Effects of Screen Time Use on Psychological Symptoms in Adolescents Following Concussion

屏幕使用时长对青少年脑震荡后心理症状的影响

Excessive screen time (ST) use has been linked to more depressive and anxiety symptoms, whereas moderate use may confer benefits for psychological health in adolescents. However, its role in psychological health following concussion in adolescents remains unclear. This study examined the effects of ST use on depressive and anxiety symptoms in adolescents following concussion. Moderate recreational ST use was associated with significant recovery, while low and high ST use were associated with persistent symptoms in adolescents following concussion. Adolescents may benefit from recommendations that support a “Goldilocks” approach to ST use following concussion.

过长时间使用电子屏幕（ST）与青少年抑郁、焦虑症状加重有关，而适度使用则可能对其心理健康有益。然而，屏幕使用时长在青少年脑震荡后心理健康中的作用仍不明确。本研究探讨了屏幕使用时长对青少年脑震荡后抑郁及焦虑症状的影响。结果显示，适度的娱乐性屏幕使用与症状显著恢复相关，而屏幕使用时长过少或过多均与脑震荡后青少年症状持续存在相关。对青少年而言，遵循“刚刚好”的屏幕使用建议，可能有助于其脑震荡后恢复。

REF: Lima Santos JP, Zynda AJ, Perry CA, et al. Effects of Screen Time Use on Psychological Symptoms in Adolescents Following Concussion. J Neurotrauma. 2026;43(5-6):501-506. doi:10.1177/08977151251385568 PMID: 41027657

由人工翻译修正

A Modified Repetitive Closed Head Injury Model Inducing Persistent Neuroinflammation and Functional Deficits Without Extensive Cortical Tissue Destruction

一种改良型重复性闭合性颅脑损伤模型：在无广泛皮质组织破坏的情况下诱导持续性神经炎症与功能缺损

Traumatic brain injury (TBI) remains a significant clinical challenge, with limited treatment options and long-term neurological impairments. Mild to moderate TBI represents the most common form, making it a critical therapeutic target. However, current animal models poorly reflect human TBI pathophysiology, necessitating improved preclinical paradigms. Here, we present a refined repetitive closed head injury (rCHI) model using consecutive controlled impacts within a single session, without craniotomy. This rCHI model successfully replicates key TBI features—BBB dysfunction, chronic neuroinflammation, and functional impairments—without direct cortical destruction. It serves as a valuable platform for evaluating acute-phase interventions and investigating neuroprotective strategies targeting inflammation and BBB integrity. Our findings highlight the importance of injury severity in shaping TBI outcomes and reinforce the need for tailored therapeutic approaches.

创伤性脑损伤（TBI）仍是一项重大临床难题，其治疗手段有限，且常伴随长期神经功能缺损。轻至中度创伤性脑损伤是最常见的类型，因此成为重要的治疗研究靶点。然而，现有动物模型难以很好地模拟人类创伤性脑损伤的病理生理过程，亟需优化临床前研究模型。本文建立了一种改良的重复性闭合性颅脑损伤（rCHI）模型，该模型无需开颅，仅在单次实验中通过连续可控撞击即可实现。此重复性闭合性颅脑损伤模型可成功重现创伤性脑损伤的核心特征——血脑屏障功能障碍、慢性神经炎症以及神经功能缺损，且不会造成直接的皮质破坏。该模型为评估急性期干预措施、研究针对炎症及血脑屏障完整性的神经保护策略提供了理想平台。本研究结果强调了损伤严重程度对创伤性脑损伤预后的重要影响，并进一步证实了开展个体化治疗方案的必要性。

REF: Fadon-Padilla L, Chu C, Liang Y, et al. A Modified Repetitive Closed Head Injury Model Inducing Persistent Neuroinflammation and Functional Deficits Without Extensive Cortical Tissue Destruction. J Neurotrauma. 2026;43(5-6):485-500. doi:10.1177/08977151251387679 PMID: 41173520

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A Spatial Gene Expression Signature of the Mouse Brain Post-Injury at the Focal Point of Contusion

小鼠脑挫伤灶部位损伤后空间基因表达特征

Traumatic brain injury (TBI) results from a primary injury that impacts the brain in a spatially dependent manner. In this study, we investigated the topographical relationship of early transcriptional responses to a single, focal TBI in mice by controlled cortical impact. The data suggest that infiltrating neutrophils and monocytes play an evolving, multifaceted role in modulating the metabolic, transcriptional, and synaptic activity of brain tissue post-injury.

