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Stevens D, Grant C, Botha T, Vosloo G, Rossouw H, De Jager P, Holtzhausen L. Concussion risk and symptomology severity in adolescents are associated with pre-season drowsiness and emotional complaints. SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2024; 36:v36i1a16255. [PMID: 39100103 PMCID: PMC11294670 DOI: 10.17159/2078-516x/2024/v36i1a16255] [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: 08/06/2024] Open
Abstract
Background Concussions are an ever present risk for many sports. Underlying emotional disturbances and drowsiness are associated with worse post-concussion symptom scores. Yet, not study has examined associations of both emotional disturbances and drowsiness on concussion severity and symptomology. Objectives Examine the associations between baseline sleepiness, emotional complaints, and concussion risk and symptom severity in adolescent athletes. Methods A cohort of 626 adolescent athletes underwent baseline/pre-season concussion screening. Those who experienced a physician diagnosed concussion underwent follow up concussion symptomology assessment. Over 90% of players were seen within two weeks of the concussion incident. Linear regression examined for associations between concussion symptom scores and baseline drowsiness and baseline emotional symptoms. Logistic regression examined for association between each symptom and baseline drowsiness and baseline emotional symptoms. Results Of the 626 athletes that underwent baseline testing, 292 experienced a concussion. Of those 292 athletes, 174 (59.6%) reported baseline drowsiness and 183 (62.7%) baseline emotional symptoms. Baseline drowsiness and emotional complaints were associated with a 2.6 (95% confidence interval = 1.9 to 3.6) and 2.8 (95% confidence interval = 2.0 to 3.9) times greater odds of sustaining a concussion respectively. Increased symptomology after concussion was associated with both baseline drowsiness (unstandardised b = 4.6, p < 0.01) and baseline emotional complaints (unstandardised b = 6.0, p < 0.01). Conclusion Preseason drowsiness and emotional complaints in adolescent athletes are associated with higher risk of adverse clinical outcomes following concussion. Therefore, clinicians and coaches should be aware, and properly screen, for sleep and emotional problems as part of pre-season/baseline health screening.
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Affiliation(s)
- D Stevens
- Flinders Health and Medical Research Institute, Flinders University, South Australia,
Australia
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria,
South Africa
| | - C Grant
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria,
South Africa
| | - T Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria,
South Africa
| | - G Vosloo
- Sport Medical Service, Loftus, Pretoria,
South Africa
| | - H Rossouw
- Sport Medical Service, Loftus, Pretoria,
South Africa
| | - P De Jager
- Sport Medical Service, Loftus, Pretoria,
South Africa
| | - L Holtzhausen
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria,
South Africa
- Sports Medicine Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha,
Qatar
- Department of Exercise and Sports Science, University of the Free State, Bloemfontein,
South Africa
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2
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Gimbel SI, Wang CC, Hungerford L, Twamley EW, Ettenhofer ML. Associations of mTBI and post-traumatic stress to amygdala structure and functional connectivity in military Service Members. FRONTIERS IN NEUROIMAGING 2023; 2:1129446. [PMID: 37554633 PMCID: PMC10406312 DOI: 10.3389/fnimg.2023.1129446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/07/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Traumatic brain injury (TBI) is one of the highest public health priorities, especially among military personnel where comorbidity with post-traumatic stress symptoms and resulting consequences is high. Brain injury and post-traumatic stress symptoms are both characterized by dysfunctional brain networks, with the amygdala specifically implicated as a region with both structural and functional abnormalities. METHODS This study examined the structural volumetrics and resting state functional connectivity of 68 Active Duty Service Members with or without chronic mild TBI (mTBI) and comorbid symptoms of Post-Traumatic Stress (PTS). RESULTS AND DISCUSSION Structural analysis of the amygdala revealed no significant differences in volume between mTBI and healthy comparison participants with and without post-traumatic stress symptoms. Resting state functional connectivity with bilateral amygdala revealed decreased anterior network connectivity and increased posterior network connectivity in the mTBI group compared to the healthy comparison group. Within the mTBI group, there were significant regions of correlation with amygdala that were modulated by PTS severity, including networks implicated in emotional processing and executive functioning. An examination of a priori regions of amygdala connectivity in the default mode network, task positive network, and subcortical structures showed interacting influences of TBI and PTS, only between right amygdala and right putamen. These results suggest that mTBI and PTS are associated with hypo-frontal and hyper-posterior amygdala connectivity. Additionally, comorbidity of these conditions appears to compound these neural activity patterns. PTS in mTBI may change neural resource recruitment for information processing between the amygdala and other brain regions and networks, not only during emotional processing, but also at rest.
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Affiliation(s)
- Sarah I. Gimbel
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Traumatic Brain Injury Clinic, Naval Medical Center San Diego, San Diego, CA, United States
- General Dynamics Information Technology, Falls Church, VA, United States
| | - Cailynn C. Wang
- Department of Psychology, University of California, San Diego, San Diego, CA, United States
| | - Lars Hungerford
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Traumatic Brain Injury Clinic, Naval Medical Center San Diego, San Diego, CA, United States
- General Dynamics Information Technology, Falls Church, VA, United States
| | - Elizabeth W. Twamley
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Mark L. Ettenhofer
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Traumatic Brain Injury Clinic, Naval Medical Center San Diego, San Diego, CA, United States
- General Dynamics Information Technology, Falls Church, VA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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3
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Obenaus A, Rodriguez-Grande B, Lee JB, Dubois CJ, Fournier ML, Cador M, Caille S, Badaut J. A single mild juvenile TBI in male mice leads to regional brain tissue abnormalities at 12 months of age that correlate with cognitive impairment at the middle age. Acta Neuropathol Commun 2023; 11:32. [PMID: 36859364 PMCID: PMC9976423 DOI: 10.1186/s40478-023-01515-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 01/12/2023] [Indexed: 03/03/2023] Open
Abstract
Traumatic brain injury (TBI) has the highest incidence amongst the pediatric population and its mild severity represents the most frequent cases. Moderate and severe injuries as well as repetitive mild TBI result in lasting morbidity. However, whether a single mild TBI sustained during childhood can produce long-lasting modifications within the brain is still debated. We aimed to assess the consequences of a single juvenile mild TBI (jmTBI) at 12 months post-injury in a mouse model. Non-invasive diffusion tensor imaging (DTI) revealed significant microstructural alterations in the hippocampus and the in the substantia innominata/nucleus basalis (SI/NB), structures known to be involved in spatial learning and memory. DTI changes paralled neuronal loss, increased astrocytic AQP4 and microglial activation in the hippocampus. In contrast, decreased astrocytic AQP4 expression and microglia activation were observed in SI/NB. Spatial learning and memory were impaired and correlated with alterations in DTI-derived derived fractional ansiotropy (FA) and axial diffusivity (AD). This study found that a single juvenile mild TBI leads to significant region-specific DTI microstructural alterations, distant from the site of impact, that correlated with cognitive discriminative novel object testing and spatial memory impairments at 12 months after a single concussive injury. Our findings suggest that exposure to jmTBI leads to a chronic abnormality, which confirms the need for continued monitoring of symptoms and the development of long-term treatment strategies to intervene in children with concussions.
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Affiliation(s)
- Andre Obenaus
- Department of Pediatrics, University of California, Irvine, CA, USA
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | | | - Jeong Bin Lee
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Christophe J Dubois
- CNRS UMR 5536 RMSB, University of Bordeaux, 146 Rue Léo Saignat, 33076, Bordeaux Cedex, France
| | | | - Martine Cador
- CNRS, EPHE, INCIA UMR5287, University of Bordeaux, F33000, Bordeaux, France
| | - Stéphanie Caille
- CNRS, EPHE, INCIA UMR5287, University of Bordeaux, F33000, Bordeaux, France
| | - Jerome Badaut
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
- CNRS, EPHE, INCIA UMR5287, University of Bordeaux, F33000, Bordeaux, France.
- CNRS UMR 5536 RMSB, University of Bordeaux, 146 Rue Léo Saignat, 33076, Bordeaux Cedex, France.
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4
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Volumetric MRI Findings in Mild Traumatic Brain Injury (mTBI) and Neuropsychological Outcome. Neuropsychol Rev 2023; 33:5-41. [PMID: 33656702 DOI: 10.1007/s11065-020-09474-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
Region of interest (ROI) volumetric assessment has become a standard technique in quantitative neuroimaging. ROI volume is thought to represent a coarse proxy for making inferences about the structural integrity of a brain region when compared to normative values representative of a healthy sample, adjusted for age and various demographic factors. This review focuses on structural volumetric analyses that have been performed in the study of neuropathological effects from mild traumatic brain injury (mTBI) in relation to neuropsychological outcome. From a ROI perspective, the probable candidate structures that are most likely affected in mTBI represent the target regions covered in this review. These include the corpus callosum, cingulate, thalamus, pituitary-hypothalamic area, basal ganglia, amygdala, and hippocampus and associated structures including the fornix and mammillary bodies, as well as whole brain and cerebral cortex along with the cerebellum. Ventricular volumetrics are also reviewed as an indirect assessment of parenchymal change in response to injury. This review demonstrates the potential role and limitations of examining structural changes in the ROIs mentioned above in relation to neuropsychological outcome. There is also discussion and review of the role that post-traumatic stress disorder (PTSD) may play in structural outcome in mTBI. As emphasized in the conclusions, structural volumetric findings in mTBI are likely just a single facet of what should be a multimodality approach to image analysis in mTBI, with an emphasis on how the injury damages or disrupts neural network integrity. The review provides an historical context to quantitative neuroimaging in neuropsychology along with commentary about future directions for volumetric neuroimaging research in mTBI.
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Lopez DA, Christensen ZP, Foxe JJ, Ziemer LR, Nicklas PR, Freedman EG. Association between mild traumatic brain injury, brain structure, and mental health outcomes in the Adolescent Brain Cognitive Development Study. Neuroimage 2022; 263:119626. [PMID: 36103956 DOI: 10.1016/j.neuroimage.2022.119626] [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: 06/01/2022] [Revised: 07/20/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Children that experience a mild traumatic brain injury (mTBI) are at an increased risk of neural alterations that can deteriorate mental health. We test the hypothesis that mTBI is associated with psychopathology and that structural brain metrics (e.g., volume, area) meaningfully mediate the relation in an adolescent population. METHODS We analyzed behavioral and brain MRI data from 11,876 children who participated in the Adolescent Brain Cognitive Development (ABCD) Study. Mixed-effects models were used to examine the longitudinal association between mTBI and mental health outcomes. Bayesian methods were used to investigate brain regions that are intermediate between mTBI and symptoms of poor mental health. RESULTS There were 199 children with mTBI and 527 with possible mTBI across the three ABCD Study visits. There was a 7% (IRR = 1.07, 95% CI: 1.01, 1.13) and 15% (IRR = 1.16, 95% CI: 1.05, 1.26) increased risk of emotional or behavioral problems in children that experienced possible mTBI or mTBI, respectively. Possible mTBI was associated with a 17% (IRR: 1.17, 95% CI: 0.99, 1.40) increased risk of experiencing distress following a psychotic-like experience. We did not find any brain regions that meaningfully mediated the relationship between mTBI and mental health outcomes. Analysis of volumetric measures found that approximately 2% to 5% of the total effect of mTBI on mental health outcomes operated through total cortical volume. Image intensity measure analyses determined that approximately 2% to 5% of the total effect was mediated through the left-hemisphere of the dorsolateral prefrontal cortex. CONCLUSION Results indicate an increased risk of emotional and behavioral problems in children that experienced possible mTBI or mTBI. Mediation analyses did not elucidate the mechanisms underlying the association between mTBI and mental health outcomes.
