The predictive value of serum p-CREB level on secondary cognitive impairment in patients with mild-to-moderate craniocerebral trauma

Han, Chenyang; Yang, Yi; Ruan, Shuiliang; Li, Guo; Guan, Qing

doi:10.1007/s10143-018-01072-2

Cited by 5 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Under normal circumstances, there is a certain dynamic balance between FT3 and FT4, and TT3 and TT4 in the blood circulation. FT3 and FT4 play their biological role by entering the target cells [ 10 ]. When the brain is seriously injured, intracranial hemorrhage induces an increase in intracranial pressure, ischemia, and hypoxia in brain tissue.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Prognosis with Dynamic Changes of Thyroid Hormone and Cortisol Hormone in Patients with Severe Craniocerebral Injury

Ding

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Objective. To analyze the dynamic changes of thyroid hormone and cortisol hormone (COR) and their relationship with prognosis in patients with severe craniocerebral injury. Methods. A retrospective analysis of 48 patients with severe craniocerebral injury who were admitted to our hospital from January 2014 to January 2017 was performed. According to the Glasgow Outcome Scale (GOS) after 3 months of treatment, the patients were divided into a favorable prognosis group (GOS score = 4-5) and a poor prognosis group (GOS score = 1–3). Clinical data such as ICU hospitalization time and mechanical ventilation time between the two groups were collected and compared. The GCS score was evaluated and recorded at 24 h and 7 d after injury, respectively. The fasting venous blood was collected from patients at 24 h and 7 d after injury, and the levels of thyrotropin (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), and free thyroxine (FT4) were detected by the time-resolved fluorescence immunoassay, while the cortisol (COR) levels were examined by the chemiluminescence assays. The prognostic risk factors of patients with severe craniocerebral injury were analyzed using logistic regression analysis. A nomogram prediction model was constructed based on the results of the logistic analysis. The value of each factor in predicting the prognosis of patients with severe craniocerebral injury was analyzed using the ROC curve. Results. Significant differences existed between the poor prognosis group and the favorable prognosis group in age, whether complicated with a cerebral hernia, intracranial hematoma volume, admission time, ICU hospitalization time, GCS score, and mechanical ventilation time ( P < 0.05 ). At 24 h after injury, the levels of TT4, FT3, and FT4 in the poor prognosis group were significantly lower than those in the favorable prognosis group ( P < 0.05 ). On the 7th day after the injury, the levels of FT3, FT4, TT3, TT4, and TSH in the poor prognosis group were prominently lower than those in the favorable prognosis group ( P < 0.05 ). At 24 h after injury, the COR level in the poor prognosis group was observably higher than that in the favorable prognosis group ( P < 0.05 ). Logistic regression analysis showed that age, complicated with a cerebral hernia, length of stay in ICU, FT3, FT4, TT4, and COR were the risk factors affecting the prognosis of patients with severe craniocerebral injury ( P < 0.05 ), while the GCS score was the protective factor ( P < 0.05 ). ROC curve analysis revealed that the area under the curve (AUC) of ICU length of stay, GCS score, FT3, and FT4 to predict the prognosis of patients with severe craniocerebral injury was better with 0.841, 0.885, 0.881, and 0.850, respectively. The survival curve drawn by the K-M method showed that high levels of serum FT3, FT4, and TT4 and low levels of COR were conducive to improve the overall survival time of patients ( P < 0.05 ). Conclusion. Abnormal levels of thyroid hormone and cortisol hormone were found in patients with severe craniocerebral injury. Age, combined brain herniation, ICU length of stay, FT3, FT4, TT4, COR, and GCS scores were all prognostic factors in patients with severe traumatic brain injury. These factors have high value in judging the death and survival of patients with severe craniocerebral injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Relationship between Prognosis with Dynamic Changes of Thyroid Hormone and Cortisol Hormone in Patients with Severe Craniocerebral Injury

Ding

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

show abstract

“…CREB modulates transcription factors via phosphorylation (27) and CREB signaling in the hippocampus is associated with emotional and cognitive behaviors (28). The phosphorylation of CREB by PKA serves a role in various nervous system diseases such as Alzheimer's disease and craniocerebral trauma (29,30), and BDNF is a downstream target of PKA/CREB signaling (31). Several studies have reported that BDNF down-regulation contributes to structural damage and functional impairment in the central nervous system (32)(33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

