Brain injury最新文献_第8页

Epidemiology and outcomes of brain trauma in rural and urban populations: a systematic review and meta-analysis. 农村和城市人口脑外伤的流行病学和后果：系统回顾和荟萃分析。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-06-05 DOI: 10.1080/02699052.2024.2361641

Julia Chequer de Souza, Geoffrey P Dobson, Celine J Lee, Hayley L Letson

{"title":"Epidemiology and outcomes of brain trauma in rural and urban populations: a systematic review and meta-analysis.","authors":"Julia Chequer de Souza, Geoffrey P Dobson, Celine J Lee, Hayley L Letson","doi":"10.1080/02699052.2024.2361641","DOIUrl":"10.1080/02699052.2024.2361641","url":null,"abstract":"Objective: To identify and describe differences in demographics, injury characteristics, and outcomes between rural and urban patients suffering brain injury.Data sources: CINAHL, Emcare, MEDLINE, and Scopus.Review methods: A systematic review and meta-analysis of studies comparing epidemiology and outcomes of rural and urban brain trauma was conducted in accordance with PRISMA and MOOSE guidelines.Results: 36 studies with ~ 2.5-million patients were included. Incidence of brain injury was higher in males, regardless of location. Rates of transport-related brain injuries, particularly involving motorized vehicles other than cars, were significantly higher in rural populations (OR:3.63, 95% CI[1.58,8.35], p = 0.002), whereas urban residents had more fall-induced brain trauma (OR:0.73, 95% CI[0.66,0.81], p < 0.00001). Rural patients were 28% more likely to suffer severe injury, indicated by Glasgow Coma Scale (GCS)≤8 (OR:1.28, 95% CI[1.04,1.58], p = 0.02). There was no difference in mortality (OR:1.09, 95% CI[0.73,1.61], p = 0.067), however, urban patients were twice as likely to be discharged with a good outcome (OR:0.52, 95% CI[0.41,0.67], p < 0.00001).Conclusions: Rurality is associated with greater severity and poorer outcomes of traumatic brain injury. Transport accidents disproportionally affect those traveling on rural roads. Future research recommendations include addition of prehospital data, adequate follow-up, standardized measures, and sub-group analyses of high-risk groups, e.g. Indigenous populations.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"953-976"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247161","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

Effectiveness of hypertonic saline infusion in management of traumatic brain injury: an updated systematic review and meta-analysis of randomized controlled trials. 输注高渗盐水治疗脑外伤的效果：随机对照试验的最新系统回顾和荟萃分析。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-06-10 DOI: 10.1080/02699052.2024.2363340

Lixin Cai, Wei He

{"title":"Effectiveness of hypertonic saline infusion in management of traumatic brain injury: an updated systematic review and meta-analysis of randomized controlled trials.","authors":"Lixin Cai, Wei He","doi":"10.1080/02699052.2024.2363340","DOIUrl":"10.1080/02699052.2024.2363340","url":null,"abstract":"Objective: This study aimed to find out the efficacy of using Hypertonic saline solution (HSS) over mannitol in the management of TBI by comparing their performance in improving different outcomes.Methods: Electronic databases were searched for randomized controlled trials (RCTs) assessing the impact of HSS vs. mannitol on ICP in patients who suffered TBI. Outcomes of interest were mortality, neurologic functional outcomes, risk ratio (RR) of successful ICP treatment, reduction in ICP after 30-60 and 90-120 min, improvement in cerebral perfusion pressure (CPP) at 30-60 and 90-120 min, and also treatment failure. Evaluations were reported as RR or mean difference (MD) with 95% confidence intervals (CIs) using weighted random-effects models.Results: The analysis included 624 patients from 15 RCTs. HSS infusion had a significant impact on the improvement of CPP at 30-60 min [MD = 5.54, 95% CI (3.04, 8.03),p < 0.001] compared to mannitol. However, results yielded no significant difference between HSS and mannitol in terms of mortality, neurologic functional outcomes, successful ICP treatment, reduction in ICP after 30-60 min and 90-120 min, improvement in CPP at 90-120 min, and treatment failure.Conclusion: HSS and mannitol are both effective treatments for elevated ICP due to TBI. However, further research is required to derive a better comparison.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"977-984"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295568","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

