated with the Injury Severity Score (ISS) (r = 0.275, p = 0.001), GCS (r = - 0.125, p = 0.02), and serum S100B (r = 0.205, p = 0.001). Early Propranolol administration showed a significant reduction in cytokine levels and TBI biomarkers from baseline to 48 h post-injury, particularly among patients with positive HsTnT, indicating the potential role in modulating inflammation post-TBI.Trial registration: ClinicalTrials.gov NCT04508244. It was registered first on 11/08/2020. Recruitment started on 29 December 2020 and is ongoing. The study was partly presented at the 23rd European Congress of Trauma and Emergency Surgery (ECTES), April 28-30, 2024, in Estoril, Lisbon, Portugal.
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Affiliation(s)
- Ayman El-Menyar
- Department of Surgery, Clinical Research, Trauma and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar.
- Department of Clinical Medicine, Weill Cornell Medicine, P.O. Box 24144, Doha, Qatar.
| | - Mohammad Asim
- Department of Surgery, Clinical Research, Trauma and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Naushad Khan
- Department of Surgery, Clinical Research, Trauma and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Sandro Rizoli
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Ismail Mahmood
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mushreq Al-Ani
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Ahad Kanbar
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Abubaker Alaieb
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Suhail Hakim
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Basil Younis
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Taha
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Hisham Jogol
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Tariq Siddiqui
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Abdel Aziz Hammo
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Nuri Abdurraheim
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Alabdallat
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | | | - Khalid Ahmed
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Sajid Atique
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Irshad H Chaudry
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kirti S Prabhu
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Shahab Uddin
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
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9
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Solomou G, Sunny J, Mohan M, Hossain I, Kolias AG, Hutchinson PJ. Decompressive craniectomy in trauma: What you need to know. J Trauma Acute Care Surg 2024:01586154-990000000-00780. [PMID: 39137371 DOI: 10.1097/ta.0000000000004357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
ABSTRACT Decompressive craniectomy (DC) is a surgical procedure in which a large section of the skull is removed, and the underlying dura mater is opened widely. After evacuating a traumatic acute subdural hematoma, a primary DC is typically performed if the brain is bulging or if brain swelling is expected over the next several days. However, a recent randomized trial found similar 12-month outcomes when primary DC was compared with craniotomy for acute subdural hematoma. Secondary removal of the bone flap was performed in 9% of the craniotomy group, but more wound complications occurred in the craniectomy group. Two further multicenter trials found that, whereas early neuroprotective bifrontal DC for mild to moderate intracranial hypertension is not superior to medical management, DC as a last-tier therapy for refractory intracranial hypertension leads to reduced mortality. Patients undergoing secondary last-tier DC are more likely to improve over time than those in the standard medical management group. The overall conclusion from the most up-to-date evidence is that secondary DC has a role in the management of intracranial hypertension following traumatic brain injury but is not a panacea. Therefore, the decision to offer this operation should be made on a case-by-case basis. Following DC, cranioplasty is warranted but not always feasible, especially in low- and middle-income countries. Consequently, a decompressive craniotomy, where the bone flap is allowed to "hinge" or "float," is sometimes used. Decompressive craniotomy is also an option in a subgroup of traumatic brain injury patients undergoing primary surgical evacuation when the brain is neither bulging nor relaxed. However, a high-quality randomized controlled trial is needed to delineate the specific indications and the type of decompressive craniotomy in appropriate patients.
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Affiliation(s)
- Georgios Solomou
- From the Division of Neurosurgery, Department of Clinical Neurosciences (G.S., J.S., M.M., I.H., A.G.K. P.J.H.), Addenbrooke's Hospital, University of Cambridge, Cambridge; National Hospital for Neurology and Neurosurgery (J.S.), London, United Kingdom; and Neurocenter (I.H.), Department of Neurosurgery, Turku University Hospital, Turku, Finland
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Velez DR, Duncan AJ, Zreik K. Traumatic Brain Injury Patients Admitted on High-Census Days Receive Less Critical Care and Have an Increased Risk for Delirium. Cureus 2024; 16:e65957. [PMID: 39221291 PMCID: PMC11365572 DOI: 10.7759/cureus.65957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION The utilization of healthcare services in a growing population has raised concerns about its impact on clinical outcomes. Studies have shown that increased hospital census is associated with higher admission rates and unnecessary consults, tests, and procedures in various areas of healthcare. Traumatic brain injuries (TBIs), a significant concern due to their potential for long-term disabilities, are commonly encountered in intensive care units (ICUs) and are a leading cause of patient mortality. Despite extensive research on various aspects of TBI, the effect of the patient census on TBI outcomes remains unexplored. This study aims to investigate the relationship between healthcare provider patient census and clinical outcomes in TBI patients at a level I trauma center. METHODS A retrospective review was conducted from 2017 to 2022. The mean number of patients per day in the trauma service was determined, with patients below this average considered to be present on low-census days and those above it on high-census days. Patient demographics, mechanisms of injury, vital signs, TBI severity, and associated injuries were analyzed. Adjusted regression analyses were conducted. RESULTS Over the study period, 1,527 TBI patients were identified. Demographics were similar between patients admitted on high- and low-census days. Patients with moderate TBI were 30% less likely to be admitted to the ICU on high-census days, whereas there was no difference in ICU admission for patients with mild or severe TBI. Delirium was significantly higher in patients admitted on high-census days compared to those on low-census days. This was further identified to be predominantly driven by patients with mild TBI admitted on high-census days. CONCLUSION While most outcomes remained consistent, significant rates of delirium were found in our mild TBI patients admitted on high-census days suggesting the need for additional factors in the evaluation of these patients on admission. This study also reveals potential under-triage in moderate TBI patients on high-census days as they had significantly lower rates of ICU admission. These findings emphasize the need for further investigations to optimize patient care strategies within the context of fluctuating healthcare system demands.
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Affiliation(s)
- David R Velez
- Department of General Surgery, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Anthony J Duncan
- Department of General Surgery, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Khaled Zreik
- Department of Trauma and Acute Care Surgery, Sanford Medical Center Fargo, Fargo, USA
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11
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Shi Y, Hu Y, Xu GM, Ke Y. Development and validation of a predictive model for pulmonary infection risk in patients with traumatic brain injury in the ICU: a retrospective cohort study based on MIMIC-IV. BMJ Open Respir Res 2024; 11:e002263. [PMID: 39089740 DOI: 10.1136/bmjresp-2023-002263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/28/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE To develop a nomogram for predicting occurrence of secondary pulmonary infection in patients with critically traumatic brain injury (TBI) during their stay in the intensive care unit, to further optimise personalised treatment for patients and support the development of effective, evidence-based prevention and intervention strategies. DATA SOURCE This study used patient data from the publicly available MIMIC-IV (Medical Information Mart for Intensive Care IV) database. DESIGN A population-based retrospective cohort study. METHODS In this retrospective cohort study, 1780 patients with TBI were included and randomly divided into a training set (n=1246) and a development set (n=534). The impact of pulmonary infection on survival was analysed using Kaplan-Meier curves. A univariate logistic regression model was built in training set to identify potential factors for pulmonary infection, and independent risk factors were determined in a multivariate logistic regression model to build nomogram model. Nomogram performance was assessed with receiver operating characteristic (ROC) curves, calibration curves and Hosmer-Lemeshow test, and predictive value was assessed by decision curve analysis (DCA). RESULT This study included a total of 1780 patients with TBI, of which 186 patients (approximately 10%) developed secondary lung infections, and 21 patients died during hospitalisation. Among the 1594 patients who did not develop lung infections, only 85 patients died (accounting for 5.3%). The survival curves indicated a significant survival disadvantage for patients with TBI with pulmonary infection at 7 and 14 days after intensive care unit admission (p<0.001). Both univariate and multivariate logistic regression analyses showed that factors such as race other than white or black, respiratory rate, temperature, mechanical ventilation, antibiotics and congestive heart failure were independent risk factors for pulmonary infection in patients with TBI (OR>1, p<0.05). Based on these factors, along with Glasgow Coma Scale and international normalised ratio variables, a training set model was constructed to predict the risk of pulmonary infection in patients with TBI, with an area under the ROC curve of 0.800 in the training set and 0.768 in the validation set. The calibration curve demonstrated the model's good calibration and consistency with actual observations, while DCA indicated the practical utility of the predictive model in clinical practice. CONCLUSION This study established a predictive model for pulmonary infections in patients with TBI, which may help clinical doctors identify high-risk patients early and prevent occurrence of pulmonary infections.
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Affiliation(s)
- Yulin Shi
- Department of Rehabilitation Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yong Hu
- Department of Rehabilitation Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Guo Meng Xu
- Department of Rehabilitation Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yaoqi Ke
- Department of Respiratory Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
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12
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Chiani F, Mastrorilli V, Marchetti N, Macioce A, Nappi C, Strimpakos G, Pasquini M, Gambadoro A, Battistini JI, Cutuli D, Petrosini L, Marinelli S, Scardigli R, Farioli Vecchioli S. Essential role of p21 Waf1/Cip1 in the modulation of post-traumatic hippocampal Neural Stem Cells response. Stem Cell Res Ther 2024; 15:197. [PMID: 38971774 PMCID: PMC11227726 DOI: 10.1186/s13287-024-03787-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/07/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Traumatic Brain Injury (TBI) represents one of the main causes of brain damage in young people and the elderly population with a very high rate of psycho-physical disability and death. TBI is characterized by extensive cell death, tissue damage and neuro-inflammation with a symptomatology that varies depending on the severity of the trauma from memory loss to a state of irreversible coma and death. Recently, preclinical studies on mouse models have demonstrated that the post-traumatic adult Neural Stem/Progenitor cells response could represent an excellent model to shed light on the neuro-reparative role of adult neurogenesis following damage. The cyclin-dependent kinase inhibitor p21Waf1/Cip1 plays a pivotal role in modulating the quiescence/activation balance of adult Neural Stem Cells (aNSCs) and in restraining the proliferation progression of progenitor cells. Based on these considerations, the aim of this work is to evaluate how the conditional ablation of p21Waf1/Cip1 in the aNSCS can alter the adult hippocampal neurogenesis in physiological and post-traumatic conditions. METHODS We designed a novel conditional p21Waf1/Cip1 knock-out mouse model, in which the deletion of p21Waf1/Cip1 (referred as p21) is temporally controlled and occurs in Nestin-positive aNSCs, following administration of Tamoxifen. This mouse model (referred as p21 cKO mice) was subjected to Controlled Cortical Impact to analyze how the deletion of p21 could influence the post-traumatic neurogenic response within the hippocampal niche. RESULTS The data demonstrates that the conditional deletion of p21 in the aNSCs induces a strong increase in activation of aNSCs as well as proliferation and differentiation of neural progenitors in the adult dentate gyrus of the hippocampus, resulting in an enhancement of neurogenesis and the hippocampal-dependent working memory. However, following traumatic brain injury, the increased neurogenic response of aNSCs in p21 cKO mice leads to a fast depletion of the aNSCs pool, followed by declined neurogenesis and impaired hippocampal functionality. CONCLUSIONS These data demonstrate for the first time a fundamental role of p21 in modulating the post-traumatic hippocampal neurogenic response, by the regulation of the proliferative and differentiative steps of aNSCs/progenitor populations after brain damage.
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Affiliation(s)
- Francesco Chiani
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | | | - Nicole Marchetti
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
- PhD Course in Sciences of Nutrition, Aging, Metabolism and Gender Pathologies, Catholic University of Roma, 00100, Rome, Italy
| | - Andrea Macioce
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Chiara Nappi
- Instituto de Neurosciencias, Universidad Miguel-Hernandez, Alicante, Spain
| | - Georgios Strimpakos
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Miriam Pasquini
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Alessia Gambadoro
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | | | - Debora Cutuli
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179, Rome, Italy
| | - Laura Petrosini
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179, Rome, Italy
| | - Sara Marinelli
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Raffaella Scardigli
- European Brain Research Institute (EBRI), Viale Regine Elena, 00161, Rome, Italy
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
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13
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Chiang HS, Motes M, Afkhami-Rohani B, Adhikari A, LoBue C, Kraut M, Cullum CM, Hart J. Verbal retrieval deficits due to traumatic brain injury are associated with changes in event related potentials during a Go-NoGo task. Clin Neurophysiol 2024; 163:1-13. [PMID: 38663098 PMCID: PMC11216819 DOI: 10.1016/j.clinph.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Verbal retrieval (VR) deficits often occur after traumatic brain injury (TBI), but the mechanisms remain unclear. We examined how event-related potentials (ERPs) during a Go-NoGo task were associated with VR deficits. METHODS Sixty veterans with a history of TBI underwent a neuropsychological battery and a Go-NoGo task with concurrent EEG recording. We compared task performance and ERP measures (N2, P3) between those with and those without persistent injury-related VR deficits. We then used generalized linear modeling to examine the relationship between ERP measures and scores on measures of executive function and processing speed. RESULTS Go-NoGo task performance was comparable between the groups. Those with VR deficits had larger N2 amplitude in NoGo than in Go conditions. In participants with VR deficits, larger NoGo N2/P3 amplitude predicted faster processing speed. Furthermore, larger P3 amplitude and shorter P3 latency of the difference wave (NoGo - Go) predicted faster processing speed in those with VR deficits. CONCLUSIONS Despite no difference in Go-NoGo task performance, ERP amplitude and latency measures associated with cognitive control during Go-NoGo distinguished TBI individuals with VR deficits from those without. SIGNIFICANCE This study furthers our understanding of VR deficits in TBI and implicates potential application of ERP measures in monitoring and treating such deficits.
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Affiliation(s)
- Hsueh-Sheng Chiang
- University of Texas Southwestern Medical Center, Department of Neurology, USA; The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Michael Motes
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Borna Afkhami-Rohani
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Ashna Adhikari
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Christian LoBue
- University of Texas Southwestern Medical Center, Department of Psychiatry, USA; University of Texas Southwestern Medical Center, Department of Neurological Surgery, USA.
| | - Michael Kraut
- The Johns Hopkins School of Medicine, Department of Radiology, USA.
| | - C Munro Cullum
- University of Texas Southwestern Medical Center, Department of Neurology, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, USA; University of Texas Southwestern Medical Center, Department of Neurological Surgery, USA.
| | - John Hart
- University of Texas Southwestern Medical Center, Department of Neurology, USA; The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, USA.
