Self-Reported Cognitive Difficulties and Their Modifiable Risk Factors in Former Elite Male Rugby League Players

前精英男性橄榄球联盟运动员自我报告的认知困难及其可改变风险因素

Participation in collision and contact sport in Australia—specifically rugby league—is popular. With recent attention to the possible long-term health consequences of head impact exposure during a contact or collision sport career, the importance of understanding the contribution of modifiable risk factors as they relate to cognitive function has been highlighted. Risk factors for cognitive decline in the general population include cardiovascular health, sleep disorders, chronic pain, depression, anxiety, smoking, physical impairment, and physical inactivity. This study examined the associations between these risk factors and self-reported cognitive function in 130 former elite male rugby league players in Australia. When adjusted for age and number of concussion-related signs and symptoms experienced during their career, predictors of perceived cognitive difficulties included less than 5 h of sleep on average, history of stroke, current clinical symptoms of anxiety, physical impairment, and number of risk factors. The number of concussion-related signs and symptoms experienced was not related to perceived cognitive impairment, although it was associated with specific risk factors. Early education and intervention by medical professionals to manage these risk factors may provide a pathway for improving perceived cognitive health and functioning in former elite male rugby league players in the future.

在澳大利亚，冲撞接触类运动（尤其是橄榄球联盟运动）参与度较高。近年来，关于冲撞接触类运动职业生涯中头部撞击暴露可能带来的长期健康影响备受关注，因此，明确与认知功能相关的可改变风险因素及其作用，其重要性日益凸显。普通人群中认知功能下降的风险因素包括心血管健康问题、睡眠障碍、慢性疼痛、抑郁、焦虑、吸烟、身体功能障碍及缺乏身体活动。本研究调查了这些风险因素与 130 名澳大利亚前精英男性橄榄球联盟运动员自我报告认知功能之间的关联。 在对年龄及职业生涯中经历的脑震荡相关体征和症状数量进行校正后发现，感知到认知困难的预测因素包括：平均睡眠时间不足 5 小时、有中风病史、当前存在临床焦虑症状、身体功能障碍，以及风险因素的总数量。尽管职业生涯中经历的脑震荡相关体征和症状数量与特定风险因素存在关联，但它与感知到的认知障碍并无直接关联。未来，医疗专业人员通过早期健康宣教和干预来管理这些风险因素，或可为改善前精英男性橄榄球联盟运动员感知到的认知健康与功能提供有效途径。

REF: Grellman K, Smith OJ, Terry DP, Quarrie KL, Iverson GL, Gardner AJ. Self-Reported Cognitive Difficulties and Their Modifiable Risk Factors in Former Elite Male Rugby League Players. J Neurotrauma. 2025;42(15-16):1453-1463. doi:10.1089/neu.2024.0543 PMID: 40329786

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Mitigation of Acute Seizures and Neuropathology after Traumatic Brain Injury by Structure-Based Discovery-Identified Drugs

基于结构发现的药物对创伤性脑损伤（TBI）后急性癫痫发作及神经病理改变的缓解作用

Our objective was to test the hypothesis that structure-based identified or designed compounds exhibiting neuroprotective, antioxidant, and anti-inflammatory properties in vitro will mitigate early seizures and neuropathology after traumatic brain injury (TBI) in vivo. The FBApro+ treatment regimen also reduced the mean relative theta and alpha power and increased the mean relative gamma power in the electroencephalogram (p < 0.05). Our data identified FBA as a novel structure-based discovered compound with promising favorable effects on structural and functional recovery after TBI.

