Depression and cognitive sequelae after a traumatic brain lesion.

INTRODUCTION: To improve rehabilitation in young people with an acquired brain injury, the Danish Ministry of Health initiated the "National study on young brain injury survivors" in 2012. Using data from this initiative, we examined the changes in depression, cognition, global functional outcome and return to work/school among young traumatic brain injury (TBI) survivors. METHOD: This was an observational one-year follow-up study based on data from "Danish registry for young adults with acquired brain injury". The main measures were Major Depression Inventory, neuropsychological examination, and Glasgow Outcome Scale - extended (GOS-E). RESULTS: A total of 76 young TBI survivors attended two interdisciplinary examinations and had complete data. Sixty-six (86.8%) had rehabilitation between the two visits, and the global functional outcome was vastly higher at the second visit (z = -3.373, p = 0.0007). At the first versus the second visit, the prevalence proportion of depression was 14.5% (95% confidence interval (CI): 7.5-24.4) versus 10.5% (95% CI: 4.7-19.7), and for cognitive sequelae it was 31.6% (95% CI: 21.4-43.3) versus 19.7% (95% CI: 11.5-30.5). Patients with depression and/or cognitive sequelae had a lower GOS-E score (p = 0.0016) than patients without depression/cognitive sequelae and a negative association was found between depression, cognitive sequelae and return to work/school (p = 0.045). CONCLUSION: Emotional and cognitive rehabilitation for young TBI survivors seems essential as depression and cognitive sequelae are associated with a lower global functional outcome and return to work/school. FUNDING: none. TRIAL REGISTRATION: not relevant.

Depression and cognitive sequelae registered within the first year among young Danish TBI survivors.

The aim of the study was to determine the proportion of depression and cognitive sequelae among young (15-30 years) Danish TBI survivors referred to interdisciplinary evaluation through a nationwide government-initiated health initiative. The cross-sectional study is based on data from the "Danish register for young adults with acquired brain injury" on TBI survivors included from October 2013 to December 2016. The main measures were Major depression inventory, Trail making test A and B, Fluency, Word learning with selective reminding, Matrix reasoning, Coding and Glasgow outcome scale - extended (GOS-E). During the study period, 131 young TBI survivors were referred to one of five national outpatient clinics. Ninety-six had complete data and of these 14.6% fulfilled the ICD-10 diagnostic criteria for depression and 34.4% had cognitive sequelae. An association was found between depression and cognitive sequelae (p = 0.004). Patients with both depression and cognitive sequelae (n = 10) had a significantly lower mean score on GOS-E (p = 0.0001). Depression and cognitive sequelae were frequent and associated with a poorer global functional outcome among young TBI survivors referred within a year after trauma. This finding and the notion that only 20% of the expected TBI population was referred to this nationwide health initiative indicate an unacknowledged need for interdisciplinary follow-up.

A case report revealing acute onset psychosis and cognitive impairment as primary manifestation in relapsing-remitting multiple sclerosis.

Acute psychosis and cognitive impairment is a significant problem in RRMS. As it concerns in relatively young age group, our case report underscores the importance of early recognition which could impose diagnostic challenge in multiple sclerosis.

Direct MRI-guided stereotaxic viral mediated gene transfer of alpha-synuclein in the Göttingen minipig CNS.

The aim was to establish a non-primate large animal PD model by lentiviral vector mediated mutant alpha-synuclein overexpression in the substantia nigra. Lentivirus encoding A53T alpha-synuclein (6 x 2.5 µl) was stereotaxically injected into the substantia nigra of six adult female Göttingen minipigs. Contralateral control injections encoding enhanced green fluorescent protein (EGFP) were performed. Gait-analysis was performed pre- and postoperatively. PCR of the transgenes and immunohistochemical staining against alpha-synuclein, EGFP, GFAP and TH was performed after 20 weeks. Gait analysis revealed a significant increase in step length and height, and a decrease in the double stand phase. PCR verified the mesencephalic presence of transgenes. IHC analysis showed alpha-synuclein expression in nigral neurons, around the injection tract and in related nigrostriatal projections. The alpha-synuclein positive neurons appeared swollen and vacuolated, in contrast to the EGFP-injected control side. To transduct all nigrostriatal cells with few microinjections, wider dissemination of the transgene must be achieved.