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101. Lactate supplementation in severe traumatic brain injured adults by primed constant infusion of sodium L‐lactate

Author

Wolahan, Stephanie M, Mao, Howard C, Real, Courtney, Vespa, Paul M, and Glenn, Thomas C

Subjects
Biomedical and Clinical Sciences, Neurosciences, Traumatic Head and Spine Injury, Nutrition, Physical Injury - Accidents and Adverse Effects, Traumatic Brain Injury (TBI), Brain Disorders, Adult, Aged, Blood Glucose, Brain, Brain Injuries, Traumatic, Energy Metabolism, Female, Humans, Infusions, Intravenous, Lactic Acid, Male, Middle Aged, Sodium Lactate, traumatic brain injury, lactate infusion, metabolism, Psychology, Neurology & Neurosurgery, Biological psychology
Abstract

Carbohydrate fuel augmentation following traumatic brain injury may be a viable treatment to improve recovery when cerebral oxidative metabolism of glucose is depressed. We performed a primed constant sodium L-lactate infusion in 11 moderate to severely brain injured adults. Blood was collected before and periodically during the infusion study. We quantified global cerebral uptake of glucose and lactate and other systemic metabolites associated with energy metabolism. Our hypothesis was that cerebral lactate uptake, as measured by the arteriovenous difference of lactate (AVDlac), would increase in severely injured TBI patients in the neurocritical care unit. Infusion of sodium L-lactate changed net cerebral lactate release, where the arteriovenous difference of lactate is negative, to net cerebral lactate uptake. Results from a mixed effects model of AVDlac with the fixed effects of infusion time, arterial lactate concentration, arterial glucose concentration and arteriovenous difference of glucose shows that doubling arterial lactate concentration (from .92 to 1.84 mM) results in an increase in AVDlac from -.078 mM to .090 mM. We did not detect changes in systemic glucose during the course of the infusion study and observed significant changes in alanine (30% [20 39]), glutamine (34% [24 43]), acetate (87% [60 113]), valine (40% [28 51]), and leucine (24% [16 32]) from baseline levels. Further studies are required to establish the impact of lactate supplementation on cerebral and systemic flux of lactate, on gluconeogenesis, and on the impact on cerebral energetics following injury. © 2017 Wiley Periodicals, Inc.

Published
2018

102. Acute glucose and lactate metabolism are associated with cognitive recovery following traumatic brain injury

Author

Mannino, Christina, Glenn, Thomas C, Hovda, David A, Vespa, Paul M, McArthur, David L, Van Horn, John D, and Wright, Matthew J

Subjects
Biological Psychology, Psychology, Physical Injury - Accidents and Adverse Effects, Neurosciences, Brain Disorders, Traumatic Head and Spine Injury, Traumatic Brain Injury (TBI), Mental health, Neurological, Injuries and accidents, Adult, Brain Injuries, Traumatic, Cognition, Energy Metabolism, Frontal Lobe, Glasgow Coma Scale, Glucose, Humans, Lactic Acid, Neuropsychological Tests, Temporal Lobe, traumatic brain injury, brain metabolism, cognition, neuropsychology, glucose, lactate, Neurology & Neurosurgery, Biological psychology
Abstract

Traumatic brain injury (TBI) is associated with acute cerebral metabolic crisis (ACMC). ACMC-related atrophy appears to be prominent in frontal and temporal lobes following moderate-to-severe TBI. This atrophy is correlated with poorer cognitive outcomes in TBI. The current study investigated ability of acute glucose and lactate metabolism to predict long-term recovery of frontal-temporal cognitive function in participants with moderate-to-severe TBI. Cerebral metabolic rate of glucose and lactate were measured by the Kety-Schmidt method on days 0-7 post-injury. Indices of frontal-temporal cognitive processing were calculated for six months post-injury; 12 months post-injury; and recovery (the difference between the six- and 12-month scores). Glucose and lactate metabolism were included in separate regression models, as they were highly intercorrelated. Also, glucose and lactate values were centered and averaged and included in a final regression model. Models for the prediction frontal-temporal cognition at six and 12 months post-injury were not significant. However, average glucose and lactate metabolism predicted recovery of frontal-temporal cognition, accounting for 23% and 22% of the variance, respectively. Also, maximum glucose metabolism, but not maximum lactate metabolism, was an inverse predictor in the recovery of frontal-temporal cognition, accounting for 23% of the variance. Finally, the average of glucose and lactate metabolism predicted frontal-temporal cognitive recovery, accounting for 22% of the variance. These data indicate that acute glucose and lactate metabolism both support cognitive recovery from TBI. Also, our data suggest that control of endogenous fuels and/or supplementation with exogenous fuels may have therapeutic potential for cognitive recovery from TBI.

Published
2018

103. A review of the diagnosis and management of vertebral basilar (posterior) circulation disease.

Author

Ausman, James, Liebeskind, David, Gonzalez, Nestor, Saver, Jeffrey, Martin, Neil, Villablanca, Juan, Vespa, Paul, Duckwiler, Gary, Jahan, Reza, Niu, Tianyi, Salamon, Noriko, Yoo, Bryan, Tateshima, Satoshi, Buitrago Blanco, Manuel, and Starkman, Sidney

Subjects
Posterior circulation, stroke, vertebral basilar insufficiency
Abstract

We have reviewed the English literature published in the last 70 years on Diseases of the Vertebral Basilar Circulation, or Posterior Circulation Disease (PCD). We have found that errors have been made in the conduct and interpretation of these studies that have led to incorrect approaches to the management of PCD. Because of the difficulty in evaluating the PC, the management of PCD has been incorrectly applied from anterior circulation disease (ACD) experience to PCD. PCD is a common form of stroke affecting 20-40% patients with stroke. Yet, the evidence is strong that the Anterior Circulation (AC) and Posterior Circulations (PC) differ in their pathology, in their clinical presentations, in the rapidity of development of symptoms, in optimal imaging methods, and in available treatments. There appears to be two categories of patients who present with PCD. The first, acute basilar artery occlusion has a more rapid onset. The diagnosis must be made quickly and if imaging proves a diagnosis of Basilar Artery Occlusion (BAO), the treatment of choice is Interventional removal of the basilar artery thrombosis or embolus. The second category of PCD and the most commonly seen PCD disease process presents with non-specific symptoms and early warnings of PCD that now can be related to ischemic events in the entire PC vessels. These warning symptoms and signs occur much earlier than those in the AC. IA angiography is still the gold standard of diagnosis and is superior in definition to MR and CT angiography which are commonly used as a convenient screening imaging tool to evaluate PCD but are both inferior to IA angiography in definition for lesions below 3-4 mm. In at least two reported studies 7T MR angiography appears superior to other imaging modalities and will become the gold standard of imaging of PCD in the future. Medical treatments applied to the ACD have not been proven of value in specific forms of PCD. Interventional therapy was promising but of unproven value in Randomized Controlled Trials (RCT) except for the treatment of Basilar Artery Occlusion (BAO). Surgical revascularization has been proved to be highly successful in patients, who are refractory to medical therapy. These studies have been ignored by the scientific community basically because of an incorrect interpretation of the flawed EC-IC Bypass Trial in 1985 as applying to all stroke patients. Moreover, the EC-IC Bypass Study did not include PCD patients in their study population, but the study results were extrapolated to patients with PCD without any scientific basis. This experience led clinicians to an incorrect bias that surgical treatments are of no value in PCD. Thus, incorrectly, surgical treatments of PCD have not been considered among the therapeutic possibilities for PCD. QMRA is a new quantitative MR technique that measures specific blood flow in extra and intracranial vessels. QMRA has been used to select those patients who may benefit from medical, or interventional, or surgical treatment for PCD based on flow determinations with a high success rate. QMRA accurately predicts the flows in many large and small vessels in the PC and AC and clearly indicates that both circulations are intimately related. From medical and surgical studies, the longer one waits for surgical treatment the higher the risk of a poor outcome results. This observation becomes obvious when the rapidity of development of PCD is compared with ACD. Recent advances in endovascular therapy in the treatment of acute basilar thrombosis is a clear sign that early diagnosis and treatment of PCD will reduce the morbidity and mortality of these diseases. In this review it is evident that there are multiple medical and surgical treatments for PCD depending upon the location of the lesion(s) and the collateral circulation demonstrated. It is clear that the AC and PC have significant differences. With the exception of the large population studies from Oxford England, the reported studies on the management of PCD in the literature represent small selected subsets of the universe of PC diseases, the information from which is not generalizable to the universe of PCD patients. At this point in the history of PCD, there are not large enough databases of similar patients to provide a basis for valid randomized studies, with the exception of the surgical studies. Thus, a high index of suspicion of the early warning symptoms of PCD should lead to a rapid individual clinical assessment of patients selecting those with PCD. Medical, interventional, and/or surgical treatments should be chosen based on knowledge presented in this review. Recording the results in a national Registry on a continuing basis will provide the data that may help advance the management of PCD based on larger data bases of well documented patient information to guide the selection of future therapies for PCD treatments. It is also clear that the management of patients within the complex of diseases that comprise PCD should be performed in centers with expertise in the imaging, medical, interventional and surgical approaches to diseases of the PCD.

Published
2018

104. Network Analysis in Disorders of Consciousness: Four Problems and One Proposed Solution (Exponential Random Graph Models)

Author

Dell'Italia, John, Johnson, Micah A, Vespa, Paul M, and Monti, Martin M

Subjects
Biomedical and Clinical Sciences, Biological Psychology, Clinical Sciences, Neurosciences, Psychology, Brain Disorders, Neurological, network analysis, exponential random graph model, functional magnetic resonance imaging, coma, disorders of consciousness, Clinical sciences, Biological psychology
Abstract

In recent years, the study of the neural basis of consciousness, particularly in the context of patients recovering from severe brain injury, has greatly benefited from the application of sophisticated network analysis techniques to functional brain data. Yet, current graph theoretic approaches, as employed in the neuroimaging literature, suffer from four important shortcomings. First, they require arbitrary fixing of the number of connections (i.e., density) across networks which are likely to have different "natural" (i.e., stable) density (e.g., patients vs. controls, vegetative state vs. minimally conscious state patients). Second, when describing networks, they do not control for the fact that many characteristics are interrelated, particularly some of the most popular metrics employed (e.g., nodal degree, clustering coefficient)-which can lead to spurious results. Third, in the clinical domain of disorders of consciousness, there currently are no methods for incorporating structural connectivity in the characterization of functional networks which clouds the interpretation of functional differences across groups with different underlying pathology as well as in longitudinal approaches where structural reorganization processes might be operating. Finally, current methods do not allow assessing the dynamics of network change over time. We present a different framework for network analysis, based on Exponential Random Graph Models, which overcomes the above limitations and is thus particularly well suited for clinical populations with disorders of consciousness. We demonstrate this approach in the context of the longitudinal study of recovery from coma. First, our data show that throughout recovery from coma, brain graphs vary in their natural level of connectivity (from 10.4 to 14.5%), which conflicts with the standard approach of imposing arbitrary and equal density thresholds across networks (e.g., time-points, subjects, groups). Second, we show that failure to consider the interrelation between network measures does lead to spurious characterization of both inter- and intra-regional brain connectivity. Finally, we show that Separable Temporal ERGM can be employed to describe network dynamics over time revealing the specific pattern of formation and dissolution of connectivity that accompany recovery from coma.

Published
2018

105. Antiepileptogenesis and disease modification: Clinical and regulatory issues

Author

Jacqueline A. French, Martina Bebin, Marc A. Dichter, Jerome Engel Jr., Adam L. Hartman, Sergiusz Jóźwiak, Pavel Klein, James McNamara Sr., Roy Twyman, and Paul Vespa

Subjects
antiepileptogenesis, clinical trials, disease modification, Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract This is a summary report of clinical and regulatory issues discussed at the 2018 NINDS workshop, entitled “Accelerating Therapies for Antiepileptogenesis and Disease Modification.” The intent of the workshop was to optimize and accelerate development of therapies for antiepileptogenesis (AEG) and disease modification in the epilepsies. The working group discussed nomenclature for antiepileptogenic therapies, subdividing them into “antiepileptogenic therapies” and “disease modifying therapies,” both of which are urgently needed. We use the example of traumatic brain injury to explain issues and complexities in designing a trial for disease‐preventing antiepileptogenic therapies, including identifying timing of intervention, selecting the appropriate dose, and the need for biomarkers. We discuss the recent trials of vigabatrin to prevent onset and modify epilepsy outcome in children with tuberous sclerosis (Epistop and PreVeNT). We describe a potential approach to a disease modification trial in adults, using patients with temporal lobe epilepsy. Finally, we discuss regulatory hurdles for antiepileptogenesis and disease‐modifying trials.

Published
2021
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108. Venere e gli astragali. Una nuova interpretazione del basilicus iactus in Plauto, Curculio, 349-361

Author

Marco Vespa

Subjects
astragali, basilicus, curculio, gioco, plauto, venere, General Works
Abstract

Volgendo l’attenzione alla problematica traduzione del cosiddetto basilicus iactus menzionato nella commedia Curculio di Plauto questo articolo cerca di fornire un nuovo contributo allo studio della cultura ludica latina. Sulla scorta di evidenze interne al testo, in particolare a proposito dell’identità drammatica dei suoi protagonisti e delle isotopie narrative presenti, e grazie a testimonianze esterne alla commedia, nello specifico alcune tradizioni cultuali greche e magno-greche, questa ricerca propone di intendere l’espressione basilicus iactus non come “colpo del re” bensì come “colpo della regina”, con un rinvio implicito alla dea Venus e al colpo degli astragali che dalla divinità prendeva il nome.

Published
2022
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111. New astroglial injury-defined biomarkers for neurotrauma assessment

Author

Halford, Julia, Shen, Sean, Itamura, Kyohei, Levine, Jaclynn, Chong, Albert C, Czerwieniec, Gregg, Glenn, Thomas C, Hovda, David A, Vespa, Paul, Bullock, Ross, Dietrich, W Dalton, Mondello, Stefania, Loo, Joseph A, and Wanner, Ina-Beate

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Traumatic Brain Injury (TBI), Traumatic Head and Spine Injury, Biotechnology, Physical Injury - Accidents and Adverse Effects, Brain Disorders, Injuries and accidents, Apoptosis Regulatory Proteins, Astrocytes, Biomarkers, Brain Concussion, Brain Injuries, Traumatic, Cells, Cultured, Fatty Acid-Binding Protein 7, Fructose-Bisphosphate Aldolase, Humans, Intracellular Signaling Peptides and Proteins, Kinetics, Phosphoproteins, Proteome, Tumor Suppressor Proteins, brain trauma, proteomics, cell culture, cerebrospinal fluid, exploratory factor analysis, Cardiorespiratory Medicine and Haematology, Neurology & Neurosurgery, Clinical sciences
Abstract

Traumatic brain injury (TBI) is an expanding public health epidemic with pathophysiology that is difficult to diagnose and thus treat. TBI biomarkers should assess patients across severities and reveal pathophysiology, but currently, their kinetics and specificity are unclear. No single ideal TBI biomarker exists. We identified new candidates from a TBI CSF proteome by selecting trauma-released, astrocyte-enriched proteins including aldolase C (ALDOC), its 38kD breakdown product (BDP), brain lipid binding protein (BLBP), astrocytic phosphoprotein (PEA15), glutamine synthetase (GS) and new 18-25kD-GFAP-BDPs. Their levels increased over four orders of magnitude in severe TBI CSF. First post-injury week, ALDOC levels were markedly high and stable. Short-lived BLBP and PEA15 related to injury progression. ALDOC, BLBP and PEA15 appeared hyper-acutely and were similarly robust in severe and mild TBI blood; 25kD-GFAP-BDP appeared overnight after TBI and was rarely present after mild TBI. Using a human culture trauma model, we investigated biomarker kinetics. Wounded (mechanoporated) astrocytes released ALDOC, BLBP and PEA15 acutely. Delayed cell death corresponded with GFAP release and proteolysis into small GFAP-BDPs. Associating biomarkers with cellular injury stages produced astroglial injury-defined (AID) biomarkers that facilitate TBI assessment, as neurological deficits are rooted not only in death of CNS cells, but also in their functional compromise.

