Pub Date : 2025-03-21Epub Date: 2025-01-01DOI: 10.1080/02699052.2024.2432967
Thomas S Nabity, John T Ransom
Objective: Extracellular vesicles (EVs) derived from regenerative mesenchymal stem cells might safely treat traumatic brain injury (TBI). We evaluated the safety and efficacy of a human bone marrow derived mesenchymal stem cell EVs (hBM-MSC EV) investigational product (IP) in a patient with severe TBI.
Design: A single case study employing an IP with a strong safety profile in over 200 patients.
Method: The patient was dosed intravenously three times/week in the first week of six successive months. Functional Independence Measure (FIM) and Functional Assessment Measure (FAM) were performed to quantify effects. Safety monitoring was performed every week for nine months.
Results: No adverse events occurred. Within eight weeks FIM and FAM scores improved by 48-55% and were sustained for the entire 36 weeks. All specific outcome items assessed by FIM and FAM that were initially low showed sustained improvements ranging from 41% to 233%, with the greatest improvements seen in locomotion, mobility and cognitive function.
Conclusion: After moderate improvement with conventional therapy, the substantial improvement observed following introduction of the IP suggests that hBM-MSC EVs may offer a novel and safe means to improve TBI patient outcomes. Appropriate randomized, controlled clinical trials to conclusively evaluate this therapeutic option are indicated.
{"title":"Treatment of severe traumatic brain injury with human bone marrow mesenchymal stem cell extracellular vesicles: a case report.","authors":"Thomas S Nabity, John T Ransom","doi":"10.1080/02699052.2024.2432967","DOIUrl":"10.1080/02699052.2024.2432967","url":null,"abstract":"<p><strong>Objective: </strong>Extracellular vesicles (EVs) derived from regenerative mesenchymal stem cells might safely treat traumatic brain injury (TBI). We evaluated the safety and efficacy of a human bone marrow derived mesenchymal stem cell EVs (hBM-MSC EV) investigational product (IP) in a patient with severe TBI.</p><p><strong>Design: </strong>A single case study employing an IP with a strong safety profile in over 200 patients.</p><p><strong>Method: </strong>The patient was dosed intravenously three times/week in the first week of six successive months. Functional Independence Measure (FIM) and Functional Assessment Measure (FAM) were performed to quantify effects. Safety monitoring was performed every week for nine months.</p><p><strong>Results: </strong>No adverse events occurred. Within eight weeks FIM and FAM scores improved by 48-55% and were sustained for the entire 36 weeks. All specific outcome items assessed by FIM and FAM that were initially low showed sustained improvements ranging from 41% to 233%, with the greatest improvements seen in locomotion, mobility and cognitive function.</p><p><strong>Conclusion: </strong>After moderate improvement with conventional therapy, the substantial improvement observed following introduction of the IP suggests that hBM-MSC EVs may offer a novel and safe means to improve TBI patient outcomes. Appropriate randomized, controlled clinical trials to conclusively evaluate this therapeutic option are indicated.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"330-335"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913844","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}
Purpose: To develop a series of infographics providing persons with traumatic brain injury (TBI) and their circle of care with evidence-based information on sex and gender topics in TBI.
Materials and methods: We employed an iterative participatory design engaging knowledge users, scientists, and experts in brain injury and patient education. To inform infographic content, we conducted an information needs assessment with knowledge users through semi-structured interviews and referred to our previously published evidence syntheses on TBI topics. We followed principles of graphic design and science communication to create materials reflecting lived experiences of knowledge users.
Results: We created a series of infographics with actionable messages and visual representations of evidence-based information. We achieved a Flesch Reading-Ease score of 60.1, corresponding to a Grade 7/8 reading level. The infographics met the color contrast criteria of the Web Content Accessibility Guidelines. Knowledge users found the material useful, visually appealing, and helpful in understanding complex topics.
Conclusions: There is value in merging art and science to develop educational materials that meet the unique information needs of knowledge users. Iterative participatory design engaging diverse stakeholders is essential for co-creating knowledge translation tools to improve access to health information and quality of care after TBI.
