Chronic Hypopituitarism After Traumatic Brain Injury

Bavisetty, Sumati; Bavisetty, Supriya; McArthur, David L.; Dusick, Joshua R.; Wang, Christina; Boscardin, W. John; Swerdloff, Ronald S.; Levin, Harvey S.; Chang, Dongwoo John; Muizelaar, J. Paul; Kelly, Daniel F.

doi:10.1227/01.neu.0000313577.16309.cd

Cited by 4 publications

(5 citation statements)

References 79 publications

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“…Focal structural brain damage is thought to be able to generate fatigue through the disruption of definite neural circuits. Brain areas that are considered to play a role in fatigue perception include brainstem structures such as the ascending reticular formation and the monaminergic nuclei (Blomstrand et al, 1989; Staub & Bogousslavsky, 2001), as well as hypothalamic and diencephalic regions (Bavisetty et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…It can be assessed with self-report scales and it seems to be associated with quality of life reduction independently of physical disability (Chaudhuri & Behan, 2004). To date, the bases of fatigue are still incompletely understood; different physiopathological mechanisms have been proposed including mono-aminergic dysfunctions (Blomstrand, Perrett, Parry-Billings, & Newsholme, 1989) and neuroendocrine deficits (Bavisetty et al, 2008). The role of global brain white and gray matter damage in MS-related fatigue has been investigated in different studies (de Lange et al, 2005; Tedeschi et al, 2007), but also injury of distinct anatomical networks seems to be relevant in fatigue.…”

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confidence: 99%

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Frontal networks play a role in fatigue perception in multiple sclerosis.

Pardini

Bonzano

Mancardi

et al. 2010

Behavioral Neuroscience

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Fatigue, an overwhelming lack of physical or mental energy, is a common complaint in patients affected by multiple sclerosis (MS). Although different mechanisms have been proposed to explain MS-related fatigue, injury of distinct anatomical networks seems to be relevant in fatigue etiology. Particularly, theories point to fronto-striatal network pathological changes as a possible neural basis of fatigue. To investigate the role of fronto-striatal white matter structural alterations in fatigue perception we prospectively recruited 40 relapsing remitting patients with MS and 15 healthy controls. In patients with MS, fatigue was assessed using a validated measure, the Modified Fatigue Impact Scale (MFIS; Kos et al., 2005). Brain MRI scans were acquired for each subject enrolled with diffusion tensor imaging. Diffusion tensor data were correlated with MFIS scores using voxel-wise analysis of fractional anisotropy maps and fiber tractography algorithms. A significant cluster of voxels correlating with fatigue scores located in the deep left frontal white matter was identified. Fiber tractography revealed the cluster to be included in a complex fronto-frontal, fronto-striatal, fronto-occipital, and fronto-limbic network. Structural properties of the traced white matter fiber bundles correlated with fatigue perception and patients with clinically relevant fatigue were found to present reduced white matter integrity in the aforementioned tracts compared to those with lower levels of fatigue. Our observations show a significant involvement of different frontal networks in the pathophysiology of fatigue, thus accounting for the multifaceted nature of this disabling symptom.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Frontal networks play a role in fatigue perception in multiple sclerosis.

Pardini

Bonzano

Mancardi

et al. 2010

Behavioral Neuroscience

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“…Following severe TBI, a disruption in local blood flow (25) can cause ischemia and eventually causes hypoxia on the brain. Hyperglycaemia serves as an inhibitor of the tricarboxylic acid cycle and it causes anaerobic glycolysis which underlies the accumulation of lactic acid mechanism and impaired pH homeostasis (26,27).…”

Section: Discussionmentioning

confidence: 99%

Hyperglycaemia on admission-related mortality in patients with severe traumatic brain injury: A systematic review and meta-analysis

Danta¹,

Quila²

2023

Acta fac medic Naissensis

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Introduction: This present study focuses on the findings of clinical trials that have revealed unsatisfactory results and mortality escalation rates of patients suffering from serious traumatic brain injuries (TBI). Aim: The main objective of this research was to investigate whether hyperglycaemia is a significant indicator of mortality in patients with the diagnosis of severe TBI. Methods: The research was performed using meta-analysis. The research material was collected throughout PubMed, Cochrane, NCBI, and Google Scholar from 2010 to 2020. Results: The research subjects were patients with TBI, proven to have hyperglycaemia on admission (random blood sugar evaluation > 200 mg/dl on arrival at the emergency department), with or without a history of DM (HbA1C evaluation ≥ 6.5%), a Glasgow Coma Scale score ≤ 8, and aged 0 - 100 years. The pooled risk ratio (RR) for mortality in severe TBI with hyperglycaemia on admission was 2.39. The evidence of mortality appeared significantly greater in patients with TBI with hyperglycaemia on admission than in those with normal blood glucose levels (RR = 2.39, p < 0.00001). The pooled RR had wide heterogeneity (I2 = 0.87), so the random-effect model was used. Conclusion: Hyperglycaemia on admission is often associated with unsatisfactory clinical outcomes and greater mortality.

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“…Although the exact underlying pathogenesis of PTHP has not yet been elucidated, various theories have been studied. A widely-accepted hypothesis suggests that as a consequence of a TBI, there is an ischemic insult to the pituitary gland [64]. The long hypophysial vessels are in particular vulnerable to vascular injury.…”

Section: Pituitary Dysfunctionmentioning

confidence: 99%

Biomechanics of Traumatic Head and Neck Injuries on Women: A State-of-the-Art Review and Future Directions

Carmo

Grigioni²,

Fernandes³

et al. 2023

Biology

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The biomechanics of traumatic injuries of the human body as a consequence of road crashes, falling, contact sports, and military environments have been studied for decades. In particular, traumatic brain injury (TBI), the so-called “silent epidemic”, is the traumatic insult responsible for the greatest percentage of death and disability, justifying the relevance of this research topic. Despite its great importance, only recently have research groups started to seriously consider the sex differences regarding the morphology and physiology of women, which differs from men and may result in a specific outcome for a given traumatic event. This work aims to provide a summary of the contributions given in this field so far, from clinical reports to numerical models, covering not only the direct injuries from inertial loading scenarios but also the role sex plays in the conditions that precede an accident, and post-traumatic events, with an emphasis on neuroendocrine dysfunctions and chronic traumatic encephalopathy. A review on finite element head models and finite element neck models for the study of specific traumatic events is also performed, discussing whether sex was a factor in validating them. Based on the information collected, improvement perspectives and future directions are discussed.

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Chronic Hypopituitarism After Traumatic Brain Injury

Cited by 4 publications

References 79 publications

Frontal networks play a role in fatigue perception in multiple sclerosis.

Frontal networks play a role in fatigue perception in multiple sclerosis.

Hyperglycaemia on admission-related mortality in patients with severe traumatic brain injury: A systematic review and meta-analysis

Biomechanics of Traumatic Head and Neck Injuries on Women: A State-of-the-Art Review and Future Directions

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