Abstract:
:Diagnosis and early prognosis of the vegetative state/unresponsive wakefulness syndrome (VS/UWS) and its differentiation from the minimally-conscious state still rest on the clinical observation of responsiveness. The incidence of established clinical indicators of responsiveness also has proven variable in the single subject and is correlated to measures of heart rate variability (HRV) describing the sympathetic/parasympathetic balance. We tested responsiveness when the HRV descriptors nuLF and peakLF were or were not in the ranges with highest incidence of response based on findings from previous studies (10.0-70.0 and 0.05-0.11 Hz, respectively). Testing was blind by The Coma Recovery Scale-revised in the two conditions and in two experimental sessions with a one-week interval. The incidence of responses was not randomly distributed in the "response" and "no-response" conditions (McNemar test; p < 0.0001). The observed incidence in the "response" condition (visual: 55.1%; auditory: 51.5%) was higher than predicted statistically (32.1%) or described in previous clinical studies; responses were only occasional in the "no-response" condition (visual, 15.9%; auditory, 13.4%). Models validated the predictability with high accuracy. The current clinical criteria for diagnosis and prognosis based on neurological signs should be reconsidered, including variability over time and the autonomic system functional state, which could also qualify per se as an independent indicator for diagnosis and prognosis.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Riganello F,Cortese MD,Dolce G,Lucca LF,Sannita WGdoi
10.1089/neu.2014.3539subject
Has Abstractpub_date
2015-07-15 00:00:00pages
1071-7issue
14eissn
0897-7151issn
1557-9042journal_volume
32pub_type
杂志文章abstract::Despite clinical symptoms, a large majority of people with mild traumatic brain injury (TBI) have normal computed tomography (CT) and magnetic resonance imaging (MRI) scans. Therefore, present-day neuroimaging tools are insufficient to diagnose or classify low grades of TBI. Advanced neuroimaging techniques, such as d...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2020.7151
更新日期:2021-01-11 00:00:00
abstract::Endothelial progenitor cells (EPCs) play a key role in tissue repair and regeneration. Previous studies have shown a positive correlation between the number of circulating EPCs and clinical outcomes of patients with traumatic brain injury (TBI). A recent study has further shown that intravenous infusion of human umbil...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.2996
更新日期:2013-12-15 00:00:00
abstract::Prevention of the immediate excitotoxic phase occurring in response to spinal cord injury (SCI) is a major issue to reduce the neuronal damage responsible for any ensuing motor deficits. The present study evaluated the neuroprotective efficacy of three noncompetitive NMDA receptor antagonists: Gacyclidine (GK-11), a n...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2000.17.1079
更新日期:2000-11-01 00:00:00
abstract::Clinical trials aimed at developing therapies for traumatic brain injury (TBI) require outcome measures that are reliable, validated, and easily administered. The most widely used of these measures, the Glasgow Outcome Scale (GOS) and the GOS-Extended (GOS-E), have been criticized as suffering from ceiling effects. In...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.1319
更新日期:2005-11-01 00:00:00
abstract::Remarkable advances have been made in pharmacologic treatments of acute and chronic spinal cord injury. The recent National Acute Spinal Cord Injury Study (NASCIS) showed that very high dose methylprednisolone given within 8 hr after injury improves neurologic recovery. The mechanism is believed to be inhibition of li...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::Recent calls have been made for the inclusion of health-related quality of life (HRQoL) in traumatic brain injury studies. This study reports the impact of TBI on traditional measures (general health, depression, social isolation, labor force participation), self-assessed health function status using the SF-36 version...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0735
更新日期:2009-10-01 00:00:00
abstract::Talampanel [(R)-7-acetyl-5-(4-aminophenyl)-8,9-dihydro-8-methyl-7H-1,3-dioxolo[4,5-h][2,3] benzodiazepine] is an orally active noncompetitive antagonist of the AMPA subtype of glutamate excitatory amino acid receptors. The purpose of this study was to determine whether treatment with talampanel would protect in a rat ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150152693728
更新日期:2001-10-01 00:00:00
