scholarly journals A pilot study exploring pupil response measurement in mild traumatic brain injury

2015 ◽  
Vol 42 (S1) ◽  
pp. S40-S40
Author(s):  
W Ting ◽  
J Topolovec-Vranic ◽  
M McGowan ◽  
MD Cusimano
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Healthy Controls ◽  
Response Dynamics ◽  
Post Injury ◽  
Response Measurement ◽  
Pupil Response ◽  
Post Traumatic ◽  
Traumatic Symptoms

Background: Pupillometry, the measurement of pupil response dynamics via the pupillary light reflex, is seldom used in the assessment of mild traumatic brain injury (mTBI). We hypothesized that there would be quantifiable differences in detailed pupil response measurements in patients with acute and chronic mTBI. Methods: We conducted 49 bilateral pupillometry measurements, in acute mTBI patients at 1-week (N=11), 2-4w (N=9), and 3-7mo post-injury (N=3); 14 patients with persistent post-traumatic symptoms (PTS) once, and healthy controls across a first visit (N=7) and second visit 2-4w later (N=5). Results: The percentage of left pupil diameter change was significantly greater in the acute mTBI group at second visit (mean=36.3% (2.96)), compared to controls at second visit (mean=31.6% (4.39)) (F=5.87, p=0.0321). We did not identify significant differences between acute mTBI patients and controls at first visit, PTS patients versus controls, and within the acute mTBI group across three longitudinal visits. Conclusion: While these preliminary data suggest that pupillometry under these conditions does not distinguish between patients who had a recent mTBI or those with PTS and healthy controls, further research is warranted investigating pupil behavior and its clinical utility in mTBI.

scholarly journals 0014 Reduced Cortical Thickness as a Biomarker of Daytime Sleepiness in Mild Traumatic Brain Injury

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A5-A6
Author(s):  
N S Dailey ◽  
A C Raikes ◽  
A Alkozei ◽  
M A Grandner ◽  
W D Killgore
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Cortical Thickness ◽  
Daytime Sleepiness ◽  
Healthy Controls ◽  
Inferior Parietal Lobule ◽  
Post Injury ◽  
Attention Network ◽  
Parietal Lobule

Abstract Introduction Sleep disruptions, including the increase of daytime sleepiness, are reported in roughly 70% of all individuals who have suffered a mild traumatic brain injury (mTBI). Prior research using magnetic resonance imaging (MRI) has identified associations between functional brain changes and daytime sleepiness following mTBI. In the present study, we aimed to identify whether structural differences in cortical thickness are associated with increased daytime sleepiness in adults with mTBI. Methods A total of 58 adults between 18 and 45 years of age (M=23.58±5.31) participated in the study, including 19 healthy controls and 39 individuals with a documented mTBI. Individuals with mTBI were further divided based on time-since-injury into a sub-acute (n=22) or chronic (n=17) group. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS) and cortical thickness was measured using high-resolution T1-weighted structural MRI. Whole-brain vertex-wise estimations of cortical thickness were calculated using FreeSurfer (v.6.0) and entered into a GLM to identify between-group differences in cortical thickness and the association with ESS. Results Significant differences in cortical thickness were found between the two mTBI groups (cluster-forming threshold p<.01; cluster-wise threshold p<.05; two-tailed; FWE-corrected). Specifically, lower cortical thickness in the left hemisphere was found in the inferior parietal lobule (p=.01), precuneus (p=.03), and pars triangularis (p=.04) for the sub-acute, compared to chronic group. Furthermore, a significant negative correlation was found between ESS and cortical thickness in the inferior parietal lobule (r=-.55, p=.009) for the sub-acute mTBI group. Conclusion More daytime sleepiness was associated with reduced inferior parietal cortical thickness in those 2 to 12-weeks post-injury, an association not observed in those 6 to 12-months post-injury or healthy controls. The inferior parietal lobule is part of the frontoparietal attention network and has been associated with vulnerability to sleep loss. Our findings suggest structural damage to the attention network following mTBI may be one factor affecting daytime sleepiness in mTBI. These findings may reflect a potential biomarker of sleep disturbances in mTBI. Support USAMRMC grant (W81XWH-12–0386).

