Incidence of Traumatic Brain Injury in the United States, 2003

Rutland-Brown, Wesley; Langlois, Jean; Thomas, Karen E.; Xi, Yongli

doi:10.1097/00001199-200611000-00009

Cited by 719 publications

(454 citation statements)

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“…Traumatic brain injury (TBI), a major cause of death and disability, annually accounts for 2.5 million Emergency Department visits, 52,000 deaths and 92,000 survivors with disability in the United States alone 1. It is estimated that the prevalence of Americans with chronic TBI‐related disability is 5.3 million 2, 3, 4, 5.…”

Section: Introductionmentioning

confidence: 99%

Phosphodiesterase‐5 inhibition potentiates cerebrovascular reactivity in chronic traumatic brain injury

Kenney

Amyot

Moore

et al. 2018

Ann Clin Transl Neurol

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BackgroundTraumatic cerebrovascular injury (TCVI), a common consequence of traumatic brain injury (TBI), presents an attractive therapeutic target. Because phosphodiesterase‐5 (PDE5) inhibitors potentiate the action of nitric oxide (NO) produced by endothelial cells, they are candidate therapies for TCVI. This study aims to: (1) measure cerebral blood flow (CBF), cerebrovascular reactivity (CVR), and change in CVR after a single dose of sildenafil (ΔCVR) in chronic TBI compared to uninjured controls; (2) examine the safety and tolerability of 8‐week sildenafil administration in chronic symptomatic moderate/severe TBI patients; and as an exploratory aim, (3) assess the effect of an 8‐week course of sildenafil on chronic TBI symptoms.MethodsForty‐six subjects (31 chronic TBI, 15 matched healthy volunteers) were enrolled. Baseline CBF and CVR before and after administration of sildenafil were measured. Symptomatic TBI subjects then completed an 8‐week double‐blind, placebo‐controlled, crossover trial of sildenafil. A neuropsychological battery and neurobehavioral symptom questionnaires were administered at each study visit.ResultsAfter a single dose of sildenafil, TBI subjects showed a significant increase in global CVR compared to healthy controls (P < 0.001, d = 0.9). Post‐sildenafil CVR maps showed near‐normalization of CVR in many regions where baseline CVR was low, predominantly within areas without structural abnormalities. Sildenafil was well tolerated. Clinical Global Impression (CGI) scale showed a trend toward clinical improvement while on sildenafil treatment.FindingsSingle‐dose sildenafil improves regional CVR deficits in chronic TBI patients. CVR and ΔCVR are potential predictive and pharmacodynamic biomarkers of PDE5 inhibitor therapy for TCVI. Sildenafil is a potential therapy for TCVI.

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Section: Introductionmentioning

confidence: 99%

Phosphodiesterase‐5 inhibition potentiates cerebrovascular reactivity in chronic traumatic brain injury

Kenney

Amyot

Moore

et al. 2018

Ann Clin Transl Neurol

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“…The United States Government's Center for Disease Control (CDC) estimates that there are more than one million concussions that occur annually in the United States, using their definitional statement of concussion being a condition "of temporarily altered mental status as a result of head trauma (www.cdc.gov, see Rutland-Brown et al, 2006). "…”

Section: Introduction: Brief History Of Concussionmentioning

confidence: 99%

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Bigler

2007

J Int Neuropsychol Soc

358

248

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On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion. These studies implicate common regions of injury, including the upper brainstem, base of the frontal lobe, hypothalamic-pituitary axis, medial temporal lobe, fornix, and corpus callosum. Limitations of current neuropsychological techniques for the clinical assessment of memory and executive function are explored and recommendations for improved research designs offered, that may enhance the study of long-term neuropsychological sequelae of concussion. (JINS, 2008, 14, 1-22.)

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“…Among the survivors, 80,000 to 90,000 individuals are left with significant long-term cognitive and motor disabilities (Jacobs, 1988;Max, Rice, & MacKenzie, 1990;McKinlay, Brooks, Bond, Martinage, & Marshall, 1981;Rutland-Brown, Langlois, Thomas, & Xi, 2006;Thomsen, 1984;Thurman, Alverson, Dunn, Guerrero, & Sniezek, 1999). However, efforts to identify the neuropathologic correlates of these deficits have gained only limited success to date (Bigler, 2001a;Levine et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Structural consequences of diffuse traumatic brain injury: A large deformation tensor-based morphometry study

et al. 2008

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Traumatic brain injury (TBI) is one of the most common causes of long-term disability. Despite the importance of identifying neuropathology in individuals with chronic TBI, methodological challenges posed at the stage of inter-subject image registration have hampered previous voxel-based MRI studies from providing a clear pattern of structural atrophy after TBI. We used a novel symmetric diffeomorphic image normalization method to conduct a tensor-based morphometry (TBM) study of TBI. The key advantage of this method is that it simultaneously estimates an optimal template brain and topology preserving deformations between this template and individual subject brains. Detailed patterns of atrophies are then revealed by statistically contrasting control and subject deformations to the template space. Participants were 29 survivors of TBI and 20 control subjects who were matched in terms of age, gender, education, and ethnicity. Localized volume losses were found most prominently in white matter regions and the subcortical nuclei including the thalamus, the midbrain, the corpus callosum, the mid-and posterior cingulate cortices, and the caudate. Significant voxel-wise volume loss clusters were also detected in the cerebellum and the frontal/ temporal neocortices. Volume enlargements were identified largely in ventricular regions. A similar pattern of results was observed in a subgroup analysis where we restricted our analysis to the 17 TBI participants who had no macroscopic focal lesions (total lesion volume> 1.5 cm 3 ). The current study confirms, extends, and partly challenges previous structural MRI studies in chronic TBI. By demonstrating that a large deformation image registration technique can be successfully combined with TBM to identify TBI-induced diffuse structural changes with greater precision, our approach is expected to increase the sensitivity of future studies examining brain-behavior relationships in the TBI population.

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Incidence of Traumatic Brain Injury in the United States, 2003

Cited by 719 publications

References 0 publications

Phosphodiesterase‐5 inhibition potentiates cerebrovascular reactivity in chronic traumatic brain injury

Phosphodiesterase‐5 inhibition potentiates cerebrovascular reactivity in chronic traumatic brain injury

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Structural consequences of diffuse traumatic brain injury: A large deformation tensor-based morphometry study

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