Mild Traumatic Brain Injury and Neuroinflammation
Notice bibliographique
Résumé
Despite being a common problem, there are many gaps in the understanding of mild traumatic brain injury (mTBI). Its pathophysiology is unclear, diagnostic criteria are variable, and the associated symptomatology is non-specific. As a result, there are challenges associated with precise mTBI diagnosis and treatment. The dissertation seeks to identify distinctive features, both clinical and pathophysiological, exclusively associated with mTBI. In addition, the neuroinflammatory component of mTBI is explored in detail in the context of inflammatory cytokines’ potential use as prognostic biomarkers and development of a targeted treatment. Three studies were conducted to explore mTBI. We conducted a retrospective chart review to identify the clinical presentation exclusively associated with mTBI that sets it apart from other similar conditions. This was accomplished through symptomatology comparison between the patients with head injuries that meet the ACRM (1993) criteria for mTBI diagnosis vs. those who do not. The results of this study showed that 20.5% of patients with chronic post-concussive symptoms do not meet the ACRM (1993) criteria of mTBI despite sustaining a head injury. In addition, no symptom specific differences were found between the two populations. A detailed systematic review and meta-analysis were also conducted to identify the common inflammatory cytokines associated with mTBI and to explore their potential use as prognostic biomarkers. The results show significantly elevated blood IL-6, IL-1RA, IFN-γ (at <24 hrs.) and MCP-1/CCL2 (within a week) levels in patients with mTBI compared to healthy controls in majority of the included studies. A meta-analysis was further conducted that supported these findings by showing significantly elevated IL-6, MCP-1/CCL2, and IL-1β levels in patients with mTBI in the acute stages (<7 days). In addition, elevated IL-6, TNF-α, IL-1RA, IL-10, and MCP-1/CCL2 levels were associated with poor prognosis in patients with mTBI. In addition, a systematic review was conducted to identify the inflammatory cytokines associated with adverse psychological outcome in population with mTBI. The results show that IL-6, TNF-α, IL-10, and CRP are associated with PTSD and/or depression in the population with mTBI, particularly in the chronic stages. Collectively, these studies show that all symptomatic patients with head trauma, whether or not they meet the subjective criteria of mTBI, should be managed and offered early rehabilitation to avoid long tern adverse consequences. In addition, this thesis supports the neuro-inflammatory hypothesis of mTBI and identifies inflammatory cytokines that could be potentially utilized as prognostic biomarkers and for the development of mTBI treatment.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».