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The representative MRI images of each TBI group. (A) Right frontal injury (B) Left frontal injury (C) Bilateral frontal injury (D) Non-frontal injury, Right temporal injury. MRI, Magnetic Resonance Imaging; TBI, Traumatic brain injury.
Source publication
Background:
Cognitive and emotional disturbances are common serious issues in patients with traumatic brain injury (TBI). However, predictors associated with neuropsychological functions were not consistent.
Objective:
To investigate factors affecting cognition and emotion in patients with TBI, we evaluated executive function, memory, and emotio...
Citations
... Early parcellation efforts aimed at defining regional boundaries using limited samples, including the widely used Brodmann atlas and automated anatomical labeling (AAL) atlas [36,37]. The Brainnetome Atlas is a connectivity-based parcellation of the brain, which establishes a priori, biologically valid brain parcellation scheme of the entire cortical and subcortical GM into sub-regions showing a coherent pattern of anatomical connections and provides a new framework for human brain research and in particular connectome analysis [38][39][40][41]. ...
Background: Traumatic brain injury (TBI) often results in persistent cognitive impairment and psychiatric symptoms, while lesion location and severity are not consistent with its clinical complaints. Previous studies found cognitive deficits and psychiatric disorders following TBI are considered to be associated with prefrontal and medial temporal lobe lesions, however, the location and extent of contusions often cannot fully explain the patient′s impairments. Thus, we try to find the structural changes of gray matter (GM) and white matter (WM), clarify their correlation with psychiatric symptoms and memory following TBI, and determine the brain regions that primary correlate with clinical measurements. Methods: Overall, 32 TBI individuals and 23 healthy controls were recruited in the study. Cognitive impairment and psychiatric symptoms were examined by Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), and Wechsler Memory Scale-Chinese Revision (WMS-CR). All MRI data were scanned using a Siemens Prisma 3.0 Tesla MRI system. T1 MRI data and diffusion tensor imaging (DTI) data were processed to analyze GM volume and WM microstructure separately. Results: In the present study, TBI patients underwent widespread decrease of GM volume in both cortical and subcortical regions. Among these regions, four brain areas including the left inferior temporal gyrus and medial temporal lobe, supplementary motor area, thalamus, and anterior cingulate cortex (ACC) were highly implicated in the post-traumatic cognitive impairment and psychiatric complaints. TBI patients also underwent changes of WM microstructure, involving decreased fractional anisotropy (FA) value in widespread WM tracts and increased mean diffusivity (MD) value in the forceps minor. The changes of WM microstructure were significantly correlated with the decrease of GM volume. Conclusions: TBI causes widespread cortical and subcortical alterations including a reduction in GM volume and change in WM microstructure related to clinical manifestation. Lesions in temporal lobe may lead to more serious cognitive and emotional dysfunction, which should attract our high clinical attention.
... It is well known that deficits in executive function and memory are commonly detected within TBI, and these deficits are more difficult to treat as compared with deficits associated with other cognitive disorders as a result of the vulnerability of the affected brain regions (such as the frontal and temporal lobes). These sequalae negatively affect patients' quality of life as well as their rehabilitation process (8). Numerous studies have demonstrated that cognitive training can improve multiple cognitive domains inTBI involving reasoning, goal management, attention, as well as reorganized modular networks (9)(10)(11). ...
... As age, education level, TBI severity, and patients' state of consciousness have been reported as factors influencing patients' cognition (8), this study was proposed to conduct subgroup analyses following measurements of baseline levels of RLAS and MoCA to reduce the effects of raw scores on the obtained results. The rTMS in this study applied to two sites of targeting and may have different efficacy in different subjects, providing a new direction for rTMS intervention in cognition in TBI. ...
