scholarly journals Connectomic Assessment of Injury Burden and Longitudinal Structural Network Alterations in Moderate-to-severe Traumatic Brain Injury

2021 ◽  
Author(s):  
Yusuf Osmanlioglu ◽  
Drew Parker ◽  
Jacob A Alappatt ◽  
James J Gugger ◽  
Ramon R Diaz-Arrastia ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Structural Connectivity ◽  
Public Health Problem ◽  
Brain Regions ◽  
Brain Network ◽  
Major Public Health Problem ◽  
Post Injury ◽  
Structural Network ◽  
Injury Burden

Traumatic brain injury (TBI) is a major public health problem. Caused by external mechanical forces, a major characteristic of TBI is the shearing of axons across the white matter, which causes structural connectivity disruptions between brain regions. This diffuse injury leads to cognitive deficits, frequently requiring rehabilitation. Heterogeneity is another characteristic of TBI as severity and cognitive sequelae of the disease have a wide variation across patients, posing a big challenge for treatment. Thus, measures assessing network-wide structural connectivity disruptions in TBI are necessary to quantify injury burden of individuals, which would help in achieving personalized treatment, patient monitoring, and rehabilitation planning. Despite TBI being a disconnectivity syndrome, connectomic assessment of structural disconnectivity has been very scarce. In this study, we propose a novel connectomic measure that we call network anomaly score (NAS) to capture the integrity of structural connectivity in TBI patients by leveraging two major characteristics of the disease: diffuseness of axonal injury and heterogeneity of the disease. Over a longitudinal cohort of moderate-to-severe TBI patients, we demonstrate that structural network topology of patients are more heterogeneous and are significantly different than that of healthy controls at 3 months post-injury, where dissimilarity further increases up to 12 months. We also show that NAS captures injury burden as quantified by post-traumatic amnesia and that alterations in the structural brain network is not related to cognitive recovery. Finally we compare NAS to major graph theory measures used in TBI literature and demonstrate the superiority of NAS in characterizing the disease.

scholarly journals Enhanced prefrontal functional–structural networks to support postural control deficits after traumatic brain injury in a pediatric population

2017 ◽  
Vol 1 (2) ◽  
pp. 116-142 ◽  
Author(s):  
Ibai Diez ◽  
David Drijkoningen ◽  
Sebastiano Stramaglia ◽  
Paolo Bonifazi ◽  
Daniele Marinazzo ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control ◽  
Postural Control ◽  
Pediatric Population ◽  
Structural Connectivity ◽  
Brain Network ◽  
Body Sway ◽  
Brain Network Reorganization ◽  
Structural Networks

Traumatic brain injury (TBI) affects structural connectivity, triggering the reorganization of structural–functional circuits in a manner that remains poorly understood. We focus here on brain network reorganization in relation to postural control deficits after TBI. We enrolled young participants who had suffered moderate to severe TBI, comparing them to young, typically developing control participants. TBI patients (but not controls) recruited prefrontal regions to interact with two separated networks: (1) a subcortical network, including parts of the motor network, basal ganglia, cerebellum, hippocampus, amygdala, posterior cingulate gyrus, and precuneus; and (2) a task-positive network, involving regions of the dorsal attention system, together with dorsolateral and ventrolateral prefrontal regions. We also found that the increased prefrontal connectivity in TBI patients was correlated with some postural control indices, such as the amount of body sway, whereby patients with worse balance increased their connectivity in frontal regions more strongly. The increased prefrontal connectivity found in TBI patients may provide the structural scaffolding for stronger cognitive control of certain behavioral functions, consistent with the observations that various motor tasks are performed less automatically following TBI and that more cognitive control is associated with such actions.

Differencial Diagnosis of Hypovolemia and Cushing‘s Response in Traumatic Brain Injury Patients, Using Hemodynamic Assessment Methods, to Prevent Secondary Brain Damage

2015 ◽  
Vol 25 (2) ◽  
pp. 83-86
Author(s):  
Giedrė Zinkevičiūtė Žarskienė ◽  
Diana Bilskienė ◽  
Andrius Macas
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Vegetative State ◽  
Public Health Problem ◽  
Morbidity And Mortality ◽  
Infusion Therapy ◽  
Secondary Brain Injury ◽  
Major Public Health Problem ◽  
Hemodynamic Assessment ◽  
Cord Injury

