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Du M, Li J, Yu S, Chen X, She Y, Lu Y, Shu H. RAGE mediates hippocampal pericyte responses and neurovascular unit lesions after TBI. Exp Neurol 2024; 380:114912. [PMID: 39097075 DOI: 10.1016/j.expneurol.2024.114912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/13/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024]
Abstract
Traumatic brain injury impairs brain function through various mechanisms. Recent studies have shown that alterations in pericytes in various diseases affect neurovascular function, but the effects of TBI on hippocampal pericytes remain unclear. Here, we investigated the effects of RAGE activation on pericytes after TBI using male C57BL/6 J mice. Hippocampal samples were collected at different time points within 7 days after TBI, the expression of PDGFR-β, NG2 and the HMGB1-S100B/RAGE signaling pathway was assessed by Western blotting, and the integrity of the hippocampal BBB at different time points was measured by immunofluorescence. RAGE-associated BBB damage in hippocampal pericytes occurred early after cortical impact. By culturing primary mouse brain microvascular pericytes, we determined the different effects of HMGB1-S100B on pericyte RAGE. To investigate whether RAGE blockade could protect neurological function after TBI, we reproduced the process of CCI by administering FPS-ZM1 to RAGE-/- mice. TEM images and BBB damage-related assays showed that inhibition of RAGE resulted in a significant improvement in the number of hippocampal vascular basement membranes and tight junctions and a reduction in perivascular oedema compared with those in the untreated group. In contrast, mouse behavioural testing and doublecortin staining indicated that targeting the HMGB1-S100B/RAGE axis after CCI could protect neurological function by reducing pericyte-associated BBB damage. In conclusion, the present study provides experimental evidence for the strong correlation between the pericyte HMGB1-S100B/RAGE axis and NVU damage in the hippocampus at the early stage of TBI and further demonstrates that pericyte RAGE serves as an important target for the protection of neurological function after TBI.
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Affiliation(s)
- Minghao Du
- Department of Neurosurgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China; Mini-Invasive Neurosurgery and Translational Medical Center, Xi'an Central Hospital, Xi'an Jiaotong University, Xi'an 710003, China
| | - Jiani Li
- Department of Gastroenterology, Xi'an Central Hospital, Xi'an Jiaotong University, Xi'an 710003, China
| | - Sixun Yu
- Department of Neurosurgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China
| | - Xin Chen
- Department of Neurosurgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China
| | - Youyu She
- Mini-Invasive Neurosurgery and Translational Medical Center, Xi'an Central Hospital, Xi'an Jiaotong University, Xi'an 710003, China
| | - Yichen Lu
- Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China.
| | - Haifeng Shu
- Department of Neurosurgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China.
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Chiani F, Mastrorilli V, Marchetti N, Macioce A, Nappi C, Strimpakos G, Pasquini M, Gambadoro A, Battistini JI, Cutuli D, Petrosini L, Marinelli S, Scardigli R, Farioli Vecchioli S. Essential role of p21 Waf1/Cip1 in the modulation of post-traumatic hippocampal Neural Stem Cells response. Stem Cell Res Ther 2024; 15:197. [PMID: 38971774 PMCID: PMC11227726 DOI: 10.1186/s13287-024-03787-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/07/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Traumatic Brain Injury (TBI) represents one of the main causes of brain damage in young people and the elderly population with a very high rate of psycho-physical disability and death. TBI is characterized by extensive cell death, tissue damage and neuro-inflammation with a symptomatology that varies depending on the severity of the trauma from memory loss to a state of irreversible coma and death. Recently, preclinical studies on mouse models have demonstrated that the post-traumatic adult Neural Stem/Progenitor cells response could represent an excellent model to shed light on the neuro-reparative role of adult neurogenesis following damage. The cyclin-dependent kinase inhibitor p21Waf1/Cip1 plays a pivotal role in modulating the quiescence/activation balance of adult Neural Stem Cells (aNSCs) and in restraining the proliferation progression of progenitor cells. Based on these considerations, the aim of this work is to evaluate how the conditional ablation of p21Waf1/Cip1 in the aNSCS can alter the adult hippocampal neurogenesis in physiological and post-traumatic conditions. METHODS We designed a novel conditional p21Waf1/Cip1 knock-out mouse model, in which the deletion of p21Waf1/Cip1 (referred as p21) is temporally controlled and occurs in Nestin-positive aNSCs, following administration of Tamoxifen. This mouse model (referred as p21 cKO mice) was subjected to Controlled Cortical Impact to analyze how the deletion of p21 could influence the post-traumatic neurogenic response within the hippocampal niche. RESULTS The data demonstrates that the conditional deletion of p21 in the aNSCs induces a strong increase in activation of aNSCs as well as proliferation and differentiation of neural progenitors in the adult dentate gyrus of the hippocampus, resulting in an enhancement of neurogenesis and the hippocampal-dependent working memory. However, following traumatic brain injury, the increased neurogenic response of aNSCs in p21 cKO mice leads to a fast depletion of the aNSCs pool, followed by declined neurogenesis and impaired hippocampal functionality. CONCLUSIONS These data demonstrate for the first time a fundamental role of p21 in modulating the post-traumatic hippocampal neurogenic response, by the regulation of the proliferative and differentiative steps of aNSCs/progenitor populations after brain damage.
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Affiliation(s)
- Francesco Chiani
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | | | - Nicole Marchetti
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
- PhD Course in Sciences of Nutrition, Aging, Metabolism and Gender Pathologies, Catholic University of Roma, 00100, Rome, Italy
| | - Andrea Macioce
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Chiara Nappi
- Instituto de Neurosciencias, Universidad Miguel-Hernandez, Alicante, Spain
| | - Georgios Strimpakos
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Miriam Pasquini
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Alessia Gambadoro
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | | | - Debora Cutuli
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179, Rome, Italy
| | - Laura Petrosini
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179, Rome, Italy
| | - Sara Marinelli
- Institute of Biochemistry and Cell Biology, IBBC, CNR, Monterotondo, Rome, Italy
| | - Raffaella Scardigli
- European Brain Research Institute (EBRI), Viale Regine Elena, 00161, Rome, Italy
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
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Mitchell JT, Covington NV, Morrow E, de Riesthal M, Duff MC. Memory and Traumatic Brain Injury: Assessment and Management Practices of Speech-Language Pathologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:279-306. [PMID: 38032245 PMCID: PMC10950318 DOI: 10.1044/2023_ajslp-23-00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/14/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Memory impairments are among the most commonly reported deficits and among the most frequent rehabilitation targets for individuals with traumatic brain injury (TBI). Memory and learning are also critical for rehabilitation success and broader long-term outcomes. Speech-language pathologists (SLPs) play a central role in memory management for individuals with TBI across the continuum of care. Yet, little is known about the current practice patterns of SLPs for post-TBI memory disorders. This study aims to examine the clinical management of memory disorders in adults with TBI by SLPs and identify opportunities to improve post-TBI memory outcomes. METHOD SLPs from across the continuum of care were recruited to complete an online survey. The survey assessed key practice areas specific to memory and memory disorders post-TBI, including education and training, knowledge and confidence, and assessment and treatment patterns. RESULTS Surveys from 155 SLPs were analyzed. Results revealed that TBI-specific training remains low in the field. Respondents varied in their practice patterns in assessing and treating memory disorders. Most SLPs do not appear to have access to appropriate standardized assessments to measure unique forms of memory. Respondents also reported a range of barriers and opportunities to advance memory outcomes following TBI and provided suggestions of areas in which they would like to see more basic and clinical research. CONCLUSIONS These findings establish a baseline of the current practices for clinical management of memory impairment in adults with TBI by SLPs. Improved opportunities for clinician training, the development of a single tool to assess multiple forms of memory, better access to existing memory assessments, and implementation of evidence-based interventions promise to lead to improved memory outcomes for individuals with TBI.
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Affiliation(s)
- Jade T. Mitchell
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Natalie V. Covington
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
- Courage Kenny Research, Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Emily Morrow
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN
| | - Michael de Riesthal
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Gan S, Sun Y, Liu K, Jia X, Li X, Zhang M, Bai L. APOE ε4 allele status modulates the spatial patterns of progressive atrophy in the temporal lobes after mild traumatic brain injury. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12550. [PMID: 38371357 PMCID: PMC10870335 DOI: 10.1002/dad2.12550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION We evaluated how the apolipoprotein E (APOE) ε4 allele modulated the spatial patterns of longitudinal atrophy in the Alzheimer's disease-vulnerable brain areas of patients with mild traumatic brain injury (mTBI) from the acute to chronic phase post injury. METHODS Fifty-nine adult patients with acute mTBI and 48 healthy controls with APOE ε4 allele testing underwent T1-weighted magnetic resonance imaging and neuropsychological assessments with 6 to 12 months of follow-up. Progressive brain volume loss was compared voxel-wise in the temporal lobes. RESULTS Patients with the APOE ε4 allele presented significant longitudinal atrophy in the left superior and middle temporal gyri, where the progressive gray matter volume loss predicted longitudinal impairment in language fluency, whereas mTBI APOE ε4 allele noncarriers showed mainly significant longitudinal atrophy in the medial temporal lobes, without significant neuropsychological relevance. DISCUSSION The atrophy progression observed in mTBI patients with the APOE ε4 allele may increase the possibility of developing a specific phenotype of Alzheimer's disease with language dysfunction. Highlights The apolipoprotein E (APOE) ε4 allele and mild traumatic brain injury (mTBI) are risk factors for Alzheimer's disease (AD) progression.It is unclear how the interaction of mTBI with the APOE ε4 allele impacts the progressive atrophy topography in AD-vulnerable brain regions.In this study, patients with the APOE ε4 allele showed progressive atrophy patterns similar to the early stage of logopenic variant of primary progressive aphasia (lvPPA) phenotype of AD. APOE ε4 allele carriers with mTBI history may be at the risk of developing a given AD phenotype with language dysfunction.
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Affiliation(s)
- Shuoqiu Gan
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and TechnologyXi'an Jiaotong UniversityXi'anChina
- Institute of Artificial IntelligenceHefei Comprehensive National Science CenterHefeiChina
- Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiChina
- Department of Medical Imagingthe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Yingxiang Sun
- Department of Medical Imagingthe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Kejia Liu
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and TechnologyXi'an Jiaotong UniversityXi'anChina
| | - Xiaoyan Jia
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and TechnologyXi'an Jiaotong UniversityXi'anChina
| | - Xuan Li
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and TechnologyXi'an Jiaotong UniversityXi'anChina
| | - Ming Zhang
- Department of Medical Imagingthe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and TechnologyXi'an Jiaotong UniversityXi'anChina
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Ly MT, Merritt VC, Ozturk ED, Clark AL, Hanson KL, Delano-Wood LM, Sorg SF. Subjective memory complaints are associated with decreased cortical thickness in Veterans with histories of mild traumatic brain injury. Clin Neuropsychol 2023; 37:1745-1765. [PMID: 36883430 DOI: 10.1080/13854046.2023.2184720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/21/2023] [Indexed: 03/09/2023]
Abstract
Objective: Memory problems are frequently endorsed in Veterans following mild traumatic brain injury (mTBI), but subjective complaints are poorly associated with objective memory performance. Few studies have examined associations between subjective memory complaints and brain morphometry. We investigated whether self-reported memory problems were associated with objective memory performance and cortical thickness in Veterans with a history of mTBI. Methods: 40 Veterans with a history of remote mTBI and 29 Veterans with no history of TBI completed the Prospective-Retrospective Memory Questionnaire (PRMQ), PTSD Checklist (PCL), California Verbal Learning Test-2nd edition (CVLT-II), and 3 T T1 structural magnetic resonance imaging. Cortical thickness was estimated in 14 a priori frontal and temporal regions. Multiple regressions adjusting for age and PCL scores examined associations between PRMQ, CVLT-II scores, and cortical thickness within each Veteran group. Results: Greater subjective memory complaints on the PRMQ were associated with lower cortical thickness in the right middle temporal gyrus (β = 0.64, q = .004), right inferior temporal gyrus (β = 0.56, q = .014), right rostral middle frontal gyrus (β = 0.45, q = .046), and right rostral anterior cingulate gyrus (β = 0.58, q = .014) in the mTBI group but not the control group (q's > .05). These associations remained significant after adjusting for CVLT-II learning. CVLT-II performance was not associated with PRMQ score or cortical thickness in either group. Conclusions: Subjective memory complaints were associated with lower cortical thickness in right frontal and temporal regions, but not with objective memory performance, in Veterans with histories of mTBI. Subjective complaints post-mTBI may indicate underlying brain morphometry independently of objective cognitive testing.