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Affiliation(s)
- Daniel A Lopez
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA; Department of Public Health Sciences, Division of Epidemiology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Zachary P Christensen
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - John J Foxe
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Laura R Ziemer
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Paige R Nicklas
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Edward G Freedman
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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6
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Arneson D, Zhang G, Ahn IS, Ying Z, Diamante G, Cely I, Palafox-Sanchez V, Gomez-Pinilla F, Yang X. Systems spatiotemporal dynamics of traumatic brain injury at single-cell resolution reveals humanin as a therapeutic target. Cell Mol Life Sci 2022; 79:480. [PMID: 35951114 PMCID: PMC9372016 DOI: 10.1007/s00018-022-04495-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/10/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The etiology of mild traumatic brain injury (mTBI) remains elusive due to the tissue and cellular heterogeneity of the affected brain regions that underlie cognitive impairments and subsequent neurological disorders. This complexity is further exacerbated by disrupted circuits within and between cell populations across brain regions and the periphery, which occur at different timescales and in spatial domains. METHODS We profiled three tissues (hippocampus, frontal cortex, and blood leukocytes) at the acute (24-h) and subacute (7-day) phases of mTBI at single-cell resolution. RESULTS We demonstrated that the coordinated gene expression patterns across cell types were disrupted and re-organized by TBI at different timescales with distinct regional and cellular patterns. Gene expression-based network modeling implied astrocytes as a key regulator of the cell-cell coordination following mTBI in both hippocampus and frontal cortex across timepoints, and mt-Rnr2, which encodes the mitochondrial peptide humanin, as a potential target for intervention based on its broad regional and dynamic dysregulation following mTBI. Treatment of a murine mTBI model with humanin reversed cognitive impairment caused by mTBI through the restoration of metabolic pathways within astrocytes. CONCLUSIONS Our results offer a systems-level understanding of the dynamic and spatial regulation of gene programs by mTBI and pinpoint key target genes, pathways, and cell circuits that are amenable to therapeutics.
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Affiliation(s)
- Douglas Arneson
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Guanglin Zhang
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - In Sook Ahn
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Zhe Ying
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Graciel Diamante
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Ingrid Cely
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Victoria Palafox-Sanchez
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Fernando Gomez-Pinilla
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Brain Injury Research Center, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Xia Yang
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Institute for Quantitative and Computational Biosciences, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095 USA
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7
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Braga MFM, Juranek J, Eiden LE, Li Z, Figueiredo TH, de Araujo Furtado M, Marini AM. GABAergic circuits of the basolateral amygdala and generation of anxiety after traumatic brain injury. Amino Acids 2022; 54:1229-1249. [PMID: 35798984 DOI: 10.1007/s00726-022-03184-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Traumatic brain injury (TBI) has reached epidemic proportions around the world and is a major public health concern in the United States. Approximately 2.8 million individuals sustain a traumatic brain injury and are treated in an Emergency Department yearly in the U.S., and about 50,000 of them die. Persistent symptoms develop in 10-15% of the cases including neuropsychiatric disorders. Anxiety is the second most common neuropsychiatric disorder that develops in those with persistent neuropsychiatric symptoms after TBI. Abnormalities or atrophy in the temporal lobe has been shown in the overwhelming number of TBI cases. The basolateral amygdala (BLA), a temporal lobe structure that consolidates, stores and generates fear and anxiety-based behavioral outputs, is a critical brain region in the anxiety circuitry. In this review, we sought to capture studies that characterized the relationship between human post-traumatic anxiety and structural/functional alterations in the amygdala. We compared the human findings with results obtained with a reproducible mild TBI animal model that demonstrated a direct relationship between the alterations in the BLA and an anxiety-like phenotype. From this analysis, both preliminary insights, and gaps in knowledge, have emerged which may open new directions for the development of rational and more efficacious treatments.
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Affiliation(s)
- Maria F M Braga
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Jenifer Juranek
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, 77030, USA
| | - Lee E Eiden
- Section On Molecular Neuroscience, National Institute of Mental Health, Intramural Research Program, Bethesda, MD, 20814, USA
| | - Zheng Li
- Section On Synapse Development and Plasticity, National Institute of Mental Health, Intramural Research Program, Bethesda, MD, 20814, USA
| | - Taiza H Figueiredo
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marcio de Araujo Furtado
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Ann M Marini
- Department of Neurology and Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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8
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Sihag S, Naze S, Taghdiri F, Gumus M, Tator C, Green R, Colella B, Blennow K, Zetterberg H, Dominguez LG, Wennberg R, Mikulis DJ, Tartaglia MC, Kozloski JR. Functional brain activity constrained by structural connectivity reveals cohort-specific features for serum neurofilament light chain. COMMUNICATIONS MEDICINE 2022; 2:8. [PMID: 35603281 PMCID: PMC9053240 DOI: 10.1038/s43856-021-00065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background Neuro-axonal brain damage releases neurofilament light chain (NfL) proteins, which enter the blood. Serum NfL has recently emerged as a promising biomarker for grading axonal damage, monitoring treatment responses, and prognosis in neurological diseases. Importantly, serum NfL levels also increase with aging, and the interpretation of serum NfL levels in neurological diseases is incomplete due to lack of a reliable model for age-related variation in serum NfL levels in healthy subjects. Methods Graph signal processing (GSP) provides analytical tools, such as graph Fourier transform (GFT), to produce measures from functional dynamics of brain activity constrained by white matter anatomy. Here, we leveraged a set of features using GFT that quantified the coupling between blood oxygen level dependent signals and structural connectome to investigate their associations with serum NfL levels collected from healthy subjects and former athletes with history of concussions. Results Here we show that GSP feature from isthmus cingulate in the right hemisphere (r-iCg) is strongly linked with serum NfL in healthy controls. In contrast, GSP features from temporal lobe and lingual areas in the left hemisphere and posterior cingulate in the right hemisphere are the most associated with serum NfL in former athletes. Additional analysis reveals that the GSP feature from r-iCg is associated with behavioral and structural measures that predict aggressive behavior in healthy controls and former athletes. Conclusions Our results suggest that GSP-derived brain features may be included in models of baseline variance when evaluating NfL as a biomarker of neurological diseases and studying their impact on personality traits. Neurofilament light chain (NfL) is a marker released into the blood as a result of central nervous system damage or neurodegeneration. However, we know little about how NfL levels relate to brain structure and activity. Here, we use imaging data and advanced statistical methods to look at the relationship between brain activity and structure in healthy people and former athletes with a history of multiple concussions, and determine whether these can predict NfL levels in the blood. We find the relationship between brain activity and structure and NfL levels is different between the two groups. Our findings help us to understand how brain injury might impact NfL levels and their relationship with brain activity, and could guide how NfL and imaging data are used as tools in research and in the clinic. Sihag et al. analyse brain imaging data, circulating neurofilament light chain levels and personality scores in a cohort of former athletes with a history of concussions. The authors use graph signal processing to identify brain structural and connectivity features associated with neurofilament levels and with aggressive behaviour.
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9
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Tuerk C, Dégeilh F, Catroppa C, Anderson V, Beauchamp MH. Pediatric Moderate-Severe Traumatic Brain Injury and Gray Matter Structural Covariance Networks: A Preliminary Longitudinal Investigation. Dev Neurosci 2021; 43:335-347. [PMID: 34515088 DOI: 10.1159/000518752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/23/2021] [Indexed: 11/19/2022] Open
Abstract
Pediatric traumatic brain injury (TBI) is prevalent and can disrupt ongoing brain maturation. However, the long-term consequences of pediatric TBI on the brain's network architecture are poorly understood. Structural covariance networks (SCN), based on anatomical correlations between brain regions, may provide important insights into brain topology following TBI. Changes in global SCN (default-mode network [DMN], central executive network [CEN], and salience network [SN]) were compared sub-acutely (<90 days) and in the long-term (approximately 12-24 months) after pediatric moderate-severe TBI (n = 16), and compared to typically developing children assessed concurrently (n = 15). Gray matter (GM) volumes from selected seeds (DMN: right angular gyrus [rAG], CEN: right dorsolateral prefrontal cortex [rDLPFC], SN: right anterior insula) were extracted from T1-weighted images at both timepoints. No group differences were found sub-acutely; at the second timepoint, the TBI group showed significantly reduced structural covariance within the DMN seeded from the rAG and the (1) right middle frontal gyrus, (2) left superior frontal gyrus, and (3) left fusiform gyrus. Reduced structural covariance was also found within the CEN, that is, between the rDLPFC and the (1) calcarine sulcus, and (2) right occipital gyrus. In addition, injury severity was positively associated with GM volumes in the identified CEN regions. Over time, there were no significant changes in SCN in either group. The findings, albeit preliminary, suggest for the first time a long-term effect of pediatric TBI on SCN. SCN may be a complementary approach to characterize the global effect of TBI on the developing brain. Future work needs to further examine how disruptions of these networks relate to behavioral and cognitive difficulties.
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Affiliation(s)
- Carola Tuerk
- Department of Psychology, University of Montreal, Montreal, Québec, Canada,
| | - Fanny Dégeilh
- Department of Psychology, University of Montreal, Montreal, Québec, Canada.,Sainte-Justine Hospital Research Center, Montreal, Québec, Canada
| | - Cathy Catroppa
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Québec, Canada.,Sainte-Justine Hospital Research Center, Montreal, Québec, Canada
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Ferrazzano P, Yeske B, Mumford J, Kirk G, Bigler ED, Bowen K, O'Brien N, Rosario B, Beers SR, Rathouz P, Bell MJ, Alexander AL. Brain Magnetic Resonance Imaging Volumetric Measures of Functional Outcome after Severe Traumatic Brain Injury in Adolescents. J Neurotrauma 2021; 38:1799-1808. [PMID: 33487126 PMCID: PMC8219192 DOI: 10.1089/neu.2019.6918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Adolescent traumatic brain injury (TBI) is a major public health concern, resulting in >35,000 hospitalizations in the United States each year. Although neuroimaging is a primary diagnostic tool in the clinical assessment of TBI, our understanding of how specific neuroimaging findings relate to outcome remains limited. Our study aims to identify imaging biomarkers of long-term neurocognitive outcome after severe adolescent TBI. Twenty-four adolescents with severe TBI (Glasgow Coma Scale ≤8) enrolled in the ADAPT (Approaches and Decisions after Pediatric TBI) study were recruited for magnetic resonance imaging (MRI) scanning 1-2 years post-injury at 13 participating sites. Subjects underwent outcome assessments ∼1-year post-injury, including the Wechsler Abbreviated Scale of Intelligence (IQ) and the Pediatric Glasgow Outcome Scale-Extended (GOSE-Peds). A typically developing control cohort of 38 age-matched adolescents also underwent scanning and neurocognitive assessment. Brain-image segmentation was performed on T1-weighted images using Freesurfer. Brain and ventricular cerebrospinal fluid volumes were used to compute a ventricle-to-brain ratio (VBR) for each subject, and the corpus callosum cross-sectional area was determined in the midline for each subject. The TBI group demonstrated higher VBR and lower corpus callosum area compared to the control cohort. After adjusting for age and sex, VBR was significantly related with GOSE-Peds score in the TBI group (n = 24, p = 0.01, cumulative odds ratio = 2.18). After adjusting for age, sex, intracranial volume, and brain volume, corpus callosum cross-sectional area correlated significantly with IQ score in the TBI group (partial cor = 0.68, n = 18, p = 0.007) and with PSI (partial cor = 0.33, p = 0.02). No association was found between VBR and IQ or between corpus callosum and GOSE-Peds. After severe adolescent TBI, quantitative MRI measures of VBR and corpus callosum cross-sectional area are associated with global functional outcome and neurocognitive outcomes, respectively.
