The incidence of traumatic brain injury (TBI) in the United States was 3.5 million cases in 2009, according to the Centers for Disease Control and Prevention. It is a contributing factor in 30.5% of injury-related deaths among civilians. Additionally, since 2000, more than 260,000 service members were diagnosed with TBI, with the vast majority classified as mild or concussive (76%). The objective assessment of TBI via imaging is a critical research gap, both in the military and civilian communities. In 2011, the Department of Defense (DoD) prepared a congressional report summarizing the effectiveness of seven neuroimaging modalities (computed tomography [CT], magnetic resonance imaging [MRI], transcranial Doppler [TCD], positron emission tomography, single photon emission computed tomography, electrophysiologic techniques [magnetoencephalography and electroencephalography], and functional near-infrared spectroscopy) to assess the spectrum of TBI from concussion to coma. For this report, neuroimag...

A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury

Antarctic krill (Euphausia superba) oil has been receiving increasing attention due to its nutritional and functional potentials. However, its application as a novel food ingredient has not yet been fully explored. This review summarizes the chemical composition, extraction technologies, potential health benefits, and current applications of krill oil, with the aim of providing suggestions for its exploitation. Krill oil is a unique lipid consisting of diverse lipid classes and is characterized by a high concentration (39.29% to 80.69%) of phospholipids (PLs) associated with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). It also contains considerable amounts of bioactive minor components such as astaxanthin, sterols, tocopherols, vitamin A, flavonoids, and minerals. The current technologies used in krill oil production are solvent extraction, nonsolvent extraction, super/subcritical fluid extraction, and enzyme-assisted pretreatment extraction, which all greatly influence the yield and quality of the end-product. In addition, krill oil has been documented to have various health benefits, including anti-inflammatory effects, cardiovascular disease (CVD) prevention, women's health, neuroprotection, and anticancer activities. Although krill oil products used for dietary supplements have been commercially available, few studies have attempted to explore the underlying molecular mechanisms to elucidate how exactly the krill oil exerts different biological activities. Further studies should focus on this to improve the development of krill oil products for human consumption.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/1541-4337.12427

Antarctic Krill (Euphausia superba) Oil: A Comprehensive Review of Chemical Composition, Extraction Technologies, Health Benefits, and Current Applications.