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Affiliation(s)
- Monica T Ly
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
| | - Victoria C Merritt
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Erin D Ozturk
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- San Diego Joint Doctoral Program, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Alexandra L Clark
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Karen L Hanson
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
| | - Lisa M Delano-Wood
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Scott F Sorg
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, USA
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Zhuang Y, Xu X, Li H, Niu F, Yang M, Ge Q, Lu S, Deng Y, Wu H, Zhang B, Liu B. Megf10-related engulfment of excitatory postsynapses by astrocytes following severe brain injury. CNS Neurosci Ther 2023; 29:2873-2883. [PMID: 37081759 PMCID: PMC10493650 DOI: 10.1111/cns.14223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 04/22/2023] Open
Abstract
AIMS To investigate astrocyte-related phagocytosis of synapses in the ipsilateral hippocampus after traumatic brain injury (TBI). METHODS We performed controlled cortical impact to simulate TBI in mice. Seven days postinjury, we performed cognitive tests, synapse quantification, and examination of astrocytic phagocytosis in association with Megf10 expression. RESULTS During the subacute stage post-TBI, we found a reduction in excitatory postsynaptic materials in the ipsilateral hippocampus, which was consistent with poor performance in the cognitive test. The transcriptome data suggested that robust phagocytosis was responsible for this process. Coincidently, we identified phagocytic astrocytes containing secondary lysosomes that were wrapped around the synapses in the ipsilateral hippocampus. Moreover, a significant increase in the co-location of GFAP and PSD-95 in the CA1 region suggested astrocytic engulfment of excitatory postsynaptic proteins. After examining the reported phagocytic pathways, we found that both the transcription level and protein expression of Megf10 were elevated. Co-immunofluorescence of GFAP and Megf10 demonstrated that the expression of Megf10 was spatially upregulated in astrocytes, exclusively in the CA1 region, and was related to the astrocytic engulfment of PSD-95. CONCLUSION Our study elaborated that the Megf10-related astrocytic engulfment of PSD-95 in the CA1 region of the ipsilateral hippocampus aggravated cognitive dysfunction following severe TBI.
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Affiliation(s)
- Yuan Zhuang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xiaojian Xu
- Beijing Key Laboratory of Central Nervous System InjuryBeijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
| | - Hao Li
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Fei Niu
- Beijing Key Laboratory of Central Nervous System InjuryBeijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
| | - Mengshi Yang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Qianqian Ge
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Shenghua Lu
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yu Deng
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Hongbin Wu
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Bin Zhang
- Department of Intensive Care Unit, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of Central Nervous System InjuryBeijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
- Center for Nerve Injury and RepairBeijing Institute of Brain DisordersBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
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Hou J, Huibregtse ME, Alexander IL, Klemsz LM, Fu T, Rosenberg M, Fortenberry JD, Herbenick D, Kawata K. Structural brain morphology in young adult women who have been choked/strangled during sex: A whole-brain surface morphometry study. Brain Behav 2023; 13:e3160. [PMID: 37459254 PMCID: PMC10454256 DOI: 10.1002/brb3.3160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION Being choked/strangled during partnered sex is an emerging sexual behavior, particularly prevalent among young adult women. Using a multiparameter morphometric imaging approach, we aimed to characterize neuroanatomical differences between young adult women (18-30 years old) who were exposed to frequent sexual choking and their choking naïve controls. METHODS This cross-sectional study consisted of two groups (choking [≥4 times in the past 30 days] vs. choking-naïve group). Participants who reported being choked four or more times during sex in the past 30 days were enrolled in the choking group, whereas those without were assigned to the choking naïve group. High-resolution anatomical magnetic resonance imaging (MRI) data were analyzed using both volumetric features (cortical thickness) and geometric features (fractal dimensionality, gyrification, sulcal depth). RESULTS Forty-one participants (choking n = 20; choking-naïve n = 21) contributed to the final analysis. The choking group showed significantly increased cortical thickness across multiple regions (e.g., fusiform, lateral occipital, lingual gyri) compared to the choking-naïve group. Widespread reductions of the gyrification were observed in the choking group as opposed to the choking-naïve group. However, there was no group difference in sulcal depth. The fractal dimensionality showed bi-directional results, where the choking group exhibited increased dimensionality in areas including the postcentral gyrus, insula, and fusiform, whereas decreased dimensionality was observed in the bilateral superior frontal gyrus and pericalcarine cortex. CONCLUSION These data in cortical morphology suggest that sexual choking events may be associated with neuroanatomical alteration. A longitudinal study with multimodal assessment is needed to better understand the temporal ordering of sexual choking and neurological outcomes.
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Affiliation(s)
- Jiancheng Hou
- Research Center for Cross‐Straits Cultural DevelopmentFujian Normal UniversityFuzhouChina
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
| | - Megan E. Huibregtse
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
- Department of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlantaGeorgiaUSA
| | - Isabella L. Alexander
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
| | - Lillian M. Klemsz
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
| | - Tsung‐Chieh Fu
- Department of Applied Health Science, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- The Center for Sexual Health Promotion, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - James Dennis Fortenberry
- Department of Pediatrics, Indiana University School of MedicineIndiana UniversityIndianapolisIndianaUSA
| | - Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- The Center for Sexual Health Promotion, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Keisuke Kawata
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
- Program in NeuroscienceThe College of Arts and SciencesIndiana UniversityBloomingtonIndianaUSA
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Morrow EL, Mayberry LS, Duff MC. The growing gap: A study of sleep, encoding, and consolidation of new words in chronic traumatic brain injury. Neuropsychologia 2023; 184:108518. [PMID: 36804844 PMCID: PMC10174227 DOI: 10.1016/j.neuropsychologia.2023.108518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/31/2022] [Accepted: 02/16/2023] [Indexed: 02/18/2023]
Abstract
Word learning is an iterative and dynamic process supported by multiple neural and cognitive systems. Converging evidence from behavioral, cellular, and systems neuroscience highlights sleep as an important support for memory and word learning over time. In many lab-based word learning experiments, participants encode and subsequently retrieve newly learned words in a single session. These designs are inadequate to capture the full dynamic word learning process, making them less ecologically valid. Single timepoint studies also limit investigation of the role of behavioral and lifestyle factors, like sleep, in supporting word learning over time. Adults with a history of traumatic brain injury (TBI), who commonly exhibit deficits in the memory systems that support word learning and report concomitant sleep disturbance, provide a unique opportunity to examine the link between memory, sleep, and word learning. Here we examined word learning over time and the influence of sleep on short- and long-term word recall in 50 adults with chronic moderate-severe TBI and 50 demographically matched neurotypical peers. We used a randomized within-participant crossover design to assess immediate encoding of new words and the consolidation of those words over time across intervals that did or did not involve sleep. Participants completed this study over the course of two weeks in their own homes to capture the iterative, dynamic process of real-world word learning. We also measured sleep in free living conditions using actigraphy throughout the experiment. Participants with TBI exhibited a word learning deficit that began at encoding and persisted across time. Critically, this deficit grew over the course of the week. The performance gap between groups was larger at the 1-week post-test than the immediate post-test, suggesting deficits in both encoding and consolidation of new words in individuals with TBI. Participants with and without TBI remembered more words when they slept after learning. Ecologically valid research designs that examine the relationship between memory, sleep, and word learning over time promise to advance mechanistic accounts of word learning and improve the long-term retention of new words in individuals with and without brain injury.
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Affiliation(s)
- Emily L Morrow
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, USA; Department of Medicine, Division of General Internal Medicine & Public Health, Vanderbilt University Medical Center, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, USA.
| | - Lindsay S Mayberry
- Department of Medicine, Division of General Internal Medicine & Public Health, Vanderbilt University Medical Center, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, USA
| | - Melissa C Duff
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, USA
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9
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Taing AS, Mundy ME, Ponsford JL, Spitz G. Traumatic brain injury alters the relationship between brain structure and episodic memory. Brain Behav 2023; 13:e3012. [PMID: 37132290 PMCID: PMC10275516 DOI: 10.1002/brb3.3012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Focal and diffuse pathology resulting from traumatic brain injury (TBI) often disrupts brain circuitry that is critical for episodic memory, including medial temporal lobe and prefrontal regions. Prior studies have focused on unitary accounts of temporal lobe function, associating verbally learned material and brain morphology. Medial temporal lobe structures, however, are domain-sensitive, preferentially supporting different visual stimuli. There has been little consideration of whether TBI preferentially disrupts the type of visually learned material and its association with cortical morphology following injury. Here, we investigated whether (1) episodic memory deficits differ according to the stimulus type, and (2) the pattern in memory performance can be linked to changes in cortical thickness. METHODS Forty-three individuals with moderate-severe TBI and 38 demographically similar healthy controls completed a recognition task in which memory was assessed for three categories of stimuli: faces, scenes, and animals. The association between episodic memory accuracy on this task and cortical thickness was subsequently examined within and between groups. RESULTS Our behavioral results support the notion of category-specific impairments: the TBI group had significantly impaired accuracy for memory for faces and scenes, but not animals. Moreover, the association between cortical thickness and behavioral performance was only significant for faces between groups. CONCLUSION Taken together, these behavioral and structural findings provide support for an emergent memory account, and highlight that cortical thickness differentially affects episodic memory for specific categories of stimuli.
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Affiliation(s)
- Abbie S. Taing
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
- Monash Epworth Rehabilitation Research CentreRichmondVictoriaAustralia
| | - Matthew E. Mundy
- Faculty of Health and EducationTorrens UniversityMelbourneVictoriaAustralia
| | - Jennie L. Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
- Monash Epworth Rehabilitation Research CentreRichmondVictoriaAustralia
| | - Gershon Spitz
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
- Monash Epworth Rehabilitation Research CentreRichmondVictoriaAustralia
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10
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Verhulst MMLH, Glimmerveen AB, van Heugten CM, Helmich RCG, Hofmeijer J. MRI factors associated with cognitive functioning after acute onset brain injury: Systematic review and meta-analysis. Neuroimage Clin 2023; 38:103415. [PMID: 37119695 PMCID: PMC10165272 DOI: 10.1016/j.nicl.2023.103415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/22/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Abstract
Impairments of memory, attention, and executive functioning are frequently reported after acute onset brain injury. MRI markers hold potential to contribute to identification of patients at risk for cognitive impairments and clarification of mechanisms. The aim of this systematic review was to summarize and value the evidence on MRI markers of memory, attention, and executive functioning after acute onset brain injury. We included ninety-eight studies, on six classes of MRI factors (location and severity of damage (n = 15), volume/atrophy (n = 36), signs of small vessel disease (n = 15), diffusion-weighted imaging measures (n = 36), resting-state functional MRI measures (n = 13), and arterial spin labeling measures (n = 1)). Three measures showed consistent results regarding their association with cognition. Smaller hippocampal volume was associated with worse memory in fourteen studies (pooled correlation 0.58 [95% CI: 0.46-0.68] for whole, 0.11 [95% CI: 0.04-0.19] for left, and 0.34 [95% CI: 0.17-0.49] for right hippocampus). Lower fractional anisotropy in cingulum and fornix was associated with worse memory in six and five studies (pooled correlation 0.20 [95% CI: 0.08-0.32] and 0.29 [95% CI: 0.20-0.37], respectively). Lower functional connectivity within the default-mode network was associated with worse cognition in four studies. In conclusion, hippocampal volume, fractional anisotropy in cingulum and fornix, and functional connectivity within the default-mode network showed consistent associations with cognitive performance in all types of acute onset brain injury. External validation and cut off values for predicting cognitive impairments are needed for clinical implementation.
