Journal of neurotrauma最新文献

{"title":"Optimal Arterial Pressure Transducer Positioning for Neurocritical Care Patients: A Review.","authors":"Andrés Giglio, Monserrat Pino, Andrés Ferre, Pablo Hasbun, Sergio Aguilera, DaiWai M Olson, Raimund Helbok, Andrés Reccius","doi":"10.1089/neu.2024.0463","DOIUrl":"https://doi.org/10.1089/neu.2024.0463","url":null,"abstract":"<p><p>This narrative review addresses the critical issue of arterial transducer positioning for cerebral perfusion pressure (CPP) measurement in neurocritical care. Despite CPP's importance in guiding management, optimal transducer placement remains ambiguous and unaddressed by current guidelines. We synthesized evidence from 20 relevant articles to inform standardization efforts. Key findings include a 10-12 mmHg CPP discrepancy between phlebostatic axis and Monro foramen transducer locations at 30° head elevation. There is no consensus on anatomical landmarks for \"head-level\" measurement, and only one guideline explicitly advises against the phlebostatic axis approach. Limited clinical evidence suggests increased institutionalization rates for patients with measurement discrepancies. Emerging dual-transducer strategies aim to address these challenges. The review highlights significant variability in CPP measurement practices, potentially impacting patient care and research interpretation. We emphasize the urgent need for standardized protocols and improved reporting in research. Addressing this variability is crucial for optimizing neurocritical care management and enhancing research comparability. Our findings underscore the importance of consistent arterial transducer positioning in neurocritical care and call for further research to establish evidence-based standardization, ultimately improving patient outcomes and research quality in this critical field.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Adherence to Guidelines and Patient Outcomes in Severe Pediatric Traumatic Brain Injury: A Scoping Review.","authors":"Nadia Savy, Lise De Cloedt, Nadia Roumeliotis, Guillaume Coll, Catherine Sarret, Guillaume Emeriaud","doi":"10.1089/neu.2024.0523","DOIUrl":"https://doi.org/10.1089/neu.2024.0523","url":null,"abstract":"<p><p>This scoping review aimed to systematically describe the literature reporting the relationship between guidelines adherence and outcomes in children with severe traumatic brain injury (TBI). The search for articles of interest was performed in the Pubmed, Embase, Cochrane Library, and Google Scholar databases. Two investigators independently screened publications from 2000 to March 2024 reporting the relationship between the implementation of a protocolized management or adherence to guidelines for severe pediatric TBI management and patient outcomes. Discrepancies regarding study eligibility were resolved by consensus, and with a third reviewer if needed. Inclusion criteria included pediatric severe TBI, reporting of clinical outcomes, with comparison of whether guidelines were respected or not. Among 2141 articles identified after the systematic search, eight articles were included in the review. The implementation of a management protocol for severe TBI was reported in five studies and was associated with a reduction in mortality and an improvement in functional prognosis. Three articles also highlighted a statistical association between adherence to guidelines and improved outcomes. In conclusion, guidelines adherence after a pediatric severe TBI was associated with improved survival and functional patient outcomes in all studies identified, although the strength of this observation is limited by the observational or pre-post design of all included studies.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional, and National Burden of Traumatic Brain Injury, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.","authors":"Long Gu, Lihan Zhang, Chun Li, Lu Jiang, Jian Zhou, Yuke Xie, JieRu Yang, Chuan Jiang, Lifang Zhang, Yong Jiang, Jianhua Peng","doi":"10.1089/neu.2025.0039","DOIUrl":"https://doi.org/10.1089/neu.2025.0039","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a major global health concern, contributing substantially to mortality and disability. While previous studies have reported the global and regional burden of TBI, few have explored its long-term trends, cause-specific burden, sociodemographic disparities, and future projections in a comprehensive framework. To address this gap, we conducted a retrospective analysis using the Global Burden of Disease 2021 data to estimate TBI incidence, prevalence, and years lived with disability across sex, age, and Sociodemographic Index (SDI) quintiles. We used average annual percent change (AAPC) to evaluate temporal trends from 1990 to 2021 and applied Spearman's correlation to examine the association between age-standardized incidence rate (ASIR) and SDI. Projections of future trends were made using an autoregressive integrated moving average model. The results revealed that global TBI cases