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Affiliation(s)
- Peter Ferrazzano
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
- Department of Pediatrics, University of Wisconsin, Madison, Wisconsin, USA
| | - Benjamin Yeske
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
| | - Jeanette Mumford
- Center for Healthy Minds, University of Wisconsin, Madison, Wisconsin, USA
| | - Gregory Kirk
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
| | - Erin D. Bigler
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | | | - Nicole O'Brien
- Department of Pediatrics, Division of Critical Care Medicine Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Bedda Rosario
- Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sue R. Beers
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul Rathouz
- Department of Population Health, University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Michael J. Bell
- Department of Pediatrics, Children's National Medical Center, Washington, DC, USA
| | - Andrew L. Alexander
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
- Waisman Center Brain Imaging Laboratory, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
- Department of Psychiatry, University of Wisconsin, Madison, Wisconsin, USA
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11
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Urban K, Schudlo L, Keightley M, Alain S, Reed N, Chau T. Altered Brain Activation in Youth following Concussion: Using a Dual-task Paradigm. Dev Neurorehabil 2021; 24:187-198. [PMID: 33012188 DOI: 10.1080/17518423.2020.1825539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A concussion is known as a functional injury affecting brain communication, integration, and processing. There is a need to objectively measure how concussions disrupt brain activation while completing ecologically relevant tasks.The objective of this study was to compare brain activation patterns between concussion and comparison groups (non-concussed youth) during a cognitive-motor single and dual-task paradigm utilizing functional near-infrared spectroscopy (fNIRS) in regions of the frontal-parietal attention network and compared to task performance.Youth with concussion generally exhibited hyperactivation and recruitment of additional brain regions in the dorsal lateral prefrontal (DLPFC), superior (SPC) and inferior parietal cortices (IPC), which are associated with processing, information integration, and response selection. Additionally, hyper- or hypo-activation patterns were associated with slower processing speed on the cognitive task. Our findings corroborate the growing literature suggesting that neural recovery may be delayed compared to the restoration of behavioral performance post-concussion.Concussion, near-infrared spectroscopy, dual-task paradigm, cognitive, motor, brain activation.
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Affiliation(s)
- Karolina Urban
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Science Institute, University of Toronto, Toronto, Canada
| | - Larissa Schudlo
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.,Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, Canada
| | | | - Sam Alain
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Science Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Tom Chau
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
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12
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Dennis EL, Caeyenberghs K, Asarnow RF, Babikian T, Bartnik-Olson B, Bigler ED, Figaji A, Giza CC, Goodrich-Hunsaker NJ, Hodges CB, Hoskinson KR, Königs M, Levin HS, Lindsey HM, Livny A, Max JE, Merkley TL, Newsome MR, Olsen A, Ryan NP, Spruiell MS, Suskauer SJ, Thomopoulos SI, Ware AL, Watson CG, Wheeler AL, Yeates KO, Zielinski BA, Thompson PM, Tate DF, Wilde EA. Challenges and opportunities for neuroimaging in young patients with traumatic brain injury: a coordinated effort towards advancing discovery from the ENIGMA pediatric moderate/severe TBI group. Brain Imaging Behav 2021; 15:555-575. [PMID: 32734437 PMCID: PMC7855317 DOI: 10.1007/s11682-020-00363-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Traumatic brain injury (TBI) is a major cause of death and disability in children in both developed and developing nations. Children and adolescents suffer from TBI at a higher rate than the general population, and specific developmental issues require a unique context since findings from adult research do not necessarily directly translate to children. Findings in pediatric cohorts tend to lag behind those in adult samples. This may be due, in part, both to the smaller number of investigators engaged in research with this population and may also be related to changes in safety laws and clinical practice that have altered length of hospital stays, treatment, and access to this population. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric Moderate/Severe TBI (msTBI) group aims to advance research in this area through global collaborative meta-analysis of neuroimaging data. In this paper, we discuss important challenges in pediatric TBI research and opportunities that we believe the ENIGMA Pediatric msTBI group can provide to address them. With the paucity of research studies examining neuroimaging biomarkers in pediatric patients with TBI and the challenges of recruiting large numbers of participants, collaborating to improve statistical power and to address technical challenges like lesions will significantly advance the field. We conclude with recommendations for future research in this field of study.
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Affiliation(s)
- Emily L Dennis
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA.
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Boston, MA, USA.
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Robert F Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Brain Research Institute, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Brenda Bartnik-Olson
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Erin D Bigler
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Anthony Figaji
- Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Christopher C Giza
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Naomi J Goodrich-Hunsaker
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Cooper B Hodges
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Marsh Königs
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Amsterdam, The Netherlands
| | - Harvey S Levin
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Hannah M Lindsey
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Abigail Livny
- Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Tel-Hashomer, Israel
- Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Tel-Hashomer, Israel
| | - Jeffrey E Max
- Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA
- Department of Psychiatry, Rady Children's Hospital, San Diego, CA, USA
| | - Tricia L Merkley
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Mary R Newsome
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Nicholas P Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Matthew S Spruiell
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Stacy J Suskauer
- Kennedy Krieger Institute, Baltimore, MD, USA
- Departments of Physical Medicine & Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
| | - Ashley L Ware
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Christopher G Watson
- Department of Pediatrics, Children's Learning Institute, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Anne L Wheeler
- Hospital for Sick Children, Neuroscience and Mental Health Program, Toronto, Canada
- Physiology Department, University of Toronto, Toronto, Canada
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Brandon A Zielinski
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, USA
| | - David F Tate
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
- Missouri Institute of Mental Health and University of Missouri, St Louis, MO, USA
| | - Elisabeth A Wilde
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
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13
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King DJ, Seri S, Beare R, Catroppa C, Anderson VA, Wood AG. Developmental divergence of structural brain networks as an indicator of future cognitive impairments in childhood brain injury: Executive functions. Dev Cogn Neurosci 2020; 42:100762. [PMID: 32072940 PMCID: PMC6996014 DOI: 10.1016/j.dcn.2020.100762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/01/2019] [Accepted: 01/19/2020] [Indexed: 11/29/2022] Open
Abstract
Brain insults during childhood can perturb the already non-linear trajectory of typical brain maturation. The diffuse effects of injury can be modelled using structural covariance networks (SCN), which change as a function of neurodevelopment. However, SCNs are estimated at the group-level, limiting applicability to predicting individual-subject outcomes. This study aimed to measure the divergence of the brain networks in paediatric traumatic brain injury (pTBI) patients and controls, and investigate relationships with executive functioning (EF) at 24 months post-injury. T1-weighted MRI acquired acutely in 78 child survivors of pTBI and 33 controls underwent 3D-tissue segmentation to estimate cortical thickness (CT) across 68 atlas-based regions-of-interest (ROIs). Using an 'add-one-patient' approach, we estimate a developmental divergence index (DDI). Our approach adopts a novel analytic framework in which age-appropriate reference networks to calculate the DDI were generated from control participants from the ABIDE dataset using a sliding-window approach. Divergence from the age-appropriate SCN was related to reduced EF performance and an increase in behaviours related to executive dysfunctions. The DDI measure showed predictive value with regard to executive functions, highlighting that early imaging can assist in prognosis for cognition.
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Affiliation(s)
- Daniel J King
- School of Life and Health Sciences & Aston Neuroscience Institute, Aston University, Birmingham, B4 7ET, UK; Department of Clinical Neurophysiology, Birmingham Women's and Children's Hospital NHS Foundation Trust, UK
| | - Stefano Seri
- School of Life and Health Sciences & Aston Neuroscience Institute, Aston University, Birmingham, B4 7ET, UK; Department of Clinical Neurophysiology, Birmingham Women's and Children's Hospital NHS Foundation Trust, UK
| | - Richard Beare
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Monash University, Melbourne, Australia
| | - Cathy Catroppa
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Psychology, Royal Children's Hospital, Melbourne, Australia
| | - Vicki A Anderson
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Psychology, Royal Children's Hospital, Melbourne, Australia
| | - Amanda G Wood
- School of Life and Health Sciences & Aston Neuroscience Institute, Aston University, Birmingham, B4 7ET, UK; Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; School of Psychology, Faculty of Health, Melbourne Burwood Campus, Deakin University, Geelong, Victoria, Australia.
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14
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Poudel GR, Dominguez D JF, Verhelst H, Vander Linden C, Deblaere K, Jones DK, Cerin E, Vingerhoets G, Caeyenberghs K. Network diffusion modeling predicts neurodegeneration in traumatic brain injury. Ann Clin Transl Neurol 2020; 7:270-279. [PMID: 32105414 PMCID: PMC7086000 DOI: 10.1002/acn3.50984] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/10/2019] [Indexed: 02/03/2023] Open
Abstract
Objective Traumatic brain injury (TBI) is a heterogeneous disease with multiple neurological deficits that evolve over time. It is also associated with an increased incidence of neurodegenerative diseases. Accordingly, clinicians need better tools to predict a patient’s long‐term prognosis. Methods Diffusion‐weighted and anatomical MRI data were collected from 17 adolescents (mean age = 15y8mo) with moderate‐to‐severe TBI and 19 healthy controls. Using a network diffusion model (NDM), we examined the effect of progressive deafferentation and gray matter thinning in young TBI patients. Moreover, using a novel automated inference method, we identified several injury epicenters in order to determine the neural degenerative patterns in each TBI patient. Results We were able to identify the subject‐specific patterns of degeneration in each patient. In particular, the hippocampus, temporal cortices, and striatum were frequently found to be the epicenters of degeneration across the TBI patients. Orthogonal transformation of the predicted degeneration, using principal component analysis, identified distinct spatial components in the temporal–hippocampal network and the cortico‐striatal network, confirming the vulnerability of these networks to injury. The NDM model, best predictive of the degeneration, was significantly correlated with time since injury, indicating that NDM can potentially capture the pathological progression in the chronic phase of TBI. Interpretation These findings suggest that network spread may help explain patterns of distant gray matter thinning, which would be consistent with Wallerian degeneration of the white matter connections (i.e., “diaschisis”) from diffuse axonal injuries and multifocal contusive injuries, and the neurodegenerative patterns of abnormal protein aggregation and transmission, which are hallmarks of brain changes in TBI. NDM approaches could provide highly subject‐specific biomarkers relevant for disease monitoring and personalized therapies in TBI.