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Affiliation(s)
- Marlous M L H Verhulst
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands.
| | - Astrid B Glimmerveen
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands; Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rick C G Helmich
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands; Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jeannette Hofmeijer
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
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11
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Morrow EL, Duff MC. Word Learning as a Window to Memory and Rehabilitation Outcomes in Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:956-965. [PMID: 36356223 PMCID: PMC10166188 DOI: 10.1044/2022_ajslp-22-00073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/20/2022] [Accepted: 08/15/2022] [Indexed: 05/10/2023]
Abstract
PURPOSE The purpose of this viewpoint is to advocate for increased study of word learning abilities and word learning interventions in traumatic brain injury (TBI). METHOD We describe the word learning process and the unique opportunities afforded by studying each component and stage. Building on discussions at the 2022 International Cognitive-Communication Disorders Conference, we describe how word learning may underlie a variety of functional outcomes after TBI, making it a promising target for rehabilitation. Finally, we discuss principles that may guide study in this critical area to advance outcomes after TBI for children and adults. RESULTS Word learning is a dynamic and iterative process taking place over time and in multiple stages. Thus, studying word learning affords the opportunity to parse the relative contributions of multiple memory systems to different phases and components of the process. However, single-timepoint designs are insufficient to capture the full word learning process, which occurs over time and across contexts. Word learning also presents an opportunity to assess the contributions of behavioral and lifestyle factors (e.g., sleep and exercise) to different memory phases. Understanding these interactions could drive clinical interventions aimed at improving memory through manipulable external behaviors. CONCLUSIONS Word learning is key to success in functional spheres across the life span. The importance of words to daily life remains after TBI, even as the memory systems that support word learning are disrupted. The empirical study of word learning and rehabilitation of word learning deficits in TBI presents a promising new direction in understanding the breadth of neurogenic cognitive-communication disorders and an opportunity to explore a potential driver of functional outcome and impactful rehabilitation target.
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Affiliation(s)
- Emily L. Morrow
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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12
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Beaudouin F, Tröss T, Hadji A, Steendahl IB, Meyer T, Fünten KAD. Do Sports-related Concussions Induce Subsequent Injuries in Elite Male Football Players? Int J Sports Med 2023. [PMID: 36347430 DOI: 10.1055/a-1974-3965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
To assess the players' risk of a subsequent injury after sustaining concussive injuries and their return-to-competition in German professional men's football. A prospective injury database in the 1st Bundesliga was created encompassing 7 seasons (2014/15-2020/21). Cox proportional hazard model analyzed whether a concussive injury increased the risk of a subsequent injury in the first year after the index injury. 6,651 injuries were reported (n=182 concussive injuries). The incidence rate was 0.15 (95% CI 0.13-0.17) per 1000 football hours. A concussive injury was associated with only a slightly numerical higher risk of 7% (HR=1.07, 95% CI 0.78-1.47) in the subsequent year after the injury compared to a randomly selected non-concussive injury, but the effect was not significant. The risk was higher after 6-12 months post-SRC reaching 70% (HR=1.70, 95% CI 1.15-2.52). For 0-3 months (HR=0.76, 95% CI 0.48-1.20) and 3-6 months (HR=0.97, 95% CI 0.62-1.50) the injury risk was lower. The present data do not confirm previously published investigations about an increased injury risk after SRC. Contrasting effects of lower hazard ratios were found early after SRC, followed by an increase after 6-12 months. Further research should look into compliance rates with regards to return-to-competition protocols.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröss
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Abed Hadji
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Ida Bo Steendahl
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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13
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Zhao F, Lim H, Morrow EL, Turkstra LS, Duff MC, Mutlu B. Designing evidence-based support aids for social media access for individuals with moderate-severe traumatic brain injury: A preliminary acceptability study. Front Digit Health 2022; 4:991814. [PMID: 36606124 PMCID: PMC9808081 DOI: 10.3389/fdgth.2022.991814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 01/07/2023] Open
Abstract
Background Adults with traumatic brain injury (TBI) report significant barriers to using current social media platforms, including cognitive overload and challenges in interpreting social cues. Rehabilitation providers may be tasked with helping to address these barriers. Objectives To develop technological supports to increase social media accessibility for people with TBI-related cognitive impairments and to obtain preliminary data on the perceived acceptability, ease of use, and utility of proposed technology aids. Methods We identified four major barriers to social media use among individuals with TBI: sensory overload, memory impairments, misreading of social cues, and a lack of confidence to actively engage on social media platforms. We describe the process of developing prototypes of support aids aimed at reducing these specific social media barriers. We created mock-ups of these prototypes and asked 46 community-dwelling adults with TBI (24 females) to rate the proposed aids in terms of their acceptability, ease of use, and utility. Results Across all aids, nearly one-third of respondents agreed they would use the proposed aids frequently, and the majority of respondents rated the proposed aids as easy to use. Respondents indicated that they would be more likely to use the memory and post-writing aids than the attention and social cue interpretation aids. Conclusions Findings provide initial support for social-media-specific technology aids to support social media access and social participation for adults with TBI. Results from this study have design implications for future development of evidence-based social media support aids. Future work should develop and deploy such aids and investigate user experience.
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Affiliation(s)
- Fangyun Zhao
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States,Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Hajin Lim
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Emily L. Morrow
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Lyn S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, United States
| | - Melissa C. Duff
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States,Correspondence: Melissa Duff
| | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
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14
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Zheng L, Pang Q, Xu H, Guo H, Liu R, Wang T. The Neurobiological Links between Stress and Traumatic Brain Injury: A Review of Research to Date. Int J Mol Sci 2022; 23:ijms23179519. [PMID: 36076917 PMCID: PMC9455169 DOI: 10.3390/ijms23179519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Neurological dysfunctions commonly occur after mild or moderate traumatic brain injury (TBI). Although most TBI patients recover from such a dysfunction in a short period of time, some present with persistent neurological deficits. Stress is a potential factor that is involved in recovery from neurological dysfunction after TBI. However, there has been limited research on the effects and mechanisms of stress on neurological dysfunctions due to TBI. In this review, we first investigate the effects of TBI and stress on neurological dysfunctions and different brain regions, such as the prefrontal cortex, hippocampus, amygdala, and hypothalamus. We then explore the neurobiological links and mechanisms between stress and TBI. Finally, we summarize the findings related to stress biomarkers and probe the possible diagnostic and therapeutic significance of stress combined with mild or moderate TBI.
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Affiliation(s)
- Lexin Zheng
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Qiuyu Pang
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Heng Xu
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Hanmu Guo
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Rong Liu
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Tao Wang
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
- Shanghai Key Lab of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, China (Academy of Forensic Science), Shanghai 200063, China
- Correspondence:
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15
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Yener N, Glendon K, Pain MT. The association between sport-related concussion and musculoskeletal injury in university rugby athletes. Phys Ther Sport 2022; 55:264-270. [DOI: 10.1016/j.ptsp.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
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16
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Dulas MR, Morrow EL, Schwarb H, Cohen NJ, Duff MC. Temporal order memory impairments in individuals with moderate-severe traumatic brain injury. J Clin Exp Neuropsychol 2022; 44:210-225. [PMID: 35876336 PMCID: PMC9422773 DOI: 10.1080/13803395.2022.2101620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/09/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Temporal order memory is a core cognitive function that underlies much of our behavior. The ability to bind together information within and across events, and to reconstruct that sequence of information, critically relies upon the hippocampal relational memory system. Recent work has suggested traumatic brain injury (TBI) may particularly impact hippocampally mediated relational memory. However, it is currently unclear whether such deficits extend to temporal order memory, and whether deficits only arise at large memory loads. The present study assessed temporal order memory in individuals with chronic, moderate-severe TBI across multiple set sizes. METHOD Individuals with TBI and Neurotypical Comparison participants studied sequences of three to nine objects, one a time. At test, all items were re-presented in pseudorandom order, and participants indicated the temporal position (i.e., first, second, etc.) in which each object had appeared. Critically, we assessed both the frequency and the magnitude of errors (i.e., how far from its studied position was an item remembered). RESULTS Individuals with TBI were not impaired for the smallest set size, but showed significant impairments at 5+ items. Group differences in the error frequency did not increase further with larger set sizes, but group differences in error magnitude did increase with larger memory loads. Individuals with TBI showed spared performance for the first object of each list (primacy) but were impaired on the last object (recency), though error frequency was better for last compared to middle items. CONCLUSIONS Our findings demonstrate that TBI results in impaired temporal order memory for lists as small as five items, and that impairments are exacerbated with increasing memory loads. Assessments that test only small set sizes may be insufficient to detect these deficits. Further, these data highlight the importance of additional, sensitive measures in the assessment of cognitive impairments in TBI.
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Affiliation(s)
- Michael R. Dulas
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana (IL)
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana (IL)
| | - Emily L. Morrow
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville (TN)
| | - Hillary Schwarb
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana (IL)
- Interdisciplinary Health Sciences Institutes, University of Illinois at Urbana-Champaign, Urbana (IL)
| | - Neal J. Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana (IL)
- Interdisciplinary Health Sciences Institutes, University of Illinois at Urbana-Champaign, Urbana (IL)
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville (TN)
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17
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Macruz FBDC, Feltrin FS, Zaninotto A, Guirado VMDP, Otaduy MCG, Tsunemi MH, Nucci MP, Rimkus C, Andrade CS, Leite CDC. Longitudinal assessment of magnetization transfer ratio, brain volume, and cognitive functions in diffuse axonal injury. Brain Behav 2022; 12:e2490. [PMID: 35103410 PMCID: PMC8933768 DOI: 10.1002/brb3.2490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/08/2021] [Accepted: 12/29/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Diffuse axonal injury (DAI) is a frequent mechanism of traumatic brain injury (TBI) that triggers a sequence of parenchymal changes that progresses from focal axonal shear injuries up to inflammatory response and delayed axonal disconnection. OBJECTIVE The main purpose of this study is to evaluate changes in the axonal/myelinic content and the brain volume up to 12 months after TBI and to correlate these changes with neuropsychological results. METHODS Patients with DAI (n = 25) were scanned at three time points after trauma (2, 6, and 12 months), and the total brain volume (TBV), gray matter volume, and white matter volume (WMV) were calculated in each time point. The magnetization transfer ratio (MTR) for the total brain (TB MTR), gray matter (GM MTR), and white matter (WM MTR) was also quantified. In addition, Hopkins verbal learning test (HVLT), Trail Making Test (TMT), and Rey-Osterrieth Complex Figure test were performed at 6 and 12 months after the trauma. RESULTS There was a significant reduction in the mean TBV, WMV, TB MTR, GM MTR, and WM MTR between time points 1 and 3 (p < .05). There was also a significant difference in HVLT-immediate, TMT-A, and TMT-B scores between time points 2 and 3. The MTR decline correlated more with the cognitive dysfunction than the volume reduction. CONCLUSION A progressive axonal/myelinic rarefaction and volume loss were characterized, especially in the white matter (WM) up to 1 year after the trauma. Despite that, specific neuropsychological tests revealed that patients' episodic verbal memory, attention, and executive function improved during the study. The current findings may be valuable in developing long-term TBI rehabilitation management programs.
