Sleep Problems and Their Relationship to Cognitive and Behavioral Outcomes in Young Children with Traumatic Brain Injury

BACKGROUND Fatigue and sleep problems are common after a traumatic brain injury (TBI) and are experienced as highly distressing symptoms, playing a significant role in the recovery trajectory, and they can drastically impact the quality of life and societal participation of the patient and their family and friends. However, the etiology and development of these symptoms are still uncertain. OBJECTIVE The aim of this study is to examine the development of fatigue and sleep problems following moderate to severe TBI and to explore the changes in underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors across time. METHODS This study is a longitudinal multicenter observational cohort study with 4 measurement points (3, 6, 12, and 18 months postinjury) including subjective questionnaires and cognitive tasks, preceded by 7 nights of actigraphy combined with a sleep diary. Recruitment of 137 moderate to severe TBI patients presenting at emergency and neurology departments or rehabilitation centers across the Netherlands is anticipated. The evolution of fatigue and sleep problems following TBI and their association with possible underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors will be examined. RESULTS Recruitment of participants for this longitudinal cohort study started in October 2017, and the enrollment of participants is ongoing. The first results are expected at the end of 2020. CONCLUSIONS To the authors’ knowledge, this is the first study that examines the development of both post-TBI fatigue and sleep longitudinally within a biopsychosocial model in moderate to severe TBI using both subjective and objective measures. Identification of modifiable factors such as mood and psychosocial stressors may give direction to the development of interventions for fatigue and sleep problems post-TBI. CLINICALTRIAL Netherlands Trial Register NTR7162; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=7162 (Archived by WebCite at http://www.webcitation.org/6z3mvNLuy) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11295

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Increased Mortality in Very Young Children with Traumatic Brain Injury due to Child Abuse: A Nationwide Analysis of 10,964 Patients

10.1542/peds.147.3_meetingabstract.912 ◽

2021 ◽

Author(s):

Christina M. Theodorou ◽

Miriam A. Nuno ◽

Kaeli J. Yamashiro ◽

Sarah C. Stokes ◽

Jordan E. Jackson ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Child Abuse ◽

Brain Injury ◽

Young Children ◽

Very Young Children

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Sleep problems contribute to post-concussive symptoms in service members with a history of mild traumatic brain injury without posttraumatic stress disorder or major depressive disorder

Neurorehabilitation ◽

10.3233/nre-192702 ◽

2019 ◽

Vol 44 (4) ◽

pp. 511-521 ◽

Cited By ~ 1

Author(s):

Lisa H. Lu ◽

Matthew W. Reid ◽

Douglas B. Cooper ◽

Jan E. Kennedy

Keyword(s):

Traumatic Brain Injury ◽

Posttraumatic Stress Disorder ◽

Major Depressive Disorder ◽

Brain Injury ◽

Depressive Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Sleep Problems ◽

Major Depressive ◽

History Of

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Traumatic brain injury in young children with isolated scalp haematoma

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-316066 ◽

2019 ◽

Vol 104 (7) ◽

pp. 664-669 ◽

Cited By ~ 2

Author(s):

Silvia Bressan ◽

Amit Kochar ◽

Ed Oakley ◽

Meredith Borland ◽

Natalie Phillips ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Young Children ◽

Ct Scan ◽

Head Trauma ◽

Secondary Analysis ◽

Predictor Variable ◽

Pediatric Emergency ◽

Research Network ◽

Registration Number

ObjectiveDespite high-quality paediatric head trauma clinical prediction rules, the management of otherwise asymptomatic young children with scalp haematomas (SH) can be difficult. We determined the risk of intracranial injury when SH is the only predictor variable using definitions from the Pediatric Emergency Care Applied Research Network (PECARN) and Children’s Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE) head trauma rules.DesignPlanned secondary analysis of a multicentre prospective observational study.SettingTen emergency departments in Australia and New Zealand.PatientsChildren <2 years with head trauma (n=5237).InterventionsWe used the PECARN (any non-frontal haematoma) and CHALICE (>5 cm haematoma in any region of the head) rule-based definition of isolated SH in both children <1 year and <2 years.Main outcome measuresClinically important traumatic brain injury (ciTBI; ie, death, neurosurgery, intubation >24 hours or positive CT scan in association with hospitalisation ≥2 nights for traumatic brain injury).ResultsIn children <1 year with isolated SH as per PECARN rule, the risk of ciTBI was 0.0% (0/109; 95% CI 0.0% to 3.3%); in those with isolated SH as defined by the CHALICE, it was 20.0% (7/35; 95% CI 8.4% to 36.9%) with one patient requiring neurosurgery. Results for children <2 years and when using rule specific outcomes were similar.ConclusionsIn young children with SH as an isolated finding after head trauma, use of the definitions of both rules will aid clinicians in determining the level of risk of ciTBI and therefore in deciding whether to do a CT scan.Trial registration numberACTRN12614000463673.

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Sex Differences in Animal Models of Traumatic Brain Injury

Journal of Experimental Neuroscience ◽

10.1177/1179069519844020 ◽

2019 ◽

Vol 13 ◽

pp. 117906951984402 ◽

Cited By ~ 9

Author(s):

Todd G Rubin ◽

Michael L Lipton

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Animal Models ◽

Enhanced Recovery ◽

Behavioral Outcomes ◽

Epidemiologic Studies ◽

Adequate Treatment ◽

Heterogeneous Nature ◽

Models Of Injury ◽

Underlying Mechanisms

Traumatic brain injury (TBI) is highly prevalent and there is currently no adequate treatment. Understanding the underlying mechanisms governing TBI and recovery remains an elusive goal. The heterogeneous nature of injury and individual’s response to injury have made understanding risk and susceptibility to TBI of great importance. Epidemiologic studies have provided evidence of sex-dependent differences following TBI. However, preclinical models of injury have largely focused on adult male animals. Here, we review 50 studies that have investigated TBI in both sexes using animal models. Results from these studies are highly variable and model dependent, but largely show females to have a protective advantage in behavioral outcomes and pathology following TBI. Further research of both sexes using newer models that better recapitulate mild and repetitive TBI is needed to characterize the nature of sex-dependent injury and recovery, and ultimately identifies targets for enhanced recovery.

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