Browsing by Subject "TBI"

Now showing 1 - 5 of 5
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    Behavioral Recovery and Early Decision Making in Patients with Prolonged Disturbance in Consciousness after Traumatic Brain Injury
    (Mary Ann Liebert, 2020-01-15) Giacino, Joseph T.; Sherer, Mark; Christoforou, Andrea; Maurer-Karattup, Petra; Hammond, Flora M.; Long, David; Bagiella, Emilia; Physical Medicine and Rehabilitation, School of Medicine
    The extent of behavioral recovery that occurs in patients with traumatic disorders of consciousness (DoC) following discharge from the acute care setting has been under-studied and increases the risk of overly pessimistic outcome prediction. The aim of this observational cohort study was to systematically track behavioral and functional recovery in patients with prolonged traumatic DoC following discharge from the acute care setting. Standardized behavioral data were acquired from 95 patients in a minimally conscious (MCS) or vegetative state (VS) recruited from 11 clinic sites and randomly assigned to the placebo arm of a previously completed prospective clinical trial. Patients were followed for 6 weeks by blinded observers to determine frequency of recovery of six target behaviors associated with functional status. The Coma Recovery Scale-Revised and Disability Rating Scale were used to track reemergence of target behaviors and assess degree of functional disability, respectively. Twenty percent (95% confidence interval [CI]: 13-30%) of participants (mean age 37.2; median 47 days post-injury; 69 men) recovered all six target behaviors within the 6 week observation period. The odds of recovering a specific target behavior were 3.2 (95% CI: 1.2-8.1) to 7.8 (95% CI: 2.7-23.0) times higher for patients in MCS than for those in VS. Patients with preserved language function ("MCS+") recovered the most behaviors (p ≤ 0.002) and had the least disability (p ≤ 0.002) at follow-up. These findings suggest that recovery of high-level behaviors underpinning functional independence is common in patients with prolonged traumatic DoC. Clinicians involved in early prognostic counseling should recognize that failure to emerge from traumatic DoC before 28 days does not necessarily portend unfavorable outcome.
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    Machine Learning Classification of Facial Affect Recognition Deficits after Traumatic Brain Injury for Informing Rehabilitation Needs and Progress
    (2020-12) Iffat Naz, Syeda; Christopher, Lauren; King, Brian; Neumann, Dawn
    A common impairment after a traumatic brain injury (TBI) is a deficit in emotional recognition, such as inferences of others’ intentions. Some researchers have found these impairments in 39\% of the TBI population. Our research information needed to make inferences about emotions and mental states comes from visually presented, nonverbal cues (e.g., facial expressions or gestures). Theory of mind (ToM) deficits after TBI are partially explained by impaired visual attention and the processing of these important cues. This research found that patients with deficits in visual processing differ from healthy controls (HCs). Furthermore, we found visual processing problems can be determined by looking at the eye tracking data developed from industry standard eye tracking hardware and software. We predicted that the eye tracking data of the overall population is correlated to the TASIT test. The visual processing of impaired (who got at least one answer wrong from TASIT questions) and unimpaired (who got all answer correctly from TASIT questions) differs significantly. We have divided the eye-tracking data into 3 second time blocks of time series data to detect the most salient individual blocks to the TASIT score. Our preliminary results suggest that we can predict the whole population's impairment using eye-tracking data with an improved f1 score from 0.54 to 0.73. For this, we developed optimized support vector machine (SVM) and random forest (RF) classifier.
