Journal of Head Trauma Rehabilitation最新文献

{"title":"Internalized Disability Stigma Among People Living With Chronic Traumatic Brain Injury.","authors":"Umesh M Venkatesan, Shannon B Juengst, Lauren Krasucki, McKenzie Buszkiewic","doi":"10.1097/HTR.0000000000001063","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001063","url":null,"abstract":"<p><strong>Objective: </strong>Qualitative evidence suggests that disability stigma is an important concept in the lived experiences of individuals with traumatic brain injury (TBI). However, there have been no studies in this population specifically evaluating internalized disability stigma. We sought to characterize variability in levels of internalized stigma and examine the applicability of the \"why try\" effect (reduced self-efficacy and life goal attainment as consequences of internalized stigma) to people living with chronic TBI.</p><p><strong>Setting: </strong>Outpatient research laboratory.</p><p><strong>Participants: </strong>Eighty-four adults with chronic TBI (1.4-22.6 years post-injury).</p><p><strong>Design: </strong>Cross-sectional observational study.</p><p><strong>Main measures: </strong>Items were adapted from the Internalized Stigma of Mental Illness questionnaire to capture disability-related internalized stigma and perceived discrimination. Primary outcome measures included societal participation and self-efficacy for TBI symptom management, which were assessed using validated instruments (Participation Assessment with Recombined Tools-Objective and TBI Self-Efficacy Scale, respectively).</p><p><strong>Results: </strong>Raw and residualized (adjusted for perceived discrimination) internalized stigma scores were normally distributed. Individuals who reported internalized stigma at levels greater than predicted by their perceived discrimination tended to have more recent injuries (d = .60) and poorer processing speed (d = .50) compared to those reporting relatively lower internalized stigma. Higher internalized stigma was associated with lower self-efficacy, which, in turn, was associated with lower societal participation (indirect effect = - .26, 95% CI = [-.50, - .09]), independent of mental health symptoms.</p><p><strong>Conclusions: </strong>Findings provide preliminary support for clinically meaningful variability in internalized stigma among people with TBI, and for the applicability of the \"why try\" model to this population. Further theory-informed research could stimulate the development of behavioral health interventions for reducing stigma internalization and its harmful effects on post-injury psychosocial functioning.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Intimate Partner Violence-Related Head Trauma in Community-Recruited Women.","authors":"Carrie Esopenko, Divya Jain, Amelia J Hicks, Emily Carter, Ella Carlsson, Andrew Cwiek, Katherine Dorman, Adriana P Méndez-Fernández, Emma N Read, Elizabeth Rebuck, Philine Rojczyk, Carmen Velez, Inga K Koerte, Alexander P Lin, David F Tate, Frank G Hillary, Elisabeth A Wilde, Amy D Marshall","doi":"10.1097/HTR.0000000000001062","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001062","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to characterize the experiences of intimate partner violence (IPV)-related head trauma (HT) among cisgender women.</p><p><strong>Setting: </strong>Three geographic regions across the United States.</p><p><strong>Participants: </strong>Seventy-two cisgender women aged 18 to 60 years (mean age = 39.6 years).</p><p><strong>Design: </strong>In-depth semi-structured interviews.</p><p><strong>Main measures: </strong>Participants completed a semi-structured interview, which was audio-recorded to determine the number and mechanisms of IPV-HT injuries experienced over their lifetime. Quotes from interview transcriptions were used to illustrate how participants describe their IPV-HT episodes.</p><p><strong>Results: </strong>A total of 69/72 cisgender women reported at least 1 injury episode that involved IPV-HT. Participants reported between 1 and 9 injury episodes that involved HT during their lifetimes. Participants reported a total of 240 injury episodes, of which 186 represented a single, isolated injury, while 54 were a repetitive exposure by the same mechanism(s) of injury over time. The time over which an injury episode was repeated ranged from 1 month to 16 years (mean: 4.72 years, standard deviation: 4.70 years). The most frequent mechanisms of injury were blunt force trauma (41.7%) and strangulation (22.1%), while 22.5% of episodes involved multiple mechanisms. The most common within-person overlap of mechanisms was blunt force trauma and strangulation (n = 21, 31%). The interview quotes demonstrated that the true frequency of IPV-HT may be unknown and/or unable to be recalled, highlighting the challenges in capturing accurate IPV-HT exposure within this population even through in-depth interviews.