increased from 17.0 million in 1990 to 20.8 million in 2021, although the global ASIR decreased from 324.43 to 259.02 per 100,000, with an AAPC of -0.80%. The age-standardized prevalence rate (ASPR) also declined in high SDI locations, from 539.7 to 425.9 per 100,000 (AAPC: -0.76%), with similar declines observed in high-middle SDI locations. Southern Sub-Saharan Africa showed the largest reductions, whereas Oceania experienced a slight increase in ASIR, largely driven by falls and road injuries, with notable gender-specific patterns. By 2031, TBI incidence rates are projected to decline for both sexes, with falls remaining stable and road injuries decreasing. While the ASIR and ASPR of TBI have decreased, the absolute number of cases has risen, underscoring the need for public health interventions that consider regional differences in TBI trends and causes in order to effectively reduce the burden.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-Year Psychiatric Outcome of Pediatric Mild Traumatic Brain Injury: A Prospective Longitudinal Controlled Study.","authors":"Jeffrey E Max, Nicholas Judd, Erin D Bigler, Elisabeth A Wilde, Jo Ellen Patterson, Todd M Edwards, Ainara Calahorra, Elise Zimmerman, John R Hesselink, Mingxiong Huang, Tony T Yang, Emily A Troyer, Annemarie Angeles-Quinto, Wenjing Meng, Emily L Dennis, Florin Vaida","doi":"10.1089/neu.2024.0460","DOIUrl":"10.1089/neu.2024.0460","url":null,"abstract":"<p><p>The objective of this study was to clarify the occurrence, phenomenology, and risk factors for novel psychiatric disorder (NPD) in the first 12 months after mild traumatic brain injury (mTBI) and orthopedic injury (OI). Children aged 8-15 years with mTBI (<i>n</i> = 220) and with OI but no TBI (<i>n</i> = 110) from consecutive admissions to Rady Children's Hospital Emergency Department were followed prospectively at baseline, 3-, 6-, and 12-month postinjury with semi-structured psychiatric interviews to document the presence of NPDs that developed in each participant. Preinjury child variables (academic, adaptive, and cognitive function, and psychiatric disorder), preinjury family variables (family function, family psychiatric history, and socioeconomic status), and injury severity were assessed and analyzed as potential confounders and predictors of NPD that occurred at any assessment in the 12 months after injury. This study extends our analyses of counts of NPD that were limited to the first 3 months of follow-up published in this journal. In multipredictor analyses adjusted for potential confounders, NPD risk increased over time in children with OI: 6-month versus 3-month adjusted odds ratio (aOR) = 17.766, CI₉₅ (1.712, 184.376), <i>p</i> = 0.020; 12-month versus 3-month aOR = 21.165, CI₉₅ (1.481, 302.473), <i>p</i> = 0.020, but not in the mTBI arm, corresponding to a significant group-by-time interaction: adjusted ratio of ORs for mTBI versus OI at 6-month versus 3-month aROR = 0.029, CI₉₅ (0.002, 0.411), <i>p</i> = 0.012, and at 12-month versus 3-month aROR = 0.024, CI₉₅ (0.001, 0.496), <i>p</i> = 0.012. Higher NPD risk was associated in unadjusted analyses with preinjury lifetime psychiatric disorder (OR = 8.995, CI₉₅ [1.935, 41.802], <i>p</i> = 0.003) and poorer preinjury family function (OR = 0.383, CI₉₅ [0.171, 0.861], <i>p</i> = 0.014), and in adjusted analyses with poorer preinjury family function, adjusted OR = 0.491, CI₉₅ [0.243, 0.989], <i>p</i> = 0.047, and with preinjury lifetime psychiatric disorder (OR = 5.081, CI₉₅ [0.997, 25.901], <i>p</i> = 0.050). These findings demonstrate that when considering the entire first postinjury year, mild injury to the brain and OI had similar effects on psychiatric outcome, but the onset of deleterious effects was earlier in the mTBI group. NPD in the first year after mTBI and OI is predicted primarily by preinjury family function.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A High Omega-3, Low Omega-6 Diet Reduces Headache Frequency and Intensity in Persistent Post-Traumatic Headache: A Randomized Trial.","authors":"Daisy Zamora, Kimbra Kenney, Mark Horowitz, Wesley R Cole, Beth A MacIntosh, Jacques P Arrieux, Margaret Dunlap, Olafur S Palsson, Cora Davis, Carol B Moore, Wanda Rivera, J Kent Werner, Ramon Diaz-Arrastia, Anthony F Domenichiello, Pranavi Nara, Ameer Y Taha, Duncan A Sylvestre, Chris E Ramsden, Keturah R Faurot","doi":"10.1089/neu.2025.0126","DOIUrl":"https://doi.org/10.1089/neu.2025.0126","url":null,"abstract":"<p><p>Targeted manipulation of dietary omega-3 and omega-6 fatty acids has previously been shown to decrease nontraumatic headaches in controlled trials. This study assessed the effects of a diet high in omega-3 fatty acids and low in omega-6 linoleic acid (H3L6 diet) on headache frequency and severity, headache impact, and plasma nociceptive mediators in a persistent post-traumatic headache (pPTH) population. One hundred and twenty-two participants with pPTH were randomized 1:1 to 12 weeks of either the H3L6 (<i>n</i> = 62) or a control (n = 60) diet. <i>A