Traumatic brain injury is the leading cause of death and further cause of disability and a major public health problem. Although the severity of the injury depends directly on the primary brain injury, secondary brain injury deteriorates the outcomes. The main causes of secondary ischemic injury include hypotension (systolic blood pressure 90mmHg) and hypoxaemia (PaO260mmHg), which are directly associated with increase of morbidity and mortality due to severe traumatic brain injury. Hypoxia and hypotension during decompresive craniotomy are independently associated with significant increaeses in vegetative state development and higher frequency of disability. Intraoperative period, including immediate anaesthesia during urgent craniotomy, is a critical moment for these patients. Their intraoperative hypotension can be caused by various factors, such as blood loss due other traumatic injuries, direct pulmonary or heart disorders, sympathetic tone lesions (spinal cord injury and neurogenic shock), potent anesthetic medicaments action or current hypovolemia and inadequate infusion therapy. How to solve this situation? Usually we choose a larger infusion therapy and vasoactive drugs. Is it realy a best solution for the patient? Severe brain trauma and related complications are the most common morbidity and mortality causes in young and middle-aged people. The initial injury we can not influence, but to avoid the major secondary brain injury risks, especially such as hypotension and hypoxia, are required. Only quick and accurate diagnosis, secondary risk factors prevention and immediate treatment may improve the outcomes.

scholarly journals Effects of Traumatic Brain Injury on Regional Cerebral Blood Flow in Rats as Measured with Radiolabeled Microspheres

1989 ◽  
Vol 9 (1) ◽  
pp. 117-124 ◽  
Author(s):  
Iwao Yamakami ◽  
Tracy K. McIntosh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Regions ◽  
Post Injury ◽  
Fluid Percussion ◽  
Hemodynamic Variables ◽  
Acute Changes ◽  
Injury Recovery ◽  
Left Parietal Cortex ◽  
Experimental Traumatic Brain Injury

To clarify the effect of experimental brain injury on regional CBF (rCBF), repeated rCBF measurements were performed using radiolabeled microspheres in rats Subjected to fluid-percussion traumatic brain injury. Three consecutive microsphere injections in six uninjured control rats substantiated that the procedure induces no significant changes in hemodynamic variables or rCBF. Animals were subjected to left parietal fluid-percussion brain injury of moderate severity (2.1–2.4 atm) and rCBF values were determined (a) prior to injury and 15 min and 1 h following injury (n = 7); and (b) prior to injury and 30 min and 2 h following injury (n = 7). At 15 min post injury, there was a profound reduction of rCBF in all brain regions studied (p < 0.01). Although rCBF in the hindbrain had recovered to near-normal by 30 min post injury, rCBF in both injured and contralateral (uninjured) forebrain areas remained significantly suppressed up to 1 h post injury. At 2 h post injury, recovery of rCBF to near-normal values was observed in all brain regions except the focal area of injury (left parietal cortex) where rCBF remained significantly depressed (p < 0.01). This prolonged focal oligemia at the injury site was associated with the development of reproducible cystic necrosis in the left parietotemporal cortex at 4 weeks post injury. Our results demonstrate that acute changes in rCBF occur following experimental traumatic brain injury in rats and that rCBF remains significantly depressed up to 2 h post injury in the area circumscribing the trauma site.

scholarly journals Changes in Structural Connectivity Following a Cognitive Intervention in Children With Traumatic Brain Injury

2016 ◽  
Vol 31 (2) ◽  
pp. 190-201 ◽  
Author(s):  
Weihong Yuan ◽  
Amery Treble-Barna ◽  
McKay M. Sohlberg ◽  
Beth Harn ◽  
Shari L. Wade
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mixed Model ◽  
Diffusion Tensor ◽  
Structural Connectivity ◽  
Cognitive Intervention ◽  
Preliminary Evidence ◽  
Brain Network ◽  
Clustering Coefficient ◽  
Characteristic Path Length

