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Sex-Specific Effects of Buprenorphine on Endoplasmic Reticulum Stress, Abnormal Protein Accumulation, and Cell Loss After Pediatric Mild Traumatic Brain Injury in Mice. 丁丙诺啡对小鼠轻度脑损伤后内质网应激、异常蛋白质积累和细胞损失的性别特异性影响。
Q3 CLINICAL NEUROLOGY Pub Date : 2023-08-30 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0051
Megan B Faulkner, Mariam Rizk, Zahraa Bazzi, Robert C Dysko, Zhi Zhang

Traumatic brain injury (TBI) in children often leads to poor developmental outcomes attributable to progressive cell loss caused by secondary injuries, including endoplasmic reticulum (ER) stress. Buprenorphine (BPN) is commonly used in children for pain management; however, the effects of BPN on ER stress in the pediatric population are still inconclusive. This study investigated the sex-specific effects of BPN on ER stress, abnormal protein accumulation, and cell loss in a mouse impact acceleration model of pediatric TBI. On post-natal day 20-21 (P20-21), male and female littermates were randomized into sham, TBI + saline and TBI + BPN groups. BPN (0.075 mg/kg) was administered to TBI + BPN mice at 30 min after injury and then every 6-12 h for 2 days. The impact of BPN was evaluated at 1, 3, and 7 days post-injury. We found that TBI induced more prominent ER stress pathway activation at 1 and 3 days post-injury in males, compared to females, whereas abnormal protein accumulation and cell loss were more severe in females at 7 days post-injury, compared with males. Although BPN partially ameliorated abnormal protein accumulation and cell loss in both males and females, BPN only decreased ER stress pathway activation in males, not in females. In conclusion, BPN exhibits sex-specific effects on ER stress, abnormal protein accumulation, and cell loss in a time-dependent manner at the acute phase after pediatric TBI, which provides the rationale to assess the potential effects of BPN on long-term outcomes after pediatric TBI in both males and females.

儿童创伤性脑损伤(TBI)通常会导致发育不良,这归因于继发性损伤(包括内质网应激)引起的进行性细胞损失。丁丙诺啡(BPN)通常用于儿童疼痛管理;然而,在儿科人群中,BPN对ER应激的影响仍然没有定论。本研究在儿童TBI小鼠撞击加速模型中研究了BPN对ER应激、异常蛋白质积累和细胞损失的性别特异性影响。在产后第20-21天(P20-21),将同窝出生的男性和女性随机分为假手术组、TBI+生理盐水组和TBI+BPN组。BPN(0.075 mg/kg)在30 受伤后分钟,然后每6-12 h,持续2天。在损伤后1、3和7天评估BPN的影响。我们发现,与雌性相比,TBI在雄性损伤后1天和3天诱导了更显著的ER应激通路激活,而与雄性相比,雌性损伤后7天的异常蛋白质积累和细胞损失更严重。尽管BPN部分改善了雄性和雌性的异常蛋白质积累和细胞损失,但BPN只降低了雄性的ER应激途径激活,而不是雌性。总之,在儿童TBI后的急性期,BPN以时间依赖的方式对ER应激、异常蛋白质积累和细胞损失表现出性别特异性影响,这为评估BPN对儿童TBI(男性和女性)后长期结果的潜在影响提供了依据。
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引用次数: 0
Traumatic Brain Injuries Impact on School One Month and One Year After Injury. 外伤性脑损伤对学校的影响。
Q3 CLINICAL NEUROLOGY Pub Date : 2023-08-10 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2022.0069
Erik B Philipson, Joan Machamer, Sureyya Dikmen, Nancy Temkin

