1
|
Miller AL, Evanson NK, Taylor JM. Use of donepezil for neurocognitive recovery after brain injury in adult and pediatric populations: a scoping review. Neural Regen Res 2024; 19:1686-1695. [PMID: 38103232 PMCID: PMC10960296 DOI: 10.4103/1673-5374.389628] [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: 05/24/2023] [Revised: 10/07/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Abstract
There are few pharmacologic options for the treatment of cognitive deficits associated with traumatic brain injury in pediatric patients. Acetylcholinesterase inhibitors such as donepezil have been evaluated in adult patients after traumatic brain injury, but relatively less is known about the effect in pediatric populations. The goal of this review is to identify knowledge gaps in the efficacy and safety of acetylcholinesterase inhibitors as a potential adjuvant treatment for neurocognitive decline in pediatric patients with traumatic brain injury. Investigators queried PubMed to identify literature published from database inception through June 2023 describing the use of donepezil in young adult traumatic brain injury and pediatric patients with predefined conditions. Based on preselected search criteria, 340 unique papers were selected for title and abstract screening. Thirty-two records were reviewed in full after eliminating preclinical studies and papers outside the scope of the project. In adult traumatic brain injury, we review results from 14 papers detailing 227 subjects where evidence suggests donepezil is well tolerated and shows both objective and patient-reported efficacy for reducing cognitive impairment. In children, 3 papers report on 5 children recovering from traumatic brain injury, showing limited efficacy. An additional 15 pediatric studies conducted in populations at risk for cognitive dysfunction provide a broader look at safety and efficacy in 210 patients in the pediatric age group. Given its promise for efficacy in adults with traumatic brain injury and tolerability in pediatric patients, we believe further study of donepezil for children and adolescents with traumatic brain injury is warranted.
Collapse
Affiliation(s)
- Avery L. Miller
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Nathan K. Evanson
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J. Michael Taylor
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
2
|
Mayer AR, Dodd AB, Robertson-Benta CR, Zotev V, Ryman SG, Meier TB, Campbell RA, Phillips JP, van der Horn HJ, Hogeveen J, Tarawneh R, Sapien RE. Multifaceted neural and vascular pathologies after pediatric mild traumatic brain injury. J Cereb Blood Flow Metab 2024; 44:118-130. [PMID: 37724718 PMCID: PMC10905640 DOI: 10.1177/0271678x231197188] [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: 03/06/2023] [Revised: 06/01/2023] [Accepted: 07/25/2023] [Indexed: 09/21/2023]
Abstract
Dynamic changes in neurodevelopment and cognitive functioning occur during adolescence, including a switch from reactive to more proactive forms of cognitive control, including response inhibition. Pediatric mild traumatic brain injury (pmTBI) affects these cognitions immediately post-injury, but the role of vascular versus neural injury in cognitive dysfunction remains debated. This study consecutively recruited 214 sub-acute pmTBI (8-18 years) and age/sex-matched healthy controls (HC; N = 186), with high retention rates (>80%) at four months post-injury. Multimodal imaging (functional MRI during response inhibition, cerebral blood flow and cerebrovascular reactivity) assessed for pathologies within the neurovascular unit. Patients exhibited increased errors of commission and hypoactivation of motor circuitry during processing of probes. Evidence of increased/delayed cerebrovascular reactivity within motor circuitry during hypercapnia was present along with normal perfusion. Neither age-at-injury nor post-concussive symptom load were strongly associated with imaging abnormalities. Collectively, mild cognitive impairments and clinical symptoms may continue up to four months post-injury. Prolonged dysfunction within the neurovascular unit was observed during proactive response inhibition, with preliminary evidence that neural and pure vascular trauma are statistically independent. These findings suggest pmTBI is characterized by multifaceted pathologies during the sub-acute injury stage that persist several months post-injury.
Collapse
Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/LBERI, Albuquerque, NM, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Andrew B Dodd
- The Mind Research Network/LBERI, Albuquerque, NM, USA
| | | | - Vadim Zotev
- The Mind Research Network/LBERI, Albuquerque, NM, USA
| | | | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Richard A Campbell
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - John P Phillips
- The Mind Research Network/LBERI, Albuquerque, NM, USA
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | | | - Jeremy Hogeveen
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Rawan Tarawneh
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Robert E Sapien
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, USA
| |
Collapse
|
3
|
Duquette-Laplante F, Macaskill M, Jutras B, Jemel B, Koravand A. Brain functional connectivity in children with a mild traumatic brain injury: A scoping review. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-12. [PMID: 38100747 DOI: 10.1080/21622965.2023.2293248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
INTRODUCTION The occurrence of mild traumatic brain injury(mTBI) is estimated at 0,2-0,3% cases annually. Following a mTBI, some children experience persistent symptoms, and functional connectivity(FC) changes may be implicated. However, characteristics of FC have not been widely described in this population. This scoping review aimed to identify and understand the impacts of mTBI on EEG-measured FC in children, provide an overview of the available literature, detail analysis techniques, and describe gaps in the research. METHODS PubMed, Web of Science, Medline, Embase, ProQuest and CINAHL were searched up to June 25, 2023, with the terms child, mTBI, EEG, FC, and their synonyms. Ten studies were identified. RESULTS Five studies reported significant differences between the mTBI group and controls. In addition to group differences, six studies reported significant variation over time. Brain Network Analysis(BNA), utilized in seven studies, was the primary FC analysis recorded. Two of the five studies that reported significant differences following mTBI utilized the BNA. The other three applied alternative analysis methods. DISCUSSION FC assessment based on EEG can identify some differences in children with mTBI. BNA was more useful in following changes over time. Further research is suggested, considering the limited age range and number of retrieved studies.
Collapse
Affiliation(s)
- F Duquette-Laplante
- Audiology and Speech Pathology Program, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- School of Speech-Language Pathology and Audiology, Université de Montréal, Montreal, Canada
- Research Center, CHU Sainte-Justine, Montreal, Canada
| | - M Macaskill
- Centre de Recherche en Audiologie pédiatrique, Hôpital Necker, Paris, France
| | - B Jutras
- School of Speech-Language Pathology and Audiology, Université de Montréal, Montreal, Canada
- Research Center, CHU Sainte-Justine, Montreal, Canada
| | - B Jemel
- School of Speech-Language Pathology and Audiology, Université de Montréal, Montreal, Canada
- Research Laboratory in Neurosciences and Cognitive Electrophysiology, Research Center CIUSS-NIM, Hôpital Rivière des Prairies, Montréal, Canada
| | - A Koravand
- Audiology and Speech Pathology Program, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| |
Collapse
|
4
|
Segev S, Silberg T, Bar O, Erez N, Ahonniska-Assa J, Brezner A, Landa J. Prolonged duration of post-traumatic amnesia: A sensitive classification for predicting cognitive outcomes in children recovering from traumatic brain injury. J Int Neuropsychol Soc 2023; 29:831-838. [PMID: 36781415 DOI: 10.1017/s1355617723000024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE A paucity of data exists regarding the duration of post-traumatic amnesia (PTA) as a predictor of cognitive functioning among children after traumatic brain injury (TBI). The study aimed to assess the relationship between PTA duration and areas of neurocognitive function among the pediatric population in the sub-acute phase of recovery and rehabilitation. METHODS Data were collected from medical files on 103 children aged 5.5-16.5 hospitalized at a pediatric rehabilitation department with a diagnosis of moderate-severe TBI (msTBI) between the years 2004-2019. The Children Orientation and Amnesia Test was used to evaluate PTA duration. Measures of high-order cognitive abilities of attention and executive function were collected using the Test of Everyday Attention-Child version (TEA-Ch). RESULTS Three PTA duration groups were assembled out of a cluster analysis: "Long PTA" (M = 21 days), "Very Long PTA" (M = 47 days), and "Extremely Long PTA" (M = 94 days). Analyses revealed that the "Long PTA" group preformed significantly better than the "Very Long PTA" and "Extremely Long PTA" groups on all TEA-Ch measures, that is, Selective Attention, Attentional Control Switching, and Sustained Attention. CONCLUSIONS This study is the first to demonstrate that PTA duration is a useful predictor of high-order cognitive functions among children with msTBI in the sub-acute phase of recovery and rehabilitation. The findings emphasize the importance of using a more sensitive classification of prolonged PTA durations to improve outcome prediction and allocation of resources to those who can benefit most after severe brain injuries.
Collapse
Affiliation(s)
- Shira Segev
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Tamar Silberg
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Orly Bar
- Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Neta Erez
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Jaana Ahonniska-Assa
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
- The School of Behavioral Sciences, The Academic College of Tel Aviv Yaffo, Tel Aviv-Yafo, Israel
| | - Amichai Brezner
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Jana Landa
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
- The Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| |
Collapse
|
5
|
Briggs R, Epps A, Brookes N, Tate R, Lah S. Predictive validity of the Westmead Post-Traumatic Amnesia Scale for functional outcomes in school-aged children who sustained traumatic brain injury. J Neuropsychol 2023; 17:193-209. [PMID: 36208456 DOI: 10.1111/jnp.12294] [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: 07/11/2021] [Accepted: 09/12/2022] [Indexed: 11/26/2022]
Abstract
The Westmead Post-Traumatic Amnesia Scale (WPTAS) is routinely used for the assessment of post-traumatic amnesia (PTA) in children who sustained traumatic brain injury (TBI). Yet, the WPTAS' predictive validity for functional outcomes is largely unknown. We aimed to determine whether PTA duration measured by the WPTAS (i) differentially predicts functional outcomes and (ii) contributes to predictions of outcomes beyond the Glasgow Coma Scale (GCS) in children who sustained TBI. Participants were children and adolescents with moderate-to-severe TBI (n = 55) aged 8-15 years. PTA duration was assessed with the WPTAS. Outcomes at the first outpatient follow-up were scored on the Kings Outcome Scale for Childhood Head Injury (KOSCHI) and the TBI Outcome Domain Scale-Extended (ODS-E). Longer PTA and lower GCS were both significantly correlated with worse (i) global outcomes: presence of disability on the KOSCHI and lower score on the ODS-E and (ii) select specific outcomes on the ODS-E: mobility, mood and cognition. PTA duration predicted cognitive outcome on the ODS-E independently, beyond GCS. Together, PTA duration and GCS, predicted the global KOSCHI outcome, as well as the ODS-E mobility and mood outcomes. Neither GCS nor PTA duration correlated with the ODS-E communication, impulsivity/disinhibition, headache, fatigue, sensory impairments or somatic complaints outcomes. PTA duration measured by the WPTAS is a significant unique predictor of functional cognitive outcomes in children who sustained moderate-to-severe TBI, and in combination with the GCS, a significant predictor of global, and several specific functional outcomes.
