Journal of neurotrauma
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Journal of neurotrauma · Jan 2025
Impact of Post-Traumatic Epilepsy on Mental Health and Multidimensional Outcome and Quality of Life: An NIDILRR TBIMS Study.
Traumatic brain injury (TBI) and subsequent post-traumatic epilepsy (PTE) often impair daily activities and mental health (MH), which contribute to long-term TBI-related disability. PTE also affects driving capacity, which impacts functional independence, community participation, and satisfaction with life (SWL). However, studies evaluating the collective impact of PTE on multidimensional outcomes are lacking. ⋯ The implications underscore the crucial need for effective PTE management strategies during the first year post-TBI to minimize the adverse impact on factors influencing multidimensional year-2 participation and SWL outcomes. Addressing transportation barriers is warranted to enhance the well-being of those with PTE and msTBI, emphasizing a holistic approach. Further research is recommended for SEM validation studies, including testing causal inference pathways that might inform future prevention and treatment trials.
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Journal of neurotrauma · Jan 2025
Exploring synaptic pathways in traumatic brain injury: a cross-phenotype genomics approach.
Traumatic brain injury (TBI), a global leading cause of mortality and disability, lacks effective treatments to enhance recovery. Synaptic remodeling has been postulated as one mechanism that influences outcomes after TBI. We sought to investigate whether common mechanisms affecting synapse maintenance are shared between TBI and other neuropsychiatric conditions using pathway enrichment tools and genome-wide genotype data, with the goal of highlighting novel treatment targets. ⋯ Three of those pathways were shared between TBI and SCZ, suggesting possible pathophysiologic commonalities. In this study, we utilize comparative and integrative genomic approaches across brain conditions that share synaptic mechanisms to explore the pathophysiology of TBI outcomes. Our results implicate associations between TBI outcome and synaptic pathways as well as pathobiological overlap with other neuropsychiatric diseases.
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Journal of neurotrauma · Jan 2025
Intravenous Immunomodulatory Nanoparticles Prevent Secondary Damage after Traumatic Brain Injury.
After traumatic brain injury (TBI), monocyte/macrophage infiltration is a key early step in the development of an inflammatory cascade that leads to substantial secondary damage. Intravenous (IV) immunomodulatory nanoparticle (IMP) administration after TBI limits inflammatory cell infiltration and reduces both behavioral decline and lesion size without any noticeable toxicity. Here we show that there is a dose-response relationship between the amount of IMP administered and tissue damage which plateaus at a well-tolerated dose. ⋯ Thus, IMP treatment within 6 h after TBI limits inflammatory responses and gliosis, improves anatomical and behavioral outcomes and prevents detrimental changes in gene expression in both neural and non-neural cellular elements of the brain. IMPs are non-toxic and are made of an FDA-approved material that is stable at room temperature. They could easily be given IV immediately after TBI in the field by emergency medical technicians or in the emergency room to prevent secondary damage, thereby improving outcomes.
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Journal of neurotrauma · Jan 2025
Randomized Controlled TrialAcupuncture Treatment for Chronic Post-traumatic Headache in Individuals with Mild Traumatic Brain Injury: A Pilot Study.
Chronic post-traumatic headache (CPTH) after a mild traumatic brain injury (mTBI) has been reported in up to 60% of patients and can be extremely debilitating. While pharmacological treatments are typically used for CPTH, they frequently cause side effects and have limited effectiveness, leading individuals with CPTH to be unsatisfied with current treatment options and to seek nonpharmacological options. Acupuncture has been identified as a potential treatment option; however, the evidence in this population remains limited. ⋯ There were no significant changes in acute medication use or sleep quality. While there were some QOL improvements identified, these results should be interpreted with caution. Overall, acupuncture was shown to be safe and well-tolerated in people with CPTH after mTBI, and five acupuncture treatments using a standardized protocol shows promise in providing headache relief for this population.
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Journal of neurotrauma · Jan 2025
Randomized Controlled TrialGoal-Oriented Attentional Self-Regulation Training in Chronic Mild Traumatic Brain Injury is Linked to Microstructural Plasticity in Prefrontal White Matter.
Impaired attention is one of the most common, debilitating, and persistent consequences of traumatic brain injury (TBI), which impacts overall cognitive and executive functions in these patients. Previous neuroimaging studies, trying to understand the neural mechanism underlying attention impairment post TBI, have highlighted the role of prefrontal white matter tracts in attentional functioning in mild TBI (mTBI). Goal-Oriented Attentional Self-Regulation (GOALS) is a cognitive rehabilitation training program that targets executive control functions in participants by applying mindfulness-based attention regulation and goal management strategies. ⋯ Our results show significantly better white matter microstructural integrity in left and right anterior corona radiata (ACR) in the GOALS group compared with the control group post-training. Moreover, we found a significant correlation between sustained attention ability of GOALS training participants and white matter integrity of their right ACR pre- and post-training. Finally, our findings indicated that the improved white matter integrity of the ACR in GOALS training participants was the result of increased neurite density and decreased fiber orientation dispersion within this tract.