{"title":"\"Gender matters\": the development of infographics to raise awareness and promote gender-transformative care in traumatic brain injury.","authors":"Thaisa Tylinski Sant'Ana, Alina Rodrigues, Farrah Schwartz, Angela Colantonio, Tatyana Mollayeva","doi":"10.1080/02699052.2024.2429698","DOIUrl":"10.1080/02699052.2024.2429698","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a series of infographics providing persons with traumatic brain injury (TBI) and their circle of care with evidence-based information on sex and gender topics in TBI.</p><p><strong>Materials and methods: </strong>We employed an iterative participatory design engaging knowledge users, scientists, and experts in brain injury and patient education. To inform infographic content, we conducted an information needs assessment with knowledge users through semi-structured interviews and referred to our previously published evidence syntheses on TBI topics. We followed principles of graphic design and science communication to create materials reflecting lived experiences of knowledge users.</p><p><strong>Results: </strong>We created a series of infographics with actionable messages and visual representations of evidence-based information. We achieved a Flesch Reading-Ease score of 60.1, corresponding to a Grade 7/8 reading level. The infographics met the color contrast criteria of the Web Content Accessibility Guidelines. Knowledge users found the material useful, visually appealing, and helpful in understanding complex topics.</p><p><strong>Conclusions: </strong>There is value in merging art and science to develop educational materials that meet the unique information needs of knowledge users. Iterative participatory design engaging diverse stakeholders is essential for co-creating knowledge translation tools to improve access to health information and quality of care after TBI.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"300-311"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685907","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}
Pub Date : 2025-03-21Epub Date: 2024-11-12DOI: 10.1080/02699052.2024.2425737
Berno U H Overbeek, Willemijn S van Erp, Henk J Eilander, Raymond T C M Koopmans, Jan C M Lavrijsen
Objectives: Medical complications occur frequently in MCS and influence advance medical decision-making. This study aimed to report on medical complications and advance medical decision-making in a nationwide group of MCS patients.
Methods: In this descriptive cross-sectional study, clinical and advance medical decision-making characteristics were collected in a survey, completed by the treating physician.
Results: The MCS population consisted of 32 patients: 65.6% traumatic etiology, 68.8% male. Patients had a median of five complications: hypertonia/spasticity (81.3%) and pneumonia (50.0%) occurred most frequently. Most patients had curative goals: three patients had a fully curative treatment scenarios, 29 a curative scenario with ≥ 1 treatment restrictions, two a palliative and two a symptomatic scenario. Conversations about advance medical decision-making were complicated by disputes with next of kin, inability to evaluate medical treatment because of medical instability, next of kin not being ready to discuss medical treatment, or a treatment scenario explicitly based on requests of next of kin.
Conclusion: Medical complications are common in MCS patients and advance medical decision making was complicated. This legitimates realization of specialized care across acute, post-acute and long-term care. Further longitudinal research into advance medical decision-making is recommended.
{"title":"Medical complications and advance medical decision-making in the minimally conscious state.","authors":"Berno U H Overbeek, Willemijn S van Erp, Henk J Eilander, Raymond T C M Koopmans, Jan C M Lavrijsen","doi":"10.1080/02699052.2024.2425737","DOIUrl":"10.1080/02699052.2024.2425737","url":null,"abstract":"<p><strong>Objectives: </strong>Medical complications occur frequently in MCS and influence advance medical decision-making. This study aimed to report on medical complications and advance medical decision-making in a nationwide group of MCS patients.</p><p><strong>Methods: </strong>In this descriptive cross-sectional study, clinical and advance medical decision-making characteristics were collected in a survey, completed by the treating physician.</p><p><strong>Results: </strong>The MCS population consisted of 32 patients: 65.6% traumatic etiology, 68.8% male. Patients had a median of five complications: hypertonia/spasticity (81.3%) and pneumonia (50.0%) occurred most frequently. Most patients had curative goals: three patients had a fully curative treatment scenarios, 29 a curative scenario with ≥ 1 treatment restrictions, two a palliative and two a symptomatic scenario. Conversations about advance medical decision-making were complicated by disputes with next of kin, inability to evaluate medical treatment because of medical instability, next of kin not being ready to discuss medical treatment, or a treatment scenario explicitly based on requests of next of kin.</p><p><strong>Conclusion: </strong>Medical complications are common in MCS patients and advance medical decision making was complicated. This legitimates realization of specialized care across acute, post-acute and long-term care. Further longitudinal research into advance medical decision-making is recommended.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"249-256"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614667","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}
Pub Date : 2025-03-21Epub Date: 2024-11-16DOI: 10.1080/02699052.2024.2425743
Carolyn Murray, Anthea Worley, Julie Luker, Susan Hillier
Primary objective: The purpose of this study was to explore how 'quality' is understood for traumatic brain injury (TBI) rehabilitation from the perspectives of the rehabilitation recipients, their families and the providing clinicians.