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14
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Kennedy E, Liebel SW, Lindsey HM, Vadlamani S, Lei PW, Adamson MM, Alda M, Alonso-Lana S, Anderson TJ, Arango C, Asarnow RF, Avram M, Ayesa-Arriola R, Babikian T, Banaj N, Bird LJ, Borgwardt S, Brodtmann A, Brosch K, Caeyenberghs K, Calhoun VD, Chiaravalloti ND, Cifu DX, Crespo-Facorro B, Dalrymple-Alford JC, Dams-O’Connor K, Dannlowski U, Darby D, Davenport N, DeLuca J, Diaz-Caneja CM, Disner SG, Dobryakova E, Ehrlich S, Esopenko C, Ferrarelli F, Frank LE, Franz CE, Fuentes-Claramonte P, Genova H, Giza CC, Goltermann J, Grotegerd D, Gruber M, Gutierrez-Zotes A, Ha M, Haavik J, Hinkin C, Hoskinson KR, Hubl D, Irimia A, Jansen A, Kaess M, Kang X, Kenney K, Keřková B, Khlif MS, Kim M, Kindler J, Kircher T, Knížková K, Kolskår KK, Krch D, Kremen WS, Kuhn T, Kumari V, Kwon J, Langella R, Laskowitz S, Lee J, Lengenfelder J, Liou-Johnson V, Lippa SM, Løvstad M, Lundervold AJ, Marotta C, Marquardt CA, Mattos P, Mayeli A, McDonald CR, Meinert S, Melzer TR, Merchán-Naranjo J, Michel C, Morey RA, Mwangi B, Myall DJ, Nenadić I, Newsome MR, Nunes A, O’Brien T, Oertel V, Ollinger J, Olsen A, Ortiz García de la Foz V, Ozmen M, Pardoe H, Parent M, Piras F, Piras F, Pomarol-Clotet E, Repple J, Richard G, Rodriguez J, Rodriguez M, Rootes-Murdy K, Rowland J, Ryan NP, Salvador R, Sanders AM, Schmidt A, Soares JC, Spalleta G, Španiel F, Sponheim SR, Stasenko A, Stein F, Straube B, Thames A, Thomas-Odenthal F, Thomopoulos SI, Tone EB, Torres I, Troyanskaya M, Turner JA, Ulrichsen KM, Umpierrez G, Vecchio D, Vilella E, Vivash L, Walker WC, Werden E, Westlye LT, Wild K, Wroblewski A, Wu MJ, Wylie GR, Yatham LN, Zunta-Soares GB, Thompson PM, Pugh MJ, Tate DF, Hillary FG, Wilde EA, Dennis EL. Verbal Learning and Memory Deficits across Neurological and Neuropsychiatric Disorders: Insights from an ENIGMA Mega Analysis. Brain Sci 2024; 14:669. [PMID: 39061410 PMCID: PMC11274572 DOI: 10.3390/brainsci14070669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions using data drawn from 55 international studies, aggregating 15,883 unique participants aged 15-90. The effects of dementia, mild cognitive impairment, Parkinson's disease, traumatic brain injury, stroke, depression, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder on immediate, short-, and long-delay verbal learning and memory (VLM) scores were estimated relative to matched healthy individuals. Random forest models identified age, years of education, and site as important VLM covariates. A Bayesian harmonization approach was used to isolate and remove site effects. Regression estimated the adjusted association of each clinical group with VLM scores. Memory deficits were strongly associated with dementia and schizophrenia (p < 0.001), while neither depression nor ADHD showed consistent associations with VLM scores (p > 0.05). Differences associated with clinical conditions were larger for longer delayed recall duration items. By comparing VLM across clinical conditions, this study provides a foundation for enhanced diagnostic precision and offers new insights into disease management of comorbid disorders.
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Affiliation(s)
- Eamonn Kennedy
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- Division of Epidemiology, University of Utah, Salt Lake City, UT 84108, USA;
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Spencer W. Liebel
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Hannah M. Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Shashank Vadlamani
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
| | - Pui-Wa Lei
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA 16802, USA;
| | - Maheen M. Adamson
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA 94304, USA (X.K.); (V.L.-J.)
- Neurosurgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada; (M.A.); (A.N.)
| | - Silvia Alonso-Lana
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, 08022 Barcelona, Spain
| | - Tim J. Anderson
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand; (T.J.A.); (J.C.D.-A.); (T.R.M.)
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
- Department of Neurology, Te Whatu Ora–Health New Zealand Waitaha Canterbury, Christchurch 8011, New Zealand
| | - Celso Arango
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, 28040 Madrid, Spain; (C.M.D.-C.); (J.M.-N.)
| | - Robert F. Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
- Brain Research Institute, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany; (M.A.); (S.B.)
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), School of Medicine, University of Cantabria, 39008 Santander, Spain;
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
- UCLA Steve Tisch BrainSPORT Program, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Laura J. Bird
- School of Clinical Sciences, Monash University, Clayton, VIC 3800, Australia;
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany; (M.A.); (S.B.)
- Center of Brain, Behaviour and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
| | - Amy Brodtmann
- Cognitive Health Initiative, School of Translational Medicine, Monash University, Melbourne, VIC 3800, Australia;
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia;
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC 3125, Australia;
| | - Vince D. Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory University, Atlanta, GA 30322, USA; (V.D.C.); (K.R.-M.)
| | - Nancy D. Chiaravalloti
- Centers for Neuropsychology, Neuroscience & Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ 07936, USA;
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
| | - David X. Cifu
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA;
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Department of Psychiatry, Virgen del Rocio University Hospital, School of Medicine, University of Seville, IBIS, 41013 Seville, Spain
| | - John C. Dalrymple-Alford
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand; (T.J.A.); (J.C.D.-A.); (T.R.M.)
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch 8041, New Zealand
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (C.E.)
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
| | - David Darby
- Department of Neuroscience, Monash University, Melbourne, VIC 3800, Australia; (D.D.); (C.M.); (L.V.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia; (H.P.); (E.W.)
| | - Nicholas Davenport
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - John DeLuca
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Kessler Foundation, East Hanover, NJ 07936, USA
| | - Covadonga M. Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, 28040 Madrid, Spain; (C.M.D.-C.); (J.M.-N.)
| | - Seth G. Disner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - Ekaterina Dobryakova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany;
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (C.E.)
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (F.F.); (A.M.)
| | - Lea E. Frank
- Department of Psychology, University of Oregon, Eugene, OR 97403, USA
| | - Carol E. Franz
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
| | - Paola Fuentes-Claramonte
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
| | - Helen Genova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Autism Research, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Christopher C. Giza
- UCLA Steve Tisch BrainSPORT Program, University of California Los Angeles, Los Angeles, CA 90095, USA;
- Department of Pediatrics, Division of Neurology, UCLA Mattel Children’s Hospital, Los Angeles, CA 90095, USA
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Alfonso Gutierrez-Zotes
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Hospital Universitari Institut Pere Mata, 43007 Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea; (M.H.); (J.K.); (J.L.)
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, 5007 Bergen, Norway;
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
| | - Charles Hinkin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
| | - Kristen R. Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA;
- Section of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Daniela Hubl
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland;
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA;
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Quantitative & Computational Biology, Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (M.K.); (J.K.); (C.M.)
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, 69120 Heidelberg, Germany
| | - Xiaojian Kang
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA 94304, USA (X.K.); (V.L.-J.)
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA;
| | - Barbora Keřková
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
| | - Mohamed Salah Khlif
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia;
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (M.K.); (J.K.); (C.M.)
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Karolina Knížková
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, 128 00 Prague, Czech Republic
| | - Knut K. Kolskår
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Denise Krch
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ 07936, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
| | - Taylor Kuhn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
| | - Veena Kumari
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK;
| | - Junsoo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea; (M.H.); (J.K.); (J.L.)
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Roberto Langella
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Sarah Laskowitz
- Brain Imaging and Analysis Center, Duke University, Durham, NC 27710, USA; (S.L.); (R.A.M.)
| | - Jungha Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea; (M.H.); (J.K.); (J.L.)
| | - Jean Lengenfelder
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Victoria Liou-Johnson
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA 94304, USA (X.K.); (V.L.-J.)
| | - Sara M. Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA; (S.M.L.); (J.O.)
- Department of Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Astri J. Lundervold
- Department of Biological and Medical Psychology, University of Bergen, 5007 Bergen, Norway;
| | - Cassandra Marotta
- Department of Neuroscience, Monash University, Melbourne, VIC 3800, Australia; (D.D.); (C.M.); (L.V.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
| | - Craig A. Marquardt
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - Paulo Mattos
- Institute D’Or for Research and Education (IDOR), São Paulo 04501-000, Brazil;
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (F.F.); (A.M.)
| | - Carrie R. McDonald
- Department of Radiation Medicine and Applied Sciences and Psychiatry, University of California San Diego, La Jolla, CA 92093, USA;
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
- Institute for Translational Neuroscience, University of Münster, 48149 Münster, Germany
| | - Tracy R. Melzer
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand; (T.J.A.); (J.C.D.-A.); (T.R.M.)
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch 8041, New Zealand
| | - Jessica Merchán-Naranjo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, 28040 Madrid, Spain; (C.M.D.-C.); (J.M.-N.)
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (M.K.); (J.K.); (C.M.)
| | - Rajendra A. Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC 27710, USA; (S.L.); (R.A.M.)
- VISN 6 MIRECC, Durham VA, Durham, NC 27705, USA
| | - Benson Mwangi
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Daniel J. Myall
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Mary R. Newsome
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada; (M.A.); (A.N.)
- Faculty of Computer Science, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Terence O’Brien
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia;
- Department of Neuroscience, The School of Translational Medicine, Alfred Health, Monash University, Melbourne VIC 3004, Australia
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt University, 60590 Frankfurt, Germany;
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA; (S.M.L.); (J.O.)
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway;
- Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
- NorHEAD—Norwegian Centre for Headache Research, 7491 Trondheim, Norway
| | - Victor Ortiz García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), School of Medicine, University of Cantabria, 39008 Santander, Spain;
| | - Mustafa Ozmen
- Division of Epidemiology, University of Utah, Salt Lake City, UT 84108, USA;
- Department of Electrical and Electronics Engineering, Antalya Bilim University, 07190 Antalya, Turkey
| | - Heath Pardoe
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia; (H.P.); (E.W.)
| | - Marise Parent
- Neuroscience Institute & Department of Psychology, Georgia State University, Atlanta, GA 30303, USA;
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Federica Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Edith Pomarol-Clotet
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Geneviève Richard
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
| | - Jonathan Rodriguez
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
| | - Mabel Rodriguez
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
| | - Kelly Rootes-Murdy
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory University, Atlanta, GA 30322, USA; (V.D.C.); (K.R.-M.)
| | - Jared Rowland
- WG (Bill) Hefner VA Medical Center, Salisbury, NC 28144, USA;
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MA-MIRECC), Durham, NC 27705, USA
| | - Nicholas P. Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia;
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Raymond Salvador
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
| | - Anne-Marthe Sanders
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Andre Schmidt
- Department of Psychiatry (UPK), University of Basel, 4002 Basel, Switzerland;
| | - Jair C. Soares
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Gianfranco Spalleta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Filip Španiel
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
- 3rd Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic
| | - Scott R. Sponheim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - Alena Stasenko
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - April Thames
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA 90292, USA; (S.I.T.); (P.M.T.)
| | - Erin B. Tone
- Department of Psychology, Georgia State University, Atlanta, GA 30303, USA;
| | - Ivan Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (I.T.); (L.N.Y.)
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC V5Z 1M9, Canada
| | - Maya Troyanskaya
- Michael E DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA;
- H Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jessica A. Turner
- Psychiatry and Behavioral Health, Ohio State Wexner Medical Center, Columbus, OH 43210, USA;
| | - Kristine M. Ulrichsen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Guillermo Umpierrez
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Elisabet Vilella
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Hospital Universitari Institut Pere Mata, 43007 Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, VIC 3800, Australia; (D.D.); (C.M.); (L.V.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
| | - William C. Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA;
- Richmond Veterans Affairs (VA) Medical Center, Central Virginia VA Health Care System, Richmond, VA 23249, USA
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia; (H.P.); (E.W.)
| | - Lars T. Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, 0372 Oslo, Norway
| | - Krista Wild
- Department of Psychology, Phoenix VA Health Care System, Phoenix, AZ 85012, USA;
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Mon-Ju Wu
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Glenn R. Wylie
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Rocco Ortenzio Neuroimaging Center, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (I.T.); (L.N.Y.)
| | - Giovana B. Zunta-Soares
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA 90292, USA; (S.I.T.); (P.M.T.)