Rates of symptom reporting following traumatic brain injury

2010 ◽  
Vol 16 (3) ◽  
pp. 401-411 ◽  
Author(s):  
SUREYYA DIKMEN ◽  
JOAN MACHAMER ◽  
JESSE R. FANN ◽  
NANCY R. TEMKIN
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Traumatic Injury ◽  
Symptom Reporting ◽  
Psychiatric History ◽  
Post Injury ◽  
Post Traumatic ◽  
Severity Levels ◽  
Traumatic Symptoms

AbstractThis study examines rates of reporting of new or worse post-traumatic symptoms for patients with a broad range of injury severity at 1 month and 1 year after traumatic brain injury (TBI), as compared with those whose injury spared the head, and assesses variables related to symptom reporting at 1 year post-injury. Seven hundred thirty two TBI subjects and 120 general trauma comparison (TC) subjects provided new or worse symptom information at 1 month and/or 1 year post-injury. Symptom reporting at 1 year post-injury was compared in subgroups based on basic demographics, preexisting conditions, and severity of brain injury. The TBI group reported significantly more symptoms at 1 month and 1 year after injury than TCs (each p < .001). Although symptom endorsement declined from 1 month to 1 year, 53% of people with TBI and 24% of TC continued to report 3 or more symptoms at 1 year post-injury. Symptom reporting in the TBI group was significantly related to age, gender, preinjury alcohol abuse, pre-injury psychiatric history, and severity of TBI. Symptom reporting is common following a traumatic injury and continues to be experienced by a substantial number of TBI subjects of all severity levels at 1 year post-injury. (JINS, 2010, 16, 401–411.)

scholarly journals Free-living Turning Rather Than Gait Differentiates People with Chronic Mild Traumatic Brain Injury from Controls

2021 ◽  
Author(s):  
Dylan Powell ◽  
Alan Godfrey ◽  
Lucy Parrington ◽  
Kody R. Campbell ◽  
Laurie A. King ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Physical Function ◽  
Mild Traumatic Brain Injury ◽  
Healthy Controls ◽  
Post Injury ◽  
Free Living ◽  
Sensitive Measure ◽  
Gait Characteristics

Abstract Background: Physical function remains a crucial component of mild traumatic brain injury (mTBI) assessment and recovery. Traditional approaches to assess mTBI lack sensitivity to subtle deficits post-injury, which can impact quality of life, daily function and can lead to chronic issues. Inertial measurement units (IMU) provide an objective alternative for measuring physical function of gait and turning and can be used in any environment. Our recent work has found that turning quality is more sensitive than the quantity of physical activity when comparing chronic mTBI and healthy controls. However, no studies have compared the quality of free-living gait and turning characteristics concurrently in chronic mTBI and healthy controls. This study aimed to determine whether free-living gait or turning is more sensitive in differentiating chronic mTBI from controls.Methods: Thirty-two people with chronic self-reported balance symptoms after mTBI (age: 40.88 ± 11.78 years, median days post injury: 440.68 days) and 23 healthy controls (age: 48.56 ± 22.56 years) were assessed for ~7 days using a single IMU at the waist on a belt. Free-living gait and turning characteristics were evaluated for chronic mTBI and controls using multi-variate analysis. Receiver operating characteristics (ROC) and Area Under the Curve (AUC) analysis were used to determine outcome sensitivity to chronic mTBI.Results: Free-living gait characteristics were not different in chronic mTBI and controls (all p>0.05). In contrast, all but two (number of turns and average velocity CV) free-living turning characteristics were significantly different between chronic mTBI and controls, whilst controlling for age and sex (Bonferroni adjusted p<0.002). The chronic mTBI group had larger turn angles and longer turn durations compared to controls. ROC and AUC analysis showed turn duration (AUC = 0.92) was the most sensitive measure for differentiating chronic mTBI from controls. Conclusions: Results show that turning rather than gait characteristics were significantly different between chronic mTBI and controls, with turn duration being the most sensitive measure. These results suggest turning is a suitable surrogate biomarker to assess and monitor chronic mTBI.

A-97 Headache before and after Mild Traumatic Brain Injury: Acute-to-Subacute Outcomes in Patients with no Headache, Pre-Existing Headache, and Post-Traumatic Headache

2021 ◽  
Vol 36 (6) ◽  
pp. 1145-1145
Author(s):  
Justin E Karr ◽  
Michael W Williams ◽  
Grant L Iverson ◽  
Sheng-Jean Huang ◽  
Chi-Cheng Yang
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Neuropsychological Tests ◽  
Neuropsychological Test ◽  
Future Research ◽  
Cognitive Symptoms ◽  
Post Injury ◽  
Before And After ◽  
Post Traumatic

Abstract Objective Patients who experience a mild traumatic brain injury (MTBI) may have a headache condition preceding injury, develop a post-traumatic headache after injury, or experience headache neither before nor after injury. This study examined whether MTBI patients with no headache, pre-existing headache, and post-traumatic headache differed in acute-to-subacute outcomes. Method Patients with MTBI were recruited from an outpatient neurosurgery clinic in Taipei, Taiwan after emergency department referral (N = 291; 40.2% men; M = 37.9 ± 13.9 years-old; Mdn = 7 days-since-injury, range = 0–21), completing neuropsychological tests of attention, memory, and verbal fluency and questionnaires evaluating depression, anxiety, and post-concussion symptoms. Participants with no headache (reported neither pre- or post-injury), pre-existing headache (reported pre-injury headache, of whom some reported worsened post-injury headache), and post-traumatic headache (denied pre-injury headache, reported post-injury headache) were compared using non-parametric ANCOVA, controlling for gender and days-since-injury. Results Neuropsychological test performances did not differ between headache groups. Participants with pre-injury headache and post-traumatic headache had greater change in self-reported physical (F = 25.52, p &lt; 0.011, η2 = 0.15) and cognitive symptoms (F = 3.74, p = 0.025, η2 = 0.03) than participants with no headache. Participants with pre-injury headache reported worse post-injury anxiety symptoms than participants with post-traumatic headache (F = 12.02, p &lt; 0.011, η2 = 0.08). Conclusion(s) Participants with pre-injury and post-traumatic headache did not differ in outcome within 21 days of injury but had worse self-reported physical and cognitive symptoms than participants with no headache. Most participants with pre-injury headache experienced worsened headache following MTBI (53.7%). Future research is needed to assess whether more specific headache subtypes are differentially associated with MTBI outcome.

