The Australian Traumatic Brain Injury Initiative: Systematic Review of Predictive Value of Biological Markers for People With Moderate-Severe Traumatic Brain Injury

澳大利亚创伤性脑损伤行动计划：中重度创伤性脑损伤患者生物标志物预测价值的系统综述

The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to co-design a data resource to predict outcomes for people with moderate-severe traumatic brain injury (TBI) across Australia. Fundamental to this resource is the data dictionary, which is an ontology of data items. Here, we report the systematic review and consensus process for inclusion of biological markers in the data dictionary. This systematic review and consensus process has identified fluid and imaging biomarkers with high predictive value of clinical and long-term outcomes following moderate-severe TBI.

澳大利亚创伤性脑损伤行动计划（AUS-TBI）旨在联合设计一项数据资源，用以预测全澳大利亚范围内中重度创伤性脑损伤（TBI）患者的预后情况。该数据资源的核心构成是数据词典，这是一份数据条目本体论文件。本研究阐述了将生物标志物纳入数据词典所采用的系统综述方法及共识形成流程。通过该系统综述与共识流程，研究筛选出了对中重度创伤性脑损伤后临床结局及长期预后具有高预测价值的体液生物标志物与影像学生物标志物。

REF: Bagg MK, Hellewell SC, Keeves J, et al. The Australian Traumatic Brain Injury Initiative: Systematic Review of Predictive Value of Biological Markers for People With Moderate-Severe Traumatic Brain Injury. J Neurotrauma. 2025;42(21-22):2116-2137. doi:10.1089/neu.2023.0464 PMID: 38115587

由人工翻译修正

The Australian Traumatic Brain Injury Initiative: Systematic Review and Consensus Process to Determine the Predictive Value of Demographic, Injury Event, and Social Characteristics on Outcomes for People With Moderate-Severe Traumatic Brain Injury

澳大利亚创伤性脑损伤行动计划：关于人口统计学特征、损伤事件及社会特征对中重度创伤性脑损伤患者预后预测价值的系统综述与共识形成流程

The objective of the Australian Traumatic Brain Injury (AUS-TBI) Initiative is to develop a data dictionary to inform data collection and facilitate prediction of outcomes of people who experience moderate-severe TBI in Australia. The aim of this systematic review was to summarize the evidence of the association between demographic, injury event, and social characteristics with outcomes, in people with moderate-severe TBI, to identify potentially predictive indicators. This review identified numerous predictors capable of enabling early identification of those at risk for poor outcomes and improved personalization of care through inclusion in routine data collection.

澳大利亚创伤性脑损伤行动计划（AUS-TBI）的目标是编制一份数据词典，为数据收集工作提供指导，并助力预测澳大利亚境内中重度创伤性脑损伤（TBI）患者的预后情况。本系统综述旨在汇总人口统计学特征、损伤事件及社会特征与中重度创伤性脑损伤患者预后关联性的相关证据，从而筛选出具有潜在预测价值的指标。本综述识别出多种预测因子，这些因子可用于早期识别预后不良的高危人群；将其纳入常规数据收集工作后，还能进一步提升临床诊疗的个体化水平。

REF: Gabbe BJ, Keeves J, McKimmie A, et al. The Australian Traumatic Brain Injury Initiative: Systematic Review and Consensus Process to Determine the Predictive Value of Demographic, Injury Event, and Social Characteristics on Outcomes for People With Moderate-Severe Traumatic Brain Injury. J Neurotrauma. 2025;42(21-22):2096-2115. doi:10.1089/neu.2023.0461 PMID: 38115598

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The Australian Traumatic Brain Injury Initiative: Single Data Dictionary to Predict Outcome for People With Moderate-Severe Traumatic Brain Injury

澳大利亚创伤性脑损伤行动计划：用于预测中重度创伤性脑损伤患者预后的统一数据词典

In this series of eight articles, the Australian Traumatic Brain Injury Initiative (AUS-TBI) consortium describes the Australian approach used to select the common data elements collected acutely that have been shown to predict outcome following moderate-severe traumatic brain injury (TBI) across the lifespan. This article presents the unified single data dictionary, together with additional measures chosen to facilitate comparative effectiveness research and data linkage. Implementation of the AUS-TBI approach aims to maximize ongoing data collection and linkage, to facilitate personalization of care and improved outcomes for people who experience moderate-severe TBI.

