Journal of neurotrauma最新文献

{"title":"Regeneration after Spinal Cord Injury: A Review on the Crucial Aspects of V2a Interneurons.","authors":"Armin Khavandegar, Luke J Bolstad, Amgad S Hanna, Daniel J Hellenbrand","doi":"10.1177/08977151251386031","DOIUrl":"https://doi.org/10.1177/08977151251386031","url":null,"abstract":"<p><p>Spinal cord injuries (SCI) are extremely difficult to treat due to the limited capacity for neural regeneration across the injury site. However, V2a interneurons have been a point of interest in SCI research over the last decade, as they have been shown to contribute to the promotion of neuroplasticity after injury. These excitatory interneurons contain either long or short projections that are effective at driving rhythmic motor firing. By possessing ipsilateral, contralateral, or propriospinal projections, subtypes of V2a interneurons expressing the visual system homeobox-2 (Vsx-2) gene have been shown to extend their projections past the site of injury and restore injured spinal circuits that contribute to the respiration and right-left coordination. Moreover, Vsx-2/Zfhx3-expressing V2a interneurons in the midthoracic region of the spinal cord are a point of interest due to their unique ability to extend long projections caudally past the injury site and into the lumbar region, which resulted in substantial improvement in hind limb function after SCI in mice. Here, we collectively summarize the origin, subtypes, and the role Vsx-2 V2a interneurons play after SCI. We further describe the various techniques utilized to promote the accumulation and growth of these interneurons across or around the site of injury, effectively rewiring motor networks to contribute to functional recovery.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238731","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":"IL6 in Combination with Either NfL, NTproBNP, or GFAP to Safely Discharge Children with Mild Traumatic Brain Injury.","authors":"Anne-Cécile Chiollaz, Virginie Pouillard, Michelle Seiler, Céline Habre, Fabrizio Romano, Céline Ritter Schenk, Fabian Spigariol, Christian Korff, Fabienne Maréchal, Verena Wyss, Lyssia Gruaz, Joan Montaner, Sergio Manzano, Jean-Charles Sanchez","doi":"10.1177/08977151251385576","DOIUrl":"https://doi.org/10.1177/08977151251385576","url":null,"abstract":"<p><p>Mild traumatic brain injury (mTBI) in children is a public health concern resulting in one of the main causes of pediatric emergency department (PED) visits. However, the acute care of mTBI patients remains challenging due to the limited use of specific and safe diagnostic tools. The objective of the study was to evaluate the performance of combined blood biomarkers in distinguishing between children with mTBI who had intracranial injuries (ICI) visible on CT scans and required hospitalization and those who did not. The aim was to safely discharge children with mTBI by ruling out the need for unnecessary CT scans and decreasing the length of stay in observation for symptoms monitoring in the PED. This was a prospective multicenter cohort study of children aged 0-16 years who presented to the PED within 24 h of sustaining mTBI. Blood was drawn at admission, and levels of IL6, neurofilament light (NfL) chain protein, <i>N</i>-terminal prohormone of brain natriuretic peptide (NTproBNP), glial fibrillary acidic protein (GFAP), IL10, S100 calcium-binding protein B, and heart fatty acid binding protein were analyzed. Biomarker performances to identify patients without ICIs were evaluated through receiver operating characteristic curves, where sensitivity was set at 100%. Patients were dichotomized into two groups: (1) with ICI on CT (=CT+) and (2) without ICI on CT or kept in observation without CT (=CT- and Obs.). All CT scans were reviewed by the same pediatric radiologist, following Pediatric Emergency Care Applied Research Network criteria to identify the presence of ICI. Biomarker age correlation was assessed in a healthy group of children aged 0-16 years. 419 children with mTBI and 99 healthy children were enrolled. Twenty-three percent (<i>n</i> = 97/419) of children underwent CT scan examination, while the other (<i>n</i> = 322/419) were kept in observation at the PED. Nineteen percent (<i>n</i> = 18/97) of the children who underwent a CT scan had ICI (=CT+), corresponding to four percent of all mTBI included patients. All the single and duplex combinations of blood-biomarkers were tested for their capacity to safely rule out ICI. IL6 was present in the three best combinations, reaching 100% sensitivity (SE) and with the highest associated specificity (SP). IL6 + NfL yielded 61% SP, followed by IL6 + NTproBNP with 60% SP, and IL6 + GFAP with 57% SP. Neither IL6 nor NTproBNP was found to be age correlated. IL6 in combination with either NfL, NTproBNP, or GFAP could safely rule out 61% of children without ICI (corresponding to 33/79 unnecessary CT scans and 212/322 observation stays at PED). Blood panels incorporating IL6 show promise as decision-making tools for the acute management of children with mTBI. However, further external studies are required to validate these findings.