Collapse
Affiliation(s)
- Rachel Briggs
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Adrienne Epps
- Brain Injury Rehabilitation Program, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Naomi Brookes
- Brain Injury Rehabilitation Program, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
6
|
Catroppa C, Sood NT, Morrison E, Kenardy J, Lah S, McKinlay A, Ryan N, Crowe L, Soo C, Godfrey C, Anderson V. The Australian and New Zealand brain injury lifespan cohort protocol: Leveraging common data elements to characterise longitudinal outcome and recovery. BMJ Open 2023; 13:e067712. [PMID: 36657763 PMCID: PMC9853218 DOI: 10.1136/bmjopen-2022-067712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Cognitive, behavioural, academic, mental health and social impairments are common following paediatric traumatic brain injury (TBI). However, studies are often reliant on small samples of children drawn from narrow age bands, and employ highly variable methodologies, which make it challenging to generalise existing research findings and understand the lifetime history of TBI. METHOD AND ANALYSIS This study will synthesise common data sets from national (Victoria, New South Wales, Queensland) and international (New Zealand) collaborators, such that common data elements from multiple cohorts recruited from these four sites will be extracted and harmonised. Participant-level harmonised data will then be pooled to create a single integrated data set of participants including common cognitive, social, academic and mental health outcome variables. The large sample size (n=1816), consisting of participants with mild, moderate and severe TBI, will provide statistical power to answer important questions that cannot be addressed by small, individual cohorts. Complex statistical modelling, such as generalised estimation equation, multilevel and latent growth models, will be conducted. ETHICS AND DISSEMINATION Ethics approval was granted by the Human Research Ethics Committee (HREC) of the Royal Children's Hospital (RCH), Melbourne (HREC Reference Number 2019.168). The approved study protocol will be used for all study-related procedures. Findings will be translated into clinical practice, inform policy decisions, guide the appropriate allocation of limited healthcare resources and support the implementation of individualised care.
Collapse
Affiliation(s)
- Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Nikita Tuli Sood
- Brain and Mind, Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Elle Morrison
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Justin Kenardy
- The University of Queensland, Saint Lucia Campus, Saint Lucia, Queensland, Australia
| | - Suncica Lah
- The University of Sydney, Sydney, New South Wales, Australia
| | | | - Nicholas Ryan
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Louise Crowe
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Cheryl Soo
- Applied Medical Research, Ingham Institute, Liverpool, New South Wales, Australia
| | - Celia Godfrey
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| |
Collapse
|
7
|
Sheeba S, Cavaleri R, Summers S, Browne C. Effectiveness of non-pharmacological treatments for vestibular and oculomotor dysfunction in patients with persistent post-concussive symptoms: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e066634. [PMID: 36609322 PMCID: PMC9827270 DOI: 10.1136/bmjopen-2022-066634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Concussion is a form of mild traumatic brain injury that disrupts brain function. Although symptoms are mostly transient, recovery can be delayed and result in persistent postconcussive symptoms (PPCS). Vestibular and oculomotor dysfunction are among the most debilitating impairments associated with PPCS. However, pharmacological interventions for these impairments are associated with deleterious side effects. Accordingly, increasing research has examined the utility of non-pharmacological interventions for PPCS. The aim of this review is to synthesise and evaluate the effectiveness of non-pharmacological interventions for the treatment of vestibular and oculomotor dysfunction for patients with PPCS. METHODS AND ANALYSIS Systematic searches of MEDLINE, PubMed, Web of Science and Scopus will identify randomised controlled trials employing non-pharmacological treatments for vestibular and/or oculomotor dysfunction for PPCS. Such interventions may include, but are not limited to, vestibular rehabilitation, optokinetic stimulation and vestibulo-ocular reflex exercises. Assessments of oculomotor function will include versional eye movements, vergence eye movements, visual-fixation movements and accommodation response. Assessments of vestibular function will include the Fukuda Step test, functional balance tests, force displacement tests, and subjective reports of balance disruption or vertigo. Where appropriate, meta-analyses of standardised mean differences will be conducted using a random effects model for continuous outcomes. For dichotomous outcomes (improved vs not improved following treatment), effects will be expressed as relative risk. The impact of heterogeneity will be calculated using the I2 statistic. The Physiotherapy Evidence Database scale will be used to determine the methodological quality of individual studies and Grading of Recommendations, Assessment, Development and Evaluations used to assess the certainty and quality of evidence for each outcome. ETHICS AND DISSEMINATION Ethical approval is not required for this review. Findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42021254720.
Collapse
Affiliation(s)
- Stella Sheeba
- School of Science, Western Sydney University, Sydney, New South Wales, Australia
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Rocco Cavaleri
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Simon Summers
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Cherylea Browne
- School of Science, Western Sydney University, Sydney, New South Wales, Australia
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Translational Neuroscience Facility, UNSW Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
8
|
Sheldrake E, Lam B, Al-Hakeem H, Wheeler AL, Goldstein BI, Dunkley BT, Ameis S, Reed N, Scratch SE. A Scoping Review of Magnetic Resonance Modalities Used in Detection of Persistent Postconcussion Symptoms in Pediatric Populations. J Child Neurol 2022; 38:85-102. [PMID: 36380680 DOI: 10.1177/08830738221120741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Up to 30% of youth with concussion experience PPCSs (PPCS) lasting 4 weeks or longer, and can significantly impact quality of life. Magnetic resonance imaging (MRI) has the potential to increase understanding of causal mechanisms underlying PPCS. However, there are no clear modalities to assist in detecting PPCS. This scoping review aims to synthesize findings on utilization of MRI among children and youth with PPCS, and summarize progress and limitations. Thirty-six studies were included from 4907 identified papers. Many studies used multiple modalities, including (1) structural (n = 27) such as T1-weighted imaging, diffusion weighted imaging, and susceptibility weighted imaging; and (2) functional (n = 23) such as functional MRI and perfusion-weighted imaging. Findings were heterogeneous among modalities and regions of interest, which warrants future reviews that report on the patterns and potential advancements in the field. Consideration of modalities that target PPCS prediction and sensitive modalities that can supplement a biopsychosocial approach to PPCS would benefit future research.
Collapse
Affiliation(s)
- Elena Sheldrake
- Bloorview Research Institute, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Brendan Lam
- Bloorview Research Institute, Toronto, Ontario, Canada
| | | | - Anne L Wheeler
- Neuroscience and Mental Health Program, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin I Goldstein
- 7978Centre for Addiction and Mental Health, Toronto, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin T Dunkley
- Neuroscience and Mental Health Program, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie Ameis
- 7978Centre for Addiction and Mental Health, Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Nick Reed
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Shannon E Scratch
- Bloorview Research Institute, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
9
|
Albrecht JN, Jaramillo V, Huber R, Karlen W, Baumann CR, Brotschi B. Technical feasibility of using auditory phase-targeted stimulation after pediatric severe traumatic brain injury in an intensive care setting. BMC Pediatr 2022; 22:616. [PMID: 36289537 PMCID: PMC9597971 DOI: 10.1186/s12887-022-03667-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/26/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background Supplementary treatment options after pediatric severe traumatic brain injury (TBI) are needed to improve neurodevelopmental outcome. Evidence suggests enhancement of brain delta waves via auditory phase-targeted stimulation might support neuronal reorganization, however, this method has never been applied in analgosedated patients on the pediatric intensive care unit (PICU). Therefore, we conducted a feasibility study to investigate this approach: In a first recording phase, we examined feasibility of recording over time and in a second stimulation phase, we applied stimulation to address tolerability and efficacy. Methods Pediatric patients (> 12 months of age) with severe TBI were included between May 2019 and August 2021. An electroencephalography (EEG) device capable of automatic delta wave detection and sound delivery through headphones was used to record brain activity and for stimulation (MHSL-SleepBand version 2). Stimulation tolerability was evaluated based on report of nurses, visual inspection of EEG data and clinical signals (heart rate, intracranial pressure), and whether escalation of therapy to reduce intracranial pressure was needed. Stimulation efficacy was investigated by comparing EEG power spectra of active stimulation versus muted stimulation (unpaired t-tests). Results In total, 4 out of 32 TBI patients admitted to the PICU (12.5%) between 4 and 15 years of age were enrolled in the study. All patients were enrolled in the recording phase and the last one also to the stimulation phase. Recordings started within 5 days after insult and lasted for 1–4 days. Overall, 23–88 h of EEG data per patient were collected. In patient 4, stimulation was enabled for 50 min: No signs of patient stress reactions were observed. Power spectrums between active and muted stimulation were not statistically different (all P > .05). Conclusion Results suggests good feasibility of continuously applying devices needed for auditory stimulation over multiple days in pediatric patients with TBI on PICU. Very preliminary evidence suggests good tolerability of auditory stimuli, but efficacy of auditory stimuli to enhance delta waves remains unclear and requires further investigation. However, only low numbers of severe TBI patients could be enrolled in the study and, thus, future studies should consider an international multicentre approach.
Collapse
Affiliation(s)
- Joëlle Ninon Albrecht
- grid.7400.30000 0004 1937 0650Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland
| | - Valeria Jaramillo
- grid.7400.30000 0004 1937 0650Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.5475.30000 0004 0407 4824Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK ,grid.5475.30000 0004 0407 4824Neuromodulation Laboratory, School of Psychology, University of Surrey, Guildford, UK ,grid.7445.20000 0001 2113 8111Care Research and Technology Centre, UK Dementia Research Institute, at Imperial College, University of Surrey, London, Guildford, UK
| | - Reto Huber
- grid.7400.30000 0004 1937 0650Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich (UZH), Zurich, Switzerland
| | - Walter Karlen
- grid.5801.c0000 0001 2156 2780Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland ,grid.6582.90000 0004 1936 9748Institute of Biomedical Engineering, University of Ulm, Ulm, Germany
| | - Christian Rainer Baumann
- grid.412004.30000 0004 0478 9977Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Barbara Brotschi
- grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Department of Neonatology and Paediatric Intensive Care, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland
| |
Collapse
|
10
|
Chadwick L, Peckham SB, Yeates KO. Adult Cognitive Outcomes Following Childhood Mild Traumatic Brain Injury: A Scoping Review. J Head Trauma Rehabil 2022; 37:285-292. [PMID: 35452023 DOI: 10.1097/htr.0000000000000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This review aimed to (1) summarize the existing literature regarding cognitive outcomes in adults with a history of pediatric mild traumatic brain injury (mTBI) and (2) identify gaps in the literature to provide directions for future research. PARTICIPANTS Participants sustained mTBI in childhood (0-17 years of age) and underwent cognitive assessment in adulthood (older than 18 years) at least 1 year postinjury. DESIGN MEDLINE Ovid and PsycINFO Ovid databases were searched to identify original research studies that examined adult cognitive outcomes after childhood mTBI. MAIN MEASURES Cognitive outcome measures assessed memory, attention, visuospatial abilities, processing speed, comprehension, reasoning, intellectual functioning, and executive functioning. Outcome measures ranged from self-reported cognitive symptoms to objective testing. RESULTS A total of 4216 articles were screened, leading to the inclusion of 6 published studies for review (3 prospective cohort and 3 retrospective cohort), with 131 537 participants (mTBI = 6724; controls = 123 823). Review of the included articles suggests that adults with a history of childhood mTBI perform within the average range expected for adult cognitive functioning, although they may perform more poorly than non-head-injured comparison groups on a variety of cognitive measures. Injury-related factors, such as requiring electroencephalography within 24 hours of injury and posttraumatic amnesia lasting longer than 30 minutes, may be associated with variability in adult cognitive outcomes. CONCLUSION The weight of the available evidence suggests that childhood mTBI does not have a significant impact on adult cognitive functioning. However, further research is needed to provide a more comprehensive understanding of the long-term cognitive outcomes of childhood mTBI and to identify predictors of those outcomes in adulthood.