在系列论文中，澳大利亚创伤性脑损伤行动计划（AUS-TBI）协作组阐述了澳大利亚所采用的研究方法——该方法用于筛选急性期收集的通用数据要素，这些要素已被证实可预测全生命周期内中重度创伤性脑损伤（TBI）患者的预后。本文详述了这份统一的标准化数据词典，同时纳入了为推动比较效果研究及数据联动而选定的补充测量指标。澳大利亚创伤性脑损伤行动计划（AUS-TBI）研究方法的落地实施，旨在最大化持续性数据收集与数据联动的效能，进而助力中重度创伤性脑损伤患者的个体化诊疗，并改善其预后转归。

REF: Fitzgerald M, Ponsford JL, Hill R, et al. The Australian Traumatic Brain Injury Initiative: Single Data Dictionary to Predict Outcome for People With Moderate-Severe Traumatic Brain Injury. J Neurotrauma. 2025;42(21-22):2078-2095. doi:10.1089/neu.2023.0467 PMID: 38117144

由人工翻译修正

The Australian Traumatic Brain Injury Initiative: Systematic Review of the Effect of Acute Interventions on Outcome for People With Moderate-Severe Traumatic Brain Injury

澳大利亚创伤性脑损伤行动计划：急性期干预措施对中重度创伤性脑损伤患者预后影响的系统综述

The Australian Traumatic Brain Injury Initiative (AUS-TBI) is developing a data resource to enable improved outcome prediction for people with moderate-severe TBI (msTBI) across Australia. Fundamental to this resource is the collaboratively designed data dictionary. This systematic review and consultation aimed to identify acute interventions with potential to modify clinical outcomes for people after msTBI, for inclusion in a data dictionary. From the systematic review and consensus process, 12 interventions were identified as potential modifiers to be included in the AUS-TBI national data resource.

澳大利亚创伤性脑损伤行动计划（AUS-TBI）正着手构建一项数据资源，以期提升全澳大利亚范围内中重度创伤性脑损伤（msTBI）患者的预后预测水平。该数据资源的核心基石，是经由协作设计而成的数据词典。本项系统综述与咨询工作旨在筛选出具备改善中重度创伤性脑损伤患者临床预后潜力的急性期干预措施，并将其纳入数据词典。通过系统综述与共识形成流程，研究最终确定了12项干预措施作为潜在预后改善手段，纳入澳大利亚创伤性脑损伤行动计划（AUS-TBI）国家数据资源库。

REF: Keeves J, Gadowski A, McKimmie A, et al. The Australian Traumatic Brain Injury Initiative: Systematic Review of the Effect of Acute Interventions on Outcome for People With Moderate-Severe Traumatic Brain Injury. J Neurotrauma. 2025;42(21-22):2062-2077. doi:10.1089/neu.2023.0465 PMID: 38279797

由人工翻译修正

The Australian Traumatic Brain Injury Initiative: Systematic Review and Consensus Process to Determine the Predictive Value of Pre-existing Health Conditions for People with Moderate-Severe Traumatic Brain Injury

澳大利亚创伤性脑损伤行动计划：关于基础健康状况对中重度创伤性脑损伤患者预测价值的系统综述与共识形成流程

The first aim of the Australian Traumatic Brain Injury Initiative (AUS-TBI) encompasses development of a set of measures that comprehensively predict outcomes for people with moderate-severe TBI across Australia. This process engaged diverse stakeholders and information sources across six areas: social, health, and clinical factors; biological markers; treatments; and longer-term outcomes. Here, we report the systematic review of pre-existing health conditions as predictors of outcome for people with moderate-severe TBI. Following the consensus meeting, 5 out of 11 were included (migraine, mental health conditions, ≥4 pre-existing health conditions, osteoporosis, and body mass index [BMI]) as common data elements in the AUS-TBI data dictionary. Upon further discussion, 3 additional pre-existing health conditions were included. These are pre-existing heart disease, frailty score, and previous incidence of TBI.

