Browsing by Subject "mild traumatic brain injury"

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  • Anttila, Emmi (Helsingin yliopisto, 2021)
    Mild traumatic brain injury (TBI) is defined as an injury that disrupts the normal functioning of the brain and is the result of external force to the head. It is the most common type of traumatic head injury, and it is common especially in contact sports and within military personnel. Mild TBI typically causes no clear structural changes to the head, but it can induce persistent clinical symptoms, as well as microscopic pathological changes to the brain that may eventually lead to neurodegeneration and increase the risk for several diseases. Mild TBI is a risk factor for several neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and chronic traumatic encephalopathy. The primary objective of this study was to develop a repetitive mild TBI mouse model for future research purposes in the field of head trauma and neurodegeneration. The injury was induced as a closed head injury with an electromagnetic impactor. Literature and pilot experiments were used to define the parameters of the impactor required to induce a brain injury of desired severity. The characterization criteria of the mild TBI model considered the criteria used to define human mild TBI, as well as long term effects often reported after repetitive mild TBI: neurodegeneration as tau protein related pathology, neuroinflammation, and memory deficits. The secondary objective of this study was to tentatively test a prolyl oligopeptidase (PREP) inhibitor on the behavioral and histological effects of mild TBI. The functioning of the mild TBI model was studied by histopathological and behavioral assessments. After baseline behavioral assessment and repetitive (1 injury every 24 hours altogether 5 times) mild TBI inductions, the mice were monitored for approximately 3 months, during which several rounds of behavioral tests were performed. Barnes maze and novel object recognition tests were used to assess memory functions, and locomotor activity test was used to assess general locomotor activity. After euthanasia, brain histopathology was performed to study the amount of tau protein and the level of neuroinflammation. Due to the low number of animals in the study, the results are directional and need to be confirmed in subsequent studies. The histopathology showed greater amount of neuroinflammation and tau protein in the brains of injured mice, but statistical evaluations could not be made. Memory functions were slightly worse in the injured mice compared to controls, but significance of the results is unclear. Locomotor activity was not influenced by the mild TBIs. PREP inhibition treatment increased the locomotor activity of the mice, but the significance is unclear. The mild TBI model seems promising and the characterization criteria were partially met. The results of the study need to be verified in subsequent studies with a greater amount of animals. The model developed here can be used to study the involvement of head trauma in neurodegeneration, as well as treatment alternatives to changes caused by mild TBIs. As there currently are no curative treatments to neurodegenerative diseases, research regarding neurodegeneration and its risk factors is highly important.
  • Kaltiainen, Hanna; Liljeström, Mia; Helle, Liisa; Salo, Anne; Hietanen, Marja; Renvall, Hanna; Forss, Nina (2019)
    Despite the high prevalence of mild traumatic brain injury (mTBI), current diagnostic tools to objectively assess cognitive complaints after mTBI continue to be inadequate. Our aim was to identify neuronal correlates for cognitive difficulties in mTBI patients by evaluating the possible alterations in oscillatory brain activity during a behavioral task known to be sensitive to cognitive impairment after mTBI. We compared oscillatory brain activity during rest and cognitive tasks (Paced Auditory Serial Addition Test [PASAT] and a vigilance test [VT]) with magnetoencephalography between 25 mTBI patients and 20 healthy controls. Whereas VT induced no significant differences compared with resting state in either group, patients exhibited stronger attenuation of 8- to 14-Hz oscillatory activity during PASAT than healthy controls in the left parietotemporal cortex (p
  • CENTER TBI Study Pa; Mikolic, Ana; Polinder, Suzanne; Steyerberg, Ewout W.; van Klaveren, David; Palotie, Aarno; Piippo-Karjalainen, Anna; Pirinen, Matti; Raj, Rahul; Ripatti, Samuli (2021)
    The majority of traumatic brain injuries (TBIs) are categorized as mild, according to a baseline Glasgow Coma Scale (GCS) score of 13-15. Prognostic models that were developed to predict functional outcome and persistent post-concussive symptoms (PPCS) after mild TBI have rarely been externally validated. We aimed to externally validate models predicting 3-12-month Glasgow Outcome Scale Extended (GOSE) or PPCS in adults with mild TBI. We analyzed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project, which included 2862 adults with mild TBI, with 6-month GOSE available for 2374 and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) results available for 1605 participants. Model performance was evaluated based on calibration (graphically and characterized by slope and intercept) and discrimination (C-index). We validated five published models for 6-month GOSE and three for 6-month PPCS scores. The models used different cutoffs for outcome and some included symptoms measured 2 weeks post-injury. Discriminative ability varied substantially (C-index between 0.58 and 0.79). The models developed in the Corticosteroid Randomisation After Significant Head Injury (CRASH) trial for prediction of GOSE
  • Huovinen, Antti (Helsingin yliopisto, 2020)
    Tausta: Traumaattisen aksonaalisen vaurion (TAI) merkitystä prognostisena tekijänä lievässä traumaattisessa aivovammassa ei ole tutkittu tarpeeksi. Yksittäisiä tutkimuksia löytyy TAI:n merkityksestä oireisuuteen ja kokonaisvaltaiseen toipumiseen lievän aivovamman jälkeen, mutta kirjallisuudessa ei löydy viitteitä, jotka suoraan tutkisivat lievillä aivovammapotilailla TAI-leesioiden vaikutusta työhönpaluuseen Tavoitteet: Tavoitteena on tutkia, mikä on traumaattisen aksonaalisen vaurion prognostinen merkitys työhönpaluuseen, posttraumaattisiin persistoiviin oireisiin sekä kokonaisvaltaiseen toipumiseen lievän traumaattisen aivovamman jälkeen. Metodit: Tutkimus sisälsi 113 prospektiivisesti kerättyä lievän aivovamman saanutta työikäistä ja työssäkäyvää potilasta. Akuuttivaiheen jälkeen potilaat lähetettiin HUS Aivovammapoliklinikalle neurologin arvioon noin kuukauden kuluessa tapaturmasta. Tätä edeltävästi potilaat kävivät 3T MRI-tutkimuksessa 3-17 vuorokauden sisällä vammasta. HUS Aivovammapoliklinikalla arvioitiin myös oireisuus Rivermead Post-Concussion Symptom Questionnaire -kyselyllä (RPQ) ja kokonaisvaltainen toipuminen Glasgow Outcome Scale Extended -mittarin (GOS-E) avulla. Työhönpaluu arvioitiin retrospektiivisesti jatkuvana muuttujana ja onnistunut työhönpaluu varmistettiin strukturoidulla puhelinhaastattelulla. Tulokset: 98,2% aivovammapotilaista oli palannut työelämään vuoden kohdalla. Työhönpaluuajan mediaani oli 9 vuorokautta. TAI-potilaat (n=22) eivät tilastollisesti eronneet muista lievän aivovamman saaneista potilaista oireisuuden suhteen, ja heidän kokonaisvaltainen toipuminen oli yhtä hyvää. Työhönpaluuajoissa ei ollut tilastollisesti merkittävää eroa ryhmien välillä. Pohdinta ja johtopäätökset: Tutkimuksessa TAI-potilaat toipuivat yhtä hyvin kuin muut lievän aivovamman saaneet potilaat. Traumaattinen aksonaalinen vaurio ei välttämättä ole prognostinen tekijä työhönpaluulle lievässä aivovammassa. Sen sijaan, että tavoittelisimme yhä tarkempia kuvantamismenetelmiä, jatkossa syytä olisi keskittyä muihin riskitekijöihin sekä suojaaviin tekijöihin, jotka vaikuttavat lievästä aivovammasta toipumiseen.