</p><p><strong>Conclusions: </strong>This study provides important information on the experience of HT among women with exposure to IPV. Such findings may improve our ability to characterize and understand the injuries resulting from IPV among women, which may, in turn, benefit existing tools for determining experiences of IPV-HT and probable brain injury.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the Influence of Lung-Related Injuries and Other Factors on Delirium in Traumatic Brain Injury Patients: A National Analysis.","authors":"Jordan Shin, Jeffry Nahmias, Patrick Chen, Jefferson Chen, Michael Lekawa, Lily Nguyen, Areg Grigorian","doi":"10.1097/HTR.0000000000000992","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000992","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a known risk factor for delirium, a condition associated with prolonged hospitalization and cognitive deterioration. Although the relationship between TBI and delirium is established, the influence of traumatic lung injuries on delirium development is less understood. Respiratory disorders can significantly influence the central nervous system, with sequelae such as hypoxia and hypercapnia causing neurologic dysfunction. Therefore, we hypothesized that TBI patients suffering lung-associated conditions, stemming either from traumatic lung injury (TLI) or subsequent pulmonary surgery will be associated with an increased risk of developing delirium.</p><p><strong>Methods: </strong>The 2021 Trauma Quality Improvement Program database was queried for patients with TBI, excluding those with pre-existing dementia. TBI patients developing delirium were compared to those without delirium. A multivariable logistic regression analysis was performed to determine pulmonary and neurogenic-associated risk factors for delirium.</p><p><strong>Results: </strong>Among 155,252 TBI patients, 3244 (2.1%) developed delirium. Delirium-afflicted patients showed elevated rates of TLI (25.0% vs 13.3%, p < .001), severe head trauma (51.4% vs 37.8%, p < .001), sepsis (3.1% vs 0.5%, p < .001) and more commonly underwent pulmonary operations (21.8% vs 6.6%, p < .001). The strongest associated risk factors for delirium included unplanned intubation (OR 2.79, CI 2.47-3.16, p < .001), pulmonary surgery (OR 1.47, CI 1.32-1.63, p < .001), COPD (OR 1.52, CI 1.34-1.72, p < .001), TLI (OR 1.25, CI 1.14-1.38, p < .001), and severe head injury (OR 1.12, CI 1.04-1.22, p = .003).</p><p><strong>Conclusion: </strong>Delirium affects approximately 2% of the national TBI population. Our study reveals an influence of lung-related conditions for delirium onset. These results emphasize the intimate relationship of the brain and pulmonary system. Future prospective studies are needed to validate these findings as they may impact TBI management and outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Performance is Associated With 1-Year Participation and Life Satisfaction Outcomes: A Traumatic Brain Injury Model Systems Study.","authors":"Natalie Gilmore, Thomas F Bergquist, Jennifer Bogner, John D Corrigan, Kristen Dams-O'Connor, Laura E Dreer, Brian C Healy, Shannon B Juengst, Raj G Kumar, Therese M O'Neil-Pirozzi, Amy K Wagner, Joseph T Giacino, Brian L Edlow, Yelena G Bodien","doi":"10.1097/HTR.0000000000000997","DOIUrl":"10.1097/HTR.0000000000000997","url":null,"abstract":"<p><strong>Objective: </strong>To determine, in persons with traumatic brain injury (TBI), the association between cognitive change after inpatient rehabilitation discharge and 1-year participation and life satisfaction outcomes.</p><p><strong>Design: </strong>Secondary analysis of prospectively collected TBI Model Systems (TBIMS) data.</p><p><strong>Setting: </strong>Inpatient rehabilitation and community.</p><p><strong>Participants: </strong>499 individuals with TBI requiring inpatient rehabilitation who completed the Brief Test of Adult Cognition by Telephone (BTACT) at inpatient rehabilitation discharge (ie, baseline) and 1-year postinjury.</p><p><strong>Main outcome measures: </strong>Participation Assessment with Recombined Tools-Objective (PART-O) and Satisfaction with Life Scale (SWLS).</p><p><strong>Results: </strong>Of 2,840 TBIMS participants with baseline BTACT, 499 met inclusion criteria (mean [standard deviation] age = 45 [19] years; 72% male). Change in BTACT executive function (EF) was not associated with 1-year participation (PART-O; β = 0.087, 95% CI [-0.004, 0.178], P = .061) when it was the sole model predictor. Change in BTACT episodic memory (EM) was associated with 1-year participation (β = 0.096, [0.007, 0.184], P = .035), but not after adjusting for demographic, clinical, and functional status covariates (β = 0.067, 95% CI [-0.010, 0.145], P = .089). Change in BTACT EF was not associated with life satisfaction total scores (SWLS) when it was the sole model predictor (β = 0.091, 95% CI [-0.001, 0.182], P = .0503). Change