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238564","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":"Visualizations of Autoregulatory Insults in Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research-Traumatic Brain Injury Cohort Study.","authors":"Rozerin Kevci, Anders Hånell, Anders Lewén, Per Enblad, Shubhayu Bhattacharyay, Guido Di Tommaso, Erta Beqiri, Peter Smielewski, Teodor Svedung Wettervik","doi":"10.1177/08977151251384988","DOIUrl":"https://doi.org/10.1177/08977151251384988","url":null,"abstract":"<p><p>Cerebral blood flow disturbances, including ischemia and hyperemia, due to impaired cerebral autoregulation (CA), are common and unfavorable in traumatic brain injury (TBI). The pressure reactivity index (PRx) reflects CA status and is associated with patient outcomes. Yet, the impact of the combined intensity and duration of CA insults and the temporal evolution of CA impairment in relation to outcome remains unclear. Moreover, how PRx modulates safe and dangerous thresholds for intracranial pressure (ICP), cerebral perfusion pressure (CPP), and CPP deviation from optimal CPP (ΔCPPopt) is not well defined. This study aimed to clarify these relationships using granular outcome heatmaps. In this prospective, observational, cohort within the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI), 166 patients with TBI, admitted between 2014 and 2017 from 21 recruiting centers, were included. Demography, admission status, and clinical outcome were evaluated. A favorable outcome was defined as Extended Glasgow Outcome Scale (GOSE) 5-8 at 6 months post-injury. High-frequency data of ICP, CPP, PRx, and ΔCPPopt during the first 7 days of neurocritical care were analyzed and visualized in color-coded heatmaps. PRx >0.30 and negative ΔCPPopt were strongly associated with unfavorable outcomes, particularly when sustained for longer durations. The physiological ranges associated with a favorable outcome for PRx and ΔCPPopt remained stable over the first 7 days post-injury. PRx modulated the safe and dangerous intervals of the other cerebral physiological variable, as the combination of high PRx together with high ICP, low CPP, and negative ΔCPPopt, respectively, was particularly associated with worse outcomes. Moreover, the unfavorable effect of negative ΔCPPopt primarily occurred when combined with PRx >0.00 rather than for negative ΔCPPopt (mmHg) in general. PRx may be used to fine-tune safe ICP, CPP, and ΔCPPopt targets, particularly in defining the lower limit of CA. Future studies should focus on evaluating the PRx/CPP curve location and steepness rather than mainly focusing on mmHg-deviation from CPPopt or any specific target.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238806","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":"Regionally Specific Resting-State Beta Neural Power Predicts Brain Injury and Symptom Recovery in Adolescents with Concussion: A Longitudinal Study.","authors":"J Christopher Edgar, Lisa Blaskey, Yuhan Chen, Olivia E Podolak, Drayton L Murray, Marybeth McNamee, Kimberly Konka, Jeffrey I Berman, Timothy P L Roberts, Mingxiong Huang, Kristy B Arbogast, Christina L Master","doi":"10.1177/08977151251383542","DOIUrl":"https://doi.org/10.1177/08977151251383542","url":null,"abstract":"<p><p>Mild traumatic brain injury (mTBI) is common in adolescents. Magnetoencephalography (MEG) studies (primarily reporting on adult males) have demonstrated abnormal resting-state (RS) brain activity in mTBI. The present study sought to identify RS abnormalities in male and female adolescents with mTBI (no previous Diagnostic and Statistical Manual of Mental Disorders - 5th Edition diagnosis) identified from an outpatient specialty care concussion program setting as a basis for evaluating potential clinical utility. Visit 1 MEG RS data were obtained from 46 adolescents with mTBI (mean age: 15.4 years, 25 females) within 4 months of a mTBI (mTBI acute to subacute period) as well as from 34 typically developing (TD) controls (mean age: 14.8 years; 17 females) identified from the local community. Visit 2 RS data (follow-up ∼4.3 months after Visit 1; mTBI subchronic period) were obtained from 36 mTBI (19 females) and 29 TD (14 females) of those participants. Source-space RS neural activity was examined from 4 to 56 Hz. Visit 1 <i>t</i>-tests showed that group differences were largest in the beta range (16-30 Hz; mTBI < TD), with whole-brain linear mixed model (LMM) analyses examining beta-band group differences as a function of Visit. A main effect of Group indicated Visits 1 and 2 beta-band group differences in midline superior frontal gyrus, right temporal pole, and right central sulcus (all mTBI < TD). The group effects were