Does early exercise intolerance effect time to return to play, symptom burden, neurocognition, Vestibular-Ocular-Motor (VOM) function and academic ability in acutely concussed student-athletes? 早期运动不耐受是否会影响急性脑震荡学生运动员重返赛场的时间、症状负担、神经认知、前庭-眼球-运动（VOM）功能和学习能力？

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-06-23 DOI: 10.1080/02699052.2024.2367477

K Glendon, G Blenkinsop, A Belli, M T G Pain

{"title":"Does early exercise intolerance effect time to return to play, symptom burden, neurocognition, Vestibular-Ocular-Motor (VOM) function and academic ability in acutely concussed student-athletes?","authors":"K Glendon, G Blenkinsop, A Belli, M T G Pain","doi":"10.1080/02699052.2024.2367477","DOIUrl":"10.1080/02699052.2024.2367477","url":null,"abstract":"Introduction: Early Exercise Intolerance (EEI) is associated with delayed recovery and longer time to Return To Play (RTP), but this has not been established.Participants; (n = 52, male n = 30) UK university-aged rugby-union student-athletes.Methods: Student-athletes completed baseline screening (July-October 2021 and 2022). The test battery was repeated within 48 h, 4, 8 and 14 days after a Sports-Related Concussion (SRC) with the Buffalo Concussion Bike or Treadmill Test to set sub-symptom heart rate threshold. Student-athletes then completed a controlled early exercise protocol in-between reassessment (days 3, 5-7 and 9-13). Those with EEI were compared to those with early-exercise tolerance.Outcome measures: Post-Concussion Symptom Scale, Immediate Post-Concussion and Cognitive Test, Vestibular-Ocular Motor Screening Tool and the Revised Perceived Academic Impact Tool.Results: EEI was seen throughout the initial 14-days post-SRC (23.8%, 22.4%, 25.5%. 25.0%). EEI was associated with a slower reaction time within 48 h (-0.01 (-0.030-0.043) Vs 0.06 (0.033-0.24), p = 0.004) and greater VOMS scores within 48 h; (0.00 (0.00-4.00) Vs 5.50 (2.75-9.00), p = 0.016) and 4 days (0.00 (0.00-2.00) Vs 5.00 (0.00-6.00), p = 0.044). RTP was 12.5 days longer in those with EEI at 14-days post-SRC.Conclusion: EEI is prevalent following an SRC in university-aged student-athletes and was associated with delayed recovery and RTP.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1004-1014"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442164","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

Enhancing traumatic brain injury emergency care: the impact of grading and zoning nursing management. 加强脑外伤急救护理：分级和分区护理管理的影响。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-06-06 DOI: 10.1080/02699052.2024.2361631

Yan-Qian Ge, Si-Yuan Ma, Hui Yu, Xing Lu, Li Ding, Jia-Yan Zhang

{"title":"Enhancing traumatic brain injury emergency care: the impact of grading and zoning nursing management.","authors":"Yan-Qian Ge, Si-Yuan Ma, Hui Yu, Xing Lu, Li Ding, Jia-Yan Zhang","doi":"10.1080/02699052.2024.2361631","DOIUrl":"10.1080/02699052.2024.2361631","url":null,"abstract":"Objective: This research aimed to evaluate the impact of grading and zoning nursing management on traumatic brain injury (TBI) patients' emergency treatment outcomes.Methods: This randomized controlled trial included 200 TBI patients. They were treated with a conventional care (control group, n = 100) and a novel grading and zoning approach (study group, n = 100), respectively. This innovative model organized care into levels based on urgency and complexity, facilitating targeted medical response and resource allocation. Key metrics compared included demographic profiles, consultation efficiency (time metrics and emergency treatment rates), physiological parameters (HR, RR, MAP, SpO2, RBS), and patient outcomes (hospital and ICU stays, complication rates, and emergency outcomes).Results: The study group demonstrated significantly improved consultation efficiency, with reduced times for physician visits, examinations, emergency stays, and specialist referrals (all p < 0.001), alongside a higher emergency treatment rate (93% vs. 79%, p = 0.004), notably better physiological stability, improved HR, RR, MAP, SpO2 and RBS (p < 0.001), shorter hospital and ICU stays, fewer complications, and superior emergency outcomes.Conclusion: Grading and zoning nursing management substantially enhances TBI patients' emergency care efficiency and clinical outcomes, suggesting a viable model for improving emergency treatment protocols.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"985-991"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282945","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 rare case of herpes simplex virus encephalitis from viral reactivation following surgically treated traumatic brain injury. 一例罕见的脑外伤手术治疗后病毒再激活引起的单纯疱疹病毒脑炎。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-07-04 DOI: 10.1080/02699052.2024.2370834