in BTACT EM was associated with 1-year life satisfaction before (β = 0.114, 95% CI [0.025, 0.202], P = .012) and after adjusting for covariates (β = 0.103, [0.014, 0.191], P = .023). In secondary analyses, change in BTACT EF was associated with PART-O Social Relations and Out and About subdomains before (Social Relations: β = 0.127, 95% CI [0.036, 0.217], P = .006; Out and About: β = 0.141, 95% CI [0.051, 0.232], P = .002) and after (Social Relations: β = 0.168, 95% CI [0.072, 0.265], P < .002; Out and About: β = 0.156, 95% CI [0.061, 0.252], P < .002) adjusting for functional status and further adjusting for covariates (Social Relations: β = 0.127, 95% CI [0.040, 0.214], P = .004; Out and About: β = 0.136, 95% CI [0.043, 0.229], P = .004). However, only the models adjusting for functional status remained significant after multiple comparison correction (ie, Bonferroni-adjusted alpha level = 0.002).</p><p><strong>Conclusion: </strong>EF gains during the first year after TBI were related to 1-year social and community participation. Gains in EM were associated with 1-year life satisfaction. These results highlight the potential benefit of cognitive rehabilitation after inpatient rehabilitation discharge and the need for interventions targeting specific cognitive functions that may contribute to participation and life satisfaction after TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E226-E239"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disturbance and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury and Orthopedic Injury.","authors":"Caroline A Luszawski, Nori M Minich, Erin D Bigler, H Gerry Taylor, Ann Bacevice, Daniel M Cohen, Barbara A Bangert, Nicholas A Zumberge, Lianne M Tomfohr-Madsen, Brian L Brooks, Keith Owen Yeates","doi":"10.1097/HTR.0000000000001005","DOIUrl":"10.1097/HTR.0000000000001005","url":null,"abstract":"<p><strong>Objective: </strong>Sleep disturbance (SD) is common after pediatric mild traumatic brain injury (mTBI) and may predict increased postconcussive symptoms (PCS) and prolonged recovery. Our objective was to investigate the relation of SD with PCS in children with mTBI and those with orthopedic injury (OI).</p><p><strong>Setting: </strong>Emergency departments (EDs) at 2 children's hospitals in the Midwestern United States.</p><p><strong>Participants: </strong>Children and adolescents aged 8 to 16 years old diagnosed with either a mTBI ( n = 143) or OI ( n = 74) and recruited within 24 hours postinjury.</p><p><strong>Design: </strong>Observational, prospective, concurrent cohort study with longitudinal follow-up.</p><p><strong>Main measures: </strong>Parents rated children's preinjury sleep retrospectively shortly after injury, and postinjury sleep at 3 and 6 months postinjury, using the Sleep Disorders Inventory for Students. Parents rated children's preinjury symptoms retrospectively in the emergency department, and parents and children rated PCS at 3 and 6 months, using the Health and Behavior Inventory and the Postconcussive Symptom Interview. Weekly ratings on the Health and Behavior Inventory were also obtained remotely.</p><p><strong>Results: </strong>Postinjury SD was modestly but not significantly higher in the mTBI group compared to the OI group ( P = .060, d = 0.32). Children with mTBI who were symptomatic postacutely based on parent ratings had worse parent-rated sleep outcomes at 3 and 6 months postinjury compared to children who were not symptomatic. Greater preinjury SD also predicted more postinjury SD and more severe PCS regardless of injury type.</p><p><strong>Conclusions: </strong>The results suggest potential bidirectional associations between SD and PCS after mTBI. Studies of treatments for SD following pediatric mTBI are needed.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"157-166"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Care After Intimate Partner Violence Acquired Brain Injury: Current Systems Silence Survivors and Providers.","authors":"Loretta Tsu, Maureen Varty, Desiree Reinken, Heather Coats","doi":"10.1097/HTR.0000000000001003","DOIUrl":"10.1097/HTR.0000000000001003","url":null,"abstract":"<p><strong>Objective: </strong>A qualitative meta-synthesis was conducted to answer the following question- What barriers are experienced by survivors of intimate partner violence and service providers when seeking or providing resources or care after experiencing brain injury (BI)?</p><p><strong>Setting: </strong>This approach was completed through 2 main phases-a systematic search and literature appraisal and reciprocal translation with interpretive triangulation of the extracted data. The databases searched were PubMed, CINAHL, and PsycInfo.</p><p><strong>Participants: </strong>The initial search yielded 559 articles. The final synthesis included 16 articles for the qualitative meta-synthesis.