scholarly journals Injury of the Ascending Reticular Activating System in Patients With Fatigue and Hypersomnia Following Mild Traumatic Brain Injury

Medicine ◽  
2016 ◽  
Vol 95 (6) ◽  
pp. e2628 ◽  
Author(s):  
Sung Ho Jang ◽  
Hyeok Gyu Kwon
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System

scholarly journals Difference in the ascending reticular activating system injury between mild traumatic brain injury and cerebral concussion

2019 ◽  
Vol 10 (1) ◽  
pp. 99-103
Author(s):  
Sung Ho Jang ◽  
Seong Ho Kim ◽  
Han Do Lee
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Diffusion Tensor ◽  
Control Groups ◽  
Cerebral Concussion ◽  
Ascending Reticular Activating System ◽  
Fiber Number ◽  
Reticular Activating System ◽  
And Control

Abstract Introduction We investigated differences in the ascending reticular activating system (ARAS) injuries between patients with mild traumatic brain injury (mTBI) and cerebral concussion by using diffusion tensor tractography (DTT). Methods Thirty-one patients with mTBI, 29 patients with concussion, and 30 control subjects were recruited. We used DTT to reconstruct the lower ventral and dorsal ARAS, and the upper ARAS. The fractional anisotropy (FA) value and the fiber number (FN) of the lower ventral and dorsal ARAS, and the upper ARAS were determined. Results Significant differences were observed in the FA values of the lower ventral and dorsal ARAS on both sides between the mTBI and control groups and between the concussion and control groups (p < 0.05). The FN value was significantly different in the lower ventral ARAS on both sides between the concussion and control groups and between the mTBI and concussion groups (p < 0.05). Conclusion Both the mTBI and concussion patients suffered injuries in the lower ventral and dorsal ARAS, with the concussion patients exhibiting more severe injury in the ventral ARAS than that in the mTBI patients. These results suggest that the terms mTBI and concussion should be used differentially, even though they have used interchangeably for a long time.

scholarly journals The relationship between consciousness and the ascending reticular activating system in patients with traumatic brain injury

2020 ◽  
Author(s):  
Sung Ho Jang ◽  
YOUNGHYEON KWON
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Control Group ◽  
Impaired Consciousness ◽  
Patient Subgroup ◽  
Chronic Stage ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
Gcs Score ◽  
The Relationship

Abstract Background: We investigated the relationship between consciousness and the ascending reticular activating system(ARAS) by using diffusion tensor tractography(DTT) in patients with traumatic brain injury(TBI).Methods: Twenty-six patients with TBI and 13 healthy control subjects were recruited for this study. Glasgow Coma Scale(GCS) scores were used for evaluation of subject consciousness state at the chronic stage of TBI(at DTT scanning), According to the GCS score, the patient group was divided into two subgroups: A(14 patients;impaired consciousness:GCS score<15, and B(12 patients;intact consciousness;GCS score=15). Fractional anisotropy(FA) and tract volume(TV) values were assessed in the lower dorsal and upper ARAS.Results: The FA values of the lower dorsal ARAS and the upper ARAS in patient subgroup A were significantly lower than those in patient subgroup B and the control group(p<0.05). However, the FA and TV values for the lower dorsal ARAS and the upper ARAS were not significantly different between patient subgroup B and the control group(p>0.05). The FA value of the lower dorsal ARAS(r=0.473,p<0.05) and the TV of upper ARAS(r=0.484,p<0.05) had moderate positive correlations with the GCS score. The FA value of the upper ARAS had a strong positive correlation with the GCS score of the patient group(r=0.780,p<0.05).Conclusions: We detected a close relationship between consciousness at the chronic stage of TBI and injuries of the lower dorsal and upper ARAS(especially, the upper ARAS) in patients who showed impaired consciousness at the onset of TBI. We believe that our results can be useful during the development of therapeutic strategies for patients with impaired consciousness following TBI.