priori</i> primary end-points were the plasma levels of the antinociceptive docosahexaenoic acid (DHA) derivative 17-hydroxy-DHA and the Headache Impact Test (HIT-6) score. Secondary end-points included headache days/month and average daily headache pain intensity (0-10 scale). Statistical analyses followed intention-to-treat principles and were adjusted for baseline values. Relative to the control group, the H3L6 group significantly reduced headache days/month (-2.1, 95% confidence interval [CI]: -3.5 to -0.8, <i>p</i> = 0.002) and average headache intensity (-0.9, 95% CI: -1.2 to -0.5, <i>p</i> < 0.001) and increased circulating 17-hydroxy-DHA (nanograms/milliliter; difference 0.07, 95% CI: 0.02-0.11, <i>p</i> = 0.003), although it did not significantly improve HIT-6 scores (-1.6, 95% CI: -4.0 to 0.8, <i>p</i> = 0.18). In conclusion, the H3L6 diet reduced headache pain and increased antinociceptive mediators, supporting its potential as an adjunct nonpharmacological pPTH therapy.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Assessment on Days 1-14 for the Characterization of Traumatic Brain Injury: Recommendations from the 2024 NINDS Traumatic Brain Injury Classification and Nomenclature Initiative Clinical/Symptoms Working Group.","authors":"David K Menon, Noah D Silverberg, Adam R Ferguson, Thomas J Bayuk, Shubhayu Bhattacharyay, David L Brody, Scott A Cota, Ari Ercole, Anthony Figaji, Guoyi Gao, Christopher C Giza, Fiona Lecky, Rebekah Mannix, Ana Mikolić, Kasey E Moritz, Claudia S Robertson, Abel Torres-Espin, Spyridoula Tsetsou, John K Yue, Hibah O Awad, Kristen Dams-O'Connor, Adele Doperalski, Andrew I R Maas, Michael A McCrea, Nsini Umoh, Geoffrey T Manley","doi":"10.1089/neu.2024.0577","DOIUrl":"10.1089/neu.2024.0577","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The current classification of traumatic brain injury (TBI) primarily uses the Glasgow Coma Scale (GCS) to categorize injuries as mild (GCS 13-15), moderate (GCS 9-12), or severe (GCS ≤8). However, this system is unsatisfactory, as it overlooks variations in injury severity, clinical needs, and prognosis. A recent report by the National Academies of Sciences, Engineering, and Medicine (USA) recommended updating the classification system, leading to a workshop in 2024 by the National Institute of Neurological Disorders and Stroke. This resulted in the development of a new clinical, biomarker, imaging, and modifier (CBI-M) framework, with input from six working groups, including the Clinical/Symptoms Working Group (CSWG). The CSWG included both clinical and non-clinical experts and was informed by individuals with lived experience of TBI and public consultation. The CSWG primarily focused on acute clinical assessment of TBI in hospital settings, with discussion and recommendations based on pragmatic expert reviews of literature. Key areas reviewed included: assessment of neurological status; performance-based assessment tools; age and frailty, pre-existing comorbidities, and prior medication; extracranial injuries; neuroworsening; early physiological insults; and physiological monitoring in critical care. This article reports their discussions and recommendations. The CSWG concluded that the GCS remains central to TBI characterization but must include detailed scoring of eye, verbal, and motor components, with identification of confounding factors and clear documentation of non-assessable components. Pupillary reactivity should be documented in all patients, but recorded separately from the GCS, rather than as an integrated GCS-Pupils score. At ceiling scores on the GCS (14/15), history of loss of consciousness (LoC) and the presence and duration of post-traumatic amnesia should be recorded using validated tools, and acute symptoms documented in patients with a GCS verbal score of 4/5 using standardized rating scales. Additional variables to consider for a more complete characterization of TBI include injury mechanism, acute physiological insults and seizures; and biopsychosocial-environmental factors (comorbidities, age, frailty, socioeconomic status, education, and employment). The CSWG recommended that, for a complete characterization of TBI, disease progression/resolution should be monitored over 14 days. While there was a good basis for the recommendations listed above, evidence for the use of other variables is still emerging. These include: detailed documentation of neurological deficits, vestibulo-oculomotor dysfunction, cognition, mental health symptoms, and (for hospitalized patients) data-driven integrated measures of physiological status and therapy intensity. These recommendations are based on expert consensus due to limited high-quality evidence. Further research is needed to validate and refine these guidelines, ensuring they ca","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1038-1055"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Identification and Characterization of Traumatic Brain Injury-Recommendations from the 2024 National Institute