Published
2017

112. Diagnosis of Fatal Human Case of St. Louis Encephalitis Virus Infection by Metagenomic Sequencing, California, 2016

Author

Chiu, Charles Y, Coffey, Lark L, Murkey, Jamie, Symmes, Kelly, Sample, Hannah A, Wilson, Michael R, Naccache, Samia N, Arevalo, Shaun, Somasekar, Sneha, Federman, Scot, Stryke, Doug, Vespa, Paul, Schiller, Gary, Messenger, Sharon, Humphries, Romney, Miller, Steve, and Klausner, Jeffrey D

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Infectious Diseases, Clinical Research, Brain Disorders, Aetiology, 2.1 Biological and endogenous factors, Infection, Good Health and Well Being, Aged, Bronchopneumonia, California, Encephalitis Virus, St. Louis, Encephalitis, St. Louis, Fatal Outcome, Genome, Viral, High-Throughput Nucleotide Sequencing, Humans, Lymphoma, Mantle-Cell, Male, Metagenome, Phylogeny, Reverse Transcriptase Polymerase Chain Reaction, SLEV, St. Louis encephalitis virus, United States, West Nile virus, Zika virus, arboviruses, flavivirus infections, mNGS, meningitis/encephalitis, metagenomic next-generation sequencing, mosquitoborne infections, outbreak surveillance, vector-borne infections, viruses, whole-genome viral sequencing, Medical Microbiology, Public Health and Health Services, Microbiology, Clinical sciences, Epidemiology, Health services and systems
Abstract

We used unbiased metagenomic next-generation sequencing to diagnose a fatal case of meningoencephalitis caused by St. Louis encephalitis virus in a patient from California in September 2016. This case is associated with the recent 2015-2016 reemergence of this virus in the southwestern United States.

Published
2017

113. Traumatic hemorrhagic brain injury: impact of location and resorption on cognitive outcome.

Author

Martin, Ryan M, Wright, Matthew J, Lutkenhoff, Evan S, Ellingson, Benjamin M, Van Horn, John D, Tubi, Meral, Alger, Jeffry R, McArthur, David L, and Vespa, Paul M

Subjects
Brain, Humans, Cerebral Hemorrhage, Disease Progression, Magnetic Resonance Imaging, Longitudinal Studies, Follow-Up Studies, Cognition, Neuropsychological Tests, Adolescent, Adult, Middle Aged, Female, Male, Young Adult, Cognitive Dysfunction, Brain Injuries, Traumatic, DAI = diffuse axonal injury, FLAIR = fluid-attenuated inversion recovery, GCS = Glasgow Coma Scale, GOS = Glasgow Outcome Scale, GOSE = GOS-extended, GRE = gradient recalled echo, ICH = intracerebral hemorrhage, ICP = intracranial pressure, MNI = Montreal Neurological Institute, MP-RAGE = magnetization-prepared gradient echo, MRI, ROI = region of interest, SDMT = Symbol Digit Modalities Test, SDMT-O = SDMT-Oral, SDMT-W = SDMT-Written, SRT-6 = 6-trial version of the Selective Reminding Test, TBI = traumatic brain injury, TMT-B = part B of the Trail Making Test, brain, hemorrhage, neuropsychological, trauma, traumatic brain injury, Brain Injuries, Traumatic, Neurology & Neurosurgery, Clinical Sciences, Neurosciences
Abstract

OBJECTIVE Hemorrhagic contusions are often the most visible lesions following traumatic brain injury. However, the incidence, location, and natural history of traumatic parenchymal hemorrhage and its impact on neurological outcome have been understudied. The authors sought to examine the location and longitudinal evolution of traumatic parenchymal hemorrhage and its association with cognitive outcome. METHODS Sixteen patients with hemorrhagic contusions due to acceleration-deceleration injuries underwent MRI in the acute (mean 6.3 days postinjury) and chronic (mean 192.9 days postinjury) phases. ImageJ was used to generate GRE and FLAIR volumes. To account for the effect of head-size variability across individuals, the authors calculated each patient's total brain tissue volume using SIENAX. GRE and FLAIR volumes were normalized to the total brain tissue volume, and values for absolute and percent lesion volume and total brain volume change were generated. Spearman's rank correlations were computed to determine associations between neuroimaging and 6-month postinjury neuropsychological testing of attention (Symbol Digit Modalities Test [SDMT], oral [O] and written [W] versions), memory (Selective Reminding Test, total learning and delayed recall), and executive function (Trail Making Test Part B [TMT-B]). RESULTS The patients' mean age was 31.4 ± 14.0 years and their mean Glasgow Coma Scale score at admission was 7.9 ± 2.8. Lesions were predominantly localized to the frontal (11 lesions) and temporal (9 lesions) lobes. The average percent reductions in GRE and FLAIR volumes were 44.2% ± 46.1% and 80.5% ± 26.3%, respectively. While total brain and frontal lesion volumes did not correlate with brain atrophy, larger temporal lobe GRE and FLAIR volumes were associated with larger volumes of atrophy (GRE: acute, -0.87, p < 0.01, chronic, -0.78, p < 0.01; FLAIR: acute, -0.81, p < 0.01, chronic, -0.88, p < 0.01). Total percent volume change of GRE lesions correlated with TMT-B (0.53, p < 0.05) and SDMT-O (0.62, p < 0.05) scores. Frontal lobe lesion volume did not correlate with neuropsychological outcome. However, robust relationships were seen in the temporal lobe, with larger acute temporal lobe GRE volumes were associated with worse scores on both oral and written versions of the SDMT (SDMT-W, -0.85, p < 0.01; SDMT-O, -0.73, p < 0.05). Larger absolute change in temporal GRE volume was strongly associated with worse SDMT scores (SDMT-W, 0.88, p < 0.01; SDMT-O, 0.75, p < 0.05). The same relationships were also seen between temporal FLAIR lesion volumes and neuropsychological outcome. CONCLUSIONS Traumatic parenchymal hemorrhages are largely clustered in the frontal and temporal lobes, and significant residual blood products are present at 6 months postinjury, a potential source of ongoing secondary brain injury. Neuropsychological outcome is closely tied to lesion volume size, particularly in the temporal lobe, where larger GRE and FLAIR volumes are associated with more brain atrophy and worse SDMT scores. Interestingly, larger volumes of hemorrhage resorption were associated with worse SDMT and TMT-B scores, suggesting that the initial tissue damage had a lasting impact on attention and executive function.

Published
2017

114. Multi-Delay ASL can identify leptomeningeal collateral perfusion in endovascular therapy of ischemic stroke

Author

Lou, Xin, Yu, Songlin, Scalzo, Fabien, Starkman, Sidney, Ali, Latisha K, Kim, Doojin, Rao, Neal M, Hinman, Jason D, Vespa, Paul M, Jahan, Reza, Tateshima, Satoshi, Gonzalez, Nestor R, Duckwiler, Gary R, Saver, Jeffrey L, Yoo, Bryan, Salamon, Noriko, Lyu, Jinhao, Ma, Lin, Wang, Danny JJ, and Liebeskind, David S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Cerebrovascular, Stroke, Brain Disorders, Biomedical Imaging, Neurosciences, Aged, Aged, 80 and over, Brain Ischemia, Cerebrovascular Circulation, Female, Humans, Infarction, Middle Cerebral Artery, Magnetic Resonance Angiography, Male, Meninges, Middle Aged, Perfusion Imaging, Spin Labels, collateral circulation, stroke, perfusion imaging, arterial spin-labeling, cerebral blood flow, Oncology and Carcinogenesis, Oncology and carcinogenesis
Abstract

Background and purposeMulti-delay arterial spin-labeling (ASL) perfusion imaging has been used as a promising modality to evaluate cerebral perfusion. Our aim was to assess the association of leptomeningeal collateral perfusion scores based on ASL parameters with outcome of endovascular treatment in patients with acute ischemic stroke (AIS) in the middle cerebral artery (MCA) territory.Materials and methodsASL data at 4 post-labeling delay (PLD) times (PLD = 1.5, 2, 2.5, 3 s) were acquired during routine clinical magnetic resonance examination on AIS patients prior to endovascular treatment. A 3-point scale of leptomeningeal collateral perfusion grade on 10 anatomic regions was determined based on arterial transit times (ATT), cerebral blood flow (CBF), and arterial cerebral blood volume (CBV), estimated by the multi-delay ASL protocol. Based on a 90-day modified Rankin Scale (mRS), the patients were dichotomized to moderate/good (mRS 0-3) and poor outcome (mRS 4-6) and the regional collateral flow scores were compared.ResultsFifty-five AIS patients with unilateral MCA stroke (mean 73.95±14.82 years) including 23 males were enrolled. Compared with poor outcome patients, patients with moderate to good outcomes had a significantly higher leptomeningeal collateral perfusion scores on CBV (3.01±2.11 vs. 1.82±1.51, p=0.024) but no differences on scores on CBF (2.31±1.61 vs. 1.66±1.32, p=0.231) and ATT (2.67±2.33 vs. 3.42±3.37, p=0.593).ConclusionsHigher leptomeningeal collateral perfusion scores on CBV images by ASL may be a specific marker of clinical outcome after endovascular treatment in patients with acute MCA ischemic stroke. Further study with larger sample size is warranted.

Published
2017

115. Traumatic Brain Injury Severity, Neuropathophysiology, and Clinical Outcome: Insights from Multimodal Neuroimaging

Author

Irimia, Andrei, Goh, Sheng-Yang Matthew, Wade, Adam C, Patel, Kavi, Vespa, Paul M, and Van Horn, John D

Subjects
Clinical and Health Psychology, Psychology, Traumatic Head and Spine Injury, Neurosciences, Physical Injury - Accidents and Adverse Effects, Epilepsy, Brain Disorders, Neurodegenerative, Clinical Research, Traumatic Brain Injury (TBI), Neurological, traumatic brain injury, clinical outcome, Glasgow Coma Scale, Glasgow Outcome Score, post-traumatic seizures, neuroimaging, magnetic resonance imaging, Clinical Sciences, Clinical sciences, Biological psychology
Abstract

BACKGROUND:The relationship between the acute clinical presentation of patients with traumatic brain injury (TBI), long-term changes in brain structure prompted by injury and chronic functional outcome is insufficiently understood. In this preliminary study, we investigate how acute Glasgow coma score (GCS) and epileptic seizure occurrence after TBIs are statistically related to functional outcome (as quantified using the Glasgow Outcome Score) and to the extent of cortical thinning observed 6 months after the traumatic event. METHODS:Using multivariate linear regression, the extent to which the acute GCS and epileptic seizure occurrence (predictor variables) correlate with structural brain changes (relative cortical atrophy) was examined in a group of 33 TBI patients. The statistical significance of the correlation between relative cortical atrophy and the Glasgow Outcome Score was also investigated. RESULTS:A statistically significant correlative relationship between cortical thinning and the predictor variables (acute GCS and seizure occurrence) was identified in the study sample. Regions where the statistical model was found to have highest statistical reliability in predicting both gray matter atrophy and neurological outcome include the frontopolar, middle frontal, postcentral, paracentral, middle temporal, angular, and lingual gyri. In addition, relative atrophy and GOS were also found to be significantly correlated over large portions of the cortex. CONCLUSION:This study contributes to our understanding of the relationship between clinical descriptors of acute TBI, the extent of injury-related chronic brain changes and neurological outcome. This is partly because the brain areas where cortical thinning was found to be correlated with GCS and with seizure occurrence are implicated in executive control, sensory function, motor acuity, memory, and language, all of which may be affected by TBI. Thus, our quantification suggests the existence of a statistical relationship between acute clinical presentation, on the one hand, and structural/functional brain features which are particularly susceptible to post-injury degradation, on the other hand.

Published
2017

116. Heads Up! A Novel Provocative Maneuver to Guide Acute Ischemic Stroke Management

Author

Ali, Latisha K, Weng, Julius K, Starkman, Sidney, Saver, Jeffrey L, Kim, Doojin, Ovbiagele, Bruce, Buck, Brian H, Sanossian, Nerses, Vespa, Paul, Bang, Oh Young, Jahan, Reza, Duckwiler, Gary R, Viñuela, Fernando, and Liebeskind, David S

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Brain Disorders, Clinical Research, Aging, Stroke, Cardiovascular, Neurosciences, Cerebral blood flow, Collaterals, Endovascular stroke therapy, Ischemic stroke
Abstract

BackgroundA common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making.MethodsA prospective cohort study of

Published
2017

117. Hepatitis E Virus-Associated Meningoencephalitis in a Lung Transplant Recipient Diagnosed by Clinical Metagenomic Sequencing.

Author

Murkey, Jamie A, Chew, Kara W, Carlson, Margrit, Shannon, Chelsea L, Sirohi, Deepika, Sample, Hannah A, Wilson, Michael R, Vespa, Paul, Humphries, Romney M, Miller, Steve, Klausner, Jeffrey D, and Chiu, Charles Y

Subjects
encephalitis, hepatitis E virus, lung transplant, meningitis, metagenomic next-generation sequencing (mNGS)., metagenomic next-generation sequencing
Abstract

Hepatitis E virus (HEV) infection uncommonly causes chronic hepatitis and neurologic disease. We describe a case of genotype 3a HEV meningoencephalitis diagnosed by metagenomic next-generation sequencing, illustrating the power of an unbiased molecular approach to microbial testing and the first reported case of HEV infection presumably acquired through lung transplantation.