Research design: A participatory study using a mixed-methods, triangulation design.
Methods: The study involved 1. a systematic literature search; 2. Individual semi-structured interviews with people with TBI and/or their caregivers and TBI rehabilitation clinicians, and 3. an online consensus process.
Outcomes and results: 22 participants (7 people with TBI, 8 caregivers, 7 clinicians) participated in individual interviews. Their transcribed data were coded into broad categories via in-depth reflexive, thematic analysis; these categories were then mapped to 13 quality domains extracted from the literature. The emergent themes were then presented to the individuals, via an electronic consensus tool in two rounds. This resulted in 12 prioritized domains of quality that encompass service features, staff qualities and effectiveness.
Conclusion: These evidence-informed and consensus-agreed indicators for quality may help guide both the provision and evaluation of TBI rehabilitation, that is valued and meaningful.
{"title":"Understanding 'quality' in adult traumatic brain injury rehabilitation from the perspectives of different stakeholders: a participatory mixed methods study.","authors":"Carolyn Murray, Anthea Worley, Julie Luker, Susan Hillier","doi":"10.1080/02699052.2024.2425743","DOIUrl":"10.1080/02699052.2024.2425743","url":null,"abstract":"<p><strong>Primary objective: </strong>The purpose of this study was to explore how 'quality' is understood for traumatic brain injury (TBI) rehabilitation from the perspectives of the rehabilitation recipients, their families and the providing clinicians.</p><p><strong>Research design: </strong>A participatory study using a mixed-methods, triangulation design.</p><p><strong>Methods: </strong>The study involved 1. a systematic literature search; 2. Individual semi-structured interviews with people with TBI and/or their caregivers and TBI rehabilitation clinicians, and 3. an online consensus process.</p><p><strong>Outcomes and results: </strong>22 participants (7 people with TBI, 8 caregivers, 7 clinicians) participated in individual interviews. Their transcribed data were coded into broad categories via in-depth reflexive, thematic analysis; these categories were then mapped to 13 quality domains extracted from the literature. The emergent themes were then presented to the individuals, via an electronic consensus tool in two rounds. This resulted in 12 prioritized domains of quality that encompass service features, staff qualities and effectiveness.</p><p><strong>Conclusion: </strong>These evidence-informed and consensus-agreed indicators for quality may help guide both the provision and evaluation of TBI rehabilitation, that is valued and meaningful.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"257-266"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643476","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}
Pub Date : 2025-03-21Epub Date: 2024-11-16DOI: 10.1080/02699052.2024.2426683
Ana Paula Salazar, Sophie Lecours, Lisa Engel, Monique A M Gignac, Shlomit Rotenberg, Sareh Zarshenas, Michelle McDonald, Emily Nalder, Carolina Bottari
Objective: To investigate brain injury (BI) associations' perspectives regarding the impacts of the second year of the COVID-19 pandemic on individuals with BI and BI associations services across Canada.
Methods: This qualitative descriptive study included 26 representatives of Canadian BI associations that participated in six online focus groups to discuss the effects of the second year of the pandemic on clients living with BI and on the provision of community services.