</p><p><strong>Design: </strong>After data extraction, a qualitative exploratory design evaluated the experiences of survivors and service providers when connecting with resources.</p><p><strong>Results: </strong>The findings highlight larger systemic barriers preventing smooth relationships between survivors and providers. Survivor barriers include risk-driven safety mechanisms and a lack of awareness and understanding of BI. Provider barriers are a lack of clarity within providers' scope and training limitations, diagnosis complexity, first responder's initial response to survivors, lack of open discussion, screening limitations, financial barriers, infrastructure barriers, and lack of resources. Systemic barriers include stigmatization, BI symptoms mistaken as other diagnoses like mental health, access and awareness of resources, and navigation of complex systems.</p><p><strong>Conclusion: </strong>This qualitative meta-synthesis demonstrates that survivors and providers face multiple individual and systemic barriers when seeking and providing resources after BI. Future research is needed to understand survivors' help-seeking behaviors and assistance needs and providers' education about BI and organizational relationships and networks. Recommendations are made for future research to understand how to reduce barriers for providers working with survivors, from trauma-informed education and communication to connecting with resources, where to concentrate, and initiatives for collaboration to increase the network of resources yet improve its accessibility.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"179-192"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 NABIS Conference on Brain Injury Abstracts.","authors":"","doi":"10.1097/HTR.0000000000001029","DOIUrl":"10.1097/HTR.0000000000001029","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"220"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Psychiatric Hospitalization After Discharge From Inpatient Neurorehabilitation for Traumatic Brain Injury.","authors":"Marc A Silva, Michelle E Fox, Farina Klocksieben, Jeanne M Hoffman, Risa Nakase-Richardson","doi":"10.1097/HTR.0000000000000995","DOIUrl":"10.1097/HTR.0000000000000995","url":null,"abstract":"<p><strong>Objective: </strong>To examine, among persons discharged from inpatient rehabilitation for traumatic brain injury (TBI), the degree to which pre-TBI factors were associated with post-TBI hospitalization for psychiatric reasons. The authors hypothesized that pre-TBI psychiatric hospitalization and other pre-TBI mental health treatment would predict post-TBI psychiatric hospitalization following rehabilitation discharge, up to 5 years post-TBI.</p><p><strong>Setting: </strong>Five Veterans Affairs Polytrauma Rehabilitation Centers.</p><p><strong>Participants: </strong>Participants with nonmissing rehospitalization status and reason, who were followed at 1 year ( N  = 1006), 2 years ( N = 985), and 5 years ( N = 772) post-TBI.</p><p><strong>Design: </strong>A secondary analysis of the Veterans Affairs TBI Model Systems, a multicenter, longitudinal study of veterans and active-duty service members with a history of mild, moderate, or severe TBI previously admitted to comprehensive inpatient medical rehabilitation. This study examined participants cross-sectionally at 3 follow-up timepoints.</p><p><strong>Main measures: </strong>Psychiatric Rehospitalization was classified according to Healthcare Cost and Utilization Project multilevel Clinical Classifications diagnosis terminology (Category 5).</p><p><strong>Results: </strong>Rates of post-TBI psychiatric hospitalization at years 1, 2, and 5 were 4.3%, 4.7%, and 4.1%, respectively. While bivariate comparisons identified pre-TBI psychiatric hospitalization and pre-TBI mental health treatment as factors associated with psychiatric rehospitalization after TBI across all postinjury timepoints, these factors were statistically nonsignificant when examined in a multivariate model across all timepoints. In the multivariable analysis, pre-TBI psychiatric hospitalization was significantly associated with increased odds of post-TBI psychiatric hospitalization only at 1-year post-TBI (adjusted odds ratio = 2.65; 95% confidence interval, 1.07-6.55, P = .04). Posttraumatic amnesia duration was unrelated to psychiatric rehospitalization.</p><p><strong>Conclusions: </strong>Study findings suggest the limited utility of age, education, and pre-TBI substance use and mental health utilization in predicting post-TBI psychiatric hospitalization. Temporally closer social and behavior factors, particularly those that are potentially modifiable, should be considered in future research.