Journal of neurotrauma最新文献

{"title":"Association Between Acute Plasma Glial Fibrillary Acidic Protein Levels and White Matter Integrity in Recent Trauma Survivors.","authors":"Megan E Huibregtse, Tianyi Li, Nathaniel G Harnett, Esther L Yuh, Timothy D Ely, Tanja Jovanovic, Vince D Calhoun, Thomas C Neylan, Stacey L House, Gari D Clifford, Meredith A Bucher, Sarah D Linnstaedt, Xinming An, Alana C Conti, Antonia V Seligowski, Qiao Li, Daniel G Dillon, Lisa M Vizer, Lauren A McKibben, Liz Marie Albertorio-Sáez, Francesca L Beaudoin, Kevin K W Wang, Liana Matson, Steven E Harte, Steven E Bruce, John P Haran, Alan B Storrow, Christopher Lewandowski, Paul I Musey, Phyllis L Hendry, Christopher W Jones, Robert A Swor, Claire Pearson, David A Peak, Brian J O'Neil, Ronald C Kessler, Karestan C Koenen, Kerry J Ressler, Samuel A McLean, Jennifer S Stevens","doi":"10.1177/08977151251363590","DOIUrl":"10.1177/08977151251363590","url":null,"abstract":"<p><p>Traumatic brain injuries (TBIs) account for over 2.5 million emergency department (ED) visits each year in the United States. The bulk of TBI research in acute care settings has focused exclusively on individuals who receive computed tomography (CT) scanning. Recently, more sensitive TBI assessment tools have been identified, including blood biomarkers such as glial fibrillary acidic protein (GFAP) and magnetic resonance imaging (MRI) of white matter microstructural integrity. These methods can evaluate for evidence of TBI in CT-negative patients. However, limited prior work has investigated the relationship between blood GFAP levels and white matter microstructural integrity. The present study examined the association between acute (≤72 h) GFAP levels and white matter microstructural integrity at 2 weeks post-trauma among ED patients (<i>n</i> = 328) recruited after a qualifying traumatic experience. We hypothesized that acute GFAP concentrations would be associated with disrupted microstructural integrity, quantified with Tract-Based Spatial Statistics-derived diffusion tensor imaging (DTI) metrics (reduced fractional anisotropy and increased axial diffusivity [AD], radial diffusivity, and mean diffusivity), in tracts previously shown to be vulnerable to TBI. Our secondary hypothesis was that there would be a stronger association between GFAP levels and white matter integrity among female relative to male trauma survivors, in line with previous literature suggesting that females' axons are less resilient to stretch injury. To test the primary hypothesis, we fit four sets of linear regression models to assess the association between natural log-transformed acute GFAP concentration and DTI metrics for 15 white matter regions of interest (ROIs). The false discovery rate (FDR) was controlled at 0.05 for each set of models. Models were adjusted for age, sex, neuroimaging site, and a composite lifetime traumatic stress variable. To test the secondary hypotheses, we fit identical sets of linear regression models, with an additional interaction term between sex and ln(GFAP). We followed up all significant results surviving FDR correction with correlational tractography to examine the location and direction of tracts associated with the DTI metric passing through those ROIs. We observed significant and positive associations between acute GFAP and AD in the parahippocampal cingulum (<i>B</i> = 1.416 × 10<sup>-5</sup>, standard error [SE] = 4.806 × 10<sup>-6</sup>, <i>p</i> = 0.003, FDR-corrected <i>p</i> = 0.026), and the sagittal stratum (<i>B</i> = 1.012 × 10<sup>-5</sup>, SE = 3.438 × 10<sup>-6</sup>, <i>p</i> = 0.003, FDR-corrected <i>p</i> = 0.026), including fibers of the inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus. Furthermore, the association between GFAP and AD of the parahippocampal cingulum was stronger in female trauma survivors compared with male trauma survivors (<i>B</i> = 2.898 × 10<sup>-5</sup>, SE","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1758-1774"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789383","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":"Citicoline-Amantadine Trial in Traumatic Brain Injury: A Prospective Randomized Study.","authors":"Dina Salah Eldin Mahmoud Badre, Marwa Ahmed Khairy Elbeialy, Mai Fathy","doi":"10.1177/08977151251375914","DOIUrl":"https://doi.org/10.1177/08977151251375914","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a global health problem. Amantadine and citicoline showed considerable effects on neurorecovery from TBI. In a randomized controlled trial, the effects of amantadine and citicoline and their combinations were compared on arousal and behavioral consequences in the early phase of moderate TBI. Patients were divided into three groups (15 patients each) with moderate TBI; group C (citicoline) received 1 g citicoline every 12 h for 7 days. Participants received 500 mg oral drops syrup twice a day or the same dose as oral drops syrup of citicoline through a nasogastric tube (NG) or percutaneous endoscopic gastrostomy (PEG) tube in a total dose of 1000 mg/day for a 30-day study period. Group A (amantadine) received 200 mg of amantadine sulfate in a 500 mL solution every 12 h for 7 days. Participants received two 100-mg tablets twice a day or through an NG or PEG tube as 400 mg for a 30-day study period. Group CA (Citicoline + Amantadine) received 1 g citicoline every 12 h and 200 mg of amantadine sulfate in a 500 mL solution every 12 h for 7 days, then 500 mg of citicoline syrup twice daily plus 200 tablets twice daily amantadine for a 30-day study period. Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), and mini-mental state (MMS) were used to assess the patient's conditions on the 1st, 4th, and 7th days (acute phase) in the intensive care unit (ICU), then 30 days after injury. The endpoints of the study were either the death of the patient or the completion of the study period of 30 days. The number of mechanically ventilated patients, the number of ventilated days, mortality, total ICU, and hospital length of stay were measured. GCS on days 4, 7, and 30 were significantly higher in group A and group CA compared with group C, with no significant differences between groups A and CA. DRS in days 4 and 7 became significantly lower in groups A and CA compared with group C, with no significant differences between groups A and CA. MMS in days 4, 7, and 30 became significantly lower in group C, with no significant differences between groups A and CA. The duration of mechanical ventilation, ICU, and hospital stay was significantly longer in group C, with no significant differences between groups A and CA. This study showed that amantadine alone or in combination with citicoline has a favorable effect on the recovery of consciousness and cognitive behavior in patients with moderate TBI and reduces the mechanical ventilation days, hospital, and ICU length of stay.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199402","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":"Gut Microbiome Differentiates Levels of Consciousness in Patients with Prolonged Disorders of Consciousness after Brain Injury.","authors":"Wendong You, Yajun Lin, Anqi Wei, Jiawei Cai, Liang Wen, Yuanxiang Lin, Xiaofeng Yang, Zanyi Wu","doi":"10.1177/08977151251360256","DOIUrl":"10.1177/08977151251360256","url":null,"abstract":"<p><p>Differentiation of levels of consciousness in patients with prolonged disorders of consciousness (DOC) remains a major challenge, especially differentiation between vegetative state (VS) and minimally conscious state (MCS). This study was to investigate the alterations of gut microbiota in patients with DOC and to identify potential microbiome biomarkers that can differentiate levels of consciousness. In this study, we collected fecal samples from patients with prolonged DOC, including 19 patients in MCS and 14 patients in VS; 16S-rRNA sequencing was used to investigate the gut microbiome of patients. Gut microbiota diversity, composition, and discriminant bacterial taxa were analyzed to identify potential biomarkers for differentiating levels of consciousness. We found that diversity and composition of gut microbiome were significantly altered in patients with DOC, and decreased alpha diversity was associated with lower levels of consciousness. Specific bacterial taxa including <i>Firmicutes, Escherichia_shigella, Raecalibacterium, Lachnospiraceae</i>, and <i>Ruminococcaceae_UCG_013</i> were more abundant in patients in MCS, whereas <i>Clostridiales</i> were more abundant in patients in VS. In conclusion, the study results demonstrated that patients with DOC exhibited distinct diversity and composition of gut microbiota. And there was a decreasing trend of alpha diversity of gut microbiota from patients in MCS to patients in VS, which indicates that lower alpha diversity was associated with more severe level of unconsciousness. Specific bacterial taxa may be potential biomarkers to differentiate MCS and VS.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1775-1785"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667786","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":"Repeated Exposures to Air Travel-Relevant Hypobaria Induce Anxiety-Like Behavior and Alter Functional Connectivity and White Matter Integrity in a Ferret Model of Traumatic Brain Injury.","authors":"Li Jiang, Molly J Goodfellow, Su Xu, Amanda Hrdlick, Boris Piskoun, Julie L Proctor, Xiao Liang, Steven Roys, Xin Li, Rao P Gullapalli, Ulrich H Leiste, William Fourney, Jody C Cantu, Catriona H T Miller, Jiachen Zhuo, Gary Fiskum","doi":"10.1089/neu.2024.0531","DOIUrl":"10.1089/neu.2024.0531","url":null,"abstract":"<p><p>Under-vehicle blast (UVB) caused by landmine detonation induces a distinct traumatic brain injury (TBI) and can be accompanied by head impact. Injured soldiers often undergo multiple flights after injury to access medical care and return to duty. Previous work has shown that low air pressure during air travel (hypobaria [HB]) exacerbates neurological injury, but