Brain Injury (Brain Inj)

Publisher: International Association for the Study of Traumatic Brain Injury; European Brain Injury Society, Informa Healthcare

Journal description

This journal covers all aspects of brain injury from basic science, neurological techniques and outcomes to vocational aspects, with studies of rehabilitation and outcome of both patients and their families. It addresses both adult and pediatric issues and it embraces issues such as family and peer relationships, effects of alcohol and drugs, communication problems and management techniques and creating new programs. Brain Injury uses case studies to illustrate different approaches to a subject, and provides a forum for the appraisal of theories which may influence future research. Brain Injury is the official journal of the International Brain Injury Association (IBIA) and the European Brain Injury Society (EBIS).

Current impact factor: 1.51

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2011 Impact Factor 1.36

Additional details

5-year impact 2.06
Cited half-life 7.50
Immediacy index 0.38
Eigenfactor 0.01
Article influence 0.55
Website Brain Injury website
Other titles Brain injury (Online), BI
ISSN 1362-301X
OCLC 38266063
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Informa Healthcare

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • On author's personal website or institution website
    • Publisher copyright and source must be acknowledged
    • On a non-profit server
    • Must link to publisher version
    • Publisher's version/PDF cannot be used
    • NIH funded authors may post articles to PubMed Central for release 12 months after publication
    • Wellcome Trust authors may deposit in Europe PMC after 6 months
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Patients with chronic subdural haematoma and contralateral subdural effusion are rare after head injury. Surgery might reduce clinical progression of subdural effusion, but is not used routinely. This study aimed to investigate the effect of surgery on subdural effusion and clinical outcome. Methods: A retrospective study was performed, comparing operation and non-operation in the patients with chronic subdural haematoma and contralateral subdural effusion, in a series of 47 patients divided into two groups. The operation group of 21 patients underwent bilateral surgery. The non-operation group of 26 patients underwent surgery on the side with chronic subdural haematoma. Neurological status was assessed by the Glasgow Coma score and Modified Rankin Scale score on admission and at follow-up. All cases underwent pre- and post-operative computed tomography scans. Results: Pre-operative clinical and radiological data were similar in the two groups. The rate of subdural effusion progression was significantly lower in the operation group than in the non-operation group (p < 0.05). Thirteen cases (50%) in the non-operation group and three cases (14.3%) in the operation group had progression of subdural effusion to chronic subdural haematoma (p < 0.05). Chronic subdural haematoma recurrence rate, mortality and neurological recovery were similar, with no significant difference between groups. Conclusions: The patients benefitted from surgery for subdural effusion when they had chronic subdural haematoma and contralateral subdural effusion.
    Brain Injury 03/2015;
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    ABSTRACT: Primary objective: To describe and evaluate a new day programme for persons living with an acquired brain injury (ABI), including persons exhibiting challenging behaviours. Activities were designed to reduce participants’ social isolation, increase participation in community activities and increase social and leisure skills. It was expected that community integration would increase and challenging behaviours and family burden would decrease for day programme participants. Methods and procedures: Pre–post convenience sample design. Sixty-one participants and family members completed questionnaires before starting the day programme and after 6-month participation. Measures: Community Integration Questionnaire, Overt Behaviour Scale, Burden Assessment Scale, Goal Attainment Scaling. Results: Participants had increased community integration (p = 0.000) and decreased family burden (p = 0.006). There was a trend to decreased severity of challenging behaviour. Participants and family members were very satisfied. Results suggest that the programme was effective in reducing participants’ social isolation and increasing appropriate interpersonal behaviours. Conclusions: Participation increased community integration and reduced burden on family caregivers. ABI day programmes help fill the void left after other rehabilitation services end and provide survivors with opportunities to engage in a variety of activities. Persons living with ABI have need for ongoing social, recreational and life skill coaching services after formal rehabilitation has been completed.