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Affiliation(s)
- Govinda R Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Juan F Dominguez D
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Helena Verhelst
- Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Oost-Vlaanderen, Belgium
| | | | - Karel Deblaere
- Department of Neuroradiology, Ghent University Hospital, Ghent, Oost-Vlaanderen, Belgium
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Guy Vingerhoets
- Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Oost-Vlaanderen, Belgium
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC, Australia
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15
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Shen J, Johnson S, Chen C, Xiang H. Virtual Reality for Pediatric Traumatic Brain Injury Rehabilitation: A Systematic Review. Am J Lifestyle Med 2020; 14:6-15. [PMID: 31903073 PMCID: PMC6933564 DOI: 10.1177/1559827618756588] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective. Pediatric traumatic brain injury (TBI) is associated with physical and psychobehavioral impairment in children. Effective rehabilitation programs postinjury are critical for children with TBI. Virtual reality (VR) has been increasingly adopted for brain injury rehabilitation. However, scientific synthesis is lacking in evaluating its effectiveness in pediatric TBI rehabilitation. This article aimed to conduct a systematic review on the effectiveness of VR-based pediatric TBI rehabilitation. Methods. A systematic literature search was conducted in PubMed, PsycInfo, SCOPUS, CENTRAL, BioMed Central, CiNAHL, and Web of Science through November 2015. Personal libraries and relevant references supplemented the search. Two authors independently reviewed the abstracts and/or full text of 5824 articles. Data extraction and qualitative synthesis was conducted along with quantitative assessment of research quality by 2 authors. Results. A positive impact was found for VR-based interventions on children's physical rehabilitation post-TBI. The quality of research evidence was moderate, which largely suffered from small samples, lack of immersive VR experience, and lack of focus on socioemotional outcomes post-TBI. Conclusions. The present review identified positive effects of VR interventions for pediatric TBI rehabilitation especially in physical outcomes. Future research should include larger samples and broader post-TBI outcomes in children using VR-based interventions.
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Affiliation(s)
- Jiabin Shen
- Jiabin Shen, PhD, Research Institute at
Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205;
e-mail:
| | - Sarah Johnson
- Center for Pediatric Trauma Research (JS, SJ, CC,
HX)
- Center for Injury Research and Policy (JS, SJ, CC,
HX)
- The Research Institute at Nationwide Children’s
Hospital, Columbus, Ohio; The Ohio State University College of Medicine,
Columbus, Ohio (JS, HX)
| | - Cheng Chen
- Center for Pediatric Trauma Research (JS, SJ, CC,
HX)
- Center for Injury Research and Policy (JS, SJ, CC,
HX)
- The Research Institute at Nationwide Children’s
Hospital, Columbus, Ohio; The Ohio State University College of Medicine,
Columbus, Ohio (JS, HX)
| | - Henry Xiang
- Center for Pediatric Trauma Research (JS, SJ, CC,
HX)
- Center for Injury Research and Policy (JS, SJ, CC,
HX)
- The Research Institute at Nationwide Children’s
Hospital, Columbus, Ohio; The Ohio State University College of Medicine,
Columbus, Ohio (JS, HX)
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16
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Dinet V, Petry KG, Badaut J. Brain-Immune Interactions and Neuroinflammation After Traumatic Brain Injury. Front Neurosci 2019; 13:1178. [PMID: 31780883 PMCID: PMC6861304 DOI: 10.3389/fnins.2019.01178] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/18/2019] [Indexed: 01/04/2023] Open
Abstract
Traumatic brain injury (TBI) is the principal cause of death and disability in children and young adults. Clinical and preclinical research efforts have been carried out to understand the acute, life-threatening pathophysiological events happening after TBI. In the past few years, however, it was recognized that TBI causes significant morbidity weeks, months, or years after the initial injury, thereby contributing substantially to the overall burden of TBI and the decrease of life expectancy in these patients. Long-lasting sequels of TBI include cognitive decline/dementia, sensory-motor dysfunction, and psychiatric disorders, and most important for patients is the need for socio-economic rehabilitation affecting their quality of life. Cerebrovascular alterations have been described during the first week after TBI for direct consequence development of neuroinflammatory process in relation to brain edema. Within the brain-immune interactions, the complement system, which is a family of blood and cell surface proteins, participates in the pathophysiology process. In fact, the complement system is part of the primary defense and clearance component of innate and adaptive immune response. In this review, the complement activation after TBI will be described in relation to the activation of the microglia and astrocytes as well as the blood-brain barrier dysfunction during the first week after the injury. Considering the neuroinflammatory activity as a causal element of neurological handicaps, some major parallel lines of complement activity in multiple sclerosis and Alzheimer pathologies with regard to cognitive impairment will be discussed for chronic TBI. A better understanding of the role of complement activation could facilitate the development of new therapeutic approaches for TBI.
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Affiliation(s)
- Virginie Dinet
- INSERM U1029, Angiogenesis and Neuroinflammation Group, University of Bordeaux, Bordeaux, France
| | - Klaus G. Petry
- INSERM U1029, Angiogenesis and Neuroinflammation Group, University of Bordeaux, Bordeaux, France
| | - Jerome Badaut
- CNRS UMR 5287, INCIA, Brain molecular Imaging Team, University of Bordeaux, Bordeaux, France
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, United States
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17
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Pan PJ, Ullman HE, Mathern GW, Salamon N. Physical Growth of the Contralateral Cerebrum is Preserved After Hemispherotomy in Childhood. Pediatr Neurol 2019; 96:48-52. [PMID: 30928301 DOI: 10.1016/j.pediatrneurol.2019.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hemispherotomy can be an effective treatment for refractory childhood epilepsy. However, the extent of postoperative brain development after hemispherotomy remains incompletely understood. This study aims to provide an anatomic foundation in assessing development of the contralateral hemisphere, by measuring volumetric growth after hemispherotomy. METHODS Eleven patients with hemimegalencephaly, Rasmussen's encephalitis, and cerebral infarction who underwent hemispherotomy before age 12 years, an immediate preoperative magnetic resonance imaging, and at least three years of follow-up magnetic resonance imagings were retrospectively analyzed. The volume of the contralateral hemisphere was measured before and after surgery. Growth curves were compared with those of healthy individuals from an open database. The growth rate relative to the healthy individuals ("catch-up rate") was calculated. RESULTS A positive volumetric growth of the contralateral hemisphere was observed across all pathologies. The hemimegalencephaly subgroup underwent hemispherotomy at the earliest time and had the largest postoperative growth rate, which exceeded that of healthy individuals. The Rasmussen subgroup underwent surgery at the second earliest time and had an intermediate growth rate, which was similar to that of healthy individuals. The infarction subgroup underwent surgery at the latest time and had the slowest growth rate, which was less than that of healthy individuals. CONCLUSIONS The contralateral hemisphere continues to increase in volume after hemispherotomy in childhood. Further studies with a larger sample size and correlation with cognitive outcomes may aid in characterizing the prognosis after hemispherotomy.
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Affiliation(s)
- Patrick J Pan
- Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Henrik E Ullman
- Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Gary W Mathern
- Department of Neurosurgery, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Noriko Salamon
- Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California.
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18
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King DJ, Ellis KR, Seri S, Wood AG. A systematic review of cross-sectional differences and longitudinal changes to the morphometry of the brain following paediatric traumatic brain injury. Neuroimage Clin 2019; 23:101844. [PMID: 31075554 PMCID: PMC6510969 DOI: 10.1016/j.nicl.2019.101844] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 01/27/2023]
Abstract
Paediatric traumatic brain injury (pTBI) is a leading cause of disability for children and young adults. Children are a uniquely vulnerable group with the disease process that occurs following a pTBI interacting with the trajectory of normal brain development. Quantitative MRI post-injury has suggested a long-term, neurodegenerative effect of TBI on the morphometry of the brain, in both adult and childhood TBI. Changes to the brain beyond that of anticipated, age-dependant differences may allow us to estimate the state of the brain post-injury and produce clinically relevant predictions for long-term outcome. The current review synthesises the existing literature to assess whether, following pTBI, the morphology of the brain exhibits either i) longitudinal change and/or ii) differences compared to healthy controls and outcomes. The current literature suggests that morphometric differences from controls are apparent cross-sectionally at both acute and late-chronic timepoints post-injury, thus suggesting a non-transient effect of injury. Developmental trajectories of morphometry are altered in TBI groups compared to patients, and it is unlikely that typical maturation overcomes damage post-injury, or even 'catches up' with that of typically-developing peers. However, there is limited evidence for diverted developmental trajectories being associated with cognitive impairment post-injury. The current review also highlights the apparent challenges to the existing literature and potential methods by which these can be addressed.
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Affiliation(s)
- D J King
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK
| | - K R Ellis
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK
| | - S Seri
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK
| | - A G Wood
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK; Child Neuropsychology, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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Parent M, Li Y, Santhakumar V, Hyder F, Sanganahalli BG, Kannurpatti SS. Alterations of Parenchymal Microstructure, Neuronal Connectivity, and Cerebrovascular Resistance at Adolescence after Mild-to-Moderate Traumatic Brain Injury in Early Development. J Neurotrauma 2019; 36:601-608. [PMID: 29855211 PMCID: PMC6354598 DOI: 10.1089/neu.2018.5741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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) is a leading cause of morbidity in children. To investigate outcome of early developmental TBI during adolescence, a rat model of fluid percussion injury was developed, where previous work reported deficits in sensorimotor behavior and cortical blood flow at adolescence.1 Based on the nonlocalized outcome, we hypothesized that multiple neurophysiological components of brain function, namely neuronal connectivity, synapse/axonal microstructural integrity, and neurovascular function, are altered and magnetic resonance imaging (MRI) methods could be used to determine regional alterations. Adolescent outcomes of developmental TBI were studied 2 months after injury, using functional MRI (fMRI) and diffusion tensor imaging (DTI). fMRI-based resting-state functional connectivity (RSFC), representing neural connectivity, was significantly altered between sham and TBI. RSFC strength decreased in the cortex, hippocampus, and thalamus, accompanied by decrease in spatial extent of their corresponding RSFC networks and interhemispheric asymmetry. Cerebrovascular reactivity to arterial CO2 changes diminished after TBI across both hemispheres, with a more pronounced decrease in the ipsilateral hippocampus, thalamus, and motor cortex. DTI measures of fractional anisotropy and apparent diffusion coefficient, reporting on axonal and microstructural integrity of the brain, indicated similar interhemispheric asymmetry, with highest change in the ipsilateral hippocampus and regions adjoining the ipsilateral thalamus, hypothalamus, and amygdala. TBI-induced corpus callosal microstructural alterations indicated measurable changes in interhemispheric structural connectivity. Hippocampus, thalamus, and select cortical regions were most consistently affected in multiple imaging markers. The multi-modal MRI results demonstrate cortical and subcortical alterations in neural connectivity, cerebrovascular resistance, and parenchymal microstructure in the adolescent brain, indicating the highly diffuse and persistent nature of the lateral fluid percussion TBI early in development.