large (Cohen's <i>d</i> values 0.75 to 1.31). Of clinical significance in the mTBI group, a decrease in mTBI symptoms from Visit 1 to 2 was associated with an increase in beta power in 4 other brain regions. Present findings suggest that RS beta power has potential as a measure and perhaps as a mechanism of clinical recovery in adolescents with mTBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232857","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":"Neuroprotective Effects of <i>Salvia Miltiorrhiza</i>-Derived Extracellular Nanovesicles in Traumatic Brain Injury.","authors":"Bei-Bei Chen, Yao Wang, Ya-Nan Li, Cong-Cong Han, Jin-Xiu Guo, Jun-Jun Meng, Wen-Xue Sun, Wei-Hua Kong, Lei Feng, Rong Rong, Pei Jiang","doi":"10.1177/08977151251383549","DOIUrl":"https://doi.org/10.1177/08977151251383549","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) initiates a series of pathogenic processes, including neuroinflammation, oxidative stress, and metabolic failure, that ultimately result in neurological damage. Plant-derived bioactive compounds have demonstrated promise as treatments to reduce TBI-associated neurodegeneration. However, most previous studies have investigated the efficacy of a single active ingredient, and many such compounds have poor permeability across the blood-brain barrier (BBB), limiting their therapeutic potential. Cells release vesicles containing various signaling factors, ions, and nutrients that are subsequently taken up by adjacent cells via endocytosis. The present study explored the therapeutic effects of extracellular vesicles derived from <i>Salvia miltiorrhiza</i>-derived extracellular vesicles (SalEVs) for the treatment of TBI in mice model via biochemical, histological, microfluorometric, behavioral, and omics analyses. Isolated SalEVs contain an array of bioactive compounds, including tanshinones and salvianolic acids, encapsulated within a unique bilayer lipid structure, as revealed by electron microscopy and chromatography. Membrane labeling indicated that these SalEVs readily crossed the BBB of TBI model mice and accumulated at the injury site. Systemic administration of SalEVs to TBI model mice suppressed microglial activation, infiltration at the injury site, and proinflammatory phenotype transition as well as astroglial activation, neuronal reactive oxygen species accumulation, and apoptotic neuronal cell death. In addition, SalEVs preserved the dendritic structure following TBI. Omics revealed changes in gene and metabolite expression consistent with these anti-inflammatory, antioxidant, and neuroprotective effects. Behavioral tests also revealed partial rescue of TBI-induced spatial memory deficits. Systemic SalEV administration may be an effective therapeutic strategy for TBI by simultaneously targeting multiple pathogenic pathways.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238537","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":"Modulatory Effect of Norepinephrine on Cardiorespiratory Improvement, Spinal Microenvironment and Gene Expression Following Mid-Cervical Spinal Cord Contusion in Rats.","authors":"Rui-Yi Chen, Kun-Ze Lee","doi":"10.1177/08977151251384976","DOIUrl":"https://doi.org/10.1177/08977151251384976","url":null,"abstract":"<p><p>Maintaining the arterial blood pressure within an appropriate range following acute spinal cord injury is crucial for neurological recovery. However, the therapeutic efficacy and underlying mechanism of hemodynamic management remain to be determined. The present study aimed to investigate the modulatory effect of norepinephrine on cardiorespiratory function, spinal cord microenvironment, and gene expression following cervical spinal cord injury. Adult rats underwent implantation of osmotic pump filled with norepinephrine (125 μg/kg/h, 7 days) or saline (0.9%) immediately after mid-cervical spinal cord contusion. The cardiorespiratory parameters and spinal cord microenvironment (i.e., spinal cord blood flow, oxygenation, and hemorrhage level) were measured in anesthetized rats at 1 week post-injury. Transcriptome analysis was also used to evaluate the alteration of spinal cord gene expression following cervical spinal cord injury and norepinephrine treatment. Cervical spinal cord injury caused reductions in both arterial blood pressure and minute ventilation at 1 week post-injury. These cardiorespiratory impairments were profoundly improved by norepinephrine treatment. Although spinal cord blood flow and oxygenation were not significantly enhanced by norepinephrine, the correlation analysis revealed that there is a significant and positive correlation between the systolic blood pressure and minute ventilation and spinal oxygenation in contused rats that received norepinephrine. Notably, spinal hemorrhage was alleviated more in contused + NE animals (24 ± 4 mg/dL) than in contused + saline animals (45 ± 12 mg/dL). Moreover, transcriptome analysis of spinal cord tissue revealed that cervical spinal cord contusion led to an up-regulation of inflammation-related genes and down-regulation of neural transmission-related genes, which were partially mitigated by norepinephrine. These results demonstrated that hemodynamic management using norepinephrine effectively improves cardiorespiratory function and modulates the spinal microenvironment following cervical spinal cord injury.