Results: Findings revealed three main themes: 1) ongoing pandemic-related challenges faced by clients living with BI, including worsening mental health and basic needs insecurities, difficulties faced by clients in adhering to safety measures, and ongoing technological issues; 2) ongoing adaptations to accommodate clients' needs, including offering tailored services, ensuring consistent and transparent safety measures, and providing hybrid services; and 3) developing a sustainable 'new normal' aligned with association mandates and resources by expanding networks and building resilience.
Conclusion: The unfolding of the pandemic has brought increased challenges for people with BI and reinforced the need for adapted, clear, and accessible public health information to ensure the safety of vulnerable populations in times of crisis. It is essential to bolster community-based associations that provide direct care to people with BI.
目的调查脑损伤(BI)协会对 COVID-19 大流行第二年对加拿大各地脑损伤患者和脑损伤协会服务的影响的看法:这项定性描述研究包括加拿大脑损伤协会的 26 名代表,他们参加了六个在线焦点小组,讨论大流行第二年对脑损伤患者和社区服务的影响:研究结果揭示了三大主题:1)感染 BI 的患者持续面临与大流行相关的挑战,包括心理健康和基本需求不安全状况的恶化、患者在遵守安全措施方面面临的困难以及持续存在的技术问题;2)为满足患者需求而持续进行的调整,包括提供量身定制的服务、确保一致且透明的安全措施以及提供混合服务;以及 3)通过扩大网络和建设复原力,根据协会的任务和资源发展可持续的 "新常态":大流行病的发展给生物多样性感染者带来了更多的挑战,并加强了对经过调整的、清晰的和可获取的公共卫生信息的需求,以确保弱势群体在危机时期的安全。必须加强以社区为基础的协会,为生物感染者提供直接护理。
{"title":"Responding to the ongoing pandemic-related challenges of individuals with brain injury through the perspective of community-service in Canada: A qualitative study.","authors":"Ana Paula Salazar, Sophie Lecours, Lisa Engel, Monique A M Gignac, Shlomit Rotenberg, Sareh Zarshenas, Michelle McDonald, Emily Nalder, Carolina Bottari","doi":"10.1080/02699052.2024.2426683","DOIUrl":"10.1080/02699052.2024.2426683","url":null,"abstract":"<p><strong>Objective: </strong>To investigate brain injury (BI) associations' perspectives regarding the impacts of the second year of the COVID-19 pandemic on individuals with BI and BI associations services across Canada.</p><p><strong>Methods: </strong>This qualitative descriptive study included 26 representatives of Canadian BI associations that participated in six online focus groups to discuss the effects of the second year of the pandemic on clients living with BI and on the provision of community services.</p><p><strong>Results: </strong>Findings revealed three main themes: 1) ongoing pandemic-related challenges faced by clients living with BI, including worsening mental health and basic needs insecurities, difficulties faced by clients in adhering to safety measures, and ongoing technological issues; 2) ongoing adaptations to accommodate clients' needs, including offering tailored services, ensuring consistent and transparent safety measures, and providing hybrid services; and 3) developing a sustainable 'new normal' aligned with association mandates and resources by expanding networks and building resilience.</p><p><strong>Conclusion: </strong>The unfolding of the pandemic has brought increased challenges for people with BI and reinforced the need for adapted, clear, and accessible public health information to ensure the safety of vulnerable populations in times of crisis. It is essential to bolster community-based associations that provide direct care to people with BI.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"267-276"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643472","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}
Pub Date : 2025-03-21Epub Date: 2024-12-06DOI: 10.1080/02699052.2024.2430386
Weifang Xu, Xiaolan Ma, Chen Zhang
Objective: To identify risk factors in people with heart disease prior to undergoing cardiac surgery and to provide a prediction model.
Methods: 106 patients who underwent cardiac surgery were selected by convenience sampling method. Case-control study design was used to divide them into control and observation groups according to whether there was postoperative brain injury. General demographic data, perioperative surgery, postoperative recovery, past medical history and preoperative conditions, laboratory test indicators were collected. Univariate and multivariate Logistic regression analyses were performed to select influencing factors. A nomogram model for predicting postoperative brain injury was established.
