scholarly journals Stress-dose hydrocortisone reduces critical illness-related corticosteroid insufficiency associated with severe traumatic brain injury in rats

Critical Care ◽  
2013 ◽  
Vol 17 (5) ◽  
pp. R241 ◽  
Author(s):  
Xin Chen ◽  
Zilong Zhao ◽  
Yan Chai ◽  
Lanlan Luo ◽  
Rongcai Jiang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Critical Illness ◽  
Severe Traumatic Brain Injury ◽  
Stress Dose ◽  
Corticosteroid Insufficiency

scholarly journals Corticosteroid receptor rebalancing alleviates critical illness-related corticosteroid insufficiency after traumatic brain injury by promoting paraventricular nuclear cell survival via Akt/CREB/BDNF signaling

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Bin Zhang ◽  
Miao Bai ◽  
Xiaojian Xu ◽  
Mengshi Yang ◽  
Fei Niu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Critical Illness ◽  
Low Dose ◽  
Cell Loss ◽  
High Dose ◽  
Protective Effects ◽  
Signaling Mechanism ◽  
High Dose Methylprednisolone ◽  
Corticosteroid Insufficiency

Abstract Background We previously found that high-dose methylprednisolone increased the incidence of critical illness-related corticosteroid insufficiency (CIRCI) and mortality in rats with traumatic brain injury (TBI), whereas low-dose hydrocortisone but not methylprednisolone exerted protective effects. However, the receptor-mediated mechanism remains unclear. This study investigated the receptor-mediated mechanism of the opposite effects of different glucocorticoids on the survival of paraventricular nucleus (PVN) cells and the incidence of CIRCI after TBI. Methods Based on controlled cortical impact (CCI) and treatments, male SD rats (n = 300) were randomly divided into the sham, CCI, CCI + GCs (methylprednisolone 1 or 30 mg/kg/day; corticosterone 1 mg/kg/day), CCI + methylprednisolone+RU486 (RU486 50 mg/kg/day), and CCI + corticosterone+spironolactone (spironolactone 50 mg/kg/day) groups. Blood samples were collected 7 days before and after CCI. Brain tissues were collected on postinjury day 7 and processed for histology and western blot analysis. Results We examined the incidence of CIRCI, mortality, apoptosis in the PVN, the receptor-mediated mechanism, and downstream signaling pathways on postinjury day 7. We found that methylprednisolone and corticosterone exerted opposite effects on the survival of PVN cells and the incidence of CIRCI by activating different receptors. High-dose methylprednisolone increased the nuclear glucocorticoid receptor (GR) level and subsequently increased cell loss in the PVN and the incidence of CIRCI. In contrast, low-dose corticosterone but not methylprednisolone played a protective role by upregulating mineralocorticoid receptor (MR) activation. The possible downstream receptor signaling mechanism involved the differential effects of GR and MR on the activity of the Akt/CREB/BDNF pathway. Conclusion The excessive activation of GR by high-dose methylprednisolone exacerbated apoptosis in the PVN and increased CIRCI. In contrast, refilling of MR by corticosterone protects PVN neurons and reduces the incidence of CIRCI by promoting GR/MR rebalancing after TBI.

Neurocognitive status and return to work after moderate to severe traumatic brain injury.

2019 ◽  
Vol 64 (4) ◽  
pp. 435-444
Author(s):  
Tessa Hart ◽  
Jessica M. Ketchum ◽  
Therese M. O'Neil-Pirozzi ◽  
Thomas A. Novack ◽  
Doug Johnson-Greene ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Severe Traumatic Brain Injury

Problem-solving therapy for suicide prevention in veterans with moderate-to-severe traumatic brain injury.

2017 ◽  
Vol 62 (4) ◽  
pp. 600-608 ◽  
Author(s):  
Sean M. Barnes ◽  
Lindsey L. Monteith ◽  
Georgia R. Gerard ◽  
Adam S. Hoffberg ◽  
Beeta Y. Homaifar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Problem Solving ◽  
Suicide Prevention ◽  
Severe Traumatic Brain Injury ◽  
Problem Solving Therapy
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