Objective. Structural connectivity analysis based on graph theory and diffusion tensor imaging tractography is a novel method that quantifies the topological characteristics in the brain network. This study aimed to examine structural connectivity changes following the Attention Intervention and Management (AIM) program designed to improve attention and executive function (EF) in children with traumatic brain injury (TBI). Methods. Seventeen children with complicated mild to severe TBI (13.66 ± 2.68 years; >12 months postinjury) completed magnetic resonance imaging (MRI) and neurobehavioral measures at time 1, 10 of whom completed AIM and assessment at time 2. Eleven matched healthy comparison (HC) children (13.37 ± 2.08 years) completed MRI and neurobehavioral assessment at both time points, but did not complete AIM. Network characteristics were analyzed to quantify the structural connectivity before and after the intervention. Results. Mixed model analyses showed that small-worldness was significantly higher in the TBI group than the HC group at time 1, and both small-worldness and normalized clustering coefficient decreased significantly at time 2 in the TBI group whereas the HC group remained relatively unchanged. Reductions in mean local efficiency were significantly correlated with improvements in verbal inhibition and both parent- and child-reported EF. Increased normalized characteristic path length was significantly correlated with improved sustained attention. Conclusion. The results provide preliminary evidence suggesting that graph theoretical analysis may be a sensitive tool in pediatric TBI for detecting ( a) abnormalities of structural connectivity in brain network and ( b) structural neuroplasticity associated with neurobehavioral improvement following a short-term intervention for attention and EF.

scholarly journals Disrupted Structural Connectome Is Associated with Both Psychometric and Real-World Neuropsychological Impairment in Diffuse Traumatic Brain Injury

2014 ◽  
Vol 20 (9) ◽  
pp. 887-896 ◽  
Author(s):  
Junghoon Kim ◽  
Drew Parker ◽  
John Whyte ◽  
Tessa Hart ◽  
John Pluta ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Shortest Path ◽  
Real World ◽  
Path Length ◽  
Verbal Learning ◽  
Structural Connectivity ◽  
Global Network ◽  
Behavioral Impairment ◽  
Structural Network

AbstractTraumatic brain injury (TBI) is likely to disrupt structural network properties due to diffuse white matter pathology. The present study aimed to detect alterations in structural network topology in TBI and relate them to cognitive and real-world behavioral impairment. Twenty-two people with moderate to severe TBI with mostly diffuse pathology and 18 demographically matched healthy controls were included in the final analysis. Graph theoretical network analysis was applied to diffusion tensor imaging (DTI) data to characterize structural connectivity in both groups. Neuropsychological functions were assessed by a battery of psychometric tests and the Frontal Systems Behavior Scale (FrSBe). Local connection-wise analysis demonstrated reduced structural connectivity in TBI arising from subcortical areas including thalamus, caudate, and hippocampus. Global network metrics revealed that shortest path length in participants with TBI was longer compared to controls, and that this reduced network efficiency was associated with worse performance in executive function and verbal learning. The shortest path length measure was also correlated with family-reported FrSBe scores. These findings support the notion that the diffuse form of neuropathology caused by TBI results in alterations in structural connectivity that contribute to cognitive and real-world behavioral impairment. (JINS, 2014, 20, 1–10)

scholarly journals Neurobiological consequences of traumatic brain injury

2011 ◽  
Vol 13 (3) ◽  
pp. 287-300 ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Public Health Problem ◽  
Brain Regions ◽  
Common Clinical Presentation ◽  
The Common ◽  
The Brain ◽  
Chronic Sequelae ◽  
Ca Homeostasis ◽  
Recent Attention

Traumatic brain injury (TBI) is a worldwide public health problem typically caused by contact and inertial forces acting on the brain. Recent attention has also focused on the mechanisms of injury associated with exposure to blast events or explosions. Advances in the understanding of the neuropathophysiology of TBI suggest that these forces initiate an elaborate and complex array of cellular and subcellular events related to alterations in Ca(++) homeostasis and signaling. Furthermore, there is a fairly predictable profile of brain regions that are impacted by neurotrauma and the related events. This profile of brain damage accurately predicts the acute and chronic sequelae that TBI survivors suffer from, although there is enough variation to suggest that individual differences such as genetic polymorphisms and factors governing resiliency play a role in modulating outcome. This paper reviews our current understanding of the neuropathophysiology of TBI and how this relates to the common clinical presentation of neurobehavioral difficulties seen after an injury.

scholarly journals Characteristics and outcomes of physical activity interventions for individuals with mild traumatic brain injury: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027240 ◽  
Author(s):  
Christophe Alarie ◽  
Isabelle J Gagnon ◽  
Enrico Quilico ◽  
Bonnie Swaine
Keyword(s):  
Physical Activity ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Scoping Review ◽  
Grey Literature ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Research Dissemination ◽  
Health Related ◽  
Review Protocol