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    PEG-PDLLA micelle treatment improves axonal function of the corpus callosum following traumatic brain injury
    (Mary Ann Liebert, Inc., 2014-07-01) Ping, Xingjie; Jiang, Kewen; Lee, Seung-Young; Cheng, Ji-Xing; Jin, Xiaoming; Department of Anatomy & Cell Biology, IU School of Medicine
    The initial pathological changes of diffuse axonal injury following traumatic brain injury (TBI) include membrane disruption and loss of ionic homeostasis, which further lead to dysfunction of axonal conduction and axon disconnection. Resealing the axolemma is therefore a potential therapeutic strategy for the early treatment of TBI. Monomethoxy poly (ethylene glycol)-poly (D, L-lactic acid) di-block copolymer micelles (mPEG-PDLLA) have been shown to restore depressed compound action potentials (CAPs) of spinal axons and promote functional recovery after spinal cord injury. Here, we evaluate the effect of the micelles on repairing the injured cortical axons following TBI. Adult mice subjected to controlled cortical impact (CCI) were treated with intravenous injection of the micelles at 0 h or 4 h after injury. Evoked CAPs were recorded from the corpus callosum of coronal cortical slices at 2 days after injury. The CCI caused significant decreases in the amplitudes of two CAP peaks that were respectively generated by the faster myelinated axons and slower unmyelinated axons. Micelle treatment at both 0 h and 4 h after CCI resulted in significant increases in both CAP peak amplitudes. Injection of fluorescent dye-labeled micelles revealed high fluorescent staining in cortical gray and white matters underneath the impact site. Labeling membrane-perforated neurons by injecting a membrane impermeable dye Texas Red-labeled dextran into lateral ventricles at 2 h post-CCI revealed that immediate micelle injection after CCI did not reduce the number of dye-stained cortical neurons and dentate granule cells of the hippocampus, indicating its ineffectiveness in repairing plasma membrane of neuronal somata. We conclude that intravenous administration of mPEG-PDLLA micelles immediately or at 4 h after TBI allows brain penetration via the compromised blood brain-barrier, and thereby improves the function of both myelinated and unmyelinated axons of the corpus callosum.
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    People with traumatic brain injury, who often lose empathy, can regain it with treatment
    (The Conversation US, Inc., 2019-05-24) Neumann, Dawn; Physical Medicine and Rehabilitation, School of Medicine
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    Racial and Ethnic Differences in Traumatic Brain Injury Outcomes From 2009 to 2023: Protocol for a Systematic Review
    (JMIR, 2024-10-03) Pappadis, Monique R.; Talley, Kelli G.; Garcia, Patricia; Aguirre, Caitlin R.; Onwudebe, Chinedu K.; Smith, Michelle; Lequerica, Anthony H.; Neurology, School of Medicine
    Background: In 2009, Gary and colleagues reviewed prior research examining racial and ethnic differences in outcomes after traumatic brain injury (TBI). Over the past 15 years, advances in research and changes in the demographic composition of the United States warrant a comprehensive understanding of racial and ethnic disparities after TBI. Objective: A systematic review will be conducted to examine racial and ethnic differences in TBI outcomes from 2009 to 2023. Methods: Preliminary searches and study screening processes will identify relevant English-language articles published from January 2009 to December 2023 using the CINAHL, Gale OneFile, PsycINFO (Ovid), and PubMed electronic databases. Relevant articles will include quantitative or mixed method approaches, involve individuals with TBI or their caregivers, and compare 2 or more groups by race or ethnicity on post-TBI outcomes. Quality will be assessed using the Newcastle-Ottawa Scale. This systematic review protocol was developed following PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. Results will be summarized, and a subgroup analysis may be conducted based on demographics (eg, age, gender, or sex). Results: We have already identified abstracts using the search strategy for all 4 of the included electronic databases. We recently updated the search and will begin abstract screening of the additional abstracts identified from the last search completed in January 2024. This systematic review is anticipated to be completed by fall 2024, and its findings will be disseminated to the scientific community, persons with TBI, caregivers, and the lay audience. Conclusions: This systematic review will advance our understanding regarding outcome disparities among minoritized individuals with TBI, examine progress over the past 15 years in minimizing barriers encountered by these racial and ethnic groups, and provide professionals with a roadmap illustrating existing gaps in rehabilitation care, making way for further development and implementation of evidence-based interventions to improve health equity in TBI outcomes.