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, University of Southern California, Los Angeles, CA 90089, USA
| | - Mary Jo Pugh
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- Division of Epidemiology, University of Utah, Salt Lake City, UT 84108, USA;
| | - David F. Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Frank G. Hillary
- Department of Psychology, Penn State University, State College, PA 16801, USA;
- Department of Neurology, Hershey Medical Center, State College, PA 16801, USA
- Social Life and Engineering Science Imaging Center, Penn State University, State College, PA 16801, USA
| | - Elisabeth A. Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Emily L. Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
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Kabatas S, Civelek E, Boyalı O, Sezen GB, Ozdemir O, Bahar-Ozdemir Y, Kaplan N, Savrunlu EC, Karaöz E. Safety and efficiency of Wharton's Jelly-derived mesenchymal stem cell administration in patients with traumatic brain injury: First results of a phase I study. World J Stem Cells 2024; 16:641-655. [PMID: 38948099 PMCID: PMC11212551 DOI: 10.4252/wjsc.v16.i6.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/26/2024] [Accepted: 05/09/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is characterized by a disruption in the normal function of the brain due to an injury following a trauma, which can potentially cause severe physical, cognitive, and emotional impairment. Stem cell transplantation has evolved as a novel treatment modality in the management of TBI, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. Wharton's Jelly-derived mesenchymal stem cells (WJ-MSCs) have recently shown beneficial effects in the functional recovery of neurological deficits. AIM To evaluate the safety and efficiency of MSC therapy in TBI. METHODS We present 6 patients, 4 male and 2 female aged between 21 and 27 years who suffered a TBI. These 6 patients underwent 6 doses of intrathecal, intramuscular (i.m.) and intravenous transplantation of WJ-MSCs at a target dose of 1 × 106/kg for each application route. Spasticity was assessed using the Modified Ashworth scale (MAS), motor function according to the Medical Research Council Muscle Strength Scale, quality of life was assessed by the Functional Independence Measure (FIM) scale and Karnofsky Performance Status scale. RESULTS Our patients showed only early, transient complications, such as subfebrile fever, mild headache, and muscle pain due to i.m. injection, which resolved within 24 h. During the one year follow-up, no other safety issues or adverse events were reported. These 6 patients showed improvements in their cognitive abilities, muscle spasticity, muscle strength, performance scores and fine motor skills when compared before and after the intervention. MAS values, which we used to assess spasticity, were observed to statistically significantly decrease for both left and right sides (P < 0.001). The FIM scale includes both motor scores (P < 0.05) and cognitive scores (P < 0.001) and showed a significant increase in pretest posttest analyses. The difference observed in the participants' Karnofsky Performance Scale values pre and post the intervention was statistically significant (P < 0.001). CONCLUSION This study showed that cell transplantation has a safe, effective and promising future in the management of TBI.
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Affiliation(s)
- Serdar Kabatas
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
- Center for Stem Cell & Gene Therapy Research and Practice, University of Health Sciences Turkey, Istanbul 34255, Türkiye.
| | - Erdinç Civelek
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
| | - Osman Boyalı
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
| | - Gülseli Berivan Sezen
- Department of Neurosurgery, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Istanbul 34255, Türkiye
| | - Omer Ozdemir
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
| | - Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul 34668, Türkiye
| | - Necati Kaplan
- Department of Neurosurgery, Istanbul Rumeli University, Çorlu Reyap Hospital, Tekirdağ 59860, Türkiye
| | - Eyüp Can Savrunlu
- Department of Neurosurgery, Nevşehir State Hospital, Nevşehir 50300, Türkiye
| | - Erdal Karaöz
- Center for Regenerative Medicine and Stem Cell Research & Manufacturing (LivMedCell), Liv Hospital, Istanbul 34340, Türkiye
- Department of Histology and Embryology, Istinye University, Faculty of Medicine, Istanbul 34010, Türkiye
- Center for Stem Cell and Tissue Engineering Research and Practice, Istinye University, Istanbul 34340, Türkiye
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Kabatas S, Civelek E, Boyalı O, Sezen GB, Ozdemir O, Bahar-Ozdemir Y, Kaplan N, Savrunlu EC, Karaöz E. Safety and efficiency of Wharton’s Jelly-derived mesenchymal stem cell administration in patients with traumatic brain injury: First results of a phase I study. World J Stem Cells 2024; 16:640-654. [DOI: 10.4252/wjsc.v16.i6.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/26/2024] [Accepted: 05/09/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is characterized by a disruption in the normal function of the brain due to an injury following a trauma, which can potentially cause severe physical, cognitive, and emotional impairment. Stem cell transplantation has evolved as a novel treatment modality in the management of TBI, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. Wharton’s Jelly-derived mesenchymal stem cells (WJ-MSCs) have recently shown beneficial effects in the functional recovery of neurological deficits.
AIM To evaluate the safety and efficiency of MSC therapy in TBI.
METHODS We present 6 patients, 4 male and 2 female aged between 21 and 27 years who suffered a TBI. These 6 patients underwent 6 doses of intrathecal, intramuscular (i.m.) and intravenous transplantation of WJ-MSCs at a target dose of 1 × 106/kg for each application route. Spasticity was assessed using the Modified Ashworth scale (MAS), motor function according to the Medical Research Council Muscle Strength Scale, quality of life was assessed by the Functional Independence Measure (FIM) scale and Karnofsky Performance Status scale.
RESULTS Our patients showed only early, transient complications, such as subfebrile fever, mild headache, and muscle pain due to i.m. injection, which resolved within 24 h. During the one year follow-up, no other safety issues or adverse events were reported. These 6 patients showed improvements in their cognitive abilities, muscle spasticity, muscle strength, performance scores and fine motor skills when compared before and after the intervention. MAS values, which we used to assess spasticity, were observed to statistically significantly decrease for both left and right sides (P < 0.001). The FIM scale includes both motor scores (P < 0.05) and cognitive scores (P < 0.001) and showed a significant increase in pretest posttest analyses. The difference observed in the participants’ Karnofsky Performance Scale values pre and post the intervention was statistically significant (P < 0.001).
CONCLUSION This study showed that cell transplantation has a safe, effective and promising future in the management of TBI.
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Affiliation(s)
- Serdar Kabatas
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
- Center for Stem Cell & Gene Therapy Research and Practice, University of Health Sciences Turkey, Istanbul 34255, Türkiye
| | - Erdinç Civelek
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
| | - Osman Boyalı
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
| | - Gülseli Berivan Sezen
- Department of Neurosurgery, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Istanbul 34255, Türkiye
| | - Omer Ozdemir
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Türkiye
| | - Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul 34668, Türkiye
| | - Necati Kaplan
- Department of Neurosurgery, Istanbul Rumeli University, Çorlu Reyap Hospital, Tekirdağ 59860, Türkiye
| | - Eyüp Can Savrunlu
- Department of Neurosurgery, Nevşehir State Hospital, Nevşehir 50300, Türkiye
| | - Erdal Karaöz
- Center for Regenerative Medicine and Stem Cell Research & Manufacturing (LivMedCell), Liv Hospital, Istanbul 34340, Türkiye
- Department of Histology and Embryology, Istinye University, Faculty of Medicine, Istanbul 34010, Türkiye
- Center for Stem Cell and Tissue Engineering Research and Practice, Istinye University, Istanbul 34340, Türkiye
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17
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Czyżewski W, Litak J, Sobstyl J, Mandat T, Torres K, Staśkiewicz G. Aquaporins: Gatekeepers of Fluid Dynamics in Traumatic Brain Injury. Int J Mol Sci 2024; 25:6553. [PMID: 38928258 PMCID: PMC11204105 DOI: 10.3390/ijms25126553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Aquaporins (AQPs), particularly AQP4, play a crucial role in regulating fluid dynamics in the brain, impacting the development and resolution of edema following traumatic brain injury (TBI). This review examines the alterations in AQP expression and localization post-injury, exploring their effects on brain edema and overall injury outcomes. We discuss the underlying molecular mechanisms regulating AQP expression, highlighting potential therapeutic strategies to modulate AQP function. These insights provide a comprehensive understanding of AQPs in TBI and suggest novel approaches for improving clinical outcomes through targeted interventions.
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Affiliation(s)
- Wojciech Czyżewski
- Department of Neurosurgery, Maria Sklodowska-Curie National Research Institute of Oncology, ul. W.K. Roentgena 5, 02-781 Warsaw, Poland;
- Department of Didactics and Medical Simulation, Medical University of Lublin, 20-954 Lublin, Poland
| | - Jakub Litak
- Department of Clinical Immunology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Jan Sobstyl
- Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Tomasz Mandat
- Department of Neurosurgery, Maria Sklodowska-Curie National Research Institute of Oncology, ul. W.K. Roentgena 5, 02-781 Warsaw, Poland;
| | - Kamil Torres
- Department of Plastic, Reconstructive Surgery with Microsurgery, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Grzegorz Staśkiewicz
- Department of Human, Clinical and Radiological Anatomy, Medical University, 20-954 Lublin, Poland;
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18
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Dmytriw AA, Hadjinicolaou A, Ntolkeras G, Tamilia E, Pesce M, Berto LF, Grant PE, Pang E, Ahtam B. Magnetoencephalography for the pediatric population, indications, acquisition and interpretation for the clinician. Neuroradiol J 2024:19714009241260801. [PMID: 38864180 DOI: 10.1177/19714009241260801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Magnetoencephalography (MEG) is an imaging technique that enables the assessment of cortical activity via direct measures of neurophysiology. It is a non-invasive and passive technique that is completely painless. MEG has gained increasing prominence in the field of pediatric neuroimaging. This dedicated review article for the pediatric population summarizes the fundamental technical and clinical aspects of MEG for the clinician. We discuss methods tailored for children to improve data quality, including child-friendly MEG facility environments and strategies to mitigate motion artifacts. We provide an in-depth overview on accurate localization of neural sources and different analysis methods, as well as data interpretation. The contemporary platforms and approaches of two quaternary pediatric referral centers are illustrated, shedding light on practical implementations in clinical settings. Finally, we describe the expanding clinical applications of MEG, including its pivotal role in presurgical evaluation of epilepsy patients, presurgical mapping of eloquent cortices (somatosensory and motor cortices, visual and auditory cortices, lateralization of language), its emerging relevance in autism spectrum disorder research and potential future clinical applications, and its utility in assessing mild traumatic brain injury. In conclusion, this review serves as a comprehensive resource of clinicians as well as researchers, offering insights into the evolving landscape of pediatric MEG. It discusses the importance of technical advancements, data acquisition strategies, and expanding clinical applications in harnessing the full potential of MEG to study neurological conditions in the pediatric population.
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Affiliation(s)
- Adam A Dmytriw
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Division of Neuroradiology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Aristides Hadjinicolaou
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA
| | - Georgios Ntolkeras
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Eleonora Tamilia
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Matthew Pesce
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Laura F Berto
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - P Ellen Grant
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Elizabeth Pang
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Banu Ahtam
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
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19
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Semework M, Laeke T, Aklilu AT, Tadele A, Ashagre Y, Teklewold P, Kolias AG, Hutchinson P, Balcha A, Yohannes D, Hassen GW. Extended tests for evaluating post-traumatic brain injury deficits in resource-limited settings: methods and pilot study data. Front Neurol 2024; 15:1397625. [PMID: 38933324 PMCID: PMC11199529 DOI: 10.3389/fneur.2024.1397625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/29/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction Traumatic brain injury (TBI) is one of the leading causes of all injury-related deaths and disabilities in the world, especially in low to middle-income countries (LMICs) which also suffer from lower levels of funding for all levels of the health care system for patients suffering from TBI. These patients do not generally get comprehensive diagnostic workup, monitoring, or treatment, and return to work too quickly, often with undiagnosed post-traumatic deficits which in turn can lead to subsequent incidents of physical harm. Methods Here, we share methods and results from our research project to establish innovative, simple, and scientifically based practices that dramatically leverage technology and validated testing strategies to identify post-TBI deficits quickly and accurately, to circumvent economic realities on the ground in LMICs. We utilized paper tests such as the Montreal cognitive assessment (MoCA), line-bisection, and Bell's test. Furthermore, we combined modifications of neuroscience computer tasks to aid in assessing peripheral vision, memory, and analytical accuracies. Data from seventy-one subjects (51 patients and 20 controls, 15 females and 56 males) from 4 hospitals in Ethiopia are presented. The traumatic brain injury group consists of 17 mild, 28 moderate, and 8 severe patients (based on the initial Glasgow Comma Score). Controls are age and education-matched subjects (no known history of TBI, brain lesions, or spatial neglect symptoms). Results We found these neurophysiological methods can: 1) be implemented in LMICs and 2) test impairments caused by TBI, which generally affect brain processing speed, memory, and both executive and cognitive controls. Discussion The main findings indicate that these examinations can identify several deficits, especially the MoCA test. These tests show great promise to assist in the evaluation of TBI patients and support the establishment of dedicated rehabilitation centers. Our next steps will be expansion of the cohort size and application of the tests to other settings.
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Affiliation(s)
- Mulugeta Semework
- Zuckerman Mind, Brain, and Behavior Institute, Columbia University, New York, NY, United States
| | - Tsegazeab Laeke
- Neurosurgery Unit, Black Lion Specialized Hospital, Department of Neurosurgery, College of Health Science Addis Ababa University, Addis Ababa, Ethiopia
| | - Abenezer Tirsit Aklilu
- Neurosurgery Unit, Black Lion Specialized Hospital, Department of Neurosurgery, College of Health Science Addis Ababa University, Addis Ababa, Ethiopia
| | - Abraham Tadele
- Department of Neurosurgery, AABET Hospital, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Peter Teklewold
- Department of Neurosurgery, AABET Hospital, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | | | - Dagnachew Yohannes
- Hawassa University Comprehensive Specialized Hospital and College of Medicine, Hawassa, Ethiopia
| | - Getaw Worku Hassen
- Department of Emergency Medicine, Metropolitan Hospital Center, New York Medical College, New York, NY, United States
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20
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Wei L, Lei J, Lu Y, Lei W, Wu X. Pachymic acid exposure prevents DNA damage induced neuronal cell injury. Minerva Med 2024; 115:412-414. [PMID: 37382518 DOI: 10.23736/s0026-4806.23.08747-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Affiliation(s)
- Lixiao Wei
- The First School of Clinical Medicine of Lanzhou University, Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, China
- Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China
| | - Jing Lei
- Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China
| | - Yali Lu
- Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China
| | - Wenjuan Lei
- Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China
| | - Xinan Wu
- The First School of Clinical Medicine of Lanzhou University, Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, China -
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21
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Palou Martinez Y, Arrey Agbor DB, Panday P, Ejaz S, Gurugubelli S, Prathi SK, Nath TS. Mood Disorders in the Wake of Traumatic Brain Injury: A Systematic Review. Cureus 2024; 16:e62524. [PMID: 39022497 PMCID: PMC11253579 DOI: 10.7759/cureus.62524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/16/2024] [Indexed: 07/20/2024] Open
Abstract
Traumatic brain injury (TBI) frequently leads to a myriad of long-term consequences, among which mood disorders present a significant challenge. This systematic review delves into the complex interplay between TBI and subsequent mood disorders, focusing on research studies conducted over the past decade. Encompassing an age range from 12 years old to older adults (60+ years), our review aims to elucidate the epidemiological patterns, neurobiological mechanisms, and psychosocial factors that contribute to the development of mood disorders following TBI. By synthesizing the current literature, we seek to uncover the prevalence and clinical implications of this often-under-recognized comorbidity. For the quality appraisal of the reviewed articles, the Newcastle-Ottawa risk-of-bias tool and Scale for the Assessment of Narrative Review Articles (SANRA) checklist were employed. Ultimately, this review endeavors to provide a comprehensive understanding of the intricate relationship between TBI and mood disorders, offering insights crucial for improved management and intervention strategies in affected individuals.
