Neurotrauma reports最新文献

{"title":"Sleep Fragmentation as a Diagnostic Biomarker of Traumatic Brain Injury.","authors":"Grant S Mannino, Christian R Baumann, Mark R Opp, Rachel K Rowe","doi":"10.1089/neur.2025.0050","DOIUrl":"10.1089/neur.2025.0050","url":null,"abstract":"<p><p>Sleep disturbances are among the most prevalent and persistent consequences of traumatic brain injury (TBI), yet they remain underutilized as clinical indicators of injury status. In this perspective, we propose that sleep fragmentation-defined as the frequency of transitions between sleep and wakefulness-represents a functional, scalable, and underrecognized diagnostic biomarker of TBI. Drawing on empirical findings from a mouse model of diffuse TBI, we show that summary measures of sleep fragmentation and duration can reliably distinguish injured from uninjured animals using dimensionality reduction and machine learning techniques. Current biomarkers such as glial fibrillary acidic protein and neurofilament light chain provide valuable insights into structural damage but offer limited information about how injury affects behavior and day-to-day function. Sleep-based metrics, by contrast, reflect neural network integrity and capture ongoing physiological disruption. Critically, these metrics can be collected non-invasively, longitudinally, and in real-world settings using actigraphy, making them a practical complement to blood-based diagnostics that require biological sampling and specialized laboratory infrastructure. Our analysis demonstrates that sleep metrics collected over 48 h post-injury-specifically the number of sleep-wake transitions-carry a strong diagnostic signal. Sleep metrics offer a behaviorally grounded complement aligned with the goals of precision medicine and functional assessment. With further validation, these features may also support monitoring recovery or stratifying injury severity. This perspective highlights sleep fragmentation as a non-invasive diagnostic biomarker for TBI with the potential to enhance individualized monitoring and support early detection efforts in both research and clinical settings.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"482-490"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accounting for Withdrawal of Life-Sustaining Treatment in the Analysis of Traumatic Brain Injury Studies.","authors":"Brian C Healy, Brian L Edlow, Yelena G Bodien","doi":"10.1089/neur.2025.0010","DOIUrl":"10.1089/neur.2025.0010","url":null,"abstract":"<p><p>Studies that aim to evaluate outcomes after severe traumatic brain injury (TBI) must account for patients who die after withdrawal of life-sustaining treatment (WLST). If we are willing to assume that some of the patients who die of WLST might have had a good outcome at 6 months, the choice of analytic approach may impact the results. In this study, 6-month clinical outcomes for patients with TBI were simulated under six different scenarios related to WLST. Each scenario represents different assumptions related to the decision to choose WLST and how that decision relates to the 6-month clinical outcome. For each simulated dataset and scenario, three analytic approaches were used to estimate the probability of a good outcome at 6 months: complete case analysis, worst-case imputation, and inverse probability weighted analysis. The bias of the estimate from each of the approaches was used to compare the performance of the analysis approaches. When the probability of WLST was equal for all patients (i.e., covariates were not factored into the WLST decision), both the complete case analysis and the inverse probability weighted analysis were unbiased. When only patients who would have a poor outcome at 6 months were eligible to have WLST, only the worst-case imputation analysis was unbiased. When the probability of WLST was a function of observed patient characteristics that were also related to 6-month outcome (e.g., age, injury severity), only the inverse probability weighted analysis was unbiased. Finally, when the probability of missingness was related to an unobserved patient characteristic, none of the approaches were unbiased. If some patients who die of WLST might have had a good outcome, inverse probability weighting could be considered to decrease bias associated with censoring or imputing poor outcomes for participants with WLST.