Journal of neurotrauma最新文献

{"title":"Assessment of Cerebral Autoregulation Using Ultrasound-Based Intra- and Extracranial Blood Flow Indices in a Swine Model of Brain Injury.","authors":"Mohamad H Tiba, Zachary J Sharpe, Nicholas L Greer, Alexis N Davis, Courtney A Dennis, Paul Picton, Venkatakrishna Rajajee, Kevin R Ward, Jonathan M Rubin, Jeffrey Brian Fowlkes","doi":"10.1177/08977151251372544","DOIUrl":"10.1177/08977151251372544","url":null,"abstract":"<p><p>Cerebrovascular autoregulation (CA) is a protective mechanism against brain injury. We present an ultrasound-based volumetric blood flow indices to monitor CA. Swine were instrumented under general anesthesia to monitor mean arterial blood pressure (MAP), intracranial pressure (ICP), and blood flow in the internal carotid artery (ICA) and femoral artery (FA) and flow velocity and volumetric flow in the middle cerebral artery (MCA) using transcranial Doppler. Animals were subjected to several physiological challenges to perturb cerebral pressure and flow hemodynamics as follows: (1) Vasopressor challenge by controlled infusion of norepinephrine to raise MAP to 150-160 mmHg, followed by its down titration. (2) Epidural hematoma by inflating a subdurally-placed balloon to raise ICP to 35-45 mmHg, followed by deflation of the balloon. (3) Hemorrhage and resuscitation by controlled removal of the blood from jugular vein. After a 10-15 min period of hypovolemia, resuscitated started to raise MAP to 65 mmHg. Pressure reactivity index (PRx) was calculated as a moving Pearson correlation coefficient between MAP and ICP. The flow/flow indices [FFx(s)] were calculated as a moving Pearson correlation coefficient between FA blood flow and one of the following (mean flow velocity in the MCA, relative volumetric flow in the MCA and blood flow in the ICA). FFx(s) were compared to PRx using area under the receiver operator characteristic curve (AUROC) and the precision recall curve (AUPRC). FFx(s) demonstrated AUPRC and AUROC ranges (0.88-0.91) and (0.73-0.79). The FFx(s) can act as excellent potential surrogates for the PRx for the assessments of CA.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1891-1900"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957605","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":"Transcranial Photobiomodulation Improves Cognitive Function, Post-Concussion, and PTSD Symptoms in Mild Traumatic Brain Injury.","authors":"Tsz-Lok Lee, David Yuen-Chung Chan, Danny Tat-Ming Chan, Mei-Chun Cheung, David Ho-Keung Shum, Agnes Sui-Yin Chan","doi":"10.1089/neu.2025.0048","DOIUrl":"10.1089/neu.2025.0048","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) occurs in millions of people globally each year, with mild TBI (mTBI) representing over 90% of cases. Despite the common assumption of full recovery, significant disturbances persist in many patients with mTBI, including cognitive deficit, headache, dizziness, sleep problems, and symptoms of post-traumatic stress disorder (PTSD). Given that effective treatment is still scarce, the present study investigated the efficacy of transcranial photobiomodulation (tPBM) as an intervention for improving these sequelae in patients with mTBI. In this randomized placebo-controlled trial, 17 patients with mTBI were recruited. Participants were randomized to receive both real and sham tPBM conditions with a counterbalanced order, with a 1-week washout between interventions. Assessments were conducted at baseline, after real tPBM, and after sham tPBM. These included neuropsychological tests, measurements of oxygenated hemoglobin using functional near-infrared spectroscopy during a visual working memory task, and self-rated questionnaires assessing sleep quality, physical post-concussion symptoms, pain intensity, and PTSD symptoms. Compared with the baseline, participants demonstrated significant improvements. After receiving tPBM, patients showed enhanced cognitive efficiency, as evidenced by improved visual working memory performance, better learning in verbal memory tests, improved subjective sleep quality, fewer physical post-concussion symptoms, reduced pain intensity, and decreased PTSD symptoms. In contrast, no significant improvement was observed after patients received the sham tPBM. In addition, the statistically significant improvement in behavioral symptoms also reached the minimal clinically important difference, suggesting clinical significance. These findings support the potential of tPBM as a safe, non-invasive clinical intervention for cognitive deficits and associated symptoms in mTBI. Further exploration is encouraged to evaluate tPBM as a rehabilitation strategy for enhancing recovery in TBI patients.