Traumatic brain injury (TBI) is a major cause of death and disability among the American population, but the impact TBIs have on the school experience of high school, and post-secondary students, is poorly understood. In this study, a cohort of 79 students, ages 15-22, with mild-to-severe TBIs, were retrospectively identified from the University of Washington Traumatic Brain Injury Database and Sample Repository. The Sickness Impact Profile (SIP) was used to determine the frequency at which schooling was impacted by a TBI and identify the most common self-reported issues students faced in their return to school. At 1 month post-injury, 70% of students either had not returned to school as a result of their TBI or had returned to school but experienced issues related to their TBI. The most-reported issues at 1 month were a difficulty keeping up with school work as a result of it taking longer to complete assignments, tiring easily, having to take frequent rests, and grades that were not as good as they used to be. At 1 year post-injury, the number of students whose TBIs were affecting their school situation dropped 20 percentage points to 49%. The most reported issues at 1 year were forgetting more quickly what was learned in class and having more difficulty understanding new concepts and material. These findings indicate that TBIs have a profound effect on a student's school experiences up to at least 1 year post-injury.

创伤性脑损伤(TBI)是美国人口死亡和残疾的主要原因,但人们对TBI对高中和中学后学生的学习体验的影响知之甚少。在这项研究中,从华盛顿大学创伤性脑损伤数据库和样本库中回顾性地确定了79名年龄在15-22岁之间患有轻度至重度TBI的学生。疾病影响档案(SIP)用于确定TBI影响学校教育的频率,并确定学生在返校过程中面临的最常见的自我报告问题。在受伤后1个月,70%的学生要么因TBI而没有返校,要么已经返校,但遇到了与TBI相关的问题。1个月时报告最多的问题是难以跟上学业进度,因为完成作业需要更长的时间,容易疲劳,必须经常休息,成绩也不如以前。受伤后1年,TBI影响学业的学生人数下降了20个百分点,降至49%。一年级时报告最多的问题是更快地忘记课堂上学到的东西,更难理解新的概念和材料。这些发现表明,TBI对学生受伤后至少一年的学校经历有着深远的影响。
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引用次数: 0
Blast Exposure Induces Acute Alterations in Circadian Clock Genes in the Hypothalamus and Pineal Gland in Rats: An Exploratory Study 爆炸暴露诱导大鼠下丘脑和松果体昼夜节律时钟基因急性改变的探索性研究
Q3 CLINICAL NEUROLOGY Pub Date : 2023-08-01 DOI: 10.1089/neur.2023.0048
Manoj Govindarajulu, Mital Y. Patel, Jishnu K S Krishnan, Joseph B. Long, Peethambaran Arun
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引用次数: 0
Synaptojanin 1 Modulates Functional Recovery After Incomplete Spinal Cord Injury in Male Apolipoprotein E Epsilon 4 Mice. 突触结合蛋白1调节雄性载脂蛋白E Epsilon 4小鼠脊髓不完全损伤后的功能恢复。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2023-07-27 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0023
Carlos A Toro, Jens Hansen, Mustafa M Siddiq, Kaitlin Johnson, Jiqing Cao, Adriana Pero, Ravi Iyengar, Dongming Cai, Christopher P Cardozo

Apolipoprotein E epsilon 4 (ApoE4) is the second most common variant of ApoE, being present in ∼14% of the population. Clinical reports identify ApoE4 as a genetic risk factor for poor outcomes after traumatic spinal cord injury (SCI) and spinal cord diseases such as cervical myelopathy. To date, there is no intervention to promote recovery of function after SCI/spinal cord diseases that is specifically targeted at ApoE4-associated impairment. Studies in the human and mouse brain link ApoE4 to elevated levels of synaptojanin 1 (synj1), a lipid phosphatase that degrades phosphoinositol 4,5-bisphosphate (PIP2) into inositol 4-monophosphate. Synj1 regulates rearrangements of the cytoskeleton as well as endocytosis and trafficking of synaptic vesicles. We report here that, as compared to ApoE3 mice, levels of synj1 messenger RNA and protein were elevated in spinal cords of healthy ApoE4 mice associated with lower PIP2 levels. Using a moderate-severity model of contusion SCI in mice, we found that genetic reduction of synj1 improved locomotor function recovery at 14 days after SCI in ApoE4 mice without altering spared white matter. Genetic reduction of synj1 did not alter locomotor recovery of ApoE3 mice after SCI. Bulk RNA sequencing revealed that at 14 days after SCI in ApoE4 mice, genetic reduction of synj1 upregulated genes involved in glutaminergic synaptic transmission just above and below the lesion. Overall, our findings provide evidence for a link between synj1 to poor outcomes after SCI in ApoE4 mice, up to 14 days post-injury, through mechanisms that may involve the function of excitatory glutaminergic neurons.