Collapse
Affiliation(s)
- Leah Chadwick
- Departments of Psychology (Ms Chadwick, Mr Peckham, and Dr Yeates) and Pediatrics and Clinical Neurosciences (Dr Yeates), University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada (Ms Chadwick and Dr Yeates); and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (Ms Chadwick, Mr Peckham, and Dr Yeates)
| | | | | |
Collapse
|
11
|
Max JE, Troyer EA, Arif H, Vaida F, Wilde EA, Bigler ED, Hesselink JR, Yang TT, Tymofiyeva O, Wade O, Paulsen JS. Traumatic Brain Injury in Children and Adolescents: Psychiatric Disorders 24 Years Later. J Neuropsychiatry Clin Neurosci 2022; 34:60-67. [PMID: 34538075 PMCID: PMC9818773 DOI: 10.1176/appi.neuropsych.20050104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The investigators aimed to extend findings regarding predictive factors of psychiatric outcomes among children and adolescents with traumatic brain injury (TBI) from 2 to 24 years postinjury. METHODS Youths aged 6-14 years who were hospitalized following TBI from 1992 to 1994 were assessed at baseline for TBI severity and for preinjury psychiatric, adaptive, and behavioral functioning; family functioning; family psychiatric history; socioeconomic status; and intelligence within weeks of injury. Predictors of psychiatric outcomes following pediatric TBI at 3, 6, 12, and 24 months postinjury have previously been reported. In this study, repeat psychiatric assessments were completed at 24 years postinjury with the same cohort, now adults aged 29-39 years, with the outcome measure being presence of a psychiatric disorder not present before the TBI ("novel psychiatric disorder"). RESULTS Fifty participants with pediatric TBI were initially enrolled, and the long-term outcome analyses focused on data from 45 individuals. Novel psychiatric disorder was present in 24 out of 45 (53%) participants. Presence of a current novel psychiatric disorder was independently predicted by the presence of a preinjury lifetime psychiatric disorder and by severity of TBI. CONCLUSIONS Long-term psychiatric outcome (mean=23.92 years [SD=2.17]) in children and adolescents hospitalized for TBI can be predicted at the point of the initial hospitalization encounter by the presence of a preinjury psychiatric disorder and by greater injury severity.
Collapse
Affiliation(s)
- Jeffrey E. Max
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Emily A. Troyer
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Hattan Arif
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Florin Vaida
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Elisabeth A. Wilde
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Erin D. Bigler
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - John R. Hesselink
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Tony T. Yang
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Olga Tymofiyeva
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Owen Wade
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Jane S. Paulsen
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| |
Collapse
|
12
|
Koerte IK, Bahr R, Filipcik P, Gooijers J, Leemans A, Lin AP, Tripodis Y, Shenton ME, Sochen N, Swinnen SP, Pasternak O. REPIMPACT - a prospective longitudinal multisite study on the effects of repetitive head impacts in youth soccer. Brain Imaging Behav 2021; 16:492-502. [PMID: 34505977 PMCID: PMC8825640 DOI: 10.1007/s11682-021-00484-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
Repetitive head impacts (RHI) are common in youth athletes participating in contact sports. RHI differ from concussions; they are considered hits to the head that usually do not result in acute symptoms and are therefore also referred to as “subconcussive” head impacts. RHI occur e.g., when heading the ball or during contact with another player. Evidence suggests that exposure to RHI may have cumulative effects on brain structure and function. However, little is known about brain alterations associated with RHI, or about the risk factors that may lead to clinical or behavioral sequelae. REPIMPACT is a prospective longitudinal study of competitive youth soccer players and non-contact sport controls aged 14 to 16 years. The study aims to characterize consequences of exposure to RHI with regard to behavior (i.e., cognition, and motor function), clinical sequelae (i.e., psychiatric and neurological symptoms), brain structure, function, diffusion and biochemistry, as well as blood- and saliva-derived measures of molecular processes associated with exposure to RHI (e.g., circulating microRNAs, neuroproteins and cytokines). Here we present the structure of the REPIMPACT Consortium which consists of six teams of clinicians and scientists in six countries. We further provide detailed information on the specific aims and the design of the REPIMPACT study. The manuscript also describes the progress made in the study thus far. Finally, we discuss important challenges and approaches taken to overcome these challenges.
Collapse
Affiliation(s)
- Inga K Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany. .,Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Jolien Gooijers
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Goup Biomedical Sciences, KU Leuven, Leuven, Belgium.,KU Leuven Brain Institute (LBI), Leuven, Belgium
| | - Alexander Leemans
- PROVIDI Lab, Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alexander P Lin
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,Boston University Alzheimer's Disease Center and Boston University CTE Center, Boston University School of Medicine, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nir Sochen
- Department of Applied Mathematics, School of Mathematical Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Stephan P Swinnen
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Goup Biomedical Sciences, KU Leuven, Leuven, Belgium.,KU Leuven Brain Institute (LBI), Leuven, Belgium
| | - Ofer Pasternak
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
13
|
Quinn de Launay K, Martino A, Riggs L, Reed N, Beal DS. Pediatric concussion working memory outcomes: a scoping review. Brain Inj 2021; 35:1121-1133. [PMID: 34506212 DOI: 10.1080/02699052.2021.1972148] [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: 10/20/2022]
Abstract
Objective: Characterize the working memory (WM) profile of children and youth who have experienced concussion by systematically synthesizing existing literature on the neuropsychological outcomes of these injuries.Methods: Implemented a peer-reviewed search strategy combining key concepts of concussion/mild traumatic brain injury (mTBI), WM, and pediatrics across MedLine, Embase, PsycINFO, and CINAHL. Included studies written in English with extractable results on a WM outcome measure in individuals aged 21 and under who experienced concussion. Applied narrative synthesis to identify trends in the literature. Assessed risk of bias and quality using the NHLBI's Quality Assessment of Observational Cohort and Cross-Sectional Studies.Results: 40 articles met inclusion criteria. 34/40 studies compared WM performance in children or youth with concussion to healthy controls, pre-injury performance, or normative values, of which 15 reported significantly lower WM performance in the concussion sample. Visual/spatial WM was more consistently impacted than verbal WM. Cognitive demanding dual-task conditions were also reliably impacted.Conclusion: Literature indicated that WM is vulnerable to negative outcomes following pediatric concussion, yet the nature of outcomes is variable. Clinicians and researchers should implement comprehensive and theoretically motivated WM assessments to better understand the WM components impacted by injury.
Collapse
Affiliation(s)
- Keelia Quinn de Launay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Amanda Martino
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Lily Riggs
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deryk S Beal
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Speech-Language Pathology, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| |
Collapse
|
14
|
Arif H, Troyer EA, Paulsen JS, Vaida F, Wilde EA, Bigler ED, Hesselink JR, Yang TT, Tymofiyeva O, Wade O, Max JE. Long-Term Psychiatric Outcomes in Adults with History of Pediatric Traumatic Brain Injury. J Neurotrauma 2021; 38:1515-1525. [PMID: 33765846 PMCID: PMC8336207 DOI: 10.1089/neu.2020.7238] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective of the study was to compare psychiatric outcomes in adults with and without history of pediatric traumatic brain injury (TBI). Youth ages 6 to 14 years hospitalized for TBI from 1992 to 1994 were assessed at baseline and at 3, 6, 12, and 24 months post-injury. In the current study, psychiatric assessments were repeated at 24 years post-injury with the same cohort, now adults ages 29 to 39 years. A control group of healthy adults also was recruited for one-time cross-sectional assessments. Outcome measures included: 1) presence of a psychiatric disorder since the 24-month assessment not present before the TBI ("novel psychiatric disorder," NPD), or in the control group, the presence of a psychiatric disorder that developed after the mean age of injury of the TBI group plus 2 years; and 2) Time-to-Event for onset of an NPD during the same time periods. In the TBI group, NPDs were significantly more common, and presence of a current NPD was significantly predicted by presence of a pre-injury lifetime psychiatric disorder and by abnormal day-of-injury computed tomography (CT) scan. Compared with controls, the TBI group also had significantly shorter Time-to-Event for onset of any NPD. These findings demonstrate that long-term psychiatric outcomes in adults previously hospitalized for pediatric TBI are significantly worse when compared with adult controls without history of pediatric TBI, both in terms of prevalence and earlier onset of NPD. Further, in the TBI group, long-term NPD outcome is predicted independently by presence of pre-injury psychiatric disorder and abnormal day-of-injury CT scan.
Collapse
Affiliation(s)
- Hattan Arif
- Departments of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Emily A. Troyer
- Departments of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Jane S. Paulsen
- Departments of Neuroscience, University of Iowa, Iowa City, Iowa, USA
- Neurology, University of Iowa, Iowa City, Iowa, USA
- Psychiatry, and University of Iowa, Iowa City, Iowa, USA
- Psychology, University of Iowa, Iowa City, Iowa, USA
| | - Florin Vaida
- Family Medicine and Public Health, University of California, San Diego, San Diego, California, USA
| | - Elisabeth A. Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Erin D. Bigler
- Department of Psychology and Neuroscience, Brigham Young University, Provo, Utah, USA
| | - John R. Hesselink
- Radiology, University of California, San Diego, San Diego, California, USA
| | - Tony T. Yang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Owen Wade
- Psychiatry, and University of Iowa, Iowa City, Iowa, USA
| | - Jeffrey E. Max
- Departments of Psychiatry, University of California, San Diego, San Diego, California, USA
- Psychiatry, and University of Iowa, Iowa City, Iowa, USA
- Rady Children's Hospital, San Diego, San Diego, California, USA
| |
Collapse
|
15
|
Mckinlay A. Long‐Term Outcomes of Traumatic Brain Injury in Early Childhood. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12084] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Audrey Mckinlay
- Melbourne School of Psychological Sciences, University of Melbourne, Australia,
- University of Canterbury, Christchurch, New Zealand,
| |
Collapse
|
16
|
Chevignard M, Câmara-Costa H, Dellatolas G. Pediatric traumatic brain injury and abusive head trauma. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:451-484. [PMID: 32958191 DOI: 10.1016/b978-0-444-64150-2.00032-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Childhood traumatic brain injury (TBI) commonly occurs during brain development and can have direct, immediately observable neurologic, cognitive, and behavioral consequences. However, it can also disrupt subsequent brain development, and long-term outcomes are a combination of preinjury development and abilities, consequences of brain injury, as well as delayed impaired development of skills that were immature at the time of injury. There is a growing number of studies on mild TBI/sport-related concussions, describing initial symptoms and their evolution over time and providing guidelines for effective management of symptoms and return to activity/school/sports. Mild TBI usually does not lead to long-term cognitive or academic consequences, despite reports of behavioral/psychologic issues postinjury. Regarding moderate to severe TBI, injury to the brain is more severe, with evidence of a number of detrimental consequences in various domains. Patients can display neurologic impairments (e.g., motor deficits, signs of cerebellar disorder, posttraumatic epilepsy), medical problems (e.g., endocrine pituitary deficits, sleep-wake abnormalities), or sensory deficits (e.g., visual, olfactory deficits). The most commonly reported deficits are in the cognitive-behavioral field, which tend to be significantly disabling in the long-term, impacting the development of autonomy, socialization and academic achievement, participation, quality of life, and later, independence and ability to enter the workforce (e.g., intellectual deficits, slow processing speed, attention, memory, executive functions deficits, impulsivity, intolerance to frustration). A number of factors influence outcomes following pediatric TBI, including preinjury stage of development and abilities, brain injury severity, age at injury (with younger age at injury most often associated with worse outcomes), and a number of family/environment factors (e.g., parental education and occupation, family functioning, parenting style, warmth and responsiveness, access to rehabilitation and care). Interventions should identify and target these specific factors, given their major role in postinjury outcomes. Abusive head trauma (AHT) occurs in very young children (most often <6 months) and is a form of severe TBI, usually associated with delay before appropriate care is sought. Outcomes are systematically worse following AHT than following accidental TBI, even when controlling for age at injury and injury severity. Children with moderate to severe TBI and AHT usually require specific, coordinated, multidisciplinary, and long-term rehabilitation interventions and school adaptations, until transition to adult services. Interventions should be patient- and family-centered, focusing on specific goals, comprising education about TBI, and promoting optimal parenting, communication, and collaborative problem-solving.
