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Journal of the American College of... Mar 2017Heart failure (HF) is a systemic illness with grave implications for bodily functions. The brain, among other vital organs, often suffers insults as a result of HF, and... (Review)
Review
Heart failure (HF) is a systemic illness with grave implications for bodily functions. The brain, among other vital organs, often suffers insults as a result of HF, and both anatomic and functional brain abnormalities were found in the HF population. This injury was demonstrated across a wide range of clinical conditions and cardiac functions and was shown to affect patients' outcomes. Although reduced cardiac output and high burden of cardiovascular risk factors are the prevailing explanations for these findings, there are data showing the involvement of neurohormonal, nutritional, and inflammatory mechanisms in this complex process. Here, the authors review the suggested pathophysiology behind brain injury in HF, describe its effect on patients' outcomes, offer a diagnostic approach, and discuss possible therapeutic options.
Topics: Brain; Brain Injuries; Cerebrovascular Circulation; Cognitive Dysfunction; Heart Failure; Humans
PubMed: 28335844
DOI: 10.1016/j.jacc.2017.01.022 -
Human Brain Mapping Jan 2022Traumatic brain injury (TBI) is a major cause of disability worldwide, but the heterogeneous nature of TBI with respect to injury severity and health comorbidities make... (Review)
Review
Traumatic brain injury (TBI) is a major cause of disability worldwide, but the heterogeneous nature of TBI with respect to injury severity and health comorbidities make patient outcome difficult to predict. Injury severity accounts for only some of this variance, and a wide range of preinjury, injury-related, and postinjury factors may influence outcome, such as sex, socioeconomic status, injury mechanism, and social support. Neuroimaging research in this area has generally been limited by insufficient sample sizes. Additionally, development of reliable biomarkers of mild TBI or repeated subconcussive impacts has been slow, likely due, in part, to subtle effects of injury and the aforementioned variability. The ENIGMA Consortium has established a framework for global collaboration that has resulted in the largest-ever neuroimaging studies of multiple psychiatric and neurological disorders. Here we describe the organization, recent progress, and future goals of the Brain Injury working group.
Topics: Brain Injuries, Traumatic; Humans; Multicenter Studies as Topic; Neuroimaging
PubMed: 32476212
DOI: 10.1002/hbm.25046 -
Clinics in Sports Medicine Jan 2011The rising awareness of the long-term health problems associated with concussions re-emphasizes the need for understanding the mechanical etiology of concussions. This... (Review)
Review
The rising awareness of the long-term health problems associated with concussions re-emphasizes the need for understanding the mechanical etiology of concussions. This article reviews past studies defining the common mechanisms for mild traumatic brain injury and summarizes efforts to convert the external input to the head (force, acceleration, and velocity) into estimates of motions and deformations of the brain that occur during mild traumatic brain injury. Studies of how these mechanical conditions contribute to the cellular mechanisms of damage in mild traumatic brain injury are reviewed. Finally, future directions for improving understanding concussion biomechanics are discussed.
Topics: Acceleration; Athletic Injuries; Biomechanical Phenomena; Brain Concussion; Brain Injuries; Energy Transfer; Humans; Population Surveillance; Risk Factors; United States
PubMed: 21074079
DOI: 10.1016/j.csm.2010.08.009 -
Cells Dec 2020Perinatal brain injury or neonatal encephalopathy (NE) is a state of disturbed neurological function in neonates, caused by a number of different aetiologies. The most... (Review)
Review
Perinatal brain injury or neonatal encephalopathy (NE) is a state of disturbed neurological function in neonates, caused by a number of different aetiologies. The most prominent cause of NE is hypoxic ischaemic encephalopathy, which can often induce seizures. NE and neonatal seizures are both associated with poor neurological outcomes, resulting in conditions such as cerebral palsy, epilepsy, autism, schizophrenia and intellectual disability. The current treatment strategies for NE and neonatal seizures have suboptimal success in effectively treating neonates. Therapeutic hypothermia is currently used to treat NE and has been shown to reduce morbidity and has neuroprotective effects. However, its success varies between developed and developing countries, most likely as a result of lack of sufficient resources. The first-line pharmacological treatment for NE is phenobarbital, followed by phenytoin, fosphenytoin and lidocaine as second-line treatments. While these drugs are mostly effective at halting seizure activity, they are associated with long-lasting adverse neurological effects on development. Over the last years, inflammation has been recognized as a trigger of NE and seizures, and evidence has indicated that this inflammation plays a role in the long-term neuronal damage experienced by survivors. Researchers are therefore investigating the possible neuroprotective effects that could be achieved by using anti-inflammatory drugs in the treatment of NE. In this review we will highlight the current knowledge of the inflammatory response after perinatal brain injury and what we can learn from animal models.
