Journal of neurotrauma最新文献

{"title":"Post-Concussion Changes in the Functional Brain Connectome Relative to Pre-Injury Baseline: A Prospective Observational Study.","authors":"Nathan W Churchill, Michael G Hutchison, Simon J Graham, Tom A Schweizer","doi":"10.1089/neu.2024.0499","DOIUrl":"https://doi.org/10.1089/neu.2024.0499","url":null,"abstract":"<p><p>There is growing concern about the long-term health consequences of concussion, stemming from its high incidence and evidence of post-injury sequelae. This has raised critical questions about clinical assessments of concussion recovery, and whether brain function has fully recovered at medical clearance. The major knowledge gap is only partly addressed by conventional cross-sectional neuroimaging studies, due to a lack of pre-injury baseline imaging. To address this gap, 187 university-level athletes had resting-state functional magnetic resonance imaging collected at pre-season baseline. Of this cohort, 25 were later concussed, with imaging at early symptomatic injury (SYM), medical clearance to return to play (RTP), and 1-3 months post-RTP (POST). An additional 27 uninjured athletes were reimaged as controls. Brain maps were parcellated, and functional connectivity was measured between regions. Mixed models assessed connectivity change at each post-concussion session, along with the moderating effect of time to medical clearance. Concussed athletes had a significantly altered connectome, with predominantly reduced frontotemporal connectivity. Effects were most extensive at SYM, with diminishing but significant effects at RTP and POST, all of which exceeded uninjured control variability (all <i>z</i> ≤ -3.71, <i>p</i> ≤ 0.001). For participants with a longer time to medical clearance, more extensive connectivity decreases were also seen at all post-concussion imaging sessions. These findings provide direct evidence that functional brain recovery lags beyond medical clearance, with more pronounced effects among individuals who have prolonged clinical recovery. Such prospective analyses provide a unique window into biological recovery processes, with major implications for the clinical management of concussion.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181853","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":"Recovery Trajectories of Patients with Mild Traumatic Brain Injury.","authors":"Skye King, Ieke Winkens, Melloney Wijenberg, Jan Schepers, Sven Stapert, Jeanine Verbunt, Marleen Rijkeboer, Joukje van der Naalt, Caroline van Heugten","doi":"10.1089/neu.2024.0610","DOIUrl":"https://doi.org/10.1089/neu.2024.0610","url":null,"abstract":"<p><p>Within the mild traumatic brain injury (mTBI) population, there is heterogeneity both in symptom presentation and recovery patterns. Components of the fear-avoidance model (FAM) may be useful in understanding this heterogeneity. This longitudinal study aimed to identify latent trajectory classes of postconcussion symptoms (PCS) and evaluate how these classes differ on components of the FAM, following mTBI compared with controls. Participants included 185 patients with mTBI and 180 patients with orthopedic injury. PCS, catastrophizing, activity avoidance, somatic focus, depression, participation restrictions and satisfaction were measured 2 weeks, 3, 6, and 12 months post-injury. Multivariate latent class growth analysis identified classes of participants with similar longitudinal trajectories on three variables: cognitive, emotion, and somatic symptoms. Demographic and injury characteristics were used to predict class membership. Class membership was used to predict FAM outcomes. In the mTBI group, Class 1 (C1, 5.9%) had very high maintained symptoms. Class 2 (C2, 20.5%) had high decreasing symptoms. Class 3 (C3, 19.5%) had moderate decreasing symptoms. Class 4 (C4, 54%) experienced low decreasing symptoms. Belonging to class 1 or 2 predicted worse outcomes, including higher catastrophizing, activity avoidance, depression, and participation dissatisfaction. In the control group, two classes were found. Findings highlight the heterogeneity within the mTBI population and the universal disabling impact of person-related behavioral characteristics across medical conditions. Persistent symptoms management and education after mTBI should target those with higher emotion and somatic symptoms, catastrophizing, and depression at 2 weeks post-injury. Interventions targeting catastrophizing, avoidance behaviors, and emotional health may assist in recovery.