Brain injury最新文献

Identifying mild traumatic brain injury in the post-acute polytrauma setting: a scoping review of diagnostic approaches and screening tools. 识别轻度创伤性脑损伤后急性多发创伤设置：诊断方法和筛选工具的范围审查。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2025-01-02 DOI: 10.1080/02699052.2024.2443771

Matthew J Burke, Yomna E Ahmed, Zoe Li, Kris Sanchez, Alexander Winston, Peter Broadhurst, Barbara Haas, Rosalie J Steinberg, Marina B Wasilewski, Noah D Silverberg, Lawrence R Robinson, Sander L Hitzig

{"title":"Identifying mild traumatic brain injury in the post-acute polytrauma setting: a scoping review of diagnostic approaches and screening tools.","authors":"Matthew J Burke, Yomna E Ahmed, Zoe Li, Kris Sanchez, Alexander Winston, Peter Broadhurst, Barbara Haas, Rosalie J Steinberg, Marina B Wasilewski, Noah D Silverberg, Lawrence R Robinson, Sander L Hitzig","doi":"10.1080/02699052.2024.2443771","DOIUrl":"10.1080/02699052.2024.2443771","url":null,"abstract":"Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults. Of the 696 studies identified, only six met the inclusion criteria, highlighting the limited research in this area.Results: The review assessed various diagnostic tools including the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), neuropsychological tests, advanced imaging, and oculomotor assessments. However, these tools are limited in their ability to confirm whether an mTBI has occurred. The American Congress of Rehabilitation Medicine's updated mTBI criteria may offer the best diagnostic potential but require validation.Conclusion: According to the findings, there is a significant gap in validated diagnostic tools for mTBI in post-acute settings, which may negatively affect patient outcomes. Developing and validating effective screening tools for mTBI in the post-acute polytrauma setting should be the priority of future research in this area.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"445-456"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effectiveness and safety of botulinum toxin treatment for sialorrhea due to severe brain injury. 肉毒杆菌毒素治疗重型颅脑损伤性唾液漏的有效性和安全性。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2025-01-03 DOI: 10.1080/02699052.2024.2444536

Teresa Clark, Ezgi Arikan, Lloyd Bradley

{"title":"The effectiveness and safety of botulinum toxin treatment for sialorrhea due to severe brain injury.","authors":"Teresa Clark, Ezgi Arikan, Lloyd Bradley","doi":"10.1080/02699052.2024.2444536","DOIUrl":"10.1080/02699052.2024.2444536","url":null,"abstract":"Introduction: Sialorrhea may be a consequence of severe acquired brain injury (ABI). Salivary gland botulinum neurotoxin (SG-BoNT) injections can reduce saliva production, but there is limited evidence for their use in ABI.We reviewed the effectiveness, impact on chest infection frequency, and safety of SG-BoNT for sialorrhea in a cohort of patients with severe ABI.Materials/methods: Retrospective cohort study of 49 patients, in a specialist ABI care facility, with sialorrhea who received SG-BoNT.Outcome measures included pre- and post-injection Drooling Severity and Frequency Scale (DSFS) scores, pre- and post-injection chest infection frequency, and adverse events.Results: Forty-nine patients received 79 SG-BoNT treatments (100 to 200 units of botulinum toxin A).Post-treatment the whole group showed significantly reduced mean DSFS scores (z = -6.4, p < 0.00001) and significantly fewer chest infections (z = -3.15, p = 0.0016). A reduction in chest infection frequency was seen in patients who received repeated treatments (2 or more) and/or higher SG-BoNT doses. There were no adverse events.Conclusions: There is limited evidence for SG-BoNT in the treatment of sialorrhea for people with ABI but this treatment is clinically effective with no detectable adverse effects in this cohort. The reduction in chest infection frequency following repeated SG-BoNT injections is an important novel finding.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"476-481"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Longitudinal analysis highlights structural changes in grey- and white-matter within military personnel exposed to blast. 纵向分析强调了暴露在爆炸中的军事人员灰质和白质的结构变化。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2024-12-27 DOI: 10.1080/02699052.2024.2446948

Allen A Champagne, Nicole S Coverdale, Christopher Skinner, Betty Anne Schwarz, Rafael Glikstein, Gerd Melkus, Christopher I Murray, Gabriel Ramirez-Garcia, Douglas J Cook