Collapse
Affiliation(s)
- Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France; GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France.
| | - Hugo Câmara-Costa
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France; Centre d'Etudes en Santé des Populations, INSERM U1018, Paris, France
| | - Georges Dellatolas
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
| |
Collapse
|
17
|
Linden MA, O’Rourke C, Lohan M. Traumatic brain injury and social competence among young male offenders. Disabil Rehabil 2020; 42:2422-2429. [DOI: 10.1080/09638288.2019.1629699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Mark A. Linden
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, UK
| | - Conall O’Rourke
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, UK
| | - Maria Lohan
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, UK
| |
Collapse
|
18
|
A Novel Clinical Research Modality for Enrolling Diverse Participants Using a Diverse Team. Brain Sci 2020; 10:brainsci10070434. [PMID: 32650502 PMCID: PMC7408300 DOI: 10.3390/brainsci10070434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
The advancement of the pediatric traumatic brain injury (TBI) knowledge base requires biospecimens and data from large samples. This study seeks to describe a novel clinical research modality to establish best practices for enrolling a diverse pediatric TBI population and quantifying key information on enrollment into biobanks. Screening form responses were standardized and cleaned through Google Sheets. Data were used to analyze total individuals at each enrollment stage. R was utilized for final analysis, including logistic model and proportion statistical tests, to determine further significance and relationships. Issues throughout data cleaning shed light on limitations of the consent modality. The results suggest that through a diverse research team, the recruited sample exceeds traditional measures of representation (e.g., sex, race, ethnicity). Sex demographics of the study are representative of the local population. Screening for candidates is critical to the success of the consent modality. The consent modality may be modified to increase the diversity of the study population and accept bilingual candidates. Researchers must implement best practices, including increasing inclusivity of bilingual populations, utilizing technology, and improving participant follow-up, to improve health disparities for understudied clinical populations.
Collapse
|
19
|
Hsia RY, Mannix RC, Guo J, Kornblith AE, Lin F, Sokolove PE, Manley GT. Revisits, readmissions, and outcomes for pediatric traumatic brain injury in California, 2005-2014. PLoS One 2020; 15:e0227981. [PMID: 31978188 PMCID: PMC6980591 DOI: 10.1371/journal.pone.0227981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/04/2020] [Indexed: 01/23/2023] Open
Abstract
Long-term outcomes related to emergency department revisit, hospital readmission, and all-cause mortality, have not been well characterized across the spectrum of pediatric traumatic brain injury (TBI). We evaluated emergency department visit outcomes up to 1 year after pediatric TBI, in comparison to a referent group of trauma patients without TBI. We performed a longitudinal, retrospective study of all pediatric trauma patients who presented to emergency departments and hospitals in California from 2005 to 2014. We compared emergency department visits, dispositions, revisits, readmissions, and mortality in pediatric trauma patients with a TBI diagnosis to those without TBI (Other Trauma patients). We identified 208,222 pediatric patients with an index diagnosis of TBI and 1,314,064 patients with an index diagnosis of Other Trauma. Population growth adjusted TBI visits increased by 5.6% while those for Other Trauma decreased by 40.7%. The majority of patients were discharged from the emergency department on their first visit (93.2% for traumatic brain injury vs. 96.5% for Other Trauma). A greater proportion of TBI patients revisited the emergency department (33.4% vs. 3.0%) or were readmitted to the hospital (0.9% vs. 0.04%) at least once within a year of discharge. The health burden within a year after a pediatric TBI visit is considerable and is greater than that of non-TBI trauma. These data suggest that outpatient strategies to monitor for short-term and longer-term sequelae after pediatric TBI are needed to improve patient outcomes, lessen the burden on families, and more appropriately allocate resources in the healthcare system.
Collapse
Affiliation(s)
- Renee Y Hsia
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America.,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, United States of America
| | - Rebekah C Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America.,Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Joanna Guo
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America
| | - Aaron E Kornblith
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America
| | - Feng Lin
- Department of Biostatistics and Epidemiology, University of California, San Francisco, California, United States of America
| | - Peter E Sokolove
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America
| | - Geoffrey T Manley
- Brain and Spinal Injury Center (BASIC), University of California, San Francisco, California, United States of America.,Department of Neurological Surgery, University of California, San Francisco, California, United States of America
| |
Collapse
|
20
|
Guberman GI, Houde JC, Ptito A, Gagnon I, Descoteaux M. Structural abnormalities in thalamo-prefrontal tracks revealed by high angular resolution diffusion imaging predict working memory scores in concussed children. Brain Struct Funct 2020; 225:441-459. [PMID: 31894406 DOI: 10.1007/s00429-019-02002-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
Because of their high prevalence, heterogeneous clinical presentation, and wide-ranging sequelae, concussions are a challenging neurological condition, especially in children. Shearing forces transmitted across the brain during concussions often result in white matter damage. The neuropathological impact of concussions has been discerned from animal studies and includes inflammation, demyelination, and axonal loss. These pathologies can overlap during the sub-acute stage of recovery. However, due to the challenges of accurately modeling complex white matter structure, these neuropathologies have not yet been differentiated in children in vivo. In the present study, we leveraged recent advances in diffusion imaging modeling, tractography, and tractometry to better understand the neuropathology underlying working memory problems in concussion. Studying a sample of 16 concussed and 46 healthy youths, we used novel tractography methods to isolate 11 working memory tracks. Along these tracks, we measured fractional anisotropy, diffusivities, track volume, apparent fiber density, and free water fraction. In three tracks connecting the right thalamus to the right dorsolateral prefrontal cortex (DLPFC), we found microstructural differences suggestive of myelin alterations. In another track connecting the left anterior-cingulate cortex with the left DLPFC, we found microstructural changes suggestive of axonal loss. Structural differences and tractography reconstructions were reproduced using test-retest analyses. White matter structure in the three thalamo-prefrontal tracks, but not the cingulo-prefrontal track, appeared to play a key role in working memory function. The present results improve understanding of working memory neuropathology in concussions, which constitutes an important step toward developing neuropathologically informed biomarkers of concussion in children.
Collapse
Affiliation(s)
- Guido I Guberman
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada.
- Montreal Neurological Institute, 3801 University, Montreal, QC, H3A 2B4, Canada.
| | | | - Alain Ptito
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Isabelle Gagnon
- Department of Pediatrics, Faculty of Medicine, Montreal Children's Hospital, McGill University, Quebec, Canada
| | - Maxime Descoteaux
- Department of Computer Science, Sherbrooke University, Sherbrooke, QC, Canada
| |
Collapse
|
21
|
H. Hsu N, Dukarm P. Neuropsychological Assessment. Concussion 2020. [DOI: 10.1016/b978-0-323-65384-8.00002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
22
|
Abstract
Traumatic brain injury (TBI) represents a major clinical and economic challenge for health systems worldwide, and it is considered one of the leading causes of disability in young adults. The recent development of brain-computer interface (BCI) tools to target cognitive and motor impairments has led to the exploration of these techniques as potential therapeutic tools in patients with TBI. However, little evidence has been gathered so far to support applicability and efficacy of BCIs for TBI in a clinical setting. In the present chapter, results from studies using BCI approaches in conscious patients with TBI or in animal models of TBI as well as an overview of future directions in the use of BCIs to treat cognitive symptoms in this patient population will be presented.
Collapse
Affiliation(s)
- Virginia Conde
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Clinical Neuroscience Laboratory, Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
| |
Collapse
|
23
|
Relative Head Impact Exposure and Brain White Matter Alterations After a Single Season of Competitive Football: A Pilot Comparison of Youth Versus High School Football. Clin J Sport Med 2019; 29:442-450. [PMID: 31688173 DOI: 10.1097/jsm.0000000000000753] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Youth athletes are believed to be more susceptible to white matter (WM) degradation resulting from head impact exposure relative to high school (HS) athletes; this hypothesis has not been objectively tested. The purpose of this study was to determine preseason to postseason changes in WM integrity from repetitive head impacts for youth football (YFB) players compared with HS football players during a competitive football season. DESIGN Prospective cohort. SETTING One season of YFB (grades 7 and 8) and varsity HS football (grades 10-12). PATIENTS OR OTHER PARTICIPANTS Twelve YFB (13.08 ± 0.64 years) and 21 HS (17.5 ± 0.78 years) athletes. INTERVENTIONS Participants completed 2 magnetic resonance imaging sessions: preseason and postseason. Head impact exposure was recorded during practice and games using a helmet-mounted accelerometer. MAIN OUTCOME MEASURES Tract-based spatial statistics were used to evaluate group differences in preseason to postseason changes in diffusion tensor imaging, including fractional anisotropy and mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). RESULTS The HS group exhibited significant preseason to postseason reductions in MD, AD, and RD (P < 0.05, corrected) in widespread WM areas. Significant WM reductions for the YFB group were only observed for AD (P < 0.05, corrected), but was more limited in extent compared with HS. CONCLUSIONS Significant preseason to postseason AD reduction was found in both YFB and HS groups after one season of competitive play. Our results did not confirm recent speculation that younger children are more susceptible to the deleterious effects of repetitive head impacts compared with their older counterparts.
Collapse
|
24
|
Gordon EM, May GJ, Nelson SM. MRI-based measures of intracortical myelin are sensitive to a history of TBI and are associated with functional connectivity. Neuroimage 2019; 200:199-209. [PMID: 31203023 PMCID: PMC6703948 DOI: 10.1016/j.neuroimage.2019.06.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/29/2019] [Accepted: 06/12/2019] [Indexed: 01/31/2023] Open
Abstract
Traumatic brain injuries (TBIs) induce persistent behavioral and cognitive deficits via diffuse axonal injury. Axonal injuries are often examined in vivo using diffusion MRI, which identifies damaged and demyelinated regions in deep white matter. However, TBI patients can exhibit impairment in the absence of diffusion-measured abnormalities, suggesting that axonal injury and demyelination may occur outside the deep white matter. Importantly, myelinated axons are also present within the cortex. Cortical myelination cannot be measured using diffusion imaging, but can be mapped in-vivo using the T1-w/T2-w ratio method. Here, we conducted the first work examining effects of TBI on intracortical myelin in living humans by applying myelin mapping to 46 US Military Veterans with a history of TBI. We observed that myelin maps could be created in TBI patients that matched known distributions of cortical myelin. After controlling for age and presence of blast injury, the number of lifetime TBIs was associated with reductions in the T1-w/T2-w ratio across the cortex, most significantly in a highly-myelinated lateral occipital region corresponding with the human MT+ complex. Further, the T1-w/T2-w ratio in this MT+ region predicted resting-state functional connectivity of that region. By contrast, a history of blast TBI did not affect the T1-w/T2-w ratio in either a diffuse or focal pattern. These findings suggest that intracortical myelin, as measured using the T1-w/T2-w ratio, may be a TBI biomarker that is anatomically complementary to diffusion MRI. Thus, myelin mapping could potentially be combined with diffusion imaging to improve MRI-based diagnostic tools for TBI.
