CoChat
Sign Up
Cited by 1,141Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchAutomotive and Human Injury Biomechanics

Classification of traumatic brain injury for targeted therapies

Open access
Saatman, Kathryn E., Duhaime, Ann-Christine, Bullock, Ross, Maas, Andrew I.R., Valadka, Alex, Manley, Geoffrey T.·2008·Journal of Neurotrauma
DOI 10.1089/neu.2008.0586PMC PMC2721779
Open this paper in CoChat — free account

Abstract

The heterogeneity of traumatic brain injury (TBI) is considered one of the most significant barriers to finding effective therapeutic interventions. In October, 2007, the National Institute of Neurological Disorders and Stroke, with support from the Brain Injury Association of America, the Defense and Veterans Brain Injury Center, and the National Institute of Disability and Rehabilitation Research, convened a workshop to outline the steps needed to develop a reliable, efficient and valid classification system for TBI that could be used to link specific patterns of brain and neurovascular injury with appropriate therapeutic interventions. Currently, the Glasgow Coma Scale (GCS) is the primary selection criterion for inclusion in most TBI clinical trials. While the GCS is extremely useful in the clinical management and prognosis of TBI, it does not provide specific information about the pathophysiologic mechanisms which are responsible for neurological deficits and targeted by interventions. On the premise that brain injuries with similar pathoanatomic features are likely to share common pathophysiologic mechanisms, participants proposed that a new, multidimensional classification system should be developed for TBI clinical trials. It was agreed that preclinical models were vital in establishing pathophysiologic mechanisms relevant to specific pathoanatomic types of TBI and verifying that a given therapeutic approach improves outcome in these targeted TBI types. In a clinical trial, patients with the targeted pathoanatomic injury type would be selected using an initial diagnostic entry criterion, including their severity of injury. Coexisting brain injury types would be identified and multivariate prognostic modeling used for refinement of inclusion/exclusion criteria and patient stratification. Outcome assessment would utilize endpoints relevant to the targeted injury type. Advantages and disadvantages of currently available diagnostic, monitoring, and assessment tools were discussed. Recommendations were made for enhancing the utility of available or emerging tools in order to facilitate implementation of a pathoanatomic classification approach for clinical trials.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1089/neu.2008.0586

Cites

71 of 71 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The secondary insult characterizes consecutive neuropathological processes initiated at the moment of injury with delayed clinical presentation, and these types of injury are variably sensitive to therapeutic interventions.

    “The secondary insult (ie, secondary damage, nonmechanical damage), characterizes consecutive neuropathological processes initiated at the moment of injury with delayed clinical presentation.For example, intracranial hypertension, hypoxia, hyponatremia, and cerebral ischemia refer to secondary insults, and these types of injury are variably sensitive to therapeutic interventions (94,97,111).”

    From Pituitary Dysfunction After Traumatic Brain Injury: A Clinical and Pathophysiological Approach (2015) · cites this paper as [111]

    The paper’s “Classification by Pathophysiology” section says secondary injury can arise from processes set in motion at injury and develop at variable times afterward; it also names hypoxia and hyponatremia as secondary insults. The “Common Pathoanatomical and Pathophysiological Sequelae” section says some such processes might be remediable therapeutic targets, but it does not establish that these injury types are variably sensitive to interventions or that they necessarily have a delayed clinical presentation. The indexed passages provide no page numbers. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Each animal model reflects a specific type of TBI and does not fully recapitulate primary and secondary damage evident in human TBI, resulting in restricted translation.

    “This strategy presents additional challenges as each animal model reflects a specific type of TBI and does not fully recapitulate primary and secondary damage evident in human TBI (45) resulting in restricted translation (46).”

    From The Inflammatory Continuum of Traumatic Brain Injury and Alzheimer’s Disease (2018) · cites this paper as [45]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

1 retracted

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Saatman, K. E., Duhaime, A.-C., Bullock, R., Maas, A. I. R., Valadka, A., & Manley, G. T.
Affiliations
  • University of Kentucky (US)
  • Dartmouth–Hitchcock Medical Center (US)
  • University of Miami (US)
  • University of Antwerp (BE)
  • The University of Texas Health Science Center at Houston (US)
  • University of California, San Francisco (US)
Corresponding author
Manley, Geoffrey T.
ORCID
Venue
Journal of Neurotrauma
Publisher
SAGE Publications
Published
2008-07
Volume
25
Issue
7
Pages
719-738
ISSN
  • 0897-7151 (ISSN-L)
  • 1557-9042
DOI
10.1089/neu.2008.0586
PMC
PMC2721779
OpenAlex
W2050800676
Cited by
1,141
References
70
Citations by year
2026: 25 · 2025: 62 · 2024: 63 · 2023: 45 · 2022: 57 · 2021: 63 · 2020: 74 · 2019: 69 · 2018: 87 · 2017: 79 · 2016: 64 · 2015: 102 · 2014: 59 · 2013: 62 · 2012: 70
FWCI
32.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neurotrauma (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
Funders
  • National Institute on Disability and Rehabilitation Research
  • National Institute of Neurological Disorders and Stroke (P01NS038660, R01NS042691, R01NS050173, P01NS058484, R01NS045131)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD045364)
Topics
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
Keywords
traumatic brain injury, targeted therapy, pathophysiological mechanisms, Glasgow Coma Scale, clinical trial design, patient selection criteria, patient stratification, prognostic model, preclinical models, outcome measurement, neurovascular injury
MeSH terms
Animals, Brain Injuries, Clinical Trials as Topic, Data Interpretation, Statistical, Diagnosis, Differential, Diagnostic Imaging, Disability Evaluation, Disease Models, Animal, Humans, Trauma Severity Indices, Glasgow Coma Scale, Endpoint Determination

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review