载脂蛋白Eε4(ApoE4)是载脂蛋白第二常见的变体,存在于约14%的人群中。临床报告确定ApoE4是创伤性脊髓损伤(SCI)和脊髓疾病(如颈脊髓病)后预后不佳的遗传风险因素。到目前为止,还没有专门针对ApoE4相关损伤的干预措施来促进SCI/脊髓疾病后的功能恢复。对人类和小鼠大脑的研究将ApoE4与突触素1(synj1)水平升高联系起来,synj1是一种脂质磷酸酶,可将磷酸肌醇4,5-二磷酸(PIP2)降解为肌醇4-单磷酸。Synj1调节细胞骨架的重排以及突触小泡的内吞和运输。我们在这里报道,与ApoE3小鼠相比,健康ApoE4小鼠的脊髓中synj1信使RNA和蛋白质水平升高,与较低的PIP2水平相关。使用小鼠中度挫伤性脊髓损伤模型,我们发现在ApoE4小鼠脊髓损伤后14天,synj1的基因减少改善了运动功能的恢复,而没有改变多余的白质。synj1的基因减少不会改变ApoE3小鼠在SCI后的运动恢复。本体RNA测序显示,在ApoE4小鼠SCI后14天,synj1的基因减少上调了损伤上方和下方参与谷氨酸能突触传递的基因。总的来说,我们的研究结果通过可能涉及兴奋性谷氨酸能神经元功能的机制,为ApoE4小鼠脊髓损伤后14天内synj1与不良预后之间的联系提供了证据。
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引用次数: 0
Impact of Subarachnoid Hemorrhage on the Cardiac Autonomic Function During Rehabilitation in Children After Severe Traumatic Brain Injury. 蛛网膜下腔出血对儿童重型颅脑损伤康复期心脏自主功能的影响。
Q3 CLINICAL NEUROLOGY Pub Date : 2023-07-14 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0032
Gilad Sorek, Sharon Shaklai, Isabelle Gagnon, Kathryn Schneider, Mathilde Chevignard, Nurit Stern, Yahaloma Fadida, Liran Kalderon, Michal Katz-Leurer

This study aimed to investigate the impact of traumatic subarachnoid hemorrhage (tSAH) on cardiac autonomic control system (CACS) function in children after severe traumatic brain injury (TBI) during the subacute rehabilitation period. Thirty-three participants, 8-18 years of age, 42 (14-149) days after severe TBI at the beginning of the subacute rehabilitation, were included in the study. Six participants were diagnosed with tSAH during acute medical care (tSAH group). Heart rate variability (HRV) was assessed by the standard deviation of the N-N interval (SDNN) and the square root of the mean square differences of successive R-R interval (RMSSD) using a Polar RS800CX device while sitting at rest for 5 min. A second assessment was performed 8 weeks later. No significant difference between the tSAH and non-tSAH groups were found in the demographic and functional characteristics or injury severity. However, in comparison to the non-tSAH group, the tSAH group had lower SDNN (23.9 [10.5-47.3] vs. 43.9 [21.8-118.8], respectively; p = 0.005) and RMSSD values (11.8 [5.9-24.5] vs. 29.6 [8.9-71.7], respectively; p = 0.004). Neither group demonstrated changes in HRV values at rest in the second assessment, whereas the significant difference in SDNN (p = 0.035) and RMSSD (p = 0.008) remained. Children diagnosed with SAH after severe TBI presented poorer CACS function during the subacute rehabilitation. Given that reduced HRV values may be a marker for potential heart disease, the medical team should be aware of the influence of existing tSAH. Future studies with larger sample sizes and longer follow-up periods are warranted to further investigate this topic. ClinicalTrials.gov number: NCT03215082.