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"435-441"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Traumatic Brain Injury on the Orexin/Hypocretin System.","authors":"Rebecca T Somach, Miranda M Lim, Akiva S Cohen","doi":"10.1089/neur.2024.0111","DOIUrl":"https://doi.org/10.1089/neur.2024.0111","url":null,"abstract":"<p><p>Traumatic Brain Injuries (TBIs) are known to cause a myriad of symptoms in patients. One common symptom after injury is sleep disruptions. One neuropeptide system has been studied repeatedly as a potential cause of sleep disruptions after TBI- the orexin/hypocretin system. Orexin promotes wakefulness and arousal while disrupting the orexin system causes increased sleepiness and narcolepsy. Studies of TBI in human and animal subjects have shown that TBI affects the orexin system. This review serves as an overview of how TBI affects the orexin/hypocretin system, including structural and functional changes to the neurons after injury. This review is the first to include studies that examine how TBI affects orexin/hypocretin receptors. This review also examines how sex is accounted for in the studies of the orexin system after TBI.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"322-335"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crossing the Valley of Death in Spinal Cord Injury: Learning from Successful Translators.","authors":"Vieri Failli, Stephen M Strittmatter, Martin E Schwab, Aileen J Anderson, Angela Ruban, Hassan Al-Ali, Armin Curt, Adrien Cohen, Jane T C Hsieh","doi":"10.1089/neur.2025.0029","DOIUrl":"https://doi.org/10.1089/neur.2025.0029","url":null,"abstract":"<p><p>A straightforward path to successful scientific translation remains uncharted, particularly in a complex progressive condition such as spinal cord injury (SCI), which affects multiple body functions simultaneously. Evolving regulatory requirements add to the complexity and expense of attaining a treatment that is both safe and efficacious. Although rare, there are examples of SCI scientists who have successfully navigated the \"valley of death\" from discovery science to completed clinical trials. This article reflects the translational journey of five SCI scientists who have encountered similar and different scenarios while striving to launch or complete a clinical trial. Learning from these experiences has identified lessons learned and gaps, particularly with respect to funding and support for SCI translation.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"298-310"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Spinal Cord Injury in British Columbia, Canada: 20 Years of Population-Based Administrative Data.","authors":"Michael Bond, Aidan Beresford, Vanessa Noonan, Naama Rotem-Kohavi, Marcel Dvorak, Brian Kwon, Guiping Liu, Jason M Sutherland","doi":"10.1089/neur.2025.0012","DOIUrl":"https://doi.org/10.1089/neur.2025.0012","url":null,"abstract":"<p><p>Traumatic spinal cord injury (TSCI) is a debilitating condition that can have significant effects on physical function and overall quality of life. Mechanisms of injury can vary from major trauma to low-energy falls. There has been a recent increase in the number of elderly patients with TSCI. A retrospective analysis of population-based hospital records linked with health care administrative datasets was conducted to measure age-standardized rates of TSCI over time. The study was conducted to describe the epidemiology and demographic characteristics of patients who experienced TSCI between 2001 and 2021 in the province of British Columbia, Canada. Demographic, clinical characteristics, and rates of TSCI were evaluated over time. Linear regression was used to assess changes over time. The study identified 3622 patients with TSCI. The average age at the time of injury was 51.1 (standard deviation [SD] 21.19) and 75.0% were males. The average annual age-standardized rate in this population was 35.4 per million. The overall rate remained stable throughout the study period. The mean age at injury increased from 41.9 to 57.5 over the study period of 2001-2021 (<i>p</i> < 0.001). The most frequent causes of injury were low-energy falls (49.9%) and motor vehicle injuries (36.6%). The proportion of injuries related to falls increased over the study period (<i>p</i> < 0.001). Motor and sensory complete TSCI were seen in higher rates among younger patients, and cervical spine injuries were most common among all age-groups. The rate of TCSI was consistent during the study period, though the demographic of patients and their injury mechanism changed considerably; elderly low-energy falls were an increasing proportion of cases. Continued vigilance in elderly fall prevention is needed to reduce the incidence of TCSI among the elderly.