Abhiraj D Bhimani, Daniel D Cummins, Roshini Kalagara, Sumanth Chennareddy, Zachary L Hickman

{"title":"A rare case of herpes simplex virus encephalitis from viral reactivation following surgically treated traumatic brain injury.","authors":"Abhiraj D Bhimani, Daniel D Cummins, Roshini Kalagara, Sumanth Chennareddy, Zachary L Hickman","doi":"10.1080/02699052.2024.2370834","DOIUrl":"10.1080/02699052.2024.2370834","url":null,"abstract":"Objective: Herpes simplex virus encephalitis (HSVE) is associated with significant morbidity and mortality. Here, we present the occurrence of HSVE in a 36-year-old immunocompetent patient following craniotomy for a traumatic acute subdural hematoma (ASDH).Methods: Imaging after four days of progressive headache following a fall with head-strike demonstrated a 1 cm thick left holohemispheric ASDH with significant cerebral compression, edema, and 8 mm of left-to-right midline shift, and an emergent craniotomy and ASDH evacuation were performed, with additional treatment needed for reaccumulation. Postoperatively, the patient developed a worsening leukocytosis, became febrile, and was hypotensive requiring vasopressor support.Results: Despite empiric antibiotics, the patient remained persistently febrile with significant leukocytosis. Repeat head CT showed a new left insular hypodensity and a subsequent viral encephalitis panel was positive for HSV-1. The patient was then started on intravenous acyclovir, with progressive neurological exam improvement. Of note, the patient was noted to have a positive serum HSV-1 IgG antibody titer, indicative of prior infection.Conclusions: Given the known systemic immunosuppression in brain injury and the high prevalence of HSV seropositivity, clinicians should consider the possibility of HSVE from HSV reactivation in TBI patients with persistent fever, leukocytosis, and/or neurological deficits without an obvious etiology.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1046-1051"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497096","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

Personalized, parcel-guided non-invasive transcranial magnetic stimulation for the treatment of post-concussive syndrome: safety and proof of concept. 个性化、包裹引导的非侵入性经颅磁刺激治疗脑震荡后综合征：安全性和概念验证。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-07-04 DOI: 10.1080/02699052.2024.2371975

Si Jie Tang, Jonas Holle, Nicholas B Dadario, Mark Ryan, Olivia Lesslar, Charles Teo, Michael Sughrue, Jacky Yeung

{"title":"Personalized, parcel-guided non-invasive transcranial magnetic stimulation for the treatment of post-concussive syndrome: safety and proof of concept.","authors":"Si Jie Tang, Jonas Holle, Nicholas B Dadario, Mark Ryan, Olivia Lesslar, Charles Teo, Michael Sughrue, Jacky Yeung","doi":"10.1080/02699052.2024.2371975","DOIUrl":"10.1080/02699052.2024.2371975","url":null,"abstract":"Objective: To determine the safety and proof of concept of a parcel-guided, repetitive Transcranial Magnetic Stimulation (rTMS) in patients who develop a heterogeneous array of symptoms, known collectively as post-concussive syndrome (PCS), following traumatic brain injury (TBI).Methods: We performed a retrospective review of off-label, individualized, parcel-guided rTMS in 19 patients from December 2020 to May 2023. Patients had at least one instance of mild, moderate, or severe TBI and developed symptoms not present prior to injury. rTMS targets were identified based on machine learning connectomic software using functional connectivity anomaly matrices compared to healthy controls. EuroQol (EQ-5D), as a measurement of quality of life, and additional questionnaires dependent on individual's symptoms were submitted prior to, after, and during follow-up from rTMS.Results: Nineteen patients showed improvement in EQ-5D and Rivermead Post Concussion Symptoms Questionnaires - 3 after treatment and follow-up. For nine patients who developed depression, five (55%) attained response and remission based on the Beck Depression Inventory after treatment. Eight of ten patients with anxiety had a clinically significant reduction in Generalized Anxiety Disorder-7 scores during follow-up.Conclusion: Parcel-guided rTMS is safe and may be effective in reducing PCS symptoms following TBI and should incite further controlled studies.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1015-1025"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533566","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

