Improving prognostic models of six-month clinical outcomes after severe traumatic brain injury with daily inpatient biomarkers: A Bayesian modelling approach.

Background: A key limitation of the IMPACT model for prognostication after severe traumatic brain injury (TBI) is the use of predictors from hospital admission only. We sought to identify if including daily blood labs (e.g.

False-Positive Rates and Associated Factors on the Vestibular/Ocular Motor Screening (VOMS) Using the Military Acute Concussion Evaluation 2 (MACE 2) Cutoffs in U.S. Military Personnel.

Objective: This study examined false-positive rates and associated factors on the Vestibular/Ocular Motor Screening (VOMS) in healthy US Army Special Operations Command (USASOC) personnel using the symptom provocation cutoff of ≥1 for any VOMS item as recommended in the Military Acute Concussion Evaluation 2 (MACE 2).

Setting: Military site.

Participants: Active-duty USASOC personnel aged 18 to 40 years with 20/20 vision, no duty limitations, and no recent concussion.

Identifying a Biological Signature of Trauma-Related Neurodegeneration Following Repeated Traumatic Brain Injuries Compared with Healthy Controls.

The objective of this study was to compare participants at-risk for trauma-related neurodegeneration to a healthy control group on outcomes associated with Alzheimer's disease (AD), such as subjective symptoms, neurocognitive performance, plasma biomarkers, volumetrics, amyloid-beta (Aβ) positron emission tomography (PET), and tau PET. Participants completed a comprehensive assessment protocol for neurodegenerative disease, including magnetic resonance imaging (MRI), PET scans for tau and Aβ, blood draw, subjective symptom reports related to neurodegenerative disease, and objective neurocognitive assessment. Surveys included the Neurobehavioral Symptom Inventory (NSI), Insomnia Severity Index (ISI), Epworth Sleepiness Severity (ESS), PTSD Checklist for DSM-5 (PCL-5), Brief Symptom Inventory-18 (BSI-18), Satisfaction with Life Scale (SWLS), Barratt Impulsivity Scale (BIS), and Buss Perry Aggression Questionnaire (BPAQ).

Effect of Obese Body Mass Index on Clinical Outcomes and Inflammatory Blood Biomarkers following Sport-Related Concussion in Collegiate Athletes and Military Cadets: Findings from the NCAA-DoD CARE Consortium.

Background: Obesity is associated with chronic circulatory inflammation; higher acute inflammation is associated with worse outcomes from concussion. The purpose of this study is to evaluate the effect of obese body mass index (BMI; ≥ 30.0) on clinical outcomes (e.

Distinct symptom recoveries based upon highest level of care in patients with sport-related concussion or traumatic brain injury and Glasgow Coma Scale 13-15.

There are limited data directly comparing recovery across traumatic brain injury subpopulations. We compared symptom recovery profiles between patients with Glasgow Coma Scale (GCS) 13-15 traumatic brain injury (TBI) from the same region in three cohorts: (1) Participants with sport-related concussion (SRC), (2) participants evaluated and discharged from the level 1 trauma center emergency department (ED), and (3) participants who required 1 + night(s) in the inpatient unit (IP). The current analysis aggregates data from two prospective cohort studies at the same institution resulting in a combined dataset of 395 patients with TBI (224 with SRC, 95 discharged from the ED, and 75 admitted [IP]).

Sensory driven neurophysiological mechanisms of concussion: a parsimonious and falsifiable theory.

Every time a person sustains a blow to the head, they receive multiple atypical sensory inputs, often including pain. These directly stimulate the central nervous system. Yet, sensory input as a causal agent of neurophysiological dysfunction and post-concussion symptoms has never been explored.

No Association Between Fencing Response After Concussion and Recovery Time, Concussion Severity, or Clinical Outcomes in Professional American Football Players.

Background And Objectives: The relationship between tonic posturing (also known as the "fencing response") after concussion and clinical outcomes is unclear. The objective of this study was to compare clinical outcomes between professional American football players with a documented fencing response after concussion to players without documented fencing response after concussion.