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1695-1707"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248345","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":"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":"1805-1815"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","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":"Randomized Controlled Trial of Brock String Vision Therapy for Receded Near Point of Convergence Following Concussion.","authors":"Alicia M Trbovich, Aaron J Zynda, Tori Togashi, Chris Burley, Anne Mucha, Michael W Collins, Anthony P Kontos","doi":"10.1177/08977151251359960","DOIUrl":"10.1177/08977151251359960","url":null,"abstract":"<p><p>The objective of this study was to compare the effectiveness of Brock string vision therapy (BSVT) with usual care (UC) for receded near point of convergence (NPC) following concussion. This study employed a single-blind, randomized controlled trial design involving participants aged 11-30 years within 10 days of a concussion. Participants with receded NPC (i.e., mean NPC ≥5 cm) were randomized to either BSVT or UC. The BSVT group was prescribed BSVT exercises (5 reps, 2× daily, using ∼3 meters string with three colored beads). The UC group was prescribed symptom-specific management strategies (i.e., breaks during reading or other visual tasks) and behavioral management (e.g., sleep, hydration, diet) until follow-up (7-14 days post-enrollment). Two-way mixed effects analyses of variance examined the interaction between group (BSVT, UC) and time (enrollment, follow-up) on mean NPC (primary outcome) and secondary outcomes (e.g., Concussion Clinical Profile Screen [CP Screen]). Fifty participants were enrolled, with 25 in BSVT (age = 15.8 ± 4.1, 44% F, 84% sport-related concussion [SRC]) and 25 in UC (age = 17.9 ± 4.8, 36% F, 60% SRC). Results supported an interaction in the BSVT group for NPC (F[1, 48] = 5.3, <i>p</i> = 0.026, η_p² = 0.10) and CP Screen Neck (F[1, 43] = 4.9, <i>p</i> = 0.033, η_p² = 0.10). The BSVT group exhibited greater improvement in mean NPC distance (-8.9 cm, 95% confidence interval [CI] = -12.1, -5.7, <i>p</i> < 0.001) than the UC group (-3.8 cm, 95% CI = -6.9, -0.6, <i>p</i> = 0.02), and greater improvement in CP Screen Neck symptoms (-0.6, 95% CI, -1.1, -0.03, <i>p</i> = 0.039) than the UC group (0.27, 95% CI, -0.3, 0.8, <i>p</i> = 0.32). BSVT improved mean NPC distance compared with UC, suggesting that this simple, inexpensive, and early intervention may be effective for treating receded NPC following concussion. <b>Trial registration:</b> www.clinicaltrials.gov; identifier: NCT04076657.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1708-1718"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075426","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":"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":"1719-1731"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413749/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory, White Matter, and Neurodegenerative Mechanisms in Fluid Ability Decrements in Chronic Mild-to-Moderate Traumatic Brain Injury.","authors":"Samantha H Penhale, Abigail B Waters, Shoumi Sarkar, Leah E McQuillan, John Maczuzak, Somnath Datta, Damon Lamb, Claudia Robertson, Richard Rubenstein, Amy K Wagner, Firas Kobeissy, Kevin K W Wang, John B Williamson","doi":"10.1089/neu.2024.0566","DOIUrl":"10.1089/neu.2024.0566","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) affects millions globally each year, with mild TBI comprising about 75% of cases. While most mild TBI symptoms are resolved within 3 months, some patients experience persistent issues. This study aimed to identify underlying mechanisms contributing to decrements in fluid cognitive abilities in chronic (>6 months) mild-to-moderate TBI. Specifically, the study focused on the relationships between cognitive performance, white matter integrity, TBI-related symptoms, and blood biomarkers, which are thought to be indicative of biological processes including neuronal injury (neurofilament light [NF-L], neurofilament