本研究旨在探讨亚急性康复期严重颅脑损伤(TBI)后,创伤性蛛网膜下腔出血(tSAH)对儿童心脏自主控制系统(CACS)功能的影响。33名参与者,年龄8-18岁,亚急性康复开始时严重TBI后42(14-149)天,被纳入研究。6名参与者在急性医疗护理期间被诊断为tSAH(tSAH组)。心率变异性(HRV)通过N-N间期的标准差(SDNN)和连续R-R间期的均方根差(RMSSD)进行评估,使用Polar RS800CX设备,在休息5分钟时进行评估 min。8周后进行第二次评估。tSAH组和非tSAH组在人口统计学和功能特征或损伤严重程度方面没有发现显著差异。然而,与非tSAH组相比,tSAH组的SDNN较低(分别为23.9[10.5-47.3]和43.9[21.8-11.8];p = 0.005)和RMSSD值(分别为11.8[5.9-24.5]和29.6[8.9-71.7];p = 0.004)。在第二次评估中,两组都没有表现出静息时HRV值的变化,而SDNN的显著差异(p = 0.035)和RMSSD(p = 0.008)。严重TBI后诊断为SAH的儿童在亚急性康复过程中CACS功能较差。鉴于HRV值降低可能是潜在心脏病的标志,医疗团队应意识到现有tSAH的影响。未来的研究需要更大的样本量和更长的随访期来进一步研究这一主题。ClinicalTrials.gov编号:NCT03215082。
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引用次数: 0
Mature and Myelinating Oligodendrocytes Are Specifically Vulnerable to Mild Fluid Percussion Injury in Mice. 成熟和髓鞘化的少突胶质细胞特别易受小鼠轻微流体叩击损伤的影响
Q3 CLINICAL NEUROLOGY Pub Date : 2023-06-29 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0037
Alexandra A Adams, Teresa L Wood, Haesun A Kim

Myelin loss and oligodendrocyte death are well documented in patients with traumatic brain injury (TBI), as well as in experimental animal models after moderate-to-severe TBI. In comparison, mild TBI (mTBI) does not necessarily result in myelin loss or oligodendrocyte death, but causes structural alterations in the myelin. To gain more insight into the impact of mTBI on oligodendrocyte lineage in the adult brain, we subjected mice to mild lateral fluid percussion injury (mFPI) and characterized the early impact (1 and 3 days post-injury) on oligodendrocytes in the corpus callosum using multiple oligodendrocyte lineage markers (platelet-derived growth factor receptor [PDGFR]-α, glutathione S-transferase [GST]-π, CC1, breast carcinoma-amplified sequence 1 [BCAS1], myelin basic protein [MBP], myelin-associated glycoprotein [MAG], proteolipid protein [PLP], and FluoroMyelin™). Two regions of the corpus callosum in relation to the impact site were analyzed: areas near (focal) and anterior (distal) to the impact site. mFPI did not result in oligodendrocyte death in either the focal or distal corpus callosum, nor impact on oligodendrocyte precursors (PDGFR-α+) and GST-π+ oligodendrocyte numbers. In the focal but not distal corpus callosum, mFPI caused a decrease in CC1+ as well as BCAS1+ actively myelinating oligodendrocytes and reduced FluoroMyelin intensity without altering myelin protein expression (MBP, PLP, and MAG). Disruption in node-paranode organization and loss of Nav1.6+ nodes were observed in both the focal and distal regions, even in areas without obvious axonal damage. Altogether, our study shows regional differences in mature and myelinating oligodendrocyte in response to mFPI. Further, mFPI elicits a widespread impact on node-paranode organization that affects regions both close to and remotely located from the site of injury.