Published
2017

118. Prevention of prostate cancer metastasis by a CRISPR-delivering nanoplatform for interleukin-30 genome editing

Author

Fieni, Cristiano, Ciummo, Stefania Livia, Sorrentino, Carlo, Marchetti, Simona, Vespa, Simone, Lanuti, Paola, Lotti, Lavinia Vittoria, and Di Carlo, Emma

Abstract

Prostate cancer (PC) is a leading cause of cancer-related deaths in men worldwide. Interleukin-30 (IL-30) is a PC progression driver, and its suppression would be strategic for fighting metastatic disease. Biocompatible lipid nanoparticles (NPs) were loaded with CRISPR-Cas9gRNA to delete the human IL30 (hIL30) gene and functionalized with anti-PSCA-Abs (Cas9hIL30-PSCA NPs). Efficiency of the NPs in targeting IL-30 and the metastatic potential of PC cells was examined in vivoin xenograft models of lung metastasis, and in vitroby using two organ-on-chip (2-OC)-containing 3D spheroids of IL30+PC-endothelial cell co-cultures in circuit with either lung-mimicking spheroids or bone marrow (BM)-niche-mimicking scaffolds. Cas9hIL30-PSCA NPs demonstrated circulation stability, genome editing efficiency, without off-target effects and organ toxicity. Intravenous injection of three doses/13 days, or five doses/20 days, of NPs in mice bearing circulating PC cells and tumor microemboli substantially hindered lung metastasization. Cas9hIL30-PSCA NPs inhibited PC cell proliferation and expression of IL-30 and metastasis drivers, such as CXCR2, CXCR4, IGF1, L1CAM, METAP2, MMP2, and TNFSF10, whereas CDH1 was upregulated. PC-Lung and PC-BM 2-OCs revealed that Cas9hIL30-PSCA NPs suppressed PC cell release of CXCL2/GROβ, which was associated with intra-metastatic myeloid cell infiltrates, and of DKK1, OPG, and IL-6, which boosted endothelial network formation and cancer cell migration. Development of a patient-tailored nanoplatform for selective CRISPR-mediated IL-30 gene deletion is a clinically valuable tool against PC progression.

Published
2024
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119. Contrasting Characteristics and Outcomes of Sports-Related and Non–Sports-Related Traumatic Brain Injury

Author

Ntikas, M, Stewart, W, Ietswaart, M, Hunter, A, Maas, A, Menon, D, Wilson, L, Ackerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castaño-León, A, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubović, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovács, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maegele, M, Majdan, M, Manara, A, Manley, G, Maréchal, H, Martino, C, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyirádi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Rădoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnák, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Singh, R, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Steyerberg, E, Stocchetti, N, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Thibaut, A, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Valeinis, E, Vallance, S, Vámos, Z, van der Jagt, M, van der Naalt, J, Van der Steen, G, van Dijck, J, van Erp, I, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, van Wijk, R, Vande Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbüchel, N, Voormolen, D, Vulekovic, P, Wang, K, Whitehouse, D, Wiegers, E, Williams, G, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Ntikas, Michail, Stewart, William, Ietswaart, Magdalena, Hunter, Angus M., Maas, Andrew I. R., Menon, David K., Wilson, Lindsay, Ackerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark Steven, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubović, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, Kolias, Angelos G., Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Maréchal, Hugues, Martino, Costanza, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Nair, Nandesh, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Oresic, Matej, Ortolano, Fabrizio, Otesile, Olubukola, Palotie, Aarno, Parizel, Paul M., Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Rădoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Retel Helmrich, Isabel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Singh, Ranjit D., Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Thomas, Matt, Thibaut, Aurore, Tibboel, Dick, Timmers, Marjolijn, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, van der Jagt, Mathieu, van der Naalt, Joukje, Van der Steen, Gregory, van Dijck, Jeroen T. J. M., van Erp, Inge A., van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, van Veen, Ernest, van Wijk, Roel P. J., Vande Vyvere, Thijs, Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Peter, Wang, Kevin K. W., Whitehouse, Daniel, Wiegers, Eveline, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Ziverte, Agate, Zoerle, Tommaso, Ntikas, M, Stewart, W, Ietswaart, M, Hunter, A, Maas, A, Menon, D, Wilson, L, Ackerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castaño-León, A, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubović, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovács, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maegele, M, Majdan, M, Manara, A, Manley, G, Maréchal, H, Martino, C, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyirádi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Rădoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnák, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Singh, R, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Steyerberg, E, Stocchetti, N, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Thibaut, A, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Valeinis, E, Vallance, S, Vámos, Z, van der Jagt, M, van der Naalt, J, Van der Steen, G, van Dijck, J, van Erp, I, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, van Wijk, R, Vande Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbüchel, N, Voormolen, D, Vulekovic, P, Wang, K, Whitehouse, D, Wiegers, E, Williams, G, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Ntikas, Michail, Stewart, William, Ietswaart, Magdalena, Hunter, Angus M., Maas, Andrew I. R., Menon, David K., Wilson, Lindsay, Ackerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark Steven, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubović, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, Kolias, Angelos G., Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Maréchal, Hugues, Martino, Costanza, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Nair, Nandesh, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Oresic, Matej, Ortolano, Fabrizio, Otesile, Olubukola, Palotie, Aarno, Parizel, Paul M., Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Rădoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Retel Helmrich, Isabel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Singh, Ranjit D., Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Thomas, Matt, Thibaut, Aurore, Tibboel, Dick, Timmers, Marjolijn, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, van der Jagt, Mathieu, van der Naalt, Joukje, Van der Steen, Gregory, van Dijck, Jeroen T. J. M., van Erp, Inge A., van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, van Veen, Ernest, van Wijk, Roel P. J., Vande Vyvere, Thijs, Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Peter, Wang, Kevin K. W., Whitehouse, Daniel, Wiegers, Eveline, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Ziverte, Agate, and Zoerle, Tommaso

Abstract

Importance: Exposure to traumatic brain injury (TBI) has raised widespread concern over participation in sports, particularly over possible long-term consequences. However, little is known about the outcomes of individuals presenting to hospitals with sports-related TBI. Objective: To compare the characteristics and outcomes of individuals presenting to hospitals with sports-related and non-sports-related TBI. Design, setting, and participants: The CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) observational cohort study was conducted at hospitals in 18 countries. The study enrolled 4509 patients who had TBI and had an indication for computed tomography (CT), of whom 4360 were 16 years or older. Outcomes were assessed at 3 and 6 months, and groups were compared using regression analyses adjusting for clinical and demographic differences. Data were collected between December 9, 2014, and December 17, 2017, and analyzed from August 2022 to March 2023. Exposure: Sports-related and non-sports-related TBI with subgroups selected by severity of injury. Main outcomes and measures: The main outcome was the Glasgow Outcome Scale-Extended (GOSE) at 6 months, with secondary outcomes covering postconcussion symptoms, health-related quality of life, and mental health. Results: A total of 4360 patients were studied, including 256 (6%) with sports-related TBI (mean [SD] age, 38.9 [18.1] years; 161 [63%] male) and 4104 with non-sports-related TBI (mean [SD] age, 51.0 [20.2] years; 2773 [68%] male). Compared with patients with non-sports-related TBI, patients with sports-related TBI were younger, more likely to have tertiary education, more likely to be previously healthy, and less likely to have a major extracranial injury. After adjustment, the groups did not differ in incomplete recovery (GOSE scores <8) at 6 months (odds ratio [OR], 1.27; 95% CI, 0.90-1.78; P = .22 for all patients; OR, 1.20; 95% CI, 0.83-1.73; P = .34 for those with mild TBI; a