IntroductionTraumatic brain injury (TBI) is a major public health problem, and it is estimated that 85% of TBIs are diagnosed as mild and are commonly referred to as a concussion. In adults, symptoms are expected to resolve within 10–14 days after the injury, but up to 15% of individuals continue to have symptoms beyond this period. Recent clinical recommendations suggest the use of physical activity (PA) as a therapy to manage persisting symptoms. However, the recommendations regarding PA lack clarity about important intervention parameters to help clinicians deliver the intervention. The objectives of this scoping review are thus to identify the characteristics, the measurement tools, the health-related outcomes and the reported effectiveness of PA-based interventions for adults with persisting symptoms of a mild TBI (mTBI).Methods and analysisThis scoping review protocol will follow Arksey and O’Malley’s six-step iterative process enhanced by another study and will be conducted by a team of researchers and clinical experts. Five databases (MEDLINE, CINAHL, PsycINFO, SPORTDiscuss and Embase), as well as Google, will be searched using an extensive search strategy to capture relevant scientific and grey literature. Articles will be selected if they report on an intervention designed to have an impact on health-related outcomes or participation among individuals having sustained an mTBI. A data extraction form based on the Consensus on Exercise Reporting Template and the Template for Intervention Description and Replication checklists will be created. Quantitative and qualitative data will be analysed accordingly, synthesised and collated in tables.Ethics and disseminationThis scoping review generates new knowledge from published and publicly available literature; thus, an ethical approval is unnecessary to conduct this research. Dissemination of the results will involve all team members in activities aimed to facilitate knowledge uptake among TBI rehabilitation clinical experts locally, nationally and internationally.

scholarly journals CT Scan importance in the first eight hours of head injury

2018 ◽  
Vol 5 (4) ◽  
pp. 766
Author(s):  
Mohammed Alfageeh ◽  
Moneerah Bahran ◽  
Sultan Albargi ◽  
Ibrahim Althomali ◽  
Adnan Alzahrani ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Public Health Problem ◽  
Neurological Deficits ◽  
Major Public Health Problem ◽  
Adults And Children ◽  
The Brain

Traumatic brain injury following head injury is a major public health problem that can result in significant long-term morbidity and mortality among adults and children worldwide. Emergency brain imaging is necessary for individuals subjected to traumatic brain injury to early detect treatable conditions. Prompt neurosurgical management of treatable conditions can prevent further damage and secondary neurological deficits. This will subsequently improve the outcome and reduce long-term disability. Computed Tomography (CT) of the brain is the investigation of choice for assessment of patients with head injury due to its availability, advantages, and sensitivity for multiple lesions following head trauma. This article will review and discuss the importance of CT imaging in evaluating patients with traumatic brain injury, its advantages, limitations, and prognostic values.

scholarly journals Clinical profile and outcome of traumatic brain injury in children: record-based descriptive study

2021 ◽  
Vol 8 (10) ◽  
pp. 4950
Author(s):  
Lekha Bhupendra Rathod ◽  
Umakant G. Shidam ◽  
Ruchir Kesaria ◽  
Sanket Mohata ◽  
Prashant Lakhe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Medical Records ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Aspects ◽  
Common Symptom ◽  
Major Public Health Problem ◽  
Paediatric Patients

Background: Paediatric head injury is considered to be a major public health problem and is often associated with significant morbidity and mortality in severe cases. The present study aimed to explore the demographics, mechanism of injury and clinical aspects of injury in children in a peripheral hospital attached to tertiary care centre.Methods: Electronic medical records of all paediatric patients aged ≤12 years with traumatic brain injury admitted during one-year period from January to December 2018 were reviewed. Epidemiological and clinical data of paediatric patients with traumatic brain injury (TBI) were analysed using SPSS version 20.Results: The medical records of 203 paediatric patients with TBI were analysed. The majority of the injury occurred in patients belonging to age-group 1-6 years. The number of male children outnumbered (58.1%) that of female children (41.9%). Fall from height was the most common mode of injury, followed by fall from a staircase. As per the Glasgow coma scale, 4% patients had severe head injury. Vomiting and headache was the most common symptom at admission (50.2%), a subdural hematoma was the most common lesion seen on computed tomography scans; frontal bone was the most common site of skull bone injury. Cutaneous injuries associated with contused lacerated wounds were the most common external injuries, 92.1% completely recovered with conservative management.Conclusions: Increasing incidence of paediatric trauma suggests the need for supervision during play and identification of environmental risk factors for such injuries. Parental advice and supervision is recommended to prevent accidental falls.

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