髓鞘脱失和少突胶质细胞死亡在创伤性脑损伤(TBI)患者以及中度至重度 TBI 后的实验动物模型中均有大量记录。相比之下,轻度创伤性脑损伤(mTBI)并不一定会导致髓鞘脱落或少突胶质细胞死亡,但会引起髓鞘结构的改变。为了更深入地了解轻微创伤性脑损伤对成人大脑少突胶质细胞系的影响,我们对小鼠进行了轻微外侧体液叩击伤(mFPI),并使用多种少突胶质细胞系标记物(血小板衍生生长因子受体 [PDGFR]-α、谷胱甘肽 S 转移酶 [GST]-π、CC1、乳腺癌扩增序列 1 [BCAS1]、髓鞘碱性蛋白 [MBP]、髓鞘相关糖蛋白 [MAG]、蛋白脂质蛋白 [PLP] 和 FluoroMyelin™)。分析了胼胝体与撞击部位相关的两个区域:撞击部位附近(病灶)和撞击部位前方(远端)。mFPI不会导致病灶或远端胼胝体中的少突胶质细胞死亡,也不会影响少突胶质细胞前体(PDGFR-α+)和GST-π+少突胶质细胞的数量。在病灶而非远端胼胝体中,mFPI 会导致 CC1+ 和 BCAS1+ 活性髓鞘化少突胶质细胞减少,并降低 FluoroMyelin 的强度,但不会改变髓鞘蛋白的表达(MBP、PLP 和 MAG)。在病灶和远端区域,甚至在没有明显轴突损伤的区域,都观察到了节点-旁节点组织的破坏和Nav1.6+节点的丢失。总之,我们的研究表明,成熟和髓鞘化少突胶质细胞对 mFPI 的反应存在区域差异。此外,mFPI 对节点-旁节点组织产生广泛影响,既影响靠近损伤部位的区域,也影响远离损伤部位的区域。
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引用次数: 0
Mortality in ASIA Impairment Scale grade A to D Patients With Odontoid Fracture and Magnetic Resonance Imaging Evidence of Spinal Cord Injury. 有脊髓损伤磁共振成像证据的颌骨骨折 ASIA 损伤量表 A 至 D 级患者的死亡率。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2023-06-01 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0005
Bizhan Aarabi, Christopher J Neal, David S Hersh, James S Harrop, Michael G Fehlings, Elizabeth G Toups, James D Guest, Beatrice Ugiliweneza, Noori Akhtar-Danesh, Shekar N Kurpad, Robert G Grossman

Odontoid fractures are common, often presenting in the elderly after a fall and infrequently associated with traumatic spinal cord injury (tSCI). The goal of this study was to analyze predictors of mortality and neurological outcome when odontoid fractures were associated with signal change on magnetic resonance imaging (MRI) at admission. Over an 18-year period (2001-2019), 33 patients with odontoid fractures and documented tSCI on MRI were identified. Mean age was 65.3 years (standard deviation [SD] = 17.2), and 21 patients were male. The mechanism of injury was falls in 25 patients, motor vehicle accidents in 5, and other causes in 3. Mean Injury Severity Score (ISS) was 40.5 (SD = 30.2), Glasgow Coma Scale (GCS) score was 13 (SD = 3.4), and American Spinal Injury Association (ASIA) motor score (AMS) was 51.6 (SD = 42.7). ASIA Impairment Scale (AIS) grade was A, B, C, and D in 9, 2, 3, and 19 patients, respectively. Mean intramedullary lesion length was 32.3 mm (SD = 18.6). The odontoid peg was displaced ventral or dorsal in 15 patients. Twenty patients had surgical intervention: anterior odontoid screw fixation in 7 and posterior spinal fusion in 13. Eleven (33.3%) patients died in this series: withdrawal of medical care in 5; anoxic brain injury in 4; and failure of critical care management in 2. Univariate logistic regression indicated that GCS score (p < 0.014), AMS (p < 0.002), AIS grade (p < 0.002), and ISS (p < 0.009) were risk factors for mortality. Multi-variate regression analysis indicated that only AMS (p < 0.002) had a significant relationship with mortality when odontoid fracture was associated with tSCI (odds ratio, 0.963; 95% confidence interval, 0.941-0.986).

