Journal of neurotrauma
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Journal of neurotrauma · Mar 2024
Sleep Disturbance during Post-Traumatic Amnesia and Early Recovery following Traumatic Brain Injury.
Following moderate to severe traumatic brain injury (TBI), sleep disturbance commonly emerges during the confused post-traumatic amnesia (PTA) recovery stage. However, the evaluation of early sleep disturbance during PTA, its recovery trajectory, and influencing factors is limited. This study aimed to evaluate sleep outcomes in patients experiencing PTA using ambulatory gold-standard polysomnography (PSG) overnight and salivary endogenous melatonin assessment at two timepoints (a hormone which influences the sleep-wake cycle). ⋯ However, disturbances to other sleep-wake parameters (e.g., increased awakenings, wake time and sleep latency) persisted after PTA resolved. This is the first study to evaluate sleep disturbance in a patient cohort as they progressed through the early TBI recovery phases. There is a clear need for tailored assessment of sleep disturbance during PTA, which currently does not form part of routine hospital assessment, to suggest new treatment paradigms, enhance patient recovery and reduce its long-term impacts.
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Journal of neurotrauma · Mar 2024
Cannabidiol alleviates neurological deficits after traumatic brain injury by improving intracranial lymphatic drainage.
Traumatic brain injury (TBI)-a severe clinical problem-is compounded by a lack of effective treatments and impeded intracranial metabolic waste clearance. The glymphatic system and meningeal lymphatic vessels are instrumental in TBI pathophysiology and crucial for clearing harmful substances. Cannabidiol (CBD) has the potential to address metabolic imbalances and improve cognitive functions in neurodegenerative diseases, but its specific effect on TBI remains unclear. ⋯ A key observation was that disrupting efferent lymphatic channels nullified CBD's positive effects on waste removal and cognitive enhancements, whereas its anti-inflammatory benefits continued. This finding suggests that CBD's ability to improve waste clearance may operate via the lymphatic system, thereby improving neurological outcomes in TBI patients. Therefore, our study underscores CBD's potential therapeutic role in TBI management.
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Journal of neurotrauma · Mar 2024
Meningeal damage and interface astroglial scarring in the rat brain exposed to a laser-induced shock wave(s).
In the past decade, signature clinical neuropathology of blast-induced traumatic brain injury has been under intense debate, but interface astroglial scarring (IAS) seems to be convincing. In this study, we examined whether IAS could be replicated in the rat brain exposed to a laser-induced shock wave(s) (LISW[s]), a tool that can produce a pure shock wave (primary mechanism) without dynamic pressure (tertiary mechanism). Under certain conditions, we observed astroglial scarring in the subpial glial plate (SGP), grey-white matter junctions (GM-WM), ventricular wall (VW) and regions surrounding cortical blood vessels, accurately reproducing clinical IAS. ⋯ With the high-impulse single exposure or the multiple exposure (low impulse), fibrotic reaction or fibrotic scar formation was observed, in addition to astroglial scarring, in the cortical surface region. Although there are some limitations, this seems to be the first report on the shock wave-induced IAS rodent model. The model may be useful to explore potential therapeutic approaches for IAS.
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Journal of neurotrauma · Mar 2024
Recovery after Sport-Related Concussion in Collegiate Athletes with Self-Reported Pre-Injury Migraines.
Pre-injury migraines might be a risk factor for prolonged recovery after sport-related concussion (SRC). We sought to examine whether a pre-injury history of migraines is associated with worse recovery following SRC in collegiate athletes. Data were collected through a prospective concussion surveillance system in 11 NCAA Division III college athletic programs between 09/2014-03/2020. ⋯ In collegiate athletes, pre-injury migraine history was independently associated with longer RTL but not RTP. When comparing the proportions of those with successful RTP by days, significantly lower proportions of those with migraines showed successful RTP at ≤ 28 days and ≤ 56 days. Futures studies should study the generalizability of our findings in other school levels.
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Journal of neurotrauma · Mar 2024
An Investigation of mTBI Home Cage Behavior: The Home Cage Assay Advantages.
This study utilized the Noldus PhenoTyper Home Cage Monitoring system (HCM) to assess the behavioral and cognitive changes of experimental closed-head mild traumatic brain injury (mTBI). ⋯ Home cage monitoring is a valuable tool for studying the subtle effects of mTBI, complementing traditional assays. The automated evaluation of habituation to novel stimuli (e.g., novel environment) could serve as a potentially sensitive tool for assessing mTBI-associated behavioral deficits.