the effects of one or more HB exposures on chronic brain injury are unknown. We hypothesized that multiple HB exposures after TBI would result in worse outcomes than 0-1 exposures. Sedated male ferrets underwent UVB and controlled cortical impact (CCI) under anesthesia (BCCI), followed by zero (normobaria [BCCI + NB]), one (BCCI + 1HB), or five (BCCI + 5HB) 6-h HB exposure(s) over 6 months post-injury or remained experimentally naïve. Anxiety-like behavior was assessed with the Open Field at 6 months post-injury. Ferrets also underwent T₂-weighted (T2w), resting-state functional magnetic resonance imaging, and diffusion-weighted imaging scans at pre-injury baseline and 6 months post-injury under anesthesia. Relative to naïve, BCCI + 5HB animals expressed significantly more anxiety-like behavior. Region of interest (ROI)-to-ROI functional connectivity (FC) analysis was conducted to evaluate FC changes within the anxiety network. ROI-based diffusion tensor and kurtosis imaging modeling was conducted to evaluate the white matter (WM) integrity of major anxiety-associated WM tracts. Results indicated increased FC between prefrontal cortex, amygdala, and hippocampus and decreased fractional anisotropy and mean kurtosis in cerebral WM, corpus callosum, cingulum, and fornix WM tracts when comparing BCCI + 5HB with all other groups. Together, these suggest that multiple HB exposures after BCCI exacerbate changes in neurological activity in the anxiety regulation brain network, as well as structural damage in the anxiety-associated WM tracts. Our findings demonstrate that air travel after TBI, particularly multiple flights, can have a chronic negative impact on brain structure and function.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1830-1842"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285022","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":"Ageing with Traumatic Brain Injury: Long-Term Cognition and Wellbeing.","authors":"Amber Ayton, Gershon Spitz, Amelia J Hicks, Jennie Ponsford","doi":"10.1089/neu.2024.0524","DOIUrl":"10.1089/neu.2024.0524","url":null,"abstract":"<p><p>Whether and how traumatic brain injury (TBI) impacts ageing in the decades post-injury remains a matter of debate, partly due to a lack of controlled studies. This study examined the long-term impact of TBI on cognition and wellbeing in middle-aged and older adults and explored the relationship between age, cognition, and wellbeing, compared with a non-TBI control group. Cross-sectional data from 143 participants aged ≥40 with moderate-severe TBI (6-33 years post-injury; mean age 59.64) were compared with 71 non-TBI controls (mean age 62.10) group matched on age, gender, and premorbid IQ. Individuals with significant confounding comorbidities were excluded. A battery of neuropsychological tests and wellbeing measures (emotional distress, sleep, health-related quality of life [HRQoL]) was administered. Older age and TBI were each independently associated with poorer cognition across multiple domains (<i>p</i> < 0.05). The relationship between verbal learning and memory impairment post-TBI differed between age groups: individuals with TBI in their 40s-60s performed significantly worse than same-aged controls on verbal story acquisition (<i>B</i> = 0.09, <i>p =</i> 0.040, 95% confidence interval [CI] [0.004, 0.17]) and recall (<i>B</i> = 0.12, <i>p =</i> 0.009, 95% CI [0.03, 0.21]), and verbal wordlist recall (<i>B</i> = 0.11, <i>p</i> = 0.007, 95% CI [0.03, 0.19]). In comparison, no significant group differences in verbal memory emerged for ages 70-90. The TBI group reported greater emotional distress (<i>B</i> = 3.55, <i>p</i> < 0.001, 95% CI [1.73, 5.37]), poorer sleep quality (<i>B</i> = 1.07, <i>p =</i> 0.016, 95% CI [0.20, 1.94]), and poorer physical HRQoL (<i>B</i> = -4.26, <i>p =</i> 0.003, 95% CI [-7.08, -1.43]) than controls at all ages. Poorer physical HRQoL was related to poorer cognition post-TBI (<i>p</i> < 0.05). Our results challenge the notion that TBI exacerbates ageing. Moderate-severe TBI resulted in significant long-term impairments in cognition and wellbeing, with verbal learning and memory more impaired during middle-adulthood but not older adulthood compared to controls. TBI was not associated with changes to wellbeing with ageing. Intervention for verbal memory deficits in middle-aged adults with TBI is important, along with wider long-term supports for cognition, wellbeing, and activity participation in all individuals with TBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1786-1795"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976617","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":"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":"1796-1804"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","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":"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":"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":"1663-1670"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","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":"White