The Neurobiology of Encephalopathy of Prematurity

2017 ◽  
Author(s):  
Gwendolyn J. Gerner ◽  
Vera Joanna Burton
Keyword(s):  
Brain Injury ◽  
Premature Birth ◽  
Clinical Care ◽  
Neurodevelopmental Outcomes ◽  
Future Directions ◽  
Clinical Considerations ◽  
Underlying Mechanisms

The risk of brain injury following premature birth increases with birth at earlier gestational ages and lower birthweights. The presentation of brain injury and subsequent neurodevelopmental sequelae in this population are extremely heterogeneous, as the injury is due to multifactorial causes; however, increasing amounts of research are elucidating the underlying mechanisms and pathways. This chapter broadly reviews the neurobiology of encephalopathy of prematurity, as well as clinical considerations, associated neurodevelopmental outcomes, and future directions in clinical care and research.

scholarly journals Neuroactive Steroids in Hypoxic–Ischemic Brain Injury: Overview and Future Directions

2020 ◽  
Author(s):  
Nicolas Toro-Urrego ◽  
Marco Avila-Rodriguez ◽  
María Inés Herrera ◽  
Andrea Aguilar ◽  
Lucas Udovin ◽  
...  
Keyword(s):  
Brain Injury ◽  
Estrogenic Activity ◽  
Neuroactive Steroids ◽  
Ischemic Brain Injury ◽  
Neuroprotective Effects ◽  
Future Directions ◽  
Ischemic Brain ◽  
Public Health Burden ◽  
Hypoxic Ischemic Brain Injury ◽  
Underlying Mechanisms

Hypoxic–ischemic brain injury is a number one cause of long-term neurologic disability and death worldwide. This public health burden is mainly characterized by a decrease in oxygen concentration and blood flow to the tissues, which lead to an inefficient supply of nutrients to the brain. This condition induces cell death by energy depletion and increases free radical generation and inflammation. Hypoxic–ischemic brain injury may occur in ischemic-stroke and over perinatal asphyxia, being both leading causes of morbidity in adults and children, respectively. Currently, there are no effective pharmaceutical strategies to prevent the triggering of secondary injury cascades, including oxidative stress and metabolic dysfunction. Neuroactive steroids like selective estrogen receptor modulators, SERMs, and selective tissue estrogenic activity regulators, STEARs, exert several neuroprotective effects. These encompass mitochondrial survival, a decrease in reactive oxygen species, and maintenance of cell viability, among others. In this context, these neurosteroids constitute promising molecules, which could modify brain response to injury. Here we show an updated overview of the underlying mechanisms of hypoxic–ischemic brain injury. We also highlight the neuroprotective effects of neurosteroids and their future directions.

Future Directions in Clinical Care, Research, and Nosology

2018 ◽  
Author(s):  
Frederick J. Stoddard Jr ◽  
David M. Benedek ◽  
Mohammed R. Milad ◽  
Robert J. Ursano
Keyword(s):  
Scientific Discovery ◽  
Clinical Care ◽  
Age Groups ◽  
Global Burden ◽  
Categorical Approach ◽  
Future Directions ◽  
Care Research ◽  
Novel Therapeutics ◽  
Underlying Mechanisms

The science of the study of trauma and stress has accelerated as never before, due to increased recognition of the need, greater capabilities for the research, and expanding knowledge. The increased understanding of underlying mechanisms of psychopathology may lead to better diagnostics that are biologically based and to improving the development of novel therapeutics, especially in device-based neurotherapeutics. Similarly, a greater understanding of the neurobiology of trauma- and stressor-related disorders is shifting its nosology towards a dimensional rather than categorical approach. While the acceleration of scientific discovery is exciting, much more is still needed to address the global burden of trauma and stress across all age groups. While history suggests that trauma and stressors surely lie ahead for our society, it also reminds us that our knowledge, understanding, and hope will continue to foster advances for those who need care.

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

scholarly journals Optimising neurodevelopmental and psychosocial outcomes for survivors with CHD: a research agenda for the next decade

2021 ◽  
pp. 1-3
Author(s):  
Erica Sood ◽  
Jeffrey P Jacobs ◽  
Bradley S Marino
Keyword(s):  
Health Disparities ◽  
Outcomes Research ◽  
Research Agenda ◽  
Clinical Care ◽  
Neurodevelopmental Outcome ◽  
Psychosocial Outcomes ◽  
The United States ◽  
Future Research ◽  
Neurodevelopmental Outcomes ◽  
Working Groups

