Journal of neurotrauma
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Journal of neurotrauma · Dec 2024
Mild Traumatic Brain Injury in Older Adults: Recovery Course and Insights on Early Predictors of Outcome.
Mild traumatic brain injury (mTBI) is a growing health concern in the context of an aging population. Older adults comprise a distinct population, with an increased vulnerability for mTBI due to comorbid diseases and age-associated frailty compared with the adult population. The aim of this study was to assess the recovery course and determinants of outcome in a large cohort of older patients with mTBI. ⋯ Our results demonstrate that almost half of older patients with mTBI show complete recovery with complaints and physical frailty as predictors of outcome at 3 months post-injury. Recovery still improves after 3 months and further follow-up is necessary to identify other factors that are associated with long-term outcomes in this specific category of patients with mTBI. The recovery course in older patients with mTBI is dynamic and further research on factors associated with long-term outcomes in this specific patient population is imperative to enhance treatment strategies.
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Journal of neurotrauma · Dec 2024
A Comprehensive Proteomic and Bioinformatic Analysis of Human Spinal Cord Injury Plasma Identifies Proteins Associated with the Complement Cascade and Liver Function as Potential Prognostic Indicators of Neurological Outcome.
Spinal cord injury (SCI) is a major cause of disability, with complications postinjury often leading to lifelong health issues with the need for extensive treatment. Neurological outcome post-SCI can be variable and difficult to predict, particularly in incompletely injured patients. The identification of specific SCI biomarkers in blood may be able to improve prognostics in the field. ⋯ Many of the proteins of interest identified using proteomics were detected only in a single group and therefore have potential as binary (present or absent) biomarkers, RBP4 and PRX-2 in particular. Additional investigations into the chronology of these proteins and their levels in other tissues (cerebrospinal fluid in particular) are needed to better understand the underlying pathophysiology, including any potentially modifiable targets. Pathway analysis highlighted the complement cascade as being significant across groups of differential functional recovery.
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Journal of neurotrauma · Dec 2024
Repetitive mild closed-head injury induced synapse loss and increased local BOLD-fMRI signal homogeneity.
Repeated mild head injuries due to sports, or domestic violence and military service are increasingly linked to debilitating symptoms in the long term. Although symptoms may take decades to manifest, potentially treatable neurobiological alterations must begin shortly after injury. Better means to diagnose and treat traumatic brain injuries requires an improved understanding of the mechanisms underlying progression and means through which they can be measured. ⋯ Injury-affected regions with higher synapse density showed a greater increase in fMRI regional homogeneity. Taken together, these observations may reflect compensatory mechanisms following injury. Multimodal studies are needed to provide deeper insights into these observations.