scholarly journals Beta blocker use in traumatic brain injury based on the high-sensitive troponin status (BBTBBT): methodology and protocol implementation of a double-blind randomized controlled clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ayman El-Menyar ◽  
Mohammad Asim ◽  
Ahmed Abdel-Aziz Bahey ◽  
Talat Chughtai ◽  
Abdulnasser Alyafai ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Calcium Binding ◽  
Troponin T ◽  
Controlled Clinical Trial ◽  
Post Injury ◽  
Double Blind ◽  
Severity Of Injury ◽  
The Impact ◽  
High Sensitive Troponin

Abstract Background Beta-adrenergic receptor blockers (BB) play an important role in the protection of organs that are susceptible for secondary injury due to stress-induced adrenergic surge. However, the use of BB in traumatic brain injury (TBI) patients is not yet the standard of care which necessitates clear scientific evidence to be used. The BBTBBT study aims to determine whether early administration of propranolol based on the high-sensitive troponin T(HsTnT) status will improve the outcome of TBI patients. We hypothesized that early propranolol use is effective in reducing 10- and 30-day mortality in TBI patients. Secondary outcomes will include correlation between serum biomarkers (troponin, epinephrine, cytokines, enolase, S100 calcium binding protein B) and the severity of injury and the impact of BB use on the duration of hospital stay and functional status at a 3-month period. Methods The BBTBBT study is a prospective, randomized, double-blinded, placebo-controlled three-arm trial of BB use in mild-to-severe TBI patients based on the HsTnT status. All enrolled patients will be tested for HsTnT at the first 4 and 6 h post-injury. Patients with positive HsTnT will receive BB if there is no contraindication (group 1). Patients with negative HsTnT will be randomized to receive either propranolol (group 2) or placebo (group 3). The time widow for receiving the study treatment is the first 24 h post-injury. Discussion Early BB use may reduce the catecholamine storm and subsequently the cascade of immune and inflammatory changes associated with TBI. HsTnT could be a useful fast diagnostic and prognostic tool in TBI patients. This study will be of great clinical interest to improve survival and functional outcomes of TBI patients. Trial registration ClinicalTrials.gov NCT04508244. Registered on 7 August 2020. Recruitment started on 29 December 2020 and is ongoing.

The effects of amantadine on traumatic brain injury outcome: a double-blind, randomized, controlled, clinical trial

Brain Injury ◽  
2018 ◽  
Vol 32 (8) ◽  
pp. 1050-1055 ◽  
Author(s):  
Hossein Ghalaenovi ◽  
Arash Fattahi ◽  
Jalil Koohpayehzadeh ◽  
Mahmoud Khodadost ◽  
Neda Fatahi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Double Blind ◽  
Randomized Controlled

scholarly journals The Impact of Neurocognitive Functioning on the Course of Posttraumatic Stress Symptoms following Civilian Traumatic Brain Injury

2021 ◽  
Vol 10 (21) ◽  
pp. 5109
Author(s):  
Dominique L. G. Van Praag ◽  
Filip Van Den Eede ◽  
Kristien Wouters ◽  
Lindsay Wilson ◽  
Andrew I. R. Maas ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Posttraumatic Stress ◽  
Visual Information ◽  
Verbal Learning ◽  
Neurocognitive Functioning ◽  
Ptsd Symptoms ◽  
Post Injury ◽  
Change Scores ◽  
The Impact