蝶骨骨折很常见,通常发生在跌倒后的老年人身上,很少与创伤性脊髓损伤(tSCI)相关。本研究旨在分析入院时骨突骨折伴有磁共振成像(MRI)信号变化时的死亡率和神经功能预后预测因素。在 18 年的时间里(2001-2019 年),共确定了 33 名骨突骨折并在 MRI 上记录有 tSCI 的患者。平均年龄为 65.3 岁(标准差 [SD] = 17.2),21 名患者为男性。25名患者的受伤机制为跌倒,5名患者为车祸,3名患者为其他原因。平均受伤严重程度评分(ISS)为 40.5(标准差 = 30.2),格拉斯哥昏迷量表(GCS)评分为 13(标准差 = 3.4),美国脊柱损伤协会(ASIA)运动评分(AMS)为 51.6(标准差 = 42.7)。ASIA损伤量表(AIS)分级分别为A、B、C和D级的患者分别有9人、2人、3人和19人。髓内病变的平均长度为32.3毫米(标准差=18.6)。15例患者的蝶骨钉向腹侧或背侧移位。20名患者接受了手术治疗:7名患者接受了蝶骨前路螺钉固定术,13名患者接受了脊柱后路融合术。该系列中有 11 例(33.3%)患者死亡:5 例因放弃治疗而死亡;4 例因缺氧性脑损伤而死亡;2 例因重症监护管理失败而死亡。
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引用次数: 0
Effect of Impact Parameters on a Unilateral Contusion Model of Spinal Cord Injury in a Virtual Population of Non-Human Primates. 冲击参数对非人灵长类虚拟群体脊髓损伤单侧挫伤模型的影响
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2023-06-01 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0006
Numaira Obaid, Ana-Maria Bojic, Shervin Jannesar, Ernesto Salegio, Yvette Nout-Lomas, Michael Beattie, Jacqueline Bresnahan, Carolyn Sparrey

Non-human primate (NHP) spinal cord injury experiments exhibit high intersubject variability in biomechanical parameters even when a consistent impact protocol is applied to each subject. Optimizing impact parameters to reduce this variability through experiments is logistically challenging in NHP studies. Finite element models provide a complimentary tool to inform experimental design without the cost and complexity of live animal studies. A morphologically variable virtual population (N = 10) of NHPs quantified the interaction of morphological variability and different impact conditions in a unilateral cervical contusion, including impactor size (4 and 5 mm) and mediolateral alignment over the cord midline (0.5 and 1 mm). We explored the effect of these conditions on the magnitude and intersubject variability of impact force and cord lateral slippage. The study demonstrated that a 1-mm mediolateral alignment maximized peak forces and minimized lateral slippage. A 5-mm impactor was beneficial in increasing peak forces, whereas a 4-mm impactor reduced lateral slippage. Comparatively, intersubject variability in peak forces and lateral slippage were minimized with a 0.5-mm mediolateral alignment. The study highlights that impact parameters selected based on peak forces may not be beneficial in reducing variability. The study also showed that morphology was an important contributor to variability. Integrating morphology variability through a virtual population in an injury simulation to investigate mechanistic research questions will more effectively capture the heterogeneity of experiments and provide better insights for effective experimental design.