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Affiliation(s)
- Maxime Parent
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Ying Li
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences–New Jersey Medical School, Newark, New Jersey
| | - Vijayalakshmi Santhakumar
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences–New Jersey Medical School, Newark, New Jersey
- Department of Molecular, Cell and Systems Neuroscience, University of California at Riverside, Riverside, California
| | - Fahmeed Hyder
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Basavaraju G. Sanganahalli
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Sridhar S. Kannurpatti
- Department of Radiology, Rutgers Biomedical and Health Sciences–New Jersey Medical School, Newark, New Jersey
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20
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Ng R, Lai P, Brown TT, Järvinen A, Halgren E, Bellugi U, Trauner D. Neuroanatomical correlates of emotion-processing in children with unilateral brain lesion: A preliminary study of limbic system organization. Soc Neurosci 2018; 13:688-700. [PMID: 28990866 PMCID: PMC6117211 DOI: 10.1080/17470919.2017.1386126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 08/12/2017] [Indexed: 12/27/2022]
Abstract
In this study, MRI and DTI were employed to examine subcortical volume and microstructural properties (FA, MD) of the limbic network, and their relationships with affect discrimination in 13 FL (6 right FL, M = 10.17 years; 7 left FL; M = 10.09) and 13 typically-developing children (TD; M = 10.16). Subcortical volume of the amygdala, hippocampus and thalamus and FA and MD of the fornix and anterior thalamic radiation (ATR) were examined. Results revealed no group differences across emotion-perception tasks or amygdalar volume. However, contrasting neuroanatomical patterns were observed in right versus left FL youth. Right FL participants showed increased left hippocampal and thalamic volume relative to left FL participants; whereas, the latter group showed increased right thalamic volume. DTI findings also indicated right FL children show greater MD of right fornix than other groups, whereas, left FL youth showed greater MD of left fornix. Right FL youth also showed lower FA of right fornix than left FL children, whereby the latter showed greater FA of left fornix and ATR. Differential associations between DTI indices and auditory/visual emotion-perception were observed across FL groups. Findings indicate diverging brain-behavioral relationships for emotion-perception among right and left FL children.
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Affiliation(s)
- Rowena Ng
- Laboratory for Cognitive Neuroscience; Salk Institute for Biological Studies, 10010 N. Torrey Pines Rd., La Jolla, CA, 92037
- Institute of Child Development; University of Minnesota, Twin Cities, 51 East River Road, Minneapolis, MN, 55455
| | - Philip Lai
- San Diego State University/University of California, San Diego Joint Doctoral Program in Language and Communicative Disorders, 6330 Alvarado Court #208, San Diego, CA 92120
| | - Timothy T. Brown
- Center for Multimodal Imaging and Genomics; University of California San Diego, 8950 Villa La Jolla Drive, Suite C101, La Jolla, CA 92037
- Department of Radiology; University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 93094
| | - Anna Järvinen
- Laboratory for Cognitive Neuroscience; Salk Institute for Biological Studies, 10010 N. Torrey Pines Rd., La Jolla, CA, 92037
| | - Eric Halgren
- Center for Multimodal Imaging and Genomics; University of California San Diego, 8950 Villa La Jolla Drive, Suite C101, La Jolla, CA 92037
- Department of Radiology; University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 93094
| | - Ursula Bellugi
- Laboratory for Cognitive Neuroscience; Salk Institute for Biological Studies, 10010 N. Torrey Pines Rd., La Jolla, CA, 92037
| | - Doris Trauner
- Department of Neurosciences; University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 93094
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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.
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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
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22
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Sone JY, Courtney-Kay Lamb S, Techar K, Dammavalam V, Uppal M, Williams C, Bergman T, Tupper D, Ort P, Samadani U. High prevalence of prior contact sports play and concussion among orthopedic and neurosurgical department chairs. J Neurosurg Pediatr 2018; 22:1-8. [PMID: 29701560 DOI: 10.3171/2018.1.peds17640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Increased understanding of the consequences of traumatic brain injury has heightened concerns about youth participation in contact sports. This study investigated the prevalence of high school and collegiate contact sports play and concussion history among surgical department chairs. METHODS A cross-sectional survey was administered to 107 orthopedic and 74 neurosurgery chairs. Responses were compared to published historical population norms for contact sports (high school 27.74%, collegiate 1.44%), football (high school 10.91%, collegiate 0.76%), and concussion prevalence (12%). One-proportion Z-tests, chi-square tests, and binary logistic regression were used to analyze differences. RESULTS High school contact sports participation was 2.35-fold higher (65.3%, p < 0.001) for orthopedic chairs and 1.73-fold higher (47.9%, p = 0.0018) for neurosurgery chairs than for their high school peers. Collegiate contact sports play was 31.0-fold higher (44.7%, p < 0.001) for orthopedic chairs and 15.1-fold higher (21.7%, p < 0.001) for neurosurgery chairs than for their college peers. Orthopedic chairs had a 4.30-fold higher rate of high school football participation (46.9%, p < 0.001) while neurosurgery chairs reported a 3.05-fold higher rate (33.3%, p < 0.001) than their high school peers. Orthopedic chairs reported a 28.1-fold higher rate of collegiate football participation (21.3%, p < 0.001) and neurosurgery chairs reported an 8.58-fold higher rate (6.5%, p < 0.001) compared to their college peers. The rate at which orthopedic (42.6%, p < 0.001) and neurosurgical (42.4%, p < 0.001) chairs reported having at least 1 concussion in their lifetime was significantly higher than the reported prevalence in the general population. After correction for worst possible ascertainment bias, all results except high school contact sports participation remained significant. CONCLUSIONS The high prevalence of youth contact sports play and concussion among surgical specialty chairs affirms that individuals in careers requiring high motor and cognitive function frequently played contact sports. The association highlights the need to further examine the relationships between contact sports and potential long-term benefits as well as risks of sport-related injury.
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Affiliation(s)
- Je Yeong Sone
- 1Department of Chemistry, New York University College of Arts and Science
| | | | - Kristina Techar
- 3Department of Surgery and.,4Neurosurgery, University of Minnesota
| | | | - Mohit Uppal
- 3Department of Surgery and.,4Neurosurgery, University of Minnesota
| | - Cedric Williams
- 3Department of Surgery and.,4Neurosurgery, University of Minnesota
| | - Thomas Bergman
- 3Department of Surgery and.,4Neurosurgery, University of Minnesota
| | - David Tupper
- 5Section of Neuropsychology, Hennepin County Medical Center; and
| | - Paul Ort
- 6Department of Orthopedics, VA NY Harbor Healthcare, NYU School of Medicine, New York, New York
| | - Uzma Samadani
- 3Department of Surgery and.,4Neurosurgery, University of Minnesota.,7Surgery, Minneapolis VA Medical Center, Minneapolis, Minnesota
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Multimodal Assessment of Recurrent MTBI across the Lifespan. J Clin Med 2018; 7:jcm7050095. [PMID: 29723976 PMCID: PMC5977134 DOI: 10.3390/jcm7050095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/18/2018] [Accepted: 04/22/2018] [Indexed: 12/25/2022] Open
Abstract
Recurrent mild traumatic brain injuries (mTBI) and its neurological sequelae have been the focus of a large number of studies, indicating cognitive, structural, and functional brain alterations. However, studies often focused on single outcome measures in small cohorts of specific populations only. We conducted a multimodal evaluation of the impact of recurrent mTBI on a broad range of cognitive functions, regional brain volume, white matter integrity, and resting state functional connectivity (RSFC) in young and older adults in the chronic stage (>6 months after the last mTBI). Seventeen young participants with mTBI (age: 24.2 ± 2.8 (mean ± SD)) and 21 group-wise matched healthy controls (age: 25.8 ± 5.4 (mean ± SD)), as well as 17 older participants with mTBI (age: 62.7 ± 7.7 (mean ± SD)) and 16 group-wise matched healthy controls (age: 61.7 ± 5.9 (mean ± SD)) were evaluated. We found significant differences in the verbal fluency between young participants with mTBI and young healthy controls. Furthermore, differences in the regional volume of precuneus and medial orbitofrontal gyrus between participants with mTBI and controls for both age groups were seen. A significant age by group interaction for the right hippocampal volume was noted, indicating an accelerated hippocampal volume loss in older participants with mTBI. Other cognitive parameters, white matter integrity, and RSFC showed no significant differences. We confirmed some of the previously reported detrimental effects of recurrent mTBI, but also demonstrated inconspicuous findings for the majority of parameters.
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24
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Davenport ND, Gullickson JT, Grey SF, Hirsch S, Sponheim SR. Longitudinal evaluation of ventricular volume changes associated with mild traumatic brain injury in military service members. Brain Inj 2018; 32:1245-1255. [PMID: 29985658 DOI: 10.1080/02699052.2018.1494854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PRIMARY OBJECTIVE To investigate differences in longitudinal trajectories of ventricle-brain ratio (VBR), a general measure of brain atrophy, between Veterans with and without history of mild traumatic brain injury (mTBI). RESEARCH DESIGN Structural magnetic resonance imaging (MRI) was used to calculate VBR in 70 Veterans with a history of mTBI and 34 Veterans without such history at two time points approximately 3 and 8 years after a combat deployment. MAIN OUTCOMES AND RESULTS Both groups demonstrated a quadratic relationship between VBR and age that is consistent with normal developmental trajectories. Veterans with history of mTBI had larger total brain volume, but no interaction between mTBI and age was observed for brain volume, ventricular volume, or VBR. CONCLUSIONS In our longitudinal sample of deployed Veterans, mTBI was not associated with gross brain atrophy as reflected by abnormally high VBR or abnormal increases in VBR over time.