    Brain Injury 03/2015;
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    ABSTRACT: The aim of the study was to investigate the effects of using low-dose mannitol (0.3 g kg(-1)) on the pulsatility index (PI) and minimum diastolic blood flow velocity (FV-min) of the middle cerebral artery in a traumatic brain injury (TBI). Low-dose mannitol (0.3 g kg(-1)) was administered to a group of 20 patients with a TBI. Transcranial Doppler (TCD) ultrasonography was used to monitor the PI and FV-min. The study included patients with a diffuse traumatic brain injury and Glasgow coma score < 8. The initial TCD ultrasonography values were pathological (PI > 1.4 and FV-min < 20 cm s(-1)). TCD ultrasonography examinations were carried out before mannitol administration, immediately after administration and 1, 2 and 3 hours after the administration of mannitol. A one-way analysis of variance revealed significant changes in the PI (F = 8.392; p < 0.001) and FV-min (F = 8.291; p = 0.001) after the use of mannitol. Low-dose mannitol administration appears to be efficacious for improving the indicators of disturbed circulation in a TBI (FV-min increase, PI decrease). The maximum decrease in the PI was recorded 1 hour after the administration of mannitol and was 10.9% of the initial value. The maximum increase in the FV-min was recorded 1 hour after administration and was 29.7% of the initial value. These changes were significant ∼ 2 hours later.
    Brain Injury 03/2015; DOI:10.3109/02699052.2015.1004743
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    ABSTRACT: Post-traumatic brain injury symptoms, such as mental fatigue, have considerable negative impacts on quality-of-life. In the present study the effects of methylphenidate in two different dosages were assessed with regard to mental fatigue, pain and cognitive functions in persons who had suffered a traumatic brain injury. Fifty-one subjects were included and 44 completed the study. The treatment continued for 12 weeks, including three treatment periods with no medication for 4 weeks, administration of low dose methylphenidate (up to 5 mg × 3) for 4 weeks and normal dose methylphenidate (up to 20 mg × 3) for a further 4 weeks. The patients were randomized into three groups where all groups were given all treatments. Significantly reduced mental fatigue, assessed with the Mental Fatigue Scale (MFS) and increased information processing speed (coding, WAIS-III), were detected. The SF-36 vitality and social functioning scales were also improved significantly. Pain was not reduced by methylphenidate. The positive effects of treatment were dose-dependent, with the most prominent effects being at 60 mg methylphenidate/day spread over three doses. Observed side-effects were increased blood pressure and increased heart rate. Methylphenidate was generally well-tolerated and it improved long-lasting mental fatigue and processing speed after traumatic brain injury.
    Brain Injury 03/2015; DOI:10.3109/02699052.2015.1004747
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    ABSTRACT: Objective: The simple test for evaluating hand function (STEF) is widely used for clinical evaluation of upper extremity function in Japan. However, except for test–re-test reliability, its psychometric properties have not been investigated. The aim of this study is to explore its internal consistency, concurrent validity and responsiveness in patients with sub-acute stroke. Design: This was a prospective longitudinal study. Patients: Thirty-four inpatients who had suffered hemiparetic stroke within 60 days of participation were enrolled. Methods: To investigate its internal consistency and responsiveness, they were assessed with the STEF and Action Research Arm Test (ARAT) at admission and 3 weeks later. To explore its concurrent validity, the Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL) and Functional Independence Measure (FIM™) were also evaluated at admission. Results: The Cronbach’s alpha for the STEF was 0.98–0.99, indicating excellent internal consistency. The STEF score strongly correlated with the ARAT, FMA and MAL scores and moderately with the FIM™ score. Effect sizes and the standardized response mean were 0.27 and 0.52 for the STEF and 0.30 and 0.95 for the ARAT, respectively. Conclusion: This study indicates that the STEF is reliable, valid and sensitive to changes when applied to patients with sub-acute stroke.
    Brain Injury 03/2015;
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    ABSTRACT: To assess brain injury services utilization and their determinants using Andersen's model. Prospective follow-up of the PariS-TBI inception cohort. Out of 504 adults with severe traumatic brain injury (TBI), 245 survived and 147 received a 4-year outcome assessment (mean age 33 years, 80% men). Provision rates of medical, rehabilitation, social and re-entry services and their relations to patients' characteristics were assessed. Following acute care discharge, 78% of patients received physiotherapy, 61% speech/cognitive therapy, 50% occupational therapy, 41% psychological assistance, 63% specialized medical follow-up, 21% community re-entry assistance. Health-related need factors, in terms of TBI severity, were the main predictors of services. Provision of each therapy was significantly associated with corresponding speech, motor and psychological impairments. However, care provision did not depend on cognitive impairments and cognitive therapy was related to pre-disposing and geographical factors. Community re-entry assistance was provided to younger and more independent patients. These quantitative findings illustrate strengths and weaknesses of late brain injury care provision in urban France and highlight the need to improve treatment of cognitive impairments.