of Neurological Disorders and Stroke Traumatic Brain Injury Classification and Nomenclature Initiative Retrospective Classification Working Group.","authors":"John D Corrigan, Michael L Alosco, Joukje van der Naalt, Rachel Sayko Adams, Breton M Asken, Sidney Hinds, Anthony H Lequerica, Virginia Newcombe, Olli Tenovuo, Eve Valera, Deborah Yurgelun-Todd, Adele Doperalski, Hibah O Awwad, Kristen Dams-O'Connor, Andrew I R Maas, Michael A McCrea, Nsini Umoh, Geoffrey T Manley","doi":"10.1089/neu.2024.0590","DOIUrl":"10.1089/neu.2024.0590","url":null,"abstract":"<p><p>The National Institute of Neurological Disorders and Stroke (NINDS) convened experts in traumatic brain injury (TBI) research, policy, clinical practice and people with lived experience to propose a system of injury classification less susceptible to misinterpretation and misrepresentation inherent in the current use of \"mild\", \"moderate\" and \"severe\". One of six working groups addressed Retrospective Classification of TBI. The Working Group consisted of 14 experts in brain injury research representing a breadth of professional disciplines. Initial conclusions based on expert opinion were vetted and revised based on public input at the January 2024 NINDS TBI Classification and Nomenclature Workshop. The Working Group examined five types of methodologies for identifying past TBIs (self/proxy-report, medical record extraction, imaging, fluid-based biomarkers, and performance-based tests). They concluded that self/proxy-report is essential for clinical, research and surveillance applications and that clinicians and researchers should employ elicitation protocols that have been studied and found valid. Medical record extraction was also identified as an invaluable tool for identification of past history of medically attended TBIs; however, there is a need to standardize the case definition employed and procedures used. The use of imaging methods, fluid-based biomarkers, and performance-based assessments in isolation lacked sufficient evidence of both sensitivity and specificity in detecting past histories of TBI to be recommended for this use at this time. The Working Group also evaluated identification of repetitive head impacts (RHI), finding no evidence of a common definition of RHI, a requisite initial step for the development and validation of standardized instruments.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1086-1095"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging Characterization of Acute Traumatic Brain Injury with Focus on Frontline Clinicians: Recommendations from the 2024 National Institute of Neurological Disorders and Stroke Traumatic Brain Injury Classification and Nomenclature Initiative Imaging Working Group.","authors":"Christine L Mac Donald, Esther L Yuh, Thijs Vande Vyvere, Brian L Edlow, Lucia M Li, Andrew R Mayer, Pratik Mukherjee, Virginia F J Newcombe, Elisabeth A Wilde, Inga K Koerte, Deborah Yurgelun-Todd, Yu-Chien Wu, Ann-Christine Duhaime, Hibah O Awwad, Kristen Dams-O'Connor, Adele Doperalski, Andrew I R Maas, Michael A McCrea, Nsini Umoh, Geoffrey T Manley","doi":"10.1089/neu.2025.0079","DOIUrl":"10.1089/neu.2025.0079","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Neuroimaging screening and surveillance is one of the first frontline diagnostic tools leveraged in the acute assessment (first 24 h postinjury) of patients suspected to have traumatic brain injury (TBI). While imaging, in particular computed tomography, is used almost universally in emergency departments worldwide to evaluate possible features of TBI, there is no currently agreed-upon reporting system, standard terminology, or framework to contextualize brain imaging findings with other available medical, psychosocial, and environmental data. In 2023, the NIH-National Institute of Neurological Disorders and Stroke convened six working groups of international experts in TBI to develop a new framework for nomenclature and classification. The goal of this effort was to propose a more granular system of injury classification that incorporates recent progress in imaging biomarkers, blood-based biomarkers, and injury and recovery modifiers to replace the commonly used Glasgow Coma Scale-based diagnosis groups of mild, moderate, and severe TBI, which have shown relatively poor diagnostic, prognostic, and therapeutic utility. Motivated by prior efforts to standardize the nomenclature for pathoanatomic imaging findings of TBI for research and clinical trials, along with more recent studies supporting the refinement of the originally proposed definitions, the Imaging Working Group sought to update and expand this application specifically for consideration of use in clinical practice. Here we report the recommendations of this working group to enable the translation of structured imaging common data elements to the standard of care. These leverage recent advances in imaging technology, electronic medical record (EMR) systems, and artificial intelligence (AI), along with input from