scholarly journals The relationship between consciousness and the ascending reticular activating system in patients with traumatic brain injury

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sung Ho Jang ◽  
Young Hyeon Kwon
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Control Group ◽  
Impaired Consciousness ◽  
Patient Subgroup ◽  
Chronic Stage ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
Gcs Score ◽  
The Relationship

Abstract Background We investigated the relationship between consciousness and the ascending reticular activating system (ARAS) by using diffusion tensor tractography (DTT) in patients with traumatic brain injury (TBI). Methods Twenty-six patients with TBI and 13 healthy control subjects were recruited for this study. Glasgow Coma Scale (GCS) scores were used for evaluation of subject consciousness state at the chronic stage of TBI (at DTT scanning), According to the GCS score, the patient group was divided into two subgroups: A (14 patients;impaired consciousness: GCS score < 15, and B (12 patients;intact consciousness;GCS score = 15). Fractional anisotropy (FA) and tract volume (TV) values were assessed in the lower dorsal and upper ARAS. Results The FA values of the lower dorsal ARAS and the upper ARAS in patient subgroup A were significantly lower than those in patient subgroup B and the control group(p <  0.05). However, the FA and TV values for the lower dorsal ARAS and the upper ARAS were not significantly different between patient subgroup B and the control group(p > 0.05). The FA value of the lower dorsal ARAS(r = 0.473,p <  0.05) and the TV of upper ARAS(r = 0.484,p <  0.05) had moderate positive correlations with the GCS score. The FA value of the upper ARAS had a strong positive correlation with the GCS score of the patient group(r = 0.780,p <  0.05). Conclusions We detected a close relationship between consciousness at the chronic stage of TBI and injuries of the lower dorsal and upper ARAS (especially, the upper ARAS) in patients who showed impaired consciousness at the onset of TBI. We believe that our results can be useful during the development of therapeutic strategies for patients with impaired consciousness following TBI. Trial registration YUMC 2019–06–032-003. Retrospectively registered 06 Jun 2020.

Neurophysiology and Treatment of Disorders of Consciousness Induced by Traumatic Brain Injury: Orexin Signaling as a Potential Therapeutic Target

2019 ◽  
Vol 25 (39) ◽  
pp. 4208-4220 ◽  
Author(s):  
Huiling Tang ◽  
Qiumei Zhu ◽  
Wei Li ◽  
Siru Qin ◽  
Yinan Gong ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disorders Of Consciousness ◽  
Potential Therapeutic Target ◽  
Therapeutic Modalities ◽  
Point Of Entry ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
The Brain ◽  
Novel Therapeutic

Background: Traumatic brain injury (TBI) can cause disorders of consciousness (DOC) by impairing the neuronal circuits of the ascending reticular activating system (ARAS) structures, including the hypothalamus, which are responsible for the maintenance of the wakefulness and awareness. However, the effectiveness of drugs targeting ARAS activation is still inadequate, and novel therapeutic modalities are urgently needed. Methods: The goal of this work is to describe the neural loops of wakefulness, and explain how these elements participate in DOC, with emphasis on the identification of potential new therapeutic options for DOC induced by TBI. Results: Hypothalamus has been identified as a sleep/wake center, and its anterior and posterior regions have diverse roles in the regulation of the sleep/wake function. In particular, the posterior hypothalamus (PH) possesses several types of neurons, including the orexin neurons in the lateral hypothalamus (LH) with widespread projections to other wakefulness-related regions of the brain. Orexins have been known to affect feeding and appetite, and recently their profound effect on sleep disorders and DOC has been identified. Orexin antagonists are used for the treatment of insomnia, and orexin agonists can be used for narcolepsy. Additionally, several studies demonstrated that the agonists of orexin might be effective in the treatment of DOC, providing novel therapeutic opportunities in this field. Conclusion: The hypothalamic-centered orexin has been adopted as the point of entry into the system of consciousness control, and modulators of orexin signaling opened several therapeutic opportunities for the treatment of DOC.

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