    Brain Injury 03/2015; DOI:10.3109/02699052.2015.1004646
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    ABSTRACT: Prevention of secondary brain injury is a key component of acute management of patients with severe traumatic brain injury (TBI). Haemoglobin concentration may have an impact on optimization of cerebral oxygenation. Patients with TBI may best be served by an organized trauma service. The objective is to determine if haemoglobin concentration or dedicated trauma admission has an impact on outcomes after severe TBI. This study retrospectively analysed consecutive patients with severe TBI admitted to a level-I trauma centre over 3 years. Patients <16 years-old and with length of stay (LOS) <24 hours were excluded. Data were collected on demographics; injury severity; LOS; admission service; survival to discharge; and haemoglobin levels from hospital days 1-7. Data were also collected on number of transfusions of packed red blood cells. The sample was stratified based on admission service and survival to discharge. Of 147 patients (age = 54.1 ± 3.7 years), overall mortality rate was 15.4% (n = 23). Overall, non-survivors had lower daily and 7-day mean haemoglobin levels (10.7 ± 0.9 vs. 12.9 ± 0.4 g dL(-1), p < 0.001). Non-surgical admissions had lower haemoglobin levels and a higher mortality rate (28.9% vs. 12.2%, p < 0.001) compared to dedicated trauma admissions. Among patients with severe TBI, higher haemoglobin levels and maintenance as a dedicated trauma admission are associated with higher survival to discharge.
    Brain Injury 03/2015; DOI:10.3109/02699052.2015.1004558
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    ABSTRACT: This study aimed to investigate the challenges and positive experiences of researchers who work with people who have experienced an acquired brain injury and their families. People who were currently or had previously worked as a researcher in the field of acquired brain injury (using either quantitative or qualitative methods) were invited to participate in a focus group or individual interview about their experiences. An expert reference group meeting was held to discuss strategies that could be implemented to enhance the researcher experience based on the interview data. A total of 19 researchers who worked across four different research teams took part in the study. Six inter-connected themes were identified: researcher motivation, meaning and fulfillment; human connection; knowing and understanding the role; complexity of brain injury in the research context; the research process; and state of the researcher. A number of recommendations for supporting researchers more effectively were identified. Researchers described a number of positive aspects as well as tensions they encountered in their role. The findings highlight the need to ensure researchers are supported effectively to ensure the quality of research studies in the field of brain injury.
    Brain Injury 03/2015; DOI:10.3109/02699052.2014.1002422
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    ABSTRACT: Cognitive recovery from sports concussion may be incomplete after resolution of other symptoms. It was hypothesized that independent effects of the number of days since last concussion (Days) and total number of concussions (Number) would predict poorer cognitive functioning. Cognition was assessed in an NCAA Division I student-athlete population (n = 87) using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery. In a MANOVA, the five ImPACT Composite scores were dependent variables, with Group (Concussion, Unaffected) as the independent variable and prior number of concussions (Number) and days since last concussion (Days; 68-2495 days) entered as covariates. The hypothesis that Days and Number would each independently affect cognitive functioning (as assessed by ImPACT Composite scores) was only partly supported. A significant, multivariate, main effect of Days (p = 0.01) indicated that more Days predicted better cognitive functioning overall (p = 0.01). Univariate effects emerged such that more Days specifically predicted better visual memory (p = 0.004) and faster reaction times (p = 0.02). A trend toward a Group*Days*Number three-way interaction for reaction time emerged (p = 0.06), such that smaller Number and more Days each predicted slower reaction time. Cognitive recovery following sports concussion may take far longer than was previously thought, the aetiology of cognitive reductions may be very complex and the ImPACT appears to be sensitive to subtle changes in cognition across time.