Cognitive impairment, defined as a decline in memory and executive function, is one of the most severe complications of traumatic brain injury (TBI). Patients with TBI are often unable to return to work due to cognitive impairment and their overall quality of life is reduced. TBI can bring a serious economic burden to patient's families and to society. Reported findings on the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving cognitive impairment following TBI are inconsistent. The purpose of the proposed study is to investigate whether rTMS can improve memory and executive function in patients with TBI. Herein, we propose a prospective randomized placebo-controlled (rTMS, sham rTMS, cognitive training), parallel-group, single-center trial. 36 participants with a TBI occurring at least 6 months prior will be recruited from an inpatient rehabilitation center. Participants will be randomly assigned to the real rTMS, sham rTMS, or cognitive training groups with a ratio of 1:1:1. A 20-session transcranial magnetic stimulation protocol will be applied to the left and right dorsolateral prefrontal cortices (DLPFC) at frequencies of 10 Hz and 1 Hz, respectively. Neuropsychological assessments will be performed at four time points: baseline, after the 10th rTMS session, after the 20th rTMS session, and 30 days post-intervention. The primary outcome is change in executive function assessed using the Shape Trail Test (STT). The secondary outcome measures are measures from neuropsychological tests: the Hopkins Verbal Learning Test (HVLT), the Brief Visuospatial Memory Test (BVMT), the Digit Span Test (DST). We report on positive preliminary results in terms of improving memory and executive function as well as beneficial changes in brain connectivity among TBI patients undergoing rTMS and hypothesize that we will obtain similar results in the proposed study.
... Besides WM, contusion cores were observed in frontal, temporal and orbital gyri. Hee Kwak et al. [97] have recently reported that patients with frontal lesions showed higher agitation (e.g. aggressiveness, restlessness or mood swings measured by on the Agitated Behaviour Scale) and poorer performance in executive and emotional functions (measured by Wisconsin Card Sorting Test, for more detail the reader is referred to [83,97]). ...
... Hee Kwak et al. [97] have recently reported that patients with frontal lesions showed higher agitation (e.g. aggressiveness, restlessness or mood swings measured by on the Agitated Behaviour Scale) and poorer performance in executive and emotional functions (measured by Wisconsin Card Sorting Test, for more detail the reader is referred to [83,97]). ...
Neuroimaging studies are becoming increasingly bigger, and multi-centre collaborations to collect data under similar protocols, but different scanning sites, are now commonplace.However, with increasing sample size the complexity of databases and the entailed data management as well as computational burden are growing. This thesis aims to highlight and address challenges faced by large multi-centre magnetic resonance imaging(MRI) studies. The methods implemented are then applied to traumatic brain injury (TBI) data.Firstly, a pre-processing pipeline for both anatomical and diffusion MRI was proposed, that allows for a high throughput of MRI scans. After describing the choices for processing tools,the performance of the integrated quality assurance was assessed based on the results from a large multi-centre dataset for TBI. Secondly, the applicability of the pipelines for processing mild TBI (mTBI) data from three sites was shown in a case study. For this, volumetric and diffusion metrics in the acute phase are analysed for their prognostic potential. Further-more, the cohort was examined for longitudinal changes. Thirdly, independent scan-rescan datasets are examined to gain a better understanding of the degree of reproducibility which can be achieved in imaging studies. This involves analysing the robustness of brain parcellations based on structural or diffusion imaging. The effect of using different MRI scanners or imaging protocols was also assessed and discussed. Fourthly, sources of diffusion MRI variability and different approaches to cope with these are reviewed. Using this foundation,state-of-the art methods for diffusion MRI harmonisation were compared against each other using both a benchmark dataset and mTBI cohort. Lastly, a solution to localise brain lesions was proposed. Its implications for lesion analysis, are assessed in the light of an application to a more severe TBI patient cohort, imaged on two different scanners. Furthermore, a lesion matching algorithm was introduced to automatically examine lesion evolution with time post-injury. In summary, this thesis explored different options for MRI data analysis in the context of large multi-centre studies. Different approaches are studied and compared using a number of different MRI datasets, including scan-rescan data across different MRI scanners and imaging protocols. The potential of the optimised solutions was illustrated through applications to TBI data.
