Traumatic CNS Injury: From Bench to Bedside

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 4219

Special Issue Editor


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Guest Editor
Neurosciences Institute, INUB-MEDITECH Research Group, El Bosque University, Bogotá 113033, Colombia
Interests: trauma; neurotrauma; prehospital care; emergency care; critical care; trauma surgery
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Special Issue Information

Dear Colleagues,

In the field of CNS traumatic injury, taking results from the laboratory into the clinic that can directly benefit patients is often a very lengthy and complex process.

In recent decades, several areas linked to the care of these patients have evolved from the diagnosis point to medical and surgical care. The introduction of biomarkers and new technological devices for better selection of the most critical patients has shown a trend towards more precise treatment pathways.

Additionally, recent clinical studies, involving medical and surgical therapies, have also shown which interventions definitively work or not and how they can be managed in different contexts.

This linear process seems straightforward, but we all know how many barriers can be met in the scientific process. Issues related to methodological designs, selection bias and difficulties with the preclinical models can be associated with different impacts over the results.

The aim of this Special Issue is to provide an opportunity to share different kinds of primary and secondary studies where all these aspects of the translation of science could be highlighted with the focus of very deep and detailed messages to take home for scientists dedicated to the care of these patients worldwide, in different settings and with different levels of resource availability.

Prof. Dr. Andres M. Rubiano
Guest Editor

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Keywords

  • neurotrauma
  • traumatic brain injury
  • translational science
  • bench to bedside
  • neuroprotection

Published Papers (4 papers)