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Affiliation(s)
| | - Fabrício Stewan Feltrin
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Ana Zaninotto
- Neuropsychology Division, Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | | | | | - Miriam Harumi Tsunemi
- Department of Biostatistics, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Mariana Penteado Nucci
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Carolina Rimkus
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Celi Santos Andrade
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Claudia da Costa Leite
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil
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18
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Adamson MM, Main K, Harris OA, Kang X. Sex differences in cortical thickness and diffusion properties in patients with traumatic brain injury: a pilot study. Brain Inj 2022; 36:488-502. [PMID: 35113752 DOI: 10.1080/02699052.2022.2034046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Cortical thickness and diffusion properties are important measures of gray and white matter integrity in those with traumatic brain injury (TBI). Many studies show that healthy adult females have greater cortical thickness than males across numerous brain sites. In this study, we explored this sex difference in patients with TBI. METHOD Participants consisted of 32 patients with TBI and 21 neurologically healthy controls. All were scanned by magnetic resonance imaging (MRI). Differences in cortical thickness and diffusion properties were examined between groups (i.e., TBI/control, male/female). RESULTS Patients with TBI had more cortical thinning (both hemispheres) compared to controls. They also showed decreased fractional anisotropy (FA) for several major white matter tracts. Healthy females had significantly greater cortical thickness compared to healthy males. However, this difference was smaller among the patients with TBI. We found no sex differences in diffusion properties. There were moderate correlations between cortical thickness, diffusion properties, and cognitive performance, as measured by the Trail Making Test B. CONCLUSION These findings contribute to a growing discussion on sex differences in cortical thickness and diffusion properties. Sexual dimorphism could necessitate different clinical profiles, targets, and rehabilitation strategies in patients with TBI.
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Affiliation(s)
- Maheen M Adamson
- Rehabilitation Service, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Keith Main
- Research Division, Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA.,General Dynamics Information Technology, Falls Church, Virginia, USA
| | - Odette A Harris
- Rehabilitation Service, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Xiaojian Kang
- Rehabilitation Service, VA Palo Alto Health Care System, Palo Alto, California, USA
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19
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Xu H, Tao Y, Zhu P, Li D, Zhang M, Bai G, Yin B. Restoration of aberrant shape of caudate sub-regions associated with cognitive function improvement in mild traumatic brain injury. J Neurotrauma 2022; 39:348-357. [PMID: 35019763 DOI: 10.1089/neu.2021.0426] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is an important but less recognized public health concern. Research shows that altered subcortical structures mediate cognitive impairment in patients with mTBI. This has been performed mostly using voxel-based morphometry methods and traditional volume measurement methods, which have certain limitations. In this study, we conducted a vertex-wise shape analysis to understand the aberrant patterns of caudate sub-regions and recovery from mTBI. The study involved 36 mTBI patients and 34 matched healthy controls (HCs) observed at seven-days (acute phase) and followed-up for one-month (subacute phase) post-injury. Different aberrant shapes of the caudate sub-regions were observed at acute phase, which revealed atrophy in the bilateral dorsal medial caudate, and increase in the size of the right ventral anterior caudate in mTBI patients related to HCs. Moreover, specific and significant shape restoration of right dorsal medial caudate in mTBI was observed at subacute phase, which significantly associated with the cognitive function improvement of the patients. These findings suggest that the restoration of the aberrant shape atrophy of right dorsal medial caudate plays a vital role in the improvement of cognitive function of mTBI patients, providing an alternative clinical target for these patients.
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Affiliation(s)
- Hui Xu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Neurosurgery, Wenzhou, China.,McMaster University, 3710, Department of Psychiatry and Behavioural Neurosciences,, Hamilton, Ontario, Canada;
| | - Yin Tao
- McMaster University, 3710, Department of Psychiatry and Behavioural Neurosciences,, Hamilton, Ontario, Canada.,Xi'an Jiaotong University School of Life Science and Technology, 529492, he Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, Xi'an, Shaanxi, China;
| | - Pingyi Zhu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Radiology, Wenzhou, China;
| | - Dandong Li
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Neurosurgery, Wenzhou, China;
| | - Ming Zhang
- Xi'an Jiaotong University Medical College First Affiliated Hospital Department of Medical Imaging, 535072, Xi'an, Shaanxi, China;
| | - Guanghui Bai
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Radiology, Wenzhou, China;
| | - Bo Yin
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Neurosurgery, Wenzhou, China;
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20
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Kong LZ, Zhang RL, Hu SH, Lai JB. Military traumatic brain injury: a challenge straddling neurology and psychiatry. Mil Med Res 2022; 9:2. [PMID: 34991734 PMCID: PMC8740337 DOI: 10.1186/s40779-021-00363-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/27/2021] [Indexed: 12/12/2022] Open
Abstract
Military psychiatry, a new subcategory of psychiatry, has become an invaluable, intangible effect of the war. In this review, we begin by examining related military research, summarizing the related epidemiological data, neuropathology, and the research achievements of diagnosis and treatment technology, and discussing its comorbidity and sequelae. To date, advances in neuroimaging and molecular biology have greatly boosted the studies on military traumatic brain injury (TBI). In particular, in terms of pathophysiological mechanisms, several preclinical studies have identified abnormal protein accumulation, blood-brain barrier damage, and brain metabolism abnormalities involved in the development of TBI. As an important concept in the field of psychiatry, TBI is based on organic injury, which is largely different from many other mental disorders. Therefore, military TBI is both neuropathic and psychopathic, and is an emerging challenge at the intersection of neurology and psychiatry.
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Affiliation(s)
- Ling-Zhuo Kong
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Rui-Li Zhang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Shao-Hua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. .,The Key Laboratory of Mental Disorder's Management in Zhejiang Province, Hangzhou, 310003, China. .,Brain Research Institute of Zhejiang University, Hangzhou, 310003, China. .,Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, China. .,MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University, Hangzhou, 310003, China.
| | - Jian-Bo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. .,The Key Laboratory of Mental Disorder's Management in Zhejiang Province, Hangzhou, 310003, China. .,Brain Research Institute of Zhejiang University, Hangzhou, 310003, China. .,Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, China. .,MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University, Hangzhou, 310003, China.
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21
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Mazaharally M, Stojanovski S, Trossman R, Szulc-Lerch K, Chakravarty MM, Colella B, Glazer J, E Green R, Wheeler AL. Patterns of change in cortical morphometry following traumatic brain injury in adults. Hum Brain Mapp 2021; 43:1882-1894. [PMID: 34953011 PMCID: PMC8933328 DOI: 10.1002/hbm.25761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 01/18/2023] Open
Abstract
Progressive cortical volumetric loss following moderate–severe traumatic brain injury (TBI) has been observed; however, regionally specific changes in the structural determinants of cortical volume, namely, cortical thickness (CT) and cortical surface area (CSA), are unknown and may inform the patterns and neural substrates of neurodegeneration and plasticity following injury. We aimed to (a) assess differences in CT and CSA between TBI participants and controls in the early chronic stage post‐injury, (b) describe longitudinal changes in cortical morphometry following TBI, and (c) examine how regional changes in CT and CSA are associated. We acquired magnetic resonance images for 67 participants with TBI at up to 4 time‐points spanning 5 months to 7 years post‐injury, and 18 controls at 2 time‐points. In the early chronic stage, TBI participants displayed thinner cortices than controls, predominantly in frontal regions, but no CSA differences. Throughout the chronic period, TBI participants showed widespread CT reductions in posterior cingulate/precuneus regions and moderate CT increase in frontal regions. Additionally, CSA showed a significant decrease in the orbitofrontal cortex and circumscribed increase in posterior regions. No changes were identified in controls. Relationships between regional cortical changes in the same morphological measure revealed coordinated patterns within participants, whereas correlations between regions with CT and CSA change yielded bi‐directional relationships. This suggests that these measures may be differentially affected by neurodegenerative mechanisms such as transneuronal degeneration following TBI and that degeneration may be localized to the depths of cortical sulci. These findings emphasize the importance of dissecting morphometric contributions to cortical volume change.
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Affiliation(s)
- Maria Mazaharally
- Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sonja Stojanovski
- Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Trossman
- Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kamila Szulc-Lerch
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, The University of Oxford, Oxford, UK
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada.,Department of Biomedical Engineering, McGill University, Montreal, Canada
| | - Brenda Colella
- Cognitive Neurorehabilitation Sciences Laboratory, Research Department, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Joanna Glazer
- Cognitive Neurorehabilitation Sciences Laboratory, Research Department, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Robin E Green
- Cognitive Neurorehabilitation Sciences Laboratory, Research Department, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
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22
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Motanis H, Khorasani LN, Giza CC, Harris NG. Peering into the Brain through the Retrosplenial Cortex to Assess Cognitive Function of the Injured Brain. Neurotrauma Rep 2021; 2:564-580. [PMID: 34901949 PMCID: PMC8655812 DOI: 10.1089/neur.2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The retrosplenial cortex (RSC) is a posterior cortical area that has been drawing increasing interest in recent years, with a growing number of studies studying its contribution to cognitive and sensory functions. From an anatomical perspective, it has been established that the RSC is extensively and often reciprocally connected with the hippocampus, neocortex, and many midbrain regions. Functionally, the RSC is an important hub of the default-mode network. This endowment, with vast anatomical and functional connections, positions the RSC to play an important role in episodic memory, spatial and contextual learning, sensory-cognitive activities, and multi-modal sensory information processing and integration. Additionally, RSC dysfunction has been reported in cases of cognitive decline, particularly in Alzheimer's disease and stroke. We review the literature to examine whether the RSC can act as a cortical marker of persistent cognitive dysfunction after traumatic brain injury (TBI). Because the RSC is easily accessible at the brain's surface using in vivo techniques, we argue that studying RSC network activity post-TBI can shed light into the mechanisms of less-accessible brain regions, such as the hippocampus. There is a fundamental gap in the TBI field about the microscale alterations occurring post-trauma, and by studying the RSC's neuronal activity at the cellular level we will be able to design better therapeutic tools. Understanding how neuronal activity and interactions produce normal and abnormal activity in the injured brain is crucial to understanding cognitive dysfunction. By using this approach, we expect to gain valuable insights to better understand brain disorders like TBI.