Purpose
While prior research has established that traumatic brain injury (TBI) is a risk factor for violent offending, there is little understanding of mechanisms that may underpin this relationship. This is problematic, as a better understanding of these mechanisms could facilitate more effective targeting of treatment. This study aims to address these gaps in the extant literature by examining TBI as a predictor of violent offending and test for mediation effects through cognitive constructs of dual systems imbalance and hostility among a sample of justice-involved youth (JIY).
Design/methodology/approach
The Pathways to Desistance data were analyzed. The first three waves of this data set comprising the responses of 1,354 JIY were analyzed. Generalized structural equation modeling was used to test for direct and indirect effects of interest. A bootstrap resampling process was used to compute unbiased standard errors for determining the statistical significance of mediation effects.
Findings
Lifetime experience of TBI was associated with increased violent offending frequency at follow-up. Hostility significantly mediated this relationship, but dual systems imbalance did not. This indicated that programming focused on reducing hostility among JIY who have experienced TBI could aid in reducing violent recidivism rates.
Originality/value
To the best of the author’s knowledge, this study was the first to identify significant mediation of the relationship between TBI and violent offending through hostility.
Objectives:
To investigate the role of short nucleolar RNA host gene 1 (SNHG1) in regulating inflammation and brain injury in traumatic brain injury (TBI).
Methods:
The Feeney's free-falling method was used to induce moderate TBI model in mice. Lipopolysaccharide (LPS) was employed to construct the microglia in vitro. Reverse transcription-PCR (RT-PCR) was conducted to monitor expression of SNHG1, microRNAs (miR)-377-3p, oxidative and inflammatory factors. TdT-mediated dUTP nick end labeling and immunohistochemistry were adopted to determine neuronal cell apoptosis. Flow cytometry was conducted to measure apoptosis. Moreover, Bax, Bcl2, Caspase3, dual-specific phosphatase-1 (DUSP1)/mitogen-activated protein kinase/NF-KB were tested by western blot. Furthermore, bioinformatics, dual-luciferase assay and RNA-binding protein immunoprecipitation experiment were implemented to verify the targeting relationship among SNHG1, miR-377-3p and DUSP1.
Results:
SNHG1 was knocked down, while miR-377-3p was overexpressed in TBI mice and lipopolysaccharide-induced microglia. Meanwhile, overexpressing SNHG1 reduced neuronal damage and weakened the oxidative stress and inflammation in TBI on matter in vivo or in vitro. Additionally, overexpressing SNHG1 attenuated miR-377-3p-mediated inflammatory factors, oxidative stress and neuronal damage. Moreover, miR-377-3p was the target of SNHG1 and DUSP1.
Conclusions:
This study provides a better understanding of the SNHG1/miR-377-3p/DUSP1 axis in regulating the development of TBI, which is helpful to formulate a treatment plan for TBI.
Background
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality today, which will surpass many infectious diseases in the coming years/ decades. Post-traumatic epilepsy (PTE) is one of the most common debilitating consequences of TBI. PTE is a secondary, acquired epilepsy that causes recurrent, spontaneous seizures more than a week after TBI. The extent of head injury in individuals who develop PTE is unknown; however, trauma is thought to account for 20% of symptomatic epilepsy worldwide. Understanding the mechanisms of epilepsy following TBI is crucial for the discovery of new anticonvulsant drugs for the treatment of PTE, as well as for improving the quality of life of patients with PTE.
Objective
This review article explains the rationale for the usage of a chemical model to access new treatments for post-traumatic epilepsy.
Results
There are multiple methods to control and manage PTE. The essential and available remedy for the management of epilepsy is the use of antiepileptic drugs. Antiepileptic drugs (AEDs) decrease the frequency of seizures without affecting the disease's causality. Antiepileptic drugs are administrated for the prevention and treatment of PTE; however, 30% of epilepsy patients are drug-resistant, and AED side effects are significant in PTE patients. There are different types of animal models, such as the liquid percussion model, intracortical ferric chloride injection, and cortical subincision model, to study PTE and neurophysiological mechanisms underlying the development of epilepsy after head injury. However, these animal models do not easily mimic the pathological events occurring in epilepsy. Therefore, animal models of PTE are an inappropriate tool for screening new and putatively effective AEDs. Chemical kindling is the most common animal model used to study epilepsy. There is a strong similarity between the kindling model and different types of human epilepsy.