Published
2024

120. Research considerations for prospective studies of patients with coma and disorders of consciousness

Author

Tinti, L, Lawson, T, Molteni, E, Kondziella, D, Rass, V, Sharshar, T, Bodien, Y, Giacino, J, Mayer, S, Amiri, M, Muehlschlegel, S, Venkatasubba Rao, C, Vespa, P, Menon, D, Citerio, G, Helbok, R, Mcnett, M, Agarwal, S, Aiyagari, V, Akbari, Y, Albertson, A, Alexander, S, Alexandrov, A, Alkhachroum, A, Al-Mufti, F, Appavu, B, Gebrewold, M, Ayounb, M, Badenes, R, Bader, M, Badjiata, N, Balu, R, Barlow, B, Barra, M, Beekman, R, Beghi, E, Beqiri, E, Berlin, T, Bilotta, F, Bleck, T, Boerwinkle, V, Boly, M, Bonnel, A, Brazzi, L, Brown, E, Bulic, S, Caceres, E, Caceres, A, Cafiero, T, Carroll, E, Cediel, E, Chou, S, Claassen, J, Condie, C, Conti, A, Cosmas, K, Costa, P, Creutzfeldt, C, Dangayach, N, Dauri, M, Debicki, D, Degeorgia, M, Der-Nigoghossian, C, Desai, M, Dhar, R, Diringer, M, Durr, E, Edlow, B, Ercole, A, Estraneo, A, Falcone, G, Farrokh, S, Ferguson, A, Fernandez-Espejo, D, Fink, E, Fins, J, Foreman, B, Franchi, F, Frontera, J, Ganesan, R, Gaspard, N, Ghavam, A, Gibbons, C, Gilmore, E, Glustein, C, Gosseries, O, Green, T, Greer, D, Guanci, M, Gupta, D, Hahn, C, Hakimi, R, Hammond, F, Hanley, D, Hartings, J, Hassan, A, Hemphill, C, Da Cunha, A, Hinson, H, Hirsch, K, Hocker, S, Hu, P, Hu, X, Human, T, Hwang, D, Illes, J, Jaffa, M, James, M, Janas, A, Johnson, S, Jones, M, Jox, R, Kalanuria, A, Keller, E, Kennedy, L, Kennelly, M, Keogh, M, Kim, J, Kim, K, Kirsch, H, Kirschen, M, Ko, N, Kreitzer, N, Kromm, J, Kumar, A, Kurtz, P, Laureys, S, Lejeune, N, Lewis, A, Liang, J, Ling, G, Livesay, S, Luppi, A, Macdonald, J, Maddux, C, Mahanes, D, Mainali, S, Maldonado, N, Ribeiro, R, Mascia, L, Massimini, M, Mathur, R, Mccredie, V, Mejia-Mantilla, J, Mendoza, M, Meyfroidt, G, Mijangos, J, Moberg, D, Moheet, A, Montalenti, E, Monti, M, Morrison, C, Munar, M, Murtaugh, B, Naccache, L, Nagayama, M, Nairon, E, Nakagawa, T, Naldi, A, Narenthiran, G, Natarajan, G, Nemetsky, E, Newcombe, V, Nielsen, N, Niznick, N, Noronha-Falcão, F, Nyquist, P, Olson, D, Othman, M, Owen, A, Padayachy, L, Pajoumand, M, Park, S, Pergakis, M, Perry, H, Polizzotto, L, Pouratian, N, Spivack, M, Prisco, L, Provencio, J, Puglises, F, Puybasset, L, Rao, C, Rasmussen, L, Rasulo, F, Ray, B, Ricci, Z, Richardson, R, Shinotsuka, C, Robba, C, Robertson, C, Rohaut, B, Rolston, J, Romagnoli, S, Rosanova, M, Rosenthal, E, Rowe, S, Rubin, M, Russell, M, Silva, G, Sanz, L, Sarasso, S, Sarwal, A, Schiff, N, Schnakers, C, Seder, D, Shah, V, Shapiro-Rosenbaubm, A, Shapshak, A, Sharma, K, Shutter, L, Sitt, J, Slomine, B, Smetana, K, Smielewski, P, Smith, W, Stamatakis, E, Steinberg, A, Stevens, R, Suarez, J, Sung, G, Sussman, B, Taran, S, Mazzeo, A, Thibaut, A, Thompson, D, Threlkeld, Z, Toker, D, Torbey, M, Tosto, J, Trevick, S, Tsaousi, G, Turgeon, A, Udy, A, Varelas, P, Videtta, W, Voss, H, Vox, F, Wagner, A, Wahlster, S, Wainwright, M, Whyte, J, Witherspoon, B, Yakhkind, A, Yeager, S, Young, M, Zafar, S, Zafonte, R, Zahuranec, D, Zammit, C, Zhang, B, Ziai, W, Zimmerman, L, Zink, E, Tinti, Lorenzo, Lawson, Thomas, Molteni, Erika, Kondziella, Daniel, Rass, Verena, Sharshar, Tarek, Bodien, Yelena G, Giacino, Joseph T, Mayer, Stephan A, Amiri, Moshgan, Muehlschlegel, Susanne, Venkatasubba Rao, Chethan P, Vespa, Paul M, Menon, David K, Citerio, Giuseppe, Helbok, Raimund, McNett, Molly, Agarwal, Sachin, Aiyagari, Venkatesh, Akbari, Yama, Albertson, Asher, Alexander, Sheila, Alexandrov, Anne, Alkhachroum, Ayham, Al-Mufti, Fawaz, Amiri, Moshagan, Appavu, Brian, Gebrewold, Meron Awraris, Ayounb, Marc, Badenes, Rafael, Bader, Mary Kay, Badjiata, Neeraj, Balu, Ram, Barlow, Brooke, Barra, Megan, Beekman, Rachel, Beghi, Ettore, Beqiri, Erta, Berlin, Tracey, Bilotta, Federico, Bleck, Thomas, Bodien, Yelena, Boerwinkle, Varina, Boly, Melanie, Bonnel, Alexandra, Brazzi, Luca, Brown, Emery, Bulic, Sebina, Caceres, Eder, Caceres, Adrian, Cafiero, Tullio, Carroll, Elizabeth, Cediel, Emilio G, Chou, Sherry, Claassen, Jan, Condie, Chad, Conti, Alfredo, Cosmas, Katie, Costa, Paolo, Creutzfeldt, Claire, Dangayach, Neha, Dauri, Mario, Debicki, Derek, DeGeorgia, Michael, Der-Nigoghossian, Caroline, Desai, Masoom, Dhar, Rajat, Diringer, Michael, Durr, Emily, Edlow, Brian, Ercole, Ari, Estraneo, Anna, Falcone, Guido, Farrokh, Salia, Ferguson, Adam, Fernandez-Espejo, Davinia, Fink, Ericka, Fins, Joseph, Foreman, Brandon, Franchi, Federico, Frontera, Jennifer, Ganesan, Rishi, Gaspard, Nicolas, Ghavam, Ahmeneh, Giacino, Joseph, Gibbons, Christie, Gilmore, Emily, Glustein, Chavie, Gosseries, Olivia, Green, Theresa, Greer, David, Guanci, Mary, Gupta, Deepak, Hahn, Cecil, Hakimi, Ryan, Hammond, Flora, Hanley, Daniel F, Hartings, Jed, Hassan, Ahmed, Hemphill, Claude, Da Cunha, Arthur Henrique Galvão Bruno, Hinson, Holly, Hirsch, Karen, Hocker, Sarah, Hu, Peter, Hu, Xiao, Human, Theresa, Hwang, David, Illes, Judy, Jaffa, Matthew, James, Michael L, Janas, Anna, Johnson, Susan, Jones, Morgan, Jox, Ralf J, Kalanuria, Atul, Keller, Emanuela, Kennedy, Lori, Kennelly, Megan, Keogh, Maggie, Kim, Jenn, Kim, Keri, Kirsch, Hannah, Kirschen, Matthew, Ko, Nerissa, Kreitzer, Natalie, Kromm, Julie, Kumar, Abhay, Kurtz, Pedro, Laureys, Steven, Lejeune, Nicolas, Lewis, Ariane, Liang, John, Ling, Geoffrey, Livesay, Sarah, Luppi, Andrea, MacDonald, Jennifer, Maddux, Craig, Mahanes, Dea, Mainali, Shraddha, Maldonado, Nelson, Ribeiro, Rennan Martins, Mascia, Luciana, Massimini, Marcello, Mathur, Rohan, Mayer, Stephan, McCredie, Victoria, Mejia-Mantilla, Jorge, Mendoza, Michael, Menon, David, Meyfroidt, Geert, Mijangos, Julio, Moberg, Dick, Moheet, Asma, Montalenti, Elisa, Monti, Martin, Morrison, Chris, Munar, Marina, Murtaugh, Brooke, Naccache, Lionel, Nagayama, Masao, Nairon, Emerson, Nakagawa, Thomas, Naldi, Andrea, Narenthiran, Ganesalingam, Natarajan, Girija, Nemetsky, Esther, Newcombe, Virginia, Nielsen, Niklas, Niznick, Naomi, Noronha-Falcão, Filipa, Nyquist, Paul, Olson, DaiWai, Othman, Marwan, Owen, Adrian, Padayachy, Llewellyn, Pajoumand, Mehrnaz, Park, Soojin, Pergakis, Melissa, Perry, Heidi, Polizzotto, Len, Pouratian, Nader, Spivack, Marilyn Price, Prisco, Lara, Provencio, Javier, Puglises, Francesco, Puybasset, Louis, Rao, Chethan, Rasmussen, Lindsay, Rasulo, Frank, Ray, Bappaditya, Ricci, Zaccaria, Richardson, Risa, Shinotsuka, Cassia Righy, Robba, Chiara, Robertson, Courtney, Rohaut, Benjamin, Rolston, John, Romagnoli, Stefano, Rosanova, Mario, Rosenthal, Eric, Rowe, Shaun, Rubin, Michael, Russell, Mary Beth, Silva, Gisele Sampaio, Sanz, Leandro, Sarasso, Simone, Sarwal, Aarti, Schiff, Nicolas, Schnakers, Caroline, Seder, David, Shah, Vishank Arun, Shapiro-Rosenbaubm, Amy, Shapshak, Angela, Sharma, Kartavya, Sharma, Kumar Ajay, Shutter, Lori, Sitt, Jacobo, Slomine, Beth, Smetana, Keaton, Smielewski, Peter, Smith, Wade, Stamatakis, Emmanuel, Steinberg, Alexis, Stevens, Robert, Suarez, Jose, Sung, Gene, Sussman, Bethany, Taran, Shaurya, Mazzeo, Anna Teresa, Thibaut, Aurore, Thompson, David, Threlkeld, Zachary, Toker, Daniel, Torbey, Michel, Tosto, Jenna, Trevick, Stephen, Tsaousi, Georgia, Turgeon, Alexis, Udy, Andrew, Varelas, Panos, Vespa, Paul, Videtta, Walter, Voss, Henning, Vox, Ford, Wagner, Amy, Wahlster, Sarah, Wainwright, Mark, Whyte, John, Witherspoon, Briana, Yakhkind, Aleksandra (Sasha), Yeager, Susan, Young, Michael, Zafar, Sahar, Zafonte, Ross, Zahuranec, Darin, Zammit, Chris, Zhang, Bei, Ziai, Wendy, Zimmerman, Lara, Zink, Elizabeth, Tinti, L, Lawson, T, Molteni, E, Kondziella, D, Rass, V, Sharshar, T, Bodien, Y, Giacino, J, Mayer, S, Amiri, M, Muehlschlegel, S, Venkatasubba Rao, C, Vespa, P, Menon, D, Citerio, G, Helbok, R, Mcnett, M, Agarwal, S, Aiyagari, V, Akbari, Y, Albertson, A, Alexander, S, Alexandrov, A, Alkhachroum, A, Al-Mufti, F, Appavu, B, Gebrewold, M, Ayounb, M, Badenes, R, Bader, M, Badjiata, N, Balu, R, Barlow, B, Barra, M, Beekman, R, Beghi, E, Beqiri, E, Berlin, T, Bilotta, F, Bleck, T, Boerwinkle, V, Boly, M, Bonnel, A, Brazzi, L, Brown, E, Bulic, S, Caceres, E, Caceres, A, Cafiero, T, Carroll, E, Cediel, E, Chou, S, Claassen, J, Condie, C, Conti, A, Cosmas, K, Costa, P, Creutzfeldt, C, Dangayach, N, Dauri, M, Debicki, D, Degeorgia, M, Der-Nigoghossian, C, Desai, M, Dhar, R, Diringer, M, Durr, E, Edlow, B, Ercole, A, Estraneo, A, Falcone, G, Farrokh, S, Ferguson, A, Fernandez-Espejo, D, Fink, E, Fins, J, Foreman, B, Franchi, F, Frontera, J, Ganesan, R, Gaspard, N, Ghavam, A, Gibbons, C, Gilmore, E, Glustein, C, Gosseries, O, Green, T, Greer, D, Guanci, M, Gupta, D, Hahn, C, Hakimi, R, Hammond, F, Hanley, D, Hartings, J, Hassan, A, Hemphill, C, Da Cunha, A, Hinson, H, Hirsch, K, Hocker, S, Hu, P, Hu, X, Human, T, Hwang, D, Illes, J, Jaffa, M, James, M, Janas, A, Johnson, S, Jones, M, Jox, R, Kalanuria, A, Keller, E, Kennedy, L, Kennelly, M, Keogh, M, Kim, J, Kim, K, Kirsch, H, Kirschen, M, Ko, N, Kreitzer, N, Kromm, J, Kumar, A, Kurtz, P, Laureys, S, Lejeune, N, Lewis, A, Liang, J, Ling, G, Livesay, S, Luppi, A, Macdonald, J, Maddux, C, Mahanes, D, Mainali, S, Maldonado, N, Ribeiro, R, Mascia, L, Massimini, M, Mathur, R, Mccredie, V, Mejia-Mantilla, J, Mendoza, M, Meyfroidt, G, Mijangos, J, Moberg, D, Moheet, A, Montalenti, E, Monti, M, Morrison, C, Munar, M, Murtaugh, B, Naccache, L, Nagayama, M, Nairon, E, Nakagawa, T, Naldi, A, Narenthiran, G, Natarajan, G, Nemetsky, E, Newcombe, V, Nielsen, N, Niznick, N, Noronha-Falcão, F, Nyquist, P, Olson, D, Othman, M, Owen, A, Padayachy, L, Pajoumand, M, Park, S, Pergakis, M, Perry, H, Polizzotto, L, Pouratian, N, Spivack, M, Prisco, L, Provencio, J, Puglises, F, Puybasset, L, Rao, C, Rasmussen, L, Rasulo, F, Ray, B, Ricci, Z, Richardson, R, Shinotsuka, C, Robba, C, Robertson, C, Rohaut, B, Rolston, J, Romagnoli, S, Rosanova, M, Rosenthal, E, Rowe, S, Rubin, M, Russell, M, Silva, G, Sanz, L, Sarasso, S, Sarwal, A, Schiff, N, Schnakers, C, Seder, D, Shah, V, Shapiro-Rosenbaubm, A, Shapshak, A, Sharma, K, Shutter, L, Sitt, J, Slomine, B, Smetana, K, Smielewski, P, Smith, W, Stamatakis, E, Steinberg, A, Stevens, R, Suarez, J, Sung, G, Sussman, B, Taran, S, Mazzeo, A, Thibaut, A, Thompson, D, Threlkeld, Z, Toker, D, Torbey, M, Tosto, J, Trevick, S, Tsaousi, G, Turgeon, A, Udy, A, Varelas, P, Videtta, W, Voss, H, Vox, F, Wagner, A, Wahlster, S, Wainwright, M, Whyte, J, Witherspoon, B, Yakhkind, A, Yeager, S, Young, M, Zafar, S, Zafonte, R, Zahuranec, D, Zammit, C, Zhang, B, Ziai, W, Zimmerman, L, Zink, E, Tinti, Lorenzo, Lawson, Thomas, Molteni, Erika, Kondziella, Daniel, Rass, Verena, Sharshar, Tarek, Bodien, Yelena G, Giacino, Joseph T, Mayer, Stephan A, Amiri, Moshgan, Muehlschlegel, Susanne, Venkatasubba Rao, Chethan P, Vespa, Paul M, Menon, David K, Citerio, Giuseppe, Helbok, Raimund, McNett, Molly, Agarwal, Sachin, Aiyagari, Venkatesh, Akbari, Yama, Albertson, Asher, Alexander, Sheila, Alexandrov, Anne, Alkhachroum, Ayham, Al-Mufti, Fawaz, Amiri, Moshagan, Appavu, Brian, Gebrewold, Meron Awraris, Ayounb, Marc, Badenes, Rafael, Bader, Mary Kay, Badjiata, Neeraj, Balu, Ram, Barlow, Brooke, Barra, Megan, Beekman, Rachel, Beghi, Ettore, Beqiri, Erta, Berlin, Tracey, Bilotta, Federico, Bleck, Thomas, Bodien, Yelena, Boerwinkle, Varina, Boly, Melanie, Bonnel, Alexandra, Brazzi, Luca, Brown, Emery, Bulic, Sebina, Caceres, Eder, Caceres, Adrian, Cafiero, Tullio, Carroll, Elizabeth, Cediel, Emilio G, Chou, Sherry, Claassen, Jan, Condie, Chad, Conti, Alfredo, Cosmas, Katie, Costa, Paolo, Creutzfeldt, Claire, Dangayach, Neha, Dauri, Mario, Debicki, Derek, DeGeorgia, Michael, Der-Nigoghossian, Caroline, Desai, Masoom, Dhar, Rajat, Diringer, Michael, Durr, Emily, Edlow, Brian, Ercole, Ari, Estraneo, Anna, Falcone, Guido, Farrokh, Salia, Ferguson, Adam, Fernandez-Espejo, Davinia, Fink, Ericka, Fins, Joseph, Foreman, Brandon, Franchi, Federico, Frontera, Jennifer, Ganesan, Rishi, Gaspard, Nicolas, Ghavam, Ahmeneh, Giacino, Joseph, Gibbons, Christie, Gilmore, Emily, Glustein, Chavie, Gosseries, Olivia, Green, Theresa, Greer, David, Guanci, Mary, Gupta, Deepak, Hahn, Cecil, Hakimi, Ryan, Hammond, Flora, Hanley, Daniel F, Hartings, Jed, Hassan, Ahmed, Hemphill, Claude, Da Cunha, Arthur Henrique Galvão Bruno, Hinson, Holly, Hirsch, Karen, Hocker, Sarah, Hu, Peter, Hu, Xiao, Human, Theresa, Hwang, David, Illes, Judy, Jaffa, Matthew, James, Michael L, Janas, Anna, Johnson, Susan, Jones, Morgan, Jox, Ralf J, Kalanuria, Atul, Keller, Emanuela, Kennedy, Lori, Kennelly, Megan, Keogh, Maggie, Kim, Jenn, Kim, Keri, Kirsch, Hannah, Kirschen, Matthew, Ko, Nerissa, Kreitzer, Natalie, Kromm, Julie, Kumar, Abhay, Kurtz, Pedro, Laureys, Steven, Lejeune, Nicolas, Lewis, Ariane, Liang, John, Ling, Geoffrey, Livesay, Sarah, Luppi, Andrea, MacDonald, Jennifer, Maddux, Craig, Mahanes, Dea, Mainali, Shraddha, Maldonado, Nelson, Ribeiro, Rennan Martins, Mascia, Luciana, Massimini, Marcello, Mathur, Rohan, Mayer, Stephan, McCredie, Victoria, Mejia-Mantilla, Jorge, Mendoza, Michael, Menon, David, Meyfroidt, Geert, Mijangos, Julio, Moberg, Dick, Moheet, Asma, Montalenti, Elisa, Monti, Martin, Morrison, Chris, Munar, Marina, Murtaugh, Brooke, Naccache, Lionel, Nagayama, Masao, Nairon, Emerson, Nakagawa, Thomas, Naldi, Andrea, Narenthiran, Ganesalingam, Natarajan, Girija, Nemetsky, Esther, Newcombe, Virginia, Nielsen, Niklas, Niznick, Naomi, Noronha-Falcão, Filipa, Nyquist, Paul, Olson, DaiWai, Othman, Marwan, Owen, Adrian, Padayachy, Llewellyn, Pajoumand, Mehrnaz, Park, Soojin, Pergakis, Melissa, Perry, Heidi, Polizzotto, Len, Pouratian, Nader, Spivack, Marilyn Price, Prisco, Lara, Provencio, Javier, Puglises, Francesco, Puybasset, Louis, Rao, Chethan, Rasmussen, Lindsay, Rasulo, Frank, Ray, Bappaditya, Ricci, Zaccaria, Richardson, Risa, Shinotsuka, Cassia Righy, Robba, Chiara, Robertson, Courtney, Rohaut, Benjamin, Rolston, John, Romagnoli, Stefano, Rosanova, Mario, Rosenthal, Eric, Rowe, Shaun, Rubin, Michael, Russell, Mary Beth, Silva, Gisele Sampaio, Sanz, Leandro, Sarasso, Simone, Sarwal, Aarti, Schiff, Nicolas, Schnakers, Caroline, Seder, David, Shah, Vishank Arun, Shapiro-Rosenbaubm, Amy, Shapshak, Angela, Sharma, Kartavya, Sharma, Kumar Ajay, Shutter, Lori, Sitt, Jacobo, Slomine, Beth, Smetana, Keaton, Smielewski, Peter, Smith, Wade, Stamatakis, Emmanuel, Steinberg, Alexis, Stevens, Robert, Suarez, Jose, Sung, Gene, Sussman, Bethany, Taran, Shaurya, Mazzeo, Anna Teresa, Thibaut, Aurore, Thompson, David, Threlkeld, Zachary, Toker, Daniel, Torbey, Michel, Tosto, Jenna, Trevick, Stephen, Tsaousi, Georgia, Turgeon, Alexis, Udy, Andrew, Varelas, Panos, Vespa, Paul, Videtta, Walter, Voss, Henning, Vox, Ford, Wagner, Amy, Wahlster, Sarah, Wainwright, Mark, Whyte, John, Witherspoon, Briana, Yakhkind, Aleksandra (Sasha), Yeager, Susan, Young, Michael, Zafar, Sahar, Zafonte, Ross, Zahuranec, Darin, Zammit, Chris, Zhang, Bei, Ziai, Wendy, Zimmerman, Lara, and Zink, Elizabeth

Abstract

Disorders of consciousness are neurological conditions characterized by impaired arousal and awareness of self and environment. Behavioural responses are absent or are present but fluctuate. Disorders of consciousness are commonly encountered as a consequence of both acute and chronic brain injuries, yet reliable epidemiological estimates would require inclusive, operational definitions of the concept, as well as wider knowledge dissemination among involved professionals. Whereas several manifestations have been described, including coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state, a comprehensive neurobiological definition for disorders of consciousness is still lacking. The scientific literature is primarily observational, and studies-specific aetiologies lead to disorders of consciousness. Despite advances in these disease-related forms, there remains uncertainty about whether disorders of consciousness are a disease-agnostic unitary entity with a common mechanism, prognosis or treatment response paradigm. Our knowledge of disorders of consciousness has also been hampered by heterogeneity of study designs, variables, and outcomes, leading to results that are not comparable for evidence synthesis. The different backgrounds of professionals caring for patients with disorders of consciousness and the different goals at different stages of care could partly explain this variability. The Prospective Studies working group of the Neurocritical Care Society Curing Coma Campaign was established to create a platform for observational studies and future clinical trials on disorders of consciousness and coma across the continuum of care. In this narrative review, the author panel presents limitations of prior observational clinical research and outlines practical considerations for future investigations. A narrative review format was selected to ensure that the full breadth of study design considerations could be addressed and to facilit