    Brain Injury 03/2015; DOI:10.3109/02699052.2014.999352
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    ABSTRACT: Abstrcat Objectives: Most of the retrospective studies have demonstrated that traumatic brain injury mediated hypopituitarism could be more frequent than previously known. Therefore, this study has prospectively investigated pituitary function and their correlation with severity, pressure effect and Glasgow Outcome Scale in the acute phase of moderate-to-severe traumatic brain injury. One hundred consecutive moderate-to-severe traumatic brain injury patients from August 2012 to November 2013 formed the study group. Apart from clinical assessment, non-contrast computed tomography of the head was performed on all patients on admission. The hormonal analysis (fT3, fT4, TSH, GH, Cortisol, Prolactin) was performed within 24 hours of traumatic brain injury and was repeated on the 7(th) day amongst the patients who survived. Growth hormone was the most common hormone to decrease. Cortisol was the most common hormone to increase. Risk of pituitary insufficiency was increased in patients with severe traumatic brain injury, patients with increased intracranial pressure and who had low Glasgow Outcome Scale. Neuroendocrine dysfunction occurs often in the acute phase of moderate-to-severe traumatic brain injury, more commonly in patients with severe traumatic brain injury, patients with pressure effects and low Glasgow Outcome Scale. Hormonal analysis should be considered in patients with moderate-to-severe traumatic brain injury, so that appropriate hormonal replacement can be done to optimize the clinical outcome.
    Brain Injury 03/2015; 29(3):336-42. DOI:10.3109/02699052.2014.955882
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    ABSTRACT: Abstract Objective: To investigate whether electro-acupuncture can serve as a method of inducing brain ischaemic tolerance (BIT) by encouraging the expression of glutamate transporter-1 (GLT-1) and suppressing the release of glutamate (Glu). Sprague-Dawley (SD) rats were divided into sham, ischaemia and EA groups. EA was performed on dazhui and baihui acupoints and the rat cerebral ischaemia model was achieved by occluding the middle cerebral artery (MCA) for 2 hours, followed by reperfusion. Dialysate was collected from the striatum in vivo to detect the concentration of Glu and the expression of Glutamate Transporter-1 (GLT-1) was examined. The changes of neurological deficit scores were evaluated at 24 hours after reperfusion, while the infarct volumes of brains were then measured with 2,3,5-triphenyltetrazolium chloride (TTC) staining. Compared with the ischaemia group, the concentration of Glu decreased and the expression of GLT-1 increased at most of the detective time points in the EA group; the neurological deficit scores were lower and the infarct volumes were smaller in the EA group. EA can up-regulate the expression of GLT-1 and inhibit the excessive release of Glu in the striatum in the process of subsequent ischaemic-reperfusion brain injury, which may be one of the mechanisms of inducing BIT and, thus, be neuroprotective for early ischaemic brain injury.
    Brain Injury 02/2015; 29(3):396-402. DOI:10.3109/02699052.2014.896944
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    ABSTRACT: Abstract Objective: Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease associated with repetitive brain trauma (RBT). Initially described in boxers, CTE has now been found in other contact sport athletes with a history of RBT. In recent years, there has been tremendous media attention regarding CTE, primarily because of the deaths of high profile American football players who were found to have CTE upon neuropathological examination. However, the study of CTE remains in its infancy. This review focuses on research from the Centre for the Study of Traumatic Encephalopathy (CSTE) at Boston University. This study reviews the formation of the CSTE, major CSTE publications and current ongoing research projects at the CSTE. The neuropathology of CTE has been well-described. Current research focuses on: methods of diagnosing the disease during life (including the development of biomarkers), examination of CTE risk factors (including genetic susceptibility and head impact exposure variables); description of the clinical presentation of CTE; development of research diagnostic criteria for Traumatic Encephalopathy Syndrome; and assessment of mechanism and pathogenesis. Current research at the BU CSTE is aimed at increasing understanding of the long-term consequences of repetitive head impacts and attempting to begin to answer several of the unanswered questions regarding CTE.