Topics: Animals; Brain Injuries; Cytokines; Disease Models, Animal; Female; Inflammation; Microglia; Pregnancy; Receptors, Purinergic; Toll-Like Receptors
PubMed: 33302543
DOI: 10.3390/cells9122640 -
Neurobiology of Disease Aug 2016In this review, we highlight critical unresolved questions in the etiology and mechanisms causing preterm brain injury. Involvement of neurons, glia, endogenous factors... (Review)
Review
In this review, we highlight critical unresolved questions in the etiology and mechanisms causing preterm brain injury. Involvement of neurons, glia, endogenous factors and exogenous exposures is considered. The structural and functional correlates of interrupted development and injury in the premature brain are under active investigation, with the hope that the cellular and molecular mechanisms underlying developmental abnormalities in the human preterm brain can be understood, prevented or repaired.
Topics: Animals; Brain; Brain Injuries; Humans
PubMed: 26477300
DOI: 10.1016/j.nbd.2015.10.012 -
Neurobiology of Disease Mar 2019Posttraumatic epilepsy (PTE) is one of the most debilitating and understudied consequences of traumatic brain injury (TBI). It is challenging to study the effects,... (Review)
Review
Posttraumatic epilepsy (PTE) is one of the most debilitating and understudied consequences of traumatic brain injury (TBI). It is challenging to study the effects, underlying pathophysiology, biomarkers, and treatment of TBI and PTE purely in human patients for a number of reasons. Rodent models can complement human PTE studies as they allow for the rigorous investigation into the causal relationship between TBI and PTE, the pathophysiological mechanisms of PTE, the validation and implementation of PTE biomarkers, and the assessment of PTE treatments, in a tightly controlled, time- and cost-efficient manner in experimental subjects known to be experiencing epileptogenic processes. This article will review several common rodent models of TBI and/or PTE, including their use in previous studies and discuss their relative strengths, limitations, and avenues for future research to advance our understanding and treatment of PTE.
Topics: Animals; Biomarkers; Brain Injuries, Traumatic; Disease Models, Animal; Epilepsy, Post-Traumatic; Humans; Mice; Rats; Risk Factors; Translational Research, Biomedical
PubMed: 30121231
DOI: 10.1016/j.nbd.2018.08.007 -
The Journal of Surgical Research Dec 2010To review the inflammatory sequelae of traumatic brain injury (TBI) and altitude exposure and discuss the potential impact of aeromedical evacuation (AE) on this process. (Review)
Review
BACKGROUND
To review the inflammatory sequelae of traumatic brain injury (TBI) and altitude exposure and discuss the potential impact of aeromedical evacuation (AE) on this process.
METHODS
Literature review and expert opinion regarding the inflammatory effects of TBI and AE.
RESULTS
Traumatic brain injury has been called the signature injury of the current military conflict. As a result of the increasing incidence of blast injury, TBI is responsible for significant mortality and enduring morbidity in injured soldiers. Common secondary insults resulting from post-traumatic cerebral inflammation are recognized to adversely impact outcome. AE utilizing Critical Care Air Transport Teams has become a standard of care practice following battlefield injury, to quickly and safely transport critically injured soldiers to more sophisticated echelons of care. Exposure to the hypobaric conditions of the AE process may impose an additional physiologic risk on the TBI patient as well as a "second hit" inflammatory stimulus.
CONCLUSIONS
We review the known inflammatory effects of TBI and altitude exposure and propose that optimizing the post-traumatic inflammatory profile may assist in determining an ideal time to fly for head-injured soldiers.