本研究旨在验证以下假说：在体外实验中表现出神经保护、抗氧化及抗炎特性的、基于结构发现或设计的化合物，能够在体内实验中缓解创伤性脑损伤（TBI）后的早期癫痫发作与神经病理改变。FBApro + 治疗方案还降低了脑电图（EEG）中平均相对 θ 波（theta）和 α 波（alpha）功率，并提高了平均相对 γ 波（gamma）功率（p < 0.05）。研究数据表明，FBA 是一种新型的基于结构发现的化合物，对创伤性脑损伤后的结构及功能恢复具有良好潜力。

REF: Kajevu N, Banuelos I, Andrade P, et al. Mitigation of Acute Seizures and Neuropathology after Traumatic Brain Injury by Structure-Based Discovery-Identified Drugs. J Neurotrauma. 2025;42(15-16):1433-1452. doi:10.1089/neu.2024.0070 PMID: 40244871

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Combined Human Neural Stem Cell and Structured Treadmill Walking Therapy Enhances Recovery in a Pediatric Porcine Traumatic Brain Injury Model

人神经干细胞联合结构化跑步机步行治疗促进幼猪创伤性脑损伤模型的恢复

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, and is indiscriminate in who it affects, including children. Although there are currently no Food and Drug Administration-approved therapeutics, promising results from recent induced pluripotent stem cell-derived neural stem cell (iNSC) studies have demonstrated decreased tissue damage and functional deficits in pre-clinical TBI models. Moreover, while the rest has been traditionally identified as the standard of care following TBI, research now suggests that physical activity postinjury may significantly enhance neuroprotective and regenerative signaling in patients. Combining these two therapies may therefore synergistically improve recovery outcomes in TBI patients. In this study, we evaluated the combined therapeutic efficacy of iNSCs and structured treadmill walking on cellular, tissue, and functional recovery in a translational pediatric pig TBI model. The findings suggest that the combination of iNSCs with structured treadmill walking significantly enhanced TBI recovery beyond the therapeutic potential of iNSCs or exercise alone. Therefore, this novel combination therapy needs to be further explored as a potential transformative treatment option for pediatric TBI patients.

创伤性脑损伤（TBI）是全球范围内导致死亡和残疾的主要原因之一，其影响人群广泛，儿童亦在此列。目前，美国食品药品监督管理局（FDA）尚未批准任何针对 TBI 的治疗药物，但近期诱导多能干细胞来源的神经干细胞（iNSC）相关研究已取得积极成果 —— 在临床前 TBI 模型中，该细胞可减少组织损伤并改善功能障碍。此外，传统上 TBI 后的标准诊疗方式包括休息，但现有研究表明，损伤后的身体活动可能显著增强患者体内的神经保护和再生信号传导。因此，将这两种治疗方式结合，或许能通过协同作用改善 TBI 患者的恢复预后。 本研究在具有转化价值的儿童猪 TBI 模型中，评估了 iNSC 与结构化跑步机步行联合治疗在细胞、组织及功能恢复方面的疗效。结果显示，相较于单独使用 iNSC 或单独进行运动干预，iNSC 联合结构化跑步机步行能显著提升 TBI 的恢复效果，其疗效超出了单一疗法的治疗潜力。因此，这种新型联合疗法需进一步研究，有望成为儿童 TBI 患者潜在的突破性治疗方案。

REF: Schantz SL, Cosgrave GS, Schifino AG, et al. Combined Human Neural Stem Cell and Structured Treadmill Walking Therapy Enhances Recovery in a Pediatric Porcine Traumatic Brain Injury Model. J Neurotrauma. 2025;42(15-16):1416-1432. doi:10.1089/neu.2024.0542 PMID: 40509986

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Traumatic Brain Injury Diagnostic Interview: Development, Interrater Reliability, and 2-Week Post-Injury Clinical Profiles