Matter Integrity in Women with Repetitive Traumatic Brain Injury due to Intimate Partner Violence.","authors":"Justin E Karr, David K Powell, Agnes E White, Sharon E Leong, Michael T Maisel, Ahmed A Bahrani","doi":"10.1177/08977151251360777","DOIUrl":"10.1177/08977151251360777","url":null,"abstract":"<p><p>Many women survivors of intimate partner violence (IPV) experience traumatic brain injury (TBI) due to physical violence, with a large portion of these women exposed to repetitive IPV-TBI. Limited research has examined neurological outcomes following repetitive IPV-TBI among survivors. The few existing studies have observed both structural and functional effects on neuroimaging. This pilot investigation is the first case-control study to assess differences in white matter between women survivors of IPV with and without repetitive IPV-TBI history. Participants underwent diffusion tensor imaging (DTI) and cognitive testing to compare white matter integrity between groups and assess the association between white matter integrity and fluid cognitive functioning. Participants were recruited from shelters, IPV service organizations, and the local community in Kentucky, USA. The final sample included 11 women with repetitive IPV-TBI (mean [M] = 34.2 years old, standard deviation [SD] = 7.3; 54.5% White; 81.8% with ≥12 years of education) and 11 women survivors without IPV-TBI history (M = 28.4 years old, SD = 9.7; 72.7% White; 90.9% with ≥12 years of education). Women completed the Brain Injury Screening Questionnaire, NIH Toolbox Cognition Battery, and DTI. Women with and without repetitive IPV-TBI were compared using tract-based spatial statistics (TBSS), which involved voxel-wise comparisons of fractional anisotropy (i.e., estimating white matter integrity) across groups using threshold-free cluster enhancement. Group differences in the corpus callosum, primarily posterior, and anterior thalamic radiation, primarily left, were noted. Lower white matter integrity was associated with reduced fluid cognitive functioning in the full sample among clusters that differed across groups (<i>rho</i> = -0.44, <i>p</i> = 0.040), but this association was nonsignificant when stratified by group (repetitive IPV-TBI: <i>rho</i> = -0.37, <i>p</i> = 0.259; no IPV-TBI: <i>rho</i> = 0.06, <i>p</i> = 0.873). Results from this case-control study suggest that repetitive IPV-TBI history corresponded with lower white matter integrity, most prominently in the posterior corpus callosum. Lower white matter integrity also correlated with reduced fluid cognitive ability across the study sample, regardless of IPV-TBI status. Despite a small sample size and cross-sectional design, this study builds on early neuroimaging research on IPV-TBI, further documenting the physical neurological effects of repetitive IPV-TBI among women survivors. Future research on IPV-TBI should assess whether white matter integrity among survivors corresponds with functional impairment, remains stable or progressive over time, or responds to intervention to improve brain health in this community.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1747-1757"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674918","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":"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":"1868-1890"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","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":"The Ukraine War: Traumatic Brain Injury in a Front-Line Hospital.","authors":"Andrii Sirko, Rocco A Armonda, David L Brody, Alex B Valadka","doi":"10.1177/08977151251365558","DOIUrl":"10.1177/08977151251365558","url":null,"abstract":"<p><p>The location close to the front lines of Mechnikov Hospital in the eastern Ukrainian city of Dnipro creates both opportunities and challenges. The same medical teams have worked closely together for years. They have learned how to provide the best possible care despite personnel shortages and overwhelming patient volumes, including many patients who are critically ill with systemic as well as neurological injuries. Outcomes are better than many might expect. International support and collaboration have been instrumental in achieving these good outcomes. Mechnikov Hospital neurosurgeons have developed new patient care pathways and management techniques that they disseminate internationally through publications and academic conferences. Prospective studies and other research activities are underway despite the obvious challenges caused by the war. The lessons learned by the team at Mechnikov Hospital will benefit other patients both now and in the future, especially as the international medical community prepares for possible large-scale combat operations in austere environments.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1901-1906"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784479","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}