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Affiliation(s)
- Yaneisi Palou Martinez
- Research and Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Divine Besong Arrey Agbor
- Clinical Research and Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, Richmond University Medical Center, Staten Island, USA
| | - Priyanka Panday
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Samrah Ejaz
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Simhachalam Gurugubelli
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, Memorial Healthcare, Gulfport, USA
| | - Suviksh K Prathi
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Research, St. George's University School of Medicine, St. George's, GRD
| | - Tuheen Sankar Nath
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Surgical Oncology, Tata Medical Centre, Kolkata, IND
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22
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Kagialis A, Simos N, Manolitsi K, Vakis A, Simos P, Papadaki E. Functional connectivity-hemodynamic (un)coupling changes in chronic mild brain injury are associated with mental health and neurocognitive indices: a resting state fMRI study. Neuroradiology 2024; 66:985-998. [PMID: 38605104 PMCID: PMC11133187 DOI: 10.1007/s00234-024-03352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE To examine hemodynamic and functional connectivity alterations and their association with neurocognitive and mental health indices in patients with chronic mild traumatic brain injury (mTBI). METHODS Resting-state functional MRI (rs-fMRI) and neuropsychological assessment of 37 patients with chronic mTBI were performed. Intrinsic connectivity contrast (ICC) and time-shift analysis (TSA) of the rs-fMRI data allowed the assessment of regional hemodynamic and functional connectivity disturbances and their coupling (or uncoupling). Thirty-nine healthy age- and gender-matched participants were also examined. RESULTS Patients with chronic mTBI displayed hypoconnectivity in bilateral hippocampi and parahippocampal gyri and increased connectivity in parietal areas (right angular gyrus and left superior parietal lobule (SPL)). Slower perfusion (hemodynamic lag) in the left anterior hippocampus was associated with higher self-reported symptoms of depression (r = - 0.53, p = .0006) and anxiety (r = - 0.484, p = .002), while faster perfusion (hemodynamic lead) in the left SPL was associated with lower semantic fluency (r = - 0.474, p = .002). Finally, functional coupling (high connectivity and hemodynamic lead) in the right anterior cingulate cortex (ACC)) was associated with lower performance on attention and visuomotor coordination (r = - 0.50, p = .001), while dysfunctional coupling (low connectivity and hemodynamic lag) in the left ventral posterior cingulate cortex (PCC) and right SPL was associated with lower scores on immediate passage memory (r = - 0.52, p = .001; r = - 0.53, p = .0006, respectively). Uncoupling in the right extrastriate visual cortex and posterior middle temporal gyrus was negatively associated with cognitive flexibility (r = - 0.50, p = .001). CONCLUSION Hemodynamic and functional connectivity differences, indicating neurovascular (un)coupling, may be linked to mental health and neurocognitive indices in patients with chronic mTBI.
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Affiliation(s)
- Antonios Kagialis
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, 71003, Crete, Greece
| | - Nicholas Simos
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Katina Manolitsi
- Department of Neurosurgery, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Antonios Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Panagiotis Simos
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, 71003, Crete, Greece.
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece.
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23
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Ma X, Wang H, Ye G, Zheng X, Wang Y. Hsa_circ_0018401 and miR-127-5p Expressions Are Diagnostic and Prognostic Markers for Traumatic Brain Injury (TBI) in Trauma Patients. Neuroscience 2024; 545:59-68. [PMID: 38492795 DOI: 10.1016/j.neuroscience.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Abstract
This study investigated the potentials of hsa_circ_0018401 and miR-127-5p in traumatic brain injury (TBI) diagnosis, stratification and outcome prediction. A retrospective analysis of clinical data and blood samples of n = 109 TBI patients was performed. Expression levels of hsa_circ_0018401 and miR-127-5p were measured using Real-time PCR. The diagnostic values, as well as the values in TBI stratification, of hsa_circ_0018401 and miR-127-5p were assessed by receiver operating characteristic analyses. The prognostic impacts were investigated for one-year endpoint events using multivariable Cox regression analyses and receiver operating characteristic analysis. The target genes for miR-127-5p were predicted. An upregulation of hsa_circ_0018401 and a downregulation of miR-127-5p expression was detected in patients with TBI, and the highest or lowest levels were found in moderate/severe TBI. A negative correlation between miR-423-3p level and Dual luciferase reporter assay verified the binding relationship between hsa_circ_0018401 and miR-127-5p. Hsa_circ_0018401 and miR-127-5p, used alone or combinedly, showed clinical values for TBI diagnosis and stratification, as well as outcome prediction. The proteins for target genes covered TBI-related functions and pathways. Therefore, hsa_circ_0018401 and miR-127-5p could represent promising new biomarkers to identify TBI from healthy, moderate/severe TBI from mild TBI, as well as to predict the TBI outcome.
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Affiliation(s)
- Xiancun Ma
- Department of Emergency, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Huimin Wang
- Department of Emergency, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Gaige Ye
- Department of Emergency, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Xin Zheng
- Department of Emergency, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Yu Wang
- Department of Emergency, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China.
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24
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Ray S, Luke J, Kreitzer N. Patient-centered mild traumatic brain injury interventions in the emergency department. Am J Emerg Med 2024; 79:183-191. [PMID: 38460465 DOI: 10.1016/j.ajem.2024.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/11/2024] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) results in 2.5 million emergency department (ED) visits per year in the US, with mild traumatic brain injury (mTBI) accounting for 90% of cases. There is considerable evidence that many experience chronic symptoms months to years later. This population is rarely represented in interventional studies. Management of adult mTBI in the ED has remained unchanged, without consensus of therapeutic options. The aim of this review was to synthesize existing literature of patient-centered ED treatments for adults who sustain an mTBI, and to identify practices that may offer promise. METHODS A systematic review was conducted using the PubMed and Cochrane databases, while following PRISMA guidelines. Studies describing pediatric patients, moderate to severe TBI, or interventions outside the ED were excluded. Two reviewers independently performed title and abstract screening. A third blinded reviewer resolved discrepancies. The Mixed Methods Appraisal Tool (MMAT) was employed to assess the methodological quality of the studies. RESULTS Our search strategy generated 1002 unique titles. 95 articles were selected for full-text screening. The 26 articles chosen for full analysis were grouped into one of the following intervention categories: (1) predictive models for Post-Concussion Syndrome (PCS), (2) discharge instructions, (3) pharmaceutical treatment, (4) clinical protocols, and (5) functional assessment. Studies that implemented a predictive PCS model successfully identified patients at highest risk for PCS. Trials implementing discharge related interventions found the use of video discharge instructions, encouragement of daily light exercise or bed rest, and text messaging did not significantly reduce mTBI symptoms. The use of electronic clinical practice guidelines (eCPG) and longer leaves of absence from work following injury reduced symptoms. Ondansetron was shown to reduce nausea in mTBI patients. Studies implementing ED Observation Units found significant declines in inpatient admissions and length of hospital stay. The use of tablet-based tasks was found to be superior to many standard cognitive assessments. CONCLUSION Validated instruments are available to aid clinicians in identifying patients at risk for PCS or serious cognitive impairment. EDOU management and evidence-based modifications to discharge instructions may improve mTBI outcomes. Additional research is needed to establish the therapeutic value of medications and lifestyle changes for the treatment of mTBI in the ED.
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Affiliation(s)
- Sarah Ray
- University of Cincinnati School of Medicine, USA
| | - Jude Luke
- University of Cincinnati School of Medicine, USA
| | - Natalie Kreitzer
- Department of Emergency Medicine, University of Cincinnati, USA.
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25
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Govier DJ, Gilbert TA, Jacob RL, Lafferty M, Mulcahy A, Pogoda TK, Zogas A, O’Neil ME, Pugh MJ, Carlson KF. Prevalence and Correlates of VA-Purchased Community Care Use Among Post-9/11-Era Veterans With Traumatic Brain Injury. J Head Trauma Rehabil 2024; 39:207-217. [PMID: 38709829 PMCID: PMC11074530 DOI: 10.1097/htr.0000000000000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Post-9/11-era veterans with traumatic brain injury (TBI) have greater health-related complexity than veterans overall, and may require coordinated care from TBI specialists such as those within the Department of Veterans Affairs (VA) healthcare system. With passage of the Choice and MISSION Acts, more veterans are using VA-purchased care delivered by community providers who may lack TBI training. We explored prevalence and correlates of VA-purchased care use among post-9/11 veterans with TBI. SETTING Nationwide VA-purchased care from 2016 through 2019. PARTICIPANTS Post-9/11-era veterans with clinician-confirmed TBI based on VA's Comprehensive TBI Evaluation (N = 65 144). DESIGN This was a retrospective, observational study. MAIN MEASURES Proportions of veterans who used VA-purchased care and both VA-purchased and VA-delivered outpatient care, overall and by study year. We employed multivariable logistic regression to assess associations between veterans' sociodemographic, military history, and clinical characteristics and their likelihood of using VA-purchased care from 2016 through 2019. RESULTS Overall, 51% of veterans with TBI used VA-purchased care during the study period. Nearly all who used VA-purchased care (99%) also used VA-delivered outpatient care. Veterans' sociodemographic, military, and clinical characteristics were associated with their likelihood of using VA-purchased care. Notably, in adjusted analyses, veterans with moderate/severe TBI (vs mild), those with higher health risk scores, and those diagnosed with posttraumatic stress disorder, depression, anxiety, substance use disorders, or pain-related conditions had increased odds of using VA-purchased care. Additionally, those flagged as high risk for suicide also had higher odds of VA-purchased care use. CONCLUSIONS Veterans with TBI with greater health-related complexity were more likely to use VA-purchased care than their less complex counterparts. The risks of potential care fragmentation across providers versus the benefits of increased access to care are unknown. Research is needed to examine health and functional outcomes among these veterans.
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Affiliation(s)
- Diana J. Govier
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR
- Oregon Health & Science University – Portland State University School of Public Health, Portland, OR
| | - Tess A. Gilbert
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR
| | - R. Lorie Jacob
- Center of Innovation for Complex Chronic Care, Edward Hines Jr. VA Hospital, Hines, IL
| | - Megan Lafferty
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR
| | - Abby Mulcahy
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR
- Oregon Health & Science University – Portland State University School of Public Health, Portland, OR
| | - Terri K. Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA
- Boston University School of Public Health, Boston, MA
| | - Anna Zogas
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA
- Boston University Chobanian & Avedisian School of Medicine Section of General Internal Medicine, Boston, MA
| | - Maya E. O’Neil
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR
- Oregon Health & Science University, Portland, OR
| | - Mary Jo Pugh
- Informatics, Decision-Enhancement and Analytic Sciences Center of Innovation, Salt Lake City, UT
- University of Utah, Salt Lake City, UT
| | - Kathleen F. Carlson
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR
- Oregon Health & Science University – Portland State University School of Public Health, Portland, OR
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Mahmoodkhani M, Behfarnia P, Aminmansour B. Compare the GCS and the Rotterdam CT Score in Predicting the Mortality and Disability of Patients with Traumatic Brain Injury. Adv Biomed Res 2024; 13:35. [PMID: 39234431 PMCID: PMC11373729 DOI: 10.4103/abr.abr_453_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/13/2024] [Accepted: 02/24/2024] [Indexed: 09/06/2024] Open
Abstract
Background Given the dearth of extensive research comparing the Glasgow Coma Scale with the Rotterdam scoring system for predicting mortality in trauma patients, this study was conducted to determine which scale provides a more realistic prediction of mortality in trauma patients after three months. Materials and Methods This observational study was performed at Kashani Hospital in Isfahan, Iran. Patients with TBI who were admitted between February 2022 and February 2023 were included in the study. Approval from the Ethical Committee of Isfahan University of Medical Sciences was obtained prior to conducting this study. Results We included 152 adult patients who completed the GOS-E and the QOLIBRI-OS three-month post-injury. The median age was 35 years (IQR = 17-70). Most patients 139 (91.4%) were classified as having a severe TBI. Conclusion The results of the present study showed that both the use of GCS and Rotterdam CT scores can be effective in predicting the three-month mortality and QOLIBRI-OS scores of patients, with the difference that the predictive power of the three-month Rotterdam CT score is greater than that of the GCS.
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Affiliation(s)
- Mehdi Mahmoodkhani
- Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parham Behfarnia
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Aminmansour
- Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Cai A, Li Y, Xi X, Wang Q, Yang J, Wang L, Li H, Luo X, Zeng X. Analysis of risk factors and development of predictive model for malnutrition in patients with traumatic brain injury. Nutr Neurosci 2024:1-11. [PMID: 38662341 DOI: 10.1080/1028415x.2024.2342152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Malnutrition is a highly prevalent complication in patients with traumatic brain injury (TBI), and it is closely related to the prognosis of patients. Accurate identification of patients at high risk of malnutrition is essential. Therefore, we analyzed the risk factors of malnutrition in patients with TBI and developed a model to predict the risk of malnutrition. A retrospective collection of 345 patients with TBI, and they were divided into malnutrition and comparison groups according to the occurrence of malnutrition. Univariate correlation and multifactor logistic regression analyses were performed to determine patients' malnutrition risk factors. We used univariate and logistic regression (forward stepwise method) analyses to identify significant predictors associated with malnutrition in patients with TBI and developed a predictive model for malnutrition prediction. The model's discrimination, calibration, and clinical utility were evaluated using the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA). A total of 216 patients (62.6%) developed malnutrition. Multifactorial logistic regression analysis showed that pulmonary infection, urinary tract infection, dysphagia, application of NGT, GCS score ≤ 8, and low ADL score were independent risk factors for malnutrition in patients with TBI (P < 0.05). The area under the curve of the model was 0.947. Calibration plots showed good discrimination of model calibration. DCA showed that the column line plot models were all clinically meaningful when nutritional interventions were performed over a considerable range of threshold probabilities (0-0.98). Malnutrition is widespread in patients with TBI, and the nomogram is a good predictor of whether patients develop malnutrition.