Topics: Aviation; Blast Injuries; Brain Injuries; Humans; Military Medicine; Military Personnel; Safety; Warfare; Wounds and Injuries
PubMed: 20006349
DOI: 10.1016/j.jss.2009.07.040 -
Annals of the Royal College of Surgeons... Jan 2016In the 20th century, the complications of head injuries were controlled but not eliminated. The wars of the 21st century turned attention to blast, the instant of impact... (Review)
Review
In the 20th century, the complications of head injuries were controlled but not eliminated. The wars of the 21st century turned attention to blast, the instant of impact and the primary injury of concussion. Computer calculations have established that in the first 5 milliseconds after the impact, four independent injuries on the brain are inflicted: 1) impact and its shockwave, 2) deceleration, 3) rotation and 4) skull deformity with vibration (or resonance). The recovery, pathology and symptoms after acute brain trauma have always been something of a puzzle. The variability of these four modes of injury, along with a variable reserve of neurones, explains some of this problem.
Topics: Acute Disease; Brain Injuries; Cognition; Diagnostic Imaging; Global Health; Humans; Incidence; Recovery of Function; Trauma Severity Indices
PubMed: 26688392
DOI: 10.1308/rcsann.2016.0003 -
The Journal of Trauma and Acute Care... Jan 2023Coagulopathy after traumatic brain injury (TBI) is common and has been closely associated with poor clinical outcomes for the affected patients. Traumatic brain... (Review)
Review
Coagulopathy after traumatic brain injury (TBI) is common and has been closely associated with poor clinical outcomes for the affected patients. Traumatic brain injury-induced coagulopathy (TBI-IC) is consumptive in nature and evolves rapidly from an injury-induced hypercoagulable state. Traumatic brain injury-induced coagulopathy defined by laboratory tests is significantly more frequent than clinical coagulopathy, which often manifests as secondary, recurrent, or delayed intracranial or intracerebral hemorrhage. This disparity between laboratory and clinical coagulopathies has hindered progress in understanding the pathogenesis of TBI-IC and developing more accurate and predictive tests for this severe TBI complication. In this review, we discuss laboratory tests used in clinical and research studies to define TBI-IC, with specific emphasis on what the tests detect and what they do not. We also offer perspective on developing more accurate and predictive tests for this severe TBI complication.
Topics: Humans; Brain Injuries, Traumatic; Blood Coagulation Disorders; Brain Injuries; Thrombophilia
PubMed: 35838367
DOI: 10.1097/TA.0000000000003748 -
Seizure Dec 2015Post-traumatic epilepsy continues to be a major concern for those experiencing traumatic brain injury. Post-traumatic epilepsy accounts for 10-20% of epilepsy cases in... (Review)
Review
Post-traumatic epilepsy continues to be a major concern for those experiencing traumatic brain injury. Post-traumatic epilepsy accounts for 10-20% of epilepsy cases in the general population. While seizure prophylaxis can prevent early onset seizures, no available treatments effectively prevent late-onset seizure. Little is known about the progression of neural injury over time and how this injury progression contributes to late onset seizure development. In this comprehensive review, we discuss the epidemiology and risk factors for post-traumatic epilepsy and the current pharmacologic agents used for treatment. We highlight limitations with the current approach and offer suggestions for remedying the knowledge gap. Critical to this pursuit is the design of pre-clinical models to investigate important mechanistic factors responsible for post-traumatic epilepsy development. We discuss what the current models have provided in terms of understanding acute injury and what is needed to advance understanding regarding late onset seizure. New model designs will be used to investigate novel pathways linking acute injury to chronic changes within the brain. Important components of this transition are likely mediated by toll-like receptors, neuroinflammation, and tauopathy. In the final section, we highlight current experimental therapies that may prove promising in preventing and treating post-traumatic epilepsy. By increasing understanding about post-traumatic epilepsy and injury expansion over time, it will be possible to design better treatments with specific molecular targets to prevent late-onset seizure occurrence following traumatic brain injury.
Topics: Brain Injuries; Epilepsy; Epilepsy, Post-Traumatic; Humans; Risk Factors
PubMed: 26519659
DOI: 10.1016/j.seizure.2015.10.002