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Affiliation(s)
- Nicholas D Davenport
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
| | - James T Gullickson
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
| | - Scott F Grey
- c RTI International , Research Triangle Park , NC , USA
| | - Shawn Hirsch
- c RTI International , Research Triangle Park , NC , USA
| | - Scott R Sponheim
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
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- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
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25
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España LY, Lee RM, Ling JM, Jeromin A, Mayer AR, Meier TB. Serial Assessment of Gray Matter Abnormalities after Sport-Related Concussion. J Neurotrauma 2017; 34:3143-3152. [DOI: 10.1089/neu.2017.5002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Lezlie Y. España
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ryan M. Lee
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Josef M. Ling
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
| | | | - Andrew R. Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
- Neurology Department, University of New Mexico School of Medicine, Albuquerque, New Mexico
- Department of Psychology, 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
- Laureate Institute for Brain Research, Tulsa, Oklahoma
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26
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Alterations in Mesoscopic Oscillations affecting Episodic Memory following Developmental Traumatic Brain Injury. Exp Neurol 2017; 300:259-273. [PMID: 29066322 DOI: 10.1016/j.expneurol.2017.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/27/2017] [Accepted: 10/20/2017] [Indexed: 11/20/2022]
Abstract
Certain deficits of episodic memory among young adults are the delayed consequences of an earlier mild or moderate Traumatic Brain Injury (mTBI). We examined alterations in hippocampal Local Field Oscillations (LFOs) of equivalently-impaired juvenile rodents to identify reliable functional markers of single-incidence mTBI. Two persistent, behavior-dependent, electrophysiological markers of injury were identified in the absence of external physiological symptoms by the analysis of wirelessly-transmitted hippocampal LFOs (3-80Hz) during repeat measures of the Novel Object Recognition (NOR) paradigm. Using a new method for detecting functional network activity at a single recording site, we correlated instantaneous increases in theta frequency and gamma magnitude with injury during periods of functional network organization and dissolution, presented here as Theta Epochs (TEs) and Theta Non-Epochs (TNEs), respectively. We estimated the efficacy of networks across pairs of such sites using new metrics such as the Coherence of Theta Phase (PCOH) and Inter-Epoch Intervals (IEIs) and demonstrated that behavioral deficits observed during the NOR testing stage correspond to electrophysiological deficits recorded during the preceding NOR familiarization stage. Increased theta frequency during TNEs and increased smoothness of PCOH during TEs were found to be robust markers of injury during memory-reliant behaviors.
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27
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Mishra VR, Zhuang X, Sreenivasan KR, Banks SJ, Yang Z, Bernick C, Cordes D. Multimodal MR Imaging Signatures of Cognitive Impairment in Active Professional Fighters. Radiology 2017; 285:555-567. [PMID: 28741982 DOI: 10.1148/radiol.2017162403] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Purpose To investigate whether combining multiple magnetic resonance (MR) imaging modalities such as T1-weighted and diffusion-weighted MR imaging could reveal imaging biomarkers associated with cognition in active professional fighters. Materials and Methods Active professional fighters (n = 297; 24 women and 273 men) were recruited at one center. Sixty-two fighters (six women and 56 men) returned for a follow-up examination. Only men were included in the main analysis of the study. On the basis of computerized testing, fighters were separated into the cognitively impaired and nonimpaired groups on the basis of computerized testing. T1-weighted and diffusion-weighted imaging were performed, and volume and cortical thickness, along with diffusion-derived metrics of 20 major white matter tracts were extracted for every subject. A classifier was designed to identify imaging biomarkers related to cognitive impairment and was tested in the follow-up dataset. Results The classifier allowed identification of seven imaging biomarkers related to cognitive impairment in the cohort of active professional fighters. Areas under the curve of 0.76 and 0.69 were obtained at baseline and at follow-up, respectively, with the optimized classifier. The number of years of fighting had a significant (P = 8.8 × 10-7) negative association with fractional anisotropy of the forceps major (effect size [d] = 0.34) and the inferior longitudinal fasciculus (P = .03; d = 0.17). A significant difference was observed between the impaired and nonimpaired groups in the association of fractional anisotropy in the forceps major with number of fights (P = .03, d = 0.38) and years of fighting (P = 6 × 10-8, d = 0.63). Fractional anisotropy of the inferior longitudinal fasciculus was positively associated with psychomotor speed (P = .04, d = 0.16) in nonimpaired fighters but no association was observed in impaired fighters. Conclusion Without enforcement of any a priori assumptions on the MR imaging-derived measurements and with a multivariate approach, the study revealed a set of seven imaging biomarkers that were associated with cognition in active male professional fighters. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Virendra R Mishra
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
| | - Xiaowei Zhuang
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
| | - Karthik R Sreenivasan
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
| | - Sarah J Banks
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
| | - Zhengshi Yang
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
| | - Charles Bernick
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
| | - Dietmar Cordes
- From the Department of Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV 89106
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28
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Moss RA, Priluck J, Bonilla X, Evans C, Macedo PS. Neuropsychological assessment in two cases of adult mild traumatic brain injury with a history of childhood head trauma. APPLIED NEUROPSYCHOLOGY. ADULT 2017; 24:385-393. [PMID: 27144284 DOI: 10.1080/23279095.2016.1159562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The existence of residual cognitive deficits following mild traumatic brain injury (MTBI) has been a topic of controversy. The current paper describes neuropsychological assessment in two cases of adulthood mild traumatic brain injury. Both patients showed objective results demonstrating cognitive impairment. The first patient experienced a head trauma around the age of 4 and the other patient had a head injury around the age of 7. Discussion focuses on the need for the systematic consideration of a history of childhood head injury as a moderating factor that may account for why a subgroup of patients show cognitive deficits following MTBI.
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Affiliation(s)
- Robert A Moss
- a North Mississippi Medical Center , Tupelo , MS , USA
| | - Jacob Priluck
- b American School of Professional Psychology, Argosy University , Washington , DC , USA
| | - Xavier Bonilla
- b American School of Professional Psychology, Argosy University , Washington , DC , USA
- c Mid Atlantic Internship Consortium, Argosy University , Washington , DC , USA
| | - Charles Evans
- c Mid Atlantic Internship Consortium, Argosy University , Washington , DC , USA
- d Washington Medical Group , Washington , DC , USA
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29
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Van Horn JD, Irimia A, Torgerson CM, Bhattrai A, Jacokes Z, Vespa PM. Mild cognitive impairment and structural brain abnormalities in a sexagenarian with a history of childhood traumatic brain injury. J Neurosci Res 2017; 96:652-660. [PMID: 28543689 DOI: 10.1002/jnr.24084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/30/2022]
Abstract
In this report, we present a case study involving an older, female patient with a history of pediatric traumatic brain injury (TBI). Magnetic resonance imaging and diffusion tensor imaging volumes were acquired from the volunteer in question, her brain volumetrics and morphometrics were extracted, and these were then systematically compared against corresponding metrics obtained from a large sample of older healthy control (HC) subjects as well as from subjects in various stages of mild cognitive impairment (MCI) and Alzheimer disease (AD). Our analyses find the patient's brain morphometry and connectivity most similar to those of patients classified as having early-onset MCI, in contrast to HC, late MCI, and AD samples. Our examination will be of particular interest to those interested in assessing the clinical course in older patients having suffered TBI earlier in life, in contradistinction to those who experience incidents of head injury during aging.
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Affiliation(s)
- John Darrell Van Horn
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - Andrei Irimia
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - Carinna M Torgerson
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - Avnish Bhattrai
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - Zachary Jacokes
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - Paul M Vespa
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California
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30
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Ichkova A, Rodriguez-Grande B, Bar C, Villega F, Konsman JP, Badaut J. Vascular impairment as a pathological mechanism underlying long-lasting cognitive dysfunction after pediatric traumatic brain injury. Neurochem Int 2017; 111:93-102. [PMID: 28377126 DOI: 10.1016/j.neuint.2017.03.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 12/11/2022]
Abstract
Traumatic brain injury (TBI) is the leading cause of death and disability in children. Indeed, the acute mechanical injury often evolves to a chronic brain disorder with long-term cognitive, emotional and social dysfunction even in the case of mild TBI. Contrary to the commonly held idea that children show better recovery from injuries than adults, pediatric TBI patients actually have worse outcome than adults for the same injury severity. Acute trauma to the young brain likely interferes with the fine-tuned developmental processes and may give rise to long-lasting consequences on brain's function. This review will focus on cerebrovascular dysfunction as an important early event that may lead to long-term phenotypic changes in the brain after pediatric TBI. These, in turn may be associated with accelerated brain aging and cognitive dysfunction. Finally, since no effective treatments are currently available, understanding the unique pathophysiological mechanisms of pediatric TBI is crucial for the development of new therapeutic options.
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Affiliation(s)
| | | | - Claire Bar
- CNRS UMR 5287, INCIA, University of Bordeaux, France; Department of Pediatric Neurology, University Children's Hospital of Bordeaux, France
| | - Frederic Villega
- Department of Pediatric Neurology, University Children's Hospital of Bordeaux, France
| | | | - Jerome Badaut
- CNRS UMR 5287, INCIA, University of Bordeaux, France; Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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31
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Narayana PA. White matter changes in patients with mild traumatic brain injury: MRI perspective. Concussion 2017; 2:CNC35. [PMID: 30202576 PMCID: PMC6093760 DOI: 10.2217/cnc-2016-0028] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/10/2017] [Indexed: 12/20/2022] Open
Abstract
This review focuses on white matter (WM) changes in mild traumatic brain injury (mTBI) as assessed by multimodal MRI. All the peer reviewed publications on WM changes in mTBI from January 2011 through September 2016 are included in this review. This review is organized as follows: introduction to mTBI, the basics of multimodal MRI techniques that are potentially useful for probing the WM integrity, summary and critical evaluation of the published literature on the application of multimodal MRI techniques to assess the changes of WM in mTBI, and correlation of MRI measures with behavioral deficits. The MRI–pathology correlation studies based on preclinical models of mTBI are also reviewed. Finally, the author's perspective of future research directions is described.
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Affiliation(s)
- Ponnada A Narayana
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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32
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Wilke S, List J, Mekle R, Lindenberg R, Bukowski M, Ott S, Schubert F, Ittermann B, Flöel A. No Effect of Anodal Transcranial Direct Current Stimulation on Gamma-Aminobutyric Acid Levels in Patients with Recurrent Mild Traumatic Brain Injury. J Neurotrauma 2017; 34:281-290. [DOI: 10.1089/neu.2016.4399] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Skadi Wilke
- Department of Neurology, Charité–University Hospital, Berlin, Germany
| | - Jonathan List
- Department of Neurology, Charité–University Hospital, Berlin, Germany
| | - Ralf Mekle
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Berlin, Germany
| | - Robert Lindenberg
- Department of Neurology, Charité–University Hospital, Berlin, Germany
| | - Martin Bukowski
- Department of Neurology, Charité–University Hospital, Berlin, Germany
| | - Stefanie Ott
- Department of Neurology, Charité–University Hospital, Berlin, Germany
| | - Florian Schubert
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Berlin, Germany
| | - Agnes Flöel
- Department of Neurology, Charité–University Hospital, Berlin, Germany
- Center for Stroke Research Berlin, Charité–University Hospital, Berlin, Germany
- NeuroCure Cluster of Excellence, Charité–University Hospital, Berlin, Germany
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33
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Xu Z, Lv XA, Dai Q, Ge YQ, Xu J. Acute upregulation of neuronal mitochondrial type-1 cannabinoid receptor and it's role in metabolic defects and neuronal apoptosis after TBI. Mol Brain 2016; 9:75. [PMID: 27485212 PMCID: PMC4971620 DOI: 10.1186/s13041-016-0257-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/29/2016] [Indexed: 12/18/2022] Open
Abstract
Metabolic defects and neuronal apoptosis initiated by traumatic brain injury (TBI) contribute to subsequent neurodegeneration. They are all regulated by mechanisms centered around mitochondrion. Type-1 cannabinoid receptor (CB1) is a G-protein coupled receptor (GPCR) enriched on neuronal plasma membrane. Recent evidences point to the substantial presence of CB1 receptors on neuronal mitochondrial outer membranes (mtCB1) and the activation of mtCB1 influences aerobic respiration via inhibiting mitochondrial cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/complex I pathway. The expression and role of neuronal mtCB1 under TBI are unknown. Using TBI models of cultured neurons, wild type and CB1 knockout mice, we found mtCB1 quickly upregulated after TBI. Activation of mtCB1 promoted metabolic defects accompanied with ATP shortage but protected neurons from apoptosis. Selective activation of plasma membrane CB1 showed no effects on neuronal metabolism and apoptosis. Activation of mtCB1 receptors inhibited mitochondrial cAMP/PKA/complex I and resulted in exacerbated metabolic defects accompanied with a higher ratio of ATP reduction to oxygen consumption decrease as well as neuronal apoptosis. Further research found the remarkable accumulation of protein kinase B (AKT) on neuronal mitochondria following TBI and the activation of mtCB1 upregulated mitochondrial AKT/complex V activity. Upregulation of mitochondrial AKT/complex V activity showed anti-apoptosis effects and alleviated ATP shortage in metabolic defects. Taken together, we have identified mtCB1 quickly upregulate after TBI and a dual role the mtCB1 might play in metabolic defects and neuronal apoptosis initiated by TBI: the inhibition of mitochondrial cAMP/PKA/complex I aggravates metabolic defects, energy insufficiency as well as neuronal apoptosis, but the coactivation of mitochondrial AKT/complex V mitigates energy insufficiency and neuronal apoptosis.
