Mild, moderate and severe

terminology implications for clinical and experimental traumatic brain injury

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: When describing clinical or experimental traumatic brain injury (TBI), the adjectives 'mild,' 'moderate' and 'severe' are misleading. 'Mild' clinical TBI frequently results in long-term disability. 'Severe' rodent TBI actually resembles mild or complicated mild clinical TBI.

RECENT FINDINGS: Many mild TBI patients appear to have recovered completely but have postconcussive symptoms, deficits in cognitive and executive function and reduced cerebral blood flow. After moderate TBI, 31.8% of patients died or were discharged to skilled nursing or hospice. Among survivors of moderate and severe TBI, 44% were unable to return to work. On MRI, 88% of mild TBI patients have evidence of white matter damage, based on measurements of fractional anisotropy and mean diffusivity/apparent diffusion coefficient. After sports concussion, clinically recovered patients have abnormalities in functional connectivity on functional MRI. Methylphenidate improved fatigue and cognitive impairment and, combined with cognitive rehabilitation, improved memory and executive functioning. In comparison to clinical TB, because the entire spectrum of experimental rodent TBI, although defined as moderate or severe, more closely resembles mild or complicated mild clinical TBI.

SUMMARY: Many patients after mild or moderate TBI suffer long-term sequelae and should be considered a major target for translational research. Treatments that improve outcome in rodent TBI, even when the experimental injuries are defined as severe, might be most applicable to mild or moderate TBI.

Original languageEnglish (US)
Pages (from-to)672-680
Number of pages9
JournalCurrent Opinion in Neurology
Volume31
Issue number6
DOIs
StatePublished - Dec 1 2018

Fingerprint

Brain Concussion
Terminology
Rodentia
Cerebrovascular Circulation
Hospice and Palliative Care Nursing
Methylphenidate
Return to Work
Translational Medical Research
Anisotropy
Executive Function
Traumatic Brain Injury
Cognition
Sports
Fatigue
Survivors
Rehabilitation
Magnetic Resonance Imaging
Wounds and Injuries

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Mild, moderate and severe : terminology implications for clinical and experimental traumatic brain injury. / Yamamoto, Satoshi; Levin, Harvey S.; Prough, Donald.

In: Current Opinion in Neurology, Vol. 31, No. 6, 01.12.2018, p. 672-680.

Research output: Contribution to journalArticle

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