Relationships between injury kinematics, neurological recovery, and pathology following concussion.

Autor:	Wofford KL; Center for Brain Injury & Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA., Grovola MR; Center for Brain Injury & Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA., Adewole DO; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA., Browne KD; Center for Brain Injury & Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA., Putt ME; Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA., O'Donnell JC; Center for Brain Injury & Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA., Cullen DK; Center for Brain Injury & Repair, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA.
Jazyk:	angličtina
Zdroj:	Brain communications [Brain Commun] 2021 Nov 17; Vol. 3 (4), pp. fcab268. Date of Electronic Publication: 2021 Nov 17 (Print Publication: 2021).
DOI:	10.1093/braincomms/fcab268
Abstrakt:	Mild traumatic brain injury affects millions of individuals annually primarily through falls, traffic collisions, or blunt trauma and can generate symptoms that persist for years. Closed-head rotational loading is the most common cause of mild traumatic brain injury and is defined by a rapid rotational acceleration of brain tissue within an intact skull. Injury kinematics-the mechanical descriptors of injury-inducing motion-explain movement of the head, which govern energy transfer, and, therefore, determine injury severity. However, the relationship between closed-head rotational injury kinematics-such as angular velocity, angular acceleration, and injury duration-and outcome after mild traumatic brain injury is not completely understood. To address this gap in knowledge, we analysed archived surgical records of 24 swine experiencing a diffuse closed-head rotational acceleration mild traumatic brain injury against 12 sham animals. Kinematics were contrasted against acute recovery outcomes, specifically apnea time, extubation time, standing time, and recovery duration. Compared to controls, animals experiencing a mild traumatic brain injury were far more likely to have apnea ( P < 0.001), shorter time to extubation ( P = 0.023), and longer time from extubation to standing ( P = 0.006). Using least absolute shrinkage and selection operator-based regressions, kinematic parameters, including maximum negative angular velocity and time from peak angular velocity to maximum angular deceleration, were selected to explain variation in apnea time, standing time, and recovery duration. Simplified linear models employing the least absolute shrinkage and selection operator-selected variables explained a modest degree of variation in apnea time (adjusted R 2 = 0.18), standing time (adjusted R 2 = 0.19), and recovery duration (adjusted R 2 = 0.27). Neuropathology was correlated with multiple injury kinematics, with maximum angular acceleration exhibiting the strongest correlation ( R 2 = 0.66). Together, these data suggest the interplay between multiple injury kinematics, including maximum negative angular velocity (immediately preceding cessation of head motion) and time from peak angular velocity to maximum angular deceleration, best explain acute recovery metrics and neuropathology after mild traumatic brain injury in swine. Future experiments that independently manipulate individual kinematic parameters could be instrumental in developing translational diagnostics for clinical mild traumatic brain injury. (Published by Oxford University Press on behalf of the Guarantors of Brain 2021. This work is written by a US Government employee and is in the public domain in the US.)
Databáze:	MEDLINE
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