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Affiliation(s)
- Helen Motanis
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Laila N. Khorasani
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Christopher C. Giza
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Neil G. Harris
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- Intellectual Development and Disabilities Research Center, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- *Address correspondence to: Neil G. Harris, PhD, Department of Neurosurgery, University of California at Los Angeles, Wasserman Building, 300 Stein Plaza, Room 551, Los Angeles, CA 90095, USA;
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23
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Brain Volume in Veterans: Relationship to Posttraumatic Stress Disorder and Mild Traumatic Brain Injury. J Head Trauma Rehabil 2021; 35:E330-E341. [PMID: 32108709 DOI: 10.1097/htr.0000000000000559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Clarify associations between diagnosis of posttraumatic stress disorder (PTSD) and deployment traumatic brain injury (TBI) on salient regional brain volumes in returning combat veterans. PARTICIPANTS Iraq and Afghanistan era combat veterans, N = 163, 86.5% male. MAIN MEASURES Clinician-administered PTSD Scale (CAPS-5), Mid-Atlantic MIRECC Assessment of TBI (MMA-TBI), magnetic resonance imaging. METHODS Hierarchical regression analyses evaluated associations and interactions between current and lifetime PTSD diagnosis, deployment TBI, and bilateral volume of hippocampus, anterior cingulate cortex, amygdala, orbitofrontal cortex, precuneus, and insula. RESULTS Deployment TBI was associated with lower bilateral hippocampal volume (P = .007-.032) and right medial orbitofrontal cortex volume (P = .006). Neither current nor lifetime PTSD diagnosis was associated with volumetric outcomes beyond covariates and deployment TBI. CONCLUSION History of deployment TBI is independently associated with lower volumes in hippocampus and medial orbitofrontal cortex. These results support TBI as a potential contributing factor to consider in reduced cortical volume in PTSD.
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24
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Rakesh D, Whittle S. Socioeconomic status and the developing brain - A systematic review of neuroimaging findings in youth. Neurosci Biobehav Rev 2021; 130:379-407. [PMID: 34474050 DOI: 10.1016/j.neubiorev.2021.08.027] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/13/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023]
Abstract
A growing literature has shown associations between socioeconomic disadvantage and neural properties (such as brain structure and function). In this review, we aimed to synthesize findings on the neural correlates of socioeconomic status (SES) in youth samples across neuroimaging modalities. We also aimed to disentangle the effects of different SES measures (e.g., parent income and education) in our synthesis. We found relatively consistent patterns of positive associations between SES and both volume and cortical surface area of frontal regions, and amygdala, hippocampal, and striatal volume (with most consistent results for composite SES indices). Despite limited longitudinal work, results suggest that SES is associated with developmental trajectories of gray matter structure. Higher SES was also found to be associated with increased fractional anisotropy of some white matter tracts, although there were more null than positive findings. Finally, methodological heterogeneity in brain function and connectivity studies prevented us from making strong inferences. Based on our findings, we make recommendations for future research, discuss the role of mitigating factors, and implications for policy.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia.
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
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25
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Faillot M, Chaillet A, Palfi S, Senova S. Rodent models used in preclinical studies of deep brain stimulation to rescue memory deficits. Neurosci Biobehav Rev 2021; 130:410-432. [PMID: 34437937 DOI: 10.1016/j.neubiorev.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
Deep brain stimulation paradigms might be used to treat memory disorders in patients with stroke or traumatic brain injury. However, proof of concept studies in animal models are needed before clinical translation. We propose here a comprehensive review of rodent models for Traumatic Brain Injury and Stroke. We systematically review the histological, behavioral and electrophysiological features of each model and identify those that are the most relevant for translational research.
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Affiliation(s)
- Matthieu Faillot
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France
| | - Antoine Chaillet
- Laboratoire des Signaux et Systèmes (L2S-UMR8506) - CentraleSupélec, Université Paris Saclay, Institut Universitaire de France, France
| | - Stéphane Palfi
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France
| | - Suhan Senova
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France.
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26
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De Freitas DJ, De Carvalho D, Paglioni VM, Brunoni AR, Valiengo L, Thome-Souza MS, Guirado VMP, Zaninotto AL, Paiva WS. Effects of transcranial direct current stimulation (tDCS) and concurrent cognitive training on episodic memory in patients with traumatic brain injury: a double-blind, randomised, placebo-controlled study. BMJ Open 2021; 11:e045285. [PMID: 34446480 PMCID: PMC8395342 DOI: 10.1136/bmjopen-2020-045285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Deficits in episodic memory following traumatic brain injury (TBI) are common and affect independence in activities of daily living. Transcranial direct current stimulation (tDCS) and concurrent cognitive training may contribute to improve episodic memory in patients with TBI. Although previous studies have shown the potential of tDCS to improve cognition, the benefits of the tDCS applied simultaneously to cognitive training in participants with neurological disorders are inconsistent. This study aims to (1) investigate whether active tDCS combined with computer-assisted cognitive training enhances episodic memory compared with sham tDCS; (2) compare the differences between active tDCS applied over the left dorsolateral prefrontal cortex (lDLPFC) and bilateral temporal cortex (BTC) on episodic memory and; (3) investigate inter and intragroup changes on cortical activity measured by quantitative electroencephalogram (qEEG). METHODS AND ANALYSIS A randomised, parallel-group, double-blind placebo-controlled study is conducted. Thirty-six participants with chronic, moderate and severe closed TBI are being recruited and randomised into three groups (1:1:1) based on the placement of tDCS sponges and electrode activation (active or sham). TDCS is applied for 10 consecutive days for 20 min, combined with a computer-based cognitive training. Cognitive scores and qEEG are collected at baseline, on the last day of the stimulation session, and 3 months after the last tDCS session. We hypothesise that (1) the active tDCS group will improve episodic memory scores compared with the sham group; (2) differences on episodic memory scores will be shown between active BTC and lDLPFC and; (3) there will be significant delta reduction and an increase in alpha waves close to the location of the active electrodes compared with the sham group. ETHICS AND DISSEMINATION This study was approved by Hospital das Clínicas, University of São Paulo Ethical Institutional Review Border (CAAE: 87954518.0.0000.0068). TRIAL REGISTRATION NUMBER NCT04540783.
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Affiliation(s)
- Daglie Jorge De Freitas
- Division of Neurology/Neurosurgery, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, HCFMUSP, Sao Paulo, Brazil
| | - Daniel De Carvalho
- Division of Neurology/Neurosurgery, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, HCFMUSP, Sao Paulo, Brazil
| | - Vanessa Maria Paglioni
- Division of Neurology/Neurosurgery, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, HCFMUSP, Sao Paulo, Brazil
| | - Andre R Brunoni
- Institute of Psychiatry, Hospital das Clinicas da Universidade de Sao Paulo, IPq HCFMUSP, University of São Paulo, São Paulo, Brazil
- Interdisciplinary Center for Applied Neuromodulation and Service of Interdisciplinary Neuromodulation, University of Sao Paulo, Sao Paulo, Brazil
| | - Leandro Valiengo
- Institute of Psychiatry, Hospital das Clinicas da Universidade de Sao Paulo, IPq HCFMUSP, University of São Paulo, São Paulo, Brazil
- Interdisciplinary Center for Applied Neuromodulation and Service of Interdisciplinary Neuromodulation, University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Sigride Thome-Souza
- Institute of Psychiatry, Hospital das Clinicas da Universidade de Sao Paulo, IPq HCFMUSP, University of São Paulo, São Paulo, Brazil
| | - Vinícius M P Guirado
- Division of Neurology/Neurosurgery, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, HCFMUSP, Sao Paulo, Brazil
| | - Ana Luiza Zaninotto
- Division of Neurology/Neurosurgery, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, HCFMUSP, Sao Paulo, Brazil
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Wellingson S Paiva
- Division of Neurology/Neurosurgery, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, HCFMUSP, Sao Paulo, Brazil
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27
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Acute pediatric traumatic brain injury severity predicts long-term verbal memory performance through suppression by white matter integrity on diffusion tensor imaging. Brain Imaging Behav 2021; 14:1626-1637. [PMID: 31134584 DOI: 10.1007/s11682-019-00093-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Mediation analysis was used to investigate the role of white matter integrity in the relationship between injury severity and verbal memory performance in participants with chronic pediatric traumatic brain injury (TBI). DTI tractography was used to measure fractional anisotropy (FA) within the corpus callosum, fornix, cingulum bundles, perforant pathways, and uncinate fasciculi. Injury severity was indexed using Glasgow Coma Scale (GCS) scores obtained at the time of the injury. Verbal memory was measured by performance on the long-delay free recall (LDFR) trial of the California Verbal Learning Test-Children's version. Participants were between the ages of 10-18 and included 21 children with TBI (injured before age 9) and 19 typically-developing children (TDC). Children with TBI showed lower FA across all pathways and poorer LDFR performance relative to TDC. Within the TBI group, mediation analysis revealed neither a significant total effect of GCS on LDFR nor significant direct effects of GCS on LDFR across pathways; however, the indirect effects of GCS on LDFR through FA of the corpus callosum, left perforant pathway, and left uncinate fasciculus were significant and opposite in sign to their respective direct effects. These results suggests that the predictive validity of GCS for LDFR is initially suppressed by the substantial variance accounted for by FA, which is uncorrelated with GCS, and the predictive validity of GCS increases only when FA is considered, and the opposing path is controlled. These findings illustrate the complex associations between acute injury severity, white matter pathways, and verbal memory several years following pediatric TBI.
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28
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Mouthon AL, Meyer-Heim A, Huber R, Van Hedel HJA. Neural correlates of memory recovery: Preliminary findings in children and adolescents with acquired brain injury. Restor Neurol Neurosci 2021; 39:61-71. [PMID: 33579882 PMCID: PMC7990412 DOI: 10.3233/rnn-201140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: After acquired brain injury (ABI), patients show various neurological impairments and outcome is difficult to predict. Identifying biomarkers of recovery could provide prognostic information about a patient’s neural potential for recovery and improve our understanding of neural reorganization. In healthy subjects, sleep slow wave activity (SWA, EEG spectral power 1–4.5 Hz) has been linked to neuroplastic processes such as learning and brain maturation. Therefore, we suggest that SWA might be a suitable measure to investigate neural reorganization underlying memory recovery. Objectives: In the present study, we used SWA to investigate neural correlates of recovery of function in ten paediatric patients with ABI (age range 7–15 years). Methods: We recorded high-density EEG (128 electrodes) during sleep at the beginning and end of rehabilitation. We used sleep EEG data of 52 typically developing children to calculate age-normalized values for individual patients. In patients, we also assessed every-day life memory impairment at the beginning and end of rehabilitation. Results: In the course of rehabilitation, memory recovery was paralleled by longitudinal changes in SWA over posterior parietal brain areas. SWA over left prefrontal and occipital brain areas at the beginning of rehabilitation predicted memory recovery. Conclusions: We show that longitudinal sleep-EEG measurements are feasible in the clinical setting. While posterior parietal and prefrontal brain areas are known to belong to the memory “core network”, occipital brain areas have never been related to memory. While we have to remain cautious in interpreting preliminary findings, we suggest that SWA is a promising measure to investigate neural reorganization.
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Affiliation(s)
- Anne-Laure Mouthon
- Swiss Children's Rehab - Research Department and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland
| | - Andreas Meyer-Heim
- Swiss Children's Rehab - Research Department and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland
| | - Reto Huber
- Child Development Centre and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland
| | - Hubertus J A Van Hedel
- Swiss Children's Rehab - Research Department and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland
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29
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Traumatic brain injury and the misuse of alcohol, opioids, and cannabis. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:195-243. [PMID: 33648670 DOI: 10.1016/bs.irn.2020.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Traumatic brain injury (TBI), most often classified as concussion, is caused by biomechanical forces to the brain resulting in short- or long-term impairment in brain function. TBI resulting from military combat, sports, violence, falls, and vehicular accidents is a major cause of long-term physical, cognitive, and psychiatric dysfunction. Psychiatric disorders associated with TBI include depression, anxiety, and substance use disorder, all having significant implications for post-TBI recovery and rehabilitation. This chapter reviews the current preclinical and clinical literature describing the bidirectional relationship between TBI and misuse of three commonly abused drugs: alcohol, opioids, and cannabis. We highlight the influence of each of these drugs on the incidence of TBI, as well as trends in their use after TBI. Furthermore, we discuss factors that may underlie post-injury substance use. Understanding the complex relationship between TBI and substance misuse will enhance the clinical treatment of individuals suffering from these two highly comorbid conditions.
