The Epidemiology and Impact of Traumatic Brain Injury

Langlois, Jean; Rutland-Brown, Wesley; Wald, Marlena M.

doi:10.1097/00001199-200609000-00001

Cited by 3,263 publications

(2,146 citation statements)

References 17 publications

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“…It is estimated that the prevalence of Americans with chronic TBI‐related disability is 5.3 million 2, 3, 4, 5. The magnitude of this problem has led to extensive pre‐clinical research and clinical trials to improve functional outcomes 6.…”

Section: Introductionmentioning

confidence: 99%

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

Kenney

Amyot

Moore

et al. 2018

Ann Clin Transl Neurol

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

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Section: Introductionmentioning

confidence: 99%

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

Kenney

Amyot

Moore

et al. 2018

Ann Clin Transl Neurol

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“…An estimated 1.6–3.8 million sports‐related concussions occur annually in the United States,6 accounting for 6% and 9% of athletic injuries at the collegiate and high school levels, respectively, though these numbers are conservative, as many concussions are never reported 7, 8. Repeat concussions are associated with greater severity of symptomatology, longer recoveries, and earlier onset of age‐related memory loss and dementia 9.…”

Section: Introductionmentioning

confidence: 99%

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rizzo

Hudson

Dai³

et al. 2016

Ann Clin Transl Neurol

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ObjectiveThe King–Devick (KD) test, which is based on rapid number naming speed, is a performance measure that adds vision and eye movement assessments to sideline concussion testing. We performed a laboratory‐based study to characterize ocular motor behavior during the KD test in a patient cohort with chronic concussion to identify features associated with prolonged KD reading times.MethodsTwenty‐five patients with a concussion history (mean age: 31) were compared to control participants with no concussion history (n = 42, mean age: 32). Participants performed a computerized KD test under infrared‐based video‐oculography.ResultsAverage intersaccadic intervals for task‐specific saccades were significantly longer among concussed patients compared to controls (324.4 ± 85.6 msec vs. 286.1 ± 49.7 msec, P = 0.027). Digitized KD reading times were prolonged in concussed participants versus controls (53.43 ± 14.04 sec vs. 43.80 ± 8.55 sec, P = 0.004) and were highly correlated with intersaccadic intervals. Concussion was also associated with a greater number of saccades during number reading and larger average deviations of saccade endpoint distances from the centers of the to‐be‐read numbers (1.22 ± 0.29° vs. 0.98 ± 0.27°, P = 0.002). There were no differences in saccade peak velocity, duration, or amplitude.InterpretationProlonged intersaccadic intervals, greater numbers of saccades, and larger deviations of saccade endpoints underlie prolonged KD reading times in chronic concussion. The KD test relies upon a diffuse neurocognitive network that mediates the fine control of efferent visual function. One sequela of chronic concussion may be disruption of this system, which may produce deficits in spatial target selection and planning of eye movements.

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“…The most common causes of TBI are falls and road traffic accidents (RTA) (Peeters et al., 2015). Violence‐related mechanisms are less frequent and represent around 10% of all TBI in the general population (Langlois, Rutland‐Brown, & Wald, 2006). …”

Section: Introductionmentioning

confidence: 99%

“…TBI can result in lifelong cognitive, behavioral, and emotional consequences (Langlois et al., 2006). Cognitive deficits can be dominated by executive, memory, and attention dysfunction in adults (Mazaux et al., 1997).…”

Section: Introductionmentioning

confidence: 99%

Traumatic brain injury among female offenders in a prison population: results of the FleuryTBI study

et al. 2016

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AimThe study was designed to estimate the prevalence of traumatic brain injury (TBI) in a French prison population of female offenders, study the variables known to be associated with TBI, and compare our results with those obtained among male offenders as described in a previous paper.ParticipantsAll female offenders (adults and juveniles) consecutively admitted to Fleury‐Mérogis prison over a 3‐month period were included in the study.MethodDuring the admission procedure, female offenders were interviewed by healthcare staff using a self‐reported questionnaire.ResultsIn all, 100 female offenders were included. The rate of self‐reported TBI was high, with a prevalence of 21%. The first cause of TBI was violence related (35%) and a majority of female offenders with a history of TBI reported having sustained more than one TBI. When compared with those who did not report a TBI, epilepsy and use of alcohol were higher among female offenders with a history of TBI. Perceived health was significantly worse for women who reported a TBI.ConclusionsThis study findings provide additional evidence that TBI among offender populations is serious and that specific actions need to be developed and implemented in correctional settings such as screening for TBI upon arrival.

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The Epidemiology and Impact of Traumatic Brain Injury

Cited by 3,263 publications

References 17 publications

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

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

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Traumatic brain injury among female offenders in a prison population: results of the FleuryTBI study

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