Abstract Neurodevelopmental and psychosocial impairments negatively impact health-related quality of life for survivors with CHD and complicate the transition to independent adulthood. Risk for neurodevelopmental and psychosocial impairments is influenced by a complex interplay among genetic, foetal, surgical, perioperative, family, and social factors, requiring a multi-pronged approach to neuroprotection and intervention. To ensure future research can ultimately reduce the burden of CHD for individuals, families, and society, the most pressing issues in cardiac neurodevelopment requiring scientific investigation must be identified. Through funding from an R13 Grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health of the United States of America, the Cardiac Neurodevelopmental Outcome Collaborative convened a two-day meeting of international experts in cardiac neurodevelopmental and psychosocial research, clinical care, and health disparities, including patient and family stakeholders, to define the cardiac neurodevelopmental and psychosocial outcomes research agenda for the next decade. Seven multidisciplinary working groups were formed to address key domains crucial to the advancement of cardiac neurodevelopmental and psychosocial outcomes research: 1) Foetal Brain Development and Neuroprotection, 2) Surgical/Perioperative Neuroprotection and Neurodevelopment, 3) Characterization of Neurodevelopmental and Psychological Outcomes, 4) Neurodevelopmental and Psychosocial Intervention, 5) Parent Mental Health and Family Functioning, 6) Neurodevelopmental Education, Outreach and Advocacy, and 7) Health Disparities and Neurodevelopmental Outcomes. Working groups identified significant gaps in knowledge and critical questions that must be answered to further knowledge, policy, care, and outcomes. The development of a research agenda in cardiac neurodevelopmental and psychosocial outcomes is critical for informing collaborative initiatives and allocation of funding for research to scientific inquiries of highest value to key stakeholders.

scholarly journals Role of interleukins in the pathogenesis of pulmonary fibrosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yi Xin She ◽  
Qing Yang Yu ◽  
Xiao Xiao Tang
Keyword(s):  
Pulmonary Fibrosis ◽  
Therapeutic Strategy ◽  
Future Directions ◽  
Regulation Mechanisms ◽  
Underlying Mechanisms ◽  
Multiple Cells ◽  
The Relationship

AbstractInterleukins, a group of cytokines participating in inflammation and immune response, are proved to be involved in the formation and development of pulmonary fibrosis. In this article, we reviewed the relationship between interleukins and pulmonary fibrosis from the clinical, animal, as well as cellular levels, and discussed the underlying mechanisms in vivo and in vitro. Despite the effects of interleukin-targeted treatment on experimental pulmonary fibrosis, clinical applications are lacking and unsatisfactory. We conclude that intervening in one type of interleukins with similar functions in IPF may not be enough to stop the development of fibrosis as it involves a complex network of regulation mechanisms. Intervening interleukins combined with other existing therapy or targeting interleukins affecting multiple cells/with different functions at the same time may be one of the future directions. Furthermore, the intervention time is critical as some interleukins play different roles at different stages. Further elucidation on these aspects would provide new perspectives on both the pathogenesis mechanism, as well as the therapeutic strategy and drug development.

A Review of Implementation Concepts and Strategies Surrounding Traumatic Brain Injury Clinical Care Guidelines

2021 ◽  
Author(s):  
Angela Lumba-Brown ◽  
Eric M Prager ◽  
Nicole Harmon ◽  
Michael McCrea ◽  
Michael J. Bell ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Clinical Care ◽  
Care Guidelines

Evaluating the feasibility and efficacy of the Amsterdam memory and attention training for children (Amat-c) following acquired brain injury (ABI): protocol for a pilot study with online clinician support

2021 ◽  
pp. 1-12
Author(s):  
Cathy Catroppa ◽  
Edith Botchway ◽  
Nicholas P. Ryan ◽  
Vicki Anderson ◽  
Elle Morrison ◽  
...  
Keyword(s):  
Brain Injury ◽  
Repeated Measures ◽  
Clinical Care ◽  
Acquired Brain Injury ◽  
Attention Training ◽  
Control Group ◽  
Attention And Memory ◽  
Post Intervention ◽  
Memory And Attention ◽  
Clinician Support

Abstract Background: Attention and memory deficits are common following paediatric acquired brain injury (ABI). However, there are few evidence-based interventions to improve these domains and benefit the everyday life of children post-injury. The Amsterdam Memory and Attention Training for children (Amat-c) has been translated from Dutch to English and shown to improve attention and memory skills in children following ABI. This protocol describes a study to expand accessibility of the program by using online, clinician-supported delivery with children post-ABI. Method/design: The study is a randomized controlled trial. Participants will be 40 children aged 8–16 a minimum of one-year post-ABI. Participants in the treatment group will complete 18 weekly sessions of the Amat-c program with weekly online clinician support. Participants in the active-control group will be administered ABI psychoeducation via a booklet for parents, with weekly online clinician contact. Attention and memory will be assessed at three time points up to six months post-intervention. Results: Analysis will be repeated measures multivariate planned comparisons; using the Statistical Package for the Social Sciences (IBM SPSS Statistics) General Linear Model procedure will compare pre- and post-intervention and six-month follow-up outcomes. Discussion: If shown efficacious in improving attention and memory, our team will then take a key role in implementing Amat-c into clinical care.

Sign in / Sign up

Export Citation Format

Share Document