澳大利亚创伤性脑损伤行动计划（AUS-TBI）的首要目标，是制定一套预后预测指标体系，用以全面预测全澳大利亚范围内中重度创伤性脑损伤（TBI）患者的预后情况。该指标体系的构建过程纳入了六大领域的多方利益相关者与信息来源，具体包括社会因素、健康因素、临床因素、生物标志物、治疗手段及远期预后。本研究阐述了一项针对基础健康状况作为中重度创伤性脑损伤患者预后预测因子的系统综述。经共识会议讨论，11项候选指标中有5项被纳入澳大利亚创伤性脑损伤行动计划（AUS-TBI）数据词典，列为通用数据要素，分别为偏头痛、精神健康疾病、合并≥4种基础健康状况、骨质疏松症及身体质量指数（BMI）。经进一步研讨，又增补纳入3项基础健康状况指标，包括既往心脏病病史、衰弱评分及创伤性脑损伤既往史。

REF: Antonic-Baker A, Auvrez C, Tao G, et al. The Australian Traumatic Brain Injury Initiative: Systematic Review and Consensus Process to Determine the Predictive Value of Pre-existing Health Conditions for People with Moderate-Severe Traumatic Brain Injury. J Neurotrauma. 2025;42(21-22):2047-2061. doi:10.1089/neu.2023.0462 PMID: 38450564

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Repetitive Mild Traumatic Brain Injury Disrupts Learning and Memory: A Novel Olfactory Approach to Detection

重复性轻度创伤性脑损伤对学习记忆功能的损伤作用：一种新型嗅觉检测方法

Traumatic brain injury (TBI) leads to significant public health concerns due to cognitive decline and increased risks of neurological conditions like Alzheimer’s disease and chronic traumatic encephalopathy. Preclinical models are essential for exploring how mild TBI leads to neuronal dysfunction and neurodegeneration. Using a mouse model, we applied repetitive, mild, side-alternating impacts to induce rapid head rotational acceleration–deceleration. Our findings revealed that this side-impact model specifically affects the hippocampus, evidenced by activated CD68+ microglia appearing in the dentate gyrus, stratum lacunosum-moleculare, and corpus callosum. Importantly, no olfactory dysfunction was observed. However, injured mice exhibited learning and memory deficits in an olfaction-based task. These results suggest that repetitive mild TBI damages hippocampal regions, leading to cognitive dysfunction characterized by impaired learning and memory, as demonstrated by this novel behavioral method.

创伤性脑损伤（TBI）可引发认知功能减退，并增加阿尔茨海默病、慢性创伤性脑病等神经系统疾病的发病风险，因此已成为一项重大公共卫生问题。临床前模型对于探究轻度创伤性脑损伤诱发神经元功能障碍及神经退行性病变的机制具有关键意义。本研究采用小鼠模型，通过施加重复性、轻度、双侧交替的撞击，诱导小鼠头部产生快速的旋转加减速运动。研究结果显示，该侧方撞击模型会特异性损伤海马体，具体证据为齿状回、腔隙分子层及胼胝体区域出现CD68阳性小胶质细胞的活化。值得注意的是，实验未观察到小鼠出现嗅觉功能障碍；但在嗅觉相关行为学实验中，脑损伤小鼠表现出明显的学习记忆功能缺损。上述结果表明，重复性轻度创伤性脑损伤可造成海马体区域损伤，进而引发以学习记忆障碍为主要特征的认知功能缺损，这一结论也通过本研究提出的新型行为学检测方法得到验证。

REF: Guilhaume-Correa F, Melendes EJ, Yin Y, et al. Repetitive Mild Traumatic Brain Injury Disrupts Learning and Memory: A Novel Olfactory Approach to Detection. J Neurotrauma. 2025;42(21-22):2030-2046. doi:10.1177/08977151251365669 PMID: 40843642