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238573","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":"Acute Administration of Ampakine CX1739 after Cervical Spinal Cord Injury.","authors":"Anna F Fusco, Sabhya Rana, Maya M Macintyre, Isabelle A Gonzalez, Roberto A Ribas, Ramon C Sun, David D Fuller","doi":"10.1177/08977151251382939","DOIUrl":"https://doi.org/10.1177/08977151251382939","url":null,"abstract":"<p><p>Treatment with a positive allosteric AMPA receptor modulator (\"ampakine\") can improve respiratory muscle activation and bladder function after sub-acute (days) to chronic (weeks to months) spinal cord injury (SCI). Prior studies of SCI and excitotoxicity provide evidence that ampakines may also promote neuroprotection. We hypothesized that initiating daily low-dose treatment with the low-impact ampakine CX1739 acutely after SCI would be neuroprotective and promote recovery. Adult rats received unilateral 150 kydne C4 contusion; CX1739 (5 mg/kg, <i>n</i> = 12) or vehicle (hydroxypropyl beta-cyclodextrin, HPCD; <i>n</i> = 11) given 15 min post-SCI and daily for 14 days. Breathing was evaluated using whole-body plethysmography, and locomotion was evaluated using an open field test. Cervical spinal cords were stained with NeuN to identify neuronal soma, MCA-6H63 to identify degenerating axons, and Iba-1 to identify microglia and macrophages. No differences between the HPCD and ampakine groups were noted in neuronal counts, number of MCA-6H63 positive axons, or Iba-1 staining. Respiratory rate and tidal volume were similar between groups. Ampakine treatment, however, was associated with reduced open-field motor scores and increased relative risk of post-SCI complications. We conclude that ampakine CX1739 (5 mg/kg) given daily over 0-14 days post-SCI provides no discernible benefit, and acute ampakine treatment is contraindicated, in contrast to delayed dosing paradigms. Ampakine treatment should be reserved for the subacute and chronic SCI conditions, beyond the acute period of glutamate-related neurotoxicity. These results will be particularly important in determining the optimal timing of ampakine administration as CX1739 progresses in clinical trials.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238581","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":"Pharmacological Interventions for Agitated Behaviors in Patients with Traumatic Brain Injury: An Updated Systematic Review.","authors":"Tal Klimenko, Marie-Michèle Briand, Christophe Dumais, Yorgios Alexandros Cavayas, Francis Bernard, Caroline Arbour, Lisa Burry, Marc Perreault, Marie-Julie Potvin, David Williamson","doi":"10.1177/08977151251381347","DOIUrl":"https://doi.org/10.1177/08977151251381347","url":null,"abstract":"<p><p>The aim of this updated systematic review was to assess the efficacy and safety of pharmacological agents in the management of agitated behaviors following traumatic brain injury (TBI). We updated a 2019 systematic review, which originally included 21 studies, by performing a search strategy in MedLine, Embase, PsychInfo, Cinhal, Directory of Open Access Journals, and Latin American and Caribbean Literature on Health Sciences Literature (up to Jan 7^th, 2025) for evidence on the risks and benefits of nine medication classes used to control agitated behaviors following TBI. We included all randomized controlled trials, quasi-experimental and observational studies examining the effects of medications administered to control agitated behaviors in TBI patients. Of the 58 studies screened in full-text, 11 additional studies were added to the 21 original studies for a total of 32 studies. Of these new studies, three studies evaluating dexmedetomidine suggested some potential benefits in reducing agitation. New studies on risperidone, olanzapine, carbamazepine, and valproic acid failed to show efficacy compared with control groups. Among studies identified in the first review, propranolol did reduce intensity of agitation but not its frequency. In conclusion, there remain insufficient data to recommend the use of any medications for the management of agitation following TBI. Dexmedetomidine may have potential benefit in an acute setting, and the benefits of antipsychotics, carbamazepine, and amantadine remain unclear. Beta-blockers and valproic have shown benefits, but results are inconsistent. More studies in the acute, rehabilitation, and outpatient settings are needed to assess the efficacy and safety of pharmacological agents for the management of agitated behaviors.