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30
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Wright MJ, Monti MM, Lutkenhoff ES, Hardy DJ, Litvin PY, Kelly DF, Guskiewicz K, Cantu RC, Vespa PM, Hovda DA, Lopez WD, Wang C, Swerdloff R, Fuster JM. Memory in repeat sports-related concussive injury and single-impact traumatic brain injury. Brain Inj 2020; 34:1666-1673. [PMID: 32990043 DOI: 10.1080/02699052.2020.1825806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Repeat sports-related concussive/subconcussive injury (RC/SCI) is related to memory impairment. Objective & Methods: We sought to determine memory differences between persons with RC/SCI, moderate-to-severe single-impact traumatic brain injury (SI-TBI), and healthy controls. MRI scans from a subsample of participants with SI-TBI were used to identify the neuroanatomical correlates of observed memory process differences between the brain injury groups. Results: Both brain injury groups evidenced worse learning and recall in contrast to controls, although SI-TBI group had poorer memory than the RC/SCI group. Regarding memory process differences, in contrast to controls, the SI-TBI group evidenced difficulties with encoding, consolidation, and retrieval, while the RC/SCI group showed deficits in consolidation and retrieval. Delayed recall was predicted by encoding, with consolidation as a secondary predictor in the SI-TBI group. In the RC/SCI group, delayed recall was only predicted by consolidation. MRI data showed that the consolidation index we used mapped onto hippocampal atrophy. Conclusions: RC/SCI is primarily associated with consolidation deficits, which differs from SI-TBI. Given the role of the hippocampus in memory consolidation and the fact that hyperphosphorylated tau tends to accumulate in the medial temporal lobe in RC/SCI, consolidation deficits may be a cognitive marker of chronic traumatic encephalopathy in athletes.
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Affiliation(s)
- Matthew J Wright
- Lundquist Institute at Harbor-UCLA Medical Center , Torrance, California, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine , Los Angeles, California, USA
| | - Martin M Monti
- Department of Psychology, UCLA , Los Angeles, California, USA.,Department of Neurosurgery, UCLA School of Medicine , Los Angeles, California, USA
| | - Evan S Lutkenhoff
- Department of Psychology, UCLA , Los Angeles, California, USA.,Department of Neurosurgery, UCLA School of Medicine , Los Angeles, California, USA
| | - David J Hardy
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine , Los Angeles, California, USA.,Department of Psychology, Loyola Marymount University , Los Angeles, California, USA
| | - Pavel Y Litvin
- Lundquist Institute at Harbor-UCLA Medical Center , Torrance, California, USA
| | - Daniel F Kelly
- Department of Neurosurgery, Brain Tumor Center & Pituitary Disorders Program, John Wayne Cancer Institute at Saint John's Health Center , Santa Monica, California, USA
| | - Kevin Guskiewicz
- Department of Exercise & Sports Science, Center for the Study of Retired Athletes at the University of North Carolina , Chapel Hill, North Carolina, USA
| | - Robert C Cantu
- Department of Neurosurgery, Boston University School of Medicine , Boston, Massachusetts, USA
| | - Paul M Vespa
- Department of Neurosurgery, UCLA School of Medicine , Los Angeles, California, USA.,Department of Neurology, UCLA School of Medicine , Los Angeles, California, USA
| | - David A Hovda
- Department of Neurosurgery, UCLA School of Medicine , Los Angeles, California, USA
| | - Walter D Lopez
- Lundquist Institute at Harbor-UCLA Medical Center , Torrance, California, USA
| | - Christina Wang
- Lundquist Institute at Harbor-UCLA Medical Center , Torrance, California, USA
| | - Ronald Swerdloff
- Lundquist Institute at Harbor-UCLA Medical Center , Torrance, California, USA
| | - Joaquín M Fuster
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine , Los Angeles, California, USA
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31
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Proessl F, Dretsch MN, Connaboy C, Lovalekar M, Dunn-Lewis C, Canino MC, Sterczala AJ, Deshpande G, Katz JS, Denney TS, Flanagan SD. Structural Connectome Disruptions in Military Personnel with Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder. J Neurotrauma 2020; 37:2102-2112. [DOI: 10.1089/neu.2020.6999] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Felix Proessl
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael N. Dretsch
- U.S. Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama, USA
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Chris Connaboy
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mita Lovalekar
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Courtenay Dunn-Lewis
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Maria C. Canino
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adam J. Sterczala
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gopikrishna Deshpande
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Alabama, USA
- Center for Neuroscience, Auburn University, Auburn, Alabama, USA
- School of Psychology, Capital Normal University, Beijing, China
| | - Jeffrey S. Katz
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Alabama, USA
- Center for Neuroscience, Auburn University, Auburn, Alabama, USA
| | - Thomas S. Denney
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Alabama, USA
- Center for Neuroscience, Auburn University, Auburn, Alabama, USA
| | - Shawn D. Flanagan
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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32
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Kaskikallio A, Karrasch M, Koikkalainen J, Lötjönen J, Rinne JO, Tuokkola T, Parkkola R, Grönholm-Nyman P. White Matter Hyperintensities and Cognitive Impairment in Healthy and Pathological Aging: A Quantified Brain MRI Study. Dement Geriatr Cogn Disord 2020; 48:297-307. [PMID: 32209796 DOI: 10.1159/000506124] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Brain changes involving the white matter (WM), often an indication of cerebrovascular pathology, are frequently seen in patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). Few studies have examined possible cognitive domain- or group-specific cognitive effects of WM pathology in old age, MCI, and AD. OBJECTIVE Our purpose was to examine the relationship between WM hyperintensities (WMH), a typical marker for WM pathology, and cognitive functioning in healthy old age and pathological aging using quantified MRI data. METHODS We utilized multidomain neuropsychological data and quantified MRI data from a sample of 42 cognitively healthy older adults and 44 patients with MCI/AD (total n = 86). RESULTS After controlling for age and education, WMH in the temporal and parieto-occipital lobes was associated with impairments in processing speed and parieto-occipital pathology with verbal memory impairment in the whole sample. Additionally, temporal WMH was associated with impaired processing speed in the patient group specifically. CONCLUSIONS WM pathology is strongly associated with impaired processing speed, and our results indicate that these impairments arise from WMH in the temporal and parieto-occipital regions. In MCI and AD patients with temporal WMH, processing speed impairments are especially prominent. The results of this study increase our knowledge of cognitive repercussions stemming from temporal and/or parieto-occipital WM pathology in healthy and pathological aging.
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Affiliation(s)
| | | | | | | | - Juha O Rinne
- Turku PET Centre, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, University and University Hospital of Turku, Turku, Finland
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33
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Morrow EL, Dulas MR, Cohen NJ, Duff MC. Relational Memory at Short and Long Delays in Individuals With Moderate-Severe Traumatic Brain Injury. Front Hum Neurosci 2020; 14:270. [PMID: 32754022 PMCID: PMC7366514 DOI: 10.3389/fnhum.2020.00270] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/16/2020] [Indexed: 11/13/2022] Open
Abstract
Memory deficits are a common and frequently-cited consequence of moderate-severe traumatic brain injury (TBI). However, we know less about how TBI influences relational memory, which allows the binding of the arbitrary elements of experience and the flexible use and recombination of relational representations in novel situations. Relational memory is of special interest for individuals with TBI, given the vulnerability of the hippocampus to injury mechanisms, as well as a growing body of literature establishing the role of relational memory in flexible and goal-directed behavior. In this study, participants with and without a history of moderate-severe TBI completed a continuous relational memory task for face-scene pairings. Participants with TBI exhibited a disruption in relational memory not only when tested after a delay, but also when tested with no experimenter-imposed delay after stimulus presentation. Further, canonical assessments of working and episodic memory did not correspond with performance on the face-scene task, suggesting that this task may tap into relational memory differently and with greater sensitivity than standardized memory assessments. These results highlight the need for rigorous assessment of relational memory in TBI, which is likely to detect deficits that have specific consequences for community reintegration and long-term functional outcomes.
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Affiliation(s)
- Emily L Morrow
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Michael R Dulas
- Beckman Institute, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Neal J Cohen
- Beckman Institute, The University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Interdisciplinary Health Sciences Institutes, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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34
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Tepe V, Papesh M, Russell S, Lewis MS, Pryor N, Guillory L. Acquired Central Auditory Processing Disorder in Service Members and Veterans. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:834-857. [PMID: 32163310 DOI: 10.1044/2019_jslhr-19-00293] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose A growing body of evidence suggests that military service members and military veterans are at risk for deficits in central auditory processing. Risk factors include exposure to blast, neurotrauma, hazardous noise, and ototoxicants. We overview these risk factors and comorbidities, address implications for clinical assessment and care of central auditory processing deficits in service members and veterans, and specify knowledge gaps that warrant research. Method We reviewed the literature to identify studies of risk factors, assessment, and care of central auditory processing deficits in service members and veterans. We also assessed the current state of the science for knowledge gaps that warrant additional study. This literature review describes key findings relating to military risk factors and clinical considerations for the assessment and care of those exposed. Conclusions Central auditory processing deficits are associated with exposure to known military risk factors. Research is needed to characterize mechanisms, sources of variance, and differential diagnosis in this population. Existing best practices do not explicitly consider confounds faced by military personnel. Assessment and rehabilitation strategies that account for these challenges are needed. Finally, investment is critical to ensure that Veterans Affairs and Department of Defense clinical staff are informed, trained, and equipped to implement effective patient care.