Results: Univariate Logistic regression analysis showed that age, female, stroke, diabetes mellitus, perioperative administration of dexmedetomidine, intraoperative use of cardiopulmonary bypass were related factors for postoperative brain injury(p < 0.05). Multivariate Logistic regression analysis showed that females, history of stroke, and intraoperative use of cardiopulmonary bypass were risk factors, and perioperative administration of dexmedetomidine was protective factor(p < 0.05). Nomogram model was established with an AUC of 0.847 and accuracy of 84.7%.
Conclusion: Preoperative stroke history and females are risk factors for brain injury after coronary artery bypass grafting under cardiopulmonary bypass, and perioperative use of dexmedetomidine is protective factor.
{"title":"Analysis of influencing factors for postoperative brain injury in patients with cardiac surgery.","authors":"Weifang Xu, Xiaolan Ma, Chen Zhang","doi":"10.1080/02699052.2024.2430386","DOIUrl":"10.1080/02699052.2024.2430386","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors in people with heart disease prior to undergoing cardiac surgery and to provide a prediction model.</p><p><strong>Methods: </strong>106 patients who underwent cardiac surgery were selected by convenience sampling method. Case-control study design was used to divide them into control and observation groups according to whether there was postoperative brain injury. General demographic data, perioperative surgery, postoperative recovery, past medical history and preoperative conditions, laboratory test indicators were collected. Univariate and multivariate Logistic regression analyses were performed to select influencing factors. A nomogram model for predicting postoperative brain injury was established.</p><p><strong>Results: </strong>Univariate Logistic regression analysis showed that age, female, stroke, diabetes mellitus, perioperative administration of dexmedetomidine, intraoperative use of cardiopulmonary bypass were related factors for postoperative brain injury(<i>p</i> < 0.05). Multivariate Logistic regression analysis showed that females, history of stroke, and intraoperative use of cardiopulmonary bypass were risk factors, and perioperative administration of dexmedetomidine was protective factor(<i>p</i> < 0.05). Nomogram model was established with an AUC of 0.847 and accuracy of 84.7%.</p><p><strong>Conclusion: </strong>Preoperative stroke history and females are risk factors for brain injury after coronary artery bypass grafting under cardiopulmonary bypass, and perioperative use of dexmedetomidine is protective factor.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"320-329"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789609","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}
Pub Date : 2025-03-21Epub Date: 2024-12-02DOI: 10.1080/02699052.2024.2429700
Áine M Kelly, Clíodhna McHugh, James Hale, Joice Cunningham, Noreen Boyle, Oisín Joyce, Brendan O'Connell, Gareth Farrell, Fiona Wilson
Objectives: To investigate the effect of multiple seasons of play on serum S100B concentration in male professional rugby players, while also assessing the acute effects following a season of play and concussion.
Methods: A prospective study of professional male rugby players over three seasons (2016/17 to 2018/19) was conducted. Serum sampling was carried out during pre-season, post-season and following a concussion; sustained during match play at a home game (between 2-24hrs), during each season. Serum S100B concentrations were determined by ELISA assay.
Results: Fourteen players sustained 24 concussions over three seasons, of which 13 samples (54%) were collected. Pre- and post-season serum S100B remained stable across multiple seasons. S100B concentration increased significantly following concussion compared with pre-season (p = 0.002) and post-season (p = 0.009), reflective in a 3.23-fold-change post-concussion, with no difference found between pre- and post-season values. S100B concentration measured at post-season was not significantly different for players who had a concussion during a season and players who did not.
Conclusion: S100B remains stable across multiple seasons of play in professional rugby players. As concussion results in a temporary increase in S100B concentration, returning to pre-season values by post-season, S100B may be a useful diagnostic marker for improving existing management protocols for sports-related concussions.