Background: One out of seven individuals who have suffered a traumatic brain injury (TBI) develops a posttraumatic stress disorder (PTSD), which is often associated with neurocognitive impairment. The present study explores the impact of neurocognitive functioning after mild, moderate, and severe TBI on the course of PTSD symptoms. Methods: The data of 671 adults admitted to hospital for a TBI was drawn from the Collaborative European Neurotrauma Effectiveness Research (CENTER-TBI) study. After six- and 12-months post-injury, participants completed the PTSD Checklist-5 (PCL-5), from which change scores were calculated. At six months, participants also completed a neurocognitive assessment including the Rey Auditory Verbal Learning Test, the Trail Making Test, and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Linear regressions were performed to identify associations between cognitive functioning and PCL-5 change scores. Results: Overall, mean PCL-5 change scores showed no clear change (−0.20 ± 9.88), but 87 improved and 80 deteriorated by a change score of 10 or more. CANTAB Rapid Visual Information Processing scores were significantly associated with PCL-5 change scores. Conclusions: Strong sustained attention was associated with improvement in PTSD symptoms. Assessing cognitive performance may help identify individuals at risk of developing (persisting) PTSD post-TBI and offer opportunities for informing treatment strategies.

Brain-Heart Link: The Role of High Sensitive Troponin T in Traumatic Brain Injury

2017 ◽  
Vol 225 (4) ◽  
pp. e75
Author(s):  
Ayman El-Menyar ◽  
Hassan Al-Thani ◽  
Rifat Latifi ◽  
John A. Savino
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Troponin T ◽  
High Sensitive Troponin

Examining the Prospective Relationship between Family Affective Responsiveness and Theory of Mind in Chronic Paediatric Traumatic Brain Injury

2016 ◽  
Vol 18 (1) ◽  
pp. 88-101 ◽  
Author(s):  
Nicholas P. Ryan ◽  
Kim Mihaljevic ◽  
Miriam H. Beauchamp ◽  
Cathy Catroppa ◽  
Louise Crossley ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Theory Of Mind ◽  
Childhood And Adolescence ◽  
Post Injury ◽  
Related Factors ◽  
Lesion Location ◽  
Severe Tbi ◽  
The Impact ◽  
Affective Responsiveness

Childhood and adolescence coincide with rapid structural and functional maturation of brain networks implicated in Theory of Mind (ToM); however, the impact of paediatric traumatic brain injury (TBI) on the development of these higher order skills is not well understood. ToM can be partitioned intoconative ToM, defined as the ability to understand how indirect speech acts involving irony and empathy are used to influence the mental or affective state of the listener; andaffective ToM, concerned with understanding that facial expressions are often used for social purposes to convey emotions that we want people to think we feel. In a sample of 84 children with mild-severe TBI and 40 typically developing controls, this study examined the effect of paediatric TBI on affective and conative ToM; and evaluated the respective contributions of injury-related factors (injury severity/lesion location) and non-injury-related environmental variables (socio-economic status (SES)/family functioning) to long-term ToM outcomes. Results showed that the poorest ToM outcomes were documented in association with mild-complicated and moderate TBI, rather than severe TBI. Lesion location and SES did not significantly contribute to conative or affective ToM. Post-injury family affective responsiveness was the strongest and most significant predictor of conative ToM. Results suggest that clinicians should exercise caution when prognosticating based on early clinical indicators, and that group and individual-level outcome prediction should incorporate assessment of a range of injury- and non-injury-related factors. Moreover, the affective quality of post-injury family interactions represents a potentially modifiable risk factor, and might be a useful target for family-centred interventions designed to optimise social cognitive outcomes after paediatric TBI.

A-125 The Impact of Bilingualism on Symbol Digit Modalities Test Performance Following Traumatic Brain Injury

2021 ◽  
Vol 36 (6) ◽  
pp. 1175-1175
Author(s):  
Raelynn Munoz ◽  
Daniel W Lopez-Hernandez ◽  
Rachel A Rugh-Fraser ◽  
Jasman Sidhu ◽  
Pavel Y Litvin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Deficits ◽  
Test Performance ◽  
Oral Performance ◽  
Neurocognitive Performance ◽  
Post Injury ◽  
Cognitive Speed ◽  
The Impact ◽  
Larger Sample