{"title":"Longitudinal analysis highlights structural changes in grey- and white-matter within military personnel exposed to blast.","authors":"Allen A Champagne, Nicole S Coverdale, Christopher Skinner, Betty Anne Schwarz, Rafael Glikstein, Gerd Melkus, Christopher I Murray, Gabriel Ramirez-Garcia, Douglas J Cook","doi":"10.1080/02699052.2024.2446948","DOIUrl":"10.1080/02699052.2024.2446948","url":null,"abstract":"Objective: The purpose of this study was to determine whether gray matter volume and diffusion-based metrics in associated white matter changed in breachers who had neuroimaging performed at two timepoints. A secondary purpose was to compare these changes in a group who had a one-year interval between their imaging timepoints to a group that had a two-year interval between imaging.Methods: Between timepoints, clusters with significantly different gray matter volume were used as seeds for reconstruction of associated structural networks using diffusion metrics.Results: Of 92 eligible participants, 62 had imaging at two timepoints, 36 with a one-year interval between scans and 26 with a two-year interval between scans. A significant effect of time was documented in the midcingulate cortex, but there was no effect of timepoint (1 versus 2 years). The associated white matter in this cluster had three regions with differences in fractional anisotropy compared to baseline, while there was no effect of timepoint (1 versus 2 years).Conclusions: This study provides preliminary evidence that military personnel involved in repetitive exposure to sub-concussive blast overpressures may experience changes to both gray matter and white matter structures.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"509-517"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship between language comprehension and chronic neurobehavioral symptoms in adults with mild traumatic brain injury. 成人轻度创伤性脑损伤的语言理解与慢性神经行为症状的关系

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2024-12-29 DOI: 10.1080/02699052.2024.2445700

T G Flaugher, S Chang, T Reistetter, R S Norman

{"title":"Relationship between language comprehension and chronic neurobehavioral symptoms in adults with mild traumatic brain injury.","authors":"T G Flaugher, S Chang, T Reistetter, R S Norman","doi":"10.1080/02699052.2024.2445700","DOIUrl":"10.1080/02699052.2024.2445700","url":null,"abstract":"Primary objectives: Annually, millions of Americans sustain mild traumatic brain injuries (mTBI), and some may experience neurobehavioral symptoms (NBS), like slow processing speed that persist chronically or longer than 6 months post injury. In turn, cognitive processes like language comprehension may be compromised. This study investigates the relationship between NBS and language comprehension in individuals with mTBI history and low or high NBS.Methods & procedures: Thirty-one adults with mTBI and high (n = 13; female = 11) and low (n = 18; female = 10) NBS completed a language comprehension task in speeded and unspeeded conditions. Reduced language comprehension, as measured by slower response times (RTs) and reduced accuracy, was expected to be high compared to low NBS group, regardless of condition. Language comprehension correlates (e.g. cognition and general processing speed) were also measured.Main outcomes & results: Adults with high NBS showed reduced comprehension, measured by slower RTs in the unspeeded condition compared to low NBS. No difference in accuracy or errors produced was observed. Cognitive skills and processing speed are negatively correlated and predicted language comprehension task performance.Conclusions: NBS and predictive factors specific to the individual are important to monitor post-mTBI, as they may affect language functioning.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"482-495"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endophenotype presentation of athletes with concussion contingent on sex and time since injury. 运动员脑震荡的内表型表现与受伤后的性别和时间有关。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2025-01-09 DOI: 10.1080/02699052.2025.2449934

Joshua A Beitchman, Jane S Chung, Jacob C Jones, Linda S Hynan, Nyaz Didehbani, C Munro Cullum, Shane M Miller, Mathew Stokes