Factors influencing recovery in a pediatric sample with disorders of consciousness: insights from an observational study. 影响意识障碍儿科样本康复的因素：一项观察性研究的启示。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-07-05 DOI: 10.1080/02699052.2024.2372451

María Cecilia González, F Leguizamón, L Dei Vecchi, M Andreu, M Ferrea

{"title":"Factors influencing recovery in a pediatric sample with disorders of consciousness: insights from an observational study.","authors":"María Cecilia González, F Leguizamón, L Dei Vecchi, M Andreu, M Ferrea","doi":"10.1080/02699052.2024.2372451","DOIUrl":"10.1080/02699052.2024.2372451","url":null,"abstract":"Objective: To estimate rates and time to reach emergence of consciousness from vegetative state/unresponsive wakefulness syndrome (VS/UWS), and explore factors associated with improved recovery in children and adolescents with disorders of consciousness (DoC) following severe traumatic and non-traumatic brain injury.Methods: Analytical, retrospective, cohort study. Clinical records of consecutively referred patients admitted in VS/UWS to a neurological rehabilitation institute in Argentina, between 2005 and 2021 were reviewed. Seventy children and adolescents were included in the analysis. A specialized 12-week rehabilitation program was administered, and emergence was defined by scores ≥44 points on the Western Neuro Sensory Stimulation Profile (WNSSP), sustained for at least 3 weeks on consecutive weekly evaluations.Results: Emergence from VS/UWS to consciousness occurred within 5.4 (SD 2.6) weeks in almost one-third of patients. Multivariate Cox regression analysis showed emergence was significantly lower in patients with hypoxic ischemic encephalopathy compared to patients with other non-traumatic etiologies [HRadj 0.23 (95% CI 0.06-0.89); p = 0.03)].Conclusions: Our findings reinforce growing evidence on the impact of etiology on DoC recovery in pediatric populations, ultimately influencing treatment and family-related decisions in child neurorehabilitation.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1026-1034"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533565","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

Cardiorespiratory fitness assessment and training in the early sub-acute phase of recovery following traumatic brain injury: a systematic review. 脑外伤后亚急性早期恢复阶段的心肺功能评估和训练：系统综述。

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-06-03 DOI: 10.1080/02699052.2024.2361638

Sara Gallow, Jack Beard, Jennifer McGinley, John Olver, Gavin Williams

{"title":"Cardiorespiratory fitness assessment and training in the early sub-acute phase of recovery following traumatic brain injury: a systematic review.","authors":"Sara Gallow, Jack Beard, Jennifer McGinley, John Olver, Gavin Williams","doi":"10.1080/02699052.2024.2361638","DOIUrl":"10.1080/02699052.2024.2361638","url":null,"abstract":"Objectives: To examine the safety of cardiorespiratory fitness (CRF) assessment and training in the early sub-acute phase of recovery (≤3 months) following moderate-to-extremely severe traumatic brain injury (TBI).Methods: A systematic review was completed in accordance with the PRISMA guidelines. Studies investigating adults and adolescents ≥15 years with moderate-to-extremely severe TBI were considered for inclusion. The methodological quality of the included studies was evaluated according to the McMaster Guidelines for Critical Review Form - Quantitative Studies.Results: Eleven studies with a total of 380 participants were included in the review. Adverse events (AEs) and symptom monitoring were poorly reported. Only four studies reported on the occurrence of AEs, with a total of eight AEs reported. Three of the reported AEs were concussion-like symptoms with no further exercise-induced symptom exacerbation reported. No serious AEs were reported.Conclusion: There is no evidence to suggest that CRF assessment and training is unsafe in the early sub-acute phase of recovery following moderate-to-extremely severe TBI. However, despite the low AE and symptom exacerbation rates identified, a timeframe for safe commencement was unable to be established due to poor reporting and/or monitoring of exercise-induced symptoms and AEs in the current literature.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"941-952"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199381","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

Runx1 promotes neuronal injury in ischemic stroke through mediating miR-203-3p/Pde4d axis. Runx1 通过介导 miR-203-3p/Pde4d 轴促进缺血性中风的神经元损伤