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A Model of Traumatic Brain Injury Oligomerizes Tau in Cortical Organoids and Induces Clinically Relevant Pathologies that Synergize with MAPT Mutation

创伤性脑损伤模型可诱导皮质类器官中 Tau 蛋白寡聚化，并触发与 MAPT 基因突变具有协同作用的临床相关病理改变

Traumatic brain injury (TBI) is the most important environmental risk factor for neurodegenerative disease. Tauopathy plays an important role in post-traumatic neurodegeneration. Human-induced pluripotent stem cell (hiPSC)-derived cortical organoids have exciting potential to reveal the influence of genotype on post-traumatic neurodegeneration because they permit manipulation of the genome in a human system. This study established an isogenic 3D cortical organoid model of TBI to investigate tau pathology and other clinically relevant injury phenotypes. The model can reproduce gene-trauma interactions in vitro, so it has the capacity to answer important questions about why different patients have different outcomes after similar TBIs. MAPT mutation was not necessary for injury to induce tau hyperphosphorylation in 4-month-old organoids and both tau hyperphosphorylation and tau oligomerization in 6-month-old organoids. This capacity to induce advanced tau pathology in wild-type human organoids could have utility beyond the field of TBI research.

创伤性脑损伤（TBI）是引发神经退行性疾病的首要环境风险因素。Tau蛋白病在创伤后神经退行性病变进程中发挥关键作用。人诱导多能干细胞（hiPSC）来源的皮质类器官具有巨大潜力，其能够揭示基因型对创伤后神经退行性病变的影响。原因在于该模型可在人体细胞体系中实现基因组的精准调控。本研究构建了一株同源的创伤性脑损伤三维皮质类器官模型，用以探究Tau蛋白相关病理改变及其他具有临床相关性的损伤表型。该模型可在体外重现基因-创伤的相互作用，因此能够解答一个关键科学问题：为何不同患者在遭受相似程度的创伤性脑损伤后，预后情况却存在显著差异。研究发现，对于4月龄的类器官，创伤诱导 Tau 蛋白过度磷酸化无需依赖MAPT基因突变；而在6月龄的类器官中，Tau蛋白过度磷酸化与寡聚化这两种病理改变的发生，同样不依赖MAPT基因突变。这种在野生型人类类器官中诱导晚期Tau蛋白病理改变的能力，其应用价值可拓展至创伤性脑损伤研究领域之外。

REF: Shiravi S, Yufa A, Papavasileiou P, et al. A Model of Traumatic Brain Injury Oligomerizes Tau in Cortical Organoids and Induces Clinically Relevant Pathologies that Synergize with MAPT Mutation. J Neurotrauma. 2025;42(21-22):2015-2029. doi:10.1177/08977151251374286 PMID: 40900146

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STARSHIP Part 2: Disturbed Pressure Reactivity Duration and Magnitude in Pediatric Severe Traumatic Brain Injury—Outcome Implications

STARSHIP研究第二部分：儿童重度创伤性脑损伤中压力反应性紊乱的持续时间与强度及其对预后的影响

Cerebral autoregulation (CA) plays a critical role in maintaining cerebral blood flow (CBF) amid fluctuations in systemic blood pressure, with dysfunction increasing vulnerability to secondary brain injury, particularly after traumatic brain injury (TBI). While extensively studied in adults, CA dynamics in pediatric TBI (pTBI) remain relatively unexplored. Studying Trends in AutoRegulation in Severe Head Injury in Pediatrics (STARSHIP), the first multicenter, prospective study on CA in pTBI, investigates the pressure reactivity index (PRx) and its association with outcomes. PRx, calculated as the Pearson’s correlation between mean arterial pressure and intracranial pressure, provides insights into the patient’s CA status. In this article, STARSHIP Part 2 characterizes PRx disturbances using dose metrics that take the magnitude of PRx disturbance, and the time in which the patient experiences this derangement, into consideration. Our results highlight the predictive strength of PRx metrics, with percentage time above a threshold of 0 emerging as the most robust indicator of 12-month outcome. This work supports further investigation into the feasibility and impact of interventions guided by real-time CA monitoring in severe pTBI.