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238607","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":"Prognostic Value of Electroencephalography in Critically Ill Adult Patients with Traumatic Brain Injury: A Systematic Review.","authors":"Marit Verboom, Robert van den Berg, Mark van de Ruit, Mathieu van der Jagt","doi":"10.1177/08977151251381351","DOIUrl":"https://doi.org/10.1177/08977151251381351","url":null,"abstract":"<p><p>Prognostication after moderate-to-severe traumatic brain injury (TBI) remains challenging in the intensive care unit (ICU) despite the existence of well-validated online prognostication tools. Changes in brain activity related to TBI can be measured using electroencephalography (EEG), making it a potentially interesting diagnostic tool to refine prognostication. The primary objective of this systematic review was to evaluate the literature concerning the prognostic value of EEG among patients with TBI in the ICU. Five databases were searched from inception until August 13, 2024. The search identified 1492 unique records. Eventually, 27 manuscripts met the inclusion criteria (>18 years old, Glasgow Coma Scale ≤12, EEG performed in the ICU). The QUIPS (QUality In Prognostic Studies) and PROBAST (Prediction model Risk Of Bias ASsessment Tool) tools were used to assess the study quality and bias. Due to high heterogeneity in EEG feature and outcome definitions and a lack of correction for confounding factors, all studies had a moderate-to-high risk of bias. Nonetheless, specific EEG features (identified through visual and quantitative EEG, EEG reactivity, and machine learning techniques) were found to be predictive of neurological outcomes up to 1.5 years after TBI. While epileptiform discharges and seizures were not consistently associated with outcomes, a higher alpha variability, a more continuous EEG, present EEG reactivity, and present EEG sleep features were predictive of better outcomes. The combination of EEG features with clinical parameters demonstrated improved predictive performance compared with models using standard clinical parameters alone. Still, the EEG features described and their potential additional value in outcome prediction after TBI merit further investigation.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232898","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":"The Polytrauma Clinical Triad Among Women with a History of Intimate Partner Violence.","authors":"Sharon E Leong, T K Logan, Christal L Badour, Justin E Karr","doi":"10.1089/neu.2025.0064","DOIUrl":"10.1089/neu.2025.0064","url":null,"abstract":"<p><p>Women with a history of intimate partner violence (IPV) are at risk for traumatic brain injury (TBI) with persistent neurobehavioral symptoms, post-traumatic stress disorder (PTSD), and chronic pain, which, together, characterize the polytrauma clinical triad. Among predominantly male Veteran samples, research has suggested that the triad may exacerbate health problems, compared with the presence of any component of the triad alone. The current study is the first to explore the polytrauma clinical triad among a sample of cisgender women who have experienced IPV (<i>N</i> = 198; <i>M</i> = 39.6 years old, <i>SD</i> = 11.9; 83.3% White, 7.1% Hispanic; 59.1% college-educated). Compared with participants without TBI history, participants with IPV-related TBI had higher rates of chronic pain (43.8% vs. 29.0%, <i>p</i> = 0.045, odds ratio [<i>OR</i>] = 1.87 [95% confidence interval: 1.01, 3.43]), PTSD with chronic pain (19.0% vs. 6.5%, <i>p</i> = 0.009, <i>OR</i> = 3.84 [1.41, 10.46]), neurobehavioral symptoms with chronic pain (40.0% vs. 22.6%, <i>p</i> = 0.030, <i>OR</i> = 2.01 [1.07, 3.79]), and the polytrauma clinical triad (19.0% vs. 6.5%, <i>p</i> = 0.009, <i>OR</i> = 3.84 [1.41, 10.46]), after adjusting for age and education. After controlling for IPV severity, however, there were no statistically significant group differences, suggesting that IPV severity may be closely linked to both risk of TBI and elevated symptomatology associated with the polytrauma clinical triad. Additionally, as the number of lifetime TBIs increased, the odds of having chronic pain (<i>p</i> = 0.011, <i>OR</i> = 1.17 [1.04, 1.33]) and chronic pain with concurrent neurobehavioral symptoms (<i>p</i> = 0.007, <i>OR</i> = 1.05 [1.05, 1.34]) also increased. These findings suggest that, especially when comorbid with IPV-related TBI, chronic pain may be a priority treatment target among individuals with a history of IPV. Considering that women with a history of IPV often experience concurrent health conditions, multicomponent interventions that address each condition within the polytrauma clinical triad may benefit this population.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1816-1829"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285024","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}