Published
2024

121. Concomitant spine trauma in patients with traumatic brain injury: Patient characteristics and outcomes

Author

Lennart Riemann, Obada T. Alhalabi, Andreas W. Unterberg, Alexander Younsi, The CENTER-TBI investigators and participants, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Cović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Ðula Ðilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I.R. Maas, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Ranjit D. Singh, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Inge A. van Erp, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Thijs Vande Vyvere, Roel P. J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Daniel Whitehouse, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, and Tommaso Zoerle

Subjects
traumatic brain injury, traumatic spine injury, outcome, CENTER-TBI, spine trauma, Neurology. Diseases of the nervous system, RC346-429
Abstract

ObjectiveSpine injury is highly prevalent in patients with poly-trauma, but data on the co-occurrence of spine trauma in patients with traumatic brain injury (TBI) are scarce. In this study, we used the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) database to assess the prevalence, characteristics, and outcomes of patients with TBI and a concurrent traumatic spinal injury (TSI).MethodsData from the European multi-center CENTER-TBI study were analyzed. Adult patients with TBI (≥18 years) presenting with a concomitant, isolated TSI of at least serious severity (Abbreviated Injury Scale; AIS ≥3) were included. For outcome analysis, comparison groups of TBI patients with TSI and systemic injuries (non-isolated TSI) and without TSI were created using propensity score matching. Rates of mortality, unfavorable outcomes (Glasgow Outcome Scale Extended; GOSe < 5), and full recovery (GOSe 7–8) of all patients and separately for patients with only mild TBI (mTBI) were compared between groups at 6-month follow-up.ResultsA total of 164 (4%) of the 4,254 CENTER-TBI core study patients suffered from a concomitant isolated TSI. The median age was 53 [interquartile range (IQR): 37–66] years and 71% of patients were men. mTBI was documented in 62% of cases, followed by severe TBI (26%), and spine injuries were mostly cervical (63%) or thoracic (31%). Surgical spine stabilization was performed in 19% of cases and 57% of patients were admitted to the ICU. Mortality at 6 months was 11% and only 36% of patients regained full recovery. There were no significant differences in the 6-month rates of mortality, unfavorable outcomes, or full recovery between TBI patients with and without concomitant isolated TSI. However, concomitant non-isolated TSI was associated with an unfavorable outcome and a higher mortality. In patients with mTBI, a negative association with full recovery could be observed for both concomitant isolated and non-isolated TSI.ConclusionRates of mortality, unfavorable outcomes, and full recovery in TBI patients with and without concomitant, isolated TSIs were comparable after 6 months. However, in patients with mTBI, concomitant TSI was a negative predictor for a full recovery. These findings might indicate that patients with moderate to severe TBI do not necessarily exhibit worse outcomes when having a concomitant TSI, whereas patients with mTBI might be more affected.

Published
2022
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122. Comparing Seizures Captured by Rapid Response EEG and Conventional EEG Recordings in a Multicenter Clinical Study

Author

Deepika Kurup, Kapil Gururangan, Masoom J. Desai, Matthew S. Markert, Dawn S. Eliashiv, Paul M. Vespa, and Josef Parvizi

Subjects
electroencephalography, rapid response EEG, reduced channel montage, seizure detection, non-convulsive status epilepticus (NCSE), highly epileptiform patterns, Neurology. Diseases of the nervous system, RC346-429
Abstract

ObjectiveA recent multicenter prospective study (DECIDE trial) examined the use of Ceribell Rapid Response EEG (Rapid-EEG) in the emergent evaluation and management of critically ill patients suspected to have non-convulsive seizures. We present a detailed, patient-level examination of seizures detected either on initial Rapid-EEG or subsequent conventional EEG within 24 h to investigate whether seizures were missed on Rapid-EEG due to the exclusion of midline/parasagittal coverage.MethodsWe identified from 164 patients studied in the DECIDE trial those who had seizures detected on Rapid-EEG but not conventional EEG (n = 6), conventional EEG but not Rapid-EEG (n = 4), or both Rapid-EEG and conventional EEG (n = 9). We examined the electrographic characteristics of ictal and interictal findings on both devices, especially their detection in lateral or midline/parasagittal chains, and patient clinical histories to identify contributors toward discordant seizure detection.ResultsSeizures detected on both EEG systems had similar electrographic appearance and laterality. Seizures detected only on conventional EEG (within 24 h following Rapid-EEG) were visible in the temporal chains, and external clinical factors (e.g., treatment with anti-seizure medications, sedation, and duration of recordings) explained the delayed presentation of seizures. Patients with seizures detected only by Rapid-EEG were treated with anti-seizure medications, and subsequent conventional EEG detected interictal highly epileptiform patterns with similar laterality.ConclusionsOur case series demonstrates that electrographic data obtained from initial Rapid-EEG and subsequent conventional EEG monitoring are largely concordant relative to morphology and laterality. These findings are valuable to inform future investigation of abbreviated EEG systems to optimize management of suspected non-convulsive seizures and status epilepticus. Future, larger studies could further investigate the value of Rapid-EEG findings for forecasting and predicting seizures in long-term EEG recordings.

Published
2022
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123. Extension between functors from groups

Author

Vespa, Christine

Subjects
Mathematics - Algebraic Topology, Mathematics - Category Theory, Mathematics - K-Theory and Homology
Abstract

Motivated in part by the study of the stable homology of automorphism groups of free groups, we consider cohomological calculations in the category $\mathcal{F}(\textbf{gr})$ of functors from finitely generated free groups to abelian groups.In particular, we compute the groups $Ext^*\_{\mathcal{F}(\textbf{gr})}(T^n \circ \mathfrak{a}, T^m \circ \mathfrak{a})$ where $\mathfrak{a}$ is the abelianization functor and $T^n$ is the n-th tensor power functor for abelian groups. These groups are shown to be non-zero if and only if $*=m-n \geq 0$ and $Ext^{m-n}\_{\mathcal{F}(\textbf{gr})}(T^n \circ \mathfrak{a}, T^m \circ \mathfrak{a})=\mathbb{Z}[Surj(m,n)]$ where $Surj(m,n)$ is the set of surjections from a set having $m$ elements to a set having $n$ elements. We make explicit the action of symmetric groups on these groups and the Yoneda and external products. We deduce from these computations those of rational Ext-groups for functors of the form $F \circ \mathfrak{a}$ where $F$ is a symmetric or an exterior power functor. Combining these computations with a recent result of Djament we obtain explicit computations of stable homology of automorphism groups of free groups with coefficients given by particular contravariant functors.

Published
2015
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124. Comparative Design Space Exploration of Dense and Semi-Dense SLAM

Author

Zia, M. Zeeshan, Nardi, Luigi, Jack, Andrew, Vespa, Emanuele, Bodin, Bruno, Kelly, Paul H. J., and Davison, Andrew J.

Subjects
Computer Science - Robotics, Computer Science - Computer Vision and Pattern Recognition
Abstract

SLAM has matured significantly over the past few years, and is beginning to appear in serious commercial products. While new SLAM systems are being proposed at every conference, evaluation is often restricted to qualitative visualizations or accuracy estimation against a ground truth. This is due to the lack of benchmarking methodologies which can holistically and quantitatively evaluate these systems. Further investigation at the level of individual kernels and parameter spaces of SLAM pipelines is non-existent, which is absolutely essential for systems research and integration. We extend the recently introduced SLAMBench framework to allow comparing two state-of-the-art SLAM pipelines, namely KinectFusion and LSD-SLAM, along the metrics of accuracy, energy consumption, and processing frame rate on two different hardware platforms, namely a desktop and an embedded device. We also analyze the pipelines at the level of individual kernels and explore their algorithmic and hardware design spaces for the first time, yielding valuable insights., Comment: IEEE International Conference on Robotics and Automation 2016

Published
2015
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125. On some properties of the category of cocommutative Hopf algebras

Author

Vespa, Christine and Wambst, Marc

Subjects
Mathematics - Category Theory, Mathematics - Quantum Algebra
Abstract

By a recent work of Gran-Kadjo-Vercruysse, the category of cocommutative Hopf algebras over a field of characteristic zero is semi-abelian. In this paper, we explore some properties of this categoy, in particular we show that its abelian core is the category of commutative and cocommutative Hopf algebras., Comment: 12 pages

Published
2015

126. Correction to: Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness

Author

Mainali, Shraddha, Aiyagari, Venkatesh, Alexander, Sheila, Bodien, Yelena, Boerwinkle, Varina, Boly, Melanie, Brown, Emery, Brown, Jeremy, Claassen, Jan, Edlow, Brian L., Fink, Ericka L., Fins, Joseph J., Foreman, Brandon, Frontera, Jennifer, Geocadin, Romergryko G., Giacino, Joseph, Gilmore, Emily J., Gosseries, Olivia, Hammond, Flora, Helbok, Raimund, Claude Hemphill, J., Hirsch, Karen, Kim, Keri, Laureys, Steven, Lewis, Ariane, Ling, Geoffrey, Livesay, Sarah L., McCredie, Victoria, McNett, Molly, Menon, David, Molteni, Erika, Olson, DaiWai, O’Phelan, Kristine, Park, Soojin, Polizzotto, Len, Javier Provencio, Jose, Puybasset, Louis, Venkatasubba Rao, Chethan P., Robertson, Courtney, Rohaut, Benjamin, Rubin, Michael, Sharshar, Tarek, Shutter, Lori, Sampaio Silva, Gisele, Smith, Wade, Stevens, Robert D., Thibaut, Aurore, Vespa, Paul, Wagner, Amy K., Ziai, Wendy C., Zink, Elizabeth, and Suarez, Jose I.

Published
2022
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127. ZnO Nanorods Create a Hypoxic State with Induction of HIF-1 and EPAS1, Autophagy, and Mitophagy in Cancer and Non-Cancer Cells

Author

Michele Aventaggiato, Adele Preziosi, Hossein Cheraghi Bidsorkhi, Emily Schifano, Simone Vespa, Stefania Mardente, Alessandra Zicari, Daniela Uccelletti, Patrizia Mancini, Lavinia Vittoria Lotti, Maria Sabrina Sarto, and Marco Tafani

Subjects
ZnO nanorods, hypoxia, autophagy, mitophagy, nanomaterials, cancer, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Nanomaterials are gaining increasing attention as innovative materials in medicine. Among nanomaterials, zinc oxide (ZnO) nanostructures are particularly appealing because of their opto-electrical, antimicrobial, and photochemical properties. Although ZnO is recognized as a safe material and the Zn ion (Zn2+) concentration is strictly regulated at a cellular and systemic level, different studies have demonstrated cellular toxicity of ZnO nanoparticles (ZnO-NPs) and ZnO nanorods (ZnO-NRs). Recently, ZnO-NP toxicity has been shown to depend on the intracellular accumulation of ROS, activation of autophagy and mitophagy, as well as stabilization and accumulation of hypoxia-inducible factor-1α (HIF-1α) protein. However, if the same pathway is also activated by ZnO-NRs and how non-cancer cells respond to ZnO-NR treatment, are still unknown. To answer to these questions, we treated epithelial HaCaT and breast cancer MCF-7 cells with different ZnO-NR concentrations. Our results showed that ZnO-NR treatments increased cell death through ROS accumulation, HIF-1α and endothelial PAS domain protein 1 (EPAS1) activation, and induction of autophagy and mitophagy in both cell lines. These results, while on one side, confirmed that ZnO-NRs can be used to reduce cancer growth, on the other side, raised some concerns on the activation of a hypoxic response in normal cells that, in the long run, could induce cellular transformation.

Published
2023
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128. Effects of Mindfulness-Based Interventions (MBIs) in Patients with Early-Stage Alzheimer’s Disease: A Pilot Study

Author

M. V. Giulietti, R. Spatuzzi, P. Fabbietti, and A. Vespa

Subjects
mindfulness, cognitive status, neuropsychiatric symptoms, depression, quality of life, Alzheimer’s disease, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Bachground In this study, we hypothesize that mindfulness-based interventions (MBIs) may improve well-being and the related outcomes in Alzheimer’s dementia patients (AD-P) at an early stage. MBIs consist of the practice of consciously observing the psychic contents in the present moment (thoughts, sensations, feelings, and other events). This attention allows one to become aware of the psychic contents and integrate them, thus favoring the quality of life and an increase in the mood of practitioners. Methods The randomized controlled study enrolled 22 AD-P at an early stage (age ≥ 60 years) treated with MBIs and 22 patients without treatment (six months of MBI training). Tests (T0–T1 six months): Mini-Mental State Examination (MMPI); Spiritual Well-Being (SWB); Beck Depression Inventory (BDI); SF36. Test-Caregiver: Everyday Cognition scales (ECOG). Results AD-P with mindfulness: Improvement of ECOG (p = 0.026), quality of life (p < 0.001), spiritual well-being (p < 0.001); decrease in depression BDI (p < 0.001). The MMSE remains unchanged. The control group of untreated patients showed a significant worsening in all these dimensions. Conclusions MBI training is effective in increasing quality of life and preventing worsening in patients with early-stage Alzheimer’s dementia.

Published
2023
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129. Structural Analysis of Social Behavior: Using Cluster Analysis to Examine Intrapsychic Personality Traits Associated With Depression in Women With Breast Cancer

Author

Anna Vespa, Maria Velia Giulietti, Paolo Fabbietti, Mirko Di Rosa, Pisana Gattafoni, Riccardo Sarzani, Giorgio Arnaldi, Giancarlo Balercia, Rossana Berardi, Gianmaria Salvo, Luigi Attademo, and Roberta Spatuzzi

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background This study aimed to investigate personality traits associated with depression in breast cancer women (BCW). Methods Sample: 236 BCW recently diagnosed (early stages). Tests: SASB-Structural-Analysis of Social-Behavior; IPAT-CDQ-Depression . Statistical analysis: cluster K-Means analysis to explore SASB personality-traits considering the 8 SASB clusters (Cl); CDQ scores dichotomized by 50th percentile cutoff (high/low); Pearson’s chi square test to compare CDQ levels and SASB traits. Results Cluster analysis results supported two distinguishable SASB personality traits (for all SASB Cl-Scales P < .001) classified as “Love and Autonomy” (62.2%) and “Control and Hate” (37.8%). Patients with Love/Autonomy traits are spontaneous, accept their deepest feelings and desire to be close to other people (Cl1, Cl2, Cl3, Cl4). They show a medium value of self-control and a low tendency to self-abusive and self-critical behaviors (Cl5, Cl6). They pay attention to themselves and to their needs at emotional and physical levels also if may be occasionally engaged in self-destructive behaviors (Cl7, Cl8). Women with Control/Hate traits are not spontaneous and do not always express emotions (C1, Cl2, Cl3, Cl4) and flexibility in their relationship with others (Cl5, Cl6). In stressful situations, they may ignore the option of choices for self-growth and neglect their needs and those of others (Cl7, Cl8). BCWs with Control/Hate traits scored higher in depression ( P

Published
2022
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131. Mechanical thrombectomy for acute ischemic stroke with cerebral microbleeds.