Collapse
Affiliation(s)
- Evan M Gordon
- VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Dr, 151-C, Waco, TX, 76711, USA; Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, 1600 Viceroy Dr #800, Dallas, TX, 75235, USA; Department of Psychology and Neuroscience, Baylor University, Baylor Sciences Building Suite B.309, Waco, TX, 76706, USA.
| | - Geoffrey J May
- VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Dr, 151-C, Waco, TX, 76711, USA; Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, 1600 Viceroy Dr #800, Dallas, TX, 75235, USA; Department of Psychology and Neuroscience, Baylor University, Baylor Sciences Building Suite B.309, Waco, TX, 76706, USA; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, 8441 Riverside Parkway, Bryan, TX, 77807, USA
| | - Steven M Nelson
- VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Dr, 151-C, Waco, TX, 76711, USA; Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, 1600 Viceroy Dr #800, Dallas, TX, 75235, USA; Department of Psychology and Neuroscience, Baylor University, Baylor Sciences Building Suite B.309, Waco, TX, 76706, USA; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, 8441 Riverside Parkway, Bryan, TX, 77807, USA
| |
Collapse
|
25
|
Schneider DK, Galloway R, Bazarian JJ, Diekfuss JA, Dudley J, Leach JL, Mannix R, Talavage TM, Yuan W, Myer GD. Diffusion Tensor Imaging in Athletes Sustaining Repetitive Head Impacts: A Systematic Review of Prospective Studies. J Neurotrauma 2019; 36:2831-2849. [PMID: 31062655 DOI: 10.1089/neu.2019.6398] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Daniel K. Schneider
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Medical Education, Riverside Methodist Hospital, Columbus, Ohio
| | - Ryan Galloway
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Duke University School of Medicine, Durham, North Carolina
| | - Jeffrey J. Bazarian
- Department of Emergency Medicine, University of Rochester School of Medicine, Rochester, New York
| | - Jed A. Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jon Dudley
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - James L. Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Thomas M. Talavage
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
| |
Collapse
|
26
|
Guilhaume-Correa F, Cansler SM, Shalosky EM, Goodman MD, Evanson NK. Greater neurodegeneration and behavioral deficits after single closed head traumatic brain injury in adolescent versus adult male mice. J Neurosci Res 2019; 98:557-570. [PMID: 31541497 DOI: 10.1002/jnr.24535] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/28/2022]
Abstract
Traumatic brain injury (TBI) is a major public health concern affecting 2.8 million people per year in the United States, of whom about 1 million are children under 19 years old. Animal models of TBI have been developed and used in multiple ages of animals, but direct comparisons of adult and adolescent populations are rare. The current studies were undertaken to directly compare outcomes between adult and adolescent male mice, using a closed head, single-impact model of TBI. Six-week-old adolescent and 9-week-old adult male mice were subjected to mild-moderate TBI. Histological measures for neurodegeneration, gliosis, and microglial neuroinflammation, and behavioral tests of locomotion and memory were performed. Adolescent TBI mice have increased mortality (Χ2 = 20.72, p < 0.001) compared to adults. There is also evidence of hippocampal neurodegeneration in adolescents that is not present in adults. Hippocampal neurodegeneration correlates with histologic activation of microglia, but not with increased astrogliosis. Adults and adolescents have similar locomotion deficits after TBI that recover by 16 days postinjury. Adolescents have memory deficits as evidenced by impaired novel object recognition between 3-4 and 4-16 days postinjury (F1,26 = 5.23, p = 0.031) while adults do not. In conclusion, adults and adolescents within a close age range (6-9 weeks) respond to TBI differently. Adolescents are more severely affected by mortality, neurodegeneration, and inflammation in the hippocampus compared to adults. Adolescents, but not adults, have worse memory performance after TBI that lasts at least 16 days postinjury.
Collapse
Affiliation(s)
- Fernanda Guilhaume-Correa
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Shelby M Cansler
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Emily M Shalosky
- Department of Biological Sciences, University of Cincinnati, Cincinnati, Ohio
| | | | - Nathan K Evanson
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| |
Collapse
|
27
|
Mayer AR, Stephenson DD, Wertz CJ, Dodd AB, Shaff NA, Ling JM, Park G, Oglesbee SJ, Wasserott BC, Meier TB, Witkiewitz K, Campbell RA, Yeo RA, Phillips JP, Quinn DK, Pottenger A. Proactive inhibition deficits with normal perfusion after pediatric mild traumatic brain injury. Hum Brain Mapp 2019; 40:5370-5381. [PMID: 31456319 PMCID: PMC6864901 DOI: 10.1002/hbm.24778] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/11/2019] [Accepted: 08/16/2019] [Indexed: 12/14/2022] Open
Abstract
Although much attention has been generated in popular media regarding the deleterious effects of pediatric mild traumatic brain injury (pmTBI), a paucity of empirical evidence exists regarding the natural course of biological recovery. Fifty pmTBI patients (12–18 years old) were consecutively recruited from Emergency Departments and seen approximately 1 week and 4 months post‐injury in this prospective cohort study. Data from 53 sex‐ and age‐matched healthy controls (HC) were also collected. Functional magnetic resonance imaging was obtained during proactive response inhibition and at rest, in conjunction with independent measures of resting cerebral blood flow. High temporal resolution imaging enabled separate modeling of neural responses for preparation and execution of proactive response inhibition. A priori predictions of failed inhibitory responses (i.e., hyperactivation) were observed in motor circuitry (pmTBI>HC) and sensory areas sub‐acutely and at 4 months post‐injury. Paradoxically, pmTBI demonstrated hypoactivation (HC>pmTBI) during target processing, along with decreased activation within prefrontal cognitive control areas. Functional connectivity within motor circuitry at rest suggested that deficits were limited to engagement during the inhibitory task, whereas normal resting cerebral perfusion ruled out deficits in basal perfusion. In conclusion, current results suggest blood oxygen‐level dependent deficits during inhibitory control may exceed commonly held beliefs about physiological recovery following pmTBI, potentially lasting up to 4 months post‐injury.
Collapse
Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/LBERI, Albuquerque, New Mexico.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico.,Department of Neurology, University of New Mexico, Albuquerque, New Mexico.,Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico
| | | | | | - Andrew B Dodd
- The Mind Research Network/LBERI, Albuquerque, New Mexico
| | | | - Josef M Ling
- The Mind Research Network/LBERI, Albuquerque, New Mexico
| | - Grace Park
- Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Scott J Oglesbee
- Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
| | | | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Richard A Campbell
- Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico
| | - Ronald A Yeo
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - John P Phillips
- The Mind Research Network/LBERI, Albuquerque, New Mexico.,Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Davin K Quinn
- Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico
| | - Amy Pottenger
- Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
| |
Collapse
|
28
|
Botchway EN, Godfrey C, Nicholas CL, Hearps S, Anderson V, Catroppa C. Objective sleep outcomes 20 years after traumatic brain injury in childhood. Disabil Rehabil 2019; 42:2393-2401. [PMID: 30945574 DOI: 10.1080/09638288.2019.1578422] [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: 10/27/2022]
Abstract
Purpose: To assess objective sleep outcomes and correlates in young adults with a history of childhood traumatic brain injury.Materials and methods: Participants included 45 young adults who sustained brain injury in childhood (mild = 12, moderate = 22, and severe = 11) and 13 typically developing control participants. Sleep was assessed with actigraphy and sleep diaries recorded over 14 consecutive days. Rates of good sleep (sleep efficiency ≥ 85%) and poor sleep (sleep efficiency < 85%) were also evaluated.Results: At 20-years postinjury, participants with traumatic brain injury and controls presented with similar outcomes across the objective sleep parameters (all p > 0.050) and rates of poor sleepers were also similar between these groups (p = 0.735): 67% and 77%, respectively. However, moderate and severe traumatic brain injury and female sex were associated with longer sleep duration.Conclusions: These findings provide preliminary insights into objective sleep outcome and associated factors in the very-long-term after childhood brain injuries. They also indicate the need to monitor sleep outcomes in young adults with and without traumatic brain injury.Implication for rehabilitationSustaining traumatic brain injury in childhood can impact on several functional domains including sleep.Sleep disturbances, particularly insomnia-related symptoms, are common in this population, with evidence of poor outcomes reported until adolescence postinjury, while outcomes beyond adolescence remain unexplored.In this first investigation of objective sleep outcomes in young adults with a history of childhood traumatic brain injury, we showed that insomnia-related symptoms are highly prevalent in both young adults with traumatic brain injury (67%) and healthy controls (77%).These findings suggest the need to routinely evaluate and treat sleep problem in young adults in general, irrespective of history of childhood traumatic brain injury.
Collapse
Affiliation(s)
- Edith N Botchway
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Christian L Nicholas
- Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Stephen Hearps
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| |
Collapse
|
29
|
Moore RD, Sicard V, Pindus D, Raine LB, Drollette ES, Scudder MR, Decker S, Ellemberg D, Hillman CH. A targeted neuropsychological examination of children with a history of sport-related concussion. Brain Inj 2018; 33:291-298. [PMID: 30427210 DOI: 10.1080/02699052.2018.1546408] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Experimental research suggests that sport-related concussion can lead to persistent alterations in children's neurophysiology and cognition. However, the search for neuropsychological tests with a similar ability to detect long-term deficits continues. PRIMARY OBJECTIVE The current study assessed whether a target battery of neuropsychological measures of higher cognition and academic achievement would detect lingering deficits in children 2 years after injury. RESEARCH DESIGN Cross-sectional. METHODS AND PROCEDURE A total of 32 pre-adolescent children (16 concussion history, 16 control) completed a targeted battery of neuropsychological and academic tests. MAIN OUTCOMES AND RESULTS Children with a history of concussion exhibited selective deficits during the Raven's Coloured Progressive Matrices, Comprehensive Trail-Making Test, and the mathematics sub-section of the WRAT-3. Deficit magnitude was significantly related to age at injury, but not time since injury. CONCLUSIONS The current results suggest that neuropsychological measures of higher cognition and academic achievement may be sensitive to lingering deficits, and that children injured earlier in life may exhibit worse neuropsychological and academic performance.