key stakeholders, including patients with lived experience, caretakers, providers across medical disciplines, radiology industry partners, and policymakers. It was recommended that (1) there would be updates to the definitions of key imaging features used for this system of classification and that these should be further refined as new evidence of the underlying pathology driving the signal change is identified; (2) there would be an efficient, integrated tool embedded in the EMR imaging reporting system developed in collaboration with industry partners; (3) this would include AI-generated evidence-based feature clusters with diagnostic, prognostic, and therapeutic implications; and (4) a \"patient translator\" would be developed in parallel to assist patients and families in understanding these imaging features. In addition, important disclaimers would be provided regarding known limitations of current technology until such time as they are overcome, such as resolution and sequence parameter considerations. The end goal is a multifaceted TBI characterization model incorporating clinical, imaging, blood biomarker, and psychosocial and environmental modifiers to better serve p","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1056-1064"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marking a New Age in Characterization of Acute Traumatic Brain Injury: The National Institute of Neurological Disorders and Stroke Traumatic Brain Injury Classification and Nomenclature Initiative.","authors":"Geoffrey T Manley, Kristen Dams-O'Connor, Hibah O Awwad, Adele Doperalski, Nsini Umoh, Andrew I R Maas, Michael A McCrea","doi":"10.1089/neu.2025.0134","DOIUrl":"10.1089/neu.2025.0134","url":null,"abstract":"<p><p>This special issue of the <i>Journal of Neurotrauma</i> features a series of articles reporting the findings and recommendations of each of the six NINDS Initiative Working Groups. The collective efforts of the Working Groups with input from the broader TBI community mark a major step toward gaining more precise characterization of TBI and offer significant advantages over the current state of characterization for both clinicians, researchers, and people with lived experience. On behalf of all those who contributed to what marks a new era of improved characterization of TBI, we express our gratitude to NINDS for spearheading this effort and to the <i>Journal of Neurotrauma</i> for showcasing this important work.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1021-1022"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward More Holistic Early Traumatic Brain Injury Evaluation and Care: Recommendations from the 2024 National Institute of Neurological Disorders and Stroke Traumatic Brain Injury Classification and Nomenclature Initiative Psychosocial and Environmental Modifiers Working Group.","authors":"Lindsay D Nelson, Lindsay Wilson, Jennifer S Albrecht, David B Arciniegas, Ernest J Barthélemy, Sarah N Fontaine, Raquel C Gardner, Shannon B Juengst, Monique R Pappadis, Jennie Ponsford, Danny G Thomas, Keith Owen Yeates, Kristin Dams-O'Connor, Geoffrey T Manley, Andrew I R Maas, Michael A McCrea, Hibah O Awwad, Adele Doperalski, Nsini Umoh","doi":"10.1089/neu.2024.0569","DOIUrl":"10.1089/neu.2024.0569","url":null,"abstract":"<p><p>Biopsychosocial and environmental factors play a major role in acute clinical presentation, recovery, and outcome of traumatic brain injury (TBI). As part of the 2024 National Institute of Neurological Disorders and Stroke (NINDS) TBI Classification and Nomenclature Initiative, the Psychosocial and Environmental Modifiers (PEM) Working Group was assembled to perform a narrative review and summary of expert opinions regarding how non-TBI factors influence the presenting features and outcomes of TBI and to make recommendations for incorporating these Modifiers into clinical care and research. With input from working group members and other interested parties, we summarize the membership, methods, and outcomes of the PEM Working Group activities. Modifiers were considered with the NINDS Social Determinants of Health Framework in mind and fall under three broad headings: individual-level variables (e.g., demographics, preinjury health, culture), injury-related variables (e.g., cause and context of injury, second insults), and community-/societal-level factors (e.g., family/community support, socioeconomic position, structural racism). Recommendations include steps to increase awareness of Modifiers in health care encounters, identify Modifier-related disparities in TBI-related care and outcomes, better understand the mechanisms by which Modifiers influence TBI-related clinical presentation and outcomes, and intervene to improve the health and well-being of persons exposed to TBI. These recommendations are intended to be a starting point that will evolve as knowledge grows and additional input is incorporated.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1023-1037"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}