{"title":"A cross-season analysis of S100B as a potential marker of concussion in professional rugby players.","authors":"Áine M Kelly, Clíodhna McHugh, James Hale, Joice Cunningham, Noreen Boyle, Oisín Joyce, Brendan O'Connell, Gareth Farrell, Fiona Wilson","doi":"10.1080/02699052.2024.2429700","DOIUrl":"10.1080/02699052.2024.2429700","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of multiple seasons of play on serum S100B concentration in male professional rugby players, while also assessing the acute effects following a season of play and concussion.</p><p><strong>Methods: </strong>A prospective study of professional male rugby players over three seasons (2016/17 to 2018/19) was conducted. Serum sampling was carried out during pre-season, post-season and following a concussion; sustained during match play at a home game (between 2-24hrs), during each season. Serum S100B concentrations were determined by ELISA assay.</p><p><strong>Results: </strong>Fourteen players sustained 24 concussions over three seasons, of which 13 samples (54%) were collected. Pre- and post-season serum S100B remained stable across multiple seasons. S100B concentration increased significantly following concussion compared with pre-season (<i>p</i> = 0.002) and post-season (<i>p</i> = 0.009), reflective in a 3.23-fold-change post-concussion, with no difference found between pre- and post-season values. S100B concentration measured at post-season was not significantly different for players who had a concussion during a season and players who did not.</p><p><strong>Conclusion: </strong>S100B remains stable across multiple seasons of play in professional rugby players. As concussion results in a temporary increase in S100B concentration, returning to pre-season values by post-season, S100B may be a useful diagnostic marker for improving existing management protocols for sports-related concussions.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"312-319"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766169","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}
Pub Date : 2025-03-21Epub Date: 2024-11-21DOI: 10.1080/02699052.2024.2427803
Travis W Murphy, Robert J Cueto, Jiepei Zhu, Jacob Milling, Justin Sauter, Muna Oli, Ian T Griffin, Gagan Midathala, J Adrian Tyndall, Bruce Spiess, Kevin K W Wang, Firas H Kobeissy, Torben K Becker
Introduction: Dodecafluoropentane emulsion (DDFPe) administration has previously demonstrated improved gas exchange in single-organ perfusion models. This could translate to prevention of brain injury in cardiac arrest.
Methods: We induced cardiac arrest in 12 pigs, performing CPR after 5-minute downtime. Pigs were randomly assigned to DDFPe (n = 7) or saline placebo (n = 5) groups. Neurologic injury biomarkers were measured at baseline, after return of spontaneous circulation (ROSC), and every 24 hours in survivors. Blinded Neurological Alertness Score, Neurological Dysfunction Score, and Overall Performance Score was performed in addition to histopathological scoring of parietal and hippocampal sections.
Results: One placebo and four DDFPe pigs survived the 96-hour observation period. The odds ratio for ROSC was 7.2 (p = 0.22). Survival odds ratio was 4.6 (p = 0.29). All surviving animals had impaired motor responses that recovered by 72 hours. DDFPe animals showed better neuro-behavioral scores than placebo.
Conclusion: The findings of this novel study provide a proof of concept and early signal toward efficacy of intravenous DDFPe in cardiac arrest. The trend toward improved ROSC and functional survival may reflect improved microcirculatory gas exchange in DDFPe animals. Improving gas exchange in brain microcirculation during resuscitation from cardiac arrest may provide a significant therapeutic benefit.