Collapse
Affiliation(s)
- R D Moore
- a Arnold School of Public Health , University of South Carolina , Columbia , SC , USA
| | - V Sicard
- b Department of Kinesiology , Université de Montréal , Montreal , QC , Canada.,c Centre de recherche en neuropsychologie et cognition , Université de Montréal , Montreal , QC , Canada
| | - D Pindus
- d College of Science , Northeastern University , Boston , MA , USA
| | - L B Raine
- d College of Science , Northeastern University , Boston , MA , USA
| | - E S Drollette
- e Department of Kinsiology School of Health and Human Sciences , University of North Carolina-Greensboro , Greensboro , NC , USA
| | - M R Scudder
- f Departement of Psychiatry , University of Pittsburgh , Pittsburgh , PA , USA
| | - S Decker
- g Department of Psychology , University of South Carolina , Columbia , SC , USA
| | - D Ellemberg
- b Department of Kinesiology , Université de Montréal , Montreal , QC , Canada.,c Centre de recherche en neuropsychologie et cognition , Université de Montréal , Montreal , QC , Canada
| | - C H Hillman
- h Department of Kinesiology and Community Health , College of Applied Health Sciences, Univeristy of Illinois at Urbana-Champaign , Champaign , IL , USA
| |
Collapse
|
30
|
Sawamura D, Ikoma K, Ogawa K, Sakai S. Clinical utility of neuropsychological tests for employment outcomes in persons with cognitive impairment after moderate to severe traumatic brain injury. Brain Inj 2018; 32:1670-1677. [PMID: 30351982 DOI: 10.1080/02699052.2018.1536281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To retrospectively examine the clinical utility of neuropsychological tests (NPTs) for predicting employment outcomes in persons with cognitive impairment after moderate to severe traumatic brain injury (TBI). METHODS 132 individuals of working age with cognitive impairment after moderate to severe TBI were classified into three groups by employment status: competitive employment (CE); supported employment (SE); and unemployed (UE). NPT scores were compared among groups. Using multinomial logistic regression with group allocation as the dependent variable, significant variables were identified, and receiver operating characteristic (ROC) curves were calculated. RESULTS Comparison of NPT results among the three groups showed significant differences for all NPTs (all items, p < 0.01). Using multinomial logistic regression analysis, Rivermead Behavioral Memory Test (RBMT) and Behavioral Assessment of the Dysexecutive Syndrome from CE versus SE and Trail Making Test-B and RBMT from SE versus UE were identified. ROC curve analysis indicated small to moderate accuracy (area under the curve, 0.63-0.84). CONCLUSION NPT scores can predict future employment status in patients with cognitive impairment after TBI. These findings may lead to improved clinical assessments when providing work support. Future research should consider occupational categories, managerial categories, and types of re-employment.
Collapse
Affiliation(s)
- Daisuke Sawamura
- a Department of Functioning and Disability, Faculty of Health Sciences , Hokkaido University , Sapporo , Japan.,b Department of Rehabilitation , Hokkaido University Hospital , Sapporo , Japan
| | - Katsunori Ikoma
- c Department of Rehabilitation Medicine , Hokkaido University , Sapporo , Japan
| | - Keita Ogawa
- b Department of Rehabilitation , Hokkaido University Hospital , Sapporo , Japan
| | - Shinya Sakai
- a Department of Functioning and Disability, Faculty of Health Sciences , Hokkaido University , Sapporo , Japan
| |
Collapse
|
31
|
Dégeilh F, Bernier A, Gravel J, Beauchamp MH. Developmental trajectories of adaptive functioning following early mild traumatic brain injury. Dev Psychobiol 2018; 60:1037-1047. [PMID: 30276812 DOI: 10.1002/dev.21786] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/03/2018] [Accepted: 08/24/2018] [Indexed: 01/05/2023]
Abstract
Adaptive behavior impairments have been reported in children with severe traumatic brain injury (TBI) but are not typically found following mild TBI. It is possible that mild TBI induces subtle changes in adaptive functioning that are not captured in conventional group comparisons. This study aimed to explore time course changes in adaptive functioning following early mild TBI. Parents of 63 children with mild TBI and 53 children with orthopedic injuries aged between 1.5 and 5 years at the time of injury completed the Adaptive Behavior Assessment System-II at three time points: retrospectively to assess pre-injury functioning, then at 6 and 18 months post-injury. Developmental trajectories of adaptive functioning domains (practical, conceptual, and social) reported by parents were modeled using linear mixed-model analyses. Findings suggest that mild TBI may disrupt the expected developmental progression of children's social adaptive behavior, but does not appear to alter practical and conceptual domains.
Collapse
Affiliation(s)
- Fanny Dégeilh
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Annie Bernier
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Jocelyn Gravel
- Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Sainte-Justine Research Center, Montreal, Quebec, Canada
| |
Collapse
|
32
|
The long-term outcomes of sport-related concussion in pediatric populations. Int J Psychophysiol 2018; 132:14-24. [DOI: 10.1016/j.ijpsycho.2018.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 03/08/2018] [Accepted: 04/04/2018] [Indexed: 12/14/2022]
|
33
|
Mayer AR, Kaushal M, Dodd AB, Hanlon FM, Shaff NA, Mannix R, Master CL, Leddy JJ, Stephenson D, Wertz CJ, Suelzer EM, Arbogast KB, Meier TB. Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils. Neurosci Biobehav Rev 2018; 94:149-165. [PMID: 30098989 DOI: 10.1016/j.neubiorev.2018.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 12/20/2022]
Abstract
There is growing public concern about neurodegenerative changes (e.g., Chronic Traumatic Encephalopathy) that may occur chronically following clinically apparent and clinically silent (i.e., sub-concussive blows) pediatric mild traumatic brain injury (pmTBI). However, there are currently no biomarkers that clinicians can use to objectively diagnose patients or predict those who may struggle to recover. Non-invasive neuroimaging, electrophysiological and neuromodulation biomarkers have promise for providing evidence of the so-called "invisible wounds" of pmTBI. Our systematic review, however, belies that notion, identifying a relative paucity of high-quality, clinically impactful, diagnostic or prognostic biomarker studies in the sub-acute injury phase (36 studies on unique samples in 28 years), with the majority focusing on adolescent pmTBI. Ultimately, well-powered longitudinal studies with appropriate control groups, as well as standardized and clearly-defined inclusion criteria (time post-injury, injury severity and past history) are needed to truly understand the complex pathophysiology that is hypothesized (i.e., still needs to be determined) to exist during the acute and sub-acute stages of pmTBI and may underlie post-concussive symptoms.
Collapse
Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States; Neurology Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychiatry Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychology Department, University of New Mexico, Albuquerque, NM, 87131, United States.
| | - Mayank Kaushal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Christina L Master
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States; Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - John J Leddy
- UBMD Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, NY, 14214, United States
| | - David Stephenson
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Christopher J Wertz
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Elizabeth M Suelzer
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| |
Collapse
|
34
|
Woolhouse R, McKinlay A, Grace RC. Women in Prison With Traumatic Brain Injury: Prevalence, Mechanism, and Impact on Mental Health. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:3135-3150. [PMID: 28831827 DOI: 10.1177/0306624x17726519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Relatively little is known about the characteristics of female offenders. Here, we studied the prevalence of traumatic brain injury (TBI) and mental health issues in an exclusively female prison population in New Zealand. Participants ( N = 38) were recruited from all security levels at Christchurch Women's Prison. Measures for depression, anxiety, and stress, sleep, and a history of TBI were administered; 94.7% (36/38) of participants presented with a history of TBI. Younger age at first injury was associated with an increased risk of mental health problems. The study concludes that TBI is highly prevalent among female offenders and may be linked to increased mental health problems. TBI should be considered as an important factor in offender pathways and treatment programs.
Collapse
Affiliation(s)
| | - Audrey McKinlay
- 1 University of Canterbury, Christchurch, New Zealand
- 2 The University of Melbourne, Australia
| | | |
Collapse
|
35
|
Wendel KM, Lee JB, Affeldt BM, Hamer M, Harahap-Carrillo IS, Pardo AC, Obenaus A. Corpus Callosum Vasculature Predicts White Matter Microstructure Abnormalities after Pediatric Mild Traumatic Brain Injury. J Neurotrauma 2018; 36:152-164. [PMID: 29739276 DOI: 10.1089/neu.2018.5670] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Emerging data suggest that pediatric traumatic brain injury (TBI) is associated with impaired developmental plasticity and poorer neuropsychological outcomes than adults with similar head injuries. Unlike adult mild TBI (mTBI), the effects of mTBI on white matter (WM) microstructure and vascular supply are not well understood in the pediatric population. The cerebral vasculature plays an important role providing necessary nutrients and removing waste. To address this critical element, we examined the microstructure of the corpus callosum (CC) following pediatric mTBI using diffusion tensor magnetic resonance imaging (DTI), and investigated myelin, oligodendrocytes, and vasculature of WM with immunohistochemistry (IHC). We hypothesized that pediatric mTBI leads to abnormal WM microstructure and impacts the vasculature within the CC, and that these alterations to WM vasculature contribute to the long-term altered microstructure. We induced in mice a closed-head injury (CHI) mTBI at post-natal day (P) 14; then at 4, 14, and 60 days post-injury (DPI) mice were sacrificed for analysis. We observed persistent changes in apparent diffusion coefficient (ADC) within the ipsilateral CC following mTBI, indicating microstructural changes, but surprisingly changes in myelin and oligodendrocyte densities were minimal. However, vascular features of the ipsilateral CC such as vessel density, length, and number of junctions were persistently altered following mTBI. Correlative analysis showed a strong inverse relationship between ADC and vessel density at 60 DPI, suggesting increased vessel density following mTBI may restrict WM diffusion characteristics. Our findings suggest that WM vasculature contributes to the long-term microstructural changes within the ipsilateral CC following mTBI.
Collapse
Affiliation(s)
- Kara M Wendel
- 1 Department of Anatomy and Neurobiology, University of California, Irvine School of Medicine , Irvine, California
| | - Jeong Bin Lee
- 2 Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, California
| | - Bethann M Affeldt
- 2 Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, California
| | - Mary Hamer
- 2 Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, California
| | | | - Andrea C Pardo
- 3 Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine , Chicago, Illinois
| | - Andre Obenaus
- 1 Department of Anatomy and Neurobiology, University of California, Irvine School of Medicine , Irvine, California
- 2 Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, California
- 4 Department of Pediatrics, University of California, Irvine School of Medicine , Irvine, California
| |
Collapse
|
36
|
Kennedy E, Cohen M, Munafò M. Childhood Traumatic Brain Injury and the Associations With Risk Behavior in Adolescence and Young Adulthood: A Systematic Review. J Head Trauma Rehabil 2018; 32:425-432. [PMID: 28092286 PMCID: PMC5690295 DOI: 10.1097/htr.0000000000000289] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To systematically review the evidence that childhood traumatic brain injury (TBI) is associated with risk behavior in adolescence and young adulthood. Risk behavior included one or more of the following: use of substances, including alcohol, tobacco, and illicit substances; involvement in criminal behavior; and behavioral issues with conduct. METHODS A literature search was conducted using these terms: child, pediatric, traumatic brain injury, head injury, adolescent, psychosocial, antisocial, conduct, substance use. Studies describing original research were included if they reported outcomes over the age of 13 years in participants who sustained a TBI between birth and age 13 years. RESULTS Six journal articles were reviewed based on 4 separate studies. Three articles indicated a relationship between childhood TBI and increased problematic substance use in adolescence and young adulthood. Three articles supported an association between childhood TBI and later externalizing behavior; however, 2 articles did not support this link. CONCLUSION More research is warranted to explore the association between childhood TBI and later risk behavior as the relationship is not currently understood. Future research should build on existing longitudinal research with continued use of medical records for identifying TBI and inclusion of a non-brain-related trauma group to control for general injury effects.
