Browsing by Author "Debert, Chantel T"
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- ItemOpen AccessMetabolomics Study of the Diagnosis and Prognosis of Severe Traumatic Brain Injury (sTBI)(2020-11-30) Banoei, Mohammad Mehdi; Winston, Brent W; Habibi, Hamid R; Lewis, Ian A; Couillard, Phillippe; Debert, Chantel T; Fraser, Douglas D;Traumatic brain injury (TBI) is defined as neurologic injury resulting from an external mechanical force, which is associated with long-term neurological and cognitive disability and affects individuals of all ages, ethnicities, and socioeconomic characteristics. TBI severe enough to cause hospitalization occurs in over 10 million people each year worldwide. TBI is the most common cause of death and long-term disability in children and young adults in developed countries. Currently, clinical assessment and neuroimaging (e.g. CT and MRI) are the most reliable techniques used for the diagnosis and prognosis of TBI. Unfortunately, this approach has considerable shortcomings when considering sensitivity and specificity of TBI diagnosis and prognosis. Disease stratification and the prediction of outcomes and are key problems for the management of severe TBI (sTBI).This study showed that metabolomics can be applied for the diagnosis and prognosis of sTBI using nuclear magnetic resonance (NMR) spectroscopy and direct infusion tandem mass spectrometry (DI-MS/MS). The results are promising for the diagnose sTBI when compared to orthopedic injury (OI) controls and for the prognostication sTBI outcomes at 3, 6, and 12-months post-injury particularly in predicting poor outcomes from the good outcome. We also investigated the metabolomics on animal models for sTBI. Using the cortical controlled impact (CCI) mouse model of sTBI demonstrated a difference in metabolic profiles of CCI and CCI mice receiving a plastic CAP to cover the skull in the craniotome area (CCI+CAP) mice when compared to sham controls. Our result revealed that the highest degree of metabolic alterations occurs at 8 hours post-injury and that the CCI+CAP mice have a prolonged brain injury compared to CCI mice (assessed at 7 days post-injury).
- ItemOpen AccessMultimodal fNIRS-EEG Neuroimaging To Monitor Mild Traumatic Brain Injury(2024-04-09) Oni, Ibukunoluwa Kolawole; Dunn, Jeffrey Frank; Goodyear, Bradley Gordon; Debert, Chantel T; Federico, Paolo; Dalton, Colin; Neary, Patrick JMild traumatic brain injury (mTBI) has become a major health issue in North America. Approximately 75% of the 1.5 million TBIs that are seen in emergency departments yearly in the US are categorized as mTBI1,2. mTBI results in a variety of symptoms that are difficult to assess and monitor in a hospital emergency department. A number of neuroimaging studies using different techniques have attempted unsuccessfully to identify a consensus on the best approach to diagnosis and monitoring of mTBI. Current neuroimaging methods, when used independently, have demonstrated changes in brain structure and function resulting from mTBI3,4, though findings are highly variable across studies. The complexity and heterogeneity of injury necessitate a combination of methods to better understand the impact of mTBI on the brain and to improve our ability to diagnose and assess recovery following mTBI. In this project, we developed methods to combine simultaneous recordings of functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) from mTBI patients. First, we investigated the reliability and reproducibility of the data output fro m both modalities in 15 healthy adults during a resting state task. We found moderate reliability and reproducibility in our fNIRS-EEG data. Next, we investigated the changes in the brain functional activity in 15 adults within 3 months of their mTBI. We compared the data from these patients to 30 normal controls. We investigated the effect of channel selection in fNIRS on the ability to identify groups based on either selecting an individual channel or averaging a group of channels, finding that individual channel selection fared better in identifying differences between groups. In the investigation of differences between the mTBI and controls, We found that task modulated the frequency power of the fNIRS but not the EEG data and that region of measurement influenced the differences between groups. In this thesis, methods were developed to allow for accurate data collection from fNIRS and EEG. These methods can be further expanded to the combination of other modalities in a simultaneous recording. Continued investigation into the combination of modalities will likely play a part in the improvement of recovery methods following an mTBI.
- ItemOpen AccessUtility of serum IGF-1 for diagnosis of growth hormone deficiency following traumatic brain injury and sport-related concussion(2018-04-02) Lithgow, Kirstie; Chin, Alex; Debert, Chantel T; Kline, Gregory AAbstract Background Growth hormone deficiency (GHD) is a potential consequence of traumatic brain injury (TBI), including sport-related concussion (SRC). GH stimulation testing is required for definitive diagnosis; however, this is resource intensive and can be associated with adverse symptoms or risks. Measurement of serum IGF-1 is more practical and accessible, and pituitary tumour patients with hypopituitarism and low serum IGF-1 have been shown to have a high probability of GHD. We aimed to evaluate IGF-1 measurement for diagnosing GHD in our local TBI population. Methods We conducted a retrospective chart review of patients evaluated for GHD at the TBI clinic and referred for GH stimulation testing with insulin tolerance test (ITT) or glucagon stimulation test (GST) since December 2013. We obtained demographics, TBI severity, IGF-1, data pertaining to pituitary function, and GH stimulation results. IGF-1 values were used to calculate z-scores per age and gender specific reference ranges. Receiver operator curve analysis was performed to evaluate diagnostic threshold of IGF-1 z-score for determining GHD by GST or ITT. Results Sixty four patient charts were reviewed. 48 patients had mild, six had moderate, eight had severe TBI, and two had non-traumatic brain injuries. 47 patients underwent ITT or GST. 27 were confirmed to have GHD (peak hGH < 5 μg/L). IGF-1 level was within the age and gender specific reference range for all patients with confirmed GHD following GH stimulation testing. Only one patient had a baseline IGF-1 level below the age and gender specific reference range; this patient had a normal response to GH stimulation testing. ROC analysis showed IGF-1 z-score AUC f, confirming lack of diagnostic utility. Conclusion Baseline IGF-1 is not a useful predictor of GHD in our local TBI population, and therefore has no value as a screening tool. TBI patients undergoing pituitary evaluation will require a dynamic test of GH reserve.