创伤性脑损伤诊断访谈（TBI-DI）：编制、评分者间信度及损伤后 2 周临床特征分析

Because most traumatic brain injuries (TBIs) do not present with objective indicators (e.g., neuroimaging findings) to confirm the diagnosis, clinicians often rely on self- or observer-reporting of alteration of consciousness (AOC; e.g., loss of consciousness [LOC], amnesia, other signs of altered mental status), and symptoms to make diagnoses. Moreover, there is no universal agreement on signs and symptoms to sufficiently diagnose TBI, which leads to variability and ambiguity in how TBI is diagnosed in clinical and research settings. The lack of standardized procedures for the diagnosis of acute TBI is a major challenge that hampers the ability to evaluate and compare TBI studies and advance the science and treatment of TBI. We present a new semi-structured TBI Diagnostic Interview (TBI-DI), developed for prospective TBI research to collect injury information important to verifying eligibility for the diagnosis of TBI. Specifically, the TBI-DI collects patient (and/or witness) reports of head trauma, AOC (including LOC and amnesia), and TBI-related symptomology. We describe the protocol, interrater reliability of the TBI-DI items to the same audio-recorded interview, and observed injury characteristics for interviews conducted at 2 weeks post-injury. The TBI-DI and associated SOP appear well-suited for use in a multicenter prospective study of TBI. Future research should examine the stability of reporting by respondents and the alignment between interview and objective clinical information. The TBI-DI solicits diverse acute diagnostic information that, when combined with clinical information (including confounding factors) and objective injury indicators, may inform more rigorous scientific reporting and evidence-based TBI diagnostic practices.

由于大多数创伤性脑损伤（TBI）缺乏可用于确诊的客观指标（如神经影像学异常），临床医生通常需依赖患者自我报告或观察者报告的意识改变（AOC）表现（如意识丧失 [LOC]、遗忘、其他精神状态改变迹象）及症状来做出诊断。此外，目前对于确诊 TBI 所需的体征和症状尚无统一标准，这导致临床实践和研究中 TBI 的诊断存在差异且缺乏明确性。急性 TBI 诊断缺乏标准化流程已成为重大挑战，不仅阻碍了对 TBI 相关研究的评估与比较，也影响了 TBI 领域科学研究和治疗方法的推进。本研究提出一种新的半结构化创伤性脑损伤诊断访谈（TBI-DI），该工具专为前瞻性 TBI 研究设计，旨在收集对验证 TBI 诊断资格至关重要的损伤信息。具体而言，TBI-DI 会收集患者（和 / 或目击者）关于头部创伤、意识改变（包括意识丧失和遗忘）及 TBI 相关症状的报告。 研究团队阐述了 TBI-DI 的实施流程、基于同一录音访谈记录的评分者间信度，以及损伤后 2 周开展访谈所观察到的损伤特征。结果表明，TBI-DI 及其相关标准操作程序（SOP）非常适合用于多中心前瞻性 TBI 研究。未来研究应进一步考察受访者报告内容的稳定性，以及访谈信息与客观临床信息的一致性。TBI-DI 可收集多样化的急性诊断信息，将这些信息与临床信息（包括混杂因素）及客观损伤指标相结合，有望为更严谨的科学报告和循证 TBI 诊断实践提供参考。

REF: Simons MU, Maio A, Huber DL, et al. Traumatic Brain Injury Diagnostic Interview: Development, Interrater Reliability, and 2-Week Post-Injury Clinical Profiles. J Neurotrauma. 2025;42(15-16):1404-1415. doi:10.1089/neu.2024.0402 PMID: 40200896

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Long-Term Participation after Mild Traumatic Brain Injury in Comparison to Orthopedic Trauma Controls: Results from a Longitudinal Multicenter Observational Cohort Study

轻度创伤性脑损伤（mTBI）患者与骨科创伤对照组的长期参与度对比：一项多中心纵向观察队列研究结果

A subgroup of patients shows incomplete recovery after mild traumatic brain injury (mTBI). Outcomes are commonly measured on the level of symptoms or functional recovery. An alternative way to study outcome after mTBI is to measure the level of participation. The objectives of this study were to examine (1) the level of participation in patients with mTBI at 12 months post-injury in comparison to a non-head injury orthopedic trauma control group; (2) the relationship between the outcome domains participation, functional outcome, and post-concussion symptoms. People with mTBI more often report post-concussion symptoms, but functional recovery is not different between the groups. Participation seems to better represent incomplete recovery than functional outcome, but future research should confirm these findings.

