Brain injury最新文献

Background: Traumatic Brain Injury (TBI) affects hundreds of thousands of people in the United States each year and represents a significant public health problem. There is considerable heterogeneity of causes, diagnostic tools, treatments, and outcomes of TBI, and the volume of research on the topic reflects this. Despite the large body of research, significant gaps remain in our knowledge of how to diagnose and treat TBI. To address this, the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System was developed.

Methods: This scoping review aimed to provide a descriptive overview of how FITBIR data has been used in published research since its inception, including the types of studies conducted, datasets used, and methodological approaches. Online databases were used to identify papers that utilized FITBIR data for secondary applications.

Results: Forty-nine articles were identified for inclusion through a literature search. We summarize the secondary uses of FITBIR data, focusing on how many and which data sets were used, as well as the varied approaches to data use.

Conclusions: This review demonstrates successful use of existing TBI data to expand the knowledge base regarding diagnosis, treatment, and outcomes, and suggests promising potential for future harmonization and synthesis of available datasets.

Purpose: The prevalence of acquired brain injury (ABI) is disproportionately high among people experiencing homelessness. Most people in this situation experienced their first ABI before their first experience of homelessness. However, little is known about their trajectories. This study aimed to identify key moments and turning points into homelessness among people with a history of both ABI and homelessness.

Materials and methods: A qualitative descriptive study was conducted, involving 26 semi-structured interviews using the life history mapping method with individuals who had experienced both homelessness and ABI. Data were analyzed using Paillé and Mucchielli's thematic analysis method.

Results: Participants reported an average of 4.7 ABIs, with the majority (77%) having sustained a first ABI before the age of 18. Five themes emerged from the analysis: 1) homelessness as a series of losses 2) the cross-cutting effects of violence; 3) foregrounding ABI as a turning point; 4) foregrounding substance use as a turning point; and 5) relations and occupations as counterweights to losses.

Conclusion: This study highlights the turning points on the path to homelessness for people with ABI. It provides insight into their life trajectories and supports the development of homelessness prevention interventions specific to the needs of this population.

Objectives: This study aimed to refine and validate the Sources of Reading Self-Efficacy Scale for College and University Students (SOURSES-C).

Method: Using an iterative, user-informed approach grounded in Bandura's Sources of Self-Efficacy theory, the study proceeded in two phases. Phase 1 involved distributing the original scale via an online survey to college students with and without concussion, followed by interviews with students with concussion to guide item refinement. Phase 2 tested the revised SOURSES-C with new samples to evaluate its structural validity, convergent validity, and reliability.

Results: The SOURSES-C was refined to a 10-item scale with three components: Effort, Enjoyment, and Processing. Confirmatory factor analysis supported the three-component structure with structural invariance across students with and without concussion. The scale showed strong convergent validity through significant correlations with both reading performance and academic self-efficacy. Internal consistency was high for the total scale (Cronbach's α = .88) and each component: Effort (α = .90), Enjoyment (α = .83), and Processing (α = .75).

Conclusion: These findings support the SOURSES-C as a psychometrically sound tool for assessing reading self-efficacy in college students with concussion. With further validation, the scale shows promise as a measure that clinicians and educators can use to identify changes in reading self-efficacy following concussion and to evaluate the effectiveness of targeted interventions.

Introduction: S100B is the most studied biomarker for prognosis of traumatic brain injury (TBI), and saliva is a promising matrix. This study evaluated the prognostic value of S100B in saliva and plasma after moderate to severe traumatic brain injury (TBI).

Methods: A prospective cohort included 25 adult patients (18-60 years) admitted to three hospitals with a Glasgow Coma Scale score of 3 to 12 within four hours post-trauma. Saliva and plasma samples were collected three hours after the trauma, with an additional saliva sample collected at six hours. Outcomes were assessed using the Glasgow Outcome Scale at discharge and its extended version.