{"title":"Endophenotype presentation of athletes with concussion contingent on sex and time since injury.","authors":"Joshua A Beitchman, Jane S Chung, Jacob C Jones, Linda S Hynan, Nyaz Didehbani, C Munro Cullum, Shane M Miller, Mathew Stokes","doi":"10.1080/02699052.2025.2449934","DOIUrl":"10.1080/02699052.2025.2449934","url":null,"abstract":"Introduction: Athletes with concussions experience heterogeneous symptoms and clinical trajectories. Subclassification provides diagnostic clarity that may improve prognostication and individualized treatments.Methods: We hypothesized that endophenotypes of adolescent athletes with concussions differ based on sex and time since injury. Post-concussive testing was performed for athletes (n = 1385) in the North Texas Concussion Registry (ConTex) at four timepoints: acute [0-3 days post-injury (DPI)], subacute-early (4-7DPI), subacute-late (8-28DPI), and persistent (29+DPI). Six endophenotypes (cognitive, headache, ocular-motor, vestibular, affective, sleep) were constructed by allocating post-concussion testing data elements described by the Concussion Subtype Workgroup.Results: Endophenotypes were defined using correlations between data elements and compared based on sex or time since injury. Correlograms revealed endophenotypes differed based on sex and time since injury. The affective endophenotype was dependent on the interaction between sex and time since injury and was more prevalent at the subacute-late and persistent timepoints. The sleep endophenotype became more prevalent at the persistent timepoint. Affective and sleep endophenotypes were interrelated with cognitive, vestibular, and headache endophenotypes at the persistent timepoint suggesting that dysregulated mood and sleep influence lingering symptoms.Conclusions: Adolescent symptom-based concussion endophenotypes differ based on sex and time since injury. Clinical consideration may improve identification of separate trajectories following sport-related concussion and provide targeted care.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"526-538"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ENGAGE-TBI: adaptation of a community-based intervention to improve social participation after brain injury. ENGAGE-TBI：适应社区干预以提高脑损伤后的社会参与。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2025-01-07 DOI: 10.1080/02699052.2025.2449927

Jessica Kersey, Elnaz Alimi, Amy Roder McArthur, Hannah Marquez, Carolyn Baum, Elizabeth Skidmore, Joy Hammel

{"title":"ENGAGE-TBI: adaptation of a community-based intervention to improve social participation after brain injury.","authors":"Jessica Kersey, Elnaz Alimi, Amy Roder McArthur, Hannah Marquez, Carolyn Baum, Elizabeth Skidmore, Joy Hammel","doi":"10.1080/02699052.2025.2449927","DOIUrl":"10.1080/02699052.2025.2449927","url":null,"abstract":"Background: Social isolation is prevalent after traumatic brain injury (TBI) and has negative implications for health and well-being. Interventions targeting social participation show promise for reducing social isolation. We adapted a social participation intervention, ENGAGE, to meet the needs of people with TBI. ENGAGE relies on social learning and guided problem-solving to achieve social participation goals.Methods: This study was conducted in two phases. First, we conducted focus groups with 12 participants with TBI to inform adaptations. We then tested the adapted protocol (n = 6). Post-intervention interviews informed additional refinements. We collected preliminary data on feasibility and effects on social participation (Activity Card Sort, PROMIS Ability to Participate in Social Roles, PROMIS Satisfaction with Participation in Social Roles) and social isolation (PROMIS Social Isolation).Results: Intervention adaptations included simplified processes for developing goals and plans, simplified workbook materials, greater time for reflection on lessons learned, and expanded peer mentorship. ENGAGE-TBI resulted in high satisfaction for 80% of participants and high engagement in intervention for 100% of participants. Attendance and retention benchmarks were achieved. Improvements in social participation exceeded the minimal clinically important difference on all measures.Conclusions: The promising preliminary data support further investigation into the feasibility and effects of ENGAGE-TBI.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"518-525"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"Part of the world again": qualitative enquiry into community participation during inpatient rehabilitation and transition years following severe brain injury. “再次成为世界的一部分”：对严重脑损伤后住院康复和过渡期间社区参与的定性调查。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2025-01-14 DOI: 10.1080/02699052.2024.2443772