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158200","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":"Perineuronal Net Changes Reveal a Distinct Right and Left Spinal Phrenic Circuit.","authors":"Judith Sánchez-Ventura, Kayla Anne Schardien, Tara Fortino, Lana V Zholudeva, Michael A Lane, Esther Udina","doi":"10.1089/neu.2024.0597","DOIUrl":"https://doi.org/10.1089/neu.2024.0597","url":null,"abstract":"<p><p>Respiratory failure is one of the greatest causes of morbidity and mortality after cervical lesions, the most common type of spinal cord injury (SCI). Fortunately, several pre-clinical and clinical studies have shown spontaneous, but limited, respiratory recovery after injury. However, there are still many unanswered questions about what is driving this recovery, so there is a growing need to further elucidate the neuroplastic potential of the phrenic network. Here, we investigated the structural plasticity of the right and left phrenic networks by analyzing perineuronal net (PNN) changes after a C2 hemisection (C2Hx) in mice. For this purpose, the right and left phrenic systems were traced with a pseudorabies virus, a trans-synaptic retrograde tracer applied to the diaphragm muscle, labeling the entire phrenic motor network. We found most PNN-bearing neurons within the ventral horn in naïve animals, specifically around phrenic motoneurons (PhMNs), but not phrenic spinal interneurons. Right, but not left, C2Hx resulted in a significant increase in PNNs and glutamatergic synapses around ipsilateral PhMNs, suggesting that the right C2Hx requires greater neuroplasticity to overcome respiratory dysfunction. The results from this study uncover profound anatomical and functional asymmetries in left- and right-sided phrenic networks, underlying the complex nature of the spinal respiratory system, and contribute to a more advanced understanding of how the phrenic network adapts to trauma. Overall, this work underscores the importance of studying neuroplasticity and how it holds the potential to help improve outcomes for individuals living with SCI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174032","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 Blood-Based Protein Biomarkers in Traumatic Brain Injury: A Living Systematic Review and Meta-Analysis.","authors":"Stefania Mondello, Krisztina Amrein, Endre Czeiter, Giuseppe Citerio, Ramon Diaz-Arrastia, Guoyi Gao, Alfonso Lagares, Geoffrey T Manley, David K Menon, Virginia Newcombe, Jussi P Posti, Lindsay Wilson, Henrik Zetterberg, Ewout W Steyerberg, Andras Buki, Andrew I R Maas","doi":"10.1089/neu.2024.0620","DOIUrl":"https://doi.org/10.1089/neu.2024.0620","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Circulating biomarkers might improve the prediction of outcomes in patients with traumatic brain injury (TBI) beyond current approaches. Robust and up-to-date evidence is required to support their clinical utility and integration into medical practice to guide decision-making. Our objective was to critically appraise the existing evidence for six core blood-based TBI biomarkers (S100 calcium-binding protein B, glial fibrillary acidic protein [GFAP], neuron-specific enolase, ubiquitin C-terminal hydrolase-L1 [UCH-L1], tau and neurofilament proteins), in predicting outcome after TBI. Electronic databases, including Medline and Embase, were searched for articles published from their inception to October 2023. Studies were included if they evaluated the accuracy of blood biomarker concentrations at hospital presentation for outcome prediction in adult patients with TBI. Outcomes assessed were mortality, Glasgow Outcome Scale (GOS)/GOS extended (GOS-E), or the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Study selection, data extraction, and quality assessment using the modified Quality Assessment of Prognostic Accuracy Studies tool were performed by two authors independently, with disagreements being resolved through discussion or arbitration. If appropriate, a meta-analysis was conducted by calculating the weighted summary area under the curve (AUC) and using a bivariate regression model. Of 12,792 retrieved records, 32 articles, including 7481 patients with TBI, were selected as relevant. Two biomarkers showed strong associations with in-hospital and 6-month mortality: GFAP (unadjusted pooled AUC 0.81 [95% confidence interval [CI] 0.75-0.87] and 0.82 [0.80-0.85], respectively) and UCH-L1 (0.80 [0.74-0.85] and 0.83 [0.77-0.88]). Their addition to models that included established risk factors consistently improved the predictive value, though models and performance