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Affiliation(s)
- Victoria Tepe
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
- The Geneva Foundation, Tacoma, WA
| | - Melissa Papesh
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Shoshannah Russell
- Walter Reed National Military Medical Center, Bethesda, MD
- Henry Jackson Foundation, Bethesda, MD
| | - M Samantha Lewis
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
- School of Audiology, Pacific University, Hillsboro, OR
| | - Nina Pryor
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
- Air Force Research Laboratory, Wright-Patterson Air Force Base, OH
| | - Lisa Guillory
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia
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35
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Warnock A, Toomey LM, Wright AJ, Fisher K, Won Y, Anyaegbu C, Fitzgerald M. Damage Mechanisms to Oligodendrocytes and White Matter in Central Nervous System Injury: The Australian Context. J Neurotrauma 2020; 37:739-769. [DOI: 10.1089/neu.2019.6890] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrew Warnock
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Lillian M. Toomey
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Alexander J. Wright
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Katherine Fisher
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Yerim Won
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Chidozie Anyaegbu
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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36
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Xu C, Diao YF, Wang J, Liang J, Xu HH, Zhao ML, Zheng B, Luan Z, Wang JJ, Yang XP, Wei MG, Duan JH, Wang KQ, Chen C, Chen F, Ming D, Zhang S, Sun HT, Li XH. Intravenously Infusing the Secretome of Adipose-Derived Mesenchymal Stem Cells Ameliorates Neuroinflammation and Neurological Functioning After Traumatic Brain Injury. Stem Cells Dev 2020; 29:222-234. [DOI: 10.1089/scd.2019.0173] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Chao Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Yun-Feng Diao
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Jing Wang
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
- Department of Neurosurgery, Shanxi Dayi Hospital, Taiyuan, China
| | - Jun Liang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Hai-Huan Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Ming-Liang Zhao
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Bin Zheng
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Zuo Luan
- Department of Pediatrics, Pediatric Surgery of Navy General Hospital, Beijing, China
| | - Jing-Jing Wang
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Xi-Ping Yang
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Meng-Guang Wei
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Jing-Hao Duan
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Ke-Qiang Wang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Chong Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Feng Chen
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Sai Zhang
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Hong-Tao Sun
- Institute of Traumatic Brain Injury and Neurology, Characteristic Medical Center of PAPF, Tianjin, China
| | - Xiao-Hong Li
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
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37
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Roberts CM, Spitz G, Mundy M, Ponsford JL. Retrograde Autobiographical Memory From PTA Emergence to Six-Month Follow-Up in Moderate to Severe Traumatic Brain Injury. J Neuropsychiatry Clin Neurosci 2019; 31:112-122. [PMID: 30404534 DOI: 10.1176/appi.neuropsych.18010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The overwhelming focus of research on memory following traumatic brain injury (TBI) has been on anterograde amnesia, and very little attention has been paid to retrograde amnesia. There is evidence to suggest that retrograde autobiographical memory deficits exist after severe TBI, although there have been no prospective studies of autobiographical memory in a representative sample of moderate to severe cases recruited from hospital admissions. METHODS The purpose of the present study was to report changes in autobiographical memory performance among a group of patients soon after emergence from posttraumatic amnesia (PTA) and at the 6-month follow-up compared with a healthy control (HC) group. The authors also examined associations with anterograde memory function and community integration to assist in understanding the functional impact of autobiographical memory deficits and potential underlying mechanisms. The Autobiographical Memory Interview and the Rey Auditory Verbal Learning Test were used as measures of retrograde and anterograde memory, respectively, and the Community Integration Questionnaire was used as a measure of functional outcome in the TBI group. RESULTS The results demonstrated that both personal semantic and episodic autobiographical memory scores were impaired following emergence from PTA and at the 6-month follow-up. Only subtle differences emerged in change over time in different injury severity groups. Recent retrograde memory function was associated with anterograde memory performance, which supports some degree of overlap in underlying mechanisms. CONCLUSIONS The findings suggest that autobiographical memory deficits are prevalent following moderate to severe TBI and warrant consideration in rehabilitation.
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Affiliation(s)
- Caroline M Roberts
- From the Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia (CMR, GS, MM, JLP); the Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia (CMR, GS, JLP); and Epworth Healthcare, Melbourne, Australia (JLP)
| | - Gershon Spitz
- From the Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia (CMR, GS, MM, JLP); the Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia (CMR, GS, JLP); and Epworth Healthcare, Melbourne, Australia (JLP)
| | - Matthew Mundy
- From the Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia (CMR, GS, MM, JLP); the Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia (CMR, GS, JLP); and Epworth Healthcare, Melbourne, Australia (JLP)
| | - Jennie L Ponsford
- From the Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia (CMR, GS, MM, JLP); the Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia (CMR, GS, JLP); and Epworth Healthcare, Melbourne, Australia (JLP)
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38
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A Latent Content Analysis of Barriers and Supports to Healthcare: Perspectives From Caregivers of Service Members and Veterans With Military-Related Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:342-353. [PMID: 29385014 DOI: 10.1097/htr.0000000000000373] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify barriers and supports that caregivers of individuals with military-related traumatic brain injury (TBI) encounter when navigating the military healthcare system; this information will be used as the foundation of a new patient-reported outcome measure. SETTING Community. PARTICIPANTS Forty-five caregivers of service members and veterans (SMV) who sustained a medically documented mild, moderate, severe, or penetrating TBI. DESIGN Latent content analysis. MAIN MEASURES Nine focus group discussions of barriers and supports to navigating the military healthcare system and community resources. RESULTS Latent content analysis indicated that caregivers discussed barriers (66%) and supports (34%) to obtaining care within the military healthcare system and the community. Caregivers most frequently discussed SMVs' interactions with healthcare, their own interactions with healthcare, family care, and community organizations. CONCLUSIONS Caregivers confront numerous challenges while pursuing healthcare services. Although much of the discussion focused on barriers and perceived unmet needs within the military healthcare system, caregivers also recognized supports within the military healthcare system and general community. Increased attention to accessibility and quality of services, as well as reducing financial burden, can lead to improved health-related quality of life for caregivers and their SMVs.
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39
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Rigon A, Schwarb H, Klooster N, Cohen NJ, Duff MC. Spatial relational memory in individuals with traumatic brain injury. J Clin Exp Neuropsychol 2019; 42:14-27. [PMID: 31475607 DOI: 10.1080/13803395.2019.1659755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Relational memory is the ability to bind arbitrary relations between elements of experience into durable representations and the flexible expression of these representations. It is well known that individuals with traumatic brain injury (TBI) have declarative memory impairments, but less is known about how TBI affects relational memory binding, the deficit at the heart of declarative, or relational, memory impairment. The aim of the current study is to examine such deficits.Method: We used a spatial reconstruction task (SRT) with 29 individuals with TBI and 23 normal comparison (NC) participants to investigate four different types of spatial relations: (A) identity-location relations, i.e., the relationship between a specific item and its known location; (B) item-item relations, or the relationship between one item and another; (C) item-display relations, or the relationship between an item and its position in the display; and (D) compound-item relations, i.e., relations that involve combinations of A, B, and C.Results: Our data revealed that individuals with TBI showed impairments in learning identity-location relations and increased compound errors compared to NCs. We also found evidence that when item identity is disregarded, individuals with TBI do not perform differently from NCs. An exploratory analysis revealed that while relational memory performance was significantly correlated with scores on the California Verbal Learning Test (CVLT), more participants with TBI exhibited impairment on the SRT than of the CVLT.Conclusions: Our findings show that relational memory is impaired following TBI, and provide preliminary evidence for an easy-to-administer task with increased sensitivity to memory impairment.
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Affiliation(s)
- Arianna Rigon
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Communication Disorders, Marshall University, Huntington, WV
| | - Hillary Schwarb
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Nathaniel Klooster
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Neal J Cohen
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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40
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Harris TC, de Rooij R, Kuhl E. The Shrinking Brain: Cerebral Atrophy Following Traumatic Brain Injury. Ann Biomed Eng 2019; 47:1941-1959. [PMID: 30341741 PMCID: PMC6757025 DOI: 10.1007/s10439-018-02148-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022]
Abstract
Cerebral atrophy in response to traumatic brain injury is a well-documented phenomenon in both primary investigations and review articles. Recent atrophy studies focus on exploring the region-specific patterns of cerebral atrophy; yet, there is no study that analyzes and synthesizes the emerging atrophy patterns in a single comprehensive review. Here we attempt to fill this gap in our current knowledge by integrating the current literature into a cohesive theory of preferential brain tissue loss and by identifying common risk factors for accelerated atrophy progression. Our review reveals that observations for mild traumatic brain injury remain inconclusive, whereas observations for moderate-to-severe traumatic brain injury converge towards robust patterns: brain tissue loss is on the order of 5% per year, and occurs in the form of generalized atrophy, across the entire brain, or focal atrophy, in specific brain regions. The most common regions of focal atrophy are the thalamus, hippocampus, and cerebellum in gray matter and the corpus callosum, corona radiata, and brainstem in white matter. We illustrate the differences of generalized and focal gray and white matter atrophy on emerging deformation and stress profiles across the whole brain using computational simulation. The characteristic features of our atrophy simulations-a widening of the cortical sulci, a gradual enlargement of the ventricles, and a pronounced cortical thinning-agree well with clinical observations. Understanding region-specific atrophy patterns in response to traumatic brain injury has significant implications in modeling, simulating, and predicting injury outcomes. Computational modeling of brain atrophy could open new strategies for physicians to make informed decisions for whom, how, and when to administer pharmaceutical treatment to manage the chronic loss of brain structure and function.
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41
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Shahror RA, Linares GR, Wang Y, Hsueh SC, Wu CC, Chuang DM, Chiang YH, Chen KY. Transplantation of Mesenchymal Stem Cells Overexpressing Fibroblast Growth Factor 21 Facilitates Cognitive Recovery and Enhances Neurogenesis in a Mouse Model of Traumatic Brain Injury. J Neurotrauma 2019; 37:14-26. [PMID: 31298621 DOI: 10.1089/neu.2019.6422] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Traumatic brain injury (TBI) is a progressive and complex pathological condition that results in multiple adverse consequences, including impaired learning and memory. Transplantation of mesenchymal stem cells (MSCs) has produced limited benefits in experimental TBI models. Fibroblast growth factor 21 (FGF21) is a novel metabolic regulator that has neuroprotective effects, promotes remyelination, enhances angiogenesis, and elongates astrocytic processes. In this study, MSCs were genetically engineered to overexpress FGF21 in order to improve their efficacy in TBI. MSCs overexpressing FGF21 (MSC-FGF21) were transplanted to mouse brain by intracerebroventricular injection 24 h after TBI was induced by controlled cortical impact (CCI). Hippocampus-dependent spatial learning and memory, assessed by the Morris water maze test, was markedly decreased 3-4 weeks after TBI, a deficit that was robustly recovered by treatment with MSC-FGF21, but not MSC-mCherry control. Hippocampus-independent learning and memory, assessed by the novel object recognition test, was also impaired; these effects were blocked by treatment with both MSC-FGF21 and MSC-mCherry control. FGF21 protein levels in the ipsilateral hippocampus were drastically reduced 4 weeks post-TBI, a loss that was restored by treatment with MSC-FGF21, but not MSC-mCherry. MSC-FGF21 treatment also partially restored TBI-induced deficits in neurogenesis and maturation of immature hippocampal neurons, whereas MSC-mCherry was less effective. Finally, MSC-FGF21 treatment also normalized TBI-induced impairments in dendritic arborization of hippocampal neurons. Taken together, the results indicate that MSC-FGF21 treatment significantly improved TBI-induced spatial memory deficits, impaired hippocampal neurogenesis, and abnormal dendritic morphology. Future clinical investigations using MSC-FGF21 to improve post-TBI outcomes are warranted.
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Affiliation(s)
- Rami Ahmad Shahror
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan.,TMU Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Gabriel R Linares
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.,Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Yun Wang
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Shih-Chang Hsueh
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan.,TMU Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Chung-Che Wu
- TMU Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - De-Maw Chuang
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan.,Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Yung-Hsiao Chiang
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan.,TMU Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kai-Yun Chen
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan.,TMU Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
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42
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The Effects of Moderate-to-Severe Traumatic Brain Injury on Episodic Memory: a Meta-Analysis. Neuropsychol Rev 2019; 29:270-287. [DOI: 10.1007/s11065-019-09413-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 07/30/2019] [Indexed: 12/22/2022]
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43
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Volume and shape analysis of the Hippocampus and amygdala in veterans with traumatic brain injury and posttraumatic stress disorder. Brain Imaging Behav 2019; 14:1850-1864. [DOI: 10.1007/s11682-019-00127-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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44
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Wallace EJ, Mathias JL, Ward L. Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis. Brain Imaging Behav 2019; 12:1607-1621. [PMID: 29383621 DOI: 10.1007/s11682-018-9823-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI, diffusion may be altered; however the exact nature of these changes has yet to be determined. A meta-analysis was therefore conducted to determine the location and extent of changes in DTI following adult TBI. The data from 44 studies that compared the FA and/or MD/ADC data from TBI and Control participants in different regions of interest (ROIs) were analyzed. The impact of injury severity, post-injury interval (acute: ≤ 1 week, subacute: 1 week-3 months, chronic: > 3 months), scanner details and acquisition parameters were investigated in subgroup analyses, with the findings indicating that mild TBI should be examined separately to that of moderate to severe injuries. Lower FA values were found in 88% of brain regions following mild TBI and 92% following moderate-severe TBI, compared to Controls. MD/ADC was higher in 95% and 100% of brain regions following mild and moderate-severe TBI, respectively. Moderate to severe TBI resulted in larger changes in FA and MD/ADC than mild TBI. Overall, changes to FA and MD/ADC were widespread, reflecting more symmetric and a higher amount of diffusion, indicative of white matter damage.
