Journal of neurotrauma
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Journal of neurotrauma · Feb 2023
Noninvasive assessment of intracranial hypertension in patients with traumatic brain injury using CT radiomic features：a pilot study.
This study aimed to assess intracranial hypertension in patients with traumatic brain injury non-invasively using computed tomography (CT) radiomic features. Fifty patients from the primary cohort were enrolled in this study. The clinical data, pre-operative cranial CT images, and initial intracranial pressure readings were collected and used to develop a prediction model. ⋯ The external validation results showed a good discrimination with an area under the curve of 0.725 (95% CI: 0.500-0.951). Although the FO model was inferior to the SO model, it had better prediction ability than the CF model. The study shows that the radiomic features analysis, especially second-order features, can be used to evaluate intracranial hypertension non-invasively compared with conventional clinical features, given its potential for clinical practice and further research.
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Journal of neurotrauma · Feb 2023
White Matter Integrity Relates to Cognition in Service Members and Veterans Following Complicated Mild, Moderate, and Severe TBI, but not Uncomplicated Mild TBI.
The extant literature investigating the relationship between diffusion tensor imaging (DTI) and cognition following traumatic brain injury (TBI) is limited by small sample sizes and inappropriate control groups. The present study examined DTI metric differences between service members and veterans (SMVs) with bodily injury (Trauma Control; TC), uncomplicated mild TBI (mTBI), complicated mild TBI (compTBI), and severe-moderate TBI combined (smTBI), and how DTI metrics related to cognition within each group. Participants were 226 SMVs (56 TC, 112 mTBI, 29 compTBI, 29 smTBI) with valid neuropsychological testing and DTI at least 11 months post-injury. ⋯ In contrast, there were no significant relationships between DTI metrics and cognition/emotional functioning within the mTBI or TC groups. Overall, findings suggest a dose-response relationship between TBI severity and the strength of the relationship between white matter integrity and cognitive performance, with essentially no relationship in mTBI, some findings in compTBI, and several strongly significant relationships in smTBI. In contrast to previously reported findings, there were no differences in DTI metrics between controls, mTBI, and compTBI, and DTI metrics were unrelated to cognition in our relatively large mTBI group.
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Journal of neurotrauma · Feb 2023
Functional Connectivity in the Mouse Brainstem Represents Signs of Recovery from Concussion.
Mild traumatic brain injury (mTBI) is one of the most frequent neurological disorders. Diagnostic criteria for mTBI are based on cognitive or neurological symptoms without fully understanding the neuropathological basis for explaining behaviors. From the neuropathological perspective of mTBI, recent neuroimaging studies have focused on structural or functional differences in motor-related cortical regions but did not compare topological network properties between the post-concussion days in the brainstem. ⋯ Functional connectivity and local network properties on post-concussion day 2 were also significantly decreased compared with those on post-concussion day 14, but there were no significant group differences in global network properties between days 2 and 14. We also observed that the local efficiency and clustering coefficient of the brainstem network were significantly correlated with anxiety-like behaviors on post-concussion days 7 and 14. This study suggests that functional connectivity in the mouse brainstem provides vital recovery signs from concussion through functional reorganization.
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Journal of neurotrauma · Feb 2023
Multicenter StudySerum Acylcarnitine and Long-term Functional Prognosis after Traumatic Brain Injury with Intracranial Injury: A Multicenter Prospective Study.
Serum biomarkers have potential to help predict prognosis of traumatic brain injury (TBI). The objective of this study was to evaluate the association between serum acylcarnitine levels and functional outcomes at 1 month/6 months after injury for TBI patients with intracranial hemorrhage or diffuse axonal injury. This study is a multi-center prospective cohort study in which adult TBI patients with intracranial injury visiting the emergency departments (EDs) from December 2018 to June 2020 were enrolled. ⋯ The odds for 1-month poor functional outcome increased in the high-normal and the high groups [adjusted odds ratios, AORs (95% confidence intervals, CIs): 1.56 (1.09-2.23) and 2.47 (1.63-3.75)], compared with the low-normal group) and also as a continuous variable [1.05 (1.03-1.07) for each 1 μmol/L]. Regarding 6-month mortality, the high group had significantly higher odds when compared with the low-normal group [AOR (95% CI): 2.16 (1.37-3.40)]. Higher serum acylcarnitine levels are associated with poor functional outcomes at 1 month/6 months after injury for TBI patients with intracranial injury.
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Journal of neurotrauma · Feb 2023
Ccr2 gene ablation does not influence seizure susceptibility, tissue damage or cellular inflammation after murine pediatric traumatic brain injury.
Pediatric traumatic brain injury (TBI) is a major public health issue, and a risk factor for the development of post-traumatic epilepsy that may profoundly impact the quality of life for survivors. As the majority of neurotrauma research is focused on injury to the adult brain, our understanding of the developing brain's response to TBI remains incomplete. Neuroinflammation is an influential pathophysiological mechanism in TBI, and is thought to increase neuronal hyperexcitability, rendering the brain more susceptible to the onset of seizures and/or epileptogenesis. ⋯ Similarly, acute post-injury treatment with a CCR2 antagonist did not influence seizure susceptibility or the extent of tissue damage in wild-type (WT) mice. Together, our findings suggest that CCR2 is not a crucial driver of epileptogenesis or neuroinflammation after TBI in the developing brain. We propose that age may be an important factor differentiating our findings from previous studies in which targeting CCL2/CCR2 has been reported to be anti-inflammatory, neuroprotective or anti-seizure.