Author

Shi, Zhong-Song, Duckwiler, Gary R, Jahan, Reza, Tateshima, Satoshi, Gonzalez, Nestor R, Szeder, Viktor, Saver, Jeffrey L, Kim, Doojin, Ali, Latisha K, Starkman, Sidney, Vespa, Paul M, Salamon, Noriko, Villablanca, J Pablo, Viñuela, Fernando, Feng, Lei, Loh, Yince, and Liebeskind, David S

Subjects
Humans, Cerebrovascular Disorders, Brain Ischemia, Cerebral Hemorrhage, Magnetic Resonance Imaging, Thrombectomy, Aged, Aged, 80 and over, Middle Aged, Female, Male, Stroke, Hemorrhage, Brain Disorders, Clinical Research, Good Health and Well Being
Abstract

BackgroundThe influence of cerebral microbleeds (CMBs) on post-thrombolytic hemorrhagic transformation (HT) in patients with acute ischemic stroke remains controversial.ObjectiveTo investigate the association of CMBs with HT and clinical outcomes among patients with large-vessel occlusion strokes treated with mechanical thrombectomy.MethodsWe analyzed patients with acute stroke treated with Merci Retriever, Penumbra system or stent-retriever devices. CMBs were identified on pretreatment T2-weighted, gradient-recall echo MRI. We analyzed the association of the presence, burden, and distribution of CMBs with HT, procedural complications, in-hospital mortality, and clinical outcome.ResultsCMBs were detected in 37 (18.0%) of 206 patients. Seventy-three foci of microbleeds were identified. Fourteen patients (6.8%) had ≥2 CMBs, only 1 patient had ≥5 CMBs. Strictly lobar CMBs were found in 12 patients, strictly deep CMBs in 12 patients, strictly infratentorial CMBs in 2 patients, and mixed CMBs in 11 patients. There were no significant differences between patients with CMBs and those without CMBs in the rates of overall HT (37.8% vs 45.6%), parenchymal hematoma (16.2% vs 19.5%), procedure-related vessel perforation (5.4% vs 7.1%), in-hospital mortality (16.2% vs 18.3%), and modified Rankin Scale score 0-3 at discharge. CMBs were not independently associated with HT or in-hospital mortality in patients treated with either thrombectomy or intravenous thrombolysis followed by thrombectomy.ConclusionsPatients with CMBs are not at increased risk for HT and mortality following mechanical thrombectomy for acute stroke. Excluding such patients from mechanical thrombectomy is unwarranted. The risk of HT in patients with ≥5 CMBs requires further study.

Published
2016

132. Cohomologie des foncteurs polynomiaux sur les groupes libres

Author

Djament, Aurélien, Pirashvili, Teimuraz, and Vespa, Christine

Subjects
Mathematics - K-Theory and Homology, Mathematics - Algebraic Topology, Mathematics - Category Theory, Mathematics - Rings and Algebras
Abstract

We show that extension groups between two polynomial functors on free groups are the same in the category of all functors and in a subcategory of polynomial functors of bounded degree. We give some applications. ---- On montre que les groupes d'extensions entre foncteurs polynomiaux sur les groupes libres sont les m\^emes dans la cat\'egorie de tous les foncteurs et dans une sous-cat\'egorie de foncteurs polynomiaux de degr\'e born\'e. On donne quelques applications., Comment: 14 pages, in French

Published
2014

133. Leibniz homology of Lie algebras as functor homology

Author

Hoffbeck, Eric and Vespa, Christine

Subjects
Mathematics - Algebraic Topology, Mathematics - Category Theory
Abstract

We prove that Leibniz homology of Lie algebras can be described as functor homology in the category of linear functors from a category associated to the Lie operad., Comment: 26 pages

Published
2014

135. Les effets néfastes de la kubeia. Mise en jeu du prestige et de l’image sociale en Grèce classique

Author

Marco Vespa

Subjects
Achilles, boardgames, classical Athens, dice, elite, gambling, Social Sciences
Abstract

In several texts from classical antiquity, the invention of dice and board games is associated with attempts to put an end to crisis in the political community, as the stories about Palamedes seem to show. Beside the fictional context of mythical narratives the cultural value of dice and board games enters into other discursive representations. In particular, the speech of the rhetorician Alcidamas (On the Betrayal of Palamedes, fr. 2 Avezzù) in the 4th century BC invites us to analyse the dark side of board games, especially those that fell into the category of κυβεία, that is gambling activities. Different texts from classical Athens, from Herodotus to Cratinus, including Isocrates, use enunciative processes in order to devaluate these gambling activities and stigmatize citizens/soldiers and political élites. This article demonstrates how play has been one of the ways of building or disfiguring the social image of an individual within the civic community.

Published
2020
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136. Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury

Author

Dominique L.G. Van Praag, Kristien Wouters, Filip Van Den Eede, Lindsay Wilson, Andrew I.R. Maas, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Iris Ceyisakar, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Roel P.J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, and Tommaso Zoerle

Subjects
Cognition, Head injury, Neuropsychology, Posttraumatic stress disorder, Stress, Neurology. Diseases of the nervous system, RC346-429
Abstract

Introduction: Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI). Research question: We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample. Material and methods: The study is part of the CENTER-TBI project (Collaborative European Neurotrauma Effectiveness Research) that aims to better characterize TBI. For this cross-sectional study, we included patients of all severities aged over 15, and a Glasgow Outcome Score Extended (GOSE) above 3. Participants were assessed at six months post-injury on the PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Primary analysis was a complete case analysis. Regression analyses were performed to investigate the association between the PCL-5 and cognition. Results: Of the 1134 participants included in the complete case analysis, 13.5% screened positive for PTSD. Probable PTSD was significantly associated with higher TMT-(B-A) (OR ​= ​1.35, 95% CI: 1.14–1.60, p ​

Published
2022
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137. Type 2 Inflammation in Eosinophilic Esophagitis: From Pathophysiology to Therapeutic Targets

Author

Francesca Racca, Gaia Pellegatta, Giuseppe Cataldo, Edoardo Vespa, Elisa Carlani, Corrado Pelaia, Giovanni Paoletti, Maria Rita Messina, Emanuele Nappi, Giorgio Walter Canonica, Alessandro Repici, and Enrico Heffler

Subjects
eosinophilic esophagitis, type 2 inflammation, therapeutic targets, precision medicine, pathophysiology, Physiology, QP1-981
Abstract

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation, whose incidence is rising. It significantly affects patients’ quality of life and, if left untreated, results in fibrotic complications. Although broad consensus has been achieved on first-line therapy, a subset of patients remains non-responder to standard therapy. The pathogenesis of EoE is multifactorial and results from the complex, still mostly undefined, interaction between genetics and intrinsic factors, environment, and antigenic stimuli. A deep understanding of the pathophysiology of this disease is pivotal for the development of new therapies. This review provides a comprehensive description of the pathophysiology of EoE, starting from major pathogenic mechanisms (genetics, type 2 inflammation, epithelial barrier dysfunction, gastroesophageal reflux, allergens, infections and microbiota) and subsequently focusing on the single protagonists of type 2 inflammation (involved cells, cytokines, soluble effectors, surface proteins and transcription factors) that could represent present and future therapeutic targets, while summarizing previous therapeutic approaches in literature.

Published
2022
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138. Role of SIRT3 in Microgravity Response: A New Player in Muscle Tissue Recovery

Author

Michele Aventaggiato, Federica Barreca, Laura Vitiello, Simone Vespa, Sergio Valente, Dante Rotili, Antonello Mai, Lavinia Vittoria Lotti, Luigi Sansone, Matteo A. Russo, Mariano Bizzarri, Elisabetta Ferretti, and Marco Tafani

Subjects
simulated microgravity, sirtuins, SIRT3, muscle tissue, ROS, mitochondria, Cytology, QH573-671
Abstract

Life on Earth has evolved in the presence of a gravity constraint. Any change in the value of such a constraint has important physiological effects. Gravity reduction (microgravity) alters the performance of muscle, bone and, immune systems among others. Therefore, countermeasures to limit such deleterious effects of microgravity are needed considering future Lunar and Martian missions. Our study aims to demonstrate that the activation of mitochondrial Sirtuin 3 (SIRT3) can be exploited to reduce muscle damage and to maintain muscle differentiation following microgravity exposure. To this effect, we used a RCCS machine to simulate microgravity on ground on a muscle and cardiac cell line. During microgravity, cells were treated with a newly synthesized SIRT3 activator, called MC2791 and vitality, differentiation, ROS and, autophagy/mitophagy were measured. Our results indicate that SIRT3 activation reduces microgravity-induced cell death while maintaining the expression of muscle cell differentiation markers. In conclusion, our study demonstrates that SIRT3 activation could represent a targeted molecular strategy to reduce muscle tissue damage caused by microgravity.

Published
2023
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139. The Impact of Social Determinants of Health on Meningococcal Vaccination Awareness, Delivery, and Coverage in Adolescents and Young Adults in the United States: A Systematic Review

Author

Catherine Masaquel, Katharina Schley, Kelly Wright, Josephine Mauskopf, Ronika Alexander Parrish, Jessica Vespa Presa, and Dial Hewlett

Subjects
meningococcal disease, vaccine recommendation, meningococcal vaccination, health equity, health disparity, Medicine
Abstract

Vaccines remain a fundamental intervention for preventing illness and death. In the United States, suboptimal vaccine uptake in adolescents and young adults has been observed for meningococcal conjugate (MenACWY) and serogroup B meningococcal (MenB) vaccines, particularly among marginalized communities, despite current recommendations by the Advisory Committee on Immunization Practices. A systematic literature search was conducted in the MEDLINE and MEDLINE In-Process, Embase, Cochrane, PsychInfo, and CINAHL databases to identify both drivers of, and barriers to, MenACWY and MenB vaccine uptake in adolescents and young adults. A total of 34 of 46 eligible studies that presented outcomes stratified by race/ethnicity, geography, and socioeconomic status were selected for review. Results showed MenACWY and MenB vaccination coverage in adolescents and young adults is impacted by racial/ethnic, socioeconomic, and geographic disparities. Gaps also exist in insurance for, or access to, these vaccines in adolescents and young adults. Moreover, there was variability in the understanding and implementation of the shared decision-making recommendations for the MenB vaccine. Disease awareness campaigns, increased clarity in accessing all meningococcal vaccines, and further research on the relationships between measures of marginalization and its impact on vaccine coverage in adolescents and young adults are needed to reduce the incidence of severe infections.

Published
2023
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140. How Is the Norepinephrine System Involved in the Antiepileptic Effects of Vagus Nerve Stimulation?

Author

Alexandre Berger, Simone Vespa, Laurence Dricot, Manon Dumoulin, Evelina Iachim, Pascal Doguet, Gilles Vandewalle, and Riëm El Tahry

Subjects
VNS, epilepsy, norepinephrine, locus coeruleus, vagus nerve, biomarker, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Vagus Nerve Stimulation (VNS) is an adjunctive treatment for patients suffering from inoperable drug-resistant epilepsy. Although a complete understanding of the mediators involved in the antiepileptic effects of VNS and their complex interactions is lacking, VNS is known to trigger the release of neurotransmitters that have seizure-suppressing effects. In particular, norepinephrine (NE) is a neurotransmitter that has been associated with the clinical effects of VNS by preventing seizure development and by inducing long-term plastic changes that could restore a normal function of the brain circuitry. However, the biological requisites to become responder to VNS are still unknown. In this review, we report evidence of the critical involvement of NE in the antiepileptic effects of VNS in rodents and humans. Moreover, we emphasize the hypothesis that the functional integrity of the noradrenergic system could be a determining factor to obtain clinical benefits from the therapy. Finally, encouraging avenues of research involving NE in VNS treatment are discussed. These could lead to the personalization of the stimulation parameters to maximize the antiepileptic effects and potentially improve the response rate to the therapy.

Published
2021
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141. Sedation-Induced Burst Suppression Predicts Positive Outcome Following Traumatic Brain Injury

Author

Joel Frohlich, Micah A. Johnson, David L. McArthur, Evan S. Lutkenhoff, John Dell'Italia, Courtney Real, Vikesh Shrestha, Norman M. Spivak, Jesús E. Ruiz Tejeda, Paul M. Vespa, and Martin M. Monti

Subjects
traumatic brain injury (TBI), burst suppression, barbiturates, coma, disorders of consciousness, EEG biomarker, Neurology. Diseases of the nervous system, RC346-429
Abstract

While electroencephalogram (EEG) burst-suppression is often induced therapeutically using sedatives in the intensive care unit (ICU), there is hitherto no evidence with respect to its association to outcome in moderate-to-severe neurological patients. We examined the relationship between sedation-induced burst-suppression (SIBS) and outcome at hospital discharge and at 6-month follow up in patients surviving moderate-to-severe traumatic brain injury (TBI). For each of 32 patients recovering from coma after moderate-to-severe TBI, we measured the EEG burst suppression ratio (BSR) during periods of low responsiveness as assessed with the Glasgow Coma Scale (GCS). The maximum BSR was then used to predict the Glasgow Outcome Scale extended (GOSe) at discharge and at 6 months post-injury. A multi-model inference approach was used to assess the combination of predictors that best fit the outcome data. We found that BSR was positively associated with outcomes at 6 months (P = 0.022) but did not predict outcomes at discharge. A mediation analysis found no evidence that BSR mediates the effects of barbiturates or propofol on outcomes. Our results provide initial observational evidence that burst suppression may be neuroprotective in acute patients with TBI etiologies. SIBS may thus be useful in the ICU as a prognostic biomarker.

Published
2021
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142. Circulating Extracellular Vesicles Are Increased in Newly Diagnosed Celiac Disease Patients

Author

Konstantinos Efthymakis, Giuseppina Bologna, Pasquale Simeone, Laura Pierdomenico, Giulia Catitti, Simone Vespa, Angelo Milano, Domenico De Bellis, Francesco Laterza, Assunta Pandolfi, Caterina Pipino, Michele Sallese, Marco Marchisio, Sebastiano Miscia, Matteo Neri, and Paola Lanuti

Subjects
extracellular vesicles, flow cytometry, celiac disease, gluten-free diet regimen (GFD), Nutrition. Foods and food supply, TX341-641
Abstract

Extracellular vesicles (EVs) are a class of circulating entities that are involved in intercellular crosstalk mechanisms, participating in homeostasis maintenance, and diseases. Celiac disease is a gluten-triggered immune-mediated disorder, characterized by the inflammatory insult of the enteric mucosa following local lymphocytic infiltration, resulting in villous atrophy. The goal of this research was the assessment and characterization of circulating EVs in celiac disease patients, as well as in patients already on an adequate gluten-free regimen (GFD). For this purpose, a novel and validated technique based on polychromatic flow cytometry that allowed the identification and enumeration of different EV sub-phenotypes was applied. The analysis evidenced that the total, annexin V+, leukocyte (CD45+), and platelet (CD41a+) EV counts were significantly higher in both newly diagnosed celiac disease patients and patients under GFD compared with the healthy controls. Endothelial-derived (CD31+) and epithelial-derived (EpCAM+) EV counts were significantly lower in subjects under gluten exclusion than in celiac disease patients, although EpCAM+ EVs maintained higher counts than healthy subjects. The numbers of EpCAM+ EVs were a statistically significant predictor of intraepithelial leukocytes (IEL). These data demonstrate that EVs could represent novel and potentially powerful disease-specific biomarkers in the context of celiac disease.