    Brain Injury 02/2015; 29(2):154-63. DOI:10.3109/02699052.2014.965215
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    ABSTRACT: Abstract Background: Sports-related concussions are commonplace at all levels of play and across all age groups. The dynamic, evolving nature of this injury coupled with a lack of objective biomarkers creates a challenging management issue for the sports medicine team. Athletes who return to play following a concussion are known to be at higher risk for an additional brain injury, which necessitates a careful, informed return to play (RTP) process. The goal of this paper is to outline historical attempts at developing RTP guidelines and trace their evolution over time, culminating in a discussion of the process and outcomes of the most recent consensus statements/guidelines published by the international Concussion In Sport Group (CISG), the American Academy of Neurology (AAN), the National Athletic Trainers' Association, and the 2013 Team Physician Consensus Statement Update. An evaluation of the pros and cons of these guidelines is presented along with suggestions for future directions. In addition, the Institute of Medicine recently conducted a comprehensive report outlining the current state of evidence regarding youth concussions, which provides specific recommendations for future research. The different methodologies utilized in the development of consensus statements have distinct advantages and disadvantages, and both approaches add value to the everyday management of sports concussions. Importantly, the overall approach for management of sports concussion is remarkably similar using either consensus-based or formal evidence-based methods, which adds confidence to the current guidelines and allows practitioners to focus on accepted standards of clinical care. Moving forward, careful study designs need to be utilized to avoid bias in selection of research subjects, collection of data, and interpretation of results. Although useful, clinicians must venture beyond consensus statements to examine reviews of the literature that are published in much greater frequency than consensus statements.
    Brain Injury 02/2015; 29(2):185-94. DOI:10.3109/02699052.2014.965212
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    ABSTRACT: Abstract Background: Anti-NMDA (N-methyl D-Aspartate) encephalitis is an autoimmune disorder of the central nervous system which presents acutely with seizures, disturbances in consciousness and behavioural change. Although there is an increasing amount of information about the diagnosis and acute treatment strategies, little is known about rehabilitation needs and outcomes for this patient group. Case report: This study presents a 52-year old woman who initially presented with generalized seizures and drowsiness. She was admitted to hospital where autoimmune encephalitis was diagnosed based on a positive serum anti-NMDA antibody titre. When medically stabilized, she was transferred to a specialist neurorehabilitation unit for ongoing care. Her main clinical issues were around behavioural disturbance, communication, continence, mobility and cognition. A multi-disciplinary approach was taken to her problems and she was eventually discharged back to community living having made substantial improvements in all domains of functioning. The clinical challenges encountered throughout her rehabilitation and the approach to ameliorating these is described. Conclusion: Although having a relatively rare diagnosis, the specific rehabilitation needs of this patient were met through an existing specialist neurorehabilitation service. A broader case series is required to determine needs and effective approaches across this patient group as a whole.
    Brain Injury 01/2015; DOI:10.3109/02699052.2015.1004741
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    ABSTRACT: Abstract Primary objective: Neuroglobin (NGB) is a known neuroprotector and is up-regulated after ischaemia-hypoxia brain damage. However, no studies have investigated NGB levels after ischaemic pre-conditioning and middle cerebral artery occlusion (MCAO). Methods and procedures: This study subjected rats to different ischaemic pre-conditioning and MCAO regimens and assayed NGB levels in the hippocampus, cortex and hypothalamus by immunohistochemistry, quantitative polymerase chain reaction (PCR) and western blot. Main outcomes and results: After 30 minutes of ischaemic pre-conditioning, the number of NGB-positive cells and NGB levels in the hippocampus, cortex and hypothalamus were increased with longer reperfusion times, peaked at 24-hours reperfusion and slightly decreased at 48-hours reperfusion. Similarly, the mRNA and protein expression levels of NGB were also up-regulated; they peaked at 24-hours reperfusion and slightly decreased at 48-hours reperfusion. Conclusions: NGB may regulate neuroprotection against ischaemia and hypoxia-mediated brain damage after ischaemic pre-conditioning. The results provide additional evidence supporting the utility of ischaemic pre-conditioning and help elucidate its potential regulatory mechanism.
    Brain Injury 01/2015; DOI:10.3109/02699052.2014.1002004