varied substantially across studies. In four studies measuring both markers, UCH-L1 outperformed GFAP in improving risk stratification when added to established prediction models. At ∼1.5 ng/mL (five studies), the summary sensitivity of GFAP for predicting mortality was 78% (95% CI 67-85%), and the summary specificity was 79% (95% CI 64-89%). The other assessed biomarkers had fair to good performance in mortality prediction with unclear added benefits. Neurofilament light (NfL) (three studies) demonstrated the strongest association in predicting a 6-month poor outcome (GOS-E ≤4; GOS ≤3) (unadjusted pooled AUC 0.81 [95% CI 0.75-0.87]), whereas the other assessed biomarkers had a fair performance with unclear or irrelevant added value. All core biomarkers had only marginal or no association with incomplete recovery and post-concussion symptoms/syndrome, as assessed by RPQ. Serious problems were found in the design and analysis of many of the studies. We conclude that admission measurements of core blood TBI biomarkers, in particular GFAP and UCH-L1, are strongly associated w","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159619","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":"Prediction of Mental Health Complications Following Mild Traumatic Brain Injury.","authors":"Shuyuan Shi, Ana Mikolić, Joelle LeMoult, Jason Rights, William J Panenka, Noah D Silverberg","doi":"10.1089/neu.2024.0505","DOIUrl":"https://doi.org/10.1089/neu.2024.0505","url":null,"abstract":"<p><p>Prognostic models can support prevention of mental health complications after mild traumatic brain injury (mTBI). The present study aimed to identify risk factors and develop prognostic model(s) for mental health complications following mTBI. This secondary analysis of data from a randomized controlled trial included 513 adults presenting to emergency departments/urgent care centers. Candidate predictors were demographic, injury-related and health history information collected during medical chart review and eligibility screening, and scores on questionnaires completed at 2 weeks postinjury. The primary outcome was presence/absence of new or worsened major depressive disorder, anxiety disorders, and post-traumatic stress disorder (PTSD), determined with a structured psychodiagnostic interview (Mini International Neuropsychiatric Interview) at 3 and 6 months after mTBI. Logistic regression assessed the prognostic value of 22 pre-, peri-, and early postinjury factors. Least absolute shrinkage and selection operator (LASSO) was used to select predictors in prognostic model development. Younger age, identifying as a person of color, prior mTBI(s), maladaptive illness perceptions, and greater PTSD, and depression and anxiety symptom severity measured at 2 weeks postinjury were significant predictors of new/worsened mental health complications 3-6 months following mTBI. A comprehensive model (with 9 LASSO-selected predictors) showed strong discriminability for predicting mental health complications (optimism-corrected area under the receiver operating characteristic curve [AUC] = 0.80), outperforming a basic model that included only variables commonly collected as part of usual clinical care (optimism-corrected AUC = 0.71). Certain pre-injury and demographic characteristics are associated with increased risk of mental health complications after mTBI. Assessing for early postinjury illness beliefs and psychological symptoms can further improve prognostic accuracy.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142787","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":"<i>Letter:</i> Comments on \"Acupuncture Treatment for Chronic Post-Traumatic Headache in Individuals with Mild Traumatic Brain Injury: A Pilot Study\".","authors":"Qiongying Shen, Xiaoying Wang, Xinyi Hu, Yi Liang","doi":"10.1089/neu.2025.0140","DOIUrl":"https://doi.org/10.1089/neu.2025.0140","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142785","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":"<i>Response to the Letter to the Editor:</i> \"Comments on 'Acupuncture Treatment for Chronic Post-Traumatic Headache in Individuals with Mild Traumatic Brain Injury: A Pilot Study'\".","authors":"Amanda A Herrmann, Ella A Chrenka, Sophia G Bouwens, Ellie K Tansey, Ayla A Wolf, Kerri W Chung, Marny T Farrell, Samantha J Sherman, Aleta L Svitak, Leah R Hanson","doi":"10.1089/neu.2025.0178","DOIUrl":"https://doi.org/10.1089/neu.2025.0178","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142786","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":"Outcomes