IF 1.5 4区医学

Brain injury Pub Date : 2024-10-14 Epub Date: 2024-07-12 DOI: 10.1080/02699052.2024.2373914

Yongwen Deng, Shengli Sun

{"title":"Runx1 promotes neuronal injury in ischemic stroke through mediating miR-203-3p/Pde4d axis.","authors":"Yongwen Deng, Shengli Sun","doi":"10.1080/02699052.2024.2373914","DOIUrl":"10.1080/02699052.2024.2373914","url":null,"abstract":"Background: It has been reported that Runx1 engaged in IS progression, but the detailed mechanism of Runx1 in IS is still unclear.Methods: Mice and HT22 cells were subjected to the process of middle cerebral artery occlusion and reperfusion (MCAO/R) and oxygen-glucose deprivation/reoxygenation (OGD/R), respectively. Infract volume was tested using TTC staining. The levels of inflammatory cytokines were investigated using ELISA assay. Cell viability was examined utilizing MTS. Apoptosis rate was evaluated using flow cytometry and TUNEL. The productions of SOD and MDA were monitored by means of commercial kits. The correlations among Runx1, miR-203-3p and Pde4d were ascertained using dual luciferase reporter gene, ChIP and RNA-RNA pull-down assays.Results: Runx1 and Pde4d were abnormally elevated, while miR-203-3p was notably declined in MCAO/R mice and OGD/R-induced HT22 cells. OGD/R treatment suppressed cell viability and facilitated cell apoptosis, inflammation and oxidative stress, which were compromised by Runx1 knockdown or miR-203-3p upregulation. Runx1 bound to miR-203-3p promoter, thus decreasing miR-203-3p expression. MiR-203-3p inhibited Pde4d expression via targeting Pde4d mRNA. Runx1 deficiency-induced protection effects on OGD/R-treated HT22 cells were offset by miR-203-3p downregulation.Conclusion: Runx1 aggravated neuronal injury caused by IS through mediating miR-203-3p/Pde4d axis.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1035-1045"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589602","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

Using machine learning to discover traumatic brain injury patient phenotypes: national concussion surveillance system Pilot. 利用机器学习发现脑外伤患者表型：国家脑震荡监测系统试点。

IF 1.5 4区医学

Brain injury Pub Date : 2024-09-18 Epub Date: 2024-05-09 DOI: 10.1080/02699052.2024.2352524

Dana Waltzman, Jill Daugherty, Alexis Peterson, Angela Lumba-Brown

{"title":"Using machine learning to discover traumatic brain injury patient phenotypes: national concussion surveillance system Pilot.","authors":"Dana Waltzman, Jill Daugherty, Alexis Peterson, Angela Lumba-Brown","doi":"10.1080/02699052.2024.2352524","DOIUrl":"10.1080/02699052.2024.2352524","url":null,"abstract":"Objective: The objective is to determine whether unsupervised machine learning identifies traumatic brain injury (TBI) phenotypes with unique clinical profiles.Methods: Pilot self-reported survey data of over 10,000 adults were collected from the Centers for Disease Control and Prevention (CDC)'s National Concussion Surveillance System (NCSS). Respondents who self-reported a head injury in the past 12 months (n = 1,364) were retained and queried for injury, outcome, and clinical characteristics. An unsupervised machine learning algorithm, partitioning around medoids (PAM), that employed Gower's dissimilarity matrix, was used to conduct a cluster analysis.Results: PAM grouped respondents into five TBI clusters (phenotypes A-E). Phenotype C represented more clinically severe TBIs with a higher prevalence of symptoms and association with worse outcomes. When compared to individuals in Phenotype A, a group with few TBI-related symptoms, individuals in Phenotype C were more likely to undergo medical evaluation (odds ratio [OR] = 9.8, 95% confidence interval[CI] = 5.8-16.6), have symptoms that were not currently resolved or resolved in 8+ days (OR = 10.6, 95%CI = 6.2-18.1), and more likely to report at least moderate impact on social (OR = 54.7, 95%CI = 22.4-133.4) and work (OR = 25.4, 95%CI = 11.2-57.2) functioning.Conclusion: Machine learning can be used to classify patients into unique TBI phenotypes. Further research might examine the utility of such classifications in supporting clinical diagnosis and patient recovery for this complex health condition.","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"880-888"},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897151","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