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"167-178"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Environment and Neurobehavioral Outcomes 1 Year After Severe Pediatric TBI in the Intensive Care Unit.","authors":"Aimee E Miley, Jamie Patronick, Nanhua Zhang, Rachel L Bode, Anthony Fabio, Amery Treble-Barna, Ranjit S Chima, Anna-Lynne R Adlam, Michael J Bell, Stephen R Wisniewski, Sue R Beers, Shari L Wade, Brad G Kurowski","doi":"10.1097/HTR.0000000000000943","DOIUrl":"10.1097/HTR.0000000000000943","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association of home and neighborhood environment with neurobehavioral outcomes after severe pediatric traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Domestic and international children's medical centers.</p><p><strong>Participants: </strong>Participants enrolled in the study were 18 years or younger at the time of their severe TBI (Glasgow Coma Scale [GCS] ≤ 8), admitted to the intensive care unit, and underwent placement of an intracranial pressure (ICP) monitor. Exclusionary criteria included less severe injury (GCS > 8), pregnancy, and/or ICP monitor placement occurred at a non-participating hospital.</p><p><strong>Design: </strong>A multicenter, observational cohort study.</p><p><strong>Main measures: </strong>Outcomes assessed at 12 months post-injury included measures of global functioning, intellectual ability, caregiver-report measures of family functioning, executive functioning behaviors, behavior problems, and health-related quality of life. We examined mortality risk (assessed acutely after injury), family functioning (assessed at 12 months post-injury) and parenting practices, social environment, and neighborhood stressors (all assessed > 12 months post-injury), as correlates and moderators of the 12-month post-injury outcomes.</p><p><strong>Results: </strong>Home and neighborhood factors were associated with neurobehavioral outcomes (ie, intellectual ability, executive functioning, behavioral adjustment, and health-related quality of life) but not with global functioning outcomes. A negative association between a more vulnerable home and neighborhood environment and neurobehavioral outcomes was more consistent in older children compared with younger children, based on age of injury. The influence of mortality risk on neurobehavioral outcomes was variable.</p><p><strong>Conclusion: </strong>Parenting practices and quality of social and neighborhood environment are associated with neurobehavioral outcomes 12 months after severe pediatric TBI. More research is needed to better understand the relationship between home/neighborhood stressors and TBI recovery to develop and implement strategies for patients and families to optimize outcomes. Future intervention development should focus on addressing parenting practices and social environment in a developmentally sensitive way for children who have sustained a severe TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"147-156"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroinflammatory Biomarkers and Their Associations With Cognitive, Affective, and Functional Outcomes 3 to 12 Months After a Traumatic Brain Injury: A Pilot Study.","authors":"Kathryn S G Collazos, Gemayaret Alvarez, Arsham Alamian, Victoria Behar-Zusman, Charles A Downs","doi":"10.1097/HTR.0000000000000999","DOIUrl":"10.1097/HTR.0000000000000999","url":null,"abstract":"<p><strong>Background: </strong>Neuroinflammation is an important feature of traumatic brain injury (TBI) that remains poorly understood in the 3- to 12-month period post-TBI.</p><p><strong>Objective: </strong>The purpose of our pilot study was to examine the relationships between biomarkers of neuroinflammation and functional outcomes in TBI patients 3 to 12 months postinjury.</p><p><strong>Methods: </strong>TBI patients ( n =  36) 3 to 12 months post-TBI were recruited from a South Florida TBI clinic from May 2022 to June 2023. The Disability Rating Scale, Satisfaction with Life Scale, NIH Toolbox Sorting Working Memory, Neuro-Quality of Life Cognitive Function, Anxiety, Depression, and Sleep assessments were performed. Multiple plasma biomarkers were assayed. Analysis of variance was used to compare between-group results. Linear regression was performed to analyze relationships between biomarkers and outcomes.</p><p><strong>Results: </strong>Brain-derived neurotrophic factor concentrations were higher as postinjury time interval increased and were associated with cognitive battery outcomes. S-100β and glial fibrillary acidic protein were associated with anxiety score and hospital length of stay; S-100β was also associated with depression. Interleukin 6 was associated with cognitive function score and time since injury.</p><p><strong>Conclusions: </strong>We found S-100β, glial fibrillary acidic protein, Interleukin 6, and brain-derived neurotrophic factor to play a larger role in the TBI recovery period than other biomarkers examined. Clinicians should continue to monitor for symptoms post-TBI, as the neuroinflammatory process continues to persist even into the later rehabilitation stage.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"137-146"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}