Published
2022
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143. Rapid Detection of Brettanomyces bruxellensis in Wine by Polychromatic Flow Cytometry

Author

Domenico De Bellis, Alessio Di Stefano, Pasquale Simeone, Giulia Catitti, Simone Vespa, Antonia Patruno, Marco Marchisio, Eleonora Mari, Lisa Granchi, Carlo Viti, Piero Chiacchiaretta, Angelo Cichelli, Rosanna Tofalo, and Paola Lanuti

Subjects
Brettanomyces bruxellensis, flow cytometry, wine contamination, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Brettanomyces bruxellensis is found in several fermented matrices and produces relevant alterations to the wine quality. The methods usually used to identify B. bruxellensis contamination are based on conventional microbiological techniques that require long procedures (15 days), causing the yeast to spread in the meantime. Recently, a flow cytometry kit for the rapid detection (1–2 h) of B. bruxellensis in wine has been developed. The feasibility of the method was assessed in a synthetic medium as well as in wine samples by detecting B. bruxellensis in the presence of other yeast species (Saccharomyces cerevisiae and Pichia spp.) and at the concentrations that produce natural contaminations (up to 105 cells/mL), as well as at lower concentrations (103–102 cells/mL). Wine samples naturally contaminated by B. bruxellensis or inoculated with four different strains of B. bruxellensis species together with Saccharomyces cerevisiae and Pichia spp., were analyzed by flow cytometry. Plate counts were carried out in parallel to flow cytometry. We provide evidence that flow cytometry allows the rapid detection of B. bruxellensis in simple and complex mixtures. Therefore, this technique has great potential for the detection of B. bruxellensis and could allow preventive actions to reduce wine spoilage.

Published
2022
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144. First Marriages in the United States: Data from the 2006-2010 National Survey of Family Growth. National Health Statistics Reports. Number 49

Author

National Center for Health Statistics (DHHS/PHS), Copen, Casey E., Daniels, Kimberly, Vespa, Jonathan, and Mosher, William D.

Abstract

Objectives: This report shows trends and group differences in current marital status, with a focus on first marriages among women and men aged 15-44 years in the United States. Trends and group differences in the timing and duration of first marriages are also discussed. These data are based on the 2006-2010 National Survey of Family Growth (NSFG). National estimates of probabilities of first marriage by age and probabilities of separation and divorce for women and men's first marriages are presented by a variety of demographic characteristics. Data are compared with similar measures for 1982, 1995, and 2002. Methods: The analyses presented in this report are based on a nationally representative sample of 12,279 women and 10,403 men aged 15-44 years in the household population of the United States. The overall response rate for the 2006-2010 NSFG was 77%-78% for women and 75% for men. Results: The percentage of women who were currently cohabiting (living with a man in a sexual relationship) rose from 3.0% in 1982 to 11% in 2006- 2010; it was higher in some groups, including Hispanic groups, and the less educated. In 2006-2010, women and men married for the first time at older ages than in previous years. The median age at first marriage was 25.8 for women and 28.3 for men. Premarital cohabitation contributed to the delay in first marriage for both women and men.

Published
2012

146. Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Hospital Course, Confounders, and Medications

Author

Barra, M, Zink, E, Bleck, T, Caceres, E, Farrokh, S, Foreman, B, Cediel, E, Hemphill, J, Nagayama, M, Olson, D, Suarez, J, Aiyagari, V, Akbari, Y, Al-Mufti, F, Alexander, S, Alexandrov, A, Alkhachroum, A, Amiri, M, Appavu, B, Gebre, M, Bader, M, Badjiata, N, Balu, R, Beekman, R, Beghi, E, Bell, K, Beqiri, E, Berlin, T, Bodien, Y, Boerwinkle, V, Boly, M, Bonnel, A, Brown, E, Carroll, E, Chou, S, Citerio, G, Classen, J, Condie, C, Cosmas, K, Creutzfeldt, C, Dangayach, N, Degeorgia, M, Der-Nigoghoss, C, Desai, M, Diringer, M, Dullaway, J, Edlow, B, Ercole, A, Estraneo, A, Falcone, G, Padayachy, L, Park, S, Pergakis, M, Polizzotto, L, Pouratian, N, Spivack, M, Prisco, L, Provencio, J, Puybasset, L, Rasmussen, L, Rass, V, Richardson, R, Shinots, C, Robba, C, Robertson, C, Rohaut, B, Rolston, J, Rosanova, M, Rosenthal, E, Russell, M, Silva, G, Sanz, L, Sarasso, S, Sarwal, A, Schiff, N, Schnakers, C, Seder, D, Shah, V, Shapiro-Rosen, A, Shapshak, A, Sharma, K, Sharshar, T, Shutter, L, Sitt, J, Slomine, B, Smielewski, P, Smith, W, Stamatakis, E, Steinberg, A, Ferioli, S, Fernandez-Esp, D, Fink, E, Fins, J, Frontera, J, Ganesan, R, Ghavam, A, Giacino, J, Gibbons, C, Gilmore, E, Gosseries, O, Green, T, Greer, D, Guanci, M, Hahn, C, Hakimi, R, Hanley, D, Hartings, J, Hassan, A, Hinson, H, Hirsch, K, Hocker, S, Hu, P, Hu, X, Human, T, Hwang, D, Illes, J, Jaffa, M, James, M, Janas, A, Jones, M, Keller, E, Keogh, M, Kim, J, Kim, K, Kirsch, H, Kirschen, M, Ko, N, Kondziella, D, Kreitzer, N, Stevens, R, Sussman, B, Taran, S, Thibaut, A, Threlkeld, Z, Tinti, L, Toker, D, Torbey, M, Trevick, S, Turgeon, A, Udy, A, Varelas, P, Venkatasubba, C, Vespa, P, Videtta, W, Voss, H, Vox, F, Wagner, A, Wainwright, M, Whyte, J, Witherspoon, B, Yakhind, A, Zafonte, R, Zahuranec, D, Zammit, C, Zhang, B, Ziai, W, Zimmerman, L, Kromm, J, Kumar, A, Kurtz, P, Laureys, S, Lawson, T, Lejeune, N, Lewis, A, Liang, J, Ling, G, Livesay, S, Luppi, A, Madden, L, Maddux, C, Mahanes, D, Mainali, S, Maldonado, N, Ribeiro, R, Massimini, M, Mayer, S, Mccredie, V, Mcnett, M, Mejia-Mantill, J, Menon, D, Meyfroidt, G, Mijangos, J, Moberg, D, Moheet, A, Molteni, E, Monti, M, Morrison, C, Muehlschlegel, S, Murtaugh, B, Naccache, L, Nairon, E, Natarajan, G, Newcombe, V, Nielsen, N, Noronha-Falc‹, F, Nyquist, P, Othman, M, Owen, A, Barra M. E., Zink E. K., Bleck T. P., Caceres E., Farrokh S., Foreman B., Cediel E. G., Hemphill J. C., Nagayama M., Olson D. W. M., Suarez J. I., Aiyagari V., Akbari Y., Al-Mufti F., Alexander S., Alexandrov A., Alkhachroum A., Amiri M., Appavu B., Gebre M. A., Bader M. K., Badjiata N., Balu R., Beekman R., Beghi E., Bell K., Beqiri E., Berlin T., Bodien Y., Boerwinkle V., Boly M., Bonnel A., Brown E., Carroll E., Chou S., Citerio G., Classen J., Condie C., Cosmas K., Creutzfeldt C., Dangayach N., DeGeorgia M., Der-Nigoghoss C., Desai M., Diringer M., Dullaway J., Edlow B., Ercole A., Estraneo A., Falcone G., Padayachy L., Park S., Pergakis M., Polizzotto L., Pouratian N., Spivack M. P., Prisco L., Provencio J., Puybasset L., Rasmussen L., Rass V., Richardson R., Shinots C. R., Robba C., Robertson C., Rohaut B., Rolston J., Rosanova M., Rosenthal E., Russell M. B., Silva G. S., Sanz L., Sarasso S., Sarwal A., Schiff N., Schnakers C., Seder D., Shah V. A., Shapiro-Rosen A., Shapshak A., Sharma K., Sharshar T., Shutter L., Sitt J., Slomine B., Smielewski P., Smith W., Stamatakis E., Steinberg A., Ferioli S., Fernandez-Esp D., Fink E., Fins J., Frontera J., Ganesan R., Ghavam A., Giacino J., Gibbons C., Gilmore E., Gosseries O., Green T., Greer D., Guanci M., Hahn C., Hakimi R., Hanley D. F., Hartings J., Hassan A., Hinson H., Hirsch K., Hocker S., Hu P., Hu X., Human T., Hwang D., Illes J., Jaffa M., James M. L., Janas A., Jones M., Keller E., Keogh M., Kim J., Kim K., Kirsch H., Kirschen M., Ko N., Kondziella D., Kreitzer N., Stevens R., Sussman B., Taran S., Thibaut A., Threlkeld Z., Tinti L., Toker D., Torbey M., Trevick S., Turgeon A., Udy A., Varelas P., Venkatasubba C., Vespa P., Videtta W., Voss H., Vox F., Wagner A., Wainwright M., Whyte J., Witherspoon B., Yakhind A., Zafonte R., Zahuranec D., Zammit C., Zhang B., Ziai W., Zimmerman L., Kromm J., Kumar A., Kurtz P., Laureys S., Lawson T., Lejeune N., Lewis A., Liang J., Ling G., Livesay S., Luppi A., Madden L., Maddux C., Mahanes D., Mainali S., Maldonado N., Ribeiro R. M., Massimini M., Mayer S., McCredie V., McNett M., Mejia-Mantill J., Menon D., Meyfroidt G., Mijangos J., Moberg D., Moheet A., Molteni E., Monti M., Morrison C., Muehlschlegel S., Murtaugh B., Naccache L., Nairon E., Natarajan G., Newcombe V., Nielsen N., Noronha-Falc‹ F., Nyquist P., Othman M., Owen A., Barra, M, Zink, E, Bleck, T, Caceres, E, Farrokh, S, Foreman, B, Cediel, E, Hemphill, J, Nagayama, M, Olson, D, Suarez, J, Aiyagari, V, Akbari, Y, Al-Mufti, F, Alexander, S, Alexandrov, A, Alkhachroum, A, Amiri, M, Appavu, B, Gebre, M, Bader, M, Badjiata, N, Balu, R, Beekman, R, Beghi, E, Bell, K, Beqiri, E, Berlin, T, Bodien, Y, Boerwinkle, V, Boly, M, Bonnel, A, Brown, E, Carroll, E, Chou, S, Citerio, G, Classen, J, Condie, C, Cosmas, K, Creutzfeldt, C, Dangayach, N, Degeorgia, M, Der-Nigoghoss, C, Desai, M, Diringer, M, Dullaway, J, Edlow, B, Ercole, A, Estraneo, A, Falcone, G, Padayachy, L, Park, S, Pergakis, M, Polizzotto, L, Pouratian, N, Spivack, M, Prisco, L, Provencio, J, Puybasset, L, Rasmussen, L, Rass, V, Richardson, R, Shinots, C, Robba, C, Robertson, C, Rohaut, B, Rolston, J, Rosanova, M, Rosenthal, E, Russell, M, Silva, G, Sanz, L, Sarasso, S, Sarwal, A, Schiff, N, Schnakers, C, Seder, D, Shah, V, Shapiro-Rosen, A, Shapshak, A, Sharma, K, Sharshar, T, Shutter, L, Sitt, J, Slomine, B, Smielewski, P, Smith, W, Stamatakis, E, Steinberg, A, Ferioli, S, Fernandez-Esp, D, Fink, E, Fins, J, Frontera, J, Ganesan, R, Ghavam, A, Giacino, J, Gibbons, C, Gilmore, E, Gosseries, O, Green, T, Greer, D, Guanci, M, Hahn, C, Hakimi, R, Hanley, D, Hartings, J, Hassan, A, Hinson, H, Hirsch, K, Hocker, S, Hu, P, Hu, X, Human, T, Hwang, D, Illes, J, Jaffa, M, James, M, Janas, A, Jones, M, Keller, E, Keogh, M, Kim, J, Kim, K, Kirsch, H, Kirschen, M, Ko, N, Kondziella, D, Kreitzer, N, Stevens, R, Sussman, B, Taran, S, Thibaut, A, Threlkeld, Z, Tinti, L, Toker, D, Torbey, M, Trevick, S, Turgeon, A, Udy, A, Varelas, P, Venkatasubba, C, Vespa, P, Videtta, W, Voss, H, Vox, F, Wagner, A, Wainwright, M, Whyte, J, Witherspoon, B, Yakhind, A, Zafonte, R, Zahuranec, D, Zammit, C, Zhang, B, Ziai, W, Zimmerman, L, Kromm, J, Kumar, A, Kurtz, P, Laureys, S, Lawson, T, Lejeune, N, Lewis, A, Liang, J, Ling, G, Livesay, S, Luppi, A, Madden, L, Maddux, C, Mahanes, D, Mainali, S, Maldonado, N, Ribeiro, R, Massimini, M, Mayer, S, Mccredie, V, Mcnett, M, Mejia-Mantill, J, Menon, D, Meyfroidt, G, Mijangos, J, Moberg, D, Moheet, A, Molteni, E, Monti, M, Morrison, C, Muehlschlegel, S, Murtaugh, B, Naccache, L, Nairon, E, Natarajan, G, Newcombe, V, Nielsen, N, Noronha-Falc‹, F, Nyquist, P, Othman, M, Owen, A, Barra M. E., Zink E. K., Bleck T. P., Caceres E., Farrokh S., Foreman B., Cediel E. G., Hemphill J. C., Nagayama M., Olson D. W. M., Suarez J. I., Aiyagari V., Akbari Y., Al-Mufti F., Alexander S., Alexandrov A., Alkhachroum A., Amiri M., Appavu B., Gebre M. A., Bader M. K., Badjiata N., Balu R., Beekman R., Beghi E., Bell K., Beqiri E., Berlin T., Bodien Y., Boerwinkle V., Boly M., Bonnel A., Brown E., Carroll E., Chou S., Citerio G., Classen J., Condie C., Cosmas K., Creutzfeldt C., Dangayach N., DeGeorgia M., Der-Nigoghoss C., Desai M., Diringer M., Dullaway J., Edlow B., Ercole A., Estraneo A., Falcone G., Padayachy L., Park S., Pergakis M., Polizzotto L., Pouratian N., Spivack M. P., Prisco L., Provencio J., Puybasset L., Rasmussen L., Rass V., Richardson R., Shinots C. R., Robba C., Robertson C., Rohaut B., Rolston J., Rosanova M., Rosenthal E., Russell M. B., Silva G. S., Sanz L., Sarasso S., Sarwal A., Schiff N., Schnakers C., Seder D., Shah V. A., Shapiro-Rosen A., Shapshak A., Sharma K., Sharshar T., Shutter L., Sitt J., Slomine B., Smielewski P., Smith W., Stamatakis E., Steinberg A., Ferioli S., Fernandez-Esp D., Fink E., Fins J., Frontera J., Ganesan R., Ghavam A., Giacino J., Gibbons C., Gilmore E., Gosseries O., Green T., Greer D., Guanci M., Hahn C., Hakimi R., Hanley D. F., Hartings J., Hassan A., Hinson H., Hirsch K., Hocker S., Hu P., Hu X., Human T., Hwang D., Illes J., Jaffa M., James M. L., Janas A., Jones M., Keller E., Keogh M., Kim J., Kim K., Kirsch H., Kirschen M., Ko N., Kondziella D., Kreitzer N., Stevens R., Sussman B., Taran S., Thibaut A., Threlkeld Z., Tinti L., Toker D., Torbey M., Trevick S., Turgeon A., Udy A., Varelas P., Venkatasubba C., Vespa P., Videtta W., Voss H., Vox F., Wagner A., Wainwright M., Whyte J., Witherspoon B., Yakhind A., Zafonte R., Zahuranec D., Zammit C., Zhang B., Ziai W., Zimmerman L., Kromm J., Kumar A., Kurtz P., Laureys S., Lawson T., Lejeune N., Lewis A., Liang J., Ling G., Livesay S., Luppi A., Madden L., Maddux C., Mahanes D., Mainali S., Maldonado N., Ribeiro R. M., Massimini M., Mayer S., McCredie V., McNett M., Mejia-Mantill J., Menon D., Meyfroidt G., Mijangos J., Moberg D., Moheet A., Molteni E., Monti M., Morrison C., Muehlschlegel S., Murtaugh B., Naccache L., Nairon E., Natarajan G., Newcombe V., Nielsen N., Noronha-Falc‹ F., Nyquist P., Othman M., and Owen A.

