To examine the preinjury rates of Axis I disorders and the prospective rates within the first 6 years after traumatic brain injury (TBI).
Cross-sectional, longitudinal, and cross-sequential.
...Community-based research and training center.
Persons (N=188) who had sustained TBI within 4 years of enrollment into the project were interviewed at either 2 and 3 assessments. Each assessment was approximately 1 year apart. Several Axis I diagnoses were analyzed to detect cross-sectional differences (by age and time postinjury) and average individual changes over the multiple measurement time points.
Not applicable.
Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders.
The odds ratios changed longitudinally within each subject, indicating a decreased probability of having an Axis I diagnosis over time. There were few cross-sectional differences in age; therefore, age at the time of injury had little impact on Axis I diagnoses. Cross-sectional time since injury was not associated with more psychiatric disorders, whereas cross-sectional preinjury history of psychiatric disorders was predictive of postinjury psychiatric disorders. After controlling for cross-sectional effects, the frequencies of Axis I disorders increased in depression, anxiety, and posttraumatic stress disorders in the first assessment postinjury and declined in subsequent assessments.
Cross-sequential analyses that control for cross-sectional and longitudinal differences produced a more complete description of psychiatric disorders after TBI.
We present Chandra X-ray imaging and spectroscopy for 14 quasars in spatially resolved pairs targeted as part of a complete sample of binary quasars with small transverse separations drawn from Sloan ...Digital Sky Survey (SDSSDR6) photometry. We measure the X-ray properties of all 14 QSOs, and study the distribution of X-ray and optical-to-X-ray power-law indices in these binary quasars. We find no significant difference when compared with large control samples of isolated quasars, true even for SDSS J1254+0846, discussed in detail in a companion paper, which clearly inhabits an ongoing, pre-coalescence galaxy merger showing obvious tidal tails. We present infrared photometry from our observations with SAO Wide-field InfraRed Camera at the MMT, and from the Wide-field Infrared Survey Explorer Preliminary Data Release, and fit simple spectral energy distributions to all 14 QSOs. We find preliminary evidence that substantial contributions from star formation are required, but possibly no more so than for isolated X-ray-detected QSOs. Sensitive searches of the X-ray images for extended emission and the optical images for optical galaxy excess show that these binary QSOs--expected to occur in strong peaks of the dark matter distribution--are not preferentially found in rich cluster environments. While larger binary QSO samples with richer far-IR and submillimeter multiwavelength data might better reveal signatures of merging and triggering, optical color selection of QSO pairs may be biased against such signatures. X-ray and/or variability selection of QSO pairs, while challenging, should be attempted. We present in an Appendix a primer on X-ray flux and luminosity calculations.
Objectives:
This study examines the relative contribution of employment-related and general self-efficacy to perceptions of quality of life (QoL) for individuals with traumatic brain injury.
Design:
...Correlational.
Setting:
Community-based research and training center.
Participants:
427 individuals with self-reported TBI under the age of 65 were included in analysis.
Main Outcome Measure:
Employment-related self-efficacy, general self-efficacy, perceived quality of life (PQoL), unmet important needs (UIN).
Results:
Significant correlations were found between income, injury severity, age at injury, and employment and the QoL variables. In addition, employment-related and general self-efficacy correlated positively with both PQoL and UIN. Employment-related and general self-efficacy accounted for 16% of the variance in PQoL and 9.5% of the variance in UIN, over and above other variables traditionally associated with QoL.
Conclusions:
These findings highlight the importance of including subjective appraisals of employment, such as perceived self-efficacy at the workplace, in assessing QoL and successful return to work following TBI.
Succinate semialdehyde (SSA) is a mitochondrially generated intermediate in the metabolism of γ-aminobutyrate (GABA), which accumulates in response to a variety of biotic and abiotic stresses. SSA ...can be reduced to γ- hydroxybutyrate (GHB) in plants exposed to various abiotic stress conditions. Recent evidence indicates that distinct cytosolic and plastidial glyoxylate reductase isoforms from Arabidopsis thaliana (L.) Heynh (GLYR1 and GLYR2, respectively) catalyze the in vitro conversion of SSA to GHB, as well as glyoxylate to glycolate, via NADPH-dependent reactions. In the present study, recombinant Arabidopsis GLYR1 was demonstrated to catalyze the NADPH-dependent reduction of both glyoxylate and SSA simultaneously to glycolate and GHB, respectively. Six-hour time-course experiments with intact vegetative wild-type Arabidopisis plants subjected to submergence demonstrated that GHB accumulates in rosette leaves, and this is accompanied by increasing levels of GABA and alanine, NADH/NAD.sup.+ and NADPH/NADP.sup.+ ratios, and GLYR1 and GLYR2 transcript abundance. The use of GLYR (glyr1 or glyr2 knockout) and NAD kinase1 (NADK1 suppression or overexpression) mutants demonstrated that under submergence the production of GHB is mediated via both GLYR isoforms, the loss of either GLYR1 or GLYR2 activity influences redox status and the levels of GABA and alanine, and the manipulation of NADP(H) availability, specifically in the cytosol, influences the production of GHB. These results suggest that biochemical mechanisms are more important than transcriptional mechanisms in the regulation of GLYR activity and SSA detoxification in plants during the onset of submergence-induced oxygen deficiency.