Methods: Players with a fencing response after concussion were matched 1:2 to players without documented fencing response after in-game concussion by age, position, and concussion history from the 2018 to 2023 seasons.

Follow up rates and patient interest in clinical care after mild traumatic brain injury presenting to a level 1 trauma center: a TRACK-TBI prospective cohort study.

Study Objective: To evaluate the rates of clinical follow-up and patient interest in clinical follow-up within the first year of traumatic brain injury (TBI) with presenting Glasgow Coma Scale (GCS) score between 13 and 15.

Methods: This is a secondary analysis of a prospective cohort study which enrolled patients with TBI first evaluated at a 1 of 23 level 1 trauma centers ( = 1,916). At 2 weeks and 3 months, the participants were asked "have you seen any healthcare provider for your TBI?" and "if so, did it help?.

Association of Subacute Mild Traumatic Brain Injury Symptoms With Long-Term Persistent Symptoms, Functional Limitations, and Quality of Life.

Background And Objectives: The objective was to evaluate the association of subacute postconcussion symptoms (with the total Rivermead Post-Concussion Questionnaire [RPQ] score) with persistent symptoms, functional limitations, and quality of life at 6 months in patients with mild traumatic brain injury (mTBI).

Methods: This was a secondary analysis of the Transforming Research and Clinical Knowledge of Traumatic Brain Injury, which was a prospective cohort study of patients with TBI and admission Glasgow Coma Scale score between 13 and 15 at 18 US Level 1 trauma centers through 2014-2018. Participants were included in the study if presenting within 24 hours of external force trauma to the head and met the American Congress of Rehabilitation Medicine's criteria for TBI.

Association of Risk-Taking Behaviors, Vestibular Provocation and Action Boundary Perception Following Sport-Related Concussion in Adolescents.

: The purpose of this study was to evaluate the association between risk-taking behaviors, vestibular symptoms/impairment and perception-action coupling behavior in recently concussed adolescents. : This study utilized a cross-sectional design to evaluate the early effects of concussion on 12-18-year-old adolescents (n = 47) recruited from a concussion specialty clinic at their presenting clinical appointment. The Perception-Action Coupling Task (PACT) was used to assess action boundary perception by evaluating the participant's ability to quickly and accurately determine whether a virtual "ball" fits in a virtual "hole".

Confirmatory Factor Analysis and Concurrent Validity of the Concussion Clinical Profiles Screening Tool (CP Screen).

The factor structure of the Concussion Clinical Profiles Screen (CP Screen) has not been empirically evaluated. In this study, 323 patients (59% male; 74% sport-related) completed CP Screen, ImPACT, and Vestibular/Ocular-Motor Screening (VOMS) at initial clinical visit within 30 days of concussion (±/-6.10 days).

The Role of Body Mass Index on Physical Activity, Symptoms, and Related Outcomes Following Pediatric Concussion.

Objective: To determine the step count and self-reported activity levels for obese and nonobese pediatric patients following concussion and predict self-reported symptoms, quality of life, and psychological health over time.

Study Design: Participants completed the Post-Concussion Symptom Scale (PCSS), Pediatric Quality of Life (PedsQL), and Behavioral Symptom Inventory-18 (BSI-18) at an initial visit (<72 hours), 3-5 days postinjury, 10-18 days postinjury, and 1 and 2 months postinjury. Physical activity data (eg, step count) were collected via a commercial actigraph.

Perceived Cognitive Function in Neurosurgical Patients.

Background And Objectives: This study explores perceived cognitive function in preoperative cranial neurosurgical patients and its association with neuropsychological testing (NPT).

Methods: A total of 96 patients were referred for NPT by neurosurgical service. Patients completed the Neuro-QoL Item Bank v2.

Identifying the 'Miserable Minority' Among Pediatric Patients Following Concussion.

Objectives: To investigate whether there are empirically-detectable subgroups of concussion severity and recovery across three consecutive concussions, as well as to define risk factor and clinical assessment differences across subgroups.

Methods: The present study was a retrospective chart review of 202 adolescents 13.17 ± 1.