Epidemiology and Pathophysiology of Traumatic Brain Injury Introduction Epidemiology of Traumatic Brain Injury Definitions of Traumatic Brain Injury Classification of Traumatic Brain Injury Concussion Blunt Force Head Injury Penetrating Brain Injury Military or Blast Brain Trauma Sports Injuries Concussion in Sports Chronic Traumatic Encephalopathy Pediatric Traumatic Brain Injury Geriatric Traumatic Brain Injury Molecular Biology and Pathophysiology of Traumatic Brain Injury Primary Diffuse Brain Injury Diffuse Axonal Injury Primary Focal Brain Injury Secondary Traumatic Brain Injury Genetics and Brain Trauma A Default Mode of Brain Function References Neuropsychiatric and Psychiatric Symptoms after Traumatic Brain Injury Neuropsychiatric Syndromes in Adults Adult Cognitive Disorders Frontal Brain Syndromes of Impaired Executive Function Attentional Impairment Following Pediatric TBI Pediatric Neuropsychiatric Syndromes Neuropsychiatric/Somatic Syndromes Psychiatric Syndromes References Taking the Neuropsychiatric History after Traumatic Brain Injury Introduction General Premorbid Neuropsychiatric History Birth and Perinatal History Developmental History Handedness Laterality and Motor Skills Seizures and "Spells" Substance Use and Abuse Premorbid Personality Preinjury Cognitive Status Aggressive Behaviors Specific Neuropsychiatric TBI History Attentional History after TBI Memory History after TBI Speech and Language History after TBI Visuospatial History after TBI Executive Function History after TBI Affect and Mood History after TBI Thought Processing History after TBI Suicidal Ideation after TBI Neurobehavioral Treatment History Following TBI Activities of Daily Living History after TBI Pre-TBI Medical History (Past Medical History) Family History Review of Systems after TBI Child Brain Injury History Preinjury Developmental History Family History Attentional History after TBI Communication History after TBI Memory History after TBI Visuospatial History after TBI Intellectual History after TBI Executive Function History after TBI Mood and Affective History after TBI Academic History after TBI Review of Records Adult or Child Record Review Child Record Review References Performing the Neuropsychiatric Mental Status and Neurological Examinations after Traumatic Brain Injury Adult Mental Status Examination Sensory Domain-Specific Recognition Praxis Mood and Affect Thought Processing Thought Content and Perception Insight and Self-Awareness Judgment and Decision-Making Capacity Risk to Self or Others Adult Neurological Examination after TBI Head and Neck Examination Cranial Nerve Examination Sensory Function Examination Motor Impairment Examination Motor Vehicle Driving after Traumatic Brain Injury Child Mental Status Examination Speech and Language Memory and Orientation Visuospatial and Constructional Ability Executive Function Affect and Mood Thought Processing, Content, and Perception Child Neurological Examination Appearance Cranial Nerve Examination Motor Examination Gait Examination Sensory Testing Coordination Testing References Use of Neuroimaging in the Neuropsychiatric Assessment of Traumatic Brain Injury Introduction Structural Imaging of Primary Brain Trauma Functional Imaging of Brain Trauma Positron Emission Tomography Single Photon Emission Computed Tomography after TBI Magnetic Resonance Spectroscopy after TBI Functional Magnetic Resonance Imaging (fMRI) after TBI Electroencephalography after TBI Nonaccidental Trauma (Child Abuse) Birth Trauma Extracranial Birth Trauma Skull Fractures in the Newborn Traumatic intracranial Hemorrhage in the Newborn References Standardized Neurocognitive Assessment of Traumatic Brain Injury Introduction Basic Concepts of Psychological Testing Adult Neurocognitive Assessment Comparison Standards for Deficit Measurement Measurement of Neuropsychological Deficits Deficit Measurement Paradigm Practice Effects of Repeated Neuropsychological and Psychological Testing Using Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs) Measuring Attention Measuring Memory Measuring Language and Communication Disorders Following TBI Aphasia Verbal Expression Verbal Comprehension Verbal Academic Skills Measuring Somatosensory and Motor Function Measurement of Visuospatial Processing and Constructional Tasks Measuring Executive Functions and Reasoning Measuring General Ability Measuring Pediatric Neurocognition after TBI Measuring Symptom Validity and Response Bias in Children Establishing a Preinjury Cognitive Baseline in Children Measuring Attention in Children Measuring Memory in Children Measuring Language in Children Measuring Visuoperceptual Ability in Children Measuring Sensory Motor Function in Children Measuring Executive Function in Children Measuring General Ability in Children Measuring Cognitive Injury in the Very Young Child References Behavioral Assessment Following Traumatic Brain Injury Introduction Adult Behavioral Measurements Child Behavioral Measurements References Neuropsychiatric Examination Database and Treatment Planning History Mental Status Examination Neurological Examination Brain Neuroimaging Neuropsychological Measures Psychological and Behavioral Measures Impact of Brain Injury on Caregivers Neuropsychiatric Treatment Planning Following TBI Neuropsychopharmacological Management of Cognitive and Executive Disorders Following TBI Neuropharmacologic Management of Behavioral Symptoms Following Traumatic Brain Injury Assisting the Family after TBI Neurobehavioral Analysis of Case Studies References Forensic Examinations of Traumatic Brain Injury: Distinctions from Examinations for Treatment Introduction Critical Differences between Treatment Examinations and Forensic Assessment of Traumatic Brain Injury Legal Rules Governing the Admissibility of Scientific Evidence at Court Mandated Reporting Evaluating Civil Competence Following Traumatic Brain Injury Testamentary Capacity and Vulnerability to Undue Influence Contractual Capacity Personal Injury Disability Aphasia and Dysphasia Language Use Other than English Fitness-for-Duty Dangerousness and Risk of Violence Suicide Risk Assessment Competency to Stand Trial Criminal Responsibility and the Insanity Defense Health-Care Decision Making and Informed Consent Persistent Vegetative States Do-Not-Resuscitate (DNR) Orders Advance Directives References Causation, Damages, Impairments, Disability, Outcomes, and Forensics of TBI Examinations Introduction Causation Damages Determining Impairment Following TBI Disability Determination Adult Outcomes of TBI Child Outcomes In Traumatic Brain Injury Forensics of Inflicted Child TBI (Child Abuse) Forensics of Mild Traumatic Brain Injury Forensics of Neuropsychiatric Neuroimaging in TBI Forensics of Structural Neuroimaging after TBI Forensics of Functional Neuroimaging after TBI inflicted Child TBI Forensics of TBI Symptom Validity Determination Basic Principles of Forensic Medical Report Writing References Neurobehavioral Analysis of Traumatic Brain Injury Forensic Data Introduction Analysis and Collection of Acute Injury Data Following TBI Police Record or Injury Report Police Investigative File Accident Scene Photographs First Responder or Ambulance Reports Emergency Department Records Hospital Record Rehabilitation Records Neuropsychology/Psychology Records Outpatient Treatment Analysis of the Forensic TBI Examination Database Using Collateral History Sources Preinjury Medical Records Academic and Employment Records Legal Records Military Records Causation Analysis Damages Analysis Neurobehavioral Analysis of Forensic Case Studies References

Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment

Background. Cognitive deficits are among the most disabling consequences of traumatic brain injury (TBI), leading to long-term outcomes and interfering with the individual’s recovery. One of the most effective ways to reduce the impact of cognitive disturbance in everyday life is cognitive rehabilitation, which is based on the principles of brain neuroplasticity and restoration. Although there are many studies in the literature focusing on the effectiveness of cognitive interventions in reducing cognitive deficits following TBI, only a few of them focus on neural modifications induced by cognitive treatment. The use of neuroimaging or neurophysiological measures to evaluate brain changes induced by cognitive rehabilitation may have relevant clinical implications, since they could add individualized elements to cognitive assessment. Nevertheless, there are no review studies in the literature investigating neuroplastic changes induced by cognitive training in TBI individuals. Objective. Due to lack of data,...

https://journals.sagepub.com/doi/pdf/10.1177/1545968317723748

Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A Review.

We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following sear ...

/pdf/application-of-optical-methods-in-the-monitoring-of-3gt19fy7te.pdf

Application of optical methods in the monitoring of traumatic brain injury: A review.

To investigate cerebral reactions to cognitive rehabilitation tasks, oxyhemoglobin changes were compared in 9 patients with cognitive impairments after traumatic brain injury (TBI) and 47 healthy controls using functional near infrared spectroscopy (fNIRS) during nine cognitive rehabilitation tasks employed at Nagoya City Rehabilitation Center. Forty-seven measurement channels were placed on the frontal to temporal cortices, and organized into seven channel regions. Oxyhemoglobin changes were normalized based on the mean oxyhemoglobin value at the resting state, and integrated throughout a task. Statistical analyses of the differences between the TBI patients and controls were performed with the two-sided Mann-Whitney U test. Oxyhemoglobin changes were high for both controls and TBI patients in the lateral frontal regions. Oxyhemoglobin changes in TBI patients tended to be higher than controls in the medial frontal regions for most training tasks, and significant differences (p < 0.05) were seen for two tasks in the medial frontal regions. Different regions were activated during the tasks in TBI patients compared to controls. fNIRS measurement is useful in the evaluation of changes of neuronal activities during rehabilitation tasks in TBI patients.

Oxyhemoglobin changes during cognitive rehabilitation after traumatic brain injury using near infrared spectroscopy.

The aim of this study was to examine the sensibility of NIRS in observation of brain activation during a verbal fluency test. Twenty-three participants were given letter fluency and semantic fluency tests and the hemodynamism was measured by NIRS. Thirty-three pairs of optodes were attached, so they can measure signals from 52 channels consisting of adjacent pairs of emitters and detectors. Results were investigated in terms of the change of blood flow volume value of OxyHb for word generation. The results showed a significant interaction between task (letter fluency and semantic fluency) and cortical area (prefrontal and temporal) in the analysis of variance. Here, the prefrontal area showed marked activation in the left hemisphere during letter fluency task, whereas the temporal area showed activation in the semantic fluency task performance. These findings by NIRS confirmed different cerebral functions between semantic and letter fluency tasks, which were coincident with the findings by previou...

Yuri Nagano

Papers

Oxyhemoglobin changes during cognitive rehabilitation after traumatic brain injury using near infrared spectroscopy.

Brain Mechanisms in Japanese Verbal Fluency Test: Evidence from Examination by NIRS (Near-Infrared Spectroscopy)

PET Study in Patients with Neuropsychological Impairments in the Chronic State after Traumatic Diffuse Brain Injury