Long-term follow-up studies conducted during the K-12 school years suggest that challenges related to childhood traumatic brain injury (TBI) tend to persist or worsen over time. A 1999 survey of ...State Directors of Special Education revealed that most states had emerging initiatives for children with TBI and were expanding their capacity to serve this growing population. To determine whether significant changes in patterns of identification and service delivery had occurred, State Directors and brain injury consumer organizations were surveyed. Survey results show some improvement, but significant gaps remain. Most state education administrators perceive a gap between incidence of childhood TBI and identification of students with TBI to receive special education services. Recommendations for policy changes and research are provided.
Primary objective: To characterize sleep architecture and self-reported sleep quality, fatigue and daytime sleepiness in individuals with TBI. Possible relationships between sleep architecture and ...self-reported sleep quality, fatigue and daytime sleepiness were examined.
Methods: Forty-four community-dwelling adults with TBI completed the Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF) and Epworth Sleepiness Scale (ESS). They underwent two nights of in-laboratory nocturnal polysomnography (NPSG). Pearson product-moment correlation coefficients and hierarchical linear regression was used to analyse the data.
Results: Based on the PSQI cut-off score of ≥ 10, 22 participants were characterized as poor sleepers. Twenty-seven participants met criteria for clinically significant fatigue as measured by the GFI of the MAF. Fourteen participants met criteria for excessive daytime sleepiness as measured by the ESS. Poor sleep quality was associated with poor sleep efficiency, short duration of stage 2 sleep and long duration of rapid eye movement sleep. There was little-to-no association between high levels of fatigue or daytime sleepiness with NPSG sleep parameters.
Conclusions: A high proportion of the sample endorsed poor sleep quality, fatigue and daytime sleepiness. Those who reported poorer sleep quality evidenced a shorter proportion of time spent in stage 2 sleep. These findings suggest that disruptions in stage 2 sleep might underlie the symptoms of sleep disturbance experienced following TBI.
Traumatic brain injury (TBI) often leads to heterogeneous clinical outcomes, which may be influenced by genetic variation. A single-nucleotide polymorphism (SNP) in the dopamine D2 receptor (
DRD2
) ...may influence cognitive deficits following TBI. However, part of the association with
DRD2
has been attributed to genetic variability within the adjacent ankyrin repeat and kinase domain containing 1 protein (
ANKK1
). Here, we utilize the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study to investigate whether a novel
DRD2 C957T
polymorphism (rs6277) influences outcome on a cognitive battery at 6 months following TBI—California Verbal Learning Test (CVLT-II), Wechsler Adult Intelligence Test Processing Speed Index Composite Score (WAIS-PSI), and Trail Making Test (TMT). Results in 128 Caucasian subjects show that the rs6277 T-allele associates with better verbal learning and recall on CVLT-II Trials 1–5 (T-allele carrier 52.8 ± 1.3 points, C/C 47.9 ± 1.7 points; mean increase 4.9 points, 95% confidence interval 0.9 to 8.8;
p
= 0.018), Short-Delay Free Recall (T-carrier 10.9 ± 0.4 points, C/C 9.7 ± 0.5 points; mean increase 1.2 points 0.1 to 2.5;
p
= 0.046), and Long-Delay Free Recall (T-carrier 11.5 ± 0.4 points, C/C 10.2 ± 0.5 points; mean increase 1.3 points 0.1 to 2.5;
p
= 0.041) after adjusting for age, education years, Glasgow Coma Scale, presence of acute intracranial pathology on head computed tomography scan, and genotype of the
ANKK1
SNP rs1800497 using multivariable regression. No association was found between
DRD2 C947T
and non-verbal processing speed (WAIS-PSI) or mental flexibility (TMT) at 6 months. Hence,
DRD2 C947T
(rs6277) may be associated with better performance on select cognitive domains independent of
ANKK1
following TBI
.
To quantify posttraumatic brain injury (post-TBI) mental fatigue objectively by documenting changes in performance on neuropsychological tests as a result of sustained mental effort and to examine ...the relationship between objectively measured mental fatigue and self-reported situational and day-to-day fatigue.
The study included 202 community-dwelling individuals with mild-severe TBI and 73 noninjured controls.
Measures included Cambridge Neuropsychological Test Automated Battery, Global Fatigue Index, and situational fatigue rating.
Subjects were administered a 30-minute computerized neuropsychological test battery 3 times. The second and third administrations of the battery were separated by approximately 2 hours of interviews and administration of self-report measures.
The neuropsychological test scores were factor analyzed, yielding 3 subscales: speed, accuracy, and executive function. Situational fatigue and day-to-day fatigue were significantly higher in individual with TBI group than in individuals without TBI and were associated with speed subscale scores. Individuals with TBI evidenced a significant decline in performance on the accuracy subscale score. These declines in performance related to sustained mental effort were not associated with subjective fatigue in the TBI group. While practice effects on the speed and accuracy scores were observed in non-brain-injured individuals, they were not evidenced in individuals with TBI.
Findings were largely consistent with previous literature and indicated that while subjective fatigue is associated with poor performance in individuals with TBI, it is not associated with objective decline in performance of mental tasks.
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