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Biomedicines
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Traumatic CNS Injury: From Bench to Bedside
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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 10952

Special Issue Editor

Prof. Dr. Andres M. Rubiano

E-Mail Website
Guest Editor
Neurosciences Institute, INUB-MEDITECH Research Group, El Bosque University, 113033 Bogotá, Colombia
Interests: trauma; neurotrauma; prehospital care; emergency care; critical care; trauma surgery
Special Issues, Collections and Topics in MDPI journals

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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Related Special Issue

Published Papers (6 papers)

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Research

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14 pages, 879 KiB  
Article
Mortality-Associated Factors in a Traumatic Brain Injury Population in Mexico
by Erick Martínez-Herrera, Evelyn Galindo-Oseguera, Juan Castillo-Cruz, Claudia Erika Fuentes-Venado, Gilberto Adrián Gasca-López, Claudia C. Calzada-Mendoza, Esther Ocharan-Hernández, Carlos Alberto Zúñiga-Cruz, Eunice D. Farfán-García, Alfredo Arellano-Ramírez and Rodolfo Pinto-Almazán
Biomedicines 2024, 12(9), 2037; https://doi.org/10.3390/biomedicines12092037 - 7 Sep 2024
Viewed by 819
Abstract
Background: Traumatic brain injury (TBI) is a major cause of death and disability, with a rising incidence in recent years. Factors such as age, sex, hypotension, low score on the Glasgow Coma Scale, use of invasive mechanical ventilation and vasopressors, etc., have been [...] Read more.
Background: Traumatic brain injury (TBI) is a major cause of death and disability, with a rising incidence in recent years. Factors such as age, sex, hypotension, low score on the Glasgow Coma Scale, use of invasive mechanical ventilation and vasopressors, etc., have been associated with mortality caused by TBI. The aim of this study was to identify the clinical and sociodemographic characteristics that influence the mortality or survival of patients with TBI in a tertiary care hospital in Mexico. Methods: A sample of 94 patients aged 18 years or older, from both sexes, with an admitting diagnosis of mild-to-severe head trauma, with initial prehospital treatment, was taken. Data were extracted from the Single Registry of Patients with TBI at the Ixtapaluca Regional High Specialty Hospital (HRAEI). Normality tests were used to decide on the corresponding statistical analysis. Results: No factors associated with mortality were found; however, survival analysis showed that the presence of seizures, aggregate limb trauma, and subjects with diabetes mellitus, heart disease or patients with four concomitant comorbidities had 100% mortality. In addition, having seizures in the prehospital setting increased the risk of mortality four times. Although they did not have a direct association with mortality, they significantly decreased survival. A larger sample size is probably required to obtain an association with mortality. Conclusions: These results reflect the severity of the clinical situation in this population and, although no risk factors were identified, they enlighten us about the conditions presented by patients who died. Full article
(This article belongs to the Special Issue Traumatic CNS Injury: From Bench to Bedside)
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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
Viewed by 1587
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
Cited by 2 | Viewed by 1705
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 6 | Viewed by 1403
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

Jump to: Research

30 pages, 1330 KiB  
Review
Evaluating Sex Steroid Hormone Neuroprotection in Spinal Cord Injury in Animal Models: Is It Promising in the Clinic?
by Angélica Coyoy-Salgado, Julia Segura-Uribe, Hermelinda Salgado-Ceballos, Tzayaka Castillo-Mendieta, Stephanie Sánchez-Torres, Ximena Freyermuth-Trujillo, Carlos Orozco-Barrios, Sandra Orozco-Suarez, Iris Feria-Romero, Rodolfo Pinto-Almazán, Gabriela Moralí de la Brena and Christian Guerra-Araiza
Biomedicines 2024, 12(7), 1478; https://doi.org/10.3390/biomedicines12071478 - 4 Jul 2024
Viewed by 1357
Abstract
The primary mechanism of traumatic spinal cord injury (SCI) comprises the initial mechanical trauma due to the transmission of energy to the spinal cord, subsequent deformity, and persistent compression. The secondary mechanism of injury, which involves structures that remained undamaged after the initial [...] Read more.
The primary mechanism of traumatic spinal cord injury (SCI) comprises the initial mechanical trauma due to the transmission of energy to the spinal cord, subsequent deformity, and persistent compression. The secondary mechanism of injury, which involves structures that remained undamaged after the initial trauma, triggers alterations in microvascular perfusion, the liberation of free radicals and neurotransmitters, lipid peroxidation, alteration in ionic concentrations, and the consequent cell death by necrosis and apoptosis. Research in the treatment of SCI has sought to develop early therapeutic interventions that mitigate the effects of these pathophysiological mechanisms. Clinical and experimental evidence has demonstrated the therapeutic benefits of sex-steroid hormone administration after traumatic brain injury and SCI. The administration of estradiol, progesterone, and testosterone has been associated with neuroprotective effects, better neurological recovery, and decreased mortality after SCI. This review evaluated evidence supporting hormone-related neuroprotection over SCI and the possible underlying mechanisms in animal models. As neuroprotection has been associated with signaling pathways, the effects of these hormones are observed on astrocytes and microglia, modulating the inflammatory response, cerebral blood flow, and metabolism, mediating glutamate excitotoxicity, and their antioxidant effects. Based on the current evidence, it is essential to analyze the benefit of sex steroid hormone therapy in the clinical management of patients with SCI. Full article
(This article belongs to the Special Issue Traumatic CNS Injury: From Bench to Bedside)
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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 8 | Viewed by 3391
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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