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Affiliation(s)
- Ang Cai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yi Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiao Xi
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA
| | - Qingmei Wang
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA
| | - Junfeng Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Liugen Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Heping Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, People's Republic of China
| | - Xi Zeng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, People's Republic of China
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28
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Belding JN, Bonkowski J, Englert R. Traumatic brain injury and occupational risk of low-level blast exposure on adverse career outcomes: an examination of administrative and medical separations from Service (2005-2015). Front Neurol 2024; 15:1389757. [PMID: 38689879 PMCID: PMC11058224 DOI: 10.3389/fneur.2024.1389757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Although traumatic brain injury (TBI) has been linked with adverse long-term health, less research has examined whether TBI is linked with non-clinical outcomes including involuntary job loss. Symptoms associated with TBI may influence one's ability to maintain gainful employment including employment in the U.S. military. That influence may impact military service members with exposure to repetitive low-level blast (LLB). Understanding the association between TBI and involuntary job loss outcomes among military populations is particularly important as it may be associated with differences in eligibility for post-service benefits. The purpose of the present research was to determine whether (1) TBI and related conditions are associated with involuntary job loss (i.e., medical and administrative separations from service) among military personnel, and (2) occupational risk of LLB is associated with involuntary job loss in both the presence and absence of clinical diagnoses of TBI and related conditions. Method This research leveraged population-level data from the Career History Archival Medical and Personnel System for enlisted personnel who served on active duty between 2005-2015. Risk of LLB exposure was categorized using military occupational specialty as a proxy. Medical diagnoses were identified using ICD-9 codes. Separations for medical and administrative reasons were identified. Results Risk for administrative separation differed across medical diagnoses of interest, but those who worked in high-risk occupations were more likely to be administratively separated than those working in low-risk occupations. Risk for medical separation was associated with occupational risk of LLB and each of the diagnoses of interest, though significant interactions suggested that the effects of certain diagnoses of interest (e.g., concussion, cognitive problems, postconcussive syndrome, migraines) on medical separations was greater among those working in high-risk occupations. Discussion Taken together, the present research suggests that TBI and associated medical conditions, as well as occupational risk of LLB, are associated with long-term involuntary job loss for medical reasons. This study is the first to demonstrate involuntary military job loss outcomes associated with TBI, mental health conditions, and conditions associated with blast exposure using both inpatient and outpatient population-level data and may have important implications for civilian employment and post-service benefits.
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Affiliation(s)
| | - James Bonkowski
- Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Robyn Englert
- Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
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Kawata K, Rettke DJ, Thompson C, Mannix R, Bazarian JJ, Datta D. Effectiveness of biomedical interventions on the chronic stage of traumatic brain injury: a systematic review of randomized controlled trials. Front Neurol 2024; 15:1321239. [PMID: 38562423 PMCID: PMC10983769 DOI: 10.3389/fneur.2024.1321239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Traumatic brain injury (TBI), in any form and severity, can pose risks for developing chronic symptoms that can profoundly hinder patients' work/academic, social, and personal lives. In the past 3 decades, a multitude of pharmacological, stimulation, and exercise-based interventions have been proposed to ameliorate symptoms, memory impairment, mental fatigue, and/or sleep disturbances. However, most research is preliminary, thus limited influence on clinical practice. This review aims to systematically appraise the evidence derived from randomized controlled trials (RCT) regarding the effectiveness of pharmacological, stimulation, and exercise-based interventions in treating chronic symptoms due to TBI. Our search results indicate that despite the largest volume of literature, pharmacological interventions, especially using neurostimulant medications to treat physical, cognitive, and mental fatigue, as well as daytime sleepiness, have yielded inconsistent results, such that some studies found improvements in fatigue (e.g., Modafinil, Armodafinil) while others failed to yield the improvements after the intervention. Conversely, brain stimulation techniques (e.g., transcranial magnetic stimulation, blue light therapy) and exercise interventions were effective in ameliorating mental health symptoms and cognition. However, given that most RCTs are equipped with small sample sizes, more high-quality, larger-scale RCTs is needed.
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Affiliation(s)
- Keisuke Kawata
- Department of Kinesiology, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
- Program in Neuroscience, The College of Arts and Sciences, Indiana University, Bloomington, IN, United States
| | - Devin J. Rettke
- Department of Kinesiology, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| | - Christopher Thompson
- Department of Kinesiology, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Jeffrey J. Bazarian
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Dibyadyuti Datta
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
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Jiang H, Giarratana AO, Theis T, Nagaraj V, Zhou X, Thakker-Varia S, Schachner M, Alder J. Single Nucleotide Polymorphism in Cell Adhesion Molecule L1 Affects Learning and Memory in a Mouse Model of Traumatic Brain Injury. Int J Mol Sci 2024; 25:3043. [PMID: 38474289 DOI: 10.3390/ijms25053043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
The L1 cell adhesion molecule (L1) has demonstrated a range of beneficial effects in animal models of spinal cord injury, neurodegenerative disease, and ischemia; however, the role of L1 in TBI has not been fully examined. Mutations in the L1 gene affecting the extracellular domain of this type 1 transmembrane glycoprotein have been identified in patients with L1 syndrome. These patients suffer from hydrocephalus, MASA (mental retardation, adducted thumbs, shuffling gait, aphasia) symptoms, and corpus callosum agenesis. Clinicians have observed that recovery post-traumatic brain injury (TBI) varies among the population. This variability may be explained by the genetic differences present in the general population. In this study, we utilized a novel mouse model of L1 syndrome with a mutation at aspartic acid position 201 in the extracellular domain of L1 (L1-201). We assessed the impact of this specific single nucleotide polymorphism (SNP) localized to the X-chromosome L1 gene on recovery outcomes following TBI by comparing the L1-201 mouse mutants with their wild-type littermates. We demonstrate that male L1-201 mice exhibit significantly worse learning and memory outcomes in the Morris water maze after lateral fluid percussion (LFP) injury compared to male wild-type mice and a trend to worse motor function on the rotarod. However, no significant changes were observed in markers for inflammatory responses or apoptosis after TBI.
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Affiliation(s)
- Haoyu Jiang
- Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
| | - Anna O Giarratana
- Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
| | - Thomas Theis
- Cell Biology and Neuroscience, Rutgers School of Arts and Sciences, Piscataway, NJ 08854, USA
| | - Vini Nagaraj
- Cell Biology and Neuroscience, Rutgers School of Arts and Sciences, Piscataway, NJ 08854, USA
| | - Xiaofeng Zhou
- Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
| | - Smita Thakker-Varia
- Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
| | - Melitta Schachner
- Cell Biology and Neuroscience, Rutgers School of Arts and Sciences, Piscataway, NJ 08854, USA
| | - Janet Alder
- Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
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Peper CJ, Kilgore MD, Jiang Y, Xiu Y, Xia W, Wang Y, Shi M, Zhou D, Dumont AS, Wang X, Liu N. Tracing the path of disruption: 13C isotope applications in traumatic brain injury-induced metabolic dysfunction. CNS Neurosci Ther 2024; 30:e14693. [PMID: 38544365 PMCID: PMC10973562 DOI: 10.1111/cns.14693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 05/14/2024] Open
Abstract
Cerebral metabolic dysfunction is a critical pathological hallmark observed in the aftermath of traumatic brain injury (TBI), as extensively documented in clinical investigations and experimental models. An in-depth understanding of the bioenergetic disturbances that occur following TBI promises to reveal novel therapeutic targets, paving the way for the timely development of interventions to improve patient outcomes. The 13C isotope tracing technique represents a robust methodological advance, harnessing biochemical quantification to delineate the metabolic trajectories of isotopically labeled substrates. This nuanced approach enables real-time mapping of metabolic fluxes, providing a window into the cellular energetic state and elucidating the perturbations in key metabolic circuits. By applying this sophisticated tool, researchers can dissect the complexities of bioenergetic networks within the central nervous system, offering insights into the metabolic derangements specific to TBI pathology. Embraced by both animal studies and clinical research, 13C isotope tracing has bolstered our understanding of TBI-induced metabolic dysregulation. This review synthesizes current applications of isotope tracing and its transformative potential in evaluating and addressing the metabolic sequelae of TBI.
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Affiliation(s)
- Charles J. Peper
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Mitchell D. Kilgore
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Yinghua Jiang
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Yuwen Xiu
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Winna Xia
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Yingjie Wang
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Mengxuan Shi
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Di Zhou
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Aaron S. Dumont
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
| | - Xiaoying Wang
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
- Neuroscience Program, Tulane Brain InstituteTulane UniversityNew OrleansLouisianaUSA
| | - Ning Liu
- Clinical Neuroscience Research Center, Departments of Neurosurgery and NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
- Neuroscience Program, Tulane Brain InstituteTulane UniversityNew OrleansLouisianaUSA
- Tulane University Translational Sciences InstituteNew OrleansLouisianaUSA
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Chen B, Tan Q, Zhang H, Chu W, Wen H, Tian X, Yang Y, Li W, Li W, Chen Y, Feng H. Contralesional Anodal Transcranial Direct Current Stimulation Promotes Intact Corticospinal Tract Axonal Sprouting and Functional Recovery After Traumatic Brain Injury in Mice. Neurorehabil Neural Repair 2024; 38:214-228. [PMID: 38385458 DOI: 10.1177/15459683241233261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
BACKGROUND Anodal transcranial direct current stimulation (AtDCS), a neuromodulatory technique, has been applied to treat traumatic brain injury (TBI) in patients and was reported to promote functional improvement. We evaluated the effect of contralesional AtDCS on axonal sprouting of the intact corticospinal tract (CST) and the underlying mechanism in a TBI mouse model to provide more preclinical evidence for the use of AtDCS to treat TBI. METHODS TBI was induced in mice by a contusion device. Then, the mice were subjected to contralesional AtDCS 5 days per week followed by a 2-day interval for 7 weeks. After AtDCS, motor function was evaluated by the irregular ladder walking, narrow beam walking, and open field tests. CST sprouting was assessed by anterograde and retrograde labeling of corticospinal neurons (CSNs), and the effect of AtDCS was further validated by pharmacogenetic inhibition of axonal sprouting using clozapine-N-oxide (CNO). RESULTS TBI resulted in damage to the ipsilesional cortex, while the contralesional CST remained intact. AtDCS improved the skilled motor functions of the impaired hindlimb in TBI mice by promoting CST axon sprouting, specifically from the intact hemicord to the denervated hemicord. Furthermore, electrical stimulation of CSNs significantly increased the excitability of neurons and thus activated the mechanistic target of rapamycin (mTOR) pathway. CONCLUSIONS Contralesional AtDCS improved skilled motor following TBI, partly by promoting axonal sprouting through increased neuronal activity and thus activation of the mTOR pathway.
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Affiliation(s)
- Beike Chen
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qiang Tan
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Blood Transfusion, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, China
| | - Hongyan Zhang
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Weihua Chu
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Huizhong Wen
- Department of Neurobiology, College of Basic Medical Science, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xuelong Tian
- College of Bioengineering, Chongqing University, Chongqing, China
| | - Yang Yang
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Neurosurgery, The 904th Hospital of PLA, School of Medicine of Anhui Medical University, Wuxi, Jiangsu Province, China
| | - Weina Li
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenyan Li
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yujie Chen
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hua Feng
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Jaafari O, Salih S, Alkatheeri A, Alshehri M, Al-Shammari M, Maeni M, Alqahtani A, Alomaim W, Hasaneen M. Appropriate incorporation of susceptibility-weighted magnetic resonance imaging into routine imaging protocols for accurate diagnosis of traumatic brain injuries: a systematic review. J Med Life 2024; 17:273-280. [PMID: 39044937 PMCID: PMC11262612 DOI: 10.25122/jml-2023-0487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/12/2024] [Indexed: 07/25/2024] Open
Abstract
Traumatic brain injury (TBI) results from physical or traumatic injuries to the brain's surrounding bony structures and associated tissues, which can lead to various sequelae, including simple concussion, acute epidural hematoma, parenchymal contusions, subarachnoid hemorrhage, diffuse axonal injury, and chronic traumatic encephalopathy. Susceptibility-weighted imaging (SWI) has enhanced the accuracy of neuroimaging for these injuries. SWI is based on 3D gradient echo magnetic resonance imaging (MRI) with long echo times and flow compensation. Owing to its sensitivity to deoxyhemoglobin, hemosiderin, iron, and calcium, SWI is extremely informative and superior to conventional MRI for the diagnosis and follow-up of patients with acute, subacute, and prolonged hemorrhage. This systematic review aimed to evaluate and summarize the published articles that report SWI results for the evaluation of TBI and to determine correlations between clinical status and SWI results. Consequently, our analysis also aimed to identify the appropriate MRI sequences to use in the assessment of patients with TBI. We searched the Medline and Embase online electronic databases for relevant papers published from 2012 onwards. We found that SWI had higher sensitivity than gradient echo MRI in detecting and characterizing microbleeds in TBIs and was able to differentiate diamagnetic calcifications from paramagnetic microhemorrhages. However, it is important that future research not only continues to evaluate the utility of SWI in TBIs but also attempts to overcome the limitations of the studies described in this review, which should help validate the conclusions and recommendations from our analysis.