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Affiliation(s)
- Erica J Wallace
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia
| | - Jane L Mathias
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia.
| | - Lynn Ward
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia
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45
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Ubukata S, Oishi N, Sugihara G, Aso T, Fukuyama H, Murai T, Ueda K. Transcallosal Fiber Disruption and its Relationship with Corresponding Gray Matter Alteration in Patients with Diffuse Axonal Injury. J Neurotrauma 2019; 36:1106-1114. [DOI: 10.1089/neu.2018.5823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shiho Ubukata
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- Medical Innovation Center, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Naoya Oishi
- Medical Innovation Center, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Toshihiko Aso
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- Human Brain Research Center, Graduate School of Medicine, and Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Hidenao Fukuyama
- Beijing Institute of Technology, Beijing, China
- Research and Educational Unit of Leaders for Integrated Medical System, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Keita Ueda
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
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46
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Kinno R, Mori Y, Kubota S, Nomoto S, Futamura A, Shiromaru A, Kuroda T, Yano S, Ishigaki S, Murakami H, Baba Y, Ono K. High serum high-density lipoprotein-cholesterol is associated with memory function and gyrification of insular and frontal opercular cortex in an elderly memory-clinic population. Neuroimage Clin 2019; 22:101746. [PMID: 30856540 PMCID: PMC6411909 DOI: 10.1016/j.nicl.2019.101746] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 02/05/2019] [Accepted: 03/02/2019] [Indexed: 12/03/2022]
Abstract
The issue of whether serum lipid marker values are cognitively and neurologically significant for elderly individuals attending a memory clinic has been controversial. We investigated the associations of serum lipid markers with the memory function and cortical structure in 52 patients aged ≥75 years who had attended our memory clinic based on their subjective memory complaints. None had a history of medication for hyperlipidemia. The Wechsler Memory Scale-Revised (WMS-R) was administered to all patients for the assessment of their memory function. Serum low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDLC), and triglyceride (TG) were measured for each patient. Surface-based morphometry (SBM) was performed for the calculation of each patient's cortical thickness and gyrification index based on structural MRI data. Our analyses revealed that the serum HDLC level was positively and significantly correlated with the WMS-R subtests of visual paired associates I/II and logical memory I (p < 0.05). The serum TG level was negatively correlated with the logical memory I subtest. The SBM results showed positive correlations between the serum HDLC level and the gyrification indices of the bilateral insular and frontal opercular cortices, and those two gyrification indices were positively correlated with the logical memory I and visual paired associates I/II. These results suggest that in these elderly patients, a high serum HDLC level was associated with not only preserved memory function but also gyrification of the insular and frontal opercular cortex. We conclude that elderly individuals' serum lipid markers should be carefully assessed in memory clinic settings, because serum HDLC may be a biomarker for memory function and cortical structure.
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Affiliation(s)
- Ryuta Kinno
- Department of Neurology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama-Shi, Kanagawa 227-8501, Japan.
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Satomi Kubota
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Shohei Nomoto
- Department of Neurology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama-Shi, Kanagawa 227-8501, Japan
| | - Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Azusa Shiromaru
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Seiichiro Ishigaki
- Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo Tsuzuki-ku, Yokohama-Shi, Kanagawa 224-8503, Japan
| | - Hidetomo Murakami
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Yasuhiko Baba
- Department of Neurology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama-Shi, Kanagawa 227-8501, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan.
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Konstantinou N, Pettemeridou E, Stamatakis EA, Seimenis I, Constantinidou F. Altered Resting Functional Connectivity Is Related to Cognitive Outcome in Males With Moderate-Severe Traumatic Brain Injury. Front Neurol 2019; 9:1163. [PMID: 30687219 PMCID: PMC6335280 DOI: 10.3389/fneur.2018.01163] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 12/17/2018] [Indexed: 12/30/2022] Open
Abstract
TBI results in significant cognitive impairments and in altered brain functional connectivity. However, no studies explored so far, the relationship between global functional connectivity and cognitive outcome in chronic moderate-severe TBI. This proof of principle study employed the intrinsic connectivity contrast, an objective voxel-based metric of global functional connectivity, in a small sample of chronic moderate-severe TBI participants and a group of healthy controls matched on gender (males), age, and education. Cognitive tests assessing executive functions, verbal memory, visual memory, attention/organization, and cognitive reserve were administered. Group differences in terms of global functional connectivity maps were assessed and the association between performance on the cognitive measures and global functional connectivity was examined. Next, we investigated the spatial extent of functional connectivity in the brain regions found to be associated with cognitive performance, using traditional seed-based analyses. Global functional connectivity of the TBI group was altered, compared to the controls. Moreover, the strength of global functional connectivity in affected brain areas was associated with cognitive outcome. These findings indicate that impaired global functional connectivity is a significant consequence of TBI suggesting that cognitive impairments following TBI may be partly attributed to altered functional connectivity between brain areas involved in the specific cognitive functions.
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Affiliation(s)
- Nikos Konstantinou
- Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Eva Pettemeridou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus.,Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | | | - Ioannis Seimenis
- Medical Physics Laboratory, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
| | - Fofi Constantinidou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus.,Department of Psychology, University of Cyprus, Nicosia, Cyprus
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48
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Zhang J, Tian L, Zhang L, Cheng R, Wei R, He F, Li J, Luo B, Ye X. Relationship between white matter integrity and post-traumatic cognitive deficits: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2019; 90:98-107. [PMID: 30072375 DOI: 10.1136/jnnp-2017-317691] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate relationships between cognitive domains and white matter changes in different regions in patients with cognitive deficits after traumatic brain injury (TBI). METHODS Databases including PubMed, Embase, Web of Science and CENTRAL were searched for studies published before 5 August 2017. Correlation coefficients between cognition and white matter integrity, measured by diffusion metrics, including fractional anisotropy (FA), were pooled from 49 studies including 1405 patients. The influence of demographic factors was assessed by meta-regression analysis. RESULTS Significant pooled FA-executive correlations (p<0.001) were found across various regions, including the corpus callosum (CC) (r=0.42, 95% CI 0.30 to 0.54), superior longitudinal fasciculus (r=0.50, 95% CI 0.41 to 0.59) and internal capsule (IC) (r=0.49, 95% CI 0.37 to 0.61). The fornix (r=0.62, 95% CI 0.45 to 0.78) and cingulum (r=0.57, 95% CI 0.34 to 0.81) particularly correlated with memory (p<0.001). The CC and IC also showed significant relationships with attention and processing speed (p<0.001). Demographic factors had no influence overall, except that studies with a greater proportion of males had stronger correlations between memory and white matter (p<0.05). CONCLUSIONS FA is the most sensitive metric for detecting post-TBI cognitive decline across various domains. Representative white matter regions, such as the CC and IC, perform better than whole-brain white matter for reflecting a wide range of cognitive domains, including memory, attention and executive functions. Moreover, the fornix and cingulum particularly reflect memory function. They yield insights into particular imaging indicators that have neuropsychological value.
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Affiliation(s)
- Jie Zhang
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Liang Tian
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Li Zhang
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Ruidong Cheng
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Ruili Wei
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Fangping He
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Juebao Li
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Benyan Luo
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Xiangming Ye
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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49
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Manoli R, Chartaux-Danjou L, Delecroix H, Daveluy W, Moroni C. Why evaluate one-week-delayed verbal recall in patients with severe traumatic brain injury? Brain Inj 2018; 32:1684-1689. [PMID: 30359148 DOI: 10.1080/02699052.2018.1539245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PRIMARY OBJECTIVE The aim of this study was to propose new measures to evaluate memory processes in patients with severe traumatic brain injury (TBI). In this purpose, we analyzed learning and consolidation processes depending on own patient's performance during a memory test. METHODS One-week Free and Cued Selective Reminding Test - word version (1W-FCSRT-word), which special feature relies on a 30-min and a 1-week-delayed recall after encoding, was administered to a group of 43 patients with severe TBI (age range from 20 to 54 years) and a group of neurologically healthy volunteers matched for age and gender. RESULTS Patients performed worse than healthy volunteers for the learning score. Their forgetting percentage was above healthy volunteers' performance and difference between the two groups increased with the delay from the learning phase. CONCLUSION In patients with severe TBI, our results underlined an altered learning and an impairment of long-term consolidation. It is crucial to detect these deficits in the aim to highlight, with a better accuracy, these patients' memory complaints and to propose a better professional rehabilitation.
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Affiliation(s)
- Romina Manoli
- a PSITEC Lab (EA 4072) , University of Lille , Villeneuve-d'Ascq , France
| | | | | | - Walter Daveluy
- b U.E.R.O.S. Lille , UGECAM Hauts-de-France , Lille , France
| | - Christine Moroni
- a PSITEC Lab (EA 4072) , University of Lille , Villeneuve-d'Ascq , France
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50
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Shao M, Cao J, Bai L, Huang W, Wang S, Sun C, Gan S, Ye L, Yin B, Zhang D, Gu C, Hu L, Bai G, Yan Z. Preliminary Evidence of Sex Differences in Cortical Thickness Following Acute Mild Traumatic Brain Injury. Front Neurol 2018; 9:878. [PMID: 30386291 PMCID: PMC6199374 DOI: 10.3389/fneur.2018.00878] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/27/2018] [Indexed: 12/02/2022] Open
Abstract
The main objective of this study was to evaluate sex differences in cortical thickness after acute mild traumatic brain injury (mTBI) and its associations with clinical outcomes. Thirty-two patients with mTBI at acute phase (2.4 ± 1.3 days post-injury) and 30 healthy controls were enrolled. All the participants underwent comprehensive neurocognitive assessments and MRI to assess cortical thickness. Significant sex differences were determined by using variance analysis of factorial design. Relations between the cortical thickness and clinical assessments were measured with the Spearman Correlation. Results revealed that patients with mTBI had significantly reduced cortical thickness in the left entorhinal cortex while increased cortical thickness in the left precuneus cortex and right lateral occipital cortex, compared with healthy controls. The interaction effect of the group × sex on cortical thickness was significant. Female patients had significant thicker cortical thickness in the left caudal anterior cingulate cortex (ACC) than male patients and had higher scores on Posttraumatic stress disorder Checklist—Civilian Version (PCL-C). Spearman correlational analysis showed a significantly positive correlations between the cortical thickness of the left caudal ACC and PCL-C ratings in female patients. Sex differences in cortical thickness support its potential as a neuroimaging phenotype for investigating the differences in clinical profiles of mild TBI between women and men.
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Affiliation(s)
- Meihua Shao
- Radiology Department of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jieli Cao
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Wenming Huang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Chuanzhu Sun
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Shuoqiu Gan
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Limei Ye
- Radiology Department of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Bo Yin
- Neurosurgery Department of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Danbin Zhang
- Radiology Department of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chenghui Gu
- Neurosurgery Department of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liuxun Hu
- Neurosurgery Department of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guanghui Bai
- Radiology Department of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhihan Yan
- Radiology Department of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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