heavy, ubiquitin C-terminal hydrolase-L1), vascular injury (vascular endothelial growth factor A), glial injury (glial fibrillary acidic protein [GFAP]), neurodegeneration (tau, phosphorylated-tau), immune response (GFAP immunoglobulin G), and inflammation (tumor necrosis factor-α, interleukin [IL]-2, IL-4, IL-6, IL-8, IL-10, interferon-γ, and macrophage inflammatory protein-1α). The final study sample included 57 participants (42 males, 15 females) aged 19-59 with a history of chronic, remote mild-to-moderate TBI. Participants underwent cognitive and behavioral testing, neuroimaging, and a blood draw. Diffusion-weighted magnetic resonance imaging was used to assess white matter integrity in tracts connecting frontal and parietal regions with fractional anisotropy utilized as the metric. Blood samples were analyzed for TBI-related biomarkers. The study found that higher fluid cognition scores were associated with higher white matter integrity in frontal-parietal networks, fewer reported TBI-related symptoms, and mixed biomarker and cytokine levels. Inflammatory processes were linked to lower fractional anisotropy in white matter pathways, more reported symptoms, and increased biomarkers of injury. Higher white matter integrity was also associated with fewer reported neurobehavioral symptoms. The findings provide evidence for a complex interplay of ongoing neuroinflammatory processes, white matter integrity, symptomology, and cognitive function in chronic mild-to-moderate TBI. The results underscore the importance of considering both structural brain changes and systemic responses in understanding the long-term effects of TBI. The observed correlations between cognitive deficits, white matter disruptions, and biomarker profiles suggest potential avenues for targeted interventions aimed at mitigating these effects in TBI patients.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1732-1746"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484689","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":"Diffusion Tensor Imaging in Acute, Chronic, and Remote Mild Traumatic Brain Injury: A Systematic Review of Cross-Sectional and Longitudinal Studies.","authors":"Shiv Patil, Mert Karabacak, Serhat Aydin, Inna Sagi, Andrea Soddu, Burak Berksu Ozkara, Konstantinos Margetis, Sotirios Bisdas","doi":"10.1177/08977151251363258","DOIUrl":"10.1177/08977151251363258","url":null,"abstract":"<p><p>Mild traumatic brain injury (mTBI) is a global health concern that remains difficult to clinically evaluate due to variable diagnostic criteria and a lack of objective biomarkers. Diffusion tensor imaging (DTI) has been shown to be a sensitive measure of microstructural injury caused by head injury that cannot be visualized by conventional neuroimaging, which may potentially aid in the diagnosis and prognosis of mTBI. This review seeks to evaluate the available literature concerning the role of DTI in evaluating microstructural alterations in white matter (WM) associated with mTBI. An initial systematic search from PubMed, CENTRAL, Embase, MEDLINE, Web of Science, and Scopus yielded 1507 articles published between 2007 and 2024. A total of 79 studies met the full eligibility criteria for inclusion in this qualitative synthesis. The majority of studies demonstrated DTI abnormalities in the setting of acute, chronic, and remote mTBI, predominantly in the WM tracts of the corpus callosum, corona radiata, internal capsule, and longitudinal fasciculus. Many studies identified associations between DTI parameters and clinical measures of mTBI, such as cognitive performance, executive functioning, and comorbidities, including post-concussion syndrome and post-traumatic stress disorder. Overall, the weight of evidence in this review supports the cautious integration of DTI in the clinical assessment of mTBI. The observed discrepancies reported in the literature on DTI may be explained by significant variability in study design, analytical technique, and measured clinical outcomes. Further research that implements consistent methodology is crucial to fully realize the use of DTI as an imaging biomarker of mTBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1671-1694"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784478","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>Clostridium butyricum</i> Restores Intestinal Barrier Integrity