Journal of neurotrauma
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Journal of neurotrauma · Feb 2014
Review Meta AnalysisOlfactory dysfunction in pediatric traumatic brain injury: A systematic review.
The neuropsychological outcomes of pediatric traumatic brain injury (TBI) have received increasing study over the past 20 years and are currently well delineated in the research literature. One outcome that has received little attention is that of olfactory dysfunction after pediatric TBI. This is despite literature indicating that anosmia and olfactory dysfunction are common after adult TBI and are likely to be linked to severity of injury, neuropathology, and executive dysfunction. ⋯ The studies found were limited by methodological weaknesses, variability in measures, small sample size, and difficulty of comparison across cohorts studied. Despite this, they reported consistent findings of anosmia and olfactory dysfunction in their TBI cohorts and identified a dose-response relationship between severity of injury and olfactory dysfunction. The results of the studies are discussed in terms of relevant findings, limitations, and areas requiring further exploration.
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Journal of neurotrauma · Feb 2014
ReviewThe Presence and Role of Iron in Mild Traumatic Brain Injury: An Imaging Perspective.
Mild traumatic brain injury (mTBI), although often presenting without the gross structural abnormalities seen in more severe forms of brain trauma, can nonetheless result in lingering cognitive and behavioral problems along with subtle alterations in brain structure and function. Repeated injuries are associated with brain atrophy and dementia in the form of chronic traumatic encephalopathy (CTE). The mechanisms underlying these dysfunctions are poorly understood. ⋯ In addition, there is evidence that iron may contribute to pathology after mTBI through a number of mechanisms, including generation of reactive oxygen species (ROS), exacerbation of oxidative stress from other sources, and encouragement of tau phosphorylation and the formation of neurofibrillary tangles. Finally, recent animal studies suggest that iron may serve as a therapeutic target in mitigating the effects of mTBI. However, research on the presence and role of iron in mTBI and CTE is still relatively sparse, and further work is necessary to elucidate issues such as the sources of increased iron and the chain of secondary injury.
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Journal of neurotrauma · Feb 2014
Functionally-detected cognitive impairment in high school football players without clinically-diagnosed concussion.
Head trauma and concussion in football players have recently received considerable media attention. Postmortem evidence suggests that accrual of damage to the brain may occur with repeated blows to the head, even when the individual blows fail to produce clinical symptoms. There is an urgent need for improved detection and characterization of head trauma to reduce future injury risk and promote development of new therapies. ⋯ This new category was associated with significantly higher numbers of head collision events to the top-front of the head, directly above the DLPFC. The discovery of this new category suggests that more players are suffering neurological injury than are currently being detected using traditional concussion-assessment tools. These individuals are unlikely to undergo clinical evaluation, and thus may continue to participate in football-related activities, even when changes in brain physiology (and potential brain damage) are present, which will increase the risk of future neurological injury.
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Journal of neurotrauma · Feb 2014
Hypopituitarism in Pediatric Survivors of Inflicted Traumatic Brain Injury.
Endocrine dysfunction is common after accidental traumatic brain injury (TBI). Prevalence of endocrine dysfunction after inflicted traumatic brain injury (iTBI) is not known. The aim of this study was to examine endocrinopathy in children after moderate-to-severe iTBI. ⋯ Larger, multi-center, prospective studies would provide more data to determine the extent of endocrine dysfunction in iTBI. We recommend that any child with a history of iTBI be followed closely for growth velocity and pubertal changes. If growth velocity is slow, PRL level and a full endocrine evaluation should be performed.
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Journal of neurotrauma · Feb 2014
Blockage of the Upregulation of Voltage-Gated Sodium Channel Nav1.3 Improves Outcomes after Experimental Traumatic Brain Injury.
Excessive active voltage-gated sodium channels are responsible for the cellular abnormalities associated with secondary brain injury following traumatic brain injury (TBI). We previously presented evidence that significant upregulation of Nav1.3 expression occurs in the rat cortex at 2 h and 12 h post-TBI and is correlated with TBI severity. In our current study, we tested the hypothesis that blocking upregulation of Nav1.3 expression in vivo in the acute stage post-TBI attenuates the secondary brain injury associated with TBI. ⋯ The Morris water maze memory retention test showed that both the aCSF and ODN groups took longer to find a hidden platform, compared with the sham group (p<0.01). However, latency in the aCSF group was significantly higher than in the ODN group (p<0.05). Our in vivo Nav1.3 inhibition studies suggest that therapeutic strategies to block upregulation of Nav1.3 expression in the brain may improve outcomes following TBI.