Severe traumatic brain injury: maximizing outcomes

Tang, Mary E.; Lobel, Darlene A.

doi:10.1002/msj.20106

Cited by 26 publications

(10 citation statements)

References 43 publications

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“…The plasma 1/2 life of USPIO has previously been shown to be ∼ 2 hr in mice (Weissleder et al, 1990), which is well within the window of BBB disruption induced by the intravenous mannitol used in our study. Intravenous mannitol is much better tolerated and is used safely in patients under a variety of clinical settings (Castillo et al, 2009; Tang and Lobel, 2009). Hence this method of BBB disruption is suitable for longitudinal studies in AD model animals and could potentially be used in patients under research settings.…”

Section: Discussionmentioning

confidence: 99%

Detection of amyloid plaques targeted by USPIO-Aβ1–42 in Alzheimer's disease transgenic mice using magnetic resonance microimaging

et al. 2011

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Amyloid plaques are one of the pathological hallmarks of Alzheimer's disease (AD). The visualization of amyloid plaques in the brain is important to monitor AD progression and to evaluate the efficacy of therapeutic interventions. Our group has developed several contrast agents to detect amyloid plaques in vivo using magnetic resonance microimaging (μMRI) in AD transgenic mice, where we used intra-carotid mannitol to enhance blood brain barrier (BBB) permeability. In the present study, we used ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles, chemically coupled with Aβ 1-42 peptide to detect amyloid deposition along with mannitol for in vivo μMRI by femoral intravenous injection. A 3D gradient multi-echo sequence was used for imaging with a 100 μm isotropic resolution. The amyloid plaques detected by T2*-weighted μMRI were confirmed with matched histological sections. Furthermore, two different quantitative analyses were used. The region of interest-based quantitative measurement of T2* values showed contrast injected APP/PS1 mice had significantly reduced T2* values compared to wild-type mice. In addition, the scans were examined with voxel-based morphometry (VBM) using statistical parametric mapping (SPM) for comparison of contrast injected AD transgenic and wild-type mice. The regional differences seen in VBM comparing USPIO-Aβ1-42 injected APP/PS1 and wild type mice correlated with the amyloid plaque distribution histologically, contrasting with no differences between the two groups of mice without contrast agent injection in regions of the brain with amyloid deposition. Our results demonstrated that both approaches were able to identify the differences between AD transgenic mice and wild type mice, after injected with USPIO-Aβ1-42. The feasibility of using less invasive intravenous femoral injections for amyloid plaque detection in AD transgenic mice facilitates using this method for longitudinal studies in the pathogenesis of AD.

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Section: Discussionmentioning

confidence: 99%

Detection of amyloid plaques targeted by USPIO-Aβ1–42 in Alzheimer's disease transgenic mice using magnetic resonance microimaging

et al. 2011

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“…Traumatic brain injury is a leading cause of death and permanent neurological damage in those below the age of 45 in industrialized countries and it is a silently growing epidemic [1]. Much of the mortality is related to severity of primary neurological impairment and secondary brain injury caused by hypoxia and hypotension [2]. Despite significant improvement in the intensive treatment of patients with severe traumatic brain-injured (STBI), these patients show high susceptibility to infections such as urinary tract infections, septicaemia, and particularly, ventilator-associated pneumonia with incidence up to 60% [3].…”

Section: Introductionmentioning

confidence: 99%

Early Changes in Frequency of Peripheral Blood Lymphocyte Subpopulations in Severe Traumatic Brain‐Injured Patients

et al. 2010

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Infections are leading causes of increased morbidity and mortality of severe traumatic brain‐injured (STBI) patients. The mechanism underlying the susceptibility to the infections is still unexplained. The purpose of the study was to investigate changes in frequency of leucocytes subpopulations in peripheral blood of patients with STBI during the course of intensive care treatment. Twenty patients with STBI were included in the study. Healthy age‐ and sex‐ volunteers served as control. Peripheral blood samples were taken from these patients at day 1, 4 and 7, and peripheral blood mononuclear cells (PBMC) were isolated. The percentage of T, B lymphocyte, NK and NKT cells as well as monocytes was analysed by simultaneous detection of surface antigens using fluorochrome‐conjugated monoclonal antibodies. The two major subsets of T lymphocytes (CD3+CD56−CD4+ and CD3+CD56−CD8+) and NK cells (CD3−CD56+dim and CD3−CD56+bright) were also analysed by flow cytometry. Extracranial infections were presented in 55% patients with STBI. At day 4, the percentage of T lymphocytes with cytotoxic phenotype significantly diminished and their numbers restored at day 7. The frequency of NKT cells showed the identical time‐dependent pattern, whereas the percentage of NK cells diminished on day 4 but did not restore after 7 days. The frequency of B lymphocytes did not change significantly during the time investigated, whereas the percentage of monocytes increased immediately after the injury and gradually diminished. The decrease in cells with cytotoxic phenotype might explain high incidence of susceptibility to infection of patients with STBI.

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“…8 The exact etiology of the more than fourfold increased rate of DVTs in TBI patients is not entirely clear 11 ; however it is thought that TBIs exert a dampening effect on the physiologic dynamics of fibrinolysis, which, when coupled with the immobility caused by prolonged hospitalization creates a highly pro-thrombotic state. [16][17][18] Pharmacological venous thromboprophylaxis (VTEp) is effective in reducing rates of VTE 2,17 ; however, some literature suggests that VTEp increases the risk of intracranial hemorrhage (ICH) progression 19,20 ; therefore, many physicians are hesitant to administer VTEp for fear of causing secondary progression of TBI. 17 Unfortunately, this delay may cause undue risk from VTE.…”

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confidence: 99%

A Systematic Review of the Risks and Benefits of Venous Thromboembolism Prophylaxis in Traumatic Brain Injury

Margolick

Dandurand

Duncan

et al. 2018

Can. J. Neurol. Sci.

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Severe traumatic brain injury: maximizing outcomes

Cited by 26 publications

References 43 publications

Detection of amyloid plaques targeted by USPIO-Aβ1–42 in Alzheimer's disease transgenic mice using magnetic resonance microimaging

Detection of amyloid plaques targeted by USPIO-Aβ1–42 in Alzheimer's disease transgenic mice using magnetic resonance microimaging

Early Changes in Frequency of Peripheral Blood Lymphocyte Subpopulations in Severe Traumatic Brain‐Injured Patients

A Systematic Review of the Risks and Benefits of Venous Thromboembolism Prophylaxis in Traumatic Brain Injury

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