Suzanne Currie, Jacinta Douglas, Kate D'Cruz, Di Winkler

{"title":"\"Part of the world again\": qualitative enquiry into community participation during inpatient rehabilitation and transition years following severe brain injury.","authors":"Suzanne Currie, Jacinta Douglas, Kate D'Cruz, Di Winkler","doi":"10.1080/02699052.2024.2443772","DOIUrl":"10.1080/02699052.2024.2443772","url":null,"abstract":"Purpose: To understand the experience of community and social participation for people with severe ABI during inpatient rehabilitation and the transition years.Methods: Constructivist grounded theory methodology informed participant recruitment and data analysis. Adults with ABI were recruited using purposive sampling and data collected via in-depth interviews.Results: Thirteen adults with severe ABI participated, with average age of 36.7 yrs at the time of injury, 9.1 months length of stay of in inpatient rehabilitation, and 4 years post discharge from hospital at time of interviews.The core category developed from thematic analysis was 'lack of focus on community and social participation.' Additional categories included: restricted participation, a focus on impairment and function, acceptance and connection within the community, influence of family and delayed return to community participation.Conclusion: Community and social participation are recognized as the goal of rehabilitation following ABI; however, experiences shared by participants revealed that community and social participation were not the focus of their rehabilitation.Implications for rehabilitation: To support positive holistic outcomes, focus on community and social participation is required within the rehabilitation continuum, using participatory frameworks, contextual goal setting, transparent endorsement for community access and the provision of opportunities for meaningful experiences with family and friends.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"464-475"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cerebral ischemia-reperfusion induces the expression of phoenixin receptor (GPR173) and adult neurogenesis marker proteins in the rat striatum. 脑缺血再灌注诱导大鼠纹状体中凤凰素受体（GPR173）和成体神经发生标志蛋白的表达。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2024-12-29 DOI: 10.1080/02699052.2024.2443004

Kinga Mordecka-Chamera, Artur Pałasz, Aleksandra Suszka-Świtek, Katarzyna Bogus, Władysław Skałba, Aneta Piwowarczyk-Nowak, John J Worthington, Marta Pukowiec, Veerta Sharma, Łukasz Filipczyk

{"title":"Cerebral ischemia-reperfusion induces the expression of phoenixin receptor (GPR173) and adult neurogenesis marker proteins in the rat striatum.","authors":"Kinga Mordecka-Chamera, Artur Pałasz, Aleksandra Suszka-Świtek, Katarzyna Bogus, Władysław Skałba, Aneta Piwowarczyk-Nowak, John J Worthington, Marta Pukowiec, Veerta Sharma, Łukasz Filipczyk","doi":"10.1080/02699052.2024.2443004","DOIUrl":"https://doi.org/10.1080/02699052.2024.2443004","url":null,"abstract":"Objective: Brain ischemia is considered an extremely potent stress factor at the cellular and molecular level which may lead to massive neuronal death. Alternatively, short brain ischemia and reperfusion (I/R) can actually stimulate neurogenesis, angiogenesis and peptidergic signaling. There is little known about the potential effect of I/R on brain expression of the novel neuropeptide; phoenixin (PNX) and its receptor GPR173.Methods: The study was carried out on adult male Wistar rats divided into seven groups: control, sham operation and 5 ischemic experimental groups across the time course of reperfusion. We examined mRNA and protein expression of GPR173 and neurogenesis markers Musashi-1, doublecortin (DCX), and Sox-2 in the striatum.Results: GPR-173 positive cells were found only in the ischemic hemisphere, where Musashi-1, DCX and Sox-2-positive cells were also observed. Gene expression analysis also showed a significant increase of GPR-173 mRNA level in the I/R striatum in comparison with the control one. Results confirm previous findings suggesting that I/R stimulates adult neurogenesis in the striatum and affects peptidergic signaling in this structure.Conclusions: A very fast occurence of GPR-173 expression revealed in the striatum may potentially be exclusively related to neuroprotective neurochemical changes that occur in this region after I/R.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":"39 6","pages":"457-463"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acoustic neuromodulation with or without micro-voltage tACS reduces post-concussive symptoms. 有或没有微电压tACS的听神经调节可减少脑震荡后症状。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-12 Epub Date: 2025-02-06 DOI: 10.1080/02699052.2024.2445709

Catherine L Tegeler, Thaddeus J Haight, Wesley R Cole, Hossam A Shaltout, Y Sammy Choi, Tyler E Harris, Nora Rachels, Paula G Bellini, Michael J Roy, Charles H Tegeler