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"311-321"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Dynamics of Retinal Inflammation Following Blast Exposure in a Ferret Model.","authors":"Rex Jeya Rajkumar Samdavid Thanapaul, Chetan Pundkar, Gaurav Phuyal, Manoj Y Govindarajulu, Ashwathi Menon, Joseph B Long, Peethambaran Arun","doi":"10.1089/neur.2024.0127","DOIUrl":"https://doi.org/10.1089/neur.2024.0127","url":null,"abstract":"<p><p>Blast-induced traumatic ocular injury (bTOI) is a major cause of vision loss in military personnel involved in recent combat operations. However, its underlying mechanisms remain poorly understood, hindering the development of effective treatments. This study investigated the temporal expression patterns of key inflammatory markers in the retina after blast exposure using a ferret model. Ferrets (<i>n</i> = 40) were subjected to two tightly coupled blasts (20 psi) using an advanced blast simulator. Retinal tissues were collected at 4 h, 24 h, or 28 days post-blast. Differential mRNA expression of Toll-like receptors (<i>TLR</i>s: <i>1-9</i>), cytokines (<i>IL</i>: <i>1β, 6,</i> and <i>10</i>), and cyclooxygenase enzymes (<i>COX</i>: 1 and 2) was assessed using quantitative real-time polymerase chain reaction after blast exposure and compared with sham controls. Our results revealed a rapid and sustained upregulation of multiple <i>TLR</i>s (1, 2, 4, 5, 7, and 8) in the retina following blast exposure, indicating a robust inflammatory response. This was accompanied by a significant increase in pro- and anti-inflammatory cytokines (<i>IL-1β</i>, <i>IL-6 IL-10,</i> and <i>COX2</i>) at 4 h post-blast, suggesting their involvement in the acute pathogenesis of bTOI. Our findings emphasize the critical role of early innate immune responses and the potential for chronic inflammation in bTOI, highlighting the importance of timely therapeutic interventions. Targeting these inflammatory pathways may offer therapeutic avenues for mitigating retinal damage and improving ocular function.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"283-290"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Seizures in Hospitalizations with Traumatic Brain Injury: A U.S. Population-Based Study.","authors":"Alka Mithal, Maanek Sehgal, Christopher Newey, Derek Ems, Vince Florio, Gurkirpal Singh","doi":"10.1089/neur.2025.0001","DOIUrl":"https://doi.org/10.1089/neur.2025.0001","url":null,"abstract":"<p><p>In the United States, data on outcomes in adults hospitalized with traumatic brain injury (TBI) and concomitant seizures are limited. Here, we report on a feasibility analysis to understand the prevalence and consequences of concomitant seizures in patients with TBI. A retrospective database study was conducted using the National Inpatient Sample 2016-2020. Hospitalizations in patients (≥18 years of age) with TBI were assessed and stratified into groups either with or without concomitant seizures. All patient data were stratified by age, sex, ethnicity, and payer type. The primary outcome was the prevalence of seizures or epilepsy among hospitalizations for TBI. Other outcome variables recorded were mean charges, length of hospital stay, and case fatality. Overall, 1,591,575 hospitalizations with TBI were assessed over the study period. TBI prevalence remained relatively constant throughout the study period and was higher in men and those aged ≥65 years. Concomitant seizures were observed in 12.2% of all patients and were highest for men, the 45-64 years age group, and Black and Native Americans. Mean charges were significantly higher and length of hospital stay was significantly longer in TBI hospitalizations with seizures compared with those without seizures across all study years. No significant difference in case fatality between patients with seizures compared with those without seizures was observed. Data from this analysis showed differences in demographics and outcomes for TBI hospitalizations with versus without concomitant seizures, highlighting potential disparities in health care for patients experiencing seizures that warrant further research.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"291-297"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Acceptability of Telephone-Administered Traumatic Brain Injury Common Data Elements and the Rehabilitation Needs Survey in Community-Dwelling Adults Exposed to the United States Criminal Legal System.","authors":"Casey LaDuke, Kabrianna Tamura, Micaela Linder, Ronald Day, Kristen Dams-O'Connor","doi":"10.1089/neur.2024.0158","DOIUrl":"https://doi.org/10.1089/neur.2024.0158","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is common among legally-impacted adults and has also been linked to negative outcomes throughout the criminal legal system. Despite this, relatively limited TBI research has focused on or even included legally-impacted adults. Existing literature in this population has used heterogeneous TBI definitions, populations, and measures when studying outcomes. This study therefore investigates the feasibility and acceptability of telephone-administered TBI common data elements (CDEs) and the Rehabilitation Needs Survey (RNS) in 85 legally-impacted community-dwelling