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Affiliation(s)
- Osama Jaafari
- Radiology Department, Royal Commission Medical Center, King Fahad, Al-Nakheel, Yanbu, Saudi Arabia
| | - Suliman Salih
- Department of Radiography and Medical Imaging, Fatima College of Health Sciences, Al Ain, United Arab Emirates
| | - Ajnas Alkatheeri
- Department of Radiography and Medical Imaging, Fatima College of Health Sciences, Al Ain, United Arab Emirates
| | - Muhamed Alshehri
- Department of Radiology and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Majedh Al-Shammari
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Mousa Maeni
- Radiology Department, Royal Commission Medical Center, King Fahad, Al-Nakheel, Yanbu, Saudi Arabia
| | - Abdullah Alqahtani
- Radiology Department, Royal Commission Medical Center, King Fahad, Al-Nakheel, Yanbu, Saudi Arabia
| | - Wijdan Alomaim
- Department of Radiography and Medical Imaging, Fatima College of Health Sciences, Al Ain, United Arab Emirates
| | - Mohamed Hasaneen
- Department of Radiography and Medical Imaging, Fatima College of Health Sciences, Al Ain, United Arab Emirates
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Kar SK, Choudhary P, Raje D, Bharti V. Multi-modal intervention for neuropsychological symptoms following traumatic brain injury: A case report. Indian J Psychiatry 2024; 66:311-312. [PMID: 39100119 PMCID: PMC11293285 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_823_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/14/2024] [Accepted: 02/20/2024] [Indexed: 08/06/2024] Open
Affiliation(s)
- Sujita K Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Priyanshi Choudhary
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Devika Raje
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Vikas Bharti
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
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Boland R, Kokiko-Cochran ON. Deplete and repeat: microglial CSF1R inhibition and traumatic brain injury. Front Cell Neurosci 2024; 18:1352790. [PMID: 38450286 PMCID: PMC10915023 DOI: 10.3389/fncel.2024.1352790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/25/2024] [Indexed: 03/08/2024] Open
Abstract
Traumatic brain injury (TBI) is a public health burden affecting millions of people. Sustained neuroinflammation after TBI is often associated with poor outcome. As a result, increased attention has been placed on the role of immune cells in post-injury recovery. Microglia are highly dynamic after TBI and play a key role in the post-injury neuroinflammatory response. Therefore, microglia represent a malleable post-injury target that could substantially influence long-term outcome after TBI. This review highlights the cell specific role of microglia in TBI pathophysiology. Microglia have been manipulated via genetic deletion, drug inhibition, and pharmacological depletion in various pre-clinical TBI models. Notably, colony stimulating factor 1 (CSF1) and its receptor (CSF1R) have gained much traction in recent years as a pharmacological target on microglia. CSF1R is a transmembrane tyrosine kinase receptor that is essential for microglia proliferation, differentiation, and survival. Small molecule inhibitors targeting CSF1R result in a swift and effective depletion of microglia in rodents. Moreover, discontinuation of the inhibitors is sufficient for microglia repopulation. Attention is placed on summarizing studies that incorporate CSF1R inhibition of microglia. Indeed, microglia depletion affects multiple aspects of TBI pathophysiology, including neuroinflammation, oxidative stress, and functional recovery with measurable influence on astrocytes, peripheral immune cells, and neurons. Taken together, the data highlight an important role for microglia in sustaining neuroinflammation and increasing risk of oxidative stress, which lends to neuronal damage and behavioral deficits chronically after TBI. Ultimately, the insights gained from CSF1R depletion of microglia are critical for understanding the temporospatial role that microglia develop in mediating TBI pathophysiology and recovery.
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Affiliation(s)
- Rebecca Boland
- Department of Neuroscience, College of Medicine, Chronic Brain Injury Program, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, United States
| | - Olga N Kokiko-Cochran
- Department of Neuroscience, College of Medicine, Chronic Brain Injury Program, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, United States
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Silvestro S, Raffaele I, Quartarone A, Mazzon E. Innovative Insights into Traumatic Brain Injuries: Biomarkers and New Pharmacological Targets. Int J Mol Sci 2024; 25:2372. [PMID: 38397046 PMCID: PMC10889179 DOI: 10.3390/ijms25042372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
A traumatic brain injury (TBI) is a major health issue affecting many people across the world, causing significant morbidity and mortality. TBIs often have long-lasting effects, disrupting daily life and functionality. They cause two types of damage to the brain: primary and secondary. Secondary damage is particularly critical as it involves complex processes unfolding after the initial injury. These processes can lead to cell damage and death in the brain. Understanding how these processes damage the brain is crucial for finding new treatments. This review examines a wide range of literature from 2021 to 2023, focusing on biomarkers and molecular mechanisms in TBIs to pinpoint therapeutic advancements. Baseline levels of biomarkers, including neurofilament light chain (NF-L), ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), Tau, and glial fibrillary acidic protein (GFAP) in TBI, have demonstrated prognostic value for cognitive outcomes, laying the groundwork for personalized treatment strategies. In terms of pharmacological progress, the most promising approaches currently target neuroinflammation, oxidative stress, and apoptotic mechanisms. Agents that can modulate these pathways offer the potential to reduce a TBI's impact and aid in neurological rehabilitation. Future research is poised to refine these therapeutic approaches, potentially revolutionizing TBI treatment.
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Affiliation(s)
| | | | | | - Emanuela Mazzon
- IRCCS Centro Neurolesi Bonino Pulejo, Via Provinciale Palermo, SS 113, Contrada Casazza, 98124 Messina, Italy; (S.S.); (I.R.); (A.Q.)
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Fu Y, Jin Z. Effects of Dexmedetomidine on Cognitive Function, Oxidative Stress and Brain Protection in Patients Undergoing Craniocerebral Surgery. ACTAS ESPANOLAS DE PSIQUIATRIA 2024; 52:19-27. [PMID: 38454897 PMCID: PMC10926013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND The protective mechanism of dexmedetomidine on the brains of patients undergoing craniocerebral surgery remains unclear. The aim of this study was to examine the impact of dexmedetomidine on cognitive function, oxidative stress, and brain protection in such patients. METHODS Fifty-four patients who underwent craniocerebral surgery at our hospital from January 2020 to June 2023 were retrospectively selected as study subjects. They were divided into two groups: the control group (n = 27) and the study group (n = 27), based on different auxiliary anesthesia protocols. Patients in the study group received dexmedetomidine before anesthesia induction, using a midline intravenous pump to assist anesthesia, while the control group received an equivalent amount of normal saline. The remaining anesthesia induction and maintenance protocols were consistent for both groups. Cognitive function was assessed using the Mini Mental State Examination (MMSE) before and 1 day after surgery for both groups. Oxidative stress indicators, including malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) levels in the serum of both groups, were measured using enzyme-linked immunosorbent assay (ELISA). Additionally, changes in postoperative brain injury indicators, namely neuron-specific enolase (NSE) and central nervous system-specific protein (S100β), were detected and compared in the serum of both groups. Concurrently, postoperative adverse reactions were recorded for both groups. RESULTS The MMSE scale scores of both groups of patients 24 hours after surgery were significantly lower than those before surgery. However, the MMSE scale scores of the study group patients were notably higher than those in the control group, with a statistically significant difference (p < 0.05). One hour after surgery, the serum levels of MDA, GSH-Px, and SOD in both groups of patients were significantly elevated compared to pre-surgery levels. Yet, the study group exhibited significantly lower levels of MDA, GSH-Px, and SOD in comparison to the control group, and these differences were statistically significant (p < 0.05). The serum levels of NSE and S100β in both groups were markedly higher than preoperative levels 24 hours after surgery. However, the study group demonstrated significantly lower levels of serum NSE and S100β compared to the control group, with a statistically significant difference (p < 0.05). The incidence of postoperative complications in the study group was 7.41% (2/27), indicating a decreasing trend compared to 18.52% (5/27) in the control group. However, this difference did not reach statistical significance (χ2 = 1.477, p = 0.224). CONCLUSION Dexmedetomidine-assisted anesthesia in craniocerebral surgery can effectively enhance postoperative cognitive function, mitigate oxidative stress, and facilitate overall postoperative recovery for patients. The intervention exhibits a favorable safety profile with no reported serious adverse reactions, establishing it as a relatively safe and reliable approach.
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Affiliation(s)
- Yan Fu
- Department of Anesthesiology, The First People’s Hospital of Daishan, 316200 Zhoushan, Zhejiang, China
| | - Zhu Jin
- Department of Anesthesiology, Sahzu International Medical Center, 311215 Hangzhou, Zhejiang, China
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Razavi SM, Arab ZN, Niknejad A, Hosseini Y, Fouladi A, Khales SD, Shahali M, Momtaz S, Butler AE, Sukhorukov VN, Jamialahmadi T, Abdolghaffari AH, Sahebkar A. Therapeutic effects of anti-diabetic drugs on traumatic brain injury. Diabetes Metab Syndr 2024; 18:102949. [PMID: 38308863 DOI: 10.1016/j.dsx.2024.102949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/05/2024]
Abstract
AIMS In this narrative review, we have analyzed and synthesized current studies relating to the effects of anti-diabetic drugs on traumatic brain injury (TBI) complications. METHODS Eligible studies were collected from Scopus, Google Scholar, PubMed, and Cochrane Library for clinical, in-vivo, and in-vitro studies published on the impact of anti-diabetic drugs on TBI. RESULTS Traumatic brain injury (TBI) is a serious brain disease that is caused by any type of trauma. The pathophysiology of TBI is not yet fully understood, though physical injury and inflammatory events have been implicated in TBI progression. Several signaling pathways are known to play pivotal roles in TBI injuries, including Nuclear factor erythroid 2-related factor 2 (Nrf2), High mobility group box 1 protein/Nuclear factor kappa B (HMGB1/NF-κB), Adiponectin, Mammalian Target of Rapamycin (mTOR), Toll-Like Receptor (TLR), Wnt/β-catenin, Janus Kinase/Signal Transducers and Activators of Transcription (JAK/STAT), Nod-like receptor protein3 (NLRP3) inflammasome, Phosphoglycerate kinase 1/Kelch-like ECH-associated protein 1 (PGK1/KEAP1)/Nrf2, and Mitogen-activated protein kinase (MAPK) . Recent studies suggest that oral anti-diabetic drugs such as biguanides, thiazolidinediones (TZDs), sulfonylureas (SUs), sodium-glucose cotransporter-2 inhibitors (SGLT2is), dipeptidyl peptidase-4 inhibitors (DPPIs), meglitinides, and alpha-glucosidase inhibitors (AGIs) could have beneficial effects in the management of TBI complications. These drugs may downregulate the inflammatory pathways and induce antioxidant signaling pathways, thus alleviating complications of TBI. CONCLUSION Based on this comprehensive literature review, antidiabetic medications might be considered in the TBI treatment protocol. However, evidence from clinical trials in patients with TBI is still warranted.
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Affiliation(s)
- Seyed Mehrad Razavi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Zahra Najafi Arab
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amirhossein Niknejad
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Yasamin Hosseini
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Abtin Fouladi
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Darban Khales
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mostafa Shahali
- School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeideh Momtaz
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran; Department of Toxicology and Pharmacology, School of Pharmacy, and Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Alexandra E Butler
- Research Department, Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain
| | - Vasily N Sukhorukov
- Institute of General Pathology and Pathophysiology, Moscow, Russia; Institute of Experimental Cardiology Named after Academician V.N. Smirnov, Federal State Budgetary Institution National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Moscow, Russia
| | - Tannaz Jamialahmadi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hossein Abdolghaffari
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Pulliam A, Gier EC, Gaul DA, Moore SG, Fernández FM, LaPlaca MC. Comparing Brain and Blood Lipidome Changes following Single and Repetitive Mild Traumatic Brain Injury in Rats. ACS Chem Neurosci 2024; 15:300-314. [PMID: 38179922 PMCID: PMC10797623 DOI: 10.1021/acschemneuro.3c00603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
Traumatic brain injury (TBI) is a major health concern in the United States and globally, contributing to disability and long-term neurological problems. Lipid dysregulation after TBI is underexplored, and a better understanding of lipid turnover and degradation could point to novel biomarker candidates and therapeutic targets. Here, we investigated overlapping lipidome changes in the brain and blood using a data-driven discovery approach to understand lipid alterations in the brain and serum compartments acutely following mild TBI (mTBI) and the potential efflux of brain lipids to peripheral blood. The cortices and sera from male and female Sprague-Dawley rats were analyzed via ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) in both positive and negative ion modes following single and repetitive closed head impacts. The overlapping lipids in the data sets were identified with an in-house data dictionary for investigating lipid class changes. MS-based lipid profiling revealed overall increased changes in the serum compartment, while the brain lipids primarily showed decreased changes. Interestingly, there were prominent alterations in the sphingolipid class in the brain and blood compartments after single and repetitive injury, which may suggest efflux of brain sphingolipids into the blood after TBI. Genetic algorithms were used for predictive panel selection to classify injured and control samples with high sensitivity and specificity. These overlapping lipid panels primarily mapped to the glycerophospholipid metabolism pathway with Benjamini-Hochberg adjusted q-values less than 0.05. Collectively, these results detail overlapping lipidome changes following mTBI in the brain and blood compartments, increasing our understanding of TBI-related lipid dysregulation while identifying novel biomarker candidates.