Repeated exposure to sevoflurane in neonatal rats impairs cognition in adulthood via the PKA‑CREB‑BDNF signaling pathway

et al. 2021

View full text Add to dashboard Cite

Sevoflurane (Sev) anesthesia is widely used in pediatrics due to its low blood-gas partition coefficient and lack of pungency. However, Sev treatment may lead to cognitive dysfunction in later life. The current study administered Sev to neonatal rats to investigate the effects of Sev treatment on cognitive performance in adulthood. In total, 6-day-old rats received 3% Sev for 2 h daily for 3 consecutive days. The cognitive function of rats in adulthood was evaluated in 56-day-old rats by Morris water maze test. The hippocampal neuron morphology was observed by Nissl staining. Hippocampal brain-derived neurotrophic factor (BDNF) levels were measured by ELISA. The protein expression of protein kinase A (PKA), cAMP response element binding protein (CREB), phosphorylated-CREB (p-CREB) and BDNF in hippocampus were assessed by western blotting. The water maze results demonstrated that neonatal treatment with Sev resulted in a significant impairment of cognition in 56-day-old adult rats. Behavioral analysis revealed that Sev treatment increased latency to first pass the platform and decreased residence in target quadrants and across platform frequency compared with the control group in Morris water maze tests. Furthermore, compared with the control group, neonatal exposure to Sev reduced the number of neurons and the concentration of BDNF in the hippocampus, a brain region important for learning and memory. Additionally, Sev significantly decreased the expression of PKA, p-CREB, BDNF and the p-CREB/CREB ratio. Treatment with bucladesine, a selective PKA agonist, partially reversed the deleterious effects of Sev. In summary, the results indicated that PKA-CREB-BDNF signaling served an important role in the cognitive decline caused by neonatal exposure to Sev.

show abstract

“…The BI index is the most classic tool for evaluating the self-care ability of patients. The higher the scores of the above three evaluation methods, the better the rehabilitation outcome of the patient in terms of cognitive function, limb movement ability, and self-care ability (14,15). The results of this study suggest that rehabilitation training can significantly increase the values of the MMSE, FMA, and BI in patients with craniocerebral trauma.…”

Section: Discussionmentioning

confidence: 99%

Effect of rehabilitation training based on the ICF concept on the recovery of construction workers with craniocerebral trauma: a randomized study

Lü¹,

Lu²,

Chen³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

Background: Craniocerebral trauma is a common neurosurgical disease. In recent years, there has been a significant increase in craniocerebral injuries caused by accidental injuries of construction workers. We aimed to analyze the effect of International Classification of functioning, disability and health (ICF) concept rehabilitation training on the recovery of patients (construction workers) with craniocerebral trauma. Methods: A total of 142 patients with craniocerebral trauma from construction sites were randomly divided into two groups. The control group (n=71) received routine rehabilitation training, and the ICF group (n=71) received ICF concept rehabilitation training. Before and after rehabilitation training, the NIHSS was used to evaluate neurological function, the MMSE was used to evaluate cognitive function, the FMA method was used to evaluate limb motor ability, the BI index was used to evaluate self-care ability, and the ICF scale was used to evaluate the rehabilitation outcome. Results: There were no significant differences in general information and NIHSS, MMSE, FMA, and BI scores before rehabilitation training between the control and ICF groups. After rehabilitation training, NIHSS scores decreased significantly, while MMSE, FMA, and BI scores increased significantly compared with the control group. Conclusions: ICF concept rehabilitation training significantly improved neurological function and cognitive function, enhanced the motor function of limbs, improved self-care ability, and led to a better rehabilitation outcome of patients with craniocerebral trauma.

show abstract

The predictive value of serum p-CREB level on secondary cognitive impairment in patients with mild-to-moderate craniocerebral trauma

Cited by 5 publications

References 13 publications

Relationship between Prognosis with Dynamic Changes of Thyroid Hormone and Cortisol Hormone in Patients with Severe Craniocerebral Injury

Relationship between Prognosis with Dynamic Changes of Thyroid Hormone and Cortisol Hormone in Patients with Severe Craniocerebral Injury

Repeated exposure to sevoflurane in neonatal rats impairs cognition in adulthood via the PKA‑CREB‑BDNF signaling pathway

Effect of rehabilitation training based on the ICF concept on the recovery of construction workers with craniocerebral trauma: a randomized study

Contact Info

Product

Resources

About