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Affiliation(s)
- Zhen Xu
- Department of Neurosurgery, First affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou, 310006, China.
| | - Xiao-Ai Lv
- Department of Surgery, First affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou, 310006, China
| | - Qun Dai
- Central laboratory, First affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou, 310006, China
| | - Yu-Qing Ge
- Central laboratory, First affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou, 310006, China
| | - Jie Xu
- Department of Neurosurgery, Huzhou Central Hospital, 198 Hongqi Lane, Huzhou, 313003, China
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Ryan NP, Catroppa C, Godfrey C, Noble-Haeusslein LJ, Shultz SR, O'Brien TJ, Anderson V, Semple BD. Social dysfunction after pediatric traumatic brain injury: A translational perspective. Neurosci Biobehav Rev 2016; 64:196-214. [PMID: 26949224 PMCID: PMC5627971 DOI: 10.1016/j.neubiorev.2016.02.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 12/21/2022]
Abstract
Social dysfunction is common after traumatic brain injury (TBI), contributing to reduced quality of life for survivors. Factors which influence the development or persistence of social deficits after injury remain poorly understood, particularly in the context of ongoing brain maturation during childhood and adolescence. Aberrant social interactions have recently been modeled in adult and juvenile rodents after experimental TBI, providing an opportunity to gain new insights into the underlying neurobiology of these behaviors. Here, we review our current understanding of social dysfunction in both humans and rodent models of TBI, with a focus on brain injuries acquired during early development. Modulators of social outcomes are discussed, including injury-related and environmental risk and resilience factors. Disruption of social brain network connectivity and aberrant neuroendocrine function are identified as potential mechanisms of social impairments after pediatric TBI. Throughout, we highlight the overlap and disparities between outcome measures and findings from clinical and experimental approaches, and explore the translational potential of future research to prevent or ameliorate social dysfunction after childhood TBI.
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Affiliation(s)
- Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; Department of Psychology, Royal Children's Hospital, Parkville, VIC, Australia.
| | - Celia Godfrey
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia.
| | - Linda J Noble-Haeusslein
- Departments of Neurological Surgery and Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA.
| | - Sandy R Shultz
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
| | - Terence J O'Brien
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
| | - Vicki Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; Department of Psychology, Royal Children's Hospital, Parkville, VIC, Australia.
| | - Bridgette D Semple
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
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35
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Faden AI, Wu J, Stoica BA, Loane DJ. Progressive inflammation-mediated neurodegeneration after traumatic brain or spinal cord injury. Br J Pharmacol 2016; 173:681-91. [PMID: 25939377 PMCID: PMC4742301 DOI: 10.1111/bph.13179] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/31/2015] [Accepted: 04/14/2015] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) has been linked to dementia and chronic neurodegeneration. Described initially in boxers and currently recognized across high contact sports, the association between repeated concussion (mild TBI) and progressive neuropsychiatric abnormalities has recently received widespread attention, and has been termed chronic traumatic encephalopathy. Less well appreciated are cognitive changes associated with neurodegeneration in the brain after isolated spinal cord injury. Also under-recognized is the role of sustained neuroinflammation after brain or spinal cord trauma, even though this relationship has been known since the 1950s and is supported by more recent preclinical and clinical studies. These pathological mechanisms, manifested by extensive microglial and astroglial activation and appropriately termed chronic traumatic brain inflammation or chronic traumatic inflammatory encephalopathy, may be among the most important causes of post-traumatic neurodegeneration in terms of prevalence. Importantly, emerging experimental work demonstrates that persistent neuroinflammation can cause progressive neurodegeneration that may be treatable even weeks after traumatic injury.
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Affiliation(s)
- Alan I Faden
- Department of Anesthesiology, Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Junfang Wu
- Department of Anesthesiology, Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bogdan A Stoica
- Department of Anesthesiology, Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, USA
| | - David J Loane
- Department of Anesthesiology, Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, USA
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36
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Wei ZZ, Lee JH, Zhang Y, Zhu YB, Deveau TC, Gu X, Winter MM, Li J, Wei L, Yu SP. Intracranial Transplantation of Hypoxia-Preconditioned iPSC-Derived Neural Progenitor Cells Alleviates Neuropsychiatric Defects After Traumatic Brain Injury in Juvenile Rats. Cell Transplant 2016; 25:797-809. [PMID: 26766038 DOI: 10.3727/096368916x690403] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Traumatic brain injury (TBI) is a common cause of mortality and long-term morbidity in children and adolescents. Posttraumatic stress disorder (PTSD) frequently develops in these patients, leading to a variety of neuropsychiatric syndromes. Currently, few therapeutic strategies are available to treat juveniles with PTSD and other developmental neuropsychiatric disorders. In the present investigation, postnatal day 14 (P14) Wistar rats were subjected to TBI induced by a controlled cortical impact (CCI) (velocity = 3 m/s, depth = 2.0 mm, contact time = 150 ms). This TBI injury resulted in not only cortical damages, but also posttrauma social behavior deficits. Three days after TBI, rats were treated with intracranial transplantation of either mouse iPSC-derived neural progenitor cells under normal culture conditions (N-iPSC-NPCs) or mouse iPSC-derived neural progenitor cells pretreated with hypoxic preconditioning (HP-iPSC-NPCs). Compared to TBI animals that received N-iPSC-NPCs or vehicle treatment, HP-iPSC-NPC-transplanted animals showed a unique benefit of improved performance in social interaction, social novelty, and social transmission of food preference tests. Western blotting showed that HP-iPSC-NPCs expressed significantly higher levels of the social behavior-related genes oxytocin and the oxytocin receptor. Overall, HP-iPSC-NPC transplantation exhibits a great potential as a regenerative therapy to improve neuropsychiatric outcomes after juvenile TBI.
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Affiliation(s)
- Zheng Zachory Wei
- Laboratories of Stem Cell Biology and Regenerative Medicine, Department of Neurology, Experimental Research Center and Neurological Disease Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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37
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Green REA. Editorial: Brain Injury as a Neurodegenerative Disorder. Front Hum Neurosci 2016; 9:615. [PMID: 26778994 PMCID: PMC4700280 DOI: 10.3389/fnhum.2015.00615] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/26/2015] [Indexed: 12/14/2022] Open
Affiliation(s)
- Robin E A Green
- Cognitive Neurorehabilitation Sciences Lab, Toronto Rehabilitation InstituteToronto, ON, Canada; Department of Psychiatry, Division of Neurosciences, University of TorontoToronto, ON, Canada
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38
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Abstract
Due to a high incidence of traumatic brain injury (TBI) in children and adolescents, age-specific studies are necessary to fully understand the long-term consequences of injuries to the immature brain. Preclinical and translational research can help elucidate the vulnerabilities of the developing brain to insult, and provide model systems to formulate and evaluate potential treatments aimed at minimizing the adverse effects of TBI. Several experimental TBI models have therefore been scaled down from adult rodents for use in juvenile animals. The following chapter discusses these adapted models for pediatric TBI, and the importance of age equivalence across species during model development and interpretation. Many neurodevelopmental processes are ongoing throughout childhood and adolescence, such that neuropathological mechanisms secondary to a brain insult, including oxidative stress, metabolic dysfunction and inflammation, may be influenced by the age at the time of insult. The long-term evaluation of clinically relevant functional outcomes is imperative to better understand the persistence and evolution of behavioral deficits over time after injury to the developing brain. Strategies to modify or protect against the chronic consequences of pediatric TBI, by supporting the trajectory of normal brain development, have the potential to improve quality of life for brain-injured children.
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Affiliation(s)
- Bridgette D Semple
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Jaclyn Carlson
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
- Department of Physical Therapy and Rehabilitation Science, University of California School of Medicine, 513 Parnassus Ave., HSE 814, San Francisco, CA, 94143, USA.
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Bondi CO, Semple BD, Noble-Haeusslein LJ, Osier ND, Carlson SW, Dixon CE, Giza CC, Kline AE. Found in translation: Understanding the biology and behavior of experimental traumatic brain injury. Neurosci Biobehav Rev 2015; 58:123-46. [PMID: 25496906 PMCID: PMC4465064 DOI: 10.1016/j.neubiorev.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 10/26/2014] [Accepted: 12/02/2014] [Indexed: 12/14/2022]
Abstract
The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided.
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Affiliation(s)
- Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bridgette D Semple
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole D Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shaun W Carlson
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Christopher C Giza
- Pediatric Neurology and Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States; Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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40
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List J, Ott S, Bukowski M, Lindenberg R, Flöel A. Cognitive function and brain structure after recurrent mild traumatic brain injuries in young-to-middle-aged adults. Front Hum Neurosci 2015; 9:228. [PMID: 26052275 PMCID: PMC4440350 DOI: 10.3389/fnhum.2015.00228] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 04/09/2015] [Indexed: 12/14/2022] Open
Abstract
Recurrent mild traumatic brain injuries (mTBIs) are regarded as an independent risk factor for developing dementia in later life. We here aimed to evaluate associations between recurrent mTBIs, cognition, and gray matter volume and microstructure as revealed by structural magnetic resonance imaging (MRI) in the chronic phase after mTBIs in young adulthood. We enrolled 20 young-to-middle-aged subjects, who reported two or more sports-related mTBIs, with the last mTBI > 6 months prior to study enrolment (mTBI group), and 21 age-, sex- and education matched controls with no history of mTBI (control group). All participants received comprehensive neuropsychological testing, and high resolution T1-weighted and diffusion tensor MRI in order to assess cortical thickness (CT) and microstructure, hippocampal volume, and ventricle size. Compared to the control group, subjects of the mTBI group presented with lower CT within the right temporal lobe and left insula using an a priori region of interest approach. Higher number of mTBIs was associated with lower CT in bilateral insula, right middle temporal gyrus and right entorhinal area. Our results suggest persistent detrimental effects of recurrent mTBIs on CT already in young-to-middle-aged adults. If additional structural deterioration occurs during aging, subtle neuropsychological decline may progress to clinically overt dementia earlier than in age-matched controls, a hypothesis to be assessed in future prospective trials.