Low plasma levels of calcitonin gene-related peptide in persistent post-traumatic headache attributed to mild traumatic brain injury

Cephalalgia ◽  
2020 ◽  
Vol 40 (12) ◽  
pp. 1276-1282 ◽  
Author(s):  
Håkan Ashina ◽  
Haidar Muhsen Al-Khazali ◽  
Afrim Iljazi ◽  
Sait Ashina ◽  
Niklas Rye Jørgensen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Plasma Levels ◽  
Healthy Controls ◽  
Age And Gender ◽  
Calcitonin Gene ◽  
Post Traumatic ◽  
And Gender ◽  
Plasma Measurements

Objective To investigate the role of calcitonin gene-related peptide (CGRP) in persistent post-traumatic headache (PTH) attributed to mild traumatic brain injury (TBI). Methods A total of 100 individuals with persistent PTH attributed to mild TBI and 100 age- and gender-matched healthy controls were enrolled between July 2018 and June 2019. Blood was drawn from the antecubital vein and subsequently analyzed using a validated radioimmunoassay for human CGRP. Measurements were performed on coded samples by a board-certified laboratory technician who was blind to clinical information. Results CGRP plasma levels were lower in subjects with persistent PTH (mean, 75.8 pmol/L; SD, 26.4 pmol/L), compared with age- and gender-matched healthy controls (mean, 88.0 pmol/L; SD, 34.1 pmol/L) ( p = 0.04). No correlation was found of CGRP plasma levels with monthly headache days ( r = −0.11; p = 0.27), monthly migraine-like days ( r = 0.15; p = 0.13), headache quality ( r = −0.14; p = 0.15), or a chronic migraine-like headache phenotype ( r = −0.02; p = 0.85). Conclusions CGRP plasma measurements are unlikely a feasible blood-based biomarker of persistent PTH. Future studies should assess whether CGRP plasma measurements can be used to predict development of persistent PTH.

scholarly journals Age, Sex, and Cerebral Microbleeds Affect White Matter Integrity Across Adulthood After Mild Traumatic Brain Injury

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 829-829
Author(s):  
David Robles ◽  
Ammar Dharani ◽  
Nikhil Chaudhari ◽  
Kenneth Rostowsky ◽  
Layal Wehbe ◽  
...  
Keyword(s):  
Older Adults ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Diffusion Tensor ◽  
Cerebral Microbleeds ◽  
Future Research ◽  
Post Injury ◽  
Post Traumatic ◽  
Anterior Body

Abstract The contributions of age, sex, and cerebral microbleeds (CMBs) to WM changes after mild traumatic brain injury (mTBI) have not been studied. We used diffusion tensor imaging (DTI) to map WM fractional anisotropy (FA) changes across the first ~6 months post-mTBI in 109 subjects aged 18-77 (46 females; age µ: 40 y, σ: 17 y) imaged within ~1 week post-injury and ~6 months later. After partialing out age, sex, and CMB counts, significant mean FA decreases were found in the anterior body, posterior body, and splenium of the corpus callosum (CC; p = 0.003, 0.009 and 0.015, respectively), left superficial frontal fasciculus (p = 0.008), and left branch of the corticospinal tract (CST; p = 0.007). Age contributed to mean FAs measured acutely in the CC body (p = 0.04), and chronically in the CC genu (p &lt; 0.001), CC body (p = 0.01), and middle longitudinal fasciculi (p = 0.04), older adults exhibiting larger decreases. CMB counts were positively associated with mean FA decreases in the CC body (p = 0.04) and middle longitudinal fasciculi (p = 0.04). Significant age-by-sex and CMB count-by-age interactions mediated FA decreases in the CC genu (p = 0.02 and p = 0.03, respectively), older males exhibiting larger decreases. Thus, the CC, longitudinal fasciculi, superficial frontal WM and CST are particularly vulnerable to post-traumatic neurodegeneration moderated by age, sex and CMB count, men and older adults being at highest risk for adverse effects. Future research should investigate our findings relative to cognitive function.

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