Brain injury : [BI]
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Brain injury : [BI] · Jan 2015
ReviewThe role of apolipoprotein E episilon (ε)-4 allele on outcome following traumatic brain injury: A systematic review.
The apolipoprotein E gene (APOE) has emerged as a candidate for prognosticating traumatic brain injury (TBI) recovery, with APOEε4 identified as a susceptibility marker for poor outcome, despite large discrepancy in its reported influence post-TBI. ⋯ The influence of APOEε4 on neuropsychological testing, functional outcome and in paediatric populations was incongruous. This review supports the majority of research indicating APOEε4 adversely influences recovery following TBI, particularly with respect to dementia-related outcomes and outcomes following sTBI.
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Brain injury : [BI] · Jan 2015
ReviewTranscranial magnetic stimulation: A potential new treatment for depression associated with traumatic brain injury.
Each year, more than 1.7 million Americans suffer a traumatic brain injury (TBI) and the lifetime prevalence of major depressive disorder following TBI is between 25-50%. There are no validated established strategies to treat TBI depression. Repetitive transcranial magnetic stimulation (rTMS) is a novel putative treatment option for post-TBI depression, which, compared with standard pharmacological agents, may provide a more targeted treatment with fewer side-effects. However, TBI is associated with an increased risk of both early and late spontaneous seizures, a significant consideration in evaluating rTMS as a potential treatment for TBI depression. Whilst the risk of seizure from rTMS is low, underlying neuropathology may somewhat increase that risk. ⋯ It is concluded that pilot safety and tolerability studies should be first conducted in persons with TBI and neuropsychiatric comorbidities. These results could be used to help design larger randomized controlled trials.
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Brain injury : [BI] · Jan 2015
ReviewOutcomes from mild and moderate traumatic brain injuries among children and adolescents: A systematic review of studies from 2008-2013.
To systematically review existing empirical evidence concerning neuropsychological, psychosocial and academic outcomes following mild and moderate TBI during childhood and adolescence. ⋯ The results suggest that not all children with mild or moderate TBI recover without long-term problems. Few studies followed children and adolescents with mild TBIs for extended periods of time, although it is clinically important to monitor patients over time.
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Brain injury : [BI] · Jan 2015
ReviewOutcomes from mild and moderate traumatic brain injuries among children and adolescents: A systematic review of studies from 2008-2013.
To systematically review existing empirical evidence concerning neuropsychological, psychosocial and academic outcomes following mild and moderate TBI during childhood and adolescence. ⋯ The results suggest that not all children with mild or moderate TBI recover without long-term problems. Few studies followed children and adolescents with mild TBIs for extended periods of time, although it is clinically important to monitor patients over time.
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Brain injury : [BI] · Jan 2015
ReviewEmbracing failure: What the Phase III progesterone studies can teach about TBI clinical trials.
Despite positive preclinical studies and two positive Phase II clinical trials, two large Phase III clinical trials of progesterone treatment of acute traumatic brain injury (TBI) recently ended with negative results, so a 100% failure rate continues to plague the field of TBI trials. ⋯ Better definitions of injury and healing and better outcome measures are essential to change the embrace of failure that has dominated the field for over 30 years. This review offers suggestions to improve the situation.