and Challenges in Treating Acute Subdural Hematoma in Older Adults with a GCS Score of 3-5: A Nationwide Retrospective Analysis in Korea.","authors":"Ki Seong Eom","doi":"10.1089/neu.2025.0009","DOIUrl":"https://doi.org/10.1089/neu.2025.0009","url":null,"abstract":"<p><p>Traumatic brain injury with a Glasgow Coma Scale (GCS) score of 3-5 is characterized by severe injury, poor prognosis, and low survival rates. Deciding between aggressive neurosurgery and treatment discontinuation is challenging among older adults. This study analyzed the characteristics, treatment, and outcomes of acute subdural hematoma (ASDH) in older adults with a GCS score of 3-5 to assess the benefits of surgery and guide future treatment decisions. We analyzed the data of 205 older adults (aged 65 years or older) with ASDH and a GCS score of 3-5 registered in the Korean Neuro-Trauma Data Bank System from January 2018 to June 2021. The patients were divided into death and survival groups, and the demographic, clinical, and radiological characteristics; treatment methods; mortality rates; and treatment outcomes were analyzed, along with the relationship between variables and mortality. We also compared the Glasgow Outcome Scale-Extended (GOSE) scores and investigated whether surgical treatment affected mortality and good recovery rates according to age. According to the GOSE, 76.1% of patients died, 12.7% survived in a vegetative state, 3.9% had severe disabilities, and only 4.0% showed good recovery. The GCS score at admission was significantly associated with pupil reactivity; Rotterdam computed tomography score; time interval from injury to operation and arrival to operation; treatment; and hospital stay between patients who died and those who survived. Surgical treatment was significantly associated with a lower mortality rate but not with good recovery rates.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120044","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":"Mild Traumatic Brain Injury Impairs Fear Extinction and Network Excitability in the Infralimbic Cortex.","authors":"Catherine E Ubri, Anthony M Farrugia, Akiva S Cohen","doi":"10.1089/neu.2025.0046","DOIUrl":"https://doi.org/10.1089/neu.2025.0046","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a leading cause of morbidity and disability, with mild TBI (concussions) representing over 80% of cases. Although often considered benign, mild TBI is associated with persistent neuropsychiatric conditions, including post-traumatic stress disorder, anxiety, and depression. A hallmark of these conditions is impaired fear extinction (FE), the process by which learned fear responses are inhibited in safe contexts. This dysfunction contributes to maladaptive fear expression and is linked to altered neurocircuitry, particularly in the infralimbic cortex (IL), a key region in FE. Despite extensive evidence of impaired FE in patients with mild TBI and animal models, the specific mechanisms underlying this deficit remain poorly understood. This study aimed to address this gap by combining cued-FE behavior, local field potential recordings, and whole-cell patch-clamp techniques to investigate how mild TBI affects IL network activity and excitability in a mouse model of TBI. Our results demonstrate that mild lateral fluid percussion injury significantly impairs FE memory, as evidenced by an elevated cued-fear response during extinction testing 10 days post-injury. Field potential recordings revealed decreased activation of the IL network in both layers II/III and V, which was consistent with the observed behavioral deficits. Further analysis of synaptic physiology revealed an imbalance in excitatory and inhibitory neurotransmission (E/I imbalance) in the IL, characterized by reduced excitatory input and enhanced inhibitory input to neurons in both layers. Moreover, intrinsic excitability was altered in IL neurons after mild TBI. This study provides novel insights into how mild TBI disrupts the neurocircuitry underlying FE, specifically by suppressing IL excitability. These results highlight the importance of understanding the mechanistic disruptions in IL activity for developing therapeutic strategies to address fear-based disorders in patients with mild TBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120033","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":"https://doi.org/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":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-20","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}