Career duration and later-life health conditions among former professional American-style football players.

Objectives: Career duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised.

Predictive Blood Biomarkers of Targeted Intervention for Chronic Mental Health Symptoms following Traumatic Brain Injury.

The purpose of this study was to assess the performance of predictive blood biomarkers for responsiveness to targeted treatments for chronic psychological issues years after traumatic brain injury (TBI). Targeted Evaluation Action and Monitoring of TBI was a prospective 6-month interventional trial of participants with chronic TBI sequelae ( = 95). Plasma biomarkers were analyzed pre-intervention: glial fibrillary acidic protein (GFAP), tau, hyperphosphorylated tau Thr231 (p-Tau), von Willebrand factor (vWF), brain lipid-binding protein (BLBP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), vascular endothelial growth factor-a (VEGFa), and claudin-5 (CLDN5).

The role of nutrition in mild traumatic brain injury rehabilitation for service members and veterans.

Background: Veterans Affairs and the Department of Defense (DOD) acknowledge that nutrition may be a modifier of mild traumatic brain injury (TBI) sequelae. Military clinicians are considering nutritional supplements and dietary interventions when managing patients with mild TBI. Therefore, clinicians should be familiar with the current evidence for nutritional interventions in mild TBI and special considerations related to the military lifestyle.

Impact of obese body mass index on inflammasome blood biomarkers and neurocognitive performance following traumatic brain injury with Glasgow coma scale 13 to 15.

Activation of the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome is a moderating factor between obesity and cognitive impairment in animals, but this has never been tested in humans following mild traumatic brain injury (mTBI). This is a retrospective cohort analysis of subjects enrolled at a single level 1 trauma center (n = 172). Participants completed Trail Making Test Part A and B (TMT-A and B) at six- and twelve-months, Blood samples were obtained within 24 h of mTBI and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), caspase-1, interleukin-18 (IL-18), and IL-1β were assayed.

Immediate post-concussion assessment and cognitive testing Pediatric (ImPACT Pediatric) change scores and factors associated with performance in patients aged 5-9 years following concussion: Preliminary findings.

Background: Computerized neurocognitive testing is one component of a multidomain assessment of concussion. However, the use of computerized neurocognitive testing has been limited to patients aged 11 years and up, leaving clinicians with few options to evaluate younger children.

Purpose: To examine the change in Immediate Post-concussion Assessment and Cognitive Testing Pediatric (ImPACT Pediatric) (ImPACT Applications, 2021) scores and factors associated with performance in children aged 5-9 years following a concussion.

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study.

Objectives: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.

Applying Dynamical Systems Theory to Improve Personalized Medicine Following Mild Traumatic Brain Injury.

A sizable proportion of patients with mild traumatic brain injury (mTBI) have persistent symptoms and functional impairments months to years following injury. This phenomenon is continually observed despite an explosion of research and interest in improving mTBI clinical outcomes over the last two decades. All pharmacological clinical trials to date have failed to demonstrate improved outcomes for mTBI.

Age of First Exposure Does Not Relate to Post-Career Health in Former Professional American-Style Football Players.

Objective: Prior studies examining small samples of symptomatic former professional football players suggest that earlier age of first exposure (AFE) to American football is associated with adverse later life health outcomes. This study examined a larger, more representative sample of former professional American football players to assess associations between AFE before age 12 (AFE < 12) and clinical outcomes compared with those who started at age 12 or older (AFE 12 +).

Methods: Former professional American football players who completed a questionnaire were dichotomized into AFE < 12 and AFE 12 + .

Interaction of obesity and proteins associated with the NLRP3 inflammasome following mild traumatic brain injury.

The NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome has been associated with worse outcomes from severe traumatic brain injury (TBI). The NLRP3 inflammasome is also strongly associated with other pro-inflammatory conditions, such as obesity. Little is known about the potential effect of mild TBI (mTBI) on the NLRP3 inflammasome and the extent to which modifying factors, such as obesity, may augment the inflammatory response to mTBI.