{"title":"Dodecafluoropentane improves neuro-behavioral outcomes and return of spontaneous circulation rate in a swine model of cardiac arrest.","authors":"Travis W Murphy, Robert J Cueto, Jiepei Zhu, Jacob Milling, Justin Sauter, Muna Oli, Ian T Griffin, Gagan Midathala, J Adrian Tyndall, Bruce Spiess, Kevin K W Wang, Firas H Kobeissy, Torben K Becker","doi":"10.1080/02699052.2024.2427803","DOIUrl":"10.1080/02699052.2024.2427803","url":null,"abstract":"<p><strong>Introduction: </strong>Dodecafluoropentane emulsion (DDFPe) administration has previously demonstrated improved gas exchange in single-organ perfusion models. This could translate to prevention of brain injury in cardiac arrest.</p><p><strong>Methods: </strong>We induced cardiac arrest in 12 pigs, performing CPR after 5-minute downtime. Pigs were randomly assigned to DDFPe (<i>n</i> = 7) or saline placebo (<i>n</i> = 5) groups. Neurologic injury biomarkers were measured at baseline, after return of spontaneous circulation (ROSC), and every 24 hours in survivors. Blinded Neurological Alertness Score, Neurological Dysfunction Score, and Overall Performance Score was performed in addition to histopathological scoring of parietal and hippocampal sections.</p><p><strong>Results: </strong>One placebo and four DDFPe pigs survived the 96-hour observation period. The odds ratio for ROSC was 7.2 (<i>p</i> = 0.22). Survival odds ratio was 4.6 (<i>p</i> = 0.29). All surviving animals had impaired motor responses that recovered by 72 hours. DDFPe animals showed better neuro-behavioral scores than placebo.</p><p><strong>Conclusion: </strong>The findings of this novel study provide a proof of concept and early signal toward efficacy of intravenous DDFPe in cardiac arrest. The trend toward improved ROSC and functional survival may reflect improved microcirculatory gas exchange in DDFPe animals. Improving gas exchange in brain microcirculation during resuscitation from cardiac arrest may provide a significant therapeutic benefit.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"277-285"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680833","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}
Pub Date : 2025-03-21Epub Date: 2024-11-19DOI: 10.1080/02699052.2024.2428404
Beth J Bollinger, Sara Pd Chrisman, Jordan Sahlberg, Jason A Mendoza, Tonya M Palermo, Chuan Zhou, M Alison Brooks, Frederick P Rivara, Payton Pedersen, Emily Prentice, Colby Hansen
Background: A significant portion of youth sustain a concussion every year, with around 30% experiencing persistent post-concussion symptoms (PPCS). Research has shown exercising just below the exertion level that provokes symptoms can lead to more rapid recovery. However, youth often struggle to adhere to exercise recommendations following concussion.
Methods: We conducted structured qualitative interviews (n = 32) with concussed youth and their parents to examine factors influencing motivation to engage in exercise post-concussion. Questions were framed through the lens of Self-Determination Theory (SDT) and Thematic Analysis was used to code and analyze transcripts.
Results: Four primary factors appeared to motivate youth to exercise after receiving a concussion: 1) social support, 2) accountability, 3) goal setting, and 4) structure. Utilizing the lens of SDT, one could theorize that including social support and accountability helped fulfill the need of relatedness, setting goals helped fulfill the need of autonomy, and providing program structure helped fulfill the need for competence.
Conclusions: Our results suggest that Self-Determination Theory may be a useful frame for examining exercise adherence post-concussion. Incorporating social support, accountability, goal setting and structure could increase the effectiveness of exercise prescription post-concussion and should be the focus of further study.
{"title":"Understanding factors influencing exercise program adherence for youth with persistent post-concussive symptoms (PPCS).","authors":"Beth J Bollinger, Sara Pd Chrisman, Jordan Sahlberg, Jason A Mendoza, Tonya M Palermo, Chuan Zhou, M Alison Brooks, Frederick P Rivara, Payton Pedersen, Emily Prentice, Colby Hansen","doi":"10.1080/02699052.2024.2428404","DOIUrl":"10.1080/02699052.2024.2428404","url":null,"abstract":"<p><strong>Background: </strong>A significant portion of youth sustain a concussion every year, with around 30% experiencing persistent post-concussion symptoms (PPCS). Research has shown exercising just below the exertion level that provokes symptoms can lead to more rapid recovery. However, youth often struggle to adhere to exercise recommendations following concussion.</p><p><strong>Methods: </strong>We conducted structured qualitative interviews (<i>n</i> = 32) with concussed youth and their parents to examine factors influencing motivation to engage in exercise post-concussion. Questions were framed through the lens of Self-Determination Theory (SDT) and Thematic Analysis was used to code and analyze transcripts.</p><p><strong>Results: </strong>Four primary factors appeared to motivate youth to exercise after receiving a concussion: 1) social support, 2) accountability, 3) goal setting, and 4) structure. Utilizing the lens of SDT, one could theorize that including social support and accountability helped fulfill the need of relatedness, setting goals helped fulfill the need of autonomy, and providing program structure helped fulfill the need for competence.</p><p><strong>Conclusions: </strong>Our results suggest that Self-Determination Theory may be a useful frame for examining exercise adherence post-concussion. Incorporating social support, accountability, goal setting and structure could increase the effectiveness of exercise prescription post-concussion and should be the focus of further study.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"286-299"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675260","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}
Pub Date : 2025-02-27DOI: 10.1080/02699052.2025.2469705
Nicholas W Sheets, Yan Shen, Jeneva M Garland, David S Plurad, Lori F Harbour, Alessandro Orlando, Samir M Fakhry
Background: Methamphetamine (Meth) use is rising in the US. Most research focuses on severe TBI, neglecting milder cases. We evaluated Meth's impact on patient outcomes and hospital resource use across all TBI severities.