Abstract

The convergence of an interdisciplinary team of neurocritical care specialists to organize the Curing Coma Campaign is the first effort of its kind to coordinate national and international research efforts aimed at a deeper understanding of disorders of consciousness (DoC). This process of understanding includes translational research from bench to bedside, descriptions of systems of care delivery, diagnosis, treatment, rehabilitation, and ethical frameworks. The description and measurement of varying confounding factors related to hospital care was thought to be critical in furthering meaningful research in patients with DoC. Interdisciplinary hospital care is inherently varied across geographical areas as well as community and academic medical centers. Access to monitoring technologies, specialist consultation (medical, nursing, pharmacy, respiratory, and rehabilitation), staffing resources, specialty intensive and acute care units, specialty medications and specific surgical, diagnostic and interventional procedures, and imaging is variable, and the impact on patient outcome in terms of DoC is largely unknown. The heterogeneity of causes in DoC is the source of some expected variability in care and treatment of patients, which necessitated the development of a common nomenclature and set of data elements for meaningful measurement across studies. Guideline adherence in hemorrhagic stroke and severe traumatic brain injury may also be variable due to moderate or low levels of evidence for many recommendations. This article outlines the process of the development of common data elements for hospital course, confounders, and medications to streamline definitions and variables to collect for clinical studies of DoC.

Published
2023

147. Prognostic Models for Global Functional Outcome and Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Author

Mikolic, A, Steyerberg, E, Polinder, S, Wilson, L, Zeldovich, M, von Steinbueche, N, Newcombe, V, Menon, D, van der Naalt, J, Lingsma, H, Maas, A, van Klaveren, D, Akerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Castano Leon, A, Maegele, M, Majdan, M, Manara, A, Manley, G, Martino, C, Marechal, H, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Nieboer, D, Nyiradi, J, Olubukola, O, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Vallance, S, Valeinis, E, Vamos, Z, van Der Jagt, M, Van Der Steen, G, van Der Naalt, J, van Dijck, J, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, Vande Vyvere, T, van Wijk, R, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Winzeck, S, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Mikolic A., Steyerberg E. W., Polinder S., Wilson L., Zeldovich M., von Steinbueche N., Newcombe V. F. J., Menon D. K., van der Naalt J., Lingsma H. F., Maas A. I. R., van Klaveren D., Akerlund C., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Carbayo Lozano G., Carbonara M., Cavallo S., Chevallard G., Chieregato A., Citerio G., Clusmann H., Coburn M., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Fizelier C. D., Dark P., Dawes H., De Keyser V., Degos V., Della Corte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Kornaropoulos E., Koskinen L. O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Lecky F., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Lingsma H., Castano Leon A. M., Maegele M., Majdan M., Manara A., Manley G., Martino C., Marechal H., Mattern J., McMahon C., Melegh B., Menon D., Menovsky T., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nieboer D., Nyiradi J., Olubukola O., Oresic M., Ortolano F., Palotie A., Parizel P. M., Payen J. F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Pisica D., Ples H., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Retel Helmrich I., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosand J., Rosenfeld J. V., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Te Ao B., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Vallance S., Valeinis E., Vamos Z., van Der Jagt M., Van Der Steen G., van Der Naalt J., van Dijck J. T. J. M., van Essen T. A., Van Hecke W., van Heugten C., Van Praag D., van Veen E., Vande Vyvere T., van Wijk R. P. J., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. W., Wiegers E., Williams G., Winzeck S., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Zelinkova V., Ziverte A., Zoerle T., Mikolic, A, Steyerberg, E, Polinder, S, Wilson, L, Zeldovich, M, von Steinbueche, N, Newcombe, V, Menon, D, van der Naalt, J, Lingsma, H, Maas, A, van Klaveren, D, Akerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Castano Leon, A, Maegele, M, Majdan, M, Manara, A, Manley, G, Martino, C, Marechal, H, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Nieboer, D, Nyiradi, J, Olubukola, O, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Vallance, S, Valeinis, E, Vamos, Z, van Der Jagt, M, Van Der Steen, G, van Der Naalt, J, van Dijck, J, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, Vande Vyvere, T, van Wijk, R, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Winzeck, S, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Mikolic A., Steyerberg E. W., Polinder S., Wilson L., Zeldovich M., von Steinbueche N., Newcombe V. F. J., Menon D. K., van der Naalt J., Lingsma H. F., Maas A. I. R., van Klaveren D., Akerlund C., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Carbayo Lozano G., Carbonara M., Cavallo S., Chevallard G., Chieregato A., Citerio G., Clusmann H., Coburn M., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Fizelier C. D., Dark P., Dawes H., De Keyser V., Degos V., Della Corte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Kornaropoulos E., Koskinen L. O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Lecky F., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Lingsma H., Castano Leon A. M., Maegele M., Majdan M., Manara A., Manley G., Martino C., Marechal H., Mattern J., McMahon C., Melegh B., Menon D., Menovsky T., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nieboer D., Nyiradi J., Olubukola O., Oresic M., Ortolano F., Palotie A., Parizel P. M., Payen J. F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Pisica D., Ples H., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Retel Helmrich I., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosand J., Rosenfeld J. V., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Te Ao B., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Vallance S., Valeinis E., Vamos Z., van Der Jagt M., Van Der Steen G., van Der Naalt J., van Dijck J. T. J. M., van Essen T. A., Van Hecke W., van Heugten C., Van Praag D., van Veen E., Vande Vyvere T., van Wijk R. P. J., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. W., Wiegers E., Williams G., Winzeck S., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Zelinkova V., Ziverte A., and Zoerle T.

Abstract

After mild traumatic brain injury (mTBI), a substantial proportion of individuals do not fully recover on the Glasgow Outcome Scale Extended (GOSE) or experience persistent post-concussion symptoms (PPCS). We aimed to develop prognostic models for the GOSE and PPCS at 6 months after mTBI and to assess the prognostic value of different categories of predictors (clinical variables; questionnaires; computed tomography [CT]; blood biomarkers). From the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we included participants aged 16 or older with Glasgow Coma Score (GCS) 13-15. We used ordinal logistic regression to model the relationship between predictors and the GOSE, and linear regression to model the relationship between predictors and the Rivermead Post-concussion Symptoms Questionnaire (RPQ) total score. First, we studied a pre-specified Core model. Next, we extended the Core model with other clinical and sociodemographic variables available at presentation (Clinical model). The Clinical model was then extended with variables assessed before discharge from hospital: early post-concussion symptoms, CT variables, biomarkers, or all three categories (extended models). In a subset of patients mostly discharged home from the emergency department, the Clinical model was extended with 2-3–week post-concussion and mental health symptoms. Predictors were selected based on Akaike’s Information Criterion. Performance of ordinal models was expressed as a concordance index (C) and performance of linear models as proportion of variance explained (R2). Bootstrap validation was used to correct for optimism. We included 2376 mTBI patients with 6-month GOSE and 1605 patients with 6-month RPQ. The Core and Clinical models for GOSE showed moderate discrimination (C = 0.68 95% confidence interval 0.68 to 0.70 and C = 0.70[0.69 to 0.71], respectively) and injury severity was the strongest predictor. The extended models had better

Published
2023

148. New Cerebral Microbleeds After Mechanical Thrombectomy for Large-Vessel Occlusion Strokes

Author

Shi, Zhong-Song, Duckwiler, Gary R, Jahan, Reza, Tateshima, Satoshi, Gonzalez, Nestor R, Szeder, Viktor, Saver, Jeffrey L, Kim, Doojin, Ali, Latisha K, Starkman, Sidney, Vespa, Paul M, Salamon, Noriko, Villablanca, J Pablo, Viñuela, Fernando, Feng, Lei, Loh, Yince, and Liebeskind, David S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Bioengineering, Biomedical Imaging, Cerebrovascular, Brain Disorders, Neurosciences, Stroke, Adult, Aged, Aged, 80 and over, Brain, Female, Hemorrhage, Humans, Male, Microcirculation, Middle Aged, Retrospective Studies, Risk Factors, Thrombectomy, Arthritis & Rheumatology, Biomedical and clinical sciences, Clinical sciences
Abstract

The interval appearance of cerebral microbleeds (CMBs) after endovascular treatment has never been described. We investigated the frequency and predictors of new CMBs that developed shortly after mechanical thrombectomy for acute ischemic stroke, and its impact on clinical outcome.We retrospectively analyzed patients with large-vessel occlusion strokes treated with Merci Retriever, Penumbra System, or stent-retriever devices. Serial T2*-weighted gradient-recall echo (GRE) magnetic resonance imaging (MRI) before and 48 h after endovascular thrombectomy were assessed to identify new CMBs. We examined independent factors associated with new CMBs after mechanical thrombectomy. We analyzed the association of the presence, burden, and distribution of new CMBs with clinical outcome.A total of 187 consecutive patients with serial GRE were enrolled in this study. CMBs were evident in 36 (19.3%) patients before mechanical thrombectomy. New CMBs occurred in 41 (21.9%) patients after mechanical thrombectomy. Of the 68 new CMBs, 45 appeared in the lobar location, 18 in the deep location and 5 in the infratentorial location. The presence of baseline CMBs was associated with new CMBs after mechanical thrombectomy (OR 5.38; 95% CI 2.13-13.59; P < 0.001), no matter whether the patients were treated primarily with mechanical thrombectomy or with intravenous thrombolysis followed by mechanical thrombectomy. Patients with new CMBs did not have increased rates of hemorrhagic transformation, in-hospital mortality, and modified Rankin Scale score 4 to 6 at discharge.New CMBs are common after mechanical thrombectomy in one-fifth of patients with acute ischemic stroke. Baseline CMBs before mechanical thrombectomy predicts the development of new CMBs. New CMBs after mechanical thrombectomy do not influence clinical outcome.

Published
2015

149. Lactate: brain fuel in human traumatic brain injury: a comparison with normal healthy control subjects.

Author

Glenn, Thomas, Martin, Neil, Horning, Michael, McArthur, David, Vespa, Paul, Hovda, David, and Brooks, George

Subjects
TBI, brain, fuel augmentation, glucose, lactate, mass spectrometry, stable isotopes, Adolescent, Adult, Brain, Brain Injuries, Female, Humans, Lactic Acid, Male, Middle Aged, Young Adult
Abstract

We evaluated the hypothesis that lactate shuttling helps support the nutritive needs of injured brains. To that end, we utilized dual isotope tracer [6,6-(2)H2]glucose, that is, D2-glucose, and [3-(13)C]lactate techniques involving arm vein tracer infusion along with simultaneous cerebral (arterial [art] and jugular bulb [JB]) blood sampling. Traumatic brain injury (TBI) patients with nonpenetrating brain injuries (n=12) were entered into the study following consent of patients legal representatives. Written and informed consent was obtained from control volunteers (n=6). Patients were studied 5.7±2.2 (mean±SD) days post-injury; during periods when arterial glucose concentration tended to be higher in TBI patients. As in previous investigations, the cerebral metabolic rate for glucose (CMRgluc, i.e., net glucose uptake) was significantly suppressed following TBI (p

Published
2015

150. Endogenous Nutritive Support after Traumatic Brain Injury: Peripheral Lactate Production for Glucose Supply via Gluconeogenesis

Author

Glenn, Thomas C, Martin, Neil A, McArthur, David L, Hovda, David A, Vespa, Paul, Johnson, Matthew L, Horning, Michael A, and Brooks, George A

Subjects
Brain Disorders, Physical Injury - Accidents and Adverse Effects, Liver Disease, Digestive Diseases, Traumatic Head and Spine Injury, Neurosciences, Traumatic Brain Injury (TBI), Injuries and accidents, Adolescent, Adult, Brain Injuries, Female, Gluconeogenesis, Glucose, Humans, Lactic Acid, Male, Middle Aged, Nutritional Status, Young Adult, brain, gluconeogenesis, glucose, glucose homeostasis, glycemia, lactate, mass spectrometry, TBI, Clinical Sciences, Neurology & Neurosurgery
Abstract

We evaluated the hypothesis that nutritive needs of injured brains are supported by large and coordinated increases in lactate shuttling throughout the body. To that end, we used dual isotope tracer ([6,6-(2)H2]glucose, i.e., D2-glucose, and [3-(13)C]lactate) techniques involving central venous tracer infusion along with cerebral (arterial [art] and jugular bulb [JB]) blood sampling. Patients with traumatic brain injury (TBI) who had nonpenetrating head injuries (n=12, all male) were entered into the study after consent of patients' legal representatives. Written and informed consent was obtained from healthy controls (n=6, including one female). As in previous investigations, the cerebral metabolic rate (CMR) for glucose was suppressed after TBI. Near normal arterial glucose and lactate levels in patients studied 5.7±2.2 days (range of days 2-10) post-injury, however, belied a 71% increase in systemic lactate production, compared with control, that was largely cleared by greater (hepatic+renal) glucose production. After TBI, gluconeogenesis from lactate clearance accounted for 67.1% of glucose rate of appearance (Ra), which was compared with 15.2% in healthy controls. We conclude that elevations in blood glucose concentration after TBI result from a massive mobilization of lactate from corporeal glycogen reserves. This previously unrecognized mobilization of lactate subserves hepatic and renal gluconeogenesis. As such, a lactate shuttle mechanism indirectly makes substrate available for the body and its essential organs, including the brain, after trauma. In addition, when elevations in arterial lactate concentration occur after TBI, lactate shuttling may provide substrate directly to vital organs of the body, including the injured brain.

Published
2015

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