Results: Plasma S100B levels were higher than salivary (p = 0.0113) and decreased significantly between 3 and 6 hours (p < 0.0001). Salivary S100B at 6 hours was significantly higher in patients with unfavorable outcomes (p = 0.0248). Among all measures, salivary S100B at 6 hours demonstrated the highest prognostic accuracy, with an area under the curve (AUC). AUC for salivary S100B was 0.71 at 3 hours and 0.62 at 3 months, compared to 0.66 for plasma.

Conclusion: Salivary S100B at 6 hours post-TBI showed superior prognostic performance compared to plasma and earlier saliva samples, highlighting its potential as a noninvasive biomarker for TBI prognosis.

Objective: To examine theincremental effects of multiple mild traumatic brain injuries (mTBIs) on persistent post-concussion-like symptoms (PPCS), post-traumatic stress disorder (PTSD), and complex PTSD (C-PTSD) in a large community sample.

Settingand participants: A cross-sectional survey of 1710 individuals from the UK general population, recruited online. Subgroups included individuals with no TBI history (n = 581), a single mTBI (n = 581), and multiple mTBIs (n = 548).

Main measures: TBI history was assessed using the Ohio State TBI Identification method. PPCS and PTSD/C-PTSD symptoms were measured with the Rivermead Post-Concussion Symptoms Questionnaire and the International Trauma Questionnaire.

Results: Individuals with multiple mTBIs reported significantly higher cognitive, somatic, affective, and total PPCS severity (R² = .04-.06, p < 0.001) compared to those with one or no mTBIs. Single mTBI participants also reported more symptoms than those with no TBI. Multiple mTBIs were associated with greater PTSD/C-PTSD symptom severity and higher C-PTSD prevalence (p < 0.001). Results remained significant after adjusting for covariates.

Conclusions: Multiple mTBIs are linked to increased PPCS and PTSD/C-PTSD severity in the general population. Early identification and tailored interventions are essential to reduce long-term psychological and neurological effects.

Purpose of research: The objectives of this narrative review were (1) to identify in recent literature the definition of a significant acute traumatic intracranial injury in adults with traumatic brain injury (TBI) and (2) to discuss the relevance of the elements within each definition.

Methods: A literature review was conducted to identify relevant publications from the past 25 years (2000-2025) including original research articles, systematic reviews, clinical guidelines, and consensus statements that addressed the concept of significant acute intracranial traumatic injuries.

Results: While the definition established during the development of the Canadian CT Head Rule remains the most widely utilized, its validity in aging populations is still uncertain. Currently, the BIG (uBIG, mBIG) criteria represent the most extensively validated classification systems. Mild Traumatic Brain Injury Risk Score and the QueBIC decision tool are the first rules specific to mild TBI, external validation is still required. Recent advancements in neuroimaging, such as the NIRIS, HITS, and SBNS TBI CT classifications, underscore the critical importance of precise lesion characterization. Positive correlation between biomarkers (GFAP and UCH-L1) and TBI severity is promising, further research is necessary to establish specific biomarker thresholds for identifying significant acute traumatic intracranial injuries.

Conclusion: To date, there is no contemporary consensus definition of a significant acute traumatic intracranial lesion in patients presenting with TBI. Several factors appear essential for defining a significant lesion, including comorbidities, clinical presentation, CT scan injury characteristics and biomarkers.

Objective: The Understanding Traumatic Brain Injury Massive Open Online Course (TBI MOOC) was developed to increase TBI knowledge and reduce misconceptions of TBI in the community.

Method: This study assessed participant knowledge of TBI across three domains: 1. Perceptions of concussion, 2. Emotional and Behavioral changes, and 3. Recovery after TBI prior to and after completing the March 2023 iteration of the Understanding TBI MOOC using a modified version of the Common Misconceptions about TBI survey.

Results: Participants (n = 903) who completed both pre- and post-course surveys had lower baseline knowledge scores about Recovery after TBI, than scores for Perceptions of concussion and Emotional and behavioral changes. Completion of the Understanding TBI MOOC led to an increase in overall survey scores and when broken down into sub-scales regardless of participant demographics or experiences.

Conclusion: The Understanding TBI MOOC improved survey scores across all demographics and experiences indicating that the MOOC is an effective tool to improve knowledge about TBI in the community.