部分轻度创伤性脑损伤（mTBI）患者存在恢复不完全的情况。目前对预后的评估通常聚焦于症状或功能恢复层面，而评估 mTBI 预后的另一种方法是衡量患者的 “参与度”（指患者参与日常社会活动、工作、学习等的程度）。本研究旨在实现两个目标：（1）对比损伤后 12 个月 mTBI 患者与非头部损伤的骨科创伤对照组的参与度水平；（2）分析 “参与度” 这一预后维度与功能预后、脑震荡后症状之间的关联。 研究发现，mTBI 患者报告脑震荡后症状的比例更高，但两组患者在功能恢复方面无显著差异。相较于功能预后，参与度更能反映患者恢复不完全的情况，但这一结论仍需未来研究进一步验证。

REF: Manders J, Wijenberg M, King S, Stapert S, Verbunt J, van Heugten C. Long-Term Participation after Mild Traumatic Brain Injury in Comparison to Orthopedic Trauma Controls: Results from a Longitudinal Multicenter Observational Cohort Study. J Neurotrauma. 2025;42(15-16):1394-1403. doi:10.1089/neu.2024.0413 PMID: 40244906

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Trajectory of Post-Traumatic Stress During the First Year after Pediatric Traumatic Brain or Orthopedic Injury

儿童创伤性脑损伤或骨科损伤后第一年创伤后应激障碍的发展轨迹

Up to 50% of children sustaining physical injury develop post-traumatic stress symptoms (PTSS). Most studies of PTSS have not included patients with traumatic brain injury (TBI); consequently, the influence of injury type and severity on the longitudinal course of PTSS is unclear. To address this gap, we completed a longitudinal prospective cohort study examining the trajectory of self-reported PTSS severity during the first year after TBI or orthopedic injury (OI). PTSS persisted for a significant minority of patients with TBI across the first year of recovery, particularly those with mTBI. Screening should emphasize risk factors to target patients with the greatest need for trauma-focused intervention. Cost-effective, scalable, evidence-based trauma-focused interventions are essential to meet American College of Surgeons standards to provide psychological screening and treatment to children sustaining PTSS.

高达 50% 遭受躯体损伤的儿童会出现创伤后应激症状（PTSS）。目前大多数关于 PTSS 的研究未纳入创伤性脑损伤（TBI）患者，因此损伤类型和严重程度对 PTSS 纵向发展过程的影响尚不明确。为填补这一空白，研究团队开展了一项纵向前瞻性队列研究，旨在分析 TBI 或骨科损伤（OI）患儿在损伤后第一年自我报告的 PTSS 严重程度变化轨迹。 结果显示，在 TBI 患儿中，有相当一部分（尤其是轻度 TBI 患儿）在损伤后第一年仍持续存在 PTSS。临床筛查应重点关注风险因素，以便锁定最需要接受创伤针对性干预的患儿。为达到美国外科医师学会制定的标准 —— 为出现 PTSS 的儿童提供心理筛查和治疗，开发具有成本效益、可推广且循证的创伤针对性干预措施至关重要。

REF: Ewing-Cobbs L, Cox CS Jr, Clark A, Keenan HT. Trajectory of Post-Traumatic Stress During the First Year after Pediatric Traumatic Brain or Orthopedic Injury. J Neurotrauma. 2025;42(15-16):1382-1393. doi:10.1089/neu.2024.0578 PMID: 40261714

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A Nomogram Predicts the Risk Factors for Post-Traumatic Cerebral Infarction in Polytrauma Patients with Traumatic Brain Injury

列线图预测多发伤合并创伤性脑损伤（TBI）患者创伤后脑梗死（PTCI）的风险因素

Post-traumatic cerebral infarction (PTCI) is a significant complication in polytrauma patients with traumatic brain injury (TBI). Identifying high-risk patients for early intervention is crucial. This study aims to investigate the independent risk factors for PTCI in polytrauma patients with TBI to establish and validate a prediction model. The nomogram prediction model demonstrates excellent performance according to the ROC, calibration curve, and DCA, providing valuable insights for the early identification of high-risk PTCI patients.