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Affiliation(s)
- Alexis
N. Pulliam
- Coulter
Department of Biomedical Engineering, Georgia
Institute of Technology/Emory University, Atlanta, GA 30332 USA
- Petit
Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Eric C. Gier
- School
of Chemistry and Biochemistry, Georgia Institute
of Technology, Atlanta, GA 30332 USA
- Petit
Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - David A. Gaul
- School
of Chemistry and Biochemistry, Georgia Institute
of Technology, Atlanta, GA 30332 USA
- Petit
Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Samuel G. Moore
- School
of Chemistry and Biochemistry, Georgia Institute
of Technology, Atlanta, GA 30332 USA
- Petit
Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Facundo M. Fernández
- School
of Chemistry and Biochemistry, Georgia Institute
of Technology, Atlanta, GA 30332 USA
- Petit
Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Michelle C. LaPlaca
- Coulter
Department of Biomedical Engineering, Georgia
Institute of Technology/Emory University, Atlanta, GA 30332 USA
- Petit
Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Stromberg KM, Martindale SL, Walker WC, Ou Z, Pogoda TK, Miles SR, Dismuke-Greer CE, Carlson KF, Rowland JA, O’Neil ME, Pugh MJ. Mild traumatic brain injury, PTSD symptom severity, and behavioral dyscontrol: a LIMBIC-CENC study. Front Neurol 2024; 14:1286961. [PMID: 38274880 PMCID: PMC10808394 DOI: 10.3389/fneur.2023.1286961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
Background Behavioral dyscontrol occurs commonly in the general population and in United States service members and Veterans (SM/V). This condition merits special attention in SM/V, particularly in the aftermath of deployments. Military deployments frequently give rise to posttraumatic stress disorder (PTSD) and deployment-related mild TBI traumatic brain injury (TBI), potentially leading to manifestations of behavioral dyscontrol. Objective Examine associations among PTSD symptom severity, deployment-related mild traumatic brain injury, and behavioral dyscontrol among SM/V. Design Secondary cross-sectional data analysis from the Long-Term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium prospective longitudinal study among SM/V (N = 1,808). Methods Univariable and multivariable linear regression models assessed the association and interaction effects between PTSD symptom severity, as assessed by the PTSD Checklist for the Diagnostic and Statistical Manual, 5th edition (PCL-5), and deployment-related mild TBI on behavioral dyscontrol, adjusting for demographics, pain, social support, resilience, and general self-efficacy. Results Among the 1,808 individuals in our sample, PTSD symptom severity (B = 0.23, 95% CI: 0.22, 0.25, p < 0.001) and deployment-related mild TBI (B = 3.27, 95% CI: 2.63, 3.90, p < 0.001) were significantly associated with behavioral dyscontrol in univariable analysis. Interaction effects were significant between PTSD symptom severity and deployment mild TBI (B = -0.03, 95% CI: -0.06, -0.01, p = 0.029) in multivariable analysis, indicating that the effect of mild TBI on behavioral dyscontrol is no longer significant among those with a PCL-5 score > 22.96. Conclusion Results indicated an association between PTSD symptom severity, deployment-related mild TBI, and behavioral dyscontrol among SM/V. Notably, the effect of deployment-related mild TBI was pronounced for individuals with lower PTSD symptom severity. Higher social support scores were associated with lower dyscontrol, emphasizing the potential for social support to be a protective factor. General self-efficacy was also associated with reduced behavioral dyscontrol.
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Affiliation(s)
- Kelsee M. Stromberg
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
- Department of Internal Medicine, Division of Epidemiology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Sarah L. Martindale
- Research and Academic Affairs Service Line, W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, United States
- Veterans Integrated Service Networks (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, United States
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - William C. Walker
- Department of Physical Medicine and Rehabilitation (PM&R), School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
- Department of PM&R, Central Virginia VA Health Care System, Richmond, VA, United States
| | - Zhining Ou
- Department of Internal Medicine, Division of Epidemiology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Terri K. Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, United States
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States
| | - Shannon R. Miles
- Mental Health and Behavioral Sciences Services, James A. Haley Veterans’ Hospital, Tampa, FL, United States
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Clara E. Dismuke-Greer
- Health Economics Resource Center (HERC), Ci2i, VA Palo Alto Health Care System, Menlo Park, CA, United States
| | - Kathleen F. Carlson
- VA HSR&D Center to Improve Veteran Involvement in Care (CIVIC) and RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, United States
- Oregon Health and Science University – Portland State University School of Public Health, Oregon Health & Science University, Portland, OR, United States
| | - Jared A. Rowland
- Research and Academic Affairs Service Line, W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, United States
- Veterans Integrated Service Networks (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, United States
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Maya E. O’Neil
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
- Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
| | - Mary Jo Pugh
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
- Department of Internal Medicine, Division of Epidemiology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
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Harris JL, Wang X, Christian SK, Novikova L, Kalani A, Hui D, Ferren S, Barbay S, Ortiz JP, Nudo RJ, Brooks WM, Wilkins HM, Chalise P, Michaelis ML, Michaelis EK, Swerdlow RH. Traumatic Brain Injury Alters the Trajectory of Age-Related Mitochondrial Change. J Alzheimers Dis 2024; 97:1793-1806. [PMID: 38306050 DOI: 10.3233/jad-231237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Background Some epidemiologic studies associate traumatic brain injury (TBI) with Alzheimer's disease (AD). Objective To test whether a TBI-induced acceleration of age-related mitochondrial change could potentially mediate the reported TBI-AD association. Methods We administered unilateral controlled cortical impact (CCI) or sham injuries to 5-month-old C57BL/6J and tau transgenic rTg4510 mice. In the non-transgenics, we assessed behavior (1-5 days, 1 month, and 15 months), lesion size (1 and 15 months), respiratory chain enzymes (1 and 15 months), and mitochondrial DNA copy number (mtDNAcn) (1 and 15 months) after CCI/sham. In the transgenics we quantified post-injury mtDNAcn and tangle burden. Results In the non-transgenics CCI caused acute behavioral deficits that improved or resolved by 1-month post-injury. Protein-normalized complex I and cytochrome oxidase activities were not significantly altered at 1 or 15 months, although complex I activity in the CCI ipsilesional cortex declined during that period. Hippocampal mtDNAcn was not altered by injury at 1 month, increased with age, and rose to the greatest extent in the CCI contralesional hippocampus. In the injured then aged transgenics, the ipsilesional hippocampus contained less mtDNA and fewer tangles than the contralesional hippocampus; mtDNAcn and tangle counts did not correlate. Conclusions As mice age their brains increase mtDNAcn as part of a compensatory response that preserves mitochondrial function, and TBI enhances this response. TBI may, therefore, increase the amount of compensation required to preserve late-life mitochondrial function. If TBI does modify AD risk, altering the trajectory or biology of aging-related mitochondrial changes could mediate the effect.
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Affiliation(s)
- Janna L Harris
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
- Departments of Cell Biology and Physiology, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Xiaowan Wang
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Sarah K Christian
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Lesya Novikova
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Anuradha Kalani
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Dongwei Hui
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Sadie Ferren
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Scott Barbay
- Departments of Physical Medicine and Rehabilitation, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Judit Perez Ortiz
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Randolph J Nudo
- Departments of Physical Medicine and Rehabilitation, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
| | - William M Brooks
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
- Departments of Neurology, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Heather M Wilkins
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
- Departments of Neurology, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Prabhakar Chalise
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
- Departments of Biostatistics and Data Science, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Mary Lou Michaelis
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Elias K Michaelis
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Russell H Swerdlow
- University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
- Departments of Cell Biology and Physiology, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
- Departments of Neurology, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
- Departments of Biochemistry and Molecular Biology, University of Kansas Alzheimer's Disease Research Center, The University of Kansas Medical Center, Kansas City, KS, USA
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Callender L, Lai T, Driver S, Ketchum JM, Ochoa C, Corrigan JD, Hammond FM, Harrison-Felix C, Martin AM, Rabinowitz AR, Starosta AJ, Dubiel R. The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset. J Head Trauma Rehabil 2024; 39:82-93. [PMID: 38167717 PMCID: PMC10947995 DOI: 10.1097/htr.0000000000000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To determine if the interaction of opiate misuse and marijuana use frequency is associated with behavioral health outcomes. SETTING Community. PARTICIPANTS Three thousand seven hundred fifty participants enrolled in the Traumatic Brain Injury Model Systems who completed the Pain Survey and had complete opioid use and marijuana use information. DESIGN Cross-sectional, secondary analysis from a multisite observational cohort. MAIN OUTCOME MEASURES Clinically significant behavioral health symptoms for posttraumatic stress disorder (PTSD), depression, anxiety, and sleep quality. RESULTS Three thousand five hundred thirty-five (94.3%) participants did not misuse opiates, 215 (5.7%) did misuse opiates (taking more opioid pain medication than prescribed and/or using nonprescription opioid pain medication); 2683 (70.5%) participants did not use marijuana, 353 (9.3%) occasionally used marijuana (less than once a week), and 714 (18.8%) regularly used marijuana (once a week or more frequently). There was a statistically significant relationship (P < .05) between the interaction of opiate misuse and marijuana use frequency and all behavioral health outcomes and several covariates (age, sex, cause of injury, severity of injury, and pain group category). Pairwise comparisons confirm that statistically significant associations on behavioral health outcomes are driven by endorsing opiate misuse and/or regular marijuana use, but occasional marijuana use was not associated. CONCLUSIONS Higher odds of clinically significant PTSD, depression, anxiety, and poor sleep quality are present in people with traumatic brain injury (TBI) who misuse opiates and/or who use marijuana regularly. In the absence of opiate misuse, regular marijuana use had higher odds of worse behavioral health outcomes than occasional and no use. The interaction of opiate misuse and regular marijuana use yielded the highest odds. Individuals with TBI should be informed of the relationship of substance use and behavioral health outcomes and that current chronic pain may mediate the association.
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Affiliation(s)
- Librada Callender
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas (Mss Callender and Ochoa, Drs Lai, Driver, and Dubiel); Research Department, Craig Hospital, Englewood, Colorado (Drs Ketchum and Harrison-Felix); College of Medicine, The Ohio State University, Columbus (Dr Corrigan); Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine & Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Mental Health and Behavioral Science Service, James A. Haley Veterans Hospital, Tampa, Florida (Dr Martin); Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa (Dr Martin); Department of Physical Medicine and Rehabilitation, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Rabinowitz); and Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle (Dr Starosta)
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Teasell R, Flores-Sandoval C, Bateman EA, MacKenzie HM, Sequeira K, Bayley M, Janzen S. Overview of randomized controlled trials of moderate to severe traumatic brain injury: A systematic review. NeuroRehabilitation 2024; 54:509-520. [PMID: 38669488 DOI: 10.3233/nre-240019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
BACKGROUND Given the complexity of post-TBI medical, surgical, and rehabilitative care, research is critical to optimize interventions across the continuum of care and improve outcomes for persons with moderate to severe TBI. OBJECTIVE To characterize randomized controlled trials (RCTs) of moderate to severe traumatic brain injury (TBI) in the literature. METHOD Systematic searches of MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO for RCTs up to December 2022 inclusive were conducted in accordance with PRISMA guidelines. RESULTS 662 RCTs of 91,946 participants published from 1978 to 2022 met inclusion criteria. The number of RCTs published annually has increased steadily. The most reported indicator of TBI severity was the Glasgow Coma Scale (545 RCTs, 82.3%). 432 (65.3%) RCTs focused on medical/surgical interventions while 230 (34.7%) addressed rehabilitation. Medical/surgical RCTs had larger sample sizes compared to rehabilitation RCTs. Rehabilitation RCTs accounted for only one third of moderate to severe TBI RCTs and were primarily conducted in the chronic phase post-injury relying on smaller sample sizes. CONCLUSION Further research in the subacute and chronic phases as well as increasing rehabilitation focused TBI RCTs will be important to optimizing the long-term outcomes and quality of life for persons living with TBI.
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Affiliation(s)
- Robert Teasell
- Parkwood Institute Research, Lawson Research Institute, London, ON, Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
| | | | - Emma A Bateman
- Parkwood Institute Research, Lawson Research Institute, London, ON, Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
| | - Heather M MacKenzie
- Parkwood Institute Research, Lawson Research Institute, London, ON, Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
| | - Keith Sequeira
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
| | - Mark Bayley
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- University Health Network, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Shannon Janzen
- Parkwood Institute Research, Lawson Research Institute, London, ON, Canada
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Snowden T, Morrison J, Boerstra M, Eyolfson E, Acosta C, Grafe E, Reid H, Brand J, Galati M, Gargaro J, Christie BR. Brain changes: aerobic exercise for traumatic brain injury rehabilitation. Front Hum Neurosci 2023; 17:1307507. [PMID: 38188504 PMCID: PMC10771390 DOI: 10.3389/fnhum.2023.1307507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Traumatic Brain Injury (TBI) accounts for millions of hospitalizations and deaths worldwide. Aerobic exercise is an easily implementable, non-pharmacological intervention to treat TBI, however, there are no clear guidelines for how to best implement aerobic exercise treatment for TBI survivors across age and injury severity. Methods We conducted a PRISMA-ScR to examine research on exercise interventions following TBI in children, youth and adults, spanning mild to severe TBI. Three electronic databases (PubMed, PsycInfo, and Web of Science) were searched systematically by two authors, using keywords delineated from "Traumatic Brain Injury," "Aerobic Exercise," and "Intervention." Results Of the 415 papers originally identified from the search terms, 54 papers met the inclusion criteria and were included in this review. The papers were first grouped by participants' injury severity, and subdivided based on age at intervention, and time since injury where appropriate. Discussion Aerobic exercise is a promising intervention for adolescent and adult TBI survivors, regardless of injury severity. However, research examining the benefits of post-injury aerobic exercise for children and older adults is lacking.
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Affiliation(s)
- Taylor Snowden
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Jamie Morrison
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Meike Boerstra
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Eric Eyolfson
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Crystal Acosta
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Erin Grafe
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Hannah Reid
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Justin Brand
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | | | - Judith Gargaro
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Brian R. Christie
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Island Medical Program and Department of Cellular and Physiological Sciences, The University of British Columbia, Victoria, BC, Canada
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Verduzco-Mendoza A, Mota-Rojas D, Olmos Hernández SA, Gálvez-Rosas A, Aguirre-Pérez A, Cortes-Altamirano JL, Alfaro-Rodríguez A, Parra-Cid C, Avila-Luna A, Bueno-Nava A. Traumatic brain injury extending to the striatum alters autonomic thermoregulation and hypothalamic monoamines in recovering rats. Front Neurosci 2023; 17:1304440. [PMID: 38144211 PMCID: PMC10748590 DOI: 10.3389/fnins.2023.1304440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
The brain cortex is the structure that is typically injured in traumatic brain injury (TBI) and is anatomically connected with other brain regions, including the striatum and hypothalamus, which are associated in part with motor function and the regulation of body temperature, respectively. We investigated whether a TBI extending to the striatum could affect peripheral and core temperatures as an indicator of autonomic thermoregulatory function. Moreover, it is unknown whether thermal modulation is accompanied by hypothalamic and cortical monoamine changes in rats with motor function recovery. The animals were allocated into three groups: the sham group (sham), a TBI group with a cortical contusion alone (TBI alone), and a TBI group with an injury extending to the dorsal striatum (TBI + striatal injury). Body temperature and motor deficits were evaluated for 20 days post-injury. On the 3rd and 20th days, rats were euthanized to measure the serotonin (5-HT), noradrenaline (NA), and dopamine (DA) levels using high-performance liquid chromatography (HPLC). We observed that TBI with an injury extending to the dorsal striatum increased core and peripheral temperatures. These changes were accompanied by a sustained motor deficit lasting for 14 days. Furthermore, there were notable increases in NA and 5-HT levels in the brain cortex and hypothalamus both 3 and 20 days after injury. In contrast, rats with TBI alone showed no changes in peripheral temperatures and achieved motor function recovery by the 7th day post-injury. In conclusion, our results suggest that TBI with an injury extending to the dorsal striatum elevates both core and peripheral temperatures, causing a delay in functional recovery and increasing hypothalamic monoamine levels. The aftereffects can be attributed to the injury site and changes to the autonomic thermoregulatory functions.