创伤性脑损伤（TBI）源于原发性损伤，该损伤以空间依赖性方式对大脑造成影响。本研究通过控制性皮质撞击法，探究小鼠单次局灶性创伤性脑损伤后早期转录应答的拓扑分布关系。数据表明，浸润的中性粒细胞和单核细胞在调节损伤后脑组织的代谢、转录及突触活动中，发挥着动态演变且多方面的作用。

REF: Kounelis-Wuillaume SK, Frank AM, Goguet E, et al. A Spatial Gene Expression Signature of the Mouse Brain Post-Injury at the Focal Point of Contusion. J Neurotrauma. 2026;43(5-6):461-484. doi:10.1177/08977151251390528 PMID: 41250842

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N-Formylmethionine Is a Biologically Active Diagnostic Marker of Mild Traumatic Brain Injury

N-甲酰甲硫氨酸是轻型创伤性脑损伤的一种具有生物活性的诊断标志物

Traumatic brain injury (TBI) is a major health problem worldwide. Approximately 2.8 million people in the United States sustain a TBI each year, the majority of which can be classified as mild TBI (mTBI) or concussive injuries. Although mTBI may not cause overt brain damage, it triggers many cellular and molecular changes in brain cells, resulting in neurological, cognitive, and behavioral impairments. Metabolites are released in response to mTBI and can serve as diagnostic markers, as well as potentially contributing to ongoing pathophysiological changes. N-formylmethionine (fMet) is used as the first amino acid for protein synthesis in mitochondria, bacteria, and chloroplasts. Both formylated peptides and free fMet have been detected in human plasma. While a number of studies have demonstrated that formylated peptides can activate the innate immune response, less is known about the role of free fMet in health and disease. In this study, we quantified the free fMet concentration in plasma samples obtained from persons who have sustained an mTBI and compared it with the plasma concentrations detected in healthy volunteers. Our results show that the plasma levels of fMet increased within 24 h of a documented mTBI in both males and females. Receiver operator characteristic (ROC) analysis indicated that the acute change in plasma fMet (<48 h after an injury) has an area under ROC (AUROC) of 0.82 in identifying an mTBI. Interestingly, when fMet was measured in plasma samples collected from these patients 3 months later, it remained elevated and had an AUROC of 0.88. The systemic administration of fMet to mTBI mice impaired brain mitochondrial function, suggesting that it may affect ongoing mTBI pathophysiology.

创伤性脑损伤（TBI）是全球范围内一个重大的健康问题。在美国，每年约有280万人发生创伤性脑损伤，其中绝大多数可归为轻型创伤性脑损伤（mTBI）或脑震荡。尽管轻型创伤性脑损伤通常不会造成明显的脑组织结构损伤，但会引发脑细胞内一系列细胞与分子水平的改变，进而导致神经功能、认知功能及行为异常。机体在轻型创伤性脑损伤后会释放多种代谢产物，这些代谢物既可作为诊断标志物，也可能参与后续持续的病理生理改变。N-甲酰甲硫氨酸（fMet）是线粒体、细菌及叶绿体中蛋白质合成起始使用的第一个氨基酸。甲酰化多肽及游离fMet均已在人体血浆中被检测到。多项研究表明，甲酰化多肽可激活固有免疫应答，但关于游离fMet在健康与疾病中的作用目前仍知之甚少。本研究检测并定量了轻型创伤性脑损伤患者血浆中的游离fMet浓度，并与健康志愿者的血浆浓度进行对比。结果显示，男性与女性患者在确诊轻型创伤性脑损伤后24小时内，血浆fMet水平均出现升高。受试者工作特征曲线（ROC）分析表明，损伤后48小时内血浆fMet的急性变化用于诊断轻型创伤性脑损伤的曲线下面积（AUROC）为0.82。值得注意的是，在对这些患者伤后3个月采集的血浆样本检测中，fMet水平仍持续升高，其曲线下面积达0.88。对轻型创伤性脑损伤小鼠腹腔注射fMet可损伤脑线粒体功能，提示该物质可能影响轻型创伤性脑损伤的持续病理生理进程。