非人灵长类(NHP)脊髓损伤实验在生物力学参数方面表现出很高的受试者间变异性,即使对每个受试者采用一致的冲击方案。在非人灵长类研究中,通过实验优化冲击参数以减少这种变异性在逻辑上具有挑战性。有限元模型提供了一种辅助工具,可为实验设计提供信息,而无需活体动物研究的成本和复杂性。一个形态可变的虚拟 NHPs 群体(N = 10)量化了单侧颈椎挫伤中形态可变性与不同撞击条件的相互作用,包括撞击器大小(4 毫米和 5 毫米)和脊髓中线的内外侧对齐(0.5 毫米和 1 毫米)。我们探讨了这些条件对撞击力和脊髓侧向滑动的大小和受试者间变异性的影响。研究表明,1 毫米的内外侧对齐可使峰值力最大化,并使侧向滑动最小化。5 毫米撞击器有利于增加峰值力,而 4 毫米撞击器则减少了侧向滑动。相比之下,0.5 毫米的内外侧对齐可使受试者之间的峰值力和侧向滑移变异性最小。该研究强调,根据峰值力选择冲击参数可能不利于减少变异性。研究还表明,形态是造成变异性的一个重要因素。通过伤害模拟中的虚拟群体来整合形态变异性,以研究机理研究问题,将更有效地捕捉实验的异质性,并为有效的实验设计提供更好的见解。
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引用次数: 0
Telomere Length Associates With Symptom Severity After Mild Traumatic Brain Injury in Older Adults. 端粒长度与老年人轻度脑外伤后症状严重程度的关系
Q3 CLINICAL NEUROLOGY Pub Date : 2023-05-23 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2023.0012
Sarah R Martha, Ernesto J Tolentino, Andrew A Bugajski, Hilaire J Thompson

The objectives were to compare differences in telomere length (TL) among younger (21-54 years) and older adults (≥55) with mild traumatic brain injury (mTBI) to non-injured controls and to examine the association between TL and the severity of post-concussive symptoms over time. We performed a quantitative polymerase chain reaction to determine the TL (Kb/genome) of peripheral blood mononuclear cell samples (day 0, 3 months, and 6 months) from 31 subjects. The Rivermead Post-Concussion Symptoms Questionnaire was used to assess symptoms. Group-by-time comparisons of TL and symptom severity were evaluated with repeated-measures analysis of variance. Multiple linear regression examined the relationship between TL, group (mTBI and non-injured controls), and symptom severity total and subscale scores. Significant aging-related differences in TL were found within mTBI groups by time (day 0, 3 months, and 6 months; p = 0.025). Older adults with mTBI experienced significant worsening of changes in total symptom severity scores over time (day 0, 3 months, and 6 months; p = 0.016). Shorter TLs were associated with higher total symptom burden among each of the four groups at day 0 (baseline; p = 0.035) and 3 months (p = 0.038). Shorter TL was also associated with higher cognitive symptom burden among the four groups at day 0 (p = 0.008) and 3 months (p = 0.008). Shorter TL was associated with higher post-injury symptom burden to 3 months in both older and younger persons with mTBI. Large-scale, longitudinal studies of factors associated with TL may be useful to delineate the mechanistic underpinnings of higher symptom burden in adults with mTBI.