Methods: This study included National Trauma Data Bank (NTDB) patients from 2017-2019, aged 18-54, with near-isolated TBI, a drug screen, and negative blood alcohol. Meth+ patients were compared to Meth- patients on demographics, injury severity, and outcomes using χ² and Wilcoxon rank-sum tests.
Results: Of 29,416 patients with TBI patients, 337 (1%) were Meth+. Meth+ patients had significantly higher ICU admissions (61% vs. 50%, p < 0.001), mechanical ventilation (32% vs. 22%, p < 0.001), and tracheostomy (7% vs. 4%, p < 0.008). Meth+ had longer hospital stays (median 4 vs. 3 days, p < 0.001) and higher cerebral monitor use (8% vs. 5%, p < 0.05). Mortality rates were similar (5% vs. 5%, p = 0.46). Meth+ patients had more preexisting mental health/personality (20% vs. 12%, p < 0.001) and substance use disorders (44% vs. 6%, p < 0.001).
Conclusions: Meth use in patients with near-isolated TBI patients is linked to greater injury severity, increased resource use, and longer hospital stays but does not significantly impact mortality. Targeted interventions are needed to manage clinical challenges and optimize resource utilization.
{"title":"Methamphetamine and traumatic brain injury outcomes: an analysis of 29,416 patients from the national trauma data bank.","authors":"Nicholas W Sheets, Yan Shen, Jeneva M Garland, David S Plurad, Lori F Harbour, Alessandro Orlando, Samir M Fakhry","doi":"10.1080/02699052.2025.2469705","DOIUrl":"https://doi.org/10.1080/02699052.2025.2469705","url":null,"abstract":"<p><strong>Background: </strong>Methamphetamine (Meth) use is rising in the US. Most research focuses on severe TBI, neglecting milder cases. We evaluated Meth's impact on patient outcomes and hospital resource use across all TBI severities.</p><p><strong>Methods: </strong>This study included National Trauma Data Bank (NTDB) patients from 2017-2019, aged 18-54, with near-isolated TBI, a drug screen, and negative blood alcohol. Meth+ patients were compared to Meth- patients on demographics, injury severity, and outcomes using χ² and Wilcoxon rank-sum tests.</p><p><strong>Results: </strong>Of 29,416 patients with TBI patients, 337 (1%) were Meth+. Meth+ patients had significantly higher ICU admissions (61% vs. 50%, <i>p</i> < 0.001), mechanical ventilation (32% vs. 22%, <i>p</i> < 0.001), and tracheostomy (7% vs. 4%, <i>p</i> < 0.008). Meth+ had longer hospital stays (median 4 vs. 3 days, <i>p</i> < 0.001) and higher cerebral monitor use (8% vs. 5%, <i>p</i> < 0.05). Mortality rates were similar (5% vs. 5%, <i>p</i> = 0.46). Meth+ patients had more preexisting mental health/personality (20% vs. 12%, <i>p</i> < 0.001) and substance use disorders (44% vs. 6%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Meth use in patients with near-isolated TBI patients is linked to greater injury severity, increased resource use, and longer hospital stays but does not significantly impact mortality. Targeted interventions are needed to manage clinical challenges and optimize resource utilization.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522467","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}