abstract::We investigated the activation of lower limb motor pools by supraspinal and spinal networks after human spinal cord injury (SCI). We compared electromyographic (EMG) activity from six muscles during voluntarily attempted non-weight-bearing single-joint movements, multijoint movements approximating stepping in a supine...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150260338010
更新日期:2002-10-01 00:00:00
abstract::Clinical scenario: A 37-year-old man suffered a complete spinal cord injury (C8, American Spinal Injury Association Impairment Scale [ASIA] score A) 10 years ago in a car accident. Should primary prevention of cardiovascular disease be a priority in this patient? In order to answer this question, we performed a system...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2012.2313
更新日期:2012-07-20 00:00:00
abstract::Traumatic brain injury (TBI) is a major cause of death and disability and impairs health-related quality of life (HRQOL). Psychiatric disorders have been recognized as major components of TBI morbidity, yet few studies have addressed the relationship between these outcomes. Sample size, selection bias, and retrospecti...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2089
更新日期:2012-04-10 00:00:00
abstract::The generation of oxygen radicals and the process of lipid peroxidation have become a focus of attention for investigators in the fields of central nervous system (CNS) injury and stroke (e.g., ischemia). While absolute proof for their involvement in the pathophysiology of traumatic and ischemic damage to the CNS rema...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::Heterogeneity within brain injury presents a challenge to the development of informative molecular diagnostics. Recent studies show progress, particularly in cerebrospinal fluid, with biomarker assays targeting one or a few structural proteins. Protein-based assays in peripheral fluids, however, have been more challen...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.3116
更新日期:2014-04-15 00:00:00
abstract::The etiology of multiple sclerosis (MS) is still not well known. Previous data show conflicting results regarding the association between MS and prior brain trauma. This study aims to investigate the risk for MS following a traumatic brain injury (TBI) using a large-scale cohort study design. This study used data from...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.1936
更新日期:2012-01-01 00:00:00
abstract::The lack of effective therapies for moderate-to-severe traumatic brain injuries (TBIs) leaves patients with lifelong disabilities. Neural stem cells (NSCs) have demonstrated great promise for neural repair and regeneration. However, direct evidence to support their use as a cell replacement therapy for neural injuries...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6443
更新日期:2020-06-01 00:00:00
abstract::Traumatic brain injury (TBI) is a major health problem causing disability and death worldwide. There is no effective treatment, due in part to the complexity of the injury pathology and factors affecting its outcome. The extent of brain injury depends on the type of insult, age, sex, lifestyle, genetic risk factors, s...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6955
更新日期:2020-03-01 00:00:00
abstract::This paper encompasses the prediction of early and late recovery from traumatic brain injury (TBI). Predictors of the duration of coma and the utilization of posttraumatic amnesia duration to predict residual memory function are discussed. The issues surrounding prediction of long-term neurobehavioral recovery from TB...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.1995.12.913
更新日期:1995-10-01 00:00:00
abstract::4-Aminopyridine (4AP), a potassium channel antagonist, can improve hindlimb motor function in dogs with chronic thoracolumbar spinal cord injury (SCI); however, individual response is variable. We hypothesized that injury characteristics would differ between dogs that do and do not respond to 4AP. Our objective was to...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.5975
更新日期:2019-05-01 00:00:00
abstract::Non-human primate (NHP) models of spinal cord injury better reflect human injury and provide a better foundation to evaluate potential treatments and functional outcomes. We combined finite element (FE) and surrogate models with impact data derived from in vivo experiments to define the impact mechanics needed to gene...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.3974
更新日期:2016-06-15 00:00:00
abstract::Recently, locomotor training has been shown to improve overground locomotion in patients with spinal cord injury (SCI). This has triggered renewed interest in the role of exercise in rehabilitation after SCI. However, there are no mouse models for voluntary exercise and recovery of function following SCI. Here, we rep...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.157