Collapse
Affiliation(s)
- Eleanor Kennedy
- MRC Integrative Epidemiology Unit at the University of Bristol, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, United Kingdom (Ms Kennedy and Dr Munafò); and College of Life and Environmental Sciences, University of Exeter, United Kingdom (Ms Cohen)
| | - Miriam Cohen
- MRC Integrative Epidemiology Unit at the University of Bristol, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, United Kingdom (Ms Kennedy and Dr Munafò); and College of Life and Environmental Sciences, University of Exeter, United Kingdom (Ms Cohen)
| | - Marcus Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, United Kingdom (Ms Kennedy and Dr Munafò); and College of Life and Environmental Sciences, University of Exeter, United Kingdom (Ms Cohen)
| |
Collapse
|
37
|
Servatius RJ, Spiegler KM, Handy JD, Pang KC, Tsao JW, Mazzola CA. Neurocognitive and Fine Motor Deficits in Asymptomatic Adolescents during the Subacute Period after Concussion. J Neurotrauma 2018; 35:1008-1014. [DOI: 10.1089/neu.2017.5314] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Richard J. Servatius
- Rutgers Biomedical Health Sciences, Pharmacology, Physiology, and Neuroscience, Rutgers University, Newark, New Jersey
- Graduate School of Biomedical Sciences, Rutgers University, Newark, New Jersey
- State University of New York Upstate Medical University, Syracuse, New York
| | - Kevin M. Spiegler
- Graduate School of Biomedical Sciences, Rutgers University, Newark, New Jersey
| | - Justin D. Handy
- Rutgers Biomedical Health Sciences, Pharmacology, Physiology, and Neuroscience, Rutgers University, Newark, New Jersey
- Central New York Research Corporation, Syracuse, New York
| | - Kevin C.H. Pang
- Rutgers Biomedical Health Sciences, Pharmacology, Physiology, and Neuroscience, Rutgers University, Newark, New Jersey
- Graduate School of Biomedical Sciences, Rutgers University, Newark, New Jersey
| | - Jack W. Tsao
- University of Tennessee Health Science Center, Memphis, Tennessee
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Catherine A. Mazzola
- Rutgers Biomedical Health Sciences, Pharmacology, Physiology, and Neuroscience, Rutgers University, Newark, New Jersey
- Morristown Medical Center, Morristown, New Jersey
| |
Collapse
|
38
|
Gordon EM, Scheibel RS, Zambrano-Vazquez L, Jia-Richards M, May GJ, Meyer EC, Nelson SM. High-Fidelity Measures of Whole-Brain Functional Connectivity and White Matter Integrity Mediate Relationships between Traumatic Brain Injury and Post-Traumatic Stress Disorder Symptoms. J Neurotrauma 2018; 35:767-779. [PMID: 29179667 PMCID: PMC8117405 DOI: 10.1089/neu.2017.5428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Traumatic brain injury (TBI) disrupts brain communication and increases risk for post-traumatic stress disorder (PTSD). However, mechanisms by which TBI-related disruption of brain communication confers PTSD risk have not been successfully elucidated in humans. This may be in part because functional MRI (fMRI), the most common technique for measuring functional brain communication, is unreliable for characterizing individual patients. However, this unreliability can be overcome with sufficient within-individual data. Here, we examined whether relationships could be observed among TBI, structural and functional brain connectivity, and PTSD severity by collecting ∼3.5 hours of resting-state fMRI and diffusion tensor imaging (DTI) data in each of 26 United States military veterans. We observed that a TBI history was associated with decreased whole-brain resting-state functional connectivity (RSFC), while the number of lifetime TBIs was associated with reduced whole-brain fractional anisotropy (FA). Both RSFC and FA explained independent variance in PTSD severity, with RSFC mediating the TBI-PTSD relationship. Finally, we showed that large amounts of per-individual data produced highly reliable RSFC measures, and that relationships among TBI, RSFC/FA, and PTSD could not be observed with typical data quantities. These results demonstrate links among TBI, brain connectivity, and PTSD severity, and illustrate the need for precise characterization of individual patients using high-data fMRI scanning.
Collapse
Affiliation(s)
- Evan M. Gordon
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
| | - Randall S. Scheibel
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | | | | | - Geoffrey J. May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX
| | - Eric C. Meyer
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX
| | - Steven M. Nelson
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
| |
Collapse
|
39
|
McKinlay A, Buck K. Misconceptions about traumatic brain injury among educators: has anything changed over the last 20 years? Disabil Rehabil 2018; 41:1419-1426. [DOI: 10.1080/09638288.2018.1429500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Audrey McKinlay
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Kimberly Buck
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| |
Collapse
|
40
|
Kosari-Nasab M, Shokouhi G, Ghorbanihaghjo A, Abbasi MM, Salari AA. Anxiolytic- and antidepressant-like effects of Silymarin compared to diazepam and fluoxetine in a mouse model of mild traumatic brain injury. Toxicol Appl Pharmacol 2018; 338:159-173. [DOI: 10.1016/j.taap.2017.11.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 12/31/2022]
|
41
|
Obtaining a History of Childhood Traumatic Brain Injury Using the Ohio State University TBI Identification Method to Elicit Adult Recall. J Head Trauma Rehabil 2017; 32:E24-E28. [DOI: 10.1097/htr.0000000000000284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
42
|
Lah S, David P, Epps A, Tate R, Brookes N. Preliminary validation study of the Sydney Post-Traumatic Amnesia Scale (SYPTAS) in children with traumatic brain injury aged 4 to 7 years. APPLIED NEUROPSYCHOLOGY-CHILD 2017; 8:61-69. [PMID: 29058469 DOI: 10.1080/21622965.2017.1381100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to assess the validity (developmental, concurrent, and predictive) of the Sydney Post-Traumatic Amnesia Scale (SYPTAS) for assessment of post-traumatic amnesia (PTA) in 4 to 7 year old children with traumatic brain injury (TBI). The design of this study is a retrospective cohort study. The SYPTAS was administered to 35 children (26 boys) aged 4.0 to 7.8 years who were consecutively admitted to a children's hospital with mild (n = 26), moderate (n = 3), or severe (n = 7) TBI. Concurrent validity of the SYPTAS was assessed against the Glasgow Coma Scale Scores (GCS). Predictive validity of the SYPTAS for functional outcomes was evaluated against the King's Outcome Scale for Childhood Head Injury (KOSCHI) at discharge and outpatient follow-ups. The length of PTA, measured by the SYPTAS, was invariant of children's chronological age, confirming the scale's developmental validity. Longer PTA was associated with lower GCS, endorsing concurrent validity of PTA duration measured by the SYPTAS, as a clinical indicator of TBI severity. PTA duration measured by the SYPTAS was a significant predictor of functional outcomes on the KOSCHI at discharge and follow-ups. This study provides evidence that the SYPTAS has good developmental, concurrent and predictive validity for assessment of PTA in children aged 4 to 7 years. PTA duration assessed by the SYPTAS is a clinical indicator of TBI severity and can aid rehabilitation planning post TBI.
Collapse
Affiliation(s)
- Suncica Lah
- a School of Psychology , The University of Sydney , Sydney , New South Wales , Australia.,b Australian Research Council Centre of Excellence in Cognition and its Disorders , Sydney , New South Wales , Australia
| | - Pamela David
- a School of Psychology , The University of Sydney , Sydney , New South Wales , Australia
| | - Adrienne Epps
- c Paediatric Rehabilitation , Sydney Children's Hospital , Randwick , New South Wales , Australia
| | - Robyn Tate
- d John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern , The University of Sydney , New South Wales , Australia
| | - Naomi Brookes
- c Paediatric Rehabilitation , Sydney Children's Hospital , Randwick , New South Wales , Australia
| |
Collapse
|
43
|
Volpe DSJ, Oliveira NCAC, Santos AC, Linhares MBM, Carlotti APCP. Neuropsychological outcome of children with traumatic brain injury and its association with late magnetic resonance imaging findings: A cohort study. Brain Inj 2017; 31:1689-1694. [PMID: 28872351 DOI: 10.1080/02699052.2017.1358398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate neuropsychological outcome after traumatic brain injury (TBI) and its association with trauma severity and late magnetic resonance imaging (MRI) findings. METHODS Prospective cohort study of patients with TBI admitted to the paediatric intensive care unit over 5 years. Trauma severity was determined by Glasgow Coma Scale (GCS), neurological outcome by King's Outcome Scale for Childhood Head Injury (KOSCHI) and neuropsychological outcome by Wechsler Intelligence Scale for Children - Fourth Edition. RESULTS Twenty-five children (median age 6 years at trauma) were included. Patients were divided into Disability (DIS)(n = 10) and Good Recovery (GR)(n = 15) groups. Initial GCS score was not significantly different in both groups (median 6 vs. 10; p = 0.34). DIS group had lower values of working memory index (WMI)(median 74 vs. 94; p = 0.004), perceptual reasoning index (PRI)(75 vs. 96; p = 0.03), verbal comprehension index (VCI)(65 vs. 84; p = 0.02), processing speed index (PSI)(74 vs. 97; p = 0.01) and full-scale intelligence quotient (FSIQ)(65 vs. 87; p = 0.008). In the GR group, 60% of patients had normal or minimally altered MRI versus 10% of patients in the DIS group (p = 0.018). Fractional anisotropy positively correlated with WMI(r = 0.65; p = 0.005), PRI(r = 0.52; p = 0.03) and FSIQ(r = 0.50; p = 0.04). CONCLUSIONS Neuropsychological impairment was observed in 40% of children who suffered a TBI and was associated with late MRI abnormalities.
Collapse
Affiliation(s)
- Daniele S J Volpe
- a Division of Pediatric Critical Care, Department of Pediatrics, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Nátali C A C Oliveira
- b Division of Psychology, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - A Carlos Santos
- c Division of Neuroradiology, Department of Internal Medicine, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Maria B M Linhares
- b Division of Psychology, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Ana P C P Carlotti
- a Division of Pediatric Critical Care, Department of Pediatrics, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| |
Collapse
|
44
|
Clarkson BDS, Kahoud RJ, McCarthy CB, Howe CL. Inflammatory cytokine-induced changes in neural network activity measured by waveform analysis of high-content calcium imaging in murine cortical neurons. Sci Rep 2017; 7:9037. [PMID: 28831096 PMCID: PMC5567248 DOI: 10.1038/s41598-017-09182-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/20/2017] [Indexed: 01/07/2023] Open
Abstract
During acute neuroinflammation, increased levels of cytokines within the brain may contribute to synaptic reorganization that results in long-term changes in network hyperexcitability. Indeed, inflammatory cytokines are implicated in synaptic dysfunction in epilepsy and in an array of degenerative and autoimmune diseases of the central nervous system. Current tools for studying the impact of inflammatory factors on neural networks are either insufficiently fast and sensitive or require complicated and costly experimental rigs. Calcium imaging offers a reasonable surrogate for direct measurement of neuronal network activity, but traditional imaging paradigms are confounded by cellular heterogeneity and cannot readily distinguish between glial and neuronal calcium transients. While the establishment of pure neuron cultures is possible, the removal of glial cells ignores physiologically relevant cell-cell interactions that may be critical for circuit level disruptions induced by inflammatory factors. To overcome these issues, we provide techniques and algorithms for image processing and waveform feature extraction using automated analysis of spontaneous and evoked calcium transients in primary murine cortical neuron cultures transduced with an adeno-associated viral vector driving the GCaMP6f reporter behind a synapsin promoter. Using this system, we provide evidence of network perturbations induced by the inflammatory cytokines TNFα, IL1β, and IFNγ.
Collapse
Affiliation(s)
| | - Robert J Kahoud
- Department of Neurology, Mayo Clinic, Rochester, MN, USA 55905, USA
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA 55905, USA
| | | | - Charles L Howe
- Department of Neurology, Mayo Clinic, Rochester, MN, USA 55905, USA.