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Research

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14 pages, 2616 KiB  
Article
The Relationship between Injury Characteristics and Post-Traumatic Recovery after Diffuse Axonal Injury
by Rita de Cássia Almeida Vieira, Leonardo Zumerkorn Pipek, Daniel Vieira de Oliveira, Wellingson Silva Paiva and Regina Marcia Cardoso de Sousa
Biomedicines 2024, 12(2), 311; https://doi.org/10.3390/biomedicines12020311 - 29 Jan 2024
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Abstract
Background: The diagnosis and prognosis of diffuse axonal injury (DAI) remain challenging. This research aimed to analyze the impact on activities of daily living (ADL), functional outcomes, quality of life (QoL), and the association between lesion severity and DAI location identified through imaging [...] Read more.
Background: The diagnosis and prognosis of diffuse axonal injury (DAI) remain challenging. This research aimed to analyze the impact on activities of daily living (ADL), functional outcomes, quality of life (QoL), and the association between lesion severity and DAI location identified through imaging exams. Methods: This prospective cohort study included 95 patients diagnosed with DAI. Data were collected at admission, three, six, and twelve months post-injury. The associations between variables were evaluated using a mixed-effects model. Results: Functional recovery and QoL improved between three and twelve months after DAI. An interaction was observed between independence in performing ADL and subarachnoid hemorrhage (p = 0.043) and intraventricular hemorrhage (p = 0.012). Additionally, an interaction over time was observed between the Glasgow Outcome Scale (GOS) and DAI severity (p < 0.001), brain lesions (p = 0.014), and the Disability Rating Scale (DRS) with injury in brain hemispheres (p = 0.026) and Adams classification (p = 0.013). Interaction effects over time were observed with the general health perceptions and energy/vitality domains with intraventricular hemorrhage, and the social functioning domain with the obliteration of basal cisterns and Gentry’s classification. Conclusion: The use of CT in the acute phase of DAI is important for predicting outcomes. The severity and location of DAI are associated with functional outcomes, ADL, and QoL. Full article
(This article belongs to the Special Issue Traumatic CNS Injury: From Bench to Bedside)
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9 pages, 430 KiB  
Article
Wessex Head Injury Matrix in Patients with Prolonged Disorders of Consciousness: A Reliability Study
by Maria Daniela Cortese, Francesco Arcuri, Martina Vatrano, Giovanni Pioggia, Antonio Cerasa, Maria Girolama Raso, Paolo Tonin and Francesco Riganello
Biomedicines 2024, 12(1), 82; https://doi.org/10.3390/biomedicines12010082 - 28 Dec 2023
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Abstract
Introduction: The Wessex Head Injury Matrix (WHIM) was developed to assess patients with disorders of consciousness (DOC) and was tested in terms of inter-rater reliability (IRR) and test–retest reliability (TRR) in the year 2000. The American Congress of Rehabilitation and Medicine reported that [...] Read more.
Introduction: The Wessex Head Injury Matrix (WHIM) was developed to assess patients with disorders of consciousness (DOC) and was tested in terms of inter-rater reliability (IRR) and test–retest reliability (TRR) in the year 2000. The American Congress of Rehabilitation and Medicine reported that IRR and TRR were unproven. We aim to assess the reliability of the WHIM in prolonged DOC patients (PDOC). Methods: A total of 51 PDOC patients (32 unresponsive wakefulness syndrome (UWS/VS) and 19 minimally conscious state (MCS)) who were hosted in a dedicated unit for long-term brain injury care were enrolled. The time from injury ranged from 182 to 3325 days. Two raters administered the Coma Recovery Scale-Revised (CRS-R) and the WHIM to test the IRR and TRR. The TRR was administered two weeks after the first assessment. Results: For the CRS-R, the agreement in IRR and TRR was perfect between the two raters. The agreement for the WHIM ranged from substantial to almost perfect for IRR and from fair to substantial for the TRR. Conclusions: The WHIM showed a strong IRR when administered by expert raters and strongly correlated with the CRS-R. This study provides further evidence of the psychometric qualities of the WHIM and the importance of its use in PDOC patients. Full article
(This article belongs to the Special Issue Traumatic CNS Injury: From Bench to Bedside)
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14 pages, 3055 KiB  
Article
Prognostic Value of Plasma Biomarkers S100B and Osteopontin in Pediatric TBI: A Prospective Analysis Evaluating Acute and 6-Month Outcomes after Mild to Severe TBI
by Laura S. Blackwell, Bushra Wali, Yijin Xiang, Ali Alawieh, Iqbal Sayeed and Andrew Reisner
Biomedicines 2023, 11(8), 2167; https://doi.org/10.3390/biomedicines11082167 - 1 Aug 2023
Cited by 3 | Viewed by 928
Abstract
Blood based traumatic brain injury (TBI) biomarkers offer additional diagnostic, therapeutic, and prognostic utility. While adult studies are robust, the pediatric population is less well studied. We sought to determine whether plasma osteopontin (OPN) and S100B alone or in combination predict mortality, head [...] Read more.
Blood based traumatic brain injury (TBI) biomarkers offer additional diagnostic, therapeutic, and prognostic utility. While adult studies are robust, the pediatric population is less well studied. We sought to determine whether plasma osteopontin (OPN) and S100B alone or in combination predict mortality, head Computed tomography (CT) findings, as well as 6-month functional outcomes after TBI in children. This is a prospective, observational study between March 2017 and June 2021 at a tertiary pediatric hospital. The sample included children with a diagnosed head injury of any severity admitted to the Emergency Department. Control patients sustained trauma-related injuries and no known head trauma. Serial blood samples were collected at admission, as well as at 24, 48, and 72 h. Patient demographics, acute clinical symptoms, head CT, and 6-month follow-up using the Glasgow outcome scale, extended for pediatrics (GOSE-Peds), were also obtained. The cohort included 460 children (ages 0 to 21 years) and reflected the race and sex distribution of the population served. Linear mixed effect models and logistic regressions were utilized to evaluate the trajectory of biomarkers over time and predictors of dichotomous outcomes. Both OPN and S100B correlated with injury severity based on GCS. S100B and OPN showed lower AUC values (0.59) in predicting positive head CT. S100B had the largest AUC (0.87) in predicting mortality, as well as 6-month outcomes (0.85). The combination of the two biomarkers did not add meaningfully to the model. Our findings continue to support the utility of OPN as a marker of injury severity in this population. Our findings also show the importance of S100B in predicting mortality and 6-month functional outcomes. Continued work is needed to examine the influence of age-dependent neurodevelopment on TBI biomarker profiles in children. Full article
(This article belongs to the Special Issue Traumatic CNS Injury: From Bench to Bedside)
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Review

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18 pages, 1673 KiB  
Review
Pathophysiology-Based Management of Secondary Injuries and Insults in TBI
by Leonardo de Macedo Filho, Luisa F. Figueredo, Gustavo Adolfo Villegas-Gomez, Matthew Arthur, Maria Camila Pedraza-Ciro, Henrique Martins, Joaquim Kanawati Neto, Gregory J. Hawryluk and Robson Luís Oliveira Amorim
Biomedicines 2024, 12(3), 520; https://doi.org/10.3390/biomedicines12030520 - 26 Feb 2024
Cited by 1 | Viewed by 1007
Abstract
Traumatic Brain Injury (TBI) remains a leading cause of morbidity and mortality among all ages; despite the advances, understanding pathophysiological responses after TBI is still complex, involving multiple mechanisms. Previous reviews have focused on potential targets; however, the research on potential targets has [...] Read more.
Traumatic Brain Injury (TBI) remains a leading cause of morbidity and mortality among all ages; despite the advances, understanding pathophysiological responses after TBI is still complex, involving multiple mechanisms. Previous reviews have focused on potential targets; however, the research on potential targets has continuously grown in the last five years, bringing even more alternatives and elucidating previous mechanisms. Knowing the key and updated pathophysiology concepts is vital for adequate management and better outcomes. This article reviews the underlying molecular mechanisms, the latest updates, and future directions for pathophysiology-based TBI management. Full article
(This article belongs to the Special Issue Traumatic CNS Injury: From Bench to Bedside)
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