REF: Dash PK, Moore AN, Underwood E, et al. N-Formylmethionine Is a Biologically Active Diagnostic Marker of Mild Traumatic Brain Injury. J Neurotrauma. 2026;43(5-6):452-460. doi:10.1177/08977151251394021 PMID: 41213604

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Relationship Between Exercise Tolerance and Event-Related Potentials on Recovery in Adults with Postconcussion Syndrome

成人脑震荡后综合征患者运动耐量与事件相关电位在康复中的相关性

From the diagnosis and management through to determining recovery, the clinical pathway for concussions and postconcussion syndrome (PCS) is reliant on symptom reporting. Under-reporting or over-reporting bias necessitates the need for more objective measures. Exercise intolerance has shown to be a strong predictor of adolescent concussion patients likely to have protracted recoveries. Its role in predicting outcomes for adults is less clear. In addition to physiological measures, event-related potentials (ERPs) have demonstrated altered cognitive processing across the concussion recovery stages in various demographics. The aim of the present study was to assess the relationship between baseline exercise tolerance and ERPs on the degree of improvement in symptoms postrehabilitation in adults with persistent postconcussion symptoms (PPCS). The baseline measures did not predict outcomes for patients receiving the customized rehabilitation program, suggesting that a comprehensive program may overcome initial physiological and cognitive vulnerabilities, leading to more robust recovery regardless of baseline presentation.

从诊断、管理直至康复评估，脑震荡及脑震荡后综合征（PCS）的临床诊疗路径均依赖于症状自述。由于存在漏报或夸大报告的偏倚，亟需更客观的评估指标。研究表明，运动不耐受是青少年脑震荡患者出现迁延性康复的有力预测因子，但其对成人患者预后的预测作用尚不明确。除生理学指标外，事件相关电位（ERP）也显示，在不同人群的脑震荡康复各阶段，认知加工过程均存在异常改变。本研究旨在探讨持续性脑震荡症状（PPCS）成人患者基线运动耐量与事件相关电位，同康复后症状改善程度之间的关系。结果显示，基线指标无法预测接受个体化康复方案患者的预后，提示综合康复方案可改善患者初期的生理与认知薄弱环节，无论基线状态如何，均能实现更充分的康复。

REF: Moser N, Popovic MR, Kalsi-Ryan S. Relationship Between Exercise Tolerance and Event-Related Potentials on Recovery in Adults with Postconcussion Syndrome. J Neurotrauma. 2026;43(5-6):442-451. doi:10.1177/08977151251387163 PMID: 41167616

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Visualizations of Autoregulatory Insults in Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research-Traumatic Brain Injury Cohort Study

创伤性脑损伤中自身调节损伤的可视化分析：一项欧洲神经创伤疗效协作研究–创伤性脑损伤队列研究

Cerebral blood flow disturbances, including ischemia and hyperemia, due to impaired cerebral autoregulation (CA), are common and unfavorable in traumatic brain injury (TBI). The pressure reactivity index (PRx) reflects CA status and is associated with patient outcomes. Yet, the impact of the combined intensity and duration of CA insults and the temporal evolution of CA impairment in relation to outcome remains unclear. Moreover, how PRx modulates safe and dangerous thresholds for intracranial pressure (ICP), cerebral perfusion pressure (CPP), and CPP deviation from optimal CPP (ΔCPPopt) is not well defined. This study aimed to clarify these relationships using granular outcome heatmaps. PRx may be used to fine-tune safe ICP, CPP, and ΔCPPopt targets, particularly in defining the lower limit of CA. Future studies should focus on evaluating the PRx/CPP curve location and steepness rather than mainly focusing on mmHg-deviation from CPPopt or any specific target.