- Department of Neuroscience, Mayo Clinic, Rochester, MN, USA 55905, USA.
- Department of Immunology, Mayo Clinic, Rochester, MN, USA 55905, USA.
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA 55905, USA.
| |
Collapse
|
45
|
Chhor V, Moretti R, Le Charpentier T, Sigaut S, Lebon S, Schwendimann L, Oré MV, Zuiani C, Milan V, Josserand J, Vontell R, Pansiot J, Degos V, Ikonomidou C, Titomanlio L, Hagberg H, Gressens P, Fleiss B. Role of microglia in a mouse model of paediatric traumatic brain injury. Brain Behav Immun 2017; 63:197-209. [PMID: 27818218 PMCID: PMC5441571 DOI: 10.1016/j.bbi.2016.11.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/22/2016] [Accepted: 11/02/2016] [Indexed: 12/20/2022] Open
Abstract
The cognitive and behavioural deficits caused by traumatic brain injury (TBI) to the immature brain are more severe and persistent than TBI in the mature brain. Understanding this developmental sensitivity is critical as children under four years of age sustain TBI more frequently than any other age group. Microglia (MG), resident immune cells of the brain that mediate neuroinflammation, are activated following TBI in the immature brain. However, the type and temporal profile of this activation and the consequences of altering it are still largely unknown. In a mouse model of closed head weight drop paediatric brain trauma, we characterized i) the temporal course of total cortical neuroinflammation and the phenotype of ex vivo isolated CD11B-positive microglia/macrophage (MG/MΦ) using a battery of 32 markers, and ii) neuropathological outcome 1 and 5days post-injury. We also assessed the effects of targeting MG/MΦ activation directly, using minocycline a prototypical microglial activation antagonist, on these processes and outcome. TBI induced a moderate increase in both pro- and anti-inflammatory cytokines/chemokines in the ipsilateral hemisphere. Isolated cortical MG/MΦ expressed increased levels of markers of endogenous reparatory/regenerative and immunomodulatory phenotypes compared with shams. Blocking MG/MΦ activation with minocycline at the time of injury and 1 and 2days post-injury had only transient protective effects, reducing ventricular dilatation and cell death 1day post-injury but having no effect on injury severity at 5days. This study demonstrates that, unlike in adults, the role of MG/MΦ in injury mechanisms following TBI in the immature brain may not be negative. An improved understanding of MG/MΦ function in paediatric TBI could support translational efforts to design therapeutic interventions.
Collapse
Affiliation(s)
- Vibol Chhor
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France; Department of Anesthesia and Intensive Care, Georges Pompidou European Hospital, Paris, France
| | - Raffaella Moretti
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France; Università degli Studi di Udine, Udine, Italy
| | - Tifenn Le Charpentier
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Stephanie Sigaut
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Sophie Lebon
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Leslie Schwendimann
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Marie-Virginie Oré
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Chiara Zuiani
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Valentina Milan
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Julien Josserand
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Regina Vontell
- Department of Perinatal Imaging and Health, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Julien Pansiot
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Vincent Degos
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France; Department of Anesthesia and Intensive Care, Pitié Salpétrière Hospital, F-75013 Paris, France
| | | | - Luigi Titomanlio
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France
| | - Henrik Hagberg
- Department of Perinatal Imaging and Health, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom; Department of Clinical Sciences, Sahlgrenska Academy/East Hospital, Gothenburg University, 416 85 Gothenburg, Sweden
| | - Pierre Gressens
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France; Department of Perinatal Imaging and Health, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Bobbi Fleiss
- PROTECT, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris, France; PremUP, Paris, France; Department of Perinatal Imaging and Health, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom.
| |
Collapse
|
46
|
The relationship between neuropsychological performance and depression in patients with traumatic brain injury. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1177/0081246316654327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Traumatic brain injury is a multi-faceted condition that affects individuals on physical, cognitive, and emotional levels. The study investigated the relationship between depression and neuropsychological performance in a group with traumatic brain injury. A retrospective review was conducted on 75 participants who completed neuropsychological assessments. Information on clinical characteristics, sociodemographic information, neuropsychological outcomes, and Beck Depression Inventory scores were included in the analysis. Results indicated that 36% of the participants reported experiencing severe symptoms of depression, 28% moderate symptoms of depression, and 36% mild/minimal symptoms of depression. Performance on the Rey Auditory Verbal Learning Test indicated inverse relationships with depression scores suggesting that traumatic brain injury patients with lower depression scores perform better on verbal memory tasks. Similarly, findings for the written and oral versions of the Symbol Digit Modalities Test reflected inverse correlations with depression scores, indicating that lower depression scores are correlated with increased processing speed and capacity. A significant positive association between the time taken to complete the Trail Making Test Trail A and Trail B and depression scores was found, suggesting that higher depression scores in this sample were related to slower performance speed and lower executive performance. When specific clinical and sociodemographic variables were included as covariates in a partial correlational analysis, neuropsychological performance indicators and depression scores remained significant for Symbol Digit Modalities Test (oral and written), the Rey Auditory Verbal Learning Test Retrieval and Recognition trials, and Trail Making Test (Trail B). This study indicates that in a traumatic brain injury cohort, depression levels are significantly associated with specific neuropsychological performance measures. The findings of this study have implications for psychosocial treatment planning after a traumatic brain injury and contribute to our understandings of the inter-relationship between cognition and emotion.
Collapse
|
47
|
Elbourn E, Togher L, Kenny B, Power E. Strengthening the quality of longitudinal research into cognitive-communication recovery after traumatic brain injury: A systematic review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:1-16. [PMID: 27315590 DOI: 10.1080/17549507.2016.1193896] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 04/23/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE (i) To systematically review longitudinal and prognostic studies relating to the trajectory of cognitive-communication recovery after TBI and (ii) to provide recommendations to strengthen future research. METHOD Thirteen health literature databases were accessed up until July 2014. MAIN MEASURES Articles were screened systematically against pre-determined inclusion and exclusion criteria. Quality reviews were performed on the selected articles using a modified Downs & Black Rating Scale. Two independent reviewers performed the reviews. RESULT Sixteen longitudinal and prognostic articles met the inclusion criteria. There was evidence of either maintenance or improvement of cognitive-communication skills during the first 3 years post-injury. However, the studies did not provide detailed recovery trajectories, by failing to evaluate numerous data points over time. No studies evaluated recovery beyond 3 years post-injury. Injury severity, lesion location, brain volume loss and conversation skills may predict specific cognitive-communication outcomes. There was high variability in study characteristics and measures. CONCLUSION There is currently scarce evidence regarding cognitive-communication recovery and prognosis. People with TBI may recover or maintain pre-morbid cognitive-communication skills during the early rehabilitation stage. Further research detailing the recovery trajectory with a view to evaluating predictive factors is strongly indicated. Guidelines for future research are provided.
Collapse
Affiliation(s)
- Elise Elbourn
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| | - Leanne Togher
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| | - Belinda Kenny
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| | - Emma Power
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| |
Collapse
|
48
|
McKinlay A, Linden M, DePompei R, Aaro Jonsson C, Anderson V, Braga L, Castelli E, de Koning P, Hawley CA, Hermans E, Kristiansen I, Madden A, Rumney P, Savage R, Wicks B. Service provision for children and young people with acquired brain injury: Practice recommendations. Brain Inj 2016; 30:1656-1664. [DOI: 10.1080/02699052.2016.1201592] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Audrey McKinlay
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Mark Linden
- School of Nursing and Midwifery, Queen’s University, Belfast, UK
| | - Roberta DePompei
- School of Speech and Language Pathology, University of Akron, Akron, OH, USA
| | | | - Vicki Anderson
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Lucia Braga
- Rede Sarah de Hospitais de Reabilitação, Salvador, Brazil
| | | | - Peter de Koning
- Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
| | - Carol A. Hawley
- Faculty of Medicine, The University of Warwick, Coventry, UK
| | | | - Ingela Kristiansen
- Department of Pediatric Neurology, Uppsala University Hospital, Uppsala, Sweden
| | | | - Peter Rumney
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Ron Savage
- Sarah Jane Brain Foundation, NY, NY, USA
| | | |
Collapse
|
49
|
Accuracy of Self-report as a Method of Screening for Lifetime Occurrence of Traumatic Brain Injury Events that Resulted in Hospitalization. J Int Neuropsychol Soc 2016; 22:717-23. [PMID: 27265159 DOI: 10.1017/s1355617716000497] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) occurs frequently during child and early adulthood, and is associated with negative outcomes including increased risk of drug abuse, mental health disorders and criminal offending. Identification of previous TBI for at-risk populations in clinical settings often relies on self-report, despite little information regarding self-report accuracy. This study examines the accuracy of adult self-report of hospitalized TBI events and the factors that enhance recall. METHODS The Christchurch Health and Development Study is a birth cohort of 1265 children born in Christchurch, New Zealand, in 1977. A history of TBI events was prospectively gathered at each follow-up (yearly intervals 0-16, 18, 21, 25 years) using parental/self-report, verified using hospital records. RESULTS At 25 years, 1003 cohort members were available, with 59/101 of all hospitalized TBI events being recalled. Recall varied depending on the age at injury and injury severity, with 10/11 of moderate/severe TBI being recalled. Logistic regression analysis indicated that a model using recorded loss of consciousness, age at injury, and injury severity, could accurately classify whether or not TBI would be reported in over 74% of cases. CONCLUSIONS This research demonstrates that, even when individuals are carefully cued, many instances of TBI will not recalled in adulthood despite the injury having required a period of hospitalization. Therefore, screening for TBI may require a combination of self-report and review of hospital files to ensure that all cases are identified. (JINS, 2016, 22, 717-723).
Collapse
|
50
|
Abstract
BACKGROUND Childhood mild traumatic brain injury (mTBI) has been associated with negative adult outcomes. Effective interventions require identification of the injury event. There is currently little information regarding the accuracy of adult recall of childhood mTBI. METHOD Prospectively collected information from a large birth cohort was used to examine adult recall accuracy at age 25 for 161 childhood mTBI events occurring before age 10. RESULTS At age 25 cohort members recalled 11 outpatient injuries and 16 inpatient injuries. Recall accuracy increased with age. Logistic regression analysis distinguished between respondents who reported and did not report a childhood mTBI event correctly classifying 84.5% of cases. Age at injury, injury severity and loss of consciousness (LoC) made a unique statistically significant contribution to the model. CONCLUSIONS Most childhood mTBI events are not recalled in adulthood. Age at injury, injury severity and LoC significantly increase likelihood of recall and should be used in measures that evaluate whether injury has occurred. Implications for rehabilitation Traumatic brain injury occurs frequently and often results in ongoing deficits in attention, concentration, executive function and later mental health problems. Identification of a history of traumatic brain injury is essential to ensure that appropriate rehabilitative input is provided. Rehabilitation professionals need to be aware that mental health problems may be secondary to a prior traumatic brain injury. It is important for rehabilitation professionals elicit an accurate history of traumatic brain injury to ensure that their treatment plans are tailored to the needs of this group.
Collapse
Affiliation(s)
- Audrey McKinlay
- a Melbourne School of Psychological Science , The University of Melbourne , Melbourne , Australia
| | - L John Horwood
- b Christchurch Health and Development Study , University of Otago , Christchurch , New Zealand
| |
Collapse
|