Objectives: Executive dysfunction (ED) following acquired brain injury (ABI) is a well-established predictor of poor functional abilities and employment outcomes. However, there has been a lack of research focusing on the distinct contributions of different ED profiles. This study aimed to determine whether different ED profiles predict difficulties in returning to work for individuals who have suffered an ABI. Methods: Sixty-five working-age individuals who experienced an ABI participated in this study. The FrSBe and the ADLQ-T self-report scales were utilized to assess ED profiles and functional abilities, respectively. These measures were compared between individuals who did and did not return to their jobs. Mediation analysis was conducted to evaluate the contribution of each ED profile and its predictive capacity for return to work.

Results: Overall measures of ED reliably predicted challenges in performing daily activities and returning to work. Additionally, the predictive relationship between ED profiles and return to work was partially mediated by difficulties in daily activities.

Conclusions: Various ED profiles (executive cognition, apathy, and disinhibition) contribute predictively to the ability to return to work. These findings suggest that ED profiles offer valuable insights for better characterizing the challenges individuals face in returning to their jobs following an ABI.

Background: Ischemic strokes (ISs) lead to multiple neurological disorders, including physical, behavioral, and cognitive impairments. It is associated with high mortality, reduced quality of life if survival occurs, and high healthcare costs. Ruthenium Red (RR) is an inhibitor of the mitochondrial calcium uniporter, and Fucoidan (FCN) is a P-selectin blocker with anti-inflammatory and antioxidant properties. The aim of this study was to investigate the ability of pretreatment with fucoidan and ruthenium red to reduce neural injury as a prophylactic treatment against IS injury.

Methods: Forty-eight male rats were assigned to six groups. The rats in the sham group received no intervention. Global cerebral ischemia and reperfusion were induced in the IS group via the 4-vessel model. A single dose of RR (2.5 mg/kg) or FCN (50 mg/kg) was administered separately and simultaneously in the IS+ pre (RR), IS+ pre (FCN), and IS+ pre (RR+FCN) groups before exposure to IS. The levels of oxidative stress, inflammation, and neuronal death in the hippocampal tissue were assessed. Learning and memory were assessed using the shuttle box and novel object recognition tests.

Results: Our study results showed that exposure to stroke significantly decreased superoxide dismutase (SOD) levels while increasing malondialdehyde (MDA), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha. Pretreatment with fucoidan and ruthenium red significantly reduced oxidative stress, tissue inflammation, and neuronal death in the hippocampal CA1 region, especially when both drugs were used simultaneously. Learning and memory impairments following stroke were significantly reduced in the groups that received pretreatment.

Conclusion: Pretreatment with fucoidan and ruthenium red effectively reduced the incidence of neural complications associated with ischemic stroke. Synergistic neuroprotective effects were observed when the two drugs were used simultaneously.

Objective: To explore how South African occupational therapists (OTs) assess work readiness (WR) in clients with acquired brain injury (ABI), identify contextual challenges, and propose improvements.

Method: A qualitative descriptive study using thematic analysis of semi-structured interviews with seven OTs experienced in vocational rehabilitation with individuals with ABI. Purposive and snowball sampling was used, and data was manually coded using NVivo 14.

Results: Thematic analysis, informed by the study objectives, identified three main themes: 1) how OTs assess WR 2) contextual influences on WR evaluation, and 3) recommendations for improving WR evaluation in South Africa. OTs use a multifaceted approach when assessing WR, incorporating a variety of assessments to evaluate physical, cognitive, and psychosocial skills, while collaborating with multiple stakeholders. Systemic challenges influence WR, such as unemployment, socioeconomic status, stigma, disparities between the private and public health sectors, lack of knowledge and implementation of labor policies, and the lack of contextually appropriate standardized tests.

Conclusion: Findings suggest that South African OTs evaluate WR comparably to international practices, yet face distinctive systemic barriers that are not typically present in high-income settings. This highlights the need for a contextually appropriate guideline to enhance WR evaluations in individuals with ABI.