因脑血管自身调节（CA）功能受损所致的脑血流紊乱（包括缺血与充血）在创伤性脑损伤（TBI）中十分常见，且预后不良。压力反应性指数（PRx）可反映脑血管自身调节状态，并与患者预后相关。然而，脑血管自身调节损伤的强度与持续时间的共同作用，以及调节功能受损随时间的演变过程对预后的影响仍不明确。此外，PRx如何界定颅内压（ICP）、脑灌注压（CPP）以及脑灌注压偏离最优值（ΔCPPopt）的安全与危险阈值，目前尚未明确。本研究旨在通过精细化预后热图阐明上述关联。PRx可用于优化调整 ICP、CPP及ΔCPPopt的安全目标值，尤其在确定脑血管自身调节下限方面具有价值。未来研究应重点评估PRx/CPP曲线的位置与斜率，而非仅关注与最优脑灌注压（CPPopt）的毫米汞柱偏差或某一特定目标值。

REF: Kevci R, Hånell A, Lewén A, et al. Visualizations of Autoregulatory Insults in Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research-Traumatic Brain Injury Cohort Study. J Neurotrauma. 2026;43(5-6):429-441. doi:10.1177/08977151251384988 PMID: 41054809

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Sharing Clinically Relevant Research Results with Active-Duty Special Operations Forces: Toward an Ethical Framework for Responsible Disclosure

与现役特种作战部队共享临床相关研究成果：构建负责任披露的伦理框架

Structured acquisition and analysis of individual-level health data in the context of biomedical research can yield novel results with potential clinical or personal relevance to participants. While approaches to returning individual-level research results to study participants in civilian contexts have received some attention, unique ethical considerations informing approaches to sharing military research results, and particularly in research studies involving active-duty Special Operations Forces (SOF), are underexplored. As the number of research studies enrolling active-duty military personnel grows, an ethical framework to guide responsible handling and sharing of individual-level research results in these distinctive contexts is crucial to safeguard the rights and welfare of research participants and to elucidate appropriate practices for investigators. After exploring the landscape of ethical, clinical, legal, and logistical considerations, both motivating and complicating routine sharing of individual-level biomedical research results with active-duty SOF personnel, we propose a framework to guide responsible disclosure of results to capture potential benefits while mitigating possible risks.

在生物医学研究中，对个体层面健康数据的系统性采集与分析，能够产生具有创新性的研究结果，这些结果可能对研究参与者具有临床或个人层面的参考价值。尽管在民用场景下，将个体层面研究结果反馈给研究参与者的相关方式已受到一定关注，但针对军事研究成果共享、尤其是涉及现役特种作战部队（SOF）的研究，其背后独特的伦理考量仍未得到充分探讨。随着招募现役军人参与的研究项目不断增多，建立一套伦理框架以指导在这类特殊场景下负责任地处理与共享个体研究结果，对于保障研究参与者的权益与福祉、明确研究者的恰当操作规范至关重要。本文首先梳理了在向现役特种作战部队人员常规共享个体生物医学研究结果时，具有推动作用及复杂化影响的伦理、临床、法律与后勤管理等多方面问题，随后提出了一套指导研究结果负责任披露的框架，以期在获取潜在收益的同时降低可能风险。

REF: Young MJ, Tramazzo JC, McKinney IR, et al. Sharing Clinically Relevant Research Results with Active-Duty Special Operations Forces: Toward an Ethical Framework for Responsible Disclosure. J Neurotrauma. 2026;43(5-6):412-428. doi:10.1177/08977151251398056 PMID: 41918487

由人工翻译修正

Modeling of Intensive Care Risk Factors for Spreading Depolarizations in Severe Traumatic Brain Injury