更新日期:2005-01-01 00:00:00
abstract::Despite limited evidence to support the use of amantadine to enhance cognitive function after traumatic brain injury (TBI), the clinical use for this purpose is highly prevalent and is often based on inferred belief systems. The aim of this study was to assess effect of amantadine on cognition among individuals with a...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/neu.2018.5767
更新日期:2018-10-01 00:00:00
abstract::Severe traumatic brain injury (TBI) is one of the major causes of death in younger age groups. In Umeå, Sweden, an intracranial pressure (ICP) targeted therapy protocol, the Lund concept, has been used in treatment of severe TBI since 1994. Decompressive craniectomy is used as a protocol-guided treatment step. The pri...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.356E
更新日期:2007-06-01 00:00:00
abstract::In human diffuse axonal injury (DAI), axons are exposed to transient tensile strain. Over the ensuing several hours, injured axons enter a "pathological cascade" of events that lead to secondary axotomy. Use of animal models of traumatic axonal injury (TAI) has allowed description of a number of pathological changes b...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1999.16.1225
更新日期:1999-12-01 00:00:00
abstract::Changes in the modes of cerebrovascular pressure transmission during cerebral vasodilation induced by hypercapnic challenge were examined as a means for developing the basis for a bedside method to evaluate regulation of cerebral blood flow. Recordings of arterial blood pressure (ABP) and intracranial pressure (ICP) o...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.0129
更新日期:2007-03-01 00:00:00
abstract::To examine the mechanism of the increase in cerebral blood flow induced by L-arginine administration after traumatic brain injury, the cerebral hemodynamic effects of L-arginine, D-arginine, and the free radical scavengers superoxide dismutase (SOD) and catalase were compared in the controlled cortical impact injury m...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150360517209
更新日期:2003-01-01 00:00:00
abstract::Bone marrow stromal cells (BMSC) transplanted into the contused spinal cord may support repair by improving tissue sparing. We injected allogeneic BMSC into the moderately contused adult rat thoracic spinal cord at 15 min (acute) and at 3, 7, and 21 days (delayed) post-injury and quantified tissue sparing and BMSC sur...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2009.0987
更新日期:2009-12-01 00:00:00
abstract::Magnetic resonance imaging data were acquired at ∼24 h and ∼3 months post-injury on mild traumatic brain injury (mTBI; n = 75) and orthopedic injury (n = 60) cohorts. The mTBI subjects were randomly assigned to a treatment group with atorvastatin or a non-treatment mTBI group. The treatment group was further divided i...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,随机对照试验
doi:10.1089/neu.2015.4253
更新日期:2016-10-15 00:00:00
abstract::Striatal-enriched tyrosine phosphatase (STEP) has been identified as a component of physiological and pathophysiological signaling pathways mediated by N-methyl-d-aspartate (NMDA) receptor/calcineurin/calpain activation. Activation of these pathways produces a subsequent change in STEP isoform expression or activation...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2253
更新日期:2012-07-01 00:00:00
abstract::Older adults tend to have poorer outcomes compared to younger adults following moderate-to-severe traumatic brain injury (TBI). Currently, there is a need for research focusing on how elderly TBI has changed as the U.S. population shifts. This study provides a statewide account of moderate-to-severe TBI in regard to i...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2197
更新日期:2012-05-01 00:00:00
abstract::Several behavioral factors such as violence, impulsivity, and alcohol-related problems are associated with traumatic spinal cord injury (TSCI). Such factors have been associated with inherently low neuronal serotonergic capacity that in turn is reflected in low activity of monoamine oxidase (MAO) as measured in platel...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4462
更新日期:2016-11-01 00:00:00
abstract::Our aim for this study was to quantitatively develop an early epidural hematoma (EDH) natural evolutionary curve and assess association of the most common radiological signs of initially nonsurgical supratentorial EDHs on early computed tomography (CT), in addition to their CT time for EDH enlargement. We retrospectiv...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究
doi:10.1089/neu.2013.3297
更新日期:2015-04-01 00:00:00