Journal of neurotrauma
-
Journal of neurotrauma · Apr 2024
Characterizing diffusion from microdialysis catheters in the human brain: a magnetic resonance imaging study with gadobutrol.
Cerebral microdialysis (CMD) catheters allow continuous monitoring of patients' cerebral metabolism in severe traumatic brain injury (TBI). The catheters consist of a terminal semi-permeable membrane that is inserted into the brain's interstitium to allow perfusion fluid to equalize with the surrounding cerebral extracellular environment before being recovered through a central non-porous channel. However, it is unclear how far recovered fluid and suspended metabolites have diffused from within the brain, and therefore what volume or region of brain tissue the analyses of metabolism represent. ⋯ Cerebral microdialysis allows continuous monitoring of regional cerebral metabolism-the volume of which is now clearer from this study. It also has the potential to deliver small molecule therapies to focal pathologies of the human brain. This study provides a platform for future development of new catheters optimally designed to treat such conditions.
-
Journal of neurotrauma · Apr 2024
Lesion Frequency Distribution Maps of Traumatic Axonal Injury on Early Magnetic Resonance Imaging after Moderate and Severe Traumatic Brain Injury and Associations to 12 Months Outcome.
Traumatic axonal injury (TAI) is a common finding on magnetic resonance imaging (MRI) in patients with moderate-severe traumatic brain injury (TBI), and the burden of TAI is associated with outcome in this patient group. Lesion mapping offers a way to combine imaging findings from numerous individual patients into common lesion maps where the findings from a whole patient cohort can be assessed. The aim of this study was to evaluate the spatial distribution of TAI lesions on different MRI sequences and its associations to outcome with use of lesion mapping. ⋯ On VLSM, poor outcome was associated with TAI lesions bilaterally in the splenium, the right side of tectum, tegmental mesencephalon, and pons. In conclusion, we found higher frequency of TAI in posterior corpus callosum, and TAI in splenium, mesencephalon, and pons were associated with poor outcome. If lesion frequency distribution maps containing outcome information based on imaging findings from numerous patients in the future can be compared with the imaging findings from individual patients, it would offer a new tool in the clinical workup and outcome prediction of the patient with TBI.
-
Journal of neurotrauma · Apr 2024
Time-Dependent Long-Term Effect of Memantine Following Repetitive Mild Traumatic Brain Injury.
Repetitive mild traumatic brain injury (rmTBI, e.g. sports concussions) may be associated with both acute and chronic symptoms and neurological changes. Despite the common occurrence of these injuries, therapeutic strategies are limited. One potentially promising approach is N-methyl-d-aspartate receptor (NMDAR) blockade to alleviate the effects of post-injury glutamatergic excitotoxicity. ⋯ Memantine treatment, either immediately or six-months post-injury, appears to confer greater rescue of neuroinflammatory changes (microglia) than vehicle or treatment at the three-month time point. Although memantine is already being prescribed chronically to address persistent symptoms associated with rmTBI, this study represents the first evidence of which we are aware to suggest a small, but durable effect of memantine treatment in mild, concussive injuries. This effect suggests that memantine, while potentially beneficial, is insufficient to treat all aspects of rmTBI alone, and should be combined with other therapeutic agents in a multi-therapy approach, with attention given to the timing of treatment.
-
Journal of neurotrauma · Apr 2024
A Four Country Study of Strangulation-related Alterations in Consciousness in Women who have Experienced Intimate Partner Violence: Co-occurrence with Traumatic Brain Injuries and Measures of Psychological Distress.
At least one in three women experience intimate partner violence (IPV) in their lifetime. The most commonly sustained IPV-related brain injuries include strangulation-related alterations in consciousness (S-AICs) and traumatic brain injuries (TBIs). Moreover, survivors of IPV-related S-AICs and/or TBIs often demonstrate psychological distress such as depression, anxiety, and post-traumatic stress. ⋯ These data underscore the importance of assessing for S-AIC in women who have experienced IPV and when present, to also assess for TBIs and the presence of psychological distress. Unfortunately, there were methodological differences across sites precluding cross-site comparisons. Nonetheless, data were collected across four culturally and geographically diverse countries, and therefore highlight IPV-related BIs as a global issue which needs to be aggressively studied with policies established and then implemented to address find.
-
Journal of neurotrauma · Apr 2024
Psychological Predictors of Mental Health Difficulties after Pediatric Concussion.
Children often experience mental health difficulties after a concussion. Yet, the extent to which a concussion precipitates or exacerbates mental health difficulties remains unclear. This study aimed to examine psychological predictors of mental health difficulties after pediatric concussion. ⋯ When acute mental health was factored into the model, a total of 47.0%-68.8% of variance was explained by the model. Overall, in this sample of children, several pre-injury demographic and psychological factors were observed to predict mental health difficulties after a concussion. These findings need to be validated in future research involving larger, multi-site studies that include a broader cohort of children after concussion.