Abstract Objective Traumatic brain injury (TBI) survivors exhibit cognitive deficits. Research suggests that multilingualism can influence neurocognitive performance. We examined the effects of TBI and bilingualism/monolingualism on a test of attention and cognitive speed (i.e., Symbol Digit Modalities Test; SDMT). Method The sample consisted of 55 healthy comparison (27 Spanish-English bilinguals; 28 English-monolinguals), 34 acute TBI (14 Spanish-English bilinguals; 23 English-monolinguals), and 27 chronic TBI (13 Spanish-English bilinguals; 12 English-monolinguals) participants. Acute TBI participants were tested 6 months post-injury; chronic TBI participants were tested 12 months or more post-injury. A series of 3X2 ANOVAs were conducted to determine the effect of TBI and language on SDMT written and oral performance. Results ANOVAs revealed the healthy comparison group outperformed both TBI groups on SDMT written, p = 0.000, ηp2 = 0.21. Also, the healthy comparison and chronic TBI groups outperformed the acute TBI group on SDMT oral, p = 0.000, ηp2 = 0.13. Interaction effects emerged between TBI and bilingualism/monolingualism. On SDMT written and oral, acute TBI English-monolinguals outperformed acute TBI Spanish-English bilinguals; meanwhile, chronic TBI Spanish-English bilinguals outperformed chronic TBI English-monolinguals, p < 0.05, ηp2 = 0.09–0.10. Conclusion The acute TBI group performed worse than healthy comparison adults on both SDMT tasks. Furthermore, the chronic TBI group demonstrated better SDMT oral abilities compared to the acute TBI group. Relative to monolinguals with TBI, our findings suggest better cognitive recovery of attention and cognitive speed in bilingual TBI participants. Future studies with larger sample sizes should examine if learning English first or second impacts Spanish-English bilingual TBI survivors’ SDMT performance compared to English-monolingual TBI survivors.

scholarly journals Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis

2020 ◽  
Author(s):  
Julia K. Böhm ◽  
◽  
Helge Güting ◽  
Sophie Thorn ◽  
Nadine Schäfer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Antiplatelet Therapy ◽  
Post Injury ◽  
Coagulation Profile ◽  
Trauma Induced Coagulopathy ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
The Impact ◽  
Admission Glasgow Coma Scale

Abstract Background Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood. Methods This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis. Results Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to − 6, hypothermia and hypotension increased risk significantly. Conclusion Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management.

The impact of deployment and traumatic brain injury on the health and behavior of children of US military service members and veterans

2017 ◽  
Vol 23 (3) ◽  
pp. 425-441
Author(s):  
Tracey A Brickell ◽  
Louis M French ◽  
Sara M Lippa ◽  
Rael T Lange
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Military Service ◽  
Emotional Health ◽  
Post Injury ◽  
Number Of Children ◽  
Us Military ◽  
Combat Deployment ◽  
And Behavior ◽  
The Impact

This study examined the impact of service member/veteran (SMV) combat deployment and traumatic brain injury (TBI) on the health and behavior of his or her children. Participants were 104 female spouse caregivers of US SMVs who had sustained a mild, severe, or penetrating TBI. Participants completed the Children’s Health and Behavior Questionnaire (CHBQ; r = .758 to .881) that evaluates school grades, behavior, medical health, emotional health, and social participation: (a) prior to the first combat deployment, (b) in the month prior to the TBI, (c) within 2 years after the TBI, and (d) 2 or more years after the TBI. A substantial number of children experienced a decline in health and behavior following the TBI (41.7%–79.1%). Of those who declined (a) 68.8%–75.5% declined within the first 2 years post-injury, followed by improvement or stabilization; (b) 6.7%–15.6% declined only after 2 or more years post-injury; (c) 15.6%–25.0% declined within the first 2 years post-injury and then again 2 or more years post-injury; and (d) 16.9%–26.5% experienced a decline as a result of deployment, followed by an additional decline after the SMV’s TBI. Services are required for children of SMVs following TBI and deployment, particularly children at risk for poor outcome.

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