重型创伤性脑损伤中扩散性去极化的重症监护危险因素建模

Spreading depolarizations (SDs) are a mechanism of secondary injury associated with poor outcomes, occurring in 60% of patients who undergo surgery following severe brain trauma. They are triggered by functional metabolic failure in peri-lesional tissue and are associated with several variables that are routinely managed in neurocritical care, such as low blood pressure, tissue hypoxia, and fever. To understand SD risk factors and develop prediction models, here we performed a retrospective analysis of an observational study of 138 patients who underwent electrocorticographic (ECoG) monitoring of SDs. The results confirm the importance of key systemic variables as SD risk factors and support the notion that SD occurrence can be influenced by modifiable factors that adversely impact the balance of energy supply–demand in vulnerable tissue. The final prediction model, while requiring further validation and with undetermined generalizability, suggests a potential tool for use in neurocritical care to identify cerebral and systemic states that are associated with SDs and secondary injury. The model thus represents an important step toward more widespread application of results and insights obtained from invasive ECoG monitoring.

扩散性去极化（SD）是一种与不良预后相关的继发性脑损伤机制，在重型颅脑损伤接受手术治疗的患者中发生率达60%。扩散性去极化由损伤灶周围组织的代谢功能衰竭诱发，并与神经重症监护中常规管理的多项指标相关，如低血压、组织缺氧及发热等。为明确扩散性去极化的危险因素并构建预测模型，本研究对138例行皮层脑电图（ECoG）监测扩散性去极化的观察性队列患者进行了回顾性分析。研究结果证实了关键全身指标作为扩散性去极化危险因素的重要性，并支持以下观点：可调控因素会破坏受损脑组织的能量供需平衡，进而影响扩散性去极化的发生。最终构建的预测模型虽有待进一步验证且外推性尚未明确，但可为神经重症监护提供一种潜在工具，用于识别与扩散性去极化及继发性脑损伤相关的脑部及全身状态。因此，该模型是推动有创皮层脑电图监测成果与研究结论更广泛应用的重要一步。

REF: Hartings JA, Cong X, Foreman B, Jandarov R. Modeling of Intensive Care Risk Factors for Spreading Depolarizations in Severe Traumatic Brain Injury. J Neurotrauma. 2026;43(5-6):400-411. doi:10.1177/08977151251388453 PMID: 41163388

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Linking Limbic-Prefrontal White Matter Microstructure to Behavioral Problems Following Pediatric Traumatic Brain Injury

儿童创伤性脑损伤后边缘系统-前额叶白质微结构与行为问题的关联研究

Diffusion tensor imaging studies in children suggest a link between abnormal white matter in limbic-prefrontal circuitry and behavioral problems. However, in children with traumatic injury, links between atypical limbic-prefrontal circuitry and new behavioral problems remain largely unexamined. In a prospective longitudinal study of children ages 8–15 years, we examined white matter microstructure 7 weeks following a traumatic brain injury (TBI) or extracranial injury (EI) relative to typically developing children (TDC). Together, these findings suggest disrupted microstructural organization of the limbic-prefrontal circuitry as a neurobiological predictor of behavioral problems following TBI.

针对儿童的弥散张量成像研究表明，边缘系统-前额叶环路的白质异常与行为问题存在关联。然而，在遭受创伤性脑损伤的儿童中，非典型边缘系统-前额叶环路与新发行为问题之间的联系在很大程度上仍未被研究。本研究对8–15岁儿童开展了一项前瞻性纵向研究，分别检测了创伤性脑损伤（TBI）组、颅外损伤（EI）组患儿在受伤后7周的白质微结构，并与正常发育儿童（TDC）进行对比。综上，这些研究结果提示，边缘系统-前额叶环路的微结构完整性受损，可作为创伤性脑损伤后儿童出现行为问题的神经生物学预测指标。

REF: DeMaster D, Watson CG, Prasad MR, Cox CS Jr, Fischer JT, Ewing-Cobbs L. Linking Limbic-Prefrontal White Matter Microstructure to Behavioral Problems Following Pediatric Traumatic Brain Injury. J Neurotrauma. 2026;43(5-6):387-399. doi:10.1177/08977151251388405 PMID: 41192919

由人工翻译修正