{"title":"Acoustic neuromodulation with or without micro-voltage tACS reduces post-concussive symptoms.","authors":"Catherine L Tegeler, Thaddeus J Haight, Wesley R Cole, Hossam A Shaltout, Y Sammy Choi, Tyler E Harris, Nora Rachels, Paula G Bellini, Michael J Roy, Charles H Tegeler","doi":"10.1080/02699052.2024.2445709","DOIUrl":"10.1080/02699052.2024.2445709","url":null,"abstract":"Objective: Persistent post-concussive symptoms (PPCS) are common and disruptive, particularly in military service members (SM), yet there are no approved therapies targeting underlying physiological processes. This study was designed to compare acoustic neuromodulation using Cereset Research™ Standard Operating Procedures (CR-SOP), with Cereset Research Cranial Electrical Stimulation (CR-CES), on PPCS.Methods: SM, veterans, or dependents with PPCS (Neurobehavioral Symptom Inventory [NSI] Score ≥23) were randomized to receive 10 sessions of engineered tones linked to brainwaves (CR-SOP) or 5 sessions of CR-CES, which adds intermittent low voltage transcranial alternating current stimulation (tACS) to CR-SOP. Designed to assess non-inferiority between varied doses of CR-SOP and CR-CES, the primary outcome was a change in post-concussive symptoms on the NSI, with secondary outcomes of heart rate variability (HRV) and self-report measures of PTSD, sleep, headaches, and depression.Results: Among study participants (n = 80, 21.3% female, mean age 40.2 [SD 13.2], 4.8 deployments, 3.2 TBIs), mean NSI declined from 45.6 to 29.5 after intervention (p < 0.0001), with gains sustained at 3 months (29.7). No significant between group differences for NSI (CR-SOP: baseline 43.9, post-intervention 26.0, 3-month 27.2, and CR-CES 46.4, 30.7, and 31.1, respectively), and no evidence of inferiority between the groups with respect to NSI. Similar improvements were seen on PCL-5, ISI, HIT-6, and PHQ-9, with no HRV differences between groups.Conclusion: Both acoustic neuromodulation alone (CR-SOP) and a lower dose of CR-SOP, with tACS added (CR-CES), significantly improved PPCS out to 3 months.Registration: ClinicalTrials.gov - NCT03649958.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"496-508"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A prediction model of adenosine diphosphate inhibition among traumatic brain injury patients. 外伤性脑损伤患者二磷酸腺苷抑制的预测模型。

IF 1.5 4区医学

Brain injury Pub Date : 2025-05-11 DOI: 10.1080/02699052.2025.2502425

Caitlyn J Smith, Susanna D Howard, John D Arena, Yohannes G Ghenbot, Zarina S Ali, Dmitry Petrov, Monisha A Kumar, James M Schuster

{"title":"A prediction model of adenosine diphosphate inhibition among traumatic brain injury patients.","authors":"Caitlyn J Smith, Susanna D Howard, John D Arena, Yohannes G Ghenbot, Zarina S Ali, Dmitry Petrov, Monisha A Kumar, James M Schuster","doi":"10.1080/02699052.2025.2502425","DOIUrl":"https://doi.org/10.1080/02699052.2025.2502425","url":null,"abstract":"Introduction: Coagulopathy in the setting of traumatic brain injury (TBI) increases the risk of poor outcomes. Thromboelastography with platelet mapping (TEG-PM) provides a dynamic assessment of clotting parameters including adenosine diphosphate (ADP) inhibition and can guide antiplatelet reversal.Methods: A cross-sectional study of a single Level I Trauma Center traumatic brain injury database from February 2015 to March 2024 was conducted to develop a prediction model of ADP inhibition. Included patients had evidence of traumatic intracranial hemorrhage on CT at the time of presentation and underwent TEG-PM testing. Patients with a history of antiplatelet or anticoagulant use were excluded. Significant ADP inhibition was defined as ≥ 60%.Results: 485 patients were included. Patients with significant ADP inhibition were younger and more likely to have a severe head injury (Glasgow Coma Scale 3-8). In a multivariate logistic regression model including age and head injury severity as independent variables, severe head injury significantly increased the likelihood of ADP inhibition (odds ratio 2.14, 95% confidence interval 1.28-3.58).Conclusion: The observation that severe head injury was significantly associated with ADP inhibition could help identify patients at risk for platelet dysfunction in settings without TEG-PM.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0