脑血流自动调节功能（CA）在全身血压波动时，对维持脑血流量（CBF）发挥着关键作用；一旦该功能出现障碍，会增加继发性脑损伤的发生风险，在创伤性脑损伤（TBI）后尤为显著。尽管成人脑血流自动调节功能的相关研究已较为深入，但儿童创伤性脑损伤（pTBI）患者的脑血流自动调节功能动态变化，目前仍相对缺乏探索。儿童重型颅脑损伤脑血流自动调节功能变化趋势研究（STARSHIP）是首个针对儿童创伤性脑损伤脑血流自动调节功能的多中心前瞻性研究，旨在探讨压力反应指数（PRx）及其与患者预后的关联性。压力反应指数通过计算平均动脉压与颅内压的皮尔逊相关系数得出，可用于评估患者的脑血流自动调节功能状态。在本文（即STARSHIP研究第二部分）中，研究团队采用一种整合了压力反应指数紊乱强度、以及患者处于该功能紊乱状态时长的剂量学指标，对压力反应指数的异常特征进行了量化分析。研究结果证实了压力反应指数相关指标具有较强的预后预测价值，其中压力反应指数＞0的时间占比是预测患者12个月预后的最可靠指标。本研究的结论为进一步探索基于实时脑血流自动调节功能监测的干预策略在儿童重型创伤性脑损伤中的可行性与应用价值，提供了有力的理论支持。

REF: Smith CA, Bögli SY, Placek M, et al. STARSHIP Part 2: Disturbed Pressure Reactivity Duration and Magnitude in Pediatric Severe Traumatic Brain Injury-Outcome Implications. J Neurotrauma. 2025;42(21-22):2004-2014. doi:10.1177/08977151251367052 PMID: 40844417 PMCID: PMC12505629

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Mild Brain Injuries Incurred During Intimate Partner Violence Are Related to Objective and Self-Reported Balance Measures

亲密伴侣暴力所致轻度脑损伤与客观性及自评性平衡功能评估指标的关联性研究

Individuals who experience intimate partner violence (IPV) sometimes self-report balance and vestibular problems; however, objectively measured balance has rarely been investigated in this population. Given the risk for persistent physical, neurocognitive, and psychological effects of brain injury (BI) in women who experience IPV, the present study evaluated the association between mild IPV-BIs, objective balance, and self-reported vestibular symptoms in women with at least one instance of physical IPV (n = 144). Results from the present study add to the literature describing the complex health problems experienced by women who experience IPV and IPV-related brain injuries. Future research could include in-person evaluations designed to identify treatable vestibular symptoms and problems.

遭受亲密伴侣暴力（IPV）的人群有时会自述存在平衡及前庭功能异常相关症状，但针对该人群开展的客观性平衡功能检测研究却较为匮乏。鉴于遭受亲密伴侣暴力的女性，其脑损伤（BI）可能引发持续性的躯体、神经认知及心理层面的不良后果，本研究纳入144名至少经历过一次躯体性亲密伴侣暴力的女性作为研究对象，旨在分析亲密伴侣暴力相关轻度脑损伤、客观性平衡功能与自述前庭症状三者间的关联性。本研究结果进一步丰富了相关研究文献，揭示了遭受亲密伴侣暴力及相关脑损伤的女性所面临的复杂健康问题。未来研究可纳入面对面临床评估环节，以筛查出可干预的前庭功能症状及相关病变。

REF: Joseph Denk AL, Iverson GL, Terry DP, Valera EM. Mild Brain Injuries Incurred During Intimate Partner Violence Are Related to Objective and Self-Reported Balance Measures. J Neurotrauma. 2025;42(21-22):1995-2003. doi:10.1177/08977151251372612 PMID: 40892435

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