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Affiliation(s)
- Jonathan List
- Department of Neurology, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Stefanie Ott
- Department of Neurology, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Martin Bukowski
- Department of Neurology, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Robert Lindenberg
- Department of Neurology, Charité Universitätsmedizin Berlin Berlin, Germany ; Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Agnes Flöel
- Department of Neurology, Charité Universitätsmedizin Berlin Berlin, Germany ; Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin Berlin, Germany ; NeuroCure Cluster of Excellence, Charité Universitätsmedizin Berlin Berlin, Germany
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41
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What can be learned from adolescent time diary research. J Adolesc Health 2015; 56:259-66. [PMID: 25592884 DOI: 10.1016/j.jadohealth.2014.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 11/08/2014] [Accepted: 11/10/2014] [Indexed: 11/24/2022]
Abstract
Time use is increasingly being recognized as a determinant and indicator of adolescent well-being internationally. Three existing literature reviews of time-use research with children and adolescents have identified time-use diaries as the preferred data collection method. Furthermore, they have encouraged researchers to examine multidimensional patterns of overall time use in large-sample whole child populations to better understand the health, well-being, and quality of life of children and young people. However, these three existing reviews differ in the time frames covered; the age ranges targeted; the categories of time use examined; and the time-use data collection and analysis methods used. This study aimed to map the extent and nature of time diary studies with well adolescents (aged 10-19 years) and the use of person-centered data analysis of overall time use as a multidimensional unit. Finally, it explores whether and how the included studies analyzed the relationship between time use and health, well-being, and quality of life. A scoping review method was employed using Arksey and O'Malley's five-step framework. Thirty-three studies met the inclusion criteria. Most studies were secondary analyses of cross-sectional population-level time-use or lifestyle survey data. One-third of studies (n = 11) captured data representing 24 hours of the day. Two studies (6%) used person-centered analyses, while six studies (18%) empirically examined time use in relation to health and well-being. No studies examined adolescent 24-hour time use and quality of life. Adolescent time-use researchers are encouraged to be explicit in identifying the stage of adolescence to which their studies relate; capture 24-hour time-use data; analyze overall activity patterns as multidimensional units using person-centered methods; and use robust, reliable, valid, sensitive, and age-appropriate instruments to empirically examine time use and health, well-being, and quality of life. Through this, healthy patterns of everyday activity for adolescents can be illuminated.
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42
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Mayer AR, Hanlon FM, Ling JM. Gray matter abnormalities in pediatric mild traumatic brain injury. J Neurotrauma 2015; 32:723-30. [PMID: 25313896 DOI: 10.1089/neu.2014.3534] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pediatric mild traumatic brain injury (pmTBI) is the most prevalent neurological insult in children and is associated with both acute and chronic neuropsychiatric sequelae. However, little is known about underlying pathophysiology changes in gray matter diffusion and atrophy from a prospective stand-point. Fifteen semi-acute pmTBI patients and 15 well-matched healthy controls were evaluated with a clinical and neuroimaging battery, with a subset of participants returning for a second visit. Clinical measures included tests of attention, processing speed, executive function, working memory, memory, and self-reported post-concussive symptoms. Measures of diffusion (fractional anisotropy [FA]) and atrophy were also obtained for cortical and subcortical gray matter structures to characterize effects of injury as a function of time. Patients exhibited decreased scores in the domains of attention and processing speed relative to controls during the semi-acute injury stage, in conjunction with increased anisotropic diffusion in the left superior temporal gyrus and right thalamus. Evidence of increased diffusion in these regions was also present at four months post-injury, with performance on cognitive tests partially normalizing. In contrast, signs of cortical atrophy in bilateral frontal areas and other left-hemisphere cortical areas only emerged at four months post-injury for patients. Current results suggest potentially differential time-courses of recovery for neurobehavioral markers, anisotropic diffusion and atrophy following pmTBI. Importantly, these data suggest that relying on patient self-report or standard clinical assessments may underestimate the time for true injury recovery.
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Affiliation(s)
- Andrew R Mayer
- 1 The Mind Research Network/Lovelace Biomedical and Environmental Research Institute , Albuquerque, New Mexico
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43
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Esopenko C, Levine B. Aging, neurodegenerative disease, and traumatic brain injury: the role of neuroimaging. J Neurotrauma 2015; 32:209-20. [PMID: 25192426 PMCID: PMC4321975 DOI: 10.1089/neu.2014.3506] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) is a highly prevalent condition with significant effects on cognition and behavior. While the acute and sub-acute effects of TBI recover over time, relatively little is known about the long-term effects of TBI in relation to neurodegenerative disease. This issue has recently garnered a great deal of attention due to publicity surrounding chronic traumatic encephalopathy (CTE) in professional athletes, although CTE is but one of several neurodegenerative disorders associated with a history of TBI. Here, we review the literative on neurodegenerative disorders linked to remote TBI. We also review the evidence for neuroimaging changes associated with unhealthy brain aging in the context of remote TBI. We conclude that neuroimaging biomarkers have significant potential to increase understanding of the mechanisms of unhealthy brain aging and neurodegeneration following TBI, with potential for identifying those at risk for unhealthy brain aging prior to the clinical manifestation of neurodegenerative disease.
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Affiliation(s)
- Carrie Esopenko
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Departments of Psychology and Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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Faden AI, Loane DJ. Chronic neurodegeneration after traumatic brain injury: Alzheimer disease, chronic traumatic encephalopathy, or persistent neuroinflammation? Neurotherapeutics 2015; 12:143-50. [PMID: 25421001 PMCID: PMC4322076 DOI: 10.1007/s13311-014-0319-5] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
It has long been suggested that prior traumatic brain injury (TBI) increases the subsequent incidence of chronic neurodegenerative disorders, including Alzheimer disease, Parkinson disease, and amyotrophic lateral sclerosis. Among these, the association with Alzheimer disease has the strongest support. There is also a long-recognized association between repeated concussive insults and progressive cognitive decline or other neuropsychiatric abnormalities. The latter was first described in boxers as dementia pugilistica, and has received widespread recent attention in contact sports such as professional American football. The term chronic traumatic encephalopathy was coined to attempt to define a "specific" entity marked by neurobehavioral changes and the extensive deposition of phosphorylated tau protein. Nearly lost in the discussions of post-traumatic neurodegeneration after traumatic brain injury has been the role of sustained neuroinflammation, even though this association has been well established pathologically since the 1950s, and is strongly supported by subsequent preclinical and clinical studies. Manifested by extensive microglial and astroglial activation, such chronic traumatic brain inflammation may be the most important cause of post-traumatic neurodegeneration in terms of prevalence. Critically, emerging preclinical studies indicate that persistent neuroinflammation and associated neurodegeneration may be treatable long after the initiating insult(s).
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Affiliation(s)
- Alan I Faden
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, Health Sciences Facility II (HSFII), #S247 20, Penn Street, Baltimore, MD, 21201, USA,
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Semple BD, Noble-Haeusslein LJ, Jun Kwon Y, Sam PN, Gibson AM, Grissom S, Brown S, Adahman Z, Hollingsworth CA, Kwakye A, Gimlin K, Wilde EA, Hanten G, Levin HS, Schenk AK. Sociosexual and communication deficits after traumatic injury to the developing murine brain. PLoS One 2014; 9:e103386. [PMID: 25106033 PMCID: PMC4126664 DOI: 10.1371/journal.pone.0103386] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 06/10/2014] [Indexed: 12/19/2022] Open
Abstract
Despite the life-long implications of social and communication dysfunction after pediatric traumatic brain injury, there is a poor understanding of these deficits in terms of their developmental trajectory and underlying mechanisms. In a well-characterized murine model of pediatric brain injury, we recently demonstrated that pronounced deficits in social interactions emerge across maturation to adulthood after injury at postnatal day (p) 21, approximating a toddler-aged child. Extending these findings, we here hypothesized that these social deficits are dependent upon brain maturation at the time of injury, and coincide with abnormal sociosexual behaviors and communication. Age-dependent vulnerability of the developing brain to social deficits was addressed by comparing behavioral and neuroanatomical outcomes in mice injured at either a pediatric age (p21) or during adolescence (p35). Sociosexual behaviors including social investigation and mounting were evaluated in a resident-intruder paradigm at adulthood. These outcomes were complemented by assays of urine scent marking and ultrasonic vocalizations as indices of social communication. We provide evidence of sociosexual deficits after brain injury at p21, which manifest as reduced mounting behavior and scent marking towards an unfamiliar female at adulthood. In contrast, with the exception of the loss of social recognition in a three-chamber social approach task, mice that received TBI at adolescence were remarkably resilient to social deficits at adulthood. Increased emission of ultrasonic vocalizations (USVs) as well as preferential emission of high frequency USVs after injury was dependent upon both the stimulus and prior social experience. Contrary to the hypothesis that changes in white matter volume may underlie social dysfunction, injury at both p21 and p35 resulted in a similar degree of atrophy of the corpus callosum by adulthood. However, loss of hippocampal tissue was greater after p21 compared to p35 injury, suggesting that a longer period of lesion progression or differences in the kinetics of secondary pathogenesis after p21 injury may contribute to observed behavioral differences. Together, these findings indicate vulnerability of the developing brain to social dysfunction, and suggest that a younger age-at-insult results in poorer social and sociosexual outcomes.
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Affiliation(s)
- Bridgette D. Semple
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, United States of America
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
| | - Linda J. Noble-Haeusslein
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, United States of America
- Department of Physical Therapy and Rehabilitation, University of California San Francisco, San Francisco, California, United States of America
| | - Yong Jun Kwon
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
| | - Pingdewinde N. Sam
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, United States of America
- San Francisco State University, San Francisco, California, United States of America
| | - A. Matt Gibson
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
| | - Sarah Grissom
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
| | - Sienna Brown
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
| | - Zahra Adahman
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
| | | | - Alexander Kwakye
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
| | - Kayleen Gimlin
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, United States of America
| | - Elisabeth A. Wilde
- Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School, Houston, Texas, United States of America
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, United States of America
| | - Gerri Hanten
- Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School, Houston, Texas, United States of America
| | - Harvey S. Levin
- Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School, Houston, Texas, United States of America
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, United States of America
| | - A. Katrin Schenk
- Department of Physics, Randolph College, Lynchburg, Virginia, United States of America
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