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Affiliation(s)
- Antonio Verduzco-Mendoza
- Programa de Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Ciudad de México, Mexico
| | - Daniel Mota-Rojas
- Neurofisiología, Conducta y Bienestar Animal, DPAA, Universidad Autónoma Metropolitana, Unidad Xochimilco, Ciudad de México, Mexico
| | | | - Arturo Gálvez-Rosas
- Neurociencias Básicas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (LGII), SSa, Ciudad de México, Mexico
| | - Alexander Aguirre-Pérez
- Neurociencias Básicas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (LGII), SSa, Ciudad de México, Mexico
| | - José Luis Cortes-Altamirano
- Neurociencias Básicas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (LGII), SSa, Ciudad de México, Mexico
- Departamento de Quiropráctica, Universidad Estatal del Valle de Ecatepec, Ecatepec de Morelos, Estado de México, Mexico
- Madrid College of Chiropractic, Real Centro Universitario Escorial María Cristina, Madrid, Spain
| | - Alfonso Alfaro-Rodríguez
- Neurociencias Básicas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (LGII), SSa, Ciudad de México, Mexico
| | - Carmen Parra-Cid
- Unidad de Ingeniería de Tejidos, Instituto Nacional de Rehabilitación LGII, SSa, Ciudad de México, Mexico
| | - Alberto Avila-Luna
- Neurociencias Básicas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (LGII), SSa, Ciudad de México, Mexico
| | - Antonio Bueno-Nava
- Neurociencias Básicas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (LGII), SSa, Ciudad de México, Mexico
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Liu Y, Zhao Z, Guo J, Ma Y, Li J, Ji H, Chen Z, Zheng J. Anacardic acid improves neurological deficits in traumatic brain injury by anti-ferroptosis and anti-inflammation. Exp Neurol 2023; 370:114568. [PMID: 37820939 DOI: 10.1016/j.expneurol.2023.114568] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/23/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is an important cause of disability and death. TBI leads to multiple forms of nerve cell death including ferroptosis due to iron-dependent lipid peroxidation. Anacardic acid (AA) is a natural component extracted from cashew nut shells, which has been reported to have neuroprotective effects in traumatic brain injury. We investigated whether AA has an anti-ferroptosis effect in TBI. METHODS We used the Feeney free-fall impact method to construct a TBI model to investigate the effect of AA on ferroptosis caused by TBI, in which Ferrostatin-1 (Fer-1), a ferroptosis inhibitor, served as a positive control group. We first identified the therapeutic effect of AA on TBI through modified neurological severity score (mNSS) and determined the appropriate concentration. Secondly, we investigated the effect of AA on the expression level of the key protein of ferroptosis by Western blotting and immunohistochemistry. Then the effect of AA on nerve tissue injury and nerve function improvement was verified. Finally, enzym-linked immunosorbent assay (ELISA) was used to verify that AA could reduce inflammation after TBI. RESULTS We found the intensely inhibitory effect of AA on ferroptosis, which is in parallel with the results obtained after Fer-1 treatment. In addition, AA and Fer-1 mitigated TBI-mediated tissue defects, destruction of the blood-brain barrier, and neurodegeneration. Novel object recognition (NOR), mNSS and water maze test showed that AA could significantly reduce the impairment of neural function and behavioral cognitive ability caused by TBI. Finally, we also demonstrated that AA has not only an anti-ferroptosis effect, but also an anti-inflammation effect. CONCLUSIONS AA can reduce the neurological impairment and behavioral cognitive impairment caused by TBI through the dual effect of anti-ferroptosis and anti-inflammation.
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Affiliation(s)
- Yu Liu
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China; Xuzhou Medical University, Xuzhou 221000, China
| | - Zongren Zhao
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China
| | - Jianqiang Guo
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China; Xuzhou Medical University, Xuzhou 221000, China
| | - Yuanhao Ma
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China; Xuzhou Medical University, Xuzhou 221000, China
| | - Jing Li
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China
| | - Huanhuan Ji
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China
| | - Zhongjun Chen
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China
| | - Jinyu Zheng
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223022, China.
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Banbury C, Harris G, Clancy M, Blanch RJ, Rickard JJS, Goldberg Oppenheimer P. Window into the mind: Advanced handheld spectroscopic eye-safe technology for point-of-care neurodiagnostic. SCIENCE ADVANCES 2023; 9:eadg5431. [PMID: 37967190 PMCID: PMC10651125 DOI: 10.1126/sciadv.adg5431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 10/19/2023] [Indexed: 11/17/2023]
Abstract
Traumatic brain injury (TBI), a major cause of morbidity and mortality worldwide, is hard to diagnose at the point of care with patients often exhibiting no clinical symptoms. There is an urgent need for rapid point-of-care diagnostics to enable timely intervention. We have developed a technology for rapid acquisition of molecular fingerprints of TBI biochemistry to safely measure proxies for cerebral injury through the eye, providing a path toward noninvasive point-of-care neurodiagnostics using simultaneous Raman spectroscopy and fundus imaging of the neuroretina. Detection of endogenous neuromarkers in porcine eyes' posterior revealed enhancement of high-wave number bands, clearly distinguishing TBI and healthy cohorts, classified via artificial neural network algorithm for automated data interpretation. Clinically, translating into reduced specialist support, this markedly improves the speed of diagnosis. Designed as a hand-held cost-effective technology, it can allow clinicians to rapidly assess TBI at the point of care and identify long-term changes in brain biochemistry in acute or chronic neurodiseases.
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Affiliation(s)
- Carl Banbury
- School of Chemical Engineering, Advanced Nanomaterials Structures and Applications Laboratories, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Georgia Harris
- School of Chemical Engineering, Advanced Nanomaterials Structures and Applications Laboratories, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Michael Clancy
- School of Chemical Engineering, Advanced Nanomaterials Structures and Applications Laboratories, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Ministry of Justice, 102 Petty France, Westminster, London, UK
| | - Richard J. Blanch
- Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, Robert Aiken Institute for Clinical Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, UHB NHS Foundation Trust, West Midlands, UK
| | | | - Pola Goldberg Oppenheimer
- School of Chemical Engineering, Advanced Nanomaterials Structures and Applications Laboratories, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Healthcare Technologies Institute, Institute of Translational Medicine, Mindelsohn Way, Birmingham, B15 2TH, UK
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O'Neil-Pirozzi TM, Sevigny M, Pinto SM, Hammond FM, Juengst SB. Early Factors Predictive of Extreme High and Low Life Satisfaction 10 Years Post-Moderate to Severe Traumatic Brain Injury. J Head Trauma Rehabil 2023; 38:448-457. [PMID: 36854110 PMCID: PMC10460820 DOI: 10.1097/htr.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To identify demographic, injury-related, and 1-year postinjury clinical and functional predictors of high and low life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach. SETTING Multicenter longitudinal database study. PARTICIPANTS A total of 3040 people from the National Institute on Disability, Independent Living, and Rehabilitation Research TBI Model Systems database with life satisfaction data at 10 years post-TBI. DESIGN Multicenter, cross-sectional, observational design. MAIN MEASURES Satisfaction With Life Scale (outcome), Glasgow Coma Scale, Disability Rating Scale, Functional Independence Measure, Participation Assessment with Recombined Tools-Objective, Patient Health Questionnaire-9, and General Anxiety Disorder-7 (standardized predictors). RESULTS Greater cognitive and motor independence, more frequent community participation, and less depressive symptoms 1 year post-moderate to severe TBI predicted extreme high life satisfaction 10 years later. Non-Hispanic White and Hispanic individuals were significantly more likely than Black individuals to have extreme high life satisfaction 10 years post-TBI. CONCLUSIONS Extreme phenotyping analysis complements existing knowledge regarding life satisfaction post-moderate to severe TBI. From a chronic disease management perspective, future studies are needed to examine the feasibility and impact of early postinjury medical and rehabilitative interventions targeting cognitive and motor function, community participation, and mood on the maintenance/enhancement of long-term life satisfaction post-TBI.
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Affiliation(s)
- Therese M O'Neil-Pirozzi
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts (Dr O'Neil-Pirozzi); Research Department, Craig Hospital, Denver, Colorado (Mr Sevigny); Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas (Dr Pinto); Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Dr Juengst); and Department of Physical Medicine and Rehabilitation, UT Houston Health Sciences Center, Houston, Texas (Dr Juengst)
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Lee JW, Song S, Kim Y, Park SB, Han DH. Soccer's AI transformation: deep learning's analysis of soccer's pandemic research evolution. Front Psychol 2023; 14:1244404. [PMID: 37908810 PMCID: PMC10613686 DOI: 10.3389/fpsyg.2023.1244404] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/13/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction This paper aims to identify and compare changes in trends and research interests in soccer articles from before and during the COVID-19 pandemic. Methods We compared research interests and trends in soccer-related journal articles published before COVID-19 (2018-2020) and during the COVID-19 pandemic (2021-2022) using Bidirectional Encoder Representations from Transformers (BERT) topic modeling. Results In both periods, we categorized the social sciences into psychology, sociology, business, and technology, with some interdisciplinary research topics identified, and we identified changes during the COVID-19 pandemic period, including a new approach to home advantage. Furthermore, Sports science and sports medicine had a vast array of subject areas and topics, but some similar themes emerged in both periods and found changes before and during COVID-19. These changes can be broadly categorized into (a) Social Sciences and Technology; (b) Performance training approaches; (c) injury part of body. With training topics being more prominent than match performance during the pandemic; and changes within injuries, with the lower limbs becoming more prominent than the head during the pandemic. Conclusion Now that the pandemic has ended, soccer environments and routines have returned to pre-pandemic levels, but the environment that have changed during the pandemic provide an opportunity for researchers and practitioners in the field of soccer to detect post-pandemic changes and identify trends and future directions for research.
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Affiliation(s)
- Jea Woog Lee
- Intelligent Information Processing Lab, Chung-Ang University, Seoul, Republic of Korea
| | - Sangmin Song
- Department of Artificial Intelligence, Chung-Ang University, Seoul, Republic of Korea
| | - YoungBin Kim
- Graduate School of Advanced Imaging Science, Multimedia and Film, Chung-Ang University, Seoul, Republic of Korea
| | - Seung-Bo Park
- Graduate School of Sports Medicine, CHA University, Seongnam-si, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Republic of Korea
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50
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Gowthami N, Pursotham N, Dey G, Ghose V, Sathe G, Pruthi N, Shukla D, Gayathri N, Santhoshkumar R, Padmanabhan B, Chandramohan V, Mahadevan A, Srinivas Bharath MM. Neuroanatomical zones of human traumatic brain injury reveal significant differences in protein profile and protein oxidation: Implications for secondary injury events. J Neurochem 2023; 167:218-247. [PMID: 37694499 DOI: 10.1111/jnc.15953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023]
Abstract
Traumatic brain injury (TBI) causes significant neurological deficits and long-term degenerative changes. Primary injury in TBI entails distinct neuroanatomical zones, i.e., contusion (Ct) and pericontusion (PC). Their dynamic expansion could contribute to unpredictable neurological deterioration in patients. Molecular characterization of these zones compared with away from contusion (AC) zone is invaluable for TBI management. Using proteomics-based approach, we were able to distinguish Ct, PC and AC zones in human TBI brains. Ct was associated with structural changes (blood-brain barrier (BBB) disruption, neuroinflammation, axonal injury, demyelination and ferroptosis), while PC was associated with initial events of secondary injury (glutamate excitotoxicity, glial activation, accumulation of cytoskeleton proteins, oxidative stress, endocytosis) and AC displayed mitochondrial dysfunction that could contribute to secondary injury events and trigger long-term degenerative changes. Phosphoproteome analysis in these zones revealed that certain differentially phosphorylated proteins synergistically contribute to the injury events along with the differentially expressed proteins. Non-synaptic mitochondria (ns-mito) was associated with relatively more differentially expressed proteins (DEPs) compared to synaptosomes (Syn), while the latter displayed increased protein oxidation including tryptophan (Trp) oxidation. Proteomic analysis of immunocaptured complex I (CI) from Syn revealed increased Trp oxidation in Ct > PC > AC (vs. control). Oxidized W272 in the ND1 subunit of CI, revealed local conformational changes in ND1 and the neighboring subunits, as indicated by molecular dynamics simulation (MDS). Taken together, neuroanatomical zones in TBI show distinct protein profile and protein oxidation representing different primary and secondary injury events with potential implications for TBI pathology and neurological status of the patients.
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Affiliation(s)
- Niya Gowthami
- Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nithya Pursotham
- Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Gourav Dey
- Proteomics and Bioinformatics Laboratory, Neurobiology Research Center, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Institute of Bioinformatics, Bengaluru, India
| | - Vivek Ghose
- Proteomics and Bioinformatics Laboratory, Neurobiology Research Center, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Institute of Bioinformatics, Bengaluru, India
| | - Gajanan Sathe
- Proteomics and Bioinformatics Laboratory, Neurobiology Research Center, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Institute of Bioinformatics, Bengaluru, India
| | - Nupur Pruthi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Narayanappa Gayathri
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rashmi Santhoshkumar
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Balasundaram Padmanabhan
- Department of Biophysics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vivek Chandramohan
- Department of Biotechnology, Siddaganga Institute of Technology (SIT), Tumakuru, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - M M Srinivas Bharath
- Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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