Volume Change in Frontal Cholinergic Structures After Traumatic Brain Injury and Cognitive Outcome

Abstract Objective: This study examines the relationship of serum total tau, neurofilament light (NFL), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) with neurocognitive performance in service members and veterans with a history of traumatic brain injury (TBI). Method: Service members (n = 488) with a history of uncomplicated mild (n = 172), complicated mild, moderate, severe, or penetrating TBI (sTBI; n = 126), injured controls (n = 116), and non-injured controls (n = 74) prospectively enrolled from Military Treatment Facilities. Participants completed a blood draw and neuropsychological assessment a year or more post-injury. Six neuropsychological composite scores and presence/absence of mild neurocognitive disorder (MNCD) were evaluated. Within each group, stepwise hierarchical regression models were conducted. Results: Within the sTBI group, increased serum UCH-L1 was related to worse immediate memory and delayed memory (R2Δ = .065–.084, ps < .05) performance, while increased GFAP was related to worse perceptual reasoning (R2Δ = .030, p = .036). Unexpectedly, within injured controls, UCH-L1 and GFAP were inversely related to working memory (R2Δ = .052–.071, ps < .05), and NFL was related to executive functioning (R2Δ = .039, p = .021) and MNCD (Exp(B) = 1.119, p = .029). Conclusions: Results suggest GFAP and UCH-L1 could play a role in predicting poor cognitive outcome following complicated mild and more severe TBI. Further investigation of blood biomarkers and cognition is warranted.

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Cognitive outcome in traumatic brain injury survivors

Current Opinion in Critical Care ◽

10.1097/01.ccx.0000155358.31983.37 ◽

2005 ◽

Vol 11 (2) ◽

pp. 111-116 ◽

Cited By ~ 62

Author(s):

Claire Helen Salmond ◽

Barbara Jacquelyn Sahakian

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Outcome

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Postural neurologic deficits after decompressive craniectomy: A case series of sinking skin flap syndrome in traumatic brain injury

Neurorehabilitation ◽

10.3233/nre-210160 ◽

2020 ◽

pp. 1-10

Author(s):

Emma A. Bateman ◽

Jordan VanderEnde ◽

Keith Sequeira ◽

Heather M. MacKenzie

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Rare Complication ◽

Skin Flap ◽

Case Series ◽

Cognitive Outcome ◽

Definitive Treatment ◽

Care Providers ◽

Neurologic Deficits ◽

The Impact

BACKGROUND: Hemicraniectomy to manage raised intracranial pressure following traumatic brain injury (TBI) has improved survival but may increase the incidence of Sinking Skin Flap Syndrome (SSFS). SSFS is a clinical syndrome in which patients with craniectomy develop objective neurologic abnormalities due to the pressure of the atmosphere on the unprotected brain, often presenting with postural headaches and neurologic deficits that localize to the craniectomy site. Previously thought to be a rare complication of craniectomy after TBI, evidence suggests SSFS is under-recognized. OBJECTIVE: To describe the clinical and radiographic features leading to diagnosis and the impact of temporizing and definitive management of SSFS on outcomes in inpatients with moderate/severe TBI. METHODS: Two patients’ symptoms, qualitative behaviour observation, physical and cognitive outcome measures, and neuroimaging pre- and post-temporizing measures and cranioplasty are presented. RESULTS: Both patients demonstrated partial improvements with temporizing measures and substantial improvements in functional, cognitive, physical, and rehabilitation outcomes from the cranioplasty and resolution of SSFS. CONCLUSIONS: Rehabilitation care providers are critical to the timely diagnosis and management of SSFS, including the use of temporizing measures and advocacy for definitive treatment with cranioplasty. These cases highlight the diverse clinical presentations and importance of SSFS diagnosis to improve patient outcomes.

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Chronic ibuprofen administration worsens cognitive outcome following traumatic brain injury in rats

Experimental Neurology ◽

10.1016/j.expneurol.2006.04.008 ◽

2006 ◽

Vol 201 (2) ◽

pp. 301-307 ◽

Cited By ~ 54

Author(s):

K BROWNE ◽

A IWATA ◽

M PUTT ◽

D SMITH

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Outcome

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306 GCS Does Not Predict Cognitive Outcome 30 Years After Severe Traumatic Brain Injury

Neurosurgery ◽

10.1093/neuros/nyx417.306 ◽

2017 ◽

Vol 64 (CN_suppl_1) ◽

pp. 264-265

Author(s):

Molly E Hubbard ◽

Abdullah Bin Zahid ◽

Gabrielle Meyer ◽

Kathleen Vonderhaar ◽

David Y Balser ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Assessment Tool ◽

Cognitive Status ◽

Cognitive Outcomes ◽

Cognitive Outcome ◽

Symptom Severity Score ◽

History Of ◽

Severe Tbi

Abstract INTRODUCTION Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US. The effects of TBI on quality of life may not become apparent for years after the injury. There are conflicting reports in the literature regarding long term outcomes. Physicians are often asked to predict long term functional and cognitive outcomes, with limited data available. METHODS Patients with severe TBI (GCS = 9) who previously participated in a clinical trial during the 1980s were followed up with and compared to healthy controls without history of TBI. A health questionnaire, sports concussion assessment tool version 3 (SCAT3) and the Telephone Interview for Cognitive Status-modified (TICS-m) were completed over the phone and compared with controls using t-test. GCS at admission and 12-month GRS were used to predict to TICS-M at 30 years using linear regression. RESULTS >45 of the initial 168 subjects were confirmed alive, and 37 (13 females; mean age: 52.43 years S.D. 10.7) consented. Controls (n = 58; 23 females; mean age = 54 years, S.D. 11.5) had lower symptom severity score (6.7 S.D. 12.6 versus 20.6 S.D. 25.3; P = 0.005), lower total number of symptoms (3.4 S.D. 4.7 versus 7.12 S.D. 6.5; P = 0.006), higher standardized assessment of concussion score (25.6 S.D. 2.8 versus 21.2 S.D. 6.9; P = 0.001), and lower corrected MPAI-4 (22.3 S.D. 17.0 versus 43.7 S.D. 12.8; P < 0.001). GCS at admission did not predict cognitive status at 30-years assessed using TICS-M (P = 0.345). The Glasgow Outcome Scale score at 12-months was correlated to TICS-M at 30 years (R = 0.548, P < 0.001); each point decrease in GOS decreasing the score at TICS-M by 5.6 points. CONCLUSION Remote history of TBI disrupts the lives of survivors long after injury. Admission GCS does not predict cognitive status 30 years after TBI. The GOS at 12-months predicted the cognitive status assessed using TICS-M score at 30 years.

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