创伤后脑梗死（PTCI）是多发伤合并创伤性脑损伤（TBI）患者的严重并发症。识别高危患者以进行早期干预至关重要。本研究旨在探究多发伤合并 TBI 患者发生 PTCI 的独立风险因素，进而建立并验证预测模型。根据受试者工作特征曲线（ROC）、校准曲线及决策曲线分析（DCA）结果，该列线图预测模型表现优异，为早期识别 PTCI 高危患者提供了重要参考依据。

REF: Miao J, Qian X, Miao Z, et al. A Nomogram Predicts the Risk Factors for Post-Traumatic Cerebral Infarction in Polytrauma Patients with Traumatic Brain Injury. J Neurotrauma. 2025;42(15-16):1371-1381. doi:10.1089/neu.2024.0511 PMID: 40392753

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Prediction of Mental Health Complications Following Mild Traumatic Brain Injury

轻度创伤性脑损伤（mTBI）后心理健康并发症的预测

Prognostic models can support prevention of mental health complications after mild traumatic brain injury (mTBI). The present study aimed to identify risk factors and develop prognostic model(s) for mental health complications following mTBI. Certain pre-injury and demographic characteristics are associated with increased risk of mental health complications after mTBI. Assessing for early postinjury illness beliefs and psychological symptoms can further improve prognostic accuracy.

预后模型有助于预防轻度创伤性脑损伤（mTBI）后的心理健康并发症。本研究旨在明确 mTBI 后心理健康并发症的风险因素，并构建相关预后模型。研究发现，某些损伤前特征和人口统计学特征与 mTBI 后心理健康并发症风险升高相关。评估损伤后早期的疾病认知和心理症状，可进一步提高预后预测的准确性。

REF: Shi S, Mikolić A, LeMoult J, Rights J, Panenka WJ, Silverberg ND. Prediction of Mental Health Complications Following Mild Traumatic Brain Injury. J Neurotrauma. 2025;42(15-16):1359-1370. doi:10.1089/neu.2024.0505 PMID: 40415548

由人工翻译修正

Recovery Trajectories of Patients with Mild Traumatic Brain Injury

轻度创伤性脑损伤（mTBI）患者的恢复轨迹

Within the mild traumatic brain injury (mTBI) population, there is heterogeneity both in symptom presentation and recovery patterns. Components of the fear-avoidance model (FAM) may be useful in understanding this heterogeneity. This longitudinal study aimed to identify latent trajectory classes of postconcussion symptoms (PCS) and evaluate how these classes differ on components of the FAM, following mTBI compared with controls. Findings highlight the heterogeneity within the mTBI population and the universal disabling impact of person-related behavioral characteristics across medical conditions. Persistent symptoms management and education after mTBI should target those with higher emotion and somatic symptoms, catastrophizing, and depression at 2 weeks post-injury. Interventions targeting catastrophizing, avoidance behaviors, and emotional health may assist in recovery.

在轻度创伤性脑损伤（mTBI）患者群体中，其症状表现和恢复模式均存在异质性。恐惧回避模型（FAM）的相关要素或有助于理解这种异质性。本纵向研究旨在确定脑震荡后症状（PCS）的潜在轨迹类别，并评估与对照组相比，轻度创伤性脑损伤患者中这些轨迹类别在恐惧回避模型要素上的差异。 研究结果突显了轻度创伤性脑损伤患者群体内部的异质性，以及与个体相关的行为特征在不同疾病状态下普遍存在的致残影响。对于轻度创伤性脑损伤患者，创伤后 2 周时若出现较明显的情绪症状、躯体症状、灾难化思维及抑郁情绪，应将其作为脑震荡后持续症状管理和健康宣教的重点对象。针对灾难化思维、回避行为及情绪健康的干预措施，或有助于促进患者恢复。

REF: King S, Winkens I, Wijenberg M, et al. Recovery Trajectories of Patients with Mild Traumatic Brain Injury. J Neurotrauma. 2025;42(15-16):1345-1358. doi:10.1089/neu.2024.0610 PMID: 40432603

由人工翻译修正