adults. Regarding feasibility, completion rates across measures were high (88-100%), and noncompletion was most commonly due to participants declining to continue. Regarding acceptability, data collectors were able to administer and code most measures with relative ease. Reported difficulties related to measures requiring detailed data collector training to administer and code, such as the Brain Injury Screening Questionnaire (BISQ) and Brief Test of Adult Cognition by Telephone, or challenges inherent to self-report tests in general. In addition, data collectors recommended adding specific questions to the BISQ to query head injuries experienced during or as a result of their exposure to the criminal legal system. Overall, results support the use of telephone-administered TBI CDEs and the RNS in legally-impacted adults, and underscore the need for culturally-responsive training and technical assistance for TBI researchers engaging with this population.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"274-282"},"PeriodicalIF":1.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content.","authors":"Adrienne K Ho","doi":"10.1089/neur.2025.0008","DOIUrl":"https://doi.org/10.1089/neur.2025.0008","url":null,"abstract":"<p><p>Previous studies on restrictive versus liberal blood hemoglobin transfusion triggers in critically ill or cardiac surgery patients had established a paradigm favoring restrictive triggers. In contrast, the hemoglobin transfusion threshold in traumatic brain injury optimization and transfusion strategy in patients with acute brain injury trials (2024) suggest that a liberal hemoglobin (90-100 g/L) transfusion trigger is associated with better neuro-outcomes than a restrictive (70 g/L) trigger in anemic patients with acute brain injury. Increased blood oxygen content is one obvious possible reason for the observed superior neuro-outcomes with more liberal red blood cell transfusion. In this author's opinion, another plausible reason is that in replacing extracranial blood loss, which most of the patients in both trials had, avoidance of blood alternatives that could worsen intracranial hypertension might also have benefitted the liberal transfusion cohorts.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"257-260"},"PeriodicalIF":1.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Pediatric Traumatic Brain Injury Patients in a Tertiary Regional Trauma Center in the Philippines.","authors":"Maurice V Bayhon, Ibet Marie Y Sih","doi":"10.1089/neur.2025.0002","DOIUrl":"https://doi.org/10.1089/neur.2025.0002","url":null,"abstract":"<p><strong>Abstract: </strong>Traumatic brain injury (TBI) is a leading cause of disability and death in children. Limited data exists on pediatric TBI in Southeast Asia, especially in low- and -middle-income countries. This study investigates the clinical characteristics and outcomes of pediatric TBI patients in a tertiary trauma center in the Philippines. This retrospective cohort study examined pediatric patients (18 years and under) with TBI admitted to a Philippine trauma center from 2021 to 2023. A total of 218 patients were included. Data on demographics, injury mechanisms, TBI severity, cranial imaging, surgical procedures, complications, and discharge outcomes were analyzed.</p><p><strong>Abstract: </strong>Among the 218 patients, 75% were male, and most were aged 13-18. The primary mechanism of injury was motor vehicle crashes (MVCs), especially in older children (80%). For patients under 5, falls and MVCs were equally common. Most cases were mild (69%), and 40.8% had negative cranial imaging. Epidural hematoma (20%) was the most common abnormal finding. Of the patients, 8% required surgery, with craniotomy for epidural hematoma being the most frequent procedure. Half of those who underwent surgery had neurological deficits, and there was one recorded death. Overall, 86.7% of patients were discharged without complications, though only 34.6% of those with severe TBI had good outcomes. The overall complication rate was 8.7%, with mild neurological deficits being most common. The case fatality rate was 4.6%, with severe TBI showing a higher rate of 30.8%. The majority of patients were male teenagers involved in MVCs. Although most TBIs were mild, there was a notable incidence of severe TBI, particularly with epidural hematoma. These findings suggest higher-impact trauma in the Philippines. The complication and mortality rates align with other studies. Efforts should focus on road safety, traffic law enforcement, and public education. A multi-center prospective study is needed to better understand the factors influencing outcomes in pediatric TBI.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"251-256"},"PeriodicalIF":1.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}