via the IL-22/Reg3 Pathway Following Traumatic Brain Injury in Mice.","authors":"Min Liu, Ying Pang, Li Xu, Tongjie Ji, Junyu Yang, Dan Huang, Meng Cheng, Mu Chen, Bingsong Huang, Siyi Xu, Kaijun Zhao, Jing Zhang, Takehiko Yokomizo, Chunlong Zhong","doi":"10.1177/08977151251367404","DOIUrl":"10.1177/08977151251367404","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) disrupts the intestinal barrier, linking brain trauma to systemic inflammation and secondary complications. This study investigated the role of gut microbiota and its metabolites in intestinal barrier dysfunction following TBI, using a controlled cortical impact mouse model. TBI-induced gut dysbiosis was characterized by reduced microbial diversity and a loss of butyrate-producing bacteria, which led to decreased levels of short-chain fatty acids (SCFAs), particularly butyric acid. This disruption compromised the interleukin-22/regenerating islet-derived protein 3 (IL-22/Reg3) signaling pathway, which is essential for maintaining gut barrier integrity. Supplementation with <i>Clostridium butyricum</i> restored butyric acid production, enhanced IL-22/Reg3 expression, and alleviated TBI-induced intestinal permeability. These findings identify the SCFA/IL-22/Reg3 axis as a key mediator of gut barrier homeostasis after TBI and highlight the potential therapeutic role of butyrate-producing probiotics in managing TBI-associated intestinal complications.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1843-1867"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957610","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":"Effects of Screen Time Use on Psychological Symptoms in Adolescents Following Concussion.","authors":"João Paulo Lima Santos, Aaron J Zynda, Courtney A Perry, Richelle S Stiffler, Cyndi L Holland, Michael W Collins, Anthony P Kontos, Amelia Versace","doi":"10.1177/08977151251385568","DOIUrl":"https://doi.org/10.1177/08977151251385568","url":null,"abstract":"<p><p>Excessive screen time (ST) use has been linked to more depressive and anxiety symptoms, whereas moderate use may confer benefits for psychological health in adolescents. However, its role in psychological health following concussion in adolescents remains unclear. This study examined the effects of ST use on depressive and anxiety symptoms in adolescents following concussion. A total of 102 adolescents comprising 62 (mean [standard deviation (SD)] = 15.2 [1.7] years; 45.2% female) within 10 days of a diagnosed concussion, and 40 age- and sex-matched healthy controls (mean age [SD] = 14.99 [1.62] years; 50% female) participated in the study. Psychological symptoms were assessed using the Children's Depression Rating Scale and the Screen for Child Anxiety Related Emotional Disorders in the first 10 days (V1) and 3 months (V2) postinjury. Recreational ST use was self-reported at V1. K-means clustering classified adolescents with concussion into ST subgroups. Robust regression and false discovery rate correction examined group differences at V1 and V2 postinjury. Three clusters of ST use were identified: low (<i>N</i> = 14; mean [SD] = 1.97 [0.89] h/day), moderate (<i>N</i> = 25; mean [SD] = 5.22 [0.86] h/day), and high (<i>N</i> = 23; mean [SD] = 8.96 [1.42] h/day). At V1, all groups reported higher depressive and anxiety symptoms than controls (<i>p</i> < 0.041). At V2, all symptoms in the moderate-use group returned to control levels; however, the high-use group reported elevated depressive symptoms (F = 12.48, <i>p</i> = 0.001, <i>Q</i> = 0.003), and the low-use group reported elevated anxiety (F = 23.15, <i>p</i> < 0.001, <i>Q</i> < 0.001) compared with controls. Moderate recreational ST use was associated with significant recovery, while low and high ST use were associated with persistent symptoms in adolescents following concussion. Adolescents may benefit from recommendations that support a \"Goldilocks\" approach to ST use following concussion.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199365","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> From Classification to Clinical Care: Reflections on Blood Biomarkers in TBI.","authors":"Cyril Pernod, Nathan Beucler","doi":"10.1177/08977151251384937","DOIUrl":"https://doi.org/10.1177/08977151251384937","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186028","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}