我们的目的是比较轻度脑外伤(mTBI)患者中年轻人(21-54 岁)和老年人(≥55 岁)与未受伤的对照组在端粒长度(TL)上的差异,并研究随着时间的推移端粒长度与脑震荡后症状严重程度之间的关系。我们采用定量聚合酶链反应测定了 31 名受试者外周血单核细胞样本(第 0 天、3 个月和 6 个月)的 TL(Kb/基因组)。Rivermead 脑震荡后症状问卷用于评估症状。通过重复测量方差分析评估了TL和症状严重程度的组间时间比较。多元线性回归检验了 TL、组别(mTBI 和非损伤对照组)以及症状严重程度总分和分量表得分之间的关系。按时间(0 天、3 个月和 6 个月;P = 0.025)划分,mTBI 组内的 TL 存在显著的衰老相关差异。患有 mTBI 的老年人随着时间的推移(0 天、3 个月和 6 个月;p = 0.016),症状严重程度总分的变化显著恶化。在第 0 天(基线;p = 0.035)和 3 个月(p = 0.038)时,较短的 TL 与四组中每一组较高的总症状负担相关。在第 0 天(p = 0.008)和 3 个月(p = 0.008)时,较短的 TL 也与四组中较高的认知症状负担有关。在老年和年轻的 mTBI 患者中,较短的 TL 与较高的伤后 3 个月症状负担有关。对与TL相关的因素进行大规模纵向研究,可能有助于明确成年mTBI患者较高症状负担的机理基础。
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引用次数: 0
Association Between the Attention Network Test, Neuropsychological Measures, and Disability in Post-Acute Traumatic Brain Injury. 急性颅脑损伤后注意网络测试、神经心理学测量和残疾之间的关系。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2023-05-15 eCollection Date: 2023-01-01 DOI: 10.1089/neur.2022.0068
Abhishek Jaywant, Emily Blunt, Keith Jamison, Nayoung Kim, Arindam RoyChoudhury, Nicholas D Schiff, Amy Kuceyeski, Kristen Dams-O'Connor, Sudhin Shah

Cognitive impairment after traumatic brain injury (TBI) is persistent and disabling. Assessing cognitive function in a reliable and valid manner, using measures that are sensitive to the integrity of underlying neural substrates, is crucial in clinical research. The Attention Network Test (ANT) is one such assessment measure that has demonstrated associations with neural regions involved in attention; however, clinical utility of the ANT is limited because its relationship with neuropsychological measures of cognitive function (i.e., its construct validity) has not yet been established in TBI. We evaluated the association between the ANT and 1) a neuropsychological battery assessing executive function and memory and 2) global function assessed by the Glasgow Outcome Scale-Extended (GOSE). Forty-eight adults with complicated mild-severe TBI were evaluated ∼5 months post-injury. Using principal component analysis and multi-variate linear regression adjusted for age, gender, education, and cause of injury, we found that ANT reaction time and executive network scores predicted a principal component assessing processing speed and executive function. Conversely, the ANT did not predict a principal component assessing memory. The ANT was weakly associated with the GOSE. Among persons with TBI during the post-acute phase of recovery, the ANT has good construct validity as evidenced by its associations with neuropsychological measures of processing speed and executive function, but not memory. Given that ANT networks are known to relate to specific neuroanatomical regions, the ANT may be a useful outcome measure for evaluating novel therapeutics targeting attention and executive functions after TBI.

创伤性脑损伤(TBI)后的认知障碍是持续的和致残的。以可靠有效的方式评估认知功能,使用对潜在神经基质完整性敏感的措施,在临床研究中至关重要。注意力网络测试(ANT)就是这样一种评估措施,它已经证明了与注意力相关的神经区域的关联;然而,ANT的临床应用是有限的,因为它与认知功能的神经心理学测量(即其结构有效性)的关系尚未在TBI中得到证实。我们评估了ANT与1)评估执行功能和记忆的神经心理组和2)通过格拉斯哥结果扩展量表(GOSE)评估的整体功能之间的关系。48名患有复杂轻度-重度TBI的成年人在受伤后~5个月接受了评估。使用主成分分析和根据年龄、性别、教育程度和受伤原因调整的多变量线性回归,我们发现ANT反应时间和执行网络得分预测了评估处理速度和执行功能的主成分。相反,ANT没有预测评估记忆的主要成分。ANT与GOSE的相关性较弱。在急性期后恢复期的TBI患者中,ANT具有良好的结构有效性,这可以通过其与处理速度和执行功能的神经心理学测量的关联来证明,但与记忆无关。鉴于已知ANT网络与特定的神经解剖学区域有关,ANT可能是评估TBI后针对注意力和执行功能的新疗法的有用结果指标。
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Neurotrauma reports
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