Conclusion
Today, researchers use experimental animal models to evaluate new anticonvulsant drugs. The chemical kindling models, such as pentylenetetrazol, bicuculline, and picrotoxin-induced seizures, are important experimental models to analyze the impact of putative antiepileptic drugs.
Objective:
This study investigated the performance on, and correlates of, the Brief Visuospatial Memory Test - Revised (BVMT-R) in patients with traumatic brain injury (TBI).
Methods:
Participants included 100 patients with TBI and 100 demographically matched controls. We first used regression analysis to determine predictors of BVMT-R performance in the clinical group. We then used analysis of variance as well as logistic regression to determine how BVMT-R findings differed between the clinical and control groups.
Results:
Injury severity and visuospatial ability both contributed to the prediction of BVMT-R Total Recall and Delayed Recall scores in the TBI group. Mean differences between the TBI and control groups on these variables were statistically significant, but overall individual classification accuracy was limited at 59%.
Conclusions:
The BVMT-R has some clinical utility in the evaluation of patients with TBI but should not be used in isolation.
Background:
Adults with chronic traumatic brain injury (TBI) may experience long-term deficits in multiple cognitive domains. Higher-order functions, such as verbal memory, are impacted by deficits in the ability to acquire verbal information.
Objective:
This study investigated the effects of a neuroplasticity-based computerized cognitive remediation program for auditory information processing in adults with a chronic TBI.
Methods:
Forty-eight adults with TBI were randomly assigned to an intervention or control group. Both groups underwent a neuropsychological assessment at baseline and post-training. The Intervention group received 40 one-hour cognitive training sessions with the Brain Fitness Program.
Results:
The intervention group improved in performance on measures of the Woodcock-Johnson-III Understanding Directions subtest and Trail Making Test Part-A. They also reported improvement on the cognitive domain of the Cognitive Self-Report Questionnaire.
Conclusions:
The present study demonstrated that a neuroplasticity-based computerized cognitive remediation program may improve objective and subjective cognitive function in adults with TBI several years post-injury.
This review aimed at providing a brief and comprehensive summary of recent research regarding the use of the Wisconsin Card-Sorting Test (WCST) to assess executive function in patients with traumatic brain injury (TBI). A bibliographical search, performed in PubMed, Web of Science, Scopus, Cochrane Library, and PsycInfo, targeted publications from 2010 to 2020, in English or Spanish. Information regarding the studies' designs, sample features and use of the WCST scores was recorded. An initial search eliciting 387 citations was reduced to 47 relevant papers. The highest proportion of publications came from the United States of America (34.0%) and included adult patients (95.7%). Observational designs were the most frequent (85.1%), the highest proportion being cross-sectional or case series studies. The average time after the occurrence of the TBI ranged from 4 to 62 years in single case studies, and from 6 weeks up to 23.5 years in the studies with more than one patient. Four studies compared groups of patients with TBI according to the severity (mild, moderate and/or severe), and in two cases, the studies compared TBI patients with healthy controls. Randomized control trials were seven in total. The noncomputerized WCST version including 128 cards was the most frequently used (78.7%). Characterization of the clinical profile of participants was the most frequent purpose (34.0%). The WCST is a common measure of executive function in patients with TBI. Although shorter and/or computerized versions are available, the original WCST with 128 cards is still used most often. The WCST is a useful tool for research and clinical purposes, yet a common practice is to report only one or a few of the possible scores, which prevents further valid comparisons across studies. Results might be useful to professionals in the clinical and research fields to guide them in assessment planning and proper interpretation of the WCST scores.
